May 24, 2019
In This Issue

Research Spotlight: Dr. Vajravelu Receives Endocrine Society Early Investigator Award

CPCE In the News:
Where Should a Child Die? Hospice Homes Help Families With the Unimaginable

CPCE In the News:
America just had its lowest number of births in 32 years, report finds

Open positions in cancer survivorship research

Upcoming Events

Recent Publications
Dr. Vajravelu Receives Endocrine Society Early Investigator Award

CPCE congratulates Mary Ellen Vajravelu, MD, MSHP for being selected as one of five recipients of the Endocrine Society’s 2019 Early Investigators Awards. These awards provide monetary support to assist in the development of early career investigators and recognition of their accomplishments in areas of general endocrinology.

Dr. Vajravelu joined CPCE in the fall of 2018, after completing pediatric residency and fellowship in endocrinology at CHOP and a Master of Science in Health Policy Research (MSHP) at Penn. She received her medical degree from Case Western Reserve University.

Dr. Vajravelu’s research focuses on pediatric obesity and type 2 diabetes, with particular interests in the use of innovative healthcare delivery strategies such as mobile health. Dr. Vajravelu combines her training in epidemiology, biostatistics, and qualitative research with her advanced training in quality improvement and patient safety to study and improve clinical effectiveness of therapies for children with endocrine-related diseases.
Where Should a Child Die? Hospice Homes Help Families With the Unimaginable

This article from the New York Times takes an in-depth look at hospice and respite care for children in the United States. State regulation and licensing, as well as financing within the context of the U.S. healthcare system, present significant challenges, such that only three hospice homes for children exist nationwide. CPCE Core Faculty member Chris Feudtner, MD, PhD, MPH discusses these challenges and options for children who need end-of-life care.

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America just had its lowest number of births in 32 years, report finds

A recent report from the National Center for Health Statistics at the US Centers for Disease Control and Prevention (CDC) indicates that birth rates in the US continue to decline. The provisional data is based on 2018 birth certificate records, and will be finalized later this year. CPCE Core Faculty member Heather Burris, MD, MPH commented on an apparent increase in early prenatal care among both black and white women. Nevertheless, disparities still exist.

Open positions in cancer survivorship research

CPCE Core Faculty member Lisa Schwartz, PhD is seeking lab staff at various levels (PhD, MS/MA, BS/BA, student, postdoctoral research fellow). Her lab focuses on self-management of adolescents and young adults (AYA) impacted by cancer (those with cancer predisposition, on active treatment, or survivors). Areas of study include: 1) a multi-site study tracking self-management of AYA survivors, 2) mobile health (text, app, biosensor) interventions and assessment, 3) implementation of survivorship care plans, 4) pain and acupuncture, and 5) longitudinal tracking and outcomes of families with youth tested for cancer predisposition. Many studies include digital/mHealth components, mixed methods, validation of measures, and interventions. For more details, click here or contact Dr. Schwartz
Upcoming Events

Preparing Future Faculty
Date: May 29, 2019
Time: 11:30 AM - 1:00 PM
Location: Abramson Research Center, Room 123-ABC
Are you interested in teaching at the collegiate level? Do you want to learn more about the interview process, negotiating the job offer, and getting started? Join the CHOP Office of Academic Training and Outreach Programs for an insightful session with 3 former CHOP/Penn Postdocs with faculty appointments at undergraduate serving institutions where they balance teaching and research. Learn more.

Developing Personalized, Adaptive Interventions using the Sequential Multiple Assignment Randomized Trial (SMART) Design - Clinical Trials RAG Seminar
Date: June 5, 2019
Time: 12:00 PM - 1:00 PM
Location: Roberts Center, Room 2-160
Presented by Kristin A. Linn, PhD, Assistant Professor, Biostatistics, Perelman School of Medicine. For more information or to RSVP, email clinicaltrialsRAG@email.chop.edu .

The 7th annual Symposium on Advances in Genomics, Epidemiology and Statistics 
Date: Friday, June 7, 2019
Location: Arthur H. Rubenstein Auditorium. Smilow Center for Translational Research 
All participants of SAGES 2019 are invited to submit an abstract for poster presentation at the time of registration. Poster awards will be available for trainees in pre-doc as well as post-doc categories. A limited number of submissions will be selected for oral presentation at the Symposium. All trainees who submit an abstract for poster presentations are also eligible to receive travel support including transportation and lodging. For further information, please visit: https://www.med.upenn.edu/sages/. 

