Monthly Archives: July 2013

Why you should protect your son or daughter against HPV

By Patsy Stinchfield, MS, CPNP

Patsy is a pediatric nurse practitioner and the director of infectious disease/immunology and infection prevention at Children’s Hospitals and Clinics of Minnesota.

The Centers for Disease Control and Prevention released a new report indicating that only about half of adolescent girls – and far fewer boys – received the first dose of the recommended HPV vaccine and only about a third  have completed the three-dose series.

As a parent and a practicing clinician, the fact that many of our children are missing an opportunity to get protected against HPV, short for the human papillomavirus (a common sexually transmitted disease) and related cancers concerns me. Since the introduction of the HPV vaccine, the number of HPV cases which leads to cervical cancer cases has been cut in half. In half. That’s monumental. We know this vaccine works, and we need to use it to the fullest extent possible.

The vaccine is safe, as well.  In the more than 56 million doses given thus far, no serious safety events have occurred.  The most commonly reported event is fainting, which happens with other vaccines given to teens, as well, leading to our usual practice of having teens sit for 15 minutes after vaccination.

HPV infects about 79 million Americans, 14 million of whom become infected each year. About 21,000 women are affected by cancer linked with HPV, and cervical cancer is the most common. More than 4,000 women, usually in child –bearing years, die of cervical cancer. It’s also associated with other cancers, such as those that affect the throat, tongue and tonsils, in men.  But, the infection that causes these cancers can be prevented with the vaccine series. What parent wouldn’t want his or her child to be protected against cancer?

The HPV vaccines are given as a series of three shots over six months to protect against HPV infection and the health problems the infection can cause, according to the CDC. Two (Cervarix and Gardasil) protect against cervical cancers in women. One (Gardasil) also protects against genital warts and cancers of the anus, vagina and vulva. Both vaccines are available for girls. Only Gardasil is available for boys.

I recommend to families that children – both boys and girls – get the vaccine well before they’re sexually active to offer the best protection. Typically, we suggest 11 or 12.  And, the full series – all three shots – need to be taken in order to be truly effective.

According to a recent blog post from CNN about the study:

“We don’t wait for exposure to occur before we vaccinate with any other routinely recommended vaccine,” CDC Director Dr. Thomas Frieden has said in the past.

I sometimes hear from parents that they’re worried their son or daughter will be encouraged to have sexual relations because they’ve been vaccinated. While I understand their concern, there is no link between getting vaccinated and increased sexual activity.

Unfortunately, I’ve seen first-hand the devastation that vaccine-preventable diseases cause in children who haven’t been immunized. Let’s work together to take HPV-associated cancers off that list. It’s the right thing to do.

Five Question Friday: Michael Scribner-O’Pray

Meet Michael Scribner-O’Pray, an RN in the Emergency Department at Children’s Hospitals and Clinics of Minnesota.

Michael Scribner O'Pray and his daughter, Grace

How long have you worked at Children’s? I started working at Children’s as an Emergency Medical Technician in the Emergency Department in 1998 while I was going to nursing school.  After graduating in 2000, I worked as a nurse on the float team for a year before coming back home to the Emergency Department in 2001.

What drew you to pediatrics? When our daughter, Grace, was admitted to Children’s as a toddler, I experienced, first-hand, what a difference great nursing care can make for a family. We were frightened by how sick our daughter had become and struggled to make sense of the storm of new information and emotions swirling around us in the Emergency Department.

Thankfully, the care providers we encountered (most memorably, Marie Koldberg, RN) were calm, confident and remarkably skilled.  They not only engaged our daughter directly, as the patient, they treated us, her parents, as the principal members of Grace’s health care team. During our four-day stay at Children’s, I realized that great nursing requires its practitioners to engage their entire selves – emotionally, intellectually, physically and spiritually.

What do you enjoy most about working in the Emergency Department? What could be better than getting paid to meet remarkable families every day and help alleviate suffering?

