Letter To The Editor

The experience of Drs Kilbride and Daily concerning the survival and morbidity of infants with birth weights less than 800 g appears to be very similar to our own. Their reported survival between 1980 and 1990 for infants between 701 and 700 g birth weight demonstrates the identical improvement over time which we describe down to at least 500 g. Most of the increased survival at the University of Washington attributable to surfactant therapy has occurred after 1990.

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Survival ≤ 800 Grams!?

PEDIATRICS ◽

10.1542/peds.98.2.316 ◽

1996 ◽

Vol 98 (2) ◽

pp. 316-317

Author(s):

Howard W. Kilbride ◽

Donna K. Daily

Keyword(s):

Birth Weight ◽

University Of Washington ◽

Population Demographics ◽

Attitude Changes ◽

The University ◽

Stable Outcome ◽

Over Time

La Pine et al1 report improved survival and stable outcome for ≤800-g birth weight infants born 1977 through 1990 at the University of Washington. The authors do not provide enough data determine if the greater survival was secondary to attitude changes, alteration of perinatal/neonatal practices, or variation population demographics over time. Although determining cause of improved survival was not the authors' intent, addressing these issues may assist the reader in determining if the University of Washington experience is generalizable to other centers.

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1523: How We Learn Resection Skills: Analysis of Data from the University of Washington Turp Simulator

The Journal of Urology ◽

10.1016/s0022-5347(18)38731-7 ◽

2004 ◽

Vol 171 (4S) ◽

pp. 401-401

Author(s):

Robert M. Sweet ◽

Timothy Kowalewski ◽

Peter Oppenheimer ◽

Jeffrey Berkley ◽

Suzanne Weghorst ◽

...

Keyword(s):

University Of Washington ◽

The University

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MENTORING FEMALE ENGINEERING STUDENTS: A MODEL PROGRAM AT THE UNIVERSITY OF WASHINGTON

Journal of Women and Minorities in Science and Engineering ◽

10.1615/jwomenminorscieneng.v1.i2.30 ◽

1994 ◽

Vol 1 (2) ◽

pp. 123-135 ◽

Cited By ~ 9

Author(s):

Suzanne Gage Brainard ◽

L. Ailes-Sengers

Keyword(s):

Engineering Students ◽

Model Program ◽

University Of Washington ◽

The University

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Sex-Specific Long-Term Trends in Length of Hospital Stay, Postmenstrual Age at Discharge, and Survival in Very Low Birth Weight Infants

Neonatology ◽

10.1159/000515899 ◽

2021 ◽

pp. 1-9

Author(s):

Matthias Fröhlich ◽

Tatjana Tissen-Diabaté ◽

Christoph Bührer ◽

Stephanie Roll

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Hospital Stay ◽

Very Low Birth Weight ◽

Survival Rates ◽

Length Of Hospital Stay ◽

Mortality Rates ◽

Vlbw Infants ◽

Postmenstrual Age ◽

Over Time

Introduction: In very low birth weight (<1,500 g, VLBW) infants, morbidity and mortality have decreased substantially during the past decades, and both are known to be lower in girls than in boys. In this study, we assessed sex-specific changes over time in length of hospital stay (LOHS) and postmenstrual age at discharge (PAD), in addition to survival in VLBW infants. Methods: This is a single-center retrospective cohort analysis based on quality assurance data of VLBW infants born from 1978 to 2018. Estimation of sex-specific LOHS over time was based on infants discharged home from neonatal care or deceased. Estimation of sex-specific PAD over time was based on infants discharged home exclusively. Analysis of in-hospital survival was performed for all VLBW infants. Results: In 4,336 of 4,499 VLBW infants admitted from 1978 to 2018 with complete data (96.4%), survival rates improved between 1978–1982 and 1993–1997 (70.8 vs. 88.3%; hazard ratio (HR) 0.20, 95% confidence interval 0.14, 0.30) and remained stable thereafter. Boys had consistently higher mortality rates than girls (15 vs. 12%, HR 1.23 [1.05, 1.45]). Nonsurviving boys died later compared to nonsurviving girls (adjusted mean survival time 23.0 [18.0, 27.9] vs. 20.7 [15.0, 26.3] days). LOHS and PAD assessed in 3,166 survivors displayed a continuous decrease over time (1978–1982 vs. 2013–2018: LOHS days 82.9 [79.3, 86.5] vs. 60.3 [58.4, 62.1] days); PAD 40.4 (39.9, 40.9) vs. 37.4 [37.1, 37.6] weeks). Girls had shorter LOHS than boys (69.4 [68.0, 70.8] vs. 73.0 [71.6, 74.4] days) and were discharged with lower PAD (38.6 [38.4, 38.8] vs. 39.2 [39.0, 39.4] weeks). Discussion/Conclusions: LOHS and PAD decreased over the last 40 years, while survival rates improved. Male sex was associated with longer LOHS, higher PAD, and higher mortality rates.

