 |
Saturday, April 28 - Tuesday, May 1, 2001 Jointly
sponsored by the In cooperation with |
Expanded schedules for:
Saturday, 4/28
Monday, 4/30 Tuesday,
5/1
Schedule-at-a-Glance |
SUNDAY, APRIL 29
|
7:30am - 9:00am
APA PAST OFFICER'S BREAKFAST
8:00am - 10:00am
SUBSPECIALTIES/THEMES (Original
Science Abstract Programs)
Behavioral Pediatrics II
Cytokines
and Signaling Molecules: Immunology
Disparities of Care and Cost of
Care
Endocrinology I: Insulin
Responsiveness
Genetic Basis of Disease
I
Hematology and Oncology
II
Neonatal Immunology and
Hematology
Neonatal-Patient Oriented
Research I
Neurology
Nutrition and Metabolism
I
Strategies for Asthma
Management
8:00am - 10:00am
TOPIC SYMPOSIA
Steroid-Resistant
Nephrotic Syndrome: New Advances and Insights
Chairs: William E. Smoyer, University of Michigan, Ann Arbor,
MI and H. William Schnaper, Northwestern University, Chicago, IL
Steroid-resistant nephrotic syndrome is one of the most common forms of primary nephrotic syndrome in childhood. Recent genetic and molecular studies indicate that the podocyte plays a central role in the pathogenesis of this disorder. This symposium will address recent advances in our understanding of the development, cell biology, and pathology of the glomerular podocyte. The recent identification of NPHS2, the gene encoding the glomerular protein podocin, and its role in autosomal recessive steroid-resistant nephrotic syndrome will be discussed. Finally, new strategies for therapeutic intervention in steroid-resistant nephrotic syndrome will be described.
Development of the Glomerular Capillary Wall
Dale R. Abrahamson, University of Kansas Medical Center, Kansas City,
KS
Cell Biology and Pathology of Podocytes
Peter Mundel, Albert Einstein College of
Medicine, Bronx, NY
The Genetic Basis of Steroid-Resistant Nephrotic
Syndrome
Corinne Antignac, INSERM, Paris, France
Therapeutic Interventions for Steroid-Resistant
Nephrotic Symdrome
Frederick J. Kaskel, Albert Einstein College of
Medicine, Bronx, NY
Sponsored Jointly with the American Society of Pediatric Nephrology
The Fetus as a Patient
Chairs: James F. Padbury, Women & Infants Hospital of Rhode
Island, Brown University, Providence RI and Diana Bianchi, Tufts
University, New England Medical, The Floating Hospital for Children,
Boston, MA
Advances in molecular genetics, in our understanding of the origin of metabolic diseases and in imaging techniques are all having a major impact on perinatal medicine. The role of these new insights and interventions is no greater anywhere than their impact on the care of the fetus. This symposium will review these advances from the point of "The Fetus as the Patient." We will present new data demonstrating maternal-fetal chimerism and the role of this phenomenon in various pathobiologies. Advanced fetoscopic imaging techniques and the ways they can support new fetal therapies will be presented. Molecular diagnosis of genetic metabolic disorders can now be made prenatally to allow earlier fetal treatment and improvement in outcomes.
Bidirectional Feto-Maternal Cell Trafficking:
Relevance for Pediatric and Adult Disorders
Diana W. Bianchi, Tufts University, New England Medical Center,
Boston, MA
Fetal Surgery: In Praise of Tunnel Vision
Francois Luks, Brown University School of Medicine, Rhode Island
Hospital, Hasbro Children’s Hospital, Providence, RI
Genetic Metabolic Disorders: Current Status of
Prenatal Diagnosis and Treatment
Mark Korson, Tufts University, New England Medical Center, Boston, MA
8:00am - 11:00am
SPECIAL INTEREST GROUPS
Adolescent Medicine CANCELLED
Advocacy
Training
In 1997, the Residency Review Committee required that all pediatric
residents be prepared for the role of child advocate. Last year,
our SIG accepted the challenge of developing standards for child
advocacy training. We welcome all who are interested in teaching
about child advocacy to join us in that task. We are
particularly interested in hearing from residents about their
experiences - what have you done, what worked and what are the
generalizable lessons for other programs. E-mail your thoughts
to the co-chairs, David Keller (david.keller@ummed.edu)
or Rosalind Vaz (RVaz@lifespan.org).
We look forward to seeing you in Baltimore!
Continuity
Clinic Directors
The Continuity Directors SIG, which was organized by Jan Drutz over 10
years ago, has continued as a very active network for preceptors in
resident continuity settings.
We’re very pleased that over the years, the group has grown and completed projects that none of us individually could have accomplished. The annual SIG meeting, workshops, directories with clearing house information, newsletters (The Continuity Connection), and research have blossomed by the involvement of countless individuals committed to enhancing resident education. Our group has remained consistently enthusiastic and highly motivated because of all the Continuity Directors’ and preceptors’ attendance and active participation!
