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Saturday, April 29
8:00am–11:00am
2105—Advocacy Training Initiative—Part I
PAS Mini Course
Room 2011, Moscone West
Chairs: Alice A. Kuo, University of California Los Angeles, Los
Angeles, CA; and Philip R. Nader, University of California San
Diego, La Jolla, CA
Target Audience: Pediatric
program directors and attendees interested in advocacy.
Development of advocacy training
experiences is evolving, and there is a national need for
opportunities to bring together residents, faculty, program
directors and community partners to facilitate the development
of this nascent field. After last year’s PAS meeting, the
leadership of the APA Advocacy Training SIG and the AAP
Community Pediatrics Training Initiative agreed to collaborate
to provide a more cohesive conference experience for
participants interested in advocacy training. However, before
training experiences can be developed into residency
curricula, the variety of advocacy skills that can be used to
promote child health should be appreciated. In this part of
the first-ever ATI Conference, we will focus on skill-building
in child advocacy. Through a panel discussion, guest lecturers
and resident presentations on child advocacy projects,
participants will gain skills in various aspects of child
advocacy.
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Welcome
Alice A. Kuo, University of California Los Angeles, Los Angeles, CA
Philip R. Nader, University of
California San Diego, La Jolla, CA
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Advocacy Skills Panel Discussion
— 1–2 residents
— 1–2 community partners
Anda Kuo, University of California San Francisco, San Francisco, CA
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State Legislative Advocacy on
Behalf of Children and Pediatricians–How to be Effective
in Difficult Budget Times
Kris Calvin, American Academy of Pediatrics, California District IX
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Resident Presentations (3
Resident Presentations TBD)
Sponsored jointly by
the APA Advocacy Training SIG, the AAP Community Pediatrics
Training Initiative and the Pediatric Academic Societies
8:00am–11:00am
2120—Management of Childhood Hypertension:
Guidelines and Controversies
PAS/ASPN/IPHA Mini Course
Room 2003-2005, Moscone West
Chairs: Steven R. Daniels, University of Colorado, Denver, CO; and
Ronald J. Portman, University of Texas Medical School,
Houston, TX
Target Audience: General
pediatricians, emergency medicine physicians, hospitalists,
intensivists, nephrologists and cardiologists.
The 2004 NHLBI guidelines for the
evaluation and management of childhood hypertension answered
many questions about how to approach hypertensive children,
but left others unanswered. This mini course is designed to
address some of the more controversial aspects of managing
hypertensive children, with the hope of stimulating further
discussion about the optimal approach to these patients.
Practical approaches to clinical management will be
emphasized.
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Overview
Stephen R. Daniels, The Children's Hospital/University of Colorado,
Denver, CO
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Overview of Treatment Guidelines
from the 4th Report
Bonita E. Falkner, Thomas Jefferson University, Philadelphia, PA
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Management of Pre-hypertension:
Lifestyle Changes or Pharmacologic Treatment?
Shawna D. Nesbitt, University of Texas Southwestern Medical Center,
Dallas, TX
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Choice of Agent for Children with
Primary Hypertension
Joseph T. Flynn, Children's Hospital at Montefiore, Bronx, NY
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Treatment of Severe Hypertension
in Ambulatory and Inpatient Settings
Joshua Samuels, University of Texas, Houston, TX
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Treatment of Hypertension in
Special Populations
Donald L. Batisky, Columbus Children's Hospital/The Ohio State
University College of Medicine, Columbus, OH
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Discussion
Sponsored jointly by
the American Society of Pediatric Nephrology, the
International Pediatric Hypertension Association and the
Pediatric Academic Societies
8:00am–11:00am
2157—I Can Do That! Preparing Residents To
Perform Minor Procedures
PAS Educational Workshop
Yerba Buena Gardens Salon 12, SF Marriott
Leader: Steve Selbst, Wilmington, DE; Co-leader: Joel Fein and Jonathan
Bennett
Target Audience: Trainees,
fellows, junior faculty, mid-level faculty, senior faculty,
and community practitioners.
