November 9, 2018

Pediatric Bone Mineral Accrual Z-Score Calculation Equations and Their Application in Childhood Disease.

Cancer therapy during childhood including chemotherapy and/or radiation can result in long-term late effects and chronic health conditions, such as bone deficits. Annual gains in bone mineral content and bone mineral density in children vary with age, pubertal status, height-velocity, and lean body mass accrual, so evaluating bone health in pediatric cancer survivors requires consideration of these determinants. The objective of this study from Dr. Sogol Mostoufi-Moab and colleagues was to develop sex- and pubertal-status-specific reference equations for calculating bone accrual in children with bone health-threatening conditions.

User Testing an Information Foraging Tool for Ambulatory Surgical Site Infection Surveillance. Surveillance for surgical site infections (SSIs) after ambulatory surgery in children requires a detailed manual chart review to assess criteria defined by the National Health and Safety Network (NHSN). Electronic health records (EHRs) impose an inefficient search process where infection preventionists must manually review every postsurgical encounter. Using text mining and business intelligence software, CPCE faculty members Dr. Jeffrey Gerber, Dr. Susan Coffin, and Dr. Robert Grundmeier developed an information foraging application, the SSI Workbench, to visually present which postsurgical encounters included SSI-related terms and synonyms, antibiotic, and culture orders.

Mothers' Facebook posts about infant health: findings from the Grow2Gether study.

Social media is a common way for mothers to seek advice about their infants. However, little is known about how low-income urban mothers use social media to obtain infant health information and whether this information is consistent with expert pediatric recommendations. Dr. Alexander Fiks’ Grow2Gether study enrolled forty-three low-income mothers in a private Facebook group intervention focused on infant care and moderated by a psychologist. The Facebook group interactions showed that when mothers posed direct questions regarding infant health, their peers generally gave answers that did not contradict American Academy of Pediatrics guidelines. However, mothers' posts simply describing sleep and screen time practices commonly contradicted guidelines.

Association of Weekend Admission and Weekend Discharge with Length of Stay and 30-Day Readmission in Children's Hospitals.

Worse outcomes among adults presenting for/receiving care on weekends (ie, "the weekend effect") have been observed for many diseases. However, little is known about the overall impact of the weekend effect in hospitalized children. Here, Dr. Christopher Bonafide and colleagues in the Pediatric Research in Inpatient Settings (PRIS) Network explore the association between weekend admission and length of stay (LOS) and between weekend discharge and 30-day all-cause readmission.

Occurrence of Treatment-Related Cardiotoxicity and Its Impact on Outcomes Among Children Treated in the AAML0531 Clinical Trial: A Report From the Children's Oncology Group.

Chemotherapy is a widely used cancer treatment that has many severe side effects including cardiotoxicity, or damage to the heart muscle. While it is know that late cardiotoxicity after pediatric acute myeloid leukemia therapy causes substantial morbidity and mortality, the impact of early-onset cardiotoxicity on treatment outcomes is less well understood. CPCE’s Dr. Richard Aplenc, working with the Children’s Oncology Group (COG), evaluated the risk factors for incident early cardiotoxicity and the impacts of cardiotoxicity on event-free survival and overall survival. This research found that early treatment-related cardiotoxicity may be associated with decreased event-free survival and overall survival. Cardioprotective strategies are urgently needed to improve relapse risk and both short- and long-term mortality outcomes.

Comparison of Methods for Identification of Pediatric Severe Sepsis and Septic Shock in the Virtual Pediatric Systems Database.

Pediatric sepsis is a major cause of mortality of children worldwide. It can be challenging to recognize because the signs and symptoms of pediatric sepsis are similar to those of common febrile illnesses of childhood. Pediatric sepsis research at CPCE aims to improve our ability to quickly identify children with sepsis using quality improvement strategies involving clinical data contained within electronic health records. Our Dr. Fran Balamuth contributed to this new research comparing the performance of three methods of identifying children with severe sepsis and septic shock from the Virtual Pediatric Systems database to prospective screening using consensus criteria.

Pragmatic Strategies for Shared Decision-making.

Shared decision-making is a process that brings together clinical expertise and families' values to arrive at a treatment choice. The process is especially useful for situations with more than one reasonable option. However, for pediatricians who want to adhere to shared decision-making best practices, there is limited practical guidance regarding how to communicate with parents and patients. Here, CPCE faculty members Dr. Alexander Fiks and Dr. Jennifer Walter describe pragmatic strategies to support shared decision-making around both high-stakes decisions in the acute setting as well as in the ongoing management of chronic conditions in settings such as primary care.

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Gerber Foundation Pediatric Research Grants (concept paper due November 15)

The Gerber Foundation is accepting concept papers for research projects focused on improving the health, nutrition, and/or development of infants and young children. In particular, the foundation is looking for practical solutions that can be rapidly implemented on a broad scale and within a predictable time frame to clinical application. Major target areas include new diagnostic tools, new treatment regimens, symptom relief, preventative measures, assessment of deficiencies or excesses (vitamins, minerals, drugs, etc.), and risk assessment tools or measures for environmental hazards, trauma, etc. Grant amounts will range up to $350,000.

American Kidney Fund Clinical Scientist in Nephrology Program (due November 30)

The goal of the American Kidney Fund Clinical Scientist in Nephrology (CSN) fellowship program is to improve the quality of care provided to kidney patients and to promote clinical research in nephrology. The CSN program enhances the training of nephrologists who wish to pursue an academic career and whose primary professional commitment is to scholarship in the provision of patient care. The fellowship may be granted yearly, with a maximum duration of two years for each fellowship. The maximum level of funding of $80,000 per year shall be used principally to support the candidate and his or her career development, including salary.

Damon Runyon Cancer Research Foundation Physician-Scientist Training Award (due December 3)

The annual program provides physicians who wish to pursue a career in cancer research with the opportunity for a protected research training experience under the mentorship of a highly qualified mentor after they have completed their clinical training. The award program will provide up to $460,000 over four years in financial support. In addition, the foundation will retire up to $100,000 of any outstanding medical school debt owed by a grant recipient.

ACOG Women's Health Policy Research Award (due December 15)

The American Congress of Obstetricians and Gynecologists is accepting applications for the 2015 Warren H. Pearse Women's Health Policy Research Award. The annual program includes a single grant of $10,000 for research that explores an aspect of healthcare policy that assists, defines, or restricts the ability of a physician to deliver health care to women in either the general population or a specific area. Applicants must be a junior fellow or fellow of the college at the time of application.

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.