Home Medication Regimen Complexity in Newly Diagnosed Pediatric Oncology Patients.

Background: Parents of children newly diagnosed with cancer require specialized education to provide care for their child at home, including the management of complex medication regimens.

Objective: To assess the complexity of home medication regimens in a cohort of newly diagnosed pediatric oncology patients.

Methods: We inventoried and categorized all discharge medications for each patient and used the Medication Regimen Complexity Index (MRCI) to quantify the complexity of the prescribed medication regimens.

Call to Action: Bolstering the Diminishing Pediatric Nursing Workforce.

Background: Pediatric workforce shortages became more apparent with coronavirus disease 2019 (COVID-19) and the rise in other viruses. Among factors affecting these shortages are undergraduate and graduate curricula that include pediatric content and clinical experiences.

Method: A narrative review was conducted to examine the state of the pediatric nursing workforce, describe curricular models in undergraduate and graduate programs, and determine the effects of these models on pediatric content and clinical experiences as well as subsequent employment in pediatric nursing.

Relationships Among Stress, Diabetes Distress, and Biomarkers in Children with Type 1 Diabetes Mellitus from Diverse Income and Racial Backgrounds.

Introduction: The purpose of this quantitative study was to consider factors that may negatively impact glycemic levels in Black and White children 8-12 years old with a diagnosis of type 1 diabetes mellitus.

Method: Perceived stress, diabetes distress, morning and afternoon salivary cortisol, inflammatory biomarkers, and hemoglobin A1c (HbA1c) were measured in this quantitative, cross-sectional phase of a larger, mixed methods study. Thirty-four children and their parents completed self-report surveys, and children provided blood and salivary samples, to examine effect sizes of relationships among variables of interest.

Self-Esteem Among U.S. African American and Latinx Adolescents With Depressive Symptoms and Overweight and/or Obesity.

Purpose: To examine the concept of self-esteem among African American and Latinx adolescents with overweight and/or obesity and depressive symptoms in the United States.

Method: Using key terms in CINAHL, PubMed, and PsycINFO databases, an initial search yielded 371 articles; after examining title, abstract, and full text, 33 articles remained. The concept of adolescent self-esteem was analyzed using Rodger's evolutionary method.

Strategies to Strengthen Nursing PhD Enrollment: An Ecological Systems Perspective.

Background: Nurses with a Doctor of Philosophy (PhD) degree are essential to developing nursing knowledge, promoting health outcomes, and educating the next generation of nurses. Declining enrollment in nursing PhD programs calls for purposeful action. Guided by Bronfenbrenner's Ecological Systems Framework, this article outlines barriers and facilitators, and offers strategies to increase PhD enrollment.

Using Mixed Methods Research in Children with Type 1 Diabetes: a Methodological Review.

Purpose Of Review: Many factors influence disease management and glycemic levels in children with type 1 diabetes (T1D). However, these concepts are hard to examine in children using only a qualitative or quantitative research paradigm. Mixed methods research (MMR) offers creative and unique ways to study complex research questions in children and their families.

Enteral Nutrition During Extracorporeal Membrane Oxygenation in the Neonatal and Pediatric Populations: A Literature Review.

Objectives: The number of infants and children requiring extracorporeal membrane oxygenation (ECMO) is rising. While critically ill, providers may believe that enteral nutrition puts the patient at risk for severe complications such as necrotizing enterocolitis. However, enteral nutrition is associated with the potential to improve the gut barrier and reduce the risk of morbidity and mortality.

Biomarkers of Stress and Inflammation in Children.

Children are increasingly exposed to stressors that can affect their immune function. Given the possible negative effects of stress and inflammation on health, researchers need to use appropriate biomarkers to measure both the effects of stress and subsequent inflammatory responses. The purpose of this paper is to briefly review stress and inflammatory pathways, identify biomarkers used to measure chronic stress and chronic inflammation particularly in children in clinical and community settings, and to discuss methodological considerations when measuring stress and inflammation in children.

Definitions, theories, and measurement of stress in children.

Problem: Stress in children remains a complex concept to examine due to the inherent subjectivity and lack of specific manifestations, as well as the multiple ways stress can be defined and measured in children. Because stress is multifactorial,is experienced daily by children, and undergirds adolescent health and early mental illness, it is crucial to have a clear understanding of stress and the effects of stress in children from infancy through age twelve years.

Eligibility Criteria: To be included in this review, literature must pertain to and highlight theories, definitions/classifications, and measurements of stress in children from infancy to 12 years of age.

Maternal-infant bonding for the opioid exposed dyad: A rodgers' evolutionary concept analysis.

Aim: This concept analysis aimed to offer insight into how opioid exposure affects the quality and construction of the maternal-infant bond.

Background: Maternal-infant bonding can be influenced by maternal opioid use disorder and the neonatal intensive care unit environment. Many interventions for mothers with opioid use disorder focus on enhancing parental skills, but often the emotional and relational features of the maternal-infant bond have been overlooked.

Areas of satisfaction and challenges to success of mid-career nurse scientists in academia.

Background: Mid-career nurse scientists in academia face many challenges that can lead to burnout and exiting the profession. Finding ways to increase satisfaction and support will help retain these critical faculty in research positions.

