Search

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

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

Objective: Although the purposes and outcomes of screening and diagnostic tests are different, they are often confused. Therefore, it is important to delineate the clinical concept of cancer screening tests to be clear in our communication not only among healthcare professionals but also with client populations. The aim of this study is to both describe and analyze the concept of cancer screening and explain their practical meaning in global contexts. Methods: Comparative case studies of cervical and liver cancer screening tests were used as the basis for developing an understanding of a specific concept (phenomenon) of cancer screening and for delineating the relationships between factors that cause screening to occur. Results: A cancer screening is defined as an action taken by both the patient and health-care provider to detect a possible pre-cancerous condition among healthy and asymptomatic individuals who are at sufficient risk of a specific disorder to warrant further investigation or treatment. The case study-based concept analysis has been shown to be useful for improving our understanding of the multi-dimensional nature of the concept in global contexts. Conclusions: New paradigms maximizing participation in cancer screening to detect diseases before symptoms are manifested rather than focusing on diagnosis and treatment of symptomatic infectious diseases need to be developed and implemented.

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

Dinoroseobacter shibae DFL12(T), a member of the globally important marine Roseobacter clade, comprises symbionts of cosmopolitan marine microalgae, including toxic dinoflagellates. Its annotated 4 417 868 bp genome sequence revealed a possible advantage of this symbiosis for the algal host. D. shibae DFL12(T) is able to synthesize the vitamins B(1) and B(12) for which its host is auxotrophic. Two pathways for the de novo synthesis of vitamin B(12) are present, one requiring oxygen and the other an oxygen-independent pathway. The de novo synthesis of vitamin B(12) was confirmed to be functional, and D. shibae DFL12(T) was shown to provide the growth-limiting vitamins B(1) and B(12) to its dinoflagellate host. The Roseobacter clade has been considered to comprise obligate aerobic bacteria. However, D. shibae DFL12(T) is able to grow anaerobically using the alternative electron acceptors nitrate and dimethylsulfoxide; it has the arginine deiminase survival fermentation pathway and a complex oxygen-dependent Fnr (fumarate and nitrate reduction) regulon. Many of these traits are shared with other members of the Roseobacter clade. D. shibae DFL12(T) has five plasmids, showing examples for vertical recruitment of chromosomal genes (thiC) and horizontal gene transfer (cox genes, gene cluster of 47 kb) possibly by conjugation (vir gene cluster). The long-range (80%) synteny between two sister plasmids provides insights into the emergence of novel plasmids. D. shibae DFL12(T) shows the most complex viral defense system of all Rhodobacterales sequenced to date.

Bacterioplankton of the marine Roseobacter clade have genomes that reflect a dynamic environment and diverse interactions with marine plankton. Comparative genome sequence analysis of three cultured representatives suggests that cellular requirements for nitrogen are largely provided by regenerated ammonium and organic compounds (polyamines, allophanate, and urea), while typical sources of carbon include amino acids, glyoxylate, and aromatic metabolites. An unexpectedly large number of genes are predicted to encode proteins involved in the production, degradation, and efflux of toxins and metabolites. A mechanism likely involved in cell-to-cell DNA or protein transfer was also discovered: vir -related genes encoding a type IV secretion system typical of bacterial pathogens. These suggest a potential for interacting with neighboring cells and impacting the routing of organic matter into the microbial loop. Genes shared among the three roseobacters and also common in nine draft Roseobacter genomes include those for carbon monoxide oxidation, dimethylsulfoniopropionate demethylation, and aromatic compound degradation. Genes shared with other cultured marine bacteria include those for utilizing sodium gradients, transport and metabolism of sulfate, and osmoregulation.

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

Understanding health from a social perspective is important if appropriate interventions and policies are to be developed to eliminate disparity. Epidemiological data show Blacks are disproportionately affected by most illnesses. Social factors such as race and class have significantly contributed to this disparity. This article addresses these social factors using Durkheim’s sociological theory along with conflict and micro-interaction social theories. Each theory is discussed along with its social implications. Nurses can play a significant role in helping the government achieve the goals of Healthy People 2010. To do this, they must address racial and class disparities in educational curricula, practice, and research.

As severe social problems persist, analysts from various sectors suggest that policies and programs could increase their sensitivity and sustainability through collaborative relationships among universities, communities, and political officials. A model of collaboration is presented along with the benefits, challenges, and roles of the three collaboration partners (university, community, and government). The three stages of the collaboration process (initiation, deliberation, and implementation) are discussed in the context of an actual community-based application.

