2006 PAS Annual Meeting

April 29–May 2 
San Francisco, California

Track/Area of Interest

At A Glance Page 
(PDF format)

(as of April 12, 2006) 

General Pediatrics and Preventive Pediatrics

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.

• Welcome
  Alice A. Kuo, University of California Los Angeles, Los Angeles, CA
  Philip R. Nader, University of California San Diego, La Jolla, CA

• Advocacy Skills Panel Discussion
  — 1–2 residents
  — 1–2 community partners
  Anda Kuo, University of California San Francisco, San Francisco, CA

• 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

• 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
2115—Genetics and the Pediatric Medical Educator: What We Need To Know and How Can We Teach It
PAS Mini Course
Room 2006, Moscone West
Chairs: Joseph Gigante, Vanderbilt Children's Hospital, Nashville, TN; and Marilyn C. Dumont-Driscoll, University of Florida College of Medicine, Gainesville, FL

Target Audience: Medical educators, general pediatricians and anyone who would like to learn more about how genetics affects primary care.

There have been rapid advances in knowledge and technology in the field of genetics. General pediatricians have become the first line of information and counseling for patients and families seeking to understand the unique role of genetics in their overall medical care. Yet genetics has played a relatively small part in the medical school curriculum, and the emerging gap in physician knowledge has created an enormous need for education in a previously underemphasized area of medical education. Genetic medicine also raises some of the most subtle medical, psychosocial, cultural and bioethical dilemmas faced by primary care pediatricians and their patients.

This mini course is designed to help participants understand and incorporate genetics in their patient encounters, as well as enhance their comfort in teaching genetics. Using a collaborative faculty presentation, basic genetic concepts, core competencies and new paradigms will be discussed. Strategies for incorporating genetics into primary care practice and teaching genetics will include case presentations; “missed opportunities,” where genetics impacts a patient and pediatrician; and interactive educational games that can be used at the participant’s own site. Resources, such as internet sites that contain current genetic information, will be distributed and discussed.

• Ethical, Legal, Social and Cultural Issues and Genetics
  Joseph Gigante, Vanderbilt Children's Hospital, Nashville, TN

• Using the Family History To Focus Anticipatory Guidelines and Screening at Health Maintenance Visits
  Marilyn C. Dumont-Driscoll, University of Florida College of Medicine, Gainesville, FL

• Genetic Tests for the Pediatrician: What, When, How and Why
  Daniel J. Driscoll, University of Florida College of Medicine, Gainesville, FL

• Hearing Loss: Resources for Genetic Information
  Teri Lee Turner, Baylor College of Medicine, Houston, TX

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.

• Overview
  Stephen R. Daniels, The Children's Hospital/University of Colorado, Denver, CO

• Overview of Treatment Guidelines from the 4th Report
  Bonita E. Falkner, Thomas Jefferson University, Philadelphia, PA

• Management of Pre-hypertension: Lifestyle Changes or Pharmacologic Treatment?
  Shawna D. Nesbitt, University of Texas Southwestern Medical Center, Dallas, TX

• Choice of Agent for Children with Primary Hypertension
  Joseph T. Flynn, Children's Hospital at Montefiore, Bronx, NY

• Treatment of Severe Hypertension in Ambulatory and Inpatient Settings
  Joshua Samuels, University of Texas, Houston, TX

• Treatment of Hypertension in Special Populations
  Donald L. Batisky, Columbus Children's Hospital/The Ohio State University College of Medicine, Columbus, OH

• Discussion

Sponsored jointly by the American Society of Pediatric Nephrology, the International Pediatric Hypertension Association and the Pediatric Academic Societies

8:00am–11:00am
2130—Newborn Hearing Screening: From the Bedside to Beyond
PAS/PIDS Mini Course
Room 3010, Moscone West
Chairs: Mark R. Schleiss and Lisa Ann Schimmenti, University of Minnesota Medical School, Minneapolis, MN

Target Audience: General pediatricians, geneticists and infectious disease specialists.

