Bonnie Holaday

Parenting stress and mothers of young children with chronic illness: A cross-cultural study

This study examined the sources of parenting stress among mothers from Israel, Japan, Jordan, and the United States who had a young child with a chronic illness. The results indicated mothers from all four countries experienced high levels of child-focused and parent-focused stress that indicated a need for nursing intervention.

Preparation of children for surgery and invasive procedures: Milestones on the way to success

The cost of a preparation program is relatively low, but its value for the subject undergoing treatment is very high. Feelings of satisfaction and contentment usually accompany the preparation process, and are mutual. Therefore, it is highly recommended to make the necessary efforts to develop preparation programs and to implement them regularly and systematically. It is probable that a preparation program that allows for the special characteristics of each child and family, that is accompanied by diverse demonstration aids, and that stresses a love for children and counseling, as well as cooperation between all the agents involved ... should in most cases be a successful one.

Negative and positive adaptive behaviors of Thai school-aged children who have a sibling with cancer

It is a difficult situation for any child who has to set aside some of his or her own personal needs to help an ill sibling. Thus, the child who is experiencing childhood cancer in the family should not be perceived as an external victim of the situation. The child is an insider who is able to adapt and respond to the situation in the family. The nursing care of the family ought to examine and prevent the adverse effects of the situation by providing advice and counseling to parents, as well as to the sibling of the child with cancer. Maintaining positive adaptive behaviors can be achieved by recognition and admiration by parents, grandparents, and health-care providers.

Diaper type and fecal contamination in child day care

In this study, modern all-in-one, front closure, reusable cloth diapers were compared with single-use, disposable paper diapers for their effect on fecal contamination in the child day care environment. Four licensed child day care centers were surveyed from which 1722 bacterial samples were cultured. The frequency of isolation of fecal organisms ranged from a low of 12% of the total bacterial isolates at a center using cloth diapers to a high of 46% and 45%, respectively, obtained at a center using first paper and then cloth diapers. Diaper type, cloth versus paper, when the method of application and the handling are made comparable, showed no significant difference in the frequency or the intensity of fecal contamination in child day care centers, as measured in the play/sleep area, the diaper change area, or on the hands of the care givers and children. Future studies to control microbial contamination in child day care centers should focus on effective ways of reducing contamination of sink faucets, hands of the caregivers, and hands of the children.

Vygotsky's Zone of Proximal Development: Implications for Nurse Assistance of Children's Learning

Vygotskys general theoretical framework of cognitive development is reviewed, including his concept of the zone of proximal development: the region of potential mastery lying between the level at which the child has the ability for independent performance and the level at which the child can master the task only with adult collaboration. Examples of the use of Vygotskian theory in nursing practice are provided.

Breastfeeding and Growth of Children in the Peri/postnatal Epigenetic Twins Study (PETS) Theoretical Epigenetic Mechanisms

Background: The prevalence of overweight infants and toddlers has increased by 60% in the past 30 years and is a significant contributor to diabetes, cardiovascular disease, and early morbidity and mortality. The World Health Organization’s updated meta-analysis in 2013 observed an association between breastfeeding and a lower prevalence of obesity later in life. The purpose of this study was to assess the growth of children in a cohort of Australian twins to examine associations between duration of breastfeeding and growth at 18 months of age. Our hypothesis is that the anthropometric measurements of the participants will be greater with shorter duration of breastfeeding. Methods: Methods include using cross-sectional data from a cohort at the 18-month visit (n = 179) in the Peri/postnatal Epigenetics Twins Study (PETS) to assess the relationship between duration of breastfeeding and infant size at 18 months of age. Inclusion criteria were birth weight of more than 2000 grams and breastfed for less than 1 month, 1 to 3 months, or 4 to 6 months. Results: The analysis suggested that infants breastfed for 1 to 3 months were significantly larger than infants breastfed for 4 to 6 months in terms of mean body mass index (BMI) (0.61 kg/m2; P = .02; 95% confidence interval [CI], 0.17-1.05), arm circumference (0.66 cm; P = .006; 95% CI, 0.26-1.06), and abdominal circumference (1.16 cm; P = .03; 95% CI, 0.26-2.06). The analysis also suggested that infants breastfed for less than 1 month were significantly larger than infants breastfed for 4 to 6 months in terms of mean arm circumference (0.72 cm; P = .009; 95% CI, 0.26-1.17). Conclusion: Results suggest that supplementing with non–breast milk before 4 months of age was associated with an increased BMI, arm circumference, and abdominal circumference at 18 months of age. The mean BMI decreased from 85% to 65% when infants were breastfeeding for 4 to 6 months as compared to breastfeeding for 1 to 3 months. Breastfeeding for 4 to 6 months appeared to protect against the risk of obesity for the children in the PETS.

Revisioning Graduate Professional-Development Programs.

Revisioning graduate professional-development programs is critical to enhancing graduate education. Both graduate students and employers have expressed a desire for an educational experience that better prepares students for their professional roles. This article describes the revisioning of a graduate professional-development program using a systems-developmental framework. The authors hope their process and model will generate further dialogue about this increasingly important topic.

Revisiting structural adjustment programs in sub-Saharan Africa: a long-lasting impact on child health.

