Author: "Jennifer Reid" / Search Limiters: Peer Reviewed - Searchworks@Jio Institute Digital Library Search Results

121 results on '"Jennifer Reid"'

1. Prevalence, Characteristics, and Outcomes of People With A High Body Mass Index Across the Kidney Disease Spectrum: A Population-Based Cohort Study

Author: Gurleen Sahi, Jennifer Reid, Louise Moist, Michael Chiu, Amanda Vinson, Saverio Stranges, Kyla Naylor, Yunxu Zhu, and Kristin K. Clemens
Subjects: Diseases of the genitourinary system. Urology, RC870-923
Abstract: Background: Obesity has a major impact on health and health care, particularly in those with chronic kidney disease (CKD). Objective: The objective was to describe the prevalence, characteristics, and outcomes of people living with CKD and obesity (defined by a body mass index [BMI] ≥30 kg/m 2 ) in Canada. Design: Population-based cohort study using linked administrative health data (ICES). Patients: Adults aged 18 year and older with CKD G1-5D who had a height and weight recorded during a visit to an academic hospital in London Ontario Canada, between January 2010 and December 2019. Measures: CKD as defined by CKD 3A or higher. BMI as defined by weight kg/m 2 . Methods: As a primary interest, we described the percentage of patients with CKD across different BMI categories (
Published: 2024
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2. Prevalence and characteristics of people with a high body mass index across the kidney disease spectrum: a population-based cohort study

Author: Gurleen Sahi, Jennifer Reid, Michael Chiu, Louise Moist, Kyla Naylor, Saverio Stranges, Kamel Omer, Amanda Vinson, Janet Madill, and Kristin K Clemens
Subjects: Demography. Population. Vital events, HB848-3697
Abstract: The prevalence of obesity is growing globally and has major health implications, particularly for those with chronic kidney disease (CKD). People with obesity have a higher risk of CKD progression and face barriers to transplantation. Studies on the epidemiology and outcomes of obesity in the Canadian CKD population are lacking. This population-based cohort study included adults aged 18 and over with a hospital encounter in London, Ontario, Canada from 2010 to 2019 where height and weight were recorded. They were stratified into CKD stages 1-5 (by estimated glomerular filtration rate (eGFR)), dialysis or renal transplant status and by body mass index (BMI) using Canada Obesity Guidelines. Outcomes included prevalence of BMIs by CKD stage, and CKD progression and transplant outcomes across BMI classes. Our cohort included 198,151 patients. The prevalence of BMI ≥30 kg/m2 grew as eGFR declined (i.e., 37% in stage 1, 41.5% in stage 3b, 40.9% in stage 4) but fell in end-stages (i.e., 37.4% in Stage 5, 38.8% in dialysis, 38.5% in transplant recipients). CKD progression and kidney failure appeared more frequent in those with a BMI ≥30 kg/m2. In a smaller sample, we noted that end-stage patients with a BMI ≥30 kg/m2 were less frequently transplanted, but experienced post-transplant complications less often. This study revealed that high BMI is a prevalent issue in the Canadian CKD population and may influence kidney outcomes and transplant candidacy. This data will help inform clinical trials to create and study weight loss interventions for those with CKD and obesity.
Published: 2024
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3. Building impactful systems-focused simulations: integrating change and project management frameworks into the pre-work phase

Author: Mirette Dubé, Glenn Posner, Kimberly Stone, Marjorie White, Alyshah Kaba, Komal Bajaj, Adam Cheng, Vincent Grant, Simon Huang, and Jennifer Reid
Subjects: Simulation, Systems integration, Quality improvement, System improvement, Patient safety, Change management, Computer applications to medicine. Medical informatics, R858-859.7
Abstract: Abstract Healthcare organizations strive to deliver safe, high-quality, efficient care. These complex systems frequently harbor gaps, which if unmitigated, could result in harm. Systems-focused simulation (SFS) projects, which include systems-focused debriefing (SFD), if well designed and executed, can proactively and comprehensively identify gaps and test and improve systems, enabling institutions to improve safety and quality before patients and staff are placed at risk. The previously published systems-focused debriefing framework, Promoting Excellence and Reflective Learning in Simulation (PEARLS) for Systems Integration (PSI), describes a systematic approach to SFD. It includes an essential “pre-work” phase, encompassing evidence-informed steps that lead up to a SFD. Despite inclusion in the PSI framework, a detailed description of the pre-work phase, and how each component facilitates change management, was limited. The goal of this paper is to elucidate the PSI “Pre-work” phase, everything leading up to the systems-focused simulation and debriefing. It describes how the integration of project and change management principles ensures that a comprehensive collection of safety and quality issues are reliably identified and captured.
Published: 2021
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4. Integrating administrative and clinical datasets to improve patient outcomes.

Author: Jennifer Reid, Blayne Welk, Amit Garg, Theresa Fitzgerald, Glen Kearns, and Salimah Shariff
Subjects: linkage, evaluation, electronic health records, administrative data, Demography. Population. Vital events, HB848-3697
Abstract: Integrating electronic health records (EHR) with health administrative data offer opportunities for enhanced decision support, health systems evaluations and research for improved patient care. We describe the process of integrating EHR data from 12 hospitals in Southwestern Ontario, Canada and present a health systems evaluation enabled by this linkage. With support and buy-in from the hospital Chief Executive Officers, a data sharing agreement (DSA) with ICES was executed, outlining the process to approve data transfer requests. Due to the complexity and volume of the EHR, complete data were not immediately transferred to ICES; instead, a project subcommittee comprising of physician leadership, local and regional privacy and risk officers, and ICES staff was assembled to review and approve project-specific data integration requests. An evaluation of the adoption of an electronic medication reconciliation system within the EHR on potentially inappropriate prescribing after hospital discharge was conducted using interrupted time-series analyses. The data integration request process begins with confirmation of data availability and accuracy within the EHR, enabled by a dedicated health information analyst and institutional decision support teams. Once data feasibility is confirmed, project rationale is submitted to the project subcommittee approval. Following approval, the request undergoes privacy and legal assessment as per the DSA and a project-ready dataset is submitted for linkage. An evaluation of the adoption of an electronic medication reconciliation system demonstrated an immediate and dramatic reduction in inappropriate medication prescribing and associated adverse events such as a fall or fracture among elderly patients discharged following acute inpatient stays. Administrative data are valuable at assessing population-based health, but often lack key clinical information present in EHRs. Integrating both data sources offers a more comprehensive picture of patient care and allows for robust analyses. Rigorous investigations generate trusted evidence for decision makers to inform policy and quality improvements within the healthcare system.
Published: 2022
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5. Simulation-based clinical systems testing for healthcare spaces: from intake through implementation

Author: Nora Colman, Cara Doughty, Jennifer Arnold, Kimberly Stone, Jennifer Reid, Ashley Dalpiaz, and Kiran B. Hebbar
Subjects: Patient Safety, FMEA, Healthcare design, Latent safety threats, Computer applications to medicine. Medical informatics, R858-859.7
Abstract: Abstract Healthcare systems are urged to build facilities that support safe and efficient delivery of care. Literature demonstrates that the built environment impacts patient safety. Design decisions made early in the planning process may introduce flaws into the system, known as latent safety threats (LSTs). Simulation-based clinical systems testing (SbCST) has successfully been incorporated in the post-construction evaluation process in order to identify LSTs prior to patient exposure and promote preparedness, easing the transition into newly built facilities. As the application of simulation in healthcare extends into the realm of process and systems testing, there is a need for a standardized approach by which to conduct SbCST in order to effectively evaluate newly built healthcare facilities. This paper describes a systemic approach by which to conduct SbCST and provides documentation and evaluation tools in order to develop, implement, and evaluate a newly built environment to identify LSTs and system inefficiencies prior to patient exposure.
Published: 2019
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6. Pediatric Emergency Medicine Simulation Curriculum: Vitamin K Deficiency in the Newborn

Author: Elizabeth Sanseau, Leah H. Carr, Jennifer Case, Khoon-Yen Tay, Anne Ades, Kesi Yang, Hannah Huang, Anna Bustin, Grace Good, Shannon Gaines, Julie Augenstein, Daisy Ciener, Jean Pearce, Jennifer Reid, Kimberly Stone, Rebekah Burns, and Anita Thomas
Subjects: Neonate, Newborn, Infant, Simulation, Vitamin K Deficiency, Cerebral Hemorrhage, Medicine (General), R5-920, Education
Abstract: Introduction The American Academy of Pediatrics recommends vitamin K prophylaxis at birth for all newborns to prevent vitamin K deficiency bleeding (VKDB). Despite a lack of evidence for serious harms, barriers to prophylaxis, including parental refusal, are rising, as are cases of VKDB. Methods This simulation involved an infant presenting to the emergency department who decompensated due to a cerebral hemorrhage caused by VKDB and was treated by pediatric and emergency providers. The case was incorporated into the fellow and division monthly curricula, and participants completed postsimulation surveys. The patient required a secure airway, seizure management, vitamin K, and a fresh frozen plasma infusion upon suspicion of the diagnosis, plus a coordinated transfer to definitive care. The case included a description of the simulated case, learning objectives, instructor notes, an example of the ideal flow of the scenario, anticipated management mistakes, and educational materials. Results The simulations were carried out with 48 total participants, including 40 fellows and eight attendings, from five different training institutions over 1 year. In surveys, respondents gave overall positive feedback. Ninety-four percent of participants gave the highest score on a Likert scale indicating that the simulation was relevant, and over 80% gave the highest score indicating that the experience helped them with medical management. Discussion This simulation trained physicians how to recognize and treat a distressed infant with VKDB. The case was perceived to be an effective learning tool for both fellow and attending physicians.
Published: 2021
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7. The experience of gestational diabetes for indigenous Māori women living in rural New Zealand: qualitative research informing the development of decolonising interventions

Author: Jennifer Reid, Anneka Anderson, Donna Cormack, Papaarangi Reid, and Matire Harwood
Subjects: Gestational diabetes, Type 2 diabetes, Indigenous, Māori, Decolonising, Kaupapa Māori, Gynecology and obstetrics, RG1-991
Abstract: Abstract Background Although early detection and management of excess rates of gestational diabetes mellitus (GDM) among Indigenous women can substantially reduce maternal and offspring complications, current interventions seem ineffective for Indigenous women. While undertaking a qualitative study in a rural community in Northland, New Zealand about the complexities of living with diabetes, we observed a common emotional discourse about the burden of diabetic pregnancies. Given the significance of GDM and our commitment to give voice to Indigenous Māori women in ways that could potentially inform solutions, we aimed to explore the phenomenon of GDM among Māori women in a rural context marked by high area-deprivation. Method A qualitative and Kaupapa Māori methodology was utilised. A sub-sample of women (n = 10) from a broader study designed to improve type 2 diabetes mellitus (T2DM) who had experienced GDM or pre-existing diabetes during pregnancy and/or had been exposed to diabetes in utero were interviewed. Participants in the broader study were recruited via the local primary care clinic. Experiences of GDM, in relation to their current T2DM, was sought. Narrative data was analysed for themes. Results Intergenerational experiences informed perceptions that GDM was an inevitable heritable illness that “just runs in the family.” The cumulative effects of deprivation and living with GDM compounded the complexities of participant’ lives including perceptions of powerlessness and mental health deterioration. Missed opportunities for health services to detect and manage diabetes had ongoing health consequences for the women and their offspring. Positive relationships with healthcare providers facilitated management of GDM and helped women engage with self-management. Conclusion Māori women living with T2DM were clear that health providers had failed to intervene in ways that would have potentially slowed or prevented progression of GDM to T2DM. Participants revealed missed opportunities for appropriate diagnostic testing, treatment and health promotion programmes for GDM. Poor collaboration between health services and social services meant psychosocial issues were rarely addressed and the cycle of intergenerational poverty and disadvantage prevailed. These data highlight opportunities for extended case management to include whānau (family) engagement, input from social services, and evidence-based medicine and/or long-term management and prevention of T2DM.
Published: 2018
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8. Pediatric Toxidrome Simulation Curriculum: Bupropion Overdose

Author: Emily Hartford, Anita Thomas, Ashley Keilman, Neil Uspal, Kimberly Stone, Jennifer Reid, and Rebekah Burns
Subjects: Bupropion Overdose, Seizure, Ventricular Tachycardia, Toxidrome, Simulation, Emergency Medicine, Medicine (General), R5-920, Education
Abstract: Introduction Bupropion is a commonly used antidepressant, and overdose can lead to both neurologic and cardiovascular toxicity, including agitation, seizure, tachycardia, QT and QRS prolongation, and rhythm disturbances. Methods We developed this simulation case for attendings, fellows, nurse practitioners, and nurses in the pediatric emergency department (ED). The scenario involved a 13-year-old male presenting to the ED with altered mental status and a generalized tonic-clonic seizure shortly after arrival. The team needed to quickly perform primary and secondary surveys, manage his airway and breathing, and initiate treatment for seizure. The team had to obtain an abbreviated history and include ingestion in the differential. The patient then developed pulseless ventricular tachycardia, and the team needed to respond with high-quality CPR, defibrillation, and advanced airway management. Preparatory materials, a debriefing guide, and scenario evaluation forms assisted with facilitation. Results Twenty-eight physicians, 56 nurses, 10 nurse practitioners, four pharmacists, two students, and one respiratory therapist completed this simulation in 13 sessions. On a 5-point Likert scale, participants agreed with the stated objective of ability to manage a patient with a bupropion overdose (M = 4.09; range, 2-5). The scenario was rated as highly relevant (M = 4.93) and the debriefing as very effective (M = 4.85). Discussion This scenario is a complete educational resource for setting up, implementing, and debriefing in an interprofessional setting. It was well received by learners from diverse professional backgrounds working together in actual care teams in the pediatric ED.
Published: 2019
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9. The significance of relational continuity of care for Māori patient engagement with predominantly non‐Māori doctors: findings from a qualitative study

Author: Jennifer Reid, Donna Cormack, and Marie Crowe
Subjects: continuity of care, relational continuity, health disparities, primary healthcare, access, Public aspects of medicine, RA1-1270
Abstract: Abstract Objective: This qualitative study explored self‐reported experiences of primary healthcare among a sample of urban Māori adults. This paper specifically focuses on the theme of relational continuity of care identified in participant discussions of access and engagement with their predominantly non‐Māori general practitioners (GPs). Methods: The study involved a purposively selected subsample (n=42) of the Christchurch Māori cohort of the Hauora Manawa Community Heart Study (n=244). Participants took part in in‐depth interviews, which were transcribed and analysed thematically. Results: Analysis identified compromised access to a preferred GP as a principal barrier to receiving quality and non‐discriminatory care from predominantly non‐Māori clinicians. In contrast to discussions of healthcare provided by usual GPs, episodic encounters with non‐regular clinicians were commonly framed as experiences discouraging utilisation and the perceived value of primary healthcare. Conclusions: Facilitating relational continuity of care for Māori patients and their clinicians may contribute towards mediating determinants of inequality at the clinical interface. Implications: Reducing significant health disparities between Māori and non‐Māori was a key goal of the reconfiguration of primary healthcare in the early 2000s. The role of relational continuity of care in achieving equitable inter‐ethnic health outcomes in primary healthcare settings is an important consideration.
Published: 2016
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10. Pediatric Emergency Medicine Simulation Curriculum: Marijuana Ingestion

