Journal of Pediatric Nursing RSS feed: Current Issue. The Journal of Pediatric Nursing: Nursing Care of Children and Families (JPN) is interested in publishing clinical, theory, programmatic and research papers on a variety of topics. JPN is the official journal of the Society of Pediatric Nurses and Pediatric Endocrinology Nursing Society. Papers are published covering the life span from birth to adolescence. Subject matter pertinent to the nursing care needs of healthy and ill infants, children and adolescents addressing their biopsychosocial needs is disseminated in the Journal. In addition, the Journal features regular columns to which authors are encouraged to submit brief papers and announcements. These columns include Child Health Policy, Clincial Practice, Hot Topics, Research Commentary, Technology, SPN News and PENS News. Also, as a special feature, selected articles exemplifying timely topics are published as an Editor's Choice selection. Cecily L. Betz, PhD, RN, FAAN is the Founder and Editor-in-Chief and Angela Green, PhD, APN is the Associate Editor. http://www.pediatricnursing.org/?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. All rights reserved. Journal of Pediatric Nursing0882-5963273June 2012 © 2012 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.pediatricnursing.org/article/PIIS0882596312000905/abstract?rss=yesInformation for Authors10.1016/S0882-5963(12)00090-5Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-Xe1e1http://www.pediatricnursing.org/article/PIIS0882596312000541/abstract?rss=yesSurvival of children with chronic medical conditions has dramatically improved over the two plus decades of my career because of advances in knowledge and technology. Children who had no options in previous decades now survive, and children who once were expected to die before adolescence survive into adulthood. Because of this, we have shifted from “how to help them survive” to “how to help them thrive.” In this shift, we have implemented aggressive preventative care and screened for and aggressively managed medical morbidity. We have worked with children and families to help them learn to manage their chronic medical condition at home and at school. Yet, with all of this, we see ongoing issues with family and self-management, with school, with peers, with developmentally appropriate activities, and as a result, with quality of life (QOL) across chronic illnesses as diverse as diabetes, congenital heart disease, and cancer. This leads to the question, what else can we do?Routine Assessment of Quality of Life: The Next Step in Helping Children With Chronic Medical Conditions ThriveAngela Green10.1016/j.pedn.2012.02.006Journal of Pediatric Nursing 27, 3 (2012)2012-03-14Journal of Pediatric Nursing2012-03-14273S0882-5963(11)X0009-XEditorial193193http://www.pediatricnursing.org/article/PIIS0882596312000589/abstract?rss=yesIn Drs. article on “Preparing nurses for the 21st century: Perceptions of nurse mangers, nursing faculty, and staff nurses,” they recommend that the Society of Pediatric Nursing (SPN) update and revise the textbook Core Curriculum for the Nursing Care of Children and Their Families (). Additional suggestions for the SPN include the development of a pediatric nursing toolkit and advocacy for the adoption of the core curriculum and toolkit to the American Association Colleges of Nursing (AACN).Letter to the EditorDebbie Arnow, Myra Martz Huth10.1016/j.pedn.2012.02.010Journal of Pediatric Nursing 27, 3 (2012)2012-03-05Journal of Pediatric Nursing2012-03-05273S0882-5963(11)X0009-XCorrespondence194194http://www.pediatricnursing.org/article/PIIS0882596311001904/abstract?rss=yesThis study examined the agreement between parent and child perceptions of parenting behaviors, the relationship of the behaviors with the child's weight status, and the ability of the parent to correctly identify weight status in 176 parent–child dyads (89 Caucasian and 87 African American). Correlational and regression analyses were used. Findings included moderate to weak correlations in child and parent assessments of parenting behaviors. Caucasian dyads had higher correlations than African American dyads. Most parents correctly identified their own and their child's weight status. Parents of overweight children used increased controlling behaviors, but the number of controlling behaviors decreased when the parent expressed concern with their child's weight.Parenting Behaviors of African American and Caucasian Families: Parent and Child Perceptions, Associations With Child Weight, and Ability to Identify Abnormal Weight StatusMichele Polfuss, Marilyn Frenn10.1016/j.pedn.2011.03.012Journal of Pediatric Nursing 27, 3 (2012)2011-05-12Journal of Pediatric