• Grand Rounds contact:
    grandrounds@dshs.state.tx.us


    Continuing Education contact:
    ce.service@dshs.state.tx.us

     

Presentations

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Fall 2016 Semester

The Fall 2016 semester of Grand Rounds begins on October 5 and ends on November 30, 2016. All presentations are free and are held on Wednesdays from 11:00 am to 12:30 pm, Central Time, in Austin (K-100 Lecture Hall,located in the lobby of the Bernstein building at 1100 W. 49th Street, see map) or via webinar.

If you have a disability and need accommodations for this event, please contact us one week before the event so we may arrange for accommodations.


Upcoming Presentations

Questions? E-mail grandrounds@dshs.state.tx.us

   

shepherd, suzanne

Suzanne Shepherd
Healthcare Chair and Past President, 
Down Syndrome Association
of Central Texas (DSACT)

Barta, Adam

Adam Barta, MD
Attending Physician, Blackstock Family Health Center and Clinical Assistant Professor,
UT Austin Dell Medical School

GR-10-05-2016 presentation image

Down Syndrome Today: New Information and New Obligations for Clinicians

Presenters: 
Suzanne Shepherd, Healthcare Chair and Past President, Down Syndrome Association of Central Texas (DSACT)
Adam Barta, MD, Attending Physician, Blackstock Family Health Center and Clinical Assistant Professor, UT Austin Dell Medical School

Description:
Research shows that new and expectant parents want -- but often do not receive-- current, accurate information about Down syndrome when they are given a positive diagnosis or test result. This lack of information leaves parents feeling uninformed, isolated and overwhelmed at a critical time. Best practice in this area, as recommended by AAP, ACOG and others, calls for providing current information about Down syndrome to new and expectant parents at the time of diagnosis. This best practice is now law in Texas. The Texas Down Syndrome Information Act requires physicians and genetics counselors to provide to new and expectant parents current, evidence-based information about Down syndrome at the time of diagnosis or positive test result. 

Please join Suzanne Shepherd, JD, Healthcare Chair of the Down Syndrome Association of Central Texas, and Adam Barta, MD, Attending Physician Blackstock Family Health Center and Clinical Assistant Professor, UT Austin Dell Medical School, for a presentation about the DSIA. We will also cover the current range of medical and developmental outcomes of individuals with Down syndrome, status of Down syndrome cognition research, and current published research about prenatal cell-free DNA testing.

Objective:  
To provide healthcare professionals with:

  • Insight into the current range of developmental and medical outcomes of individuals with Down syndrome.
  • Current information about best practices, professional guidelines and new Texas law (Texas Down Syndrome Information Act) related to delivering the diagnosis of     Down syndrome prenatally or postnatally.
  • Current information about resources for parents available through the Down Syndrome Association of Central Texas
  • Awareness of latest Down syndrome cognition research. 
  • Current information on cell-free DNA tests for Trisomy 21.

1.5 continuing education credit/contact hours available for the following: 

  • AMA PRA Category 1 Credits™
  • Continuing Nursing Education
  • Social Workers
  • Certified Health Education Specialists and Master-Certified Health Education Specialists
  • Licensed Professional Counselors
  • Licensed Marriage and Family Therapists
  • Licensed Chemical Dependency Counselors
  • Registered Sanitarians
  • Licensed Psychologists

A certificate of attendance is available for those not seeking the credits/contact hours listed above.

Presentation documents (.pdf):   slides    handouts  

Suggested resources
: To request a full-text copy of any of the articles below, please e-mail library@dshs.state.tx.us .