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Predictors of mortality in premature babies with respiratory distress syndrome treated by early rescue surfactant therapy

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-190244 ◽

2021 ◽

pp. 1-6

Author(s):

V. Gahlawat ◽

H. Chellani ◽

I. Saini ◽

S. Gupta

Keyword(s):

Mechanical Ventilation ◽

Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Surfactant Therapy ◽

Mask Ventilation ◽

Predictors Of Mortality ◽

Antenatal Steroid ◽

Bag And Mask Ventilation

OBJECTIVE: To determine the predictors of mortality following early rescue surfactant therapy in preterm babies with respiratory distress syndrome. STUDY DESIGN: Prospective cohort study enrolling babies between 28 weeks to 34 weeks with respiratory distress syndrome requiring early rescue surfactant therapy. For statistical analysis babies were further divided into two subgroups: survivors and non-survivors. Maternal and neonatal variables were compared between the two groups to find out the predictors of mortality. RESULTS: Out of total 110 babies, 72 (65.45%) survived. The mean birth weight and mean gestational age of the study population was 1614.36 (±487.86) g and 31.40 (±2.0)1 weeks, respectively. Birth weight < 1500 g, gestational age < 32 weeks, primiparity, vaginal delivery, prolonged rupture of membranes, lack of antenatal steroid cover, bag and mask ventilation at birth, sepsis, apneic episodes and mechanical ventilation were significantly associated with death on univariate analysis. On multivariate analysis, very low birth weight, vaginal delivery, lack of antenatal steroid cover, bag and mask ventilation at birth and mechanical ventilation were found to be independent predictors of mortality. CONCLUSIONS: Some of the identified predictors of mortality are modifiable and can be used to draw up a screening tool to predict the clinical severity and mortality among these babies.

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136. Don’t Sweat the Small Stuff: Solutions for Large-Scale Stewardship Obstacles

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.181 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S79-S80

Author(s):

Joanne Huang ◽

Zahra Kassamali Escobar ◽

Rupali Jain ◽

Jeannie D Chan ◽

John B Lynch ◽

...

Keyword(s):

