Quick Access to the:

Continuity Clinic Curriculum

Weekly Schedule: 8am Daily (no sessions on days where there is Morning Report, Didactics, or Criticle Care Conference), 1pm Daily (M/W/F), 1:30pm (when there is a noon conference, didactics or noon grand rounds)

PLEASE BE PREPARED BY READING THE PRIMARY RESOURCE(S), YALE WEEK CASE & BOARD QUESTIONS (if applicable), AND BE READY TO PARTAKE IN THIS DISCUSSION.

This is not a lecture, as it is formatted to be an open discussion with the residents as moderators/facilitators. Your participation, both as moderator and learner is being documented and may affect your continuitity clinic evaluations if you are consistently late, ill-prepared, or not participating.

Moderators, PLEASE DO NOT USE the moderator versions of Yale and Board Questions (on the big screen) unless there are useful charts or images. Thanks!

For more information click here, or scroll below.

Yale Primary Care Pediatrics Curriculum (CLICK HERE!)

learner pin 87166 | moderator pin 894247

(please ask a co-resident or an attending for the appropriate user name)

Wk 43 (4/6 - 4/10): Understanding Health Care Needs of Child Trafficking Victims (YW-23)

Primary Reference:
- Greenbaum J, Kaplan D, Young J; Council on Child Abuse and Neglect; Council on Immigrant Child and Family Health. Exploitation, Labor and Sex Trafficking of Children and Adolescents: Health Care Needs of Patients. Pediatrics. 2023;151(1): e2022060416. https://publications.aap.org/pediatrics/article/151/1/e2022060416/190310/Exploitation-Laborand-Sex-Trafficking-of-Children
Moderators:
- Mpm: Iqra
- Tpm: Anjali
- Wpm: Kavya
- Thpm: Melody
- Fam: Iqra| Fpm: Priya
Resources:
- Nevada Attorney General https://ag.nv.gov/Human_Trafficking/HT_Help/
- State agencies and organizations that combat child sex trafficking and exploitation. https://www.childwelfare.gov/
- Polaris Project, advocacy organization related to human trafficking. https://polarisproject.org/
- National Human Trafficking Hotline. https://humantraffickinghotline.org/
- Love146, International human rights nonprofit organization. https://love146.org/
- Covenant House New Jersey, organization that developed QYIT screening tool: https://covenanthousenj.org
- Trafficking Screening Tools: https://www.nctsn.org/sites/default/files/resources/tip-sheet/trafficking-screening-tools.pdf
- Delta 8.7, United Nations educational platform to eradicate trafficking and child labor: https://unu.edu/cpr/project/delta-87

Wk 42 (3/30 - 4/3): Child Care (YW-13)

Primary Reference(s):
- Donoghue EA, AAP Council on Early Childhood, et al. Quality Early Education and Child Care From Birth to Kindergarten. Pediatrics. 2017;140(2): e20171488. https://doi.org/10.1542/peds.2017-1488
Moderators:
- Mpm: Julia
- Tpm: Gisell
- Wpm: Chidelu
- Thpm: Travis
- *self study for everyone else.
Board Questions: none
Resources:
- Nevada 2-1-1 https://www.nevada211.org/children-services/
- Nevada Child Care Resources https://childcare.gov/state-resources/nevada
- First 5 Nevada https://www.first5nevada.org/services/child-care-and-early-education/
- Nevada Child Care https://www.nevadachildcare.org/parent-portal/
- Useful websites for choosing a quality child care center: Child Care Aware: 1-800-424-2246, www.childcareaware.org
- Information on accreditation:
  - National Association for the Education of Young Children (NAEYC) www.naeyc.org
  - National Accreditation Commission for Early Care and Education Programs (NAC) https://www.earlylearningleaders.org/accreditation/accreditation-overview/
  - National Association of Family Child Care (NAFCC) http://www.nafcc.org/
CLINIC UPDATE:
- We still have FLU and RSV Vaccines!
- If the patient is checked in and then leaves before being seen, use LWBS in the Smart Set
- If the patient's encounter is opened on accident use ERRONEOUS ENCOUNTER in the Smart Set

Week 41 (3/23 - 3/27): Short Stature (YW-32)

Primary Reference: Allen DB, Cuttler L. Short stature in childhood: challenges and choices. NEJM. 2013;368: 1220-8.
Board Questions: For Learners, For Moderators
Moderators:
- Mpm: Pingala
- Tpm: Rosa (discuss w/ an attending)
- Wam: Julio (discuss w/ an attending)
- Wpm: Gurbi
- Thpm: Connor
- Fam: Gurbi (1:1 with Sravya)
- Fpm: Arifa (1:1 with Bhagawan)
Resources:
- Article for parents about physical development. https://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/Physical-Development-of-School-Age-Children.aspx
- Parent information about short stature. https://www.healthychildren.org/English/health-issues/conditions/Glands-Growth-Disorders/Pages/When-a-Child-is-Unusually-Short.aspx
Clinic Updates/Tips/Tools:
- If you code for any Developmental Testing (e.g. ASQ, MCHAT, Vanderbilt) use 96110 with a 59 modifier
- Please do not sign off on any vaccine orders until an attending has seen your patient, alternatively, you may PEND them and the attending can sign them off.

Week 40 (3/16-3/20): Lead (YW-6)

Primary References:
- CDC. Recommended Actions Based on Blood Lead Level
- Half of US Populations exposed to adverse lead levels in early childhood
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Samaa | Mpm: Nariman
- Tpm: Roma
- Wpm: Aasna
- Thpm: Niki
- Fam: Liesel | Fpm: Gurbi (discuss w/ attending)
Resources:
- Nevada Childhood Lead Poisoning Prevention Program (NvCLPPP) https://nvclppp.org/
- SNHD Lead Poisoning Prevention https://www.southernnevadahealthdistrict.org/community-health-center/clppp/
- List of recent recalls from US Consumer Product Safety Commission. http://www.cpsc.gov/en/Recalls/
- CDC Lead Poisoning Prevention Program with information for patients and providers. https://www.cdc.gov/lead-prevention/about/index.html , https://www.cdc.gov/lead-prevention/hcp/clinical-guidance/index.html
- Handout for parents on lead exposure from CDC. https://stacks.cdc.gov/view/cdc/122730

Week 39 (3/9-3/13): Complementary and Integrative Health (YW-81)

Primary Reference: McClafferty H, et al. Pediatric Integrative Medicine. Pediatrics. 2017;140(3): e20171961.
Moderators:
- Mpm: Julia
- Tpm: Rosa
- Wpm: SAMAA's QI
- Thpm: Iqra
- Fam: Iqra (students to participate)
- Fpm: Bhagawan
Resources:
- American Academy of Pediatrics, professional and parent resources on complementary and alternative medicine. https://www.aap.org/en/get-involved/aap-sections/integrative-medicine/
- Natural Medicines Comprehensive Database. https://trchealthcare.com/product/natmed-pro/
- National Institutes of Health, National Center for Complementary and Integrative Health (NCCIH). https://nccih.nih.gov/
- Natural Standard Database, provides evidence-based information on CAM. https://trchealthcare.com/product/natmed-pro/

Week 38 (3/2-3/6): Eating Disorders (YW-75)

Primary Reference: Hornberger L, Lane MA, Committee on Adolescence. Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics. 2021;147(1): e2020040279.
Board Questions: For Learners, For Moderators
Moderators:
- - Mpm: Pingala
  - Tam: Katie | Tpm: Chidelu
  - Wpm: Travis
  - Thpm: Bhosa
  - Fpm: Sravya
Resources:
- Resources for teens and parents on eating disorders from The Center for Young Women’s Health. https://youngwomenshealth.org/?s=eating+disorder
- Resources for families from the National Eating Disorders Association. www.nationaleatingdisorders.org
Clinic Updates/Tips/Tools:
- - Continue to offer Flu and RSV Vaccines
  - Don't forget to add BMI, Diet Counseling and Exercise Counseling as Dx's at WCC 3yo and up

Week 37 (2/23 - 2/27): Exercise is Medicine:

Primary Reference: Lobelo F, et al. Physical Activity Assessment and Counseling in Pediatric Clinical Settings. Pediatrics. 2020;145(3): e20193992
Board Questions: None
Moderators:
- Mpm: Liesel
- Tam: Andrzej | Tpm: Roma
- Wpm: Julia
- Tpm: Rosa
- Fam: Sravya (self study) | Fpm: Arifa
Resources:
- https://gethealthyclarkcounty.org/
- Community/Rec Centers & Classes:
- Exercise is Medicine Health Care Provider Resource Page from the American College of Sports Medicine (includes Physical Activity Vital Sign and exercise prescription templates): https://www.exerciseismedicine.org/eim-in-action/health-care/resources/
- Patient information on fitness topics (e.g., Aerobic Training, How to Get Fit, Overcoming Obstacles to Physical Activity) from AAP Healthy Children: https://www.healthychildren.org/english/healthyliving/fitness/pages/default.aspx
- Strategies for engaging families in healthy lifestyle changes by age and stage from the AAP Healthy Active Living for Families: https://www.aap.org/en/patient-care/healthy-active-living-for-families/
- Patient information on exercise and nutrition topics in English and Spanish from Nemours Children’s Hospital: https://kidshealth.org/en/teens/food-fitness/
- Curated list of online exercise videos for children (including Cosmic Kids Yoga, P.E. with Joe): https://www.nytimes.com/wirecutter/blog/best-kids-exercise-videos/
- Free online beginner running plan from Couch to 5K: https://www.nhs.uk/better-health/get-active/get-running-with-couch-to-5k/
- Free (with online sign-up) walking and beginner running plans from body positive and inclusive online running community, Slow AF Run Club: https://slowafrunclub.com/training-plans
- Move Your Way Campaign Materials for Kids and Teens: https://odphp.health.gov/ourwork/nutrition-physical-activity/move-your-way-community-resources/campaignmaterials/materials-kids-and-teens

Week 36 (2/16 - 2/20): Ambulatory Mock Code Week

Primary Reference: AAP Committee on Pediatric Emergency Medicine Preparation for Emergencies in the Offices of Pediatricians and Pediatric Primary Care Providers Pediatrics July 2007, 120 (1) 200-212
Board Questions: None
Moderator: Samaa

Week 35 (2/9 - 2/13) - Pediatric Hypertension (YW-101)

Primary Reference: Flynn JT, Falkner BE. New clinical practice guideline for the management of high blood pressure in children and adolescents. Hypertension. 2017;70: 683-686.
- Yale Pediatric HTN Screening Algorithm
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Melody | Mpm: Gurbi
- Tpm: Kavya
- Wam: Priya | Wpm: Julio
- Thpm: Ola
- Fam: Ola | Fpm: Gisell
Resources:
- MD CALC - Pediatric Hypertension Guidelines
- Pedialink - Proper BP Measurement
- Online pediatric blood pressure norms chart. https://www.nhlbi.nih.gov/files/docs/guidelines/child_tbl.pdf
- Information for patients from International Pediatric Hypertension Association. http://www.iphapediatrichypertension.org/faqs/
Clinic Updates/Tips/Tools:

Week 34 (2/2-2/6): Heart Murmurs (YW-PCPC)

Primary Reference(s): Gonzalez VJ, Kyle WB, Allen HD. Cardiac Examination and Evaluation of Murmurs. Pediatrics in Review. 2021;42(7): 375-382
Board Questions: For Leaners, For Moderators
Moderators:
- Mpm: Samaa
- Tpm: Connor
- Wpm: Nikki
- Thpm: Santi
- Fpm: Pingala
Resources:
- Menashe V. Heart murmurs data supplement (audio files). Pediatrics in Review. 2007;28: e19-e22. https://publications.aap.org/pediatricsinreview/article/28/4/e19/34040/Heart-Murmurs
- Biancaniello T. Innocent murmurs: a parent’s guide. Circulation. 2004;109(11): e162-e163. http://circ.ahajournals.org/cgi/reprint/109/11/e162
- There are many other sites that host audio files of murmurs, including:

https://depts.washington.edu/physdx/heart/demo.html

https://www.easyauscultation.com/heart-murmur-sounds

https://murmurquiz.org/

http://pted.org/

Clinic Updates/Tips/Tools:
- Flu and RSV Vaccines are Available!
  - Follow the SNHD Respiratory Disease Dashboard

Wk 33 (1/26-1/30) - Fetal Alcohol Spectrum Disorder (YW-76)

Primary References: Hoyme HE, et al. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders. Pediatrics. 2016;138(2): e20154256. | 2024 Fact Sheet
Moderators:
- Mpm: Bhagawan
- Tpm: Travis
- Wpm: Iqra
- Thpm: Julio
- Fpm: Anjali
Resources:
- AAP FASD Toolkit. An AAP resource for physicians. http://www.aap.org/fasd
- AAP resources for PAE screening. http://www.aap.org/pae
- CDC information on FASD. https://www.cdc.gov/fasd/
- Ackerman Center: https://www.grantagift.com/drug-effect-fasd-clinic
- Nevada Families for FASD Awareness: https://www.nevadafasd.org/

Week 32 (1/19 - 1/23) : Common Anomalies of the Hands & Feet (YW-94)

Primary References:
- Dare DM, Dodwell ER. Pediatric flatfoot: cause, epidemiology, assessment, and treatment. Curr Opin Pediatr. 2014;26(1):93-100
- Morozova OM, Chang TF, Brown ME. Toe Walking: When Do We Need to Worry? Curr Probl Pediatr Adolesc Health Care. 2017;47: 156-160
Moderators:
- - Tpm: Katie
  - Wpm: Katie
  - Thpm: Aasna
  - Fpm: Chidelu
Clinic Resources:

Podiatry Referral Information for Flat Feet at our clinic
Video of child exhibiting toe walking. https://www.youtube.com/watch?v=aBPfv3vEUvE

2. Video of Silfverskiöld test from Global HELP and Seattle Children’s Hospital. https://www.youtube.com/watch?v=La9LUJwGGQ0

3. Handout on calf stretches for toe walking from University of Rochester Medical Center. https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/childrens-hospital/developmentaldisabilities/ndbp-site/documents/toe-walking-guide.pdf

4. Information for parents on orthopedic conditions from POSNA/OrthoKids (in English and Spanish).

a. https://orthokids.org/conditions/flexible-flat-feet/

b. https://orthokids.org/conditions/toe-walking/

Week 31 (1/12 - 1/16): Toilet Training (YW-46)

Primary Reference(s): Baird DC, Bybel M, Kowalski AW. Toilet training: common questions and answers. American Family Physician. 2019;100(8): 468-474.
Board Questions: For Learners For Moderators
Moderators:
- - Mpm: Emily
  - Tpm: Bhosa
  - Wpm: Nariman
  - Thpm: Pingala
  - Fpm: Priya
Resources:
- HealthyChildren - Potty Training. https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/default.aspx
- Toilet training handout for parents. https://www.aafp.org/afp/2019/1015/p468-s1.html
- AAP handout on Toilet Training Children with Special Needs. https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/ToiletTraining-Children-with-Special-Needs.aspx
- Mount Sinai Beginning Toilet Training https://parenting.mountsinai.org/parent-guides/beginning-toilet-training/?search=toilet%20training
- Mount Sinai Potty Training with Positive Discipline https://parenting.mountsinai.org/parent-guides/potty-training-with-positive-discipline/?search=toilet%20training
Clinic Updates/Tips/Tools:
- - Continue to bring up the Flu and RSV vaccines
    1. You can watch the activity for Respiratory Viruses at the CDC
    2. SNHD Respiratory Disease Dashboard

Week 29 (1/5 - 1/9): Resolutions

Discuss as a group your personal goals in Continuity Clinic, for example:
- Improving Continuity with patients
- Improving efficiency, billing and documentation
- Memorizing milestones
Discuss the article: "Healthy New Year's Resolutions for Children & Teens" from Healthychildren.org" and incorporate it in to your WCC this week.

Weeks 28 & 27 (12/22 - 1/2): Holiday Break from CCC

Happy Holidays! No CCC's these weeks.

Week 26 (12/15-12/19): Sleep (YW-131)

Primary Reference(s): Bhargava S. Diagnosis and Management of Common Sleep Problems in Children. Pediatrics in Review. 2011;32: 91-99
Board Questions: For Learners, For Moderators
Moderators:
- Mpm: Rosa
- Tpm: Bhosa
- Wpm: Arifa
- Thpm: Anjali
Resources:
- Information for families on sleep disorders from American Academy of Sleep Medicine. www.sleepeducation.com

2. ‘Baby sleep: Helping baby sleep through the night’. Mayo Clinic guide for parents regarding infant sleep http://www.mayoclinic.org/healthy-living/infant-and-toddler-health/in-depth/babysleep/art-20045014

3. ‘Sleeping Angels’ blog about children’s sleep by Dr. Dennis Rosen, Psychology Today. http://www.psychologytoday.com/blog/sleeping-angels

4. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. www.pediatrics.org/cgi/doi/10.1542/peds.2016-2940

Clinic Updates/Tips/Tools:

Week 25 (12/8-12/12): Discipline (YW-72)

Primary Reference(s): Sege RD, Siegel BS, Council on Child Abuse and Neglect, Committee on Psychosocial Aspects of Child and Family Health. Policy Statement: Effective Discipline to Raise Healthy Children. Pediatrics. 2018;142(6): e20183112. *medical students: if you can't access the article, please ask a resident or an attending to obtain it for you (please participate on your long day in the afternoon)
Board Questions: None this week!
Moderators:
- Mpm: Iqra
- Tpm: Santiago
- Wpm: Gurbi
- Thpm: Kavya
- Fpm: Niki
Resources:
- Information for parents on discipline from AAP, including list of age-appropriate strategies. http://www.healthychildren.org/English/family-life/family-dynamics/communicationdiscipline/Pages/Disciplining-Your-Child.aspx
- Information for parents on discipline from the CDC, including list of age-appropriate strategies. ttps://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/index.html
- Information for parents on time out. www.cyberparent.com/timeout
- Discipline tips for parents. http://www.helpandhope.org/Parenting_Tips/articles/discipline.asp
- Top Tips for Surviving Tantrums: https://www.healthychildren.org/English/family-life/familydynamics/communication-discipline/Pages/Temper-Tantrums.aspx
- Effective Discipline to Raise Healthy Children (AAP stance against Corporal punishment, yelling)
- Positive Parenting (Defines positive parenting and gives example cases)
Clinic Updates/Tips/Tools:
- Keep bringing up the RSV and Flu Vaccines!

Week 24 (12/1-12/5): Growth Faltering & Malnutrition (YW-88)

Primary Reference:
- Tang MN, et al. Failure to Thrive or Growth Faltering: Medical, Developmental/Behavioral, Nutritional, and Social Dimensions. Pediatrics in Review. 2021;42(11): 590-601.
Moderators:
- Mpm/Tpm: Gisell
- Wpm/Fpm: Roma
- Thpm: Ola
Resources:
- CDC and WHO growth charts: https://www.cdc.gov/growthcharts/
- Handout on growth faltering. https://www.aafp.org/pubs/afp/issues/2023/0600/patient-information-growth-faltering.html
- National Institute of Health DRI Tables, Nutrient Recommendations and Databases: https://ods.od.nih.gov/HealthInformation/nutrientrecommendations.aspx#dri
- Peditools’ CDC BMI Calculator: https://peditools.org/growthpedi/index.php
- BMI and Z-score calculator: https://www.bcm.edu/bodycomplab/BMIapp/BMI-calculator-kids.html

Week 23 (11/24-11/28): Happy Thanksgiving & Happy Native American/First Nations Heritage Month

No CCC this Week!
Learn about the first people in what is now Las Vegas & UNLV's Campus - The History of the Nuwuvi People
Resources: Nevada Indian Commission, National Museum of the American Indian - Smithsonian

Week 22 (11/17 - 11/21): Toxic Stress in Childhood (YW-21)

Primary Reference:
- Garner A, Yogman M, Committee on Psychosocial Aspects of Child and Family Health. Preventing Childhood Toxic Stress: Partnering With Families and Communities to Promote Relational Health. Pediatrics. 2021;148(2): e2021052582.
Board Questions: None this week
Moderators:
- Mpm: Nariman
- Tpm: Julia
- Wpm: Julia
- Thpm: Samaa
- Fpm: Julio
Resources:
- The Effects of Childhood Stress on Health Across the Lifespan. https://stacks.cdc.gov/view/cdc/6978
- Center on the Developing Child, Harvard University http://developingchild.harvard.edu/topics/science_of_early_childhood/toxic_stress_response/
- The Adverse Childhood Experiences Study, ACE Score Calculators. https://www.mdcalc.com/calc/10464/adverse-childhood-experiences-ace-score
- Social Determinants of Health at the CDC. https://www.cdc.gov/about/priorities/why-is-addressing-sdoh-important.html#cdc_generic_section_1-why-are-sdoh-important-to-cdc
Clinic Tips!
- We still have plenty of Beyfortus and Flu Vaccines! (Please make sure to bring it up to families when applicable!)
- Please be mindful when choosing between:
  - Z00.121 -Encounter for routine child health examination with abnormal findings
  - Z00.129 -Encounter for routine child health examination without abnormal findings
  - You can change a "with" to a "without" (but you have to do it in the visit diagnosis (click the delta triangle) AND in the problem list.
- EP and TS modifiers are ONLY for WCC. The TS is ONLY when you order a referral, and please do not attach a WCC as a referral dx.

Week 21 (11/10 - 11/14): Headache (YW-29)

Primary Reference(s):
- Orr SL. Headache in Children and Adolescents. Continuum: Lifelong Learning in Neurology. 2024; 30(2): 438-472
Board Questions: For Learners, For Moderators
Moderators:
- Mpm: Liesel
- T: Holiday
- Wpm: Andrzej
- Thpm: Bhagawan
- Fam: Chidelu (include students) | Fpm: Chidelu
Resources:
- Handout for parents from Pediatric Migraine Foundation. https://americanmigrainefoundation.org/resource-library/pediatric-migraine-parents/
- Handout on migraine headaches from American Family Physician. http://www.aafp.org/afp/2002/0215/p635.html
- Handout on headache in children. https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/headaches/

Week 20 (11/3 - 11/7): Preoperative Assessment (YW-125)

Primary Reference: Goldschneider KR, Cravero JP, AAP Section on Anesthesiology and Pain Medicine. The pediatrician's role in the evaluation and preparation of pediatric patients undergoing anesthesia. Pediatrics. 2014;134: 634-641
- Table 2
Board Questions: None this week!
Moderators:
- *Medical Students can particpiate on their long day in the afternoon*
- Mpm: Travis
- Tpm: Sravya
- Wpm: Travis
- Tpm: Priya
- Fam: Aasna (self-study) | Fpm: Sravya
Resources:
- Infographic about perioperative medications. Wanderer JP, Rathmell JP. Perioperative Medication Management. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2017;126(1): A21-A21. https://doi.org/10.1097/ALN.0000000000001477
- Information for parents from American Society of Anesthesiologists. https://www.asahq.org/madeforthismoment/preparing-for-surgery/prep/preparing-for-surgerykids-checklist/
Clinic Tips/Updates:
- Timely Order Placement:
  - Please make sure all orders (POC testing and vaccines) are entered and signed before ending the visit. We’ve had several situations where patients were left waiting in the exam room because orders were not completed, which delays the workflow, increases room turnover time, and leads to patient dissatisfaction.
- Rotavirus Vaccines: We are in the transition from Rotateq to Rotarix. Our current policy is:
  - RotaTeq should not be administered beyond 32 weeks of age, and should not be started in infants 15 weeks or older.
  - Rotarix should not be started for infants 15 weeks or older, and no doses should be given to infants 25 weeks or older.
  - When continuing the Rotavirus boosters, please make sure to order the same product
- Kinrix (DTaP-IPV) is indicated for children 4–6 years of age only.

Week 19 (10/27 - 10/31): Pediatric Dental Care (YW-85)

Primary References:
- Krol DM, Whelan K, AAP Section on Oral Health. Clinical Report: Maintaining and improving the oral health of young children. Pediatrics. 2023;151(1): e2022060417. https://doi.org/10.1542/peds.2022-060417
- American Dental Association. Primary and Permanent tooth eruption charts. Retrieved April 2, 2025, from http://www.mouthhealthy.org/en/az-topics/e/eruption-charts
Board Questions: none this week!
Moderators:
- Mpm: Ola
- Tpm: Gurbi
- Wpm: Ola
- Thpm: Anjali
- *Medical students can participate on their long day, *Lied clinic residents need only participate when its their "continuity clinic" day.
Resources:
- AAP Oral Health Initiative , AAPD Healthy Smiles Guidebook
- AAPD oral health information sheet for parents
- Links to AAPD policy statements on various issues related to oral health. http://www.aapd.org/media/policies.asp
- Caries Risk Assessment Tool (CAT) for providers
- NIH Fact Sheet on Fluoride for Health Professionals, June 26, 2024. https://ods.od.nih.gov/factsheets/Fluoride-HealthProfessional/
Clinic Tips:
- You can use Dr. Simangan's dot phrase in your AVS, .DPSDENT for a list of dentists and a QR code to look up dentists in their area.
- The Flouride Varnish Application CPT code: 99188
- Dental Clearance Billing:
  - - Primary Diagnosis: Pre-Operative medical clearance Z01.818
    - Secondary Diagnosis: Dental Caries, Etc
    - CPT CODE (consult code): 99241-99245 (based on complexity) --usually 99243 for us

A CONSULT code should NOT be used in general pediatrics clinic (only subspeciality) - however scenarios for a consult code in a general peds clinic include dental and surgical clearances in this instance you must include the THREE R'S:

- - 1. R - Request for Consult (must be in the HPI with which Physician or Dentist is requesting)
    2. R - Reason for Consult (must be in the HPI/AP why the consultation is needed)
    3. R - Report of Consult (the note must be printed and faxed/sent with who requested it)
PCO-Preoperative Assessment Chapter
Make sure to make a copy of the Medical clearance form and give it to an MA for uploading

- see more dental care info HERE

Week 18 (10/20-10/24): Learning Disabilities (YW-12)

Primary Reference(s):
- Rimrodt S, Lipkin P. Learning Disabilities and School Failure. Pediatrics in Review. 2011;32(8): 315- 324
Board Questions: For Learners, For Moderators
Moderators:
- Mpm: Katie
- Tpm: Nariman
- Thpm: Pingala
- Fam: Aasna (students to participate)
- Fpm: Kavya
Resources:
- CCSD Child find https://ssd.ccsd.net/child-find-department/
- National Center for Learning Disabilities http://www.ncld.org
- National Institute of Neurological Disorders Learning Disabilities Information http://www.ninds.nih.gov/disorders/learningdisabilities/learningdisabilities.htm
- Individuals with Disabilities Education Improvement Act website http://idea.ed.gov
- Overdiagnosis of ADHD, JAMA 2021
- IEP Defenders - a local law firm that gives IEP support
Clinic Updates/Tips/Tools:
- Check out the Development, Disabilities & Education Section of Resources of this Clinic Site!
- On the After Visit Summary (AVS) Please remember to put a reason WHY and roughly WHEN you want the patient to come back.
  - If it is a well check, after 3 years and the patient has private insurance, then they can only do a well visit once every 365 days, but if it's a Medicaid/MCO they can have a well visit after their birthday (regardless of the last visit)
  - If the patient is behind in vaccines, or needs a vaccine catch up visit, calculate the minimum date and use WEEKS rather than months to make sure they dont come her early; or give them a date to come back on or after.
- If you are precepting a medical student, please make sure to make changes and attest the note. You will be presenting and summarizing when the medical student presented to you, not them presenting to the attending again.
- Please make sure to order the vaccines through the preset orders (if you order from the name only, it may confuse the billing in the system)

Week 17 (10/13-10/17): Antibiotic Stewardship (YW-56)

Primary Reference(s): Gerber JS, et al. AAP Committee on Infectious Diseases, Pediatric Infectious Diseases Society. Antibiotic Stewardship in Pediatrics. Pediatrics. 2021;147(1): e2020040295. Bonus
Board Questions: For Learners, For Moderators
Moderators:
1. M: Giselle | Mpm: Anjali
2. Tam: Samaa (self study)
3. Wpm: Priya
4. Thpm: Arifa
5. Fam: Connor (involve students) | Fpm: Bhagawan
Resources:
1. 5-step patient-centered interviewing. Adapted by Fortin AH, Stein J from: Fortin AH 6th, Dwamena FC, Frankel RM, Lepisto BL, Smith RC. Smith’s Patient Centered Interviewing: An Evidence-based Method. 4th ed. New York: McGraw Hill, 2019. https://medicine.yale.edu/pediatrics/pcpc/learner/02b%20Agenda%20Fivesteps_335873_153_3833 2_v2.pdf
2. Get Smart campaign from CDC has links to information for families and providers about appropriate antibiotic use. http://www.cdc.gov/getsmart/
3. CDC compilation of guidelines for approaching antibiotic prescribing for common infectious diseases for pediatric ambulatory patients. https://www.cdc.gov/antibiotic-use/community/forhcp/outpatient-hcp/pediatric-treatment-rec.html
4. DHHS Nevada https://dpbh.nv.gov/Programs/HAI/dta/AMR/
Clinic Updates/Tips/Tools:
1. FLU vaccines are available! (the order is currently in the Private orders for both Private and VFC)
  - Please obtain a signed VACCINE REFUSAL FORM for those that parents that do not want it (available in the cabinet above the sink)

Week 16 (10/6-10/10): Urinary Tract Infections (YW-48)

Primary Reference(s): Mattoo TK, Shaikh N, Nelson CP. Contemporary Management of Urinary Tract Infections in Children. Pediatrics. 2021;147(2): e2020012138.
Board Questions: For Learners, For Moderators
Moderators: Mpm: Julio | Tpm: Samaa | Wpm: Melody | Thpm: Liesel | Fpm: Nariman
Resources:
- UTICalc for children 2-23 months of age, online tool to estimate probability of UTI. https://uticalc.pitt.edu
- Information from the National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-tract-infections-inchildren/treatment
- Patient information on VUR. https://www.niddk.nih.gov/health-information/urologicdiseases/hydronephrosis-newborns/vesicoureteral-reflux
- Pediatrics 2016: Reaffirmation of AAP Clinical Practice Guideline: The Diagnosis and Management of the Initial Urinary Tract Infection in Febrile Infants and Young Children 2–24 Months of Age
- Pediatrics 2021: Contemporary Management of UTI
- AAP News & Journal Post 2021: A Clinical Practice Literature Review of Pediatric UTIs
Clinic Updates & Tips:

Week 15 (9/29-10/3): Constipation (YW-83)

Primary Reference(s): LeLeiko NS, Mayer-Brown S, Cerezo C, Plante W. Constipation. Pediatrics in Review. 2020;41(8): 379- 392
- MDCalc: Rome IV Criteria for Functional Constipation
Board Questions: For Learners, For Moderators
Moderators:
- Mpm: Nikki
- Tpm: Connor
- Wpm: Priya
- Thpm: Ola
- Fam: Iqra (involve students)
- Fpm: Santiago
Resources:
Clinic Updates/Tips:
- Age specific codes do matter (*these are the only Z-Codes acceptiable for a primary billing code)
  - Z00.110 = under 8 days
  - Z00.111 = 8-28 days
  - Z00.129 = 0-17 years
  - Z00.00 = 18+ (also use CPT 99395 established or 99385 for new)

Week 14 (9/22 - 9/26): Lymphadenopathy (YW-99)

Primary Reference(s): Sahai S. Lymphadenopathy. Pediatrics in Review. 2013;34: 216-227. https://doi.org/10.1542/pir.34-5-216
Board Questions: For Learners, For Moderators
Moderators:
- - Mpm: Travis
  - Tpm: Samaa (self study)
  - Wpm: Travis
  - Thpm: Arifa
  - Fam: Emily (students to participate)| Fpm: Giselle
Resources:
- Patient information on lymphadenopathy from Mayo Clinic. http://www.mayoclinic.org/diseasesconditions/swollen-lymph-nodes/basics/definition/con-20029652
Clinic Updates/Tips/Tools:
- Avoid using ICD-10 codes that are too similar and from the same code class (meaning the first letter in the code). This is called an Excludes1 note and can't be reported and the claim could be denied. Instead find a code from a different code class (which for some reason is called an Excludes 2 note) which can be reported. Examples are given here. (by the way, billing helps to fix these issues, but still try to fix it on your end too!)

Week 12 (9/25 - 9/29): Otitis Media & Externa (YW-116)

Primary Reference(s):
Board Questions: For Learners, For Moderators
Primary Moderators:
- - Mam: Niki | Mpm: Anjali
  - Tam: Liesel (discuss w/ attending or students if available)
  - Tpm: Ola
  - Wpm: Julio
  - Thpm: Bhagawan
  - Fpm: Chidelu
Resources:
- - AAFP Patient Information page. http://www.aafp.org/afp/2007/1201/p1659.html
  - Healthy Children AAP Patient Information page.
  - Mayo Clinic Patient Information page. http://www.mayoclinic.com/health/ear-infections/DS00303
Clinic Updates/Tips/Tools:
- - Menigitis Vaccine Order Protocol Change:
    - There are now 2 separate orders for each brand. In your preference lists, you now have access to both of those orders (currently set as Bexsero - Private, Trumenba - VFC)
      - Meningococcal B, Recombinant (Trumenba)
      - Meningococcal B, OMV (Bexsero)
    - If you search for these orders, you can just search for their brand name, or how you normally would.

Wk 11 (9/15-9/19): Fever in Children Less than 36 Months (YW-50)

Primary Reference(s):
- Leazer RC. Evaluation and Management of Young Febrile Infants: An Overview of the New AAP Guideline. Pediatrics in Review. 2023;44(3): 127–138. https://doi.org/10.1542/pir.2022-005624
- Author’s note: The AAP Clinical Practice Guideline by Pantell, et al. (see Additional References) offers a deeper exploration of this important topic and is worth reviewing. Specifically, the management algorithms in Figures 1, 2, and 3 are high yield. https://doi.org/10.1542/peds.2021-052228
Moderators:
- Tam: Liesel (for the Med Students)
- Tpm: Aasna
- Wpm: Sravya
- Thpm: Katie
- Fpm: Julia
Board Questions: For Learners, For Moderators Only
Clinical Resources/Tools:
- Fever information for parents from AAP. https://www.healthychildren.org/English/health-issues/conditions/fever/pages/Fever-Without-Fear.aspx
- Mayo Clinic fever handout for parents. https://www.mayoclinic.org/diseases-conditions/fever/in-depth/fever/art-20050997
- PECARN Fever Tool. https://www.mdcalc.com/calc/10204/pecarn-rule-low-risk-febrile-infants-29-60-days-old
- Seattle Children's Fever Pathway https://www.seattlechildrens.org/globalassets/documents/healthcare-professionals/clinical-standard-work/Neonatal-fever-org-pathway.pdf

Week 10 (9/1-9/5): Identification of the Sick Child (YW-122)

Primary Reference: Buntinx F, et al. Dealing with low-incidence serious diseases in general practice. British Journal of General Practice. 2011;61: 43-6.
Board Questions: For Learners, For Moderators
Moderators:
- - M-Holiday
  - Tpm: Santiago
  - Wam: Niki (med students to participate)| Wpm: Sravya
  - Thpm: Santiago
  - Fpm: Nariman
Clinic Updates/Tips
- - Please order Rotarix for 2 month olds to start the series, and complete the Rotateq series for 4 and 6 month olds
  - Paper saving tips:
    1. Use the Printed Bright Futures instead of the WCC Handouts included in Epic (they are only 1-2 pages long!)
    2. If attaching a non-English handout to your AVS, you can decide to delete the default English portion (and cut your printouts by half!)
  - The LATCH Breastfeeding Clinic is up an running! They are every Tues/Thurs from 9am to 2pm. Sessions are about 1 hour each. Drop ins are mostly welcome but check the door schedule to see availability. You can use .LATCH to attach the flyers to your AVS for advertising and the email address for families to schedule appointments. Please use the ICD 10 code, P92.5 to help track the patients. Thanks!
Clinic Tools:

Week 9 (8/25 - 8/29): Rhinorrhea & Congestion (YW-51)

Primary Reference(s):
- Gargiulo KA, Spector ND. Stuffy Nose. Pediatrics in Review. 2010;31: 320-324
- DeMuri GP, Wald ER. Acute Bacterial Sinusitis in Children. Pediatrics in Review. 2013;34: 429-437
Board Questions: Learners, Moderators
Primary Moderators:
- Mpm: Priya
- Tpm: Ola
- Wpm: Aasna
- Thpm: Bhagawan
- Fpm: Chidelu
Resources:
- DX & Management of Acute Bacterial Sinusitis: 2013 AAP Guideline
- Healthy Children Guidelines for Referral to Pediatric Surgical Specialists. http://www.healthychildren.org/English/family-life/health-management/Pages/Guidelines-forReferral-to-Pediatric-Surgical-Specialists.aspx
- Healthy Children information on Ear Nose and Throat conditions – includes parent information on colds, allergic rhinitis, and sinusitis. www.healthychildren.org/English/healthissues/conditions/ear-nose-throat/Pages/default.aspx
Clinic Updates/Tips/Tools:
- Gripa/Gripe is a Spanish term that can mean rhinorrhea, a cold, or flu. Gripador means stapler.

Week 8 (8/18 - 8/22): Vision Screening (YW-106)

Primary Resources:

Board Questions: For Learners, For Moderators

Moderators:

Mam: Connor | Mpm: Samaa
Wam: Morning Clinic Report
Fam: Priya | Fpm: Julia
*For days without a formal session, please review the resources and discuss the topic with your precepting attending (Melody, Iqra, Gurbi, Rosa, Sravya)*

Resources:

- Diagrams of cover-uncover test and alternating cover test in Figures 6&7 of Rogers & Jordan, Pediatrics in Review, 2013. http://pedsinreview.aappublications.org/content/34/3/126.full.pdf+htm
- AAO: Pediatric Eye Evaluations
- Spot Vision Screener Conversion Chart

Clinic Updates/Tips/Tools:

- Remember that the Vision screening results is under the Screening tab -> Hearing/Vision Screening then click the little page post it
- You can also type in .VISION and the results will pop up.
- We typically screen for Vision per the EPSDT and AAP Recommendations and billing is automated through EPIC. (But if you are curious, it is 99177 for the Photoscreener [with a 33 modifier when age 3-5], and 99173 for the eye chart)

Week 7 (8/11-8/15): School Absenteeism (YW-15)

Primary Resource:

Moderators:

Mam: Liesel
Mpm: Nariman
Tam: *LATCH Breastfeeding info session
Wpm: Katie
Fam: Giselle (med students to participate in the discussion)
Fpm: Travis

*Self study for Melody, Iqra, Gurbi & Sravya - Please review the material (including the moderator version) and ask your attending and colleagues about their experience related to the material)

Resources:

Attendance works factors contributing to chronic absenteeism: https://www.attendanceworks.org/reducing-chronic-absence-requires-problem-solving-supportnot-blame-punishment/
Attendance Works - https://www.attendanceworks.org/
Positive Behavior Intervention – www.pbis.org
Research Brief: Breakfast for Learning - https://frac.org/wpcontent/uploads/breakfastforlearning-1.pdf
Improving Attendance by Addressing School Health Assessments and Immunizations – Connecticut memo: https://portal.ct.gov/-/media/SDE/Digest/2017-18/Memo-on-Improving-Attendance.pdf
Leading Health Conditions Impacting Student Attendance - https://www.attendanceworks.org/wpcontent/uploads/2017/09/School-Health-Chart-for-CA_Sept9_draft.docx
Healthy Schools Campaign - https://healthyschoolscampaign.org/issues/school-health/

Billing Tip of the Week: Vaccines

Please make sure to associate a diagnosis to each vaccine given to make sure that they don't get denied by payers. (Click the double circles next to the order)
- Acceptible codes are Z00.121 (WCC w/ abn finding), Z00.129 (WCC w/o abn findings), Z23 (encounter for immunication)
FYI: administration codes and VFC modifiers (SL), are automatically added so you don't have to! In other practices (like us in the past) you have to calculate each component e.g. DTap = 90461 (first component), 90462 (2 additional components)
AAP News - AAP releases 2025-’26 flu vaccine recommendations; efforts to increase vaccination ‘urgently needed’
- One tip is to schedule there flu vaccine upon checkout! you can include this in your AVS, and we expect the flu shot in the upcoming months.

Week 6 (8/4-8/8): Health Supervision (YW-1)

Primary Resources:
Moderators:
- Mam/pm: Arifa
- Tam/pm: Aasna
- Wam/pm: Arifa
- Fpm: Julia
- *self study for everyone else
Resources:
- Information on AAP recommendations. www.aap.org & www.brightfutures.aap.org
- National Immunization Program, including VFC and ACIP. http://www.cdc.gov/vaccines/
  - AAP Vaccine Schedule. https://publications.aap.org/redbook/resources/15585/Immunization-Schedules
- USPSTF guidelines. http://www.uspreventiveservicestaskforce.org
  - Summary of recommendations pertaining to children and adolescents http://www.uspreventiveservicestaskforce.org/BrowseRec/Index?age=Pediatric,Adolescent
- Summary of changes to AAP periodicity schedule. https://www.aap.org/periodicityschedule_ga=2.48250790.1498715460.1681139220- 166700260.1680024856
Billing Tip:
- You may have noticed that the Plan Tab has several new additions in the "Visit Diagnosis" section.
- If you click on the "Common" Button the "Expand Menu to Buttons", you can have all the buttons part of our BMI Quality project.
  - this allows a double ICD-10 Code (both Z and E codes if you really wanna know!) that can be used for diagnosis and when ordering labs
- If you want to rename them to, click the wrench to the right and replace the caption.
- If you ever lose the buttons or want to start from scratch, you can restore defaults.
- Ask any of the attendings for technical support.

Week 5 (7/28 - 8/1): Clinic Scavenger Hunt

Print off a Scavenger Hunt Form and complete the Scavenger hunt once during this week. The winner gets a firm handshake and better clinic knowledge.
Check with the attending who has the answer key.
Billing Tip: Modifiers
- Modifier EP indicates a normal, routine screening. ONLY use with WCC
- Modifier TS indicates that a referral or follow-up services are recommended. When using modifier TS, link the most current diagnosis code(s) that reflects the condition requiring follow-up on the billing claim.These should come after the encounter code (e.g., Z00.121). ONLY with WCC
- Modifier 25 must be used with non-preventive medicine Evaluation and Management (E&M) services (e.g., codes 99212-99215) when reported in conjunction with vaccine administration when the E&M is significant and separately identifiable. Continue to use EP and TS modifiers as well.
- See more billing tips below!

