Analysis of genetic diversity and population structure of peanut cultivars and breeding lines from China, India and the US using simple sequence repeat markers.

Cultivated peanut is grown worldwide as rich-source of oil and protein. A broad genetic base is needed for cultivar improvement. The objectives of this study were to develop highly informative simple sequence repeat (SSR) markers and to assess the genetic diversity and population structure of peanut cultivars and breeding lines from different breeding programs in China, India and the US. A total of 111 SSR markers were selected for this study, resulting in a total of 472 alleles. The mean values of gene diversity and polymorphic information content (PIC) were 0.480 and 0.429, respectively. Country-wise analysis revealed that alleles per locus in three countries were similar. The mean gene diversity in the US, China and India was 0.363, 0.489 and 0.47 with an average PIC of 0.323, 0.43 and 0.412, respectively. Genetic analysis using the STRUCTURE divided these peanut lines into two populations (P1, P2), which was consistent with the dendrogram based on genetic distance (G1, G2) and the clustering of principal component analysis. The groupings were related to peanut market types and the geographic origin with a few admixtures. The results could be used by breeding programs to assess the genetic diversity of breeding materials to broaden the genetic base and for molecular genetics studies.

Clergy Wellness: An Assessment of Perceived Barriers to Achieving Healthier Lifestyles.

This study sought to obtain a better understanding of how clergy view their health and to investigate their self-reported health status. Additionally, this study sought to explore personal and professional barriers among clergy to living a healthier life. An electronic 32-item survey was sent to all practicing clergy in Kansas East and West conferences of United Methodist church by the Kansas Area Office of the United Methodist Church. Survey items included participants' demographic information and health conditions (e.g., diabetes, heart disease, high blood pressure, high cholesterol). The self-reported general health, mental health, and physical health data were also collected to compare to the general population in Kansas. Clergy were also asked to identify perceived barriers to health. A total of 150 clergy participated in the survey. The majority (93.7 %) self-reported their health as good, very good, or excellent. Participating clergy self-reported a higher prevalence of chronic diseases (diabetes, heart disease, high blood pressure, and high cholesterol) than the Kansas general population, but those differences were not statistically significant. More than three-fourths (77.4 %) of the participating clergy reported weights and heights that classified them as either overweight or obese. Lack of family time was the most frequently reported personal barrier to achieving a healthier lifestyle. An unpredictable work schedule was reported as the most frequent professional barrier to achieving a healthier lifestyle. This study suggests that Kansas clergy generally view their overall health status favorably despite being overweight or obese. Clergy also self-reported higher prevalence of chronic diseases than the general Kansas population, though the prevalence was not statistically different. This study provides additional insight into clergy health and offers suggestions to address the barriers preventing clergy from working toward better health.

Caregiving and coping in carers of people with anorexia nervosa admitted for intensive hospital care.

OBJECTIVE: The aim of the study was to examine how carers cope practically and emotionally with caring for individuals with anorexia nervosa who require intensive hospital care. METHOD: This study explores objective burden (time spent with caregiving and number of tasks), subjective burden (psychological distress), and social support in a sample of parents (n = 224) and partners (n = 28) from a consecutive series of patients (n = 178) admitted to inpatient units within the United Kingdom. RESULTS: Most time was spent providing emotional support and less with practical tasks. Time spent with caregiving was associated with carer distress and was fully mediated by carer burden. This was ameliorated by social support. Partners received minimal support from others, and we found similar levels of burden and distress for mothers and partners. DISCUSSION: The data indicate that professional and social support alleviates carer distress and may be of particular value for partners who are more isolated than parents. The data also suggest that time spent with practical support may be of more value than emotional support.

A multi-centre cohort study of short term outcomes of hospital treatment for anorexia nervosa in the UK.

