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A 130 km2 tabular iceberg calved from Petermann Glacier in northwestern Greenland on 5 August 2012. Subsequent fracturing generated many individual large “ice islands”, including Petermann ice island (PII)-A-1-f, which drifted between Nares Strait and the North Atlantic. Thinning caused by basal and surface ablation increases the likelihood that these ice islands will fracture and disperse further, thereby increasing the risk to marine transport and infrastructure as well as affecting the distribution of freshwater from the polar ice sheets. We use a unique stationary and mobile ice-penetrating radar dataset collected over four campaigns to PII-A-1-f to quantify and contextualize ice island surface and basal ablation rates and calibrate a forced convection basal ablation model. The ice island thinned by 4.7 m over 11 months. The majority of thinning (73 %) resulted from basal ablation, but the volume loss associated with basal ablation was ∼12 times less than that caused by areal reduction (e.g. wave erosion, calving, and fracture). However, localized thinning may have influenced a large fracture event that occurred along a section of ice that was ∼40 m thinner than the remainder of the ice island. The calibration of the basal ablation model, the first known to be conducted with field data, supports assigning the theoretically derived value of 1.2×10−5 m2∕5 s-1/5 ∘C−1 to the model's bulk heat transfer coefficient with the use of an empirically estimated ice–ocean interface temperature. Overall, this work highlights the value of systematically collecting ice island field data for analyzing deterioration processes, assessing their connections to ice island morphology, and adequately developing models for operational and research purposes.

This paper reconciled the soil ecology benefits of forages and ruminants with reducing GHG emissions from beef. A scenario analysis compared four integrated systems for beef, pork and broilers. Slaughter cattle diets were either business as usual (BAU) or grass fed (GF), and the combined red meat consumption could not exceed the recommendation for human health. The four consumption scenarios included (PS1) equal beef and pork with BAU beef, (PS2) equal beef and pork with GF beef, (PS3) more pork and less beef with GF beef and (PS4) more pork and less beef with BAU beef. Broiler consumption was increased to force all four scenarios to provide the same amount of protein. All four scenarios required similar feed grain areas (2.5 to 3 Mha). At 2.3, 4.4, 2.2 and 1.2 Mha for PS1, PS2, PS3 and PS4, respectively, the areas in harvestable forage showed much greater variation. From high to low GHG emissions, the ranking of scenarios was PS2, PS1, PS3 and PS4. Although allowing for avoidance of soil organic matter loss changed this ranking, the carbon footprint of beef production was still double or more that of pork in all four PS. To reconcile the agro-ecological benefits of beef with reducing GHG emissions, PS3 may be better than PS4. Along with eating more pork and broilers, and less red meat overall, consumers can choose GF beef as an occasional alternative.

It is important to increase our knowledge of the role of land use in changing the regional climate. This study asked, “Has the increase in continuous cropping over the past 50 years on the Canadian Prairies influenced the daily mean and range of morning dew point temperatures (Td) during the foliar expansion period (from mid-June to mid-July) of annual field crops?” We found that there has been a general increase in the decadal average of mean daily Td and in the range of morning Td from the 1960s to the 2000s. The increase in the observed range of Td between the daily minimum value, which typically occurs near sunrise, and the late morning peak was found to be related to the increase in annual crop acreage and consequent decrease in summerfallow area. The relationship was more significant in the subhumid climatic zone than in the semiarid climatic zone, and it was influenced by whether the region was experiencing either wet, normal, or dry conditions.

In China, dairy cattle managed in collective feedlots contribute about 30% of the milk production and are believed to be an important contributor to national methane emissions. Methane emissions from a collective dairy feedlot in North China Plain (NCP) were measured during the winter, spring, summer, and fall seasons with open-path lasers in combination with an inverse dispersion technique. Methane emissions from the selected dairy feedlot were characterized by an apparent diurnal pattern with three peaks corresponding to the schedule of feeding activities. On a per capita basis, daily methane emission rates of these four seasons were 0.28, 0.32, 0.33, and 0.30 kg head−1 d−1, respectively. In summary, annual methane emission rate was 112.4 kg head−1 yr−1 associated with methane emission intensity of 32.65 L CH4 L−1 of milk and potential methane conversion factor Ym of 6.66% of gross energy intake for mature dairy cows in North China Plain.

