Confronting the Nursing Profession's Workforce Challenges: Embracing Iceberg Demographics.

U.S. Supreme Court rulings on reproductive rights and affirmative action inadvertently present the nursing profession with a propitious opportunity to capitalize on the nation's rich mosaic of iceberg demographic identities-inherited and acquired traits that may not be visibly apparent-to address imminent challenges such as worker shortages and other perplexities within the workplace milieu.

Urgently Needed: Equity Tools to Navigate Demographic Gale-Force Wind Gusts.

Gale-force demographic disruptors such as unequal population growth can potentially prevent our state from achieving the exemplary goals and targeted outcomes set forth in Healthy North Carolina 2030 These forces also present opportunities if carefuly addressed. Policy prescriptions and strategic investments required to ensure success are outlined here, following an overview of demographic drivers that create public health vulnerabilities.

Coronavirus Vaccine Distribution: Moving to a Race Conscious Approach for a Racially Disparate Problem.

Strikingly ignoring the critical impact of systemic racism in vulnerabilities to the deadly coronavirus, phase one of the vaccine rollout is not reaching the Black population that has suffered the most from COVID. An urgent need exists for a race-conscious approach that ensures equitable opportunities to both access and receive the vaccines.

Disruptive Demographics: Their Effects on Nursing Demand, Supply and Academic Preparation.

The nursing profession faces both a labor shortage and a diversity problem. Nine proactive strategies-rooted in the disruptive demographic trends that are transforming our nation-are advanced to address these 2 critical issues.

The Effects of Krill Oil on mTOR Signaling and Resistance Exercise: A Pilot Study.

INTRODUCTION: Krill oil supplementation has been shown to improve postexercise immune function; however, its effect on muscle hypertrophy is currently unknown. Therefore, the aim of present study was to investigate the ability of krill oil to stimulate mTOR signaling and its ability to augment resistance training-induced changes in body composition and performance. METHODS: C2C12 myoblasts cells were stimulated with krill oil or soy-derived phosphatidylcholine (S-PC), and then, the ratio of P-p70-389 to total p70 was used as readout for mTOR signaling. In double-blind, placebo-controlled study, resistance trained subjects consumed either 3 g krill oil daily or placebo, and each took part in an 8-week periodized resistance training program. Body composition, maximal strength, peak power, and rate of perceived recovery were assessed collectively at the end of weeks 0 and 8. In addition, safety parameters (comprehensive metabolic panel (CMP), complete blood count (CBC), and urine analysis (UA)) and cognitive performance were measured pre- and posttesting. RESULTS: Krill oil significantly stimulated mTOR signaling in comparison to S-PC and control. No differences for markers on the CMP, CBC, or UA were observed. Krill oil significantly increased lean body mass from baseline (p=0.021, 1.4 kg, +2.1%); however, there were no statistically significant differences between groups for any measures taken. CONCLUSION: Krill oil activates mTOR signaling. Krill oil supplementation in athletes is safe, and its effect on resistance exercise deserves further research.

Gastroesophageal intussusception in a leopard (Panthera pardus).

An 8-yr-old male leopard (Panthera pardus) was presented with a 4-day history of lethargy, vomiting, and anorexia. Thoracic and abdominal radiographs revealed a soft-tissue mass cranial to the diaphragm and atypical appearance of the gastric fundus. Esophagoscopy revealed gastric mucosa in the lumen of the esophagus, which confirmed gastroesophageal intussusception. An exploratory celiotomy with manual reduction of the intussusception was performed. Reduction was verified by intraoperative esophagoscopy and gastroscopy. An incisional fundic gastropexy to the left abdominal wall was performed to reduce the chance of a recurrence of the intussusception. No postoperative complications related to the surgery were observed, and the animal resumed eating within 48 hr of surgery. A subsequent recurrence of clinical signs was not noted by the owner.

Esophageal hiatal hernia in three exotic felines--Lynx lynx, Puma concolore, Panthera leo.

