Scholars@Duke
David Ashley Turner

David Ashley Turner

Adjunct Professor in the Department of Pediatrics
Pediatrics, Critical Care Medicine
david.turner@duke.edu
Box 3046 Med Ctr, Durham, NC 27710
5268-A Hosp North, Durham, NC 27710

Selected Publications

Is "No News is Good News" Enough? A Thematic Analysis Exploring Clinical Reasoning Assessment in Pediatric Residency Programs.

Journal Article Academic pediatrics · November 2024 ObjectiveClinical reasoning (CR) includes numerous essential skills for clinicians, but how these skills are assessed in pediatric residency training is not well described. This study aimed to explore pediatric residency program leader perspective ... Full text Cite

Competency based medical education - Where do I start?

Journal Article Curr Probl Pediatr Adolesc Health Care · October 2024 Full text Link to item Cite

Advancing anti-oppression and social justice in healthcare through competency-based medical education (CBME).

Journal Article Med Teach · September 2024 Competency-based medical education (CBME) focuses on preparing physicians to improve the health of patients and populations. In the context of ongoing health disparities worldwide, medical educators must implement CBME in ways that advance social justice a ... Full text Link to item Cite

Competency based medical education and trust in the learning environment.

Journal Article Curr Probl Pediatr Adolesc Health Care · September 2024 Full text Link to item Cite

A realist synthesis of prospective entrustment decision making by entrustment or clinical competency committees.

Journal Article Med Educ · July 2024 INTRODUCTION: The real-world mechanisms underlying prospective entrustment decision making (PEDM) by entrustment or clinical competency committees (E/CCCs) are poorly understood. To advance understanding in this area, the authors conducted a realist synthe ... Full text Link to item Cite

The Influence of the Extracorporeal Membrane Oxygenation Circuit and Components on Anticoagulation Management: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.

Journal Article Pediatr Crit Care Med · July 1, 2024 OBJECTIVES: To derive systematic-review informed, modified Delphi consensus regarding the influence of extracorporeal membrane oxygenation (ECMO) circuit components on anticoagulation practices for pediatric ECMO for the Pediatric ECMO Anticoagulation Coll ... Full text Link to item Cite

Analysis of fellowship program director opinions of entrustable professional activities in adolescent medicine fellowship.

Journal Article Int J Adolesc Med Health · June 1, 2024 OBJECTIVES: This study aimed to explore the minimum entrustable professional activity (EPA) supervision levels at which pediatric fellowship program directors (FPDs) would be willing to graduate fellows and the levels deemed necessary for safe and effectiv ... Full text Link to item Cite

Implementing Entrustable Professional Activities in Pediatric Fellowships: Facilitating the Process.

Journal Article Pediatrics · June 1, 2024 BACKGROUND AND OBJECTIVES: Entrustable professional activities (EPAs) will be used for initial certification by the American Board of Pediatrics by 2028. Less than half of pediatric fellowships currently use EPAs for assessment, yet all will need to adopt ... Full text Link to item Cite

The Next Era of Assessment: Building a Trustworthy Assessment System.

Journal Article Perspect Med Educ · 2024 Assessment in medical education has evolved through a sequence of eras each centering on distinct views and values. These eras include measurement (e.g., knowledge exams, objective structured clinical examinations), then judgments (e.g., workplace-based as ... Full text Link to item Cite

Level of Supervision for the Entrustable Professional Activities Common to General Pediatrics and the Subspecialties Decreases from Residency to Fellowship.

Journal Article Acad Pediatr · 2024 OBJECTIVES: To compare level of supervision (LOS) ratings of graduating pediatric residents with their assessments as fellows for the five Entrustable Professional Activities (EPAs) common to general pediatrics and the subspecialties and to determine if th ... Full text Link to item Cite

Foreword: Preparing future pediatricians and pediatric subspecialists: Competency-based medical education – Part 2

Journal Article Current Problems in Pediatric and Adolescent Health Care · January 1, 2024 Full text Cite

A realist evaluation of prospective entrustment decisions in paediatric residency clinical competency committees

Journal Article Medical Education · January 1, 2024 Purpose: Making entrustment decisions (granting more responsibility, advancement and graduation) are important actions in medical training that pose risks to trainees and patients if not done well. A previous realist synthesis of the existing literature re ... Full text Cite

Relationship between epa level of supervision with their associated subcompetency milestone levels in pediatric fellow assessment.

Journal Article BMC Med Educ · October 3, 2023 BACKGROUND: Entrustable Professional Activities (EPA) and competencies represent components of a competency-based education framework. EPAs are assessed based on the level of supervision (LOS) necessary to perform the activity safely and effectively. The b ... Full text Link to item Cite

Early Clinical Variables Associated With Refractory Convulsive Status Epilepticus in Children.

Journal Article Neurology · August 1, 2023 BACKGROUND AND OBJECTIVES: The objective of this study was to determine patient-specific factors known proximate to the presentation to emergency care associated with the development of refractory convulsive status epilepticus (RSE) in children. METHODS: A ... Full text Link to item Cite

Development of an Approach to Assessing Pediatric Fellows' Transport Medical Control Skills.

Journal Article Hosp Pediatr · July 1, 2023 BACKGROUND AND OBJECTIVE: Pediatric interfacility transport teams facilitate access to subspecialty care, and physicians often guide management remotely as transport medical control (TMC). Pediatric subspecialty fellows frequently perform TMC duties, but t ... Full text Link to item Cite

Clinical competency committee perceptions of entrustable professional activities and their value in assessing fellows: A qualitative study of pediatric subspecialty program directors.

Journal Article Med Teach · June 2023 OBJECTIVES: To examine the composition and processes of Clinical Competency Committees (CCCs) assigning entrustable professional activity (EPA) levels of supervision for pediatric subspecialty fellows and to examine fellowship program director (FPD) perspe ... Full text Link to item Cite

Identifying and Addressing Item Bias in the General Pediatrics Certifying Examination.

Journal Article Pediatrics · June 1, 2023 This article describes a 2-phase process implemented by the American Board of Pediatrics in 2021 to investigate and remove potential bias on its General Pediatrics Certifying Examination at the item (question) level based on gender or race and ethnicity. P ... Full text Link to item Cite

Comparative Effectiveness of Dual- Versus Mono-Sedative Therapy on Opioid Administration, Sedative Administration, and Sedation Level in Mechanically Ventilated, Critically Ill Children.

Journal Article J Pediatr Pharmacol Ther · 2023 OBJECTIVE: We estimated the effect of early initiation of dual therapy vs monotherapy on drug administration and related outcomes in mechanically ventilated, critically ill children. METHODS: We used the electronic medical record at a single tertiary medic ... Full text Link to item Cite

Minimum Supervision Levels Required for Pediatric Cardiology Fellowship Graduation by Pediatric Cardiology Fellowship Program Directors

Journal Article Pediatric Cardiology · January 1, 2023 Entrustable professional activities (EPAs) are “observable essential tasks expected to be performed by a physician for safe patient care in practice.” Six Pediatric Cardiology (PC) EPAs and their level of supervision (LOS) scales were developed by medical ... Full text Cite

Benefits and Limitations of Virtual Recruitment: Perspectives From Subspeciality Directors.

Journal Article Pediatrics · October 1, 2022 BACKGROUND AND OBJECTIVES: Because of the coronavirus disease 2019 pandemic and recommendations from a range of leaders and organizations, the pediatrics subspecialty 2020 recruitment season was entirely virtual. Minimal data exist on the effect of this ch ... Full text Link to item Cite

Making prospective entrustment decisions: Knowing limits, seeking help and defaulting.

