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Background Children with terminal cancer and their families describe a preference for home‐based end‐of‐life care. Inadequate support outside of the hospital is a limiting factor in home location feasibility, particularly in rural regions lacking pediatric‐trained hospice providers. Methods The purpose of this longitudinal palliative telehealth support pilot study was to explore physical and emotional symptom burden and family impact assessments for children with terminal cancer receiving home based‐hospice care. Each child received standard of care home‐based hospice care from an adult‐trained rural hospice team with the inclusion of telehealth pediatric palliative care visits at a scheduled minimum of every 14 days. Results Eleven children (mean age 11.9 years) received pediatric palliative telehealth visits a minimum of every 14 days, with an average of 4.8 additional telehealth visits initiated by the family. Average time from enrollment to death was 21.6 days (range 4‐95). Children self‐reported higher physical symptom prevalence than parents or hospice nurses perceived the child was experiencing at time of hospice enrollment with underrecognition of the child's emotional burden. At the time of hospice enrollment, family impact was reported by family caregivers as 46.4/100 (SD 18.7), with noted trend of improved family function while receiving home hospice care with telehealth support. All children remained at home for end‐of‐life care. Conclusion Pediatric palliative care telehealth combined with adult‐trained rural hospice providers may be utilized to support pediatric oncology patients and their family caregivers as part of longitudinal home‐based hospice care.

Direct alcohol fuel cells (DAFCs) have the potential to provide high power densities for transportation and portable applications. However, widespread use of DAFCs is greatly hindered by the lack of anode electrocatalysts that are inexpensive, stable, resistant to CO poisoning, and highly active toward alcohol oxidation. One promising approach to overcoming these challenges is to combine transition metal catalysts with oxide supports, such as SiO2, which are known to enhance alcohol oxidation by promoting CO oxidation at oxide|metal interfacial regions through the so-called bifunctional mechanism. Herein, we report on a membrane-coated electrocatalyst (MCEC) architecture for alcohol oxidation, in which a thin, permeable silicon oxide (SiO x ) nanomembrane encapsulates a well-defined Pt thin film (SiO x |Pt). A key advantage of the MCEC design compared to oxide-supported nanoparticles is that the oxide encapsulation maximizes the density of oxide|metal interfacial sites between the SiO x and Pt catalyst. A series of electroanalytical measurements indicates that the SiO x overlayers provide proximal hydroxyls, in the form of silanol groups, which can enhance alcohol oxidation by interacting with adsorbed intermediates at SiO x |Pt interfaces. Thanks to these interactions, the SiO x |Pt electrocatalysts exhibit significantly enhanced CO oxidation activity and roughly a 2-fold increase in the maximum methanol oxidation current density compared to bare Pt. Overall, these demonstrations highlight the potential of using SiO x -based MCECs for CO tolerant and highly active methanol oxidation electrocatalysts.

Context. Telemedicine has the potential to extend care reach and access to home-based hospice services for children. Few studies have explored nurse perspectives regarding this communication modality for rural pediatric cohorts. Objectives. The objective of this qualitative study was to learn from the experiences of rural hospice nurses caring for children at the end of life using telehealth modalities to inform palliative communication. Methods. Voice-recorded qualitative interviews with rural hospice nurse telehealth users inquiring on nurse experiences with telehealth. Semantic content analysis was used. Results. About 15 hospice nurses representing nine rural hospice agencies were interviewed. Nurses participated in an average of eight telehealth visits in the three months prior. Nurses were female with a mean age of 38 years and an average of seven years of hospice nursing experience. Five themes about telehealth emerged: accessible support, participant inclusion, timely communication, informed and trusted planning, and familiarity fostered. Each theme had both benefits and cautions associated as well as telehealth suggestions. Nurses recommended individualizing communication, pacing content, fostering human connection, and developing relationships even with technology use. Conclusion. The experiences of nurses who use telehealth in their care for children receiving end-of-life care in rural regions may enable palliative care teams to understand both the benefits and challenges of telehealth use. Nurse insights on telehealth may help palliative care teams better honor the communication needs of patients and families while striving to improve care access.

Children with cancer and their families experience shifts in spiritual wellness from diagnosis through treatment and survivorship or bereavement. An interdisciplinary team conducted a systematic review of quantitative and qualitative research on spiritual assessments, interventions, and outcomes in childhood cancer following PRISMA guidelines using a PROSPERO registered protocol. Thirty‐nine well‐designed studies were included in the final analysis. The findings from this systematic review indicate the need for early spiritual assessment with offering of continued support for the spiritual functioning of children with cancer and their families as a standard of care.