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40
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September 2021 List
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September 2021 List
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<a href="http://doi.org/10.1089/pmr.2020.0121" target="_blank" rel="noreferrer noopener">http://doi.org/10.1089/pmr.2020.0121</a>
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Improving Neonatal Intensive Care Unit Providers' Perceptions of Palliative Care through a Weekly Case-Based Discussion
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Palliative Medicine Reports
Date
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2021
Subject
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neonatology; quality of life; end-of-life care; interdisciplinary; provider perspectives
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Allen JD; Shukla R; Baker R; Slaven JE; Moody K
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Objective: The primary objective was to evaluate the efficacy of a weekly palliative care-guided, case-based discussion of high-risk infants on Neonatal Intensive Care Unit (NICU) physician (MD) and Advanced Practice Provider (APP) perceptions of pediatric palliative care (PPC). Study Design: The study setting was a level IV academic NICU in a United States midwestern children's hospital. A pre/post design was used to evaluate the effects of a weekly palliative care-guided, case-based discussion of high-risk infants on neonatology providers' (MD and APP) perspectives of palliative and end-of-life care in the NICU using a previously published survey instrument. Surveys were completed at baseline and after 12 months of implementation. Data was analyzed with a Wilcoxon Signed Rank test with significance set at p < 0.05. Results: Thirty-one providers (13 APPs and 18 MDs) completed both pre- and post-intervention surveys. Post-intervention, providers were more likely to endorse that they "are comfortable with PPC", "feel comfortable teaching PPC to trainees", "feel confident handling end-of-life care", "have time to discuss PPC", and "were satisfied with the transition to end-of-life care for their most recent patient". They also were more likely to report, "families' perception of burden is relevant when making ethical decisions", that "parents are involved in decisions regarding palliative care", and that their "institution is supportive of palliative care." (p-values < 0.05 for all). Conclusion: NICU provider perceptions of palliative care can be improved through the implementation of a case-based interdisciplinary conference that emphasizes palliative care domains in the context of Neonatal ICU care.
Identifier
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<a href="http://doi.org/10.1089/pmr.2020.0121" target="_blank" rel="noreferrer noopener">10.1089/pmr.2020.0121</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2021
Allen JD
Baker R
End-of-life Care
Interdisciplinary
Moody K
Neonatology
Palliative Medicine Reports
provider perspectives
Quality Of Life
September 2021 List
Shukla R
Slaven JE
-
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Title
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November 2020 List
Text
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November 2020 List
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<a href="http://doi.org/10.1136/bmjopen-2019-034817" target="_blank" rel="noreferrer noopener">http://doi.org/10.1136/bmjopen-2019-034817</a>
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Title
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My child's legacy: A mixed methods study of bereaved parents and providers' opinions about collaboration with NICU teams in quality improvement initiatives
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BMJ Open
Date
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2020
Subject
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bereavement; legacy-making; mixed-methods study; neonatal intensive care unit; NICU; parental perspectives; provider perspectives
Creator
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Bourque C J; Dahan S; Mantha G; Reichherzer M; Janvier A
Description
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Objective Although stakeholders' participation in healthcare is increasingly recommended, bereaved parents are often excluded for perceived potential risks to them. The objective of this study is to describe the ongoing involvement and the perspectives of bereaved parents engaged in different types of activities in Neonatal Intensive Care Units and providers who work with them. Design/methods Mixed methods convergent analysis. Setting Canadian paediatric tertiary care university hospital. Participants All bereaved members of the resource parents group (n=8) and most providers who work with them (n=16) answered a satisfaction/needs questionnaires. Results Since 2011, eight bereaved parents were involved in a large number of activities mostly related to palliative care (research, education or clinical care initiatives). Three engaged in peer-to-peer support activities while the others preferred activities outside of clinical units and/or without direct interactions with other families. All of them reported that their participation had positive impacts, but two parents also reported a reactivation of traumatic experiences during a medical simulation activity. All participants expressed a desire for further collaboration. Motivation to contribute gravitated around two central themes: helping others and helping themselves. Many wanted to give back, help other families, improve the system and meet with providers who had cared for their child. All stated that this kind of involvement empowered them and gave meaning to their experiences. Providers and researchers all reported positive experiences, mainly due to the unique perspectives of bereaved parents who took part in their projects. Conclusion(s) With careful recruitment and supervision, some bereaved parents can become resource parents involved in different types of activities. It is important to understand the positive impacts this type of engagement can have on their healing process and to control the risks related to their participation. Research is needed to develop pertinent tools and measures to evaluate the outcomes and impacts of their participation. Copyright ©
