I am interested in hearing from all of you about the realization of the goal. The main concepts behind the goal are to increase newsletter and Virtual Community submissions and encourage nursing research. Please e-mail me with any ideas, and seriously consider writing something to share.

During our SIG leadership training, we had a session with Ilisa Halpern Paul, who serves as the ONS health policy associate. She has written many columns and comments in several ONS publications. She is very verbal about oncology nurses being informed and articulate about their patients and issues. She also emphasizes the need to develop relationships with our national legislators about any subject that impacts cancer care. Also, please watch your state issues and verbalize to your legislatures about clean air bills, tobacco legislation, etc. We can have an impact, and according to Ilisa, our opinions are highly respected.

I would like to feature practical applications of programs that are working in your practice in the Practice Corner of the newsletter. Does anyone have examples of tobacco education/cessation programs that are working? We can share you ideas in the newsletters as a way of networking. I would also like to feature submissions about cancer prevention programs that may be working, advocacy issues, and research in your area regarding cancer prevention and detection.

Have you checked out our SIG Web site? What would make the site more useful to you? We would like to make the site interactive with a discussion forum and a LISTSERV type interaction. We need to feed your ideas to ONS.

The first article in this newsletter focuses on searching PUBMED and is written by a very special medical librarian who teaches me daily and helps me understand the magic of the computer. The second article includes information about the American Cancer Society guidelines for nutrition and physical activity for cancer prevention and is written by a dedicated oncology dietitian who is a member of our SIG. The article discusses important evidence based guidelines that we can teach to our community programs.

Welcome new members! I encourage you to stay in touch and add to our networking! Newsletter content for the next issue will be due by Dec 20, 2007, so start thinking about how you can contribute. Have a happy fall!

Congratulations to SIG Member for Congress Acceptance
The abstract submitted for a Congress discussion session, “Cancer vaccines- are we there yet? Ethical, legal and social issues on vaccine development and use,” was accepted. It is co sponsored by the Ethics SIG (coordinator, Ellen Giarelli, EdD, RN, CRNP). Congratulations Ellen! The SIG thanks you for all of your hard work.

Strategic Plan Guidelines Approved
The Prevention/Early Detection SIG strategic plan revisions were approved. They can be viewed on the P/D SIG Virtual Community at http://prevention1.vc.ons.org/page/6862/

Sue Shultz, MA
York, PA
sshultz@wellspan.org

PubMed is a sophisticated, powerful medical database with more than 16 million citations that can be searched using keywords or text words. PubMed is underpinned by a vast dictionary of medical indexing terms known as Medical Subject Headings (MeSH), which it uses to translate your request into a search query. Best of all, PubMed is free.

Sometimes you need to find a piece of clinical or research information quickly. How can you do that in PubMed? Let’s look at some examples.

Example One

You read in a recent news report that there may be tests to detect early throat cancer relapse. The news summary talks about biological markers, survival, relapse, cytokines, blood levels, and throat cancer. It also notes the name of the investigator (Carter Van Waes) and the journal in which the study appears (Clinical Cancer Research). You would like to know what the article citation is and if there is any other similar information available. Here’s what you might try.

In the PubMed Search box, put the authors name and the journal.

Click here for a detailed example.

PubMed correctly interprets your request as Van Waes (author) and Clinical Cancer Research (journal) and collects papers matching these criteria. The first citation retrieved is the one from the news story. Click here to view an example.

Example Two

Someone who got their information from a widely circulated e-mail calls you asking for information about using a CA-125 blood test for early diagnosis of ovarian cancer. Here’s what you might try. Click here for a detailed example.

PubMed allows you to display results in a variety of formats with 20 items to a page. By using the pull-down display window, you can alter the retrieval look to your satisfaction in six usable ways.

By using the pull-down show window, you can change the number of items that you want to display on the page from 5 to 500 items. In order to print a clean copy with a minimum of wasted space, open the pull-down window, select “send to” and then select your printer.

