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Background: Social media (SM) has received considerable attention as a potential risk factor for adolescent suicide. Few empirical studies, however, have examined adolescents' daily negative and positive experiences on SM and its proximal impacts on suicidal ideation (SI), particularly using intensive monitoring designs. Method: Adolescents (N = 60; 14–17 years; 49% girls; 62% LGBTQ+) recruited using SM across the United States and participated in an 8‐week intensive monitoring protocol. Ecological momentary assessment (three brief surveys per day) asked about negative and positive SM experiences and SI (passive and active). Multilevel modelling was used to evaluate the within‐person relationships between daily SM experiences (e.g. individual fluctuations compared to a person's average) and SI, controlling for average levels of SM experiences, SM use screen time, and lifetime SI. Results: Significant within‐person effects of negative and positive SM experiences were associated with days when adolescents had SI. Specifically, on days when teens endorsed more frequent negative SM experiences than usual, they were more likely to report SI. However, more positive SM experiences than usual were associated with a lower likelihood of having SI. There were no significant effects of SM use ('screen time') on SI or on the reverse associations of SI on next‐day SM experiences. Conclusions: Results indicate that SM experiences may be dynamic and modifiable risk and protective factors for SI in adolescents, whereas there is no effect of SM screen time on SI. Our results highlight that targeting negative SM experiences and augmenting the positive experiences on SM may be critical targets to improve teens' mental health and prevent suicide, rather than focusing on limiting SM screen time. [ABSTRACT FROM AUTHOR]

Objects: Studies of older age bipolar disorder (OABD) have mostly focused on "younger old" individuals. Little is known about the oldest OABD (OOABD) individuals aged ≥70 years old. The Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE‐BD) project provides an opportunity to evaluate the OOABD group to understand their characteristics compared to younger groups. Methods: We conducted cross‐sectional analyses of the GAGE‐BD database, an integrated, harmonized dataset from 19 international studies. We compared the sociodemographic and clinical characteristics of those aged <50 (YABD, n = 184), 50–69 (OABD, n = 881), and ≥70 (OOABD, n = 304). To standardize the comparisons between age categories and all characteristics, we used multinomial logistic regression models with age category as the dependent variable, with each characteristic as the independent variable, and clustering of standard errors to account for the correlation between observations from each of the studies. Results: OOABD and OABD had lower severity of manic symptoms (Mean YMRS = 3.3, 3.8 respectively) than YABD (YMRS = 7.6), and lower depressive symptoms (% of absent = 65.4%, and 59.5% respectively) than YABD (18.3%). OOABD and OABD had higher physical burden than YABD, especially in the cardiovascular domain (prevalence = 65% in OOABD, 41% in OABD and 17% in YABD); OOABD had the highest prevalence (56%) in the musculoskeletal domain (significantly differed from 39% in OABD and 31% in YABD which didn't differ from each other). Overall, OOABD had significant cumulative physical burden in numbers of domains (mean = 4) compared to both OABD (mean = 2) and YABD (mean = 1). OOABD had the lowest rates of suicidal thoughts (10%), which significantly differed from YABD (26%) though didn't differ from OABD (21%). Functional status was higher in both OOABD (GAF = 63) and OABD (GAF = 64), though only OABD had significantly higher function than YABD (GAF = 59). Conclusions: OOABD have unique features, suggesting that (1) OOABD individuals may be easier to manage psychiatrically, but require more attention to comorbid physical conditions; (2) OOABD is a survivor cohort associated with resilience despite high medical burden, warranting both qualitative and quantitative methods to better understand how to advance clinical care and ways to age successfully with BD. Key points: Limited knowledge of older and oldest older age bipolar disorder derived from limited sample sizes.The Global Aging and Geriatric Experiments in Bipolar Disorder consortium provided international data to compare younger age, older age, and oldest older age people with BDInternational sites (n = 14) provided data on patients aged <50 (n = 184 YABD), 50–69 (n = 881 OABD), and ≥70 (n = 304 OOABD) to assess differences among three groupsOABD and OOABD represent distinct cohorts within BD and differ in sociodemographic and clinical characteristics from YABD in general. OOABD individuals may be easier to manage psychiatrically but require more attention to their comorbid physical conditions. OOABD likely is a survivor cohort associated with resilience despite high medical burden, warranting future study using both qualitative and quantitative methods to better understand what makes OOABD resilient, how to advance clinical care and age successfully with BD. [ABSTRACT FROM AUTHOR]