Identifier
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<a href="http://doi.org/10.1136/bmjopen-2019-034817" target="_blank" rel="noreferrer noopener">10.1136/bmjopen-2019-034817</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
Bereavement
Bmj Open
Bourque C J
Dahan S
Janvier A
legacy-making
Mantha G
mixed-methods study
Neonatal Intensive Care Unit
Nicu
November 2020 List
Parental Perspectives
provider perspectives
Reichherzer M
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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November 2020 List
Text
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November 2020 List
URL Address
<a href="http://doi.org/10.4037/ccn2020710" target="_blank" rel="noreferrer noopener">http://doi.org/10.4037/ccn2020710</a>
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Title
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Perspectives of Pediatric Providers on Patients With Complex Chronic Conditions: A Mixed-Methods Sequential Explanatory Study
Publisher
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Critical Care Nurse
Date
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2020
Subject
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complex chronic conditions; mixed-methods study; pediatric intensive care unit; pediatric palliative care; PICU; provider perspectives
Creator
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Kobussen T A; Hansen G; Brockman R J; Holt T R
Description
An account of the resource
BACKGROUND: Children with complex chronic conditions present unique challenges to the pediatric intensive care unit, including prolonged length of stay, complex medical regimens, and complicated family dynamics. OBJECTIVES: To examine perspectives of pediatric intensive care unit health care providers regarding pediatric patients with complex chronic conditions, and to explore potential opportunities to improve these patients' care. METHODS: A prospective mixed-methods sequential explanatory study was conducted in a tertiary medical-surgical pediatric intensive care unit using surveys performed with REDCap (Research Electronic Data Capture) followed by semistructured interviews. RESULTS: The survey response rate was 70.6% (77 of 109). Perspectives of health care providers did not vary with duration of work experience. Ten semistructured interviews were conducted. Eight overarching themes emerged from the interviews: (1) the desire for increased formal education specific to pediatric complex chronic care patients; (2) designation of a primary intensivist; (3) modifying delivery of care to include a discrete location for care provision; (4) establishing daily, short-term, and long-term goals; (5) monitoring and documenting care milestones; (6) strengthening patient and family communications with the health care team; (7) optimizing discharge coordination and planning; and (8) integrating families into care responsibilities. CONCLUSIONS: Pediatric intensive care unit health care providers' perspectives of pediatric patients with complex chronic conditions indicated opportunities to refine the care provided by establishing daily goals, coordinating discharge planning, and creating occasions for close communication between patients, families, and providers.
Identifier
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<a href="http://doi.org/10.4037/ccn2020710" target="_blank" rel="noreferrer noopener">10.4037/ccn2020710</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
Brockman R J
Complex Chronic Conditions
Critical Care Nurse
Hansen G
Holt T R
Kobussen T A
mixed-methods study
November 2020 List
Pediatric Intensive Care Unit
Pediatric Palliative Care
Picu
provider perspectives
-
Dublin Core
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Title
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February 2022 List
Text
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February 2022 List
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<a href="http://doi.org/10.1111/apa.16235" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/apa.16235</a>
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Provider concordance regarding elements of goals-of-care discussions in neonatal intensive care
Publisher
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Acta Paediatrica
Date
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2021
Subject
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end of life; neonatal; palliative care; provider perspectives
Creator
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Guttmann K; Liu B; Kelley A
Description
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Clinicians may struggle to discuss goals of care with parents in the Neonatal Intensive Care Unit (NICU) and may view key elements of such conversations differently. We previously described the relationship between components of goals-of-care discussions and change in moral distress following goals-of-care discussions.1 With the analysis described here, we sought to determine how providers who participated in the same goals-of-care discussion viewed key discussion elements in comparison with other provider participants. Understanding differences and concordance in perceptions may help to (1) understand the quality of goals-of-care discussions, (2) improve metrics of communication quality and (3) inform the development of targeted interventions to improve communication quality.
