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  1. Article ; Online: Clinical Progress Note: High Flow Nasal Cannula Therapy for Bronchiolitis Outside the ICU in Infants.

    Piper, Laura / Stalets, Erika L / Statile, Angela M

    Journal of hospital medicine

    2020  Volume 15, Issue 1, Page(s) 49–51

    Language English
    Publishing date 2020-02-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2233783-0
    ISSN 1553-5606 ; 1553-5592
    ISSN (online) 1553-5606
    ISSN 1553-5592
    DOI 10.12788/jhm.3328
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6276: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 542: Show issues

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  2. Article ; Online: Inappropriate Use of Peripherally Inserted Central Catheters in Pediatrics: A Multisite Study.

    Burek, Alina G / Davis, Mary Beth / Pechous, Brittany / Shaughnessy, Erin E / Meier, Katie A / Mooney, Sarah / Woodruff, Dana / Bruner, Meaghan / Piper, Laura / Liegl, Melodee / Pan, Amy / Brousseau, David C / Ullman, Amanda J

    Hospital pediatrics

    2024  Volume 14, Issue 3, Page(s) 180–188

    Abstract: Objectives: This study aimed to describe how the current practice of peripherally inserted central catheter (PICC) use in hospitalized children aligns with the Michigan Appropriateness Guide for Intravenous Catheters (miniMAGIC) in Children ... ...

    Abstract Objectives: This study aimed to describe how the current practice of peripherally inserted central catheter (PICC) use in hospitalized children aligns with the Michigan Appropriateness Guide for Intravenous Catheters (miniMAGIC) in Children recommendations, explore variation across sites, and describe the population of children who do not receive appropriate PICCs.
    Methods: A retrospective study was conducted at 4 children's hospitals in the United States. Children with PICCs placed January 2019 to December 2021 were included. Patients in the NICU were excluded. PICCs were categorized using the miniMAGIC in Children classification as inappropriate, uncertain appropriateness and appropriate.
    Results: Of the 6051 PICCs identified, 9% (n = 550) were categorized as inappropriate, 9% (n = 550) as uncertain appropriateness, and 82% (n = 4951) as appropriate. The number of PICCs trended down over time, but up to 20% of PICCs each year were not appropriate, with significant variation between sites. Within inappropriate or uncertain appropriateness PICCs (n = 1100 PICC in 1079 children), median (interquartile range) patient age was 4 (0-11) years, 54% were male, and the main reason for PICC placement was prolonged antibiotic course (56%, n = 611). The most common admitting services requesting the inappropriate/uncertain appropriateness PICCs were critical care 24%, general pediatrics 22%, and pulmonary 20%. Complications resulting in PICC removal were identified in 6% (n = 70) of inappropriate/uncertain PICCs. The most common complications were dislodgement (3%) and occlusion (2%), with infection and thrombosis rates of 1% (n = 10 and n = 13, respectively).
    Conclusions: Although the majority of PICCs met appropriateness criteria, a substantial proportion of PICCs were deemed inappropriate or of uncertain appropriateness, illustrating an opportunity for quality improvement.
    MeSH term(s) Child ; Child, Preschool ; Female ; Humans ; Male ; Anti-Bacterial Agents ; Catheterization, Peripheral/adverse effects ; Catheters ; Child, Hospitalized ; Retrospective Studies ; Infant, Newborn ; Infant
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2024-02-09
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ISSN 2154-1671
    ISSN (online) 2154-1671
    DOI 10.1542/hpeds.2023-007518
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  3. Article ; Online: Development and evaluation of a pediatric hospital medicine board review course.

    Herrmann, Lisa E / Jones, Yemisi O / Kinnear, Benjamin / Rule, Amy / Piper, Laura / Shah, Samir S / Klein, Melissa

    BMC medical education

    2022  Volume 22, Issue 1, Page(s) 804

    Abstract: Background: The American Board of Medical Specialties recognized Pediatric Hospital Medicine (PHM) for subspecialty certification in 2016, with the first certification exam in 2019. To address the need for exam preparatory materials, we designed and ... ...