Abstract Carbon sequestration in agricultural soils is frequently promoted as a practical solution for slowing down the rate of increase of CO2 in the atmosphere. Consequently, there is a need to improve our understanding of how land management practices may affect the net removal of greenhouse gases (GHG) from the atmosphere. In this paper we examine the role of agriculture in influencing the GHG budget and briefly discuss the potential for carbon mitigation by agriculture. We also examine the opportunities that exist for increasing soil C sequestration using management practices such as reduced tillage, reduced frequency of summer fallowing, introduction of forage crops into crop rotations, conversion of cropland to grassland and nutrient addition via fertilization. In order to provide information on the impact of such management practices on the net GHG budget we ran simulations using CENTURY (a C model) and DNDC (a N model) for five locations across Canada, for a 30-yr time period. These simulations provide information on the potential trade-off between C sequestration and increased N2O emissions. Our model output suggests that conversion of cropland to grassland will result in the largest reduction in net GHG emissions, while nutrient additions via fertilizers will result in a small increase in GHG emissions. Simulations with the CENTURY model also indicated that favorable growing conditions during the last 15 yr could account for an increase of 6% in the soil C at a site in Lethbridge, Alberta. [ABSTRACT FROM AUTHOR]

This paper studies the patterns of individuals’ student loan repayment for up to 12 years, tracking borrowers through the formative ages of the early 20s to the late 30s. Using social sequence and cluster analysis to understand these longitudinal repayment histories, we identify five archetypes of loan repayment that describe borrowers’ experiences: persistent defaulters, perpetual payers, rapid full payers, late full payers, and consolidators. We find significant stratification by race/ethnicity, social class, and institutional sector into repayment clusters, with minoritized borrowers and those attending for-profit institutions more likely to experience adverse borrowing outcomes and to experience them for longer.

We quantify the biases in the diurnal cycle of air temperature in ERA5, using hourly climate station data for four stations in Saskatchewan, Canada. Compared with ERA-Interim, the biases in ERA5 have been greatly reduced, and show no differences with snow cover. We compute fits to the ERA5 mean air temperature biases based on ERA5 effective cloud albedo. They can be used to improve the ERA5 diurnal cycle of air temperature for modeling agricultural processes. Diurnally, ERA5 has a negative wind speed bias, which increases quasi-linearly with wind speed, and is greater in the daytime than at night. We evaluate ERA5 precipitation against the original climate station precipitation data, and a second generation adjusted precipitation dataset by Mekis and Vincent (2011). For the warm season, ERA5 has a high bias of 8 ± 9% above the Mekis dataset. ERA5 is −22 ± 7% below the Mekis estimate in winter, suggesting that their correction with snow may be too large. It is likely that the ERA5 precipitation bias is small, which is encouraging for agricultural modeling. Data from a BSRN site near Regina shows that the biases in the downwelling shortwave and longwave radiation estimates in ERA5 are small, and have changed little from ERA-Interim. We show that the annual cycle of the Saskatchewan surface energy and water budgets in ERA5 are realistic. In particular the damping of extremes in summer precipitation by the extraction of soil water is comparable in ERA5 to our earlier observational estimate based on gravity satellite data.

Over the past 30 years, the Canadian Twin Otter research group has operated an aircraft platform for the study of atmospheric greenhouse gas fluxes (carbon dioxide, ozone, nitrous oxide and methane) and energy exchange (latent and sensible heat) over a wide range of terrestrial ecosystems in North America. Some of the acquired data from these projects have now been archived at the Flight Research Laboratory and Agriculture and Agri-Food Canada. The dataset, which contains the measurements obtained in eight projects from 1987 to 2011 are now publicly available. All these projects were carried out in order to improve our understanding of the biophysical controls acting on land-surface atmosphere fluxes. Some of the projects also attempted to quantify the impacts of agroecosystems on the environment. To provide information on the data available, we briefly describe each project and some of the key findings by referring to previously published relevant work. As new flux analysis techniques are being developed, we are confident that much additional information can be extracted from this unique data set.

