ABSTRACT
There is a growing need for advanced practice providers in the NICU. Physician assistants (PAs) with postgraduate training in neonatology can help meet these demands. The premise of training PAs to work in the NICU is being adopted by multiple centers nationwide. Unfortunately, there are no standardized curricula for neonatal PA training that can be utilized to initiate residencies. Since our program is the longest running neonatal PA residency in the nation, we are in a unique position to share the accumulated experiences of our curriculum development. In this article, we describe our neonatal PA residency as it exists today with selected lessons learned. In addition, we present mixed qualitative and quantitative assessments of graduates. We believe that neonatal PA residency graduates become ideal candidates to fill the growing national need. We propose that our model program can be a stepping stone to enhance the role of PAs in neonatal care.
Subject(s)
Education, Medical, Graduate , Intensive Care, Neonatal/methods , Neonatology/education , Physician Assistants/education , Clinical Competence , Curriculum , Fellowships and Scholarships , Female , Humans , Interviews as Topic , Male , Program Development , Qualitative Research , United StatesSubject(s)
Infant, Premature, Diseases/therapy , Infant, Premature , Superior Mesenteric Artery Syndrome/complications , Superior Mesenteric Artery Syndrome/diagnosis , 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use , Dexamethasone/adverse effects , Dexamethasone/therapeutic use , Enteral Nutrition/methods , Gastroesophageal Reflux/complications , Gastroesophageal Reflux/therapy , Humans , Infant, Newborn , Infant, Premature/growth & development , Intensive Care, Neonatal , Lansoprazole , Male , Superior Mesenteric Artery Syndrome/drug therapy , Vomiting/etiologyABSTRACT
Cell-mediated immunity is an important vertebrate defense against pathogens, but components of this response may vary in quality. Such variation could arise through the effects of ecology on optimal immunocompetence. We used injections of phytohaemagglutinin (PHA) to measure the factors influencing T-cell proliferation in nestling house sparrows ( Passer domesticus). Bivariate analyses revealed positive associations with nestling mass and size, but no effect of ectoparasites. The response to PHA was, however, strongly affected by brood identity. A mixed model with brood identity as a random factor and nestling mass, size, number of ectoparasites, parental feeding rate, clutch size, brood size at hatching, and date uncovered significant positive correlations between PHA response and both nestling mass and the brood size at hatching. Because many of these variables are related hierarchically, we used path analysis to explore the relationships in more detail. We found that a nestling immune response was affected by several indirect paths. Brood size at hatch had both positive and negative paths, and date in the season had several indirect negative effects through its effect on brood size and nestling mass. The approach used and the results obtained offer some new ideas for incorporating immune responses into life history theory.
