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Climate change poses a threat to children, who are increasingly vulnerable, depending on adults to protect them from the impacts of these changes including extreme weather events, poor air and water quality and risk to mental health. Children living in poverty carry additional burdens and risks, living in environments that consistently experience poor air and water quality from polluting industries, compounded by the effects of climate change. COVID-19 has placed additional challenges to children's health and increases the complexity of addressing climate change and environmental justice. The intersection between climate change and COVID-19 exacerbates these existing disparities by impacting children's physical and mental health that are a direct product of poverty and structural racism. This article examines the nexus of climate change, COVID-19, and environmental justice that impacts the mental and physical health of children including anxiety, stress, adverse childhood experiences, and depression; increases in violence and aggression; and the effects of air pollution. Public health professionals and health care providers must be aware of national strategies that protect children from environmental health risks and emerging infectious diseases, such as climate change and COVID-19, respectively. Key Take Away Points: (1) Anthropogenic climate change poses a threat to the health of children, especially of those in marginalized communities; (2) COVID-19 has exacerbated these detrimental health impacts for children experiencing the effects of climate change; and (3) There are opportunities to protect children's health through equitable polices and programs.

Background: Transgender and nonbinary (TGNB) people experience inequities in health care access, quality, and outcomes. Health care professionals' lack of knowledge and biased attitudes toward gender minorities contribute to inequitable care. Purpose: This study examined the effect of TGNB health education on nursing students' knowledge and attitudes about caring for TGNB clients. Methods: A quasi-experimental study using a one-group pretest/posttest design was conducted with 46 nursing students at 2 private baccalaureate nursing programs. Results: A paired-samples t test found a significant increase in knowledge about caring for TGNB clients at posttest (P = .02). Attitudes toward caring for TGNB clients showed a significant improvement in the Sex and Gender Beliefs subscale at posttest (P = .014). Conclusions: The findings suggest that TGNB health education is effective for inclusion in nursing curricula to better prepare nurses to care for gender-diverse clients. [ABSTRACT FROM AUTHOR]

Purpose: To examine state Area Agencies on Aging (AAAs) in Pennsylvania for services they provide to older adults regarding extreme events and how readiness can be captured through social networks and policies at the local, state, and federal levels. Method: Using an online survey, 79% of AAA directors answered questions describing perceptions and actions related to social capital and its influence on policy. Results: AAAs acknowledged weather/temperature changes impact the need to prepare for common scenarios of extreme weather, temperature, and flooding. AAAs reported major social connections with county government and one state agency, with limited connections with federal agencies. Conclusion: Multiple opportunities exist for AAAs to consider climate change in expansion efforts, specifically regarding health care. Geriatric nurses can play a key role in expansion, advocacy, and policy development for AAAs that serve older adults in the context of climate change. [Journal of Gerontological Nursing, 50(6), 11–15.] [ABSTRACT FROM AUTHOR]

With climate change and re‐oligotrophication of lakes due to restoration efforts, the relative importance of benthic cyanobacteria is increasing, but they are much less studied than their planktonic counterparts. Following a major water level rise event that inundated massive reed stands in Lake Kinneret, Israel, we discovered the appearance of a vast abundance of Gloeotrichia pisum (cyanobacteria). This provided an opportunity to investigate the biology and ecology of a benthic epiphytic colonial cyanobacterium, proliferating under altered environmental conditions, with possible toxin production potential and as a model for an invasive epiphyte. The species was identified by its typical morphology, and by sequencing its 16S rRNA gene and the intragenic space. We report on the abundance and spatial distribution of the detected colonies, their morphological characteristics, and pigment composition. High phycoerythrin content provides a brownish color and supports growth at low light levels. Genomic community composition analysis revealed that G. pisum colonies host a diverse microbial community of microalgae, cyanobacteria, bacteria, and archaea with a conserved and characteristic taxonomic composition. The Synechococcales order showed high relative abundance in the colony, as well as other prokaryotes producing secondary metabolites, such as the rhodopsin producer Pseudorhodobacter. The microbial consortium in the colonies performed nitrogen fixation. The diazotroph's phylogenetic relations were demonstrated. Tests for the presence of cyanotoxins (microcystin and cylindrospermopsin) proved negative. This study is the first documentation of this genus in Israel, providing insights into the invasive nature of G. pisum and the ecological implications of its appearance in a lake ecosystem. [ABSTRACT FROM AUTHOR]

