Characterizing How Pediatric Clinicians Create Choice Awareness When Performing Shared Decision-Making.

Objective: To characterize how clinicians create choice awareness when performing shared decision-making (SDM).

Methods: We conducted a secondary analysis of a cross-sectional observational study designed to characterize the decision-making processes of parents and clinicians across a range of medical decisions in different pediatric settings. For the observational study, clinicians were recruited from 6 pediatric specialties (craniofacial, hematology and oncology, hospital medicine, neonatology, pulmonary, and sports medicine) at a single US children's hospital.

Association of Maternal Residence with Failure to Detect Fetal Congenital Heart Disease.

False-negative screening for prenatal congenital (CHD) and critical congenital heart disease (CCHD) requiring early intervention may result in increased morbidity and mortality. The association between false-negative obstetric screening and maternal community population remains unclear. A retrospective review of prenatal and postnatal CHD diagnoses was performed at Children's Nebraska from January to December 2024.

Tiered Clinician Vaccine Communication Strategy to Improve Childhood Vaccine Uptake: A Cluster Randomized Clinical Trial.

Importance: No experimental studies to date have tested the effectiveness of clinician communication strategies to improve vaccine uptake among children of parents with negative vaccine attitudes.

Objective: To evaluate the effect of a tiered vaccine communication strategy on children of parents with negative vaccine attitudes.

Design, Setting, And Participants: This cluster randomized clinical trial was conducted from September 1, 2019, to March 31, 2023, at primary care pediatric clinics in Colorado (n = 12) and Washington State (n = 12).

Early Experience With Postmortem CT Imaging.

Objective: Postmortem computed tomography (PMCT) is a procedure fairly unfamiliar to many US radiologists. We embarked on a collaboration between the department of radiology and the medical examiner's office (MEO) with the purpose of introducing PMCT into the autopsy workflow and the goal of assisting forensic pathologist decision-making regarding the need for autopsy in determining cause of death.

Methods: Establishing this service involved coordination, education, and extensive planning involving numerous professionals volunteering their time and effort.

Dual- vs Single-Chamber Ventricular Pacing in Isolated Congenital Complete Atrioventricular Block in Infancy.

Background: The optimal pacemaker programming strategy for infants with isolated congenital complete atrioventricular block (CCAVB) remains unresolved. Dual-chamber pacing maintains atrioventricular synchrony and physiological heart rate variability but increases the burden of ventricular pacing on a myocardium that may be inherently prone to left ventricular (LV) dysfunction.

Objectives: This study sought to compare clinical outcomes of dual (DDD)- vs single (VVI)- chamber pacing in infants with CCAVB (DAVINCHI).

Fossil vertebrates from southern Zealandia: taonga of international significance.

Vertebrate fossils from Aotearoa New Zealand have revealed the global significance of Zealandia on the origins of modern birds, the history of cetaceans during major climatic events of the Cenozoic and the evolution of cartilaginous and ray-finned fish. Internationally important collections of vertebrate fossils are housed in collections across Aotearoa and have attracted researchers from around the world studying evolution, biogeography and climate change. This special issue of the Journal of the Royal Society of New Zealand celebrates the vertebrate fossils of Aotearoa by showcasing taonga (treasures) that are significant to global and local vertebrate history.

The fossil vertebrate primary type specimens in the collection of the University of Otago Department of Geology.

The 47 vertebrate type specimens held in the University of Otago Geology Department are catalogued in detail. A short history of the collection is followed by lists of the type specimens under the Classes Actinopterygii, Reptilia, Aves and Mammalia. A fish trace-fossil is included at the end of the Actinopterygii.

Don't be rash: how effort, religion, and decision-type influence judgments of morality.

The present study explored how knowledge (Study 1) and inferences (Study 2) about religiosity influence impressions of morality depending on whether effort is exerted to reach a morally controversial decision. In Study 1, undergraduates judged a [religious/nonreligious] doctor who exerted [little/great] effort into their decision to euthanize a patient. Results indicated that when the doctor was nonreligious or exerted low effort, they were considered less moral compared to when they were religious or exerted high effort.

The Delicate Situation of Childhood Vaccination: On the Dispreferredness of Soliciting Parents' Intent to Vaccinate.

In the Netherlands, parents of newborns typically participate in two-, four-, and eight-week medical consultations to monitor their children's development and discuss vaccinations, which will not be administered before eight weeks. During these visits, healthcare professionals routinely ask parents if they intend to vaccinate their children (i.e.

American Academy of Pediatrics Recommended Cardiac Screening Questions in Preparticipation Physical Evaluation Forms.

To evaluate the utilization of the American Academy of Pediatrics' (AAP) cardiovascular screening questions within preparticipation physical evaluation forms from the 50 state high school athletic associations. We found that fewer than one-half of state forms incorporated all 10 AAP questions; moreover, a subset failed to adhere to criteria recommended by either the AAP or American Heart Association.

Premorbid weight in pulmonary arterial hypertension.

