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AJN The American Journal of Nursing - Current Issue
AJN The American Journal of Nursing - Current Issue
AJN is the oldest and largest circulating nursing journal in the world. The Journal's mission is to promote excellence in nursing and health care through the dissemination of evidence-based, peer-reviewed clinical information and original research, discussion of relevant and controversial professional issues, adherence to the standards of journalistic integrity and excellence, and promotion of nursing perspectives to the health care community and the public.

How Will We Care for the Mentally Ill?
imageMental health care is at risk, again.
Electronic Health Records
No abstract available
Multimodal Analgesia for Acute Pain
No abstract available
Why Sex Education Matters for Adolescents with Autism Spectrum Disorder
imageA proactive approach may prevent inappropriate behaviors, sexual victimization.
Canadian Nurses Caught Up in Immigration Policy Confusion
imageIn March, Canadian APRNs were prevented from working in Michigan.
ANA Expands Opposition to Capital Punishment
The change is based on ethical concerns, including racial bias.
NewsCAP: New guidelines for syncope issued
No abstract available
Ohio Collaborative Model Proactively Addresses the Looming Nursing Shortage
Financial support and mentoring to help more students attain BSNs.
NewsCAP: 12-to-34-year-olds have the highest rate of being sexually assaulted
No abstract available
NewsCAP: Diagnostics and treatment options for adult diabetic retinopathy have significantly improved
No abstract available
Early Ambulation Is Crucial for Improving Patient Health
Helping post-op patients move as soon as possible should be a clinical priority.
From the Agencies
No abstract available
New Warnings About Protecting Children from Dangerous Substances
Nurses can lead the way with education and advocacy.
NewsCAP: In May, the International Council of Nurses awarded the Christiane Reimann Prize to Linda Aiken, PhD, RN, FAAN, FRCN
imageNo abstract available
Telemedicine and Telehealth: The Potential to Improve Rural Access to Care
imageDespite the promise of remote health care services, their operation faces hurdles.
Replacing the ACA
Women, especially low-income women, may lose the most.
AJN On the Cover
imageNo abstract available
AJN On the Web
No abstract available
New Treatment for Duchenne Muscular Dystrophy
* Deflazacort (Emflaza) is the first corticosteroid approved by the Food and Drug Administration for the treatment of Duchenne muscular dystrophy. * Adverse effects of deflazacort include weight gain, Cushingoid appearance, and an increased risk of infections.
New Injectable Drug Treats Moderate-To-Severe Plaque Psoriasis
* Injectable brodalumab (Siliq), a human monoclonal antibody that inhibits the release of inflammatory cytokines and chemokines, has been approved to treat moderate-to-severe plaque psoriasis. * Because brodalumab may increase the risk of suicidal ideation and behavior, it is only available for those in the Food and Drug Administration's Risk Evaluation and Mitigation Strategy program.
Depression.
No abstract available
CE: Original Research: The Experiences of Pregnant Smokers and Their Providers
imageBackground: The U.S. Department of Health and Human Services’ initiative Healthy People 2020 targets tobacco use, including smoking during pregnancy, as a continuing major health concern in this country. Yet bringing the U.S. Public Health Service's 2008 clinical practice guideline, Treating Tobacco Use and Dependence, into routine prenatal care remains challenging. Our previous nurse-managed intervention study of rural pregnant women found no significant cessation effect and significant discordance between self-reported smoker status and urinary cotinine levels. Purpose: The overall purpose of this follow-up study was to increase our understanding of the experiences of pregnant smokers and their providers. No qualitative studies could be found that simultaneously explored the experiences of both groups. Design and methods: This qualitative descriptive study used focus group methodology. Nine focus groups were held in two counties in upper New York State; six groups consisted of providers and three consisted of pregnant women. Four semistructured questions guided the group discussions, which were audiotaped and transcribed verbatim. Transcripts were read and coded independently by six investigators. Themes were identified using constant comparative analysis and were validated using the consensus process. Results: The total sample consisted of 66 participants: 45 providers and 21 pregnant women. Most of the providers were white (93%) and female (93%). A majority worked as RNs (71%); the sample included perinatal and neonatal nursery nurses, midwives, and physicians. The pregnant women were exclusively white (reflecting the rural demographic); the average age was 24 years. All the pregnant women had smoked at the beginning of their pregnancies. Four common themes emerged in both the provider and the pregnant women groups: barriers to quitting, mixed messages, approaches and attitudes, and program modalities. These themes corroborate previous findings that cigarette smoking is used for stress relief, especially when pregnancy itself is a stressor, and that pregnant women may feel guilty but don't want to be nagged or preached to. Conclusions: These results have implications for how smoking cessation programs for pregnant women should be designed. Health care providers need to be cognizant of their approaches and attitudes when addressing the subject of smoking cessation. Specific educational suggestions include “putting a face” to the issue of tobacco use during pregnancy. More research is needed on how best to implement the 2008 clinical practice guideline in specific populations.
