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Ethical implications of next-generation sequencing and the future of newborn screening. 下一代测序的伦理意义和新生儿筛查的未来。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2021-06-30 DOI: 10.1097/JXX.0000000000000631
Shelley White-Corey, Jessica L Peck, Rosa I Pérez

Abstract: Over the last 50 years, routine newborn blood screening for congenital disorders has been hailed as a miracle of modern science, saving countless lives by providing a means to detect and treat life-threatening disorders before symptoms present. Despite progress made with more than 5,000 babies effectively identified with rare conditions each year, congenital anomalies collectively remain at the top of the list as the cause of death for babies under 1 year of age, accounting for more than 20% of all infant mortalities. Rapid technological advances have seen the original singular newborn screen for phenylketonuria expand to a core set of 34 conditions and an additional 26 secondary conditions on the Recommended Uniform Screening Panel, with wide state-to-state variation for implementation. As genomic analysis evolves to enable next-generation sequencing, debates continue over the ethical, legal, and social implications of identifying conditions for which there is no effective treatment. Nurse practitioners should be engaged and informed in providing evidence-based support to families engaging in ethical complex decision making surrounding newborn screening while effectively balancing risk-benefit analysis with individual beliefs and values.

摘要:在过去的50年里,新生儿先天性疾病的常规血液筛查被誉为现代科学的奇迹,通过在症状出现之前发现和治疗危及生命的疾病,挽救了无数生命。尽管取得了进展,每年有5 000多名婴儿被有效地确诊为罕见疾病,但先天性异常仍然是导致1岁以下婴儿死亡的首要原因,占所有婴儿死亡率的20%以上。快速的技术进步使苯丙酮尿新生儿单一筛查扩大到推荐统一筛查小组的34种核心条件和另外26种次要条件,各州之间的实施差异很大。随着基因组分析的发展使下一代测序成为可能,关于确定没有有效治疗的疾病的伦理、法律和社会影响的争论仍在继续。护士从业人员应该参与并了解如何为家庭提供基于证据的支持,这些家庭参与围绕新生儿筛查的复杂伦理决策,同时有效地平衡风险-收益分析与个人信仰和价值观。
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引用次数: 1
Written scholarship as a foundation for professional practice: Similarities and differences between writing coaches and editors. 作为专业实践基础的书面奖学金:写作教练与编辑的异同。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2021-06-23 DOI: 10.1097/JXX.0000000000000638
Rodney Rod W Hicks

Abstract: Scholarship forms the scientific basis of advanced practice registered nurse (APRN) practice. Although the number of manuscripts from APRNs has grown, the vast majority of APRNs do not publish works that affect practice, education, research, or policy. Many APRNs are unaware of resources, such as a writing coach and an editor, that facilitate producing publishable scholarship. This article describes the similarities and differences of the two resources.

摘要:奖学金是高级执业注册护士(APRN)执业的科学基础。尽管来自APRNs的手稿数量有所增长,但绝大多数APRNs并不发表影响实践、教育、研究或政策的作品。许多aprn不知道有什么资源,比如写作教练和编辑,可以促进产生可发表的学术成果。本文描述了这两种资源的异同。
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引用次数: 0
Help or hindrance: Exploring nurse practitioners' perceptions of transition to practice legislation. 帮助或阻碍:探索护士从业人员过渡到实践立法的看法。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2021-06-03 DOI: 10.1097/JXX.0000000000000623
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引用次数: 0
Food for thought. 发人深思。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2021-06-03 DOI: 10.1097/JXX.0000000000000618
Kim Curry
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引用次数: 0
Integrating strategies for improving diagnostic reasoning and error reduction. 整合改进诊断推理和减少错误的策略。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2021-05-21 DOI: 10.1097/JXX.0000000000000617
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引用次数: 0
Strategies and techniques to enhance nurse practitioner learning. 加强护士执业学习的策略和技巧。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2021-05-21 DOI: 10.1097/JXX.0000000000000572
Judith A Berg, Rodney Hicks, Mary Ellen Roberts
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引用次数: 1
Rethinking DNP education: Just another mountain to climb. 重新思考DNP教育:只是另一座要爬的山。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2021-05-21 DOI: 10.1097/JXX.0000000000000604
Michelle A Beauchesne

Abstract: The World Health Organization designated 2020 as the International Year of the Nurse and Midwife in celebration of the 200th birthday of Florence Nightingale, the founder of modern nursing. This article considers the future of nurse practitioner education in light of nursing history. First, a brief overview describes the progression of nursing education since the founding of the Nightingale School in 1860. Then, current challenges in NP education are discussed. Potential solutions to these issues are presented.