Journal Article Med Educ · September 2022 INTRODUCTION: Many studies focused on entrustment have not considered prospective entrustment decisions, where clinical competency and entrustment committees determine how much supervision trainees will require in the future for tasks occurring in not comp ... Full text Link to item Cite

Fellow Entrustment for the Common Pediatric Subspecialty Entrustable Professional Activities Across Subspecialties.

Journal Article Acad Pediatr · August 2022 OBJECTIVE: To determine the relationship between level of supervision (LOS) ratings for the Common Pediatric Subspecialty Entrustable Professional Activities (EPAs) with their associated subcompetency milestones across subspecialties and by fellowship trai ... Full text Link to item Cite

Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS).

Journal Article Acad Emerg Med · April 2022 BACKGROUND: Tracheal intubation (TI) practice across pediatric emergency departments (EDs) has not been comprehensively reported. We aim to describe TI practice and outcomes in pediatric EDs in contrast to those in intensive are units (ICUs) and use the da ... Full text Link to item Cite

An Entrustable Professional Activity Addressing Racism and Pediatric Health Inequities.

Journal Article Pediatrics · February 1, 2022 Racism and discrimination are the root of many pediatric health inequities and are well described in the literature. Despite the pervasiveness of pediatric health inequities, we have failed to adequately educate and prepare general pediatricians and pediat ... Full text Link to item Cite

Transport Medical Control Education for Pediatric Critical Care Fellows: A National Needs Assessment Study.

Journal Article Pediatr Crit Care Med · January 1, 2022 OBJECTIVES: Characterize transport medical control education in Pediatric Critical Care Medicine fellowship. DESIGN: Cross-sectional survey study. SETTING: Pediatric Critical Care Medicine fellowship programs in the United States. SUBJECTS: Pediatric Criti ... Full text Link to item Cite

Best Practices in Medical Documentation: A Curricular Module.

Journal Article Acad Pediatr · 2022 OBJECTIVE: To create and validate a checklist for high-quality documentation and pilot a multi-modal, immersive educational module across multiple institutions. We hypothesized that this module would improve knowledge, skills, and attitudes in medical docu ... Full text Link to item Cite

Achieving Entrustable Professional Activities During Fellowship.

Journal Article Pediatrics · November 2021 BACKGROUND AND OBJECTIVES: Entrustable Professional Activities (EPAs) were developed to assess pediatric fellows. We previously showed that fellowship program directors (FPDs) may graduate fellows who still require supervision. How this compares with their ... Full text Link to item Cite

Learner Levels of Supervision Across the Continuum of Pediatrics Training.

Journal Article Acad Med · July 1, 2021 PURPOSE: To describe trajectories in level of supervision ratings for linked entrustable professional activities (EPAs) among pediatric learners in medical school, residency, fellowship. METHOD: The authors performed secondary analyses of 3 linked datasets ... Full text Link to item Cite

Continued Supervision for the Common Pediatric Subspecialty Entrustable Professional Activities May Be Needed Following Fellowship Graduation.

Journal Article Acad Med · July 1, 2021 PURPOSE: Entrustable professional activities (EPAs) are one approach to competency-based medical education (CBME), and 7 EPAs have been developed that address content relevant for all pediatric subspecialties. However, it is not known what level of supervi ... Full text Link to item Cite

Entrustment Unpacked: Aligning Purposes, Stakes, and Processes to Enhance Learner Assessment.

Journal Article Acad Med · July 1, 2021 Educators use entrustment, a common framework in competency-based medical education, in multiple ways, including frontline assessment instruments, learner feedback tools, and group decision making within promotions or competence committees. Within these mu ... Full text Link to item Cite

Distant and Hidden Figures: Foregrounding Patients in the Development, Content, and Implementation of Entrustable Professional Activities.

Journal Article Acad Med · July 1, 2021 Entrustable professional activities (EPAs) describe activities that qualified professionals must be able to perform to deliver safe and effective care to patients. The entrustable aspect of EPAs can be used to assess learners through documentation of entru ... Full text Link to item Cite

Quantified electronic health record (EHR) use by academic surgeons.

Journal Article Surgery · June 2021 BACKGROUND: The electronic health record has improved medical billing, research, and sharing of patient data, but its clinical use by physicians has been linked to rising physician burnout leading to numerous subjective editorials about the electronic heal ... Full text Link to item Cite

Can We Finally Agree: How We Round Really Matters?

Journal Article Pediatr Crit Care Med · April 1, 2021 Full text Link to item Cite

The New Trainee Effect in Tracheal Intubation Procedural Safety Across PICUs in North America: A Report From National Emergency Airway Registry for Children.

Journal Article Pediatr Crit Care Med · December 2020 OBJECTIVES: Tracheal intubation carries a high risk of adverse events. The current literature is unclear regarding the "New Trainee Effect" on tracheal intubation safety in the PICU. We evaluated the effect of the timing of the PICU fellow academic cycle o ... Full text Link to item Cite

Cardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions.

Journal Article BMJ Open Qual · December 2020 Thousands of children experience a cardiac arrest event in the hospital each year, with more than half of these patients not surviving to hospital discharge. Cardiopulmonary resuscitation (CPR) depth, rate, velocity and percentage of high-quality chest com ... Full text Open Access Link to item Cite

First-line medication dosing in pediatric refractory status epilepticus.

Journal Article Neurology · November 10, 2020 OBJECTIVE: To identify factors associated with low benzodiazepine (BZD) dosing in patients with refractory status epilepticus (RSE) and to assess the impact of BZD treatment variability on seizure cessation. METHODS: This was a retrospective study with pro ... Full text Link to item Cite

An Online Curriculum in the PICU-Do You Have Plans Tonight?

Journal Article Pediatr Crit Care Med · November 2020 Full text Link to item Cite

Respiratory Therapist Intubation Practice in Pediatric ICUs: A Multicenter Registry Study.

Journal Article Respir Care · October 2020 BACKGROUND: Tracheal intubation by respiratory therapists (RTs) is a well-established practice that has been described primarily in adult and neonatal patients. However, minimal data exist regarding RTs' intubation performance in pediatric ICUs. The purpos ... Full text Link to item Cite

Impact of Failure of Noninvasive Ventilation on the Safety of Pediatric Tracheal Intubation.

Journal Article Crit Care Med · October 2020 OBJECTIVES: Noninvasive ventilation is widely used to avoid tracheal intubation in critically ill children. The objective of this study was to assess whether noninvasive ventilation failure was associated with severe tracheal intubation-associated events a ... Full text Link to item Cite

Establishing the Knowledge and Skills Necessary in Pediatric Critical Care Medicine: A Systematic Approach to Practice Analysis.

Journal Article Pediatr Crit Care Med · July 2020 OBJECTIVES: To describe the practice analysis undertaken by a task force convened by the American Board of Pediatrics Pediatric Critical Care Medicine Sub-board to create a comprehensive document to guide learning and assessment within Pediatric Critical C ... Full text Link to item Cite

Burnout in Pediatric Critical Care Medicine Fellows.

Journal Article Crit Care Med · June 2020 OBJECTIVES: Assess the overall level of burnout in pediatric critical care medicine fellows and examine factors that may contribute to or protect against its development. DESIGN: Cross-sectional observational study. SETTING: Accreditation Council for Gradu ... Full text Link to item Cite

Ketamine Use for Tracheal Intubation in Critically Ill Children Is Associated With a Lower Occurrence of Adverse Hemodynamic Events.

Journal Article Crit Care Med · June 2020 OBJECTIVES: Tracheal intubation in critically ill children with shock poses a risk of hemodynamic compromise. Ketamine has been considered the drug of choice for induction in these patients, but limited data exist. We investigated whether the administratio ... Full text Link to item Cite

Expanding Faculty Development of Teaching Skills: A National Needs Assessment of Pediatric Critical Care Medicine Faculty.

