Primary Prevention Practices Research Articles

Sun Protection Policies and Practices in Preschool and Elementary Schools in Andalusia (Spain).

Sun exposure in childhood is a major risk factor for the development of skin cancer as an adult. School children spend much of their time outdoors exposed to ultraviolet radiation during recreational and sports activities. Skin cancer incidence tripled from 1978 to 2002 in Spain. Andalusia, the largest and sunniest region of Spain, lacks data on the sun protection measures taken in schools. To address this deficit, the aim of this study was to determine photoprotection practices and policies in preschools and primary schools in Andalusia. This descriptive study involved the administration of an online questionnaire completed by principals regarding school sun protection policies and practices. Preschool and primary schools were selected from the database of the Ministry of Education of the Andalusian Regional Government. Information of interest included photoprotection policies, students' sun protection knowledge, sun protection measures, relevant curricular content, and availability of shade at the school. A total of 2425 schools were contacted. Of them, 420 schools responded (17.31%), with the highest number of responses received from Malaga (23.8%) and Seville (19.5%) provinces. Of those responding, 67.1% of the schools did not have written sun protection policies. The photoprotection measures reported included mandatory use of a cap or hat (3.3%), use of sunglasses in outdoor areas (30%), and active encouragement of students to use sunscreen (50.7%). Roughly 24% of schools evaluated their shaded areas, with 52.9% reporting insufficient protection for most activities. The study results showed that photoprotection policies and practices in Andalusian schools were mostly insufficient. Given that skin cancer incidence has increased considerably over the last decade, it is important to concentrate on improving primary prevention practices. Additionally, photoprotection programs in schools have been shown to improve children's knowledge, attitudes, and habits regarding photoprotection. Thus, it is essential for Andalusian preschools and primary schools to develop policies and strategies to help reduce children's sun exposure while at school.

Habitudes de prescription de l’activité physique par des médecins cardiologues en Côte d’Ivoire

Regular physical activity (PA) has multiple health benefits that contribute to the prevention and management of many non-communicable diseases such as cardiovascular disease. However, a large proportion of the world's population is not active enough to benefit its health. Despite the potential of physicians to increase the level of PA practice in both primary and secondary prevention, there appears to be little intervention in this direction during medical consultations. What is the situation in Côte d’Ivoire? We conducted a prospective study that focused on the description and analysis of the practice of PA awareness and prescribing of Côte d’Ivoire cardiologist physicians and to examine the extent to which their socio-cultural characteristicsdemographics, their personal PA practices, barriers and needs influenced their PA prescribing in primary or secondary prevention settings. The results showed a high rate of overweight and obesity (64 %) and a low level of PA (40 %). We noted a high rate of locating (90 %) and advising AP (92 %). High blood pressure (98 %) and obesity (94 %) were the major conditions for which physicians prescribed PA. They were mainly about walking (94 %) and through oral counselling (80 %). Among the brakes identified were mainly the lack of knowledge about PA prescribing, lack of consultation time and lack of motivation of patients in 48 %, 44 % and 34 % of cases respectively. In terms of the needs expressed to promote the prescription of PA, it was mainly the personal conviction of the physician of the interest of prescribing an PA (80 %), of the organization of training on the prescription of PA (78 %) and completion of patient handouts (56 %).

Modelos teóricos de promoción de la salud en la práctica habitual en atención primaria de salud

ObjectiveTo understand which theoretical models apply to current primary care practice of primary prevention and health promotion in a sample of primary health centres of seven autonomous regions in Spain according to the various professionals involved. MethodDescriptive qualitative research with the participation of 145 professionals from 14 primary health centres of seven autonomous regions in Spain. Theoretical sampling was used and 14 discussion groups were carried out. Data analysis followed thematic contents analysis procedures and was based on seven health promotion theoretical models at micro-, meso- and macro-level. ResultsCurrent practice of primary prevention and health promotion activities mainly follow intrapersonal models, which focus on assisting the empowerment of patients by means of raising awareness of risk and benefits of behavioural change and on guiding the adoption of the new healthy behaviour. To a lesser degree, the activities of some professionals adhere to interpersonal models, which involve also the family and the health professional. In only a few instances community models of health promotion were used. ConclusionsPrimary prevention and health promotion practice of primary healthcare professionals follow mainly intrapersonal models, few cases use interpersonal models and community models are only occasionally employed. Advance of public participation and community orientation in primary healthcare services is needed.

