AJN News: E-Cigarettes and Children, Transgender Health, Nursing Workforce Survey, More

AJN’s monthly news section covers timely and important research and policy stories that are relevant to the nursing world. Here are some of the stories you’ll find in our current issue (news articles in AJN are free access):

E-cigarette packaging uses colorful images to depict various flavors. Photo by David Becker / Reuters.

Toxic Exposures of Young Children to E-Cigarettes on the Rise

A new analysis of calls to U.S. poison control centers found that e-cigarette exposures in children younger than six increased dramatically from 2012 to 2015. Though child-resistant packaging for e-cigarette products was federally mandated in January, advocates are also calling for regulations on eye-catching packaging, which can be attractive to children.

Transgender Rights in Health Care

Recent federal actions are raising awareness about the needs of gender-nonconforming individuals, who have poor health outcomes and often face substandard care, insufficient insurance coverage, and inadequate health outreach.

A Snapshot of the 2015 National Nursing Workforce

Results of a large-scale survey of RNs reveal that education levels among nurses are increasing, along with gender and ethnic diversity, and that the aging of the RN population is slowing—an indicator that concerns about an impending nursing shortage due to retirements may be unwarranted.

Abigail Begin next to her family’s well in Maine. The family only learned that the well contained arsenic after signing up for a study that offered a water quality test. Photo by Amy Temple.

Arsenic Levels in Drinking Water Linked to Bladder Cancer

In light of significantly elevated rates of the disease in Maine, New Hampshire, and Vermont, investigators conducted a population-based case–control study that found a connection between bladder cancer incidence and exposure to arsenic via well water. […]

August 11th, 2016|Nursing, nursing perspective|0 Comments

Zika Transmission Update: New Findings Shed More Light

zika-400The unfolding Zika epidemic demonstrates how we learn about any “emerging infection.” Ongoing surveillance, close clinical observation, and follow-up of recovering individuals steadily refine our understanding of its epidemiology, the public health measures needed, and management of the disease and its sequelae.

Local transmission in the U.S.

The U.S. has seen more than 1800 travel-related cases of Zika infection. Regular travel between countries and the presence of genus Aedes mosquitoes in much of the U.S. made the establishment of local transmission here inevitable, especially in the warmest and most mosquito-abundant parts of the country. Since early July, the Florida Department of Health has identified 15 cases of local Zika transmission in Miami-Dade and Broward counties. Testing of close contacts of cases as well as of asymptomatic people in the community continues in an effort to confirm the extent of the outbreak.

An epidemic of locally acquired cases in the U.S. remains unlikely; window and door screens and the widespread use of air conditioning decrease (though don’t eliminate) human exposure to mosquitoes.

But even with limited local spread, the possibility of microcephaly or other neurological injury in utero is serious, and the CDC has issued its first ever infectious disease–related travel advisory inside U.S. borders. Pregnant women are cautioned to avoid travel to parts of Florida where there is active transmission of the virus as well as to any new areas of active transmission that may be identified in the future. Reports of a poorly contained epidemic in nearby Puerto Rico remain concerning because of the potential for additional travel-related cases that can intensity local spread in Florida.

Sexual transmission from women

The transmission of Zika virus from men to their sexual partners has been repeatedly confirmed. Now, early this summer, the CDC reported a case of apparent female-to-male sexual transmission of Zika in New York City. On the day a woman returned from an area of active Zika transmission, she had condomless sexual intercourse with her male partner. She developed symptoms of Zika infection the next day, and two days later, blood and urine samples were positive for Zika. Her partner became symptomatic six days after intercourse; urine but not serum collected three days later was positive for Zika virus. (The incubation period for Zika virus is thought to be from three to 14 days; viremia likely lasts up to a week.)

In-depth follow-up with each individual as well as with the diagnosing physician confirmed all details of the illnesses. The infected man had no other possible exposures to Zika. Coincidentally, a July report demonstrated the presence of Zika virus RNA in cervical mucus and genital and endocervical swabs three days after illness onset in a French woman with confirmed Zika infection. How long the virus is present in the genital tract and what cofactors might promote transmission are not known. […]

August 5th, 2016|Nursing|0 Comments

Guarding the Flame of Quality: When Nursing Journal Editors Talk Shop

LegoNurse Lego nurse

After first spending a few days on holiday in Scotland (lots of ruined castles, cathedrals, and some expensive scotch—saw one aged 40 years and costing 13,000 pounds!), I recently attended the annual meeting of the International Academy of Nursing Editors (INANE, www.nursingeditors.org) in London. I know a few folks reading this may be thinking (and this is in my best British Monty Python voice), “Wot? A meeting of editors of nursing journals talking about writing and editing? I’d rather stick a pencil in my eye.”

