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Purpose: This systematic review aimed to assess the literature for management strategies and economic impact of salivary gland hypofunction and xerostomia induced by cancer therapies and to determine the quality of evidence-based management recommendations.Methods: The electronic databases of MEDLINE/PubMed and EMBASE were searched for articles published in English since the 1989 NIH Development Consensus Conference on the Oral Complications of Cancer Therapies until 2008 inclusive. For each article, two independent reviewers extracted information regarding study design, study population, interventions, outcome measures, results, and conclusions.Results: Seventy-two interventional studies met the inclusion criteria. In addition, 49 intensity-modulated radiation therapy (IMRT) studies were included as a management strategy aiming for less salivary gland damage. Management guideline recommendations were drawn up for IMRT, amifostine, muscarinic agonist stimulation, oral mucosal lubricants, acupuncture, and submandibular gland transfer.Conclusions: There is evidence that salivary gland hypofunction and xerostomia induced by cancer therapies can be prevented or symptoms be minimized to some degree, depending on the type of cancer treatment. Management guideline recommendations are provided for IMRT, amifostine, muscarinic agonist stimulation, oral mucosal lubricants, acupuncture, and submandibular gland transfer. Fields of sparse literature identified included effects of gustatory and masticatory stimulation, specific oral mucosal lubricant formulas, submandibular gland transfer, acupuncture, hyperbaric oxygen treatment, management strategies in pediatric cancer populations, and the economic consequences of salivary gland hypofunction and xerostomia. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review aimed to assess the literature for prevalence, severity, and impact on quality of life of salivary gland hypofunction and xerostomia induced by cancer therapies.Methods: The electronic databases of MEDLINE/PubMed and EMBASE were searched for articles published in English since the 1989 NIH Development Consensus Conference on the Oral Complications of Cancer Therapies until 2008 inclusive. Two independent reviewers extracted information regarding study design, study population, interventions, outcome measures, results and conclusions for each article.Results: The inclusion criteria were met by 184 articles covering salivary gland hypofunction and xerostomia induced by conventional, 3D conformal radiotherapy or intensity-modulated radiotherapy in head and neck cancer patients, cancer chemotherapy, total body irradiation/hematopoietic stem cell transplantation, radioactive iodine treatment, and immunotherapy.Conclusions: Salivary gland hypofunction and xerostomia are induced by radiotherapy in the head and neck region depending on the cumulative radiation dose to the gland tissue. Treatment focus should be on optimized/new approaches to further reduce the dose to the parotids, and particularly submandibular and minor salivary glands, as these glands are major contributors to moistening of oral tissues. Other cancer treatments also induce salivary gland hypofunction, although to a lesser severity, and in the case of chemotherapy and immunotherapy, the adverse effect is temporary. Fields of sparse literature included pediatric cancer populations, cancer chemotherapy, radioactive iodine treatment, total body irradiation/hematopoietic stem cell transplantation, and immunotherapy. [ABSTRACT FROM AUTHOR]

Goals: The aims of this secondary data analysis were to (a) categorize patterns in the development, duration, intensity, and resolution of sore mouth (which can be considered a proxy for oral mucositis) severity and distress over two cycles of chemotherapy in cancer outpatients and (b) examine the relationship of demographic (age, gender, marital status, and educational level) and disease characteristics (type of cancer and type of chemotherapy) to specific patterns of sore mouth (SM).Materials and Methods: Visual graphical analysis (VGA) was applied to identify individual patterns of SM severity and distress in 51 outpatients receiving chemotherapy who provided daily reports of sore mouth using a computerized interactive voice response system. The majority were female (n = 41, 8%) with a mean age of 53 (SD = 8.35). Most had breast cancer (68%), and one third received chemotherapy with adriamycin and cyclophosphamide (AC). VGA is a technique in which graphs of individual patients' symptoms are coded for specific individual or group profiles.Main Results: Seven distinct patterns were identified based on variability in onset, duration, and intensity (degree of severity or distress). Chemotherapy agents were significantly associated with patterns of SM. The AC regimen was significantly associated with late onset; however, the intensity did not last long. In contrast, patients receiving R-CHOP were significantly more likely to experience duration intensity (SM after day 15 and a score equal to or greater than a 5 on a 1-10 scale).Conclusions: VGA revealed symptom patterns often hidden in traditional analysis. Understanding individual variability is important to the design and implementation of future intervention research and clinical care. [ABSTRACT FROM AUTHOR]

