Inside Pediatrics Spring 2018

P E D I A T R I C S

Spring/Summer 2018

SURVIVAL OF THE LITTLEST Children’s, UAB lead the way in neonatal care and research

F rom our beginnings as Holy largest pediatric medical facilities in the U.S., Children’s of Alabama has a long and storied history. While our past is something to be celebrated, our future brims with extraordinary possibilities thanks to our skilled physicians and staff. Innocents Hospital for Children in 1911 to now being one of the

On the Cover: Patients in Children’s of Alabama’s Neonatal Intensive Care Unit represent a complex mix. “The focus of neonatal care at Children’s becomes more complex every year as smaller and smaller infants survive and care advances for more and more formally fatal illnesses,” said Carl “Tim” Coghill, M.D., UAB professor of pediatrics and medical director of Children’s NICU. See story on page 11.

controlled trials and clinical studies. Meanwhile, our Division of Pediatric Neurology is growing to accommodate its nationally renowned Comprehensive Behavioral Intervention for Tics program and developing specialty clinics. And last but not least, our Pediatric and Infancy Center for Acute Nephrology through its Nephrotoxic Injury Negated by Just-in- Time Action (NINJA) initiative has become

Children’s is at the forefront of a new approach to behavioral health care. Our new Psychiatric Intake Response Center (PIRC), which opened in March 2018, connects communities to mental health care services and resources for children and adolescents.

the first new program added to the Solutions for Patient Safety consortium. Inspired by our past, our present advancements are building blocks for the future of pediatric health care in Alabama and around the globe, but one thing will never change — our commitment to providing excellent patient care

One of three centers of its kind nationwide, the PIRC is a response to growing community needs and to the rise of pediatric psychiatric visits to emergency rooms. In our partnership with the University of Alabama at Birmingham (UAB) Department of Pediatrics, we continue to break new ground in clinical care and research. Our Division of Neonatology is a top center in developing and analyzing

and educating communities on issues affecting children’s health and well-being. Staying true to our mission, Children’s is an advocate for all children at all levels of care. Enjoy ,

Children’s of Alabama 1600 7th Avenue South Birmingham, Alabama 35233

(205) 638-9100 childrensal.org

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Navigating Mental Health Care

ADMINISTRATION Mike Warren, President and CEO Coke Matthews, Executive Vice President Garland Stansell, Chief Communications Officer EDITORIAL Cassandra Mickens, Editor Trent Graves, Design

Baby NINJA Combats Acute Kidney Injury

Joined at the Hip

Amy Dabbs, Digital Content Denise McGill, Photography CONTRIBUTORS

Andre Green Adam Kelley John Tracy Tina Wilson

Mary Stephens Pugh Rhonda Lee Lother PHYSICIAN MARKETING Tiffany Kaczorowski MEDICAL LEADERSHIP Mitchell Cohen, M.D. Katherine Reynolds Ireland Chair of Pediatrics, University of Alabama at Birmingham Physician-in-Chief, Children’s of Alabama Mike Chen, M.D. Joseph M. Farley Chair in Pediatric Surgery, University of Alabama at Birmingham Chief of Pediatric Surgery and Surgeon-in-Chief, Children’s of Alabama Lee I. Ascherman, M.D., M.P.H. Chief of Service, Child and Adolescent Psychiatry, University of Alabama at Birmingham For questions or additional information or to share feedback, please contact us at insidepediatrics@childrensal.org. An online version of the magazine is available at childrensal.org/insidepediatrics.

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Neurology Division Expands Services

News, Honors and Awards

CONT E N T

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NAVIGATING MENTAL HEALTH CARE The process of seeking mental health care is a daunting task for many, but the new Psychiatric Intake Response Center at Children’s of Alabama is working to connect communities with the best services available.

