Efficacy of Distraction Therapy in Reducing Needlestick Pain in Pediatrics: A Scoping Review

Purpose/Background Pediatric pain management is often overlooked due to time constraints and lack of resources or education on interventions used, such as distraction or pharmacological therapy. Lack of pain management leads to patient and caregiver distress, as well as an increased number of attempts to perform the procedure. This scoping review evaluates the efficacy of distraction therapy compared to nonopioid pharmacological interventions for acute needlestick pain in children ages 6 to 12 years; patient and caregiver levels of distress were also evaluated in most studies. Methods The UTHSC (University of Tennessee Health Science Center) Library database was searched for full-text articles published in the last 5 years. Terms used included “pediatric needlestick pain”, “pain management”, “distraction and acute pain”, “lumbar puncture”, and “venipuncture”. 37 articles resulted, 25 underwent rapid critical appraisal for quality of evidence which resulted in 10 articles being selected based on ages 6 to 12 years, pain scale, intervention, and relevance to our PICOT question. Results Of our 10 articles, 6 articles demonstrated reduced pain when using distraction techniques. 7 articles showed decreased anxiety, fear, and distress. 5 articles stated increased parental and patient satisfaction. 2 articles reported decreased staff distress. However, only 3 articles demonstrated a statistically significant reduction in pain scores. Implications for Nursing Practice Although few of our articles showed statistical significance in pain reduction, most of our articles report lower pain scores with interventions used. Separating pain and anxiety in the pediatric population is difficult, therefore any reduction in pain scores should be seen as significant and interventions should be implemented appropriately

Teach-Back Method to Reduce CHF Readmissions: A Scoping Review

Purpose/Background The purpose of this scoping review is to evaluate the effectiveness of the teach-back method on education as it relates to congestive heart failure readmission rates. Congestive heart failure (CHF) is the most common cause of hospitalizations among those 65 years and older in the United States. CHF readmission rates in Tennessee are higher than the already elevated national average. The current literature suggests a need to reduce 30-day readmissions, improve patient outcomes, and enhance self-efficacy in patients with CHF. The research proposes a correlation between high readmission rates and poor knowledge retention of patients with CHF, but small sample sizes and poor follow-up have interfered with accurate results. We reviewed the existing research regarding the impact of teach-back education on readmission rates and associated outcomes in patients with CHF. Methods The articles included were written in the English language, issued in medical or nursing journals, published within the past decade, involved human participants, consisted of an adult patient population (classified as by age \u3e 18 years), encompassed a diagnosis of heart failure, used the teach-back method, and evaluated the outcome of 30-day readmissions. Articles included in this review are systematic reviews/meta-analyses, randomized control trials, case-control/cohort studies, and qualitative/descriptive studies. The databases were searched from October 2020 to October 2022: CINAHL, Cochrane, JAMA, Medline, and Ovid. Results Ten articles published between 2013 and 2022 evaluated the use of teach-back education for patients diagnosed with heart failure in the acute care setting. Teach-back reduced 30-day readmissions in 9/10 articles (unchanged in one), increased patient knowledge of heart failure among all the articles, improved self-management capability (9/10), and promoted treatment adherence (7/10; not examined in 2). Implications for Nursing Practice When educating patients with CHF, incorporating the teach-back method has proven to reduce 30-day hospital readmissions and improve patient outcomes

Spontaneous Parity Violation in SUSY Strong Gauge Theory

We suggest simple models of spontaneous parity violation in supersymmetric strong gauge theory. We focus on left-right symmetric model and investigate vacuum with spontaneous parity violation. Non-perturbative effects are calculable in supersymmetric gauge theory, and we suggest two new models. The first model shows confinement, and the second model has a dual description of the theory. The left-right symmetry breaking and electroweak symmetry breaking are simultaneously occurred with the suitable energy scale hierarchy. The second model also induces spontaneous supersymmetry breaking.Comment: 14 page

Penn Macy initiative to advance academic nursing practice

Academic nursing practice holds great promise for the future of the nursing discipline. The successful and intentional integration of the tripartite mission of research, education, and clinical practice can facilitate both the evolution of the science and implementation of evidence-based practice, while imbuing practitioners in the making with the world of the possible. Although many schools of nursing have been involved in some aspects of academic practice, the lack of common focus and direction has hampered concerted movement. The Penn Macy Initiative was conceived as a vehicle to help build and coalesce the critical mass needed to bridge this gap. The Penn Macy Initiative, its implementation and experience in the first 3 years, and how its alumni fellows, an annual conference, and Web-based consultation will continue to provide impetus, leadership, and resources for academic nursing practice in the years to come are described

The potential for atmospheric water harvesting to accelerate household access to safe water

With Sustainable Development Goal 6 (SDG-6), member states of the UN declared their ambition for universal access to safely managed water, recognising this as fundamental to human health, wellbeing, socioeconomic development, and gender equity. Through the support of expert groups, the UN defined safely managed water as a continuous supply of uncontaminated water delivered directly to every household worldwide. Currently, 2·2 billion people (primarily in low-income and middle-income countries [LMICs]) do not have this level of water service; globally, 200 million hours are spent collecting water from locations beyond the household plot each year, mostly by women and girls.2 The appendix (p 1) provides further reading on water policy and services in low-income settings