This is a short explanation of simple searching in PubMed. For more information, or to refresh your skills, consult the PubMed tutorials by clicking the tutorials link under Entrez PubMed from the bar at the left side of the PubMed home page. The quick tours section provides short animated and narrated helpful guides to searching.

Click here to visit the quick tours page.

Additional quick tours are listed below.

Search PubMed for an Author (Three minutes, June 2005)

Searching PubMed by Author and Subject (One minute, June 2005)

PubMed Simple Subject Search Example (One minute, June 2005)

Search for a Journal (Five minutes, June 2007)

Retrieving Citations from a Journal Issue (One minute, December 2005)

According to the American Cancer Society (ACS), weight control, dietary choices, and levels of physical activity are the most important modifiable determinants of cancer risk for those who do not use tobacco. The ACS argues that as many as one-third of the more than 500,000 cancer deaths that occur in the United States each year can be attributed to diet and physical activity habits; in addition, another third can be attributed to exposure to tobacco products. Excellent concrete details on how to alter risk through diet and behavior modification are available in the most recent update to the Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer with Healthy Food Choices and Physical Activity (http://caonline.amcancersoc.org).

In this most recent revision of the historic document, the assembled panel of experts in the areas of nutrition, physical activity, and cancer derived four guidelines from the existing cancer literature. In addition, they offered several points of clarification to be used when following each guideline. Finally, the committee felt strongly about making a statement regarding community support for fundamental changes in diet and physical activity. Without support from families, friends, and the community at large, positive change is difficult for even the most determined of individuals.

As in past documents, the experts summarized the existing literature for nutrition and physical activity’s effect on cancer risk reduction for a number of the most prevalent cancers, such as breast, colon, prostate, and lung. They expanded to include a number of gynecological cancers, as well as a number of cancers that involve the alimentary canal. They also offered an expert opinion on a number of consistently hot topics regarding cancer prevention and nutritional variables, such as coffee, bioengineered foods, soy, sugar substitutes, and an assortment of others. There are four basic guidelines with ACS points of explanation.

Maintain a healthy weight thought life
The goals are to balance caloric intake with caloric expenditure (through physical activity), avoid excessive weight gain throughout life, and if one is overweight, achieve and maintain a healthy weight. Weight maintenance is evidence of a balance in caloric intake and expenditure. Losing weight, if needed, should be done slowly and carefully while combining a calorie restrictive diet and enough physical activity to cause the body to tap into reserves. In order to lose one pound of body weight in one week, an individual must create a caloric deficit of approximately 3,500 calories or 500 calories per day for seven days; hence the recommendation to eat less and move more! We currently use body mass index as the objective measure of desirable weight. Click here to view an example.

Adopt a physically active lifestyle
Adults should engage in at least 30 minutes of moderate to vigorous physical activity five or more days each week; forty-five to 60 minutes is preferable. Children should be moving for 60 minutes each day, for at least five days per week. Usual activities are those that we do each day as part of our daily living. They are typically of low intensity and are shorter in duration. Moderate activities are those that require deliberate intention to move and effort, such as brisk walking. Other examples of moderate activities include dancing, leisurely bicycling, skating, horse back riding, and yoga. Vigorous activities generally engage large muscle groups and cause a change in breathing, heart rate and sweating. Examples of vigorous activities include jogging or running, jumping rope, swimming, aerobic dance, and martial arts. The ACS article goes on to highlight activities in the sports, home, and occupational categories that are examples of moderate activity and of vigorous activity.

Consume a healthy diet, with an emphasis on plant sources
One can do this by choosing foods and amounts (serving sizes) that help to achieve and maintain a healthy weight, eating five or more servings of fruits and vegetables each day, choosing whole grains over processed grains, and limiting consumption of processed and/or red meats.

Serving sizes for food and beverages vary. Spin the container around and check to see what is considered a serving size. It is often less than we expect and less than we eat. Choosing foods that are lower-calorie versions or alternatives will help with weight loss or maintenance. Examples of these foods includes fruits and vegetables, lower-fat versions of higher-fat foods, and lower-calorie versions of higher-calorie food. These are not one and the same. Food manufacturers can remove fat and then add back carbohydrates, which relates to the same number of total calories, but fewer from fat. This is all fine and good, except if one is trying to lose or maintain weigh. Then, a calorie is a calorie, regardless of the origin!

