Genetic factors associated with hidradenitis suppurativa, a literature review.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by deep-seated, painful lesions most frequently occurring in intertriginous areas of the skin. HS leads to poor quality of life in affected individuals and is difficult to diagnose and treat. Objective: Understanding the genetics associated with familial inheritance may lead to a better understanding of the pathogenesis of this debilitating disease. Methods: Articles published until March 9, 2023, were identified in PubMed using the following search terms: hidradenitis suppurativa and gene* or acne inversa and gene*. Results: The rate of monogenic mutations associated with HS is less than 7%, with the most common genetic mutations reported in sporadic and familial HS cases being in NCSTN and less frequently in PSENEN. Individuals with mutations in the gamma-secretase complex tended to have more severe HS and an early age of onset. Limitations: This study was limited to the case studies available in PubMed, the majority of which used targeted gene panels to detect genetic mutations. Conclusion: Approximately 30% of individuals diagnosed with HS report having a positive family history; however, very few studies demonstrate monogenic familial transmission of HS. The case studies of syndromic HS reported a variety of genetic mutations associated with HS, some of which were familial, while others were sporadic, suggesting that other pathways may be involved in the pathogenesis of HS and other potential mutations that have yet to be evaluated. More research is needed to understand the genetic mutations in HS.

Real-time continuous glucose monitoring improves glycemic control and reduces hypoglycemia: Real-world data.

AIM: To study the effect of real time continuous glucose monitor (RT-CGM) use on glycemic parameters in patients with diabetes mellitus (DM) in real world practice. METHODS: We retrospectively studied 91 adult subjects with DM who had been using Dexcom™ RT-CGM. Two consecutive hemoglobin A1c (HbA1c), both prior to and after at least 3 months of RT-CGM initiation, were collected. A total of 31 subjects completed a 5-14 day user blinded CGM using a Freestyle Libre™ prior to RT-CGM initiation. The first two week period following at least 3 months use of RT-CGM was analyzed for CGM metrics. RESULTS: A total of 51.6 % of subjects had T1DM, 34.1 % used continuous subcutaneous insulin infusion (CSII), and 62.6 % had DM for > 10 years. Both HbA1c obtained following RT-CGM initiation decreased significantly compared to baseline (8.11 + 1.47% vs 7.69 + 1.25 %; P = 0.002 & 8.16 + 1.51 % vs 7.62 + 1.06 %; P = 0.001). Subjects with baseline HbA1c > 7.0 % showed even more robust reduction in both HbA1c after RT-CGM initiation (8.74 + 1.24 % vs 7.99 + 1.22 %; P = 0.000 & 8.74 + 1.32 % vs 7.85 + 1.07 %; P = 0.001). On comparison of CGM metrics, there was a significant reduction in time spent in hypoglycemia (sugars < 70 mg/dl) including severe hypoglycemia (sugars < 54 mg/dl) after initiation of the RT-CGM (9.16 + 8.68 % vs 1.29 + 2.21 %; P = <0.001 & 4.58 + 5.43 % vs 0.28 + 0.58 %; P = <0.001). CoV of glucose was also decreased significantly (39.61 + 9.36 % vs 31.06 + 6.74 %; P = <0.001) with RT- CGM use. CONCLUSION: RT-CGM use for at least 3 months in patients with DM results in meaningful HbA1c reductions with stable glycemic control without increasing the risk of hypoglycemia.

Burdens and Educational Needs of Informal Caregivers of Older Adults With Urinary Incontinence: An Internet-Based Study.

PURPOSE: The purpose of this study was to describe the burden and educational needs of informal caregivers of care-dependent older adults with urinary incontinence (UI). DESIGN: A cross-sectional, descriptive survey of informal caregivers recruited through Google Ads was performed. METHODS: An online survey, including the Overactive Bladder-Family Impact Measure, was used to assess five areas of the experience of the informal caregiver that may be affected by caring for a person with UI and their educational needs. FINDINGS: Respondents (n = 77) reported a substantial impact of their care recipients' UI on their lives, with concern, travel, and social subscales most affected. However, 42% never sought treatment on behalf of their care recipient. Educational needs included UI treatment strategies and guidance to select appropriate supplies. CONCLUSIONS: Caregivers underreported their care recipient's UI and need substantially more support from healthcare providers to manage the condition. CLINICAL RELEVANCE: Nurses should assess for UI among care-dependent older adults and, if present, provide information and strategies to lessen the impact on caregiver lives.

