High Symptom Burden Predicts Poorer Quality of Life Among Children and Adolescents Receiving Hematopoietic Stem Cell Transplantation or Chimeric Antigen Receptor T-Cell Therapy.

Background: Children with cancer and other serious illnesses experience symptom burden during hematopoietic stem cell transplantation and chimeric antigen receptor T-cell therapy, yet limited research has characterized how these symptoms interact with overall quality of life over time.

Objective: The aim of this study was to examine the longitudinal relationship between symptoms and quality of life in children receiving hematopoietic stem cell transplantation or chimeric antigen receptor T-cell therapy.

Methods: A multisite study design was used to collect symptom and quality of life information at pre-cell infusion and days +30, +60, and +90 from children (N = 140) receiving hematopoietic stem cell transplantation and chimeric antigen receptor T-cell therapy.

Bloodstream Infections in Infants and Children With Congenital Heart Disease Undergoing Cardiac Surgery.

Background: Children with congenital heart disease undergoing cardiac surgery are at risk for laboratory-confirmed bloodstream infections (LCBIs). These infections can lead to morbidity, mortality, and increased health care costs. The role of mucosal barrier injury in causing LCBIs is unknown.

Parent Psychological Distress Is Associated with Symptom Burden and Health-Related Quality of Life in Children and Adolescents Undergoing Stem Cell Transplantation or Chimeric Antigen Receptor T Cell Therapy.

Hematopoietic stem cell transplantation (HSCT) and chimeric antigen receptor T cell therapy (CAR-T) are potentially curative treatment options for children with life-threatening conditions but can result in a high symptom burden, poor health-related quality of life (HRQoL), and parent psychological distress. In this study we investigated the associations over time between parent psychological distress and symptom burden and HRQoL in children undergoing HSCT or CAR-T. This multisite study used a longitudinal, repeated-measures design.

Identifying Breast Cancer Recurrence in Administrative Data: Algorithm Development and Validation.

Breast cancer recurrence is an important outcome for patients and healthcare systems, but it is not routinely reported in cancer registries. We developed an algorithm to identify patients who experienced recurrence or a second case of primary breast cancer (combined as a "second breast cancer event") using administrative data from the population of Ontario, Canada. A retrospective cohort study design was used including patients diagnosed with stage 0-III breast cancer in the Ontario Cancer Registry between 1 January 2009 and 31 December 2012 and alive six months post-diagnosis.

Reimagining Critical Care Education During COVID-19 With High-Level Technology.

Methods of critical care (CC) education were quickly challenged when faced with the COVID-19 pandemic requiring social distancing and limited group sizes. A new delivery model was designed-one that included a smart video conferencing and recording system and an online platform to access education. Over the course of 4 weeks, the CC program was revamped to meet the immediate needs of CC new hires coming to this tertiary and quaternary medical center.

Cumulative Stress Debriefings to Combat Compassion Fatigue in a Pediatric Intensive Care Unit.

Background: Nurses working in pediatric intensive care units report high levels of compassion fatigue from exposure to critical and traumatic events. Cumulative stress debriefings can reduce compassion fatigue.

Objective: To evaluate the use of cumulative stress debriefings to alleviate symptoms of compassion fatigue and promote job satisfaction in nurses.

Development of population-level colon cancer pathway concordance measures and association with survival.

Clinical cancer pathways help standardize healthcare delivery to optimize patient outcomes and health system costs. However, population-level measurement of concordance between standardized pathways and actual care received is lacking. Two measures of pathway concordance were developed for a simplified colon cancer pathway map for Stage II-III colon cancer patients in Ontario, Canada: a cumulative count of concordant events (CCCE) and the Levenshtein algorithm.

Longitudinal impact of a poverty simulation on healthcare practitioners' attitudes towards poverty.

Background: Many clinicians have limited knowledge about the challenges of living in poverty, leading to stigma and differential treatment in healthcare settings. A poverty simulation event may help clinicians gain empathy and knowledge about the ways that poverty impacts health and well-being.

Purpose: This study evaluated the impact of a poverty simulation and the effect of personal characteristics on clinicians' attitudes towards poverty.

Cerebral oxygen saturation and cerebrovascular instability in newborn infants with congenital heart disease compared to healthy controls.

Objective: Infants with Congenital Heart Disease (CHD) are at risk for developmental delays, though the mechanisms of brain injury that impair development are unknown. Potential causes could include cerebral hypoxia and cerebrovascular instability. We hypothesized that we would detect significantly reduced cerebral oxygen saturation and greater cerebrovascular instability in CHD infants compared to the healthy controls.

The Impact of Chest Binding in Transgender and Gender Diverse Youth and Young Adults.

Purpose: There is a sparsity of information on chest binding practices among transmasculine and gender diverse people regardless of age and even less information pertaining to adolescents and young adults (AYA). The purpose of this study was to understand binding trends in AYA and to recognize how chest binding impacts chest dysphoria and life satisfaction.

Methods: Data were collected from eligible participants via a national online survey.

An End-of-Life Care Educational Series to Improve Staff Knowledge and Comfort Levels.

Nursing staff play a key role in enhancing a patient's quality of life during end of life; however, they perceive lack of knowledge to be the largest barrier in providing quality end-of-life (EOL) care. Literature suggests that implementation of palliative and EOL care education can improve nursing EOL care practices. In order to address the gap in nursing knowledge and comfort, a quasi-experimental study was conducted; this study included the implementation of a multimodal EOL care educational series on an inpatient pediatric hematology oncology floor over 6 months.

Addressing Healthcare Professional Burnout: A Quality Improvement Intervention.

