Measuring high-risk parents' opinions about direct-to-consumer genetic testing for adult-onset inherited cancer syndromes in their adolescent and young adult children

Neither direct-to-consumer (DTC) genetic testing nor predictive genetic testing for adult-onset conditions is recommended for minor children due to ethical concerns and low clinical utility. However, parents with pathogenic variants (PVs) in disease-causing genes may be interested in pursuing genetic testing that includes the familial PV for their children. The Pediatric Testing Attitudes Scale (P-TAS) was previously developed to examine high-risk parents' opinions about pediatric BRCA genetic testing for adult-onset breast/ovarian cancer. Here, the psychometric properties of the P-TAS were examined in a new sample of N = 126 parents (M age = 47.2 years) with PVs in a more complete set of cancer risk genes represented on DTC panel tests. The mean score on the P-TAS was 44 out of a maximum score of 60, indicating that a majority of parents generally held favorable opinions about testing their children for adult-onset inherited cancer syndromes. The internal consistency of the full scale was high (α = 0.91). A factor analysis identified two-component scales, labeled Attitudes and Beliefs (α = 0.93) and Decision Making and Communication (α = 0.83). In a multivariable regression model, P-TAS co-factors accounted for 34% of variance in parental opinions, including the frequency of prior family communication about cancer and the likelihood of utilizing DTC genetic testing with children (R2  = 0.34, p < 0.001). Results suggest that the P-TAS remains a reliable measure to assess high-risk parents' opinions about pediatric DTC genetic testing for adult-onset conditions, with promising validity. Applications of the P-TAS include informing genetic counseling practice, pediatric medical care, and policy guidelines surrounding DTC genetic testing.

Comfort measures for peripheral I.V. catheter placement in children

ABSTRACT

I.V. catheter placement is one of the most common causes of procedural pain in children. Interventions to address this pain are readily available but inconsistently used in practice. The focus of this article is to identify and encourage best practice for pain mitigation in peripheral I.V. catheter placement in children.

Moral Distress Entangled: Patients and Providers in the COVID-19 Era

Moral distress is defined as the inability to act according to one’s own core values. During the COVID-19 pandemic, moral distress in medical personnel has gained attention, related to the impact of pandemic-associated factors, such as the uncertainty of treatment options for the virus and the accelerated pace of deaths. Measures to provide aid and mitigate the long-term pandemic effect on providers are starting to be designed. Yet, little has been said about the moral distress experienced by patients and the relational and additive effect on provider moral distress. Pandemic-associated factors affecting moral distress in patients include the constraining effects of isolation on spiritual and religious traditions as well as the intentional separation of patients from their families. This paper will explore the idea that patients are suffering their own moral distress and further how this impacts the intensity of moral distress experienced by the providers—nurses and physicians. The paucity of research in this area with the implications on patient’s distress, decision making, and distress experienced by providers compels further investigation and analysis.

Visual intelligence education as an innovative interdisciplinary approach for advancing communication and collaboration skills in nursing practice

BACKGROUND

Recognizing the relationship of keen observation to communication, critical thinking, and leadership in evidence-based literature, educators have expanded the use of art museums to augment visual intelligence skills. The purpose of this pilot intervention was to evaluate an innovative, interdisciplinary approach for integrating visual intelligence skills into an advanced communications and collaboration course.

METHOD

Collaborating with museum educators, the intervention for doctoral students was conducted at the National Gallery of Art. The aims were to explore and evaluate observation skills, use of intentional language in communication, impact of visual intelligence on perception, and role of visual intelligence with empathy.

RESULTS

Descriptive and nonparametric statistics highlighted significant differences in pre- to post-assessment scores related to the expansiveness of intentional visual observation, alternate views, perception and empathy, suggesting that visual intelligence training's impact can be identified and evaluated.

CONCLUSION

Healthcare providers' ability to communicate effectively, including observing, listening, explaining, and empathizing, significantly impacts healthcare outcomes and patient perceptions of satisfaction. All educators have access to a variety of two-dimensional art and the opportunity to implement interdisciplinary learning experiences to enhance visual intelligence. The intervention was considered a successful new learning modality for advanced communications skills and was integrated into the curriculum.

Animal performance and meat quality in cull cows with early weaned calves in Argentina

Early weaning of calves (60 days old) is adopted in cow-calf operations for its high reproductive response. The objective of this research work was to find how age classes are related to beef quality in early weaning cull cows. Twenty four cows were grouped in four different age classes (teeth and number of calves produced) from two teeth and no calf produced, up to 12 years and 7 calves produced. All cows grazed a perennial pasture based on alfalfa and fescue. There were differences (P<0.05) in final weight (younger cows being lighter) but no other differences could be found during field conditions or in abattoir data (carcass weight and yield, top value hindquarter cuts weight and carcass percent). No differences (P>0.05) could be found in meat quality attributes except for moisture, protein and fat yellowness. Differences (P<0.05) in sensory attributes could only be found in connective tissue.

Prevalence of deep venous thrombosis in the lower extremities of children in the intensive care unit

PURPOSE

To determine the prevalence of lower extremity deep venous thrombosis (LE-DVT) in children who spent at least 72 h in the pediatric intensive care unit (ICU).

MATERIALS AND METHODS

Children up to the age of 17 years who spent at least 72 h in the ICU underwent lower extremity venous ultrasound at the end of their stay. Prevalence range for the sample size was calculated with a confidence interval of 95%.

RESULTS

Among 76 children who spent 3-141 days in the ICU, the prevalence of acute (and silent) DVT was 4% (confidence interval 0-9%). All three affected children had femoral venous catheters in that leg during their ICU stay (17 unaffected children also had catheters).

CONCLUSION

Children in an ICU setting are at significantly lower risk for thrombosis than adults in the same setting.