Sustaining a Concept-Based Curriculum: Beyond the Launch.

Background: Many schools of nursing are transitioning to a concept-based curriculum (CBC) to better prepare students to practice across complex practice settings.

Problem: Current literature focused on transitioning to a CBC lacks discussion on how to sustain a CBC once it is implemented.

Approach: In this article, the authors emphasize the importance of intentionally sustaining a dynamic CBC and provide strategies to accomplish this aspect of the curriculum trajectory.

Are Sexually Transmitted Infection/HIV Behavioral Interventions for Women of Color Culturally Grounded? A Review of the Literature.

Although behavioral interventions for women of color have been shown to be effective in reducing sexually transmitted infections (STIs), STI/HIV rates continue to increase. To alleviate sexual health disparities, it is necessary to understand the cultural behaviors of the target population to design culturally grounded interventions. The purposes of our review were to examine the current state of STI/HIV behavioral interventions for women of color, determine how culture has been incorporated into interventions, and identify gaps in the literature.

Self-management in liver transplantation.

Background: Self-management is crucial for liver transplant (LT) recipients to maintain transplants and optimize health outcomes. However, previous literature has been primarily limited to examining medication adherence; there is a knowledge gap regarding self-management in the LT population.

Aim: The aims of this study were to 1) comprehensively describe self-management behaviors and activities in LT recipients, 2) explore levels of overall self-management, and 3) explore the relationships of self-efficacy, cognition, and health information seeking behavior with self-management.

Self-Management in Liver Transplant Recipients: A Narrative Review.

Introduction: Although self-management is essential for liver transplant recipients, there is no review that has synthesized findings related to self-management in this population.

Objective: This narrative review aimed to synthesize the current findings and identify the gaps in knowledge about self-management in liver recipients.

Methods: A search of PubMed, CINAHL Plus, PsychINFO, ProQuest, and Web of Science was conducted using the following terms: [Self-care OR Self-management OR Health behavior] AND [Liver transplantation].

Development and Psychometric Testing of a Sexual Concerns Questionnaire for Kidney Transplant Recipients.

Background And Purpose: This study describes the development and psychometric testing of the Sexual Concerns Questionnaire (SCQ) in kidney transplant (KTx) recipients.

Methods: Construct validity was assessed using the Kroonenberg and Lewis exploratory/confirmatory procedure and testing hypothesized relationships with established questionnaires. Configural and weak invariance were examined across gender, dialysis history, relationship status, and transplant type.

What are patients saying about sex after a kidney or simultaneous kidney/pancreas transplant?

Context-Chronic illnesses such as kidney failure and diabetes and their treatments can affect people's identity, including their sexual identity. Little is known about patients' perspective on the effect of transplant on their sexual identity. Objective-To explore the sexual concerns of kidney and simultaneous pancreas/kidney transplant recipients.

Informational needs of liver transplant recipients during a two-year posttransplant period.

Objectives: To describe the informational needs of liver transplant (LTx) recipients, examine potential differences in informational needs by sociodemographic and clinical variables, and examine informational needs at various time points posttransplant.

Methods: A descriptive, cross-sectional design was used. Informational needs were assessed by the Informational Needs Questionnaire-liver, a new questionnaire developed to include LTx recipients' perspectives.

Sexual concerns among kidney transplant recipients.

Background: Little is known about the specific sexual concerns of kidney transplant (KTx) recipients. The primary objectives of this study were to: (i) describe the importance of sexuality to KTx recipients; (ii) investigate the sexual concerns of KTx recipients; and (iii) examine the relationship between sexual concerns and quality of life (QOL). A secondary objective was to examine potential sexual concern differences by gender, pre-transplant dialysis status, and donor type.

Depicting Changes in Multiple Symptoms Over Time.

Ridit analysis, an acronym for Relative to an Identified Distribution, is a method for assessing change in ordinal data and can be used to show how individual symptoms change or remain the same over time. The purposes of this article are to (a) describe how to use ridit analysis to assess change in a symptom measure using data from a longitudinal study, (b) give a step-by-step example of ridit analysis, (c) show the clinical relevance of applying ridit analysis, and (d) display results in an innovative graphic. Mean ridit effect sizes were calculated for the frequency and distress of 64 symptoms in lung transplant patients before and after transplant.

A longitudinal study of patients' symptoms before and during the first year after lung transplantation.

Background: Lung transplantation provides a viable option for survival of end-stage respiratory disease. In addition to prolonging survival, there is considerable interest in improving patient-related outcomes such as transplant recipients' symptom experiences.

Methods: A prospective, repeated measures design was used to describe the symptom experience of 85 lung transplant recipients between 2000 and 2005.

Factors affecting employment at initiation of dialysis.

