Department of Pediatrics Annual Report 2012-13
McMaster University | Department of Pediatrics | Academic Year 2012-13
this is our time to listen to care to heal to grow to learn McMaster Children & Youth University lecture, February 2013.
Table of Contents Chair’s message
Chair’s message....................................................................2 Dean’s message....................................................................3 President’s message............................................................5 Year in Review.......................................................................6 News Headlines..................................................................12
2
McMaster Children and Youth University
Community
14
Excellence in Education
If you can dream it
McMaster Children and Youth University . ....................14
Innovation
Life lessons..........................................................................18 Building new approaches to learning.............................20
26
Recognition Dinner.............................................................22 Excellence in Research If you can dream it..............................................................26 Seed money.........................................................................30 Supporting research..........................................................32
The next best thing
Simulation
36
Featured grants and awards.............................................35 The next best thing.............................................................36
The birds and the bees Transition
Excellence in Care The birds and the bees......................................................40
40
Giving back a life.................................................................43 Good cop..............................................................................45 A new approach to an old problem.................................46 Caring for teens...................................................................48 Helping those who need it most.......................................50
Giving back a life
Clinical Care
43
Additional Selected publications........................................................52 Publications.........................................................................53 Faculty listing.......................................................................66 Education and research endowment funds...................70
Caring for teens Adolescent Medicine
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2 Dr. Lennox Huang
MESSAGE FROM THE CHair Dear friends and colleagues, The Department of Pediatrics continues to grow while furthering our mission of improving the health of children and youth. 2012-13 was a fantastic year for the department and our annual report contains just some of our key accomplishments and important stories. A common theme to these stories is one of giving. We give our time and energy to help our patients and families through clinical care. We give to each other to support research and education through departmental endowments and start-up funding. We give back to our community through innovative programs like the McMaster Children and Youth University led by Katrin Scheinemann and Sandy Raha. In 2012-13 our department enjoyed significant success on the research front with major CIHR operating grants awarded to Katherine Morrison, Stephanie Atkinson, Anne Klassen, and Chris Fusch. Jeff Pernica and Salhab El Helou received new investigator funding from the Hamilton Health Sciences Foundation and Melissa Parker received an Early Career Award. Our annual Child Health Research Trainee Day celebrated its 4th year in 2012 with the largest and most diverse number of participants to date. Our report features stories related to three areas of research excellence: transition, neonatal care, and the crossover between obesity, metabolism and exercise. We continue to have one of the best pediatric residency training programs in the country. Many of our educational innovations have been disseminated by award winning program director Moyez Ladhani who also leads the Pediatric Program Directors of Canada. New to this year’s report, we have included a resident perspective. Outgoing chief resident Heather Bhan reflects on her time at McMaster. Our subspecialty residency and fellow-
ship programs expand each year and we now offer training in 10 subspecialty areas ranging from Developmental Pediatrics to Critical Care. Finally, we continue to grow and innovate in our core clinical mission. We welcomed a number of new faculty members including: Connie Williams, Anthony Crocco, Jay Green, Alim Pardhan, Quang Ngo, Erich Hanel, and Arif Somani. 2012-13 also saw the appointment of Jon Gilleland as the inaugural McMaster Children’s Hospital Patient Safety Officer. Continuous improvements in the care we deliver, combined with innovations such as the use of simulation in adolescent medicine and to test clinical environments, keep us as the —Sir Winston forefront of Pediatrics.
We make a living by what we get. We make a life by what we give.” Churchill
Research, education and clinical care are often treated as isolated silos in academic medicine. As I think of my colleagues and read through the stories from the past year, I can’t help but think of these elements more as threads tightly woven into the fabric of our department.
Lennox Huang, MD FAAP Chair & Associate Professor Department of Pediatrics, McMaster University Chief of Pediatrics McMaster Children’s Hospital at Hamilton Health Sciences, and St. Joseph’s Healthcare Hamilton 3
MESSAGE FROM THE DEAN This past year has seen the continuation of success in research, learning and care at the department of Pediatrics, and I would like to congratulate all of the faculty and staff of the Department on their accomplishments. The transition to make the McMaster Children’s Hospital the focal point of the McMaster University Medical Centre was highlighted with the completion and opening of the state-of-the-technology but patient-centric Michael G. DeGroote Pediatric Intensive Care Unit. This unit, provided through the generous gift of McMaster’s key philanthropist and friend, allows members of the department to have the resources to provide the very best care for children in crisis. In research, the impact of your discoveries is positively impacting beyond the wide community of the McMaster Children’s Hospital. An example is that assistant professor Jeff Pernica is leading a team that won Grand Challenges Canada’s Stars in Global Health award for their plan to simplify and speed up diagnosing intestinal infections in children in Africa. This past year also saw the launch of a new interdisciplinary research group, the Metabolism and Childhood Obesity Research Program which has become known as the MAC-Obesity Research Program. More than 30 laboratory researchers and clinicians with a wide range of expertise have been combined under the leadership of Dr. Katherine Morrison from pediatrics and Dr. Greg Steinberg from medicine. We anticipate that this dynamic collaboration will find new ways to prevent as well as treat obesity-related diseases in children. Members of the department continue to take on leadership roles. This included associate professor Dr. Jan Willem Gorter, who became the director of McMaster’s CanChild Centre for Childhood Disability Research and took the endowed Scotiabank Chair in Child Health Research. Well-deserved honours have been given to members of the Department. The founding chair of the Department, Dr. Alvin Zipursky, was inducted as an officer of the Order of Canada for his contributions to pediatrics in Canada and in developing countries. 4
Such a wonderful year of achievements can only indicate that this next year will see additional excellence. Thank you.
Dr. John G. Kelton Dean and Vice-President Faculty of Health Sciences Dean of the Michael G. DeGroote School of Medicine
MESSAGE FROM THE president It was another year of tremendous growth for McMaster Children’s Hospital. We completed the emergency department, opened the redeveloped Pediatric Intensive Care Unit and Ophthalmology Clinic, and created the Eating Disorders Inpatient Unit. I’ll begin with the “front door” to the hospital, the emergency department. This is a huge milestone for the hospital. Building of the new pediatric emergency department began in 2010, the year before the emergency department at McMaster University Medical Centre converted to treating only children. Construction occurred in two stages, and with its completion the emergency department now has a beautiful atrium waiting room, separate ambulance and walkin entrances, trauma treatment rooms, a fast-track area, large and private examination rooms and an isolation area for infectious illnesses. With the building complete, pediatric mental health emergency services were finally transferred to McMaster Children’s Hospital, a fit for the mental health inpatient unit. All of this is significant to families who are now getting emergency care designed for children and youth. If you build it, they will come: in 2010, the hospital saw about 14,000 pediatric emergency visits; the number has more than doubled only two years later. The new Michael G. DeGroote Pediatric Intensive Care Unit opened, thanks to a generous $10 million donation by Michael G. DeGroote. The 12-room unit is designed for family-centred care, with spacious, private rooms, family lounges, and some overnight family accommodation. Every year, nearly 600 children require critical care at the hospital. We opened our new inpatient eating disorders unit this year, with six inpatient beds and a day treatment program for four patients. About 75-100 patients are expected to be treated annually in this service. The outpatient eating disorders program is the busiest in the province, with more than 3,500 clinic visits annually. Finally, the Hogarth Family and Pioneer Energy Ophthalmology Centre replaced the previous ophthalmology clinic, thanks to a $1 million donation from the Hogarth Family. The clinic is unique to the region and sees about 13,000 visits annually, making it Ontario’s busiest.
children, and helps to recruit more of the best and the brightest physicians, staff, educators, researchers and students. Together, the pediatric academic department and the children’s hospital truly create innovative care. It is the best of partnerships, in which research leads care into the future, and education ensures those stepping into healthcare will have the knowledge to provide the best care moving forward. I am proud of this academic department and the work being done at McMaster Children’s Hospital.
Peter Fitzgerald President of McMaster Children’s Hospital
Dramatic growth such as this enables McMaster Children’s Hospital to widen the circle of care for 5
year in review The Department of Pediatrics is pleased to support the development of new and renovated clinical areas in 2012. Highlights include:
Hemophilia Clinic Kidney Stone Clinic Pediatric Critical Care Unit Eating Disorders Clinic Type 2 Diabetes Clinic Pediatric Emergency Department
January 2012
February 2012
Drs. Jan Willem Gorter and Christina Grant are invited to sit on the Transition to Adult Healthcare Services Working Group with the Provincial Council for Children’s Health. (Page 40: The birds and the bees; Page 43: Giving back a life). Dr. Katherine Morrison is invited to present at the 9th Annual Dorothy Waffarn Memorial Endowed Lecture at the University of California. (Page 46: A new approach to an old problem). Dr. Christina Grant is appointed Chair of the Department Education Coordinators Committee for the Faculty of Health Sciences.
First ever Dr. Brian Timmons (and colleague Dr. Mark Tremblay) develop and publish Canada’s first ever Physical Activity and Sedentary Behaviour Guidelines for the Early Years (ages 0-4 years), released by the Canadian Society for Exercise Physiology and ParticipACTION.
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Dr. Jon Gilleland (left) is appointed Patient Safety Officer. (Page 45: Good Cop).
Dr. Ronit Mesterman receives first place for her poster presentation at the National Canadian Botulinum Toxin Conference.
March 2012 Drs. Andrea Mucci (right) and Heather Toews are appointed Chief Residents for Pediatrics. (Page 18: Life lessons). Pediatric Resident, Dr. Jonathan DellaVedova, is elected as the Professional Association of Interns and Residents of Ontario (PAIRO) President for 2012-2013.
April 2012 5th Annual McMaster Child Health Pediatric Celebration for Undergraduate Research Trainees is hosted by the Department of Pediatrics.
Pediatrics faculty are recognized at the Canadian Pediatric Society Conference
Dr. Peter Dent
Dr. Elyanne Ratcliffe
Dr. Bob Issenman
receives the Alan Ross Award which recognizes lifelong excellence in the fields of pediatric research, education, healthcare and advocacy.
receives the Young Investigator Award which recognizes research accomplishments in child and youth health.
receives the CPS Lifetime Membership Award in recognition of his outstanding contributions to the health of children and youth.
Dr. Sheri Findlay is appointed associate chair, Clinical, Department of Pediatrics. Masters students, Naomi Fink (supervised by Dr. Christoph Fusch) and Ninette Shenouda (supervised by Dr. Brian Timmons) receive the Oded Bar-Or Bursary from the School of Graduate Studies. The bursary is awarded to graduate students enrolled in medical sciences, rehabilitation science, or kinesiology, who are conducting research in pediatric exercise and/or pediatric nutrition.
U.S. Patent Dr. Anthony Chan and Leslie Berry obtain a U.S. patent for a novel assay to assess thrombin generation potential in patient plasma or blood samples.
May 2012 The following trainees are recognized at the Faculty Development Day: u Pediatric Resident, Dr. Meera Umamaheswaran
receives her Basic Teaching Certificate. u Pediatric Neurology Fellow, Dr. Khalid Hundallah
and General Pediatrics Research Fellow, Dr. Khaled Al-Dajam successfully complete the University Teaching Program. Dr. Stephanie Atkinson is inducted as a Fellow of the American Society for Nutrition (ASN) in recognition of her distinguished career in the field of nutrition. Arum Choi, clinical researcher in the Division of Neonatology, receives the award for Best Presentation by a Student at the 11th Annual Neonatal & MaternalFetal Medicine Research Day at the University of Toronto. Dr. Katrin Scheinemann and the neuro-oncology team have nine abstracts accepted at the International Symposium on Pediatric Neuro-Oncology in Toronto. Dr. Scheinemann is also a keynote speaker at the event. Nora Fayed (supervised by Dr. Gabriel Ronen) is selected for a Michael G. DeGroote Fellowship Award. The focus of her research is on “Developing a harmonized system for assessing functioning, particularly in 7
children with epilepsy”. She also receives a three-year CIHR fellowship award for researching outcomes in children with epilepsy. She is ranked third in this CIHR competition.
2012 Residents’ Appreciation Event Awards
Bruno DiGravio, Regional Educational Lead for Waterloo Pediatrics Clerkship, wins the Ari Shali Teaching Award, the highest award bestowed by the graduating MD class.
Teaching Awards Dr. Andrea Hunter receives the Outstanding Preceptor Award for Pediatrics from the graduating MD class. General Pediatrician Dr. Madan Roy
Subspecialist Dr. Burke Baird
Resident Research Awards
June 2012 The Annual Pediatric Child Health Research Day is hosted by the Department of Pediatrics. The following trainees receive awards: Poster Competition
Dr. Kim Genier
Dr. Nancy Nashid
Resident Category: Nancy Nashid & Andrea Granados (supervised by Dr. Jeffrey Pernica): “Comparison of Human Rhinovirus infection and viral load in asthmatic and non-asthmatic children admitted to the hospital” Fellow/PhD Category: Ivan Stevic (supervised by Dr. Anthony Chan): “Inhibition of the prothrombinase complex on the surface of red blood cells”
Dr. Bosco Paes Award Dr. Heather Bhan
St Joseph’s Award Dr. Greg Harvey
Pediatric resident, Dr. Greg Harvey (supervised by Dr. Melissa Parker) wins an award at the 24th Annual National Pediatric Resident and Fellow Research Competition in Winnipeg, for his study: “ The Pediatric Fast Fluid Trial”.
Dr. Moyez Ladhani receives the CAME Certificate of Merit Award.
Ivan Stevic (supervised by Dr. Anthony Chan) receives the Faculty of Health Sciences Graduate Programs Excellence Award. 8
Masters/Medical Student Category: Asmaa Manaan (supervised by Dr. Christoph Fusch): “Artificial Placenta”
2012 New Investigator Fund (HHS) Recipients Dr. Jeff Pernica is awarded a $48,000 HHS New Investigator Fund grant for his research project: “Short Course Antimicrobial Therapy for Paediatric Community Acquired Pneumonia: A Pilot Study”. Dr. Salhab el Helou is awarded a $18,000 HHS New Investigator Fund grant for his study: “MISUEF vs. INSURE. A Comparison of Minimally Invasive Surfactant Application Techniques in Preterm Infants”.
Canadian Institutes of Health Research (CIHR) Grants Dr. Katherine Morrison is awarded a $943,636 CIHR Open Operating Grant for her project, “Canadian Pediatric Weight Management Registry (CANPWR): Identifying the characteristics of successful change in Canadian pediatric weight management programs”. Dr. Stephanie Atkinson is awarded a $752,034 CIHR Open Operating Grant for her project entitled: “Be Healthy in Pregnancy (BHIP) with Nutrition & Exercise”. Dr. Christoph Fusch is awarded a $472,126 CIHR Open Operating Grant to fund a study on “The Effect of Individualized Fortification of Breast Milk on Somatic Growth and Neurodevelopmental Outcome in Preterm Infants”. Dr. Anne Klassen is awarded a $100,000 CIHR Open Operating Grant to fund “A study to field-test the patient-reported outcome measure for bariatric and body-contouring surgery patients”.
Innovation Grant Drs. Katrin Scheinemann and Brian Timmons (Co-PI’s), successfully secure a $200,000 Canadian Cancer Society Innovation Grant for their study: “Exercise intervention in children treated with radiation for brain tumours”.
Dr. Karen Wong (supervised by Dr. Anne Klassen) is awarded the Canadian Society of Plastic Surgeons Education Foundation Outcomes Grant for a study entitled; “CLEFT-Q: Developing a Patient-Reported Outcome Measure for Cleft Lip and/or Palate”. Her grant is ranked 1st out of 15. Dr. Moyez Ladhani’s oral presentation (“Mandatory Group Learning Activities: Getting Residents Ready for Lifelong Learning”) is selected as a finalist for the “What Works” segment at the International Conference on Residency Education. For his research into how “Obesity-induced inflammation contributes to metabolic diseases such as
Welcome New Faculty The Department welcomes several new assistant clinical professors in the Division of Emergency Medicine. Quang Nhut Ngo
Alim Pardhan
Anthony Crocco Erich Hanel
Oral Competition Linda Gillis (supervised by Dr. Brian Timmons & Dr. Stuart Phillips): “Milk combined with high intensity training improves body fat and protein balance in overweight children” Neurology resident, Dr. Chintan Shah is successful in the EEG Certification Examination by the Canadian Society of Clinical Neurophysiologists. Dr. Rajesh RamachandranNair and his team’s abstract on “Sudden Unexpected Death in Epilepsy” is accepted for a platform presentation at the Annual Canadian Neurological Sciences Federation meeting in Ottawa. He is also an invited speaker at the first international meeting of the Partners Against Mortality in Epilepsy organized by the American Epilepsy Society.
Promotions Drs. Jonathan Gilleland, Jonathan Andrew Latchman, Gilleland and Brian Timmons are promoted to Associate Professor. Andrew Latchman
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New Resource for Ontario Ministry Drs. Jan Willem Gorter, Marc WoodburySmith, Marilyn Wright, Peter Rosenbaum, and Carol DeMatteo’s research on “Developmental Trajectories of Youth with Disabilities”
contribute to the Ontario Ministry of Children and Youth Services’ new resource: Stepping Stones; a collaborative new policy to improve youth services.
diabetes”, Dr. Jonathan Schertzer secures an Operating Grant ($300,000) and a Scholar Award ($500,000) from the Canadian Diabetes Association.
International. He is the first McMaster student in the engineering, medical sciences and nature sciences category to win the award.
The abstract, “Chemotherapy passport: a tool to improve safe delivery of chemotherapy” wins the Quality & Patient Safety Award at the 8th Annual Paediatric Patient Safety Symposium - Optimizing Quality in the Era of Efficiency. Trishana Nayiager and Paula MacDonald present the paper on behalf of the chemotherapy committee at the conference at The Hospital for Sick Children.
The Department welcomes assistant professor Dr. Tania Cellucci to the Division of Rheumatology.
The following members of the pediatric residency program successfully complete their exams and are welcomed into the fellowship of the Royal College of Physicians and Surgeons of Canada: Drs. Sadhana Balakrishnan; Maisa Dekna; Kathleen Nolan; Kristy Parker; Meera Umamaheswaran; Cara Davidson; Sophia Xu; Ziad Solh; Anna Gunz; Jodie Ouahed; Dalal Abdelgadir; Tram Nguyen; and Meera Rayar. McMaster Children’s Hospital hosts the first annual Mac Kids Walk and Wheel for Miracles at Pier 4 Park in Hamilton.
Dr. Melissa Parker receives a CIHR ICS Travel Award to present her abstract, co-authored by Asmaa Manan, entitled “Translating guidelines into practice: a survey study to assess health care provider attitudes, preferences and beliefs regarding pediatric fluid resuscitation practices” at the American Heart Association Scientific Sessions and Resuscitation Science Symposium in Los Angeles in November. She later receives a Young Investigator Award at the Symposium.
AUGUST 2012 Dr. Gita Wahi successfully defends her MSc thesis in Health Research Methodology from the Department of Clinical Epidemiology and Biostatistics at McMaster.
July 2012 Dr. April Kam is invited to present her poster, “Non-compliance with follow-up appointments to outpatient specialty clinics after pediatric emergency department discharge” at the International Conference on Emergency Medicine in Dublin, Ireland. Adeel Safdar’s (former student of Dr. Mark Tarnopolsky) PhD research on aging earns a Distinguished Dissertation Award from the Canadian Association for Graduate Studies and University Microfilms 10
Laura Ramsingh wins Best Poster: Masters Student Award, at the Canadian Obesity Network Student Meeting in Edmonton, Alberta for her presentation entitled, “Examining body composition in adults born at extremely low birth weight”.
Dr. Arif Somani joins the Department as associate professor in the Division of Critical Care.
September 2012 Drs. David Callen and Resident Robyn Whitney are recognized with Department of Pediatric Neurology Teaching Awards. Dr. Stephanie Atkinson is reappointed as chair of the Institute Advisory Board of the CIHR Institute of Nutrition, Metabolism & Diabetes for three years.
Dr. Brian Timmons is recognized by the Ministry of Economic Development and Innovation with an Early Researcher Award for his demonstrated excellence and academic contributions to the research question: “Are Active Preschoolers Healthy Preschoolers?” Dr. Jay Green, assistant clinical professor, joins the Division of Emergency Medicine.
Drs. Peter Dent, Saroj Saigal, Charlie Malcolmson and Mohan Pai are honoured at the annual Department of Pediatrics Recognition Dinner at Liuna Station. (Page 22: Recognition dinner). Dr. Sourabh Dutta receives the Department of Pediatrics 20112012 Best Grand Rounds Award for the presentation, “Breast Milk Flora - Hardly a Sterile Topic”.
October 2012 Dr. Stephanie Atkinson receives the Queen Elizabeth II Diamond Jubilee Medal from the Governor General in recognition of her service with Osteoporosis Canada and for being an advocate for nutrition and bone health. Dr. Rajesh RamachandranNair is an invited speaker at the biennial meeting of the Canadian League Against Epilepsy in Calgary. His presentation is entitled: “Sudden Unexpected Death in Epilepsy Patients”. The Pediatric Residency Program presents 10 abstracts at the International Conference on Residency Education – one of which is ranked in the top 5 of all abstracts at the conference. Pediatric residents receive Regional Medical Associate Scholarship Awards: Drs. Greg Harvey (supervised by Melissa Parker) ($3,717); Julia Frei (supervised by Dr. Lucy Giglia) ($7,464); and Jenna Dowhaniuk (supervised by Dr. Herbert Brill) ($4,700).
November 2012 Dr. Bob Issenman and medical student Caroline Jeon’s poster, “Migraine Based Therapy in the Treatment of Cyclic Vomiting Syndrome” is awarded Poster of Distinction at the annual North American Society of Pediatric Gastroenterology, Hepatology and Nutrition meeting. Teams from the Department of Pediatrics raise over $5,000 at the National Inside Ride, in support of the McMaster Children’s Hospital Oncology Unit.
The Department welcomes Dr. Connie Williams, assistant professor to the Division of Neonatology.
Dr. Heather Bahn is the first recipient of the Department of Pediatrics’ Resident of the Month award. Drs. Jan Willem Gorter and Peter Rosenbaum attend special ceremonies to honour Princess Margriet of the Netherlands.