Nursing2011-05-12273S0882-5963(11)X0009-XArticles195205http://www.pediatricnursing.org/article/PIIS0882596311001916/abstract?rss=yesAs the number of individuals with autism grows, it is critical for nurses in all settings to understand how autism influences the family unit, as they will likely interact with these children, the adults, and their families. The intent of this descriptive narrative study was to explore the experiences of families of individuals with autism as perceived by the mother. Through personal interviews, 16 mothers' perceptions of the impact of autism on the family unit during different stages of the life cycle were revealed through a constructivist lens. Pediatric nurses employed in acute care settings, community, and schools are poised to assess and support these families following diagnosis and throughout the child's life.Coping With Autism: A Journey Toward AdaptationHeidi R. Lutz, Barbara J. Patterson, Jean Klein10.1016/j.pedn.2011.03.013Journal of Pediatric Nursing 27, 3 (2012)2011-06-27Journal of Pediatric Nursing2011-06-27273S0882-5963(11)X0009-XArticles206213http://www.pediatricnursing.org/article/PIIS0882596311000315/abstract?rss=yesThe purpose of the study was to explore relationships between caregiver holding and feeding behaviors and the transitional newborn infant’s cortisol response. Behaviors of 46 mothers, fathers, and their term transitional newborn infants were measured with the Index of Mother-Infant Separation (IMIS). Repeated measures of infant salivary cortisol were used to calculate area under the curve. A higher percentage of observations in which mother was holding infant was related to lower infant total cortisol during the first 6 hours after birth (r = −.24, p = .05, one-tailed).Social Regulation of the Stress Response in the Transitional Newborn: A Pilot StudyCynthia Anderson Elverson, Margaret E. Wilson, Melody A. Hertzog, Jeffrey A. French10.1016/j.pedn.2011.01.029Journal of Pediatric Nursing 27, 3 (2012)2011-03-21Journal of Pediatric Nursing2011-03-21273S0882-5963(11)X0009-XArticles214224http://www.pediatricnursing.org/article/PIIS0882596311000303/abstract?rss=yesTrichotillomania (TTM), or compulsive hair pulling, is a disorder that typically onsets in childhood. It is mistaken to believe that children will “age out” of this behavior, as pediatric TTM often has a chronic, debilitating course that does not remit without treatment, resulting in considerable psychological and physical impairment. Because most children with TTM will be seen initially by nursing professionals in the practices of dermatologists, pediatricians, gastroenterologists, and other disciplines, raising nurses' awareness of this disorder is of the utmost importance for accurate nursing diagnosis and assessment. As the health care providers who spend the greatest amount of time with patients, nurses' detection and diagnosis of TTM can make a critical difference in the initiation of early intervention. Therefore, the purpose of this article is to provide an overview of pediatric TTM, including its epidemiology, clinical presentation, and treatment options, from the perspective of nurses who may interact with such patients in their workplace.Pediatric Trichotillomania: Clinical Presentation, Treatment, and Implications for Nursing ProfessionalsChrista D. Labouliere, Eric A. Storch10.1016/j.pedn.2011.01.028Journal of Pediatric Nursing 27, 3 (2012)2011-03-09Journal of Pediatric Nursing2011-03-09273S0882-5963(11)X0009-XArticles225232http://www.pediatricnursing.org/article/PIIS0882596311000480/abstract?rss=yesSkin cancer is increasing faster than any other cancer in the United States. Individuals who have had excessive sun exposure during childhood and adolescence set the stage for the development of skin cancers later in life. In 2009, there were more than 1 million newly diagnosed cases of skin cancer in the United States. This primary prevention program combined the guidelines in the literature resulting in a unique evidence-based program for teachers and informational guidelines for parents. These guidelines were used in classrooms and at home, supporting intervention among school-age children, specifically those in kindergarten through fifth grade.Skin Protection for (SPF) Kids ProgramDeborah K. Walker10.1016/j.pedn.2011.01.031Journal of Pediatric Nursing 27, 3 (2012)2011-03-14Journal of Pediatric Nursing2011-03-14273S0882-5963(11)X0009-XArticles233242http://www.pediatricnursing.org/article/PIIS0882596310003842/abstract?rss=yesThe purpose of this study was to determine if there is a difference between temperature readings obtained using two different electronic temperature devices: one measuring temporal artery temperature (TAT) and one measuring rectal temperature (RT). A comparative single-group