87 Evolution of Atrial Fibrillation

Abstract Background Atrial Fibrillation (AF) is a common cardiac arrhythmia and a well-established risk factor for stroke with its prevalence increasing with age. AF related strokes are associated with increased mortality and morbidity however the risk of stroke is reduced by almost 70% by oral anticoagulation (OAC). Methods Analysis of data using SPSS allowed us to identify all acute stroke patients admitted in 2018 with AF. We compared data on patients who were admitted with known AF and those who were newly identified with AF and looked at their outcomes. Results 373 stroke patients admitted,of which 108(29%) patients had AF, mean age 79. 68(63%) had known AF and 40(37%) had a new diagnosis of AF. 52(76.5%) of the known AF were on an OAC (11 on warfarin) and 40(78%) on a Non- Vitamin K antagonist oral anticoagulant (NOAC). 16 patients (23.5%) with known AF were not anticoagulated on admission. (Reasons for no OAC-3 had a history of previous intracerebral haemorrhage (ICH). 2 a history of bleeding and 1 a history excess alcohol). 10 patients were on antiplatelet therapy and were subsequently anticoagulated on discharge. 33(48.5%) of the known AF were discharged home versus 15(37.5%) in the new AF cohort and while mortality was higher in the known AF, there were more patients in the new AF cohort 14(35%) that required long term care compared with 3(4%) in the known AF cohort which not only indicates the severity of their stroke but also suggests that if AF had been detected and treated sooner their outcome may have been very different. Conclusion There has been a significant increase in primary prevention practices for AF and this is reflected in the number of stroke patients presenting with known AF on a NOAC, however more needs to be done as there are still patients who have AF that are not being anticoagulated in the community.

A roadmap for a comprehensive control of cervical cancer in Poland: integration of available solutions into current practice in primary and secondary prevention.

In Poland, cervical cancer incidence and mortality still remain considerably higher than in Western European countries or North America. Recent data indicate decreasing trends in women younger than 60 years and stable trends in older women. In this article, we identified obstacles in primary and secondary prevention of cervical cancer in Poland. We analysed local legislation, management structure and organization of cervical cancer prevention in Poland and reviewed solutions available and implemented in other European countries. The main weaknesses include: (i) very low coverage of organized screening; concurrent unregistered opportunistic screening with unknown coverage and high test consumption (ii) suboptimal quality assurance in organized screening and no external quality assurance in opportunistic screening (iii) very low coverage of human papillomavirus vaccination that is not centrally reimbursed (iv) absence of pilot evaluation of (a) interventions that may improve population coverage and (b) performance of new preventive strategies. The proposed solutions are multifaceted and involve: (i) legislative and organizational regulation of cervical cancer screening aimed at comprehensive registration of procedures, data access and quality assurance (ii) pilot testing and implementation of new ways to increase coverage of cervical cancer screening, in particular among older women (iii) pilot evaluation with possible introduction of human papillomavirus-based screening and (iv) inclusion of human papillomavirus vaccination into the reimbursed national immunization program.

Evaluation of A Suicide Prevention Program in Switzerland: Protocol of A Cluster Non-Randomized Controlled Trial

Suicide is a major public health concern, which disproportionally affects young people. Therefore, effective prevention strategies are needed, but there is a dearth of controlled trials on this topic. Our study will evaluate the effectiveness of a suicide prevention program in Switzerland, where data are scarce. It will test whether the prevention program (1) increases knowledge of suicide and awareness of suicidal risks, (2) provides resources to seek/offer help, (3) increases communication skills related to suicide, (4) increases coping skills, (5) is acceptable, and (6) reduces suicidal ideation and psychological distress. The project will be a single-center cluster non-randomized controlled trial designed to compare an intervention group benefitting from the suicide prevention program with a control group. The potential benefits include a better understanding and evaluation of suicide prevention programs, which may lead to improved primary and secondary prevention practices.

