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Boston Children's Hospital

Boston Children's Hospital is the main pediatric training and research hospital of Harvard Medical School, Harvard University. It is a nationally ranked, freestanding acute care children's hospital located at the centre of Harvard Longwood Medical and Academic Area in Boston, Massachusetts. The hospital is home to the world's largest pediatric research enterprise, and it is the leading recipient of pediatric research funding from the National Institutes of Health (NIH). It provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults aged 0–21 throughout Massachusetts, the United States, and the world. The hospital also sometimes treats adults that require pediatric care. The hospital uses the Brigham and Women's Hospital's rooftop helipad and is an ACS verified level I pediatric trauma center, one of three in Boston. The hospital features a regional pediatric intensive-care unit and an American Academy of Pediatrics verified level IV neonatal intensive care unit.

Overview
One of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age. Its Advanced Fetal Care Center can begin interventions at 15 weeks gestation, and, in some situations (e.g., congenital heart disease and strabismus), Children's also treats adult patients. The institution is home to 40 clinical departments and 258 specialized clinical programs. From 1 October 2017, through 30 September 2018 (fiscal year 2018), the hospital recorded: • 622,000 outpatient visits • 60,000 emergency department visits • 28,000 inpatient and day surgical cases • 5.4-day average length of stay • a 2.13 average case-mix The hospital's clinical staff includes approximately 2,000 active medical and dental staff, 475 residents, fellows, and interns, and over 2,700 nurses. In addition to clinical personnel, Boston Children's has the largest pediatric research enterprise with 3,000 researchers and scientific staff and more NIH funding than any other children's hospital. A trained team of more than 460 volunteers devote thousands of hours each year to support the hospital staff and patients. , the hospital reported more than 750 affiliated physicians across Massachusetts, Connecticut, New Hampshire, New Jersey, and New York, 8 satellite and physician offices, 7 community hospitals and 1 community health center. Kevin B. Churchwell serves as the hospital's current CEO. , the Boston Children's Hospital's Global Services team serves over 2,500 patients from more than 160 countries. Services provided including coordination of visits, medical records, travel, accommodation, and immigration. The hospital offers a global medical second opinion program in partnership with Grand Rounds, Inc. There are more than 3000 Harvard faculty affiliated with Boston Children’s Hospital. Boston Children's was the first stand-alone pediatric hospital in New England to be awarded Magnet status by the American Nurses Credentialing Center. Boston Children's Hospital is home to the United States' first pediatric and adolescent transgender health program. ==History==
History
Children's was founded on 20 July 1869, by Francis Henry Brown, a Civil War surgeon, who traveled to Europe in 1867 to study the pioneering specialized approach to treating children. Brown was impressed with the treatments he witnessed and he wanted to bring that level of care to Boston. Brown opened a 20-bed facility in a small townhouse at 9 Rutland Street in Boston's South End. Approximately one year after opening, the hospital was moved to the corner of Rutland and Washington Streets. Children's Hospital stayed at this location until 1871 when the hospital moved to Huntington Avenue before its final move to what would become the Harvard Longwood Medical and Academic Area. In 1891 Thomas Morgan Rotch, Children's chief physician, established the nation's first laboratory for the modification and production of bacteria-free milk. Before the establishment of this laboratory, breast milk was often the carrier of many deadly diseases that children were especially susceptible to. 1900s Harvard Medical School affiliated itself with Boston Children's in 1903. , (1914) Boston Children's Hospital moved to an area of more than 130,000 square feet on Longwood Avenue in 1914, where the Ebenezer Francis farm was located. The cost of the area was $120,000. William Ladd, a doctor with Children's, devised procedures for correcting various congenital defects such as intestinal malformations in 1920, launching the specialty of pediatric surgery. Robert E. Gross, a surgeon at Children's and later a professor of child surgery at Harvard Medical School, performed the world's first successful surgical procedure to correct a congenital heart defect with the "ligation of a patent ductus arteriosus" in 1948. He achieved the world's first partial remission of acute leukemia. He went on to co-found the