Caroline Helwick

October 18, 2013

"If you can dream it, you can do it." These words by Walt Disney describe the spirit of the American Academy of Pediatrics (AAP), so it's fitting that the 2013 National Conference and Exhibition will be held in Orlando, Florida, October 26 to 29.

As the world's largest pediatrics-focused medical education event and technical exhibition, the AAP experience offers unparalleled opportunities to network with colleagues and hear from those at the forefront of pediatric care, said AAP president Thomas McInerny, MD.

"We begin on October 25 with our preconference PEDS21 symposium — Early Brain and Child Development: Building Brains, Forging Futures — which will cover how to translate new advances in basic developmental science into your practice. We'll continue over the next 4 days with a special track on early brain development and epigenetics, as well as nearly 60 other sessions covering the latest advances and best practices in pediatric care," he said.

Planning group chair Robert Cicco, MD, who is associate director of the neonatal intensive care unit at Western Pennsylvania Hospital in Pittsburgh, said he is looking forward to that symposium. "This session relates to the concept of the life course and the effect of toxic stress on children and families," he said.

"We know that children who experience violence, mental illness in the family, obesity, or other adverse experiences early in life are at risk of becoming adults with poor health, substance abuse, and so forth. We also know that early in life, the brain can be adversely affected by psychosocial events. The question is, what we can do to buffer those experiences, to allow the brain to develop normally and to potentially reduce risks down the road," Dr. Cicco told Medscape Medical News. This highlighted session delves into this important area.

Physicians need to shift from thinking of themselves as service providers to figuring out how we better partner with patients to improve outcomes.

One of 2 keynote speakers will tap into the Disney theme of excellence. Fred Lee's presentation is entitled Learning From Disney — Going From Good to Great in Patient Perceptions. Lee has been a cast member at Disney and a senior vice president of a major medical center. Using an insider's experience and a keen eye for cultural comparisons, he authored the best seller, If Disney Ran Your Hospital: 9 1/2 Things You Would Do Differently. Lee has expertise in helping hospitals achieve a culture that inspires patient and employee loyalty, and will share his insights with physicians at the meeting.

"Mr. Lee will be talking about how physicians need to shift from thinking of themselves as service providers to figuring out how we better partner with patients to improve outcomes," said Dr. Cicco.

This theme continues with a presentation by another physician-author, Atul Gawande, MD, whose keynote address is entitled The Century of the System.

Dr. Gawande is a surgeon, writer, public health researcher, and professor of surgery and of health policy and management at Harvard Medical School in Boston. He is also cofounder and chair of Lifebox, an international not-for-profit organization that implements systems and technologies to reduce surgical deaths globally.

"Dr. Gawande's talk will focus on how we as physicians can alter the way we deliver healthcare to be more focused on improving patient outcomes and reducing healthcare expenditures," Dr. Cicco said. This theme intersects with the Choosing Wisely campaign, through which AAP members are learning to practice value-based care.

Other plenary speakers will address genetic testing for diagnosis, celiac disease vs non-celiac gluten sensitivity, long-term follow-up care for pediatric cancer survivors, the impact of violence on children, adult outcomes of childhood attention deficit hyperactivity disorder (ADHD), early screening and diagnosis for autism spectrum disorders, the effect of endocrine disruptors on the developing male reproductive system, and the management of incidental findings from clinical genome sequencing.

This year, for the first time, attendees will be presented with both sides of the hottest issues in several point–counterpoint sessions. They will hear evidence related to each topic, listen to a debate, and then be asked to vote at the end of the session. Experts will debate the use of electrocardiogram screening prior to competitive sports, the possible association between pediatric autoimmune neuropsychiatric disorders and streptococcal infections, medication for ADHD in preschoolers, and the use of supplements during breastfeeding.

"I'm very excited about these sessions," Dr. Cicco said. "There's so much networking that's done outside of the CME sessions, with attendees discussing how to handle controversial things in practice, so we set these topics up as debates. We think these will be engaging for the audience and will stimulate much discussion."

A dozen or so subspecialty sessions will be held during the conference, with invited speakers, preferred papers, and posters. Sergio Golombek, MD, from New York Medical College, highlighted sessions that will be especially attractive in the area of perinatal medicine.

"We have several workshops that should attract attendees. One hands-on experience will address controversies about CPAP." Rangasamy Ramanathan, MD, from Los Angeles, who has a great deal of experience with noninvasive ventilation, will be putting this controversy into perspective, teaching physicians when and how to use continuous positive airway pressure and how to know when it may not be appropriate," Dr. Golombek said.

Malpractice Trial

A mock trial, which will have its first run at the conference, is expected to be entertaining and informative, Dr. Golombek said. The event will be a simulated trial with an actual judge and attorneys for both sides, plus pediatricians playing the parts of plaintiff and defense experts, witness, bailiff, and even a court reporter.

"This is a brilliant idea and we hope it will be fun for attendees," he said.

Daily sessions in perinatal medicine will focus on timely topics. Dr. Golombek will comoderate the Transfusion Medicine — State of the Art session, which will explore the risks and benefits of red blood cell transfusion in the neonatal intensive care unit and the possible association with necrotizing enterocolitis.

In other sessions, topics such as delayed cord clamping, the use of dialysis for renal injury, and the question of whether to treat transient hypothyroxinemia of prematurity will be very informative for attendees.

As the world grows smaller, global child health has become a rising concern. The meeting will face this head on with lectures and sessions, said Parminder Suchdev, MD, associate professor of pediatrics and global health at Emory University in Atlanta.

The Christopherson Lecture will be delivered by Zulfiqar Bhutta, PhD, who is Husein Laljee Dewraj professor and foundation chair of the division of women and child health at Aga Khan University in Karachi, Pakistan. His research interests include newborn and child survival, maternal and child undernutrition, and micronutrient deficiencies.

"Dr. Bhutta will talk about the priorities for global health beyond 2015," Dr. Suchdev said. Other sessions will focus on global heath in the postmillennium world. Attendees interested in global issues will appreciate hearing Indi Trehan, MD, discuss ways to overcome the effects of child malnutrition; Martin Cetron, MD, describe the impact of refugees in the United States; and Elizabeth Molyneux, MD, outline how physicians in Malawi use neonatal warmers and bubble CPAP from locally available materials.

Hot Topics

Even bioethical issues will be on the table. A workshop will address whether pediatricians working internationally "do more harm than good," Dr. Suchdev added.

Many other topics of interest will receive their due at the meeting. Controversies regarding autism spectrum disorder will take center stage at the session entitled Quirky Normal or Normally Quirky? Inattentive, Delayed, or Autistic: You Make the Diagnosis.

The session will begin with a discussion of how behaviors that would have been thought of as quirky in the past have evolved into characteristics that now define certain mental health diagnoses, helping pediatricians identify behaviors that are truly indicative of autism spectrum disorder or obsessive-compulsive disorder. Screening tools, resources for families, and treatment recommendations will be described.

Surgeons will appreciate the Appendicitis — New Approaches session and the Current Challenges in Pediatric Oncology session, and all attendees will relate to the ethical concerns raised in the Evolution of Pediatric Ethics Over the Past 40 Years sessions.

Dr. Cicco, Dr. Golombek, and Dr. Suchdev have disclosed no relevant financial relationships.


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