The SDBP is an international interdisciplinary academic organization whose members are developmental-behavioral pediatricians, neurodevelopmentalists, pediatric psychologists, nurse practitioners, child psychiatrists, academic generalists and trainees in these professions with a broad range of interests across the field of developmental-behavioral pediatrics.

“Dr. High has been an integral part of our department of pediatrics for more than 15 years,” said Robert B. Klein, MD, pediatrician-in-chief at Hasbro Children’s Hospital. “Her expertise and dedication to children with developmental and behavioral issues make her a natural choice to lead the Society of Developmental and Behavioral Pediatrics.”

High, of Providence, has been a member of the SDBP since 1988 and has served in various SDBP roles including member of the executive council; book review editor of the Journal of Developmental and Behavioral Pediatrics; delegate to the American Board of Pediatrics for maintenance of certification in pediatric subspecialties; chair of the Autism Special Interest Group; and liaison to the American Academy of Pediatrics section on developmental and behavioral pediatrics, among others.

“The SDBP is a tremendous resource for clinicians treating children with developmental and behavioral issues,” High said. “The organization strives to provide clinicians with the tools they need to provide the highest level of care for patients and their families. The society promotes an understanding of social, educational, and cultural influences on children. I have been involved with the society for more than two decades and am proud to lead an extraordinary group of professionals who have clearly demonstrated their commitment to their patients and to research of evidence-based practices that improve child outcomes in this field.”

High is a member of the American Academy of Pediatrics (AAP) and serves as chair of its national committee on early childhood, adoption and dependent care;. In Rhode Island, she is on the executive committee of the state chapter of the AAP; is a member of the RI Department of Health Pregnancy Risk Assessment Monitoring System steering committee; the Birth Defects Advisory Council; the RI Department of Health Successful Start developmental screening and services workgroup; Reach Out and Read Rhode Island advisory board and the Rhode Island Kids Count board of directors.

Her clinical and research interests include infant behavioral issues such as colic; sleep problems and feeding problems; literacy promotion as part of well child care; autism and developmental disorders; and the interrelationship of medical and psychological problems in childhood. She sees patients as a member of interdisciplinary teams in the Children’s Neurodevelopment Center and the Partial Hospital Program at Hasbro Children’s Hospital and at the Brown Center for the Study of Children at Risk at Women and Infants’ Hospital.

The SDBP, formed in 1982, is an interdisciplinary professional organization with more than 700 members that promotes the developmental and behavioral health of all infants, children, adolescents and their families by advancing research, education, evidence-based clinical practice and advocacy.

According to experts at Bradley Hospital, it’s common for children to feel anxious about the unknown and they will look to their parents to provide support and comfort. “Children follow their parents’ cues, so if mom or dad seem stressed or are constantly talking about how worried they are, a child will pick up on that. But if parents cope well, their child will also cope better,” says Henry T. Sachs, MD, medical director at Bradley Hospital.

The key to helping children manage their anxiety is to address and acknowledge their fears without causing alarm or panic. “Reassure your child that everyone in the family is fine and that you will all work together to stay healthy. Being calm and confident will do wonders in helping a child feel safe and secure,” says Sachs.

He suggests parents proactively ask their children what they have heard about H1N1, which will indicate whether there are any rumors or misinformation that need to be addressed. Information and knowledge can help children feel a sense of control, so parents should also be prepared to provide some simple, age-appropriate facts about H1N1.

“Younger children will need equal amounts of fact and reassurance, but older kids and teens will likely have more specific questions or may need help separating fact from fiction,” Sachs says. “Although we want to shelter our children, it’s important to be honest and accurate about the situation.”

Sachs points out that these conversations also provide a good opportunity to remind children that good hygiene – particularly frequent hand-washing and covering coughs or sneezes – is the best way to stay healthy and avoid spreading disease, including H1N1.

