Comprehensive Care of Women With Genetic Predisposition to Breast and Ovarian Cancer.

Women at risk for hereditary breast and ovarian cancer syndromes are frequently seen in primary care and gynecology clinics. They present with a distinctive set of clinical and emotional needs that revolve around complex risk management discussions and decision making. The care of these women calls for the creation of individualized care plans that facilitate adjustment to the mental and physical changes associated with their choices. This article provides an update on comprehensive evidence-driven care of women with hereditary breast and ovarian cancer. The aim of this review is to aid clinicians in identifying those at risk for hereditary cancer syndromes and provide practical advice on patient-centered medical and surgical risk management. Topics of discussion include enhanced surveillance, preventive medications, risk-reducing mastectomy and reconstruction, risk-reducing bilateral salpingo-oophorectomy, fertility, sexuality, and menopausal management, with attention to the importance of psychological support. High-risk patients may benefit from a multidisciplinary team that provides realistic expectations with consistent messaging. The primary care provider must be aware of the special needs of these patients and the consequences of their risk management interventions.

Analysis of Citation Patterns and Impact of Predatory Sources in the Nursing Literature.

PURPOSE: This study was undertaken to learn how predatory journal articles were cited in articles published in legitimate (nonpredatory) nursing journals. The extent of citation and citation patterns were studied. DESIGN: A two-phase approach was used. METHODS: In Phase 1, 204 articles published in legitimate nursing journals that cited a predatory publication were randomly selected for analysis from a list of 814 articles with predatory journal citations. In Phase 2, the four predatory journal articles that were cited most frequently were analyzed further to examine their citation patterns. FINDINGS: The majority (n = 148, 72.55%) of the articles that cited a predatory publication were research reports. Most commonly, the predatory article was only cited once (n = 117, 61.58%). Most (n = 158, 82.72%) of the predatory articles, though, were used substantively, that is, to provide a basis for the study or methods, describe the results, or explain the findings. The four articles in Phase 2 generated 38 citations in legitimate journals, published from 2011 to 2019, demonstrating persistence in citation. An evaluation of the quality of these articles was mixed. CONCLUSIONS: The results of this study provide an understanding of the use and patterns of citations to predatory articles in legitimate nursing journals. Authors who choose predatory journals as the channel to disseminate their publications devalue the work that publishers, editors, and peer reviewers play in scholarly dissemination. Likewise, those who cite these works are also contributing to the problem of predatory publishing in nursing. CLINICAL RELEVANCE: Nurse authors should not publish their work in predatory journals and should avoid citing articles from these journals, which disseminates the content through the scholarly nursing literature.

Teaching Nursing Students and Nurses About Predatory Publishing.

BACKGROUND: All nurses, not just nurse authors, must be aware of the problems and concerns of predatory publishing practices. This is an important topic for nurse educators. METHOD: Nurse educators must teach nursing students and nurses about the differences between reputable nursing journals and those produced by predatory publishers. Although there are several differences between reputable and predatory nursing journals, the lack of adequate peer review is an important problem. An active teaching strategy is provided that nurse educators may use to facilitate learning about reputable and predatory nursing journals. RESULTS: Nursing students and nurses will be able to assess a journal for features that suggest the publication is reputable or one that may be produced by a predatory publisher. CONCLUSION: Nurse educators should teach nursing students and nurses about predatory publishing practices so they can begin to use appropriate discretion when searching for evidence that informs patient care. [J Nurs Educ. 2019;58(11):627-631.].

Citations of articles in predatory nursing journals.

BACKGROUND: Nursing journals from predatory publication outlets may look authentic and seem to be a credible source of information. However, further inspection may reveal otherwise. PURPOSE: The purpose of this study was to analyze publication and dissemination patterns of articles published in known predatory nursing journals. METHOD: Using Scopus, reference lists were searched for citations from seven identified predatory nursing journals. Bibliographic information and subsequent citation information were then collected and analyzed. FINDINGS: A total of 814 citations of articles published in predatory nursing journals were identified. Further analysis indicated that these articles were cited in 141 nonpredatory nursing journals of various types. DISCUSSION: Predatory nursing journals continue to persist, yet fewer may now be in existence. Education and information may help authors and reviewers identify predatory journals, thereby discouraging submissions to these publications and hesitancy among authors to cite articles published in them.

