Baylor College of Medicine Department of Pediatrics College of Medicine Department of Pediatrics Baylor Baylor College of Medicine Department of Pediatrics 2016 Annual Report 2016 Annual Report 2016 bcm.edu texaschildrens.org © 2017 Baylor College of Medicine Department of Pediatrics and Texas Children’s Hospital. All rights reserved. TABLE OF CONTENTS Welcome Patient Care Changing the milieu of childhood adversity: Section blends approaches to prevent, intervene and heal . 6 Teamwork at its finest: Program focuses on rare lung diseases . 10 They can survive: Global initiative changes outcomes of cancer and blood disorders in Africa . 14 Wherever they are: Emergency Medicine leads programs for improving children’s outcomes . 18 Navigating complex systems: Palliative Care team helps families and children with serious illness . 24 Education Diversity enriches experience: Residents bring varied backgrounds to patient care . 30 Voices of Diversity: Meet the residents . 32 Research Quicker diagnosis for liver disease: Researchers uncover hope for biliary atresia patients . 38 The language of life: Neuroscientists chart paths toward viable therapies . 42 News of Note Baylor, Texas Children’s lead site for largest autism study ever . 47 Texas Children’s The Woodlands opens . 47 Collaborators develop immunotherapy for cancer treatment . 48 Vaccine unit studies people with Zika virus . 48 Teaching kitchen offers classes in Children’s Hospital of San Antonio . .48 Video game promotes eating fruit and vegetables . 49 Cancer patients make their mark . 49 Spotlight on the Department of Pediatrics By the Numbers 2016 . 51 Department of Pediatrics Leadership . 52 Welcome Welcome Dear Colleagues, The world today is as complex as it is massive . In medicine, the days of the “all-knowing” independent clinician, researcher or educator have passed . Many of the challenges we face as physicians, scientists and medical leaders are so large and so complex that they require the contributions of entire multidisciplinary teams .We need absolutely everyone . In the pursuit of excellence, diversity is a necessity . Today, our Department of Pediatrics is more inclusive and more diverse than ever before, closely resembling the wonderfully diverse city in which we live and work . We embrace and celebrate diversity in its broadest sense . In fact, it is our view that diversity will be one of the key drivers of our march to preeminence in pediatric medicine . No program or hospital can attract the greatest talent if its culture is exclusive or unwelcoming of segments of our community . In a very real sense, our Department of Pediatrics is itself a community .We all share a passion for improving the health and lives of children and families, but we bring to that passion diverse and complementary backgrounds, experiences and areas of focus . Each of us brings to each discussion our own unique perspectives, and the conversations are very rich . The children, families and broader community we serve all benefit. I’m thrilled that our department is not filled with people from identical backgrounds. Such a program could not possibly match the capabilities and potential of the amazingly diverse faculty and trainees you will see profiled in the pages of this annual report. I hope you find our story informative and inspiring. Sincerely, Mark W. Kline, MD Physician-in-Chief Texas Children’s Hospital J .S . Abercrombie Professor and Chairman Ralph D . Feigin Chair Department of Pediatrics Baylor College of Medicine The Department of Pediatrics is more diverse than ever before, closely resembling the diverse city in which we live and work. 2 Department of Pediatrics 2016 Annual Report Department of Pediatrics 2016 Annual Report 3 Patient Care Patient Care Section blends approaches to careers.Two factors influenced Department Chair Mark W . Kline, MD, Changing prevent, intervene and heal Giardino to become a board-certified thought that increasingly, the lines child abuse pediatrician . One was between the disciplines of pediatrics the Milieu of Imagine you are standing by a river, inspiration from the commitment and public health have blurred . Childhood seeing children float by. You pluck them of his residency’s leaders to abused out of the river to rescue them, but children. The other influence was “Medicine has focused on the individual Adversity you need to go upstream to find out more personal . patient, and public health focuses on how, why and where they’re falling into populations,” Kline said. “You’re only the water . doing half the job if you focus on the A report of child abuse is made every 10 seconds in the United patient to the exclusion of community Going upstream to find and correct States, and four children die as a and population health . Likewise, you’re the causes of problems is the model of result of abuse every day. only half of a public health practitioner public health . – U.S. Centers for Disease if you focus on populations and you Control and Prevention never consider the impact you’re “We have been spending all of our making on the individuals . time scooping kids out of the river, “At the end of my internship, I and now we’re developing a program, evaluated a healthy child at risk “It really came together when I was a strategy, to start going upstream,” for child abuse, and I made a recruiting Dr . Greeley to be chief of said Christopher Greeley, MD, MS, recommendation that he needed to our Child Abuse Pediatrics program . chief of the Section of Public Health be removed from his family to be kept His principal strength is understanding Pediatrics at Texas Children’s Hospital safe,” Giardino said .