Everyone is welcome to join us for our annual meeting in Baltimore. This provides an opportunity for preceptors and directors to net work and learn about current projects and "hot topics" of interest. As usual, we will focus primarily on one interactive discussion interest (selected from suggestions made at our 5/00 meeting) and continue discussion on the Continuity Program evaluation in the RRC accreditation process and curriculum development. Specific agenda information will be available in the spring newsletter and on the PAS Web site.
Managed
Care
The Special Interest Group on Managed Care is committed to educating
medical students, pediatric housestaff and faculty about managed care
and its impact on pediatric education, teaching and research. This
year’s program will focus on several training programs who have
developed formal curriculum and clinical experiences highlighting
managed care. Representatives from the "Partners in Quality
Care" programs funded by the Robert Wood Johnson will be invited
to discuss what they have done locally to improve education of
students and housestaff in managed care. It should be an interesting
and exciting session. All are welcome!!
Nutrition
Functional Foods in the Pediatric Diet
This topic will be presented by Walter Glinsmann, MD Fellow at the Center for Food and Nutrition Policy at Georgetown University.
Functional foods are defined as foods or food components that provide a health benefit beyond basic nutrition. These functional components may range from alpha carotene and fiber to probiotics and prebiotics. Many families are interested and aware of the functional value of foods and seek information from health care providers about their use in pediatrics. This talk will address issues specific to infancy and childhood with discussion of specific topics to follow.
| 8:00am - 11:00am WORKSHOPS |
 Requires
advance enrollment |
WS1
1 Achieving Cultural Competency in PediatricsThe U.S. rapidly is growing more culturally diverse. In several cities, whites already are in the minority. Culture has a profound impact on pediatrics, affecting multiple aspects of clinical care, including outcomes, processes, quality, satisfaction, obtaining an accurate history, and adherence. Cultural competency is 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. The Latino and African-American cultures 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 Latino and African-American culture, 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 G. Askew, Department of Pediatrics, Boston Medical Center and Boston University Schools of Medicine & Public Health, Boston, MA
WS
12 Administrative Healthcare Data for Pediatric Research: The Healthcare Cost and Utilization Project (HCUP)This session will provide an introduction to HCUP, a family of databases and tools maintained by the Agency for Healthcare Research and Quality (AHRQ). The objectives of HCUP are to provide data and tools for research on use of health care services in the U.S. HCUP is a partnership among states, industry, and the federal government; currently 26 states contribute data to the project. HCUP includes uniformly formatted administrative databases including state inpatient data, a nationwide sample of inpatient data, a children’s inpatient dataset, and ambulatory surgery data. HCUP data provide many advantages for research: (1) all payers including uninsured, (2) all stays within participating institutions, (3) permit state-level analyses, (4) large sample sizes permit studies of subgroups (e.g., minorities, rare diseases or procedures), and (5) charge data.
Recent innovations in dissemination make these data even more accessible. HCUP also includes software and Internet tools to better use these databases, for example, HCUPnet (interactive web-based query tool for HCUP data), free software (HCUP Quality Indicators, performance measures), and clinical groupers (Clinical Classification Software). HCUP has been infrequently used for pediatric research, but recent advances – the Children’s Nationwide Inpatient Sample and the Child and Adolescent Clinical Classification Software – will make the databases and tools even more useful to study children’s health care issues. Examples of research studies using HCUP data and tools will be used to illustrate applications.
A. Elixhauser, C. Steiner, J. Thompson, Agency for Healthcare Research and Quality, Rockville, MD and University of Arkansas for Medical Sciences, Little Rock, AR
WS1
3 Asthma in Children-Problem Based LearningTwo cases of children with asthma will be presented. The group will work through these cases formulating a plan for diagnosis and management. Objectives Include: Recognize warning signs of asthma, determination of asthma, class severity; identification of asthma triggers; familiarity with concepts of pulmonary function testing and peak flow monitoring; understanding of the role of inflammation and anti-inflammatory therapy; recognition and comprehension of potential side effects of medications and the disease patterns, development of asthma action plans using peak flow measurements and formulation of environmental control measures based on history and allergy testing. Co-sponsored by the AAP Section on Allergy and Immunology
Diane Schuller, Penn State College of Medicine, Jay Selcow, AAP Section on Allergy and Immunology
WS1
4 Community-Based Medical Education: Learning from the Dyson InitiativeThe importance of community-based pediatric training was formally recognized when, in 1996, the Residency Review Committee (RRC) for Pediatrics mandated structured educational experiences in community pediatrics. Under the leadership of late Foundation president pediatrician Anne E. Dyson, the Dyson Foundation, launched a program to stimulate innovation in community pediatrics residency training. The ultimate goal of The Dyson Initiative—Pediatric Training in the Community, which allocates $2.5 million over five years to pediatric residency programs, is to expand the repertoire of residency training to include teaching and experiences in community-based medicine and advocacy.