Minor procedures are important in
pediatric residency and office practice. Training and
performing certain procedures varies between residency
programs. With limited exposure, peds residents and
practitioners may avoid procedures or call consultants when
uncomfortable. The goal of this hands-on workshop is to teach
techniques and instructional methods for minor office
procedures. Workshop leaders will demonstrate skills and allow
practice of: 1) Wound repair- use glue, fast absorbing
sutures, staples 2) Remove foreign bodies from ears, nose,
eyes; reimplant avulsed teeth 3) Troubleshoot G- tube and
trach-tube complications 4) Extricate embedded fishhooks,
subungual hematomas, hair tourniquets 5) Master intraosseous
infusion, new needleless systems and IV safety devices 6)
Manage paraphimosis, zipper entrapment, rectal prolapse.
Participants will become adept at several procedures and be
able to teach them to others.
Objectives:
– Participants should improve
their own technical skills during the workshop.
– Participants will become aware of teaching modalities and
be able to conduct similar teaching sessions at their own
institutions.
Format: Lecture, demonstration,
hands-on practicing, and question-and-answer period.
8:00am–11:00am
2159—Pediatric Medical-legal Documentation:
The Pen Is Mightier Than the Word
PAS Educational Workshop
Golden Gate Hall B3, SF Marriott
Leader: Allison Jackson, Washington, DC; Co-leader: Elizabeth Jacobs
Target Audience: Trainees,
fellows, junior faculty, mid-level faculty, and community
practitioners.
This workshop is planned with the
goal of developing physicians in the knowledge of, skills and
attitudes for the medical evaluation, assessment and
documentation of patients who are alleged victims of child
abuse using an interactive case-based approach. Course content
will address the program purpose and learning objectives and
will include: 1) elements of the history and physical that may
raise suspicion for child abuse; 2) the role of physicians in
the evaluation, management, and documentation for alleged
child abuse victims; 3) how the content and quality of the
medical documentation can benefit or impede the civil and
criminal outcomes.
Objectives:
– List elements of the history
that aid in making a diagnosis of child maltreatment.
– Describe physical findings consistent with or suspicious
for child maltreatment.
– Apply forensic terminology for documentation purposes.
– Understand the pediatrician's role as a medical advocate.
Format: This workshop will be
held in a small group setting in a classroom. This program
will begin with a welcome and introduction by the workshop
leaders. Following the introduction three completed
medicolegal documentation forms will be distributed to the
participants. Each case will either be one of physical abuse,
sexual abuse or neglect. The participants will break into
three groups based on the case they have received. Each group
will review the medicolegal form and prepare a mock trial for
which the characters will be an expert witness, a prosecutor,
and a defense attorney. Thirty minutes will then be devoted to
each case to include the role-play and discussion. After the
role-play, each group will be given the full case to review
and complete and medicolegal documentation form which will be
submitted to and analyzed by the facilitators. A summary of
the results will be shared with the participants after the
workshop.
10:30am–12:30pm
2320—Emergency Medicine I
PAS Platform Session
Room 3001, Moscone West
Chairs: Christopher S. Kennedy and Jan D. Luhmann
11:45am–2:45pm
2418—The Richard Sarkin Legacy: Using
Hollywood Movies To Teach Communication Skills and Adult
Learning Theory
PAS Educational Workshop
Golden Gate Hall A2, SF Marriott
Leader: Larrie Greenberg, Washington, DC; Co-leaders: Patience White,
Christopher White
Target Audience: Fellows, junior
faculty, mid-level faculty, and senior faculty.
Richard Sarkin was a pioneer in
using Hollywood movie clips as a way to enhance teaching and
learning. In this workshop we will explore how Rich used
movies to teach and apply adult learning theory and to improve
doctor-patient communication. Participants will view and
analyze snippets from movies and discuss their observations in
small groups. Discussions will focus around the
teaching/learning points the movies illustrate and how/when to
best use these snippets. What will also evolve is how learners
collaboratively and proactively can generate, through previous
experiences and some knowledge, information that teachers in a
traditional teacher-centered model would give them in a
passive learning mode.
Objectives:
– To recognize how movies can
help to teach communication skills and adult learning theory
– To practice using movie clips to recognize how they can be
used in teaching and learning
– To analyze the strengths/weaknesses of movies as a
teaching tool
Format: We will use a very brief
interactive discussion followed by small group assessments of
movie clips as they pertain to doctor-patient communication
and adult learning theory.
11:45am–2:45pm
2436—Pediatric Emergency Medicine Program
Directors
APA Special Interest Group
Pacific Suite C, SF Marriott
Chairs: Mark Hostetler, mhostetler@peds.bsd.uchigago.edu;
and Usha Sankrithi, sankrithi@comcast.net.
