scholarly journals Taking the next step in publication productivity analysis in pediatric neurosurgery

2018 ◽  
Vol 21 (6) ◽  
pp. 655-665 ◽  
Author(s):  
Ryan P. Lee ◽  
Raymond Xu ◽  
Pooja Dave ◽  
Sonia Ajmera ◽  
Jock C. Lillard ◽  
...  
Keyword(s):  
Basic Science ◽  
Pediatric Neurosurgery ◽  
Faculty Members ◽  
Children's Hospital ◽  
Tier 1 ◽  
Children’S Hospital ◽  
Fellowship Programs ◽  
The Mean ◽  
Tier 3 ◽  
Number Of Citations

OBJECTIVEThere has been an increasing interest in the quantitative analysis of publishing within the field of neurosurgery at the individual, group, and institutional levels. The authors present an updated analysis of accredited pediatric neurosurgery training programs.METHODSAll 28 Accreditation Council for Pediatric Neurosurgery Fellowship programs were contacted for the names of pediatric neurosurgeons who were present each year from 2011 through 2015. Faculty names were queried in Scopus for publications and citations during this time period. The 5-year institutional Hirsch index [ih(5)-index] and revised 5-year institutional h-index [ir(5)-index] were calculated to rank programs. Each publication was reviewed to determine authorship value, tier of research, clinical versus basic science research, subject matter, and whether it was pediatrics-specific. A unique 3-tier article classification system was introduced to stratify clinical articles by quality and complexity, with tier 3 being the lowest tier of publication (e.g., case reports) and tier 1 being the highest (e.g., randomized controlled trials).RESULTSAmong 2060 unique publications, 1378 (67%) were pediatrics-specific. The pediatrics-specific articles had a mean of 15.2 citations per publication (median 6), whereas the non–pediatrics-specific articles had a mean of 23.0 citations per publication (median 8; p < 0.0001). For the 46% of papers that had a pediatric neurosurgeon as first or last author, the mean number of citations per publication was 12.1 (median 5.0) compared with 22.5 (median 8.0) for those in which a pediatric neurosurgeon was a middle author (p < 0.0001). Seventy-nine percent of articles were clinical research and 21% were basic science or translational research; however, basic science and translational articles had a mean of 36.9 citations per publication (median 15) compared with 12.6 for clinical publications (median 5.0; p < 0.0001). Among clinical articles, tier 1 papers had a mean of 15.0 citations per publication (median 8.0), tier 2 papers had a mean of 18.7 (median 8.0), and tier 3 papers had a mean of 7.8 (median 3.0). Neuro-oncology papers received the highest number of citations per publication (mean 25.7). The most common journal was the Journal of Neurosurgery: Pediatrics (20%). MD/PhD faculty members had significantly more citations per publication than MD faculty members (mean 26.7 vs 14.0; p < 0.0001) and also a higher number of publications per author (mean 38.6 vs 20.8). The median ih(5)- and ir(5)-indices per program were 14 (range 5–48) and 10 (range 5.6–37.2), respectively. The mean ir(5)/ih(5)-index ratio was 0.8. The top 5 fellowship programs (in descending order) as ranked by the ih(5)-index corrected for number of faculty members were The Hospital for Sick Children, Toronto; Children’s Hospital of Pittsburgh; University of California, San Francisco Benioff Children’s Hospital; Seattle Children’s Hospital; and St. Louis Children’s Hospital.CONCLUSIONSAbout two-thirds of publications authored by pediatric neurosurgeons are pediatrics-specific, although non–pediatrics-specific articles averaged more citations. Most of the articles authored by pediatric neurosurgeons are clinical, with basic and translational articles averaging more citations. Neurosurgeons with PhD degrees averaged more total publications and more citations per publication. In all, this is the most advanced and informative analysis of publication productivity in pediatric neurosurgery to date.

scholarly journals The Utility of Interaction Design as a Novel Tool to Improve Hand Hygiene Frequency on a Pediatric Hematology-Oncology Ward

