Reid Rebinsky - Medicine
Validation of the Pediatric Appendicitis Risk Calculator (pARC) in a Pediatric Emergency Department Setting
Our project aimed to evaluate the performance of two clinical decision-making tools, the Pediatric Appendicitis Score (PAS) and pediatric Appendicitis Risk Calculator (pARC). These tools use symptoms and bloodwork results to help guide clinicians’ next steps in diagnostic workup. The goal of these tools is to identify patients which patients really do have appendicitis and avoid unnecessary testing in those who don’t. We reviewed charts from the McMaster University Medical Centre pediatric ED to calculate patients’ PAS and pARC scores and see how well these scores performed in ruling out appendicitis. We found that the pARC score may outperform PAS in the patient group we studied, but further research is still needed.
Michelle Schneeweiss - Medicine
A pilot quality improvement project implementing a nursing directive for children with suspected appendicitis
The appendix is an intestinal pouch that commonly gets plugged, infected and inflamed in children causing appendicitis. This is the most common reason for surgery in children. It is difficult to diagnose and requires urgent tests like blood work and ultrasound. Ordinarily, those tests could only be ordered by physicians who are often busy in the Emergency Department (ED). Our study changed that by allowing nurses to order those urgent tests, as to avoid any unnecessary delays. Our results show 20% reduction in time spent in the ED when nurses order blood work or ultrasound using an advanced medical directive.
Catherine Campbell - Medicine
A multi-disciplinary approach to perioperative care for children with medical complexity: Pre-operative care coordination team (POCCT)
A summary of the creation and current process of the POCCT team at McMaster Children's which has been successful at improving perioperative care for children with medical complexity
Nicole Wu - Health Sciences
Assessing Completeness of Pediatric Endoscopy Reporting
Endoscopy is an investigational tool that examines the digestive system. Endoscopy reporting standards help ensure quality assurance and continuous improvement through indicator attainment for report completeness. The study's purpose was to investigate whether endoscopy reports at McMaster University Medical Centre (MUMC) met the Canadian and American gastrointestinal reporting standards, and whether computer software-assisted endoscopy reporting was superior to dictation. Elective pediatric endoscopies at MUMC were evaluated for completeness, no report had reflected all suggested indicators. The comparison between software-assisted and dictated reports at MUMC and William Osler Health System showed no statistically significant differences in the standardized indicators, respectively.
Isabella Stefanova - Medicine
Variation in interpretation of 24-hr Ambulatory Blood Pressure Monitoring in children with confirmed or suspected hypertension by Canadian pediatric nephrologists and cardiologists
Pediatric kidney and heart doctors can use 24-hour blood pressure (BP) measurements instead of one-time BP measurements at clinic visits to more accurately reflect a child’s blood pressure. Interpretation of the 24-hour blood pressure measurements and choice of treatment based on these measurements can differ between different doctors. This study circulated a series of questions to pediatric heart and kidney doctors to investigate these differences. There was a substantial variation in how doctors interpreted the 24-hour blood pressure values, as well as in their choices of treatment.
Tara Sabzvari - Life Science
A Population-Based Study of Prevalence Trends and Geospatial Analysis of Hypospadias in Ontario Through the Use of the Prospective Hypospadias Database (REPAIR)
Over the years of media exposure, news and public-school education it has become evident for most individuals that the environment indeed affects human health. For centuries the health of a child rearing mother has also been important. However, now with the buzz around climate change, carbon footprint and pollution it appears that a fetus’s health is in far more danger than previously expected. Chemicals from agriculture, industrial activities and farming have an effect on the child development of hypospadias in the womb. Hypospadias although not life threatening in most cases, is on the rise due to these chemicals that the mother is exposed to.
Gelila Alemayheu - Masters of Global Health
Children with community-acquired pneumonia complicated by effusion from 2015-2019: a single-centre retrospective cohort study
A chart review of children who were hospitalized between Sept 2014-Sept 2019 with complicated community-acquired pneumonia (cCAP) at McMaster Children’s Hospital was conducted. Results showed cCAP was not rare, was associated with prolonged hospitalization, and commonly caused critical illness. Despite the use of molecular assays on pleural fluid samples, a causative microorganism was not identified in almost half the cases. The microbiology of cCAP does not appear to have evolved much in the past decade, with pneumococcus and S. pyogenes accounting for the vast majority of cases. Reducing drainage procedures may reduce overall length of stay at the hospital.
Ritika Arora - Masters of Public Health
Implementation of a pilot workshop to build Parental Resilience
Resilience is the ability to bounce back from adversity and can also be understood as coping with or persevering through setbacks. Resilience is a process rather than a personality trait, and can be mediated through several factors at the individual, familial and community level. Parental resilience examines how parents cope with stressful situations and build resilience in their children. A 2-day workshop titled “Tips & Tricks to Foster Resilience in Children: A guide for parents” delivered to parents of elementary school children found promising qualitative findings and acceptability. Effectiveness should be evaluated with a larger and varied sample of parents/caregivers.
Hana Murji & Simer Saini - Life Science
Depressive illness as a result of inflammation in the gastrointestinal tract, and psychobiotic treatment
Serotonin is important in regulating digestion, mood, and overall well-being. Proinflammatory molecules in the gut can inhibit the serotonin transporter pathway thereby reducing availability of serotonin, resulting in depression. 90% of serotonin is produced in the gastrointestinal tract, yet conventional treatment does not align with the modern understanding of the gut-brain relationship. This project is exploring a gap in new research that explores how the probiotic, L. plantarum IS-10506, can restore levels of serotonin. The study uses the COBWEB software to visualize the interaction between the biochemical variables in this complex system, and then observing the effects of psychobiotic treatment.