Impact of Covid-19 on lung cancer and mesothelioma specialist nurses: A survey of experiences and perceptions.

PURPOSE: The covid-19 global pandemic has impacted on nurses who have rapidly adapted to new ways of working, and experienced negative impacts due to over-stretched services. Two surveys captured the experiences of lung cancer and mesothelioma specialist nurses in the United Kingdom (UK) in 2020, but the impact of later stages of the pandemic was unknown. This study aimed to explore the impact of covid-19 on lung Cancer and mesothelioma nurses since January 2021, the second wave of the pandemic. METHODS: An online cross-sectional survey with both open and closed questions explored the impact of covid-19 on ways of working and workload, quality of care, and health and wellbeing. The survey was open to UK based lung cancer and mesothelioma advanced or specialist nurses. RESULTS: 85 nurses responded to the survey. The majority were Clinical Nurse Specialists, based in England. Respondents reported changes in ways of working due to redeployment, staff shortages, and home working. Widespread adoption of virtual working practices led to concerns of negative impacts. Perceived excessive workload impacted on care with two-thirds of the sample (57, 67%) reporting they had been unable to provide the same quality of care to patients. Impacts on nurses' health and wellbeing were reported with two-thirds of the sample (56, 66%) reporting a deterioration in emotional wellbeing and mental health. Coping mechanisms employed included online team support to share experiences and increased uptake of exercise; however, impacts on lifestyle and access to coping mechanisms varied. CONCLUSION: Nurses have stepped up to the challenges of the pandemic with teamwork and innovation, but pressure arising from the pandemic and high workloads led to negative impacts on wellbeing. The authors have provided recommendations to improve patient care and support the wellbeing of nurses, which will be key to a resilient workforce living with covid-19. Whilst this study focussed on lung cancer and mesothelioma specialists, the findings have wider implications for other cancer specialties.

A cultural heuristic approach to the study of Jamaican undergraduate students' achievement motivation.

BACKGROUND: In recent years, there have been increasing calls to develop a more contextually based sociocultural perspective of achievement motivation. AIM: This mixed-methods study examined why Jamaican undergraduate students are motivated or unmotivated and how this relates to the extant literature on achievement motivation. SAMPLE(S): This study was conducted in two phases and consisted of 175 and 189 Jamaican undergraduate students across phases one and two, respectively. METHODS: First, a qualitative investigation using open-ended questionnaires and semi-structured interviews explored Jamaican undergraduate students' conceptualization of motivation and the factors that positively or negatively impacted their motivation. The second phase consisted of using prototype theory to capture a hierarchical cognitive representation of Jamaican students' motivation using coded themes derived from phase one of the study. RESULTS AND CONCLUSIONS: The overall results indicated that personal, cognitive, contextual, and sociocultural factors are important determinants of Jamaican undergraduate students' academic motivation and that sociocultural (e.g., familial, economic, religious) factors appear to play a more critical role in impacting their motivation.

Implementing online medication reconciliation at a large academic medical center.

BACKGROUND: Most examples of successful medication reconciliation (MR) programs have reported on paper-based systems, the most common of which is a standardized MR form that often serves as a medication order form. An interdisciplinary process was undertaken by Bellevue Hospital, New York City, to develop a full, online MR program. PHASE 1. MOVING BEYOND PAPER: In 2005 Bellevue piloted a paper-based MR process. However, this effort was unsuccessful, so an online MR application that would be more accessible and easier to audit was initiated. The longitudinal outpatient medication list--the definitive, electronic medication list for patients in our system--formed the basis of the MR project. The list included every prescription written in the electronic health record (EHR). Historical medication could also be entered into the list, representing a useful function in the outpatient setting for patients who transfer their care to Bellevue and are already on chronic medications. In a two-month pilot in Summer 2006, compliance was achieved for only 20% of patients. PHASE 2. AUDITING AND MANDATORY FUNCTIONALITY: In April 2007, MR was made a mandatory part of the admission process; a blocking function in the EHR prevented medication orders if the admission MR had not been completed. Compliance rates subsequently increased to 90% throughout the hospital. To "close the loop" in the reconciliation process, in November 2007, a discharge reconciliation was made a mandatory part of the discharge process, resulting in 95% compliance. LESSONS LEARNED: Successful implementation of admission and discharge MR suggested several lessons, including (1) mandatory functionality leads to adaptation and integration of MR into housestaff work flows and (2) an electronic MR is preferable to a paper-based process in organizations with an EHR and computerized physician order entry.

Side-to-side comparisons of bone mineral density in upper and lower limbs of collegiate athletes.

This cross-sectional study investigated the effects of participation in various sports on side-to-side (contralateral) differences in bone mineral density (BMD) of the upper and lower limbs. The BMD of the arms and legs was measured using dual energy X-ray absorptiometry. The subjects were 184 collegiate athletes, both men and women, who participated in NCAA Division I-A baseball, basketball, football, golf, soccer, tennis, cross-country, indoor/outdoor track, and volleyball. Results revealed greater BMD of the right arms compared with the left arms for all teams, with the most pronounced differences observed in men's and women's tennis and men's baseball. Differences in the lower limbs were less common. No significant differences in lower limb BMD were found in the women. In men, differences in lower limb BMD were found in the football and tennis teams, with the nondominant leg having greater bone mass. Recognition of contralateral differences in bone density may be of particular interest to strength and conditioning professionals as they consider the need to include bilateral and unilateral training programs in an effort to maximize performance and minimize stress-related injuries.