Journal Article Pediatr Crit Care Med · May 2020 OBJECTIVES: High-quality clinical teaching is an essential element in preparing trainees to become independently competent clinicians. In order to better understand the context-specific faculty development needs of teaching faculty in a specific community, ... Full text Link to item Cite

Doing Virtually Anything to Educate Students.

Journal Article Pediatr Crit Care Med · May 2020 Full text Link to item Cite

Improving Well-Being Among Trainees: A Partnership to Reduce Barriers to Primary Care Services.

Journal Article J Grad Med Educ · April 2020 BACKGROUND: Improved well-being is a focus for graduate medical education (GME) programs. Residents and fellows often express difficulty with visiting primary care physicians, and this issue has not been thoroughly investigated. OBJECTIVE: We reported impl ... Full text Link to item Cite

Online Learning and Residents' Acquisition of Mechanical Ventilation Knowledge: Sequencing Matters.

Journal Article Crit Care Med · January 2020 OBJECTIVE: Rapid advancements in medicine and changing standards in medical education require new, efficient educational strategies. We investigated whether an online intervention could increase residents' knowledge and improve knowledge retention in mecha ... Full text Link to item Cite

Agreement of Program Directors With Clinical Competency Committees for Fellow Entrustment.

Journal Article J Med Educ Curric Dev · 2020 OBJECTIVES: Fellowship program directors (FPD) and Clinical Competency Committees (CCCs) both assess fellow performance. We examined the association of entrustment levels determined by the FPD with those of the CCC for 6 common pediatric subspecialty entru ... Full text Link to item Cite

What's in a Name? Role Clarity Goes Well Beyond a Simple Title.

Journal Article J Patient Exp · December 2019 BACKGROUND: Role clarity is important for patient care but challenging in graduate medical education (GME). METHODS: Badge buddies were integrated for all GME trainees at a single institution, and surveys were conducted prior to and 5 months following impl ... Full text Link to item Cite

Documentation Burden on General Surgery Faculty

Conference JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS · October 1, 2019 Link to item Cite

Assessing Competence in Central Venous Catheter Placement by Pediatric Critical Care Fellows: A National Survey Study.

Journal Article Crit Care Med · August 2019 OBJECTIVES: To describe the current approach to initial training, ongoing skill maintenance, and assessment of competence in central venous catheter placement by pediatric critical care medicine fellows, a subset of trainees in whom this skill is required. ... Full text Link to item Cite

The Current State of Pediatric Acute Respiratory Distress Syndrome.

Journal Article Pediatr Allergy Immunol Pulmonol · June 1, 2019 Pediatric acute respiratory distress syndrome (PARDS) is a significant cause of morbidity and mortality in children. Children with PARDS often require intensive care admission and mechanical ventilation. Unfortunately, beyond lung protective ventilation, t ... Full text Link to item Cite

KETAMINE USE IN TRACHEAL INTUBATION AND ADVERSE HEMODYNAMIC EVENTS

Conference CRITICAL CARE MEDICINE · January 1, 2019 Link to item Cite

Improving Resident and Fellow Engagement in Patient Safety Through a Graduate Medical Education Incentive Program.

Journal Article J Grad Med Educ · December 2018 BACKGROUND: Collaboration between graduate medical education (GME) and health systems is essential for the success of patient safety initiatives. One example is the development of an incentive program aligning trainee performance with health system quality ... Full text Link to item Cite

Competencies, Milestones, and a Level of Supervision Scale for Entrustable Professional Activities for Scholarship.

Journal Article Acad Med · November 2018 PROBLEM: Scholarship is an important element of both undergraduate and graduate medical education, and scholarly activity is required for all pediatric fellows. However, despite the creation of entrustable professional activities (EPAs) for scholarship, th ... Full text Link to item Cite

Documenting or Operating: Where Is Time Spent in General Surgery Residency?

Journal Article J Surg Educ · November 2018 OBJECTIVE: The utilization of electronic health records (EHR) has become essential in the daily activities of physicians for documentation and as an information source. However, the amount of time spent by residents utilizing the EHR has not been thoroughl ... Full text Link to item Cite

Current Use of Invasive and Noninvasive Monitors in Academic Pediatric Intensive Care Units.

Journal Article J Pediatr Intensive Care · September 2018 To describe the current use of noninvasive monitoring compared with traditional invasive monitoring in Pediatric Critical Care Medicine (PCCM) accredited fellowship programs in the United States. A web-based survey with the primary aim of describing the ut ... Full text Link to item Cite

Effect of the Adoption of a Comprehensive Electronic Health Record on Graduate Medical Education: Perceptions of Faculty and Trainees.

Journal Article South Med J · August 2018 OBJECTIVES: Health systems are adopting electronic health records (EHRs). There are few studies on the effects of EHR implementation on graduate medical education. The authors sought to longitudinally assess perceptions of the impact of EHRs on graduate me ... Full text Link to item Cite

Downward Trend in Pediatric Resident Laryngoscopy Participation in PICUs.

Journal Article Pediatr Crit Care Med · May 2018 OBJECTIVES: As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounc ... Full text Link to item Cite

Using an internet intervention to support self-management of low back pain in primary care: findings from a randomised controlled feasibility trial (SupportBack).

Journal Article BMJ Open · March 9, 2018 OBJECTIVE: To determine the feasibility of a randomised controlled trial of an internet intervention for low back pain (LBP) using three arms: (1) usual care, (2) usual care plus an internet intervention or (3) usual care plus an internet intervention with ... Full text Link to item Cite

Trainees’ perception of education in communication and professionalism across two programs in two countries

Journal Article Proceedings of Singapore Healthcare · March 1, 2018 Background: Different health care systems impact on medical education. Objective: We aim to describe the differences and similarities in the perceptions of pediatric residents on education in professionalism and communication skills across two countries. M ... Full text Cite

Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial.

Journal Article Lancet · February 24, 2018 BACKGROUND: Despite effective assessment methods and medications targeting osteoporosis and related fractures, screening for fracture risk is not currently advocated in the UK. We tested whether a community-based screening intervention could reduce fractur ... Full text Link to item Cite

Validity of Level of Supervision Scales for Assessing Pediatric Fellows on the Common Pediatric Subspecialty Entrustable Professional Activities.

Journal Article Acad Med · February 2018 PURPOSE: Entrustable professional activities (EPAs) represent the routine and essential activities that physicians perform in practice. Although some level of supervision scales have been proposed, they have not been validated. In this study, the investiga ... Full text Link to item Cite

Frequency of Desaturation and Association With Hemodynamic Adverse Events During Tracheal Intubations in PICUs.

Journal Article Pediatr Crit Care Med · January 2018 OBJECTIVES: Oxygen desaturation during tracheal intubation is known to be associated with adverse ICU outcomes in critically ill children. We aimed to determine the occurrence and severity of desaturation during tracheal intubations and the association wit ... Full text Link to item Cite

Pediatric Critical Care Medicine Training: 2004–2016*

Journal Article Pediatric Critical Care Medicine · January 2018 Objectives:To describe growth trends in the number of programs, positions, and applicants in pediatric critical care medicine fellowship training as part of the Pediatric Critical Care Me ... Full text Cite

Effects of Methadone on Corrected Q-T Interval Prolongation in Critically Ill Children.

