Psychiatric-Mental Health Nurse Educators' Perceptions of Teaching Dissociative Disorders: A Reflexive Thematic Analysis.

BACKGROUND AND PURPOSE: Although the prevalence of dissociative disorders (DDs) is up to 10 percent of the general population, psychiatric-mental health (PMH) registered nurses lack education on how to care for individuals diagnosed with these disorders. METHOD: Sixty-two PMH nurse educators completed an anonymous online survey about their perceptions of teaching DDs to nursing students. Braun and Clarke's six-phase framework was used to conduct an inductive, reflexive thematic analysis of the data. RESULTS: Three primary themes were identified: lack of resources, differing opinions on the value of teaching DDs, and stigma. CONCLUSION: Though roughly 75 percent of participants reported that they teach DDs to their nursing students, they endorsed concerning misperceptions about the diagnoses. By failing to properly educate future PMH RNs about DDs, individuals with DDs are at risk of receiving inadequate and inappropriate nursing care and experiencing poor outcomes.

Facilitators of and Barriers to the Therapeutic Nurse-Patient Relationship: Perceptions From Psychiatric Mental Health Nurses.

BACKGROUND: The therapeutic relationship serves as a cornerstone in psychiatric mental health nursing practice, providing a basis for implementing various interventions. AIMS: This study aimed to explore the perspectives of psychiatric mental health nurses regarding factors that facilitate and impede the therapeutic nurse-patient relationship. METHODS: A descriptive study was conducted among psychiatric mental health nurses employed at two community psychiatric hospitals in the northeast area of the United States. A list of facilitators and barriers was developed based on an extensive literature review and subsequently validated by three experts in the field of psychiatric mental health nursing. Participants rated these factors on a 10-point scale. RESULTS: The study included 74 registered nurses from two psychiatric hospitals, yielding a 24% response rate. The highest-ranked facilitator was awareness that the relationship enables collaborative goal setting with patients. The most significant barrier was insufficient time due to administrative tasks. CONCLUSIONS: This study highlights the importance of understanding facilitators and barriers in the therapeutic nurse-patient relationship. Replicating the study nationally on a larger scale among psychiatric mental health nurses is recommended.

Collaborative Care for Chronic Pain After Traumatic Brain Injury: A Randomized Clinical Trial.

Importance: Chronic pain after traumatic brain injury (TBI) is prevalent and associated with poor outcomes. By providing multidisciplinary care through expert consultation, a collaborative care (CC) treatment approach may reduce pain interference. Objective: To compare CC with usual care (UC) in decreasing pain interference. Design, Setting, and Participants: This randomized clinical trial was conducted from July 2018 through April 2021 at 2 hospital-based academic rehabilitation medicine clinics in Seattle, Washington. Participants included adults with mild-to-severe TBI (at least 6 months before enrollment) and chronic pain. Data analysis was performed from March 30, 2022, to August 30, 2023. Intervention: The CC intervention (called TBI Care) included up to 12 in-person or telephone visits over 16 weeks with a care manager (CM) who provided person-centered cognitive behavioral treatment. The CM met weekly with members of the expert team to review participants and discuss recommendations to optimize treatment. Main Outcomes and Measures: The primary outcome was pain interference on the Brief Pain Inventory at treatment conclusion (4 months after randomization). Secondary outcomes included pain interference at 8 months; pain severity; symptoms of depression, anxiety, and sleep disturbance; pain-related emergency department visits; community participation; and participant satisfaction. Linear mixed-effects regression was used for analysis. Results: A total of 1379 individuals were screened for eligibility, and 158 were randomized (79 to CC and 79 to UC). The participants were mostly women (92 participants [58%]) with a mean (SD) age of 46.8 (13.2) years and a mean (SD) of 15.3 (3.0) years of education. TBI occurred a mean (SD) of 4.0 (5.9) years (median [IQR], 1.9 [0.8-4.5] years) before enrollment. All TBI severities were included, and of 149 participants for whom TBI severity was known, the majority (97 participants [65%]) had mild TBI. In the CC group, 71 participants (90%) completed at least 11 sessions, and, at 4 months, this group had significantly lower pain interference scores compared with the UC group (mean [SD], 3.46 [2.17] vs 5.03 [2.28]). This difference was maintained at 8 months after randomization, with mean (SD) TBI care pain interference scores of 3.61 (2.22) for CC vs 4.68 (2.51) for UC. At 4 months, there was significantly lower pain severity in the CC group vs UC group (mean [SD] score, 3.63 [1.95] vs 4.90 [1.96]), as well as symptoms of depression (mean [SD] score, 8.07 [5.34] vs 11.31 [6.37]) and anxiety (mean [SD], 6.20 [5.17] vs 9.58 [6.00]). Satisfaction with pain treatment (mean [SD] score, 2.99 [1.23] vs 2.52 [1.25]), clinical care (mean [SD] score, 3.28 [1.00] vs 2.84 [1.26]), and overall health care (mean [SD] score, 3.25 [0.88] vs 2.82 [1.00]) were significantly higher in the CC group vs the UC group; global impression of change was significantly lower in the CC group vs the UC group (mean [SD] score, 2.74 [1.02] vs 3.47 [1.26]) (lower scores denote a better impression of change). Conclusions and Relevance: In this randomized clinical trial of CC compared with UC for patients with TBI, CC was effective at reducing pain interference and was sustained at 8-month follow-up. Further research is needed to examine the implementation and cost-effectiveness of CC for TBI in other health care settings. Trial Registration: ClinicalTrials.gov Identifier: NCT03523923.

