Demographic Trends in Boston: Some Implications for Municipal Services

The City of Boston is gaining in population during the 1980s, after several decades of loss. During the current decade and beyond, population trends will bring increases in the number of children, adults between the ages of twenty-five and forty-four, and those aged seventy-five and over, along with declines among the older teenagers and college-age population, the more mature adults, and the younger elderly. A recent analysis of the income distribution indicates that while there were more well-to-do residents in Boston in 1985 than there were in 1980, there were also more poor and near poor. Average family income has declined in real terms during this five-year period, whereas it has increased for unrelated individuals. Minorities, children, and the elderly are more likely to be living in poverty than other segments of the population. Related to this, single-parent families and those who live alone contribute the largest share of families and unrelated individuals in poverty. The implications of these trends for two areas of municipal services — health care and education — are examined, because these services are especially responsive to demographic pressures. Data on health insurance coverage cite the need of the poor for health services. This need might be met by rebuilding Boston City Hospital or by alternative health insurance coverage plans. Among Boston\u27s public school children, a high proportion lack strong economic and familial support systems. The schools need to assess the extent to which, within the constraints of a limited budget, they can serve the very needy and those who seek a high-quality education

My Life as a Woman : Editing the World; and, Liberal Catholicism Reexamined

Margaret O\u27Brien Steinfels recounts her story as a woman in a high role in the workplace and the Catholic sphere. She highlights the supposed desire of American Catholics for a women\u27s revolution in many aspects of Catholic life and the Church\u27s response to such stances and voices. Peter Steinfels argues for an emergence and prominence in liberal Catholicism as a heroic stance to take amid the pains of the Church and of the world.https://ecommons.udayton.edu/uscc_marianist_award/1014/thumbnail.jp

Creation and Implementation of a Pediatric Advanced Practice Nurse Critical Care Fellowship Program

Advanced practice registered nurses (APRNs) who begin their careers in the pediatric intensive care unit (PICU) may be challenged in this practice environment. Inadequate prior experience as a staff nurse, limited opportunities for clinical placements in the PICU during graduate education, and being in a fast-paced, high-acuity practice environment without prior exposure to critically ill children are practice challenges in the PICU setting. The goal of postgraduate education training programs (fellowship programs) for the acute care pediatric nurse practitioner (ACPNP) is to prepare students to become beginner practitioners who can function effectively in the acute care setting within a few months of being hired, much like that of their physician counterparts who complete a fellowship. The health care environment continues to be influenced by trends in national health care reform, shifts in the models for physician training, and the Accreditation Council for Graduate Medical Education resident duty hour restrictions. These emerging trends have given health care organizations the opportunity to evaluate their current care delivery and training models. It is expected that the demand for APRNs with specialty training will increase. The aim of this article is to describe our experience in the creation and implementation of a critical care pediatric nurse practitioner (CCPNP) fellowship training program at a large midwestern U.S. tertiary care center. It is expected that the demand for APRNs with specialty training will increase. When this fellowship was created, there were no known fellowships available for pediatric nurse practitioners (PNPs) interested in pediatric critical care. To meet the needs of these providers, a focused training program is required to provide specific preparation and competencies to practice to the full extent of the provider\u27s license. A recent recommendation is for health care administrators to consider implementing fellowship training programs to assist nurse practitioners transitioning into specialty roles (Kells, Dunn, Melchiono, & Burke, 2015). We used several online search engines to identify pediatric health care institutions with active advanced practice provider postgraduate fellowships. Our search in June 2017 identified fellowship programs in primary care, pediatric hematology/oncology, palliative care, neuro-critical care, and urgent care/emergency department. To our knowledge, this fellowship program was the first of its kind and seeks to provide postgraduate specialty training and education focused on the unique requirements of critically ill children and their families to help fill a knowledge gap when entering practice in this highly specialized practice environment

Implementation of a Quit Smoking Programme in Community Adult Mental Health Services–A Qualitative Study