This workshop will focus on curricular changes that can be implemented to strengthen community-based training. Representatives from Dyson Initiative-funded sites will present innovative curricular enhancements, focusing on those changes that need not require a large monetary investment. They will also discuss the faculty development strategies that accompany curricular change. In the second part of the workshop, Dyson Initiative grantees will present their experience with community collaboration. Practical lessons learned from taking the residency outside the hospital/clinic walls will provide participants with insight into this integral facet of community pediatrics.
M. K. Goyal and J. S. Palfrey, The Dyson Foundation, Millbrook, NY and Department of General Pediatrics, Children’s Hospital, Boston, MA
WS1
5 Design and Implementation of a Competency-Based CurriculumThe process of designing curriculum begins by identifying specific educational objectives or "competencies" that must be achieved. We will discuss the concept of establishing a "minimal set" of required competencies, and whether that process actually enhances or reduces learner achievement. The steps of curriculum development will be presented, including the process of needs assessment, and the conversion of published educational guidelines (such as those of the APA and COMSEP) to specific, objective, measurable competencies. The development of evaluations appropriate for each competency will also be described. We will then discuss practical considerations regarding implementing, evaluating, and revising the curriculum.
The University of Maryland Pediatric Residency Program is one of the few in the country to have adopted a competency-based curriculum. Excerpts will be presented, along with practical lessons learned from their experience in curriculum development and implementation.
Finally, participants will split into smaller, multidisciplinary Curriculum Development Teams to identify competencies and design a competency-based curriculum focused on a specific clinical topic. Sponsored by the APA Education Committee.
J. M. Devries and C. Carraccio, Departments of Pediatrics, Oakwood Healthcare System, Dearborn, MI and University of Maryland Medical Center, Baltimore, MD
WS1
6 Did the Student Do It, Can the Student Do It, Will the Student Do It? Designing Low-Cost Objective Structured Clinical Evaluations (OSCEs) for Pediatric ClerkshipsAn OSCE is a clinical performance evaluation tool designed to appraise student behaviors or skills in a variety of areas. OSCEs can provide powerful formative and summative feedback to both students and curricula. Unfortunately, an OSCE can be quite labor intensive and expensive to set up and operate.
The objective of this workshop will be to design OSCE stations that minimize the use of scarce labor and financial resources yet still effectively measure student performance. Participants will review different methodologies, costs associated with each, and the National Core Curriculum in Pediatrics. Using a combination of inexpensive "low tech" and "high tech" props, participants will design OSCE stations to measure specified student skills and competencies. By the conclusion of the workshop, the participant should be familiar with how to create and implement a low-cost 10-15 station OSCE designed primarily to give students formative feedback.
W. V. Raszka and P. B. Patterson, Department of Pediatrics, University of Vermont College of Medicine, Burlington, VT and The Barbara Bush Children’s Hospital at Maine Medical Center, Portland, ME
WS1
7 Parental Permission and Patient Assent for Participation in Pediatric Research: A Workshop for New InvestigatorsChildren are a vulnerable class of research subjects because they lack the developmental, intellectual and legal capacity to provide informed consent. Research information is given to parents who are asked to make a decision regarding participation based on their perception of what is in the best interest of their child and society at large. We propose to conduct a workshop for new investigators that will accomplish the following goals: (1) Workshop participants will be able to present the essential elements of informed consent to parents in both written and verbal format. (2) Participants will be able to discuss research involvement with children in a manner appropriate for the child’s age, maturity and psychological state. (3) Participants will be able to evaluate the appropriateness of involving adolescents in research with/without parental permission. These goals will be accomplished using a combination of didactic and interactive methods. Case studies consisting of background information, case vignettes, discussion questions and references will be used to explore ethical principles and federal regulations guiding the consent process. Sample consent documents, and videotapes of investigators interacting with parents and potential subjects will be reviewed and critiqued by workshop participants for content, style and effectiveness of communication. The workshop evaluation will consist of pre and post-test questions designed to allow the participant to directly assess their knowledge and skill acquisition.
K. L. Meert, G. Deisinger and E. R. Stinson, Department of Pediatrics, and Office of Research and Graduate Studies, Wayne State University, Detroit, MI
WS1
8 Promoting Environmental Health Education Among Pediatric Chief ResidentsSession Closed - Invitation Only. Contact the APA at info@ambpeds.org for further details.
