Outbreak of Ralstonia pickettii associated with contamination of saline products distributed internationally, the United Kingdom, 2024.

We describe an outbreak of Ralstonia pickettii in the United Kingdom, with isolates genetically indistinguishable from a 2023 Australian outbreak linked to internationally distributed saline solutions. Confirmed cases (n = 3) had bacteraemia, clinically relevant infection, indwelling venous lines and frequent healthcare contact. Multi-stakeholder intervention was required including product recall and risk communications. We recommend a low threshold for investigating clusters of Ralstonia species and similar opportunistic pathogens, considering contaminated product sources. Effective mitigation requires multi-agency partnership and international collaboration.

Density of a cryptic Australian small mammal: The threatened Julia Creek dunnart (Sminthopsis douglasi).

Globally, hundreds of mammal species face the threat of extinction in the coming decades, and in many cases, their ecology remains poorly understood. Fundamental ecological knowledge is crucial for effective conservation management of these species, but it is particularly lacking for small, cryptic mammals. The Julia Creek dunnart (Sminthopsis douglasi), a threatened, cryptic carnivorous marsupial that occurs in scattered populations in the central west of Queensland, Australia, was once so poorly studied that it was believed extinct. Sporadic research since its rediscovery in the early 1990s has revealed that S. douglasi is distributed across land at risk from many threats. Fundamental knowledge of S. douglasi population density is urgently required to inform conservation management at key sites, yet the species has historically proven hard to detect. Indeed, the status of the largest known population of S. douglasi, in Bladensburg National Park, is unknown. Here, we conducted a population study on S. douglasi at two sites within Bladensburg National Park via live mark-recapture surveys during 2022 and 2023. From likelihood-based spatially explicit capture-recapture (SECR) modelling we provide the first estimates of density and population size for S. douglasi. Live trapping resulted in captures of 49 individual S. douglasi (with 83 captures total, including recaptures). We estimated S. douglasi to occur at a density of 0.38 individuals ha-1 (0.25-0.58) at one site and 0.16 individuals ha-1 (0.09-0.27) at another site, with an estimated mean population size in suitable habitat at Bladensburg National Park of 1211 individuals (776-1646). Our S. douglasi density estimates were similar to that reported for other threatened small mammals in Australia. We also found evidence of extreme S. douglasi population fluctuations over time at Bladensburg National Park, which is of concern for its future conservation. Our study has provided the first estimate of density for S. douglasi, a threatened dasyurid species from the Mitchell Grass Downs of central western Queensland, Australia. Our research provides crucial population data to assist the management of this poorly studied species. We demonstrate a method that can be applied to species with low detection probability to ultimately help address the mammal extinction crisis faced by Australia and the rest of the world.

Eradicating an invasive mammal requires local elimination and reduced reinvasion from an urban source population.

Invasive mammal eradications are increasingly attempted across large, complex landscapes. Sequentially controlled management zones can be at risk of reinvasion from adjacent uncontrolled areas, and managers must weigh the relative benefits of ensuring complete elimination from a zone or minimizing reinvasion risk. This is complicated in urban areas, where habitat heterogeneity and a lack of baseline ecological knowledge increase uncertainty. We applied a spatial agent-based model to predict the reinvasion of a well-studied species, the brushtail possum (Trichosurus vulpecula), across an urban area onto a peninsula that is the site of an elimination campaign in Aotearoa New Zealand. We represented fine-scale urban habitat heterogeneity in a land cover layer and tested management scenarios that varied four factors: the density of possums remaining following an elimination attempt, the maintenance trap density on the peninsula, and effort expended toward preventing reinvasion by means of a high-density trap buffer at the peninsula isthmus or control of the source population adjacent to the peninsula. We found that achieving complete elimination on the peninsula was crucial to avoid rapid repopulation. The urban isthmus was predicted to act as a landscape barrier and restrict immigration onto the peninsula, but reliance on this barrier alone would fail to prevent repopulation. In combination, complete elimination, buffer zone, and source population control could reduce the probability of possum repopulation to near zero. Our findings support urban landscape barriers as one tool for sequential invasive mammal elimination but reaffirm that novel methods to expose residual individuals to control will be necessary to secure elimination in management zones. Work to characterize the urban ecology of many invasive mammals is still needed.

Effects of Parental Care on the Magnitude of Inbreeding Depression: A Meta-Analysis in Fishes.