Dana-Farber Cancer Institute in 1950. John Enders, his assistant Thomas Weller, and colleague Frederick Robbins, successfully cultured the polio virus in 1949, making possible the development of the Salk and Sabin vaccines for polio. They won the Nobel Prize for their work in 1954. Enders and his team went on to culture the measles virus. Judah Folkman published "Tumor angiogenesis: Therapeutic implications" in the 1971 November issue of the New England Journal of Medicine. It was the first paper to describe Folkman's theory that tumors recruit new blood vessels to grow. The Boston Brace, a new, lower profile brace for patients with scoliosis was developed by Chief of Orthopedics John E. Hall and orthotist Bill Miller at the Boston Children's scoliosis clinic in 1972. Endostatin, one of the most potent inhibitors of blood vessel growth, is discovered by Drs. Michael O'Reilly and Judah Folkman in 1997. offering the possibility of cell replacement and gene therapies for patients with neurodegenerative disease, neural injury or paralysis. In 1998, Children's establishes its Advanced Fetal Care Center to provide diagnostic services, genetic and obstetrical counseling, and prenatal or immediate postpartum intervention for fetuses with complex birth defects. The same year, Larry Benowitz , PhD grows nerve cells in the damaged spinal cords of rats, a significant step in the treatment of spinal cord injuries. The next year, Benowitz discovers that inosine is important in controlling axon regeneration in nerve cells. 2000–present In 2002, Scott Pomeroy and Todd Golub use microarray gene expression profiling to identify different types of brain tumors and predict clinical outcome. This allows radiation and chemotherapy to be tailored to kill cancer cells while leaving healthy tissue alone. In 2005, in the best-documented effort to date, Drs. Felix Engel and Mark Keating get adult heart-muscle cells to divide and multiply in mammals, the first step in regenerating heart tissue. Also in 2005, neurosurgeon Benjamin Warf brought a technique back to Boston Children's for shuntlessly treating hydrocephalus, the condition of excess fluid around the brain. The clinic provides "counseling and resources in the years before medical intervention is appropriate, along with psychological support and a stepwise approach to medical treatment." In 2016, the hospital receives approval by the Massachusetts Public Health Council for a $1 billion expansion to the Longwood Medical and Academic Area. The hospital plans to build an 11-story building with 71 new beds, renovate part of the current campus, and build a new outpatient clinic in Brookline, Massachusetts. == The Dana-Farber/Boston Children's Cancer and Blood Disorders Center ==
The Dana-Farber/Boston Children's Cancer and Blood Disorders Center
The Dana-Farber/Boston Children's Cancer and Blood Disorders Center is a well-known hospital in Boston, Massachusetts, focused on treating children with cancer and blood disorders. It brings together the resources and expertise of Dana-Farber Cancer Institute and Boston Children's Hospital to offer advanced care and innovative treatments. The center is recognized globally for its research and for developing new therapies to improve outcomes for young patients. It provides a combination of compassionate care and access to the latest medical advances. == Controversies ==
Controversies
Justina Pelletier controversy In 2013, Boston Children's Hospital became part of a dispute concerning the treatment of minor Justina Pelletier, which ultimately involved the Massachusetts Department of Children and Families. In February 2012, Pelletier was taken to the emergency-room at Boston Children's Hospital, a trip prompted by severe stomach pain and difficulty walking, For a variety of symptoms, Pelletier had previously been taken by her parents to see doctors across multiple states, receiving multiple diagnoses. She had most recently been diagnosed with mitochondrial disease while a patient at Tufts Medical Center. The BCH doctors doubted that difficult-to-confirm diagnosis, owing to the lack of abnormal blood markers and the fact that there had been no finding of an accumulation of mitochondria in the cell membranes of skeletal muscles, often called the "hallmark of mitochondrial disorders". Moreover, Peters suspected that Pelletier was a victim of factitious disorder by proxy—a form of medical abuse in which parents subject their children to excessive medical care. The Boston Children's Hospital team crafted a treatment plan, with input from some of Pelletier's doctors at Tufts, to "de-medicalize" the case and provide in-hospital psychological care. Pelletier was held in Boston Children's Hospital's psychiatric ward, Bader 5, from 14 February 2013, until January 2014, when she was transferred to Wayside Youth and Family Support Network, a residential treatment center in Framingham. Reports