Frequency of actionable secondary findings in 7472 Korean genomes derived from the National Project of Bio Big Data pilot study.

Exome and genome sequencing (ES/GS) in genetic medicine and research leads to discovering genomic secondary findings (SFs) unrelated to the purpose of the primary test. There is a lack of agreement to return the SF results for individuals undergoing the test. The aim of this study is to investigate the frequency of actionable secondary findings using GS data obtained from the rare disease study and the Korean Genome and Epidemiology Study (KoGES) in the National Project of Bio Big Data pilot study. Pathogenic (P) or likely pathogenic (LP) variants of 78 SF genes recommended by the American College of Medical Genetics and Genomics (ACMG) were screened in the rare disease study and KoGES. The pathogenicity of SF gene variants was determined according to the ACMG interpretation. The overall SF rate was 3.75% for 280 individuals with 298 P/LP variants of 41 ACMG SF genes which were identified among 7472 study participants. The frequencies of genes associated with cardiovascular, cancer, and miscellaneous phenotypes were 2.17%, 1.22%, and 0.58%, respectively. The most frequent SF gene was TTN followed by BRCA2. The frequency of actionable SFs among participants with rare disease and general population participants in the Korean population presented here will assist in reporting results of medically actionable SFs in genomic medicine.

Albumin-binding recombinant human IL-18BP ameliorates macrophage activation syndrome and atopic dermatitis via direct IL-18 inactivation.

Given the clinical success of cytokine blockade in managing diverse inflammatory human conditions, this approach could be exploited for numerous refractory or uncontrolled inflammatory conditions by identifying novel targets for functional blockade. Interleukin (IL)-18, a pro-inflammatory cytokine, is relatively underestimated as a therapeutic target, despite accumulated evidence indicating the unique roles of IL-18 in acute and chronic inflammatory conditions, such as macrophage activation syndrome. Herein, we designed a new form of IL-18 blockade, i.e., APB-R3, a long-acting recombinant human IL-18BP linked to human albumin-binding Fab fragment, SL335, for extending half-life. We then explored the pharmacokinetics and pharmacodynamics of APB-R3. In addition to an extended serum half-life, APB-R3 alleviates liver inflammation and splenomegaly in a model of the macrophage activation syndrome induced in IL-18BP knockout mice. Moreover, APB-R3 substantially controlled skin inflammation in a model of atopic dermatitis. Thus, we report APB-R3 as a new potent IL-18 blocking agent that could be applied to treat IL-18-mediated inflammatory diseases.

Optimal allocation and operation of sewer monitoring sites for wastewater-based disease surveillance: A methodological proposal.

Wastewater-based epidemiology (WBE) is drawing increasing attention as a promising tool for an early warning of emerging infectious diseases such as COVID-19. This study demonstrated the utility of a spatial bisection method (SBM) and a global optimization algorithm (i.e., genetic algorithm, GA), to support better designing and operating a WBE program for disease surveillance and source identification. The performances of SBM and GA were compared in determining the optimal locations of sewer monitoring manholes to minimize the difference among the effective spatial monitoring scales of the selected manholes. While GA was more flexible in determining the spatial resolution of the monitoring areas, SBM allows stepwise selection of optimal sampling manholes with equiareal subcatchments and lowers computational cost. Upon detecting disease outbreaks at a regular sewer monitoring site, additional manholes within the catchment can be selected and monitored to identify source areas with a required spatial resolution. SBM offered an efficient method for rapidly searching for the optimal locations of additional sampling manholes to identify the source areas. This study provides strategic and technical elements of WBE including sampling site selection with required spatial resolution and a source identification method.

Feasibility of an Advance Care Planning Program (ACP) for Korean Community-Dwelling Older Adults and ACP Training of Advance Practice Nurses.

This study aimed to develop a locally suitable advance care planning (ACP) program for older community-dwelling adults and a training program for nurse facilitators in Korea, and to evaluate their feasibility from the facilitators' experiences. This was a mixed methods pilot study that assessed the feasibility of an ACP program by analyzing survey, checklist, and focus group interview data. The ACP program was named CLOSE (Communicating and Listening to Our Seniors' voices about End-of-life care). Home health care nurses (N = 9) participated in this study. The participants reported that CLOSE was applicable to older community-dwelling adults and the training program was useful for increasing facilitator competency. We suggest some lessons from this pilot study that can be used to improve the ACP program and encourage community health nurses to participate in ACP as facilitators.

