Nurses in distress
Nurses leaving hospitals because of ethical concerns
A study conducted by the University of Pennsylvania School of Nursing has found that one-quarter of practicing nurses and social workers (1,215 in all) experience "moral distress" that causes them to want to leave their current positions. Issues causing moral distress include protecting patients' rights, supporting them through difficult end-of-life decisions, and fairly distributing resources. Such issues led the study participants to feel powerless (32.5%), overwhelmed (34.7%), frustrated (52.8%), and fatigued (40%).
The study notes that the nurses' desire to leave is in part fueled by experiencing more "ethical stress" and inadequate institutional support for dealing with ethical decisions, as well as a perception of little respect for their profession. Only 58.3% of the nurses and social workers surveyed reported that "members of my profession and physicians respect each other" and only 55.4% indicated there was trust among nurses and social workers and physicians.
Nearly two-thirds of the participants reported facing ethical issues over which they have no control; nearly one-quarter report having received no ethics training. The study suggests investing in institutional ethics resources and establishing a climate of respect as ways to possibly increase job satisfaction and job turnover.
Down syndrome
Study links extra protein with lower incidence of cancer
A study published in the journal Nature provides a possible reason why people with Down syndrome develop cancer at a lower rate than the general population. An extra copy of chromosome 21 is the cause of mental retardation and distinct facial and physical features in people with Down syndrome. This extra chromosome also provides an additional source of a protein produced by the gene Ets2, which is found on chromosome 21. This protein helps keep tumors from growing.
The study, done on mice that were genetically engineered to produce extra amounts of Ets2, showed that the more Ets2 the mice had, the less likely they were to develop cancer. The extra protein produced by Ets2 will be further studied to see if it could be useful in the development of new cancer drugs.
Medication effects
Common drugs trigger most ED visits by older adults
Adverse effects of warfarin, insulin, and digoxin were responsible for about 58,000 emergency department (ED) visits a year in the U.S. by adults age 65 and older. That's a full third of all ED visits in the U.S. by seniors who had adverse reactions to medications.
The biggest problem for older people taking these drugs is the fluctuating nature of dosing and the need to work with the health care provider to get the dose just right. Warfarin doses are based on international normalized ratio results; insulin doses are based on blood glucose levels; and digoxin doses are based on the patient's age, body weight, and renal function. Doses for each of these drugs are frequently adjusted based on the test results. This information is a reminder that health care providers and patients must work to do the best job they can in managing these common medications.
Did you know?
Restless legs syndrome may cause cardiovascular problems
According to a study published in the January 1, 2008 issue of Neurology, people with restless legs syndrome (RLS) face twice the risk of a stroke or heart disease compared to people who don't have the condition. A neurologic disorder affecting 5% to 10% of adults in the United States, RLS is characterized by restlessness and a need to move the legs; symptoms occur mainly at night and can interfere with sleep. Most people with RLS have up to 300 periodic leg movements a night, which are associated with increases in blood pressure and heart rate. They also suffer from sleep deprivation, which has been associated with cardiovascular disease.
The study suggests that RLS has indications beyond just symptoms, and the data reinforce other studies that have linked disrupted sleep and arousals with hypertension and heart disease.