Out of the Hospital, Out of the Box: Utilizing the CNS Role in Home Healthcare Settings.

The United States has poorer population health outcomes compared to similar developed nations despite higher healthcare spending. Multiple factors contribute to this problem, including high healthcare costs, insurance coverage limitations, and a lack of focus on preventive care and wellness. Clinical Nurse Specialists (CNSs), primarily known for their impact in acute care settings, increasingly demonstrate their value in outpatient settings like home healthcare.

Media Interview Tips and Techniques for the Registered Nurse.

Background: As the largest segment of the healthcare workforce, nurses have a unique opportunity to increase the visibility of the nursing profession's contributions to healthcare services and clinical outcomes across population groups by participating in media interviews. Although a media interview can be intimidating, there are steps one can take to ensure optimal media engagement. Nurses should collaborate with the media by becoming familiar with the elements of good reporting.

The 4M Model.

Engaging the health care team, including older adults and their caregivers, with the Institute for Healthcare Improvement 4M Model can help ensure every older adult receives (1) optimal health care, (2) is not harmed by health care, and (3) is satisfied with their health care. The evidence-based 4 Ms Model includes 4 significant concepts specific to older adult care: What matters, Mentation, Mobility, and Medication. Unfortunately, clinicians do not consistently apply the 4 Ms Model when caring for older adults.

Educating Bachelor of Science in Nursing Students in Leadership Strategies Needed for Care Management and Disease Management for the Heart Failure Patient Population.

During Bachelor of Science in Nursing (BSN) program education, student nurses are introduced to topics such as patient care across health care settings, health promotion, research, safety and quality, technology, and leadership in the health care system. As one of the most common diseases in the population, heart failure (HF) is covered throughout the BSN curriculum. There are various educational strategies used by nursing schools to ensure BSN students possess the necessary leadership skills and are prepared for providing HF patient care in care management settings.

Effectiveness of an End-of-Life Nursing Education Consortium Training on Registered Nurses' Educational Needs in Providing Palliative and End-of-Life Patient Care.

Registered nurses play a critical role in delivering effective palliative and end-of-life patient care. Previous literature has cited that registered nurses report a lack of adequate palliative care training in academic and continuing education programs. Providing care to patients at the end of life requires knowledge in a variety of areas such as nonpharmacologic symptom management, cultural considerations, and pain management.

Tacrolimus restores the high- and low-pressure baroreflex control of renal sympathetic nerve activity in cisplatin-induced renal injury rats.

New Findings: What is the central question of this study? Does immunosuppression restore the baroreflex control of renal sympathetic nerve activity (RSNA) in an animal model of kidney injury? What is the main finding and its importance? Tacrolimus, a calcineurin inhibitor, restored the high- and low-pressure baroreflex control of RSNA following cisplatin-induced renal injury.

Abstract: Cisplatin administration causes depression of renal haemodynamic and excretory function and is associated with renal sympatho-excitation and loss of baroreflex regulation of renal sympathetic nerve activity (RSNA). This study investigated whether administration of the immunosuppressant tacrolimus in this cisplatin-mediated renal injury model could restore, or the acute intra-renal infusion of tumour necrosis factor α (TNF-α) could blunt, the high- or low-pressure baroreflex control of RSNA.

Perceived Barriers to Exercise in the First Trimester of Pregnancy.

Regular physical activity has been shown to improve pregnancy outcomes. We sought to identify barriers to exercise during the first trimester of pregnancy. Five hundred forty-nine pregnant women in their first trimester rated barriers to exercise on a scale of 1 () to 5 () and recorded physical activity (minutes/week).

Sepsis in the Burn Patient.

Sepsis is the leading cause of death in burn patients. Interventions are challenging owing to a lack of specific guidelines. All burn types involve a risk for complications.

Creating a Research Agenda and Setting Research Priorities for Clinical Nurse Specialists.

Purpose/objectives: The purpose of this article is to describe the evolution and results of the process for establishing a research agenda and identification of research priorities for clinical nurse specialists, approved by the National Association of Clinical Nurse Specialists (NACNS) membership and sanctioned by the NACNS Board of Directors.

Description Of The Project/program: Development of the research agenda and identification of the priorities were an iterative process and involved a review of the literature; input from multiple stakeholders, including individuals with expertise in conducting research serving as task force members, and NACNS members; and feedback from national board members.

Outcome: A research agenda, which is to provide an enduring research platform, was established and research priorities, which are to be applied in the immediate future, were identified as a result of this process.

Combined XIL-6R and urocortin-2 treatment restores MDX diaphragm muscle force.

Introduction: Duchenne muscular dystrophy (DMD) is characterized by progressive muscle degeneration leading to immobility, respiratory failure, and premature death. As chronic inflammation and stress are implicated in DMD pathology, the efficacy of an anti-inflammatory and anti-stress intervention strategy in ameliorating diaphragm dysfunction was investigated.

