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Bhandari V, Black R, Gandhi B, Hogue S, Kakkilaya V, Mikhael M, Moya F, Pezzano C, Read P, Roberts KD, Ryan RM, Stanford RH, Wright CJ. RDS-NExT workshop: consensus statements for the use of surfactant in preterm neonates with RDS. J Perinatol 2023; 43:982-990. [PMID: 37188774 PMCID: PMC10400415 DOI: 10.1038/s41372-023-01690-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To provide the best clinical practice guidance for surfactant use in preterm neonates with respiratory distress syndrome (RDS). The RDS-Neonatal Expert Taskforce (RDS-NExT) initiative was intended to add to existing evidence and clinical guidelines, where evidence is lacking, with input from an expert panel. STUDY DESIGN An expert panel of healthcare providers specializing in neonatal intensive care was convened and administered a survey questionnaire, followed by 3 virtual workshops. A modified Delphi method was used to obtain consensus around topics in surfactant use in neonatal RDS. RESULT Statements focused on establishing RDS diagnosis and indicators for surfactant administration, surfactant administration methods and techniques, and other considerations. After discussion and voting, consensus was achieved on 20 statements. CONCLUSION These consensus statements provide practical guidance for surfactant administration in preterm neonates with RDS, with a goal to contribute to improving the care of neonates and providing a stimulus for further investigation to bridge existing knowledge gaps.
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Affiliation(s)
- Vineet Bhandari
- The Children's Regional Hospital at Cooper/Cooper Medical School of Rowan University, Camden, NJ, USA.
| | | | - Bheru Gandhi
- Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | | | - Venkatakrishna Kakkilaya
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Fernando Moya
- Division of Wilmington Pediatric Subspecialists, Department of Pediatrics, UNC School of Medicine, Wilmington, NC, USA
| | - Chad Pezzano
- Department of Cardio-Respiratory Services Pediatric -Albany Medical Center, Albany, NY, USA
| | - Pam Read
- AESARA Inc., Chapel Hill, NC, USA
| | | | - Rita M Ryan
- UH Rainbow Babies and Children's Hospital -Case Western Reserve University, Cleveland, OH, USA
| | | | - Clyde J Wright
- Section of Neonatology, Department of Pediatrics, Children's Hospital Colorado and the University of Colorado School of Medicine, Aurora, CO, USA
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Peek AL, Rebbeck TJ, Leaver AM, Foster SL, Refshauge KM, Puts NA, Oeltzschner G. A comprehensive guide to MEGA-PRESS for GABA measurement. Anal Biochem 2023; 669:115113. [PMID: 36958511 PMCID: PMC10805000 DOI: 10.1016/j.ab.2023.115113] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/25/2023]
Abstract
The aim of this guideline is to provide a series of evidence-based recommendations that allow those new to using MEGA-PRESS to produce high-quality data for the measurement of GABA levels using edited magnetic resonance spectroscopy with the MEGA-PRESS sequence at 3T. GABA is the main inhibitory neurotransmitter of the central nervous system and has been increasingly studied due to its relevance in many clinical disorders of the central nervous system. MEGA-PRESS is the most widely used method for quantification of GABA at 3T, but is technically challenging and operates at a low signal-to-noise ratio. Therefore, the acquisition of high-quality MRS data relies on avoiding numerous pitfalls and observing important caveats. The guideline was developed by a working party that consisted of experts in MRS and experts in guideline development and implementation, together with key stakeholders. Strictly following a translational framework, we first identified evidence using a systematically conducted scoping literature review, then synthesized and graded the quality of evidence that formed recommendations. These recommendations were then sent to a panel of 21 world leaders in MRS for feedback and approval using a modified-Delphi process across two rounds. The final guideline consists of 23 recommendations across six domains essential for GABA MRS acquisition (Parameters, Practicalities, Data acquisition, Confounders, Quality/reporting, Post-processing). Overall, 78% of recommendations were formed from high-quality evidence, and 91% received agreement from over 80% of the expert panel. These 23 expert-reviewed recommendations and accompanying extended documentation form a readily useable guideline to allow those new to using MEGA-PRESS to design appropriate MEGA-PRESS study protocols and generate high-quality data.
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Affiliation(s)
- A L Peek
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2141, Australia; NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, Queensland, Australia.
| | - T J Rebbeck
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2141, Australia; NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, Queensland, Australia.
| | - A M Leaver
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2141, Australia.
| | - S L Foster
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2141, Australia; Department of Radiology, Westmead Hospital, Hawkesbury Road, Westmead, New South Wales, 2145, Australia.
| | - K M Refshauge
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2141, Australia.
| | - N A Puts
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, UK.
| | - G Oeltzschner
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, 21205, United States.
