Understanding the sleep-pain relationship in patients with interstitial cystitis/bladder pain syndrome.

INTRODUCTION: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic pelvic pain condition with critical symptoms of urinary urgency and frequency, persistent bladder-related pain, and reduced quality of life. Poor quality sleep can lead to significant disturbances in daily life and increased pain in IC/BPS patients. Resilience, depressive symptoms, and pain catastrophizing have univariate associations with sleep and pain in IC/BPS, suggesting they may be mechanisms in this sleep and pain relationship. METHODS: This online study recruited patients self-reporting a diagnosis of IC/BPS through support groups, social media posts (Facebook, Reddit, and Instagram), and urology clinic advertisements. Participants completed questionnaires on demographics, urologic symptoms, pain, pain catastrophizing, depressive symptoms, and resilience. Only those participants who met the RICE criteria for IC/BPS diagnosis were included. A multiple mediation model was first examined, followed by a serial mediation model. RESULTS: Seventy-four participants (Mage= 47.0, standard deviation [SD] 16.7, range 18-83 years) met inclusion criteria. A multiple mediation model showed greater sleep disturbance was associated with greater pain severity through depressive symptoms and pain catastrophizing, but not resilience (b=0.79, bootSE=0.26, bootCI [0.33, 1.35]). A serial mediation showed that the sleep-to-pain relationship had a significant indirect effect through pain catastrophizing and depressive symptoms (b=0.78, bootSE=0.26, bootCI [0.35, 1.32]). CONCLUSIONS: Findings suggest depressive symptoms and pain catastrophizing may be important psychosocial mechanisms in the sleep-to-pain relationship. These results help guide future sleep and pain research in IC/BPS and aid in developing and refining treatments.

Differentiating Childhood Traumas in Inflammatory Bowel Disease.

Background: Inflammatory bowel disease is characterized by chronic inflammation of the gastrointestinal tract. Research on inflammatory bowel disease has shown a connection to childhood traumatic events. However, few studies have focused on specific types of traumatic experiences and the impact of confiding in others on disease-related outcomes. This comparative, cross-sectional study expected that: (1) patients would report higher prevalence rates of childhood traumas than healthy controls; (2) healthy controls would report fewer and less severe traumatic experiences than patients and less confiding in others compared to patients; (3) childhood trauma severity would be indirectly related to depressive symptoms through resilience and confiding in others would moderate this relationship. Methods: Participants completed an online survey; an inflammatory bowel disease patient group (N = 195, Mage = 40.48, 76.4% female) was compared to a similarly recruited sample of healthy controls (N = 190, Mage = 31.16, 59.5% female). Results: Patients reported a higher prevalence of experiencing sexual traumas (P = .031), major upheavals (i.e., disruptions) (P = .048), and violence (P = .050) than controls. Patients had significantly higher total trauma severity odds ratios (OR 0.89, 95% CI[0.81,0.97]) and significantly lower total confiding in other odds ratios than controls (OR 1.09, 95% CI[1.02,1.16]). Childhood trauma severity was indirectly related to depressive symptoms through resilience, b = .05, SE = 0.09, 95% CI[0.01,0.09]; however, confiding did not moderate this relationship. Conclusions: Patients reported more sexual, disruptive, and violent traumas. Although confiding did not act as a moderator, trauma was related to depressive symptoms through resilience.

Physician-Pharmacist Collaborative Drug Therapy Management in Pediatric Hypertension.

OBJECTIVE: Pediatric hypertension affects 2% to 5% of children and adolescents in the United States and is frequently undertreated. The increasing prevalence of pediatric hypertension and worsening physician shortage create difficulties in closing this treatment gap. Physician-pharmacist collaborations have been shown to improve patient outcomes in adult patients. Our aim was to demonstrate a similar benefit for pediatric hypertension. METHODS: Pediatric patients whose hypertension was managed at a single pediatric cardiology clinic from January 2020 to December 2021 were enrolled in collaborative drug therapy management (CDTM). Patients whose hypertension was managed in the same clinic from January 2018 to December 2019 were used as a comparison group. The primary outcomes were achievement of at-goal blood pressure at 3, 6, and 12 months and time to control of hypertension. Secondary outcomes were appointment adherence and serious adverse events. RESULTS: A total of 151 patients were included in the CDTM group, and 115 patients were included in the traditional care group. Of those, 100 CDTM patients and 78 traditional care patients were assessed for the primary outcome. Fifty-four (54%) CDTM patients and 28 (36%) traditional care patients achieved at-goal blood pressure at 12 months (OR, 2.09; 95% CI, 1.14-3.85). Appointment non-adherence was 9.4% for CDTM and 16% for traditional care (OR, 0.54; 95% CI, 0.35-0.82). Adverse events were similar between groups. CONCLUSIONS: CDTM increased rates of at-goal blood pressure without increased adverse events. Physician-pharmacist collaboration may improve treatment of hypertension in pediatric patients.