design was used with each participant acting as his or her control. The sample consisted of 47 pediatric patients between 3 and 36 months of age. Data analysis revealed no statistically significant differences between TAT and RT; however, concerns related to statistical significance versus clinical significance are discussed.Temperature Measurement in Pediatrics: A Comparison of the Rectal Method Versus the Temporal Artery MethodJessica Bahorski, Terri Repasky, Donna Ranner, Ally Fields, Michelle Jackson, Lucy Moultry, Karen Pierce, Mary Sandell10.1016/j.pedn.2010.12.015Journal of Pediatric Nursing 27, 3 (2012)2011-02-25Journal of Pediatric Nursing2011-02-25273S0882-5963(11)X0009-XArticles243247http://www.pediatricnursing.org/article/PIIS0882596311000819/abstract?rss=yesLiterature on mothers' acceptance of their children's tube feeding is heterogeneous. When a child is fed via gastrostomy, parents may report higher quality of life and higher stress levels. Qualitative research suggests that tube feeding can conflict with fundamental expectations about the mothering role. In this qualitative meta-analysis, parental statements from various studies have been excerpted and theory-based analyzed. Data suggest that feeding a child orally is not only an important aspect of mothering but also a key element for the development of a motherhood identity. Nonoral feeding often results in psychological stress and a struggle to negotiate the motherhood identity successfully and may result in traumatization of the mother. Preventive psychological guidance is recommended to decrease the risk of posttraumatic stress disorder in mothers and disturbances in the mother–child relationship and to assist in maternal coping with a child's feeding disorder.The Impact of Child Tube Feeding on Maternal Emotional State and Identity: A Qualitative Meta-AnalysisMarkus Wilken10.1016/j.pedn.2011.01.032Journal of Pediatric Nursing 27, 3 (2012)2011-03-16Journal of Pediatric Nursing2011-03-16273S0882-5963(11)X0009-XArticles248255http://www.pediatricnursing.org/article/PIIS0882596311001655/abstract?rss=yesPerceptions of living with inflammatory bowel disease (IBD) during adolescence were explored in a cross-sectional study with a multimethod design. The adolescents as a group described general well-being and ability to handle the disease, which was related to their self-reported self-esteem. However, a subgroup of adolescents with a severe disease course reported a more negative view of the impact of IBD in their daily lives. Encouraging adolescents to communicate in different ways may help professionals to identify vulnerable subgroups with impaired health and to provide more appropriate support and treatment for those most in need.Self-Reported Health, Self-Management, and the Impact of Living With Inflammatory Bowel Disease During AdolescenceHelene Lindfred, Robert Saalman, Staffan Nilsson, Carina Sparud-Lundin, Margret Lepp10.1016/j.pedn.2011.02.005Journal of Pediatric Nursing 27, 3 (2012)2011-03-31Journal of Pediatric Nursing2011-03-31273S0882-5963(11)X0009-XArticles256264http://www.pediatricnursing.org/article/PIIS0882596311002466/abstract?rss=yesThere are identified gaps regarding the accuracy of axillary temperatures as a means of predicting core temperatures in infants and children. This article discusses the relationship between rectal and axillary temperatures in infants less than 1 year of age. This quality improvement project evaluated 425 paired temperature measurements in 86 infants admitted to an inpatient pediatric unit over a 2-month period. A correlation analysis showed statistically significant differences between the two measurements. The results of this project promoted the development of a standard of care for temperature measurement at the project facility.Rectal Versus Axillary Temperatures: Is There a Significant Difference in Infants Less Than 1 Year of Age?Chris A. Stine, Donna M. Flook, Durae L. Vincze10.1016/j.pedn.2011.04.004Journal of Pediatric Nursing 27, 3 (2012)2011-07-04Journal of Pediatric Nursing2011-07-04273S0882-5963(11)X0009-XArticles265270http://www.pediatricnursing.org/article/PIIS0882596311005276/abstract?rss=yesBedside nurses involved in research and evidence-based practice (EBP) have the ability to change policies, patient care, and outcomes. This article describes the journey of a research committee using the Magnet® component of new knowledge, innovation, and improvements. Using several tools, the unit-based committee developed skills in meeting management, nursing research methods, and EBP. Focusing to improve family and nurse communication about the plan of care, the committee recommended changes in the existing Plan of Care tool, including family input and recommendations for