Relationships between obesity and outcomes in pulmonary arterial hypertension (PAH) are complex. Previous work suggested obesity, occurring alongside PAH, may be associated with better survival. In our work, we suggest obesity prior to PAH development is associated with worse survival.

Pacing in Pediatric Patients with Postoperative Atrioventricular Block.

Surgery for congenital heart disease may compromise atrioventricular (AV) nodal conduction, potentially resulting in postoperative AV block. In the majority of cases, AV nodal function recovers during the early postoperative period and may only require short-term pacing support, typically provided via temporary epicardial wires. Permanent pacing is indicated when the postoperative AV block persists for more than 7 to 10 days due to the risk of mortality if a pacemaker is not implanted.

Revisiting Chapman (Trichiuroidea: Gempylidae), an Eocene gemfish from the Burnside Mudstone, Dunedin, New Zealand.

The remains of a unique fossil bony fish were discovered in late Eocene (39.1-36.7 Ma: NZ Kaiatan stage) mudstone at Burnside near Dunedin, New Zealand in the 1930s and subsequently named and described by Frederick Chapman.

Limited Axial Interpretation of Coronary CT Angiography in the Emergency Department Setting.

Purpose: Incorporating coronary CT angiographic (CCTA) imaging into emergency department (ED) workflows has been limited by the need for 24/7 real-time postprocessing. The aim of this study was to determine whether interpretation of transaxial CCTA images alone (limited axial interpretation [LI]) is noninferior to interpretation of combined transaxial and multiplanar reformation images (full interpretation [FI]) in assessing patients with acute chest pain in the ED.

Methods: CCTA examinations from 74 patients were evaluated by two radiologists, one without dedicated CCTA training and one with basic CCTA experience.

Development of PIVOT with MI: A motivational Interviewing-Based vaccine communication training for pediatric clinicians.

Delay or refusal of childhood vaccines is common and may be increasing. Pediatricians are parents' most trusted source for vaccine information, yet many struggle with how to communicate with parents who resist recommended vaccines. Evidence-based communication strategies for vaccine conversations are lacking.

Ventricular Tachycardia in a Pediatric Patient with High-Risk Thrombotic Thrombocytopenia Purpura.

An 8-year-old previously healthy male was diagnosed with thrombotic thrombocytopenic purpura (TTP) and increased serum cardiac troponin I. Telemetry recorded non-sustained ventricular tachycardia, without ST-segment changes or other abnormalities on serial electrocardiogram. This case illustrates that cardiac monitoring by telemetry should be considered in high-risk TTP with elevated cardiac troponin.

Validation of a Process for Shared Decision-Making in Pediatrics.

Objective: We sought to confirm, refute, or modify a 4-step process for implementing shared decision-making (SDM) in pediatrics that involves determining 1) if the decision includes >1 medically reasonable option; 2) if one option has a favorable medical benefit-burden ratio compared to other options; and 3) parents' preferences regarding the options; then 4) calibrating the SDM approach based on other relevant decision characteristics.

Methods: We videotaped a purposive sample of pediatric inpatient and outpatient encounters at a single US children's hospital. Clinicians from 7 clinical services (craniofacial, neonatology, oncology, pulmonary, pediatric intensive care, hospital medicine, and sports medicine) were eligible.

Preparticipation State Cardiac Screening Forms for Athletes.

Background And Objectives: Annual preparticipation physical evaluation (PPE) is used in the United States to screen adolescents for potential causes of sudden cardiac death. The American Heart Association recommends 14 screening elements of history and physical examination. This study sought to define the utilization of these screening elements by each of the 50 states before high school athletics.

Transfer patient imaging: secondary interpretation reimbursement.

Introduction: Trauma center radiologists vary widely in the degree to which they provide secondary interpretations for transferred patients' advanced imaging. A general perception of uncertainty over reimbursement for these exams often results in reluctance to provide routine overreads. The purpose of this study is to assess the difference in reimbursement rates between primary interpretations and secondary interpretations in the emergency department (ED) setting.

Transfer Patient Imaging: Assessment of the Impact of Discrepancies Identified by Emergency Radiologists.

Purpose: Advanced imaging examinations of emergently transferred patients (ETPs) are overread to various degrees by receiving institutions. The practical clinical impact of these second opinions has not been studied in the past. The purpose of this study is to determine if emergency radiology overreads change emergency medicine decision making on ETPs in the emergency department (ED).

Parent Attitudes Towards Childhood Vaccines After the Onset of SARS-CoV-2 in the United States.

Objective: To understand the influence of a novel infectious disease epidemic on parent general attitudes about childhood vaccines.

Methods: We conducted a natural experiment utilizing cross-sectional survey data from parents of infants in Washington and Colorado participating in a larger trial that began on September 27, 2019. At enrollment, parents completed the short version of the Parental Attitudes about Childhood Vaccines (PACV-SF), a validated survey scored from 0 to 4, with higher scores representing more negative attitudes.