Increasing the Representation of Minority Students in the Biomedical Workforce: the ReTOOL Program.

With the growing burden of cancer in minority populations and limited progress in eliminating cancer disparities, it has become important to develop a diverse oncology workforce in basic, clinical, and behavioral research who will address cancer disparities and increase the participation of minority populations in clinical trials. To address the lack of well-trained underrepresented minority cancer scientists in Florida, the University of Florida collaborated with Florida A&M University in 2012 to establish the Florida Prostate Cancer Research Training Opportunities for Outstanding Leaders (ReTOOL) Program. Since 2012, the ReTOOL program has expanded to (1) cover all areas of cancer disparities; (2) offer training opportunities to minority students from all historically Black colleges and universities (HBCUs) in Florida; and (3) successfully secure both intramural and extramural federal funding to continuously provide research training opportunities for minority students in Florida. Focusing primarily on training Black students, the ReTOOL model includes culturally sensitive recruitment, mentorship, didactic curriculum, networking, and hands on experience in cancer research. This paper discusses the lessons learned from administering the ReTOOL program for 5 years, which includes having the right inputs (such as majority-minority institutions partnership, funding, faculty advisors, committed mentors, culturally competent staff, and standardized program requirements) and processes (such as pipeline approach, structured applications system, didactic curriculum, research experience, and continuous mentoring) for an effective research training program. The program impact is an increase in the pool of underrepresented minority candidates with scientific and academic career progression paths focused on reducing cancer health disparities.

Substance dependence and the use of pro re nata anxiolytic/hypnotic drugs in a hospital setting.

Patients hospitalized for treatment of psychiatric illness commonly receive pro re nata (p.r.n.) anti-anxiety and hypnotic agents. The relationship between illicit drug use and p.r.n. anti-anxiety/hypnotic drug use in hospitalized psychiatric patients has not been extensively examined. The purpose of the present study was to examine this relationship. A retrospective review of 99 randomly selected hospitalized patients abstracted information regarding the utilization of p.r.n. anxiolytic and hypnotic medications. Seventy percent of the patients surveyed evidenced substance dependence. The substance users utilized p.r.n. anxiolytics (t = 2.29, df = 81, p < .05) and bedtime hypnotics (t = 4.23, df = 90, p < .0001) more frequently than the nonusers. Hospitalized substance abusers appear to continue their substance abuse in the hospital, substituting prescription preparations for illicit drugs. Nevertheless, cumulative literature now suggests that p.r.n. anxiolytic and hypnotic agents play a critical role in the management of aggressive behavior and insomnia in patients hospitalized with psychiatric illness.

HIV-related lipodystrophy: a clinical syndrome with implications for nursing practice.

Since the clinical introduction of protease inhibitors for the treatment of HIV disease in 1996, optimism has grown for the long-term survival of persons living with HIV disease. With the addition of protease inhibitors to highly active antiretroviral therapy, the number of deaths from AIDS has decreased dramatically. However, along with reports of dramatic clinical improvement, many cases of a novel lipodystrophy syndrome associated with high triglyceride levels, diabetes, accumulations of fatty tissue, and alterations in body shape have been reported by researchers, clinicians, and persons living with HIV disease. This article reviews the literature on the defining characteristics and pathogenesis of HIV-related lipodystrophy, summarizes the current state of the science, and discusses related research and clinical implications.

Revision of HIV center medical staging scale.

HIV-related symptomatology represents both an indirect measure of immune functioning and a clinically significant indicator of disease progression. The most widely used classification system for HIV-related symptomatology is the Center for Disease Control (CDC) system. Although the CDC scale has widely recognized clinical utility, it provides only nominal-level measurement, which may be problematic for both clinicians and researchers. This article describes the revision and validation of the HIV Center Medical Staging Scale (rHCMSS), and ordinal-level physical illness scale that provides a means of independently measuring the progression of HIV-disease symptomatology and immunological decline. Concurrent use of the rHCMSS, the CDC classification system, and T-lymphocyte and viral load data will provide a more comprehensive indication of HIV-disease progression for clinical and research purposes.

Primary care providers' views of precepting nurse practitioner students.

PURPOSE: To explore perceived barriers to and facilitators of precepting as viewed by experienced community-based preceptors. DATA SOURCES: Twenty-four nurse practitioner and physician preceptors participated in a 20-minute telephone interview, using a semi-structured format. The interviews were audio-taped and transcribed. Constant comparative analysis was used to organize the preceptors' responses into thematic categories. CONCLUSIONS: Overall, most preceptors were satisfied with the precepting experience; however, many preceptors cited increasing difficulty with teaching students in primary care sites due various organizational constraints such as the imperative to increase productivity. Good communication with school of nursing faculty was cited as the key factor to continued willingness to precept. IMPLICATIONS FOR PRACTICE: Understanding factors that are important for preceptors continuing in their clinical teaching role is important for schools of nursing, especially given the increasing time-limitations that many providers face due to social and economic changes in health-care delivery.

