Priorities For Future Studies Research Articles

Role of Routine Suppressive Antibiotic Therapy After Debridement, Antibiotics, and Implant Retention for Acute Periprosthetic Joint Infections.

The first-line management strategy for acute periprosthetic joint infections (PJIs) is debridement, antibiotics, and implant retention (DAIR). Suppressive antibiotic therapy (SAT) after DAIR is proposed to improve outcomes, yet its efficacy remains under scrutiny. We conducted a multicenter retrospective study in patients with acute PJI of the hip or knee who were treated with DAIR in centers from Europe and the United States. We analyzed the effect of SAT using a Cox model landmarked at 12 weeks. The primary covariate of interest was SAT, which was analyzed as a time-varying covariate. Patients who experienced treatment failure or were lost to follow-up within 12 weeks were excluded from the analysis. The study included 510 patients with 66 treatment failures with a median follow-up of 801 days. We did not find a statistically significant association between SAT and treatment failure (hazard ratio, 1.37; 95% CI, .79-2.39; P = .27). Subgroup analyses for joint, country cohort, and type of infection (early or late acute) did not show benefit for SAT. Secondary analysis of country cohorts showed a trend toward benefit for the US cohort (hazard ratio, 0.36; 95% CI, .11-1.15; P = .09), which also had the highest risk of treatment failure. The utility of routine SAT as a strategy for enhancing DAIR's success in acute PJI remains uncertain. Our results suggest that SAT's benefits might be restricted to specific groups of patients, underscoring the need for randomized controlled trials. Identifying patients most likely to benefit from SAT should be a priority in future studies.

Searching for the critically endangered European eel in oceanic islands: A pioneer study in the freshwater systems of Madeira, Macaronesia

Abstract The globally threatened European eel (Anguilla anguilla) is the only freshwater fish native to Macaronesia. Despite being a keystone species to freshwater habitats, little is known about its population, environmental associations and conservation requirements in oceanic islands. The density and geographical‐related factors influencing the distribution of A. anguilla in the subtropical Archipelago of Madeira (Portugal) were examined. Data on the species occurrence was initially collected using an online survey addressed to citizens. Eels were then sampled through electrofishing in 31 sampling sites along 11 streams on Madeira Island, and eel‐habitat associations were investigated using LMMs and GLMMs. One stream was also sampled in Porto Santo Island. The presence of A. anguilla was confirmed in the two islands of the archipelago with streams (Madeira and Porto Santo). Eels are distributed throughout Madeira Island, being more abundant – particularly small size individual– at lower altitudes (mostly below 150 m). The number of weirs was an important predictor of eel density, suggesting that these flood‐control structures limit their upstream migration. This study represents a pioneer sampling effort of the European eel in Madeira and results provide much‐needed baseline information on the species distribution and related environmental factors in oceanic islands. While most eel research has historically focused on mainland habitats where dams pose a significant threat to eel habitats, our study underscores the critical importance of addressing smaller, often overlooked barriers that may also cause habitat fragmentation. The European eel is a panmictic species, thus, the conservation of the Macaronesian subpopulations can have substantial benefits for its global recovery. A comprehensive investigation of the impact of man‐made obstacles on eel habitat is still needed. Similarly, other common threats such as interactions with non‐indigenous species and infection by Anguillicola crassus should be a research priority in future studies.

Thermal process of a silicon wafer under a CW laser and 100–10000 Hz pulsed laser irradiation

The thermal process of a (001) silicon wafer subjected to a continuous-wave (CW) laser and 100–10000 Hz pulsed laser irradiation is investigated experimentally and numerically. The temperature evolution of the spot center is measured using an infrared radiation pyrometer. The waveforms of the temperature evolution curves provide valuable information about melting, solidification, vaporization, and fracture. To gain a better understanding of the thermal process, a three-dimensional finite element model is established, and numerical simulations are conducted to analyze the temperature, stress, and dislocation field. The results show that the 10 kHz laser exhibits the highest heating efficiency before vaporization, but the lowest ablation efficiency after vaporization due to the shielding effect of vapor. The diffusion time of vapor is found to be more than 50 µs. Fracture occurs during 1 kHz laser irradiation. The motion of liquid may play a significant role, but it cannot be evidenced by a simulation due to complex dependence of material parameters on dislocation. This issue should be addressed as a priority in future studies.

