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Purpose: The objectives of this study were to develop measures of end-of-life (EOL) care processes in nursing homes and to validate the instrument for measuring them. Design and Methods: A survey of directors of nursing was conducted in 608 eligible nursing homes in New York State. Responses were obtained from 313 (51.5% response rate) facilities. Secondary data on structural characteristics of the nursing homes were obtained from the Online Survey Certification and Reporting System. Exploratory factor analyses and internal consistency reliability analyses were performed. Multivariate regression models with fixed and random effects were estimated. Results: Four EOL process domains were identified--assessment, delivery, communication and coordination of care among providers, and communication with residents and families. The scales measuring these EOL process domains demonstrated acceptable to high internal consistency reliability and face, content, and construct validity. Facilities with more EOL quality assurance or monitoring mechanisms in place and greater emphasis on EOL staff education had better scores on EOL care processes of assessment, communication and coordination among providers, and care delivery. Facilities with better registered nurse and certified nurse aide staffing ratios and those with religious affiliation also scored higher on selected care process measures. Implications: This study offers a new validated tool for measuring EOL care processes in nursing homes. Our findings suggest wide variations in care processes across facilities, which in part may stem from lack of gold standards for EOL practice in nursing homes.

Aim : To understand Parkinson's Disease (PD) care partners' a) specific challenges that led to worsening strain and b) their suggestions for supports to help them during the ongoing pandemic. Method : Using a qualitative descriptive design, semi-structured interviews with family care partners (n = 19) were completed. Participants were recruited from 10 sites across the United States that varied in size, demographics of patient population served, and geographic location (urban, suburban, rural). Interviews were audio-recorded, de-identified, transcribed verbatim, and coded in a phased manner. The research team analyzed the data and identified themes. Results : During the pandemic, the already difficult task of caregiving was made worse by having to choose between poor options. Five themes exemplified PD care partner experiences: (1) Managing risks and benefits of medical care in settings outside the home vs meeting these needs at home; (2) Struggling to maintain employment benefits with the costs of care and risks of bringing in outside caregivers; (3) Struggling to balance caregiving and self-care; (4) Struggling to be supportive and taking on new caregiving roles in the face of less support services; and (5) Wanting social connections and feeling pressured to maintain isolation. Care partners wanted timely access to, and guidance from healthcare teams to help them. Conclusions : Care partner burden was worsened by lack of guidance when confronted by choices that could lead to negative outcomes. Movement disorder and palliative care providers may be able to alleviate some care partner burden through building systems for timely access and guidance. [ABSTRACT FROM AUTHOR]

A study of 10 Latina nursing faculty explored cultural competence and ways to integrate culture and community in nursing curriculum. Teaching strategies they identified included keeping the concept of "The Other" in class discussions and interpreting culture as community. (Contains 31 references.) (SK)

A descriptive survey method was used to explore moral reasoning among 43 nursing graduate students nearing the end of their master's and doctoral programs. As a group, these students possess the maturity to reason at principled stages, to provide care independently, and to develop research careers. (JOW)

Background: In a single‐arm pilot study, we assessed the feasibility and usefulness of an innovative patient‐centered communication tool (UR‐GOAL tool) that addresses aging‐related vulnerabilities, patient values, and prognostic awareness for use in treatment decision making between older adults with newly diagnosed acute myeloid leukemia (AML), their caregivers, and oncologists. Methods: Primary feasibility metric was retention rate; >50% was considered feasible. We collected recruitment rate, usefulness, and outcomes including AML knowledge (range 0–14) and perceived efficacy in communicating with oncologists (range 5–25). Due to the pilot nature and small sample size, hypothesis testing was performed at α = 0.10. Results: We included 15 patients (mean age 76 years, range 64–88), 12 caregivers, and 5 oncologists; enrollment and retention rates for patients were 84% and 73%, respectively. Patients agreed that the UR‐GOAL tool helped them understand their AML diagnosis and treatment options, communicate with their oncologist, and make more informed decisions. From baseline to post‐intervention, patients and caregivers scored numerically higher on AML knowledge (patients: +0.6, p = 0.22; caregivers: +1.1, p = 0.05) and perceived greater efficacy in communicating with their oncologists (patients: +1.5, p = 0.22; caregivers: +1.2, p = 0.06). Conclusion: We demonstrated that it is feasible to incorporate the UR‐GOAL tool into treatment decision making for older patients with AML, their caregivers, and oncologists. [ABSTRACT FROM AUTHOR]

* BACKGROUND Skillful communication between and among clinicians and patients' families at the patients' end of life is essential for decision making. Yet communication can be particularly difficult during stressful [...]

Crop germplasm conserved in genebanks, are a fundamental resource of genetic diversity for crop improvement activities, underpinning future food security and sustainable agricultural practices. However, taxonomic errors in genebank germplasm (due to misclassification, contamination and poor data collation) restrict the effective use of this material for correct purpose. Earlier studies investigating species genetic diversity using genebank germplasm, have shown varying levels of taxonomic error within the Brassica species. In response to this reported taxonomic error of global collections, together with the availability of a multiplex PCR (MPCR) marker, targeting the specific chromosomes (A, B and C) of the six Brassica species in U's triangle, this study was undertaken to confirm the taxonomic identity of accessions within the Australian Grains Genebank's (AGG) long-term Brassica collection. A total of 5161 accessions were analysed with MPCR for taxonomic identification, of which, 4842 (93.8%) were confirmed to be consistent (correct) with their labelled taxonomy, while the remaining 319 (6.2%) were identified as taxonomically inconsistent (in-error). Through the evaluation of earlier regeneration and original seed of the error accessions with MPCR, we determined that 80.9% of the taxonomic errors were traced back to the original seed, while 19.1% of errors were the result of genebank seed regeneration handling practices. Results from this study directly enhance information of the AGG Brassica collection and shape directions for distribution, acquisition and regeneration practices within the AGG and potentially other global genebanks, which will facilitate in a more effective use of these valuable genetic resources by researchers and breeders. [ABSTRACT FROM AUTHOR]