America’s children and teens are gaining…weight. As many as 16.9 percent of children ages 2-19 are obese; another 14.8 percent are overweight, placing them at risk for later, chronic problems ranging from diabetes and sleep apnea to depression and heart disease.

In an exploration of childhood obesity, [“Overview of the epidemiology and management of childhood obesity,” Minerva Pediatrica, Dec. 2012], Johns Hopkins University School of Nursing (JHUSON) graduate student Lisa Santo Domingo, MSN, RN, CPNP, and a colleague describe the scope of the epidemic, its medical complications, and the key role primary care providers play in treatment and prevention.

And, according to researcher Douglas A. Granger, PhD and colleagues, how a child responds to stressful events and environments may play a role in the propensity for obesity. The study examined relationships among children’s weight, eating, and levels of the stress hormone cortisol. Tracking amounts of cortisol in the saliva of test subjects (ages 5 to 7 and 8 to 9 ) provided a proxy measure for the capacity for self-control, a factor implicated in stress eating and, therefore, obesity. According to Granger, “Children react differently to stress, based on their resilience, environment, and capacity for self-regulation. If we can identify those young people at risk for greater stress responses, then we may be able to intervene to reduce the likelihood of comfort eating as a stress response” [“Adrenocortical regulation, eating in the absence of hunger and BMI in young children,” Appetite, Dec. 2012].

In other articles, Granger and colleagues note that pediatricians play a key role in reducing chronic stress, which can place children at risk for serious health problems—ranging from depression to heart disease, asthma, and cancer—in later life [“The science of early life toxic stress for pediatric practice and advocacy.” Pediatrics, online January 2013] and found that physical and emotional responses to stress in people with borderline personality disorder (BPD) far exceed those in healthy individuals [“Biobehavioral reactivity to social evaluative stress in women with borderline personality disorder,” Personality Disorders: Theory Research and Treatment, December 2012].

Texts, Calls Reduce No-Shows

When patients miss clinic appointments for treatment of a chronic problem like diabetes, they risk serious medical complications; clinics lose time and money. In The Journal for Nurse Practitioners (Nov.-Dec. 2012), assistant professor Sharon Olsen, PhD, RN; JHUSON graduate Elie Salameh, DNP, CRFNP, and colleagues report how three simple actions cut a 25 percent no-show rate at a primary care clinic to just under 7 percent within two follow-up visits among patients with diabetes. The steps included patient education about the importance of keeping appointments, updating patient contact data at each visit, and up to three timely text, phone, or mail reminders about appointments.

Olsen says, “Our findings from this small study are encouraging. Future research may tell us if a similar approach could help reduce no-shows among patients with other chronic illnesses, leading to better health for the patient and more cost-effective health care, too.” [“Nonattendance with clinic follow-up appointments: Diabetes as exemplar.”]

In Other Nursing Research News

Simulation technologies that provide hands-on health care training can be expensive. Pamela R. Jeffries, PhD, RN, and colleagues describe how a consortium of schools and programs pooled personnel, knowledge, and finances to create a regional simulation learning environment. [“Creating a professional development plan for a simulation consortium. Clinical Simulation in Nursing. December 2012.]

An innovative new process created by associate professor Sarah L. Szanton, PhD, CRNP, associate professor Mary Terhaar, DNSc, RN, and a Johns Hopkins School of Public Health colleague helps students in the Doctor of Nursing Practice program understand when and if their research requires human subject protection approval [“Development of an institutional review board preapproval process for DNP students: Process and outcome.” Journal of Nursing Education, December 2012].

In AACN Advanced Critical Care [Jan-Mar 2013], professor Cynda Hylton Rushton, PhD, RN, examines the dilemma that critical care clinicians face when patient or family treatment wishes collide with moral and medical principles [“Principled moral outrage: An antidote to moral distress”].

In the December 2012 Journal of Addictions Nursing, associate professor Joan Kub, PhD, RN, explores outreach, peer assistance, and other services for nurses experiencing addiction or mental problems with an expert in the field. [“An interview with Stephanie K. Trumm, RN, CARN.”]