Background: The United States has the largest, most diverse immigrant population. Nurses will care for immigrant clients in all areas of nursing practice. Purpose: The purpose of this study was to determine nursing students' self-efficacy in working with immigrant clients following a service-learning experience. Methods: A pre-/posttest descriptive study was used to measure students' self-efficacy in cultural aspects of screening, providing health education, and assisting with health care access prior to and after a voluntary service-learning experience at a resettlement agency. Results: Statistical significance was found in overall scale score and in all 19 individual items except 2 related to working with (P =.21) and communicating with (P =.49) the health care team. Overall, pretest and posttest results revealed that students' self-efficacy working with immigrant clients was improved. Conclusion: Collaborating with an immigrant resettlement program to provide a structured immigrant health learning experience for prelicensure nursing students can improve self-efficacy in working with immigrant clients. [ABSTRACT FROM AUTHOR]

Renibacterium salmoninarum is the causative agent of bacterial kidney disease and a significant threat to healthy and sustainable production of salmonid fish worldwide. This pathogen is difficult to culture in vitro, genetic manipulation is challenging, and current therapies and preventative strategies are only marginally effective in preventing disease. The complete genome of R. salmoninarum ATCC 33209 was sequenced and shown to be a 3,155,250-bp circular chromosome that is predicted to contain 3,507 open-reading frames (ORFs). A total of 80 copies of three different insertion sequence elements are interspersed throughout the genome. Approximately 21% of the predicted ORFs have been inactivated via frameshifts, point mutations, insertion sequences, and putative deletions. The R. salmoninarum genome has extended regions of synteny to the Arthrobacter sp. strain FB24 and Arthrobacter aurescens TCI genomes, but it is approximately 1.9 Mb smaller than both Arthrobacter genomes and has a lower G+C content, suggesting that significant genome reduction has occurred since divergence from the last common ancestor. A limited set of putative virulence factors appear to have been acquired via horizontal transmission after divergence of the species; these factors include capsular polysaccharides, heme sequestration molecules, and the major secreted cell surface antigen p57 (also known as major soluble antigen). Examination of the genome revealed a number of ORFs homologous to antibiotic resistance genes, including genes encoding [beta]-lactamases, efflux proteins, macrolide glycosyltransferases, and rRNA methyltransferases. The genome sequence provides new insights into R. salmoninarum evolution and may facilitate identification of chemotherapeutic targets and vaccine candidates that can be used for prevention and treatment of infections in cultured salmonids.

Author(s): Donna M. Muzny [1]; Steven E. Scherer (corresponding author) [1]; Rajinder Kaul [2]; Jing Wang [3]; Jun Yu [3]; Ralf Sudbrak [4, 5]; Christian J. Buhay [1]; Rui Chen [...]

Author(s): LaDeana W. Hillier [1]; Robert S. Fulton [1]; Lucinda A. Fulton [1]; Tina A. Graves [1]; Kymberlie H. Pepin [1]; Caryn Wagner-McPherson [1]; Dan Layman [1]; Jason Maas [1]; [...]

