Category: Conference News

Technology Enabled Knowledge Translation Part 3

Digital Trends – Kendall Ho (UBC – Digital Emergency Medicine)Kendall Ho seemed very excited by the potential of emerging technologies, although the talk was more of a fly over than a dissection of practical application of IT in paediatric practice. But it did leave me with the idea that perhaps it could be an area that I ask more about. I’ve recently started routinely asking for a digital history when I meet patients, and I wonder if this should include a social media history, and a health app history. What’s your weekly average steps per day?

Key Points:

  • Patient engagement is facilitated by emerging technologies
  • There is a dialogue, or partnership in the application of health technologies between health providers and health clients, where patients and providers educate each other about new applications of tech.
  • Health related digital technology can facilitate equity
  • No digital genome without a digital phenome

Cool links: 

  • MindHealthBC, and the Australian corollary BeyondBlue and HeadSpace
  • This is my Food – Nutrition application (link is via CommonSense media review site)
  • I got this – Diabetes education app for children

IPA Session on Technology Enabled Knowledge Translation Part 2

A Pediatric Education Initiative for Global Impact – Kevin Forsyth

Kevin Forsyth proposed that in order get good implementation of the health related sustainable development goals, you need first to have good education, and that education in

Provision of high quality services for children requires a competent and motivated health workforce
Key Points:

  • You need a good workforce to implement the SDGs, and a good workforce needs coordinated support
  • The world needs a globally organised paediatric academic community – you can email Kevin to be a part of this…

Cool links:

IPA Session on Technology Enabled Knowledge Translation Part 1

Anthony Costello – The Knowledge GapAnthony Costello spoke about how the fact that it is not doctors, but a variety of other types of front-line health professionals who care for childhood illnesses around the world, means there needs to be a well integrated, efficient, and accountable program for delivering consistent neonatal and child health care around the world

Key Points:

  • How to reach marginalised populations
  • Need for accounaability in WHO and country level leadership
  • Empowerment and voice of women is important

Cool links:

IMNCI initiative http://www.who.int/maternal_child_adolescent/topics/child/imci/en/

mHealth https://en.m.wikipedia.org/wiki/MHealth

Cool quote:

“One person’s diversity is another person’s fragmentation”

IPA Plenary Session with Zulfi Bhutta

Zulfiqar Bhutta is the incoming president of the IPA, and has remains a consistently eloquent presenter on issues of global child health.

Main Points:

  • There is increasing evidence of the link between maternal, infant and child health
  • Our understanding of intergenerational transmission of violence needs more development
  • Statistics – need disaggregated data to demonstrate inequities within countries and communities
  • Road ahead is a long one – need to look at health not just within the health SDG but across all 17 SDGs

Cool links:

IPA Plenary Session with Richard Horton

Richard Horton, Editor-in-Chief of the Lancet gave a passionate delivery in his overview of issues affecting the health of children internationally.

Key Points:

  • Child health organisations need to think and act politically to promote child health
  • Progress in Global Child Health initiatives are fragile and non-linear
  • Independent Accountability Panels will ensure continuity of progress in the Every Woman, Every Child movement in delivering on its goals, as opposed to the changing “signature policies” of governments and policy makers

Cool links:

Cool quotes:

“What is essential is invisible to the eye”

EAPS 2014 Day 4 – Plenary Session – Inflammation

Medical science has amazing frontiers!

Prof Marco Gattorno delivered a brain exploding tour of “Inflammasome-opathies” and “Interferonopathies”. Paediatric rheumatologists well recognise Gattorno for his work with PRINTO and numerous other research enterprises, and this mixed audience seemed spellbound by the pace, diversity, and uniqueness of the pathologies he presented, which was essentially a brief (incomplete) review of the monogenic autoinflammatory disorders. Several new disorders have been named in the past few years, and another (SAVI) just in the past few months.

His talk covered seven clinical patterns of presentation, and briefly outlined exemplary cases:

Gattorno’s take on one aspect can be found in his article “The central role of blockade of IL-1 blockade in the treatment of monogenic and multifactorial autoinflammatory diseases”

I am just in the process of trying to make sense of his talk, and hope to post my summary shortly.