Recruiting & Staffing
Pediatric Emergency Departments in 2006
This session will explore the
very timely issues related to recruiting and staffing a
pediatric emergency department (PED) in 2006. Using a
diversified panel of experts this two-part discussion will
explore first the issues related to recruiting PEM faculty and
then the complex interplay of financial, governmental,
teaching and institutional demands that must be considered
when formulating a comprehensive staffing pattern for the PED.
Issues include the 80-hour work week, “graduated” resident
responsibility, mid-level providers, private versus teaching
institutions, financial expectations and the current state of
the job market. Panelists include graduating fellows,
mid-level providers, fellowship program directors, PEM
division chiefs and directors of academic, private and
community programs. Come one, come all, as this will be a very
lively and informative group discussion of all facets related
to recruiting and staffing in the PED in 2006. We will also be
selecting the new chair(s) for the SIG for the upcoming 3-year
term
12:00pm–3:00pm
2500—Advocacy Training Initiative—Part II
PAS Mini Course
Room 2011, Moscone West
Chairs: Alice A. Kuo, University of California Los Angeles, Los
Angeles, CA; and Philip R. Nader, University of California San
Diego, La Jolla, CA
Target Audience: Pediatric
program directors and attendees interested in advocacy.
Building upon the Child Advocacy
Skills in Part I of the ATI Conference, Part II will now focus
on how to incorporate these skills into meaningful residency
curricular experiences. Pediatric residents are increasingly
committed to promoting child health in arenas other than the
pediatric exam room. Programs are being called upon to provide
structured curricular experiences for residents in child
advocacy, and these experiences may build upon existing
curricula in community pediatrics or be completely separate.
New avenues for partnerships between pediatric residency
programs and community agencies can occur as a result of child
advocacy rotations or projects. This part of the conference
will give participants new ideas for child advocacy training
experiences, address the how-tos on a shoestring budget, and
present ideas for evaluating your community/advocacy
curriculum.
Please join us for the Advocacy
Training SIG from 3:15-5:15pm immediately following the
Advocacy Training Initiative.
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Welcome
Alice A. Kuo, University of California Los Angeles, Los Angeles, CA
Philip R. Nader, University of
California San Diego, La Jolla, CA
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Different Forms of Advocacy
Training Curricular Experiences
David M. Keller, University of Massachusetts Medical School, Worcester,
MA
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Implementing a Required Child
Advocacy Rotation with No Budget
Sanjeev Kumar Sriram, University of California Los Angeles, Los
Angeles, CA
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Evaluating Community/Advocacy
Educational Experiences
Jeffrey M. Kaczorowski, University of Rochester, Strong Memorial
Hospital, Rochester, NY
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Resident Poster Session
Sponsored jointly by
the APA Advocacy Training SIG, the AAP Community Pediatrics
Training Initiative and the Pediatric Academic Societies
12:00pm–3:00pm
2520—Pediatric Assessment of Sexual Abuse:
State of the Science 2006
PAS Mini Course
Room 3011, Moscone West
Chair: Vince Palusci, Wayne State University School of Medicine,
Hospital of Michigan, Detroit, MI
This three-hour mini course will
address the medical evaluation of child sexual abuse in the
pediatric setting. The topics that will be addressed are:
– Physical sequelae of sexual
abuse: What’s new and how has the literature of the past 10
years shaped this field.
– Medical conditions that mimic sexual abuse: What a
clinician must know about anogenital medical conditions and
congenital findings.
– Sexually transmitted diseases in children: Beyond
cultures, DNA amplification techniques in children and the
newest recommendations for HIV post assault prophylaxis will
be presented.
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Overview
Vincent J. Palusci, Wayne State University School of Medicine, Hospital
of Michigan, Detroit, MI
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Interpretation of Medical
Findings in Suspected Child Sexual Abuse: Update 2006
Joyce Adams, University of California San Diego Medical Center, San
Diego, CA
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Mimics of Sexual Abuse
Lori Frasier, University of Utah School of Medicine, Salt Lake City UT
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Sexually Transmitted Diseases in
Children: Beyond Cultures, DNA Amplification Technology
Nancy Denny Kellogg, University of Texas San Antonio, San Antonio, TX
3:15pm–5:15pm
2740—Use of Ultrasound in the Pediatric
Acute Care Setting
PAS Topic Symposium
Room 2006, Moscone West
Chairs: Dee Hodge III, St. Louis Children's Hospital and Washington
University School of Medicine, St. Louis, MO; and Mary A.
