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Biomedical subjects

L J Loescher

Publications and source records attributed to L J Loescher.

At least 19 recordsLinked to original sources
PubMed2000

The influence of technology on cancer nursing.

OBJECTIVES: To summarize technologies that have been described in nursing literature (in the context of oncology) over the last 25 years, and to present projections of possible technology in the future of oncology nursing. DATA SOURCES: CINAHL (1982 to present), MEDLINE (1976 to 1984), and author identification of articles. CONCLUSIONS: Technology has greatly influenced the evolution of oncology nursing, particularly concerning treatment (chemotherapy, radiation therapy, biotherapy, marrow and blood transplantation), access devices, and genetic and information technologies. IMPLICATIONS FOR NURSING PRACTICE: Nurses must be prepared to deal with how technology affects their philosophical perspective of nursing and the challenges presented by technology.

Computers↗
PubMed1999

The family history component of cancer genetic risk counseling.

Family history is an important risk factor for inherited cancers. Obtaining a family history is therefore a key component of cancer genetic risk counseling (CGRC). Many oncology nurses do not have training in cancer genetic risk counseling. However, every nurse is capable of obtaining a basic family history. The family history can help in identifying patterns of cancer transmission in families. Nurses can then refer families with a strong history of cancer to nurse geneticists, genetic counselors, or others qualified to make a further assessment of risk. If those resources are unavailable locally, the Internet can be of assistance. This article summarizes genetic and clinical characteristics of inherited cancers, the significance of family history, interview approaches, questions to ask about personal and family history of cancer, what a pedigree is and how to draw one, what to do with family information including risk analysis and documentation, and available resources on the Internet.

Arizona↗
PubMed1998

Toward a holistic view of genetic technology as a way of knowing.

Technology changes the face of science and, ultimately, nature. How do we as nurses come to know technology? Nurses' ways of knowing, as described by Carper, help nurses better understand technology as a way of knowing; that is, using empirical, ethical, personal, and esthetic ways of knowing provides a means to incorporate technology into holistic nursing practice. Knowledge of technology also requires considering clients' and families' multiple facets of knowing. The article summarizes the nature of technology, nurses' ways of knowing in the context of genetic technology, and the rationale for understanding clients' and families' ways of knowing.

Diffusion of Innovation↗
PubMed1998

DNA testing for cancer predisposition.

PURPOSE/OBJECTIVES: To describe and review scientific and regulatory aspects of molecular genetic technology in the context of DNA testing for cancer predisposition. DATA SOURCES: Published professional articles, texts, and proceedings; commercial testing companies; computerized data bases; and the World Wide Web. DATA SYNTHESIS: This article reviews the basic molecular biology (e.g., DNA, genes, chromosomes, DNA mutations) that is the foundation for indirect and direct methods of DNA testing for cancer predisposition. Key issues in DNA testing include who should be tested, provision of testing, and regulatory concerns. Benefits and problems of testing contribute to its current controversial status. CONCLUSIONS: Understanding the mechanisms of DNA testing for cancer requires knowledge of basic molecular biology. Family history of the cancer in question is a key indicator for predisposition testing. Accessing information regarding research-based testing is challenging. DNA testing for cancer predisposition is not a perfect test, as exemplified by issues related to test regulation and sensitivity. IMPLICATIONS FOR NURSING PRACTICE: Basic knowledge of DNA testing for cancer predisposition will help nurses to (a) have a better understanding of the indications for and ramifications of testing, (b) provide information about testing to patients and the lay public, (c) counsel patients and families at high risk for inherited cancers more effectively, and (d) interpret DNA test results.

DNA↗
PubMed1995

Public education projects in skin cancer. The evolution of skin cancer prevention education for children at a comprehensive cancer center.

BACKGROUND: Skin cancer affects more Americans than any other type of cancer. Children are prime targets for prevention education, because sun overexposure in early childhood may affect the development of skin cancer later in life. Preventive behaviors adopted early in life may be less resistant to change than those acquired in adulthood. Thus, there is a need to educate children at an early age about sun overexposure. METHODS: This article describes the evolution of skin cancer prevention research at the Arizona Cancer Center, a National Cancer Institute--designated comprehensive cancer center. Research focusing on children is high-lighted. RESULTS: From its roots in the Arizona Sun Awareness Project, an informal public skin cancer education program, skin cancer prevention research at the Arizona Cancer Center has produced two developmentally appropriate, age-based curricula aimed at teaching children about the benefits and dangers of the sun. The elementary school curriculum, Sunny Days, Healthy Ways, has undergone two tests of feasibility and is the intervention used in a large, randomized, experimental trial. The preschool curriculum, Be Sun Safe, has been tested in a randomized trial and was found to have a positive effect on preschoolers' knowledge and comprehension of sun safety. CONCLUSIONS: Educating children about skin cancer may be an important way of decreasing the incidence of skin cancer. Although informal skin cancer prevention education can be helpful, educational programs preferably should be research based and evaluated for effectiveness before public distribution. The Arizona Cancer Center experience can serve as a model for other programs.

