Seminars

The intensity and distribution of esophageal eosinophilia in children with eosinophilic esophagitis and seasonal allergic rhinitis

Dr. Dalal Behbehani, PGY2

Supervisor: Dr. Mary Sherlock

This presentation will discuss a work in progress retrospective chart review project on the intensity and distribution of esophageal eosinophilia in children newly diagnosed with eosinophilic esophagitis and a known history of seasonal allergic rhinitis.

Objectives:

1. Understanding the definition and clinical diagnosis of eosinophilic esophagitis EoE in children
2. Understanding the diagnosis of seasonal allergic rhinitis in children
3. Exploring a possible correlation of seasonal allergic rhinitis and the intensity and distribution of esophageal eosinophilia in EoE

Intravenous Ketorolac Vs. Morphine In Children Presenting With Suspected Appendicitis: A Pilot Single Center Non Inferiority Randomised Controlled Trial KETO-APP STUDY

Dr. Mohamed Eltorki | Assistant Professor, Division of Pediatric Emergency Medicine, Department of Pediatrics, McMaster University

Children presenting to the Emergency Department with suspected appendicitis often have moderate to severe abdominal pain. Our study will explore the feasibility of a larger trial to determine if intravenous ketorolac is non-inferior to intravenous morphine for treatment of pain.

This session will review the following:

-Current analgesic used for patients with suspected appendicitis and practice variation across Canadian sites
-Prior evidence comparing ketorolac vs. morphine
-Design of a feasibility trial

Sexual Health Assessments of at Risk Pediatric Patients by Residents: An Educational Intervention

Dr. Rosalind Bihun, PGY2

Supervisor: Dr. Allison Rodrigues

My resident research project aims to compare the ability of pediatric residents to perform full sexual health assessments before and after an educational intervention. We hope to deliver an online module on sexual health history taking and appropriate STI screening to residents. A retrospective chart review assessing sexual health assessments in adolescents will then be completed to see the impact of this intervention.

Objectives:

1. To elicit feedback regarding the methodology of this research project.
2. To collect suggestions regarding the most effective delivery of educational interventions.

Safety and Efficacy of Anticoagulation Therapy in Children with Solid Tumours and Lymphomas at Risk of Thrombocytopenia: A Retrospective Study

Dr. Bishal Harry, PGY2

Supervisors: Drs. Mihir Bhatt & Uma Athale

This project assesses the safety and efficacy of McMaster’s anticoagulation therapy protocol for children with solid tumours and lymphomas.

Objectives:

1. To explore the importance and complications of anticoagulation strategies in childhood tumours and lymphomas.
2. To discuss quantitative analysis of the safety and efficacy of McMaster’s current anticoagulation protocol in managing thrombosis in pediatric cancer patients. 

Controversies about treatment 3-4.5 hours after acute stroke: Lessons from the ECASS III trial re-analysis in the pursuit of the truth, and the implications for practice guidelines

Dr. Lehana Thabane

Stroke is a devastating disease with over 400,000 Canadians living with the effects of stroke. Alteplase is one of the thrombolytic medications by the FDA, Health Canada, and other regulators for early treatment for stroke within 3 hrs of symptom onset based on the NINDS-II trial. Beyond 3 hrs, the evidence is mixed. The ECASS III was the only trial that showed significant benefit at 3-4.5 hrs from symptom onset; but it also showed an increase in harm. However, Alteplase is widely used in practice because of the “strong” recommendations by many national clinical guidelines. One of the key criticisms for the ECASS III trial results was that the significant result of benefit was not adjusted for baseline imbalance on some key prognostic factors. We re-analysed the original ECASS III data adjusting for key baseline imbalances using multiple methods. Our findings show no significant benefits and continue to find significant risks with alteplase 3–4.5 hours after stroke. In this talk, I will share some key lessons from the ECASS III re-analysis on how to use the scientific method in the pursuit of truth, and the implications for clinical practice guidelines. 

TRansition US Together (TRUST) Study: A Parent-Centered Educational Toolkit to Support their Adolescents with JIA and cSLE as they Transition to Adult Care

Dr. Molly Dushnicky, PGY2

Supervisor: Dr. Michelle Batthish

The transition from pediatric to adult care is a difficult, and potentially dangerous, period of time for youth with chronic disease. Our pediatric rheumatology clinic, among other clinics, have initiated adolescent-directed tools and strategies to support this transition. However, to date, there are limited resources to support parents in helping their youth through this process. The TRUST study will implement a “Parent Toolkit” to the transition process in pediatric rheumatology and assess it’s efficacy in development of Transition Readiness.

Objectives:

1. Understanding of the challenges of the healthcare transition from pediatric to adult care
2. Understand the role of the parent/caregiver in supporting their youth through this process

Assessing social histories in Pediatric inpatient population during COVID-19

Dr. Nina Mazze, PGY2

Supervisor: Dr. Kristin Inch

To discuss the components and importance of social histories in general pediatrics. To discuss an approach to assessing social histories in our general pediatrics inpatient population. To identify areas of improvement to optimize patient advocacy and our understanding of the social determinants of health.

