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Background: Moral resilience is the integrity and emotional strength to remain buoyant and achieve moral growth amid distressing situations. Evidence is still emerging on how to best cultivate moral resilience. Few studies have examined the predictive relationship of workplace well-being and of organizational factors with moral resilience. Research aims: The aims are to examine associations of workplace well-being (i.e., compassion satisfaction, burnout, and secondary traumatic stress) and moral resilience, and to examine associations of workplace factors (i.e., authentic leadership and perceived congruence of organizational mission and behaviors) and moral resilience. Research design: This study uses a cross-sectional design. Participants and research context: Nurses practicing in a hospital in the United States were surveyed using validated instruments (N = 147). Individual factors were measured using demographics and the Professional Quality of Life Scale. Organizational factors were measured using the Authentic Leadership Questionnaire and a single item measuring organizational mission/behavior congruence. Moral resilience was measured using the Rushton Moral Resilience Scale. Ethical considerations: The study was approved by an institutional review board. Findings: Resilience was noted to have significant small correlations with burnout, secondary traumatic stress, compassion satisfaction, and organizational mission/behavior congruence. Burnout and secondary traumatic stress predicted less resilience, whereas compassion satisfaction and perceived congruence between organizational mission and behaviors predicted higher resilience. Discussion: Burnout and secondary traumatic stress, increasingly experienced by nurses and other health professionals, have negative effects on moral resilience. Compassion satisfaction can increase resilience, which is especially important in nursing. Organizational practices promoting integrity and confidence can have positive effects on resilience. Conclusions: Continued work to confront workplace well-being issues, especially burnout, is needed as a way of increasing moral resilience. Studies of organizational and work environment factors to bolster resilience are likewise needed to assist organizational leaders in devising the best strategies. [ABSTRACT FROM AUTHOR]

Collaborative fisheries research programs engage stakeholders in data collection efforts, often with the benefit of increasing transparency about the status and management of natural resources. These programs are particularly important in marine systems, where management of recreational and commercial fisheries have historically been contentious. One such program is the California Collaborative Fisheries Research Program (CCFRP), which was designed in 2006 to engage recreational anglers in the scientific process and evaluate the efficacy of California's network of marine protected areas. CCFRP began on the Central Coast of California and expanded statewide in 2017 to include six partner institutions in three regions: Northern, Central, and Southern California. To date, over 2,000 volunteer anglers have participated in the program, with many anglers volunteering for multiple years. However, the impacts of outreach, education, and collaborative research on those anglers at the statewide scale are currently unknown. Thus, the objective of the current study was to survey the statewide pool of volunteer anglers to assess the degree to which participation in CCFRP has influenced angler perceptions of MPAs, fisheries management, and conservation. We received 259 completed surveys out of a pool of 1,386 active anglers, equating to an 18.7% response rate. Participation in CCFRP resulted in a significant, positive impact on anglers' attitudes towards MPAs in California across all regions. Anglers who participated in six or more CCFRP fishing trips had a more positive perception of MPAs than those who participated in fewer trips. Volunteer anglers across all regions perceived that they caught larger fishes, a higher abundance of fishes, and a greater diversity of species inside MPAs, consistent with the ecological findings of the program. These results highlight the benefits of involving community members in collaborative scientific research. Collaboration between researchers and the broader community increases transparency and trust between stakeholders, and results in greater understanding of natural resource dynamics, ultimately producing better management outcomes. [ABSTRACT FROM AUTHOR]