2020 ◽  
Vol 41 (S1) ◽  
pp. s411-s411
Author(s):  
Johanna Blaak ◽  
Rachel DiMaio ◽  
Julia Kupis ◽  
Ross Sweetzir ◽  
Conny Betuzzi ◽  
...  
Keyword(s):  
Health Services ◽  
Hand Hygiene ◽  
Interaction Design ◽  
Qualitative Interviews ◽  
Cell Transplant ◽  
Children's Hospital ◽  
University Of Calgary ◽  
Children’S Hospital ◽  
The Mean ◽  
Alberta Health

Johanna Blaak, W21C, University of Calgary; Rachel DiMaio, University of Calgary; Julia Kupis, University of Calgary; Ross Sweetzir, Cisco Systems; Conny Betuzzi, Alberta Children’s Hospital, Alberta Health Services; Corey Dowler, Alberta Children’s Hospital, Alberta Health Services; Krista McIntytre, Alberta Children’s Hospital, Alberta Health Services; Jaime Kaufman, University of Calgary; Greg Hallihan, University of Calgary; John Conly, Foothills Medical Centre; Joseph Vayalumkal, Alberta Childrens HospitalBackground: Interaction design offers a novel interventional strategy to enhance hand-hygiene compliance (HHC) and reduce hospital-acquired infections (HAIs) in the pediatric setting. A quality improvement initiative in collaboration with the University of Calgary and Alberta Health Services led to the implementation of a pilot project with sensor-embedded alcohol -based hand rub (ABHR) dispensers at a hematology-oncology and hematopoietic stem cell transplant unit at Alberta Children’s Hospital (ACH). Methods: Internet of things (IoT) sensors were installed in ABHR dispensers (n = 3) on the unit. Usage data were transmitted to a local server using an MQTT messaging protocol for 16 weeks. Real-time data visualization was presented on a central display next to the nursing station with 11 unique pediatric themes including dinosaurs, transportation, and Canadian animals. Data were collected with and without visualization, and frequency of use (FoU) was determined for both periods. Qualitative interviews with unit stakeholders (n = 13) were held to determine perceptions of the intervention. Results: During the first 8 weeks of the study period, the mean daily use without visualization was 47 times (SD, 14.5) versus 99 times (SD, 23.9) with visualization. When accounting for novelty, by removing the first week of data, the mean daily use was 92 (SD 19.6). The percentage increase from period 1 to period 2 was 96.6%, accounting for novelty. Qualitative interviews with stakeholders (n = 13) on the unit indicated that the intervention increased their personal awareness of hand hygiene (75%) and acted as a constant reminder to perform hand hygiene for everyone on the unit including nonclinical staff, patients, and family members (92%). Conclusions: These limited data suggest that interaction design may improve HH frequency and show promise as a tool for increased HH awareness and education. Interaction design provides a unique, innovative, and acceptable hand hygiene improvement strategy for staff, patients, and families in the pediatric inpatient setting.Funding: NoneDisclosures: None

scholarly journals Pediatric neurosurgery at British Columbia’s Children’s Hospital

2015 ◽  
Vol 31 (9) ◽  
pp. 1419-1427 ◽  
Author(s):  
Paul Steinbok ◽  
Felix Durity ◽  
John Kestle ◽  
D. Douglas Cochrane
Keyword(s):  
Pediatric Neurosurgery ◽  
Children's Hospital ◽  
Children’S Hospital

Perceived benefits and barriers to a career in pediatric neurosurgery: a survey of neurosurgical residents

2013 ◽  
Vol 12 (5) ◽  
pp. 422-433 ◽  
Author(s):  
Mark S. Dias ◽  
Jeffrey S. Sussman ◽  
Susan Durham ◽  
Mark R. Iantosca
Keyword(s):  
Brain Injuries ◽  
Pediatric Neurosurgery ◽  
The United States ◽  
Fellowship Training ◽  
Web Based ◽  
Intrinsic Nature ◽  
Children's Hospital ◽  
Resident Perceptions ◽  
Children’S Hospital ◽  
Fast Healing

