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Educate patients about risk, diagnosis, treatment, and side effects. [ABSTRACT FROM AUTHOR]

Learn about the special needs of the patient who's had this surgical procedure. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular disease (CVD) accounts for 46% of all mortality in the country of Georgia (former Soviet Union). Young adults in that country have not been studied regarding CVD and a need exists to understand lifestyle modifications to promote cardiovascular health., Design: An interpretive description qualitative design was used to explore Georgian young adults' knowledge, attitudes, and beliefs of CVD preventative practices and life experiences., Methods: A convenience sample of 19 ethnic Georgian participants (18-40 years old) who were fluent in either English, Georgian, or Russian from a local private university was used. Semi-structured interviews were conducted via video conferencing utilizing an interpreter., Results: Four themes were identified: (1) CVD and risk factor knowledge, (2) prevention attitudes, beliefs, and gender differences, (3) health literacy influences, and (4) culture and societal impacts. CVD knowledge was limited and influenced by health literacy and the current healthcare system in Georgia., Conclusion: Cultural and societal gender norms influence cardiovascular health behaviors., Clinical Implications: Georgian nurses can play a key role in CVD education and screening for young adults in Georgia., (© 2023 Sigma Theta Tau International.)

Purpose: To explore the experiences of lung cancer survivors (LCSs) and their informal and professional caregivers with post-treatment care and to empower them to implement action-based study findings., Participants & Setting: Participants were recruited using purposeful and snowball sampling from patients at a National Cancer Institute-designated cancer center in the northeastern United States., Methodologic Approach: This study used a participatory action research (PAR) four-phase design. Phase 1 was a focused ethnography; phase 2 consisted of a core group of participants deciding on an action, which was implemented in phase 3; and phase 4 consisted of an evaluation of the action., Findings: The study found 28 categories, eight patterns, and three themes. The themes were the need for resources and education, involvement in mentoring and advocacy, and the value of living versus surviving. The action was creating two flyers focused on resources and advocacy for post-treatment support for LCSs. All participants agreed with the themes and action. Tobacco management and smoking-related stigma for LCSs were the only topics of dissent., Implications for Nursing: Oncology nurses can use PAR to empower survivors in their post-treatment care. Future PAR cycles should focus on creating support groups and alleviating stigma for LCSs and their caregivers.

Host immune cells and clinical interventions often fail to eradicate biofilm-mediated infections, resulting in chronic inflammation. The role of the biofilm three-dimensional structure in this tolerant phenotype has been studied extensively; however, the impact of small molecules released from biofilm-bacteria in modulating host immune function is less well understood. A model of mixed-species biofilms composed of Fusobacterium necrophorum and Porphyromonas levii was developed to evaluate bovine neutrophil responses to bioactive molecules released from either biofilm or planktonic bacteria. We hypothesized that different soluble extracellular factors (ECFs) would be released from planktonic and biofilm bacteria, resulting in altered neutrophil function. Neutrophils exposed to ECFs from planktonic bacteria showed significantly elevated levels of reactive oxygen species (ROS). In contrast, biofilm components from these same species of bacteria failed to induce such a response. Size-exclusion filtration of ECFs revealed that the bioactive molecule causing neutrophil ROS responses was below 3 kDa. Intensive heat, nuclease, lipase, or protease treatments of the <3 kDa fractions did not alter neutrophil functional responses. Protoporphyrin IX (PPIX) is an important heme precursor and growth requirement for many anaerobes. Porphyromonas species can accumulate environmental PPIX at the cell surface as a strategy to protect the bacteria from oxidative stress and we investigated the direct interaction of bovine neutrophils with PPIX. In the present study, evidence suggests that the accumulation of protoporphyrin in these dual-species biofilm ECFs attenuates neutrophil ROS production and chemotaxis. The diminished neutrophil response to biofilm ECFs via the action of PPIX may represent a biofilm immune-evasion strategy that could assist in explaining the ineffectual host clearance of biofilm-mediated infections involving these bacteria., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