Although epidemiological literature reports a significant overlap between depression and alcoholism among women, the dynamics of this relationship requires further exploration. The present paper documents significant lifetime histories of depression among women in treatment for alcohol problems, and presents findings on these women's experiences of the relationship between depression and alcohol use problems. In this community-based treatment sample, 18 out of 18 women participating in qualitative interviews reported histories of depression and almost 80% were currently using anti-depressant medication. The use ofalcohol as an attempt to escape difficult emotions or alternatively to produce positive emotional experiences is discussed within the gendered context of the stories women tell about their depression and alcohol use. [ABSTRACT FROM AUTHOR]

BACKGROUND:: Research to address clinical symptoms and the way they change over time in an individual is of paramount importance to healthcare researchers who are interested in improving the quality of life for ill patients. However, typical statistical methods that rely on means can obscure individual trajectories of change. Visual graphical analysis (VGA) is a technique that can provide researchers with an alternative method of quantitative statistical analysis that is more sensitive to individual change and variation. OBJECTIVES:: To (a) describe the use of VGA as a method to evaluate longitudinal data, (b) discuss challenges to using this method, and (c) offer recommendations for future research in which the method could be implemented. APPROACH:: This methodological article uses data collected from a primary study to present the method of VGA. Daily self-reported sore mouth severity scores from patients receiving outpatient chemotherapy were used in this VGA. The steps of VGA include (a) determining inclusion criteria, (b) managing missing data, (c) creating visual graphs, (d) identifying specific patterns, and (e) performing validation and verification. DISCUSSION:: Because symptoms occur differently for each patient, this method allows researchers to see symptom trajectories on an individual basis. Creation and analysis of longitudinal graphs could be used also to inspect other symptoms or clinical problems such as headaches, fatigue, constipation, nausea and vomiting, and psychological difficulties. The value of VGA is that it allows a researcher to study the patterns of an individual's experience, as opposed to averaging all individuals' responses over time. Although graphical analysis is exploratory in nature, it may lead to enhanced longitudinal recognition of symptoms that might not be identified otherwise by quantitative data analysis using summary statistics. [ABSTRACT FROM AUTHOR]

Questionnaires assessing heavy drinking and binge eating were administered to 58 women with alcohol problems. A sub-sample of the binge-eaters then participated in qualitative interviews about their perceptions of the connections between their two problems. Seventy-one percent self-identified as binge-eaters with most reporting 'severe' binge eating. Binge-eaters were younger, more frequent drinkers and drank more often for emotional relief than non-binge-eaters. Binge eating and heavy drinking appeared to serve similar functions in a given client (i.e. emotional relief or reward functions). We discuss implications of the findings for the development of better treatments for women struggling with both health issues. Copyright © 2006 SAGE Publications Ltd. [ABSTRACT FROM AUTHOR]

This paper explores women's choice of controlled drinking or abstinence goals in harm reduction treatment programs for alcohol use problems. Situated within debates about controlled or abstinence goals for alcohol use, this research project provides a specific focus on women's treatment needs. We explore evidence which reveals that women in treatment for alcohol problems often hold deeply internalized dominant social ideologies on addiction. Results demonstrate that while offered the choice of abstinence or controlled use goals, most women defined themselves as 'addicts,' adopted a disease metaphor of 'addiction,' and chose abstinence. The findings here raise questions about whether or not clients receive sufficient education about harm reduction and controlled drinking and make adequately informed choices. [ABSTRACT FROM AUTHOR]

Testicular cancer (TC) strikes men between the ages of 15 and 35. If detected early, this disease can be irradicated in virtually every patient. Unfortunately, several hundred men will die from this disease each year. Research has shown that men do not know the importance of testicular self-examination, and they are not knowledgeable about TC. Nurses should be able to discuss treatment modalities, sideeffect management related to those treatments, and special issues dealing with sexuality, body image perception, and infertility. [ABSTRACT FROM AUTHOR]

Testicular cancer (TC) strikes men between the ages of 15 and 35. If detected early, this disease can be irradicated in virtually every patient. Unfortunately, several hundred men will die from this disease each year. Research has shown that men do not know the importance of testicular self-examination, and they are not knowledgeable about TC. Nurses should be able to discuss treatment modalities, side-effect management related to those treatments, and special issues dealing with sexuality, body image perception, and infertility. [ABSTRACT FROM AUTHOR]