Billing Tips 2024+.pdf

Week 4 (7/21-7/25): Homeschool & Private School (YW-14)

Primary Reference: Vezzola N. Homeschooling and Unschooling. LAIF – L’Associazione Istruzione Famigliare. Accessed on September 19, 2024
Moderators:
- Mam: Santiago (Med Student learning session)
- Wam: Clinic Morning Report at MEB
- Thpm: Julio
- Fpm: Ola
- *all other days are self-study as there is only 1 new resident per session*
Resources:
- State by state laws on homeschooling e.g., notification, need for curricula: https://responsiblehomeschooling.org/state-by-state/
  - https://education.jhu.edu/edpolicy/policy-research-initiatives/homeschoolhub/states/nevada/
- Nevada DOE Homeschooling, Advocates for Homeschooling, CCSD-Homeschooling
- Nevada Opportunity Scholarship (for children w/in 300% of FPL that want to go to private school)
- Info on private schooling demographics, including state-by-state: https://nces.ed.gov/programs/coe/indicator/cgc/private-school-enrollment
- Nevada DOE Private Schools, Nevada Educations Options Coalition
- Johns Hopkins Homeschooling hub: https://education.jhu.edu/edpolicy/policy-researchinitiatives/homeschool-hub/
- Department of Defense homeschooling page: https://www.dodea.edu/non-dod-schools/homestudy-virtual-education

Week 3 (7/14 - 7/18): Motivational Inteviewing (YW-103):

Primary Reference: Erickson SJ, et al. Brief interventions and motivational interviewing with children, adolescents, and their parents in pediatric health care settings: a review. Archives of Pediatrics and Adolescent Medicine. 2005;159(12): 1173-80.
- Yale: The Rulers of Motivational Interviewing
Moderators:
- Tam/pm: Bhagawan
- Thpm: Anjali
- Fpm: Samaa
Resources:
- Motivational interviewing training resources for providers. www.motivationalinterviewing.org/
- Motivational interviewing Overview in podcast form. http://www.psychiatrictimes.com/AAAP2014/motivational-interviewing-inspirational-overview
- “Change Talk” app. https://itunes.apple.com/us/app/change-talk-childhoodobesity/id821851796?mt=8
- MI Skillset app. http://www.miskillset.com/
- SAMHSA Motivational Interviewing Resource Page. http://www.integration.samhsa.gov/clinicalpractice/motivational-interviewing
- NHCHC: Motivational Interviewing - for homeless adults but principles are very clear. https://www.nhchc.org/training-technical-assistance/online-courses/mi/
- Practice exercise about using MI for vaccine hesitancy. https://www.nytimes.com/interactive/2021/05/20/opinion/covid-19-vaccinechatbot.html?referringSource=articleShare

Week 1-2 (6/30-7/11): Clinic Adjustment

Goals for the 2 weeks:
- Make sure your logins work
- Install and Explore Haiku on your phone
- Share EPIC tips and tricks with each other, create a smart phrase, customize your EPIC tabs, make a macro!
  - https://docs.google.com/document/d/1rDPVDHPNtTsP84n8oMmTuxVEShPpdGZM/edit?usp=sharing&ouid=108883666646567718290&rtpof=true&sd=true
- Explore EPIC, especially the screening tabs
- Discuss billing tips with colleagues and attendings:
  - https://www.contemporarypediatrics.com/view/2021-evaluation-and-management-coding-update
Board Questions: None this week!
Moderators: Everyone

2024-2025 Archive

6/23-6/30: Thank you PGY-3s! You will be missed 🥹

Week 52 (6/16-6/20): Happy Juneteenth!

Primary References:
- Juneteenth | National Museum of African Amerian History and Culture
- AAP: Talking With Your Children About Racism: Start, Continue the Conversation
Board Questions: None this week!

Moderators: EveryoneWeek 51 (6/9-6/13): Travel Preparedness (YW-9)

Primary Reference: Chehab H, Fischer PR, Christenson JC. Preparing Children for International Travel. Pediatrics in Review. 2021;42(4): 189-202. https://doi.org/10.1542/pir.2018-0353
Board Questions: For Learners, For Moderators
Moderators: Mpm (Samaa Self Study), Wpm (Niki), Thpm (Julio Self Study), Fam (Niki to teach med students).
Clinic Resources:
- State Department Travel Advisories. https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/
- Links to CDC sites (non-Yellow Book).
  - Health notices for travelers. http://wwwnc.cdc.gov/travel/notices.htm
  - Country specific information. http://wwwnc.cdc.gov/travel/destinations/list.htm
  - Malaria information by country. http://www.cdc.gov/malaria/travelers/country_table/a.html
  - List of travel clinics. http://wwwnc.cdc.gov/travel/page/travel-clinics.htm
- Links to CDC Yellow Book. http://wwwnc.cdc.gov/travel/page/yellowbook-home
- WHO website on International Travel and Health. http://www.who.int/ith/en/
- Insect Repellent handout. http://www.healthychildren.org/English/safety-prevention/at-play/pages/Insect-Repellents.aspx

Week 50 (6/2-6/6): Bites and Stings from Outdoor Arthropods (YW-59)

Primary Reference: Read pages 841-845 from: Juckett G. Athropod Bites. American Family Physician. 2013;88(12): 841- 847. https://www.aafp.org/afp/2013/1215/p841.html
- https://lasvegassun.com/news/2025/may/29/its-mosquito-season-southern-nevada-health-distric/
Board Questions: For Learners, For Moderators
Moderators:
- Mpm: Chidelu
- Wpm: Chidelu
- Fam: Travis (teaching students)
- *self study for all other days since there are not enough new participants.
Clinic Resources:
- SNHD Mosquito Surveillance - https://www.southernnevadahealthdistrict.org/programs/mosquito-surveillance/
- Information for families about insect repellent from American Academy of Pediatrics. https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Insect-Repellents.aspx
- Information on insect repellents from the EPA. https://www.epa.gov/insect-repellents
- Tickborne Diseases of the United States, CDC manual for healthcare providers with photos. https://www.cdc.gov/ticks/tickbornediseases/TickborneDiseases-P.pdf
- Tips on mosquito prevention from CDC. https://www.cdc.gov/mosquitoes/index.html

Week 49 (5/26 - 5/30): Media and Child Health (YW 26)

Primary References:
- American Academy of Pediatrics Council on Communications and Media. Media and young minds. Pediatrics. 2016;138(5): e20162591. http://pediatrics.aappublications.org/content/pediatrics/138/5/e20162591.full.pdf
- American Academy of Pediatrics Council on Communications and Media. Media use in school aged children and adolescents. Pediatrics. 2016;138(5): e20162592. http://pediatrics.aappublications.org/content/pediatrics/early/2016/10/19/peds.2016- 2592.full.pdf
Board Questions: None
Moderators: Michael!
Resources:
- AAP guide to creating a Family Media Plan, available in English and Spanish. www.HealthyChildren.org/MediaUsePlan
- AAP clearinghouse of resources for providers and families related to media use. https://www.aap.org/en/patient-care/media-and-children/

Week 48 (5/19 - 5/23): Acne Vulgaris (YW-55)

Primary Reference: Reynolds R, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2024;S0190-9622(23): 03389-3. https://doi.org/10.1016/j.jaad.2023.12.017
- AAP News https://publications.aap.org/aapnews/news/31630/7-acne-treatments-recalled-for-elevated-levels-of?autologincheck=redirected
Board Questions: For Learners, For Moderators
Moderators:
- Mpm: Sam
- Tam: Yash (med students to participate)
- Wam: Yash | Wpm: Erum
- Tpm: Sam
- Fpm: Priya
Resources:
- American Acne & Rosacea Society - Acne Guidelines
- Patient handout from Society for Pediatric Dermatology. http://pedsderm.net/site/assets/files/1028/spd_acne_long_updated.pdf
- Patient information handout on acne. American Family Physician. https://familydoctor.org/condition/acne/
Clinic Updates/Tips:
- Check the board for vaccines/tests out of stock

Week 47 (5/12 - 5/16): Childhood Nutrition

Primary Reference:
- USDA 2020-2025 Dietary Guidelines for Americans. Retrieved February 25, 2024, from https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf (Read chapters 2 & 3, pages 52-89)
- AAP News: Updated Yellow Book packed with practical guidance to address nutrition in pediatric patients https://publications.aap.org/aapnews/news/31944/Updated-Yellow-Book-packed-with-practical-guidance
Board Questions: For Leaners, For Moderators
Moderators:
- Mpm: Connor
- Tam: Connor (med students to participate)
- Thpm: Katie
- Fpm: Aasna
- Camila, Erum, Sam - Self Study
Resources:
- Growth charts and National Health and Nutrition Examination Survey data. www.cdc.gov/growthcharts/
- WHO Child Growth Standards. www.who.int/childgrowth/standards/en/
- Individualized patient information regarding nutrition choices. http://www.choosemyplate.gov/
- Patient information about nutrition. http://www.nlm.nih.gov/medlineplus/nutrition.html
- Dietary guidelines for Americans, 2015-2020. http://health.gov/dietaryguidelines/2015/guidelines/ pages 51-90 are the pediatric chapters. An infographic about how these have changes since inception in 1980, which also serves as a summary, can be found at https://cspinet.org/sites/default/files/attachment/dietary-guidelines-infographic.jpg
- Dietary guidelines worldwide, collected by the UN. http://www.fao.org/ag/humannutrition/nutritioneducation/fbdg/en/
- Guidelines for introduction of peanuts to infants, National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/sites/default/files/addendum_guidelines_peanut_appx_d.pdf

Week 46 (5/5 - 5/9): Parental Loss & Separation

Primary Reference:
- Schonfeld DJ, Demaria T, Committee on Psychosocial Aspects of Child and Family Health, Disaster Preparedness Advisory Council. Supporting the grieving child and family. Pediatrics. 2016;138(3): e20162147. https://doi.org/10.1542/peds.2016-2147
Moderators:
- Mam: Santiago (med students to participate)| Mpm: Leyden
- Tam: Samaa | Tpm: Santiago
- Wpm: Bhagawan
- Thpm: Dr. Sugay from the SNHD - Measles Update
- Friday: Self Study
Resources:
- Bereavement support groups and camps by location. nacg.org/find-support
- The Coalition to Support Grieving Students. https://grievingstudents.org/
- Website on secondary loss. http://whatsyourgrief.com/secondary-loss-one-loss-isnt-enough/
- Grief counseling center for families with children in Connecticut. www.covect.org
- Information from AAP on grief and parent support. https://www.aap.org/en-us/advocacy-andpolicy/aap-health-initiatives/Children-and-Disasters/Pages/Promoting-Adjustment-and-HelpingChildren-Cope.aspx
- Sibling Loss: Experiencing Grief Through a Child’s Eyes by Dr. Erin Bowen. https://www.aap.org/en/news-room/aap-voices/sibling-loss/
- How Children Understand Death & What You Should Say. https://www.healthychildren.org/English/healthy-living/emotional-wellness/BuildingResilience/Pages/How-Children-Understand-Death-What-You-Should-Say.aspx
- Five Ways to Help Your Child Remember and Celebrate Loved Ones. https://www.healthychildren.org/English/healthy-living/emotional-wellness/BuildingResilience/Pages/Five-Ways-to-Remember-Loved-Ones.aspx
- Tips to Support Children when a Parent is in Prison. https://www.healthychildren.org/English/healthy-living/emotional-wellness/BuildingResilience/Pages/Tips-to-Support-Children-When-a-Parent-is-in-Prison.aspx
- Sesame Street Workshop: Incarceration. https://sesameworkshop.org/topics/incarceration/ (includes resources in Spanish)
- How to Help Children after their Parents Separate or Divorce. https://www.healthychildren.org/English/healthy-living/emotional-wellness/BuildingResilience/Pages/How-to-Support-Children-after-Parents-Separate-or-Divorce.aspx

Week 45 (4/28 - 5/2): Joint Pain (YW-96)

Primary References:
- Tse SML, Laxer RM. Approach to Acute Limb Pain in Childhood. Pediatrics in Review. 2006;27(5): 170- 180. http://pedsinreview.aappublications.org/content/pedsinreview/27/5/170.full.pdf
- Junnila JL, Cartwright VW. Chronic musculoskeletal pain in children: Part I. Initial evaluation. Am Fam Physician. 2006;74(1): 115-122. http://www.aafp.org/afp/2006/0701/p115.html
Moderators:
- Mpm/Tpm: Sravya
- Wam: Clinic Morning Report
- Thpm: Michael
- Fam/Fpm: Priya
Resources:
- New England Journal of Medicine, Videos in Clinical Medicine, Reduction of Pulled Elbow. http://www.nejm.org/doi/full/10.1056/NEJMvcm1211809
- Searchable database of orthopedic diagnosis sponsored by the American Academy of Orthopedic Surgery. Includes diagnostic physical exam maneuvers as well as radiologic references. http://orthoinfo.aaos.org/
- Primer on PedsRheum from SickKids (Toronto, Canada). Basic epidemiology and diagnostics for both common and uncommon rheumatologic diagnoses. https://rheum.member365.com/publicFr/form/index/ca4376e626a6f390b2818f8355e034589879da7a
- Review of pediatric musculoskeletal exam techniques using annotated videos and reference images. https://www.pmmonline.org/doctor/clinical-assessment/examination/
- Education, tools, and links for for families of children affected by inflammatory arthritis. https://www.arthritis.org/juvenile-arthritis

Week 44 (4/21 - 4/25): Outpatient Management of Children in Foster Care

Primary Reference :
- Jones VF, et al. AAP Clinical Report: Pediatrician Guidance in Supporting Families of Children who are Adopted, Fostered, or in Kinship Care. Pediatrics. 2020;146(6): e2020034629. https://pediatrics.aappublications.org/content/146/6/e2020034629
Moderators:
- Mpm: Julio
- Tam: Anjali A (Teaching Students) | Tpm: Daun'lee
- Wpm: Liesel
- Thpm: Nariman
Resoures:

Week 43 (4/14-4/18): Attachment, Temperament, and Parenting (YW-43)

Primary Reference:
- Hong YR, Park JS. Impact of attachment, temperament, and parenting on human development. Korean J Pediatr. 2012;55(12): 449–454. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3534157/pdf/kjped-55-449.pdf
Moderators:
- Mam: Erum (Self Study) | Mpm: Katie
- Tpm: Sravya
- Wpm: Kaitlyn (Self Study)
- Thpm: Sravya
- Fam: Arifa - Include Students in the Discussion
- Fpm: Chelsea (Self Study)
Resources:
- Links to AAP parenting articles on temperament.
  - http://www.healthychildren.org/English/ages-stages/gradeschool/Pages/How-to-Understand-Your-Childs-Temperament.aspx
- Bright Course Fact Sheet - What is Temperament
  - https://www.brightcourse.com/LessonFiles/Factsheets/0567.pdf
- Temperament scale handout for parents. http://centerforparentingeducation.org/library-ofarticles/child-development/unique-child-equation/temperament/temperament-rating-scales/
- Carey Temperament Scales, for use by providers. https://www.b-di.com/ctsinfo.html#:~:text=The%20Carey%20Temperament%20Scales%20are,to%2013%20years%20of%20age.
- Information on the Neonatal Behavioral Assessment Scale, used in the first 2 months of childhood following specific training. https://research.childrenshospital.org/research-units/brazelton-institute-research/nbas
- Circle of Security, International. Training on parenting and attachment: https://www.circleofsecurityinternational.com/

Week 42 (4/7-4/11): Fetal Alchol Spectrum Disorder (YW-42)

Primary Reference:
- Hoyme HE, et al. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders. Pediatrics. 2016;138(2): e20154256. https://pediatrics.aappublications.org/content/138/2/e20154256
Moderators
- Mam/Mpm: the Yale site was down over the weekend
- Wpm: Chelsea
- Thpm: Connor
- Fam: Ola (teaching the Med Students)
Resources:
- AAP FASD Toolkit. An AAP resource for physicians. http://www.aap.org/fasd
- AAP resources for PAE screening. http://www.aap.org/pae
- CDC information on FASD. Free educational materials to print for families. www.cdc.gov/fasd
- Nevada Families for FASD Awareness https://www.nevadafasd.org/
- State-by-state estimates of alcohol use in women of childbearing age. https://www.cdc.gov/ncbddd/fasd/data-maps-2019.html
- Scroll down on this CCC page to the FASD Curriculum Archive for more resources and videos.

Week 41 (3/31-4/4): Autism Spectrum Disorder (YW-41)

Primary References:
- Hyman SL, Levy SE, Myers SM, and the council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. Executive Summary: Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics. 2020;145(1): e20193448. http://pediatrics.aappublications.org/content/145/1/e20193448
- AAP News: AAP president: Undermining research on vaccines, autism ‘poses a threat’ to children’s health https://publications.aap.org/aapnews/news/31704/AAP-president-Undermining-research-on-vaccines
Moderators:
- Mam (Connor-Self Study) | Mpm (Bhagawan)
- Tam (Shield) | Tpm (Travis)
- Wam (Anjali SS) | Wpm (Kaitlyn SS)
- Thpm (Shield)
- Fam/pm (Ola Self Study)
- *for residents doing "self-study" you are required to still read the material but to avoid repetition, these sessions will be smaller discussion groups with attendings and residents who may have already discussed/moderated the material using the curriuculum model. As a group you may dissect the CDC Autism Case Training: Making an Autsim Diagnosis document
Resources:
- NV Pediatric Acces Line (PALS) https://center4cs.org/
- AAP Autism Spectrum Disorder, Bright Futures Toolkit
- Autism Speaks. http://autismspeaks.org
- Autism information from US Department of Health & Human Services. https://www.hhs.gov/programs/topic-sites/autism/index.html
- First Signs, information for families. www.firstsigns.org
- CDC autism information. www.cdc.gov/ncbddd/autism/index.htm , resources
- Links to various screening tools for providers. www.firstsigns.org/screening/tools/rec.htm
- ACT (Autism Case Training): A Developmental-Behavioral Pediatrics Curriculum. https://www.cdc.gov/autism/media/pdfs/act-dev-beh-pediatrics-curriculum.pdf

Week 40 (3/24-3/28): No CCC this week

Week 39 (3/17-3/21): Prevention of Tobacco Use (YW-52)

Primary References:
Board Questions: None this week!
Moderators:
- - - Mam/Mpm: Samaa
    - Tam: Camila | Tpm: Yash
    - Wam: Julio (SS) |Wpm: Camila
    - Thpm: Julia
    - Fam: Anjali R.
Clinic Resources:
- Patient handout from American Family Physician. www.aafp.org/afp/2008/0215/p491.html
- Clearinghouse of smoking cession resources from CDC. http://www.cdc.gov/Tobacco/quit_smoking/how_to_quit/index.htm
- Summary of “5-A’s” for behavior change. https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/clinicians-providers/guidelines-recommendations/tobacco/5steps.pdf
Clinic Updates
- OUT of some Private Vaccines - Check with your MA/Attendings

Week 38 (3/10-3/14): The Medical Home and Children & Youth with Special Health Care Needs (YW-13)

Primary Reference: Katkin JP, et al. Guiding principles for team-based pediatric care. Pediatrics. 2017;140(2): e20171489.

Review Questions: For Learners, For Moderators

Moderators:

Mpm: Aasna
Tam: Niki | Tpm: Daun'lee
Wpm: Arifa
Thpm: Niki
Fam: Leyden | Fpm: Julio (self study)

Clinic Resources:

Nevada Parents Empowering Parents - State Chapter of PEP which trains parents of disabled children on advocacy and a variety of topics
- https://nvpep.org/
Children with Special Health Care Needs Screening Tool
- https://www.childhealthdata.org/docs/cshcn/technical-summary-of-cshcn-screener.pdf
American College of Physicians online resources for patient-centered medical homes.
- http://www.acponline.org/running_practice/delivery_and_payment_models/pcmh/
National Center of Medical Home Implementation, AAP sponsored web site for resources, screening tools, and technical assistance.
- http://www.medicalhomeinfo.org/
Family Voices, A national family advocacy organization with links to state family coordinators and resources.
- http://www.familyvoices.org

Week 37 (3/3-3/7): Newborn Screening (YW-105)

Primary Reference: Fabie NAV, Pappas KB, Feldman GL. The current state of newborn screening in the United States. Pediatric Clinics of North America. 2019;66(2): 369-386
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Michael |Mpm: Bhagawan (Self Study)
- Wam: Camila (Self Study) | Wpm: Priya
- Tpm: Sam
- F: Leyden (Self Study)
Clinic Resources:
- UPC Clinic Resources Section
- American College of Medical Genetics information sheets and confirmatory algorithms.
  - https://www.acmg.net/ACMG/Medical-Genetics-Practice-Resources/ACT_Sheets_and_Algorithms.aspx
- HRSA National Newborn Screening Resources
  - https://newbornscreening.hrsa.gov/about-newborn-screening/newborn-screening-resources
- Links to information about genetic conditions for providers and families
  - http://ghr.nlm.nih.gov/
- CDC Newborn Screening Portal
  - https://www.cdc.gov/newbornscreening/index.html
- Nevada Newborn Screening Program
  - https://med.unr.edu/nsphl/newborn-screening

Week 36 (2/24 - 2/28): Transition from Pediatric to Adult-Oriented Healthcare (YW-134)

Primary Reference: Davidson LF, Doyle MH. Health-care transition: a vital part of care, growth, and change for pediatric patients. Pediatrics in Review. 2021;42(12): 684-693.
Board Questions: For Learners, For Moderators
Moderators:
- Mpm: Lior
- Tpm: Lior
- Wam: Michael | Wpm: Camila
- Thpm: Shield
- Fam: Anjali R | Fpm: Katie (Self Study)
Clinic Resources:
- American Academy of Pediatrics National Center for Medical Home Implementation Transition Tools
  - https://medicalhomeinfo.aap.org/tools-resources/Pages/For-Practices.aspx
- “Got Transition,” clearinghouse of resources from The National Alliance to Advance Adolescent Health. http://www.gottransition.org/
  - Recommended timeline for transition https://www.gottransition.org/resource/?hct-timeline-parents-caregivers
- McManus M, Turchi RM. Coding, payment options for pediatric to adult transition services. AAP News. 2015.
  - http://www.aappublications.org/content/36/9/10.full
- Washington State Department of Health Adolescent Health Transition Project, with examples of portable medical summaries.
  - http://depts.washington.edu/healthtr/
- American College of Physicians, Pediatric to Adult Care Transitions Initiative, toolkit for providers with general and specialty-specific transition tools.
  - https://www.acponline.org/clinical-information/high-value-care/resources-for-clinicians/pediatric-to-adult-care-transitions-initiative
- A more extensive list of transition-related resources appears at the end of the AAP/AAFP/ACP 2011 Clinical Report.
  - http://pediatrics.aappublications.org/content/128/1/182.full.pdf+html
- Society for Adolescent Health and Medicine https://adolescenthealth.org/

Week 35 (2/17-2/21): Adolescent Contraception (YW-63)

Primary Reference:
Board Questions: For Learners, For Moderators
Moderators:
- M: Holiday
- Tpm: Chidelu
- Wam: Arifa (students will participate) | Wpm: Camila
- Tpm: Sanitago
- Fam: Group does the questions together (Chelsea Self Study)
- Fpm: Ola
Clinic Resources:
- 2016 US medical eligibility criteria for contraceptive use from CDC.
  - https://www.cdc.gov/mmwr/volumes/65/rr/rr6503a1.htm?s_cid=rr6503a1_e
- List of emergency contraception alternatives. http://ec.princeton.edu/questions/dose.html
- Birth control information for teens. http://www.pamf.org/teen/sex/birthcontrol/
- Birth control information for teens. www.bedsider.org
- Patient information about sexual assault. http://www.911rape.org/home
- Health information for teens in Q&A format. http://goaskalice.columbia.edu/
- State specific information on reproductive health, rights, and public policy. https://www.guttmacher.org/statecenter/
- SNHD Teen Care Privacy Letter. https://www.southernnevadahealthdistrict.org/download/family-planning/teen-care-and-privacy.doc
- Dr. Levy's Links
Clinic Updates: Keep up the good work with coding your BMI-Diet-Exercise ! See the reminder posts around clinic or ask an attending of help if you need it.

Week 34 (2/10-2/14): Heavy Menstrual Bleeding (YW-102)

Primary Reference:
Board Questions: For Moderators, For Learners
Moderators:
- Mpm: Julia
- Tpm: Julia
- Wam: Kaitlyn | Wpm: Group Board Q's, Camila (Self Study)
- Tpm: Aasna
- Fam: Liesel | Fpm: Group Board Q's, Katie (Self Study)
Clinic Resources:
- Center for Young Women’s Health, Boston Children’s Hospital. www.youngwomenshealth.org
- Menstruation Tracking Apps
- Project Marilyn https://projectmarilyn.com/
- A Report on Evaluation of Access to Menstrual Products - Nevada Dept of Education

Week 33 (2/3-2/7): Precocious Puberty (YW-118)

Primary References:
- Bakhtiani P, Geffner M. Early Puberty. Pediatrics in Review. 2022;43(9): 483-492. https://publications.aap.org/pediatricsinreview/article/43/9/483/188936/Early-Puberty
Board Questions: For Learners, For Moderators
Moderators:
- Mpm: Nariman
- Tam: Julia (self study) | Tpm: Nariman
- Wam: Bhagawan |Wpm: Camila (Self study)
- Thpm: Samaa
- Fam: Nariman
Clinic Resources:
- Handout for families from American Academy of Family Physicians.
  - https://familydoctor.org/condition/central-precocious-puberty/
- Handout for families from American Academy of Pediatrics and Pediatric Endocrine Society
  - www.pedsendo.org/assets/patients_families/EdMat/Precocious%20Puberty.pdf

Wk 32 (1/27-1/31): Normal & Delayed Pubertal Development (YW-114)

Primary References (Required for Moderators & Participants - including Medical Students & Family Practice)
- Bakhtiani P, Geffner M. Delayed Puberty. Pediatrics in Review. 2022;43(8): 426- 435. https://publications.aap.org/pediatricsinreview/article/43/8/426/188578/Delayed-Puberty
Board Questions (at the end of the session, or waiting on late comers): For Learners, For Moderators
Moderators:
- Mpm: Connor
- Tam: Chelsea | Tpm: Sravya
- Wpm: Chelsea
- Thpm: Travis
- Fpm: Sravya
Resources:
- AAP Handouts for teens, AAFP Handouts for teens
- Pediatric Endocrine Society: Delayed Boys, Delayed Girls

Clinic Tools/Updates:
- See the board or ask an Attending for any vaccine/tests updates

Wk 31 (1/21-1/24): Developmental Hip Dysplasia (YW-137)

Primary References (Required for Moderators & Participants - including Medical Students & Family Practice)
- Shaw BA, Segal LS, AAP Section on Orthopaedics. Evaluation and Referral for Developmental Dysplasia of the Hip in Infants. Pediatrics. 2016;138(6): e1-e11.
- Hip-Safe Swaddling. Yale PCPC video.
Board Questions: For Learners, For Moderators
Moderators:
- M: Holiday
- Tam: Santiago | Tpm: Anjali A
- Wpm: Anjali A
- Thpm: Santiago
- Fpm: Julio
Resources:

Clinic Tools/Updates:
- All vaccines in stock! Ask for updates from the MAs or attendings.

Wk 30 (1/13-1/17): Vaccine Hesitancy (YW-127)

Primary References (Required)
Board Questions: None
Moderators:
- Mpm: Priya
- Tpm: Priya
- Wpm: Giselle
- Tpm: Yash
- Fpm: Anjali R.
Resources:
- Description of CMS codes for vaccine counseling from AAFP. https://www.aafp.org/pubs/fpm/blogs/gettingpaid/entry/vaccine_counseling_codes.html
- Provider Resources for Vaccine Conversations with Parents. https://www.cdc.gov/vaccines/hcp/conversations/index.html
- Vaccine Education Center (CHOP), including “Vaccines on the Go” Mobile App available for download. http://www.chop.edu/service/vaccine-education-center
- Additional studies investigating the purported link between vaccines and autism http://www.cdc.gov/vaccinesafety/00_pdf/CDCStudiesonVaccinesandAutism.pdf
- School vaccine exemption laws, by state (Nevada has religious exemption only). https://www.cdc.gov/phlp/docs/school-vaccinations.pdf and https://www.ncsl.org/research/health/school-immunization-exemption-state-laws.aspx
- AAP refusal to vaccinate resources https://www.aap.org/en/patient-care/immunizations/implementing-immunization-administration-in-your-practice/refusal-to-vaccinate/ (includes the refusal to vaccinate forms)
- Healy CM, Pickering L. How to Communicate With Vaccine-Hesitant Parents. Pediatrics. 2011;127: S127-S133. Table 1 lists credible online vaccine resources. http://pediatrics.aappublications.org/content/early/2011/04/18/peds.2010-1722S.full.pdf+html

Clinic Tools/Updates/Tips:
- Check with the attendings or MA's about vaccines that are out of stock

Wk 29 (1/6-1/10): Assessment and Treatment of Childhood Overweight and Obesity (YW-109)

Primary References
Board Questions: None
Moderators:
- Mam: Daun'lee | Mpm: Julio
- Tam: Chelsea | Tpm: Daun'lee
- Wpm: Chelsea
- Thpm: Travis
- Fpm: Katie
Resources:
- AAP Institute for Healthy Childhood Weight: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity
  - Obesity Education: Modules, Webinars & Podcasts
- Change Talk: Childhood Obesity – brief simulated patient encounters to practice motivational interviewing: https://simulations.kognito.com/changetalk/?dly=20
- WeCan and LetsMove, from NIH and Mrs. Obama. http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/ http://www.letsmove.gov

Clinic Tools:
- AAP IHCW: Pediatric Obesity Algorithm
- Healthy Eating Plates from Harvard School of Public Health
  - Children’s version: https://www.hsph.harvard.edu/nutritionsource/kids-healthy-eating-plate
  - Adult’s version: https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate
- Southern Nevada Health District - Get Healthy Clark County

Wk 27-28 (12/23-1/23): Holiday Break from CCC

Wk 26 (12/16-12/20): Sports Participation (YW-125)

Primary Reference: Miller SM, Peterson AR. The Sports Preparticipation Evaluation. Pediatrics in Review. 2019;40(3): 108-128. https://pedsinreview.aappublications.org/content/40/3/108
- Las Vegas Teen Flag Football Star Collapses and Dies 'Playing the Game She Loves' - People Magazine
Board Questions: None
Moderators:
- Mam: Bhagawan |Mpm: Lior
- Tpm: Aasna-Yash Co-Discussion
- Wam: Bhagawan | Wpm: Santiago
- Th: Lior
Resources:
- PPE-5, the pre-participation evaluation form endorsed by AAP, AAFP, and other professional organizations. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Pages/PPE.aspx
- AAP Parent guidance on Performance Enhancing Substances.

- Nevada Interscholastic Activity Association

Wk 25 (12/9 - 12/13): Bone Health in Children: Guidelines for Vitamin D and Calcium Intake (YW-54)

Primary Reference:

1. Golden N, et al. Optimizing Bone Health in Children and Adolescents. Pediatrics. 2014;134; 12291239

2. Read Table in: Institute of Medicine of the National Academies. Dietary reference intakes for calcium and vitamin D. 2010 Report Brief

Board Questions: Learner | Moderator
Moderators
- Mam: Ola | Mpm: Liesel
- Tam: Chidelu (Self study)| Tpm: Yash
- Wam: Ola| Wpm: Michael
- Thpm: Nariman
- Fam: Niki | Fpm: Chidelu
Resources:
- Information for parents/patients about vitamin D from the AAP.
- Handout on bone health from Pediatric Endocrine Society.

Wk 24 (12/2 - 12/6): Food Allergy (YW-70)

Primary Reference: Cosme-Blanco W, Arroyo-Flores E, Ale H. Food Allergies. Pediatrics in Review. 2020;41(8): 403-415.
- AAP Clinical Report Highlights Early Introduction of Peanut-based Foods to Prevent Allergies
Board Questions: For Learners, For Moderators
Moderators:
- 1. Mam: Shield | Mpm: Camila
  2. Tam: Self Study | Tpm: Camila
  3. Wam: Self Study | Wpm: Santiago
  4. Thpm: Erum
  5. Fpm: Self Study
Resources:

Week 23 (11/25-11/29): Happy Thanksgiving & Happy Native American/First Nations Heritage Month

No CCC this Week!
Learn about the first people in what is now Las Vegas & UNLV's Campus - The History of the Nuwuvi People
Resources: Nevada Department of Native American Affairs, Idigenous Women Rising

Wk 22 (11/18-11/22): Infant Oral Pathology (YW-94)

Objectives:
- Describe the presentation of common oral anomalies the clinician may encounter in infants
- Discuss the etiology, predilections, and consequences of common oral anomalies
- Review relevant treatment options and evidence-based recommendations
Primary Reference:
- AAPD Oral Health Policies and Recommendations: Management Considerations for Pediatric Oral Surgery and Oral Pathology. The Reference Manual of Pediatric Dentistry. 2015;402-411.
- Mueller DT, Callanan VP. Congenital malformations of the oral cavity. Otolaryngologic Clinics of North America. 2007;40(1): 141–160.
Board Questions: For Learners , For Moderators
Moderators:
- Mpm: Chelsea
- Tpm: Daun'lee
- Wpm: Aasna
- Thpm: Michael
- Fam: Aasna | Fpm: Kaitlyn
Resources:
- AAPD Dental Growth and Development (Timelines for Dental Eruption) http://www.aapd.org/media/Policies_Guidelines/R_DentalGrowth.pdf
- AAPD Speech and Language Milestones http://www.aapd.org/media/Policies_Guidelines/R_SpeechMilestones.pdf
- AAPD Policy Statements on Various Issues related to Oral Health http://www.aapd.org/policies
Clinic Updates/Tips:

Wk 20 (11/12-11/15): Primary Care of the Premature Infant (YW-23)

Objectives

Understand how the nutritional needs of the premature infant differ from those of term infants
Identify the specific medical and social concerns that need to be addressed in the premature infant
Review projected growth and developmental trajectories for premature infants
Identify recommended screening evaluations and immunizations for premature infants

Primary Reference:

- Andrews B, et al. NICU Follow-up: Medical and Developmental Management Age 0 to 3 Years. Neoreviews. 2014;15: e123.
- AAP News - US Preterm Rates increase to 10.5% in 2021

Board Questions: For Learners, For Moderators

Moderators:

M: HOLIDAY!
Tpm: Chidelu
Wpm: Anjali A
Thpm: Ola
Fam/Fpm: Sravya

Resources:

- World Health Organization Fetal-Infant Growth Chart for Preterm Infants (“Fenton chart”). https://ucalgary.ca/resource/preterm-growth-chart/preterm-growth-chart
- AHRQ Resource kit on Transitioning Newborns from NICU to Home. https://www.ahrq.gov/patient-safety/settings/hospital/resource/nicu/toolkit.html
- AAP Recommendations for the Prevention of RSV Disease in Infants and Children, February 2024. https://publications.aap.org/redbook/resources/25379/AAP-Recommendations-for-the-Preventionof-RSV
- CDC Information about RSV vaccination for families. https://www.cdc.gov/vaccines/vpd/rsv/public/child.html
- FAQs about nirsevimab from AAP. https://www.aap.org/en/patient-care/respiratory-syncytialvirus-rsv-prevention/nirsevimab-frequently-asked-questions/
Clinic Updates/Tips:
- We DO have niresvimab available in clinic!

Wk 19 (11/4 - 11/8) - Cerumen Impaction (YW-30)

Objectives

- Describe the anatomy and physiology relevant to cerumen.
- Explain proper ear hygiene to prevent cerumen impaction.
- List the medical indications for cerumen removal.
- Describe medically-sound remedies for cerumen impaction, including indications, contraindications and modifications in special circumstances.

Primary Reference:

- Urkin J, Bar-David Y, Holdstein Y. Cleaning Earwax Impaction: Clinical Tips for the Primary Care Clinician. Clinical Pediatrics. 2015;54(14): 1311-1314.
- 2017 American Academy of Otolaryngology – Head and Neck Surgery Clinical Practice Guideline by Schwartz, et al.

Board Questions: For Learners, For Moderators

Moderators:

Mam: Arifa | Mpm: Giselle
Tpm: Sam
Wpm: Giselle
Thpm: Michael
Fam: Sam | Fpm: Arifa

Resources:

- Video on Ear Candling: “Do Ear Candles Remove Ear Wax? Fact or Fiction.” https://www.youtube.com/watch?v=qvTU2HFquCQ
- Kidshealth information for parents about ear wax. http://kidshealth.org/en/parents/earwax.html 3.
- Nationwide Children’s Hospital handout for parents about ear wax. http://www.nationwidechildrens.org/ear-wax

Clinic Updates:

Please use the IMMUNIZATION TAB to order vaccines in EPIC (rather than typing them in the order). EPIC has some auto populating that is not always accurate.
Pentacel is out of stock, please use Vaxelis, or the invidiual components

Week 18 (10/28-11/1): Flouride Varnish (YW-69)

Objectives

Describe the benefits and indications for fluoride varnish.
Know the current recommendations for fluoride varnish (USPSTF, AAP).
Demonstrate the application of fluoride varnish.
Counsel families on varnish aftercare and caries prevention at home.

Primary References:

Moderators:

Mam: Lior | Mpm: Julia

Tam: Liesel | Tpm: Anajali A (Self Study)

Wam: Liesel | Wpm: Priya

Th: Happy Halloween!! no CCC

Fam: Samaa | Fpm: Samaa

Clinic Resources:

Smiles for Life, a national oral health curriculum. www.smilesforlifeoralhealth.org
Video demonstration of fluoride varnish application from Smiles for Life. www.youtube.com/watch?v=cV5OmL7C8K4
Online training course about fluoride varnish from Smiles for Life. www.smilesforlifeoralhealth.org/courses/caries-risk-assessment-fluoride-varnish-and-counseling
Mobile App from Smiles for Life https://www.smilesforlifeoralhealth.org/resources/android-ios-apps/
AAP Oral Health https://www.aap.org/en/patient-care/oral-health/

Week 17 (10/20-10/25: Children with Medical Complexity - Physical Examination, Medical Technology Care, and Decision Making (YW-73)

Describe important considerations in the physical exam for children with medical complexity (CMC)
Discuss medical technologies used by CMC and potential complications that may arise
Provide anticipatory guidance for families of CMC for preventative health and safety

Primary Reference(s):
- Glader L, Plews-Ogan J, Agrawal R. Children with medical complexity: creating a framework for care based on the International Classification of Functioning, Disability and Health. Dev Med Child Neurol. 2016;58(11): 1116-1123. https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.13201
- Kingsley EP. Welcome to Holland. Down Syndrome Association of Simcoe County. 1987. Retrieved April 29, 2021, from http://www.dsasc.ca/uploads/8/5/3/9/8539131/welcome_to_holland.pdf
Board Questions: none this week
Moderators:
- Mam: Anjali R | Mpm: Shield
- Tam: Nariman | Tpm: Sam
- Wam: Travis | Wpm: Travis
Resources:
- GeneReviews, resource for clinicians to help care for children with underlying genetic syndromes. https://www.ncbi.nlm.nih.gov/pubmed/20301295
- Educational module for additional practice in assessment of CMC. Huth K, Long-Gagne S, Mader J, Sbrocchi AM. Approach to clinical assessment of children with medical complexity. MedEdPORTAL. 2018;14:10765. https://www.mededportal.org/doi/10.15766/mep_2374-8265.10765

Week 16 (10/14-10/18): Children with Medical Complexity: Initial Assessment (YW-57)

Recognize characteristics of children with medical complexity (CMC)
Describe important considerations in the history for CMC
Recognize the importance of participation and quality of life for CMC at home and in the community

Primary Reference(s):
- Kuo DZ, Houtrow AJ, Council on Children with Disabilities. Recognition and Management of Medical Complexity. Pediatrics. 2016;138(6): e20163021.
- Sadof M, et al. The “HEADS AT” training tool for residents: A roadmap for caring for children with medical complexity. Clinical Pediatrics. 2015;54(12): 1210-1214. (Review Table 2 in preparation for this week.)
Board Questions: none this week
Moderators:
- Mam: Lior | Mpm: Bhagawan
- Tam: Connor | Tpm: Anjali (Self Study)
- Wam: Connor | Wpm: Camila
- Thpm: Arifa
- Fam: Lior | Fpm: Arifa
Resources:
- GeneReviews, resource for clinicians to help care for children with underlying genetic syndromes. https://www.ncbi.nlm.nih.gov/pubmed/20301295
- Educational module for additional practice in assessment of CMC. Huth K, Long-Gagne S, Mader J, Sbrocchi AM. Approach to clinical assessment of children with medical complexity. MedEdPORTAL. 2018;14:10765. https://www.mededportal.org/doi/10.15766/mep_2374-8265.10765
- Rosenbaum P, Gorter JW, Rosenbaum P. The “F-words” in childhood disability: I swear this is how we should think! Child: Care, Health and Development. Wiley Online Libr. 2011;38(4):457-463. doi:10.1111/j.1365-2214.2011.01338.x https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2214.2011.01338.x
Clinic Updates/Tips/Tools:

Week 15 (10/7-10/11) Feedback Sessions

Objectives:

Reflect on your performace in continuity clinic
Think of ways you can improve and what goals you want to set for yourself
Discuss this reflection and goals with the preceptor for 5+ minutes.

Resources

Week 14 (9/30-10/4): Climate Change (YW-50)

Objectives:
- Identify why climate change disproportionately affects infants and children, especially in the context of structural racism and discrimination.
- Link climate change to increasingly intense disasters and weather emergencies and list steps families can take to prepare.
- Describe why and how climate change affects youth mental health.
- Incorporate proactive and adaptive changes in pediatric practice to respond to climate change, support health for children and families, and maintain hope.
Primary Reference:
- Ahdoot S, et al. AAP Technical Report: Climate Change and Children’s Health: Building a Healthy Future for Every Child. Pediatrics. 2024;153(3): e2023065505.
- Focus on the Recommendations starting on page 80. Ahdoot, et al. AAP Policy Statement: Climate Change and Children’s Health: Building a Healthy Future for Every Child. Pediatrics. 2024;153(3): 75-85.
Board Questions: For Moderators, For Learners
Moderators:
- Mam: Shield | Mpm: Erum
- Tam: Katie | Tpm: Katie
- Wam: Leyden | Wpm: Erum
- Thpm: Leyden
- Fam: Niki | Fpm: Niki
Resources:
- Nevada Clinicians for Climate Action https://www.nvcliniciansforclimate.org/
- HealthyChildren.Org - How Climate Change Affects Children's Health
- Family disaster preparedness information provided in many languages. https://www.ready.gov/kids
- Climate information for families from the AAP. https://www.aap.org/en/patient-care/climate-change/
- Low Income Home Energy Assistance Program. https://www.benefits.gov/benefit/623
- U.S. Department of Health and Human Services Disaster Distress helpline. Call or Text 1-800-985- 5990; https://www.samhsa.gov/find-help/disaster-distress-helpline
- Program for doubling SNAP dollars at farmer’s markets. https://doubleupamerica.org/
- Pediatric Envronmental Health Specialty Units Webinars https://www.pehsu.net/webinars.html
Clinic Updates/Tips/Tools:

Week 13 (9/23-9/27): Hematuria & Proteinuria (YW-47)

Objectives:
- Know the current American Academy of Pediatrics recommendations for screening urinalysis
- Identify the most common causes of hematuria and proteinuria in the pediatric population
- Describe the diagnostic approaches used to evaluate hematuria and proteinuria
Primary Reference: Viteri B, et al. Hematuria and proteinuria in children. Pediatrics in Review. 2018;39(12): 573-587.
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Aasna | Mpm: Anjali A
- Tam: Aasna | Tpm: Anjali R
- Wam: Priya | Wpm: Chelsea (Self Study)
- Thpm: Priya
- Fpm: Julia
Resources:
- https://familydoctor.org/proteinuria-in-children/
- HealthyChildren.Org
Clinic Updates/Tips/Tools:
- We still have about ~100 Pediarix Doses (dtap-ipv-hep b) that expire 10/21/24. Please try to use this whenever possible so that we dont have to waste them.