  1. Bull MJ; Committee on Genetics. Health supervision for children with Down syndrome. Pediatrics. 2011 Aug;128(2):393-406. doi: 10.1542/peds.2011-1605
  2. National Society of Genetic Counselors. Abnormal prenatal cell-free DNA screening results, 2015. Available at http://nsgc.org/page/abnormal-non-invasive-prenatal-testing-results
  3. Skotko BG, Kishnani PS, Capone GT; Down Syndrome Diagnosis Study Group. Prenatal diagnosis of Down syndrome: how best to deliver the news. Am J Med Genet A. 2009 Nov;149A(11):2361-7. doi: 10.1002/ajmg.a.33082
  4. Skotko BG, Capone GT, Kishnani PS; Down Syndrome Diagnosis Study Group. Postnatal diagnosis of Down syndrome: synthesis of the evidence on how best to deliver the news. Pediatrics. 2009 Oct;124(4):e751-8. doi: 10.1542/peds.2009-0480.
  5. Texas Department of State Health Services. Information about Down syndrome for new and expecting parents, 2016.  Available at http://www.dshs.texas.gov/birthdefects/downsyndrome/

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      william, karen

      Karen Williams, MSSW 
      Williams Group

      GR-10-12-2016 presentation image2

      Obesity and Distress: The "Second Brain" Connection

      Presenter:
      Karen Williams, MSSW, Williams Group

      Description: 
      Over the last 30 years, two alarming epidemics have coincided among U.S. children and adolescents: one is the increase in obesity, and the other is the increase in psychological distress, anxiety, and trauma. Childhood obesity has more than tripled in the last three decades, and there has been an equally dramatic increase in childhood distress, anxiety, and trauma, with one-half of our nation's children having their lives touched by violence, crime,and personal and family adversity each year. Research has linked both obesity and unmitigated distress, anxiety and trauma, aka "toxic stress", to a host of common preventable emotional,behavioral, social, and physical health problems. This workshop provides an overview of the latest neuroscience that links distress, anxiety, and trauma to obesity.

      Learning Objectives:

      • Discuss the role of the vagus nerve.
      • Describe at least one reason the gut is called our “second brain”.
      • Identify the links between childhood adversity, distress, and health risks.

      1.5 continuing education credit/contact hours available for the following:

      • AMA PRA Category 1 Credits™
      • Continuing Nursing Education
      • Social Workers 
      • Certified Health Education Specialists and Master-Certified Health Education Specialists
      • Licensed Professional Counselors 
      • Licensed Marriage and Family Therapists 
      • Licensed Chemical Dependency Counselors 
      • Registered Sanitarians
      • Licensed Psychologists

      A certificate of attendance is available for those not seeking the credits/contact hours listed above.

      Presentation documents (.pdf):   slides    handouts    additional questions and answers

      Suggested resources: To request a full-text copy of any of the articles below, please e-mail  library@dshs.state.tx.us .

      1. Gershon M. The Second Brain: A Groundbreaking New Understanding of Nervous Disorders of the Stomach and Intestine. New York: Harper Perennial, 1999. 
      2. Knight R, Buhler B. Follow Your Gut: the Enormous Impact of Tiny Microbes. New York: Simon & Schuster, 2015.
      3. Perlmutter D, Loberg K. Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain-for Life. New York: Little, Brown and Co., 2015

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          maddock, jay

          Jay Maddock, PhD
          Dean and Professor, School of Public Health, 
          Texas A&M University

          GR-10-19-2016 presentation image2

          Obesity: A Public Health Approach

          Presenter: 
          Jay Maddock, PhD, Dean and Professor, School of Public Health, Texas A&M University

          Description: 
          Over the past twenty years, Texas and the United States have witnessed massive increases in the rates of overweight and obesity. While genetic factors are highly linked to obesity, these do not change rapidly over time. Environments, culture and lifestyles play an important role in the development of obesity. This talk will examine factors including community design, increasing portion sizes and the proliferation of electronic devices and their relationship to rising obesity rates. Policy and environmental interventions will be discussed to help change this trajectory to reduce the subsequent increase in diabetes, heart disease and medical care costs.

          Learning Objectives:  

          • Describe the leading contributors to the rise of obesity.
          • Synthesize ways that communities can address the obesity problem.
          • Discuss individual vs. community approaches to addressing obesity.