WS1
9 Shaken Baby Syndrome: Medical-Legal Issues from Diagnosis to the CourtroomShaken Baby Syndrome is the most common cause of morbidity and mortality in inflicted, abusive head injury; the leading cause of traumatic death in infancy. Recent medical and legal controversies involving high-profile court cases as well the fact that the syndrome is frequently overlooked or misdiagnosed will be focused issues in this workshop. The workshop is designed to guide the physician through the process of diagnostic evaluation, therapeutic intervention, working with a child protection team response that includes medical, psychosocial, law enforcement and legal components, collection of evidence, preparation for court and aspects of expert testimony. Covered topics will include epidemiology, history taking, physical exam, differential diagnosis, laboratory, radiological and diagnostic testing, crime scene investigation, forensic evidence and the legal response.
Factual educational material will be presented with varied audiovisual formats including videotapes of perpetrators as well as demonstrations of the physical dynamics of shaking. The audience will have the opportunity to directly participate through the utilization of role modeling, mock investigation and courtroom trial.
M. Frogel and D. Esernio-Jenssen, Schneider Children’s Hospital, New Hyde Park, NY and M. Fisher, Special Victim’s Bureau, District Attorney’s Office, Queens, NY
WS
20 Visions and Images of LearningQuality training of medical students and residents can be quite demanding and difficult. Issues such as time, resources, curriculum, evaluation and teacher development are important for any educational program. However, the success of such a program is best measured in terms of how well trainees are learning. Effective teaching can only be determined by looking at how well learners change their behavior.
The goal of this workshop is to closely examine how medical students and residents learn in clinical settings. An emphasis will be placed on what constitutes effective learning, rather than effective teaching. Through the use of brainstorming, small group discussion, videotaped vignettes, photograph analysis and role play, participants will actively explore ways in which medical trainees learn. Medical students will participate in this workshop to enhance discussions and simulations. The advantages and disadvantages of rote learning versus meaningful learning will be discussed. Participants will be challenged to find practical solutions to common learning problems and apply these to their own settings.
L. W. Greenberg and R. T. Sarkin, George Washington School of Medicine, Washington, DC and SUNY at Buffalo School of Medicine, Buffalo, NY
10:15am - 11:45am
APS PLENARY/HOWLAND AWARD & ST. GEME AWARD
Presidential Address (Thomas
F. Boat, University of Cincinnati College of Medicine)
John Howland Award Presentation (Delbert A. Fisher, Nichols Institute)
11:15am
Joseph W. St. Geme Award Presentation
10:45am - 2:30pm
COMMERCIAL EXHIBITS
OPEN AND POSTERS AVAILABLE FOR VIEWING
Available for Viewing -
10:45am - 2:30pm
Author Attendance - 11:45am
- 1:45pm
11:45am - 1:45pm
POSTER SESSION II
Allergy, Immunology,
Rheumatology
Endocrinology
Bone, Calcium, Vitamin D
Thyroid - Basic and Clinical
Clinical
Growth - Basic and Clinical
Genetics
Dysmorphology/Teratology
Inborn Errors of Metabolism
Hematology/Oncology:
Leukemia/Lymphoma
Solid Tumors
Neuro-Oncology
Clinical Stem Cell Transplantation
Supportive Care
Infectious Diseases:
Neonatal
Respiratory Syncytial Virus
Vaccines
Haemophilus influenzae
Pneumococcus
Miscellaneous
Viral Diseases
HIV
Neonatal Hematology/Immunology
Neonatology:
Neonatal Iron Metabolism
Parenteral Nutrition
Lipid Metabolites
Lactation
Enteral Feeding
Antioxidants
HRSA Workshop Posters
Poster
session on current general pediatric residency and faculty development
grant activities funded under section 747 of the public health service
act
This poster session will:
1. Highlight the uniqueness of these grant activities as well as their
contributions in shaping graduate medical education for the nation;
2. Provide a forum for project directors to discuss their activities,
challenges and innovations directly with other project directors and
colleagues interested in medical education, with the possibility for
replication in other programs;
3. Provide an opportunity for initiating networks and collaborative
activities with other grantees and participants at the annual meeting
and;
4. Provide an opportunity to showcase measurable outcomes from
residency and faculty development programs.
12:00noon - 1:30pm
PERINATAL BRAIN CLUB
12:00noon - 2:00pm
APA LUNCHEONS
Regional Chairs
Fellows
SIG Chairs
1:45pm - 2:30pm
APS BUSINESS MEETING
2:00pm - 5:00pm
SPECIAL INTEREST GROUPS
Culture,
Ethnicity and Health Care
Information on this SIG will be available here in early 2001.
Division
Directors in General Pediatrics
The Division Directors in General Pediatrics SIG addresses all issues
pertaining to Sections of General Pediatrics, including section and
clinic management, patient care issues, finances, educational
responsibilities and clinical research.