This study uses 55 years of hourly observations of air temperature, relative humidity, daily precipitation, snow cover and cloud cover from 15 climate stations across the Canadian Prairies to analyze biosphere-atmosphere interactions. We will provide examples of the coupling between climate, snow cover, clouds, and land use. Snow cover acts as a fast climate switch. With the first snow fall, air temperature falls by 10 °C, and a similar increase in temperature occurs with snow melt. Climatologically, days with snow cover are 10 °C cooler than days with no snow cover in Alberta. However the interannual variability has a larger range, so that for every 10 % decrease in days with snow cover, the mean October to April climate is warmer by 1.4 to 1.5 °C. Snow cover also transforms the coupling between clouds and the diurnal cycle of air temperature from a boundary layer regime dominated by shortwave cloud forcing in the warm season to one dominated by longwave cloud forcing with snow cover. Changing agricultural land use in the past thirty years, specifically the reduction of summer fallowing, has cooled and moistened the growing season climate and increased summer precipitation. These hourly climate data provide a solid observational basis for understanding land surface coupling, which can be used to improve the representation of clouds and land-surface processes in atmospheric models.

The challenges of accurately measuring in situ ammonia (NH3) losses from agricultural systems are well known. Using an open path laser coupled with a backward Lagrangian stochastic dispersion model is a promising approach for quantifying both point- and area-sources; however, this approach requires the open path laser to detect low NH3 concentrations and small concentration differences. In this study, we compared the new GasFinder3 open path laser (Boreal laser Inc., Edmonton, Canada) with the GasFinder2 sensor, the previous version. The study took place at two locations: an outdoor open-air manure compost site, and a field of wheat stubble which was fertilized with urea ammonium nitrate. Results showed the two lasers reported similar concentrations during three days of measurements at the compost site, but differed at the field site, where concentrations were close to the minimum detection limit. The GasFinder3 had a lower standard deviation under all conditions, especially with low wind speed and high relative humidity.

To assess tradeoffs between environmental sustainability and changes in food production on agricultural land in Canada the Unified Livestock Industry and Crop Emissions Estimation System (ULICEES) was developed. It incorporates four livestock specific GHG assessments in a single model. To demonstrate the application of ULICEES, 10% of beef cattle protein production was assumed to be displaced with an equivalent amount of pork protein. Without accounting for the loss of soil carbon, this 10% shift reduced GHG emissions by 2.5 TgCO2e y−1. The payback period was defined as the number of years required for a GHG reduction to equal soil carbon lost from the associated land use shift. A payback period that is shorter than 40 years represents a net long term decrease in GHG emissions. Displacing beef cattle with hogs resulted in a surplus area of forage. When this residual land was left in ungrazed perennial forage, the payback periods were less than 4 years and when it was reseeded to annual crops, they were equal to or less than 40 years. They were generally greater than 40 years when this land was used to raise cattle. Agricultural GHG mitigation policies will inevitably involve a trade-off between production, land use and GHG emission reduction. ULICEES is a model that can objectively assess these trade-offs for Canadian agriculture.

The three main farm products from Canadian agriculture, i.e., proteins, vegetable oils, and carbohydrates, account for 98% of the land in annual crops in Canada. The intensities and efficiencies of these field crops in relation to their Greenhouse Gas (GHG) emissions were assessed for their value as land use change indicators. To facilitate spatial comparisons, this assessment was carried out at the Ecodistrict (ED) scale. The Unified Livestock Industry and Crop Emissions Estimation System (ULICEES) model was modified to operate at the ED scale, and used to quantify the GHG emission intensity of protein. GHG emissions were also calculated for plant products not used for livestock feed. The livestock GHG emissions and GHG-protein intensities estimated using ED scale inputs to ULICEES were reasonably close to GHG-protein intensities generated by the version of ULICEES driven by provincial scale census data. Carbohydrates were split into two groups, i.e., whether or not they supported livestock. Annual farm product data at 5-year intervals were used to generate GHG emissions from all farm operations. The range of GHG emissions from all farm operations in Western Canada was from 42 to 54 Mt CO2e between in 1991 and 2011, while GHG emissions from livestock ranged from 22 to 34 Mt CO2e over the same period. The Eastern Canadian GHG emissions from all farm operations declined gradually from 24 to 22 Mt CO2e over the period, with most of the eastern GHG emissions being from livestock. Ruminant livestock accounted for most of the livestock GHG emissions, particularly in the west. Provincial scale GHG emission efficiencies of the four farm product groups were assessed on a per-unit of GHG emissions basis for 2006. The most GHG-efficient province for protein was Ontario, whereas the most GHG-efficient province for all three plant products was Saskatchewan. The coastal provinces were the least GHG-efficient sources of all four farm product groups.