Significance of an Online Evidence-Based Practice Education Module for Acute, Ambulatory, Public, and School Health Nurses.

Recent surveys of Magnet facilities and nurses found low rates of implementation of evidence-based practice in U.S. health care settings. Nursing Experts: Translating the Evidence (NExT) is a collaboration of nurses and librarians providing free online evidence-based practice nursing education benefiting nurses in all settings. The NExT online modules empowered participants to efficiently access valuable resources to inform and improve their practice in a convenient, accessible, self-paced format. Quantitative and qualitative evaluation methods and the value of collaboration are discussed. [J Contin Educ Nurs. 2023;54(4):176-184.].

Antibacterial effects in blood irradiated with a polychromatic device mediated through reactive oxygen species: possible involvement of haem.

The antibacterial effects of a polychromatic light device designed for intravenous application were assessed in vitro. Staphylococcus aureus, Klebsiella pneumoniae, or Escherichia coli were exposed to a 60-min sequential light cycle comprising 365, 530, and 630 nm wavelengths in circulated sheep blood. Bacteria were quantified by viable counting. The potential involvement of reactive oxygen species in the antibacterial effect was assessed using the antioxidant N-acetylcysteine-amide. A modified device was then used to determine the effects of the individual wavelengths. Exposure of blood to the standard wavelength sequence caused small (c. 0.5 Log 10 CFU) but statistically significant reductions in viable counts for all three bacteria, which were prevented by the addition of N-acetylcysteine-amide. Bacterial inactivation did not occur in blood-free medium, but supplementation with haem restored the moderate bactericidal effect. In single-wavelength experiments, bacterial inactivation occurred only with red (630 nm) light. Concentrations of reactive oxygen species were significantly higher under light stimulation than in unstimulated controls. In summary, exposure of bacteria within blood to a cycle of visible light wavelengths resulted in small but statistically significant bacterial inactivation apparently mediated by a 630 nm wavelength only, via reactive oxygen species possibly generated by excitation of haem groups.

Patient-Reported Pain Distributions in Inflammatory Bowel Disease: Impact on Patient Psychosocial Outcomes.

Inflammatory bowel disease (IBD) is a painful chronic gastrointestinal disease associated with diminished quality of life. No research documents IBD body pain or the associations of pain patterns to outcomes. Objectives were to map patient body pain areas and examine the associations between pain patterns with depression, catastrophizing, pain severity, and quality of life. A cross-sectional survey was collected from consecutive tertiary-care IBD clinic patients ( n = 255). Patients were classified into three pain pattern groups (No Pain; Localized Pain Only; and Widespread Pain) with more than 40% reporting widespread pain. The Localized Pain Only and Widespread Pain groups reported pain in the abdomen, the uterus/testes, vagina/penis, bladder, and pelvis/buttock areas. The body area most often reported was the anterior abdomen for the Localized Pain Only and Widespread Pain groups, with additional endorsement of lower back and anterior thigh and knees for the Widespread Pain group. The pain versus no pain patients reported greater depressive symptoms, catastrophizing, and diminished quality of life. Patients reported a variety of pain patterns during clinic visits. Widespread pain is associated with greatest pain and poorest psychosocial outcomes.

A Systematic Review on Improving the Family Experience After Consent for Deceased Organ Donation.

INTRODUCTION: The demand for transplanted organs outweighs the supply and intensifies the need to improve care for donor families. Studies have shown inadequate care by hospital staff can increase posttraumatic stress disorder and complicated grief in these families but putting solutions into practice remains slow. OBJECTIVE: This systematic review identified factors that relieve or contribute to distress for deceased organ donor families in the time since the decision to donate. Additionally, it provides insights into potential improvements at public health, educational, and health system levels to address these deficiencies. METHODS: Search terms included organ don*, famil* or relati*, family-centered, grief, and experience*. The search covered original research articles, published in English, from 2014 to July 2021. RESULTS: Four key themes emerged among the studies. (a) Understanding factors that affect the emotional aftermath can help staff prevent posttraumatic stress disorder and complicated grief. (b) Improving communication by hospital staff includes: avoiding medical jargon, providing adequate audio and visual explanations, and understanding that the next of kin is struggling to comprehend the tragedy and the information they are being told. (c) End-of-life care such as memory making, bringing in palliative care resources, and parting ceremonies can assist with familial coping as well as staff interactions. (d) Families want more support in the months and years after the donation decision. DISCUSSION: Changes at multiple levels can improve the quality of care for families whose relative gave the gift of life, but more research and translation into practice are needed.

