Public Health

US News badges

For fifth year in a row, Children’s National Hospital nationally ranked a top 10 children’s hospital

US News badges

Children’s National Hospital in Washington, D.C., was ranked in the top 10 nationally in the U.S. News & World Report 2021-22 Best Children’s Hospitals annual rankings. This marks the fifth straight year Children’s National has made the Honor Roll list, which ranks the top 10 children’s hospitals nationwide. In addition, its neonatology program, which provides newborn intensive care, ranked No.1 among all children’s hospitals for the fifth year in a row.

For the eleventh straight year, Children’s National also ranked in all 10 specialty services, with seven specialties ranked in the top 10.

“It is always spectacular to be named one of the nation’s best children’s hospitals, but this year more than ever,” says Kurt Newman, M.D., president and CEO of Children’s National. “Every member of our organization helped us achieve this level of excellence, and they did it while sacrificing so much in order to help our country respond to and recover from the COVID-19 pandemic.”

“When choosing a hospital for a sick child, many parents want specialized expertise, convenience and caring medical professionals,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “The Best Children’s Hospitals rankings have always highlighted hospitals that excel in specialized care. As the pandemic continues to affect travel, finding high-quality care close to home has never been more important.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals. The rankings recognize the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News. The top 10 scorers are awarded a distinction called the Honor Roll.

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

Below are links to the seven Children’s National specialty services that U.S. News ranked in the top 10 nationally:

The other three specialties ranked among the top 50 were cardiology and heart surgerygastroenterology and gastro-intestinal surgery, and urology.

coronavirus

Children have more COVID-19 antibodies than previously thought, study finds

coronavirus

Seroprevalence of antibodies to SARS-CoV-2 in healthy children and children with chronic diseases is higher than researchers previously believed, according to a new study published in The Pediatric Infectious Diseases Journal. The study, which included 385 children in the Washington metropolitan area, found a 9.46% SARS-CoV-2 seroprevalence among this group. Researchers from Children’s National Hospital also identified predictive factors such as specific symptoms, race and ethnicity, that are associated with the antibodies’ presence in the blood, also known as seropositivity.

The 9.46% seroprevalence in healthy children and children with chronic diseases is higher than previously reported. However, this rate remains below the theoretical herd immunity threshold, estimated between 50% and 67% for the general population in the absence of any interventions — like vaccination — and assuming possible lasting immunity.

“We believe our estimate is a close approximation of seroprevalence for the diverse pediatric population in our region,” said the study authors, including Burak Bahar, M.D., lead author and director of Laboratory Informatics at Children’s National.

Since most symptomatic individuals are adults and they have been the main focus for seroprevalence studies, there is still a lack of information about SARS-CoV-2 seroprevalence for pediatric patients and healthy kids. With this study, researchers wanted to shed light on the knowledge gap in COVID-19 pediatric research.

“Parents are key allies who can help scientists better understand the virus’ behavior in children,” said Dr. Bahar.

Until now, it was also unknown if children with chronic diseases had less evidence of antibodies due to underlying conditions, particularly illnesses that cause weakened immune systems. The study showed no notable difference in the association with seropositivity among chronic illness groups, including immunocompromised children.

“Our findings offer important information as all children, with chronic illness or not, could be considered for ‘back to school’ transitions, because they have the same levels of protection. This means they all can have access to social, emotional and behavioral development,” said the authors.

The researchers explored co-existing conditions, symptomatology and demographics as predictors of antibody presence. The analysis showed that children with chronic conditions like asthma, diabetes and cancer were not predictors. This means that these sick kids, when introduced to the virus, make antibodies at the same levels as kids without these diseases.

While most participants were asymptomatic, in those who tested positive for anti-SARS-CoV-2 antibodies, fever, headache and cough were the most common symptoms.

Among the demographics, Hispanic children had a higher seropositive rate than white children. However, median household income based on reported zip code and state of residency were not found to be associated with having antibodies or not.

To determine the impact of continued infections in the community, future studies are needed to identify possible changes in the seroprevalence over a more extended period and to assess seropositivity with vaccination implementation, as that may influence the current rate.

The study is a snapshot in time from July to October 2020. The sample size of 385 patients included both healthy children and those with chronic diseases (69.7%) ranging from 2 months to 22 years old. From the sample pool, 38 individuals were found to have antibodies against SARS-CoV-2. To assess demographic characteristics, symptoms and co-existing conditions associated with seropositivity the researchers used a survey.

A related SARS-CoV-2 antibody production study published on Sept. 3, 2020 in the Journal of Pediatrics, also led by Bahar et al., found that antibodies are detected 18 days after a positive COVID-19 test in children. The authors further noted that the virus and antibodies can co-exist in young patients, so even if seropositivity is detected, they may still transmit the virus.

2021 residents

Incoming residency class at Children’s National three times more diverse than national average

2021 residents

The new class of residents arriving at Children’s National Hospital on June 9, will be the hospital’s most diverse class ever. 51% of the incoming intern class identify with races and ethnicities underrepresented in medicine (UIM) including Black, Latino and Southeast Asian, a percentage that is more than three times the national average for diversity within residency programs.

“We have worked hard to make our residency class more diverse because we know that diversity among academic pediatricians helps dismantle systemic health care inequities faced by children,” said Aisha Barber, M.D., M.Ed., director of the Pediatric Residency Program at Children’s National. “Studies show that when patients see someone they identify with, it enhances patient trust and satisfaction. Diversity within medical ranks has also been associated with improved health care outcomes for patients from underrepresented backgrounds.”

Children’s National created outreach and pipeline programs designed to reach a larger more diverse group of medical students and to increase diverse students’ interest in academic pediatrics at Children’s National. Program leaders reach out through various student medical association meetings, nationally and regionally.

In 2015, the hospital developed Advancing Diversity in Academic Pediatrics, a scholarship program for senior medical students from backgrounds UIM to experience what a career in academic pediatrics might look like for them. Since the start of the scholarship program, the diversity of incoming resident classes has grown from 12% to the current 51%.

“This scholarship program changed my career trajectory as it introduced me to the field of pediatric academic medicine,” said Jessica Hippolyte, M.D., M.P.H., pediatric chief resident at Children’s National and graduate of the scholarship program. “I was paired with minority resident and faculty mentors, networked with senior program leadership, received guidance on the application process and gained tremendous insight on all the opportunities available to Children’s National residents.”

Under the scholarship program, fourth year medical students are invited for a month-long clinical rotation and given a stipend funded by the CEO’s office at Children’s National. The program’s curriculum not only focuses on the clinical experience, but through relationships with mentors, focuses on the development of interview skills and the creation of a competitive curriculum vitae, or CV.

Since the program began, there have been over 70 participants and a 25% match rate to the pediatric residency program at Children’s National. Four members of the 2021 class are graduates of the scholarship program.

Every March, medical students learn which residency programs they will train with on what is known as ‘Match Day’. Children’s National receives over 2,000 applications per year for 41 residency positions. That’s more than half of medical student applications in the U.S. for pediatrics. Applicants were recruited from some of the top medical schools in the U.S. including the University of Pennsylvania, Columbia University, University of California, San Francisco and University of California, Los Angeles.