Hegenbarth, Children's Mercy Hospitals and Clinics, University
of Missouri-Kansas City School or Medicine, Kansas City, MO
Target Audience: Pediatric
emergency medicine physicians, academic generalists and
pediatric radiologists.
Ultrasonography is a noninvasive,
portable form of imaging with many applications in pediatric
and emergency practice. It is an established part of the
curriculum of the training of physicians in emergency medicine
residency programs and integrated in day-to-day practice.
However, the use of ultrasound performed by pediatricians and
pediatric emergency medicine physicians in settings such as
the emergency department is controversial and remains a hot
topic at many centers. The primary issues of controversy
include training, credentialing, billing, costs and
applications. This session will explore these issues through
an introduction by the moderator followed by three
presentations and audience discussion.
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An Introduction to Ultrasound in
the Pediatric Acute Care Setting
Dee Hodge, St. Louis Children's Hospital and Washington University
School of Medicine, St. Louis, MO
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Training
Ann Dietrich, Children's Hospital, Ohio State University, Columbus, OH
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Potential Applications of Bedside
Ultrasonography in the Pediatric Acute Care Setting
Jay K. Pershad, University of Tennessee Health Sciences Center &
LeBonheur Children's Medical Center, Memphis, TN
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Obtaining Privileges in Limited
Bedside Ultrasound
Mary A. Hegenbarth, Children's Mercy Hospitals and Clinics, University
of Missouri-Kansas City School of Medicine, Kansas City,
MO
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Discussion
3:15pm–5:15pm
2745—Asthma: Improving Care and Outcomes
PAS Poster Symposium
Room 3012, Moscone West
Chairs: Craig M. Schramm and Stanley J. Szefler
3:15pm–5:15pm
2774—Telemedicine and Its Applications in
Pediatrics: Improving Quality and Addressing Access Barriers
PAS Educational Workshop
Golden Gate Hall C2, SF Marriott
Leader: James Marcin, Sacramento, CA; Co-leader: Stacey Cole
Target Audience: Trainees,
fellows, junior faculty, mid-level faculty, senior faculty,
and community practitioners.
This workshop will provide an
overview of telemedicine, and demonstrate how telemedicine
assists in the care of pediatric patients in various settings.
Interactive lectures will be given on the critical components
of a successful telemedicine program. Video clips of
consultations and interviews will be shown to provide an
understanding of telemedicine from various perspectives. A
step-by-step process will be laid out to help evaluate the
possibility of using telemedicine for their services.
Panelists: Juan Trujano, Anita
Grady and Kristi MacLeod
Objectives:
– To understand the technology
of telemedicine, including telecommunications.
– To become familiar with the important structural,
managerial and financial considerations of telemedicine.
– To understand the impact of telemedicine on measures of
quality of care and satisfaction.
Format: This workshop will
primarily be conducted in a lecture/panel format. Sessions
will be interactive and include discussion, sample video
clips, and a live demonstration of equipment and telemedicine
consultations.
Sunday, April 30
7:00am–8:00am
3020—Career Training, Promotion,
Satisfaction and Opportunities in Academic Pediatric Emergency
Medicine
PAS Meet the Professor
Yerba Buena Gardens Salon 6, SF Marriott
This session is designed to
provide trainees and junior faculty with insight and advice
concerning the pursuit of an academic career in pediatric
emergency medicine. An overview of the fellowship training and
the academic promotion process will be presented. Training
beyond fellowship, the importance of mentorship and balance of
both academic and personal life will be discussed. In
addition, the current issues and areas of opportunity in the
field will be presented.
8:00am–10:00am
3100—Advances in Pathogenesis, Diagnosis
and Management of Kawasaki Disease
PAS/PIDS Topic Symposium
Room 3001, Moscone West
Chairs: Marian Melish, University of Hawaii, Kapiolani Children's
Hospital, Honolulu, HI; and Stanford T. Shulman, Children's
Memorial Hospital, Northwestern University, Feinberg School of
Medicine, Chicago, IL
Target Audience: Infectious
disease specialists, cardiologists, rheumatologists,
immunologists and primary care pediatricians.
Cloning the IgA antibody response
in acute Kawasaki Disease has led to exciting new insights
into the etiology and pathogenesis of this enigmatic illness.
The diagnosis of incomplete Kawasaki Disease remains a
significant clinical problem, and new guidelines have been
published to help the clinician in making this diagnosis.