Aims and objectives: To describe how nurses and nurse managers consider sustainable development principles in their daily work, how well they recognise these principles and how these principles are considered in decision‐making in perioperative work. Background: Sustainable development involves interpersonal social and cultural relations and long‐term economic and ecological thinking in societal decision‐making. These dimensions are well‐suited for a foundation of decision‐making in acute health care. No previous research has been performed on perioperative work from the sustainable development perspective. Design: Qualitative descriptive design was used. Data were collected from perioperative nurses (n = 20) and nurse managers (n = 6) working in five surgical departments in a Finnish university hospital. Data were analysed by content analysis. The reporting follows qualitative research checklist (COREQ). Results: The principles of sustainable development were poorly known among the participants. Nurse managers considered their opportunities to influence decision‐making were reduced by their limited economic knowledge. Resource use, individuality, and ecological viewpoints were emphasised in the decision‐making process in perioperative work. Conclusions: Findings reveal that perioperative nurses and nurse managers are aware of economic and ecological sustainability, but they do not actively consider it as part of their work. Social and cultural sustainability must be developed further in decision‐making in perioperative work. Relevance to clinical practice: Perioperative nurses and nurse managers consider that it is important to develop the principles of sustainable development in perioperative work. This research indicates that economic understanding is not guiding decision‐making, and there is a lack of knowledge about the benefits of ecological procedures. Social and cultural sustainability are not connected in perioperative work, although there is collaboration between the surgical team and the patient is essential. This study helps to organise operating room management effectively and diversely. [ABSTRACT FROM AUTHOR]

Aims: A variety of surgical techniques are available for vaginal prolapse repair, indicating a lack of consensus. A debate regarding the utility of hydrodissection for splitting the surgical plane of the vaginal wall exists. The aim of this study is to evaluate the impact of hydrodissection in anterior colporrhaphy (AC). Materials: Patients undergoing primary AC were randomly assigned to an approach with (study group) versus without (control group) hydrodissection. Five surgeons performed both techniques, and the trimmed vaginal tissue was retrieved for histological analysis. Two pathologists, blinded to the surgical approach, evaluated the presence of a loose connective tissue at the surgical dissection plane (controversially deemed 'fascia', as explained in this article). In addition, we compared the operative time, pain score and haemoglobin levels. After statistical analysis, data were presented using percentile, and statistical significance was tested using the χ2 and Fisher's exact tests. Results: Forty‐six patients underwent primary elective AC, with 23 patients in each, the study and control groups. The groups were comparable regarding age (study group 60.33 ± 11.95 years and control group 59.86 ± 12.04, P = 0.90), menopausal status (study group 17 (73.9%) and control group 15 (68.2%), P = 0.67) and other characteristics. We found no difference in sample characteristics between the two groups. Connective tissue was found in only 13.6% (n = 3) of patients after hydrodissection and in 27.3% (n = 6) of patients without hydrodissection (P = 0.46). The hydrodissection group had significantly less bleeding than the control group (ΔHB 0.66 ± 0.66 vs 1.21 ± 0.84, P = 0.05). Conclusions: After hydrodissection, less bleeding was noted without compromise the surgical planes. [ABSTRACT FROM AUTHOR]

Internationally, nurses are gaining recognition for their contributions to public health and global health initiatives, however, their contributions to surveillance and the detection of new and emerging infectious disease, which is an important element of global health security, remain largely unknown. The purpose of this study was to investigate the perceptions of nurse experts related to the current and optimal roles of nurses in surveillance of new and emerging infectious diseases. Additionally, this study aimed to identify the skills needed by nurses in all practice settings for optimal performance of surveillance and to identify barriers to achieving optimal performance of surveillance. A three-round Delphi study was conducted. Nurse experts participated in Round 1 interviews followed by ranking current and optimal role, skill, and barrier statements in Rounds 2 and 3. Findings revealed four current roles and 13 optimal roles for nurses in surveillance, 13 skills needed to perform surveillance activities, and seven barriers to optimal performance of surveillance activities by nurses. Results of this study are intended to inform nursing practice and education in the U.S., and to provide guidance on the role of nurses in surveillance of new and emerging infectious disease as part of the Global Health Security Agenda. [ABSTRACT FROM AUTHOR]

