Characterization of R-Loop-Interacting Proteins in Embryonic Stem Cells Reveals Roles in rRNA Processing and Gene Expression.

Chromatin-associated RNAs have diverse roles in the nucleus. However, their mechanisms of action are poorly understood, in part because of the inability to identify proteins that specifically associate with chromatin-bound RNAs. Here, we address this problem for a subset of chromatin-associated RNAs that form R-loops-RNA-DNA hybrid structures that include a displaced strand of ssDNA. R-loops generally form cotranscriptionally and have important roles in regulation of gene expression, immunoglobulin class switching, and other processes. However, unresolved R-loops can lead to DNA damage and chromosome instability. To identify factors that may bind and regulate R-loop accumulation or mediate R-loop-dependent functions, we used a comparative immunoprecipitation/MS approach, with and without RNA-protein crosslinking, to identify a stringent set of R-loop-binding proteins in mouse embryonic stem cells. We identified 364 R-loop-interacting proteins, which were highly enriched for proteins with predicted RNA-binding functions. We characterized several R-loop-interacting proteins of the DEAD-box family of RNA helicases and found that these proteins localize to the nucleolus and, to a lesser degree, the nucleus. Consistent with their localization patterns, we found that these helicases are required for rRNA processing and regulation of gene expression. Surprisingly, depletion of these helicases resulted in misregulation of highly overlapping sets of protein-coding genes, including many genes that function in differentiation and development. We conclude that R-loop-interacting DEAD-box helicases have nonredundant roles that are critical for maintaining the normal embryonic stem cell transcriptome.

Experiential Learning of Childhood Growth and Development Through a Pediatric Play Project.

ABSTRACT: The adoption of a new undergraduate nursing curriculum granted the opportunity to develop a new method for teaching growth and development. The Pediatric Play Project was designed as part of clinical experience where students explored principles of growth and development by designing a toy or play activity for a hospitalized pediatric patient. Students exhibited immense creativity while meeting learning outcomes, and the project received positive feedback from students and faculty. With minor refinement of the project, students will continue to gain understanding of the nurse's role in promoting growth and development for the hospitalized child.

Standardizing Strep Throat Documentation in a Pediatric Outpatient Setting During COVID-19: A Quality Improvement Pilot Project.

Clinicians' nonadherence to the 2012 Infectious Diseases Society of America's group A streptococcal (GAS) pharyngitis guidelines leads to unnecessary in-person clinic visits, unnecessary use of bacterial testing, and inappropriate antibiotic prescriptions. Quality improvement methodology was used during nurse telephone triage at an outpatient pediatric clinic to standardize nurse documentation to align with the GAS guidelines. This pilot project's standardization resulted in improved communication among clinicians and decreased unnecessary resource and antibiotic use despite encountering barriers related to COVID-19.

Using Cognitive Interviewing to Design Interventions for Implementation in Oncology Settings.

BACKGROUND: Implementation of effective interventions into clinical practice is slow, in large part, because researchers do not sufficiently attend to the realities of nurses who implement interventions. OBJECTIVES: The aim of the study was to provide an exemplar of how cognitive interviewing-an important and underused method for developing nursing research-can be used to design survey items and assess multilevel implementation factors. METHODS: We utilized the Consolidated Framework for Implementation Research to create a survey to assess factors that influence how oncology nurses deliver physical activity interventions. Two rounds of cognitive interviews were conducted with five purposively selected oncology nurses to assess survey items' clarity and effectiveness at eliciting desired information. We used a cognitive interviewing coding scheme to code data and revise unclear items. Participants completed the revised survey online and underwent a second interview to provide additional feedback. RESULTS: Seven important changes were made to the survey: how to assess nurses' perceptions of other nurses' beliefs and practices; language to capture data relating to nursing leadership and administration; increased detail to assess factors related to nurses' workplaces; language related to capturing factors related to policy; language to capture data related to equity, disparities, and cultural tailoring; terms replacement with language used by nurses; and strategy to capture data about nurses' knowledge of national physical activity recommendations for cancer survivors. DISCUSSION: Cognitive interviewing can be applied to develop survey items that capture real-world experiences and perspectives of practicing nurses. This is an essential step in developing nursing interventions that are ready to be implemented and increasing the uptake of evidence-based nursing care. Cognitive interviewing can be used across nursing settings, populations, and interventions to develop understandings of attitudes, attributes, characteristics, and perceptions for a variety of nursing interventions.