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A new service at Children’s of families and providers better navigate the mental health care system. Children’s and the Anne B. LaRussa Foundation of Hope have established the Psychiatric Intake Response Center (PIRC). The PIRC is located in Children’s Emergency Department and opened in March 2018. Licensed mental health clinicians, via telephone or in person, assess a child or teen’s mental, emotional and behavioral needs, and recommend the best treatment options. Anyone with a mental health question or concern regarding a child or adolescent is encouraged to contact the PIRC at 205-638-PIRC (7472). The PIRC is open seven days a week, year-round from 8 a.m. to 11 p.m. Via telephone, clinicians can match patients and their families with mental health services and providers in a five-county area (Jefferson, Shelby, St. Clair, Blount and Walker), assess risk factors, answer questions about mental health issues and provide community resource information and safety planning for future crises. “The PIRC is only one of three in the country — the others being in Cincinnati and Akron, Ohio. It’s a tremendous opportunity for Children’s of Alabama to offer an innovative and much-needed mental health service to those in the community,” said PIRC Director Cindy Jones, who, with Children’s Behavioral Health Administrative Director Stacy White, spent a year and a half planning the service. Dr. Tobias Martinez serves as the PIRC medical director. “We provide access to a mental health professional who will guide and support them along the way. The response from the community, including Alabama Department of Mental Health Commissioner Lynn Beshear, has been extremely supportive,” Jones said. Alabama, one of three of its kind in the U.S., aims to help patients,

Members of the Children’s of Alabama Psychiatric Intake Response (PIRC) team include, from left: Kaitlin McAnnally, R.N.; Cindy Jones, director; Shannon Messina, mental health therapist; Tobias Martinez, M.D., medical director; and mental health therapists Matt Foster and Susan Bennett-Smith.

Added Martinez, “There is a nationwide trend of increased volume of pediatric psychiatric visits to emergency rooms. Our program’s mission is to help guide patients and their families to the most appropriate level of care.” For high-risk children and teens who may need services in Children’s Emergency Department, the PIRC will provide crisis evaluations on a first- come, first-served basis, considering treatment room availability and urgency. Patients will be assessed by a mental health team of board-certified child and adolescent psychiatrists, fellows, nurse practitioners, registered nurses and PIRC staff to determine the appropriate level of care. The PIRC does not provide over-the-phone diagnoses or 37,176

psychiatric evaluations, over-the-phone scheduling or rescheduling of outpatient appointments, home visits, transportation or prescriptions or refills. Clinicians emphasize the PIRC is not a suicide hotline, but instead a valuable resource for parents, teachers, counselors, grandparents, foster parents or anyone who is seeking mental health services on a child’s behalf. Anyone experiencing a crisis should call 911 or go to the nearest emergency room. Anyone experiencing suicidal thoughts should call the 24-hour, seven-day-a-week National Suicide Prevention Lifeline number at 1-800-273-TALK (8255). For more information, visit childrensal.org/psychiatric-intake- response-center .

136 calls to the PIRC in March and April

children and adolescents in Alabama served by community mental heatlh

centers in FY2017 Source: Alabama Dept. of Mental Health

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STUDY FINDS CAFFEINE REDUCES ACUTE KIDNEY INJURY IN NEONATES

David Askenazi, M.D., is director of the Pediatric and Infancy Center for Acute Nephrology (PICAN) at Children’s of Alabama and a UAB professor of pediatrics. (Courtesy UAB News) Preterm neonates who are exposed to caffeine within the first seven days after birth have reduced incidence and severity of acute kidney injuries than neonates who did not, according to findings from the Neonatal Kidney Collaborative’s Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates study, published in JAMA Pediatrics. David Askenazi, M.D., professor in the University of Alabama at Birmingham’s Department of Pediatrics and director of the UAB and Children’s of Alabama’s Pediatric and Infant Center for Acute Nephrology, was the study’s co-author, and is the chair of the Neonatal Kidney Collaborative. “We have found that neonatal acute kidney injury occurs in one of every four preterm neonates and has an association with increased hospital stays, medical expenditures, morbidity and mortality,” Askenazi said. “This research provides hope that interventions — in this case, caffeine administration — can help neonates with who are at an increased risk of acute kidney injury.” The multicenter, cohort study evaluated 675 preterm neonates born at less than 33 weeks’ gestation and found that 11.2 percent of neonates who received caffeine developed acute kidney injury versus 31.6 percent of those who did not get caffeine. In neonatal intensive care units across the country, neonates are given caffeine to stimulate them and allow their underdeveloped lungs and brains to continue to breathe; caffeine has been used for years to prevent episodes of apnea intermittent hypoxia and need for intubation. This study suggests caffeine may also help the kidneys. “The study’s findings certainly have potential to change clinical treatment and timing of caffeine provision, which may ultimately reduce the morbidity and mortality associated with neonatal kidney development and disease,” Askenazi said.

BABYNINJA FIGHTS BACK In the battle against acute kidney injury, Baby NINJA proves to be victorious. Children’s of Alabama is the first pediatric hospital in the nation to implement Nephrotoxic Injury Negated by Just-in-Time Action in its Neonatal Intensive Care Unit to prevent AKI in neonates.

