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In March 2020, scientists across industry, academic, and healthcare settings were forced to halt their ongoing research studies because of isolation mandates associated with the management of contagion in the COVID-19 pandemi.In March 2020, scientists across industry, academic, and healthcare settings were forced to halt their ongoing research studies because of isolation mandates associated with the management of contagion in the COVID-19 pandemi.

COVID-19 has impacted most hospitals around the world, resulting in changes to daily operations and the suspension of some programs. Preceptor training is an area that has been impacted by COVID-19 restrictions. These programs have a positive impact on the retention of new RNs, which is especially important as the pandemic continues to strain morale. A 12-week, step-by-step education plan that leverages audio/video technologies such as Zoom and FaceTime was developed to preserve the positive benefits of the preceptor–preceptee relationship in the setting of COVID-19. [J Contin Educ Nurs. 2022;53(5):221–224.]

Background Survival rates for breast cancer (BC) have improved, but quality of life post-diagnosis/treatment can be adversely affected, with survivors reporting a constellation of psychoneurological symptoms (PNS) including stress, anxiety, depression, pain, fatigue, sleep disturbance, and cognitive dysfunction. Methods To assess a potential relationship between telomere length (TL) and the development/persistence of PNS, we longitudinally studied 70 women (ages 23–71) with early stage BC (I-IIIA) at 5 time-points: prior to treatment (baseline), the mid-point of their chemotherapy cycle, 6 months, 1 year, and 2 years following the initiation of chemotherapy. Measures quantified included assessments of each of the PNS noted above and TL [using both a multiplex qPCR assay and a chromosome-specific fluorescence in situ hybridization (FISH) assay]. Results Variables associated with qPCR mean TLs were age ( p  = 0.004) and race (T/S ratios higher in Blacks than Whites; p  = 0.019). Significant differences (mostly decreases) in chromosome-specific TLs were identified for 32 of the 46 chromosomal arms at the mid-chemo time-point ( p  = 0.004 to 0.049). Unexpectedly, the sequential administration of doxorubicin [Adriamycin], cyclophosphamide [Cytoxan], and docetaxel [Taxotere] (TAC regimen) was consistently associated with higher TLs, when compared to TLs in women receiving a docetaxel [Taxotere], Carboplatin [Paraplatin], and trastuzumab [Herceptin] [TCH] chemotherapy regimen [association was shown with both the qPCR and FISH assays ( p  = 0.036)]. Of the PNS, pain was significantly negatively associated with TL (higher pain; shorter telomeres) for a subset of chromosomal arms (5q, 8p, 13p, 20p, 22p, Xp, Xq) ( p  = 0.014–0.047). Chromosomal TLs were also associated with 7 of the 8 cognitive domains evaluated, with the strongest relationship being noted for chromosome 17 and the visual memory domain (shorter telomeres; lower scores). Conclusions We showed that race and age were significantly associated with telomere length in women treated for early stage BC and that acquired telomere alterations differed based on the woman’s treatment regimen. Our study also demonstrated that pain and cognitive domain measures were significantly related to telomere values in this study cohort. Expanding upon the knowledge gained from this longitudinal study could provide insight about the biological cascade of events that contribute to PNS related to BC and/or its treatment.

Background Psychological distress is associated with worsening symptoms during the active treatment period and lower quality of life in women with early‐stage breast cancer. Many studies have indicated risk for heightened psychological distress across the breast cancer trajectory. Purpose The aim of this review is to examine the literature for instruments used to measure psychological distress among women with breast cancer during chemotherapy. Methods This study used the Arksey and O’Malley framework of scoping reviews. Two databases, PubMed & CINAHL, were searched for peer‐reviewed original articles that were published within the last ten years, included participants with a diagnosis of breast cancer stages I to III, and receiving chemotherapy, English text articles, and studies that report psychological distress measures. Findings The initial screening yielded 529 relevant studies. After applying the exclusion criteria, a total of 17 studies concerning the assessment of psychological distress during chemotherapy were retained for the analysis of variables and measures of psychological distress. The instruments used to measure psychological distress varied, with a total of 21 measures. The most frequently utilized measure was the Hospital Anxiety and Depression Scale (n = 5), followed by the Impact of Event Scale (n = 2), the Distress Thermometer (n = 2), and the Perceived Stress Scale (n = 2). Conclusion This review identified the gaps related to inconsistencies in the operationalization and instruments used to measure psychological distress among breast cancer survivors during chemotherapy. Standardization of measures assessing psychological distress, along with conceptual clarity, is essential for measuring distress in research and clinical practice.

The purpose of this study was: (1) to characterise the association of wound area, wound exudate C‐reactive protein (CRP), broad‐spectrum matrix metalloprotease protein (MMPs), and symptoms of fatigue and pain in individuals with chronic venous leg ulcers (CVLUs) over time and (2) to identify factors associated with the wound healing trajectory in CVLUs. Seventy four participants with CVLU who received weekly sharp debridement were recruited from a wound care clinic during the 8‐week study period. To examine associations among wound CRP, MMPs, pain, fatigue, and wound healing trajectory over time, we calculated Bayes factors (BF) based on a linear mixed model. The mean age of participants was 71.8 (SD = 9.8) and the mean wound area was 2278 mm2 (SD = 7085 mm2) at baseline. Higher fatigue was strongly associated with higher MMPs (BF = 9, 95% HDI: [−.05, .43]), lower CRP (BF = 11, 95% HDI: [−.02, .002]), and large areas of wound (BF = 20, 95% HDI: [−.001, .01]). Higher CRP and MMPs activity in wound exudate and higher fatigue were associated with a larger wound area. To facilitate wound healing, clinicians need to utilise the multifactorial approach, which includes wound treatment and management of symptoms such as pain and fatigue, because of the molecular and psycho‐behavioural factors involved in wound healing.

