Objective To determine the association between preoperative nutritional status and postoperative outcomes in children undergoing surgery for congenital heart defects (CHD). Methods Seventy-one patients with CHD were enrolled in a prospective, two-center cohort study. We adjusted for baseline risk differences using a standardized risk adjustment score for surgery for CHD. We assigned a World Health Organization Z-score for each subjects’ preoperative triceps skinfold measurement, an assessment of total body fat mass. We obtained preoperative plasma concentrations of markers of nutritional status (prealbumin, albumin) and myocardial stress (B-type natriuretic peptide, BNP). Associations between indices of preoperative nutritional status and clinical outcomes were sought. Results Subjects had a median (IQR) age of 10.2 (33) months. In the UCSF cohort, duration of mechanical ventilation (median 19 hours, IQR 29), length of ICU stay (median 5 days, IQR 5), duration of any continuous inotropic infusion (median 66 hours, IQR 72) and preoperative BNP levels (median 30 pg/mL, IQR 75) were associated with a lower preoperative triceps skinfold Z-score (p<0.05). Longer duration of any continuous inotropic infusion and higher preoperative BNP levels were also associated with lower preoperative prealbumin (12.1 ± 0.5 mg/dL) and albumin (3.2 ± 0.1) (p<0.05). Conclusions Lower total body fat mass and acute and chronic malnourishment are associated with worse clinical outcomes in children undergoing surgery for CHD at UCSF, a resource-abundant institution. There is an inverse correlation between total body fat mass and BNP levels. Duration of inotropic support and BNP increase concomitantly as measures of nutritional status decrease, supporting the hypothesis that malnourishment is associated with decreased myocardial function.

Results demonstrate the effectiveness of a culturally responsive, paraprofessionally delivered intervention to reduce depressive symptoms among LBC patients. Therefore, community oncology practices can affiliate with trained paraprofessionals to implement mental health services to address distress among our growing and increasingly ethnically, linguistically, and economically diverse oncology patient population.

Among Latina BCS, the prevalence of depressed mood may be higher than European-Americans and presents a formidable clinical challenge. These findings underscore the need for timely, appropriate assessment of distress and its contributing factors including patients' socio-ecological contexts and family strain to inform effective patient-centered and family-centered psychosocial referrals and intervention strategies to reduce distress and the undue burden of cancer among Latinos. Latino survivors constitute an increasing proportion of patients in community medical practices. Thus, the requisite to perform follow-up cancer care that addresses the needs of the whole person is rapidly emerging in prominence as a component of medical practice. Therefore, primary care providers and oncology and mental health specialists must work collaboratively via the sharing of electronic medical records, survivorship care plans, and consultations to implement the Institute of Medicine and National Comprehensive Cancer Network recommendations by attending to the psychological status of cancer patients to optimize patient outcomes.

Nursing research and practice have championed survivorship care, including psychosocial care. This article outlines practical strategies to recruit and retain population-based samples, ethnic minorities, and underserved survivors.

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Research provides the critical foundation to lead and articulate the studies necessary to bridge peer- and professional-based care to ensure the psychosocial needs of increasingly diverse survivors are met.

The present study was a qualitative exploration into the meaning of ethnic identity and its association with college adjustment in students attending ethnically diverse university campuses. The sample consisted of 103 participants recruited from 2 ethnically diverse universities in southern California. A constant comparative analysis of the interview data revealed 9 themes as being relevant to students' experiences of ethnicity within a multiethnic campus that reflect both the positive aspects and the negative aspects associated with campus diversity. Students' experiences with campus diversity varied by ethnic background and type of institution attended, as did the overall frequencies of reported positive and negative themes associated with diversity. The implications of these findings for ethnic identity, campus climate, and interethnic relations are discussed.

Further study of the themes using a revised semi-structured interview will be done in a larger study among hired farmworkers. The results add to the current work to understand specific health and safety concerns among these workers.