Lyme’s Disease: Recognition and Management for Emergency Nurses

This article may not exactly replicate the final version published in Emergency Nurse. It is not the copy of recordOver the last 10 years there has been a significant rise in the numbers of patients who present to the Emergency Department (ED) with a diagnosis of Lyme disease. Although some patients may remain asymptomatic a significant number of patients present with a rash focused around a previous tick bite. Others may present with a wide range of debilitating symptoms that can be very problematic, if left untreated. Due to the growing prevalence of Lyme disease within the United Kingdom (UK) and the US, this article offers an overview of the vector borne nature of this illness and provides the Emergency Nurse with information on the pathophysiology, prevention, presenting symptoms, and management of Lyme disease

Translating the power of Coverdell fellows to address global nursing challenges

Academic opportunities to enter undergraduate nursing should include access for mature, experienced professionals who are prepared to care for an ever more diverse patient population and who can provide nursing expertise in the global arena. The Coverdell Fellowships in nursing are designed to actively support Returned Peace Corps Volunteers (RPCV) in developing nursing skills in such a way that supports the local community. Coverdell Fellows already have the skills and abilities enabling them to communicate with sensitivity and to develop therapeutic relationships with diverse global populations. Many Colleges of Nursing are currently faced with the challenge of providing students with opportunities which will allow them to become more globally aware and culturally competent. Thus, working with the Peace Corps, a highly respected organization with longstanding international experience, is an obvious step not only to bolster the nursing workforce, but also to develop a more globally sensitive and competent nursing workforce in the U.S. and abroad

Peripheral nerve function and symptom distress during biotherapy for malignant melanoma

Studies of biotherapy-induced physiological changes are few, and systematic monitoring for neurotoxic effects are lacking. The purpose of this exploratory pilot study was to determine the change in peripheral nerve function and symptom distress during treatment with biotherapy for malignant melanoma. A convenience sample of 11 participants with malignant melanoma receiving interferon-alpha had measures of peripheral nerve function measured at baseline, four and 12 weeks of treatment. Data were analyzed using plots and regression slopes to determine change over time in sensation, gait/balance, vision, hearing, vibratory sense, muscle strength, deep tendon reflexes, blood pressure, and symptom distress. Declines in hearing, sensation, vibration, and muscle strength were found. Changes in visual acuity, and orthostatic blood pressure were noted, while gait/balance remained stable. Additionally, neuropathy symptoms were associated with symptom distress. The characterization of such changes can increase our understanding of the nature of the physiological effects associated with high-dose biotherapy treatment and aid clinicians to better prepare patients for anticipated changes in function and subsequent lifestyle adjustments. These findings can be used to provide information in a larger study of this phenomenon regarding important outcomes and measurement time-points of therapy-induced neuropathy and decreasing symptom distress in patients receiving cancer treatment with biologic agents

La fonction nerveuse périphérique et la souffrance liée aux symptômes pendant la biothérapie du mélanome malin

Les études sur les changements physiologiques induits par la biothérapie sont peu nombreuses, et le suivi systématique des effets neurotoxiques indésirables, insuffisant. Le but de cette étude pilote était de déterminer l’altération de la fonction nerveuse périphérique et l’évolution de la souffrance liée aux symptômes pendant le traitement par biothérapie du mélanome malin. On a mesuré la fonction nerveuse périphérique au niveau de référence et à 4 et 12 semaines de traitement à l’interféron alpha, auprès d’un échantillon de convenance de 11 participants atteints d’un mélanome malin. Les données ont été analysées à l’aide des tracés et des courbes de régression, afin de déterminer les changements survenus au niveau du toucher, de la marche/de l’équilibre, de la vision, de l’audition, de la sensibilité vibratoire, de la force musculaire, des réflexes tendineux, de la tension artérielle et de la souffrance liée aux symptômes. Des dégradations de l’audition, du toucher, de la sensibilité vibratoire et de la force musculaire ont été observées, ainsi que des modifications de l’acuité visuelle et de la tension artérielle orthostatique, tandis que la marche/l’équilibre restaient stables. En outre, des symptômes neuropathiques étaient associés à la souffrance liée aux symptômes. La caractérisation de tels changements peut rehausser notre compréhension de la nature des effets physiologiques de la biothérapie à haute dose et aider les cliniciens à mieux préparer les patients aux changements fonctionnels auxquels ils doivent s’attendre ainsi qu’aux adaptations ultérieures de leur mode de vie. Dans le cadre d’une étude plus large de ce phénomène, ces conclusions pourraient constituer une source d’information sur des résultats importants et sur les intervalles des mesures de la neuropathie induite par la thérapie et sur l’allègement de la souffrance liée aux symptômes chez les patients recevant un traitement du cancer à base d’agents biologiques

Feasibility and Acceptability of a Resistance Exercise Intervention: For Women Undergoing Chemotherapy for Breast Cancer

