Reported Outcome Measures in Mohs Micrographic Surgery in Studies With Defined Techniques for Embedding and Processing of Tissue: A Systematic Review.

BACKGROUND: Mohs micrographic surgery (MMS) is a technique that combines surgical excision and histologic evaluation to achieve higher cure rates for skin cancer than traditional surgical excision. Competing performance measures have fostered numerous histologic techniques for MMS. OBJECTIVE: To analyze differences in primary outcomes in the published literature regarding the technique of tissue processing and embedding during the MMS process. METHODS: A systematic review was performed of the published literature in MEDLINE, PubMed, Embase, and Cochrane library that included a description of the manipulation of tissue during the grossing and embedding steps of MMS. RESULTS: Inclusion criteria were met by 61 articles. Of these studies, the cure/recurrence rate was assessed in 1 article (1.6%), tissue conservation was assessed in 47 (77%), time-saving was assessed in 35 (57%), cost-saving was assessed in 6 (10%), and decreased artifact were assessed in 20 (33%). CONCLUSION: There is a lack of standardization for assessing clinical outcomes in the published literature regarding MMS process techniques. Cure is a critical outcome in studies comparing MMS processing methodologies.

Pain Intensity Assessment Scales for Dermatologic Surgery Patients: A Systematic Review.

BACKGROUND: Pain assessment plays an important role in dermatologic surgery. The numeric rating scale (NRS), visual analog scale (VAS), verbal rating scale (VRS), and Faces Pain Scale (FPS) are commonly used scales for pain measurement. Conflicting evidence exists regarding the use of each. Prompt pain recognition and treatment during procedures result in higher patient satisfaction. OBJECTIVE: Determine the most applicable scale for acute pain measurement in dermatologic surgery. MATERIALS AND METHODS: This systematic review was performed in accordance with PRISMA-Supplemental Digital Content 4, http://links.lww.com/DSS/A976 (PROSPERO; CRD42018091058). PubMed, Cochrane, EMBASE, Scopus, and Web of Science were searched between April 24, 2018, and May 06, 2018. The search query consisted of pain, pain measurement (NRS, VAS, VRS, and FPS), and assessment/comparison. The inclusion criteria included English language literature with primary/secondary outcome objectives directly comparing ≥2 pain scales in acute pain (age: 13+). Study end points included interscale correlations, patient preferences, provider preferences, study author recommendations, and failure rates. RESULTS: Eight hundred seven studies were retrieved: A total of 42 studies were included. The visual analog scale (n = 42) was most studied, followed by NRS (n = 29), VRS (n = 27), and FPS (n = 11). 93.1% studies showed a high statistical correlation between VAS and NRS. Patients preferred NRS (n = 8/11), followed by FPS (n = 3/11), VRS (n = 2/11), and VAS (n = 1/11). Study authors recommended NRS/VAS (n = 8/19), VRS (n = 6/19), and FPS (n = 1/19). Providers preferred NRS (n = 2/3) and VRS (n = 1/3). The visual analog scale had the highest failure rate (n = 11/12). CONCLUSION: The numeric rating scale is most applicable for dermatologic surgery because of reported patient and provider preferences, lowest failure rates, and most frequent study author recommendations.

Teams of community health workers and nursing students effect health promotion of underserved urban neighborhoods.

OBJECTIVE(S): The purpose of this study was to explore the effectiveness of CHW/nursing student teams in promoting secondary protection and improving access to care for residents of three urban underserved neighborhoods. The study also sought to measure CHW and resident satisfaction of such a program. DESIGN AND SAMPLE: Quasi-experimental and non-experimental designs were used for the study. Convenience samples consisted of residents who participated in the CHW program during 2005-2006, CHWs and residents who participated in the CHW program during 2005-2007 and a systematic random sample of residents across the three neighborhoods. MEASURES: Three quantitative measures were used in the study: a pre/post test with residents who participated in the program, a satisfaction survey of CHWs and participants, and a community assessment survey of the neighborhoods in which the program occurred. RESULTS: CHW/nursing student teams were shown to increase awareness of community resources, increase access to dental care, decrease use of the ER, promote use of a medical home/regular source of care, and increase the percentage of people having their blood pressure screened in the last 2 years. CONCLUSION: CHW/nursing student teams can positively impact the health of underserved populations.

Preliminary study: soy milk as effective as skim milk in promoting weight loss.

Calcium from dairy sources is beneficial to weight loss; however, no studies have compared the effects of dairy to nondairy sources of calcium on weight loss. This pilot study explored differences between soy and skim milk on changes in anthropometric values in premenopausal women. In a prospective randomized controlled trial, 14 women with overweight/obesity were randomly assigned to 720 mL soy milk (n=7) or an equivalent volume of skim milk (n=7) daily for 8 weeks. Subjects followed a 500-kcal deficit diet based on metabolic rate data. There were no anthropometric differences between soy and skim milk groups at baseline. Subjects followed an energy-restricted diet; both groups experienced reductions in kilogram weight (4.27+/-2.05 vs 3.76+/-2.25; P=0.668), body fat percent (1.30+/-1.37 vs 1.87+/-1.45; P=0.464), and abdominal circumference (11.28+/-5.23 vs 8.66+/-2.51; P=0.259) while attenuating losses of fat-free mass (1.12+/-1.29 vs 0.43+/-1.12; P=0.299) during the 8-week study. There were no significant differences in weight, fat percent, abdominal circumference, and fat-free mass between groups. To optimize the weight loss effects of calcium, one can consume 720 mL of either soy milk or skim milk daily.

Impact of Integrating Community-Based Participatory Research Into a Baccalaureate Nursing Curriculum.

BACKGROUND: Community-based participatory research (CBPR) is rapidly gaining respect within the health care community as a means to promote public health and address health disparities. It has also recently been named as one of the competencies needed by public health professionals to be effective. METHOD: This article describes an educational innovation where CBPR is integrated into a baccalaureate nursing curriculum as a strategy to create meaningful learning experiences for nursing students while benefitting the health of the community. RESULTS: The impact of this approach was analyzed over a period of 12 years. The positive outcomes for the community, students, and faculty are described, along with the unique challenges. CONCLUSION: Integrating CBPR into a nursing curriculum is an innovation that is worthy of further assessment.