Documentation of commercial and subsistence hunting of Critically Endangered black-and-white ruffed lemurs (Varecia variegata) in northeastern Madagascar

Hunting of wild animals for meat and habitat loss are the main drivers of wildlife population decline around the world, and in tropical regions in particular. While Madagascar is a hotspot for biodiversity, hunting is widespread, mostly in form of subsistence hunting, while hunting for the pet trade is less often reported.We studied hunting of the Critically Endangered black-and-white ruffed lemur (Varecia variegata) in northeastern Madagascar. Using lemur surveys (102.7 km survey effort) and 54 semi-structured and seven key informant interviews, we assessed the local knowledge, hunting pressure, and the perceived and actual abundances of V. variegata in two hunting and two non-hunting villages.V. variegata was well known (> 83%) by the respondents but abundance estimates differed significantly between hunting and non-hunting villages, with 26% and 77% of respondents, respectively, estimating a high abundance of ruffed lemurs in the adjacent forests of the villages. Actual observations of V. variegata also differed strongly, in accordance to perceived abundances. Hunting was either done by trapping animals or by pursuit hunts. In both hunting villages, adult lemurs were used for direct meat consumption and juveniles for rearing for the later trade. Hand-raised V. variegata were reported to be sold for 38–71 USD on regional markets or ‘delivered’ directly to buyers.While wildlife hunting has been widely reported from all over Madagascar, commercial hunting, hand-rearing and trading adds a new dimension of threat towards these Critically Endangered lemurs. As such, the extent of the trade is a priority for future studies.

Genetically predicted gut microbiome and risk of oral cancer.

Mounting evidence suggests a possible link between gut microbiome and oral cancer, pointing to some potential modifiable targets for disease prevention. In the present study, Mendelian randomization (MR) was used to explore whether there was a causal link between gut microbiome and oral cancer. The single nucleotide polymorphisms (SNPs) significantly associated with gut microbiome were served as instrumental variables. MR analyses were performed using genetic approaches such as inverse variance weighting (IVW), MR Egger and weighted median, with IVW as the primary approach, supplemented by MR Egger and weighted median. Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) and MR-Egger regression were used to detect the presence of horizontal pleiotropy and identify outlier SNPs. Causal effect estimates indicated that genetically predicted abundance of Prevotellaceae was associated with higher risk of oral cancer (odds ratio (OR) 1.80, 95% confidence interval (CI) 1.16-2.81, p = 0.009). There was no evidence of notable heterogeneity and horizontal pleiotropy. Genetically derived estimates suggest that Prevotellaceae may be associated with the risk of oral cancer. Such robust evidence should be given priority in future studies and explore the underlying mechanisms.

Using mHealth for Primary Prevention of Dementia: A Proof-of-Concept Study on Usage Patterns, Appreciation, and Beliefs and Attitudes Regarding Prevention.

Health- and lifestyle factors account for a substantial part of all dementia cases, which opens the opportunity for primary prevention. However, the required behavioral change is complex and involves targeting multiple risk factors. mHealth interventions can potentially contribute to improving motivation in a low-cost and scalable way. To explore usage patterns, appreciation, and beliefs and attitudes regarding dementia risk reduction during the use of the MyBraincoach mobile app. Participants were community-dwelling middle-aged adults from the Netherlands and used either the standard (education) or extended (education+motivational triggers) app version for three months. Two panel studies were combined in this paper. Chi-square tests, t-tests and linear mixed models were used, adjusted for age, sex, and education. Of all participants (n = 299, 50.2% male), 167 (55.9%) had installed the app. The most reported reason for non-use was technical problems (47%). Those who used the app were at baseline already more positive about dementia risk reduction than those who did not use the app. Of all users who completed the evaluation (n = 102), 78.4% (n = 80) stated that the app provided a positive approach towards brain health and 80.4% (n = 82) felt better informed. Younger (<60y) and lower educated participants evaluated the app most positively. Usage of the app was low, but users showed more positive beliefs and attitudes regarding dementia risk reduction. Most users evaluated the app positively and stated to have gained knowledge on the topic. Improving the use of the app must keep high priority in future studies.

