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The practice of mission and how we use money in missions flow fundamentally from the identities and values of persons engaged in ministry. In this article I argue that missionary [...]

Atlantic cod (Gadus morhua) populations in the Gulf of Maine (GoM) are at a fraction of their historical abundance, creating economic hardships for fishermen and putting at risk the genetic diversity of the remaining populations. An understanding of the biocomplexity among GoM populations will allow for adaptive genetic diversity to be conserved to maximize the evolutionary potential and resilience of the fishery in a rapidly changing environment. We used restriction-site-associated DNA sequencing (RADseq) to characterize the population structure and adaptive genetic diversity of five spawning aggregations from the western GoM and Georges Bank. We also analyzed cod caught in the eastern GoM, an under-sampled area where spawning aggregations have been extirpated. Using 3,128 single nucleotide polymorphisms (SNPs), we confirmed the existence of three genetically separable spawning groups: (1) winter spawning cod from the western GoM, (2) spring spawning cod, also from the western GoM, and (3) Georges Bank cod. Non-spawning cod from the eastern GoM could not be decisively linked to either of the three spawning groups and may represent a unique component of the resource, a mixed sample, or cod from other unsampled source populations. The genetic differentiation among the three major spawning groups was primarily driven by loci putatively under selection, particularly loci in regions known to contain genomic inversions on linkage groups (LG) 7 and 12. These LGs have been found to be linked to thermal regime in cod across the Atlantic, and so it is possible that variation in timing of spawning in western GoM cod has resulted in temperature-driven adaptive divergence. This complex population structure and adaptive genetic differentiation could be crucial to ensuring the long-term productivity and resilience of the cod fishery, and so it should be considered in future management plans. [ABSTRACT FROM AUTHOR]

To Give or Not to Give? Rethinking Dependency, Restoring Generosity, and Redefining Sustainability. By John Rowell. Tyrone, Ga.: Authentic, 2006. Pp. xi, 262. Paperback $16.99. 'I am calling for a [...]

The decline of the Atlantic cod, Gadus morhua, stock in the Gulf of Maine to a historically low biomass has been coupled with a severe contraction in spatial range. The stock is now largely concentrated in the western Gulf of Maine. This erosion of spatial stock structure may be a factor-inhibiting recovery of Gulf of Maine cod. However, recent efforts to rebuild anadromous forage fish in the coastal Maine region coupled with the proposed creation of a new Eastern Maine Closed Area (EMCA), sited where localized depletion of the cod stock has been especially severe, might enable reestablishment of lost spatial structure of Gulf of Maine cod. We carried out larval transport modeling to examine the potential benefit of recovered cod spawning in the EMCA through supplying larvae to suitable juvenile settlement areas in the Gulf of Maine coastal zone and in the Cashes Ledge Closed Area (CLCA) in the central Gulf of Maine. The results indicate that an appreciable fraction of the larvae spawned in the EMCA are retained, to an age of settlement capability, in the coastal Maine region. Spawning in the EMCA may thus be a contributor of juveniles to a local, eastern Gulf of Maine, cod sub-stock. The results further indicate that spawning in the EMCA may supply a substantial subsidy of larvae to suitable juvenile habitat in the western Gulf of Maine and the CLCA. Protection of spawning stock in the EMCA may thus provide demographic benefits for the wider Gulf of Maine cod stock. Patterns of larval-stage connectivity between various potential spawning regions (including the EMCA) and areas of suitable juvenile habitat exhibit considerable interannual variability, which is predominantly linked to variability in the large-scale Gulf of Maine circulation. This result underscores the value of spatially explicit management as a means of fostering the recovery of the Gulf of Maine cod stock. [ABSTRACT FROM AUTHOR]

Interpreting Contemporary Christianity: Global Processes and Local Identities. Edited by Ogbu U. Kalu. Grand Rapids: Eerdmans, 2008. Pp. xiv, 365. Paperback $45. Interpreting Contemporary Christianity has fourteen essays, historical reflections [...]