Hiatal hernia was diagnosed in three exotic felines-lynx (Lynx lynx), cougar (Puma concolore), and lion (Panthera leo). All cats had a history of anorexia. Thoracic and abdominal radiographs showed evidence of a soft tissue mass within the caudal mediastinum suggestive of a hiatal hernia in all animals. A barium esophagram was performed in one case. All animals underwent thoracic or abdominal surgery for hernia reduction. Surgical procedures included: intercostal thoracotomy with herniorrhaphy and esophagopexy (lynx and cougar), and incisional gastropexy (lion). Concurrent surgical procedures performed were gastrotomy for gastric foreign body removal and jejunostomy tube placement. Clinical signs related to the hiatal hernia disappeared after surgery and recurrence of signs was not reported for the time of follow-up.

Assessing ADHD-related family stressors with the Disruptive Behavior Stress Inventory (DBSI): a replication and extension.

The Disruptive Behavior Stress Inventory (DBSI) was developed to provide information related to the occurrence and severity of stressors that result from having a child with ADHD. Data provided in the initial 2002 study by Johnson and Reader (Journal of Clinical Psychology in Medical Settings, 9, 51-62) provided good preliminary support for the reliability of the DBSI, as well the ability of the scale scores to differentiate primary caregivers of children with and without a history of ADHD. The present study was an attempt to replicate major findings of the 2002 study using an additional larger sample and extend it by conducting item-level analyses to determine the degree to which individual DBSI items differentiate primary caregivers of children with and without a history of ADHD. Results provided additional support for the reliability and validity of the DBSI by replicating major findings from the 2002 study and further suggesting that a large majority of the 40 items individually differentiate between primary caregivers of children with and without a history of ADHD.

Dendritic chelating agents. 2. U(VI) binding to poly(amidoamine) and poly(propyleneimine) dendrimers in aqueous solutions.

Chelating agents are widely employed in many separation processes used to recover uranyl [U(VI)] from contaminated aqueous solutions. This article describes an experimental investigation of the binding of U(VI) to poly(amidoamine) [PAMAM] and poly(propyleneimine) [PPI] dendrimers in aqueous solutions. We combine fluorescence spectroscopy with bench scale ultrafiltration experiments to measure the extent of binding and fractional binding of U(VI) in aqueous solutions of these dendrimers as a function of (i) metal-ion dendrimer loading, (ii) dendrimer generation, (iii) dendrimer core and terminal group chemistry, and (iv) solution pH and competing ligands (NO3-, PO4(3-), CO3(2-), and Cl-). The overall results of this study suggest that uranyl binding to PAMAM and PPI dendrimers in aqueous solutions involves the coordination of the UO2(2+) ions with the dendrimer amine, amide, and carboxylic groups. We find significant binding of U(VI) to PAMAM dendrimers in (i) acidic solutions containing up to 1.0 M HNO3 and H3PO4 and (ii) in basic solutions containing up to 0.5 M Na2CO3. However, no binding of U(VI) by PAMAM dendrimers is observed in aqueous solutions containing 1.0 M NaCl at pH 3.0. These results strongly suggest that PAMAM and PPI dendrimers can serve as high capacity and selective chelating ligands for U(VI) in aqueous solutions.

Dendritic anion hosts: perchlorate uptake by G5-NH2 poly(propyleneimine) dendrimer in water and model electrolyte solutions.

Perchlorate (ClO4-) has emerged as a major groundwater and surface water contaminant in the United States. Ion exchange (IX) is the most widely used technology for treating water containing lower concentrations of perchlorate (<100 ppb). However, a major drawback of IX is the need for frequent regeneration or disposal of the perchlorate-laden resins. As a first step toward the development of high-capacity, selective and recyclable dendritic ligandsforthe recovery of perchloratefrom aqueous solutions by dendrimer filtration, we tested the hypothesis that dendrimers with hydrophobic cavities and positively charged internal groups should selectively bind ClO4- over more hydrophilic anions such as Cl-, NO3-, SO4(2-), and HCO3-. We measured the uptake of ClO4- by the fifth generation (G5-NH2) poly(propyleneimine) (PPI) dendrimer with a diaminobutane core and terminal NH2 groups in deonized water and model electrolyte solutions as a function of (i) anion-dendrimer loading, (ii) solution pH, (iii) background electrolyte concentration, and (iv) reaction time. The ClO4- binding capacity of this dendrimer is comparable to those of perchlorate-selective IX resins. However, its ClO4- binding kinetics is faster and reaches equilibrium in approximately 1 h. Note also that only a high pH (approximately 9.0) aqueous solution is needed to release more than 90% of the bound ClO4- anions by deprotonation of the dendrimer tertiary amine groups. The overall results of this study suggest that dendritic macromolecules such as the G5-PPI NH2 dendrimer provide ideal building blocks for the development of high-capacity, selective and recyclable ligands for the recovery of anions such as perchlorate from aqueous solutions by dendrimer enhanced filtration.

