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Because of external forces, such as rising cost of health care, increasing healthcare consumerism, and increased emphasis on patient-centered care, the shared model of care is taking hold, particularly in the cancer setting. The evolution of these models has caused a shift in the dialogue related to cancer treatment decision making between patients and physicians, as well as oncology nurses. These events contribute to the evolving role of the nurse during the cancer treatment decision-making process.

Women with ovarian cancer have a continued high symptom burden in comparison to other cancer survivors secondary to ongoing chemotherapy treatment. Prolonged or ineffective management of treatment-related symptoms can contribute to treatment noncompliance, worsening of symptoms, and reduced health-related quality of life.

This review of the literature was conducted to describe experimental and quasi-experimental research addressing nonpharmacologic interventions for the treatment-related symptoms of sleep disturbance, pain, anxiety, depression, and low energy or fatigue in women with ovarian cancer and to critique the quality of interventions.

A systematic search of the literature was conducted in PubMed and yielded 136 articles. Eight articles met the inclusion criteria and were evaluated.

Nonpharmacologic interventions for treatment-related symptoms were complex, with an average of 4.4 components. Intervention delivery, setting, and exposure varied widely across studies. Only three studies contained details sufficient to replicate the intervention. Lack of clarity in intervention reporting may explain perceptions of clinically inefficacious symptom management in this context. Greater attention to reporting would facilitate better translation of interventions into practice and when addressing complex cancer symptom clusters.

Nonpharmacologic interventions for treatment-related symptoms were complex, with an average of 4.4 components. Intervention delivery, setting, and exposure varied widely across studies. Only three studies contained details sufficient to replicate the intervention. Lack of clarity in intervention reporting may explain perceptions of clinically inefficacious symptom management in this context. Greater attention to reporting would facilitate better translation of interventions into practice and when addressing complex cancer symptom clusters.Preventing medication and chemotherapy errors is a priority in oncology nursing. In this article, a case is presented detailing a medication error that occurred because of inadequate assessment. Such errors still can occur despite electronic systems designed to increase medication administration safety. The authors will discuss implications for oncology nurses.
AT A GLANCE Chemotherapy errors can occur if the American Society of Clinical Oncology and Oncology Nursing Society chemotherapy administration guidelines are not practiced consistently.
Failure to observe the 10 principles of medication administration contributes to chemotherapy errors.
Electronic safeguards may not prevent chemotherapy errors.
.Although major advances have been made in radiation techniques, concerns still exist about the treatment-related acute and long-term side effects. This issue is most notable in the pediatric population because of developing organs and tissues combined with longer life expectancies. Proton beam therapy has the advantage of a reduced dose of radiation with less scatter to normal tissue, which may lead to fewer adverse side effects.
AT A GLANCE Many pediatric patients with cancer receive radiation therapy.Radiation treatments can cause significant acute and long-term side effects.Proton beam therapy reduces radiation scatter to normal tissues and may decrease acute and late toxicities.Patients with cancer are often dependent on blood transfusions during treatment. Frequent vital sign monitoring during transfusions may interrupt sleep and the patient's ability to ambulate or participate in unit activities. Relying heavily on vital sign findings may also overshadow unmeasurable symptoms of transfusion reaction. The aim of this evidence-based practice initiative was to examine the evidence regarding the optimum frequency of vital sign monitoring for patients undergoing stem cell transplantation receiving blood products and to amend policy and practice to be consistent with the literature. 
AT A GLANCE
 Patients with cancer frequently require transfusion support during treatment.Inconsistencies exist in recommendations for the frequency of vital sign monitoring during transfusion.Examining best practice guidelines suggests that less frequent vital sign monitoring may be appropriate if coupled with thoughtful physiologic assessment.The purpose of this quality improvement project was to define best practices for identifying appropriate patients for genomic testing and improve timeliness for ordering tests and reporting results. An interdisciplinary team of surgeons, radiologists, medical oncologists, and nurses agreed that the RN navigator would be the key person to facilitate timely access to genomic profiling. AT A GLANCE Genomic profiling has become the standard of care for patients with early-stage breast cancer to assist in developing individualized treatment plans. Nurse navigators can play a key role in improving timeliness of care. The APN-RN model led to improvements in turnaround time and complicance with the National Comprehensive Cancer Network's recommendations for genomic testing.Malignant pleural effusions (MPEs) are common complications that occur with advanced stages of cancer. In general, they indicate a poor prognosis and greatly affect quality of life (QOL). The treatment goal of MPEs is to provide relief of symptoms. The standard treatment for MPEs is talc pleurodesis; however, indwelling pleural catheters have become more frequently used. This article focuses on current management strategies for MPEs and assesses their influence on QOL.At a GlanceSymptoms of malignant pleural effusions (MPEs), which involve the accumulation of fluid in the pleural space, include dyspnea, shortness of breath, chest pain, and other issues that decrease functional status.Treatment for MPEs should be palliative, achieving immediate symptom relief and improved quality of life.The optimal treatment strategy for MPEs should have minimal side effects, require minimal or no hospitalization, and have low rates of recurrence.Patients with cancer suffer greatly. Rehabilitation helps them suffer less, and yet very few patients with cancer get rehabilitation services of any kind. Oncology nurses are well positioned to see the toll that cancer and its treatment take on patients and to facilitate appropriate supportive care, including rehabilitation.
.The emotional work of oncology nurses is complex. Inherent in our job is the requirement to be exquisitely empathic. We must look after, respond to, and support numerous patients and their families. Fully present, we repeatedly listen to stories of sadness and despair. Intermittently, we must either display or suppress our emotions. All of this takes place in an occupational environment where support for the nurses' emotional well-being is nonexistent. Lacking are opportunities to vent emotions, sufficient time to grieve patients' deaths, and resources to help nurses cope with work-related stress.