In addition to the increases in the racial and ethnic diversity of the incoming residents, at least 10% of the incoming class identify as LGBTQ, which mirrors the percentage of adults in D.C. who identify as LGBTQ.

“There are many factors that indicate to us that someone will make a great resident and a great doctor,” said Dr. Barber. “At Children’s National, we strive to be sure our residents understand that they’re appreciated not for how they add to diversity statistics, but for who they are as a whole person and all they have to contribute to our community.”

 

Screenshot of Drs. Northam, Newman and Batshaw

4th Annual Children’s National Hospital-NIAID Virtual Symposium

Screenshot of Drs. Northam, Newman and Batshaw

Keynote speaker Virginia Governor and pediatric neurologist, Ralph Northam, joined Dr. Kurt Newman, president and CEO of Children’s National Hospital, and Dr. Mark Batshaw, executive vice president, physician-in-chief and chief academic officer at Children’s National Hospital, during the 4th Annual Children’s National Hospital-NIAID Virtual Symposium.

Children’s National Hospital and the National Institute of Allergy and Infectious Diseases (NIAID) hosted their 4th annual symposium, attracting nationwide researchers, trainees and health care professionals to share updates on the COVID-19-related condition known as Multisystem Inflammatory Syndrome (MIS-C) in Children, allergy and immunology in the pediatric population.

“Children’s National relationship with the NIAID is a strategic and novel alliance that benefits children everywhere,” said Kurt Newman, M.D., President and CEO of Children’s National Hospital. “I’m so proud of our unique partnership and how it has enriched the high-quality research being conducted at Children’s National and enabled us to interact on pressing health issues. With the opening of our new Children’s National Research & Innovation Campus on the grounds of the former Walter Reed Army Medical Center, the sky is the limit to how we can work together with the NIAID to innovate for kids so that we help them grow up stronger.”

The discussions at the symposium centered around various topics, including clinical manifestations of SARS-CoV-2 in children, comparative disease biology manifestation in children and adults, therapies and vaccines in the pediatric setting, intersectionality of allergy, immunology and COVID-19, modulating biologic factors in immune regulation and treatments that invoke tolerance in allergy.

Keynote speaker Virginia Governor and pediatric neurologist, Ralph Northam, spoke about the COVID-19 pandemic and strategies to reintroduce children into schools and sports.

“Schools provide stability and structure. We know that children need to be in school for educational achievements and their mental health, but it has taken time to make school staff and families more comfortable with a greater time of in-person learning,” said Dr. Northam. “Our goal is to have all in-person learning this fall. That is where our children need to be because it is the safest place for children.”

During the keynote session, Dr. Northam also addressed the mental health issues related to the pandemic where pediatricians have seen an increase in depression and suicide rates.

“As we move forward to a back more normal life, we need to keep an eye on these children and make sure that they continue to get the support and treatment that they need,” said Dr. Northam.

Below are the speakers and the focus of their presentations.

  • Post-COVID cardiac manifestations in children: Anita Krishnan, M.D., Children’s National
  • Immunomodulation and Cytokine Profiling in MIS-C: Hemalatha Srinivasalu, M.D., Children’s National
  • The MUSIC study: Long-TerM OUtcomes After the Multisystem Inflammatory Syndrome in Children: Jane Newburger, M.D., Boston Children’s Hospital
  • MIS-C in Typical Cases and Down Syndrome: Dusan Bogunovic, M.D., Mount Sinai
  • Age-Related Virus-Specific T-Cell Responses to SARS-CoV-2: Susan Conway, M.D., Children’s National
  • Systems Immunology of COVID-19: Integrating Patient and Single Cell Variations: John Tsang, Ph.D., NIAID
  • Therapeutics for Children with COVID-19: Trying to be Data Driven in the Absence of Pediatric Trials: Andy Pavia, M.D., University of Utah
  • SARS-CoV-2 Vaccine Clinical Research: Alicia Widge, M.D., NIAID
  • Implementation and Public Health Aspects: Cara Biddle, M.D., M.P.H., Children’s National
  • COVID-19 and Pediatric Asthma: William Sheehan, M.D., Children’s National
  • The COVID-19 Pandemic and Immunodeficiency: The Burden and Emerging Evidence: Jessica Durkee-Shock, M.D., NIAID
  • SARS-CoV-2 Infection in Children with Cancer: The MSK Experience: Andy Kung, M.D., Memorial Sloan Kettering
  • Adaptive and Maladaptive Immunity to the Microbiota: Implication for Inflammatory Disorders: Yasmine Belkaid, M.D., NIAID
  • Deep Immune Profiling of Peanut Reactive CD4+ T-Cells Reveals Distinct Immunotypes Link to Clinical Outcome: Erik Wambre, M.D., Benaroya Research Institute
  • B Cells and Food Allergy: Not Just for Making IgE: Adora Lin, M.D., Ph.D., Children’s National
  • Emerging Biologic Therapies for Food Allergy: Hemant Sharma, M.D., Children’s National
  • The Promise and Limits of Allergen Immunotherapy: Carla Davis, M.D., Texas Children’s
  • Maternal Fetal Interactions in Food Tolerance: Michiko Oyoshi, M.D., Harvard Medical School

The Clinical and Translational Science Institute at Children’s National (CTSI-CN) and the NIAID organized the 4th annual symposium and wished to showcase some of the critical research being done on this worldwide infectious disease, particularly amongst the pediatric population and those affected with allergic and immunologic disease. By sharing this work, they hope it will help continue to drive the advancement of pediatric research in relation to this disease.

The research partnership between Children’s National and the National Institute of Allergy and Infectious Diseases (NIAID) is devoted to protecting and advancing the health of children with allergic, immunologic, autoinflammatory and infectious diseases through collaborative research and education. The partnership co-hosts an annual symposium to disseminate new information about science related to the partnership.

To view all the presentations from the symposium, click here.

For questions about the symposium or projects there, contact: CN-NIAIDPartnership@childrensnational.org.

NIAID Symposium banner

Joint Base Anacostia-Bolling ceremony

Linda Talley, M.S., R.N., inducted into Honorary Commander Program

Joint Base Anacostia-Bolling ceremony

Credit: USAF SrA Kevin Tanenbaum

Linda Talley, M.S., R.N., NE-BC, FAAN, vice president of nursing and chief nursing officer at Children’s National Hospital, was inducted as one of the Honorary Commanders for Joint Base Anacostia-Bolling during a ceremony at the base on May 14, 2021.

The Honorary Commander Program at Joint Base Anacostia-Bolling gives key community leaders the opportunity to understand the mission of the Air Force and the role of Joint Base Anacostia-Bolling in the Department of Defense’s overall mission. The program also allows military commanders and their units to connect with their community.  Honorary commanders serve as a civilian representative between Joint Base Anacostia-Bolling and the external community, ensuring an increase in direct communication and partnership.

