Influencing a Culture of Quality and Safety Through Huddles.

Background: Literature shows that interdisciplinary huddles help promote clear communication and proactive reporting of potential errors.

Local Problem: High reliability organization (HRO) and just culture models were implemented, yet fragmented team communication about patient safety remained. Huddles were implemented to identify and address patient safety issues.

Recurrent pump thrombosis is common after axial continuous-flow left ventricular assist device exchange.

In selected patients with left ventricular assist device-associated infection or malfunction, pump exchange may become necessary after conservative treatment options fail and heart transplantation is not readily available. We examined the survival and complication rate in patients (⩾19 years of age) who underwent HeartMate II to HeartMate II exchange at our institution from 1 January 2010 to 28 February 2018. Clinical outcomes were analyzed and compared for patients who underwent exchange for pump thrombosis (14 patients), breach of driveline integrity (5 patients), and device-associated infection (2 patients).

Perceived Stress and Surgical Wound Cytokine Patterns.

This was a pilot study to examine pre- and postoperative stress experienced by women who were undergoing autologous breast reconstruction and how stress might impact wound healing, specifically examining cytokines and other chemical mediators in the wound environment. A nonexperimental descriptive design over time was utilized. Participants were women who were undergoing autologous abdominal breast reconstruction for breast cancer (N = 20).

Relationship of systemic cytokine concentrations to cognitive function over two years in women with early stage breast cancer.

Unlabelled: Cancer and its treatment are frequently associated with cancer-related cognitive impairment (CRCI). While CRCI has been associated with linked to chemotherapy, there is increasing evidence that the condition may start prior to treatment and for some, remain unresolved after active treatment and into survivorship. Although the pathophysiology of the condition is complex, alterations in systemic cytokines, signaling molecules activated in response to infection or injury that trigger inflammation, are a possible mechanism linked to cognitive dysfunction in breast cancer and other conditions.

The Effects of Tai Chi on Cardiovascular Risk in Women.

Purpose: This study examined the effects of tai chi (TC) on biobehavioral factors associated with cardiovascular disease (CVD) risk in women.

Design: A randomized trial used a wait-list control group, pretest-posttest design. Data were collected immediately before, immediately after, and 2 months following the intervention.

Nonsynonymous HTR2C polymorphism predicts cortisol response to psychosocial stress II: Evidence from two samples.

The 5-HT2C receptor is the primary serotonin receptor located in the corticotrophin releasing hormone (CRH) neurons of the hypothalamus. These neurons initiate the signaling cascade that culminates in cortisol release. Therefore, genetic variation in the 5-HT2C receptor gene (HTR2C) is a prime candidate for affecting cortisol reactivity to stress.

Factors Associated With Exclusive Breastfeeding Through Four Weeks Postpartum in Thai Adolescent Mothers.

Breastfeeding initiation and duration are decreased in adolescent mothers compared to older mothers. A prospective descriptive cohort design was used to explore personal, social, cultural, and infant factors that explain and predict breastfeeding initiation and maintenance at 4 weeks postpartum. Adolescent mothers ( = 120) were recruited at prenatal clinics in Thailand.

Relationship of Mitochondrial Enzymes to Fatigue Intensity in Men With Prostate Cancer Receiving External Beam Radiation Therapy.

Purpose: Mitochondrial dysfunction is a plausible biological mechanism for cancer-related fatigue. Specific aims of this study were to (1) describe the levels of mitochondrial oxidative phosphorylation complex (MOPC) enzymes, fatigue, and health-related quality of life (HRQOL) before and at completion of external beam radiation therapy (EBRT) in men with nonmetastatic prostate cancer (PC); (2) examine relationships over time among levels of MOPC enzymes, fatigue, and HRQOL; and (3) compare levels of MOPC enzymes in men with clinically significant and nonsignificant fatigue intensification during EBRT.

Methods: Fatigue was measured by the revised Piper Fatigue Scale and the Functional Assessment of Cancer Therapy-Fatigue subscale (FACT-F).

Biobehavioral examination of fatigue across populations: report from a P30 Center of Excellence.

Objectives: This article reports the cross-studies analysis of projects from the P30 Center of Excellence for Biobehavioral Approaches to Symptom Management. Although the projects investigated diverse populations, a consistent theoretical and empirical approach guided each project.