Emergency
Medicine
The 3rd PEM Directors SIG will be meeting to discuss academic issues
in education and research for enhancement of the faculty growth within
the field. One area of focus will be the mentoring of junior
faculty. There will be a discussion on developing the future
PEM Directors and enhancing the longevity in the
field. Directors are encouraged to contact: richard.ruddy@chmcc.org
for further details.
Practice-Based
Research Network
Information on this SIG will be available here in early 2001.
School
and Community Health
The School and Community Health Special Interest Group will be held on
Sunday April 29, 2001 from 2:00 to 5:00 p.m. We will have
presentations and discussions on various topics in this area. We will
also devote time to planning a SIG long-term project that was
discussed at last year’s meeting, such as conducting a needs
assessment of pediatricians regarding training in school health or
creating a resource manual of programs. This promises to be an
interesting, productive and interactive session and we welcome all
meeting attendees. If you have any questions or suggestions for
specific topics, please contact either Elisa Zenni at (904)244-7260 or
elisa.zenni@jax.ufl.edu
or Beth Edgerton at (202) 884-5000 or eedgerto@rand.org.
We look forward to seeing you in Baltimore!
| 2:00pm - 5:00pm WORKSHOPS |
Requires
advance enrollment |
WS
21 Acute Otitis Media (AOM): Interactive Workshop to Improve Diagnostic AccuracyThe present standard treatment of AOM in the U.S. is antibiotic, although the literature suggests that many children with AOM will recover with symptom management only. Furthermore, AOM is often over diagnosed due to the difficulty in performing otologic examination in young children. The widespread use of antibiotics has lead to emergence of multidrug-resistant bacteria. Reduction of unnecessary use of antibiotic can be done in 2 major ways: 1) improving accuracy of the diagnosis, and 2) withholding antibiotic in mild cases of AOM. This workshop will make use of modern instruments and ear models to aid participants in making an accurate diagnosis, and differentiating mild from severe cases. The hands-on demonstrations include: a) use of the binocular headlight to facilitate cleaning of the ear canal, b) obtaining and interpreting a tympanogram, c) techniques for successful pneumatic otoscopy in the young child, and d) performing a tympanocentesis. In addition, participants will grade a set of tympanic membrane photographs obtained by high resolution tele-otoscopy, critique our method for distinguishing "mild" from "severe" AOM, and problem-solve management options in AOM cases with an expert facilitator. This interactive learner-oriented workshop can be replicated for students and residents in your own program with the assistance of handout materials to be provided and/or logging onto our AOM website at http://atc.utmb.edu/aom/.
D. McCormick, K. Saeed, T. Chonmaitree, C. Baldwin, University of Texas Medical Branch at Galveston, TX
WS
22 Can Meta-analysis Be Trusted?Meta-analyses are becoming increasingly popular as a way to summarize knowledge about clinical questions. Meta-analyses have an air of objectivity; but can their results be trusted at face value?
The goal of this workshop is to help clinicians interpret the findings of published meta-analyses. We will review the purpose of meta-analysis, and emphasize the importance of determining sources of heterogeneity among studies. We will discuss concepts such as publication bias and sensitivity analysis. The workshop will provide an overview of how meta-analyses are performed, focusing at each step on the elements that distinguish a good meta-analysis. The statistical methodology will be reviewed purely on a conceptual level. We will interpret funnel plots, and discuss the meaning of a random effects and fixed effects model. Workshop participants will be given examples of meta-analyses to critique, and will work through sample data analyses that illustrate key concepts. By the end, participants should be comfortable deciding when a meta-analysis is helpful, and when it may lead to false conclusions.
Yvonne W. Wu and Tom B. Newman, University of California, San Francisco, San Francisco, CA
WS
23 Developing Core Competencies for the Continuity ExperienceThis workshop provides continuity faculty an opportunity to collaborate in the development of core competencies for the continuity experience. Currently the Residency Review Committee (RRC) offers a broad description for continuity but does not address specific competencies or site-specific differences. The RRC is moving towards competency-based requirements in its next revision. Thus, it is timely to consider which competencies should be core for the continuity experience and which are most appropriate to emphasize in specific types of continuity settings (e.g., hospital- based and community sites).
The Continuity Directors’ SIG Task Force will present a working draft of competencies for continuity, developed with input from the SIG membership over the year. Attendees will break into subgroups to prioritize these competencies and to select those most appropriate for emphasis in hospital and community-based continuity sites. Teaching and evaluation methods for several key competencies will be explored. Subgroups will bring their recommendations and non-consensus suggestions to the full group for discussion. After the meeting, a summary of recommendations will be sent to attendees and to the APA Education Committee, in order to guide the APA’s response to the RRC and to aid in revision of the next APA Educational Guidelines for Residency Training in. General Pediatrics.