Other ways parents can help ease their child’s H1N1 anxiety and help them stay healthy include:

• Make sure you are up to the date on the latest information on H1N1, including symptoms, vaccinations and how the disease spreads. The RI Department of Health website, http://www.health.ri.gov/, and www.flu.gov are good resources.
• Allow your children to express their feelings and let them know it is okay to be afraid or upset. Keep in mind that when children are uncertain about situations and feel frightened, they may need even more affection and attention.
• Even if the family’s normal routine is disrupted due to school or work closures, try and keep activities as consistent and normal as possible. Children are most comfortable when they can stick with their routines.
• Encourage healthy behaviors – such as eating well, getting a good night’s sleep, and playing outside – that can help children build a strong immune system.
• Remind your children not to share their food or drinks with others.
• Try to limit your child’s exposure to media coverage about the H1N1 virus.
• If your children are being vaccinated, remind them why this is important and how the vaccine will help keep them safe and healthy.
• Keep your children home when they are sick. They should remain out of school until they are free of fever for 24 hours without the use of a fever-reducing medication.

NOTE: Some information provided by the National Association of School Psychologists and the Centers for Disease Control and Prevention.

Most children with flu have required no medications at discharge. Very young patients, those with underlying medical conditions and those living in homes with family members who are pregnant or have underlying conditions have been prescribed “Tamiflu” in accordance with national guidelines. “Tamiflu” is a prescription medicine that acts on the flu virus to lessen the duration of illness. It should not be confused with the non-prescription brand name medicine “Theraflu” that is available for purchase. In addition, some preparations of Theraflu have high doses of acetaminophen and may be unsuitable for children.

Tamiflu:
• Prescription medication
• Lessens severity and duration of flu symptoms
• Only effective when given within 24-48 hours of the onset of flu symptoms

Theraflu:
PLEASE consult your pediatrician before giving your child Theraflu as many preparations of Theraflu have high doses of acetaminophen and may be unsuitable for children.

• Over-the-counter medication
• May reduce fever or ease body aches and nasal congestion, similar to other over-the-counter products
• Does NOT lessen severity and duration of flu symptoms

“This group was started in memory of Sal Gelsomino, Laura DeAngelis and Anna Mazzulla, who were a husband, father, wife, mother, grandparents and friends to many,” said Mike Mazzulla, committee member. “What better way to honor their memory than to help children fighting cancer? Our hope is that this donation will help the children of the Hasbro Children’s Hospital hematology and oncology program.”

Sponsors for the events included Frank Chiello, Mario’s Showplace; David Levesque, Brewed Awakenings; Len Curreri, Curreri Collision; David & Judi Graham, Graham Builders, Inc. and Brian Crum, Gentry Relocation.

The group will continue to raise funds for Hasbro Children’s Hospital with future events. There will be another golf tournament on May 22, 2010, and the next Campfires for Cancer will be held on June 26, 2010.

Effective today, Monday, September 21, 2009, children younger than 18 and anyone who has influenza-like illness symptoms (fever plus cough or fever plus sore throat) may not visit patients in any of the four hospitals.

“We recognize that it may cause a hardship for patients and their families,” said Mary Reich Cooper, MD, JD, Lifespan senior vice president and chief quality officer, “and we ask for their patience and understanding. We would be remiss if we did not take steps that we believe will help minimize as much as possible the spread of both the seasonal and 2009 H1N1 flu viruses.”

Cooper noted that despite the restrictions, exceptions may be made under special circumstances. Each hospital will determine how those exceptions will be made. “Ultimately,” Cooper said, “we will continue to balance the needs of the patients, and the important role that family and friends play in a patient’s recovery, with our obligation to provide the best possible care to our patients.”

These restrictions may change as the season progresses and more information becomes available.

Aaron’s, Inc. (NYSE: AAN), the nation’s leader in the sales and lease ownership and specialty retailing of residential and office furniture, consumer electronics, home appliances and accessories, has more than 1,630 Company-operated and franchised stores in 48 states and Canada. Founded in 1955 by entrepreneur R. Charles Loudermilk, Sr. and headquartered in Atlanta, Aaron’s has been publicly traded since 1982. Aaron’s is a proud sponsor of David Reutimann’s No. 00 Aaron’s Dream Machine in the NASCAR Sprint Cup Series.