Indigenous communities in the United States experience some of the highest rates of food insecurity and diet-related diseases despite an abundance of food assistance programs and other public health interventions. New approaches that center Indigenous perspectives and solutions are emerging and urgently needed to better understand and address these challenges. This Practice Note shares lessons learned from ongoing collaboration between the Karuk Tribe and University of California, Berkeley researchers and other partners to assess and enhance food sovereignty among Tribes and Tribal communities in the Klamath River Basin. Through two participatory research and extension projects, we demonstrate the importance of centering Indigenous knowledge to strengthen research findings and identify more culturally appropriate solutions to community identified food access, health, and ecosystem challenges. Key findings suggest that approaches to food sovereignty and community health must emanate from the community, be approached holistically, reflect community values and priorities, and center Indigenous land stewardship. [ABSTRACT FROM AUTHOR]

There is a dearth of research that examines COVID‐19‐related stress among multiply marginalised individuals who are in the developmental phase of emerging adulthood. This qualitative study investigated how the intersection of emerging adulthood, sexual and gender minority (SGM) identity, and migrant status were reflected in the experiences of SGM individuals (n = 37; ages 20–25 years old) who migrated to various parts of the United States in the last 5 years. Data were collected online using semi‐structured interviews. Thematic analysis revealed that participants' developmental processes (e.g., identity exploration, building financial independence) were shaped by pandemic‐related stressors, especially unemployment and financial instability. Participants who were able to maintain employment did so but at the risk of their health and safety. Findings also showed that participants experienced feelings of anxiety and depression due to social isolation, but online communication played an important role in combatting loneliness. Findings highlight the potential for trauma‐informed and intersectional approaches to practice with SGM emerging adult migrants and expanded health services and temporary entitlement programs to mitigate the pandemic's effects on this population's psychosocial and financial well‐being. [ABSTRACT FROM AUTHOR]

Background and purpose: Aneurysmal subarachnoid hemorrhage occurs in approximately 30,000 patients annually in the United States. Uncontrolled blood pressure is a major risk factor for aneurysmal subarachnoid hemorrhage. Clinical guidelines recommend maintaining blood pressure control until definitive aneurysm securement occurs. It is unknown whether racial differences exist regarding blood pressure control and outcomes (HLOS, discharge disposition) in aneurysmal subarachnoid hemorrhage. Here, we aim to assess whether racial differences exist in 1) presentation, 2) clinical course, and 3) outcomes, including time to blood pressure stabilization, for aSAH patients at a large tertiary care medical center. Methods: We conducted a retrospective review of adult aneurysmal subarachnoid hemorrhage cases from 2013 to 2019 at a single large tertiary medical center. Data extracted from the medical record included sex, age, race, insurance status, aneurysm location, aneurysm treatment, initial systolic and diastolic blood pressure, Hunt Hess grade, modified Fisher score, time to blood pressure control (defined as time in minutes from first blood pressure measurement to the first of three consecutive systolic blood pressure measurements under 140mmHg), hospital length of stay, and final discharge disposition. Results: 194 patients met inclusion criteria; 140 (72%) White and 54 (28%) Black. While White patients were more likely than Black patients to be privately insured (62.1% versus 33.3%, p < 0.001), Black patients were more likely than White patients to have Medicaid (55.6% versus 15.0%, p < 0.001). Compared to White patients, Black patients presented with a higher median systolic (165 mmHg versus 148 mmHg, p = 0.004) and diastolic (93 mmHg versus 84 mmHg, p = 0.02) blood pressure. Black patients had a longer median time to blood pressure control than White patients (200 minutes versus 90 minutes, p = 0.001). Black patients had a shorter median hospital length of stay than White patients (15 days versus 18 days, p < 0.031). There was a small but statistically significant difference in modified Fisher score between black and white patients (3.48 versus 3.17, p = 0.04).There were no significant racial differences present in sex, Hunt Hess grade, discharge disposition, complications, or need for further interventions. Conclusion: Black race was associated with higher blood pressure at presentation, longer time to blood pressure control, but shorter hospital length of stay. No racial differences were present in aneurysmal subarachnoid hemorrhage associated complications or interventions. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore associations between trauma experiences among nurses and nursing perceptions of risk for involuntary job loss and standing in society. This observational study used 2001 data from the Nurses' Health Study II (N = 53,323 female nurses). The outcome variables were nurses' perceptions of their risk for involuntary job loss and their social standing in the United States and within their own community. The exposure variables were childhood and adulthood interpersonal trauma. Nurses reported high levels of emotional (60% childhood; 44% adulthood), physical (45% childhood, 23% adulthood), and sexual trauma (15% childhood, 11% adulthood). Emotional trauma was associated with perception of higher risk for involuntary job loss, but also higher perception of nurse societal standing. Nurses experience high rates of interpersonal trauma, which may influence how they perceive their profession. [ABSTRACT FROM AUTHOR]