Journal Article J Pediatr Pharmacol Ther · 2018 OBJECTIVES: This study aimed to determine the association between methadone use and corrected Q-T interval (QTc) prolongation in critically ill children. METHODS: A retrospective cohort study of critically ill children receiving methadone at a tertiary car ... Full text Link to item Cite

Protocol for a feasibility randomised controlled trial of Screening and Enhanced Risk management for Vascular Event-related Decline in Memory (SERVED Memory).

Journal Article BMJ Open · November 28, 2017 INTRODUCTION: Stroke is a leading cause of death and disability. The development of dementia after stroke is common. Vascular risk factors (VRF) which contribute to stroke risk can also contribute to cognitive decline, especially in vascular dementia (VaD) ... Full text Link to item Cite

Cost-effectiveness of a preferred intensity exercise programme for young people with depression compared with treatment as usual: an economic evaluation alongside a clinical trial in the UK.

Journal Article BMJ Open · November 26, 2017 OBJECTIVES: To assess the cost-effectiveness of preferred intensity exercise programme for young people with depression compared with a treatment as usual control group. DESIGN: A 'within trial' cost-effectiveness and cost-utility analysis conducted alongs ... Full text Link to item Cite

Promoters and Barriers to Implementation of Tracheal Intubation Airway Safety Bundle: A Mixed-Method Analysis.

Journal Article Pediatr Crit Care Med · October 2017 OBJECTIVES: To describe promoters and barriers to implementation of an airway safety quality improvement bundle from the perspective of interdisciplinary frontline clinicians and ICU quality improvement leaders. DESIGN: Mixed methods. SETTING: Thirteen PIC ... Full text Link to item Cite

A framework for evaluating the accessibility of raw materials from end-of-life products and the Earth's crust.

Journal Article Waste Manag · October 2017 An increasing number of geochemically scarce metallic raw materials are entering into our lives via new technologies. A reversal of this trend is not foreseeable, leading to concerns regarding the security of their supply. However, the evaluation of raw ma ... Full text Link to item Cite

Feasibility randomised multicentre, double-blind, double-dummy controlled trial of anakinra, an interleukin-1 receptor antagonist versus intramuscular methylprednisolone for acute gout attacks in patients with chronic kidney disease (ASGARD): protocol study.

Journal Article BMJ Open · September 5, 2017 INTRODUCTION: Acute gout occurs in people with chronic kidney disease, who are commonly older people with comorbidities such as hypertension, heart disease and diabetes. Potentially harmful treatments are administered to these vulnerable patients due to a ... Full text Link to item Cite

Extended and standard duration weight-loss programme referrals for adults in primary care (WRAP): a randomised controlled trial.

Journal Article Lancet · June 3, 2017 BACKGROUND: Evidence exist that primary care referral to an open-group behavioural programme is an effective strategy for management of obesity, but little evidence on optimal intervention duration is available. We aimed to establish whether 52-week referr ... Full text Link to item Cite

Defining leadership competencies for pediatric critical care fellows: Results of a national needs assessment.

Journal Article Med Teach · May 2017 INTRODUCTION: Physicians in training, including those in Pediatric Critical Care Medicine, must develop clinical leadership skills in preparation to lead multidisciplinary teams during their careers. This study seeks to identify multidisciplinary perceptio ... Full text Link to item Cite

Internet-Based Vestibular Rehabilitation for Older Adults With Chronic Dizziness: A Randomized Controlled Trial in Primary Care.

Journal Article Ann Fam Med · May 2017 PURPOSE: Vestibular rehabilitation is an effective intervention for dizziness due to vestibular dysfunction, but is seldom provided. We aimed to determine the effectiveness of an Internet-based vestibular rehabilitation program for older adults experiencin ... Full text Link to item Cite

Evaluating landfill aftercare strategies: A life cycle assessment approach.

Journal Article Waste Manag · May 2017 This study investigates the potential impacts caused by the loss of active environmental control measures during the aftercare period of landfill management. A combined mechanistic solute flow model and life cycle assessment (LCA) approach was used to eval ... Full text Link to item Cite

Relationship Between Adverse Tracheal Intubation Associated Events and PICU Outcomes.

Journal Article Pediatr Crit Care Med · April 2017 OBJECTIVE: Tracheal intubation in PICUs is a common procedure often associated with adverse events. The aim of this study is to evaluate the association between immediate events such as tracheal intubation associated events or desaturation and ICU outcomes ... Full text Link to item Cite

Association between deep sedation from continuous intravenous sedatives and extubation failures in mechanically ventilated patients in the pediatric intensive care unit

Journal Article Journal of Pediatric Pharmacology and Therapeutics · March 1, 2017 OBJECTIVE The primary objective of this study was to determine whether an association exists between deep sedation from continuous infusion sedatives and extubation failures in mechanically ventilated children. Secondary outcomes evaluated risk factors ass ... Full text Cite

Important factors in predicting mortality outcome from stroke: findings from the Anglia Stroke Clinical Network Evaluation Study.

Journal Article Age Ageing · January 28, 2017 BACKGROUND: Although variation in stroke service provision and outcomes have been previously investigated, it is less well known what service characteristics are associated with reduced short- and medium-term mortality. METHODS: Data from a prospective mul ... Full text Link to item Cite

Engaging stakeholders and target groups in prioritising a public health intervention: the Creating Active School Environments (CASE) online Delphi study.

Journal Article BMJ Open · January 13, 2017 OBJECTIVES: Stakeholder engagement and public involvement are considered as integral to developing effective public health interventions and is encouraged across all phases of the research cycle. However, limited guidelines and appropriate tools exist to f ... Full text Link to item Cite

Intravenous oxygen: a novel method of oxygen delivery in hypoxemic respiratory failure?

Journal Article Expert Rev Respir Med · January 2017 Hypoxemic respiratory failure is a common problem in critical care. Current management strategies, including mechanical ventilation and extracorporeal membranous oxygenation, can be efficacious but these therapies put patients at risk for toxicities associ ... Full text Link to item Cite

Effect of Peer-to-Peer Nurse-Physician Collaboration on Attitudes Toward the Nurse-Physician Relationship.

Journal Article J Nurses Prof Dev · 2017 The goal of this study was to pilot a novel peer-to-peer nurse-physician collaboration program and assess for changes in attitudes toward collaboration among a group of newly licensed nurses and resident physicians (n = 39). The program included large grou ... Full text Link to item Cite

Continuous High-Frequency Oscillation Therapy in Invasively Ventilated Pediatric Subjects in the Critical Care Setting.

Journal Article Respir Care · November 2016 BACKGROUND: Continuous high-frequency oscillation (CHFO) creates a pressure gradient in the small airways that accelerates expiratory flow. The intended use of CHFO therapy is to facilitate secretion removal and treat atelectasis. Our objective was to asse ... Full text Link to item Cite

A feasibility study comparing UK older adult mental health inpatient wards which use protected engagement time with other wards which do not: Study protocol

Journal Article Pilot and Feasibility Studies · September 23, 2016 Background: Protected engagement time (PET) is a concept of managing staff time on mental health inpatient wards with the aim of increasing staff and patient interaction. Despite apparent widespread use of PET, there remains a dearth of evidence as to how ... Full text Cite

Combined material flow analysis and life cycle assessment as a support tool for solid waste management decision making

Journal Article Journal of Cleaner Production · August 15, 2016 Material flow analysis (MFA) and life cycle assessment (LCA) have both widely been applied to support solid waste management (SWM) decision making. However, they are often applied independently rather than conjointly. This paper presents an approach that c ... Full text Cite

Well-"Rounded" Medical Teams-What Does It Take?

Journal Article Pediatr Crit Care Med · July 2016 Full text Link to item Cite

Developing a Tool to Assess Placement of Central Venous Catheters in Pediatrics Patients.

