Creative Arts Therapy Among Children With Cancer: Symptom Assessment Reveals Reduced Anxiety.

Background: Symptom distress is related to decreased quality of life (QOL) among children with cancer, with high levels of pain, nausea, and anxiety reported. Creative arts therapy (CAT) has been related to improved QOL and symptoms in pediatric oncology, but the quality of evidence is mixed.

Objective: This article aims to examine the QOL symptom subscales in relation to CAT over time in children during the first year of cancer treatment.

Associations between demographics and quality of life in children in the first year of cancer treatment.

Symptom distress and decreased quality of life (QOL) among children with cancer are well documented. Research is emerging on the child's voice in QOL-symptom reports, but existing QOL questionnaires are burdensome and objective biologic markers are lacking. We examined children's symptoms and QOL from parent and child perspectives and compared the results to one biologic marker (body posture).

Survey of US pediatric nurses' role in health care transition planning: Focus on assessment of self-management abilities of youth and young adults with long-term conditions.

The survival rates of youth and young adults (YYAs) diagnosed with long-term conditions have improved considerably as 90% now enter adulthood; health care transition planning (HCTP) has emerged as a nursing practice priority. The aim of this national online survey was to investigate the extent to which nurses, recruited from two major United States pediatric nursing organizations are involved with HCTP including assessing YYA self-management abilities (SMA). Findings of a 9-item assessment of self-management abilities subscale of the nurses' role in HTCP tool are reported.

Health-risk Behaviors and Type 1 Diabetes Outcomes in the Transition from Late Adolescence to Early Emerging Adulthood.

This study examined within- and between-person associations between health-risk behaviors (smoking, drinking, insulin withholding) and type 1 diabetes (T1D) outcomes (adherence and HbA1c) during the high-risk transition from late adolescence to early emerging adulthood utilizing a 2-year longitudinal study. Beginning in the senior year of high school, participants ( = 197) with T1D completed measures of health-risk behaviors, adherence, and HbA1c annually at three time points. Health-risk behaviors were associated with poorer diabetes outcomes during the transition from late adolescence to early emerging adulthood.

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Frostbite: 2019 Update.

The Wilderness Medical Society convened an expert panel to develop a set of evidence-based guidelines for prevention and treatment of frostbite. We present a review of pertinent pathophysiology. We then discuss primary and secondary prevention measures and therapeutic management.

Cancer Pain Assessment and Measurement.

Objectives: To review the incidence of cancer pain; assessment of acute, chronic, and breakthrough pain; and provide insight on assessment approaches and reliable and valid instruments for clinical and research settings.

Data Sources: Peer-reviewed journal articles, book chapters, Internet.

Conclusion: Quality pain management for patients with cancer is dependent on an accurate pain assessment and ongoing reassessment, considering the whole person.

Evaluation of Quality Improvement Initiatives to Improve and Sustain Advance Care Planning Completion and Documentation.

Despite the established benefit of advance care planning (ACP), achieving and sustaining high rates of ACP completion continue to be a challenge in many health care settings. A palliative care champions committee has targeted improving the ACP process through quality improvement initiatives at an academic medical center. To understand the impact of multiyear efforts to improve ACP, surveys of registered nurses, care coordinators, and medical assistants from inpatient and outpatient settings were conducted in 2013 and 2017 to explore comfort level with ACP, barriers preventing completion of ACP in daily practice, and suggestions for overcoming these barriers.

Provider Opinions and Experiences Regarding Development of a Social Support Assessment to Inform Hospital Discharge: The Going Home Toolkit.

Purpose Of Study: Despite over three decades of research linking social support and optimal health outcomes, social support is not systematically assessed or addressed during clinical care. This study sought input from health care providers to inform the design of an intervention intended to facilitate assessment of social support in a way that could aid in anticipatory planning during the process of hospital discharge.

Primary Practice Setting(s): Using a purposive sampling strategy, data were collected from providers in two acute care settings serving rural patients, one academic and one community based.

Mentoring Clinical Nurses to Write for Publication: Strategies for Success.

: Clinical nurses often find writing a challenge, but it's important to disseminate clinical practice initiatives that result in notable patient outcomes. Nurses have a responsibility to share what they do to improve patient care. The increased emphasis on the development and evaluation of evidence-based practice has made it necessary for nurses to share best practices that are associated with improved patient outcomes.

Wilderness Medical Society practice guidelines for the prevention and treatment of frostbite: 2014 update.

The Wilderness Medical Society convened an expert panel to develop a set of evidence-based guidelines for the prevention and treatment of frostbite. We present a review of pertinent pathophysiology. We then discuss primary and secondary prevention measures and therapeutic management.

The foundations of wilderness medicine: some historical features.