families to view and add to the sheet and participate in daily rounds, which was not the standard practice. Since this intervention was implemented, patient satisfaction has increased, as well as nurse engagement and intent to stay. This project exemplifies how nurse-driven innovations and family partnership led to new knowledge, innovations in learning about research, applying it to practice, and improving practice.New Knowledge, Innovations, and Improvement in a Magnet® Children's Hospital Cardiac CenterSharon J. Barton, Erin K. Forster, Mary E. Stuart, Ashley M. Patton, Jeong-Sook Rim, Deborah L. Torowicz10.1016/j.pedn.2011.07.002Journal of Pediatric Nursing 27, 3 (2012)2011-09-07Journal of Pediatric Nursing2011-09-07273S0882-5963(11)X0009-XMagnet® Feature Article271274http://www.pediatricnursing.org/article/PIIS0882596312000498/abstract?rss=yesIN AN EFFORT to curb medical errors, hospitals have spent a great deal of money on computers, cell phones, and other electronic devices so health care providers have instant access to patient data, drug information, or medical reference material. Unfortunately, like many innovations, this solution has come with an unintended downside—health care providers focusing on electronic devices and away from the patient. It also allows health care providers to do non-work-related tasks, such as texting friends, answering personal e-mails, or surfing the Web, even during moments of critical care. A new study has been published showing that half of health care workers running bypass machines admitted texting while performing cardiopulmonary bypass (CPB; ). This phenomenon has set off discussions in many medical settings of a problem, which has been described as “distracted doctoring.” In response, some hospitals have begun limiting the use of electronic devices in critical settings, and some nursing schools have started reminding students to focus on patients instead of devices, even as they are being handed more electronic tools. Among the respondents, 36.1% reported having a hospital policy regarding cell phone use, whereas 16.4% had a department policy.The Distracted NurseDeborah L. McBride10.1016/j.pedn.2012.02.002Journal of Pediatric Nursing 27, 3 (2012)2012-03-05Journal of Pediatric Nursing2012-03-05273S0882-5963(11)X0009-XHot Topics Column275276http://www.pediatricnursing.org/article/PIIS0882596312000553/abstract?rss=yesEACH DAY, APPROXIMATELY 3,450 U.S. teens will try their first cigarette; of these teens, 850 will become daily smokers (). Results of a Center of Disease Control and Prevention () study revealed that 93% of adults smoked their first cigarette in their teenage years. Ninety-one percent of adults who started smoking in their teens became daily smokers by the age of 20 years. According to survey data from the , a long-term decline in smoking rates among U.S. high school students has leveled off. Thus, the Healthy People (2010) goal to reduce teen smoking to less than 16% was not achieved (). Today, teen smoking continues to be a public health concern because it impacts not only teens but also the long-term smoking habits of adults. The impetus for health care professionals to develop smoking cessation programs specifically tailored to teens has long-term health benefits. The use of technology has been suggested as one approach to help teen smokers “kick the habit.” This article will explore the use of technology to aid teens in smoking cessation.Can Technology Assist Teen Smokers to “Kick the Habit”?Karen Goldschmidt, Catherine M. Hasson10.1016/j.pedn.2012.02.007Journal of Pediatric Nursing 27, 3 (2012)2012-02-27Journal of Pediatric Nursing2012-02-27273S0882-5963(11)X0009-XTechnology Column277279http://www.pediatricnursing.org/article/PIIS088259631200084X/abstract?rss=yesIT IS CRITICAL that lessons learned from research are translated and applied to everyday pediatric nursing practice to improve the quality of care for children and their families. For pediatric nursing practice, clinical nursing research is conducted to develop, refine, and expand nursing knowledge to guide practice () and ultimately improve the health and quality of life of children and their families. Clinical problems identified from pediatric nursing practice are used as sparks to ignite research, evidence-based practice (EBP) projects, and quality improvement (QI) programs. Translating research evidence into best clinical practices enhances the quality of pediatric nursing practice by improving child and family health outcomes (). Thus, improving pediatric nursing practice requires that evidence from research, EBP projects, and QI programs are conducted, translated, and integrated into everyday pediatric nursing practice ().Translational Research—Improving Everyday