Myeloperoxidase (MPO) is one of the most abundantly expressed proteins in neutrophils. It serves as a critical component of the antimicrobial defense system, facilitating microbial killing via generation of reactive oxygen species (ROS). Interestingly, emerging evidence indicates that in addition to the well-recognized canonical antimicrobial function of MPO, it can directly or indirectly impact immune cells and tissue responses in homeostatic and disease states. Here, we highlight the emerging non-canonical functions of MPO, including its impact on neutrophil longevity, activation and trafficking in inflammation, its interactions with other immune cells, and how these interactions shape disease outcomes. We further discuss MPO interactions with barrier forming endothelial and epithelial cells, specialized cells of the central nervous system (CNS) and its involvement in cancer progression. Such diverse function and the MPO association with numerous inflammatory disorders make it an attractive target for therapies aimed at resolving inflammation and limiting inflammation-associated tissue damage. However, while considering MPO inhibition as a potential therapy, one must account for the diverse impact of MPO activity on various cellular compartments both in health and disease.

Problem Identification: Growing numbers of African Caribbean immigrants with cancer reside in the United States and frequently encounter different challenges than survivors born in the United States., Literature Search: More than a decade of research was searched in the PubMed®, Embase®, CINAHL®, and Scopus® databases using terms reflective of African Caribbean immigrant survivors in the United States., Data Evaluation: The initial search in this scoping review revealed 912 articles, with seven meeting inclusion criteria. Data extracted from articles included purpose/aims, design, sample/setting, methods, and results., Synthesis: Five retrospective analyses, one case report, and one qualitative study comprised the final sample. Thematic analysis used to synthesize results revealed two themes: survival patterns and barriers., Implications for Research: The results indicated a need to identify and address root causes of disparity, and track the effectiveness of available treatments and outcomes by country of birth. Research capturing the experiences of African Caribbean immigrants would benefit from collaboration with community leaders and survivors. Oncology nurses play critical roles in leading research and developing culturally informed practices in clinical settings.

Problem Identification: Lung cancer survival rates are improving, and survivors may have unmet post-treatment care needs. Oncology nurses' understanding of these needs can guide development of holistic survivorship care., Literature Search: A comprehensive search of CINAHL®, PubMed®, and Embase® databases was performed to explore lung cancer survivor experiences with post-treatment care., Data Evaluation: The final sample included 25 studies that were critically appraised for methodologic quality., Synthesis: Eight themes were identified., Implications for Research: Issues, such as race, gender, and stigma, represent barriers to holistic lung cancer survivorship care. Little mention of care coordination emphasizes the need for research in this area. Understanding the interplay of symptom and healthy lifestyle management is needed.

In advanced cancer care, patient preferences regarding treatment are sometimes insufficiently integrated in the decision-making process. This can be the case with patients from non-Western cultural backgrounds undergoing treatment in the US. This study aimed to understand oncology and palliative care physicians' and nurses' perceptions of factors that impact involvement in treatment decisions by patients from diverse cultural backgrounds. Seventeen participants (6 MDs, 9 RNs, and 2 NPs) were interviewed using a semi-structured guide. Interviews were analyzed using conventional content analysis. Findings revealed six barriers to patient involvement in decision-making: language, socio-economic status, educational status, gender, family attitudes, and healthcare providers' behavior and attitudes. Participants did not view culture itself as a barrier to patient involvement, but rather, noted culture-amplified barriers that occurred with patients across all cultural backgrounds. To overcome these barriers, a wider integration of cultural competence in patient care is needed.

Introduction: Advance directive completion rates among the general population are low, with even lower completion rates among African Americans (AAs). This study's purpose was to identify culturally based meanings, expressions, and traditions of end-of-life (EOL) advance care planning (ACP) and decision making in order to promote culturally congruent nursing care among African Americans., Methodology: Leininger's Culture Care Theory and Ethnonursing Research Method guided the study. A convenience sample of 21 informants were interviewed in community settings. Data analysis was guided using Leininger's phases of ethnonursing data analysis for qualitative data., Results: Three themes emerged that affect EOL decision making: (a) faith in God and belief in life after death, (b) a strong matriarchal family structure, and (c) fear of talking about death and mistrust of the U.S. health care system., Discussion: AA culture, beliefs, and traditions influence EOL ACP and practices, and must be considered while providing culturally congruent care.

