Search

Breast cancer is the second leading cause of cancer death for women, whereas ovarian cancer is the deadliest gynecological cancer. Breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2) mutations can increase the risk of developing breast and ovarian cancer. Screening can assist in prevention and early detection. This study aimed to increase provider knowledge of BRCA mutations, the use of BRCA screening tools, and genetic referrals. An Institutional Review Board–approved study was implemented for providers for training on BRCA1 and BRCA2 mutations and the importance of screening and referral for those at risk. Measures included provider confidence and knowledge after training as well as number of patient referrals. A standardized webinar was required with further education provided in multiple modalities. The number of BRCA screenings and referrals for genetic screening was monitored through the electronic health record (EHR). Eight providers including five nurse practitioners and three medical doctors participated in the complete project. As a result, 56 patients were BRCA screened, and four referrals were made to receive genetic counseling. Education enhanced knowledge, increased screening tool use, and resulted in improvement in genetic referrals through the EHR. [ABSTRACT FROM AUTHOR]

In an era when resources, time, and attention spans are limited, nursing educationmust be delivered in amanner that is economical and convenient while retaining the ability to hold consumers accountable for their learning. This article highlights one organization's solution toagap inevidence-based practice education. Professional development practitioners utilized their own creative acumen to develop high-quality, organization-specific resources that provide education in an engaging, portable, and user-friendly format. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The diagnosis of endometriosis, a common gynecologic condition, is characterized by delays of up to 11 years. During this time, women may experience persistent symptoms that affect their quality of life, productivity, and relationships, and the disease may progress. It is therefore a priority to understand the factors that contribute to this delay to help improve the diagnostic pathway. Our objective was to describe the diagnosis barriers of endometriosis from the patient and health care professional perspectives using a qualitative evidence synthesis. DATA SOURCES: We searched MEDLINE, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature using combinations of the synonyms of endometriosis, diagnosis, and qualitative research. The search was restricted to English-language articles from database creation until May 2022. METHODS OF STUDY SELECTION: The initial search yielded 899 articles. Studies were included if they explored the experiences or views of affected women or health care professionals on the diagnosis of endometriosis and used qualitative methods for data collection and data analysis. Risk of bias was assessed with the Critical Appraisal Skills Programme checklist. TABULATION, INTEGRATION, AND RESULTS: Thirty-seven articles were considered for full review, with 13 eligible articles identified for inclusion. Thematic synthesis was used to identify four key themes: 1) individual factors (n56), 2) interpersonal influences (n56), 3) health system factors (n513), and 4) factors specific to endometriosis (n513). These encompassed 12 subthemes that represented barriers to the diagnosis of endometriosis: 1) difficulty establishing pathologic symptoms from normal menstruation and the use of self-care techniques; 2) menstrual stigma and the normalization of menstrual pain; 3) attitudes and lack of training for health care professionals, delayed referrals to specialist services, and poor explanation of oral contraceptive pill use in the diagnostic process; and 4) variability in presenting symptoms, overlap with other conditions, lack of a noninvasive method of diagnosis, and concerns about the value of a diagnosis. CONCLUSION: This review identified barriers to the timely diagnosis of endometriosis from the perspective of affected individuals and health care professionals. It highlights areas for improvement along the diagnostic pathway, which may guide future strategies to reduce delays. [ABSTRACT FROM AUTHOR]

Preparing students for ethical situations they will face in practice should be incorporated into nursing curricula, especially programs with a Christian focus. Linking ethical concepts with tenets from Scripture can increase students' confidence in their ability to respond through a biblical worldview to ethical dilemmas in nursing practice. Specific assignments can be geared to help students think critically about the Code of Ethics for Nurses with Interpretive Statements (Code) and biblical responses to ethical situations. Sample assignments are presented for the nine provisions of the Code. [ABSTRACT FROM AUTHOR]

Older adults from underrepresented racial and ethnic backgrounds and with low vision have independently been found to be at an increased risk of depression. This retrospective cross-sectional pilot study found that non-White older adults with low vision reported significantly more depressive symptoms than White older adults with low vision (P =.005). When controlling for diagnosis and functional impairment, the relationship was no longer significant. Older adults with low vision from underrepresented racial and ethnic groups may be more at risk for depression than White older adults with low vision, with comorbid visual conditions potentially contributing to this relationship. [ABSTRACT FROM AUTHOR]

