A consensus‐validation study used action research methods to identify relevant nursing diagnoses, nursing interventions, and patient outcomes for a population of adults with traumatic brain injury (TBI) in long‐term care. In meetings totaling 159 hours to reach 100% consensus through group discussions, the three classifications of NANDA International's (NANDA‐I's) approved nursing diagnoses, the Nursing Interventions Classification (NIC), and the Nursing Outcomes Classification (NOC) were used as the basis for three nurses experienced in working with adults with TBI to select the elements of nursing care. Among almost 200 NANDA‐I nursing diagnoses, 29 were identified as relevant for comprehensive nursing care of this population. Each nursing diagnosis was associated with 3–11 of the more than 500 NIC interventions and 1–13 of more than 300 NOC outcomes. The nurses became aware of the complexity and the need for critical thinking. The findings were used to refine the facility's nursing standards of care, which were to be combined with the interdisciplinary plan of care and included in future electronic health records.

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In a consecutive series of admissions to the Johns Hopkins Sexual Disorders Unit, 4 out of 20 patients appeared to have simulated paraphilic symptoms that further assessment indicated were either exaggerated or not present. The paper presents case histories of these 4 patients. A descriptive comparison is made between these patients and control groups of patients who admitted having paraphilic symptoms and a group of patients accused to having paraphilic symptoms but who denied them. Patients who simulated paraphilias tended to be self-referred (75%) and without current legal charges (100%). None of these patients was referred or sought treatment for pedophilia, in contrast to the other two patient groups, in which pedophilia accounted for 75% of the referrals. Several possible explanations for why patients might simulate paraphilias and implications for therapists who evaluate or treat sex offenders are discussed.

As an IgA nephropathy patient who was on a highdose steroid regimen for 9 months in 2021, I wanted to share my thoughts about the study titled "Immunosuppression versus Supportive Care on Kidney Outcomes in IgA Nephropathy in the Real-World Setting," published in this issue of CJASN. 1 The authors conclude that "Immunosuppressive therapy, compared with supportive care, was associated with a 40% lower risk of clinically important kidney outcomes in patients with IgA nephropathy." 1 I applaud the effort made by the authors to assess glucocorticoid treatment in patients with IgA nephropathy with eGFRs below 50 ml/ min per 1.73 m 2 . Patients newly diagnosed with eGFRs at this low level could greatly benefit from continued research that is very specific to treating IgA nephropathy that has already reduced kidney function so drastically.

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