In this special Complex Care Journal Club podcast episode, co-hosts Kristie Malik, Emily Goodwin and Kathleen Huth interview presenters of posters and oral abstracts relevant to the care of children with medical complexity at the Pediatric Academic Societies (PAS) 2024 annual meeting. Speakers describe the implications of their study findings, messages for patients and families, and priority areas for research that they hope can be investigated further by the complex care community in the coming years. SPEAKERS Mary Arakelyan, MPH Research Project Manager Dartmouth Health Children's Tammie Dewan, MD, MSc Clinical Assistant Professor Department of Pediatrics, University of Calgary Pediatrician, Alberta Children's Hospital Caleb Easterly, BA MD/PhD Student University of North Carolina School of Medicine Kevin Huynh, MS Medical Student University of Pittsburgh School of Medicine Ruchi Kaushik, MD, MEd, MPH Medical Director of Education and Research Imagine Pediatrics, Houston TX Joanna Leyenaar, MD, PhD Professor, Department of Pediatrics Dartmouth Health Children's Savithri Nageswaran, MD, MPH Professor, Department of Pediatrics Wake Forest University School of Medicine Julia Reedy, MA Qualitative Analyst ACCORDS, University of Colorado S. Margaret Wright, MD, MPH Clinical Assistant Professor of Pediatrics University of Missouri-Kansas City School of Medicine Justin Yu, MD, MS Assistant Professor of Pediatrics UPMC Children’s Hospital of Pittsburgh HOSTS Kristina Malik, MD Pediatrician, Special Care Clinic, Children's Hospital Colorado Emily J Goodwin, MD Pediatrician, General Academic Pediatrics Beacon Program Children’s Mercy Kansas City Kathleen Huth, MD, MMSc Pediatrician, Complex Care Service, Division of General Pediatrics Boston Children's Hospital DATE Initial publication: May 15, 2024. REFERENCES Fehlings D, Agnew B, Gimeno H, Harvey A, Himmelmann K, Lin JP, Mink JW, Monbaliu E, Rice J, Bohn E, Falck-Ytter Y. Pharmacological and neurosurgical management of cerebral palsy and dystonia: Clinical practice guideline update. Dev Med Child Neurol. 2024 Apr 19. doi: 10.1111/dmcn.15921. Epub ahead of print. PMID: 38640091. Pediatric Academic Societies. Who we are. Accessed May 6, 2024. https://www.pas-meeting.org/about/ TRANSCRIPT Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: forms.gle/Bdxb86Sw5qq1uFhW6 Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access, thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION Malik K, Goodwin EJ, Arakelyan M, Dewan T, Easterly C, Huynh K, Kaushik R, Leyenaar J, Nageswaran S, Reedy J, Wright SM, Yu J, Huth K. Practice-Changing Research in Complex Care at the Pediatric Academic Societies 2024 Annual Meeting. 5/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/practice-changing-research-in-complex-care-at-the-pediatric-academic-societies-2024-annual-meeting

World PICU Awareness Week '24 aims to shine a spotlight on the tireless efforts and innovative practices implemented in the PICU, aiming for better patient outcomes and enhanced quality of life. This series of podcasts focuses on the multifaceted nature of the ICU Liberation Bundle, understanding the importance of pain control, optimizing nutrition, and ensuring safe and timely liberation from mechanical ventilation. Through the six vital elements, we unite to advocate for the well-being and recovery of our most vulnerable patients. This episode is centered around the G Element of the Liberation bundle: Good Nutrition. GUEST Lynne Latten, BSc, RD Paediatric Intensive Care Dietitian Alder Hey Children's Hospital Liverpool, England HOST Lyvonne Tume, RN, B Nurs, MSc Clinical Nursing (Crit Care) PGDE, PhD Professor of Critical Care Nursing Edge Hill University Ormskirk, England, United Kingdom DATES Initial Publication date: May 10, 2024