          1.5 continuing education/contact hours available for the following:

          • AMA PRA Category 1 Credits™
          • Continuing Nursing Education 
          • Social Workers 
          • Certified Health Education Specialists and Master-Certified Health Education Specialists 
          • Registered Sanitarians

          A certificate of attendance is available for those not seeking the credits/contact hours listed above.

          Presentation documents (.pdf):   slides   handouts    additional questions and answers

          Suggested resources: To request a full-text copy of any of the articles below, please e-mail  library@dshs.state.tx.us .

          1. Daniels SR, Hassink SG; Committee on Nutrition. The role of the pediatrician in primary prevention of obesity. Pediatrics. 2015 Jul;136(1):e275-92. 
          2. English L, Lasschuijt M, Keller KL. Mechanisms of the portion size effect. What is known and where do we go from here? Appetite. 2015 May;88:39-49. 
          3. Hoyt LT, Kushi LH, Leung CW, et al.  Neighborhood influences on girls' obesity risk across the transition to adolescence. Pediatrics. 2014 Nov;134(5):942-9. 
          4. LeBlanc AG, Katzmarzyk PT, Barreira TV, et al. Correlates of total sedentary time and screen time in 9-11 year-old children around the world: the international study of childhood obesity, lifestyle and the environment. PLoS One. 2015 Jun 11;10(6):e0129622. 
          5. Livingstone MB, Pourshahidi LK. Portion size and obesity. Adv Nutr. 2014 Nov 14;5(6):829-34. 
          6. Wang Y, Cai L, Wu Y, et al. What childhood obesity prevention programmes work? A systematic review and meta-analysis. Obes Rev. 2015 Jul;16(7):547-65. 

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            canfield, mark
            Mark Canfield, PhD
            Birth Defects
            Epidemiology
            and Surveillance, DSHS

            langlois, peter
            Peter Langlois, PhD
            Birth Defects 
            Epidemiology
            and Surveillance, DSHS

            GR-10-26-2016 presentation image2

            Recent Findings from Epidemiologic Research on Birth Defects in Texas and Beyond

            Presenters:
            Mark Canfield, PhD and Peter Langlois, PhD

            Birth Defects Epidemiology and Surveillance, DSHS

            Description: 
            This presentation will include a thought provoking discussion of birth defects data such as prevalent types, time trends, racial/ethnic differences, and linkage with health datasets to see if children with birth defects are more likely to get cancer or suffer maltreatment. Mark Canfield, PhD and Peter Langlois, PhD, Birth Defects Epidemiology and Surveillance, DSHS, will also describe the risk factors for birth defects, including some found in the National Birth Defects Prevention Study, of which Texas was a part. This nationally recognized program will also discuss conditions of current public health concern, such as gastroschisis and Zika-related birth defects such as microcephaly.

            Learning Objectives:

            • Summarize Texas birth defects data, including prevalent types, time trends, and racial/ethnic differences.
            • Discuss results from several projects in which the Texas Birth Defects Registry was linked with other datasets within Texas Health and Human Services.
            • Describe birth defects that of current national and global interest (gastroschisis, microcephaly, critical congenital heart defects).
            • Define the risk factors for birth defects, including some found in the National Birth Defects Prevention Study.

            1.5 continuing education credit/contact hours available for the following:

            • AMA PRA Category 1 Credits™ 
            • Continuing Nursing Education 
            • Social Workers
            • Certified Health Education Specialists and Master-Certified Health Education Specialists 
            • Licensed Professional Counselors
            • Licensed Marriage and Family Therapists
            • Registered Sanitarians

            A certificate of attendance is available for those not seeking the credits/contact hours listed above.

            Presentation documents (.pdf):  slides   handouts   additional questions and answers

            Suggested resources: To request a full-text copy of any of the articles below, please e-mail library@dshs.state.tx.us.