The surgeons of the navies of the early days of western civilization--Greece, Rome, and the Italian city-states--were most likely the first practitioners of recognizable wilderness medicine. The teachings of Hippocrates and Galen ruled over the practice of medicine in Europe for centuries, but the steady evolution of understanding of the nature and causes of disease was starting to provide a useful foundation upon which to build by the turn of the 19th century. By 1800, nonetheless, the gap between medical theory and knowledge and the real ability to provide effective therapy was still enormous.

Belaya smert: the white death.

In the late autumn of 1939, shortly after Second World War had commenced, the Soviet Union invaded Finland. This act of military aggression, henceforth known to history as the Winter War, was ostensibly carried out to secure a buffer state and better protect major urban areas such as St. Petersburg (then known as Leningrad).

Fighting in thin air: operational wilderness medicine in high Asia.

Objective: The current conflict in Afghanistan is the first major military action in which the United States and other North Atlantic Treaty Organization (NATO) forces have found themselves regularly engaged in combat at high altitudes. However, high altitude warfare is not a new concept in Asia by any means.

Methods: This article will offer a short general historical review of high altitude warfare in Asia and then specifically address some of the operational challenges faced by troops carrying out missions at high altitude in the ongoing conflict in Afghanistan.

Improving sleep at altitude: a comparison of therapies.

Objective: This study aimed to compare 3 treatment modalities during sleep at an altitude of 5300 m to identify strategies for reducing the incidence of periodic breathing at high altitude.

Methods: Fifteen trekkers, with identical ascent profiles and no signs or symptoms of altitude illness, served as subjects. All study participants arrived at 5300 m after a gradual ascent from 1300 m.

Mountain research and rescue on Denali: a short history from the 1980s to the present.

Alaska's Denali (Mt. McKinley), 6194 m, is the highest and perhaps most celebrated peak on the North American continent. The cold and stormy nature of this mountain just 3° of latitude south of the Arctic Circle enhances its legend as a challenging peak.

Raymond Greene: physician, mountaineer, and raconteur.

C. Raymond Greene (1901-1982) was a man of many talents. After graduating from medical school in 1927, he spent a decade in general practice.

Evaluation of sham-CPAP as a placebo in CPAP intervention studies.

Study Objectives: To evaluate the use of sham-continuous positive airway pressure (CPAP) treatment as a placebo intervention.

Design And Setting: Analysis of polysomnograms performed in fixed order without sham-CPAP and on the first night of the sham-CPAP intervention in participants in the CPAP Apnea Trial North American Program (CATNAP), a randomized, placebo controlled trial evaluating the effects of CPAP treatment on daytime function in adults with newly diagnosed mild to moderate obstructive sleep apnea (apnea hypopnea index (AHI) 5-30).

Participants: The first 104 CATNAP participants randomized to the sham-CPAP intervention arm.

Contemporary childbirth education models.

Since the 1960s, childbirth education advocates have attempted to persuade pregnant women that educational preparation for labor and birth is an essential component of the transition to motherhood. Initially, pregnant women who were seeking unmedicated births as a refuge from the inhumane childbirth treatments of the mid-20th century embraced this view. However, with the changing childbirth climate, including a growing preference for medicated birth, scheduled inductions, and cesarean sections, attendance has diminished and childbirth education finds itself at a crossroads.

Promoting Healthy Pregnancies Through Perinatal Groups: A Comparison of CenteringPregnancy(R) Group Prenatal Care and Childbirth Education Classes.

CenteringPregnancy(R) group prenatal care is growing in popularity and has commonalities with childbirth education classes. In order for leaders of childbirth education classes to best serve their clients' needs, it is important to be aware of new, emerging models of prenatal care such as CenteringPregnancy. This article provides an overview of CenteringPregnancy and similarities and differences between CenteringPregnancy and childbirth education classes.

Midwifery data collection: options and opportunities.

Most midwives are aware of the need to collect clinical practice data and of its usefulness in supporting the care they provide, which contributes to healthy outcomes for mothers and babies. For the individual midwife, there is more than one easily accessible, standardized data collection instrument from which to choose. However, despite these choices, in an American College of Nurse-Midwives (ACNM) Division of Research (DOR) survey on midwifery clinical data collection (N = 263), the majority of member respondents (n = 135; 51%) reported using a self-designed data collection tool, and more than one-third did not know of the ACNM Nurse-Midwifery Clinical Data Sets (NMCDS).

Midwifery models: students' conceptualization of a midwifery philosophy in clay.

Formulating a professional and personal philosophy statement assists nurses and midwives in clarifying focus and direction. It also facilitates grounding of the nursing and midwifery professions or professionals by enabling the identification of both shared beliefs and unique elements. The purpose of this activity was to assist beginning student nurse-midwives (SNMs) in exploring the intersection of their own and the profession's philosophy.