• Paul Levesque posted an update 1 week ago

    On May 26, 2020, the FDA approved nivolumab with ipilimumab and two cycles of platinum-doublet chemotherapy as first-line treatment for patients with metastatic or recurrent non-small cell lung cancer (NSCLC), with no EGFR or anaplastic lymphoma kinase (ALK) genomic tumor aberrations. The approval was based on results from Study CA2099LA (CheckMate 9LA), an open-label trial in which 719 patients with NSCLC were randomized to receive nivolumab with ipilimumab and two cycles of chemotherapy (n = 361) or four cycles of platinum-doublet chemotherapy (n = 358). Overall survival (OS) was improved for patients who received nivolumab with ipilimumab and chemotherapy, with a median OS of 14.1 months [95% confidence interval (CI), 13.2-16.2] compared with 10.7 months (95% CI, 9.5-12.5) for patients who received chemotherapy (HR, 0.69; 96.71% CI, 0.55-0.87; P = 0.0006). Progression-free survival and overall response rate per blinded independent central review were also statistically significant. This was the first NSCLC application reviewed under FDA’s Project Orbis, in collaboration with Singapore’s Health Sciences Authority, Australia’s Therapeutic Goods Administration, and Health Canada. The benefit-risk analysis supports FDA’s approval of nivolumab with ipilimumab and chemotherapy.There is large disparity in the incidence of Type 2 diabetes (T2D) for Asian Pacific Islanders (APIs), one of the fastest growing minority populations in the United States. It is critical to examine biopsychosocial pathways and vulnerability factors that intensify risk for T2D in API. Increasing evidence links chronic stress to poor health outcomes and accelerated development and progression of diseases of aging, such as diabetes. Immigrant populations face unique life stressors, including the challenges associated with the process of adapting to a new environment, new language, and cultural differences. In addition, immigrants experience high levels of psychological distress related to changes of identity and values, loss of support, discrimination, and disempowerment. The purpose of this article is to propose a biopsychosocial framework to explicate potential mechanistic pathways that link cumulative life stress to risk for T2D in the API immigrant population. Unique to the proposed framework is the emphasis on inflammatory processes and accelerated cellular aging (telomere biology). A deeper understanding of biopsychosocial pathways can lead to tailored and targeted interventions to reduce the incidence of T2D in the API immigrant population.

    Comprehensive cognitive rehabilitation teaches strategies to enhance strengths and has been used by nurses to target cognitive problems in chronic conditions. However, to date, no evaluations of web-based cognitive rehabilitation, based in empowerment theory, specifically for people with type 2 diabetes (T2DM), have been done.

    The purpose of this study was to analyze a cognitive rehabilitation intervention for people with T2DM, using qualitative content analysis and 10-second event coding to determine to what extent the classes reflected empowerment theory.

    Nineteen adults with T2DM and two nurses participated in an 8-week intervention that combined webinar classes with online home-based computer training. Classes were audio recorded and 10-second event coding was used to calculate nurse-talk ratios. Transcripts were examined using content analysis and compared with the talk ratios.

    Talk ratios ranged from 40% to 74% for each class. Qualitative themes included (a) importance of goal setting; (b) pairial outcomes.

    Despite different labels used to refer to different types of nursing theories by different authors, agreements were made on three major types of theories by level of abstraction. learn more The purpose of this analysis was to discuss the characteristics of the three major types of nursing theories by level of abstraction that were published in refereed journals and to propose directions for future theoretical development in nursing.

    An integrated literature review was conducted using PUBMED, CINAHL, and PsycINFO. A total of 116 articles were included in this analysis. The retrieved articles were sorted by the type of theories (by level of abstraction), and analyzed in terms of scope, theorizing process, specificity and abstraction, contextual understanding, links to research and practice, and diversity and generalizability. Finally, themes reflecting the characteristics of the three major types of nursing theories were extracted and discussed.

    A total of 17 themes were found. Although most of the themes reflected what were known about these theories, there were three new findings. First, all the grand theories that were reviewed tended to have more specific foci rather than explaining general nature, mission, or goals of nursing. Second, middle-range theories were developed based on various types/levels of theories using various sources for theorizing. Third, situation-specific theories began to be used to generate propositions and tested through statistical and qualitative analyses.

    The efforts to try to link nursing theories to nursing practice need to be continued through further development and evaluation of the theories regardless of the types of theories.

    The efforts to try to link nursing theories to nursing practice need to be continued through further development and evaluation of the theories regardless of the types of theories.Low-income and ethnic/racial minority adults do not often participate in research or may face unique barriers when participating in research, which delays and impedes medical advances for this vulnerable population. This article describes in detail the evidenced-based methods used to enhance recruitment, participation, and retention in a clinical trial at a center serving ethnic/racial minorities and low-income individuals. The article details the partnership with a community outreach center and describes the duties and impact of a community liaison to enhance recruitment, participation, and retention in a randomized controlled trial with a 6-month follow-up. Of the 246 individuals initially recruited for screening, 80 did not meet inclusion criteria with the most common reason for disqualification being meeting criteria for substance use disorder (n = 44). One hundred sixty-six participants qualified for participation. The majority of participants identified as African American (n = 127, 77.1%) and reported an annual individual income under $10,000 (n = 121 (74.