Approximately 10–15% of children with acute Kawasaki Disease
do not respond to conventional intravenous gammaglobulin and
aspirin therapy, and new data regarding treatment with
steroids and Remicade are emerging. Knowledge regarding
optimal management of cardiac complications and long-term
outcome continues to evolve as patients diagnosed with
Kawasaki Disease in the 1970s and 1980s age.
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Overview
Marian E. Melish, University of Hawaii, Kapiolani Children's Hospital,
Honolulu, HI
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IgA Response in Acute Kawasaki
Disease Targets Inclusion Bodies in Acute Kawasaki Disease
Bronchial Epithelium
Anne H. Rowley, Northwestern University, Children's Memorial Hospital,
Chicago, IL
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Clinical Dilemma of Diagnosing
Incomplete Kawasaki Disease
Jane C. Burns, University of California, San Diego, CA
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Treatment of Refractory Kawasaki
Disease
Stanford T. Shulman, Children's Memorial Hospital, Northwestern
University, Feinberg School of Medicine, Chicago, IL
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Management of Cardiac
Complications and Long-Term Outcome
Jane W. Newburger, Harvard University, Children’s Hospital of Boston,
Boston, MA
Sponsored jointly by
the Pediatric Infectious Diseases Society and the Pediatric
Academic Societies
8:00am–10:00am
3130—Emergency Medicine II
PAS Platform Session
Room 3014, Moscone West
Chairs: Mirna M. Farah and Richard A. Saladino
8:00am–11:00am
3230—Acute Care Transport: Neonatal and
Pediatric Emergencies
PAS Educational Workshop
Golden Gate Hall A3, SF Marriott
Leader: Hilary Whyte, Toronto, ON, Canada; Co-leader: Diane Wilson
Target Audience: Trainees,
fellows, junior faculty, mid-level faculty, community
practitioners, nurses, respiratory therapists, paramedics and
EMTs, and transport team members.
Pediatric emergencies are often
un-anticipated acute life threatening events. Timely and
appropriate decision-making on the part of the health care
facility staff are often paramount to outcome in these
patients. The focus of the workshop is to provide the
practitioner with an overview of the common causes of these
events and emergent treatment, including skills required for
these patients prior to and during transport to a tertiary or
quaternary care setting using patient simulation and real life
clinical scenarios. Modules will cover neonatal and pediatric
resuscitation and stabilization in a variety of settings and
clinical cases. Skills taught and practiced will include
intubation, vascular access, thoracocentesis and chest tube
insertion. Emphasis will be on patient safety and evidence
based best clinical practices.
Objectives:
– Timely and appropriate
decision making in acute life threatening events
– Overview of causes of neonatal and Pediatric emergencies
– Resuscitation and stabilization of critical patients
– Safe and effective and timely transport strategies for
best outcomes
Format: Patient simulation with
neonatal and pediatric case based scenarios.
Supervised hands on clinical care
of the patient based on good problem solving and critical
thinking in the prehospital, community hospital and transport
milieu.
Hands on skills workshop for
intubation, ventilation/ventilator strategies, vascular access
(PIV, UV, UA, IO) thoracocentesis/chest tube insertions. Also,
round table discussions of common emergencies.
2:00pm–4:00pm
3700—Developing Valid and Relevant Outcome
Measures for Pediatric Emergency Medicine
PAS Topic Symposium
Room 2008, Moscone West
Chairs: Evaline A. Alessandrini, The Children's Hospital of
Philadelphia, Philadelphia, PA; and Marc H. Gorelick,
Children's Hospital of Wisconsin, Milwaukee, WI
Target Audience: Pediatric and
general emergency medicine physicians and/or any health care
professional or researcher interested in outcomes and quality
improvement.
To improve quality, the Institute
of Medicine (IOM) proposes that health care be safe,
effective, patient-centered, timely, efficient and equitable.
Research using important and relevant outcome measures can
distinguish differences in quality of care between health
practitioners, settings and patient populations, including
factors such as race/ethnicity or socioeconomic status.
Defining and accurately measuring outcomes are vital to both
clinical research and practice. Yet valid and relevant outcome
measures that are applicable to all children receiving
emergency care have not been developed or agreed upon.
Features of important clinical outcomes include credibility,
comprehensiveness, sensitivity, accuracy, biologic sensibility
and feasibility. This session will review general (as opposed
to condition-specific) outcome measures for use in pediatric
emergency medicine, focusing on strengths and weaknesses as
well as their relationship to the IOM quality domains.