A bibliometric analysis of 81 articles that represent excellence in nursing publication.

AIM: To analyze publication patterns of 81 articles included in a "virtual journal." BACKGROUND: From May-July 2017, editors submitted articles from their journals representing distinction in nursing research, education, or practice. Brief responses explained their rationale for article selection. This sample embodied a unique exemplar of excellence in nursing publication and warranted further bibliometric analysis, which was undertaken from February to May 2018. DESIGN/METHOD: Using Scopus, each article (N = 81) was searched to obtain bibliographic information and subsequent second and third generation citations. Three concepts guided the analysis: (a) persistence, rate of subsequent citations over time; (b) reach, geographic distribution of subsequent citations; and (c) dissemination, specialty of follow-on citations represented as nursing or another discipline. Patterns amongst the second and third generation of citations were also examined. RESULTS: Of the 81 articles, 43 (53%) were cited at least once, resulting in 721 second generation citations. There was long-term persistence (N = 2094) over the third and fourth generation citations. There was a wide geographic reach, representing 41 states in the United States and 44 countries. Dissemination was broad with citations in the medical literature eclipsing nursing in the third generation. The highest cited articles were all research reports. Patterns of silos and ripple effect were identified. No pattern could be identified for the 31 articles with zero subsequent citations. CONCLUSION: This study revealed the impact of articles perceived as exemplar representations of 80 different nursing journals. Nursing research is being widely read and cited, both in and outside the profession.

Ethics and Confidentiality for Psychologists in Academic Health Centers.

Psychologists in academic health centers (AHC) face important ethical issues including confidentiality when working with a multidisciplinary team, sharing of information through the electronic health record, obtaining informed consent in a fast-paced healthcare environment, cultural competency in the medical setting, and issues related to supervision and training. The goal of this paper is to describe ethical issues for psychologists in AHCs in the context of case examples, and to consider ethical decision-making tools to enhance clinical care. Considerations for best practices in integrated care settings will be discussed, and the APA Ethical Standards will be referenced throughout.

Quality of articles published in predatory nursing journals.

BACKGROUND: Predatory journals exist in nursing and lack the safeguards of traditional publishing practices. PURPOSE: To examine the quality of articles published in predatory nursing journals. METHOD: Randomly selected articles (n = 358) were reviewed for structural content and eight quality indicators. FINDINGS: Two-thirds (67.4%) of the articles were published between 2014 and 2016, demonstrating the acceleration of publications in predatory nursing journals. The majority (75.9%) of the articles were research reports. Most followed the IMRAD presentation of a research report but contained errors, or the study was not pertinent to the nursing discipline. CONCLUSIONS: Nursing research published in predatory journals may appear legitimate by conforming to an expected structure. However, a lack of quality is apparent, representing inadequate peer review and editorial processes. Poor quality research erodes the scholarly nursing literature.

Teaching Nursing Students to Care for Patients Who Are Inmates.

BACKGROUND: Inmates in federal or state correctional facilities or those who are under the custody of local law enforcement officials receive health care in acute care settings, and caring for these inmate-patients is difficult for many nurses. Nurse educators should teach nursing students that nurses care for all patients in all situations with respect for a person's inherent dignity and worth. METHOD: Information from relevant nursing publications was synthesized to provide nurse educators with content that can be useful when teaching nursing students to care for inmate-patients in acute care settings. A case study is provided as a teaching strategy for nurse educators. RESULTS: Respect, care, and concern are expressed differently when nurses care for inmate-patients in acute care settings. CONCLUSION: Nurse educators are responsible to teach nursing students how professional nurses should respond to patients, especially in situations that many nurses find challenging. [J Nurs Educ. 2017;56(11):655-659.].

Using the presurgical psychological evaluation to predict 5-year weight loss outcomes in bariatric surgery patients.