Pediatric Nursing Practice Through Research and Evidence-Based PracticeBecky J. Christian10.1016/j.pedn.2012.03.026Journal of Pediatric Nursing 27, 3 (2012)2012-03-22Journal of Pediatric Nursing2012-03-22273S0882-5963(11)X0009-XResearch Commentary Column280282http://www.pediatricnursing.org/article/PIIS0882596312000486/abstract?rss=yesCaring for patients with cancer is becoming more common in acute and critical-care settings. According to the , cancer is the second leading cause of death in the nation. In any setting, nurses can encounter patients experiencing cancer care anywhere along the cancer care continuum. This includes recent diagnosis, induction chemotherapy, maintenance therapy, recovery, remission, or relapse and hospice care. Nurses need to be ready to respond to the unique needs of the cancer patient, whether the care is focused on adult or pediatric patients.The Use of Simulation for Pediatric Oncology Nursing Safety Principles: Ensuring Competent Practice Through the Use of a Mnemonic, Chemotherapy Road Maps and Case-Based LearningLuanne Linnard-Palmer10.1016/j.pedn.2012.02.001Journal of Pediatric Nursing 27, 3 (2012)2012-03-05Journal of Pediatric Nursing2012-03-05273S0882-5963(11)X0009-XSPN News Column283286http://www.pediatricnursing.org/article/PIIS0882596312000504/abstract?rss=yesThe measurement of salivary cortisol has been widely used in pediatric research for more than 20 years as a biomarker of hypothalamic pituitary adrenal (HPA) axis activity during normal activity and in response to stress. recently reported cognitive–behavioral interventions that were effective in reducing pain and distress in children undergoing intravenous needle insertion, and salivary cortisol measurement was a useful marker of biological response to compare the effect of interventions in conjunction with other physiological and/or behavioral outcome measures. The inclusion of salivary cortisol as an outcome measure will provide a useful biological marker with future research to investigate the following: stress in children undergoing painful procedures, weight loss, sleep problems, and caregiver stress. The use of salivary cortisol in pediatric biobehavioral research has revealed important information about the pattern of cortisol secretion during childhood, the response to stressors in a nonclinical environment, the response to therapeutic interventions, and the identification of dysfunctional patterns of secretion in children. Salivary cortisol is a reliable noninvasive method to assess HPA function; however, collection and measurement of specimens with infants and children require special consideration. This article will summarize pertinent issues related to salivary cortisol collection to encourage “broader employment” of this method in pediatric biobehavioral research.Salivary Cortisol: A Tool for Biobehavioral Research in ChildrenMargaret F. Keil10.1016/j.pedn.2012.02.003Journal of Pediatric Nursing 27, 3 (2012)2012-03-12Journal of Pediatric Nursing2012-03-12273S0882-5963(11)X0009-XPENS Column287289http://www.pediatricnursing.org/article/PIIS0882596312000607/abstract?rss=yesCystic fibrosis (CF) is the most common life-threatening autosomal recessive genetic disease in the United States. Cystic fibrosis-related diabetes (CFRD) is the most common comorbidity of CF, and as patients age, the likelihood of developing diabetes increases. CFRD leads to decreased lung function, poor nutritional status, and decreased survival rates. Symptoms can be subtle and may be overlooked. The extent to which individuals with CF know about CFRD is unknown.A Survey of Knowledge Related to Cystic Fibrosis-Related DiabetesErin Booth10.1016/j.pedn.2012.03.002Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse2e2http://www.pediatricnursing.org/article/PIIS0882596312000619/abstract?rss=yesIdentification of asymptomatic patients with subtle dysfunction of the hypothalamic–pituitary–adrenal (HPA) axis is a diagnostic challenge. HPA axis response to hypoglycemia during an insulin tolerance test (ITT) is considered the gold standard in the evaluation of suspected adrenal insufficiency, especially in the setting of growth hormone deficiency (GHD). The short 1 μg cortroysn stimulation test (CST) is also an accurate and practical screening test for the adequacy of ACTH reserve.How Much Is Enough? The Usefulness of Peak Cortisol Levels in Identifying Adrenal Insufficiency in Children Undergoing Insulin Tolerance Test for Short StatureBarbara Duffy, Monroe Carell10.1016/j.pedn.2012.03.003Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse2e3http://www.pediatricnursing.org/article/PIIS0882596312000620/abstract?rss=yesClinicians often underestimate the fear that children have with frequent needlesticks required in the