Pediatric Academic Societies and American Academy of Pediatrics Joint Meeting May 12-16, 2000 Hynes Convention Center, Boston

Friday, May 12

9:00 am - 12:00 noon - MINI COURSES

¨ADHD: Guidelines for Office Practice
Chair: James Perrin, Mass-General Hospital for Children, Harvard Medical School, Boston

This program will provide perspective from the AAP Committee on Quality Improvement’s Subcommittee on ADHD with respect to the diagnosis and treatment of ADHD. The session will focus on key controversies in the diagnosis of ADHD, including the use of specific criteria for the diagnosis, collaboration with schools in the diagnosis, and the importance of considering other conditions that may co-exist with ADHD. The discussion of treatment will address choices in stimulants and other medications and the role of parent and school-based interventions and will present data regarding the long-term outcomes of ADHD.

Diagnosis of ADHD in Pediatric Practices
James Perrin, Mass-General Hospital for Children, Harvard Medical School, Boston

Issues in the Application of Guidelines
Heidi M. Feldman, University of Pittsburgh School of Medicine, Children’s Hospital of Pittsburgh; Pittsburgh

ADHD: Diagnosis and Treatment Guidelines for Office Practice
Martin T. Stein, University of California San Diego

¨Adolescent Gynecology (Part I of II)
Chair: Donald Greydanus, Michigan State University, College of Human Medicine; MSU/Kalamazoo Center for Medical Studies

Adolescent Contraception
This three-hour session will focus on recent advances in contraception and will cover oral contraception, emergency contraception (estrogen/progestin and progestin-only dosing), injectable and subdermal contraceptives, and barrier methods. New oral contraceptives, use of hormonal contraceptives for medical conditions (PCOS, acne, DUB), and evidence-based assessment of health risks and benefits will be highlighted. Newer data on potential side effects of injectable contraceptives, including effects on bone density, will also be reviewed. The role of condoms and spermicides in the prevention of both pregnancy and STDs will be considered. Questions from the audience are welcome.

Oral Contraceptives - Risks, benefits and Medical Uses
S. Jean Emans, Children’s Hospital, Boston

Injectable Contraceptives and Barrier Methods - Update
John W. Kulig, Floating Hospital for Children at New England Medical Center, Tufts University School of Medicine, Boston

(Part II of this is program is scheduled on Friday, May 12, from 1:00 PM - 4:00 PM)

¨Asthma and Food Allergy: Bench to Bedside (Part I of II)
Chair: D. Michael Foulds, University of Texas Health Science Center at San Antonio

Asthma: Bench to Bedside
This session will review the current knowledge on the pathogenesis of asthma and the implications for treatment. Recent developments in pharmacotherapeutic agents will be reviewed. Community-based intervention programs will be discussed.

Asthma: Molecular Immunology Updates
Patricia Finn, Brigham and Women’s Hospital, Harvard Medical School, Boston

Advances in Pharmacotherapy of Asthma in Children
Joshua Boyce, Brigham and Women’s Hospital, Massachusetts General Hospital, Boston

Asthma Intervention Programs: Do They Work?
Pamela Wood, University of Texas Health Science Center at San Antonio, San Antonio

(Part II of this is program is scheduled on Friday, May 12, from 1:00 PM - 4:00 PM)

Supported by an educational grant from Merck & Co.

¨The Importance of Breastfeeding for Premature Infants: Management Issues During and After Hospital Discharge (Part I of II)
Chair: Richard J. Schanler, Baylor College of Medicine, Houston

This program for physicians providing care to premature infants is designed to provide a review of the issues surrounding long-term feeding of human milk. Topics to be covered include the neurodevelopmental outcomes of term and preterm breast-fed infants, the adequacy of human milk to advance this development, and the requirements for growth and body composition. The need for fortification and the specifics of fortification of human milk for preterm infants will be reviewed. The stress of lactation on mothers of preterm infants and how to assess this stress will be covered along with ways to initiate and promote successful, long-term breastfeeding by mothers of premature infants.

How Well Does Breast Milk Meet the Requirements of Premature Infants?
Ekhard Ziegler, University of Iowa, Iowa City

Breastfeeding and Brain Development
Richard J. Schanler, Baylor College of Medicine, Houston

Stress and Lactation: Implications for the Mother of the Premature Infant
Chantal Lau, Baylor College of Medicine, Houston

(Part II of this is program is scheduled on Friday, May 12, from 1:00 PM - 4:00 PM)

9:00 am - 12:00 noon - WORKSHOP

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

WS02 Doing The Best For My Patient: The Application Of Single-Subject Design To Clinical Practice Or The N Of 1 Experiment
How can we evaluate the effectiveness of our pediatric interventions with our own patients in a systematic and truly experimental way? How do we evaluate the effectiveness of alternative medicine regimens with our patients? N of 1 studies (single-subject experimental designs) are actually small N studies using innovative methods to systematically explore treatment effects. These designs, frequently used in psychology and special education, are now being utilized in medicine and medical education and being published in the New England Journal of Medicine.

This workshop is an introduction to the use of single-subject design to evaluate management of some common pediatric problems, disability treatment effects, and resident education. Upon completion of the workshop, participants will be able to understand the use of single-subject designs, explore threats to validity, and demonstrate the application of three different designs in pediatric practice. The workshop will be an interactive presentation using slides, videotapes, group discussion, and a question and answer format. The content will be illustrated using published case examples including ADHD treatment, medication titration for a variety of disorders, analyzing the effectiveness of new treatments for disabled youngsters, and teaching residents new skills.

R. C. Tervo, University of Minnesota, St. Paul; W. Bryson-Brockmann, Winthrop-University Hospital, Mineola

WS03 The Inpatient Attending Physician Making The Most Of Teaching Opportunities In 2000
Many academic general and subspecialty pediatricians serve regularly as "Rotator Attending Physicians" or "Teaching Attending Physicians." These Attendings are assigned to a specific inpatient ward for a defined period (e.g., one month) during which they may assume supervisory patient care responsibilities for a panel of inpatients, or direct the educational program for that particular unit, or both. The inpatient setting offers unique opportunities for teaching because it provides multiple exposures over a short period of time to the same group of house officers and medical students. This facilitates the faculty member’s ability to determine and then meet educational, needs to evaluate performance and subsequently provide feedback, and to address general pediatric/primary care issues. The goal of this workshop, now in its sixth year, is to provide strategies for faculty members to become more effective clinical teachers during the inpatient attending month. The workshop will be structured as follows: first, participants will analyze, using a worksheet provided, the interrelated clinical, educational and administrative tasks that need to be accomplished during this on-service month. Second, we will identify how adult learning principles affect good teaching in practice during this month. Third, we will demonstrate several examples of effective teaching models that have been used in the inpatient setting. Some of these models make use of interactive techniques that incorporate general pediatrics/primary care issues. We will also discuss other educational fora, such as Work Rounds and Morning Report. Finally, we will review principles of feedback and their application in the inpatient setting. Participants will be asked to share their own insights, experiences and successful teaching strategies.

P.H. Kaleida, J.A. Lucas, and M.D. Bloom. Department of Pediatrics, University of Pittsburgh School of Medicine and Children’s Hospital of Pittsburgh, Pittsburgh and Department of Pediatrics, Albany Medical Center, Albany

9:00 am - 12:00 noon - SPECIAL INTEREST GROUPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

SG02 Complementary and Alternative Pediatrics
Chairs: Scott Faber and Sharon Reisen

This SIG brings together clinicians and researchers interested in the integration of allopathic Medicine with the best of traditional and alternative healing systems. Past meetings have discussed Acupuncture, Ayurvedic Medicine, Hypnosis, Biofeedback, and herbal treatments, combining examples from the clinical experience of the speakers with descriptions of some of the research that has been done in these areas. Much audience participation has occurred at the SIG. In 5/2000 the SIG is planning a program that will include an integrative view of developmental disabilities. Complete information will be available on the website at www.aps-spr.org in 1/2000. Join us for a session that will provide food for your own synthetic/integrative thought.

