Management of chemotherapy-induced diarrhea and constipation.

This article reviews the incidence, etiology, pathophysiology, and assessment of diarrhea and constipation related to chemotherapy. Protocols for treatment are presented. The nurse's role in prevention, patient education, assessment, and treatment is emphasized.

Advanced practice issues: results of the ONS Advanced Practice Nursing survey.

PURPOSE/OBJECTIVES: To ascertain the critical issues in current advanced practice nurse (APN) roles in oncology. DESIGN: Descriptive. SETTING: National. SAMPLE: 368 Oncology Nursing Society (ONS) APNs in oncology practice. METHODS: Subjects completed an 11-page self-administered questionnaire comprised of 62 multiple-choice and open-ended questions. Subjects were asked to identify level of importance for ONS to address selected issues in each section. MAIN RESEARCH VARIABLES: Demographic information and APN issues regarding practice, outcomes, prescriptive authority, reimbursement, education, continuing education, licensure and certification, legislation, and challenges facing oncology APNs. FINDINGS: The majority of APNs were nurse practitioners working in a hematology/oncology practice in an urban setting providing direct patient care. Priority practice issues were lack of agreement among state boards of nursing related to privileges, lack of understanding of the role by patients and healthcare professionals, and lack of an APN definition. Important APN outcomes were symptom management, quality of life, patient/family satisfaction, and cost of care. Priority educational topics were oncology disease management, pharmacology, advanced physical assessment, and reimbursement. Challenges facing oncology APNs were lack of an APN definition, reimbursement issues, documentation of outcomes, prescriptive authority, variance in education, merging of current roles, certification, loss of cancer specialty, and second licensure. CONCLUSIONS: Numerous APN issues continue to be unresolved. APN outcomes research is needed to validate the oncology APN role in cancer care. IMPLICATIONS FOR NURSING PRACTICE: Survey results and specific recommendations have been forwarded to the ONS Steering Council and Board of Directors for implementation decisions.

Functions of a breast cancer support group as perceived by the participants: an ethnographic study.

The purpose of this study was to obtain an understanding of the functions of a breast cancer support group as perceived by the participants. An ethnographic method of research was used. Data were collected by participant observation and tape-recorded interviews during the weekly support group meetings. The convenience sample included one professional group leader and 15 women diagnosed with breast cancer within a range of 2 weeks to 7 years. Two key informants were chosen to clarify and validate data. Content analysis was performed on the data obtained from the tape recordings of 10 group meetings and from the two key informant interviews. Three categories of functions of the breast cancer support group emerged from the data analysis, including exchanging information, sharing the illness experience, and providing strength. As the incidence rate of breast cancer continues to increase, it is imperative that nurses recognize the physical and psychological reactions to breast cancer and identify sources of social support for women. Nurses should be cognizant of the functions of a breast cancer support group in order to share this information with women and encourage them to actively participate with others sharing the same experience.

Identification and distribution of epoxyacyl groups in new, natural epoxy oils.

New high-epoxy vegetable oils from nine species representing three plant families and four genera have been investigated. The epoxyacyl moiety in at least one oil from each genus was characterized and shown to be the (+)-vernoloyl (cis-12,13-epoxy-cis-9-octadecenoyl) group. Intraglyceride distribution studies revealed a general preference of the (+)-vernoloyl groups for the beta-position of triglyceride molecules. Interglyceride distribution of (+)-vernoloyl groups was studied in three oils and found not to agree with predictions based on either 1,2,3-random or 1,3-random-2-random distribution. A striking exception to the general intraglyceride distribution pattern was discovered in the monoepoxy triglyceride fraction fromEuphorbia lagascae seed oil.

Gas--liquid chromatography of silylated mixtures from lipolysis of triglycerides containing unusual fatty acyl groups.

A convenient and rapid procedure involving methylation, silylation, and temperature-programmed gas-liquid chromatography (GLC) is described for analyzing unfractionated products from the hydrolysis of triglycerides with pancreatic lipase. The conditions employed for GLC were selected to provide maximum and rapid separation of silylated monoglycerides in which the acyl moieties differ in chain length or degree of substitution with oxygen-containing functional groups. Derivatives differing only in the number of double bonds present were not separated. In the GLC curves obtained, peaks representing methyl esters are generally readily distinguishable from those of other components. Therefore, the extent of lipolysis and the composition (with respect to chain length and substitution of acyl groups) of monoglycerides formed are determined simultaneously. The accuracy of the new method was demonstrated with standard mixtures and by comparison of results for several lipolysis products with data obtained by conventional procedures.