A variety of criteria may influence the efficacy of networks of marine protected areas (MPA) designed to enhance biodiversity conservation and provide fisheries benefits. Meta‐analyses have evaluated the influence of MPA attributes on abundance, biomass, and size structure of harvested species, reporting that MPA size, age, depth, and connectivity influence the strength of MPA responses. However, few empirical MPA evaluation studies have used consistent sampling methodology across multiple MPAs and years. Our collaborative fisheries research program systematically sampled 12 no‐take or highly protective limited‐take MPAs and paired fished reference areas across a network spanning 1100 km of coastline to evaluate the factors driving MPA efficacy across a large geographic region. We found that increased size and age consistently contributed to increased fish catch, biomass, and positive species responses inside MPAs, while accounting for factors such as latitude, primary productivity, and distance to the nearest MPA. Our study provides a model framework to collaboratively engage diverse stakeholders in fisheries research and provide high‐quality data to assess the success of conservation strategies. [ABSTRACT FROM AUTHOR]

Marine protected areas (MPAs) have gained attention as a conservation tool for enhancing ecosystem resilience to climate change. However, empirical evidence explicitly linking MPAs to enhanced ecological resilience is limited and mixed. To better understand whether MPAs can buffer climate impacts, we tested the resistance and recovery of marine communities to the 2014–2016 Northeast Pacific heatwave in the largest scientifically designed MPA network in the world off the coast of California, United States. The network consists of 124 MPAs (48 no‐take state marine reserves, and 76 partial‐take or special regulation conservation areas) implemented at different times, with full implementation completed in 2012. We compared fish, benthic invertebrate, and macroalgal community structure inside and outside of 13 no‐take MPAs across rocky intertidal, kelp forest, shallow reef, and deep reef nearshore habitats in California's Central Coast region from 2007 to 2020. We also explored whether MPA features, including age, size, depth, proportion rock, historic fishing pressure, habitat diversity and richness, connectivity, and fish biomass response ratios (proxy for ecological performance), conferred climate resilience for kelp forest and rocky intertidal habitats spanning 28 MPAs across the full network. Ecological communities dramatically shifted due to the marine heatwave across all four nearshore habitats, and MPAs did not facilitate habitat‐wide resistance or recovery. Only in protected rocky intertidal habitats did community structure significantly resist marine heatwave impacts. Community shifts were associated with a pronounced decline in the relative proportion of cold water species and an increase in warm water species. MPA features did not explain resistance or recovery to the marine heatwave. Collectively, our findings suggest that MPAs have limited ability to mitigate the impacts of marine heatwaves on community structure. Given that mechanisms of resilience to climate perturbations are complex, there is a clear need to expand assessments of ecosystem‐wide consequences resulting from acute climate‐driven perturbations, and the potential role of regulatory protection in mitigating community structure changes. [ABSTRACT FROM AUTHOR]

Calls for using marine protected areas (MPAs) to achieve goals for nature and people are increasing globally. While the conservation and fisheries impacts of MPAs have been comparatively well‐studied, impacts on other dimensions of human use have received less attention. Understanding how humans engage with MPAs and identifying traits of MPAs that promote engagement is critical to designing MPA networks that achieve multiple goals effectively, equitably and with minimal environmental impact.In this paper, we characterize human engagement in California's MPA network, the world's largest MPA network scientifically designed to function as a coherent network (124 MPAs spanning 16% of state waters and 1300 km of coastline) and identify traits associated with higher human engagement. We assemble and compare diverse indicators of human engagement that capture recreational, educational and scientific activities across California's MPAs.We find that human engagement is correlated with nearby population density and that site "charisma" can expand human engagement beyond what would be predicted based on population density alone. Charismatic MPAs tend to be located near tourist destinations, have long sandy beaches and be adjacent to state parks and associated amenities. In contrast, underutilized MPAs were often more remote and lacked both sandy beaches and parking lot access.Synthesis and applications: These results suggest that achieving MPA goals associated with human engagement can be promoted by developing land‐based amenities that increase access to coastal MPAs or by locating new MPAs near existing amenities during the design phase. Alternatively, human engagement can be limited by locating MPAs in areas far from population centres, coastal amenities or sandy beaches. Furthermore, managers may want to prioritize monitoring, enforcement, education and outreach programmes in MPAs with traits that predict high human engagement. Understanding the extent to which human engagement impacts the conservation performance of MPAs is a critical next step to designing MPAs that minimize tradeoffs among potentially competing objectives. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

