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8 Ways You Can Support Families in Need of Behavioral Health Services
 8 Ways You Can Support Families in Need of Behavioral Health Services 150 150 Nancy Cunningham, PsyD
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Long wait times and difficulties accessing behavioral health services cause stress for many patients and families. As awareness grows about the prevalence of behavioral health challenges for children and adolescents, more patients and families are seeking specialized care. However, due to a shortage of behavioral health specialists, wait times can seem daunting. As the pediatrician,…

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

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

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

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
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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
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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…

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

Managing Depression, Anxiety and Other Behavioral Health Issues in Primary Care
 Managing Depression, Anxiety and Other Behavioral Health Issues in Primary Care 1024 575 Rachael Hardison
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Teen girl with backpack

An estimated 20 percent of children struggle with mental health illness. As awareness grows, the call for primary care physicians to play a leading role in care grows louder. One in five children will struggle with a mental health illness by the age of 12, but a recent survey by the American Academy of Pediatrics…

Inside the Good Manufacturing Production Facility
 Inside the Good Manufacturing Production Facility 1024 575 Tiasha Letostak, PhD
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By removing a barrier to access – production of pharmaceutical products for clinical trial – the team at the GMP facility is bringing more treatments to rare diseases. A newly designed, 7,500 square foot clean room suite with multi-use viral vector and cell therapy capabilities is expediting the bench-to-bedside process of bringing life-saving treatments to…

Neurosurgery May Provide Lasting Relief From Spasticity
 Neurosurgery May Provide Lasting Relief From Spasticity 1024 575 Abbie Miller
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Selective dorsal rhizotomy can provide life-changing results, but patients work hard in physical and occupational therapy to get there. When Sushma Manjunatha watches her daughter sleep, she sees something new. Instead of being tightly curled up, with legs pulled in, her daughter’s legs are stretched out, finally relaxed. This change is the result of a…

In Sight: Three Procedures, One Surgery
 In Sight: Three Procedures, One Surgery 388 320 Jeb Phillips
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Colorectal Surgery, Urology and Gynecology coordinate to save tissue and time. A child with a complex colorectal and pelvic condition may require several surgeries over months or years before they are able to successfully manage their urine and stool. With advance planning and coordination it can be possible to treat many issues at once and…

A Narrow Focus: Perfecting Tissue Engineered Vascular Grafts
 A Narrow Focus: Perfecting Tissue Engineered Vascular Grafts 1024 575 Abbie Miller
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image of heart with fontan conduit highlighted

A pair of surgeon-researchers is perfecting tissue engineered vascular grafts through bench, clinical and computational modeling studies.

Intervention for Medically Complex Children Improves Health, Saves Money
 Intervention for Medically Complex Children Improves Health, Saves Money 800 533 Kevin Mayhood
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The population-based program features coordinated care, education and feeding tube management. A population-based intervention for children with medical complexity in central and southeast Ohio led to fewer admissions, shorter hospital stays and a reduction of inpatient charges of nearly $11.8 million over 30 months, all while making children healthier. Nationwide Children’s Hospital and its affiliated…

The Equity Equation
 The Equity Equation 1024 575 Deena Chisolm, PhD
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Deena J. Chisolm, PhD, director of the Center for Population Health and Equity Research at Nationwide Children’s Hospital, applies a health equity approach to improving infant mortality outcomes. Health care quality and outcomes differ by race, ethnicity, wealth and place of residence. In fact, we know that health outcomes such as life expectancy, health-related quality…

Discovery to Drug Development: Expanding the Role of Academic Centers
 Discovery to Drug Development: Expanding the Role of Academic Centers 1024 575 Abbie Miller
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As more researchers at academic centers become involved in drug development, institutions are responding with support and guidance. Researchers at academic institutions regularly make discoveries about disease processes and potential therapeutic agents. Translational medicine is focused on moving these discoveries out of the laboratory and into the clinic where they can potentially help patients. But…

How to Solve Feeding Disorders Without a G-Tube
 How to Solve Feeding Disorders Without a G-Tube 1024 575 Jeb Phillips
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Babies in a neonatal intensive care unit must have a safe way of receiving nutrition in order to go home. Full oral feeding is ideal, of course. But for those patients with persistent difficulty feeding by mouth, there were two primary options before 2002 to guarantee nutrients by the time of discharge. Both had their…

Human Trafficking: How many victims have you treated?
 Human Trafficking: How many victims have you treated? 1024 575 Abbie Miller
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Data shows that health care providers may be coming into contact with victims and those at risk with more frequency than expected. How many victims have you treated? The answer is probably higher than you think. According to a report published in the Annals of Health Law, 88 percent of sex trafficking survivors reported contact with…