            1. Dolk H. Preventing birth defects: The value of the NBDPS case-control approach. Birth Defects Res A Clin Mol Teratol. 2015 Aug;103(8):670-9.
            2. Hoyt AT, Canfield MA, Romitti PA,et al. Associations between maternal periconceptional exposure to secondhand tobacco smoke and major birth defects. Am J Obstet Gynecol. 2016 Jul 18. pii: S0002-9378(16)30456-2. doi: 10.1016/j.ajog.2016.07.022. [Epub ahead of print]
            3. Langlois PH, Scheuerle AE. Descriptive epidemiology of birth defects thought to arise by new mutation. Birth Defects Res A Clin Mol Teratol. 2015 Nov;103(11):913-27.
            4. Lee LJ, Symanski E, Lupo PJ, Hoyt AT, Canfield MA, et al. Data linkage between the national birth defects prevention study and the occupational information network (O*NET) to assess workplace physical activity, sedentary behaviors, and emotional stressors during pregnancy. Am J Ind Med. 2015 Dec 17. doi: 10.1002/ajim.22548. [Epub ahead of print]
            5. Mai CT, Isenburg J, Langlois PH, et al. Population-based birth defects data in the United States, 2008 to 2012: Presentation of state-specific data and descriptive brief on variability of prevalence. Birth Defects Res A Clin Mol Teratol. 2015 Nov;103(11):972-93.
            6. Reefhuis J, Gilboa SM, Anderka M, et al.. The National Birth Defects Prevention Study: A review of the methods. Birth Defects Res A Clin Mol Teratol. 2015 Aug;103(8):656-69.
            7. Van Horne BS, Moffitt KB, Canfield MA, Case AP, Greeley CS, Morgan R, Mitchell LE. Maltreatment of children under age 2 with specific birth defects: a population-based study. Pediatrics. 2015 Dec;136(6):e1504-12.
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            Toy, Eugene
            Eugene C. Toy, MD

            Assistant Dean for Educational Programs, and Professor and Vice Chair of Medical Education, Department of Obstetrics and Gynecology, University of Texas Medical School at Houston

            GR-11-02-2016 presentation image2

            Caring for Our Most Vulnerable: Levels of Neonatal Care

            Presenter:
            Eugene C. Toy, MD, Assistant Dean for Educational Programs, and Professor and Vice Chair of Medical Education, Department of Obstetrics and Gynecology, University of Texas Medical School at Houston

            Description:
            Texas is in the midst of a statewide neonatal designation process for neonatal care. This presentation, hosted by the Healthy Texas Babies initiative, will examine the background, rationale, key points of the history, and resources for application for level designation, including the scientific basis and the evidence that supports state designation of neonatal levels of care. 

            Very low birth weight infants (less than 32 weeks gestation/1500g) have much better outcomes when born in a higher level neonatal facility (level III and IV). In fact, the survival is 60% better as compared to a VLBW infant being born at a lower level facility and transferred. In Texas, less than half of the VLBW infants are born at level III and IV hospitals. A state designation hopes to ensure that hospitals have the personnel, equipment, and processes for the appropriate level of care, and to coordinate with other facilities in its region.

            Learning Objectives:  

            • Discuss the scientific basis and evidence for designated neonatal levels of care.
            • Describe the basis of neonatal levels of care in Texas.
            • Apply the neonatal levels of care requirements to one’s own hospital setting to improve the quality of care.
            • Describe the state designation process in Texas.

            1.5 continuing education credit/contact hours available for the following: 

            • AMA PRA Category 1 Credits™
            • Continuing Nursing Education 
            • Social Workers 
            • Certified Health Education Specialists and Master-Certified Health Education Specialists 
            • Registered Sanitarians 

            A certificate of attendance is available for those not seeking the credits/contact hours listed above.

            Presentation documents (.pdf):  slides   handouts

            Suggested resources: To request a full-text copy of any of the articles below, please e-mail  library@dshs.state.tx.us .