“I am pleased to accept this honor from Joint Base Anacostia-Bolling,” says Linda Talley. “I look forward to representing both the civilian and healthcare community and building a meaningful relationship with military leaders.”

The relationship will benefit both the civilian and military communities. Members of each community will be invited to participate in respective events to gain a better understanding of each other’s mission.

Talley will serve a two-year term and has been matched with the 316th Medical Squadron.

Other newly inducted Honorary Commanders include D.C. Mayor Muriel Bowser and Chief Robert Contee of the Metropolitan Police Department.

Read more about the program and inductees here.

Joint Base Anacostia-Bolling ceremony

Credit: USAF SrA Kevin Tanenbaum

Children’s National Research & Innovation Campus garage solar panel

D.C. leaders unveil city’s largest solar canopy at Children’s National Research & Innovation Campus

Children’s National Research & Innovation Campus garage solar panel

The clean energy generated by this solar array, which is on the RIC parking garage, will be distributed through the Solar for All program, Mayor Bowser’s initiative to provide 100,000 low-to-moderate income families with the benefits of locally generated clean energy.

Washington, D.C.’s largest solar canopy was recently unveiled on the grounds of the Children’s National Research & Innovation Campus (RIC), located on the former Walter Reed Army Medical Center campus. The installation is part of the District’s Solar for All program and will provide more than 325 income-qualified households with clean, renewable energy and electricity bill savings over the next 15 years.

“When we began to plan the Children’s National Research & Innovation Campus, we wanted to do more than discover new and better ways to care for children. We also wanted to support the local community,” said Children’s National Hospital President and CEO Kurt Newman, M.D. “I’m proud that we could incorporate the solar design into our campus thereby returning clean energy to the residents of D.C.’s Ward 4 and doing our part to support the environment.”

The District of Columbia Department of Energy & Environment (DOEE) awarded Children’s National and partner New Columbia Solar (NCS) with the 2021 District Sustainability Award for the execution of this project.

“I am pleased to celebrate this innovative, award-winning project, accomplished with our partners for the benefit of our residents and community,” said DOEE Director Tommy Wells. “The completion of this project by New Columbia Solar is a tremendous achievement that will not only help to meet Mayor Muriel Bowser’s climate and clean energy goals for the District, but will also help to reduce energy costs for low-income households. The District is proud to be a national leader in sustainability, and this project further demonstrates our commitment to deploying solar and developing scalable solutions in a way that prioritizes equitable access for all.”

L-R: Children’s National Hospital Vice President of Community Engagement, Advocacy & Government Affairs Tonya Kinlow; New Columbia Solar CEO Mike Healy; Councilmember Mary Cheh; DOEE Director Tommy Wells; PSC Commissioner Emile Thompson; Children’s National Hospital Chief Operating Officer Kathy Gorman; and DCSEU Director Ted Trabue.

The clean energy generated by this solar array, which is on the RIC parking garage, will be distributed through the Solar for All program, Mayor Bowser’s initiative to provide 100,000 low-to-moderate income families with the benefits of locally generated clean energy. This installation will serve more than 325 income-qualified D.C. families, saving each household up to $500 annually and saving these families up to $2.4 million over 15 years.

“This project is the perfect example of why operating a solar company in the District is so rewarding,” said NCS CEO Mike Healy. “I look at this project and see major decision-makers in D.C. coming together, in the middle of a global pandemic, to prioritize powering our city through clean energy and to offset utility expenses for the families in our community who are most in need.”

The installation began when Children’s National acquired a large five-story above-grade parking garage, which provided the perfect location for a cutting-edge solar array. The original goal for the parking garage was always to incorporate a solar array. However, the installation of the 1,148 kW system was an engineering feat, representing one of the District’s most complex solar systems.

Over the past two years operating DOEE’s Solar for All program, the D.C. Solar Energy Utility (DCSEU) has worked with local solar developers to install 130 community solar facilities across the District. These installations are expected to serve more than 4,000 income-qualified D.C. families, with more community solar projects slated to be developed in 2021 to serve an additional 2,000 households.

“It’s an honor to deliver the Solar for All program in partnership with the District government and the D.C. business community,” said DCSEU Director Ted Trabue. “These projects bring opportunities to District businesses, jobs to D.C. residents and critical electricity bill savings to families who need it, all while helping work toward a carbon-free D.C.”

As part of the larger commitment of Children’s National to positively impact the environment and the community, the organization has formed a Sustainability Council with the overall purpose to build a long-term commitment to sustainable practices; integrate sustainability in the areas of education, research, operations and community service; and incorporate sustainable designs in future construction plans.

little girl at the dentist

Limit antibiotic use before dental procedures to high-risk heart patients, says AHA

little girl at the dentist

A new scientific statement from the American Heart Association (AHA) says that good oral hygiene and regular dental care are the most important ways to reduce the risk of a heart infection called infective endocarditis (IE) caused by bacteria in the mouth.

A new scientific statement from the American Heart Association (AHA) says that good oral hygiene and regular dental care are the most important ways to reduce the risk of a heart infection called infective endocarditis (IE) caused by bacteria in the mouth. The statement was published in Circulation, the AHA’s flagship journal.

This statement addresses the impact of the major changes made in the 2007 AHA infective endocarditis (IE) guidelines that limited antibiotic prophylaxis (AP) prior to dental procedures to cardiac conditions at highest risk of complications from endocarditis by focusing on the following:

  • What was the acceptance of and compliance with the 2007 recommendations?
  • Was there an increased incidence of viridians group streptococci (VGS) infective endocarditis (IE)?
  • Were the recommendations from the guideline valid and should they be revised?

While the statement speaks to all types of heart disease, one area of particular interest in congenital heart disease was highlighted by statement co-author Craig Sable, M.D., F.A.H.A., associate division chief of Cardiology at Children’s National Hospital.

He noted that the statement specifies that children and adult congenital heart patients undergoing pulmonary valve replacement can be at higher risk for IE. The most significant risk factor for IE is the material the valve is made from, regardless of whether it is placed by surgery or catheterization.

Read more about this statement from the AHA

Watch AHA’s video explaining the statement, which features Dr. Sable.

Wayne Frederick

Celebrating Research, Education and Innovation Week at Children’s National Hospital

Wayne Frederick and Kurt Newman

Children’s National Hospital held its 11th Annual Research, Education and Innovation Week, which showcased the scholarly achievements of faculty, staff and trainees across all disciplines and the roles they play in advancing medical science and providing the highest quality care to children.

The week-long event included poster presentations, guest lectures, educational workshops and panel discussions. Eight acclaimed speakers were invited to deliver keynote lectures, including, Wayne A. I. Frederick, M.D., M.B.A., FACS, president of Howard University, James W. Collins, Jr., M.D., M.P.H., associate director for the pediatric residency program at Lurie Children’s Hospital of Chicago, Francis S. Collins, M.D., Ph.D., director of the National Institutes of Health (NIH) and Sally Allain, MSc, M.B.A., head of JLABS @ Washington D.C.  The themes for both Dr. Frederick’s and Dr. James Collins’s presentations were centered on diversity, equity and inclusion.

