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Gastrointestinal (GI) symptoms including nausea, vomiting, diarrhea, constipation, abdominal discomfort/pain, and heartburn are ubiquitous and as such are often the focus of nursing interventions. The etiologies of these symptoms include GI pathology (e.g., cancer, inflammation), dietary factors (e.g., lactose intolerance), infection, stress, autonomic nervous system dysregulation, medications, as well as a host of diseases outside the GI tract. This review focuses on a common condition (irritable bowel syndrome [IBS]) that is linked with both bowel pattern and abdominal discomfort/pain symptoms. Family and twin studies give evidence for a role of genetic factors in IBS. Whether genes are directly associated with IBS or influence disease risk indirectly by modulating the response to environmental factors remains unknown at this time. Given the multifactorial nature of IBS, it is unlikely that a single genetic factor is responsible for IBS. In addition, gene–gene (epistatic) interactions are also likely to play a role. Four genes coding for proteins involved in neurotransmission (i.e., the serotonin reuptake transporter [SERT], tryptophan hydroxylase [TPH], alpha
Climate change has been labeled the greatest threat to public health and to global health in the 21st century. Addressing climate change has also been reframed as the greatest opportunity for global health in the 21st century, providing a more proactive lens through which to plan and implement actions. Significant climate change impacts to human health are numerous and mounting, including the direct effects of heatwaves, thermal stress and changed frequency or intensity of other extreme weather events. Climate change has been termed a complex public health issue affecting all areas of nursing practice dealing with individuals, families, communities, and the national health arena, and is therefore deserving of inclusion into nursing curricula throughout the entirety of prelicensure coursework. Nursing education programs that include this content will better prepare future nurses to face projected environmental challenges to human health.
Significant maternal, fetal, and newborn morbidity and mortality can be attributed to complications of pregnancy. There are direct links between perinatal complications and poor fetal/newborn development and impaired cognitive function, as well as fetal, newborn, and maternal death. Many perinatal complications have pathophysiologic mechanisms with a genetic basis. The objective of this chapter is to focus on perinatal genomics and the occurrence of two specific complications: preterm birth and dysfunctional placental phenotype. This chapter includes discussions of genetic variation, mutation and inheritance, gene expression, and genetic biomarkers in relation to preterm birth, in addition to the impact of maternal tobacco smoke exposure on placental phenotype. The concept of epigenetics is also addressed, specifically the regulation of gene expression in the placenta and fetal origins of adult health and disease. There is great potential for nurse-researchers to make valuable contributions to perinatal genomics investigations, but this requires perseverance, increased genetics-based understanding and skills, as well as multidisciplinary mentorship.
Simulation pedagogy and the operations of simulation-based experiences have become an integral part of healthcare education. Academic and healthcare institutions constructed simulation centers or dedicated simulation spaces to provide simulation-based experiences for multiple health professions. Architectural designs resemble acute care settings that have the flexibility to change or include virtual reality and enhanced technology. Professional organizations have standards of best practice, credentialing requirements, and accreditation standards that support the need for high-quality, high-fidelity simulation experiences. Within healthcare education, simulation operation has become a specialty in itself that requires knowledge and experience of healthcare, education, and simulation pedagogy (INACSL Standards Committee, 2017). Simulation center administration needs an understanding of personnel management, including standardized patients (SPs), staff, faculty, and learners, as well as knowledge of budgeting, revenue streams, and technology. Personnel with unique skills and knowledge in engineering, healthcare, or information technology are required to support the simulation activities. Resources that manage inventory, supplies, equipment assets, and audiovisual requirements will increase efficiency and enhance fiscal responsibility. Technology assets such as high-fidelity human patient simulators can be used to enhance high-quality simulation, while audiovisual and data capturing software can be used for assessment, evaluation, and quality improvement. Simulation operations provides the infrastructure that supports the daily activities of simulation-based education.
- Go to article: The Impact of the Political and Policy Cultures of Washington, DC, on the Affordable Care Act