Supporting families through the science, advocacy, and practice of human lactation.Supporting families through the science, advocacy, and practice of human lactation.
BACKGROUND: Falls among hospitalized patients are a substantial cause of adverse health outcomes, making prevention efforts an important priority. The Morse Fall Scale (MFS) is a popular tool to assess fall risk, althoug...BACKGROUND: Falls among hospitalized patients are a substantial cause of adverse health outcomes, making prevention efforts an important priority. The Morse Fall Scale (MFS) is a popular tool to assess fall risk, although its predictive usefulness is limited in certain health care settings. PURPOSE: We aimed to explore the predictive value of the MFS, as well as additional factors associated with falls in acute care settings. METHODS: This retrospective analysis included data from 4,887 adult patients 18 years of age and older stored in the repository of an acute care inpatient hospital. Data were analyzed using multivariate regression models and area under the receiver operating characteristic curves to determine the validity of the MFS as a predictor of falls. RESULTS: Of the 4,887 patients admitted to the acute care hospital setting, 343 (7%) experienced a fall. The median age of the cohort was 70.9 years. After propensity score matching, MFS scores did not differ significantly between those who experienced falls and those who did not. Several variables, such as All Patient Refined Diagnosis Related Group severity, environmental factors, unsteady gait, low bowel continence level, lack of alertness, skin moisture status as either dry or moist, benzodiazepine administration, diabetes, previous drug use, discharge status documented in the electronic health record, sepsis, atrial fibrillation, and hospitalization duration, were significantly associated with a greater risk of falls. CONCLUSIONS: The MFS did not adequately predict falls. Several additional factors were associated with a greater risk of falls. Nurses and other clinicians should incorporate these insights into fall prevention protocols. These findings warrant inclusion in fall risk assessment guidelines, protocols, and fall prevention training programs.
Alpha-gal syndrome (AGS) is an emerging tick-borne allergic condition associated with bites from the lone star tick (Amblyomma americanum). Unlike typical tick-borne diseases caused by bacteria or viruses, in AGS there i...Alpha-gal syndrome (AGS) is an emerging tick-borne allergic condition associated with bites from the lone star tick (Amblyomma americanum). Unlike typical tick-borne diseases caused by bacteria or viruses, in AGS there is a delayed allergic reaction to galactose-α-1,3-galactose, a sugar referred to as alpha-gal, which is present in tick saliva; most mammalian meat, such as beef, pork, and lamb; animal-derived products, such as gelatin and dairy (including cow's milk); and certain medications containing animal products. AGS was first identified in the early part of this century, with a notable rise in reported cases in recent years. Contributing factors include climate change, altered wildlife migration, and other ecological shifts that have allowed the lone star tick to expand its range north and west across the United States. Clinically, AGS is characterized by an atypical, delayed allergic response that can occur hours after consumption of red meat. Sensitivity to alpha-gal is delayed for weeks to months after the tick bite, and the allergic reaction after ingesting something that contains the antigen is delayed by hours. Gastrointestinal manifestations are common, and patients may also develop urticaria, bronchospasm, or potentially life-threatening anaphylaxis. The condition is underdiagnosed, owing to its unusual presentation and limited awareness among clinicians. With the continued expansion of the lone star tick's habitat, the incidence of AGS is expected to rise. Enhanced awareness, targeted research, and improved education for both health care practitioners and the public are crucial to reducing misdiagnosis and improving management. Strengthening public health initiatives will be key in addressing this complex and evolving allergic condition. This article aims to describe the epidemiology; pathophysiology, including the role of A. americanum in transmission; and clinical presentation of AGS and highlight its link to tick bites; common barriers to accurate diagnosis; and current strategies for prevention.
Editor's note: This article, from the October 1973 issue of AJN, details Ann Burgess and Lynda Lytle Holmstrom's research interviewing rape victims and establishing one of the first crisis counseling programs in the coun...Editor's note: This article, from the October 1973 issue of AJN, details Ann Burgess and Lynda Lytle Holmstrom's research interviewing rape victims and establishing one of the first crisis counseling programs in the country. Groundbreaking at the time, it drew the attention of the FBI. As Burgess recently told AJN (see Conversations), Roy Hazelwood from the Behavioral Science Unit at the FBI Academy in Quantico, Virginia, was tasked with developing a curriculum for teaching rape investigation. At the end of one lecture, he asked if anyone knew anything about rape. A detective, who was also a nurse, told him she had recently read an article about rape in AJN. It was this article, and what followed, that led to Burgess teaching FBI investigators how to interview rape victims and eventually providing the methodology that served as the basis for profiling serial offenders.