Effect of Brief Interpersonal Therapy on Depression During Pregnancy: A Randomized Clinical Trial.

Importance: Prenatal depression is prevalent with negative consequences for both the mother and developing fetus. Brief, effective, and safe interventions to reduce depression during pregnancy are needed. Objective: To evaluate depression improvement (symptoms and diagnosis) among pregnant individuals from diverse backgrounds randomized to brief interpersonal psychotherapy (IPT) vs enhanced usual care (EUC). Design, Setting, and Participants: A prospective, evaluator-blinded, randomized clinical trial, the Care Project, was conducted among adult pregnant individuals who reported elevated symptoms during routine obstetric care depression screening in general practice in obstetrics and gynecology (OB/GYN) clinics. Participants were recruited between July 2017 and August 2021. Repeated measures follow-up occurred across pregnancy from baseline (mean [SD], 16.7 [4.2] gestational weeks) through term. Pregnant participants were randomized to IPT or EUC and included in intent-to-treat analyses. Interventions: Treatment comprised an engagement session and 8 active sessions of brief IPT (MOMCare) during pregnancy. EUC included engagement and maternity support services. Main Outcomes and Measures: Two depression symptom scales, the 20-item Symptom Checklist and the Edinburgh Postnatal Depression Scale, were assessed at baseline and repeatedly across pregnancy. Structured Clinical Interview for DSM-5 ascertained major depressive disorder (MDD) at baseline and the end of gestation. Results: Of 234 participants, 115 were allocated to IPT (mean [SD] age, 29.7 [5.9] years; 57 [49.6%] enrolled in Medicaid; 42 [36.5%] had current MDD; 106 [92.2%] received intervention) and 119 to EUC (mean [SD] age, 30.1 [5.9] years; 62 [52.1%] enrolled in Medicaid; 44 [37%] had MDD). The 20-item Symptom Checklist scores improved from baseline over gestation for IPT but not EUC (d = 0.57; 95% CI, 0.22-0.91; mean [SD] change for IPT vs EUC: 26.7 [1.14] to 13.6 [1.40] vs 27.1 [1.12] to 23.5 [1.34]). IPT participants more rapidly improved on Edinburgh Postnatal Depression Scale compared with EUC (d = 0.40; 95% CI, 0.06-0.74; mean [SD] change for IPT vs EUC: 11.4 [0.38] to 5.4 [0.57] vs 11.5 [0.37] to 7.6 [0.55]). MDD rate by end of gestation had decreased significantly for IPT participants (7 [6.1%]) vs EUC (31 [26.1%]) (odds ratio, 4.99; 95% CI, 2.08-11.97). Conclusions and Relevance: In this study, brief IPT significantly reduced prenatal depression symptoms and MDD compared with EUC among pregnant individuals from diverse racial, ethnic, and socioeconomic backgrounds recruited from primary OB/GYN clinics. As a safe, effective intervention to relieve depression during pregnancy, brief IPT may positively affect mothers' mental health and the developing fetus. Trial Registration: ClinicalTrials.gov Identifier: NCT03011801.

