AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000410348.26405.4b
In the News

Clinical News

Nelson, Roxanne

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Abstract

Editor's note: Each January AJN examines the major stories affecting nurses and health care during the previous year. This year's top stories aren't too different from those we highlighted last January: the continuing debate over the Patient Protection and Affordable Care Act and how to fix the floundering economy continue to top our list. And while we hoped that Congress would move past its partisan squabbling to address these incredibly important issues, it didn't happen, even among members of the bipartisan deficit “super committee,” which failed to find a compromise solution to reduce the deficit. For nursing, it was all about whether the Institute of Medicine's Future of Nursing report would create change. Clinical news shows that consumers are still wary of vaccines and confused about screening guidelines; on a global level, the focus seems to have shifted from AIDS to noncommunicable diseases.

Vaccines. Despite the debunking of the fraudulent 1998 study linking autism with the measles, mumps, and rubella vaccine and a recent Institute of Medicine report showing that the risk of adverse events from vaccines is low, fears surrounding vaccines linger and may be affecting vaccination rates. Last year, nearly 200 cases of measles had been reported in the United States as of August, the highest number since 1996, and most occurred in the unvaccinated (see http://1.usa.gov/qLhL1s for more from the Centers for Disease Control and Prevention). Europe reported more than 26,000 cases from January through July of 2011, according to the World Health Organization (http://bit.ly/tmd6CK ), and outbreaks in other regions of the world are a growing concern.

Backlash against human papillomavirus (HPV) vaccination in girls continued, particularly over making it a requirement for school attendance, with politicians entering the fray despite the vaccine's track record in terms of safety and HPV prevention. The recent Centers for Disease Control and Prevention recommendation that boys receive the vaccine hasn't yet met with as much resistance, although reports of opposition are beginning to emerge (see http://abcn.ws/sj903t for an ABC News report on the topic).

Kandace ONeill with ...
Kandace ONeill with ...
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Traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) in veterans. A new report, Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence (go to http://bit.ly/qPo4OT for the full report), notes that deployments to Iraq and Afghanistan over the past decade and the wartime use of explosive agents accounted for almost a tripling of TBIs in U.S. veterans between 2000 and 2010. Better acute care for TBI has led to greater survival, yet a stronger focus on cognitive—not just physical—rehabilitation is needed to improve functional status and decrease disability. And all combat veterans—with or without TBI—are at risk for PTSD, which occurs in as many as 20% of those returning from Iraq and Afghanistan, according to the U.S. Department of Veterans Affairs (http://1.usa.gov/1P2CqJ). With the continuing withdrawal of U.S. troops from Iraq, nurses are likely to see more such patients across many health care settings.

Prostate cancer screening. A draft of a recent guideline statement by the U.S. Preventive Services Task Force (USPSTF) recommending against routine screening for elevated prostate-specific antigen (PSA) levels continues to be controversial, like the task force's 2009 recommendation against routine mammographic screening in women younger than 50. The USPSTF concluded that PSA-based screening results in little or no reduction in prostate cancer–specific mortality and is associated with harms related to subsequent evaluation and treatments. (The final recommendations haven't yet been released.)

John Barnes incurred...
John Barnes incurred...
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Noncommunicable diseases. In an effort to curtail the alarming growth in the prevalence of chronic noncommunicable diseases, the United Nations held a high-level meeting on the topic, only the second of its kind. Attendees called for a multipronged strategy focused on reducing the risk factors behind the four major categories of chronic noncommunicable disease: cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes. For more on the meeting and the declaration, see http://bit.ly/kqqPNq.

Vitamins. Further analysis of the Selenium and Vitamin E Cancer Prevention Trial, published in the October 12, 2011, JAMA found that vitamin E supplements significantly increased the risk of prostate cancer. The underlying reasons for this result remain unknown.

Photo by Masaru Goto...
Photo by Masaru Goto...
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Somewhat more controversial was a report in the October 10, 2011, Archives of Internal Medicine based on data from the Iowa Women's Health Study, which said that vitamin and mineral supplements might increase the risk of death in older women. Although the story was sensationalized by the media, the study actually showed no cause and effect. The methodology has been criticized, and data regarding nutritional status, detailed information of supplements, and cause of death were insufficient.—Roxanne Nelson, Gail M. Pfeifer, MA, RN, news director

© 2012 Lippincott Williams & Wilkins, Inc.

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