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Nicholas J Bush,1 Melissa R Schick,1 Nichea S Spillane,1 Jeff Boissoneault2 1Department of Psychology, University of Rhode Island, Kingston, RI, USA; 2Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USACorrespondence: Nichea S Spillane, Department of Psychology, University of Rhode Island, 130 Flagg Road, Kingston, RI, 02881, USA, Tel +1 401-874-4252, Email nspillane@uri.eduBackground: Alcohol use in young adults is highly prevalent and associated with numerous consequences, including academic difficulties and motor vehicle accidents. Pain is one factor that has been increasingly shown to be associated with higher rates of alcohol consumption and riskier patterns of drinking among undergraduate students. Although pain has traditionally been viewed as a lesser concern for young adults, current research demonstrates that pain may be more prevalent in younger populations than originally thought. However, little is known about how common psychosocial factors, such as stress and subjective social status (SSS), influence the association between pain and alcohol consumption in college students.Objective: The study’s goal was to examine the effect of stress and SSS on the relationship between pain and alcohol consumption.Participants and Methods: Participants (N = 445, 39.3% women, Mage= 22.98) were 18- to 25-year-old college students who completed an online questionnaire.Results: Pain was significantly associated with total weekly alcohol consumption (r(445) = .22, p < 0.001); this association was significantly mediated by stress (b = 0.15, SE = 0.04, 95% CI = [.07,0.23]). SSS was significantly positively associated with alcohol consumption (r(445) = .22, p < 0.001) but was not found to significantly moderate the relationship between stress and alcohol use.Conclusion: Results suggest that efforts to reduce college student alcohol use should include assessment of pain and stress given their association with alcohol consumption. Further, findings suggest that future studies are warranted to prospectively examine pain as an antecedent for alcohol use and to examine the utility of incorporating stress management techniques in pain-focused interventions to indirectly target alcohol use.Keywords: alcohol, stress, pain, college students

PURPOSE/OBJECTIVES: To describe the development of the role of an oncology nurse practitioner (ONP) in a private practice. DATA SOURCES: Articles, book chapters, and personal experience. DATA SYNTHESIS: Successful role implementation will be facilitated by using a collaborative model supported by a shared philosophy of practice, written agreements delineating shared responsibilities and accountability, incorporation of the role into day-to-day practice, and regular evaluation and readjustment of goals. CONCLUSIONS: As oncology care has transitioned to outpatient settings, the role of the ONP can effectively meet both the medical and nursing needs of patients. A collaborative practice model can provide the framework for the physician-nurse professional relationship to ensure a higher level of patient care within the private practice selting. IMPLICATIONS FOR NURSING PRACTICE: The shift of health care to outpatient and private practice settings and the increased availability and use of ONPs mandates a systematic understanding of the process of ONP role development. [ABSTRACT FROM AUTHOR]

Background: Alcohol is a commonly used substance associated with significant public health consequences. Treatment is often stigmatized and limited with regard to both access and affordability, demonstrating the need for innovations in alcohol treatment. Accelerometer sensors can detect drinking without user input and are widely incorporated into wearable devices, increasing accessibility and affordability., Methods: We compared a distributional and random forest classification approach to detect and evaluate sensor-based drinking data. Data were collected at a local state fair (n = 194), where participants drank water at specified intervals interspersed with confounding behaviors (e.g., touching nose, rubbing forehead, or yawning) while wearing an Android-based smartwatch for 10 min. Participants were randomized to receive one of three drinking container shapes: pint, martini, or wine., Results: The random forest model achieved an overall testing accuracy of 93% (sensitivity = 0.32; specificity = 0.99; positive predictive value = 0.74). The distributional algorithm achieved an overall accuracy of 95% (sensitivity = 0.76; specificity = 0.97; positive predictive value = 0.72). The distributional algorithm had a significantly greater accuracy (t(193) = 7.73, p < 0.001, d = 0.56) and sensitivity (t(193) = 24.5, p < 0.001, d = 1.76). Equivalency testing demonstrated significant equivalency to the ground truth for sip duration (t lower (193) = 16.92, p < 0.001; t upper (193) = -9.85, p < 0.001) and between-sip interval (t lower (193) = 1.72, p = 0.044; t higher (193) = -3.96, p < 0.001). However, the random forest did not have significant equivalency to the ground truth for between-sip interval (t lower (193) = 1.98, p = 0.025; t higher (193) = 0.160, p = 0.564)., Conclusions: Overall, the results indicated that consumer-grade smartwatches can be utilized to detect and measure alcohol use behavior using machine learning and distributional algorithms. This work provides the methodological foundation for future research to analyze the behavioral pharmacology of alcohol use and develop accessible just-in-time clinical interventions., (© 2024 The Author(s). Alcohol, Clinical and Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcohol.)