Week 12 (9/16-9/20): Fatherhood (YW-67)

Primary References:
- Yogman M, Garfield CF, Committee on Psychosocial Aspects of Child and Family Health. Fathers’ Roles in the Care and Development of Their Children: The Role of Pediatricians. Pediatrics. 2016; 138(1): e20161128.
- Garfield CF. Supporting Fatherhood Before and After It Happens. Pediatrics. 2015;135: e528-e530.
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Julio | Mpm: Santiago
- Tam: Kaitlyn | Tpm: Julia
- Wam: Yash | Wpm: Mutual Discussion
- Thpm: Lior
- Fam: Yash | Fpm: Mutual Discussion
Resources:
- Information for parents from National Fatherhood Initiative. www.fatherhood.org
- Information for fathers from US Department of Health & Human Services. www.fatherhood.gov
- Step by Step: Engaging Fathers in Programs for Families. http://www.beststart.org/resources/howto/pdf/BSRC_Engaging_Fathers.pdf
- Resources for fathers. http://www.fathers.com
- Bootcamp for New Dads https://www.bootcampfornewdads.org/
  - UMC Healthy Living Institute https://www.umcsn.com/foundation-community-support/healthy-living-institute
- Paternal Postpartum Depression
  - https://ldchealth.org/DocumentCenter/View/3008/Paternal-Postpartum-Depression_final
Clinic Updates/Tips/Tools:
- We still have about 100 Pediarix Doses (dtap-ipv-hep b) that expire 10/21/24. Please try to use this whenever possible so that we dont have to waste them.
- We have about 5 or so RSV Vaccines left, hopefully a new order will be out soon as the season is coming.

Week 11 (9/9-9/13): Follow-up of Hospitalized Children (YW-91)

Primary Reference: Schmitz K. Vulnerable Child Syndrome. Pediatrics in Review. 2019;40(6): 313-315
Board Questions: none this week
Moderators:
- Mam: No clinic | Mpm: Anjali A
- Tam: Daun'lee | Tpm: Sravya
- Wam: Connor | Wpm: Chelsea (Self Study)
- Thpm: Camila
- Fam/pm: Chidelu
Resources:
- Medicare discharge planning checklist for patients and families. https://www.medicare.gov/Pubs/pdf/11376-discharge-planning-checklist.pdf
Clinic Updates/Tips/Tools:
- We still have about 100 Pediarix Doses (dtap-ipv-hep b) that expire 10/21/24. Please try to use this whenever possible so that we dont have to waste them.

Week 10 (9/3-9/66): Dysmorphology (Yale Week 32)

Delineate the full range of dysmorphic phenotypes and their associations with single gene, chromosomal, and multifactorial disorders, as well as inborn errors of metabolism
Develop a systematic approach to obtaining relevant history when there is concern for an underlying genetic condition
Recognize dysmorphic features on physical exam and determine if they warrant testing and referral

Primary References:

Board Questions: Questions at the end of the PIR article

Moderators:

Tam: Aasna | Tpm: Ola

Wam: Priyad | Wpm: Chelsea

Th: Liesel

Fam: Priyad | Fpm: Aasna

Resources:

Resources for Families:
- Family to Family Health information centers via Family Voices. https://familyvoices.org/felsc/whataref2fs/
- Children and Youth with Special Healthcare Needs National Research Network. https://cyshcnet.org/
- Healthychildren.org Handout about non-medical needs for families.
Resources for Clinicians in Assessing for Dysmorphology:
- High yield journal articles – Many of the references listed above (in the Yale Case) are excellent background reading suitable for primary care clinicians. Focus especially on Scott and Trotter (2013) and Solomon and Muenke (2012).
- National Institute of Health Elements of Morphology, glossary of common dysmorphology terminology, organized by body area with representative pictures. www.elementsofmorphology.nih.gov
- Smith’s Recognizable Patterns of Human Malformation, definitive textbook on dysmorphology.
- Handbook of Physical Measurements, comprehensive textbook with a companion digital app, outlines an objective approach to assessing for dysmorphology.
- American College of Medical Genetics and Genomics (ACMG) ACT Sheets and Algorithms. www.ncbi.nlm.nih.gov/books/NBK55827

Week 9 (8/26-8/30): Abnormal Head Size & Shape (YW-24)

Review normal skull anatomy and head growth
Distinguish between positional plagiocephaly and craniosynostosis
Describe the prevention and treatment of plagiocephaly
Understand the evaluation and treatment of craniosynostosis
Describe the diagnosis and evaluation of macrocephaly
Primary References:
- Dias MS, et al. Identifying the Misshapen Head: Craniosynostosis and Related Disorders. Pediatrics. 2020;146(3):e2020015511. https://pediatrics.aappublications.org/content/146/3/e2020015511
- Laughlin JL, et al. Prevention and management of positional skull deformities in infants. Pediatrics. 2011;128: 1236-1241. http://pediatrics.aappublications.org/content/128/6/1236.full.pdf+html
Moderators: *I have adjusted the schedule to reflect that residents are in clinic multiple times per week*
- - Mpm: Lior
  - Tpm: Julio (Kaitlyn supports)
  - Wam: Michael (Self-Study)| Wpm: Santiago
  - Thpm: Chelsea (Self-study)
  - Fpm: Katie
Board Questions: For Learners, For Moderators
Resources:
- - Handout on craniosynostosis Seattle Children’s Hospital. https://www.seattlechildrens.org/pdf/pe393.pdf
  - Handout on Craniosynostosis Children’s Health. Queensland https://www.childrens.health.qld.gov.au/fact-sheet-craniosynostosis/
  - Handout on plagiocephaly from American Physical Therapy Association https://pediatricapta.org/includes/fact-sheets/pdfs/Plagiocephaly.pdf
  - Handout on plagiocephaly Seattle Children’s Hospital. https://www.seattlechildrens.org/globalassets/documents/for-patients-and-families/pfe/pe2638.pdf
  - A Clinician's Guide to Positional Plagiocephaly from British Columbia Children’s Hospital http://www.bcchildrens.ca/neurosciencessite/Documents/BCCH034PlagiocephalyCliniciansGuideWeb1.pdf
Clinic Updates/Tips:
- - Flu Vaccines are almost ready to be administered. Please let families know.

Week 8 (8/19-8/23): School Readiness & Failure (YW-113)

Learning Objectives
- Recognize the importance of early childhood environment as it relates to successful school entry
- Identify key indicators of school readiness
- Describe causes of school failure and outline an assessment strategy
- Recognize the pediatrician’s role in helping parents get their children ready for school and in helping those who are having difficulty
Primary Reference:
- Rey-Casserly, Committee on Psychosocial Aspects of Child and Family Health, Section on Developmental and Behavioral Pediatrics. School-aged Children Who Are Not Progressing Academically: Considerations for Pediatricians. Pediatrics. 2019;144(4): e20192520.
- Williams PG, Lerner MA, Council on Early Childhood, Council on School Health. School Readiness. Pediatrics. 2019;144(2): e20191766.
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Yash (also teach Travis how to moderate) | Mpm: Sam
- Tpm: Kaitlyn
- Wam: Nariman | Wpm: Yash
- Thpm: Travis
- Fam: Nariman | Fpm: Sam
Resources:
- Guide to the Individualized Education Program. http://www.ed.gov/parents/needs/speced/iepguide/iepguide.pdf
- The National Early Childhood Technical Assistance Center. https://ectacenter.org/
- American Speech-Language-Hearing Association handouts for parents. http://www.asha.org/public/speech/development/Parent-Stim-Activities.htm
- Office of Head Start. https://eclkc.ohs.acf.hhs.gov/about-us/article/office-head-start-ohs
- School readiness handout from AAP-HealthyChildren.org.
- IEP Defenders - Local Education Law Firm
Clinic Updates/Tips/Tools:
- We have over 100 doses of pediarix (dtap, hep b, ipv) from vfc that will expire 10/17/2024, please try to prioritize this vaccine when possible.

Week 7 (8/12-8/16): Common Newborn Concerns (YW-80)

Understand the role of the prenatal visit in establishing a medical home
Describe normal newborn movements and habits
Understand the timing of and risks for shaken baby syndrome, and outline anticipatory guidance that may be preventive
Emphasize the importance of secure attachment of the child and parents early in life
Identify the most common benign newborn rashes and delineate appropriate guidance

Primary Reference(s): Peds in Review - Care of the Well Newborn
Board Questions: For Learners, For Moderators
Moderators:
- Mpm: Lior
- Tpm: Michael
- Wpm: Erum
- Tpm: Samaa
- Fam: Yash | Fpm: Arifa
Resources:
- Handout from JAMA for parents about newborn care.
  - http://jama.jamanetwork.com/article.aspx?articleid=191813
- General information regarding infant care.
  - www.mayoclinic.com/health/healthy-baby/FL99999
- Period of Purple Crying.
  - www.purplecrying.info
- Stanford Newborn Nursery Photo Gallery: Skin.
  - https://med.stanford.edu/newborns/professional-education/photo-gallery/skin.html
Clinic Updates/Tips/Tools:

Week 6 (8/5-8/9): Common Newborn Skin Findings (YW-107)

Learning Objectives:
- Identify and manage common newborn dermatologic diagnoses
- Explain newborn skin findings to families and colleagues
- Use proper dermatologic descriptive language when describing skin lesions
Primary Reference: . Goodarzi H, Wu TT, Wang J, Teng JM. Neonatal Dermatology: The Normal, the Common, and the Serious. NeoReviews. 2021;22(1): e40-e51. PDF Version
Board Questions: For Learners, For Moderators
Moderators:
- Mpm: Lior
- Tpm: Kaitlyn
- Wam: Nariman | Wpm: Camila
- Thpm: Sam
- Fam: Nariman | Fpm: Sam
Resources:
- Online handbook about black and brown skin. https://www.blackandbrownskin.co.uk/mindthegap
- Photos and descriptions of skin findings in newborns. https://med.stanford.edu/newborns/professional-education/photo-gallery.html
- PIR article with additional photos. https://doi.org/10.1542/pir.2022-005726
Clinic Updates/Tips/Tools:
- Clinic Circumcisions are on hold for now. Please refer out to Urology if parents are interested.

Wk 5 (7/29 - 8/2): High Value Care (YW-80)

Learning Objectives:
- Understand the definition of value in health care.
- Identify barriers to high value care in the primary care setting.
- Utilize strategies to evaluate potential care plans based on best practices and to communicate these to patients and families
Primary Reference(s): Owens D, et al. High-Value, Cost-conscious Health Care: Concepts for Clinicians to Evaluate the Benefits, Harms, and Costs of Medical Interventions. Ann Int Med. 2011;154(3): 174-180
Moderators:
- Mam: Connor (self study) | Mpm: Chelsea
- Tam: Daun'lee | Tpm: Yash
- Wam: Liesel (self study) | Wpm: Katie P
- Th: Chelsea
- Fam: Yash | Fpm: Katie P
Board Questions: none, but coming soon in future CCC's!
Clinical Resources:
- Choosing Wisely list of high-value care suggestions from American Academy of Pediatrics. https://www.aap.org/en/news-room/campaigns-and-toolkits/choosing-wisely/
- Lown Institute spearheads research on high-value care (http://lowninstitute.org) through its
  - RightCare Alliance. http://rightcarealliance.org
- Tufts Cost Effectiveness Registry. http://healtheconomics.tuftsmedicalcenter.org/cear4/Home.aspx
- ICER Fundamentals - https://icer.org/our-approach/methods-process/value-assessment-framework/
- Clearinghouses for various types of health care costs:
  - CDC vaccine costs. https://www.cdc.gov/vaccines-for-children/php/awardees/current-cdc-vaccine-price-list.html
  - Costs of various medical interventions. https://www.healthcarebluebook.com/page_Default.aspx
  - Cost of asthma PEM visit. https://www.cdc.gov/pcd/issues/2014/14_0139.htm
CLINIC UPDATE:
- We have expiring Pediarix (dtap-ipv-hepb) and Pentacel (dtap-ipv-hib); please use these whenever possible.

Week 4 (7/24 - 728): Health Literacy: Closing the Gap (YW-75)

Learning Objectives
- Define health literacy and understand its clinical importance
- Identify signs of suboptimal health literacy
- Learn how to assess patients’ health literacy in the office
- Practice methods for addressing poor health literacy, including the “Teach Back Method”
Primary References: Bass PF. 3 steps to boost health literacy. Contemporary Pediatrics. 2018. Retrieved April 28, 2022
- AAP - Addressing Low Health Literacy and Limited English Proficiency (LEP)
Board Questions: None
Moderators:
- Mam: Chidelu | Mpm: Michael
- Tam: Julia | Tpm: Chidelu
- Wam: Liesel (self study) | Wpm: Shield
- Thpm: Arifa
- Fam: Anjali R | Fpm: Aasna (self study)
Resources:
- CDC - What is Health Literacy
- Our collection of Health Handouts & Website for Parents
- The Newest Vital Sign Toolkit for providers. https://www.pfizer.com/health/literacy
- Pictograms of >75 commonly used prescriptions. (TIP: You can copy and paste these into your AVS!)
  - http://www.usp.org/health-quality-safety/usp-pictograms
- Health Literacy Universal Precautions Toolkit from AHRQ. https://www.ahrq.gov/health-literacy/improve/precautions/index.html
- Searchable database of patient handouts in multiple languages. www.healthfinder.gov
- Online readability calculator which provides commonly used readability scores, including grade level.
  - http://www.readabilityformulas.com/free-readability-formula-tests.php
Clinic Updates/Tips/Tools:

Week 3 (7/17-7/21): Agenda Setting (YW 4)

Primary References:
- Baker LH, O’Connell D, Platt FW. Setting the agenda for the clinical interview. Annals of Internal Medicine. 2005;143(10): 766-70.
Board Questions: None
Moderators:
- Mpm: Lior
- Tam: Daun'lee | Tpm: Nariman
- Wam: Daun'lee | Wpm: Katie
- Thpm: Connor
- Fam: Kaitlyn | Fpm: Katie
Resources:
- Institute for Family Centered Care. http://www.familycenteredcare.org/
- American Academy of Communication in Healthcare. http://www.aachonline.org/
- Bright Futures Educational Resources. https://www.aap.org/en/practice-management/bright-futures/bright-futures-in-clinical-practice/bright-futures-educational-resources/
Clinic Updates/Tips/Tools:
- 5-STEP PATIENT-CENTERED BEGINNING OF INTERVIEW

Clinic Updates:

Week 1-2 (7/1-7/12): Clinic Adjustment

Goals for the 2 weeks:
- Make sure your logins work
- Install and Explore Haiku
- Share EPIC tips and tricks with each other, create a smart phrase, customize your EPIC tabs, make a macro!
  - https://docs.google.com/document/d/1rDPVDHPNtTsP84n8oMmTuxVEShPpdGZM/edit?usp=sharing&ouid=108883666646567718290&rtpof=true&sd=true
- Explore EPIC, especially the screening tabs
- Discuss billing tips with colleagues and attendings:
  - https://www.contemporarypediatrics.com/view/2021-evaluation-and-management-coding-update
Board Questions: None this week!
Moderators: Everyone
Clinic Updates:

Yale Primary Care Pediatrics Curriculum (CLICK HERE!)

learner pin 87166 | moderator pin 894247

(please ask a co-resident or attending for the appropriate user name)

CCC Protocol

Starts promptly at:
- 8:00 AM Daily (except on days when there is Clinic Morning Report and Critical Care conference)
- 1:00 PM on Mondays, Wednesdays & Fridays
- 1:15 PM on Tuesdays & Thursdays (due to didactics/conferences)
Learners are expected to have read the curriculum and thought about the learning objectives and questions.
- Residents who may miss the session due to a holiday, nights, or rotations without clinic should still review the material.
Repeat tardiness and lack of preparation are subject to professionalism demerits.
The Goal for the session is to last 20-30 minutes. Time is protected for 30 minutes for all continuity clinic residents.
- A patient may be booked and roomed before the session is over but please try to complete as much of the session as possible.
Delinquencies are acceptable for patient-care-related reasons from your rotation but frequent delinquencies will be reported to chief resident and/or program director, deducted from professionalism scorecard and are required to be documented in evaluation.
Residents on their monthly clinic rotation need only be present for the teaching session during their regular continuity clinic time and can complete independent study or patient-care related activities during all other teaching sessions.
Yale Curriculum website: pcpc.yale.edu (YW = Yale Week on the schedule above)
- learner pin 87166 | moderator pin 894247 (please ask a co-resident or attending for the appropriate user name)
- This curriculum was developed at Yale's School of Medicine and uses adult learning methods to maximize the value of time spent learning about core topics in outpatient pediatrics. Advance preparation minimizes the amount of didactic information to be covered during conference and enable vigorous discussion of the questions posed in the case studies.

Protocol Updates:

PRE-Session:
- Learners: Please read the Assigned Primary References, Learner Module Cases, Board Questions
- Moderators: Please read the Assigned Primary References, Moderator version of Modules, Board Questions & Answers, ask Faculty for any presentation tips or clarification. Dr. Simangan will send you a text to remind you of when you will be moderating. Please let him know as soon as possible if there are any issues, OR resources you would like to share with the group.
- Faculty: Please read the Assigned Primary References, Moderator version of Modules, Board Questions & Answers
CCC-Session:
- Learners: Please come ON TIME and be ready to discuss the material
- Moderators: Please start with Board Questions (if applicable) while people are arriving then switch to the Yale Module once a majority of residents have arrived, then return to Board Questions if time permits. Please DO NOT have the Moderator versions (Yale and Board Questions) on the on the screen unless there is a relevant table or diagram.
- Faculty: Please interject the discussion with any personal anecdotes, practice experience & wisdom. Also please help with time management and watching the patient schedule. Lastly, try emphasize test taking strategies during the board review.
POST-Session
- Learners: Review the Board Questions Answers of those not covered in the session.
- Moderators: Seek feedback afterwards from residents and faculty
- Faculty: Please provide feedback to the moderating residents, and make note of any tardiness, poor preparation and any standout residents.

*We will do our best to make sure that the role of moderator is equally assigned, however this depends on how many residents are in your session for that block. If you feel there is a discrepancy, let us know and we can make corrections, thanks!*

FASD CURRICULUM ARCHIVE

Wk 32 (2/6-2/10): Fetal Alcohol Spectrum Disorder AAP Curriculum - Wk 4

CCC: Please Complete the Following (before or during the CCC session), and email the document and/or screenshot to Dr. Simangan and Dr. VIlai
Board Questions: None
Moderators: Attendings
Clinic/Practice Application
- Ask your MA or Domonique for any updates on tests/vaccines.

Wk 31 (1/30-2/3): Fetal Alcohol Spectrum Disorder AAP Curriculum - Wk 3

CCC: FASD Video 3: Common Presenting Concerns in Children with Prenatal Alcohol Exposure
- Case 3: 11 Year old Male (Anticipatory guidance for family)
Board Questions: None
Moderators: Attendings
Applicable Policies and Guidelines
- Review the Clinical Report: Families Affected by Parental Substance use
Clinic/Practice Application
- Record self (and/or practice with a college) a mock interview with birth mother regarding birth history and prenatal exposures.

Wk 30 (1/16-20): Fetal Alcohol Spectrum Disorder AAP Curriculum - Wk 2

CCC: FASD Video 2: Overcoming Social Attitudes and Women with Substance Use Disorders
- Case 2: 8 year old male (care coordination with school)
Board Questions: None
Moderators: Attendings
Applicable Policies and Guidelines
- Review the differential diagnosis tables in the article Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure
Clinic/Practice Application
- Review protocol at your clinic for documenting birth history and prenatal exposures.

Wk 29 (1/16-20): Fetal Alcohol Spectrum Disorder AAP Curriculum - Wk 1

For this block and we will do a 4 week course from the AAP on FASD. Please have the pretest DONE before coming to clinic. In clinic we will be watching FASD videos and if time permits we can cover some cases and resources. If you are on nights/wards and have no continuity clinic, you may still participate if you want your name in for the prize raffle (Eko Stethoscopes).

Pre Clinic: PRETEST
CCC: FASD Video 1: Effects and Prevalence of Prenatal Alcohol Exposure
- Case 1: 3-year-old male (screening for prenatal alcohol exposure)
Board Questions: None
Moderators: Attendings
Applicable Policies and Guidelines
- Clinical Report: Fetal Alcohol Spectrum Disorders
- Clinical Report: The Role of Integrated Care in a Medical Home for Patients With FASDs
Clinic/Practice Application
- AAP's FASD Toolkit: Behavioral Interventions in Fetal Alcohol Spectrum Disorders

2023-2024 Archive

Week 1-2 (7/3-7/14): Clinic Adjustment

Goals for the 2 weeks:
- Share EPIC tips and tricks with each other, create a smart phrase, customize your EPIC tabs
  - https://docs.google.com/document/d/1rDPVDHPNtTsP84n8oMmTuxVEShPpdGZM/edit?usp=sharing&ouid=108883666646567718290&rtpof=true&sd=true
- Discuss billing with colleagues and attendings:
  - https://www.contemporarypediatrics.com/view/2021-evaluation-and-management-coding-update
Board Questions: None this week!
Moderators: Everyone
Clinic Updates
- OUT of some Private Vaccines - Check with your MA
- OUT of flu shots, they will likely be back around September

Week 3 (7/17-7/21): Agenda Setting (YW 4)

Primary References:
- Baker LH, O’Connell D, Platt FW. Setting the agenda for the clinical interview. Annals of Internal Medicine. 2005;143(10): 766-70.
- Bright Futures: Agenda Setting Presentation (Script for Presentation)
Board Questions: None
Moderators:
- Chelsea, Lior, Misha, Sheild, Yemi
- (Wednesday and Friday are repeated residents with small numbers; Jessica and Michael you can read the topic on your own and/or discuss with any attendings)
Resources:
- Institute for Family Centered Care. http://www.familycenteredcare.org/
- American Academy of Communication in Healthcare. http://www.aachonline.org/
- Bright Futures Educational Resources. https://www.aap.org/en/practice-management/bright-futures/bright-futures-in-clinical-practice/bright-futures-educational-resources/
Clinic Updates/Tips/Tools:
- 5-STEP PATIENT-CENTERED BEGINNING OF INTERVIEW

Clinic Updates
- PRIVATE covers MMRV now!
- Always check with your MA for updates on vaccines and testing in stock.
- Out of EXTRA Newborn Screening Forms

Week 4 (7/24 - 728): Health Literacy: Closing the Gap (YW-75)

Primary References: Bass PF. 3 steps to boost health literacy. Contemporary Pediatrics. 2018. Retrieved April 28, 2022
Board Questions: None
Moderators:
- M: Kaitlyn T: Daun'lee W: Th: Valeria F:
Resources:
- Our collection of Health Handouts & Website for Parents
- The Newest Vital Sign Toolkit for providers. https://www.pfizer.com/health/literacy
- Pictograms of >75 commonly used prescriptions. (TIP: You can copy and paste these into your AVS!)
  - http://www.usp.org/health-quality-safety/usp-pictograms
- Health Literacy Universal Precautions Toolkit from AHRQ. http://www.ahrq.gov/qual/literacy/
- Searchable database of patient handouts in multiple languages. www.healthfinder.gov
- Online readability calculator which provides commonly used readability scores, including grade level.
  - http://www.readabilityformulas.com/free-readability-formula-tests.php
Clinic Updates/Tips/Tools:
- Out of Rota for Private

Wk 5 (7/31 - 8/4): High Value Care (YW-80)

Primary Reference(s): Owens D, et al. High-Value, Cost-conscious Health Care: Concepts for Clinicians to Evaluate the Benefits, Harms, and Costs of Medical Interventions. Ann Int Med. 2011;154(3): 174-180
Moderators: M: Yash T: Tim W: Nikki Th: Briana F: Anjali
Board Questions: none
Clinical Resources:
- Choosing Wisely list of high-value care suggestions from American Academy of Pediatrics. http://www.choosingwisely.org/societies/american-academy-of-pediatrics/
- Lown Institute spearheads research on high-value care (http://lowninstitute.org) through its RightCare Alliance. http://rightcarealliance.org
- Tufts Cost Effectiveness Registry. http://healtheconomics.tuftsmedicalcenter.org/cear4/Home.aspx
- ICER Fundamentals - https://icer.org/our-approach/methods-process/value-assessmentframework/
- Clearinghouses for various types of health care costs:
  - CDC vaccine costs. https://www.cdc.gov/vaccines/programs/vfc/awardees/vaccinemanagement/price-list/index.html
  - Costs of various medical interventions. https://www.healthcarebluebook.com/page_Default.aspx
  - Cost of asthma ED visit. https://www.cdc.gov/pcd/issues/2014/14_0139.htm
CLINIC UPDATE:
- Check for any out of stock vaccines or tests on the workroom board!
- You will find the vision/hearing results in the screening tab when you click the paper to the right. I have highlighted that portion in red. Per Kristina the information will automatically populate in the provider's note when the (.hearing) is used.

Wk 6 (8/7 - 8/11): Child Care (YW-61)

Primary Reference(s):
- Bradley RH, Vandell DL. Child care and the well-being of children. Arch Pediatr Adolesc Med. 2007;161(7):669-676. http://archpedi.jamanetwork.com/article.aspx?articleid=570794
- Shope TR. Infectious diseases in early education and child care programs. Pediatrics in Review. 2014; 35(5): 182-193.
Moderators: M: Erum T: Lior W: Chelsea Th: Lauren F: Michael
Board Questions: none
Clinical Resources:
- Nevada 2-1-1 https://www.nevada211.org/children-services/
- Nevada Child Care Resources https://childcare.gov/state-resources/nevada
- Useful websites for choosing a quality child care center: Child Care Aware: 1-800-424-2246, www.childcareaware.org
- Information on accreditation:
  - National Association for the Education of Young Children (NAEYC) www.naeyc.org
  - National Accreditation Commission for Early Care and Education Programs (NAC) https://www.earlylearningleaders.org/accreditation/accreditation-overview/
  - National Association of Family Child Care (NAFCC) http://www.nafcc.org/
CLINIC UPDATE:
- Check for any out of stock vaccines or tests on the workroom board!
- PCV15 has a temporary recall, continue with PCV13 for now.

Wk 7 (8/14 - 8/18): Injury Prevention (YW-5)

Primary Reference(s):
- Judy K. Unintentional injuries in pediatrics. Pediatrics in Review. 2011;32(10): 431-8. http://pedsinreview.aappublications.org/content/32/10/431.full.pdf
- Gardner HG, Committee on Injury, Violence, and Poison Prevention. Office-based counseling for unintentional injury prevention. Pediatrics. 2007;119: 202-6. https://publications.aap.org/pediatrics/article/119/1/202/70710/Office-Based-Counseling-for-Unintentional-Injury
Moderators: M: Steven T: Joshua W: Valeria Th: Sam F: Najima
Board Questions: none
Clinical Resources:
- Handouts for families from the AAP’s “The Injury Prevention Program” (TIPP). https://publications.aap.org/patiented/pages/c_tipp
- The National Action Plan for Child Injury Prevention from CDC. http://www.cdc.gov/safechild/nap
- Information for parents and providers from CDC Safe Child program. http://www.cdc.gov/safechild/resources/index.html
- Fatal and non-fatal injury statistics for providers from CDC. http://www.cdc.gov/injury/wisqars/index.html
- Injury prevention material for parents and providers from Safe Kids, USA. http://www.safekids.org
- Post-injury resources for parents and providers. http://www.aftertheinjury.org
- Bright Futures section on Promoting Safety and Injury Prevention. http://brightfutures.aap.org/pdfs/Guidelines_PDF/10-Promoting_Safety_and_Injury_Prevention.pdf
- WHO worldwide statistics on injury. https://www.who.int/news-room/fact-sheets/detail/injuries-and-violence
- Non-fiction book for providers and families.
  - Hemenway, D. While We Were Sleeping: Success stories in injury and violence prevention. University of California Press: Berkeley; 2009.
CLINIC UPDATE:
- Check for any out of stock vaccines or tests on the workroom board!

Wk 8 (8/21 - 8/25): The Difficult Encounter (YW-64)

Primary Reference(s):
- Asnes AG, Shenoy A. The difficult pediatric encounter: insights and strategies for the pediatric practitioner. Pediatrics in Review. 2008; 29(6): e35-e41
Moderators: M: Yash T: Tim W: Chelsea Th: Yemi F: Michael
Board Questions: none
Clinical Resources:
- Search tool for state-specific information regarding child welfare. http://www.childwelfare.gov/systemwide/laws_policies/state/index.cfm
CLINIC UPDATE:
- New Printers have been installed, let an attending know if you need help setting it up.
  - Resident workroom printer by the door prn2723
  - Resident workroom printer by the attendings prn2717
- Dr. LaFredo can now staff patients with Molina Medicaid insurance! (she can also see Silver Summit & Straight Medicaid)
- Check for any out of stock vaccines or tests on the workroom board!

Week 9 (8/28-9/1): Identification of the Sick Child (YW-49)

Primary Reference: Buntinx F, et al. Dealing with low-incidence serious diseases in general practice. British Journal of General Practice. 2011;61: 43-6.
Board Questions: For Learners, For Moderators
Moderators: M: Kaitlyn T: Daun'lee W: Nicole A Th: Briana F: Julia/Lauren
Clinic Updates:
- - Dr. LaFredo can now see United Healthcare (Commercial), in addtion to: Molina, Straight Medicaid, Silver Summit, Self Pay
  - Please feel free to hand out the back to school backpacks for well checks made by coordinator Terri!
Clinic Tools:

Week 10 (9/7 - 9/10): Rhinorrhea & Congestion (YW-111)

Primary Reference(s):
- Gargiulo KA, Spector ND. Stuffy Nose. Pediatrics in Review. 2010;31: 320-324
- DeMuri GP, Wald ER. Acute Bacterial Sinusitis in Children. Pediatrics in Review. 2013;34: 429-437
Board Questions: Learners, Moderators
Primary Moderators: M: HOLIDAY T: Nicole P W: Jessica Th: Shield F: Misha
Resources:
- DX & Management of Acute Bacterial Sinusitis: 2013 AAP Guideline
- Healthy Children Guidelines for Referral to Pediatric Surgical Specialists. http://www.healthychildren.org/English/family-life/health-management/Pages/Guidelines-forReferral-to-Pediatric-Surgical-Specialists.aspx
- Healthy Children information on Ear Nose and Throat conditions – includes parent information on colds, allergic rhinitis, and sinusitis. www.healthychildren.org/English/healthissues/conditions/ear-nose-throat/Pages/default.aspx
Clinic Updates/Tips/Tools:
- WE HAVE FLU SHOTS FOR VFC and PRIVATE! 2023-2024 CDC Flu Vaccine Guidelines
- Gripa/Gripe is a Spanish term that can mean rhinorrhea, a cold, or flu. Gripador means stapler.

Wk 11 (9/11-9/15): Fever in Children Less than 36 Months (YW-68)

Primary Reference(s):
- Hamilton JL, Evans SG, Bakshi M. Management of Fever in Infants and Young Children. American Family Physician. 2020;101(12): 721-729.
- AAP Pediatrics Eval & Management of Well Appearing Febrile Infants 8-60 days old AUGUST 2021
Moderators: M: Katie T: Lior W: Jessica Th: Valeria F: Samaa
- Supportive Moderators: Erum (M), Michael (F)
Board Questions: For Learners, For Moderators Only
Clinical Resources/Tools:
- Flu Vaccines are IN!
- Fever information for parents from AAP. http://www.healthychildren.org/English/healthissues/conditions/fever/pages/Fever-Without-Fear.aspx
- Mayo Clinic fever handout for parents. http://www.mayoclinic.com/health/fever/ID00052
- PECARN Fever Tool. https://www.mdcalc.com/calc/10204/pecarn-rule-low-risk-febrile-infants-29-60-days-old
- Seattle Children's Fever Pathway https://www.seattlechildrens.org/globalassets/documents/healthcare-professionals/clinical-standard-work/Neonatal-fever-org-pathway.pdf

Week 12 (9/18 - 9/22): Health Supervision (YW-1)

Primary Reference(s):
Board Questions: Learners Moderators
Moderators: M: Anjali (Yash supports) T: Santiago (Daun'lee supports) W: Anjali Th: Yash F: Najima
Resources:
- Nevada DHHS Healthy Kids Program
- Bright Futures: https://brightfutures.aap.org
- USPSTF guidelines. http://www.uspreventiveservicestaskforce.org
- USPTF Summary of recommendations pertaining to children and adolescents http://www.uspreventiveservicestaskforce.org/BrowseRec/Index?age=Pediatric,Adolescent
- AAP periodicity schedule. https://www.aap.org/periodicityschedule
- Bright Futures Books: Pocket Guide, Parent Guides
- CDC: Learn the Signs. Act Early https://www.cdc.gov/ncbddd/actearly/index.html
Clinic Reminders:
- We have the flu shot for both VFC and Private, make sure to ask at all visits (some MAs may write in the rooming tab if the family is/is not interested in it)
- Billing Tip, for all Well Child Checks with Medicaid (Silver Summit, Molina, Straight Medicaid, HPN, etc) use the EP modifier (no referral made) OR the TS modifier when "to indicate a referral to a specialist as a result of an EPSDT/well-baby/well-child exam"

Week 13 (9/25 - 9/29): Otitis Media & Externa (YW-88)

Primary Reference(s):
Board Questions: For Learners, For Moderators
Primary Moderators: M: Kaitlyn T: Attending W: Sam Th: Yemi F: Misha
Resources:
- - AAFP Patient Information page. http://www.aafp.org/afp/2007/1201/p1659.html
  - Healthy Children AAP Patient Information page.
  - Mayo Clinic Patient Information page. http://www.mayoclinic.com/health/ear-infections/DS00303
Clinic Updates/Tips/Tools:
- - New Autism DX and Referral Protocol:
    1. Consult the Pediatric Access Line https://center4cs.org/pal-members/dashboard/
    2. The PAL Team will discuss the case with you and provide recommendations the same as they would for any patient with a behavioral health issue.
    3. If they agree that ABA may be useful, they will arrange and complete a CARS (Childhood Autism Rating Scale) with the family.
    4. The PAL Psychiatrist will complete the FA 11 form and send it to the requesting/attending Pediatrician and Trini, along with the consult note.
    5. When you receive this then we will write the referral for ABA and send it to Trini. She will then have the documentation she needs to complete the referral successfully.

Week 14 (10/2 - 10/6): Lymphadenopathy (YW-52)

Primary Reference(s): Sahai S. Lymphadenopathy. Pediatrics in Review. 2013;34: 216-227. https://doi.org/10.1542/pir.34-5-216
Board Questions: For Learners, For Moderators
Moderators: M: T: W: Chelsea Th: Connor F: Camila (Chidelu helps)
Resources:
- Patient information on lymphadenopathy from Mayo Clinic. http://www.mayoclinic.org/diseasesconditions/swollen-lymph-nodes/basics/definition/con-20029652
Clinic Updates/Tips/Tools:
- Flu Shots are available for private and Medicaid insurances, please don't forget to ask at each visit.

Week 15 (10/9-10/13): Vision Screening (YW-132)

Primary Reference(s): Loh AR, Chiang MF. Pediatric vision screening. Pediatrics in Review. 2018;39(5): 225-233
Board Questions: For Learners, For Moderators
Moderators: M: Pair Discussion T: Nikki W: Camila (Jessica Supports) Th: Arifa (Najima Supports) F: Samaa
Resources:
- Diagrams of cover-uncover test and alternating cover test in Figures 6&7 of Rogers & Jordan, Pediatrics in Review, 2013. http://pedsinreview.aappublications.org/content/34/3/126.full.pdf+htm
- AAO: Pediatric Eye Evaluations
- Spot Vision Screener Conversion Chart
Clinic Updates/Tips/Tools:
- PCV13 is OUT, use PCV15 from now on!
- Lead is currently OUT! Please make a note that it should be checked at the patient's next visit.
- Remember that the Vision screening results is under the Screening tab -> Hearing/Vision Screening then click the little page as shown below

Week 16 (10/16-10/20): Constipation (YW-43)

Primary Reference(s): LeLeiko NS, Mayer-Brown S, Cerezo C, Plante W. Constipation. Pediatrics in Review. 2020;41(8): 379- 392
Board Questions: For Learners, For Moderators
Moderators: M: Pair Discussion T(pm): Tim W: Daun'lee Th: Nariman (Misha supports) F: Chidelu (Michael supports)
Resources:
Clinic Updates/Tips:
- PCV15 for VFC and PCV20 for Private, Still out of Lead

Week 17-18 (10/23-11/3): Continuity Clinic Feedback Weeks

This week for Continuity Clinic Curriculum, residents and precepting attendings are having face to face feedback sessions about their Contuity Clinic progress and discussing ways to improve.
Primary Reference: Improving Feedback Exchanges with Residents: Can You Hear Me Now? NEJM Resident 360
Moderators: Attendings
Resources:
- R2C2 Feedback Resources
- Prepare to ADAPT Feedback Resources
Clinic Updates/Tips:
- PCV15 for VFC and PCV20 for Private, Still out of Lead (make sure to comment in your note to get it done at the next visit)

Week 17 (11/6-11/10): Urinary Tract Infections (YW-135)

Primary Reference(s): Mattoo TK, Shaikh N, Nelson CP. Contemporary Management of Urinary Tract Infections in Children. Pediatrics. 2021;147(2): e2020012138.
Board Questions: For Learners, For Moderators
Moderators: M: Joshua T: Self Study W: Anjali R. Th: Steven F: HOLIDAY
Resources:
- UTICalc for children 2-23 months of age, online tool to estimate probability of UTI. https://uticalc.pitt.edu
- Information from the National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-tract-infections-inchildren/treatment
- Patient information on VUR. https://www.niddk.nih.gov/health-information/urologicdiseases/hydronephrosis-newborns/vesicoureteral-reflux
- Pediatrics 2016: Reaffirmation of AAP Clinical Practice Guideline: The Diagnosis and Management of the Initial Urinary Tract Infection in Febrile Infants and Young Children 2–24 Months of Age
- Pediatrics 2021: Contemporary Management of UTI
- AAP News & Journal Post 2021: A Clinical Practice Literature Review of Pediatric UTIs
Clinic Updates & Tips:
- PCV 15 for VFC and PCV 20 for Private Insurances (we are done with PCV13)

Week 18 (11/13-11/7): Asthma (YW-93)

Moderators: M: Shield Tpm: Julia W: Self Study Th: Katie F: Chidelu
Primary Reference(s): *keep in mind the specific sections*
- Patel SJ, Teach SJ. Asthma. Pediatrics in Review. 2019;40(11): 549-564. (Read pages 549-553 and review figure 2, recognizing that treatment recommendations have been updated in the following references.)
- NHLBI, National Asthma Education and Prevention Program. Expert panel report 3 (EPR-3): guidelines for the diagnosis and management of asthma - summary report 2007. J Allergy Clin Immunol. 2007;120: S94-138. (Figures 11-16 reinforce pertinent topics/information for this conference.)
- Expert Panel Working Group of the NHLBI. 2020 focused updates to the asthma management guidelines: a report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol. 2020;146: 1217-1270. (Read figures 2-4 which have the pertinent updates on the approach to asthma treatment - pages 15-20 of the PDF)
- NIH - Avoiding RSV in infancy reduces asthma risk - May 2023
Board Questions: For Learners, For Moderators
Resources:
- Respiratory Inhalers at a Glance Poster
- Asthma information for providers, including PDA resources and asthma action plans (English and Spanish). http://www.nhlbi.nih.gov/health/prof/lung/index.htm
- Asthma information for patients and families. http://www.nhlbi.nih.gov/health/public/lung/index.htm
- Asthma Control Test and Childhood Asthma Control Test. http://www.asthmacontroltest.com/
Clinic Updates/Tips/Tools:
- Please remember to screen for Food Insecurity for children 0-3 and document in the Screenings tab, thanks!
- The NEW RSV VACCINE Nirsevimab (Beyfortus) will be available in clinic soon - for VFC only! Read the AAP Site for more info

Week 19-20 (11/20-12/1): Happy Thanksgiving & Happy Native American/First Nations Heritage Month

No CCC this Week
Learn about the first people in what is now Las Vegas & UNLV's Campus - The History of the Nuwuvi People
Resources: Nevada Indian Commission, National Museum of the American Indian - Smithsonian

Week 21 (12/4-12/8): Headache (YW-74)

Primary Reference(s):
1. Gelfand AA. Pediatric and adolescent headache. Continuum: Lifelong Learning in Neurology. 2018;24(4): 1108-1136.
Board Questions: For Learners, For Moderators
Moderators: M: Erum Tpm: Nicole P Th: Anjali R --- All other times & night shift are Self Study
Resources:
1. Handout on migraine headaches from American Family Physician. http://www.aafp.org/afp/2002/0215/p635.html
2. Handout on headache in children. https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/headaches/
Clinic Updates/Tips/Tools:
1. PCV-20 For BOTH VFC and Private
2. Please continue the Hunger Screening at 0-3 WCC - Resource Flyers are available in the File Cube

Week 22 (12/11-12/15): Media & Child Health (YW-99)

Primary Reference(s):
1. American Academy of Pediatrics Council on Communications and Media. Media and young minds. Pediatrics. 2016;138(5): e20162591.
2. American Academy of Pediatrics Council on Communications and Media. Media use in school aged children and adolescents. Pediatrics. 2016;138(5): e20162592
Board Questions: For Learners, For Moderators
Moderators: M(PM): Yash T(PM): Daun'lee Th(PM): Yemi F(AM): Samaa (as much as you can fit in before the first patient, we are working on protecting AM clinic time). *All other continuity clinic times are self study/pair discussions*
Resources:
1. Bibliography of recent publications related to screen time from AAP. https://www.aappublications.org/collection/screen-time
2. AAP guide to creating a Family Media Plan, available in English and Spanish. www.HealthyChildren.org/MediaUsePlan
3. AAP clearinghouse of resources for providers and families related to media use. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/pages/media-andchildren.aspx
4. Children and Media Tips from the AAP. https://www.aap.org/en-us/about-the-aap/aap-pressroom/news-features-and-safety-tips/Pages/Children-and-Media-Tips.aspx
Clinic Updates/Tips/Tools:
1. Mount Sinai Tip of the Week

Week 23 (12/18 - 12/22): Tuberculosis Screening & Treatment (YW-130)

Primary Reference(s): Nolt D, Starke JR, Committee on Infectious Diseases. Tuberculosis Infection in Children and Adolescents: Testing and Treatment. Pediatrics. 2021;148(6): e2021054663.
1. SNHD names 26 schools in CCSD tuberculosis investigation
Board Questions: None this week!
Moderators: M: Kaitlyn Tpm: Katie Th: Arifa (*the rest is self study)
Resources:
1. SNHD Tuberculosis & Control Clinic
2. WHO interactive map of estimated TB cased and deaths, 2000-2017. http://gamapserver.who.int/gho/interactive_charts/tb/cases/atlas.html
3. BCG World Atlas: a database of global BCG vaccination policies and practices. www.bcgatlas.org
4. Information and handouts for patients and providers from CDC. http://www.cdc.gov/tb/pubs/TBfactsheets.htm
5. Medication trackers, by regimen:
  - 3HP: https://www.cdc.gov/tb/publications/pamphlets/LTBI_Medication_Tracker.pdf
  - 4R: https://www.cdc.gov/tb/education/pdf/4R-MedicationTracker.pdf
  - 3HR: https://www.cdc.gov/tb/topic/treatment/pdf/3HR_Medication_Tracker.pdf
  - 6H or 9H: https://www.cdc.gov/tb/publications/pdf/INH_508.pdf

Week 24-25 (12/25 - 1/5): Happy Holidays!

