Oncology Nursing Society's Genomics and Precision Oncology Learning Library Resources for Nursing Practice.

Oncology nurses need an understanding of genomic science to provide optimal care, yet they may have limited background in how this science guides treatment. The Oncology Nursing Society (ONS) responded to this identified need.

Understanding communication between patients and healthcare professionals regarding comprehensive biomarker testing in precision oncology: A scoping review.

BACKGROUND: Precision oncology, using comprehensive biomarker testing (cBT) to inform individual cancer diagnosis, prognosis and treatment, includes increasingly complex technology and clinical data sets. People impacted by cancer (patients and caregivers) and healthcare professionals (HCPs) face distinct challenges in navigating the cBT and personalized treatment landscape. This review summarizes evidence regarding cBT-related communication between people impacted by cancer and HCPs and identifies important avenues for future research in precision oncology. METHODS: A scoping review was conducted using records published in PubMed during January 2017-August 2022, focusing on the breadth of topics on patient-HCP communication and knowledge resources used by HCPs as guidance in cBT-related communication. Data were extracted from records meeting inclusion criteria, and findings were summarized according to main topics. RESULTS: The search identified 287 unique records and data were extracted from 42 records, including nine from expert input. Most records originated from the United States included patients with different types of cancer, and oncologists were the main HCPs. Patients' motivation for undergoing cBT and receiving results was generally high in different settings. However, patients' understanding of cBT-related concepts was limited, and their knowledge and information preferences changed based on cBT implications and significance to family members. HCPs were valued by patients as a trusted source of information. Limited evidence was available on HCPs' information-seeking behavior and factors influencing cBT-related knowledge and confidence, often self-reported as insufficient. CONCLUSIONS: Patient education by knowledgeable and confident HCPs, information management and a caring patient-HCP relationship communicating continuity of care regardless of cBT results are crucial to empower patients and shared decision-making in precision oncology. More data on the process and structure of cBT-related communication, distinction between and characterization of different timepoints of patient-HCP interactions are needed.

Navigating Through Disaster: Application of Oncology Nurse Navigator Competencies to Climate Disaster Preparation and Response.

OBJECTIVES: The role of the oncology nurse navigator (ONN) before, during, and after a climate disaster is critical to ensuring that individuals with cancer continue to receive the necessary care and support. The objective of this article is to provide an overview of the essential role of the ONN by highlighting the application of core competencies to climate disasters. METHODS: Competencies available for ONNs from the Oncology Nursing Society include coordination of care, communication, education, professional role, and expertise. International Council of Nurses (ICN) core competencies for disaster nursing include eight domains: preparation and planning, communication, incident management systems, safety and security, assessment, intervention, recovery, and law and ethics. These competencies are explored for application to climate disaster preparation, mitigation, and response. RESULTS: The ONN competencies and the domains of the ICN disaster nursing competencies were integrated to outline the role of the ONN in disaster preparedness and response. CONCLUSION: The ONN is pivotal in maintaining the continuity of cancer care. The ONN's expertise is critical for navigating the difficulties presented by hurricanes, floods, wildfires, and other extreme climate events as well as existing barriers to cancer care. The ONN's adeptness at coordinating care, communicating effectively, and tapping into community resources will transfer to a climate disaster, ensuring minimal treatment interruptions and access to necessary care. IMPLICATIONS FOR NURSING PRACTICE: The ONN is integral to the cancer care team in preparing and responding to climate disasters. The ONN ensures ongoing access to cancer care and advocates for the specialized care that people with cancer need. The ONS ONN Core Competencies and the ICN Disaster Competencies are applicable for developing processes and procedures to address climate disasters in clinical practice.

Artificial Intelligence: Basics, Impact, and How Nurses Can Contribute.

Applying artificial intelligence (AI) to cancer care has the potential to transform and enhance nursing practice and patient outcomes, from cancer prevention and screening through treatment, survivorship, and end-of-life care.

Climate disasters and oncology care: a systematic review of effects on patients, healthcare professionals, and health systems.

PURPOSE: Climate disasters have devastating effects on communities and society that encompass all aspects of daily life, including healthcare. Patients with cancer are particularly vulnerable when disaster strikes. As the number and intensity of disasters increases, it is important to understand the effects across the cancer care continuum. This systematic review investigates the effect of climate disasters on patients, the oncology healthcare workforce, and healthcare systems. METHODS: A medical librarian conducted a literature search in PubMed, Embase, CINAHL, and Web of Science from January 1, 2016, through May 11, 2022. Eligible studies included any published report on a climate disaster globally reporting on patient-, oncology healthcare workforce-, or healthcare systems-level outcomes. Study quality was assessed, and findings were narratively synthesized, given the diversity of reported evidence. RESULTS: The literature search identified 3618 records, of which 46 publications were eligible for inclusion. The most frequent climate disaster was hurricanes (N = 27) followed by tsunami (N = 10). Eighteen publications were from disasters that occurred in the mainland USA with 13 from Japan and 12 from Puerto Rico. Patient-level outcomes included treatment interruptions and inability to communicate with the healthcare team. At the workforce level, findings included distressed clinicians caring for others when their own lives have been affected by a disaster along with lack of disaster preparedness training. Health systems reported closures or shifting services post-disaster and a need to have improved emergency response plans. CONCLUSION: Response to climate disasters necessitates a holistic approach at the patient, workforce, and health systems levels. Specifically, interventions should focus on mitigating interruptions in care for patients, advanced coordination and planning for workforce and health systems, and contingency planning for allocation of resources by health systems.

