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May 2020 NIDUS Newsletter
Network for Investigation of Delirium: Unifying Scientists
A Note on COVID-19
 
On behalf of the entire NIDUS team, we want to wholeheartedly thank the clinicians and staff on the front-lines, tirelessly working to keep patients safe. We understand that delirium and COVID-19 go hand-in-hand, with delirium or altered mental status as a presenting symptom of COVID-19 and the high risk that patients (specifically older adults) have for developing delirium as they fight off infection. For resources on delirium and COVID-19, we recommend https://hospitalelderlifeprogram.org/for-clinicians/covid19-resources.
 
World Delirium Awareness Day 2020 – “Let’s Stop Delirium Before It Starts”
This March 11th, the delirium community celebrated the third annual World Delirium Awareness Day (WDAD)! Started in March of 2018, the purpose of WDAD is to spread the word about what delirium is and how to prevent and manage it in a variety of healthcare settings. This year’s theme was “Let’s Stop Delirium Before It Starts,” focusing on the prevention of delirium through proven methods.
 
The NIDUS team was hard at work in preparation for WDAD and released a whole host of resources and media regarding the national event. To learn more about WDAD and NIDUS, check out this blog post from Maggie Webb, Research Associate at the Marcus Institute for Aging Research in Boston, MA. Dr. Louise Rose, Professor of Critical Care Nursing from King’s College London, also penned a blog for NIDUS’ celebration of WDAD, focusing on the Del-COrS Collaboration. Del-COrS is generating a core outcome set, or set of outcomes for delirium prevention and treatment trial studies, that will help address heterogeneity in the field. 

NIDUS Principal Investigator Dr. Sharon Inouye was featured twice in podcasts for WDAD, including Kali Dayton’s “Walking Home from the ICU” that features stories and experts of sedation and immobility in an effort to improve long-term patient outcomes. Dr. Inouye also spoke with Ira Pastor from ideaXme to discuss delirium as an underdiagnosed area of brain aging and degeneration.

How else did the NIDUS team ring in WDAD 2020? Twitter was abuzz with resources, expertise, and opinions on delirium prevention for the event, and NIDUS hosted a “Twitter Chat,” or designated day to ask the NIDUS team via the hashtag #NIDUSChat and #WDAD2020 about available NIDUS resources. Highlighted were the Measurement and Harmonization Core Delirium Information Cards, along with the Research Resources Core Delirium Hub!

Our awareness raising for delirium and its prevention was not limited to cyber activities – NIDUS brought the delirium knowledge to the Marcus Institute for Aging Research office in Boston, MA with a “pledge.” Marcus colleagues took the following pledge of delirium awareness and prevention (and got a WDAD 2020 button)!

I pledge to:
  • Learn the features of delirium:
    • Acute onset and fluctuating course
    • Inattention
    • Disorganized thinking
    • Altered level of consciousness
  • Learn how delirium is PREVENTABLE
  • Check out http://deliriumnetwork.org/
  • Spread the word about delirium and NIDUS to my clinical and research networks



Finally, in our WDAD celebrations, Drs. Sharon Inouye, Edward Marcantonio, and Rich Jones created videos walking through the NIDUS resources and delivering a warm delirium awareness message! Watch the full videos at the links below:

NIDUS Overview: https://deliriumnetwork.org/
Research Resources and the Delirium Hub: https://deliriumnetwork.org/delirium-research-hub/
Measurement and Harmonization Tools: https://deliriumnetwork.org/measurement/
NIDUS Junior Faculty Working Groups: Building Confidence and Contacts!
 
Kirsten Fiest, PhD, is an Assistant Professor of Critical Care Medicine and Director of Research and Innovation in the Department of Critical Care Medicine at the University of Calgary. Dr. Fiest leads one of NIDUS’s two junior faculty working groups for peer mentoring and support in delirium research.  

How did your Junior Faculty Working Group get its start?