No CCC these weeks!

Week 26 (1/1-1/5): Discipline (YW-66)

Primary Reference(s): Sege RD, Siegel BS, Council on Child Abuse and Neglect, Committee on Psychosocial Aspects of Child and Family Health. Policy Statement: Effective Discipline to Raise Healthy Children. Pediatrics. 2018;142(6): e20183112. CORRECTION
Board Questions: None this week!
Moderators: Tpm-TIM, Wpm-SAM, THpm-Connor, Fpm-GROUP (since Camila & Julia did it once already)
Resources:
1. Information for parents on discipline from AAP, including list of age-appropriate strategies. http://www.healthychildren.org/English/family-life/family-dynamics/communicationdiscipline/Pages/Disciplining-Your-Child.aspx
2. Information for parents on discipline from the CDC, including list of age-appropriate strategies. ttps://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/index.html
3. Information for parents on time out. www.cyberparent.com/timeout
4. Discipline tips for parents. http://www.helpandhope.org/Parenting_Tips/articles/discipline.asp
5. Top Tips for Surviving Tantrums: https://www.healthychildren.org/English/family-life/familydynamics/communication-discipline/Pages/Temper-Tantrums.aspx
6. Effective Discipline to Raise Healthy Children (AAP stance against Corporal punishment, yelling)
7. Positive Parenting (Defines positive parenting and gives example cases)
Clinic Updates/Tips/Tools:
1. Please continue to complete all clinic notes within 48 hours! Thanks!
2. Some radiology groups have changed who they cover this year, Silver Summit = SimonMed (only) and AmBetter = Simon Med (only)

Week 27 (1/8-1/12): Antibiotic Stewardship (YW-87)

Primary Reference(s): Gerber JS, et al. AAP Committee on Infectious Diseases, Pediatric Infectious Diseases Society. Antibiotic Stewardship in Pediatrics. Pediatrics. 2021;147(1): e2020040295. Bonus
1. ‘Superbug’ cases rising in Nevada over past two months, Las Vegas hospital leads list
Board Questions: For Learners, For Moderators
Moderators: Tam-LIOR, Tpm-JULIA, TH-Santiago (if your day is not listed then discuss board questions with your pair)
Resources:
1. 5-step patient-centered interviewing. Adapted by Fortin AH, Stein J from: Fortin AH 6th, Dwamena FC, Frankel RM, Lepisto BL, Smith RC. Smith’s Patient Centered Interviewing: An Evidence-based Method. 4th ed. New York: McGraw Hill, 2019. https://medicine.yale.edu/pediatrics/pcpc/learner/02b%20Agenda%20Fivesteps_335873_153_3833 2_v2.pdf
2. Get Smart campaign from CDC has links to information for families and providers about appropriate antibiotic use. http://www.cdc.gov/getsmart/
3. CDC compilation of guidelines for approaching antibiotic prescribing for common infectious diseases for pediatric ambulatory patients. https://www.cdc.gov/antibiotic-use/community/forhcp/outpatient-hcp/pediatric-treatment-rec.html
4. DHHS Nevada https://dpbh.nv.gov/Programs/HAI/dta/AMR/
Clinic Updates/Tips/Tools:
1. Please continue to do your Hunger Screenings for Children 0-3 (and Pregnant Moms)
2. Be aware that insurance companies and radiology have changed up their coverage this year (confirm via respecitive websites)

Week 28 (1/16-1/19): Sleep (YW-114)

Primary Reference(s): Bhargava S. Diagnosis and Management of Common Sleep Problems in Children. Pediatrics in Review. 2011;32: 91-99
Board Questions: For Learners, For Moderators
Moderators: for sessions without a moderator, please review the primary reference and the board questions.
1. M: Happy MLK Day
  - HealthyChildren.org "Using Books To Talk with Kids about Race"
  - Social Justice Booklist
2. Tpm: Daun'lee
3. THpm: Joshua
4. Fpm: Camila
Resources:
1. Information for families on sleep disorders from American Academy of Sleep Medicine. www.sleepeducation.com

3. ‘Sleeping Angels’ blog about children’s sleep by Dr. Dennis Rosen, Psychology Today. http://www.psychologytoday.com/blog/sleeping-angels

4. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. www.pediatrics.org/cgi/doi/10.1542/peds.2016-2940

Clinic Updates/Tips/Tools:
1. Please continue to help with the clinic QI projects (Hunger Screening & Reach Out & Read)
  - Please take the Hunger Screening Feedback Survey
2. Please read through the SNHD ACTIVE TUBERCULOSIS PUBLIC HEALTH ADVISORY
3. We can now ORDER RSV VACCINES(VFC ONLY)! Read the AAP/RED BOOK/ACIP RSV Vaccine Reccomendations
  - NIRSEVEMAB Visual Guide

Week 33 (2/19-2/23): Heart Murmurs (YW-PCPC)

Primary Reference(s): Gonzalez VJ, Kyle WB, Allen HD. Cardiac Examination and Evaluation of Murmurs. Pediatrics in Review. 2021;42(7): 375-382
Board Questions: For Leaners, For Moderators
Moderators:
1. Tpm: Arifa
2. Wpm: Sam
3. Thpm: Arifa
Resources:
1. Menashe V. Heart murmurs data supplement (audio files). Pediatrics in Review. 2007;28: e19-e22. http://pedsinreview.aappublications.org/cgi/content/full/28/4/e19/DC1
2. Biancaniello T. Innocent murmurs: a parent’s guide. Circulation. 2004;109(11): e162-e163. http://circ.ahajournals.org/cgi/reprint/109/11/e162
3. There are many other sites that host audio files of murmurs, including:

https://depts.washington.edu/physdx/heart/demo.html

http://thesimtech.com/audio/

https://www.easyauscultation.com/heart-murmur-sounds

https://murmurquiz.org/

http://pted.org/

Clinic Updates/Tips/Tools:
1. RSV Vaccines are still available! RSV Visual Guide/Algorithm

Wk 34 (2/26-3/1) - Pediatric Hypertension (Yale-PCPC)

Primary Reference: Flynn JT, Falkner BE. New clinical practice guideline for the management of high blood pressure in children and adolescents. Hypertension. 2017;70: 683-686.
- Yale Pediatric HTN Screening Algorithm
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Joshua
- Mpm: Kaitlyn
- Tpm: Nicole P
- Wpm: Nariman
- Thpm: Camila
Resources:
- MD CALC - Pediatric Hypertension Guidelines
- Screening for Blood Pressure in Pediatric Primary Care
- Pedialink - Proper BP Measurement
- Online pediatric blood pressure norms chart. http://www.nhlbi.nih.gov/guidelines/hypertension/child_tbl.pdf
- Information for patients from International Pediatric Hypertension Association. http://www.iphapediatrichypertension.org/faqs/
Clinic Updates/Tips/Tools:

Week 35 (2/28-3/4): Depression (YW-38)

Primary Reference: Maslow GR, Dunlap K, Chung RJ. Depression and Suicide in Children and Adolescents. Pediatrics in Review. 2015;36(7): 299-308.
Board Questions: Learners, Moderators
Moderators:
- Mpm: Lauren
- Tam: Tim
- Tpm: Anjali R
- Fpm: Lauren
Resources:
- Nevada Pediatric Access Line Program: https://center4cs.org/pal-members/dashboard/
- AAP Mental Health Toolkit: https://publications.aap.org/toolkits/pages/Mental-Health-Toolkit
  - Bright Futures Pediatric Symptom Checklist, psychosocial screening questionnaire: http://www.brightfutures.org/mentalhealth/pdf/professionals/ped_sympton_chklst.pdf
- American Academy of Child and Adolescent Psychiatry: http://www.aacap.org
- Strengths and Difficulties Questionnaire: http://www.sdqinfo.com/
- Guidelines for Adolescent Depression in Primary Care (GLAD-PC) toolkit: www.glad-pc.org
- Guidelines for Adolescent Preventive Services (GAPS) questionnaire: http://www.ama-assn.org/ama/pub/category/1980.html 6. Search engine to help providers and patients find therapists: www.psychologytoday.com
- Clark County Metal Health Consortium https://dcfs.nv.gov/uploadedFiles/dcfsnvgov/content/Meetings/ADA_CCCMHC_2021_Status_Report_1_29_21.pdf
Clinic Updates/Tips/Tools:
- Under Charge Capture you can use G0444 for any Depression Screening you score and document about
- We are currently out of Lead Tests, make sure to document that it needs to be done at the next well visit.

Week 36 (3/11-3/15): Lead (YW-86)

Primary References:
- CDC. Recommended Actions Based on Blood Lead Level - Summary of Recommendations for Followup and Case Management for Children, 2022. Retrieved February 26, 2023
- Half of US Populations exposed to adverse lead levels in early childhood
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Connor | Mpm: Chidelu
- Tam: Katie | Tpm: Lior
- Wam: Connor | Chidelu
- THpm: Daun'lee
- Fpm: Katie
Resources:
- Nevada Childhood Lead Poisoning Prevention Program (NvCLPPP) https://nvclppp.org/
- SNHD Lead Poisoning Prevention https://www.southernnevadahealthdistrict.org/community-health-center/clppp/
- List of recent recalls from US Consumer Product Safety Commission. http://www.cpsc.gov/en/Recalls/
- Links to state and local lead programs. http://www.cdc.gov/nceh/lead/programs/default.htm
- CDC Lead Poisoning Prevention Program with information for patients and providers. http://www.cdc.gov/nceh/lead/acclpp/blood_lead_levels.htm
- Handout for parents on lead exposure from CDC. https://www.cdc.gov/nceh/lead/docs/lead-levels-in-children-fact-sheet-508.pdf
Clinic Updates/Tips/Tools:

Week 37 (3/18-3/22): Short Stature (YW-115)

Primary Reference: Allen DB, Cuttler L. Short stature in childhood: challenges and choices. NEJM. 2013;368: 1220-8.
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Joshua | Mpm: Shield
- Tam: Nicole P |
- Wam: Chelsea | Wpm: Michael
- THpm: Samaa
- Fpm: Yemi
Resources:
- Article for parents about physical development. http://www.healthychildren.org/English/agesstages/gradeschool/puberty/Pages/Physical-Development-of-School-Age-Children.aspx
- Parent information about short stature. https://www.healthychildren.org/English/healthissues/conditions/Glands-Growth-Disorders/Pages/When-a-Child-is-Unusually-Short.aspx
Clinic Updates/Tips/Tools:
- If you code for any Developmental Testing (e.g. ASQ, MCHAT, Vanderbilt) use 96110 with a 59 modifier

Week 38 (3/25-3/29): Concussions (YW-19)

Primary Reference: Halstead ME, Walter KD, Moffatt K, Council on Sports Medicine and Fitness. Clinical Report – SportRelated Concussion in Children and Adolescents. Pediatrics. 2018;142(6): e20183074.
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Misha | Mpm: Kaitlyn
- Tam: Lior | Tpm: Arifa
- Wam: Katie | Wpm: Sam
- THpm: Arifa
- Fam: Misha | Fpm: Katie
Resources:
- AAP Patient Care: Concussions https://www.aap.org/en/patient-care/concussion/
- Nevada Interscholastic Activities Association Concussions Page
- SCAT5 instrument for evaluation of athletes 13 and older. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf
- Child SCAT5 instrument for evaluating injured children aged 5-12. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097492childscat5.full.pdf
- Computerized neurocognitive assessment, helpful in determining return to play. www.impacttest.com
- Baseline testing, sideline screening, and post-injury assessments for use by physicians and athletic trainers. www.cogstate.com/go/sport
- CDC “Heads Up” toolkit with links to information and handouts for athletes, parents, and coaches. https://www.cdc.gov/headsup/youthsports/index.html
- Cribsiders Podcast #19: Concussion https://thecurbsiders.com/cribsiders-podcast/19
- PECARN Pediatric Head Injury/Trauma Algorithm https://www.mdcalc.com/pecarn-pediatric-head-injury-trauma-algorithm
Clinic Updates/Tips/Tools:

Week 39 (4/1-4/5): Language and Literacy Development (YW-79)

Primary Reference: Feldman H. How Young Children Learn Language and Speech. Pediatrics in Review. 2019;40(8): 398- 411
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Stephen| Mpm: Erum
- Tam: Stephen
- Wpm: Camila
- Thpm: Julia
- Fam: Camila| Fpm: Yas
Resources:
- NEIS. https://dhhs.nv.gov/programs/idea/early_intervention_programs/
- Reach Out and Read program website. www.reachoutandread.org
- CDC Milestones Updated https://www.cdc.gov/ncbddd/actearly/milestones/index.html
- Bright Futures Parent Handouts https://publications.aap.org/toolkits/pages/bright-futures-toolkit (updated to 2yo)
- Clark County Library eCard https://legacy.lvccld.org/ecard/language.cfm?_ga=2.195765548.1201474462.1648248122-1632926252.1648248122
- LV Adult Learning Program https://lvccld.org/adult-learning/
- Mount Sinai Parent Guides https://parenting.mountsinai.org/parent-guides/
- Dr. Sun's Reach out & Read Inteview https://news3lv.com/news/local/unlv-clinic-offers-free-books-with-well-checks
Clinic Updates/Tips/Tools:
- For 5 and under, make sure to document that you gave a book at the end of your note! (use the template). Thanks!

Week 40 (4/8-4/12): Breast Anomalies (YW-119)

Primary Reference: De Silva N. Breast development and disorders in the adolescent female. Best Practice & Research: Clinical Obstetrics & Gynaecology. 2018;48: 40-50
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Nariman | Mpm: Yash
- Tam: Self Study
- Wam: Nariman
- Thpm Nicole A
- Fam: Lauren | Fpm: Yash
Resources:
- Breast Self-Exam and Cancer Risks. https://youngwomenshealth.org/2014/02/27/breast-self-examand-cancer-risks/
- Breast Cancer Screening from ACOG. https://www.acog.org/clinical/clinical-guidance/practicebulletin/articles/2017/07/breast-cancer-risk-assessment-and-screening-in-average-risk-women
Clinic Updates/Tips/Tools:

Week 41 (4/15-4/19): Eating Disorders (YW-104)

Primary Reference: Hornberger L, Lane MA, Committee on Adolescence. Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics. 2021;147(1): e2020040279.
Board Questions: For Learners, For Moderators
Moderators:
- - Mam: Lior | Mpm: Camila
  - Tam: Yemi | Tpm: Lior
  - Wpm: Camila
  - Thpm Kaitlyn
  - Fpm: Nicole P
Resources:
- Resources for teens and parents on eating disorders from The Center for Young Women’s Health. http://www.youngwomenshealth.org/nutrition_menu.html#eating_disorders
- Resources on the Maudsley Method for families engaging in Family-Based Treatment. www.maudsleyparents.org
- Resources for families from the National Eating Disorders Association. www.nationaleatingdisorders.org
Clinic Updates/Tips/Tools:

Week 42 (4/22- 4/26): Infant Colic (YW-14)

Primary Reference: Johnson JD, Cocker K, Chang E. Infantile colic: recognition and treatment. American Family Physician. 2015;92(7): 577-582
Board Questions: Learners, Moderators
Moderators:
- Mam: Anjali R| Mpm: Anjali A
- Tam: Erum| Tpm: Pair Discussion
- Wpm: Anjali R.
- Thpm: Kaitlyn
- Fam: Pair Discussion| Fpm: Anjali A
- *Pair discussion = both residents moderated last week and will discuss the topic as a pair rather than moderator/learner.
Resources:
- Handout for families from American Academy of Family Physicians. https://familydoctor.org/condition/colic/
- Handout for families from NIH. https://medlineplus.gov/ency/patientinstructions/000753.htm
- Information on Current Good Manufacturing Practices (CGMPs) for dietary supplements. http://www.fda.gov/Food/GuidanceRegulation/CGMP/ucm079496.htm
- The Period of Purple Crying. http://purplecrying.info/
Clinic Updates/Tips/Tools:

Week 43 (4/29-5/3): ADHD (YW-56)

Primary References:
- Rajaprakash M, Leppert ML. Attention-Deficit/Hyperactivity Disorder. Pediatrics in Review. 2022;43(3): 135–147. https://doi.org/10.1542/pir.2020-000612
- Centers for Disease Control and Prevention. Attention-Deficit/Hyperactivity Disorder: Symptoms and Diagnosis. Retrieved May 4, 2021
Board Questions: Learners, Moderators
Moderators:
- Mam: Steven | Mpm: Shield
- Tpm: Lauren
- Wpm: Samaa
- Thpm: Santiago
- Fpm: Samaa
Resources:
- AAP ADHD Toolkit: Includes Vanderbilts, Patient Handouts, Medication Guides
  - Medication safety information from AAP. http://www.aap.org/family/safetypillsadhd.htm
  - Information for families from AAP. http://www.aap.org/healthtopics/adhd.cfm
- ADHD Medication Guide: http://www.adhdmedicationguide.com/
- NICHQ Vanderbilt Assessment Forms & handouts for families. https://www.nichq.org/resource/nichq-vanderbilt-assessment-scales
- Detailed information for families about Individualized Education Programs. http://www.ed.gov/parents/needs/speced/iepguide/index.html
  - IEP Defenders https://www.iepdefenders.com/ - Local IEP Professional Legal Help
Clinic Updates/Tips/Tools:vvvv

Week 44 (5/6-5/10): Social Media & Health (YW-123)

Primary Reference: Hill DL. Social Media: Anticipatory Guidance. Pediatrics in Review. 2020;41(3): 112-119.
- AAP NEWS: Beyond restrictions: Guidance for talking with families about social media use
Board Questions: None this week
Moderators:
- Mam: Joshua | Mpm: Chidelu
- Tam: Jessica | Tpm: Daun'lee
- Wpm: Sam
- Thpm: Chidelu
- Fam: Joshua | Fpm: Daun'lee
Resources:

1. Health information in English and Spanish for parents, educators, kids, and teens, with option for free weekly newsletter. @KidsHealth http://kidshealth.org

2. Sex education by teens, for teens. @Sexetc http://sexetc.org

3. Teen-friendly content created by teens, sponsored by the National Campaign to Prevent Teen and Unplanned Pregnancy. @StayTeen http://stayteen.org

4. Blog from pediatrician, Dr. Wendy Sue Swanson, Director of Digital Health at Seattle Children’s Hospital. @SeattleMamaDoc http://seattlemamadoc.seattlechildrens.org/

5. AAP Safety Tips: Talking to Kids and Teens About Social Media. https://www.aap.org/en-us/aboutthe-aap/aap-press-room/news-features-and-safety-tips/Pages/Talking-to-Kids-and-Teens-AboutSocial-Media-and-Sexting.aspx

6. Tips for Parents from the Federal Trade Commission and National Initiative for Cybersecurity Education. http://www.onguardonline.gov/articles/0012-kids-and-socializing-online

7. AAP-sponsored website and smartphone app with reliable parent-friendly content on common pediatric topics. http://www.healthychildren.org

8. AAP- sponsored personalized media use plan for children and families. http://healthychildren.org/mediauseplan

9. Tips and information on bullying and cyberbullying. http://stopbullying.gov

10. Information for parents to help kids harness the power of media and technology as a positive force. https://www.commonsensemedia.org/social-media

Clinic Updates/Tips/Tools:

Week 45 (5/13-5/17): Indoor Arthropod Bites & Infestations (YW-57)

Primary Reference:
- Devore CD, Schutze GE, Council on School Health and Committee on Infectious Diseases. Head Lice. Pediatrics. 2015;135(5): e1355-e1365.
- Read pages 845-847 from: Juckett G. Athropod Bites. American Family Physician. 2013;88(12): 841-847
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Misha | Mpm: Shield
- Tam: Chelsea | Tpm: Shield
- Wpm: Chelsea
- Thpm: Connor
- Fam: Misha
Resources;
- SNHD Bed Bugs https://www.southernnevadahealthdistrict.org/Health-Topics/bed-bugs/

Week 46 (5/20-5/24): Safe Infant Sleep (YW-10)

Primary Reference: American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome, Policy Statement. Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics. 2022;150(1): e2022057990.
- - NEVADA AAP Chapter - Back to Sleep Campaign
Board Questions: For Learners, For Moderators
Moderators:
- - Mam: Joshua | Mpm: Steven
  - Tam: Tim | Tpm: Sam
  - Wam: Steven | Wpm: Sam
  - Thpm: Yash | Fam (self study)
Resources:
- - National Institute of Child Health and Human Development “Back to Sleep” handout for parents. https://www.nichd.nih.gov/sites/default/files/2019-02/Safe_Sleep_Environ_update.pdf
  - CDC information page on SUID and SIDS. https://www.cdc.gov/sids/index.htm
  - Video on hip-safe swaddling from Yale Primary Care Pediatrics Curriculum. https://www.youtube.com/watch?v=wyCPwGa3WVQ
  - Educational apps for families:
    - Safe sleep sweep:
      - https://itunes.apple.com/us/app/safe-sleep-sweep/id1021918329?mt=8 (apple)
      - https://play.google.com/store/apps/details?id=com.sna.safesleep&hl=en (google)
    - Safe sleep for babies: (developed for the MA DA’s office)
      - https://itunes.apple.com/st/app/safe-sleep-for-babies/id1206448549?mt=8 (apple)
      - https://play.google.com/store/apps/details?id=appinventor.ai_553971.BabbyApp&hl=en (google)
Clinic Updates/Tips/Tools:
- - We are currently going through a transition in the rooming process of our patients in clinic, and we ask for your patience in the matter. Our Medical Assistants will be collecting more information and charting much more than before which may take more time getting a patient roomed BUT this will help decrease your time needed in the room and with your charting.
  - Here is a copy (sorry for the quality), of what the MA rooming checklist is now. We have a special section for Pediatrics which they will be charting for us (along with other relevant sections--mostly the new patients section), and it is your responsibility to both review it, address it, and bill for it (where applicable). Examples include the MCHAT, PHQ-9, EPDS, Hunger Screening and the Develomental Milestones. The ASQ will still be given to families and scored by us (for the time being). (As a side note, the Birth history will include the Newborn Hearing Screening results in the free text box)
  - The goal is to be rid of all additional forms for patients, improve our charting compliance, and to be more efficient for everyone.
  - For any questions or feedback, please let any of your attendings know. Thanks!!!

Week 47 (5/28-5/31) -- short week, no CCC.

Week 48 (6/3-6/7): Water Safety & Drowning Prevention (YW-45)

Primary Reference: Denny SA, et al. AAP Council on Injury Prevention, Violence, and Poison Prevention. Prevention of Drowning. Pediatrics. 2019;143(5): e20190850.
- SNHD Fatal & Non-Drowning Statistics
Board Questions: None this week
Moderators:
- Mam: Anjali R | Mpm: Kaitlyn
- Tam: Michael | Tpm: Julia
- Wam: Anjali R | Wpm Kaitlyn
- Thpm: Michael | Fpm: Michael
Resources:
- There is a good handout on EPIC that you can attach to the AVS on "Summer Safety"

1. Information from the AAP on water safety. http://www.aap.org/en-us/about-the-aap/aap-pressroom/news-features-and-safety-tips/Pages/Sun-and-Water-Safety-Tips.aspx

2. Resources for parents from PoolSafely.gov, including information on the Virginia Graeme Baker Pool and Spa Safety Act. http://www.poolsafely.gov/parents-families/resources-for-parents-families/

3. Handouts on “Water Safety at Home” and “Swimming Safety Tips” from safekids.org. http://www.safekids.org/watersafety

4. Information for parents on recognizing signs of drowning. www.uvpediatrics.com/news/2013/08/do-you-know-what-drowning-looks-like/

5. US Coast Guard guide on “How to Choose the Right Life Jacket.” http://www.uscgboating.org/images/howtochoosetherightlifejacket_brochure.pdf

Clinic Updates/Tips/Tools:
- Continue to adjust your flow and make sure to review and bill for screenings and other information collected by the M.A.s
- Ask about Flu vaccines (we still may have some in stock!)

Week 49 (6/10-6/14): Travel Preparedness (YW-134)

Primary Reference: Chehab H, Fischer PR, Christenson JC. Preparing Children for International Travel. Pediatrics in Review. 2021;42(4): 189-202. https://doi.org/10.1542/pir.2018-0353
Board Questions: For Learners, For Moderators
Moderators:
- Mam: Steven | Mpm: Shield
- Tam: Anjali A | Tpm: Nicole P
- Wam: Anjali A | Wpm: Camila
- Thpm: Chelsea | Fpm: Misha (Self Study)
Clinic Resources:
- State Department Travel Advisories. https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/
- Links to CDC sites (non-Yellow Book).
  - Health notices for travelers. http://wwwnc.cdc.gov/travel/notices.htm
  - Country specific information. http://wwwnc.cdc.gov/travel/destinations/list.htm
  - Malaria information by country. http://www.cdc.gov/malaria/travelers/country_table/a.html
  - List of travel clinics. http://wwwnc.cdc.gov/travel/page/travel-clinics.htm
- Links to CDC Yellow Book. http://wwwnc.cdc.gov/travel/page/yellowbook-home
- WHO website on International Travel and Health. http://www.who.int/ith/en/
- Insect Repellent handout. http://www.healthychildren.org/English/safety-prevention/at-play/pages/Insect-Repellents.aspx

2022-2023 Archive

Week 52 (6/26-6/30): Thank you PGY3s!

Thank a graduating resident and wish them luck!
Board Questions: None this week!
Moderators: Everyone
Clinic Updates
- OUT of some Private Vaccines - Check with your MA

Week 51 (6/19-6/23): Happy Juneteenth!

Primary References:
- Junteenth | National Museum of African Amerian History and Culture
- AAP: Talking With Your Children About Racism: Start, Continue the Conversation
Board Questions: None this week!
Moderators: Everyone
Clinic Updates
- OUT of some Private Vaccines - Check with your MA

Week 50 (6/12 -6/16): Prevention of Tobacco Use (YW-124)

Primary References:
Board Questions: None this week!
Moderators: M: Amy T: Yash W: Chelsea Th: Yemi F: Open
Clinic Resources:
- Patient handout from American Family Physician. www.aafp.org/afp/2008/0215/p491.html
- Clearinghouse of smoking cession resources from CDC. http://www.cdc.gov/Tobacco/quit_smoking/how_to_quit/index.htm
- Summary of “5-A’s” for behavior change. https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/clinicians-providers/guidelines-recommendations/tobacco/5steps.pdf
Clinic Updates
- OUT of some Private Vaccines - Check with your MA

Week 49 (6/5 -6/9): Sibling Relationships (YW-113)

Primary Reference: Hughes C, McHarg G, White N. Sibling influences on prosocial behavior. Current Opinion in Psychology. 2019;20: 96-101.
Board Questions: None this week!
Moderators: M: Joshua T: Michael W: Jessica Th: Michael F: Nicole P.
Clinic Resources:
- Handout on sibling rivalry. http://www.healthychildren.org/English/family-life/family-dynamics/Pages/Sibling-Rivalry.aspx
- Information for parents on types of sibling relationships.
Clinic Updates
- OUT of Private Vaccines for FLU, PCV13, ROTA, HPV9
- See Exam room flags below

Week 48 (5/30-6/2): Bites and Stings from Outdoor Arthropods (YW-50)

Primary Reference: Read pages 841-845 from: Juckett G. Athropod Bites. American Family Physician. 2013;88(12): 841- 847. https://www.aafp.org/afp/2013/1215/p841.html
1. Optional Read: https://www.fox5vegas.com/2023/05/11/northwest-valley-toddler-icu-recovering-scorpion-sting/
Board Questions: For Learners, For Moderators
Moderators: M: HOLIDAY T: Valeria W: Nikki Th: Nikki F: Misha
Clinic Resources:
1. Information for families about insect repellent from American Academy of Pediatrics. https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Insect-Repellents.aspx
2. Information on insect repellents from the EPA. https://www.epa.gov/insect-repellents
3. Tickborne Diseases of the United States, CDC manual for healthcare providers with photos. https://www.cdc.gov/ticks/tickbornediseases/TickborneDiseases-P.pdf
4. Tips on mosquito prevention from CDC. https://www.cdc.gov/mosquitoes/index.html

Week 47 (5/22-5/26): Travel Preparedness (YW-134)

Primary Reference: Chehab H, Fischer PR, Christenson JC. Preparing Children for International Travel. Pediatrics in Review. 2021;42(4): 189-202. https://doi.org/10.1542/pir.2018-0353
Board Questions: For Learners, For Moderators
Moderators: M: Erum T: Daun'lee W: Alis Th: Sam F: Freya
Clinic Resources:
1. State Department Travel Advisories. https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/
2. Links to CDC sites (non-Yellow Book).
  - Health notices for travelers. http://wwwnc.cdc.gov/travel/notices.htm
  - Country specific information. http://wwwnc.cdc.gov/travel/destinations/list.htm
  - Malaria information by country. http://www.cdc.gov/malaria/travelers/country_table/a.html
  - List of travel clinics. http://wwwnc.cdc.gov/travel/page/travel-clinics.htm
3. Links to CDC Yellow Book. http://wwwnc.cdc.gov/travel/page/yellowbook-home
4. WHO website on International Travel and Health. http://www.who.int/ith/en/
5. Insect Repellent handout. http://www.healthychildren.org/English/safety-prevention/at-play/pages/Insect-Repellents.aspx

Week 46 (5/15 - 5/19): The Medical Home and Children & Youth with Special Health Care Needs (YW-65)

Primary Reference: Katkin JP, et al. Guiding principles for team-based pediatric care. Pediatrics. 2017;140(2): e20171489.

Review Questions: For Learners, For Moderators

Moderators: M: Avery T: Tim W: Lior Th: Joanne F: Andy

Clinic Resources:

Nevada Parents Empowering Parents - State Chapter of PEP which trains parents of disabled children on advocacy and a variety of topics
- https://nvpep.org/
Children with Special Health Care Needs Screening Tool
- https://www.childhealthdata.org/docs/cshcn/technical-summary-of-cshcn-screener.pdf
American College of Physicians online resources for patient-centered medical homes.
- http://www.acponline.org/running_practice/delivery_and_payment_models/pcmh/
National Center of Medical Home Implementation, AAP sponsored web site for resources, screening tools, and technical assistance.
- http://www.medicalhomeinfo.org/
Family Voices, A national family advocacy organization with links to state family coordinators and resources.
- http://www.familyvoices.org

Week 45 (5/8-5/12): Newborn Screening (YW-86)

Primary Reference: Fabie NAV, Pappas KB, Feldman GL. The current state of newborn screening in the United States. Pediatric Clinics of North America. 2019;66(2): 369-386
Board Questions: For Learners, For Moderators
Moderators: M: Amy T: Briana W: Yemi Th: Anjali F:Lauren
Clinic Resources:
- UPC Clinic Resources Section
- American College of Medical Genetics information sheets and confirmatory algorithms.
  - https://www.acmg.net/ACMG/Medical-Genetics-Practice-Resources/ACT_Sheets_and_Algorithms.aspx
- HRSA National Newborn Screening Resources
  - https://newbornscreening.hrsa.gov/about-newborn-screening/newborn-screening-resources
- Links to information about genetic conditions for providers and families
  - http://ghr.nlm.nih.gov/
- CDC Newborn Screening Portal
  - https://www.cdc.gov/newbornscreening/index.html
- Nevada Newborn Screening Program
  - https://med.unr.edu/nsphl/newborn-screening

Week 44 (5/1-5/7): None this week

Week 43 (4/24 - 4/28): Transition from Pediatric to Adult-Oriented Healthcare (YW-126)

Primary Reference: Davidson LF, Doyle MH. Health-care transition: a vital part of care, growth, and change for pediatric patients. Pediatrics in Review. 2021;42(12): 684-693.
Board Questions: For Learners, For Moderators
Moderators: M: Steven T: Yash W: Sonia Th: Chelsea F: Michael
Clinic Resources:
- American Academy of Pediatrics National Center for Medical Home Implementation Transition Tools
  - https://medicalhomeinfo.aap.org/tools-resources/Pages/For-Practices.aspx
- “Got Transition,” clearinghouse of resources from The National Alliance to Advance Adolescent Health. http://www.gottransition.org/
  - Recommended timeline for transition https://www.gottransition.org/resource/?hct-timeline-parents-caregivers
- McManus M, Turchi RM. Coding, payment options for pediatric to adult transition services. AAP News. 2015.
  - http://www.aappublications.org/content/36/9/10.full
- Washington State Department of Health Adolescent Health Transition Project, with examples of portable medical summaries.
  - http://depts.washington.edu/healthtr/
- American College of Physicians, Pediatric to Adult Care Transitions Initiative, toolkit for providers with general and specialty-specific transition tools.
  - https://www.acponline.org/clinical-information/high-value-care/resources-for-clinicians/pediatric-to-adult-care-transitions-initiative
- A more extensive list of transition-related resources appears at the end of the AAP/AAFP/ACP 2011 Clinical Report.
  - http://pediatrics.aappublications.org/content/128/1/182.full.pdf+html

Week 42 (4/17 - 4/24): Sexually Transmitted Infections & PrEP (YW-31)

Primary References:
- American Academy of Pediatrics Committee on Adolescence, Society for Adolescent Health and Medicine. Screening for nonviral sexually transmitted infections in adolescents and young adults. Pediatrics. 2014;134: e302-e311
- Centers for Disease Control and Prevention: Prescribe PrEP: FAQs for the health care professional.
Board Questions: For Learners, For Moderators
Moderators: M: Kaitlyn T: Valeria W: Nikki Th: Nicole P F: Najima
Clinic Resources:
- SNHD Sexual Health Clinic
- CDC: Sexually Transmitted Diseases https://www.cdc.gov/std/default.htm
  - STD picture cards from CDC https://www.cdc.gov/std/training/picturecards.htm
  - CDC Expedited Partner Therapy Laws: Nevada https://www.cdc.gov/std/ept/legal/nevada.htm
  - CDC Pre-Exposure Prophylaxis (PrEP) - fact sheets and videos for both consumers and providers. https://www.cdc.gov/hiv/risk/prep/index.html
- HIV treatment regimen guidelines from the US Department of Health and Human Services. https://clinicalinfo.hiv.gov/en/guidelines
- Adolescent access to reproductive health without parental consent, laws by state https://www.cdc.gov/hiv/policies/law/states/minors.html
- "Measure aims to assure STI treatment, contraception for minors without parental consent" - Nevada Current 3/15/23
Clinic Update: Out of FLU for Private Vaccines

Week 41 (4/10-4/14): Personal Pronouns in the Pediatrics Setting

Primary Reference:
1. AAP News: Improving Affirmed Name and Pronoun EHR Documentation for Transgender and Gender-Diverse Youth
2. Yale SOM: FAQ's on Pronoun use
Board Questions: None this week!
Moderators: M: Osman/JP T: JP/Osman W: Nik Th: Nik F: Nik
Clinic Resources:
Clinic Update: Out of everything for Private except Rota; VFC has everything; POCT-HB are back in stock

Week 40 (4/3-4/7): Adolescent Contraception (YW-30)

Primary Reference:
Board Questions: For Learners, For Moderators
Moderators: M: Erum T: Yash W: Alis Th: Yash F: Misha
Clinic Resources:
1. 2016 US medical eligibility criteria for contraceptive use from CDC.
  - https://www.cdc.gov/mmwr/volumes/65/rr/rr6503a1.htm?s_cid=rr6503a1_e
2. List of emergency contraception alternatives. http://ec.princeton.edu/questions/dose.html
3. Birth control information for teens. http://www.pamf.org/teen/sex/birthcontrol/
4. Birth control information for teens. www.bedsider.org
5. Patient information about sexual assault. http://www.911rape.org/home
6. Health information for teens in Q&A format. http://goaskalice.columbia.edu/
7. State specific information on reproductive health, rights, and public policy. https://www.guttmacher.org/statecenter/
8. SNHD Teen Care Privacy Letter. https://www.southernnevadahealthdistrict.org/download/family-planning/teen-care-and-privacy.doc
9. Dr. Levy's Links
Clinic Update: Out of MMR and MCV4 for PRIVATE INSURANCES

Week 39 (3/27- 3/31): Adolescent Menstrual Disorders (YW-76)

Primary Reference:
Board Questions: For Moderators, For Learners
Moderators: M: Avery T: Daun'lee W: Jessica Th: Daun'lee F: Freya
Clinic Resources:
- Center for Young Women’s Health, Boston Children’s Hospital. www.youngwomenshealth.org
- Menstruation Tracking Apps

Week 38 (3/20-3-25): Flouride Varnish (YW-42)

Primary References:
Survey Questions: For Learners
Moderators: M-F: Joanne
Clinic Resources:
- Smiles for Life, a national oral health curriculum. www.smilesforlifeoralhealth.org
  - Video demonstration of fluoride varnish application from Smiles for Life. www.youtube.com/watch?v=cV5OmL7C8K4
  - Online training course about fluoride varnish from Smiles for Life. www.smilesforlifeoralhealth.org/courses/caries-risk-assessment-fluoride-varnish-and-counseling
  - Mobile App from Smiles for Life https://www.smilesforlifeoralhealth.org/resources/android-ios-apps/
- AAP Oral Health https://www.aap.org/en/patient-care/oral-health/

Week 37 (3/13-3-17): Precocious Puberty (YW-111)

Primary References:
- Carel J, Léger J. Precocious puberty. NEJM. 2008;358(22): 2366-77
- Jasik CB, Lustig RH. Adolescent obesity and puberty: the “perfect storm”. Annals of the New York Academy of Sciences. 2008;1135: 265-279
Board Questions: For Learners, For Moderators
Moderators: M: Shield T: Tim W: Yemi Th: Yemi F: Anjali
Clinic Resources:
- Handout for families from American Academy of Family Physicians.
  - https://familydoctor.org/condition/central-precocious-puberty/
- Handout for families from American Academy of Pediatrics and Pediatric Endocrine Society
  - www.pedsendo.org/assets/patients_families/EdMat/Precocious%20Puberty.pdf

Wk 36 (3/6-3/10): Normal & Delayed Pubertal Development (YW-45)

Primary References (Required for Moderators & Participants - including Medical Students & Family Practice)
- Wolf RM, Long D. Pubertal Development. Pediatrics in Review. 2016;37(7): 292-299. (Read pages 292-298; the information after that is obsolete.)
Board Questions (at the end of the session, or waiting on late people): For Learners, For Moderators
Moderators: M: Joshua T: Yash W: Lior Th: Sam F: Andy
Resources:
- AAP Handouts for teens
- Pediatric Endocrine Society: Delayed Boys, Delayed Girls

Clinic Tools/Updates:
- See the board or ask an Attending for any vaccine/tests updates

Wk 35 (2/27-3/3): Developmental Hip Dysplasia (YW-45)

Primary References (Required for Moderators & Participants - including Medical Students & Family Practice)
- Shaw BA, Segal LS, AAP Section on Orthopaedics. Evaluation and Referral for Developmental Dysplasia of the Hip in Infants. Pediatrics. 2016;138(6): e1-e11.
- Hip-Safe Swaddling. Yale PCPC video.
Board Questions (at the end of the Session, or waiting on late people): For Learners, For Moderators
Moderators: M: Amy T: Joanne W: Jessica Th: Briana F: Michael
Resources:

Clinic Tools/Updates:
- All vaccines in stock! Ask for updates from the MAs or attendings.

Wk 34 (2/21-2/24): Vaccine Hesitancy (YW-45)

Primary References (Required)
Board Questions: None, Happy President's Day!
Moderators: M: Clinic Closed T: Daun'Lee W: Sonia Th: Chelsea Th: F: Misha
Resources:
- Provider Resources for Vaccine Conversations with Parents. https://www.cdc.gov/vaccines/hcp/conversations/index.html
- Vaccine Education Center (CHOP), including “Vaccines on the Go” Mobile App available for download. http://www.chop.edu/service/vaccine-education-center
- Additional studies investigating the purported link between vaccines and autism http://www.cdc.gov/vaccinesafety/00_pdf/CDCStudiesonVaccinesandAutism.pdf
- School vaccine exemption laws, by state (Nevada has religious exemption only). https://www.cdc.gov/phlp/docs/school-vaccinations.pdf and https://www.ncsl.org/research/health/school-immunization-exemption-state-laws.aspx
- AAP refusal to vaccinate resources https://www.aap.org/en/patient-care/immunizations/implementing-immunization-administration-in-your-practice/refusal-to-vaccinate/ (includes the refusal to vaccinate forms)

Clinic Tools/Updates:
- All vaccines in stock! Ask for updates from the MAs or attendings.

Wk 33 (2/13-2/17): Treating Childhood & Adolescent Obesity (YW-101)

Primary References
Board Questions: None
Moderators: M: Erum T: Nicole P W: Alis Th: Steven F: Lauren
Resources:
- AAP Institute for Healthy Childhood Weight: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity
  - Obesity Education: Modules, Webinars & Podcasts
- Change Talk: Childhood Obesity – brief simulated patient encounters to practice motivational interviewing: https://simulations.kognito.com/changetalk/?dly=20
- WeCan and LetsMove, from NIH and Mrs. Obama. http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/ http://www.letsmove.gov

Clinic Tools:
- AAP IHCW: Pediatric Obesity Algorithm
- Dr. Meyer's Obesity Clinic (Friday afternoons), you can add this DOTPHRASE .healthylifestyleclinicintro to your AVS for interested familes.
- Healthy Eating Plates from Harvard School of Public Health
  - Children’s version: https://www.hsph.harvard.edu/nutritionsource/kids-healthy-eating-plate
  - Adult’s version: https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate
- Southern Nevada Health District - Get Healthy Clark County
FASD Survey - Due to some techincal issues, we will expand the surveys and checklist deadline until Sunday 2/19 at 5pm. If you were on nights last block and would like to participate, you may still turn in the screen shots/documents by this deadline. Sorry again!

Wk 28 (1/9-1/13): Sports Participation (YW-116)

Primary Reference: Miller SM, Peterson AR. The Sports Preparticipation Evaluation. Pediatrics in Review. 2019;40(3): 108-128. https://pedsinreview.aappublications.org/content/40/3/108
- Las Vegas Teen Flag Football Star Collapses and Dies 'Playing the Game She Loves' - People Magazine
Board Questions: None
Moderators: M: Kaitlyn T: Valeria W: Lior Th: Lior F: Freya
Resources:
- PPE-5, the pre-participation evaluation form endorsed by AAP, AAFP, and other professional organizations. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Pages/PPE.aspx
- AAP Parent guidance on Performance Enhancing Substances.

- Nevada Interscholastic Activity Association

Wk 27 (1/2 - 1/6): Bone Health in Children: Guidelines for Vitamin D and Calcium Intake (YW-55)

Primary Reference:

1. Golden N, et al. Optimizing Bone Health in Children and Adolescents. Pediatrics. 2014;134; 12291239

2. Read Table in: Institute of Medicine of the National Academies. Dietary reference intakes for calcium and vitamin D. 2010 Report Brief

Board Questions: None
Moderators
- M: Holiday T: Sam W: Nicole A. Th: Joshua F: Najima
Resources:
- Information for parents/patients about vitamin D from the AAP.
- Handout on bone health from Pediatric Endocrine Society.

