Predation of invasive silver carp by native largemouth bass is size-selective in the Illinois River.

Silver carp (Hypophthalmichthys molitrix) are a nonnative, planktivorous, and highly invasive species of cyprinid located throughout the Mississippi River Basin. Although they co-occur with largemouth bass (Micropterus nigricans), an abundant native predatory fish, their predator-prey relationship is poorly understood. This potential relationship warrants investigation as largemouth bass are large-gaped predators capable of exhibiting top-down control on planktivorous fishes. The objectives of this study were to determine if largemouth bass consume juvenile silver carp, and if there was a relationship between length of largemouth bass and length of silver carp consumed. Largemouth bass were collected from the La Grange Pool of the Illinois River using 60 Hz-pulsed DC electrofishing and their diets were analyzed (n = 389, total length = 70-578 mm). Evidence of silver carp was present in 18% of diets of largemouth bass that consumed fish. Lengths of consumed silver carp were estimated from the dimensions of their recovered chewing pads or pharyngeal teeth in the stomachs of largemouth bass. A significant relationship between length of largemouth bass and length of silver carp consumed (p < 0.001, F = 34.63, r2 = 0.61) was observed. Estimated total lengths of silver carp were 34-101 mm and were recovered from diets of largemouth bass that were 94-262 mm total length. These results indicate enhancement of native largemouth bass populations is unlikely to substantially reduce silver carp populations in the Illinois River or in other waterways where these species co-occur.

A research and development (R&D) roadmap for broadly protective coronavirus vaccines: A pandemic preparedness strategy.

Broadly protective coronavirus vaccines are an important tool for protecting against future SARS-CoV-2 variants and could play a critical role in mitigating the impact of future outbreaks or pandemics caused by novel coronaviruses. The Coronavirus Vaccines Research and Development (R&D) Roadmap (CVR) is aimed at promoting the development of such vaccines. The CVR, funded by the Bill & Melinda Gates Foundation and The Rockefeller Foundation, was generated through a collaborative and iterative process, which was led by the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota and involved 50 international subject matter experts and recognized leaders in the field. This report summarizes the major issues and areas of research outlined in the CVR and identifies high-priority milestones. The CVR covers a 6-year timeframe and is organized into five topic areas: virology, immunology, vaccinology, animal and human infection models, and policy and finance. Included in each topic area are key barriers, gaps, strategic goals, milestones, and additional R&D priorities. The roadmap includes 20 goals and 86 R&D milestones, 26 of which are ranked as high priority. By identifying key issues, and milestones for addressing them, the CVR provides a framework to guide funding and research campaigns that promote the development of broadly protective coronavirus vaccines.

The Cultural and Religious Complexities of Amish-Focused Mental Health Conditions Research: Insights from an Exhaustive Narrative Review and Case Study of Counseling Controversies.

Mental health conditions research often relies on reductionist cultural assumptions about the population studied and instruments validated from majority populations. In exhaustively reviewing the limited body of Amish mental health conditions research, we find that studies are well-executed by methodological protocols but that findings are inconsistent or limited in generalizability, instrument validity remains contested, and study investigation into Amish cultural and religious dynamics is limited. A case study from a sizeable Amish community in Ohio illustrates how various ideologies-notably old Amish religious theology, the scientific-psychological, and the Evangelical Protestant-have generated population-internal controversies among the Amish over defining and treating mental health conditions, suggesting that mental health conditions research and diagnosis of ethnic religious adherents should better account for internal cultural-religious dynamics. In order to make some assertions about how Amish culture and religion impacts mental health conditions, future research should include pre-study investigations into the targeted population's cultural and religious dynamics, consist of more nuanced case reports from therapists and psychiatrists, and include replication studies at different times and places, with deliberate attention to contextual factors.

North America's Amish-Mennonites Adopt Abroad: The Ideologies and Institutional Conditions that Cracked the Homogeneity of an Ethnic Religion.

Under what social conditions would ethnic sectarians in developed countries engage in inter-country adoption, grafting ethnically-racially diverse children into their homogenous contexts? In this article, we present a case study of Amish-Mennonite adoption-oriented children's homes in underdeveloped countries. As the ethnic-sectarian, family-oriented, evangelical Amish-Mennonites meet little success proselytizing adults, adoption-oriented children's home allowed adoptive parents to demonstrate their commitment to mission while maintaining sectarian-style control over a child's socialization. Ultimately, the children's homes were short-lived, coming and going based on larger geo-political dynamics, signaling that this unusual international adoption project is internally motivated but enabled and constrained by larger institutional contexts. Though the actual percent of inter-country adoptees to Amish-Mennonite homes is small, this case demonstrates that the right combination of values and broader political dynamics create conditions facilitating migration of children from lesser developed countries into wealthy contexts, a process cracking - even if not fully opening - Amish-Mennonite ethnic/racial homogeneity.

