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September 2017

The Evolution of Precision Medicine for Children With Aggressive Brain Tumors
The Evolution of Precision Medicine for Children With Aggressive Brain Tumors 150 150 Jonathan Finlay, MB, ChB, FRCP

The Head Start 4 clinical trial introduces risk stratification and builds on the success of bone marrow transplantation for young children with malignant embryonal tumors. Cancers in the brain and spinal cord (the central nervous system, CNS) are now the most common cause of deaths due to disease in children and adolescents. Among these tumors,…

A New Paradigm for Treating Transcription Factor-Driven Cancers
A New Paradigm for Treating Transcription Factor-Driven Cancers 150 150 Abbie Miller

Researchers describe how the association of the EWS/FLI transcription factor with GGAA-microsatellites drives Ewing sarcoma. In the current issue of Proceedings of the National Academy of Sciences, researchers from Nationwide Children’s Hospital describe a new paradigm for treating transcription factor-driven cancers. The study focuses on Ewing sarcoma and how the EWS/FLI transcription factor drives the malignancy…

Family Focus Restructures Single Ventricle Care
Family Focus Restructures Single Ventricle Care 150 150 Brianne Moore

Standardize, connected care in a multidisciplinary team environment aims to improve outcomes and quality of life for patients born with single ventricle heart anatomy. Children with single ventricle anatomy, one of the most harrowing of congenital heart defects, face unique challenges that require multiple procedures and hospital admissions to treat. In most institutions, each admittance…

Could Nutritional Supplements Impact Autism Symptoms in Toddlers Born Preterm?
Could Nutritional Supplements Impact Autism Symptoms in Toddlers Born Preterm? 150 150 Rachael Hardison

Supplementing with omega-3 and -6 fatty acids impacts language development in preterm toddlers at risk for developing autism. Delay in language development is often an early indicator in children at risk for developing autism spectrum disorder (ASD), yet clinicians are still trying to understand the best practices for how and when to implement early intervention…

6 Strategies for Incorporating Behavioral Economics in Your Practice
6 Strategies for Incorporating Behavioral Economics in Your Practice 150 150 Kevin Mayhood

Behavioral economics combines insights from psychology, economics and marketing to improve or direct decision-making. It can be used to “nudge” patients, their families and practitioners in the direction of better health if used by health care providers. While the use of behavioral economics strategies has limited study in pediatrics, the existing research indicates a number of…

“Impatient” Therapy: Physicians Too Aggressive in Treatment of ITP
“Impatient” Therapy: Physicians Too Aggressive in Treatment of ITP 150 150 Brianne Moore

Despite guidelines that advocate watching and waiting, physicians are still treating most patients with immune thrombocytopenia. When a child presents with easy bruising or bleeding, red skin spots and fatigue – symptoms similar to those for leukemia – families seek evaluation immediately. However, more often these cases are pediatric immune thrombocytopenia (ITP), an acquired disorder…

How to Improve Apparent Cause Analyses and Reduce Error Recurrence
How to Improve Apparent Cause Analyses and Reduce Error Recurrence 150 150 Brianne Moore

A quality improvement team embarks on a project focused on the accuracy of future quality improvement initiatives. An apparent cause analysis (ACA) is a process used to investigate the cause or causes of a medium or low-risk safety event. Designed as a quality improvement measure, ACAs are used to explain in detail why an issue…

Bouncing Back: Overcoming Physician Burnout With Resilience
Bouncing Back: Overcoming Physician Burnout With Resilience 1024 575 Suzanne Reed, MD and John Mahan, MD

Physician burnout is becoming increasingly recognized as an extensive and debilitating reality. Present in specialties across the spectrum of medicine, most disciplines report burnout rates of 50 to 60 percent or more, and these rates have been increasing over the last several years. Pediatrics alone demonstrated a more than 16 percent increase in burnout, up…

Children With Autism and Abdominal Pain Have Distinctive Bacterial Profiles
Children With Autism and Abdominal Pain Have Distinctive Bacterial Profiles 150 150 Kevin Mayhood

The microbiome may harbor causes of abdominal and behavioral issues and potential targets for relief. Children with autism spectrum disorder (ASD) and functional abdominal pain may have a distinct microbiome-neuroimmune profile compared to kids with gastrointestinal disorders (GI) and those with no GI illness. Building on others’ research showing that Clostridia bacteria in the gut are altered…