vary of Pelletier's condition during this stay: Pelletier's father said that Pelletier was "declining" in a way visible "to anyone," while the hospital records reflected Pelletier gaining strength, becoming less reliant on a feeding tube, and having regular bowel movements—something her parents had said was not possible without a tube forcing solution into her intestines to make her colon contract. The case, covered extensively by the media, sparked public protests and a cyberattack campaign on the hospital by Martin Gottesfeld (who was subsequently criminally charged and convicted). In mid 2014, the DCF began allowing Pelletier's parents increasingly expanded visitation rights—including unsupervised day trips, On 17 June 2014, Judge Johnston dismissed the child-protection case against the parents, holding that they had successfully demonstrated a "change in circumstances" and noting that they had been cooperative in Pelletier's treatment; the dismissal resulted in the return of Justina to her family. One of these tweets contained a reposted video in which a Boston Children's Hospital gynecologist discusses a "gender affirming hysterectomy" procedure. The video was removed after the hospital started receiving large amounts of online criticism, despite the physician not suggesting that the procedure is offered to children. On 30 August, the hospital received an anonymous bomb threat by phone which forced the hospital into a temporary lockdown, although it is unknown whether the threat was related to the harassment. On 15 September, the Federal Bureau of Investigation (FBI) announced that Catherine Leavy of Westfield, Massachusetts had been arrested in connection with the first bomb threat. She was charged with one count of making a false bomb threat through telephone and could face up to five years in prison. After the announcement, Libs of TikTok tweeted: "This is great news. Threats of violence should always be taken seriously." The Washington Post, USA Today, NPR, and Politifact rejected the tweets and claims as false. According to the hospital's website and statements, the hospital adheres to medical guidelines developed by the World Professional Association for Transgender Health and gender-affirming care involving genital surgeries are only offered to patients between the ages of 18 and 35 while surgical consultations can be offered beginning at the age of 17. The hospital said in another statement that "We condemn these attacks in the strongest possible terms, and we reject the false narrative upon which they are based". In November 2022, a third bomb threat was called in, with the caller claiming the explosives were placed in the section of the hospital responsible for gender affirming care. A subsequence police sweep yielded no explosive devices. Reactions NBC News has described Libs of TikTok as "one of the primary drivers of the harassment campaign" against Boston Children's Hospital. FBI Boston Special Agent in Charge Joseph Bonavolonta said that "Making threats of violence is not a prank — It's a federal crime.", adding that "These threats with innocent people at risk divert law enforcement from responding to actual emergencies are costly to taxpayers, and cause undue stress to victims and the community." Boston Mayor Michelle Wu condemned the threats being made against the hospital. Harvard Law School clinical instructor and transgender rights activist Alejandra Caraballo said that "It's very disturbing to see people justify attacking a children's hospital because of their transphobia and their hatred of trans people". == Adult programs ==
Adult programs
In addition to their pediatric specialties, Boston Children's Hospital serves adults through a couple of their nationally recognized programs. BCH completes adult research in addition to their pediatric research. • BCH has one of the largest adult congenital heart disease (ACHD) programs in the U.S., providing congenital cardiac care to every age. • Boston Children's Hospital also houses an adult strabismus service that offers comprehensive evaluation and treatment for adults. • BCH also houses an adult cystic fibrosis program in collaboration with nearby Brigham & Women's Hospital. • BCH houses the maternal fetal care center in collaboration with Brigham & Women's Hospital, providing care for mothers carrying babies with congenital anomalies. ==Research==
Research