Abstract Resistance exercise can maintain muscle strength & physical functioning in women undergoing chemotherapy for breast cancer. Few studies examined resistance exercise for reducing the neuromuscular side effects of chemotherapy. The purpose of this analysis was to examine the feasibility and acceptability of a resistance exercise intervention for women undergoing chemotherapy for the treatment of breast cancer. The data reported are from the final data collection interview of the intervention group (n=47) who participated in a randomized clinical trial testing a resistance exercise intervention for women with breast cancer. Data regarding feasibility and acceptability was collected using an investigator-developed questionnaire consisting of 6 Likert-scale items (range = 1-5), and 4 additional open-ended questions concerning exercise benefits and barriers. Descriptive statistics were used to analyze the Likert-scale questions. A mean score of 3.0 or greater indicated that the intervention was acceptable. A content analysis was performed on the open-ended items. Five of six questions exceeded the 3.0 set point indicating women found the remaining aspects of the intervention feasible and acceptable. Challenges in exercise were symptoms, fatigue, and time constraints. The benefits from the exercise program consisted of increased strength and energy, emotional well-being, physical well-being. Study results suggest that resistance exercise intervention conducted during chemotherapy for breast cancer is feasible and acceptable. Social support for exercise was the most important factor in continuing an exercise program during chemotherapy. Study participants can be successfully recruited into a resistance exercise program during chemotherapy for breast cancer. However, stronger emphasis in symptom management during the early phases of the study is needed to prevent study withdrawal

Self-Management of Oxaliplatin-Related Peripheral Neuropathy in Colorectal Cancer Survivors

Purpose. The purpose of this study was to evaluate medications that cancer survivors with oxaliplatin-induced peripheral neuropathy take to control neuropathic symptom, and to explore self-management techniques used at home to provide temporary relief of painful neuropathy. This was a mixed methods, descriptive, cross-sectional study using self-reported data from colorectal cancer survivors previously treated with oxaliplatin. We analyzed demographic and medication data obtained from participants, along with written comments from an open-ended question regarding methods participants had tried to self-manage symptoms of neuropathy. Results. Twenty-nine percent of the sample reported taking some type of nutritional supplement with potential neuroprotective qualities. Opioids were being taken by 10% of the sample, and nonsteroidal anti-inflammatory and over-the-counter medications were taken by 15% of participants. Twelve percent of participants were taking antidepressants and 10% were taking anticonvulsants, primarily gabapentin. Recurrent themes for nonpharmacologic treatment included avoiding the cold/keeping warm, keeping moving, massaging or rubbing the affected area, and living with it. Conclusions. Patients treated with oxaliplatin for colorectal cancer utilize a variety of traditional pharmacologic agents and nutritional supplements in an effort to self-manage neuropathic symptoms. Patients also employ a variety of home-based therapies to provide temporary relief of peripheral neuropathy symptoms

Self-Management of Oxaliplatin-Related Peripheral Neuropathy in Colorectal Cancer Survivors

Purpose. The purpose of this study was to evaluate medications that cancer survivors with oxaliplatin-induced peripheral neuropathy take to control neuropathic symptom, and to explore self-management techniques used at home to provide temporary relief of painful neuropathy. This was a mixed methods, descriptive, cross-sectional study using self-reported data from colorectal cancer survivors previously treated with oxaliplatin. We analyzed demographic and medication data obtained from participants, along with written comments from an open-ended question regarding methods participants had tried to self-manage symptoms of neuropathy. Results. Twenty-nine percent of the sample reported taking some type of nutritional supplement with potential neuroprotective qualities. Opioids were being taken by 10% of the sample, and nonsteroidal anti-inflammatory and over-the-counter medications were taken by 15% of participants. Twelve percent of participants were taking antidepressants and 10% were taking anticonvulsants, primarily gabapentin. Recurrent themes for nonpharmacologic treatment included avoiding the cold/keeping warm, keeping moving, massaging or rubbing the affected area, and living with it. Conclusions. Patients treated with oxaliplatin for colorectal cancer utilize a variety of traditional pharmacologic agents and nutritional supplements in an effort to self-manage neuropathic symptoms. Patients also employ a variety of home-based therapies to provide temporary relief of peripheral neuropathy symptoms

Fortaleciendo las capacidades de investigación en enfermería en Panamá.

La educación en enfermería impacta la necesidad de prácticas basadas en la evidencia. En consecuencia, estudiantes, profesores y profesionales de enfermería participaron en una conferencia interactiva de tres días, para ayudar a desarrollar habilidades y destrezas investigativas. Más del 85% de los participantes evaluaron cada aspecto de la conferencia, por encima del promedio o sobresaliente. Menos del 2% de los participantes evaluaron la conferencia por debajo del promedio, para cada uno de los cinco aspectos presentados. Los participantes del taller interactivo lo evaluaron como sobresaliente (50%) o por encima del promedio (36%). El contenido del taller fue evaluado como sobresaliente (50%) o por encima del promedio (39%). Aspectos relevantes del contenido del taller en cuanto a temas de investigación también fueron evaluados, satisfactoriamente. El enfoque, en formato de conferencia y taller interactivos, es un medio factible y valioso para proveer conocimientos sobre investigación cuantitativa a los estudiantes, profesores y enfermeras profesionales