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Wu Q, Jiang HJ, Chen HQ. Establishment of infection prevention and control strategy in nursing managements during surgical operations in COVID-19 patients based on Delphi method. Nurs Open 2023; 10:3906-3913. [PMID: 36811165 PMCID: PMC10170890 DOI: 10.1002/nop2.1648] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 12/04/2022] [Accepted: 02/05/2023] [Indexed: 02/24/2023] Open
Abstract
AIM The aim of this study was to establish an infection prevention and control strategy for nursing managements during surgical operations in coronavirus disease 2019 (COVID-19) patients. DESIGN A Delphi method. METHODS Between November 2021 and March 2022, we first formulated a preliminary infection prevention and control strategy based on the literature review and institutional experience. Then, we applied Delphi method and performed expert surveys to reach a final strategy for nursing managements during surgical operations in COVID-19 patients. RESULTS The strategy included seven dimensions with 34 items. The positive coefficients of Delphi experts in both surveys were 100%, indicating a high coordination among experts. The degree of authority and expert coordination coefficient were 0.91 and 0.097-0.213. After the second expert survey, value assignments for importance of each dimension and item were 4.21-5.00 and 4.21-4.76 points, respectively. The coefficients of variation for dimension and item were 0.09-0.19 and 0.05-0.19, respectively. PATIENT OR PUBLIC CONTRIBUTION Except the medical experts and research personnel, there was no other patient or public contribution involved in the study.
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Affiliation(s)
- Qi Wu
- Department of Operating Room, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hui-Juan Jiang
- Department of Operating Room, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Han-Qian Chen
- Department of Operating Room, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Cullen SW, Bowden CF, Olfson M, Marcus SC, Caterino JM, Ross AM, Doupnik SK, True G. "Treat Them Like a Human Being…They are Somebody's Somebody": Providers' Perspectives on Treating Patients in the Emergency Department After Self-Injurious Behavior. Community Ment Health J 2023; 59:253-265. [PMID: 35931907 PMCID: PMC10373641 DOI: 10.1007/s10597-022-01003-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/21/2022] [Indexed: 01/25/2023]
Abstract
To understand ED providers' perspective on how to best care for individuals who present to US emergency departments (EDs) following self-injurious behavior, purposive recruitment identified nursing directors, medical directors, and social workers (n = 34) for telephone interviews from 17 EDs. Responses and probes to "What is the single most important thing ED providers and staff can do for patients who present to the ED after self-harm?" were analyzed using directed content analysis approach. Qualitative analyses identified four themes: treat patients with respect and compassion; listen carefully and be willing to ask sensitive personal questions; provide appropriate care during mental health crises; connect patients with mental health care. Participants emphasized treating patients who present to the ED after self-injurious behavior with respect and empathy. Hospitals could incentivize provider mental health training, initiatives promoting patient-provider collaboration, and reimbursement strategies ensuring adequate staffing of providers with time to listen carefully.
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Affiliation(s)
- Sara Wiesel Cullen
- School of Social Policy & Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA, 19104, USA.
