Frontline healthcare workers' mental distress, top concerns, and assessment on hierarchy of controls in response to COVID-19: a cross-sectional survey study.

BACKGROUND: The existing studies showed that frontline healthcare workers during an epidemic experienced unusual stressors and mental distress which even lasted for years after the crisis. It is important to learn about their concerns early to mitigate the negative impact as well as to evaluate disease control from experiences on the front lines for improving responses to the outbreak. The study aimed to provide insights on how to strengthen public health responses to protect healthcare workers both physically and mentally, and effectively control the disease in light of hierarchy of controls. METHODS: A cross-sectional survey was distributed online via Qualtrics to frontline healthcare workers during the COVID-19 through a university's nursing program and received 267 valid responses from 103 certificated nursing assistants, 125 nurses, and 39 other health professionals. A descriptive data analysis with a Chi-square test at a two-sided 0.05 level of significance was performed on factors that potentially affected mental health of healthcare workers and effectiveness of disease control at workplace in five domains. The themes were summarized on open-ended questions. RESULTS: About 30% of the respondents showed the symptom of depression and needed a further investigation. The influencing factors in five domains were examined. Engineering and administrative controls, as well as PPE were widely used in response to COVID-19. The respondents assessed the state and workplace responses to COVID-19 better than the federal government responses. The workplace responses were considered most effective. Multiple factors with a statistically significant correlation with effectiveness of the disease control at workplace were identified. CONCLUSIONS: The study suggested that timely responses at policy level will be more effective than other measures in early prevention and control of the pandemic, mental distress should be addressed in addition to PPE, and nursing programs should consider providing a situation-specific career coaching or counseling for students. A longitudinal study at a larger scale is warranted to capture the variation of time change with the disease control evolvement and across geographic regions.

The Dual Epidemics of 2020: Nursing Leaders' Reflections in the Context of Whole Person/Whole Systems.

The Greater Boston Nursing Collective, a consortium composed of university nursing deans and chief nursing officers within academic medical centers and specialty hospitals in Boston, Massachusetts, was formed in 2014. Since the group's inception, our mission has been to create and reinforce whole-person/whole-system healing environments to improve the health of all communities. Through our collaboration in navigating the dual epidemics of COVID-19 and structural racism within our respective organizations, and across the United States and the world, we share experiences and lessons learned. Our common mission is clearer than ever: to create safe and joyful work environments, to protect the dignity of those we are privileged to serve, and to generate policies to advance health equity to rectify societal forces that have shaped this dual epidemic. We are humbled by the many who persist despite limited rest and respite, and whose stories, innovations, and leadership we are honored to witness and share. They have defined our generation, just as nurses in earlier crises have done: leading through service to others as our purpose and privilege.

Horizontal gene transfer in Histophilus somni and its role in the evolution of pathogenic strain 2336, as determined by comparative genomic analyses.

BACKGROUND: Pneumonia and myocarditis are the most commonly reported diseases due to Histophilus somni, an opportunistic pathogen of the reproductive and respiratory tracts of cattle. Thus far only a few genes involved in metabolic and virulence functions have been identified and characterized in H. somni using traditional methods. Analyses of the genome sequences of several Pasteurellaceae species have provided insights into their biology and evolution. In view of the economic and ecological importance of H. somni, the genome sequence of pneumonia strain 2336 has been determined and compared to that of commensal strain 129Pt and other members of the Pasteurellaceae. RESULTS: The chromosome of strain 2336 (2,263,857 bp) contained 1,980 protein coding genes, whereas the chromosome of strain 129Pt (2,007,700 bp) contained only 1,792 protein coding genes. Although the chromosomes of the two strains differ in size, their average GC content, gene density (total number of genes predicted on the chromosome), and percentage of sequence (number of genes) that encodes proteins were similar. The chromosomes of these strains also contained a number of discrete prophage regions and genomic islands. One of the genomic islands in strain 2336 contained genes putatively involved in copper, zinc, and tetracycline resistance. Using the genome sequence data and comparative analyses with other members of the Pasteurellaceae, several H. somni genes that may encode proteins involved in virulence (e.g., filamentous haemaggutinins, adhesins, and polysaccharide biosynthesis/modification enzymes) were identified. The two strains contained a total of 17 ORFs that encode putative glycosyltransferases and some of these ORFs had characteristic simple sequence repeats within them. Most of the genes/loci common to both the strains were located in different regions of the two chromosomes and occurred in opposite orientations, indicating genome rearrangement since their divergence from a common ancestor. CONCLUSIONS: Since the genome of strain 129Pt was ~256,000 bp smaller than that of strain 2336, these genomes provide yet another paradigm for studying evolutionary gene loss and/or gain in regard to virulence repertoire and pathogenic ability. Analyses of the complete genome sequences revealed that bacteriophage- and transposon-mediated horizontal gene transfer had occurred at several loci in the chromosomes of strains 2336 and 129Pt. It appears that these mobile genetic elements have played a major role in creating genomic diversity and phenotypic variability among the two H. somni strains.

