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Impact of Discharge Components on Readmission Rates for Children Hospitalized with Asthma.

According to the Centers for Disease Control and Prevention 1 in 11 children in the United States has asthma, and as prior CPCE research shows, children who are hospitalized for asthma have a roughly 20 percent chance of returning to the hospital within the next year. Dr. Kenyon and colleagues surveyed leaders at 45 hospitals and assessed their use of 13 asthma-specific discharge components. They found that while children's hospitals use a wide range of asthma-specific discharge components, the only single component strongly associated with lowered readmission is comprehensive education prior to discharge. 

Variation in practice patterns in device closure of atrial septal defects and patent ductus arteriosus: An analysis of data from the IMproving Pediatric and Adult Congenital Treatment (IMPACT) registry.

Practice variation, defined as observed differences in health care service delivery not otherwise explained by patient illness, medical need, or evidence-based recommendations, has become an important measure of quality across many fields of medicine. Reducing variability in practice variation has been shown to improve both resource utilization and patient outcomes. CPCE’s Dr. Michael O’Byrne and Dr. Andrew Glatz used data from the IMPACT registry to study cases for closure of atrial septal defect (ASD) and patent ductus arteriosus (PDA) using hierarchical multivariate models studying (1) the distribution of indications for closure and (2) in patients whose indication for closure was left (LVVO) or right ventricular volume overload (RVVO), the factors influencing probability of closure of a small defect (either in size or in terms of the magnitude of shunt). 

Pediatric Emergency Provider Sexually Transmitted Infection Screening Practices in Adolescents With Oropharyngeal or Anorectal Chief Complaints.

Sexually transmitted infections (STIs) often present with genitourinary symptoms, however, most can also present with non-genital manifestations. With urogenital screening only there is evidence that a large number of STIs are missed. This research aimed to determine the frequency and factors associated with STI testing in adolescents in the pediatric emergency department with oropharyngeal or anorectal complaints. Dr. Dowshen and colleagues found that only 20% of visits for adolescents with oropharyngeal or anorectal symptoms included STI consideration, and testing was performed in only 5% of cases. Interventions to increase awareness of appropriate STI consideration and testing for individuals presenting with possible extragenital complaints may help reduce STIs among adolescents.

Pediatric Oncology Provider Perceptions of a Pediatric Palliative Care Service: The Influence of Emotional Esteem and Emotional Labor.

Pediatric palliative care consults for children with cancer often occur late in the course of disease and close to death, even though earlier involvement of palliative care providers can improve qualify life and decrease suffering. CPCE researchers interviewed pediatric oncology providers to explore their perceptions of their hospital’s pediatric palliative care service (PPCS). The providers held highly favorable opinions about the PPCS and agreed that early consultation is ideal, but described that consulting PPCS is extremely difficult because of what it symbolizes to families and the emotional labor the provider must manage in introducing them. Interventions to encourage the early initiation of palliative care may benefit from a focus on the emotional experiences of providers.

Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia.

Pain is the most common symptom experienced by pediatric patients with cancer. Pain can negatively affect quality of life, result in patient and family distress, and is associated with long-term morbidity. Thus, effective pain management is a vital aspect of oncology patient care. CPCE researchers evaluated differences in opioid utilization by sex, age, race, and insurance in pediatric patients with acute myeloid leukemia (AML). They found moderate variability in both the overall utilization of opioids and preference for specific opioid medications. Additional work is needed to discern whether observed differences in opioid utilization by age and race reflect a difference in treatment or a difference in the experience of pain. 

A High-risk Haplotype for Premature Menopause in Childhood Cancer Survivors Exposed to Gonadotoxic Therapy.

Cancer therapy during childhood can result in long-term late effects and chronic health conditions, creating a need to identify high-risk survivors for specific treatment-related morbidity. premature menopause, or menopause before the age of 40 years, is one serious late-effects condition that affects female survivors. Dr. Goli Mostoufi-Moab and colleagues investigated the contributions of genetic factors to premature menopause risk following childhood cancer treatment. Identifying female survivors with the highest premature menopause risk is a priority, as they may be able to benefit from fertility-preserving interventions. 

Physician Perceptions Regarding Antimicrobial Use in End-of-Life Care.

Antimicrobial use is common among patients in end-of-life settings, and applying antimicrobial stewardship program guidelines to this population can be difficult due to the medical complexity of patients at the end of life. Unnecessary antimicrobial use can increase the risk of patient harm due to adverse events and drug side effects. CPCE researchers surveyed physicians to better understand why they continue or discontinue antimicrobials at the end of life and determine whether physicians prefer to continue antimicrobial use in specific situations. Their findings indicate that clinicians may over-weigh the benefits of antimicrobial therapy in end-of-life situations. Understanding the reasons why physicians prescribe antimicrobials in this patient population is important for guiding the design of antimicrobial stewardship policies and improving patient care. 

Controller adherence following hospital discharge in high risk children: A pilot randomized trial of text message reminders.

U.S. Non-Hispanic Black children with asthma have higher rates of emergency department visits, hospitalization, and repeat hospitalization compared with children of other races or ethnic backgrounds. There are many reasons for these outcome disparities, but poorer adherence to prescribed daily controller medication is one important contributor. Dr. Kenyon and colleagues assessed the feasibility of a mobile health, inhaled corticosteroid adherence reminder intervention to boost treatment adherence.