The current nursing shortage is one of the most significant challenges facing health care organizations in the United States today. Policy makers suggest that this shortage will be longer and more protracted than previous shortages. Therefore, schools of nursing must develop innovative strategies to attract young people into the profession and retain them. This article describes efforts by the University of Maryland School of Nursing to address the nursing shortage by developing a partnership with the local school system, the health care industry, and a local foundation to design and implement a pre- nursing career academy within a local school district. The authors believe that such partnerships are essential to attracting and preparing young people to enter into a professional career in nursing.

For many years, the community, in conjunction with family and friends, has had a central interest and role in child rearing and child development. As the numbers of children at risk for compromised development and less than optimal outcome increase, it becomes even more apparent that communities and persons most interested in the development of children become intricately involved in influencing those policies and programs that ultimately affect healthy child and family development. The intent of this article is to highlight the importance of advocacy and to provide a model of community action that leads to policy formation, program development and financing, and ultimately, community empowerment as related to healthy child and family development.

The efficacy of the community partnership model is well supported in the literature. The university system affords the appropriate infrastructure for successful educational partnerships within culturally diverse communities. This proposed model has global implications. By creating a new cadre of professional and paraprofessional family health care providers, it provides a viable process for resolving the current nursing shortage and simultaneously meeting the goals of Healthy People 2010. The sharing of academic expertise and resources empowers individual community members to improve the quality of health care decisions for themselves and their families while promoting the necessary leadership skills required to significantly affect policy changes. Evaluating this model through a formalized process will add to the existing body of literature documenting the value of specific interventions and ultimately facilitate policy changes for the new millennium.

The authors propose a policy direction for positive and sustainable healthy youth development. The direction they propose transcends prevention and is predicated on building community-based programs. Universities can contribute through teaching and research activities and become partners with communities as they struggle together to build self-sustaining programs that support and reinforce a community’s own desire for self-determination. No policies exist in the United States currently to foster integrated and sustained actions to change the quality of a young person’s life. Innovative efforts are required to convince local, state, and federal officials of the urgent need to develop public initiatives that sustain programs that are effective and to support the development and evaluation of new ones. Universities, communities, and policy makers must create partnerships to foster university-community collaborations based on mutual respect for one another’s knowledge and unique cultural characteristics. Only then can the political, economic, and behavioral resource issues, integral to developing and sustaining programs, be effectively addressed.

In recent years, a strategy of partnership and collaboration between government and communities has started to emerge as policy makers and service providers call for a more responsive system to address the health and well-being of children, youth, and families. The trend toward a comprehensive, holistic strategy is driven in part by concern over the effectiveness of a patchwork system of categorical health and human services designed to solve one problem at a time. At issue also is the movement "devolving" more responsibility for child and family well-being from the state to local governments and the challenge this change represents to communities. This article proposes a comprehensive, community-based strategy for reform of health and human services and examines the approach of one state that may be useful for other states interested in reform.

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

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

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

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

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

Human chromosome 16 features one of the highest levels of segmentally duplicated sequence among the human autosomes. We report here the 78,884,754 base pairs of finished chromosome 16 sequence, representing over 99.9% of its euchromatin. Manual annotation revealed 880 protein-coding genes confirmed by 1,670 aligned transcripts, 19 transfer RNA genes, 341 pseudogenes and three RNA pseudogenes. These genes include metallothionein, cadherin and iroquois gene families, as well as the disease genes for polycystic kidney disease and acute myelomonocytic leukaemia. Several large-scale structural polymorphisms spanning hundreds of kilobase pairs were identified and result in gene content differences among humans. Whereas the segmental duplications of chromosome 16 are enriched in the relatively gene-poor pericentromere of the p arm, some are involved in recent gene duplication and conversion events that are likely to have had an impact on the evolution of primates and human disease susceptibility.

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

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

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

The problems of health and development faced by contemporary adolescents require that our communities have greater access to effective, adequately scaled, and sustained youth-serving programs. These 3 dimensions of youth programs are discussed, and the role of evaluations is specified, especially those aimed at program improvement and community empowerment, in facilitating efforts to promote the positive development of young people. These areas of development include competence, confidence, character, connection, and caring/compassion—the “five C's” of positive youth development. Ten features of effective positive youth development programs are described, and the importance of engaging policymakers in order to broadly disseminate and sustain effective programs is stressed. Copyright 2002, Elsevier Science (USA). All rights reserved.

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