Building a Culture of Intimate Partner Violence Prevention in Alberta, Canada Through the Promotion of Healthy Youth Relationships.

This article explores the design and implementation of the Alberta Healthy Youth Relationships (AHYR) Strategy. The AHYR is a province-wide practice and policy change initiative in Alberta, Canada, that aims to prevent intimate partner violence by promoting service provider and systems capacity to support healthy relationships in adolescence and beyond. Developed in 2012 within a broader initiative called Shift: The Project to End Domestic Violence, the design of the AHYR began with work with provincial policy-makers, in order to create a policy climate that championed primary prevention practice. This policy climate subsequently supported the province-wide implementation of three evidence-based/evidence-informed programs that focus on building the skills and capacities required for healthy youth relationships. Through these programs, the AHYR has reached over 62,000 youth in grades 7-9, 900 teachers, 850 parents, and 1300 adults that work with youth across the province. In addition to these three programs, the AHYR also works with larger systems (e.g., policymakers, local funders, post-secondary institutions) to advance primary prevention practice. In this paper, we describe how the AHYR contributed to a culture of intimate partner violence prevention practice in the province by improving the readiness of funders and system leaders, community organizations, and practitioners to support healthy relationships best practices. We also describe how we used process evaluation to explore the potential for practice change and to inform the design of the next iteration of the AHYR. The article concludes with implications for other researchers and practitioners aiming to build a culture of intimate partner violence prevention practice within their province or state.

Use of a Deep Learning-Based Disease Severity Scale for Assessment of Retinopathy of Prematurity Primary Prevention in India

Background: There is an epidemic of retinopathy of prematurity (ROP) in low- and middle-income countries (LMIC) in part due to heterogeneity in adherence to best practices for oxygen monitoring in neonatal care units (NCU). The purpose of this study was to determine whether a deep learning based ROP severity score obtained from fundus images in a telemedicine program could be applied at the population level to compare epidemiologic differences between NCUs in South India. Methods: Fundus photos were obtained from at-risk infants at participating hospitals in the Aravind Eye Hospital ROP telemedicine system. An ROP severity score from 1-9 was calculated for each eye examination using methods previously published. Population (NCU) level ROP severity was compared across hospitals using multivariate linear regression adjusting for demographic risk factors for ROP. Masked ROP technicians assessed adherence to best practices using a quality score (1-5) for oxygen monitoring in each NCU. Findings: Images from initial screening exams of 128 infants at 11 hospitals were analyzed. Mean ROP severity was significantly different between hospitals (P=0.003). In multivariate regression controlling for birth weight, gestational age, and postnatal age, a higher NCU quality score was associated with lower ROP severity (P=0.001). Of note, the NCU with the lowest quality score had the highest ROP severity score (1.6 points above the mean, P=0.001), while the NCU with the highest quality score had the lowest ROP severity score (1.2 points below the mean, P=0.001). Interpretation: We identified variability in ROP severity between NCUs that correlated with best practices for oxygen monitoring. These findings suggest the potential utility of using image-based deep learning not just for patient-level diagnosis, but also for population-level epidemiologic surveillance of primary prevention practices, and may have broader applicability for a variety of medical conditions beyond ROP. Funding Statement: This project was supported by grants R01EY19474, K12EY027720, and P30EY10572 from the National Institutes of Health (Bethesda, MD), by grants SCH1622679, SCH-1622542, and SCH-1622536 from the National Science Foundation (Arlington, VA), and by unrestricted departmental funding and a Career Development Award (JPC) from Research to Prevent Blindness (New York, NY). Declaration of Interests: Michael F. Chiang is an unpaid member of the Scientific Advisory Board for Clarity Medical Systems (Pleasanton, CA), a Consultant for Novartis (Basel, Switzerland), and an initial member of Inteleretina (Honolulu, HI). R. V. Paul Chan is on the Scientific Advisory Board for Visunex Medical Systems (Pleasanton, CA), and a Consultant for Genentech (South San Francisco, CA). Michael Chiang and J. Peter Campbell receive research support from Genentech. J. Peter Campbell, James M. Brown, Susan Ostmo, R.V.P. Chan, Jayaskhree Kalpathy-Cramer, and Michael F. Chiang have a patent application pending on the described technology. All other authors have no conflicts of interest. Ethics Approval Statement: This study was conducted in accordance with Health Insurance Portability and Accountability Act (HIPAA) guidelines, and Institutional Review Board (IRB) approval was obtained at both Oregon Health & Science University and the Aravind Eye Hospital.