December 2012 Dr. Jan Willem Gorter is selected as the Harry Medovy Lecturer. His presentation on “Transition to Adulthood” takes place in May, 2013 at the University of Manitoba’s Department of Pediatrics and Child Health, and sets the stage for the Annual National Pediatrics Resident and Fellow Research Competition, supported by the Manitoba Institute for Child Health. Dr. Moyez Ladhani becomes a member of the Medical Education Expert Working Group for Resident Duty Hours on the National Steering Committee for Resident Duty Hours with the Royal College of Physicians and Surgeons. Dr. Anthony Chan is appointed as the International Society of Thrombosis and Hemostasis’ Chair of the SSC Subcommittee of Perinatal and Pediatric Hemostasis. Dr. Melissa Parker receives an Early Career Award of $50,000 per year, renewable up to 3 years, to support the growth of her research program in resuscitation science. (Page 30: Seed money). Dr. Natasha Johnson becomes acting leader of the Division of Adolescent Medicine. (Page 48: Caring for teens). 11
2012 news headlines Members of the Department of Pediatrics are often approached by media outlets to provide opinions and commentary on new research, clinical cases and newsmaking events. Here is a summary of the faculty, staff, residents and fellows who have made headlines this year.
Dr. Brian Timmons speaks with Kelly Crowe, CBC TV’s national health reporter while cameraman Dave Macintosh films for a segment on the impact of heat waves on children that aired on The National.
Treating the tiny victims of Canada’s fasting growing addiction Sandra Seigel Globe and Mail, Jan. 6, 2012
Defying gravity with a treadmill designed by NASA Peter Rosenbaum National Post, Jan. 31, 2012
How massage aids muscle healing Mark Tarnopolsky CBC News, Feb. 1, 2012
Hospital launches computer program to ease patient stress Lennox Huang Hamilton Spectator, Feb. 24, 2012 12
Ontario brains put their heads together Peter Szatmari, Jan Willem Gorter, Gabriel Ronen, Ronit Mesterman Hamilton Spectator, Mar. 7, 2012 Teen Drinking: Hamilton ER doc has seen it all Christina Grant Hamilton Spectator, Mar. 6, 2012
Spring forward, lose some sleep Herbert Brill Hamilton Spectator, Mar. 10, 2012 Obesity during pregnancy may deprive fetus of crucial oxygen: study Sandy Raha National Post Apr. 12, 2012
McMaster opens new pediatric intensive care unit Cynthia Cupido Hamilton Spectator, Jun. 14, 2012 Pyschological abuse may be most prevalent form of child abuse, experts say Harriet MacMillan CBS News, Jul. 30, 2012
Sleeping Beauty syndrome steals chunks of young people’s lives, says teen David Callen CTV News, Oct. 10, 2012
No common ground in maternity care debate Lennox Huang Niagara This Week, Aug. 15, 2012
Why are some Hamilton residents working 24 hours hospital shifts Jonathan DellaVedova CBC News, Oct. 11, 2012
Tackling childhood obesity Katherine Morrison Metroland News Service, Aug. 22, 2012
CPR makes you undead Melissa Parker CHCH Television, Oct. 18, 2012
Real life sleeping beauty seeks cure David Callen Hamilton Spectator, Aug. 25, 2012
Mastering motor skills with a little mischief Peter Rosenbaum Globe and Mail, Oct. 25, 2012
Hamilton doctors saving lives in Guyana Katrin Scheinemann Hamilton Spectator, Apr. 13, 2012
Youth University figures nobody’s too young to learn Sandy Raha, Katrin Scheinemann Hamilton Spectator, Aug. 25, 2012
Taking control and telling their own stories CanChild Centre for Childhood Disability Research Hamilton Spectator, Oct. 25, 2012
Insulin pump therapy studied at Mac Karen McAssey Hamilton Spectator, May 18, 2012
How fat has become the new normal Katherine Morrison Globe and Mail, Sept. 30, 2012
Early intervention will decrease baby’s chance of acquiring HIV Sandra Seigel Hamilton Spectator, Dec. 6, 2012
Banting Foundation forges link with McMaster Lennox Huang New Tecumseth Free Press Jun. 7, 2012 13
McMaster Children and youth university Bringing kids to campus pays off in ways you might expect, and lots of ways that you won’t.
“What do you think is happening in this picture?” asks Dr. Christina Grant, a specialist in adolescent medicine, and associate professor and associate chair within the department of pediatrics. She is gesturing to a photo projected onto the two large screens that dominate the front of the lecture hall. It shows three boys, one grabbing another’s shirt aggressively while two others look on. “I think he should tell a teacher!” says a girl, her hand waving in the air. “Good” says Grant, gently redirecting attention, “We’re already thinking about solutions. That’s great! But what do we see? How many boys are there?” It’s not your typical lecture. No one had a laptop, for example, and the talk began with the invigilator asking if anyone needed to use the bathroom. The topic, “Anybody Out There: How to Take the Power Back 14
from Bullies,” was less about academics than it was an opportunity to engage with a room full of people who will face, or who are facing, what Dr. Grant increasingly sees as the root of a range of health and behaviour issues: bullying.
Why engage with kids? Grant’s lecture, which took place on a Saturday morning in early spring, was part of the McMaster
excellence in Education
Children and Youth University, a series of events aimed at children ages 7 to 14. The series, now having completed its second season, is one that was founded by the Department of Pediatrics and includes lecturers from throughout the university. The founders of the program are Dr. Katrin Scheinemann, a pediatric oncology and hematology specialist, and Dr. Sandy Raha, whose research laboratory program focuses on childhood obesity. A few years ago both found themselves independently thinking about the same thing, though from slightly different angles: Scheinemann wanted to begin a children’s university based on a model that she had experienced in Germany, and Raha was looking for a chance to engage more creatively with youth. The result is a collaboration between them: the McMaster Children and Youth University. It meets once a month, is open to any children who wish to come, and is offered free of charge.
The fact that you can actually have fun learning is sometimes a foreign concept to kids of that age”
Scheinemann says that the intention was to reach out to children who otherwise may have never thought about university, or lectures, and most likely haven’t ever had a reason to visit the university property. “We wanted to give them their first taste of [university life]. To come on campus for the first time, and just see the whole variety” of what the university has to offer. Ultimately the goal was less about teaching than it was about engaging young people in the idea of education: to introduce them to the curiosity and the enthusiasm that drives academic life. If it worked, the program would get kids interested in their education, and would help them see beyond the stigmas that might cloud their view of academics. It sounded like a grand plan, and indeed, not everyone felt that it would work. But 15
what Raha and Scheinemann have learned over the past two years is not only that it works, but that it works even better than they had hoped, and that it works in ways that they could never have imagined. For some kids, just coming to the university—the physical activity of entering a lecture theatre—is enough to really spark the imagination. “I remember at one of our first lectures,” says Scheinemann, “one of the kids came a half an hour early, and walked through every row, just to see the best place to sit. She was just so excited about this. She had never experienced something like this before. She was so excited, even before the lecture, just to come on campus.” For others, it’s about learning about what people do here, and that it is something they can participate in, too. “When I tell them about what I do and why I do it,” says Raha, who presented at the inaugural event, “they actually get excited. They say, ‘we didn’t know that. We thought that scientists sit around in lab coats with tape around their glasses.’ And the fact that you can actually have fun learning is sometimes a foreign concept to kids of that age.” While the content can be exciting—a talk on archaeology with lots of bones, for example, is a clear winner—it is often the enthusiasm and the personality of the presenters that has the largest impact on the audience. That coupled with an opportunity to ask questions, based only in their curiosity, in a setting where they know they will get answers. “All too often at home we don’t want to entertain [questioning]. But if you let them, they’ll ask great 16
questions,” says Raha. “And that’s what really gets me excited. Too often, by telling kids how they should be thinking we … end up corrupting them, and by the time they get to university they are more interested in doing what it takes to get them marks than being passionate about the knowledge. My hope with this program is to let them know that it’s okay to ask questions.”
Talk into action The range of topics that work well in this setting can be a surprise too. Raha recalls one talk that was given by Dr. Marshall Beier, a member of the Department of Political Science, on the topic of “The Global Child.” “When Katrin recruited him, my first thought was ‘what have we gotten ourselves into.’” Today he recalls that event as one of the most successful they’ve offered. “[Beier] talked about how children and youth can be more involved in their environment. And I thought, it doesn’t matter what the topic is, if you can present it to the kids in a way that empowers them, they love it. They love feeling that they have control over their lives.” One of the children who attended that talk used what she learned, and that sense of empowerment, to challenge a school closing in her area. “She went to the school board and said, you know, our school shouldn’t close because of these reasons, and they listened to her. And I thought that was totally amazing, that a lecture could motivate a child to do that.”
The team behind the scenes, from left to right: Cheryl Crocker, Brianne Robertson, Dr. Katrin Scheinemann, Dr. Sandy Raha, Dr. Christina Grant, Rabia Mirza, Janice Penney, Lindsay Akrong
Giving back To date, hundreds of kids have come to campus, many of them for the first time in their lives, to take part in a program that remains the only one of its kind in North America. The registration for each of the lectures has grown to 500 a month, and with a blossoming online community and direct engagement with local youth organizations, including the Boys and Girls Club of Hamilton, the Hamilton/Burlington/Brantford YMCA, and the North Hamilton Community Health Centre, the program has also allowed an unprecedented outreach into the community.
from the 2012 season
Its success is an indication that it is addressing a need within the wider Hamilton community. It’s also meeting a specific mandate for the university as outlined in McMaster president Patrick Deane’s “Forward with Integrity” initiative to provide an innovative and stimulating learning environment where students can prepare themselves to excel not only in education, but to excel in life.
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The War of 1812: The Effect on the Families of Hamilton
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If Exercise Was Your Medicine, Would You Take It?
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Buried Treasure: Reconstructing History in South America
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Robotic Surgery
The program will head into its third season later this year. In 2013 MCYU was awarded a Forward with Integrity grant in recognition of its innovative approach to research and education. The grant is awarded through the President’s Fund, and is comprised of generous donations from McMaster Alumni, as well as through the Provost’s Academic Priorities Fund. n
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Anybody Out There? How to take the Power Back from Bullies
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The Starry Sky
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Our Genes, Our World
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The Power of Young Consumers
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life Lessons Heather Elizabeth Bhan reflects on her life within the pediatrics residency program. “I like Hamilton,” says Heather Bhan with a chuckle, the one you always seem to hear whenever someone admits that kind of thing. In this case, though, she’s referring to the city as well as the unique medical profile of the patients she’s seen in her time as a pediatric resident at McMaster. “I love the diversity of the patients that you see here. You get some of the downtown core patients, lots of immigrant populations that come in, so you see some unique conditions. It’s got a big referral base, so you can see a lot of rare conditions, which is fantastic in terms of your training.” Bhan arrived in 2006, coming into the medical program after completing a bachelor of science in chemistry, something that she had expected she would pursue as a career. “I really liked chemistry. I was a big nerd. I still am a big nerd, I guess!” she says, laughing. The move from pure science to medicine, she feels, wasn’t as obscure as it might seem at first blush. “Certainly lots of people in science are interested in medicine. And I really liked working with kids and with people. I was interested in how the body worked, and it became more of a growing interest as I moved through my undergraduate years.” Her story—one of moving from one area of interest into medicine—has been a hallmark of the medical program since it began. In many ways, she is the typical medical student at McMaster, one with a ranging interest driven by curiosity. “They really encourage problem-based learning, case-based learning,” says Bhan of 18
the program, “so it’s a really neat setup that is quite familiar to the students at McMaster. It’s lots of: ‘let’s create a scenario or a case and let’s talk through how you’d manage it.’ There’s a lot of that that happens.” That style of learning has been a growing focus—beginning with scenarios and then moving to hands-on simulation exercises with mannequins serving as patients—and one that Bhan has in part helped grow. “We actually started a resident-run simulation session that happens every one to two weeks, and it’s a senior resident who runs it for the junior resident. We found that it’s sometimes nice for the junior learners to have a resident rather than a staff member running those sessions. It’s a little bit safer in terms of making mistakes and asking whatever questions come to mind. Whenever residents are on their emergency [medicine] rotation … they’ll do a bigger more realistic scenario with the emergency doctors but ours is a more low-tech kind of ‘let’s learn the basics, let’s work through this.” She’s just completing her fourth and final year, and there’s a wistfulness that creeps into Bhan’s voice as she talks about her experience as a resident. It’s clearly been an important time, not without its challenges, that has brought some unique opportunities, such as serving for the past two years as chief resident. It’s a position that she has clearly relished because of the things that it has allowed her to do. “I really liked that as chief you had this platform that you could use to improve things
excellence in Education
You feel like it’s all worth it when you can make a difference for a family”
Dr. Heather Bhan is the chief resident of the McMaster Pediatric Residency Program.
that you thought could be better. People really listen to you when you come with suggestions and say, you know, ‘this is great, but that could be better,’ and you have the ability to make changes from there.” While there is a pace that she perhaps won’t miss, the next challenge is to find what to do next, and Bhan admits that she doesn’t quite know what that will be. “I’m going to start working within the community, but whether that’s locum based or whether I’ll sign on to a community, it’s kind of up in the air right now.”
where you get to do a lot of counselling with families, and see, well, newborns, and talk about what’s normal in development. … Any time you’re talking to a family and you’re able to relieve some of their worries or answer their questions. Any time you can explain what is going on with their kid and it makes some sense to them and there’s a clear plan for them. Families are so grateful and kids are so happy and you feel like it’s all worth it when you can make a difference for a family, or give them clarity as to what’s been going on. That’s what really makes it worth it.” There aren’t likely many chemists, nerds or otherwise, who can say that. n
“But I like general peds,” she says, noting that she’s not likely to move into a sub-specialty. “I like the variety you get… [and that] you get to see such a dynamic change from someone who can be so sick to someone who can come right back to normal in a short period of time. I like out-patient pediatrics, 19
building new approaches to learning Dr. Christina Grant reflects on a year as associate chair of education.
Dr. Christina Grant
“I like being able to mentor faculty,” says Dr. Christina Grant. “I like being the face of education for the faculty and promoting activities, leaders, and supporting program directors.” Grant is an associate professor within the department of pediatrics, and also serves as associate chair of education, a role that she has held for the past year. And though she has only been in that role for a relatively short time, there has been a lot to promote and celebrate. Leaders within the department, says Grant, have been promoted to take on more prestigious positions within the university and across the country. Dr. Karen McAssey became the chair of the medical foundations program for the graduate medical school at McMaster. In the same period, Dr. Moyez Ladhani has taken on significant leadership roles nationally, including chief examiner for the Royal College Pediatric Exam Board (OSCE) and Vice20
Chair for the Medical Council of Canada Evaluation Exam Pediatric Test Committee. Ladhani’s work as program director at McMaster was recognised with two national awards. In 2012 he received The Canadian Association for Medical Education Certificate of Merit for outstanding contributions for medical education. In 2013 he received the Royal College/AMS Donald R. Wilson Award, an award that recognizes a medical educator who has demonstrated excellence in integrating the CanMEDS roles into health related training programs.
Adopting a competency based curriculum Also recognised by those roles, says Grant, are the kinds of innovations that the pediatrics program brings to the process of learning, competency based learning being one of them. “You really want to think
excellence in Education
Dr. Moyez Ladhani
Dr. Karen McAssey
We ask, what are the developmental milestones that people have to meet at certain times in their education, rather than just a list of learning outcomes or objectives.”
about learners from a developmental milestone perspective,” says Grant, “so, we ask ‘what are the developmental milestones that people have to meet at certain times in their education’, rather than just a list of learning outcomes or objectives.”
the education of medical students and residents. The goal, says Grant, is “to give back to our community preceptors. We’ve welcomed them and made up a curriculum based on their needs to learn what’s new in education.”
Under Dr. Ladhani’s leadership, a competency based framework was launched in July, one of the first— and perhaps the first—instances of this approach to learning being adopted within a pediatric residency program in Canada.
Pedia – Clic was offered to all community preceptors who teach McMaster medical students during their pediatric clerkship. It ran for 10 weeks through the fall, online, and included modules, cases, videos, and online chat rooms. Two new problem based learning modules were posted by faculty moderators every two weeks. Each module included case histories typical of real student-preceptor interactions, probing questions for participants to identify and organize relevant ideas and knowledge, and access to electronic resources including education literature and videos.
The goal is to integrate learning into hands-on clinical practice and patient care, and allow more opportunity for faculty to observe learners in the role of clinician. “That’s the direction that medical education has gone, for example, in the United States in the area of internal medicine,” says Grant, “and it’s just getting incorporated in Canada.” It’s a an approach that meshes well with a new rotation in social pediatrics launched this past year, another area where McMaster is on the leading edge of medical education. The rotation places learners into the community, having them go and live the experience of working with Children’s Aid, with Public Health, in correctional facilities, or other areas of medical practice that they likely wouldn’t experience within the walls of the children’s hospital, yet which will become part of their work when they leave their residencies.
Building a community of practice With Dr. Karen McAssey’s leadership, the department launched an education program for community pediatricians. Called Pedia – Clic, it was designed to build an online community of practice to support
Pedia – Clic is a new kind of teaching tool, though the results are already being shown. The level of engagement in the program was high, as indicated by a total of 4,500 page views to the online program, and represents a much broader reach than traditional print or conference teaching styles. And it got people talking, both online and in person, and sharing information between peers and mentors. Participants, says McAssey, also performed significantly higher on a post-knowledge assessment.
Learning how to learn These kinds of initiatives are a means of adapting to the needs of the communities that they intend to serve. Whether it’s classroom learning, or learning online, it’s about reassessing and reconsidering how we learn, what we learn, and ultimately how we serve the community of learners that look to the Department of Pediatrics as a source of knowledge. n 21
recognition dinner Dr. Saroj Saigal In describing the impact of Dr. Saigal’s 40-year career at McMaster, Dr. Peter Rosenbaum has called her a “godmother” to the department, which was nascent when she arrived in 1971.
Dent Mrs. Diane Dent and Dr. Peter
Dr. Peter Dent Dr. Dent has been a clinician, a teacher, and a mentor, and has served as departmental chair. He was also the founder in the creation of the McMaster Children’s Hospital, which opened in 1988, and struggled for more years than he cares to recall for the creation of a dedicated children’s emergency department, a vision which became a reality in 2012. Dr. Stephanie Atkinson toasted Dr. Dent, describing him as “a role model extraordinaire as a clinical pediatric immunologist/rheumatologist, academic educator, scientist, advocate for child health and for his colleagues.” Apart from founding the children’s hospital, he was the key player in the creation of Hamilton’s Ronald McDonald house, began the annual telethon, and integrated non-MD scientists in the department of pediatrics, which is one of its great strengths today.
Since then, says Rosenbaum, “she’s had an incredibly distinguished career” having been an investigator on more than 40 peer reviewed grant applications and has authored about 150 peerreviewed papers and book chapters. She’s been invited to give more than 200 lectures, talks and keynote addresses in 29 different countries. She has also been the recipient of 18 awards, including the Landmark Award from the Section of Perinatal Pediatrics of the American Academy of Pediatrics (2009), the Society for Pediatric Research Douglas K. Richardson Award for her lifetime achievement as a clinical investigator (2011), and the Canadian Pediatric Society’s Distinguished Neonatologist Award (2005). In addition to her clinical work, Dr. Saigal has shaped the careers of 20 graduate students who have studied with her. In 1975 she began a neonatal follow-up clinic which became the work for which she is best known, a longitudinal study of low birth weight babies from birth to adulthood. It is a study that continues to alter what we know about prematurity, and our expectations of its impact on growth and development. She continues to follow the original cohort, who are now in their 30s, painting a clearer and more positive outlook for children born with severely low birth weight.
For those who worked with him over the 45 years he has been at McMaster, it is his leadership that is most remarkable. Says Atkinson, “His mentorship is a hallmark of his support of pediatric faculty. He always has some thoughtful words of guidance and is the very definition of the thoughtful, caring pediatrician.” 22
Dr. Saroj Saigal and Mr. John Campbell
Dr. Charlie Malcolmson “We all owe a part of our careers to him,” said Dr. Rob Lloyd in his remarks in recognition of Dr. Malcolmson’s service at McMaster. “He was always there, nudging, cajoling, directing us towards a better way to do things, to think and to help patients. We all need this kind of rock-solid, gentle leadership.”
Dr. Mohan Pai and Mr s. Nalini Pai
Dr. Mohan Pai
Dr. Mohan Pai is one of the founding members of the Department of Pediatrics at McMaster. Says Dr. Ronnie Barr, “He came to Winnipeg where he met Alvin Zipursky,” the founding chief of the department,“and Zip brought him here with a whole bunch of other people, to help set up the first department of pediatrics.”
Malcolmson joined the department as associate professor in 1974 and held a number of roles in his career here, including co-founding the pediatric critical care unit at McMaster Children’s Hospital, serving a term as chief of the department, and recently playing a vital role in the creation of the pediatric emergency unit. However, Lloyd noted in his remarks that the impact Malcolmson had on his colleagues was often more personal, “reminding us on a daily basis that what we do matters and that it can be done with both excellence and humility.”
At the Recognition Dinner, Barr described Pai as a member of faculty who has continually worked to build a culture of teamwork, especially in the clinical care offered by the hospital for children with cancer. “You couldn’t want a better colleague than Mohan,” says Barr, “there wasn’t an area of work that he wouldn’t take on … he has a passion for teaching, and even when he wound down his clinical practice to a large extent, he’d be the last person here. And you’d say ‘What are you doing, Mohan, you’ve got no more patients today?’ and he’d say, ‘Oh, I’ve got a student at 7 o’clock.’ He was just always available.” Pai has been acknowledged as one of the premier hemophilia physicians and investigators in Canada, and he has had a leading role in the hemophilia centre. He also served, tirelessly, within the oncology program at McMaster Children’s Hospital, especially within the area of palliative care. His work has had an impact on patient care practices locally, nationally and internationally.