Background: Burnout is a substantial phenomenon across healthcare settings, affecting more than half of healthcare professionals and leading to negative patient and health system outcomes. Infusion center professionals (ICPs) are at increased risk of burnout attributed to high patient volume and acuity levels. Strategies to address burnout have been developed and prioritized by the American Medical Association (AMA), the World Health Organization, and other organizations.

Using Patient-Reported Outcomes to Measure Symptoms in Children With Advanced Cancer.

Background: Children with advanced cancer experience symptoms despite access to quality care. Symptom research has previously relied upon retrospective designs and parent proxy rather than prospective measurement with self-report.

Objective: This study evaluated the feasibility of electronic data collection in children with advanced cancer using self-report of symptom frequency, severity, and distress.

Decreasing Central Line-Associated Bloodstream Infections Acquired in the Home Setting Among Pediatric Oncology Patients [Formula: see text].

Most children receiving cancer treatment require a central venous catheter (CVC), putting them at risk for central line-associated bloodstream infections (CLABSI). As patients are discharged home with a CVC in place, caregivers are expected to maintain the CVC following an in-hospital education session before their first discharge home. Following a review of the literature, the education process was modified to improve the quality of education for caregivers.

Nausea in Numbers: Electronic Medical Record Nausea and Vomiting Assessment for Children With Cancer.

Chemotherapy-induced nausea and vomiting (CINV) is a distressing, underrecognized effect of treatment that can occur in up to 80% of patients. The purpose of this quality improvement project was to evaluate the impact of implementation of a standardized nausea assessment tool, the Baxter Animated Retching Faces (BARF) scale, on nursing compliance with nausea assessment and the frequency and severity of patient-reported CINV for children with cancer. The Plan-Do-Study-Act cycle was used to implement this practice change.

Forecasting Ontario Oncology Drug Expenditures: A Hybrid Approach to Improving Accuracy.

Background: The Provincial Drug Reimbursement Program (PDRP) at Cancer Care Ontario (CCO) is responsible for monitoring actual and projected outpatient intravenous cancer drug spending in the province. We developed a hybrid forecasting approach combining automated time-series forecasting with expert-customizable input.

Objective: Our objectives were to provide a flexible tool in which to incorporate multiple forecasts and to improve the accuracy of the resulting forecast.

Evaluation of the Brief Alcohol Withdrawal Scale Protocol at an Academic Medical Center.

Objectives: The standard of care for treatment of alcohol withdrawal is symptom-triggered dosing of benzodiazepines using a withdrawal scale. Abbreviated scales are desired for clinician efficiency. The objective of this study was to evaluate the use of the 5-item Brief Alcohol Withdrawal Scale (BAWS) protocol.

Design, synthesis and biological evaluation of 1,3-dihydroxyxanthone derivatives: Effective agents against acetylcholinesterase.

The present work concerns the rational design and development of new inhibitors of acetylcholinesterase (AChE) based on the privileged xanthone scaffold. In order to understand and rationalize the mode of action of these target structures a theoretical study was initially conducted. From the results of rational design, a new variety of amphiphilic xanthone derivatives were synthesized, structurally characterized and evaluated as potential anti-Alzheimer agents.

Surgical and orthodontic management of maxillary canine-lateral incisor transpositions.

Transposition of the maxillary canine and the lateral incisor is a complex dental anomaly to treat. The difficulty increases if the treatment aims to correct the transposition. These case reports describe 2 patients with transposition of the maxillary lateral incisor and canine.

Bonded molar tubes: a survey of their use by specialist orthodontists.

Objective: To investigate the use of bonded molar tubes (BMTs) by specialist orthodontists.

Design: Prospective postal questionnaire.

Setting: Ireland.

Cytotoxic effects induced by combination of heliantriol B2 and dequalinium against human leukemic cell lines.

Natural occurring compounds are considered an important source of antitumoral agents. In the present study, the cytotoxic potential of three pentacyclic triterpenes isolated from Chuquiraga erinacea (Asteraceae), against the human leukemic cell lines NB4 and K562 was assessed. Heliantriol B2 (HB2) showed the highest cytotoxic activity after 24 h treatment showing IC(50) values of 1.

Qualitative assessment of the progesterone receptor and HER2 improves the Nottingham Prognostic Index up to 5 years after breast cancer diagnosis.

Purpose: To investigate whether the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) can improve the Nottingham Prognostic Index (NPI) in the classification of patients with primary operable breast cancer for disease-free survival (DFS).

Patients And Methods: The analysis is based on 1,927 patients with breast cancer treated between 2000 and 2005 at the University Hospitals, Leuven. We compared performances of NPI with and without ER, PR and/or HER2.

Economic benefits of hepatitis B vaccination at sexually transmitted disease clinics in the U.S.

Objective: This study assessed the long-term economic implications of a national program to vaccinate all adults treated at sexually transmitted disease (STD) clinics in a single year.

Methods: A model was developed to track the long-term disease outcomes and costs among a hypothetical cohort of 2 million STD clinic clients accessing services in one year, using data from published sources and demonstration projects at STD clinics in San Diego (California), Illinois, and Denver (Colorado). The model estimated net economic benefits of a routine hepatitis B vaccination policy at STD clinics nationwide compared with no vaccination.

Vaccinating adolescents in high-risk settings: lessons learned from experiences with hepatitis B vaccine.

Meeting the health needs of adolescents who live in high-risk settings such as homeless shelters, migrant camps, juvenile detention centers, prisons, and other types of residential facilities presents many challenges. Although there is no doubt that adolescents in many high-risk settings are at increased risk for hepatitis B and human papillomavirus, acute medical and psychological problems may consume all of the provider's time and resources. Potential health threats such as vaccine-preventable diseases must necessarily be given lower priority.