BACKGROUND: Psychosocial factors contribute to poorer weight loss outcomes following bariatric surgery; however, findings on associations between preoperative psychiatric diagnoses, psychological testing, and weight loss are inconsistent. OBJECTIVES: Examine associations between presurgical psychiatric diagnoses derived from a semi-structured clinical interview and test scores from the Minnesota Multiphasic Personality-Inventory-2 - Restructured Form (MMPI-2-RF) and 5-year Body Mass Index (BMI) outcomes. SETTING: Cleveland Clinic Bariatric and Metabolic Institute METHODS: 446 consecutively consented patients who underwent a Roux-en-Y gastric bypass (RYGB) at least 5 years prior were included in the study. A majority were women (74.2%) and Caucasian (66.2%). Patients' mean presurgical BMI was 49.14 kg/m2 [SD = 9.50 kg/m2]. Psychiatric diagnoses were obtained from a presurgical, semi-structured clinical interview and all participants were administered the MMPI-2-RF at their presurgical evaluations. BMIs were collected at 4 postoperative time points across a 5-year trajectory. This prospective design utilized latent growth curve modeling. RESULTS: Older patients evidenced a slower rate of BMI reduction over time. A presurgical diagnosis of Binge Eating Disorder predicted higher BMIs at the 5-year outcome. Scores on MMPI-2-RF measures of emotional and behavioral dysfunction domains incrementally predicted poorer weight loss outcomes. CONCLUSION: Preoperative indicators of psychopathology, notably indicators that are dimensional in nature, are important in predicting postoperative outcomes. Closer follow-up with patients who evidence presurgical psychological factors, both before and after surgery, may help improve outcomes.

Associations between psychological test results and failure to proceed with bariatric surgery.

BACKGROUND: The reasons why some patients who begin the presurgical process for bariatric surgery fail to complete the procedure are understudied. Previous research implies that psychological factors play a role. OBJECTIVES: To examine whether scores from baseline psychological testing incrementally predict failure to proceed with bariatric surgery beyond demographic information in patients' medical charts and data derived from a clinical interview. SETTING: Cleveland Clinic Bariatric and Metabolic Institute. METHODS: The sample (n = 1160) was mainly female (72.41%), middle aged (mean age = 46.07 yr, SD = 11.70) and of Caucasian descent (65.76%). Hierarchical logistic regressions were conducted to test the incremental validity of baseline Minnesota Multiphasic Personality Inventory-2 Restructured Form scores after controlling for information gathered from the psychological interview and medical charts. Relative risk ratios were calculated to reflect the clinical utility of the results. RESULTS: In total, 27.16% of patients failed to proceed with bariatric surgery after 1 year or more after a recommendation for surgery from their psychological evaluations. Psychological test scores were substantially associated with failure to proceed with surgery and significantly accounted for up to 6% of additional variance after controlling for psychological interview variables and medical chart data. Elevated scores on Minnesota Multiphasic Personality Inventory-2 Restructured Form scales, such as anxiety and substance use, identify patients at up to 2.5 times greater risk for failing to proceed with bariatric surgery. CONCLUSIONS: Objective psychological test data-notably, scale scores assessing for substance abuse, anxiety, and demoralization-add to information obtained from a clinical interview and medical records in identifying patients at risk for failing to proceed with bariatric surgery.

Study of Predatory Open Access Nursing Journals.

PURPOSE: The purpose of this study was to identify predatory journals in nursing, describe their characteristics and editorial standards, and document experiences of authors, peer reviewers, and editors affiliated with these journals. DESIGN: Using two sources that list predatory journals, the research team created a list of nursing journals. In Phase One, the team collected data on characteristics of predatory nursing journals such as types of articles published, article processing charge, and peer review process. In Phase Two, the team surveyed a sample of authors, reviewers, and editors to learn more about their experiences with their affiliated journals. METHODS: Data from the review of predatory nursing journals were analyzed using descriptive statistics. Written comments were summarized and categorized. FINDINGS: There were 140 predatory nursing journals from 75 publishers. Most journals were new, having been inaugurated in the past 1 to 2 years. One important finding was that many journals only published one or two volumes and then either ceased publishing or published fewer issues and articles after the first volume. Journal content varied widely, and some journals published content from dentistry and medicine, as well as nursing. Qualitative findings from the surveys confirmed previously published anecdotal evidence, including authors selecting journals based on spam emails and inability to halt publication of a manuscript, despite authors' requests to do so. CONCLUSIONS: Predatory journals exist in nursing and bring with them many of the "red flags" that have been noted in the literature, including lack of transparency about editorial processes and misleading information promoted on websites. The number of journals is high enough to warrant concern in the discipline about erosion of our scholarly literature. CLINICAL RELEVANCE: Nurses rely on the published literature to provide evidence for high-quality, safe care that promotes optimal patient outcomes. Research published in journals that do not adhere to the highest standards of publishing excellence have the potential to compromise nursing scholarship and is an area of concern.