World PICU Awareness Week '24 aims to shine a spotlight on the tireless efforts and innovative practices implemented in the PICU, aiming for better patient outcomes and enhanced quality of life. This series of podcasts focuses on the multifaceted nature of the ICU Liberation Bundle, understanding the importance of pain control, optimizing nutrition, and ensuring safe and timely liberation from mechanical ventilation. Through the six vital elements, we unite to advocate for the well-being and recovery of our most vulnerable patients. This episode is centered around the F Element: Family Engagement and Empowerment. GUEST Lorena Acevedo, MD Pediatric Intensivist Fundación CardioInfantil Bogota, Colombia Elis de Pellegrin Rossi, MA Hospital Clinical Psychologist Hospital de Clinicas de Porto Alegre Porto Alegre, Brazil HOST Cintia Johnston, Pt MsC PhD Post-doctor Advisor Professor, Postgraduate Program, Department of Pediatrics Faculty of Medicine of the University of São Paulo (FMUSP) – Brazil. DATES Initial Publication date: May 9, 2024

World PICU Awareness Week '24 aims to shine a spotlight on the tireless efforts and innovative practices implemented in the PICU, aiming for better patient outcomes and enhanced quality of life. This series of podcasts focuses on the multifaceted nature of the ICU Liberation Bundle, understanding the importance of pain control, optimizing nutrition, and ensuring safe and timely liberation from mechanical ventilation. Through the six vital elements, we unite to advocate for the well-being and recovery of our most vulnerable patients. This episode is centered around the E Element: Early Mobility and Exercise. GUESTS Joel Lim Kian Boon, MBBS, MRCPCH, MMED Consultant, Clinical Assistant Professor Children's Intensive Care Unit, KK Women's and Children's Hospital Singapore Yang Liying, MSc Senior Physiotherapist KK Women's and Children's Hospital Singapore HOST Qalab Abbas, MBBS, FCCM Associate Professor Aga Khan University Karachi, Pakistan DATES Initial Publication date: May 8, 2024

World PICU Awareness Week '24 aims to shine a spotlight on the tireless efforts and innovative practices implemented in the PICU, aiming for better patient outcomes and enhanced quality of life. This series of podcasts focuses on the multifaceted nature of the ICU Liberation Bundle, understanding the importance of pain control, optimizing nutrition, and ensuring safe and timely liberation from mechanical ventilation. Through the six vital elements, we unite to advocate for the well-being and recovery of our most vulnerable patients. This episode is centered around the D Element: How to Assess, Prevent, and Manage Delirium. GUEST Heidi Smith, MD, MSCI Professor of Anesthesiology and Pediatrics Vanderbilt University Medical Center Nashville, Tennessee, USA HOST Karen Choong, MB BCh, MSc Professor, Department of Pediatrics and Critical Care Department of Health Research Methods, Evidence and Impact McMaster University Hamilton, Ontario, CA DATES Initial Publication date: May 7, 2024

World PICU Awareness Week '24 aims to shine a spotlight on the tireless efforts and innovative practices implemented in the PICU, aiming for better patient outcomes and enhanced quality of life. This series of podcasts focuses on the multifaceted nature of the ICU Liberation Bundle, understanding the importance of pain control, optimizing nutrition, and ensuring safe and timely liberation from mechanical ventilation. Through the six vital elements, we unite to advocate for the well-being and recovery of our most vulnerable patients. This episode is centered around the B Element: Both Spontaneous Awakening Trials (SATs) and Spontaneous Breathing Trials (SBTs). GUESTS Kuban D. Naidoo, MD, CertCritCare (Paed) (SA) Physician Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand Johannesburg, South Africa HOST Robin Saggers, MBBCh (Wits) FCPaed (SA) MMed Paed (Wits) Physician Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand Johannesburg, South Africa DATES Initial Publication date: May 6, 2024