Mrs. Cathy Lee and Dr. Charlie Malcolmson
In 2009, Dr. Pai was a co-recipient of the Hamilton Health Sciences Foundation Cornerstone Award to recognize a career of caring and leadership. As a professor emeritus he continues to provide instruction, guidance and care. 23
Recognition Dinner
Christina Grant & Sheldon Norton
Ronald Barr and Mohan Pai
Lisa and Brian Timmons
Resident He ather Bhan
Rob Lloyd
David Lamont, Cynth ia Cupido, Rob Lloyd
Brandon Me aney, She ri Findlay
Maroon and Lehana Thabane
j Saigal Rob Lloyd, Anthony Crocco, Saro
24 Olaf & Lais Kraus de Camargo, Michele & Gabriel Ronen
Peter & Stephanie Atkinson
Elise Gallant pey Brian Timmons, Tammy Troy Hem
Saroj Saigal
Peter Dent
Lennox Huang
Ryan Grant, Julia Fre i, Jenna Dowhaniuk, Jon Pleizier
Lennox Huang and John Watts Ronnie Barr Paul and Vicky Bre akey
Trevor and Marlice Simon
Lori and Bob Issenman Anne Nie c amd Tony Barberi
ise and Anne-Lou John Watts
Watts
Rob and Shirley Ferguson 25
if you can dream it We’ve come a long way, and it’s just the beginning. “The ultimate goal of this research activity,” writes Dr. Christoph Fusch, “is to develop a medical device that can be connected to the circulating blood and that provides additional gas exchange. … The device shall have a high efficiency with a small priming volume, shall work in ambient air, shall be connected to the natural umbilical vessels, shall be pump-less and biocompatible and shall have a modular concept so that it can be easily adjusted to various body sizes.” The device is, in many ways, at the very cutting edge of neonatology: an artificial placenta. It is something that Fusch, his research team, and a network of researchers in the faculty of bio-engineering at McMaster have been working on for roughly the past three years. Recently, they’ve developed and tested a prototype, proving that the concept works to normalize arterial oxygen saturation to normal levels. The target population for the device is term and pre-term infants suffering from end-stage respiratory failure which, if left untreated, can result in mortality or respiratory disease requiring aggressive ventilation which, in turn, is associated with a high risk of severe permanent lung damage. The project is indicative of just how far the division has come since it was founded 40 years ago. At that time the goal was simply to help babies born severely premature to survive. Today, researchers like Fusch are finding ways to address prematurity itself, finding ways to allow babies 26
Dr. Christoph Fusch
excellence in Research
before which intubation of the airway, positive pressure recruitment of lung volume, and re-ventilation with oxygen or air wasn’t practiced, especially in the case of low birth weight babies. As a consequence, many high risk babies failed to survive. Dr. Saroj Saigal became the second member of the faculty when Sinclair brought her to Hamilton from McGill in 1972. “At that time survival of infants who were less than one kilo was a new thing,” she says. “And so, soon after we started, we had quite an improved rate of survival in infants who were less than one kilo.” Part of the job of improving survival rates was gathering data. In the first years, Sinclair completed a study of low birth weight infants, gauging their growth and development in the first weeks and months within intensive care, and comparing the results to children born at the same time who didn’t require intensive care.
When I think about the past, I think about how little we knew.” Schematic illustration of the artificial placenta
—Dr. Saroj Saigal
to grow as naturally as possible in utero in instances where, in the past, they would have been delivered pre-term.
Building a foundation It’s in the capacity of holding the Jack Sinclair Chair in Neonatology that Fusch is able to do the kind groundbreaking work that he is increasingly known for. The Sinclair chair is a $2 million research chair in neonatology funded jointly by the Hamilton Health Sciences Foundation and McMaster University. It is named for Dr. Jack Sinclair, a neonatologist who came to Hamilton 40 years ago this past fall in order to help create the Department of Pedicatrics and to found the Division of Neonatology. When the unit opened, it was still just the very early days of intensive care for neonates. The concept of intensive care for neonates was founded in the late 60s,
Drs. Saroj Saigal, Jack Sinclair in the early days of the NICU, 1973.
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At the same time, the NICU was fast becoming the site of one of the most important studies of neonatal development that had been done to that time. Initially called the Growth and Development Clinic, and later the Neonatal Follow-up Clinic, Saigal tracked the progress of 166 high risk infants as well as a similar number of infant controls from birth into adulthood. “When I think about the past, I think about how little we knew,” says Saigal. “Saving these tiny babies was very exciting. But what always worried me was how they were going to do later on. And that was not known. There were anecdotal reports and there were some reports from here and there … [but] the reports were very pessimistic. So, as soon as the unit opened I was drafted to be in the clinic, and we learned so much from our experience. Now, 40 years later, we are old hacks at all this, but at that time we really didn’t know how they were going to do.”
The NICU today Earlier in 2012 Fusch was awarded a $545,000 grant from the Canadian Institutes for Health Research (CIHR) and Natural Science and Engineering Research Council (NSERC) to develop the artificial placenta. Dr. Sourabh Dutta and Dr. Fusch also received a $200,000 HAHSO Innovation Grant for a project to discover the effect of grouping patients by level of acuity within designated areas of a NICU. That study will run for the next two years. The division also attracts over a dozen fellows per year from Canada and around the world, fellows who come to take part in important work, but also to immerse themselves in a culture that remains a legacy of the time when the division was founded all those years ago. We’ve come a long way in helping neonates, but that early work of the division set the tone for the NICU as both a place of caring but also of curiosity and discovery, something that is prevalent within the unit today. n 28
Image of the prototype
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Seed money Putting money where the expertise is. Talk to any researcher and funding is going to enter your conversation at some point. While we think of researchers in white coats with quizzical looks investigating in a lab, the reality is that sitting at a computer, writing grant proposals and looking for new sources of funding is something that preys on their time. “Even if you’re smart and work hard you still need resources,” says Dr. Melissa Parker, an assistant professor within the Division of Critical Care. As a researcher she studies resuscitation. And, as with any area of research, she depends on resources in order to get her work done. “As faculty members, we do get resources, but most of the resources we’re given are to support clinical activity. You know, you need an office and you need to be able to access medical records and to do those kinds of things. And you do get a small academic allowance per year, but you need more support to hire research staff and cover some of the other obligatory costs. There is no way around them, you have to get them from somewhere.” As researchers grow to prominence within their field, the sources of funding can become more varied and more lucrative. Indeed, those are the numbers with lots of zeros that we see from time to time in departmental newsletters, in press releases, and in the media. For Parker, though, perhaps the most important grant in terms of the work she is doing today is the one she got in 2009 in the amount of $25,000, awarded by the Department of Pediatrics, when she first came to the university. In the world of research—where fees associated just to clear articles for publication can easily run into four digits—the reality is that that money needs to be used wisely in order to achieve the greatest benefit. 30
She used the money in ways that can also seem modest at first glance. She bought a computer and a hard drive for data backup and data security, investments that she notes allowed her to begin working more efficiently. Then, she hired a research student, which added a further efficiency. “Often you may have ideas,” says Parker, “but you may not have the time to pursue them all on your own. So that’s why you need to hire people to help do some of the legwork.” She then used some of the start-up funds to pay for external statistical consultation in order to process data that was sufficiently complex that she was unable to do on her own, something that is nevertheless essential in order to get results quickly into publication.
Reaping what we sow On the strength of her work since she arrived in the department, Parker has been recognized at the Hamilton Health Sciences Research Gala as one of five New Investigators to win a HHS Early Career Award. The award provides funding to support novice investigators focus on new programs of research and advance their scientific careers. As well, she’s worked with mentoring others, including Greg Harvey, a pediatrics resident. “We’ve been quite successful, we’ve been able to present our research,” says Harvey. “We did a control trial using multiple nurses and staff where we looked into some basic resuscitation principles. We were able to present it at the International Conference of Emergency Medicine, in Dublin, Ireland, in June of 2012.” That trial also gained Harvey first prize in the National Pediatric Resident Research Competition in Winnipeg in 2012.
excellence in Research
[Research] is the ability to notice what other people haven’t noticed in things that you see everyday, and to … turn it into a scientific question which you can then evaluate in an objective way.” Harvey admits, despite having worked closely with Parker for the better part of two years, that her workload is vast. “She’s involved in tonnes of research that I’m not even aware of.”
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“She’s [also] been a tremendous mentor for me, and she’s a real leader for the resident group.”
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The best is yet to come Given the strength and scope of her work, Parker is now able to successfully compete for some of those larger grants with more zeros behind them. But it’s a position she’d not be in were it not for that initial investment, which was money but was also a vote of confidence made by the Department of Pediatrics in the potential that Parker showed in coming to McMaster. “That start up funding is really
> Seed Money
important in giving you some breathing space and some time before you basically have no support. It is a bridge until you can find larger amounts of grant funding, regardless of the source.” n
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Supporting research Encouraging knowledge acquisition and translation. Research is an essential component of academic health sciences for knowledge acquisition and implementation, as well as training of the next generation of scientists. This requires investigators to be highly trained, to have protected time to dedicate to research and to garner the competitive funding to support their research. In today’s world of fast moving science knowledge and advances in technology, many challenges exist to accomplish meaningful research results that will impact on clinical practice or health policy, as well as support capacity building through training. Success in reaching such goals requires a coordinated effort between researchers, sustainable funding and availability of support services from their institution.
Fostering an environment of curiosity “We’re trying to encourage a passion for research across all interested faculty members and trainees whether as a lead investigator or collaborative team member,” says Dr. Stephanie Atkinson, professor and associate chair, research, who leads the Department of Pediatric’s Office of Research Services. “Research is often spearheaded by PhD scientists or clinician scientists with dedicated time allocated for research. With the current focus on multi-disciplinary teams, a broader sector of faculty members can engage in research in a manner that is compatible with their other
academic duties. Our department aspires to foster research interests especially of junior physicians and non-MD clinicians in order to provide opportunities for building multi-disciplinary research teams.” To accomplish such goals, the department set in place services that will help support training and guidance of junior faculty and trainees in the research process. The ultimate tangible proof of success is the amount of research dollars that the faculty can attract. “As a result of our recent efforts in the development of structured research services, we are very pleased with the number of grants awarded to our faculty members,” says Atkinson, though she is careful that those numbers are not the only gauge of success. “We place great value on the engagement of members of the department in accessing and using the research services to foster and support early research endeavours, and by monitoring the use of such services, I feel confident that we’re reaching our goals.” Research is being generated across 16 of the departmental divisions, indicating research interests across the broad range of sub-specialties. “I’m also very excited about the large increase in research trainees in the department. In the past year, that doubled to over 100 trainees supervised by 34 faculty members. Junior faculty are taking up the challenge of engaging undergraduate trainees or medical students and resident trainees in their research projects, which can vary from chart reviews to sophisticated clinical studies. Based on the high level of participation in our research day events for all levels of trainees, one can sense that the pulse of excitement about research is escalating.” As a result, students are exposed to the ground-breaking work of both clinicians and basic scientists within pediatrics, an exposure that enriches their education but also has immediate application in improving child health. 33
internally To achieve such success, Atkinson helped the department recruit research support staff, including a research services specialist and a part-time biostatistician and data analyst, and led the Research Advisory Committee in developing infrastructure to promote and support research. For example, Lindsay Akrong who was hired in 2011, plays a unique role, and one that recognises the kind of in-house support activities that benefit researchers, such as guidance in completing ethics applications, identifying funding opportunities, preparing applications and research contracts, and encouraging creative means of knowledge translation.
We hope to breed the scientists of the future.”
Akrong also keeps an inventory of students who are interested in helping with research projects, and faculty can go to her for “match-making” with the type of student appropriate to their needs. “There are tons of undergraduate students around who need projects as part of course requirements or who are willing to volunteer in order to gain experience. And in providing exciting and meaningful research experiences for such students, we hope to breed the scientists of the future.”
across Canada The Department of Pediatrics is a member of the Maternal Infant Child and Youth Research Network (MICYRN) which links 19 academic pediatric and perinatal centres across Canada. The mission of MICYRN is to provide an integrated infrastructure that supports practice-based networks and research teams for the purpose of enhancing capacity for high quality health research, fostering and enhancing collaborations across Canada and beyond.
Research Training in Pediatrics Number of Trainees Participating in Pediatric Research (2012-13). 120
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Through MICYRN, the Department of Pediatrics began to implement REDCap (Research Electronic Data Capture), a web-based system that allows users to build and manage online surveys. The program is being adopted by MICYRN member centres throughout Canada, creating a level playing field, in a sense, allowing for a greater ease of data capture and research collaboration, including a common platform for intra-site studies. “It will not only connect us nationally, but it will be a real bonus within the department.” n 34
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Featured Grants & Awards 2012
Dr. Melissa Parker, CIHR: Travel Awards - Institute Community Support “Translating guidelines into practice: a survey study to assess health care provider attitudes, preferences and beliefs regarding pediatric fluid resuscitation practices” HHS: Early Career Award
Dr. Salhab el Helou, HHS: New Investigator Fund “Misurf & Insure - surfactant application”
Dr. Gaby Ronen, HAHSO “Enhanced physical activity in children and youth with epilepsy: Developing evidence of impacts on health, functioning, psychological wellbeing and quality of life” Drs. Christoph Fusch & Sourabh Dutta, HAHSO “Effect of cohorting patients by level of acuity to designated areas within a neonatal intensive care unit”
Dr. Jeffrey Pernica, HHS: New Investigator Fund “Short Course Antimicrobial Therapy for Paediatric Community Acquired Pneumonia: A Pilot Study”
Dr. Jeffrey Pernica, Grand Challenges: Stars in Global Health “Measuring the Impact of Novel Enteric Diagnostics - How Many Children’s Lives Can Be Saved?”
Dr. Melissa Parker, HHS: New Investigator Fund “Pilot study for SQUEEZE RCT (septic shock resuscitation)”
Dr. Christoph Fusch, CIHR: Open Operating Grant “Individualized fortification of breast milk”
Dr. Katherine Morrison, CIHR: Catalyst - eHealth Innovations “Family Centred E-Health in Pediatric Weight Management: A Pilot Study”
Dr. Anne Klassen, CIHR: Open Operating Grant “Developing a Patient-Reported Outcome Measure for Bariatric and Body Contouring Surgery Patients: the BODY-Q”
Mark Duffet, CIHR: Fellowship “The Evidence in Pediatric Intensive Care (EPIC) Research Program”
Dr. Christoph Fusch, CHRP (NSERC Partnered) “Development of a pumpless lung assist device which acts like an artificial placenta for neonates with respiratory failure.” Dr. Stephanie Atkinson, CIHR: Open Operating Grant “Be Healthy in Pregnancy (BHIP) with Nutrition and Exercise” Dr. Katherine Morrison, CIHR: Open Operating Grant “Canadian Pediatric Weight Management Registry (CANPWR): Identifying the characteristics of successful change in Canadian pediatric weight management programs.” 35
The next best thing The more realistic a simulation, the better.
… to reach for the chart, and if it’s not there, well, that’s one of the problems that would be highlighted.”
On January 14, 2013, the children’s emergency department at McMaster was the site of the most comprehensive simulation of its kind, not only in Canada or North America, but the world. Crysta Balis, an education coordinator within the Department of Pediatrics, was one of the 60 volunteers who took part. Among other things that day, she played a mom of a child with a digestive complaint. “I had a three-week-old simulation, and I was carrying a high-fidelity mannequin. It was projectile-vomiting, so at one point they actually mixed a concoction—it must have been some kind of cottage cheese—and poured it all over the blanket of the baby. And it was vile. It was gag worthy.” Clearly, the object of the simulation was to be as natural as possible—they weren’t just simulating cases, they were simulating the stress and strain of the environment, working to accurately create the kinds of demands that would, in time, be made of the space. It was about treating patients, but it was also about dealing with personnel, encouraging efficiencies, and in some instances, just finding the mop. The simulation touched all levels of the emergency department, and drew on the expertise of a team of project leaders, known as the “A Team” that consisted of the chair of pediatrics, emergency physicians, nursing 36
Crysta Balis with a simulation baby, complete with projectile-vomiting.
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leads, a pharmacist, equipment manager, and other simulation experts. The team was lead by Dr. Ehud Rosenbloom, assistant professor in the division of emergency medicine, in a process that took months to complete. To add to the verisimilitude, the scenarios were real ones: the majority of the events that day were simulations, in real time, of cases that arrived at the working ER next door. Says Rosenbloom, “We not only mirrored the fact that the patient came [into the ER] but we also mirrored what happened with that patient. Say you came in with your son with an arm injury. There was an x-ray, and the x-ray showed that he had fractured his arm. We gave that physical x-ray to the physician that was simulating [the case]. We did that to make sure that we imitated the flow,” or the movement of the patient and patient information through the department and through the areas of specialty, from triage to discharge.
“We tried to make it as immersive as possible,” says Balis, who was involved in some of the logistics of the day, “so everyone could function like it was a real day of work. You know, to reach for the chart, and if it’s not there, well, that’s one of the problems that would be highlighted. You know, there’s no place for charts.” The only difference between the real side and the simulated side of the ER were the observers, wearing red shirts, who circulated throughout the area looking for potential problems or what Rosenbloom calls “latent patient safety threats.” Those threats ranged from not knowing how to turn down the volume on the waiting room television, to the flow of communication between nurses and staff, to being able to open the door to one of the patient bays (they couldn’t, but it’s OK, it’s fixed now). It was also an opportunity to give the people who would ultimately
be working in the ER a chance to confirm that it was a place in which they could be comfortable, one in which they could confidently deliver the highest possible level of care. It was also about reassuring the teams that, if anyone had issues or preferences, that they could be part of the dialogue. It was about reassuring them that they are all part of a team.
The strength is in the details “The clinicians not only have to work with the logistics of the situation but also the temperaments of the people involved,” says Rosenbloom. They also have
Dr. Ehud Rosenbloom (right)
to think on the fly. In the middle of the day he decided to put someone in the washroom and have them lock the door from the inside. You know, just to see what would happen. “I sent one of my assistants to the washroom and then pushed the alarm button. And nobody could open the door because no one could find the key. Because it’s a new bathroom. In a new area. But now we know! Everybody knows.” Rosenbloom estimates that he ultimately devoted four months of full-time effort into making the day 38
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what it was—everything from syncing the computers, fielding volunteers, planning scenarios, to mixing vats of faux vomit and blood. The level of detail can seem excessive perhaps, but it all, says Rosenbloom, is essential in gaining the planned result, one where the department is tested to the point of reality. As a member of the Hamilton Health Sciences Simulation Committee, Rosenbloom has played a key role in designing curriculum for residents and medical students to experience mock code training and continues to investigate and implement new techniques in this area. He has successfully incorporated simulations into new educational activities and improved the quality of the simulation exercises offered at McMaster. He heads international workshops and webinars to bring the knowledge that is gained at Mac to a wider audience, and the work of Rosenbloom’s team has also been presented at multiple forums including the International Meeting on Simulation in Healthcare and the International Pediatric Simulation Symposium and Workshop. Says Rosenbloom, “We use simulation as a tool for education on a daily basis in the emergency department, and also for quality assessment” which includes bi-weekly testing in anticipation of the SimREALITY day in the ER. It’s all at the very cutting edge of education and assessment. And how did the three-week-old do? “She made it!” says Balis. “It was at the end of the day, so we didn’t get to a diagnosis, but she didn’t crash, which is always the worry, because you get attached to these little robots.” And the emergency department didn’t crash either. It opened to real patients in February of 2013. Today, it is a fully functioning department. With real moms and dads and everything. n 39
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The birds and the bees Growing up is hard to do. “It’s a board game,” says Dr. Jan Willem Gorter. “You know, it has questions, such as yes or no questions.” It’s colourful, with cards and has game pieces that move about the board during play. It requires players to answer questions, role play situations, and offer advice. First created in the Netherlands, Gorter and others are preparing an English version for use here. And it’s called SeCZ Talk. Yes, you’re saying it right—the title is a Dutch acronym for Sexuality and Chronic Conditions, and comes from a prototype that Gorter helped develop through the Netherlands’ equivalent of CanChild, a program Gorter founded. So, yes, the game is hard to discuss without a smile on your face, perhaps because the concept is one that can easily raise a
“ … after all, what can be more important than healthy relationships?” Drs. Heleen van der Stege and Diana Wiegerink from The Netherlands facilitating a workshop on the SeCZ TaLK Board Game. Natasha Johnson (adolescent medicine) and Ruth Bolton (nurse at the developmental program ) are role-playing the game while other members of the research team (Martha Cousins, CanChild; Andrea Morrison, occupational therapist Chedoke Developmental Rehabilitation Program; and Deb Stewart, CanChild) wait their turn.
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Dr. Jan Gorter and Nour Msiss
whole range of awkward feelings and thoughts. And the game doesn’t pull any punches; sex can mean anything from a physical act, to an orientation, to an area of academic interest, and it engages with its topic on all of those levels. But, while it’s a board game, it’s reason for being is patently serious. “It’s to facilitate a discussion among peers about relationships, intimacy, and sexuality.” The intended
audience for the game is teens and young adults with chronic health problems or disability, a community of people for whom talking about sex is awkward in ways that most of us simply can’t fathom. At it’s core is a desire to find a way for children with a disability to do what so many of us do—perhaps with a few bumps and bruises, a few scars and regrets—without really having to contemplate it in 41
the abstract: grow up, learn about who we are, become adults. But there’s more, too. “For children in an emotionally dependent position, if you don’t educate them, they are extremely vulnerable to abuse, including sexual abuse. Abuse is two to three times higher in children with disability than in the population as a whole.”