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Christine Stoops, D.O., MPH, a UAB pediatric neonatology fellow, is a co-investigator of Baby NINJA, a project exclusive to Children’s of Alabama that has nearly eliminated medication associated acute kidney injury in the most vulnerable premature infants.

premature infants. In March 2018, Baby NINJA won the Best Abstract Award at the 23rd International Conference on Advances in Critical Care Nephrology in San Diego, California. “What’s exciting about Baby NINJA is the simplicity of the approach,” said Christine Stoops, D.O., MPH, UAB pediatric neonatology fellow and Baby NINJA co-investigator. “It’s looking at all infants exposed to nephrotoxic medications for potential kidney injury with a daily lab level (serum creatinine), and paying careful attention to whether a baby still needs these medications or can benefit from a lower daily dose.” “With that easy shift in our mindset, we have shown greater than an 80 percent reduction in kidney injury in high-risk patients,” Stoops said. “This has the potential to reduce chronic kidney disease in these already at-risk infants.” In addition, PICAN has one of the most successful Continuous Renal Replacement Therapy (CRRT) programs to support critically ill patients who have lost kidney function. For example, PICAN in 2014 studied a new dialysis device called Aquadex FlexFlow™ and adapted the device to treat neonates and premature infants with kidney failure who are too small for hemodialysis. As a result, children as small as 1 kilogram can now receive this lifesaving therapy. Children’s is the first pediatric hospital in

T he Pediatric and Infancy Center for Acute Nephrology (PICAN) at Children’s of Alabama, in partnership with the University of Alabama at Birmingham (UAB) Department of Pediatrics, has served children in Alabama and across the world since its 2013 inception. PICAN’s three-pronged model provides the best available comprehensive multidisciplinary clinical care, education, and research for children with acute kidney injury (AKI) and neonates with kidney disease. “We believe that if we provide the best care, make important discoveries and educate our staff and those beyond our institution, we can make a huge impact in this field,” said David Askenazi, M.D., PICAN director and UAB professor of pediatrics. As a part of its efforts, PICAN implemented Nephrotoxic Injury Negated by Just-in-Time Action (NINJA), a collaboration between Children’s and Cincinnati Children’s Hospital Medical Center. Via NINJA, hospitalized

patients receiving medications that can cause kidney injury are automatically identified by using the electronic medical record system and scheduled for dose adjustments and increased renal function surveillance. The rate of acute renal injury in inpatients has been decreased by more than 60 percent, resulting in substantially decreased morbidity across

the hospital and reduced hospitalization duration. The NINJA program is so successful that this year it became the first new program added to the Solutions For Patient Safety consortium and instituted at 147 children’s

What’s exciting about Baby NINJA is the simplicity of the approach.

hospitals worldwide. A recent application of NINJA in Children’s

Neonatal Intensive Care Unit (NICU) referred to as Baby NINJA, a project exclusive to Children’s, has nearly eliminated medication associated acute kidney injury in the most vulnerable

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the country to successfully adapt Aquadex for use on infants, and the device is now being used at other major children’s hospitals, including Cincinnati Children’s, Boston Children’s Hospital and Seattle Children’s Hospital. “We do more dialysis in newborns than other hospitals in the world,” Askenazi said. “We have cared for 70 babies with CRRT and have great success in initiating the machine without cardiovascular compromise, which was a problem before using Aquadex. Our survival rate in babies has increased from 30 percent to 55 percent over the last few years.” PICAN is also the driving force behind the international Neonatal Kidney Collaborative (NKC). Under the direction of Askenazi, this network of neonatologists, pediatric nephrologists, epidemiologists and statisticians from the U.S., as well as India, Canada, and Australia, are committed better understanding AKI in neonates.

The inaugural project of NKC is the Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) study. The 24-center study captured data from over 2,000 neonates admitted to the NICU who were on intravenous fluids for at least 48 hours. “We have learned a tremendous amount from the AWAKEN database. We can now show that AKI is very common in select groups of patients. Those patients with AKI were four times more likely to die, even after controlling other factors that are associated with neonatal death,” Askenazi said. “We have recently reported that caffeine can be a protective agent against AKI, and we have 12 other manuscripts in preparation as well. Our plans are to submit a [National Institutes of Health] grant to continue our research and answer more questions on this topic in the future.” For more information, visit childrensal.org/nephrology .

