Human-centered designed communication tools for obesity prevention in early life.

Objective: How we communicate about obesity is critical as treatment paradigms shift upstream. We previously identified parental perceptions, concerns, beliefs, and communication preferences about early life obesity risk. We engaged parents of children 0 to 24 months of age and pediatricians from Indianapolis, Indiana, USA in the co-design of messages and tools that can be used to facilitate parent/provider conversations about early life obesity prevention. Methods: From April to June 2021, we conducted a series of co-design workshops with parents of children ages 0 to 24 months and pediatricians to identify their preferences for communicating obesity prevention in the setting of a pediatric well visit. Human-centered design techniques, including affinity diagraming and model building, were used to inform key elements of a communication model and communication strategy messages. These elements were combined and refined to create prototype tools that were subsequently refined using stakeholder feedback. Results: Parent participants included 11 mothers and 2 fathers: 8 white, 4 black, and 1 Asian; median age 33 years with 38% reporting annual household incomes less than $50,000. Pediatricians included 7 female and 6 male providers; 69% white. Through an iterative process of co-design, we created an exam room poster that addresses common misconceptions about infant feeding, sleep and exercise, and a behavior change plan to foster parent/provider collaboration focused on achieving children's healthy weight. Conclusions: Our hands-on, collaborative approach may ultimately improve uptake, acceptability and usability of early life obesity interventions by ensuring that parents remain at the center of prevention efforts.

Use of Hepatic Artery Infusion Pumps in the Treatment of Hepatic Metastases.

The first trials of hepatic artery infusion pump (HAIP) chemotherapy occurred in the 1990s. The high percentage of recurrent disease after curative resection of colon cancer and perioperative systemic chemotherapy has renewed.

Communicating Risk for Obesity in Early Life: Engaging Parents Using Human-Centered Design Methodologies.

Objective: Pediatricians are well positioned to discuss early life obesity risk, but optimal methods of communication should account for parent preferences. To help inform communication strategies focused on early life obesity prevention, we employed human-centered design methodologies to identify parental perceptions, concerns, beliefs, and communication preferences about early life obesity risk. Methods: We conducted a series of virtual human-centered design research sessions with 31 parents of infants <24 months old. Parents were recruited with a human intelligence task posted on Amazon's Mechanical Turk, via social media postings on Facebook and Reddit, and from local community organizations. Human-centered design techniques included individual short-answer activities derived from personas and empathy maps as well as group discussion. Results: Parents welcomed a conversation about infant weight and obesity risk, but concerns about health were expressed in relation to the future. Tone, context, and collaboration emerged as important for obesity prevention discussions. Framing the conversation around healthy changes for the entire family to prevent adverse impacts of excess weight may be more effective than focusing on weight loss. Conclusions: Our human-centered design approach provides a model for developing and refining messages and materials aimed at increasing parent/provider communication about early life obesity prevention. Motivating families to engage in obesity prevention may require pediatricians and other health professionals to frame the conversation within the context of other developmental milestones, involve the entire family, and provide practical strategies for behavioral change.

Nipple-Sparing Mastectomy in Breast Cancer: Impact on Surgical Resection, Oncologic Safety, and Psychological Well-Being.

Nipple-sparing mastectomy (NSM) is a surgical option to improve patient satisfaction with aesthetic outcome. It can be utilized to decrease body image disturbance by preserving the woman's skin and areolar complex. Data for cancer treatment and risk reduction in NSM shows the procedure is oncologically safe. Nipple-sparing mastectomy preserves the nipple to improve cosmetic appearance. Patient satisfaction is higher for NSM compared with traditional mastectomy. PubMed and Cochrane databases were searched from January 1, 2013, to December 22, 2019. The following search terms and keywords were used: nipple-sparing mastectomy, microvascular breast reconstruction, breast cancer, and nipple necrosis. Studies published in scientific journals that reported objective results (specific outcomes of skin flap and nipple-areola complex necrosis) were included. Nipple-sparing mastectomy should be discussed as a surgical option for women who meet the selection criteria to assist with psychological benefits related to body image. Research comparing levels of distress and body image disturbances in women undergoing NSM with traditional mastectomy would be helpful in addressing the psychological care of these women. Ongoing data collection needs to continue to validate that NSM is safe from a surgical and an oncologic standpoint.

Enhanced Recovery After Surgery.

Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to achieve early recovery for patients undergoing major surgical procedures. Meta-analyses, randomized controlled trials, and large prospective cohort studies were reviewed. Each item of the perioperative treatment pathway in the English language was examined and reviewed. Enhanced recovery after surgery items that were the strongest predictors for a shorter hospital stay and lower morbidity were absence of a nasogastric tube, early mobilization, early oral nutrition, early removal of the epidural, early removal of the urinary catheter, and utilization of nonopioid analgesia. Based on evidence available for each element of the perioperative care pathway, ERAS provides a protocol for perioperative care. This protocol allows for further evidence-based studies that are adequately powered between institutions.

Total Pancreatectomy With Islet Cell Transplantationfor the Treatment of Pancreatic Cancer.

Resection or removal of the pancreas causes loss of parenchyma, which can result in extreme disruption of glucose homeostasis and malabsorption of dietary nutrients. However, islet autotransplantation (IAT) may reduce or prevent the severity of pancreatogenic diabetes. This article explores total pancreatectomy with IAT within the context of pancreatic cancer treatment. At a Glance • The liver is the preferred site for implantation because of easy vascular access. • Following islet autotransplantation, the liver becomes an insulin-producing organ as the transplanted beta cells begin making insulin. • The most significant complication of implantation in the liver is portal vein occlusion because of thrombosis; consequently, a heparin drip is infused for the first seven days postoperatively to prevent portal vein thrombus formation.

Hepatic artery infusion pump in the treatment of liver metastases.

BACKGROUND: Hepatic artery infusion pump (HAIP) use in chemotherapy started in the 1960s as a way to treat liver metastases that were not amendable to locoregional therapy or surgical resection. Because of complications and limited survival benefit, the use of HAIPs fell out of favor. A resurgence has occurred in the use of these pumps, but limited information is available in the literature guiding nursing care of these patients. OBJECTIVES: The purpose of this study was to review the literature regarding the use, procedures, and nursing care of patients with HAIPs. METHODS: A systematic literature review was conducted to obtain a comprehensive range of publications. FINDINGS: Database searching resulted in 511 titles and abstracts. After eliminating duplicates and nonrelevant titles, 65 remained and were read in full. Of these, 20 were excluded because they did not fit the inclusion criteria.

Bioanalysis annual round-up: the bioanalysis editorial team is delighted to welcome you to this mid-year round-up.

This year has so far proven to be another eventful one for the journal and its affiliated website Bioanalysis Zone. Key highlights include the unveiling of the finalists for the annual Young Investigator Award [1] , the publication of four exciting special issues and a selection of noteworthy White Papers, as well as the addition of more new features on Bioanalysis Zone. Not only this, but the Impact Factor of Bioanalysis increased to 3.253 (2012), demonstrating the journal's continuing high editorial standards. This mid-year round-up looks at the highlights of the year to date and features a selection of must-read articles from volume 5. Enjoy!