D. Kittredge, M. Dumont-Driscoll, P. Algranati, R. Collins, W. Davis, J. Drutz, S. Feigelman, J. Olsson, S. Riesen, J. Serwint. (Continuity Directors SIG Task Force)
WS2
4 Evaluation of Curricular Innovations in Medical EducationIn education, research is often focused on the determination of progress that students have made toward educational goals. These studies use methodologies which not only determine outcomes but also analyze the process with which these outcomes are derived. Researchers in medical education are often faced with the difficulty of defending their methodologies to "peer-reviewers" who are accustomed to quantitative analysis of traditional scientific papers.
The methodologies in educational research may be classified into two broad categories: quantitative and qualitative studies. For medical education research, quantitative studies focus on the outcomes of the study while qualitative studies explore the process. Both types of research are necessary and should be selected based on the research question.
This workshop will address the use of varying methodologies in medical education research by reviewing the evaluation methods for several innovative curricular programs. By comparing and contrasting the methodologies employed in each of the programs, participants will be able to appreciate the uses of quantitative and qualitative studies in medical education.
A. A. Kuo, G. S. Blaschke, B. S. Siegel, W. Risko and J. P. Hafler, UCLA Medical Center, Los Angeles, CA, Naval Medical Center, San Diego, CA, Boston Medical Center, Boston, MA, Children’s Hospital, Boston, MA, and Harvard Medical School, Boston, MA
WS2
5 A Family Systems Approach to Behavior and Interaction Problems: Practical Guidelines for Primary CarePrimary care physicians increasingly encounter behavior problems (e.g., noncompliance, sleep problems, and ADHD), but sometimes these problems do not resolve with an exclusive child-symptom centered approach. Furthermore, physicians are encountering interaction-psychosocial problems (e.g., relationship and communication problems, family affective disorders, social-emotional complications of ADHD and learning problems, parent-teen conflict, and parent stresses) that require a family systems approach to assessment and treatment, i.e., viewing the problems and the solutions within the family-social context in which they arise. Most physicians are not trained in family systems-family interviewing techniques, which are needed for these clinical situations.
The goal of this workshop is to teach these techniques. Specifically, attendees will learn basic family systems principles, three models of interviewing techniques, the use of family drawings and genograms, and how to deal with the difficult family.
The workshop will be very interactive. Teaching techniques include case studies, brief didactics, videotapes of family interviews, and extensive handouts. Attendees should bring their own case studies for discussion.
William Coleman, Department of Pediatrics, University of North Carolina, Chapel Hill, NC
WS2
6 How Many More Columbines? The Connection Between School Violence and Media ViolenceIn the late 1990s, there has been an epidemic of schoolyard shootings. Yet data seem to show that the rate of juvenile violence is decreasing. Why the discrepancy? Can adolescents who are prone to commit violent crimes be identified ahead of time? Why do they commit such crimes? Are we "teaching" our children how to kill? What role do the media play in these crimes?
This workshop will employ an informal approach to answering at least some of these questions, using data, case vignettes, roleplaying and video clips.
Dr. Strasburger is a nationally known expert on children, adolescents, and the media. Lt. Col. Dave Grossman is an Army Ranger, a West Point Psychology Professor, and a Professor of Military Science who wrote the Pulitzer-Prize-nominated book, On Killing, and the recent book, Stop Teaching Our Kids to Kill. He was a consultant after the Jonesboro, AR, Paducah, KY, Springfield, OR, and Littleton, CO school shooting incidents and testified in the trial of Timothy McVeigh.
Vic Strasburger, M.D., Professor of Pediatrics, University of New Mexico School of Medicine and Lt. Col. Dave Grossman, U.S. Army (Ret.)
WS2
7 Implementing Medical School Curricular Innovations for a Changing Health Care Environment: Challenges and OpportunitiesWhile integrated health care systems where patient care is intensely managed are becoming more common, young physicians are not being taught how to provide high quality health care within these systems. Therefore, the Health Resources and Services Administration (HRSA) has funded a national medical education program, Undergraduate Medical Education for the 21st Century: A demonstration of curricular innovations to keep pace with a changing health care environment (UME-21). The $7.6 million project began in October 1997 and is administered by the American Association of Colleges of Osteopathic Medicine. UME-21 provides contract funds to eighteen allopathic medical schools to develop, implement and evaluate innovative primary care educational strategies in the clinical years of medical school. The goal of the curricular innovations is to provide future physicians with the knowledge, skills, values and attitudes necessary to provide high quality, population-based, cost-effective medical care to their patients within integrated health care systems. This project aims to foster effective primary care interdisciplinary teaching and learning in ambulatory and community-based settings.
The main goal of this workshop is to identify challenges and opportunities that arise when medical schools collaborate with integrated health systems (including managed care organizations) to effect curricular change in the clinical years of medical school. At the conclusion of the workshop, common barriers to implementation and effective strategies to address those barriers will be identified.