Anthropogenic stressors from climate change can affect individual species, community structure, and ecosystem function. Marine heatwaves (MHWs) are intense thermal anomalies where water temperature is significantly elevated for five or more days. Climate projections suggest an increase in the frequency and severity of MHWs in the coming decades. While there is evidence that marine protected areas (MPAs) may be able to buffer individual species from climate impacts, there is not sufficient evidence to support the idea that MPAs can mitigate large-scale changes in marine communities in response to MHWs. California experienced an intense MHW and subsequent El Niño Southern Oscillation event from 2014 to 2016. We sought to examine changes in rocky reef fish communities at four MPAs and associated reference sites in relation to the MHW. We observed a decline in taxonomic diversity and a profound shift in trophic diversity inside and outside MPAs following the MHW. However, MPAs seemed to dampen the loss of trophic diversity and in the four years following the MHW, taxonomic diversity recovered 75% faster in the MPAs compared to reference sites. Our results suggest that MPAs may contribute to long-term resilience of nearshore fish communities through both resistance to change and recovery from warming events. [ABSTRACT FROM AUTHOR]

The ability of the flexible neuropsychological battery approach to withstand a challenge under California's evidentiary standard, Kelly/Frye, was tested in an actual trial. Despite repeating many criticisms offered by the literature (e.g., no malingering measures, unknown accuracy rates, ignoring statistical limitations, not using age norms), the battery was allowed in "for the weight of the evidence," rather than being excluded as unreliable. [ABSTRACT FROM AUTHOR]

Background: Depressive symptoms and fatigue frequently overlap in clinical samples and the general population. The link of depressive symptoms and fatigue with increased risk of cardiovascular disease has been partly explained by shared biological mechanisms including sympathetic overactivity. Prolonged sympathetic overactivity downregulates the responsiveness of the β-adrenergic receptor (β-AR), a receptor that mediates several end-organ sympathetic responses. Purpose: The authors studied whether depression and fatigue are related to reduced β-AR responsiveness within the human body (in vivo) in an ethnically diverse sample of African and Caucasian Americans. Methods: The chronotropic dose (CD) was used to determine in vivo β-AR responsiveness in 93 healthy participants. Psychometric measures included the Center of Epidemiological Studies-Depression Scale and the Multidimensional Fatigue Symptom Inventory. Results: Hierarchical regression analyses (adjusted for age, gender, body mass index, blood pressure, smoking, and ethnicity) revealed that mental fatigue was significantly related to reduced β-AR responsiveness (i.e., higher CD values) in the whole sample. Moderation analyses indicated significant ethnicity × depression/fatigue interactions. Depressive symptoms, total fatigue, emotional fatigue, mental fatigue, and physical fatigue were related to reduced β-AR responsiveness in Caucasian American but not in African Americans. Conclusions: Our findings suggest that symptoms of depression and fatigue are related to decreased in vivo β-AR responsiveness in Caucasian Americans. The lack of this association in African Americans highlights the importance for considering ethnicity as a potential moderator in research focusing on associations between psychological variables and cardiovascular function. [ABSTRACT FROM AUTHOR]