Simple differentiation method using FBS identifies DUSP6 as a marker for fine-tuning of FGF-ERK signaling activity in human pluripotent stem cells.

Assessment of differentiation potential is a basic requirement to obtain qualified human pluripotent stem cells (hPSCs). Here, we report a simple differentiation method using fetal bovine serum (FBS) to estimate differentiation potential and propensity of hPSCs. PluriTest using RNA-sequencing showed that cells differentiated after treatment with 5% FBS. Expression patterns of three germ layer markers revealed that cells cultured in Knockout Serum Replacement-containing medium (KSR) with mouse feeder cells had higher differentiation potential than cells cultured in a chemically defined medium (E8) with recombinant matrix proteins, especially into the mesoderm and endoderm lineages. Analysis of differentially expressed genes between KSR and E8 identified DUSP6 as a marker for where cells had been cultured. Expression of DUSP6 correlated with FGF-ERK signaling activity. Fine-tuning of FGF-ERK signaling activity to a range that can shut down DUSP6 transcription but sustain NANOG transcription partially increased the differentiation potential. Our data suggest that differentiation with 5% FBS is good to estimate differentiation potential and propensity at the early stage, and that DUSP6 is an excellent marker to monitor ERK signaling activity.

Hospice care education needs of nursing home staff in South Korea: a cross-sectional study.

BACKGROUND: While the importance of hospice care education in nursing homes is recognized, the volume of research on the specific educational needs of caregivers in hospice care in nursing homes is still lacking. This study aimed to assess educational needs in hospice care among the nursing home staff in South Korea, and to examine factors related to their education needs. METHODS: This is a cross-sectional descriptive study. A total of 324 nursing staff members recruited from 15 nursing homes in South Korea participated in this cross-sectional study. Measurements included demographic information, organizational characteristics, education experiences in hospice care, and educational needs in hospice care based on questionnaires developed by Whittaker and colleagues. Data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression techniques. RESULTS: In the present study, 70.6% (n = 218) of respondents reported that they had previous experience with education in hospice care and expressed their continued need for further education. The provision of care in the last days of a patient's life was the most frequent issue identified by nursing home staff for further education. Factors predicting educational needs in hospice care included provision of hospice care services in nursing homes and the existence of hospice care team meetings in the institution. Multiple regression analysis resulted in 14.3% of explained variance in the educational needs of nursing home staff in hospice care. CONCLUSIONS: Nursing home staff members showed high levels of need for training in hospice care. Therefore, it is imperative for nursing home administrators to initiate and support well-suited hospice care education for multi-level care workers on an ongoing basis.

Socio-economic factors of high trash generation in the city of Los Angeles.

Trash is one of major pollutants in urban runoff. Some studies have been conducted to verify the different impacts of land use on trash generation in a qualitative way and focused on the performance of trash control measures. Few studies have explored the human impacts on trash generation or developed a quantitative model to describe the phenomenon. This paper examined the impact of human activity on trash generation. Spatial regimes on high trash generation areas were identified using the selected variables from best subset model regression and validated with Moran's I scatter plot and spatial analysis of variance. Bidirectional spatial lag regression with regimes was performed to develop the final model to explain the spatial distribution of trash generation and identify its major causes. The result showed that economic status and occupation of the population were correlated with trash accumulation and the dominant land use type, and the distance to rivers most affected trash generation. The effects of these indicators were different within and outside the high trash generation areas.

Genetic analysis of parathyroid and pancreatic tumors in a patient with multiple endocrine neoplasia type 1 using whole-exome sequencing.

BACKGROUND: Multiple endocrine neoplasia type 1 (MEN1) syndrome is an autosomal dominant hereditary disorder characterized by the presence of endocrine tumors affecting the parathyroid, pancreas, and pituitary. A heterozygous germline inactivating mutation in the MEN1 gene (first hit) may be followed by somatic loss of the remaining normal copy or somatic mutations in the MEN1 gene (second hit). Whole-exome sequencing has been successfully used to elucidate the mutations associated with the different types of tumors. CASE PRESENTATION: We performed whole-exome sequencing (WES) on three parathyroid tumors, one pancreatic insulinoma, and a blood sample taken from the same patient with MEN1 to study tumor heterogeneity in MEN1 originating from different tumors. We identified a novel frame-shift deletion (c.1382_1383delAG, p.E461GfsX69) in the MEN1 gene using WES, which was confirmed by Sanger sequencing. WES and the SNP array revealed somatic LOH on chromosome 11 in parathyroid tumors (left upper, left lower, and right upper parathyroid). However, we did not detect a somatic MEN1 gene mutation or LOH in the pancreatic insulinoma. WES revealed two somatic functional variants outside the MEN1 gene in the pancreatic insulinoma. CONCLUSIONS: This study revealed heterogeneity among tumors in the same patient with MEN1, suggesting that different tumor-specific tumorigenic mechanisms may contribute to the pathogenesis of MEN1 tumors. The present study supports the clinical applicability of the WES strategy to research on multiple tumor samples and blood.