We have opportunities every day to build bridges with people from vastly different life experiences from our own. What a joy it is to see the look of surprise on people’s faces when they are greeted and asked genuinely about how they are feeling in their family’s own language! (Collectively, our staff can do this in at least 15 different languages: Amharic, Arabic, Cantonese, French, Haitian Creole, Hebrew, Italian, Mandarin, Ojibwe, Oromo, Polish, Russian, Somali, Spanish and Vietnamese)

Kids and their parents often arrive in the Emergency Department hurt and scared, and we get to play a role in helping them find relief. Sometimes our interventions are as simple as offering a kind word or warm blanket, and sometimes what we do is as complex and carefully rehearsed as a major theater production.  Although we encounter plenty to go home and cry about, more often than not, we also get to witness the transformation of pain and fear into relief and joy, of suspicion and anger into trust and understanding, of grief and powerlessness into hope and constructive action.

Do you have a favorite memory from working at Children’s? For more than a decade now, Mindy Teele, a a child life specialist in the department, has been encouraging us to find creative ways to make frightening procedures like laceration repairs and IV starts more child-friendly.

Many of my favorite memories are of times that we’ve succeeded in surpassing everyone’s expectations:  the 2-year-old with a 3-inch gash in her forehead who sat happily in her mother’s lap playing playdough and coloring with her dad while we put 30 stitches in her forehead…. the 1-year-old whose mother sang her to sleep in her arms while we closed a cut right next to her eye….  the 4-year-old boy who “never sits still” who sat up by himself in bed playing with water toys while we stitched up the back of his head…. all the times each week that kids (and parents) have left our Emergency Department feeling stronger, happier and more capable than they did when they arrived — these are my favorite memories.

How do you spend your time outside of work? My schedule working weekends in the Emergency Department allows me to do some extra things during the week including driving our teenagers around town, helping to provide in-home care for my mother-in-law who has Alzheimers, and volunteering one day each week as a farm hand on a small family dairy farm near Red Wing, Minn.

I also enjoy growing food, building and fixing things, canoeing, and learning primitive skills such as basketry and weaving, birchbark canoe building, hide tanning, bow building, and foraging for wild edibles.

Recipe: Andrew Zimmern’s grilled beef salad

This is my version of a Thai-style grilled beef salad, a staple on most Thai restaurant menus in this country. With a ton of fragrant herbs, lime juice, lemongrass and chiles, the grilled beef doesn’t overwhelm the fresh ingredients, making it a perfect salad for the summer. It’s an easy, flavorful and healthy weeknight meal that the whole family will love. — Andrew Zimmern

Photo by Madeleine Hill

Ingredients

  • One 1 1/2-pound sirloin steak
  • 1 stalk of lemongrass, tender inner bulb only, thinly sliced
  • 1 shallot, thinly sliced
  • 1/2 cucumber, thinly sliced seeded and skinned
  • 1 julienned tomato, seeded and trimmed
  • 1/3 cup mint leaves
  • 1/3 cup cilantro leaves
  • 10 basil leaves, sliced in thin ribbons
  • 1 serrano chile, minced
  • 1 minced garlic clove
  • 2 tablespoons brown sugar
  • 2 tablespoons fish sauce
  • 2 tablespoons lime juice
  • 1/2 teaspoon ground white pepper
  • 1 tablespoon toasted rice powder
  • 4 romaine lettuce leaves

Instructions

Total Time: 45 min

Servings: 4

Light a grill or preheat a grill pan. Season the steak with salt and pepper. Grill over high heat until medium-rare, about 5 minutes per side. Let rest for 30 minutes.

Meanwhile, in a small bowl, whisk the fish sauce with the lime juice, sugar, lemongrass, chile, garlic and white pepper. In a separate bowl, combine the tomato with the shallot, cucumber, mint, cilantro, basil and roasted rice powder.

Slice the steak against the grain, about ¼-inch thick. Add the steak to the vegetables and herbs along with the dressing and toss. Spoon the salad into the lettuce leaves and serve.

NOTES:Roasted rice powder, known as khao kua pon in Thailand, is available at Asian markets, but you can also make it at home. In a skillet, toast raw white sticky (glutinous) rice over moderately low heat, stirring occasionally, until lightly browned, about 10 minutes. Transfer to a mortar or spice grinder and let cool completely, then grind the rice to a powder. The rice powder can be stored in an airtight container for up to three months.

 

Five Question Friday: Jessica Taylor

Meet Jessica Taylor, a pharmacist in our intensive care units.