Author: Carson Burns, Rebekah Burns, Elizabeth Sanseau, Suzan Mazor, Jennifer Reid, Kimberly Stone, and Anita Thomas
Subjects: Simulation, Altered Mental Status, Toxicology, Ingestion, Pediatrics, Pediatric Emergency Medicine, Medicine (General), R5-920, Education
Abstract: Introduction Altered mental status can be a challenging presenting symptom in children due to the wide differential diagnosis, which ranges from the relatively benign to the life threatening. Marijuana ingestion and unintentional intoxication are becoming an increasingly common cause of altered mental status in children as marijuana use and availability of enticing marijuana edibles increase in the United States. Because children present with altered mental status rather than the typical marijuana toxidrome, appropriately managing these patients in emergency settings can be particularly challenging. Methods This simulation-based curriculum involved the evaluation and management of a 6-year-old boy who presented with altered mental status from acute marijuana intoxication unbeknownst to his parents. Participants systematically evaluated a pediatric patient with a broad differential diagnosis of altered mental status and managed the patient with acute marijuana intoxication. This scenario may be modified based on trainee level (medical student vs. resident vs. fellow). Results A total of 20 trainees comprising six emergency medicine fellows and 14 pediatric residents and medical students participated in this simulation curriculum over three iterations. Trainees consistently rated it as an overall positive learning experience for pediatric altered mental status and toxidrome education. Discussion Low-frequency, high-risk illnesses such as altered mental status due to marijuana intoxication require providers to be familiar with their evaluation and management. This curriculum provides instructors with the materials to successfully implement and improve the simulation over time.
Published: 2018
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11. Pediatric Simulation Cases for Primary Care Providers: Asthma, Anaphylaxis, Seizure in the Office

Author: Elizabeth Sanseau, Jennifer Reid, Kimberly Stone, Rebekah Burns, and Neil Uspal
Subjects: Simulation, Asthma, Emergency Medicine, Anaphylaxis, Seizure, Pediatrics, Medicine (General), R5-920, Education
Abstract: Introduction Although pediatric emergencies commonly occur in the outpatient setting, studies show that primary care providers often rely on hospitals or the emergency medical system to evaluate the distressed patient. This simulation-based curriculum addresses pediatric emergencies encountered by primary care providers. The cases were facilitated by faculty at an annual conference on urgent pediatric problems. Methods Three cases are included in this curriculum: asthma, anaphylaxis, and seizure. Each features a brief narrative description of the case, learning objectives, instructor notes, an example of the ideal flow of the scenario, and anticipated management mistakes. Also provided are tools on optimizing the simulation environment, teamwork and communication, and the debrief. Educational materials are included in the respective medical pathologies. The simulations can be run using a high- or low-fidelity mannequin. Results The simulations were carried out annually for 4 years with over 100 providers. Participants overall felt the curriculum was relevant to their practice in the realms of medical management and patient-provider communication. Discussion These simulation cases train primary care providers to recognize a decompensating patient, activate the emergency response system, and initiate appropriate treatment for acutely ill pediatric patients with asthma, anaphylaxis, or seizure. The cases also reinforce teamwork and communication skills with the intention of improving overall readiness in the office. The simulations have been found to be effective learning tools at the University of Washington, which continues to train outpatient providers in emergency response annually using this curriculum.
Published: 2018
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12. Pediatric Emergency Medicine Simulation Curriculum: Cardiac Tamponade

Author: Julie A. Augenstein, Jason Deen, Anita Thomas, Emily Moser, Kimberly Stone, Jennifer Reid, and Rebekah Burns
Subjects: Ultrasound, Shock, Tamponade, Fever and Neutropenia, Pediatric Simulation, Medicine (General), R5-920, Education
Abstract: Introduction Cardiac tamponade is an uncommon presentation to the pediatric emergency department and requires early recognition and emergent intervention. Methods We developed this patient simulation case to simulate a low-frequency, high-acuity scenario for pediatric emergency medicine fellows and resident physicians in emergency medicine, pediatrics, and family medicine. We ran the case in a pediatric emergency department using a high-fidelity pediatric mannequin and equipment found in the clinical environment, including a bedside ultrasound machine. The case involved a 10-year-old patient with Hodgkin lymphoma who presented with fever, neutropenia, and shock and was found to have a pericardial effusion with tamponade after evaluation. The providers were expected to identify signs and symptoms of shock, as well as cardiac tamponade, and demonstrate appropriate emergent evaluation and management. Required personnel included a simulation technician, instructors, and a nurse. Debriefing tools tailored specifically for this scenario were created to facilitate a formal debriefing and formative learner assessment at the end of the simulation. Results This case has been implemented with 10 pediatric emergency medicine fellows during two 3-year cycles of fellow education. Session feedback reflected a high level of satisfaction with the case and an increased awareness of bedside ultrasound in the identification of cardiac tamponade. Discussion This resource for teaching the critical components for diagnosing and managing unstable cardiac tamponade in the pediatric patient, including use of bedside ultrasound, was well received by pediatric emergency medicine fellows.
Published: 2018
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13. Pediatric Toxidrome Simulation Curriculum: Liquid Nicotine Overdose

Author: Arvin Radfar Akhavan, Rebekah Burns, Kimberly Stone, Jennifer Reid, and Suzan Mazor
Subjects: Simulation, Nicotine, Toxicology, Pediatrics, Liquid Nicotine, Medicine (General), R5-920, Education
Abstract: Introduction Liquid nicotine exposure is becoming more common in the pediatric population. Toxicity may occur with exposure to small quantities given the high concentrations in solutions available commercially. Effects can include altered mental status, seizure, and death. Methods This simulation-based case involves the identification and management of a toddler presenting with acute liquid nicotine exposure, with emphasis on the general approach to the acutely ill pediatric patient, consideration in toxic exposures, and the presentation of nicotine exposure. Providers should assess airway, breathing, and circulation while concurrently providing supportive care for an actively seizing simulated patient, necessitating appropriate selection of medications and acute airway management. Additionally, providers must maintain a broad differential diagnosis and obtain a focused history to narrow that differential and identify toxic exposure as a cause of the patient's presentation. Preparatory and didactic material is provided to help the instructor prepare the simulation environment, guide learners through the case, and debrief with learners afterward. Results We implemented this curriculum with four pediatric emergency medicine fellows and 15 pediatric residents during two sessions. Feedback was overwhelmingly positive; participants who completed evaluations reported high levels of confidence with knowledge and skills directly related to the educational objectives after participation (mean Likert scores of 4.9 out of 5 in response to effectiveness of the case in teaching evaluation and management of nicotine toxicity). Discussion This comprehensive resource will aid in offering continuing education for providers and specifically in educating learners with regard to acute liquid nicotine exposure in a child.
Published: 2018
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14. Pediatric Emergency Medicine Simulation Curriculum: Electrical Injury

Author: Jonathan Berry, Kimberly Stone, Jennifer Reid, Alicia Bell, and Rebekah Burns
Subjects: Simulation, Arrhythmia, Pediatrics, Pediatric Emergency Medicine, Electrolyte Abnormality, Electrical Injury, Medicine (General), R5-920, Education
Abstract: Introduction Electrical injuries are rare but potentially life-threatening medical emergencies that require providers to manage a critically ill patient while recognizing and treating the unique sequelae associated with the diagnosis. This simulation case is designed to give pediatric and emergency medicine residents, fellows, attendings, and nurses the opportunity to practice these skills in a realistic setting. Methods This simulation-based curriculum was designed for a high-fidelity mannequin in an emergency department resuscitation room but can be adapted to fit a variety of learning environments. The case featured a 16-year-old boy presenting to the emergency department after arresting in the field after sustaining an electrical injury. He developed ventricular tachycardia during the simulation and had significant hyperkalemia, requiring emergent management. The included debriefing tools assisted instructors in providing formative feedback to learners. Results A total of 40 residents, medical students, and fellows participated in this scenario and provided overwhelmingly positive feedback about the learning experience. Mean Likert scores for participant confidence related to learning objectives after the simulation were 4 or greater on a 5-point scale. Discussion This case was developed to help learners at various levels of training recognize and manage a low-frequency, high-acuity scenario in a standardized environment. Participants specifically had the opportunity to perform airway management, cardiopulmonary resuscitation, defibrillation, and management of hyperkalemia, which may present in real life from a multitude of etiologies. The included materials helped prepare and assist facilitators with debriefing, supplemental education, and bidirectional feedback.
Published: 2018
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15. Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation

Author: Anita Thomas, Elizabeth Sanseau, Neil Uspal, Rebekah Burns, Marc Auerbach, Derya Caglar, Kimberly Stone, and Jennifer Reid
Subjects: Simulation, Ventricular Fibrillation, Hypothermia, Drowning, Pediatric Emergency Medicine, Submersion, Medicine (General), R5-920, Education
Abstract: Introduction Submersion injury or drowning is a leading preventable cause of pediatric mortality and morbidity. Submersion injuries are often accompanied by hypothermia and asphyxia that can lead to inadequate oxygen delivery to tissues and subsequent cardiac arrhythmias. Methods This simulation-based curriculum involves the identification and management of a submersion injury in a 4-year-old boy who was rescued from a cold-water submersion. The simulated patient is apneic, pulseless, bradycardic, and hypothermic; he is being bag-mask ventilated on arrival without intravenous access. He ultimately develops ventricular fibrillation. Providers must recognize the degree of submersion injury, initiate early airway protection, adequately address circulation, and be alert to developing hypothermia and cardiac arrhythmias to prevent further decompensation. This scenario can be modified based on trainee level (pediatric residents vs. pediatric emergency medicine fellows). Results A total of 22 trainees (PGY 1-PGY 6 pediatric residents and pediatric emergency medicine fellows) participated in this simulation curriculum on separate occasions and rated it as an overall positive learning experience. The curriculum's goal is to provide learners with an opportunity to manage life-threatening pediatric submersion injuries, where the correct steps need to be taken in a limited period of time. Discussion We have provided preparatory materials to help instructors set up, run, and debrief the scenario in a standardized fashion. The debriefing tools allow for adaptation depending on learners' needs and individual experiences during the simulated scenario. Also included are supporting educational materials and a learner feedback form that can be used to evaluate the session.
Published: 2017
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16. Pediatric Boot Camp Series: Infant With Altered Mental Status and Seizure—A Case of Child Abuse

Author: James Metz, Kimberly Stone, Jennifer Reid, and Rebekah Burns
Subjects: Simulation, Abuse, Seizure, Pediatrics, Battered Child Syndrome, Nonaccidental Trauma, Medicine (General), R5-920, Education
Abstract: Introduction Child abuse, also known as nonaccidental trauma (NAT), is an important cause of pediatric morbidity and mortality. The presentation of NAT is often confounded by unclear histories and victims who are unable to provide information. Medical students and trainees may fail to consider NAT as a diagnosis or be unfamiliar with the evaluation process. Methods This curriculum uses simulation, small-group discussion, and didactics to help medical students gain an understanding of presentation of NAT. Using the case of a 2-month-old boy presenting with altered mental status and seizure, participants practice the assessment and management of an acutely ill patient. Small-group discussions facilitate schema building to enhance each participant's ability to recognize and diagnose different diseases that may present as infant seizure and to identify the signs of NAT. Didactics solidify concepts addressed during the simulation and small-group discussions. Results Medical students participating in this course reported that they felt better prepared for their internships and that working through a case with a large differential diagnosis was helpful for their understanding of causes of infant seizures, including abusive head trauma. Discussion This curriculum is unique in that it uses one unifying case to allow participants to demonstrate an understanding of the evaluation and stabilization of a critically ill pediatric patient, develop a broad differential diagnosis for a nonspecific symptom, and prioritize and evaluate possible etiologies through the gathering and interpretation of data. This curriculum may be used independently or in conjunction with other learning activities as part of a pediatric boot camp.
Published: 2017
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17. A Taxonomy of Life Writing: Exploring the Functions of Meaningful Self-Sponsored Writing in Everyday Life

Author: Heather Lindenman, Dana Lynn Driscoll, Andrea Efthymiou, Matthew Pavesich, and Jennifer Reid
Abstract: This essay takes as its focus the everyday writing that people compose: the self-sponsored, nonobligatory texts that people write mainly outside of work and school. Through analysis of 713 survey responses and 27 interviews with accompanying writing samples, this study provides a panoramic view of the functions of self-sponsored writing and rhetorical activity for U.S. adults, ages 18 to 65+ years, from a range of geographic, cultural, and professional backgrounds. The Taxonomy of Life Writing presented in this essay demonstrates the range of ways that writing functions in people's daily lives. It includes 19 key functions of life writing, organized into six metafunctions: Creativity and Expression, Identity and Relationships, Organization and Coordination, Preservation and Memory, Reflection and Emotion, and Teaching and Learning. Based on our findings, we affirm the important and diverse functions that life writing serves and propose expanding the threshold concepts of writing to include greater focus on nonobligatory, self-sponsored writing activity.
Published: 2024
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18. Pediatric Emergency Medicine Simulation Curriculum: Hyponatremic Seizures

Author: Wee Chua, Rebekah Burns, Kimberly Stone, and Jennifer Reid
Subjects: Simulation, Seizures, Hyponatremia, Pediatrics, Pediatric Emergency Medicine, Electrolyte Abnormality, Medicine (General), R5-920, Education
Abstract: Abstract Introduction Seizures are a common complaint in the pediatric emergency department. Effective care of this potentially life-threatening medical emergency requires the ability to stabilize the patient while simultaneously identifying and treating the underlying cause. This simulation-based curriculum involves the identification and management of a generalized seizure in a 4-month-old infant secondary to hyponatremia. The target audience is pediatric and emergency medicine residents, fellows, faculty, and nurses. Methods There is no prerequisite preparation for the trainees prior to the case. The simulation scenario, simulation environment preparation, teamwork and communication glossary, and PowerPoint presentation are provided for the instructor in preparation for the simulation case. The setting is the emergency department (ED) resuscitation room. The simulation can be conducted in the ED resuscitation room or in the simulation lab. We used a high-fidelity infant mannequin. The debriefing tools have been tailored specifically for this scenario with advice on how the instructor can edit them for different learners. Results We have used this curriculum with a group of six pediatric emergency medicine fellows at various stages of their training at our institution. The curriculum received overwhelmingly positive feedback through the evaluation form. Discussion This resource will help support standardization of the teaching process, assisting simulation instructors to maximize their impact. In our experience, we have found that instructors who teach intermittently can successfully foster simulation-based education using similar resources. The inclusion of a learner feedback form supports the instructor's ongoing growth while helping faculty to document their teaching efforts.
Published: 2016
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19. Pediatric Emergency Medicine Simulation: Hyperkalemia due to Congenital Adrenal Hyperplasia

Author: Abigail Schuh, Rebekah Burns, Jennifer Reid, and Kimberly Stone
Subjects: Pediatric Resuscitation, Pediatric Hyperkalemia, Pediatric Congenital Adrenal Hyperplasia, Pediatric Adrenal Crisis, Medicine (General), R5-920, Education
Abstract: Abstract Congenital adrenal hyperplasia is a group of autosomal recessive diseases marked by mutation of the genes involved in steroidogenesis. There are many types of the disease with 21-hydroxylase deficiency comprising 90-95% of cases. Medical providers must be able to identify the signs and symptoms of salt-wasting, specifically related to hyperkalemia and hyponatremia. When presented with a critical potassium level, medical providers must rapidly stabilize the cardiac membranes to prevent ventricular arrhythmias. The goal of this scenario is to provide the learner with an opportunity to manage life-threatening pediatric hyperkalemia due to adrenal crisis, where both electrolyte abnormalities and the underlying etiology must be addressed. We include extensive preparatory material to help the instructor prepare the environment and learners. The debriefing tools have been tailored specifically for this scenario, with advice on how the instructor can edit them for different learners. The suggested debriefing comments/questions in the Skill Training section are written in the advocacy-inquiry debriefing style that would best be supported by formative assessment with adequate time for learners to reflect. These are the debriefing questions we use the most in our ongoing educational curriculum. The Medical Management and Teamwork Evaluations/Debriefing Forms are written in the plus/delta debriefing style and are a better fit for summative assessment. We use these less frequently, often as part of our quality improvement work. Because not all the material will be applicable to every instructor and every set of learners, we recommend instructors spend at least 30 minutes of preparatory time with all the materials to ensure familiarity, confidence, and maximal efficacy.
Published: 2015
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20. Pediatric Emergency Medicine Simulation Curriculum: Traumatic Brain Injury