BACKGROUND: Individual, family and service level characteristics and outcomes are described for adult and adolescent patients receiving specialist inpatient or day patient treatment for anorexia nervosa (AN). Potential predictors of treatment outcome are explored. METHOD: Admission and discharge data were collected from patients admitted at 14 UK hospital treatment units for AN over a period of three years (adult units N = 12; adolescent N = 2) (patients N = 177). RESULTS: One hundred and seventy-seven patients with a severe and enduring illness with wide functional impairment took part in the study. Following inpatient care, physical improvement was moderate/good with a large increase in BMI, although most patients continued to have a clinical level of eating disorder symptoms at discharge. The potentially modifiable predictors of outcome included confidence to change, social functioning and carer expressed emotion and control. CONCLUSIONS: Overall, the response to inpatient treatment was modest particularly in the group with a severe enduring form of illness. Adolescents had a better response. Although inpatient treatment produces an improvement in physical health there was less improvement in other eating disorder and mood symptoms. As predicted by the carer interpersonal maintenance model, carer behaviour may influence the response to inpatient care, as may improved social functioning and confidence to change.

Large-scale calibration and simulation of COVID-19 epidemiologic scenarios to support healthcare planning.

The COVID-19 pandemic has provided stiff challenges for planning and resourcing in health services in the UK and worldwide. Epidemiological models can provide simulations of how infectious disease might progress in a population given certain parameters. We adapted an agent-based model of COVID-19 to inform planning and decision-making within a healthcare setting, and created a software framework that automates processes for calibrating the model parameters to health data and allows the model to be run at national population scale on National Health Service (NHS) infrastructure. We developed a method for calibrating the model to three daily data streams (hospital admissions, intensive care occupancy, and deaths), and demonstrate that on cross-validation the model fits acceptably to unseen data streams including official estimates of COVID-19 incidence. Once calibrated, we use the model to simulate future scenarios of the spread of COVID-19 in England and show that the simulations provide useful projections of future COVID-19 clinical demand. These simulations were used to support operational planning in the NHS in England, and we present the example of the use of these simulations in projecting future clinical demand during the rollout of the national COVID-19 vaccination programme. Being able to investigate uncertainty and test sensitivities was particularly important to the operational planning team. This epidemiological model operates within an ecosystem of data technologies, drawing on a range of NHS, government and academic data sources, and provides results to strategists, planners and downstream data systems. We discuss the data resources that enabled this work and the data challenges that were faced.

Interventions Associated With Reduced Loneliness and Social Isolation in Older Adults: A Systematic Review and Meta-analysis.

Importance: Loneliness and social isolation are public health concerns faced by older adults due to physical, cognitive, and psychosocial changes that develop with aging. Loneliness and social isolation are associated with increased morbidity and mortality. Objective: To evaluate interventions, targeting older adults, associated with a reduction in loneliness and social isolation. Data Sources: OVID, CINAHL, CENTRAL, Embase, PsychINFO, Web of Science, and Scopus were searched from inception to March 2020. Study Selection: Peer-reviewed randomized clinical trials measuring loneliness and social isolation or support in adults aged 65 years or older. Only English language articles were included. Data Extraction and Synthesis: Two independent reviewers screened studies, extracted data, and assessed risk of bias. Random-effects models were performed to pool the overall effect size by intervention. Statistical heterogeneity was evaluated with the I2 statistic and by estimating prediction intervals. Data were analyzed from November 2021 to September 2022. Main Outcomes and Measures: Quantitative measures of loneliness, social isolation, or social support based on an effect size of standardized mean differences. Results: Seventy studies were included in the systematic review (8259 participants); 44 studies were included in the loneliness meta-analysis (33 in the community with 3535 participants; 11 in long-term care with 1057 participants), with participants' ages ranging from 55 to 100 years. Study sizes ranged from 8 to 741 participants. Interventions included animal therapy, psychotherapy or cognitive behavioral therapy, multicomponent, counseling, exercise, music therapy, occupational therapy, reminiscence therapy, social interventions, and technological interventions. Most interventions had a small effect size. Animal therapy in long-term care, when accounting for studies with no active controls, had the largest effect size on loneliness reduction (-1.86; 95% CI, -3.14 to -0.59; I2 = 86%) followed by technological interventions (videoconferencing) in long-term care (-1.40; 95% CI, -2.37 to -0.44; I2 = 70%). Conclusions and Relevance: In this study, animal therapy and technology in long-term care had large effect sizes, but also high heterogeneity, so the effect size's magnitude should be interpreted with caution. The small number of studies per intervention limits conclusions on sources of heterogeneity. Overall quality of evidence was very low. Future studies should consider measures of social isolation in long-term care and identify the contextual components that are associated with a reduction in loneliness.