A review of psychological assessment instruments for use in bariatric surgery evaluations.

Bariatric surgery is a viable treatment option for patients with extreme obesity and associated medical comorbidities; however, optimal surgical outcomes are not universal. Surgical societies, such as the American Society for Metabolic and Bariatric Surgery (ASMBS), recommend that patients undergo a presurgical psychological evaluation that includes reviewing patients' medical charts, conducting a comprehensive clinical interview, and employing some form of objective psychometric testing. Despite numerous societies recommending the inclusion of self-report assessments, only about 2/3 of clinics actively use psychological testing-some of which have limited empirical support to justify their use. This review aims to critically evaluate the psychometric properties of self-report measures when used in bariatric surgery settings and provide recommendations to help guide clinicians in selecting instruments to use in bariatric surgery evaluations. Recommended assessment batteries include use of a broadband instrument along with a narrowband eating measure. Suggestions for self-report measures to include in a presurgical psychological evaluation in bariatric surgery settings are also provided. (PsycINFO Database Record

Graze eating among bariatric surgery candidates: prevalence and psychosocial correlates.

BACKGROUND: Graze eating is defined as repetitive, unplanned eating of small amounts of food throughout the day. Little consensuses exist regarding whether graze eating, like binge eating disorder (BED), is characterized by feelings of loss of control (LOC). Furthermore, little is known about how patients who graze eat with and without LOC differ psychologically. OBJECTIVES: The present study seeks to better characterize graze eating by examining differences between graze eating with LOC (+LOC) and without LOC (-LOC) among presurgical bariatric patients. SETTING: A large, Midwestern academic medical center. METHODS: The sample consisted of 288 adult bariatric surgery candidates (mean age 45.8, standard deviation [SD] 12.57) who underwent a presurgical psychological evaluation. Graze eating, BED, and other mental health diagnoses were evaluated using a semistructured interview. Participants were also administered the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and binge eating scale (BES). Data were collected using a retrospective chart review. RESULTS: Among the 33% (n = 95) of the sample who reported preoperative graze eating, 32% (n = 30) also endorsed LOC. Graze eating, particularly with LOC, was associated with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) diagnoses of anxiety disorders and BED, and multiple measures of internalizing dysfunction on the MMPI-2-RF. CONCLUSIONS: Bariatric surgery candidates who graze eat experience a greater degree of overall distress and psychopathology including anxiety and depression. The minority who experience grazing+LOC appear to have even greater risk of psychopathology. Moreover, there appears to be significant overlap with BED. Future research should explore whether these 2 maladaptive eating patterns benefit from similar treatment.

Teaching nursing students about terminating professional relationships, boundaries, and social media.

Nurse educators should teach students about the nature of the nurse-patient relationship, which is a professional relationship and different from other relationships they have. In addition to teaching students how to establish relationships with their patients, nurse educators should also teach students about terminating relationships with patients. Without this professional guidance, nursing students may be tempted to use social media to maintain a relationship with patients. This may inadvertently lead to professional boundary violations, causing harm to patients and problems for nursing students or nurses.

The Role of the Multidisciplinary Conference in the Evaluation of Bariatric Surgery Candidates with a High-Risk Psychiatric Profile.