Urgent Care ◽

Complex Data ◽

Open Communication ◽

University Of Washington ◽

Data Set ◽

Constructive Feedback ◽

Diagnostic Coding ◽

Icd 10 ◽

Tract Infections ◽

The University

Abstract Background In an effort to support stewardship endeavors, the MITIGATE (a Multifaceted Intervention to Improve Prescribing for Acute Respiratory Infection for Adult and Children in Emergency Department and Urgent Care Settings) Toolkit was published in 2018, aiming to reduce unnecessary antibiotics for viral respiratory tract infections (RTIs). At the University of Washington, we have incorporated strategies from this toolkit at our urgent care clinics. This study aims to address solutions to some of the challenges we experienced. Challenges and Solutions Methods This was a retrospective observational study conducted at Valley Medical Center (Sept 2019-Mar 2020) and the University of Washington (Jan 2019-Feb 2020) urgent care clinics. Patients were identified through ICD-10 diagnosis codes included in the MITIGATE toolkit. The primary outcome was identifying challenges and solutions developed during this process. Results We encountered five challenges during our roll-out of MITIGATE. First, using both ICD-9 and ICD-10 codes can lead to inaccurate data collection. Second, technical support for coding a complex data set is essential and should be accounted for prior to beginning stewardship interventions of this scale. Third, unintentional incorrect diagnosis selection was common and may require reeducation of prescribers on proper selection. Fourth, focusing on singular issues rather than multiple outcomes is more feasible and can offer several opportunities for stewardship interventions. Lastly, changing prescribing behavior can cause unintended tension during implementation. Modifying benchmarks measured, allowing for bi-directional feedback, and identifying provider champions can help maintain open communication. Conclusion Resources such as the MITIGATE toolkit are helpful to implement standardized data driven stewardship interventions. We have experienced some challenges including a complex data build, errors with diagnostic coding, providing constructive feedback while maintaining positive stewardship relationships, and choosing feasible outcomes to measure. We present solutions to these challenges with the aim to provide guidance to those who are considering using this toolkit for outpatient stewardship interventions. Disclosures All Authors: No reported disclosures

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Dating at the University of Washington

Marriage and Family Living ◽

10.2307/347293 ◽

1947 ◽

Vol 9 (2) ◽

pp. 30 ◽

Cited By ~ 2

Author(s):

Rayanne D. Cupps ◽

Norman S. Hayner

Keyword(s):

University Of Washington ◽

The University

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Correlating entrance data and first year academic performance of students enrolled in the Integrated Master in Mechanical Engineering at the University of Porto

International Journal of Mechanical Engineering Education ◽

10.1177/03064190211015650 ◽

2021 ◽

pp. 030641902110156

Author(s):

TMGP Duarte ◽

AM Lopes ◽

LFM da Silva

Keyword(s):

Academic Performance ◽

Secondary School ◽

Undergraduate Students ◽

Mechanical Engineering ◽

Institutional Factors ◽

First Year ◽

Female Type ◽

The University ◽

First Year University ◽

Over Time

Understanding how the academic performance of first year undergraduate students is influenced by home, personal and institutional factors is fundamental to delineate policies able to mitigate failure. This paper investigates possible correlations between the academic performance of students at the end of high school with their achievements at the end of first year university. Data for students in the Integrated Master in Mechanical Engineering (MIEM) program within the Faculty of Engineering at the University of Porto are analysed for the period 2016/2017 to 2019/2020. The students’ performance is measured by two metrics and the students are structured as a whole and by groups, according to their gender (Male/Female), type of secondary school (Public/Private), living place (Away/Home) and the rank of MIEM in their application list of options (Option 1/Option 2–6). The information is organized statistically and possible correlations between the data are investigated. The analysis reveals limited correlation between the two metrics, meaning that all students may exhibit good or poor results at the end of first year in MIEM, independent of their status at entrance. An unanticipated pattern is exhibited for the group Option 2–6, since it shows that, despite entering into MIEM without top application marks, the students in this group can perform as well as the others. This behavior is consistent over time.

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Finding the path of least resistance: Locally adapting the MITIGATE toolkit in emergency departments and urgent care centers

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1394 ◽

2021 ◽

pp. 1-3

Author(s):

Joanne Huang ◽

Zahra Kassamali Escobar ◽

Todd S. Bouchard ◽

Jose Mari G. Lansang ◽

Rupali Jain ◽

...

Keyword(s):

Primary Care ◽

Emergency Department ◽

Antimicrobial Stewardship ◽

Emergency Departments ◽

Urgent Care ◽

Complex Data ◽

University Of Washington ◽

Primary Care Clinics ◽

Urgent Care Centers ◽

The University

Abstract The MITIGATE toolkit was developed to assist urgent care and emergency departments in the development of antimicrobial stewardship programs. At the University of Washington, we adopted the MITIGATE toolkit in 10 urgent care centers, 9 primary care clinics, and 1 emergency department. We encountered and overcame challenges: a complex data build, choosing feasible outcomes to measure, issues with accurate coding, and maintaining positive stewardship relationships. Herein, we discuss solutions to challenges we encountered to provide guidance for those considering using this toolkit.

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