Background: Tobacco smoking using a hookah (i.e., waterpipe) is a global epidemic. While evidence suggests that sexual minorities (SM) have higher odds of hookah use compared to heterosexuals, little is known about their hookah use patterns and transitions. We sought to examine transitions between hookah smoking and use of other tobacco and electronic (e-) products among SM adults aged 18 years of age and older versus their heterosexual counterparts.Methods: We analyzed nationally representative data of ever and current hookah smokers from Wave 1 (2013-2014; ever use n = 1014 SM and n = 9462 heterosexuals; current use n = 144 SM and n = 910 heterosexuals) and Wave 2 (2014-2015; ever use n = 901 SM and n = 8049 heterosexuals; current use n = 117 SM and n = 602 heterosexuals) of the Population Assessment of Tobacco and Health Study. Comparisons between groups and gender subgroups within SM identity groups were determined with Rao-Scott chi-square tests and multivariable survey-weighted multinomial logistic regression models were estimated for transition patterns and initiation of electronic product use in Wave 2.Results: Ever and current hookah smoking among SM adults (ever use Wave 1: 29% and Wave 2: 31%; current use Wave 1: 4% and Wave 2: 3%) was higher than heterosexuals (ever use Wave 1: 16% and Wave 2: 16%; current use Wave 1: 1% and Wave 2: 1%; both p < 0.0001). Among SM adults who reported hookah use at Wave 1, 46% quit hookah use at Wave 2; 39% continued hookah use and did not transition to other products while 36% of heterosexual adults quit hookah use at Wave 2 and 36% continued hookah use and did not transition to other products. Compared with heterosexuals, SM adults reported higher use of hookah plus e-products (Wave 2 usage increased by 65 and 83%, respectively).Conclusions: Compared to heterosexuals, in addition to higher rates of hookah smoking, higher percentages of SM adults transitioned to hookah plus e-product use between 2013 and 2015. Results have implications for stronger efforts to increase awareness of the harmful effects of hookah as well as vaping, specifically tailored among SM communities. [ABSTRACT FROM AUTHOR]

The author reflects on his career and his work in the field of American Jewish history. Topics covered include his publication of the paper "Antisemitism in the United States, 1778-1945" which introduced him to the literature of American Jewish history, his opportunity to work at the American Jewish Historical Society and the difficulty encountered in training in the field.

Two mid-nineteenth-century American Jewish Sunday-school textbooks-Mrs. Eliezer [Rachel Peixotto] Pyke's Scriptural Questions for the Use of Sunday Schools for the Instruction of Israelites (1843) and Simha C. Peixotto's Elementary Introduction to the Scriptures for the Use of Hebrew Children (1840)-shed important light on the relationship between Jews and the dominant Christian (largely Protestant) culture that surrounded them. A comparison of these books with the Protestant Sunday-school texts upon which they drew serves as a revealing case study of cultural borrowing and cultural resistance between minority and majority faiths. [ABSTRACT FROM AUTHOR]

The article presents the author's perspectives regarding the effectiveness of Oncology Nursing Society (ONS) research in the U.S. She stressed out that the government must have to support financially the qualitative research to minimize the mortality of patients due to the lung cancer. She further explained her experiences as one of the breast cancer survivor because of some advanced medical therapies.

The article focuses on raising of U.S. composer and conductor Leonard Bernstein in Boston Jewish community. Bernstein was raised in a Jewish community in Boston, which had some 80,000 Jews. In the community, Bernstein was influenced by professor Solomon Gregory Braslavsky, music director and organist of Mishkan Tefila.