Jessica Taylor

Why did you become a pharmacist? Unfortunately, there is not a “magical” answer for that question.  When I began thinking about what I wanted to do in the future, I knew that I enjoyed and did well in math and science and I also enjoyed helping people.  At that time, our neighbor’s daughter was a pharmacist and my mother suggested I look into that profession, but to be honest, I never stepped foot into a pharmacy until I was in college. I applied to a program out of high school for undergraduate and pharmacy school work, and the rest is history.  Fortunately for me, the more I began to learn about what a pharmacist does and the opportunities there were in the profession, the more I realized that I had indeed made the right decision to pursue this career.  A chance decision which worked out for the better, pharmacy fits well with how my brain works.

What drew you to pediatrics? Like most people who go in to pediatrics, I have always loved children.  Nearly all of my jobs have involved caring for children.  At first I was nanny in the summer for three wonderful boys. From going on hikes, to catching frogs to taking them to t-ball, we were always having adventures.  I then become a Girl Scout camp counselor where I was a lifeguard, counselor and ropes-course facilitator who taught young girls to sail, canoe, wind-surf, overcome their fears on the high-ropes course and teach them about having fun in the outdoors. I love the curiosity, playfulness, goofiness, honesty and hope that shine through in each individual child’s personality and combing my passion for children, with my career choice seemed like the perfect combination!

What do you enjoy most about your job? I love how resilient children are. I work primarily as a decentralized pharmacist in the intensive care units on the Minneapolis campus and in those units, I get to be a part of the team that cares for these incredibly sick children.  I enjoy working with the team to optimize their care, especially as it relates to medications.  But more than that, it constantly amazes me how quickly these children heal after heart surgery or some major illness, and I am honored daily that I get to play a small part in their care.

If you could travel anywhere in the world, where would it be and why? Traveling is one thing that I take pleasure in and wish I could do more of!  If I could travel anywhere in the world, I would travel to India.  I enjoy learning about and experiencing different cultures (especially the food!) and would love to visit Taj Mahal, Varanasi, Udaipur and many other places.

When you’re not at work, how do you spend your time? I spend a lot of time either in Des Moines, Iowa, visiting familiar faces or at home in the Twin Cities.  Usually you can find me listening to music concerts in the parks during the summer, visiting a farmer’s market, trying a new restaurant, or catching a Twins or Wild game.

Nine health applications for parents

We at Children’s Hospitals and Clinics of Minnesota have launched our first official iOS application to better serve our community. The app is a guide to help make the experience for our families the best, and it includes hospital maps, news and events, and the ability to find Children’s clinical staff and locations. Learn more about the app here.

As we launch our app, we also want to suggest other health apps. Here are eight you might find helpful.

iTriage application: The iTriage application not only allows you to check out what the symptoms you’re suffering from might mean, but locates nearby clinics and doctors. You can even save information about Children’s Hospitals and Clinics of Minnesota clinics, and get turn-by-turn directions on how to get here if needed. The app also allows you to save appointment details and history within the app for easy reference later on.

Instant Heart Rate: The Instant Heart Rate app uses the camera on your smartphone to measure the pulse from your finger. Simply place the tip of your index finger on the phone’s camera, and in a couple of seconds your pulse will be displayed. The app even features a real-time pulse chart to show you every heartbeat.

Ibitz: One way to keep your child healthy is simply to encourage a healthier lifestyle. Ibitz is a combination of an app and fitness tracker that not only keeps track of how active your child is, but allows them to earn points to play their favorite video games or watch TV. You as the parent decide how many points are needed and what the rewards are, encouraging your child to be more active during the day.

My Kid’s Health: My Kid’s Health is an iPad app to help parents with their children’s medical information. The app allows to track vaccination records, growth charts, appointment cards and medical records right on their iPad.

iHealthTrax: iHealthTrax is an app that lets you keep track of who’s been sick, what the symptoms are, and how long it’s lasted. The app features a calendar that lets you mark illnesses, medication, and symptoms. The app allows for multiple calendars, so you can track each family member on their own calendar and keep the details in order. This can be especially helpful for organizing your information when going to the pediatrician’s office.

WebMD: The WebMD app is a companion application to the popular website. The app allows you to research conditions and symptoms and access medication and treatment information. The app also provides advice and first aid tips.