Making the transition The game was developed through university and hospital collaboration, and is a product of the research embedded in CanChild’s investigation into lifecourse and transitions. It also benefited from a close collaboration with various clinicians from the Department of Pediatrics and McMaster Children’s Hospital. At the outset, Gorter was focussed primarily on the transition between health care settings: the movement of children with chronic disability from pediatric care into adult care. The goal was to find ways to keep children with chronic disability from, as Gorter says, “falling off the cliff.” Studies have shown—including the TRACE study, a 4-year longitudinal study that Gorter will complete this year—that, in the past, the transition into adult care has been less than successful, in part because patients haven’t been prepared to take on responsibility for their own care. They stop going to the dentist, to the doctor, to the clinics, and are then plagued by a range of health issues, many of which are preventable and entirely unrelated to their disability. But what Gorter has found is that there are other aspects of transition that can have as profound an effect on health and wellness. Part of being an adult is managing a social life, being a friend and accepting the support of friends. It means finding a horizontal identity, one that 42
comes from an awareness of self, and difference, independent of the vertical identity that we get from our parents— our cultural heritage, or the identity that comes to us from our parents sense of self, such as an interest in hockey, or camping, or religion—and finding a community that reflects that horizontal identity. These things can of course be difficult for everyone, though for those with mobility barriers or who require intense and personal care from parents and nurses, the transition can seem impossible. Gorter believes, however, that it needn’t be, and that the transition is essential to health, and that the challenge is finding the tools necessary to address a very unique set of needs. “We are social beings, and if you’re not connected, and if you don’t have the ability to connect, you not only have a small group of friends, but you’re less likely to have a job and other meaningful outcomes,” says Gorter. ”And after all, what can be more important than healthy relationships? To be able to initiate relationships and to keep them?” n
giving back a life
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Making molehills out of mountains. For people of a certain age, the face of eating disorders is Karen Carpenter. She was the first prominent victim of an eating disorder, and it was anything but veiled; she wasted away literally before our eyes, though many of those around her either turned away, or perhaps chose not to intervene into what they saw was a personal matter. After she died, it was anything but a personal matter. Eating disorders were recognised as disease, and Carpenter was the poster girl. Her profile was the one we considered as part of the disease: a victim of self image, one who denied her condition even when it was blindingly clear to those around her. And, she was an adult. Today, that profile no longer holds. We don’t look away, at least not so readily, and it’s no longer strictly an adult condition. Perhaps, through greater awareness, and better treatment options, we’ve learned that it never was. “We have children, pre-pubertal kids,” being treated in the clinic, says Sheri Findlay, director of McMaster’s eating disorder program and the associate chair of clinical practice. The fact that they are so young would once have come as a shock, and perhaps to many people still would. Still, it’s something that those working in the field have come to expect. “One of our current in-patients is 10, and that’s not shocking. It used to surprise us; it doesn’t anymore. It’s not the way it used to be.” What also doesn’t surprise them anymore is the frequency with which they see patients coming through the door with advanced eating disorders. The new eating disorder clinic opened it’s doors the first week of February, 2013, and it has been busy ever since. There are six in-patient beds and four daypatient beds, and they have been full consistently since the clinic opened. The rate is about one hundred patients a year, averaging two patients a week. It’s sad, perhaps, to see so many patients who are so young, but it’s also evidence that the system is working better than it has in the past. By 43
intervening so early in their lives, the results are greater, both in terms of recovery, but also in terms of the disruption to their adolescent growth and development. The approach that the clinic takes is also an important factor in the effectiveness of the treatment. Known as Family-Based Therapy, Findlay notes that “the reason kids have a better prognosis is because they are embedded in a family system that cares for them, insists on treatment, provides support and supervision so the child eats, takes their meds, etc.” As the most substantive development in the treatment of eating disorders Hamilton has seen, that’s what the clinic has been doing, non-stop, since it opened. “You know, we try not to be discouraging and say, ‘get over this now or you’re never going to get over it.’ That’s not really the message that you want to give people, that it’s hopeless. Because it’s not hopeless. But the truth is that it’s much better to recover as a child and move on to university or college, or work, or whatever you’re going to do without this problem. It’s really hard to recover in the adult system.” n
Dr. Sheri Findlay on prevention “There is no evidence that the incidence of eating disorders is going down. It’s probably going up. There’s also no evidence that the evidence of obesity is going down; it’s going up. Those two illnesses often parallel each other in frequency. And there is at last a lot more cooperative work being done between the obesity prevention people and the eating disorder prevention people. Because we all want the same thing, needless to say. We all want a healthy population of young people. We all want kids to be healthy and feel good about themselves. There has been increasing concern that the anti-obesity message, for a vulnerable kid, can be a pretty toxic message: ‘you’re not good enough the way
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you are,’ ‘you shouldn’t enjoy your food,’ ‘everyone needs to lose weight.’ For kids who are perfectionist and high achieving, that message gets absorbed and so the concern is, how do you get the message out there without interfering with people’s body image. Its become so ingrained, the idea of thinness to the exclusion of health. But the message shouldn’t be about weight, but about healthy activity levels and healthy eating. And I think we’re a long, long way from solving that problem.”
Hi Sheri, This is Rebekah Ca therwood writing you this em ail, you may not remember who I am, but I just wanted to send you this email to relay how much I appreciate everythi ng you and your team did for me when I was 14, and how much it shaped the person I am today. After those tough few years following my hospita lization, with the support of you, the team and my amaz ing family, I was able to accom plish a lot and leave the past behind me. I was able to go on an exchange to France for 3 mo nths in my senior year of high school. I also recently gradua ted from the University of Weste rn Ontario as a Registered nu rse, and am now working at St. Joes in Hamilton. None of these thing s would have been possible if I was not provided with the ap propriate tools to manage str ess and conquer life’s little bump s in the road. I am really ap preciative of everything that yo u helped me overcome and I am truly more confident and self assured then I have ever been. So again, thank yo u, thank you, thank you :) Rebekah Catherwoo d :)
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Good Cop Jon Gilleland becomes the hospital’s first patient safety officer
In 2012 Dr. Jon Gilleland became patient safety officer for the McMaster Children’s Hospital. It’s a new role, and one that was created around a very broad understanding of safety and prevention. “We want to build a resilient organization that really learns from itself,” says Gilleland. “I think it’s useful to make comparisons with other areas of industry where this is a concept that has really been brought to life and where you can really see the impact” such as in the airline industry. The goal is more than responding to problems when they happen, but to encourage an environment with a proactive pre-occupation with failure that continually works to gain a greater understanding of adverse events. It means striving to find best practices, and to share them, finding ways to grow, learn, and communicate effectively. And it means working as a team in order to implement and standardise those practices.
It also means acknowledging mistakes when they happen, disclosing them to patients and families and supporting them through the process. To that end, the Children’s Hospital is launching a new vision for patient safety, one that highlights awareness and building a responsive culture. Gilleland is the local principal investigator in a multicentre research study evaluating the use of the “Bedside Pediatric Early Warning System” as a means of detecting evolving serious illness at the hospital. “If there is a new way of doing things that may lead to a safer hospital stay for our patients, we’re going to look seriously at how we can bring these innovations to our patients,” says Gilleland. Ultimately, patient safety is being approached as an area of growth and innovation with a goal of translating that innovation into improved quality of care. n 45
A new approach to an old problem MAC-Obesity is using teamwork to identify and treat obesity.
“We’re not just trying to understand the pathways to childhood obesity,” says Dr. Katherine Morrison. “More importantly, we’re trying to understand the pathways to ill health in kids with obesity. We really need to understand what’s going on in their bodies that’s causing them to develop high blood pressure, problems with blood sugar, sleep problems or depression.” To further that kind of understanding, Morrison helped found the MAC-Obesity program which was launched in 2012. The intention of the program is teamwork, namely to bring together clinicians and basic science researchers to address some common questions around disturbances in metabolism related to childhood obesity. It’s a new approach, something which Morrison sees as its primary strength. “We can’t simply keep saying eat less and exercise more. We know that hasn’t worked to improve health. We need to focus on how to help patients change behaviours and on improving how our bodies regulate themselves and use energy.” 46
The program brings together the best of two worlds, namely work with patients in clinic and work in the laboratory. The MAC-Obesity program involves staff and physicians from four departments within the university, and spans the divisions within the Department of Pediatrics. It includes more than 30 researchers and clinicians, all of whom have notable accomplishments in their respective fields. The program is co-led by Dr. Gregory Steinberg, an associate professor in the Department of Medicine who holds a Canada Research Chair in Metabolism, Obesity and Type 2 Diabetes.
From the bench to bedside The intention is to use what researchers are finding in the lab in order to improve both understanding and care. “They can do things in the lab that we can’t do,” says Morrison of the researchers involved in the program. “They can use animal models and look at fat and muscle cells, [things] that we obviously can’t do. By working towards answering the same questions using different methods we will improve the health of the kids that we see in clinic.” The goal,
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ultimately, is to prevent the development of health problems related to obesity and to treat kids who already have them. Start-up funding for the program includes $450,000 from the Hamilton Health Sciences Foundation and physical space at the McMaster Children’s Hospital, in addition to $1 million and equipment and research infrastructure from the university. Recent examples of the multi-faceted research being conducted by members of the MAC-Obesity team include studies which have demonstrated the need for screening of pre-diabetes in overweight children, the identification of key genes controlling the beneficial effects of exercise and the impact of a diet high in fat on fetal development and survival. n Dr. Gregory Steinberg and Dr. Katherine Morrison.
There’s a lot more to obesity than meets the eye. “The centre blue areas are the metabolic abnormalities that develop in obesity that lead to the different diseases that are outlined there,” says Steinberg. “As you go out, these have implications at the clinical level and the population level for the development of the disease,” all of which will be studied within the MAC-Obesity program. 47
caring for Teens Applying research to improve adolescent health.
Dr. Natasha Johnson
We’re setting the stage about how you have a conversation with people about things that are important to them.” 48
“You really can’t be scared of tackling the thorny issues if you’re working with this population,” says Dr. Natasha Johnson. The population she works with is teens. “We deal with a variety of issues that are relevant to teenagers,” she says, including pubertal development, mental health issues, eating disorders, chronic illness, transition into adult care, and sexual health issues. Johnson accepted the role of head of the Division of Adolescent Medicine in 2013, becoming the second after Dr. Sheri Findlay, who was a founder of the specialty. Part of Johnson’s role is raising awareness of specific health concerns affecting teens, including information based on new research being generated
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within the department. A recent example is work being done on conversion disorders, disorders in which a patient experiences neurological symptoms like seizures or paralysis without a physical cause. Division member Dr. Christina Grant and Dr. Catherine Krasnik, a researcher from McMaster’s Department of Psychiatry and Behavioural Neurosciences, are leading a national Canadian Pediatric Surveillance Program study on pediatric conversion disorders. When published, the study results will be of interest to patients, parents, and physicians across Canada and abroad.
Advocating for teens That work belies the guiding principle within the division, which is to get the right information into the right hands. Part of the role of adolescent medicine specialists, says Johnson, is raising awareness of specific health concerns affecting teens. Dissemination of information to teens, their parents, the medical community, and the community-at-large is an important task. Through involvement with the Canadian Pediatric Society (Adolescent Health Committee and Section), the division participates in the publication of position statements and practice points on adolescent health related topics. It also means reaching out to undergraduates and post-graduate students, building an understanding of adolescent medicine and equipping them with the skills necessary to provide optimal health care to teens. “Whatever specialty they go into, notes Johnson, residents are going to see teens.” That means not only interacting with teens, but interacting with health issues specific to teens. Says Johnson, “we’re setting the stage about how you have a conversation with people about the things that are important to them in a way that makes them feel comfortable.” Over the past year that has included a presentation with Dr. Jan Willem Gorter, Director of the CanChild Centre for Childhood Disability Research, on issues surrounding sexuality in young people with developmental delay, an initial presentation of their joint research.
Finding new teaching tools “Pelvic exam simulation for pediatric residents is a novel teaching method,” says Johnson, and has proven to be a very effective one. The division now has a simulator for pelvic examination to help teach this skill in the face of reduced clinical opportunities. Simulation will be regularly incorporated into the adolescent medicine rotation for trainees of all levels. Simulation is invaluable in part due to the success of non-invasive screening methods for sexually transmitted diseases. It has meant a decline in opportunities for pediatric residents to practise pelvic exams, something which nevertheless remains an essential skill. To provide training, Johnson incorporated pelvic exam simulation as part of a clinical skills curriculum for pediatric residents in May 2011. The experience of working with simulation was summarized in a poster which she presented at the Association for Medical Education (AMEE) in Lyon, France as well as at the International Conference on Residency Education (ICRE) in Ottawa in 2012.
family based therapy The most public face of adolescent medicine is the treatment of eating disorders. When the division opened a dedicated eating disorder unit, one of the intentions of the newly expanded ward—which includes in-patient and day-treatment beds—is to keep these complex patients close to home and to reduce the number of teens who are sent elsewhere, including treatment facilities outside of Canada, for intensive services. The main approach to treatment used by the eating disorder program is Family Based Therapy (FBT), a treatment that is based on what Johnson calls an “agnostic approach,” one that doesn’t seek to place blame on the patient or their parents for the illness and does not attempt to search for the cause of an eating disorder. Instead, the focus is to work with the family, and to encourage the family in partnership with the clinic, to bring the patient back to a point of physical and psychological health. n 49
Helping those who need it most Finding effective ways to support some of the most complex patients to come through the hospital doors. In 2012, Dr. Audrey Lim, an assistant professor in the Division of General Pediatrics, became the lead of the Chronic Complex Team. The team cares for children who are often more clinically challenging than any you could expect to find anywhere, both inpatients and outpatients. “These are children with multiple complex medical concerns who are medically fragile,” says Lim, “and the majority of them have a combination of respiratory, neurological, and chromosomal anomalies.” They are often technologydependent—meaning that they require airway support such as tracheostomy or mechanical ventilation, or gastrostomy tube feeds—and some, even after years of investigation, can resist a clear diagnosis. While the patient base is perhaps small relative to the majority of services within the hospital—there are about 55 patients currently within the program—they nevertheless look to McMaster for a vast and varied range of management and support.
Providing consistent care In some respects, the team that Lim leads is providing care to a patient population that, not all that long ago, simply didn’t exist. Thanks to advances in medical science, knowledge, and a growing range of technical and mechanical supports, children with chronic conditions are now living well into adulthood. Also thanks to advances in care, more often than not they are managed at home. Still, successful treatment can create new challenges, and an understanding of those challenges provided the impetus for the Chronic Complex Team. The first task was to give children with medical complexity a clinical home. Lim notes that children with single diagnoses, such as those with gastrointestinal diseases, have clinics within the hospital that are well equipped to provide care. In the past, children presenting with a range of complex issues would move 50
through a range of services without ever finding one clinic that could provide a focus for their care. As a result, their quality of care suffered, at times dramatically so. The Chronic Complex Team includes a core of four pediatricians, respiratory therapists, a nurse practitioner, and a clinical nurse specialist. “Our role is to support the family as much as we can,” says Lim. That includes providing comprehensive care, coordinating the patients’ multiple clinic visits, and integrating their care in the community including home and school visits. It also includes working closely with the patients’ families to provide education and training in the use of mechanical supports/equipments, tracheostomy care, and feeds.
Building the knowledge base Given that this is still a new frontier of care, the clinical work that the team does is only half of the job. The other half is working to build knowledge around complex care. Again because it’s a relatively new area, the opportunity for growth in understanding and addressing needs is vast. One end of the spectrum is assessing the strengths and weaknesses of the outpatient model and optimizing care of children with medical complexity and technology dependency. Often the bulk of care is administered by family members, which is new—in the past children requiring mechanical ventilation, for example, would have been managed in the hospital by trained allied health care professionals. One area of research that Lim is involved in is finding ways to quantify and assess how well caregivers are equipped and able to care for these children at home. She is a co-investigator on a study led by the Hospital for Sick Children in Toronto to develop a tool to assess caregiver’s knowledge and skills in caring for children dependent on home mechanical ventilation.
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At the other end of the spectrum are investigations into how best to structure the medical teams themselves, for which the team at McMaster is increasingly providing a model. Lim has participated in the Provincial Council for Maternal and Child Health (PCMCH) on advancing integrated complex care as well as a PCMCH Think Tank Session toward developing new approaches to the application of government funding for children who are medically fragile and technology-dependent. In addition, the Chronic Complex Team has recently added education to its mandate, offering an elective for medical students at the clerkship level, and for residents and fellows who are interested in developing knowledge and clinical skills with a focus on chronic complex patient care.
Looking ahead Most parents, of course, never have to contemplate living with and providing care for a child with six or eight different medical problems, who requires feeding and breathing intervention, who has social and school issues, and are medically fragile. Likewise, those who work in the field of chronic complex care encounter issues that are rarely encountered, if at all, in other clinical environments. End of life management, social, education, and funding issues—the complexity of the patient base goes well beyond any disease processes and to the very heart of pediatric care itself: how best to help children and families live healthier, happier, more productive lives. n
Lauren is cared for by Chronic Complex Care team members Jeannie Kelso, respiratory therapist and Rose-Frances Clause, nurse practitioner.
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selected publications 2012 Dr. Anne Klassen’s study, “Parents of children with cancer: which factors explain differences in health-related quality of life” was published in the International Journal of Cancer. Dr. Saroj Saigal and colleagues’ article, “Psychopathology in young adults born at extremely low birth weight” was published in Psychological Medicine. Drs. Sephanie Atkinson, Mark Tarnopolsky and colleagues published their study, “Increased consumption of dairy foods and protein during diet- and exercise-induced weight loss promotes fat mass loss and lean mass gain in overweight and obese premenopausal women” in the Journal of Nutrition. Dr. Moyez Ladhani and several colleagues published the article, “Reliability and acceptability of the MMI: A noncognitive skills assessment for postgraduate admissions” in Academic Medicine.
Dr. Mark Tarnopolsky’s study, “AMP-activated protein kinase (AMPK) beta1beta2 muscle null mice reveal an essential role for AMPK in maintaining mitochondrial content and glucose uptake during exercise” was published in Proceedings of the National Academy of Sciences.
Drs. Karen Choong, Steve Arora, Lehana Thabane and colleagues’ article, “Hypotonic Versus Isotonic Maintenance Fluids After Surgery for Children: A Randomized Controlled Trial”, was published in Pediatrics.
Dr. Christoph Fush and colleagues published their study, “Fortification of breast milk in VLBW infants: metabolic acidosis is linked to the composition of fortifiers and alters weight gain and bone mineralization”. The journal article appeared in Clinical Nutrition.
Drs. Peter Rosenbaum and Jan Willem Gorter published “The ‘F-Words’ in Childhood Disability: I Swear This is How We Should Think!” in Child: Care, Health and Development. 52
Dr. Katherine Morrison and her colleagues published their study, “Cardiovascular risk factors and noninvasive assessment of subclinical atherosclerosis in youth” in the journal, Atherosclerosis. Dr. Anthony Chan and his research team published the article, “Antithrombin-heparin covalent complex reduces microemboli during cardiopulmonary bypass in a pig model” in the journal, Blood. Dr. Christine Wekerle published her study, “The dollars and senselessness in failing to prioritize child maltreatment prevention”, in Child Abuse & Neglect: The International Journal. Dr. Jack Sinclair’s article, “Selecting participants that raise a clinical trial’s population attributable fraction can increase the treatment effect within the trial and reduce the required sample size” was published in the Journal of Clinical Epidemiology. Drs. Sheri Findlay, Christina Grant, and colleagues had their article “The Integration of a Specialized Eating Disorders Nurse on a General Inpatient Pediatric Unit” accepted in press for the Journal of Pediatric Nursing.
publications 2012 Arora, Steven Lau K, Belostotsky V, Arora S, Braga L. Large utricle cyst misdiagnosed as recto-vesical fistula on voiding cystogram. Hong Kong Journal of Nephrology, 2012 Apr, 14(1), 30-32.
Athale, Uma Rayar M, Nayiager T, Webber C, Barr RD, Athale UH. Predictors of bony morbidity in children with acute lymphoblastic leukemia. Pediatric Blood and Cancer, 2012; 59:77-82 Tuckuviene R, Chriestensen AL, Chan ACK, Athale U. Body mass index and thromboembolism in children with hematological malignancies. Pediatric Blood and Cancer, 2012; 59:320-322 Athale U, Siciliano S, Cheng J, Thabane L, Chan AKC. Central venous line dysfunction is an independent predictor of poor survival in children with cancer. Journal of Pediatric Hematology/Oncology, 2012; 34:188-193 Lipshultz S, Miller TL, Scully RE, Lipsitz SR, Rifai N, Silverman LB, Colan SD, Neuberg DS, Dahlberg SE, Asselin BL, Athale UH, Clavell LA, Laverdiere C, Michon B, Schorin MA, Sallan SE. Changes in cardiac biomarkers during doxorubicin treatment of pediatric patients with high risk acute lymphoblastic leukemia: associations with long term echocardigraphic outcome. Journal of Clinical Oncology, 2012; 30:1042-1049 Pound CM, Clark C, Ni A, Athale U, Lewis V, Halton J. Corticosteroids, Behavior and Quality of Life in Children Treated with Acute Lymphoblastic Leukemia: a multicentered trial. Journal of Pediatric Hematology and Oncology, 2012, 34(7): 517-523. PMID 22735884 Lipshultz SE, Miller TL, Lipsitz SR, Neuberg DS, Dahlberg SE, Colan SD, Silverman LB, Henkel JM, Franco VI, Cushman LL, Asselin BL, Clavell LA, Athale U, Michon B, Laverdière C, Schorin MA, Larsen E, Usmani N, Sallan SE. Continuous versus bolus-infusion of doxorubicin in children with ALL: long-term cardiac outcomes. Pediatrics, 2012; 130(6):1003-11. Doi:10.1542/peds.2012-0727 Halton J, Nagel K, Brandao L, Silva M, Gibson P, Chan A, Blyth K, hicks K, Parmar N, Paddock L, Willing S, Thabane L, Athale UH. Do children with central venous line dysfunction have increased risk of symptomatic thromboembolism compared to those without CVL-dysfunction, while on cancer therapy? Study protocol. BMC Cancer, 2012; 12:314 Vrooman, LM, Neuberg DS, Kutok JL, Dahlberg S, O’Brien J, Asselin BL, Athale UH, Bahar AY, Clavell L, Kaplan N, Kelly KM, Laverdière C, Lipshultz SE, Michon B, Schorin M, Cohen HJ, Sallan SE, and Silverman LB. Postinduction dexamethasone and individualized dosing of Escherichia coli L-asparaginase each improve outcome of children and adolescents with acute lymphoblastic leukemia: Results from a randomized study -Dana-Farber Cancer Institute ALL Consortium Protocol 00-01. Journal of Clinical Oncology, 2012 January 13 (Epub ahead of prints). PMID 23358966
weight and obese young women. J Clin Endocrinol Metab 2012;97(1):251-60. Taylor V, Chau K, Atkinson SA. Are Selective Serontonin Reuptake Inhibitors a Secondary Cause of Decreases Bone Density? J Osteoporosis 2012;2012:323061. doi: 10.1155/2012/323061. Epub 2012. Morrison KM, Xu L, Tarnopolsky M, Yusuf Z, Atkinson SA, Yusuf S. Screening for dysglycemia in overweight youth presenting for weight management. Diabetes Care 2012; 35(4):711-6 . Josse AR, Atkinson SA, Tarnopolsky MA, Phillips SM. Diets higher in dairy and total dietary protein during diet- and exercise-induced weight loss preserve bone ealth in overweight and obese young women. J Clin Endocrinol Metab 2012;97(1):251-60 Atkinson SA. Impact of Pregnancy Nutrition on Offspring Bone Development. In: Gussler J, Graham MA, eds. Pregnancy Nutrition and Later Health Outcomes: Report of the 112th Abbott Nutrition Research Conference. Columbus, Ohio: Abbot Nutrition; 2012:97-109. Joly MP, Boivin M, Junker A, Bocking A, Kramer MS, Atkinson SA. An inventory of Canadian pregnancy and birth cohort studies: research in progress. BMC Pregnancy Childbirth. 2012, 12:117. doi: 10.1186/1471-2393-12-117 Alos N, Grant RM, Ramsay T, Halton J, Cummings EA, Miettunen PM, Abish S, Atkinson S, Barr R, Cabral DA, Cairney E, Couch R, Dix DB, Fernandez CV, Hay J, Israels S, Laverdière C, Lentle B, Lewis V, Matzinger M, Rodd C, Shenouda N, Stein R, Stephure D, Taback S, Wilson B, Williams K, Rauch F, Siminoski K, Ward LM. High incidence of vertebral fractures in children with acute lymphoblastic leukemia 12 months after the initiation of therapy. J Clin Oncol. 2012 Aug 1;30(22):2760-7. Morrison K, Anand S, Yusuf S, Atkinson SA, Schulze K, RaoMelacini P, McQueen M, McDonaldS, Persadie R, Hunter B, Bourgeois J, Jansen J, Teo K. Maternal and pregnancy related predictors of cardiovascular risk factors in newborns. PLoS One 2013;8(2):e55815. doi: 10.1371/journal. pone.0055815. Epub 2013 Feb 13. Pritchard JM, Papaioannou A, Tomowich C, Giangregorio LM, Atkinson SA, Beattie KA, Adachi JD, DeBeer J, Winemaker M, Avram V, Schwarcz HP. Bone mineralization is elevated and less heterogeneous in adults with type 2 diabetes and osteoarthritis compared to controls with osteoarthritis alone. Bone. 2013 May;54(1):76-82.