The PICAN team at Children’s of Alabama, standing from left: Traci Henderson, RPh; Suzanne White, RN; Gwen Powers, RN; Krysta Smith; Lynn Dill, RN; Suzanne Gurosky, RN; Louis Boohaker, MPH; Susan Keeling, RN; Daryl Ingram, RN; Paige Perry, RN; Kara Short, MSN, CRNP and Wendy Shirley, RN. Seated, from left: Tennille Webb, MD; David Askenazi, M.D.; Michael Seifert, M.D. and Brian Halloran, MS.

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Inside Pediatrics Podcast

Inside Pediatrics is a free podcast series featuring specialists at Children’s of Alabama and University of Alabama at Birmingham (UAB). Episodes cover topics related to child health and wellness, research and treatment, and complement articles appearing in Inside Pediatrics magazine. To tune in, visit childrensal.org/podcast or listen via iTunes (search Children’s of Alabama under podcasts), iHeartRadio (search Children’s of Alabama), Player FM, Stitcher, TuneIn or Google Play.

Childrens AL .org/ podcast

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JOINED AT THE HIP

To the naked eye, they’re just sky bridges, but to Children’s of Alabama and University of Alabama at Birmingham neonatologists and researchers, the pathways impact advancements in clinical care, education and research worldwide.

T he sky bridges connecting the University of Alabama at Birmingham (UAB) Women & Infants Center and Children’s of Alabama provide more than a means of travel from point A to B. For the UAB/ Children’s Division of Neonatology, the sky bridges not only facilitate seamless clinical care but also seamless research collaborations. “It’s a tremendous benefit,” said Trent Tipple, M.D., UAB associate professor of pediatrics, director of neonatology faculty development and co-director of the Neonatal-Perinatal Medicine Fellowship Training Program. “The integration is one that just makes sense. It eliminates a lot of barriers that can make research frustrating and allows one to focus on designing the best study with the necessary personnel;

to really think about how to execute a study rather than whether a study can be done.” “It’s one of the unique features here. UAB’s Regional Neonatal Intensive Care Unit and Children’s NICU are literally joined at the hip,” said Namasivayam Ambalavanan, M.D., UAB professor of pediatrics, neonatology division co-director, director of the Translational Research in Normal & Disordered Development (TReNDD) Program at UAB and principal investigator of the UAB Research Center. “This makes clinical care a lot better, and research also improves.” Carl “Tim” Coghill, M.D., UAB professor of pediatrics and medical director of Children’s NICU, said the physical proximity not only serves as a benefit

to clinicians and researchers but also patient families facing what can be a stressful experience. “Many freestanding children’s hospitals are blocks away from their associated delivery units, making it difficult for consultants to see the infants without transfer away from the mother,” Coghill said. “Children’s of Alabama used to be two blocks from UAB with no connecting bridge. With the present bridge, the closest NICU bed at UAB is only 75 feet from the nearest NICU bed at Children’s, which is closer than some beds are to each other in other respective units.” Coghill continued, “The ability to stay with a nursing staff that you know and a hospital that you are familiar with while continuing to get the best care

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is a confidence builder, and delivering great care is only good enough if it is perceived to be great care by the patients and families as well.” As a founding member of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN), part of the National Institutes of Health (NIH), UAB/Children’s is consistently one of the top centers in developing, leading, enrolling and analyzing randomized controlled trials and clinical studies. For example, neonatology division members have led three major innovative NRN studies — the SAVE Factorial Trial, the Cytokine Study and the SUPPORT Factorial Trial. A fourth trial led by UAB/Children’s neonatologists testing the effects of

caffeine late in the neonatal course and at home to shorten hospitalization and decrease apparent life-threatening events began enrollment this year. In its more than 30 years of existence, the NRN has defined the standards of multi-institutional collaborative research resulting in increased survival and decreased morbidity rates of extremely low birth weight infants and other critically ill infants in the U.S. Wally Carlo, M.D., Edwin M. Dixon Endowed Chair in Neonatology and neonatology division co-director, and Ambalavanan are principal investigators for the NRN and have led nationwide studies on ventilator care, antenatal steroids, chronic lung disease and neurodevelopment outcomes. A study in the NRN published in the

New England Journal of Medicine reported that neonatal mortality has been decreased over the last 10 years, including decreases in almost all specific causes of neonatal mortality, because of improvements in care implemented in the NRN centers. In addition, UAB/Children’s is the only facility in the U.S. to be awarded grants in all three perinatal networks from the NICHD — the NRN, the Maternal-Fetal Medicine Units Network and the Global Network for Women’s and Children’s Health Research. For more than two decades, these networks have awarded UAB/Children’s more than $20 million to fund research for pregnant women and babies. The most recent grants, awarded in 2016, will bring a total $1.1 million per year through 2021.

