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1. Behavioral Deficits at 18-22 Months of Age Are Associated with Early Cerebellar Injury and Cognitive and Language Performance in Children Born Extremely Preterm

Author

Andrea F. Duncan, Carla M. Bann, Allison Dempsey, Myriam Peralta-Carcelen, Susan Hintz, Alan H. Jobe, Michael S. Caplan, Abbot R. Laptook, Betty R. Vohr, William Oh, Angelita M. Hensman, Barbara Alksninis, Dawn Andrews, Kristen Angela, Susan Barnett, Bill Cashore, Melinda Caskey, Kim Francis, Dan Gingras, Katharine Johnson, Theresa M. Leach, Bonnie E. Stephens, Victoria E. Watson, Michele C. Walsh, Avroy A. Fanaroff, Nancy S. Newman, Deanne E. Wilson-Costello, Bonnie S. Siner, Arlene Zadell, Julie DiFiore, Monika Bhola, Harriet G. Friedman, Gulgun Yalcinkaya, Dorothy Bulas, Ronald N. Goldberg, C. Michael Cotten, Ricki F. Goldstein, Patricia Ashley, Kathy J. Auten, Kimberley A. Fisher, Katherine A. Foy, Sharon F. Freedman, Kathryn E. Gustafson, Melody B. Lohmeyer, William F. Malcolm, David K. Wallace, David P. Carlton, Barbara J. Stoll, Ira Adams-Chapman, Susie Buchter, Anthony J. Piazza, Sheena Carter, Sobha Fritz, Ellen C. Hale, Amy K. Hutchinson, Maureen Mulligan LaRossa, Rosemary D. Higgins, Stephanie Wilson Archer, Gregory M. Sokol, Brenda B. Poindexter, Anna M. Dusick, James A. Lemons, Leslie D. Wilson, Faithe Hamer, Ann B. Cook, Dianne E. Herron, Carolyn Lytle, Heike M. Minnich, Mary Anne Berberich, Carol J. Blaisdell, Dorothy B. Gail, James P. Kiley, Abhik Das, Marie G. Gantz, Jamie E. Newman, Helen Cheng, Betty K. Hastings, Elizabeth M. McClure, Jeanette O'Donnell Auman, Carolyn Petrie Huitema, W. Kenneth Poole, James W. Pickett, Dennis Wallace, Lisa A. Wrage, Kristin M. Zaterka-Baxter, Krisa P. Van Meurs, David K. Stevenson, M. Bethany Ball, Patrick D. Barnes, Barbara Bentley, Elizabeth F. Bruno, Maria Elena DeAnda, Anne M. DeBattista, Jean G. Kohn, Melinda S. Proud, Renee P. Pyle, Hali E. Weiss, Ivan D. Frantz, John M. Fiascone, Elisabeth C. McGowan, Anne Furey, Brenda L. MacKinnon, Ellen Nylen, Ana Brussa, Cecelia Sibley, Waldemar A. Carlo, Namasivayam Ambalavanan, Monica V. Collins, Shirley S. Cosby, Vivien A. Phillips, Kirstin J. Bailey, Fred J. Biasini, Maria Hopkins, Kristen C. Johnston, Kathleen G. Nelson, Cryshelle S. Patterson, Richard V. Rector, Leslie Rodriguez, Amanda Soong, Sally Whitley, Sheree York, Neil N. Finer, Maynard R. Rasmussen, Paul R. Wozniak, Yvonne E. Vaucher, Wade Rich, Kathy Arnell, Rene Barbieri-Welge, Ayala Ben-Tall, Renee Bridge, Clarence Demetrio, Martha G. Fuller, Elaine Ito, Meghan Lukasik, Deborah Pontillo, Donna Posin, Cheryl Runyan, James Wilkes, Paul Zlotnik, Edward F. Bell, John A. Widness, Michael J. Acarregui, Jonathan M. Klein, Tarah T. Colaizy, Karen J. Johnson, Diane L. Eastman, Shahnaz Duara, Charles R. Bauer, Ruth Everett-Thomas, Maria Calejo, Alexis N. Diaz, Silvia M. Frade Eguaras, Andrea Garcia, Kasey Hamlin-Smith, Michelle Harwood Berkowits, Sylvia Hiriart-Fajardo, Elaine O. Mathews, Helina Pierre, Arielle Riguard, Alexandra Stroerger, Kristi L. Watterberg, Robin K. Ohls, Janell Fuller, Julie Rohr, Conra Backstrom Lacy, Jean Lowe, Rebecca Montman, Sandra Brown, Nirupama Laroia, Dale L. Phelps, Gary J. Myers, Gary D. Markowitz, Linda J. Reubens, Diane Hust, Lisa Augostino, Julie Babish Johnson, Erica Burnell, Harris Gelbard, Rosemary L. Jensen, Emily Kushner, Joan Merzbach, Jonathan Mink, Carlos Torres, David Wang, Kelley Yost, Pablo J. Sánchez, Charles R. Rosenfeld, Walid A. Salhab, Roy J. Heyne, Sally S. Adams, James Allen, Laura Grau, Alicia Guzman, Gaynelle Hensley, Elizabeth T. Heyne, Jackie F. Hickman, Melissa H. Leps, Linda A. Madden, Melissa Martin, Nancy A. Miller, Janet S. Morgan, Araceli Solis, Lizette E. Torres, Catherine Twell Boatman, Diana M. Vasil, Kathleen A. Kennedy, Jon E. Tyson, Patricia W. Evans, Esther G. Akpa, Nora I. Alaniz, Beverly Foley Harris, Charles Green, Margarita Jiminez, Anna E. Lis, Sarah Martin, Georgia E. McDavid, Brenda H. Morris, Margaret L. Poundstone, Stacy Reddoch, Saba Siddiki, Patti L. Pierce Tate, Sharon L. Wright, Bradley A. Yoder, Roger G. Faix, Shawna Baker, Karie Bird, Anna E. Bullwinkle, Jill Burnett, Laura Cole, Karen A. Osborne, Cynthia Spencer, R. Edison Steele, Michael Steffen, Kimberlee Weaver-Lewis, T. Michael O'Shea, Robert G. Dillard, Lisa K. Washburn, Nancy J. Peters, Barbara G. Jackson, Korinne Chiu, Deborah Evans Allred, Donald J. Goldstein, Raquel Halfond, Carroll Peterson, Ellen L. Waldrep, Cherrie D. Welch, Melissa Whalen Morris, Gail Wiley Hounshell, Seetha Shankaran, Beena G. Sood, Thomas L. Slovis, Athina Pappas, Rebecca Bara, Elizabeth Billian, Laura A. Goldston, and Mary Johnson