Object Research suggests that there may be a growing disparity between the supply of and demand for both pediatric specialists and neurosurgeons. Whether pediatric neurosurgeons are facing such a disparity is disputable, but interest in pediatric neurosurgery (PNS) has waxed and waned as evidenced by the number of applicants for PNS fellowships. The authors undertook a survey to analyze current neurosurgical residents' perceptions of both benefits and deterrents to a pediatric neurosurgical career. Methods All residents and PNS fellows in the United States and Canada during the academic year 2008–2009 were invited to complete a Web-based survey that assessed 1) demographic and educational information about residents and their residency training, particularly as it related to training in PNS; 2) residents' exposure to mentoring opportunities from pediatric neurosurgical faculty and their plans for the future; and 3) residents' perceptions about how likely 40 various factors were to influence their decision about whether to pursue a PNS career. Results Four hundred ninety-six responses were obtained: 89% of the respondents were male, 63% were married, 75% were in at least their 3rd year of postgraduate training, 61% trained in a children's hospital and 29% in a children's “hospital within a hospital,” and 72% were in programs having one or more dedicated PNS faculty members. The residencies of 56% of respondents offered 6–11 months of PNS training and nearly three-quarters of respondents had completed 2 months of PNS training. During medical school, 92% had been exposed to neurosurgery and 45% to PNS during a clinical rotation, but only 7% identified a PNS mentor. Nearly half (43%) are considering a PNS career, and of these, 61% are definitely or probably considering post-residency fellowship. On the other hand, 68% would prefer an enfolded fellowship during residency. Perceived strengths of PNS included working with children, developing lasting relationships, wider variety of operations, fast healing and lack of comorbidities, and altruism. Perceived significant deterrents included shunts, lower reimbursement, cross-coverage issues, higher malpractice premiums and greater legal exposure, and working with parents and pediatric health professionals. The intrinsic nature of PNS was listed as the most significant deterrent (46%) followed by financial concerns (25%), additional training (12%), longer work hours (12%), and medicolegal issues (4%). The majority felt that fellowship training and PNS certification should be recommended for surgeons treating of all but traumatic brain injuries and Chiari I malformations and performing simple shunt-related procedures, although they felt that these credentials should be required only for treating complex craniosynostosis. Conclusions The nature of PNS is the most significant barrier to attracting residents, although reimbursement, cross-coverage, and legal issues are also important to residents. The authors provide several recommendations that might enhance resident perceptions of PNS and attract trainees to the specialty.

scholarly journals Evaluation of quality of care for patients with congenital heart disease using ECHSA Congenital Database integrated tools

2021 ◽  
Vol 25 (1) ◽  
pp. 52
Author(s):  
O. Yu. Kornoukhov ◽  
A. A. Karimov ◽  
V. N. Ilyin
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Mortality ◽  
Conflict Of Interest ◽  
Congenital Heart ◽  
Z Score ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Mean