Nurse scientists have made important contributions to evidence-based practice in tobacco control. This chapter will discuss recent tobacco control developments in the United States and globally, such as legislation giving the U.S. Food and Drug Administration regulatory authority over tobacco products manufacturing, marketing and sales, the World Health Organization Framework Convention on Tobacco Control, and a brief review of research that has guided policy advances and nursing research in tobacco control. Suggestions for future research based on the update of the U.S. Public Health Services Treating Tobacco Use and Dependence clinical practice guideline will be explored. These developments offer nursing researchers a wealth of opportunities and challenges to advance nursing and tobacco control knowledge, address research gaps, and bring a unique nursing perspective to tobacco use prevention, reduction of exposure to secondhand smoke, tobacco dependence treatment, and tobacco control policies. Additionally, we will address how nursing scholarship can and should be supported by academic and organizational leadership to support nurses in realizing their full potential in mitigating the global epidemic of tobacco-caused death and disease. [ABSTRACT FROM AUTHOR]

Samuel Heilman, professor of sociology at Queens College of the City University of New York, tried to break down silos and bridge ("synthesize") interrelated disciplines throughout his career. [ABSTRACT FROM AUTHOR]

Mono Lake sediments have recorded five major oscillations in the hydrologic balance between A.D. 1700 and 1941. These oscillations can be correlated with tree-ring-based oscillations in Sierra Nevada snowpack. Comparison of a tree-ring-based reconstruction of the Pacific Decadal Oscillation (PDO) index with a coral-based reconstruction of Subtropical South Pacific sea-surface temperature indicates a high degree of correlation between the two records during the past 300 yr. This suggests that the PDO has been a pan-Pacific phenomena for at least the past few hundred years. Major oscillations in the hydrologic balance of the Sierra Nevada correspond to changes in the sign of the PDO with extreme droughts occurring during PDO maxima. Four droughts centered on A.D. 1710, 1770, 1850, and 1930 indicate PDO-related drought reoccurrence intervals ranging from 60 to 80 yr. [Copyright &y& Elsevier]

Explores the distribution of offset, correlated rock units, relative position of northward-younging volcanic rocks in the San Francisco Bay region in California. Revelation of strike-slip deformation along East Bay fault system; Accumulation of right-lateral offset; Description of the activity of any single fault zone in the system.

A newly identified tephra in stratified deposits in southwestern Utah, dated ∼14,000 14C yr B.P., may aid in correlating late Pleistocene deposits across parts of the southern Great Basin and west-central Colorado Plateau. Geochemical analyses of the ash suggest the tephra originated from Mono Craters, California, and most probably correlates with Wilson Creek ash #3. Because the ash is 2 mm thick ∼550 km from its source, the event may have been larger than others correlated to Mono Craters eruptions. [Copyright &y& Elsevier]

Changes in the AIDS epidemic in many areas of the United States require information about the experience of the growing segment of women afflicted. This study compared patterns of emotional distress between men and women with symptomatic HIV and examined potential predictors of different levels of vulnerability. A sample of 126 low socioeconomic men and women seeking care from HIV treatment centers was surveyed using measures of physical and psychological well-being. Women had more HIV symptoms, poorer functioning, and greater disruptions in physical and psychosocial well-being. Physical health status and optimism were primary predictors of emotional distress in both men and women. More than 50% of men and women had scores indicative of clinical anxiety. Approximately 1 out of 10 had clinically relevant scores for depression. Gender differences may provide potentially useful information for tailoring assessment interventions for emotional distress in people infected with HIV. [ABSTRACT FROM AUTHOR]

Purpose: Cancer is a leading cause of death among Korean Americans (KAs), one of the most rapidly growing ethnic minority communities in the United States. An understanding about cancer screening practices among Koreans (Ks) living in Korea can be useful in designing culturally sensitive health promotion programs in the United States. The purpose of this study was to describe the cancer screening knowledge and behaviors of a sample of KAs in Los Angeles, California, compared with a similar sample of Ks in Korea. Description of study: This descriptive survey used a convenience sample of 140 KAs age 40 and older, living in Los Angeles, California, in 1998. A random sample of 149 Ks from Pusan, Korea, in 1995 to 1996 was used as a comparison group. KAs had lived in the United States for an average of 15 years. A Korean and English language 58-item self-administered questionnaire assessed knowledge of cancer screening tests and personal cancer screening practices. Results: The findings demonstrate that both KAs and Ks had low participation in cancer screening. Breast cancer screening was significantly more likely among KA women than among Ks; screening rates for cervical cancer and gastrointestinal malignancies were not significantly different between the two groups. Clinical implications: These data can be used to assist healthcare professionals in the development of educational tools and strategies for promoting cancer screening programs for KAs. The unique contribution of this study was the opportunity to compare findings from an immigrant Korean population with a similar population in the country of origin. [ABSTRACT FROM AUTHOR]

Examines resources for tobacco cessation in treating patients with tobacco dependency in the U.S. Advocacy of health professionals on smoking prevention; Benefits of nicotine replacement medications; Use of the resources by healthcare professionals in clinical practice.