Subjects
Male, Pediatrics, medicine.medical_specialty, Ultrasonography, Doppler, Transcranial, Neuroimaging, Neuropsychological Tests, Bayley Scales of Infant Development, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Child Development, Cerebellar Diseases, 030225 pediatrics, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Competence (human resources), business.industry, Brain, Infant, Cognition, Child development, Magnetic Resonance Imaging, Language development, Neurodevelopmental Disorders, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Female, business, Cohort study
Abstract

Objective To investigate associations in toddlers born extremely preterm ( Study design Cohort analysis from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Surfactant Positive Airway Pressure and Pulse Oximetry Trial Neuroimaging and Neurodevelopmental Outcomes Study of infants born extremely preterm. Subjects underwent cranial ultrasonography and near-term magnetic resonance imaging (MRI). At 18-22 months of corrected age, the assessment included the Brief Infant Toddler Social Emotional Assessment (BITSEA) Problem and Competence Scale scores and the Bayley Scales of Infant Development, Third Edition (Bayley-III). The BITSEA Problem Scale assesses dysregulation; the Competence Scale assesses social-emotional competence. We examined associations of Problem and Competence scores and positive screen rates with cranial ultrasonography and near-term MRI. Mean BITSEA and Bayley-III scores were compared using ANOVA and positive screen rates with the χ2 test. We computed correlations between BITSEA and Bayley-III scores. Results Of the 397 children, positive BITSEA screens were found in 34% for the Problem score and 26% for the Competence score. Presence of lesions on near-term MRI that included cerebellar lesions were significantly associated with lower BITSEA Competence but not with Problem scores; Competence scores were inversely related to the presence/significance of lesions. Positive screens on Competence scores and on both Competence and Problem scores were significantly associated with Bayley-III cognitive and language scores Conclusions Social–emotional competence contributes to deficits in cognitive and language development. Presence of injury on near-term MRI that includes cerebellar lesions is associated with later social–emotional competence and may be a useful predictor to guide early assessment and intervention. Trial registration ClinicalTrials.gov : NCT00063063 and NCT00233324 .

