Breast Cancer Risk Prediction Models: Challenges in Clinical Application.

Various breast cancer risk prediction models (BCRPMs) exist to assess an individual's risk of developing malignancy and risk of having a mutation associated with hereditary risk of developing cancer. This article provides oncology nurses with current information on the available BCRPMs and highlights nursing implications. Oncology nurses' understanding of BCRPMs can help to ensure that patients are receiving accurate and useful information related to their risks.

Response to "Workplace Wellness Programs: Educating Patients and Families About Discrimination Via Disclosure of Genetic Information".

An article by Steck (2018), published in the August issue of the Clinical Journal of Oncology Nursing, stated that workplace wellness programs are legally permitted to request the family medical history of employees. However, since publication, the previously cited regulations have been redacted, and the relevant information needs updated.

Genetic Nondiscrimination Laws: What Oncology Nurses Need to Know.

OBJECTIVE: To review information concerning current federal genetic nondiscrimination laws to increase awareness and knowledge of these laws for oncology nurses. DATA SOURCES: Genetic information nondiscrimination policy research, case law, professional organization Web sites, peer-reviewed journals. CONCLUSION: Genetic nondiscrimination is addressed in four major federal laws. The need continues for comprehensive federal genetic nondiscrimination legislation, applicable to all Americans regardless of their genetic predisposition. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses need to effectively advocate for patients and their families by interpreting and disseminating provisions and limitations contained in existing federal genetic discrimination laws.

Health policy engagement among graduate nursing students in the United States.

AIM: The aim was to understand how health policy education is currently being delivered in the United States' graduate nursing programs. METHODS: This exploratory cross-sectional design used an anonymous online survey to target graduate nursing students attending American Association of College of Nursing (AACN) member institutions. RESULTS: Over 75% of the sample (n = 140) reported taking a dedicated health policy course and 71.5% ( n = 131) of the sample responded that a health policy course was required and an equal distribution among master's and doctoral students. There was no significant difference between type of graduate degree sought and the requirement to take a health policy course ( P = 0.37). For students involved in health policy, there was a greater proportion of master's students involved at the state level, than doctorate of nursing practice (DNP) or PhD students ( P = 0.04). CONCLUSIONS: Health policy and advocacy education are important aspects of graduate nursing curriculum and have been integrated into curricula. Graduate nursing students at all levels reported that health policy AACN Essential competencies are being included in their program, either as stand-alone health policy courses or integrated health policy learning activities during matriculation.

Workplace Wellness Programs: Educating Patients and Families About Discrimination Via Disclosure of Genetic Information.

Oncology nurses are advocates for the ethical and legal use of patients' genetic information. However, this information may be used to discriminate against individuals when they share it while participating in workplace wellness programs. Amendments to federal genetic discrimination laws may lead employees to being financially penalized for nondisclosure of their genetic information. This article stresses the importance of nurses being aware of these laws and pushing for policy revision to protect sensitive genetic information.

Decision Making: Approaches and Tools to Respond to Ethical Issues in Genetic and Genomic Nursing.

Competent genetic and genomic nursing practice requires the incorporation of various ethical approaches, or tools, into patient decision making. Using different decision-making approaches, which converge to answer an ethical issue, nurses can be confident that their judgment is justified. A lack of convergence can signal a need to reexamine the nurse's ethical decision-making skills. This article describes four approaches that nurses can use to facilitate ethical decision making, which is a skill that must be learned and practiced; these will then be applied to a genomic case study.

The role of melanocortin 1 receptor in cutaneous malignant melanoma: along the mitogen-activated protein kinase pathway.

Cutaneous malignant melanoma (CMM) is an epidemic cancer in the United States. Survival rates for invasive CMM have not increased in past decades despite numerous clinical trials and the effective use of various combinations of chemotherapy agents to treat other cancers. Recent research has investigated the role of melanocortin 1 receptor (MC1R), a gene associated with red-hair phenotype in White individuals and with increased risk for developing CMM, in the mitogen-activated protein kinase (MAPK) pathway. This limited narrative review discusses the incidence, history, and risk factors for CMM. It explores familial CMM and provides a brief review of melanocyte development and melanogenesis. Histology of CMM and cytogenetic techniques used to identify CMM mutations is also discussed. The structure and function of MC1R is described, with particular attention to MC1R's role in the MAPK pathway. Finally, the review touches on individualized therapy for CMM using genetic biomarkers and explores the promise of genomic research for finding effective treatments.

Concept analysis: awareness of discrimination based on genetic information.

PROBLEM: All nurses have the responsibility to deliver nondiscriminatory genetic health care. Patients perceive discriminatory nursing practices when they are being treated differently and unfairly. Nurses are expected to integrate genetic information about their patients into their clinical decision making. Thus, it is both timely and imperative that nurses have an operational definition of the concept "awareness of discrimination based on genetic information." METHOD: An operational definition of the concept was derived and Wilson's method of concept analysis was utilized to show how the operational definition may be applied in three different case models. FINDINGS: Awareness of discrimination based on genetic information can be operationally defined as "to know differences against people or distinguish between people based on the ancestral, heritable, communicated facts or knowledge". CONCLUSION: This concept analysis of words and terms used in genetic health care may serve as a framework for further genetic/genomics healthcare concepts under exploration.

The need to be aware and beware of the genetic information nondiscrimination act.

Genetic advancements have presented numerous discrimination predicaments to individuals, the healthcare community, and legislators at state and federal levels. Oncology nurses should be knowledgeable about the Genetic Information Nondiscrimination Act of 2008 (GINA) and its applications to clinical practice. GINA is the first federal law passed to protect U.S. citizens with inherited disorders from being treated unfairly because of their genetic makeup. Understanding the legislation known as GINA, including how it modifies existing federal laws governing health insurance coverage and employment discrimination, can assist oncology nurses in providing important education and advocating for patients and their extended families. Federal agencies that govern and enforce GINA's provisions are identified. Case situations are included to demonstrate how to apply information concerning GINA to patients with cancer and their families who are considering or have already completed genetic testing. Privacy of genetic information is a timely issue but difficult to understand; therefore, provisions of GINA should be addressed and evaluated carefully.