SG03 Division Directors in General Pediatrics
Chairs: Benard Dreyer and John Walburn

This SIG has focused on a wide variety of issues concerning pediatricians who direct General Pediatric Programs. Members of this SIG may be involved with community-based or hospital-based programs, and come together around issues such as the impact of managed care, measuring the true complexity of visits in outpatient departments, and the development of a survey to assess the manpower and financial dynamics of General Pediatrics (the results of which were recently published in Ambulatory Child Health). We are also updating our Director of Division Directors in General Pediatrics. We are looking forward to an exciting meeting at the Boston meeting in the year 2000 and we would like to invite anyone interested in finding out about the meeting to contact either of the two Co-Chairs, Benard Dreyer, bpd1@is2.nyu.edu, or John Walburn, jwalburn@UNMC.EDU.

SG04 Environmental Health
Chairs: Sophie Balk and Benjamin Gitterman

We will be presenting an educational session/training on Smoking Cessation. This will include a videotape presentation developed by Dr. Jerry Aronson that could be used as a means for both education and advocacy. We will further discuss how this could be used as an educational tool in pediatric residency teaching programs. We hope you will join us.

SG05 Pain in Children
Chair: Neil Schechter

This new SIG will focus on the management of pain in children, a common symptom which has only recently begun to receive attention.  Future programs will address not only new research in this area but also the translation of research into clinical practice by addressing the barriers that impede implementation. The ultimate goal is to create pediatric environments (NICU, PICU, inpatient units, ambulatory services, ED) that consider the treatment of pain and discomfort as important aspects of humane clinical care.

SG08 Serving the Underserved
Chairs: Jeffrey Brown and Ronald Samuels

At the STUS SIG meeting we will work on several initiatives that were started over the last couple of years, including:
•Finalizing the STUS case based curriculum.
•Development of a national meeting to create a curriculum to be used for teaching about STUS and advocacy training in pediatric residency programs.
•Continued collaboration with the AAP CATCH Program.
•Members of the AAP Committee on Community Health Services and the Section on Community Pediatrics will attend the meeting. This is a unique opportunity to collaborate with these colleagues at the first joint meeting of the APA and AAP.
•Continued work with the Advocacy Training SIG re teaching materials.

Come and join us at our annual meeting to continue this work and explore other projects in the future.

9:00 am - 3:00 pm - EDUCATIONAL SEMINAR

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

ES01 Approaches to Teaching in the Ambulatory Setting (Session limited to 35)

This workshop will focus on teaching approaches that have been advocated in the ambulatory setting. Participants will have the opportunity to role play, discuss in groups and choose from a series of teaching models that best fit what they do in their home environment. It is anticipated that they will leave with new or reinforced skills, knowledge and attitudes about ambulatory teaching.

Richard Sarkin, Associate Professor of Clinical Pediatrics, Children’s Hospital of Buffalo, Buffalo and Larrie Greenberg, Professor, Department of Pediatrics, The George Washington University School of Medicine and Health Science, Washington D.C.

10:00 am - 12:00 noon - EDUCATIONAL SEMINARS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

ES06 Clinical Bioethics
This seminar will encourage discussion about the omission, withdrawal, or use of treatment for fetuses and newborn infants, focusing in particular on the context of the transition of the fetus to the newborn in the delivery room. Through a case presentation and discussion format, an analysis of the moral issues of delivery room practices will include consideration of quality of life, the best interest of the infant, the best interests of the family members, and futile treatment.

David K. Stevenson, Harold K. Faber Professor of Pediatrics, Stanford University School of Medicine, Palo Alto; Jane Battaglia, Associate Clinical Professor, Anesthesiology, Pediatrics and Preventive Medicine (Program in Health Care Ethics and Humanities), University of Colorado, Denver; Rosamund Rhodes, Director of Bioethics, Mount Sinai School of Medicine, New York; Amnon Goldworth, Senior Medical Ethicist in Residence, Lucile Salter Packard Children's Hospital, Palo Alto.

ES07 Effective Teaching in Office Settings
With more and more emphasis being placed on students and residents learning in office settings, effective, efficient and innovative teaching strategies are needed. This seminar will provide participants with such strategies while also providing methods to insure adequate recruitment, faculty development and retention of preceptors. "Mock teaching codes," videotapes, and other live demonstrations will be used to highlight the innovations to be introduced. Content areas will include a focus on importance of a good orientation, feedback, evaluation, and creative solutions to time constraints. Participants will also be given the tools needed to conduct a similar workshop in their own office setting.

Lewis First, Professor & Chair, Department of Pediatrics, University of Vermont – College of Medicine, Burlington

12:00 noon - 5:00 pm - SPECIAL INTEREST GROUP

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

SG09 Injury Control
Chair: Alan Woolf

Childhood injuries are the leading cause of mortality and morbidity among children outside the newborn period. The past several decades have witnessed a steady increase in the activity and interest in childhood injury control research in the United States. The Special Interest Group on Injury Control seeks to explore collaboration in the pursuit of educational and research objectives into childhood injuries and their prevention. At annual meetings, members are updated on new regulatory and research initiatives, activities of similar groups in other professional organizations, and new funding opportunities. With over 150 participants, the Injury Control SIG hopes to draw on the talents and resources of its membership in designing new methodologies in research and advising professional groups on safety related issues affecting children. The SIG plans a joint 3-hour educational session on ‘Childhood Injury Control: Progress & Prospects for the Year 2001’ with the Section on Injury and Poison Prevention in May, 2000, at the national meeting in Boston.

1:00 pm - 3:00 pm - EDUCATIONAL SEMINAR

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

ES24 Research and Child Health Advocacy
This seminar session is aimed at helping academicians to become more comfortable in approaching public officials, as well as learning some techniques that enhance the odds of success for these encounters. The Washington, DC "scene" will be reviewed with an update on issues relevant to academic pediatrics. We will also emphasize advocacy efforts at the local and state levels.

Myron Genel, Associate Dean, Yale School of Medicine, New Haven and Karen Hendricks, AAP Washington Office, Washington D.C. and Stephen Berman, Vice President AAP, Professor of Pediatrics, University of Colorado School of Medicine, Attending Physician Children’s Hospital, Denver

1:00 pm - 4:00 pm - APA COMMITTEE

Health Care Delivery Committee
Chair - Danielle Laraque, MD

The Health Care Delivery Committee (HCDC) is one of the five standing APA committees. The goals of this committee are to serve as a resource to APA members by disseminating information about health care delivery issues, recognize excellent models of care and establish collaborative relationships with other generalist organizations. Email dl2@columbia.edu for any items to bring to the HCDC. All members are welcome.

1:00 pm - 4:00 pm - MINI COURSES

¨Adolescent Gynecology (Part II of II)
Chair: Donald Greydanus, Michigan State University, College of Human Medicine; MSU/Kalamazoo Center for Medical Studies

Adolescent Gynecology
This three-hour seminar will focus on common gynecologic problems of the adolescent, including menstrual problems (amenorrhea, polycystic ovary syndrome, dysfunctional uterine bleeding, and dysmenorrhea), breast complaints (asymmetry, masses, pain) and evaluation of chronic pelvic pain. Questions from the audience are welcome.

