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1. Identify strategies to balance research responsibilities alongside other clinical, administrative, education and family roles. 2. Highlight practical insights on time management, goal-setting, and boundary-setting to prevent burnout while managing multiple responsibilities. In this early career breakout session, three investigators will share their multi-disciplinary perspectives about building and sustaining a program of research in the context of other roles as clinician, educator, caregiver and many others. During this moderated session, the panelists will highlight potential strategies and considerations for finding balance and success while navigating these different roles, including cultivating a supportive network, honing time-management skills, the art of saying "no" (or a stipulated "yes"), and identifying and prioritizing what matters. The panelists will share personal anecdotes and lessons learned from their own experiences, offering invaluable insights into how to navigate the challenges of juggling multiple responsibilities. From carving out dedicated research time amidst clinical duties to leveraging teaching opportunities to enhance research skills, attendees can expect a brief exploration of how to integrate different roles synergistically and a candid exploration of the challenges and opportunities in forging a career in research. [ABSTRACT FROM AUTHOR]

Context: Healthcare providers and parents face many challenges caring for infants at the end of life (EOL). Symptom assessment and management in critically ill infants can be especially difficult. However, the impact of the infant's EOL experience on bereaved parents is largely unknown.Objective: Explore associations between parental perceptions of infant symptoms and suffering at EOL in the neonatal intensive care unit (NICU) and parent adjustment following the death.Methods: Retrospective, cross-sectional pilot study involving parents of infants who died within the previous five years in a large, Midwestern, level IV NICU. Parents were recruited through mailed invitations, and 40 mothers and 27 fathers participated from 40 families. Parents retrospectively reported on infant symptom burden and suffering during the last week of life and the Impact of Events Scale-Revised (IES-R), and Prolonged Grief-13 (PG-13). Hierarchical regressions examined demographic/medical factors and parent perceptions at EOL in relation to post-traumatic stress symptoms (PTSS) and prolonged grief (PG).Results: Clinical levels of PTSS (Mothers = 18%; Fathers = 11%) and PG (Mothers and Fathers = 3%) were low. Maternal perception of higher symptom burden was associated with greater PTSS, R2 = 0.46, P= 0.001, and PG, R2 = 0.47, P < 0.01. Paternal perception of greater infant suffering was associated with greater PTSS, R2 = 0.48, P= 0.001, and PG, R2 = .38, P < 0.01.Conclusion: Perceptions of symptoms and suffering were associated differently with mother and father adjustment after bereavement. While not necessarily causal, better symptom management at EOL could minimize distress for both infants and their parents. [ABSTRACT FROM AUTHOR]

The purpose of this quality improvement project was to improve health-care provider consistency in addressing and documenting the use of sleep hygiene in children with neurodevelopmental disorders in alignment with evidence-based strategies. The project took place over 12 weeks and used a parent-completed screening tool and SmartPhrase technology incorporated into the patient note and discharge summary. A preimplementation and postimplementation query of the electronic medical record was used to determine change effectiveness. The postimplementation query found a 42% increase in documentation of sleep hygiene. In addition, a 55% increase in documentation of sleep hygiene with the initiation of melatonin was noted. The increase in documentation supports success of this initial practice change and demonstrates adherence to evidence-based sleep hygiene strategies. The project provided evidence of a significant improvement in electronic medical record documentation, highlighting an increased awareness of sleep issues in children with neurodevelopmental disorders. [ABSTRACT FROM AUTHOR]

Context: It is challenging to provide supportive intensive care to infants in the neonatal intensive care unit (NICU), giving them every chance for survival, while also trying to minimize suffering for both the infant and parents. Parents who believe their infant is suffering may alter treatment goals based on their perceptions; however, it is unknown how parents come to believe that their infant may be suffering.Objectives: To examine bereaved parents' perceptions of infant suffering in the NICU.Methods: Parents completed a qualitative interview exploring their perceptions of the level of suffering that their infant experienced at the end of life. Parents whose infant died in a large Midwestern Level IV regional referral NICU from July 2009 to July 2014 were invited to participate. Thirty mothers and 16 fathers from 31 families (31 of 249) participated in telephone interviews between three months and five years after their infant's death.Results: Four themes emerged from the qualitative analysis: 1) the presence/absence of suffering, 2) indicators of suffering, 3) temporal components of suffering (trajectory), and 4) influence of perceived suffering on parents, infants, and clinical decision making.Conclusion: Parents used signs exhibited by infants, as well as information they received from the health care team to form their perceptions of suffering. Perceived suffering followed different trajectories and influenced the decisions that parents made for their infant. Soliciting parent perspectives may lead to improvements in the understanding of infant well-being, particularly suffering, as well as how parents rely on these perceptions to make treatment decisions for their infant. [ABSTRACT FROM AUTHOR]