The Children’s Oncology Group’s Hodgkin Lymphoma Committee, led by Schwartz, director of pediatric hematology/oncology at Hasbro Children’s Hospital, recognized that treatment for HL in the United States was not being treated with the most modern treatment models, in large part because it was one of the first malignancies for which a curative chemotherapy regimen was developed.

Schwartz says, “For decades, the chemotherapy regimens known as MOPP and ABVD had been the standard treatment options for these patients. However, while they yielded excellent survival rates, they often resulted in long-term effects from toxicity, including infertility, second malignancy and cardiopulmonary toxicity. With the new treatment paradigm we’ve developed, in essence, we’ve been able to cure the cancer while reducing the risk of long-term effects on our patients.”

The group designed a new chemotherapy treatment known as ABVE-PC, combining six different drugs into one “dose-dense” regimen that could limit the cumulative doses of each drug below the recognized thresholds known for resulting in long-term toxicity. Their goal was to reach a rapid early response (RER) in order to further reduce cumulative therapy and to thereby increase event-free survival (EFS). They also combined the chemotherapy treatment with low dose radiation following the completion of the ABVE-PC cycles.

The treatment developed by the researchers was unique given that its focus was on early response after nine weeks, measuring to detect primary chemosensitivity – a favorable response to chemotherapy, indicating that the therapy is working. This approach differs from the traditional evaluation of the response at the end of chemotherapy. Schwartz notes that this is important, because, “This early detection allows for a reduction in therapy for those who respond well to the dose-dense treatment, and therefore, individual response can be tailored for maximum efficacy.”

Schwartz, who is also a professor of pediatrics at The Warren Alpert Medical School of Brown University, believes that the study represents a new treatment model for patients with HL. She states, “Our treatment paradigm for advanced HL relied on two treatment principles: dose density enhances therapeutic efficacy and rapid early response is evidence of chemosensitivity and can serve as a basis for reduction of therapy.”

The researchers conducted a trial of 216 eligible patients under 22 years of age, with intermediate or high risk HL; there were 76 females and 140 males. The median time from initial treatment to completion of the third cycle was approximately 8.7 weeks, and completion of the fifth cycle was approximately 16 weeks. While the dose densities of the chemotherapy agents exceeded those of the most commonly used regimens, cumulative doses of the chemotherapy were significantly lower, particularly in those with RER. The study was conducted at Children’s Oncology Group sites between 1997 and 2001.

Schwartz says, “The results of the study indicate that through this new chemotherapy treatment we have been able to effectively deliver dose-dense chemotherapy while reducing the cumulative exposure to our patients.” There are other, more immediate outcomes of the new treatment paradigm that are also of note. Schwartz also adds, “Our patients truly appreciate the rapidity of treatment. Regimens traditionally used for intermediate and advanced disease require six to eight months of chemotherapy, instead of two to three and a half months. A major benefit of this new approach is that children and young adults are able to more quickly return to school and work.”

Of the 216 eligible patients, 209 were able to be evaluated for response. Of those patients, 63 percent (132 patients) showed RER, and only two of the patients showed evidence of progressive disease. RER was achieved in 67 percent of intermediate HL patients and 61 percent of high risk HL patients. The five-year event-free survival for intermediate risk HL patients was 84 percent and 85 percent for high risk HL patients. Few relapses occurred beyond three years after enrollment.

Schwartz concludes, “We have successfully achieved five-year event free survival in 84 percent of the patients and overall survival in 95 percent of our patients with this dose-dense, early-response based treatment algorithm. Only nine weeks of chemotherapy were required in 63 percent of our patients. This study has shown conclusively that the new chemotherapeutic treatment of ABVE-PC simultaneously provides high efficacy and reduces the cumulative doses of chemotherapy and radiation. We believe this represents a significant advance in the treatment of HL.”

