Explore the vast range of titles available.

\"The Case for the Only Child debunks the myths, taking into account the many changes the nuclear family has experienced in the face of two-family incomes, women who have children later, and the economic reality of raising children in our modern world. Combining often-surprising findings with real-life stories, compassionate insight, and thought-provoking questions, Dr. Susan Newman provides a guide to help you decide for yourself how to best plan your family and raise a single child.\"--from cover, p. [4].

Introduction Sequential fractionation procedures have been an important tool in the study of phosphorus (P) dynamics in soils and sediments for over 50 years. Throughout this period, the various methodologies have been thoroughly reviewed, and several limitations are widely acknowledged, but there are also aspects of P fractionation that have received little or no discussion. As there are few alternatives to fractionation procedures, in order to advance the usefulness of these techniques, we need to explore the undisclosed variables that may falsely bias our interpretation. Discussion This article highlights specific fundamental components of P fractionation, including sample preparation and handling, determination of P in extracts, fraction validation and residual P. While researchers have project-specific objectives, we provide guidelines on how to minimise the influence of these confounding variables. For example, we recommend that samples be maintained and extracted under in situ moisture and oxic/anoxic conditions, especially with sediments. In addition, care needs to be taken to ensure the extraction process supports the operational definition, avoiding carryover and neutralisation between successive extractions. Despite the extensive use of these procedures, we will only be able to move away from operational definitions by validating links between extraction and reactivity, and our understanding of this key component is still limited. Conclusion To provide some focus for this, we make specific recommendations on fractionation procedures to be used in the assessment of P transformations in various types of soil and sediments, dependent on the study objective.

Objective: To identify barriers and facilitators to primary care access among the homeless using the Equity of Access to Medical Care Framework and to provide recommendations for medical and public health practitioners to improve health among this underserved population. Methods: A quasi-systematic review of the literature was conducted using the PubMed, CINAHL, and PsycINFO databases. Study elements from articles in the final analysis were extracted and categorized into dimensions of access from the Framework. Results: The review identified multiple barriers to primary care access for the homeless. This included lack of insurance coverage and competing priorities. Facilitators to access included tailored health care delivery systems and having a regular source of care. Conclusion: This review provides evidence that health policy initiatives, patient-centered care, and targeted interventions can assist with improving primary care access among the homeless.

Maternal obesity is known to predispose offspring to metabolic and neurodevelopmental abnormalities. While the mechanisms underlying these phenomena are unclear, high fat diets dramatically alter intestinal microbiota, and gut microbiota can impact physiological function. To determine if maternal diet-induced gut dysbiosis can disrupt offspring neurobehavioral function, we transplanted high fat diet- (HFD) or control low fat diet-associated (CD) gut microbiota to conventionally-housed female mice. Recipient mice were then bred and the behavioral phenotype of male and female offspring was tracked. While maternal behavior was unaffected, neonatal offspring from HFD dams vocalized less upon maternal separation than pups from CD dams. Furthermore, weaned male offspring from HFD dams had significant and selective disruptions in exploratory, cognitive, and stereotypical/compulsive behavior compared to male offspring from CD dams; while female offspring from HFD dams had increases in body weight and adiposity. 16S metagenomic analyses confirmed establishment of divergent microbiota in CD and HFD dams, with alterations in diversity and taxonomic distribution throughout pregnancy and lactation. Likewise, significant alterations in gut microbial diversity and distribution were noted in offspring from HFD dams compared to CD dams, and in males compared to females. Regression analyses of behavioral performance against differentially represented taxa suggest that decreased representation of specific members of the Firmicutes phylum predict behavioral decline in male offspring. Collectively, these data establish that high fat diet-induced maternal dysbiosis is sufficient to disrupt behavioral function in murine offspring in a sex-specific manner. Thus these data reinforce the essential link between maternal diet and neurologic programming in offspring and suggest that intestinal dysbiosis could link unhealthy modern diets to the increased prevalence of neurodevelopmental and childhood disorders.

This article examines the nature of price formation and transmission in the Tanzanian coffee price chain. To date, research on the real-world processes of price formation has been scant in economic geography and extant literatures. This article addresses this by focusing on price formation in geographically distant but connected markets, and the interaction between global and local price dynamics. The article employs a new framework that builds on chain and network approaches by integrating concepts from marketization and institutional approaches. The study finds that the world price of coffee has become increasingly volatile as a result of the behavior of international coffee traders and broader shifts in the character of global capital accumulation. It also demonstrates the varying role domestic marketing and local-level institutions play in shaping price formation and cushioning Tanzanian producers from sudden price changes. Finally, the study highlights the role prices, via these local-level institutions, play in extenuating differentiation between producers, creating winners and losers.

Supportive care interventions can improve quality of life and health outcomes of advanced prostate cancer survivors. Despite the high prevalence of unmet needs, supportive care for this population is sparse. The databases PubMed, SCOPUS, CINAHL, and ProQuest were searched for relevant articles. Data were extracted, organized by thematic matrix, and categorized according to the seven domains of the Supportive Care Framework for Cancer Care. The search yielded 1678 articles, of which 18 were included in the review and critically appraised. Most studies were cross-sectional with small, non-diverse samples. Supportive care interventions reported for advanced prostate cancer survivors are limited with some positive trends. Most outcomes were symptom-focused and patient self-reported (e.g., anxiety, pain, self-efficacy) evaluated by questionnaires or interview. Interventions delivered in group format reported improvements in more outcomes. Additional supportive care intervention are needed for men with advanced prostate cancer. Because of their crucial position in caring for cancer patients, nurse scientists and clinicians must partner to research and develop patient-centered, culturally relevant supportive care interventions that improve this population's quality of life and health outcomes. Efforts must concentrate on sampling, domains of needs, theoretical framework, guidelines, and measurement instruments.

