Climate Change and State of the Science for Children's Health and Environmental Health Equity.

INTRODUCTION: Climate change is impacting the physical and mental health of children and families. This is a state of the science update regarding the impacts of climate change for pediatric-focused health care providers and advanced practice registered nurses. METHOD: Using an equity lens, the authors reviewed and synthesized current literature regarding the adverse impacts of climate change. RESULTS: The poor and communities of color are disproportionately impacted by climate change. Physical health impacts include increased vector and water-born infectious diseases, increases in asthma and respiratory infections, and undernutrition. Social disruptions lead to human trafficking. Climate change is associated with mental health concerns, including anxiety and posttraumatic stress after natural disasters. DISCUSSION: As clinicians, pediatric-focused providers, and advanced practice registered nurses should use multipronged and interdisciplinary approaches to address or prevent the adverse impacts of climate change. Advocacy at all government levels is necessary to safeguard children and vulnerable populations.

Evaluating Mammographer Acceptance of MammoRisk Software.

PURPOSE: To evaluate mammographers' acceptance of the breast cancer risk assessment software tool MammoRisk (Statlife) in the clinical setting. METHODS: During a 6-month period, 1200 women undergoing routine mammography examinations at a regional, outpatient, comprehensive breast imaging center were assessed for breast cancer risk by mammographers who used the MammoRisk software. At the end of the 6-month period, the mammographers (N = 11) completed an 8-question survey on their willingness to the use of the software in the clinical setting. RESULTS: The mammographers (100%) reported that the computer software was easy to access, learn, and operate with little effect on the workflow of a busy clinic. In addition, they reported that the patient questionnaire was easy to administer and that the patients' compliance with the questionnaire was excellent. The mammographers also reported that it took less than 1 minute to fill in the patient information, and that they were willing to integrate MammoRisk into their daily practice. DISCUSSION: MammoRisk has several strengths as a risk-assessment tool, including that, when combined with complementary software, it incorporates breast density and that patients must answer fewer questions than are required for other risk-assessment tools. The software also is easy and efficient for mammographers to use. CONCLUSION: The mammographers demonstrated that MammoRisk is an easy-to-use software tool for breast cancer risk assessment, suggesting that it can be integrated readily into routine clinical settings. MammoRisk also might assist the radiologist in providing personalized screening recommendations because of its ease of use and minimal effect on workflow. Future research is needed to evaluate whether other professionals will accept the use of MammoRisk in the clinical setting.

Community collaboration--a weaving.

This article describes the collaborative efforts of the Sitka Turning Point Towards Health partnership in Sitka, Alaska. Key steps to its success include defining our terms, finding consensus, maintaining an attitude of respect, engaging people--building relationships, creating work groups, sharing leadership, committing to collaborative leadership, building in sustainability, and telling our story. We have chosen to interlace a weaving metaphor to reflect our Alaskan Native American culture and the vision of our partnership.