Other researchers involved in the study with Schwartz include Louis S. Constine of the University of Rochester Medical Center in Rochester, NY; Doojduen Villaluna of Children’s Oncology Group - Operations Center in Arcadia, CA; Wendy B. London of Children’s Oncology Group – Statistics and Data Center, University of Florida in Gainesville, FL; Robert E. Hutchison of SUNY Upstate Medical University in Syracuse, NY; Richard Sposto of Children’s Hospital Los Angeles in Los Angeles CA; Steven E. Lipshultz of University of Miami Miller School of Medicine in Miami, FL; Charles S. Turner of Wake Forest University School of Medicine in Winston-Salem, NC; Pedro A. deAlarcon of St. Jude Midwest Affiliate in Peoria, IL; and Allen Chauvenet of West Virginia University HSC in Charleston, WV.

“The benefits of a combined health care system are even more compelling today, given the significant change in the economic environment since we first announced our intent to affiliate,” said George A. Vecchione, president and CEO of Lifespan. “In fact, our ability to continue to offer high quality, cost-effective care, provide and enhance good jobs and maintain a stable health system is more important than ever to help Rhode Island’s economy move into recovery and growth.”

More about the affiliation:

• Read the executive summary of the affiliation application (PDF)
• Learn more about its benefits
• Ask a question online

“Rhode Islanders want and deserve high quality care, which will only remain in the state if we are able to compete with hospitals in Boston that have expanded their reach into Rhode Island,” said John J. Hynes, Esq., president and CEO of Care New England. “Our first commitment is to ensure that the affiliation moves forward in a way that improves health care in our state so that patients stay in Rhode Island for care, and that enhances our ability to continue to attract federal research dollars into Rhode Island in an even more competitive environment.”

If approved, an affiliation will also place Lifespan, Care New England, and their member hospitals in a better position to withstand the challenging financial environment and anticipated additional changes with health care reform. A stronger financial footing through greater economies of scale and efficiency will allow member hospitals to focus anew on their missions, including continuing to invest in their communities to improve health status and health care access.

Commenting on the importance of the affiliation, Edward J. Wing, MD, dean of The Warren Alpert Medical School of Brown University, said, “Lifespan and Care New England hospitals are important partners with Brown in fulfilling our academic and research missions. The coming together of these two systems will go a long way to enhance research activities and develop academic programs in our state.”

The Federal Trade Commission (FTC) has twice successfully cleared the federal regulatory requirements regarding the Lifespan and Care New England affiliation. The FTC’s authority is to look at whether mergers violate federal anti-trust standards. If the FTC believes that a merger may substantially lessen competition in a given marketplace, it can block the merger while it pursues a deeper investigation. In 2007 and in 2008, the parties filed for pre-merger clearance, and each time the affiliation was cleared following an intensive investigation that included analysis of competitive data.

The application to affiliate contains nearly 110,000 pages. The next step in the Hospital Conversions Act application process is for the Attorney General and Department of Health to review the application during the next 30 calendar days to determine if it is complete. If there are questions, Lifespan and Care New England have 30 business days to respond. The two state offices then have 10 business days to determine if the application is complete. If accepted, the Attorney General has up to 30 additional business days to rule on any confidentiality issues. Within 180 days, the state will hold public hearings and make a determination on the affiliation.

“We welcome the opportunity to discuss the benefits of this affiliation with the public and to work with state regulators and elected officials to complete this process,” said Vecchione and Hynes.

About Lifespan
Lifespan, a not-for-profit organization, is Rhode Island’s largest health care system. Formed in 1994, it includes Rhode Island Hospital and its Hasbro Children’s Hospital; The Miriam Hospital; Bradley Hospital and Newport Hospital. Lifespan (www.lifespan.org) is the state’s largest private employer, with more than 11,800 employees, and is affiliated with The Warren Alpert Medical School of Brown University. Lifespan hospitals are among the top recipients in the country of research funding from the National Institutes of Health. The hospitals received nearly $74 million in total research funding in fiscal 2008. All Lifespan-affiliated hospitals are charitable organizations that depend on support from the community to provide programs and services.