Objectives. This study aimed to further elucidate the biobehavioral mechanisms linking dementia caregiving with an increased cardiovascular disease risk. We hypothesized that both elevated depressive symptoms and a behavioral correlate of depression, low leisure satisfaction, are associated with systemic inflammation. Method. We studied 121 elderly Alzheimer’s disease caregivers who underwent 4 annual assessments for depressive symptoms, leisure satisfaction, and circulating levels of inflammatory markers. We used mixed-regression analyses controlling for sociodemographic and health-relevant covariates to examine longitudinal relationships between constructs of interest. Results. There were inverse relationships between total leisure satisfaction and tumor necrosis factor-α (TNF-α; p = .047), interleukin-8 (IL-8; p < .001), and interferon-γ (IFG; p = .020) but not with IL-6 (p = .21) and C-reactive protein (p = .65). Lower enjoyment from leisure activities was related to higher levels of TNF-α (p = .045), IL-8 (p < .001), and IFG (p = .002), whereas lower frequency of leisure activities was related only to higher IL-8 levels (p = .023). Depressive symptoms were not associated with any inflammatory marker (all p values > .17). Depressive symptoms did not mediate the relationship between leisure satisfaction and inflammation. Discussion. Lower satisfaction with leisure activities is related to higher low-grade systemic inflammation. This knowledge may provide a promising way of improving cardiovascular health in dementia caregivers through behavioral activation treatments targeting low leisure satisfaction. [ABSTRACT FROM AUTHOR]

Objectives. Caregivers of dementia patients are at risk for developing cardiovascular disease (CVD), and this risk increases the longer they provide care. Greater perceptions that caregiving restricts social/recreational activities (i.e., activity restriction [AR]) has been associated with poorer health, and AR may exacerbate the relations between stress and health outcomes. The current study examined the interactive role of greater exposure to stress and increased AR on plasma catecholamine (CAT) levels: norepinephrine (NE) and epinephrine (EPI). Method. A total of 84 dementia caregivers completed a standard assessment battery, and a nurse collected blood, which was assayed for NE and EPI. Separate regressions for NE and EPI were used to determine whether the relations between years caregiving and CATs were greater in those with high versus low AR. Results. A significant interaction was found between years caregiving and AR in predicting resting EPI (p = .032) but not resting NE (p = .103). Post hoc analyses indicated that years caregiving was significantly associated with EPI when AR was high (p = .008) but not when AR was low (p = .799). Additionally, years caregiving was not significantly associated with NE when AR was high or low. Discussion. The subjective experience of AR can play an important role in determining risk for detrimental physical health outcomes, particularly CVD risk. [ABSTRACT FROM AUTHOR]

Marine protected areas (MPAs) have been established across the globe to mitigate the effects of multiple stressors on marine communities. In many locations, MPAs have generated positive effects on fish communities, but the impacts of fishing pressure—the primary stressor MPAs seek to manage—have not been well investigated. We examined changes in fish biomass inside and outside of no-take MPAs over 14 years in central California, USA. Using data from the community-based science program, the California Collaborative Fisheries Research Program, we tested which environmental and human-induced stressors most influence the strength of MPA responses. While temperature and productivity were included in the best fit model, we found that fine-scale fishing effort data, following reserve implementation, best explained the spatial variation in fish community responses to MPAs. Specifically, differences in fish biomass between MPAs and sites open to fishing were larger for reserves near heavily fished locations and these areas exhibited the highest rate of change in fish biomass, indicating strong positive effects of the MPA on the most heavily exploited fish communities. As MPAs continue to be used as a prominent conservation strategy in coastal systems, managers should consider both the suite of human-induced (socio-ecological interactions) and environmental conditions that may alter MPA success as well as establish long-term monitoring programs to fully assess the functionality of marine reserves into the future. [Display omitted] • Positive effects of no-take marine reserves did not accumulate until 7 years post-implementation and varied by location. • Fishing effort in reference sites after reserve establishment best explain spatial variation in fish responses to protection. • Both human-induced and environmental conditions that may alter reserve success should be considered in future reserve design. • Long-term monitoring programs are vital to fully assess the functionality of MPAs into the future. [ABSTRACT FROM AUTHOR]