Objectives. Understanding more about the psychological state of persons notified of human immunodeficiency virus (HIV) infection is critical for designing notification and counseling programs that will have the most positive effect. Methods. The subjects were blood donors who had been notified of HIV infection by the New York Blood Center. A nurse elicited a medical history, performed a limited medical examination, and asked the subjects to complete a questionnaire that included questions about drug use, sexual behavior, and psychological characteristics. The subjects completed another questionnaire approximately 2 weeks later. Results. The average depressive symptom scores for both men and women were substantially higher than scores typically found in representative population samples. More than a quarter of the men and more than a third of the women reported seeking psychological or psychiatric services in the first few weeks following notification. Conclusions. Anticipating and meeting individuals' psychological needs may be necessary if HIV screening programs are to address effectively the needs of persons infected with HIV. Am J Public Heath. 1993;83:534-539), HIV screening programs should anticipate the psychological needs of people who test positive. Depressive symptoms were evaluated in 271 men and women who were notified that they were HIV positive after donating blood. Overall, men and women were most likely to cope with the news by talking with a health professional and least likely to cope by using alcohol or drugs or by resignation. Women were more likely than men to feel they had less control over their illness and to have problems with sexual functioning. Women scored higher on a test of depressive symptoms as did people with low self-esteem, poor social support and functioning and little optimism about the possibility of AIDS treatment discoveries. Gay and bisexual men were less likely than women and heterosexual men to seek professional psychological help.

Blood centers screen donations for a variety of problems, including the presence of HIV antibodies, to ensure the safety of the blood supply. They notify donors with abnormal test results so they can get treatment and, hopefully, to reduce the spread of infection. However, it is not known whether screening and notification result in positive behavior changes. Short-term behavior changes were assessed in HIV-positive blood donors. The subjects did not volunteer for HIV antibody testing, but were tested as a part of the standard protocol when they donated blood. Of 708 HIV-positive donors identified during the study period, 196 completed an initial interview and baseline questionnaire, and returned for a two-week follow-up visit. Questionnaires elicited information about drug use, sexual behavior, and psychological characteristics prior to notification and after. Women and men both reported practicing safer sex behavior during the two weeks between interviews than prior to the first interview. However, 40 percent reported that they still were practicing unsafe sex. The results of notification of positive HIV status was not significantly associated with behavior changes among these subjects. More information is needed about how high-risk behavior can be modified. (Consumer Summary produced by Reliance Medical Information, Inc.)

Background: Ubiquitin‐Specific Peptidase 26 (USP26), located on the X chromosome, encodes a deubiquitinating enzyme expressed mainly in testis, where it regulates protein turnover during spermatogenesis and modulates the ubiquitination levels of the Androgen Receptor (AR), and as a consequence, affects AR signaling. Methods: The patient was thoroughly characterized clinically. He was genetically tested by chromosome analysis and whole exome sequencing (WES). Results: The patient was diagnosed with Sertoli cell‐only syndrome pattern (SCOS). The WES analysis revealed only the variation in USP26: causing p.P469S in a highly evolutionary conserved amino acid as the possible cause for SCOS. The literature search identified 34 single variations and 14 clusters of variations in USP26 that were associated with male infertility. Only one of the 22 variations and of one cluster of three mutations tested for ubiquitination activity was found as damaging. Only one out of six variations tested for effect on AR function was found as damaging. Thus, the association of USP26 with male fertility was questioned. Conclusions: The finding in our patient and the discussion on the reviewed literature support a possible role for USP26 in male fertility. [ABSTRACT FROM AUTHOR]