Knowledge of cardiovascular disease risk factors and practice of primary prevention of cardiovascular disease by Community Pharmacists in Nigeria: a cross-sectional study.

Background Studies in international literature have shown that Community Pharmacists can make considerable impact in controlling cardiovascular disease risk factors, especially hypertension. In Nigeria, there are no studies on the knowledge of CVD risk factors by Community Pharmacists and their practice of primary prevention. Objective To assess the knowledge of CVD risk factors and practice of primary prevention of CVD amongst Nigerian community pharmacists. Setting Community Pharmacists in Lagos, Nigeria. Methods This cross-sectional study involved 168 Community Pharmacists. Their knowledge of CVD risk factors was assessed with the Heart Disease Fact Questionnaire. Their opportunistic screening practices for CVD risk factors (primary prevention) were also assessed. Main outcome measures Knowledge of CVD risk factors and practice of primary CVD prevention. Results The mean age of the participating pharmacists was 41.7 (± 11.2) years and 87 (51.8%) of them were males. The median number of years of practice was 9.0 (3–15) years. Mean knowledge score was 22.1 (± 3.0) with 154 (91.7%) of the subjects scoring above 70%. An average of 95.5% of the participants correctly identified hypertension, smoking, dyslipidaemia, obesity, physical inactivity and diabetes as CVD risk factors. Eighty-one (48.2%) had good practice of primary CVD prevention. Conclusion: This study shows that Community Pharmacists in Nigeria have very good knowledge level of CVD risk factors and almost 50% of them practised primary prevention of CVD.

HIGH INTENSITY HYPOLIPIDEMIC THERAPY AND DECREASED LEVEL OF LOW DENSITY LIPOPROTEIDES CHOLESTEROL: IS THE APPROACH JUSTIFIED? POINT OF VIEW

The review is focused on the issue of high-intensity treatment. The evidence provided, on efficacy of statins prescription in high intensity regimen to patients with very high cardiovascular risk. Indications outlined for this type of therapy in primary and secondary prevention practice. Problems of tolerability and safety also considered.

The Aetiology of Child Sexual Abuse: A Critical Review of the Empirical Evidence

This paper reports the results of a critical review of empirical evidence relating to the aetiology of child sexual abuse (CSA) published over the last 15 years. The current review found that the psychology, criminal history and prior victimisation of the perpetrator and the gender, disability status, sexuality and family circumstances of the victim are important risk factors for CSA. Offence characteristics such as the offender‐victim relationship, modus operandi of the perpetrator and absence of a capable guardian are also found to be important markers of risk. We make suggestions for future research frameworks and designs, and we discuss the implications of the evidence for future primary prevention initiatives, practice and policy. We use this evidence to make recommendations for the development of child maltreatment theory more generally.‘A critical review of empirical evidence relating to the aetiology of child sexual abuse published over the last 15 years’Key Practitioner Messages Understanding of CSA perpetration is not well advanced and it is likely to be far more complex than currently thought. Intersectionality exists between cultural and sociocultural influences for CSA. The causes and consequences of CSA are both different to and the same as other forms of maltreatment, but we do not yet have sufficiently nuanced evidence to say how much these diverge and converge. The evidence is mixed and difficult to interpret regarding offenders' own childhood experiences of CSA.