Sensorineural hearing loss (SNHL) in infants is the most common birth defect, and early detection improves outcome. Evidence from the CDC reveals that less than one half of screened babies are followed up. One possible reason is the low positive predictive value of bedside screening. There is a critical need to augment current strategies to prevent late diagnosis of SNHL. One solution is to propose second-tier testing for the most common causes of SNHL, as the most common causes of newborn hearing loss are infectious and genetic. Of infectious causes, cytomegalovirus (CMV) is the most common. Evidence of CMV infection can be found in 1% of newborns, with 10–15% developing hearing loss or other CNS abnormalities. Of the genetic causes, mutations in GJB2/GJB6 are the most common and are identified in up to one half of individuals with SNHL. The goal of this program will be to examine evidence for inclusion of infectious and genetic screening to augment current newborn screening protocols.

• Diagnostic Evaluation and Management of Childhood Hearing Loss
  Margaret Alene Kenna, Children's Hospital Boston, Boston, MA

• Range of Mutations in GJB2-Associated Hearing Loss
  Lisa Ann Schimmenti, University of Minnesota Medical School, Minneapolis, MN

• Congenital Cytomegalovirus Infection and Hearing Loss
  Karen B. Fowler, University of Alabama at Birmingham, Birmingham, AL

• Newborn Hearing Screening: Audiologic Assessment
  Yvonne Sininger, University of California Los Angeles, Los Angeles, CA

• Overview
  Sheryl A. Ryan, Yale University School of Medicine, New Haven, CT

Sponsored jointly by the Society for Adolescent Medicine and the Pediatric Academic Societies

8:00am–11:00am
2135—Suicide in Children and Adolescents
PAS/SAM Mini Course
Room 2004, Moscone West
Chair: Sheryl A. Ryan, Yale University School of Medicine, New Haven, CT

Target Audience: General pediatricians, behavioral pediatricians and clinicians interested in behavioral/mental health issues in children and adolescents.

This mini course is designed to provide an update on the topic of suicide among children and adolescents, what new is known about the epidemiology and etiology of suicidal behaviors (including ideation, threats, attempts and completed suicides), the connection between depression and suicide, genetics/familial associations, screening techniques and treatment for those at risk for completed suicide. This mini course will also address the increasing phenomenon of self-injurious behaviors, such as cutting, and explore how this is related/not related to suicidal behaviors and depression. Brief mention will be made about complexity of treatment for depression using pharmacologic agents that may increase the risk of suicide.

• Epidemiology and Assessment of Suicidal Behaviors and Depression
  Donald E. Greydanus, Michigan State University College of Human Medicine, Kalamazoo, MI

• Cutting and Other Self-Injurious Behaviors
  Sheryl A. Ryan, Yale University School of Medicine, New Haven, CT

• Questions and Break

• Management and Prevention of Suicide, Depression and Self-Injurious Behaviors
  Joseph L. Calles, Michigan State University, Kalamazoo Center for Medical Studies, Kalamazoo, MI

• Discussion

Sponsored jointly by the Society for Adolescent Medicine and the Pediatric Academic Societies

8:00am–11:00am
2154—Effective Management of Chronic Disease in Schools
PAS Educational Workshop
Golden Gate Hall B1, SF Marriott
Leader: Linda Grant, Boston, MA; Co-leaders: Barbara Frankowski, Rani Gereige

Target Audience: Trainees, fellows, junior faculty, mid-level faculty, senior faculty, and community practitioners.

The goals of this workshop are to provide clinicians with the skills to more effectively manage their patients with chronic disease within the school setting. These skills include: (1) more effective communication between the family, the office and the school, (2) understanding the complexity of HIPAA and FERPA, (3) developing clinical management strategies that support rather than burden school systems and (4) applying these concepts to residency advocacy programs.

The workshop will utilize case histories and will rotate participants through three modules reflecting the skill areas. Each module will be facilitated by physician school consultants who are responsible for policy in their districts and who also have residency training responsibilities.

Objectives:

– Understand the differences between HIPAA and FERPA as regards confidentiality and sharing information between primary care and schools.
– Develop guidelines for appropriate and effective school-linked case management of diabetes, asthma and other chronic illnesses.
– Develop communication strategies connecting home, school and office.
– Understand role of schools in advocacy in training programs.

Format: Workshop will be divided into three modules and participants will rotate through all three. The three modules are: Legal and communication issues (FERPA/HIPAA), Clinical Management and Advocacy in Training Programs. The modules will be chaired by three school physician consultants (and include a pediatric residency director who has incorporated these objectives into the residency).