| | - Cadence F Bowden
- Division of General Pediatrics, Center for Pediatric Clinical Effectiveness, and PolicyLab, Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA, 19146, USA
| | - Mark Olfson
- New York State Psychiatric Institute and Clinic and the Vagelos College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Steven C Marcus
- School of Social Policy & Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA, 19104, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA, 19104, USA
- Penn Center for Mental Health, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA, 19104, USA
| | - Jeffrey M Caterino
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, 751 Prior Hall 376 W 10th Ave, Columbus, OH, 43210, USA
| | - Abigail M Ross
- Graduate School of Social Service, Fordham University, 113 W. 60th St, #721-D, New York, NY, 10023, USA
| | - Stephanie K Doupnik
- Division of General Pediatrics, Center for Pediatric Clinical Effectiveness, and PolicyLab, Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA, 19146, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA, 19104, USA
- Department of Pediatrics, University of Pennsylvania, 2716 South Street, Philadelphia, PA, 19146, USA
| | - Gala True
- Section of Community and Population Medicine, Louisiana State University Health Sciences Center - New Orleans School of Medicine, 533 Bolivar St., New Orleans, LA, 70117, USA
- South Central Mental Illness Research, Education, and Clinical Center, Southeast Louisiana Veterans Health Care System, 533 Bolivar St, New Orleans, LA, 70117, USA
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Study protocol for development of an options assessment toolkit (OAT) for national malaria programs in Asia Pacific to determine best combinations of vivax radical cure for their given contexts. PLoS One 2023; 18:e0280950. [PMID: 36893173 PMCID: PMC9997949 DOI: 10.1371/journal.pone.0280950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/10/2023] [Indexed: 03/10/2023] Open
Abstract
INTRODUCTION Recent advances in G6PD deficiency screening and treatment are rapidly changing the landscape of radical cure of vivax malaria available for National Malaria Programs (NMPs). While NMPs await the WHO's global policy guidance on these advances, they will also need to consider different contextual factors related to the vivax burden, health system capacity, and resources available to support changes to their policies and practices. Therefore, we aim to develop an Options Assessment Toolkit (OAT) that enables NMPs to systematically determine optimal radical cure options for their given environments and potentially reduce decision-making delays. This protocol outlines the OAT development process. METHODS Utilizing participatory research methods, the OAT will be developed in four phases where the NMPs and experts will have active roles in designing the research process and the toolkit. In the first phase, an essential list of epidemiological, health system, and political & economic factors will be identified. In the second phase, 2-3 NMPs will be consulted to determine the relative priority and measurability of these factors. These factors and their threshold criteria will be validated with experts using a modified e-Delphi approach. In addition, 4-5 scenarios representing country contexts in the Asia Pacific region will be developed to obtain the expert-recommended radical cure options for each scenario. In the third phase, additional components of OAT, such as policy evaluation criteria, latest information on new radical cure options, and others, will be finalized. The OAT will be pilot-tested with other Asia Pacific NMPs in the final phase. ETHICS AND DISSEMINATION Human Research Ethics Committee approval has been received from the Northern Territory, Department of Health, and Menzies School of Health Research (HREC Reference Number: 2022-4245). The OAT will be made available for the NMPs, introduced at the APMEN Vivax Working Group annual meeting, and reported in international journals.
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Reed T, Wagner S, Ozark G, Chaidez C, Boyle M, Gruener G. Seeing Yourself Through the Learner's Eyes: Incorporating Smart Glasses Into Objective Structured Teaching Exercises for Faculty Development. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 43:60-64. [PMID: 36849430 PMCID: PMC9973430 DOI: 10.1097/ceh.0000000000000437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Although physicians gain clinical knowledge in their specialty, it does not mean they receive adequate instruction to teach and provide feedback. Using smart glasses (SG) to provide educators with a first-person learner perspective has not been explored in faculty development such as Objective Structured Teaching Exercises (OSTEs). METHODS Integrated within a 6-session continuing medical education-bearing certificate course, this descriptive study involved one session where participants provided feedback to a standardized student in an OSTE. Participants were recorded by mounted wall cameras (MWCs) and SG. They received verbal feedback on their performance based on a self-designed assessment tool. Participants reviewed the recorded content and identified areas for improvement, completed a survey about their experience with SG, and wrote a narrative reflection. RESULTS Seventeen physicians at the assistant professor level participated in the session; data were analyzed on the 14 who had both MWC and SG recordings and who also completed the survey and reflection. All were comfortable with the standardized student wearing SG and indicated it did not affect communication. Eighty-five percent of the participants felt the SG provided additional feedback not available with the MWC, with majority noting additional feedback was related to eye contact, body language, voice inflection, and tone. Eighty-six percent see value in using SG for faculty development, and 79% felt that periodically using SG in their teaching would improve quality. CONCLUSION Use of SG during an OSTE on giving feedback was a nondistracting and positive experience. SG provided affective feedback otherwise not perceived from a standard MWC.
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Developing a third-degree burn model of rats using the Delphi method. Sci Rep 2022; 12:13852. [PMID: 36056098 PMCID: PMC9440023 DOI: 10.1038/s41598-022-18092-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/04/2022] [Indexed: 11/18/2022] Open
Abstract
Animal experiments play an essential role in advances in the research and treatment of burns. Currently, researchers often rely on personal experience or the literature to complete the construction of animal disease models, which may lead to a lack of scientific rigor and a wide range of animal disease models with reference value. The purposes of this study were to establish a third-degree burn model of rats using the Delphi method to provide a reference. Two rounds of a Delphi expert consultation survey were conducted on experts (n = 13) in this study, and then the boundary value method was used to screen, modify and supplement the indicators. Next, the indicator weight was determined by dividing the boundary value, and finally, the index system of the rat model of third-degree burns was established. The statistical analysis results show that the positive coefficients of the two rounds of expert consultation are 100% and 88.67% respectively. The expert authority coefficient values were 0.73 and 0.67, respectively, and the expert coordination coefficient test was P < 0.001. According to the experts' suggestion, the third-degree burn model of rats with 8 first-degree indexes, 14 second-degree indexes and 46 third-degree indexes was finally established. According to the characteristics and quality requirements of animal models, this study constructs a rat model of third degree burns, which is expected to expressively improve the overall proficiency of burn research quality.