Background: Studies of alcohol analgesia often assume that changes in pain sensitivity reflect the negative reinforcing effects of alcohol in pain self-management. However, factors that may influence perceived pain relief due to alcohol use remain incompletely characterized. Thus, the primary aim of this study was to identify which factors are most strongly related to self-reported pain relief in individuals with and without chronic pain after alcohol consumption., Methods: This study combined data from two studies of alcohol analgesia in individuals who regularly consume alcohol with and without chronic pain. Alcohol analgesia expectancies were assessed during screening. In laboratory sessions, participants received an alcohol-containing (.08 g/dL target BrAC) or placebo beverage and rated subjective intoxication and subjective response (positive/negative aspects of stimulation/sedation). Participants underwent quantitative sensory testing to measure pain intensity, pain threshold, and relief. Paired sample t-tests determined effects of alcohol on pain measures. Hierarchical linear models determined factors associated with pain relief ratings in the alcohol condition., Results: Pain relief and pain threshold were higher in the alcohol session relative to placebo, but pain intensity did not differ. In a 4-step hierarchical linear model, expectancy of pain relief, subjective intoxication, and high positive affect, but not pain threshold or pain intensity, were significantly and uniquely associated with perceived relief., Conclusions: Taken together, results suggest the negative-reinforcing effects of alcohol for pain-management are not completely reflected by changes in pain sensitivity in a laboratory setting. Expectancies and subjective response may be important in determining an individual's evaluation of alcohol's efficacy for pain self-management., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors.)

Processes for intravesical chemotherapy after transurethral resection of nonmuscle invasive bladder tumors may lack standardization. In 2019, at a large health care system in Los Angeles, California, five incident reports involving chemotherapeutic agent spills from urinary catheters after bladder tumor procedures necessitated a quality improvement project. The project lead determined that a cost-effective alternative device for securing the chemotherapeutic agent in the bladder was needed at four surgical locations of the health care system. In addition, a review of the literature and an observational assessment revealed lack of adherence to standard and recommended processes for using personal protective equipment (PPE) when handling hazardous medications. After revising existing processes, acquiring a cost-effective clamp and recommended chemotherapy PPE, instructing personnel on the clamping process and use of PPE, and implementing use of the clamp, there have been no spills associated with intravesical chemotherapy across the four surgical locations., (© AORN, Inc, 2024.)

Objectives: Substance use and pain are both growing public health concerns globally. Evidence suggests that individuals may use substances in order to self-medicate their pain. The Catastrophizing, Anxiety, Negative Urgency, and Expectancy model was developed to provide a theoretical foundation for the modifiable risk factors implicated in self-medication of pain with substance use. This study aimed to use the outcomes in the Catastrophizing, Anxiety, Negative Urgency, and Expectancy model to develop a brief clinical screening tool to identify individuals at risk for self-medication., Methods: Participants (N = 520; M age = 38.8) were adults who endorsed the past three-month use of at least one substance and completed an online questionnaire. Logistic regression and receiver operator characteristic analyses were used to reduce the initial 104-item questionnaire to the items needed to achieve a minimum accuracy score of 0.95 and 0.90., Results: A 14-item and a 7-item questionnaire were derived from the initial larger questionnaire. Both of these questionnaires were significantly correlated with the outcome variables and were significantly associated with health risk and percent of use because of pain. The R2 values between the 14- and 7-item versions were only significantly different for the percent of alcohol use because of pain., Conclusions: The study provides two brief screening tools to screen for individuals at risk for self-medication of pain with substance use that can be easily implemented within clinical settings. Further, the screening tools provide insight into modifiable risk factors for self-medication and may also be valuable to monitor treatment response., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 American Society of Addiction Medicine.)