Introduction: Increased numbers of African Americans (AAs) are being diagnosed with inflammatory bowel disease (IBD), little is known about the influence of culture on their coping., Purpose: To explore the beliefs and experiences of AAs with IBD and coping in the context of their culture., Method: Twelve AA adults with IBD were interviewed and observed using focused ethnography., Results: Data analysis revealed four themes: (1) spending time living in the bathroom, (2) time and food restricted eating practices and cultural food avoidance, (3) dealing with chronic stress and perceived racial injustice, and (4) the practice of seclusion to manage bathroom urgency and emotions of fear, anxiety, and embarrassment., Discussion: Participants described coping and culture with experiences similar to other IBD populations, except in the area of perceived racial injustice. Opportunities for nurses to assist with stressors related to bathroom access, cultural eating practices, and participating in activities outside their homes.

Background: The nursing shortage has been deemed a public health crisis as the turnover rate of newly licensed graduate nurses (NLGNs) continues to grow. One of five NLGNs are leaving the profession due to work dissatisfaction and feelings of inadequacy, risking patient safety., Method: A prospective, randomized controlled trial evaluated the impact of a 6-week digital intervention (text messaging) on NLGNs' self-reported stress, resiliency, sense of support, and intention to leave their jobs, organization, and profession. Messages to the experimental group ( n = 10) conveyed emotional, esteem, and networking support, and messages to the control group ( n = 11) were medical facts., Results: The digital intervention in the form of medical facts increased the control group's sense of social support. Stress, resilience, and intention to leave their jobs, organizations, or profession did not change for either the control or experimental group., Conclusion: A digital intervention, such as text messaging, potentially can increase NLGNs' sense of support during their first year of hire. [ J Contin Educ Nurs . 2021;52(8):367-374.] .

Background: Acromial fractures are a substantial complication following reverse shoulder arthroplasty, reported to affect up to 7% of patients. Previous studies have shown that implant placement affects acromial stress during elevation of the arm in the scaption plane. The purpose of this study was to investigate the results of arm loading and variation in plane of elevation on acromial stresses., Methods: Nine elevation angles (0°-120°), in three planes of elevation (abduction (0°), scaption (30°), and forward elevation (60°)), and three hand loads (0, 2.5, 5 kg) were investigated. Finite element models were generated using computed tomography data from 10 cadaveric shoulders (age 68 ± 19 yrs) to determine acromial stress distributions. Models were created for a lateralized glenosphere (0, 5, 10 mm), inferiorized glenosphere (0, 2.5, 5 mm), and humeral offset (-5, 0, 5 mm)., Results: For all planes of elevation (0°, 30°, 60°) and hand loads (0, 2.5, 5 kg) investigated, glenoid lateralization consistently increased acromial stress, glenoid inferiorization consistently decreased acromial stress, and humeral offset proved to be insignificant in altering acromial stress. Abduction resulted in significantly higher peak acromial stresses (p = 0.002) as compared to scaption and forward elevation., Conclusions: In addition to implant position and design, patient activity, such as plane of elevation and hand loads, has substantial effects on acromial stresses., Level of Evidence: Basic science study., Competing Interests: Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: George S. Athwal is a consultant for Wright Medical and Exactech. No company was involved with this study., (© 2020 The British Elbow & Shoulder Society.)