The UNC Management Academy for Public Health: how the UNC School of Public Health and the Kenan-Flagler Business School created a winning partnership.

The University of North Carolina Management Academy for Public Health is a unique training program that combines a business education with a public health focus, to enhance the performance of individual public health managers and improve organizational strength throughout governmental public health. This article considers the implications of decisions made in creating this program, which, after initial funding through the Centers for Disease Control and Prevention Foundation, is now self-sustaining through participant fees. It details the principles behind the program's design, curriculum, evaluation, and sustainability strategies; presents results of the ongoing partnership; and draws conclusions about the program's future ability to meet a national need for public health management training.

The crucible of public health practice: major trends shaping the design of the Management Academy for Public Health.

Public health leaders and managers need new leadership and management skills as well as greater entrepreneurial acumen to respond effectively to broad demographic, socioeconomic, and political trends reshaping public health. This article asserts that the need for such training and skills was the impetus for the conceptualization, design, and launch of the Management Academy for Public Health--an innovative executive education program jointly offered by the schools of business and public health at the University of North Carolina at Chapel Hill.

Preferred method of selecting exercise intensity in adult women.

Heart rate (HR) and rating of perceived exertion (RPE) are both recommended methods of determining exercise intensity for healthy adults. The purpose of this study was to determine how adult women self-select their exercise intensity during aerobic exercise. We interviewed 100 women exercisers who had been engaged regularly in an exercise program for at least 3 months to determine their method of gauging aerobic exercise intensity. Subjects exercised for about 45.1 +/- 21.4 minutes per session (4.4 +/- 1.4 times per week). The vast majority (84%) exclusively used self-selected effort perception to monitor their exercise intensity. Only 16% were familiar with an RPE chart. Although HR is touted heavily in fitness centers and on aerobic ergometers, self-selected effort perception (and not HR) is the method of choice by women who are experienced at aerobic exercise. It is recommended that fitness center personnel increase their efforts to educate the public regarding the appropriate use of effort perception as a method of gauging exercise intensity.

Dendrimer enhanced ultrafiltration. 1. Recovery of Cu(II) from aqueous solutions using PAMAM dendrimers with ethylene diamine core and terminal NH2 groups.

This article discusses the feasibility of using dendrimer enhanced ultrafiltration (DEUF)to recover Cu(II) from aqueous solutions. Building upon the results of fundamental investigations of Cu(II) binding to PAMAM dendrimers with ethylenediamine (EDA) core and terminal NH2 groups, we combine (i) dead-end ultrafiltration (UF) experiments with (ii) atomic force microscopy (AFM) characterization of membrane fouling to assess the feasibility of using DEUF to recover Cu(II) from aqueous solutions. On a mass basis, the Cu(II) binding capacities of the EDA core PAMAM dendrimers are much larger and more sensitive to solution pH than those of linear polymers with amine groups. The dendrimer-Cu(II) complexes can be efficiently separated from aqueous solutions by ultrafiltration. The metal ion laden dendrimers can be regenerated by decreasing the solution pH to 4.0; thus enabling the recovery of the bound Cu(II) ions and recycling of the dendrimers. The UF measurements and AFM characterization studies show that EDA core PAMAM dendrimers with terminal NH2 groups have very lowtendency to foul the commercially available regenerated cellulose (RC) membranes evaluated in this study. The overall results of these experiments suggest that DEUF is a promising process for recovering metal ions such as Cu(II) from aqueous solutions.

Dendritic chelating agents. 1. Cu(II) binding to ethylene diamine core poly(amidoamine) dendrimers in aqueous solutions.

