Person-centered older military veteran care when there are consequences

The consequences of each war present themselves in many ways and differently within a veteran's lifetime. For civilian nurses to give applicable, vital care to the older veteran, they need to deeply appreciate the military culture, the strength of the ethos, as well as the various health concerns connected with the individual war/conflict. Attentiveness to the evolving health issues of older veterans are a priority at a time when many personal developmental changes are also creating life stressors for the Vietnam veterans and they are often presenting to civilian health facilities for their care. This article explores the controversial war within Vietnam (1955-1973), and the use of the universal question of "Have you ever served in the military?" An incremental veteran health assessment is discussed in order to care for the specific, prior-era physical/behavioral issues of post-traumatic stress disorder, Agent Orange, military sexual trauma, hepatitis C, and homelessness that are discussed for these men and women veterans, along with a rationale for their long-term presence, which is still evident today. Other relevant nursing interventions for veterans are suggested such as reminiscing, and art/animal-assisted therapy to supplement their medical care.

Returning enlisted veterans-upward (to) professional nursing: not all innovative ideas succeed

Military licensed vocational nurses (LVNs) provide nursing care for the ill, injured, convalescent, or disabled persons. Those who have deployed both for humanitarian and wartime situations have a tremendous experiential base in stabilization of life-threatening frontline injuries and critical care intense facilities. An educational program was created called Returning Enlisted Veterans-Upward (to) Professional Nursing for retired/discharged U.S. Army LVNs to acknowledge their special military education and experiences. This educational model represented one step in the right direction to increase men and minorities in the professional nursing workforce, yet the program had to be dissolved. "Lessons learned" are presented so others might consider a similar project.

Creating and launching. Innovative nursing education programs: perils and pearls

Nursing's future depends on continuing to seek, create, and launch innovative nursing programs. Successful innovation can improve nursing education delivery and make optimal use of available resources while tapping into the imagination and creativity of faculty and students; in addition, it can create an optimistic environment and encourage beneficial change with the faculty and staff. Innovation has been described as an art, a process of diffusion, and a process of transforming ideas into real value. The purpose of this article is to explore the concepts surrounding innovation, steps in development of an innovation, and share pearls, perils, and lessons learned so that others can explore the process within their nursing education programs.

Transformacion Para Salud: a patient navigation model for chronic disease self-management

Increased cost of chronic illnesses in United States is an urgent call to develop a cost effective approach to improve chronic disease self-management, especially among vulnerable populations. An emerging role for professionals and paraprofessionals is the patient navigator. We present an example of a conceptual framework, Transformation for Health, developed to underpin the training of certified community health workers (CHW) to deliver health care, preventive services, and health education for underserved populations to promote chronic disease self-management. Transformacion Para Salud (TPS), a patient navigation model for chronic disease self-management, was a two year demonstration program to develop a culturally sensitive intervention to facilitate patient behavior changes. Patients involved in the TPS intervention showed improvements in clinical and behavioral outcomes after twelve months of intervention. This article describes the conceptual basis and implementation of the TPS and discusses program evaluation, specific intervention outcomes, and implications for practice. Use of CHWs in the patient navigator role demonstrated a cost effective method to improve access to quality, cost-effective, primary health care services as well as to facilitate chronic disease self-management.

Effective Vaccination Policies

We present a framework for modeling the spread of pathogens throughout a population and generating policies that minimize the impact of those pathogens on the population. This framework is used to study the spread of human viruses between cities via airplane travel. It combines agent-based simulation, mathematical analysis, and an Evolutionary Algorithm (EA) optimizer. The goal of this study is to develop tools that determine the optimal distribution of a vaccine supply in the model. Using plausible benchmark vaccine allocation policies of uniform and proportional distribution, we compared their effectiveness to policies found by the EA. We then designed and tested a new, more effective policy which increased the importance of vaccinating smaller cities that are flown to more often. This "importance factor" was validated using U.S. influenza data from the last four years.

Transformation for health: a framework for conceptualizing health behaviors in vulnerable populations

Shedding light on the factors and circumstances that operate to bring about marginalization of groups can facilitate appropriate responses to the issue of health disparities among vulnerable groups in society. This is showing to be a seemingly intractable problem; however, it may well be that the approaches currently used to respond to the issues are not appropriate because we overlook the "realties" that really matter: those emanating from the people being visited by these circumstances themselves. Under normal conditions, human behavior can only be controlled by the individual. Facilitating an environment in which an individual can comprehend his or her internal and external realities is the first step toward transformative behavior.

The evolution of simulation and its contribution to competency

Nurse educators are challenged to implement teaching strategies that promote learners' clinical competency and critical-thinking skills. Additionally, these educators are asked to base their curriculum decisions, teaching practices, and evaluation methods on current research findings. Simulation offers a unique mode for experiential learning and evaluation, but the appropriate use of the spectrum of simulation typology requires strategic planning. Although simulation provides educators with new educational opportunities, the potential use of simulation in competency testing cannot be achieved until educators and researchers acquire the knowledge and skills needed to use this education strategy, develop realistic case scenarios, and design and validate standardized and reliable testing methods. Numerous pressures exist for clinical settings to document the competencies of their employees. Simulation could be used in the practice environment to promote and validate the clinical judgment and competency of nurses.