Objectives:

1. To develop a further understanding of the components and importance of social histories in general pediatrics
2. To discuss research methodology for retrospective chart reviews

Use of professional interpreters at McMaster Children’s Hospital

Dr. Hannah Kraicer-Melamed, PGY2

Supervisor: Dr. Kristin Inch

We will be presenting an overview of our plan and methodology for a pilot project entitled “Use of professional interpreters at McMaster Children’s Hospital”. Despite strong evidence for the use of professional interpreters for families with limited comfort in English, the literature states that this service is widely underused by healthcare practitioners for a variety of reasons. This project will assess the frequency and adequacy of professional interpreter use for families with limited comfort in English during admission at McMaster Children’s Hospital. It aims to serve as an initial pilot study for future work and a baseline for future interventions.

Session Objectives:

1. Advise on methods to increase survey uptake and participation
2. Comment on our plan for “rapid interpretation” of survey and consent
3. Discuss our crude definition of “adequacy” in interpreter use and limitations of use

Preparing to Define your Future: A PostDoctoral Fellow’s journey through the Department of Pediatrics

Dr. Patrick McPhee, PhD

Supervisors: Drs. Timmons, Gorter, Morrison

In this presentation I will share my successes and challenges working through a postdoctoral fellowship in the Department of Pediatrics. I will provide an overview of my research as a Postdoctoral Fellow (PDF), discuss how to negotiate roles and responsibilities as a PDF, and share strategies to strengthen your position for a career in Academia. Throughout the presentation I will share lessons learned from working with Faculty in the Department of Pediatrics.

Objectives:

1. To understand the roles and responsibilities of a PDF in the Department of Pediatrics
2. To learn how to define and achieve your own goals as a PDF
3. To understand how to balance your research, career aspirations, and personal life as a PDF

A national training program: How are researchers and families partnering together to build capacity in family engagement in research?

Dr. Andrea Cross, PhD

Supervisor: Dr. Jan Willem Gorter

Internationally, it is now recognized that health services research benefits from meaningful stakeholder involvement. However, how stakeholders (e.g., patients and families) are engaged in research is not self-evident and the demand for such roles has not kept pace with the need for appropriate training. In this presentation, I will share evidence and experiences of researchers and families in a national online training program: ‘Family Engagement in Research Certificate of Completion Program’, run in partnership by Kids Brain Health Network, CanChild Centre for Childhood Disability Research, and McMaster Centre for Continuing Education. The program is unique in that it brings families together with researchers in order to enhance knowledge and skills surrounding family engagement in research and to build a trusted community for leadership, mentorship and collaboration.

Objectives:

1. Build awareness of the value of training in family engagement in research
2. Identify tools and strategies for supporting meaningful family engagement throughout the research process

Gauging reflective practice in pediatric residency candidates through an MMI station

Dr. Spencer van Mil, PGY2

Supervisor: Dr. Quang Ngo

We used an MMI station during the CaRMS 2019 cycle to challenges candidates to demonstrate their ability to engage in reflective practices and self-assessment. We are now validating the station using Messick’s framework. Further, do the results of these stations have any predictive value for future performance and reflective practices as a pediatric resident?

Objective:

To validate an MMI station intended to identify candidates with poor reflective practices.

Retrospective Case Audit of the QTc Prolonging Effects of Domperidone in Children

Dr. Omar Taibah, PGY3

Supervisor: Dr. Tapas Mondal

This project is a retrospective chart review of ECGs in cases involving the prescription of domperidone for GERD over a period of 6 months to evaluate the effects of the medication on the QTc interval.

Objectives of the presentation:

1. Receive feedback on the study design and hypothesis.
2. Explore ideas for further outcomes to study.
3. Discuss the current practice of obtaining ECGs when prescribing domperidone.

Pediatric post-intensive care syndrome (PICS-p): A national survey of clinicians’ knowledge and perceptions

Dr. David Zorko, PGY5, Clinician Investigator Program

Supervisor: Dr. Karen Choong

Improvements in the care provided in Pediatric Intensive Care Units over the past two decades have resulted in more children surviving critical illness. However, this increased survival has been accompanied with new and persistent physical, psychological, and social morbidities impacting survivorship after critical illness. Collectively, these morbidities are known as pediatric post-intensive care syndrome (PICS-p). The objective of this national survey is to describe Canadian clinicians’ knowledge and perceptions of PICS-p, the long-term sequelae faced by children and families who survive critical illness, and the current resources in place to identify and manage the sequelae.

Objectives:

1. To highlight the importance of post-intensive care syndrome in pediatrics.
2. To review the rationale and proposed methodology for this survey study.
3. To provide feedback on study progress to date, including survey development.

Applying spaced repetition and test-enhanced learning to reinforce a pediatrics academic half day curriculum: A qualitative analysis

Dr. Gurdeep Singh, PGY2

Supervisor: Dr. Quang Ngo

Academic Half Day is a mandatory part of the resident curriculum in which residents receive didactic teaching on various pediatric topics. Our study intervention will utilize the principles of spaced repetition, test enhanced learning, and gamification to improve the overall AHD experience for residents. We will use qualitative methods to explore resident insights and experiences throughout the study, including quarterly focus groups.

Objectives:

1. To review the pedagogical principles of spaced repetition and test enhanced learning.
2. To discuss and refine methodology of qualitative data collection.
3. To review the analysis plan for qualitative data.