Background: Implementation of a multidisciplinary conference (MC) attended by medical, surgical, nutrition, bioethics, and psychology specialists may help identify treatment plans for bariatric surgery candidates with a high-risk psychiatric profile. Methods: Data were assessed for all bariatric candidates evaluated by the MC in an academic center between January 2009 and December 2010. Results: A total of 134 patients of 2798 patients assessed by four different psychologists were subsequently evaluated by the MC. The most frequent psychiatric diagnoses were mood disorders (n = 37, 27.6%), anxiety disorders (n = 24, 17.9%), and binge eating disorder (n = 19, 14.1%). More than one psychiatric diagnosis was observed in 95.6% of the cohort. Substance abuse issues were present in 25% patients. Fifteen patients (11.2%) were eventually cleared and underwent surgery, 35 (26.1%) left the program before completing their requirements, and 84 patients (62.7%) were still working toward their individualized goals in the program. For those who underwent surgery, mean preoperative management duration was 221 days (range, 111-366) with an average of 11 preoperative psychiatric visits (range, 9-15). Conclusions: Patients with a high-risk psychosocial profile seeking bariatric surgery require multiple visits and resources to determine their candidacy. The majority of these patients are either deemed ineligible for surgery or require prolonged preoperative evaluation.

Team Huddle Implementation in a General Pediatric Clinic.

Teamwork and communication are critical to ensure safe and quality patient care. However, the ability to affect these constructs within well-established healthcare settings is challenging. Using a quality improvement approach, staff development educators collaborated with clinical nursing staff to implement a daily team huddle. When incorporated into the workflow, a team huddle can promote communication and positively influence how teams function within a clinical area.(See CE Video, Supplemental Digital Content 1, http://links.lww.com/JNPD/A9).

Using presurgical psychological testing to predict 1-year appointment adherence and weight loss in bariatric surgery patients: predictive validity and methodological considerations.

BACKGROUND: Previous studies suggest that presurgical psychopathology accounts for some of the variance in suboptimal weight loss outcomes among Roux-en-Y gastric bypass (RYGB) patients, but research has been equivocal. OBJECTIVES: The present study seeks to extend the past literature by examining associations between presurgical scale scores on the broadband Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and suboptimal weight loss and poor adherence to follow-up 1 year postoperatively after accounting for several methodologic considerations. SETTING: Cleveland Clinic Bariatric and Metabolic Institute, Cleveland, Ohio, USA. METHODS: The sample consisted of 498 RYGB patients, who produced a valid presurgical MMPI-2-RF protocol at program intake. The sample was primarily female (72.9%), Caucasian (64.9%), and middle-aged (mean = 46.4 years old; standard deviation [SD] = 11.6). The mean presurgical body mass index (BMI) was 47.4 kg/m(2) (SD = 8.2) and mean percent weight loss (%WL) at 1 year postoperatively was 31.18 %WL (SD = 8.44). RESULTS: As expected, scales from the Behavioral/Externalizing Dysfunction (BXD) domain of the MMPI-2-RF were associated with worse weight loss outcomes and poor adherence to follow-up, particularly after accounting for range restriction due to underreporting. Individuals producing elevated scores on these scales were at greater risk for achieving suboptimal weight loss (<50% excess weight loss) and not following up with their appointment compared with those who scored below cut-offs. CONCLUSIONS: Patients who are more likely to engage in undercontrolled behavior (e.g., poor impulse control), as indicated by presurgical MMPI-2-RF findings, are at greater risk for suboptimal weight loss and poor adherence to follow-up following RYGB. Objective psychological assessments should also be conducted postoperatively to ensure that intervention is administered in a timely manner. Future research in the area of presurgical psychological screening should consider the impact of underreporting and other discussed methodologic issues in predictive analyses.

The orientation period: essential for new registered nurses' adaptation.

The purpose of this research study was to explore adaptation in new registered nurses using the Roy adaptation model as the guiding conceptual framework. This quantitative study employed a random sampling of new nurses in the state of North Carolina. Personal attributes of the new registered nurses and characteristics of their work setting were modeled with four measures considered suitable proxies for adaptation. Being in a formal orientation period significantly supported the new nurses' overall adaptation. This may represent the benefit of social support, including education, which seems to facilitate adaptation.

New registered nurses' personal responses to professional practice: a pilot study.

This pilot study employed a qualitative description design to inquire into new registered nurses' (RNs') personal responses to being a "new nurse." Six new RNs participated in semistructured interviews. The findings of this pilot study can be used to guide educational activities for nurse leaders and others who work with new RNs. Several strategies are discussed, which may ease new RNs' transition into professional practice.