Ecological impacts of invasive ecosystem engineers: A global perspective across terrestrial and aquatic systems

Abstract In both terrestrial and aquatic ecosystems, invasive species are a major driver of global change that is increasing in scope and impact due to the increase in global trade, habitat modification and climate change. Among invasive species, those that are known as ‘ecosystem engineers’ are considered a specific, highly influential, type of invaders, where an invader significantly alters the new environment, either physically or chemically. In this context, this perspective review discusses the different types of possible impacts of invasive ecosystems engineers (IEE) in terrestrial, freshwater, and marine ecosystems. Scanning the relevant literature on the topic, we find a 12‐year lag in the use of terms relevant to the concept of ecosystem engineers in invasion‐related publications since the first publication of the concept in 1994, with a steep increase in use between 2006 and 2014. A bibliometric mapping showed a high level of connectedness between related terms and clusters, suggesting an ample flow of concepts, ideas and knowledge between realms, ecosystems and regions, and researchers that study them. Throughout this essay, we illustrate with recent examples the context‐dependency of their (positive and negative) impacts in the three realms. We review the distinction between autogenic (altering the environment for other species with their body) and allogenic (altering the environment for other species with their actions) ecosystem engineering in the context of alien species. We also put a spotlight on the well‐studied engineering effects of IEE plants and macroalgae, terrestrial and aquatic bioturbators and burrowers as well as highly effective consumers. We finalize with discussing how IEE can strongly affect ecosystem services for human wellbeing and explore the possible contribution of IEE in restoring functions and services in the face of climate change in highly invaded and fast‐warming systems like the southeastern Mediterranean Sea or areas that face frequent fires for example. We claim that the last topic has received little attention from the scientific community and should be given priority in future studies. Read the free Plain Language Summary for this article on the Journal blog.

Drawdown, Habitat, and Kokanee Populations in a Western U.S. Reservoir

AbstractGreater drought frequency and severity due to climate change will result in greater drawdown of water storage reservoirs. However, changes to oxythermal regimes due to drawdown are reservoir specific and interface with fish species‐specific habitat requirements, producing varying effects on coldwater fish populations. We examined the effect of drawdown on the oxythermal habitat and relative abundance of kokanee Oncorhynchus nerka, a coldwater salmonid, in Island Park Reservoir on the Henrys Fork of the Snake River, Idaho. A measure of relative kokanee abundance was negatively, exponentially related to drawdown. Oxythermal patterns measured in the reservoir during 2021, a severe drought year, revealed that drawdown reduced kokanee habitat by increasing water temperatures and decreasing dissolved oxygen concentrations. Oxythermal refugia for kokanee appeared to relate to inflow from the spring‐fed Henrys Fork and other groundwater inflows. However, we did not quantify groundwater flow or connections, and we did not study kokanee population demographics or mortality. Reducing these sources of uncertainty is a priority for future study. Still, our study highlights a potential mechanism connecting reservoir drawdown to fish populations and the unique yet predictable mechanisms by which reservoir drawdown interacts with reservoir morphometry to affect fish habitat availability.

Comprehensive understanding and rational regulation of microenvironment for gas‐involving electrochemical reactions

AbstractSubstantial progress has been made in the understanding of gas‐involving electrochemical reactions recently for the sake of clean, renewable, and efficient energy technologies. However, the specific influence mechanism of the microenvironment at the reaction interface on the electrocatalytic performance (activity, selectivity, and durability) remains unclear. Here, we provide a comprehensive understanding of the interfacial microenvironment of gas‐involving electrocatalysis, including carbon dioxide reduction reaction and nitrogen reduction reaction, and classify the factors affecting the reaction thermodynamics and kinetics into gas diffusion, proton supply, and electron transfer. This categorization allows a systematic survey of the literature focusing on electrolyzer‐level (optimization of the device, control of the experimental condition, and design of the working electrode), electrolyte‐level (increase of gas solubility, regulation of proton supply, and substitution of anodic reaction), and electrocatalyst‐level strategies (promotion of gas affinity, adjustment of hydrophobicity, and enhancement of conductivity), aiming to retrieve the correlations between the microenvironment and electrochemical performance. Finally, priorities for future studies are suggested to support the comprehensive improvement of next‐generation gas‐involving electrochemical reactions.