WebMD Baby: The WebMD Baby app is a baby-specific app that comes packed with information for new parents, featuring 400 articles, 600 tips and 70 videos. The app offers parents guidance on what to expect from their baby’s physical and emotional development and has access to health-related counsel when issues come up.

CaringBridge: CaringBridge for iPhone and iPad makes it easy to stay connected to your family and friends while you’re out and about. The CaringBridge app syncs up with the CaringBridge service, which offers free personalized websites to people facing serious medical conditions or hospitalization to allow their friends and family to follow along, stay up-to-date on any developments, and offer words of encouragement.

 

Four simple steps to prevent food poisoning

Summer means picnics, buffets, barbecues and outdoor parties – and an increased risk of food poisoning. Getting sick from improperly prepared or stored food is more common and more serious than you might realize. In the United States, food poisoning sends more than 100,000 people to the hospital each year, and it can have long-term health consequences. Common symptoms include abdominal cramps, nausea, fever, joint/back aches and fatigue.

It is important to make sure that food served at picnics, buffets, barbeques and parties is safe. Four simple steps can help to protect you and your family and friends from food poisoning:

Clean it:

  • Wash hands with soap and water before preparing or eating food.
  • Wash kitchen surfaces, cutting boards and utensils with soap and hot water.
  • Wash all raw fruits and vegetables.

Separate it:

  • Don’t allow juices from meat, seafood, poultry or eggs to drip on other foods.
  • Use a separate cutting board and knife for raw meats, seafood and poultry.
  • Use different dishes for raw foods and cooked foods.
  • To avoid cross-contamination, don’t add more food to a dish or platter that already has food on it.
  • Always serve food on clean dishes.

Cook it:

  • Cook foods at a high enough temperature to kill bacteria. Use a food thermometer to be sure.
  • Cook meat and poultry until the juices run clear.
  • Don’t eat raw eggs or food items made with raw eggs, such as homemade mayonnaise, cookie dough, etc.

Chill it:

  • Keep cold foods cold and hot foods hot. Cold foods should be kept at 40° F or colder and hot foods should be kept at 140° or hotter. Use ice, ice packs, and coolers or chafing dishes, slow cookers and warming trays to keep foods at the correct temperature.
  • Refrigerate perishable foods quickly.
  • Don’t leave foods and leftovers at room temperature longer than two hours.

Additional resources:

U.S. Department of Health and Human Services

Minnesota Department of Health Food Safety Center

Recipe: Andrew Zimmern’s mixed berry cobbler

For this cobbler, I pair fresh summer berries and tart rhubarb with a buttery, cookie-like topping that the whole family will love. The cobbler is easy to throw together for a weeknight treat, plus it’s a perfect no-fuss dessert for feeding crowds. — Andrew Zimmern

Photo by Madeleine Hill

Ingredients

Fruit Filling

  • 1 quart strawberries, hulled and quartered
  • 2 cups rhubarb, sliced 1/4-inch thick
  • 1 pint blackberries
  • 3 tablespoons cornstarch
  • 1/2 cup sugar
  • 1 teaspoon vanilla extract
  • 1/2 cup flour
  • 1/4 teaspoon baking soda
  • Pinch of salt
  • 1 stick unsalted butter
  • 1/2 cup sugar
  • 1  large egg yolk
  • 1/4 teaspoon vanilla extract

Cobbler Topping

  • 1/2 cup flour
  • 1/4 teaspoon baking soda
  • Pinch of salt
  • 1 stick unsalted butter
  • 1/2 cup sugar
  • 1  large egg yolk
  • 1/4 teaspoon vanilla extract

Instructions

Servings: 6 to 8 portions
Total Time: 1 hr 40 min

Make the filling

In a large bowl, toss the strawberries, blackberries and rhubarb with the sugar, cornstarch, vanilla and salt. Let stand at room temperature for 30 minutes, tossing occasionally.

For the cobbler topping

Preheat oven to 375 degrees.

In a stand mixer, cream together butter and sugar until light and fluffy. Beat in the egg yolk and vanilla.

Combine baking soda, salt and flour in a separate mixing bowl. Add the dry ingredients to the batter, and mix with a spatula.

Place the fruit filling into a 9-inch round baking dish. Evenly distribute tablespoon-sized clumps of cobbler topping across the fruit.