            1. American Academy of Pediatrics, Committee on Fetus and Newborn. Levels of neonatal care. Pediatrics. 2012 Sep;130(3):587-97.
            2. American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. Guidelines for perinatal care. 7th ed. Elk Grove Village, IL: American Academy of Pediatrics and the American College of Obstetricians and Gynecologists; 2012.
            3. Health and Human Services Commission. Perinatal Advisory Council, Report on Determinations and Recommendations. September 2016. Austin, TX : Health and Human Services Commission.
            4. Lasswell SM, Barfield WD, Rochat RW, Blackmon L. Perinatal regionalization for very low-birth-weight and very preterm infants: a meta-analysis. JAMA. 2010 Sep 1;304(9):992-1000.
            5. Neonatal Intensive Care Unit Council. Annual Report. January 2013. Austin, TX : Health and Human Services Commission.
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            hellerstedt web

            John Hellerstedt, MD
            Commissioner,
            Texas Department of State Health Services 

            GR-11-30-2016 presentation image

            Zika: Looking Ahead

            Presenter:
            John Hellerstedt, MD, Commissioner, Texas Department of State Health Services 

            Description: 
            The Texas Department of State Health Services (DSHS), in partnership with local health departments, and the Centers for Disease Control and Prevention (CDC), has launched significant and coordinated efforts to better understand, track, and contain the Zika virus. As of the end of October, Texas had approximately 235 reported cases of Zika. All the cases are associated with travel to areas where Zika is being spread. 

            Please join Dr. John Hellerstedt, Texas DSHS Commissioner, for an in-depth discussion of what the scientific and medical communities are learning about the Zika virus and its health implications. Highlights of the presentation include patterns of transmission, risks, testing and treatment guidelines, prevention strategies, and funding.

            Learning Objectives:

            • Describe and examine the global pattern of transmission of the Zika virus.
            • Discuss the scientific and medical understanding related to Zika virus.

            1.5 continuing education credit/contact hours available for the following:

            • AMA PRA Category 1 Credits™
            • Continuing Nursing Education
            • Social Workers
            • Certified Health Education Specialists and Master-Certified Health Education Specialists
            • Registered Sanitarians

            A certificate of attendance is available for those not seeking the credits/contact hours listed above.

            Presentation documents:  slides   handouts

            Recorded presentation: Please click here if you’re interested in viewing a recorded version of the presentation. Unfortunately, continuing education credits are not available for viewing the recorded version.

            If you have trouble viewing this presentation, please contact us by email.

            Suggested resources: To request a full-text copy of any of the articles below, please e-mail  library@dshs.state.tx.us .

            1. Faria NR, Azevedo Rdo S, Kraemer MU, et al. Zika virus in the Americas: early epidemiological and genetic findings. Science. 2016 Apr 15;352(6283):345-9. 
            2. Goddard J. Essential facts about mosquito control and Zika virus. Am J Med. 2016 Aug 20. pii: S0002-9343(16)30798-7. doi: 10.1016/j.amjmed.2016.07.021. [Epub ahead of print]
            3. Melo AS, Aguiar RS, Amorim MM, et al. Congenital Zika virus infection: beyond neonatal microcephaly. JAMA Neurol. 2016 Oct 3. doi: 10.1001/jamaneurol.2016.3720.
            4. Petersen EE, Polen KN, Meaney-Delman D, et al. Update: Interim guidance for health care providers caring for women of reproductive age with possible Zika virus exposure--United States, 2016. MMWR Morb Mortal Wkly Rep. 2016 Apr 1;65(12):315-22. 
            5. Pierson TC, Graham BS. Zika virus: immunity and vaccine development. Cell. 2016 Sep 28. pii: S0092-8674(16)31253-3. doi: 10.1016/j.cell.2016.09.020. 
            6. Russell K, Oliver SE, Lewis L, et al.. Update: Interim guidance for the evaluation and management of infants with possible congenital Zika virus infection - United States, August 2016. MMWR Morb Mortal Wkly Rep. 2016 Aug 26;65(33):870-878. 
            7. Walker WL, Lindsey NP, Lehman JA, et al.  Zika virus disease cases - 50 states and the District of Columbia, January 1-July 31, 2016. MMWR Morb Mortal Wkly Rep. 2016 Sep 16;65(36):983-6.

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            Last updated December 6, 2016