EAPS 2014 Day 4 – Gastroenterology Session

Prof Marc Benninga gave a very entertaining and somewhat irreverant review of the treatment of functional constipation. The messages were pretty much in accordance with our current practice in WA. The ESPGHAN guidelines (upon which his talk – but without the entertaining slides) are available here.
An intersting point I took away from his talk is that for acute disimpaction, you get just as much success with either enema, or with polyethylene glycol bowel washout – the only difference being that with enema disimpaction, there is immediate improvement in the faecal incontinence often associated with functional constipation.

There were a couple of presentations to follow his talk: One by Natasha Nasser from Sydney (it’s been a day for Australians – I’ve seen a couple of posters too) regarding a population linkage study demonstrating an association between prematurity, mode of delivery (CS), and breast feeding and risk for acute gastroenteritis. A study presented by Michelle Jansen from the Erasmus Medical Centre in Rotterdam showed that duration of breastfeeding, and timing of introduction of gluten, were not associated with a positive anti-TTG andtibody test at 6 years of age, suggesting duration of breastfeeding beyond 6 months of age was not protective against developing *subclinical* coeliac disease, and timing of introduction of gluten also makes no difference.

EAPS 2014 – Day 4 – Paediatric Education

Yesterday, Dr Livinia Da Dalt from Padua, described their model for inculcating global child health concepts in their paediatric training program by enabling selected trainees to work for 6 months in developing nations across Africa.

This made me reflect on the situation of mandatory regional/remote training in Australia – something I feel ambivalent about (the mandatoriness, not the actual benefits of regional/remote training). Comparison with European trainees having an option to train in Africa is not useful.

This was complemented by a talk by Dr Hazen Ham (VP of the American Board of Pediatrics Foundation) today, giving a brief summary of the history and current mission of the Global Pediatric Education Consortium (GPEC) www.globalpediatrics.org . GPEC has developed a 700+ page paediatric curriculum for people to adapt and use how they wish, and so far it seems several South American Countries, Japan, and perhaps some African nations have adopted this curriculum. It has also been used to successfully lobby government for resources to improve paediatric training in Brazil (lengthening their training program from 2y to 3y !). Our own Kevin Forsyth (former RACP Dean) is apparently assisting GPEC with developing the educational business model to extend the scope of GPEC’s works into providing educational resources online . This will be interesting to see in years to come. Funding for GPEC seems to come predominantly from the American Board of Paediatrics. The RACP is not an affiliate member of GPEC.

Prof Jonas Norquist, an educational specialist from the Karolinska Institute gave a talk entitled “How to Make a Good Specialist”. He had wonderful style, and was an engaging speaker, but his message was only pithy like this:
1. Have detailed learning objectives.
2. Provide as much formative feedback as possible.
3. Have physical space in which to give feedback

Prof Nordquist has physical spaces for education as a little hobby, I suspect. Interesting to note this idea echoed in other educational forums in Perth (AISWA “Briefing the Board” 2014). The Karolinska Institute has exchange programs

EAPS 2014 – Day 3 Afternoon Sessions – Wheeze

As a part of the ongoing and complicated process of trying to appreciate and give meaning to the various ways wheezing can develop across the life cycle, Louis Bont and team have published their research into the association between RSV and susceptibility to all cause wheeze. Giving palivizumab to all “late” (32-36 wk gestation) preterm infants resulted in prevention of 61% of all causes of wheeze in infants. In his talk indicated that his cohort of patients is 6y old and they are collecting parameters which he imagines will be published in another few years.
In his talk he acknowledged that there are likely to be a number of pathways multiple asthma phenotypes (or even “endotypes”). Fortunately, the discussion remained very contained, but in my mind I continue to struggle to properly organise the relationship between wheezing illnesses.

EAPS 2014 Day 3 – Plenary talk on Neuroembryology and Autism

Perhaps not an immediately clinically relevant talk, but the concepts may well ultimately provide meaning (and perhaps interventions) for families affected by autism.

Prof Jack Price of King’s College London described his collaboration with others in the exploratoration of how neuronal cells from children with autism (they make pluripotent stem cells from hair samples from affected children!), differ; morphologically, synaptically, and epigenetically from neuronal cells derived from healthy (neurotypical) controls. Amazing technology!
Although genetic abnormalities can be found in c20% of autistic children (the SHANK3 gene seems to be popular) , his laboratory has found that neuronal cells grown from affected children without a defined genetic mutation also show similar morphological changes to those of the autistic children with a known genetic defect. The implication is that autism might be a cell phenotype associated with the disease, which may have various underlying genetic or epigenetic (or other) causes.