A5085192486- Emergency and Acute Care Studies
- Pneumonia and Respiratory Infections
- Respiratory viral infections research
- Innovations in Medical Education
- Clinical Reasoning and Diagnostic Skills
- Ultrasound in Clinical Applications
- Streptococcal Infections and Treatments
- Advanced Radiotherapy Techniques
- Injury Epidemiology and Prevention
- Breast Cancer Treatment Studies
- Pleural and Pulmonary Diseases
- Radiology practices and education
- Smoking Behavior and Cessation
- Simulation-Based Education in Healthcare
- Corneal Surgery and Treatments
- Bacterial Identification and Susceptibility Testing
- Cardiac Valve Diseases and Treatments
- Nursing education and management
- Radiation Dose and Imaging
- Ocular and Laser Science Research
- Healthcare Systems and Practices
- Dysphagia Assessment and Management
- Ocular Disorders and Treatments
- Amoebic Infections and Treatments
- Gastroesophageal reflux and treatments
Harvard University
2016-2025
Boston Children's Hospital
2015-2025
University of Nebraska at Omaha
2020
John Wiley & Sons (United Kingdom)
2020
Boston Medical Center
2011-2017
Centre Hospitalier de Gonesse
2009-2010
La Ligue Contre le Cancer
2005
Digital Research Alliance of Canada
2002
BACKGROUND AND OBJECTIVES: The impact of the coronavirus disease 2019 (COVID-19) pandemic on pediatric emergency department (ED) visits is not well characterized. We aimed to describe epidemiology ED and resource use during pandemic. METHODS: conducted a cross-sectional study using Pediatric Health Information System for 27 US children’s hospitals COVID-19 period (March 15, 2020, August 31, 2020) 3-year comparator 15 2017–2019). visit rates, patient characteristics, use, charges were...
The following recommendations on the treatment of tobacco dependence have been written as an initiative World Health Organization European Partnership Project to Reduce Tobacco Dependence.
OBJECTIVES: Unlike community-acquired pneumonia (CAP), there is a paucity of data characterizing the patient demographics and hospitalization characteristics children with aspiration pneumonia. We used large national database US children’s hospitals to assess associated compared these patients CAP. METHODS: identified hospitalized diagnosis or CAP at 47 included in Pediatric Health Information System between 2009 2014. evaluated whether differences exist (median age proportion complex...
OBJECTIVES To describe the epidemiology of pediatric injury-related visits to children’s hospital emergency departments (EDs) in United States during early and later periods severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. METHODS We conducted a cross-sectional study using Pediatric Health Information System, an administrative database identify ED at 41 hospitals SARS-CoV-2 pandemic period (March 15, 2020 March 14, 2021) 3 year comparator 15–March 2017–2020). For these...
The diagnosis of pneumonia in children is challenging, given the wide overlap many symptoms and physical examination findings with other common respiratory illnesses. We sought to derive validate novel Pneumonia Risk Score (PRS), a clinical tool utilizing signs available clinicians determine child's risk radiographic pneumonia.We prospectively enrolled 3 months 18 years whom chest radiograph (CXR) was obtained emergency department evaluate for pneumonia. Before CXR, we collected information...
Objective Entrustment describes the balance of supervision and autonomy between resident preceptor to complete doctoring tasks like procedures. alignment facilitates safe, successful outcomes, promotes learning. Study objectives describe procedural entrustment senior pediatric residents their preceptors report impact a simulation-based formative assessment (SFA) on alignment. Methods This prospective observational study enrolled convenience sample in 2023. The SFA was videoed, consisted...
This retrospective cohort study across 77 pediatric practices in Massachusetts assessed the frequency of CXR utilization among children with pneumonia diagnosed primary care setting and determined whether was associated differences antibiotic treatment outcomes. Multivariable logistic regression used to evaluate association between performance future clinic revisit, performance, change, a composite failure outcome, adjusting for markers illness severity. Among 29 528 treated pneumonia, 2462...
