A narrative analysis of the stories of mothers who have parented a child with Hodgkin lymphoma who is currently in early survivorship.

AIMS AND OBJECTIVES: To explore the lived experience of mothers of children who have survived Hodgkin lymphoma, from diagnosis, through treatment and recovery as she has lived it and in her own words and to discuss the self-reported experiences in the context of the theoretical propositions of Attachment Theory and birth order as it applies to the mother-child dyad with this life experience. BACKGROUND: While much has been written about childhood cancer survivors and their parents independently, there are unique struggles that a mother and a childhood cancer survivor face as a dyad. Examining the dyadic relationship over time offers a unique perspective to understanding the parenting experience with a child whose fate is uncertain. DESIGN AND METHOD: Narrative Inquiry was utilised to explore the bonds the mother has with her child before he or she is diagnosed with cancer, the relationship during treatment and the subsequent relationship when the child has entered survivorship. Most specifically, the research explored the attachment of the mother to her child as it relates to the Caregiving System. A purposive sample of 13 mothers of children diagnosed with Hodgkin lymphoma representing children from each birth order category (youngest child, middle child, oldest child and only child) was chosen. The interviews were analysed through thematic analysis with final themes identified. RESULTS: Several core themes emerged from the narratives regardless of birth order. The most significant was the "need to protect." Additional themes were "things will never be the same," "unique bond," "shifting priorities" and "lost innocence." CONCLUSIONS AND RELEVANCE TO PRACTICE: The research shows activation of the Caregiving Behavioral Response System as it relates as a reciprocal to Attachment Theory.

Indoor Tanning Legislation: Shaping Policy and Nursing Practice.

Legislation exists regulating adolescents' use of tanning beds; however, the rate at which adolescents use these devices has not been reduced. The purpose of this study was to provide an analysis of indoor tanning bed legislation in the United States specifically related to legal issues and parental consent along with enforcement of current laws. The investigators collected data via review of state health department websites or telephone interviews of identified contacts for all 50 states. Findings reveal wide variation in legislation related to adolescents' access to tanning devices and enforcement of violation of legal statutes. Nurses and other health care professionals can play key roles in educating families and adolescents to the dangers from the use of tanning beds along with being role models for proper skin protective behaviors. In addition, nurses should become advocates by supporting legislative efforts that ban tanning salons for all minors, with the long-term goal of reducing skin cancer caused by ultraviolet radiation (UVR) exposure from the use of tanning salons today.

Uso de máquina de anestesia como ventilador mecánico en pacientes COVID-19 en Áreas Críticas del Hospital de Especialidades Carlos Andrade Marín / Use of anesthesia machine as a mechanical ventilator in COVID-19 patient in Critical Areas of Carlos Andrade Marín Specialty Hospital

1. INTRODUCCIÓNLa pandemia ocasionada por el Corona-virus tipo 2 del Síndrome Respiratorio Agudo Grave (SARSCoV-2) en la actua-lidad, anticipa una demanda de ventila-dores mecánicos, la Organización Mun-dial de la Salud (OMS), reporta que el 5% de los contagiados cae de forma rápida en insuficiencia respiratoria y requiere de cuidados intensivos1-3. La Food and Drug Administration (FDA), quien aprobó de manera temporal el uso de la Máquina de Anestesia (MA) como Ventilador Mecánico (VM) y la American Society of Anesthesiologists (ASA) junto con la Anesthesia Patient Safety Founda-tion (APSF), publicaron una declaración donde se reconoció que las máquinas de anestesia no están diseñadas para entregar apoyo ventilatorio a largo plazo, sin em-bargo, se han transformado en la primera línea natural de apoyo durante la pan-demia cuando no hay suficientes ventila-dores en áreas críticas hospitalarias1,2,4.Países como Chile por medio de la So-ciedad de Anestesiología de Chile (SACHA), ha puesto en práctica estas recomendaciones previo a un informe técnico. De igual manera en la Unidad Técnica de Anestesiología y a través de este protocolo se procura estandarizar el manejo de la MA con varias recomenda-ciones, para que puedan ser utilizadas en forma segura y efectiva, dado que el uso de las máquinas de anestesia como VM "es una maniobra de salvataje"2. De esta manera se pretende entregar li-neamientos para dar asistencia ventila-toria a pacientes que requieren ventilación mecánica por un cuadro positivo para In-fección por Coronavirus-19 (COVID-19) utilizando una MA, ante la imposibilidad de disponer de un Ventilador de Cuidados Intensivos (VCI).

1. INTRODUCTIONThe pandemic caused by the Severe Acute Respiratory Syndrome (SARSCoV-2) Coronavirus type 2, currently anticipates a demand for mechanical ventilators, the World Health Organization (WHO), re-ports that 5% of infected people rapidly fall into respiratory failure and require in-tensive care1-3 .The Food and Drug Administration (FDA), which temporarily approved the use of the Anesthesia Machine (AM) as a Mechanical Ventilator (MV). The Ame-rican Society of Anesthesiologists (ASA) together with the Anesthesia Patient Safety Foundation (APSF), issued a state-ment acknowledging that anesthesia ma-chines are not designed to deliver long-term ventilation support, however, they have become the first natural line of su-pport during the pandemic, when there are not enough ventilators in critical hos-pital areas1,2,4.Countries such as Chile, through the Society of Anesthesiology of Chile (SACHA), have implemented these re-commendations prior to a technical report. Similarly, in the Technical Unit of Anesthesiology and through this protocol, it is trying to standardize the management of AM with several recommendations, so they can be used in the safest and most effective way, since the use of anesthesia machines as a MV "is a dangerous ma-neuver"2.In this way, guidelines are provided to in order to give mechanical ventilation as-sistance the patients who required me-chanical ventilation due to one posi-tive picture of Coroanvirus-19 Infection (COVID-19) using an AM, given the im-possibility of having an Intensive Care Ventilator (IVC).