Introduction: There is limited research on the surgical management techniques for scapular spine fractures after reverse shoulder arthroplasty (RTSA). As such, the purpose of this in vitro biomechanical study was to compare 4 fixation constructs to stabilize scapular spine insufficiency fractures., Methods: Twelve paired fresh-frozen cadaveric scapulae (N = 24) were randomized into 4 fixation groups: subcutaneous border plating (± hook) and supraspinatus fossa plating (± hook). A Levy type II fracture was simulated. Each specimen was cyclically loaded incrementally up to 700 N in 50 N steps or until failure. Between 50 and 200 N construct stiffness was measured, and stability failure was defined as displacement greater than 2.5 mm., Results: Seventy-nine percent (19 of 24) of the specimens failed before the maximum load of 700 N. The average survival force with subcutaneous border plating was 480 ± 80 N compared with 380 ± 30 N for supraspinatus fossa plating (P = .3). Fixation construct failure was significantly more likely with fossa plating over subcutaneous plating (P = .012). The presence of the lateral plate hook was beneficial in preventing failure of the lateral acromion (P = .016)., Conclusion: When appropriately surgically indicated, a dorsally applied plate to the subcutaneous border of the scapular spine with a lateral inferior supporting hook may be advantageous for internal fixation of type II scapular spine insufficiency fractures after RTSA., (Copyright © 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Background: Competency based education (CBE) has been suggested for nurse practitioner (NP) education reform. For this to occur, competencies should reflect the knowledge, skills, and attitudes that NPs need for independent practice., Purpose: This integrative review examined the general practice activities of NPs across all population foci to determine the extent to which these activities are reflected in current NP competencies., Method: Using the Whittemore and Knafl (2005) integrative review method, 17 studies that focused on NP practice between 2008 and 2018 were retrieved from three electronic databases. These studies were evaluated, analyzed and synthesized for themes. Afterwards the themes were compared with seven sets of current NP core competencies., Results: The themes for NP practice activities were direct and indirect patient care activities with a majority of NP time spent performing direct patient care activities. However, only 14% of the NP core competencies reflected these direct care activities., Conclusion: In order to successfully implement CBE, a need exists for the NP core competencies to reflect current NP practice., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objectives: This scoping review summarizes oncology resources for pre-licensure and graduate nursing programs in the United States., Data Sources: PubMed, CINAHL, and Scopus databases were searched to identify resources (2008-2019) published in peer-reviewed journals. While 1,503 papers were initially identified, 49 met inclusion criteria., Conclusion: Thematic analysis revealed five themes with subthemes: (1) didactic courses; (2) clinical opportunities; (3) didactic and clinical resources; (4) simulation resources; and (5) other., Implications for Nursing Practice: Academic educators are charged with preparing a nursing workforce capable of providing safe and quality evidence-based care across the cancer continuum. Findings offer examples that overcome curriculum barriers., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Cancer is the leading cause of death for Asian Americans, a growing population in the United States. While cancer survivors often experience complex issues after diagnosis, being an immigrant and having cancer pose additional challenges., Objective: This scoping review analyzed research about immigrant cancer survivors of Asian ethnicity in the United States and provided a structured method to understand an area of research and evidence. Aims focused on immigrants' experiences and how findings could tailor evidence-based interventions, programs, and resources., Methods: The PubMed, CINAHL, and Scopus databases were searched to identify studies in English (2009-2018) targeting Asian immigrant cancer survivors in the United States. While 385 records were initially identified, 32 studies met the inclusion criteria., Results: Thematic analysis of charted study elements revealed 4 themes with subthemes: (1) survival patterns, (2) barriers, (3) culturally informed care, and (4) quality of life (QOL). While qualitative studies provided insight about the cancer experience from immigrants' perspectives, quantitative designs posed descriptions and associations among QOL concepts., Conclusions: Study results illustrate the need for survival research that explores outcomes by Asian ethnic subgroups and tracks the influence of acculturation. Future research should test culturally informed interventions that minimize barriers and foster QOL across the cancer continuum. Culturally tailored instruments can expedite larger-scaled studies that allow generalization., Implications for Practice: Asian immigrants comprise an underserved, vulnerable, and growing group with various cancers. Nurses who care for immigrants and their families should be cognizant of cultural beliefs, values, practices, and issues related to communication, care access, and socioeconomics.