Slicing the Pie: Interpreting harmful algal blooms one pie chart at a time.

The Earth's oceans are home to a diverse array of life, from large marine mammals to microscopic organisms. Among the most important are the marine phytoplankton, which comprise the basis of marine food webs, and also produce a large percentage of the Earth's oxygen through photosynthesis. Although the vast majority of phytoplankton are essential to ocean health, several dozen species produce potent toxins, and can form what are called Harmful Algal Blooms (HABs). This activity focuses on the importance of HABs, as well as the types of data scientists collect to understand blooms. In the classroom exercises, students will calculate the proportional abundance (% contribution) of five HAB species present in water samples, and use these data to create pie graphs to depict species composition. Students will then compare these results with levels of HAB toxins in water samples collected over the same time period. Thought questions challenge students to develop hypotheses regarding how changes in the HAB community may relate to observed trends in toxin concentrations. This activity was successfully taught to visually impaired students who were able to complete the pie charts and answer the thought questions.

Change Mechanisms in Brief Interpersonal Psychotherapy for Women With Perinatal Depression: Qualitative Study.

OBJECTIVE: Brief interpersonal psychotherapy (IPT-B) has been shown to be effective in treating perinatal depression and in preventing depressive relapse among socioeconomically disadvantaged women. Yet, it is unclear how IPT-B alleviates depression. Previous research has suggested four possible change mechanisms derived from IPT's interpersonal model: decreasing interpersonal stress, facilitating emotional processing, improving interpersonal skills, and enhancing social support. This study explored how women who received IPT-B or enhanced maternity support services (MSS-Plus) evaluated their respective experiences. METHODS: A qualitative study was conducted with 16 women who had been recruited from public health clinics to participate in a larger, randomized controlled trial of women with major depression or dysthymia and who had been assigned to receive IPT-B or MSS-Plus. The sample was 63% non-Hispanic White, had an average age of 31.6 years, and was balanced in intervention group assignment, posttraumatic stress disorder status, and depression improvement. Telephone interviews included semistructured, open-ended questions eliciting participants' experiences with depression treatment. Predetermined, conceptually derived codes were based on the four postulated IPT change mechanisms. RESULTS: Thematic coded excerpts were collected and discussed. Excerpts lent support to the role of IPT-B in helping women decrease their interpersonal stress; identify, reflect on, and regulate their emotions; and improve their social skills. Evidence for increasing social support was mixed but highlighted the importance of the therapeutic relationship. CONCLUSIONS: Including qualitative findings into training in public health and other clinical settings will help illuminate the role of the provider in facilitating the change mechanisms that may lead to improved mental health among clients.

Healthy Intimate Relationships and the Adult With Autism.

OBJECTIVE: An adult faces many challenges; however, one experience that is often taken for granted by neurotypical individuals is building intimate relationships. The purpose of this article is to discuss the barriers for healthy intimate relationships for an individual with autism, strategies to overcome these barriers, recommendations for future practice and research, and resources to improve knowledge of this important yet overlooked topic. METHOD: Data collection was done using research journals and databases such as EBSCO, SAGE Knowledge, MEDLINE, and CINAHL. The reviewed articles were published from 2015 to the present time. During the search process, the following key phrases were used: autism spectrum disorder, intimate relationships, sexuality education, and social skills. In total, 1,400 articles were found with an additional 52 sources found through other sources, of which 31 met inclusion criteria and were subsequently reviewed. RESULTS: Although those with autism have many strengths and talents, deficits in communication and social interaction can affect the formation of healthy adult relationships, including friendships and romantic relationships. In addition to social challenges, a lack of education regarding safe and healthy relationships can put an individual with autism at risk. CONCLUSIONS: It is imperative that that individuals with autism, their families, and health care professionals are educated about the barriers and able to access educational resources and specialized curricula on this topic.