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Chiel L, Winthrop Z, Huth K, Gross CJ, Gomez A, Marcus CH, Winn AS. Bridge Builders: A Qualitative Study of Fellows' Successful Supervision of Residents. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1195-1202. [PMID: 35385408 DOI: 10.1097/acm.0000000000004687] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Clinical fellows, those training to become subspecialists in a program certified by the Accreditation Council for Graduate Medical Education, supervise residents on inpatient subspecialty rotations. Unlike for supervising residents or for faculty, there is a paucity of literature describing fellows' supervision of residents. The aim of this study was to understand residents' and fellows' perception of successful supervision of residents by fellows on inpatient subspecialty rotations to inform the development of curricula to support fellows as supervisors. METHOD Using grounded theory methodology, the authors held focus groups in May 2020 of pediatric residents and pediatric subspecialty fellows at Boston Children's Hospital, Boston, Massachusetts. Focus groups were conducted until thematic saturation was achieved. Deidentified transcripts were independently coded by 2 authors. The author team consolidated the codes into themes and developed an interpretive model for fellows' successful supervision of residents. Key results were confirmed via member checking. RESULTS The authors conducted 4 resident focus groups, composed of 16 pediatric residents, and 4 fellow focus groups, composed of 13 pediatric subspecialty fellows. Participants perceived that fellows who provided successful resident supervision advanced residents' professional growth and supported residents' development along 5 "bridges": (1) generalist to subspecialist, (2) trainee to autonomous practitioner, (3) individual to member of the interprofessional team, (4) emerging physician to patient-facing care provider, and (5) newcomer to engaged clinical learner. Fellows can further residents' growth in these areas by demonstrating approachability, empathy, appreciation, and kindness. CONCLUSIONS As newcomers on inpatient subspecialty rotations, residents engage in legitimate peripheral participation. Fellows who are successful supervisors move residents toward full participation in their profession via the bridge model. The fellow-resident dynamic carries advantages of near-peer learning. Fellows can harness their role, subspecialty knowledge, and familiarity with the training environment to enhance resident supervision.
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Affiliation(s)
- Laura Chiel
- L. Chiel is a fellow, Division of Pulmonary Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Zachary Winthrop
- Z. Winthrop is chief resident, Boston Combined Residency Program, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, and Department of Pediatrics, Boston Medical School and Boston University School of Medicine, Boston, Massachusetts
| | - Kathleen Huth
- K. Huth is assistant professor, Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Caroline J Gross
- C.J. Gross is a fellow, Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Amanda Gomez
- A. Gomez is a fellow, Division of Gastroenterology, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Carolyn H Marcus
- C.H. Marcus is an instructor, Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ariel S Winn
- A.S. Winn is assistant professor, Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
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Tu J, Xue X, Bai X, Liu Y, Jia M, Zhou H. Development of a self-help cognitive behavioral therapy programme for reducing the stigma of stroke survivors: a modified delphi study. Top Stroke Rehabil 2022; 30:468-482. [PMID: 35686678 DOI: 10.1080/10749357.2022.2083296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Stigma is a common psychological consequence for stroke survivors that aggravates their physical and psychological burden and hinders their rehabilitation. Currently, there are few interventions targeted at the stigma of stroke survivors. OBJECTIVES This study reports on the development of a self-help cognitive behavioral therapy (CBT) programme driven by a logical model of stigma in stroke survivors, CBT and the advice of multidomain experts. METHODS A logical model of stigma in stroke survivors was derived from a systematic search of the literature and semistructured interviews with 21 patients to identify factors influencing stigma. The item content of the programme was generated based on this logical model in combination with CBT. A modified Delphi process with an expert panel of multidomain experts was used to evaluate and refine the content of the programme. SPSS 20.0 was used for data analysis. RESULTS Seventeen experts accepted the invitation to participate, and all completed two rounds of the Delphi survey. Six sections and 26 items were identified. Consensus was reached among experts that the self-help CBT programme included the following six sections: health education, understanding stigma, cognition change, skills training and self-care, self-acceptance and relapse prevention. CONCLUSIONS The self-help CBT programme includes health education and psychological education. This study extends the limited body of research on stroke-related stigma interventions, and the next step is to evaluate its efficacy in trials.