Physical health conditions of the Amish and intervening social mechanisms: an exhaustive narrative review.

As an ethnic religion, the Amish are of interest to population health researchers due to a distinctive health profile arising from ethnic attributes, including a closed genetic pool and shared culture that shapes lifestyle practices. Amish-focused health research both furthers our knowledge of health conditions by comparing Amish with non-Amish and assists health practitioners in serving this rapidly growing population. Amish health research, now representing approximately a quarter of all Amish-focused publications, is in need of review, to the end of strengthening this knowledge body's coherence, clarifying research directions, and identifying knowledge gaps, lapses, and stagnations. Herein, we synthesize and discuss Amish physical health conditions research, both the population's distinctive health profile and mechanisms shaping this profile. Specifically, we summarize research addressing BMI, physical activity, and body image; diet and supplements; cancer; cardiovascular conditions; communicable diseases; immunity; sleep; genetic disorders; tobacco and alcohol use; periodontal conditions; traumatic injuries; natural treatments for burns; fertility; and sexually transmitted diseases. In reflection, we raise questions about the nature of intervening mechanisms shaping the Amish health profile, the strange omission of several common independent variables commonly used when studying other ethnic groups' health, several recurring methodological complications, and public health policy considerations.

Who am I? Narratives as a window to transformative moments in critical care.

Critical care clinicians practice a liminal medicine at the border between life and death, witnessing suffering and tragedy which cannot fail to impact the clinicians themselves. Clinicians' professional identity is predicated upon their iterative efforts to articulate and contextualize these experiences, while a failure to do so may lead to burnout. This journey of self-discovery is illuminated by clinician narratives which capture key moments in building their professional identity. We analyzed a collection of narratives by critical care clinicians to determine which experiences most profoundly impacted their professional identity formation. After surveying 30 critical care journals, we identified one journal that published 84 clinician narratives since 2013; these constituted our data source. A clinician educator, an art historian, and an anthropologist analyzed these pieces using a narrative analysis technique identifying major themes and subthemes. Once the research team agreed on a thematic structure, a clinician-ethicist and a trainee read all the pieces for analytic validation. The main theme that emerged across all these pieces was the experience of existing at the heart of the dynamic tension between life and death. We identified three further sub-themes: the experience of bridging the existential divide between dissimilar worlds and contexts, fulfilling divergent roles, and the concurrent experience of feeling dissonant emotions. Our study constitutes a novel exploration of transformative clinical experiences within Critical Care, introducing a methodology that equips medical educators in Critical Care and beyond to better understand and support clinicians in their professional identity formation. As clinician burnout soars amidst increasing stressors on our healthcare systems, a healthy professional identity formation is an invaluable asset for personal growth and moral resilience. Our study paves the way for post-graduate and continuing education interventions that foster mindful personal growth within the medical subspecialties.

Modification of O-ring intrauterine devices (IUDs) in mares: Contraception without estrus suppression.

A significant welfare concern for those within the horse industry is that of the overpopulation in free-roaming horses in the western US. The goal of the present study was to identify a humane and inexpensive means of providing contraception and reducing pregnancy rates in a way that could be applied to free-roaming horses on the western U.S. open range lands. A series of studies was conducted utilizing the previously-described silastic O-ring intrauterine devices (IUDs). Throughout these studies pregnancy was successfully prevented in mares with an O-ring IUD, but collective retention rates failed to exceed 50% regardless of size or durometer (material hardness/malleability). When the O-ring IUDs were compared to the recently-described Y-design IUDs (Holyoak et al., 2021) the Y-design IUDs had a markedly greater rate of retention; therefore, the Y-design IUDs would be most appropriate for potential use in free-roaming horses. Assessment of mare records revealed that the vast majority of mares continued to have ovulations and mating continued to occur while the IUDs were in place. A few mares had multiple small ovarian follicles when the IUD was in utero. Findings indicate that utilizing an IUD with the expectation of estrus suppression in mares would fail to be fruitful.

Research Trends in Amish Population Health, a Growing Literature about a Growing Rural Population.

The Amish are an endogamous rural population experiencing rapid growth; consequently, they have attracted the attention of population health researchers and service providers. With approximately one quarter of all Amish studies publications now devoted to population health (n=246), the time is ripe to review research trends. Using bibliometric measures, we map the genealogy, influence, and configuration of Amish health publications. Amish population health research has (1) a health culture-focused core with clusters representing social science and health practice, (2) peripheral clusters addressing health conditions-mental, physical, and injury/safety-and (3) several clusters straddling both. We identify fruitful interdisciplinary studies and recommend researchers investigating health culture and conditions seek ways to integrate their research agendas. This article represents a pivot-point for Amish population health research, for it provides a first-ever bibliometric mapping, allowing researchers to more easily locate their work within the literature and identify opportunities for interdisciplinary collaborations.