Both the UAB RNICU and Children’s of Alabama NICU encourage skin-to-skin care. It’s considered best practice for babies to go skin-to-skin with their mothers after birth because it helps stabilize the baby’s heart rate, glucose level, respiration and temperature.

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Under the Global Network, UAB/ Children’s researchers have led

seminal investigations of resuscitation and essential newborn care in 100 communities in six countries, which included almost 200,000 infants. These trials established the effectiveness of these interventions in reducing stillbirths and neonatal mortality, and led to worldwide implementation of training, including the globally implemented Helping Babies Breathe Program and the Essential Care for Every Baby Program launched in 2014. The programs have been introduced in more than 75 countries to save babies’ lives at birth, with the potential to reduce infant deaths soon after birth by 1 million. “It should save a million lives every single year at almost no cost,” Carlo said of the programs. “It will save the most lives in the world.” Quality Improvement Advances Patients in the Children’s NICU represent a complex patient mix. Children’s NICU is Alabama’s only extracorporeal membrane oxygenation (ECMO) provider and a designated Platinum Level Center of Excellence by the Extracorporeal Life Support Organization (ELSO). Children’s NICU is also the primary provider in the state for dialysis, tracheostomy, neurosurgical support, craniofacial surgery and jaw distractions, and a major contributor to the Home Ventilator Program. Coghill said the unit participates in multiple research and quality improvement projects through the Children’s Hospital National Consortium (CHNC) and Solutions for Patient Safety (SPS). In 2017, the unit experienced a 40 percent reduction in central line associated blood stream infections (CLABSIs) using care bundles. Allison Black, M.D., UAB assistant professor of pediatrics and associate medical director of Children’s NICU, leads

Namasivayam Ambalavanan, M.D., left, and Wally Carlo, M.D., Edwin M. Dixon Endowed Chair in Neonatology are co-directors of the UAB Division of Neonatology at Children’s of Alabama.

100 percent, and the number of infants returning from the operating room with temperature instability has decreased from 28 percent to 4 percent. “The focus of neonatal care at Children’s becomes more complex every year as smaller and smaller infants survive and care advances for more and more formally fatal illnesses,” Coghill said. “Optimization of care will require more involvement of families, and the NICU has followed the hospital’s lead in moving to family-centered rounds to get input from those who spend the

another major project through the CHNC — the Safe Transitions and Euthermia in the Perioperative Period in Infants and Neonates, or STEPP-IN. “This project promotes smooth transitions and improved communication by utilizing a specific work flow for surgical patients that includes face-to-face handoff between the surgical, anesthesia and NICU team members both pre-and post-surgery. Through this project we have improved stability and care during the critical perioperative period in some of our sickest patients,” Black said. Since Children’s initiated STEPP-IN in the summer of 2017, the percentage of patients having formal face-to- face communication between care providers has increased from 60 to

most time with the patient.” For more information, visit childrensal.org/neonatology .

The Regional Neonatal Intensive Care Unit at UAB Women & Infants Center, together with Children’s of Alabama, offers the only Level IV NICU in Alabama — which, according to American Academy of Pediatrics guidelines, provides the highest andmost comprehensive level of care available. Combined Level IV NICU beds at UAB and Children’s total as many as 175.

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GROWING UP FAST

As pediatric medicine becomes more specialized, the demand for specialists grows. The University of Alabama at Birmingham Division of Pediatric Neurology at Children’s of Alabama knows this fact all too well.

M edical advancements through specialized programs and essential personnel are vital to the continued growth of the University of Alabama at Birmingham (UAB) Division of Pediatric Neurology at Children’s of Alabama. Expansion is underway while the unremitting needs of patients are met. The neurology division is increasing its staff to accommodate its innovative Comprehensive Behavioral Intervention for Tics (CBIT) program, which has gained national recognition. CBIT, a non-drug treatment, emphasizes tic strategies or “competing responses” for the treatment of Tourette syndrome and tic disorders. Patients learn to better manage their condition and reduce the negative impact of tics on their lives. “A number of guidelines are beginning to suggest that this process should be the first therapy for people with tic disorders instead of medication,” said Leon S. Dure, M.D., William Bew White Jr. Chair in Pediatric Neurology and pediatric neurology division director. “The program has been very successful and has also benefited people who do not have good mental health coverage. We have treated close to 200 children over the past few years, and we almost never have to use medication to manage their tics.”