care of many endocrine disorders (Bracha, 2004). While fear lessened, 28% of young children with Type 1 diabetes mellitus continued to report needle fear 6 months after diagnosis (Howe et al., 2011).Concept Analysis of Fear: Focus on Childhood Fear and Implications for Endocrine NursingCarol Howe10.1016/j.pedn.2012.03.004Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse3e3http://www.pediatricnursing.org/article/PIIS0882596312000632/abstract?rss=yesMore than 200,000 international adoptions by U.S. families occurred between 1999 and 2010. Prior studies suggest that the effects of institutionalized care on growth and development may not be fully reversible.A Prospective Study of Growth and Development of Children Recently Adopted From Orphanage CareMargaret Keil10.1016/j.pedn.2012.03.005Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse3e3http://www.pediatricnursing.org/article/PIIS0882596312000644/abstract?rss=yesDiabetic ketoacidosis (DKA) is a well-known complication in children with Type 1 diabetes, with a mortality rate estimated at 2%. Sparse data are available from the literature describing the sociodemographic factors associated with DKA admissions in children. A previous study identified that children with Type 1 diabetes who are of non-Caucasian race and those with Medicaid had increased incidence of DKA admissions.Social–Demographic Factors Associated With Pediatric Diabetic Ketoacidosis Admissions in Southern West VirginiaKevin Lewis, Crystal Clark, Sachin Bendre10.1016/j.pedn.2012.03.006Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse3e4http://www.pediatricnursing.org/article/PIIS0882596312000656/abstract?rss=yesSedentary lifestyle, decreased physical activity, and poor diet contribute to the increasing problem of childhood obesity and risk for Type 2 diabetes. Children living in urban areas often have limited access to physical activity.Dance for Health: Implementation of a Dance Program to Improve Physical Activity of ChildrenTerri Lipman10.1016/j.pedn.2012.03.007Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse4e4http://www.pediatricnursing.org/article/PIIS0882596312000668/abstract?rss=yesTypically, managing diabetic ketoacidosis (DKA) in children is labor intensive and includes collection and monitoring of hourly subcutaneous blood glucose, vital signs, neurological assessment, and other laboratory values every 2 to 4 hours by nurses. Intravenous (IV) hydration is imperative and requires frequent fluid changes based on laboratory results. Managing IV fluids is problematic because of delays in physician return calls, pharmacy response to physician orders, and delivery of IV fluids to patient areas.Improving the Efficiency and Safety of Managing Children With Diabetic KetoacidosisJoan Luce10.1016/j.pedn.2012.03.008Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse4e5http://www.pediatricnursing.org/article/PIIS088259631200067X/abstract?rss=yesThe patient is a 33-month-old Caucasian female diagnosed with Type 1 diabetes mellitus (T1D). L. K. presented with 9-day history of polydipsia and polyuria. At home, the urine revealed positive ketones, and a blood glucose checked on home glucometer was 542 mg/dL. L. K. was transferred to a children's hospital and admitted with hyperglycemia and ketonuria without acidosis. Glucose management in the hospital was difficult because of hyperglycemia during the day and hypoglycemia at night without the initiation of insulin.A Case of Type 1 Diabetes in a Toddler With a Family History of Neonatal DiabetesDiane DiFazio10.1016/j.pedn.2012.03.009Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse5e5http://www.pediatricnursing.org/article/PIIS0882596312000681/abstract?rss=yesJ. D. is a 9-month-old Caucasian male with hyperinsulinism (HI). J. D. reportedly had hypoglycemia at birth (exact data unavailable). He was discharged day of life (DOL) 3, when blood glucose (BG) levels “stabilized.” On DOL 4, he had a seizure, was taken to the emergency room, and had a dangerously low BG level of 6 mg/dL (70–110). His medical evaluation was consistent with HI, but he failed medication therapy. He was discharged home on continuous feeds, but over the next several months had persistent hypoglycemia with BGs less than 50 mg/dL. Therefore, he was readmitted to his local hospital. Without additional treatment options, he was transferred to a hyperinsulinism center for further evaluation.Congenital Hyperinsulinism Associated With Beckwith Wiedemann SyndromeEnyo Dzata10.1016/j.pedn.2012.03.010Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse5e5http://www.pediatricnursing.org/article/PIIS0882596312000693/abstract?rss=yesPatient A is a 15 ½-year-old Caucasian male. Patient B is a 17-year-old Caucasian male. Patient A has been followed