Barr, Ronald Tsimicalis A, Stevens B, Ungar WJ, McKeever P, Greenberg M, Agla M, Guesriere R, Barr R, Naqui A, Moineddin R. Costs incurred by families of children newly diagnosed with cancer in Ontario. Psycho-Oncology, 21: 1113 – 1123, 2012.
Atkinson, Stephanie
Barrera M, Teall T, Barr R, Silva M, Greenberg M. Health-related quality of life in adolescent and young adult survivors of lower extremity bone tumors. Pediatric Blood and Cancer 58: 265-273, 2012
Josse AR, Atkinson SA, Tarnopolsky MA, Phillips SM. Diets higher in dairy and total dietary protein during diet- and exercise-induced weight loss preserve bone health in over-
Webber C, Barr RD. Age and gender-dependent values of skeletal muscle mass in healthy children and adolescents. Journal of Cachexia, Sarcopenia and Muscle 3: 25-29, 2012.
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Sala A Rossi E, Antillon F, Molina AL, de Maselli T, Bonilla M, Hernandez A, Ortiz R, Pacheco C, Nieves R, Navarrete M, Barrantes M, Pencharz P, Valsecchi M-G, Barr RD. Nutritional status at diagnosis is related to clinical outcomes in children and adolescents with cancer: A perspective from Central America. European Journal of Cancer 48: 243-252, 2012. Furlong W, Rae C, Greenberg M, Barr R. Surveillence and survival among adolescents and young adults with cancer in Ontario, Canada. International Journal of Cancer, 113: 2660 – 2667, 2012. Alos N, Grant R, Ramsay T, Halton J, Cummings EA, Mietunen PM, Abish S, Atkinson S, Barr R, Cabral DA, Cairney E, Couch R, Dix DB, Fernandez CV, Hay J, Israels S, Laverdiere C, Lentle B, Lewis V, Matzinger M-A, Rodd C, Shenonda N, Stein R, Stephure D, Taback S, Wilson B, Williams K, Rauch F, Siminoski K, Ward L and the Canadian STOPP Consortium. High incidence of vertebral fractures in children with acute lymphoblastic leukemia 12 months after the initiation of therapy. Journal of Clinical Oncology, 30: 2760 – 2767, 2012. Rayar M, Webber CE, Nayiager T, Sala A, Barr RD. Sarcopenia in children with acute lymphoblastic leukemia. Journal of Pediatric Hematology-Oncology, in press. Rayar M, Nayiager T, Webber CE, Barr RD, Athale UH. Predictors of bony morbidity in children with acute lymphoblastic leukemia. Pediatric Blood and Cancer, 59: 77 – 82, 2012. Furlong W, Rae C, Feeny D, Gelber RD, Laverdiere C, Michon B, Silverman L, Sallan S, Barr R. Health-related quality of life among children with acute lymphoblastic leukemia. Pediatric Blood and Cancer, 59: 717 – 724, 2012. Tsimicalis A, Stevens B, Ungar WI, Greenberg M, McKeever F, Agha M, Guerriere D, Barr R, Naqvi A, Moineddin R. Determining the costs of families’ support networks following a child’s cancer diagnosis. Cancer Nursing 36: E8 – E19, 2013. Amin L, Rosenbaum P, Barr R, Sung L, Klaassen RJ, Dix DB, Klassen A. Rasch analysis of the Peds QL: An increased understanding of the properties of a rating scale. Journal of Clinic Epidemiology, 65: 1117 – 1123, 2012. Rae C, Furlong W, Horsman J, Pullenayegun E, Demers C, St-Louis J, Lillicrap D, Barr R. Bleeding disorders, menorrhagia and iron deficiency: An examination of quality of life. Haemophilia, in press Rae C, Furlong W, Jankovic M, Moghrabi A, Naqvi A, Sala A, Samson Y, De Pauw S, Feeny D, Barr R. Economic evaluation of two treatment strategies for acute lymphoblastic leukemia in childhood. Webber C, Halton J, Walker S, Young A, Barr R. The prediction of lean body mass and fat mass from arm anthropometry at diagnosis in children with cancer. Granek L, Nathan PC, Rosenberg-Yunger Z, D’Agostino N, Amin L, Barr RD, Greenberg ML, Hodgson D, Boydell K, Klassen A. Psychological factors impacting transition from pediatric to adult care by childhood cancer survivors. Journal of Cancer Survivorship, 6: 260 – 269, 2012. Khan S, Toews H, Wang Jia-Chi, Arredondo J, Provias J, Göhring G, Barr RD. Acute lymphoblastic leukemia in a patient with constitutional chromosome 1 pter - p36.31 duplication and 1q24 – qter deletion. Journal of Pediatric Hematology – Oncology, 34: 217 – 221, 2012.
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Solh Z, Carter R, Jansen J, Barr R. Ewing sarcoma as a second malignant neoplasm in an adolescent after treatment of mature B cell lymphoblastic leukemia. Journal of Adolescent and Young Adult Oncology, in press. Matthes-Martin S, Potschger H, Barr RD, Martin M, Boztug H, Klingebiel T, Attarbaschi A, Eibler W, Mann G. Costs and cost effectiveness of allogeneic stem cell transplantation in children are predictable. Biology of Blood and Marrow Transplantation, 18: 1533 – 1539, 2012. Davidson D, Barr RD, Riad S, Griffin AM, Ferguson PC, Davis AM, Wunder JS. Health-related quality of life following treatment of soft tissue sarcoma. Webber CE, Barr RD. Age – and gender – dependent values of skeletal muscle mass in healthy children and adolescents. Journal of Cachexia Sarcopenia and Muscle, 3: 25 – 29, 2012. Antillon F, Rossi E, Molina AL, Sala A, Pencharz P, Valsecchi MG, Barr RD. Nutritional status of children during treatment for acute lymphoblastic leukemia in Guatemala. Pediatric Blood and Cancer, in press. Yee S, Buckett W, Campbell S, Yanofsky R, Barr RD. A national study of the provision of oncofertility services to female patients in Canada. Journal of Obstetrics and Gynaecology Canada, 34: 849 – 858, 2012.
Belostotsky, Vladimir Steele MR, Belostotsky V, Lau KK. The dangers of substance abuse in adolescents with chronic kidney disease: a review of the literature. CANNT J. 2012 Jan-Mar;22(1):15-22;. Lau K, Belostotsky V, Arora S, Braga L. Large utricle cyst misdiagnosed as recto-vesical fistula on voiding cystogram. Hong Kong Journal of Nephrology, 2012 Apr, 14(1), 30-32.
Brill, Herbert Huang Y, Don-Wauchope AC, Grey VL, Mansour M, Brill H, Armstrong D. Improving Serological Test Ordering Patterns for the Diagnosis of Celiac Disease through Clinical Laboratory Audit of Practice. Clinical Biochemistry 2012; 45:455-9. Bollegala N, Brill H, Marshall JK. Resource Utilization During Pediatric to Adult Transfer of Car in Individuals with IBD. Journal of Crohn’s and Colitis 2012, Jun 5, epub ahead of print.
Cellucci, Tania Cellucci T, Benseler SM. Measures of disease activity and treatment of childhood primary angiitis of thecentral nervous system (cPACNS).Arthritis & Rheumatism 2012; 64(11):3821-2. Cellucci T, Tyrrell PN, Pullenayegum E, Benseler SM. Von Willebrand Factor Antigen – A possible biomarker of disease activity in childhood central nervous system vasculitis? Rheumatology 2012; 51(10):1838-45. Cellucci T, Tyrrell PN, Sheikh S, Benseler SM. Childhood Primary Angiitis of the CNS: Identifying disease trajectories and early risk factors for persistently higher disease activity. Arthritis & Rheumatism 2012; 64(5):1665-72. Cellucci T, Shroff M, Tse SML. Case 2: A pain in the neck. Paediatrics & Child Health 2012; 17(5):247-50.
Chan, Anthony Lau KK, Giglia L, Chan H, Chan AK. Management of children after renal transplantation: Highlights for general prediatricians. [Article in Chinese] Zhongguo Dan Dai Er Ke Za Zhi [Chinese Journal of Contemporary Pediatrics], 14(2):81-88, 2012. Gruenwald CE, Manlhiot C, Abadilla AA, Kwok J, Maxwell S, Holtby HM, Brandão LR, Chan AK, Crawford-Lean L, Foreman C, Caldarone CA, Van Arsdell GS, McCrindle BW. Heparin brand is associated with postsurgical outcomes in children undergoing cardiac surgery. Annals of Thoracic Surgery, 93(3):878-883, 2012. Schechter T, Finkelstein Y, Ali M, Kahr WH, Williams S, Chan AK, deVeber G, Brandão LR. Unfractionated heparin dosing in young infants: Clinical outcomes in a cohort monitored by anti-Xa levels. Journal of Thrombosis and Haemostasis, 10(3):368-74, 2012. Monagle P, Chan AK, Goldenberg NA, Ichord RN, Journeycake JM, Nowak-Göttl U, Vesely SK; American College of Chest Physicians. Antithrombotic therapy in neonate and children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-based Clinical Practice Guidelines. Chest, 141(2 Suppl):e737S-e801S, 2012. Atkinson HM, Parmar N, Berry LR, Chan AKC*. Determination of alpha-2-macroglobulin complexes by a new immunoactivity assay. Thrombosis Research, 129(5):635-640, 2012. Manlhiot C, McCrindle BW, Menjak IB, Yoon H, Holtby HM, Brandão LR, Chan AK, Schwartz SM, Sivarajan BV, Crawford-Lean L, Foreman C, Caldarone CA, Van Arsdell GS, Gruenwald CE. Longer blood storage is associated with suboptimal outcomes in high-risk pediatric cardiac surgery. Annals of Thoracic Surgery, 93(5):1563-1569, 2012. Athale U, Siciliano S, Cheng E, Thabane L, Chan AKC. Central venous line dysfunction is an independent predictor of poor survival in children with cancer. Journal of Pediatric Hematology/Oncology, 34(3):188-193, 2012. Newall F, Chan AK, Ignjatovic V, Monagle P; on behalf of the Perinatal and Paediatric Haemostasis Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Recommendations for developing uniform laboratory monitoring of heparinoid anticoagulants in children. Journal of Thrombosis and Haemostasis, 10(1):145-147, 2012. Schechter T, Kirton A, Laughlin S, Pontigon AM, Finkelstein Y, MacGregor D, Chan A, deVeber G, Brandão LR. Safety of anticoagulants in children with arterial ischemic stroke. Blood, 119(4):949-956, 2012. Sask KN, Berry LR, Chan AKC, Brash JL. Modification of polyurethane surface with an antithrombin-heparin complex for blood contact: Influence of molecular weight of polyethylene oxide used as linker/spacer. Langmuir, 28(4):20992106, 2012. Goldenberg NA, Brandão LR, Journeycake J, Kahn SR, Monagle P, Revel-Vilk S, Sharathkumar A, Chan AKC; on behalf of the Perinatal and Paediatric Haemostasis Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition
of post-thrombotic syndrome (PTS) and standardization outcome measurement following lower extremity deep vein thrombosis in paediatric clinical investigations. Journal of Thrombosis and Haemostasis, 10(3):477-480, 2012. Kaatz S, Kouides PA, Garcia DA, Spyropolous AC, Crowther M, Douketis JD, Chan AKC, James A, Moll S, Ortel TL, Van Cott EM, Ansell J. Guidance on the emergent reversal of oral thrombin and factor Xa inhibitors. American Journal of Hematology, 87(Suppl 1):S141-S145, 2012. Tuckuviene R, Christensen AL, Chan AKC, Athale U. Body mass index and thromboembolism in children with hematological malignancies. Pediatric Blood and Cancer, 59(2):320322, 2012. Lau KK, Giglia L, Chan H, Chan AK. Management of children after renal transplantation: Highlights for general prediatricians. Translational Pediatrics, 1(1):35-46, 2012. Stevic I, Berry LR, Chan AKC. Mechanism of inhibition of the prothrombinase complex by a covalent antithrombin-heparin complex. Journal of Biochemistry, 152(2):139-148, 2012. Almonte T, Decker K, Seroski W, Walker I, Webert K, Bos C, Strike K, Waterhouse L, Goldsmith R, Chan AKC. The importance of haemophilia treatment centre administrators in patient care. (Letter) Haemophilia, 18(5):e366-e367, 2012. Manlhiot C, Brandao LR, Kwok J, Kegel S, Menjak IB, Carew CL, Chan AK, Schwartz SM, Sivarajan VB, Caldarone CA, Van Arsdell GS, McCrindle BW. Thrombotic complications and thromboprophylaxis across all three stages of single ventricle heart palliation. Journal of Pediatrics, 161(3):513519, 2012. Halton J, Nagel K, Brandão L, Silva M, Gibson P, Chan A, Blyth K, Hicks K, Parmar N, Paddock L, Willing S, Thabane L, Athale U. Do children with central venous line (CVL) dysfunction have increased risk of symptomatic thromboembolism compared to those without CVL-dysfunction, while on cancer therapy? BMC Cancer, 12(1):314-324, 2012. Teitel J, Belliveau D, Blanchette V, Chan A, Klaassen R, Price V, Ritchie B, Wu J. A Canadian survey of self-infusion practices in persons with hemophilia A. (Letter) Haemophilia, 18(6):e403-5, 2012. Revel-Vilk S, Brandão LR, Journeycake J, Goldenberg A, Monagle P, Sharathkumar A, Chan AKC; on behalf of the Perinatal and Paediatric Haemostasis Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Standardization of post-thrombotic syndrome definition and outcome assessment following upper venous system thrombosis in pediatric practice. Journal of Thrombosis and Haemostasis, 10(10):2182-2185, 2012. Paes B, Nagel K, Sunak I, Rashish G, Chan AK; Thrombosis and Hemostasis in Newborns (THiN) Group. Neonatal and infant pulmonary thromboembolism: A literature review. Blood Coagulation and Fibrinolysis, 23(7):653-662, 2012. Sask KN, Berry LR, Chan AKC, Brash JL. Polyurethane modified with an antithrombin-heparin complex via polyethylene oxide linker/spacer: Influence of PEO molecular weight and PEO-ATH bond on catalytic and direct anticoagulant functions. Journal of Biomedical Materials Research: Part A, 100(10):2821-8, 2012.
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Choong, Karen
Fusch, Christoph
Choong K, Corsi D, Tran N, Clark H, Cupido, C. Acute Rehabilitation in Critically ill Children. Journal of Pediatric Intensive Care. J Pediatr Intensive Care 2012;1(4):183-92
Donald SD, Pullenayegum E., Chapman B., Vera C., Giglia L., Fusch C., Foster. Prevalence and Predictors of Exclusive Breastfeeding at Hospital Discharge. Obstet Gynecol 2012;119(6):1171-9.
Duffett M, Burns KE, Adhikari NK, Arnold DM, Lauzier F, Kho ME, Meade MO, Hayani O, Koo K, Choong K, Lamontagne F, Zhou Q, Cook DJ. Quality of reporting of surveys in critical care journals: A methodologic review. Crit Care Med. 2012 Feb;40(2):441-449. Menon K, McNally JD, Choong K, Ward R, Lawson ML, Ramsay T, Wong HR. A Survey of stated physician practices and beliefs on the use of steroid in Pediatric fluid and/or Vasoactive infusion dependent shock. Pediatric Critical Care Medicine – In Press; Accepted for Publication, November 2012. Menon K, McNally JD, Choong K, SampsonM. A systematic review and meta-analysis on the effect of steroids in pediatric shock. Pediatric Critical Care Medicine, D-12-00341R2. In Press; Accepted for Publication, November 2012.
Cupido, Cynthia K. Choong, N. Tran, H. Clark, C. Cupido, DJ Corsi. Acute rehabilitation in critically ill children. Journal of Pediatric Critical Care, Vol. 1, No. 4, 2012
Dent, Peter Rodd C, Lang B, Ramsay T, Alos N, Huber AM, Cabral DA, Scuccimarri R, Miettunen PM, Roth J, Atkinson SA, Couch R, Cummings EA, Dent PB, Ellsworth J, Hay J, Houghton K, Jurencak R, Larché M, LeBlanc C, Oen K, Saint-Cyr C, Stein R, Stephure D, Taback S, Lentle B, Matzinger M, Shenouda N, Moher D, Rauch F, Siminoski K, Ward LM; Canadian Steroid-Associated Osteoporosis in the Pediatric Population (STOPP) Consortium. Incident vertebral fractures among children with rheumatic disorders 12 months after glucocorticoid initiation: a national observational study.Arthritis Care Res (Hoboken). 2012 Jan;64(1):122-31. doi: 10.1002/ acr.20589. Shiff NJ, Brant R, Guzman J, Cabral DA, Huber AM, Miettunen PM, Roth J, Scuccimarri R, Alos N, Atkinson SA, Collet JP, Couch R, Cummings EA, Dent PB, Ellsworth J, Hay J, Houghton K, Jurencak R, Lang B, Larche M, Leblanc C, Rodd C, Saint-Cyr C, Stein R, Stephure D, Taback S, Rauch F, Ward LM; Canadian STOPP Consortium. Glucocorticoid-related changes in body mass index among children and adolescents with rheumatic disease.Arthritis Care Res (Hoboken).2012 Jul 23.doi: 10.1002/acr.21785.
Dillenburg, Rejane Vascular and autonomic function in preschool-aged children with congenital heart disease. Currie KD, Martin AA, Millar PJ, Stone ND, Timmons BW, Dillenburg RF, MacDonald MJ. Congenit Heart Dis. 2012 May-Jun;7(3):289-97. doi: 10.1111/ j.1747-0803.2012.00664.x.
Findlay, Sheri Carter, N., Webb, C., Findlay, S., Grant, C. & Van Blyderveen, S. . The Integration of a Specialty Eating Disorders Nurse on a General Pediatric Unit. Journal of Pediatric Nursing. Oct 2012.
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Rochow N, Fusch G, Mühlinghaus A, Niesytto C, Straube S, Utzig N, Fusch C. A nutritional program to improve outcome of very low birth weight infants. Clin Nutr. 2012 Feb;31(1):124-31. Kutschmann M, Bungard , Kötting J, Trümner, Fusch C, Veit C. The Care of Preterm Infants with Birth Weight Below 1250 g. Dtsch Arztebl Int 2012;109(31-32):519-26. DOI: 10.3238/arsteb;.2012.0519. Rochow N, Chan E C, Wu W I, Selvaganapathy R, Fusch G, Berry L, Brash J, Chan AK, Fusch C. “Artificial placenta - Lung assist devices for term and preterm newborns with respiratory failure”. Int J of Artificial Organs (2012) Kutschmann M, Bungard S, Kötting J, Trümner A, Fusch C, Veit C. The care of preterm infants with birth weight below 1250g: risk-adjusted quality benchmarking a part of validating a caseload-based management system. Dtsch Arztebi Int 2012;109(31-32): 519-26 McDonald SD, Pullenayegum E, Chapman B, Vera C, Giglia L, Fusch C, Foster G. Prevalence and predictors of exclusive breastfeeding at hospital discharge. Obstet.Gynecol. 2012;119(6):1171-9.
Giglia, Lucy Lau K, Giglia L, Chan H. Chan A.K. Management of children after renal transplantation: Highlights for general pediatricians. Chinese Journal of Contemporary Pediatrics. PMID: 22357461. Feb 2012. Lau K, Giglia L, Chan H. Chan A.K. Management of children after renal transplantation: Highlights for general pediatricians. Transl Pediatr 2012, Feb 27. DOI: 10.3978/j.issn.22244336.2012.02.02.