Changes to Medicaid: The Health of 30 Million Children at Risk
 Changes to Medicaid: The Health of 30 Million Children at Risk 150 150 Steve Allen, MD
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If we care about children in our city, in our state and in our country, we must care about what happens to Medicaid. Medicaid is critical to the health of our children. That is why those of us in pediatrics are so concerned about the recently proposed American Health Care Act. The proposal, in effect,…

Stronger Together: A Multi-institutional Database Is Connecting Down Syndrome Clinics for Better Outcomes
 Stronger Together: A Multi-institutional Database Is Connecting Down Syndrome Clinics for Better Outcomes 1024 575 Stephanie Santoro, MD
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Due to medical advances, people with Down syndrome are living longer than ever before. This increased life expectancy has nearly doubled in the past 25 years. The National Down Syndrome Society estimates that 400,000 people with Down syndrome are living in the United States. Despite this increased life expectancy, little current information on the secondary…

Pediatricians and Subspecialists May Need to Up Their ADHD Game
 Pediatricians and Subspecialists May Need to Up Their ADHD Game 150 150 Kevin Mayhood
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From sixth to eighth grade, Stacy Gibson sought out kids he knew had attention-deficit/hyperactivity disorder and bought their Ritalin or Adderall, sometimes by the handful. “I would party all night,then I’d take the pills to get through class. It gave me a rush of energy that I needed,” says Gibson, now 32 and in his…

How Can We Increase the HPV Vaccination Rate?
 How Can We Increase the HPV Vaccination Rate? 150 150 Michael T. Brady, MD
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Cancer is a terrifying diagnosis for a patient to receive or a doctor to give. So it would make sense that a vaccine proven to prevent cancer would be welcomed by everyone. The human papillomavirus (HPV) vaccine could prevent 28,500 HPV-related cancer cases – cervical, vaginal, vulvar, anal, rectal, penile and oropharyngeal – each year. The Centers…

In Sight: Two Stage Surgery for Epilepsy
 In Sight: Two Stage Surgery for Epilepsy 150 150 Abbie Miller
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Surgery proves to be a viable option for patients with medically refractory epilepsy. Childhood onset epilepsy affects 1 percent of children worldwide. About 25 to 30 percent of these patients will have medically refractory epilepsy, continuing to have seizures despite using two or more antiseizure medications. Options for this group of patients include intercranial epilepsy surgery, Vagus…

A Better Approach to Prescribing Medication
 A Better Approach to Prescribing Medication 150 150 Jeb Phillips
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A small change in the way a doctor prescribes a medication can make a big difference. Officials from the accountable care organization Partners For Kids use this example all the time: Abilify, a behavioral health drug, is usually priced per pill, not by strength of dose. Two 5 mg pills cost nearly twice the amount of…

Best Practices for Research Recruitment and Retention
 Best Practices for Research Recruitment and Retention 1024 575 Tiasha Letostak, PhD
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You can’t obtain study data without participants. From initial design and promotion to communication tactics and patient satisfaction, here are some strategies to ensure success. Advancing pediatric research depends on successful recruitment and retention of study participants. Unfortunately, 9 out of 10 trials end up having to double their original timelines in order to meet…

Childhood Kidney Stones: Their Surprising Connection to Future Disease
 Childhood Kidney Stones: Their Surprising Connection to Future Disease 150 150 Jeb Phillips
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Once thought to be an adult condition, urinary stone disease is increasingly found in children – and may be related to the development of cardiovascular disease, chronic kidney disease and low bone density. By one well-regarded estimate, the risk of developing urinary stone disease in childhood doubled between 1997 and 2012. That’s worrying enough on…

Harnessing the Immune System: Has the Cure for Cancer Been Within Us All Along?
 Harnessing the Immune System: Has the Cure for Cancer Been Within Us All Along? 1024 575 Abbie Miller
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By learning to manipulate the immune system to target cancer cells, clinician-scientists are ushering in a new era in cancer treatments. The advances in cancer immunotherapy have been headline-making, and some clinical studies have produced stories of near-miraculous recoveries. From the immunotherapy drug credited with curing former president Jimmy Carter’s cancer (pembrolizumab) to the promising…

Changing the Game: Virtual Reality Distracts From Pain, Transforming the Patient Experience
 Changing the Game: Virtual Reality Distracts From Pain, Transforming the Patient Experience 844 487 Gina Bericchia
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A first-of-its-kind virtual reality experience from the hemophilia team and design experts at Nationwide Children’s Hospital and The Ohio State University distracts patients with an immersive environment of penguins, pirates and hermit crabs during infusions and other procedures. A pilot study is testing the feasibility of integrating the virtual reality technology into the clinic setting.…

How Does Genomic Medicine Become a Reality for Children’s Health?
 How Does Genomic Medicine Become a Reality for Children’s Health? 1024 575 Jan Arthur
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conceptual art of DNA