Presents a historical perspective of American Jewish political conservatism. Characterization of Jewish political involvement by chief rabbi Joseph H. Hertz; Biblical proof of Jewish conservatism; Letter of Sir Moses Montefiore to the Jewish community of Morocco as epitome of Jewish political philosophy.

Discusses the achievements of Louis Brandeis in promoting the Zionist movement in the United States. Personal history; Legal practice; Conversion to Zionism.

This article describes emotional distress in 44 women with Human Immunodeficiency Virus (HIV) symptomatic disease. Measures of self-reported symptoms of anxiety and depression revealed that emotional distress was prevalent in this group and may be sufficiently robust to warrant clinical diagnoses. Limits to functioning and disruptions in physical well-being were found to be associated with both anxiety and depression. Additionally, level of optimism was inversely related to anxiety and depression, and social support was inversely related to anxiety. These findings indicate that emotional distress in women with HIV disease is associated with, and could be ameliorated by, interventions targeted at functional status, social support, and level of optimism. [ABSTRACT FROM AUTHOR]

Responds to an article on Conservative Judaism in the United States by Gerald L. Zelizer, published in the Summer 1995 issue of `Judaism.' Problem of polarization; Boundary challenges; Crisis of authority.

The article concentrates on the experience of Canadian Jewry in the United States. In the last three decades of the nineteenth century, Jews came from eastern Europe both to the United States and to Canada; but the immigrant Jewish communities which took shape in both countries diverged strikingly. Although it is certainly true that most eastern European Jewish immigrants to Canada had originally hoped to settle in the United States, it need not be inferred that those who came to Canada were unhappy with their lot. Jews in search of a warm welcome also had good reason to remain in the Northern Dominion, since immigrants to the United States, especially in the 1890's, faced both popular and official hostility. Trade union hostility was also evident, as was antagonism from other quarters. On the other hand, the United States at that period already had considerable legislation regulating and restricting immigration. The attitude of the North American Jewish community to the immigration of co-religionists may also have drawn Jews northward.

Discusses the possible impact of the enactment of a Canadian-United States free trade area on international economic relations. Characteristics of the trade relations between the two countries; Reasons behind the plan to build the free trade area.

Focuses on the contributions of bibliographer Nathan Kaganoff to Jewish bibliography. Concentration on the field of Judaica Americana; Career history; Works on the history of Hebrew publishing and printing in the United States.

Editorial. Focuses on steps taken by the U.S. government to reduce tobacco consumption to prevent lung cancer. Statistics on the spread of lung cancer in the U.S.; Reference to a report by Cooley et al. in the same issue of 'Cancer Investigation'; Efficacy of government's efforts to discourage tobacco use.

The purpose of this presentation is to demonstrate the use of a unique statistical approach to describe symptom clusters in a multi-site, prospective study of 196 women with nonsmall cell lung cancer who were > 6 months and < 5 years from diagnosis. Average age was 65.4 years (SD=11.4); average time since diagnosis was 24 months (SD=15.9). Most had adenocarcinoma and local or regional disease with surgical treatment. The conceptual framework posited that demographic, clinical, health status, and meaning of illness factors are related to symptom experience. Data for this correlational study were collected in Alabama, California, Georgia, Massachusetts, and New York by personal interview. Two reliable and valid measures were used to assess symptoms: the Lung Cancer Symptom Scale measured occurrence and severity during the past day, and the Symptom Query Questionnaire measured symptoms during the past 4 weeks. Analysis of symptom clusters began by creating a symptom cluster variable in which symptoms were uniquely coded. Cancer-related symptom clusters and their management are featured in the ONS Research Priorities and related to patient outcomes. Yet most researchers examined individual symptoms rather than symptom clusters, and most studies of symptom clusters were limited by secondary analyses of symptoms selected for primary studies and were analyzed using correlational techniques. Most previously used analytical methods described clusters based on relationships of severity of symptoms. In contrast, this analytical approach is an intuitively elegant method of describing the occurrence and severity of symptom clusters. Then frequency analysis of the new symptom cluster variable determined the occurrence of all clusters of co-occurring symptoms, and predominant clusters were identified. Boxplots were used to describe the severity of symptoms within clusters. 97.5% of the women experienced three or more symptoms in the past day. All but three of these women had symptom clusters including fatigue. The most commonly experienced symptom cluster (64%) during the past day included fatigue, shortness of breath, cough, pain, and anorexia with fatigue and shortness of breath being most severe. Although no predominant symptom cluster was identified for the past 4 weeks, 50% of the participants experienced three or more symptoms. Funding Sources: ONS Foundation [ABSTRACT FROM AUTHOR]