Purpose: Describe areas of satisfaction and challenges to success in the faculty role for mid-career nurse scientists in academia.

The perceived reality and environment of the mid-career nurse scientist.

Background/purpose: A qualitative study was designed to explore facilitators and barriers to success from the perspectives of self-identified mid-career nurse scientists.

Methods: Data were collected from 84 respondents using open-ended items as part of an electronic survey of self-identified mid-career nurse scientists who were members of regional nursing research societies.

Discussion/conclusion: Two main themes emerged: "Perceived Realities" and "What's Needed to Achieve Career Success.

Inclusion of Effect Size Measures and Clinical Relevance in Research Papers.

Background: There are multiple issues that arise when researchers focus on and only report "statistical significance" of study findings. An important element that is often not included in reports is a discussion of clinical relevance.

Objectives: The authors address issues related to significance, the use of effect sizes, confidence or credible intervals, and the inclusion of clinical relevance in reports of research findings.

Challenges and strategies of early career nurse scientists when the traditional postdoctoral fellowship is not an option.

Purpose: The purpose of this article is to discuss challenges and strategies related to maintaining a program of research for early career nurse scientists. Nurse scientists who do not complete a traditional postdoctoral fellowship or who work in low research-resourced institutions may struggle with research collaboration and development.

Principal Results: Specific challenges experienced by nurse scientists in early career development included: advanced age at the completion of the research doctorate, gender roles and research careers, sustainable work-life balance, employment in low research-resourced institutions, and time.

Abnormal weight gain with fatigue and stress in early survivorship after childhood brain tumor diagnosis.

Background: Diagnosis and treatment for individuals with brain tumors during childhood involves sequelae, including abnormal weight gain. This symptom is commonly clustered with fatigue and increased risk for cardiovascular disease. Children's Oncology Group recommendations include annual surveillance of body mass index (BMI) and cardiometabolic comorbidities; however, there has been little emphasis on individualized screening early in survivorship.

Weight Gain and Blood Pressure in Toddlers Born Very Preterm.

Background: Preterm birth is a risk factor for elevated blood pressure in childhood and the development of hypertension and cardiometabolic disease in adulthood; however, mechanisms for the development of both are poorly understood. Rapid weight gain early in childhood may serve as a driver directly and indirectly through cortisol levels found to be elevated in early childhood in individuals born preterm.

Objectives: The objective of this pilot study was to examine the effect sizes of the relationships between weight gain and blood pressure in toddlers born very preterm.

Parental Self-Efficacy in New Mothers Predicts Infant Growth Trajectories.

The purpose of this study was to examine whether parental self-efficacy (PSE) is associated with change in infant weight-for-length score (WLZ) from age 3 to 12 months. Data were drawn from the Infant Care, Feeding, and Risk of Obesity study, conducted with low-income, African American mother-infant dyads ( = 127). PSE was measured at infant age of 3 months.

Call to action to support the success of midcareer nurse scientists.

Mid-career nurse scientists in academia are at risk for burnout and departing scientific careers, particularly those in research-intensive academic settings. With the shortage of nursing faculty and the public health need for high-quality nursing research, it is critical to retain current research-focused individuals in nursing. In this paper, we discuss definitions and expectations of mid-career scientists, challenges and barriers faced by mid-career scientists, and opportunities for mid-career scientists, informed by both nursing and non-nursing literature.

Recruitment of hard to contact, hard to engage child populations in clinics and schools.

Recruiting children with chronic disease or subgroups of children (low income, obese, specific ages, types of cancer) from clinics and schools for research studies may be particularly difficult. While some have deemed such groups as hard to reach, these groups may be more accurately described as either hard to contact or hard to engage. This is not because children are unknown to the school or clinic but because the researcher's ability to communicate directly with targeted children prior to enrollment is limited.

The Influence of Psychological Stress, Depressive Symptoms, and Cortisol on Body Mass and Central Adiposity in 10- to-12-Year-Old Children.

Purpose: The purpose of this study was to examine the influence of psychological stress and depressive symptoms on body mass and central adiposity in 10-to-12-year-old children and to determine the mediating role of cortisol in the relationships among psychological stress, depressive symptoms, body mass, or central adiposity.

Design And Methods: The convenience sample included 147 children (84 females; 63 males) who were recruited from one middle school and three elementary schools in a rural area of a southeastern state. Height, weight, waist circumference (WC), and salivary cortisol were measured.

Depressive Symptoms, Perceived Stress, and Cortisol in School-Age Children With Type 1 Diabetes: A Pilot Study.

Despite adequate insulin regimens and concurrent treatments for Type 1 diabetes (T1D), many children have trouble achieving glycemic control, as evidenced by elevated HbA1c levels. Maternal and child depressive symptoms, as well as child perceived stress, are associated with less optimal glycemic control. Cortisol, a stress hormone, may mediate the relationships among depressive symptoms, perceived stress, and glycemic control.

Infant Feeding Practices and Weight Gain in Toddlers Born Very Preterm: A Pilot Study.

Purpose: Long-term consequences of prematurity are a public health concern. A pattern of slow initial weight gain followed by a period of rapid weight gain has been associated with poor cardiometabolic health outcomes. The purpose of this study was to examine the relationships between infant feeding practices and weight gain in a sample of 18-to-24-month olds corrected age born very preterm.