Author: Jennifer Reid and Kimberly Stone
Subjects: Brain Injuries, Pediatric Resuscitation, Pediatric Trauma, Pediatric Traumatic Brain Injury, Medicine (General), R5-920, Education
Abstract: Abstract Rapid identification and stabilization of traumatic brain injury (TBI) and its potential sequelae (hypoxia, hypotension, increased intracranial pressure leading to cerebral herniation and death) is critical to ensure the best long term neurological outcomes. As definitive care (surgical decompression) may only be available at pediatric trauma centers, prompt transfer to an appropriate pediatric trauma facility can be critical. This simulation-based scenario teaches learners to recognize and manage pediatric TBI injury with an integrated team communication focus. Learners will participate in a simulation scenario and be asked to identify the signs and symptoms of traumatic brain injury and its management. At the end of training, the learners should be able to recognize the seriousness of the situation and effectively coordinate a full resuscitation team. This resource includes extensive preparatory material to help instructors prepare the environment and reflect on their learners. Background information on simulation and debriefing theory is also provided. Two different types of debriefing tools have been tailored specifically for this scenario, with advice on how the instructor can modify them further for learners with different levels of experience and different opportunities for improvement. This scenario is one component of a larger course: the Pediatric Emergency Medicine Simulation course. Over the past four years, we have found that learners' performance in medical decision making, technical skills, and teamwork skills improve over time.
Published: 2015
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21. Pediatric Emergency Medicine Simulation Curriculum: Thyroid Storm

Author: Rebekah Burns, Kimberly Stone, Jennifer Reid, Faisal Malik, and Adam Cheng
Subjects: Thyrotoxicosis, Pediatric Thyroid Storm, Endocrinology, Medicine (General), R5-920, Education
Abstract: Abstract Introduction Thyroid storm, also known as thyrotoxic crisis, is an uncommon but potentially life threatening medical emergency if not immediately recognized and treated aggressively. Its signs and symptoms may mimic that of other etiologies including infection and ingestion. It is imperative that pediatric health care providers are able to recognize potential warning signs and initiate appropriate evaluation and management. Methods This scenario teaches learners to recognize and manage thyroid storm in the emergency setting. It is simulation-based, designed for manikin-based simulation equipment, with an integrated team communication focus. Learners will participate in a simulation scenario and be asked to identify the signs and symptoms of thyroid storm, appropriate evaluation within the emergency department and emergency management. At the end of training, the learners should be able to recognize the seriousness of the situation and manage a full resuscitation team. The primary complications for the team to recognize and manage are altered mental status and vital sign instability. Results The simulation curriculum presented here was implemented at our institution using pediatric emergency medicine fellows as the targeted learners. Because of the high level of training of the learners, we elected to use the optional stage. The fellows provided feedback regarding the session afterwards. Their comments reflected appreciation for a rare presentation that many had not seen clinically before but that shares features with many other potential diagnoses such as infection or toxidrome. They felt it served as a good educational experience and will remind them to keep an open differential diagnosis and seek out key features from the history or exam that may support and endocrinologic etiology for fever, tachycardia and altered mental status. They also reported that altering the simulation mannequin to have a goiter was helpful. Discussion Thyroid storm, also known as is an uncommon but potentially life threatening medical emergency if not immediately recognized and treated aggressively. This resource teaches learners to recognize and manage thyroid storm in the emergency setting.
Published: 2015
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22. Pediatric Emergency Medicine Simulation Curriculum: Blunt Abdominal Trauma

Author: Jennifer Reid, Kimberly Stone, and Jeffrey Otjen
Subjects: Pediatrics, Pediatric Resuscitation, Pediatric Blunt Abdominal Trauma, Pediatric Trauma, Medicine (General), R5-920, Education
Abstract: Abstract Injury in general, is the leading cause of death for children in the United States and most developed countries. Blunt abdominal trauma occurs in 10-15% of injured children, with two typical patterns: isolated injury caused by a direct blow or as a part of a high-mechanism, multisystem trauma. Rapid identification of blunt abdominal trauma and its potential sequelae (e.g., hemorrhagic shock, bowel injury) is critical. Management should include monitoring, supplemental 100% oxygen, recruitment of additional resources, airway protection, and intravascular volume replacement. Rapid sequence intubation should be considered for unstable patients. Definitive care may only be available at trauma centers; thus, prompt transfer to a pediatric trauma facility may be critical. The goal of this scenario is to provide the learner with an opportunity to manage pediatric blunt abdominal trauma with hemorrhagic shock, where the correct steps need to be taken in a limited period of time. We included extensive preparatory material, to help the instructor prepare the environment and learners. The debriefing tools have been tailored specifically for this scenario, with advice on how the instructor can edit them for different learners. Supplemental learner handouts help reinforce teaching points. In addition, handouts reviewed by learners who are not able to attend a specific session generate questions amongst the residents themselves and more interest for future simulation sessions. The inclusion of a learner feedback form promotes continuous improvement of the scenario, environmental preparation, and debriefing. In addition, it helps faculty document their teaching efforts. As part of the larger pediatric emergency medicine curriculum which features recurring educational goals and objectives, we found that learners' performance (in medical management, technical skills, and teamwork) improves over time.
Published: 2015
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23. Pediatric Emergency Medicine Simulation Curriculum: Bronchiolitis

Author: Neil Uspal, Kimberly Stone, Jennifer Reid, and Tiffany Tausala Coleman-Satterfield
Subjects: Infant, Simulation, Bronchiolitis, Respiratory Distress, Tension Pneumothorax, Emergency Medicine, Medicine (General), R5-920, Education
Abstract: Abstract This scenario teaches learners to recognize and manage a critically ill patient with bronchiolitis in the emergency setting. A subset of patients with bronchiolitis experience severe respiratory symptoms requiring aggressive ventilatory support. Many of these patients have required endotrachial intubation. Recently, more of these patients have been managed with high flow nasal canula (HFNC) oxygen therapy, with retrospective studies showing decreased rates of intubation of bronchiolitic patients when this therapy has been adopted. This curriculum involves a common disease process with potential serious complications. This resource is simulation based, designed for manikin-based simulation equipment, with an integrated team-communication focus. Learners will participate in a simulation scenario and be asked to identify the signs and symptoms of bronchiolitis and their management. Two versions of this scenario are presented. The first version presents respiratory distress secondary to bronchiolitis which meets criteria for the use of high flow nasal canula oxygen therapy or nasal continuous positive airway pressure. The second version of the scenario presents respiratory failure secondary to bronchiolitis which requires intubation. The selection of which version is used should be based on individual learning objectives and availability of different therapies. There are also optional sections of both versions of the scenario requiring the recognition and management of tension pneumothorax. At the end of training, the learners should be able to recognize the seriousness of the situation and manage a full resuscitation team. The primary complications for the team to recognize and manage are respiratory distress and impending respiratory failure. This curriculum involves a common disease process with potential serious complications. It incorporates a novel treatment modality, while providing an alternative scenario for centers where use of high flow nasal cannula (HFNC) is not standard of care. It can be used both for teaching and as a tool to evaluate the implementation of HFNC. It is adaptable to the training level of the learner. Finally it utilizes simulation to promote and teach teamwork and effective communication skills.
Published: 2015
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24. Pediatric Toxidrome Simulation Curriculum: Salicylate Toxidrome

Author: Rebekah Burns, Jennifer Reid, and Suzan Mazor
Subjects: Toxidrome, Pediatric Salicylate Ingestion, Methyl Salicylates, Medicine (General), R5-920, Education
Abstract: Abstract This scenario teaches learners to recognize and manage pediatric salicylate toxicity and its complications, including metabolic acidosis, respiratory alkalosis, electrolyte abnormalities, and cerebral dysfunction. The scenario is simulation-based with an integrated team-communication focus. Learners will identify the signs and symptoms of a salicylate toxidrome and learn the appropriate evaluation for, and management of, salicylate toxicity. The learners should recognize the seriousness of the situation and organize a full resuscitation team. The primary complications for the team to recognize and manage are acid/base and metabolic disturbances, as well as altered mental status. We included extensive preparatory material to help the instructor prepare the environment and learners. The debriefing tools have been tailored specifically for this scenario with advice on how the instructor can edit them for different learners. There are options that allow the difficulty of the case and the goals for evaluation and management to be changed according to the needs of the learner group. This resource tries to anticipate most questions and issues that could arise based on the issues we've encountered, while also allowing each instructor the flexibility to tailor their educational objectives to their learners. Particular examples are the instructor evaluation/debriefing forms. It is difficult to address more than three of these issues per session. We chose to include many more than three potential issues, allowing each instructor to focus on those most relevant to their group of learners. This resource can be used in isolation or as a component of our pediatric toxidrome simulation curriculum to provide more comprehensive pediatric toxicology and resuscitation training.
Published: 2014
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25. Pediatric Emergency Medicine Simulation Curriculum: Ventricular Fibrillation

Author: Jennifer Reid and Kimberly Stone
Subjects: Resuscitation Orders, Cardiopulmonary Resuscitation, Ventricular Fibrillation, Resuscitation, Pediatrics, Arrhythmias Cardiac, Medicine (General), R5-920, Education
Abstract: Abstract Introduction Anesthesia residents and other professionals are far removed from their experiences in gross anatomy dissection. To address this, efforts were made to create videos that would remind residents of the important gross anatomy underlying the procedures that they were performing. This resource includes a set of four videos for teaching upper extremity peripheral nerve block anatomy and technique to anesthesia residents. Methods One week before the nerve block lecture, residents were assigned the four videos to review in order to get a sense of the procedure. Each video begins with a cadaver dissection of the gross anatomy pertinent to the nerve block being taught, then the physical landmarks are demonstrated on a standardized patient, and finally, ultrasound images and techniques for guiding the injection are displayed. At the beginning of the lecture parts of the videos were reviewed and questions were addressed. More detailed instruction and technique was then given, including medication and instrument specifics. The residents were then given permanent access to the videos. Results When first implemented in 2012, an initial paper survey and quiz was administered to 20 residents. The most preferred feature was the ultrasound demonstration with the patient and cadaver. Before watching the videos a mean previous knowledge score among all residents was 5/10 with a SD of 1.8. After watching the videos the mean knowledge assessment score was 8.2/10 with a SD of 1.2. In early 2014 a survey was administered to 22 second-year medical students to assess the videos as a tool for clinical correlation. Qualitative feedback, while overall positive in nature, suggested greater power over varying speeds, more illustration, and cosmetic changes. The survey also showed an increase in the mean knowledge assessment score from 65% to 87.9% before and after viewing the videos. Discussion While there are videos on performing peripheral nerve blocks, these videos include gross anatomy. Having gross anatomy, surface landmarks, and ultrasound in the same instruction helps to make important connections and we have yet to find a set of videos available that meets this same objective. In addition, this format allows students to progress at their own pace and convenience, while minimizing needless repetition from instructors.
Published: 2014
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26. Pediatric Emergency Medicine Simulation Curriculum: Seizure Scenario

Author: Jennifer Reid and Kimberly Stone
Subjects: Pediatrics, Pediatric Resuscitation, Pediatric Seizure, Medicine (General), R5-920, Education
Abstract: Abstract Pediatric seizures impact children worldwide. In developed countries, the prevalence of epilepsy is 4-8 per 1,000 children. Of all children, up to 5% will have a febrile seizure before reaching age 5. Pediatric seizures can consist of a number of different seizure types. For this scenario, the focus is on generalized pediatric seizures, which involve both hemispheres of the brain and result in impaired mental status and bilateral motor manifestations (tonic and clonic movements). Medical providers must recognize a generalized seizure early, when a pediatric patient is more likely to respond favorably to treatment. Medical providers must anticipate and treat the primary complication of respiratory insufficiency to prevent additional morbidity or mortality. The goal of this scenario is to provide the learner with an opportunity to manage a potentially life-threatening pediatric seizure, where the correct steps need to be taken in a limited period of time. This resource provides a comprehensive package to support instructors teaching pediatric seizure using a simulation-based modality. It includes background knowledge, presimulation preparation guidelines, a simulation scenario, tools to help evaluate team performance and guide debriefing, tools to elicit student feedback on the instructor's performance, and supplemental educational materials for instructors to provide to their students. We included extensive preparatory material, to help the instructor prepare the environment and learners. The debriefing tools have been tailored specifically for this scenario, with advice on how the instructor can modify them for learners with different levels of experience and opportunities for improvement. This resource will help support standardization of the teaching process, allowing simulation instructors maximize their impact. Over the past four years, we found that instructors are better able to anticipate and optimize discussion of debriefing points when utilizing this resource.
Published: 2014
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27. A Comprehensive Infant Lumber Puncture Novice Procedural Skills Training Package: An INSPIRE Simulation-Based Procedural Skills Training Package

Author: Marc Auerbach, Todd Chang, Daniel Fein, Marjorie White, Renuka Mehta, James Gerard, Pavan Zaveri, Maybelle Kou, Jennifer Reid, Dewesh Agrawal, Wendy Van Ittersum, Daniel Scherzer, Elsa Vasquez, Sujit Iyer, Anita Thomas, Taylor Sawyer, and David Kessler
Subjects: Infant, Simulation, Educational Measurement, Learning, Pediatrics, Mastery Learning, Medicine (General), R5-920, Education
Abstract: Abstract Introduction Infant lumbar puncture (LP) is such a common procedure performed by pediatric house staff that the ACGME states it is a required essential pediatric residency skill. However, as new learners enter a clinical setting, they may be asked to perform an LP without having had any experience on a live infant. The purpose of the materials in this mastery learning module is to provide a comprehensive simulation-based training and assessment package related to the infant LP procedure. Methods This multimodal package will use simulation as a formative assessment medium to review LP training on a simulator prior to performing an LP on a live infant patient. The simulated environment provides a means for trainees to achieve a specific competency level via practice without affecting live patients. In the context of the International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE) phases of training (i.e., learn, see, practice, prove, do, maintain), this simulation addresses the first four of these phases: (1) initial instruction about the procedure, (2) faculty-led demonstration, (3) hands-on simulation-based training, and (4) assessment on a simulator. Materials provided in this resource include an instruction guide, session outline/rating checklist, and a train-the-trainer video. Results Our work has demonstrated that under the right conditions participation in a simulation-based mastery learning with deliberate practice intervention improves infant LP skills. Fifty-one residents reported 32 clinical encounters. Sixteen of 17 subjects (94%) who received this module and performed a clinical infant LP obtained cerebrospinal fluid compared with 7 of 15 subjects (47%) in the control group. Discussion The use of this formative assessment in LP training has potentially broad implications in terms of resident education and improved clinical outcomes. If errors are identified and resolved in a simulated situation, not only will the trainee feel more confident, but also could lead to an improved clinical outcome on a live patient.
Published: 2014
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28. Pediatric Emergency Medicine Simulation Curriculum: Supraventricular Tachycardia