Breast Complaints in the Adolescent Girl
Marc R. Laufer, Children’s Hospital, Boston

Evaluation of Pelvic Pain in the Adolescent Girl
Marc R. Laufer, Children’s Hospital, Boston

Menstrual Disorders
S. Jean Emans, Children’s Hospital, Boston

(Part I of this is program is scheduled on Friday, May 12, from 9:00 AM - 12:00 Noon)

¨Asthma and Food Allergy: Bench to Bedside (Part II of II)
Chair: D. Michael Foulds, University of Texas Health Science Center, San Antonio

GI Immunology and Food Allergies: An Update
This session will focus on current topics and controversies in food allergy in the pediatric population. Topics will include a review of gastrointestinal immunology and the practical evaluation of suspected food allergy. Relevant cases will be presented and discussed.

An Update on the Immunopathophysiologic Basis of Food Allergy
W. Allen Walker, Harvard Medical School, Children’s Hospital, Boston

Gastrointestinal Food Allergic Disorders
Hugh Sampson, Mount Sinai School of Medicine, New York

(Part I of this is program is scheduled on Friday, May 12, from 9:00 AM - 12:00 Noon)

¨Genetics for the Practicing Pediatrician
Chair: Judith G. Hall, University of British Columbia, Vancouver, Canada

This is a session aimed at helping the practicing primary care pediatrician integrate the new developments in genetics into their practice. During the last few decades, there has been amazing progress made using molecular techniques to the understanding of biology. Many of these findings have direct application to the care of patients and families. The American Academy of Pediatrics Committee on Genetics has developed practice guidelines for common genetics disorders. The course will be practical and presented in understandable language. It will describe new genetic developments that should be part of pediatric practice.

Evaluation of the Dysmorphic Child
Cynthia Curry, Valley Children’s Hospital/UCSF, Fresno

New Developments in Newborn Screening
Harvey Levy, Children’s Hospital, Boston

The Use of Genetic Consultants and Clinical Guidelines for Genetic Disorders
H. Eugene Hoyme, Stanford University School of Medicine, Palo Alto

¨The Importance of Breastfeeding for Premature Infants: Management Issues During and After Hospital Discharge (Part II of II)
Chairs: Frank R. Greer, University of Wisconsin, Madison and Richard J. Schanler, Baylor College of Medicine, Houston

This program for physicians providing care to premature infants is designed to provide a review of the issues surrounding long-term feeding of human milk. Topics to be covered include the neurodevelopmental outcomes of term and preterm breast-fed infants, the adequacy of human milk to advance this development, and the requirements for growth and body composition. The need for fortification and the specifics of fortification of human milk for preterm infants will be reviewed. The stress of lactation on mothers of preterm infants and how to assess this stress will be covered along with ways to initiate and promote successful, long-term breastfeeding by mothers of premature infants.

Does Human Milk Support Growth and Body Composition After Discharge?
Stephanie Atkinson, McMaster University, Hamilton, Ontario, Canada

The Mechanics: How to Get the Premie to the Breast and Techniques to Use at Home
Paula Meier, Rush Children’s Hospital, Chicago

Nutritional Options for the Breastfed Premature Infant After Hospital Discharge
Richard A. Ehrenkranz, Yale University School of Medicine, New Haven

(Part I of this is program is scheduled on Friday, May 12, from 9:00 AM - 12:00 Noon)

1:00 pm - 4:00 pm - WORKSHOPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

WS04 Academic General Pediatrics: An International Perspective
Despite similarities in the clinical and public health problems facing children in most industrialized countries, wide differences are found in the goals and challenges facing academic pediatric generalists from one country to another. Approaches vary with respect to training of residents for primary care vs consultant practice, interaction with diverse health care systems (fee-for-service, capitation, universal insurance, managed care), funding for research and research training, and faculty salary arrangements.

This workshop will compare and contrast the perspectives of academic general pediatrics in the U.S., Canada, the U.K., and Australia. Generalists from each of the four countries will briefly outline the distinctive features of their respective approaches, emphasizing advantages and disadvantages vis à vis other approaches. The moderator will then facilitate debate and discussion among the presenters, as well as with workshop attendees. The objective is not only to foster greater understanding among academic pediatric generalists working in different countries, but also to learn about advantageous features in each setting that may be adoptable or adaptable in others.

M.S. Kramer, Department of Pediatrics, McGill U., Montreal, R.C. Wasserman, Department of Pediatrics, U. of Vermont, Burlington, M. Blair, Department of Child Health, Imperial College, Harrow, and F. Oberklaid, Centre for Community Child Health, U. of Melbourne

WS05 Achieving Cultural Competency In Pediatrics
The United States rapidly is growing more culturally diverse as we approach the 21st century. In several cities, whites are already in the minority. Culture has a profound impact on pediatrics, affecting a wide variety of aspects of clinical care, including outcomes, process measures, quality of care, satisfaction with care, obtaining an accurate history, and adherence. Cultural competency is defined as the ability to recognize and appropriately respond to key cultural characteristics that affect clinical care in the major cultural groups seen in your practice. In this workshop, participants will learn about a model of cultural competency that can be applied to any cultural group that might be encountered by the pediatrician. This model is based on five aspects of culture that affect clinical care: 1) normative cultural values; 2) language issues; 3) folk illnesses; 4) parent beliefs; and 5) provider practices. Latinos and African-Americans will be used to illustrate the most important ways that culture impacts pediatric care, drawing on the rich available literature and the personal experience of the workshop leaders.

Using an evidence-based approach derived from critical studies on the Latino and African-American cultures, workshop participants will learn and master the cultural competency model. Illustrative cases (including videotapes) will be presented to challenge participants and further solidify their skills. Participants can expect to acquire practical skills for recognizing and appropriately responding to crucial aspects of culture and language that affect pediatric care.

G. Flores and K. Fox, Department of Pediatrics and Pediatric Latino Clinic, Boston Medical Center and Boston University Schools of Medicine & Public Health, Boston

WS06 After Arrival: Caring For New Immigrant Children
At least 500,000 new immigrant children (refugees, adoptees, children traveling with or to visit family) arrive in the United States annually. Most pediatric practices in the United States work with these patients, who often have unique medical concerns.

The goal of this workshop is to increase providers’ knowledge about caring for new immigrant children. Using a case-based discussion format in three parts, we will: 1) Discuss medical issues common to immigrant children, such as health screening, immunizations and interpretation of tuberculin skin tests; 2) Provide strategies for working with interpreters, addressing families from diverse cultures and preparing immigrant children for optimal learning in school and 3) Describe legal considerations for these children, including benefits and entitlements available to some new arrivals, and INS regulations governing medical screening for visas and immigration status.

This workshop is intended for primary care providers who work with new immigrant children. This workshop will enable participants to: 1) Recognize medical issues specific to immigrant children; 2) Improve their skills working with interpreters, across cultures and with school systems; and 3) Identify legal considerations for immigrant children. We will distribute written resources useful to clinicians working with new immigrants.

L.M.H. Albers, E.D. Barnett, J. Ciborowski, P.L. Geltman, P.E. Klass, J. Zotter, Children’s Hospital & Boston Medical Center, Boston, MA Department of Public Health.

WS07 A Single, Simple Method For Reviewing Study Results: A Useful Tool For Evidence-Based Medicine
Clinical readers who seek to apply the principles of evidence-based medicine often find the guidelines taught for critiquing individual studies too difficult to learn and use. These guidelines suffer a major shortcoming in that they are often goal-specific or methodology-specific. Diagnostic studies call for a set of guidelines that differ from therapeutic studies. Case-control studies call for a set of guidelines that differ from those for prospective cohorts. The workshop leader teaches a single method for detecting bias and generalizability problems as well as for evaluating the study objective and the comparative strategy. The workshop’s objectives include: 1) learning how to diagram the architecture of a study to identify its major components and 2) learning how to critique the 4 major issues with a study: the basic objective of the study, the strategy of comparison, the potential for biases, and the problems with generalizability. The workshop leader will present didactic materials on diagramming a study and critiquing the 4 major issues with a study. The participants will then break into small groups to apply this approach to examples drawn from several recently published clinical pediatric studies. The participants will then reconvene as a large group to discuss the small-group analysis and conclusions.