Methane emissions from manure management represent an important mitigation opportunity, yet emission quantification methods remain crude and do not contain adequate detail to capture changes in agricultural practices that may influence emissions. Using the Canadian emission inventory methodology as an example, this letter explores three key aspects for improving emission quantification: (i) obtaining emission measurements to improve and validate emission model estimates, (ii) obtaining more useful activity data, and (iii) developing a methane emission model that uses the available farm management activity data. In Canada, national surveys to collect manure management data have been inconsistent and not designed to provide quantitative data. Thus, the inventory has not been able to accurately capture changes in management systems even between manure stored as solid versus liquid. To address this, we re-analyzed four farm management surveys from the past decade and quantified the significant change in manure management which can be linked to the annual agricultural survey to create a continuous time series. In the dairy industry of one province, for example, the percentage of manure stored as liquid increased by 300% between 1991 and 2006, which greatly affects the methane emission estimates. Methane emissions are greatest from liquid manure, but vary by an order of magnitude depending on how the liquid manure is managed. Even if more complete activity data are collected on manure storage systems, default Intergovernmental Panel on Climate Change (IPCC) guidance does not adequately capture the impacts of management decisions to reflect variation among farms and regions in inventory calculations. We propose a model that stays within the IPCC framework but would be more responsive to farm management by generating a matrix of methane conversion factors (MCFs) that account for key factors known to affect methane emissions: temperature, retention time and inoculum. This MCF matrix would be populated using a mechanistic emission model verified with on-farm emission measurements. Implementation of these MCF values will require re-analysis of farm surveys to quantify liquid manure emptying frequency and timing, and will rely on the continued collection of this activity data in the future. For model development and validation, emission measurement campaigns will be needed on representative farms over at least one full year, or manure management cycle (whichever is longer). The proposed approach described in this letter is long-term, but is required to establish baseline data for emissions from manure management systems. With these improvements, the manure management emission inventory will become more responsive to the changing practices on Canadian livestock farms.

Pediatric brain tumor survivors (PBTS) are at risk for late effects related to their diagnosis and treatment. Long-term medical follow-ups are deemed essential, implying a transition from pediatric to adult healthcare settings. This pilot study aims to assess the feasibility, acceptability, and preliminary effects of a targeted transition readiness intervention for PBTS. The program consisted of three hybrid workshops that targeted disease-related self-management skills, social skills, and cognitive functioning, as well as parallel workshops for their caregivers. The feasibility and acceptability were assessed through recruitment, retention, and satisfaction rates. Preliminary effects were primarily assessed via a pre/post assessment of transition readiness skills using the Transition Readiness Assessment (TRAQ) questionnaire. Among the eligible dyads, 12 (38%) consented to participate. Ten dyads participated in at least two workshops, and six dyads participated in all workshops. Overall, the participants were satisfied with the intervention (parents = 86%; PBTS = 73%). Although not statistically significant, a clinically relevant post-workshop increase in transition readiness skills was observed for PBTS (d = 0.36) and their caregivers (d = 0.25). The results suggest the relevance of the intervention and encourage further developments. Adjustments are needed to optimize reach and efficacy. The workshops have the potential to be adapted to be more accessible and shorter.