Journal Article J Grad Med Educ · July 2016 BACKGROUND: Pediatric critical care medicine requires the acquisition of procedural skills, but to date no criteria exist for assessing trainee competence in central venous catheter (CVC) insertion. OBJECTIVE: The goal of this study was to create and demon ... Full text Link to item Cite

The number of tracheal intubation attempts matters! A prospective multi-institutional pediatric observational study.

Journal Article BMC Pediatr · April 29, 2016 BACKGROUND: The impact of multiple tracheal intubation (TI) attempts on outcomes in critically ill children with acute respiratory failure is not known. The objective of our study is to determine the association between number of TI attempts and severe des ... Full text Link to item Cite

Family Presence During Pediatric Tracheal Intubations.

Journal Article JAMA Pediatr · March 2016 IMPORTANCE: Family-centered care, which supports family presence (FP) during procedures, is now a widely accepted standard at health care facilities that care for children. However, there is a paucity of data regarding the practice of FP during tracheal in ... Full text Link to item Cite

Development of a Quality Improvement Bundle to Reduce Tracheal Intubation-Associated Events in Pediatric ICUs.

Journal Article Am J Med Qual · 2016 Advanced airway management in the pediatric intensive care unit (PICU) is hazardous, with associated adverse outcomes. This report describes a methodology to develop a bundle to improve quality and safety of tracheal intubations. A prospective observationa ... Full text Link to item Cite

Economic Outcomes of Extracorporeal Membrane Oxygenation With and Without Ambulation as a Bridge to Lung Transplantation.

Journal Article Respir Care · January 2016 BACKGROUND: An increasing number of centers are using active rehabilitation and ambulation for critically ill patients on extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation. This investigation assessed the economic impact at a s ... Full text Link to item Cite

Solid waste systems assessment

Chapter · January 1, 2016 Introduction: Wastes are defined in the Waste Framework Directive (European Parliament and Council of the European Union, 2008) as ‘any substance or object which the holder discards or intends or is required to discard’. Over the last two to three decades, ... Full text Cite

Increased Occurrence of Tracheal Intubation-Associated Events During Nights and Weekends in the PICU.

Journal Article Crit Care Med · December 2015 OBJECTIVES: Adverse tracheal intubation-associated events are common in PICUs. Prior studies suggest provider and practice factors are important contributors to tracheal intubation-associated events. Little is known about how the incidence of tracheal intu ... Full text Link to item Cite

Greenhouse gas emission factors for recycling of source-segregated waste materials

Journal Article Resources, Conservation and Recycling · December 1, 2015 A key challenge for the waste management sector is to maximise resource efficiency whilst simultaneously reducing its greenhouse gas (GHG) emissions. For stakeholders to better understand the GHG impacts of their waste management activities and identify em ... Full text Cite

Preferred intensity exercise for adolescents receiving treatment for depression: a pragmatic randomised controlled trial.

Journal Article BMC Psychiatry · October 14, 2015 BACKGROUND: Exercise has been shown to be effective in treating depression, but trials testing the effect of exercise for depressed adolescents utilising mental health services are rare. The aim of this study was to determine the effectiveness of a preferr ... Full text Link to item Cite

Is there still a role for high-frequency oscillatory ventilation in neonates, children and adults?

Journal Article Expert Rev Respir Med · October 2015 Critically ill patients with respiratory pathology often require mechanical ventilation and while low tidal volume ventilation has become the mainstay of treatment, achieving adequate gas exchange may not be attainable with conventional ventilator modaliti ... Full text Link to item Cite

Using an internet intervention to support self-management of low back pain in primary care: protocol for a randomised controlled feasibility trial (SupportBack).

Journal Article BMJ Open · September 23, 2015 INTRODUCTION: Low back pain (LBP) is a prevalent and costly condition. The majority of patients experiencing LBP are managed in primary care, where first-line care recommendations consist of advice to self-manage and remain active. Internet interventions p ... Full text Link to item Cite

Detection of Multiple Respiratory Viruses Associated With Mortality and Severity of Illness in Children.

Journal Article Pediatr Crit Care Med · September 2015 OBJECTIVE: Respiratory viral infection is a common source of morbidity and mortality in children. Coinfection with multiple viruses occurs frequently; however, the clinical significance of concomitant viral pathogens is unclear. We hypothesized that presen ... Full text Link to item Cite

Ambulatory extracorporeal membrane oxygenation as a bridge to lung transplantation: walking while waiting.

Journal Article Chest · May 2015 The proportion of critically ill patients awaiting lung transplantation has increased since the implementation of the Lung Allocation Score (LAS) in 2005. Critically ill patients comprise a sizable proportion of wait-list mortality and are known to experie ... Full text Link to item Cite

Current medication practice and tracheal intubation safety outcomes from a prospective multicenter observational cohort study.

Journal Article Pediatr Crit Care Med · March 2015 OBJECTIVES: Tracheal intubation in PICUs is often associated with adverse tracheal intubation-associated events. There is a paucity of data regarding medication selection for safe tracheal intubations in PICUs. Our primary objective was to evaluate the ass ... Full text Link to item Cite

Standardizing postoperative PICU handovers improves handover metrics and patient outcomes.

Journal Article Pediatr Crit Care Med · March 2015 OBJECTIVES: To improve handover communication and patient outcomes for postoperative admissions to a multidisciplinary PICU. DESIGN: Prospective cohort study. SETTING: Multidisciplinary PICU in a university hospital. SUBJECTS: The multidisciplinary team re ... Full text Link to item Cite

Multicenter development, implementation, and patient safety impacts of a simulation-based module to teach handovers to pediatric residents.

Journal Article Hosp Pediatr · March 2015 OBJECTIVE: Teaching and evaluation of handovers are important requirements of graduate medical education (GME), but well-defined and effective methods have not been clearly established. Case-based computer simulations provide potential methods to teach, ev ... Full text Link to item Cite

Clinical trial metadata: defining and extracting metadata on the design, conduct, results and costs of 125 randomised clinical trials funded by the National Institute for Health Research Health Technology Assessment programme.

Journal Article Health Technol Assess · February 2015 BACKGROUND: By 2011, the Health Technology Assessment (HTA) programme had published the results of over 100 trials with another 220 in progress. The aim of the project was to develop and pilot 'metadata' on clinical trials funded by the HTA programme. OBJE ... Full text Link to item Cite

Professionalism and Communication Education in Pediatric Critical Care Medicine: The Learner Perspective.

Journal Article Acad Pediatr · 2015 OBJECTIVE: Communication and professionalism are often challenging to teach, and the impact of the use of a given approach is not known. We undertook this investigation to establish pediatric critical care medicine (PCCM) trainee perception of education in ... Full text Link to item Cite

Setting the ventilator in the PICU

Chapter · January 1, 2015 The initiation of mechanical ventilation and selection of initial ventilator settings is a complex process that must address the underlying pathophysiology and the change in clinical status which may follow intubation and the implementation of positive pre ... Full text Cite

Indications for invasive conventional mechanical ventilation

Chapter · January 1, 2015 The spectrum and severity of respiratory illness in the newly born has been changing over the past three decades with the introduction of antenatal steroids, improved management of the fetus during preterm labor and birth, and postnatal exogenous surfactan ... Full text Cite

Basics of gas exchange

Chapter · January 1, 2015 The ultimate goal of pulmonary gas exchange is adequate tissue oxygen (O2) delivery and carbon dioxide (CO2) elimination. This exchange of gas is a multistep process that begins with ventilation and movement of gas from the atmosphere through the various g ... Full text Cite

Approaches to adverse patient-ventilator interactions

Chapter · January 1, 2015 Most mechanical ventilators in neonatal and pediatric intensive care units provide continuous monitoring of respiratory variables as well as a graphical display of gas flow, tidal volume, and airway pressure. Routine analysis of these waveforms is an impor ... Full text Cite

Non invasive monitoring in mechanically ventilated pediatric patients.