8:00am–11:00am
2155—Gender-Variant Youth: The Role of the Pediatrician
PAS Educational Workshop
Room Laurel, SF Marriott
Leader: Irene Sills, Albany, NY; Co-leader: Arlene Lev

Target Audience: Trainees, fellows, junior faculty, mid-level faculty, senior faculty, and community practitioners.

This workshop is an overview of sexual and gender identity development in children and youth focusing on understanding the needs of transgender and transsexual youth. By review of case presentations, attendees will gain skills and knowledge in how to assist parents of children with gender variant behavior, children with gender identity confusion, and adolescents who exhibit cross-gender behaviors. Ethical considerations in the care of this population will be presented and discussed. Current standards for hormonal therapy will be reviewed.

Objectives:

– The participant will demonstrate an understanding of the developmental appropriateness of youth with gender variant behavior.
– The participant will prepare to assist children and adolescents with gender variant behavior and their families.
– The participant will demonstrate an understanding of the ethical issues in the medical care of transgendered adolescents.

Format: a) Short didactic presentation; b) discussions of scenarios that might present to the pediatrician; c) viewing of a short videotape; and d) roundtable discussion of ethical issues.

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

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
2158—The National Survey of Children's Health: Resources and Tips for Using New National and State Data on Child and Adolescent Health
PAS Educational Workshop
Room Pacific Suite J, SF Marriott
Leader: Christina Bethell, Portland, OR; Co-leaders: Stephen Blumberg, Debra Read

Target Audience: Trainees, fellows, junior faculty, mid-level faculty, senior faculty, and community practitioners.

The National Survey of Children's Health (NSCH) is the largest, nationally representative survey conducted with families to assess the health, well-being and health care of children and youth (n = 102,000). Publicly released in 2005, NSCH provides a wide range of national and state-level data on the health of children, youth and families. Participants will: 1) identify research topics that can be addressed using the NSCH; 2) Obtain hands-on experience using the Data Resource Center—a new resource to easily obtain and download findings from the NSCH; 3) gt ideas on using findings to stimulate efforts to improve care for children, inform research and grant development and advance evidence-based policy, program development, and advocacy.

Objectives:

– Identify the range of research topics that can be addressed using these data.
– Obtain hands-on experience using the Data Resource Center on Child and Adolescent Health (DRC)—a new resource for pediatric clinicians, researchers, and families to easily obtain and download findings from the NSCH (www.childhealthdata.org).

– Get ideas on presenting findings to enhance state and local efforts to improve the health and health care of children, youth, and families.

Format: Presentations, question and answer, hands-on practice using an online data resource center, case examples, real time technical assistance and problem solving.

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.

8:00am–11:00am
2162—Transition to Adulthood: The Role of Pediatricians
PAS Educational Workshop
Yerba Buena Gardens Salon 15, SF Marriott
Leader: Eric Levey, Baltimore, MD; Co-leaders: Patti Hackett, Suzanne McLaughlin, Robert Blum

Target Audience: Fellows, junior faculty, mid-level faculty, community practitioners.

This workshop will provide an overview of health care transition concepts and tools for primary care providers and specialists. The goal of transition in health care for all youth with/without special health care needs is to maximize lifelong functioning and potential through the provision of high-quality, developmentally appropriate health care services that continue uninterrupted as one moves from childhood to adulthood, and from pediatric to adult-oriented health care. We see an important role for pediatricians in fostering health care decision-making, self-determination and advocacy, as well as promoting health and preventing secondary conditions and disability. Participants will be divided into small, facilitated groups to assess their current transition practices and strategize regarding improvement within their own institutions and communities.

Objectives:

– Discuss and evaluate the role of the Medical Home and Specialists in preparing youth and families for adulthood.
– Review and develop strategies and tools, useful to their individual practice setting, to assist youth and family with transition to adulthood including skill building in the areas of health care decision-making, self-determination and advocacy.
– Explore the importance of collaboration between pediatric and adult-oriented health care providers, both in medical education and clinical practice.
– Strategize about the next steps for putting national policy into practice at the community level.

Format: Presentations by pediatrician for children with disabilities, med/peds physician, and parent advocate followed by question-and-answer session. Facilitated group discussions and role-play followed by reports back to the large group.