Proactive modeling of water quality impacts of extreme precipitation events in a drinking water reservoir.

Extreme precipitation events are of concern to managers of drinking water sources because these occurrences can affect both water supply quantity and quality. However, little is known about how these low probability events impact organic matter and nutrient loads to surface water sources and how these loads may impact raw water quality. This study describes a method for evaluating the sensitivity of a water body of interest from watershed input simulations under extreme precipitation events. An example application of the method is illustrated using the Wachusett Reservoir, an oligo-mesotrophic surface water reservoir in central Massachusetts and a major drinking water supply to metropolitan Boston. Extreme precipitation event simulations during the spring and summer resulted in total organic carbon, UV-254 (a surrogate measurement for reactive organic matter), and total algae concentrations at the drinking water intake that exceeded recorded maximums. Nutrient concentrations after storm events were less likely to exceed recorded historical maximums. For this particular reservoir, increasing inter-reservoir transfers of water with lower organic matter content after a large precipitation event has been shown in practice and in model simulations to decrease organic matter levels at the drinking water intake, therefore decreasing treatment associated oxidant demand, energy for UV disinfection, and the potential for formation of disinfection byproducts.

Hybrid Cellular Nanosheets for High-Performance Lithium-Ion Battery Anodes.

We report a simple synthetic method of carbon-based hybrid cellular nanosheets that exhibit outstanding electrochemical performance for many key aspects of lithium-ion battery electrodes. The nanosheets consist of close-packed cubic cavity cells partitioned by carbon walls, resembling plant leaf tissue. We loaded carbon cellular nanosheets with SnO2 nanoparticles by vapor deposition method and tested the performance of the resulting SnO2-carbon nanosheets as anode materials. The specific capacity is 914 mAh g(-1) on average with a retention of 97.0% during 300 cycles, and the reversible capacity is decreased by only 20% as the current density is increased from 200 to 3000 mA g(-1). In order to explain the excellent electrochemical performance, the hybrid cellular nanosheets were analyzed with cyclic voltammetry, in situ X-ray absorption spectroscopy, and transmission electron microscopy. We found that the high packing density, large interior surface area, and rigid carbon wall network are responsible for the high specific capacity, lithiation/delithiation reversibility, and cycling stability. Furthermore, the nanosheet structure leads to the high rate capability due to fast Li-ion diffusion in the thickness direction.

Prevalence and perpetrators of workplace violence by nursing unit and the relationship between violence and the perceived work environment.

AIMS: To identify the prevalence and perpetrators of workplace violence against nurses and to examine the relationship of work demands and trust and justice in the workplace with the occurrence of violence. DESIGN: This study employed cross-sectional data from a 2013 nurse survey conducted at a university hospital in Seoul, South Korea. The study sample included 970 female nurses from 47 nursing units, including general, oncology, intensive care units (ICUs), operating rooms, and outpatient departments. METHODS: The second version of the medium-sized Copenhagen Psychosocial Questionnaire (COPSOQ II) was used to measure work demands (i.e., quantitative demands, work pace, and emotional demands), trust and justice, and violence. Relationships among those variables were examined by conducting multiple logistic regression analyses with multilevel modeling. FINDINGS: The 12-month prevalence of verbal abuse (63.8%) was highest, followed by threats of violence (41.6%), physical violence (22.3%), and sexual harassment (19.7%), but bullying had the lowest prevalence (9.7%). Physical violence, threats of violence, and verbal abuse occurred most frequently in ICUs, whereas sexual harassment and bullying were highest in operating rooms. The main perpetrators were patients, followed by physicians and patients' families. Nurses perceiving greater work demands and less trust and justice were more likely to have been exposed to violence. CONCLUSIONS: The prevalence and perpetrators of violence varied considerably among nursing units. Greater work demands and less trust and justice were associated with nurses' experiences of violence. CLINICAL RELEVANCE: Adequate work demands and a trusted and just work environment may reduce violence against nurses. In return, reduction of violence will contribute to creating a better nursing work environment.