AbstractInbreeding results from matings between relatives and often leads to a reduction in the fitness of inbred offspring, known as inbreeding depression. There is substantial variation in the magnitude of inbreeding depression among and within species, driven by differences in the biotic and abiotic environment. Recent studies in three species found that parental care has the potential to buffer against inbreeding depression in the offspring, but the generality of this pattern is still unknown. Here, we performed a meta-analysis to test whether variation in the magnitude of inbreeding depression is related to among-species differences in parental care in fishes. We synthesized 536 effect sizes across 56 studies and 18 species, spanning 47 years of research. We found that inbred offspring suffer a smaller reduction in fitness in species that provide biparental care than in species with uniparental or no care. By using a comparative approach, this study provides novel insights into the capacity of parental care to moderate inbreeding depression and suggests that these effects may currently be underappreciated. Considering the potential effects of parental care on inbreeding depression can help us understand why some species avoid inbreeding, whereas others tolerate or even prefer inbreeding, which has important implications for the maintenance of genetic variation within populations.

E. Mavis Hetherington (1926-2023).

This article memorializes E. Mavis Hetherington (1926-2023), an eminent developmental psychologist who made major contributions to understanding of children's development. Best known for her longitudinal studies on the impact of divorce on children and families, Hetherington published and lectured widely. Her interests spanned personality and social development, child psychopathology, stress and coping in families, and related topics. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cryptic behavior and activity cycles of a small mammal keystone species revealed through accelerometry: a case study of Merriam's kangaroo rats (Dipodomys merriami).

BACKGROUND: Kangaroo rats are small mammals that are among the most abundant vertebrates in many terrestrial ecosystems in Western North America and are considered both keystone species and ecosystem engineers, providing numerous linkages between other species as both consumers and resources. However, there are challenges to studying the behavior and activity of these species due to the difficulty of observing large numbers of individuals that are small, secretive, and nocturnal. Our goal was to develop an integrated approach of miniaturized animal-borne accelerometry and radiotelemetry to classify the cryptic behavior and activity cycles of kangaroo rats and test hypotheses of how their behavior is influenced by light cycles, moonlight, and weather. METHODS: We provide a proof-of-concept approach to effectively quantify behavioral patterns of small bodied (< 50 g), nocturnal, and terrestrial free-ranging mammals using large acceleration datasets by combining low-mass, miniaturized animal-borne accelerometers with radiotelemetry and advanced machine learning techniques. We developed a method of attachment and retrieval for deploying accelerometers, a non-disruptive method of gathering observational validation datasets for acceleration data on free-ranging nocturnal small mammals, and used these techniques on Merriam's kangaroo rats to analyze how behavioral patterns relate to abiotic factors. RESULTS: We found that Merriam's kangaroo rats are only active during the nighttime phases of the diel cycle and are particularly active during later light phases of the night (i.e., late night, morning twilight, and dawn). We found no reduction in activity or foraging associated with moonlight, indicating that kangaroo rats are actually more lunarphilic than lunarphobic. We also found that kangaroo rats increased foraging effort on more humid nights, most likely as a mechanism to avoid cutaneous water loss. CONCLUSIONS: Small mammals are often integral to ecosystem functionality, as many of these species are highly abundant ecosystem engineers driving linkages in energy flow and nutrient transfer across trophic levels. Our work represents the first continuous detailed quantitative description of fine-scale behavioral activity budgets in kangaroo rats, and lays out a general framework for how to use miniaturized biologging devices on small and nocturnal mammals to examine behavioral responses to environmental factors.

Ward-based learning in a pandemic: an approach to ensuring sustainable medical education for healthcare students.

The SARS-CoV-2 pandemic has caused significant disruption to medical education, requiring those involved in its delivery to radically revise teaching programmes to ensure continuation of delivery of training to future healthcare professionals. We describe our experience of implementing an infection teaching programme on a COVID-19 ward at a London teaching hospital affiliated to University College London (UCL) Medical School during the SARS-CoV-2 pandemic. We performed a scoping literature review of all papers published on medical education delivery in the pandemic between January 2020 - May 2021. We used the results from this, along with our pre-existing knowledge of medical education theory, to summarise 10 key learning recommendations for planning medical education in a pandemic. SARS-CoV-2 is unlikely to be the only significant interruption to medical education we see in our lifetimes. We should develop robust and sustainable teaching programmes with the aim of reducing disruption in the future.

Parental sexual orientation, parental gender identity, and the development of children.