Although laboratory studies indicate alcohol reduces pain intensity and increases pain threshold, these effects likely do not completely explain perceived pain relief from alcohol intake. In this study, we tested expectancy of alcohol analgesia (EAA) as a moderator of subjective pain relief following oral alcohol challenge in individuals with and without chronic orofacial pain. Social drinkers ( N = 48; 19 chronic pain; 29 pain-free controls) completed two testing sessions: alcohol administration (BrAC: 0.08 g/dL) and placebo. Alcohol expectancy (AE) was assessed using the EAA questionnaire and two 100-mm Visual Analogue Scales (VASs) regarding strength of belief that alcohol provides pain relief (AE VAS 1) or reduces pain sensitivity (AE VAS 2). Participants completed quantitative sensory testing (QST) involving application of pressure to the masseter insertion. Pain threshold (lbf; three repetitions) and pain intensity (4, 5, and 6 lbf; three repetitions each; 100-mm VAS) were collected. After each stimulus, participants rated perceived pain relief due to consumption of the study beverage (0-100 VAS). Higher EAA and AE VAS 1 ratings were associated with stronger perceived relief in the alcohol, but not placebo, condition. However, expectancy specifically related to reduction in pain sensitivity (AE VAS 2) was not associated with relief. Additionally, changes in pain threshold and intensity were not significantly correlated with perceived relief. Taken together, results suggest expectancy that alcohol provides pain relief is an important determinant of its negative reinforcing effects. Future studies should investigate challenging these expectancies as a means of reducing alcohol-related risk in people with pain. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Recent work indicates that increasing the drinking rate of a virtual bar-goer (VB) increases the rate of drinking for participants in a virtual reality (VR) bar environment. Here, we test the hypothesis that biopsychosocial factors including typical drinking pattern and expectancy that alcohol enhances social interactions would moderate this effect., Methods: We assessed the drinking topography (DT) of participants (N=20) in a VR environment with a programmable VB during two testing sessions: one with a fast-drinking VB (30-60s sip interval) and one in which the VB drank slowly (60-120s sip interval). In this secondary analysis, linear mixed models were used to characterize potential interactions of typical daily alcohol intake (quantity-frequency index [QFI]), maximal alcohol consumed in one bout over the past six months (maxQ), Alcohol Use Disorder Identification Test (AUDIT) score, and expectancy that alcohol enhances social and physical pleasures (SPP) with time in simulation and condition on sip interval and volume., Results: Individuals with higher MaxQ showed a reduced effect of time on sip volume such that more intense recent binge episodes were associated with consistent drinking. Greater AUDIT scores were associated with lower sip intervals. In addition, greater SPP expectancy was associated with higher sip volumes, but only in the fast-drinking VB condition., Conclusions: Greater drinking behavior and social expectancies were associated with more rapid drinking topography. In addition, findings suggest challenging alcohol outcome expectancies related to social enhancement could reduce alcohol-related risks by slowing the rate of alcohol intake in social situations., Competing Interests: Declaration of Competing Interest This study was supported by the University of Florida Center for Pain Research and Behavioral Health. The University of Florida holds a copyright on INTACT VR. Authors may receive a portion of proceeds if a license is purchased from the university in the future. The software is available to non-commercial entities under a GNU GPL-2.0 open-source license. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Patients critically ill with COVID-19 develop acute respiratory distress syndrome (ARDS) and may undergo prone positioning., Objective: To compare the effects of prone positioning on oxygenation, intensive care unit length of stay, and intubation days in patients with COVID-19 ARDS and patients with non-COVID-19 ARDS., Methods: A convenience sample of intubated patients with COVID-19 and moderate to severe ARDS (per Berlin criteria) was compared with historical data from a retrospective, descriptive medical record review of patients with non-COVID-19 ARDS. The historical comparison group was age and sex matched., Results: Differences in Po2 to fraction of inspired oxygen ratios between the COVID-19 ARDS group (n = 41) and the non-COVID-19 ARDS group (n = 6) during the first 7 days of prone positioning were significant at the end of prone positioning on day 1 (P = .01), day 3 (P = .04), and day 4 (P = .04). Wilcoxon signed-rank tests showed that prone positioning had a positive impact on Po2 to fraction of inspired oxygen ratios from day 1 through day 6 in the COVID-19 ARDS group and on day 2 in the non-COVID-19 ARDS group., Conclusion: This retrospective review found greater improvement in oxygenation in the COVID-19 ARDS group than in the non-COVID-19 ARDS group. This finding may be attributed to the assertive prone positioning protocol during the pandemic and teams whose skills and training were likely enhanced by the pandemic demand. Prone positioning did not affect intensive care unit length of stay or intubation days in either group., (©2023 American Association of Critical-Care Nurses.)