R. M. Jacobson, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester

WS08 Community Oriented Primary Care: From Theory To Evidence Based Practice
Community Oriented Primary Care (COPC) is a modification of the traditional model of primary care practice, providing an evidence-based approach to the planning of clinical interventions, evaluations, and research that addresses the health care problems of a defined population. Although COPC is well established in other countries, its use in the United States has been limited due to a lack of skills and knowledge of COPC principles by U.S. practitioners and is particularly unfamiliar to most pediatricians and pediatric settings. We have demonstrated the potential for its use in the community training of academic pediatricians, especially those in urban areas, and as a tool to improve the validation and community acceptance of new approaches to clinical care and research. This workshop will seek to train fellows and faculty to apply the principles of COPC to innovative clinical pediatric practice and research. Through presentations, interactive discussions and participation in skills building exercises, this workshop will: (1) educate participants on the principles of COPC; (2) provide a framework to apply COPC to a variety of patient populations; (3) identify skills needed to implement COPC in their population; and (4) identify national and international resources for information on applying COPC principles. At the conclusion of this workshop, participants should gain sufficient knowledge to understand and begin to apply the principles of COPC to pediatric practice and clinical research in their community.

I. B. Horn, C. Focht, B. Gitterman, F. Mullan, Children’s National Medical Center, Washington, D.C.; George Washington University, Washington, D.C.

WS09 Community Pediatrics: Can It Be Taught? Can It Be Learned? Can It Be Practiced?
This program will discuss the recent AAP policy statement "The Pediatrician’s Role in Community Pediatrics" and the Pediatric Education in Community and Office Settings (PECOS) program, which will create tools to enable the community pediatrician to teach community pediatrics to students and residents. The panel will discuss the principles and activities that comprise community pediatrics and the needs of pediatricians attempting to teach community pediatrics. Panel members will represent community pediatrics in community, public health and private settings. Audience participation will be encouraged.

P. Melinkovich, Denver Community Health Services, Denver, D. Cora-Bramble, The George Washington University Medical Center; Washington, DC; J. Goldhagen, Duvall County Health Unit, Jacksonville; F. Rushton, University of South Carolina, Lowcountry Pediatrics; Beaufort

WS11 Diagnostic Dilemmas In Pulmonology
Copies of cases that emphasize common pulmonary signs and symptoms will be distributed at the beginning of the session. You will contribute to the differential and management plan. A final handout will summarize the answers, teaching points, and readings.

H. Dorkin, New England Medical Center, Department of Pediatrics

WS12 Fighting Big Tobacco: A Massachusetts Success Story
Beginning in the year 2000, the states will receive $206 billion from the Multi-state Master Settlement Agreement with the tobacco industry. Teenage smoking will become a thing of the past, right? Or has Big Tobacco put one over on us?

The leaders who developed the successful Massachusetts Tobacco Control Program and paved the way for the lawsuit against the tobacco makers will talk about the pitfalls in the settlement. How can you ensure that your state uses Settlement funds to combat tobacco use and that pediatricians are part of the process?

Come find out why teen smoking rates are NOT rising in Massachusetts as they are in nearly all other states. Physicians, attorneys, state officials, and legislators will discuss the anti-tobacco movement in Massachusetts and describe successful strategies to take home to other states.

C. Allen, Children’s Health Care, Arlington, B. Cady, Women and Infants Hospital of Rhode Island, Providence; G.Connolly, Massachusetts Department of Public Health, Boston; R. Daynard, Esq., Northeastern University School of Law, Tobacco Control Resource Center, Boston, State Representative R. Kaprielian, Boston, G. Kelder, Esq., Northeastern University School of Law, Tobacco, Law & Policy Project; Boston; S. Harshbarger, President of Common Cause, Washington

WS14 Humanistic Habits In Teaching Ambulatory Pediatrics: Modeling, Observing And Inspiring
The humanistic attributes of the physician caregiver have been addressed in medical student and resident education. Many trainees enter the system with idealism, altruism, and a passion to help others, only to leave with indifference and coldness. With care shifted to the ambulatory setting, there is a unique opportunity for clinician/educators to promote humanistic and professional habits in trainees in the environment in which they are most likely to practice.

In this workshop we plan to examine and define humanistic habits as they contribute to and enhance teaching in the ambulatory setting. Participants will have an opportunity to apply principles of humanism to scenarios such as 1)teaching at the chairside, 2)orienting trainees to a rotation, 3)observing trainees at the chairside, and 4)teaching students how to give bad news. The workshop will be divided into a large group, interactive didactic session and small groups focusing on case simulations with role playing. After each session, the facilitators will provide a template to stress essential issues. Closure will involve participant ideas on how to apply the principles in their workplaces.

S. Miller, Babies and Children’s Hospital, Columbia University, New York, R. Sarkin, SUNY at Buffalo School of Medicine, Buffalo, L. Greenberg, Children’s National Medical Center, George Washington University, Washington, DC

WS15 Orthopaedic Issues For The Pediatrician: Limp, DDH, And Scoliosis
This session will review three important pediatric orthopaedic disorders: limp, developmental dysplasia of the hip and scoliosis. The attendee will learn the most common causes of a limp in various pediatric age groups and also learn how to manage the limping child. Guidelines for referral will also be reviewed. Current issues regarding the etiology and management of developmental dysplasia of the hip will be discussed. Finally, current concepts regarding the diagnosis, management and referral guidelines for the adolescent with scoliosis will be presented.

J. Emans, Children’s Orthopaedic Surgery Foundation, Children’s Hospital, Boston; M. Goldberg, New England Medical Center, Boston

WS17 Substance Abusing Families: Helping The Parent While Protecting The Child
Few situations are as challenging to the pediatrician as dealing with a parent who is thought to be placing his/her child at risk because of substance abuse. The goal of this workshop is to develop clinical skills in brief intervention with parents who are thought to have an alcohol or drug problem. The workshop is intended for pediatricians and pediatric educators. Participants will learn: (1) To express concern in an assertive but non-judgmental fashion, (2) To use the parent-child bond, and mandated reports to child welfare agencies, as motivational tools to move ambivalent parents into substance abuse treatment, (3) The importance of alliance building and continuity of care with high risk families, and (4) How to teach other professionals these essential skills. This workshop will use a standardized case, The Silent Cry, for purposes of discussion and skills development. Two mnemonics which summarize the principles of effective interventions (FRAMER and ATTUNE) will be presented. Workshop participants will be invited to participate in a group role-play of an office intervention, either as an active player (mother, pediatrician) or as an "alter ego" of one of the players. The workshop will conclude with a discussion of how these principles can be applied in one’s own clinical practice and in teaching pediatric residents. Each participant will receive a copy of the complete teaching module, with handouts and references, for use in his or her home institution.

A.Vandeven, C. R. Wilson, J. R. Knight, Department of Pediatrics Harvard Medical School; Division of General Pediatrics, Children’s Hospital, Boston

WS18 Supporting Grieving Children: An Underpracticed Skill
Each year, 80,000 infants and children less than 19 years of age die in the US, on average about 2 child deaths per pediatrician per year. Are you satisfied with the care and support you provided to the last child in your practice who died?

