Industrial development alters wolf spatial distribution mediated by prey availability.

Increasing resource extraction and human activity are reshaping species' spatial distributions in human-altered landscape and consequently shaping the dynamics of interspecific interactions, such as between predators and prey. To evaluate the effects of industrial features and human activity on the occurrence of wolves (Canis lupus), we used wildlife detection data collected in 2014 from an array of 122 remote wildlife camera traps in Alberta's Rocky Mountains and foothills near Hinton, Canada. Using generalized linear models, we compared the occurrence frequency of wolves at camera sites to natural land cover, industrial disturbance (forestry and oil/gas exploration), human activity (motorized and non-motorized), and prey availability (moose, Alces alces; elk, Cervus elaphus; mule deer, Odocoileus hemionus; and white-tailed deer, Odocoileus virginianus). Industrial block features (well sites and cutblocks) and prey (elk or mule deer) availability interacted to influence wolf occurrence, but models including motorized and non-motorized human activity were not strongly supported. Wolves occurred infrequently at sites with high densities of well sites and cutblocks, except when elk or mule deer were frequently detected. Our results suggest that wolves risk using industrial block features when prey occur frequently to increase predation opportunities, but otherwise avoid them due to risk of human encounters. Effective management of wolves in anthropogenically altered landscapes thus requires the simultaneous consideration of industrial block features and populations of elk and mule deer.

Diet energy density estimated from isotopes in predator hair associated with survival, habitat, and population dynamics.

Sea ice loss is fundamentally altering the Arctic marine environment. Yet there is a paucity of data on the adaptability of food webs to ecosystem change, including predator-prey interactions. Polar bears (Ursus maritimus) are an important subsistence resource for Indigenous people and an apex predator that relies entirely on the under-ice food web to meet its energy needs. In this study, we assessed whether polar bears maintained dietary energy density by prey switching in response to spatiotemporal variation in prey availability. We compared the macronutrient composition of diets inferred from stable carbon and nitrogen isotopes in polar bear guard hair (primarily representing summer/fall diet) during periods when bears had low and high survival (2004-2016), between bears that summered on land versus pack ice, and between bears occupying different regions of the Alaskan and Canadian Beaufort Sea. Polar bears consumed diets with lower energy density during periods of low survival, suggesting that concurrent increased dietary proportions of beluga whales (Delphinapterus leucas) did not offset reduced proportions of ringed seals (Pusa hispida). Diets with the lowest energy density and proportions from ringed seal blubber were consumed by bears in the western Beaufort Sea (Alaska) during a period when polar bear abundance declined. Intake required to meet energy requirements of an average free-ranging adult female polar bear was 2.1 kg/day on diets consumed during years with high survival but rose to 3.0 kg/day when survival was low. Although bears that summered onshore in the Alaskan Beaufort Sea had higher-fat diets than bears that summered on the pack ice, access to the remains of subsistence-harvested bowhead whales (Balaena mysticetus) contributed little to improving diet energy density. Because most bears in this region remain with the sea ice year round, prey switching and consumption of whale carcasses onshore appear insufficient to augment diets when availability of their primary prey, ringed seals, is reduced. Our results show that a strong predator-prey relationship between polar bears and ringed seals continues in the Beaufort Sea. The method of estimating dietary blubber using predator hair, demonstrated here, provides a new metric to monitor predator-prey relationships that affect individual health and population demographics.

Cumulative effects of widespread landscape change alter predator-prey dynamics.

Predator search efficiency can be enhanced by anthropogenic landscape change, leading to increased predator-prey encounters and subsequent prey population declines. Logging increases early successional vegetation, providing ungulate forage. This increased forage, however, is accompanied by linear feature networks that increase predator hunting efficiency by facilitating predator movement and increasing prey vulnerability. We used integrated step selection analyses to weigh support for multiple hypotheses representing the combined impact of logging features (cutblocks and linear features) on wolf (Canis lupus) movement and habitat selection in interior British Columbia. Further, we examine the relationship between logging and wolf kill-sites of moose (Alces alces) identified using spatiotemporal wolf location cluster analysis. Wolves selected for linear features, which increased their movement rates. New (0-8 years since harvest) cutblocks were selected by wolves. Moose kill-sites had a higher probability of occurring in areas with higher proportions of new and regenerating (9-24 years since harvest) cutblocks. The combined selection and movement responses by wolves to logging features, coupled with increased moose mortality sites associated with cutblocks, indicate that landscape change increases risk for moose. Cumulative effects of landscape change contribute to moose population declines, stressing the importance of cohesive management and restoration of anthropogenic features.

Psychometric Evaluation of the TIC Grade, a Self-Report Measure to Assess Youth Perceptions of the Quality of Trauma-Informed Care They Received.