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Affiliation(s)
- Jinyi Tu
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiang Xue
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xuejie Bai
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yue Liu
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Miao Jia
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Hongzhen Zhou
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Miller KA, Tolliver D, Newman LR. Developing Effective Supervisors of Teaching Rounds: Consensus, Entrustment and Deliberate Practice. Acad Pediatr 2022; 22:540-541. [PMID: 34863933 DOI: 10.1016/j.acap.2021.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 11/01/2022]
Affiliation(s)
- Kelsey A Miller
- Department of Pediatrics (KA Miller and LR Newman), Boston Children's Hospital, Boston, Mass; Harvard Medical School (KA Miller), Boston, Mass.
| | - Destiny Tolliver
- Yale National Clinician Scholars Program (D Tolliver), Yale School of Medicine, New Haven, Conn
| | - Lori R Newman
- Department of Pediatrics (KA Miller and LR Newman), Boston Children's Hospital, Boston, Mass; Department of Education (LR Newman), Boston Children's Hospital, Boston, Mass
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Hosseini SM, Soltanpour Y, Paydar MM. Applying the Delphi and fuzzy DEMATEL methods for identification and prioritization of the variables affecting Iranian citrus exports to Russia. Soft comput 2022; 26:9543-9556. [PMID: 35039748 PMCID: PMC8755405 DOI: 10.1007/s00500-022-06738-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2021] [Indexed: 11/26/2022]
Abstract
Foreign trade is one of the important components in economic development and a source of foreign exchange earnings. In Iran, the government desires to develop foreign trade with a focus on non-oil exports. One of the substantial non-oil products is agricultural products. Iran is one of the top ten countries in the world in terms of producing agricultural products, especially citrus, but it does not have suitable conditions in terms of exports. Mazandaran province is a considerable source of citrus production in Iran, and the main produced citrus in the province is exported to Russia. Worth bearing in mind that although the production rate of citrus in the province is very well, the amount of export is not very appropriate. Therefore, the government struggles to adopt an appropriate approach to improve the conditions and taking the right approach is not possible without identifying the variables affecting exports. In this regard, in this study, first, the variables affecting citrus exports regarding the case are determined using literature review and the most related those to the case study are selected using the Delphi method. Then, the identified variables are ranked using the fuzzy DEMATEL method. Focusing on the results, it can be observed that “exchange rate fluctuation” and “marketing” have the most and the least impact on the development of citrus exports from the province to Russia, respectively. Moreover, to better analyze the gained results, the determined variables are divided into two main categories based on stages of trade, and each category’s variables are discussed in detail.
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Affiliation(s)
- Seyyed Mehdi Hosseini
- Department of Industrial Engineering, Babol Noshirvani University of Technology, Babol, Iran
| | - Yazdan Soltanpour
- Department of Industrial Engineering, Babol Noshirvani University of Technology, Babol, Iran
| | - Mohammad Mahdi Paydar
- Department of Industrial Engineering, Babol Noshirvani University of Technology, Babol, Iran
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Rooke F, Burford J, Doorly A, Gush C, Brennan ML. Developing consensus for definitions of key veterinary-specific quality improvement (QI) terms using an eDelphi-study method. Vet Rec 2021; 191:e1174. [PMID: 34888878 DOI: 10.1002/vetr.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/18/2021] [Accepted: 10/28/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Quality improvement (QI) methods are a continuous process of iterative tests to improve the quality of a service or product. Using common language has been linked to the successful implementation of QI in human healthcare. This study aimed to assimilate and achieve consensus on veterinary-specific definitions for terms associated with quality care and QI methods in UK veterinary practice. METHODS A four-round modified eDelphi process with a panel of 50 UK veterinary practice stakeholders was used to generate consensus. The panel selected or suggested the definition they best felt 'fitted' each term. Consensus was reached if there was >70% agreement, and terms were eliminated if there was <15% selection. RESULTS Thirty-one panellists completed all three rounds of eDelphi; eight participants completed an optional feedback round. From 14 terms, 10 reached consensus, leaving four unresolved definitions. CONCLUSIONS A majority of terms reached consensus; 90% were new or amended definitions proposed by panel members. Utilising plain English refined by stakeholders will allow successful implementation of QI in veterinary healthcare. Not all terms achieved consensus, highlighting a need for further research to enable successful integration of QI principles as seen in human healthcare.