Journal Article Expert Rev Respir Med · December 2014 Cardiopulmonary monitoring is a key component in the evaluation and management of critically ill patients. Clinicians typically rely on a combination of invasive and non-invasive monitoring to assess cardiac output and adequacy of ventilation. Recent techn ... Full text Link to item Cite

Adjunctive treatments in pediatric acute respiratory distress syndrome.

Journal Article Expert Rev Respir Med · December 2014 Acute respiratory distress syndrome (ARDS) is a devastating process that involves pulmonary inflammation, alveolar damage and hypoxemic respiratory failure. Although advances in management approaches over the past two decades have resulted in significantly ... Full text Link to item Cite

INFECTION WITH MULTIPLE RESPIRATORY VIRUSES MAY INCREASE MORTALITY

Journal Article CRITICAL CARE MEDICINE · December 1, 2014 Link to item Cite

Clinical course and outcome predictors of critically ill infants with complete DiGeorge anomaly following thymus transplantation.

Journal Article Pediatr Crit Care Med · September 2014 OBJECTIVES: To identify risk factors for PICU admission and mortality of infants with complete DiGeorge anomaly treated with thymus transplantation. We hypothesized that age at transplantation and the presence of congenital heart disease would be risk fact ... Full text Link to item Cite

A review of the use of adjunctive therapies in severe acute asthma exacerbation in critically ill children.

Journal Article Expert Rev Respir Med · August 2014 Asthma is a common and potentially life threatening childhood condition. Asthma involves not only chronic airway remodeling, but may also include frequent exacerbations resulting from bronchospasm, edema, and mucus production. In children with severe exace ... Full text Link to item Cite

Ambulatory ECMO as a bridge to lung transplant in a previously well pediatric patient with ARDS.

Journal Article Pediatrics · August 2014 Extracorporeal membrane oxygenation (ECMO) is increasingly implemented in patients with end-stage pulmonary disease as a bridge to lung transplant. Several centers have instituted an approach that involves physical rehabilitation and ambulation for patient ... Full text Link to item Cite

Internet-based vestibular rehabilitation for adults aged 50 years and over: a protocol for a randomised controlled trial.

Journal Article BMJ Open · July 22, 2014 INTRODUCTION: Dizziness is highly prevalent in older adults and can lead to falls, fear of falling, loss of confidence, anxiety and depression. Vestibular rehabilitation (VR) exercises are effective in reducing dizziness due to vestibular dysfunction, but ... Full text Link to item Cite

The authors reply.

Journal Article Pediatr Crit Care Med · July 2014 Full text Link to item Cite

Survey of in-house coverage by pediatric intensivists: characterization of 24/7 in-hospital pediatric critical care faculty coverage*.

Journal Article Pediatr Crit Care Med · February 2014 OBJECTIVE: To characterize the current state of 24/7 in-hospital pediatric intensivist coverage in academic PICUs, including perceptions of faculty and trainees regarding the advantages and disadvantages of in-hospital coverage. DESIGN: Cross-sectional obs ... Full text Link to item Cite

Perceptions of 24/7 in-hospital intensivist coverage on pediatric housestaff education.

Journal Article Pediatrics · January 2014 BACKGROUND: In recent years, the focus on patient safety and housestaff supervision has led to a steady increase in institutions providing 24/7 in-hospital (also known as in-house, henceforth referred to as IH) coverage by pediatric intensivists. Effects o ... Full text Link to item Cite

PRImary care Streptococcal Management (PRISM) study: in vitro study, diagnostic cohorts and a pragmatic adaptive randomised controlled trial with nested qualitative study and cost-effectiveness study.

Journal Article Health Technol Assess · January 2014 BACKGROUND: Antibiotics are still prescribed to most patients attending primary care with acute sore throat, despite evidence that there is modest benefit overall from antibiotics. Targeting antibiotics using either clinical scoring methods or rapid antige ... Full text Link to item Cite

607

Conference Critical Care Medicine · December 2013 Full text Cite

879

Conference Critical Care Medicine · December 2013 Full text Cite

Extracorporeal membrane oxygenation for neonatal and pediatric respiratory failure: an evidence-based review of the past decade (2002-2012).

Journal Article Pediatr Crit Care Med · November 2013 OBJECTIVE: To provide a comprehensive evidence-based review of extracorporeal membrane oxygenation for neonatal and pediatric respiratory failure. DATA SOURCE: A thorough computerized bibliographic search of the clinical literature regarding the use of ext ... Full text Link to item Cite

Targeted interventions for patellofemoral pain syndrome (TIPPS): Classification of clinical subgroups

Journal Article BMJ Open · October 16, 2013 Introduction: Patellofemoral pain (PFP) can cause significant pain leading to limitations in societal participation and physical activity. An international expert group has highlighted the need for a classification system to allow targeted intervention for ... Full text Cite

Active rehabilitation during extracorporeal membrane oxygenation as a bridge to lung transplantation.

Journal Article Respir Care · August 2013 BACKGROUND: Patients with end-stage lung disease often progress to critical illness, which dramatically reduces their chance of survival following lung transplantation. Pre-transplant deconditioning has a significant impact on outcomes for all lung transpl ... Full text Link to item Cite

Extracorporeal membrane oxygenation for adult respiratory failure.

Journal Article Respir Care · June 2013 Extracorporeal membrane oxygenation (ECMO) is a form of cardiopulmonary bypass that is a mainstay of therapy in neonatal and pediatric patients with life threatening respiratory and/or cardiac failure. Historically, the use of ECMO in adults has been limit ... Full text Link to item Cite

Lung protective ventilation: a summary of the current evidence from the 2012 American Association for Respiratory Care International Congress.

Journal Article Expert Rev Respir Med · June 2013 Over 150 invited experts presented to almost 6000 participants at the most recent American Association for Respiratory Care International Congress. These participants represented a broad international audience with a range of expertise that included respir ... Full text Link to item Cite

Are pediatric critical care medicine fellowships teaching and evaluating communication and professionalism?

Journal Article Pediatr Crit Care Med · June 2013 OBJECTIVES: To describe the teaching and evaluation modalities used by pediatric critical care medicine training programs in the areas of professionalism and communication. DESIGN: Cross-sectional national survey. SETTING: Pediatric critical care medicine ... Full text Link to item Cite

Mapping the Oxford hip score onto the EQ-5D utility index.

Journal Article Qual Life Res · April 2013 PURPOSE: To assess different mapping methods for the estimation of a group's mean EQ-5D score based on responses to the Oxford hip score (OHS) questionnaire. METHODS: Four models were considered: a) linear regression using total OHS as a continuous regress ... Full text Link to item Cite

An economic evaluation of screening 60- to 70-year-old adults for hearing loss.

Journal Article J Public Health (Oxf) · March 2013 BACKGROUND: Hearing loss is common among older adults and has consequences for sufferers, families and society, but there is substantial unmet need for intervention. Screening could expedite intervention and improve outcomes. METHODS: We use Markov models ... Full text Link to item Cite

A National Emergency Airway Registry for children: landscape of tracheal intubation in 15 PICUs.

Journal Article Crit Care Med · March 2013 OBJECTIVES: To characterize the landscape of process of care and safety outcomes for tracheal intubation across pediatric intensive care units BACKGROUND: Procedural process of care and safety outcomes of tracheal intubation across pediatric intensive care ... Full text Link to item Cite

Use of high flow nasal cannula in critically ill infants, children, and adults: a critical review of the literature.