PROBLEM. Facilitating the development of student nurses' cultural competence and translating these experiences into the clinical setting. METHODS. Qualitative methods. FINDINGS. A short-term global immersion experience informs student nurses' cultural awareness, education, and future clinical practice. CONCLUSIONS. Participation in a short-term global health experience contributes to students' personal growth and broadens their insight into multicultural care. [ABSTRACT FROM AUTHOR]

Aim This paper explores educational strategies for nurses that focus on reflectivity and promote the development of self-awareness, relationship and communication skills and ability to lead with presence and compassion in the midst of change. Background Today nurses move rapidly from carefully-controlled educational experiences to a fast- paced clinical world of increasing patient complexity amid calls for improved quality of care. Making the transition to clinical competence and leadership in practice requires a strong sense of self and emotional intelligence. Evaluation Pedagogies that integrate theoretical and data-based textbook learning with experiential learning and reflection are a foundation for the development of emotionally- and intellectually-competent leaders and requires new ways of assessing learner outcomes. Key issues Reflection is a key instructional strategy for preparing transformational nurse leaders for interdisciplinary settings where they lead patient care management. The remarkable global spread of reflection in nursing education, practice and research follows an emphasis on developing self-awareness as a leadership strategy for improving individual and organizational performance. Conclusions Empirical, experiential and anecdotal evidence suggests that reflection has the potential to prepare emotionally-capable nurse leaders. Implications for Nursing Management As educators create more reflective and nurturing learning environments, they will promote the development of emotionally-competent nurse leaders who will, in turn, inspire individual and organizational growth and positive change in society. [ABSTRACT FROM AUTHOR]

Yellow perch (YP) are metal tolerant fish that form large populations in many metal-impacted regions across Canada. While they are able to survive and reproduce successfully in environments with water and sediment metal concentrations that are toxic to many invertebrates, perch experience a suite of direct and indirect impacts. YP were studied in a series of Canadian Precambrian Shield lakes near Sudbury, Ontario, along a gradient of metal exposure downwind from metal smelters. In lakes at the high end of our exposure gradient, concentrations of metals (Cu, Ni, and Cd) in YP liver and kidney were well above levels seen in fish from reference lakes. Direct effects linked to metal-exposure were observed, ranging from effects at the cellular level, to effects in organs and tissues, individuals, and populations. In addition to direct or physiological effects, we also documented indirect, foodweb-mediated effects of metals on YP in the most contaminated lakes resulting from the elimination of metal-sensitive large benthic invertebrates and their replacement by small metal-tolerant taxa. The most common indication of such indirect effects on YP is severely stunted growth coupled with a high degree of zooplankton dependence throughout their life. Such indirect effects have important implications for ecological risk assessment (ERA) because they indicate that higher trophic levels may be functionally altered even though the functional groups that they depend on are present and abundant. Although the functional groups important to yellow perch can be abundant in metal-impacted lakes, their benthic communities are impoverished and this is strongly reflected in their size structure upon which energy transfer to higher trophic levels depends. Thus indirect (foodweb-mediated) effects can be important in situations where invertebrate size structure is impacted in such a way as to reduce the efficiency of energy transfer to higher trophic levels, and therefore measures should be taken to protect and/or restore large sensitive benthic species. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study was designed to examine the acute pain experience of hospitalized patients in order to address gaps and clarify how pain and its management influenced patients to report satisfaction or dissatisfaction.DESIGN: Descriptive, qualitative.SETTING: Two hospitals in the southwestern United States.POPULATION: Potential subjects were identified from the patient roster for each medical and surgical unit by the unit's nurse manager. Patients were hospitalized for at least 24 hrs, post-surgical or diagnosed with a painful condition. The sample comprised 241 adult participants.INTERVENTIONS: Data for the descriptive qualitative portion of the study came from three open-ended questions that were part of a 16-item survey, the American Pain Society-Patient Outcome Questionnaire-Modified. Data collectors were trained to administer the survey, ask the three open-ended questions, and record all responses.MAIN OUTCOME MEASURE(S): Four themes were identified as influencing patient satisfaction with pain management: patient pain experience, patient views of providers, patient pain management experiences, and pain management outcomes. Four common elements describe the theme, patient pain experience: Attitudes and beliefs about pain and pain management, expectations about pain, descriptions of pain, and pain management strategies. Patient views of health care providers had three common elements. The three elements described patient perceptions of provider attitudes toward pain, provider knowledge and skills, and provider responses to participants' pain. Three common elements described the theme of patient pain management experiences: patient involvement in care, effective pain management strategies, and unresolved pain. Participants described both positive and negative experiences. The fourth theme, pain management outcomes, was a synthesis of the other themes, explained by one common element; factors affecting reports of satisfaction and dissatisfaction.RESULTS/CONCLUSIONS: The study contributes to our understanding of patient responses to pain through a typology of factors that influences levels of satisfaction. It became clear that even though patients expressed disbelief of pain myths on the written questionnaire, their behaviors at the time of pain were based on these beliefs. Interview responses suggest that patient education is needed to overcome lack of knowledge, fear of addiction, side effects, and unrealistic concerns about taking pain medications and to reduce tendencies to suffer in silence. Institutions must develop a multidisciplinary philosophy of pain management to be communicated to each patient on admission to provide patients needed education. Research is needed to understand the impact of culture on the pain experience. This greater understanding can further empower patients to be active partners in their care. [CINAHL abstract] [ABSTRACT FROM AUTHOR]