This paper describes an investigation of the uptake of Cu(II) by poly(amidoamine) (PAMAM) dendrimers with an ethylenediamine (EDA) core in aqueous solutions. We use bench scale measurements of proton and metal ion binding to assess the effects of (i) metal ion-dendrimer loading, (ii) dendrimer generation/terminal group chemistry, and (iii) solution pH on the extent of binding of Cu(II) in aqueous solutions of EDA core PAMAM dendrimers with primary amine, succinamic acid, glycidol, and acetamide terminal groups. We employ extended X-ray absorption fine structure (EXAFS) spectroscopy to probe the structures of Cu(II) complexes with Gx-NH2 EDA core PAMAM dendrimers in aqueous solutions at pH 7.0. The overall results of the proton and metal ion binding measurements suggest that the uptake of Cu(II) by EDA core PAMAM dendrimers involves both the dendrimer tertiary amine and terminal groups. However, the extents of protonation of these groups control the ability of the dendrimers to bind Cu(II). Analysis of the EXAFS spectra suggests that Cu(II) forms octahedral complexes involving the tertiary amine groups of Gx-NH2 EDA core PAMAM dendrimers at pH 7.0. The central Cu(II) metal ion of each of these complexes appears to be coordinated to 2-4 dendrimer tertiary amine groups located in the equatorial plane and 2 axial water molecules. Finally, we combine the results of our experiments with literature data to formulate and evaluate a phenomenological model of Cu(II) uptake by Gx-NH2 PAMAM dendrimers in aqueous solutions. At low metal ion-dendrimer loadings, the model provides a good fit of the measured extent of binding of Cu(II) in aqueous solutions of G4-NH2 and G5-NH2 PAMAM dendrimers at pH 7.0.

3-D structural modeling of humic acids through experimental characterization, computer assisted structure elucidation and atomistic simulations. 1. Chelsea soil humic acid.

This paper describes an integrated experimental and computational framework for developing 3-D structural models for humic acids (HAs). This approach combines experimental characterization, computer assisted structure elucidation (CASE), and atomistic simulations to generate all 3-D structural models or a representative sample of these models consistent with the analytical data and bulk thermodynamic/structural properties of HAs. To illustrate this methodology, structural data derived from elemental analysis, diffuse reflectance FT-IR spectroscopy, 1-D/2-D 1H and 13C solution NMR spectroscopy, and electrospray ionization quadrupole time-of-flight mass spectrometry (ESI QqTOF MS) are employed as input to the CASE program SIGNATURE to generate all 3-D structural models for Chelsea soil humic acid (HA). These models are subsequently used as starting 3-D structures to carry out constant temperature-constant pressure molecular dynamics simulations to estimate their bulk densities and Hildebrand solubility parameters. Surprisingly, only a few model isomers are found to exhibit molecular compositions and bulk thermodynamic properties consistent with the experimental data. The simulated 13C NMR spectrum of an equimolar mixture of these model isomers compares favorably with the measured spectrum of Chelsea soil HA.

Importance of dissection in learning anatomy: personal dissection versus peer teaching.

Two studies or approaches to time savings in teaching gross anatomy were implemented and tested. Personal dissection vs. peer teaching of the upper and lower extremities revealed subtle effects of dissection on examination performance. Although peer teaching was generally successful, students preferred to dissect for themselves, lacking confidence in being taught by other students. ANOVA and multiple range tests carried out on the examination means indicated no difference between each student's scores on upper and lower extremity questions. However, subtle effects were reflected in significant differences (P < 0.05) in both ratio (upper%/lower%) and difference (upper%-lower%) between each student's percent scores on upper extremity and lower extremity questions, indicating enhanced performance on the extremity dissected. Students dissecting both extremities were intermediate in both ratio and difference, and not significantly different from either the "upper" or "lower" extremity groups. A questionnaire indicated that students who dissected only one extremity would have preferred to have dissected both extremities, and, contrary to overall examination performance, disagreed that they had learned both extremities at a satisfactory level. Although documenting adequate learning with time savings, the results are consistent with the contention that hands-on dissection enhances learning and confidence in the subject matter, because examination performance as well as personal satisfaction was enhanced on the extremity that was dissected.