Standards of nutritional care in pediatric oncology: results from a nationwide survey on the standards of practice in pediatric oncology. A Children's Oncology Group study
Child; Humans; quality of life; Nutritional Failure; Clinical Trials; Guideline Adherence/standards; Guidelines/standards; Malnutrition/diet therapy/etiology; Neoplasms/complications/mortality; Nutrition Surveys; Nutritional Support/methods/standards; Oncologic Nursing/standards
BACKGROUND: The prevalence of malnutrition in children with cancer ranges between 8% and 60%. Malnutrition is strongly associated with the nature of treatment and increases an individual's risk of infection. Clinical studies have suggested that nutrition intervention may decrease toxicity and improve survival in the oncology population. In order to identify the standards of practice in the nutritional management of a child with cancer, we conducted an international survey in institutions that are part of the Children's Oncology Group (COG) consortium. PROCEDURE: Surveys were submitted to 233 participating COG institutions. We requested one member in three disciplines complete the survey: physician, registered dietitian, and nurse or nurse practitioner. The survey was returned to the nutrition sub-committee of COG. RESULTS: Fifty-four percent of institutions responded to the survey. We found no consistency in the provision of nutrition services. Assessment of nutritional status does not routinely occur and different indices are employed to indicate the nutrition status of a patient. Institutions rely upon different guidelines when categorizing malnutrition. When nutrition intervention is clinically indicated, a variety of approaches are employed. CONCLUSIONS: This survey did not find standardized nutrition protocols being employed in the pediatric oncology population. The effect of varied nutrition practices on the quality of life, toxicity, and outcome in children with cancer is unknown. Prior to the initiation of clinical trials, uniform guidelines need to be developed and validated. Future clinical trials need to investigate the most efficacious method of nutrition assessment and intervention and its effect on quality of life, toxicity, and survival in children with cancer.
2006
Ladas EJ; Sacks N; Brophy P; Rogers PC
Pediatric Blood & Cancer
2006
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1002/pbc.20435" target="_blank" rel="noreferrer">10.1002/pbc.20435</a>
A survey of IRB process in 68 U.S. hospitals
Humans; United States; Questionnaires; Guidelines as Topic; Time Factors; Patient Advocacy; Analysis of Variance; Empirical Approach; Ethics Committees; Biomedical and Behavioral Research; Multi-site Ethics; Guideline Adherence/standards; Professional Competence/standards; Research/organization & administration; Human Experimentation; Conflict of Interest; Documentation/methods/standards; Hospital Bed Capacity/statistics & numerical data; Organizational Affiliation; Outcome and Process Assessment (Health Care)/organization & administration
PURPOSE: To compare IRB processes in 68 U.S. hospitals for the same multicenter study. DESIGN: Survey of IRB processes in 68 U.S. hospitals during 2001-2002. METHODS: Requirements of IRB submission including type and duration of review and qualifications of principal investigator were compared by hospital bed size, region, and academic affiliation. FINDINGS: The majority of hospitals (63.2%) were on the East coast, and mean bed size was 465 (range: 77-2,112). About one-third (33.8%) required that the principal investigator listed on the application be from within the institution, 26.5% required evidence of human subjects research training, 10.3% required a conflict of interest statement. Mean number of pages for the application was 5.24 (1-31) and up to eight copies were requested. Time from submission of the IRB application to approval averaged 45.4 days (range, 1-303 days), and the majority of reviews were "expedited" (61.8%). Expedited reviews required more time (mean, 54.8 days) than did either exempt (mean, 10.8 days) or full (mean, 47.1 days) reviews. CONCLUSIONS: Current IRB review processes are cumbersome and nonstandardized, and review time varies widely. The absence of efficient and streamlined review might unnecessarily impede national clinical research projects without improving participant safety.
2004
Larson E; Bratts T; Zwanziger J; Stone P
Journal Of Nursing Scholarship
2004
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1111/j.1547-5069.2004.04047.x" target="_blank" rel="noreferrer">10.1111/j.1547-5069.2004.04047.x</a>