Because breast cancer risk increases with age and women in the United States continue to delay childbirth, the incidence of breast cancer during pregnancy will rise. About 10% of patients younger than age 40 diagnosed with breast cancer are pregnant. Historically, labor-delivery and oncology, the two spheres of clinical care, rarely overlapped. However, breast cancer occurs in about 1 in 3,000 pregnancies. Case studies suggest that the administration of chemotherapeutic agents during the second and third trimesters may be safe for the mother and fetus. Three specific case studies of pregnant women with cancer who received treatment are presented to identify the issues of cancer during pregnancy. Outcomes of infants who received chemotherapy in utero and associated nursing implications also are explored. [ABSTRACT FROM AUTHOR]

Background: This paper focuses upon prayer for sickness. What do individuals suffering from illness, their families and the wider community pray for? How do they deal with unanswered prayer? Do they pray for cure, to guide medical professionals or to cope with their sickness? What rationalisations do they proffer for unanswered prayer?, Methods: Based on a critical literature review and deploying secondary data from the Twenty First Century Evangelical research programme, the data suggest that prayers for guiding medical professionals and coping are more common than for cure, at least in Global North countries such as the UK and US. But why do those who believe in miracles not ask God for divine healing? Furthermore, unanswered prayer can conflict with Christian views of God as omnipotent and all loving., Results: Respondents use a number of theodical rationalisations to resolve this conflict., Conclusions: The results are discussed in relation to cognitive dissonance theory, learned helplessness, the need to conserve a relationship with the Divine, and desire to manage risk of disappointment and reduce consequent emotional pain., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Dein S and Brown CG.)

Objective: Romantic relationship dysfunction is a risk for subsequent alcohol use, with some research suggesting gender differences in this link. We evaluated how different aspects of relationship dysfunction are related to different drinking behaviors and whether these associations vary by gender. We further examined the role of age as a potential moderator of this gender difference., Method: Qualtrics Panelists ( N = 1,470; 50% women) who were in a romantic relationship and regularly consumed alcohol completed an online survey. The sample was wide-ranging in age (range: 18-85 years old; M = 46.64, SD = 11.95). Participants reported drinking about 10 drinks per week, on average ( SD = 11.01)., Results: Five factor scores were constructed from relationship predictors (relationship distress, intrusion/jealousy, and disagreements) and drinking outcomes (consumption and coping motives). Moderation analyses indicated several significant two-way interactions between relationship dysfunction, gender, and age when predicting alcohol outcomes. Of note, the positive associations between relationship distress and both consumption and coping motives were stronger among younger than older individuals and among men than women (consistent with an externalizing stress perspective). A significant three-way interaction suggested that, for women, associations between intrusion/jealousy and coping motives were strongest at younger ages, consistent with an interpersonal sensitivity perspective. Conversely, for men, these associations were stronger at older ages, consistent with an externalizing stress perspective., Conclusions: Men and younger individuals should be of particular focus when designing and testing interventions for drinking in response to relationship distress and disagreements. Younger women and older men may benefit from interventions focused on drinking to cope with relationship jealousy and electronic intrusions.

Sentinel is a 16-channel, filtered x-ray diode array spectrometer that has been developed to measure ∼1 keV-20 keV x-ray emission generated by the National Ignition Facility (NIF) laser. Unlike the large, fixed-port versions of this diagnostic that currently exist on the NIF (known as Dante), Sentinel is a Diagnostic Instrument Manipulator compatible such that it can be fielded along the polar or equatorial lines-of-sight-an essential new capability for characterizing the often anisotropic x-ray emission from laser-driven sources. We present the diagnostic design along with preliminary diode calibrations and performance results. The novel, small-form-factor x-ray diode design allows for ≳5×-25× increased channel areal density over that of Dante, simultaneously enabling improved diagnostic robustness and fidelity of spectral reconstructions. While the Sentinel diagnostic is anticipated to improve line-of-sight spectral characterization of x-ray sources for a wide variety of programs on the NIF, the compact and portable design is also attractive to small- and mid-scale facilities with limited diagnostic real estate.

