Context Given the current context of racial disparities in health and health care and the historical context of eugenics, racial disparities in the use of genetic susceptibility testing have been widely anticipated. However, to our knowledge there are no published studies examining the magnitude and determinants of racial differences in the use of genetic susceptibility testing. Objectives To investigate the relationship between race and the use of BRCA1/2 counseling among women with a family history of breast or ovarian cancer and to determine the contribution of socioeconomic characteristics, cancer risk perception and worry, attitudes about genetic testing, and interactions with primary care physicians to racial differences in utilization. Design, Setting, and Participants Case-control study (December 1999-August 2003) of 408 women with a family history of breast or ovarian cancer, of whom 217 underwent genetic counseling for BRCA1/2 testing (cases) and 191 women did not (controls). Participants received primary care within a large health system in greater Philadelphia, Pa. Main Outcome Measures Probability of carrying a BRCA1/2 mutation, socioeconomic characteristics, perception of breast and ovarian cancer risk, worry about breast and ovarian cancer, attitudes about BRCA1/2 testing, and primary care physician discussion of BRCA1/2 testing were measured prior to undergoing BRCA1/2 counseling for cases and at the time of enrollment for controls. Results African American women with a family history of breast or ovarian cancer were significantly less likely to undergo genetic counseling for BRCA1/2 testing than were white women with a family history of breast or ovarian cancer (odds ratio, 0.22; 95% confidence interval, 0.12-0.40). This association persisted after adjustment for probability of BRCA1/2 mutation, socioeconomic characteristics, breast and ovarian cancer risk perception and worry, attitudes about the risks and benefits of BRCA1/2 testing, and primary care physician discussion of BRCA1/2 testing (adjusted odds ratio for African American vs white, 0.28; 95% confidence interval, 0.09-0.89). Conclusions Racial disparities in the use of BRCA1/2 counseling are large and do not appear to be explained by differences in risk factors for carrying a BRCA1/2 mutation, socioeconomic factors, risk perception, attitudes, or primary care physician recommendations. The benefit of predictive genetic testing will not be fully realized unless these disparities can be addressed.

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Hyperbaric oxygen therapy has a rich and diverse history, both in the United States and around the world. From its early uses in war to the building of bridges, and through many introductions to innovations in the medical community, it has been debated and modified until its ultimate acceptance in multiple areas of patient care. Numerous areas of patient care use hyperbaric therapy, from wound care to military applications, in both single monoplace chambers and multipatient settings in larger chambers. This article provides an overview on the history, trial and error, and modern development of hyperbaric oxygen in clinical care therapies in 21st century medicine and nursing.

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Public Health Nurses are the largest group of public health practitioners in both local and state health departments across the United States. Essential for the delivery of health services in the community, Public Health Nurses frequently provide care for underserved and vulnerable populations. Among these populations are the victims of campus sexual assault, a growing problem on college and university campuses. Both nationally and internationally, sexual assault has been described as a public health and human rights concern. With the signing of the Senate Bill 967 in California, affirmative consent, known as "yes means yes," requires both parties in a sexual encounter to give voluntary and affirmative consent. Many colleges and universities across the country have adopted similar standards. However, students may choose not to seek health care after an assault at the Student Health Center, preferring to obtain care in community clinics or health departments. Students must be able to be safe on and off campus, and must be able to trust they will be heard by campus authorities and the health care community, and be treated with respect. Public health nurses need to be prepared to work with victims of campus sexual assault and have a solid foundation in the issues surrounding assault, and the needs of the student to trust their caregivers. This paper presents an overview of the vulnerability and risk factors in sexual assault, presents legislation on campus and institutional responsibility, and provides a foundation for Public Health Nurses working with victims of sexual assault.