The keynote lecture “The State of Diversity in the Medical Profession” delivered by Dr. Frederick gave a voice to three often sidelined matters. First, the ongoing need to ensure greater equity and accessibility of health care for communities of color. Second, the unconscious biases that continue to permeate the medical profession, making it difficult for minorities to receive the health care they need. Third, how Historically Black Colleges and Universities in general, and Howard University in particular, shoulder an immense burden in developing African American doctors who enter the medical profession in this country.

To Dr. Frederick, progress begins with awareness and education. “I want people to understand why diversity is important, what challenges prevent it and what can be done to promote it. I also want each individual to understand the role he or she may play in fostering greater diversity,” said Dr. Fredrick. “These are institutional problems, but individual people have the power to change their environment. We will need to advocate for and work to bring about greater diversity. The more people giving momentum to this initiative, the further progress we will make.”

Dr. Frederick further explained that there are many obstacles to diversity. “Becoming a doctor requires time, money and resources. Aspiring Black doctors often forgo a medical career because they don’t have the resources to afford the education nor the luxury to defer earning a livable salary,” said Dr. Frederick. “To achieve diversity in all fields, but especially in the medical profession, we need to support students and the institutions that train them so they can make professional decisions based on their future goals rather than their immediate needs.”

The “The Racial Disparity in Adverse Birth Outcome: Zip Code Eclipses Genetic Code,” keynote lecture from Dr. James Collins shed light on African American women’s ongoing exposure to early-life impoverishment, racial discrimination and parental low socioeconomic status associated with adverse birth outcome.

“Racial disparities in certain U.S. zip codes persists even though it is known to negatively affect birth outcomes because it fails to eliminate the early-life—and generational—consequences of neighborhoods experiencing poverty and lifetime exposure to racial discrimination,” said Dr. James Collins. “We must eliminate the social and economic inequities that are the root cause of the racial disparity in adverse birth outcome.”

Children’s National faculty were also recognized for their high-quality research during the event. Awards for the best poster presentations were distributed according to the following categories:

  • Basic and Translational Research
  • Clinical Research
  • Community-Based Research
  • Education, Training and Program Development
  • Quality and Performance Improvement

The category winners conducted research on a variety of topics, including creating and applying telehealth innovation, developing educational intervention strategies, evaluating the impact of COVID-19 in the Washington Metropolitan area, using T-cell expansion for therapeutic use.

title slide for Dr. Frederick's talk

child reaching into drawer for gun

Sociodemographic factors linked to intentional youth firearm injuries

child reaching into drawer for gun

A new study led by researchers at Children’s National Hospital, finds that sociodemographic factors related to intent of injury by firearm may be useful in guiding policy and informing tailored interventions for the prevention of firearm injuries in at-risk youth.

Firearm injuries are a leading and preventable cause of injury and death among youth – responsible for an estimated 5,000 deaths and 22,000 non-fatal injury hospital visits each year in American kids. And while hospital systems are poised to tackle this issue using a public health approach, prevention efforts and policies may be differentially effective. A new study led by researchers at Children’s National Hospital, finds that sociodemographic factors related to intent of injury by firearm may be useful in guiding policy and informing tailored interventions for the prevention of firearm injuries in at-risk youth.

“We sought to explore differences by injury intent in a nationally representative sample of youth presenting to the emergency department with firearm injury,” said Shilpa Patel, M.D., M.P.H., emergency medicine physician at Children’s National Hospital. “We are hopeful that hospitals will support programs that are targeted, patient-centered and relevant to their communities to prevent firearm injury among youth.”

In one of the first comparative studies of factors and outcomes associated with intentionality of youth firearm injury in a large nationally representative sample, researchers identified more than 178,200 weighted hospital visits for firearm injuries with data collected from the Nationwide Emergency Department Sample (NEDS) from 2009 through 2016. Dr. Patel and her colleagues identified distinct risk profiles for individuals aged 21 and younger, who arrived at emergency departments with firearm injuries over an 8-year period.

Using NEDS data, researchers found that approximately one third of the injuries were categorized as unintentional, another third as assault and a small proportion as self-harm. The majority of visits were among youth age 18 to 21 years with almost 90% male, and more than 40% publicly insured. Nearly a third were admitted to the hospital and 6% died as a result of their firearm injuries. In addition, the study showed that the likelihood of unintentional injury was higher among children age 12 and younger.

Unintentional firearm injuries were also associated with rural hospital location, southern region, emergency department discharge and extremity injury. Self-harm firearm injuries were associated with older age, higher socioeconomic status, rural hospital location, transfer or death, and brain, back and spinal cord injury.

“These findings provide insight into the overlap between risk factors, outcomes and intentionality of youth firearm injury,” says Dr. Shilpa.  “For hospitals looking to implement programs to reduce youth firearm injury, distinct risk profiles identified in our study align with prior evidence to support the following: screen for firearm access and provide counseling on safe storage targeting families with younger children; screen suicidal patients for access to lethal means, especially those hospitals in rural areas; and screen for firearm access especially among children exposed to violence or at risk for assault presenting to urban hospitals.”

Other researchers who contributed to this study include members of S.A.F.E.R. (Safer through Advocacy, Firearm Education and Research) — a firearm safety advocacy group at Children’s National: Gia M. Badolato, M.P.H., Kavita Parikh, M.D., M.S.H.S., and Monika K. Goyal, M.D., M.S.C.E, all of Children’s National, and Sabah F. Iqbal, M.D., of PM Pediatrics.

 

pregnant woman getting a checkup

Children’s National awarded $4.2 million to lead maternal mental health research programs

pregnant woman getting a checkup

Mothers and their babies often experience stress, depression and anxiety, which impacts the infant’s brain development.

Children’s National Hospital announces a $4.2 million funding award from the Patient-Centered Outcomes Research Institute (PCORI) to support maternal mental health research. The Developing Brain Institute at Children’s National will lead a new program that seeks to advance perinatal mental health and well-being while addressing racial disparities in access to resources that could boost positive health outcomes for women with few opportunities.

Mothers and their babies often experience stress, depression and anxiety, which impacts the infant’s brain development. Maternal psychological distress is more pronounced among low-income mothers — a health disparity that was exacerbated during the COVID-19 pandemic.

“The new fund will support many scientific research portfolios, including our project that will ensure pregnant women in D.C. get the care they need and deserve,” said Catherine Limperopoulos, Ph.D., director of The Developing Brain Institute at Children’s National and co-principal investigator of the project.

“I’m honored to be working alongside Dr. Limperopoulos and our partners. Collectively, our team aims to meet the needs of African American pregnant and postpartum women and their families during this important transition in their lives by providing services to address social determinants of health and prevent and treat maternal distress,” said Huynh-Nhu Le, Ph.D., the co-principal investigator of the project and professor in the Clinical Psychology program, part of the department of Psychological and Brain Sciences at George Washington University.

