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Objective: The objective of this study was to examine factors associated with pediatric nurse practitioners (PNPs) reporting to work in the event of a disaster., Methods: An anonymous national survey of PNPs was conducted. Several domains were explored, including demographics, personal preparedness plans, disaster training, prior disaster experience, and likelihood of responding in the event of a disaster. A logistic regression analysis was conducted to determine which factors were associated with the respondent's likelihood of responding in the event of a disaster., Results: Factors associated with increased likelihood of responding included gender (being a male PNP), military experience, and disaster training. The most significant factor associated with an increased likelihood of responding to work during a disaster was having a specified role in the workplace disaster plan. PNPs with a specified role were three times more likely to respond than were those without a specified role., Conclusions: PNPs are health care workers with advanced skill sets. This untapped resource is available to provide care for a vulnerable population: our children. Disaster planners should explore the possibility of utilizing these highly skilled health care workers in their disaster plans., (Copyright © 2012 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.)

Background: An academic surgeon's workweek is divided among patient care, administrative duties, education, and research. The time available for research activities may change as a surgeon's career evolves. We sought to determine involvement of academic surgeons in research and to assess how this research endeavor was affected by demographic and workplace characteristics., Methods: We constructed a survey to explore the following 4 domains: demographics, time allotment, research activities, and effects of stressors. We distributed the survey to members of the Society of University Surgeons. In addition to performing descriptive statistics, we defined an active researcher as someone with a funding source who devoted 15% or more work hours to research. Using this definition, we performed statistical analyses to assess the significance of independent variables on research. Stress factors were evaluated on a Likert scale with responses ranging from 1 (not at all) to 5 (extremely)., Results: We received 314 completed surveys (response rate 23%). Of the respondents, 274 (87%) stated that they were involved in some kind of research activity; however, only 143 (46%) were active researchers. Using univariate logistic regression analysis, younger respondents and surgeons who practiced for more than 10 years were more likely to be active researchers (odds ratio [OR]: 1.93, confidence interval [CI]: 1.51-2.46 and OR: 2.06, CI: 1.64-2.59, respectively). Males were less likely than females to be active researchers (OR: 0.32, CI: 016-0.67); however, by multivariate analysis, we found that the "years in practice" of an active researcher was the most significant predictor of research activity, whereas age and sex were not. In regard to stress, most respondents reported scores of 1-3 for all 7 stressors, which is consistent with minimal to moderate stress., Conclusion: Academic surgeons are involved actively in research; however, this involvement decreases as other professional responsibilities increase. To optimize the surgical research environment, departments should invest time and resources in young investigators to prevent them from decreasing their research activities.

Objectives: The Norwood procedure with right ventricle-pulmonary artery conduit is thought to improve postoperative hemodynamics in hypoplastic left heart syndrome, but its effects on pulmonary artery growth are unknown. This study evaluated pulmonary artery growth after the Norwood procedure in patients with a right ventricle-pulmonary artery conduit as compared with patients with a modified Blalock-Taussig shunt., Methods: A total of 159 patients at our institution underwent the Norwood procedure between January 2000 and September 2005. Patients were divided into group A or B if they had a modified Blalock-Taussig shunt (n = 103) or a right ventricle-pulmonary artery conduit (n = 56). Angiograms from the pre-Glenn catheterizations were used to measure pulmonary artery size and assess shunt stenosis (n = 64)., Results: Fifty-five (53.4%) patients in group A versus 40 (71.4%) in group B underwent Glenn surgery. Group B patients often required an additional shunt (modified Blalock-Taussig) before the Glenn procedure because of hypoxemia (8/40 vs 1/55; P = .004). Branch pulmonary artery growth was better in group B patients who did not require an additional shunt (Nakata index 212 vs 169 mm(2)/m(2); P = .004) and more balanced than in group A (right pulmonary artery/left pulmonary artery ratio = 1.02 vs 1.39; P = .001) as a result of greater left pulmonary artery size (29 vs 19 mm(2); P = .001). However, group B experienced more shunt stenosis (8/32 vs 2/32; P = .001), underwent the Glenn operation earlier (192 vs 246 days; P = .03), and had central pulmonary artery hypoplasia develop more often than group A patients (25/32 vs 14/32; P = .01)., Conclusion: The Norwood procedure with a right ventricle-pulmonary artery conduit promotes better distal left pulmonary artery growth resulting in more balanced branch pulmonary artery size, but central pulmonary artery hypoplasia occurs more often. Early right ventricle-pulmonary artery conduit stenosis also increases the need for additional shunting or early Glenn surgery.

Objective: To test the hypotheses that there is a lack of correlation between extreme events and epidemiologic risk factors for sudden infant death syndrome (SIDS), and if conventional events are normal, their numbers should increase once a circadian decrease in breathing rate is established. In addition, the number of events should decrease with maternal smoking., Study Design: Three outcome variables were derived from the Collaborative Home Infant Monitoring Evaluation (CHIME) of 1082 infants: (1) at least 1 extreme event lasting > or = 30 seconds, (2) at least 1 conventional event lasting > or = 20 seconds, and (3) being part of the 50% of infants with the most events., Results: Multivariate logistic regression analyses found that extreme events were not statistically associated with any known SIDS risk factors and occurred less often during the early morning. Healthy term infants had significantly fewer of these events compared with preterm infants, subsequent siblings of infants with SIDS, and infants with an apparent life-threatening event, a finding that was not evident after 43 weeks (3 weeks postterm). Conventional events increased during the night, whereas maternal smoking was associated with a decrease in conventional events. Apneic episodes persisting for > or = 40 seconds occurred in 1.8% of the infants., Conclusions: Extreme events are associated with immaturity and do not seem to be immediate precursors of or causally related to SIDS.