Development and Validation of a New Screening Tool with Non-Invasive Indicators for Assessment of Malnutrition Risk in Hospitalised Children.

There is no evidence of the most effective nutritional screening tool for hospitalized children. The present study aimed to develop a quick, simple, and valid screening tool for identifying malnutrition risk of hospital admission with non-invasive indicators. A cross-sectional study was conducted. Children`s nutritional baseline using a questionnaire, subjective malnutritional risk, and Subjective Global Nutritional Assessment were assessed on admission. Concurrent validity was assessed using American Society for Parenteral and Enteral Nutrition (ASPEN)and Academy of Nutrition and Dietetics assessment and Subjective Global Nutritional Assessment tool. A new screening tool Simple Pediatric Nutritional risk Screening tool (SPENS) was developed, and sensitivity, specificity and reliability were evaluated. A total of 180 children aged from 1 month to 18 years were included (142 in the development phase and 38 in the validation phase). SPENS consist of four variables and shows almost perfect agreement with subjective malnutritional risk assessment (κ = 0.837) with high sensitivity and specificity (93.3% and 91.3% respectively). Compared with Subjective Global Nutritional Assessment and ASPEN and Academy of Nutrition and Dietetics assessment, SPENS had sensitivity 92.9% and 86.7%, a specificity of 87.5% and 87.0%, and an overall agreement of 0.78 and 0.728, respectively. Due to the fast, simple, easy, and practical to use, screening the SPENS can be performed by nurses, physicians, and dieticians.

Caring for children and adolescents victims of domestic violence: A qualitative study.

AIM: To explore nurses' perceptions on caring for children and adolescents who are victims of domestic violence, medical treatment of a victim of domestic violence and social aspects of recognizing this problem. BACKGROUND: Nurses are often first to recognize family violence; thus, they must have appropriate knowledge, skills and experience. Caring for child victims of domestic violence can be very stressful and emotional and nurses must have support when caring for them. METHODS: A qualitative study was conducted between June and August 2020. Interviews were conducted with paediatric nurses in a university hospital in Slovenia. Interviews were transcribed, coded and synthesized. RESULTS: We identified four main categories: violence against children; nurses' perception of caring for a child victim of domestic violence; medical treatment of a child who is a victim of domestic violence; the social aspect of recognizing violence against a child. CONCLUSIONS: Domestic violence is present regardless of country, language and nationality. Early interventions should be directed towards recognition of the signs of domestic violence and care for victims of violence and caregivers. IMPLICATIONS FOR NURSING MANAGEMENT: It is the responsibility of healthcare systems, hospital managers and nurses themselves to provide nursing care for children and adolescent victims of domestic violence based on the newest and best evidence.

Screening and assessment tools for early detection of malnutrition in hospitalised children: a systematic review of validation studies.

OBJECTIVE: The aim of the present study was to identify all currently available screening and assessment tools for detection of malnutrition in hospitalised children, and to identify the most useful tools on the basis of published validation studies. DESIGN: Systematic review. DATA SOURCES: PubMed, CINAHL and MEDLINE were searched up to October 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies in English that reported sensitivity, specificity and positive/negative predictive values (PPVs/NPVs) in the paediatric population were eligible for inclusion. DATA EXTRACTION AND SYNTHESIS: Two authors independently screened all of the studies identified, and extracted the data. The methodological qualities of the studies included were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. RESULTS: The 26 validation studies that met the inclusion criteria for this systematic review used eight screening and three assessment tools. The number of participants varied from 32 to 14 477. There was considerable variability in the chosen reference standards, which prevented direct comparisons of the predictive performances of the tools. Anthropometric measurements were used as reference standards in 16 of the identified studies, and full nutritional assessment in 5. The Pediatric Yorkhill Malnutrition Score (PYMS) screening tool performed better than Screening Tool for the Assessment of Malnutrition and Screening Tool for Risk On Nutritional status and Growth when compared in terms of anthropometric measurements, especially for body mass index (Se=90.9, Sp=81.9) and triceps skinfold thickness (Se=80.0, Sp=75.0). However, low PPVs indicated the problem of overprediction of positive cases, which was typical for all of the studies that used anthropometric measurements as the reference standard. CONCLUSIONS: This systematic review identifies the need for definition of the gold standard for validation of screening tools. Anthropometry measurements using WHO or Centers for Disease Control and Prevention growth charts should be considered as the possible reference standard in future validation studies. We would recommend the use of PYMS for hospitalised paediatric patients without chronic conditions, in combination with full nutritional assessment. PROSPERO REGISTRATION NUMBER: CRD42017077477.

Mobile Applications for Control and Self Management of Diabetes: A Systematic Review.

Mobile applications (apps) can be very useful software on smartphones for all aspects of people's lives. Chronic diseases, such as diabetes, can be made manageable with the support of mobile apps. Applications on smartphones can also help people with diabetes to control their fitness and health. A systematic review of free apps in the English language for smartphones in three of the most popular mobile app stores: Google Play (Android), App Store (iOS) and Windows Phone Store, was performed from November to December 2015. The review of freely available mobile apps for self-management of diabetes was conducted based on the criteria for promoting diabetes self-management as defined by Goyal and Cafazzo (monitoring blood glucose level and medication, nutrition, physical exercise and body weight). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) was followed. Three independent experts in the field of healthcare-related mobile apps were included in the assessment for eligibility and testing phase. We tested and evaluated 65 apps (21 from Google Play Store, 31 from App Store and 13 from Windows Phone Store). Fifty-six of these apps did not meet even minimal requirements or did not work properly. While a wide selection of mobile applications is available for self-management of diabetes, current results show that there are only nine (5 from Google Play Store, 3 from App Store and 1 from Windows Phone Store) out of 65 reviewed mobile apps that can be versatile and useful for successful self-management of diabetes based on selection criteria. The levels of inclusion of features based on selection criteria in selected mobile apps can be very different. The results of the study can be used as a basis to prvide app developers with certain recommendations. There is a need for mobile apps for self-management of diabetes with more features in order to increase the number of long-term users and thus influence better self-management of the disease.

Causes of inadequate intake of nutrients during the treatment of children with chemotherapy.

PURPOSE: The purpose of the research was to explore nurses' perceptions of different causes of inadequate food intake in children treated with chemotherapy and to determine how often nurses identify these causes. METHOD: Qualitative and quantitative approaches were used. Qualitative data were first gathered using semistructured interviews in a sample of six nurses and analysed by conventional content analysis. Based on the results of qualitative data and literature analysis, a 28-item questionnaire was developed and evaluated for its face validity in a sample of fifteen nurses. Questionnaires were then administered to twenty-seven nurses working at one pediatric oncology ward. Quantitative data were analysed using descriptive statistic. RESULTS: The major themes that emerge from the content analysis, describing nurses' perceptions of causes of inadequate food intake in children undergoing chemotherapy, were as follows: physiological causes of eating problems, psychological causes of eating problems, change in food selection, hospital food and individual counselling. 13 causes of inadequate food intake were identified from the questionnaire data. Pain due to mucositis was the most commonly identified cause of inadequate food intake in children, followed by nausea and vomiting, altered taste, loss of appetite and an altered smell. Psychological causes of eating problems are rarely identified. CONCLUSION: Nurses identify most of the physiological and psychological causes of inadequate food intake in children treated with chemotherapy. The early identification and management by nurses of inadequate food intakes should be part of the curriculum for nurse education as well as part of treatment planning in clinical environment.