Recessive C10orf2 mutations in a family with infantile-onset spinocerebellar ataxia, sensorimotor polyneuropathy, and myopathy.

Recessive mutations in chromosome 10 open reading frame 2 (C10orf2) are relevant in infantile-onset spinocerebellar ataxia (IOSCA). In this study, we investigated the causative mutation in a Korean family with combined phenotypes of IOSCA, sensorimotor polyneuropathy, and myopathy. We investigated recessive mutations in a Korean family with two individuals affected by IOSCA. Causative mutations were investigated using whole exome sequencing. Electrophysiological analyses and muscle and nerve biopsies were performed, along with magnetic resonance imaging (MRI) of the brain and lower extremities. Compound heterozygous mutations c.1460C>T and c.1485-1G>A in C10orf2 were identified as causative of IOSCA. Skeletal muscle showed mitochondrial DNA (mtDNA) deletions. Both patients showed a period of normal development until 12-15 months, followed by ataxia, athetosis, hearing loss, and intellectual disability. Electrophysiological findings indicated motor and sensory polyneuropathies. Muscle biopsy revealed variations in the size and shape of myofibers with scattered, small, and angulated degenerating myofibers containing abnormal mitochondria; these observations are consistent with myopathy and may be the result of mtDNA deletions. Sural nerve biopsy revealed an axonal neuropathy. High-signal-intensity lesions in the middle cerebellar peduncles were correlated with clinical severity, and MRI of the lower legs was compatible with the hypothesis of length-dependent axonal degeneration. We identified novel compound heterozygous mutations of the C10orf2 gene as the cause of IOSCA with sensorimotor polyneuropathy and myopathy. Signs of motor neuropathy and myopathy were discovered for the first time in IOSCA patients with C10orf2 mutations. These results suggest that the clinical spectrum of IOSCA caused by C10orf2 mutations may be more variable than previously reported.

Identification of CDH23 mutations in Korean families with hearing loss by whole-exome sequencing.

BACKGROUND: Patient genetic heterogeneity renders it difficult to discover disease-cause genes. Whole-exome sequencing is a powerful new strategy that can be used to this end. The purpose of the present study was to identify a hitherto unknown mutation causing autosomal recessive nonsyndromic hearing loss (ARNSHL) in Korean families. METHODS: We performed whole-exome sequencing in 16 individuals from 13 unrelated small families with ARNSHL. After filtering out population-specific polymorphisms, we focused on known deafness genes. Pathogenic effects of the detected mutations on protein structure or function were predicted via in silico analysis. RESULTS: We identified compound heterozygous CDH23 mutations in hearing-loss genes of two families. These include two previously reported pathological mutations, p.Pro240Leu and p.Glu1595Lys, as well as one novel mutation, p.Asn342Ser. The p.Pro240Leu mutation was found in both families. We also identified 26 non-synonymous variants in CDH23 coding exons from 16 hearing-loss patients and 30 Korean exomes. CONCLUSION: The present study is the first to show that CDH23 mutations cause hearing loss in Koreans. Although the precise contribution made by such mutations needs to be determined using a larger patient cohort, our data indicate that mutations in the CDH23 gene are one of the most important causes of non-syndromic hearing loss in East Asians. Further exome sequencing will identify common mutations or polymorphisms and contribute to the molecular diagnosis of, and development of new therapies for, hereditary hearing loss.

Magnetosome-like ferrimagnetic iron oxide nanocubes for highly sensitive MRI of single cells and transplanted pancreatic islets.

For ultrasensitive magnetic resonance imaging (MRI), magnetic nanoparticles with extremely high r2 relaxivity are strongly desired. Magnetosome-like nanoparticles were prepared by coating polyethylene glycol-phospholipid (PEG-phospholipid) onto ferrimagnetic iron oxide nanocubes (FIONs). FIONs exhibited a very high relaxivity (r2) of 324 mM(-1) s(-1), allowing efficient labeling of various kinds of cells. The magnetic resonance (MR) imaging of single cells labeled with FIONs is demonstrated not only in vitro but also in vivo. Pancreatic islet grafts and their rejection could be imaged using FIONs on a 1.5 T clinical MRI scanner. The strong contrast effect of FIONs enabled MR imaging of transplanted islets in small rodents as well as in large animals. Therefore, we expect that MR imaging of pancreatic islet grafts using FIONs has the potentials for clinical applications. Furthermore, FIONs will enable highly sensitive noninvasive assessment after cell transplantation.