This study examined neuropsychological test performance in a representative sample of 70 female patients with SLE. The influence of current or past clinically overt central nervous system involvement, use of corticosteroid medications and overall disease activity were evaluated. The results suggest two distinct patterns of cognitive dysfunction. Impaired delayed recognition memory was associated with past or current nervous system involvement, suggesting the presence of a residual neurologic deficit. Increased disease activity was associated with impaired immediate memory and concentration which may represent transient and diffuse central nervous system effects. Although corticosteroid use was associated with poor word list recall, group differences were not statistically significant when disease activity was considered as a covariate in the analysis. Follow-up studies are required to determine if these abnormalities persist or fluctuate with changes in disease activity and concurrent medications. [ABSTRACT FROM PUBLISHER]

Nervous system involvement in systemic lupus erythematosus (SLE) includes a wide array of manifestations some of which have been associated with specific autoantibodies. These include reactivity to surface neuronal and lymphocyte antigens, ribosomal P and cardiolipin. The aim of the present study was to examine the association between cognitive abnormalities and these autoantibodies in an unselected female population of SLE patients. Using a battery of standardized neuropsychological tests, cognitive impairment was identified in 15/70 (21%) SLE patients compared to 1/25 (4%) patients with rheumatoid arthritis and 1/23 (4%) healthy subjects (=0.04). Circulating antineuronal antibodies were measured by indirect immunofluorescence using human neuroblastoma cell lines IMR-6 and SK-N-SH. Lyrnphocytotoxic antibodies were measured by microcytotoxicity. Antibodies to ribosomal P and cardiolipin were measured by ELISA. Antineuronal antibodies were detected in 34%, lymphocytotoxic antibodies in 47%, anti-P antibodies in 17% and anticardiolipin antibodies in 24% of patients. In the cognitively impaired and unimpaired SLE patients there was no significant difference in the prevalence of antineuronal antibodies (33 35%), lymphocytotoxic antibodies (40 50%), anti-P antibodies (20 17%) or anticardiolipin antibodies (7 29%). The titre and isotype of autoantibodies were also similar in both groups. These results suggest that autoantibodies which have previously been associated with nervous system manifestations of SLE are not likely to be directly involved in the pathogenesis of cognitive dysfunction. [ABSTRACT FROM PUBLISHER]

Patients with the Wiskott-Aldrich syndrome have immunodeficiency characterized by defective antibody production and clinical anergy. In vitro lymphocyte proliferative responses to non-specific mitogens in these patients, however, are normal. To determine if their anergy might be the result of failure to produce cytotoxic effector lymphocytes, peripheral blood leucocytes were cultured with 51Cr-labelled chicken erythrocyte targets in the presence of PHA. Lymphocytes from patients with the Wiskott-Aldrich syndrome had normal PHA induced cytotoxicity responses and this result is discussed in relation to a postulated defect in the afferent limb of the immune response. [ABSTRACT FROM AUTHOR]

Around the world nurses, midwives and all health professionals are developing new roles and responsibilities in improving health care. By applying the science that undergirds the approach to quality improvement and safety developed in other high performance industries, health professionals are shifting from only considering personal responsibility and accountability to systems redesign. Error reporting systems in many countries and regions allow systematic analysis of near misses as well as sentinel events so that the system can be redesigned to prevent future occurrence. Health care organizations match their quality data with benchmarks established among their peers to discover gaps in quality, create quality improvement teams to close the gap, and encourage interdisciplinary collaboration and teamwork to achieve improved outcomes. Nurses are challenged to create the educational approaches so nurses have the necessary skills and leadership opportunities, as illustrated in the Quality and Safety Education for Nurses (QSEN) project. [ABSTRACT FROM AUTHOR]

