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1. Elevational gradients create environmental variation that is hypothesized to promote variation in life-history strategies. We tested whether differences in life-history strategies were associated with elevation in a songbird, the dark-eyed junco ( Junco hyemalis; Aves; A.O.U. 1998 ). 2. We monitored birds in four replicated sites per elevation, at 2000 m a.s.l. (high elevation) and 1000 m a.s.l. (low elevation), in the Rocky Mountains of Canada. 3. Over 5 years, we measured the following traits and vital rates: egg-laying schedules, morphological indicators of reproductive stage, seasonal reproductive success, indicators of competitive class (age, size, arrival time), and survival rates. 4. We found two main patterns: with an increase in breeding elevation, dark-eyed juncos delayed the development of structures necessary for reproduction (e.g. cloacal protuberance in males) and reduced the duration of their reproductive period to less than half of the time used by low-elevation birds; and 5. Juncos at high-elevation sites had 55–61% lower annual reproductive success and 15 to 20% higher survival rates. While adult juncos at high elevations produced fewer offspring, those offspring were in better condition. Proportions of age and size classes in high- compared to low-elevation populations were similar, suggesting that a life-history trade-off is present, rather than competition forcing inferior competitors to breed in a peripheral habitat. The apparent trade-off between reproduction and survival corresponded to a shorter period of favourable weather and available food in high- compared to low-elevation habitats. 6. Thus, elevation had a strong influence on life-history characteristics of a single species over a short spatial distance, suggesting a shift in life history from a high reproductive strategy at lower elevations to a high survivor strategy at high elevations. 7. This is the first paper to show a shift in avian life-history strategies along an elevational gradient (in both genders, of multiple age classes) when region (latitude) and phylogenetic histories are controlled for. [ABSTRACT FROM AUTHOR]

Background: The quality of Registered Nurses' worklife is impacting nurses' mental health, and the standard of care received by clients. Contributing factors to nurses' stress are the trauma of continuous caring for those in great suffering, and adverse working conditions., Objectives: i) to explore the prevalence of work-related stress in a provincial sample of Registered Nurses; ii) to compare the levels of compassion satisfaction, burnout and secondary traumatic stress reported by nurses in hospital, community, non-direct care settings, and, iii) to identify factors that predict levels of nursing work stress., Methods: A descriptive, predictive study with a self-report survey containing demographic questions and the Professional Quality of Life Scale was emailed to over 3,300 Registered Nurses. The scale measured the prevalence of three worklife indicators, compassion satisfaction, burnout and secondary traumatic stress. Multiple linear regression identified factors that predicted the levels of the three indicators. A subgroup analysis explored the quality of worklife based on three practice environments., Findings: Nurses (n  =  661) reported moderate compassion satisfaction, burnout, and secondary traumatic stress. The strongest predictor, satisfaction with one's current job, predicted high compassion satisfaction and lower burnout and secondary stress. The subgroup analysis identified hospital nurses as having the most work-related stress and the lowest level of compassion satisfaction., Conclusion: Innovative, collaborative action can transform nurses' practice environments. Organizational support is essential to bring about needed improvements., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: There are only a few descriptive reports on the implementation of distributed medical education (DME) and these provide accounts of successful implementation from the senior leadership perspective. In Saskatchewan, over a period of 4 years (2010-2014), four family medicine residency sites were established and two additional sites could not be developed. The aim of this study was to identify challenges, success factors and pitfalls in DME implementation based upon experiences of multiple stakeholders with both successful and unsuccessful outcomes., Methods: Data were obtained through document analysis (n = 64, spanning 2009-2016; perspectives of government, senior leadership, management and learners), focus groups of management and operations personnel (n = 10) and interviews of senior leaders (n = 4). Challenges and success factors were ascertained through categorisation. Iterative coding guided by three sensitising frameworks was used to determine themes in organisational dynamics., Results: Both challenges and success factors included contextual variables, governance, inter- and intra-organisational relationships (most common success factor), resources (most common challenge), the learning environment and pedagogy. Management and operations were only a challenge. Organisational themes affecting the outcome and the pitfalls included the pace of development across multiple sites, collaborative governance, continuity in senior leadership, operations alignment and reconciliation of competing goals., Conclusions: Emerging opportunities for DME can be leveraged through collaborative governance, aligned operations and resolution of competing goals, even in constrained contexts, to translate political will into success; however, there are pitfalls that need to be avoided. Our findings based upon multi-stakeholder perspectives add to the body of knowledge on deployment, carefully considering the conditions for success and associated pitfalls., (© 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

A group of male adolescent sexual offenders were divided into three groups: Courtship Disorders (Exhibitionism, Toucherism and Obscene Phone Calls), Sexual Assaults, and Pedophilic Offenses. Group I offenders tended to come from a less disorganized family background, were better adjusted to school and in the community and were seen by clinicians as less seriously disturbed than the adolescents in the other two groups. In addition, these adolescents did not experience the offense as a sexual act. Group II offenders (Sexual Assaulters) came from a more disturbed family background characterized by a high rate of long-term parent-child separations, committed more violent offenses and had a higher frequency of intellectual functioning in the Borderline Range of Intelligence. Group III offenders (Pedophilic Offenses) were Canadian born, had witnessed physical violence between their parents, were described as having been infants who did not enjoy being cuddled and had siblings who were truant. This study suggests that classifying adolescent sexual offenders along the line suggested in adult literature seems to be justified.

Information from 422 cases of child mistreatment in Toronto was gathered from the files of a child welfare agency and a children's hospital. These data were compared to patterns reported in previous studies and clinical writings on child mistreatment to investigate similarities and differences in families whose children have been abused in Canada, England, and the United States. Findings from the present study were similar to others in many respects. The differences were primarily in the area of lower incidences of such problems as perinatal difficulties in the children and intellectual limitations and social isolation in the parents; however, there was a higher incidence of single-parent families. The results suggest that clinicians should bear in mind that child mistreatment cannot be ruled out on the grounds that no serious problems have been noted for the child or the family.

Nutrition is an important aspect of the total environment of a growing child. The dentist should evaluate the nutrition of pediatric patients from the physical parameters of the child including growth, general appearance, posture, muscle control, oral findings, and dietary history. Some common malnutrition problems of the pediatric age group include deficiencies of iron, calcium, vitamins A, C, and D, protein and/or calories, and excess ingestion of calories. The causes of and means of preventing nursing-bottle syndrome are easily preventable in this form of dental caries which has many dental, systemic, and economic consequences. The use of group dynamics as an effective and enjoyable method of teaching preventive dentistry is discussed.