Published
2018

2. Markers of Successful Extubation in Extremely Preterm Infants, and Morbidity After Failed Extubation

Author

Sanjay Chawla, Girija Natarajan, Seetha Shankaran, Benjamin Carper, Luc P. Brion, Martin Keszler, Waldemar A. Carlo, Namasivayam Ambalavanan, Marie G. Gantz, Abhik Das, Neil Finer, Ronald N. Goldberg, C. Michael Cotten, Rosemary D. Higgins, Alan H. Jobe, Michael S. Caplan, Richard A. Polin, Abbot R. Laptook, William Oh, Angelita M. Hensman, Dan Gingras, Susan Barnett, Sarah Lillie, Kim Francis, Dawn Andrews, Kristen Angela, Michele C. Walsh, Avroy A. Fanaroff, Nancy S. Newman, Bonnie S. Siner, Kurt Schibler, Edward F. Donovan, Vivek Narendran, Kate Bridges, Barbara Alexander, Cathy Grisby, Marcia Worley Mersmann, Holly L. Mincey, Jody Hessling, Kathy J. Auten, Kimberly A. Fisher, Katherine A. Foy, Gloria Siaw, Barbara J. Stoll, Susie Buchter, Anthony Piazza, David P. Carlton, Ellen C. Hale, Stephanie Wilson Archer, Brenda B. Poindexter, James A. Lemons, Faithe Hamer, Dianne E. Herron, Lucy C. Miller, Leslie D. Wilson, Mary Anne Berberich, Carol J. Blaisdell, Dorothy B. Gail, James P. Kiley, W. Kenneth Poole, Margaret Cunningham, Betty K. Hastings, Amanda R. Irene, Jeanette O'Donnell Auman, Carolyn Petrie Huitema, James W. Pickett, Dennis Wallace, Kristin M. Zaterka-Baxter, Krisa P. Van Meurs, David K. Stevenson, M. Bethany Ball, Melinda S. Proud, Ivan D. Frantz, John M. Fiascone, Anne Furey, Brenda L. MacKinnon, Ellen Nylen, Monica V. Collins, Shirley S. Cosby, Vivien A. Phillips, Maynard R. Rasmussen, Paul R. Wozniak, Wade Rich, Kathy Arnell, Renee Bridge, Clarence Demetrio, Edward F. Bell, John A. Widness, Jonathan M. Klein, Karen J. Johnson, Shahnaz Duara, Ruth Everett-Thomas, Kristi L. Watterberg, Robin K. Ohls, Julie Rohr, Conra Backstrom Lacy, Dale L. Phelps, Nirupama Laroia, Linda J. Reubens, Erica Burnell, Pablo J. Sánchez, Charles R. Rosenfeld, Walid A. Salhab, James Allen, Alicia Guzman, Gaynelle Hensley, Melissa H. Lepps, Melissa Martin, Nancy A. Miller, Araceli Solis, Diana M. Vasil, Kerry Wilder, Kathleen A. Kennedy, Jon E. Tyson, Brenda H. Morris, Beverly Foley Harris, Anna E. Lis, Sarah Martin, Georgia E. McDavid, Patti L. Tate, Sharon L. Wright, Bradley A. Yoder, Roger G. Faix, Jill Burnett, Jennifer J. Jensen, Karen A. Osborne, Cynthia Spencer, Kimberlee Weaver-Lewis, T. Michael O'Shea, Nancy J. Peters, Beena G. Sood, Rebecca Bara, Elizabeth Billian, Mary Johnson, Richard A. Ehrenkranz, Harris C. Jacobs, Vineet Bhandari, Pat Cervone, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, and Janet Taft

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Positive pressure, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, 030225 pediatrics, Fraction of inspired oxygen, medicine, Intubation, Humans, 030212 general & internal medicine, Continuous positive airway pressure, Treatment Failure, Respiratory Distress Syndrome, Newborn, business.industry, Infant, Newborn, Gestational age, Pulmonary Surfactants, medicine.disease, Surgery, Bronchopulmonary dysplasia, Anesthesia, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Airway Extubation, Apgar score, Female, Morbidity, business, Infant, Premature
Abstract

Objectives To identify variables associated with successful elective extubation, and to determine neonatal morbidities associated with extubation failure in extremely preterm neonates. Study design This study was a secondary analysis of the National Institute of Child Health and Human Development Neonatal Research Network's Surfactant, Positive Pressure, and Oxygenation Randomized Trial that included extremely preterm infants born at 240/7 to 276/7 weeks' gestation. Patients were randomized either to a permissive ventilatory strategy (continuous positive airway pressure group) or intubation followed by early surfactant (surfactant group). There were prespecified intubation and extubation criteria. Extubation failure was defined as reintubation within 5 days of extubation. Results Of 1316 infants in the trial, 1071 were eligible; 926 infants had data available on extubation status; 538 were successful and 388 failed extubation. The rate of successful extubation was 50% (188/374) in the continuous positive airway pressure group and 63% (350/552) in the surfactant group. Successful extubation was associated with higher 5-minute Apgar score, and pH prior to extubation, lower peak fraction of inspired oxygen within the first 24 hours of age and prior to extubation, lower partial pressure of carbon dioxide prior to extubation, and non-small for gestational age status after adjustment for the randomization group assignment. Infants who failed extubation had higher adjusted rates of mortality (OR 2.89), bronchopulmonary dysplasia (OR 3.06), and death/ bronchopulmonary dysplasia (OR 3.27). Conclusions Higher 5-minute Apgar score, and pH prior to extubation, lower peak fraction of inspired oxygen within first 24 hours of age, lower partial pressure of carbon dioxide and fraction of inspired oxygen prior to extubation, and nonsmall for gestational age status were associated with successful extubation. Failed extubation was associated with significantly higher likelihood of mortality and morbidities. Trial registration ClinicalTrials.gov : NCT00233324 .