In recent years, many lesbian, gay, bisexual, transgender, and queer (LGBTQ+) adults have become parents. LGBTQ+ parenthood does, however, remain a controversial topic across the United States and around the world. Several questions have been raised. For instance, to what extent do LGBTQ+ adults make capable parents? Do children who have LGBTQ+ parents grow up in healthy ways? What factors contribute to positive family functioning in families with LGBTQ+ parents? A growing body of social science research has addressed these questions, and the findings suggest both that LGBTQ+ adults are successful in their roles as parents and that their children develop in positive ways. Overall, the findings to date suggest that parental sexual orientation and gender identity do not in themselves determine success in parenting or child development; indeed, sexual and gender minority parents and their children have shown remarkable resilience, even in the face of many challenges. Contextual issues, as well as implications of research findings for law and policy around the world are discussed.

Ideas about family formation among Chinese international students of diverse sexual identities.

Planning for marriage and childbearing is an important part of many young adults' lives. In this study, we investigated ways in which ideas about family formation among Chinese international students were associated with personal, interpersonal, and cultural factors. In total, 265 childless Chinese international students (Mage = 23 years; all cisgender) in the United States participated in an online survey; 210 self-identified as heterosexual and 55 as sexual minority individuals. Results showed that sexual minority students chose older ideal ages for marriage and parenthood than did heterosexual students. Moreover, sexual minority students were more likely to see the United States and other regions where same-sex marriage is legal as ideal places to live after marriage, but heterosexual students were more likely to describe China as ideal. In reality, however, many students expected to return home to China, and there were no differences in their expectations as a function of sexual identities. In addition, students who reported greater acculturation to culture of the United States were more likely to choose the United States as the ideal place to live. Students who endorsed the importance of filial piety and who perceived more support from family were more likely to view China as the ideal place to live. Finally, sexual minority students who wanted to become parents chose a greater variety of pathways to parenthood than did heterosexual students. Results highlighted the role of sexual orientation, social support, and cultural ideals in shaping the ways Chinese students thought about future families. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cloth Lanyards as a Source of Intermittent Transmission of Candida auris on an ICU.

OBJECTIVES: Candida auris has been implicated in ICU outbreaks worldwide and is notable for being difficult to identify and treat, its resilience in the environment, and significant patient mortality associated with invasive disease. Here, we describe a small C. auris outbreak and how it was terminated. DESIGN: Single-center, observational. SETTING: Two general adult ICUs at an urban U.K. teaching hospital. PATIENTS: All patients positive for C. auris during the 5-month outbreak were included (n = 7). INTERVENTIONS: Stepwise implementation of enhanced infection prevention and control precautions was introduced including twice-weekly screening, contact tracing, isolation precautions, and environmental decontamination. A detailed environmental screen was performed to identify potential reservoirs. This included the patient bed space and clinical equipment and a frequently handled cloth lanyard attached to a key used to access controlled drugs. Personal possessions such as mobile phones, lanyards, and identification badges were also screened. MEASUREMENTS AND MAIN RESULTS: The index case and six linked acquisitions were identified. Four of six (67%) patients were identified after discharge of all known previous C. auris cases from ICU, highlighting potential for an environmental reservoir. Environmental screening identified C. auris from a patient bed space following deep cleaning, prompting review and enhancement of cleaning procedures. The controlled drug cloth lanyard was positive for C. auris, which prompted removal and culture of all staff lanyards. C. auris was identified on 1/100 staff lanyards (1%). No mobile phones or identification badges were positive for C. auris. The outbreak terminated following withdrawal of lanyards from ICU. CONCLUSIONS: This outbreak further implicates environmental reservoirs as sustaining C. auris ICU outbreaks. Identification of C. auris on cloth lanyards highlights the need to identify commonly handled moveable objects during an outbreak. We suggest that ICUs with a C. auris outbreak should investigate similar infrequently cleaned items as potential reservoirs and review their policies on lanyard use.

COVID-19 Pandemic Preparedness in a UK Tertiary and Quaternary Children's Hospital: Tales of the Unexpected.

We describe the adaptive coping strategies required in the management of a heterogeneous group of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pediatric patients. The diverse range of presentations, presenting in distinct phenotypic waves, exemplified the importance of preparedness for the unknown. Lessons learned will be essential in planning for a likely second wave of SARS-CoV-2.

Desire for Parenthood in Context of Other Life Aspirations Among Lesbian, Gay, and Heterosexual Young Adults.