In the year I spent as a participant in Dr. Tamara Fong’s junior faculty working group, there was much interest among my colleagues in broadening the effort to include a second group. We decided to form a new group that I would lead. The eight members of the second junior faculty working group have been meeting every month for nearly a year. Participants include faculty from Brown University, Loyola University, Vanderbilt University, Harvard University, and the Universities of Calgary and Toronto. 

What does the Junior Faculty Working Group do?

We function as a support group for peer mentorship, meeting monthly by Zoom to discuss a variety of topics. Sometimes we learn from more established investigators and other times we help each other.

During one meeting, Dr. Inouye gave a talk to the group on how to take your research to the next level and succeed as a scientist in delirium research, giving examples from her own career.
Another meeting might include the group helping a member to prepare for an upcoming talk or revise a poster presentation. Members can practice their presentations and get feedback about what worked or needs improving. We also review members’ funding applications or papers, which is helpful when members want to bounce ideas off of peers for immediate feedback.

We’re all at similar stages in our career, but we’re all from different institutions and we all do slightly different things. My area is in the ICU, while some of our members focus on geriatrics, and others are interested in post-surgical care or other topics. We represent multiple professions, linked by our interest in delirium. Our different training backgrounds and methodological expertise allow the group to offer diverse feedback.

In what other ways has the group been successful?

It’s been successful in terms of what we’ve been able to accomplish and how we’ve been able to support each other, not just through the monthly meetings but also at conferences. When we go to the American Delirium Society meeting every year we always try to get together. It’s nice to know people especially when you’re more junior and starting out. To go to a conference and see ten people you know, that can change your experience and increase your confidence to ask questions and put yourself out there more. Also, if you’re looking for collaborators on projects you have a network of people you can reach out to.

What were some times when you knew that participation in the group had a positive impact?

I can think of a couple of examples where people were struggling to recruit for their research. Our group helped people navigate the challenges of recruitment, which was especially helpful for busy clinicians who were also trying to do their science. I think having the peer support and sharing what’s worked from our own projects and experiences helped them persevere.

How has leading the group helped you personally and professionally?

This project has allowed me to flex my mentoring skills and learn how to support people. It’s been so rewarding because now I have colleagues whom I consider friends in other institutions.

The other benefit is the opportunity to interact with more senior investigators including NIDUS PIs. The group has been valuable for creating connections to those individuals. As an example, Dr. Inouye and I are collaborating on some work together – entirely because of my participation in this group.

Are you looking for more members?

We always have room for more, but members need to commit to attend monthly meetings for a year. Since we want to ensure that everyone has an opportunity to give feedback and to receive feedback, we ask that people attend at least 10 of the 12 sessions that take place within the year.
It’s a junior faculty working group so prospective members need to either be new to the field of delirium or new in general to research. We are looking for people in earlier stages of their careers, say, in the first five years.

Anyone interested in joining our NIDUS-sponsored junior faculty working groups can contact Tamara Fong, MD, PhD, Assistant Scientist, Aging Brain Center, Hinda and Arthur Marcus Institute for Aging Research, Assistant Professor of Neurology, Harvard Medical School, at tfong@bidmc.harvard.edu.
NIDUS Career Development Summer Webinar Series 
Disseminating Delirium Research – all webinars are free and do not require pre-registration!
  • “Pearls from a Journal Editors” – Dr. Donna Fick, June 4th 12pm EST
  • “How to Get Writing Done” – Dr. Sharon Inouye, July 8th 12pm EST
  • “Tips on Poster/Slide Design” – Eva Zeisky, August 13th 12pm EST
Find the webinars here.
 