摘要:世界卫生组织将2020年定为国际护士和助产士年,以纪念现代护理奠基人弗洛伦斯·南丁格尔诞辰200周年。本文结合护理史,对护士执业教育的未来进行了展望。首先,简要概述了自1860年南丁格尔学校成立以来护理教育的进展。然后,讨论了当前NP教育面临的挑战。提出了这些问题的潜在解决方案。
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引用次数: 0
Genomics of aging: The role of sirtuin and metabolic health. 衰老基因组学:sirtuin和代谢健康的作用。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2021-05-21 DOI: 10.1097/JXX.0000000000000597
Kenneth Wysocki, Diane Seibert

Abstract: Healthy aging is not the result of a single factor. Genes, dietary choices/options, exercise, and environmental exposures all play a role. A family of seven nicotinamide adenine dinucleotide (NAD)-dependent sirtuin proteins are very involved in various metabolic functions, such as glucose and fat regulation, and polymorphisms in these genes have been associated with the development of obesity, type 2 diabetes, cancer, cardiovascular disease, and longevity. Nutraceuticals (i.e., resveratrol, quercetin, kaempferol, and curcumin) and other therapies (i.e., synthetic sirtuin-activating compounds, NAD, nicotinamide mononucleotide) are all being explored as in potential therapies in the sirtuin pathway and point to promising treatments to promote metabolic health and reduce obesity and age-related disease. For the clinician looking to reduce the risk of age-related metabolic disorders, evidence points to these supplements and appropriate food choices as the next generation of pharmaceutical grade therapies continue to be researched for human use.

摘要:健康老龄化不是单一因素的结果。基因、饮食选择、锻炼和环境暴露都起作用。一个由7个烟酰胺腺嘌呤二核苷酸(NAD)依赖性sirtuin蛋白组成的家族与多种代谢功能密切相关,如葡萄糖和脂肪调节,这些基因的多态性与肥胖、2型糖尿病、癌症、心血管疾病和寿命的发生有关。营养品(如白藜芦醇、槲皮素、山奈酚和姜黄素)和其他治疗方法(如合成sirtuin激活化合物、NAD、烟酰胺单核苷酸)都在探索sirtuin途径的潜在治疗方法,并指出有希望的治疗方法,以促进代谢健康,减少肥胖和年龄相关疾病。对于希望降低与年龄相关的代谢紊乱风险的临床医生来说,有证据表明,这些补充剂和适当的食物选择是下一代用于人类使用的药物级疗法的继续研究。
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引用次数: 1
Navigating the Doctor of Nursing Practice project within an academic practice partnership. 在学术实践伙伴关系中导航护理实践博士项目。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2021-05-18 DOI: 10.1097/JXX.0000000000000600
Tonja M Hartjes, Kathryn Starr, Sheri Kittelson, Laurie Duckworth

Abstract: The Doctor of Nursing Practice (DNP) curriculum was initially developed in 2004. The DNP degree is a practice doctorate, which educates nurses to the highest level of clinical nursing practice. DNP students must complete a scholarly project in accordance with the American Association of Colleges of Nursing (AACN) guidelines. The project is an opportunity for the student to integrate skills into practice and demonstrate principles of advanced nursing practice. The AACN provides recommendations for the DNP project, but much confusion regarding the context and implementation of the project still exists. At one academic health sciences center, DNP project students often complete their projects within academic practice partnerships. Such partnerships are encouraged by the AACN. Several DNP quality improvement (QI) projects were submitted a hospital's interdisciplinary quality week event. Upon review, some of the abstracts were found to contain aspects of research. This finding prompted the review of all DNP project processes to standardize methods for faculty, students, the University, and the academic practice partner.

