Paws to Care: Implementation of a Novel Medical Dog Office Hours Program to Foster Pediatric Health Care Staff Resilience and Joy.

Burnout and resiliency are significant challenges among health care workers. Animal-assisted therapy (AAT) has shown to improve patient-level outcomes; however, AAT research involving hospital staff is limited. Our novel Medical Dog ("MD") Office Hours Program aimed to provide support to pediatric hospital staff and explore the program's impact on burnout.

Engage, Develop, Learn: a pilot randomized clinical trial to test if a mobile application can enhance home support for early cognitive development among children living in poverty.

Background: Mobile applications (apps) exist to promote early child development; however, few studies have examined use of these apps among low-income families. Our objectives were to measure engagement with the Engage, Develop, Learn (EDL) app and determine if it promoted engagement and behavior change among low-income caregivers.

Methods: We conducted a pilot study among English and Spanish-speaking, low-income families with children ages 12 to 15 months who received either the EDL app or injury prevention text messages.

A randomized controlled field trial of iBsafe-a novel child safety game app.

Background: Injury is a leading cause of child morbidity and mortality worldwide. Delivering injury prevention programs via mobile platforms, such as applications (apps), may reduce risky behaviors. iBsafe is an "interactive Bike and Bite safety" mobile game app founded in behavioral theory and designed to educate kindergarten-aged children about bicycle and dog-related safety.

Secondhand smoke exposure, illness severity, and resource utilization in pediatric emergency department patients with respiratory illnesses.

Objective: Hospital-based data reveal that children who have secondhand smoke exposure (SHSe) experience severe respiratory illnesses and greater resource utilization. Our objective was to assess the relationship between SHSe and illness severity/resource utilization among children presenting to the pediatric emergency department (PED) with three common respiratory conditions-asthma, bronchiolitis, and pneumonia.

Methods: A retrospective review of a yearlong consecutive sample of PED patients with SHSe status documentation and asthma, bronchiolitis, or pneumonia diagnoses was performed.

Tobacco Smoke Exposure-Related Illnesses Among Pediatric Emergency Department Patients.

Introduction: This study aimed to determine the relationship between patients presenting to the pediatric emergency department (PED) and potential tobacco smoke exposure (TSE)-related illnesses.

Methods: A retrospective review of electronic medical records of pediatric emergency department patients (N = 116,084) was conducted. Sociodemographic characteristics, TSE-related illnesses, and TSE documentation were extracted.

Assessment of tobacco smoke exposure in the pediatric emergency department.

Objective: Tobacco smoke exposure causes significant childhood morbidity and is associated with a multitude of conditions. National organizations recommend tobacco smoke exposure screening at all pediatric clinical encounters. Data regarding tobacco smoke exposure screening in the pediatric emergency department is sparse, although children with tobacco smoke exposure-associated conditions commonly present to this setting.

Serum Cardiac Troponin I in the Evaluation of Nonaccidental Trauma.

Objective: To determine if troponin I is more often elevated in children with suspected nonaccidental trauma (NAT) compared with uninjured children of similar age, and describe associations between troponin I elevation and NAT injuries.

Study Design: Prospective 2-group study of children less than 2 years of age presenting to the emergency department with nonaccidental abdominal, thoracic, or intracranial injuries, and similarly aged uninjured children. Primary outcome was serum troponin I (≥ 0.

Patient flow analysis in resource-limited settings: a practical tutorial and case study.

Patient flow analysis (PFA), a simple quality improvement tool to identify patient flow patterns, can be used in resource-limited settings to inform service delivery improvements. A PFA at a Ghanaian hospital found that personnel constraints and a mismatch between staffing and patient arrival surges led to long wait and total attendance times. The median time from arrival to first-provider contact was 4.

Using discrete event computer simulation to improve patient flow in a Ghanaian acute care hospital.

Objectives: Crowding and limited resources have increased the strain on acute care facilities and emergency departments worldwide. These problems are particularly prevalent in developing countries. Discrete event simulation is a computer-based tool that can be used to estimate how changes to complex health care delivery systems such as emergency departments will affect operational performance.

Development of iBsafe: A Collaborative, Theory-based Approach to Creating a Mobile Game Application for Child Safety.

Unintentional injury is a leading cause of death worldwide, and the number one cause of child death in the United States. The American Academy of Pediatrics promotes safety recommendations to decrease child injury risk, however the majority of educational programs delivering these strategies are school-based or in community campaigns. Mobile technology provides an opportune platform to deliver pediatric injury prevention programs given its massive global reach and underrepresentation within the current mobile health market.

An evaluation of a dog bite prevention intervention in the pediatric emergency department.

Background: This study aimed to determine the efficacy of a video-based dog bite prevention intervention at increasing child knowledge and describe any associated factors and to assess the acceptability of providing this intervention in a pediatric emergency department (PED).

Methods: This cross-sectional, quasi-experimental study enrolled a convenience sample of 5-year-old to 9-year-old patients and their parents, presenting to a PED with nonurgent complaints or dog bites. Children completed a 14-point simulated scenario test used to measure knowledge about safe dog interactions before and after a video intervention.

Parental tobacco screening and counseling in the pediatric emergency department: practitioners' attitudes, perceived barriers, and suggestions for implementation and maintenance.

Introduction: The pediatric emergency department (PED) is a venue that underuses parental tobacco screening and brief cessation counseling. We sought to explore PED practitioners' attitudes and perceived barriers regarding the implementation and adoption of tobacco screening/cessation counseling of parental smokers in the PED setting, as well as to solicit suggestions for improving the sustainability and maintenance of such practices.

Methods: We conducted an exploratory, qualitative study of a convenience sample of PED practitioners using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework.

Global health opportunities within pediatric subspecialty fellowship training programs: surveying the virtual landscape.

Background: There is growing interest in global health among medical trainees. Medical schools and residencies are responding to this trend by offering global health opportunities within their programs. Among United States (US) graduating pediatric residents, 40% choose to subspecialize after residency training.

Pediatric dog bite victims: a need for a continuum of care.

The authors assessed the ongoing needs of 34 pediatric dog bite victims and their families 1 month after receiving care in a pediatric emergency department. More than 70% of the parents noted at least 1 new concerning behavior in their children, and more than 85% of the parents also endorsed concerns about their own reactions. Half of the parents believed that children, in general, might benefit from interventions to help with postbite fears and nearly three quarters felt that families would benefit from education regarding dog bite prevention.

Dog bite prevention: an assessment of child knowledge.

Objectives: To determine what children know about preventing dog bites and to identify parental desires for dog bite prevention education.

Study Design: This cross-sectional study sampled 5- to 15-year-olds and their parents/guardians presenting to a pediatric emergency department with nonurgent complaints or dog bites. The parent/guardian-child pairs completed surveys and knowledge-based simulated scenario tests developed on the basis of American Academy of Pediatrics and Centers for Disease Control and Prevention dog bite prevention recommendations.

Infantile-onset Pompe disease: a diagnosis not to miss.

Pompe disease is a rare genetic disorder that affects glycogen and lysosome storage secondary to a deficiency in the enzyme that breaks down glycogen (acid alpha-glucosidase). With such deficiency, glycogen buildup occurs within lysosomes and cells, causing dysfunction of several organ systems (typically skeletal and respiratory muscles). Within this disease, the spectrum of severity is attributed to the differing amounts of enzyme deficiency.