Self-Efficacy Survey Study of Pain Self-Management in Patients with Cancer.

BACKGROUND: Cancer pain prevalence remains high, and variance in self-efficacy for managing pain may explain why some patients experience greater pain severity. AIM: This study explored perceptions of self-efficacy in relation to cancer pain severity and treatment related characteristics. METHOD: A descriptive cross-sectional survey was administered to 50 cancer outpatients. Data analysis involved descriptive and correlational statistical analyses. RESULTS: Self-efficacy to manage pain was significantly associated with time since diagnosis and ability to deal with frustration, and inversely associated with pain severity level. A large proportion of patients reported low satisfaction self-managing their pain. Most patients reported independently self-managing their cancer pain; however, satisfaction with pain management was low for a large proportion of patients. Time since cancer diagnosis and ability to deal with frustration due to cancer pain were positively associated with cancer pain self-efficacy, whereas pain self-efficacy had a significant inverse correlation with cancer pain severity. CONCLUSIONS: Enhancing self-efficacy to self-manage under-treated cancer pain is important with implications for improving pain outcomes and quality of life. Further investigation on unmet needs and preferences for cancer pain self-management support is warranted.

Exploring Cancer Pain Self-Management Needs and Preferences: A Meta-Ethnography.

Self-management of chronic disease and related symptoms provides a framework for understanding the contextual factors that influence self-management knowledge and skills that patients and families require to manage their condition on a day-to-day basis. The management of cancer pain is a significant issue for patients and families, and their experience can provide insight on cancer pain self-management support needs and preferences. A meta-synthesis of 20 qualitative research articles on self-management of cancer pain was conducted to gain a deeper understanding of the self-management support needs of patients with cancer pain. Noblit and Hare's meta-ethnographic model was used. The meta-synthesis resulted in increased understanding of the needs and preferences for self-management support of cancer pain and the role of the health care practitioner. Practical implications are presented.

First detection of tetrodotoxin in the bivalve Paphies australis by liquid chromatography coupled to triple quadrupole mass spectrometry with and without precolumn reaction.

Two methods for the determination of tetrodotoxin (TTX) in marine biota have been developed and validated using ultra-performance LC coupled to triple quadrupole MS. The direct analysis of TTX is completed in one method, while the other method detects the dehydration product of TTX after reaction with base. The methods were validated in a single-laboratory trial and used to test Paphies australis (pipi) samples collected from Whangapoua, New Zealand during April 2011. Pa. australis is a commonly eaten species of bivalve that was found to contain TTX at levels up to 0.80 mg/kg in this study. The methods exhibited recoveries ranging from 94 to 120%, and the within laboratory reproducibility ranged from 6 to 27% for Pleurobranchaea maculata (grey-side gilled sea slug) and bivalve matrixes. Use of the method using a dehydration step showed no evidence of TTX analogs in any of the samples.

Current status of mosquito control programs in North Carolina: the need for cost-effectiveness analysis.

Mosquito control in the U.S. is both technically specialized and labor intensive with mosquito control programs (MCPs) carrying out services at federal, state, and local levels. The scope of each MCP varies depending on the needs of the region. In the 1970s, the North Carolina Department of Environment and Natural Resources formed the Public Health Pest Management (PHPM) section to play an active leadership role in training and support for local mosquito control programs across the state. PHPM was disbanded, however, in July 2011 due to state budget cuts. The extent to which recent budget shortfalls have impacted services provided by MCPs is largely unknown. Consequently, the primary objectives of the study described in this article were to 1) assess the current status of MCPs in North Carolina, 2) evaluate the extent to which the operational status of local MCPs affects public health, and 3) evaluate the impacts of losing the PHPM section in North Carolina.

Government-supported clinical knowledge and information resource portals are key to ensuring quality, safe health care and evidence-based practice - the Australian context.