Preadmission predictors for first semester course success in a baccalaureate nursing program.

BACKGROUND: Identifying students' who are able to complete a rigorous course of study, graduate on time, and pass the NCLEX-RN© is a principle role of nursing program admissions teams. PURPOSE: To examine which preadmission factors predict students' success in the first semester of a baccalaureate nursing program. METHODS: Undergraduate students' data from the academic years 2013 to 2017 were analyzed (N = 927). Bivariate and multiple regression analyses were used to examine potential predictors of first semester course success, and scores on standardized NCLEX preparation exams. RESULTS: Preadmission cumulative GPA (OR = 3.82, 95% CI = 1.43-10.16) and prerequisite science GPA (OR = 2.57, 95% CI = 1.14-5.78) predicted success in the pathopharmacology course. Preadmission cumulative GPA (OR = 6.53, 95% CI = 1.59-26.85) and TEAS composite score (OR = 1.15, 95% CI = 1.09-1.22) predicted success in the health assessment course. Preadmission cumulative GPA (OR = 3.42, 95% CI = 1.18-9.92) and TEAS composite score (OR = 1.05, 95% CI = 1.01-1.10) predicted success in the foundations course. Higher preadmission cumulative GPA (B = 14.19, p < 0.01), prerequisite science GPA (B = 12.62, p < 0.01), and TEAS composite score (B = 0.48, p < 0.01) predicted a higher pathopharmacology-KAPLAN, Inc. test scores. Higher preadmission cumulative GPA (B = 62.52, p < 0.01), prerequisite science GPA (B = 61.18, p < 0.01), and TEAS composite score (B = 4.76, p < 0.01) predicted a higher fundamentals-HESI test scores. CONCLUSIONS: Preadmission cumulative GPA, prerequisite science GPA, and TEAS composite score were significant predictors of success in first semester courses and performance on standardized tests.

Pilot intervention to promote tolerance for uncertainty in early multiple sclerosis.

PURPOSE/OBJECTIVE: The ability to tolerate uncertainty about the future may be foundational to positive psychological adjustment. Conversely, intolerance of uncertainty (IU) has been shown to be a vulnerability factor for anxiety and depression. One stressor with a very high degree of uncertainty about the future is a new diagnosis of multiple sclerosis (MS). However, few psychological interventions in MS have directly targeted IU. Research Method/Design: Forty-eight participants with early MS and moderate levels of distress were randomized to receive either 6 sessions of a brief psychological intervention designed to improve the ability to tolerate uncertainty (n = 23) or treatment as usual (TAU; n = 25). Measures of mood, IU, and MS acceptance were administered at baseline and about 8 weeks later. Intervention effects were tested via linear regression controlling for baseline levels. RESULTS: Participants were primarily Caucasian (85%) women (73%) and had lived with an MS diagnosis for an average of 376.3 days. Groups did not differ at baseline on most demographic or outcome variables. The intervention was well-tolerated, and most participants (82.6%) completed all 6 sessions and reported benefit. Postintervention, those in the intervention group demonstrated lower levels of IU and more MS acceptance relative to the TAU group. There was no effect of the intervention on global anxiety. Decreases in IU were associated with increases in MS acceptance (r = -.63). Effect sizes for these changes were moderate. CONCLUSIONS/IMPLICATIONS: These pilot results demonstrate that IU is responsive to a brief psychological intervention, and improvement with IU is associated with positive psychological outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Harmful Algal Blooms (HABs): Track them like a scientist.