Deciphering Electrolyte Selection for Electrochemical Reduction of Carbon Dioxide and Nitrogen to High‐Value‐Added Chemicals

AbstractElectrochemical reduction of CO2 (CO2RR) and nitrogen (NRR) constitute alternatives to fossil fuel‐based technologies for the production of high‐value‐added chemicals. Yet their practical application is still hampered by the low energy and Faradaic efficiencies although numerous efforts have been paid to overcome the fatal shortcomings. To date, most studies have focused on designing and developing advanced electrocatalysts, while the understanding of electrolyte, which would significantly influence the reaction microenvironment, are still not enough to provide insight to construct highly active and selective electrochemical systems. Here, a comprehensive review of the different electrolytes participating in the CO2RR and NRR is provided, including acidic, neutral, alkaline, and water‐in‐salt electrolyte as aqueous electrolytes, as well as organic electrolyte, ionic‐liquids electrolyte, and the mixture of the two as non‐aqueous electrolytes. Through the discussion of the roles of these various electrolytes, it is aimed to grasp their essential function during the electrochemical process and how these functions can be used as design parameters for improving electrocatalytic performance. Finally, priorities for future studies are suggested to support the in‐depth understanding of the electrolyte effects and thus guide efficient selection for next‐generation gas‐involving electrochemical reactions.

Storylines, metaphors, and solutions in the work-readiness literature: A frame analysis

AimTo investigate how the literature frames the reported poor work-readiness of new graduate nurses and the solutions it recommends. DesignCritical frame analysis of work-readiness literature storylines. MethodsDeductive and inductive analysis of work-readiness literature published 2016–2019. ResultsThe three systematic reviews, literature review, and analysis of transition guidelines reinforced the belief that nursing graduates should be work-ready. In addition, the articles summarized service and academic innovations intended to assist newly qualified nurses transition to practice. ConclusionThe literature attributes perceived graduates' poor work-readiness to divergent faculty and employer expectations, personal deficiencies, defective learning environments, and poor workplace support. Internships, mentorship, academic-service partnerships, and curricular and pedagogical innovation are the dominant recommendations for reform. Workplace clinical education and training are not mechanisms for correcting graduates' work performance but essential activities for sustaining the nursing workforce. ImpactThe study should encourage more use of frame analysis in nursing education research. Fact-checking storylines must be a priority for future studies. Research that clarifies the fault lines between advocates of work-readiness and dissident academic leaders has the potential to promote dialogue. Work-ready, theory-gap, and other deficit metaphors must be put aside for the debate because universities must not relinquish their responsibility for educating students for the 21st century.

Subjective socioeconomic status: An indicator of intimate partner violence in middle-aged adults in Hong Kong.

Intimate partner violence (IPV) has recently been recognised as a global public health issue that can cause various kinds of long-lasting physical, sexual and psychological health problems. Limited studies are available concerning the relationship between objective and subjective socioeconomic status (SES) and IPV, and the impact of experiencing IPV on health consequences. This is a cross-sectional study aiming to examine the association between objective and subjective SES as risk factors of IPV, and further investigate how they affect health status in adults who experienced IPV. A total of 400 participants were recruited from June to September 2016 among 18 districts in Hong Kong. Results from multiple linear regression showed that having a higher education (adjusted B [aB]=0.22, 95% CI=0.01, 0.45), having lower levels of subjective SES (aB=-0.08, 95% CI=-0.15, -0.01), experiencing childhood stress (aB=0.58, 95% CI=0.27, 0.89) and being married (aB=0.60, 95% CI=0.01, 1.19) were significantly associated with IPV. While employment and household income were not associated with IPV. Participants with higher levels of subjective SES were more likely to report somatic symptom (aB=-0.44, 95% CI=-0.87, -0.02), anxiety (aB=-0.38, 95% CI=-0.72, -0.04) and depressive symptom (aB=-0.52, 95% CI=-0.94, -0.10). Low subjective SES, instead of low objective SES, was found associated with IPV in Chinese adults. A priority for future studies is the confirmation and expansion of subjective SES and its function in clinical measures. Programmes instilling hope and optimism will be helpful to enhance subjective SES and boost physical and mental well-being in IPV survivors.

The Entreprenuerial Marketing: Concept, Nature And Orientations

Entrepreneurial Marketing is the old and untouched, unfocussed Entrepreneurship and Marketing topic. Its research is has started around 30 years old. The purpose of this paper is to discuss the Evolution and the Nature of Entrepreneurial Marketing, Historical perspective of the Evolution of EM and Six core dimensions of entrepreneurial marketing are identified. The Research aims to focus on the Marketing Orientation as well as Entrepreneurial Orientations in Venture Creation and Management. A comprehensive assessment of the most representative publications from worldwide marketing and entrepreneurial journals was employed in this conceptual study. This study provides a brief overview of the evolution of EM as well as an examination of the most frequent definitions. Insights are drawn from a variety of sources, including corporate entrepreneurship, innovation and new product creation, creative leadership, and change management research. Entrepreneurial marketing's intellectual substance and validity are assessed. Priorities for future study are offered, as well as consequences for theory development, training, and management practice

The impact of diabetes on young transplant recipients: An American perspective.