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The CBIT program at Children’s, the first of its kind in the South, is led by occupational therapist Jan Rowe, Dr. OT, OTR/L, FAOTA. Rowe is nationally recognized for her work and travels the country training fellow occupational therapists interested in administering a similar procedure. In addition to expanding clinics for neuroimmunology, movement disorders, seizures and headaches, UAB/Children’s has added a great number of general neurology and specialized neurology clinics, including a specialized pediatric neurogenetics clinic under the direction of Amitha Ananth, M.D., UAB assistant professor. “Since genetics has become such a large part of neurology, it’s great to have someone so knowledgeable as Dr. Ananth to lead our team to educate families about their conditions, outcomes and novel treatments.” Dure said. Children’s is also part of a recently concluded National Institutes of Health (NIH) study of children living in the South diagnosed with Niemann-Pick disease type C, a rare neurodegenerative condition. Participants received the alternative drug cyclodextrin as part the study. Before Children’s stepped in to help administer medication, participants had to travel every two weeks for a two-to three-day period to NIH headquarters in Bethesda, Maryland. Now, participants only travel one day.

A number of guidelines are

beginning to suggest that [CBIT] should be the first therapy for people with tic disorders instead of medication.

Leon S. Dure, M.D., William Bew White Jr. Chair in Pediatric Neurology and director of the UAB Division of Pediatric Neurology at Children’s of Alabama, checks in with patient McKenna Phillips of Hunstville, Alabama, during a clinic visit.

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POWELL NAMED CHAIR OF NEUROBIOLOGY

Craig Powell, M.D., Ph.D., has been named chair of the Department of Neurobiology at the University of Alabama at Birmingham (UAB) School of Medicine and director of the Civitan International Research Center. Powell is a national leader in research pertaining to molecular mechanisms of learning and memory, synaptic plasticity and neuropsychiatric disorders such as autism, intellectual disability and Alzheimer’s disease. Powell comes to UAB from the University of Texas Southwestern Medical Center’s Department of Neurology and Neurotherapeutics, where he is the Ed and Sue Rose Distinguished Professor in Neurology, as well as director of Preclinical Research in Neurology and chief of Developmental Brain Disorders Section in Neurology. “With my laboratory’s longstanding focus on autism, intellectual disability and cognitive dysfunction in general, the additional opportunity to lead the UAB Civitan International Research Center is a great honor,” Powell said. “As a physician and a scientist, I am uniquely poised to leverage the existing clinical research strengths at UAB and Children’s of Alabama to move our neurobiology discoveries from the laboratory to help patients and their families.” Craig Powell, M.D., Ph.D., is the new chair of the Department of Neurobiology at the UAB School of Medicine. (Courtesy UAB News)

“When the initial study was complete, the pharmaceutical company offered a long-term extension so these patients could continue their treatment until the [U.S. Food and Drug Administration] approves the medication,” Dure said. “We administer the drug to these children in outpatient surgery through a spinal tap. It’s not easy to find a facility willing to do this and manage these children, but we were happy to take this program on and help make this process a lot easier for them.” Will Brumbeloe of Boaz, Alabama, whose 6-year-old daughter Kamryn is part of the study, says, “Children’s makes it simple, fast and really easy. Everybody we have come across has been great – the nurses, the doctors, the entire team. It has been a huge relief for us. It has provided a center for everybody to come together for one goal. Children’s is not just a Birmingham hospital. It’s an outreach hospital to me personally.” For more information, visit childrensal.org/neurology . Children’s of Alabama occupational therapist Jan Rowe, Dr., OT, OTR/L, FAOTA, who heads the Comprehensive Behavioral Intervention for Tics (CBIT) program, leads Brock Senel of Instanbul, Turkey, in an exercise to control his Tourette syndrome without medication.

Occupational Therapist Jan Rowe, Dr. OT, OTR/L, FAOTA, discusses the Comprehensive Behavioral Intervention for Tics (CBIT) program on Children’s of Alabama’s Inside Pediatrics Podcast. To listen, visit childrensal.org/podcast , or listen via iTunes (search Children’s of Alabama under podcasts), iHeartRadio (search Children’s of Alabama), Stitcher or Google Play.