Goldfarb, David Puryear S, Seropola G, Ho-Foster A, Arscott-Mills T, Mazhani L, Firth J, Goldfarb DM, Ncube R, Bisson GP, Steenhff AP. Yield of Contact Tracing from Pediatric Tuberculosis Index Cases in Gaborone, Botswana. Int J of TB and Lung Disease (In press) Renuart AJ, Steenhoff AP, Goldfarb DM, Mokomane M, Tawanana EO, Mohan N, Silverman JA. Microbiology of urinary tract infections in Gaborone, Botswana. PLoS ONE (In press). Welch H, Steenhoff AP, Chakalisa U, Arscott-Mills T, Mazhani L, Mokomane M, Foster-Fabiano S, Wirth KE, Skinn A, Pernica JM, Smieja M, Goldfarb D. Hospital-based Surveillance for Rotavirus Gastroenteritis using Molecular Testing and Immunoassay during the 2011 Season in Botswana. Pediatr Infect Dis J. 2013 Jan 21. [Epub ahead of print]
Gorter, Jan Willem Siebes RC, Ketelaar M, Gorter JW, Alsem M, Jongmans MJ. Needs of families with children who have a physical dis-
ability: a literature review. Critical Reviews™ in Physical and Rehabilitation Medicine. 2012; 24(1–2): 85–108. Martin AA, Cotie LM, Timmons BW, Gorter JW, Macdonald MJ. Arterial Structure and Function in Ambulatory Adolescents with Cerebral Palsy Are Not Different from Healthy Controls. Int J Pediatr. 2012;2012:168209. Epub 2012 Jun 10. Gorter JW, Noorduyn SG, Obeid J, Timmons BW. Accelerometry: A Feasible Method to Quantify Physical Activity in Ambulatory and Nonambulatory Adolescents with Cerebral Palsy. Int J Pediatr. 2012;2012:329284. Epub 2012 Jun 26. Ketelaar M, Bult MK, Gorter JW, Verschuren O, Jongmans MJ. Participatie; klaar om deel te nemen? Nederlands. Tijdschrift voor Fysiotherapie 2012;122(2):68-75 (in Dutch). Klein B, Gorter JW, Rosenbaum P. Diagnostic shortfalls in early childhood chronic stress: a review of the issues. Child Care Health Dev. 2012 Dec 5. doi:10.1111/cch.12009. Di Rezze B, Law M, Gorter JW, Eva K, Pollock N. A narrative review of generic intervention fidelity measures: their suitability for paediatric rehabilitation. Physical & Occupational Therapy In Pediatrics. 2012 Aug 21. [Epub ahead of print] PubMed PMID: 22909269. Kertoy MK, Russell DJ, Rosenbaum P, Jaffer S, Law M, McCauley D, Gorter JW. Development of an outcome measurement system for service planning for children and youth with special needs. Child Care Health Dev. 2012 Jul 30. doi:10.1111/j.1365-2214.2012.01409.x. [Epub ahead of print]. Fehlings D, Narayanan U, Andersen J, Beauchamp R, Gorter JW, Kawamura A, Kiefer G, Mason M, McCormick A, Mesterman R, Switzer L, Watt J. Botulinum Toxin-A use in Paediatric Hypertonia: Canadian Practice Patterns. Can J Neurol Sci. 2012 Jul;39(4):508-15. Gorter JW. Making links across the lifespan in neurology. Can J Neurol Sci.2012 Jan;39(1):1-2. McCauley D, Gorter JW, Russell DJ, Rosenbaum P, Law M, Kertoy M. Assessment of environmental factors in disabled children 2-12 years: development and reliability of the Craig Hospital Inventory of Environmental Factors (CHIEF) for Children-Parent Version. Child Care Health Dev. 2012 Jun 8. doi: 10.1111/j.1365-2214.2012.01388.x. [Epub ahead of print].
Grant, Christina Krasnik, C., Grant, C. Conversion disorder: Not a malingering matter. Paediatric Child Health Vol. 17 (5). May 2012.
Hernandez, Alexandra Suzanne Schuh, Roger Zemek, Amy Plint, Karen J.L. Black, Stephen Freedman, Robert Porter, Serge Gouin, Alexandra Hernandez and David W. Johnson. Magnesium use in asthma pharmacotherapy: A pediatric emergency research Canada study. Pediatrics 2012;129:852-859.
Issenman, Robert JONES N et al Helicobacter pylori in First Nation and Recent Immigrant Populations in Canada. Canadian J of Gastroenterol. 2012 February 26 (2) 97-103
Kam, April Mikrogianakis A, Kam A, Silver S, Bakanisi B, Henao O, Okrainec A, and Azzie G.Telesimulation: An innovative and effective tool for teaching novel intraosseous insertion techniques in developing countries. (selected for one of the top Global Emergency Articles for 2011 by Global Emergency Medical Literature Review). Academic Emergency Medicine. 18:420-427. Dec, 2012. Johnston BC, Donen R, Pooni A, Pond J, Xie F, Giglia L, Kam A, Bhamber A, Bami K, Patel Y, Guyatt G.A Conceptual Framework of Health Related Quality of Life Impact in Acute Gastroenteritis. J Pediatr Gastroenterol Nutr 2012 Nov 6 [Epub ahead of print] Nov, 2012. Pernica J, Mah J, Kam A. The Management of Paediatric Community-Acquired Pneumona by Canadian Physicians. Kam A, Leal J, Freedman SB. “Pediatric cellulitis: success of emergency department short-course intravenous antibiotics.” Pediatric Emergency Care. 26(3):171-176. Dec, 2012. Kam A, Manini AF, Nelson LS. “First, remove the offending agent.” Am J Cardiol,Aug 1; 102(3):370-371. Dec, 2012. Kam A, Kitai I, Malloy P, Ford-Jones E. “Adolescent Tuberculosis: multi-focal involvement and delay in diagnosis. A 5year experience from the Hospital for Sick Children, Toronto, Canada, 1999-2004.” Pediatric Infectious Diseases Journal, 26 (4): 355-356, 2007. Dec, 2012.
Klassen, Anne Pusic AL, Cemal Y, Albornoz C, Klassen A, Cano S, Sulimanoff I, Herandez M, Massey M, Cordeiro P, Morrow M, Mehrara B.Quality of life among breast cancer patients with lymphedema: A systematic review of patient-reported outcome instruments and outcomes. J. Cancer Surviiv. 2012 Dec 5. [Epub ahead of print] Dec, 2012. Granek L, Rosenberg-Yunger ZRS, Dix D, Klassen RJ, Sung L, Cairney J, Klassen AF.Caregiving, single parents and cumulative stresses when caring for a child with cancer. Child, Care Health Dev. 2012 Nov 2. [Epub ahead of print{]. Nov, 2012. Lee EH, Klassen AF, Cano SJ, Waters J, Nehal KS, Pusic AL.A systematic review of patient-reported outcome measures of nonmelanoma skin cancer in the dermatologic population. J AM Acad Dematol. 2012 Oct 24. [Epub ahead of print]. Oct, 2012. Amin L, Rosenbaum P, Barr R, Sung L, Klassen RJ, Dix D, Klassen A. Rasch analysis of the PedsQL: an increased understanding of the properties of a rating scale. J Clinical Epidemiol. 2012 Oct; 65(10):1117-23 Oct, 2012. Klassen AF, Cano S, Scott A et al. Satifaction and Quality of Life Issues in Body Contouring Surgery Patients: A qualitative study. Obes Surg 2012 Oct; 22(10):1527-34 Oct, 2012. Cano SJ, Klassen AF, Scott AM, Cordeiro PG, Pusic AL The BREAST Q: Further validation in independent clinical samples. Plast Reconstr Surg 2012 Sept; 129:293-302 Sep, 2012. Granek L, Nathan PC, Rosenberg-Yunger Z, D’Agostino N, Amin L, Barr RD, Greenberg ML, Hodgson D, Boydell K,
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Klassen AF Psychological factors impacting transition from pediatric to adult care by childhood cancer survivors. J Cancer Surviv. 2012 Sept; 6(3):260-9 Sep, 2012. Pusic A, Klassen A, Cano S. Discussion: The BREAST-Q: Further validation in independent clinical trials. Plast RReconstr Surg. 2012 Sept; 130(3):482e-3e. (Letter to Editor) Sep, 2012. Dix D, Gulati S, Robinson P, Syed I, Klassen AF Demands and reqards associated with working in pediatric oncology: a qualitative study of Canadian staff J Pediatr Oncol Hematol. 2012 Aug 34;6:430-5 Aug, 2012. Ho A, Scott AM, Klassen AF, Cano SJ, Pusic AL, Van Laeken N, Measuring quality of life and patient satisfaction in facial paralysis patients: a systematic review of patient reported outcome measures. Plast Reconstr Surg. 2012 Jul; 130(1):91-9 Jul, 2012. McCarthy CM, Cano SF, Klassen AF, Scott A, Cemal Y, VanLaeken N, Lennox PA, Corderio PG, Pusic AL. The magnitude of effect of cosmetic breast augmentation on patient satisfaction and health-related quality of life. Plast Reconstr Surg. 2012 Jul; 130(1):218-23 Jul, 2012. Klassen A, Tsangaris E, Forrest CR, Wong KW, Pusic AL, Cano SJ, Syed I, Dua M, Kainth S, Johnson J, Goodacre T.Quality of life of children treated for cleft-lip and/or palate: a systematic review. J Plast Reconstr Aesthet Surg 2012 May; 65 (5): 547-57. May, 2012. Klassen AF, Gulati S, WattL, Dix D, Sung L, & Shaw N. Immigrant to Canada, newcomer to childhood cancer: a qualitative study of challenges faced by immigrant parents. Psychooncology 2012 May; 21:558-62 May, 2012. Gulati S, Watt L, Shaw N, Sung L, Poureslami I, Dix D & Klassen AF. Communication and language challenges experienced by Chinese and South Asian immigrant parents of children with cancer in Canada: Implications for health services delivery. Pediatr Blood Cancer 2012 Apr: 58: 572-8. Epub 2011 Mar. SRI Apr, 2012. Zwicker J, Susan R Harris, Klassen AF. Quality of life domains affected in children with developmental coordination disorder: a systematic review. Child: care, health and development. 2012 Apr 20 [Epub ahead of print]. Apr, 2012. Pusic AL, Klassen AF, Snell L, Cano SJ, McCarthy C, Scott A, Cemal Y, Cordeiro PG.Measuring and managing patient expectations for breast reconstruction: Impact on quality of life and patient satisfaction. Expert Rev Pharmacoecon Outcome Res 2012 Apr: 12:149-58 Apr, 2012. Lindsay S, King G, Klassen A, Esses V, Stachel M.Working with immigrant families raising a child with a physical disability: Challenges and recommendations for health care and community service providers. Disabil Rehabil 2012 Mar 29 [Epub ahead of print] Mar, 2012. Klassen AF, Gulati S, Dix D.Healthcare Providers Perspectives about Working with Parents of Children with Cancer: A Qualitative Study. J. Pediat Oncol Nursing 2012 Mar-Apr; 29:92-7. Mar, 2012. Watt L, Gulati S, Sung L, Dix D, Poureslami I & Kalssen AF. Perceptions about complementary and alternative medicine use among Chinese immigrant parents of children with cancer. Support Care Cancer 2012 Feb; 20:253-60. Epub 2011 Feb 12. SRI Feb, 2012.
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Klassen AF, Dix D, Klaasen R, Yanofsky R, Sung L. Impact of caring for a child with cancer on single parents compared with parents from two-parent families. Pediatr Blood Cancer 2012 Jan; 58:74-9. Epub 2011 Jan 19. Jan, 2012. Pusic AL, Klassen AF, Cano SJ.Use of BREAST-Q in clinical outcomes research. Plast Reconstr Sug. 2012 Jan: 129:166e7e. (Letter to the editor). Jan, 2012.
Kraus de Camargo, Olaf Generic patient-reported outcomes in child health research: a review of conceptual content using World Health Organization definitions. Fayed N, de Camargo OK, Kerr E, Rosenbaum P, Dubey A, Bostan C, Faulhaber M, Raina P, Cieza A. Dev Med Child Neurol. 2012 Dec;54(12):1085-95. doi: 10.1111/ j.1469-8749.2012.04393.x. Epub 2012 Aug 22. Review.
Latchman, Andrew Antony C, Latchman A, Walton M. An Unusual Case of an Abdominal mass in a 3 Year Old. University of Toronto Medical Journal. 2012 May;89(3):140-42. Morinis J. Butt M. Latchman A. Calculation of total fluid intake in 32 to 34 week gestational age infants in Canada: Does weight or day of life matter. Journal of Neonatal-Perinatal Medicine 5(2012)1-5.
Lau, Keith Hastings MC, Afshan S, Sanders J, Lau KK, Eison TM, Moldoveanu Z, Julian BA, Novak J, Wyatt RJ. Serum Galactose-deficient IgA1 Level is Not Associated with Proteinuria in Children with IgA Nephropathy. International Journal of Nephrology, vol.2012, Article ID 315467, 7 pages, 2012. doi:10.1155/2012/315467. Lau K, Butani L. Increasing organ donation: We can do better. Journal of Transplantation Technology and Research (In Press). Dec 4, 2012. Lau K, Belostotsky V, Arora S, Braga L. Large utricle cyst misdiagnosed as recto-vesical fistula on voiding cystogram. HKJ Nephrol. (In Press), April 2012; 14 (1): 30-32. Lau KK, Butani L. Expanding the Organ Donor Pool: Using En Bloc Kidneys in Pediatric Recipients. J Nephrol Therapeutic. Feb 21, 2012. Lau K., Giglia L., Chan H., Chan A. Management of children after renal transplantation: highlights for general pediatricians. Zhongguo Dang Dai Er Ke Za Zhi. 2012 Feb; 14 (2): 81-8. Chinese. Lau K, Butani L. Update on the management of Systemic Lupus Erythematosus from a Pediatric Nephrology Perspective. Current Rheumatology Reviews, Volume 8, Number 1, Feb. 2012, pp 30-38 (9). Steele, M., Belostotsky, V., Lau, K. The dangers of substance abuse in adolescents with chronic kidney disease: a review of the literature. CANNTJ. 2012 Jan-Mar. 22 (1):15-22, quiz 23-24.
Li, Chumei Chung BH, Mullegama S, Marshall CR, Lionel AC, Weksberg R, Dupuis L, Brick L, Li C, Scherer SW, Aradhya S, Stavropoulos DJ, Elsea SH, Mendoza-Londono R. Severe intellec-
tual disability and autistic features associated with microduplication 2q23.1. Eur J Hum Genet. 2012 Apr;20(4):398-403. Seema R. Lalani*§, Chad Shaw§, Xueqing Wang, Ankita Patel, Lance W. Patterson, Katarzyna Kolodziejska, Przemyslaw Szafranski, Zhishuo Ou, Qi Tian, Sung-Hae L Kang, Amina Jinnah, Alixandra M. Baycroft, Sophia Ali, Aamir Malik, Patricia Hixson, Lorraine Potocki, James R. Lupski, Pawel Stankiewicz, Carlos A. Bacino, Brian Dawson, Arthur L. Beaudet, Fatima M. Boricha, Runako Whittaker, Chumei Li, Stephanie M. Ware, Sau Wai Cheung, John Lynn Jefferies, John W. Belmont. Rare Recurrent DNA Copy Number Variants Associated with Syndromic Cardiovascular Malformations. European Journal of Human Genetics (2013) 21, 173–181; doi:10.1038/ejhg.2012.155; published August 2012. Dalal Abdelgadir, Malgorzata J.M. Nowaczyk and Chumei Li . Trisomy 22 Mosaicism and Normal Developmental Outcome: Report of Two Patients and Review of the Literature. Am J Med Genetics Part A 9999:1–6. 2012.
MacMillan, Harriet Tanaka M, Wekerle C, Leung E, Waechter R, Gonzalez A, Jamieson E, MacMillan HL. Preliminary evaluation of the Childhood Experiences of Violence Questionnaire short form. Journal of Interpersonal Violence 2012;27:396-407. Jack SM, Ford-Gilboe MC, Wathen N, Davidov DM, McNaughton DB, Coben JH, Olds DL, and MacMillan HL for the NFP IPV Research Team. Development of a nurse home visitation intervention for intimate partner violence. BMC Health Services Research 2012,12:50. Scribano PV, Stevens J, Kaizar E; NFP-IPV Research Team. Effects of intimate partner violence before, during, and after pregnancy in nurse visited first time mothers. Maternal Child Health Journal. 2012 (Epub ahead of print).
Gonzalez A, Boyle MH, Georgiades K, Duncan L, Atkinson LR, MacMillan HL. Childhood and family influences on body mass index in early adulthood: findings from the Ontario Child Health Study. BMC Public Health 2012;12:755 Davidov DM, Nardorff MR, Jack SM, Coben JH and the NFP IPV Research Team. Nurse home visitors’ perspectives of mandatory reporting of children’s exposure to intimate partner violence to child protection agencies. Public Health Nursing 2012;29:412-423. Davidov DM, Nadorff MR, Jack SM, Coben JH and the NFP IPV Research Team. Nurse home visitors’ perceptions of mandatory reporting of intimate partner violence to law enforcement agencies. Journal of Interpersonal Violence 2012;27:2484-2502. Wathen CN, Macgregor JC, Hammerton J, Coben JH, Herrman H, Stewart DE, MacMillan HL. Priorities for research in child maltreatment, intimate partner violence and resilience to violence exposures: results of an international Delphi consensus development process. BMC Public Health 2012;12:684. Wathen CN, MacMillan HL. Health care’s response to women exposed to partner violence: moving beyond universal screening. JAMA. 2012 Aug 15;308(7):712-713. Catallo C, Jack S, Ciliska D, MacMillan HL. Minimizing the risk of intrusion: a grounded theory of intimate partner violence disclosure in emergency departments. Journal of Advanced Nursing 2012, Aug 29 (Epub ahead of print). Jack SM, Sheehan D, Busser D, Gonzalez A, Zwygers E, MacMillan HL. Adaptation and implementation of the NurseFamily Partnership in Canada. Canadian Journal of Public Health 2012;103(Suppl.1):S42-S48.
Mesterman, Ronit
Catallo C, Jack SM, Ciliska D, MacMillan HL. Identifying the turning point: using the transtheoretical model of change to map intimate partner violence disclosure in emergency department settings. International Scholar Researching Network Nursing 2012;Article ID:239468.
Fehlings D, Narayanan U, Andersen J, Beauchamp R, Gorter JW, Kawamura A, Kiefer G, Mason M, McCormick A, Mesterman R, Switzer L, Watt J. Botulinum toxin-A use in paediatric hypertonia: Canadian practice patterns Can J Neurol Sci. 2012 Jul;39(4):508-15.
Beynon C, Gutmanis IA, Tutty L, Wathen CN, MacMillan HL. Why physicians and nurses ask (or don’t) about partner violence. A qualitative analysis. BMC Public Health 2012;12:473
Mondal, Tapas
Hibbard R, Barlow J, MacMillan HL and the Committee on Child Abuse and Neglect and American Academy of Child and Adolescent Psychiatry. Clinical Report: Psychological maltreatment. Pediatrics 2012;130:372-378. Afifi TO, Mota N, Dasiewicz P, MacMillan HL, Sareen J. Physical punishment and mental disorders: results from a nationally representative US sample. Pediatrics 2012;130:1-9. Gonzalez A, Boyle MH, Kyu HH, Duncan L, Georgiades K, MacMillan HL. Childhood and family influences on depression, chronic conditions and their co-morbidity: findings from the Ontario Child Health Study. Journal of Psychiatric Research 2012;46:1475-1482. Landy CK, Wahoush O, Sheehan D, MacMillan HL; NFP Research Team. Mothers’ experiences in the Nurse-Family Partnership program: a qualitative case study. BMC Nursing 2012;11:15
A wireless wearable ECG sensor for long-term applications. Ebrahim Nemati, M. Jamal Deen, Tapas Mondal. IEEE Communications Magazine 01/2012; 50:36-43. An unusual case of mitral valve infective endocarditis. Singh, Narendra C.; Mondal, Tapas. Follow Journal of Pediatric Infectious Diseases, Volume 7 (4) IOS Press – Jan 1, 2012 Differential contribution of Igepal and CnTAB micelles on the photophysics of nonsteroidal drug Naproxen. Mati SS, Mondal TK, Dhar S, Chall S, Bhattacharya SC. Spectrochim Acta A Mol Biomol Spectrosc. 2012 Jun 15;92:122-30. doi: 10.1016/j.saa.2012.02.042. Factors influencing participation in a population-based biorepository for childhood heart disease. Papaz T, Safi M, Manickaraj AK, Ogaki C, Breaton Kyryliuk J, Burrill L, Dodge C, Chant-Gambacort C, Walter LL, Rosenberg H, Mondal T, Smythe J, Lougheed J, Bergin L, Gordon E, Chitayat D, Oechslin E, Mital S. Pediatrics. 2012 Nov;130(5):e1198-205. doi: 10.1542/peds.2012-0687.
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Genetic determinants of right-ventricular remodeling after tetralogy of Fallot repair. Jeewa A, Manickaraj AK, Mertens L, Manlhiot C, Kinnear C, Mondal T, Smythe J, Rosenberg H, Lougheed J, McCrindle BW, van Arsdell G, Redington AN, Mital S. Pediatr Res. 2012 Oct;72(4):407-13. doi: 10.1038/ pr.2012.95.
Morrison, Katherine Morrison KM, Xu L, Tarnopolsky M, Yusuf Z, Atkinson SA, Yusuf S. Screening for dysglycemia in overweight youth presenting for weight management. Diabetes Care. 2012 Apr;35(4):711-6. Bruin JE, AK Woynillowicz, BP Hettinga, MA Tarnopolsky, KM Morrison, HC Gerstein and AC Holloway. Maternal antioxidants prevent beta cell apoptosis and promote formation of dual hormone-expressing endocrine cells in male offspring following fetal and neonatal nicotine exposure. J Diabetes. JDB-2011-089.R3. March 1, 2012 Ball GDC, Perez Garcia A, Chanoine JP, Morrison KM, Legault L, Sharma AM, Gokiert R, Holt NL. Should I Stay or should I go? Understanding families’ decisions regarding initiating, continuing, and terminating health services for managing pediatric obesity: The protocol for a multi-center, qualitative study. BMC Health Services Research. December 2012, 12:486 De Long, NE, JR Hyslop, CJ Nicholson, KM Morrison, HC Gerstein and AC Holloway. Postnatal metabolic and reproductive consequences of fetal and neonatal exposure to the smoking cessation drug bupropion. Reproductive Sciences. December 2012.