Methods: Common data elements included the following measures of psychobehavioral variables: the PROMIS Short-Form Fatigue Scale, the Center of Epidemiologic Studies Depression Scale, and the Perceived Stress Scale.

Association of Mitochondrial Dysfunction and Fatigue: A Review of the Literature.

Fatigue is often described by patients as a lack of energy, mental or physical tiredness, diminished endurance, and prolonged recovery after physical activity. Etiologic mechanisms underlying fatigue are not well understood; however, fatigue is a hallmark symptom of mitochondrial disease, making mitochondrial dysfunction a putative biological mechanism for fatigue. Therefore, this review examined studies that investigated the association of markers of mitochondrial dysfunction with fatigue and proposes possible research directions to enhance understanding of the role of mitochondrial dysfunction in fatigue.

Managing the health care needs of adolescents with autism spectrum disorder: the parents' experience.

Parents of adolescents with autism spectrum disorder (ASD) experience the challenges of navigating the health care system, locating information about ASD, lacking an understanding of prescribed medications, and experiencing minimal social support from health care providers. The purpose of this phenomenological study was to describe the experiences of parents who manage the health needs of an adolescent with ASD. Qualitative interviews were conducted at a university setting with 12 parents of 10 adolescents with ASD residing in Central Virginia.

Symptom Cluster Research in Women with Breast Cancer: A Comparison of Three Subgrouping Techniques.

Aims: To examine how symptom cluster subgroups defined by extreme discordant composite scores, cut-off scores, or a median split influence statistical associations with peripheral cytokine levels in women with breast cancer.

Background: Systemic cytokine dysregulation has been posited as a potential biological mechanism underlying symptom clusters in women with breast cancer. Symptom characteristics may play an important role in identifying cytokines of significant etiological importance, however, there is no consensus regarding the ideal subgrouping technique to use.

A Conceptual Model of Psychoneurological Symptom Cluster Variation in Women with Breast Cancer: Bringing Nursing Research to Personalized Medicine.

Personalized medicine applies knowledge about the patient's individual characteristics in relation to health and intervention outcomes, including treatment response and adverse side-effects, to develop a tailored treatment plan. For women with breast cancer, personalized medicine has substantially improved the rate of survival, however, a high proportion of these women report multiple, co-occurring psychoneurological symptoms over the treatment trajectory that adversely affect their quality of life. In a subset of these women, co-occurring symptoms referred to as symptoms clusters, can persist long after treatment has ended.

Mindfulness: an effective coaching tool for improving physical and mental health.

Purpose: This article provides an overview of the mechanisms of action, evidence base, and practice of mindfulness, with an emphasis on how to easily incorporate this valuable skill into practice.

Data Sources: PubMed, CINAHL, PsychInfo Databases.

Conclusions: Conscious attention to the present moment in a receptive way is known as mindfulness.

Psychosocial therapies for patients with cancer: a current review of interventions using psychoneuroimmunology-based outcome measures.

Background: As part of a new standard of quality cancer care, the Institute of Medicine has recommended inclusion of therapies that address psychosocial needs of cancer patients. A range of psychosocial therapies for managing acute and chronic stress have been developed for patients with cancer, based on the scientific framework of psychoneuroimmunology (PNI). The current review aimed to identify studies of new and emerging PNI-based psychosocial therapies in patients with cancer that have used neuroendocrine-immune biomarkers as outcomes.

A model of neurodevelopmental risk and protection for preterm infants.

The purpose of this article is to introduce a model of neurodevelopmental risk and protection that may explain some of the relationships among biobehavioral risks, environmental risks, and caregiving behaviors that potentially contribute to neurobehavioral and cognitive outcomes. Infants born before 30 weeks of gestation have the poorest developmental prognosis of all infants. These infants have lengthy hospitalization periods in the neonatal intensive care unit (NICU,) an environment that is not always supportive of brain development and long-term developmental needs.

Psychoneuroimmunology-Based Stress Management during Adjuvant Chemotherapy for Early Breast Cancer.

Objective. In a randomized trial of women with early stage breast cancer undergoing adjuvant chemotherapy, two stress management interventions, tai chi training and spiritual growth groups, were compared to a usual care control group, to evaluate psychosocial functioning, quality of life (QOL), and biological markers thought to reflect cancer- and treatment-specific mechanisms. Method.