World PICU Awareness Week '24 aims to shine a spotlight on the tireless efforts and innovative practices implemented in the PICU, aiming for better patient outcomes and enhanced quality of life. This series of podcasts focuses on the multifaceted nature of the ICU Liberation Bundle, understanding the importance of pain control, optimizing nutrition, and ensuring safe and timely liberation from mechanical ventilation. Through the six vital elements, we unite to advocate for the well-being and recovery of our most vulnerable patients. This episode is centered around the A Element: Assess, Prevent, and Manage Pain and the C Element: Choice of Analgesia and Sedation. GUESTS Melissa Pilbeam, BPharm Senior PICU Pharmacist Queensland Children’s Hospital Brisbane, Australia Lisa Russell, BNurs Clinical Nurse Specialist Paeditric Intesive Care Unit (PICU) Children’s Hospital Westmead Sydney, Australia HOST Kate Madden, MD Senior Associate, BCH Medical-Surgical ICU. Boston Children's Hospital Assistant Professor of Anesthesiology Harvard University Boston, MA, USA DATES Initial Publication date: May 5, 2024

In this World Shared Practice Forum podcast, we will explore the role of podcasts for learning and discuss the most popular pediatric critical care podcasts from across the world. Drs. Peta Alexander, Erin Bennett, Rahul Damania, Patrick Davies, Zachary Hodges, Greg Kelly, Elizabeth Mack, and Alice Shanklin will describe their podcast series and explore how podcasts have impacted pediatric critical care education. LEARNING OBJECTIVES Upon listening to this presentation, learners will be able to: - Identify the potential benefits of listening to podcasts for learning. - Describe and contrast the most popular pediatric critical care podcasts today. AUTHORS Peta Alexander, MBBS, FRACP, FCICM Senior Associate Cardiologist, Department of Cardiology Boston Children’s Hospital Associate Professor in Pediatrics Harvard Medical School Podcast: Pediatrica Intensiva https://pedsintensiva.com/ Erin Bennett, MD, MPH Associate Professor, Division of Critical Care Medicine, Department of Pediatrics University of Arkansas for Medical Sciences/Arkansas Children’s Hospital Podcast: PCCM Audio Summary https://www.sccm.org/Research/Journals/Journal-Audio-Summaries Rahul Damania, MD Pediatric Critical Care Physician Cleveland Clinic Children's Hospital Podcast: PICU Doc on Call https://picudoconcall.org/ Patrick Davies, BMedSci, BMBS, MRCPCH Consultant in Paediatric Intensive Care, Honorary Associate Professor Nottingham Children's Hospital Paediatric Critical Care Unit, and University of Nottingham Podcast: The PicPod https://picpod.net/ Zachary Hodges, MD Pediatric Critical Care Fellow Physician University of Texas Southwestern Podcast: PedsCrit https://www.buzzsprout.com/1809998 Greg Kelly, MBBS, MBA, FRACP, FCICM Pediatric Intensivist Children's Hospital at Westmead, Sydney, Australia Podcast: Pediatrica Intensiva https://pedsintensiva.com/ Elizabeth Mack, MD, MS Pediatric Critical Care Physician Professor, pediatrics Medical University of South Carolina (MUSC) Podcast: SCCM Podcast https://www.sccm.org/podcast Alice Shanklin, MD Critical Care Fellow Children's National Hospital Podcast: PedsCrit https://www.buzzsprout.com/1809998 Traci Wolbrink, MD, MPH Senior Associate in Critical Care Medicine; Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Associate Professor of Anesthesia Harvard Medical School DATES Initial Publication: April 22, 2024. ARTICLES REFERENCED 5:55 Cadogan article, https://pubmed.ncbi.nlm.nih.gov/24554447/ 6:04 Mallin article, https://pubmed.ncbi.nlm.nih.gov/24556776/ 6:16 Kelly article, https://pubmed.ncbi.nlm.nih.gov/34935729/ 7:22 Riddell article, https://pubmed.ncbi.nlm.nih.gov/31517682/ 15:44 Oransky/Retraction Watch podcast, https://picpod.net/2024/04/01/picpod-79-ivan-oransky-from-retraction-watch/ PODCASTS REFERENCED 99% Invisible podcast, https://99percentinvisible.org/ Dr. Death podcast, https://wondery.com/shows/dr-death/ Huberman Lab podcast, https://www.hubermanlab.com/podcast Not Otherwise Specified podcast, https://not-otherwise-specified-podcast.nejm.org/ On Purpose podcast, https://www.jayshetty.me/podcast The Effort Report podcast, https://effortreport.libsyn.com/ The Hamilcast podcast, https://thehamilcast.com/ The New York Times Daily podcast, https://www.nytimes.com/column/the-daily The PAPERs podcast, https://paperspodcast.ki.se/ CITATION Alexander P, Bennett E, Damania R, Davies P, Hodges Z, Kelly G, Mack E, Shanklin A, Wolbrink TA. The Sound of Knowledge: Popular PICU Podcasts Today. 04/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/the-sound-of-knowledge-popular-picu-podcasts-today-by-t-wolbrink-et-al-openpediatrics?si=6a8c08da65264791a37e2ef8ce9f9d32&utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing.