Average hospital length of stay, nurses' work demands, and their health and job outcomes.

PURPOSE: To examine the relationship between average hospital length of stay (LOS) of nursing units and work demands perceived by nurses, and between work demands and nurses' health and job outcomes. DESIGN: A cross-sectional study using nurse survey data collected in a tertiary university hospital in Seoul, South Korea, in 2013 including 746 staff nurses working on 36 general, oncology, or intensive care units. METHODS: Each unit's average LOS was categorized as short (1st quartile), medium (2nd and 3rd quartiles), or long (4th quartile). Work demands (i.e., quantitative demands, work pace, and emotional demands), and nurses' health and job outcomes were measured using the Copenhagen Psychosocial Questionnaire II. Their relationships were examined by multiple linear or logistic regression analyses with multilevel modeling. FINDINGS: The nurses reported high mean scores of work demands and poor health and job outcomes, compared with other occupations. The nurses working on units with a short or medium (vs. long) LOS perceived higher quantitative and emotional demands, and a higher work pace. Greater quantitative and emotional demands were associated with poor self-rated health, greater sleeping troubles, work-family conflict, stress and burnout, lower job satisfaction, and a greater intent to leave. A higher work pace was also significantly related to greater work-family conflict. CONCLUSIONS: A shorter LOS was associated with higher work demands, and higher work demands were associated with worse nurse outcomes. Thus, excessive work demands should be avoided to prevent nurses' health and job outcomes from deteriorating. CLINICAL RELEVANCE: Nurse managers need to monitor the impacts of reducing LOS on work demands and nurse outcomes and request additional nurses to meet increasing work demands.

Multispectral remote sensing of harmful algal blooms in Lake Champlain, USA.

ABSTRACT: This study developed satellite remote sensing models to detect cyanobacterial blooms via chlorophyll a in Lake Champlain. Landsat Enhanced Thematic Mapper Plus data was used to retrieve chlorophyll a concentrations, phytoplankton, and cyanobacteria biovolume by calibrating and validating with coincident observation data. Correlation analysis results showed that band 2 (green band) and the band ratio of 2/1 (green/blue) were most highly correlated to chlorophyll a concentration (r = 0.76 and 0.82, respectively). Multiple regression results identified band 2 and 3 (red), and band ratio of 2/1 and 3/1 (red/blue) as critical information to estimate chlorophyll a concentrations. The regression models accounted for 72 to 83% of the variability in chlorophyll a observations, allowing for estimates of phytoplankton and cyanobacteria levels in the lake. Satellite image processing results successfully showed the temporal and spatial distribution of chlorophyll a, phytoplankton, and cyanobacteria in the lake. This information can be used to evaluate the effect of pollution sources and weather conditions, and assist decision making for water management.

Multivariate analyses for monitoring EDCs and PPCPs in a lake water.

The analysis of endocrine disrupting compounds (EDCs) and pharmaceutical and personal care products (PPCP), present at trace level in surface waters, is often expensive, time-consuming, and complex. Implementing effective monitoring strategies for these compounds is essential to determine the types of analytes, sampling locations, and sampling frequencies. Multivariate analyses were used to investigate the patterns of EDCs and PPCPs in Lake Mead, Nevada, for these purposes. The results of cluster analysis and principal component analysis to identify the patterns among compounds demonstrated that selected pharmaceuticals tended to be present together with each other, whereas hormones did not show patterns with other compounds. The results of cluster analysis and discriminant analysis to investigate the spatial variation of EDCs and PPCPs eliminated redundant sampling locations, verifying the current selection of sampling locations in Lake Mead. The results of autocorrelation provided optimal sampling frequencies for EDCs and PPCPs, suggesting either monthly or quarterly monitoring of these compounds in Lake Mead. The patterns of the compounds could be site specific; depending on weather and hydrological conditions of the water systems, but this study's approaches will facilitate effective assessment and monitoring of EDCs and PPCPs in surface water.