The persistently high fertility of a North American population: A 25-year restudy of parity among the Ohio Amish.

Why do the North American Amish maintain high fertility when surrounding populations have nearly all completed the demographic transition? Using the same theoretical predictors and methods as a 1996 Population Studies paper, we explore fertility changes, specifically changes in mean parity, between 1988 and 2015 among one sizeable Amish population in Ohio. Findings suggest that wealth flow shifts (as measured by a decline in farming families) and institutional changes (reflected in Amish denominational gradations) help to explain a decline in mean parity from 5.3 to 4.85, while ideological pronatalism (represented by higher fertility among church leaders) helps to explain why fertility has not been more responsive to structural incentives to limit family size. While this restudy confirms the trend of a slow decline in Amish fertility, it also invites a more methodologically expansive inquiry into Amish fertility patterns.

The Amish health culture and culturally sensitive health services: An exhaustive narrative review.

As the Amish population is growing, researcher and practitioner interest in the Amish health culture is also growing. This is largely due to demand from practitioners for population-specific cultural guidance. Once a small area of study, health-themed publications in Amish studies (n = 246) now account for approximately one-fourth of all peer-reviewed publications, and a sizeable percentage address the health culture, i.e. Amish beliefs, practices, attitudes, decision-making processes, financing, and values. In this article, we provide a first-ever exhaustive narrative review of the Amish health culture literature (addressing Amish health conditions elsewhere). Specifically, we address Amish use of modern medicine, complementary & alternative medicine, cultural norms for birthing and intercourse, support and care for the sick and aged, health knowledge, payment for services, barriers to service access, service provider effectiveness, health programming, and ethical conflicts. Our goal is to organize the literature, synthesize findings, identify orienting perspectives, and clarify research questions and directions. Following our synthesis, we reflect on the current state of Amish health culture research, drawing particular attention to strengths and limitations of the oft-used cultural competency paradigm, and recommending more rigorous social scientific theorization of the Amish health culture.

Evaluation and Revision of an Instrument Measuring Attitudes toward the Amish.

The attitudes non-members hold toward the Amish-or any ethnic, racial, and religious group-has consequences for that population, from criminal victimization to an ability to exercise human rights. Given the rapid growth and expansion of the Amish in North America, an effective tool is needed to measure public attitudes toward the Amish. William McGuigan (2007; 2014) recently led the development of an Attitudes Toward the Amish (ATA) instrument, which was tested in northwestern Pennsylvania. In using the ATA in northeastern Missouri, we encountered problems with the instrument's operational validity: no significant differences were found in the responses between a university undergraduate population of largely urban/suburban origin and the local rural population when we would otherwise expect differences. We revised the instrument and administered it to the same populations. Of the 16 items in the revised version, 14 were significantly different at the p<.05 level. A factor analysis revealed four components with face validity. Based on these results, we offer the Revised ATA (RATA) as an improved instrument and make recommendations for designing instruments intended to measure attitudes toward out-groups.

Chronic Wasting Disease in Cervids: Implications for Prion Transmission to Humans and Other Animal Species.

Chronic wasting disease (CWD) is a prion-related transmissible spongiform encephalopathy of cervids, including deer, elk, reindeer, sika deer, and moose. CWD has been confirmed in at least 26 U.S. states, three Canadian provinces, South Korea, Finland, Norway, and Sweden, with a notable increase in the past 5 years. The continued geographic spread of this disease increases the frequency of exposure to CWD prions among cervids, humans, and other animal species. Since CWD is now an established wildlife disease in North America, proactive steps, where possible, should be taken to limit transmission of CWD among animals and reduce the potential for human exposure.

Refractory Hypotension Caused by Prazosin Overdose Combined With Acetaminophen and Naproxen Toxicity: A Case Report and Review of the Literature.

BACKGROUND: Pediatric exposure to prazosin is unusual because it is most commonly indicated for the treatment of hypertension. Prazosin's increase in popularity as a treatment for posttraumatic stress disorder makes it important for emergency physicians to be aware of how to manage potential toxic ingestion because of prazosin overdose. CASE REPORT: A 16-year-old, 76-kg female presented after ingesting 110 mg of prazosin, 209.3 g of acetaminophen, and 55 g of naproxen. She was admitted to the pediatric intensive care unit for rapidly deteriorating hypotension (lowest blood pressure 47/19 mm Hg) refractory to aggressive fluid resuscitation and infusions of epinephrine and norepinephrine each at 0.5 mcg/kg/min. Stabilization of blood pressure was eventually achieved, and associated with use of a vasopressin infusion of 0.004 units/kg/min. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Because of the increasing exposure of children to prazosin, clinicians should be aware of the pharmacology behind alpha-1 antagonist overdose and consider treatment options, such as vasopressin, when hypotension is resistant to standard fluid and catecholamine therapy.