Diet-induced thermogenesis (DIT) is lower in the evening and at night than in the morning. This may help explain why meal timing affects body weight regulation and why shift work is a risk factor for obesity. The separate effects of the endogenous circadian system--independent of behavioral cycles--and of circadian misalignment on DIT are unknown.

Thirteen healthy adults undertook a randomized crossover study with two 8-day laboratory visits three baseline days followed either by repeated simulated night shifts including 12-h inverted behavioral cycles (circadian misalignment) or by recurring simulated day shifts (circadian alignment). DIT was determined for up to 114 min (hereafter referred to as "early DIT") following identical meals given at 8AM and 8PM in both protocols.

During baseline days, early DIT was 44% lower in the evening than morning. This was primarily explained by a circadian influence rather than any behavioral cycle effect; early DIT was 50% lower in the biological evening than biological morning, independent of behavioral cycle influences. Circadian misalignment had no overall effect on early DIT.

The circadian system plays a dominating role in the morning/evening difference in early DIT and may contribute to the effects of meal timing on body weight regulation.

The circadian system plays a dominating role in the morning/evening difference in early DIT and may contribute to the effects of meal timing on body weight regulation.

An intervention using Wi-Fi scales and graphic e-mail feedback, the caloric titration method (CTM), to reduce age-related weight gain over 1 year among college students was evaluated.

First-year college students (n = 167) were randomized to CTM or control (C) groups and provided Wi-Fi scales. The CTM group was instructed to weigh daily, view a weight graph e-mailed to them after weighing, and try to maintain their weight. The C group could weigh at any time but did not receive feedback. At 6 months and 1 year, the C group provided weights. For intention to treat analysis, an adjusted mixed model was used to analyze the effect of the intervention.

Baseline body mass index was 22.9 ± 3.0 kg/m(2) . Ninety-five percent of the CTM participants weighed ≥ 3 times/week, compared to 15% in the C group (P < 0.001). LNMMA After 1 year, the C group had gained 1.1 ± .4 kg whereas the CTM group lost 0.5 ± 3.7 kg (F = 3.39, P = 0.035). The difference in weight change between the two groups at 1 year was significant (P = 0.004). Retention was 81%.

CTM intervention was effective in preventing age-related weight gain in young adults over 1 year and thus offers promise to reduce overweight and obesity.

CTM intervention was effective in preventing age-related weight gain in young adults over 1 year and thus offers promise to reduce overweight and obesity.

To determine whether upper gastrointestinal tract (UGI) bypass itself has beneficial effects on the factors involved in regulating glucose homeostasis in patients with type 2 diabetes (T2D).

A 12-month randomized controlled trial was conducted in 17 overweight/obese subjects with T2D, who received standard medical care (SC, n = 7, BMI = 31.7 ± 3.5 kg/m(2) ) or duodenal-jejunal bypass surgery with minimal gastric resection (DJBm) (n = 10; BMI = 29.7 ± 1.9 kg/m(2)). A 5-h modified oral glucose tolerance test was performed at baseline and at 1, 6, and 12 months after surgery or starting SC.

Body weight decreased progressively after DJBm (7.9 ± 4.1%, 9.6 ± 4.2%, and 10.2 ± 4.3% at 1, 6, and 12 months, respectively) but remained stable in the SC group (P < 0.001). DJBm, but not SC, improved (1) oral glucose tolerance (decreased 2-h glucose concentration, P = 0.039), (2) insulin sensitivity (decreased homeostasis model assessment of insulin resistance, P = 0.013), (3) early insulin response to a glucose load (increased insulinogenic index, P = 0.