Journal Article Intensive Care Med · February 2013 BACKGROUND: High flow nasal cannula (HFNC) systems utilize higher gas flow rates than standard nasal cannulae. The use of HFNC as a respiratory support modality is increasing in the infant, pediatric, and adult populations as an alternative to non-invasive ... Full text Link to item Cite

Assessment of the financial implications for laparoscopic liver surgery: A single-centre UK cost analysis for minor and major hepatectomy

Journal Article Surgical Endoscopy · January 1, 2013 Background: Laparoscopic hepatectomy is progressively gaining popularity. However, it is still unclear whether the laparoscopic approach offers cost advantages compared with the open approach, especially when major hepatectomies are required. Data providin ... Full text Cite

Isoflurane for life-threatening bronchospasm: a 15-year single-center experience.

Journal Article Respir Care · November 2012 BACKGROUND: Children with severe bronchospasm requiring mechanical ventilation may become refractory to conventional therapy. In these critically ill patients, isoflurane is an inhaled anesthetic agent available in some centers to treat bronchospasm. We hy ... Full text Link to item Cite

State of the art: strategies for extracorporeal membrane oxygenation in respiratory failure.

Journal Article Expert Rev Respir Med · November 2012 Extracorporeal membrane oxygenation (ECMO) is an important rescue therapy for patients with cardiac and/or respiratory failure, with a growing body of literature supporting its use. Despite widespread use of ECMO, there remains a paucity of data on optimal ... Full text Link to item Cite

The role of business and industry in climate management after Durban

Journal Article Carbon Management · October 1, 2012 Full text Cite

Dexmedetomidine for transport of a spontaneously breathing combative child.

Journal Article Pediatrics · September 2012 Interhospital transport presents a challenge for pediatricians, and airway protection is often a significant concern. The severely agitated child without respiratory compromise poses an extremely difficult dilemma, as most sedative agents can cause respira ... Full text Link to item Cite

Technological advances in extracorporeal membrane oxygenation for respiratory failure.

Journal Article Expert Rev Respir Med · August 2012 Extracorporeal membrane oxygenation (ECMO) for neonatal and pediatric cardiac and/or respiratory failure is well established, and its use for adult respiratory failure is rapidly increasing. Management strategies developed over the past 30 years coupled wi ... Full text Link to item Cite

Prevalence, characteristics, and opinions of pediatric rapid response teams in the United States.

Journal Article Hosp Pediatr · July 2012 OBJECTIVE: Rapid response teams (RRTs) have been proposed as patient safety initiatives for hospitalized children. The aim of this study was to determine the prevalence, characteristics, and opinions of RRTs in hospitals with PICUs in the United States. ME ... Full text Link to item Cite

Clinical and cost effectiveness of booklet based vestibular rehabilitation for chronic dizziness in primary care: single blind, parallel group, pragmatic, randomised controlled trial.

Journal Article BMJ · June 6, 2012 OBJECTIVE: To determine the clinical and cost effectiveness of booklet based vestibular rehabilitation with and without telephone support for chronic dizziness, compared with routine care. DESIGN: Single blind, parallel group, pragmatic, randomised control ... Full text Link to item Cite

Ask the experts: The implications of COP17 at Durban

Journal Article Carbon Management · June 1, 2012 The 17th COP to the UNFCCC met in Durban in November 2011. Carbon Management has invited a panel of experts to express their views on the talks. The experts speak to Lucy Marum, Assistant Commissioning Editor, as they speculate on the implications for indu ... Full text Cite

Towards standardization in GHG quantification and reporting

Journal Article Carbon Management · June 1, 2012 Full text Cite

Nontraditional modes of mechanical ventilation: progress or distraction?

Journal Article Expert Rev Respir Med · June 2012 As technology continues to develop, a wide range of novel and nontraditional modes of mechanical ventilation have become available for the management of critically ill patients. Proportional assist ventilation, neurally adjusted ventilatory assist and adap ... Full text Link to item Cite

Successful treatment of disseminated cryptococcal infection in a pediatric acute lymphoblastic leukemia patient during induction.

Journal Article J Pediatr Hematol Oncol · May 2012 Disseminated cryptococcal infection is rarely reported in the setting of pediatric acute leukemia, despite the immunocompromised state of these patients. However, when present, disseminated cryptococcal infection poses treatment challenges and is associate ... Full text Link to item Cite

Bias flow does not affect ventilation during high-frequency oscillatory ventilation in a pediatric animal model of acute lung injury.

Journal Article Pediatr Crit Care Med · March 2012 OBJECTIVE: During high-frequency oscillatory ventilation, bias flow is the continuous flow of gas responsible for replenishing oxygen and removing CO(2) from the patient circuit. Bias flow is usually set at 20 L/min, but many patients require neuromuscular ... Full text Link to item Cite

A beginner's guide to carbon footprinting

Journal Article Carbon Management · February 1, 2012 Carbon footprinting is one of the foremost methods available for quantifying anthropogenic environmental impacts and for helping tackle the threat of climate change. However, for any person undertaking a carbon footprinting analysis for the first time, the ... Full text Cite

Targeted interventions improve shared agreement of daily goals in the pediatric intensive care unit.

Journal Article Pediatr Crit Care Med · January 2012 Featured Publication OBJECTIVE: To improve communication during daily rounds using sequential interventions. DESIGN: Prospective cohort study. SETTING: Multidisciplinary pediatric intensive care unit in a university hospital. SUBJECTS: The multidisciplinary rounding team in th ... Full text Link to item Cite

Carbon footprinting in the UK waste management sector

Journal Article Carbon Management · December 1, 2011 The UK waste management sector is under increasing pressure to measure, report and manage its GHG emissions. In recent years, it has become common for large waste management companies to report their annual carbon footprint, and a sector-specific standard ... Full text Cite

Active rehabilitation and physical therapy during extracorporeal membrane oxygenation while awaiting lung transplantation: a practical approach.

Journal Article Crit Care Med · December 2011 OBJECTIVE: Extracorporeal membrane oxygenation as a bridge to lung transplantation has traditionally been associated with substantial morbidity and mortality. A major contributor to these complications may be weakness and overall deconditioning secondary t ... Full text Link to item Cite

Successful use of extracorporeal membrane oxygenation for pH1N1-induced refractory hypoxemia in a child with hypoplastic left heart syndrome.

Journal Article Pediatr Crit Care Med · November 2011 Featured Publication OBJECTIVE: To report the first successful use of extracorporeal membrane oxygenation for acute respiratory distress syndrome secondary to 2009 pH1N1 influenza A infection in a child status post the Fontan operation for hypoplastic left heart syndrome. DESI ... Full text Link to item Cite

Use of extracorporeal life support in adults with severe acute respiratory failure.

Journal Article Expert Rev Respir Med · October 2011 Extracorporeal membrane oxygenation (ECMO) is a recognized and accepted therapeutic option in the treatment of neonatal and pediatric respiratory failure. However, early studies in adults did not demonstrate a survival benefit associated with the utilizati ... Full text Link to item Cite

Development of a collaborative program to provide extracorporeal membrane oxygenation for adults with refractory hypoxemia within the framework of a pandemic.

Journal Article Pediatr Crit Care Med · July 2011 Featured Publication OBJECTIVE: We report the process used to rapidly develop a collaborative adult respiratory extracorporeal membrane oxygenation program as a response to caring for young adult patients with refractory hypoxemia in the setting of the pH1N1 pandemic. DESIGN: ... Full text Link to item Cite

Extracorporeal membrane oxygenation for severe refractory respiratory failure secondary to 2009 H1N1 influenza A.

