Anti-racist strategies for clinical and translational research: Design, implementation, and lessons learned from a new course.

Translational research should examine racism and bias and improve health equity. We designed and implemented a course for the Master of Science in Clinical Investigation program of the Northwestern University Clinical and Translational Sciences Institute. We describe curriculum development, content, outcomes, and revisions involving 36 students in 2 years of "Anti-Racist Strategies for Clinical and Translational Science." Ninety-six percent of students reported they would recommend the course. Many reported changes in research approaches based on course content. A course designed to teach anti-racist research design is feasible and has a positive short-term impact on learners.

Utility of a psychosocial assessment during an acute care hospitalization.

Adolescence involves immense physical, cognitive, social and emotional changes, which can lead teenagers to partake in risky behaviors. While experimentation and risk-taking are critical components of an adolescent's development of autonomy, these behaviors are known to contribute to the morbidity, mortality and social concerns of this age group. This observation prompted national organizations like the American Academy of Pediatrics to recommend risk behavior screening on an annual basis. Based on this recommendation and the time constraints of outpatient clinicians, as well as teenagers' underattendance for routine outpatient visits, hospital-based clinicians should implement the no-missed-opportunities paradigm5 when caring for adolescent patients. An acute care hospitalization for a teenager should serve as an additional opportunity to provide preventive care services. Utilization of a psychosocial screening tool can augment a clinician's ability to risk-stratify an adolescent, thus alerting the clinician to provide additional resources, education or interventions during that hospital encounter. The acronyms HEADDSS (Home, Education, Activities, Diet, Drugs, Sexual activity/sexuality and Safety/suicide) and SSHADESS (Strengths, School, Home, Activities, Drugs, Emotions/eating, Sexuality, Safety) can be employed as tools to remember the various elements of an adolescent's psychosocial health. In order to solicit honest, in-depth responses during the assessment, hospital-based pediatricians should strive to establish an environment of mutual trust. Clinicians should ask open-ended questions, remain non-judgmental and should preface any conversation involving sensitive topics with a discussion regarding the patient's right to confidentiality (and the circumstances in which it may be breeched). If risky behaviors are identified during the assessment, then appropriate counseling or intervention should be arranged during the acute care stay, with an outpatient follow-up plan established prior to discharge. By including the provision of preventative services in the inpatient setting, pediatric healthcare providers stand to add an additional layer of support for the adolescent population.

Inpatient management of an acute asthma exacerbation using clinical care pathways.

Asthma exacerbations remain a leading cause of hospitalization in the pediatric population, and many children who require hospitalization for status asthmaticus are managed using clinical care pathways (CPGs). Clinical care pathways are often created or adopted by healthcare systems in order to establish specific, evidence-based guidelines that standardize and coordinate quality care in both the emergency room and inpatient settings. This paper reviews the use of these guidelines and the updated evidence-based recommendations regarding best-practice for acute asthma care of hospitalized children, including the 2020 recommendations from the National Asthma Education and Prevention Program Expert Panel (NAEPP).