Updates on thyroid disorders in pregnancy and the postpartum period.

ABSTRACT: NPs play a pivotal role in caring for pregnant people. This article provides an overview of gestational and postpartum thyroid disorders, including their assessment, management, and indications for referral. The goal of this article is to help providers better assess and manage thyroid disorders during pregnancy and improve patient outcomes.

Health Literacy Assessment of Detained Individuals and Correctional Officers Within a Large Urban Jail: Optimizing Health Education.

BACKGROUND: Little research has been done to address the health literacy level of detained individuals and correctional officers. PURPOSE: The aim of this pilot project was to describe the health literacy of individuals detained or working within a large urban jail to inform their health education. METHODS: Health literacy assessments were conducted using the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) and the Newest Vital Sign (NVS) tools. RESULTS: Of the 48 participants, 17% (n = 8) exhibited low health literacy on the REALM-SF, whereas 38% (n = 18) demonstrated the need for improved health literacy when assessed with the NVS. Detained individuals from the women's tiers were more likely to have lower health literacy than the detained veterans or correctional officers. CONCLUSIONS: Results indicate that tailored health education programming, using evidence-based health literacy improvement techniques, should be offered to the individuals detained or working within a correctional facility.

Asymptomatic GBS bacteriuria during antenatal visits: To treat or not to treat?

Inconsistencies persist regarding the efficacy of treating asymptomatic group B Streptococcus bacteriuria in pregnant individuals with colony counts below 10 (100,000) CFU/mL. Despite these discrepancies, treatment still occurs. This article examines the role of screening and treatment, evidence-based guidelines, and practice patterns to provide clarification and resolve local practice disparities.

The Significance of Vitamin D Status in Breast Cancer: A State of the Science Review.

The potential role of vitamin D in the development of breast cancer has been the subject of considerable interest. Laboratory and genetic studies demonstrate promising anticarcinogenic effects of vitamin D. However, inconsistencies persist in results of human studies that have assessed vitamin D supplementation for the prevention of primary and secondary cancers. Despite these discrepancies, screening for vitamin D deficiency and vitamin D supplementation have increased dramatically in the past decade. No official institutional guidelines recommend vitamin D supplementation for cancer prevention, and yet these newly adopted practice norms have outpaced rigorous scientific study. Higher circulating levels of vitamin D [25-hydroxyvitamin D, or 25(OH)D] appear to be associated with reduced risk and improved survivorship of certain malignancies. However, the association has not been found for all cancers. This state of the science review examines the association between vitamin D supplementation, circulating 25(OH)D level, vitamin D receptor polymorphisms, and the risk and mortality of breast cancer. The review addresses the role of supplementation and optimal 25(OH)D levels.

Improving satisfaction among established patients in a midwestern pain clinic.

BACKGROUND: A problem in many health care practices is deciding the appropriate appointment length for new and established patients. Patients become frustrated when there is inadequate time to have their needs met, yet when a patient's clinic time is spontaneously lengthened, the provider gets behind in schedule, causing delays and greater frustration for others. AIM: The aims of this evidence based project were to determine whether implementation of a flexible appointment system would improve the current scheduling process in a pain clinic by allowing complex patients the opportunity to schedule a longer clinic appointment and would improve patient satisfaction. DESIGN: This evidence-based practice innovation followed a program evaluation process using a descriptive, existing survey completed by clinic staff and patients. SETTING: A Midwestern pain clinic caring for patients with acute and chronic pain diagnoses. PARTICIPANTS: A convenience sample of 120 patients were surveyed before and after the process change. Thirteen staff members completed the survey on SurveyMonkey pre and post procedural change at the same intervals the patients were surveyed. RESULTS: Patients were more satisfied with the time that they spent in the exam room and the waiting room. The process change improved communication with staff and patients and provided an opportunity to discuss their concerns and health changes prior to their scheduled appointment. CONCLUSION: Allowing an option for flexible scheduling in appointment lengths provided an opportunity to meet patient needs, offer improved service, and improve patient-provider communication.