Marine phytoplankton comprise the foundation of oceanic food webs and generate most of the Earth's oxygen. Of the many phytoplankton species in the ocean, a few dozen produce potent toxins, and at high concentrations can form what are called Harmful Algal Blooms (HABs) or "red tides" that can discolor marine waters. Managers and scientists have been monitoring coastal waters and shellfish resources for HABs and their toxins to ensure seafood safety and understand why blooms occur. This educational activity focuses on a prominent HAB species that causes paralytic shellfish poisoning (PSP). Students will learn about the importance of HABs and PSP, as well as how scientists collect and use data to understand and predict blooms. Students will plot data on HAB species collected by scientists over multiple years of sampling. Students will also plot results over time and across regions, report on observed patterns, and complete grade-appropriate calculations. Lastly, group discussion will focus on determining whether geographic patterns exist that might influence where shellfish beds are closed. This activity is timely given the widespread wildlife mortalities and beach closures due to Florida red tide, as well as recent dog deaths attributed to exposure to freshwater cyanobacteria (blue-green algae) blooms.

Improving the quality of depression and pain care in multiple sclerosis using collaborative care: The MS-care trial protocol.

BACKGROUND AND OBJECTIVES: Evidence-based pharmacological and behavioral interventions are often underutilized or inaccessible to persons with multiple sclerosis (MS) who have chronic pain and/or depression. Collaborative care is an evidence-based patient-centered, integrated, system-level approach to improving the quality and outcomes of depression care. We describe the development of and randomized controlled trial testing a novel intervention, MS Care, which uses a collaborative care model to improve the care of depression and chronic pain in a MS specialty care setting. METHODS: We describe a 16-week randomized controlled trial comparing the MS Care collaborative care intervention to usual care in an outpatient MS specialty center. Eligible participants with chronic pain of at least moderate intensity (≥3/10) and/or major depressive disorder are randomly assigned to MS Care or usual care. MS Care utilizes a care manager to implement and coordinate guideline-based medical and behavioral treatments with the patient, clinic providers, and pain/depression treatment experts. We will compare outcomes at post-treatment and 6-month follow up. PROJECTED PATIENT OUTCOMES: We hypothesize that participants randomly assigned to MS Care will demonstrate significantly greater control of both pain and depression at post-treatment (primary endpoint) relative to those assigned to usual care. Secondary analyses will examine quality of care, patient satisfaction, adherence to MS care, and quality of life. Study findings will aid patients, clinicians, healthcare system leaders, and policy makers in making decisions about effective care for pain and depression in MS healthcare systems. (PCORI- IH-1304-6379; clinicaltrials.gov: NCT02137044). This trial is registered at ClinicalTrials.gov, protocol NCT02137044.

A Randomized Trial of Collaborative Care for Perinatal Depression in Socioeconomically Disadvantaged Women: The Impact of Comorbid Posttraumatic Stress Disorder.

OBJECTIVE: The comorbidity of posttraumatic stress disorder (PTSD) with antenatal depression poses increased risks for postpartum depression and may delay or diminish response to evidence-based depression care. In a secondary analysis of an 18-month study of collaborative care for perinatal depression, the authors hypothesized that pregnant, depressed, socioeconomically disadvantaged women with comorbid PTSD would show more improvement in the MOMCare intervention providing Brief Interpersonal Psychotherapy and/or antidepressants, compared to intensive public health Maternity Support Services (MSS-Plus). METHODS: A multisite randomized controlled trial with blinded outcome assessment was conducted in the Seattle-King County Public Health System, July 2009-January 2014. Pregnant women were recruited who met criteria for a probable diagnosis of major depressive disorder (MDD) on the Patient Health Questionnaire-9 and/or dysthymia on the MINI-International Neuropsychiatric Interview (5.0.0). The primary outcome was depression severity at 3-, 6-, 12-and 18-month follow-ups; secondary outcomes included functional improvement, PTSD severity, depression response and remission, and quality of depression care. RESULTS: Sixty-five percent of the sample of 164 met criteria for probable comorbid PTSD. The treatment effect was significantly associated with PTSD status in a group-by-PTSD severity interaction, controlling for baseline depression severity (Wald χ²1 = 4.52, P = .03). Over the 18-month follow-up, those with comorbid PTSD in MOMCare (n = 48), versus MSS-Plus (n = 58), showed greater improvement in depression severity (Wald χ²1 = 8.51, P < .004), PTSD severity (Wald χ²1 = 5.55, P < .02), and functioning (Wald χ²1 = 4.40, P < .04); higher rates of depression response (Wald χ²1 = 4.13, P < .04) and remission (Wald χ²1 = 5.17, P < .02); and increased use of mental health services (Wald χ²1 = 39.87, P < .0001) and antidepressant medication (Wald χ²1 = 8.07, P < .005). Participants without comorbid PTSD in MOMCare (n = 33) and MSS-Plus (n = 25) showed equivalent improvement on these outcomes. CONCLUSIONS: Collaborative depression care had a greater impact on perinatal depressive outcomes for socioeconomically disadvantaged women with comorbid PTSD than for those without PTSD. Findings suggest that a stepped care treatment model for high-risk pregnant women with both MDD and PTSD could be integrated into public health systems in the United States. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01045655.