Niec, Anne Moharir M, Niec A, Wekerle C. Burn injury from car seat in an 11-month-old infant. Madhavi Moharir, Anne Niec, Christine Wekerle. Paediatri Child Health, 2012; 17(9)495-497.
Paes, Bosco Papenburg J, Carbonneau J, Hamelin M-E, Isabel S, Bouhy X, Ohoumanne N, Déry P, Paes BA, Corbeil J, Bergeron MG, De Serres G, Boivin G. Molecular Evolution of Respiratory Syncytial Virus Fusion Gene, Canada, 2006–2010. Emerg Infect Dis; Vol 18(1):120-4, 2012 Giffin M, Brennan B, Paes BA. Fetal intracerebral mass with major perinatal implications. NeoReviews; Vol 13:e251-53, 2012 Paes B, Mitchell I, Li A, Lanctot KL. Respiratory hospitalizations and respiratory syncytial virus prophylaxis in special populations. Eur J Pediatr; Vol 171:833-841, 2012 Paes B, Mitchell I, Li A, Lanctot KL.A comparative study of respiratory syncytial virus (RSV) prophylaxis in premature infants within the Canadian registry. Eur J Clin Microbiol Infect Dis; Vol 31(10):2703-11, 2012 Manzoni P, Paes B, Resch B, Mejias A, Ramilo O, CarbonellEstrany X, Bont L. High risk for RSV bronchiolitis in late preterms and selected infants affected by rare disorders: a dilemma of specific prevention. Early Hum Dev; Vol 88(Suppl 2):S34-41, 2012
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Mosalli R, Abd El-Azim AA, Qutub MA, Zagoot E, Janish M, Paes BA. Perceived barriers to the implementation of a baby friendly initiative in Jeddah, Saudi Arabia. Saudi Med J; Vol 33(8):895-900, 2012 Paes BA, Nagel K, Sunak I, Rashish G, Chan AK; on behalf of the Thrombosis and Hemostasis in Newborns (THiN) Group. Neonatal and infant pulmonary thromboembolism: a literature review. Blood Coagul Fibrinolysis; Vol 23(7):653662, 2012 Hussman JM, Lanctôt KL, Paes B. The cost effectiveness of palivizumab in congenital heart disease: a review of the current evidence. J Med Econ; Vol 2012 Sep 27. [Epub ahead of print] Nagel K, Pai MK, Paes BA, Chan AK. Diagnosis and treatment of intracranial hemorrhage in children with hemophilia. Blood Coagul Fibrinolysis; Vol 2012 Oct 17. [Epub ahead of print] Elnazir B, Oni O, Hassan T, Greally P, Paes B. Does prophylaxis with palivizumab reduce hospitalisation rates for respiratory-syncytial-virus-related infection in cystic fibrosis children less than 2 years of age? J Paediatr Child Health; Vol 48(11):1033-8, 2012 Bracht M, Basevitz D, Cranis M, Paulley R, Paes B. Strategies for reducing the risk of respiratory syncytial virus infection in infants and young children: a canadian nurses’ perspective. Neonatal Netw; Vol 31(6):357-68, 2012 Bracht M, Basevitz D, Cranis M, Paulley R, Paes B. Identifying and ensuring optimal care for all children at risk of developing serious respiratory syncytial virus disease: a canadian nurses’ perspective. Neonatal Netw; Vol 31(6):36986, 2012 Bracht M, Basevitz D, Cranis M, Paulley R, Paes B. Practical resources for nurses and other health care providers involved in the care of children at risk for respiratory syncytial virus infection. Neonatal Netw; Vol 31(6):387-400, 2012 Hussman JM, Li A, Paes B, Lanctôt KL. A review of costeffectiveness of palivizumab for respiratory syncytial virus. Expert Rev Pharmacoecon Outcomes Res; Vol 12(5):553-67, 2012 Mosalli R, Shaiba L, Alfaleh K, Paes B. Premedication for neonatal intubation: Current practice in Saudi Arabia. Saudi J Anaesth; Vol 6(4):385-92, 2012
Parker, Melissa Harvey G, Parker MJ. Pediatric fluid resuscitation targets: how do we get there? MUMJ 2012;9(1):39-41. Dec, 2012. Parker MJ, Manan A, Urbanski S.Prospective evaluation of direct approach with a tablet device as a strategy to enhance survey study participant response rate. BMC Research Notes 2012;5:605. Oct, 2012. Parker MJ Ethical consideration related to mobile medical technology use in medical research Journal of Mobile Medical Technology in Medicine 2012;Sept. 1(3):50-52 Sep, 2012. Parker, MJ Use of a tablet to enhance standardisation procedures in a randomized trial. Journal of Mobile Technology in Medicine. 2012;1(1):24-26. Mar, 2012.
Pernica, Jeffrey
Ratcliffe, Elyanne
Pernica JM, Mah JK, Kam AJ. Canadian Pediatricians’ Prescribing Practices for Community-Acquired Pneumonia. Clin Pediatr (Phila), 2013 May 15th. Epub ahead of print.
Collins J, Borojevic R, Verdu EF, Ratcliffe EM. Postnatal patterning of the enteric nervous system is dependent on the presence of endogenous microbiota. Gastroenterology 2012; 142 (5): S-91-91.
Abouanaser SF, Srigley JA, Nguyen T, Dale SE, Johnstone J, Wilcox L, Jamieson F, Rawte P, Pernica JM. Bordetella holmesii: an emerging cause of septic arthritis. J Clin Microbiol. 51(4):1313-5. Apr 2013. Welch H, Steenhoff AP, Chakalisa U, Arscott-Mills T, Tiwarenge S, Madan S, Gokhale N, Mazhani L, Mokomane M, Foster-Fabiano S, Wirth K, Skinn A, Pernica JM, Smieja M, Goldfarb DM. Hospital-based surveillance for rotavirus gastroenteritis using molecular testing and immunoasssays during the 2011 season in Botswana. Pediatr Infect Dis J. 2013 Jan 21 Epub ahead of print. Pernica JM, Leblanc JC, Soto-Castellares G, Donroe JA, Carhuancho Meza BA, Rainham DGC, Gilman RH. In-Press, Arch Dis Child, 2012. Risk factors predisposing to road traffic injury in children living in Lima, Peru; a case control study. Arch Dis Child. 2012 Aug 97(8):709-13.
Portwine, Carol Dix D, Cellot S, Price V, Gillmeister B, Ethier MC, Johnston DL, Lewis V, Michon B, Mitchell D, Stobart K, Yanofsky R, Portwine C, Silva M, Bowes L, Zelcer S, Brossard J, Traubici J, Allen U, Beyene J, Sung L. Association between corticosteroids and infection, sepsis, and infectious death in pediatric acute myeloid leukemia (AML): results from the Canadian infections in AML research group. Clin Infect Dis. 2012 Dec; 55 (12):1608-14. Epub 2012 Sep 5. PMID: 22955431 D, Science M, Dix D, Portwine C, Zelcer S, Johnston DL, Yanofsky R, Gassas A, Ethier MC, Sung L. Pandemic (H1N1) 2009 influenza in Canadian pediatric cancer and hematopoietic stem cell transplant patients.Tran Influenza Other Respi Viruses. 2012 Nov;6(6):e105-13. Epub 2012 Mar 14. PMID: 22417068
Raha, Sandeep Samjoo IA, Safdar A, Hamadeh MJ, Glover AW, Mocellin NJ, Santana J, Little JP, Steinberg GR, Raha S, Tarnopolsky MA. Markers of skeletal muscle mitochondrial function and lipid accumulation are moderately associated with thehomeostasis model assessment indes of insulin resistance in obese men. PLoS One. 2013 Jun 12;8(6):e66322 AK Woynillowicz, S Raha, CJ Nicholson, AC Holloway. The effect of smoking cesation pharmacotherapies on pancreatic beta cell function. Toxicol Appl Pharmacol. 2012 Nov 15;265(1):122-7. S Raha, V Taylor, AC Holloway. Effect of atypical antipsychotics on fetal growth: Is the placenta involved? J Pregnancy. 2012;2012:315203. Epub 2012 Jul 11. E Hayes, AM Lechowicz, J Petrik, Y Storozhuk, S Paez-Parent, Q Dai, I Samjoo, M Mansell, A Gruslin, A Holloway, S Raha. Adverse fetal and neonatal outcomes associated with a life-long high fat diet: Role of altered development of the placental vasculature. PLoS One. 2012;7(3):e33370.
Feasibility of conducting a prospective cohort study in pediatric surgery: introducing the Caregiver Quality of Life of pediatric patients referred for feeding tube insertion (CARE) study, Journal of Pediatric Surgery Vol 47, Issue 5, 2012 May Pemberton J, Nederveen J, Lamond A, Bailey K, Ratcliffe E, Walton JM
Ronen, Gabriel Bitton JY, Sauerwein HC, Weiss SK, Donner EJ, Whiting S, Dooley JM, Snead C, Farrell K, Wirrell EC, Mohamed IS, Ronen GM, Salas-Prato M, Amre D, Maryse Lassonde M, Carmant L. A randomized controlled trial of flunarizine as add-on therapy and effect on cognitive outcome in children with infantile spasms. Epilpesia 2012; 53: 1570-1574.
Rosenbaum, Peter Harvey A, Rosenbaum P, Hanna S, Yousefi-Nooraie R, Graham HK Longitudinal changes in mobility following single event multilevel surgery in ambulatory children with cerebral palsy. Journal of Rehabilitation Medicine 2012; 44: 137–143. Majnemer A, Poulin C, Shevell M, Law M, Rosenbaum P Indicators of distress in families of children with cerebral palsy. Disability and Rehabilitation 2012 Jan 12. [Epub ahead of print] PMID: 22235883 Garner, R. E., Arim, R. G., Kohen, D. E., Lach, L. M., MacKenzie, M. J., Brehaut J. C., & Rosenbaum, P. L. Parenting children with neurodevelopmental disorders and/or behaviour problems. Child: Care, Health & Development. doi: 10.1111/ j.1365-2214.2011.01347.x Amin L, Rosenbaum P, Barr R, Sung L, Klaassen RJ, Dix DB, Klassen A. Rasch analysis of the PedsQL: an increased understanding of the properties of a rating scale. (2012). Journal of Clinical Epidemiology 65 1117e1123. McCauley, D., Gorter, J.W., Russell, D., Rosenbaum, P., Law, M., & Kertoy, M. (2012). Assessment of environmental factors in disabled children 2–12 years: development and reliability of the Craig Hospital Inventory of Environmental Factors (CHIEF) for Children–Parent Version. Child: Care, Health and Development, doi:10.1111/j.1365-2214.2012.01388.x Kertoy, M., Russell, D., Rosenbaum, P., Jaffer, S., Law, M., McCauley, D. & Gorter, J. W. Development of an outcome measurement system for service planning for children and youth with special needs. Child Care Health Dev. 2012 Jul 30. doi: 10.1111/j.1365-2214.2012.01409.x. [Epub ahead of print] Hidecker, M.J.C., Ho, N.T., Dodge, N., Hurvitz, E., Slaughter, J., Workinger, M.S., Kent, R.D., Rosenbaum, P., Lenski, M., Messaros, B.M., VanderBeek, S.B., DeRoos, S., Paneth, N. (2012) Inter-relationships of functional status in cerebral palsy: Analyzing Gross Motor Function, Manual Ability, and Communication Function Classification Systems in children. Developmental Medicine and Child Neurology. Aug;53(8):704-10.
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King G, Zwaigenbaum L, Bates A, Baxter D, Rosenbaum P. Parent views of the positive contributions of elementary and high school-aged children with autism spectrum disorders and Down syndrome. (November 2012), 38 (6), pg. 817-828.
Manoranjana B, Venugopala C, McFarlanea N, Doblea BW, Dunnc S, Scheinemann K, Singh S. Medulloblastoma stem cells: Modeling tumor heterogeneity. Cancer Letters. E-Pub 2012.
Arim, R. G., Garner, R. E., Brehaut J. C., Lach, L. M., MacKenzie, M. J., Rosenbaum, P. L., & Kohen, D. E. (2012). Contextual influences of parenting behaviours for children with neurodevelopmental disorders: Results from a Canadian National Survey. Disability & Rehabilitation, 34, 2222-2233. doi:10.3109/09638288.2012.680650
Sherlock, Mary
Klein B, Gorter JW, Rosenbaum P. Diagnostic shortfalls in early childhood chronic stress: A review of the issues. Child: Care, Health and Development 2012 Dec 5. doi: 10.1111/ cch.12009. [Epub ahead of print]
Treatments for pediatric inflammatory bowel disease. Sherlock ME, Griffiths AM, Curr Gastroenterol Rep. 2012 Apr;14(2):166-73.
Fayed N, de Camargo OK, Kerr E, Rosenbaum P, Dubey A, Bostan C, Faulhaber M, Raina P, Cieza A. (2012) Generic patient-reported outcomes in child health research: a review of conceptual content using World Health Organization definitions. Dev Med Child Neurol. Dec;54(12):1085-95.
Rosenbloom, Ehud Rosenbloom E, Finkelstein Y, Kozer E, Meta-analysis - Are antipyretics effective in preventing the recurrence of febrile seizures. European Journal of Child Neurology. May 2012.
Saigal, Saroj Murphy KE, Willan AR, Hannah ME, Ohlsson A, Kelly EN, Matthews SG, Saigal S, et al. Multiple Courses of Antenatal corticosteroids for Preterm Birth Study Collaborative Group. Effect of antenatal corticosteroids on fetal growth and gestational age at birth. Obstet Gynecao 2012;119(5);917-23.
Virtual reality simulation training for health professions trainees in gastrointestinal endoscopy. Cochrane Database Syst Rev. 2012 Jun 13;6:CD008237. Walsh CM, Sherlock ME, Ling SC, Carnahan H
Shivananda, Sandesh Shivananda S, Ahliwahlia L, Kluchkow M, Luc J, Jankov J, McNamara PJ. Variation in the management of persistent pulmonary hypertension of newborn (PPHN): A survey of physicians in Canada, Australia, and New Zealand. American Journal of Perinatology. 2012 Aug; 29 (7): 519-26. Gupta V, Whelan KF, Schneider L, Farrokhyar F, Shivananda S, Lee S, Sabri K. National variations in retinopathy of prematurity screening criteria in Canada: existent guidelines and actual practice patterns. Canadian Journal of Ophthalmology. 2012 Aug; 47 (6): 473-478.
Tarnopolsky, Mark Anglin RE, Garside SL, Tarnopolsky MA, Mazurek MF, Rosebush PI. The psychiatric manifestations of mitochondrial disorders: a case and review of the literature. J. Clin. Psychiatry, 73(4):506-12, 2012.
S.Saigal Quality of life of former premature infants during adolescence and beyond. Early Hum Dev 2013;89(4):209-13. Epub 2013 Feb 23..
Anglin RE, Mazurek MF, Tarnopolsky MA, Rosebush, PI. The mitochondrial genome and psychiatric illness. Am. J. Med. Genet. B. Neuropsychiatr. Genet., 159B(7):749-59, 2012.
Samaan, M. Constantine
Anglin RE, Rosebush P, Noseworthy M, Tarnopolsky M, Mazurek M. Psychiatric symptoms correlate with metabolic indices i the hippocampus and cingulated in patients with mitochondrial disorders. Transl. Psychiatry, 2:e187, 2012.
Samaan MC, Alassaf A, Dellavedova J, Murthy T. Exerciseinduced hypoglycemic hemiplegia in type 1 diabetes: A rare find with multiple potential causative mechanisms. Case Reports in Medicine. Published 2011. Online link to paper: http://www.hindawi.com/journals/crim/aip/529097/ Dec, 2012.
Scheinemann, Katrin Fried I, Hawkins C, Scheinemann K, Tsangaris E, Hesselson L, Bartels U, Huang A, Laperriere N, Dirks P, Bouffet E, Tabori U. Favorable outcome with conservative treatment for children with low grade brainstem tumors. Pediatric Blood and Cancer. 2012; 58 (4): 556-560. Lafay-Cousin L, Hawkins C, Carret AS, Johnston D, Zelcer S, Wilson B, Jabado N, Scheinemann K, Eisenstat D, Fryer C, Fleming A, Mpofu C, Larouche V, Strother D, Bouffet E, Huang A. Central nervous system atypical teratoid rhabdoid tumours: The Canadian Paediatric Brain Tumour Consortium experience. Eur J Cancer. 2012; 48 (3): 353-9. Manoranjan B, Venugopal C, McFarlane N, Doble B, Dunn S, Scheinemann K, Singh S. Medulloblastoma stem cells: where development and cancer cross pathways. Pediatric Research 2012; 71 (4-2): 516 - 522.
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Anglin RE, Rosebush PI, Noseworthy MD, Tarnopolsky MA, Mazurek MF. Psychiatric symptoms correlate with metabolic indices in the hippocampus and cingulate in patients with mitochondrial disorders. Transl. Psychiatry, 2:e187, 2012. Berryer MH, Hamdan FF, Klitten LL, Moller RS, Carmant L, Schwartzentruber J, Patry L, Dobrzeniecka S, Rochefort D, Neugnot M, Lacaille JC, Niu Z, Eng CM, Yang Y, Palardy S, Belhumeur C, Rouleau GA, Tommerup N, Immken L, Beauchamp MH, Patel GS, Majewski J, Tarnopolsky MA, Scheffzek K, Hjalgrim H, Michaud JL, Di Cristo G. Mutations in SYNGAP1 cause intellectual disability, autism and a specific form of epilepsy by inducing haploinsufficiency. Hum Mutat., 34(2):385-94, 2013. Bruin JE, Woynillowicz AK, Hettinga BP, Tarnopolsky MA, Morrison KM, Gerstein HC, Holloway AC. Maternal antioxidants prevent beta cell apoptosis and promote formation of dual hormone-expressing endocrine cells in male offspring following fetal and neonatal nicotine exposure. J. Diabetes, 4(3):297-306, 2012.
Burd NA, Yang Y, Moore DR, Tang JE, Tarnopolsky MA, Phillips SM. Greater stimulation of myofibrillar protein synthesis with ingestion of whey protein isolate v. micellar casein at rest and after resistance exercise in elderly men. Br. J. Nutr., 31:1-5, 2012. Cermak NM, Noseworthy MD, Bourgeois JM, Tarnopolsky MA, Gibala MJ. Diffusion tensor MRI to assess skeletal muscle disruption following eccentric exercise. Muscle & Nerve, 46(1):42-50, 2012. Cermak NM, Snijders T, McKay BR, Parise G, Verdijk LB, Tarnopolsky MA, Gibala MJ, Loon LJ. Eccentric exercise increases satellite cell content in type II muscle fibers. Med. Sci. Sports Exerc., 45(2):230-7, 2012. Crane JD, MacNeil LG, Tarnopolsky MA. Long-term aerobic exercise is associated with greater muscle strength throughout the life span. J. Gerontol A. Biol. Sci. Med. Sci., epub ahead of print December, 2012. Crane JD, Ogborn DI, Cupido C, Melov S, Hubbard A, Bourgeois JM, Tarnopolsky MA. Massage therapy attenuates inflammatory signalling after exercise-induced muscle damage. Sci. Transl. Med., 4(119):119ra13, 2012. Gillen JB, Little JP, Punthakee Z, Tarnopolsky MA, Riddell MC, Gibala MJ. Acute high-intensity interval exercise reduces the postprandial glucose response and prevalence of hyperglycemia in patients with type 2 diabetes. Diabetes Obes. Metab., 14(16):575-7, 2012. Ha AH, Tarnopolsky MA, Bergstra TG, Nair GM, Al-Qubbany A, Healey JS. Predictors of Atrio-ventricular conduction disease, long-term outcomes in patients with myotonic dystrophy types I and II. Pacing Clin. Electrophysiol, 35(10)1262-9, 2012. Haack TB, Hogarth P, Kruer MC, Gregory A, Wieland T, Schwarzmayr T, Graf E, Sanford L, Meyer E, Kara E, Cuno SM, Karik SI, Dandu VH, Nardocci N, Zorzi G, Dunaway T, Tarnopolsky M, Skinner S, Frucht S, Hanspal E, SchranderStumpel C, Heron D, Mignot C, Garavaglia B, Bhatia K, Hardy J, Strom TM, Boddaert N, Houlden HH, Kurian MA, Meitinger T, Prokisch H, Hayflich SJ. Exome sequencing reveals de novo WDR45 mutations causing a phenotypically distinct, x-linked dominant form of NBIA. Am. J. Hum. Genet., 91(6):1144-9, 2012. Josse AR, Atkinson SA, Tarnopolsky MA, Phillips SM. Diets higher in dairy foods and dietary protein support bone health during diet-and-exercise-induced weight loss in overweight and obese premenopausal women. J. Clin Endocrinol. Metab., 97(1):251-60, 2012. Koene S, Rodenburg RJ, van der Knaap MS, Willemsen MA, Sperl W, Laugel V, Ostergaard E, Tarnopolsky M, Martin MA, Nesbitt V, Fletcher J, Edvardson S, Procaccio V, Slama A, van den Heuvel LP, Smeitink JA. Natural disease course and genotype-phenotype correlations in complex 1 deficiency caused by nuclear gene defects: what we learned from 130 cases. J. Inherit. Metab. Dis., 35(5):737-47, 2012. Kusko RL, Banerjee C. Long KK, Darcy A, Otis J, Sebastiani P, Melov S, Tarnopolsky M, Bhasin S, Montano M. Premature expression of a muscle fibrosis axis in chronic HIV infection. Skeletal Muscle, 2(1):10, 2012.