Twenty years of experience with a clinical ladder: a tool for professional growth, evidence-based practice, recruitment, and retention.

A clinical ladder program was introduced in a 257-bed facility 20 years ago. The program, developed by nurses for nurses, has evolved as integral to the facility's recruitment and retention, professional development, and evidence-based practice initiatives. This clinical ladder program has been used to encourage staff nurses to reach outside of their comfort zone to develop new skills. In this way, it has served as a means to identify leadership potential as a tool toward succession planning. The program provided evidence for the institution's Magnet designation (2004) and again for its bid for redesignation in 2008.

Examining the Feasibility of a Mindfulness Intervention for the Prevention of Falls: A Pilot Study.

This pilot study was designed to assess the feasibility of implementing a mindfulness intervention in the prevention of falls. We employed a quasi-experimental design consisting of 22 participants from two retirement homes in Ontario partaking in the regional falls prevention class. Participants were assigned to either an eight-week intervention, comprising mindfulness exercises incorporated into the standard falls prevention class, or to the standard falls prevention class. Participants were assessed using the Tinetti Balance and Gait Scale and the Timed Up and Go (TUG) test. The mindfulness intervention showed no significant effect on TUG or balance scores; however, there was a significant effect on assessments of gait. Given the ease of implementation of mindfulness-based interventions, further research may be warranted in mindfulness as a potential modality for falls prevention.

C-type natriuretic peptide receptor expression in pancreatic alpha cells.

Atrial natriuretic peptide (ANP), brain type natriuretic peptide (BNP) and C-type natriuretic peptide (CNP) comprise a family of natriuretic peptides that mediate their biological effects through three natriuretic peptide receptor subtypes, NPR-A (ANP, BNP), NPR-B (CNP) and NPR-C (ANP, BNP, CNP). Several reports have provided evidence for the expression of ANP and specific binding sites for ANP in the pancreas. The purpose of this study was to identify the ANP receptor subtype and to localize its expression to a specific cell type in the human pancreas. NPR-C immunoreactivity, but neither ANP nor NPR-A, was detected in human islets by immunofluorescent staining. No immunostaining was observed in the exocrine pancreas or ductal structures. Double-staining revealed that NPR-C was expressed mainly in the glucagon-containing alpha cells. NPR-C mRNA and protein were detected in isolated human islets by RT-PCR and Western blot analysis, respectively. NPR-C expression was also detected by immunofluorescent staining in glucagonoma but not in insulinoma. ANP, as well as BNP and CNP, stimulated glucagon secretion from perifused human islets (1,111 +/- 55% vs. basal [7.3 fmol/min]; P < 0.001). This response was mimicked by cANP(4-23), a selective agonist of NPR-C. In conclusion, the NPR-C receptor is expressed in normal and neoplastic human alpha cells. These findings suggest a role for natriuretic peptides in the regulation of glucagon secretion from human alpha cells.

Rapid response teams: a proactive critical care approach.

Time and again, hospital code teams are dispatched to a patient in cardiac arrest only to find their resuscitative efforts unsuccessful. Are there earlier interventions that may have saved the patient? Do any warning signs exist before the patient actually goes into a full code or cardiac arrest event? The answer is a repeated yes, and the solution is a rapid response team.

Engaging staff in the Magnet journey: the key is communication.