BACKGROUND: Parricide is an exceptionally rare phenomenon, constituting approximately 2% to 3% of all homicides in the United States. Double parricide, involving multiple victims and/or offenders, is even less common. Th...BACKGROUND: Parricide is an exceptionally rare phenomenon, constituting approximately 2% to 3% of all homicides in the United States. Double parricide, involving multiple victims and/or offenders, is even less common. The most famous case of double parricide in recent history is that of the Menendez brothers, who were convicted of the 1989 murders of their parents. PURPOSE: This narrative review examines the evolving societal, academic, and legal attitudes toward the Menendez brothers' case over 35 years. METHODS: An examination was conducted of criminological studies, media analyses, legal records, and primary source materials such as letters and drawings from the Menendez case. RESULTS: Findings indicate a shift over 35 years from framing the brothers as deviant and greedy to understanding their actions as extreme responses to prolonged familial trauma. Media narratives, true crime portrayals, social media advocacy (through documentaries and platforms like TikTok), and evolving victimology and trauma theories have influenced public opinion and legal reconsideration. The application of machine learning and artificial intelligence (AI)-driven analysis through multiple professional lenses reveals patterns in pre-offense communications and artwork that may have been underappreciated in traditional forensic evaluation. IMPLICATIONS FOR FORENSIC NURSING: Forensic nurses are essential in assessing trauma, documenting abuse, and contributing to interdisciplinary evaluations. Trauma-informed approaches enhance accurate risk assessment and ethical consideration of both survivors' and offenders' experiences in cases of extreme familial violence. The emerging integration of AI tools in forensic practice offers forensic nurses new capabilities for systematic case analysis, while maintaining the critical human expertise needed for clinical judgment and compassionate care. CONCLUSIONS: The Menendez case serves as a powerful reminder that our understanding of complex human behavior deepens over time, and that maintaining openness to new perspectives and methodologies is essential to providing ethical, evidence-based forensic care.
BACKGROUND: Although RNs play a critical role in achieving the United Nations' 17 Sustainable Development Goals (SDGs), their contributions are not widely recognized, even among nurses themselves or within the nursing pr...BACKGROUND: Although RNs play a critical role in achieving the United Nations' 17 Sustainable Development Goals (SDGs), their contributions are not widely recognized, even among nurses themselves or within the nursing profession. To achieve the SDGs by 2030, governments, civil society, academics, and the private sector must all work together to deliver innovative and integrated solutions. While much work is needed to increase and sustain RNs' engagement with the SDGs, there is evidence that RNs are contributing to the SDG targets worldwide at individual, organizational, and systems levels. PURPOSE: The main purpose of this global study was to describe RNs' self-reported actions to advance the SDGs, exploring the ways RNs contribute to their achievement. A secondary goal was to identify recommendations for further action. METHODS: This qualitative descriptive cross-sectional study used convenience and snowball sampling to recruit an international sample. Data were collected anonymously via an online survey. Each participant was asked to name and describe one action they had taken within the past year to advance the SDGs. Free-text responses were analyzed using directed content analysis. The social-ecological model provided a framework for analysis. RESULTS: A total of 309 participants from 25 countries responded to the survey. Through our analysis, RNs' SDG-related actions were initially grouped into three categories--individual, community/organization, and systems/policy--with each containing subcategories. A fourth category was added to reflect responses indicating no action. Some examples of actions taken included visiting policymakers, donating to local food banks, educating students, recycling, reducing disparities, conducting research on gender, increasing awareness of inequalities, and using telehealth to increase access to health care. CONCLUSIONS: Findings from this study provide a better understanding of RNs' contributions toward achieving the SDGs. This evidence can be used to inform the development of recommendations that aim to spread and scale RNs' contributions to the sustainable development agenda.