Introduction: In February 2022, we introduced the innovative new role of mental health nurse clinician (MHNC) in pediatric hematology/ oncology in a pediatric hospital in Quebec with the aim of better addressing the needs of young cancer patients and their families. In two previous articles, we explained the method used to develop the role, as well as the strategy employed to implement it., Objectives: In this article, we seek to evaluate the effectiveness of the implementation strategy by measuring role feasibility. We will also examine role acceptability and appreciation 1 year following implementation., Methodology: We asked three groups of participants (adolescents, parents and care providers) to complete a research questionnaire based on the Theoretical Framework of Acceptability (TFA), with good inter-rater reliability and discriminant validity. The questionnaire, which was made available online, consisted of statements with Likert-scale responses (from 1 to 5), as well as open questions. We performed a standard descriptive analysis and used the responses to the open questions to support or add nuance to the quantitative results., Results: In total, 31 healthcare professionals, 10 adolescent cancer patients and 10 parents of adolescent cancer patients filled out the questionnaire. Between February 2022 and February 2023, the MHNC provided a total of 691 interventions to 112 individuals (patients and parents). Follow-up sessions were offered to 61 individuals, and 99.6% of them accepted. We found a very strong correlation (r = 0.96) between the number of hours worked by the MHNC and the number of interventions provided. The vast majority of participants from all three groups agreed that the role is appropriate, appreciated and necessary, and that it brings much-needed clinical expertise in mental health to the department. Care providers, adolescents, and parents indicated that they would request this service again and would recommend it to others, if it were needed. The results, therefore, demonstrate excellent feasibility and high levels of acceptability and appreciation., Conclusion: Our study shows that the implemented MHNC role helps improve the clinical management of the mental health of adolescents with cancer, as well as their parents. The role brings much-needed expertise in psychiatric nursing care and supports the clinical practice of care providers. Another study will be conducted in the near future to measure the effectiveness of the MHNC's interventions., (© 2024 Canadian Association of Nurses in Oncology (CANO).)

Objective: The Psychosocial Assessment Tool (PAT) is a brief caregiver report, family-centered, psychosocial risk screening tool widely used in pediatrics and available in many languages. Although French is an official language of Canada, a French-Canadian version of the PAT has not yet been validated, which impedes access to this tool for family psychosocial screening. This study aimed to translate, adapt as necessary, and validate the French-Canadian version of the PAT., Methods: The PAT 3.0 was translated into French using the forward-backwards method. Interviews with healthcare workers (n = 5) and a focus group of parents of children newly diagnosed with cancer (n = 4) led to minor modifications to improve cultural adaptation and comprehensibility. Subsequently, 66 French-speaking parents of children newly diagnosed with cancer participated in a quantitative validation study; completing the French-Canadian PAT and related caregiver measures., Results: The French-Canadian PAT has an overall internal consistency of KR-20 = 0.64, with subscales ranging from 0.57 to 0.86. The total PAT score significantly correlated with the Distress Thermometer (r = 0.54). Congruent validity was demonstrated for most PAT subscales, except for Family Beliefs and Family Problems. The sample followed this distribution on the Pediatric Psychosocial Preventative Health Model: 21.2% universal, 53% targeted, and 25.8% clinical., Conclusion: The French-Canadian PAT provides insight into family psychosocial risk. This study is a step toward equitable access to care by providing French-speaking families with access to a tool aligned with the psychosocial standards of care in pediatric oncology. Future research should focus on implementing the PAT in Canadian clinical settings., (© 2024 The Author(s). Pediatric Blood & Cancer published by Wiley Periodicals LLC.)

Background: Pediatric cancer is associated with stressors that increase the risk for distress across family members. Psychosocial support varies and may not meet family needs and preferences. This study investigated family members' points of view regarding psychosocial service needs, as a first step of a large participative research project aiming to develop interventions grounded in key stakeholders' perspectives., Methods: This study documented the perceptions of 370 parents, 11 siblings, and 60 individuals who themselves had received a cancer diagnosis as a child and employed a mixed-methods design through an online survey., Results: Respondents indicated their key concerns were coping with intense emotions, accepting their feelings toward the diagnosis, and managing the psychological burden that accompanies cancer, its treatment, and associated life changes., Conclusion: The results suggest that an intervention program should address emotion management as well as interventions focusing on the entire family system.