Bake until the topping is deeply browned and the juices bubbling up around it appear thickened, about 45 to 50 minutes.

Let cool for a bit, but serve warm.

 

The silent killer: How a near drowning impacted two families

Cooper Whitfield

No one heard 4-year-old Cooper struggle, splash, or cry for help. That’s because he didn’t.

A year ago last June, Cooper’s mom, Christie Whitfield, took Cooper and his two siblings, Molly and Kendall who were 7 and 1 at the time, to a private neighborhood pool. What began as a joy-filled, sun-soaked afternoon nearly ended in tragedy.

The hot weather drew dozens to the pool. The chairs near the shallow end of the pool were taken, so Whitfield found a seat near the deep end where she could apply sunscreen on Kendall.

Meanwhile, her oldest, Molly, jumped into the pool with a family friend. Whitfield put goggles on her son and told Cooper, who didn’t know how to swim but could touch the 3-foot section of the pool, to wait for her by the stairs of the shallow end until she could join him.

“Buddy, wait for me by the steps,” she said.

Moments later, Whitfield turned around. Cooper was nowhere to be found.

“Where’s Cooper?” she shouted.

That’s when she saw him at the bottom of the pool. Maternal instincts kicking in, she jumped into the water and screamed to others to call 911. She pulled Cooper, blue and unconscious, out of the pool.

The following moments zoomed by in a blur.

“I just kept thinking, ‘Somebody please save my baby,’” she said. “It was an out-of-body experience, but I still kept thinking and believing he was going to be okay and that this wasn’t going to be the end.”

Whitfield was trained and had been certified in CPR. But in those moments, she couldn’t comprehend what to do, she said.

Leah Mickschl and Cooper Whitfield

Leah Mickschl did.

Mickschl, a mom of two and an RN at Midwest Children’s Resource Center, started performing CPR on Cooper. It took three rounds before he regained consciousness, she said.

“I think about it all the time,” Mickschl said.

Surveillance later showed that Cooper had jumped into the water and tried to reach a raft but missed it. He didn’t splash or gasp. Silently, he fell to the bottom of the pool. A pool that was full of adults and children who thought Cooper was just swimming underwater.

Within minutes of the rescue, police and emergency responders arrived. Mickschl stayed behind with Whitfield’s other two children so she could accompany him in an ambulance to Children’s Hospitals and Clinics of Minnesota in Minneapolis, where he was treated in the Emergency Department. While he was still in shock and remained quiet, he was breathing normally.

Cooper remained at Children’s overnight for observation so physicians could make sure there was no brain or lung damage. Today, he’s a healthy, happy 5-year-old who has returned to the water.

In a situation like a near drowning, every second counts. Police told Whitfield had it not been for Mickschl’s quick intervention, Cooper may have suffered brain damage.

“Leah is an absolute hero,” Whitfield said. “I can’t say enough about her and how calmly and quickly she handled the situation.”

Mickschl, who grew up around water, said the event has made her more aware of her surroundings when she is by water and when her two kids, 8 and 10, are in water.

She added that what happened to Whitfield could happen to anyone.

“It was an awful day that has changed my life – I look at everything differently now,” Whitfield said. “I have an appreciation for so much. Life is so precious and can change in the blink of an eye.”

The Whitfield Family

Whitfield and Mickschl share their tips for parents and caregivers:

  • Inches count. While Cooper was able to touch the bottom of the pool in the 3-foot section, he nearly drowned where the depth was only 3-and-a-half feet.
  • Always be aware and always be present. If you have to step away, ask someone to watch your child.
  • Register your child for swimming lessons.
  • Get CPR certified.
  • Always use a lifejacket. Cooper typically wore one at the pool, but it got left behind.
  • Drowning is a leading cause of death in kids ages 1 to 4. Boys are at a higher risk for drowning.
  • Drowning is silent.

Find more water safety tips here.

Read our original story about the rescue and the honor Mickschl received for her efforts.

Join Christie, Leah and our trauma team when they hand out life jackets at local parks on Wednesday, July 10.

Children’s staff plants the seeds of cancer care in Jamaica

This post is by Dr. Joanna Perkins, a member of the Children’s cancer and blood disorders team. She, along with pediatric nurse practitioner Dawn Niess, are in the midst of helping Bustamante Hospital for Children in Kingston, Jamaica, formalize a pediatric cancer care program.