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News, Honors and Awards

FARGUSON NAMED DIRECTOR OF NEURODEVELOPMENTAL INITIATIVES Crayton “Tony” Farguson, M.D. , has been named Director of Neurodevelopmental Initiatives, a key coordinating role between the UAB School of Medicine, the UAB Department of Pediatrics and Children’s of Alabama. Fargason will work to integrate activities with UAB’s well-established entities such as the Department of Genetics, the Institute for Precision Medicine and Southern Research, as well as with partner HudsonAlpha. Fargason will continue to serve as the Medical Director and Vice President of Clinical Affairs at Children’s, as he has for nearly 20 years, and will continue his work as a Professor in the UAB Department of Pediatrics. TOFIL ELECTED TO MEMBERSHIP IN SOCIETY FOR PEDIATRIC RESEARCH Nancy Tofil, M.D., MEd , Pediatric Critical Care, has been elected to membership in the Society for Pediatric Research (SPR). The goal of SPR is to create a network of multidisciplinary researchers to improve child health. SIMPSON ELECTED TO AMERICAN PEDIATRIC SOCIETY Tina Simpson, M.D., M.P.H., Adolescent Medicine, has been elected to the American Pediatric Society. The American Pediatric Society is dedicated to the advancement of child health through promotion of pediatric research, recognition of achievement and cultivation of excellence in pediatrics through advocacy, scholarship, education and leadership development. TIPPLE TO JOIN AMERICAN JOURNAL OF PHYSIOLOGY EDITORIAL BOARD Trent Tipple, M.D. , Neonatology, has been invited to join the editorial board of the American Journal of Physiology — Lung Cellular and Molecular Physiology, for a three-year appointment. The editorial board is a critically important element of the journal, serving as the primary source of reviewers of submitted manuscripts. It ensures the veracity of the reports that they publish and serves multiple important functions to support the workings and reputation of the journal. BENTON TO RECEIVE PAUL V. MILES FELLOWSHIP AWARD The American Board of Pediatrics has selected Cason Benton, M.D. , Academic General Pediatrics, to receive the 2018 Paul V. Miles (PVM) Fellowship Award. The award is given annually to an accomplished mid-career pediatrician dedicated to improving the quality of health care for children. WALLEY APPOINTED DIRECTOR OF UAB TOBACCO CONSULT SERVICE Susan Walley, M.D. , Pediatric Hospital Medicine, has accepted the role of Director of the UAB Tobacco Consult Service. Walley assumed her role February 1 and the funding, which will support 10 percent of her time, will come from Dr. Mark Dransfield of UAB Lung Health Center. The UAB Tobacco Consult service provides free assistance to patients who want to quit smoking. WALLEY RECEIVES OUTSTANDING WOMAN UAB FACULTY MEMBER AWARD Susan Walley, M.D. , Pediatric Hospital Medicine, was selected to receive the Becky Trigg Outstanding Woman UAB Faculty Member Award. The award is given out by the UAB Commission on the Status of Women to honor women in the UAB and Birmingham community who have mentored and served other women, taken a courageous stance or overcome adversity to achieve a goal.

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WALL AND TOFIL NAMED TO ENDOWED CHAIRS IN PEDIATRICS Terry Wall, M.D. , Academic General Pediatrics, was named the John W. Benton Endowed Chair in Pediatrics, and Nancy Tofil, M.D. , Pediatric Critical Care, was named the Ann Dial McMillan Endowed Chair in Critical Care Medicine.