Controlled breathing with or without peppermint aromatherapy for postoperative nausea and/or vomiting symptom relief: a randomized controlled trial.

PURPOSE: With little scientific evidence to support use of aromatherapy for postoperative nausea and/or vomiting (PONV) symptoms, this study evaluated controlled breathing with peppermint aromatherapy (AR) and controlled breathing alone (CB) for PONV relief. DESIGN: A single blind randomized control trial design was used. METHODS: On initial PONV complaint, symptomatic subjects received either CB (n = 16) or AR (n = 26) intervention based on randomization at enrollment. A second treatment was repeated at 5 minutes if indicated. Final assessment occurred 10 minutes post initial treatment. Rescue medication was offered for persistent symptoms. FINDINGS: Among eligible subjects, PONV incidence was 21.4% (42/196). Gender was the only risk factor contributing to PONV symptoms (P = .0024). Though not statistically significant, CB was more efficacious than AR, 62.5% versus 57.7%, respectively. CONCLUSIONS: CB can be initiated without delay as an alternative to prescribed antiemetics. Data also support use of peppermint AR in conjunction with CB for PONV relief.

Physical Activity: A Systematic Review to Inform Nurse Recommendations During Treatment for Colorectal Cancer.

Colorectal cancer (CRC) is the third most common cancer in the world (American Cancer Society [ACS], 2021). Because of increasing survival rates, there is a need improve survivors' quality of life (QOL), physical functioning, recurrence risk, and comorbidity prevalence (ACS, 2020). Many patients with CRC have poor QOL during and after treatment; other common side effects include fatigue, depression, anxiety, and decreased sleep quality (Bourke et al., 2014; Cramer et al., 2014; Gao et al., 2020). Focusing on the treatment period is important because physical activity (PA) may decrease side effects and prevent PA decline and functional decline, both of which can become significant barriers to PA following treatment. In addition, patients with CRC have a higher rate of comorbidities than patients without cancer, making lifestyle changes pre- and post-treatment particularly important for their continued survival and QOL (ACS, 2020).

Prayer practices among young adults.

Prayer is the most common complementary and alternative intervention used by most Americans. Yet, little is known about the prayer practices of young adults. In this exploratory study, 4 types of prayer practices of 62 young adults (21-30 years old) are described. The 4 different categories of prayer were: contemplative-meditative, ritualistic, petitionary, and colloquial. Participants most often used colloquial prayer practice, that is, asking God to provide guidance or talking to God in their own words. Recommendations for future research are included.

Hematopoietic Stem Cell Transplantation: Stress, Psychoneurologic Symptoms, and Coping Strategies in Adolescents and Young Adults
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Psychoneurologic symptoms commonly reported by adolescents and young adults (AYAs) following hematopoetic stem cell transplantation (HSCT) include anxiety, depression, fatigue, and pain. Complementary and alternative medicine (CAM) appeals to AYAs as a means of coping with these symptoms. One example of CAM is a publicly available illness blog authored by a young adult woman undergoing HSCT. 
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The Association Between Sexual Health and Physical, Mental, and Social Health in Adolescent Women.

PURPOSE: Developmental models link sexual well-being to physical, mental/emotional, and social well-being, yet little empirical literature evaluates these relationships in adolescents. Better understanding of how and when sexuality complements other aspects of health may yield important points to enhance existing health education and prevention efforts. METHODS: Data were drawn from a 10-year longitudinal cohort study of sexual relationships and sexual behavior among adolescent women (N = 387; 14-17 years at enrollment). Sexual health data were drawn from quarterly partner-specific interviews and were linked to physical, mental/emotional, and social health information in annual questionnaires. Random intercept, mixed effects linear, ordinal logistic, or binary logistic regression were used to estimate the influence of sexual health on health and well-being outcomes (Stata, v.23, StataCorp, College Station, TX). All models controlled for participant age and race/ethnicity. RESULTS: Higher sexual health was significantly associated with less frequent nicotine and substance use, lower self-reported depression, lower thrill seeking, higher self-esteem, having fewer friends who use substances, higher religiosity, better social integration, lower frequency of delinquent behavior and crime, and more frequent community group membership. Sexual health was not associated with the number of friends who used cigarettes. CONCLUSIONS: Positive sexually related experiences in romantic relationships during adolescence may complement physical, mental/emotional, and social health. Addressing specific aspects of healthy sexual development during clinical encounters could dually help primary prevention and health education address other common adolescent health issues.