Wk 25-26 (12/19 - 12/30): Holiday Weeks

Primary Reference: No Assignments this week
Feel free to organize something fun for your continuity day!
Dec 19 to 23 has a dress up week
- M: Elf T: Disney W: Ugly Day Th: Holiday Lights & Bells F: Winter Wonderland (Clinic is only 1/2 day)

Wk 24 (12/12 - 12/16): Food Allergy (YW-52)

Primary Reference: Cosme-Blanco W, Arroyo-Flores E, Ale H. Food Allergies. Pediatrics in Review. 2020;41(8): 403-415.
- AAP Clinical Report Highlights Early Introduction of Peanut-based Foods to Prevent Allergies
Board Questions: For Learners, For Moderators
Moderators: M: Shield T: Yash W: Yemi Th: Avery F: Lauren
Resources:

Wk 23 (12/5-12/9): Infant Oral Pathology (YW-70)

Yale Week 12 Case: Infant Oral Pathology
Primary Reference:
- AAPD Oral Health Policies and Recommendations: Management Considerations for Pediatric Oral Surgery and Oral Pathology. The Reference Manual of Pediatric Dentistry. 2015;402-411.
- Mueller DT, Callanan VP. Congenital malformations of the oral cavity. Otolaryngologic Clinics of North America. 2007;40(1): 141–160.
Board Questions: For Learners , For Moderators
Moderators: M: Erum T: Tim W: Jessica Th: Jessica F: Andy
Resources:
- AAPD Dental Growth and Development (Timelines for Dental Eruption) http://www.aapd.org/media/Policies_Guidelines/R_DentalGrowth.pdf
- AAPD Speech and Language Milestones http://www.aapd.org/media/Policies_Guidelines/R_SpeechMilestones.pdf
- AAPD Policy Statements on Various Issues related to Oral Health http://www.aapd.org/policies
Clinic Updates/Tips: (always check the board for updates)

Wk 22 (11/28-12/2): Ex-Preemie Care (YW-106)

Primary Reference:
- Andrews B, et al. NICU Follow-up: Medical and Developmental Management Age 0 to 3 Years. Neoreviews. 2014;15: e123.
- AAP News - US Preterm Rates increase to 10.5% in 2021
Board Questions: For Learners, For Moderators
Moderators: M: Amy T: Joanne W: Yemi Th: Lior F: Anjali
Clinic Updates/Tips:
- POC RSV testing for 2 years and under only, (we can send out RSV testing for older children if requested)
- Growth charts can be adjusted for Fenton (preemie charts) and corrected gestation age ONLY if you update the birth history

Wk 21 (11/21- 11/25) - Thanksgiving Week

Primary Reference:
- History of the Nuwuvi People
- Talking to Kids About Thanksgiving: Center Truth, Connection and Being Grateful
Board Questions: None This week
Moderators: Everyone
Practice Tips: None this week
Clinic Updates:
- Help out Amy with her COVID Vaccine QI project
- Silver Summit WCCs get a $100 Gift Card! Ask Domonique for the card

Wk 20 (11/14 - 11/18) - Cerumen Impaction (YW-89)

Primary Reference:
- Urkin J, Bar-David Y, Holdstein Y. Cleaning Earwax Impaction: Clinical Tips for the Primary Care Clinician. Clinical Pediatrics. 2015;54(14): 1311-1314.
- 2017 American Academy of Otolaryngology – Head and Neck Surgery Clinical Practice Guideline by Schwartz, et al.
Board Questions: For Learners, For Moderators
Moderators: M: Chelsea T: Brianna W: Chelsea Th: Steven F: Michael
Practice Tips:
- Kidshealth information for parents about ear wax. http://kidshealth.org/en/parents/earwax.html 3.
- Nationwide Children’s Hospital handout for parents about ear wax. http://www.nationwidechildrens.org/ear-wax
Clinic Updates:
- Help out Amy with her COVID Vaccine QI project
- Silver Summit WCCs get a $100 Gift Card! Ask Domonique for the card

Week 19 (11/7 - 11/11): Abnormal Head Size & Shape (YW-83)

Primary References:
- Dias MS, et al. Identifying the Misshapen Head: Craniosynostosis and Related Disorders. Pediatrics. 2020;146(3):e2020015511. https://pediatrics.aappublications.org/content/146/3/e2020015511
- Laughlin JL, et al. Prevention and management of positional skull deformities in infants. Pediatrics. 2011;128: 1236-1241. http://pediatrics.aappublications.org/content/128/6/1236.full.pdf+html
Moderators: M: Shield T: Nicole P W: Nicole A Th: Kaitlyn F: HOLIDAY
Board Questions: For Learners, For Moderators
Resources:
- Handout on craniosynostosis Seattle Children’s Hospital. https://www.seattlechildrens.org/pdf/pe393.pdf
- Handout on Craniosynostosis Children’s Health. Queensland https://www.childrens.health.qld.gov.au/fact-sheet-craniosynostosis/
- Handout on plagiocephaly from American Physical Therapy Association https://pediatricapta.org/includes/fact-sheets/pdfs/Plagiocephaly.pdf
- Handout on plagiocephaly Seattle Children’s Hospital. https://www.seattlechildrens.org/globalassets/documents/for-patients-andfamilies/pfe/pe2638.pdf
- Handout on Plagiocephaly from British Columbia Children’s Hospital http://www.bcchildrens.ca/neurosciencessite/Documents/BCCH034PlagiocephalyCliniciansGuideWeb1.pdf
Clinic Updates/Tips:
- Please avoid sharing moderator versions on the monitor (unless there is a graphic that you would like to share)
- Check the board for vaccines/tests out of stock - Out of HepA and POCT-RSV
- We can give 6 months+ COVID Vaccines now (on Thursdays)!
- Support Dr. Amy Dao with her QI Project on COVID Vaccines, live now!

Week 18 (10/31 - 11/4): Fluoride Varnish (YW-42) & Happy Halloween!!!

Primary Reference:
- Clark MB, Keels MA, Slayton RL, Section on Oral Health. Fluoride use in caries prevention in the primary care setting. Pediatrics. 2020; 146(6): e2020034637.
Moderators: M: Erum T: Valeria W: Alis Th: Sonia F: Freya
Board Questions: For Learners, For Moderators
Resources:
- Smiles for Life, a national oral health curriculum. www.smilesforlifeoralhealth.org
- Video demonstration of fluoride varnish application from Smiles for Life. www.youtube.com/watch?v=cV5OmL7C8K4 and available for download at www.smilesforlifeoralhealth.org/wp-content/uploads/2020/01/fluoride.mp4
- AAP Oral Health Practice Tools https://www.aap.org/en/patient-care/oral-health/oral-health-practice-tools/
Clinic Updates/Tips:
- Make sure to fill out and file a Fluoride Varnish Consent form
- Check the board for vaccines/tests out of stock
- We can give 6 months+ COVID Vaccines now (on Thursdays)!

Week 17 (10/24 - 10/28): Care for Transgender Youth (YW-32)

Primary Reference:
- de Vries A, Klink D, Cohen-Kettenis PT. What the Primary Care Pediatrician Needs to Know About Gender Incongruence and Gender Dysphoria in Children and Adolescents. Pediatr Clin North Am. 2016;63(6): 1121-1135
- Turban J, Ferraiolo T, Martin A, Olezeski C. Ten Things Transgender and Gender Nonconforming Youth Want Their Doctors to Know. Journal of the American Academy of Child and Adolescent Psychiatry. 2017; 56(4): 275-277
Board Questions: None this week
Moderators: M: Amy T: Joanne W: Sam Th: Misha F: HOLIDAY
Resources:
- Family Acceptance Project, resources for patients, families, clinicians. https://familyproject.sfsu.edu/publications
- National Center for Transgender Equality. https://transequality.org
- Resources for patients, families, and educators from Welcoming Schools. https://welcomingschools.org/
- Information about school inclusivity and nationwide, school-based research from GLSEN. https://www.glsen.org/
- Child and family support resources from PFLAG. https://pflag.org/
- Clothing for trans girls, Ruby Shines. https://rubyshines.com/
- Patient information about chest binding. https://anchorhealthct.org/all-about-chest-binding/
- Signs for posting in gender inclusive bathrooms. http://www.bathroom.support/
- 24/7 information and support for trans youth and national research, Trevor Project. https://www.thetrevorproject.org/ , 866-488-7386
- Trans peer support, Trans Lifeline. https://translifeline.org/ , 877-565-8860
- World Professional Association for Transgender Health. https://www.wpath.org/
Clinic Updates/Tips:
- Check the board for vaccines/tests out of stock
- We can give 6 months+ COVID Vaccines now!

Week 16 (10/17 - 10/21): Acne Vulgaris (YW-35)

Primary Reference: Ashton R, Weinstein M. Acne Vulgaris in the Pediatric Patient. Pediatrics in Review. 2019;40(11): 577-589.
Board Questions: For Learners, For Moderators
Moderators: M: Avery T: Yash W: Jessica Th: Najima F: Michael
Resources:
- American Acne & Rosacea Society - Acne Guidelines
- Patient handout from Society for Pediatric Dermatology. http://pedsderm.net/site/assets/files/1028/spd_acne_long_updated.pdf
- Patient information handout on acne. American Family Physician. https://familydoctor.org/condition/acne/
Clinic Updates/Tips:
- Check the board for vaccines/tests out of stock
Grand Rounds https://us06web.zoom.us/j/87069289961?pwd=aFNUKzdLci9yajgrMXVvRkFaTWxvQT09

Week 15 (10/10-10/14): Male GU Development and Assessment (YW-29)

Primary Reference:
- Wu WJ, Gitlin JS. The male genital system. Pediatrics In Review. 2020;41(3): 101–111.
- Cavanaugh RM. Screening for genitourinary abnormalities in adolescent males. Pediatrics In Review. 2009;30(11): 431–438.
Board Questions: For Learners, For Moderators
Moderators: M: Kaitlyn T: Daun'Lee W: Yemi Th: Shield F: Lauren
Resources:
- USPTF guidelines on testicular cancer screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/testicular-cancerscreening
- CDC STI Guidelines. https://www.cdc.gov/std/treatment-guidelines/default.htm
- American Cancer Society patient handout on testicular cancer. https://www.cancer.org/cancer/testicular-cancer/detection-diagnosis-staging/detection.html
- References for Children on Testicular Self Exam. https://kidshealth.org/en/teens/tse.html
Clinic Updates/Tips:
- Check the board for vaccines/tests out of stock

Week 14 (10/3-10/7): Childhood Nutrition (YW-85)

Primary Reference: USDA 2020-2025 Dietary Guidelines for Americans. Retrieved May 6, 2022, (Read chapters 2 & 3, pages 52-89)
Board Questions: For Learners, For Moderators
Moderators: M: Steven T: Briana W: Lior Th: Nikki F: Anjali
Resources:
- Growth charts and National Health and Nutrition Examination Survey data. www.cdc.gov/growthcharts/
- WHO Child Growth Standards. www.who.int/childgrowth/standards/en/
- Picky Eaters: HealthyChildren, CDC, Kids Eat in Color, MyPlate
- Individualized patient information regarding nutrition choices. http://www.choosemyplate.gov/
- Patient information about nutrition. http://www.nlm.nih.gov/medlineplus/nutrition.html
- American Dietary Guidelines since 1908s' https://cspinet.org/sites/default/files/attachment/dietary-guidelines-infographic.jpg
- Dietary guidelines worldwide, collected by the UN. http://www.fao.org/ag/humannutrition/nutritioneducation/fbdg/en/
- Guidelines for introduction of peanuts to infants, National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/sites/default/files/addendum_guidelines_peanut_appx_d.pdf
Clinic Updates/Tips:
- Make sure ALL Referrals our marked as OUTGOING/EXTERNAL

Week 12 & 13 (9/19-9/30): Continuity Clinic Feedback Sessions

Attendings and Residents will have 5-10 minute one-on-one feedback sessions
Primary Reference:
- Relationship, Reaction, Content and Coaching Feedback Method
  - R2C2 Feedback and Coaching for Residents, Sample Action Plan
When not in your session:
- Please make sure your inbox and task box are cleared (notes, charts, charges, patient calls, labs, etc.)
- Work on any macros, smart phrases, favorites, etc.
Clinic Updates:
- Ask your attending for any vaccine/test changes

Week 11 (9/12-9/16): Climate Change (YW-24)

Primary Reference:
- Ahdoot S, et al. AAP Technical Report: Global climate change and children’s health. Pediatrics. 2015;136(5): e1468–e1484
- Focus on the Recommendations on page 995 only. Council on Environmental Health, et al. AAP Policy Statement: Global climate change and children’s health. Pediatrics. 2015;136(5): 992-997.
Board Questions: For Moderators, For Learners
Moderators: M: Josh T: Nicole P W: Alis Th: Erum F: Andy
Resources:
- HealthyChildren.Org - How Climate Change Affects Children's Health
- Family disaster preparedness information provided in many languages. https://www.ready.gov/kids
- Climate information for families from the AAP. https://www.aap.org/en/patient-care/climate-change/
- Low Income Home Energy Assistance Program. https://www.benefits.gov/benefit/623
- U.S. Department of Health and Human Services Disaster Distress helpline. Call or Text 1-800-985- 5990; https://www.samhsa.gov/find-help/disaster-distress-helpline
- Program for doubling SNAP dollars at farmer’s markets. https://doubleupamerica.org/
- Pediatric Envronmental Health Specialty Units Webinars https://www.pehsu.net/webinars.html
Clinic Updates/Tips/Tools:
- We have FLU SHOTS for VFC & Private
- we are OUT of shots for VFC (MMRV, MCV-4, IPV, VZV), Private (VZV)

Week 10 (9/6-9/9): Hematuria & Proteinuria (YW-91)

Primary Reference: Viteri B, et al. Hematuria and proteinuria in children. Pediatrics in Review. 2018;39(12): 573-587.
Board Questions: For Learners, For Moderators
Moderators: M: Holiday T: Tim W: Sonia Th: Freya F: Michael (Freya Supports)
Resources:
- https://familydoctor.org/proteinuria-in-children/
- HealthyChildren.Org
Clinic Updates/Tips/Tools:

Week 9 (8/29 - 9/2): Infant and Toddler Development (YW-3)

Primary Reference:
- Scharf RJ, Scharf GJ, Stroustrup A. Developmental Milestones. Pediatrics in Review. 2016;37(1): 2538.
- Algorithm in Figure 2 on pages 4 of: AAP Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics. Promoting Optimal Development: Identifying Infants and Young Children with Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics. 2020;145(1): e20193449.
Board Questions: For Learners, For Moderators
Moderators: M: Kaitlyn (Josh Supports) T: Valeria W: Lior (Joanne Supports) Th: Yash (Lauren Supports) F: Najima
Resources:
- CDC Develomental Milestones Revised 2022
  - https://www.cdc.gov/ncbddd/actearly/milestones/index.html
- Information from CDC for parents on childhood development.
  - http://www.cdc.gov/ncbddd/childdevelopment/index.html
- Information from CDC on parenting and behavioral guidance.
  - http://www.cdc.gov/parents/essentials/
- Information on disabilities in children and early intervention programs from the Center for Parent Information and Resources.
  - http://www.parentcenterhub.org/
- Information from Zero to Three, a non-profit organization devoted to early childhood health.
  - http://www.zerotothree.org
- Parents’ Evaluation of Developmental Status.
  - http://www.pedstest.com
- Ages & Stages Questionnaires.
  - http://www.brookespublishing.com/tools/asq/index.htm
  - https://www.healthychildren.org/english/ages-stages/
- Autism screening and MCHAT-R.
  - http://mchatscreen.com
- Information on toxic stress and resiliency (includes extensive list of resources to share with families).
  - http://aap.org/theresilienceproject
- Evidence-based interventions for the primary care setting
  - Healthy Steps: https://www.healthysteps.org/
  - Video Interaction Project: https://www.videointeractionproject.org/
  - Incredible Years: http://www.incredibleyears.com/
  - Triple P: http://www.triplep.net/glo-en/home/
  - Parent Child Interaction Therapy: http://www.pcit.org/
Clinic Updates/Tips/Tools:
- Out of PRIVATE vaccines: VAXELIS (hib/hepb/ipv/dtap), GARDASIL (HPV)

Week 8 (8/22-8/26): School Readiness & Failure (YW-27)

Primary Reference:
- Rey-Casserly, Committee on Psychosocial Aspects of Child and Family Health, Section on Developmental and Behavioral Pediatrics. School-aged Children Who Are Not Progressing Academically: Considerations for Pediatricians. Pediatrics. 2019;144(4): e20192520.
- Williams PG, Lerner MA, Council on Early Childhood, Council on School Health. School Readiness. Pediatrics. 2019;144(2): e20191766.
Board Questions: For Learners, For Moderators
Moderators: M: Avery T: Daun'lee (Briana Supports) W: Jessica Th: Amy F: Sylvester
Resources:
- Guide to the Individualized Education Program. http://www.ed.gov/parents/needs/speced/iepguide/iepguide.pdf
- The National Early Childhood Technical Assistance Center. https://ectacenter.org/
- American Speech-Language-Hearing Association handouts for parents. http://www.asha.org/public/speech/development/Parent-Stim-Activities.htm
- Office of Head Start. https://eclkc.ohs.acf.hhs.gov/about-us/article/office-head-start-ohs
- School readiness handout from AAP.
Clinic Updates/Tips/Tools:
- MCV4 and MMRV are back in stock!

Week 7 (8/15-8/19): Fatherhood (YW-9)

Primary References:
- Yogman M, Garfield CF, Committee on Psychosocial Aspects of Child and Family Health. Fathers’ Roles in the Care and Development of Their Children: The Role of Pediatricians. Pediatrics. 2016; 138(1): e20161128.
- Garfield CF. Supporting Fatherhood Before and After It Happens. Pediatrics. 2015;135: e528-e530.
Board Questions: For Learners, For Moderators
Moderators: M: Erum (Amy supports) T: Nicole P W: Nicole A Th: Andy F: Andy
Resources:
- Information for parents from National Fatherhood Initiative. www.fatherhood.org
- Information for fathers from US Department of Health & Human Services. www.fatherhood.gov
- Step by Step: Engaging Fathers in Programs for Families. http://www.beststart.org/resources/howto/pdf/BSRC_Engaging_Fathers.pdf
- Resources for fathers. http://www.fathers.com
- Bootcamp for New Dads https://www.bootcampfornewdads.org/
  - UMC Healthy Living Institute https://www.umcsn.com/foundation-community-support/healthy-living-institute
- Paternal Postpartum Depression
  - https://ldchealth.org/DocumentCenter/View/3008/Paternal-Postpartum-Depression_final
Clinic Updates/Tips/Tools:

Week 6 (8/5-8/12): Management of Suspected Child Abuse (YW-15)

Primary Reference: Glick JC, Lorand MA, Bilka KR. Physical Abuse of Children. Pediatrics in Review. 2016;37(4): 146-158
Board Questions: For Learners, For Moderators
Moderators: M: Josh T: Valeria W: Chelsea (Jessica Support) Th: Anjali (Misha Support) F: Freya
Resources:
- Prevent Child Abuse Nevada Chapter https://nic.unlv.edu/pcanv.html
- Information on child maltreatment from CDC. www.cdc.gov/ViolencePrevention/childmaltreatment/
- Information on child maltreatment from WHO. https://www.who.int/news-room/fact-sheets/detail/child-maltreatment
- US Department of Health and Human Services statistics on child abuse. https://www.acf.hhs.gov/cb/data-research/child-maltreatment
- Suggested reading about the history of child protection in the United States
  - Out of the Darkness: The Story of Mary Ellen Wilson. https://www.amazon.com/OutDarkness-Story-Ellen-Wilson/dp/0966940008
- CPS Reporting Online https://www.clarkcountynv.gov/residents/family_services/services/child_protection.php (includes the online form)
Clinic Updates/Tips/Tools:
- MCV is in stock

Week 5 (8/1-8/5): Common Newborn Skin Findings (YW-6)

Primary Reference: . Goodarzi H, Wu TT, Wang J, Teng JM. Neonatal Dermatology: The Normal, the Common, and the Serious. NeoReviews. 2021;22(1): e40-e51. PDF Version
Board Questions: For Learners, For Moderators
Moderators: M: Avery T: Briana W: Yemi Th: Sonia F: Sylvester
Resources:
Clinic Updates/Tips/Tools:
- Online handbook about black and brown skin. https://www.blackandbrownskin.co.uk/mindthegap
- Photos and descriptions of skin findings in newborns. https://med.stanford.edu/newborns/professional-education/photo-gallery.html

Week 4 (7/25-7/29): Follow-up of Hospitalized Children (YW-67)

Primary Reference: Schmitz K. Vulnerable Child Syndrome. Pediatrics in Review. 2019;40(6): 313-315
Board Questions: none this week
Moderators: M: Amy T: Tim W: Nicole A Th: Alis F: Najima
Resources:
- Medicare discharge planning checklist for patients and families. https://www.medicare.gov/Pubs/pdf/11376-discharge-planning-checklist.pdf
Clinic Updates/Tips/Tools:

Week 3 (7/18 - 7/22): Health Literacy: Closing the Gap (Yale Week 19)

Primary References: Bass PF. 3 steps to boost health literacy. Contemporary Pediatrics. 2018. Retrieved April 28, 2022
Board Questions: None
Moderators:
- M: Maral T: Joanne W: Jessica Th: Nicole P. F: Freya
Resources:
- The Newest Vital Sign Toolkit for providers. https://www.pfizer.com/health/literacy
- Pictograms of >75 commonly used prescriptions. (TIP: You can copy and paste these into your AVS!)
  - http://www.usp.org/health-quality-safety/usp-pictograms
- Health Literacy Universal Precautions Toolkit from AHRQ. http://www.ahrq.gov/qual/literacy/
- Searchable database of patient handouts in multiple languages. www.healthfinder.gov
- Handout for parents about giving liquid medications. https://www.healthychildren.org/English/safety-prevention/at-home/medicationsafety/Pages/Using-Liquid-Medicines.aspx
- Online readability calculator which provides commonly used readability scores, including grade level.
  - http://www.readabilityformulas.com/free-readability-formula-tests.php
- Instructions on testing readability of your own text using Microsoft Word (FYI, this chapter is written at a 12th grade level!).
  - http://office.microsoft.com/en-us/word-help/test-your-document-s-readability-HP010148506.aspx
Clinic Updates/Tips/Tools:
- Out of PENTACEL (Dtap, HIB, IPV)

Week 2 (7/11 - 7/15): Agenda Setting (YW 4)

Primary References:
- Baker LH, O’Connell D, Platt FW. Setting the agenda for the clinical interview. Annals of Internal Medicine. 2005;143(10): 766-70.
- Bright Futures: Agenda Setting Presentation (Script for Presentation)
Board Questions: None
Moderators:
- M: Steven T: Tim W: Yemi Th: Alis F: Misha
Resources:
- Institute for Family Centered Care. http://www.familycenteredcare.org/
- American Academy of Communication in Healthcare. http://www.aachonline.org/
- Bright Futures Educational Resources. https://www.aap.org/en/practice-management/bright-futures/bright-futures-in-clinical-practice/bright-futures-educational-resources/
Clinic Updates/Tips/Tools:
- 5-STEP PATIENT-CENTERED BEGINNING OF INTERVIEW

Week 1 (7/5 - 7/8): Welcome Week!

Get to know your colleagues, attendings and staff.
Make sure on your logins work (EPIC, Haiku, Canto)
Split into small groups and trade EPIC, EHR, and Billing tips
(Optional) Set up speech dictation

Primary Reference: None
Board Questions: None
Moderators: Attendings
Resources: https://sites.google.com/unlv.edu/peds/resources#h.p_DyC-y6q_SfyB
Clinic Updates/Tips/Tools:

CCC 2021-2022 Archive

Week 1 (6/28 - 7/2): Goodbye and Welcome! ¡Adios y Bienvenidos!

No CCC this week! Thank your seniors and welcome the new interns!
Board Questions: None this week!
Moderators: Everyone!

Wk 2 (7/5 - 7/9): EPIC Tips & Tricks, Oral Presentations

As a continuation of clinic orientation, senior residents will partner with interns to share EPIC Tips, Tricks and Oral Presentations to set them up for SUCCESS!

Moderators: All Seniors
Board Questions: None
Clinic Resources:
- EPIC Help, EPIC FAQs
- Outpatient Presentation Guides: Well Child Presentation, Sick Visit Presentation
- UCF: Guide to the Comprehensive Pediatric H&P
CLINIC UPDATE: LEAD TESTING IS CURRENTLY OUT OF SERVICE, ANY TESTING BETWEEN 5/28/21-7/6/21 MUST BE RETESTED AT THE NEXT VISIT. WE WILL LET YOU KNOW WHEN LEAD TESTING IS AVAILABLE.

Wk 3 (7/12-7/16): Integrated Children's Mental Health

Understand how to access and benefit from the PAL (Pediatric Access Line).
Demonstrate basic knowledge of principles of integrated children's mental health.

Primary References: Implementing Integrated Care in Pediatric Mental Health: Principles, Current Models, and Future Directions, UNLV PAL Info Sheet
Moderators: Dr. Lisa Durette (PD for Child Psychiatry Fellowship), and Angela Townsend (Program Care Coordinator). M/F: in person, T/W/Th: via Zoom
Board Questions: None
Clinic Resources: https://center4cs.org/ https://www.unlv.edu/cicfc

Wk 4 (7/19-7/23): Agenda Setting in the Outpatient Visit (YW-3)

Explain the importance of effective agenda-setting in the outpatient clinic
Identify potential barriers to effective agenda-setting
Demonstrate effective agenda-setting using the exhaustive “What else?” and negotiation of priorities at the outset of the encounter
Discuss core elements of visit closure

Primary Reference(s): Baker LH, O’Connell D, Platt FW. Setting the agenda for the clinical interview. Annals of Internal Medicine. 2005;143(10): 766-70
Moderators: M: Briana, T: Erik, W: Valeria, Th: Mahdika, F: Avery
Board Questions: None
Clinic Resources:
- Yale: 5 Step Patient Centered Beginning of Interview

Wk 5 (7/26-7/30): The Difficult Encounter (YW-88)

Become aware of negative feelings during challenging provider/parent interactions
Be able to use empathic, understanding responses during difficult encounters
Set clear boundaries effectively when appropriate.

Primary Reference(s): Asnes AG, Shenoy A. The difficult pediatric encounter: insights and strategies for the pediatric practitioner. Pediatrics in Review. 2008; 29(6): e35-e41.
Moderators: M: Freya T: Hager W: Manisha Th: Joanne F: Arianna
Board Questions: none
Clinical Resources:
- Search tool for state-specific information regarding child welfare.
  - http://www.childwelfare.gov/systemwide/laws_policies/state/index.cfm

Wk 6 (8/2-8/6): High Value Care (YW-8)

Understand the definition of value in health care.
Identify barriers to high value care in the primary care setting.
Utilize strategies to evaluate potential care plans based on best practices and to communicate these to patients and families

Primary Reference(s): Owens D, et al. High-Value, Cost-conscious Health Care: Concepts for Clinicians to Evaluate the Benefits, Harms, and Costs of Medical Interventions. Ann Int Med. 2011;154(3): 174-180
Moderators: M: Maral T: Andy W: Cherry Th: Kiran F: Najima
Board Questions: none
Clinical Resources:
- Choosing Wisely list of high-value care suggestions from American Academy of Pediatrics. http://www.choosingwisely.org/societies/american-academy-of-pediatrics/
- Lown Institute spearheads research on high-value care (http://lowninstitute.org) through its RightCare Alliance. http://rightcarealliance.org
- Tufts Cost Effectiveness Registry. http://healtheconomics.tuftsmedicalcenter.org/cear4/Home.aspx
- Clearinghouses for various types of health care costs:
  - CDC vaccine costs. https://www.cdc.gov/vaccines/programs/vfc/awardees/vaccinemanagement/price-list/index.html
  - Costs of various medical interventions. https://www.healthcarebluebook.com/page_Default.aspx
  - Cost of asthma ED visit. https://www.cdc.gov/pcd/issues/2014/14_0139.htm
CLINIC UPDATE: Please try to finish your notes before you leave clinic, but if you need more time you can use any of the clinic desktops on your own time or any of the computers in the 1701 W. Charleston Building - Pediatrics Suite: Rooms 670-6, 670-7 (not Dr. Meyers' computer). Also, POCT-Lead Testing is now available. Make sure to re/check any patients that had lead testing between October 27, 2020 and June 15, 2020 or missed their testing at the 12 or 24m WCC. Read more about the recall here.

Wk 7 (8/9-8/13): Fever in Children Less than 36 Months (YW-92)

Know how to respond to common parental misconceptions about fever
Identify children at low- and high-risk for invasive bacterial infection
Know common management strategies for managing febrile young children
Describe the impact of pneumococcal conjugate vaccine on the management of fever in children.

Primary Reference(s):
- Hamilton JL, Evans SG, Bakshi M. Management of Fever in Infants and Young Children. American Family Physician. 2020;101(12): 721-729.
- AAP Pediatrics Eval & Management of Well Appearing Febrile Infants 8-60 days old AUGUST 2021
Moderators: M: Evins T: Cynthia W: Will Th: Sonia F: Jessica
Board Questions: For Learners, For Moderators Only
Clinical Resources:
- Fever information for parents from AAP. http://www.healthychildren.org/English/healthissues/conditions/fever/pages/Fever-Without-Fear.aspx
- Mayo Clinic fever handout for parents. http://www.mayoclinic.com/health/fever/ID00052
CLINIC UPDATES:
- After the CCC session, touch base with your M.A. to discuss any possible issues/updates with patients
- Plug in your laptops after you finish up for the day, and turn off the keyboard backlight to save battery
- Use the LAPTOP TICKET if you have any issues with your laptop, the forms are near the printers, and turn it into an attending or to Shelly
- Please follow up on any labs or imaging you may have ordered on a previous patient. See the Caregiver Call Section for help with documentation.
- Please make sure your vaccines orders are supervised by your attending (and also changed to them as the ordering provider)
- Starting September/October, the 11:20am and 4:20am double booking will be replaced with a double booking at 10am and 3pm (this will keep the numbers up without having to book a 11:40 and 4:40 where patients show up late)
- Efforts will be made to have the Pharmacy on File.

Week 8 (8/16 - 8/20): Identification of the Sick Child (YW-68)

Recognize the importance of observation in identifying sick children
Understand the value of a clinician's instinct in determining which children have serious illness
Become familiar with the most common serious illnesses in young children

Primary Reference: Buntinx F, et al. Dealing with low-incidence serious diseases in general practice. British Journal of General Practice. 2011;61: 43-6.
Board Questions: For Learners, For Moderators
Moderators: M: Hager T: Briana W: Will Th: Gerard F: Tara
Clinic Updates:
- A new whiteboard was added to the Silver Room, please make sure you have an assigned MA with you.
- Use the laptop tickets if you have any issues. thanks!
Clinic Tool:
- from Chapter 11 in Harriet Lane:

Week 9 (8/23 - 8/27): Health Supervision (YW-1)

Design a plan for routine screening during a health supervision visit
Describe the organizations that decide the periodicity schedule and recommended interventions
Evaluate the evidence supporting the topics discussed during a well-child visit
Critique current well-child visit models and offer alternative approaches to typical well-child care
Discuss the relevance of well-child care on adult health outcomes

Primary Reference(s):
1. Needlman R. Thoughts on health supervision: learning-focused primary care. Pediatrics. 2006;117(6): e1233-e1236.
2. Coker TR Thomas T, Chung PJ. Does Well-Child Care Have a Future in Pediatrics? Pediatrics. 2013;131(S149): s149-159.
Board Questions: Learners Moderators
Moderators: M: Freya T: Andy W: Alis Th: Joanne F: Arianna
Resources:
1. Bright Futures: https://brightfutures.aap.org
2. USPSTF guidelines. http://www.uspreventiveservicestaskforce.org and
  - Summary of recommendations pertaining to children and adolescents http://www.uspreventiveservicestaskforce.org/BrowseRec/Index?age=Pediatric,Adolescent
3. Summary of changes to AAP periodicity schedule.
  - https://pediatrics.aappublications.org/content/147/3/e2020049776
4. Bright Futures Books: Pocket Guide, Parent Guides, Physical Exams
5. CDC: Learn the Signs. Act Early https://www.cdc.gov/ncbddd/actearly/index.html
Clinic Updates/Tips/Tools:
1. The Bright Futures Parent Guides are 1-2 pages only, easier to read, already printed out, and are overall preferred vs the WCC Guides in Epic. If it runs out, you can find more here and here
2. Billing Tips: For Patients insured with Medicaid (which will be in the insurance name as well, and includes Silver Summit), use an EP modifier (since we follow EPSDT guidelines at our well visits), or a TS modifier (if the patient will be referred to a specialist at this well child visit)
3. Please plug in your laptop between patients and after you finish with clinic for the day, and continue to submit laptop tickets so we can fix them, so far we are fixing 4, so thanks for your help!
4. CCSD COVID CLEARANCE FORMS

Wk 10 (8/30 - 9/3): Ambulatory Mock Code Week

Understand the importance of Preparing for Office Emergencies
Know where to find all emergency equipment and medications
Participate in a Mock Code Session
Practice High Quality CPR and Oxygen Tank Use

Primary Reference: AAP Committee on Pediatric Emergency Medicine Preparation for Emergencies in the Offices of Pediatricians and Pediatric Primary Care Providers Pediatrics July 2007, 120 (1) 200-212
Board Questions: None
Moderators: Attendings
Clinic Updates, Tips & Tools:
- EPIC Remote Access is BACK! Go to Suite 200 Classroom 4 at Delta Point (901 S. Rancho) for access. Bring any laptops or tablets which you may need help setting this up.
- A Temporary Resident Work & Study Room is available in the 1701 Suite, Room 670-14. Please keep it tidy.
- For those on Caregiver/Mommy Call, please check New Innovations to see who is on call, the nursery calendar has the attending who can assist you. Please note this changes on a daily basis.

Week 11 (9/7 - 9/10): Rhinorrhea & Congestion (YW-108)

Identify the signs and symptoms of an uncomplicated upper respiratory infection, allergic rhinitis and conjunctivitis, and acute and chronic sinusitis, differentiating these from other causes of rhinorrhea
Discuss the available modalities for testing, for environmental control, and for treatment of allergic rhinitis and conjunctivitis
Describe treatment of sinusitis and reasons for referral

Primary Reference(s):
- Gargiulo KA, Spector ND. Stuffy Nose. Pediatrics in Review. 2010;31: 320-324
- DeMuri GP, Wald ER. Acute Bacterial Sinusitis in Children. Pediatrics in Review. 2013;34: 429-437
Board Questions: Learners, Moderators
Primary Moderators: M: HOLIDAY T: Lauren W: Nicole P Th: Sylvester F: Yemi
- Supportive Moderators: M: HOLIDAY T: Erik W: Valeria Th: Mahdika F: Ryan
Resources:
- DX & Management of Acute Bacterial Sinusitis: 2013 AAP Guideline
- CCSD COVID Clearance Forms
Clinic Updates/Tips/Tools:
- Gripa/Gripe is a Spanish term that can mean rhinorrhea, a cold, or flu. Gripador means stapler.

Week 13 (9/20 - 9/24): Newborn Concerns (YW-9)

Understand the role of the prenatal visit in establishing a medical home
Describe normal newborn movements and habits
Understand the timing of and risks for shaken baby syndrome, and outline anticipatory guidance that may be preventive
Emphasize the importance of secure attachment of the child and parents early in life
Identify the most common benign newborn rashes and delineate appropriate guidance

Primary Reference(s): Benitz WE, Committee on Fetus and Newborn. AAP Policy Statement – Hospital Stay for Healthy Term Newborns. Pediatrics. 2015;135(5): 948-953.
Board Questions: For Learners, For Moderators
Moderators: M: Zach T: Manisha W: Cherry Th: Jessica T/Sonia (support) F: Jessica B
Resources:
- Handout from JAMA for parents about newborn care.
  - http://jama.jamanetwork.com/article.aspx?articleid=191813
- General information regarding infant care.
  - www.mayoclinic.com/health/healthy-baby/FL99999
- Period of Purple Crying.
  - www.purplecrying.info
- Stanford Newborn Nursery Photo Gallery: Skin.
  - https://med.stanford.edu/newborns/professionaleducation/photo-gallery/skin.html
Clinic Updates/Tips/Tools:
- When ordering an XRAY, please make sure to give the IMAGING SLIP (reprint if necessary), let the family know where they should go AND document where you are sending them in your note.

Week 12 (9/13 - 9/17): Ear Infections (YW-19)

Describe the pathophysiology of acute otitis media (AOM), including the underlying anatomy, common pathogens, and natural history
Differentiate between mild and severe AOM utilizing history and physical exam findings
Develop a step-wise treatment approach including indications for observation or active treatment
Understand the possible complications of AOM, and indications for referral to specialty services
Differentiate otitis externa from AOM and describe pathogenesis, treatment, and indications for referral.

Primary Reference(s):
- Pages 965-966, 970-990 of: Lieberthal AS, et al. AAP Clinical Practice Guideline: The diagnosis and management of acute otitis media. Pediatrics. 2013;131:3 e964-e999.
- Long M. Otitis externa. Pediatrics in Review 2013;34: 143-144.
Board Questions: For Learners, For Moderators
Primary Moderators: M: Nicole A T: Josh W: Steven Th: Kiran F: Najima
- Supportive Moderators: M: Amy T: Arianna W: Avery Th Kiran F: Najima
Resources:
- Otoscope Examination Tips
Clinic Updates/Tips/Tools:
- Reminder: only residents in good clinical standing which includes having the primary care waiver can "precept' a medical student. All residents are however welcome to invite medical students into a patient room for a significant findings (with the parent's permission first)
- Attendings will do our best to help with any urgent tasks, labs and patient calls. We have already developed a protocol for urgent patient calls during office hours. If you are requested to follow up with a family about labs or a patient call and are unable to (due to nights), please let the attending know.
- The 3:20 double bookings have started as the 4:20 double bookings are being seen and phased out.

Week 14 (9/27 - 10/1): Lymphadenopathy (YW-75)

1. Define lymphadenopathy.

2. Develop a differential diagnosis for acute and chronic cervical lymphadenopathy specific to different age groups.

3. Describe key components of the history and physical exam to evaluate lymphadenopathy.

4. Discuss the diagnostic workup for pediatric patients presenting with lymphadenopathy.

5. Understand the indications for lymph node biopsy.

Primary Reference(s): Sahai S. Lymphadenopathy. Pediatrics in Review. 2013;34: 216-227.
Board Questions: For Learners, For Moderators
Moderators: M: Tim/Evins T: Cynthia W: Alis Th: Mahdika F: Misha/Amy
Resources:
- Patient information on lymphadenopathy from Mayo Clinic. http://www.mayoclinic.org/diseasesconditions/swollen-lymph-nodes/basics/definition/con-20029652
Clinic Updates/Tips/Tools:
- Flu Shots are available for private and Medicaid insurances, please don't forget to ask at each visit.

Week 15 (10/4-10/8): Vision Screening (YW-50)

Describe published recommendations for routine screening of vision
Appreciate common disorders of vision in childhood
Practice physical exam techniques to identify common problems related to childhood vision

Primary Reference(s): Loh AR, Chiang MF. Pediatric vision screening. Pediatrics in Review. 2018;39(5): 225-233
Board Questions: For Learners, For Moderators
Moderators: M: Zach T: Hager W: Will Th: Kiran F: Tara
Resources:
- Diagrams of cover-uncover test and alternating cover test in Figures 6&7 of Rogers & Jordan, Pediatrics in Review, 2013. http://pedsinreview.aappublications.org/content/34/3/126.full.pdf+htm
- AAO: Pediatric Eye Evaluations
- Spot Vision Screener Conversion Chart
Clinic Updates/Tips/Tools:
- Ryan started a QI project using the WCC forms, please take a look at the bottom of the forms, and help fill them out if not done already. Place the form in the bin in the silver room when done.
- Brittany MS4, is visiting from Michigan State University for the month.

Week 16 (10/11-10/15): Constipation (YW-62)

Understand the definition of constipation
Create a treatment plan for constipation, including initial and maintenance therapy, relapse prevention, and medication discontinuation
Know when subspecialty referral is indicated

Primary Reference(s): LeLeiko NS, Mayer-Brown S, Cerezo C, Plante W. Constipation. Pediatrics in Review. 2020;41(8): 379- 392
Board Questions: For Learners, For Moderators
Moderators: M: Nicole A T: Andy W: Nicole P Th: Sonia F: Ryan
Resources:
Clinic Updates/Tips:
- Continue to encourage flu shots! Dont forget to encourage parents of children who are too young to receive them.
- Since the recent EPIC update some major issue have come up, which we are working on fixing ASAP.
  - Immunizations are not synchronizing well with EPIC (so please check WEB-IZ)
  - Printing can be done on personal laptops, EXCEPT the AVS
  - AVS printing on some devices are creating XPS documents, please ask the attending to print it for you.
- The NBS password now ends with 21e

Week 17 (10/18 - 10/2): Urinary Tract Infections (YW-122)

Discern situations in which obtaining a urine sample in a febrile child is appropriate
Review methods of obtaining urine samples and their relative merits and drawbacks
Develop an age-appropriate approach to diagnosis and treatment of urinary tract infection
Evaluate when further work-up, specifically imaging studies, is necessary

Primary Reference(s): Mattoo TK, Shaikh N, Nelson CP. Contemporary Management of Urinary Tract Infections in Children. Pediatrics. 2021;147(2): e2020012138.
Board Questions: For Learners, For Moderators
Moderators: M: Freya T: Erik W: Steven Th: Attending F: Avery
Resources:
- UTICalc for children 2-23 months of age, online tool to estimate probability of UTI. https://uticalc.pitt.edu
- Information from the National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-tract-infections-inchildren/treatment
- Patient information on VUR. https://www.niddk.nih.gov/health-information/urologicdiseases/hydronephrosis-newborns/vesicoureteral-reflux
- Pediatrics 2016: Reaffirmation of AAP Clinical Practice Guideline: The Diagnosis and Management of the Initial Urinary Tract Infection in Febrile Infants and Young Children 2–24 Months of Age
- Pediatrics 2021: Contemporary Management of UTI
- AAP News & Journal Post 2021: A Clinical Practice Literature Review of Pediatric UTIs
- Mt Sinai Provider Tip of the Week
Clinic Updates & Tips:
- Web-IZ integration and Printing are still an issue, please find a way to check WebIZ and ask an attending to print for you. Thanks!
- Continue to ask families if they want the flu shot.