Background: Competency-based education (CBE) has been recommended for nurse practitioner (NP) education. To implement CBE, existing NP core competencies need to be reduced in number and refined., Purpose: This study refined and reduced redundancy in the National Organization of Nurse Practitioner Faculties (NONPF) and the American Association of Colleges of Nursing (AACN) NP core competencies through the consensus of experts in NP practice. This study used the current NP Core Competencies (NONPF, 2017), the Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006), and the Common Advanced Practice Registered Nurse Doctoral-Level Competencies (AACN, 2017a) because these documents are the competencies-accredited NP programs commonly used in curriculum development. The primary aim of this study was to refine and reduce redundancy of these competencies; a secondary aim was to ensure that the final competencies were clear and measurable., Methods: A Delphi approach was used to reach consensus among an expert panel who reviewed the core competencies via an online questionnaire. Descriptive statistics were used to calculate median and interquartile ranges; content analysis was conducted with qualitative data., Results: Consensus was reached after 3 rounds and resulted in 49 final core competencies., Implications for Practice: This study provides the NP community with a manageable list of relevant, clear, and measurable competencies that faculty members can use to implement CBE in their programs.

An integrative review was conducted to evaluate the extent and quality of literature regarding adult oncology patients' trust in nurses. Nineteen studies met the inclusion criteria. Three themes were identified, which are as follows: nurse trust facilitating behaviors, nurse attributes, and the influence of patient-nurse trust on health and psychosocial well-being. Findings indicate that the extent of literature is limited in specific examples of nurse interventions that facilitate interpersonal patient-nurse trust. Future research should include more detailed nurse actions and attributes that build patient-nurse trust to fully understand the benefits of trust in oncology patients.

Given the chronic nature of inflammatory bowel disease, understanding the coping behaviors of individuals affected with the disease is important to influence health outcomes. Although minorities comprise a significant portion of individuals with the disease, little is known about the potential influence of one's culture, specifically among African Americans, on coping with inflammatory bowel disease. This integrative literature review examined the past decade of research related to the coping behaviors of African Americans living with inflammatory bowel disease to identify opportunities for further research. Five studies were identified via database searches of PubMed, PsychInfo, CINAHL, and the Cochrane Library and limited to studies published in English, full-text, peer-reviewed, and adult samples that included African Americans. Findings lacked information specific to coping in African Americans. Results were categorized by coping and disease activity, acquisition of knowledge, and personal coping. An association between poor coping behaviors and active disease was reported. The disease frequently hindered academic pursuits of college students, with increased knowledge about the disease associated with the use of better coping strategies. Personal coping behaviors were reported in stressful social situations, food choices, and religion. Results emphasized the need for future research to explore the influence of culture on the coping behaviors of African Americans with inflammatory bowel disease.

Here we characterized the murine dextran sulfate sodium (DSS) model of acute colitis. Specifically, we evaluated azithromycin and metronidazole treatment regimens to assess their effects on animal wellbeing, pathologic changes, barrier function, cytokine and chemokine profiles, and neutrophil migration in colon tissue. Azithromycin treatment significantly reduced the severity of colitis, as assessed through body weight change, water consumption, macroscopic lesions, and animal behaviors (activity level, climbing, and grooming), but did not alter food consumption or feeding behavior. Mucosal barrier function (evaluated by using FITC-labeled dextran) was decreased after DSS exposure; azithromycin did not significantly alter barrier function in mice with colitis, whereas metronidazole exacerbated the colitis-related deficit in barrier function. In addition, metronidazole appeared to exacerbate disease as assessed through water consumption and animal behaviors (overall activity, climbing, grooming, and drinking) but had no effect on weight loss, macroscopic lesions, or eating behavior. Pathologic changes were typical for DSS treatment. Antibiotic treatment resulted in reduced levels of proinflammatory cytokines and chemokines and decreased neutrophil adhesion and emigration in DSS-exposed mice. The results highlight the importance of clinical and behavioral assessments in addition to laboratory evaluation as tools to evaluate animal welfare and therapeutic efficacy in disease models. Data from this study suggest that azithromycin may convey some benefits in the mouse DSS colitis model through modulation of the immune response, including neutrophil migration into tissues, whereas metronidazole may exacerbate colitis.