Objective The aim of this study was to describe Australia's government-supported clinical knowledge and information resource portals and their alignment with government policies for digital health within an Australian context, and to clarify the role of hospital libraries in the public health system as an adjunct to state and territory portals. Methods Government-supported clinical resource portals in Australian states and territories were examined and benchmarked. A comprehensive search of Australian state, territory, and federal government websites was conducted for strategies, policies, and projects relating to medical research, digital health, and health workforce education. These documents were screened for reference to clinical knowledge and information resource portals, clinical decision support tools, hospital libraries, or educational resources for the health workforce. Additionally, information was derived from relevant published Australian studies to provide context and additional information about access to evidence in public hospitals. Results Clinical resource portals are a vital part of evidence-based health care in Australia; however, there are inconsistencies in these portals due to differences in policy, funding, and strategy between Australia's states and territories. Libraries in the healthcare sector play a key role in ensuring centralised clinical knowledge and information resource portals are easily available to clinicians, and in building on the initial portal collection, curate bespoke library collections for their individual organisations. Conclusion This investigation highlights the importance of government-supported clinical knowledge and information resource portals and the role they play in the provision of safe, quality, evidence-based health care. These portals, in conjunction with hospital library activities, are an integral part of the clinical governance framework.

Identifying and shifting educators' failure pedagogical mindsets through reflective practices.

BACKGROUND: In this paper, we add to the scant literature base on learning from failures with a particular focus on understanding educators' shifting mindset in making-centred learning environments. AIMS: The aim of Study 1 was to explore educators' beliefs about failure for learning and instructional practices within their local making-centred learning environments. The aim of Study 2 was to examine how participation in a video-based professional development cycle regarding failure moments in making-centred learning environments might have shifted museum educators' failure pedagogical mindsets. SAMPLE: In Study 1, the sample included 15 educators at either a middle school or museum. In Study 2, the sample included 39 educators across six museums. METHODS: In Study 1, educators engaged in a semi-structured interview that lasted between 45 and 75 min. In Study 2, the six museums video recorded professional development sessions. RESULTS: Results from Study 1 highlighted educators' failure pedagogical mindsets as either underdeveloped or rigid and absent of relational thinking between self- and youth-failures. One key result from Study 2 was a shift from an abstract sense of failure as youth-focused to a practical sense of failure as educator-focused and/or relational (i.e., youth educator-focused failure moments). CONCLUSIONS: Based on the results from Study 1 and Study 2, our research suggests that exploring an educator's relationship with failure is important and witnessing and reflecting upon their own failure pedagogical mindset in action may facilitate a shift towards a more complex and interconnected space for growth and development of both educators and youth.

Breastfeeding Rates in the Military Are Unchanged Before and After the Onset of the COVID-19 Pandemic.

Introduction: The COVID-19 pandemic brought changes in clinical operations and raised concerns about breastfeeding safety. We investigated the change in breastfeeding rates within a military population, a model of universal health care coverage, and elucidated factors that enhance or deter breastfeeding. Methods: A retrospective analysis was performed on mothers delivering infants ≥35 weeks' gestation at a military treatment facility (MTF) before (PRE) and during (PERI) the pandemic. Demographic data and feeding methods (exclusive, any, and no breastfeeding) from birth to 6 months of life were obtained. The primary outcome compared the breastfeeding rates between PRE and PERI. Logistic regressions identified factors associated with breastfeeding. Results: Of the 372 dyads, 189 (51%) were in PRE and 183 (49%) were in PERI. Exclusive breastfeeding rates in the nursery (77% versus 78%, p = 0.7), at 1 month (70% versus 65%, p = 0.3), at 2 months (65% versus 62%, p = 0.6), 4 months (49% versus 56%, p = 0.2), and 6 months of life (42% versus 47%, p = 0.5) were similar between PRE and PERI. Trends for any breastfeeding were also unchanged. Interactions with a lactation consultant were most strongly associated with exclusive breastfeeding in the nursery (odds ratio 21.88, confidence interval 5.84-82.00, p < 0.001). Discussion: Breastfeeding rates from birth to 6 months of life in infants receiving care at a single MTF were unchanged before and during the pandemic. Access to lactation consultants appears to be a significant contributing factor, and universal health care coverage may have improved access to this resource. Accessibility to breastfeeding resources and education is essential to support and strengthen breastfeeding within the military community.

