Glycoprotein IIb-IIIa receptor inhibition with eptifibatide in percutaneous intervention for symptomatic peripheral vascular disease: the circulate pilot trial.

The benefits of glycoprotein (GP) IIb-IIIa inhibitors in percutaneous coronary intervention are well established, but the experience with these agents in the setting of peripheral interventions is limited. In this single-center pilot trial, the safety and feasibility of adjunctive treatment with the GP IIb-IIIa inhibitor eptifibatide (INTEGRILIN, Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts, and Schering-Plough Corporation, Kenilworth, New Jersey) was evaluated in 85 patients undergoing percutaneous transluminal angioplasty or stenting for severe claudication or critical limb ischemia. Eptifibatide treatment was safe, with low rates of major bleeding (3.5%) and thrombocytopenia (1.2%); one patient developed a post-procedure compartment syndrome requiring fasciotomy. The procedure was technically successful (defined as <30% residual stenosis or >50% increase in vessel diameter) in 84 of 85 (98.8%) patients. None of the patients required target vessel revascularization (TVR) during hospitalization, and only 1 patient (1.2%) required TVR within 30 days. These results demonstrate that adjunctive use of eptifibatide during percutaneous peripheral intervention is safe and supports further studies to establish the potential efficacy of GP IIb-IIIa inhibitors in this setting.     

Children's mental health and school success.

An integrative review of literature was undertaken to examine the impact of children's mental health on their school success. The literature confirmed a confluence of problems associated with school performance and child and adolescent mental health. Poor academic functioning and inconsistent school attendance were identified as early signs of emerging or existing mental health problems during childhood and adolescence. Among the goals of school nursing is to provide a process for identification and resolution of students' health needs as they affect educational achievement. Thus, it is within the scope of practice and goals of school nursing to also address children's mental health needs, as they affect school performance. This review of literature supports the conclusion that school nursing is well positioned to respond to the need for mental health promotion, illness prevention, and early intervention related to children's mental health.     

Epigenetics,maternal prenatal psychosocial stress,and infant mental health

This paper provides a summary of literature on epigenetic effects and infant health outcomes of maternal psychosocial stress during pregnancy. A search of literature yielded a large body of publications between 2008 and 2018. Relevant articles were selected, and additional sources were located from ancestry searches of reference lists. Results implicate maternal prenatal stress as a source of epigenetic mechanisms that affect fetal brain development and program risk for emotional dysregulation and mental disorders over a lifetime and across generations. Implications for nursing practice are explored at multiple levels of policy advocacy, public education, primary prevention, screening and intervention.     

The influence of social‐developmental context and nurse visitation intervention on self‐agency change in unmarried adolescent mothers

Pregnancy among unmarried adolescents has been linked to negative personal control beliefs. In contrast, self‐agency beliefs about control over future possibilities have been linked to delay in subsequent childbearing. In this secondary analysis, we examined factors associated with self‐agency change in 429 unmarried adolescent mothers from intervention and control groups of a nurse home visitation study. Adolescent mothers who participated in a sustained relationship with a nurse made greater gains in self‐agency than did control group mothers (p = .034). Adolescents with lower cognitive ability who were behind their age‐appropriate grade level in school made the greatest self‐agency gains. © 2013 Wiley Periodicals, Inc. Res Nurs Health 36:158–170, 2013     

Testing the relationship between self-agency and enactment of health behaviors

A theoretical review provides a rationale for examining self-agency as a developmental foundation underlying processes of self-regulated change and a potential moderator of intervention effectiveness among participants in a nurse home-visitation program. Self-agency is defined as the conceptual understanding of self as an agent capable of shaping motives, behavior, and future possibilities (Damon & Hart, 1991). Availability of a sample of 186 mothers who received nurse home visitation provided an opportunity to test the relationship between participant self-agency and enactment of targeted health behaviors. Self-agency items from the Pearlin Mastery Scale (1978) were used to differentiate mothers who endorsed self-agency from those who did not. Consistent with the theoretical premise, mothers who endorsed self-agency at an established threshold were significantly more likely to enact health behaviors promoted during nurse visitation. Results provide support for the relationship between the development of self-agency and enactment of health behaviors targeted by a nurse home-visitation program.     

Pain,Racial Discrimination,and Depressive Symptoms among African American Women

African American women with osteoarthritis (OA) are at high risk of experiencing pain. They report more pain than non-Hispanic White women and men of other racial/ethnic groups. This pain can limit independence and diminish their quality of life. Despite the detrimental effects that pain can have on older African American women with OA, there is a dearth of literature examining factors beyond the OA pathology that are associated with pain outcomes within this population. The purpose of this study was to examine the relationships between racial discrimination and depressive symptoms with pain intensity in African American women with OA. The sample comprised of 120 African American women, aged 50-80 years, with OA, from Texas and New Mexico. The women completed survey booklets to answer study questionnaires. We used multiple linear regression to test associations between racial discrimination, depressive symptoms, and pain intensity. We tested whether depressive symptoms mediated the relationship between racial discrimination and pain intensity by using bootstrapping. Results indicated that racial discrimination was significantly associated with pain intensity and that this relationship was mediated by depressive symptoms, even after controlling for body mass index, years of education, and length of time with OA. Both depressive symptoms and racial discrimination may be modifiable. If these modifiable factors are addressed in this population, there may be decreased pain in middle-aged and older African American women.