In January 2013, Dawn Niess and I “warmly” welcomed the Chief Medical Officer and Chief Nursing Officer (Dr. Michelle-Ann Richards-Dawson, and Ms. Patricia Ingram-Martin, respectively) from Bustamante Hospital for Children (BHC) in Kingston, Jamaica, to Children’s. Their visit was a welcome one for many reasons, but, not least of all was the sunny and mild weekend they brought with them from Jamaica!

Our discussions that day led to plans for Dawn and me to travel to Kingston to further our collaboration. We are working with a Minnesota non-profit – The Organization for Strategic Development in Jamaica (OSDJ) – a partnership created in response to a request from the Jamaican Ministry of Health to OSDJ, with the goal to improve the care and outcomes for children with cancer in Jamaica. Wayland Richards, president of OSDJ, invited Dawn and me to participate in a fact-finding trip to Kingston, to help us better understand the needs of children undergoing cancer treatment in Jamaica. We were also invited to present on multiple pediatric oncology topics to the pediatricians, pediatric nurses and other healthcare providers caring for kids with cancer in Jamaica.

This initiative follows very important ongoing work of our own pediatric neurosurgeon, Dr. Joseph Petronio, and a team of physical medicine and rehabilitation specialty staff from Gillette Children’s Specialty Healthcare. Their team has been making trips over the past seven years, in a similar collaboration that is working to improve care for Jamaican children with cerebral palsy.

Jamaica is an amazingly beautiful island in the Caribbean; the third largest island in the Greater Antilles. It is made up of 14 parishes, and Kingston is the capital city. Kingston is located at the base of the Blue Mountains, world famous for their sunrises and coffee beans. Over the years, approximately 2.5 million Jamaicans have emigrated to other countries, particularly the United States, Canada, and the United Kingdom. They comprise what is referred to as the Jamaican Diaspora, and many are actively involved in collaborations with Jamaica on issues such as the improvement of health care.

The climate is tropical, with hot and humid weather year-round. This was a welcomed change for Dawn and I, who missed two snowstorms during our April week in Jamaica! There is a well-deserved sense of great pride amongst Jamaicans for their many international achievements, not the least of which is in the sport of track and field, and in the reggae music industry. Although we were not lucky enough to meet Usain Bolt or Shaggy, we were delighted to be given the opportunity to listen to an extremely talented local reggae band “One Drop Routz”, who we hope will be a part of an upcoming reggae festival to be held in Minneapolis later this year, as a fundraising event for BHC.

BHC was established in November 1963 and is the only pediatric specialty hospital on the island. It is named after the late Prime Minister, Sir Alexander Bustamante. BHC serves children from birth to 12 years of age, has 283 inpatient beds, and is staffed by 679 amazing and talented pediatric health care professionals. There are multiple medical and surgical specialists at BHC, but no pediatric hematologists/oncologists, and no specialty trained pediatric oncology nurses. At BHC, general pediatricians and general pediatric nurses provide all of the care for the children going through cancer treatment, as well as treatment for many other types of diseases.

The doctors, nurses and staff at BHC are highly educated and passionate advocates for the children they serve. Working with their staff felt very similar to working with staff here at Children’s. The major differences we saw were in the facilities themselves. The clinics and inpatients units have open windows; with a lack of air conditioning, the tropical breezes help keep the buildings cool. Several of their waiting areas are outdoors. It was amazing to us to see patients and families sitting outside, sometimes for many hours, waiting for their appointments. Despite that, people appeared comfortable and somehow managed to entertain their children during these long waits. Everyone seemed grateful for their care.

Unlike at Children’s, cancer patients at BHC are hospitalized amongst children with other diseases, throughout several inpatient wards. This makes it difficult to concentrate specialists and supportive care services for children with cancer in one area. A central pharmacy provides services for the emergency department, outpatient clinics, and all inpatient units. There is no computer system, so staff run orders and medications back and forth from building to building. The physicians mix and administer chemotherapy on the inpatient wards. This gave me an even greater appreciation for our pharmacy and nursing colleagues at Children’s!