A Descriptive Survey Study of Patient Needs and Preferences for Cancer Pain Self-Management Support.

OBJECTIVES: To characterize the needs and preferences for pain self-management support (SMS) among patients with cancer during the transition of cancer care from the hospital to the home setting. SAMPLE & SETTING: 38 participants with cancer pain at a research-intensive cancer center in New England. METHODS & VARIABLES: A descriptive, cross-sectional survey study was conducted to investigate relationships among preferred and received support, extent and management of transitional change, and pain outcomes. Pain intensity and interference were measured using the Brief Pain Inventory-Short Form, transitional change was measured using the Measurement of Transitions in Cancer Scale, and SMS was measured using dichotomous questions. RESULTS: About half of participants reported concordance between preferred and received cancer pain SMS in the hospital and at home. The extent of transitional change in cancer care was found to be a significant predictor of average pain intensity in the hospital and pain interference at home. Satisfaction with cancer pain SMS was a significant predictor of pain intensity at home. IMPLICATIONS FOR NURSING: The extent of change during care transitions should be considered when fulfilling patient needs and preferences for cancer pain SMS to optimize outcomes.

Assessment of qualifications needed by environmental health graduates entering private-sector employment.

The goal of the study described here was to provide a snapshot of knowledge, skills, and abilities currently required by employers in the private sector of the environmental health and safety field, specifically for entry-level positions attainable by individuals recently earning a bachelor's degree in environmental health. Information was collected first through the screening of 115 entry-level job descriptions posted on a popular environmental health and safety Internet job-seeking site. Because of the predominance of industrial hygiene and safety job descriptions found, a second data source was created-an online opinion survey taken by 98 American Industrial Hygiene Association-registered consultants certified in industrial hygiene. Important results from both data sources indicated that employers preferred a four-year science degree for new hires.

Bedbug infestations in the news: a picture of an emerging public health problem in the United States.

Bedbug (Cimex lectularis) infestations have become a major complaint in all but three states in the United States. Increasing infestations have also been reported in Asia, Australia, Europe, and Canada. Newspaper articles often herald the onset of a new health issue for the public, and they can be used for epidemiological tracking of increasing populations of irritating and potentially serious vectoring pests. This news coverage model is useful in validating the typical spread of a new contagious entity, or in predicting the waves of public reaction to the spread of a new pest or health problem. The authors' analysis covers the years 2001 to 2006, showing the incidence of bedbug news coverage from the East Coast, the Midwest, the South, and the West in the United States. Rural and urban examples are included in a four-year time frame starting with news in the Northeast and ending with an attempt to eradicate the pest from the state of Hawaii.

Comparisons of mosquito populations before and after construction of a wetland for water quality improvement in Pitt County, North Carolina, and data-reliant vectorborne disease management.

Wetlands serve an important purpose in flood control and water quality, but constructed-wetland sites also provide habitats for mosquito breeding. Communities near constructed-wetland sites often raise a "mosquito" objection when constructed wetlands are proposed. Wildlife and wetland advocates can confuse the public by making unsubstantiated claims about natural predators eliminating or controlling mosquito problems in a constructed wetland. Management of constructed-wetland mosquito habitat, with adequate mosquito surveillance and data analysis, can help lead to a successful project and satisfied citizens. The cooperative project described in this paper, was conducted in the town of Simpson, North Carolina, and was designed to determine the mosquito population impact of wetland construction at Mill Branch Stream, a small tributary of the Tar River in Eastern North Carolina. In the authors' analysis of three years of mosquito surveillance data, month (time of year standing in for temperature and day length) was a significant factor in regression analysis for mosquito numbers, but rainfall was not. Numbers of mosquitoes were not found to be significantly higher after construction than before construction.

BSL-3 laboratory practices in the United States: comparison of select agent and non-select agent facilities.