Context: Dementia care giving can lead to increased stress, physical and psychosocial morbidity, and mortality. Anecdotal evidence suggests that hospice care provided to people with dementia and their caregivers may buffer caregivers from some of the adverse outcomes associated with family caregiving in Alzheimer's Disease (AD). Objectives: This pilot study examined psychological and physical outcomes among 32 spousal caregivers of patients with AD. It was hypothesized that caregivers who utilized hospice services would demonstrate better outcomes after the death of their spouse than caregivers who did not utilize hospice. Methods: The charts of all spousal caregivers enrolled in a larger longitudinal study from 2001 to 2006 ( N=120) were reviewed, and participants whose spouse had died were identified. Of these, those who received hospice care ( n=10) were compared to those who did not ( n=22) for various physiological and psychological measures of stress, both before and after the death of the care recipient. An Analysis of Covariance (ANCOVA), with postdeath scores as the dependent variable and pre-death scores as covariates, was used for all variables. Results: Significant group differences were found in postdeath depressive symptoms (HAM-D; F(1,29)=6.10, p<0.05) and anxiety symptoms (HAM-A; F(1,29)=5.71, p<0.05). Most psychological outcome variables demonstrated moderate effect sizes with a Cohen's d of>0.5 between groups. Conclusions: These data suggest that hospice enrollment may ameliorate the detrimental psychological effects in caregivers who have lost a spouse with Alzheimer's Disease. Based on these pilot data, further prospective investigation is warranted. [ABSTRACT FROM AUTHOR]

This study examined whether satisfaction from leisure activities moderates the relationship between caregiving demands (i.e., hours per day spent caring for a spouse with dementia) and resting levels of the catecholamines norepinephrine (NE) and epinephrine (EPI). Spousal caregivers (n = 107; mean age = 73.95 ± 8.12 years) were assessed in home for plasma levels of NE and EPI, amount of care provided, and leisure satisfaction. Regression was used to determine whether leisure satisfaction moderated the relationship between hours providing care per day and catecholamine levels. A significant interaction was found between hours caregiving and leisure satisfaction for NE, but not for EPI. Post hoc regressions were conducted for both NE and EPI. At low leisure satisfaction, time spent caring for a spouse was positively associated with plasma NE (β = 0.41; p = 0.005) and EPI (β = 0.44; p = 0.003). In contrast, at high levels of satisfaction, time caregiving was not significantly associated with plasma NE (β = –0.08; p = 0.57) or EPI (β = 0.23; p = 0.12). These findings suggest that leisure satisfaction may protect caregivers from increases in catecholamines, which have been implicated in cardiovascular risk. Further support for these findings may impact psychological treatments for distressed caregivers. [ABSTRACT FROM PUBLISHER]

Objective T cells from patients with systemic lupus erythematosus (SLE) express increased amounts of PP2Ac, which contributes to decreased production of interleukin-2 (IL-2). Because IL-2 is important in the regulation of several aspects of the immune response, it has been proposed that PP2Ac contributes to the expression of SLE. This study was designed to determine whether genetic variants of PPP2AC are linked to the expression of SLE and specific clinical manifestations and account for the increased expression of PP2Ac. Methods We conducted a trans-ethnic study of 8,695 SLE cases and 7,308 controls of 4 different ancestries. Eighteen single-nucleotide polymorphisms (SNPs) across PPP2CA were genotyped using an Illumina custom array. PPP2CA expression in SLE and control T cells was analyzed by real-time polymerase chain reaction. Results A 32-kb haplotype comprising multiple SNPs of PPP2CA showed significant association with SLE in Hispanic Americans, European Americans, and Asians, but not in African Americans. Conditional analyses revealed that SNP rs7704116 in intron 1 showed consistently strong association with SLE across Asian, European American, and Hispanic American populations (odds ratio 1.3 [95% confidence interval 1.14-1.31], meta-analysis P = 3.8 × 10−7). In European Americans, the largest ethnic data set studied, the risk A allele of rs7704116 was associated with the presence of renal disease, anti-double-stranded DNA, and anti-RNP antibodies. PPP2CA expression was ∼2-fold higher in SLE patients carrying the rs7704116 AG genotype than those carrying the GG genotype ( P = 0.007). Conclusion Our data provide the first evidence of an association between PPP2CA polymorphisms and elevated PP2Ac transcript levels in T cells, which implicates a new molecular pathway for SLE susceptibility in European Americans, Hispanic Americans, and Asians. [ABSTRACT FROM AUTHOR]