COLLABORATIVE CARE FOR PERINATAL DEPRESSION IN SOCIOECONOMICALLY DISADVANTAGED WOMEN: A RANDOMIZED TRIAL.

BACKGROUND: Both antenatal and postpartum depression have adverse, lasting effects on maternal and child well-being. Socioeconomically disadvantaged women are at increased risk for perinatal depression and have experienced difficulty accessing evidence-based depression care. The authors evaluated whether "MOMCare,"a culturally relevant, collaborative care intervention, providing a choice of brief interpersonal psychotherapy and/or antidepressants, is associated with improved quality of care and depressive outcomes compared to intensive public health Maternity Support Services (MSS-Plus). METHODS: A randomized multisite controlled trial with blinded outcome assessment was conducted in the Seattle-King County Public Health System. From January 2010 to July 2012, pregnant women were recruited who met criteria for probable major depression and/or dysthymia, English-speaking, had telephone access, and ≥18 years old. The primary outcome was depression severity at 3-, 6-, 12-, 18-month postbaseline assessments; secondary outcomes included functional improvement, PTSD severity, depression response and remission, and quality of depression care. RESULTS: All participants were on Medicaid and 27 years old on average; 58% were non-White; 71% were unmarried; and 65% had probable PTSD. From before birth to 18 months postbaseline, MOMCare (n = 83) compared to MSS-Plus participants (n = 85) attained significantly lower levels of depression severity (Wald's χ(2) = 6.09, df = 1, P = .01) and PTSD severity (Wald's χ(2) = 4.61, df = 1, P = .04), higher rates of depression remission (Wald's χ(2) = 3.67, df = 1, P = .05), and had a greater likelihood of receiving ≥4 mental health visits (Wald's χ(2) = 58.23, df = 1, P < .0001) and of adhering to antidepressants in the prior month (Wald's χ(2) = 10.00, df = 1, P < .01). CONCLUSION: Compared to MSS-Plus, MOMCare showed significant improvement in quality of care, depression severity, and remission rates from before birth to 18 months postbaseline for socioeconomically disadvantaged women. Findings suggest that evidence-based perinatal depression care can be integrated into the services of a county public health system in the United States. CLINICAL TRIAL REGISTRATION: ClinicalTrials.govNCT01045655.

The Effect of Temperature on Synchronization of Brood Development of the Bopyrid Isopod Parasite Probopyrus pandalicola with Molting of Its Host, the Daggerblade Grass Shrimp Palaemonetes pugio.