Each year, 3 M people of all ages die in the US. If each death affects only 1 child, 3 M children become bereaved. Do you know the 75 children in your practice who lost a parent, grandparent, sibling, or friend last year? Did you acknowledge their bereavement in person, by phone, or in a note? Did you counsel the family about the child attending the wake or funeral? Did you help answer the question "Why?" Did you explain the different ways people can feel when someone dies? Did you say, "We can talk about this anytime you want to?"

If you answered "yes", join us to share your experience. If you answered "no", join us to discover how personally & professionally satisfying it could have been.

In this workshop, a primary pediatrician will share decades of experience with grieving children. We will review children’s understanding of death and explore techniques for discussing death, helping children and their families cope, and promoting healthy adaptation to loss over a lifetime.

O.J. Sahler, Children’s Hospital at Strong, Rochester, and M. A. Wessel and D. J. Schonfeld, Department of Pediatrics, Yale Medical Center, New Haven

1:00 pm - 4:00 pm - SPECIAL INTEREST GROUP

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

SG13 Pediatric Telephone Care
Chairs: Andrew Hertz and Allison Kempe

Information on this SIG will be posted on our website in early 2000.

4:15 pm - 6:15 pm - POSTER SESSION I AND OPENING RECEPTION

6:30 pm - 7:30 pm - PEDIATRIC BOWL
Chair: Lewis First, University of Vermont, Burlington

Fashioned after the television version of the College Bowl, this event will feature teams of pediatricians competing by answering questions designed to test their clinical acumen and knowledge of pediatric trivia. Points will be awarded for correct answers and the team with the highest score will win bragging rights.

Team Leaders:
William Gerson, Pediatric Medicine, South Burlington and Marshall Land, Pediatric Medicine, South Burlington

Saturday, May 13

8:00 am - 10:00 am - TOPIC SYMPOSIA

¨Computers in Medicine: From the Health Center to the Home to the Genome
Chair: Gary Fleisher, Children’s Hospital, Harvard Medical School, Boston

From molecular biology to clinical care, computers will play a decisive role in pediatrics in the next millennium. This symposium will address the technological solutions for the storage and dissemination of medical information. The translation of basic scientific discoveries into clinical practice and issues related to social concerns, access, privacy, and security will be discussed.

Information Infrastructure for the Next Generation Medicine
Isaac S. Kohane, Harvard Medical School, Boston

Health Applications on the Web: Access, Privacy, and Safety
Kenneth D. Mandl, Children's Hospital, Boston

Bioinformatics in Support of Molecular Medicine
Russ B. Altman, Stanford University, Stanford

¨Genetics of Sexual Differentiation and Gender Assignment
Chair: Kenneth Copeland, University College of Medicine, Oklahoma City

This session will cover recent advances in molecular genetics relevant to sexual differentiation and their impact on management of children with ambiguous genitalia.

Genes, Gonads and Germ Cells
David Page, Howard Hughes Medical Institute, Whitehead Institute of Biomedical Research, Cambridge

Cell Signaling in Sexual Differentiation
Andrew P. McMahon, Harvard University, Boston

"Genes to Gender: Impact of Molecular Biology on Management of Ambiguous Genitalia"
Charmian Quigley, Eli Lilly and Co. and Indiana University, Indianapolis

Sponsored Jointly with the Lawson Wilkins Pediatric Endocrine Society and the AAP Section on Endocrinology

10:15 am - 12:15 pm - TOPIC SYMPOSIUM

¨Child Health Services Research: Scientific Opportunities and Methods
Chair: Larry Kleinman, Lehigh Valley Hospital, Allentown

This session will discuss child health services research as an emerging field of applied science. The session will highlight both scientific opportunities and accomplishments. Dr. Kleinman will frame the context of health services research as an applied science. Dr. Simpson will elaborate on the continuum of child health services research, and the relationship of this work to the agenda of the Agency for Healthcare Research and Quality, and a principal federal agency for health services research. Dr. Stein will speak on the state-of-the-art in measuring the health and well being of children, emphasizing the methodological foundations of the work. Dr. Homer will address scientific methods in the quality of health care, from concept to measurement, to improvement and then back to measurement. The session will acknowledge specific controversies in the field and provide ample opportunity for discussion among participants and panelists.

Applied Science and the Context of Child Health Services Research
Larry Kleinman, Lehigh Valley Hospital, Penn State College of Medicine, Allentown

Child Health Services Research: Its Scope and Continuum
Lisa Simpson, Agency for Healthcare Research and Quality, Chevy Chase

Using Health Status Assessment in Children as an Outcome
Ruth E. Stein, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx

Quality of Care and Improving the Delivery of Child Health Services
Charles J. Homer, National Initiative for Children’s Healthcare Quality, Boston

1:30 pm - 2:30 pm - APS PRESIDENTIAL PLENARY - HOWLAND AWARD
Presidential Address - Rebecca H. Buckley, Duke University School of Medicine
John Howland Award Presentation - Samuel A. Katz

2:30 pm - 3:00 pm - JOSEPH W. ST. GEME, JR. LEADERSHIP AWARD
Joseph W. St. Geme, Jr. Award Presentation - Evan Charney, Dept. of Pediatrics, University of Massachusetts Medical Center, Shrewsbury
St. Geme Awardee Introduced by: Kenneth B. Roberts, Professor of Pediatrics, University of North Carolina School of Medicine, Greensboro

Presented on behalf of the American Pediatric Society, American Academy of Pediatrics, American Board of Pediatrics, Ambulatory Pediatric Association, Association of Pediatric Program Directors, Association of Medical School Pediatric Department Chairman and Society for Pediatric Research

3:15 pm - 4:45 pm - STATE OF THE ART PLENARY

¨The Developing Brain and Human Disease
Chair: Joseph J. Volpe, Children’s Hospital, Harvard Medical School, Boston

The three outstanding speakers in this session will explore the exciting boundary between advances in developmental genetics of the brain and clinical medicine. An understanding of the developmental determinants of neuronal fate has led to a new molecular understanding of several inherited diseases of the human brain involving abnormalities in brain patterning and neuronal organization and migration. Exciting recent findings have challenged the depressing notion that regeneration and/or replacement of developmentally deficient or damaged brain is impossible. The convergence of information on neuronal fate and neural stem cells raises the very real possibility of exciting new cell-based therapies for a range of congenital and acquired diseases of the human brain.

Genetic Control of Neuronal Fate in the Developing Brain
Robert F. Hevner, Langley Porter Psychiatric Institute, University of California, San Francisco

Genetic Basis of Abnormal Neuronal Migration in the Human Brain
Christopher Walsh, Harvard Medical School, Boston

Neural Stem Cells and Therapy of Disorders of the Developing Nervous System
Evan Y. Snyder, Harvard Medical School, Children’s Hospital, Boston

Supported by an educational grant from the March of Dimes Birth Defects Foundation

¨Pathogenesis of Viral Respiratory Infections
Chair: Mark R. Denison, Vanderbilt University Medical Center, Nashville

Viruses interact intimately with the host cell environment from the time of initial contact through assembly and release of new infectious virus particles. During infection viruses use preexisting host cell components, modify the intracellular environment, and use mechanisms to avoid host cell immunity in order facilitate their replication and survive to be transmitted to new hosts. The symposium will explore specific aspects of the pathogenesis of four respiratory viral pathogens; the coronaviruses, parainfluenza viruses, influenza virus, and respiratory syncytial virus. The symposium speakers will describe unique features of the replication, cell biology or immune response of each virus and how understanding of molecular mechanisms of pathogenesis provides critical information in efforts to prevent or treat viral respiratory infections.