Author: Kimberly Stone and Jennifer Reid
Subjects: Pediatrics, Pediatric Resuscitation, Pediatric Supraventricular Tachycardia, Pediatric Arrhythmias, Medicine (General), R5-920, Education
Abstract: Abstract Supraventricular tachycardia (SVT) is the most common rhythm disturbance in children, affecting approximately 1 in 250 children. Its incidence is greater in critically ill children or those with congenital or acquired heart disease. Medical providers should recognize children in SVT early. Medical providers should initiate reinstitution of a normal sinus rhythm rapidly and beware of the risk for potential deterioration of the rhythm if not treated appropriately in a timely manner. The goal of this scenario is to provide the learner with an opportunity to manage life-threatening pediatric supraventricular tachycardia, where the correct steps need to be taken in a limited period of time. We included extensive preparatory material, to help the instructor prepare the environment and learners. The debriefing tools have been tailored specifically for this scenario, with advice on how the instructor can edit them for different learners. This resource will help support standardization of the teaching process, helping simulation instructors maximize their impact. Supplemental learner handouts can reinforce teaching points. The inclusion of a learner feedback form supports the instructor's ongoing growth while helping faculty to document their teaching efforts. In addition, we created this resource to stand alone, and providing a standard collection of instructor resources since we have had to rely on a variety of instructors to implement our curriculum. Over the past 4 years, we found that instructors who teach intermittently can successfully foster simulation-based education using this resource. While resources do not replace experience and grounding in simulation education theory, they can help instructors at all levels provide more consistent learning experiences for students.
Published: 2014
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29. Pediatric Emergency Medicine Simulation Curriculum: Status Asthmaticus

Author: Jennifer Reid and Kimberly Stone
Subjects: Status Asthmaticus, Pediatric Resuscitation, Pediatric Asthma, Medicine (General), R5-920, Education
Abstract: Abstract Status asthmaticus continues to be a major cause of morbidity and mortality worldwide. Status asthmaticus is characterized by airway inflammation, excessive airway mucous production and/or plugging and bronchospasm, and leading to airflow obstruction. This can result in a progression from respiratory insufficiency to respiratory failure. Medical providers must recognize children in status asthmaticus early when they are more likely to respond favorably to treatment. The goal of this scenario is to provide the learner with an opportunity to manage life-threatening pediatric status asthmaticus, where the correct steps need to be taken in a limited period of time. This resource provides a comprehensive package to support instructors teaching pediatric status asthmaticus. It includes background knowledge, presimulation preparation guidelines, a simulation scenario, tools to help evaluate team performance and guide debriefing, tools to elicit student feedback on the instructor's performance, and supplemental educational materials for instructors to provide their students. Also included are extensive preparatory materials to help the instructor prepare the environment and learners. Debriefing tools have been tailored specifically for this scenario, with advice on how the instructor can edit them for different learners. This resource will help support standardization of the teaching process, helping simulation instructors maximize their impact. Supplemental learner handouts can help reinforce the teaching points. The inclusion of a learner feedback form supports the instructor's ongoing growth while helping faculty to document their teaching efforts.
Published: 2014
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30. Pediatric Emergency Medicine Simulation Curriculum: Anaphylaxis

Author: Jennifer Reid and Kimberly Stone
Subjects: Pediatrics, Pediatric Anaphylaxis, Pediatric Resuscitation, Medicine (General), R5-920, Education
Abstract: Abstract Anaphylaxis is a potentially fatal disorder which can mimic other illnesses initially and rapidly progress if not treated. Anaphylaxis is characterized by acute onset of skin or mucosal changes and respiratory compromise, reduced blood pressure, or end organ dysfunction. Medical providers must recognize children in anaphylaxis early and initiate systemic treatment rapidly to prevent further decompensation and cardiopulmonary failure. The goal of this scenario is to provide the learner with an opportunity to manage life-threatening pediatric anaphylaxis, where the correct steps need to be taken in a limited period of time. Included are extensive preparatory materials to help the instructor prepare the environment and learners. The debriefing tools have been tailored specifically for this scenario, with advice on how the instructor can edit them for different learners. This resource will help support standardization of the teaching process, allowing simulation instructors to maximize their impact. Supplemental learner handouts can help reinforce the teaching points. The inclusion of a learner feedback form supports the instructor's ongoing growth while helping faculty document their teaching efforts. This scenario, by itself, can be inserted into other ongoing educational programs. It provides a standard collection of instructor resources. This has been particularly helpful, since we have had to rely on a variety of instructors to implement our curriculum. Over the past 4 years, we found that by using this as an individual resource, instructors who teach intermittently can successfully foster simulation-based education. While these resources do not replace experience and grounding in simulation education theory, they can help instructors at all levels provide more consistent learning experiences for students.
Published: 2013
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31. Pediatric Emergency Medicine Simulation Curriculum: Septic Shock

Author: Jennifer Reid and Kimberly Stone
Subjects: Septic Shock, Shock, Septic, Pediatrics, Pediatric Resuscitation, Shocks, Medicine (General), R5-920, Education
Abstract: Abstract Septic shock continues to be a major cause of morbidity and mortality in children. Early recognition and management of severe sepsis and septic shock in the first hour of resuscitation have been shown to decrease mortality. Medical providers must recognize children in septic shock early precisely because they are more likely to respond favorably to treatment. The goal of this scenario is to provide the learner with an opportunity to manage life-threatening pediatric septic shock, where the correct steps need to be taken in a limited period of time. This resource provides a comprehensive package to support instructors teaching pediatric septic shock. It includes background knowledge, presimulation preparation guidelines, a simulation scenario, tools to help evaluate team performance and guide debriefing, tools to elicit student feedback on the instructor's performance, and supplemental educational materials for instructors to provide their students. Also included are extensive preparatory material, to help the instructor prepare the environment and learners. The debriefing tools, have been tailored specifically for this scenario, with advice on how the instructor can tailor them to different learners. This resource will help support standardization of the teaching process, helping simulation instructors maximize their impact. Supplemental learner handouts can help reinforce the teaching points even after the session has finished. The inclusion of a learner feedback form supports the instructor's ongoing growth while helping faculty to document their teaching efforts.
Published: 2013
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32. Pediatric Emergency Medicine Simulation Curriculum: Hypovolemic Shock

Author: Jennifer Reid and Kimberly Stone
Subjects: Shock, Hypovolemic Shock, Pediatrics, Medicine (General), R5-920, Education
Abstract: Abstract This module provides a comprehensive package to support instructors teaching pediatric hypovolemic shock. It includes background knowledge, presimulation preparation guidelines, a simulation scenario, tools to help evaluate team performance and guide debriefing, and tools to elicit student feedback on the instructor's performance. Additionally, it has supplemental educational materials for instructors to provide their students. We included extensive preparatory material to help the instructor prepare the environment and learners. The debriefing tools, to assist the instructor in their teaching, have been tailored specifically for this scenario with the addition of advice on how the instructor can tailor them to different learners. This course will help support standardization of the teaching process, helping simulation instructors maximize their impact. Supplemental learner handouts can help reinforce the teaching points even after the session has finished. The inclusion of a learner feedback form supports the instructor's ongoing growth while helping faculty to document their teaching efforts. This is the most comprehensive collection of educational material available for this topic. This scenario is one component of a larger course: the Pediatric Emergency Medicine Simulation Curriculum. Exposure to multiple scenarios within the curriculum fosters reinforcement of recurring learning objectives (e.g., closed loop communication) over time. A companion curriculum, the Pediatric Toxidrome Simulation Curriculum, is also available on MedEdPORTAL.
Published: 2013
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33. Pediatric Toxidrome Simulation Curriculum: Cholinergic Toxidrome

Author: Jennifer Reid, Suzan Mazor, and Sara Kim
Subjects: Overdose, Cholinergic Agents, Cholinergic Toxicity, Toxidrome, Medicine (General), R5-920, Education
Abstract: Abstract This resource provides a comprehensive package to support instructors teaching pediatric cholinergic toxidrome. It includes background knowledge, presimulation preparation guidelines, and a simulation scenario, as well as tools to help evaluate team performance, guide debriefing, and elicit student feedback on instructor performance. Additionally, it has supplemental educational materials for instructors to provide to their students. This resource can be used in isolation or as a component of our pediatric toxidrome simulation curriculum to provide more comprehensive pediatric toxicology and resuscitation training. This curriculum is the most comprehensive pediatric cholinergic toxidrome curriculum we have seen. Other scenarios lack the detailed preparatory material, potential mistakes, and supplemental educational materials provided here. We have included extensive preparatory material to help the instructor prepare the environment and learners. The scenario itself is more complex, with more potential variations for clinical case progression than seen elsewhere. The debriefing tools, included to assist the instructor in his/her teaching, have been tailored specifically for this scenario, with advice on how to adapt them to different learners. This curriculum helps support standardization of the teaching process, assisting simulation instructors to maximize their impact. Supplemental learner handouts can reinforce the teaching points even after the session has finished. The inclusion of a learner feedback form supports the instructor's ongoing growth while helping faculty document their teaching efforts.
Published: 2012
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34. Obstetric Bleeding Curriculum

Author: Julia Metzner, Jennifer Reid, Christopher Wu, Stefan Lombaard, Michael Fialkow, Megan Sherman, and Sara Kim
Subjects: Anesthesia, Crisis Management, Massive Intraoperative Hemorrhage, Obstetric Bleeding Emergency, Scenario Development, Medicine (General), R5-920, Education
Abstract: Abstract One out of ten deliveries are complicated by postpartum hemorrhage (PPH) with an associated maternal mortality rate as high as 17%. The most common cause of PPH is uterine atony. Uterine atony, or failure of the myometrial muscle fibers to contract following delivery, can lead to rapid and severe hemorrhage and hypovolemic shock. The effective management of major PPH relies on an organized multidisciplinary approach involving the obstetrician, anesthesiologist, hematologist, nursing staff, laboratory, and blood bank personnel. This simulation was been designed to provide an opportunity for anesthesia and OB/GYN residents to practice the diagnosis and management of an obstetric bleeding emergency in a realistic, but risk-free environment. This simulation scenario has been implemented successfully in our simulation curriculum at University of Washington ISIS Simulation Center. It is best run in a standard simulation center with a high-fidelity mannekin (Laerdal SimMan). The simulation takes two hours to complete and works best with three-to five-learners per session. Participants at the institution, first-, second-, and third-year clinical anesthesia residents, acknowledged the realism and value of the experience in their feedback. Perceived benefits included optimization of clinical performance and decision-making during crisis management, and a sharpening communication skills while interacting with a multidisciplinary team.
Published: 2011
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35. Pediatric Toxidrome Simulation Curriculum: Opioid Toxidrome

Author: Jennifer Reid, Suzan Mazor, and Sara Kim
Subjects: Crisis Management, Respiratory Failure, Opioid Toxicity, Team Communication, Resucitation, Adverse Effects, Medicine (General), R5-920, Education
Abstract: Abstract This course teaches learners to recognize and manage pediatric opioid toxicity and its complication, respiratory failure. The course is simulation-based, with an integrated team communication focus. The learners identify the signs and symptoms of an opioid toxidrome, learn its antidote, and learn that repeated doses of the antidote may be necessary in managing opioid toxicity. The learners should recognize the seriousness of the situation and recruit a full resuscitation team. The primary complication for the team to recognize and manage is respiratory failure. This resource can be used in isolation or as a component of our pediatric toxidrome simulation curriculum to provide more comprehensive pediatric toxicology and resuscitation training. A companion curriculum, the pediatric emergency medicine simulation curriculum, is also available on MedEdPORTAL. This curriculum is the most comprehensive pediatric opioid toxidrome curriculum we have seen. While other scenarios do exist, they lack the background, detailed forethought of learner prerequisites, and potential mistakes and supplemental educational materials provided here. We have included extensive preparatory material to help the instructor prepare the environment, prepare the learners, and set the stage for the educational experience. The scenario itself is more complex, with more potential variations for clinical case progression than seen elsewhere. The debriefing tools are otherwise not available in the literature. This will help support standardization of the teaching process, guiding even less experienced debriefers to maximize their impact. Supplemental learner handouts can help reinforce the teaching points even after the scenario has finished. The inclusion of a learner feedback form, not seen elsewhere in the literature, supports the instructor's ongoing growth while helping faculty to document their teaching efforts. This is the most comprehensive collection of educational material available for this topic.
Published: 2010
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36. Pediatric Toxidrome Simulation Curriculum: Anticholinergic Toxidrome

Author: Jennifer Reid, Suzan Mazor, and Sara Kim
Subjects: Seizures, Resuscitation, Anticholinergic Toxidrome, Anticholinergic Overdose, Cardiac Dysrhythmias, Medicine (General), R5-920, Education
Abstract: Abstract This course teaches learners to recognize and manage pediatric anticholinergic toxicity and its main complications, seizures and cardiac dysrhythmia. The course is simulation based, with an integrated team communication focus. The learners identify the signs and symptoms of anticholinergic toxidrome, learn its antidote, and learn that repeated doses of the antidote may be necessary in managing anticholinergic toxicity. The primary complications for the team to recognize and manage are seizures and cardiac dysrhythmias. There are many types of drugs and botanicals with anticholinergic effects, including diphenhydramine, tricyclic antidepressants, antihistamines, scopolamine, jimsonweed, and belladonna alkaloids. The prevalence of anticholinergic drugs in many over-the-counter preparations make them a common element in many homes. Accidental and suicidal overdoses with these drugs are common, particularly in early childhood. Likewise, recreational poisonings with anticholinergic botanicals are common in adolescents. The goal of this course is to provide the learners with an opportunity to manage a life-threatening pediatric anticholinergic overdose, where the correct steps need to be taken in a limited period of time. In this simulation, the learners should recognize the seriousness of the situation and recruit a full resuscitation team. This resource can be used in isolation or as a component of our pediatric toxidrome simulation curriculum to provide more comprehensive pediatric toxicology and resuscitation training. A companion curriculum, the pediatric emergency medicine simulation curriculum, is also available on MedEdPORTAL. This curriculum is the most comprehensive pediatric anticholinergic toxidrome curriculum we have seen. Other scenarios do exist, but they lack the detailed preparatory material, potential mistakes, and supplemental educational materials provided here.
Published: 2010
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37. Gendered Disparities in Take-Ups of Employee Health Benefits

Author: Keene, Jennifer Reid and Prokos, Anastasia H.
Published: 2010
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38. Higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support (RECOVERY)

