An interprofessional web-based approach to providing breast cancer education.

This paper describes the process that nursing, social work, and pharmacy faculty at a state university undertook to develop interprofessional web-based breast cancer education modules for incorporation into required curriculum. Eight web modules initially developed to educate baccalaureate nursing students on breast cancer were revised and expanded at each health professional school to include discipline-specific information pertinent to social work and pharmacy scope of practice. A specialized internet-accessible web-delivered application was constructed consisting of eight reusable learning objects, or modules, including epidemiology, risk factors and screening, diagnosis, staging and grading, treatment, survivorship, disparities, and metastatic breast cancer. These modules were organized for easy integration into existing courses and allowed for an efficient means of providing expert, evidence-based content. Innovative methods to integrate nursing, social work, and pharmacy education are needed to achieve an effective interprofessional educational approach to teaching breast cancer content.

Improving nursing students' breast cancer knowledge through a novel academic and non-profit foundation partnership.

The unique partnership between an affiliate of the Susan G. Komen for the Cure(©) foundation and a school of nursing offered faculty the ability to creatively inject breast cancer content into the baccalaureate curriculum. In-house breast cancer experts and external consultants developed seven breast cancer-specific educational Web-based modules to supplement a packed curriculum taught by generalists in a cost-efficient manner. Easily integrated into the baccalaureate program, these modules provided evidence-based breast cancer content to nursing students. Following completion of the modules, baccalaureate students' knowledge of breast cancer improved.

Telomere-based cancer treatment: emerging targeted therapies.

Chemotherapy and radiation therapy are standard care in cancer treatment; however, both have numerous adverse side effects because they affect healthy as well as cancerous cells. The side effects, including decreased white blood cell count, nausea, hair loss, and fatigue, can be severe enough that patients may decide to forgo treatment. Targeted therapies are treatments that focus on specific molecules in cancerous cells and avoid disruption of healthy cells. Telomeres, the ends of chromosomes, are possible targets. In healthy cells, telomeres become shorter with each cell division, limiting the number of divisions that a normal cell can undergo. Many cancer cells have telomerase activity, which rebuilds telomeres after each cell division and confers immortality to cancer cells. Telomerase is an enzyme normally present to a significant degree only in the cells of developing fetuses. Treatments that target the telomerase enzyme itself or the chromosomal telomeres are being developed and tested in early clinical trials. This article focuses on several approaches to telomere-targeted therapy.

Cancer screening across the aging continuum.

OBJECTIVES: To review current screening guidelines and practice related to cancer screening among older adults and to establish a best practice approach to screening for older individuals applicable to all levels of care. STUDY DESIGN: A comprehensive literature search was performed with consideration given to research and practice. METHODS: Review article. RESULTS: There is some evidence to support the effectiveness of screening for cancer among older adults, particularly when comorbidity, functional status, and life expectancy are considered. Moreover, most older individuals (at least the subpopulations of well-educated individuals of white race/ethnicity) have positive attitudes about cancer screening and are willing to engage in available screening tests. However, strict adherence to any of the selected guidelines for all older individuals can result in unnecessary stress and burden to some individuals related to screening and subsequent testing. Furthermore, screening for all older adults regardless of age and status has ethical implications for the community at large. CONCLUSION: Providers should take an individualized approach to screening that addresses the immediacy of the screening benefit, associated risks of screening, preferences of the patient or his or her proxy, ethical concerns (eg, the futility of screening or treatment), and the patient's life expectancy, health status, and quality of life.

Predictors of nosocomial bloodstream infections among critically ill adult trauma patients.

OBJECTIVE: To identify the independent predictors of nosocomial bloodstream infections (BSIs) among critically ill adult trauma patients. DESIGN: A prospective, cohort design was used to study patients who met predetermined inclusion criteria. Basic descriptive and univariate statistical analyses were performed to identify unadjusted predictors. A forward stepwise multivariate logistic regression analysis was then conducted to identify independent predictors of nosocomial BSI. SETTING: Level I university-affiliated shock trauma center. PATIENTS: Three hundred sixty-one critically ill adult trauma patients, 55 of whom developed nosocomial BSIs (15.2%). RESULTS: Data analysis of 45 variables indicated that only 9 were independent predictors of nosocomial BSI: presence of a chest tube, use of immunosuppressive agents, presence of microbial resistance, length of stay, presence of preexisting infection, percentage change of serum albumin levels, patient disposition, transfusion of 10 or more units of blood, and number of central venous catheters (CVCs) for patients who had 4 or more. The classification index of the final regression model at a cut-off point of 0.5 had a specificity of 97.4%, a sensitivity of 60%, a positive predictive value of 76.7%, a negative predictive value of 93%, and an overall precision of 91%. CONCLUSION: In this study, only 9 variables were independent predictors of nosocomial BSI. Our findings are specific to critically ill adult trauma patients and should be interpreted within the context of this particular population.

Biology of lung cancer with implications for new therapies.

PURPOSE/OBJECTIVES: To provide an overview of the biology of lung cancer with respect to genetic carcinogenesis and specific mutations and to discuss new therapies being developed to target lung cancer's biologic processes. DATA SOURCES: Published articles, abstracts, book chapters, lectures, and personal experiences with experimental agents. DATA SYNTHESIS: Lung cancer is the number one cause of cancer deaths for men and women in the United States, with minimal changes in the five-year survival rate during the past decade. New understanding of the biologic process of lung cancer is providing potential new therapies that many hope will lead to increased survival for patients with lung cancer. CONCLUSIONS: Exciting new therapies for lung cancer are being developed that target specific biologic processes of lung cancer. IMPLICATIONS FOR NURSING: When nurses are familiar with the rationale behind biologic therapies, they can understand the drugs, assess toxicities, and help patients make educated decisions about therapeutic alternatives.