New construction of biosafety level 3 (BSL-3) laboratories in the United States has increased in the past decade to facilitate research on potential bioterrorism agents. The Centers for Disease Control and Prevention inspect BSL-3 facilities and review commissioning documentation, but no single agency has oversight over all BSL-3 facilities. This article explores the extent to which standard operating procedures in US BSL-3 facilities vary between laboratories with select agent or non-select agent status. Comparisons are made for the following variables: personnel training, decontamination, personal protective equipment (PPE), medical surveillance, security access, laboratory structure and maintenance, funding, and pest management. Facilities working with select agents had more complex training programs and decontamination procedures than non-select agent facilities. Personnel working in select agent laboratories were likely to use powered air purifying respirators, while non-select agent laboratories primarily used N95 respirators. More rigorous medical surveillance was carried out in select agent workers (although not required by the select agent program) and a higher level of restrictive access to laboratories was found. Most select agent and non-select agent laboratories reported adequate structural integrity in facilities; however, differences were observed in personnel perception of funding for repairs. Pest management was carried out by select agent personnel more frequently than non-select agent personnel. Our findings support the need to promote high quality biosafety training and standard operating procedures in both select agent and non-select agent laboratories to improve occupational health and safety.

Emergency mosquito control on a selected area in eastern north Carolina after hurricane irene.

Natural disasters such as hurricanes may contribute to mosquito abundance and, consequently, arbovirus transmission risk. In 2011, flooding from Hurricane Irene in eastern North Carolina (NC) resulted in increased mosquito populations that hindered recovery efforts. Budget shortfalls in NC have reduced the functionality of long-term mosquito surveillance and control programs; hence, many counties rely on the Federal Emergency Management Agency for post-disaster mosquito control. This pilot study examines mosquito abundance pre- and post-aerial insecticide spraying at eight study sites in Washington and Tyrrell Counties in rural eastern NC after Hurricane Irene. Percent change was calculated and compared for traps in areas that received aerial pesticide application and those that did not. Traps in spray zones show decreases in mosquito abundance when compared to control traps (treatment: -52.93%; control: 3.55%), although no significant differences (P = 0.286) were found in mosquito abundance between groups. Implications of reactive rather than proactive mosquito control responses are discussed.

Europe's Care Regimes and the Role of Migrant Care Workers Within Them.

This paper is an examination of the recent restructuring and subsequent convergence of European long-term care models. This paper also aims to highlight the increased role of migrant care workers and the need for great social and governmental recognition for all care providers. The provision of long term care is complex, divided between state, market and family providers; the state alone could not and does not act as the sole provider of care (Banks 1998). The extent to which different sectors are relied upon is largely dependent on the ideology of the country's welfare state (Timonen and Doyle 2007).

Pubic lice (Pthirus pubis): history, biology and treatment vs. knowledge and beliefs of US college students.

Pubic lice (Pthirus pubis) maintain a worldwide parasitic population infesting two to over 10 percent of human populations, continuing a presence that has been constant since early evidence 10,000 years ago. Outbreaks in the 1970s have been recorded, but incomplete records preclude description of a definitive population cycle. Current levels of infestation in a US college student population were investigated in this study. Knowledge and opinions of students were also recorded in an online survey administered to college students taking a basic health course at a mid-sized East Coast University. In a group of 817 students, 35 reported experience with pubic lice or other STD infection. Knowledge, beliefs, and treatment attitudes were examined for the 782 students who did not have experience with either pubic lice or STD infection. These students deemed antibiotics as a viable treatment for pubic lice infestation. They also indicated negative attitudes toward the use of pesticide crèmes, which are the most useful prescription. Symptoms and transmission myths in student answers are described.

Door to door survey and community participation to implement a new county mosquito control program in Wayne County, North Carolina, USA.

Community involvement in mosquito management programs provides more sustainable and effective organization and service. A door to door survey in Wayne County, NC carried out by student volunteers, resulted in 60 household responses. Residents had not previously experienced outreach from the county (88%), and 95% of them thought the student door to door survey was an effective form of outreach. One third of the residents thought mosquitoes were severe where they lived, but only 9% thought they had any containers in their yard that might breed mosquitoes. Only 15% of the residents were concerned about mosquito borne diseases. These responses provide evidence that outreach and education on mosquito control and diseases were necessary steps for future mosquito control community planning.