In This Issue
Research Spotlight: CHOP-Led Research Reveals Disparities in Bystander CPR
CPCE In the News:
If you've got school aged kids, the time for vaccination is now
CPCE In the News:
US military families face challenges getting healthcare for kids
Upcoming Events
Recent Publications
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CHOP-Led Research Reveals Disparities in Bystander CPR
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A study published in the
Journal of the American Heart Association indicates that African American children from neighborhoods with lower socioeconomic characteristics who suffer from cardiac arrest are less likely to receive bystander CPR (BCPR), suggesting that targeted training in these neighborhoods may increase levels of BCPR and improve outcomes of out-of-hospital cardiac arrest (OHCA).
Maryam Y. Naim, MD from the CHOP Cardiac Center is the lead author of the study, with contributions from CPCE and HAU members
Heather Griffis,
Lihai Song, and
Joseph Rossano, along with colleagues from the CHOP Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Los Angeles, Emory University, Sky Ridge Medical Center, and University of Texas Health Science Center.
The team analyzed data from the Cardiac Arrest Registry to Enhance Survival (CARES) from 2013 – 2017 for OHCA patients aged 18 years or younger, and created an index for each cardiac arrest based on neighborhood characteristics (median income, unemployment percentage, percentage high school education, and predominant race).
Among their findings: BCPR was provided in 48% of arrests, was more common in white patients and more common for older children (aged 2 – 18 years). With respect to neighborhood characteristics, BCPR was more common in neighborhoods with higher income, lower unemployment, higher education levels, and predominantly white neighborhoods.
“As most bystander CPR is provided by family members, lower response rates are likely due to a lack of CPR training and recognition of cardiac arrests,” Dr. Naim said in a news release from the journal. Training new parents before release from the hospital or at pediatrician visits are potential opportunities.
For further reading:
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If you've got school-age kids, the time for vaccination is now
With the start of a new school year fast approaching, parents with children in the School District of Philadelphia should make sure their children are up to date on district vaccination requirements. CPCE Affiliate Faculty member and director of research for CHOP’s Vaccine Education Center
Kristen Feemster, MD, MPH, MSHP discussed the potential consequence of noncompliance. “It’s a requirement,” she said, “if the student doesn’t have everything they need, they may not be able to attend school until they’re up to date.”
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US military families face challenges getting healthcare for kids
In 2016, over 1.7 million children had a parent in the U.S. military, and many received insurance coverage through TRICARE—a health care program that supplies health insurance benefits to active and retired military members, as well as their families. In a new
Health Affairs study, our PolicyLab colleagues including
Doug Strane, MPH,
Meredith Matone, DrPH, MHS, and
David Rubin, MD, MSCE, found that families who receive insurance through TRICARE reported lower access to and quality of care than civilian families with public or private coverage.
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Upcoming Events
Youth Mental and Behavioral Summit
Date: September 24, 2019
Time: 9:00 AM - 4:00 PM
Location: Community Behavioral Health, 801 Market Street, 11th Floor
The summit is intended to to help equip providers and caretakers of youth to engage in a trauma-informed, community-based system of care by identifying and addressing youth mental and behavioral health needs. All physical and behavioral providers and caretakers of youth across multiple sectors are welcome to attend. This event is supported by a CHOP Cares Community Fund grant, the Department of Behavioral Health and Intellectual disAbility Services, and Philadelphia University + Thomas Jefferson University. Register
here.
Third Annual Integrative Health Symposium-From Pathogenesis to Salutogenesis: A Wellness Perspective for Patients and Their Healthcare Team
Date: September 27, 2019
Time: 8:00 AM - 4:00 PM
Location: Colket Translational Research Building
Salutogenesis is an approach that seeks to build on strengths and to support health in all the domains of a person’s life. In this one-day symposium, attendees will learn about salutogenesis and the relationship between stress, coping and health. Lectures will focus on how to manage provider stress and burnout and how to support a patient’s well-being through nutrition, mind-body techniques, positive psychology, trauma-informed care and other integrative modalities. Learn more and register
here.