<p><strong>Background.</strong> A quality of surgical care evaluation based solely on workload and hospital mortality is incomplete. ECHSA Congenital Database integrated tools provide complexity-adjusted methods to evaluate surgical results and the surgical performance of a hospital, and make it possible to demonstrate hospital service level among other congenital heart programmes.</p><p><strong>Methods.</strong> Data on 2,521 operations in a population of children, including 532 newborns, with congenital heart disease (CHD) were uploaded on the European Congenital Heart Surgeons Association Congenital Database. These data were collected between 2012 and 2018 at the Filatov Children's Hospital. We compared our personal results with database mean values according to the following criteria: 1) proportion of newborns among all paediatric surgical cases, 2) hospital mortality, 3) Aristotle Basic Score (ABS) value, 4) STS-EACTS Mortality Score (MtS) value, and 5) MtS Performance value. All data on the database website were analysed using integrated database tools.</p><p><strong>Results.</strong> The proportion of newborns in the Filatov Children's Hospital was 21.1%, while the database mean value was 18.6%, and hospital mortality values were 3.89% and 3.61%, respectively. The mean ABS in the Filatov Children's Hospital was 6.78 ± 2.08, while that on the database was 6.57 ± 2.12 (Z-score = 0.075). The mean MtS values for the hospital and database were 0.74 ± 0.59 and 0.72 ± 0.64, respectively (Z-score = 0.031). The calculated MtS performance for the Filatov Children's Hospital was 0.72 ± 0.56, while that for all European respondents was 0.54 ± 0.29 (Z-score = 0.603).</p><p><strong>Conclusion.</strong> Cooperation with a multicentre international database, such as ECHSA Congenital Database, provides modern complexity-adjusted tools for evaluation of quality of care for children with CHD. The Filatov Children’s Hospital is a high-volume cardiac surgery centre that demonstrates an adequate survival rate regarding complexity level and surgical risk compared to European respondents of the ECHSA Congenital Database.</p><p>Received 19 October 2020. Revised 18 November 2020. Accepted 19 November 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

Fixation with C-2 laminar screws in occipitocervical or C1–2 constructs in children 5 years of age or younger: a series of 18 patients

2014 ◽  
Vol 14 (1) ◽  
pp. 87-93 ◽  
Author(s):  
Jennifer G. Savage ◽  
Daniel H. Fulkerson ◽  
Anish N. Sen ◽  
Jonathan G. Thomas ◽  
Andrew Jea
Keyword(s):  
Cervical Spine ◽  
Screw Placement ◽  
Upper Cervical Spine ◽  
Children's Hospital ◽  
Translaminar Screw ◽  
Upper Cervical ◽  
Children’S Hospital ◽  
The Mean ◽  
Translaminar Screws

Object There are rare indications for upper cervical spine fusion in young children. Compared with nonrigid constructs, rigid instrumentation with screw fixation increases the fusion rate and reduces the need for halo fixation. Instrumentation may be technically challenging in younger children. A number of screw placement techniques have been described. Use of C-2 translaminar screws has been shown to be anatomically feasible, even in the youngest of children. However, there are few data detailing the clinical outcome. In this study, the authors describe the clinical and radiographic follow-up of 18 children 5 years of age or younger who had at least one C-2 translaminar screw as part of an occipitocervical or C1–2 fusion construct. Methods A retrospective review of all children treated with instrumented occipitocervical or C1–2 fusion between July 1, 2007, and June 30, 2013, at Riley Children's Hospital and Texas Children's Hospital was performed. All children 5 years of age or younger with incorporation of at least one C-2 translaminar screw were identified. Results Eighteen children were studied (7 boys and 11 girls). The mean age at surgery was 38.1 months (range 10–68 months). Indications for surgery included traumatic instability (6), os odontoideum (3), destructive processes (2), and congenital instability (7). A total of 24 C-2 translaminar screws were placed; 23 (95.8%) of 24 were satisfactorily placed (completely contained within the cortical walls). There was one medial cortex breach without neurological impingement. There were no complications with screw placement. Three patients required wound revisions. Two patients died as a result of their original condition (trauma, malignant tumor). The mean follow-up duration for the surviving patients was 17.5 months (range 3–60 months). Eleven (91.7%) of the 12 patients followed for 6 months or longer showed radiographic stability or completed fusion. Conclusions Use of C-2 translaminar screws provides an effective anchor for internal fixation of the upper cervical spine. In this study of children 5 years of age or younger, the authors found a high rate of radiographic fusion with a low rate of complications.