Childhood trauma, depression, resilience and suicide risk in individuals with inflammatory bowel disease.

Despite the prevalence of suicide risk in inflammatory bowel disease populations, research has yet to examine associations between childhood trauma, resilience, depression and suicide risk. In the present online study, 172 participants responded to measures of childhood trauma, resilience, depression and suicide risk. A moderated mediation revealed that resilience does not moderate the associations between childhood trauma, depressive symptoms and suicide risk. However, a serial mediation revealed that childhood trauma is associated with decreased resilience, which is related to higher depressive symptoms, and ultimately higher suicide risk, thus suggesting resilience and depression as significant intervention targets.

Exploring data management content in doctoral nursing handbooks.

OBJECTIVE: While data management (DM) is an increasing responsibility of doctorally prepared nurses, little is understood about how DM education and expectations are reflected within student handbooks. The purpose of this study was to assess the inclusion of DM content within doctoral nursing student handbooks. METHODS: A list of 346 doctoral programs was obtained from the American Association of Colleges of Nursing (AACN). Program websites were searched to locate program handbooks, which were downloaded for analysis. A textual review of 261 handbooks from 215 institutions was conducted to determine whether DM was mentioned and, if so, where the DM content was located. Statistical analysis was performed to compare the presence of DM guidance by type of institution, Carnegie Classification, and the type of doctoral program handbook. RESULTS: A total of 1,382 codes were identified across data life cycle stages, most commonly in the handbooks' project requirements section. The most frequent mention of DM was in relation to collecting and analyzing data; the least frequent related to publishing and sharing data and preservation. Significant differences in the frequency and location of codes were identified by program type and Carnegie Classification. CONCLUSIONS: Nursing doctoral program handbooks primarily address collecting and analyzing data during student projects. Findings suggest limited education about, and inclusion of, DM life cycle content, especially within DNP programs. Collaboration between nursing faculty and librarians and nursing and library professional organizations is needed to advance the adoption of DM best practices for preparing students in their future roles as clinicians and scholars.

Development of a Multisite Nursing Simulation Work Group Focusing on the International Nursing Association for Clinical Simulation and Learning Standards.

BACKGROUND: Simulation faculty development refers to the education of faculty in preparation and facilitation of simulation-based experiences. A college of nursing with six campuses implemented a simulation work group to ensure consistent simulation faculty development across six campuses. METHOD: The simulation work group was formed in four stages and used the International Nursing Association for Clinical Simulation and Learning Standards as a framework for standardizing simulation. The work group consisted of 14 faculty from five nursing campuses. Members were recruited via email, telephone call, or a simulation newsletter. RESULTS: Challenges were identified and addressed. Work group implementation has provided the simulation program with new initiatives and a unified scheduling system, budget, standardized debriefing, and student evaluation method. CONCLUSION: With the greater dependence on simulation as an educational modality, implementation of a simulation work group may enable collaboration and growth across campuses while decreasing the disparity of simulation experiences. [J Nurs Educ. 2021;60(3):165-168.].

A survey of current practices in data management education in nursing doctoral programs.

BACKGROUND: The inclusion of data management instruction within nursing doctoral curricula has not been systematically examined. PURPOSE: The purpose of this study is to determine the extent of data management education within nursing doctoral programs. METHOD: Separate surveys were created for DNP (332) and PhD (138) program directors. Survey questions were based on the stages of the UK Data Service Research Data Lifecycle. RESULTS: One hundred and four nursing doctoral program directors responded, a 22% response rate. Sixty-seven (64%) were from DNP programs while 37 (35%) were from PhD programs. Although program directors reported that they were teaching stages of the research data lifecycle, data management is mostly being taught through individual mentoring or a single lecture within a required course, and that students' project data were not being preserved. CONCLUSIONS: Nursing doctoral programs need to develop consistent data management education, build an awareness of data policies, and clarify student project data sharing and ownership.

Academic practice partnerships: A review of a statewide population health nursing leadership initiative.