Published
2017

3. Blood Cytokine Profiles Associated with Distinct Patterns of Bronchopulmonary Dysplasia among Extremely Low Birth Weight Infants

Author

Carl T. D'Angio, Namasivayam Ambalavanan, Waldemar A. Carlo, Scott A. McDonald, Kristin Skogstrand, David M. Hougaard, Seetha Shankaran, Ronald N. Goldberg, Richard A. Ehrenkranz, Jon E. Tyson, Barbara J. Stoll, Abhik Das, Rosemary D. Higgins, Alan H. Jobe, Abbot R. Laptook, William Oh, Lewis P. Rubin, Angelita M. Hensman, Avroy A. Fanaroff, Michele C. Walsh, Nancy S. Newman, Bonnie S. Siner, Edward F. Donovan, Vivek Narendran, Barbara Alexander, Cathy Grisby, Jody Hessling, Marcia Worley Mersmann, Holly L. Mincey, C. Michael Cotten, Kathy J. Auten, Ellen C. Hale, Linda L. Wright, Sumner J. Yaffe, Elizabeth M. McClure, Brenda B. Poindexter, James A. Lemons, Diana D. Appel, Dianne E. Herron, Leslie D. Wilson, W. Kenneth Poole, Betty K. Hastings, Kristin M. Zaterka-Baxter, Jeanette O'Donnell Auman, Scott E. Schaefer, David K. Stevenson, Krisa P. Van Meurs, M. Bethany Ball, Monica V. Collins, Shirley S. Cosby, Neil N. Finer, Maynard R. Rasmussen, David Kaegi, Kathy Arnell, Clarence Demetrio, Wade Rich, Charles R. Bauer, Shahnaz Duara, Ruth Everett-Thomas, Lu-Ann Papile, Conra Backstrom Lacy, Sheldon B. Korones, Henrietta S. Bada, Tina Hudson, Walid A. Salhab, Susie Madison, Kathleen A. Kennedy, Brenda H. Morris, Esther G. Akpa, Patty A. Cluff, Claudia I. Franco, Anna E. Lis, Georgia E. McDavid, Patti Pierce Tate, T. Michael O'Shea, Nancy J. Peters, G. Ganesh Konduri, Rebecca Bara, Geraldine Muran, Patricia Gettner, Monica Konstantino, and JoAnn Poulsen

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Gastroenterology, Article, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Internal medicine, mental disorders, medicine, Humans, 030212 general & internal medicine, Macrophage inflammatory protein, Bronchopulmonary Dysplasia, Respiratory Distress Syndrome, Newborn, biology, Respiratory distress, business.industry, C-reactive protein, Case-control study, Infant, Newborn, Oxygen Inhalation Therapy, medicine.disease, Pathophysiology, Low birth weight, Cytokine, Bronchopulmonary dysplasia, Infant, Extremely Low Birth Weight, Case-Control Studies, Pediatrics, Perinatology and Child Health, Immunology, biology.protein, Cytokines, Female, medicine.symptom, business, Infant, Premature
Abstract

Objective To explore differences in blood cytokine profiles among distinct bronchopulmonary dysplasia (BPD) patterns. Study design We evaluated blood spots collected from 943 infants born at ≤1000 g and surviving to 28 days on postnatal days 1, 3, 7, 14, and 21 for 25 cytokines. Infants were assigned to the following lung disease patterns: (1) no lung disease (NLD); (2) respiratory distress syndrome without BPD; (3) classic BPD (persistent exposure to supplemental oxygen until 28 days of age); or (4) atypical BPD (period without supplemental oxygen before 28 days). Median cytokine levels for infants with BPD were compared with the IQR of results among infants with NLD. Results The distribution of enrolled infants by group was as follows: 69 (NLD), 73 (respiratory distress syndrome), 381 (classic BPD), and 160 (atypical BPD). The remaining 260 infants could not be classified because of missing data (104) or not fitting a predefined pattern (156). Median levels of 3 cytokines (elevated interleukin [IL]-8, matrix metalloproteinase-9; decreased granulocyte macrophage colony-stimulating factor) fell outside the IQR for at least 2 time points in both infants with atypical and classic BPD. Profiles of 7 cytokines (IL-6, IL-10, IL-18, macrophage inflammatory protein-1α, C-reactive protein, brain-derived neurotrophic factor, regulated on activation, normal T cell expressed and secreted) differed between infants with classic and atypical BPD. Conclusions Blood cytokine profiles may differ between infants developing classic and atypical BPD. These dissimilarities suggest the possibility that differing mechanisms could explain the varied patterns of pathophysiology of lung disease in extremely premature infants.