8:00am–12:00pm
2180A—LWPES Plenary Session I
LWPES Plenary Session
Room 3007-3009, Moscone West
Chairs: Lynne Levitsky, Massachusetts General Hospital, Boston, MA; Henry Anhalt, Saint Barnabas Medical Center, Livingston, NJ; and Alan D. Rogol, University of Virginia, Charlottesville, VA

Target Audience: Endocrinologists, nephrologists, cardiologists, general pediatricians, immunologists, geneticists and molecular biologists.

• Opening Remarks
  Lynne L. Levitsky, Massachusetts General Hospital, Boston, MA

• Lawson Wilkins Lecture:
  Recent years have witnessed a significant revision of the traditional view of fat cells as simple stores of excess energy. Studies in the speaker's lab as well as many others have clearly demonstrated that adipocytes produce and regulate many metabolic and hormonal signals, which generate profound effects on systemic endocrine equilibrium. In his earlier studies, he also demonstrated that these cells exhibit an inflammatory capacity that is abnormal in obesity and key to the pathogenesis of insulin resistance and diabetes. Recently, he identified a key molecular mechanism underlying the link between inflammatory responses and insulin action. This pathway involves obesity-related activation of the serine, threonine kinase, JNK, and the consequent inhibition of insulin receptor signaling via phosphorylation of a substrate of insulin receptor, IRS-1.

  • Integration of Metabolic and Inflammatory Pathways in Metabolic Disease
    Gokhan S. Hotamisligil, Harvard School of Public Health, Boston, MA

• Robert Blizzard Lecture:
  One of the greatest questions asked of physicians caring for children with autoimmune diabetes is "why did this happen?" This session will unravel some of the mysteries surrounding the etiology and pathogenesis of autoimmune diabetes from an investigator who has dedicated his life to this issue.

  • On the Unravelling of the Etiopathogenesis of Type 1 Diabetes: Are We Stuck or Are We Winning?
    Gian Franco Bottazzo, Ospedale Pediatrico Bambino Gesú, Scientific Institute, Rome, Italy

• Break

• Esoterix Lecture:
  The attendee will familiarize him/herself with newer molecular mechanisms of growth failure that are due to abnormalities in receptor and post-receptor translation of GH signaling.

  • Molecular Mechanisms and Defects in Growth Hormone Receptor Signaling
    Peter Rotwein, Oregon Health and Science University, Portland, OR

9:00am–11:00am
2195—Historical Perspectives
PAS Poster Symposium
Room 2008, Moscone West
Chairs: Thor Willy Hansen and John V. Hartline

10:30am–12:30pm
2325—General Pediatrics I
PAS Platform Session
Room 2009, Moscone West
Chairs: Howard Bauchner and Cynthia Christy

11:45am–2:45pm
2404—Early Identification of Mental Health and Developmental Problems in Foster Care Youth: Tools and Innovative Treatment Strategies
PAS Educational Workshop
Golden Gate Hall B1, SF Marriott
Leader: David Harmon, Jacksonville, FL; Co-leaders: Steven Blatt, Moira Szilagyi

Target Audience: Trainees, fellows, junior faculty, mid-level faculty, senior faculty, and community practitioners.

This interactive workshop will present an overview of the early identification of children in foster care with mental health problems and developmental delays. This will be done through a round table discussion among an expert panel as well as question-and-answer session. Tools will be presented for this purpose and new innovative treatment options will be discussed as well. It will include case presentations with small group discussions. This workshop is geared toward all learner/audience levels and will be an ideal time to network with those who are taking care of children in foster care.

Objectives:

– Tools to identify mental health problems
– Tools to identify developmental delays
– Innovative treatment of developmental and behavioral problems using mentoring
– Innovative treatment of developmental and behavioral problems using foster parents

Format: We will assemble of panel of experts on foster care to have a roundtable discussion, demonstrate tools, and hold a question-and-answer session. It will be presented in a very interactive format ideal for networking these problems.

11:45am–2:45pm
2406—Enhancing Efficiency and Productivity in the Patient Care Environment with the Use of Personal Digital Assistants (PDAs)
PAS Educational Workshop
Golden Gate Hall C2, SF Marriott
Leader: Srinivasan Suresh, Detroit, MI; Co-leaders: Anne Mortensen, Kate Sheppard

Target Audience: Trainees, fellows, junior faculty, mid-level faculty, and senior faculty.