The process of globalization, particularly in developing countries, has been significantly accelerated through the global economic policies implemented by major international financial institutions such as the International Monetary Fund (IMF) and the World Bank. While the primary goal of these neoliberal policies was geared towards financial stability and economic development, there is evidence of negative impacts of these policies on the health of the population in the countries of the third world. This paper explores this issue by reviewing Structural Adjustment Programs (SAPs) and their impact on child health in Sub-Saharan Africa (SSA). It examines the possible pathways and causal links between SAPs and child health in SSA. We argue that the adoption of SAPs by countries in SSA and the market-driven approach to healthcare has played a detrimental role in worsening indicators of child health in the region. The paper underscores the importance of looking beyond the indicators of purely economic growth when global macroeconomic policies are implemented. Linking specific macroeconomic policies with health opens up avenues for investigation of the conditions required for healthier populations. Besides the general indicators of population health, particular attention should be given to the often neglected, yet too sensitive to the impact of economic policies, indicators of child health. The paper highlights the value of healthy public policy and the role of the World Health Organization (WHO) and the United Nations Childrens Fund (UNICEF) in adding health to the agenda of policymakers across sectors and levels of government. It concludes by promoting the value of effective global action in the face of the global economy and trade.

Childhood Diarrhea and Malnutrition in Pakistan, Part I: Incidence and Prevalence

D IARRHEA WAS one of the leading causes of disease and death among children throughout the world until the first decade of the 20th century (Kain, 1991). Presently, diarrhea is no longer regarded as a public health problem in developed countries (World Health Organization, 1984). Advancement is mostly attributable to improved sanitary environments, availability of pure water, sanitary control of food and beverages, and increased public and individual concern for hygiene (Mahmud, Jalil, Karlberg, & Lindblad, 1993). Now, at the end of the 20th century, diarrhea and malnutrition continue to constitute a major threat to children in impoverished vicinities in developing countries worldwide. (See Table 1 for definition of terms.) A review of the literature indicates that studies can be difficult to compare because some report episodes per year (Baqui et al., 1992; Bhan et al., 1986; Government of Pakistan, 1984; Huttly et al., 1989; Kumar, Datta, Wadhwa, & Singhi, 1985; Motarjemi, Kaferstein, Moy, & Quevedo, 1993; Sircar et al., 1984), whereas others report in days per year (Cruz et al., in press b, cited in Torun & Chew, 1991; Dialogue on Diarrhea, 1989: Torun & Chew, 1991), and yet others report both (Black, Brown, Becker, & Yunus, 1982). It should be noted that children under 5 years of age are vulnerable to morbidity and mortality from diarrhea (Feachem, 1986; Motarjemi et al., 1993; Tomkins & Watson, 1989). In Pakistan, infants under 1 year old are extremely vulnerable to morbidity and mortality from diarrhea; the reported death rate is 200,000 annually (Dialogue on Diarrhea, 1989). Evidence of the pandemic nature of diarrhea and malnutrition in children can be found in research from the Indian subcontinent, Asia, Africa, and Central and South America. For example, in rural Bangladesh, the prevalence of diarrheal illness under the age of 5 years has been approximated to be 12.8 days per 100 child-days, which indicates that each child spent 46 days per year with diarrhea (Black et al., 1982). Other studies from Indian villages in children under 5 years of age showed varied incidences of 0.7 episodes per child per year (Bhan et al., 1986) to 2.2 episodes per child per year (Oyejide & Fagbami, 1988). The incidence in urban Nigerian children is 3.2 episodes per child per year (Oyejide & Fagbami, 1988), and in poor Peruvian children of Lima, 9.8 episodes per child per year (Lopez, Romana, Brown, Black, & Kanashiro, 1989). Findings from the Pan American study indicate diarrheal diseases as the major cause of death in children under 5 years of age, accounting for 29% of the total (Sanders & Carver, 1985, p. 17). Although mortality is not as great a problem in developed countries, in the United States children 5 years of age and younger experience 20 million episodes of diarrhea each year, leading to several million doctor visits, 200,000 hospitalizations, and approximately 400 deaths (Duggan, Santosham, & Glass, 1992). It has been reported that much of this morbidity is the result of dehydration associated with acute watery diarrhea (Diarrhea Treatment, 1993; Duggan, Santosham, & Glass, 1992). Malnutrition is also a leading cause of morbidity and mortality in developing countries (Badruddin, 1986; Jalil, 1991; Mull, 1991; Torun & Chew, 1991). According to The Progress of Nations (1993) report, 17% of the children younger than 5 years of age in Ecuador are malnourished compared with the South

Exploring mHealth as a New Route to Bridging the Nursing Theory-Practice Gap

The purpose of this article is to evaluate mHealth as a tool for research and development of nursing theories. Mobile health (mHealth) is one of the most promising new advances in health care technology. mHealth is defined as the use of mobile technology in the provision of health care delivery or health promotion (Qiang, Yamamichi, Hausman, & Altman, 2011). The need for innovative and effective interventions for the prevention and management of chronic illness is evident. The use of mHealth interventions in the treatment and monitoring of chronic illness is still young but shows great promise. Currently, the public health and psychological sciences are using their theories to guide interventional studies by operationalizing concepts through mHealth’s multifaceted capabilities for patient interaction. Outcomes measures from chronic illness–mHealth studies are thematically evaluated by using theoretical nursing outcome-related concepts of Meleis’s transitions theory and Mishel’s uncertainty in illness theory. Despite a small sample of articles, there are strong themes of activation and engagement within this literature review. The application of nursing theory in mHealth offers a new method to operationalize theoretical concepts, test theory-based interventions, and gain new contextual insight into the health-illness patient experience.