New graduate clinical nurse specialists (CNSs) face many challenges when starting their new role. To address this, a CNS fellowship program was developed to mentor new CNSs during their first year of practice. This CNS fellowship program would provide opportunities to increase skills related to each of the CNS spheres of influence, including nursing practice, patient care, and systems and organization. Experienced CNSs mentored CNS fellows and identified learning opportunities. The fellows completed an online self-assessment based on the National Association of Clinical Nurse Specialists CNS Competency Checklist during week one of orientation and again at months 3, 6, 9, and 12. The CNS fellows completed and presented three projects designed to explore the spheres of the CNS role, along with a formal onboarding. The results of the fellowship depicted significant competency development within all three CNS spheres at program completion. The CNS fellowship program provided structure and guidance to the newly graduated CNSs and clearly transitioned staff nurses to advanced practice nurses. The fellowship has demonstrated a positive effect on both the new CNSs and the organization in which it was developed., Competing Interests: The authors have no conflicts of interest to disclose., (© 2019 Harborside™.)

Problem Statement: To define the Oncology Nursing Society Research Agenda for 2019-2022., Design: Multimethod, consensus-building approach by members of the Research Agenda Project Team., Data Sources: Expert opinion, literature review, surveys, interviews, focus groups, town hall, and review of research priorities from other cancer care organizations and funding agencies., Analysis: Content analysis and descriptive statistics were used to synthesize research priority themes that emerged., Findings: Three priority areas for scientific development were identified., Implications for Nursing: The Research Agenda can be used to focus oncology nurses' research, scholarship, leadership, and health policy efforts to advance quality cancer care, inform research funding priorities, and align initiatives and resources across the ONS enterprise.

Objectives: To assess nurses' attitudes and perceptions about research., Sample & Setting: 623 RNs at a National Cancer Institute-designated comprehensive cancer center in the midwestern United States., Methods & Variables: This study used a cross-sectional, descriptive survey to describe nurses' attitudes toward nursing research, perceptions of the research environment, and research involvement., Results: Nurses' attitudes toward research were generally more positive than negative. Results suggested that the biggest obstacle to nurses participating in research is time., Implications for Nursing: Understanding oncology nurses' attitudes toward research and the research environment is vital for the future of patient outcomes research. Results from this study inform strategic goals for increasing nursing research capacity, including the use of research teams and access to research mentors and resources, as well as nursing research fellowship programs.

Many nurses practicing today lack basic education about LGBTQ (lesbian, gay, bisexual, transgender, queer) patient care. How can they better prepare to care for this population? This article provides insight on LGBTQ people, their health risks and disparities, and how nurses can work with LGBTQ patients to improve outcomes.

Up to 10% of Fontan patients require pacemakers; an epicardial approach has historically been used. A transvenous approach can be used but carries risk of Fontan obstruction, thromboembolism, and can be technically challenging. The safety and efficacy of these approaches is not well described. The aim of this study was to compare epicardial and transvenous pacemaker outcomes in Fontan patients, specifically, device performance and adverse event rate. A retrospective review was performed on Fontan pacemaker patients followed at a single institution. Thirty-one Fontan pacemaker patients were identified between 1985 and 2017. Twenty-six had an epicardial system, five transvenous, and three converted from epicardial to transvenous. Average atrial lead sensing at placement was 3.23 versus 2.35 mV (p = 0.52) for epicardial and transvenous leads, respectively. Median atrial and ventricular lead longevity was 86.4 versus 98.8 months (p = 0.56) and 73.2 versus 140 months (p = 0.3) with generator longevity of 65.5 versus 73.9 (p = 0.16) months for epicardial versus transvenous systems, respectively. One major complication occurred in a transvenous patient, and two minor complications occurred in epicardial patients. All transvenous patients received warfarin except one, who converted to dabigatran. Epicardial patients received aspirin (n = 20), warfarin (n = 3) or a warfarin/aspirin combination (n = 3). No thromboembolic events occurred. System revision was required in 13 epicardial and 5 transvenous patients. There were two deaths, none related to the pacemaker system. Transvenous pacemakers can be utilized with equal efficacy compared to epicardial pacemakers with trends toward longer lead longevity in transvenous pacemaker systems.