A potentially compelling environment for the use of Personal Digital Assistants (PDA) exists in most hospitals. This workshop will demonstrate effectively using the Pocket PC PDA in facilitating resident education, bedside clinical teaching, and patient care, sign-out and communication in the aftermath of the 80-hour week, and improving the cost effectiveness of wireless networks in the patient care setting.

A hands-on workshop component will demonstrate how these handheld computers are a valuable tool for physicians by allowing them to have immediate access to relevant clinical information such as drug interactions, calculating important parameters, or expanding the differential diagnosis, providing a readily accessible and permanent means of recording and tracking patient procedures, enabling fluid transfer of vital patient information to other health care providers, and managing and accessing patient data.

Objectives:

– Familiarity with common medical applications using Pocket PCs
– Ability to integrate effective usage of PDAs in clinical decision-making
– Understand the importance of creating and/or sustaining a robust wireless network in a patient care facility
– Keep abreast of the technological advances in medical education and patient care in the 21st century

Format: (1) Hands-on, real-time demonstration of applications using Pocket PCs, (2) interactive discussion and (3) problem solving with examples.

11:45am–2:45pm
2416—Publishing Research in Pediatric Education: The Devil Is in the Methods
PAS Educational Workshop
Room Pacific Suite J, SF Marriott
Leader: James Perrin, Boston, MA; Co-leaders: John Co and Benjamin Siegel

Target Audience: Junior, mid-level and senior faculty.

Increasing numbers of pediatric faculty have taken on studies of pediatric education, and new and promising techniques can help pediatric educators in these investigations. Many academic centers have a wealth of researchers who can collaborate with pediatric educators in their efforts. This workshop provides guidance in choosing a research question, determining how to study it using both qualitative and quantitative methods, and writing up the study for publication. Based on the experience of Ambulatory Pediatrics, the leaders will share reasons for success and failure in publishing research in pediatric education. Participants will work on their own research questions as well as studies that the journal has evaluated.

Objectives:

– To describe ways of defining interesting questions in research in pediatric education
– To clarify strategies for the presentation of research methods and findings for journal publication
– To compare and contrast qualitative and quantitative research in pediatric education

Format: Case examples of research papers sent to Ambulatory Pediatrics for review; characterization of reasons for rejecting papers; brief, didactic presentations on qualitative and quantitative methods and on guides to publication and research problems for participants to work on in small groups.

Designed to meet elements of the core curriculum for pediatric fellowship subspecialty training.

11:45am–2:45pm
2420—Running an Academic Practice Wearing a Private Practice Hat
PAS Educational Workshop
Golden Gate Hall A3, SF Marriott
Leader: Elaine Schulte, Albany, NY; Co-leaders: Linda Domovich, Maryellen Gusic

Target Audience: Mid-level faculty and senior faculty.

Unfortunately, most academic providers have little or no training in the business of medicine, nor do their institutions offer professional development in this realm.

During this workshop we will put on our private practice hats, and study two models of successful, combined resident and faculty pediatric practices. Through case-based, large group discussion, participants will learn how to: 1) understand productivity standards and financial reports, 2) teach billing and compliance to learners, 3) manage staffing needs; determine the appropriate provider-to-nurse ratio, optimize room utilization, maintain morale, address reporting structure, 4) provide continuity of care in an academic practice, including managing schedules of 30+ providers, and 5) successfully market their practice. Workshop leaders will share information as well as tools participants can use in their home institutions.

Objectives:

– Participants will better understand the business aspect of operating an outpatient general academic pediatric office.
– Participants will develop skills to address many challenges in office practice.

Format: Large and small group discussions, case-based problem solving.

11:45am–2:45pm
2422—Sex Ed: Learning To Teach Sexual Education Across the Pediatric Age Spectrum
PAS Educational Workshop
Golden Gate Hall C3, SF Marriott
Leader: Michelle Barratt, Houston, TX; Co-leaders: Andrea Bortot

Target Audience: Fellows, junior faculty, and mid-level faculty

The workshop goal is to provide resources for training residents and students in a stepwise manner regarding sexuality and sex education for adolescents and all age groups. Anticipatory Guidance regarding sex must provide for the needs of a new mom (anatomic nomenclature, etc.) through parent of an elementary aged child (upcoming bodily changes, etc.) through parent and their adolescent (direct conversation about healthy choices, etc.). Examples of training by standardized patients, viewing video clips, role modeling, and web-based resources will be presented.