BackgroundApproximately 30-40% of children MethodsPredominantly healthy infants (≤2 years) were recruited in Oxfordshire, UK, and provided ≥1 fecal samples. Independent risk factors for toxigenic/non-toxigenic C. difficile colonization and acquisition were identified using multivariable regression. Infant C. difficile isolates were whole-genome sequenced to assay genetic diversity and prevalence of toxin-associated genes, and compared with sequenced strains from Oxfordshire CDI cases.Results338/365 enrolled infants provided 1332 fecal samples, representing 158 C. difficile colonization or carriage episodes (107[68%] toxigenic). Initial colonization was associated with age, and reduced with breastfeeding but increased with pet dogs. Acquisition was associated with older age, Caesarean delivery, and diarrhea. Breastfeeding and pre-existing C. difficile colonization reduced acquisition risk. Overall 13% of CDI C. difficile strains were genetically related to infant strains. 29(18%) infant C. difficile sequences were consistent with recent direct/indirect transmission to/from Oxfordshire CDI cases (≤2 single nucleotide variants [SNVs]); 79(50%) shared a common origin with an Oxfordshire CDI case within the last ~5 years (0-10 SNVs). The hypervirulent, epidemic ST1/ribotype 027 remained notably absent in infants in this large study, as did other lineages such as STs 10/44 (ribotype 015); the most common strain in infants was ST2 (ribotype 020/014)(22%).ConclusionsIn predominantly healthy infants without significant healthcare exposure C. difficile colonization and acquisition reflect environmental exposures, with pet dogs identified as a novel risk factor. Genetic overlap between some infant strains and those isolated from CDI cases suggest common community reservoirs of these C. difficile lineages, contrasting with those lineages found only in CDI cases, and therefore more consistent with healthcare-associated spread.

Background: The global nursing workforce is confounded by shortages of nurses, faculty, and academic nursing leaders. Nursing academic leaders influence faculty recruitment and retention influencing the enrollment pipeline to fill nurse workforce capacity., Objective: To identify leadership qualities nursing faculty prefer in nursing academic leaders globally., Design: A multi-country exploratory design employed a three-round Delphi process including Demographic Data and open-ended questions., Setting: An online Qualtrics survey was emailed to schools of nursing selected from seven global regions: United States (North America), Mexico (Latin America/ Caribbean), South Africa (Africa), Saudi Arabia (Middle East), Korea (Asia), Sweden (Europe), and Australia (Oceania)., Participants: A convenience sample of faculty members employed in schools of nursing in the seven countries., Method: A 43-item Qualtrics survey developed from literature review of leadership qualities of nursing academic leaders was distributed to nursing faculty who participated in three Delphi rounds using descriptive statistics to analyze each round. Open-ended questions were analyzed using qualitative descriptive analysis., Results: In Round 1, 54 faculty rated the 43 leadership qualities using a Likert Scale, identified the top 10, and added additional qualities not in the list. In Round 2, 26 of the original participants rated the resulting 29 leadership qualities. In Round 3, 16 of the original participants ranked their top 8 leadership qualities: mutual trust and respect; clear communication; creating a cohesive culture; assuring diversity, equity, and inclusivity; integrity; developing effective team structure; effective decision-making; and leading by example. In Round 3 participants rated nurses' preparedness for academic leadership. Open-ended questions identified 1) Strategies to prepare nurses for academic leadership roles and 2) Essential characteristics for effective academic leaders., Conclusion: Developing key leadership skills can increase the leadership capacity of nursing academic leaders, enhancing work environments, faculty recruitment and retention, helping mitigate a global challenge., Competing Interests: Declaration of competing interest There is no conflict of interest to declare and authors did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: The National Institute of Health Toolbox Cognition Battery (NIHTB-CB) is increasingly used in Alzheimer disease (AD) research. We examined the relation of AD biomarkers with performance in the NIHTB-CB in late middle age., Methods: This is a cross-sectional analysis of 334 Hispanic participants aged 64.22±3.35 years from a study of AD biomarkers. White matter hyperintensities (WMH), infarcts, and cortical thickness in AD regions (CT) were assessed with 3T magnetic resonance imaging. Amyloid and tau were assessed with 18F-Florbetaben and 18F-MK6240 positron emission tomography, respectively., Results: Lower CT and infarcts were associated with worse Oral Reading Recognition and Cognition Crystallized Composite scores. Lower CT and higher WMH were associated with worse Pattern Comparison Processing Speed. Amyloid and tau were not associated with any test., Discussion: Amyloid and tau, the culprits of AD, are not related to the NIHTB-CB in late middle age. Continued follow-up will reveal if AD impacts performance on the NIHTB-CB., Competing Interests: J.A.L. receives a stipend from Wolters Kluwer. N.V. is Editor in Chief of the journal Alzheimer Disease and Associated Disorders and has served as a paid consultant to vTv Therapeutics Inc. and Recruitment Partners. K.W. has a consulting agreement with Cerveau Technologies. Cerveau Technologies provided a standard and precursor for 18F-MK-6240; however, Cerveau was not involved in the design or interpretation of study results. A.M.B. received consulting/advisory fees from Cognition Therapeutics, Cognito Therapeutics, and CogState. He is a Section Editor of Alzheimer & Dementia. The remaining authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)