Adolescent↗
PubMed1995

Educating preschoolers about sun safety.

OBJECTIVES: This feasibility study examined whether a sun safety curriculum designed for and administered to preschoolers affects their cognition (knowledge, comprehension, application) regarding sun safety. METHODS: Twelve classes of 4- to 5-year-olds were recruited from local preschools and randomly assigned to an intervention group or a control group. The intervention group received an investigator-developed sun safety curriculum; the control group did not. Children in both groups were tested at the beginning of the study about their cognition related to sun safety. They then received posttests 2 and 7 weeks following the pretest. RESULTS: The curriculum had a significant effect on the knowledge (P = .01) and comprehension (P = .006) components of cognition. The application component of cognition was not significantly changed by the curriculum. CONCLUSIONS: A structured curriculum was found to be an efficacious means of enhancing knowledge and comprehension of sun safety in preschool children. At the preoperational developmental stage, however, children may not be able to apply such knowledge and comprehension.

Analysis of Variance↗
PubMed1995

Genetics in cancer prediction, screening, and counseling: Part I, Genetics in cancer prediction and screening.

PURPOSE/OBJECTIVES: To review molecular biology and gene technology as they relate to cancer prediction and screening. DATA SOURCES: Published professional articles, texts, and proceedings; computerized data bases. DATA SYNTHESIS: Basic principles of inheritance and mutations; a discussion of proto-oncogenes, oncogenes, and anti-oncogenes; a summary of gene-mapping techniques; and a review of genes linked to familial, breast, ovarian, and colorectal cancers. CONCLUSIONS: Most human cancers are influenced genetically but are not inherited. Discoveries about cancer genes play a major role in identifying individuals and families who are likely to develop cancer. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to heighten their awareness of this science and its ramifications, which ultimately will affect recommendations for early detection and screening.

Genes, Tumor Suppressor↗
PubMed1995

Genetics in cancer prediction, screening, and counseling: Part II, The nurse's role in genetic counseling.

PURPOSE/OBJECTIVES: To describe an expanded role for oncology nurses in genetic counseling for cancer. DATA SOURCES: Published professional articles, computerized data bases, lay publications. DATA SYNTHESIS: A description of the availability of genetic counseling, of motivation for undergoing genetic counseling, and of the basic components of genetic counseling for cancer. CONCLUSIONS: The need for genetic counseling will increase as more families with inherited cancer are identified, more cancer genes are isolated, and genetic analysis becomes more available. IMPLICATIONS FOR NURSING PRACTICE: Advances in genetic technology provide nurses with the opportunity for an expanded role in genetic counseling for cancer. Oncology nurses also can act as case finders of families with inherited cancers and conduct research in this area.

Genetic Counseling↗
PubMed1994

"Sunshine and skin health": a curriculum for skin cancer prevention education.

Skin cancer rates are increasing. Instilling preventive behavior in youngsters is essential to prevent overexposure during childhood. The effectiveness of a curriculum for increasing knowledge and skills, creating supportive attitudes, and engendering a supportive environment to enhance skin cancer prevention was tested on 139 fourth-, fifth-, and sixth-graders. One class in each grade was assigned to treatment (curriculum) and another to control. The curriculum increased knowledge of the effects of exposure to sunlight, skin cancer, and prevention immediately and eight weeks later, across all grades. It also cultivated less favorable attitudes toward tanning and, among fourth-graders, reduced unfavorable attitudes toward sunscreen. Behavioral changes were less consistently evident, with students reporting less suntanning, fourth-graders more frequently using sunscreen, and fifth- and sixth-graders more frequently wearing protective clothing compared with controls. The curriculum was more effective at influencing knowledge and attitudes than changing behavior, highlighting the need for student- and parent-oriented cues to action.

Child↗
PubMed1993

Skin cancer prevention and detection update.

The best way to remedy the skin cancer epidemic is for the population to collectively practice primary preventive behaviors. However, many advances have been made in the areas of secondary and tertiary prevention, including the search for intermediate markers to facilitate skin cancer screening of high-risk groups and the use of chemopreventive agents in individuals with a history of high-risk lesions.

Female↗
PubMed1992

Professional and consumer concerns about the environment, lifestyle, and cancer.