OBJECTIVE: In 2012, the state public health nurse (PHN) Leaders Workgroup formed with members from the state PHN Administrators organization and PHN faculty to facilitate the development of statewide PHN Academic practice partnerships (APP's). In 2016, the workgroup received a state Nurses Foundation grant for $6,000 followed by $5,000 in 2017 to fund the first 2 years of APP projects. DESIGN: The workgroup disseminated two calls for proposals to the Deans of state academic nursing institutions and local health department leaders, utilizing an application adapted from the American Association of Colleges of Nursing (AACN) APP Toolkit. Selection criteria included project intent; partner support; anticipated outcomes; budget; geographic location; and alignment with the Robert Wood Johnson Foundation (RWJF) Culture of Health framework. SAMPLE AND RESULTS: Sixteen proposals were received and reviewed by workgroup members resulting in 10 funded pilot projects. In 2018, the workgroup was awarded $55,980 from the RWJF to expand this initiative; funding an additional 10 APP's to date. Partnerships were reported as valuable by students, faculty, and practice partners. Barriers included provider participation, adherence to project timelines, communication, and the navigation of group dynamics. CONCLUSION: Academic practice partnerships positively impact patient outcomes, patient satisfaction, nursing outcomes, and student learners.

Glomerular filtration rate determined by measuring serum clearance of a single dose of inulin and serum symmetric dimethylarginine concentration in clinically normal cheetahs (Acinonyx jubatus).

OBJECTIVE: To establish a reference interval for glomerular filtration rate (GFR) determined by measuring serum clearance of a single IV dose of inulin in clinically normal cheetahs (Acinonyx jubatus) and compare serum symmetric dimethylarginine (SDMA) concentration in cheetahs with GFR. ANIMALS: 33 cheetahs housed at 3 institutions. PROCEDURES: A single bolus of inulin (3,000 mg/m2) was administered IV, and 5 serial blood samples were collected and analyzed for serum inulin concentration with the anthrone technique. The GFR was estimated with a modified slope-intercept method for the slow component of the serum concentration-versus-time curve. Blood urea nitrogen and serum creatinine concentrations were measured in samples obtained immediately prior to inulin administration, and serum SDMA concentration was measured in stored samples. RESULTS: Mean ± SD measured GFR was 1.58 ± 0.39 mL/min/kg, and the calculated reference interval was 0.84 to 2.37 mL/min/kg. There were significant negative correlations between GFR and serum creatinine concentration (r = -0.499), BUN concentration (r = -0.592), and age (r = -0.463). Serum SDMA concentration was not significantly correlated with GFR (r = 0.385), BUN concentration (r = -0.281), or serum creatinine concentration (r = 0.165). CONCLUSIONS AND CLINICAL RELEVANCE: A reference interval for GFR in clinically normal cheetahs was obtained. Further evaluation of animals with renal disease is needed to determine whether measuring serum clearance of a single IV dose of inulin is a reliable diagnostic test for early detection of renal disease in cheetahs.

Pediatric Practicums Conducted in School Settings: An Integrative Review.

Background Examining nursing pedagogical strategies is important to assure that nursing students have opportunities to become knowledgeable and skilled clinicians. However, little is known about the nursing pedagogical strategy of using schools for pediatric practicum. The purpose of this review is to integrate the evidence regarding the use of schools as practicum sites for nursing students to obtain pediatric clinical experience. Method Searches were conducted in three electronic databases resulting in 70 publications; eight publications met the inclusion criteria. Results Five themes were identified using content analysis: description of practicum settings; level of education, number of students, clinical time and geographic region of the college; theoretical framework; nursing student activities and assignments; nursing student outcomes, evaluation of pediatric practicum experience, and school student health outcomes. Conclusion Findings support the use of schools for pediatric practicums.  This practicum broadens nursing students' knowledge of promoting health among well and chronically ill children.

Hospital breastfeeding support and exclusive breastfeeding by maternal prepregnancy body mass index.

Overweight and obese mothers in the United States have disproportionately lower rates of exclusive breastfeeding than mothers of normal weight. The Ten Steps to Successful Breastfeeding (Ten Steps), a series of evidence-based practices designed to support breastfeeding initiation, duration, and exclusivity, demonstrate effectiveness at the population level. It is unknown, however, whether they are consistently provided to women across all maternal body mass index (BMI) categories. We sought to determine whether pre-pregnancy BMI is associated with the implementation and effectiveness of the Ten Steps. We used data from Listening to Mothers III, a cross-sectional survey administered to a sample of mothers who delivered in U.S. hospitals between July 2011 and June 2012. Measures of the Ten Steps were based on maternal self-report on Listening to Mothers III. Our analytic sample was limited to mothers of term infants intending to breastfeed (N = 1,506, weighted). We conducted chi-square testing and constructed weighted multivariable logistic regression models to account for potential confounders. Results suggest that two practices (i.e., holding their babies skin-to-skin for the first time and being encouraged to breastfeed on demand) were more strongly associated with exclusive breastfeeding among mothers with obesity than other mothers. Additionally, mothers with obesity reported holding babies skin-to-skin significantly less often than other mothers. Thus, interventions aimed at helping mothers with obesity to hold their babies skin-to-skin in the first hour and teaching them to breastfeed on demand have the potential to decrease the breastfeeding disparities in this population.