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Affiliation(s)
- Freya Rooke
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK.,Centre for Evidence-Based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
| | - John Burford
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
| | | | | | - Marnie L Brennan
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK.,Centre for Evidence-Based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
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13
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Giltenane M, Sheridan A, Kroll T, Frazer K. Identification of quality indicators of public health nursing practice: "modified Delphi" approach. Public Health Nurs 2021; 39:214-228. [PMID: 34697828 DOI: 10.1111/phn.13000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Identify process indicators to measure public health nursing practice during first postnatal visits in Ireland. DESIGN Using a RAND/UCLA appropriateness- "modified Delphi" method, a two-round rating and ranking process was completed in 2016. Fifty-nine statements were reviewed for consensus and priority ranking. SAMPLE The sample comprised a panel of 21 national and international experts. RESULTS Fifty-nine indicators were identified and subsequently reduced across two rounds of consensus testing. Fifty-six indicators achieved consensus and priority ranking identified 13 indicators to measure care for mothers and 15 indicators to measure care for newborns resulting in 28 process indicators to enable Public Health Nurses (PHNs) to measure care during the first postnatal visit. CONCLUSIONS Measurement of care using quality indicators plays an integral role in quality improvement. Developing quality indicators is important in improving care outcomes. This two round "modified Delphi" study combined with literature and previous qualitative findings identified process indicators to measure public health nursing practice at first postnatal visits and enables benchmarking. Developing quality indicators for public health nursing practice using a "modified Delphi" technique has enabled a platform to provide consensus amongst a panel of experts and identified key processes of care by PHNs and mothers.
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Affiliation(s)
- Martina Giltenane
- Lecturer in Nursing/Program Director Master in Health Sciences (Public Health Nursing), Room 410 School of Nursing and Midwifery, Aras Moyola, National University of Ireland, Galway, Ireland
| | - Ann Sheridan
- Lecturer and Researcher Mental Health, Subject Head-Mental Health Nursing, Chairperson Irish Institute of Mental Health Nursing, UCD School of Nursing, Midwifery & Health Systems, Room B310 UCD Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Thilo Kroll
- Professor of Health Systems Management, Associate Dean for Research, Innovation and Impact, UCD School of Nursing, Midwifery and Health Systems, Fellow at the UCD Geary Institute for Public Policy, Room B225 UCD Health Sciences Centre, University College Dublin (UCD), Belfield, Dublin 4, Ireland
| | - Kate Frazer
- Director Graduate Research, Head of Subject: Public Health and Community Nursing, Fellow European Academy Nursing Science, Fellow UCD Geary Institute Public Policy, Room B224, UCD School of Nursing, Midwifery and Health Systems, UCD College of Health and Agricultural Sciences, Belfield, Dublin 4, Ireland
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Wuthisuthimethawee P, Rojsaengroeng R, Krongtrivate T. Development of Hospital MCI and Disaster Preparedness Assessment Tool for Thailand. Risk Manag Healthc Policy 2021; 14:3465-3471. [PMID: 34456593 PMCID: PMC8387310 DOI: 10.2147/rmhp.s314391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/10/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Hospital preparedness is a key component to mitigate the effects of mass casualty incidents (MCIs) and disasters. Improving hospital preparedness requires an assessment of the country's current health system capacity, readiness, and preparedness. Although a variety of assessment tools exist, none are entirely suitable for Thailand's healthcare system. Objective To develop an assessment tool to evaluate hospital preparedness for MCI and disaster in Thailand. Methods A cross-sectional study was conducted from 1 March 2015 to December 2016. The contents of the first drafted tool were prepared based on evidence from a systematic search of electronic databases published up to 31 December 2014. Key elements identification, extraction, and further organization were based on the World Health Organization health system framework. Validity was tested by experts and emergency management personnel in four domains using a 5-point scale evaluation form. The feasibility of using this assessment tool was carried out in 41 hospitals on a voluntary basis. The tool was considered valid if the item-objective congruence (IOC) index results were at least 0.6 and feasible for median values of at least 4. Results Seventy-six full texts and guidelines out of 5869 titles and abstracts from a systematic search were enrolled in the study. A constructive literature review was performed to develop a hospital assessment tool. The IOC index results of the assessment tool components were 1.0, 0.9, 0.7, and 1.0 in framework appropriateness, relevance of items, clearness, and usefulness, respectively. The median (interquartile range) values of framework appropriateness, relevance of items, clearness, and usefulness were 4.0 (4.0‒5.0), 4.3 (4.3‒4.5), 4.0 (4.0‒4.0), and 5.0 (4.0‒5.0), respectively. Conclusion An assessment tool to evaluate hospital MCI and disaster preparedness based on the WHO health system framework was valid and feasible at the national level of Thailand.