This integrative review synthesized baccalaureate minority nursing students' perceptions of their clinical experiences. The diversity of the nursing workforce does not mirror the United States population. Attrition rates of minority nursing students remain higher than rates for White students. Literature examining facilitators and barriers to minority student success predominantly focuses on academic factors, excluding those relevant to clinical education. An integrative review using literature from nursing and education. Three common perceived barriers were identified: discrimination from faculty, peers, nursing staff, and patients; bias in faculty grading practices; and isolation. Although little is known about the relationship between clinical failures and overall attrition, this review provides evidence that minority students encounter significant barriers in clinical education. To increase the diversity of the nursing workforce, faculty must address these issues and make modifications to ensure an equal opportunity at a quality education for all students.

People with spinal cord injury (SCI) face many environmental barriers to community participation. In this article, a community‐based participatory research (CBPR) project that implemented the Photovoice method with 10 individuals with SCI to gather evidence of the environmental factors affecting their participation in the community in and around Charleston, SC, is described. The specific aim of this project was to use Photovoice to create an evidence base of environmental barriers and facilitators to community participation through analysis of data based on the World Health Organization's International Classification of Functioning, Disability and Health taxonomy of environmental factors. Barriers and facilitators were most frequently photographed in the built environment. The participants have started to share their evidence of issues affecting citizens with disabilities with the public and policy makers. The results of this project illustrate that Photovoice is effective in empowering individuals with SCI to address environmental factors affecting their community participation.

Background: In response to the coronavirus disease 2019 (COVID-19) pandemic, elementary and secondary schools in the United States transitioned to remote learning to slow viral spread and protect students and school officials. This move interrupted academic education and school-based health interventions focused on physical activity (PA) and healthy eating behaviors to help combat childhood obesity. Little is known on how these interventions were affected by COVID-19. Methods: This concurrent multimethodological study incorporated two independent components: qualitative descriptive semistructured interviews with public school administrators and quantitative descriptive cross-sectional needs assessment survey of public school personnel. Results: Three themes were identified from interviews with school administrators (N = 28): changes in school-based interventions addressing PA and healthy eating behaviors, changes in academic delivery affecting PA and healthy eating behaviors, and needs of school administrators. From the survey (N = 1311), 635 (48.4%) participants indicated that schools' abilities to address PA and healthy eating behaviors were negatively impacted by COVID-19. The majority (n = 876, 66.8%) of participants strongly agreed or agreed that the pandemic would affect future school-based interventions related to PA and healthy eating behaviors. Conclusions: While schools are prime locations for delivering school-based weight management interventions related to childhood obesity, participants reported the pandemic had overall negative impacts on interventions addressing PA and healthy eating behaviors. Understanding these impacts is essential to adapting school-based interventions to changes from COVID-19 so students may receive health information and access health promotion interventions in remote learning environments and during social distancing.

Patient safety continues to be a major concern for healthcare providers and organizations. Handovers, also called handoffs, serve as the transfer of postoperative care from the anesthesia provider to the postanesthesia care unit (PACU) provider. Ineffective handovers result in gaps in care and potential harm to the patient. We conducted a scoping review to identify key factors affecting patient safety during the process of postoperative handovers. We searched empirical literature examining factors associated with patient safety and postoperative handovers in the context of anesthesia, in the Cumulative Index to Nursing & Allied Health Literature, Ovid, Google Scholar, and The Joint Commission websites between January 2004 and March 2014. We excluded obstetric and cardiac anesthesia-related studies. A total of 31 articles met criteria for inclusion in the review. Factors at multiple levels of the Social Ecological Model affecting patient safety and handovers were identified. Intrapersonal factors included individual communication styles; interpersonal factors were related to anesthesia and to PACU provider team dynamics; organizational environmental factors described the dynamic PACU environment; and organizational policy-level factors included emphasizing a culture of patient safety. This scoping review demonstrates a multilevel analysis of factors affecting handovers and patient safety.Patient safety continues to be a major concern for healthcare providers and organizations. Handovers, also called handoffs, serve as the transfer of postoperative care from the anesthesia provider to the postanesthesia care unit (PACU) provider. Ineffective handovers result in gaps in care and potential harm to the patient. We conducted a scoping review to identify key factors affecting patient safety during the process of postoperative handovers. We searched empirical literature examining factors associated with patient safety and postoperative handovers in the context of anesthesia, in the Cumulative Index to Nursing & Allied Health Literature, Ovid, Google Scholar, and The Joint Commission websites between January 2004 and March 2014. We excluded obstetric and cardiac anesthesia-related studies. A total of 31 articles met criteria for inclusion in the review. Factors at multiple levels of the Social Ecological Model affecting patient safety and handovers were identified. Intrapersonal factors included individual communication styles; interpersonal factors were related to anesthesia and to PACU provider team dynamics; organizational environmental factors described the dynamic PACU environment; and organizational policy-level factors included emphasizing a culture of patient safety. This scoping review demonstrates a multilevel analysis of factors affecting handovers and patient safety.