Background: Many women living with HIV (WLWH) experience pain. Alcohol use with the intent to treat pain could lead to hazardous drinking and difficulty in reducing drinking. Naltrexone acts on opioid receptors important for pain regulation and is an approved treatment for alcohol use disorder. In this secondary analysis of a randomized double-blind placebo-controlled naltrexone clinical trial, the goals were to (1) compare alcohol reduction between women who drank to treat pain and those who did not and (2) examine differences in alcohol reduction by both drinking intention and treatment arm., Methods: Women living with HIV (N = 194, mean age 48.3 years, 83% non-Hispanic Black, 11% Hispanic) with hazardous drinking (>7 drinks/week) were randomized to receive daily treatment with naltrexone 50 mg or placebo for 4 months. Study visits occurred at baseline and 2, 4, and 7 months (posttreatment). The number of drinks/week was measured using the Timeline Follow Back. Use of alcohol to treat pain was self-reported. Participants were categorized as using alcohol to treat pain or not and in the naltrexone or placebo group. Chi-square, t-test, MANOVA, and sequential mixed effects models were used to determine group differences in demographic factors, mean/drinks per week, and percent change in mean drinks/week at baseline and each follow-up visit., Results: There was a consistent decrease in drinking throughout the study. There was not a significant difference in mean drinks/week at any point in the study between women who used alcohol to treat pain and those who did not. When considering treatment arm, at 2 months only those who did not use alcohol to treat pain in the naltrexone group had a significantly lower mean drinks/week than the other groups (p = 0.007); all groups had similar decreases in drinking from 4 months onward., Conclusion: In the naltrexone group, WLWH who drank to treat pain reduced their alcohol consumption more slowly than WLWH who did not drink to treat pain. Replication of these findings would suggest that alcohol treatment guidelines should address pain as a factor in drinking outcomes., (© 2023 Research Society on Alcohol.)

Background: Task-based functional connectivity (FC) of pain-related regions resulting from expectancy-based placebo induction has yet to be examined, limiting our understanding of regions and networks associated with placebo analgesia., Methods: Fifty-five healthy pain-free adults over 18 (M = 22.8 years, SD = 7.75) were recruited (65.5% women; 63.6% non-Hispanic/Latino/a/x; 58.2% White). Participants completed a baseline followed by a placebo session involving the topical application of an inactive cream in the context of an expectancy-enhancing instruction set. Noxious heat stimuli were applied to the thenar eminence of the right palm using an fMRI-safe thermode. Stimulus intensity was individually calibrated to produce pain ratings of approximately 40 on a 100-point visual analogue scale., Results: A total of 67.3% of the participants showed a reduction in pain intensity in the placebo condition with an average reduction in pain across the whole sample of 12.7%. Expected pain intensity was associated with reported pain intensity in the placebo session (b = 0.32, p = 0.004, R 2  = 0.15). Voxel-wise analyses indicated seven clusters with significant activation during noxious heat stimulation at baseline (p FDR  < 0.05). Generalized psychophysiological interaction analysis suggested that placebo-related FC changes between middle frontal gyrus-superior parietal lobule during noxious stimulation were significantly associated with the magnitude of pain reduction (p FDR  < 0.05)., Conclusions: Results suggest that stronger expectancy-based placebo responses might be underpinned by greater FC among attentional and somatosensory regions., Significance: This article provides support and insight for task-dependent functional connectivity differences related to the magnitude of placebo analgesia. Our findings provide key support that the magnitude of expectation-based placebo response depends on the coupling of regions associated with somatosensory and attentional processing., (© 2023 European Pain Federation - EFIC ®.)