Global Health in Our Own Backyard: Controversies, Initiatives, and Innovations for Our Local Underserved Populations
Abstract submission deadline: June 14, 2019
Date: October 4-5, 2019.
Location: Colket Building
Abstract submission is open for the 11th Annual CHOP Global Health Conference "Global Health in Our Own Backyard," This Philadelphia-based Conference will explore the intersections between domestic, local and international global pediatric health to better reach the underserved here in the United States. We will take inspiration from innovative programs in the U.S. and from around the world, and think critically about how to apply both South-North and national lessons to provide better, more equitable care in the United States. Registration will open shortly, so please save the date. For more information, click here.

24th Annual Jonathan Lax Memorial Lecture: Discovery and Development of HIV Broadly Neutralizing Antibodies
Date: June 24, 2019
Time: 5:30 - 7:30 PM
Location: The Wistar Institute, Caplan Auditorium, 3601 Spruce Street
This free scientific lecture on innovations in HIV/AIDS research, treatment, and prevention is held each year in memory of leading AIDS activist Jonathan Lax. This year's honoree is Michel C. Nussenzweig, M.D., Ph.D., Zanvil A. Cohn and Ralph M. Steinman Professor, Investigator, Howard Hughes Medical Institute, and Senior Physician, The Rockefeller University. Learn more.
Recent Publications

Nearly 85% of pediatric cancer patients become long-term survivors, and many manifest an accumulating burden of physical and psychosocial late effects of cancer treatment in the years after their therapy is complete. A major challenge in accomplishing delivery of age-appropriate care across the lifespan is providing an effective transition of care. Best clinical practices and models of survivorship care transition have not been established. A team of researchers including CPCE’s Lisa Schwartz, PhD conducted a survey to characterize current transitional care practices for young adult survivors of childhood cancer (CCS) at U.S. institutions. Interventions to establish effective partnerships with adult providers on appropriate care of CCS may facilitate expanded availability of these services.

The overuse of antimicrobial drugs constitutes a considerable threat to modern healthcare. This is in large part due to the contrast between the slow pace of drug development and rapid rise in antimicrobial resistance. The antimicrobial resistance situation in Sweden is still favorable, but the Public Health Agency estimates the direct and indirect healthcare costs associated with resistant strains to increase exponentially, along with morbidity and mortality. CPCE Director Theo Zaoutis, MD, MSCE contributed to a study evaluating an antimicrobial stewardship intervention that included a combination of education, decision support, email-based feedback, and physician-directed reward as an ASP in a Swedish pediatric emergency department. 

The complexity of transcatheter therapy for congenital heart disease has increased over recent years. To facilitate complex structural interventions, operators often perform pre ‐procedure three ‐dimensional (3D) imaging and use adjunctive procedural imaging such as transesophageal or intracardiac echocardiography. Many of these patients require multiple lifetime cardiac catheterizations and other examinations resulting in significant cumulative radiation exposure. Infants and children, who comprise a large proportion of these cases, are more susceptible to the damaging effects of ionizing radiation. This study conducted by Michael O'Byrne, MD, MSCE and colleagues hypothesized that Cardiac MRI fusion imaging could simplify prespecified, select congenital cardiac interventions with associated reduction in fluoroscopy time, radiation exposure, and contrast dose.

One of the most common solid tumors of childhood is neuroblastoma; an estimated 750 cases occur each year in the United States. More than half of these children have high-risk neuroblastoma, which is very difficult to treat. Survivors of this type of neuroblastoma can tend to experience multiple late effects related to the intense treatment regimens required. Specifically, notable growth failure is common. This study led by Goli Mostoufi-Moab, MD, MSCE examined whether diffusion tensor imaging (DTI) is useful in the clinical evaluation and therapy of these children with growth failure. 

There is a significant body of work concerning how interpersonal teams (IPT) interact with patients’ families, but how the members of each IPT interact with one another has not been as thoroughly considered. These team-team dynamics have an important impact on patient care. Jennifer Walter, MD, PhD, MS and Chris Feudtner, MD, PhD, MPH contributed to this under-conceptualized aspect of patient care in a paper that looks at the connections between IPT-family practices, IPT-IPT practices, and family and IPT outcomes. The purpose of this work is to provide more precise descriptions of these types of practices, to make team training and evaluation more straightforward, and to provide a framework for future study of these relationships. 


About CPCE

We are a pediatric research center dedicated to discovering and sharing knowledge about best practices in pediatric care by facilitating, organizing and centralizing the performance of clinical effectiveness research -- research aimed at understanding the best ways to prevent, diagnose and treat diseases in children. CPCE’s multidisciplinary team conducts research on a diverse range of clinical effectiveness topics.

CPCE E-News is edited by Holly Burnside. Please feel free to contact us with questions or feedback.