As a result of the vaccines discovered in the 20th Century, parents and many healthcare providers of the 21st Century have limited or no experience with the devastating effects of diseases such as polio, smallpox or measles. Fear of disease has shifted to concerns regarding vaccine safety. Scientific evidence has refuted many of the misconceptions regarding vaccine safety; however, parental refusal of vaccines is increasing. Here we review six of the most prevalent controversies surrounding vaccine safety: the proposed causal relationship between receipt of the measles-mumps-rubella vaccine and autism; thimerosal as a potential trigger for autism; religious objection based on some vaccine viruses being grown in cell lines from aborted fetal tissues; parental worries that use of the human papillomavirus vaccine may lead to youth promiscuity; fears regarding the purported association between pertussis vaccination and adverse neurological outcomes; and concerns regarding too many vaccines overloading or weakening the infant immune system. Healthcare providers are ideally positioned to correct these misconceptions, but they must recognize and acknowledge parents' concerns, educate themselves on the latest scientific research that addresses these, and dedicate sufficient time to discuss vaccine safety with worried parents.

Background: The surgeon general states that skin cancer is a key public health problem. Skin cancer is highly preventable; however, it is the most commonly diagnosed cancer in the United States. Purpose: The purpose of this scholarly project was to increase the skin cancer knowledge and lesion identification among primary care nurse practitioners. Methods: A descriptive survey using a convenience sample of current members of the Nebraska Nurse Practitioners Association was administered to determine baseline knowledge of skin cancer. This was followed by a 15-minute online educational program. A posttest was then administered. The data were collected using SurveyMonkey.com, and a pairwise comparison was completed. The program was available online for 9 weeks with one reminder at 4 weeks. This was approved by Creighton University Institutional Review Board as an exempt study. Results: Approximately 350 surveys were distributed to members of Nebraska Nurse Practitioners via e-mail with 14 respondent; three completed only the pretest and one completed only the posttest. There were 10 who completed the entire program. Findings: Ten of ten respondents improved their overall scores from pretest to posttest. A paired t test was used, and on average, subjects improved their scores by 25% (p G .0001). The evaluation indicated that 70% of respondents were likely to change their practice because of participating in this program. Conclusions: This study revealed that nurse practitioners can increase their skin cancer knowledge and skin lesion identification after a brief online educational program. A larger sample would be needed to be able to generalize these findings.

Background and Purpose: Patients with severe obstructive sleep apnea (OSA) have an almost 4-fold higher odds of resistant hypertension than those with less severe OSA. Obstructive sleep apnea screening practices in primary care are deficient. Additional study is needed regarding the value of OSA screening in hypertensive adults who present to the primary care clinic. Methods: This was a convenience sample of adults with hypertension from a rural primary care clinic in Iowa. Staff identified patients who met the inclusion criteria for the project. The STOP-Bang Questionnaire was used to screen the patients for OSA. Providers subsequently used discretion as to ordering polysomnography (PSG). Conclusions: Thirty-two patients were screened over a 3-month time period. All of the men included in the study scored either high or intermediate risk for OSA. Forty percent of the study participants scored high risk for OSA, with 33% of those participants referred for PSG. At project conclusion, three participants had undergone PSG testing, and all were diagnosed with sleep apnea. Implications for Practice: To ensure timely diagnosis and treatment of OSA, primary care providers should consider screening all hypertensive adults for OSA. With compulsory screening and subsequent identification and treatment of patients with OSA, nurse practitioner providers can pave the way in reducing mortality and morbidity associated with OSA, as well as resistant hypertension.

No abstract

No abstract