A Midwestern acute care facility shares its successful internal communication plan to engage stakeholders and describes its significance in achieving designation as a Magnet hospital. This plan remains a framework for ongoing communications toward sustaining a Magnet culture, completing annual interim reports, and preparing for redesignation in 4 years.

Cost-Effectiveness of a Care Transition Intervention Among Multimorbid Patients.

The purpose of this pilot study was to assess the cost-effectiveness of four different doses (based on patients' level of cognition and activation) of a home-based care transitions intervention compared with usual care at 2 and 6 months after hospital discharge to home for 126 adult patients with three or more chronic diseases. Health care utilization was measured, and a cost-effectiveness analysis was used to estimate incremental costs and quality-adjusted life-years associated with each intervention arm. At 6 months, results from this pilot study are very promising and support cost-effectiveness for Group 2-low cognition/high activation, Group 3-normal cognition/low activation, and Group 4-normal cognition/high activation patients. However, Group 1-low cognition/low activation needs a more intensive treatment than what was provided in the intervention, because of their low cognition and activation levels. Our intervention strategies provided to the groups would be scalable to a larger patient population and across different facilities.

Alternative sources of adult stem cells: a possible solution to the embryonic stem cell debate.

The complex moral and ethical debate surrounding the definition of the origins of human life, together with conflicting current and proposed legislation on state and federal levels, is hindering the course of research into the therapeutic uses of human embryonic stem cells. However, newly identified sources of adult stem cells, free from many of the ethical and legal concerns attached to embryonic stem cell research, may offer great promise for the advancement of medicine. These alternative sources may alleviate the need to resolve the stem cell debate before further therapeutic benefits of stem cell research can be realized. While legislation and ethics evolve to address the legal and moral issues of embryonic stem cell research, innovative researchers will continue to search for and find real and present solutions for cell-based therapies using adult stem cells.

Effect of high-oleic trait and paste storage variables on sensory attribute stability of roasted peanuts.

There has been much interest in the effect of the high-oleic acid trait of peanuts on various quality factors since discovery of high levels of oleic acid in a peanut mutant genotype. The trait provides greater oxidative stability for the high-oleic oil and seed. Several research groups have investigated high-oleic peanut oil and roasted peanut flavor characteristics, which were similar within high-oleic lines compared to Florunner. It was observed that some high-oleic lines derived from the Sunrunner cultivar have consistently higher predicted breeding values for roasted peanut attribute than Sunrunner itself. This study investigated if this apparent effect of the trait was an artifact arising from the handling procedures during processing and storage or from flavor fade. High-oleic lines used were derived by backcrossing the trait into existing cultivars, and the comparison of sensory attribute intensity was with the recurrent parent used in backcrossing. Previous comparisons have been between lines differing in more than just oleate content, that is, with widely different background genotypes that could contribute to the differences observed. Differential rates of change in sensory attributes were found in different background genotypes, suggesting that the comparison of high- and normal-oleic lines should be made in common background genotypes as well as in common production and postharvest environments. There was no measurable change in roasted peanut attribute in samples stored at -20 degrees C over the 63 day duration of this experiment. There were changes in roasted peanut in samples stored at 22 degrees C, confirming that storage at -20 degrees C is sufficient for large studies that require multiple sensory panel sessions over a period of weeks.

Effect of the high-oleic trait on roasted peanut flavor in backcross-derived breeding lines.