Global Health in Our Own Backyard: Controversies, Initiatives, and Innovations for Our Local Underserved Populations
Date: October 4-5, 2019.
Location: Colket Translational Research Building
Registration is now open for the 11th Annual CHOP Global Health Conference "Global Health in Our Own Backyard." This Philadelphia-based Conference will explore the intersections between domestic, local and international global pediatric health to better reach the underserved here in the United States. We will take inspiration from innovative programs in the U.S. and from around the world, and think critically about how to apply both South-North and national lessons to provide better, more equitable care in the United States. For more information, click
here.
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Recent Publications
Despite professional recommendations that all residents should have end-of-life and palliative care skills, pediatric residents report inadequate training in some aspects of end-of-life (EOL) care, such as symptom management, communication, and self-care in dealing with grief. Insufficient training in EOL care can negatively impact residents, who report the death of their patients as one of the hardest components of residency. In order to quantify pediatric residents’ exposure to EOL care,
Chris Feudtner, MD, PhD, MPH,
Jennifer Walter, MD, PhD, and
Heather Griffis, PhD, with their team, identified and described all patient deaths that occurred in a 3 year period in one children’s hospital. They found that exposure to EOL care for these residents is limited but variable, and suggest designing resident support and education with this variability in mind.
Studies show that toxic metal exposure, including arsenic, may influence fetal growth resulting in higher infant mortality as well as chronic developmental and metabolic disorders among survivors. However, there are mixed findings regarding prenatal exposure as it relates to fetal growth. In this study, of which
Heather Burris, MD, MPH was a part, the effects of chronic low-level arsenic exposure and fetal growth were explored. The team found that higher maternal blood arsenic levels at delivery were associated with higher odds of both small for gestational age and large for gestational age.
There remains a disparity between female physicians and male physicians who successfully advance to the rank of professor. Although women make up a greater percentage of the academic and clinical workforce, this is not reflected in higher-level academic and clinical positions.
Hansel Otero, MD and others studied the gender distribution of academic pediatric radiology faculty members in the USA and Canada. Women were found to make up almost half the total academic pediatric radiology workforce, compared to the percentage of all pediatric radiologists who are women, which is 21%. Men continue to occupy more pediatric radiology faculty positions, and senior academic ranks.
There are 7 categories of juvenile idiopathic arthritis (JIA), including psoriatic arthritis (PsA). Juvenile PsA has a clinically diverse presentation, and little is known about the epidemiology of pediatric PsA. To address the gap in literature,
Tim Brandon, MPH
and
Pam Weiss, MD, MSCE
and a team of CHOP researchers sought to identify the overall risk of arthritis and the clinical features associated with the development of arthritis among children with psoriasis (PsO) and subsequent risk of inflammatory comorbidities. They found that most children with PsA first develop arthritis. PsA was associated with an increased risk of several clinically relevant inflammatory comorbidities.
For sexually active adolescents, the most effective form of pregnancy prevention is long acting reversible contraceptives (LARCs), although usage rates are low. The Affordable Care Act (ACA) mandated that insurers cover LARCs without cost sharing, but compliance with this policy is not well documented.
Aletha Akers, MD, MPH and
Nadia Dowshen, MD, MSHP, contributed to a study that assessed LARC coverage by insurers in a large pediatric health system. Of 37 plans analyzed, 57% were adherent and 43% were nonadherent, either because they required cost sharing, or because they did not offer LARC services at all. Nonadherence to the ACA amounts to a barrier to LARC access for adolescent patients at a high risk of unintended pregnancy.
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About CPCE
We are a pediatric research center dedicated to discovering and sharing knowledge about best practices in pediatric care by facilitating, organizing and centralizing the performance of clinical effectiveness research -- research aimed at understanding the best ways to prevent, diagnose and treat diseases in children. CPCE’s multidisciplinary team conducts research on a diverse range of clinical effectiveness topics.
CPCE E-News is edited by
Holly Burnside. Please feel free to contact us with questions or feedback.
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