Cellular Pathogenesis of Coronavirus Infections
Mark R. Denison, Vanderbilt University Medical Center, Nashville

Receptor Mediated Entry of Paramyxoviruses
Anne Moscona, Mount Sinai School of Medicine, New York

Molecular Determinants of Influenza Virus Virulence
Kanta Subbarao, Centers for Disease Control, Atlanta

Neonatal Immune Response to Respiratory Syncytial Virus
James E. Crowe, Jr., Vanderbilt University School of Medicine, Nashville

Supported by an educational grant from ICN Pharmaceuticals

5 pm - 7:15 pm - POSTER SESSION II

Sunday, May 14

7:00 am - 8:00 am - PUBLIC POLICY LEGISLATIVE BREAKFAST SYMPOSIUM

¨Medical Science and the Brave New World of Electronic Publishing
Moderator: James Perrin, Editor, Journal of the Ambulatory Pediatric Association

Speakers: Jerold Lucey, Editor-in-Chief, Pediatrics and Alvin Zipursky, Editor, Pediatric Research

8:00 am - 10:00 am - TOPIC SYMPOSIUM

¨The Neurobiologic Basis of Behavior and Development
Chair: James M. Perrin, Mass General Hospital for Children, Boston

This session will describe recent work linking developmental aspects of brain function and structures with understanding of child development, developmental disabilities, and child and adolescent behavior. Expanding knowledge in areas of brain development, anatomic structures, and molecular biology of the central nervous system broaden the base for understanding clinical phenomena. New work has helped to characterize environmental and central nervous system influences on child and adolescent behavior. Recent long-term follow-up data from the Infant Health and Development Program inform regarding the predictors of outcomes for children at developmental risk.

Brain Development and Developmental Disabilities
Mark L. Batshaw, Children’s National Medical Center, George Washington University School of Medicine, Washington

Neurobiologic Representations fo the Social World: Developmental Considerations
Felton Earls, Harvard Medical School, Boston

The Infant Health and Development Project: Implications for Neurobiologic Basis of Development
Marie McCormick, Harvard School of Public Health, Boston

9:00 am - 12:00 noon - WORKSHOPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

WS19 Children’s Health 2000 Won’t Happen Without Reimbursement/Financing
One can teach and preach combined inissions of clinical care, research, education and advocacy issues, but it cannot be achieved without adequate financing and reimbursement for professional and hospital services. The formal educational preparation and in- training experience of most doctors is usually deficient and poorly coordinated.

This workshop will present an overview of reimbursement and financing principles for the pediatric generalist and medical and surgical subspecialist, whether engaged in private solo, multispecialty, HMO or academic practices in the following areas:
1. The medical encounter - an overview from patient care through reimbursement.
2. Understanding medical finance - the basics.
3.Application of medical finance - understanding the business of practice revenue.
4. Needs for medical finance - different settings, yet similar needs. How do different practice settings impact reimbursement? facility vs. non-facility fees.
5. Sources of reimbursement / finance and different payment arrangements.
6. Who controls / does what related to coding and RVU’S.
In conclusion, the attendee will be given direction for future study and sources of information.

S. Berman, The Children’s Hospital, Denver; R.A. Molteni, Children’s Hospital, Seattle; C.M. Vanchiere, Children’s Clinic of SW La., Lake Charles

WS20 Community Based Teaching: Creative Solutions For The New Age
The community setting has become a critical arena for diverse and challenging patient care. As such, effective and focused teaching strategies are essential tools for preceptors. This workshop reviews several problems frequently encountered in community teaching settings, such as limited teaching time, limited continuity with the learner, limited space, expansive patient load, and expansive clinical information to discuss. Participants will explore and practice strategies to avoid such problems, tackle such problems, or work around them.

Despite a great deal of recent attention to strategies such as the one minute preceptor, problem-based learning, and the use of teaching scripts, the challenges to effective teaching and efficient learning persist. This workshop will cover a spectrum of teaching strategies from the perspective of learning success. Implications for effectiveness of learning, learning in the managed care environment, and learner styles will be addressed. The challenges of teaching in the community setting can be transformed into opportunities for a stimulating and highly satisfying teacher-learner interaction. In this workshop, participation, rehearsal, audiovisuals and "hands-on" techniques will help attendees to develop or expand their teaching repertoire for community based clinical training.

L. Chandran and J. E. Fischel, Department of Pediatrics, State University of New York at Stony Brook, Stony Brook

WS22 Evidence-Based Pediatrics And The Cochrane Collaboration
An interactive classroom session with several facilitators and demonstrations of new resources in pediatric medicine. This session will provide attendees with an increased awareness of the scientific foundation of evidence-based pediatric practice and will demonstrate the Cochrane Library and other evidence-based resources which can assist the pediatrician in providing optimal care.

V. Moyer, University of Texas – Houston Medical School, Department of Pediatrics, Houston; A. Ohlsson, Mount Sinai Hospital, Toronto, T. Klassen, University of Alberta, Edmonton

WS23 From Jonesboro To Melrose Place: Media Violence, Sexual Violence And The Internet
Hollywood claims that the media merely reflect a more violent society. Some public health activists claim that the media actually cause violence among teenagers. The literature is complex, but the answers are extremely important, given the events of the past two years. Where does the truth lie?

This workshop will explore the current state-of-the-art knowledge regarding media violence and sexual violence in movies, on television and in music videos, and the impact of the Internet. Participants will learn how to counsel teens and their parents and what solutions are practical demonstrations, and hand-outs will be provided.

Dr. Strasburger is a pediatrician and adolescent medicine specialist who has authored or co-authored most of the AAP’s statements on media for the past decade. Dr. Donnerstein is one of the primary authors of the National Television Violence Study.

V. C. Strasburger, University of New Mexico School of Medicine, Albuquerque; E. Donnerstein, University of California, Santa Barbara

WS24 Malpractice And Communication Skills For Difficult Situations
Medical students have not always had access to information and behavior skills training related to malpractice, and communication skills for difficult situations. Perhaps, as a result, some pediatricians become involved in lawsuits that might have been avoided by using interpersonal skills to enhance the physician-patient relationship. Research suggests that many families file malpractice suits when adverse outcomes are associated with poor physician-patient relationships, physicians’ criticism of one another, and unclear communications. This research has led multidisciplinary faculty and risk management staff to develop a 6 hour, small group course for practicing physicians, residents and 4th year medical students taking their 4 week ambulatory pediatrics rotation. The proposed workshop presents a mini version of the course and suggests how it may be adopted elsewhere.

Participants are challenged to: identify patient dissatisfactions that increase risk of suits, communicate effectively in adverse circumstances, relate physician’s interpersonal behaviors to patients’ perception of quality care and understand risk management’s issues and roles. Participants practice with surrogate patients who present 10 cases based on research and actual lawsuits. Scenarios range from a diagnosis of cerebral palsy in which a mother wants to blame her obstetrician to a case of iatrogenic death. The workshop will include a brief lecture, role plays and discussions that focus on: structuring difficult interactions, dealing with patients varied responses to bad news, what to do when you or another physician has erred and principles of risk reduction.

J. Gigante, G.B. Hickson, T. Trotter, J. W. Pichert, Vanderbilt Children’s Hospital, Nashville

WS27 Searching For The Evidence – Use Of Electronic Databases & Internet In Research & Clinical Decision Making
Evidence-based Medicine requires new skills in identifying and retrieving information for both the researcher and clinician, yet many of us have received little training in how to acquire this expertise. Computers can provide easily accessible tools to meet this challenge. In this workshop, we will (1) explore available sources of information focusing on MEDLINE searches of the primary literature, as well as identification of internet based sites for secondary sources, guidelines, & more; (2) create well-formulated researchable questions using the PICO method; (3) find on-line resources to address practical clinical scenarios; and (4) use directed computer exercises to demonstrate how participants can improve the efficiency and comprehensiveness of their primary literature searches. The workshop will enhance participants’ skills in searching for evidence both for research purposes and to provide support for clinical decision making. Materials will be distributed to aid teaching medical students and residents this topic. It features hands-on, real-time computer exercises under expert guidance. Participants should have at least an introductory level of understanding about MEDLINE searches and the Internet; Workshop limited to 20 participants.