摘要:护理实践博士(DNP)课程最初于2004年开发。DNP学位是一个实践博士学位,它教育护士临床护理实践的最高水平。DNP的学生必须按照美国护理学院协会(AACN)的指导方针完成一个学术项目。该项目为学生提供了将技能融入实践并展示高级护理实践原则的机会。AACN为DNP项目提供了建议,但关于项目的背景和实施仍然存在许多混乱。在一个学术健康科学中心,DNP项目的学生经常在学术实践伙伴关系中完成他们的项目。AACN鼓励这种伙伴关系。在医院跨学科质量周活动中,提交了多个DNP质量改进(QI)项目。经过审查,发现一些摘要包含了研究的各个方面。这一发现促使对所有DNP项目流程进行审查,以使教师、学生、大学和学术实践合作伙伴的方法标准化。
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引用次数: 0
Counterpunching to improve the health of people with Parkinson's disease. 改善帕金森病患者的健康状况。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2021-04-07 DOI: 10.1097/JXX.0000000000000598
Melinda Hermanns, Beth Mastel-Smith, Rachel Donnell, Allison Quarles, Melissa Rodriguez, Tianjing Wang

Background: Boxing programs designed specifically for people with Parkinson's disease (PD) can be beneficial in improving the physical, mental, and functional health of persons with PD.

Purpose: This study examined the effect of a boxing program, Rock Steady Boxing (RSB), on the health of people with PD from both the boxers' and their caregivers' perspectives as well as evaluated balance, quality of life (QoL), and depressive symptoms after 12 weeks of RSB.

Methods: A mixed methods, one-group experimental design with focus groups were embedded within an intervention study. Six boxers completed baseline and 12-week postassessments.

Results: The majority of boxers maintained or improved scores for balance, QoL, and reduced depressive symptoms. Findings indicate physical and mental benefits of RSB among persons with PD and this was further validated by qualitative data from boxers and caregivers, along with quantitative data of boxers. Caregivers and boxers reported that boxers' ability to perform activities of daily living (ADLs) improved and is supported by quantitative improvements in the Parkinson's disease Questionnaire-39 ADL subscale. All boxers reported reduced stigma, and caregivers and boxers valued the opportunity to work out in an environment free of stigma, a finding not previously reported.

Conclusions: It is important for nurse practitioners to recognize exercise benefits for people with PD and recommend the program to patients and include caregivers in their overall assessment of health and wellness.

Implications for practice: Nurse practitioners and other health practitioners may consider recommending a boxing program, such as RSB, for their PD patients as a sole or supplemental exercise program.

背景:专门为帕金森病(PD)患者设计的拳击项目有助于改善PD患者的身体、精神和功能健康。目的:本研究从拳击手及其照顾者的角度,考察了摇滚稳定拳击(RSB)对PD患者健康的影响,并评估了12周后的平衡、生活质量(QoL)和抑郁症状。方法:采用混合方法,单组实验设计和焦点小组嵌入干预研究。6名拳击手完成了基线和12周后评估。结果:大多数拳击手在平衡、生活质量和抑郁症状方面保持或改善得分。研究结果表明,在PD患者中,RSB对身体和精神都有好处,这一点通过拳击手和护理人员的定性数据以及拳击手的定量数据得到了进一步验证。护理人员和拳击手报告说,拳击手进行日常生活活动(ADL)的能力得到改善,并得到帕金森病问卷-39 ADL子量表定量改善的支持。所有的拳击手都报告说耻辱减少了,照顾者和拳击手都重视在一个没有耻辱的环境中锻炼的机会,这一发现以前没有报道过。结论:对于执业护士来说,认识到运动对PD患者的好处,向患者推荐运动计划,并将护理人员纳入他们对健康和保健的总体评估是很重要的。对实践的启示:执业护士和其他健康从业者可能会考虑推荐一个拳击项目,如RSB,为他们的PD患者作为唯一或补充的锻炼项目。
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引用次数: 5
期刊
Journal of the American Association of Nurse Practitioners
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