in an endocrine clinic since the age of 18 months with growth hormone (GH) and thyroid deficiencies. GH was discontinued 4 months prior because of growth completion (bone age 16y 6 m @ 15y 1 m). He had an appendectomy 1 month ago and reported diminished energy level and a 15-lb weight loss despite adequate oral intake and absence of gastrointestinal symptoms. No acute illness was noted. Patient B has been followed in endocrine clinic since age 7 years with growth hormone deficiency (GHD). GH was discontinued 6 months prior because of poor compliance (bone age 14y @ 15y 5 m). He reported a 20-lb weight loss and diminished energy levels. No changes had occurred in his medical regimen, and no other acute illness was present.Unexplained Weight Loss in Two Growth Hormone-Deficient Adolescent MalesCynthia Gordner10.1016/j.pedn.2012.03.011Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse5e6http://www.pediatricnursing.org/article/PIIS088259631200070X/abstract?rss=yes16-year 7-month-old Caucasian female. Referred by a neurosurgeon for evaluation of her endocrine status. She had a pituitary lesion and polyuria and polydipsia suggestive of diabetes insipidus (DI).The Need for Assessing Cortisol-Binding Globulin in Evaluation for Cushing's Syndrome in a Young GirlPatty Graves10.1016/j.pedn.2012.03.012Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse6e6http://www.pediatricnursing.org/article/PIIS0882596312000711/abstract?rss=yesA 22-month-old female, severe failure to thrive. Length was 66 cm (−5.1 SD), and weight was 6.6 kg (−6.7 SD). Prominent forehead and midfacial hypoplasia were noted. Muscle mass was decreased.Failure to Thrive Because of Inherited Congenital Isolated Growth Hormone DeficiencyLisa Michele Pincham10.1016/j.pedn.2012.03.013Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse6e6http://www.pediatricnursing.org/article/PIIS0882596312000723/abstract?rss=yesIn October 2010, a Special Interest Group (SIG) was initiated to support endocrine nursing practice at an urban medical facility. A SIG is a forum in which nurses involved in the care of patients within a specific specialty area have the opportunity to collaborate to further nursing practice, exchange ideas, and discuss standards of care to provide a consistent patient and family care experience.Standardization of Endocrine Nursing Practice: Establishment of a Special Interest GroupLisa Michele Pincham, Isabel Couto10.1016/j.pedn.2012.03.014Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse6e7http://www.pediatricnursing.org/article/PIIS0882596312000735/abstract?rss=yesOsteoporosis is a challenge facing children of all ages with multiple different health conditions and physical abilities. The reality of this challenge stemmed the development of the child health program's interdisciplinary bone health project team in a tertiary care, in-patient pediatric hospital. The committee's goal was to develop protocols and tools to help identify at-risk children and ultimately prevent fragility fractures in these children. An evidence-based screening tool was developed to allow primary caregivers to quickly recognize the child who is most at risk for osteoporosis and determine the next step to take related to bone health. The use of standardized evidence-based diagnosis, treatment, and prevention protocols empowers all care providers to make bone health a priority for their patients. A “handle with care” protocol, along with identifiable signage, gives caregivers and others who may handle the child the ability to do so safely, with adequate knowledge of fracture prevention strategies. A resource for families and caregivers, which includes the definition of pediatric osteoporosis, diagnostic criteria, and prevention strategies, has been developed. Nutrition and lifestyle recommendations, including activities of daily living, safe handling practices, and tips to prevent injury, are also included. All children admitted to the children's hospital are screened during their admission using a standard nursing database with a specific bone health screen added. The process from screening to initial workup, diagnosis, and treatment or prevention arm will be described in detail. Any child identified as high risk or having pediatric osteoporosis will be automatically entered in the “fragile: handle with care” protocol. This multidisciplinary approach to bone health and fracture prevention is the key to successful outcomes for all children at risk for osteoporosis. Roll-out and sustainability of this project have depended greatly on networking and collaboration with many stakeholders from initiation through to maintenance of this practice change. A working component is to expand screening and fracture prevention methods by identifying