The bopyrid isopod Probopyrus pandalicola is a hematophagous ectoparasite that sexually sterilizes some palaemonid shrimps, including female daggerblade grass shrimp Palaemonetes pugio. The reproduction of parasitic isopods is thought to occur synchronously with host molting because the brood would be unsuccessful if molting occurred before the larvae were free swimming. Temperature affects the length of the molting cycle of shrimp, and therefore may also affect the incubation time of isopod broods. The purpose of the present study was to determine the effect of temperature on brood development of the parasite and on the degree of synchronization with the molting of its host. Parasitized P. pugio were monitored daily at 2 experimental temperatures, 23 and 15 C, in temperature-controlled chambers for the duration of a full parasite reproductive cycle. Developmental stage was determined by the visible coloration of the brood through the exoskeleton of the host, and was designated as egg, embryo I, embryo II, or epicaridium larvae. Temperature significantly affected median brood incubation time, which was only 11 days at 23 C, as compared to 35 days at 15 C. The final developmental stage (epicaridium larvae) was 3 times shorter at 23 C (median 3 days; n = 45) than at 15 C (median 9 days; n = 15). Temperature significantly affected the intermolt period of parasitized shrimp, which was shorter at 23 C (median 12 days) than at 15 C (median 37 days). A smaller percentage of the intermolt period elapsed between larval release and shrimp molting at 23 C (0.0%) than at 15 C (3.1%), indicating closer synchronization between host molting and parasite reproduction at the warmer temperature. At 15 C, the isopods utilized a smaller proportion of the time that was available for brood incubation during the intermolt period of their host. Brood size ranged from 391 to 4,596 young and was positively correlated with parasite and host size. Because development progressed more rapidly at 23 C, warmer temperatures could increase the prevalence of P. pandalicola. The corresponding reduction in the abundance of ovigerous grass shrimp as a result of sexual sterilization by bopyrids could adversely impact estuarine ecosystems, as grass shrimp are a crucial link in transferring energy from detritus to secondary consumers.

Sexual sterilization of the daggerblade grass shrimp Palaemonetes pugio (Decapoda: Palaemonidae) by the bopyrid isopod Probopyrus pandalicola (Isopoda: Bopyridae).

Probopyrus pandalicola is a bopyrid isopod that infects several palaemonid shrimp species, including the daggerblade grass shrimp Palaemonetes pugio . The parasite can have several negative effects on its host, including loss of hemolymph, reduced reproductive potential, and decreased molting frequency and growth. To date, there are conflicting reports on whether Probopyrus pandalicola affects the reproductive capability of both male and female daggerblade grass shrimp. The purpose of this study was to determine whether infection by Probopyrus pandalicola resulted in the sexual sterilization of Palaemonetes pugio , and if the reproductive capability of male and/or female shrimp was restored after the bopyrid was removed. We found that parasitized and deparasitized males were able to fertilize the eggs of unparasitized females successfully, as 18.9 ± 7.1% and 42.7 ± 5.2% of the females paired with them became ovigerous in 4 wk, respectively. Neither parasitized nor deparasitized females became ovigerous when placed with unparasitized males during the 4-wk period. However, 45.4 ± 20.6% of deparasitized females did become ovigerous within 10 wk. Despite the fact that female shrimp are able to reproduce again when no longer parasitized, the majority of females remain infected with the bopyrid for their entire lives. Therefore, the sexual sterilization of female shrimp could potentially have a significant impact on estuarine food webs, as grass shrimp are conduits of detrital energy and a food source for many recreationally and commercially important species in estuaries on the East Coast of the United States and in the Gulf of Mexico.

Examination of the teaching styles of nursing professional development specialists, part II: correlational study on teaching styles and use of adult learning theory.

This article, the second in a two-part series, details a correlational study that examined the effects of four variables (graduate degrees in nursing education, professional development training in adult learning theory, nursing professional development [NPD] certification, and NPD specialist experience) on the use of adult learning theory to guide curriculum development. Using the Principles of Adult Learning Scale, 114 NPD specialists tested the hypothesis that NPD specialists with graduate degrees in nursing education, professional development training in adult learning theory, NPD certification, and NPD experience would use higher levels of adult learning theory in their teaching practices to guide curriculum development than those without these attributes. This hypothesis was rejected as regression analysis revealed only one statistically significant predictor variable, NPD certification, influenced the use of adult learning theory. In addition, analysis revealed NPD specialists tended to support a teacher-centered rather than a learner-centered teaching style, indicating NPD educators are not using adult learning theory to guide teaching practices and curriculum development.

Culturally relevant treatment services for perinatal depression in socio-economically disadvantaged women: the design of the MOMCare study.