Advance directive completion rates among the general population are low. Studies report even lower completion rates among African Americans are affected by demographic variables, cultural distinctives related to patient autonomy, mistrust of the health care system, low health literacy, strong spiritual beliefs, desire for aggressive interventions, importance of family-communal decision making, and presence of comorbidities. An integrative review was conducted to synthesize nursing knowledge regarding cultural perspectives of end-of-life and advance care planning among African Americans. Twenty-four articles were reviewed. Nurses educate patients and families about end-of-life planning as mandated by the Patient Self-Determination Act of 1991. Implementation of advance directives promote patient and family centered care, and should be encouraged. Clinicians must be sensitive and respectful of values and practices of patients of diverse cultures, and initiate conversations with open-ended questions facilitating patient trust and sharing within the context of complex beliefs, traditions, and lifeways.

Background: Growing increases in current and projected cancer survivors demands a workforce that can safely meet their health care needs spanning a lifetime. The literature lacks sufficient evidence regarding the knowledge needed by non-oncology nurses who care for cancer survivors in settings not designated for cancer care. This study identified this oncology knowledge and perceived barriers., Method: The Cancer Nursing Curriculum Survey was completed by a national pool of 302 oncology and 313 medical-surgical nurses who rated the depth and importance of 33 cancer concepts needed by non-oncology nurses for cancer survivor care., Results: Concept means for depth and importance were similar between both groups, with importance rated higher. Major concepts focused on symptom management. Barriers included lack of time, knowledge, and access to resources., Conclusion: The findings indicate the understanding of knowledge needed by non-oncology nurses for survivor care and provide a first step to design continuing education to address needs. J Contin Educ Nurs. 2018;49(1):12-18., (Copyright 2018, SLACK Incorporated.)

Purpose: This study explored the experiences of Black nurse faculty employed in predominantly White schools of nursing. High attrition rates of this group were noted in previous literature. Understanding their experiences is important to increase nurse diversity., Design: Hermeneutic phenomenology was used to explore the experiences of 15 Black nurse faculty using interviews., Findings: Four themes were extracted as the following: cultural norms of the workplace, coping with improper assets, life as a "Lone Ranger," and surviving the workplace environment., Discussion: The study provided insight to understand the meaning that Black faculty members give to their experiences working in predominantly White schools of nursing. Findings exemplify the need to improve culturally competent work environments and mentoring programs., Implications for Practice: Results suggest that better communication and proper respect from students, colleagues, and administrators are necessary. The limited research on this topic illustrates that Black nurse faculty remain under investigated; research is necessary to determine effective change strategies.

Biofilms composed of anaerobic bacteria can result in persistent infections and chronic inflammation. Host immune cells have difficulties clearing biofilm-related infections and this can result in tissue damage. Neutrophils are a vital component of the innate immune system and help clear biofilms. The comparative neutrophilic response to biofilms versus planktonic bacteria remains incompletely understood, particularly in the context of mixed infections. The objective of this study was to generate mixed species anaerobic bacterial biofilms composed of two opportunistic pathogens, Fusobacterium necrophorum and Porphyromonas levii, and evaluate neutrophil responses to extracellular fractions from both biofilms and planktonic cell co-cultures of the same bacteria. Purified bovine neutrophils exposed to culture supernatants from mixed species planktonic bacteria showed elevated oxidative activity compared to neutrophils exposed to biofilms composed of the same bacteria. Bacterial lipopolysaccharide plays a significant role in the stimulation of neutrophils; biofilms produced substantially more lipopolysaccharide than planktonic bacteria under these experimental conditions. Removal of lipopolysaccharide significantly reduced neutrophil oxidative response to culture supernatants of planktonic bacteria. Oxidative responses to LPS-removed biofilm supernatants and LPS-removed planktonic cell supernatants were similar. The limited neutrophil response to biofilm bacteria observed in this study supports the reduced ability of the innate immune system to eradicate biofilm-associated infections. Lipopolysaccharide is likely important in neutrophil response; however, the presence of other extracellular, immune modifying molecules in the bacterial media also appears to be important in altering neutrophil function., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Strengthening attention-regulation efficiency of nurse graduates is important to the quality and safety of nursing practice in increasingly complex and cognitively distracting workplaces. Neuroscientific evidence suggests that regular practice of focused meditation can enhance attentional skills. This study explored meditation as an educational strategy for enhancing nursing students' attentional efficiency., Method: A randomized-control trial with 52 prelicensure nursing students examined differences between those who meditated and those who did not on measurements of alerting, orienting, and executive attention. Stress and mindfulness were also explored., Results: Meditation demonstrated moderate strength for enhancing executive attention, F = 4.26 (1, 49), n 2 = .080, p = .044. Additional outcomes specific to the meditation group were reduced stress and increased mindfulness, F = 7.16 (2, 47), n 2 = .234, p = .002., Conclusion: Results support the consideration of meditation training as a strategy for enhancing nursing students' attentional efficiency and other self-regulatory skills necessary for safe nursing practice. [J Nurs Educ. 2017;56(7):430-434.]., (Copyright 2017, SLACK Incorporated.)