Journal Article Respir Care · July 2011 Featured Publication BACKGROUND: Respiratory failure and acute respiratory distress syndrome secondary to H1N1 influenza infection is a source of substantial morbidity and mortality, having caused over 265,000 hospitalizations in the United States in 2009. During the H1N1 pand ... Full text Link to item Cite

Successful extracorporeal membrane oxygenation for respiratory failure in an infant with DiGeorge anomaly, following thymus transplantation.

Journal Article Respir Care · June 2011 Featured Publication We report the first successful use of venovenous extracorporeal membrane oxygenation (ECMO) for refractory respiratory failure in an infant with DiGeorge anomaly, following thymus transplantation. A 23-month-old female with complete immune-incompetent DiGe ... Full text Link to item Cite

Senior pediatric residents as teachers for an innovative multidisciplinary mock code curriculum.

Journal Article J Grad Med Educ · June 2011 BACKGROUND: Resuscitation education for pediatric residents may be limited due to the low frequency of actual codes in children. Mock codes represent an opportunity to increase trainee education in acute resuscitations, and we designed a unique multidiscip ... Full text Link to item Cite

CA-MRSA brain abscess in a healthy infant

Journal Article Journal of Pediatric Infectious Diseases · April 25, 2011 We report the first case of a previously healthy term 5 week old infant with no known risk factors who developed a frontal lobe abscess from community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). To date, only 16 cases of invasive CA-MRS ... Full text Cite

Long term follow-up of a randomised controlled trial of services for urinary symptoms.

Journal Article BMC Health Serv Res · March 14, 2011 BACKGROUND: Given the extent and priority of urinary symptoms there is little evidence available to inform service provision in relation to the long term effects of interventions. This study aims to determine the long term (6 year) clinical effectiveness a ... Full text Link to item Cite

Pediatric acute respiratory failure: areas of debate in the pediatric critical care setting.

Journal Article Expert Rev Respir Med · February 2011 Featured Publication Pediatric intensive care units across the world care for large numbers of mechanically ventilated infants and children on a daily basis, yet management of these patients is far from standardized. This lack of standardization may be a necessity in certain s ... Full text Link to item Cite

The CHD challenge: comparing four cost-effectiveness models.

Journal Article Value Health · January 2011 OBJECTIVES: To compare four UK models evaluating the cost-effectiveness of interventions in coronary heart disease (CHD), exploring the relative importance of structure and inputs in accounting for differences, and the scope for consensus on structure and ... Full text Link to item Cite

The Accreditation Council for Graduate Medical Education proposed work hour regulations.

Journal Article Pediatr Crit Care Med · January 2011 Featured Publication Full text Link to item Cite

Do pediatric residents prefer interactive learning? Educational challenges in the duty hours era.

Journal Article Med Teach · 2011 Featured Publication BACKGROUND: The volume of information that physicians must learn is increasing; yet, trainee educational time is limited. Many experts propose using trainees' learning preferences to guide teaching. However, data regarding predominant learning preferences ... Full text Link to item Cite

A UK-based cost-utility analysis of radiofrequency ablation or oesophagectomy for the management of high-grade dysplasia in Barrett's oesophagus.

Journal Article Aliment Pharmacol Ther · December 2010 BACKGROUND: In the UK, oesophagectomy is the current recommendation for patients with persistent high-grade dysplasia in Barrett's oesophagus. Radiofrequency ablation is an alternative new technology with promising early trial results. AIM: To undertake a ... Full text Link to item Cite

Factors associated with survival in pediatric extracorporeal membrane oxygenation--a single-center experience.

Journal Article J Pediatr Surg · October 2010 AIM: We aimed to examine outcomes of extracorporeal membrane oxygenation (ECMO) therapy in the pediatric population and identify pre-ECMO and on-ECMO characteristics that are associated with survival. METHODS: We retrospectively reviewed the ECMO records a ... Full text Link to item Cite

The use of vasoactive agents via peripheral intravenous access during transport of critically III infants and children.

Journal Article Pediatr Emerg Care · August 2010 Featured Publication OBJECTIVES: Many experts recommend that vasoactive agents be infused via a central venous line (CVL) because of the potential risk of infiltration, but CVL placement in pediatric patients is often challenging. We hypothesized that it is safe to administer ... Full text Link to item Cite

Postoperative handoff communication: a simulation-based training method.

Journal Article Simul Healthc · August 2010 Featured Publication Full text Link to item Cite

'Resident-educators': a unique approach to resuscitation education.

Journal Article Med Educ · May 2010 Featured Publication Full text Link to item Cite

Cost effectiveness of management strategies for urinary tract infections: results from randomised controlled trial.

Journal Article BMJ · February 5, 2010 OBJECTIVE: To assess the cost effectiveness of different management strategies for urinary tract infections. DESIGN: Cost effectiveness analysis alongside a randomised controlled trial with a one month follow-up. SETTING: Primary care. PARTICIPANTS: 309 no ... Full text Link to item Cite

Effectiveness of five different approaches in management of urinary tract infection: randomised controlled trial.

Journal Article BMJ · February 5, 2010 OBJECTIVE: To assess the impact of different management strategies in urinary tract infections. DESIGN: Randomised controlled trial. SETTING: Primary care. PARTICIPANTS: 309 non-pregnant women aged 18-70 presenting with suspected urinary tract infection. I ... Full text Link to item Cite

"RESIDENT EDUCATORS"-A UNIQUE APPROACH TO RESUSCITATION EDUCATION

Conference CRITICAL CARE MEDICINE · December 1, 2009 Link to item Cite

Adalimumab for the treatment of psoriasis.

Journal Article Health Technol Assess · September 2009 This paper presents a summary of the evidence review group (ERG) report into the clinical and cost-effectiveness of adalimumab for the treatment of moderate to severe plaque psoriasis based upon a review of the manufacturer's submission to the National Ins ... Full text Link to item Cite

Automated measurement of the lower inflection point in a pediatric lung model.

Journal Article Pediatr Crit Care Med · July 2009 Featured Publication OBJECTIVE: To determine which flow setting most accurately detects the lower inflection point (Pflex) using an automated constant flow method and varying endotracheal tube (ETT) sizes with and without an airleak in a pediatric lung model. DESIGN: Intervent ... Full text Link to item Cite

Infliximab for the treatment of adults with psoriasis.

Journal Article Health Technol Assess · June 2009 This paper presents a summary of the evidence review group (ERG) report into the clinical and cost-effectiveness of infliximab for the treatment of moderate to severe plaque psoriasis, in accordance with the licensed indication, based on the evidence submi ... Full text Link to item Cite

Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study.

Journal Article Health Technol Assess · March 2009 OBJECTIVES: To estimate clinical and dipstick predictors of infection and develop and test clinical scores; to compare management using clinical and dipstick scores with commonly used alternative strategies; to estimate the cost-effectiveness of each strat ... Full text Link to item Cite

Addressing the unit of analysis in medical care studies: a systematic review.

Journal Article Med Care · June 2008 Featured Publication OBJECTIVE: We assessed the frequency that patients are incorrectly used as the unit of analysis among studies of physicians' patient care behavior in articles published in high impact journals. METHODS: We surveyed 30 high-impact journals across 6 medical ... Full text Link to item Cite

Insights in pediatric ventilation: timing of intubation, ventilatory strategies, and weaning.

Journal Article Curr Opin Crit Care · February 2007 Featured Publication PURPOSE OF REVIEW: Mechanical ventilation is a common intervention provided by pediatric intensivists. This fact notwithstanding, the management of mechanical ventilation in pediatrics is largely guided by a few pediatric trials along with careful interpre ... Full text Link to item Cite