Cognitive-behavioral intervention, patient navigation and peer support, such tailored strategies developed in the program will provide effective mental health screening and care for 1,000 mothers living in Washington D.C. that is responsive to their cultural, social, environmental, behavioral and medical needs. The participants will access the resources either online or in-person, depending on the type of assistance that fits their lifestyle.

“I am overjoyed that PCORI has provided this essential funding, giving life to our project. The research done here will have a grand effect! Our goals are ambitious: To dissect all aspects of maternal health, beyond just mental health, literally creating a detailed timeline of events a mother can anticipate experiencing from pregnancy, at delivery and postpartum,” said Shanae Bond, one of the women whose firsthand experience giving birth in D.C. informed the study design. “With the maternal health crisis we are currently facing, it’s imperative to gain this type of insight to not only support mothers but to learn how they wish to be supported and how to best improve the care they receive – based on how it impacts, improves (or impairs) their lives,” said Bond.

The multidisciplinary group includes doctors, midwives, psychologists, advisors, community leaders and four prenatal care centers, MedStar Washington Hospital Center, Howard University, The George Washington University and Unity Health Care.

“Our initiative brings together obstetrics, pediatrics, and mental health care in an integrated care model. This collaboration brings early identification and immediate care coordination to its rightful place at the center of care,” said Loral Patchen, Ph.D., CNM, vice chair, Innovation and Community Programs at MedStar Washington Hospital Center. “The prenatal period offers an opportunity for us to support emotional healing, build coping strategies, and offer a safe space for people to prepare for the complex transitions that accompany childbearing. Offering services prior to delivery optimizes opportunity for strong parent-infant attachment and mitigates potential disruptions.”

Kristin L. Atkins, M.D., FACOG, assistant professor in the Obstetrics and Gynecology Department at Howard University College of Medicine, mentioned that Howard University is honored to partner with Children’s National Hospital. “The new program will help discover more about prenatal care interventions related to maternal mental health and how they may impact fetal and pediatric brain development,” said Dr. Atkins. “We are just discovering the impact of long-standing stress on health and well-being, and this starts in utero.”

To Jennifer Keller, M.D., MPH, FACOG, associate professor at The George Washington University School of Medicine & Health Sciences, this project is essential. “The events of the last year have had a profound impact on families in this city,” said Dr. Keller. “This project begins at a time of critical mental health needs for pregnant people in D.C.”

Siobhan Burke, M.D., director of OB/GYN at Unity Health Care, is also thrilled to be part of this partnership. “We all know underlying stressors such as financial difficulties, housing instability and systemic racism can impact health, but it’s important to find out what these things do to the developing fetus and to explore strategies to make lives better,” said Dr. Burke.

In 2020, Children’s National established The Clark Parent & Child Network funded by a $36 million investment from the A. James & Alice B. Clark Foundation. The Clark Network aims to provide families with greater access to mental health care and community resources. New projects like the D.C. mother-infant behavioral wellness program underwritten by PCORI funding will become natural extensions of this essential work.

“This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other stakeholders, but also for its potential to fill an important gap in our health knowledge and give people information to help them weigh the effectiveness of their care options,” said PCORI Executive Director Nakela L. Cook, M.D., M.P.H.. “We look forward to following the study’s progress and working with Children’s National Hospital to share the results.”

This $4.2 million PCORI funding has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.

 

using a laser to cut PPE face shields for staff during covid-19

Multidisciplinary team develops innovative PPE that fits clinical needs during COVID-19

using a laser to cut PPE face shields for staff during covid-19

Children’s National engineers and clinicians developed plexiglass shields for testing sites, comfortable face shields for clinical providers, affordable oversized breath shields for ophthalmology and 3D printed flip-up attachments to the safety goggles for nurses.

The Children’s National Hospital innovation working group shares a retrospective on their local experience in mobilizing resources to offer relief following the personal protective equipment (PPE) shortages at the beginning of COVID-19. Engineers and clinicians developed plexiglass shields for testing sites, comfortable face shields for clinical providers, affordable oversized breath shields for ophthalmology and 3D printed flip-up attachments to the safety goggles for nurses.

The study, published in the Surgical Innovation Journal, narrates a series of events that occurred at the beginning of the pandemic, where the increased demand for personal protective equipment (PPE) usage in healthcare personnel skyrocketed and led to a severe national shortage. Still, the multidisciplinary approach at Children’s National facilitated the response and preparedness to the emerging situation back in March of 2020, serving as a framework for the current and future challenges.

To meet the needs of one of the busiest pediatric emergency departments in the country, the researchers aimed to develop a plexiglass shield that was reliable, reusable and practical while staying pediatric-friendly. The prototype had advantages and disadvantages while administering a COVID-19 swab test in a tent.

The 2020 FDA Emergency Authorization Use (EUA) issued in April provided manufacturing guidelines to produce face shields. Given the federal support, innovators at Children’s National, in partnership with GCMI, designed a rigid and foam prototype. Both prototypes were measured by comfort, visibility, breathability, ability to perform the job, durability, stability, fit and easy assembly. The rigid prototype performed the highest in all metrics and it had few adjustments after various tests.

“While the FDA has become nimbler as evidenced by rapid issuance of EUA of the vaccines, regulatory concerns are still paramount,” Operfmann et al. write. “Having staff experienced with regulatory processes is important to introduce new regulated devices.”

In May 2020, there was also a production lag on the available oversized breath shields for ophthalmology slits, which cost between $35 and $40. To lift the burden, the researchers designed and produced in-house a cost-effective oversized breath shield for less than $9. They used a 40 W laser machine to cut through the thick clear cast acrylic while following the compatible measurements of commercial lamps. The team also distributed the breath shields to other Children’s National regional clinics.

Within the nursing staff, the main factor associated with abiding to PPE compliance is the usage of safety goggles before entering a room. But in time-sensitive situations like patients with severe COVID-19 symptoms, the equipment can be easily forgotten. To support busy shifts, researchers designed a 3D printable attachment valued at $5 for safety goggles, which are more comfortable to keep on, even during downtime. The efficacy of the flip-up attachment is yet to be determined in an upcoming trial.

“Hospitals have already begun augmenting their disaster preparation plans and ensuring they have adequate stockpiles of equipment for future events,” Opfermann et al. write.

Children’s National authors on the study include: Justin Opfermann, M.S., Anuradha Dayal, M.D.Alyssa Abo, M.D., M.B.A., Tyler Salvador, B.S., Kolaleh Eskandanian, Ph.D., M.B.A., P.M.P., Raven McLeese, R.N., and Kevin R. Cleary, Ph.D.

Children’s National Hospital joins unprecedented coalition to address pediatric drug shortages

Shortages of essential medicines for children are a persistent problem plaguing hospitals across the United States.

Children’s National Hospital joins in announcing the launch of a groundbreaking Children’s Hospital Coalition: Powered by PhlowTM (CHC). This first-in-kind coalition brings together some of the top children’s hospitals across the nation, in collaboration with Phlow, to provide certainty in availability and access for key medicines necessary to sustain life and conquer disease and to address the nation’s broken essential medicines supply chain.