Author: Obbina Abani, Ali Abbas, Fatima Abbas, Joshua Abbas, Kasim Abbas, Mustafa Abbas, Sadia Abbasi, Hakam Abbass, Alfie Abbott, Alison Abbott, Nabeel Abdallah, Ammar Abdelaziz, Ashraf Abdelaziz, Mohamed Abdelfattah, Bushra Abdelqader, Audrey Abdul, Basir Abdul, Siddiqui Abdul, Althaf Abdul Rasheed, Ajibode Abdulakeem, Rezan Abdul-Kadir, Abdullah Abdullah, Abdulfatahi Abdulmumeen, Rasheed Abdul-Raheem, Niyaz Abdulshukkoor, Kula Abdusamad, Yazeed Abed El Khaleq, Mai Abedalla, Abeer Abeer Ul Amna, Lynn Abel, Katrina Abernethy, Movin Abeywickrema, Chandra Abhinaya, Affyarsyah Abidin, Adebanke Aboaba, Abigail Aboagye-Odei, Christopher Aboah, Heba Aboelela, Hani Abo-Leyah, Karim Abouelela, Ahmed Abou-Haggar, Mahmoud Abouibrahim, Ahmed Abousamra, Mona Abouzaid, Miriam Abraham, Tizzy Abraham, Abraheem Abraheem, Judith Abrams, Rebecca Abrams, Hyacinth-John Abu, Ahmed Abu-Arafeh, Syed M Abubacker, Akata Abung, Yousuf Abusamra, Yaa Aceampong, Amaka Achara, Devikumar Acharya, Faustina Acheampong, Prince Acheampong, Sarah Acheampong, Janet Acheson, Shiella Achieng, Andres Acosta, Rebecca Acquah, Catherine Acton, Jacqueline Adabie-Ankrah, Paul Adair, Fiona Adam, Matthew Adam, Huzaifa Adamali, Marta Adamczyk, Carol Adams, Charlotte Adams, Daniel Adams, Kate Adams, Laura Adams, Nikkita Adams, Richard Adams, Tim Adams, Laura Adamu-Ikeme, Krishma Adatia, Kirsty Adcock, Lawrence Addai-Boampong, Afua Addo, Oluwatobi Adeagbo, Ade Adebiyi, Ogunlana Adedeji, Yewande Adegeye, Ken Adegoke, Vicki Adell, Sherna Adenwalla, Femi W Adeoye, Oluwasegun A Adesemoye, Emmanuel O Adewunmi, Adedamola Adeyanju, Joyce Adeyemi, Tenifayo Adeyemo, Binay Adhikari, Shanti A Adhikari, Rina Adhikary, Adhikarla Aditya, Patience Adjepong, Gabrielle Adkins, Adnan Adnan, Marguerite Adriaanse, John Aeron-Thomas, Debbie Affleck, Carmel Afnan, Muhammad Afridi, Patricia Afrim, Felicia Akua Afriyie, Zainab A Aftab, Meenakshi Agarwal, Rachel Agbeko, Chris Agbo, Sunil Aggarwal, Arameh Aghababaie, Laura Aguilar Jimenez, Jacqueline Afrakomah Agyekum, Kwame Agyen, Shafana Ahamed Sadiq, Mohamed H Ahammed Nazeer, Mohammad Ahmad, Syed Ahmad, Afshan Ahmed, Ashar Ahmed, Asim Ahmed, Basheer A R Ahmed, Bilal Ahmed, Forizuddin Ahmed, Hamze Ahmed, Hanad Ahmed, Irshad Ahmed, Khaled Ahmed, Khalil Ahmed, Liban Ahmed, Mahin Ahmed, Maria C Ahmed, Muhammad S Ahmed, Naseer Ahmed, Nausheen Ahmed, Osama Ahmed, Rajia A Ahmed, Rawya Ahmed, Rizwan Ahmed, Saif Ahmed, Sammiya Ahmed, Sana G Ahmed, Syed Ahmed, Syed H Ahmed, Roa Ahmed Ali, Bilal Ahmed Mohamud, Sana Ahmed, Sana Ahmer, Augustine Ahonia, Christine Aiken, Dhiraj Ail, Mark Ainsworth, Myriam Aissa, Lindianne Aitken, Bini Ajay, Abdulakeem Ajibode, Ayesha Ajmi, Nasim Akhtar, Nauman Akhtar, Suha Akili, Bolutito Akinbiyi, Oludoyinsola Akindolie, Yinka Akinfenwa, Olugbenga Akinkugbe, Ibrahim Akinpelu, Mohammad Akram, Olugbenro Aktinade, Uzayr Akudi, Ahmad S A R Al Aaraj, Asma Al Balushi, Majd Al Dakhola, Aladdin Al Swaifi, Eslam Al-Abadi, Adegoke Alabi, Narendra 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Czekaj, Patrycja Czylok, Shane D'Souza, Joana da Rocha, Mohammed Dafalla, Andrew Dagens, Helen Daggett, Jacqui Daglish, Sandeep Dahiya, Anne Dale, Katie Dale, Michaela Dale, Sam Dale, Susan Dale, Jolyon Dales, Umberto D'Alessandro, Helen Dalgleish, Helen Dallow, Carlo D'aloia, Dermot Dalton, Morag Dalton, Zoe Daly, Mansi Damani, Eleanor Damm, Akila Danga, Joanne Dangerfield, Amelia Daniel, Priya Daniel, Allison Daniels, Adela Dann, Kwaku Gyasi Danso, Sandra Danso-Bamfo, Quang Tung Dao, Suzanne Darby, Alex Darbyshire, Janet Darbyshire, Paul Dargan, Paul Dark, Kate Darlington, Sarah Darnell, Thomas Darton, Guledew Darylile, Avisnata Das, Manjusha Das, Sukamal Das, Martin Daschel, Joanne Dasgin, Dibyendu Datta, Anna Daunt, Vaishali Dave, Emily Davenport, Mark Davey, Miriam Davey, Molly Davey, Mini David, Alexander Davidson, Laura Davidson, Neil Davidson, Richard Davidson, Albert Davies, Alison Davies, Amanda Davies, Amy Davies, Angela Davies, Bethan Davies, Caroline Davies, Carolyn 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Souza, Anthony De Soyza, Natasha de Vere, Johannes de Vos, Bethan Deacon, Sharon Dealing, Anna Dean, Julie Dean, Katrina Dean, Stephen Dean, Tessa Dean, Jill Deane, James Dear, Effie Dearden, Catherine Deas, Samuel Debbie, Gabor Debreceni, Vashist Deelchand, Matthew Deeley, Joanne Deery, Emmanuel Defever, Manuela Del Forno, Arnold Dela Rosa, Gonzalo De-La-Cedra, Amanda Dell, Carrie Demetriou, David DeMets, Jane Democratis, Jacqueline Denham, Emmanuelle Denis, Laura Denley, Craig Denmade, Alexandra Dent, Kathy Dent, Martin Dent, Elise Denton, Tom Denwood, Nishigandh Deole, Darshita Depala, Maria Depante, Susan Dermody, Amisha Desai, Asmita Desai, Purav Desai, Sanjeev Deshpande, Vai Deshpande, Sirjana Devkota, Usha Devkota, Debbie Devonport, Matthew Devonport, Prakash Dey, Vishal Dey, Rogin Deylami, Kevin Dhaliwal, Sundip Dhani, Amandeep Dhanoa, Mili Dhar, Ankush Dhariwal, Dawpadee Dharmasena, Devesh Dhasmana, Ekanjali Dhillon, Reiss Dhillon, Syra Dhillon, Meghnath Dhimal, Dipali Dhiru, Trupti Dhorajiwala, Priya Dias, Stephanie Diaz, Kayleigh Diaz-Pratt, Mohammed Dibas, Debbie Dickerson, Pamela Dicks, Matt Dickson, Stuart Dickson, J Digby, Ronneil Digpal, Sean Dillane, Sarah Diment, Paul Dimitri, Georgios Dimitriadis, Sajeel Din, Thai H Dinh, Thi T T Dinh, Alex Dipper, Sabiq Dipro, Laura Dirmantaite, Lorelle Dismore, Lisa Ditchfield, Sarah Diver, Lavanya Diwakar, Preeti Diwan, Caroline Dixon, Giles Dixon, Kate Dixon, Brice Djeugam, Sipho Dlamini, Petr Dlouhy, Andrea D'Mello, Paul Dmitri, Thi Tien Do, Laurence Dobbie, Marinela Dobranszky Oroian, Charlotte Dobson, Lee Dobson, Marie Docherty, David Dockrell, Jacqueline Dodd, James Dodd, Jackie Dodds, Rebecca Dodds, Steve Dodds, Richi Dogra, Conor Doherty, Erin Doherty, Warren Doherty, Yumiko Doi, Iain Doig, Eleanor Doke, Daniel Dolan, Mark Dolman, Rozzie Dolman, Lisa Donald, Katie Donald, Callum Donaldson, Christopher Donaldson, Denise Donaldson, Gillian Donaldson, Kate Donaldson, Phu Khiem Dong, Martha Donkor, Sinead Donlon, Joanne Donnachie, Eilish Donnelly, Ronan Donnelly, Phil Donnison, Aravindhan Donohoe, Gemma Donohoe, Bryan Donohue, Emma Dooks, Reece J Doonan, Rogier Van Doorn, Grainne Doran, Rachael Dore, Kane Dorey, Sharon Dorgan, Kataryna Dos Santos, Moonira Dosani, Davinder Dosanjh, Paula Dospinescu, Isabelle Doss, Theonymfi Doudouliaki, Andrew Dougherty, Jill Doughty, Katie Douglas, Jonathan Douse, Allyn Dow, Lucy Dowden, Michelle Dower, Sud Dowling, Nicola Downer, Charlotte Downes, Rob Downes, Thomas Downes, Damian Downey, Robert Downey, Caroline Downing, Louise Downs, Simon Dowson, Cornel Dragan, Cristina Dragos, Maire Drain, Chelsea Drake, Victoria Drew, Olivia Drewett, Anthony Drexel, Celine Driscoll, Helena Drogan, Odysseas Drosos, Graham Drummond, Katie Drury, Kay Druryk, Ronald Druyeh, Jack Dryburgh-Jones, Simon Drysdale, An Du Thinh, Hazel Dube, Judith Dube, Stephen Duberley, Paige K Duckenfield, Hayley Duckles-Leech, Nicola Duff, Emma Duffield, Heather Duffy, Helen Duffy, Katharine Duffy, Lionel Dufour, Annette Duggan, Parveen Dugh, Rauand Duhoky, Janice Duignan, Jennifer Dulay, Simon Dummer, Alexis Duncan, Andrew Duncan, Christopher Duncan, Fullerton Duncan, Gregory Duncan, Holly Duncan, Robert Duncan, Stephanie Dundas, Do Van Dung, Aileen Dunleavy, Julia Dunleavy, Alessia Dunn, Charlotte Dunn, Damian Dunn, Laura Dunn, Paul Dunn, Charlene Dunne, Karen Dunne, Fiona Dunning, Aidan Dunphy, Tran Thi Hai Duong, Venkat Duraiswamy, Beatriz Duran, Ingrid DuRand, Leanne Durdle, Natalie Duric, Alison Durie, Emily Durie, Samuel Durogbola, Chris Durojaiye, Laura Durrans, Katie Durrant, Hannah Durrington, Iheukwumere Duru, Haris Duvnjak, Akshay Dwarakanath, Laasya Dwarakanath, Dennis Dwomoh Nkrumah, Ellen Dwyer, Zara Dyar, Claudia Dyball, Kristyn Dyer, Harvey Dymond, Tom Dymond, Chris Eades, Lauren Eadie, Rebekah Eadie, Laura Eagles, Beena Eapen, Naomi Earl, Joanne Early, Melissa Earwaker, Nicholas Easom, Clare East, Amy Easthope, Fraser Easton, Jack Easton, Patrick Easton, Ruth Eatough, Oluwadamilola Ebigbola, Martin Ebon, Alison Eccles, Sinan Eccles, Chloe Eddings, Michael Eddleston, Maureen Edgar, Katharine Edgerley, Nicholas Edmond, Mary Edmondson, Tracy Edmunds, Abby Edwards, Alexandra Edwards, Catherine Edwards, Joy Edwards, Kennedy Edwards, Mandy Edwards, Martin Edwards, Sophie Edwards, Jenny Eedle, Aline Eggink, Dawn Egginton, Sam Eggleston, Loveth Ehiorobo, Sarah Eisen, Ugochukwu Ekeowa, Mohamed Ekoi, Ayomide Ekunola, Soha El Behery, Nagla Elashhar, Lisa Elawamy, Mohamed Elbeshy, Kate El-Bouzidi, Jennifer Elder, Mohammed El-Din, Emma Eldridge, Diana Eleanor, Uchenna Elenwa, Ibrahim Eletu, Eman Elfar, Mayy Magdy Elgamal, Amr Elgohary, Mohamed A A Elhadi, Stellios Elia, Jennifer Elias, Tania Elias, Nadia Elkaram, Andrew V Elkins, Julie Ellam, Nikki Ellard, Laura N Ellerton, Lucy Elliot, Amy Elliott, Fiona Elliott, Kerry Elliott, Scott Elliott, Sian Elliott, Annie Ellis, Christine Ellis, Kaytie Ellis, Leila Ellis, Rupert Ellis, Tak-Yan Ellis, Yvette Ellis, Alison C Ellwood, Rahma Elmahdi, Einas Elmahi, Hannah-May Elmasry, Mohammed El-Naggar, Najla Elndari, Omer Elneima, Mohamed Elokl, Ahmed Elradi, Mohamed Elsaadany, Mohammed A S A Elsayed, Sally El-Sayeh, Hana El-Sbahi, Mohammad Elsebaei, Tarek Elsefi, Karim El-Shakankery, Alguili Elsheikh, Hosni El-Taweel, Sarah Elyoussfi, Jonathan Emberey, Jonathan R Emberson, John Emberton, Anna Emery, Julian Emmanuel, Ingrid Emmerson, Michael Emms, Florence Emond, Marieke Emonts, Nicu Enachi, Dickson Enenche, Angila Engden, Katy English, Emma Entwistle, Hene Enyi, Marios Erotocritou, Peter Eskander, Hanif Esmail, Fatheha Essa, Brynach Evans, Chris Evans, Debra Evans, E Evans, Emrys Evans, Gail Evans, Gareth Evans, Isabel Evans, Jack Evans, Jacqueline Evans, Jennifer Evans, John Evans, Jolanta Evans, Lisa Evans, Lynn Evans, Mim Evans, Morgan Evans, Ranoromanana Evans, Sharon Evans, Sian Evans, Teriann Evans, Tomos Evans, Caroline Everden, Serenydd Everden, Lynette Every, Hayley Evison, Lynsey Evison, Chiamaka Ezenduka, Jacqueline Faccenda, Leila Fahel, Youstina Fahmay, Ian Fairbairn, Sara Fairbairn, Terry Fairbairn, Andy Fairclough, Louise Fairlie, Mark Fairweather, Anne Fajardo, Naomi Falcone, Euan Falconer, John Fallon, Andrea Fallow, David Faluyi, Victoria Fancois, Ayaan Farah, Muna Farah, Qayyum Farah, Nowin Z Fard, Leila Fares, Amr Farg, Adam Farmer, Katie Farmer, Toni Farmery, Samantha Farnworth, Faiyaz Farook, Hadia Farooq, Sidrah Farooq, Fiona Farquhar, Holly Farr, Aaron Farrell, Barbara Farrell, Fayed Farrukh, James Farthing, Syeda Farzana, Rahmatu Fasina, Azam Fatemi, Mina Fatemi, Suman Fathima, Nibah Fatimah, Maria Faulkner, Saul N Faust, Clair Favager, Joe Fawke, Sinmidele Fawohunre, Abul Fazal, Aisthath Fazleen, Simon Fearby, Connie Fearnley, Alex Feben, Federico Fedel, Daria Fedorova, Christopher Fegan, Mae Felongo, Lynsey Felton, Tim Felton, Kate Fenlon, Andrea Fenn, Ruth Fennelly, Isabelle Fenner, Ciara Fenton, Melisa Fenton, Gloria Ferenando, Cameron Ferguson, Jenny Ferguson, Kathryn Ferguson, Katie Ferguson, Susan Ferguson, Susie Ferguson, Victoria Ferguson, Denzil Fernandes, Candida Fernandez, Eduardo Fernandez, Maria Fernandez, Sonia Fernandez Lopez, Jaime Fernandez Roman, Callum J Fernando, Jessica Fernando, Ahmed Feroz, Pietro Ferranti, Thais Ferrari, Eleanor Ferrelly, Alexandra Ferrera, Emma Ferriman, Sheldon Ferron, Nicholas Fethers, Ben Field, Janet Field, Rebecca Field, Karen Fielder, Lindsey Fieldhouse, Andra Fielding, Julie Fielding, Sarah Fielding, Asma Fikree, Santos Filipa, Sarah A Filson, Shona Finan, Sarah Finbow, Deborah J Finch, Joanne Finch, Laurie Finch, Simon Finch, Spencer Finch, Natalie Fineman, Jim Finlayson, Lauren Finlayson, Adam Finn, Joanne Finn, Dylan Finnerty, Clare Finney, Deborah Finucane, Sofia Fiouni, Jo Fiquet, Promise Firi, James Fisher, Neil