A remote method for simultaneous measurement of corneal thickness and curvature at a single point.

Advances in refractive surgery have been limited by the measurement technology for determining corneal thickness and curvature. A measurement technique is needed that can provide a detailed corneal thickness and curvature model without contacting the cornea or obstructing the view of the surgeon or surgical equipment. The authors present preliminary results of a method to remotely measure the thickness and curvature of the human cornea at a single point. The method combines ray tracing and interferometry to estimate thickness and curvature in two orthogonal planes in an area less than 100 microns in diameter. This technique has been successfully used to provide very accurate estimates of several thin-shelled test objects. Based upon these results, recommendations are given for further improvement of the technique and extension to a multipoint cornea-modeling system.

Human immunodeficiency virus (HIV) disease in persons with severe mental illnesses.

Extant research has found alarming rates of the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in persons with severe mental illnesses (SMI), with seroprevalence rates ranging from 4% to 23%. However, persons with SMI have received less attention than any other group that has been disproportionately affected by HIV/AIDS. As such, preventing and treating HIV in persons with SMI has been indicated as one of the highest priority research initiatives by the NIH Office on AIDS research. This article reviews current research findings and discusses the nursing research and practice implications for assessment, prevention, and treatment of HIV in this vulnerable population.

Childhood depressive disorders.

About 5% of children and adolescents in the general population suffer from depressive disorders at any given point in time. Children under stress, those who experience loss, or children who have attention, learning, conduct, or anxiety disorders are at a higher risk for depressive disorders. Depressive disorders cause diminished quality of life and can ultimately affect mortality through increased risk of suicide and acts of violence. This article describes the incidence and prevalence of childhood depressive disorders, reviews the diagnostic criteria for and the symptom manifestations of depressive illnesses, and discusses recommended treatments.

Disease severity and symptoms of depression in Black Americans infected with HIV.

The purpose of this study was to examine depressive symptomatology in a sample of human immunodeficiency virus (HIV) infected Black Americans and to determine the extent to which measures of HIV disease severity were associated with depressive symptoms. Seventy-nine HIV-infected Black men and women (ages 25 to 68 years) participated. Measures included the Center for Epidemiologic Studies Depression Scale (CES-D) and multiple HIV disease severity variables including CD4+ lymphocyte count, CDC HIV stage, and HIV RNA viral load. Levels of self-reported depressive symptoms were high, with 58% (n = 48/79) of study participants exhibiting elevated depressive symptoms (CES-D score of > or =16). No relationship was found between CD4+ count, CDC HIV stage, sociodemographic variables, and depressive symptoms. Viral load, however, was positively correlated with elevated depressive symptoms. Although the level of depressive symptomatology was high, only two participants were receiving antidepressant medication. This study suggests that there is a significant unmet need for identification and treatment of depressive symptoms among Blacks receiving routine care for HIV disease.

Purpose in life and depressive symptoms in persons living with HIV disease.

PURPOSE: To examine relationships among purpose in life, HIV disease severity, demographic variables, and depressive symptoms in people living with HIV disease (PLWHIV). The hypothesis tested was that purpose in life is a stronger predictor of depressive symptoms than is HIV disease severity. DESIGN: Descriptive, correlational study using a convenience sample of 123 PLWHIV recruited from an urban infectious disease clinic in a university teaching hospital in the Southeast United States. METHODS: A self-administered questionnaire, including a sociodemographic tool, the Center for Epidemiologic Studies Depression Scale (CES-D), and the Purpose in Life Scale (PIL), was used to collect data. Concurrent severity of HIV disease measures included HIV RNA viral load, CD4+ T-lymphocyte count, and the Revised HIV Medical Symptom Scale. Analytical methods included descriptive and inferential statistics and hierarchical regression analysis. FINDINGS: Depressive symptoms were greater and purpose in life was lower than in normative samples. Purpose in life was a stronger predictor of depressive symptoms than was HIV disease severity. CONCLUSIONS: Purpose in life was more important than were laboratory markers of disease progression for predicting depressive co-morbidity. Results from this study indicate the need for routine assessment of depressive symptoms in PLWHIV. Purpose in life should be explored as a potential buffer for depressive symptoms.