TRAFFICKING NO LONGER A STAND-ALONE ISSUE
Awareness of human trafficking or modern slavery is increasing. "The international response to modern slavery began with the adoption of the Palermo Protocol in 2000 and has continued to grow. Multilateral organizations are ramping up efforts to combat trafficking by incorporating anti-trafficking policies into discussions of other pressing topics. What was once a stand-alone issue is being integrated into work on other topics, including national security, human rights, violence against women and children, migration management and refugee protection, business responsibility and supply chain accountability, and economic development. In addition to leveraging their member states' expertise and resources, multilateral organizations generate momentum to develop global, regional, and even domestic strategies to help dismantle trafficking networks and empower vulnerable populations." Download the full Trafficking in Persons Report 2016 at https://www.state.gov/documents/organization/258876.pdf Accessed 10/12/2017
Be sure to read "What Nurses Need to Know about Human Trafficking" in this issue of JCN. Do you have firsthand experience assisting a person who has been trafficked? Email a brief description of the interaction to mailto:[email protected] and we may place it on our blog to increase awareness of this global issue.
MIDLIFE WOMEN NEED OBESITY SCREENING
Midlife women should be screened for overweight/obesity and offered appropriate education, treatment, and support. Ekta Kapoor, MBBS, from the Mayo Clinic in Rochester, Minnesota, and colleagues relay, "The importance of weight management cannot be overemphasized, as cardiovascular disease is the leading cause of death in postmenopausal women; weight gain in midlife also contributes to other health risks. Primary care physicians must screen midlife women for overweight/obesity and offer them appropriate advice and referral. Unique barriers to adoption of healthy lifestyle measures, including the presence of vasomotor symptoms, mood disorders, and sleep disturbances should be addressed in postmenopausal women. Providers should offer counseling regarding lifestyle change, behavior modification, and psychological support. Menopausal hormone therapy should be considered for management of bothersome symptoms, when indicated. However, menopausal hormone therapy cannot be recommended as a treatment for central obesity in midlife women, despite its favorable influence on body fat distribution."
In addition, researchers write, "We recommend that medical practitioners actively screen for overweight/obesity in midlife women and offer appropriate education, treatment, and support. This includes management of issues unique to midlife women that interfere with adoption of healthy lifestyle measures."-http://www.physiciansbriefing.com/Article.asp?AID=727160 Accessed 10/17/2017
INFORMED EYES ON SKIN
What if massage therapists were trained to recognize skin cancer? In Arizona, there are 10,000 actively licensed massage therapists, each averaging 12 clients weekly or roughly 7,000 client interactions yearly.
University of Arizona College of Nursing Associate Professor Lois J. Loescher, PhD, RN, plans to train massage therapists, with their unique access to skin, to effectively communicate sun safety, identify and recognize suspicious skin lesions, and provide resources for appropriate healthcare follow-up for their clients. Through "Massage Therapists Skin Health Awareness, Referral, and Education (MTsSHARE) to Reduce Skin Cancer Risk in Arizonans," Loescher and her team aim to address, expand, and evaluate the effectiveness of skin surveillance in an innovative and previously unaddressed way.
She states, "We wants to empower massage therapists to assist in detection and help clients understand the importance of sun safety, recognize suspicious skin lesions, and recommend follow-up with a dermatologist. We're not suggesting that massage therapists should become dermatologists. All we're doing is advocating for another pair of eyes on the skin." Currently, massage therapists receive little formal training on skin cancer.
According to the American Cancer Society, skin cancer is the most common form of cancer in the U.S., with more than 5 million cases annually. In Arizona, the incidence of nonmelanoma skin cancer is three to six times higher than in the northern states.
Loescher and her coinvestigators will conduct pilot testing with 20 Tucson-based massage therapists. After fine-tuning, they will expand to 80 massage therapists throughout Arizona.
"Massage therapists see their clients more often than primary care providers see their patients. Although most melanomas are diagnosed by physicians, they typically are detected through observations from the patients themselves or someone who is close to the patient. Our goal is to have a huge public-health impact in skin cancer prevention and early detection. Overall, we want to promote a larger role for skin cancer prevention within massage therapy school curricula and continuing education," notes Loescher.
The team sees this study as one way to expand the number of informed eyes that are trained on skin including service providers, such as hair stylists, aestheticians, and even tattoo artists.-University of Arizona College of Nursing Press Release 5/22/17
LOW TESTOSTERONE LINK TO FEMALE INCONTINENCE?
Might there be a link to low testosterone and female incontinence? Investigator Michelle Kim, MD, PhD, from Massachusetts General Hospital in Boston thinks there may be. She notes, "Testosterone may prevent pelvic floor atrophy, thereby reducing the risk of urinary incontinence." Her research team analyzed data from 2,123 women who participated in the 2012 National Health and Nutrition Examination Survey and had serum total testosterone measured.
"Levator ani muscles are known to have androgen receptors. In one rodent model, testosterone administered after surgically induced urinary incontinence resulted in levator hypertrophy. Because it is unclear whether the same association exists in humans, Kim and colleagues assessed the correlation between testosterone and incontinence. On univariate analysis, a low level of serum testosterone was significantly associated with stress, urgency, and mixed incontinence (p < .001 for all). After adjustment for age, the association remained significant for stress and mixed incontinence, but not for urgency incontinence."
Kim states, "This makes sense because the mechanism of stress urinary incontinence relies so heavily on the integrity of the pelvic floor, whereas urgency may not." On a multivariate analysis that controlled for age, body mass index, diabetes, race, parity, and time of venipuncture, women in the lowest quartile of testosterone levels were significantly more likely than those in the other three quartiles to report stress incontinence (odds ratio [OR], 1.49; p < .05) or mixed incontinence (OR, 1.65; p < .01). Urge incontinence was elevated numerically but not significantly in this model.
Tomas Griebling, MD, from the University of Kansas Medical Center in Kansas City, who moderated the briefing, stated, "This opens the possibility of testosterone replacement therapy for women with incontinence. Obviously, more research has to be done, but this sets the stage."-American Urological Association 2017 Annual Meeting: Abstract PD05-07. Presented May 15, 2017; https://www.medscape.com/viewarticle/880215 Accessed 10/16/2017
THE WORK OF OUR HANDS
"As we begin working on our computers, do we intentionally consecrate the work of our hands for the honor and glory of God? Or the cell phone we use, by which we will connect with other human beings and have the chance to bless them rather than curse? Perhaps many of us would say with confidence that we easily and naturally commit our overt acts of ministry to God: 'Bless this mission team,' or 'Bless this worship service,' or 'Bless these funds that we give for your work.' What does not come so naturally is to commit to God the very ordinary, mundane tasks and tools of our day, even though we know, of course, that all things can be used by God and for God. We are simply not in the habit, the spiritual discipline, of consecrating all aspects of our days to God, moment by moment."
"What a simple thing 'praying without ceasing' would be if we would determine to place all things, from the mean to the celebrated, into God's hands. When we live in ongoing awareness of the reality of the living God-yes, the one who is right beside me even now as I type these words-we are praying without ceasing....God is ready to sanctify our most basic actions in ways that increase our awareness of and dependence on him."
-From Thin Places: An Evangelical Journey into Celtic Christianity by Tracy Balzer, 2007, Leafwood Publishers, Abilene, Texas.
-PulseBeats compiled by Cathy Walker