A major limitation we observed was the lack of access to port-a-caths for administering chemotherapy. Although there are several outstanding pediatric surgeons at BHC, due to financial limitations of BHC and the health system in general, access to equipment like port-a-caths is very limited. Most children receive chemotherapy through peripheral IVs, which can lead to very severe skin burns.

Dawn and I led a three-day conference on multiple aspects of caring for children with cancer. We then attended and taught at the annual Advancements in Medicine and Healthcare conference, a three-day conference at the nearby University of the West Indies. We were extremely honored to be invited to meet with the Jamaican Minister of Health, the Honorable Dr. Fenton R. Ferguson. We joined with several other health care professionals, local and international, to continue dialogue and expand ideas on ways to improve the care for Jamaican children with cancer. 

After returning home, we at Children’s were delighted to host the Jamaican Ambassador to the United States, the Honorable Ambassador Stephen Vasciannie. Ambassador Vasciannie met with staff from Children’s, OSDJ, and other Twin Cities hospitals, and is very supportive of our Minnesotan-Jamaican health care collaborative.

Presently, we are planning teleconferences, and future trips to Jamaica, to help formalize a pediatric cancer care program at BHC. I am very optimistic that our new relationships with the wonderful staff at BHC will form a strong basis for ongoing knowledge exchange, and I do believe that together we can make great strides at improving care for children with cancer in Jamaica.

How Children’s is exploring the health impact of bullying

Click to see the full image.

Hardly a day goes by when we don’t hear a story about bullying: from television reports, to pending legislation, to our own children coming home with tear-streaked faces. For most, school is out for the summer and while our attention to this pressing health issue may wane during the next few months, the problem of bullying doesn’t disappear.

Today, we released a report on the health and developmental impacts bullying has on kids in our communities.

We know that kids and parents struggle with how to address this issue. From a developmental perspective, it’s important for children to learn how to resolve conflict independently. The trick for all of us is to understand when a conflict is no longer healthy and to intervene appropriately. We discuss this idea in the paper and offer some developmentally appropriate guidance to parents (see below) to monitor for and address bullying-related activity with their children.

So how do you do that? Here’s adapted guidance from the American Academy of Pediatrics and other experts on how to address conflict resolution and bullying.

Preschoolers (ages 5 and younger)

Parents can help their child handle conflict by teaching them to:

  • Share
  • Use language rather than action to express anger or feelings, and
  • Respond to physical aggression by another child by saying, “That hurts. Don’t do it.” Seek the help of an adult.

Grade school (ages 5-12)

To assess whether a child has been involved in bullying, parents should ask and consider enlisting others to help if the answers reveal that a child is experiencing bullying:

  • Have you been involved in any fights?
  • How do you avoid (or not avoid) getting into fights?
  • Are you afraid of getting hurt or bullied by other children?
  • How would you react if you saw a fight or bulling incident?

If responses to these questions are concerning, consider some of the following as next steps:

  • If the child is reluctant to talk about bullying, it may make sense to get a counselor or pediatrician involved.
  • Once the child talks about what happened and identifies the bully or bullies, contact the relevant teacher and/or administrator to develop an approach that works in the school setting and is comfortable for the bullied child.
  • Explore methods for providing the child skills he/she needs to respond to future situations.

Parents also need to stay on top of these issues as the child gets older. When their child is in second grade, parents should:

  • Assess if their child has a regular group of friends.
  • Ask what happens when friends disagree.
  • Be familiar with those friends, and
  • Observe what happens when your child is with those friends.

By fourth grade, it’s especially important that children develop self-esteem and feel good about themselves. Parents should observe if their child is:

  • Unhappy or withdrawn,
  • Unable to listen or do homework, or
  • Engaging in destructive behavior.

Middle school (ages 12-14)

Kids need to be encouraged to talk, but may be reluctant to be open and honest if parents or pediatricians come on too strong.

What parents can do:

Some questions for older kids might include:

  • How are things going at school?
  • What do you think of the other kids in your classes?
  • Does anyone get picked on?

Effective action

There are a number of actions parents can take once they determine their child is a target of bullying. These actions range from teaching kids social skills and building their self-confidence to knowing when and how to contact the school or law enforcement authorities.

We hope this report will contribute to important ongoing discussions happening in our state on how to best address bullying. If you’d like to learn more about our in-depth review of how bullying impacts the health of Minnesota kids, visit childrensmn.org/bullying.