Primary prevention and screening practices among long-term breast cancer survivors.

Parallel to increasing survival of breast cancer (BC) patients, a need has arisen to characterize the follow-up required to improve and maintain their health. Our study aimed to assess changes in lifestyle habits over time among the study population, compare compliance rates of selected primary and secondary prevention practices between long-term BC survivors and an age-matched comparison group, and identify factors associated with compliance to these practices. The study population comprised 250 Israeli BC survivors, diagnosed with BC between 1999 and 2003, without evidence of disease after 8-12 years, and 250 women with no cancer history, individually matched to survivors by age and area of residence. Data collection and analysis were conducted during August 2012-June 2015 and included socio-demographic variables, lifestyle habits, health promotion by the family physician, and participation in screening procedures and prevention measures. Higher performance rates of mammography and colonoscopy among BC survivors were observed, as well as a greater likelihood of receiving an influenza vaccine and undergoing a bone mineral density scan (adjusted-ORs: 7.7, 1.48, 1.42, and 2.59, respectively) compared to controls. Factors identified with compliance to selected practices were age, higher levels of education and income, never smoking, and strenuous physical activity. The survivors adopted healthier lifestyles, which were similar to those of women who never had cancer. About 10 years after BC diagnosis, the survivors generally comply with primary and secondary prevention practices.

Work-related rhinitis - Is it always an occupational disease?

Rhinitis is a chronic inflammatory disease of the upper respiratory tract, characterized by a high prevalence and a complex pathogenesis. Work-related rhinitis (WRR) can be divided into occupational rhinitis (OR) and work-exacerbated rhinitis (WER). It is not only considered as a disease entity but also in the context of medical certification as the allergic disease associated with occupational exposure. Epidemiology of work-related rhinitis has been found to vary depending on the occupation and specific exposure, on the other hand the prevalence data may be underestimated due to the lack of uniform diagnostic criteria. This paper reviews the issues comprising the pathogenesis, epidemiology, diagnosis and treatment of patients with work-related rhinitis. It also discusses the significance of the disease in occupational medicine, particularly in terms of preventive worker care, general principles of good practice in primary and secondary WRR prevention and the necessary directions of changes in medical certification in the cases of occupational rhinitis. Med Pr 2016;67(6):801-815.

Unraveling the organizational mechanism at the root of safety compliance in an Italian manufacturing firm

Safety performance is recognized as the more proximal and effective precursor of safety outcomes. In particular, safety compliance significantly reduces workplace accidents and injuries. However, it is not entirely clear what role organizational factors play in determining workers’ safety. The present study contributes to defining which organizational factors increase safety compliance by testing a mediational model in which supervisor support is related to safety climate, which in turn is related to organizational identification that finally is related to safety compliance. We tested our hypotheses in a sample of 186 production workers of an Italian manufacturing firm using a cross-sectional design. Findings confirm our hypotheses. Management should consider these organizational factors in order to implement primary prevention practices against work accidents.

From Global to Local: strengthening district health systems management as entry point to achieve health-related sustainable development goals