Teamwork and Coaching for Successful Manuscript Development by Nurse Faculty: A Novel Approach.

ABSTRACT: The current nurse faculty shortage warrants new models for both retaining faculty effectively and coaching new faculty efficiently. An approach for retaining faculty members through meeting publication review criteria while conserving senior faculty mentoring time is proposed. This article describes a successful manuscript development process using teamwork and coaching among faculty. The outcomes of this efficacious process - submission and acceptance of publishable manuscripts - are reported for two institutions: one is research intensive, and the other is teaching intensive. A noted outcome also includes ideas for future manuscript development process replication.

Cutting Corners: Provider Perceptions of Interpretation Services and Factors Related to Use of an Ad Hoc Interpreter.

INTRODUCTION: This study assessed health providers' perceptions of factors related to professional interpretation services and the association between these factors and the potential use of ad hoc interpreters. METHOD: Data were collected from a convenience sample of 150 health services providers at a large, regional health system in South Carolina. RESULTS: Providers rated "ability to communicate effectively during a clinical encounter" as paramount regarding the use of interpretation services. The most important factors related to the likely use of ad hoc interpreters (cutting corners) included locating a qualified interpreter, having to wait for a qualified interpreter, and technical difficulties regarding phone and video technology. CONCLUSION: Health care organizations may benefit from increasing staff awareness about patient safety and legal and regulatory risks involved with the use of ad hoc interpreters.

Content, placement, and acquisition of cancer education for Latino patient care: a qualitative study of medical and nursing students.

A focus group study was conducted with five medical and nursing education programs in Southeastern USA. Twenty-five third and fourth year students were queried about their experiences, beliefs, and attitudes regarding Latino patients and cancer care. A general inductive process using open coding and content comparison to identify emerging themes was used to analyze the qualitative data. Investigators used a process of constant comparison to identify emerging themes. Themes included: (1) importance of cultural specificity and relevance in cancer training, (2) timing and placement of cancer education in the curriculum, including classes and/or clinical rotations, (3) anatomical system specificity of cancer training-studying cancer in the context of a specific body system, and (4) the prevention-focused nature of cancer training. Results of the focus groups have been used to inform a web-based survey of medical and nursing students to identify gaps in cancer education specific to Latino populations.

Knowledge, perceptions, and motivations related to HPV vaccination among college women.

Little research exists on the factors that affect the uptake patterns of the recently developed Gardasil® vaccine among young women. Human papillomavirus (HPV)-related knowledge, attitudes, beliefs, and behaviors of 18-24-year-old female students (n = 1,975) were assessed via an electronic survey. Mean HPV knowledge score, on a 10-point scale, was 6.8. A weak positive correlation (r (1,976) = 0.123, p < 0.001) was found between knowledge score and having received the vaccine. Parent recommendation, doctor recommendation, and perceiving the consequences of HPV as severe and prevalent were strongly related to previous vaccination. Data suggest a need for increased education about the vaccine and the importance of physician recommendation in increasing vaccine uptake.

An interinstitutional academic collaborative partnership to end health disparities.

Much has been published in the health care literature describing partnerships between academic institutions and community or health care agencies that are designed to improve health outcomes in medically underserved populations. However, little has been published regarding partnerships between minority- and majority-serving academic institutions with this same aim. Key principles of collaborative partnerships are used in a descriptive analysis of the development, functions, and benefits of such an interinstitutional academic partnership that was formed to reduce and ultimately eliminate health disparities in rural South Carolina. Lessons learned from the partnership parallel other human relationships where mutual respect and trust, open and clear communication, and shared decision and problem solving are important for building and sustaining partnerships.

The LIFE project: a community-based weight loss intervention program for rural African American women.

Obesity continues to be a significant health problem for African American women. While a number of obesity interventions target urban African American women, few target rural ones. The LIFE Project is a 10-week intervention designed to reduce obesity in this rural population. Two different interventions (spiritually based and nonspiritually based) were pilot tested, each utilizing a pretest, posttest design. Results demonstrated that both interventions led to significant reductions in weight, but the spiritually based intervention led to additional improvements. The LIFE Project also demonstrated that churches are appropriate settings to deliver health interventions to these women.

Evidence-based nursing: the role of the advanced practice registered nurse in the management of heart failure patients in the outpatient setting.

