Development of reference values for the Functional Mobility Assessment.

PURPOSE: To obtain reference values for healthy participants performing the Functional Mobility Assessment (FMA). The FMA is a reliable and valid tool used to examine functional abilities subjectively and objectively in patients with lower-extremity sarcoma in all components of the International Classification of Functioning, Disability, and Health model (body function, activity, and participation). METHODS: Children, adolescents, and young adults who were healthy, representing a sample of convenience (n = 503; 260 females, age 10-21 years), participated in this study. RESULTS: Means and standard deviations for all participants: Timed Up and Down Stairs 6.18 ± 0.8 seconds, Timed Up and Go 3.78 ± 0.6 seconds, 9-minute run/walk 4161 ± 893 feet, and the FMA total 59 ± 3. CONCLUSION: The reference values provided in this study will allow health care professionals to compare the functional abilities of children, adolescents, and young adults with lower extremity sarcoma to age- and gender-matched healthy peers when using the FMA.

Sperm banking for adolescent and young adult cancer patients: sperm quality, patient, and parent perspectives.

BACKGROUND: Infertility is often a complication for adolescent and young adult males who receive cancer therapy, a problem that might be averted through using cryopreserved sperm. We aim to evaluate feasibility of offering newly diagnosed patients the opportunity to bank sperm and, to determine the beliefs and decision-making processes of patients and their parents who considered sperm banking. PROCEDURE: Eligible patients and parents were approached and offered sperm cryopreservation. Semen samples from patients who sequentially attempted sperm banking were analyzed. Questionnaires were then administered to patients and parents who had been approached about sperm banking. RESULTS: Semen samples from 68 patients were analyzed. Nine patients were azoospermic; all had been pre-treated with chemotherapy. Fifty patients completed the questionnaire. Parent and patient made the decision together to bank 80% of the time. All sons who attempted to bank and their parents felt they had made the right decision, including those who attempted but failed. CONCLUSIONS: Viable sperm can be collected successfully from adolescent and young adults who are newly diagnosed with cancer. Semen quality was dramatically reduced by one course of gonadotoxic therapy. Parents and patients want information regarding sperm cryopreservation early. Parents appear to play an important role in the decision to sperm bank. We recommend sperm banking be offered to all eligible patients.

The lived experience of adolescent females with type 1 diabetes.

PURPOSE: The purpose of this study was to gain a better understanding of what it means for adolescent females to live with type 1 diabetes. METHODS: Van Manen's phenomenological framework was used to guide the project of inquiry. Adolescents were recruited from a diabetes camp. A purposive sample of 10 adolescent females, aged 16 and 17 years, volunteered to participate in the study. Unstructured, one-on-one interviews were conducted and participants' accounts were transcribed and analyzed for themes. RESULTS: Five themes were identified: (1) blending in with the adolescent culture, (2) standing out and being watched, (3) weighing the options and making choices, (4) being tethered to the system and to diabetes, and (5) struggling with conflicts. These adolescent females struggled with several conflicts and choices they were forced to make on a daily basis. They felt tethered to a disease that would never go away and to the healthcare system. Yet, they adopted ways to handle their disease so that it was manageable within the context of their lives. Fitting in with their peers was often more important than diabetes management. CONCLUSIONS: Making visible the experience of adolescent females living with type 1 diabetes has implications for practice, education, and research in diabetes education.

Achieving a new balance: women's transition to second-time parenthood.

OBJECTIVE: To describe the experience of transition to second-time parenthood from the mother's perspective. DESIGN: Descriptive phenomenology using Colaizzi's approach. SETTING: Participants were interviewed in their homes. PARTICIPANTS: Ten second-time mothers with a second child between the ages of 6 months and 24 months. RESULTS: The birth of the second child motivated these women to seek and achieve a new balance to integrate a second child into the existing family. Seven themes emerged as common elements in all of the women's lives: (a) balancing the positive and negative elements of the early weeks, (b) knowing what to expect, (c) establishing a new routine, (d) maintaining the marital relationship, (e) taking a break, (f) seeking out support, and (g) nurturing relationships among family members. CONCLUSIONS: Mothers overwhelmingly found the addition of a second child to the family to be a positive experience regardless of the effort it took to accommodate their lives to the needs of two children. Although second-time mothers approach the experience with a wealth of knowledge, this research highlights that these women may have concerns that are not addressed. The nurse can focus assessments and offer interventions to meet the needs of these women as they become mothers for the second time.

Sperm banking for adolescents with cancer.

Recent advances in diagnostic and therapeutic methods in pediatric oncology have led to greater survival rates in children with malignancies. However, major long-term complications can occur that limit the quality of survival, infertility being one of them. Chemotherapy, radiation treatment, surgery, and combinations of these treatments have been implicated in causing infertility, with males being especially sensitive to therapy. Cryopreservation of semen, or sperm banking, is an easy, widely available means to preserve fertility for adolescent and young adult males with cancer. In this article, the pertinent literature is reviewed, and a sperm-banking program is described. Recommendations are offered for institutions attempting to develop a successful program, and the nurse's role in education and facilitation is discussed.