children with osteoporosis in the community through education of professionals and families.Childhood Osteoporosis: Screening, Prevention, Treatment, and Safe Handling Practices in a Tertiary Care Pediatric HospitalNicole Kirouac, Shayne Taback, Kathy Miller, Arlene Stocki, Gina Rempel, Joanna Gies, Pat Ozechowsky, Leslie Galloway, Paige McCullough, Courtney Wuskynyk10.1016/j.pedn.2012.03.015Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse7e7http://www.pediatricnursing.org/article/PIIS0882596312000747/abstract?rss=yesFour certified diabetic educators (CDEs) with varying roles at our hospital work together to meet the challenges we face in providing care for our pediatric patients. We meet weekly to address diabetes improvement initiatives both at the hospital and community at large.Diabetes Nurse Leadership Group: A Forum for Improving Diabetes CareDawn Hagerty, Linda Cohen, Sandy Hirsch, Maria Yomtov10.1016/j.pedn.2012.03.016Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse7e8http://www.pediatricnursing.org/article/PIIS0882596312000759/abstract?rss=yesBritish Columbia is a vast province consisting of a population that spans five regional health authorities and one provincial health authority. General care can be accessed within these health authorities; however, pediatric subspecialty care is mainly provided at our hospital located in Vancouver. This requires many families to travel long distances to receive subspecialty care.Mentorship Program for Regional Endocrine NursesMabel Tan10.1016/j.pedn.2012.03.017Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse8e8http://www.pediatricnursing.org/article/PIIS0882596312000760/abstract?rss=yesGonadotropin-releasing hormone agonists (GnRHa) are the standard of care for treating patients with central precocious puberty (CPP). However, there is a paucity of long-term, posttreatment follow-up data for patients previously treated with GnRHa.A Multicenter, Observational Study of Girls with Central Precocious Puberty Treated With Histrelin Subcutaneous ImplantPaul Thornton10.1016/j.pedn.2012.03.018Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse8e8http://www.pediatricnursing.org/article/PIIS0882596312000772/abstract?rss=yesApproximately 5% of all newborns are born small for gestational age (SGA), below 2 standard deviation scores (SDS) for height and/or weight. Beneficial effects of long-term growth hormone (GH) treatment on height have not been studied in short Japanese SGA children.Long-Term Efficacy of Growth Hormone in Short Japanese Children Born Small for Gestational AgeCharles DiPaula, Toshiaki Tanaka, Susumu Yokoya, Anne-Marie Kappelgaard10.1016/j.pedn.2012.03.019Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse8e9http://www.pediatricnursing.org/article/PIIS0882596312000784/abstract?rss=yesRecombinant growth hormone (GH) is used to treat short stature in children with GH deficiency and other conditions. Treatment adherence, which may be poor because of the need for daily injections and treatment length, may be improved with easy-to-use injection devices.Comparison of Device Preference and Use Errors for a New Growth Hormone Injection Device Versus Comparator DevicesMaryann Olsen10.1016/j.pedn.2012.03.020Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse9e9http://www.pediatricnursing.org/article/PIIS0882596312000796/abstract?rss=yesCentral precocious puberty (CPP) is defined as the reactivation of the hypothalamic–pituitary–gonadal (HPG) axis before age 8 in girls and age 9 in boys. Gonadotropin-releasing hormone analog (GnRHa) therapy is the standard of care for patients with CPP. In a Phase 3 open-label study, a 12-month histrelin subcutaneous implant (Supprelin LA) suppressed peak luteinizing hormone (LH) and sex steroid levels for 1 year; a subsequent implant suppressed the HPG axis through a second year. Herein reports on Year 3 of histrelin therapy.Treatment of Children With Central Precocious Puberty: 3 Years of Continuous Suppression With Histrelin Subdermal ImplantsLawrence Silverman10.1016/j.pedn.2012.03.021Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XPENS Abstractse9e10http://www.pediatricnursing.org/article/PIIS0882596312000899/abstract?rss=yesTable of Contents10.1016/S0882-5963(12)00089-9Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XFrontmatterA1A2http://www.pediatricnursing.org/article/PIIS0882596312000887/abstract?rss=yesEditorial Board10.1016/S0882-5963(12)00088-7Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XFrontmatterA3A3http://www.pediatricnursing.org/article/PIIS0882596312000978/abstract?rss=yesInformation for Readers10.1016/S0882-5963(12)00097-8Journal of Pediatric Nursing 27, 3 (2012)2012-06-01Journal of Pediatric Nursing2012-06-01273S0882-5963(11)X0009-XFrontmatterA5A5