Background And Objectives: Half the individuals who reach ESRD are working age (< 65 years old) and many are at risk for job loss. Factors that contribute to job retention among working-age patients with chronic kidney disease before ESRD are unknown. The purpose of the study is to understand factors associated with maintaining employment among working-age patients with advanced kidney failure.

Sexuality, an important component of the quality of life of the kidney transplant recipient.

People who receive a kidney transplant experience overall better quality of life (QOL) than those on dialysis. However, one area of QOL that does not seem to improve after transplant is sexuality. The purposes of this review were to evaluate the literature specific to sexuality after kidney and kidney/pancreas transplant, identify gaps in the literature, and suggest directions for future research.

Blood oxygen level-dependent and perfusion magnetic resonance imaging: detecting differences in oxygen bioavailability and blood flow in transplanted kidneys.

Functional magnetic resonance imaging (fMRI) is a powerful tool for examining kidney function, including organ blood flow and oxygen bioavailability. We have used contrast enhanced perfusion and blood oxygen level-dependent (BOLD) MRI to assess kidney transplants with normal function, acute tubular necrosis (ATN) and acute rejection. BOLD and MR-perfusion imaging were performed on 17 subjects with recently transplanted kidneys.

Medical care of kidney transplant recipients after the first posttransplant year.

Kidney transplantation is the treatment of choice for patients with ESRD. Despite improvements in short-term patient and graft outcomes, there has been no major improvement in long-term outcomes. The use of kidney allografts from expanded-criteria donors, polyoma virus nephropathy, underimmunosuppression, and incomplete functional recovery after rejection episodes may play a role in the lack of improvement in long-term outcomes.

BOLD-MRI assessment of intrarenal oxygenation and oxidative stress in patients with chronic kidney allograft dysfunction.

Blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) uses deoxyhemoglobin as an endogenous contrast agent for the noninvasive assessment of tissue oxygen bioavailability. We hypothesized that intrarenal oxygenation was impaired in patients with chronic allograft nephropathy (CAN). Ten kidney-transplant recipients with CAN and nine healthy volunteers underwent BOLD-MRI.

Noninvasive assessment of early kidney allograft dysfunction by blood oxygen level-dependent magnetic resonance imaging.

Background: Blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) is a noninvasive method to assess tissue oxygen bioavailability, using deoxyhemoglobin as an endogenous contrast agent. We hypothesized that BOLD-MRI could accurately discriminate different types of rejection early after kidney transplantation.

Methods: Twenty-three patients underwent imaging in the first four months posttransplant.

Sexuality among women recipients of a pancreas and kidney transplant.

Significant improvements in health and quality of life generally follow organ transplantation; however, there is evidence that women who have received transplants experience difficulty with sexual function. The specific nature and extent of this difficulty has not been documented. The purpose of this study was to describe sexual functioning and sexual self-esteem among women recipients of a simultaneous pancreas and kidney transplant.

Assessment of acute renal transplant rejection with blood oxygen level-dependent MR imaging: initial experience.

Purpose: To prospectively assess the oxygenation state of renal transplants and determine the feasibility of using blood oxygen level-dependent (BOLD) magnetic resonance (MR) imaging to differentiate between acute tubular necrosis (ATN), acute rejection, and normal function.

Materials And Methods: This HIPAA-compliant study had institutional human subjects review committee approval, and written informed consent was obtained from all patients. BOLD MR imaging was performed in 20 patients (age range, 21-70 years) who had recently received renal transplants.

ATR blockade reduces IFN-gamma production in lymphocytes in vivo and in vitro.

Background: Type 1 angiotensin II (Ang II) receptor (AT(1)R) signaling induces proinflammatory responses. Recent studies suggest that T lymphocytes express AT(1)R; yet the effects of Ang II binding to AT(1)R on T cells are poorly understood. We examined the effect of AT(1)R blockade on release of the proinflammatory cytokine, interferon-gamma (IFN-gamma) by human lymphocytes in vivo and in vitro.

Life after transplantation: new transitions in quality of life and psychological distress.

Individuals with kidney failure often elect to undergo kidney transplantation because they believe that they will be more active and return a sense of normality to their lives with a functioning transplant. Therefore it is important to assess whether these objectives are being met. To do so, we can examine health-related quality of life (HRQOL) in transplant recipients.

Donor genomics influence graft events: the effect of donor polymorphisms on acute rejection and chronic allograft nephropathy.

Background: Organs procured from deceased donors emanate from individuals with diverse genetic backgrounds. Donor organs, therefore, may vary in their response to injury and immune stimuli in a genetically determined manner. We assessed polymorphisms from 244 renal allograft donors to better understand the impact of donor polymorphisms on selected transplant outcomes.