Shortages of essential medicines for children are a persistent problem plaguing hospitals across the United States. A 2019 survey of 330 U.S. hospitals, including 29 children’s hospitals, demonstrated that medicine shortages disproportionately and uniquely impact children’s hospitals. (Vizient, 2020) The COVID-19 pandemic has exposed further vulnerabilities in the overall U.S. hospital supply chain, particularly regarding essential injectable medications. To address this issue, the CHC is charged with a mission to deliver on the promise of ensuring a reliable supply of high-quality, affordable essential medicines to treat children.

CHC logi

“Far too often, the health care needs of children are not a priority. The coalition will draw attention to this important issue of shortages of essential medicines and more importantly, start to fix the problem,” says Kurt Newman, M.D., president and chief executive officer of Children’s National. “I know we can do better for children who require these life-saving treatments and cures, and I’m proud to join this great group of organizations in developing an innovative solution.”

The coalition is working together to further escalate this issue on the national agenda, to encourage children’s hospitals to join in this cause, and educate other hospitals on how this coalition will aid in ending shortages of essential medicines. Ultimately, the goal of the CHC is to increase the resiliency and reliability of the pediatric pharmaceutical supply chain.

“The pharmacists on my team are on the front lines of this struggle every day, so we know the need for this effort all too well,” says Eric Balmir, M.S., PharmaD, C.I.M., vice president and chief pharmacy officer at Children’s National. “We’re proud to be part of the solution, working to ensure that every child has access to the essential medicines they need.”

The CHC will identify and prioritize the most needed essential medicines, including sterile injectable medicines and medications used to treat pediatric cancers and rare diseases. Phlow will work quickly to ensure a high-quality, reliable supply of these essential medicines and will provide transparent, cost-plus pricing for all coalition members under uniform long-term purchasing agreements. Through this collaboration, the CHC will work toward improving the delivery of pediatric care.

Currently, the 11 founding hospital members of the CHC are: Arkansas Children’s, Boston Children’s Hospital, Children’s Hospital Los Angeles, Children’s Hospital of Richmond at VCU, Children’s National Hospital, Children’s Wisconsin, Cincinnati Children’s, Cook Children’s, Intermountain Primary Children’s Hospital, Ann & Robert H. Lurie Children’s Hospital of Chicago and Nationwide Children’s Hospital. Please visit www.childrenshospitalcoalition.org for more information on how to join the CHC.

coronavirus

An analysis of articles on pediatric COVID-19 cases

coronavirus

In a recent editorial, Dr. Briony Varda commented on a systematic review and meta-analysis of articles reporting on pediatric cases of COVID-19.

In a recent editorial, Children’s National Hospital Pediatric Urologist Briony Varda, M.D., M.P.H., and Emilie K. Johnson, M.D., M.P.H., from Ann & Robert H. Lurie Children’s Hospital of Chicago, comment on a systematic review and meta-analysis of articles reporting on pediatric cases of coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection.

Their take home messages were that although COVID-19 is typically milder in children than in adults, children (particularly infants) do appear to have cardiac damage from COVID-19 which may be a consideration for preoperative evaluation among surgeons. They also note the MIS-C is another emerging concern for children following an infection with COVID-19.

Read the full editorial in the Journal of Pediatric Urology.

illustration of lungs with coronavirus inside

Pediatric asthma exacerbations during the COVID-19 pandemic

illustration of lungs with coronavirus inside

The authors found that in 2020, the District of Columbia did not experience the typical “September asthma epidemic” of exacerbations seen in past years.

In the United States, pediatric asthma exacerbations typically peak in the fall due to seasonal factors such as increased spread of common respiratory viruses, increased exposure to indoor aeroallergens, changing outdoor aeroallergen exposures and colder weather. In early 2020, measures enacted to reduce spread of the coronavirus (COVID-19) — such as social distancing, quarantines and school closures — also reduced pediatric respiratory illnesses and asthma morbidity. Children’s National Hospital immunologist and allergist William J. Sheehan, M.D., and colleagues sought to determine if these measures also affected the 2020 fall seasonal asthma exacerbation peak in Washington, D.C.

The authors found that in 2020, the District of Columbia did not experience the typical “September asthma epidemic” of exacerbations seen in past years. Emergency department visits, hospitalizations and intensive care unit admissions for asthma during the 2020 fall season were significantly reduced compared to previous years.

The authors conclude that, “this is likely due to social distancing, quarantines and school closures enacted during the pandemic. This is a small silver lining in a very difficult year. As 2021 brings optimism for gradual improvements of the pandemic, careful monitoring is necessary to recognize and prepare for childhood asthma morbidity to return to pre-pandemic levels.”

Additional study authors include: Shilpa J. Patel, M.D., M.P.H., Rachel H.F. Margolis, Ph.D., Eduardo R. Fox, M.D., Deborah Q. Shelef, M.P.H., Nikita Kachroo, B.S., Dinesh Pillai, M.D. and Stephen J. Teach, M.D., M.P.H.

Read the full study in the Journal of Allergy and Clinical Immunology: In Practice.

Asthma-Related Healthcare Utilization by Month

Asthma-Related Healthcare Utilization by Month (2016-2020). Asthma-related emergency department (ED) visits, hospitalizations and pediatric intensive care unit (PICU) admissions over time by month between 2016 and 2020. The p-values are for comparisons of mean monthly numbers for fall seasons of 2016-2019 to fall season of 2020. Image courtesy of the Journal of Allergy and Clinical Immunology: In Practice.

coronavirus molecules with DNA

Novel SARS-CoV-2 spike variant found in a newborn in Washington, D.C.

coronavirus molecules with DNA

Researchers at Children’s National Hospital found a new SARS-CoV-2 spike variant in a neonatal patient, according to a study that genetically sequenced the virus in 27 pediatric patients. The newborn presented with a viral load of 50,000 times more particles than the average patient, which led to identifying the N679S spike protein variant — the earliest known sample of this coronavirus lineage in the U.S. mid-Atlantic region.

While the paper is posted to the preprint server medRxiv and has not been peer-reviewed, it represents an early step towards establishing better surveillance of the COVID-19 pandemic. The new variant helps understand the process of viral adaptation, potentially informing treatment development and vaccine design for any viral variants in the future.

All genomes change and evolve. Additional viral variants are expected to emerge as more patients are infected. The data analysis recognized eight other cases in Washington, D.C., with the N679S variant, pointing toward a European origin due to the genetic similarity between of SARS-CoV-2 strains in the U.S. and United Kingdom.

“We need to sequence more cases to identify variants and stay ahead of the virus,” said Drew Michael, Ph.D., molecular geneticist at Children’s National and senior author of the study. “The United States sequences a tiny fraction of all cases, and because we are not sequencing enough, we are not aware of the variants in SARS-CoV-2 that may be spreading in our community.”