J. Pascoe, C. Christian, K. Ling-McGeorge, H. Loeser, F. McCurdy, C. A. Olson, S. Rattner, B. Zatelli
WS2
8 A Model for Education, Research, and Delivery of Comprehensive Health Supervision Using a Parent/Child/Clinician Computer SystemRecent guidelines for health supervision include Bright Futures, AAP GHS III, and DSM-pc codes of psychiatric risk. Problems with implementation include: lack of evidence, time required, lack of economic reinforcement, complexity of DSM-pc coding, and lack of training for management, particularly of mental health concerns. Our Child Health and Development Interactive System (CHADIS) facilitates implementation of guidelines using computerized parent questionnaires, e.g., all DSM-pc categories, child strengths, health risks. Computer analysis of responses results in suggested diagnoses with specifically related prompts and guides (e.g., trigger questions, differential diagnoses, potential recommendations, menus of appropriate products and resources such as tutors, etc.) on the electronic medical record worksheet the clinician uses during the visit. The clinician’s interaction with the system results in reports (health passport and memory book) for parents. Products and local resources are provided with reviews by experts and without advertising. CHADIS will include validated tools for some aspects of developmental surveillance (e.g., START; Communication Screening System) and for further evaluation of problems (e.g., autism checklists, depression inventories). CHADIS will be free, initially offered to faculty interested in training and collaborative research. We will demonstrate how CHADIS addresses common problems such as encopresis, sleep problems, ADHD; present data on parent response to CHADIS and pilot prevalence data for DSM-pc; elaborate on its use for collaborative research; and provide an opportunity for joining the network.
Raymond Sturner and Barbara Howard, The Johns Hopkins University School of Medicine, Baltimore, MD
WS2
9 Redesigning Primary Care for Children: The Example of ADHDDespite clinicians’ universal intentions to provide excellent care, actual care often falls short. These gaps in care lead to worsened health status, decreased satisfaction, increased costs, and clinician and staff distress. Achieving major enhancements in care requires substantial restructuring of the approach to care and changing office systems to better meet patient, family, and staff needs.
The National Initiative for Children’s Healthcare Quality (NICHQ) seeks to eliminate the gap between what is and what can be in health care for all children by raising the will to improve, developing better strategies to accomplish change, and directly assisting practices in their improvement activities. This direct assistance entails measuring current performance, training practice staff about how to achieve change, providing expertise in providing tools and materials to enhance improvement, and supporting change through the formation of "collaborative learning groups." NICHQ, building on the practice guidelines of the American Academy of Pediatrics, has launched a new project to transform care for children with ADHD.
The objective of this workshop is to provide participants with the fundamentals of how to promote change in primary care settings for children so that they better meet the needs of children, families, clinicians, and staff. We will build on the example of ADHD, and give participants the opportunity to plan actual changes they might bring back to their care settings.
C. J. Homer, P. Margolis, P. Heinrich, L. White, J. Perrin. National Initiative for Children’s Healthcare Quality, Boston, MA, Chapel Hill, NC; and Seattle, WA; Mass General Hospital for Children, Boston, MA
2:00pm - 4:00pm
STATE OF THE ART PLENARY
Entrepreneurism
and Conflicts of Interest in Academic Medicine
Chair: Ora H. Pescovitz, Indiana University School of Medicine,
Indianapolis, IN
This symposium will address a topic of considerable public debate, especially as it relates to research involving human subjects, among these clinical trials using children as subjects, and research involving gene therapy. A recent two-day meeting at NIH was devoted to this subject and it is likely that there will be new and more explicit guidelines promulgated by HHS. The symposium will address these issues from the perspective of academic pediatrics and pediatric research, in particular with regard to the impact on education at both the undergraduate and graduate levels and the availability of appropriate tests and therapies for children. The role of professional societies, such as the sponsoring members of the PAS meeting, will be examined. The symposium is planned to allow at least 30 minutes of interactive discussion between the members of the panel and the audience.
Panel
Marcia Angell, Emeritus Editor, The New England Journal of Medicine,
Cambridge, MA
Greg Koski, Director, Office of Human Research
Protection, US Department of Health and Human Services, Rockville, MD
Robert P. Kelch, University of Iowa College of Medicine, Iowa City, IA
Stephen P. Spielberg, Pediatric Drug Development, Janssen Research
Foundation, Titusville, NJ
Sponsored Jointly with the Public Policy Council of APS, AMSPDC and
SPR and the Public Policy Committee of APA
Supported by an educational grant from the Children’s Research
Foundation of Cincinnati
2:30pm - 4:00pm
STATE OF THE ART PLENARY
Predictors
of Adult Disease
Chair: Sherin U. Devaskar, Mattel Children’s Hospital, University of
California, Los Angeles, CA
This session will provide important new mechanistic information about the maternal, placental and fetal influences on certain adult onset diseases. Investigators undertaking studies that are on the cutting edge will provide an overview and share some of their recent experimental results during this session. The first lecture will concentrate on maternal health and its role on adult onset diseases; the second lecture will delineate the role of placental factors; while the third session will detail fetal origins of adult hypertensive disease.