Introduction: African-American women have higher rates of early-onset breast cancer compared with their Caucasian counterparts; yet, when diagnosed with breast cancer at a young age, they underuse genetic counseling and testing to manage their risk of developing future cancers., Methods: Self-reported baseline data were collected between September 2012 and January 2013 and analyzed in 2014 from a subpopulation of 340 African-American young breast cancer survivors (YBCSs) enrolled in an RCT. YBCSs were diagnosed with invasive breast cancer or ductal carcinoma in situ between ages 20 and 45 years and were randomly selected from a statewide cancer registry. Logistic regression examined predictors of using cancer genetics services., Results: Overall, 28% of the sample reported having genetic counseling and 21% reported having genetic testing, which were significantly lower (p≤0.005) compared with white/other YBCSs participating in the parent study. In a multivariate analysis, income was positively associated with counseling (B=0.254, p≤0.01) and testing (B=0.297, p≤0.01), whereas higher education levels (B=-0.328, p≤0.05) and lack of access to healthcare services owing to cost (B=-1.10, p≤0.03) were negatively associated with genetic counseling. Lower income and lack of care because of high out-of-pocket costs were commonly reported barriers., Conclusions: Despite national recommendations for genetic evaluation among women with early-onset breast cancer, few African-American YBCSs reported undergoing genetic counseling and testing. Most reported that their healthcare provider did not recommend these services. Interventions addressing patient, provider, and structural healthcare system barriers to using genetic counseling and testing in this population are needed., (Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.)

The purpose of this project was to design, implement, and evaluate a virtual simulation experience (VSE) facilitating student access to diverse cultures and strengthening their ability to provide culturally congruent care., Design: Faculty from two universities collaborated in designing a pre/postnatal VSE with African American and Amish patients. Students viewed patient assessments, interacted with patients, worked in teams to develop culturally appropriate care plans, and engaged in debriefing. Outcomes measurements included Jeffreys' Transcultural Self-Efficacy Test (TSET), researcher developed care plans, and program evaluation., Results: Over 80% (N=141) of the invited students consented. Significant increases occurred in overall and subscale post-TSET scores (P<.001). Care plan mean scores were ≥8.82 out of 10 points per category. Students recognized the need to be nonjudgmental in patient care., Conclusions: This study suggests that VSEs are effective in transcending geographic barriers, gaining access to diverse cultures, and strengthening students' cultural competence., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Despite reported challenges encountered by nurses who provide palliative care to children, few researchers have examined this phenomenon from the perspective of nurses who care for children with life-threatening illnesses in pediatric intensive care units., Objectives: To describe and interpret the essence of the experiences of nurses in pediatric intensive care units who provide palliative care to children with life-threatening illnesses and the children's families., Methods: A hermeneutic phenomenological study was conducted with 12 pediatric intensive care unit nurses in the northeastern United States. Face-to-face interviews and field notes were used to illuminate the experiences., Results: Five major themes were detected: journey to death; a lifelong burden; and challenges delivering care, maintaining self, and crossing boundaries. These themes were illuminated by 12 subthemes: the emotional impact of the dying child, the emotional impact of the child's death, concurrent grieving, creating a peaceful ending, parental burden of care, maintaining hope for the family, pain, unclear communication by physicians, need to hear the voice of the child, remaining respectful of parental wishes, collegial camaraderie and support, and personal support., Conclusion: Providing palliative care to children with life-threatening illnesses was complex for the nurses. Findings revealed sometimes challenging intricacies involved in caring for dying children and the children's families. However, the nurses voiced professional satisfaction in providing palliative care and in support from colleagues. Although the nurses reported collegial camaraderie, future research is needed to identify additional supportive resources that may help staff process and cope with death and dying., (©2016 American Association of Critical-Care Nurses.)