Published
2016

4. Outcome of Preterm Infants with Transient Cystic Periventricular Leukomalacia on Serial Cranial Imaging Up to Term Equivalent Age

Author

Subrata Sarkar, Seetha Shankaran, John Barks, Barbara T. Do, Abbot R. Laptook, Abhik Das, Namasivayam Ambalavanan, Krisa P. Van Meurs, Edward F. Bell, Pablo J. Sanchez, Susan R. Hintz, Myra H. Wyckoff, Barbara J. Stoll, Waldemar A. Carlo, Alan H. Jobe, Michael S. Caplan, Richard A. Polin, Martin Keszler, William Oh, Betty R. Vohr, Angelita M. Hensman, Barbara Alksninis, Kristin M. Basso, Robert Burke, Melinda Caskey, Katharine Johnson, Mary Lenore Keszler, Andrea M. Knoll, Theresa M. Leach, Emilee Little, Elisabeth C. McGowan, Elisa Vieira, Victoria E. Watson, Suzy Ventura, Michele C. Walsh, Avroy A. Fanaroff, Anna Marie Hibbs, Deanne E. Wilson-Costello, Nancy S. Newman, Allison H. Payne, Bonnie S. Siner, Monika Bhola, Gulgun Yalcinkaya, Harriet G. Friedman, William E. Truog, Eugenia K. Pallotto, Howard W. Kilbride, Cheri Gauldin, Anne Holmes, Kathy Johnson, Allison Knutson, Kurt Schibler, Edward F. Donovan, Cathy Grisby, Kate Bridges, Barbara Alexander, Estelle E. Fischer, Holly L. Mincey, Jody Hessling, Teresa L. Gratton, Lenora Jackson, Kristin Kirker, Greg Muthig, Jean J. Steichen, Stacey Tepe, Marcia Worley Mersmann, Kimberly Yolton, Ronald N. Goldberg, C. Michael Cotten, Ricki F. Goldstein, Patricia L. Ashley, William F. Malcolm, Kathy J. Auten, Kimberley A. Fisher, Sandra Grimes, Kathryn E. Gustafson, Melody B. Lohmeyer, Joanne Finkle, Matthew M. Laughon, Carl L. Bose, Janice Bernhardt, Gennie Bose, Diane Warner, Janice Wereszczak, David P. Carlton, Ira Adams-Chapman, Ellen C. Hale, Yvonne Loggins, Ann M. Blackwelder, Diane I. Bottcher, Colleen Mackie, Rosemary D. Higgins, Stephanie Wilson Archer, Gregory M. Sokol, Brenda B. Poindexter, James A. Lemons, Anna M. Dusick, Lu-Ann Papile, Carolyn Lytle, Abbey C. Hines, Heike M. Minnich, Dianne E. Herron, Lucy Smiley, Susan Gunn, Leslie Dawn Wilson, Kathleen A. Kennedy, Jon E. Tyson, Georgia E. McDavid, Esther G. Akpa, Julie Arldt-McAlister, Nora I. Alaniz, Katrina Burson, Pamela J. Bradt, Susan Dieterich, Allison Dempsey, Andrea F. Duncan, Patricia W. Evans, Claudia I. Franco, Carmen Garcia, Charles Green, Beverly Foley Harris, Margarita Jiminez, Janice John, Patrick M. Jones, Layne M. Lillie, Anna E. Lis, Terri Major-Kincade, Karen Martin, Sara C. Martin, Brenda H. Morris, Patricia Ann Orekoya, Stacey Reddoch, Shawna Rodgers, Saba Siddiki, Maegan C. Simmons, Daniel Sperry, Patti L. Pierce Tate, Laura L. Whitely, Sharon L. Wright, Leif D. Nelin, Sudarshan R. Jadcherla, Patricia Luzader, Christine A. Fortney, Gail E. Besner, Nehal A. Parikh, Dennis Wallace, Marie G. Gantz, W. Kenneth Poole, Margaret M. Crawford, Jenna Gabrio, Betty K. Hastings, Jamie E. Newman, Jeanette O'Donnell Auman, Carolyn M. Petrie Huitema, Kristin M. Zaterka-Baxter, David K. Stevenson, M. Bethany Ball, Marian M. Adams, Alexis S. Davis, Andrew W. Palmquist, Melinda