Identifier
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<a href="http://doi.org/10.1111/apa.16235" target="_blank" rel="noreferrer noopener">10.1111/apa.16235</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2021
Acta Paediatrica
End Of Life
February 2022 List
Guttmann K
Kelley A
Liu B
Neonatal
Palliative Care
provider perspectives
-
Dublin Core
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Title
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December 2020 List
Text
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December 2020 List
URL Address
<a href="http://doi.org/10.1542/hpeds.2020-0075" target="_blank" rel="noreferrer noopener">http://doi.org/10.1542/hpeds.2020-0075</a>
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Shared Decision-making With Parents of Hospitalized Children: A Qualitative Analysis of Parents' and Providers' Perspectives
Publisher
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Hospital Pediatrics
Date
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2020
Subject
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parent perspectives; provider perspectives; qualitative analysis; shared decision-making
Creator
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Hoang K; Halpern-Felsher B; Brooks M; Blankenburg R
Description
An account of the resource
OBJECTIVES: Shared decision-making (SDM) is the pinnacle of patient-centered care and has been shown to improve health outcomes, especially for children with chronic medical conditions. However, parents perceive suboptimal involvement during hospitalization. The objective was to explore the perspectives of parents of hospitalized children and their hospital providers on facilitators and barriers to SDM in the hospital and identify strategies to increase SDM. METHODS: A qualitative study was conducted by using semistructured interviews with parents of hospitalized children with and without complex chronic conditions and their pediatric hospital medicine faculty. Parents and faculty were matched and individually interviewed on the same day. Two investigators iteratively coded transcripts and identified themes using modified grounded theory, with an additional author reviewing themes. RESULTS: Twenty-seven parents and 16 faculty participated in the interviews. Four themes emerged: (1) parents and providers value different components of SDM; (2) providers assume SDM is easier with parents of children with medical complexity; (3) factors related to providers, parents, patients, and family-centered rounds were identified as barriers to SDM; and (4) parents and providers identified strategies to facilitate SDM in the hospital. CONCLUSIONS: There is a discrepancy between parents' and providers' understanding of SDM, with parents most valuing their providers' ability to actively listen and explain the medical issue and options with them. There are many barriers that exist that make it difficult for both parties to participate. Several strategies related to family-centered rounds have been identified that can be implemented into clinical practice to mitigate these barriers.
Identifier
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<a href="http://doi.org/10.1542/hpeds.2020-0075" target="_blank" rel="noreferrer noopener">10.1542/hpeds.2020-0075</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
Blankenburg R
Brooks M
December 2020 List
Halpern-Felsher B
Hoang K
Hospital Pediatrics
parent perspectives
provider perspectives
Qualitative Analysis
Shared Decision-making
-
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Title
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Special Edition #2 2022 List
Text
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Special Edition #2
URL Address
<a href="http://doi.org/10.1542/hpeds.2020-0075" target="_blank" rel="noreferrer noopener">http://doi.org/10.1542/hpeds.2020-0075</a>
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Shared Decision-making With Parents of Hospitalized Children: A Qualitative Analysis of Parents' and Providers' Perspectives
Publisher
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Hospital Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2020
Subject
The topic of the resource
parent perspectives; provider perspectives; qualitative analysis; shared decision-making
Creator
An entity primarily responsible for making the resource
Hoang K; Halpern-Felsher B; Brooks M; Blankenburg R
Description
An account of the resource
OBJECTIVES: Shared decision-making (SDM) is the pinnacle of patient-centered care and has been shown to improve health outcomes, especially for children with chronic medical conditions. However, parents perceive suboptimal involvement during hospitalization. The objective was to explore the perspectives of parents of hospitalized children and their hospital providers on facilitators and barriers to SDM in the hospital and identify strategies to increase SDM. METHODS: A qualitative study was conducted by using semistructured interviews with parents of hospitalized children with and without complex chronic conditions and their pediatric hospital medicine faculty. Parents and faculty were matched and individually interviewed on the same day. Two investigators iteratively coded transcripts and identified themes using