BACKGROUND Although chest radiograph (CXR) is frequently used to diagnose pneumonia, there concern that radiographic findings may lag clinical findings, raising doubt around the reliance on CXR. This study sought determine percentage of children develop pneumonia after an initially normal CXR, and describe characteristics these patients. METHODS a retrospective cohort in large tertiary pediatric emergency department (ED) over 10-year period. Children younger than 21 years age with suspected...
OBJECTIVES Clinicians often use the presence of auscultatory crackles to guide antibiotic treatment for pneumonia, despite evidence that do not strongly predict pediatric pneumonia. We evaluated association with both clinician-diagnosed pneumonia and radiographic hypothesized physicians would overestimate prevalence in children focal crackles. METHODS performed a prospective cohort study 3 months-18 years old undergoing chest radiography evaluate an urban tertiary-care emergency department....
To assess the characteristics of children hospitalized with complicated pneumonia at US children's hospitals and compare these those community-acquired (CAP).We identified (parapneumonic effusion, empyema, necrotizing pneumonia, or lung abscess) CAP across 34 between 2011 2019. We evaluated differences in patient characteristics, antibiotic selection, outcomes CAP. We, also, assessed seasonal variability frequency 2 conditions prevalence over 9-year study period.Compared (n = 75 702), 6402)...
Prescription errors are a significant cause of iatrogenic harm in the health care system. Pediatric emergency department (ED) patients particularly vulnerable to error. We sought decrease prescription an academic pediatric ED by 20% over 24-month period implementing identified national best practice guidelines.From 2017 2019, multidisciplinary, fellow-driven quality improvement (QI) project was conducted using Model for Improvement. Four key drivers were including simplifying electronic...
Pediatric requirements include procedural skills training such as peripheral intravenous (PIV) catheter placement and bag-mask ventilation (BMV). Clinical experiences may be limited temporally remote from scheduled teaching. Just-in-time (JIT) prior to utilization can promote skill development mitigate learning decay. Our objective was assess the impact of JIT on pediatric residents' performance, knowledge, confidence with PIV BMV.
This cohort study assesses radiographic evidence of pneumonia and antibiotic use in children with clinically suspected community-acquired pneumonia.
SUMMARY Background Deliberate practice facilitates skill mastery. We aimed to create a novel resident‐as‐teacher rotation, leveraging deliberate framework with repeated in real‐life teaching settings, feedback from dedicated faculty member coaches. Methods A rotation was designed for 35 Postgraduate Year‐2 ( PGY 2) paediatric residents. To facilitate practice, experiences were observed by coaches and different audiences. Participating residents received pre‐rotation, post‐rotation follow‐up...
Abstract Background The practice of emergency medicine has become increasingly complex. Constant advances in clinical practice, innovative technologies, patient safety and quality initiatives, local national policy changes continue to add the cognitive load on providers. New professional development approaches are needed help providers remain current despite busy disparate clinician schedules. Methods We used a Web‐based, spaced education platform, distribute questions faculty fellows within...
BACKGROUND Current guidelines and recent studies on pediatric pneumonia pertain to children older than 3 months of age. Little information exists regarding the diagnostic evaluation, management, outcomes infants less 90 days with pneumonia. METHODS We compared <90 age diagnosed across 38 US children’s hospitals from 2016 2021 5 years evaluated whether differences exist in patient characteristics, testing, antibiotic treatment, between young children. Additionally, we assessed seasonal...
Chest radiograph (CXR) is routinely performed among children with suspected pneumonia, though it not clear how specific radiographic findings impact antibiotic treatment for pneumonia. We evaluated the of viral features on undergoing pneumonia evaluation in emergency department (ED).Children presenting to a pediatric ED who underwent CXR were prospectively enrolled. Prior performance, physicians indicated their level suspicion The report was reviewed assess presence (peribronchial cuffing,...