The Boston Children's Hospital's research facility consists of more than of laboratory space including 58,000 square-feet of clinical research space, the hospital's research staff included over 3,000 researchers and scientific staff. Boston Children's researchers have been honored as members of the National Academy of Sciences, Institute of Medicine, American Academy of Arts and Sciences, and Howard Hughes Medical Institute. Laboratory facilities ; John F. Enders Pediatric Research Laboratories : Named in honor of John Franklin Enders, the Boston Children's Hospital researcher and Nobel laureate who cultured poliovirus and the measles virus. ; Karp Family Research Laboratories : This building opened in 2003 and increased the hospital's research space by over 60%. The Precision Vaccines Program of Boston Children's Hospital is located on the 13th floor of the 201 Brookline Ave in the Alexandria Center for Life Science-Fenway mega campus. Informatics program The Computational Health Informatics Program (CHIP) at Boston Children's Hospital was founded in 1994. The program's research includes several free and open-source software projects. Stem cell program Children's Stem Cell Program investigator George Q. Daley, M.D., Ph.D., has made dozens of iPS lines developed at Boston Children's Hospital available for use by other scientists through the Harvard Stem Cell Institute, an institution affiliated with Boston Children's Hospital. In 2010, a drug that boosts numbers of blood stem cells, originally discovered in zebrafish in the Boston Children's Hospital laboratory of Leonard I. Zon, M.D., went to clinical trial in patients with leukemia and lymphoma. Center on Media and Child Health The Center on Media and Child Health (CMCH) is a non-profit organization based at Boston Children's Hospital. CMCH was founded in 2002, by pediatrician Michael Rich, Associate Professor of Pediatrics at Harvard Medical School; and Associate Professor of Society, Human Development, and Health at Harvard T.H. Chan School of Public Health. CMCH conducts scientific research to improve the understanding of media influence and provide evidence-based expertise to initiatives and programs that address children's involvement with media. CMCH researchers investigate correlations between media use and children's physical and mental health outcomes, measuring media exposure in youth. Combining techniques of momentary sampling and video capture, this method is more sensitive to the variety of media used, more responsive to media multitasking, and more accurate in its capture of both media content and usage time. Precision Vaccines Program The Precision Vaccines Program (PVP) is a multi-disciplinary academic program employing cutting edge technologies such as systems biology, human in vitro modelling and adjuvant science to advance discovery and development of vaccines tailored for vulnerable populations. Led by Dr. Ofer Levy, the Precision Vaccines Program focuses on improving vaccine safety and effectiveness of vaccines including those against infectious diseases and fentanyl overdose. == Awards ==
Awards
Nobel Prizes Children's Hospital scientist John Enders and his team were first to successfully culture the polio virus and were awarded the Nobel Prize in Physiology or Medicine in 1954. Joseph Murray, chief plastic surgeon at Children's Hospital Boston from 1972 to 1985 was awarded the Nobel Prize in Physiology or Medicine in 1990 for his research on immunosuppression, specifically his "discoveries concerning organ and cell transplantation in the treatment of human disease". Lasker Awards William Lennox received the Lasker Award in 1951 for his work researching epilepsy. Lennox organized the American Epilepsy League and the Committee for Public Understanding of Epilepsy. Robert Gross received the Lasker Award in 1954 for performing the first operation for patent ductus arteriosus, a congenital heart defect, in 1938. He received an additional Lasker in 1959 for being the first surgeon to graft artery tissue from one person to another in 1958. John Enders was awarded the Lasker in 1954; the same year he was awarded the Nobel Prize for "achievement in the cultivation of the viruses poliomyelitis, mumps, and measles". Sidney Farber received the Lasker in 1966 for his 1947 discovery that a combination of aminopterin and methotrexate, both folic acid antagonists, could produce remission in patients with acute leukemia, and for "his constant leadership in the search for chemical agents against cancer". Porter W. Anderson, Jr. received the Albert Lasker Clinical Medical Research Award with David H. Smith in 1996 for groundbreaking work in the development and commercialization of the Hemophilus influenza type B vaccine. U.S. News & World Report In 2016, it was ranked as the best children's hospital in America by U.S. News & World Report and was ranked #1 in cancer, #1 in cardiology, #2 in endocrinology, #1 in gastroenterology and GI surgery, #1 in neonatology, #1 in nephrology, #1 in neurology and neurosurgery, #1 in orthopedics, #2 in pulmonology, and #1 in urology. In 2021 the hospital was ranked #1 best children's hospital in the United States by U.S. News & World Report on the publications' honor roll list. As of 2021 Boston Children's has placed nationally in all 10 ranked pediatric specialties on U.S. News & World Report. ==References==
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