Week 18 (10/25 - 10/29): Asthma (YW-23)

Describe the pathophysiology, triggers and risk factors for asthma
Classify asthma severity and assess asthma control according to national guidelines
Propose an appropriate treatment plan based on disease severity
Model asthma-related patient counseling and develop an asthma action planDescribe the pathophysiology, triggers and risk factors for asthma
Classify asthma severity and assess asthma control according to national guidelines
Propose an appropriate treatment plan based on disease severity
Model asthma-related patient counseling and develop an asthma action plan

Primary Reference(s): *keep in mind the specific sections*
1. Patel SJ, Teach SJ. Asthma. Pediatrics in Review. 2019;40(11): 549-564. (Read pages 549-553 and review figure 2, recognizing that treatment recommendations have been updated in the following references.)
2. NHLBI, National Asthma Education and Prevention Program. Expert panel report 3 (EPR-3): guidelines for the diagnosis and management of asthma - summary report 2007. J Allergy Clin Immunol. 2007;120: S94-138. (Figures 11-16 reinforce pertinent topics/information for this conference.)
3. Expert Panel Working Group of the NHLBI. 2020 focused updates to the asthma management guidelines: a report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol. 2020;146: 1217-1270. (Read figures 2-4 which have the pertinent updates on the approach to asthma treatment - pages 15-20 of the PDF)
Board Questions: For Learners, For Moderators
Moderators: M: Josh T: Cynthia W: Cherry Th: Jessica T F: Happy Nevada Day!
Resources:
1. Asthma information for providers, including PDA resources and asthma action plans (English and Spanish). http://www.nhlbi.nih.gov/health/prof/lung/index.htm
2. Asthma information for patients and families. http://www.nhlbi.nih.gov/health/public/lung/index.htm
3. Asthma Control Test and Childhood Asthma Control Test. http://www.asthmacontroltest.com/
Clinic Updates/Tips/Tools:
1. Respiratory Inhalers at a Glance Poster
2. Mt Sinai Parenting Tip of the Week
3. For the After Visit Summary, please be accurate for when you want the patient to follow up. Check for recent well child checks, don't forget the 30 month well check, and watch out for vaccine timings.

Week 19 (11/1 - 11/5): Headache (YW-96)

Understand the definition of key primary headache types including migraine and tension type headaches and how these definitions differ from adult definitions
Know the indications for imaging and referral in the evaluation of primary headache
Identify the key components in the management of pediatric headaches including the role for complementary and alternative medicines
Understand the key components in the management of chronic daily headaches

Primary Reference(s):
1. Gelfand AA. Pediatric and adolescent headache. Continuum: Lifelong Learning in Neurology. 2018;24(4): 1108-1136.
Board Questions: For Learners, For Moderators
Moderators: M: Evins T: Briana W: Valeria Th: Joanne F: Yemi
Resources:
1. Handout on migraine headaches from American Family Physician. http://www.aafp.org/afp/2002/0215/p635.html
2. Handout on headache in children. https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/headaches/
Clinic Updates/Tips/Tools:
1. Headache Diary
2. Please by specific on your AVS to help our check out staff:
  - Always put WHY you want a follow pu
  - If you want more time at the next visit
  - If you want them to follow up with you
  - For vaccines, go by WEEKS not months
  - If the just need to follow up at the well check, just state follow up for next well check, and you don't have to put the date, the check out staff will find out for you.
3. Please check your EPIC messages and tasks regularly. If you need help setting up EPIC on your personal device, see here: Remote Access
4. Say hello to Kenneth! He's our clinic Sub-I for the month.

Week 20 (11/8 - 11/12): Media & Child Health (YW-30)

Identify forms and frequency of media exposure
Review evidence of potential positive and negative effects of media exposure on children
Counsel families regarding the responsible and productive use of media

Primary Reference(s):
1. American Academy of Pediatrics Council on Communications and Media. Media and young minds. Pediatrics. 2016;138(5): e20162591.
2. American Academy of Pediatrics Council on Communications and Media. Media use in school aged children and adolescents. Pediatrics. 2016;138(5): e20162592
Board Questions: For Learners, For Moderators
Moderators: M: Amy T: HagerW: Manisha Th: HOLIDAY F: Arianna
Resources:
1. Bibliography of recent publications related to screen time from AAP. https://www.aappublications.org/collection/screen-time
2. AAP guide to creating a Family Media Plan, available in English and Spanish. www.HealthyChildren.org/MediaUsePlan
3. AAP clearinghouse of resources for providers and families related to media use. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/pages/media-andchildren.aspx
4. Children and Media Tips from the AAP. https://www.aap.org/en-us/about-the-aap/aap-pressroom/news-features-and-safety-tips/Pages/Children-and-Media-Tips.aspx
Clinic Updates/Tips/Tools:
1. Mount Sinai Tip of the Week

Week 21 (11/15 - 11/19): Antibiotic Use in Primary Care (YW-17)

Discuss the potential benefits and harms of antibiotic use from both an individual and a community-based standpoint
Describe principles of responsible antibiotic prescribing
Practice methods to counsel family members about antibiotics

Primary Reference(s): Gerber JS, et al. AAP Committee on Infectious Diseases, Pediatric Infectious Diseases Society. Antibiotic Stewardship in Pediatrics. Pediatrics. 2021;147(1): e2020040295.
Board Questions: For Learners, For Moderators
Moderators: M: Zach T: Lauren W: Will Th: Kiran F: Najima
Resources:
1. 5-step patient-centered interviewing. Adapted by Fortin AH, Stein J from: Fortin AH 6th, Dwamena FC, Frankel RM, Lepisto BL, Smith RC. Smith’s Patient Centered Interviewing: An Evidence-based Method. 4th ed. New York: McGraw Hill, 2019. https://medicine.yale.edu/pediatrics/pcpc/learner/02b%20Agenda%20Fivesteps_335873_153_3833 2_v2.pdf
2. Get Smart campaign from CDC has links to information for families and providers about appropriate antibiotic use. http://www.cdc.gov/getsmart/
3. CDC compilation of guidelines for approaching antibiotic prescribing for common infectious diseases for pediatric ambulatory patients. https://www.cdc.gov/antibiotic-use/community/forhcp/outpatient-hcp/pediatric-treatment-rec.html
Clinic Updates/Tips/Tools:
1. Please have your notes done within 48 hours of the date of service.

Week 22 (11/22 - 11/26): Thanksgiving Week & Happy Indigenous People Month!

Come by clinic to celebrate with your co-residents and attendings!
Call or video chat with your family!
Be thankful!

Monday: TBD

Tuesday: High Tea Time (starts at 1pm) - Bring a light snack or dessert!

Wednesday: Potluck (starts around Noon) - Bring or order food to share! Patients are blocked after 3pm

Thursday: Clinic is Closed all Day!

Friday: Clinic is Closed all Day!

Week 23 (11/29 - 12/3): Discipline (YW-89)

Understand social determinants of development and behavior
Develop an understanding of the various discipline modalities
Learn how to guide parents with age-appropriate discipline techniques

Primary Reference(s): Sege RD, Siegel BS, Council on Child Abuse and Neglect, Committee on Psychosocial Aspects of Child and Family Health. Policy Statement: Effective Discipline to Raise Healthy Children. Pediatrics. 2018;142(6): e20183112. CORRECTION
Board Questions: None this week!
Moderators: M: Tim T: Andy W: Alis Th: Sonia F: Jessica B
Resources:
1. Information for parents on discipline from AAP, including list of age-appropriate strategies. http://www.healthychildren.org/English/family-life/family-dynamics/communicationdiscipline/Pages/Disciplining-Your-Child.aspx
2. Information for parents on discipline from the CDC, including list of age-appropriate strategies. ttps://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/index.html
3. Information for parents on time out. www.cyberparent.com/timeout
4. Discipline tips for parents. http://www.helpandhope.org/Parenting_Tips/articles/discipline.asp
5. Top Tips for Surviving Tantrums: https://www.healthychildren.org/English/family-life/familydynamics/communication-discipline/Pages/Temper-Tantrums.aspx
6. Effective Discipline to Raise Healthy Children (AAP stance against Corporal punishment, yelling)
7. Positive Parenting (Defines positive parenting and gives example cases)
Clinic Updates/Tips/Tools:
1. Please continue to complete all clinic notes within 48 hours! Thanks!
2. Mt Sinai Tips of the Week: Tummy Time

Week 24 (12/6 - 12/10): Sleep (YW-114)

Learn age-appropriate anticipatory guidance regarding sleep
Recognize and treat inappropriate sleep patterns in childhood and adolescence
Understand how to diagnose and treat childhood obstructive sleep apnea

Primary Reference(s): Bhargava S. Diagnosis and Management of Common Sleep Problems in Children. Pediatrics in Review. 2011;32: 91-99
Board Questions: For Learners, For Moderators
Moderators: M: Freya T: Erik W: Nicole P Th: Maral F: Sylvester
Resources:
1. Information for families on sleep disorders from American Academy of Sleep Medicine. www.sleepeducation.com

3. ‘Sleeping Angels’ blog about children’s sleep by Dr. Dennis Rosen, Psychology Today. http://www.psychologytoday.com/blog/sleeping-angels

4. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. www.pediatrics.org/cgi/doi/10.1542/peds.2016-2940

Clinic Updates/Tips/Tools:
1. Mt. Sinai Provider Tip of the Week: Comfort Positioning During Painful Procedures
2. Starting Monday we are giving our patients the Santa letter. If you have a patient in mind that you believe can benefit from this please let Nubia know so she can either call them and fill out for them or she can also email it to them. We are passing them out from today until December 17th. If you see any letters around the office please put them at Nubia's desk.

Week 25 (12/13 - 12/17): Learning Disabilities (YW-100)

Identify common types of specific learning disabilities in children
Create a differential diagnosis for children with suspected learning difficulties
Develop a plan for assessment and treatment of a child with learning difficulties
Discuss the role of the school system in special education services under the Individuals with Disabilities Education Improvement Act

Primary Reference(s):
1. Bravender T. School Performance: The Pediatrician’s Role. Clinical Pediatrics. 2008;47(6): 535-545
2. Lagae L. Learning Disabilities: Definitions, Epidemiology, Diagnosis and Intervention Strategies. Pediatric Clinics of North America. 2008;55(6): 1259-1268.
Board Questions: For Learners, For Moderators
Moderators: M: Nicole A T: Josh W: Steven Th: Jessica T F: Misha
Resources:
1. National Center for Learning Disabilities http://www.ncld.org
2. National Institute of Neurological Disorders Learning Disabilities Information http://www.ninds.nih.gov/disorders/learningdisabilities/learningdisabilities.htm
3. Individuals with Disabilities Education Improvement Act website http://idea.ed.gov
4. Overdiagnosis of ADHD, JAMA 2021
Clinic Updates/Tips/Tools:
1. Check out the Development, Disabilities & Education Section of Resources of this Clinic Site!
2. No RSV tests available as of 12/14/21

Week 26 (12/20 - 12/24): Christmas Week!

Come by clinic to celebrate with your co-residents and attendings!
Call or video chat with your family!
Spread Holiday Cheer!

Monday: TBD
Tuesday: Milks & Cookies (& other deserts)
Wednesday: Potluck?
Thursday: no continuity clinic, last patient booked at 11am
Friday: Closed

Week 27 (1/3-1/7): Children with Medical Complexity: Initial Assessment (YW-57)

Recognize characteristics of children with medical complexity (CMC)
Describe important considerations in the history for CMC
Recognize the importance of participation and quality of life for CMC at home and in the community

Primary Reference(s):
1. Kuo DZ, Houtrow AJ, Council on Children with Disabilities. Recognition and Management of Medical Complexity. Pediatrics. 2016;138(6): e20163021.
2. Sadof M, et al. The “HEADS AT” training tool for residents: A roadmap for caring for children with medical complexity. Clinical Pediatrics. 2015;54(12): 1210-1214. (Review Table 2 in preparation for this week.)
Board Questions: none this week
Moderators: M: Maral T: Misha W: Cherry Th: Yemi F: Tara
Resources:
1. GeneReviews, resource for clinicians to help care for children with underlying genetic syndromes. https://www.ncbi.nlm.nih.gov/pubmed/20301295
2. Educational module for additional practice in assessment of CMC. Huth K, Long-Gagne S, Mader J, Sbrocchi AM. Approach to clinical assessment of children with medical complexity. MedEdPORTAL. 2018;14:10765. https://www.mededportal.org/doi/10.15766/mep_2374-8265.10765
3. Rosenbaum P, Gorter JW, Rosenbaum P. The “F-words” in childhood disability: I swear this is how we should think! Child: Care, Health and Development. Wiley Online Libr. 2011;38(4):457-463. doi:10.1111/j.1365-2214.2011.01338.x https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2214.2011.01338.x
Clinic Updates/Tips/Tools:
1. We are scheduling COVID-19 Shots in clinic now! Tell families to inquire at check out on how to get set up!
2. Community Access to Child Health (CATCH) Grant Applications are due January 24th. More info here or ask Dr. Simangan!

Week 28 (1/10 - 1/14): Children with Medical Complexity - Physical Examination, Medical Technology Care, and Decision Making (YW-59)

Describe important considerations in the physical exam for children with medical complexity (CMC)
Discuss medical technologies used by CMC and potential complications that may arise
Provide anticipatory guidance for families of CMC for preventative health and safety

Primary Reference(s):
1. Glader L, Plews-Ogan J, Agrawal R. Children with medical complexity: creating a framework for care based on the International Classification of Functioning, Disability and Health. Dev Med Child Neurol. 2016;58(11): 1116-1123. https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.13201
2. Kingsley EP. Welcome to Holland. Down Syndrome Association of Simcoe County. 1987. Retrieved April 29, 2021, from http://www.dsasc.ca/uploads/8/5/3/9/8539131/welcome_to_holland.pdf
Board Questions: none this week
Moderators: M: Amy T: Evins W: Valeria Th: Kiran F: Avery
Resources:
1. GeneReviews, resource for clinicians to help care for children with underlying genetic syndromes. https://www.ncbi.nlm.nih.gov/pubmed/20301295
2. Educational module for additional practice in assessment of CMC. Huth K, Long-Gagne S, Mader J, Sbrocchi AM. Approach to clinical assessment of children with medical complexity. MedEdPORTAL. 2018;14:10765. https://www.mededportal.org/doi/10.15766/mep_2374-8265.10765

Week 29 (1/18 - 1/21): COVID-19 Rapid Diagnostic Testing, Quarantine & Isolation

(Moderator Version, Learner Version)

Know where to find the most up to date information on the COVID-19 Pandemic
Have an understanding of what is the general symptoms timeline for COVID-19
Know what types of Rapid Diagnostic Tests (RDT) are currently available for SARS-CoV-2 and how they work.
Understand when and which RDT should be used.
Be able to discuss areas of uncertainty with the current RDTs for COVID-19.
Develop an understanding of current quarantine and isolation recommendations.

Primary Reference(s):
1. Drain, Paul K. “Rapid Diagnostic Testing for SARS-CoV-2” New England Journal of Medicine 7 January 2022.
2. CDC COVID-19: Quaratine and Isolation. Website. Updated January 9, 2022.
Board Questions: none this week
Moderators: M: HOLIDAY (please still read through) T: Briana W: Will Th: Sonia F: Cynthia
Resources:
Clinic Updates/Tips/Tools:
1. Please complete all your notes (both clinic & hospital notes) before you leave clinic. If they are immunizations or other results from that day that need to be completed, please recheck EPIC the following day to complete them. If they are old vaccines/results, please message Kathy Kauder and Nancy Sanchez in Epic with the patient linked to the message. We have a severe amount of deficient notes that need to be completed, otherwise we may have to start taking disciplinary action. If you need help, please reach out to any attendings or chiefs.

Week 30 (1/24 - 1/28): Iron Deficiency Anemia (YW-53)

Understand the diagnostic evaluation of an anemic child
Describe common reasons for iron depletion/deficiency in US children
Outline the diagnosis and treatment of iron deficiency anemia and the next steps of management if a trial of supplemental iron has failed
Know the screening guidelines for anemia recommended by the American Academy of Pediatrics

Primary Reference(s): Baker RD, Greer FR, Committee on Nutrition. Clinical Report - Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010;126(5): 1040-1050.
Board Questions: For Learners, For Moderators
Moderators: M: Zach T: Lauren W: Alis Th: Sylvester F: Hager
Resources:
1. Handout for parents on iron deficiency anemia. www.kidshealth.com/parent/medical/heart/ida.html
Clinic Updates/Tips/Tools:
1. We have Pfizer Vaccines for 5+, typically on Thursdays, please let parents know that they can schedule this on the way out.

Week 32 (2/7 - 2/11): Toilet Training (YW-121)

Identify developmental markers that suggest a child is ready for toilet training
Assess parental obstacles to toilet training
Provide anticipatory guidance regarding toilet training
Identify health conditions that would interfere with toilet training

Primary Reference(s): Baird DC, Bybel M, Kowalski AW. Toilet training: common questions and answers. American Family Physician. 2019;100(8): 468-474.
Board Questions: For Learners For Moderators
Moderators: M: Tim T: Erik W: Freya Th: Jessica T F: Najima
Resources:
1. Toilet training handout for parents. https://www.aafp.org/afp/2019/1015/p468-s1.html
2. AAP handout on Toilet Training Children with Special Needs. https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/ToiletTraining-Children-with-Special-Needs.aspx
3. Mount Sinai Beginning Toilet Training https://parenting.mountsinai.org/parent-guides/beginning-toilet-training/?search=toilet%20training
4. Mount Sinai Potty Training with Positive Discipline https://parenting.mountsinai.org/parent-guides/potty-training-with-positive-discipline/?search=toilet%20training
Clinic Updates/Tips/Tools:
1. Mount Sinai Parenting Tip of the Week: Postpartum Depression & the Baby Blues
2. UNLV-CSUN Preschool Toilet Training

Week 33 (2/14-2/18): Heart Murmurs (YW-98)

Identify the six systolic and two continuous innocent murmurs of childhood
Recognize specific clinical features that are suggestive of pathologic murmurs
Describe options for further evaluation of murmurs and discuss their costs and benefits

Primary Reference(s): Etoom Y, Ratnapalan S. Evaluation of Children with Heart Murmurs. Clinical Pediatrics. 2014;53(2): 111-117.
Board Questions: For Leaners, For Moderators
Moderators: M: Freya T: Josh W: Nicole P Th: Sonia F: Jessica B.
Resources:
1. Menashe V. Heart murmurs data supplement (audio files). Pediatrics in Review. 2007;28: e19-e22. http://pedsinreview.aappublications.org/cgi/content/full/28/4/e19/DC1
2. Biancaniello T. Innocent murmurs: a parent’s guide. Circulation. 2004;109(11): e162-e163. http://circ.ahajournals.org/cgi/reprint/109/11/e162
3. There are many other sites that host audio files of murmurs, including:

https://depts.washington.edu/physdx/heart/demo.html http://thesimtech.com/audio/

https://www.easyauscultation.com/heart-murmur-sounds

https://www.med.ucla.edu/wilkes/intro.html

https://murmurquiz.org/

http://pted.org/

Clinic Updates/Tips/Tools:
1. Similac Formula Recall! Please inform families to check their cans/bottles: https://abbott.mediaroom.com/2022-02-17-Abbott-Voluntarily-Recalls-Powder-Formulas-Manufactured-at-One-Plant

Wk 34 (2/21-25) - Pediatric Hypertension (YW-22)

Define "hypertension" in the pediatric patient and distinguish between elevated blood pressure, stage 1 hypertension, and stage 2 hypertension
Recognize which children and adolescents need regular blood pressure monitoring
Demonstrate proper technique for blood pressure measurement
Initiate an evaluation for secondary causes, comorbidities, and end-organ damage in the pediatric hypertensive patient
Design an effective management strategy for treatment of children and adolescents with hypertension

Primary Reference: Flynn JT, Falkner BE. New clinical practice guideline for the management of high blood pressure in children and adolescents. Hypertension. 2017;70: 683-686.
Board Questions: For Learners, For Moderators
Moderators: M: Holiday T: Steven W: Valeria Th: Sylvester F: Tara
Resources:
- MD CALC - Pediatric Hypertension Guidelines
- Screening for Blood Pressure in Pediatric Primary Care
- Pedialink - Proper BP Measurement
- Online pediatric blood pressure norms chart. http://www.nhlbi.nih.gov/guidelines/hypertension/child_tbl.pdf
- Information for patients from International Pediatric Hypertension Association. http://www.iphapediatrichypertension.org/faqs/
Clinic Updates/Tips/Tools:
- Similac Formula Recall!
  - Please inform families to check their cans/bottles: https://abbott.mediaroom.com/2022-02-17-Abbott-Voluntarily-Recalls-Powder-Formulas-Manufactured-at-One-Plant
  - Bilingual Flyer made by Dr. Yousufzai
  - You can copy & paste this into the AVS:
    - To find out if the product you have is included in this recall, visit similacrecall.com and type in the code on the bottom of the package, or call +1-800-986-8540 (U.S.) and follow the instructions provided. No action is needed for previously consumed product.

Week 35 (2/28-3/4): Depression (YW-87)

List the symptoms associated with major depressive disorder, compare them to other depressive disorders, and recognize ways they might manifest in pediatric patients
Appreciate the prevalence of depression and suicide in pediatric patients and identify risk factors
Understand the risks and benefits of some of the main treatment options for depression

Primary Reference: Maslow GR, Dunlap K, Chung RJ. Depression and Suicide in Children and Adolescents. Pediatrics in Review. 2015;36(7): 299-308.
Board Questions: Learners, Moderators
Moderators: M: Maral T: Briana W: Cherry Th: Kiran F: Yemi
Resources:
- 1. Bright Futures Pediatric Symptom Checklist, psychosocial screening questionnaire: http://www.brightfutures.org/mentalhealth/pdf/professionals/ped_sympton_chklst.pdf
- 2. American Academy of Child and Adolescent Psychiatry: http://www.aacap.org
- 3. Strengths and Difficulties Questionnaire: http://www.sdqinfo.com/
- 4. Guidelines for Adolescent Depression in Primary Care (GLAD-PC) toolkit: www.glad-pc.org
- 5. Guidelines for Adolescent Preventive Services (GAPS) questionnaire: http://www.ama-assn.org/ama/pub/category/1980.html 6. Search engine to help providers and patients find therapists: www.psychologytoday.com
Clinic Updates/Tips/Tools:
- Lead Screening is BACK! (but limited, please only order for 1 years old at this time)
- Vaxelis (Dtap, HiB, HepB, IPV) is available for both VFC and Private! - Great for the 2nd and 4th Month WCC!
- Menigitis B Vaccines are BACK (for VFC Only)!
- Freya Starts her QI Project this week, please see the QI Page for information on how to help!
- New CDC Milestones
- Similac Formula Recall!
  - Please inform families to check their cans/bottles: https://abbott.mediaroom.com/2022-02-17-Abbott-Voluntarily-Recalls-Powder-Formulas-Manufactured-at-One-Plant
  - Bilingual Flyer made by Dr. Yousufzai
  - You can copy & paste this into the AVS:
    - To find out if the product you have is included in this recall, visit similacrecall.com and type in the code on the bottom of the package, or call +1-800-986-8540 (U.S.) and follow the instructions provided. No action is needed for previously consumed product.

Week 36 (3/7 - 3/11): Lead (YW-99)

Identify sources of environmental lead exposure
Describe acute and chronic problems caused by lead poisoning
Become familiar with screening recommendations and available tests
Review treatment of children with elevated lead levels

Primary Reference: American Academy of Pediatrics Council on Environmental Health. Prevention of Childhood Lead Toxicity. Pediatrics. 2016;138(1): e20161493.
Board Questions: For Learners, For Moderators
Moderators: M: Evins T: Cynthia W: Evins Th: Mahdika F: Misha
Resources:
- Half of US Populations exposed to adverse lead levels in early childhood
- List of recent recalls from US Consumer Product Safety Commission. http://www.cpsc.gov/en/Recalls/
- Links to state and local lead programs. http://www.cdc.gov/nceh/lead/programs/default.htm
- CDC Lead Poisoning Prevention Program with information for patients and providers. http://www.cdc.gov/nceh/lead/acclpp/blood_lead_levels.htm
- Handout for parents on lead exposure from CDC. https://www.cdc.gov/nceh/lead/docs/lead-levels-in-children-fact-sheet-508.pdf
Clinic Updates/Tips/Tools:
- We have a limited amount of lead testing, for now we have decided to screen only at the 12m WCC, or on a case-by-case scenario.
- The Similac Recall Flyer is on the front page under quick info-handouts

Week 37 (3/14-3/18): Short Stature (YW-111)

Review the physiology of normal growth
Define “short stature” and distinguish it from failure to thrive
Describe features in the history and physical that are suggestive of normal variations in growth
Identify pathologic causes of short stature and develop a diagnostic approach
Discuss the indications for growth hormone therapy

Primary Reference: Allen DB, Cuttler L. Short stature in childhood: challenges and choices. NEJM. 2013;368: 1220-8.
Board Questions: For Learners, For Moderators
Moderators: M: Amy T: Lauren W: Alis Th: Joanne F: Arianna
Resources:
- Article for parents about physical development. http://www.healthychildren.org/English/agesstages/gradeschool/puberty/Pages/Physical-Development-of-School-Age-Children.aspx
- Parent information about short stature. https://www.healthychildren.org/English/healthissues/conditions/Glands-Growth-Disorders/Pages/When-a-Child-is-Unusually-Short.aspx
Clinic Updates/Tips/Tools:

Week 38 (3/21 - 3/25): Concussions (YW-48)

Recognize which sports increase the risk of head injury
Diagnose concussion in the office setting
Create a management plan including a return-to-play timeline for an athlete with concussion
Counsel a young athlete on concussion prevention

Primary Reference: Halstead ME, Walter KD, Moffatt K, Council on Sports Medicine and Fitness. Clinical Report – SportRelated Concussion in Children and Adolescents. Pediatrics. 2018;142(6): e20183074.
Board Questions: For Learners, For Moderators
Moderators: M: Zach T: Hager W: Will Th: Jessica T F: Najima
Resources:
- AAP Patient Care: Concussions https://www.aap.org/en/patient-care/concussion/
- SCAT5 instrument for evaluation of athletes 13 and older. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf
- Child SCAT5 instrument for evaluating injured children aged 5-12. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097492childscat5.full.pdf
- Computerized neurocognitive assessment, helpful in determining return to play. www.impacttest.com
- Baseline testing, sideline screening, and post-injury assessments for use by physicians and athletic trainers. www.cogstate.com/go/sport
- CDC “Heads Up” toolkit with links to information and handouts for athletes, parents, and coaches. https://www.cdc.gov/headsup/youthsports/index.html
- Cribsiders Podcast #19: Concussion https://thecurbsiders.com/cribsiders/19
- PECARN Pediatric Head Injury/Trauma Algorithm https://www.mdcalc.com/pecarn-pediatric-head-injury-trauma-algorithm
Clinic Updates/Tips/Tools:

Week 39 (3/28 - 4/1): Language and Literacy Development (YW-7)

1. Identify the sequence of language and literacy development in young children

2. Understand the importance of evaluation of language and literacy in routine pediatric health supervision

3. Effectively use Reach Out and Read to help parents foster acquisition of language and literacy skills in young children (especially in at-risk populations)

Primary Reference: Feldman H. How Young Children Learn Language and Speech. Pediatrics in Review. 2019;40(8): 398- 411
Board Questions: For Learners, For Moderators
Moderators: M: Nicole A. T: Josh W: Sonia Th: Manisha F: Avery
Resources:
- NEIS. https://dhhs.nv.gov/programs/idea/early_intervention_programs/
- Reach Out and Read program website. www.reachoutandread.org
- CDC Milestones Updated https://www.cdc.gov/ncbddd/actearly/milestones/index.html
- Bright Futures Parent Handouts https://publications.aap.org/toolkits/pages/bright-futures-toolkit (updated to 2yo)
- Clark County Library eCard https://legacy.lvccld.org/ecard/language.cfm?_ga=2.195765548.1201474462.1648248122-1632926252.1648248122
- LV Adult Learning Program https://lvccld.org/adult-learning/
- Mount Sinai Parent Guides https://parenting.mountsinai.org/parent-guides/
- Dr. Sun's Reach out & Read Inteview https://news3lv.com/news/local/unlv-clinic-offers-free-books-with-well-checks
Clinic Updates/Tips/Tools:
- We are no longer out of POCT Flu testing

Week 40 (4/4-4/8): Breast Anomalies (YW-40)

Develop a plan for the evaluation and management of adolescents and young adults presenting with breast complaints.
Discuss differential diagnosis of galactorrhea and breast masses in adolescent and young adult females.

Primary Reference: De Silva N. Breast development and disorders in the adolescent female. Best Practice & Research: Clinical Obstetrics & Gynaecology. 2018;48: 40-50
Board Questions: For Learners, For Moderators
Moderators: M: Freya T: Hager W: Steven Th: Sylvester F: Jessica B
Resources:
- Breast Self-Exam and Cancer Risks. https://youngwomenshealth.org/2014/02/27/breast-self-examand-cancer-risks/
- Breast Cancer Screening from ACOG. https://www.acog.org/clinical/clinical-guidance/practicebulletin/articles/2017/07/breast-cancer-risk-assessment-and-screening-in-average-risk-women
Clinic Updates/Tips/Tools:
- Continue to encourage COVID Vaccines which are done every Thursday (age 5-11 y/o only)
- Hep A for VFC (Uninsured and Medicaids) is currently unavailable (4/6/22)
- POCT COVID is available (pick the QuickVue option)

Week 41 (4/11-4/15): Eating Disorders (YW-33)

Define the diagnostic criteria for common eating disorders
Identify common and serious complications associated with eating disorders
Develop an approach to identify children and adolescents at high risk for eating disorders
Outline a treatment plan for an adolescent with an eating disorder

Primary Reference: Hornberger L, Lane MA, Committee on Adolescence. Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics. 2021;147(1): e2020040279.
Board Questions: For Learners, For Moderators
Moderators: M: Evins T: Andy W: Nicole P. Th: Evins F: Misha
Resources:
- Resources for teens and parents on eating disorders from The Center for Young Women’s Health. http://www.youngwomenshealth.org/nutrition_menu.html#eating_disorders
- Resources on the Maudsley Method for families engaging in Family-Based Treatment. www.maudsleyparents.org
- Resources for families from the National Eating Disorders Association. www.nationaleatingdisorders.org
Clinic Updates/Tips/Tools:
- For POCT COVID Antigen Testing, select: BD Veritor

Week 41 (4/18 - 4/22): Infant Colic (YW-60)

1. Understand the evaluation of an infant with unexplained crying

2. Know the natural history and characteristics of colic

3. Become familiar with the treatment options for colic and the evidence supporting these treatments

Primary Reference: Johnson JD, Cocker K, Chang E. Infantile colic: recognition and treatment. American Family Physician. 2015;92(7): 577-582
Board Questions: Learners, Moderators
Moderators: M: Tim T: Josh W: Nicole P. Th: Sonia F: Tim
Resources:
- Handout for families from American Academy of Family Physicians. https://familydoctor.org/condition/colic/
- Handout for families from NIH. https://medlineplus.gov/ency/patientinstructions/000753.htm
- Information on Current Good Manufacturing Practices (CGMPs) for dietary supplements. http://www.fda.gov/Food/GuidanceRegulation/CGMP/ucm079496.htm
- The Period of Purple Crying. http://purplecrying.info/
Clinic Updates/Tips/Tools:

Week 43 (4/25-4/29): ADHD (YW-79)

Understand the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) and the use of ADHD-specific rating scales
Learn how to guide parents in advocating for their children with special needs
Utilize appropriate treatment regimens for ADHD and understand the potential side effects of those regimens
Incorporate the care of patients with ADHD and their families into your primary care practice using the comprehensive medical home model

Primary References:
- Wolraich ML, et al, and the AAP Subcommittee on Children and Adolescents with AttentionDeficit/Hyperactive Disorder. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019;144(4): e20192528.
  - Figure 2 ADHD Patient Care Algorithm
- Centers for Disease Control and Prevention. Attention-Deficit/Hyperactivity Disorder: Symptoms and Diagnosis. Retrieved May 4, 2021
Board Questions: Learners, Moderators
Moderators: M: Maral T: Lauren W: Cherry Th: Kiran F: Tara
Resources:
- AAP ADHD Toolkit (AAP ID required)
- ADHD Medication Guide: http://www.adhdmedicationguide.com/
- Information for families from AAP. http://www.aap.org/healthtopics/adhd.cfm
- Medication safety information from AAP. http://www.aap.org/family/safetypillsadhd.htm
- NICHQ Vanderbilt Assessment Forms & handouts for families. https://www.nichq.org/resource/nichq-vanderbilt-assessment-scales
- Detailed information for families about Individualized Education Programs. http://www.ed.gov/parents/needs/speced/iepguide/index.html
Clinic Updates/Tips/Tools:

Week 44 (5/2-5/6: Social Media & Health (YW-44)

Analyze current use of social media by children and adolescents
Identify recommendations regarding the appropriate use of social media
Evaluate the pros and cons of using social media in a pediatric practice

Primary Reference: Hill DL. Social Media: Anticipatory Guidance. Pediatrics in Review. 2020;41(3): 112-119.
Board Questions: None this week
Moderators: M: Amy T: Briana W: Valeria Th: Alis F: Yemi
Resources:

1. Health information in English and Spanish for parents, educators, kids, and teens, with option for free weekly newsletter. @KidsHealth http://kidshealth.org

2. Sex education by teens, for teens. @Sexetc http://sexetc.org

3. Teen-friendly content created by teens, sponsored by the National Campaign to Prevent Teen and Unplanned Pregnancy. @StayTeen http://stayteen.org

4. Blog from pediatrician, Dr. Wendy Sue Swanson, Director of Digital Health at Seattle Children’s Hospital. @SeattleMamaDoc http://seattlemamadoc.seattlechildrens.org/

6. Tips for Parents from the Federal Trade Commission and National Initiative for Cybersecurity Education. http://www.onguardonline.gov/articles/0012-kids-and-socializing-online

7. AAP-sponsored website and smartphone app with reliable parent-friendly content on common pediatric topics. http://www.healthychildren.org

8. AAP- sponsored personalized media use plan for children and families. http://healthychildren.org/mediauseplan

9. Tips and information on bullying and cyberbullying. http://stopbullying.gov

10. Information for parents to help kids harness the power of media and technology as a positive force. https://www.commonsensemedia.org/social-media

Clinic Updates/Tips/Tools:

Week 45 (5/9-5/13): Indoor Arthropod Bites & Infestations (YW-80)

Differentiate clinically significant arthropod bites and stings based upon pattern of distribution and potential exposures in the home

2. Manage reactions to arthropods and be able to identify common complications

3. Counsel families on prevention of arthropod bites, including eliminating home infestation

Primary Reference: Devore CD, Schutze GE, Council on School Health and Committee on Infectious Diseases. Head Lice. Pediatrics. 2015;135(5): e1355-e1365.
- Read pages 845-847 from: Juckett G. Athropod Bites. American Family Physician. 2013;88(12): 841-847
Board Questions: For Learners, For Moderators
Moderators: M: Freya T: Erik W: Joanne Th: Mahdika F: Arianna
Resources;
- SNHD Bed Bugs https://www.southernnevadahealthdistrict.org/Health-Topics/bed-bugs/

Week 46 (5/16 - 5/20): Safe Infant Sleep (YW-107)

Understand the rates and risk factors for sudden unexpected infant death (SUID)
Know the guidelines for optimizing safety of the sleep environment
Learn to address common parental concerns regarding SUID prevention

Primary Reference: American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome, Policy Statement. SIDS and other sleep-related infant deaths: updated 2016 recommendations for a safe infant sleeping environment. Pediatrics. 2016;138(5): e20162938.
Board Questions: For Learners, For Moderators
Moderators: M: Evins T: Hager W: Manisha Th: Jessica T F: Avery
Resources:
- AAP NEWS Ban on crib bumpers, inclined sleepers nears final approval
- AAP Technical Report: SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment
- National Institute of Child Health and Human Development “Back to Sleep” handout for parents. https://www.nichd.nih.gov/sites/default/files/2019-02/Safe_Sleep_Environ_update.pdf
- CDC information page on SUID and SIDS. https://www.cdc.gov/sids/index.htm
- Video on hip-safe swaddling from Yale Primary Care Pediatrics Curriculum. https://www.youtube.com/watch?v=wyCPwGa3WVQ
Clinic Updates/Tips/Tools:
- Out of POCT Lead
- we still have FLU vaccines

Week 46 (5/23 - 5/27): Firearm Safety (YW-47)

Become familiar with the epidemiology of gun-related violence in children and adolescents
Describe the AAP's policy on firearms and firearm-related injuries
Identify the pediatric provider's role in gun violence prevention

Primary References:
- Petty JK, et al. Firearm Injuries and Children: Position Statement of the American Pediatric Surgical Association. Pediatrics. 2019;144 (1): e20183058.
- Dodson NA, Hemenway D. Toward a deeper understanding of gun violence. Pediatrics. 2020;146(1): e20193333. https://pediatrics.aappublications.org/content/pediatrics/early/2020/06/09/peds.20193333.full.pdf
Board Questions: None this week
Moderators: M: Zach T: Andy W: Manisha Th: Kiran F: Najima
Resources:
- AAP Advocacy Page, Gun Violence Prevention https://www.aap.org/en/advocacy/gun-violence-prevention/
Clinic Updates/Tips/Tools:
- Out of Rapid Flu and Rapid COVID Testing
- Low on Lead Testing

Week 49 (6/6 - 6/10): Clinic Emergencies Part 1

Primary Reference: Preparation for Emergencies in the Offics of Pediatricians and Pediatric Primary Care Providers
- CCC Session Worksheet.
Board Questions: None
Moderators: Attendings
Resources:
Clinic Updates/Tips/Tools:

Week 50 (6/13-6/17): Water Safety & Drowning Prevention (YW-45)

Understand the definition and epidemiology of drowning
Become familiar with standards of pool fencing
Gain an understanding on how to counsel families about water safety
Understand how to advise families regarding swimming lessons

Primary Reference: https://publications.aap.org/pediatrics/article/143/5/e20190850/37134/Prevention-of-Drowning
Board Questions: None
Moderators: M: Nicole A T: Josh W: Nicole P Th: Sylvester F: Avery
Resources:

1. Information from the AAP on water safety. http://www.aap.org/en-us/about-the-aap/aap-pressroom/news-features-and-safety-tips/Pages/Sun-and-Water-Safety-Tips.aspx

2. Resources for parents from PoolSafely.gov, including information on the Virginia Graeme Baker Pool and Spa Safety Act. http://www.poolsafely.gov/parents-families/resources-for-parents-families/

3. Handouts on “Water Safety at Home” and “Swimming Safety Tips” from safekids.org. http://www.safekids.org/watersafety

4. Information for parents on recognizing signs of drowning. www.uvpediatrics.com/news/2013/08/do-you-know-what-drowning-looks-like/

5. US Coast Guard guide on “How to Choose the Right Life Jacket.” http://www.uscgboating.org/images/howtochoosetherightlifejacket_brochure.pdf

Clinic Updates/Tips/Tools:

Week 51 (6/20-6/24): Clinic Emergencies Part 2

Primary Reference: Preparation for Emergencies in the Offics of Pediatricians and Pediatric Primary Care Providers
Board Questions: None
Moderators: Attendings
Resources:
Clinic Updates/Tips/Tools:

Week 52 (6/27-6/30): Thank you seniors!

Primary Reference: None
Board Questions: None
Moderators: Attendings
Resources:
Clinic Updates/Tips/Tools:

Week 1 (6/28 - 7/2): Goodbye and Welcome! ¡Adios y Bienvenidos!

No CCC this week! Thank your seniors and welcome the new interns!
Board Questions: None this week!
Moderators: Everyone!

Wk 2 (7/5 - 7/9): EPIC Tips & Tricks, Oral Presentations

As a continuation of clinic orientation, senior residents will partner with interns to share EPIC Tips, Tricks and Oral Presentations to set them up for SUCCESS!

Moderators: All Seniors
Board Questions: None
Clinic Resources:
- EPIC Help, EPIC FAQs
- Outpatient Presentation Guides: Well Child Presentation, Sick Visit Presentation
- UCF: Guide to the Comprehensive Pediatric H&P
CLINIC UPDATE: LEAD TESTING IS CURRENTLY OUT OF SERVICE, ANY TESTING BETWEEN 5/28/21-7/6/21 MUST BE RETESTED AT THE NEXT VISIT. WE WILL LET YOU KNOW WHEN LEAD TESTING IS AVAILABLE.

Wk 3 (7/12-7/16): Integrated Children's Mental Health

Understand how to access and benefit from the PAL (Pediatric Access Line).
Demonstrate basic knowledge of principles of integrated children's mental health.

Primary References: Implementing Integrated Care in Pediatric Mental Health: Principles, Current Models, and Future Directions, UNLV PAL Info Sheet
Moderators: Dr. Lisa Durette (PD for Child Psychiatry Fellowship), and Angela Townsend (Program Care Coordinator). M/F: in person, T/W/Th: via Zoom
Board Questions: None
Clinic Resources: https://center4cs.org/ https://www.unlv.edu/cicfc

Wk 4 (7/19-7/23): Agenda Setting in the Outpatient Visit (YW-3)

Explain the importance of effective agenda-setting in the outpatient clinic
Identify potential barriers to effective agenda-setting
Demonstrate effective agenda-setting using the exhaustive “What else?” and negotiation of priorities at the outset of the encounter
Discuss core elements of visit closure

Primary Reference(s): Baker LH, O’Connell D, Platt FW. Setting the agenda for the clinical interview. Annals of Internal Medicine. 2005;143(10): 766-70
Moderators: M: Briana, T: Erik, W: Valeria, Th: Mahdika, F: Avery
Board Questions: None
Clinic Resources:
- Yale: 5 Step Patient Centered Beginning of Interview

Wk 5 (7/26-7/30): The Difficult Encounter (YW-88)

Become aware of negative feelings during challenging provider/parent interactions
Be able to use empathic, understanding responses during difficult encounters
Set clear boundaries effectively when appropriate.

Primary Reference(s): Asnes AG, Shenoy A. The difficult pediatric encounter: insights and strategies for the pediatric practitioner. Pediatrics in Review. 2008; 29(6): e35-e41.
Moderators: M: Freya T: Hager W: Manisha Th: Joanne F: Arianna
Board Questions: none
Clinical Resources:
- Search tool for state-specific information regarding child welfare.
  - http://www.childwelfare.gov/systemwide/laws_policies/state/index.cfm

Wk 6 (8/2-8/6): High Value Care (YW-8)

Understand the definition of value in health care.
Identify barriers to high value care in the primary care setting.
Utilize strategies to evaluate potential care plans based on best practices and to communicate these to patients and families

Primary Reference(s): Owens D, et al. High-Value, Cost-conscious Health Care: Concepts for Clinicians to Evaluate the Benefits, Harms, and Costs of Medical Interventions. Ann Int Med. 2011;154(3): 174-180
Moderators: M: Maral T: Andy W: Cherry Th: Kiran F: Najima
Board Questions: none
Clinical Resources:
- Choosing Wisely list of high-value care suggestions from American Academy of Pediatrics. http://www.choosingwisely.org/societies/american-academy-of-pediatrics/
- Lown Institute spearheads research on high-value care (http://lowninstitute.org) through its RightCare Alliance. http://rightcarealliance.org
- Tufts Cost Effectiveness Registry. http://healtheconomics.tuftsmedicalcenter.org/cear4/Home.aspx
- Clearinghouses for various types of health care costs:
  - CDC vaccine costs. https://www.cdc.gov/vaccines/programs/vfc/awardees/vaccinemanagement/price-list/index.html
  - Costs of various medical interventions. https://www.healthcarebluebook.com/page_Default.aspx
  - Cost of asthma ED visit. https://www.cdc.gov/pcd/issues/2014/14_0139.htm
CLINIC UPDATE: Please try to finish your notes before you leave clinic, but if you need more time you can use any of the clinic desktops on your own time or any of the computers in the 1701 W. Charleston Building - Pediatrics Suite: Rooms 670-6, 670-7 (not Dr. Meyers' computer). Also, POCT-Lead Testing is now available. Make sure to re/check any patients that had lead testing between October 27, 2020 and June 15, 2020 or missed their testing at the 12 or 24m WCC. Read more about the recall here.