Affect recognition has emerged as a potential mechanism underlying the social competence challenges experienced by pediatric brain tumour survivors (PBTSs). However, many social interactions were altered during the pandemic, with the widespread use of masking potentially impacting affect recognition abilities. Here, we examine affect recognition in PBTSs and typically developing youth (TD) after the onset of the global pandemic. Twenty-three PBTSs and 24 TD between 8 and 16 years old were recruited and completed two performance-based affect recognition tasks (full and partial facial features) and a self-reported questionnaire on mask exposure in their social interactions. Their parents completed parent proxy questionnaires on their child's social adjustment and sociodemographics. The scores between the PBTSs and TD did not differ significantly in full ( t (45) = 1.33, p = 0.19, d = 0.39, 95% CI [-0.69, 3.40]) or partial ( t (37.36) = 1.56, p = 0.13, d = 0.46, 95% CI [-0.47, 3.60]) affect recognition, suggesting similar affect recognition between the two groups. These skills were also not significantly correlated with social adjustment or mask exposure ( p > 0.05). However, the combined sample had significantly better scores in affect recognition when exposed to partial facial cues versus full. Additionally, participants obtained lower scores on a measure of full facial affect recognition and higher scores on a measure of partial affect recognition compared to pre-pandemic data. The pandemic may have influenced affect recognition across youth, underscoring the importance of further research into its lasting impact on the social competence of youth.

Background : Social competence is a domain in which pediatric brain tumour survivors (PBTS) are at risk of challenges. To follow-up on our earlier work, in this study we assessed specific social interaction behaviors and emotional functioning in PBTS relative to typically developing youth (TD). The study coincided with the onset of the global pandemic. Methods : Sixteen PBTS and 16 typically developing youth (TD) between 8-16 years old participated in the study. Youth completed an assessment of social behavior and parents completed online surveys regarding child social and emotional adjustment. Results : PBTS experienced greater impairments in social interaction behaviors and on indices of social adjustment relative to TD. PBTS and TD experienced similar levels of emotional problems. Social behavior challenges were associated with indices of anxiety, rather than depression. Time since pandemic onset was not associated with social emotional outcomes. Conclusions : It will be important to monitor and support the social adjustment of populations such as PBTS, as well as the emotional adjustment across PBTS and TD youth, following the pandemic.

Objective: The objective of this article is to describe the process of implementing and performing a preliminary assessment of an innovative mental health nursing practice in a pediatric hematology/oncology department. The preliminary assessment will help us determine whether the implementation strategy used was appropriate., Background: Pediatric cancers present patients and their families with many difficulties that can sometimes give rise to mental health issues during and after treatment. A mental health nurse clinician with expertise in hematology/oncology could help patients and families experiencing such issues by providing care that complements currently available psychosocial services. As implementing changes in practice is often challenging, and introducing a role without a clear plan can lead to failure, we decided it was important to develop a clear implementation strategy. Our project, which involves creating the role of a mental health nurse clinician (MHNC) in pediatric hematology/oncology, is divided into three stages: (1) development of the MHNC role, (2) development of an implementation strategy and (3) evaluation of role feasibility, acceptability and appreciation one year after implementation. In this article, we discuss the second stage. The objectives of this article are to (1) present the strategy involved in implementing the role of the MHNC and (2) report on the findings of a preliminary post-implementation assessment of the feasibility, acceptability and appreciation of the role for exploratory purposes., Methodology: The implementation strategy we developed was based on the approach proposed by Fry and Rogers (2009) and adapted to the context of our project. The five steps of the approach are: (1) the communication strategy, (2) the consultative process to define the role and scope of practice, (3) education, (4) the establishment of a support structure and (5) assessment and feedback mechanisms. This last step took the form of a preliminary exploratory assessment, which we performed by administering a survey to nurses, specialized nurse practitioners, and doctors three months after the MHNC role was implemented., Results: In the results section, we present our detailed five-step implementation plan. The preliminary results of the survey administered three months following implementation indicate that the MHNC worked an average of 150 hours a month and carried out 22.7 consultations and 52.3 follow-ups per month, the average length of which was 53.1 minutes. In all, 96% of the healthcare professionals who responded to the survey said that someone with this type of expertise is needed in pediatric hematology/oncology, and only 28% said that they themselves felt they had the knowledge and skills required to effectively manage the medications used to treat mental health disorders., Conclusion: Our results seem to confirm the feasibility, acceptability, and appreciation of the MHNC role, suggesting that the implementation strategy proposed by Fry and Rogers (2009) is well suited to the development of a mental health nursing practice in pediatric hematology/oncology. In the third stage of this project, we will carry out a structured, rigorous assessment of the role's feasibility, acceptability, and appreciation by patients, families, and healthcare professionals one year after implementation., (© 2024 Canadian Association of Nurses in Oncology (CANO).)