Thailand has performed admirably in its health reform over the last few decades. Healthcare is provided at a relatively low cost and healthcare needs have transitioned to begin to address diseases and mortality of developed countries. The challenges now faced by Thailand are similar to most developed countries reflecting adult mortality and risk factors of an uppermiddle income population and the need to modify institutional structures to reflect these changing circumstances.
 The approach to these challenges has focused on the ‘implementation of knowledge based health development’ and critically identifies ‘the triangle that moves the mountain’ (health reform) as a movement that mobilises; the creation of relevant knowledge, social movement and political involvement’ to address ‘inter-connected, complex and extremely difficult to solve’ problems. The move to District Health Systems as the access point to healthcare and the service delivery structure demands competent qualified leadership and management. It requires an understanding of the differences in managing professionally dominated complex adaptive systems compared to traditional approaches of managing within bureaucratic structures.
 This can be best described as managing connected, integrated care focused both on individuals as patients and communities with a strong emphasis on primary healthcare, prevention and evidence-based practice. It also requires an understanding of how distributed networks of practice (DNOP) provide the potential for researchers, practitioners and other agencies and communities to collaborate, learn and improve healthcare across geographic, jurisdictional and organisational boundaries.
 This approach provides recognition of the need to build the capacity and capability of health professionals in the management and leadership of health systems and Thailand is moving towards this goal in implementing specific health systems management curriculum which focuses on action-based research and learning together at the District health level augurs well for continued ability to address current health challenges and to achieve SDGs.
 Abbreviations: DHS – District Health System; DNOP – Distributed Networks of Practice; HSRI – Health Systems Research Institute; MoPH – Ministry of Public Health; NHSO – National Health Security Office; SDG – Strategic Development Goal; UHC – Universal Health Coverage.

Do Economic Evaluations in Primary Care Prevention and the Management of Hypertension Conform to Good Practice Guidelines? A Systematic Review.

Background: Results of previous research have identified the need for further investigation into the compliance with good practice guidelines for current decision-analytic modeling (DAM). Objective: To identify the extent to which recent model-based economic evaluations of interventions focused on lowering the blood pressure (BP) of patients with hypertension conform to published guidelines for DAM in health care using a five-dimension framework developed to assess compliance to DAM guidelines. Methods: A systematic review of English language articles was undertaken to identify published model-based economic evaluations that examined interventions aimed at lowering BP. The review covered the period January 2000 to March 2015 and included the following electronic bibliographic databases: EMBASE and Medline via Ovid interface and the Centre for Reviews and Dissemination’s (CRD) NHS-EED. Data were extracted based on different components of good practice across five dimensions utilizing a framework to assess compliance to DAM guidelines. Results: Thirteen articles were included in this review. The review found limited compliance to good practice DAM guidelines, which was most frequently justified by the lack of data. Conclusions: The assessment of structural uncertainty cannot yet be considered common practice in primary prevention and management of hypertension, and researchers seem to face difficulties with identifying sources of structural uncertainty and then handling them correctly. Additional guidelines are needed to aid researchers in identifying and managing sources of potential structural uncertainty. Adherence to guidelines is not always possible and it does pose challenges, in particular when there are limitations due to data availability that restrict, for example, a validation process.

Survey on the Knowledge, Attitudes, Primary Prevention Practices and Screening of Skin Cancers in Albinos in Burkina Faso

The objective is to study the knowledge that albinos have on skin cancers, and their attitudes in terms of primary prevention and the screening practices for skin cancers in Burkina Faso. Methods: This is a cross-sectional and descriptive KAP study conducted from May 18th to July 7th 2015. It involved albinos aged at least 12 years. Their general knowledge, prevention attitudes and screening practices were considered. Results: All the responding albinos had already heard about skin cancers. Their main source of information was health workers (65.6%). They were showing at least two risk factors (99.2%) but only 68.3% affirmed having already undergone screening for skin cancer. Ignorance of the existence of screening was the main obstacle to it (16/26). The prevention means used was sun avoidance, the use of cream and protection clothing respectively in 84%, 41.5% and 51.2%. The skin lesions found were hyperpigmented macules (77.8%) then actinic keratosis (40.7%) and finally cheilitis (35.8%). We detected 4 cases of skin cancers confirmed by biopsy. Conclusion: Risk factors are frequent. Participation to screening is still insignificant. A lot is still to be done to extend the protection means. A good awareness-raising campaign and the accessibility to protection means remain for all, the best defense in the fight against skin cancers in albinos.

Relationship Between Low Back Pain With Quality of Life, Depression, Anxiety and Stress Among Emergency Medical Technicians.