Speakers will discuss outcome and process measures such as
health-related quality of life; satisfaction, confidence and
trust in health care; mortality; admission rates; emergency
department recidivism; length of stay; and costs. A discussion
and question-and-answer period will end the session.
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Introduction
Evaline A. Alessandrini, The Children's Hospital of Philadelphia,
Philadelphia, PA
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Mortality and Admission Rates
James M. Chamberlain, Children's National Medical Center, Washington,
DC
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Emergency Department Length of
Stay, Costs and Satisfaction
Marc H. Gorelick, Children's Hospital of Wisconsin, Milwaukee, WI
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Emergency Department Recidivism,
Confidence and Trust in Health Care Practitioners
Evaline A. Alessandrini, The Children's Hospital of Philadelphia,
Philadelphia, PA
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Health-Related Quality of Life
Martha (Molly) W. Stevens, Children's Hospital of Wisconsin, Milwaukee,
WI
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Discussion
2:00pm–5:00pm
3764—Helping Children in Disasters:
Community Training
PAS Educational Workshop
Golden Gate Hall C2, SF Marriott
Leader: Karen Olness, Cleveland, OH; Co-leader: Anna Mandalakas and
Marisa Herran
Target Audience: Trainees,
fellows, junior faculty, mid-level faculty, senior faculty,
and community practitioners.
This workshop will address the
special issues of children in disasters and provide guidelines
for child health professionals who wish to help their
communities prepare for disasters. This workshop will use a
problem based training format with appropriate case histories
to allow participants to consider decision making for children
in natural or man made disasters. Components of this training
include the problems and priorities for children in disasters,
how to identify resources in the local community that are
available for disaster-impacted children, how to mobilize
rapid responses on behalf of children, and how to reduce long
term psychological problems for children.
Objectives:
– List the special issues of
children who experience disasters.
– Provide information on preparing a community to help
children in disasters.
Format: Problem based learned
format including discussion of relevant case histories.
2:00pm–5:00pm
3765—High-Fidelity Pediatric Simulation:
Setting a National Human Performance and Patient Safety
Research and Training Agenda
PAS Educational Workshop
Yerba Buena Gardens Salon 2, SF Marriott
Leader: Louis Halamek, Palo Alto, CA; Co-leaders: Mary Patterson,
Joseph Lopreiato
Target Audience: Trainees,
fellows, junior faculty, and mid-level faculty, senior
faculty.
The goal of this workshop is to
bring together those who are interested in using high fidelity
multidisciplinary pediatric simulation to improve the training
of healthcare professionals and in establishing the evidence
base to support the use of this methodology. This will be an
interactive panel-led session coupled with video presentations
and small breakout group discussions that will allow
participants to identify the elements of a national
simulation-based research and training agenda and a strategy
for implementation of such a plan. Participants will learn
what they can do on the local and national levels to validate
and disseminate its use.
Objectives:
– Define high fidelity
simulation.
– Describe the unique challenges of pediatric simulation.
– Understand why a national research and training agenda is
indicated.
– Develop the major elements of this agenda and develop an
action plan.
Format: I plan to use the three
panelists to lead a facilitated, interactive discussion with
the audience in order to accomplish the workshop objectives
(setting a national agenda and creating an action plan).
2:00pm–5:00pm
3774—What We Have Is Failure To
Communicate—Teaching Residents the Art of Effective
Communication
PAS Educational Workshop
Yerba Buena Gardens Salon 13, SF Marriott
Leader: Steven Selbst, Wilmington, DE; Co-leader: Lindsey Lane and
Maria Carmen Diaz
Target Audience: Trainees,
fellows, junior faculty, mid-level faculty, senior faculty,
and community practitioners.
Poor communication leads to
errors/lawsuits. ACGME requires residents demonstrate
competence in communication. This workshop proposes a dynamic
curriculum to teach residents effective communication.
Workshop leaders discuss (1) Listening skills to address
parental concerns, (2) difficult patients, (3) delivering bad
news, (4) informed consent, (5) feedback to residents and
students, (6) essential info at morning rounds, signout, and
(7) professionalism with nursing staff, consultants. Case
scenarios, videotape, role-playing demonstrate successful
communication techniques, underscore pitfalls.
Objectives:
– Understand how to effectively
deliver bad news to families.
– Know how to obtain informed consent from parents.
