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School nurses are at the forefront of health care providers for many families of junior high and high school students and are used as primary sources of information and guidance about recommended student vaccinations. In the case of the relatively new vaccine for human papillomavirus (HPV), school nurses must be both knowledgeable about the infection itself and unbiased when asked to give students and families information about the vaccine. This article explores the development and current status of HPV and the HPV vaccine and the ethical principles of autonomy, utilitarianism, beneficence, nonmaleficence, justice, and cultural and religious issues as they relate to discussions with students and families about HPV vaccinations. School nurses are advocates for the health of students. Therefore, they must critically evaluate the application of these ethical principles when providing information and recommendations about the HPV vaccination. [ABSTRACT FROM AUTHOR]

CONTEXT: A recent survey of rural Midwestern cancer patients revealed that humor was one of the most frequently used complementary therapies. Psychoneuroimmunology research suggests that, in addition to its established psychological benefits, humor may have physiological effects on immune functioning. OBJECTIVE: To determine the effect of laughter on self-reported stress and natural killer cell activity. DESIGN: Randomized, pre-post test with comparison group. SETTING: Indiana State University Sycamore Nursing Center, which is a nurse-managed community health clinic in a mid-sized, Midwestern city. PARTICIPANTS: 33 healthy adult women. INTERVENTION: Experimental subjects viewed a humorous video while subjects in the distraction control group viewed a tourism video. MAIN OUTCOME MEASURES: Self-reported stress and arousal (Stress Arousal Check List), mirthful laughter (Humor Response Scale), and immune function (chromium release natural killer [NK] cell cytotoxicity assay). RESULTS: Stress decreased for subjects in the humor group, compared with those in the distraction group (U32 = 215.5; P = .004). Amount of mirthful laughter correlated with postintervention stress measures for persons in the humor group (r16 = -.655; P = .004). Subjects who scored greater than 25 on the humor response scale had increased immune function postintervention (t16 = 2.52 P = .037) and compared with the remaining participants (t32 = 32.1; P = .04). Humor response scale scores correlated with changes in NK cell activity (r16 = .744; P = 001). CONCLUSION: Laughter may reduce stress and improve NK cell activity. As low NK cell activity is linked to decreased disease resistance and increased morbidity in persons with cancer and HIV disease, laughter may be a useful cognitive-behavioral intervention. [ABSTRACT FROM AUTHOR]

PURPOSE/OBJECTIVES: To present barriers and strategies related to successful clinical trial participation and integrate them into a model for successful trial participation. DATA SOURCES: The proposed model was developed based on a literature review related to clinical trial participation, review of empirical studies related to clinical trials, and experiences with subject participation. DATA SYNTHESIS: Successful clinical trial participation depends on study design, participant factors, issues related to ethnic diversity, the informed consent process, and physician factors. CONCLUSIONS: Clinical trial participation is critical for all disciplines. However, nurses either are researchers or co-investigators with physicians on clinical trials, and it is critical for them to understand specific barriers and success strategies for patient participation. Future studies need to be conducted related to participation in nursing clinical trial research. These study results will facilitate successful nursing clinical trials. IMPLICATIONS FOR NURSING PRACTICE: This model can be used in implementation of clinical trials across disciplines prior to and during enrollment of patients into studies. [ABSTRACT FROM AUTHOR]