Wk 7 (8/9-8/13): Fever in Children Less than 36 Months (YW-92)

Know how to respond to common parental misconceptions about fever
Identify children at low- and high-risk for invasive bacterial infection
Know common management strategies for managing febrile young children
Describe the impact of pneumococcal conjugate vaccine on the management of fever in children.

Primary Reference(s):
- Hamilton JL, Evans SG, Bakshi M. Management of Fever in Infants and Young Children. American Family Physician. 2020;101(12): 721-729.
- AAP Pediatrics Eval & Management of Well Appearing Febrile Infants 8-60 days old AUGUST 2021
Moderators: M: Evins T: Cynthia W: Will Th: Sonia F: Jessica
Board Questions: For Learners, For Moderators Only
Clinical Resources:
- Fever information for parents from AAP. http://www.healthychildren.org/English/healthissues/conditions/fever/pages/Fever-Without-Fear.aspx
- Mayo Clinic fever handout for parents. http://www.mayoclinic.com/health/fever/ID00052
CLINIC UPDATES:
- After the CCC session, touch base with your M.A. to discuss any possible issues/updates with patients
- Plug in your laptops after you finish up for the day, and turn off the keyboard backlight to save battery
- Use the LAPTOP TICKET if you have any issues with your laptop, the forms are near the printers, and turn it into an attending or to Shelly
- Please follow up on any labs or imaging you may have ordered on a previous patient. See the Caregiver Call Section for help with documentation.
- Please make sure your vaccines orders are supervised by your attending (and also changed to them as the ordering provider)
- Starting September/October, the 11:20am and 4:20am double booking will be replaced with a double booking at 10am and 3pm (this will keep the numbers up without having to book a 11:40 and 4:40 where patients show up late)
- Efforts will be made to have the Pharmacy on File.

Week 8 (8/16 - 8/20): Identification of the Sick Child (YW-68)

Recognize the importance of observation in identifying sick children
Understand the value of a clinician's instinct in determining which children have serious illness
Become familiar with the most common serious illnesses in young children

Primary Reference: Buntinx F, et al. Dealing with low-incidence serious diseases in general practice. British Journal of General Practice. 2011;61: 43-6.
Board Questions: For Learners, For Moderators
Moderators: M: Hager T: Briana W: Will Th: Gerard F: Tara
Clinic Updates:
- A new whiteboard was added to the Silver Room, please make sure you have an assigned MA with you.
- Use the laptop tickets if you have any issues. thanks!
Clinic Tool:
- from Chapter 11 in Harriet Lane:

Week 9 (8/23 - 8/27): Health Supervision (YW-1)

Design a plan for routine screening during a health supervision visit
Describe the organizations that decide the periodicity schedule and recommended interventions
Evaluate the evidence supporting the topics discussed during a well-child visit
Critique current well-child visit models and offer alternative approaches to typical well-child care
Discuss the relevance of well-child care on adult health outcomes

Primary Reference(s):
1. Needlman R. Thoughts on health supervision: learning-focused primary care. Pediatrics. 2006;117(6): e1233-e1236.
2. Coker TR Thomas T, Chung PJ. Does Well-Child Care Have a Future in Pediatrics? Pediatrics. 2013;131(S149): s149-159.
Board Questions: Learners Moderators
Moderators: M: Freya T: Andy W: Alis Th: Joanne F: Arianna
Resources:
1. Bright Futures: https://brightfutures.aap.org
2. USPSTF guidelines. http://www.uspreventiveservicestaskforce.org and
  - Summary of recommendations pertaining to children and adolescents http://www.uspreventiveservicestaskforce.org/BrowseRec/Index?age=Pediatric,Adolescent
3. Summary of changes to AAP periodicity schedule.
  - https://pediatrics.aappublications.org/content/147/3/e2020049776
4. Bright Futures Books: Pocket Guide, Parent Guides, Physical Exams
5. CDC: Learn the Signs. Act Early https://www.cdc.gov/ncbddd/actearly/index.html
Clinic Updates/Tips/Tools:
1. The Bright Futures Parent Guides are 1-2 pages only, easier to read, already printed out, and are overall preferred vs the WCC Guides in Epic. If it runs out, you can find more here and here
2. Billing Tips: For Patients insured with Medicaid (which will be in the insurance name as well, and includes Silver Summit), use an EP modifier (since we follow EPSDT guidelines at our well visits), or a TS modifier (if the patient will be referred to a specialist at this well child visit)
3. Please plug in your laptop between patients and after you finish with clinic for the day, and continue to submit laptop tickets so we can fix them, so far we are fixing 4, so thanks for your help!
4. CCSD COVID CLEARANCE FORMS

Wk 10 (8/30 - 9/3): Ambulatory Mock Code Week

Understand the importance of Preparing for Office Emergencies
Know where to find all emergency equipment and medications
Participate in a Mock Code Session
Practice High Quality CPR and Oxygen Tank Use

Primary Reference: AAP Committee on Pediatric Emergency Medicine Preparation for Emergencies in the Offices of Pediatricians and Pediatric Primary Care Providers Pediatrics July 2007, 120 (1) 200-212
Board Questions: None
Moderators: Attendings
Clinic Updates, Tips & Tools:
- EPIC Remote Access is BACK! Go to Suite 200 Classroom 4 at Delta Point (901 S. Rancho) for access. Bring any laptops or tablets which you may need help setting this up.
- A Temporary Resident Work & Study Room is available in the 1701 Suite, Room 670-14. Please keep it tidy.
- For those on Caregiver/Mommy Call, please check New Innovations to see who is on call, the nursery calendar has the attending who can assist you. Please note this changes on a daily basis.

Week 11 (9/7 - 9/10): Rhinorrhea & Congestion (YW-108)

Identify the signs and symptoms of an uncomplicated upper respiratory infection, allergic rhinitis and conjunctivitis, and acute and chronic sinusitis, differentiating these from other causes of rhinorrhea
Discuss the available modalities for testing, for environmental control, and for treatment of allergic rhinitis and conjunctivitis
Describe treatment of sinusitis and reasons for referral

Primary Reference(s):
- Gargiulo KA, Spector ND. Stuffy Nose. Pediatrics in Review. 2010;31: 320-324
- DeMuri GP, Wald ER. Acute Bacterial Sinusitis in Children. Pediatrics in Review. 2013;34: 429-437
Board Questions: Learners, Moderators
Primary Moderators: M: HOLIDAY T: Lauren W: Nicole P Th: Sylvester F: Yemi
- Supportive Moderators: M: HOLIDAY T: Erik W: Valeria Th: Mahdika F: Ryan
Resources:
- DX & Management of Acute Bacterial Sinusitis: 2013 AAP Guideline
- CCSD COVID Clearance Forms
Clinic Updates/Tips/Tools:
- Gripa/Gripe is a Spanish term that can mean rhinorrhea, a cold, or flu. Gripador means stapler.

Week 13 (9/20 - 9/24): Newborn Concerns (YW-9)

Understand the role of the prenatal visit in establishing a medical home
Describe normal newborn movements and habits
Understand the timing of and risks for shaken baby syndrome, and outline anticipatory guidance that may be preventive
Emphasize the importance of secure attachment of the child and parents early in life
Identify the most common benign newborn rashes and delineate appropriate guidance

Primary Reference(s): Benitz WE, Committee on Fetus and Newborn. AAP Policy Statement – Hospital Stay for Healthy Term Newborns. Pediatrics. 2015;135(5): 948-953.
Board Questions: For Learners, For Moderators
Moderators: M: Zach T: Manisha W: Cherry Th: Jessica T/Sonia (support) F: Jessica B
Resources:
- Handout from JAMA for parents about newborn care.
  - http://jama.jamanetwork.com/article.aspx?articleid=191813
- General information regarding infant care.
  - www.mayoclinic.com/health/healthy-baby/FL99999
- Period of Purple Crying.
  - www.purplecrying.info
- Stanford Newborn Nursery Photo Gallery: Skin.
  - https://med.stanford.edu/newborns/professionaleducation/photo-gallery/skin.html
Clinic Updates/Tips/Tools:
- When ordering an XRAY, please make sure to give the IMAGING SLIP (reprint if necessary), let the family know where they should go AND document where you are sending them in your note.

Week 12 (9/13 - 9/17): Ear Infections (YW-19)

Describe the pathophysiology of acute otitis media (AOM), including the underlying anatomy, common pathogens, and natural history
Differentiate between mild and severe AOM utilizing history and physical exam findings
Develop a step-wise treatment approach including indications for observation or active treatment
Understand the possible complications of AOM, and indications for referral to specialty services
Differentiate otitis externa from AOM and describe pathogenesis, treatment, and indications for referral.

Primary Reference(s):
- Pages 965-966, 970-990 of: Lieberthal AS, et al. AAP Clinical Practice Guideline: The diagnosis and management of acute otitis media. Pediatrics. 2013;131:3 e964-e999.
- Long M. Otitis externa. Pediatrics in Review 2013;34: 143-144.
Board Questions: For Learners, For Moderators
Primary Moderators: M: Nicole A T: Josh W: Steven Th: Kiran F: Najima
- Supportive Moderators: M: Amy T: Arianna W: Avery Th Kiran F: Najima
Resources:
- Otoscope Examination Tips
Clinic Updates/Tips/Tools:
- Reminder: only residents in good clinical standing which includes having the primary care waiver can "precept' a medical student. All residents are however welcome to invite medical students into a patient room for a significant findings (with the parent's permission first)
- Attendings will do our best to help with any urgent tasks, labs and patient calls. We have already developed a protocol for urgent patient calls during office hours. If you are requested to follow up with a family about labs or a patient call and are unable to (due to nights), please let the attending know.
- The 3:20 double bookings have started as the 4:20 double bookings are being seen and phased out.

Week 14 (9/27 - 10/1): Lymphadenopathy (YW-75)

1. Define lymphadenopathy.

2. Develop a differential diagnosis for acute and chronic cervical lymphadenopathy specific to different age groups.

3. Describe key components of the history and physical exam to evaluate lymphadenopathy.

4. Discuss the diagnostic workup for pediatric patients presenting with lymphadenopathy.

5. Understand the indications for lymph node biopsy.

Primary Reference(s): Sahai S. Lymphadenopathy. Pediatrics in Review. 2013;34: 216-227.
Board Questions: For Learners, For Moderators
Moderators: M: Tim/Evins T: Cynthia W: Alis Th: Mahdika F: Misha/Amy
Resources:
- Patient information on lymphadenopathy from Mayo Clinic. http://www.mayoclinic.org/diseasesconditions/swollen-lymph-nodes/basics/definition/con-20029652
Clinic Updates/Tips/Tools:
- Flu Shots are available for private and Medicaid insurances, please don't forget to ask at each visit.

Week 15 (10/4-10/8): Vision Screening (YW-50)

Describe published recommendations for routine screening of vision
Appreciate common disorders of vision in childhood
Practice physical exam techniques to identify common problems related to childhood vision

Primary Reference(s): Loh AR, Chiang MF. Pediatric vision screening. Pediatrics in Review. 2018;39(5): 225-233
Board Questions: For Learners, For Moderators
Moderators: M: Zach T: Hager W: Will Th: Kiran F: Tara
Resources:
- Diagrams of cover-uncover test and alternating cover test in Figures 6&7 of Rogers & Jordan, Pediatrics in Review, 2013. http://pedsinreview.aappublications.org/content/34/3/126.full.pdf+htm
- AAO: Pediatric Eye Evaluations
- Spot Vision Screener Conversion Chart
Clinic Updates/Tips/Tools:
- Ryan started a QI project using the WCC forms, please take a look at the bottom of the forms, and help fill them out if not done already. Place the form in the bin in the silver room when done.
- Brittany MS4, is visiting from Michigan State University for the month.

Week 16 (10/11-10/15): Constipation (YW-62)

Understand the definition of constipation
Create a treatment plan for constipation, including initial and maintenance therapy, relapse prevention, and medication discontinuation
Know when subspecialty referral is indicated

Primary Reference(s): LeLeiko NS, Mayer-Brown S, Cerezo C, Plante W. Constipation. Pediatrics in Review. 2020;41(8): 379- 392
Board Questions: For Learners, For Moderators
Moderators: M: Nicole A T: Andy W: Nicole P Th: Sonia F: Ryan
Resources:
Clinic Updates/Tips:
- Continue to encourage flu shots! Dont forget to encourage parents of children who are too young to receive them.
- Since the recent EPIC update some major issue have come up, which we are working on fixing ASAP.
  - Immunizations are not synchronizing well with EPIC (so please check WEB-IZ)
  - Printing can be done on personal laptops, EXCEPT the AVS
  - AVS printing on some devices are creating XPS documents, please ask the attending to print it for you.
- The NBS password now ends with 21e

Week 17 (10/18 - 10/2): Urinary Tract Infections (YW-122)

Discern situations in which obtaining a urine sample in a febrile child is appropriate
Review methods of obtaining urine samples and their relative merits and drawbacks
Develop an age-appropriate approach to diagnosis and treatment of urinary tract infection
Evaluate when further work-up, specifically imaging studies, is necessary

Primary Reference(s): Mattoo TK, Shaikh N, Nelson CP. Contemporary Management of Urinary Tract Infections in Children. Pediatrics. 2021;147(2): e2020012138.
Board Questions: For Learners, For Moderators
Moderators: M: Freya T: Erik W: Steven Th: Attending F: Avery
Resources:
- UTICalc for children 2-23 months of age, online tool to estimate probability of UTI. https://uticalc.pitt.edu
- Information from the National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-tract-infections-inchildren/treatment
- Patient information on VUR. https://www.niddk.nih.gov/health-information/urologicdiseases/hydronephrosis-newborns/vesicoureteral-reflux
- Pediatrics 2016: Reaffirmation of AAP Clinical Practice Guideline: The Diagnosis and Management of the Initial Urinary Tract Infection in Febrile Infants and Young Children 2–24 Months of Age
- Pediatrics 2021: Contemporary Management of UTI
- AAP News & Journal Post 2021: A Clinical Practice Literature Review of Pediatric UTIs
- Mt Sinai Provider Tip of the Week
Clinic Updates & Tips:
- Web-IZ integration and Printing are still an issue, please find a way to check WebIZ and ask an attending to print for you. Thanks!
- Continue to ask families if they want the flu shot.

Week 18 (10/25 - 10/29): Asthma (YW-23)

Describe the pathophysiology, triggers and risk factors for asthma
Classify asthma severity and assess asthma control according to national guidelines
Propose an appropriate treatment plan based on disease severity
Model asthma-related patient counseling and develop an asthma action planDescribe the pathophysiology, triggers and risk factors for asthma
Classify asthma severity and assess asthma control according to national guidelines
Propose an appropriate treatment plan based on disease severity
Model asthma-related patient counseling and develop an asthma action plan

Primary Reference(s): *keep in mind the specific sections*
1. Patel SJ, Teach SJ. Asthma. Pediatrics in Review. 2019;40(11): 549-564. (Read pages 549-553 and review figure 2, recognizing that treatment recommendations have been updated in the following references.)
2. NHLBI, National Asthma Education and Prevention Program. Expert panel report 3 (EPR-3): guidelines for the diagnosis and management of asthma - summary report 2007. J Allergy Clin Immunol. 2007;120: S94-138. (Figures 11-16 reinforce pertinent topics/information for this conference.)
3. Expert Panel Working Group of the NHLBI. 2020 focused updates to the asthma management guidelines: a report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol. 2020;146: 1217-1270. (Read figures 2-4 which have the pertinent updates on the approach to asthma treatment - pages 15-20 of the PDF)
Board Questions: For Learners, For Moderators
Moderators: M: Josh T: Cynthia W: Cherry Th: Jessica T F: Happy Nevada Day!
Resources:
1. Asthma information for providers, including PDA resources and asthma action plans (English and Spanish). http://www.nhlbi.nih.gov/health/prof/lung/index.htm
2. Asthma information for patients and families. http://www.nhlbi.nih.gov/health/public/lung/index.htm
3. Asthma Control Test and Childhood Asthma Control Test. http://www.asthmacontroltest.com/
Clinic Updates/Tips/Tools:
1. Respiratory Inhalers at a Glance Poster
2. Mt Sinai Parenting Tip of the Week
3. For the After Visit Summary, please be accurate for when you want the patient to follow up. Check for recent well child checks, don't forget the 30 month well check, and watch out for vaccine timings.

Week 19 (11/1 - 11/5): Headache (YW-96)

Understand the definition of key primary headache types including migraine and tension type headaches and how these definitions differ from adult definitions
Know the indications for imaging and referral in the evaluation of primary headache
Identify the key components in the management of pediatric headaches including the role for complementary and alternative medicines
Understand the key components in the management of chronic daily headaches

Primary Reference(s):
1. Gelfand AA. Pediatric and adolescent headache. Continuum: Lifelong Learning in Neurology. 2018;24(4): 1108-1136.
Board Questions: For Learners, For Moderators
Moderators: M: Evins T: Briana W: Valeria Th: Joanne F: Yemi
Resources:
1. Handout on migraine headaches from American Family Physician. http://www.aafp.org/afp/2002/0215/p635.html
2. Handout on headache in children. https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/headaches/
Clinic Updates/Tips/Tools:
1. Headache Diary
2. Please by specific on your AVS to help our check out staff:
  - Always put WHY you want a follow pu
  - If you want more time at the next visit
  - If you want them to follow up with you
  - For vaccines, go by WEEKS not months
  - If the just need to follow up at the well check, just state follow up for next well check, and you don't have to put the date, the check out staff will find out for you.
3. Please check your EPIC messages and tasks regularly. If you need help setting up EPIC on your personal device, see here: Remote Access
4. Say hello to Kenneth! He's our clinic Sub-I for the month.

Week 20 (11/8 - 11/12): Media & Child Health (YW-30)

Identify forms and frequency of media exposure
Review evidence of potential positive and negative effects of media exposure on children
Counsel families regarding the responsible and productive use of media

Primary Reference(s):
1. American Academy of Pediatrics Council on Communications and Media. Media and young minds. Pediatrics. 2016;138(5): e20162591.
2. American Academy of Pediatrics Council on Communications and Media. Media use in school aged children and adolescents. Pediatrics. 2016;138(5): e20162592
Board Questions: For Learners, For Moderators
Moderators: M: Amy T: HagerW: Manisha Th: HOLIDAY F: Arianna
Resources:
1. Bibliography of recent publications related to screen time from AAP. https://www.aappublications.org/collection/screen-time
2. AAP guide to creating a Family Media Plan, available in English and Spanish. www.HealthyChildren.org/MediaUsePlan
3. AAP clearinghouse of resources for providers and families related to media use. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/pages/media-andchildren.aspx
4. Children and Media Tips from the AAP. https://www.aap.org/en-us/about-the-aap/aap-pressroom/news-features-and-safety-tips/Pages/Children-and-Media-Tips.aspx
Clinic Updates/Tips/Tools:
1. Mount Sinai Tip of the Week

Week 21 (11/15 - 11/19): Antibiotic Use in Primary Care (YW-17)

Discuss the potential benefits and harms of antibiotic use from both an individual and a community-based standpoint
Describe principles of responsible antibiotic prescribing
Practice methods to counsel family members about antibiotics

Primary Reference(s): Gerber JS, et al. AAP Committee on Infectious Diseases, Pediatric Infectious Diseases Society. Antibiotic Stewardship in Pediatrics. Pediatrics. 2021;147(1): e2020040295.
Board Questions: For Learners, For Moderators
Moderators: M: Zach T: Lauren W: Will Th: Kiran F: Najima
Resources:
1. 5-step patient-centered interviewing. Adapted by Fortin AH, Stein J from: Fortin AH 6th, Dwamena FC, Frankel RM, Lepisto BL, Smith RC. Smith’s Patient Centered Interviewing: An Evidence-based Method. 4th ed. New York: McGraw Hill, 2019. https://medicine.yale.edu/pediatrics/pcpc/learner/02b%20Agenda%20Fivesteps_335873_153_3833 2_v2.pdf
2. Get Smart campaign from CDC has links to information for families and providers about appropriate antibiotic use. http://www.cdc.gov/getsmart/
3. CDC compilation of guidelines for approaching antibiotic prescribing for common infectious diseases for pediatric ambulatory patients. https://www.cdc.gov/antibiotic-use/community/forhcp/outpatient-hcp/pediatric-treatment-rec.html
Clinic Updates/Tips/Tools:
1. Please have your notes done within 48 hours of the date of service.

Week 22 (11/22 - 11/26): Thanksgiving Week & Happy Indigenous People Month!

Come by clinic to celebrate with your co-residents and attendings!
Call or video chat with your family!
Be thankful!

Monday: TBD

Tuesday: High Tea Time (starts at 1pm) - Bring a light snack or dessert!

Wednesday: Potluck (starts around Noon) - Bring or order food to share! Patients are blocked after 3pm

Thursday: Clinic is Closed all Day!

Friday: Clinic is Closed all Day!

Week 23 (11/29 - 12/3): Discipline (YW-89)

Understand social determinants of development and behavior
Develop an understanding of the various discipline modalities
Learn how to guide parents with age-appropriate discipline techniques

Primary Reference(s): Sege RD, Siegel BS, Council on Child Abuse and Neglect, Committee on Psychosocial Aspects of Child and Family Health. Policy Statement: Effective Discipline to Raise Healthy Children. Pediatrics. 2018;142(6): e20183112. CORRECTION
Board Questions: None this week!
Moderators: M: Tim T: Andy W: Alis Th: Sonia F: Jessica B
Resources:
1. Information for parents on discipline from AAP, including list of age-appropriate strategies. http://www.healthychildren.org/English/family-life/family-dynamics/communicationdiscipline/Pages/Disciplining-Your-Child.aspx
2. Information for parents on discipline from the CDC, including list of age-appropriate strategies. ttps://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/index.html
3. Information for parents on time out. www.cyberparent.com/timeout
4. Discipline tips for parents. http://www.helpandhope.org/Parenting_Tips/articles/discipline.asp
5. Top Tips for Surviving Tantrums: https://www.healthychildren.org/English/family-life/familydynamics/communication-discipline/Pages/Temper-Tantrums.aspx
6. Effective Discipline to Raise Healthy Children (AAP stance against Corporal punishment, yelling)
7. Positive Parenting (Defines positive parenting and gives example cases)
Clinic Updates/Tips/Tools:
1. Please continue to complete all clinic notes within 48 hours! Thanks!
2. Mt Sinai Tips of the Week: Tummy Time

Week 24 (12/6 - 12/10): Sleep (YW-114)

Learn age-appropriate anticipatory guidance regarding sleep
Recognize and treat inappropriate sleep patterns in childhood and adolescence
Understand how to diagnose and treat childhood obstructive sleep apnea

Primary Reference(s): Bhargava S. Diagnosis and Management of Common Sleep Problems in Children. Pediatrics in Review. 2011;32: 91-99
Board Questions: For Learners, For Moderators
Moderators: M: Freya T: Erik W: Nicole P Th: Maral F: Sylvester
Resources:
1. Information for families on sleep disorders from American Academy of Sleep Medicine. www.sleepeducation.com

3. ‘Sleeping Angels’ blog about children’s sleep by Dr. Dennis Rosen, Psychology Today. http://www.psychologytoday.com/blog/sleeping-angels

4. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. www.pediatrics.org/cgi/doi/10.1542/peds.2016-2940

Clinic Updates/Tips/Tools:
1. Mt. Sinai Provider Tip of the Week: Comfort Positioning During Painful Procedures
2. Starting Monday we are giving our patients the Santa letter. If you have a patient in mind that you believe can benefit from this please let Nubia know so she can either call them and fill out for them or she can also email it to them. We are passing them out from today until December 17th. If you see any letters around the office please put them at Nubia's desk.

Week 25 (12/13 - 12/17): Learning Disabilities (YW-100)

Identify common types of specific learning disabilities in children
Create a differential diagnosis for children with suspected learning difficulties
Develop a plan for assessment and treatment of a child with learning difficulties
Discuss the role of the school system in special education services under the Individuals with Disabilities Education Improvement Act

Primary Reference(s):
1. Bravender T. School Performance: The Pediatrician’s Role. Clinical Pediatrics. 2008;47(6): 535-545
2. Lagae L. Learning Disabilities: Definitions, Epidemiology, Diagnosis and Intervention Strategies. Pediatric Clinics of North America. 2008;55(6): 1259-1268.
Board Questions: For Learners, For Moderators
Moderators: M: Nicole A T: Josh W: Steven Th: Jessica T F: Misha
Resources:
1. National Center for Learning Disabilities http://www.ncld.org
2. National Institute of Neurological Disorders Learning Disabilities Information http://www.ninds.nih.gov/disorders/learningdisabilities/learningdisabilities.htm
3. Individuals with Disabilities Education Improvement Act website http://idea.ed.gov
4. Overdiagnosis of ADHD, JAMA 2021
Clinic Updates/Tips/Tools:
1. Check out the Development, Disabilities & Education Section of Resources of this Clinic Site!
2. No RSV tests available as of 12/14/21

Week 26 (12/20 - 12/24): Christmas Week!

Come by clinic to celebrate with your co-residents and attendings!
Call or video chat with your family!
Spread Holiday Cheer!

Monday: TBD
Tuesday: Milks & Cookies (& other deserts)
Wednesday: Potluck?
Thursday: no continuity clinic, last patient booked at 11am
Friday: Closed

Week 27 (1/3-1/7): Children with Medical Complexity: Initial Assessment (YW-57)

Recognize characteristics of children with medical complexity (CMC)
Describe important considerations in the history for CMC
Recognize the importance of participation and quality of life for CMC at home and in the community

Primary Reference(s):
1. Kuo DZ, Houtrow AJ, Council on Children with Disabilities. Recognition and Management of Medical Complexity. Pediatrics. 2016;138(6): e20163021.
2. Sadof M, et al. The “HEADS AT” training tool for residents: A roadmap for caring for children with medical complexity. Clinical Pediatrics. 2015;54(12): 1210-1214. (Review Table 2 in preparation for this week.)
Board Questions: none this week
Moderators: M: Maral T: Misha W: Cherry Th: Yemi F: Tara
Resources:
1. GeneReviews, resource for clinicians to help care for children with underlying genetic syndromes. https://www.ncbi.nlm.nih.gov/pubmed/20301295
2. Educational module for additional practice in assessment of CMC. Huth K, Long-Gagne S, Mader J, Sbrocchi AM. Approach to clinical assessment of children with medical complexity. MedEdPORTAL. 2018;14:10765. https://www.mededportal.org/doi/10.15766/mep_2374-8265.10765
3. Rosenbaum P, Gorter JW, Rosenbaum P. The “F-words” in childhood disability: I swear this is how we should think! Child: Care, Health and Development. Wiley Online Libr. 2011;38(4):457-463. doi:10.1111/j.1365-2214.2011.01338.x https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2214.2011.01338.x
Clinic Updates/Tips/Tools:
1. We are scheduling COVID-19 Shots in clinic now! Tell families to inquire at check out on how to get set up!
2. Community Access to Child Health (CATCH) Grant Applications are due January 24th. More info here or ask Dr. Simangan!

Week 28 (1/10 - 1/14): Children with Medical Complexity - Physical Examination, Medical Technology Care, and Decision Making (YW-59)

Describe important considerations in the physical exam for children with medical complexity (CMC)
Discuss medical technologies used by CMC and potential complications that may arise
Provide anticipatory guidance for families of CMC for preventative health and safety

Primary Reference(s):
1. Glader L, Plews-Ogan J, Agrawal R. Children with medical complexity: creating a framework for care based on the International Classification of Functioning, Disability and Health. Dev Med Child Neurol. 2016;58(11): 1116-1123. https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.13201
2. Kingsley EP. Welcome to Holland. Down Syndrome Association of Simcoe County. 1987. Retrieved April 29, 2021, from http://www.dsasc.ca/uploads/8/5/3/9/8539131/welcome_to_holland.pdf
Board Questions: none this week
Moderators: M: Amy T: Evins W: Valeria Th: Kiran F: Avery
Resources:
1. GeneReviews, resource for clinicians to help care for children with underlying genetic syndromes. https://www.ncbi.nlm.nih.gov/pubmed/20301295
2. Educational module for additional practice in assessment of CMC. Huth K, Long-Gagne S, Mader J, Sbrocchi AM. Approach to clinical assessment of children with medical complexity. MedEdPORTAL. 2018;14:10765. https://www.mededportal.org/doi/10.15766/mep_2374-8265.10765

Week 29 (1/18 - 1/21): COVID-19 Rapid Diagnostic Testing, Quarantine & Isolation

(Moderator Version, Learner Version)

Know where to find the most up to date information on the COVID-19 Pandemic
Have an understanding of what is the general symptoms timeline for COVID-19
Know what types of Rapid Diagnostic Tests (RDT) are currently available for SARS-CoV-2 and how they work.
Understand when and which RDT should be used.
Be able to discuss areas of uncertainty with the current RDTs for COVID-19.
Develop an understanding of current quarantine and isolation recommendations.

Primary Reference(s):
1. Drain, Paul K. “Rapid Diagnostic Testing for SARS-CoV-2” New England Journal of Medicine 7 January 2022.
2. CDC COVID-19: Quaratine and Isolation. Website. Updated January 9, 2022.
Board Questions: none this week
Moderators: M: HOLIDAY (please still read through) T: Briana W: Will Th: Sonia F: Cynthia
Resources:
Clinic Updates/Tips/Tools:
1. Please complete all your notes (both clinic & hospital notes) before you leave clinic. If they are immunizations or other results from that day that need to be completed, please recheck EPIC the following day to complete them. If they are old vaccines/results, please message Kathy Kauder and Nancy Sanchez in Epic with the patient linked to the message. We have a severe amount of deficient notes that need to be completed, otherwise we may have to start taking disciplinary action. If you need help, please reach out to any attendings or chiefs.

Week 30 (1/24 - 1/28): Iron Deficiency Anemia (YW-53)

Understand the diagnostic evaluation of an anemic child
Describe common reasons for iron depletion/deficiency in US children
Outline the diagnosis and treatment of iron deficiency anemia and the next steps of management if a trial of supplemental iron has failed
Know the screening guidelines for anemia recommended by the American Academy of Pediatrics

Primary Reference(s): Baker RD, Greer FR, Committee on Nutrition. Clinical Report - Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010;126(5): 1040-1050.
Board Questions: For Learners, For Moderators
Moderators: M: Zach T: Lauren W: Alis Th: Sylvester F: Hager
Resources:
1. Handout for parents on iron deficiency anemia. www.kidshealth.com/parent/medical/heart/ida.html
Clinic Updates/Tips/Tools:
1. We have Pfizer Vaccines for 5+, typically on Thursdays, please let parents know that they can schedule this on the way out.

Week 31 (1/31 - 2/4): Atopic Dermatitis (YW-24)

Understand the definition, epidemiology, and pathogenesis of atopic dermatitis
Recognize the clinical manifestation patterns of atopic dermatitis at different ages
Recognize possible triggers of and associations with atopic dermatitis, including secondary infections
Understand the principles of treatment of atopic dermatitis

Primary Reference(s): Waldman AR, et al. Atopic dermatitis. Pediatrics in Review. 2018;39(4): 180-191
Board Questions: For Learners, For Moderators
Moderators: M: Nicole A T: Andy W: Manisha Th: Joanne F: Arianna
Resources:
Clinic Updates/Tips/Tools:
1. We have Pfizer Vaccines for 5+, typically on Thursdays, please let parents know that they can schedule this on the way out.

Week 32 (2/7 - 2/11): Toilet Training (YW-121)

Identify developmental markers that suggest a child is ready for toilet training
Assess parental obstacles to toilet training
Provide anticipatory guidance regarding toilet training
Identify health conditions that would interfere with toilet training

Primary Reference(s): Baird DC, Bybel M, Kowalski AW. Toilet training: common questions and answers. American Family Physician. 2019;100(8): 468-474.
Board Questions: For Learners For Moderators
Moderators: M: Tim T: Erik W: Freya Th: Jessica T F: Najima
Resources:
1. Toilet training handout for parents. https://www.aafp.org/afp/2019/1015/p468-s1.html
2. AAP handout on Toilet Training Children with Special Needs. https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/ToiletTraining-Children-with-Special-Needs.aspx
3. Mount Sinai Beginning Toilet Training https://parenting.mountsinai.org/parent-guides/beginning-toilet-training/?search=toilet%20training
4. Mount Sinai Potty Training with Positive Discipline https://parenting.mountsinai.org/parent-guides/potty-training-with-positive-discipline/?search=toilet%20training
Clinic Updates/Tips/Tools:
1. Mount Sinai Parenting Tip of the Week: Postpartum Depression & the Baby Blues
2. UNLV-CSUN Preschool Toilet Training

Week 33 (2/14-2/18): Heart Murmurs (YW-98)

Identify the six systolic and two continuous innocent murmurs of childhood
Recognize specific clinical features that are suggestive of pathologic murmurs
Describe options for further evaluation of murmurs and discuss their costs and benefits

Primary Reference(s): Etoom Y, Ratnapalan S. Evaluation of Children with Heart Murmurs. Clinical Pediatrics. 2014;53(2): 111-117.
Board Questions: For Leaners, For Moderators
Moderators: M: Freya T: Josh W: Nicole P Th: Sonia F: Jessica B.
Resources:
1. Menashe V. Heart murmurs data supplement (audio files). Pediatrics in Review. 2007;28: e19-e22. http://pedsinreview.aappublications.org/cgi/content/full/28/4/e19/DC1
2. Biancaniello T. Innocent murmurs: a parent’s guide. Circulation. 2004;109(11): e162-e163. http://circ.ahajournals.org/cgi/reprint/109/11/e162
3. There are many other sites that host audio files of murmurs, including:

https://depts.washington.edu/physdx/heart/demo.html http://thesimtech.com/audio/

https://www.easyauscultation.com/heart-murmur-sounds

https://www.med.ucla.edu/wilkes/intro.html

https://murmurquiz.org/

http://pted.org/

Clinic Updates/Tips/Tools:
1. Similac Formula Recall! Please inform families to check their cans/bottles: https://abbott.mediaroom.com/2022-02-17-Abbott-Voluntarily-Recalls-Powder-Formulas-Manufactured-at-One-Plant

Wk 34 (2/21-25) - Pediatric Hypertension (YW-22)

Define "hypertension" in the pediatric patient and distinguish between elevated blood pressure, stage 1 hypertension, and stage 2 hypertension
Recognize which children and adolescents need regular blood pressure monitoring
Demonstrate proper technique for blood pressure measurement
Initiate an evaluation for secondary causes, comorbidities, and end-organ damage in the pediatric hypertensive patient
Design an effective management strategy for treatment of children and adolescents with hypertension

Primary Reference: Flynn JT, Falkner BE. New clinical practice guideline for the management of high blood pressure in children and adolescents. Hypertension. 2017;70: 683-686.
Board Questions: For Learners, For Moderators
Moderators: M: Holiday T: Steven W: Valeria Th: Sylvester F: Tara
Resources:
- MD CALC - Pediatric Hypertension Guidelines
- Screening for Blood Pressure in Pediatric Primary Care
- Pedialink - Proper BP Measurement
- Online pediatric blood pressure norms chart. http://www.nhlbi.nih.gov/guidelines/hypertension/child_tbl.pdf
- Information for patients from International Pediatric Hypertension Association. http://www.iphapediatrichypertension.org/faqs/
Clinic Updates/Tips/Tools:
- Similac Formula Recall!
  - Please inform families to check their cans/bottles: https://abbott.mediaroom.com/2022-02-17-Abbott-Voluntarily-Recalls-Powder-Formulas-Manufactured-at-One-Plant
  - Bilingual Flyer made by Dr. Yousufzai
  - You can copy & paste this into the AVS:
    - To find out if the product you have is included in this recall, visit similacrecall.com and type in the code on the bottom of the package, or call +1-800-986-8540 (U.S.) and follow the instructions provided. No action is needed for previously consumed product.

Week 35 (2/28-3/4): Depression (YW-87)

List the symptoms associated with major depressive disorder, compare them to other depressive disorders, and recognize ways they might manifest in pediatric patients
Appreciate the prevalence of depression and suicide in pediatric patients and identify risk factors
Understand the risks and benefits of some of the main treatment options for depression

Primary Reference: Maslow GR, Dunlap K, Chung RJ. Depression and Suicide in Children and Adolescents. Pediatrics in Review. 2015;36(7): 299-308.
Board Questions: Learners, Moderators
Moderators: M: Maral T: Briana W: Cherry Th: Kiran F: Yemi
Resources:
- 1. Bright Futures Pediatric Symptom Checklist, psychosocial screening questionnaire: http://www.brightfutures.org/mentalhealth/pdf/professionals/ped_sympton_chklst.pdf
- 2. American Academy of Child and Adolescent Psychiatry: http://www.aacap.org
- 3. Strengths and Difficulties Questionnaire: http://www.sdqinfo.com/
- 4. Guidelines for Adolescent Depression in Primary Care (GLAD-PC) toolkit: www.glad-pc.org
- 5. Guidelines for Adolescent Preventive Services (GAPS) questionnaire: http://www.ama-assn.org/ama/pub/category/1980.html 6. Search engine to help providers and patients find therapists: www.psychologytoday.com
Clinic Updates/Tips/Tools:
- Lead Screening is BACK! (but limited, please only order for 1 years old at this time)
- Vaxelis (Dtap, HiB, HepB, IPV) is available for both VFC and Private! - Great for the 2nd and 4th Month WCC!
- Menigitis B Vaccines are BACK (for VFC Only)!
- Freya Starts her QI Project this week, please see the QI Page for information on how to help!
- New CDC Milestones
- Similac Formula Recall!
  - Please inform families to check their cans/bottles: https://abbott.mediaroom.com/2022-02-17-Abbott-Voluntarily-Recalls-Powder-Formulas-Manufactured-at-One-Plant
  - Bilingual Flyer made by Dr. Yousufzai
  - You can copy & paste this into the AVS:
    - To find out if the product you have is included in this recall, visit similacrecall.com and type in the code on the bottom of the package, or call +1-800-986-8540 (U.S.) and follow the instructions provided. No action is needed for previously consumed product.

Week 36 (3/7 - 3/11): Lead (YW-99)

Identify sources of environmental lead exposure
Describe acute and chronic problems caused by lead poisoning
Become familiar with screening recommendations and available tests
Review treatment of children with elevated lead levels

Primary Reference: American Academy of Pediatrics Council on Environmental Health. Prevention of Childhood Lead Toxicity. Pediatrics. 2016;138(1): e20161493.
Board Questions: For Learners, For Moderators
Moderators: M: Evins T: Cynthia W: Evins Th: Mahdika F: Misha
Resources:
- Half of US Populations exposed to adverse lead levels in early childhood
- List of recent recalls from US Consumer Product Safety Commission. http://www.cpsc.gov/en/Recalls/
- Links to state and local lead programs. http://www.cdc.gov/nceh/lead/programs/default.htm
- CDC Lead Poisoning Prevention Program with information for patients and providers. http://www.cdc.gov/nceh/lead/acclpp/blood_lead_levels.htm
- Handout for parents on lead exposure from CDC. https://www.cdc.gov/nceh/lead/docs/lead-levels-in-children-fact-sheet-508.pdf
Clinic Updates/Tips/Tools:
- We have a limited amount of lead testing, for now we have decided to screen only at the 12m WCC, or on a case-by-case scenario.
- The Similac Recall Flyer is on the front page under quick info-handouts

Week 37 (3/14-3/18): Short Stature (YW-111)

Review the physiology of normal growth
Define “short stature” and distinguish it from failure to thrive
Describe features in the history and physical that are suggestive of normal variations in growth
Identify pathologic causes of short stature and develop a diagnostic approach
Discuss the indications for growth hormone therapy

Primary Reference: Allen DB, Cuttler L. Short stature in childhood: challenges and choices. NEJM. 2013;368: 1220-8.
Board Questions: For Learners, For Moderators
Moderators: M: Amy T: Lauren W: Alis Th: Joanne F: Arianna
Resources:
- Article for parents about physical development. http://www.healthychildren.org/English/agesstages/gradeschool/puberty/Pages/Physical-Development-of-School-Age-Children.aspx
- Parent information about short stature. https://www.healthychildren.org/English/healthissues/conditions/Glands-Growth-Disorders/Pages/When-a-Child-is-Unusually-Short.aspx
Clinic Updates/Tips/Tools:

Week 38 (3/21 - 3/25): Concussions (YW-48)

Recognize which sports increase the risk of head injury
Diagnose concussion in the office setting
Create a management plan including a return-to-play timeline for an athlete with concussion
Counsel a young athlete on concussion prevention

Primary Reference: Halstead ME, Walter KD, Moffatt K, Council on Sports Medicine and Fitness. Clinical Report – SportRelated Concussion in Children and Adolescents. Pediatrics. 2018;142(6): e20183074.
Board Questions: For Learners, For Moderators
Moderators: M: Zach T: Hager W: Will Th: Jessica T F: Najima
Resources:
- AAP Patient Care: Concussions https://www.aap.org/en/patient-care/concussion/
- SCAT5 instrument for evaluation of athletes 13 and older. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf
- Child SCAT5 instrument for evaluating injured children aged 5-12. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097492childscat5.full.pdf
- Computerized neurocognitive assessment, helpful in determining return to play. www.impacttest.com
- Baseline testing, sideline screening, and post-injury assessments for use by physicians and athletic trainers. www.cogstate.com/go/sport
- CDC “Heads Up” toolkit with links to information and handouts for athletes, parents, and coaches. https://www.cdc.gov/headsup/youthsports/index.html
- Cribsiders Podcast #19: Concussion https://thecurbsiders.com/cribsiders/19
- PECARN Pediatric Head Injury/Trauma Algorithm https://www.mdcalc.com/pecarn-pediatric-head-injury-trauma-algorithm
Clinic Updates/Tips/Tools:

Week 39 (3/28 - 4/1): Language and Literacy Development (YW-7)

1. Identify the sequence of language and literacy development in young children

2. Understand the importance of evaluation of language and literacy in routine pediatric health supervision

3. Effectively use Reach Out and Read to help parents foster acquisition of language and literacy skills in young children (especially in at-risk populations)

Primary Reference: Feldman H. How Young Children Learn Language and Speech. Pediatrics in Review. 2019;40(8): 398- 411
Board Questions: For Learners, For Moderators
Moderators: M: Nicole A. T: Josh W: Sonia Th: Manisha F: Avery
Resources:
- NEIS. https://dhhs.nv.gov/programs/idea/early_intervention_programs/
- Reach Out and Read program website. www.reachoutandread.org
- CDC Milestones Updated https://www.cdc.gov/ncbddd/actearly/milestones/index.html
- Bright Futures Parent Handouts https://publications.aap.org/toolkits/pages/bright-futures-toolkit (updated to 2yo)
- Clark County Library eCard https://legacy.lvccld.org/ecard/language.cfm?_ga=2.195765548.1201474462.1648248122-1632926252.1648248122
- LV Adult Learning Program https://lvccld.org/adult-learning/
- Mount Sinai Parent Guides https://parenting.mountsinai.org/parent-guides/
- Dr. Sun's Reach out & Read Inteview https://news3lv.com/news/local/unlv-clinic-offers-free-books-with-well-checks
Clinic Updates/Tips/Tools:
- We are no longer out of POCT Flu testing

Week 40 (4/4-4/8): Breast Anomalies (YW-40)

Develop a plan for the evaluation and management of adolescents and young adults presenting with breast complaints.
Discuss differential diagnosis of galactorrhea and breast masses in adolescent and young adult females.