1.5 CE Test Hours: Original Research: The Experiences of Pregnant Smokers and Their Providers
imageNo abstract available
CE: Antipsychotic Medications
image Antipsychotic medications are primarily used to manage various symptoms of psychosis. In recent years, more adults—and teenagers—are taking at least one type of psychotropic medication, the majority of which are prescribed by primary care and family physicians. Because nurses are now caring for people of varying ages, and with varying diagnoses, who are taking these types of medications, they need to develop a working knowledge of the agents available and know when it's appropriate to prescribe them for mental health disorders as well as for disorders unrelated to mental health. This article is the first in a series on commonly used psychotropic medications.
1.5 CE Test Hours: Antipsychotic Medications
imageNo abstract available
Irritable Bowel Syndrome
image Irritable bowel syndrome (IBS) is a common, chronic gastrointestinal (GI) condition characterized by disturbances in bowel habits and abdominal pain in the absence of known organic pathology. IBS reduces quality of life and is costly to treat. It is diagnosed using the symptom-based Rome criteria for functional GI disorders, which was recently updated and released as Rome IV. Both physiologic and psychological variables play a role in the etiology of IBS and perpetuate symptoms. Although research has shed light on IBS pathophysiology, therapeutic interventions remain symptom driven, employing both pharmacologic and nonpharmacologic approaches. Here, the authors review the epidemiology and pathophysiology of IBS, summarize diagnostic and treatment strategies, and discuss implications for nursing practice.
Risks and Benefits of Immediate Antiepileptic Drug Treatment for a First Unprovoked Seizure
Editor's note: This is a summary of a nursing care–related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org .
Advance Care Planning: The Nurse's Role
image This series on palliative care is developed in collaboration with the Hospice and Palliative Nurses Association (HPNA; http://hpna.advancingexpertcare.org ). The HPNA aims to guide nurses in preventing and relieving suffering and in giving the best possible care to patients and families, regardless of the stage of disease or the need for other therapies. The HPNA offers education, certification, advocacy, leadership, and research.
Navigating the Publishing Process
image This is the fourth and final article in a series to help nurses share their knowledge, skills, and insight through writing for publication. Nurses have something important to contribute no matter what their nursing role. This series will help nurses develop good writing habits and sharpen their writing skills. It will take nurses step by step through the publication process, highlighting what gets published and why, how to submit articles and work with editors, and common pitfalls to avoid. For the previous articles in this series, see http://bit.ly/2lhnYKJ .
The Bigger Picture: A New Nurse Embraces Her Ability to Still Ask ‘Why?’
Updated several times a week with posts by a wide variety of authors, AJN’s blog Off the Charts allows us to provide more timely—and often more personal—perspectives on professional, policy, and clinical issues. Best of the Blog will be a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com .
Aspirin Use Associated with Reduced Risk of Cancer
According to this study: * Long-term aspirin use is associated with a modest but significantly reduced risk of overall cancer, especially gastrointestinal tract cancer.
