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Objective: The purpose of this study was to evaluate the poverty-related knowledge and attitudes of primary care providers and staff following an educational initiative focused on poverty and social determinants of health (SDoH)., Methods: A descriptive posttest-only design was used. All providers and staff in three outpatient primary care clinics (including one medical home and one women's health clinic) received education (two sessions, one hour in length) on poverty and SDoH. The educational initiative's effectiveness was evaluated by measuring perceptions of (a) knowledge/understanding related to SDoH and low SES and (b) preparedness to serve patients of low SES., Results: Thirty-two of the 55 participants in the educational sessions completed the survey (58%). Average post-education ratings for perceptions of both preparedness and knowledge/understanding were significantly higher than for the corresponding pre-education items (p < .001), with large effect sizes. Study limitations and implications are presented.

Objective: Published studies have demonstrated that adding vertebral fracture assessment (VFA) to dual-energy X-ray absorptiometry (DXA) identifies more patients with increased fracture risk than DXA alone. But who needs VFA? This study attempts to determine if some test other than VFA could duplicate the additional information obtained by performing VFA on all first-time patients. This study looked at the Fracture Risk Assessment Tool (FRAX), height loss, age, documented back pain, and nonvertebral fragility fractures., Methods: VFA was performed on 1,259 (all) DXA patients at their first visit from March 2010 through September 2013. All DXA and VFA results were read by the same International Society for Clinical Densitometry-certified clinician., Results: By DXA alone, 44% were osteoporosis. Adding VFA increased clinical osteoporosis by 36% of the original total patients. Eighty-three "normal bone mineral density" patients were changed to clinical osteoporosis. FRAX identified 53% of the patients with diagnosis changes. Historical height loss was not reliable. Increasing age correlated only weakly with clinical osteoporosis., Conclusion: These are modest numbers from a nonacademic referral practice and may not be typical of other populations. Thirty-six percent of our patients were misclassified by DXA alone, with fragility fractures already taken into account for T-scores of -1.5 and lower. FRAX, height loss, age, back pain, and fragility fractures all failed to identify many of the patients identified by VFA. Seeing the lateral spine images obtained by VFA influenced patients and families. VFA on all first-time patients should be reconsidered., Abbreviations: BMD = bone mineral density DXA = dual-energy X-ray absorptiometry FRAX = Fracture Risk Assessment Tool HL = height loss ISCD = International Society for Clinical Densitometry VF = vertebral fracture VFA = vertebral fracture assessment.

Aim: An integrative review was conducted to identify and evaluate interventions for test anxiety (TA) in undergraduate nursing students., Background: Test performance has a major impact on the academic success of nursing students. Therefore, testing is a source of stress and anxiety, which may impair academic performance., Method: A systematic search was conducted to locate peer-reviewed literature about interventions for TA in undergraduate nursing students., Results: Review of 33 publications dated 1973 to 2014 identified 19 interventions for TA in undergraduate nursing students. Findings included experimental evidence supporting aromatherapy, music therapy, and various cognitive or behavioral interventions. Nonexperimental evidence supporting collaborative testing, crib sheets, and humorous exam items was also found., Conclusion: Many interventions for mitigating TA in nursing students have been evaluated since the 1970s. Current research is needed to corroborate and strengthen the evidentiary support for existing interventions and to evaluate new interventions., Competing Interests: The author declares no conflict of interest., (Copyright © 2017 National League for Nursing.)