New Publications
  1. Oh ES, Akeju O, Avidan MS, Cunningham C, Hayden KM, Jones RN, Khachaturian AS, Khan BA, Marcantonio ER, Needham DM, Neufeld KJ, Rose L, Spence J, Tieges Z, *Vlisides P, Inouye SK, on behalf of the NIDUS Writing Group. A Roadmap to Advance Delirium Research: Recommendations from the NIDUS Scientific Think Tank. Alzheimer’s Dement. 2020;1-8. 
  2. Khachaturian AS, Hayden KM, Devlin JW, Fleisher LA, Lenz Lock S, Cunningham C, Oh ES, Fong TG, Fick DM, Marcantonio ER, Iyengar V, Rockwood K, Kuchel GA, Eckenhoff RG, MacLullich AMJ, Jones RN, Davis D, D’Antonio PM, Fargo KN, Albert MS, Williamson JD, Ling SM, Weiss J, Karlawish J, Peterson RC, Blazer DG, Khachaturian ZS, Inouye SK. International drive to illuminate delirium: A developing public health blueprint for action. Alzheimer’s Dement. 2020;16:711-725
  3. Hshieh TT, Fong TG, Schmitt EM, Marcantonio ER, Xu G, Gou YR, Travison TG, Metzger ED, Jones RN, Inouye SK, for the BASIL Study Group. Does Alzheimer’s Disease and Related Dementias Modify Delirium Severity and Hospital Outcomes? J Am Geriatr Soc. 2020. [Epub ahead of print].
  4. AARP Global Conuncil on Brain Health Recommendations to Prevent and Treat Delirium.   
  5. Young J, Green J, Farrin A, Collinson M, Hartley S, Smith J, Teale E, Siddiqi N, Inouye SK. A multicenter, pragmatic, cluster randomized, controlled feasibility trial of the POD system of care. Age Ageing. 2020. [Epub ahead of print]. 
  6. Smith J, Green J, Siddiqi N, Inouye SK, Collinson M, Farrin A, Young JB. Investigation of ward fidelity to a multi-component delirium prevention intervention during a multi-centre, pragmatic, cluster randomized, controlled feasibility trial. Age Ageing. 2020. [Epub ahead of print].
  7. *Vasunilashorn SM, Ngo LH, Inouye SK, *Fong TG, Jones RN, Dillon ST, Libermann TA, O'Connor M, Arnold SE, Xie Z, Marcantonio ER. Apolipoprotein E genotype and the association between C-reactive protein and postoperative delirium: Importance of gene-protein interactions. Alzheimers Dement. 2020;16:572-580.
  8. Racine AM, Touroutoglou A, Abrantes T, Wong B,* Fong TG, *Cavallari M, Travison TG, Gou Y, Marcantonio ER, Alsop DC, Jones RN, Inouye SK, Dickerson BC. Older Patients with Alzheimer’s Disease-Related Cortical Atrophy who Develop Post-Operative Delirium May Be at Increased Risk of Long-Term Cognitive Decline After Surgery. J Alzheimers Dis. 2020; 75:187-199
  9. Wang W, Lin N, Oberhaus JD, Avidan MS. Assessing Method Agreement for Paired Repeated Binary Measurements Administered by Multiple Raters. Stat Med 2020; 39:279-293.
  10. Fritz BA, King CR, Ben Abdallah A, Lin N, Mickle AM, Budelier TP, Oberhaus J, Park D, Maybrier HR, Wildes TS, Avidan MS, Apakama G, Aranake-Chrisinger A, Bolzenius J, Burton J, Cui V, Emmert DA, Goswami S, Graetz TJ, Gupta S, Jordan K, Kronzer A, McKinnon SL, Muench MR, Murphy MR, *Palanca BJ, Patel A, Spencer JW, Stevens TW, Strutz P, Tedeschi CM, Torres BA, Trammel ER, Upadhyayula RT, Winter AC, Jacobsohn E, *Fong T, Gallagher J, Inouye SK, Schmitt EM, Somerville E, Stark S, Lenze EJ, Melby SJ, Tappenden J. Preoperative Cognitive Abnormality, Intraoperative Electroencephalogram Suppression, and Postoperative Delirium: A Mediation Analysis. Anesthesiology. 2020. [Epub ahead of print].

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About NIDUS

 
NIDUS is a collaborative research network dedicated to spurring innovation and new advances in delirium research through development of new research and measurement resources, training opportunities, pilot funding and dissemination of information. It is funded through an award from the National Institutes of Health/National Institute on Aging (grant no. R24AG054259).
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