Fisher, Daniel Fishman, Krystofer Fishwick, Carolyn Fitton, Felicity Fitzgerald, Fiona Fitzgerald, Karen Fitzjohn, Jan Flaherty, Michael Flanagan, Charles Flanders, Nikolaos Flaris, Gail Fleming, Julie Fleming, Lucy Fleming, Paul Fleming, William Flesher, Alison Fletcher, Anna Fletcher, Jonathan Fletcher, Lucy Fletcher, Simon Fletcher, Sophie Fletcher, Fiona Flett, Karen Flewitt, Sarah Flockhart, Christopher Flood, Ian Floodgate, Jonathan Flor, Vincent Florence, Mary Flowerdew, Sharon Floyd, Margaret J Flynn, Rachel Flynn, Claire Foden, Adama Fofana, Georgina Fogarty, Paul Foley, Linda Folkes, Tracey Fong, Daniela M Font, Aiwyne Foo, Jane Foo, Andrew Foot, Helen R Foot, Jayne Foot, Jane Forbes, Amber Ford, Jamie Ford, Imogen Fordham, Jennifer Foreman, Matthew Forester, Mohammad Forkan, Caroline Fornolles, Adam Forrest, Ellie Forsey, Miranda Forsey, Thomas Forshall, Elliot Forster, Abigail Forsyth, Julian Forton, Conrad Foster, Emily Foster, Joseph Foster, Rachel A Foster, Tracy Foster, Angela Foulds, Ian Foulds, Folakemi Fowe, Natasha Fowkes, Emily Fowler, Robert Fowler, Stephen Fowler, Amy Fox, Claire Fox, Heather Fox, Jonathan Fox, Laura Fox, Lauren Fox, Natalie Fox, Olivia Fox, Simon Fox, Sarah-Jane Foxton, Eva Fraile, Rebecca Frake, Alex Francioni, Olesya Francis, Rebecca Francis, Sarah Francis, Theodora Francis-Bacon, Helen Frankland, Jessica Franklin, Siobhan Franklin, Catherine Fraser, Andi Fratila, Sharon Frayling, Martyn Fredlund, Anna Freeman, Carol Freeman, Elaine Freeman, Hannah Freeman, Nicola Freeman, Clare Freer, Eleanor French, Thomas French, Karen Freshwater, Matthew Frise, Renate Fromson, Adam Frosh, John Frost, Victoria Frost, Oliver Froud, Rachel Frowd, Arun Fryatt, Andrzej Frygier, Bridget Fuller, Liz Fuller, Lucy Fuller, Tracy Fuller, Duncan Fullerton, Carrie Fung, Gayle Fung, Sarah Funnell, John Furness, Andrew Fyfe, Nytianandan G, Elizabeth Gabbitas, Claire Gabriel, Zoë Gabriel, Hadiza Gachi, Sophie Gaffarena, Sarah Gage, Joshua Gahir, Sarveen Gajebasia, Katarzyna Gajewska-Knapik, Babita Gajmer, Zacharoula Galani, Christopher Gale, Hugo Gale, Linda Gale, Rebecca Gale, Swetha Gali, Bernadette Gallagher, Jude Gallagher, Rosie Gallagher, William Gallagher, Feroze Gallam, Joanne Galliford, Catherine Galloway, Chris Galloway, Emma Galloway, Jacqui Galloway, James Galloway, Anna Galvin, Victoria Galvis, Gareth Gamble, Laura Gamble, Liz Gamble, Brian Gammon, Chien N Gan, Muhammad B Ganaie, Jaikumar Ganapathi, Ramesh Ganapathy, Kaminiben Gandhi, Sarah Gandhi, Usha Ganesh, Thenugan Ganeshanathan, Saibal Ganguly, Abrar Gani, Pauline Ganley, Ukraina Garcia, Emma-James Garden, Antoni D Gardener, Emma Gardiner, Michael Gardiner, Phil Gardiner, Siobhan Gardiner, Caroline Gardiner-Hill, Jonathan Gardner, Louis Gardner, Mark Garfield, Atul Garg, Isha Garg, Nathan Garlick, Daniel Garner, Justin Garner, Lucie Garner, Zoe Garner, Rosaline Garr, Kathryn A Garrero, Manisha Gartaula, Florence Garty, Rachel Gascoyne, Hyeriju Gashau, Aoife Gatenby, Erin Gaughan, Alok Gaurav, Mariana Gavrila, Jane Gaylard, Sophie Gayle, Catherine Geddie, Ian Gedge, Sarah Gee, Fartuun Geele, Kalaichelvi Geerthan, Minnie Gellamucho, Karzan Gelly, Leila Gelmon, Sandra Gelves-Zapata, Gemma Genato, Neal Gent, Susan Gent, Natalie Geoghegan, Aparna George, Bini George, Sam George, Susan George, Tina George, Valerie P George, Simon Georges, Domonique Georgiou, Peter Gerard, Leigh Gerdes, Louise Germain, Helen Gerrish, Abel Getachew, Louise Gethin, Siobhan Gettings, Hisham Ghanayem, Bijan Ghavami Kia, Shaista Ghazal, Anca Gherman, Alison Ghosh, Dipansu Ghosh, Justin Ghosh, Subhamay Ghosh, Sarra Giannopoulou, Malick Gibani, Chris Gibb, Ben Gibbison, Kerry Gibbons, Alex Gibson, Bethan Gibson, Jamie Gibson, Kimberley Gibson, Kirsty Gibson, Sian Gibson, Mary Gigi, Cat Gilbert, Jeanette Gilbert, Kayleigh Gilbert, Benjamin Giles, James Gilham, Mandy Gill, Lynne Gill, Paul Gillen, Annelies Gillesen, Katherine Gillespie, Elizabeth Gillham, Andrew Gillian, Deborah Gilliland, Robert Gillott, Danielle Gilmour, Kate Gilmour, Lesley Gilmour, Louis Ginn, Franciscus Ginting, Theodora Giokanini-Royal, Anna Gipson, Barbie Giri, Joanna Girling, Rhian Gisby, Angelena Gkioni, Aikaterini Gkoritsa, Effrossyni Gkrania-Klotsas, Amy Gladwell, James Glanville, Jessica Glasgow, Susannah Glasgow, Jon Glass, Lynn Glass, Sharon Glaysher, Lisa Gledhill, Eleanor Glenday, Ana Glennon, Jodie Glossop, John Glover, Kyle Glover, Michelle Glover, Jan Glover Bengtsson, Deborah Glowski, Sharon Glynn, Chevanthy Gnanalingam, Julie Goddard, Wendy Goddard, Emily Godden, Jo Godden, Sarah Godlee, Emma Godson, Gillian Godwin, Sukanya Gogoi, Aiky Goh, Manjinder Gohel, Rebeca Goiriz, Sriya Gokaraju, Raphael Goldacre, Arthur Goldsmith, Portia Goldsmith, Darren Gomersall, Lucia Gomez, Raquel Gomez-Marcos, Ali Gondal, Celia Gonzalez, Jack Goodall, Vicky Goodall, Bob Goodenough, Anna Goodfellow, Laura Goodfellow, James Goodlife, Camelia Goodwin, Elizabeth Goodwin, Jayne Goodwin, Paula Goodyear, Rajiv Gooentilleke, Michelle Goonasekara, Sheila Gooseman, Shameer Gopal, Chris Gordon, Sally Gordon, Robin 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Christopher A Green, David Green, Frederick Green, Joel Green, Marie Green, Nicola Green, Stacey Green, Diarra Greene, Philippa Greenfield, Alan Greenhalgh, Daniel Greenwood, Sandra Greer, James Gregory, Jane Gregory, Katie Gregory, Tamsin Gregory, Jill Greig, Julia Greig, Rebecca Grenfell, Teena Grenier, Jack Grenville, Jo Gresty, Susan Grevatt, Glaxy Grey, Samuel Gribben, Andrew Gribbin, Amy Gribble, Natasha Grieg, Douglas Grieve, Ben Griffin, Denise Griffin, Mel Griffin, Sian Griffith, Andrew Griffiths, Daniel Griffiths, David Griffiths, Donna Griffiths, Isabel Griffiths, Mark Griffiths, Nicola Griffiths, Oliver Griffiths, Sandra Griffiths, Sarah Griffiths, Scott Griffiths, Yvonne Griffiths, Sofia Grigoriadou, Steph Grigsby, Paul Grist, Evelina Grobovaite, Dorothy Grogono, Clarissa Grondin, Rachel Groome, Pauline Grose, Liliana Grosu, Jenny Grounds, Margaret Grout, Helen Grover, Jayne Groves, Neil Grubb, Julie Grundy, Francesca Guarino, Sharada Gudur, Jacinta Guerin, Sharazeq 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Hale, Jennie Hale, Carmel Halevy, Paul Halford, William Halford, Alaina Halim, Alistair Hall, Anthony Hall, Claire Hall, Elizabeth Hall, Fiona Hall, Helen Hall, Jennifer Hall, Kathryn Hall, Laura Hall, Jan Hallas, Kyle Hallas, Charles Hallett, Jackie Halliday, Akmal Hallman, Heather Halls, Maryam Hamdollah-Zadeh, Ifedadepo A Hamed-Adekale, Bilal Hameed, Mohammed Hameed, Raph L Hamers, Imran Hamid, Mohamad Hamie, Raymond Hamill, Bethany Hamilton, Fergus Hamilton, Gus Hamilton, Leigh Hamilton, Melanie Hamilton, Nicola Hamilton, Sara Hamilton, Ruth Hamlin, Eleanor Hamlyn, Beatrice Hammans, Shirley Hammersley, Kate Hammerton, Bev Hammond, Emily Hammond, Leah Hammond, Sally Hammond, Fiona Hammonds, Ibrahim Hamoodi, Karen Hampshire, James A Hampson, Jude Hampson, Lucy Hampson, Lisa Hamzah, Jenny Han, Ozan Hanci, Sadiyah Hand, Lala Handayani, Jasmine Handford, Soran Handrean, Nina K Handzewniak, Sarah Haney, Vu Thi Kim Hang, Sheharyar Hanif, E Hanison, Esther Hanison, Jennifer Hannah, Amy Hannington, Merhej Hannun, Aidan Hanrath, Helena Hanratty, Daniel Hansen, Anita Hanson, Ashley Hanson, Helen Hanson, Jane Hanson, Kathryn Hanson, Steve Hanson, Ala Haqiqi, Monjurul Haque, Henry Harcourt, Lesley Harden, Zoe Harding, Simon Hardman, Marc Hardwick, Gareth Hardy, Joanna Hardy, Yasmine Hardy, Kumar Haresh, Rachel Harford, Beverley Hargadon, James Hargraves, Carolyn Hargreaves, Alice Harin, Mohammed Haris, Edward Harlock, Paula Harman, Tracy Harman, Mark Harmer, Muhammad A Haroon, Charlie Harper, Heather Harper, James Harper, Peter Harper, Rosemary Harper, Sarah Harrhy, Kate Harrington, Sian Harrington, Yasmin Harrington-Davies, Jade Harris, Jess Harris, John Harris, Laura Harris, Marie-Clare Harris, Nichola Harris, Sophie Harris, David Harrison, Laura Harrison, Melanie Harrison, Olakunbi A Harrison, Rachael Harrison, Rowan Harrison, Susie Harrison, Thomas Harrison, Wendy Harrison, Elizabeth Harrod, Ciaran Hart, Dominic Hart, Jessica Hartley, Lisa Hartley, Rosemary Hartley, Ruth Hartley, Tom Hartley, William Hartrey, Phillipa Hartridge, Stuart Hartshorn, Alice Harvey, Angela Harvey, Anna Harvey, Max Harvey, Catherine Harwood, Helen Harwood, Zoe Harzeli, Brigitte Haselden, Kazi Hashem, Mohammed Hashimm, Tadaaki Hashimoto, Imranullah Hashmi, Jack Haslam, Zena Haslam, Grace Hasnip, Adil Hassan, Ali Hassan, Amro Hassan, Awab Hassan, Zeinab Hassan, Sapna Hassasing, Jane Hassell, Philip Hassell, Alex Hastings, Bethany Hastings, Janice Hastings, Sarah Hathaway-Lees, Jonathan Hatton, Jennifer Hau, May Havinden-Williams, Stefan Havlik, Daniel B Hawcutt, Kadean Hawes, Liz Hawes, Nicola Hawes, Lydia Hawker, Annie Hawkins, Joe Hawkins, Nancy Hawkins, W John Hawkins, Dan Hawley, Ed Hawley-Jones, Edward Haworth, Alasdair W Hay, Cathy Hay, Amna Hayat, Jamal Hayat, Mohamed-Riyal Hayathu, Anne Hayes, Jonas Hayes, Kate Hayes, Melony Hayes, Fiona Hayes, Patrick Hayle, Chloe Haylett, Antara Hayman, Melanie Hayman, Matthew Haynes, Richard Haynes, Rachel Hayre, Carole Hays, Sarah Haysom, James Hayward, Patrick Haywood, Hazel Haywood Hasford, Tracy Hazelton, Phoebe Hazenberg, Zhengmai He, Elizabeth Headon, Carrie Heal, Brendan Healy, Jessica L Healy, Amy Hearn, David Heasman, Angela Heath, Debbie Heath, Rowan Heath, Diane Heaton, Adam Heavens, Kerry Hebbron, Catherine Heckman, Gemma Hector, Sadie Heddon, Andy Hedges, Katrine Hedges, Cheryl Heeley, Elaine Heeney, Richard Heinink, Rajdeep Heire, Ingvild Helgesen, Joanne Hemingway, Ulla Hemmila, Beth Hemmings, Scott Hemphill, Deborah Hemsley, Abigail Henderson, Eilidh Henderson, Jennifer Henderson, Steven Henderson, Joanne Henry, Karol Henry, Lavinia Henry, Margo Henry, Natalie Henry, David Henshall, Gillian Herdman, Rosaleen Herdman-Grant, Morag Herkes, Lucas E Hermans, Fe Marie Hernandez, Emma Heron, Lisa Heron, William Herrington, Emilia Heselden, Peta Heslop, Tracey Heslop, Simon Hester, Emily Hetherington, Joseph Hetherington, Chamila Hettiarachchi, Pramodh Hettiarachchi, Hayley Hewer, John Hewertson, 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Uddin, Ruzena Uddin, Jacinta Ugoji, Edith N Ukaegbu, Mazhar Ul Haq, Waqar Ul Hassan, Zia Ul-Haq, Salamat Ullah, Sana Ullah, Sanda Ullah, Ju Um, Athavan Umaipalan, Anil Umate, Judith Umeadi, Akudo Umeh, Wilfred Umeojiako, Ben Ummat, Emma Underhill, Charlotte Underwood, Jonathan Underwood, Adam Unsworth, Veerpal Uppal, Veerpal S Uppal, Gerry Upson, Masood Ur Rasool, Alison Uriel, Sebastian Urruela, Hiromi Uru, Jess Usher, Miranda Usher, Rebecca Usher, Alexandra Usher-Rea, Andrew Ustianowski, Effua Usuf, Febriansyah Nur Utomo, Hiromi Uzu, Linda C Vaccari, Uddhav Vaghela, Abhay Vaidya, Denny Vail, Bernardas Valecka, Jennifer Valentine, Balan Valeria, Pramodh Vallabhaneni, Nick Vallotton, Luke Vamplew, Ekaterini Vamvakiti, Joannis Vamvakopoulos, Sarah Van Blydenstein, Lucia van Bruggen, Maud van de Venne, Alex van der Meer, Nora van der Stelt, Lynne van Koutrik, Alexander Van Loggerenberg, Joseph Vance-Daniel, Rama Vancheeswaran, Samuel I Vandeyoon, Padma Vankayalapati, Piyush Vanmali, Chloe Vansomeren, William Van't Hoff, Sejal Vara, Stehen J Vardy, Anu Varghese, Maria Varghese, William Varney, Giulia Varnier, Anna-Nektaria Varouxaki, Resti Varquez, Valeria Vasadi, Olivia Vass, Katherine Vassell, Vimal Vasu, Vasanthi Vasudevan, Manu Vatish, Sue Vaughan, Heloyes Vayalaman, Darini Vayapooree, Christopher Vaz, Niki Veale, Sachuda Veerasamy, Swati Velankar, Luxmi Velauthar, Neyme Veli, Nicola Vella, Aravind Velugupati, Anitha Velusamy, Ian Venables, Mavi Venditti, Ramya Venkataramakrishnan, Richard Venn, Robert Venn, Michelle Venter, Lyn Ventilacion, Joanne Vere, Mark Veres, Stefania Vergnano, Will Verling, Amit Verma, Rachel Vernall, Britney Vernon, Mark