– Be able to give effective feedback to students and
residents.
– Work well with nurses and staff.
Format: Videotape, discussion,
and question-and-answer period.
4:15pm–5:45pm
3810—RNA Interference, Technological
Development of siRNAs and Potential Treatments for Childhood
Diseases
PAS State of the Art Plenary
Room 3016-3018, Moscone West
Chair: R. Alan B. Ezekowitz, Harvard Medical School, Massachusetts
General Hospital, Boston, MA
Target Audience: Basic scientists
studying a broad range of childhood diseases, translational
scientists of all disciplines studying clinical implications
of basic science research, clinical scientists studying
childhood and other diseases in need of improved therapies and
clinicians interested in cutting-edge science and its medical
implications.
RNA interference is a recently
discovered, naturally occurring intracellular process that
regulates gene expression through the silencing of specific
mRNAs. Methods of harnessing this natural pathway are being
developed that allow the catalytic degradation of targeted
mRNAs using specifically designed complementary small
inhibitory RNAs (siRNA). siRNAs are being chemically modified
to acquire drug-like properties. Numerous recent high-profile
publications have provided proofs of concept that RNA
interference may be useful therapeutically. Much of the design
of these siRNAs can be accomplished bioinformatically, thus
potentially expediting drug discovery and opening new avenues
of therapy for many childhood diseases including uncommon
pediatric and orphan diseases. A discussion of the science
behind RNA interference will be followed by a presentation of
the potential practical issues in applying this technology to
disease. The program then describes two therapeutic programs
currently under way with applications to pediatric diseases. A
question-and-answer time will follow each discussion.
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The Science of RNA Interference
John J. Rossi, Beckman Research Institute of City of Hope, Duarte, CA
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RNA Interference and Its
Potential Applications for Controlling Disease
Judy Lieberman, CBR Institute for Biomedical Research and Harvard
Medical School, Boston, MA
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Silencing the VEGF Pathway with
siRNAs and the Potential Application to Retinopathy of
Prematurity
Pamela Pavco, Sirna Therapeutics, Boulder, CO
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siRNA as Therapy for Respiratory
Syncytial Virus
John P. DeVincenzo, University of Tennessee School of Medicine,
Memphis, TN
4:15pm–6:15pm
3845—Endocrinology: Insulin
Resistance/Obesity
PAS/LWPES Poster Symposium
Room 3003-3005, Moscone West
Chairs: I. David Schwartz and Svetlana Ten
Monday, May 1
8:00am–10:00am
4110—Pediatric Fluids and Hyponatremia: Are
We Giving Too Much Water?
PAS/ASPN/LWPES Topic Symposium
Room 3007-3011, Moscone West
Chairs: John W. Foreman, Duke University Medical Center, Durham, NC;
and D. Michael Foulds, University of Texas Health Science
Center at San Antonio, San Antonio, TX
Target Audience: Nephrologists,
general pediatricians, emergency room doctors, intensivists,
hospitalists, endocrinologists and anyone who administers IV
maintenance fluids.
In the 1950s, Holiday and Segar
devised formulae for calculating intravenous maintenance
fluids for infants and children who were unable to drink.
These formulae have been taught and used now for over 40 years
and have generally stood the test of time. However, several
recent investigators have challenged these formulae and argued
that they put children at risk of hyponatremia. Since Holiday
and Segar devised these formulae, new information has arisen,
such as the concept of non-osmotic stimulation of ADH release
in sick children and our ability to measure ADH levels in
plasma on a routine basis. Arieff and Ayus were the first to
point out that children and women are at particular risk for
developing hyponatremic encephalopathy. Moritz and Ayus have
subsequently argued that hypotonic parenteral fluid should not
be used unless there are ongoing free water losses or
hypernatremia. In addition to this new clinical data,
Verkman’s group has exciting data identifying molecular
mechanisms of cerebral edema, including after water
intoxication. Dr. Arieff will review who is at risk and why.
Dr. Verkman’s group has developed data regarding mechanisms
of cerebral edema in experimental animals. Dr. Moritz will
describe the new concepts of maintenance fluids. Dr. Friedman
will defend the current practice. At the end there will be
time for an exchange between the speakers and the audience on
the right fluid to use in today’s children.