S. Proud, Barbara Bentley, Elizabeth Bruno, Maria Elena DeAnda, Anne M. DeBattista, Beth Earhart, Lynne C. Huffman, Jean G. Kohn, Casey Krueger, Hali E. Weiss, Ivan D. Frantz, John M. Fiascone, Brenda L. MacKinnon, Anne Furey, Ellen Nylen, Myriam Peralta-Carcelen, Monica V. Collins, Shirley S. Cosby, Fred J. Biasini, Kristen C. Johnston, Kathleen G. Nelson, Cryshelle S. Patterson, Vivien A. Phillips, Sally Whitley, Uday Devaskar, Meena Garg, Isabell B. Purdy, Teresa Chanlaw, Rachel Geller, Neil N. Finer, David Kaegi, Maynard R. Rasmussen, Paul R. Wozniak, Kathy Arnell, Clarence Demetrio, Martha G. Fuller, Chris Henderson, Wade Rich, Yvonne E. Vaucher, Tarah T. Colaizy, Michael J. Acarregui, Jane E. Brumbaugh, Dan L. Ellsbury, John A. Widness, Karen J. Johnson, Donia B. Campbell, Diane L. Eastman, Nancy J. Krutzfield, Shahnaz Duara, Charles R. Bauer, Ruth Everett-Thomas, Sylvia Fajardo-Hiriart, Arielle Rigaud, Maria Calejo, Silvia M. Frade Eguaras, Michelle Harwood Berkowits, Andrea Garcia, Helina Pierre, Alexandra Stoerger, Kristi L. Watterberg, Jean R. Lowe, Tara Dupont, Janell F. Fuller, Robin K. Ohls, Conra Backstrom Lacy, Rebecca Montman, Barbara Schmidt, Haresh Kirpalani, Sara B. DeMauro, Aasma S. Chaudhary, Soraya Abbasi, Toni Mancini, Dara M. Cucinotta, Judy C. Bernbaum, Marsha Gerdes, Hallam Hurt, Noah Cook, Carl T. D'Angio, Dale L. Phelps, Ronnie Guillet, Satyan Lakshminrusimha, Julie Babish Johnson, Erica Burnell, Linda J. Reubens, Cassandra A. Horihan, Rosemary L. Jensen, Emily Kushner, Joan Merzbach, Gary J. Myers, Mary Rowan, Holly I.M. Wadkins, Anne Marie Scorsone, Melissa Bowman, Julianne Hunn, Stephanie Guilford, Deanna Maffett, Osman Farooq, Diane Prinzing, Anne Marie Reynolds, Michael G. Sacilowski, Ashley Williams, Karen Wynn, Kelley Yost, William Zorn, Lauren Zwetsch, Luc P. Brion, R. Sue Broyles, Roy J. Heyne, Merle Ipson, Walid A. Salhab, Charles R. Rosenfeld, Diana M. Vasil, Lijun Chen, Alicia Guzman, Gaynelle Hensley, Jackie F. Hickman, Melissa H. Leps, Susie Madison, Nancy A. Miller, Janet S. Morgan, Lara Pavageau, Sally S. Adams, Cristin Dooley, Elizabeth T. Heyne, Lizette E. Lee, Linda A. Madden, Catherine Twell Boatman, Roger G. Faix, Bradley A. Yoder, Karen A. Osborne, Cynthia Spencer, Kimberlee Weaver-Lewis, Shawna Baker, Karie Bird, Jill Burnett, Michael Steffen, Jennifer J. Jensen, Sarah Winter, Karen Zanetti, T. Michael O'Shea, Robert G. Dillard, Lisa K. Washburn, Barbara G. Jackson, Nancy J. Peters, Korinne Chiu, Deborah Evans Allred, Donald J. Goldstein, Raquel Halfond, Carroll Peterson, Ellen L. Waldrep, Cherrie D. Welch, Melissa Whalen Morris, Gail Wiley Hounshell, Athina Pappas, Rebecca Bara, Laura A. Goldston, Geraldine Muran, Girija Natarajan, Mary Christensen, Stephanie A. Wiggins, Diane White, Richard A. Ehrenkranz, Harris Jacobs, Christine G. Butler, Patricia Cervone, Patricia Gettner, Sheila Greisman, Monica Konstantino, JoAnn Poulsen, Elaine Romano, Janet Taft, and Joanne Williams