In this Complex Care Journal Club podcast episode, Dr. Lorna Fraser discusses the results of a prospective cohort study comparing outcomes for children receiving home blends vs formula via gastrostomy tube. She describes the central role of patients and families in study design, opportunities for ensuring equitable access to blended diets, and next steps from this work. SPEAKER Lorna Fraser, PhD, MBChB, MRCPCH, MSc, MMedSci Professor of Palliative Care and Child Health, Cicely Saunders Institute and School of Life Sciences and Population Health King’s College London HOST Kathleen Huth, MD, MMSc Pediatrician, Complex Care Service, Division of General Pediatrics Boston Children's Hospital Assistant Professor of Pediatrics Harvard Medical School DATES Initial Publication date: April 8, 2024 JOURNAL ARTICLES Journal Club Article Citations Fraser LK, Bedendo A, O'Neill M, Taylor J, Hackett J, Horridge KA, Cade J, Richardson G, Phung H, McCarter A, Hewitt CE. Safety, resource use and nutritional content of home-blended diets in children who are gastrostomy fed: Findings from 'YourTube' - a prospective cohort study. Arch Dis Child. 2023 Dec 21:archdischild-2023-326393. doi: 10.1136/archdischild-2023-326393. Fraser LK, Bedendo A, O'Neill M, Taylor J, Hackett J, Horridge K, Cade J, Richardson G, Phung H, Mccarter A, Hewitt C. 'YourTube' the role of different diets in gastrostomy-fed children: Baseline findings from a prospective cohort study. Dev Med Child Neurol. 2023 Nov 10. doi: 10.1111/dmcn.15799. OTHER REFERENCES Hron B, Fishman E, Lurie M, Clarke T, Chin Z, Hester L, Burch E, Rosen R. Health Outcomes and Quality of Life Indices of Children Receiving Blenderized Feeds via Enteral Tube. J Pediatr. 2019 Aug;211:139-145.e1. doi: 10.1016/j.jpeds.2019.04.023. Epub 2019 May 23. PMID: 31128885; PMCID: PMC6660979. Maddison J, Taylor J, O'Neill M, Cade J, Hewitt C, Horridge K, McCarter A, Fraser LK, Beresford B. Outcomes for gastrostomy-fed children and their parents: qualitative findings from the 'Your Tube' study. Dev Med Child Neurol. 2021 Sep;63(9):1099-1106. doi: 10.1111/dmcn.14868. Epub 2021 Apr 1. PMID: 33792913. University of York. YourTube: Home blended diets for children who are gastrostomy fed. Infographic. Accessed March 13, 2024. https://www.york.ac.uk/media/healthsciences/images/research/phs/mhrc/Yourtube%20-%200102%20Infographic%20print.pdf University of York. YourTube for parent/healthcare professional. YouTube. January 19, 2024. Accessed March 13, 2024. https://youtu.be/5POi2Cjp8og University of York. YourTube for young people. YouTube. January 19, 2024. Accessed March 13, 2024. https://youtu.be/NlVriI0O-oI TRANSCRIPT https://op-docebo-images.s3.amazonaws.com/Transcripts/Building+the+Evidence+for+Blended+Diets_Fraser_040824.pdf Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6 Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: [email protected] CITATION Fraser L, Huth K. Building the Evidence for Blended Diets: Benefits and Barriers to Access. 4/2024. OPENPediatrics. Online Podcast. https://on.soundcloud.com/pcQSrJTHvF4H4yiY6

