Reexamining the complex issue of obesity in childhood: A new guideline and patient-focused approach.

ABSTRACT: Obesity in childhood is a complex, multifaceted condition with various contributors, including genetic, environmental, socioeconomic, and physiologic factors. The latest guidelines recommend annual evaluation beginning at age 2 years. Treatment strategies should be family focused and should target nutrition, physical activity, and behavior.

Bleeding and ketorolac use in pediatric circumcision.

BACKGROUND: Circumcision is a common surgical procedure performed in pediatric male patients. Ketorolac is an effective adjunct in multimodal regimens for postoperative pain control. However, many urologists and anesthesiologists refrain from administering ketorolac due to concern for postoperative bleeding. AIMS: Compare the risk of clinically significant bleeding after circumcision with and without intraoperative ketorolac administration. METHODS: A single-center, retrospective cohort study was conducted of pediatric patients 1-18 years of age who underwent isolated circumcision by one urologist from 2016 to 2020. Clinically significant bleeding was defined as bleeding requiring intervention within the first 24 h of circumcision. Interventions included use of absorbable hemostats, placement of sutures, or return to the operating room. RESULTS: Of 743 patients, 314 (42.3%) did not receive ketorolac and 429 (57.7%) received intraoperative ketorolac 0.5 mg/kg. Postoperative bleeding requiring intervention occurred in one patient (0.32%) in the non-ketorolac group versus four patients (0.93%) in the ketorolac group (difference 0.6%, 95% CI [-0.8%, 2.0%], p = 0.403). CONCLUSIONS: There was no statistically significant difference in postoperative bleeding requiring intervention between the non-ketorolac and ketorolac groups. Future studies regarding the association between ketorolac and postoperative bleeding are needed.

Experiences of weight stigma in adolescents with severe obesity and their families.

AIM: To describe the experiences of weight stigma in adolescents with severe obesity and their parents. DESIGN: Qualitative descriptive secondary analysis. METHODS: A secondary analysis on 31 transcripts from a larger study of 46 transcripts conducted between February 2019 and June 2020. Semi-structured interviews were conducted with 19 parents (n = 17 mothers, n = 2 fathers) and 12 adolescents (n = 7 male, n = 5 female). Interviews were digitally audio recorded, transcribed and analysed using conventional content analysis. RESULTS: Four common themes were identified reflecting experiences of weight stigma: weight-based teasing and bullying, interactions with healthcare providers (HCPs), family interactions and blame. Subthemes were fairness and impact on mental health. CONCLUSION: This secondary analysis adds to the sparse literature documenting the experiences of weight stigma from adolescents with severe obesity and their families. It is important to understand the experiences of weight stigma from the adolescent and parent perspective as it can inform healthcare, education and policies across communities and facilitate holistic health for this vulnerable population. IMPACT: The need for research to better understand how experiences of weight stigma correlate with physiological and psychological outcomes and inform innovative interventions are critical to improve treatment of severe obesity. Healthcare providers across disciplines are in a strategic position to change the paradigm through which we provide care to youth with severe obesity and guide families in supporting their children's weight management efforts without contributing to weight stigma.

Vitamin D Screening Variations in Children and Adolescents: Who should be Screened?

PROBLEM: No consensus on vitamin D deficiency (VDD) screening in children and adolescents exists. Early VDD detection can improve the health of children. VDD can cause bone mineralization diseases, such as rickets in children. The purpose of this review is to determine existing VDD screening recommendations or clinical practice guidelines in children and adolescents. ELIGIBILITY CRITERIA: Inclusion criteria were VDD screening 'guideline', 'clinical practice guideline', and 'recommendations' for children and adolescents in English, published 2001-2018. RESULTS: Eight current guidelines addressed VDD screening recommendations with the common recommendation results endorsing screening only for VDD in at-risk children and adolescents. CONCLUSIONS: There is insufficient evidence for pediatric healthcare providers to recommend which VDD risk factors should be utilized for screening in children and adolescents. IMPLICATIONS: Further studies should focus on developing a validated VDD screening tool for children and adolescents based on risk factors.

Crossing the "line": College students and academic integrity in nursing.

BACKGROUND: Researchers have shown a relationship between academic integrity in the classroom and acts of dishonest behavior in the clinical setting which is concerning for nursing faculty and the health care field. OBJECTIVES: The purpose of this study was to compare the attitudes toward academic integrity and the frequency of behaviors related to academic dishonesty in nursing and non-nursing students at a religiously affiliated institution. DESIGN: A cross-sectional, descriptive design was used to collect data regarding the knowledge, behavior, perceptions, and attitudes related to academic integrity via an online survey. SETTINGS AND PARTICIPANTS: Nursing students and non-nursing students who attended a religiously affiliated (Jesuit) University in the United States were surveyed for this study. RESULTS: Results of the study suggest upper division and second degree nursing students are less tolerant and more condemnatory of cheating than younger students. Frequent dishonest classroom behaviors include asking and telling other students what was on the exam while the most frequent dishonest clinical behaviors included documenting findings that were not assessed or findings that were false. CONCLUSION: Recommendations for nursing faculty include frequent and timely discussion of expected behaviors and values of nurses in order to support students' development of honesty and integrity beyond the classroom and into the clinical setting.

Nursing Examinations: Promotion of Integrity and Prevention of Cheating.

Academic integrity is a concern in higher education. The authors describe the findings of a nursing faculty task force developed with the goal of reducing incidents of cheating on classroom examinations in a school of nursing. Following a review of the literature, a modified Delphi technique was used to prioritize the suggested strategies into recommendations for faculty to follow. The findings and recommendations from the task force are presented and serve as a guide for nursing faculty in implementing measures to promote academic integrity during classroom examinations.