Perhaps one of the most important initiatives to advance our understanding of pediatric disease is genomic analysis. Genomics encompasses all aspects of understanding the human genetic code, especially how genetic information contained in every human cell can be interpreted to prevent disease and customize treatments for nearly every type of illness. Genomic analysis allows us…

Long Acting Reversible Contraceptives: A First-Line Approach to Prevent Teen Pregnancy
 Long Acting Reversible Contraceptives: A First-Line Approach to Prevent Teen Pregnancy 150 150 Elise Berlan, MD, MPH
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Unplanned teen pregnancies remain a problem in American society. In the United States, 82 percent of teen pregnancies are unplanned, and the United States has the highest teenage pregnancy rate among high income nations. Despite being highly effective and safe, misconceptions around long acting reversible contraceptives (LARC), such as etonogestrel implants and intrauterine devices (IUDs),…

Uncovering Racial Disparities in Down Syndrome
 Uncovering Racial Disparities in Down Syndrome 1024 575 Stephanie Santoro, MD
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Life expectancy for people with Down syndrome varies depending on race, but why? An estimated 6000 infants with Down syndrome (DS) are born in the United States annually, making it the most common liveborn trisomy and chromosomal condition.[1] And a significant increase in overall life expectancy has been noted over the last several decades.[2] However,…

Creating the Patient-Centered Medical Neighborhood
 Creating the Patient-Centered Medical Neighborhood 1024 575 Tiasha Letostak, PhD
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How do we create a more integrated healthcare delivery system to improve outcomes in our community? The Agency for Healthcare Research and Quality (AHRQ) conceptualizes the medical neighborhood as a patient-centered medical home (PCMH) and the network of other clinicians providing health care services to patients within it, along with community and social service organizations, as well…

Using Social Media to Advance Care
 Using Social Media to Advance Care 150 150 Nationwide Children's
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As the use of social media has grown, so has the medical community’s understanding of how it can be harnessed for health care. From collaborating with peers and educating the public to building your career, physicians have a growing responsibility and growing presence in the social media arena. David R. Stukus, MD Section of Allergy…

Achieving CLARITY
 Achieving CLARITY 1024 575 Abbie Miller
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conceptual art of DNA

Multidisciplinary team from Nationwide Children’s wins international genomics competition. Accurate, patient-centered, comprehensive. That’s how the judges and leaders of the CLARITY Undiagnosed Challenge described the work of a team from Nationwide Children’s Hospital. Those same words could be used to describe the highly motivated and diverse team who surprised themselves by winning the challenge. “When we entered the challenge, we knew we would…

Simulating Surgery With High-Performance Computing
 Simulating Surgery With High-Performance Computing 1024 575 Abbie Miller
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By applying high-performance computing to the field of otolaryngology, a team of researchers is developing a simulation environment for teaching surgical techniques related to the temporal bone. The purpose of training — whether a fire drill or practicing a surgical technique — is to create successes and avoid failures. “The impact of training is safety…

The Smallest Victims of the Opioid Crisis
 The Smallest Victims of the Opioid Crisis 1024 575 Abbie Miller
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Black and white photo of infant crying in hospital

Research, protocols and community connections lead to help infants with neonatal abstinence syndrome and their mothers. It’s a sound you’d never forget. The panicked, high-pitched cry of a newborn withdrawing from the drugs his mother took. All the sensations that drive an addict to use again and again just for the relief – shaking, vomiting,…

The Journey to a Program Project Grant
 The Journey to a Program Project Grant 1024 575 Tiasha Letostak, PhD
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Recommendations from a multi-institutional research team who persevered to obtain a P01 to develop a vaccine for RSV. In 2015, the National Institute of Allergy and Infectious Diseases (NIAID) awarded a $6.75 million program project grant to Mark Peeples, PhD, Octavio Ramilo, MD, and M. Asuncion Mejias, MD, PhD, all principal investigators in the Center for Vaccines and Immunity at The Research Institute at Nationwide Children’s…

The Collapse of Biofilms?
 The Collapse of Biofilms? 1024 575 Jeb Phillips
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Illustration showing the precise pattern of a biofilm - a perfect, 3D matrix

Scientists are working to eliminate the causes of countless chronic and recurrent human infections. Before the discoveries that could lead to biofilm eradication, before the idea that he was even working on treatments for the bacterial communities that are crucial to most human infections, Steven Goodman, PhD, had a mystery on his hands. For nearly 15 years. Dr. Goodman, then a biochemist…

Taking Aim at the Opioid Problem
 Taking Aim at the Opioid Problem 1024 683 Abbie Miller
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open bottle of pills

Pediatric specialists offer practical advice for protecting vulnerable patients from a growing epidemic. The opioid epidemic in the United States is so widespread that even parents and teachers are now being issued opioid overdose kits complete with naloxone. It’s in rural communities, suburban neighborhoods and inner cities. It’s so far-reaching that physicians and non-experts alike are being called to work together…