Vertue, Liberty Verueco, Jerik Verula, Anna Veterini, Natalie Vethanayagam, Shambavi Vettikumaran, Lucy Veys, Carinna Vickers, Saji Victor, SImpson Victoria, Celine P Vidaillac, Jennifer Vidler, Bavithra Vijayakumar, Vinod W Vijayaraghavan Nalini, Brigita Vilcinskaite, Alicija Vileito, Neringa Vilimiene, Lynn Vinall, Sylvia Vinay, Latha Vinayakarao, Olivia Vincent, Rachel Vincent, Rosie Vincent, Pritpal Virdee, Emma Virgilio, Abdullah M Virk, Elisa Visentin, Martina Vitaglione, Karunakaran Vithian, Sorice Vittoria, Sankkita Vivekananthan, Elena Vlad, Ben Vlies, Linda von Oven, Claire Vooght, Kim Thi Vu Thai, Kritchai Vutipongsatorn, Alain Vuylsteke, Eleftheria Vyras, Richard Wach, Beverley Wadams, Susan Wadd, Natalia Waddington, Phillip Wade, Jonathan Wadsley, Kirsten Wadsworth, Syed E I Wafa, Daniel Wagstaff, Lynda Wagstaff, Dalia Wahab, Zaroug Wahbi, Abiodun Waheed Adigun, Sawan Waidyanatha, Alicia Waite, Rachel Wake, Alice Wakefield, William Wakeford, Fiona Wakinshaw, Emma Waldeck, Andrew Walden, Lorna Walding, Alexandria Waldron, Joanne Waldron, Emma Wales, Batool Wali, Danielle Walker, Gemma Walker, Harriet Walker, Ian Walker, Kevin Walker, Kim Walker, Lauren Walker, Linda Walker, Lynne Walker, Olivia Walker, Rachel Walker, Rebecca Walker, Sara Walker, Susan Walker, Gillian Wallace, Rebecca Wallbutton, Jessica Wallen, Karl Wallendszus, Arabella Waller, Rosemary Waller, Gabiel Wallis, Gabriel Wallis, Louise Wallis, Matthew Wallis, Emma Walmsley, Donna Walsh, Elizabeth Walsh, Livia Walsh, Deborah Walstow, Daniel Walter, Alex Walters, Holt Walters, James Walters, Jocelyn Walters, Eileen Walton, Lucy Walton, Maisie Walton, Michael Walton, Olivia Walton, Sharon Walton, Susan Walton, Mandy Wan, Junita Wanda, Mary Wands, Rachel Wane, Frank Wang, Nick Wang, Ran Wang, Shentong Wang, Deborah Warbrick, Samantha Warburton, Christopher Ward, Deborah Ward, Emma Ward, Hannah Ward, Janice Ward, Joanna Ward, Luke Ward, Nicola Ward, Rachael Ward, Thomas Ward, Tom Ward, Scott A Warden, Gibril Wardere, Steve Wardle, Hassan Wardy, Gareth Waring, Scott Waring, Jenny Warmington, Ben Warner, Christian Warner, Lewis Warnock, Sarah Warran, Jade Warren, Lisa Warren, Rebecca Warren, Yolanda Warren, Davina Warrender, Hannah Warren-Miell, Adilia Warris, Gill Warwick, Helen Wassall, Sean Wasserman, Elizabeth Wasson, Hazel J Watchorn, Holly Waterfall, Abby Waters, Donald Waters, Mark Waterstone, Abigail Watkin, Catherine Watkins, Catrin Watkins, Eleanor Watkins, Karen Watkins, Lynn Watkins, Abigail Watson, Adam J R Watson, Ekaterina Watson, Eleanor Watson, Felicity Watson, J G R Watson, Louisa Watson, Paul Watson, Rebecca Watson, Robert Watson, Kathleen Watson, Malcolm Watters, Donna Watterson, Khairiah Wattimena, Daniel Watts, John Watts, Merlin Watts, Victoria Waugh, Emma Wayman, Matthew Wayman, Akhlaq Wazir, Mark Weatherhead, Nick Weatherly, Chloe Webb, Claire Webb, Hayley Webb, Kathryn Webb, Kylie Webb, Stephen Webb, Cheryl Websdale, Deborah Webster, Ian Webster, Jemma Webster, Tim Webster, Jordan Wedlin, Ling Wee, Rebecca Weerakoon, Thanuja Weerasinghe, Janaka Weeratunga, Maria Weetman, Shuying Wei, Immo Weichert, Emma Welch, Hugh Welch, James Welch, Leanne Welch, Steven Welch, Benjamin Welham, Samantha Weller, Lucy Wellings, Brian Wells, Susan Wellstead, Berni Welsh, Richard Welsh, Ingeborg Welters, Rachael Welton, Victoria Wenn, Lauren Wentworth, Joan Wesonga, Kate Wesseldine, Joe West, Magdelena West, Raha West, Ruth West, Sophie West, Luke Western, Ruth Westhead, Heather Weston, Alice Westwood, Kelly Westwood, Sharon Westwood, Bill Wetherill, Sharon Wheaver, Helen Wheeler, Ben Whelan, Matthew Whelband, Amanda Whileman, Alison Whitcher, Andrew White, Ayesha White, Benjamin White, Catherine White, Christopher White, Duncan White, James White, Jonathan White, Katie White, Marie White, Nick White, Nikki White, Sarah White, Sonia White, Tracey White, Catherine Whitehead, Kelly Whitehorn, Anne Whitehouse, Claire Whitehouse, Tony Whitehouse, Julia Whiteley, Louiza Whiteley, Sophie Whiteley, Rachael Whitham, Gabriel Whitlingum, David Whitmore, Elizabeth Whittaker, Lindsay Whittam, Ashley Whittington, Helen Whittle, Robert Whittle, Eunice Wiafe, Lou Wiblin, Olivia Wickens, John Widdrington, Jason Wieboldt, Hannah Wieringa, Cornelia Wiesender, Laura Wiffen, Andrew Wight, Ashleigh Wignall, Christopher Wignall, Annamaria Wilce, Danielle Wilcock, Emma Wilcock, Louise Wilcox, Ben Wild, Laura Wild, Stephen Wild, Michael Wilde, Laura Wilding, Peter Wilding, Tracey Wildsmith, Joe Wileman, Joy Wiles, Kate Wiles, Elva Wilhelmsen, Thomas Wiliams, Janet Wilkie, David Wilkin, Hannah Wilkins, Joy Wilkins, Suzanne Wilkins, Iain Wilkinson, Lesley Wilkinson, Nicola Wilkinson, Sophia Wilkinson, Susan Wilkinson, Tim Wilkinson, Sylvia Willetts, Aimee Williams, Alexandra Williams, Alison Williams, Angharad Williams, Anna Williams, Ava Williams, Carl Williams, Caroline V Williams, Claire Williams, Dewi Williams, Eleri Williams, Gail Williams, Gemma Williams, Gina Williams, Hannah Williams, Heledd Williams, James Williams, Jennie Williams, Jill Williams, John Williams, Joseph Williams, Karen Williams, Kathryn Williams, Mandy Williams, Marie Williams, Mark Williams, Matthew Williams, Patricia Williams, Penny Williams, Rachel Williams, Robin Williams, Rupert Williams, Samson Williams, Sarah Williams, Sophie Williams, Steffan Williams, Tamanna Williams, Tania Williams, Annie Williamson, Cath Williamson, Catherine Williamson, Dawn Williamson, James D Williamson, Jodie Williamson, Rachel Williamson, Helen Williamson, Elaine Willis, Elizabeth Willis, Emily Willis, Heather Willis, Herika Willis, Joanna Willis, Louise Wills, Lucy Willsher, Catherine Willshire, Francesca Willson, Jayne Willson, Alison Wilson, Andrea Wilson, Anna Wilson, Antoinette Wilson, Billy Wilson, David Wilson, Imogen Wilson, James Wilson, Karen Wilson, Kate Wilson, Kristy-Ann Wilson, Lucinda Wilson, Mark Wilson, Stephen Wilson, Toni Wilson, John Wilson, Khin Lei Yee Win, Marlar Win, Than Win, Tin Tin Win, Wut Yee Win Win, Lucinda Winckworth, Laura Winder, Piers Winder, Stuart Winearl, Helen Winmill, Simon Winn, Carmen Winpenny, Helen Winslow, Helen Winter, Jonathan Winter, Barbara Winter-Goodwin, Joseph Winterton, Hannah Winwood, Jack Wischhusen, Stephen Wisdom, Matthew Wise, Martin Wiselka, Rebecca Wiseman, Sophie Wiseman, Steven Wishart, Tabitha WIshlade, Eric Witele, Nicholas Withers, Janet Wittes, Donna Wixted, Therese Wodehouse, Will Wolf, Nicola Wolff, Kirsten Wolffsohn, Rebecca Wolf-Roberts, Elena Wolodimeroff, Adam Wolstencroft, Alan Wong, Charlotte Wong, Chi-Hung Wong, Chi-Man Wong, Edwin Wong, Jessica S Y Wong, Kit Y Wong, Mei Yin Wong, Nick Wong, Sam Wong, Ting Wong, Aaron B Wongkyezeng, Amanda Wood, Caroline Wood, Dianne Wood, Fiona Wood, Gordon Wood, Hannah Wood, Jennifer Wood, Joe Wood, Lisa Wood, Louise Wood, Madeleine Wood, Stephen Wood, Tracy Wood, Katharine Woodall, Rebecca Woodfield, Christopher Woodford, Elizabeth Woodford, Jill Woodford, Louise Woodhead, Timothy Woodhead, Philip Woodland, Marc Woodman, Myles Woodman, Stephen Woodmansey, Charlotte Woods, Jane Woods, Katherine Woods, Sarah Woods, Zoe Woodward, Megan Woolcock, Gemma Wooldridge, Rebecca Woolf, Chris Woollard, Christopher Woollard, Louisa Woollen, Emma Woolley, Jade Woolley, Daniel Woosey, Dan Wootton, Joanne Wootton, Daniel Worley, Stephy Worton, Jonathan Wraight, Maria Wray, Kim Wren, Lynn Wren, Caroline Wrey Brown, Catherine Wright, Demi Wright, Francesca Wright, Holly Wright, Imogen Wright, Lianne Wright, Rachel Wright, Sarah Wright, Stephanie Wright, Tim Wright, Caroline Wroe, Hannah Wroe, Henry Wu, Peishan Wu, Pensee Wu, Jonathan Wubetu, Fitria Wulandari, Retno Wulandari, Subie Wurie, Craig Wyatt, Frederick Wyn-Griffiths, Inez Wynter, Bindhu Xavier, Arnold Xhikola, Bingru E Xia, Zhongyang Xia, Effua Yacoba, Santosh Yadav, Masseh Yakubi, May Yan, Yuuki Yanagisawa, Freda Yang, Yingjia Yang, Michael Yanney, Woei Lin Yap, Nabil Yaqoob, Salima Yasmin, Bryan Yates, David Yates, Edward Yates, Helen Yates, Thomas Yates, Mark Yates, Jessica Ye, Charlotte Yearwood Martin, Khin Yein, Fiona Yelnoorkar, Lam Minh Yen, Alastair Yeoh, Chun Yu Yeung, Peter Yew, Durgesh Yewatkar, Laura Ylquimiche Melly, Inez Ynter, H Yong, Jemma Yorke, Jasmine Youens, Abdel Younes Ibrahim, Eoin Young, Gail Young, Louise Young, Asfand Yousafzar, Sajeda Youssouf, Ahmed Yousuf, Hartantri Yovita, Chrissie Yu, Jack S J Yuan, Nindya Yufaniaputri, Bernard Yung, Daniel Yusef, Said Yusef, Intekhab Yusuf, Anna-Sophia Zafar, Silvia Zagalo, Su Zaher, Aqsa Zahoor, Mahrukh Zainab, Thornton Zak, Kareem Zaki, Nabhan Zakir, Kasia Zalewska, Ane Zamalloa, Mohsin Zaman, Shakir Zaman, Julie Zamikula, Louise Zammit, Marie Zammit-Mangion, Marcelina Zawadzka, Mohammed Zayed, Esther Zebracki, Daniel Zehnder, Lisa Zeidan, Darius Zeinali, Jing Zhang, Xiaobei Zhao, Dongling Zheng, Doreen Zhu, Madiha Zia, Omar Zibdeh, Rabia Zill-E-Huma, Ei Thankt Zin, Eva Zincone, Garikai Zindoga, Eleanor Zinkin, Vivian Zinyemba, Christos Zipitis, Letizia Zitter, Arkadiusz Zmierczak, Garazi Zubikarai, Azam Zubir, Naz Zuhra, Rasha Zulaikha, Sabrina Zulfikar, Carol Zullo, Ana Zuriaga-Alvaro, University of St Andrews. Infection and Global Health Division, University of St Andrews. School of Medicine, and Group, RECOVERY Collaborative
Subjects: Adult, Male, Hypoxia/etiology, SARS-CoV-2, COVID-19, 3rd-DAS, General Medicine, Adrenal Cortex Hormones/therapeutic use, AC, Dexamethasone/therapeutic use, Hospitals, Oxygen, Treatment Outcome, SDG 3 - Good Health and Well-being, MCP, Humans, Female
Abstract: Background Low-dose corticosteroids have been shown to reduce mortality for patients with COVID-19 requiring oxygen or ventilatory support (non-invasive mechanical ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation). We evaluated the use of a higher dose of corticosteroids in this patient group. Methods This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing multiple possible treatments in patients hospitalised for COVID-19. Eligible and consenting adult patients with clinical evidence of hypoxia (ie, receiving oxygen or with oxygen saturation Findings Between May 25, 2021, and May 13, 2022, 1272 patients with COVID-19 and hypoxia receiving no oxygen (eight [1%]) or simple oxygen only (1264 [99%]) were randomly allocated to receive usual care plus higher dose corticosteroids (659 patients) versus usual care alone (613 patients, of whom 87% received low-dose corticosteroids during the follow-up period). Of those randomly assigned, 745 (59%) were in Asia, 512 (40%) in the UK, and 15 (1%) in Africa. 248 (19%) had diabetes and 769 (60%) were male. Overall, 123 (19%) of 659 patients allocated to higher dose corticosteroids versus 75 (12%) of 613 patients allocated to usual care died within 28 days (rate ratio 1·59 [95% CI 1·20–2·10]; p=0·0012). There was also an excess of pneumonia reported to be due to non-COVID infection (64 cases [10%] vs 37 cases [6%]; absolute difference 3·7% [95% CI 0·7–6·6]) and an increase in hyperglycaemia requiring increased insulin dose (142 [22%] vs 87 [14%]; absolute difference 7·4% [95% CI 3·2–11·5]). Interpretation In patients hospitalised for COVID-19 with clinical hypoxia who required either no oxygen or simple oxygen only, higher dose corticosteroids significantly increased the risk of death compared with usual care, which included low-dose corticosteroids. The RECOVERY trial continues to assess the effects of higher dose corticosteroids in patients hospitalised with COVID-19 who require non-invasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation. Funding UK Research and Innovation (Medical Research Council), National Institute of Health and Care Research, and Wellcome Trust.
Published: 2023
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39. Predictors of Perceived Work-Family Balance: Gender Difference or Gender Similarity?