A comparison of ethical issues in nursing practice across nursing units.

BACKGROUND: The complexity and variety of ethical issues in nursing is always increasing, and those issues lead to special concerns for nurses because they have critical impacts on nursing practice. RESEARCH OBJECTIVES: The purpose of this study was to gather comprehensive information about ethical issues in nursing practice, comparing the issues in different types of nursing units including general units, oncology units, intensive care units, operating rooms, and outpatient departments. RESEARCH DESIGN: The study used a descriptive research design. Ethics/human rights issues encountered by nurses in their daily nursing practice were identified by using the Ethical Issues Scale. PARTICIPANTS: The study sample included 993 staff nurses working in a university hospital in South Korea. ETHICAL CONSIDERATIONS: This study was approved by the University Institutional Review Board. Completed questionnaires were returned sealed with signed informed consent. FINDINGS: The most frequently and disturbingly encountered issues across nursing units were "conflicts in the nurse-physician relationship," "providing care with a possible risk to your health," and "staffing patterns that limit patient access to nursing care." The findings of this study showed that nurses from different nursing units experienced differences in the types or frequency of ethical issues. In particular, intensive care units had the greatest means of all the units in all three component scales including end-of-life treatment issues, patient care issues, and human rights issues. DISCUSSION: Nurses experienced various ethical challenges in their daily practice. Of the ethical issues, some were distinctively and frequently experienced by nurses in a specific unit. CONCLUSION: This study suggested that identifying and understanding specific ethical issues faced by nurses in their own areas may be an effective educational approach to motivate nurses and to facilitate nurses' reflection on their experiences.

Assessment of nutrient distributions in Lake Champlain using satellite remote sensing.

The introduction of nutrients to lakes causing eutrophic conditions is a major problem around the world. Proper monitoring and modeling are important to effectively manage eutrophication in lake waters. The goal is to develop remote sensing models for nutrients, total phosphorus and total nitrogen, in Lake Champlain. The remote sensing models were created using multivariate linear regression with the unique band combinations of Landsat Enhanced Thematic Mapper Plus (ETM+) imagery based on the empirical relationship with the field observations. The resulting models successfully showed nutrient distributions in the most eutrophic part of Lake Champlain, Missisquoi Bay, with reasonable adjusted coefficient of determination values (R(2)=0.81 and 0.75 for total phosphorus and total nitrogen, respectively). The results show the feasibility and the utility of satellite imagery to detect spatial distributions of lake water quality constituents, which can be used to better understand nutrient distributions in Lake Champlain. This approach can be applicable to other lakes experiencing eutrophication assisting decision making when implementing Best Management Practices and other mitigation techniques to lakes.

New Graduate Nurses' Experiences by Generation in South Korea: A Qualitative Meta-Synthesis.

BACKGROUND: As the nursing organization environment evolves into one in which several generations work together, there are concerns about generational differences leading to conflicts. PURPOSE: A synthesis of qualitative studies was used to gain insight into the experiences and perceptions of new nurses working in South Korean hospitals and identify generational differences between nurses of Generations X and Y. METHODS: Eight databases were searched systematically for qualitative studies published up to June 2020. The Critical Appraisal Skills Programme Checklist for Qualitative Research was used to evaluate the quality of the retrieved studies, and the data were synthesized thematically using the Thomas and Harden method. RESULTS: Of the 2,482 studies retrieved, 19 were included in this meta-synthesis. The experience of new nurses were presented in the three analytical themes of work experience, interpersonal relationships, and adaptation, from which eight descriptive themes were derived: (a) dissatisfied with own work performance, (b) negative feedback on work outcomes, (c) irregular daily life, (d) colleagues who help adapt to work life or make work life harder, (e) feelings of sympathy toward peers, (f) disrespectful patients or caregivers, (g) effective reactions, and (h) ineffective reactions. Although the new nurses from Generations X and Y reported similar experiences during their first year of nursing, differences were found in their values and tendencies regarding work and interpersonal relationships. Compared with new Generation X nurses, new Generation Y nurses placed more value on the meaning of individual work contributions, intimacy with colleagues, and appropriate feedback. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings of this study support nursing administrators implementing strategies that both acknowledge and reduce the impact of generational category on nursing teams. Furthermore, emphasizing communication and acknowledging ongoing change as generations progress may strengthen bonds that lead nurses to value each other and their work.