“Novel SARS-CoV-2 spike variant identified through viral genome sequencing of the pediatric Washington D.C. COVID-19 outbreak,” was published on the preprint server medRxiv. Additional authors include Jonathan LoTempio, Erik Billings, Kyah Draper, Christal Ralph, Mahdi Moshgriz, Nhat Duong, Jennifer Dien Bard, Xiaowu Gai, David Wessel, M.D., Roberta L. DeBiasi, M.D., M.S., Joseph M. Campos, Ph.D., Eric Vilain, M.D., Ph.D. and Meghan Delaney, D.O., M.P.H.

You can read the full preprint on medRxiv.

Nurse comforting patient

End-of-life-care goals for adults living with HIV

Nurse comforting patient

Palliative care is specialized medical care for people living with a serious illness with the goal of improving quality of life. HIV is one illness where studies have shown that palliative care for persons living with HIV (PLWH) can improve pain and symptom control as well as psychological well-being.

There are about 1.2 million people living with human immunodeficiency virus (HIV) in the U.S., according to the CDC. In 2018, more than 37,000 people were newly diagnosed.

Integrating culturally sensitive palliative care services as a component of the HIV care continuum may improve health equity and person-centered care.

In a recent article published in the American Journal of Hospice and Palliative Medicine, Maureen Lyon, Ph.D., clinical health psychologist at Children’s National Hospital, and her colleagues examined factors influencing end-of-life care preferences among PLWH. Researchers conducted a survey of 223 adults living with HIV from five hospital-based clinics in Washington, DC. Participants completed an end-of-life care survey at as part of the FACE™-HIV Advance Care Planning clinical trial. Two distinct groups of patients were identified with respect to end-of-life care preferences: (1) a Relational class (75%) who prioritized family and friends, comfort from church services and comfort from persons at the end-of-life; and (2) a Transactional/Self-Determination class (25%) who prioritized honest answers from their doctors and advance care plans over relationships. African Americans had three times the odds of being in the Relational class versus the Transactional/Self-determination class, Odds ratio=3.30 (95% CI, 1.09, 10.03), p=0.035.

Those who prioritized relationships if dying were significantly more likely to be females and African Americans; while those who prioritized self-determination over relationships were significantly more likely to be males and non-African Americans. The four transgendered participants prioritized relationships.

Survey results show that most PLWH receiving care in Washington, D.C., preferred to die at home, regardless of race. Yet in the United States, most persons who die of HIV related causes die in the hospital. Sexual minorities feared dying alone, consistent with the stigma and discrimination which places many at risk of social isolation. Non-heterosexuals were less likely to find the church as a source of comfort, which may reflect feelings of discrimination, due to homophobic messages. However, if the church community is affirming of sexual minority status, religion could serve as a protective factor. Study findings may generate interventions to decrease social isolation and increase palliative care services for non-heterosexual PLWH.

These results fill a gap in our understanding of the self-reported goals and values of adults living with HIV with respect to end-of-life care. Findings contribute specificity to previous research about the importance of family, relationships and religiousness/spirituality with respect to end-of-life issues for ethnic and racial minorities.

Researchers from Children’s National involved in this study include Maureen Lyon, Ph.D., Jichuan Wang, Ph.D. and Lawrence D’Angelo, M.D., M.P.H.

The full study can be found in the American Journal of Hospice & Palliative Medicine.

boy checking his blood glucose

There’s still more to learn about COVID-19 and diabetes

boy checking his blood glucose

Researchers have learned a lot about COVID-19 over the past year and are continuing to learn and study more about this infection caused by the SARS-CoV-2 virus. There have been many questions about whether COVID-19 affects people with diabetes differently than those without and why this might occur.

Diabetes experts, like Brynn Marks, M.D., M.S.H.P.Ed., endocrinologist at Children’s National Hospital, have been studying the relationship between COVID-19 and diabetes, especially in the pediatric population. Dr. Marks tells us more about what we know so far and further research that needs to be done when it comes to COVID-19 and diabetes.

1.      What do we know about COVID-19 and its effect on people with known diabetes?

The Centers for Disease Control and Prevention (CDC) currently lists type 2 diabetes (T2D) as a high risk condition for severe illness related to COVID-19 infection, while stating that adults with type 1 diabetes (T1D) might be at increased risk. A recent study from Vanderbilt University found that people with T1D and T2D were at approximately equal risk for complications of COVID-19 infection. As compared to adults without diabetes, adults with T1D and T2D were 3-4 times more likely to be hospitalized and to have greater illness severity. Given these comparable risks, both the American Diabetes Association and the Juvenile Diabetes Research Foundation are lobbying for adults with T1D to be given the same level or priority for COVID-19 vaccines as adults with T2D.

However, as pediatricians, we all know to be wary of extrapolating adult data to pediatrics. Children are less likely to be infected with COVID-19 and if they are, the clinical course is typically mild. To date, there have not been any studies of the impact of COVID-19 on youth with known T2D. Our clinical experience at Children’s National Hospital and reports from international multicenter studies indicate that youth with T1D are not at increased risk for hospitalization from COVID-19 infection. However, paralleling ongoing disparities in T1D care, African Americans with known T1D and COVID-19 infection were more likely to be develop diabetic ketoacidosis (DKA) than their White counterparts.

With the increased use of diabetes technologies, including continuous glucose monitors, insulin pumps and automated insulin delivery systems, diabetes care lends itself well to telemedicine. Studies from Italy during the period of lockdown showed better glycemic control among youth with T1D. Further studies are needed to better understand the implications of telehealth on diabetes care, particularly among those in rural areas with limited access to care.

Brynn Marks

Diabetes experts, like Brynn Marks, M.D., M.S.H.P.Ed., endocrinologist at Children’s National Hospital, have been studying the relationship between COVID-19 and diabetes, especially in the pediatric population.

2.      What do we know about the impact of the COVID-19 pandemic on children with newly diagnosed diabetes?

Nationwide studies from Italy and Germany over the first few months of the pandemic found no increase in the incidence of pediatric T1D during the COVID-19 pandemic as compared to the year before; in fact, the Italian study found that fewer children were diagnosed with T1D during the pandemic. However, many centers are seeing higher rates of DKA and more severe DKA at diagnosis during the pandemic, possibly due to decreased primary care visits and/or fears of contracting COVID-19 while seeking care.

To date, no studies have been published exploring the incidence of T2D in youth. A group from Children’s National, including myself, Myrto Flokas, M.D., Abby Meyers, M.D., and Elizabeth Estrada, M.D., from the Division of Endocrinology and Randi Streisand, Ph.D., C.D.C.E.S. and Maureen Monaghan, Ph.D., C.D.C.E.S., from the Department of Psychology and Behavioral Health, are gathering data to compare the incidence of T1D and T2D during the pandemic as compared to the year before.