    Abstract Background: The American Board of Medical Specialties recognized Pediatric Hospital Medicine (PHM) for subspecialty certification in 2016, with the first certification exam in 2019. To address the need for exam preparatory materials, we designed and evaluated a novel PHM board review course that was offered both in-person and online.
    Methods: Course content was based on the American Board of Pediatrics (ABP) PHM certifying exam outline. Course objectives were developed from published PHM core competencies and the 2012 ABP general pediatrics content objectives. National experts served as faculty, presenting didactic sessions, and contributing to a question bank for high-yield review. For program evaluation, we applied the Kirkpatrick Model, evaluating estimated exam pass rates (Level 4), participant learning (Level 2) via post-presentation practice questions, and participants' ratings of presenters (via five-point Likert scale) and satisfaction (Level 1).
    Results: There were 112 in-person and 144 online participants with estimated pass rates of 89 and 93%, respectively. The mean correct response for the post-presentation knowledge questions was 84%. Faculty effectiveness ratings ranged from 3.81 to 4.96 (median score 4.60). Strengths included the pace of the course, question bank, and printed syllabus. Suggestions for improvement included question bank expansion, focus on "testable" points rather than general information, and challenges with long days of didactic presentations.
    Conclusions: This novel PHM board review course demonstrated effectiveness. Hospitalists preferred focused "testable" information, an active learning environment, and a robust question bank. Future preparatory courses should consider including more opportunities for practice questions, focused content review, and learner engagement.
    MeSH term(s) Humans ; Child ; United States ; Hospitals, Pediatric ; Certification ; Program Evaluation ; Forecasting ; Pediatrics
    Language English
    Publishing date 2022-11-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2044473-4
    ISSN 1472-6920 ; 1472-6920
    ISSN (online) 1472-6920
    ISSN 1472-6920
    DOI 10.1186/s12909-022-03862-1
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  4. Article: Multi-male groups positively linked to infant survival and growth in a cooperatively breeding primate

    Heslin Piper, Laura A / Becky E. Raboy / James M. Dietz

    Behavioral ecology and sociobiology. 2017 Dec., v. 71, no. 12

    2017  

    Abstract: Cooperative breeding is a system where helper individuals care for breeding individuals’ offspring. As a result, social environment is likely to play a key role in regulating reproductive success. In primates, cooperative breeding is only found in the ... ...

    Abstract Cooperative breeding is a system where helper individuals care for breeding individuals’ offspring. As a result, social environment is likely to play a key role in regulating reproductive success. In primates, cooperative breeding is only found in the family Callitrichidae. Callitrichid males typically provide more infant care than non-breeding females, and in many callitrichid species, the presence of multiple males has been linked to infant survival. Leontopithecus chrysomelas (the golden-headed lion tamarin) is an endangered callitrichid found in the Atlantic Forest of Brazil. We used long-term data for wild L. chrysomelas to assess the influence of social group composition on reproductive success. Our survival model found that infant survival was negatively associated with group size, but this cost was mitigated by the presence of multiple adult males vs a single adult male. We also found that infants raised in groups with multiple adult males exhibited faster growth rates and higher adult weights than infants raised with a single adult male. This study adds novel evidence for the positive influence of adult males on callitrichid reproduction, demonstrating that adult males influence infant growth, as well as survival, in wild populations of cooperatively breeding primates. We suggest that social group composition, particularly the presence of adult males, be considered in future conservation strategies given its importance for reproductive success. SIGNIFICANCE STATEMENT: In cooperatively breeding species, group members care for breeding individuals’ offspring. Due to this care, group composition may have a strong influence on infant success. In cooperatively breeding primates, males often provide more infant care than females. We investigated the influence of group composition on infant success in a cooperatively breeding primate, the golden-headed lion tamarin. Using long-term field data, we found that infant survival decreased as group size increased. However, this effect was reduced when multiple adult males were present in the group compared to a single male. We also found that infants grew faster and reached larger adult weights in the presence of multiple adult males compared to a single male. Our results demonstrate the importance of group composition for cooperative breeders and provide new evidence for the positive influence of adult males on cooperatively breeding primate infants.
    Keywords adults ; alloparental behavior ; breeding ; child care ; females ; forests ; group size ; infant growth ; infants ; Leontopithecus chrysomelas ; males ; models ; progeny ; reproductive success ; social class ; social environment ; Brazil
    Language English
    Dates of publication 2017-12
    Size p. 176.
    Publishing place Springer Berlin Heidelberg
    Document type Article
    ZDB-ID 194510-5
    ISSN 1432-0762 ; 0340-5443
    ISSN (online) 1432-0762
    ISSN 0340-5443
    DOI 10.1007/s00265-017-2404-3
    Database NAL-Catalogue (AGRICOLA)

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    In stock of ZB MED Bonn / Germany

    Z 78/731: Show issues

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  5. Article ; Online: The Autonomy Toolbox: A Multicenter Collaborative to Promote Resident Autonomy.

    Allen, Karen / Najjar, Mohammed / Ostermeier, Austen / Washington, Nicole / Genies, Marquita C / Hazle, Matthew / Hardy, Charles / Lewis, Kristen / McDaniel, Lauren / McFarlane, Daniel J / Macias, Charlie / Molloy, Matthew J / Perry, Michael F / Piper, Laura / Sevov, Claire / Titus, Lauren / Toth, Heather / Unaka, Ndidi I / Weisgerber, Michael C /
    Kasick, Rena

    Hospital pediatrics

    2023  Volume 13, Issue 6, Page(s) 490–503

    Abstract: Objectives: Autonomy is necessary for resident professional development and well-being. A recent focus on patient safety has increased supervision and decreased trainee autonomy. Few validated interventions exist to improve resident autonomy. We aimed ... ...