Maternal Health and Its Influence on Adult Diseases
Judith G. Hall, University of British Columbia, Vancouver, BC, Canada
The Placenta Dilemma
Susan Fisher, University of California, San Francisco, CA
Fetal Origins of
Adult Hypertension
Susan Bagby, Oregon Health Sciences University, Portland, OR
Stem
Cells
Chair: Jeffrey M. Lipton, Schneider Children’s Hospital, New Hyde
Park, NY
This session focuses on the developmental biology of hematopoiesis, utilizing the zebrafish as a genetic model. The focus of research over the next few years, described in this session, will be to understand stem cell biology, particularly focusing on the induction and self-renewal of the hematopoietic stem cell. Through the analysis of these newly derived mutant genes and cell biology, the hope is to develop a better understanding of stem cell plasticity. The fields of stem cell biology and cancer biology are likely to merge as we understand more about cell differentiation and proliferation during development.
Hematopoietic Stem Cell Development in Zebrafish
Leonard I. Zon, Children’s Hospital, Howard Hughes Medical
Institute, Boston, MA
Advances in
Stem Cell Biology
Ron McKay, National Institutes of Health, Bethesda, MD
Sponsored Jointly with the American Society of Pediatric Hematology/Oncology
4:15pm - 6:15pm
SUBSPECIALTIES/THEMES
Brain
Metabolism and Injury
Developmental
Biology
Endocrinology
II
Glucocorticoids:
More Bad News
Lung
Oxidant Injury: Responses and Treatment Approaches
Neonatal
Infections: Mechanisms of Injury
Neonatal-Patient
Oriented Research II
Regulation
of Pulmonary Vascular Tone I
4:15pm - 6:15pm
TOPIC SYMPOSIA
Pediatric
AIDS: Global Challenges
Chair: Mark W. Kline, Baylor College of Medicine, Houston, TX
This symposium will provide a broad overview of the state of the pediatric AIDS pandemic. The results of recent trials investigating approaches to prevention and treatment of vertical HIV transmission in the developing world will be discussed. Collaborative approaches and opportunities for partnership in international pediatric AIDS treatment, education, and research will be highlighted.
Pediatric AIDS: State of the Pandemic
Meg Gwynne Ferris, Baylor College of Medicine, Houston, TX
Approaches to Prevention of Mother-to-Child HIV
Transmission in the Developing World
Lynne M. Mofenson, National Institute of Child Health and Human
Development, Rockville, MD
Collaborative Approaches to International AIDS
Training and Research
Kenneth Bridbord, Fogarty International Center, National Institutes of
Health, Bethesda, MD
Models of Partnership in Pediatric AIDS Treatment,
Education and Clinical Research: Romania and Botswana
Mark W. Kline, Baylor College of Medicine, Houston, TX
Sponsored Jointly with the Pediatric Infectious Diseases Society
Vascular
Development and Antiangiogenic Strategies for Cancer Treatment
Chair: James Bristow, University of California, San Francisco, CA
It has long been hypothesized that tumor expansion is dependent on the growth of new blood vessels. Recently, a new understanding of the molecular mechanisms of vascular development and growth has been achieved and has suggested new targets for cancer treatment. This program will clarify the role of novel growth factors in vascular development and tumor growth and review the novel strategies currently being developed to interfere with tumor growth.
Cellular Interactions During Vascular Development
Patricia D’Amore, Schepens Eye Research Institute, Boston, MA
Angiopoietins and the Regulation of Vascular Growth
Jocelyn Holash, Regeneron Pharmaceuticals, Tarrytown, NY
Tumor Microvasculature
Lance Munn, Massachusetts General Hospital, Boston, MA
Antiangiogenic Strategies for Cancer Treatment
<<to be determined>>
5:00pm - 6:00pm
APA BUSINESS MEETING & AWARDS
Health Care Delivery Award
Ray E. Helfer Award for Innovation in Pediatric Education
International Health Research Award
Ludwig-Seidel Award
Public Policy Award
Research Award
Teaching Award
Evening
APS MEMBER DINNER IN
HONOR OF THE HOWLAND AWARD RECIPIENT
By Invitation - APS Members
Only
Evening
APA BOARD/AWARDEES DINNER
Schedules for:
Saturday, 4/28
Monday, 4/30
Tuesday,
5/1
Schedule-at-a-Glance
Affiliated Societies and Club Schedules
Last Modified: September 26, 2006