The high-oleic trait of peanut (Arachis hypogaea L.) has been suggested to have a positive impact on the roasted peanut sensory attribute. A series of lines derived by backcrossing the high-oleic trait into several existing cultivars were compared with their parent cultivars at locations in Florida, Georgia, North Carolina, and Texas. Breeders grew their high-oleic lines and parents in three-replicate tests at one or two locations. The Florida high-oleic line F435-2-3-B-2-1-b4-B-B-3-b3-b3-1-B was grown at each location. The test included normal- and high-oleic variants of F435, GK 7, NC 7, NC 9, Sunrunner, Tamrun 96, and Tamspan 90. Sound-mature kernel samples were roasted, ground into paste, and evaluated by a sensory panel using a 14-point flavor intensity unit (fiu) scale. Background genotype had an effect (P < 0.01) on the heritable sensory attributes roasted peanut, sweet, and bitter. Oleate level had a positive effect on roasted peanut intensity, increasing it by 0.3 fiu averaged across all seven background genotypes. However, the magnitude of improvement varied across background genotypes. The high-oleic trait had no effect or increased the intensity of the roasted peanut attribute in each background genotype. The increase was greatest in Tamrun 96 (+0.6 fiu, P < 0.05) and Spanish genotypes Tamspan 90 (+0.4 fiu, P < 0.05) and F435 (+0.4 fiu, P < 0.10). A change of 0.5 fiu or more should be perceptible to consumers. Interaction between oleate level and background genotype was detected for sweet (P < 0.10) and bitter (P < 0.01) attributes. The trait had an increasing effect on the bitter attribute only in the background genotype of Tamspan 90 (+0.7 fiu, P < 0.01). There was a nonsignificant increase in bitterness in the other Spanish background genotype, F435. Changes in bitterness in runner- and Virginia-type backgrounds were close to zero. Incorporation of the high-oleic trait into peanut cultivars is likely to improve the intensity of the roasted peanut attribute, but it may also increase the bitter attribute in Spanish genotypes.

Oral health progress in Kansas.

In 2003, Kansas received a grade of "D+" from Oral Health America in an annual rating of the state's oral health status (Oral Health America, 2003). This low grade confirmed what advocates had been saying for some time: Kansas---at several levels--is not taking seriously the oral health needs of many of its citizens. The purpose of this article is to discuss the Kansas dental health system and the role of the nurse in oral health.

Confirmatory factor analysis for two questionnaires of caregiving in eating disorders.

Objective: Caring for someone diagnosed with an eating disorder (ED) is associated with a high level of burden and psychological distress which can inadvertently contribute to the maintenance of the illness. The Eating Disorders Symptom Impact Scale (EDSIS) and Accommodation and Enabling Scale for Eating Disorders (AESED) are self-report scales to assess elements of caregiving theorised to contribute to the maintenance of an ED. Further validation and confirmation of the factor structures for these scales are necessary for rigorous evaluation of complex interventions which target these modifiable elements of caregiving. Method: EDSIS and AESED data from 268 carers of people with anorexia nervosa (AN), recruited from consecutive admissions to 15 UK inpatient or day patient hospital units, were subjected to confirmatory factor analysis to test model fit by applying the existing factor structures: (a) four-factor structure for the EDSIS and (b) five-factor structure for the AESED. Results: Confirmatory factor analytic results support the existing four-factor and five-factor structures for the EDSIS and the AESED, respectively. Discussion: The present findings provide further validation of the EDSIS and the AESED as tools to assess modifiable elements of caregiving for someone with an ED.

Effects of nurse staffing on hospital-acquired conditions and length of stay in community hospitals.

BACKGROUND: Error-free care is the goal of health care professionals, consumers, and public policy makers. Because nurses can be the last barrier between a patient and an error, there is a need to examine this pressing nursing issue-nurse staffing. PURPOSE: This research examined the predictive relationships between nurse staffing and patient outcomes in hospitals. METHOD: A quantitative, cross-sectional design was used to examine data on nearly 35,000 patients from 11 medical-surgical units in 4 hospitals. Data were extracted from administrative databases over a 2-year period and were analyzed using hierarchical linear modeling. DISCUSSION: Findings from the study indicated that higher registered nurse (RN) and licensed practical nurse hours per equivalent patient day and higher percentages of RNs in the skill mix predicted a lower number of adverse events and shorter lengths of stay, controlling for patient age and complications. CONCLUSION: This study, with its improved methodology, supports previous findings and should be used as evidence for changes to nurse staffing.