    Abstract Objectives: Autonomy is necessary for resident professional development and well-being. A recent focus on patient safety has increased supervision and decreased trainee autonomy. Few validated interventions exist to improve resident autonomy. We aimed to use quality improvement methods to increase our autonomy metric, the Resident Autonomy Score (RAS), by 25% within 1 year and sustain for 6 months.
    Methods: We developed a bundled-intervention approach to improve senior resident (SR) perception of autonomy on Pediatric Hospital Medicine (PHM) services at 5 academic children's hospitals. We surveyed SR and PHM faculty perceptions of autonomy and targeted interventions toward areas with the highest discordance. Interventions included SR and faculty development, expectation-setting huddles, and SR independent rounding. We developed a Resident Autonomy Score (RAS) index to track SR perceptions over time.
    Results: Forty-six percent of SRs and 59% of PHM faculty completed the needs assessment survey querying how often SRs were afforded opportunities to provide autonomous medical care. Faculty and SR ratings were discordant in these domains: SR input in medical decisions, SR autonomous decision-making in straightforward cases, follow-through on SR plans, faculty feedback, SR as team leader, and level of attending oversight. The RAS increased by 19% (3.67 to 4.36) 1 month after SR and faculty professional development and before expectation-setting and independent rounding. This increase was sustained throughout the 18-month study period.
    Conclusions: SRs and faculty perceive discordant levels of SR autonomy. We created an adaptable autonomy toolbox that led to sustained improvement in perception of SR autonomy.
    MeSH term(s) Child ; Humans ; Internship and Residency ; Professional Autonomy ; Surveys and Questionnaires ; Faculty, Medical ; Clinical Competence ; General Surgery
    Language English
    Publishing date 2023-05-04
    Publishing country United States
    Document type Multicenter Study ; Journal Article
    ISSN 2154-1671
    ISSN (online) 2154-1671
    DOI 10.1542/hpeds.2022-006827
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Variations in Care for Breastfed Infants Admitted to US Children's Hospitals: A Multicenter Survey of Inpatient Providers.

    Bochner, Risa E / Kuroki, Robyn / Lui, Karen / Russell, Christopher J / Rackovsky, Elia / Piper, Laura / Ban, Kathryn / Yang, Katharine / Mandal, Purnima / Mackintosh, Liza / Mirzaian, Christine B / Gross, Elissa

    Hospital pediatrics

    2019  Volume 10, Issue 1, Page(s) 70–75

    Abstract: Background: Studies have revealed an association between hospitalization of breastfed infants and weaning posthospitalization. It is unknown what steps inpatient providers at children's hospitals are currently taking to support breastfeeding mothers of ... ...

    Abstract Background: Studies have revealed an association between hospitalization of breastfed infants and weaning posthospitalization. It is unknown what steps inpatient providers at children's hospitals are currently taking to support breastfeeding mothers of hospitalized infants, their comfort providing breastfeeding counseling, and what training they receive.
    Methods: We conducted a multicenter survey study of pediatric providers who care for infants hospitalized at 3 urban, tertiary-care children's hospitals over a 12-month period. A convenience sample of nurses, residents, and attending physicians agreed to participate. Participants completed a 24-question questionnaire addressing provider practices, comfort with breastfeeding counseling, and previous breastfeeding education. Data were summarized as medians (interquartile ranges) and frequencies (percentages). Kruskal-Wallis and χ
    Results: A total of 361 out of 1097 (33%) eligible providers completed the survey: 133 (21%) nurses, 166 (45%) residents, and 62 (63%) attending physicians. Provider practices varied by provider type. We observed a general trend that providers do not routinely review breastfeeding techniques, directly observe feeds, or use standardized breastfeeding assessment tools. Residents and attending physicians were more likely than nurses to feel comfortable with breastfeeding counseling (
    Conclusions: Practices, comfort, and previous education varied by provider type. There was a general pattern that providers do not routinely perform certain practices. Further studies are needed to determine if inpatient provider practices affect weaning posthospitalization and if inpatient quality improvement initiatives will help mothers continue breastfeeding posthospitalization.
    MeSH term(s) Breast Feeding ; Female ; Hospitalization ; Hospitals, Pediatric ; Humans ; Infant ; Inpatients ; Mothers ; Patient Care/standards ; Patient Education as Topic ; Surveys and Questionnaires ; United States
    Language English
    Publishing date 2019-12-11
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ISSN 2154-1671
    ISSN (online) 2154-1671
    DOI 10.1542/hpeds.2019-0199
    Database MEDical Literature Analysis and Retrieval System OnLINE

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