BACKGROUND: Depression during pregnancy has been demonstrated to be predictive of low birthweight, prematurity, and postpartum depression. These adverse outcomes potentially have lasting effects on maternal and child well-being. Socio-economically disadvantaged women are twice as likely as middle-class women to meet diagnostic criteria for antenatal major depression (MDD), but have proven difficult to engage and retain in treatment. Collaborative care treatment models for depression have not been evaluated for racially/ethnically diverse, pregnant women on Medicaid receiving care in a public health system. This paper describes the design, methodology, culturally relevant enhancements, and implementation of a randomized controlled trial of depression care management compared to public health Maternity Support Services (MSS). METHODS: Pregnant, public health patients, >18 years with a likely diagnosis of MDD or dysthymia, measured respectively by the Patient Health Questionnaire-9 (PHQ-9) or the Mini-International Neuropsychiatric Interview (MINI), were randomized to the intervention or to public health MSS. The primary outcome was reduction in depression severity from baseline during pregnancy to 18-months post-baseline (one-year postpartum). BASELINE RESULTS: 168 women with likely MDD (96.4%) and/or dysthymia (24.4%) were randomized. Average age was 27.6 years and gestational age was 22.4 weeks; 58.3% racial/ethnic minority; 71.4% unmarried; 22% no high school degree/GED; 65.3% unemployed; 42.1% making <$10,000 annually; 80.4% having recurrent depression; 64.6% PTSD, and 72% unplanned pregnancy. CONCLUSIONS: A collaborative care team, including a psychiatrist, psychologist, project manager, and 3 social workers, met weekly, collaborated with the patients' obstetrics providers, and monitored depression severity using an electronic tracking system. Potential sustainability of the intervention within a public health system requires further study.

Examination of the teaching styles of nursing professional development specialists, part I: best practices in adult learning theory, curriculum development, and knowledge transfer.

The American Nurses Association advocates for nursing professional development (NPD) specialists to have an earned graduate degree, as well as educational and clinical expertise. However, many NPD specialists have limited exposure to adult learning theory. Limited exposure to adult learning theory may affect NPD educational practices, learning outcomes, organizational knowledge transfer, and subsequently, the professional development of the nurses they serve and quality of nursing care. An examination of current teaching practices may reveal opportunities for NPD specialists to enhance educational methods to promote learning, learning transfer, and organizational knowledge and excellence. This article, the first in a two-part series, examines best practices of adult learning theories, nursing professional development, curriculum design, and knowledge transfer. Part II details the results of a correlational study that examined the effects of four variables on the use of adult learning theory to guide curriculum development for NPD specialists in hospitals.

Evaluating the environmental impacts of a nano-enhanced field emission display using life cycle assessment: a screening-level study.

Carbon nanotube (CNT) field emission displays (FEDs) are currently in the product development stage and are expected to be commercialized in the near future because they offer image quality and viewing angles comparable to a cathode ray tube (CRT) while using a thinner structure, similar to a liquid crystal display (LCD), and enable more efficient power consumption during use. To address concerns regarding the environmental performance of CNT-FEDs, a screening-level, cradle-to-grave life cycle assessment (LCA) was conducted based on a functional unit of 10,000 viewing hours, the viewing lifespan of a CNT-FED. Contribution analysis suggests the impacts for material acquisition and manufacturing are greater than the combined impacts for use and end-of-life. A scenario analysis of the CNT paste composition identifies the metal components used in the paste are key contributors to the impacts of the upstream stages due to the impacts associated with metal preparation. Further improvement of the manufacturing impacts is possible by considering the use of plant-based oils, such as rapeseed oil, as alternatives to organic solvents for dispersion of CNTs. Given the differences in viewing lifespan, the impacts of the CNT-FED were compared with a LCD and a CRT display to provide more insight on how to improve the CNT-FED to make it a viable product alternative. When compared with CRT technology, CNT-FEDs show better environmental performance, whereas a comparison with LCD technology indicates the environmental impacts are roughly the same. Based on the results, the enhanced viewing capabilities of CNT-FEDs will be a more viable display option if manufacturers can increase the product's expected viewing lifespan.