Diversity in academia requires attention, especially with the expected increase in minority populations in the United States (American Association of Colleges of Nursing, (AACN) 2014). Despite theoretical papers that suggest that several challenges are encountered by minority faculty employed in predominately White institutions, a dearth of research on this topic has been published. The purpose of this literature review was to analyze the published research that addressed the workplace environment of African-American faculty employed in predominately White institutions. In utilizing the keywords in various combinations, 236 articles were retrieved through multiple databases. After applying inclusion and exclusion criteria, 15 studies were reviewed with only three related to nursing. Two themes were extracted from the review: 1) the cultural climate of the workplace environment and, 2) underrepresentation of African-American faculty. It is apparent from this review that additional research is needed to understand the experiences of this group of faculty to target effective recruitment and retention strategies.

Background: Bariatric surgery research, often longitudinal, bears the challenge of maintaining retention and decreasing attrition of participants to avoid bias., Objectives: To explore factors influencing the retention and attrition for bariatric surgical research participants., Methods: Databases searched included: PubMed, CINAHL, Scopus, and others. As a secondary aim, studies reporting on retention/attrition factors in clinical follow-up visits were included., Results: Of the 1145 articles retrieved, 44 met inclusion criteria, and underwent qualitative analysis. Four descriptive articles focused on longitudinal research participation and 40 on clinical follow-up visits. Willingness to participate in research was high (92%) and decreased with more invasive procedures or extra visits. A large observational longitudinal study presented 24-month retention/attrition data (92% for some data and 66% visit completion) and the retention strategies employed. One study indicated that research follow-up possibly increased clinical follow-up and another demonstrated a higher retention by increasing compensation. No consistent, modifiable demographic or psychosocial variables associated or predictive of retention or attrition in clinical follow-up were identified., Conclusions: Research on factors related to participant retention and attrition is sparse. It is essential for studies to document retention/attrition data. Existing research has demonstrated a patient willingness to participate in research and that retention strategies have been successful in the short term. Further research should explore the motivations, perspectives and attitudes of bariatric surgical research participants regarding participation and explore predictors to develop evidence-based retention strategies. Research has yet to identify consistent and modifiable demographic or psychosocial variables predictive of clinical follow-up, possibly due to the heterogeneity of follow-up across studies. Further investigation into follow-up definition, content, counseling approaches, and new telemedicine technologies may prove helpful in developing predictors and evidence-based strategies. The relationship between research and clinical retention and attrition deserves further characterization., (Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Purpose: This integrative review was conducted to examine factors that influence mammography screening and use of cancer genetic services among younger African American women at increased risk for developing breast cancer., Data Sources: Research articles were identified using PubMed, CINAHL, PsychINFO, and Cochrane library to find studies published from 2003 to 2013., Conclusions: Findings from this review indicate that while younger African American women receive mammograms more often than the general population, they are not being referred for genetic testing when appropriate. This is a major concern because African American women tend to experience more aggressive forms of breast cancer at an earlier age than the general population; it is imperative that they undergo genetic testing for optimal management of their breast cancer risk., Implications for Practice: Nurse practitioners have a significant role in breast cancer screening and genetic testing of at-risk women, particularly in identifying and referring young women for testing. Further communication efforts are needed to improve young women's knowledge of breast cancer risk and the benefits of genetic testing. Reducing barriers to breast healthcare services requires nursing efforts that focus on populations at greatest risk for poor health outcomes., (©2015 American Association of Nurse Practitioners.)