ICUs Overused for Some Elderly Patients
According to this study: * Admission to the ICU doesn't improve survival among patients hospitalized with exacerbations of chronic obstructive pulmonary disease or heart failure, or in those with acute myocardial infarction, who are not clearly in need of critical care at the time of admission.
Use of Marijuana Among Pregnant Women Increases
According to this study: * From 2002 to 2014, past-month use of marijuana by pregnant U.S. women increased from an adjusted prevalence of 2.4% to 3.9%.
Zika Virus can Persist in Body Fluids for Prolonged Periods
According to this study: * Zika virus remains detectable in body fluids for a longer period than dengue or other flaviviruses.
Prediabetes Increases Risk of Cardiovascular Disease
According to this study: * Prediabetes defined as impaired glucose tolerance or impaired fasting glucose is associated with an increased risk of cardiovascular disease and all-cause mortality.
Verification
imageA visiting nurse finds himself cast as a player in a universal drama.

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CMS lifts ban on nursing home arbitration agreement
The CMS' proposed rule released Monday will prevent the Obama administration's nursing home arbitration ban from ever going into effect.
Lawmakers show hesitance in cutting Medicare programs
House lawmakers pushed back against the Medicare Payment Advisory Commission's calls to cut Medicare reimbursements to some types of providers.
Nursing homes and hospice providers face looming emergency preparedness deadline
Many long-term care providers may not be prepared to meet CMS emergency preparedness requirements—the cost of which is estimated at $370 million the first year.
Managed-care plans increasingly taking over Medicaid long-term care. Not everyone is happy about it.
States are increasingly turning to private firms to provide managed long-term supports and services (MLTSS). Their goal is to rein in costs and increase budget predictability, but some advocates are claiming that they are seeing care suffer under...
Pilon named president of Transylvania Regional Hospital, and other newsmakers
Michele Pilon has been named president and chief nursing officer at Transylvania Regional Hospital in Brevard, N.C., effective Nov. 14.
Florida high court sides with nursing home resident on enforcing unsigned contract
The Florida Supreme Court has ruled a patient couldn't be forced to arbitrate disputes with the nursing home he resides in because he didn't sign the underlying contract.
Crackdown on nursing homes' use of arbitration may lead to lawsuits
The nursing home industry may end up suing the Obama administration over its move to preserve residents' right to sue the facilities when disputes arise.
AmeriHealth, Centene, UPMC win $7B in Medicaid contracts
The Pennsylvania Department of Human Services awarded a massive Medicaid bid last week to AmeriHealth Caritas, Centene Corp. and UPMC after delaying the decision for several months.
Health system reforms needed to address low quality of life for elderly blacks
Black people are living longer than they did 20 years ago, but they have poorer health and less access to long-term care in their later years compared with whites, according to a new study.
Select Medical rides outpatient rehab boom to Q2 profit
Select Medical Holdings overcame an earnings wobble in its specialty hospital division to post solid second-quarter gains in revenue and profit on the strength of rising outpatient volumes.
Alzheimer's reimbursement bill gains support in House
A bill that could save more than $690 million in healthcare costs by reimbursing care planning for Alzheimer's disease is gaining momentum in Congress.
North Dakota nursing homes brace for state funding cutbacks
North Dakota's nursing homes and other long-term care facilities are bracing themselves for diminished funding at the beginning of next year.
CMS reports success in reducing overuse of antipsychotic drugs; patient advocates skeptical
The CMS says it has surpassed its goal for reducing the use of antipsychotic medications in nursing homes. Patient advocates, however, are expressing skepticism over the claim.
Long-term care costs continue to rise
Long-term care grew more expensive again this year, with the cost of the priciest option, a private nursing home room, edging closer to $100,000 annually. Americans are paying more for other care options like home health aides and assisted living...
U.S. economy adds 160,000 jobs in April
The U.S. economy added 160,000 jobs in April, underwhelming many economists, but the total would have been lower had it not been for the relentless hiring that continues throughout healthcare. The healthcare industry created 44,200 jobs last month,...

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