An Educational Program to Improve African American Women’s Knowledge and Self Efficiency in Seeking Treatment for Endometrial Cancer

In the United States, there is a significant difference in the survival rate for endometrial cancer for African American women when compared to women of other ethnic groups, specifically White women. There is supporting evidence that supports that morbidity and mortality rates for endometrial cancer increase if diagnosed in later stages. There are many contributing factors to a patient receiving an early diagnosis of a disease. One of the key determinants to early diagnosis of endometrial cancer is understanding risk factors, and what symptoms require further evaluation. An educational program was developed to identify knowledge deficits in the African American community regarding the risk factors, symptoms, diagnosis, treatment, and self efficacy in seeking treatment for endometrial cancer. This quantitative study was conducted in a community-based setting and the targeted population was African American women aged 50 or older, postmenopausal, and living in a large Metropolitan area in Tennessee. Prior to the educational presentation, the 24 participants completed a questionnaire using the Likert Scale to assess their knowledge of risk factors, symptoms, treatment, and self-efficacy in seeking treatment of endometrial cancer. After education was provided by the parish nurse, participants were asked to complete a posteducational questionnaire evaluating their knowledge and feelings of self-efficacy in seeking treatment for endometrial cancer. Upon completion of the preeducational survey and the posteducational survey, a two–tailed paired sample t test was completed for each question to determine the significance of the educational program on the participant\u27s knowledge and self-efficacy in seeking treatment for endometrial cancer. The analysis of the pre- and posteducational surveys showed a significant increase of knowledge of endometrial cancer after completion of the educational program. There was not a significant increase in confidence in seeking treatment based on the survey results. Nurses can use this vii educational framework in multiple healthcare settings to provide culturally sensitive education for African American women

Lifestyle Modifications to Support Mental Health

https://scholarworks.uvm.edu/fmclerk/1864/thumbnail.jp

The red leg dilemma: a scoping review of the challenges of diagnosing lower limb cellulitis

Background: Suspected lower limb cellulitis presentations are commonly misdiagnoses, resulting in avoidable antibiotic prescribing or hospital admissions. Understanding the challenges posed in diagnosing cellulitis may help enhance future care.Objectives: To examine and map out the challenges and facilitators identified by patients and health professionals in diagnosing lower limb cellulitis.Methods: A scoping systematic review was performed in MEDLINE and Embase in October 2017. Thematic analysis was used to identify key themes. Quantitative data was summarised by narrative synthesis.Results: Three themes were explored: (i) clinical case reports of misdiagnosis, (ii) service development and (iii) diagnostic aids. Forty‐seven different pathologies were misdiagnosed, including seven malignancies. Two different services have been piloted to reduce the misdiagnosis rates of lower limb cellulitis and save costs. Four studies have looked at biochemical markers, imaging and a scoring tool to aid diagnosis.Conclusions: This review highlights the range of alternative pathologies that can be misdiagnosed as cellulitis, and emerging services and diagnostic aids developed to minimise misdiagnosis. Future work should focus on gaining a greater qualitative understanding of the diagnostic challenges from the perspective of patients and clinicians.This article is protected by copyright. All rights reserved

Enhanced Auditory Brainstem Response and Parental Bonding Style in Children with Gastrointestinal Symptoms

The electrophysiological properties of the brain and influence of parental bonding in childhood irritable bowel syndrome (IBS) are unclear. We hypothesized that children with chronic gastrointestinal (GI) symptoms like IBS may show exaggerated brainstem auditory evoked potential (BAEP) responses and receive more inadequate parental bonding. = 0.024). Multiple regression analysis in females also supported these findings.It is suggested that children with chronic GI symptoms have exaggerated brainstem responses to environmental stimuli and inadequate parental behaviors aggravate these symptoms

Quantitating the effect of prosthesis design on femoral remodeling using high-resolution region-free densitometric analysis (DXA-RFA)

Dual energy X‐ray absorptiometry (DXA) is the reference standard method used to study bone mineral density (BMD) after total hip arthroplasty (THA). However, the subtle, spatially complex changes in bone mass due to strain‐adaptive bone remodeling relevant to different prosthesis designs are not readily resolved using conventional DXA analysis. DXA region free analysis (DXA RFA) is a novel computational image analysis technique that provides a high‐resolution quantitation of periprosthetic BMD. Here, we applied the technique to quantitate the magnitude and areal size of periprosthetic BMD changes using scans acquired during two previous randomized clinical trials (2004 to 2009); one comparing three cemented prosthesis design geometries, and the other comparing a hip resurfacing versus a conventional cementless prosthesis. DXA RFA resolved subtle differences in magnitude and area of bone remodeling between prosthesis designs not previously identified in conventional DXA analyses. A mean bone loss of 10.3%, 12.1%, and 11.1% occurred for the three cemented prostheses within a bone area fraction of 14.8%, 14.4%, and 6.2%, mostly within the lesser trochanter (p < 0.001). For the cementless prosthesis, a diffuse pattern of bone loss (−14.3%) was observed at the shaft of femur in a small area fraction of 0.6% versus no significant bone loss for the hip resurfacing prosthesis (p < 0.001). BMD increases were observed consistently at the greater trochanter for all prostheses except the hip‐resurfacing prosthesis, where BMD increase was widespread across the metaphysis (p < 0.001). DXA RFA provides high‐resolution insights into the effect of prosthesis design on the local strain environment in bone