The astrobiology primer: an outline of general knowledge--version 1, 2006

The Astrobiology Primer has been created as a reference tool for those who are interested in the interdisciplinary field of astrobiology. The field incorporates many diverse research endeavors, but it is our hope that this slim volume will present the reader with all he or she needs to know to become involved and to understand, at least at a fundamental level, the state of the art. Each section includes a brief overview of a topic and a short list of readable and important literature for those interested in deeper knowledge. Because of the great diversity of material, each section was written by a different author with a different expertise. Contributors, authors, and editors are listed at the beginning, along with a list of those chapters and sections for which they were responsible. We are deeply indebted to the NASA Astrobiology Institute (NAI), in particular to Estelle Dodson, David Morrison, Ed Goolish, Krisstina Wilmoth, and Rose Grymes for their continued enthusiasm and support. The Primer came about in large part because of NAI support for graduate student research, collaboration, and inclusion as well as direct funding. We have entitled the Primer version 1 in hope that it will be only the first in a series, whose future volumes will be produced every 3-5 years. This way we can insure that the Primer keeps up with the current state of research. We hope that it will be a great resource for anyone trying to stay abreast of an ever-changing field.

'Active' filters for upgrading phosphorus removal from pond systems

This paper investigates limestone and iron slag filters as an upgrade option for phosphorus removal from wastewater treatment ponds. A review of 'active' filter technology and the results from laboratory and field research using packed columns of the different media is presented. It is shown that both limestone and iron slag can remove phosphorus but highlights that different types of limestone give markedly different performance. Filter performance appears to be improved by increasing temperature and by the presence of algae, presumably because of its tendency to elevate pH. Performance is related to hydraulic retention time (HRT), but this relationship is not linear, particularly at low HRTs. Importantly for future research, the results from field-testing with pond effluent show significant differences compared to those obtained when using a synthetic feed in the laboratory. For the iron slag filter, higher performance was observed in the field (72% in field vs. 27% in laboratory, at a 12 hour-HRT), while the opposite was observed for the limestone (64% in laboratory vs. 18% in field, at a 12-hour HRT).

Exciting chaos with noise: unexpected dynamics in epidemic outbreaks

In this paper, we identify a mechanism for chaos in the presence of noise. In a study of the SEIR model, which predicts epidemic outbreaks in childhood diseases, we show how chaotic dynamics can be attained by adding stochastic perturbations at parameters where chaos does not exist apriori. Data recordings of epidemics in childhood diseases are still argued as deterministic chaos. There also exists noise due to uncertainties in the contact parameters between those who are susceptible and those who are infected, as well as random fluctuations in the population. Although chaos has been found in deterministic models, it only occurs in parameter regions that require a very large population base or other large seasonal forcing. Our work identifies the mechanism whereby chaos can be induced by noise for realistic parameter regions of the deterministic model where it does not naturally occur.

Methods for short time series analysis of cell-based biosensor data

This paper describes two approaches for sensing changes in spiking cells when only a limited amount of spike data is available, i.e., dynamically constructed local expansion rates and spike area distributions. The two methods were tested on time series from cultured neuron cells that exhibit spiking both autonomously and in the presence of periodic stimulation. Our tested hypothesis was that minute concentrations of toxins could affect the local statistics of the dynamics. Short data sets having relatively few spikes were generated from experiments on cells before and after being treated with a small concentration of channel blocker. In spontaneous spiking cells, local expansion rates show a sensitivity that correlates with channel concentration level, while stimulated cells show no such correlation. Spike area distributions on the other hand showed measurable differences between control and treated conditions for both types of spiking, and a much higher degree of sensitivity. Because these methods are based on analysis of short time series analysis, they might provide novel means for cell drug and toxin detection.

Efficient cw end-pumped, end-cooled Nd:YVO(4) diode-pumped laser

Using a novel end-pumped, end-cooled geometry, we demonstrated a Nd:YVO(4) cw laser that produces close to 2 W of single-mode output when pumped by a high-brightness 100-mum-core diode fiber source. An optical-optical conversion efficiency of 49% was obtained. Beam quality was found to be nearly diffraction-limited (M(2) = 1.08) and independent of pumping power.

Wound infection rates in dogs and cats after use of cotton muslin or disposable impermeable fabric as barrier material: 720 cases (1983-1989)

A retrospective study involving 720 dogs and cats that underwent a variety of elective surgical procedures was done to compare the effectiveness of reusable cotton barrier materials with that of a commercially available disposable barrier system for prevention of wound infection. The overall wound infection rate, using cotton barrier materials, was 3.1% and for disposable materials, was 4.4%. The difference between groups was not significant.