Introduction: Pediatric hematological and oncological illnesses present many coping challenges. Mental health issues can arise during and after treatment, in both patients and their families. The current model of care does not always seem to meet the needs identified by some young patients. In Quebec, nurses are allowed to assess and care for patients experiencing physical and mental health difficulties (Ordre des infirmières et infirmiers du Québec, 2016). Therefore, a mental health nurse clinician (MHNC) with experience in pediatric hematology/oncology could provide care that is complementary to that offered by psychologists, social workers, and other psychosocial professionals in the pediatric hematology/oncology unit in order to meet any needs that remain unmet. The MHNC project has three stages: (1) role development, (2) role implementation, and (3) role assessment one year after implementation. In this first article, we explain how the MHNC role was developed., Methodology: We used the participatory, evidence-based, patient-focused process for advanced practice nursing (APN) role development, implementation, and evaluation (PEPPA Framework; Bryant-Lukosius & Dicenso, 2004) to develop this model. The first five steps in the PEPPA Framework were applied in the creation of the MHNC role to (1) select the target population, (2) identify the stakeholders to be involved, (3) ascertain needs, (4) determine and prioritize problems and set goals, and (5) define a new model of care., Results: After multiple meetings involving numerous health professionals and managers, the MHNC role was developed with a versatile, transdisciplinary perspective to address better the needs of young cancer patients (especially those in their teens) and their families. The role was developed around four main areas of practice: (1) interventions offered to patient-family, (2) interventions offered to health professionals, (3) psychiatric consultation-liaison, and (4) education and research., Conclusion: The next steps are to use a strategic plan to implement the role and then to evaluate the impact of the role one year after implementation., (© 2024 Canadian Association of Nurses in Oncology (CANO).)

Background: Pediatric brain tumor survivors (PBTS) are at risk of physical, cognitive, and psychosocial challenges related to their diagnosis and treatment. Routine follow-up care as adults is therefore essential to their long-term health and quality of life. In order to successfully navigate to adult healthcare, it is recommended that youth develop transition readiness skills. Existing transition readiness interventions often focus on disease management. However, PBTS are also at risk of social competence and cognitive functioning challenges. In this paper, we describe the protocol of this pilot study and the methodology that will be used for the evaluation of the feasibility, acceptability, and preliminary efficacy testing of the first targeted transition intervention workshops specifically designed to meet the needs of PBTS and their caregivers., Methods: This study will use a mixed method to evaluate three 1 ½-h workshops targeted for dyads (N = 40) of PBTS (14 years or older) and their parents. Dyads will be recruited via a community pediatric cancer organization and the long-term follow-up clinic of a large pediatric hospital. Participants will complete an online survey which includes the Transition Readiness Assessment Questionnaire (TRAQ) before and after the workshops. Each workshop will cover a specific topic related to PBTS transition readiness: disease management, social competence, and cognitive functioning. Workshops will follow the same structure: topic presentation, discussion by a post-transfer survivor or parent, teaching two strategies, and workshop evaluation. Workshops will be co-led by healthcare specialists and patient partners. Feasibility and acceptability will be assessed via recruitment, attendance, retention, and Likert scales, and they will be analyzed by describing and comparing rates. Satisfaction will be measured using satisfaction surveys and audio-recorded focus groups. Qualitative data will be described through thematic content analysis. In order to test the preliminary efficacy of this study, we will compare transition readiness skills pre- and post-workshops using paired samples T test and ANCOVA to examine the impact of workshop on TRAQ skills., Discussion: Results of the study will inform refinement and future broader implementation of targeted transition readiness workshops for the specific needs of pediatric brain tumor survivors., (© 2024. The Author(s).)