About Care New England
Care New England, located in Providence, was founded in 1996 by Butler Hospital, Kent Hospital and Women & Infants Hospital. Care New England is a not-for-profit health care system that offers a continuum of quality care. Our system includes two teaching hospitals affiliated with The Warren Alpert Medical School of Brown University, Butler and Women & Infants; a community hospital, Kent; a visiting nurse and home care/hospice agency, Care New England Home Health; and one Care New England Wellness Center. Care New England has 6,612 employees, 1,573 physicians, 613 licensed beds and 162 infant bassinets (FY08). For more information about Care New England, please visit www.carenewengland.org.

Following a similar model, the AWCR is looking for teens in Rhode Island and across the country between the ages of 14 and 20 who have lost more than 10 pounds and maintained that weight loss for at least one year. Researchers are interested in learning from teens about how they achieved their weight loss success. Participants in the AWCR are asked to complete questionnaires and an interview that may be done either in person at the Weight Control and Diabetes Research Center (WCDRC) at The Miriam Hospital or through mail and telephone contact.

“The major challenge in treating obesity for teens and adults is not only losing weight but keeping it off. There is very little research on effective weight control strategies for teens, and the research that has been done has focused on the actual weight loss itself, not the strategies that help teens successfully maintain that weight loss and avoid regain,” said Rena Wing, PhD, who will serve as one of the primary investigators. She is director of the WCDRC and is a professor of psychiatry and human behavior at Alpert Medical School. Elissa Jelalian, PhD, will co-direct the study. She is a child psychologist with the Bradley Hasbro Children’s Research Center and the WCDRC who has conducted research on weight regulation and behavioral interventions for overweight children and adolescents.

“We’re hoping the Adolescent Weight Control Registry will shed some light on what weight management tools and strategies work for this specific population, who are often dealing with additional stressors such as peer pressure, teasing and low self-esteem,” said Jelalian, who is also an associate professor of psychiatry and human behavior at Alpert Medical School. “This information could ultimately lead to improved and more effective obesity treatment programs for adolescents.”

To learn more about the AWCR, please call (401) 793-8931 or visit: http://www.weightresearch.org/AWCR.html

The certification was created in 2008 by the Commission on Dietitian Registration and the American Dietitians Association. Currently, only 218 registered dietitians in the country have been certified as specialists in oncology nutrition.

This credential provides Pasquazzi and Robinson with a unique knowledge of how cancer and its treatment affects a patient’s nutrition status. They also evaluate a patient’s lifestyle practices, including age-specific requirements and nutrition treatment goals. They then work with the patient to suggest modifications and strategies to optimize quality of life.

“The training and education Karen and Lisa have received to become certified as specialists in oncology nutrition are a great benefit to our cancer patients at Rhode Island Hospital,” said Katherine Pennington, director of food and nutrition services at RIH. “Many patients don’t think about the impact their food choices will have on cancer treatment, but Karen and Lisa provide patients with the knowledge and tools they need to make informed choices that will help improve their quality of life and work in concert with their treatment.”

Pasquazzi, of Cranston, has worked in food and nutrition services at Rhode Island Hospital since 1978, and as a senior dietitian since 1987. She has also provided nutrition counseling to Ocean State Community Resources; Avatar, Inc.; Health Concepts, Ltd.; the Center for Medical Weight Management; and Medical Homes of Rhode Island. She earned her bachelor’s degree in nutrition and dietetics from the University of Rhode Island.

Robinson, of Barrington, has worked at Rhode Island Hospital as a clinical dietitian since 1988. Prior to joining RIH, she served as a dietitian at Christian Hospital Health Technologies, Inc., in St. Louis, MO; Cambridge Hospital, Cambridge, MA; Boston City Hospital, Boston, MA; Harper-Grace Hospitals, Detroit, MI; and Hunt Memorial Hospital in Danvers, MA. She received her bachelor’s degree in nutrition and dietetics from the University of Rhode Island.