Purchase tasks are used to measure the value, or demand, for various substances by assessing the amount of a substance individuals would purchase across a series of escalating prices. Marijuana purchase task (MPT) has been previously developed; however, cannabis can be consumed in various forms and measurements, thus raising questions about the applicability of the MPT across cannabis users. An adaptive MPT was developed to allow participants to select their preferred product (e.g., herbal, dabs) and division (e.g., hits, grams). Little research has been done to assess the temporal stability of these measures. Participants ( N = 50, M age = 35.3) who reported at least monthly cannabis use were recruited via Amazon's Mechanical Turk and completed a baseline and repeated original and adaptive MPT. Seventy-two percent ( N = 36) of the sample reported the same preferred product and division. Results indicated that the baseline and repeated original MPT were significantly correlated across all indices ( r range = .37-.73), while the baseline and repeated adaptive MPT was significantly correlated with P max (r = .31, p = .029) and O max ( r = .57, p < .001). Permutation testing comparing the difference between the original and adaptive MPT on all indices demonstrated a difference for break point ( r difference = .52, p = .004) and elasticity ( r difference = .94, p = .005). Correlations were lower between participants who switched their preferences on the adaptive MPT. Only elasticity was significantly different ( r difference = .93, p = .012) between tasks among participants who did not switch their preferences. Results provide support that both the original and adaptive MPT are reliable across repeated measurement and demonstrate the importance of assessing cannabis product and division preferences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Research suggests situational pain may motivate alcohol consumption, suggesting that pain may be an antecedent for problematic drinking behavior. In this pilot project, we assessed the effect of a painful thermal stimulus on drinking topography in a virtual reality bar environment using real alcohol-containing beverages. We also examined psychosocial factors that may account for individual differences in pain as an antecedent for alcohol use. Participants ( N = 20, M age = 25.65 years, 55% female, 15% Hispanic/Latino/a/x) completed a psychosocial screening battery before completing two counterbalanced alcohol self-administration sessions. In each, participants experienced either painful heat (44 °C) or nonnoxious warmth (38 °C). Sip interval (s) and sip volume (g) were measured. Effects of pain on drinking topography were assessed using multilevel models. Multilevel models assessed associations of pain-related changes in topography with hypothesized vulnerability factors. Analyses indicated a significant interaction of pain condition and sex on sip interval ( b = -.16.96, p = .015, 95% CI [-30.75, -2.97]), such that painful heat significantly decreased sip interval in men ( b = 16.38) but not women ( b = -.45). No effect of pain on sip volume was detected ( p > .49). Exploratory analyses indicated significant interactions such that the effect of the painful heat condition was stronger in individuals with higher levels of greater negative urgency but the opposite effect for pain catastrophizing. Results suggest acute pain has sex-contingent effects on drinking topography, such that men drank more rapidly while experiencing painful heat. Furthermore, analyses indicated that individuals with greater negative urgency, regardless of sex, may be at elevated risk for hazardous alcohol use when experiencing pain. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Background: Chronic cough is a demanding symptom of lung cancer. Clinical research tends to underestimate the impact of lung cancer-related cough on patient quality of life. Current guidelines do not describe how oncology nurses, as a vital part of the interprofessional team, can use nonpharmacologic interventions described by behavioral cough suppression therapy (BCST) techniques for patients with lung cancer., Objectives: This article aims to provide oncology nurses with insight into BCST and investigates how to integrate BCST into lung cancer care., Methods: A literature search for primary articles related to BCST was conducted using the electronic databases PubMed® and CINAHL®. The 2017 American College of Chest Physicians' guideline and expert panel report served as a major resource., Findings: Oncology nurses can investigate the use of BCST techniques for patients with lung cancer with chronic cough as a nonpharmacologic intervention. Assessment of patients with chronic cough should be carried out before initiating referral for BCST, including identifying cough triggers, causes of cough, and cough types.

Musculoskeletal pain is an aversive experience that exists within a variety of conditions and can result in significant impairment for individuals. Gaining greater understanding of the factors related to pain vulnerability and resilience to musculoskeletal pain may help target at-risk individuals for early intervention. This analysis builds on our previous work identifying regions where greater gray matter density was associated with lower pain following standardized, exercise induced musculoskeletal injury. Here we sought to examine the relationship between baseline resting state functional connectivity in a priori regions and networks, and delayed onset muscle soreness (DOMS) pain intensity following a single session of eccentric exercise in healthy adults. Participants completed a baseline functional MRI scan and a high intensity trunk exercise protocol in the erector spinae. Pain intensity ratings were collected 48-hours later. Resting state functional connectivity from four seed regions and 3 networks were separately regressed on pain intensity scores. Results revealed that connectivity between left middle frontal gyrus, the left occipital gyrus and cerebellar network seeds and clusters associated with discriminative, emotional, and cognitive aspects of pain were associated with lower post-DOMS pain. Results suggest resilience to clinically relevant pain is associated with aspects of regional and network neural coherence. Investigations of pain modulatory capacity that integrate multimodal neuroimaging metrics are called for. PERSPECTIVE: Our results provide key support for the role of structural and functional coherence in regional and network connectivity in adaptive pain response and represent an important step in clarifying neural mechanisms of resilience to clinically relevant pain., (Copyright © 2021 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Quality cancer care includes routine screening for psychosocial distress. This quality improvement project focused on the implementation of distress screening at a licensed affiliate of Cancer Support Community, a community-based non-profit organization that provides professionally led cancer support., Methods: An advanced practice oncology nurse assisted the staff in implementing and evaluating the process of distress screening. CancerSupportSource (CSS), a validated web-based distress screening program developed by Cancer Support Community for use in community cancer settings, was employed to screen for distress, identify potential resources, and improve in-house and community referrals. For purposes of this quality improvement project, CSS was administered in interview format by staff. The Plan-Do-Study-Act (PDSA) quality improvement approach was used to implement CSS., Results: To implement the practice of distress screening, 21 patient participants were initially screened and evaluated for distress, including risk for clinically significant levels of depression, using CSS. The tool identified participant concerns and flagged thirteen persons as at risk for depression. After implementation and evaluation of distress screening using PDSA, in a year, 51 participants were screened. Participants stated that distress screening allowed for discussion of intimate questions that may not have otherwise occurred in an intake interview., Conclusion: It was demonstrated that CSS identified psychosocial and practical needs, facilitating the referral process and identification of community resources. Application of the PDSA model was an effective quality improvement model that can be used for the implementation and sustainability of distress screening across settings., Competing Interests: The authors have no conflicts of interest to disclose., (© 2020 Harborside™.)

