Notes

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Gestational diabetes mellitus (GDM) complicates 6% to 8% of pregnancies and up to 50% of women with GDM progress to type 2 diabetes mellitus (DM) within 5 years postpartum. Clinicians have little guidance on which women are most at risk for DM progression or when evidence-based prevention strategies should be implemented in a woman's lifecycle. To help address this gap, the authors review identifiable determinants of progression from GDM to DM across the perinatal period, considering prepregnancy, pregnancy, and postpartum periods. The authors categorize evidence by pathways of risk including genetic, metabolic, and behavioral factors that influence progression to DM among women with GDM.Operating room nurses often face acute or chronic back and low back pains, shoulder and neck injuries. In recent years, the use of complementary and alternative treatment methods has been increasing due to the fact that pharmacological treatment cannot control the pain in general, and its various side effects and cost. The aim of this study was to investigate the effect of foot reflexology on low back pain of operating room nurses. This quasiexperimental study was conducted with 38 operating room nurses. The nurses in the experimental group were given a 30-minute reflexology protocol once a week for 4 weeks and their pain levels were assessed again at week 5. The control group nurses did not receive any intervention. Data were collected using a demographic information form and a visual analog scale (VAS). The low back pain of the nurses in the reflexology group decreased significantly at week 5 compared with week 1, whereas the severity of low back pain of the nurses in the control group did not change between weeks 1 and 5. There were no statistically significant differences between the groups in terms of the mean VAS pain score at week 1. However, the nurses in the reflexology group had significantly lower VAS pain mean scores at week 5 than the control group. In this study, reflexology significantly reduced the pain of nurses who had low back pain. Therefore, reflexology might be useful in controlling low back pain of operating room nurses.Traditionally, underrepresented racial and ethnic groups experience marginalization, leading to inequities and disparities in health and health care. learn more A holistic approach to care delivery can help providers meet a culturally diverse patient population's unique healing needs. A systematic assessment of nurses' cultural competency practice was conducted in Pennsylvania to reveal opportunities and provide direction for holistic, culturally competent health care services. This exploratory cross-sectional descriptive study used the Cultural Competence Education and Awareness Survey (CCEAS) to examine cultural competence practices of registered nurses employed in the state of Pennsylvania. A total of 1246 registered nurses completed the survey. Respondents expressed a strong desire for cultural competency. Education and organizational infrastructure to facilitate cultural competency could be improved. Health care leaders and policy makers at all levels should explore opportunities to strengthen nurses' culturally competent practices through ongoing professional-development activities and enhanced organizational infrastructure.This study aims to explore how the families of patients with cancer respond to and act toward complementary and alternative medicine (CAM) use. A qualitative research design based on grounded theory was adopted in this study. Semistructured and face-to-face in-depth interviews were conducted. Each participant was involved in a one-to-one individual interview. Five categories emerged regarding how the families of patients with cancer responded to and acted toward CAM use purposes of using CAM, CAM use between patients and families, role of family caregivers, actions when using CAM, and seeking religious practice. The core category following coding emphasized the paramount importance of patients' comfort. The findings revealed that the families of patients with cancer may respond and act differently regarding patients' use of CAM. During this process, patients may not inform family members that they are using CAM. Health care professionals should consider this in their interactions with family members.
No validated assessment tools are available to evaluate patient-reported outcomes specifically related to submental fat (SMF).

To develop and validate scales measuring the severity (Patient-Reported SMF Rating Scale [PR-SMFRS]) and psychological impact (Patient-Reported SMF Impact Scale [PR-SMFIS]) of SMF.

A literature review, content validation interviews (concept elicitation [n = 29] and cognitive debriefing [n = 15]) in adults with SMF, and expert interviews (n = 3) were conducted to develop the PR-SMFRS and PR-SMFIS. Psychometric validity (acceptability, reliability, and validity) for the PR-SMFRS and PR-SMFIS was assessed using data from 1 phase 2 and 5 phase 3 ATX-101 studies in patients with excess SMF.

The PR-SMFRS was constructed as a single-item, 5-point rating of the SMF amount/size. The PR-SMFIS was constructed as a 6-item scale, with an 11-point numeric rating for each item. Both scales demonstrated acceptable psychometric properties (test-retest reliability and internal consistency). The anchor-based minimally important difference analysis suggests a 1-point improvement on the PR-SMFRS (scale of 0‒4) and a 3-point improvement on the PR-SMFIS (scale of 0‒10) represent clinically meaningful change.

The PR-SMFRS and PR-SMFIS are reliable, valid instruments for assessing the severity and psychosocial impact, respectively, of SMF and detecting clinically meaningful change with intervention.
The PR-SMFRS and PR-SMFIS are reliable, valid instruments for assessing the severity and psychosocial impact, respectively, of SMF and detecting clinically meaningful change with intervention.
The purpose of this review is to summarize the complex cellular interactions of aspirin-exacerbated respiratory disease (AERD) and how these interactions promote pathogenic mechanisms of AERD.

In addition to characteristic changes in eicosanoid levels, recent studies have identified increases in alarmin cytokines (IL-33, thymic stromal lymphopoietin) as well as activated innate lymphoid and plasma cell populations in samples from AERD patients.

Patients with AERD typically demonstrate high levels of proinflammatory eicosanoids including cysteinyl leukotrienes (CysLTs) and prostaglandin D2 (PGD2) and hyporesponsiveness to prostaglandin E2 (PGE2). CysLTs are released by mast cells, eosinophils, and adherent platelets and promote epithelial release of IL-33, which activates mast cells and group 2 innate lymphoid cells (ILC2s) in concert with CysLTs. TSLP induces PGD2 release from mast cells which activates and recruits eosinophils, basophils, Th2 cells, and ILC2s via CRTH2. In turn, ILC2s and other cell types produce Th2 cytokines IL-4, IL-5, and IL-13 that, along with CysLTs and PGD2, promote bronchoconstriction, eosinophilic tissue inflammation, and mucus production.
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