Millstones and milestones No abstract available

Tax incentives for preceptors of nurse practitioner students in Massachusetts: A potential solution: Corrigendum No abstract available

Finding the evidence: Screening of Military Family Research, 2014–2017 Of 1.3 million active duty service members, the majority have family responsibilities; 54.3% are married, and 41.2% have at least one child. The authors sought to determine existing areas of focus in military family research and to identify areas that are currently understudied. The authors queried four literature databases from January 2014 to May 2017, and 2,502 articles were identified in the initial catchment. All 595 article abstracts that met inclusion criteria were sorted into one or more of 12 topics. Topics with the highest number of articles included Mental Health and Care (n = 276), Adult/Couple Partner Relationships (n = 247), and Deployment Issues (n = 244). Topics with sparse articles included Maternal/Child & Newborn Health (n = 27), Health Promotion (n = 10), and Special Heath Care Needs (n = 4). The three topics with the highest number of articles reflect interdependent and overlapping themes and showcase the importance of family relationships to the operational readiness of active duty members. The topics with fewer numbers of articles highlight areas where more evidence is needed. Understanding the current evidence allows nurse practitioners to support military families appropriately in real time.

DNA: What's your story? This is a pivotal time in history. We now recognize the implications of our uniquely personal DNA blueprint (i.e., genetics/genomics) for health and illness, and scientific research is rapidly unraveling the secrets of what that blueprint personally means to each of us. Listening to what patients have to say about the use of DNA in their health care can strengthen your role in creating a new paradigm for education and service delivery. Stories are an amazing way to reach out, connect, and learn from others about what they are going through. Stories are important in highlighting the relevancy of DNA in clinical care for patients and providers. The power and potential of the patient voice is something I have been striving to capture as the reality of genomic healthcare unfolds (DNAandU.org). The knowledge base provided by DNA stories has great potential, but only if representative of the voices of many. Nurse practitioners have an important role in accessing stories to learn, to teach, to plan for the future, and to inspire possibilities.

Using therapeutic essential oils to support the management of anxiety This brief report explores the adjunctive use of therapeutic essential oils in clinical practice to reduce overall patient anxiety and stress. The use of therapeutic essential oils is becoming increasingly popular among the general population. Studies have validated that these oils have the potential to affect patient health and wellness positively, if used properly in the clinical setting. This report discusses how to incorporate essential aromatic oils safely and efficiently in clinical practice and advocates for more research on the efficacy of aromatic oils to reduce patient anxiety in human populations.

Breast cancer risk assessment: Evaluation of screening tools for genetics referral Background and purpose: The United States Preventative Services Task Force (USPSTF) recommends breast cancer risk-screening tools to help primary care providers determine which unaffected patients to refer to genetic specialists. The USPSTF does not recommend one tool above others. The purpose of this study was to compare tool performance in identifying women at risk for breast cancer. Methods: Pedigrees of 85 women aged 40–74 years with first-degree female relative with breast cancer were evaluated using five tools: Family History Screen-7 (FHS-7), Pedigree Assessment Tool, Manchester Scoring System, Referral Screening Tool, and Ontario Family History Assessment Tool (Ontario-FHAT). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to describe each tool's ability to identify women with elevated risk as defined by Claus Model calculations (lifetime risk ≥15%). Receiver operating curves were plotted. Differences between areas under the curve were estimated and compared through logistic regression to assess for differences in tool performance. Conclusions: Claus calculations identified 14 of 85 women with elevated risk. Two tools, Ontario-FHAT and FHS-7, identified all women with elevated risk (sensitivity 100%). The FHS-7 tool flagged all participants (specificity 0%). The Ontario-FHAT flagged 59 participants as needing referral (specificity 36.2%) and had a NPV of 100%. Area under the curve values were not significantly different between tools (all p values > .05), and thus were not helpful in discriminating between the tools. Implications for practice: The Ontario-FHAT outperformed other tools in sensitivity and NPV; however, low specificity and PPV must be balanced against these findings. Thus, the Ontario-FHAT can help determine which women would benefit from referral to genetics specialists.

Breast cancer risk assessment: Evaluation of screening tools for genetics referral No abstract available

Use of technology to increase physical activity in female veterans and soldiers aged 19–64 years Background and purpose: Heart disease is the leading cause of mortality for American women, claiming 289,753 lives annually. Research has show that female veterans are more sedentary after separating from service and that mobile apps can assist in increasing physical activity. The purposes of this study were to: 1) implement a mobile application to increase physical activity, 2) compare the exercise data, and 3) determine the sustainability of using a mobile application in female active duty soldiers, military retirees, and veterans with prior service. Methods: A convenience sample of 30 participants, aged 19–64 years, was recruited from the Womack Army Medical Center, Fort Bragg, North Carolina. Active duty soldiers, retired military, and family members are eligible for care at Womack. Six of the participants with prior military service are spouses of active duty and retired military and were included in the sample. The participants documented the type of physical activity and amount of time exercised over 12 weeks using the closed discussion group. Clinically significant differences were demonstrated in individual averages of minutes exercised per week in the group of veterans (n = 4; Z = −0.944, p = .345, r = 0.3) and active duty group (n = 5; Z = −1.826, p = .068, r = 0.65). Conclusions: The study did not demonstrate a statistically significant increase in physical activity using technology. Implications for practice: Mobile technology provides nurse practitioners with tools to empower patients. The use of technology to increase physical activity is relatively new and continues to evolve.

Adjusting to the transition into assisted living: Opportunities for nurse practitioners Background and purpose: Transition from an independent living residence to assisted living (AL) is challenging. The study purpose was to understand such a transition from the perspective of older women. Methods: A hermeneutic phenomenological approach was used to explore how 17 older women living in a Continuing Care Retirement Community, many of whom were recently widowed, experienced this transition. Conclusions: Three major themes emerged from the interviews: preplanning, executing, and adjusting to the transition. Even with facility, family and staff assistance, the transition was challenging, and adjustment was affected when participants had physical or sensory impairments. Implications for practice: Older adult women transitioning to AL settings should be assessed for adjustment to the new setting. Those with sensory, cognitive, emotional, or physical problems will need additional supportive strategies to help with adjustment. With a rapidly expanding population, AL settings offer new opportunities for nurse practitioners to promote the health and well-being of older adults.

A checklist for faculty and preceptor to enhance the nurse practitioner student clinical experience The National Organization of Nurse Practitioner Faculties and the American Association of Nurse Practitioners collaborated to develop a document outlining expectations when establishing clinical experiences for nurse practitioner (NP) students. A literature review explored the beliefs of clinical preceptors and NP faculty in relation to the process of the establishment and completion of successful clinical experiences. From the literature, the development of two guidance checklists addressed the expectations and responsibilities of the NP faculty and clinical preceptor during the clinical placement process. In light of challenges to secure clinical sites for NP students, it is imperative that the clinical placement process is standardized and the communicative pathway between the NP faculty and clinical preceptor improved.