Adolescent and emerging adults' evaluation of a Facebook site providing sexual health education.

OBJECTIVE: To explore participants' evaluation of an online sexual health intervention posted on Facebook and identify appealing and effective ways to present sexual health content to adolescents and emerging adults (AEAs). DESIGN AND MEASURES: A qualitative approach using peer moderated focus groups was used to elicit reflections on the Facebook site's content, appeal, and ease of navigation. Focus group discussions were transcribed, coded, and analyzed for themes using conventional content analysis. Demographic data were analyzed with SPSS. SAMPLE: Participants (n = 63) were recruited from a Midwestern university and both an urban and rural high school. Eight focus groups were conducted. RESULTS: Participants reported significant concerns with the stigma associated with having sexual health conversations with parents, peers or providers. Participants thought the Facebook site provided reliable sexual health information, was not condescending, and was more visually appealing than other sites frequented by technology-proficient AEA. AEAs suggested developing an independent sexual health education website. CONCLUSION: Findings demonstrate the importance for having accurate and reliable sexual health information available on the internet. The use of visually appealing social media to communicate sexual health content that is interactive, informative, and user-friendly and meets the educational needs of AEA in the Midwest is recommended.

Effect of breastfeeding on postpartum depressive symptoms among adolescent and young adult mothers.

PURPOSE: To describe the association between breastfeeding and postpartum depressive symptoms among a sample of adolescent and young adult mothers and to determine whether breastfeeding difficulty moderates this association. MATERIALS AND METHODS: Data were derived from a prospective cohort of pregnant adolescent and young adult females (ages 14-21) as they transitioned to parenthood. This analysis uses data collected during pregnancy and at 6 months postpartum among mothers (n = 137) who initiated breastfeeding. Multivariable linear regression was used to adjust for prenatal depressive symptoms and other potential confounders. RESULTS: Postpartum depressive symptoms were not significantly associated with breastfeeding duration or breastfeeding at 6 months. Early breastfeeding difficulty moderated the association between depressive symptoms and breastfeeding at 6 months. Among young mothers who were still breastfeeding at 6 months, those who reported no early breastfeeding difficulties had the lowest depressive scores and those who reported much early breastfeeding difficulty had the highest depressive scores at 6 months. CONCLUSIONS: Minimizing challenges with breastfeeding may help improve postpartum mental health among adolescent and young adult mothers. Health care providers should help young pregnant women manage expectations about breastfeeding and ensure that they are linked to appropriate professional breastfeeding support during the early postpartum period.

Urinary Excretion of Aluminium and Silicon in Secondary Progressive Multiple Sclerosis.

BACKGROUND: Progressive multiple sclerosis is a chronic autoimmune condition of unknown aetiology and few therapeutic options. Human exposure to aluminium has been linked with multiple sclerosis and affected individuals are known to excrete unusually high amounts of aluminium in their urine. Silicon-rich mineral waters facilitate the removal of aluminium from the body in urine and herein we have tested their efficacy in affecting urinary excretion of aluminium in individuals diagnosed with secondary progressive multiple sclerosis (SPMS). METHODS: Urinary excretion of aluminium and silicon, measured using transversely-heated graphite furnace atomic absorption spectrometry, was determined in 15 individuals diagnosed with SPMS over 24weeks, a 12week baseline period (control) followed by a 12week treatment period, during which individuals consumed up to 1.5L of a silicon-rich mineral water every day. FINDINGS: Individuals with SPMS excreted high amounts of aluminium during the baseline period (135.2nmol/mmol Crt (70.3-222.2, n=180) and females excreted significantly more aluminium than males. Regular drinking of a silicon-rich mineral water increased the urinary excretion of aluminium significantly (349.0nmol/mmol Crt (231.7-524.7, n=180; three-way ANOVA, F1,13=59.17, p-value=0.000003) relative to the baseline period. The majority of individuals, 14 out of 15, excreted more aluminium (µmol/24h) following drinking of a silicon-rich mineral water (independent-test, p<0.05). Silicon-rich mineral waters may be an effective and non-invasive therapy for the removal of aluminium from the body of individuals with SPMS.