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MNAAP Newsletter

Searching for The Holy Grail: A Perfect Screen for Social Determinants of Health

DianaCuttsDiana Cutts, MD, FAAP, Hennepin County Medical Center; and Rich Sheward, deputy director of innovative partnerships at Children’s HealthWatch

Why screen for social determinants of health?
In the United States, we spend increasingly more money per capita on medical services compared to other industrialized nations, while we spend increasingly less on social services. Thus, despite medical advances and increased health care spending, underinvestment in addressing patients’ socioeconomic needs inhibits progress in achieving improvements in our nation’s health.

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Statewide Project to Prepare for Pediatric Disasters

Paula Kocken, MD, FAAP, Pediatric Emergency Medicine, Children’s MinnesotaPaulaKocken

How would your local hospital respond to 15 pediatric victims of a disaster presenting to the emergency department (ED) in one hour?

A surge of pediatric patients can come from a mass casualty event like the Boston Marathon or from a chlorine spill at a pool.

The National PedsReady project from 2013 showed, on average, only 60 percent of Minnesota hospitals are sufficiently prepared for a pediatric surge of patients.

Through a grant from the AAP, I am working with a multidisciplinary group and the Minnesota Department of Health (MDH) to create and roll out an educational curriculum to improve the care of young patients during a large volume event.

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Sounding the Alarm on School Start Times: Later is Attainable

By Julie Dahl, APRN, CNP, President of the MN Sleep Society, Respiratory Consultants; Julie Baughn, MD, Mayo Center for Sleep Medicine, Children’s Center; Robin Lloyd, MD, Mayo Center for Sleep Medicine, Children’s Center

It is widely known that adequate sleep is required for optimal health and learning. Yet, adolescents nationwide are sleep deprived. Why? As children transition to adolescence, their biological sleep clocks shift, with a delay in melatonin release occurring around 10:45 pm (1). With early school start times, adolescents are unable to get the quality, well-timed sleep they need.  In Minnesota, 87 percent of high schools start before 8:30 a.m. and 60 percent of adolescents report inadequate sleep (2,3).  Parents will likely turn to their pediatricians for the facts.

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Sterilization of Minors — Ethical Issues and How to Proceed

By Sheldon Berkowitz, MD, FAAP

Sterilization of minors is an uncommon procedure in pediatric practices, but an important one to understand if a family requests information about it. This article will help to understand what the ethical issues are and how to proceed if it is requested for your patient. Typically, this issue is only brought up for our patients with complex health care needs for whom it is felt that pregnancy (or fatherhood) would present significant problems for your patient or the potential offspring.

The background of this subject and the main reason why there has been so much oversight provided is that in the past, eugenics and other movements to limit reproduction of certain elements of our society led to mistreatment of our most vulnerable patients. The desire to prevent patients with diagnoses such as Trisomy 21 or mental retardation from procreating and potentially bringing more children with these problems into the population resulted in young adults being sterilized, often without any oversight as to whether this was the right thing to do or not.

As a result of these abuses of the medical system, both the American Academy of Pediatrics (AAP) and the American College of OBGYN (ACOG) have published policy statements on when and how minors can undergo sterilization. The goal of these policy statements is to protect the rights of minor patients who may not be able to speak for themselves and to limit possible harm to them if the procedure is not indicated. Because minor patients cannot legally consent to invasive procedures, their parents are given the right as surrogate decision makers to make decisions for them – as long as they are acting in the best interests of their child.

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Disasters Don’t Plan Ahead. You Can!

By Paula Kocken, MD

This was September’s theme for Disaster Preparedness Month and there certainly were enough disasters to test the theme. Hurricanes, earthquakes, and fires ravaged North America. I am certain that all of us were thinking, “What can I do to help?” I am also certain that many of us gave money to charitable organizations, donated food to groups going to aid the victims, and called our relatives and friends in the areas affected to offer help.

One thing you may not have thought was, “How can I best prepare for a disaster if it happens here?”

The best way to be prepared is to “Make a Plan” by thinking ahead in an organized fashion and creating a strategy for what you would do during the most likely disasters to strike your community. It is the idea of preparing yourself first so you are free to help others. The government has some excellent guidelines and tools listed on their websites that are very helpful and informative. Every time I go to those sites, I learn something new or get a great idea on what I need to do to prepare. Below are some of the ideas I think are the most helpful.

Have a family meeting and discuss which disasters would impact your family. In Minnesota, the top culprits include winter storms, tornados, and floods. If you have children, it is important to talk about what could happen and how they would respond to it. It is a good time for demystifying what the children see in the media while validating their concerns. The AAP Family Readiness kit has many suggestions on what to do and how to talk about disasters with children.

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