Can Behavioral Economics Help People Adopt Better Health Habits?
Can Behavioral Economics Help People Adopt Better Health Habits? 150 150 Kevin Mayhood

Simple incentives may nudge patients, caregivers and clinicians to make more healthful choices. Behavioral economics has helped electricity customers cut down on usage, new employees to start setting aside money for retirement from day one and, more recently, to change health care provider and patient behaviors. The practice combines insights from psychology, economics and marketing…

Combining Quality Measures to Improve Surgical Outcomes
Combining Quality Measures to Improve Surgical Outcomes 150 150 Kevin Mayhood

Use a refined morbidity and mortality conference with a national database, a new study suggests. A pediatric surgery morbidity and mortality (M&M) conference that applies quality improvement practices borrowed from industry can be a significantly more effective tool for learning from mistakes and making corrections, researchers from Nationwide Children’s Hospital show in a new study.…

How to Reduce Unnecessary Antibiotic Use for UTI in Urgent Cares
How to Reduce Unnecessary Antibiotic Use for UTI in Urgent Cares 150 150 Jeb Phillips

A quality improvement project shows children with negative urine cultures take antibiotics they don’t need. Even before a urine culture confirms the diagnosis, urgent care physicians often prescribe antibiotics when children present with symptoms of urinary tract infection (UTI). Early treatment is important for relief of symptoms and prevention of complications. But what if the…

Taking Innovation to Heart: Next Gen Interventions in Heart Valve Disease
Taking Innovation to Heart: Next Gen Interventions in Heart Valve Disease 1024 575 Abbie Miller

From bioengineers to interventional cardiologists, molecular biologists to cardiothoracic surgeons, experts with diverse backgrounds are focusing on the problem of heart valve disease in children. Heart valve disease affects more than 5 million Americans. And while acquired disease in the adult population certainly accounts for much of this, children with heart valve disease face multiple…

Creative Reality: Using a New Platform Technology to Improve Patient Experience
Creative Reality: Using a New Platform Technology to Improve Patient Experience 1024 575 Abbie Miller

Amy Dunn, MD, had a problem. Some of her patients in the hematology clinic at Nationwide Children’s Hospital receive hundreds of needle sticks each year. “Needle phobia is very real for these patients and their families,” says Dr. Dunn, director of Pediatric Hematology at Nationwide Children’s. “In some cases, ports need to be implanted so that these…

Emergency Departments Can Help Prevent Suicide
Emergency Departments Can Help Prevent Suicide 150 150 Brianne Moore

Secondary screenings, safety plans and phone follow-ups are key to reducing death by suicide. Suicide is the tenth leading cause of death in the United States and has increased in incidence 27 percent from 1999 to 2015. Interestingly, up to 40 percent of individuals who die by suicide visit an emergency department (ED) in the…

Mapping the Journey to Optimal Health for NICU Graduates
Mapping the Journey to Optimal Health for NICU Graduates 1024 683 Jeb Phillips

Babies born preterm need ongoing, specialized care to help them thrive after discharge from the hospital. Innovative programs are being designed to ensure that they get that care. In the early 1980s, only 10 percent of infants born before 28 weeks of gestational age survived to be discharged from the hospital. By 2015, 65 percent…

Integrating Research Into the “Journeys”
Integrating Research Into the “Journeys” 1024 683 Jeb Phillips

Along with their work to build an innovative follow-up program, Nationwide Children’s faculty and staff members are international leaders in NICU follow-up research. A number of foundation and National Institutes of Health-funded follow-up studies are housed entirely or in part at the hospital, and The Research Institute at Nationwide Children’s is one of 17 member…

Cannabidiol May Reduce Drug-Resistant Seizures by Half
Cannabidiol May Reduce Drug-Resistant Seizures by Half 150 150 Brianne Moore

Two studies demonstrate clinically significant response to oral liquid cannabidiol over placebo. Two recent studies – one published in The New England Journal of Medicine and one presented at the 2017 American Academy of Neurology annual meeting – indicate that a new plant-based, cannabis-derived treatment may be able to decrease the incidence of seizures in two complex…