Moderate to severe chronic pain affects 1 in 5 adults and its impact increases with age. People with chronic pain that interferes with their lives have an increased risk of mortality. Identifying how interfering chronic pain can lead to mortality may highlight potential intervention strategies. This study uses a novel approach to test whether lifestyle, health, social, and psychological factors mediate the relationship between pain and mortality. Survival analyses (Cox's proportional hazard modelling and a technique to assess mediation within survival models) were conducted on a large population study of adults aged 50 years or older from the English Longitudinal Study of Ageing (n = 6324). Data collected at wave 2 (2004) were used as baseline and follow-up was until 2012. The relationship between being "often troubled with pain" and mortality was examined. Lifestyle, health, social, and psychological factors were tested as potential mediators. The strongest mediating factors for the relationship between troubling pain and mortality were functional limitation (hazard ratio 1.31; 95% confidence interval 1.20-1.39), symptoms preventing walking quarter of a mile (1.45 [1.35-1.58]), physical inactivity (1.14 [1.10-1.20]), and poor self-rated health (1.32 [1.23-1.41]). Mediators of the relationship between troubling pain and mortality provide targets for preventive health programmes. Interventions to improve general health, activity, and function could improve long-term survival in patients with this clinical problem. [ABSTRACT FROM AUTHOR]

The article studies a comparison of healthcare access for older adults with disabilities to older adults without disabilities, and the effect of policies to healthcare access. Results revealed that older adults with disabilities exhibit disparities in healthcare access as compared to older adults with no disabilities. Also, it was found that implementations of legislation such as the Americans with Disabilities Act of 1990 (ADA) and Medicare had no significant impact on accessibility.

This article describes ways to develop a Case Management System that includes the principles of care planning by using an interdisciplinary team across the continuum of health services. Copyright © 2002 by Aspen Publishers, Inc. [ABSTRACT FROM AUTHOR]

Urinary incontinence has significant medical, social, psychologic, and economic implications. Continence management requires a sensitive, comprehensive, and holistic approach that accounts for the many facets of this distressing and life-altering condition. Assessment of urinary incontinence includes a focused physical examination, comprehensive history, and accounting for factors that can impact continence, such as cognition, functional ability, and impact on quality of life. Behavioral therapy for incontinence includes diet modification, toileting programs, bladder retraining, and pelvic muscle re-education. Biofeedback and electrical stimulation are treatment modalities that help clients to identify, recruit, and strengthen pelvic floor muscles and improve treatment outcomes. Other approaches include medications and devices, such as a pessary. Key words: advanced practice, behavior therapy, biofeedback, incontinence [ABSTRACT FROM AUTHOR]

Atherosclerotic coronary artery disease is a leading cause of illness and death in the United States, affecting 25% of adults and 10% of children. This preventable disease can be screened for and treated, following established guidelines. Early identification and treatment of childhood hyperlipidemia should further reduce the excessive number of deaths attributed to coronary heart disease (CHD). This review article explores the relationship of childhood cholesterol levels to CHD, diagnostic criteria, and dietary treatment. It further explores the genetic factors that may modulate dietary effects on lipid metabolism and reinforces the value of medical nutrition therapy. [ABSTRACT FROM AUTHOR]

Examines the common medications used in pharmacologic management of urinary incontinence in older adults. Medications for urge incontinence; Bladder storage agents; Bladder emptying agents.

Provides information on the methodologies used by Sierra Health Services in Las Vegas, Nevada to meet its nursing shortage challenges. Utilization of long-range plans for recruitment and retention of skilled personnel; Adoption of a nurse intern program that promotes recruitment at nursing school level; Selection of appropriate candidates for nursing.

The article focuses on coronary artery bypass grafting (CABG) surgery. It is a delicate procedure, which requires surgical skill to sew new blood vessels to the walls of the heart, bypassing arteries with blockage. Traditionally performed on a stilled heart by cardioplegia, the operation may last up to five hours or more, wherein the patient must be sustained on the heart-lung machine.

Presents instructions for getting accurate results with an easy-to-use ultrasound device for measuring bladder volume. Features of the BladderScan BVI 3000; Points to remember.

In an era when resources, time, and attention spans are limited, nursing education must be delivered in a manner that is economical and convenient while retaining the ability to hold consumers accountable for their learning. This article highlights one organization's solution to a gap in evidence-based practice education. Professional development practitioners utilized their own creative acumen to develop high-quality, organization-specific resources that provide education in an engaging, portable, and user-friendly format., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)