Older adults have unique health risks related to climate change. This commentary addresses the health impacts of climate change for older adults, identifies gaps in gerontological nursing research, and highlights areas for research to address the significant gap in nursing science. Climate risks of extreme weather events, such as heat, rain, flooding, and wildfires, as well as poor air quality, vector-borne diseases, interruptions of services, and treatment plans all place older adults at risk of experiencing greater morbidity and early mortality. Despite these risks, there is a gap in nursing research related to climate change and aging. Nurse scientists can address this gap with an interdisciplinary approach. There are climate resources and theoretical frameworks to support scientific inquiry. Funding sources must be made available to assure rigorous scholarship of climate-related health impacts for older adults. Gerontological nurse researchers must build capacity to address climate change and health. [Older adults have unique health risks related to climate change. This commentary addresses the health impacts of climate change for older adults, identifies gaps in gerontological nursing research, and highlights areas for research to address the significant gap in nursing science. Climate risks of extreme weather events, such as heat, rain, flooding, and wildfires, as well as poor air quality, vector-borne diseases, interruptions of services, and treatment plans all place older adults at risk of experiencing greater morbidity and early mortality. Despite these risks, there is a gap in nursing research related to climate change and aging. Nurse scientists can address this gap with an interdisciplinary approach. There are climate resources and theoretical frameworks to support scientific inquiry. Funding sources must be made available to assure rigorous scholarship of climate-related health impacts for older adults. Gerontological nurse researchers must build capacity to address climate change and health. [Research in Gerontological Nursing, 13(1), 6–12.] [ABSTRACT FROM AUTHOR]

Our climate is changing. These changes have an impact on health, especially in vulnerable populations such as older adults. Many older adults lack the physical, cognitive, social, and economic resources to avoid and/or mitigate the effects of exposure to extreme weather events. The purpose of the current article is to help nurses understand climate change and how that relates to the need for specific interventions to support climate adaptation for the older adult population. A model of exposure, contact to stressors, and adaptive capacity are used to address the health needs of older adults in the face of climate change. Gaps in nursing knowledge, resources for nurses, and a proposed agenda for research and practice in climate change are offered. Gerontological nurses are in an important position to lessen the harm of climate change in older adults through practice, research, and policy. [Our climate is changing. These changes have an impact on health, especially in vulnerable populations such as older adults. Many older adults lack the physical, cognitive, social, and economic resources to avoid and/or mitigate the effects of exposure to extreme weather events. The purpose of the current article is to help nurses understand climate change and how that relates to the need for specific interventions to support climate adaptation for the older adult population. A model of exposure, contact to stressors, and adaptive capacity are used to address the health needs of older adults in the face of climate change. Gaps in nursing knowledge, resources for nurses, and a proposed agenda for research and practice in climate change are offered. Gerontological nurses are in an important position to lessen the harm of climate change in older adults through practice, research, and policy. [Journal of Gerontological Nursing, 45(11), 21–29.] [ABSTRACT FROM AUTHOR]

Highlights • Nurses engaged in international learning or service experiences lack clear guidance for ethical practice. • Delphi method led to development and ranking of the items for ethical principles for global health nursing. • Study findings offer a framework for ethical practice in global health nursing. • Results for Ethical Principles for Global Health Nursing Practice and Ethical Guidelines in Global Health Nursing. Abstract Background Nurses are among the many U.S. health professionals engaged in international learning or service experiences and often travel to low-resource countries lacking guidance for ethical practice, respect for host partners, or collaborative work in different health systems. Purpose The aim of this study is to develop evidence-based principles or guidelines for ethical global health nursing practice. Methods A three-round Delphi study was conducted. Global health nurse experts participated in Round 1 focus group, followed by nurses with global health expertise ranking global health nursing statements in Rounds 2 and 3. Discussion Findings led to 10 Ethical Principles for Global Health Nursing Practice and 30 statements for Ethical Guidelines in Global Health Nursing. These Ten principles address beneficence, nonmaleficence, dignity, respect, autonomy, social justice, and professional practice. The 30 guidelines offer more specific actions nurses must consider when working in global settings. [ABSTRACT FROM AUTHOR]

HOW DOCTORS THINK. By Jerome Groopman, Houghton Mifflin. 307 pp. $26 ONCE UPON A TIME, DOCTORS made house calls and eye contact. Chatting at patients' bedsides or with their families [...]