Purpose The epigenetic clock has been acknowledged as an indicator for molecular aging, but few studies have examined possible associations of DNA methylation (DNAm) age or age acceleration (AA) with symptom burden in individuals who are treated for cancer. This study explored the association of DNAm age or AA with psychoneurological (PN) symptoms, including cognitive impairment, fatigue, sleep disturbances, pain, and depressive symptoms, in breast cancer survivors over a 2-year period. Methods We measured PN symptoms using reliable instruments and DNAm levels by Infinium HumanMethylation450K BeadChip ( N  = 72). DNAm age was calculated by the Horvath, Grim, and Hannum-based intrinsic and extrinsic age estimations. AA was defined by the residual regressing estimated epigenetic age on chronological age. Mixed regression models were fitted for AA and changes in AA to study the association over time. Separate linear regression models and a mixed-effects model were fitted for AA at each time point. Results Horvath-AA, Grim-AA, and extrinsic epigenetic AA were significantly changed over time, while intrinsic epigenetic AA did not exhibit any temporal changes. Increased AA was associated with greater anxiety and fatigue, as well as worse cognitive memory, adjusting for race, BMI, income, chemotherapy, radiation therapy, and chronological age. Increased DNAm age was associated with greater anxiety over 2 years. Conclusion Our findings suggest DNAm age and AA may be associated with PN symptoms over the course of cancer treatment and survivorship. Some PN symptoms may be amenable to preventive interventions targeted to epigenetic clocks that influence aging-associated processes.

Purpose Cognitive dysfunction in women with breast cancer continues to be an area of intense research interest. The prevalence, severity, timing, and cognitive domains that are most affected, as well as the contribution of cancer and its treatments to cognition, remain unresolved. Thus, longitudinal studies are needed that examine cognitive function during different stages of breast cancer treatment and survivorship. This longitudinal trial followed women with early-stage breast cancer, prior to chemotherapy through 2 years survivorship. Methods In women with early-stage breast cancer ( N  = −75), performance-based assessment of nine cognitive domains was performed at five time points beginning prior to chemotherapy and finishing 24 months after initial chemotherapy. Linear mixed effects models were used to examine the temporal changes in cognitive performance domains, while adjusting for cofactors, including those related to individuals, tumor attributes, chemotherapy (adjuvant or neoadjuvant), radiation, endocrine therapy, and concurrent symptoms. Results At baseline, scores on reaction time, complex attention, cognitive flexibility, executive function, and visual memory were lower than 90. At 2 years, all domains improved except for the memory domains (verbal, visual, and composite). Scores on six domains (psychomotor speed, reaction time, complex attention, cognitive flexibility, and visual memory) remained lower than 100 at 2 years. Neoadjuvant chemotherapy and fatigue had strong inverse relationship with cognitive functioning at multiple time points. Conclusion The low performance-based cognitive scores at baseline and over time warrant further study. Although most scores improved over time, memory did not improve. In all, the level of cognitive function is lower than expected for a majority college-educated sample. Thus, future studies are warranted to replicate these findings and to develop methods for identifying women with cognitive dysfunction pretreatment and into survivorship.

Purpose This scoping review aims to explore the relationship between health‐promoting lifestyle behaviors and gut microbiota in survivors of hematological cancers, including leukemia, lymphoma, and multiple myeloma. Given the rising incidence of these malignancies and the associated treatment challenges, understanding how lifestyle factors influence gut health may provide insights into improving survivorship outcomes. Methods We conducted a comprehensive search across multiple databases, including PubMed/Medline, CINAHL, and Scopus, following the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis extension for Scoping Reviews (PRISMA‐ScR). The search strategy incorporated MeSH terms related to hematological cancers, health‐promoting lifestyle behaviors, and gut microbiota. Inclusion criteria focused on primary research studies published in English that reported gut microbiota results in survivors of hematological cancers. A total of 1717 papers were initially identified, with 16 studies meeting the inclusion criteria after screening for relevance. Results The review identified a significant association between health‐promoting lifestyle behaviors, such as physical activity, nutrition, and stress management, and the composition and diversity of gut microbiota in cancer survivors. The findings suggest that engaging in these behaviors may enhance gut health, potentially mitigating treatment‐related symptoms and improving overall quality of life. Notably, the studies highlighted the importance of tailored interventions that consider individual patient needs and preferences. Conclusions This scoping review underscores the critical role of health‐promoting lifestyle behaviors in influencing gut microbiota among survivors of hematological cancers. Future research should focus on longitudinal studies to establish causal relationships and explore the mechanisms underlying these associations. By promoting healthy lifestyle choices, healthcare providers can enhance survivorship care and improve health outcomes for this population.

Recent evidence demonstrates that tobacco smoking causes an imbalance in bone turnover, leading to lower bone mass and making bone vulnerable to osteoporosis and fracture. Tobacco smoke influences bone mass indirectly through alteration of body weight, parathyroid hormone-vitamin D axis, adrenal hormones, sex hormones, and increased oxidative stress on bony tissues. Also, tobacco smoke influences bone mass through a direct effect on osteogenesis and angiogenesis of bone. A RANKL-RANK-OPG pathway is an essential regulatory pathway for bone metabolism and its importance lies in its interaction with most of the pathophysiologic mechanisms by which smoking influences bone mass. Both first- and secondhand smoke adversely affect bone mass; smoking cessation seems to reverse the effect of smoking and improve bone health. Recent advances in research on bone turnover markers could advance scientific knowledge regarding the mechanisms by which smoking may influence bone mass.