The goal of the workshop is to provide faculty and primary care clinicians with the skills necessary to integrate Evidence-based medicine in their practice and in teaching medical students & residents.

This workshop will be held in the Boston University Computer Lab. Transportation will be provided.

L.N. Werk, C. Shubkin, J. Kasper, S. Chapman, B. Siegel, H. Bauchner, Department of Medical Education, Arnold Palmer Hospital for Children & Women, Orlando, Division of General Pediatrics, Boston University School of Medicine, Boston, and Greater Lawrence Family Health Center, Lawrence

WS28 Teaching The Pediatric Sexual Abuse Examination
For a number of reasons, many practitioners of pediatric medicine are uncomfortable with the presenting complaint of possible sexual abuse. Several pediatric sexual abuse centers have been established across the United States to address this issue and also to attempt to improve the quality and consistency of care delivered. Unfortunately, however, such a center is often not readily accessible to practitioners and their patients. It is therefore imperative that pediatric training centers become adept in teaching their residents and students how to most effectively manage the alleged sexual abuse victim.

At the UT – Houston pediatric sexual abuse center, we have developed a teaching module that we are currently implementing with faculty, residents and students. It includes a pre and post module questionnaire, audiovisual material, and interactive teaching with pediatric sexual abuse experts. The course content is easily modifiable according to the level of experience of the learner and the amount of time available. Using primarily a hands-on format, we will present our module to workshop participants and explore with them ways in which it may be implemented in various teaching situations.

R. Girardet, S. Lahoti and N. McClain, Department of Pediatrics,University of Texas – Houston Medical School, Houston

WS29 Ten Common Sports Injuries In Adolescents
Pediatricians are caring for an increasing number of children and adolescents who are injured from sports participation. This session will review the diagnosis and management of the ten most common injuries in children and adolescents that develop during sports activities. Emphasis will be on when to manage and when to refer. Questions from the audience will be welcome.

M. Goldberg, New England Medical Center, Boston; L. Micheli, Children’s Orthopaedic Surgery Foundation, Children’s Hospital, Boston

WS30 The Medical Home And Measures Of Success
This session will address the meaning of the medical home concept, how to operationalize it, and how to measure its impact. Faculty will discuss the challenges of coordinating care among a variety of community and hospital settings, and offer strategies for overcoming hurdles. To address the growing need for evidence-based outcomes as a justification for service provision, the program will provide participants with knowledge and tools that can help them: (1) define the population of children with special needs; (2) develop mutually beneficial partnerships with families; and (3) ensure that children in their practice have access to all needed medical and non-medical services as a part of a medical home.

J. Palfrey, Children’s Hospital, Division of General Pediatrics, Boston; W. C. Cooley, Crotched Mountain Rehab Center, Greenfield, A. Sandler, The Olson Huff Center for Child Development, Thomas Rehabilitation Hospital, Asheville

9:00 am - 12:00 noon - SPECIAL INTEREST GROUPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

SG17 Literacy Promotion in Primary Care
Chairs: Robert Needleman and Perri Klass

This SIG will provide a forum for directors of primary care literacy programs modeled after Reach Out and Read to discuss program innovations, successes, and ongoing challenges. As in previous years, topics will include clinician and volunteer training, recruitment, fund-raising, publicity, books, and other program logistics. Participants are encouraged to bring examples of recently-developed educational materials, photos, and vignettes. We will also review current research in the field, including a discussion of current studies by SIG participants. A special session will be set aside for work on the collaborative Before-and-After-Books-and-Reading (BABAR) study, which now has more than 20 sites, and more than 900 completed interviews. Another special session will serve as an introduction to ROR for physicians and others interested in beginning a clinic-based literacy program. Teaching modes will include videotape and live demonstration, role-play, discussion, and small-group problem solving. Those interested are encouraged to contact ROR at www.reachoutandread.org.

SG19 Practice-Based Research Network
Chair: Mary Ottolini

Information on this SIG will be posted on our website in early 2000.

10:15 am - 12:00 noon - SPR PRESIDENTIAL PLENARY & AWARDS AND E. MEAD JOHNSON AWARD LECTURES

Presidential Address: Thomas Hazinski,Vanderbilt University Medical Center

Student Awards: Kyle Cowan, Aaron M. Milstone, Christine Siambani

House Officer Awards: Douglas D. Fraser, Paul J. Galardy, Matthew A. Saxonhouse

Fellow Basic Awards: Christopher E. Belcher, Elif Erkan, Syed Zaidi

Fellow Clinical Awards: Michael J. Ackerman, Okan Elidemir, Mika Ramet

David Nathan Award: Lisa Wang

Young Investigator Award Lecture:
Brendan Lee - Identification of Molecular Genetic Defect for Cleidocranial Dysplasia & Nail-patella Syndrome

E. Mead Johnson Award Lectures:
Mark Kay - Seminal Scientific Contributions to the Field of Hepatic Gene Therapy
Gregg Semenza - Molecular Response to Hypoxia

1:00 pm - 2:15 pm - MARCH OF DIMES PRIZE IN DEVELOPMENTAL BIOLOGY (Fifth Annual Lecture)
Presented by the March of Dimes

Genetic Control of Programmed Cell Death in C.elegans
H. Robert Horvitz, Professor of Biology, Howard Hughes Medical Institute Investigator, Massachusetts Institute of Technology, Cambridge, MA

1:15 pm - 2:00 pm - AAP PRESIDENTIAL PLENARY & JACOBI AWARD
Presidential Address: Donald E. Cook, American Academy of Pediatrics, Elk Grove Village
Jacobi Award: Catherine DeAngelis

2:00 pm - 5:00 pm - WORKSHOPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

WS33 Advocacy Training For Pediatric Residents: The Role Of The Community Pediatrician.
Child advocacy is central to the practice of pediatrics. Pediatricians have been exemplary child advocates at the local, state and national level. Paradoxically, only recently has training in advocacy been a requirement of residency training. There is no national consensus regarding a child advocacy curricula or how to teach it. As training programs develop their advocacy training programs, one potentially effective and rewarding model includes cooperative efforts with the AAP’s CATCH program.
Specific objectives include:
•Defining the role of CATCH and the AAP in resident advocacy training
•Learning about different models of curricula for advocacy training
•How to build institutional support for community based advocacy training
•How to incorporate community pediatricians into resident advocacy training

The workshop will use brief presentations about model programs from different training programs and interactive breakout groups. Reference material and resources will be distributed to attendees.

S.D. Blatt, J. Brown, A.S. Botash, J. Harisiades, D. Haut, D. Keller, T Tonniges. SUNY Health Science Center @ Syracuse, U of Colorado, Denver, Children’s Memorial Hospital, Chicago, AAP, Elk Grove Village, U of Massachusetts, Worcester

WS34 Community Pediatrics: The APA/AAP Interface
Community Pediatrics has matured into a well recognized discipline and the general pediatrics professional societies (APA and AAP) have had many projects and initiatives in this area. Several APA Special Interest Groups (SIG) focus on Community Pediatrics issues and the AAP Committee on Community Health Services recently released a policy statement with an expanded Community Pediatrics definition. One of the core content areas of Community Pediatrics is the commitment to service, research and teaching regarding underserved pediatric/adolescent communities and populations. In this workshop, during the first concurrent meeting of the APA and AAP, leadership in the area of Community Pediatrics will present information on their activities, specifically focusing on underserved populations and communities. A town hall meeting format will be used. APA SIG Chairs, AAP Section and Committee Chairs, AAP CATCH leadership and others involved in Community Pediatrics will make brief presentations. The discussants at the workshop will be the Presidents-elect of the two organizations (APA - Ken Roberts and AAP - Steve Berman) and there will be audience participation. The expected workshop outcome is an enhanced understanding of the Community Pediatrics interface between the two organizations with a specific focus on services for underserved pediatric/adolescent populations.