But truly, this meeting tends to be one of the highlights of my year, with rich discussions, networking, and always something new to learn. Those who submit articles to journals headed by these editors should know that their work is reviewed carefully by people who strive to present accurate and clearly written, evidence-based content that will move our profession forward.

In keeping with the tradition of a location outside of North America every third year, this year’s location was picked to coincide with the 100 anniversary of the Royal College of Nursing (RCN), which publishes several nursing specialty journals in addition to Nursing Standard. The RCN headquarters occupies a stately old building off Cavendish Square. It’s the former home of Lady Cowdray, who donated it to the RCN. And while the wide curving central staircase with murals of cherubs brings Downton Abbey to mind, the “Lego nurse” in the lobby near the main “lift” clearly belies that feeling.

Here are some highlights:

  • The director of the Florence Nightingale Museum, Natasha McEnroe, started the meeting by leading a historical discussion examining the life of Florence Nightingale through images. From early photos of the young girl who went against family wishes and the mores of the time to pursue a useful life as a nurse to photos of her in her private rooms in her later years, the images portrayed Nightingale as a proper and demure, ladylike figure, though she more than proved her mettle in her overhaul of military health care and in so many other ways. Nightingale’s work in the Crimea to improve the care of wounded soldiers made her a celebrity in England, but she shunned most requests for interviews and photos sessions. She spent most of her final years secluded, in poor health (many think because of lingering effects of brucellosis) and, fortunately for succeeding generations, focusing on writing.
  • Ben Goldacre, a British physician, academic, and author (of the books Bad Science and Bad Pharma) and a lively and provocative speaker, talked about the appalling lack of real transparency—“sham transparency,” he called it—in reporting research results. For example, although many journals have agreed not to publish results of clinical trials unless the trials are registered and all the data is publicly available, thus allowing for true representation of risks vs. benefits of the treatment under study, his investigations show that only 22% of trials are indeed fully registered but the studies are still being published. He also noted that few studies showing negative results get published. Goldacre urged editors to publicize the All Trials campaign he is leading to improve transparency. The INANE voted to sign on then and there.

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August 5th, 2016|Nursing|0 Comments

A Measure of Contentment: One Patient’s Daily Ritual

By Annelisa Ochoa for AJN By Annelisa Ochoa for AJN

A Measure of Contentment,” the August Reflections essay in AJN, describes the daily ritual of a resident in a long-term care facility. As author Nancy Ngaruiya shows us, nurses and other health care providers can sometimes notice, and support, the small pleasures and routines that make life worthwhile for patients.

Of this patient, she writes:

We make our own happiness. We define what makes us content, what actions help us find that happiness. Sometimes the recipe takes just a few ingredients. Even in an environment where freedom is limited, where rules dictate when to wake up and go to bed, what days of the week we will get assistance with a full bath and who will do it, what meals and activities are or are not available, he has defined what makes him content, perhaps even happy.

The patient in question happens to be one of those who often get frustrated, who aren’t always grateful or helpful—those who tend to be labeled as “challenging” or “difficult” by overworked providers. It’s easy to notice only the frustration of people who’ve watched their worlds shrink bit by bit as their freedoms and abilities diminish along with their health. […]

August 3rd, 2016|Nursing, nursing stories, patient experience|2 Comments

AJN in August: Burn Survivors and Social Media, HPV–Related Oropharyngeal Cancer, More

The August issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Original Research: The Lived Experience of Social Media by Young Adult Burn Survivors

Young adult burn survivors whose burns occurred before they reached young adulthood face particular socialization challenges. Social media is widely used by adolescents and young adults, allowing socialization without face-to-face communication. This qualitative, phenomenological study explores and describes young adult burn survivors’ experience of using social media. The findings, which indicate that social media use may support healing processes in this population, could help nurses develop effective interventions to better prepare young adult burn survivors for reentry into society.

CE Feature: “Human Papillomavirus–Related Oropharyngeal Cancer: A Review of Nursing Considerations

The overall incidence of head and neck cancer has declined in the United States over the past 30 years due to reduction in tobacco use. Over that same period, however, the worldwide incidence of oropharyngeal cancer has escalated significantly, most notably among men and women under age 60 who live in developed countries. This epidemic rise in oropharyngeal cancer is largely attributed to certain genotypes of the human papillomavirus (HPV). This article provides an overview of head and neck cancer—its incidence, risk factors, treatment, and posttreatment sequelae—with a focus on HPV-related oropharyngeal cancer.
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August 1st, 2016|Nursing, nursing perspective|0 Comments