Author: Keene, Jennifer Reid and Quadagno, Jill
Published: 2004
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40. Response to Lois Helmbold, "Women's Studies in Sin City: Reactionary Politics and Feminist Possibilities"

Author: Brents, Barbara G., Hausbeck, Kathryn, and Keene, Jennifer Reid
Published: 2005

41. Risk factors for abdominal reoperations in bariatric patients

Author: Christopher M. Schlachta, Melody Lam, Nawar A. Alkhamesi, Jeff Hawel, Jennifer Reid, Ahmad Elnahas, David R. Urbach, Mehran Anvari, and Aristithes G. Doumouras
Subjects: Reoperation, medicine.medical_specialty, Population, Bariatric Surgery, medicine.disease_cause, Cohort Studies, Hiatal hernia, Abdominal wall, Postoperative Complications, Risk Factors, Humans, Medicine, education, Retrospective Studies, education.field_of_study, business.industry, Gastric bypass surgery, Odds ratio, medicine.disease, Obesity, Morbid, Surgery, medicine.anatomical_structure, Cohort, business, Abdominal surgery, Cohort study
Abstract: Background With a growing bariatric population, a better understanding of the patient and health provider-related factors associated with later reoperations could help providers enhance follow-up and develop reliable benchmarking targets. Objectives To investigate the patient and provider-related risk factors associated with abdominal reoperations in bariatric patients. Setting This is a cohort study using data from a large clinical registry of Ontario bariatric patients between 2010 and 2016. Methods A multilevel mixed effect logistic regression model using hospital and surgeon identifiers as random effects was performed to adjust for clustering of patients. The primary outcome was any abdominal operation performed within 2 years of primary bariatric surgery. Results Among a cohort of 10,946 bariatric patients (86.6% receiving gastric bypass surgery), 15.8% underwent an abdominal operation within 2 years and about a third of these were urgent. The multilevel analysis demonstrated that 98% of patient variation among reoperations was a result of patient characteristics rather than disparities between surgeons or center experience. Type of procedure was not a significant factor after adjustment for surgeon and hospital level experience (OR [odds ratio] .85, 95% CI [confidence interval] .70-1.03). Concurrent abdominal wall (OR 2.40, 95% CI 1.26-4.59), hiatal hernia repairs (OR 1.29, 95% CI 1.02-1.62), and previously higher health care users (OR 1.30, 95% CI 1.15-1.46) were most significantly associated with reoperations. Conclusion Reoperations are significantly more common among certain bariatric patients, especially those undergoing concurrent hernia procedures. Reoperations were not associated with provider-related factors and may not be a suitable target for health provider benchmarking.
Published: 2022
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42. Effect of electronic medication reconciliation at the time of hospital discharge on inappropriate medication use in the community: an interrupted time-series analysis

Author: Glen Kearns, Salimah Z. Shariff, Lauren Killin, Kelly K. Anderson, Andrew Appleton, Amit X. Garg, Blayne Welk, and Jennifer Reid
Subjects: medicine.medical_specialty, medicine.medical_treatment, Inappropriate Prescribing, Interrupted Time Series Analysis, Tertiary Care Centers, Patient safety, Benzodiazepines, Electronic Prescribing, Medication Reconciliation, Health care, Hospital discharge, Medicine, Humans, Medication Errors, Medical prescription, Antipsychotic, Adverse effect, Aged, Ontario, business.industry, Research, General Medicine, Quality Improvement, Confidence interval, Patient Discharge, Patient Care Management, Emergency medicine, Accidental Falls, Patient Safety, business, Antipsychotic Agents
Abstract: BACKGROUND: It is unclear if enhanced electronic medication reconciliation systems can reduce inappropriate medication use and improve patient care. We evaluated trends in potentially inappropriate medication use after hospital discharge before and after adoption of an electronic medication reconciliation system. METHODS: We conducted an interrupted time-series analysis in 3 tertiary care hospitals in London, Ontario, using linked health care data (2011-2019). We included patients aged 66 years and older who were discharged from hospital. Starting between Apr. 13 and May 21, 2014, physicians were required to complete an electronic medication reconciliation module for each discharged patient. As a process outcome, we evaluated the proportion of patients who continued to receive a benzodiazepine, antipsychotic or gastric acid suppressant as an outpatient when these medications were first started during the hospital stay. The clinical outcome was a return to hospital within 90 days of discharge with a fall or fracture among patients who received a new benzodiazepine or antipsychotic during their hospital stay. We used segmented linear regression for the analysis. RESULTS: We identified 15 932 patients with a total of 18 405 hospital discharge episodes. Before the implementation of the electronic medication reconciliation system, 16.3% of patients received a prescription for a benzodiazepine, antipsychotic or gastric acid suppressant after their hospital stay. After implementation, there was a significant and immediate 7.0% absolute decline in this proportion (95% confidence interval [CI] 4.5% to 9.5%). Before implementation, 4.1% of discharged patients who newly received a benzodiazepine or antipsychotic returned to hospital with a fracture or fall within 90 days. After implementation, there was a significant and immediate 2.3% absolute decline in this outcome (95% CI 0.3% to 4.3%). INTERPRETATION: Implementation of an electronic medication reconciliation system in 3 tertiary care hospitals reduced potentially inappropriate medication use and associated adverse events when patients transitioned back to the community. Enhanced electronic medication reconciliation systems may allow other hospitals to improve patient safety.
Published: 2021

43. The Effects of Age, Authority, and Gender on Perceptions of Statutory Rape Offenders

Author: Sahl, Daniel and Keene, Jennifer Reid
Abstract: Using a sample of 2,838 students from a Southwestern university in the United States, the authors examine the effect of respondent's gender, the adult's gender, the age gap between the adult and teen, and the adult's authority, on students' perceptions of vignettes describing adult-teen sexual relationships. Specifically, the authors investigate four dependent variables related to perceptions of the crime: the adult offender's emotional motivation, whether the adult is a sexual predator, whether the adult should have limited interactions with children, and whether the adult should be included on a sex offender registry. ANOVA analysis revealed that a large age gap between the adult and teen, the presence of authority in the relationship, and respondent's gender were significant predictors of perceptions of the offender as a predator and sex offender. The offender's gender significantly predicted respondents' perceived motivations but had no effect on opinions regarding sex offender registration. The authors discuss the implications of these findings for perceptions of statutory rape. (Contains 2 figures and 2 tables.)
Published: 2012
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44. A Retrospective Cohort Study of Healthcare Utilization Associated with Paravertebral Blocks for Chronic Pain Management in Ontario

Author: Michael Gofeld, Jennifer Reid, Blayne Welk, George Deng, Eldon Loh, and Anne Mr Agur
Subjects: medicine.medical_specialty, Medicine (General), business.industry, nerve blocks, Chronic pain, healthcare utilization, Retrospective cohort study, RM1-950, Pain management, medicine.disease, interventional procedure, Anesthesiology and Pain Medicine, R5-920, Healthcare utilization, pain management, Emergency medicine, medicine, Limited evidence, Therapeutics. Pharmacology, business, Research Article
Abstract: Background: Injections, particularly paravertebral blocks (PVBs), are frequently performed procedures in Ontario, Canada, for the management of chronic pain, despite limited evidence and risk of complications. Aim: This study examines usage patterns of PVBs to evaluate their effects on healthcare utilization and opioid prescribing. Methods: A retrospective cohort study in Ontario using administrative data. Ontario residents receiving their initial PVBs between July 1, 2013 and March 31, 2018 were included. Changes in use of other interventions, physician visits, and opioids were compared to the 12-month periods before and after index PVBs. Data use was authorized under section 45 of Ontario’s Personal Health Information Protection Act. Results: 47,723 patients received their initial PVBs in the study period. The rate of index PVBs increased from 1.61 per 10,000 population (2013) to 2.26 per 10,000 (2018). Initial PVBs were performed most commonly by family physicians (N = 25,042), followed by anesthesiologists (N = 14,195). 23,386 patients (49%) received 1 to 9 repeat PVBs in the 12 months after index PVB; 12,474 patients (26.15%) received 10 or more. Use of other nonimage guided interventional pain procedures per patient (mean±SD) increased from 2.19 ± 9.35 to 31.68 ± 52.26 in the year before and after index PVB. Relevant physician visits per patient (mean±SD) also increased from 2.92 ± 3.61 to 9.64 ± 11.77. Mean opioid dosing did not change significantly between the year before and the year after index PVB. Conclusion: PVBs are associated with increases in healthcare utilization and no change in opioid use patterns.
Published: 2021

45. Poverty among Cohabiting Gay and Lesbian, and Married and Cohabiting Heterosexual Families

Author: Prokos, Anastasia H. and Keene, Jennifer Reid
Abstract: Using a subsample ( N = 1,365,145) of the 2000 Census 5% Public Use Microdata Sample, the authors investigate explanations for differing poverty chances of cohabiting gay and lesbian, and married and cohabiting heterosexual families. Gay and lesbian couples fare worse than married couples, but better economically than cohabiting heterosexuals. Lesbian and gay families are older and more educated than cohabiting heterosexual families, and these differences explain the largest portion of differences in poverty rates. Greater educational attainment and labor force participation are better explanations than age for differences between married families and their gay and lesbian counterparts. These results add to recent research pointing to variations in the economic circumstances of different family forms. (Contains 3 tables.)
Published: 2010
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46. School Social Work: Increasing the Legitimacy of the Profession

Author: Altshuler, Sandra J. and Webb, Jennifer Reid
Abstract: School social workers often face challenges of having to legitimize their presence as a school professional, especially as compared to school psychologists and school counselors. Why are school social workers more often vulnerable to being underappreciated and not understood by school personnel than other mental health-based school professionals? This article suggests that school social workers' apparent lack of legitimacy may stem from poorly defined role expectations and professional/educational requirements for state-level certification. To frame the argument, the article first presents the various requirements that each state has for school social workers, school counselors, and school psychologists. The article then discusses the implications of the presented information that highlights the fact that school social work lags behind school counseling and school psychology in carving out a self-defined niche with consistent expectations and responsibilities. The article concludes with suggestions for improving the legitimacy of the school social work profession, by exploring ways in which to improve professional preparation and competencies in order to achieve parity in certification standards, so that school social work can hold its own in the realm of school-based mental health and have the opportunity to serve students, families, and communities in need.
Published: 2009

47. The Job Costs of Family Demands: Gender Differences in Negative Family-to-Work Spillover

Author: Keene, Jennifer Reid and Reynolds, John R.
Abstract: This article uses the 1992 National Study of the Changing Workforce to examine family and workplace factors contributing to gender differences in negative family-to-work spillover. We focus on spillover as manifested when family demands negatively affect job performance. Among married workers, women were twice as likely as men to report that family demands negatively affect their job performance. This finding is due, in part, to the fact that women made more adjustments to their workloads - such as refusing overtime or turning down assignments - for the sake of family. Ordered probit analysis suggests that job characteristics are more salient than family factors for predicting the likelihood that family demands will detract from job performance and for explaining the gender gap in negative family-to-work spillover. Working in a demanding job or having little job autonomy was associated with more negative family-to-work spillover regardless of gender, while greater scheduling flexibility mitigated the gender gap.
Published: 2005
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48. High risk of Clostridium difficile infection among spinal cord injured patients after the use of antibiotics commonly used to treat urinary tract infections

Author: Blayne Welk, Bonnie Liu, Michael Silverman, and Jennifer Reid
Subjects: education.field_of_study, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, Proportional hazards model, business.industry, medicine.drug_class, Urology, Urinary system, Population, Hazard ratio, Antibiotics, 030232 urology & nephrology, Clostridium difficile, bacterial infections and mycoses, urologic and male genital diseases, female genital diseases and pregnancy complications, Confidence interval, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Neurology (clinical), education, business, Cohort study
Abstract: AIM To characterize the use of common urinary tract infections (UTI)-relevant antibiotics after an SCI and determine the risk of Clostridium difficile infection (CDI) from these antibiotics. METHODS We used routinely collected data from Ontario (Canada) to conduct a retrospective, cohort study. We identified people >18 years of age with a traumatic SCI between April 2003 and March 2017. The primary exposure was an outpatient UTI-relevant antibiotic prescription during our observation period, and the primary outcome was evidence of a CDI. An adjusted cox proportional hazards model was used, and antibiotic exposure was modeled as a categorical, time-varying variable based on whether the patient likely had a UTI or not. RESULTS We identified 2528 people with SCI; 1642 (65%) were exposed at least once to an antibiotic of interest. The most commonly prescribed UTI-relevant antibiotic was fluoroquinolone (34%). Most patients did not have investigations for a UTI before the use of any of the different antibiotic classes. A small number of patients (5%) used chronic (>3 months) UTI-relevant antibiotics. The overall proportion of patients diagnosed with CDI was 7.4% (9.3/10 000 patient-days). The adjusted hazard ratio for CDI within 30 days was 3.5 (95% confidence interval, 1.9-6.7, p
Published: 2020
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49. The Long-Term Effects of Spousal Care Giving on Survivors' Well-Being in Widowhood

Author: Prokos, Anastasia H. and Keene, Jennifer Reid
Published: 2005

50. Deconstructing Cognitive Heterogeneity in Puerto Rican Spanish-Speaking Children With ADHD

Author: Jennifer Reid Keene, Daniel N. Allen, Bradley Donohue, Liza E San Miguel, and Alicia Nuñez
Subjects: Male, Adolescent, Puerto rican, Academic achievement, 03 medical and health sciences, 0302 clinical medicine, medicine, Cluster Analysis, Humans, 0501 psychology and cognitive sciences, Child, Association (psychology), Memory Disorders, Working memory, General Neuroscience, Puerto Rico, 05 social sciences, Wechsler Scales, Wechsler Adult Intelligence Scale, Cognition, Hispanic or Latino, medicine.disease, Comorbidity, United States, Psychiatry and Mental health, Clinical Psychology, Memory, Short-Term, Attention Deficit Disorder with Hyperactivity, Child, Preschool, Learning disability, Female, Neurology (clinical), medicine.symptom, Cognition Disorders, Comprehension, Psychology, 030217 neurology & neurosurgery, 050104 developmental & child psychology, Clinical psychology
Abstract: Objective:There is limited understanding of the cognitive profiles of Spanish-speaking children with Attention-Deficit/Hyperactivity Disorder (ADHD). The current study investigated the cognitive cluster profiles of Puerto Rican Spanish-speaking children with ADHD using the Wechsler Intelligence Scales for Children-Fourth Edition Spanish (WISC-IV Spanish) Index scores and examined the association between cognitive cluster profiles with other potentially relevant factors.Method:Hierarchical cluster analysis was used to identify WISC-IV clusters in a sample of 165 Puerto Rican children who had a primary diagnosis of ADHD. To examine the validity of the ADHD clusters, analysis of variances and chi-square analyses were conducted to compare the clusters across sociodemographics (e.g., age and education), type of ADHD diagnosis (ADHD subtype, Learning Disorder comorbidity), and academic achievement.Results:Clusters were differentiated by level and pattern of performance. A five-cluster solution was identified as optimal that included (C1) multiple cognitive deficits, (C2) processing speed deficits, (C3) generally average performance, (C4) perceptual reasoning strengths, and (C5) working memory deficits. Among the five clusters, the profile with multiple cognitive deficits was characterized by poorer performance on the four WISC-IV Spanish Indexes and was associated with adverse sociodemographic characteristics.Conclusions:Results illustrate that there is substantial heterogeneity in cognitive abilities of Puerto Rican Spanish-speaking children with ADHD, and this heterogeneity is associated with a number of relevant outcomes.
Published: 2020
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