Background:Musculoskeletal disorders have become increasingly common among healthcare providers. They have become the most common cause of work-related disabilities among nurses.Objectives:The current cross-sectional study aimed to measure the prevalence of back pains among emergency medical technicians (EMTs), and association of back pain with quality of life, depression, anxiety and stress.Materials and Methods:One hundred and eighty registered nurses working as EMTs at the Hamadan Emergency Medical Center were selected by consensus. Data collection tools were Demographic, Perceived Quality-of-Life, Short Form Health Survey (SF-36), and Depression Anxiety Stress Scales (DAS21) and pain scale measurements.Results:Data showed that while 50.7% of the participants had an average awareness of the basic principles of back care, the majority (71.8%) had at least one type of back pain. There were associations between the prevalence of pain and depression (P = 0.049), pain and awareness (P = 0.035), and stress and job satisfaction (P = 0.024).Conclusions:A large number (about two-thirds) of EMTs had some sort of back pain; it is highly recommended to promote the attitude and motivation of the individuals to take care to prevent back injury and inform them of the principles of back care. Implications for primary prevention and care practice include encouraging EMTs to apply accurate principles of back care.

Adherence to Safe Handling Guidelines by Health Care Workers Who Administer Antineoplastic Drugs

The toxicity of antineoplastic drugs is well documented. Many are known or suspected human carcinogens where no safe exposure level exists. Authoritative guidelines developed by professional practice organizations and federal agencies for the safe handling of these hazardous drugs have been available for nearly three decades. As a means of evaluating the extent of use of primary prevention practices such as engineering, administrative and work practice controls, personal protective equipment (PPE), and barriers to using PPE, the National Institute for Safety and Health (NIOSH) conducted a web survey of health care workers in 2011. The study population primarily included members of professional practice organizations representing health care occupations which routinely use or come in contact with selected chemical agents. All respondents who indicated that they administered antineoplastic drugs in the past week were eligible to complete a hazard module addressing self-reported health and safety practices on this topic. Most (98%) of the 2069 respondents of this module were nurses. Working primarily in hospitals, outpatient care centers, and physician offices, respondents reported that they had collectively administered over 90 specific antineoplastic drugs in the past week, with carboplatin, cyclophosphamide, and paclitaxel the most common. Examples of activities which increase exposure risk, expressed as percent of respondents, included: failure to wear nonabsorbent gown with closed front and tight cuffs (42%); intravenous (I.V.) tubing primed with antineoplastic drug by respondent (6%) or by pharmacy (12%); potentially contaminated clothing taken home (12%); spill or leak of antineoplastic drug during administration (12%); failure to wear chemotherapy gloves (12%); and lack of hazard awareness training (4%). The most common reason for not wearing gloves or gowns was “skin exposure was minimal”; 4% of respondents, however, reported skin contact during handling and administration. Despite the longstanding availability of safe handling guidance, recommended practices are not always followed, underscoring the importance of training and education for employers and workers.

Assessing the learning needs of oncology nurses.

The Nurse Oncology Education Program (NOEP) is a nonprofit organization of the Texas Nurses Foundation that develops and provides education for nurses in all fields of practice on cancer prevention, detection, treatment, and survivorship. To meet the most current educational needs of nurses, NOEP conducts a biannual needs assessment survey to better understand its audience and inform its course development. The 2013 NOEP needs assessment survey used a convenience sample of licensed nurses throughout the United States. Nurses completed the online survey, and results revealed several priority areas for educational programs, including management of cancer symptoms and treatment side effects, complementary and alternative or integrative medicine, and screening recommendations. Time was noted as the largest barrier to educating patients and families about primary prevention practices. Results from this survey can be compared to those from previous surveys, particularly the 2009 and 2011 surveys, to determine changes in the demographics of NOEP's constituency, as well as consistencies in educational gaps. The results from the 2013 NOEP needs assessment survey offer valuable information about the learning needs of nurses across the country. The data can be used by the nurse educators and faculty who are responsible for providing cancer-specific education to nurses.