Potential epigenetic mechanism(s) associated with the persistence of psychoneurological symptoms in women receiving chemotherapy for breast cancer: a hypothesis.

Due to recent treatment advances, there have been improvements in the proportion of women surviving a diagnosis of breast cancer (BC). However, many of these survivors report persistent adverse side effects following treatment, such as cognitive dysfunction, depressive symptoms, anxiety, fatigue, sleep disturbances, and pain. Investigators have examined circulating levels of inflammatory markers, particularly serum cytokines, for a potential causal relationship to the development/persistence of these psychoneurological symptoms (PNS).

Effects of guided imagery on biobehavioral factors in women with fibromyalgia.

Women diagnosed with fibromyalgia (N = 72) participated in a 10-week randomized trial to examine the effectiveness of guided imagery on self-efficacy, perceived stress, and selected biobehavioral factors (FMS symptoms; immune biomarkers). Participants in both guided imagery and usual care control conditions completed measures and donated 3 cc of blood at baseline, 6- and 10-weeks. A mixed effects linear model to test for differences between groups for all behavioral and biologic variables demonstrated that after 10 weeks of daily intervention use, guided imagery participants reported statistically significant increases in self-efficacy and statistically significant decreases in stress, fatigue, pain, and depression.

The story of the evolution of a unique tai chi form: origins, philosophy, and research.

The purpose of this article is to introduce a unique tai chi form that has been successfully implemented in two large randomized clinical trials. The intervention is composed of a series of tai chi movements chosen for their particular meanings, thus adding a cognitive component to the practice of a moving meditation. Over the last decade, the intervention has continued to evolve as it has been used in different populations.

Psychoneuroimmunological relationships in women with fibromyalgia.

Introduction: The purpose of this pilot study was to characterize the relationships among perceived stress, pain, fatigue, depression, anxiety, biomarkers, and functional status in women with fibromyalgia syndrome (FMS) using a psychoneuroimmunological (PNI) framework.

Materials And Method: Using a cross-sectional, correlational design, the authors asked 50 women diagnosed with FMS to complete the Perceived Stress Scale (PSS), Brief Pain Inventory (BPI), Brief Fatigue Inventory (BFI), Center for Epidemiological Studies-Depression scale, State-Trait Anxiety Inventory (STAI), and Functional Impact Questionnaire. The authors analyzed plasma levels of 17 cytokines using a BioPlex® assay and levels of C-reactive protein (CRP) using a high-sensitivity enzyme-linked immunosorbent assay (ELISA).

Advancing the biobehavioral research of fatigue with genetics and genomics.

Purpose: To examine phenotypic considerations in the study of fatigue and to explore significant issues affecting the extension of biobehavioral research of fatigue by the inclusion of genetic and genomic markers. THEORETICAL ORGANIZATION: Fatigue is a condition that has an adverse effect on quality of life that has been a focus of nursing inquiry. Yet, the study of fatigue has been stymied by the lack of phenotypic clarity.

Tryptophan degradation in women with breast cancer: a pilot study.

Background: Altered tryptophan metabolism and indoleamine 2,3-dioxygenase activity are linked to cancer development and progression. In addition, these biological factors have been associated with the development and severity of neuropsychiatric syndromes, including major depressive disorder. However, this biological mechanism associated with both poor disease outcomes and adverse neuropsychiatric symptoms has received little attention in women with breast cancer.

Exploring the complexity of cardiometabolic risk in women.

Cardiovascular disease (CVD) is the leading cause of death in the United States. Women are more likely than men to present with advanced disease and experience higher CVD-related morbidity and mortality. Metabolic syndrome is a constellation of risk factors for Type 2 diabetes mellitus (T2DM) and CVD.

Exploring biobehavioral outcomes in mothers of preterm infants.

Purpose: To evaluate physiologic measures of stress with self-reported perceived stress and depressive symptoms among mothers of preterm babies currently hospitalized in an NICU.

Study Design And Methods: This was a cross-sectional, descriptive, single-visit study of 20 mothers of hospitalized preterm infants. Data collected included self-report behavioral measures and a brief structured interview.