Heart failure (HF) is a chronic debilitating illness that affects millions of Americans each year. Patients with HF are faced with chronic physical symptoms, emotional strain, and significant socioeconomic burden. Goals in the management of HF are to slow the disease progression, decrease symptom acuity, and prevent exacerbations that lead to hospital readmission. Management of HF remains a challenge for healthcare providers. There is a fine balance between optimizing patient functioning and minimizing healthcare expenditures. With the incidence of HF increasing annually, it is important to have effective disease management strategies in place. In any disease management program, it is important to follow those guidelines outlined by evidence-based practice. The purpose of this systematic review was to evaluate current evidence-based practice and determine what benefit exists of having an advanced practice registered nurse assist in the management of patients with HF.

Coping and psychosocial adaptation to Type 2 diabetes in older Blacks born in the Southern US and the Caribbean.

Older Black men and women (n = 212) with Type 2 diabetes completed questionnaires. Spearman's rho correlation indicated that confrontive coping strategies supported effective psychosocial adaptation for persons originally from Haiti and Jamaica, while emotive coping strategies were related to ineffective psychosocial adaptation for persons originally from Barbados and to increased psychological distress for all participants. Women used more palliative coping; no gender differences were observed for psychosocial adaptation. Health care orientation, extended family relationships, and psychological distress domains distinguished Blacks born in Haiti from Blacks born in Barbados and Jamaica, the Southern US and Jamaica, and the Southern US, Barbados, and Jamaica. Findings from this study may aid in the development of interventions focused on improving diabetes self-management for older Blacks.

Fatalism toward breast cancer among the women of Ghana.

Personal beliefs about health and illness influence many people's decisions about seeking care. This research represents a study of beliefs about breast cancer held by African women in Ghana. In-person interviews based on the revised Powe fatalism inventory (rPFI) were held with 109 women. Correlational analysis and factor analysis were performed. There were negative, nonsignificant associations between fatalism and age (r = -.095, p = 0.33), and educational level (r = -.078, p = .422). Fatalism scores were relatively low, 3.78 on an 11 -point scale. Comparisons are made to responses by African American women in other studies.

The impact of education on the use of physical restraints in the acute care setting.

BACKGROUND: Physical restraints have become an acceptable standard of practice for managing safety and behavior control in acute care settings. Although the primary intent for using physical restraints is for patient protection, there are many negative outcomes related to their use. Heightened awareness by recent Joint Commission on Accreditation of Healthcare Organizations and the Center for Medicare and Medicaid Services standards for restraint use has led health care administrators and nursing staff to explore methods of reducing or eliminating the use of restraints. An educational program was planned and implemented for nursing staff emphasizing the risks of physical restraints and the benefits of innovative optional measures including nonrestraint devices. The program was tested to determine whether increased awareness through education would reduce the use of restraints. METHOD: After current practice patterns and restraint utilization were established, a comprehensive educational program was provided to all nursing personnel. Twenty-three formal classroom inservice offerings were provided with follow-up reinforcement of self-study modules. Education included nursing assessment strategies and practical restraint optional interventions for managing patients exhibiting disruptive behaviors. FINDINGS: After the educational program, the overall use of physical restraints decreased as well as the length of time patients were restrained. CONCLUSION: Results of this study reinforce the need to increase staff awareness and knowledge of nonrestraint interventions to manage disruptive behaviors in the acute care setting.

Documentation of characteristics of early hospital readmission of elderly patients. A challenge for inservice educators.

Researchers conducted a retrospective review of 127 hospital records over a 3-month period to examine factors related to early hospital readmissions of patients age 65 and over. The leading diagnoses resulting in early readmissions were related to heart and circulatory problems, with a mean of 12.5 days between discharge and readmission. Gaps in documentation and the need for including qualitative data are discussed. Staff development educators are central to implementing strategies to correct these documentation deficiencies.

Promoting success for at-risk African-American youth: perceived barriers and resources in using community-based success criteria.

A Delphi technique was used to assess service provider and community consensus on program elements essential for promoting the success of at-risk African American youth. The respondent group consisted of 54 subjects representing three broad groups: service agencies, community leaders and members, and school system participants. The study identified barriers to the use of community-derived success constructs, opportunities for collaboration between community members and service agencies in the development of programs, and the feasibility of incorporating success constructs into program development and delivery. Although consensus was achieved on key issues, individual variations between counties point to the necessity of targeting intervention programs to the unique problems and expectations found in each community.