Background: Solid evidence of the safety and effectiveness of retinoblastoma (RB) conservative treatment using thermotherapy and systemic chemotherapy with long-term follow-up is scarce, especially in low-resource countries., Aims: This study examined the outcomes of this treatment and associated predictors in Vietnam to strengthen the current RB treatment protocol focusing on preserving eye and vision in low-resource settings., Methods and Results: A prospective cohort study was conducted at Ho Chi Minh City Eye Hospital in Vietnam from 2005 to 2019. All eligible patients with bilateral RB (one eye already removed and another eye classified as group A or B) and without previous treatment were recruited. All patients received thermotherapy and six cycles of systemic three-agent chemotherapy repeated every 4 weeks. A standardized questionnaire was used to collect information on study participants' age, symptoms, tumor characteristics, treatment, and outcomes. Among 50 eyes of all 50 patients with a median age of 9 (4-20) months, 34 eyes were in group B (68%). The median follow-up time was 60 (60-84) months. All 139 preserved tumors regressed mostly to type 4 (70.4%) and type 3 (23.7%) scars. Kaplan-Meier analysis found the overall globe-salvage rate at 5 years of 91.9% (95% CI: 80.1%-97.7%). Most eyes (41/50, 82%, 95% CI: 69.2%-90.2%) had a final visual acuity ≥0.1. The visual acuity is higher when tumors regressed to a type 4 scar (p = .007, AOR = 8.098, 95% CI: 1.79-36.53) which also shows less enucleation than a type 3 scar (p = .002, AOR = 0.06, 95% CI: 0.01-0.37%). Gender effect on visual acuity after treatment was significant and may be due to discrimination. No major complications were recorded., Conclusion: Conservative treatment of early-stage RB is safe and effective. Long-term, thorough follow-ups of patients post-treatment are needed. The regression patterns of scars could be a useful indicator of treatment failure., (© 2023 The Authors. Cancer Reports published by Wiley Periodicals LLC.)

Background: Transferring from paediatric to adult care can be challenging. Adolescents and young adults (AYAs) with chronic health conditions need to develop a specific set of skills to ensure lifelong medical follow-up due to the chronicity of their condition. The Transition Readiness Assessment Questionnaire-French version (TRAQ-FR) is a 19-item questionnaire measuring such skills. The aims of the study were to (1) describe participant characteristics and (2) identify constructs related to, and predictors of, having learned domain-specific transition readiness skills., Methods: Participants included 216 AYAs aged 14-20 years (M = 15.93; SD = 1.35; 54.1% male) recruited from five outpatient clinics in a Canadian tertiary hospital. AYAs completed the TRAQ-FR, the Pediatric Quality of Life Inventory 4.0 (PedsQL) and a sociodemographic questionnaire. Descriptive, bivariate and binary logistic regression analyses were conducted., Results: Overall, participants reported significantly higher scores on the Talking with Providers, Managing Daily Activities and Managing Medications subscales than on the Appointment Keeping and Tracking Health Issues subscales (F[41075] = 168.970, p < .001). At the item level, median scores (on a 5-point Likert scale) suggest that AYAs had begun practising five of the 19 skills (median scores ≥4; 'Yes, I have started doing this'), while a median score of 1 ('No, I don't know how') was found for one item ('Do you get financial help with school or work?'). At the subscale level, TRAQ-FR skills and skill gaps were related to AYAs' age, sex and PedsQL scores (ps < .05)., Conclusion: Older and female AYAs were more likely to have begun practising specific TRAQ-FR subscale skills. Better psychosocial functioning was also related to having learned specific transition readiness skills. AYAs show several gaps in transition readiness. Targeted intervention in transition readiness skill development could take into account AYAs' age, sex and psychosocial functioning for a successful transfer to adult care., (© 2023 John Wiley & Sons Ltd.)