Symptom Management in Oncology: Depression and Anxiety.

OBJECTIVE: To describe nursing symptom management of depression and anxiety in patients with cancer. DATA SOURCES: These include journal articles, online resources, and personal experience in providing mental health care to cancer survivors with depression and/or anxiety. CONCLUSION: Nurses can provide emotional support for patients with cancer and depression or anxiety. Nurses can become aware of nonpharmacologic and pharmacologic treatment for depression and anxiety to help patients decrease their emotional distress. Nurses can also refer patients with cancer to psychiatric professionals and emotional support programs. IMPLICATIONS FOR NURSING PRACTICE: Nurses do not have to be experts in psychiatry to manage symptoms of depression and anxiety in patients with cancer. Nurses can listen empathically, guide patients in relaxation techniques, and advocate if they need psychotropic medications or psychiatric referrals.

Environmental Sources, Chemistry, Fate, and Transport of Per- and Polyfluoroalkyl Substances: State of the Science, Key Knowledge Gaps, and Recommendations Presented at the August 2019 SETAC Focus Topic Meeting.

A Society of Environmental Toxicology and Chemistry (SETAC) Focused Topic Meeting (FTM) on the environmental management of per- and polyfluoroalkyl substances (PFAS) convened during August 2019 in Durham, North Carolina (USA). Experts from around the globe were brought together to critically evaluate new and emerging information on PFAS including chemistry, fate, transport, exposure, and toxicity. After plenary presentations, breakout groups were established and tasked to identify and adjudicate via panel discussions overarching conclusions and relevant data gaps. The present review is one in a series and summarizes outcomes of presentations and breakout discussions related to (1) primary sources and pathways in the environment, (2) sorption and transport in porous media, (3) precursor transformation, (4) practical approaches to the assessment of source zones, (5) standard and novel analytical methods with implications for environmental forensics and site management, and (6) classification and grouping from multiple perspectives. Outcomes illustrate that PFAS classification will continue to be a challenge, and additional pressing needs include increased availability of analytical standards and methods for assessment of PFAS and fate and transport, including precursor transformation. Although the state of the science is sufficient to support a degree of site-specific and flexible risk management, effective source prioritization tools, predictive fate and transport models, and improved and standardized analytical methods are needed to guide broader policies and best management practices. Environ Toxicol Chem 2021;40:3234-3260. © 2021 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

A Critical Review of a Recommended Analytical and Classification Approach for Organic Fluorinated Compounds with an Emphasis on Per- and Polyfluoroalkyl Substances.

Organic fluorinated compounds have been detected in various environmental media and biota. Some of these compounds are regulated locally (e.g., perfluorononanoic acid maximum contaminant level in drinking water by the New Jersey Dept. of Environmental Protection), nationally (e.g., perfluorooctanoic acid maximum acceptable concentration in drinking water by Health Canada), or internationally (e.g., Stockholm Convention on Persistent Organic Pollutants). Globally, regulators and researchers seek to identify the organic fluorinated compounds associated with potential adverse effects, bioaccumulation, mobility, and persistence to manage their risks, and, to understand the beneficial attributes they bring to products such as first responder gear, etc. Clarity is needed to determine the best analytical method for the goal of the analyses (e.g., pure research or analysis to determine the extent of an accidental release, monitoring groundwater for specific compounds to determine regulatory compliance, and establish baseline levels in a river of organic fluorinated substances associated with human health risk prior to a clean-up effort). Analytical techniques that identify organic fluorine coupled together with targeted chemical analysis will yield information sufficient to identify public health or environmental hazards. Integr Environ Assess Manag 2021;17:331-351. © 2020. W.L. Gore & Associates Inc. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

A critical review of the application of polymer of low concern and regulatory criteria to fluoropolymers.