Remote Control Treatment
 Remote Control Treatment 1024 575 Jeb Phillips
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Magnetic growing rods help patients who have early-onset scoliosis avoid repeated surgeries. A common surgical treatment for young children with severe early-onset scoliosis is the implantation of growing rods or expandable titanium ribs. The devices are lengthened as the child grows, helping to straighten the spine. Lengthening involves surgery under general anesthesia every six months. Magnetic Expansion Control (MAGEC)…

Omega-3 Supplements Tied to Notable, Sustained Mental Health Improvements
 Omega-3 Supplements Tied to Notable, Sustained Mental Health Improvements 150 150 Kevin Mayhood
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Case study shows reduction in bipolar youth’s psychotic mania, depression and anxiety Medications unchanged, a severely bipolar girl’s depressive, manic and psychotic symptoms improved significantly during the two years her mother added omega-3 supplements to her daily diet. The case, reported by researchers at Nationwide Children’s Hospital and Ohio State University Wexner Medical Center, is…

Can You Ration Health Care in a Just Society?
 Can You Ration Health Care in a Just Society? 150 150 Pedro Weisleder, MD, PhD
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How the Clinical Effectiveness Model enables the provision of uncompromised, yet fiscally responsible, medical care Health care costs in the United States are an unsustainable expense. In 2014, the United States’ gross domestic product (GDP) was about $17 trillion, and of that, close to $2.7 trillion was spent on health care. Per capita, we spend…

Better Care and Better Business
 Better Care and Better Business 150 150 Dave Ghose
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The changing economics of health care are forcing hospitals to find solutions that are good for patients and for the bottom line. A puzzled neonatologist approached Richard McClead, MD, after he spoke at a conference in Boston. It was 2010, and Dr. McClead just finished detailing a new initiative at Nationwide Children’s Hospital to reduce the…

InSight: Restoring Normal Habits
 InSight: Restoring Normal Habits 471 285 Tiasha Letostak, PhD
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SACRAL NERVE STIMULATION (SNS) is a new treatment that helps control urinary incontinence and fecal soiling. For some children, the nerves that control urination and bowel movements do not work correctly. The SNS unit consists of a small, safe battery and wire under the skin and sends signals to the sacral nerve. The signals help restore…

The Transfusion Evolution
 The Transfusion Evolution 576 367 Abbie Miller
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The first successful open heart surgery with cardiopulmonary bypass was performed in 1953, but it wasn’t until the 1970s that these surgeries began to have high success rates — due in large part to the availability of fresh whole blood transfusions. However, fresh whole blood is difficult to attain. In response, blood component transfusions became…

A Practical Guide to Beginning Clinical Research
 A Practical Guide to Beginning Clinical Research 150 150 Tiasha Letostak, PhD
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You wouldn’t travel to unknown destinations without a map or GPS, so why do clinical research without a plan? Here’s what you need to know to get started. Although the process for clinical research varies from institution to institution, the initial hurdles are often the same. From establishing clear protocols and outlining a detailed timeline…

Revealing the Secrets of Sepsis
 Revealing the Secrets of Sepsis 969 533 Abbie Miller
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Illustration of NK Cells, T Cells, other immune cells floating across white background

Charting new territory in the understanding of how the immune system responds to sepsis. Two children are admitted to the hospital with sepsis. Both receive antibiotics and fluid resuscitation within the critical first hour. Why does one get better after the initial crisis while the other goes on to develop additional infections and multiple organ…

Planning, Teamwork and Technology Essential to Conjoined Twins’ Separation
 Planning, Teamwork and Technology Essential to Conjoined Twins’ Separation 150 150 Abbie Miller
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In a meticulously planned 16-hour operation, a 30-person team from four specialties successfully separated 11-month-old twins conjoined at the buttocks and lower spine. Specialists from General Pediatric Surgery, Plastic and Reconstructive Surgery, Neurosurgery and Colorectal Surgery worked together to plan and execute a successful separation of conjoined twin girls, Acen and Apio, earlier this month. “In surgery,…

Treating Sickle Cell Disease in the United States
 Treating Sickle Cell Disease in the United States 1024 575 Abbie Miller
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While people with sickle cell disease have better outcomes in the United States and other Western countries, progress in treating the disease has been slow moving. Sickle cell disease is marked by painful sickle cell crises, in which sickle-shaped cells get distorted in the small vessels and cause problems including disrupting blood flow and a…

The Childhood Roots of Illness
 The Childhood Roots of Illness 1024 575 Dave Ghose
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Toddler playing with toys

A growing body of scientific evidence reveals the dramatic impact of early-life adversity on lifelong health. Kelly Kelleher, MD, compares childhood health to a boulder sitting on the peak of a mountain. A slight push could send the boulder in many directions. And once it starts rolling, it’s hard to change its path. The same…