CARLO ELECTED TO ASSOCIATION OF AMERICAN PHYSICIANS Waldemar “Wally” Carlo, M.D. , Neonatology, was elected to the Association of American Physicians.The Association of American Physicians is a professional organization founded in 1885 by seven physicians, including Drs. William Osler and William Henry Welch, for “the advancement of scientific and practical medicine.” The Association is composed of members who are leading senior physician scientists and are competitively selected. RAMANI WINS SSPR YOUNG FACULTY AWARD Manimaran Ramani, M.D. , Neonatology, was selected as a winner of the 2018 SSPR Young Faculty Award. The award program was established to honor and support travel of junior faculty. MONROE RECEIVES SSPR FOUNDER’S AWARD Kathy Monroe, M.D. , Pediatric Emergency Medicine, received the 2018 Southern Society for Pediatric Research (SSPR) Founder’s Award. The award is given to a member of SSPR who has made significant contributions to health care of children and SSPR. BHATIA NAMED TO NASEM CANCER CONTROL STUDY COMMITTEE Smita Bhatia, M.D. , Pediatric Hematology/Oncology, has been named to the National Academies of Sciences, Engineering and Medicine ad hoc Committee on National Strategy for Cancer Control in the United States. JESTER TO SERVE AS CO-CHAIR OF PEDIATRIC AFFAIRS COMMITTEE Traci Jester, M.D., R.D. , Pediatric Gastroenterology, Hepatology and Nutrition, will join the National Scientific Advisory Committee Cabinet of the Crohn’s and Colitis Foundation to serve as Co-Chair of the Pediatric Affairs Committee. This is a three-year term from June 2018 to May 2021. Dr. Jester has served on the Pediatric Affairs Committee since June 2015. BEIERLE WINS UAB GRADUATE DEAN’S EXCELLENCE AWARD Elizabeth Beierle, M.D. , Pediatric Surgery, was one of 10 graduate faculty honored with the UAB Graduate Dean’s Excellence in Mentorship Award. The award is given for exceptional work with graduate students and postdoctoral fellows. When asked about what she has learned as a mentor, Dr. Beierle said, “The most important thing I’ve learned through mentoring graduate students is that this next generation of scientists is absolutely amazing. These young investigators are going to make scientific advances that my generation and I only imagined in our wildest dreams.”

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CRON APPOINTED TO ABP RHEUMATOLOGY CONTENT DEVELOPMENT TEAM Randy Cron, M.D., Ph.D. , Pediatric Rheumatology, has been appointed as a member of the Rheumatology Content Development Team for the American Board of Pediatrics (ABP). CRON ACCEPTS ASSOCIATE EDITORSHIP Randy Cron, M.D., Ph.D. , Pediatric Rheumatology, accepted the Associate Editor position of the Editorial Board of Autoimmune and Autoinflammatory Disorders, a specialty of Frontiers in Immunology — a leading journal in its field publishing rigorously peer-reviewed research across basic, translational and clinical immunology. Dr. Cron will play an integral part in the collaborative Frontiers review process, handling manuscripts submitted to Autoimmune and Autoinflammatory Disorders and ensuring their fair, rigorous and transparent review. SAMUY APPOINTED AS SCIENTIST IN UAB INFORMATICS INSTITUTE Nichole Samuy, M.D. , Pediatric Hospital Medicine, has been appointed as a Scientist in the UAB Informatics Institute. Activities may include, but are not limited to, collaboration on relevant research, teaching or directing an informatics course, mentoring informatics trainees and advancing the service mission of the institute. PRUITT JOINS PEM COLLABORATIVE RESEARCH COMMITTEE Christopher Pruitt, M.D. , Pediatric Emergency Medicine, has joined the Pediatric Emergency Medicine Collaborative Research Committee (PEM CRC) Steering Committee. He has been an active member of PEM CRC and served as site investigator for prior PEM CRC studies. The Steering Committee consists of 10 established investigators in various subfields of PEM. The committee reviews network proposals, oversees the survey competition and serves to mentor junior investigators. KIMBERLIN TO SERVE ON FDA MEDICAL DEVICES ADVISORY COMMITTEE PANEL David Kimberlin, M.D. , Pediatric Infectious Disease, serves as a member on the Microbiology Devices Panel of the Medical Devices Advisory Committee of the Food and Drug Administration (FDA) for a term that began on Sept. 29, 2017 and ends Feb. 28, 2021.The Microbiology Panel reviews and evaluates data concerning the safety and effectiveness of marketed and investigational in vitro devices for use in clinical laboratory medicine including microbiology, virology and infectious disease, and makes appropriate recommendations to the FDA Commissioner. DOWNLOAD THE 2017 UAB DEPARTMENT OF PEDIATRICS ACADEMIC ANNUAL REPORT In fiscal year 2017, the UAB Department of Pediatrics faculty had 243 publications, research funding from the National Institutes of Health totaling $15 million and total research funding of $29 million. In addition, the department recruited 29 new faculty members, including nine who are expected to develop independent research careers based on their startup support and goals. Read more about the department’s growth and discoveries in its academic annual report at annualreport.childrensal.org and click on the Research and Academics tab.

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