Per- and polyfluoroalkyl substances (PFAS) are a group of fluorinated substances that are in the focus of researchers and regulators due to widespread presence in the environment and biota, including humans, of perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). Fluoropolymers, high molecular weight polymers, have unique properties that constitute a distinct class within the PFAS group. Fluoropolymers have thermal, chemical, photochemical, hydrolytic, oxidative, and biological stability. They have negligible residual monomer and oligomer content and low to no leachables. Fluoropolymers are practically insoluble in water and not subject to long-range transport. With a molecular weight well over 100 000 Da, fluoropolymers cannot cross the cell membrane. Fluoropolymers are not bioavailable or bioaccumulative, as evidenced by toxicology studies on polytetrafluoroethylene (PTFE): acute and subchronic systemic toxicity, irritation, sensitization, local toxicity on implantation, cytotoxicity, in vitro and in vivo genotoxicity, hemolysis, complement activation, and thrombogenicity. Clinical studies of patients receiving permanently implanted PTFE cardiovascular medical devices demonstrate no chronic toxicity or carcinogenicity and no reproductive, developmental, or endocrine toxicity. This paper brings together fluoropolymer toxicity data, human clinical data, and physical, chemical, thermal, and biological data for review and assessment to show that fluoropolymers satisfy widely accepted assessment criteria to be considered as "polymers of low concern" (PLC). This review concludes that fluoropolymers are distinctly different from other polymeric and nonpolymeric PFAS and should be separated from them for hazard assessment or regulatory purposes. Grouping fluoropolymers with all classes of PFAS for "read across" or structure-activity relationship assessment is not scientifically appropriate. Integr Environ Assess Manag 2018;14:316-334. © 2018 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Quality of Life and Resilience: Exploring a Fly Fishing Intervention for Breast Cancer Survivors.

BACKGROUND: The Casting for Recovery® therapeutic intervention provides a positive, nontraditional weekend experience for breast cancer survivors. Participants receive fly fishing instruction and participate in structured and unstructured therapeutic activities. OBJECTIVES: The aim of this study was to evaluate whether breast cancer survivors had improved resilience and quality-of-life scores after program participation. METHODS: Participants completed the Quality of Life Breast Cancer questionnaire and Connor-Davidson Resilience Scale two weeks before and three and six months after the retreats. FINDINGS: No statistically significant differences between pre- and postintervention quality-of-life or resilience scores were noted. However, qualitative data reflected a high degree of participant satisfaction, healing, and learning. Participants added that peer and volunteer connections, group camaraderie, good nutrition, being in nature, and learning a new skill were all positive aspects of the program.

Nursing burnout interventions: what is being done?

Many studies have documented high prevalence of burnout and compassion fatigue in oncology nurses. Burnout has detrimental effects on nurses, patients, and healthcare organizations. However, burnout interventions have been shown to improve the physical and mental health of nurses, patient satisfaction, and the organizational bottom line by reducing associated costs of burnout. Although treatment centers may prevent and correct burnout in oncology nurses by providing various interventions, few articles focus on those interventions. This article compiles and describes interventions that will serve as a reference to nurses and healthcare organization leaders interested in implementing similar programs.

Impact of tobacco-control legislation.

Oncology nurses should be aware of smoking-related public health legislation and tobacco use prevention resources as well as increase their knowledge of psycho-education materials, medications, and products available to aid smoking cessation. Smoking is the leading cause of preventable death; one out of five deaths in the United States is attributed to smoking. Each day, almost 4,000 Americans younger than age 18 try their first cigarette, and 1,000 of those youths will become regular smokers. In 2009, House Resolution 1256: The Family Smoking Prevention and Tobacco Control Act gave the U.S. Food and Drug Administration the authority to regulate tobacco products with emphasis placed on prevention of the use by youth through graphic health warnings. Most states and many countries have enacted bans on smoking in all enclosed public places; however, some still allow smoking in adult-specific venues, such as bars, and some have not enacted any general statewide ban on smoking in any nongovernment-owned spaces. Oncology nurses can be instrumental in advocating for tobacco control legislation as well as providing and supporting services focused on smoking cessation and the prevention of tobacco use.

A novel approach to improving current research awareness: a Web-based Nursing Research Journal Watch.

The Nursing Research Education Committee, part of the Nursing Research Council in a large tertiary care healthcare system, was developed to engage direct care nurses in research activities. This article describes several programs undertaken to meet this goal and details the most current: the development of a Web-based service, the Nursing Research Journal Watch. This innovative service was designed to raise staff awareness of nursing research. Staff development educators will learn how the Nursing Research Journal Watch was developed, launched, and evaluated for consideration in their own institutions.