Treatment of Tinnitus with a Customized, Dynamic Acoustic Neural Stimulus: Clinical Outcomes in General Private Practice

2008 ◽  
Vol 117 (11) ◽  
pp. 791-799 ◽  
Author(s):  
Peter J. Hanley ◽  
Paul B. Davis ◽  
Bardia Paki ◽  
Shaunine A. Quinn ◽  
Sandra R. Bellekom
Keyword(s):  
Private Practice ◽  
Health Care Professionals ◽  
Relative Effectiveness ◽  
Rehabilitation Program ◽  
Tier 2 ◽  
Success Rates ◽  
Tier 1 ◽  
Tinnitus Treatment ◽  
The Mean ◽  
Tier 3

Objectives: We evaluate the relative effectiveness of a newly available tinnitus treatment approach for different categories of patients in general private practice. Methods: This was a cohort study, sponsored by Neuromonics, involving the first 470 patients to undertake the Neuromonics Tinnitus Treatment in 7 Neuromonics tinnitus clinics. All patients were provided with a dynamic acoustic neural stimulus, customized to each patient's audiometric profile, for daily use as part of a structured rehabilitation program. Tinnitus disturbance was assessed before, during, and after treatment with the Tinnitus Reaction Questionnaire. Results: The outcomes displayed a relation with patients' suitability according to predefined criteria: Among the most suitable patients (tier 1 cohort), 92% exceeded the threshold for success (defined as a reduction in tinnitus-related disturbance of at least 40%), and the mean improvement in tinnitus disturbance was 72%; the discontinuance rate was 4%. For other suitability categories, the success rates and mean improvements were somewhat lower, and the discontinuance rates higher (tier 2: 60%, 49%, and 16%, respectively; tier 3: 39%, 32%, and 17%, respectively). Conclusions: The results showed that the treatment is effective for suitable patients in the private practice setting, and they provide health-care professionals with guidance as to what patients might expect from treatment, depending on their degree of suitability.

scholarly journals Improving ECG Services at a Children’s Hospital: Implementation of a Digital ECG System

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Frank A. Osei ◽  
Gregory J. Gates ◽  
Steven J. Choi ◽  
Daphne T. Hsu ◽  
Robert H. Pass ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Outpatient Service ◽  
Digital System ◽  
Quality Improvement Initiative ◽  
Fourfold Increase ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Mean ◽  
Significant Change

Background.The use of digital ECG software and services is becoming common. We hypothesized that the introduction of a completely digital ECG system would increase the volume of ECGs interpreted at our children’s hospital.Methods.As part of a hospital wide quality improvement initiative, a digital ECG service (MUSE, GE) was implemented at the Children’s Hospital at Montefiore in June 2012. The total volume of ECGs performed in the first 6 months of the digital ECG era was compared to 18 months of the predigital era. Predigital and postdigital data were compared viat-tests.Results.The mean ECGs interpreted per month were 53 ± 16 in the predigital era and 216 ± 37 in the postdigital era (p<0.001), a fourfold increase in ECG volume after introduction of the digital system. There was no significant change in inpatient or outpatient service volume during that time. The mean billing time decreased from 21 ± 27 days in the postdigital era to 12 ± 5 days in the postdigital era (p<0.001).Conclusion.Implementation of a digital ECG system increased the volume of ECGs officially interpreted and reported.

scholarly journals Faculty burnout in a large department of pediatrics

2015 ◽  
Vol 4 (2) ◽  
pp. 74 ◽  
Author(s):  
B.H. Davis ◽  
S.E.M. Hill ◽  
P. Fisher ◽  
T. Nick ◽  
Wendy L. Ward
Keyword(s):  
Health Care ◽  
Faculty Development ◽  
Maslach Burnout Inventory ◽  
Faculty Members ◽  
Personal Accomplishment ◽  
Self Report ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Health Related ◽  
National Norms

