Context Symptoms and quality of life (QOL) are critically important in hematopoietic stem cell transplantation (HSCT). However, few studies have examined these factors by transplant type among diverse cultures. Objectives To identify and compare QOL and symptom severity and prevalence by transplant type in a diverse population having HSCT. Methods The M. D. Anderson Symptom Inventory Blood and Marrow Transplantation (MDASI-BMT) module measured symptom severity and its impact. The Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) measured QOL. Results Symptom data were collected from 164 patients at eight points (pretransplant to 100 days post-transplant) and QOL data at four times. Over time, symptom severity was significantly correlated with QOL and patients who had allogeneic transplants with myeloablative regimens showed more severe sleep disturbance and poorer QOL than patients having autologous transplants. Male patients reported less fatigue than female patients. However, ethnicity was not significant. Patients whose functional status was good had fewer of the five worst symptoms and higher QOL than patients with a poor functional status. Patients with acute graft-versus-host disease had more severe symptoms than those who did not. Conclusion Type of transplant and preparative regimen are the most important aspects to consider when managing symptoms and QOL. This information is important for providing anticipatory guidance and support needed during the transplantation experience, to explore in future research the mechanisms involved in symptoms after HSCT, and to develop additional effective interventions.

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The number of Muslims in the United States is growing. This article outlines a few of the major beliefs in Islam. Religious and philosophical factors that affect health care are discussed, and practical suggestions are made for nursing actions that lead to culture care preservation, culture care accommodation, and culture care restructuring. Major topics covered include the need for cleanliness, preparation for prayer, modesty, family structure, fasting and diet, and care of the dying.

BACKGROUND Systematic symptom assessment is not routinely performed in pediatric oncology. The objectives of the current study were to characterize the symptoms of pediatric oncology outpatients and evaluate agreement between patient and proxy reports and the association between children’s ratings and oncologists’ treatment recommendations. METHODS Two versions of the pediatric Memorial Symptom Assessment Scale (pMSAS) were translated into Spanish. An age-appropriate and language-appropriate pMSAS was administered independently before visits to the oncologist to patients and family caregivers (caregivers) and after visits to consenting oncologists. Statistical analysis included Spearman correlation coefficients and weighted kappa values. RESULTS English and Spanish results were similar and were combined. A total of 60 children and their caregivers completed the pMSAS. The children had a median age of 10 years (range, 7–18 years); approximately 62% were male and 33% were Spanish-speaking. Fourteen oncologists completed the pMSAS for 25 patients. Nine patients (15%) had no symptoms and 38 patients (63%) reported ≥2 symptoms. The most common symptoms were fatigue (12 patients; 40%) and itch (9 patients; 30%) for the younger children and pain (15 patients; 50%) and lack of energy (13 patients; 45%) among the older children. Total and subscale score agreement varied by proxy type and subscale, ranging from fair to good for most comparisons. Agreement for individual symptoms between the patient and proxy ranged from a kappa of −0.30 (95% confidence interval, −0.43 to −0.01) to 0.91 (95% confidence interval, 0.75 to 1.00). Three of 51 symptomatic patients (6%) had treatment recommendations documented in the electronic health record. CONCLUSIONS Symptoms are common and cross several functional domains. Proxy and child reports are often not congruent, possibly explaining apparent undertreatment among this group of patients.

Parents used complementary and alternative medicine to support their children's medical treatment and to use all possible methods to cure their children. The reason for parents not using complementary and alternative medicine included not being aware of complementary and alternative medicine. Most of the patients have not discussed the issue of using complementary and alternative medicine with the medical staff.

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Obesity and type 2 diabetes is becoming a major health problem affecting children and adolescents in the United States. This article reviews the current literature examining the association between the presence of acanthosis nigricans (AN) and risk for developing type 2 diabetes mellitus (T2DM) in obese children and adolescents. Ethnicity, family history of diabetes, and emergence of obesity are contributing factors for development of hyperinsulinemia, and insulin resistance, and ensuing visible changes on skin which is known as the AN. The purpose of this review was to assess the validity of AN as an early indicator of T2DM. Nineteen articles that were published from 1994 to 2010 were included for this review and reported an association between AN, hyperinsulinemia, and hyperglycemia. Nurses and advanced nurse practitioners working with children and adolescents have a tremendous role in identifying the risk factors, counseling, role modeling, and referring them to available community resources to promote healthy living. Early initiatives focusing on lifestyle changes may halt the progress, chronicity, and burden of T2DM in children and adolescents.