Although it cannot be said that "everything causes cancer," our environment will never be carcinogen-free. As a result, there are many substances we come in contact with daily that could be potentially harmful to our health. Even with the growing knowledge of the mechanisms of carcinogenesis, it is difficult to single out the exact cancer-causing or -promoting effects of single substances. The confusion that exists about the environment, lifestyle, and cancer can be overwhelming for everyone. Garfinkel offered the following suggestions for health care providers to use in putting this issue into better perspective for consumers: (1) no single study of cancer risk factors should be used as a basis for writing or changing public health policy; (2) animal studies should be supportive of findings in epidemiological studies; (3) any environmental factor-cancer effect relationship should be demonstrated biologically; (4) regulatory agencies such as the EPA tend to be conservative in their interpretation of study results, and may suggest caution even when the risk of developing cancer is low; (5) regulatory agencies have been known to extrapolate future effects of carcinogen exposure from current incomplete or limited information about the carcinogen in question. With the knowledge that we do have, we must strive to take personal control over life-style factors that may cause cancer.

Animals↗
PubMed1990

Development of a contingency recruitment plan for a phase III chemoprevention trial of cervical dysplasia.

Development of contingency recruitment plans in cancer chemoprevention research is as important as formulation of the initial plan. We found that requesting recruitment information from our initial CTCD subjects provided a framework for our contingency plan. The revised recruitment plan consisted of: 1) calling and sending letters to community gynecologists in private practice or affiliated with HMO's to explain the study and ask for referrals; 2) continued personal contact by the principal investigator with referring physicians; 3) sending thank you and follow-up letters to every physician who referred patients to the study; 4) soliciting Papanicolaou smear reports from HMO's if physicians of women with abnormal Papanicolaou smears gave permission to pathologists to release this information; 5) utilizing free media such as feature articles on the CTCD in local papers, public service announcements, and television "spots;" 6) continued use of brochures and posters printed for the initial recruitment effort; and 7) continued presentations to local professional physician and nurse groups about the study. Our contingency plan to date has provided us with 100% of our projected accrual. Thus, our recruitment methods have proved to be effective in accruing subjects for this cancer chemoprevention trial.

Double-Blind Method↗
PubMed1989

Surviving adult cancers. Part 2: Psychosocial implications.

PURPOSE: To address the psychosocial implications of surviving adult cancers by a comprehensive review of the literature. DATA IDENTIFICATION: An English-language literature search using MEDLINE (1970 to 1988). Index Medicus (1970 to 1988), and bibliographic reviews of textbooks and review articles. STUDY SELECTION: Of 103 originally identified articles, 58 that specifically addressed the stated purpose were selected. DATA EXTRACTION: Four authors reviewed and critiqued the literature extrapolating the major themes on this topic. RESULTS OF DATA SYNTHESIS: There is little information on the many psychosocial variables that affect an adult's long-term cancer survival trajectory. Collation of data identified the following significant psychosocial themes: fear of recurrence and death, relationships with the health care team, adjustment to physical compromise, alterations in customary social support, isolationism, psychosocial reorientation, and employment and insurance problems. CONCLUSIONS: The continuation of a rehabilitation effort begun around the initial diagnosis of cancer would be instrumental in providing post-therapy evaluation and guidance needed by adult long-term survivors of cancer. Education, research, and support interventions need to be mobilized for this population of adults with a history of cancer.

Adaptation, Psychological↗
PubMed1989

Surviving adult cancers. Part 1: Physiologic effects.

PURPOSE: To provide an overview of the physiologic long-term and late effects of adult cancers and cancer treatments by a review of the medical and nursing literature. DATA IDENTIFICATION: Primarily from an English-language literature search using MEDLINE (1980 to 1988) and Index Medicus (1980 to 1988). STUDY SELECTION: After a consensus review by four observers, 285 articles were selected that addressed the stated purpose. DATA EXTRACTION: Four observers assessed the literature using predetermined criteria for eliciting information about long-term and late effects. RESULTS AND DATA SYNTHESIS: Much has been written about the acute phases of cancer and cancer treatments. In comparison, relatively few data are available that define physiologic long-term: and late effects of cancer treatments in adult survivors. Review of the existing data showed that these sequelae may affect virtually any body system months or years after treatment ends. In addition, few prospective studies dealing with physiologic survivorship issues have been done. CONCLUSIONS: Health care providers need to be aware of long-term or late complications that may affect the increasing number of adult cancer survivors. Attention to treatment regimens in the acute cancer phase and careful follow-up once the disease is eradicated may help to prevent or manage these complications. More prospective research should be done in this area.

Adult↗