This study aimed to determine if Alzheimer caregivers have increased allostatic load compared to non-caregivers. Potential psychological moderators (mastery, depression, and role overload) of the relationship between caregiving status and allostatic load were also explored. Eighty-seven caregivers and 43 non-caregivers underwent biological assessment of allostatic load and psychological assessments. Caregivers had significantly higher allostatic load compared to non-caregivers ( p < .05). Mastery, but not depression or overload, moderated the relationship between caregiving status and allostatic load. In conclusion, allostatic load may represent a link explaining how stress translates to downstream pathology, but more work is necessary to understand the role of psychological factors. [ABSTRACT FROM PUBLISHER]

Highlights the condition of agriculture in Central Valley, California. Description of the inland valleys; Development of a water system for agriculture; Causes of water pollution in California.

Reveals the characteristics of AIDS-associated non-Hodgkin's lymphoma in patients diagnosed and treated at San Francisco General Hospital, California. Epidemiology; Histological classification; Extralymphatic disease; Virological studies; Treatment; Patient survival.

INTRODUCTION: Advanced practice providers (APPs) are integral members of the healthcare delivery team. However, there has been a lack of standardization and uniformity in how they are utilized across inpatient, ambulatory, and procedural settings. METHODS: A multidisciplinary workforce planning committee was formed in March 2021 to evaluate all new and replacement full-time equivalent APP positions at Stanford Health Care (SHC), an academic medical center of more than 600 APPs, to optimize and standardize the role of APPs as per national benchmarks. RESULTS: Six months since the launch of the committee, there has been a 10% increase in the number of visits and procedures performed by APPs providing better access for patients. In addition, there has been a 38.7% improvement in ambulatory APPs meeting their productivity target, 19.4% improvement in ambulatory APPs meeting utilization targets, and 36.8% improvement in ambulatory APPs meeting the 50th percentile and above as per the relative value unit benchmark published by the Medical Group Management Association for Academic Medical Centers. For inpatient APPs, there has been a 38.8% improvement in APPs meeting the average daily census target. DISCUSSION: APP utilization is an important topic that has not been consistently addressed in the literature. Inappropriate utilization and lack of top of licensure practice have been associated with increased turnover, decreased job satisfaction, and professional development. By developing a multidisciplinary workforce planning committee, full-time employee positions are evaluated with a goal of optimizing and standardizing the role of APPs at SHC. [ABSTRACT FROM AUTHOR]

The article focuses on the contribution of nonresidents' share to core city revenues. In one of his articles, professor R.S. Smith raises the question whether nonresidents contribute their share to core city revenues and concluded that in the case of San Francisco metropolitan area at least, the evidence suggests that nonresidents contribute more to the tax coffers of the core city than they receive in public expenditure benefits. Smith introduces an interesting methodology to study the question. First, he divides public expenditures by the core city into those that benefit business and those that do not benefit business. Of expenditures benefiting business, Smith then estimates the amount benefiting nonresidents and so derives an estimate of nonresident benefits from core city business taxes collected from nonresidents. The difference between estimates of nonresident benefits and tax payments is the measure Smith uses to determine whether nonresidents are paying their share of San Francisco's taxes. It is not entirely clear what criterion Smith uses in allocating core city public expenditures between the business and nonbusiness sectors.

The article presents a study which aims to discuss the effect of regular physical activity in reducing cardiometabolic risks among dementia caregivers wherein dementia caregiving stress is a recognized natural model of human stress. It gives evidence for studies revealing that dementia caregivers are physically less active as compared with noncaregivers wherein dementia caregivers are more prone to manifest greater cardiometabolic risk. Therefore, it concludes that cardiometabolic risk is particularly high for caregivers with reduced levels of regular physical activity.