Background: Physician stress is at a heightened level in the midst of a changing health care environment and limited research funding conditions. Burnout of physicians has an impact on their personal health, related institutional health care costs, retention of quality faculty, and patient care and safety. The present study was designed to assess levels of burnout and sources of stress in clinical, educational, and research faculty working in a Department of Pediatrics and a large Children’s Hospital setting.Methods: The self-report Maslach Burnout Inventory was given to the 240 faculty members in a large Department of Pediatrics based at a Children’s Hospital as part of a larger faculty development needs survey designed to inform faculty development programming. Participation in the survey was voluntarily, and was presented during a mandatory faculty meeting and then emailed to all faculty so those who were unable to attend could participate. A brief survey on sources of stress, stress-related illness, and wellness programming needs was also administered.Results: Out of the 240 faculty members, 86 surveys were collected and analyzed (36% response rate). 52% were female, 84% were Caucasian. Rank of respondents appeared fairly consistent with overall Departmental distribution (40% Assistant, 22% Associate, 34% Full, 4% Instructor). 48% of respondents were Clinical Educators, with 18% Basic Scientists, 17% Clinical Attendings, and 16% Clinical Scientists, also fairly consistent with overall Departmental distributions. Results suggest 65% of faculty endorse high levels of emotional exhaustion, 56% high levels of depersonalization, and 100% felt low levels of personal accomplishment. According to Maslach Burnout Inventory (MBI) cutoff criteria, 94% of respondents were above the cutoff for Burnout, much higher than recent, published national norms. The most frequently identified top stressors were: lack of connectedness to the institution, administrative responsibilities, time conflicts, clinical workload and general workload. The most frequently identified top stress symptoms experienced were: mood issues, health-related behaviors, and psychosomatic symptoms.Conclusions: Burnout rates at this institution are higher than national norms. From the data collected, faculty development programs to address coping with burnout and prevention such as strategies to promote resilience to stress will be provided. Faculty will be periodically provided with currently available sources of individual and group support and these will be easily available on the internal website. Institutional changes that may affect burnout rates should also be considered.

scholarly journals The Relationship Between Serum Vitamin D Level and Severity of Bronchiolitis in Infants Being Referred to in Bandar Abbas Children’s Hospital, Iran

2020 ◽  
Vol 9 (3) ◽  
pp. 96-100
Author(s):  
Mohammad Bagher Rahmati ◽  
Mehran Ahmadi ◽  
Seyed Alireza Sobhani ◽  
Morteza Bakhshi ◽  
Hosein Hamadiyan ◽  
...  
Keyword(s):  
Vitamin D ◽  
Serum Vitamin ◽  
Serum Levels ◽  
Children's Hospital ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Children’S Hospital ◽  
The Mean ◽  
Bandar Abbas ◽  
The Relationship

Background: The present study aimed to investigate the relationship between the serum vitamin D level and the severity of bronchiolitis in infants. Materials and Methods: The population of this descriptive-analytical study included all infants within the age range of 1 month to 24 months old with bronchiolitis hospitalized in Bandar Abbas children’s hospital in 2018-2019. According to the exclusion and inclusion criteria, patients were entered in the study and diagnosed with bronchiolitis by a pediatric infectious disease specialist. Then, their serum levels of vitamin D were measured as well. Results: Of the 85 patients, 62.4% and 37.6% were males and females, respectively. The mean serum level of vitamin D was 29.74±13.44 ng/mL. In addition, the mean age in groups with mild-, moderate-, and severe-intensity was 9.27±4.52 months, 5.12±3.95 months, and 3.16±1.16 months (P<0.001), respectively. Further, the Spearman’s correlation between age and serum vitamin D levels was r = 0.05 (P<0.001). Based on the results, there was a statistically significant difference between the mean age in the two study groups (P<0.001). Finally, a statistically significant association was found between the severity of bronchiolitis and vitamin D status (P=0.007). Conclusion: According to the results of the present study, more than half of the infants admitted to the diagnosis of bronchiolitis had insufficient serum levels of vitamin D. There was also a significant association between the severity of bronchiolitis and serum vitamin D levels.

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