Objectives: Fine-needle aspiration (FNA) of thyroid lesions may result in infarction and diagnostic difficulties on subsequent thyroidectomy specimens. Next-generation sequencing (NGS) methods for detection of hallmark driver BRAF V600E mutations may help characterize such tumors in which histologic alterations preclude definitive tissue diagnosis., Methods: Thyroidectomy specimens with both malignant FNA diagnoses and resultant infarction were identified from our institutional database. NGS methods were used to detect BRAF V600E mutations in the infarcted thyroid carcinomas., Results: Nine thyroid carcinomas with infarction were characterized as BRAF-like papillary thyroid carcinoma based on molecular driver categorization and histologic diagnosis. BRAF V600E mutations were detected in the infarcted tissue in four (67%) of six lesions., Conclusions: We demonstrate detection of hallmark BRAF V600E mutations by NGS within infarcted tissue of thyroid carcinomas after FNA. This suggests a potential ancillary method of characterizing infarcted thyroid carcinomas whose altered histology may be nondiagnostic.

Strong, flexible, and transparent materials have garnered tremendous interest in recent years as materials and electronics manufacturers pursue devices that are bright, flexible, durable, tailorable, and lightweight. Depending on the starting components, polymers fabricated using thiol-yne chemistry have been shown to be exceptionally strong and/or flexible, while also being amenable to modification by the incorporation of nanoparticles. In the present work, novel ligands were synthesized and used to functionalize quantum dots (QDs) of various diameters. The functionalized QDs were then incorporated into thiol-yne prepolymer matrices. These matrices were subsequently polymerized to form QD thiol-yne nanocomposite polymers. To demonstrate the versatility of the fabrication process, the prepolymers were either thermally cured or photopolymerized. The resulting transparent nanocomposites expressed the size-specific color of the QDs within them when exposed to ultraviolet irradiation, demonstrating that QDs can be incorporated into thiol-yne polymers without significantly altering QD expression. With the inclusion of QDs, thiol-yne nanocomposite polymers are promising candidates for use in numerous applications including as device display materials, optical lens materials, and/or sensor materials., Competing Interests: The authors declare no competing financial interest.

Objective: To review the current state of knowledge about cancer in lesbians, gay, bisexual, and transgender (LGBT) people by focusing on four major issues across the cancer continuum including: 1) lack of data collection on sexual orientation and gender identity; 2) need for a culturally competent workforce; 3) the need for a culturally competent health care system; and 4) creating LGBT tailored patient/client information and education., Data Sources: Published literature., Conclusion: Oncology nurses and health care providers can work to improve the care of LGBT patients with cancer by following suggestions in this article., Implications for Nursing Practice: Oncology nurses and other health care providers have many distinct occasions to improve overall cancer care for LGBT patients., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Our team has developed an experimental platform to evaluate the x-ray-generated stress and impulse in materials. Experimental activities include x-ray source development, design of the sample mounting hardware and sensors interfaced to the National Ignition Facility's diagnostics insertion system, and system integration into the facility. This paper focuses on the X-ray Transport and Radiation Response Assessment (XTRRA) test cassettes built for these experiments. The test cassette is designed to position six samples at three predetermined distances from the source, each known to within ±1% accuracy. Built-in calorimeters give in situ measurements of the x-ray environment along the sample lines of sight. The measured accuracy of sample responses as well as planned modifications to the XTRRA cassette is discussed.

This issue of the Clinical Journal of Oncology Nursing (CJON) will be the final time that you will see the Evidence-Based Practice (EBP) feature column. Why? Because we have seen oncology nursing evolve in the past 20 years and EBP is everywhere! We use it in our clinics and hospital units, incorporate it into decisions about symptom management, and use evidence to develop survivorship guidelines. We discuss EBP in journal clubs and use applications on mobile devices to find the best interventions for our patients. We have oncology nurses sitting on committees to develop guidelines based on the best evidence and expert opinion. We have come a long way and it is our belief that EBP is included in almost every article in CJON and, therefore, a need no longer exists for an individual column about EBP. 
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We describe an experimental method to measure the gate profile of an x-ray framing camera and to determine several important functional parameters: relative gain (between strips), relative gain droop (within each strip), gate propagation velocity, gate width, and actual inter-strip timing. Several of these parameters cannot be measured accurately by any other technique. This method is then used to document cross talk-induced gain variations and artifacts created by radiation that arrives before the framing camera is actively amplifying x-rays. Electromagnetic cross talk can cause relative gains to vary significantly as inter-strip timing is varied. This imposes a stringent requirement for gain calibration. If radiation arrives before a framing camera is triggered, it can cause an artifact that manifests as a high-intensity, spatially varying background signal. We have developed a device that can be added to the framing camera head to prevent these artifacts.