Research has established that sexual minority young adults generally report fewer desires and fewer expectations for parenthood than do their heterosexual peers. Little is known, however, about other desires and expectations. Is parenthood the only domain in which lesbian and gay individuals report fewer desires and expectations than their heterosexual peers? Or do lower aspirations among lesbian and gay adults about parenthood also occur in other domains, such as marriage and work? In this study, we explored a variety of desires and expectations for the future among lesbian, gay, and heterosexual young adults. Participants for this internet survey were recruited via social media, and included 368 childless cisgender young adults (211 lesbian or gay and 157 heterosexual) living in the United States. There were three main findings. First, while lesbian/gay individuals were less likely than heterosexual participants to express desire for parenthood, desires in the other future domains did not vary across sexual orientation. Lesbian/gay participants were as likely as heterosexual individuals to desire marriage, friendships, and community connections, as well as career and economic success. Results for expectations were, however, very different. Lesbian/gay participants were less likely than heterosexual individuals to expect that they would marry, become parents, feel connected to a community, achieve meaningful careers, live in their ideal housing, or that they would attain financial stability. Thus, although desires were largely unrelated to sexual orientation, many expectations were strongly linked to it. Lesbian and gay individuals were also far more likely than their heterosexual peers to desire future goals that they did not expect to achieve. Overall, for lesbian/gay young adults, low parenthood aspirations were part of a general pattern of low expectations (though not reduced desires) across a number of life domains.

Longitudinal associations between coparenting and child adjustment among lesbian, gay, and heterosexual adoptive parent families.

This longitudinal study examined coparenting and child adjustment during early and middle childhood (Ms = 3 and 8 years, respectively) among 106 lesbian, gay, and heterosexual parent adoptive families. When children were in middle childhood, no differences emerged as a function of parental sexual orientation in observations or self-reports of coparenting; in addition, parents and teachers described children as well-adjusted overall. After controlling covariates, including couple relationship adjustment, more supportive coparenting in early childhood predicted fewer parent-reported child internalizing and externalizing problems in middle childhood. Within middle childhood, stronger parenting alliance was associated with fewer parent-reported child externalizing problems. These findings indicate the value of considering family processes among diverse families in contributing to child outcomes over time. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Health-Related Quality of Life Among Lesbian, Gay, and Bisexual Adults: The Burden of Health Disparities in 2016 Behavioral Risk Factor Surveillance System Data.

Purpose: Health-related quality of life (HRQoL) measures assess the burdens imposed by mental and physical health problems. We studied whether HRQoL disparities existed among lesbian, gay, and bisexual (LGB) adults. Methods: We examined HRQoL of LGB and heterosexual adults in 25 states (n = 195,378) using data from the 2016 Behavioral Risk Factor Surveillance System survey. We examined the number of days that mental or physical health was not good and days with activity limitations. We also examined frequent (≥14 days per month) mental and physical distress, frequent activity limitations (FALs), and general health status. Chi-square, linear regression, and logistic regression analyses were performed. Results: LGB adults reported significantly more days that their mental health was not good compared with heterosexual adults. Lesbian and bisexual females reported significantly more days with activity limitations than did heterosexual females. Bisexual females reported significantly more days that their physical health was not good; gay males reported significantly fewer days that their physical health was not good. Furthermore, gay and bisexual adults had significantly higher odds of reporting frequent mental distress (FMD). Specifically, gay and bisexual males had 1.6 and 1.7 higher odds of reporting FMD. Bisexual females had higher odds of reporting FMD (adjusted odds ratio [AOR] = 2.67), frequent physical distress (AOR = 1.32), FAL (AOR = 1.78), and poor or fair health (AOR = 1.55), compared with heterosexual females. Conclusions: These HRQoL analyses documented notable burdens of health disparities across sexual orientation identity, especially among bisexual females.

Sexual minority women's attitudes toward infants, children, and parenthood.

Little is known about the experiences of lesbian and bisexual women with infants or children or about their views on trade-offs required by parenthood. In this study, we examined how reactions to experiences with infants/children, perceived trade-offs of parenthood, and self-reported nurturance vary as a function of women's sexual orientation. Two hundred cisgender childless women (53 lesbian, 57 plurisexual, 90 heterosexual) from the United States, recruited via social media, participated in this study. Results showed that lesbian women reported more negative attitudes toward infants/children and parenthood than did heterosexual women. Self-reported nurturance did not differ as a function of sexual orientation. Overall, lesbian women reported that they had less favorable experiences with infants and/or children and that they anticipated more social and economic costs involved with parenthood than did heterosexual women. Lesbian women also reported lower aspirations for parenthood than heterosexual women, and this was largely accounted for by differences in perceptions of the trade-offs involved with parenthood. Plurisexual women did not differ from lesbian or heterosexual women on any outcome. These results contribute to our understanding of why lesbian women are, on average, less likely than heterosexual women to aspire to parenthood.