Ma X, Hamadeh MJ, Christie BR, Foster JA, Tarnopolsky MA. Impact of treadmill running and sex on hippocampal neurogenesis in the mouse model of amyotrophic lateral sclerosis. PLoS One, 7(4):e36048, 2012. McKay BR, Ogborn DI, Bellamy LM, Tarnopolsky MA, Parise G. Myostatin is associated with age-related human muscle stem cell dysfunction. FASEB J., 26(6):2509-21, 2012. Morrison KM, Xu L, Tarnopolsky MA, Yusuf Z, Atkinson S, Yusuf S. Screening for dysglycemia in overweight youth presenting for weight management. Diabetes Care, 35(4):711-6, 2012. Nilsson MI, Samjoo IA, Hettinga BP, Koeberl DD, Zhang H, Hawke TJ, Nissar AA, Ali T, Brandt L, Ansari MU, Hazari H, Patel N, Amon J, Tarnopolsky M. Aerobic training as an adjunctive therapy to enzyme replacement in pompe disease. Mol. Genet. Metab., 107(3):469-79, 2012. Nilsson M, Laureano M, Saeed M, Tarnopolsky M. Dysferlin aggregation in limb-girdle muscular dystrophy type 2B/myoshi myopathy necessitates mutational screen for diagnosis. Muscle & Nerve, epub ahead of print 2012. Ogborn DI, Smith KJ, Crane JD, Safdar A, Hettinga BP, Tupler R, Tarnopolsky MA. Effects of creatine and exercise on skeletal muscle of FRG1-Transgenic mice. Can. J. Neurol. Sci., 39(2):225-31, 2012. Peters SJ, Samjoo IA, Devries MC, Stevic I, Robertshaw H, Tarnopolsky M. Perilipin family (PLIN) proteins in human skeletal muscle: the effect of sex, obesity, and endurance training. Appl. Physiol. Nutr. Metab., 37(4):724-35, 2012. Rosenfeld JA, Traylor RN, Schaefer GB, McPherson EW, Ballif BC, Klopocki E, Mundlos S, Shaffer LG, Aylsworth AS, 1q21.1 Study Group. Proximal microdeletions and microduplications of 1q21.1 contribute to variable abnormal phenotypes. Eur. J. Hum. Genet., 20(7):754-61, 2012. Rowlands DS, Pearce E., Aboud A, Gillen JB, Gibala MJ, Donato S, Waddington JM, Green JG, Tarnopolsky MA. Oxidative stress, inflammation and muscle soreness in an 894-km relay trail run. Eur. J. Appl. Physiol., 112(5):1839-48, 2012. Tarnopolsky M. Exercise testing in metabolic myopathies. Phys. Med. Rehab. Clin. N. Am, 23(1):173-86, 2012. Yang Y, Breen L, burd NA, Kector AJ, Churchward-Venne TA, Josse AR, Tarnopolsky MA, Phillips SM. Resistance exercise enhances myofibrillar protein synthesis with graded intakes of whey protein in older men. Br. J. Nutr., 7:1-9, 2012. Yang Y, Churchward-Venne TA, Burd NA, Breen L, Tarnopolsky M, Phillips S. Myofibrillar protein synthesis following ingestion of soy protein isolate at rest and after resistance exercise in elderly men. Nutr. Metab., 9(1):57, 2012.
Thomas, Sumesh Manual of Neonatal Respiratory Care. 3rd ed. 2012 Chapter 71. Long-Term Outcome of Newborns with Bronchopulmonary Dysplasia . Thomas S, Murthy P, Saigal S
Timmons, Brian Tremblay MS, AG LeBlanc, V Carson, L Choquette, S Connor Gorber, C Dillman, M Duggan, MJ Gordon, A Hicks, I Jans-
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publications
sen, ME Kho, AE Latimer, C LeBlanc, K Murumets, AD Okely, JJ Reilly, JC Spence, J Stearns, and BW Timmons. Canadian physical activity guidelines for the early years (aged 0-4 years). Appl Physiol Nutr Metab, 37: 345-56, 2012.
adolescents with Cerebral Palsy. Int J Ped, Volume 2012, Article ID 168209, doi:10.1155/2012/168209, 2012.
Tremblay MS, AG LeBlanc, V Carson, L Choquette, S Connor Gorber, C Dillman, M Duggan, MJ Gordon, A Hicks, I Janssen, ME Kho, AE Latimer, C LeBlanc, K Murumets, AD Okely, JJ Reilly, JC Spence, J Stearns, and BW Timmons. Directives canadiennes en matière d’activité physique pour la petite enfance (enfants âgés de 0 à 4 ans). Appl Physiol Nutr Metab, 37: 357-69, 2012.
Rhodes, A.E., Khan, S., Boyle, M.H., Wekerle, C., ...& Manion, I. (2012). Sex differences in suicides among children and youth - the potential impact of misclassification. Canadian Journal of Public Health, 103(3), 213-217. 2012.
Tremblay MS, AG LeBlanc, V Carson, L Choquette, S Connor Gorber, C Dillman, M Duggan, MJ Gordon, A Hicks, I Janssen, ME Kho, AE Latimer, C LeBlanc, K Murumets, AD Okely, JJ Reilly, J Stearns, BW Timmons, and JC Spence. Canadian sedentary behaviour guidelines for the early years (aged 0-4 years). Appl Physiol Nutr Metab, 37: 370-80, 2012. Tremblay MS, AG LeBlanc, V Carson, L Choquette, S Connor Gorber, C Dillman, M Duggan, MJ Gordon, A Hicks, I Janssen, ME Kho, AE Latimer, C LeBlanc, K Murumets, AD Okely, JJ Reilly, J Stearns, BW Timmons, and JC Spence. Directives canadiennes en matière de comportement sédentaire pour la petite enfance (enfants âgés de 0 à 4 ans). Appl Physiol Nutr Metab, 37: 381-91, 2012. Timmons, BW, NA Proudfoot, MJ MacDonald, S Bray, Steven, J Cairney. The health outcomes and physical activity in preschoolers (HOPP) study: rationale and design. BMC Public Health, 12(1): 284, 2012 [Epub ahead of print]. Currie KD, AA Martin, PJ Millar, ND Stone, BW Timmons, RF Dillenburg, MJ MacDonald. Vascular and autonomic function in preschool-aged children with congenital heart disease. Congenit Heart Dis, 7(3): 289-297, 2012 [Epub ahead of print]. Ploeger HE, J Obeid, T Nguyen, T Takken, RM Issenman, MHG de Greef, and BW Timmons. Exercise and inflammation in pediatric Crohn’s disease. Int J Sports Med, 33(8):671-679, 2012. [Epub ahead of print]. Meyer F, KA Volterman, BW Timmons, and B Wilk. Fluid balance and dehydration in the young athlete: Assessment considerations and effects on health and performance. Am J Lifestyle Med, 6(6): 489-501, 2012. [Epub ahead of print]. LeBlanc A, J Spence, V Carson, S Connor Gorber, C Dillman, I Janssen, M Kho, J Stearns, BW Timmons, M Tremblay. Systematic review of sedentary behaviour and health indicators in the early years (aged 0-4 years). Appl Physiol Nutr Metab, 37(4): 753-772, 2012. Timmons, BW, A LeBlanc, V Carson, S Connor Gorber, C Dillman, I Janssen, M Kho, J Spence, J Stearns, M Tremblay. Systematic review of physical activity and health in the early years (aged 0-4 years). Appl Physiol Nutr Metab, 37(4): 773-792, 2012. Gorter JW, S G Noorduyn, J Obeid, and BW Timmons. Accelerometry: a feasible method to quantify physical activity in ambulatory and non-ambulatory adolescents with cerebral palsy. Int J Ped, Volume 2012, Article ID 329284, doi:10.1155/2012/329284, 2012. Martin AA, L Cotie, BW Timmons, JW Gorter, and MJ MacDonald. Arterial structure and function in ambulatory
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Wekerle, Christine
Rhodes, A.E., Boyle, M.H., Bethell, J., Wekerle, C.,...& Manion, I. (2012).Child maltreatment and onset of emergency department presentations for suicide-related behaviors. Child Abuse & Neglect: The International Journal, 36(6), 542-551. 2012. Flett, G.L., Goldstein, A.L., Hewitt, P.L., & Wekerle, C. (2012). Predictors of deliberate self-harm behaviour among emerging adolescents: An initial test of a self-punitiveness model. Current Psychology, 31(1), 49-64. 2012. Goldstein, A.L., Vilhena-Churchill, N., Stewart, S.H., & Wekerle, C. (2012). Coping motives as moderators of the relationship between emotional distress and alcohol problems in a sample of adolescents involved with child welfare. Advances in Mental Health, 11(1), 67-75. 2012. Moharir, M., Niec, A., & Wekerle, C. (2012). Burn injury in an 11 month old infant. Pediatrics & Child Health, 17(9), 495497. 2012. Flett, G.L., Druckman, T., Hewitt, P.L., & Wekerle, C. (2012). Perfectionism, coping, social support and depression in maltreated adolescents. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 30(2), 118-131. 2012. Hamilton, H., Wekerle, C., Paglia-Boak, A., & Mann, R. (2012). The role of school connectedness and the link between family involvement with Child Protective Services and adolescent adjustment. Advances in Mental Health, 11(1), 25-34. 2012. Ellenbogen, S., Trocme, N., & Wekerle, C. (2012). Selfgenerated outcome expectancies of violence in intimate relationships: A comparison of aggressive and nonaggressive adolescents in a sample of Child Protective Services users. Canadian Journal of Behavioural Science, 44(4), 300-307. 2012. Bruno, T., Butters, J., Erickson, P.G., & Wekerle, C. (2012). Missed conceptions: A gendered extension of early conception among street youth. Deviant Behavior, 33, 550-565. 2012. Fernandez, L., Wekerle, C., & Goldstein, A. (2012). Measuring adolescent dating violence: Development of Conflict in Adolescent Dating Relationships Inventory (CADRI) Short Form. Advances in Mental Health, 11(1), 35-54. 2012. Pereira, J., Vickers, R., Atkinson, L., Gonzalez, A., Wekerle, C., & Levitan, R. (2012). Parenting stress mediates between maternal maltreatment history and maternal sensitivity in a community sample. Child Abuse & Neglect: The International Journal, 30, 433-437. 2012. Tanaka, M., Wekerle, C., Leung, E., Waechter, R., Gonzalez, A., Jamieson, E., & MacMillan, H. (2012). Preliminary evaluation of the Childhood Experiences of Violence Questionnaire Short Form. Journal of Interpersonal Violence, 27, 396-407. 2012.
Williams, Connie Hellmann J, Williams C, Ives-Baine L, Shah P. Withdrawal of artificial nutrition and hydration in the Neonatal Intensive Care Unit: parental perspectives. Arch Dis Child Fetal Neonatal Ed. 2012 Mar 23 n
Wherever the art of Medicine is loved, there is also a love of Humanity.�
— Hippocrates
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faculty listing 2012 ADOLESCENT MEDICINE Dr. Sheri Findlay Associate Professor Acting Department Chair Dr. Christina Grant Associate Chair, Education Associate Professor Dr. Natasha Johnson Acting Division Head Assistant Professor
*ALLERGY & IMMUNOLOGY Dr. Susan Waserman* Division Head Professor Dr. Michael Cyr Assistant Clinical Professor Dr. Peter Dent Professor Emeritus
CARDIOLOGY Dr. Brandon Meaney Acting Division Head Associate Professor Dr. Claudia Almeida Assistant Professor Dr. Rejane Dillenburg Associate Professor Dr. Tapas Mondal Associate Professor Dr. Dragos Predescu Assistant Professor
CHILD ADVOCACY & ASSESMENT PROGRAM Dr. Anne Niec Division Head Professor Dr. Burke Baird Associate Professor 66
Dr. Elisabeth Canisius CAAP Physician
Dr. Katherine Morrison Associate Professor
Dr. Harriet MacMillan* Professor
Dr. Zubin Punthakee* Assistant Professor
Dr. Frank O’Toole Assistant Clinical Professor
Dr. M. Constantine Samaan Assistant Professor
Dr. Sandi Seigel Associate Clinical Professor Dr. Shobha Wahi Associate Clinical Professor Dr. Christine Wekerle Associate Professor
Dr. Brian Timmons Associate Professor
CRITICAL CARE Dr. Cynthia Cupido Division Head Fellowship Director Associate Professor
CHILD LIFE
Dr. Karen Choong Associate Professor
Cathy Humphreys Co-Director Chair of Admissions Assistant Clinical Professor
Dr. Jon Gilleland Associate Professor
Paola DiLalla Co-Director Distance Learning Coordinator Assistant Clinical Professor Sarah Patterson Co-Director Curriculum Coordinator Assistant Clinical Professor Allison Riggs Assistant Professor
CHILDREN’S EXERCISE & NUTRITION Dr. John VanderMeulen Division Head Professor Dr. William Conner Associate Clinical Professor Dr. Andrew Don-Wauchope Associate Professor Dr. Charlie Malcolmson Associate Clinical Professor
Dr. Lennox Huang Department Chair Associate Professor Dr. Rob Lloyd Associate Professor Dr. Melissa Parker Assistant Professor Dr. Arif Somani Associate Professor
DEVELOPMENTAL PEDIATRICS Dr. Ronit Mesterman Division Head Associate Professor Dr. Teresa Carter Associate Director, Pediatric Clerkship Associate Professor Dr. Jan Willem Gorter Associate Professor Dr. Karen Harman Fellowship Director Associate Professor
Dr. Olaf Kraus de Camargo Associate Professor
Dr. Ehud Rosenbloom Assistant Professor
Dr. Mary Zachos Associate Clinical Professor
Dr. William Mahoney Associate Clinical Professor
Dr. Chris Sulowski Assistant Professor
GENERAL PEDIATRICS
Dr. Peter Rosenbaum Professor Canada Research Chair
Dr. Rahim Valani Assistant Professor
EMERGENCY MEDICINE
Dr. Emma Wyatt Assistant Professor
Dr. Robert Issenman Acting Division Head Professor
ENDOCRINOLOGY
Dr. Hasan Al Shabanah Assistant Clinical Professor
Dr. John VanderMeulen Division Head Professor
Dr. Krishna Anchala Associate Professor
Ereny Bassilious Assistant Professor
Dr. Burke Baird Associate Professor
Dr. Karen McAssey Clerkship Director Associate Professor
Dr. Anthony Crocco Assistant Clinical Professor Dr. Jay Green Assistant Clinical Professor Dr. Erich Hanel Assistant Clinical Professor Dr. Alexandra Hernandez Assistant Professor Dr. April Kam Assistant Professor Dr. Benjamin Klein Assistant Clinical Professor
Dr. Katherine Morrison Associate Professor Dr. M. Constantine Samaan Assistant Professor Dr. Zubin Punthakee* Assistant Professor
GASTROENTEROLOGY Dr. Robert Issenman Division Head Professor
Dr. Madan Roy Division Head Acting Deputy Chief Fellowship Director Associate Professor Youness Al-Darazi Assistant Clinical Professor Dr. Bojana Babic Assistant Clinical Professor Karen Backway Assistant Clinical Professor Dr. Wendy Cheung Assistant Clinical Professor Dr. Samara Chitayat Assistant Clinical Professor Dr. Bruno DiGravio Assistant Clinical Professor Dr. Caroline Ernst Assistant Clinical Professor Dr. Giuliana Federici Assistant Clinical Professor Dr. Kelly Fitzpatrick Assistant Clinical Professor Dr. Anthony Ford-Jones Assistant Clinical Professor
Dr. Herbert Brill Fellowship Director Assistant Professor
Dr. Kathy Gambaratto Assistant Clinical Professor
Dr. Quang Ngo Assistant Clinical Professor
Dr. Elyanne Ratcliffe Associate Professor
Dr. Lucia Giglia Assistant Clinical Professor
Dr. Alim Pardhan Assistant Clinical Professor
Dr. Mary Sherlock Assistant Professor
Dr. Kristen Hallett Assistant Clinical Professor
Dr. Vanessa Razack Assistant Clinical Professor
Dr. William-Gary Smith Assistant Clinical Professor
Dr. Andrea Hunter Assistant Clinical Professor
Dr. Shruti Mehrotra Assistant Professor
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faculty listing
Dr. Natasha Johnson Assistant Professor
Dr. Murray Potter* Associate Professor
Dr. Michael Marrin Associate Professor
Dr. Moyez Ladhani Post-Graduate Director Associate Professor
HEMATOLOGY/ ONCOLOGY
Dr. Prashanth Murthy Assistant Professor
Dr. Andrew Latchman Associate Professor Dr. Audrey Lim Assistant Clinical Professor Dr. Ramsay MacNay Assistant Clinical Professor Dr. Natalie Orovec Assistant Clinical Professor Dr. Frank O’Toole Assistant Clinical Professor Dr. Umesh Rayar Assistant Clinical Professor Dr. Lillian Rojinica Assistant Clinical Professor Dr. Sandra Seigel Associate Clinical Professor Deputy Division Chief, St. Joe’s Dr. Iman Shbash Assistant Clinical Professor Dr. Gita Wahi Assistant Professor Dr. Shoba Wahi Associate Clinical Professor
GENETICS
Dr. Anthony Chan Division Head Professor Dr. Uma Athale Associate Professor Dr. Ronald Barr Professor Dr. Vicky Breaky Assistant Professor Dr. Anne Klassen Associate Professor
Dr. Sumesh Thomas Associate Professor Medical Director, NICU Dr. Bosco Paes Professor Emeritus Dr. Saroj Saigal Professor Emeritus
Dr. Mohan Pai Professor Emeritus
Dr. Jack Sinclair Professor Emeritus
Dr. Carol Portwine Associate Professor
Dr. John Watts Professor Emeritus
Dr. Katrin Scheinemann Assistant Professor
Dr. Connie Williams Assistant Professor
INFECTIOUS DISEASES
NEPHROLOGY
Dr. Jeffrey Pernica Division Head Assistant Professor
Dr. Keith Lau Division Head Associate Professor
Dr. David Goldfarb Assistant Professor Dr. Martha Fulford* Associate Professor
NEONATOLOGY
Dr. Chumei Li Division Head Associate Professor
Dr. Christoph Fusch Division Head Jack Sinclair Endowed Chair Professor
Dr. Mariya Kozenko Assistant Professor
Dr. Sourabh Dutta Associate Professor
Dr. Margaret Nowaczyk* Associate Professor
Dr. Salhab el Helou Associate Professor
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Dr. Sandesh Shivananda Assistant Professor
Dr. Steven Arora Associate Professor Dr. Vladimir Belostosky Assistant Professor
NEUROLOGY Dr. Brandon Meaney Division Head Associate Professor Dr. David Callen Neurology Residency Program Director Fellowship Director Assistant Professor
Dr. Ronit Mesterman Associate Professor
PEDIATRIC RESIDENTS
Dr. Stephanie Kay
PGY 1
Dr. Andrea Mucci, Chief Resident
Dr. Gabriel Ronen Professor
Dr. Kaleem Ashraf
Dr. Allison Rodrigues
Dr. Maria Chacon
Dr. Jillian Salvador
Dr. Rajesh RamachandranNair Associate Professor
Dr. Jessica Dooley
Dr. Lia Abigail Siapno
Dr. Rosheen Grady
Dr. Jennifer Smith
NEUROMUSCULAR & NEUROMETABOLIC
Dr. Rubeena Khan
Dr. Sophie Tanguay
Dr. Andrea Kirou-Mauro
Dr. Renee Tseng
Dr. Mark Tarnopolsky Division Head Professor
Dr. Michelle Lee
PGY 4
PEDIATRIC RESEARCH
Dr. Hana Mijovic
Dr. Stephanie Atkinson Associate Chair, Research Professor
Dr. Madhavi Moharir
Dr. Sandeep Raha Assistant Professor
Dr. Meijian Zhao
Dr. Anne Klassen Associate Professor Dr. Brian Timmons Associate Professor Dr. Lehana Thabane* Associate Professor
Dr. Willa Liao Dr. Daisy Liu
Dr. Shazli Shethwala Dr. Jessica Woolfson
Dr. Graham Black Dr. Jonathan DellaVedova Dr. Manal El Sayed Dr. Nicole Fernandes Dr. Erica Hunt Dr. Fadi Nossair
Dr. Romy Cho
Dr. Meenatchi Ranganathan
Dr. Jenna Dowhaniuk
Dr. Sarangan Uthayalingam
Dr. Julia Frei
PEDIATRIC NEUROLOGY RESIDENTS
Dr. Kim Genier Dr. Andrea Martinez
RESPIROLOGY
Dr. Nancy Nashid
Dr. Linda Pedder Assistant Clinical Professor
Dr. Luise Neuendorff
RHEUMATOLOGY
Dr. Joanna Stanisz
Dr. Peter Dent Division Head Professor Emeritus
Dr. Sanjay Vashishtha
Dr. Margaret Larche* Assistant Professor
Dr. Heather Bahn, Chief Resident
PGY 2
Dr. Anne Moffatt
Dr. Tania Cellucci Assistant Professor
Dr. Khalid Almajid
Dr. Praveen Rayar
Dr. Salma Noormahamed, PGY 1 Dr. Kaitlyn Siu, PGY 2 Dr. Maryam Fesharaki, PGY 3 Dr. Oksana Shlapak, PGY 3 Dr. Robyn Whitney, PGY 3 Dr. Samantha Marin, PGY 4 Dr. Chintan Shah, PGY 5 n
PGY 3 Dr. Meshari Al-Aifan Dr. Ghanem Al-Ghanem Dr. Shiba Asim Dr. Adriana Gonzalez-Fonseca
*Associate or Joint Appointment in
Dr. Shikha Gupta
Pediatrics
Dr. Greg Harvey 69
Education and Research Endowment Funds
The Department of Pediatrics’ Education and Research Endowment Funds were established to promote innovative education scholarship; develop educational leaders amongst our faculty and trainees; and pursue excellence in research and investigative studies on the global stage. If you are interested in giving to the Department of Pediatrics’ Education or Research Endowment Funds to support these vital initiatives, please contact: Ann Brodie Director of Development Faculty of Health Sciences Phone: 905.525.9140 x22236 E-mail: brodiea@mcmaster.ca
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PRODUCED BY Michelle Edmonds, Robert Edmonds Electra Communications Cheryl Crocker McMaster University Department of Pediatrics WRITER Glen Herbert DESIGN Electra Communications PHOTOGRAPHY Jon Evans Joanna Ward With special thanks to all the Pediatrics Faculty and Staff who contributed to the project and without whom this report would not be possible.
Department of Pediatrics McMaster University 1280 Main Street West Health Sciences Centre 3A Hamilton, Ontario, Canada L8S 4K1 Phone: 905-521-2100 Ext. 73141 Fax: 905-570-8967 fhs.mcmaster.ca/pediatrics