Little is known about the experiences of people with severe mental health difficulties in smoking cessation interventions. This study aimed to review the implementation of a smoking cessation programme across 16 community mental health day services. The aim was to establish the experience from both service user and facilitator perspectives and refine implementation for future groups. In-depth interviews were conducted with 20 service users and four focus groups held with 17 facilitators. Thematic analysis was used to analyse the data for emergent themes in relation to key enablers and barriers to implementation. Data from service users and facilitators revealed that implementation was enabled by an open and engaged recruitment approach; the resourcefulness of facilitators; programme materials and group-based format; combining the cessation programme with other and broader health initiatives; and participants\u27 motivations, including health and money. Barriers included the structure of the service; the lack of a joined-up approach across the health services; literacy issues and the serial/logical process assumed by the programme. Barriers perceived as more specific to those with mental health difficulties included the use of smoking as a coping mechanism, lack of alternative activities/structure and lack of consistent determination. The tobacco free policy, implemented shortly before the programme, interestingly emerged as both a barrier and an enabler. In conclusion, although this group-based cessation programme in community mental health settings was well-received overall, a number of key barriers persist. A joined-up approach which addresses the culture of smoking in mental health settings, inconsistencies in smoking policies, and provides consistent cessation support, is needed. Care needs to be taken with the timing as overall it may not be helpful to introduce a new smoking cessation programme at the same time as a tobacco free policy

ecocomDP: A flexible data design pattern for ecological community survey data

The idea of harmonizing data is not new. Decades of amassing data in databases according to community standards - both locally and globally - have been more successful for some research domains than others. It is particularly difficult to harmonize data across studies where sampling protocols vary greatly and complex environmental conditions need to be understood to apply analytical methods correctly. However, a body of longterm ecological community observations is increasingly becoming publicly available and has been used in important studies. Here, we discuss an approach to preparing harmonized community survey data by an environmental data repository, in collaboration with a national observatory. The workflow framework and repository infrastructure are used to create a decentralized, asynchronous model to reformat data without altering original data through cleaning or aggregation, while retaining metadata about sampling methods and provenance, and enabling programmatic data access. This approach does not create another data ‘silo’ but will allow the repository to contribute subsets of available data to a variety of different analysis-ready data preparation efforts. With certain limitations (e.g., changes to the sampling protocol over time), data updates and downstream processing may be completely automated. In addition to supporting reuse of community observation data by synthesis science, a goal for this harmonization and workflow effort is to contribute these datasets to the Global Biodiversity Information Facility (GBIF) to increase the data’s discovery and use

Genetic and Phylogenetic Divergence of Feline Immunodeficiency Virus in the Puma (Puma concolor)

Feline immunodeficiency virus (FIV) is a lentivirus which causes an AIDS-like disease in domestic cats (Felis catus). A number of other felid species, including the puma (Puma concolor), carry a virus closely related to domestic cat FIV. Serological testing revealed the presence of antibodies to FIV in 22% of 434 samples from throughout the geographic range of the puma. FIV-Pco pol gene sequences isolated from pumas revealed extensive sequence diversity, greater than has been documented in the domestic cat. The puma sequences formed two highly divergent groups, analogous to the clades which have been defined for domestic cat and lion (Panthera leo) FIV. The puma clade A was made up of samples from Florida and California, whereas clade B consisted of samples from other parts of North America, Central America, and Brazil. The difference between these two groups was as great as that reported among three lion FIV clades. Within puma clades, sequence variation is large, comparable to between-clade differences seen for domestic cat clades, allowing recognition of 15 phylogenetic lineages (subclades) among puma FIV-Pco. Large sequence divergence among isolates, nearly complete species monophyly, and widespread geographic distribution suggest that FIV-Pco has evolved within the puma species for a long period. The sequence data provided evidence for vertical transmission of FIV-Pco from mothers to their kittens, for coinfection of individuals by two different viral strains, and for cross-species transmission of FIV from a domestic cat to a puma. These factors may all be important for understanding the epidemiology and natural history of FIV in the puma