J. Brown, S. Berman and K. Roberts, Department of Pediatrics, Colorado School of Medicine, Denver; Moses Cone Memorial Hospital, Greensboro

WS35 Dermatologic Manifestations Of Systemic Disease
This session will concentrate on the recognition of the cutaneous manifestations of a variety of systemic disorders. These will include collagen vascular diseases, vasculitic disorders, hypersensitivity syndromes, neurocutaneous disorders, and disorders of pigmentation. In addition the systemic implications of vascular lesions and infiltrative lesions will be reviewed.

S. E. Gellis, Children’s Hosptial, Boston, M. Liang, Children’s Hosptial, Boston, Richard Antaya,Yale, New Haven

WS37 Evidence Based Pediatrics: What Works Best And The Challenges For The Future
The potential for the EBM movement to positively influence care of children is increasingly recognized, but its real use and effect continues to be minimal. Using the combined experience from our institutions we will cover two topics with the goals of increasing the use of EBM. The first part of the workshop will address and review the requisite tools necessary for the practice of EBM; we will address the skills necessary for EBM users to understand papers on prognosis, screen, diagnostic testing and treatment, including a discussion of odds, risks, ROC curves, and kappas. The second half of the workshop will concentrate on the common barriers that most ‘EBM users’ are likely to face eventually. This will include a discussion of difficulties at each step in the practice of EBM, including (a) using the evidence (especially when it is scant or poor), (b) summarizing the evidence (and why there is a need for a common EBM language and format), (c) problems in disseminating the products of EBM in the midst of a busy clinic, and finally (d) problems in implementing evidence in real-time, using computers. We will use our own examples to encourage audience participation.

R.L. Davis, D.A. Christakis, T. Newman, University of Washington, Seattle, and University of California, San Francisco, San Francisco

WS39 Resuscitation And Stabilization Of The Pediatric Transport Patient In "Virtual Reality"
When confronted with complications which arise during the interhospital transport of pediatric patients, health care providers must take into account the unique characteristics of critically ill children and the transport environment. This workshop is intended to introduce a hands-on, teaching tool which develops skills including: identification, management, and prevention of problems commonly encountered in critically ill pediatric transport patients. Participants join in a scenario where instructors pose as health care professionals treating a critically ill child (actually a resuscitation mannequin) at a referral facility." A variety of inappropriate and potentially dangerous interventions (ie. improperly stabilized endotracheal tube) have been performed. While resuscitating, stabilizing, and preparing the "patient" for transport, the participants try to identify and correct these inappropriate interventions using equipment provided for their use. The participants then place the "patient" into an actual ambulance. While the ambulance is in motion, the participants try to solve problems which are unique to the moving ambulance environment. For the purposes of this workshop, participants will view a video of pediatric residents participating in this teaching exercise. Workshop participants may then participate in similar scenarios where they will try to identify potential problems, resuscitate, stabilize and prepare a mannequin for transport.

G. Zuckerman, M. Pante, B. Fischberg, W. Goerlich. Departments of Pediatrics and EMS Education, Robert Wood Johnson Medical School, New Brunswick

WS40 Teenage Psychosocial And Interactive Problems: Family Systems Approaches For Primary Care
Psychosocial-behavioral problems often accompany teenagers’ entry into adolescence (e.g., separation, individuation, and independence). Problems include teen-parent conflict, noncompliance with medical regimes, somatic complaints, sexual promiscuity, substance abuse, affective disorders, and emotional-behavioral complications of ADHD and school learning problems.

Furthermore, the family is in a new family development cycle and parents are facing their own challenges with mid-life, mid-career changes.

Most psychosocial problems and transitions benefit from a family-centered approach. Detecting, treating, and referring constitute comprehensive primary care for teenagers. Participants will learn 1) family systems concepts; 2) clinical application for evaluation and management; 3) solution-oriented interviewing techniques; 4) techniques for referral; and 5) further training opportunities.

Teaching methods will include brief formal talks, interactive discussions, case studies, videos of family interviews, and extensive handouts.

W.L. Coleman,University of North Carolina, Chapel Hill

WS43 Working in International Child Health
Part 1: Children of the World 2000: An Overview
Ninety percent of children in 2000 will be born into the not-yet-industrialized parts of the world. This session will help child health professionals become aware of the difference in lifestyles and issues facing these children compared to those of children living in the western world. Participants will also gain awareness of how the health of all children impacts on all of the world’s people both now and into the 21st century.

Part 2: How to Help Children in Disasters
More than half of all people affected by disasters are children. Many will have long-term physical and mental health consequences. Their special needs and interests are often overlooked. This session will help child health professionals to understand the magnitude of the problem, to recognize the special needs of children in disaster situations, and to know how to help these children.

Part 3: Recommendations for Pediatricians Who Want to Work in International Health
Child health professionals with both short and long term experience in working internationally will compare their learning and provide recommendations for colleagues interested in becoming similarly involved.

K. Olness, Rainbow Babies and Children’s Hospital, Cleveland; B. Duncan, University of Arizona, Department of Pediatrics, Tucson; R. Haggerty, University of Rochester, Department of Pediatrics, Rochester; J. Kennell, Rainbow Babies and Children’s Hospital, Cleveland; A. Mandalakas, Rainbow Babies and Children’s Hospital, Cleveland, R. Meier, Shriners Hospital for Children, Lexington

2:00 pm - 5:00 pm - SPECIAL INTEREST GROUPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

SG20 Adolescent Medicine
Chairs: Paula Braverman and Martin Fisher
Co-leaders: Robert Sege, Shari Barkin, and Carole Sousa.

Practical Approaches to Violence Prevention
This session is co-sponsored by the Special Interest Group in Adolescent Medicine of the Ambulatory Pediatric Association and the Section on Adolescent Health of the American Academy of Pediatrics. Both the Special Interest Group and the Section on Adolescent Health focus on the provision of care to teenagers in the community, private practice, and teaching hospital setting with emphasis on the practical issues in delivering this care. The session is open to anyone interested in adolescent health and will focus on interpersonal and dating violence. Practical approaches to screening and suggestions for prevention on the individual and community level will be addressed.

SG21 Child Abuse
Chair: John Leventhal

SG24 Nutrition
Chair: Robert Karp

Micronutrient supplementation: Why, when and for whom. 

These presentations were developed so as to familiarize pediatricians with contemporary uses of micronutients in clinical  practice with both well and sick children.  

1. A historical perspective of micronutrient supplementation  - Robert Karp
•recognizing the historical deficiency disease
•chemical isolation of micronutrients and the use of nutrients in prevention of ancient scourges
•the reappearance of concern for deficiency in families of poorer children — classic diseases and increased risk for modern ones.

2.  The Infant and Child — Mike Farrell
•breast and bottle feeding
•the prevention of iron deficiency
•concerns for degenerative diseases of contemporary society.

3.  The Adolescent Infancy and Early Childhood  - Sandy Hassink
•the nutrient needs of the adolescent
•preventing osteoporosis
•the dieting