Subjects
Male, congenital, hereditary, and neonatal diseases and abnormalities, Pediatrics, medicine.medical_specialty, Adverse outcomes, Developmental Disabilities, Leukomalacia, Periventricular, Gestational Age, Article, 03 medical and health sciences, Neonatal Screening, 0302 clinical medicine, Risk Factors, 030225 pediatrics, medicine, Humans, Prospective Studies, cardiovascular diseases, reproductive and urinary physiology, Ultrasonography, business.industry, Term equivalent age, Infant, Newborn, Brain, Infant, Cystic Periventricular Leukomalacia, nervous system diseases, Logistic Models, Increased risk, nervous system, Case-Control Studies, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Gestation, Female, business, 030217 neurology & neurosurgery
Abstract

OBJECTIVE: To determine the outcome of preterm infants whose cystic periventricular leukomalacia “disappeared” on serial screening cranial imaging studies. STUDY DESIGN: Infants ≤26 weeks of gestation born between 2002 and 2012 who had cranial imaging studies at least twice, the most abnormal study at

Published
2018

5. Immunogenicity of Haemophilus influenzae Type b Protein Conjugate Vaccines in Very Low Birth Weight Infants

Author

Carl T, D'Angio, Theresa E, Murray, Lei, Li, Roy J, Heyne, T Michael, O'Shea, Robert L, Schelonka, Seetha, Shankaran, Shahnaz, Duara, Ronald N, Goldberg, Barbara J, Stoll, David K, Stevenson, Betty R, Vohr, Dale L, Phelps, Waldemar A, Carlo, Michael E, Pichichero, Abhik, Das, Rosemary D, Higgins, and Nancy J, Peters

Subjects
Male, Microbiology (medical), Haemophilus Infections, Haemophilus influenzae type, Gestational Age, Article, Humans, Infant, Very Low Birth Weight, Medicine, Haemophilus Vaccines, Vaccines, Conjugate, biology, business.industry, Extramural, Immunogenicity, Haemophilus influenzae type b, Infant, Gestational age, Antibodies, Bacterial, Low birth weight, Infectious Diseases, Pediatrics, Perinatology and Child Health, Immunology, biology.protein, Female, Antibody, medicine.symptom, business, Conjugate
Published
2013

6. Could a process improvement program improve your quality assurance?

Author

Judith Cox and Nancy J. Peters

Subjects
Quality Assurance, Health Care, business.industry, Computer science, Cost-Benefit Analysis, Process improvement, Quality control, General Medicine, Nursing Staff, Hospital, Leadership, Engineering management, Concurrent Review, Outcome and Process Assessment, Health Care, Cost Savings, Patient Satisfaction, QA/QC, Practice Guidelines as Topic, General Health Professions, Humans, business, Goals, Quality assurance, Program assurance, Needs Assessment, Nursing Assessment, Quality Indicators, Health Care
Published
2000

7. Using implementation facilitation to implement primary care mental health integration via clinical video telehealth in rural clinics: protocol for a hybrid type 2 cluster randomized stepped-wedge design

Author

Richard R. Owen, Eva N. Woodward, Karen L. Drummond, Tisha L. Deen, Karen Anderson Oliver, Nancy J. Petersen, Scott S. Meit, John C. Fortney, and JoAnn E. Kirchner

Subjects
Facilitation, Implementation, Primary care mental health integration, Integrated primary care, Rural veterans, Stepped-wedge design, Medicine (General), R5-920
Abstract

Abstract Background Integrating mental health providers into primary care clinics improves access to and outcomes of mental health care. In the Veterans Health Administration (VA) Primary Care Mental Health Integration (PCMHI) program, mental health providers are co-located in primary care clinics, but the implementation of this model is challenging outside large VA medical centers, especially for rural clinics without full mental health staffing. Long wait times for mental health care, little collaboration between mental health and primary care providers, and sub-optimal outcomes for rural veterans could result. Telehealth could be used to provide PCMHI to rural clinics; however, the clinical effectiveness of the tele-PCMHI model has not been tested. Based on evidence that implementation facilitation is an effective implementation strategy to increase uptake of PCMHI when delivered on-site at larger VA clinics, it is hypothesized that this strategy may also be effective with regard to ensuring adequate uptake of the tele-PCMHI model at rural VA clinics. Methods This study is a hybrid type 2 pragmatic effectiveness-implementation trial of tele-PCMHI in six sites over 24 months. Tele-PCMHI, which will be delivered by clinical staff available in routine care settings, will be compared to usual care. Fidelity to the care model will be monitored but not controlled. We will use the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework to evaluate the patient-level clinical effectiveness of tele-PCMHI in rural VA clinics and also to evaluate the fidelity to and outcomes of the implementation strategy, implementation facilitation. The proposed study will employ a stepped-wedge design in which study sites sequentially begin implementation in three steps at 6-month intervals. Each step will include (1) a 6-month period of implementation planning, followed by (2) a 6-month period of active implementation, and (3) a final period of stepped-down implementation facilitation. Discussion This study will evaluate the effectiveness of PCMHI in a novel setting and via a novel method (clinical video telehealth). We will test the feasibility of using implementation facilitation as an implementation strategy to deploy tele-PCMHI in rural VA clinics. Trial registration ClinicalTrials.gov registration number NCT02713217. Registered on 18 March 2016