Problem Statement: To describe research mentorship strategies needed to strengthen oncology nursing science and ensure that a cadre of nurse scientists are available to carry out the research mission of the Oncology Nursing Society (ONS)., Design: Multimethod consensus-building approach by content experts of the ONS Research Mentorship Task Force and approval by the ONS Board of Directors was employed., Data Sources: Expert opinion, surveys, notes from an all-day research mentorship retreat, and literature review were used., Analysis: Content analysis was used to synthesize notes from the research mentorship retreat., Findings: Various strategies were identified to strengthen the pipeline of oncology nurse scientists and promote development across the career trajectory., Implications for Practice: Mentorship is essential to advance the growth and impact of oncology nursing science and requires support throughout the career trajectory.

Theoretical Principles: Pediatric oncology nurses are particularly vulnerable to emotional distress. Responsible for the oversight of a child's care, these nurses sustain close interactions with multiple patients and families over time, many of whom are coping with life-limiting diagnoses. The world of pediatric oncology nurses is one where tragedy is routinely witnessed thus demanding self-care and healing across a continuum., Phenomenon Addressed: The aim of this article is to outline and review the emotional sequelae of pediatric oncology nurses' work and to suggest interventions to support well-being in light of prolonged caregiving. Three major categories that are addressed include the aspects of clinical practice that influence caregiving, the risks of burnout, compassion fatigue, moral distress and grief, and interventions to counteract these phenomena., Research Linkages: Future-nursing research should focus upon the development of validated, psychometrically sound measurement tools to assess nurse-specific variants of burnout, compassion fatigue, moral distress, and nurse grief. Qualitative research should investigate the relationship between personal variables, workplace and team characteristics, age and experience, and their influence on the predominance of burnout, compassion fatigue, moral distress, and nurse grief. Lastly, the phenomena of resiliency demands further study., (Copyright © 2018. Published by Elsevier Inc.)

Oncology professionals are fully aware that the five-year mark of being disease-free after the diagnosis of cancer is not a magical number. Cancer is now considered a chronic disease and recurrence can happen at any time, which is unexpected and frightening. Yet, for me, and for many other cancer survivors, the five-year mark is one to be celebrated.

Anemia is a decrease in circulating red blood cells that contributes to a complex group of symptoms. Anemia may be present in more than half of all patients with cancer but often is assessed, documented, prevented, and treated inadequately. Individuals with cancer are living longer, and the number of cancer treatment options provided at various points in the cancer continuum is growing; however, many treatments contribute to anemia. Because anemia can develop from multiple causes, treatment must be tailored to the underlying etiology. Cancer-related anemia can significantly affect therapeutic outcomes and patients' quality of life. Therapeutic interventions may include blood transfusions, administration of recombinant human erythropoietin, and interventions to support patient symptoms, most significantly, fatigue. Oncology nurses play a central role in risk assessment, symptom management, treatment planning, and evaluation and therefore must understand the etiology and physiology of cancer-related anemic states as well as evidence-based interventions to ensure optimal outcomes.

Objectives: To describe recent developments in hormonal therapy for breast cancer, focusing on SERMs and AIs., Data Sources: Published journal articles and texts, research reports and monographs, government publications, and professional organization guidelines., Conclusion: Research continues to identify the effectiveness of hormonal therapy in breast cancer, including adjuvant treatment in early and advanced stages as well as a chemopreventive measure. The individual drug profile must be evaluated for safety and efficacy, and the impact on QOL must be considered., Implications for Nursing Practice: It is imperative that oncology nurses understand the physiology, application, risks, and benefits of hormonal therapies.