A serving of fruit is generally one cup of raw or a medium size (tennis ball) piece of fruit. A serving of cooked fruit is one-half cup. A serving size of raw vegetables is generally one cup, and cooked is one-half cup. With that said, it is not hard to eat five or more servings each day. Fruits and vegetables are packed with vitamins, minerals, and phytochemicals that are not found in such concentration elsewhere in our diet. They are worth the effort to find, clean, and eat!

If you drink alcoholic beverages, limit consumption
For people who drink alcohol, the recommendation is no more than one drink per day for women and two per day for men. A serving size of alcohol is 1.5 oz of distilled spirits, 12 oz of beer and 5 oz of wine. According to the ACS expert panel, there is no compelling reason for an adult to start consuming alcoholic beverages to reduce their risk for cardiac disease. Cardiovascular risk can be reduced by many of the risk reduction suggestions made for cancer, such as smoking cessation, consuming a healthy lower calorie, lower fat diet, achieving a healthy weight, and becoming physically active on a regular basis.

One final point, the beneficial ingredient in red wine (resveratrol) also can be found in a much less controversial form of red grape juice, red grapes, blueberries, and cranberries.

Message from the Editor
Healthcare Policies to Play Important Roll in Elections

The implications of public policy should not be underestimated. The amount of money that could potentially be saved with adequate healthcare for preventive services is staggering. Currently, there are an estimated 46 million uninsured Americans (Institute of Medicine, 2004). There is no doubt that they are not receiving preventive services.

The American Cancer Society (ACS) has recently formally adopted and published guiding principles to use in evaluating any health insurance reform proposal (Wender, 2007). These guidelines emphasize that true reform must include available, affordable, and adequate health insurance coverage without further segmenting the insurance market. There is an ambitious goal that by 2015 every American will have access to affordable, comprehensive healthcare based on evidence-based practice and focused on wellness.

Previous research has documented the importance of health insurance in receiving basic preventive care and timely treatment for serious medical conditions. Unfortunately in the U.S., an estimated 18,000 deaths are attributed each year to the lack of health insurance. The uninsured are more likely to not access health services at all or only when a catastrophic event occurs (Institute of Medicine 2004). Also, numerous studies have specifically shown that patients with cancer without insurance or in public aid programs may not receive adequate prevention and treatment, which results in poorer outcomes for their health (Wender, 2007).

A big piece of the puzzle lies in access. Studies continue to clearly demonstrate that identifying a primary care provider and receiving regular care plays a vital role in reducing cancer mortality. Individuals who have a regular source of primary care are more likely to be up-to-date with cancer screenings and to receive timely follow-ups and evaluations for abnormal findings on an initial screen (Starfield, Shi & Macinko, 2005).

A recent article in the New York Times stressed many of the inadequacies of the U.S. healthcare system (World’s Best Cancer Care, 2007). These include lack of universal or adequate healthcare coverage, problems with access, disparities in care, and lack of emphasis on health. The editorial also emphasizes that U.S. healthcare could be greatly enhanced through improved coordination of care, increased use of computerized records, and more teaching and communication between healthcare providers and patients.

Many believe it is time that U.S. citizens wake up to the fact that the U.S. healthcare system is truly in crisis and direct efforts need to be taken to increase the health of the nation. Are you going to think about each presidential candidate’s plan to provide health coverage for all citizens, both employed and unemployed, and how their proposals foster a healthcare system that emphasizes health?

References

Institute of Medicine. (2004). Insuring America's Health: Principles and Recommendations. Washington, DC: National Academy Press.

Starfield, B., Shi, L. & Macinko, J. (2005).Contribution of primary care to health systems and health. Milbank Quarterly, 83, 457-502.

