This retrospective study evaluated the efficacy of enteral nutrition for pediatric patients undergoing the challenging treatment of allogeneic bone marrow transplantation. During the period from January 1999 to May 2000, 15 patients were transplant recipients. On admission to the hospital, 87% of patients were above the 50th percentile for weight for age. Nasogastric tubes were inserted while platelet counts remained greater than 50 x 10(9) mL/L. A specialized elemental formula for pediatric patients was commenced. These feeds were administered continuously and were titrated until caloric requirement or tolerance level had been achieved. During hospitalization for bone marrow transplantation, enteral nutrition was the major form of nutritional support for all patients. Enteral feeds continued even during maximal gut toxicity and were supported with antiemetics and analgesia. There were insignificant weight fluctuations during hospitalization, with 80% of children above the 50th percentile weight for age being discharged. Enteral nutrition via a nasogastric tube was effective in the provision of nutrition during bone marrow transplantation and continues to have an important role in this unit.
Summary:The aims of this study were to establish the nutritional status of children pre-BMT and to determine whether predictive methods of assessing nutritional status and resting energy expenditure (REE) are accurate in this population. We analysed the body cell mass (BCM) (n ¼ 26) and REE (n ¼ 24) in children undergoing BMT. BCM was adjusted for height (BCM/HT p ) and expressed as a Z score to represent nutritional status. To determine whether body mass index (BMI) was indicative of nutritional status in children undergoing BMT, BMI Z scores were compared to the reference method of BCM/ HT p Z scores. Schofield predictive equations of basal metabolic rate (BMR) were compared to measured REE to evaluate the accuracy of the predictive equations. The mean BCM/HT p Z score for the subject population was À1.0971.28. There was no significant relationship between BCM/HT p Z score and BMI Z score (r ¼ 0.34; P40.05); however there was minimal difference between measured REE and predicted BMR (bias ¼ À117 149 kcal/day). The results of this study demonstrate that children undergoing BMT may have suboptimal nutritional status and that BMI is not an accurate indication of nutritional status in this population. However, Schofield equations were found to be suitable for representing REE in children pre-BMT. Bone Marrow Transplantation (2005) 35, 775-779.
Objective A shared care model was implemented in 2006 in Queensland to facilitate paediatric oncology, haematology and palliative care patients receiving care as close to home as possible. Following initial diagnosis, care planning and treatment at the tertiary children's hospital, appropriate local care was coordinated by Regional Case Managers (RCMs) established at each of 10 Shared Care Units (SCUs). This enabled safe and quality regional care supported by a statewide network providing clinical governance and education. This paper examines learnings from 15 years of this shared care. Setting Ten hospitals throughout Queensland facilitated a statewide model of shared care for paediatric oncology, haematology and palliative care patients, supported by a tertiary hub in Brisbane. Participants Regional Case Managers in Shared Care Units and their supporting staff. Design Staff from SCUs were surveyed and focus group interviews conducted. Results The paper reviews the attributes, knowledge and experience required for RCMs. Standards of care were supported through education workshops, clinical placements, chemotherapy credentialing, guidelines and standards. RCMs facilitated communication and information sharing with the tertiary centre, advocated for their cohort of patients locally and streamlined and supported the family's experience of care. Conclusion The RCM role provided invaluable clinical leadership for the care of paediatric oncology, haematology and palliative patients across Queensland. As new treatments evolve, the expertise and coordination provided by the RCMs will be even more critical. Achieving high‐quality shared care outcomes is underpinned by the RCMs drive to achieve statewide safety and support for this cohort of children.
Background: The integrity of good clinical practice in clinical trials is underpinned by the informed consent process; however the stress of a life threatening diagnosis challenges the absorption of information and may affect the parent's ability to understand diagnosis, treatment plans and the consent process. Aims:The aim of this study was to explore and describe parental perceptions of the informed consent process in pediatric oncology clinical trials. Methods:A cross-sectional survey was used to collect responses from 50 parents of children aged 8-16 years, enrolled on a clinical trial, one month after diagnosis at an Australian tertiary pediatric oncology centre. Results:The majority of parents (47, 94%) agreed that they understood the diagnosis and information regarding the purpose of the clinical trial. Parents relied primarily on their Oncology consultant for this information. Parents discussed the diagnosis with their children although only 60% (n=30) felt that their child understood the treatment and trial process. Conclusions:Parents indicated that the current process of providing information regarding the clinical trial process met their needs and that they were able to provide informed consent. They were unsure however, of how involved they wanted their children to be in treatment decisions.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.