Primary Reference: De Silva N. Breast development and disorders in the adolescent female. Best Practice & Research: Clinical Obstetrics & Gynaecology. 2018;48: 40-50
Board Questions: For Learners, For Moderators
Moderators: M: Freya T: Hager W: Steven Th: Sylvester F: Jessica B
Resources:
- Breast Self-Exam and Cancer Risks. https://youngwomenshealth.org/2014/02/27/breast-self-examand-cancer-risks/
- Breast Cancer Screening from ACOG. https://www.acog.org/clinical/clinical-guidance/practicebulletin/articles/2017/07/breast-cancer-risk-assessment-and-screening-in-average-risk-women
Clinic Updates/Tips/Tools:
- Continue to encourage COVID Vaccines which are done every Thursday (age 5-11 y/o only)
- Hep A for VFC (Uninsured and Medicaids) is currently unavailable (4/6/22)
- POCT COVID is available (pick the QuickVue option)

Week 41 (4/11-4/15): Eating Disorders (YW-33)

Define the diagnostic criteria for common eating disorders
Identify common and serious complications associated with eating disorders
Develop an approach to identify children and adolescents at high risk for eating disorders
Outline a treatment plan for an adolescent with an eating disorder

Primary Reference: Hornberger L, Lane MA, Committee on Adolescence. Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics. 2021;147(1): e2020040279.
Board Questions: For Learners, For Moderators
Moderators: M: Evins T: Andy W: Nicole P. Th: Evins F: Misha
Resources:
- Resources for teens and parents on eating disorders from The Center for Young Women’s Health. http://www.youngwomenshealth.org/nutrition_menu.html#eating_disorders
- Resources on the Maudsley Method for families engaging in Family-Based Treatment. www.maudsleyparents.org
- Resources for families from the National Eating Disorders Association. www.nationaleatingdisorders.org
Clinic Updates/Tips/Tools:
- For POCT COVID Antigen Testing, select: BD Veritor

Week 41 (4/18 - 4/22): Infant Colic (YW-60)

1. Understand the evaluation of an infant with unexplained crying

2. Know the natural history and characteristics of colic

3. Become familiar with the treatment options for colic and the evidence supporting these treatments

Primary Reference: Johnson JD, Cocker K, Chang E. Infantile colic: recognition and treatment. American Family Physician. 2015;92(7): 577-582
Board Questions: Learners, Moderators
Moderators: M: Tim T: Josh W: Nicole P. Th: Sonia F: Tim
Resources:
- Handout for families from American Academy of Family Physicians. https://familydoctor.org/condition/colic/
- Handout for families from NIH. https://medlineplus.gov/ency/patientinstructions/000753.htm
- Information on Current Good Manufacturing Practices (CGMPs) for dietary supplements. http://www.fda.gov/Food/GuidanceRegulation/CGMP/ucm079496.htm
- The Period of Purple Crying. http://purplecrying.info/
Clinic Updates/Tips/Tools:

Week 43 (4/25-4/29): ADHD (YW-79)

Understand the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) and the use of ADHD-specific rating scales
Learn how to guide parents in advocating for their children with special needs
Utilize appropriate treatment regimens for ADHD and understand the potential side effects of those regimens
Incorporate the care of patients with ADHD and their families into your primary care practice using the comprehensive medical home model

Primary References:
- Wolraich ML, et al, and the AAP Subcommittee on Children and Adolescents with AttentionDeficit/Hyperactive Disorder. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019;144(4): e20192528.
  - Figure 2 ADHD Patient Care Algorithm
- Centers for Disease Control and Prevention. Attention-Deficit/Hyperactivity Disorder: Symptoms and Diagnosis. Retrieved May 4, 2021
Board Questions: Learners, Moderators
Moderators: M: Maral T: Lauren W: Cherry Th: Kiran F: Tara
Resources:
- AAP ADHD Toolkit (AAP ID required)
- ADHD Medication Guide: http://www.adhdmedicationguide.com/
- Information for families from AAP. http://www.aap.org/healthtopics/adhd.cfm
- Medication safety information from AAP. http://www.aap.org/family/safetypillsadhd.htm
- NICHQ Vanderbilt Assessment Forms & handouts for families. https://www.nichq.org/resource/nichq-vanderbilt-assessment-scales
- Detailed information for families about Individualized Education Programs. http://www.ed.gov/parents/needs/speced/iepguide/index.html
Clinic Updates/Tips/Tools:

Week 44 (5/2-5/6: Social Media & Health (YW-44)

Analyze current use of social media by children and adolescents
Identify recommendations regarding the appropriate use of social media
Evaluate the pros and cons of using social media in a pediatric practice

Primary Reference: Hill DL. Social Media: Anticipatory Guidance. Pediatrics in Review. 2020;41(3): 112-119.
Board Questions: None this week
Moderators: M: Amy T: Briana W: Valeria Th: Alis F: Yemi
Resources:

1. Health information in English and Spanish for parents, educators, kids, and teens, with option for free weekly newsletter. @KidsHealth http://kidshealth.org

2. Sex education by teens, for teens. @Sexetc http://sexetc.org

3. Teen-friendly content created by teens, sponsored by the National Campaign to Prevent Teen and Unplanned Pregnancy. @StayTeen http://stayteen.org

4. Blog from pediatrician, Dr. Wendy Sue Swanson, Director of Digital Health at Seattle Children’s Hospital. @SeattleMamaDoc http://seattlemamadoc.seattlechildrens.org/

6. Tips for Parents from the Federal Trade Commission and National Initiative for Cybersecurity Education. http://www.onguardonline.gov/articles/0012-kids-and-socializing-online

7. AAP-sponsored website and smartphone app with reliable parent-friendly content on common pediatric topics. http://www.healthychildren.org

8. AAP- sponsored personalized media use plan for children and families. http://healthychildren.org/mediauseplan

9. Tips and information on bullying and cyberbullying. http://stopbullying.gov

10. Information for parents to help kids harness the power of media and technology as a positive force. https://www.commonsensemedia.org/social-media

Clinic Updates/Tips/Tools:

Week 45 (5/9-5/13): Indoor Arthropod Bites & Infestations (YW-80)

Differentiate clinically significant arthropod bites and stings based upon pattern of distribution and potential exposures in the home

2. Manage reactions to arthropods and be able to identify common complications

3. Counsel families on prevention of arthropod bites, including eliminating home infestation

Primary Reference: Devore CD, Schutze GE, Council on School Health and Committee on Infectious Diseases. Head Lice. Pediatrics. 2015;135(5): e1355-e1365.
- Read pages 845-847 from: Juckett G. Athropod Bites. American Family Physician. 2013;88(12): 841-847
Board Questions: For Learners, For Moderators
Moderators: M: Freya T: Erik W: Joanne Th: Mahdika F: Arianna
Resources;
- SNHD Bed Bugs https://www.southernnevadahealthdistrict.org/Health-Topics/bed-bugs/

Week 46 (5/16 - 5/20): Safe Infant Sleep (YW-107)

Understand the rates and risk factors for sudden unexpected infant death (SUID)
Know the guidelines for optimizing safety of the sleep environment
Learn to address common parental concerns regarding SUID prevention

Primary Reference: American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome, Policy Statement. SIDS and other sleep-related infant deaths: updated 2016 recommendations for a safe infant sleeping environment. Pediatrics. 2016;138(5): e20162938.
Board Questions: For Learners, For Moderators
Moderators: M: Evins T: Hager W: Manisha Th: Jessica T F: Avery
Resources:
- AAP NEWS Ban on crib bumpers, inclined sleepers nears final approval
- AAP Technical Report: SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment
- National Institute of Child Health and Human Development “Back to Sleep” handout for parents. https://www.nichd.nih.gov/sites/default/files/2019-02/Safe_Sleep_Environ_update.pdf
- CDC information page on SUID and SIDS. https://www.cdc.gov/sids/index.htm
- Video on hip-safe swaddling from Yale Primary Care Pediatrics Curriculum. https://www.youtube.com/watch?v=wyCPwGa3WVQ
Clinic Updates/Tips/Tools:
- Out of POCT Lead
- we still have FLU vaccines

Week 46 (5/23 - 5/27): Firearm Safety (YW-47)

Become familiar with the epidemiology of gun-related violence in children and adolescents
Describe the AAP's policy on firearms and firearm-related injuries
Identify the pediatric provider's role in gun violence prevention

Primary References:
- Petty JK, et al. Firearm Injuries and Children: Position Statement of the American Pediatric Surgical Association. Pediatrics. 2019;144 (1): e20183058.
- Dodson NA, Hemenway D. Toward a deeper understanding of gun violence. Pediatrics. 2020;146(1): e20193333. https://pediatrics.aappublications.org/content/pediatrics/early/2020/06/09/peds.20193333.full.pdf
Board Questions: None this week
Moderators: M: Zach T: Andy W: Manisha Th: Kiran F: Najima
Resources:
- AAP Advocacy Page, Gun Violence Prevention https://www.aap.org/en/advocacy/gun-violence-prevention/
Clinic Updates/Tips/Tools:
- Out of Rapid Flu and Rapid COVID Testing
- Low on Lead Testing

Week 49 (6/6 - 6/10): Clinic Emergencies Part 1

Primary Reference: Preparation for Emergencies in the Offics of Pediatricians and Pediatric Primary Care Providers
- CCC Session Worksheet.
Board Questions: None
Moderators: Attendings
Resources:
Clinic Updates/Tips/Tools:

Week 50 (6/13-6/17): Water Safety 7 Drowning Prevention (YW-45)

Understand the definition and epidemiology of drowning
Become familiar with standards of pool fencing
Gain an understanding on how to counsel families about water safety
Understand how to advise families regarding swimming lessons

Primary Reference: https://publications.aap.org/pediatrics/article/143/5/e20190850/37134/Prevention-of-Drowning
Board Questions: None
Moderators: M: Nicole A T: Josh W: Nicole P Th: Sylvester F: Avery
Resources:

1. Information from the AAP on water safety. http://www.aap.org/en-us/about-the-aap/aap-pressroom/news-features-and-safety-tips/Pages/Sun-and-Water-Safety-Tips.aspx

2. Resources for parents from PoolSafely.gov, including information on the Virginia Graeme Baker Pool and Spa Safety Act. http://www.poolsafely.gov/parents-families/resources-for-parents-families/

3. Handouts on “Water Safety at Home” and “Swimming Safety Tips” from safekids.org. http://www.safekids.org/watersafety

4. Information for parents on recognizing signs of drowning. www.uvpediatrics.com/news/2013/08/do-you-know-what-drowning-looks-like/

5. US Coast Guard guide on “How to Choose the Right Life Jacket.” http://www.uscgboating.org/images/howtochoosetherightlifejacket_brochure.pdf

Clinic Updates/Tips/Tools:

Week 51 (6/20-6/24): Clinic Emergencies Part 2

Primary Reference: Preparation for Emergencies in the Offics of Pediatricians and Pediatric Primary Care Providers
Board Questions: None
Moderators: Attendings
Resources:
Clinic Updates/Tips/Tools:

Week 52 (6/27-6/30): Thank you seniors!

Primary Reference: None
Board Questions: None
Moderators: Attendings
Resources:
Clinic Updates/Tips/Tools:

CCC 2020-2021 Archive:

Wk 1 (7/1-7/2): No CCC, Welcome Interns!

Wk 2 (7/6-7/10): EPIC Tips & Tricks, Oral Presentations

Wk 3 (7/13-7/17): Language Support Services (YW 21)

Primary Reference: "Appropriate use of medical interpreters". American Family Physician. 2014;90(7): 476-80. http://www.aafp.org/afp/2014/1001/p476.pdf
Helpful Links: Adult English Classes (CCSD Library)

Wk 4 (7/20-7/24): Motivational Interviewing (YW 50)

Primary Reference: "Brief interventions and motivational interviewing with children, adolescents, and their parents in pediatric health care settings: a review. Archives of Pediatrics and Adolescent Medicine". http://archpedi.jamanetwork.com/article.aspx?articleid=486200
Helpful Links: The Rulers of Motivational Interviewing

Wk 5 (7/27 - 7/31): Ex-Preemie Care, YW 11

Primary Reference: Andrews B, et al. NICU Follow-up: Medical and Developmental Management Age 0 to 3 Years. Neoreviews. 2014;15: e123.
Clinic Tips: Growth charts can be adjusted for Fenton (preemie charts) and corrected gestation age ONLY if you update the birth history

Wk 6 (8/3 - 8/7): Postpartum Depression & Anxiety, YW 17

Primary Reference: Earls MF, et al. Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice. Pediatrics. 2019;143(1): e20183259.
Clinic Tips: On this website, click: Resources -> Mental Health; there are two important links for you, the Maternal Child Health Coalition Referral form & the NIMH Care Pathways Algorithm

Wk 7 (8/10 - 8/14): Clinic Mock Code Week

Primary Reference: AAP Committee on Pediatric Emergency Medicine Preparation for Emergencies in the Offices of Pediatricians and Pediatric Primary Care Providers Pediatrics July 2007, 120 (1) 200-212

Wk 8 (8/17 - 8/21): Twins and more! YW 13

Primary Reference: Moore JE. Multiple Births: The Art and Science of Caring for Twins, Triplets and More. Pediatrics in Review. 2007;28(3): e9-15
Practice Tip: Growth charts can be adjusted for Fenton preemie charts and corrected gestation age ONLY if you update the birth history, recommend this support group for familes with multiples http://www.lasvegasmultiples.com/

Wk 9 (8/24-8/28): Tuberculosis, YW 48

Primary Reference: Cruz AT, Starke JR, Lobato MN. Old and new approaches to diagnosing and treating latent tuberculosis in children in low-incidence countries. Current Opinion in Pediatrics. 2014;26(1): 106-113.
Practice Tips: Yes, we can order PPD's here in clinic, any positive finding must be reported to the SNHD (quick fact: Active TB Cases in Southern Nevada 2018-30, 2019-18, 2020-26)

Wk 10 (8/31-9-4): Immigrant & Refugee Health, YW 71

Primary Reference: Linton JM, Green A, AAP Council On Community Pediatrics. Providing Care for Children in Immigrant Families. Pediatrics. 2019;144(3): e20192077

Wk 11 (9/8-9/11): Foster Children, YW 20

Primary Reference: Council on Foster Care, Adoption, and Kinship Care, Committee on Adolescence, Council on Early Childhood. AAP Policy Statement: Health Care Issues for Children and Adolescents in Foster Care and Kinship Care. Pediatrics. 2015;136(4): e1131.
Practice Tip: Utilize the AAP Book Fostering Health as a resource when taking care of foster children & adolescents. (quick fact: there are about 3000 children in Clark Country in Foster care)

Wk 12 (9/14-9/18) - Teen Vaccines, YW 123

Primary Reference: Dempsey AF, Zimet GD. Interventions to improve adolescent vaccination: what may work and what still needs to be tested. American Journal of Preventive Medicine. 2015;49(6): S445-S454.
Practice Tip: CDC Simplified Vaccine Schedules for Parents: English: 7-18y Spanish: 7-18y

Wk 13 (9/21-9/25) - Poppin' Bottles YW 86

Primary Reference: Martinez JA, Ballew MP. Infant Formulas. Pediatrics in Review. 2011;32: 179-189.
Practice Tips: Found in the For Parents Tab-Newborns Section FDA.gov - Q&A for Consumers Concerning Infant Formula, Formula Adjustment, Neosure Adjustment

Wk 14 (9/28-10/2) - The High Blood, YW 64

Wk 15 (10/5-10/9) - Abnormal Pee, YW 62

Primary Reference: Viteri B, et al. Hematuria and proteinuria in children. Pediatrics in Review. 2018;39(12): 573-587
Practice Tips: See the Primary Reference for great decision algorithms.

Wk 16 (10/12-10/16) - Time to Eat (& Grow)! YW 70

Primary Reference: Ontario Dietitians in Public Health. Pediatric Nutrition Guidelines (Birth to Six Years) for Health Professionals. 2019
Practice Tips: Check out For Parents - GI/Nutrition Section

Wk 17 (10/19-10/23) - Child Abuse

Primary Reference: Glick JC, Lorand MA, Bilka KR. Physical Abuse of Children. Pediatrics in Review. 2016;37(4): 146- 158
Practice Tips: Report Suspected Child Abuse or Neglect 1-833-11183, Clark County 702-399-0081, Recognizing, Reporting & Preventing Child Abuse in Nevada

Wk 18 (10/26-10/30) - Fetal Alcohol Spectrum Disorder

Primary Reference: Hoyme HE, et al. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders. Pediatrics. 2016;138(2): e20154256.
Practice Tips: AAP - FASD Toolkit

Wk 19 (11/2 - 11/6 ) - Head Size & Shape

Primary References:
- Kabbani H, Raghuveer TS. Craniosynostosis. American Family Physician. 2004;69: 2863-70
- Laughlin JL, et al. Prevention and management of positional skull deformities in infants. Pediatrics. 2011;128: 1236-124
Practice Tips: Tape measures are available in every exam room to recheck any OFC's (you can add your measurement in the "rooming" tab in EPIC)

Wk 20 (11/9 - 11/13) - Safe Driving

Primary Reference: Durbin DR, Hoffman BD; Council on Injury, Violence, and Poison Prevention. Child Passenger Safety. Pediatrics. 2018;142(5):e20182461. Policy Statement, Technical Report
Practice Tips: NHTSA Recall Website

Wk 21 (11/16 - 11/20 ): Marijuana

Primary Reference: Ammerman S, Ryan S, Adelman WP. Committee on Substance Abuse, Committee on Adolescence. AAP Technical Report on The impact of marijuana policies on youth: clinical, research, and legal update. Pediatrics. 2015;135: e769-e785.

Wk 22 (11/23 - 11/27 ): Thanksgiving Week

Primary Reference: HealthyChildren.org - Thanksgiving During COVID-19: Keep Safety on the Table
Board Questions: For All

Wk 23 (11/30 - 12/4): Baby Mouths

Primary Reference:
- AAPD Oral Health Policies and Recommendations: Management Considerations for Pediatric Oral Surgery and Oral Pathology. The Reference Manual of Pediatric Dentistry. 2015;402-411.
- Mueller DT, Callanan VP. Congenital malformations of the oral cavity. Otolaryngologic Clinics of North America. 2007;40(1): 141–160.

Wk 24 (12/7 - 12/11) - Earwax+

Primary Reference:
- Urkin J, Bar-David Y, Holdstein Y. Cleaning Earwax Impaction: Clinical Tips for the Primary Care Clinician. Clinical Pediatrics. 2015;54(14): 1311-1314.
- 2017 American Academy of Otolaryngology – Head and Neck Surgery Clinical Practice Guideline by Schwartz, et al.
Practice Tips:
- Kidshealth information for parents about ear wax. http://kidshealth.org/en/parents/earwax.html 3.
- Nationwide Children’s Hospital handout for parents about ear wax. http://www.nationwidechildrens.org/ear-wax

Wk 25 (12/14 - 12/18): Food Allergy

Wk 26 (12/21 - 12/25): Holiday Week (Clinic Closes 12/24 @ Noon, all day 12/25)

Call your family.
Eat and be merry.

Primary Reference: HealthyChildren.org - Keep the Holidays Happy During COVID-19
Board Questions: For All

Wk 27 (12/28 - 1/1): Holiday Week (Clinic Closes 12/31 @ Noon, all day 1/1)

Call your family.
Make a resolution.

Primary Reference: HealthyChildren.org - Healthy New Year's Resolutions for Children and Teens
Board Questions: For All

Wk 28 (1/4 - 1/8): The COVID-19 Vaccines

Primary References (required as always):
- Romero Jose R MD; and Bernstein Henry H. DO, MCHCM: “COVID-19 Vaccines: A Primer for Clinicians,” Pediatric Annals Vol 49 No 12, 2020.
- Kaiser Health News: Pediatricians Want Kids to Be Part of COVID Vaccine Trials
- John’s Hopkins University: Could COVID-19 Vaccines become mandatory in the US?
UNLV's CCC Module: For Learners, For Moderators

Week 29 (1/11 - 1/15): Pediatric Clinic Mock Code Part 2

Primary References:

AAP Committee on Pediatric Emergency Medicine: "Preparation for Emergencies in the Offices of Pediatricians and Pediatric Primary Care Providers"
American Heart Association "Highlights of the 2020 American Heart Association Guidelines for CPR and ECC"

Wk 30 (1/19 - 1/22): Joint Pain

Primary References:

Tse SML, Laxer RM. Approach to Acute Limb Pain in Childhood. Pediatrics in Review. 2006;27(5): 170-180.
Junnila JL, Cartwright VW. Chronic musculoskeletal pain in children: Part I. Initial evaluation. Am Fam Physician. 2006;74(1): 115-122.
Board Questions: For Learners, For Moderators

Practice Resources:

Searchable database of orthopedic diagnosis sponsored by the American Academy of Orthopedic Surgery. Includes diagnostic physical exam maneuvers as well as radiologic references. http://orthoinfo.aaos.org/
Review of pediatric musculoskeletal exam techniques using annotated videos and reference images. http://www.arthritisresearchuk.org/health-professionals-and-students/video-resources/pgals.aspx

Week 31 (1/25- 1/29): Scoliosis & Kyphosis

Primary References:

Practice Resources:

Handout for patients and families from National Institutes of Health. http://www.niams.nih.gov/Health_Info/Scoliosis/default.asp

Description of kyphosis for patients with illustration of Scheuermann’s kyphosis. http://www.allaboutbackandneckpain.com/understandingconditions/kyphosis.asp

Week 32 (2/1 - 2/5): Sports Injury

Primary Reference: Coleman N. Sports Injuries. Pediatrics in Review. 2019;40(6): 278-290.
Practice Tips:
- General information from AAP for children and parents on safe participation in youth sports, with links to individual sports. https://www.healthychildren.org/English/healthy-living/sports/Pages/default.aspx

Information for children and parents on Little League elbow from AAP. https://www.healthychildren.org/English/health-issues/injuries-emergencies/sportsinjuries/Pages/Little-League-Elbow.aspx

Week 33 (2/8 - 2/12): Lower Extremities Deformities

Primary Reference: Smith BG. Lower extremity disorders in children and adolescents. Pediatrics in Review. 2009;30: 287- 294

Week 34 (2/15 - 2/19): Primary Immunodeficiencies

Primary Reference: Chinn IK, Orange JS. Immunodeficiency Disorders. Pediatrics in Review. 2019;40(5): 229-242
Clinic Resources:
- Mayo Clinic Medical Laboratories test catalog, clinical resource for ordering and interpreting laboratory tests. http://www.mayomedicallaboratories.com/test-catalog/index.html
- Jeffrey Modell Foundation, information on primary immunodeficiencies for families and providers. http://www.info4pi.org/
- Immune Deficiency Foundation handout for families about SCID. http://primaryimmune.org/wpcontent/uploads/2014/08/questions-about-SCID.pdf

Week 35 (2/22 - 2/26): Developmental Hip Dysplasia

Primary Reference: Shaw BA, Segal LS, AAP Section on Orthopaedics. Evaluation and Referral for Developmental Dysplasia of the Hip in Infants. Pediatrics. 2016;138(6): e1-e11.
Clinic Resources:
- Hip-Safe Swaddling. Yale PCPC video. https://youtu.be/wyCPwGa3WVQ
- Information for parents about DDH. http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=153
- Information on hip healthy swaddling. http://hipdysplasia.org/developmental-dysplasia-of-thehip/hip-healthy-swaddling/

Week 36 (3/1 - 3/5): Normal & Delayed Puberty (YW-106)

Primary Reference: Wolf RM, Long D. Pubertal Development. Pediatrics in Review. 2016;37(7): 292-299.
Clinic Resources:
- Handout for families from American Academy of Family Physicians.
  - https://familydoctor.org/boys-and-puberty/
  - https://familydoctor.org/girls-and-puberty/
- Handout for families with delayed puberty from AAP and Pediatric Endocrine Society
  - https://pedsendo.org/patient-resource/delayed-puberty-girls/
  - https://pedsendo.org/patient-resource/delayed-puberty-boys/

Week 37 (3/8-3/12): Precocious Puberty (YW-107)

- Carel J, Léger J. Precocious puberty. NEJM. 2008;358(22): 2366-77
- Jasik CB, Lustig RH. Adolescent obesity and puberty: the “perfect storm”. Annals of the New York Academy of Sciences. 2008;1135: 265-279
Clinic Resources:
- Handout for families from American Academy of Family Physicians.
  - https://familydoctor.org/condition/central-precocious-puberty/
- Handout for precocious teens from American Academy of Pediatrics.
  - www.aap.org/publiced/BR_Teen_Puberty.htm
- Handout for families from American Academy of Pediatrics and Pediatric Endocrine Society
  - www.pedsendo.org/assets/patients_families/EdMat/Precocious%20Puberty.pdf

Week 38 (3/15 - 3/19): Menstrual Disorders

- Jamieson MA. Disorders of Menstruation in Adolescent Girls. Pediatr Clin North Am. 2015;62(4): 943-61
- Rackow BW. A review of normal menstrual cycle physiology.
Clinic Resources:
- Center for Young Women’s Health, Boston Children’s Hospital. www.youngwomenshealth.org
- Menstruation Tracking Apps

Week 39 (3/22 - 3/26): Contraception (YW-84)

Primary Reference: Pages 436-449 in: Richards MJ, Buyers E. Update on Adolescent Contraception. Adv Pediatr. 2016;63(1): 429-51 and please review https://www.southernnevadahealthdistrict.org/community-health-center/family-planning/teen-health-pregnancy-prevention/
Clinic Resources:
1. 2016 US medical eligibility criteria for contraceptive use from CDC.
  - https://www.cdc.gov/mmwr/volumes/65/rr/rr6503a1.htm?s_cid=rr6503a1_e
2. List of emergency contraception alternatives. http://ec.princeton.edu/questions/dose.html
3. Birth control information for teens. http://www.pamf.org/teen/sex/birthcontrol/
4. Birth control information for teens. www.bedsider.org
5. Patient information about sexual assault. http://www.911rape.org/home
6. Health information for teens in Q&A format. http://goaskalice.columbia.edu/
7. State specific information on reproductive health, rights, and public policy. https://www.guttmacher.org/statecenter/
8. SNHD Teen Care Privacy Letter. https://www.southernnevadahealthdistrict.org/download/family-planning/teen-care-and-privacy.doc
9. Dr. Levy's Links

Week 40 (3/29 - 4/2): Approach to Adolescent Sexuality (YW-74)

Primary Reference: Marcell AV, Burstein GR, Committee on Adolescence. Sexual and Reproductive Health Care Services in the Pediatric Setting. Pediatrics. 2017;140(5): e20172858.
Clinic Resources:
- The Guttmacher Institute, information on adolescent sexual and reproductive health and rights, including state by state comparisons. www.guttmacher.org
- Information for patients, parents, teachers, and health care providers regarding normal health and development and specific diseases and conditions. www.youngwomenshealth.org or www.youngmenshealthsite.org

Week 41 (4/5 - 4/9): Sexually Transmitted Infections & PrEP (YW-118)

Primary References:
- American Academy of Pediatrics Committee on Adolescence, Society for Adolescent Health and Medicine. Screening for nonviral sexually transmitted infections in adolescents and young adults. Pediatrics. 2014;134: e302-e311
- Centers for Disease Control and Prevention: Prescribe PrEP: FAQs for the health care professional.
Clinic Resources:
- STD Epi Profile, Clark County, SNHD
- CDC 2015 Sexually Transmitted Diseases Treatment Guidelines. (charts, apps, document)
  - https://www.cdc.gov/std/tg2015/default.htm
- HIV treatment regimen guidelines from US Department of Health and Human Services.
  - https://aidsinfo.nih.gov/guidelines
- Adolescent access to reproductive health without parental consent, laws by state
  - https://www.cdc.gov/hiv/policies/law/states/minors.html
- CDC Expedited Partner Therapy Laws: Nevada
  - https://www.cdc.gov/std/ept/legal/nevada.htm
- Searchable website for current state laws regarding HIV testing and therapy.
  - https://www.hivlawandpolicy.org/state-hiv-laws
- CDC Pre-Exposure Prophylaxis (PrEP) - fact sheets and videos for both consumers and providers.
  - https://www.cdc.gov/hiv/risk/prep/index.html
- STD picture cards from CDC
  - https://www.cdc.gov/std/training/picturecards.htm

Week 42 (4/12 - 4/16): Suicide (YW-75)

Primary Reference: Shain B, Committee on Adolescence. Suicide and Suicide Attempts in Adolescents. Pediatrics. 2016;138(1): e20161420.
Clinic Resources:
- 1. National Suicide Prevention Lifeline: 1-800-273-TALK. https://suicidepreventionlifeline.org/
- 2. AAP Suicide Prevention campaign. https://www.aap.org/en-us/about-the-aap/aap-pressroom/campaigns/suicide-prevention/Pages/default.aspx
- 3. AAP Suicide Prevention Health initiative page. https://www.aap.org/en-us/advocacy-andpolicy/aap-health-initiatives/child_death_review/Pages/Suicide-Prevention.aspx
- 4. CDC Suicide prevention information. https://www.cdc.gov/violenceprevention/suicide/index.html

Week 43 (4/19 - 4/23): Quarterly Mock Code Week

Annual Code Practice in the Pediatric Office setting
Primary Reference: AAP Committee on Pediatric Emergency Medicine Preparation for Emergencies in the Offices of Pediatricians and Pediatric Primary Care Providers Pediatrics July 2007, 120 (1) 200-212

Week 44 (4/26 - 4/30): Transition to Adult Care (YW-23)

Primary Reference: Mahan JD, et al. Self-management and transition to adult health care in adolescents and young
adults: a team process. Pediatrics in Review. 2017;38(7): 305-317
Clinic Resources:
- American Academy of Pediatrics National Center for Medical Home Implementation Transition Tools
  - https://medicalhomeinfo.aap.org/tools-resources/Pages/For-Practices.aspx
- “Got Transition,” clearinghouse of resources from The National Alliance to Advance Adolescent Health.
  - http://www.gottransition.org/ including recommended timeline for transition https://www.gottransition.org/resource/?hct-timeline-parents-caregivers
- McManus M, Turchi RM. Coding, payment options for pediatric to adult transition services. AAP News. 2015.
  - http://www.aappublications.org/content/36/9/10.full
- Washington State Department of Health Adolescent Health Transition Project, with examples of portable medical summaries.
  - http://depts.washington.edu/healthtr/
- American College of Physicians, Pediatric to Adult Care Transitions Initiative, toolkit for providers with general and specialty-specific transition tools.
  - https://www.acponline.org/clinical-information/high-value-care/resources-for-clinicians/pediatric-to-adult-care-transitions-initiative
- A more extensive list of transition-related resources appears at the end of the AAP/AAFP/ACP 2011 Clinical Report.
  - http://pediatrics.aappublications.org/content/128/1/182.full.pdf+html

Week 45 (5/3 - 5/7) : Common Anomalies of the Hands & Feet (YW-94)

3. Video of Silfverskiöld test from Seattle Children’s Hospital.

4. Parent Handout on Polydactyly from Seattle Children’s Hospital.

5. Parent Handout on Flatfeet from Royal Children’s Hospital.

6. More information for parents on Flatfeet from the AAOS.

Week 46 (5/10 - 5/14): Newborn Screening (YW-15)

Primary Reference: Fabie NAV, Pappas KB, Feldman GL. The current state of newborn screening in the United States. Pediatric Clinics of North America. 2019;66(2): 369-386
Clinic Resources:
- UPC Clinic Resources Section
- American College of Medical Genetics information sheets and confirmatory algorithms.
  - https://www.acmg.net/ACMG/Medical-Genetics-Practice-Resources/ACT_Sheets_and_Algorithms.aspx
- National Newborn Screening & Genetics Resource Center. http://genes-r-us.uthscsa.edu/
- State-specific information on newborn screening programs.
  - http://genes-r-us.uthscsa.edu/resources/consumer/statemap.htm
- Links to information about genetic conditions for providers and families
  - http://ghr.nlm.nih.gov/

Week 47 (5/17 - 5/21): The Medical Home & Children with Special Health Care Needs (YW-69)

Primary Reference: Homer CJ, et al. A review of the evidence for the medical home for children with special health care needs. Pediatrics. 2008;122(4): e922-e937
Clinic Resources:
Nevada Parents Empowering Parents - State Chapter of PEP which trains parents of disabled children on advocacy and a variety of topics
- https://nvpep.org/
Children with Special Health Care Needs Screening Tool
- https://www.childhealthdata.org/docs/cshcn/technical-summary-of-cshcn-screener.pdf
American College of Physicians online resources for patient-centered medical homes.
- http://www.acponline.org/running_practice/delivery_and_payment_models/pcmh/
National Center of Medical Home Implementation, AAP sponsored web site for resources, screening tools, and technical assistance.
- http://www.medicalhomeinfo.org/
Family Voices, A national family advocacy organization with links to state family coordinators and resources.
- - http://www.familyvoices.org

Week 48 (5/24 - 5/28): Treatment of Childhood Overweight & Obesity (YW-52) (NOT PID)

Primary References:

1. AAP Institute for Healthy Weight 2-page algorithm summarizing the 2007 Expert Committee Recommendations on the Assessment and Management of Childhood Obesity

2. Spear BA, et al. Recommendations for Treatment of Child and Adolescent Overweight and Obesity. Pediatrics. 2007;120(S4): S254-S288.

3. Figure 2 in: Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet. 2002;360(9331):473-482.

Clinic Resources:
- Ohio AAP Obesity Coding Fact Sheet
- Childhood Obesity in Primary Care modules from the AAP Institute for Health Weight:
  - https://ihcw.aap.org/Pages/ChildhoodObesityPC.aspx
- AAP Change Talk: Childhood Obesity – brief simulated patient encounters to practice motivational interviewing:
  - https://simulations.kognito.com/changetalk/?dly=20
- NHANES 2000 Growth Charts. www.cdc.gov/nchs/about/major/nhanes/growthcharts/clinical_charts.htm
- WeCan from the NIH
  - http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/,
- Healthy Eating Plate from Harvard School of Public Health healthy eating plate:
  - Children’s version: https://www.hsph.harvard.edu/nutritionsource/kids-healthy-eating-plate/
  - Adult’s version: https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/

Week 49 (5/31 - 6/4): Bullying (YW-18) (not Literacy Development)

Primary Reference: Lamb J, Pepler DJ, Craig W. Approach to bullying and victimization. Canadian Family Physician. 2009;55(4): 356-360
Board Questions: For Learners, For Moderators
Clinic Resources:
- Bullying resources for children and families developed by HRSA.
  - http://www.stopbullying.gov/
- Bright Futures handout for parents with specific behavioral suggestions.
  - http://brightfutures.org/mentalhealth/pdf/families/mc/bullying.pdf
- Information for healthcare providers about violence prevention from AAP.
  - http://www.aap.org/connectedkids/
- KnowBullying App developed by Substance Abuse and Mental Health Association
  - https://store.samhsa.gov/product/knowbullying
- Information on SafeTalk Program and Kids in Crisis Organization.
  - https://www.kidsincrisis.org/get-help/safetalk/
- NCCJ Bridges Program as example of school outreach and resource program.
  - https://www.nccj.org/programs/youth-education/nccj-bridges

Week 50 (6/7 - 6/11): Travel Preparedness (YW-112)

Primary Reference: Weinberg N, Weinberg M, Maloney SA. International Travel with Children: Traveling Safely with Infants & Children. In: CDC, Brunette GW, eds. CDC Health Information for International Travel 2014: The Yellow Book. New York, NY: Oxford University Press; 2013.
Board Questions: For Learners, For Moderators
Clinic Resources:
1. State Department Travel Advisories. https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/
2. Links to CDC sites (non-Yellow Book).
  - Health notices for travelers. http://wwwnc.cdc.gov/travel/notices.htm
  - Country specific information. http://wwwnc.cdc.gov/travel/destinations/list.htm
  - Malaria information by country. http://www.cdc.gov/malaria/travelers/country_table/a.html
  - List of travel clinics. http://wwwnc.cdc.gov/travel/page/travel-clinics.htm
3. Links to CDC Yellow Book. http://wwwnc.cdc.gov/travel/page/yellowbook-home
4. WHO website on International Travel and Health. http://www.who.int/ith/en/
5. Insect Repellent handout. http://www.healthychildren.org/English/safety-prevention/at-play/pages/Insect-Repellents.aspx

Week 52 (6/21 - 6/25): Sibling Relationships (YW-113)

Primary Reference: Hughes C, McHarg G, White N. Sibling influences on prosocial behavior. Current Opinion in Psychology. 2019;20: 96-101.
Clinic Resources:
- Handout on sibling rivalry. http://www.healthychildren.org/English/family-life/family-dynamics/Pages/Sibling-Rivalry.aspx
- Information for parents on types of sibling relationships. http://www.healthychildren.org/English/family-life/family-dynamics/Pages/Types-of-SiblingRelationships.aspx

Week 51 (6/14 - 6/18): Medical Legal Partnerships (YW-103)

Primary Reference: Shin P, et al. Medical-legal partnerships: Addressing the unmet legal needs of health center patients. 2010. Geiger Gibson/RCHN Community Health Foundation Research Collaborative policy research brief no. 18. Washington, D.C.: George Washington University, School of Public Health and Health Services, Department of Health Policy.
Board Questions: None this week
Clinic Resources:
- National Center for Medical-Legal Partnerships. http://medical-legalpartnership.org/
- Center for Disease Control and prevention. Social determinants of health guidance, resources and programs. http://www.cdc.gov/socialdeterminants/
- Links to screening tools including WE-CARE and The Survey of Well-being of Young Children. https://depts.washington.edu/dbpeds/Screening%20Tools/ScreeningTools.html
- The Hunger Vital Sign screening questions. http://www.childrenshealthwatch.org/publicpolicy/hunger-vital-sign/

SEEK (A Safe Environment for Every Kid) Parent Questionnaire. http://www.uspreventiveservicestaskforce.org/Home/GetFileByID/859

Week 26 (12/20 - 12/24): Last Week of 2021!

No CCC this Week! Be safe! Friday Clinic is Closed!
Street Closures:
- Downtown: Major closures will be on Fremont Street between Las Vegas Boulevard and Sixth Street start 5 a.m. on Dec. 30, and reopening at 10 a.m. on Jan. 1.
- The Strip: The entire 4 miles from Russell to Sahara, is scheduled to close to all traffic starting at 6 p.m., and a full closure of the corridor is expected by approximately 8:00 p.m on Dec. 31. All roads will usually reopen by 6am on Jan 1.

Week 48 (5/31-6/3): Early Childhood Toxic Stress (YW-125)

1. Understand the dynamic concepts of positive, tolerable, and toxic stress

2. Review the body’s physiologic response to stress, the consequences of significant dysregulation of this response, and the effects on the developing brain of a child

3. Appreciate how early traumatic experiences, innate vulnerabilities and strengths, and the presence or absence of external supports interact to alter a child’s vulnerability to stress-related disease

4. Recognize the steps the pediatric provider can take to prevent the development of, ameliorate, and reduce damage from toxic stress

Primary Reference: Shonkoff JP, et al. The Lifelong Effects of Early Childhood Adversity and Toxic Stress. Pediatrics. 2012;129: 232-246.
Board Questions: None This Week
Moderators: M: Holiday T: Lauren W: Will Th: Sonia F: Cynthia
Resources:
- The Effects of Childhood Stress on Health Across the Lifespan. https://www.cdc.gov/violenceprevention/aces/index.html
- A Public Health Approach to Toxic Stress. American Academy of Pediatrics. http://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/EBCD/Pages/Public-HealthApproach.aspx
- Center on the Developing Child, Harvard University http://developingchild.harvard.edu/topics/science_of_early_childhood/toxic_stress_response/
- NPR ACE Score https://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean
Clinic Updates/Tips/Tools:
- POCT Tests are back - Lead, Hemoglobin, COVID, Flu

CCC 2019-2020 Archive

BLOCK 2 TOPIC SCHEDULEUnit: Intro to Clinic Part 27/29: Agenda Setting (Yale Week 2)8/5: The Difficult Encounter (Yale Week 33)8/12: Heath Supervision (Yale Week 1)8/19: High Value Care (Yale Week 63)
BLOCK 3 TOPIC SCHEDULEUnit: Gastrointestinal and Genitourinary8/26: Toilet Training (Yale Week 17)9/2: UTI (Yale Week 24)9/9: Constipation (Yale Week 42)9/16: Urinary Incontinence (Yale Week 111)
Block 4 Topic scheduleUnit: Preventative Medicine, Newborns, Nutrition9/23: Primer on Vaccines (Yale Week 3)9/30: Vaccine Hesitancy (Yale Week 4)10/7: Common Newborn Concerns (Yale Week 8)10/14: Breastfeeding: Initiation & Troubleshooting (Yale Week 7)
BLOCK 5 TOPIC SCHEDULEUnit: Heme/Onc and ID10/21: Identification of the Sick Child (Yale Week 89)10/28: Fever in Children Less than 36 Months (Yale Week 21)11/4: Lymphadenopathy (Yale Week 94)11/11: Otitis Media and Externa (Yale Week 101)
BLOCK 6 SCHEDULEUnit: ENT/Pulmonary/ophthalmology11/18: Asthma (Yale Week 39)11/25: Vision Screening (Yale week 114)12/2: Hearing Screening (Yale Week 58)12/9: Headache (Yale Week 46)
Block 7 ScheduleUnit: None. Happy Holidays! 12/16: The Pediatric Safety Net (Yale Week 15)12/23: None. Happy Holidays!12/30: None. Happy Holidays!1/6: Poverty & Social Determinants of Health (Yale Week 14)
BLOCK 8 SCHEDULE1/13: Infant and Toddler Development (Yale Week 5)1/21: Acne Vulgaris (Yale Week 10)1/27: Social Media Use (Yale Week 11)2/3: Learning Disabilities (Yale Week 20)
BLOCK 9 SCHEDULE (2/10-3/08)2/10: Breastfeeding: Prenatal Considerations (Yale Week 6)2/18: Eating Disorders (Yale Week 9)2/24: Antibiotic Use in Primary Care (Yale Week 22)3/02: School Readiness & Failure (Yale Week 19)

BLOCK 10 SCHEDULE (3/09-4/05)3/9: MOCK CODE (no reading)3/16: Rhinorrhea and Congestion (Yale Week 23)3/23: Coronavirus Module 13/30: Coronavirus Module 2
BLOCK 11 SCHEDULE (4/06-5/03)4/6: Coronavirus Module 34/13: Attention-Deficit/Hyperactivity Disorder (Yale Week 35)4/20: Depression (Yale Week 36)4/27: Heart Murmurs (Yale Week 40)
BLOCK 12 SCHEDULE (5/04-5/31)5/4: Short Stature (Yale Week 41)5/11: Lead (Yale Week 45)5/18: Pediatric Dental Care (Yale Week 47)5/25: Substance Use Disorders (Yale Week 49)
BLOCK 13 Schedule6/01: Prevention of Tobacco Use (Yale Week 50)6/08: Newborn Circumcision (Yale Week 54)6/15: Concussion (Yale Week 57)6/22: Atopic Dermatitis (Yale Week 59) 6/29: None. Congrats 3rd Years!

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