Published
2019
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8. Protocol to disseminate a hospital-site controlled intervention using audit and feedback to implement guidelines concerning inappropriate treatment of asymptomatic bacteriuria

Author

Barbara W. Trautner, Pooja Prasad, Larissa Grigoryan, Sylvia J. Hysong, Jennifer R. Kramer, Suja Rajan, Nancy J. Petersen, Tracey Rosen, Dimitri M. Drekonja, Christopher Graber, Payal Patel, Paola Lichtenberger, Timothy P. Gauthier, Steve Wiseman, Makoto Jones, Anne Sales, Sarah Krein, Aanand Dinkar Naik, and The Less is More Study Group

Subjects
Antibiotic stewardship, Asymptomatic bacteriuria, Audit and feedback, Guidelines implementation, Dissemination, Urinary tract infection, Medicine (General), R5-920
Abstract

Abstract Background Antimicrobial stewardship to combat the spread of antibiotic-resistant bacteria has become a national priority. This project focuses on reducing inappropriate use of antimicrobials for asymptomatic bacteriuria (ASB), a very common condition that leads to antimicrobial overuse in acute and long-term care. We previously conducted a successful intervention, entitled “Kicking Catheter Associated Urinary Tract Infection (CAUTI): the No Knee-Jerk Antibiotics Campaign,” to decrease guideline-discordant ordering of urine cultures and antibiotics for ASB. The current objective is to facilitate implementation of a scalable version of the Kicking CAUTI campaign across four geographically diverse Veterans Health Administration facilities while assessing what aspects of an antimicrobial stewardship intervention are essential to success and sustainability. Methods This project uses an interrupted time series design with four control sites. The two main intervention tools are (1) an evidence-based algorithm that distills the guidelines into a streamlined clinical pathway and (2) case-based audit and feedback to train clinicians to use the algorithm. Our conceptual framework for the development and implementation of this intervention draws on May’s General Theory of Implementation. The intervention is directed at providers in acute and long-term care, and the goal is to reduce inappropriate screening for and treatment of ASB in all patients and residents, not just those with urinary catheters. The start-up for each facility consists of centrally-led phone calls with local site champions and baseline surveys. Case-based audit and feedback will begin at a given site after the start-up period and continue for 12 months, followed by a sustainability assessment. In addition to the clinical outcomes, we will explore the relationship between the dose of the intervention and clinical outcomes. Discussion This project moves from a proof-of-concept effectiveness study to implementation involving significantly more sites, and uses the General Theory of Implementation to embed the intervention into normal processes of care with usual care providers. Aspects of implementation that will be explored include dissemination, internal and external facilitation, and organizational partnerships. “Less is More” is the natural next step from our prior successful Kicking CAUTI intervention, and has the potential to improve patient care while advancing the science of implementation.

Published
2018
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9. Implementation of Stroke Dysphagia Screening in the Emergency Department

Author

Stephanie K. Daniels, Jane A. Anderson, and Nancy J. Petersen

Subjects
Nursing, RT1-120
Abstract

Early detection of dysphagia is critical in stroke as it improves health care outcomes. Administering a swallowing screening tool (SST) in the emergency department (ED) appears most logical as it is the first point of patient contact. However, feasibility of an ED nurse-administered SST, particularly one involving trial water swallow administration, is unknown. The aims of this pilot study were to (1) implement an SST with a water swallow component in the ED and track nurses’ adherence, (2) identify barriers and facilitators to administering the SST through interviews, and (3) develop and implement a process improvement plan to address barriers. Two hundred seventy-eight individuals with stroke symptoms were screened from October 2009 to June 2010. The percentage of patients screened increased from 22.6 in October 2009 to a high of 80.8 in March 2010, followed by a decrease to 61.9% in June (Cochran-Armitage test z=-5.1042, P

Published
2013
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