“The next year, I the milieu in which children are injured, and professor of pediatrics at Baylor learned that this beautiful little boy had the family dynamic that culminates in College of Medicine .“What are the been killed . I asked what had happened . violence, injury and abuse of children, reasons these kids are ending up at our Because of a paperwork glitch, he and understanding strategies to door? We will always take care of these was not removed from his family .This prevent that abuse from occurring . kids, but part of what our team does is incident seared in my mind that these to focus on things that place kids and systems to protect children have to be “As I was thinking about how broadly I families at risk ”. held accountable ”. wanted to define child abuse pediatrics in recruiting a chief, I thought this is The first public health section in a A report of child abuse is made every the perfect place to launch this public department of pediatrics in the United 10 seconds in the United States, and health pediatrics program,” Kline said . States grew out of the department’s four children die as a result of abuse And Greeley agreed . Child Abuse Pediatrics program, which or neglect every day, according to the was established in 1978 . Greeley, who U .S . Centers for Disease Control and Launched in October 2015, the Public is one of five board-certified child Prevention (CDC) . Health Pediatrics section has two abuse pediatricians in the section, is major domains . One is child abuse president-elect of the Ray E . Helfer More time on prevention pediatrics, and the other is the Center Society, the international society of As child abuse physicians, Giardino and for the Study of Childhood Adversity child abuse physicians . He served for Greeley kept seeing children after they and Resilience (CARE), which focuses four years as board chair of Prevent were harmed . It would be a great day on research to help prevent adverse Child Abuse America, with Texas if no one were hurt . And the only way childhood experiences such as Children’s Senior Vice President for that to happen would be for the poverty, violence, inequality and lack of Angelo P . Giardino, MD, PhD, serving health care team to spend more time adequate resources and care . as vice chair . on prevention, they agreed . Child abuse pediatrics Greeley and Giardino met while Meanwhile, at Texas Children’s The child abuse pediatrics program has Reading to young children is a good way to build close relationships while increasing the quantity and quality of language. The Section of Public Health Pediatrics uses this strategy to relieve parental stress and improve children’s outcomes. both were early in their pediatric and Baylor, Physician-In-Chief and four main components: Department of Pediatrics 2016 Annual Report 7 Patient Care Patient Care The Child Abuse Pediatrics program interdisciplinary team members provide training and awareness sessions for civic groups, church groups and YMCAs. • Postpartum depression: If mothers Children’s and The University of University of Kansas . Early education has are depressed or unable to care Texas System conducts research into been shown to have a long-term impact for their babies,that can affect the strategies that can be deployed in on the child’s success in life . babies’ lifelong trajectory .Workgroup pediatric offices to identify stressors, members develop collaborations with link parents with resources, and give “One of the biggest obstacles for us is pediatricians, primary care physicians families some evidence-based skills to our time horizon,” said Greeley .“We and others in the community who are help them cope with the stress . can’t show definitive results next year screening for postpartum depression or next legislative session .We’re not and linking families to services . Grants from the State of Texas and the trying to fix a specific problem. We’re LENA Research Foundation support trying to make the circumstances better . • Intimate partner violence: Historically work on one promising strategy to It took decades for these circumstances called domestic violence or violence relieve parental stress and improve to occur; it’s going to take decades for in the household, this problem may children’s outcomes .