3.      Can COVID-19 cause diabetes to develop?

This has been area of great interest, but the jury is still out. The SARS-CoV-2 virus, which causes COVID-19 infection, binds the angiotensin-converting enzyme 2 (ACE2) receptor which is located in many tissues throughout the body, including the pancreas. SARS-CoV-2 has been shown to infect pancreatic tissue leading to impaired glucose stimulated insulin secretion. Although the SARS-CoV-2 virus could plausibly cause diabetes, assessment has been complicated by many confounders that could be contributing to hyperglycemia in addition to or rather than the virus itself. Stress-induced hyperglycemia from acute illness, the use of high dose steroids to treat COVID-19 infection, and the disproportionate rates of infection among those already at high risk for T2D, as well as weight gain due to changes in day-to-day life as a result of social distancing precautions are all likely contributing factors.

patient talking to doctor

Advance care planning and the trajectory of end-of-life treatment preference

patient talking to doctor

Advance care planning is a process that helps patients define their goals, values and preferences for future medical care. This information is shared with a surrogate decision maker who will make decisions for the patient if/when they are unable to make decisions for themselves. While ongoing conversations with the surrogate about goals of care are recommended, the optimal timing has not been empirically determined, until now.

Maureen Lyon, Ph.D., and her colleagues at Children’s National Hospital found that adults living with HIV and their chosen surrogate decision makers, who participated in a FAmily CEntered (FACE) advance care planning intervention, had seven times the odds of being on the same page about end of life decisions compared with controls. The researchers’ 5-year randomized clinical trial conducted in Washington, D.C., highlights a critical period 3 months after the intervention which might be optimal to schedule a booster session. FACE advance care planning had a significant effect on both surrogates’ longitudinal preparedness and confidence in decision-making and understanding of the patients’ end of life treatment preferences, compared to controls. These findings confirm advance care planning is beneficial and support African Americans’ desire to have family participate in decision making.

Children’s National researchers who contributed to this study include Maureen Lyon, Ph.D., Lawrence D’Angelo, M.D., MPH, Jichuan Wang, Ph.D., and Isabella Greenberg, MPH.

Read the full study in the American Journal of Hospice and Palliative Care.

happy children running with kite

Spurring innovation to support pediatric preparedness

happy children running with kite

There are many lessons to be learned from the response to the COVID-19 pandemic, but one that is at the forefront is to be prepared for anything and to strengthen readiness even in the unlikeliest circumstances.

This was the focus of a recent panel discussion featuring Lee Beers, M.D., F.A.A.P, medical director of Community Health and Advocacy within the Goldberg Center for Community Pediatric Health and Child Health Advocacy Institute at Children’s National Hospital. Dr. Beers is also president of the American Academy of Pediatrics.

The webinar entitled, “Protecting Our Future: Spurring Innovation to Support Pediatric Preparedness,” was hosted by Johnson & Johnson Innovation – JLABS (JLABS) as a product of BLUE KNIGHT™, a collaboration between JLABS and the Biomedical Advanced Research and Development Authority (BARDA), a component of the Office of the Assistant Secretary for Preparedness and Response within the U.S. Department of Health and Human Services.

This event focused on what innovators can do to develop therapeutics, diagnostics, vaccines and other technologies that may protect our future, our children. Experts shared what has been done to develop groundbreaking medical countermeasures that aim to prepare and protect pediatric populations from the health threats of today and those of tomorrow. The main discussions were on ecosystems readiness, adaptations for the pediatric population and the way forward in 2021.

“One size does not fit all for pediatrics when it comes to treatments and personal protective equipment,” said Dr. Beers “We need to know the need and how to do the roll-out.” Fellow panelists agreed.

Dr. Beers went on to say that mental health is the pandemic within the pandemic for our nation’s youth. There are increased cases and severity now for children who struggle to cope with the lockdowns. “We cannot have our children bear the burdens of our challenges.”

After robust questions and answers from everything from the role of artificial intelligence in preparing for future pandemics to the inclusion of families in research and decisions, the panelists walked away with a good feeling about the future with the unprecedented speed of vaccines aimed to counter the effects of the 2020 virus crisis.

The consensus priorities of 2021 should be to develop specifics for children and not just adaptations from adults, with the aim to advance equity, diversity and inclusion in treatment goals, and to build on the success of telemedicine.

Nationally, funding for pediatric research continues to trail efforts targeted for adults. That’s why Children’s National is creating a one-of-a-kind pediatric research and innovation hub. The Children’s National Research & Innovation Campus is set to open in 2021, located on a nearly 12-acre portion of the former Walter Reed Army Medical Center campus. The campus will combine the strengths of Children’s National with those of public and private partners who share the vision of accelerating new discoveries that save and improve the lives of children. At the new campus, breakthrough innovations can more quickly be translated into new treatments and technologies benefitting kids.

Sally Allain, Head of Johnson & Johnson Innovation – JLABS @ Washington, D.C., highlighted the opening of a 32,000 square-foot facility on the Research & Innovation Campus with a residency capacity for up to 50 companies. This will be the first JLABS site anchored with a children’s hospital and research institute working to bring recognition to the need for more early-stage research and innovation in pediatrics for our smallest patients.

The new site will serve as an incubator for pharmaceutical, medical device, consumer and health technology companies, and serve as the hub for BLUE KNIGHT™. BLUE KNIGHT™ aims to stimulate innovation and incubation of technologies that improve health security and response through companies focused on public health threats and emerging infectious diseases. At JLABS @ Washington, DC, companies selected for BLUE KNIGHT™ will have access to the JLABS ecosystem and being a part of the Research & Innovation Campus, as well as fee assistance for certain costs associated with access, mentorship for BARDA, and dedicated equipment for BLUE KNIGHT™ companies.

Lee Beers

Lee Beers, M.D., F.A.A.P, begins term as AAP president

Lee Beers

“The past year has been a stark reminder about the importance of partnership and working together toward common goals,” says Dr. Beers. “I am humbled and honored to be taking on this role at such a pivotal moment for the future health and safety of not only children, but the community at large.”

Lee Savio Beers, M.D., F.A.A.P., medical director of Community Health and Advocacy at the Child Health Advocacy Institute (CHAI) at Children’s National Hospital, has begun her term as president of the American Academy of Pediatrics (AAP). The AAP is an organization of 67,000 pediatricians committed to the optimal physical, mental and social health and well-being for all children – from infancy to adulthood.

“The past year has been a stark reminder about the importance of partnership and working together toward common goals,” says Dr. Beers. “I am humbled and honored to be taking on this role at such a pivotal moment for the future health and safety of not only children, but the community at large.”

Dr. Beers has pledged to continue AAP’s advocacy and public policy efforts and to further enhance membership diversity and inclusion. Among her signature issues:

  • Partnering with patients, families, communities, mental health providers and pediatricians to co-design systems to bolster children’s resiliency and to alleviate growing pediatric mental health concerns.
  • Continuing to support pediatricians during the COVID-19 pandemic with a focus on education, pediatric practice support, vaccine delivery systems and physician wellness.
  • Implementation of the AAP’s Equity Agenda and Year 1 Equity Workplan.

Dr. Beers is looking forward to continuing her work bringing together the diverse voices of pediatricians, children and families as well as other organizations to support improving the health of all children.

“Dr. Beers has devoted her career to helping children,” says Kurt Newman, M.D., president and chief executive officer of Children’s National. “She has developed a national advocacy platform for children and will be of tremendous service to children within AAP national leadership.”

Read more about Dr. Beer’s career and appointment as president of the AAP.