Wender, R.C. (2007). The adequacy of the access-to-care debate: looking through the cancer lens. Cancer, 110, 231-233.

World’s Best Medical Care? (August 12, 2007). New York Times. Retrieved August 14, 2007, from http://www.nytimes.com/2007/08/12/opinion/12sun1.html?_r=1&oref=slogin

New From National

New! Cancer Biology Web Course
You don't want to miss the Cancer Biology Online Education Series that is designed to meet the educational needs of oncology nurses and others interested in gaining a fundamental understanding of cancer biology. You will receive cutting-edge information that enables you to provide the quality care your patients deserve. Registration is now open. Click here for more information.

ASCO Clinical Trials Workshop
Don't miss this important workshop aimed at oncologists and their research teams. Worth up to 16.25 CNE, the ASCO Clinical Trials Workshop is a great opportunity to teach you about the processes and procedures required for clinical trial participation and how to effectively integrate trials into your current practice. Visit the ASCO Web site for more information at http://www.asco.org.

Head to the Windy City - ONS Educational Offerings Will Blow You Away!
Registration is now open for the ONS 8th Annual Institutes of Learning. Worth 11.0 contact hours, Institutes of Learning is a one-of-a-kind educational experience that provides you with practical, hands-on knowledge that you can take home and use in your practice. You can’t get this knowledge anywhere else. Click here for additional information.

Advance Practice Nurse Conference
Looking for education to enhance your role as a nurse practitioner or clinical nurse specialist? Check out the ONS Advanced Practice Nursing Conference. Get the latest on oncology issues and trends that will help you transform cancer care while earning up to 15 contact hours. Plus, learn more about the new preconference diagnostic session. Click here for more information. Register for either conference by September 26, 2007, to save $100.

New! Oncology Nurse Practitioner Competencies
This document outlines specialty entry level competencies for oncology nurse practitioners (ONPs) who care for adult and late adolescent patients throughout the continuum of cancer care. It should be used by nurse practitioners, educators, employers, physicians, nurses, and anyone else who seeks to understand the role of the ONP.

This important guide was developed by a multi-organizational national panel convened by the ONS that used a nationally vetted process to develop, conduct reviews, and revise the document. The ONP competencies were reviewed and critiqued by 127 ONPs, as well as twenty members of a national validation panel comprised of representatives of nursing organizations and NCI-designated comprehensive cancer centers. Click here to learn more.

Behind the Scenes of Clinical Research: From Trial to Triumph
In the August issue of ONS Connect, oncology nurses describe their roles in clinical trials and research, including their ability to keep trials on track despite reduced funding. Do you refer patients for clinical trials? Click here to take this month's instant poll.

Take Advantage of ONS Partner Products and Services
Your ONS membership entitles you to a suite of additional member benefits from companies like Verizon, Amica, Bank of America, and Dell. Click here to learn more about the products and services available from these leading vendors.

The American Association of Colleges of Nursing (AACN) Response to ONS on the Questions Regarding the DNP
To read ONS's letter to the AACN, click here.
To read the AACN's response, click here.

Nurse in Washington Internship
The Nurse in Washington Internship (NIWI) program is an annual event sponsored by the Nursing Organizations Alliance (The Alliance). With 55 member organizations,
ONS among them, The Alliance represents approximately 500,000 nurses. The Alliance sponsors the internship to promote the interests of its member groups through education, research, and health policy activities. Over the years, more than one thousand nurses have attended NIWI, many of whom have become influential participants in the political process at state and federal levels.

The purpose of the NIWI Program is to provide nurses the opportunity to learn how to influence health care through legislative and regulatory processes. Participants learn from health policy experts and government officials and network with other nurses.

One of NIWI’s objectives is to prepare participants to be responsible nurse-citizens and to educate them about how they can affect legislative and regulatory processes. This is accomplished by an outstanding faculty, who come from nursing, education, advocacy, and government backgrounds.

The next NIWI is scheduled to be held March 9-11, 2008, in Washington, D.C. The internship includes spending a day on Capitol Hill visiting legislators. It is hoped that the dialogue begun during the internship will continue after the interns return home.