Tax incentives for preceptors of nurse practitioner students in Massachusetts: A potential solution.

With a growing population, there is an increasing need for nurse practitioners to improve access to health care. There is currently a shortage of nurse practitioner (NP) preceptors across Massachusetts, making clinical placements difficult and at times unachievable. The lack of NP preceptors has a direct impact on student outcomes, educational programs, and ultimately access to care. The authors explored lessons learned about the national scale of this problem and whether Massachusetts should entertain legislative initiatives similar to other states as a solution. Data were collected from the boards of nursing and the national and state chapters of the American Association of Nurse Practitioners regarding current and pending legislation. State and federal sources and the Massachusetts Association of Colleges of Nursing provided statistical and qualitative data on current and future needs for NP preceptors. States that have successfully passed legislation have awarded tax incentives to NP preceptors, although none of the existing regulations have assessed for their effectiveness in improving preceptor availability. Massachusetts may benefit from legislation to improve NP student access to preceptors; however, incentives related to geographical location may best serve both students and the greater population.

Governance education for nurses: Preparing nurses for the future.

The complexities of today's health care environment require organizational governing boards to have deeper understanding of health needs, influences, and outcomes with diverse board leadership. Nurses understand the complexities and demands of health care, but few nurses are engaged on boards of directors and many nurses feel unprepared for the governance leadership role. The nurse of the future requires governance knowledge and competencies to influence organizational policies that will improve health care outcomes and advance health promotion. Governance education is a necessary component of preparing the nurse of the future to influence health care transformation. Until nurses can confidently embrace governance leadership as a part of their professional identity, convincing and expecting non-nurse board leaders to appoint nurses to boards will continue to be a challenge. This paper describes a strategy for incorporating governance competencies into nursing curricula across all education levels by leveraging the American Hospital Association Governance Core Competencies (2009) and the Massachusetts Nurse of the Future Core Competencies©-RN (Massachusetts Department of Higher Education Nursing Initiative, 2016).

Genome sequence of Thermofilum pendens reveals an exceptional loss of biosynthetic pathways without genome reduction.

We report the complete genome of Thermofilum pendens, a deeply branching, hyperthermophilic member of the order Thermoproteales in the archaeal kingdom Crenarchaeota. T. pendens is a sulfur-dependent, anaerobic heterotroph isolated from a solfatara in Iceland. It is an extracellular commensal, requiring an extract of Thermoproteus tenax for growth, and the genome sequence reveals that biosynthetic pathways for purines, most amino acids, and most cofactors are absent. In fact, T. pendens has fewer biosynthetic enzymes than obligate intracellular parasites, although it does not display other features that are common among obligate parasites and thus does not appear to be in the process of becoming a parasite. It appears that T. pendens has adapted to life in an environment rich in nutrients. T. pendens was known previously to utilize peptides as an energy source, but the genome revealed a substantial ability to grow on carbohydrates. T. pendens is the first crenarchaeote and only the second archaeon found to have a transporter of the phosphotransferase system. In addition to fermentation, T. pendens may obtain energy from sulfur reduction with hydrogen and formate as electron donors. It may also be capable of sulfur-independent growth on formate with formate hydrogen lyase. Additional novel features are the presence of a monomethylamine:corrinoid methyltransferase, the first time that this enzyme has been found outside the Methanosarcinales, and the presence of a presenilin-related protein. The predicted highly expressed proteins do not include proteins encoded by housekeeping genes and instead include ABC transporters for carbohydrates and peptides and clustered regularly interspaced short palindromic repeat-associated proteins.

Genomics of an extreme psychrophile, Psychromonas ingrahamii.