BACKGROUND: Agencies and clinical practices are beginning to provide trauma-informed care (TIC) to their clients. However, there are no measures to assess clients' perceptions of and satisfaction with the TIC care they have received. A 20-item questionnaire, the TIC Grade, was developed, based on the National Center for Trauma-Informed Care principles of TIC, to assess the patient or client perception of the TIC provided in settings that serve adolescents and emerging adults. OBJECTIVE: The goal of this project was to evaluate the psychometric properties of the TIC Grade instrument and to make recommendations for use of the full measure and its short form-an overall letter grade. STUDY DESIGN: The TIC Grade questionnaire was administered to youth over the age of 18 years from four community partners providing care to vulnerable young adults. Potential participants were offered questionnaires at the end of their visit. Those interested in participating left their completed anonymous questionnaire in a locked box to maintain confidentiality. Questionnaires were collected from 100 respondents; 95 were complete enough to include in analyses for psychometric evaluation. RESULTS: The findings of this project support the reliability and usability of the 20-item TIC Grade measure to assess youth's perceptions of the quality of TIC they received. CONCLUSIONS: This TIC-specific, behaviorally worded client report measure can assist service delivery organizations to assess their success at implementing TIC and to identify areas where further staff training and support are needed.

Acute Effects of Dry Needling on Myofascial Trigger Points in the Triceps Surae of Ballet Dancers: A Pilot Randomized Controlled Trial.

BACKGROUND: There is convincing evidence that dancers suffer injuries to the triceps surae musculature. Research on the immediate effects of dry needling (DN) is limited, and it is important to understand the acute effects of this treatment prior to performance. PURPOSE: The purpose of this pilot study was to assess the immediate effects of DN on myofascial trigger points in terms of skin surface temperature, pain, active and passive range of motion, and torque production in the triceps surae of ballet dancers. STUDY DESIGN: Randomized, double-blinded pilot study. METHODS: Professional ballet dancers that fit inclusion and exclusion criteria (n=11) were randomly assigned to an experimental or control group. The dancers had three pre-determined standard point (SP) measurement spots that were used as a baseline for surface temperature comparisons. The dancers were also palpated for trigger point (TP) spots. Both SP and TP spots were marked for future measurements. The experimental group received DN, while the control group received sham DN (SHAM) to their bilateral calves at the TP spots. Immediately prior to and following treatment, both DN and SHAM groups were tested for skin surface temperature, pain, range of motion, and plantar flexion torque by blinded assessors. Paired t-tests and independent t-tests were performed to examine for differences between groups. RESULTS: The surface temperature for the TP was higher than the SP measurements prior to intervention (Right calf p= .014; Left calf p= .031). There were no significant changes in VAS scale reported pain and ROM. The plantar flexion torque measurements showed an increase in the DN group of the left calf at the angular velocity of 60 degrees/sec. CONCLUSION: This was a unique pilot study examining the acute effects of DN on professional ballet dancers. The results were limited due to low sample size. However, the methodology for this study and surface temperature results invites future research. LEVEL OF EVIDENCE: Level 1b.

Penicillin Allergy Testing: An Outpatient Nurse-Driven Program for Patients With Cancer.

BACKGROUND: Penicillin allergy testing (PAT) can decrease the use of unnecessary antibiotics by clarifying who is truly allergic. OBJECTIVES: This article describes the development and implementation of an oncology outpatient nurse-driven PAT program. METHODS: A nurse-driven program, initiated with allergy screening at the first encounter, was designed to identify patients with oncologic diagnoses eligible for PAT. Once verified eligible, patients undergo a three-step testing process (scratch test, intradermal injection, and IV challenge dose) administered by the infusion nurse. FINDINGS: From November 2018 to December 2019, 82 outpatients with reported penicillin allergies were screened; 90% were eligible for PAT, and 97% of patients tested were negative for penicillin allergy. A significant reduction in aztreonam use among patients admitted for hematopoietic stem cell transplantation was also noted as compared to before PAT was offered.

Spatial and temporal variability in ringed seal (Pusa hispida) stable isotopes in the Beaufort Sea.

Arctic ecosystem dynamics are shifting in response to warming temperatures and sea ice loss. Such ecosystems may be monitored by examining the diet of upper trophic level species, which varies with prey availability. To assess interannual variation in the Beaufort Sea ecosystem, we examined spatial and temporal trends in ringed seal (Pusa hispida) δ13C and δ15N in claw growth layers grown from 1964 to 2011. Stable isotopes were correlated with climate indices, environmental conditions, seal population productivity, and geographic location. Sex and age did not influence stable isotopes. Enriched 13C was linked to cyclonic circulation regimes, seal productivity, and westward sampling locations. Higher δ15N was linked to lower sea surface temperatures, a higher percentage of pups in the subsistence harvest, and sample locations that were eastward and further from shore. From the 1960s to 2000s, ringed seal niche width expanded, suggesting a diversification of diet due to expansion of prey and/or seal space use. Overall, trends in ringed seal stable isotopes indicate changes within the Beaufort Sea ecosystem affected by water temperatures and circulation regimes. We suggest that continued monitoring of upper trophic level species will yield insights into changing ecosystem structure with climate change.