Climate Change and Oncology Nursing: A Call to Action.

Climate change is a public health crisis that amplifies exposure to known carcinogens, leading to increased cases of cancer and other diseases. This clear link is a powerful reason for all oncology nurses concerned with cancer prevention and treatment to be involved in climate change solutions. The purpose of this review is to bring awareness to the consequences climate change has on the incidence and mortality of cancer, how it affects people living with cancer, and how oncology nurses can help mitigate these suboptimal outcomes. .

Evidence-Based Practice in Oncology Nursing: Oncology Nursing Society Survey Results.

BACKGROUND: Evidence-based practice (EBP) is a clinical decision-making approach that improves quality and outcomes in health care but is not yet standard in clinical settings. OBJECTIVES: The purpose of this study was to determine EBP beliefs, knowledge, implementation strategy self-efficacy, and competencies among a national sample of oncology nurses. METHODS: Oncology nurses completed an online survey of EBP attributes and open-ended questions. Analyses were conducted on data collected from 893 participants from a range of healthcare organizations across a diverse geographic sample of the United States. FINDINGS: Respondents rated themselves competent to question clinical practice to improve quality care. Oncology nurses reported competency to question clinical practice but deficits in EBP knowledge and skills.

Draining the Swamping Hypothesis: Little Evidence that Gene Flow Reduces Fitness at Range Edges.

The genetic swamping hypothesis proposes that gene flow from central to peripheral populations inhibits local adaptation and is one of the most widely recognized explanations for range limitation. We evaluated empirical support for this hypothesis in studies quantifying patterns of gene flow to peripheral populations and their resulting fitness outcomes. We found little evidence that gene flow is generally asymmetric from central to peripheral populations and also that gene flow tends to have positive effects on edge population fitness. These findings contravene the long-held assumption that genetic swamping is a common driver of species range limits, and bear important implications for understanding the role of gene flow in range evolution and for predicting and managing eco-evolutionary responses to climate change.

Using a Genomics Taxonomy: Facilitating Patient Care Safety and Quality in the Era of Precision Oncology.

Oncology nurses need to be competent in the ever-expanding application of genomics in cancer care, and understanding foundational terms is necessary. A landscape analysis of Oncology Nursing Society (ONS) materials, a literature review, and expert opinion revealed inconsistencies and varying use of genomic terms, some of which are outdated. In response, the ONS Genomics Taxonomy was built to address inaccuracies and discrepancies in terms and to be an accessible resource for oncology nurses. The taxonomy is a living document that is updated to reflect evolving science and evidence and serves to diminish confusion, improve genomic literacy, and assist oncology nurses in providing safe genomic care.

Evidence for adaptive responses to historic drought across a native plant species range.

As climatic conditions change, species will be forced to move or adapt to avoid extinction. Exacerbated by ongoing climate change, California recently experienced a severe and exceptional drought from 2011 to 2017. To investigate whether an adaptive response occurred during this event, we conducted a "resurrection" study of the cutleaf monkeyflower (Mimulus laciniatus), an annual plant, by comparing trait means and variances of ancestral seed collections ("pre-drought") with contemporary descendant collections ("drought"). Plants were grown under common conditions to test whether this geographically restricted species has the capacity to respond evolutionarily to climate stress across its range. We examined if traits shifted in response to the recent, severe drought and included populations across an elevation gradient, including populations at the low- and high-elevation edges of the species range. We found that time to seedling emergence in the drought generation was significantly earlier than in the pre-drought generation, a response consistent with drought adaptation. Additionally, trait variation in days to emergence was reduced in the drought generation, which suggests selection or bottleneck events. Days to first flower increased significantly by elevation, consistent with climate adaptation across the species range. Drought generation plants were larger and had greater reproduction, which was likely a carryover effect of earlier germination. These results demonstrate that rapid shifts in trait means and variances consistent with climate adaptation are occurring within populations, including peripheral populations at warm and cold climate limits, of a plant species with a relatively restricted range that has so far not shifted its elevation distribution during contemporary climate change. Thus, rapid evolution may mitigate, at least temporarily, range shifts under global climate change. This study highlights the need for better understanding rapid adaptation as a means for plant communities to cope with extraordinary climate events.

What can local and geographic population limits tell us about distributions?

PREMISE OF THE STUDY: Understanding the evolutionary and ecological factors that determine plant distributions is of primary importance in botanical research. These factors may vary in predictable ways across different spatial scales, and thus, we can leverage scale to reveal the underlying processes limiting plant distributions. METHODS: We review various research considerations across local and geographic scales, including the investigation of dispersal and habitat limitation, evolutionary factors, abiotic and biotic factors, and research logistics. We also present two case studies, slender monkeyflower (Mimulus leptaleus) and cut-leaf monkeyflower (Mimulus laciniatus), in the California Sierra Nevada. KEY RESULTS: At a local spatial scale (within 50 m), no seeds were produced from plants sown at sites located just beyond known patches of M. leptaleus, but within the species' geographic range. At a much broader spatial scale (kilometers), at the highest and lowest elevations of the species' range, we found greatly reduced abundance and fecundity in plants sown outside of the geographic range limits of M. laciniatus. CONCLUSIONS: These cases illustrate two contrasting spatial scales, yet agree in their illustration of strong habitat limitation. We end by discussing future avenues of research and by suggesting ways botanical researchers can frame their studies to maximize information gained on species requirements, distribution limits, and conservation among varying spatial scales.