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Ultraviolet (UV) radiation is among the most prevalent environmental factors that influence human health and disease. Even one hour of UV irradiation extensively damages the genome. To cope with resulting deleterious DNA lesions, cells activate a multitude of DNA damage response pathways, including DNA repair. Strikingly, UV-induced DNA damage formation and repair are affected by chromatin state. When cells enter S phase with these lesions, a distinct mutation signature is created via error-prone translesion synthesis. Chronic UV exposure leads to high mutation burden in skin and consequently the development of skin cancer, the most common cancer in the United States. Intriguingly, UV-induced oxidative stress has opposing effects on carcinogenesis. Elucidating the molecular mechanisms of UV-induced DNA damage responses will be useful for preventing and treating skin cancer with greater precision. Excitingly, recent studies have uncovered substantial depth of novel findings regarding the molecular and cellular consequences of UV irradiation. In this review, we will discuss updated mechanisms of UV-induced DNA damage responses including the ATR pathway, which maintains genome integrity following UV irradiation. We will also present current strategies for preventing and treating nonmelanoma skin cancer, including ATR pathway inhibition for prevention and photodynamic therapy for treatment. This article is protected by copyright. All rights reserved.BACKGROUND As the issues of incivility, lateral and horizontal violence, and bullying continue in nursing, strategies are needed to address these disruptive behaviors. Educational activities raise awareness of these issues and can improve the ability to reduce the frequency and overall impact of incivility. METHOD This study used a pretest/posttest quasiexperimental mixed-methods design to improve dialogue and interpersonal engagement and to create behavioral change. The Workplace Civility Index (WCI) was used to measure interventional success. RESULTS WCI scores improved significantly (p less then .00001) for the experimental group postintervention. In contrast, the WCI scores decreased significantly for the control group (p = .000227). Within the experimental group, all participants noted the successful use of a positive conflict management strategy after the educational intervention. CONCLUSION Although further research is recommended, this study provided evidence to support the efficacy of an asynchronous provider-directed, learner-paced e-learning educational activity in decreasing incivility and increasing perceived comfort level during critical conversations between nurses. [J Contin Educ Nurs. 2020;51(3)138-144.]. Copyright 2020, SLACK Incorporated.BACKGROUND Resilience is a characteristic and skill that nurses can learn. This study examined the current state and influencing factors of nurse resilience and nurse perceived job-related stressors. METHOD This cross-sectional survey study was conducted at a university-affiliated hospital in China between May and August 2018. The Connor-Davidson Resilience Scale was used to measure nurse resilience. RESULTS A total of 2,981 nurses participated in the study, with an average resilience score of 61.35 ± 13.12. Nurse resilience was significantly correlated with age, years of employment, clinical rank, and education (p less then .05). Main job-related stressors included frequent inspections and examinations, heavy workload, mandatory overtime, and low wages. CONCLUSION The participants had resilience scores that were lower than in the general public in the United States and China, as well as in nurses in developed countries. Selleckchem Dihydroartemisinin This study indicated a need for hospital leaders to find ways to reduce nurse work-related stress. Building nurse resilience should be an important focus for leaders. [J Contin Educ Nurs. 2020;51(3)132-137.]. Copyright 2020, SLACK Incorporated.BACKGROUND Evidence suggests a direct correlation between high levels of staff engagement and teamwork improves quality outcomes for the organization. METHOD This evidence-based change of practice project applied the elements of a professional practice model in a medical-surgical telemetry unit to measure the effect on nurse engagement and teamwork. RESULTS Implementation of a professional practice model resulted in improved engagement on the unit, an improved culture of teamwork, a decrease in the number of patient falls, and an increase in staff satisfaction. CONCLUSION The implementation and enculturation of a professional practice model demonstrate the intent to capture the hearts and minds of nurses and create an environment in which nurses are engaged and a culture of teamwork exists. An engaged workforce helps encapsulate a safe, efficient, and effective environment not only for nurses but also for their patients. [J Contin Educ Nurs. 2020;51(3)124-131.]. Copyright 2020, SLACK Incorporated.Diabetes self-management education and support (DSME/S) has been demonstrated as an effective intervention and a billable service; however, DSME/S has yet to be successfully translated and diffused into mainstream practice. This project sought to improve glycemic control (measured by A1C or fasting blood glucose [FBG]) and quality of life (QOL) of Medicare patients age 65 years and older with type 2 diabetes (T2DM) using DSME/S. DSME/S included information sharing between patients and providers, psychosocial support, behavioral support with lifestyle modification, multi-disciplinary integration, and care coordination. Patient-specific data were compared before and 4 weeks after project implementation. Use of DSME/S increased by 15% (p less then .005). Participants demonstrated a statistically significant decrease in mean FBG and a statistically significant increase in QOL. This project demonstrated the successful translation of evidence related to DSME/S into practice through improving diabetes care and promoting continuing education for all of the providers. [J Contin Educ Nurs. 2020;51(3)119-123.]. Copyright 2020, SLACK Incorporated.BACKGROUND Previous studies of nurses' critical thinking skills that included demographic characteristics as determinants have been inconclusive. This study explored demographic determinants of critical thinking skills among nurses from public hospitals in Peninsular Malaysia. METHOD This cross-sectional study included 549 nurses recruited via multistage cluster sampling. Nurses completed the demographic questionnaire and Health Sciences Reasoning Test (HSRT). RESULTS The majority of respondents failed to demonstrate critical thinking skills with a mean overall HSRT score of 13.8 (SD = 3.4). Educational qualifications (p = .003) and clinical specialties (p = .022) were significantly related to nurses' critical thinking skills. Years of clinical experience, age, and job ranking were not significant CONCLUSION The findings indicate a need to address the present curriculum in nursing education and to reinforce critical thinking skills in the nursing workforce. Future research on how nurses in Malaysia acquire critical thinking skills is needed.
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