Objectives:

– Participants will have two new techniques to use when training students and residents on age appropriate sexual education.
– Participants will have age specific sexual education anticipatory guidance knowledge.
– Participants will increase their personal comfort discussing sexual topics with parents and patients.
– Participants will be familiar with the use of brief motivational interviewing with adolescents.

Format: The workshop will include group discussion, videotape critiquing and small group exercises.

11:45am–2:45pm
2424—Treatment of the Metabolic Syndrome in Children and Adolescents
PAS Educational Workshop
Golden Gate Hall A1, SF Marriott
Leader: J. Darrell Nesmith, Little Rock, AR; Co-leaders: Alba Morales, Mohammad Ilyas, Lisa Lubsch

Target Audience: Endocrinologists, trainees, fellows, junior faculty, mid-level faculty, senior faculty, and community practitioners.

The rise in pediatric obesity and metabolic syndrome is well established. Less understood for the pediatrician is the treatment of the metabolic syndrome. In this workshop, we aim to: 1) briefly discuss the epidemiology of the metabolic syndrome in children and adolescents, 2) discuss non-pharmacologic and pharmacologic treatment of the metabolic syndrome, and 3) review a stepped approach in treating adolescents with the metabolic syndrome.

This workshop will be largely case-based. Come prepared to devise treatment plans in a small group setting. Participants are invited to bring their own cases for discussion.

Participants will:

– Learn the epidemiology of the metabolic syndrome in children and adolescents.
– Become familiar with existing treatment guidelines for components of the metabolic syndrome in children and adolescents.
– Identify gaps in the literature regarding treatment guidelines of the metabolic syndrome in children and adolescents.
– Consider pharmacologic treatment options of metabolic syndrome treatment based on the available evidence.

Format: A short didactic presentation will be given on diabetes, hypertension, and dyslipidemia treatments from a diabetologist, nephrologist, and endocrinologist respectively. Existing published guidelines will be presented while gaps in the literature regarding treatment will be discussed. Following these short didactic presentations, small groups (at tables) will work on cases which will be presented, and a treatment plan will be derived by each group. At the end of these roundtable work group discussions, the group as a whole will discuss the treatment plans. Actual cases will be used when possible (with appropriate de-identifiers) and their treatment plans discussed.

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.

• Welcome
  Alice A. Kuo, University of California Los Angeles, Los Angeles, CA
  Philip R. Nader, University of California San Diego, La Jolla, CA

• Different Forms of Advocacy Training Curricular Experiences
  David M. Keller, University of Massachusetts Medical School, Worcester, MA

• Implementing a Required Child Advocacy Rotation with No Budget
  Sanjeev Kumar Sriram, University of California Los Angeles, Los Angeles, CA

• Evaluating Community/Advocacy Educational Experiences
  Jeffrey M. Kaczorowski, University of Rochester, Strong Memorial Hospital, Rochester, NY

• 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
2515—New Insights into the Pathogenesis and Treatment of Asthma
PAS Mini Course
Room 3012, Moscone West
Chair: Ellen F. Crain, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY

Target Audience: General pediatricians, pulmonary medicine, genetics and allergists.

This mini course will highlight new advances and developments in our understanding of pediatric asthma and its treatment. Leading investigators will present new information on the pharmacogenomics of asthma, the roles of early environmental factors in the development of asthma, advances in drug therapy, understanding of mechanisms underlying the pathophysiology of asthma and insights into the application of these advances to the care of children with asthma.

• Role of Pharmacogenomics in Asthma Management
  Michael Ephraim Wechsler, Harvard Medical School, Brigham and Women's Hospital, Boston, MA

• Early Environmental Factors in the Development of Asthma
  Fernando D. Martinez, Arizona Respiratory Center, The University of Arizona, Tucson, AZ

• Advances in Drug Treatment of Asthma
  Stanley J. Szefler, National Jewish Medical and Research Center, University of Colorado Health Sciences Center, Denver, CO

• Pathophysiology of Childhood Asthma: Search for Mechanisms
  Giuseppe N. Colasurdo, University of Texas-Houston Medical School, Houston, TX

• Epidemiology and Outcomes in Asthma
  Peter J. Gergen, National Institute of Allergy and Infectious Diseases (NIAID), Bethesda, MD

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.