modified grounded theory, with an additional author reviewing themes. RESULTS: Twenty-seven parents and 16 faculty participated in the interviews. Four themes emerged: (1) parents and providers value different components of SDM; (2) providers assume SDM is easier with parents of children with medical complexity; (3) factors related to providers, parents, patients, and family-centered rounds were identified as barriers to SDM; and (4) parents and providers identified strategies to facilitate SDM in the hospital. CONCLUSIONS: There is a discrepancy between parents' and providers' understanding of SDM, with parents most valuing their providers' ability to actively listen and explain the medical issue and options with them. There are many barriers that exist that make it difficult for both parties to participate. Several strategies related to family-centered rounds have been identified that can be implemented into clinical practice to mitigate these barriers.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/hpeds.2020-0075" target="_blank" rel="noreferrer noopener">10.1542/hpeds.2020-0075</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
2022 Special Edition 2 - Parent Perspectives
Blankenburg R
Brooks M
Halpern-Felsher B
Hoang K
Hospital Pediatrics
parent perspectives
provider perspectives
Qualitative Analysis
Shared Decision-making
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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January 2021 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
January 2021 List
URL Address
<a href="http://doi.org/10.1055/s-0040-1719071" target="_blank" rel="noreferrer noopener">http://doi.org/10.1055/s-0040-1719071</a>
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Shifting Provider Attitudes and Institutional Resources Surrounding Resuscitation at the Limit of Gestational Viability
Publisher
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American Journal of Perinatology
Date
A point or period of time associated with an event in the lifecycle of the resource
2020
Subject
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resuscitation; provider perspectives; gestational viability; periviable infants
Creator
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Arbour K; Lindsay E; Laventhal N; Myers P; Andrews B; Klar A; Dunbar AE
Description
An account of the resource
Objective This study aimed to provide contemporary data regarding provider perceptions of appropriate care for resuscitation and stabilization of periviable infants and institutional resources available to providers. Study Design A Qualtrics survey was emailed to 672 practicing neonatologists in the United States by use of public databases. Participants were asked about appropriate delivery room care for infants born at 22 to 26 weeks gestational age, factors affecting decision-making, and resources utilized regarding resuscitation. Descriptive statistics were used to analyze the dataset. Results In total, 180 responses were received, and 173 responses analyzed. Regarding preferred course of care based on gestational age, the proportion of respondents endorsing full resuscitation decreased with decreasing gestational age (25 weeks = 99%, 24 = 64%, 23 = 16%, and 22 = 4%). Deference to parental wishes correspondingly increased with decreasing gestational age (25 weeks = 1%, 24 = 35%, 23 = 82%, and 22 = 46%). Provision of comfort care was only endorsed at 22 to 23 weeks (23 weeks = 2%, 22 = 50%). Factors most impacting decision-making at 22 weeks gestational age included: outcomes based on population data (79%), parental wishes (65%), and quality of life measures (63%). Intubation with a 2.5-mm endotracheal tube (84%), surfactant administration in the delivery room (77%), and vascular access (69%) were the most supported therapies for initial stabilization. Availability of institutional resources varied; the most limited were obstetric support for cesarean delivery at the limit of viability (37%), 2.0-mm endotracheal tube (45%), small baby protocols (46%), and a consulting palliative care teams (54%). Conclusion There appears to be discordance in provider attitudes surrounding preferred actions at 23 and 22 weeks. Provider attitudes regarding decision-making at the limit of viability and identified resource limitations are nonuniform. Between-hospital variations in outcomes for periviable infants may be partly attributable to lack of provider consensus and nonuniform resource availability across institutions. Key Points Within the past decade, there has been a shift in the gray zone from 23-24 to 22-23 weeks gestation. Attitudes around resuscitation of infants are nonuniform despite perceived standardized approaches. Institutional variability in resources may contribute to variation in outcomes of periviable infants. Copyright © 2020 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
Identifier
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<a href="http://doi.org/10.1055/s-0040-1719071" target="_blank" rel="noreferrer noopener">10.1055/s-0040-1719071</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
American Journal of Perinatology
Andrews B
Arbour K
Dunbar AE
gestational viability
January 2021 List
Klar A
Laventhal N
Lindsay E
Myers P
periviable infants
provider perspectives
Resuscitation