Gait abnormalities and non-motor symptoms predict abnormal dopaminergic imaging in presumed drug-induced Parkinsonism.

Drug-induced parkinsonism (DIP) can be clinically indistinguishable from degenerative parkinsonism, and bedside assessments are needed to differentiate between these conditions. We examined 34 U.S. Veterans with DIP using 123I-FP-CIT (DAT-SPECT) to identify underlying nigrostriatal degeneration. Participants were 94% male with mean age of 64.5 ± 7.1 years. DAT-SPECT was abnormal in 12/34 (35%). Comparing normal and abnormal imaging groups, there were no differences in age, sex, race/ethnicity, psychiatric diagnosis, motor severity, or RBD Screening Questionnaire scores. Those with underlying neurodegeneration reported significantly more non-motor symptoms (NMS), worse olfactory function on the University of Pennsylvania Smell Identification Test, and greater turning duration/steps on the instrumented Timed Up and Go. Area under the curve (AUC) combining poor olfaction and total NMS burden was 0.84 (CI 0.71-0.97), while AUC for turn steps was 0.91 (CI 0.81-1.00). Gait impairment, hyposmia, and NMS may be useful alone and in combination to identify DIP patients with underlying dopaminergic degeneration.

Development of culturally tailored educational brochures on HPV and pap tests for American Indian women.

PURPOSE: Participatory formative research guided the creation of a culturally tailored educational brochure about human papillomavirus (HPV) at an American Indian women's clinic. METHOD: A review of existing educational materials and in-depth interviews were conducted. Nine steps for creating health communications messages that were patterned after National Cancer Institute guidelines guided the brochure development process. RESULTS: Of 95 women tested for HPV, 41% were positive, 32 (34%) agreed to the in-depth interview, and 9 agreed to the pretesting interview. Mean age was 41 years. Interviews revealed key themes concerning emotional reactions to abnormal Pap test results and HPV; need for basic information about HPV, Pap tests, and results; concerns about HPV stigma, sexual transmission, and communication with sexual partner; and the preferred source and format for HPV educational materials. A literature review revealed 12 areas of basic HPV content. CONCLUSIONS: A participatory process successfully engaged nursing staff and patients in creating culturally appropriate brochures for clinic use. IMPLICATIONS: This article provides specific steps for creating culturally tailored patient education materials.

Sonographic assessment of cervical length and the risk of preterm birth.

Sonographic assessment of cervical length is useful in evaluating the risk of preterm birth. Ultrasound is more accurate than digital exam and can be used in conjunction with fetal fibronectin (fFN) testing. Documentation of a long cervical length can reduce unnecessary treatments and hospitalizations in women who are unlikely to give birth preterm. Short cervical length can promote prompt intervention. Recognition of normal sonographic anatomy and proper measurement of the cervical canal are required.

Enhancing knowledge and self-confidence of novice nurses: The "Shadow-A-Nurse" ICU program.

The nursing shortage in the United States has resulted in a need for newly graduated novice nurses to rapidly transition into the nursing workforce. Although some nursing schools provide clinical experience in the intensive care unit (ICU), many novice nurses are not confident about their skills in providing critical-care nursing. To assist novice nurses in rapidly transitioning into the ICU nurse role, an innovative internship program for novice nurses was designed and implemented. A pilot study was conducted to determine if working with experienced nurses in the ICU environment, in addition to formal education and skills training in critical-care nursing, enables novice nurses to effectively transition into the role of ICU nurse. Qualitative and quantitative results of the program after the second year are discussed.