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Background: Family relationships and social networks are critically important to adolescents and young adults (AYAs) with cancer, impacting their experience and well-being throughout the cancer trajectory. A cancer diagnosis impacts the development of independence and an adult identity, which can present challenges to psychosocial well-being needs and relationships between caregivers and AYAs., Objective: The aim of this study was to explore the psychosocial and support needs of the main caregivers of AYAs., Methods: This is a secondary analysis of the BRIGHTLIGHT caregiver survey, exploring items pertaining to support offered/engaged with, appraisal of helpfulness, and caregivers' emotional and psychological distress experience. Descriptive statistics, a correlational analysis, and a 1-way analysis of variance were conducted., Results: There were 518 caregiver responses (62%). Over half received information about their caregiving needs, with the majority finding this very/fairly helpful. Most (80%) of those who had not received the information would have valued it. High levels of negative emotional and psychological well-being were reported, with 91% feeling depressed or anxious since the AYAs' diagnosis and 41% always/often experiencing these feelings. Total distress was associated with being younger, a parent, female, and unemployed, and earning a below-average income., Conclusions: The needs of caregivers are broad and multidimensional; however, some characteristics were associated with higher distress. When caregiver-specific information was provided by healthcare professionals, it was well received., Implications for Practice: Healthcare professionals should consider caregivers' needs individually and provide/signpost to support. Caregivers need to be involved in designing and implementing future research, given the heterogeneity of needs identified., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Technology is becoming an important medium for supporting patients in health care. However, successful application depends on user acceptability. The Advanced Symptom Management System (ASyMS) involves patients reporting cancer chemotherapy-related symptoms using mobile phone technology., Objective: The aim of this article was to report a study of how young people were involved in the development of ASyMS using the Medical Research Council framework for evaluating complex interventions., Methods: A convenience sample of young people aged 13 to 18 years undergoing cancer chemotherapy were recruited from 2 principal cancer treatment centers in London., Results: In phase 1, young people selected 5 symptoms from an adapted version of the Memorial Symptom Assessment Scale that were most important to them. In phase 2, young people completed the ASyMS-YG PDA (personal digital assistant) questionnaire daily on days 1 to 14 of a cycle of chemotherapy and pre/post-use questionnaires. In phase 1, 5 young people chose diarrhea, nausea, vomiting, constipation, and weight loss as the most important symptoms. In phase 2, 25 young people reported positively to using PDA technology, found ASyMS-YG simple and easy to complete, and liked that they were monitored at home. In addition to the 5 core symptoms, the ASyMS-YG reports showed the number (n = 37) of other symptoms young people experienced., Conclusions: This early development work indicates the acceptability of ASyMS-YG and has informed an exploratory trial (phase 3) and randomized controlled trial (stage 4)., Implications for Practice: This study reaffirms the importance of promoting communication between young people and health professionals.

Objective: To determine whether critically ill children are hypermetabolic and to calculate whether predictive equations are appropriate for critically ill children., Design: Prospective, clinical study., Setting: Pediatric intensive care unit., Patients: A total of 57 children (39 boys) aged 9 months to 15.8 yrs., Interventions: None., Measurements and Main Results: The median resting energy expenditure measurement measured by indirect calorimetry was 37.2 (range, 11.9-66.6) kcal x kg(-1) x day(-1). This was significantly lower than would be predicted using either the Schofield (42.7 [26.9-65.4] kcal x kg(-1) x day(-1)) or Fleisch equations (42.8 [20.9-66.2] kcalx kg(-1)-1 x day(-1), p < .001) but significantly higher than the White equation developed specifically for pediatric intensive care units (26.2 [8.5-70.1] kcal x kg(-1),day(-1), p < .0001). Methods comparison analysis showed the limits of agreement were -484 to 300, -461 to 319, and -3.2 to 854 kcal/day, respectively. Multivariate analysis indicated the following factors contribute to hypometabolism and hypermetabolism: age (p = .006), sex (p = .034), time spent in the pediatric intensive care unit (p = .001), diagnosis (p = .015), weight (p = .009), temperature (p = .04), continuous infusion for sedation (p = .04), and neuromuscular blockade (p = .03)., Conclusion: Children do not become hypermetabolic during critical illness. These data suggest that agreement between resting energy expenditure and the predictive equations are so broad that they are inappropriate for use in critically ill children.