Purpose: This paper celebrates the 60th anniversary of the Western Institute of Nursing, the nursing organization representing 13 states in the Western United States, and envisions a preferred future for nursing practice, research, and education. Background: Three landmark calls to action contribute to transforming nursing and healthcare: the Patient Protection and Affordable Care Act of 2010; the Institute of Medicine report Future of Nursing: Leading Change, Advancing Health; and the report Advancing Healthcare Transformation: A New Era for Academic Nursing. Challenges abound: U.S. healthcare remains expensive, with poorer outcomes than other developed countries; costs of higher education are high; our profession does not reflect the diversity of the population; and health disparities persist. Pressing health issues, such as increases in chronic disease and mental health conditions and substance abuse, coupled with aging of the population, pose new priorities for nursing and healthcare. Discussion: Changes are needed in practice, research, and education. In practice, innovative, cocreated, evidence-based models of care can open new roles for registered nurses and advanced practice registered nurses who have knowledge, leadership, and team skills to improve quality and address system change. In research, data can provide a foundation for clinical practice and expand our knowledge base in symptom science, wellness, self-management, and end-of-life/palliative care, as well as behavioral health, to demonstrate the value of nursing care and reduce health disparities. In education, personalized, integrative, and technology-enabled teaching and learning can lead to creative and critical thinking/decision-making, ethical and culturally inclusive foundations for practice, ensure team and communication skills, quality and system improvements, and lifelong learning. Conclusion: The role of the Western Institute of Nursing is more relevant than ever as we collectively advance nursing, health, and healthcare through education, clinical practice, and research. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of missed work breaks by smoking status in healthcare settings is unknown. The work routines of nurses (Registered Nurses [RNs] and Licensed Practical Nurses [LPNs]), who smoke at higher rates than other health professionals, may be influenced by smokers who use breaks to avoid nicotine withdrawal. The purpose of this study was to examine the relationship between nurses'' smoking status and work breaks and to explore the relationships among personal, professional, and workplace variables associated with missed work breaks. Methods: A web-based survey of 2589 staff nurses from 34 hospitals was conducted in 2006. Each hospital had been designated as a Magnet hospital by the American Nurses Credentialing Center. Data analysis included descriptive statistics, chi-square tests, and multivariate logistic regression. Results: The majority (90%) were nonsmokers; 97% were RNs. Missed breaks were common (70%) and differed by smoking status: 59% of smokers and 72% of nonsmokers frequently missed work breaks. Multivariate logistic regression determined that nonsmokers (OR=1.81, 95% CI=1.36, 2.42), LPNs (OR=2.37, 95% CI=1.16, 4.84), older nurses (OR 1.02, 95% CI=1.01, 1.03), those in emergency rooms (OR=1.75, 95% CI=1.25, 2.47), and in intensive care units (OR=1.60, 95% CI=1.22, 2.09) were more likely to miss breaks. Conclusions: Missed work breaks were common among nurses. Those who did not smoke were almost twice as likely to miss their work breaks as compared to smokers. Inequities in breaks, especially by smoking status, may cause dissension in the workplace and negatively affect patient care. Policies that support work breaks for all nurses are needed. [Copyright &y& Elsevier]

Examines the drainage reversals in the Mono Basin during the Pliocene and Pleistocene period in the U.S. Use of geomorphic features to reconstruct the Pleistocene record of shorelines; Shift in the spill point of Lake Russell; Migration of aquatic species in fast-flowing water.