Methods: Diaphragm muscle contractile function was compared in wild-type and dystrophin-deficient mdx mice treated with saline, anti-interleukin-6 receptor antibodies (xIL-6R), the corticotrophin-releasing factor receptor 2 (CRFR2) agonist, urocortin 2, or both xIL-6R and urocortin 2.

Opportunistic Fungal Infections in Critical Care Units.

Fungal infections are rare compared with bacterial infections, but they are on the increase in critical care units. Diagnosis can be difficult, resulting in increased mortality. Immunocompromised patients are at higher risk for fungal infections, including organ transplant, oncology, and HIV/AIDS patients.

Infection in the Critically Ill Older Adult.

Many challenges exist in caring for older adults with infection in critical care environments. Older adults are at high risk due to diminished reserve, age-related changes, comorbidities, subtle clinical presentations, and institutionalization. Additional risks include infections, such as pneumonia, influenza, and nosocomial infections.

The Influence of Nurse Manager Leadership Style on Staff Nurse Work Engagement.

Background: Nursing literature supports the importance of an engaged nursing workforce as a means to positively influence performance. Nurse manager leadership style plays a critical role in engaging staff nurses. These relationships have been minimally studied in nurse managers and staff nurses.

Clinical diagnosis and chemical confirmation of ciguatera fish poisoning in New South Wales, Australia.

Ciguatera fish poisoning is common in tropical and sub-tropical areas and larger fish (> 10 kg) are more susceptible to toxin accumulation with age. Although the coastal climate of northern New South Wales is considered sub-tropical, prior to 2014 there has only been 1 documented outbreak of ciguatera fish poisoning from fish caught in the region. During February and March 2014, 2 outbreaks of ciguatera fish poisoning involved 4 and 9 individuals, respectively, both following consumption of Spanish mackerel from northern New South Wales coastal waters (Evans Head and Scotts Head).

Student participation in clinical handover-an integrative review.

Aim And Objectives: To examine the literature exploring the current understanding of student nurse participation in clinical handover whilst they are enrolled in an undergraduate preregistration course.

Background: The importance of handing over the care of a patient to ensure continuity and safety of care is well-recognised. Effective preparation of student nurses to competently perform this critical task requires the use of appropriate teaching strategies to support this learning, within undergraduate preregistration nursing programs.

Delivery of an Impacted Fetal Head During Cesarean: A Literature Review and Proposed Management Algorithm.

Effective and expedient management of an impacted fetal head (IFH) at cesarean delivery is essential to avoid maternal and neonatal morbidity. The incidence of an IFH at the time of cesarean may increase because of changing practice guidelines regarding the acceptable duration of the second stage of labor. Based on limited available evidence comparing the "push," "pull," and other methods for delivery of the IFH, we suggest the primary disengagement technique be selected based on surgeon experience and propose a management algorithm "ALERT" for clinical application.

What has the mdx mouse model of Duchenne muscular dystrophy contributed to our understanding of this disease?

Duchenne muscular dystrophy (DMD) is a fatal X-chromosome linked recessive disorder caused by the truncation or deletion of the dystrophin gene. The most widely used animal model of this disease is the dystrophin-deficient mdx mouse which was first discovered 30 years ago. Despite its extensive use in DMD research, no effective treatment has yet been developed for this devastating disease.

Nursing bedside clinical handover - an integrated review of issues and tools.

Aims And Objectives: This article reviews the available literature that supports implementing bedside clinical handover in nursing clinical practice and then seeks to identify key issues if any.

Background: Clinical handover practices are recognised as being an essential component in the effective transfer of clinical care between health practitioners. It is recognised that the point where a patient is 'handed over' from one clinician to another is significant in maintaining continuity of care and that doing this poorly can have significant safety issues for the patient.

Amitriptyline is efficacious in ameliorating muscle inflammation and depressive symptoms in the mdx mouse model of Duchenne muscular dystrophy.

Mutations in the structural protein dystrophin underlie muscular dystrophies characterized by progressive deterioration of muscle function. Dystrophin-deficient mdx mice are considered a model for Duchenne muscular dystrophy (DMD). Individuals with DMD are also susceptible to mood disorders, such as depression and anxiety.

T cell CD3 receptor zeta (TCRzeta)-chain expression in children with idiopathic nephrotic syndrome.

Children with idiopathic nephrotic syndrome (INS) have an increased risk of developing life-threatening infections. Several studies have demonstrated functional abnormalities in the T lymphocytes of patients with nephrotic syndrome. Although T cells are activated in INS during relapse, as indicated by an increased expression of interleukin (IL)-2 receptor, these cells have a decreased ability to proliferate.

Adolescent alcohol use in context: the role of parents and peers among African American and European American youth.

African American youth are less likely to use alcohol than their European American counterparts; however, the greater consequences of use for African American youth highlight the need for greater research attention to this group. Two social contexts that have been linked with adolescent alcohol use are parents and peers, yet these studies have rarely included African American youth or failed to examine potential racial differences. This study examined the main and interactive effects of parents and peers, as well as the moderating role of race on alcohol use, in African American and European American rural adolescents (n=71) identified as at high-risk for alcohol use.