Obesity Education among American Indians: Evaluating a Culturally Appropriate Approach to Health Awareness.

This research focused on a key health issue that significantly affects American Indian community - obesity. We sought to understand how American Indians perceive culturally appropriate an ethnic identity education about obesity as compared with the generic education that is not sensitive to the ethnic identity of American Indians. The project utilizes a survey based observational design where a sample of American Indians is measured for their preference of educational flyers showing American Indian imagery versus generic/Caucasian imagery. The perceived obesity among American Indians was compared with actual bodyweight levels. The American Indian community strongly prefers education that is supported by culturally appropriate imagery. This result provides support to the hypothesis that cultural identity plays a vital role in health education among American Indians and can be an effective strategy in future efforts.

Adolescent use of electronic nicotine delivery systems.

Use of electronic nicotine delivery systems is flourishing among adolescents. The long-term effects have not been fully determined; however, literature suggests there is potential for significant harm. Providers must be aware of usage trends, device safety, and product knowledge. Adolescents should be evaluated through routine screening, and cessation counseling should be initiated.

How does pharmacogenetic testing alter the treatment course and patient response for chronic-pain patients in comparison with the current "trial-and-error" standard of care?

PURPOSE: To evaluate if pharmacogenetic testing (PT) holds value for pain-management practitioners by identifying the potential applications of pharmacogenetic research as well as applications in practice. DATA SOURCES: A review of the literature was conducted utilizing the databases EBSCOhost, Biomedical Reference Collection, CINAHL, Health Business: Full Text, Health Source: Nursing/Academic Edition, and MEDLINE with the keywords, personalized medicine, cytochrome P450, and phamacogenetics. CONCLUSIONS: Chronic-pain patients present some of the most challenging patients to manage medically. Often paired with persistent, life-altering pain, they might also have oncologic and psychological comorbidities that can further complicate their management. One-step in-office PT is now widely available to optimize management of complicated patients and affectively remove the "trial-and-error" process of medication therapy. IMPLICATIONS FOR PRACTICE: Practitioners must be familiar with the genetic determinants that affect a patient's response to medications in order to decrease preventable morbidity and mortality associated with drug-drug and patient-drug interactions, and to provide cost-effective care through avoidance of inappropriate medications. Improved pain managements will impove patient outcomes and satisfaction.

Overcoming barriers to research utilization and evidence-based practice among staff nurses.

Several barriers exist to research utilization among staff nurses. Two barriers that appear in the research are lack of knowledge about research utilization and perceived lack of organizational support. The goal of this article is to present recommendations to overcome these barriers so that staff development educators can promote research utilization and evidence-based practice.

Robotic-assisted surgery and the need for standardized pathways and clinical guidelines.

Robotic surgical techniques are revolutionizing the way surgery is performed in an effort to improve patient outcomes. Although current literature is limited, studies have shown that patients who undergo robotic-assisted procedures experience reduced surgical time, scarring, blood loss, pain, infection rates, and lengths of stay compared with patients who undergo open or laparoscopic procedures. Currently, start-up costs for robotic systems are high and include the major equipment purchase as well as supplemental equipment purchases and staff member training. There is a need to develop standardized perioperative procedures or clinical guidelines that define optimal application of robotic-assisted surgery to ensure a standard of care that is consistent across procedures and operators. Implementing a clinical pathway or guideline that is guided by evidence-based practice will involve change. Lewin's 1947 basic change theory and the Marker umbrella model may be of use to help facilitate change.

Community-backed drug initiatives in the UK: a review and commentary on evaluations.

This article presents a review of evaluations of community-backed initiatives for drug users in the UK. Community-backed responses have taken a number of approaches. Despite accessing over 250 publications relating to initiatives in the course of this study, a paucity of published evaluative evidence on 'what works?' and 'why does it work?' was apparent. The readily accessible literature is examined under five broad types of initiative: self-help groups, parents' groups, residents' groups, community development groups and diversionary activity groups. In a further commentary on evaluation issues for such drug initiatives, it is argued that they are under-evaluated, partly because they are on the margins of drug services and partly because of a lacuna of support in evaluation skills.