␤-Defensins are small (3 to 5 kDa in size) secreted antimicrobial and antiviral proteins that are components of innate immunity. ␤-Defensins are secreted by epithelial cells, and they are expressed at high levels in several mucosae, including the mouth, where the concentration of these proteins can reach 100 g/ml. Because of these properties, we wondered whether they could be part of the defenses that lower oral transmission of human immunodeficiency virus (HIV) compared to other mucosal sites. Our data show that select ␤-defensins, especially human ␤-defensin 2 (hBD2) and hBD3, inhibit R5 and X4 HIV infection in a dose-dependent manner at doses that are compatible with or below those measured in the oral cavity. We observed that ␤-defensin treatment inhibited accumulation of early products of reverse transcription, as detected by PCR. We could not, however, detect any reproducible inhibition of env-mediated fusion, and we did not observe any modulation of HIV coreceptors following treatment with hBD1 and hBD2, in both resting and phytohemagglutinin-activated cells. Our data instead suggest that, besides a direct inactivation of HIV virions, hBD2 inhibits HIV replication in the intracellular environment. Therefore, we speculate that ␤-defensins mediate a novel antiretroviral mechanism that contributes to prevention of oral HIV transmission in the oral cavity. Immunohistochemical data on hBD2 expression in oral mucosal tissue shows that hBD2 is constitutively expressed, forming a barrier layer across the epithelium in healthy subjects, while in HIV-positive subjects levels of hBD2 expression are dramatically diminished. This may predispose HIV-positive subjects to increased incidence of oral complications associated with HIV infection.

The purposes of this study were to describe perceptions of managerial leadership behaviors associated with staff nurse turnover and to compare nurse manager leadership behaviors as perceived by managers and their staff nurses. Effective leadership styles among nurse managers have been associated with staff nurse job satisfaction and retention. Although both transformational and transactional leadership styles have been described as effective, it is unclear which nurse manager leadership behaviors contribute most to staff nurse retention. This descriptive, correlational study was conducted at a 465-bed community hospital in the northeastern United States. All staff nurses and nurse managers employed in both ambulatory and acute care nursing units were invited to participate in the study. The study sample comprised 79 staff nurses and 10 nurse managers, who completed demographic forms and the 45-item Multifactor Leadership Questionnaire, which measures 12 dimensions of leadership style. Data were collected from July through September 2003. Active management by exception as perceived by staff nurses was the only managerial leadership style associated with staff nurse turnover (r = .26, p = .03). Compared with the perceptions among their staff nurses, nurse managers consistently perceived that they demonstrated a higher mean frequency of transformational leadership behaviors. The transactional leadership style of active management by exception not only appeared to be a deterrent to staff nurse retention but also reflected leadership perceptions among staff nurses who work evening and night shifts. This study also provides further evidence regarding a trend in which nurse managers and staff nurses do not concur on the frequency of transformational leadership behaviors but do demonstrate agreement on the frequency of transactional leadership behaviors.

Although they are responsible for the operation of business units, nurse managers are often less well prepared to manage the business activities than the clinical activities. Perceptions of nurse managers and nurse executives regarding competencies required for nursing management roles and the educational preparation required to attain them were examined. Results indicate the groups are in basic agreement about required competencies, though nurse managers appear less clear about nurse executive role responsibilities. Nurse executives value the acquisition of a master's degree as essential for nurse manager performance, while fewer nurse managers agree. Strategies nurse executives may employ to develop nurse manager business knowledge include traditional undergraduate and graduate degree programs, online programs, certificate programs, continuing education, inservice education offerings, seminars, and mentoring activities.

Nursing administrators are challenged to recruit and retain staff nurses in the midst of increasing job vacancies and staff nurse turnover rates averaging 21 %. The prevailing issues related to staff nurse recruitment and retention in the current healthcare environment are briefly reviewed as introductory content. The article outlines the case from nursing administration literature that effective leadership styles of nurse managers and nurse administrators enhance staff nurse retention. As nurse administrators continue to struggle with staff nurse recruitment and retention, evidenced-based strategies are discussed that address leader preparation and organizational leadership structure including advanced education, leadership training, and shared leadership models.

The minority status of men in nursing often results in advantages that promote rather than hinder their careers, unlike women in male-dominated professions. Benefits to men in nursing are associated with the desire for personal and professional power and with stereotypes about masculine traits. These stereotypes are initially emphasized in the family and reinforced by the power differences and patriarchal structure that continue to characterize the healthcare industry. These advantages translate into preference in hiring and promotion. Strategies that capitalize on increasing men's awareness of these benefits may be employed to increase the number of men in nursing.

To meet challenges of continuing change in the health care industry and maintain organizational viability in increasingly competitive markets, the use of the registered nurse--unlicensed assistive personnel model is an undeniable reality that fills the void created by the current shortage of nurses and decreases the costs of providing patient care. Although much has been published about the need for nurses to delegate and supervise patient care-related activities, little has been written about the skills needed to do this effectively or how these skills may be learned. Academic and clinical educators must find ways to facilitate the development of delegation and supervision abilities as nurses increasingly work with nonprofessional staff. Continuing education is an effective way for nurses to learn the skills required by changing models of patient care delivery and evolving professional roles.

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