• Overview
  Vincent J. Palusci, Wayne State University School of Medicine, Hospital of Michigan, Detroit, MI

• Interpretation of Medical Findings in Suspected Child Sexual Abuse: Update 2006
  Joyce Adams, University of California San Diego Medical Center, San Diego, CA

• Mimics of Sexual Abuse
  Lori Frasier, University of Utah School of Medicine, Salt Lake City UT

• Sexually Transmitted Diseases in Children: Beyond Cultures, DNA Amplification Technology
  Nancy Denny Kellogg, University of Texas San Antonio, San Antonio, TX

1:00pm–3:00pm
2600—Update on Treatment Options for Acute Otitis Media
PAS/PIDS Hot Topic
Room 2009, Moscone West
Chairs: Tasnee Chonmaitree, University of Texas Medical Branch, Galveston, TX; and Jerome O. Klein, Boston University School of Medicine, Boston, MA

Target Audience: Pediatricians, pediatric infectious disease specialists and anyone treating otitis media in children.

Otitis media is the most common disease seen in pediatric practice and the main reason for antibiotic prescriptions for children. The practice guidelines from the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) provided an option for management of non-severe acute otitis media (AOM) with observation rather than antibiotic treatment. While these guidelines start to affect practice management of AOM, many issues on treatment are still unresolved.

The symposium will address important issues regarding the updated treatment of AOM: 1) analyze the guideline recommendations and antibiotic choices; 2) present results on watchful waiting studies that came out after the guidelines and how to select non-severe AOM cases; 3) answer the questions on whether symptomatic drugs and adjunctive treatment should be used in place of antibiotics; 4) discuss whether withholding antibiotics affects recurrence of the disease.

• AOM Treatment: Making Sense of the AAP/AAFP Guidelines
  Jerome O. Klein, Boston University School of Medicine, Boston, MA

• Watchful Waiting in Non-severe AOM: How To Select Cases, and Does It Work in Young Children?
  David P. McCormick, University of Texas Medical Branch at Galveston, Galveston, TX

• Antihistamine and Corticosteroids: Do They Have Any Role in AOM Treatment?
  Tasnee Chonmaitree, University of Texas Medical Branch, Galveston, TX

• Recurrent AOM—Is It Influenced by Antibiotics?
  Ron Dagan, Soroka University Medical Center, Beer Sheva, Israel

• Discussion

Sponsored jointly by the Pediatric Infectious Diseases Society and the Pediatric Academic Societies

1:30pm–3:30pm
2670A—Controversies in Care in Pediatric Endocrinology—The Great Debates
LWPES Workshop
Room 3001, Moscone West
Chairs: William Clarke, University of Virginia, Charlottesville, VA; and Henry Anhalt, St. Barnabas Medical Center, Livingston, NJ

Target Audience: Endocrinologists, general pediatricians and adolescent medicine specialists.

The attendee will be part of a lively debate on a number of areas of controversy in pediatric state-of-the-art diabetes management.

• Is Primary Prevention of Type 1 Diabetes Possible?

  • Pro—Desmond A. Schatz, University of Florida, Gainesville, FL

  • Con—Dorothy J. Becker, Children's Hospital of Pittsburgh, Pittsburgh, PA

• Should Glucose Sensors Be Routinely Used?

  • Pro—Stuart Alan Weinzimer, Yale School of Medicine, New Haven, CT

  • Con—Darrell M. Wilson, Stanford University Medical Center, Stanford, CA

• Should Metformin Be Used To Treat Pediatric Patients with Insulin Resistance?

  • Pro—Michael S. Freemark, Duke University Medical Center, Durham, NC

  • Con—Philip Scott Zeitler, University of Colorado at Denver and Health Sciences Center, Denver, CO

2:15pm–5:15pm
2700—Educating Pediatric Fellows in a Competency-Based World
PAS/APPD Mini Course
Room 2007, Moscone West
Chairs: Susan Guralnick, Stony Brook University Medical Center, Stony Brook, NY; and Joseph Gilhooly, Oregon Health and Science University, Portland, OR

Target Audience: Attendees involved with fellowship programs.

Competency-based education is now the standard for residency education. Residency programs have integrated the ACGME Core Competencies into their curricula and assess