Our study aims to demonstrate the impact of diabetes, types I and II, on American young adults (18-40 years old) requiring kidney transplantation. Using the United Network for Organ Sharing database, we conducted a population cohort study that included all first-time, kidney-only transplant recipients during 2002-2019, ages 18-40 years old. Patients were grouped according to indication for transplant. Primary outcomes were cumulative all-cause mortality and death-censored graft failure. Death-censored graft failure and patient survival at 1, 5, and 10 years were calculated via the Kaplan-Meier method. Multivariate Cox regression was used to assess for potential confounders. Of 42 466 transplant recipients, 3418 (8.1%) had end-stage kidney disease associated with diabetes. At each time-point, cumulative mortality was higher in diabetics compared to patients with non-diabetic causes of renal failure. Conversely, cumulative graft failure was similar between the groups. Adjusted hazard ratios for all-cause mortality and graft failure in diabetics were 2.99 (95% CI 2.67-3.35; p < .01) and 0.98 (95% CI 0.92-1.05, p < .01), respectively. Diabetes mellitus in young adult kidney transplant recipients is associated with a nearly three-fold increase in mortality, reflecting a relatively vulnerable patient population. Identifying the underlying causes of poor outcomes in this population should be a priority for future study.

Single enrichment systems possibly underestimate both exposures and biological effects of organic pollutants from drinking water

Comprehensive enrichment of contaminants in drinking water is an essential step for accurately determining exposure levels of contaminants and testing their biological effects. Traditional methods using a single absorbent for enriching contaminants in water might not be adequate for complicated matrices with different physical-chemical profiles. To examine this hypothesis, we used an integrated enrichment system that had three sequential stages-XAD-2 resin, poly (styrene–divinylbenzene) and activated charcoal to capture organic pollutants and disinfection by-products (DBPs) from drinking water in Shanghai. Un-adsorbed Organic Compounds in Eluates (UOCEs) named UOCEs-A, -B, and-C following each adsorption stage were determined by gas chromatography-mass spectrometry to evaluate adsorption efficiency of the enrichment system. Meanwhile, biological effects such as cytotoxicity, effects on reactive oxygen species (ROS) generation and glutathione (GSH) depletion were determined in human LO2 cells to identify potential adverse effects on exposure to low dose contaminants. We found that poly-styrene–divinylbenzene (PS-DVB) and activated charcoal (AC) could still partly collect UOCEs-A and-B that the upper adsorption column incompletely captured, and that potential carcinogens like 2-naphthamine were present in all eluates. UOCEs-A at (1–4000), UOCEs-B at (1000–4000), and UOCEs-C at (2400–4000) folds of the actual concentrations had significant cytotoxicity to LO2 cells. Additionally, ROS and GSH change in cells treated with UOCEs indicated the potential for long-term effects of exposure to some mixtures of contaminants such as DBPs at low doses. These results suggested that an enriching system with a single adsorbent would underestimate the exposure level of pollutants and the biological effects of organic pollutants from drinking water. Effective methods for pollutants’ enrichment and capture of drinking water should be given priority in future studies on accurate evaluation of biological effects exposed to mixed pollutants via drinking water.

Risk Factors of Shoulder and Elbow Injuries in Baseball: A Scoping Review of 3 Types of Evidence.

Background:Shoulder and elbow overuse injuries are the most common problems in baseball players. No scoping review has compared the findings from different types of evidence.Purpose:To map the broad evidence from 3 types of evidence (epidemiological, biomechanical, and narrative) on potential risk factors for shoulder and elbow injuries in baseball and identify gaps in the existing literature to guide future research.Study Design:Scoping review.Methods:Eight electronic databases were searched from inception to May 14, 2020. Any peer-reviewed papers that investigated or discussed potential risk factors for shoulder and elbow injuries in baseball were included.Results:A total of 302 studies (107 epidemiological studies, 85 biomechanical studies, and 110 narrative reviews) were included. Risk factors were categorized into 9 domains: sports profiles, physical characteristics/functions, pitching mechanics, performance, behavioral, psychosocial, biological and developmental, injury/sports profiles, and environmental factors. Studies were consistent in supporting limited shoulder range of motion (ROM) and player positions (pitchers or catchers) as risk factors for shoulder injuries. For elbow injuries, the majority of the included studies suggested that being pitchers or catchers and working with higher ball velocity can be risk factors.Conclusion:Findings were consistent in some risk factors, such as limited shoulder ROM and positions. However, findings were inconsistent or limited for most factors, and substantial research gaps were identified. Research assessing those factors with inconsistent or limited evidence in the current literature were recognized to be priorities for future studies.

