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Cancer survivors are required to manage their health, healthcare, and a myriad of symptoms through self-management.The aim of this study was to develop a comprehensive framework of competencies and performance criteria that identifies the requisite knowledge and skills for nursing practice in the provision of self-management support for cancer survivors and their families.The competency framework was developed using the following 3-stage consensus building approach: (1) development of a preliminary list of self-management support competencies and performance criteria informed by relevant literature, (2) a 2-round modified Delphi conducted with a panel of cancer nurse experts, and (3) a research team consensus meeting to finalize framework components.Seventy-one items, comprising 13 core competencies and 58 performance criteria, across 6 domains were generated. In round 1 of the modified Delphi, a panel of 21 oncology nurses produced consensus on retaining 28 items for inclusion in the final framework. Thirty-one items (including new items generated in round 1) were sent to round 2 for further rating. A panel of 19 nurses produced consensus on retaining a further 20 items in the framework in round 2. Of the 11 items that did not reach consensus, the research team proposed to include 7 in the final framework. Fifty-nine items were included in the final framework.This study provides a comprehensive, self-management support competency framework for oncology nurses.This framework is the first step toward the development of training program curricula that prepares nurses in self-management for cancer and associated coaching knowledge and skills.

The impact of an intensive care unit (ICU) admission on family caregivers of patients who have undergone hematopoietic stem cell transplantation (HSCT) has not been well described. Aims of this study were to determine the feasibility of conducting research with family caregivers of HSCT patients during an ICU admission and generate preliminary data about their experiences and engagement in care. Using a mixed-methods, repeated measures design, we collected data from family caregivers after 48 hr in the ICU (T1) and at 48 hr after transferring out of ICU (T2). Enrolling HSCT caregivers in research while in the ICU was feasible (10/13 consented; 9/10 completed data collection at T1); however, data collection at T2 was not possible for most caregivers. Caregiver distress levels were high, and engagement in care was moderate. The three themes that emerged from interviews ( n = 5) highlighted that although HSCT family caregivers faced many challenges and received limited support during their ICU experience, they were able to access their own personal resources and demonstrated resilience.

The aim of this study was to evaluate the feasibility and acceptability of a computer-based symptom cluster heuristics tool designed to explore symptom clusters experienced by adolescents and young adults (AYAs) with cancer. The Computerized Symptom Capture Tool (C-SCAT) is a newly developed iPad application, which combines graphical images and free text responses in an innovative heuristics approach to explore symptoms and symptom clusters.Seventy-two AYAs (13-29 years of age) with cancer at five institutions across the US completed the C-SCAT 24-96 hours after the initial chemotherapy dose in a chemotherapy cycle.All participants completed the C-SCAT successfully in a mean of 25 minutes, with 74% reporting that the final image was an accurate or very accurate representation of their symptom experience. Little clarification/coaching was necessary while completing the C-SCAT. Few technical problems were encountered. Participants judged the C-SCAT questions to be clear and endorsed ease of following instructions, typing, and drawing.The C-SCAT demonstrated feasibility and acceptability. With refinement based on study results, the C-SCAT has potential to: (a) empower AYAs to communicate their symptom experience and partner with providers in their care; (b) improve symptom management and ameliorate distress; and (c) translate to use with other highly symptomatic populations.

The features of the iPad and its widespread adoption support its use as a tool in research involving children and adolescents. Although use in our current research has been limited to a hospital-based setting,the iPad’s design and features support its potential use in home- and community-based settings as well.In addition to collecting data through web-based platforms and applications, the iPad may facilitate telehealth-based interventions through the use of its built-in camera and Face Time applications.In our experience with children and adolescents,the iPad has been a useful tool to support multiple types of data collection as well as support other aspects of the research process. The use of iPad application technology certainly opens up opportunities for new and novel ways to collect meaningful data and support research with individuals across the lifespan.

We report the complete 5025-base sequence of the human 28S rRNA gene. Variability within the species has been demonstrated by sequencing a variable region from six separately cloned genes. This region is one of three large subunit rRNA regions that show extreme sequence and size variation among species. The interspecies differences suggest species-specific functions for these sections, while the intraspecies heterogeneity indicates differences among ribosomes. Comparison of the human gene with a partial sequence from the chimpanzee 28S gene yields divergence rates for the two species: 0.8% for conserved regions of the gene and 3.7% for a variable region. The rapid divergence rates of variable regions in the ribosomal gene may permit answers to the question of time of separation of closely related species.

Eco-RI-A fragments of the human ribosomal RNA gene family from two types of tissue and three individuals were cloned in λ vectors and compared by restriction enzyme digestion and electron microscopy. The EcoRI fragment A contains (i) 0.2 kb of the 3' end of the 18S rDNA, (ii) 2.5 kb of internal transcribed spacer and the 5.8S rDNA, and (iii) 4.6 kb of the 28S rDNA gene. All of the six cloned rDNA fragments isolated are identical by these analyses. Moreover, all contain a HincII site that is absent in about 50% of the rDNA identified by genomic blotting. Polymorphism in the nontranscribed spacer rDNA was studied on genomic blots of BamHI-digested DNA, using the 3' end of the 28S rDNA as a probe. The boundaries between the 18S rDNA, internal transcribed spacer, 28S rDNA, and external nontranscribed spacer were determined by R-loop analysis, further defining the organization of the ribosomal RNA precursor.

HTC cell variants chosen for their lack of tyrosine aminotransferase (EC 2.6.1.5) (TAT) induction by glucocorticoids were tested for interrelated effects on other glucocorticoid responses: TAT induction by dibutyryl cyclic AMP (dBcAMP) ± dexamethasone, glutamine synthetase (GS) induction, cyclic nucleotide phosphodiesterase (PDE) suppression, inhibition of α-aminoisobutyric acid (AIB) uptake, inhibition of plasminogen activator (PA), and induction of mouse mammary tumor virus (MTV). Loss of TAT induction by steroid was accompanied by loss of TAT induction by dBcAMP and of PDE suppression by steroid. In addition, subclones of MTV-infected cells were examined for the effect of the virus on glutamine synthetase (GS) and TAT induction. The virus had no effect on their induction in wild-type cells and no effect on GS induction in the variants. One MTV-infected subclone from a TAT variant, however, showed significant return of TAT induction.