In this World Shared Practice Forum Podcast, authors of the newly released publication, International Consensus Criteria for Pediatric Sepsis and Septic Shock, review their research and findings for treating and caring for children with sepsis and septic shock. They discuss how using the novel Phoenix Sepsis Score guided the development of this new globally applicable research model. LEARNING OBJECTIVES Upon listening to this presentation, learners will be able to: - Describe the goals and development of the new Phoenix Sepsis Score - Discuss how clinicians can apply the score in clinical practice and for research endeavors - Explain the challenges and limitations of using the Phoenix Sepsis score in lower-resource settings AUTHORS Luregn Schlapbach, MD, PhD, Prof, FCICM Head, Department of Intensive Care and Neonatology University Children’s Hospital in Zurich, Switzerland Scott Watson, MD, MPH Professor of Pediatrics University of Washington School of Medicine Associate Division Chief Division of Pediatric Critical Care Medicine Seattle Children’s Hospital Claudio Flauzino de Oliveira, MD, PhD Researcher Latin American Sepsis Institute Halden Scott, MD, MSCS Director of Research Section of Pediatric Emergency Medicine University of Colorado School of Medicine Children’s Hospital Colorado Tellen Bennett, MD, MS Professor of Biomedical Informatics and Pediatrics Vice Chair of Clinical Informatics Department of Biomedical Informatics University of Colorado School of Medicine Attending Physician Pediatric Intensive Care Unit Children’s Hospital Colorado Traci Wolbrink, MD, MPH Senior Associate in Critical Care Medicine; Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Associate Professor of Anesthesia Harvard Medical School DATES Initial publication date: March 26, 2024. ARTICLES REFERENCED Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock https://jamanetwork.com/journals/jama/fullarticle/2814296 Global Study of Disease https://pubmed.ncbi.nlm.nih.gov/31954465/ Sepsis-3 https://jamanetwork.com/journals/jama/fullarticle/2492881 Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: [email protected] CITATION Schlapbach LJ, Bennett TD, de Oliveira CF, Scott HF, Watson RS, O’Hara JE, Wolbrink TA. New Phoenix Pediatric Sepsis Criteria. 03/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/new-phoenix-pediatric-sepsis-criteria.

In this new Nursing World Shared Practice Forum video, Dr. Andrea Wallace shares the importance of implementing social determinants of health screening in healthcare delivery. She shares non-traditional strategies and resources nurses can use to participate in evidence-based practice activities. She also discusses firsthand experiences with implementing evidence-based practice in the context of improving outcomes when social determinants of health exist. LEARNING OBJECTIVES Following this discussion, learners will be able to: - Describe four social health factors - Discuss facilitators and barriers to implementing healthcare improvements when social determinants of health exist - List traditional and non-traditional strategies and resources to help nurses participate in evidence-based practice - Describe ways to incorporate evidence-based practice into nursing practice AUTHORS Andrea Wallace PhD, RN, FAAN‌ Associate Dean for Research University of Utah Julie Waitt MSN, RN, CPHON Director of Nursing Patient Services Hematopoietic Stem Cell Transplant Unit Boston Children’s Hospital‌‌‌ DATES Initial publication: March 18, 2024. Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: [email protected] CITATION Wallace A, Brodie K, DeGrazia M, Waitt J. Leveraging Research to Address Social Determinants of Health. 03/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/leveraging-research-to-address-social-determinants-of-health-by-a-wallace-openpediatrics