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CHOP PCEN Pilot and Feasibility Program (LOI due March 1)

The CHOP Pediatric Center of Excellence in Nephrology (CHOP PCEN) was established to break down barriers to implementing clinical trials in childhood kidney disease. The CHOP PCEN will support two research projects funded to a maximum of $50,000 per year for up to two years. The pilot projects must utilize at least one of the CHOP PCEN cores and focus on research that will accelerate the pace of clinical trials in nephrology.

CHOP Frontier Programs (due March 2)

Frontier Programs differentiate CHOP as innovators because of their unique combination of translational research and exceptional clinical care of children with highly complex conditions. These programs are vital to CHOP’s mission, reputation and financial well-being and contribute to our success regionally, nationally and internationally. Selected programs will be eligible to receive up to $1M in the first year and $1.5M per year for 1-2 additional years. If selected, the funding will be effective July 1, 2018.

Hillman Innovations in Care Program (due March 5)

The mission of the Rita & Alex Hillman Foundation is to improve the lives of patients and their families through nursing-driven innovation. The foundation currently is accepting proposals for innovative patient- and family-centered approaches that challenge conventional strategies, improve health outcomes, lower costs, and enhance the patient and family caregiver experience. The foundation is particularly interested in the areas of maternal and child health, care of the older adult, and chronic illness management. Two grants of up to $600,000 will be awarded in 2018.

New Program Development Award (due March 12)

The Institutional Intellectual and Developmental Disabilities Research Center at CHOP/Penn announces funding to support pilot projects relevant to elucidating the causes of and/or developing potential new therapies for intellectual or developmental disabilities. These pilot projects may be basic, translational, or clinical research. Applicants must hold a faculty appointment as an Assistant Professor for less than four years from the date of appointment by July 1, 2018. The center expects to issue three awards of up to $50,000 per year for two years.

Thrasher Research Fund Early Career Grants (due March 13)

The Thrasher Research Fund provides grants for clinical, hypothesis-driven research that offers substantial promise for meaningful advances in the prevention, diagnosis, and treatment of children's diseases, particularly research that offers broad-based applications. The fund is inviting concept papers for its Early Career Awards Grants program. Through the program, the fund awards small grants of up to $25,000 to new researchers to help them gain a foothold in the area of pediatric research. The program will consider a variety of research topics important to children's health but will give priority to applicants who show great potential to impact children's health through medical research.

Damon Runyon-Sohn Pediatric Fellowship Awards (due March 15)

The Damon Runyon Cancer Research Foundation has joined together with the Sohn Conference Foundation, dedicated to curing pediatric cancers, to establish the Damon Runyon-Sohn Pediatric Cancer Fellowship Award. This award provides funding to basic scientists and clinicians who conduct research with the potential to significantly impact the prevention, diagnosis or treatment of one or more pediatric cancers.

Fahs-Beck Fund for Research and Experimentation (due April 1)

Grants of up to $20,000 are available to help support the research of faculty members or post-doctoral researchers affiliated with non-profit human service organizations in the United States and Canada. Areas of interest to the Fund are: studies to develop, refine, evaluate, or disseminate innovative interventions designed to prevent or ameliorate major social, psychological, behavioral or public health problems affecting children, adults, couples, families, or communities, or studies that have the potential for adding significantly to knowledge about such problems.

Gerber Foundation Pediatric Research Projects (concept paper due May 15)

The foundation awards grants for research focused on issues faced by care providers that, when implemented, will improve health, nutrition, and/or developmental outcomes for infants and young children. Projects can address the etiologic mechanisms of disease; new, improved, or less invasive diagnostic procedures; the reduction or elimination of side effects; the alleviation of symptoms; new, improved, or less invasive therapies or treatments; dosage or dosing requirements or mechanisms for drugs, nutrient supplementation, or other therapeutic measures (under or overdosing); and preventative measures. The total requested grant size should be no more than $350,000.

American Legion Child Welfare Foundation Grants (due July 15)

The American Legion Child Welfare Foundation supports organizations that contribute to the physical, mental, emotional, and spiritual welfare of children. The foundation awards grants for the dissemination of information about new and innovative programs designed to benefit youth or information already possessed by well-established organizations. Projects must have the potential to help American children in a large geographic area (more than one state).

OnPAR Program for Unfunded NIH Proposals

Last year, the NIH received approximately $30 billion in federal support. In spite of this amount, about 42,500 grants were not funded. To address these unfunded proposals, the NIH has a new Pilot Program that is designed to match researchers with nonprofit disease Foundations or with investments from private companies. Through a new collaboration between the NIH and the private contractor Leidos, researchers can now upload their unfunded NIH Proposals into an online portal at the Online Partnership to Accelerate Research (OnPAR). Foundations and other potential funders can review the NIH scores, and decide whether they might be interested in funding the Projects. Currently, this Pilot Program allows researchers with priority scores better than the 30th percentile to submit their abstracts. Interested Foundations might ask that a researcher send their full NIH Application along with its scores. The consensus opinion is that there are a lot of worthy grants being submitted to the NIH, but there is only so much funding available. OnPAR is one way of trying to match researchers with private Foundations.