Exploring health coaching and mindfulness as levers for transformation in health: stakeholder perspectives.

Health coaching (HC) and mindfulness (MFN) are proven interventions for mobilizing patients' inner resources and are slowly being integrated into public primary care. Since 2015 the medical community in Gibsons BC has integrated physician-led HC and MFN-based programs into team-based care. This exploratory study aimed to understand the mechanisms by which these rural programs helped both patients and clinicians, and to elicit priorities for future study in these fields. Using a qualitative participant-engaged constructivist approach in focus groups and large-group graphic facilitation, we elicited perspectives from patients and their physicians during a 1-day event held in September 2018. Thematic analysis of transcripts using Nvivo identified emergent themes that were regularly reviewed with coresearchers, and member checked with participants via online videoconferences held at 6 weeks and 4 months postevent. We identified six main themes relating to the successful implementation of these programs: (i) accessibility and affordability, (ii) offering a toolbox of practical skills, (iii) providing attuned and openhearted care, (iv) generating hope and self-efficacy, (v) experiencing a shared humanity and connection, and (vi) addressing the health of the whole person. These themes highlight critical qualities of HC and MFN programs when implemented in a Medicare system. Key features include reducing stigma around mental health through making programs physician-led and a natural part of primary care, enriching accessibility through public funding, and enhancing patient agency through cultivating embodied awareness, self-compassion, and interpersonal skills. These themes inform the next steps to support upscaling these programs to other communities.

Different rates of pollen and seed gene flow cause branch‐length and geographic cytonuclear discordance within Asian butternuts

Summary Topological cytonuclear discordance is commonly observed in plant phylogenetic and phylogeographic studies, yet few studies have attempted to detect two other forms of cytonuclear discordance (branch length and geographical) and to uncover the causes of the discordance.We used the whole nuclear and chloroplast genome data from 80 individual Asian butternuts to reveal the pattern and processes of cytonuclear discordance.Our findings indicate that the chloroplast genome had substantially deeper divergence (branch‐length discordance) and a steeper cline in the contact zone (geographic discordance) compared with the nuclear genome. After various hypothesis have been tested, the results suggest that incomplete lineage sorting, positive selection and cytonuclear incompatibility are probably insufficient to explain this pattern. However, isolation‐by‐distance analysis and gene flow estimation point to a much higher level of gene flow by pollen compared with by seeds, which may have slowed down lineage divergence and mediated wider contact for nuclear genome compared with the chloroplast genome.Altogether, this study highlights a critical role of sex‐biased dispersal in causing discordance between the nuclear and plastid genome of Asian butternuts. Given its ubiquity among plants, asymmetric gene flow should be given a high priority in future studies of cytonuclear discordance.

Racial/Ethnic Differences in Stress, Coping, and Distress Among Mothers With a Child in the ICU.

Having a child in the intensive care unit (ICU) is a stressful event that can cause negative mental health outcomes for parents, but little is known about the experience of parental stress among members of racial/ethnic minority groups. To examine the stress and coping process in a racially/ethnically diverse sample of mothers of a child who was acutely admitted to an ICU. Participants (N = 103) completed a cross-sectional self-report survey; 86.4% completed it within a week of their child's ICU admission. Analysis of variance was used to examine racial/ethnic differences in perceived ICU-related stressors, coping behaviors, and distress level. Linear regression was used to examine the moderating effects of race/ethnicity on the relationships between stressors, coping behaviors, and distress. Mothers across racial group experienced similar stressors during the acute phase of their child's ICU admission. African American mothers reported greater overall use of coping behaviors, particularly avoidance coping, and experienced higher levels of distress than did Hispanic or non-Hispanic White mothers. Hispanic mothers experienced the least distress. The interaction of race/ethnicity and emotion-focused coping moderated the stress and coping process. Racial and ethnic diversity in sampling should be a priority in future studies of the stress and coping process of mothers with a child in an ICU. Critical care nurses should minimize known stressors for these mothers and encourage and support their preferred coping behaviors, recognizing that these may differ across racial/ethnic groups.

Correlates of protection from SARS-CoV-2 infection

Correlates of protection from SARS-CoV-2 infection