BACKGROUND: The genome sequence of the sea-ice bacterium Psychromonas ingrahamii 37, which grows exponentially at -12C, may reveal features that help to explain how this extreme psychrophile is able to grow at such low temperatures. Determination of the whole genome sequence allows comparison with genes of other psychrophiles and mesophiles. RESULTS: Correspondence analysis of the composition of all P. ingrahamii proteins showed that (1) there are 6 classes of proteins, at least one more than other bacteria, (2) integral inner membrane proteins are not sharply separated from bulk proteins suggesting that, overall, they may have a lower hydrophobic character, and (3) there is strong opposition between asparagine and the oxygen-sensitive amino acids methionine, arginine, cysteine and histidine and (4) one of the previously unseen clusters of proteins has a high proportion of "orphan" hypothetical proteins, raising the possibility these are cold-specific proteins. Based on annotation of proteins by sequence similarity, (1) P. ingrahamii has a large number (61) of regulators of cyclic GDP, suggesting that this bacterium produces an extracellular polysaccharide that may help sequester water or lower the freezing point in the vicinity of the cell. (2) P. ingrahamii has genes for production of the osmolyte, betaine choline, which may balance the osmotic pressure as sea ice freezes. (3) P. ingrahamii has a large number (11) of three-subunit TRAP systems that may play an important role in the transport of nutrients into the cell at low temperatures. (4) Chaperones and stress proteins may play a critical role in transforming nascent polypeptides into 3-dimensional configurations that permit low temperature growth. (5) Metabolic properties of P. ingrahamii were deduced. Finally, a few small sets of proteins of unknown function which may play a role in psychrophily have been singled out as worthy of future study. CONCLUSION: The results of this genomic analysis provide a springboard for further investigations into mechanisms of psychrophily. Focus on the role of asparagine excess in proteins, targeted phenotypic characterizations and gene expression investigations are needed to ascertain if and how the organism regulates various proteins in response to growth at lower temperatures.

Use of a university-community collaboration model to frame issues and set an agenda for strengthening a community.

As severe social problems persist, analysts from various sectors suggest that policies and programs should increase their sensitivity and effectiveness through collaborations among universities, communities, and political officials. A model of collaboration is presented, and the nature and importance of such collaborations are examined. The benefits, challenges, and roles of the three collaboration partners (university, community, and government) and the three stages of the collaboration process (initiation, deliberation, and implementation) are discussed in the context of a real-world application. Recommendations for future applications are presented.

Adolescent pregnancy and homicide: findings from the Maryland Office of the Chief Medical Examiner, 1994-1998.

Homicide has remained the third leading cause of death among girls aged 10 to 19 for more than a decade. Recent research indicates that pregnant or postpartum teens are three times more likely to be victims of homicide compared to their nonpregnant counterparts. These findings portray a compelling picture that leads the authors to investigate the relationship between homicide and pregnancy among teens in Maryland. The purpose of this study is to compare women whose deaths had been evaluated by the medical examiner and who had evidence of pregnancy to women without evidence of pregnancy, with a particular focus on adolescents; 329 (17.7%) adults and 66 (32.7%) adolescents were victims of homicide. Adolescent homicide victims were 3.7 (1.2 to 11.8) times more likely to be pregnant compared to adult homicide victims. The rate of homicide was nearly double in all women who were pregnant. Further research is necessary to evaluate factors associated with these risks so that the future generation and society are protected.

Enhancing resiliency in African-American children: the role of nurses in promoting collaborative relationships with policy makers and community leaders.

Throughout history, the African-American family in the United States has confronted racial and social obstacles to progress, which threaten their self-efficacy and potential ability to promote healthy child development. Though disproportionate numbers still live in poverty, many African-American children prevail despite conditions that are far from ideal. The ability of some African-American children to emerge victoriously from poverty and disadvantage is directly related to the influence of an age-old African heritage. This paper will discuss the significance of the historical background of the African-American family and the African-American community, and their influence on the promotion of healthy child development. Building upon research models that assess the factors fostering resilience in the African-American child, the role of nurses in collaborating with community leaders and policy makers is described.

Perceptions of overweight and obesity in their community: findings from focus groups with urban, African-American caretakers of preschool children.

Focus groups were conducted with parents, other caretakers, and teachers of urban, African-American preschool children attending Head Start. The research goal, congruent with the concept of cultural humility, was to elicit target population members' perspectives on the nature, importance, prevalence, and causes of overweight and obesity in their community, with an emphasis on childhood obesity. Themes that emerged revealed that participants defined obesity as a more extreme state than the medical definition, these same participants had a complex view of the relationships of weight and health, stressed numerous environmental factors contributing to obesity. Moreover these participants tended to offer suggestions for health professionals and those designing nutrition education interventions.

Fighting childhood obesity with university-community partnerships.