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Affiliation(s)
- Prasit Wuthisuthimethawee
- Department of Emergency Medicine, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Rapeeporn Rojsaengroeng
- Department of Emergency Medicine, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.,Department of Emergency Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
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15
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Shokouhyar S, Shokoohyar S, Sobhani A, Gorizi AJ. Shared mobility in post-COVID era: New challenges and opportunities. SUSTAINABLE CITIES AND SOCIETY 2021; 67:102714. [PMID: 36569573 PMCID: PMC9760257 DOI: 10.1016/j.scs.2021.102714] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/20/2020] [Accepted: 01/09/2021] [Indexed: 05/03/2023]
Abstract
This study is aimed at exploring the challenges and opportunities that the COVID-19 outbreak presents to the sustainability of shared mobility. To date, the sustainability of shared mobility has received little attention in the literature, and this study determines its central constructs that are critical to the sustainability of shared mobility. We accordingly conducted a three-phase Delphi approach composed of both qualitative and quantitative methods. Feedback was obtained from 18 international experts who are very knowledgeable regarding civil engineering and shared mobility, initially finding 18 challenges and 18 opportunities. Finally, we identified 12 key constructs as highly critical to the sustainability of shared mobility. The current work is an attempt to address gaps in exploring the challenges and opportunities that the COVID-19 outbreak has created in shared mobility, particularly when a comprehensive examination is needed. This study will serve as an inspiration and catalog for new studies within this field.
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Affiliation(s)
- Sajjad Shokouhyar
- Department of Management and Accounting, Shahid Beheshti University, Tehran, Iran
| | - Sina Shokoohyar
- Erivan K. Haub School of Business, Saint Joseph's University, Philadelphia, PA, 19131, United States
| | - Anae Sobhani
- Department of Human Geography and Planning, Utrecht University, Utrecht, 3584 CB, The Netherlands
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16
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Wang Y, Wang T, Wang A, Chen S, Jiao L, Shi J, Feng X, Meng K. Identifying the competencies of China's paediatric residents: a modified Delphi method study. BMJ Open 2021; 11:e041741. [PMID: 33597133 PMCID: PMC7893650 DOI: 10.1136/bmjopen-2020-041741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Standardised Training of Paediatric Resident (STPR) plays an essential role in training qualified paediatricians. Until now, China had no paediatric resident competency index system to effectively guide and evaluate the competence of paediatric residents. This study aimed to establish a competency index system for paediatric residents in China to provide a reference for improving the training system and quality of STPR. STUDY DESIGN AND SETTING This study conducted two rounds of Delphi expert consultation survey among paediatric medical experts (n=16), followed by screening, revising and supplementing indicators using the boundary value method. Next, the analytic hierarchy process was used to determine the weight of indicators and finally establish a competency index system for paediatric residents. RESULTS The results of the statistical analysis revealed a positive coefficient of 100% for both rounds of expert consultation. The expert authority coefficient values were 0.82 and 0.83, and the expert coordination coefficient test was p<0.01. After referring to experts' opinions, a competency index system for paediatric residents with 5 primary indicators, 14 secondary indicators and 73 tertiary indicators was finally formed and the weight of each indicator was calculated. The five primary indicators were professional quality (0.3187), knowledge and skills (0.2734), communication and cooperation (0.1986), lifelong learning (0.1302), and teaching ability (0.0791). CONCLUSIONS In this study, a competency index system for paediatric residents was constructed following the characteristics and quality requirements for paediatric residents in China and is expected to significantly improve the overall level of paediatricians' medical service quality and supply.