Sexual orientation and sleep difficulties: a review of research.

Is sexual orientation associated with sleep difficulties? In this article, we review empirical evidence that addresses this question. Stress is associated with sleep difficulties such as insomnia and, because members of sexual minorities experience greater stress, on average, than do others, lesbian, gay, and bisexual (LGB) individuals can be expected to report more sleep difficulties than their heterosexual peers. We reviewed 17 studies published since 1990, with data gathered from more than 600,000 individuals; some included data on both quantity and quality of sleep. In nine of 12 relevant studies, at least some sexual minority individuals reported shorter sleep duration than did heterosexual individuals, on average. In nine of 10 relevant studies, sexual minority individuals reported lower quality sleep, on average. Few data were available about other aspects of sleep as a function of sexual orientation. No investigators found LGB people to have fewer sleep difficulties than did heterosexual individuals. We conclude that, although research in this area is new and still limited in some respects, sleep difficulties are more common among LGB than heterosexual people. Our conclusion suggests the possibility that sleep difficulties may underlie known health disparities among members of sexual minorities. Further research is needed to evaluate differences in sleep difficulties among members of sexual minorities, and to explore treatment options for LGB individuals suffering from sleep difficulties.

Predictors of parenting intentions among childless lesbian, gay, and heterosexual adults.

Disparities in the intention to parent have been found for lesbian and gay individuals compared with heterosexual individuals, but little is known about what social contexts predict these differences. Qualities of family relationships, friendships, and romantic relationships may all play a role, but these have not been studied as a function of sexual orientation. Using a large national sample of adults in the United States, this study explored intentions for parenthood, ideal family size, and predictors of parenting intentions as a function of gender and sexual orientation. Results showed that fewer lesbian and gay than heterosexual individuals intended to become parents. In addition, among those who intended parenthood, lesbian and gay individuals reported smaller intended family sizes than did their heterosexual peers. Sociocontextual and demographic variables predicted parenting intentions similarly among all participants, regardless of sexual orientation. However, dissimilarities in the levels of these predictors explained some of the disparity in parenting intentions between lesbian/gay and heterosexual participants. Much remains to be learned about the role of sexual orientation in family formation processes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Adult Children of Gay Fathers: Parent-Child Relationship Quality and Mental Health.

According to family systems theory, parent-child relationships are an important aspect of individual wellbeing. This study explored associations among parental disclosure, parent-child relationships, and wellbeing among 84 adult children with gay fathers. We explored associations between the adult children's wellbeing and the children's ages at sexual orientation disclosure, geographic distance, relationship quality, and closeness with their fathers. We found that when parental disclosure had occurred earlier in the adult child's life, participants reported feeling closer to fathers in adulthood. Those who reported closer relationships with their fathers reported greater wellbeing. Using a stepwise regression, we found that adult children's reports of closeness with fathers were the best predictors of adult children's wellbeing.

Health Care Systems Support to Enhance Patient-Centered Care: Lessons from a Primary Care-Based Chronic Pain Management Initiative.

BACKGROUND: Supporting day-to-day self-care activities has emerged as a best practice when caring for patients with chronic pain, yet providing this support may introduce challenges for both patients and primary care physicians. It is essential to develop tools that help patients identify the issues and outcomes that are most important to them and to communicate this information to primary care physicians at the point of care. OBJECTIVE: We describe our process to engage patients, primary care physicians, and other stakeholders in the context of a pilot randomized controlled trial of a patient-centered assessment process implemented in an everyday practice setting. We identify lessons on how to engage stakeholders and improve patient-centered care for those with chronic conditions within the primary care setting. METHODS: A qualitative analysis of project minutes, interviews, and focus groups was conducted to evaluate stakeholder experiences. Stakeholders included patients, caregivers, clinicians, medical office support staff, health plan administrators, an information technology consultant, and a patient advocate. RESULTS: Our stakeholders included many patients with no prior experience with research. This approach enriched the applicability of feedback but necessitated extra time for stakeholder training and meeting preparation. Types of stakeholders varied over the course of the project, and more involvement of medical assistants and Information Technology staff was required than originally anticipated. CONCLUSION: Meaningful engagement of patient and physician stakeholders must be solicited in a well-coordinated manner with broad health care system supports in place to ensure full execution of patient-centered processes.