Preparing Advanced Practice Registered Nursing Students to Deliver Adolescent SBIRT for Substance Use.

BACKGROUND: Adolescent substance use is a significant public health problem in the United States screening, brief intervention, and referral to treatment (SBIRT) and is an evidence-based approach to assist individuals to reduce substance use before serious problems develop. Universal SBIRT is recommended for routine health care. METHOD: Advanced practice registered nursing (APRN) students completed a sophisticated adolescent SBIRT computer simulation, didactic content on substance use, and face-to-face simulation during laboratory. SBIRT skills were scored automatically by the computer program. Self-perceived competency and confidence were measured via pre- and postsurvey items, focused on adolescent SBIRT skills, using ordinal scales. RESULTS: Adolescent SBIRT was successfully integrated into an advanced health assessment nursing course. Improvements in self-reported competence and confidence scores were noted across all domains at p < .001. CONCLUSION: APRN students demonstrated learning and reported marked increases in competency and confidence in the delivery of adolescent SBIRT. This reveals promising results for SBIRT to be implemented into APRN student coursework. [J Nurs Educ. 2018;57(12):736-741.].

Current state of screening high-ACE youth and emerging adults in primary care.

BACKGROUND AND PURPOSE: Trauma comes in many forms, including interpersonal, community, and institutional trauma. The adverse childhood event (ACE) studies demonstrated that adverse experiences in childhood can have a profound, cumulative impact on the course of health and development over a lifetime. It is critical for healthcare providers, such as nurse practitioners (NPs), working in primary care to screen adolescents and emerging adults for a history of ACEs and trauma. A review of current assessment tools used in assessing this population in health settings is needed to determine how screening for ACEs is being performed. CONCLUSIONS: Clinically efficient tools for screening and assessment of high-ACE youth in primary care settings are lacking.  Developing a process to assess ACEs, risk behaviors, and physical and mental health status that is efficient to use during a time limited clinical visit is an important step in providing holistic care to a challenging population. IMPLICATIONS FOR PRACTICE: Primary care NPs are in the perfect position to implement assessments of ACEs through trauma-informed nursing care. ACE assessment in clinical practice will provide vital information to guide the development of tailored interventions for reducing risk behaviors and mitigate the long-term impacts of ACEs.

Prevalence and change of central obesity among US Asian adults: NHANES 2011-2014.

BACKGROUND: Central obesity is a major risk factor for cardiometabolic diseases. The prevalence of central obesity has not been reported fully among Asian adults in the United States (US). METHODS: Cross-sectional data of 1288 Asian adults aged 20 years or over was selected from the US National Health and Nutrition Examination Survey with a stratified multi-stage sampling design. The prevalence of central obesity was calculated with 95% confidence intervals (CIs) and Chi-square tests were conducted to test the significance of the prevalence differences across characteristic groups. RESULTS: The overall prevalence of central obesity among US Asian adults was 58.1% in 2011-2014. The prevalence of central obesity was higher in older adults (73.5%) than in young adults (45.4%) (p < 0.0001). Women had 13.4% higher prevalence than men (64.4% vs 51.0%, p < 0.0001). The prevalence increased over time (2011-2012 vs 2013-2014) in young adults (39.2% vs 51.5%), men (45.4% vs 56.6%), adults with college education or above (54.2% vs 61.7%) and non-poor adults (55.4% vs 62.4%). Compared with men, women had higher prevalence in each subgroup of age, education, poverty, and length of time (except for the subgroup of "born in the US") (all p < 0.05) and in the subgroup of "married or living with partner" for marital status (p < 0.0001). CONCLUSION: Central obesity is prevalent in Asian adults, particularly in older adults and women. More efforts are needed to prevent and treat obesity in Asian adults as Asians are incurring the greatest increase in type 2 diabetes in parallel with the rising rate of central adiposity.

Feeding Style and a Child's Body Mass Index.

INTRODUCTION: Early onset pediatric obesity has become a major health concern in the United States. A key contributing factor to early onset childhood is socialization to the eating and mealtime environment. Maternal feeding styles play an integral role in how children are socialized to the eating and mealtime environment. METHOD: The study utilized a descriptive correlational research design. The sample was 126 mother/child dyads recruited from a southeastern Michigan Head Start program. Each mother completed a research packet. RESULTS: Results indicated that maternal beliefs such as nutritional belief and belief about the child's eating style were significantly associated with maternal feeding style. Maternal behaviors were associated with maternal feeding styles. DISCUSSION: Overall, the study provides a description of maternal beliefs and behaviors related to the body weight status of a preschool-aged child.