-
Hyponatremic Encephalopathy:
Special Risk Factors for Children and Women
Allen I. Arieff, University of California San Francisco, San Francisco,
CA
-
Aquaporin 4 and Cerebral Edema
Alan S. Verkman, University of California San Francisco, San Francisco,
CA
-
0.9% Sodium Chloride: The New
Approach to Maintenance Fluids in Pediatrics
Michael L. Moritz, Children's Hospital of Pittsburgh, Pittsburgh, PA
-
Maintenance Therapy: Tried and
True
Aaron L. Friedman, Brown Medical School, Hasbro Children's Hospital,
Providence, RI
Sponsored jointly by
the AAP Section on Nephrology, the American Society of
Pediatric Nephrology, the Lawson Wilkins Pediatric Endocrine
Society and the Pediatric Academic Societies
9:00am–12:00pm
4250—Emergency Medicine
APA Special Interest Group
Room Golden Gate Hall A2, SF Marriott
Chairs: Joan Bothner, bothner.joan@tchden.org;
and Michael Kim, mkim@mcw.edu.
There has been a significant
nationwide increase in the volume of pediatric patients
presenting to emergency departments with psychiatric and
behavioral issues due to a variety of reasons, which has
resulted in a significant challenge to both the providers of
pediatric emergency care and the facilities in which they
work. The emergency medicine SIG meeting during 2006 PAS
Annual Meeting will discuss this "psychiatric crisis in
the emergency department." This topic will be presented
in three parts; challenges in clinical evaluation and
interventions, research opportunities and administrative
challenges.
12:00pm–6:45pm
Commercial Exhibits Open and Posters
Available for Viewing
PAS Exhibits
Levels 1 and 2, Moscone West
Posters Available for Viewing:
12:00pm–6:45pm
Author Attendance: 5:15pm–6:45pm
Level 1:
– Critical Care
– Gastroenterology
– Genetics
– Neonatal Epidemiology and Follow Up
– Neonatal Pulmonology
– Neonatology
– Nephrology
– Pulmonology
Level 2:
– Developmental–Behavioral Pediatrics
– Emergency Medicine
– General Pediatrics
– Medical Education
5:15pm–6:45pm
Poster Session III
PAS Poster Session
Levels 1 and 2, Moscone West
Posters Available for Viewing:
12:00pm–6:45pm
Author Attendance: 5:15pm–6:45pm
Level 1:
– Critical Care
– Gastroenterology
– Genetics
– Neonatal Epidemiology and Follow Up
– Neonatal Pulmonology
– Neonatology
– Nephrology
– Pulmonology
Level 2:
– Developmental–Behavioral Pediatrics
– Emergency Medicine
– General Pediatrics
– Medical Education
Tuesday, May 2
8:00am–10:00am
5156—Emergency Medicine III
PAS Platform Session
Room 2004, Moscone West
Chairs: Evaline A. Alessandrini and David C. Brousseau
8:00am–10:00am
5158—Endocrinology: Diabetes—Immune
Mediated
PAS Poster Symposium
Room 3020, Moscone West
Chairs: Bruce A. Boston and Susan B. Nunez
10:00am–2:00pm
Commercial Exhibits Open and Posters
Available for Viewing
PAS Exhibits
Levels 1 and 2, Moscone West
Posters Available for Viewing:
10:00am–2:00pm
Author Attendance: 12:00pm–1:30pm
Level 1:
– Adolescent Medicine
– Emergency Medicine
– Epidemiology
– General Pediatrics
– Infectious Diseases
– Neonatal Epidemiology and Follow Up
Level 2:
– Neonatal Pulmonology
– Neonatology
12:00pm–1:30pm
Poster Session IV
PAS Poster Session
Levels 1 and 2, Moscone West
Posters Available for Viewing:
10:00am–2:00pm
Author Attendance: 12:00pm–1:30pm
Level 1:
– Adolescent Medicine
– Emergency Medicine
– Epidemiology
– General Pediatrics
– Infectious Diseases
– Neonatal Epidemiology and Follow Up
Level 2:
– Neonatal Pulmonology
– Neonatology
Includes:
-
SPR Student Research Award: Metal
Contamination of Blood Bank Blood
Allison Blatz, Case Western Reserve University, Rainbow Babies &
Children's Hospital, Cleveland, OH
-
SPR House Officer Research Award:
Pathogenesis of Measles Virus Infection in Simian
Immunodeficiency Virus-Infected, Measles Virus-Vaccinated
Rhesus Monkeys
Sallie R Permar, Children's Hospital and Boston Medical Center, Boston,
MA
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