This article describes how two Robert Wood Johnson (RWJ) Executive Nurse Fellows used their leadership competencies to inspire and lead change within the community to fight the growing problem of childhood obesity. A model of University-Community partnership is proposed which incorporated the core leadership competencies of the RWJ program--interpersonal and communication effectiveness; risk-taking and creativity; self-knowledge; skills in creating change; and, strategic vision. Leadership lessons learned are provided for nurses interested in leading efforts to improve the health status of communities.

Genome sequence of the cellulolytic gliding bacterium Cytophaga hutchinsonii.

The complete DNA sequence of the aerobic cellulolytic soil bacterium Cytophaga hutchinsonii, which belongs to the phylum Bacteroidetes, is presented. The genome consists of a single, circular, 4.43-Mb chromosome containing 3,790 open reading frames, 1,986 of which have been assigned a tentative function. Two of the most striking characteristics of C. hutchinsonii are its rapid gliding motility over surfaces and its contact-dependent digestion of crystalline cellulose. The mechanism of C. hutchinsonii motility is not known, but its genome contains homologs for each of the gld genes that are required for gliding of the distantly related bacteroidete Flavobacterium johnsoniae. Cytophaga-Flavobacterium gliding appears to be novel and does not involve well-studied motility organelles such as flagella or type IV pili. Many genes thought to encode proteins involved in cellulose utilization were identified. These include candidate endo-beta-1,4-glucanases and beta-glucosidases. Surprisingly, obvious homologs of known cellobiohydrolases were not detected. Since such enzymes are needed for efficient cellulose digestion by well-studied cellulolytic bacteria, C. hutchinsonii either has novel cellobiohydrolases or has an unusual method of cellulose utilization. Genes encoding proteins with cohesin domains, which are characteristic of cellulosomes, were absent, but many proteins predicted to be involved in polysaccharide utilization had putative D5 domains, which are thought to be involved in anchoring proteins to the cell surface.

The complete genome sequence of Bacillus thuringiensis Al Hakam.

Bacillus thuringiensis is an insect pathogen that is widely used as a biopesticide (E. Schnepf, N. Crickmore, J. Van Rie, D. Lereclus, J. Baum, J. Feitelson, D. R. Zeigler, and D. H. Dean, Microbiol. Mol. Biol. Rev. 62:775-806, 1998). Here we report the finished, annotated genome sequence of B. thuringiensis Al Hakam, which was collected in Iraq by the United Nations Special Commission (L. Radnedge, P. Agron, K. Hill, P. Jackson, L. Ticknor, P. Keim, and G. Andersen, Appl. Environ. Microbiol. 69:2755-2764, 2003).

Pathogenomic sequence analysis of Bacillus cereus and Bacillus thuringiensis isolates closely related to Bacillus anthracis.

Bacillus anthracis, Bacillus cereus, and Bacillus thuringiensis are closely related gram-positive, spore-forming bacteria of the B. cereus sensu lato group. While independently derived strains of B. anthracis reveal conspicuous sequence homogeneity, environmental isolates of B. cereus and B. thuringiensis exhibit extensive genetic diversity. Here we report the sequencing and comparative analysis of the genomes of two members of the B. cereus group, B. thuringiensis 97-27 subsp. konkukian serotype H34, isolated from a necrotic human wound, and B. cereus E33L, which was isolated from a swab of a zebra carcass in Namibia. These two strains, when analyzed by amplified fragment length polymorphism within a collection of over 300 of B. cereus, B. thuringiensis, and B. anthracis isolates, appear closely related to B. anthracis. The B. cereus E33L isolate appears to be the nearest relative to B. anthracis identified thus far. Whole-genome sequencing of B. thuringiensis 97-27and B. cereus E33L was undertaken to identify shared and unique genes among these isolates in comparison to the genomes of pathogenic strains B. anthracis Ames and B. cereus G9241 and nonpathogenic strains B. cereus ATCC 10987 and B. cereus ATCC 14579. Comparison of these genomes revealed differences in terms of virulence, metabolic competence, structural components, and regulatory mechanisms.

Promoting healthy adolescent behavior and development: issues in the design and evaluation of effective youth programs.

The problems of health and development faced by contemporary adolescents require that our communities have greater access to effective, adequately scaled, and sustained youth-serving programs. These 3 dimensions of youth programs are discussed, and the role of evaluations is specified, especially those aimed at program improvement and community empowerment, in facilitating efforts to promote the positive development of young people. These areas of development include competence, confidence, character, connection, and caring/compassion-the "five C's" of positive youth development. Ten features of effective positive youth development programs are described, and the importance of engaging policymakers in order to broadly disseminate and sustain effective programs is stressed.