This year, ONS is offering a limited number of grants for nurses to attend NIWI. The deadline to apply for the grant is November 1, 2007. Recipients of the grants will receive full registration for NIWI, expenses for travel and hotel, and a per diem.

Welcome New Members

To navigate to your SIG’s page, visit the SIGs Virtual Community at http://sig.vc.ons.org and select “Find a SIG” from the top navigation.

Many features in the SIGs Virtual Community are useful to all members. Below is an outline of the information that can be found on your SIG’s page.

From your SIG’s main page, you can subscribe to SIG announcements, calendar events, and the discussion forum. Once you are subscribed to the areas, an e-mail will be sent to you every time an announcement, event, or discussion has been posted.

Announcements are added frequently with important information pertaining to your SIG, such as scholarship, leadership, and meeting information.
SIG events on the SIG calendar are showcased on the main page for your convenience. Simply click on an event for detailed information.

About Us
The About Us area features information about your SIG leaders.

News
The News section provides important information, such as minutes from past meetings and newsletters. Educational news and photos also can be found here.

Discussions
The Discussions area is very similar to the ONS List Serve, which can be found at http://listserv.vc.ons.org. Click the Discussions button at the top of your SIG’s page to access the area. You can post a message, thought, or questions and fellow SIG members can read your message and respond.

ONS National Announcements
Check this section every month for updated information from ONS such as continuing nursing education offerings, events, and important information.

If you have questions or problems navigating the SIGs Virtual Community, contact me at jshinsky@ons.org.

Articles of Interest
Prevention/Early Detection SIG Members May Enjoy These Recently Published Articles

• “Korean American Women’s Beliefs About Breast and Cervical Cancer and Associated Symbolic Meanings,” by Eunice E. Lee, PhD, RN, Toni Tripp-Reimer, PhD, RN, FAAN, Arlene M. Miller, PhD, RN, FAAN, Georgia R. Sadler, RN, MBA, PhD, and Shin-Young Lee, MSN (ONF, Vol. 34, pp. 713–720)
• “Breast Cancer Screening: Women’s Experiences of Waiting for Further Testing,” by Patricia Pineault, RN, MSN (ONF, Vol. 34, pp. 847–853)
• “Knowledge of Hereditary Prostate Cancer Among High-Risk African American Men,” by Sally Weinrich, PhD, RN, FAAN, Srinivasan Vijayakumar, MD, Isaac J. Powell, MD, Julie Priest, MSPH, Cathy Atkinson Hamner, BSN, Laryssa McCloud, PhD, and Curtis Pettaway, MD (ONF, Vol. 34, pp. 854–860)

Know someone who would like to receive a print copy of this newsletter?
To print a copy of this newsletter from your home or office computer, click here or on the printer icon located on the SIG Newsletter front page. Print copies of each online SIG newsletter also are available through the ONS National Office. To have a copy mailed to you or another SIG member, contact Membership/Leadership Administrative Assistant Carol DeMarco at cdemarco@ons.org or 866-257-4ONS, ext. 6230.

To view past newsletters, click here.

ONS Membership/Leadership Team Contact Information

Angie Stengel, MS, CAE, Director of Membership/Leadership
astengel@ons.org
412-859-6244

Diane Scheuring, MBA, CMP, Manager of Member Services
dscheuring@ons.org
412-859-6256

Carol DeMarco, Membership/Leadership Administrative Assistant
cdemarco@ons.org
412-859-6230

The Oncology Nursing Society (ONS) does not assume responsibility for the opinions expressed and information provided by authors or by Special Interest Groups (SIGs). Acceptance of advertising or corporate support does not indicate or imply endorsement of the company or its products by ONS or the SIG. Web sites listed in the SIG newsletters are provided for information only. Hosts are responsible for their own content and availability.

Oncology Nursing Society
125 Enterprise Dr.
Pittsburgh, PA 15275-1214
866-257-4ONS
412-859-6100
www.ons.org