• The population of children is growing along with an increase in complexity and diversity of health care needs. • The number of pediatric nurse scientists is inadequate to meet the demand for research underlying evidence-based care for this growing pediatric population. • Pediatric nurse scientists develop from pediatric nurses, and the number of pediatric nurses is steadily decreasing. • Nursing leaders in academia, practice, and public policy must act to support and build pediatric nursing and pediatric nursing science. The provision of safe and effective nursing care to children is dependent upon pediatric nurse scientists creating knowledge that guides and directs day-to-day nursing practice. Current trends demonstrating steady decreases of pediatric nurses and inadequate numbers of PhD-prepared pediatric nurse scientists put the health of our children at risk. The purposes of this paper are to (1) summarize current health care demands in pediatrics, (2) present our concern that the number of pediatric nurse scientists is inadequate to generate foundational knowledge to guide pediatric nursing practice, (3) present our perspectives on factors influencing the number of pediatric nurse scientists, and (4) recommend specific actions for nursing leaders, nursing faculty, and professional nursing organizations to increase the depth and breadth of pediatric nursing science to meet current and future pediatric care needs. [ABSTRACT FROM AUTHOR]

Objectives: Assessment and management of symptoms exhibited by infants can be challenging, especially at the end-of-life, because of immature physiology, non-verbal status, and limited symptoms assessment tools for staff nurses to utilize. This study explored how nurses observed and managed infant symptoms at the end-of-life in a neonatal intensive care unit. Methodology/Design Methods: This was a qualitative, exploratory study utilizing semi-structured face-to-face interviews, which were tape-recorded, transcribed verbatim, and then analyzed using the Framework Approach. Setting: The sample included 14 staff nurses who cared for 20 infants who died at a large children's hospital in the Midwestern United States. Main outcome measures: Nurses had difficulty recalling and identifying infant symptoms. Barriers to symptom identification were discovered based on the nursing tasks associated with the level of care provided. Results: Three core concepts emerged from analyses of the transcripts: Uncertainty, Discomfort, and Chaos. Nurses struggled with difficulties related to infant prognosis, time of transition to end-of-life care, symptom recognition and treatment, lack of knowledge related to various cultural and religious customs, and limited formal end-of-life education. Conclusion: Continued research is needed to improve symptom assessment of infants and increase nurse comfort with the provision of end-of-life care in the neonatal intensive care unit. [ABSTRACT FROM AUTHOR]

• Infants admitted to the NICU may be at risk for high symptom burden and potential suffering. • A variety of factors contribute to the quality of the palliative and EOL care experience for infants, families, and providers. • Respiratory distress, agitation, pain, and lethargy are distressing symptoms for parents to witness. [ABSTRACT FROM AUTHOR]

Objectives: To describe the frequency of postnatal discussions about withdrawal or withholding of life-sustaining therapy (WWLST), ensuing WWLST, and outcomes of infants surviving such discussions. We hypothesized that such survivors have poor outcomes.Study Design: This retrospective review included registry data from 18 centers of the National Institute of Child Health and Human Development Neonatal Research Network. Infants born at 22-28 weeks of gestation who survived >12 hours during 2011-2013 were included. Regression analysis identified maternal and infant factors associated with WWLST discussions and factors predicting ensuing WWLST. In-hospital and 18- to 26-month outcomes were evaluated.Results: WWLST discussions occurred in 529 (15.4%) of 3434 infants. These were more frequent at 22-24 weeks (27.0%) compared with 27-28 weeks of gestation (5.6%). Factors associated with WWLST discussion were male sex, gestational age (GA) of ≤24 weeks, birth weight small for GA, congenital malformations or syndromes, early onset sepsis, severe brain injury, and necrotizing enterocolitis. Rates of WWLST discussion varied by center (6.4%-29.9%) as did WWLST (5.2%-20.7%). Ensuing WWLST occurred in 406 patients; of these, 5 survived to discharge. Of the 123 infants for whom intensive care was continued, 58 (47%) survived to discharge. Survival after WWLST discussion was associated with higher rates of neonatal morbidities and neurodevelopmental impairment compared with babies for whom WWLST discussions did not occur. Significant predictors of ensuing WWLST were maternal age >25 years, necrotizing enterocolitis, and days on a ventilator.Conclusions: Wide center variations in WWLST discussions occur, especially at ≤24 weeks GA. Outcomes of infants surviving after WWLST discussions are poor.Trial Registration: ClinicalTrials.gov: NCT00063063. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine Army women''s condom use patterns, reasons for condom use and nonuse, and what is liked about and problems associated with condom use. Methods: Army women (n = 131) from military posts around the country were recruited. The women ranged in age from 18 to 68 years (M = 30.5, SD = 10.5). The sample was of mixed ethnicity. Questionnaires were distributed by the units and returned directly to the principal investigator. Participants completed a series of anonymous open- and closed-ended questions regarding their experiences with condoms. Closed-ended questions were analyzed with descriptive statistics and open-ended responses were content analyzed (McLaughlin & Marascuilo, 1990). Conclusions: Regular condom use was low in this sample. The most often cited responses as to why women liked using condoms included peace of mind, protection, or ease of use. The most cited problems and subsequent disuse included irritation/inflammation, breakage, improper fit, or ruining the moment. Results differed by consistency of condom use. Regular users of condoms reported a lower percentage of problems using condoms. [Copyright &y& Elsevier]