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Affiliation(s)
- Yujia Wang
- School of Public Health, Capital Medical University, Beijing, China
- Department of Education, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Tianyou Wang
- Hematologic Oncology Center, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Aihua Wang
- Department of Education, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Shengyu Chen
- Health Human Resources Development Center, National Health Commission of the People's Republic of China, Beijing, China
| | - Liping Jiao
- Department of Education, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - JingYu Shi
- School of Public Health, Capital Medical University, Beijing, China
| | - Xingmiao Feng
- School of Public Health, Capital Medical University, Beijing, China
| | - Kai Meng
- School of Public Health, Capital Medical University, Beijing, China
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17
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Marcus CH, Newman LR, Winn AS, Antanovich K, Audi Z, Cohen A, Hirsch AW, Harris HK, Miller KA, Michelson CD. TEACH and repeat: Deliberate practice for teaching. CLINICAL TEACHER 2020; 17:688-694. [PMID: 32648360 DOI: 10.1111/tct.13205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Deliberate practice facilitates skill mastery. We aimed to create a novel resident-as-teacher rotation, leveraging a deliberate practice framework with repeated practice in real-life teaching settings, with feedback from dedicated faculty member coaches. METHODS A resident-as-teacher rotation was designed for 35 Postgraduate Year-2 (PGY2) paediatric residents. To facilitate deliberate practice, teaching experiences were observed by faculty member coaches and were repeated with different audiences. Participating residents received pre-rotation, post-rotation and follow-up surveys on their confidence and comfort with teaching, supervision and feedback skills. All residents were also surveyed the year before and the year after implementation on their perceptions of their teaching, supervision and feedback skills, and whether the residency provided adequate training on these topics. RESULTS Survey response rates varied from 40 to 71%. The rotation was highly valued, and deliberate practice was a most valued aspect. Mean scores in comfort and confidence significantly increased from pre- to post-rotation, with these increases sustained months later. Prior to implementation, residents' perceptions of their teaching skills and the adequacy of their training increased incrementally with each postgraduate year. After the inaugural year of the rotation, the PGY2 class rated their teaching skills and training as higher than more experienced residents. DISCUSSION A novel resident-as-teacher rotation successfully incorporated deliberate practice in real-life settings by repeating teaching activities with feedback from dedicated coaches. The rotation led to sustained increases in residents' confidence in their teaching, supervising and feedback skills, and improved perceptions of their teaching training during residency.
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Affiliation(s)
- Carolyn H Marcus
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Lori R Newman
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Medical Education, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Ariel S Winn
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Kate Antanovich
- Pennsylvania State University, University Park, Pennsylvania, USA.,Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Zeena Audi
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.,Hassenfeld Children's Hospital at New York University Langone Medical Center, New York, New York, USA
| | - Amy Cohen
- Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Alexander W Hirsch
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Holly K Harris
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Baylor College of Medicine and Meyer Center for Developmental Pediatrics, Texas Children's Hospital, Houston, Texas, USA
| | - Kelsey A Miller
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Catherine D Michelson
- Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA
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18
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Gross CJ, Chiel LE, Gomez AR, Marcus CH, Michelson CD, Winn AS. Defining the Essential Components of a Teaching Service. Pediatrics 2020; 146:peds.2020-0651. [PMID: 32487591 DOI: 10.1542/peds.2020-0651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES A large portion of residency education occurs in inpatient teaching services without widely accepted consensus regarding the essential components that constitute a teaching service. We sought to generate consensus around this topic, with the goal of developing criteria programs that can be used when creating, redesigning, or evaluating teaching services. METHODS A list of potential components of teaching services was developed from a literature search, interviews, and focus groups. Eighteen pediatric medical education experts participated in a modified Delphi method, responding to a series of surveys rating the importance of the proposed components. Each iterative survey was amended on the basis of the results of the previous survey. A final survey evaluating the (1) effort and (2) impact of implementing components that had reached consensus as recommended was distributed. RESULTS Each survey had 100% panelist response. Five survey rounds were conducted. Fourteen attending physician characteristics and 7 system characteristics reached consensus as essential components of a teaching service. An additional 25 items reached consensus as recommended. When evaluating the effort and impact of these items, the implementation of attending characteristics was perceived as requiring less effort than system characteristics but as having similar impact. CONCLUSIONS Consensus on the essential and recommended components of a resident teaching service was achieved by using the modified Delphi method. Although the items that reached consensus as essential are similar to those proposed by the Accreditation Council for Graduate Medical Education, those that reached consensus as recommended are less commonly discussed and should be strongly considered by institutions.
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Affiliation(s)
- Caroline J Gross
- Harvard Medical School, Harvard University and Boston Children's Hospital, Boston, Massachusetts; and .,Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Laura E Chiel
- Harvard Medical School, Harvard University and Boston Children's Hospital, Boston, Massachusetts; and
| | - Amanda R Gomez
- Harvard Medical School, Harvard University and Boston Children's Hospital, Boston, Massachusetts; and
| | - Carolyn H Marcus
- Harvard Medical School, Harvard University and Boston Children's Hospital, Boston, Massachusetts; and
| | - Catherine D Michelson
- Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Ariel S Winn
- Harvard Medical School, Harvard University and Boston Children's Hospital, Boston, Massachusetts; and
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