Development Of A Self Directed Learning Program On Arterial Blood Gas Interpretation For The Nursing Profession

The author developed implemented a self-instructional module on Arterial Blood Gas Interpretation for medical and surgical nurses. The program\u27s goal was to provide more accessible continuing education for nurses who identified a need to learn Arterial Blood Gas Analysis. Nurses needed a supplemental learning program to educate them in current nursing practices at their convenience because they could not attend classes. The module contained learner objectives, educational content, learner activities, feedback and pre- and post-instructional measures. Additionally, a survey was used to establish the nurses’ reactions to the curriculum style. Modules were distributed to those nurses who identified a need for review in this area. The program was successful, in that almost double the number of nurses were reached through self-instruction than through traditional classroom settings in a cost-effective and time-saving manner. The author recommended that educators develop modules in other subjects as a supplement to traditional instructional methods. This valuable teaching tool can be shared and implemented throughout the nursing community. Appendices include sample questionnaires, module outline, implementation schedule and test score comparisons

Does Involvement in Healthy Eating Among University Students Differ Based on Exercise Status and Reasons for Exercise?

Background. Unhealthy nutritional habits are a major cause of morbidity and mortality in the US. Research indicates that regular physical activity can influence dietary habits of adults. Purpose. The purpose of this study was to examine whether university students’ involvement in healthy eating differed based on current exercise status and reported reasons for exercising. Methods. A sample of 204 university students completed a 22-item survey on healthy eating and physical activity. Results. Less than 10% met all Food Guide recommendations. The leading barriers to healthy eating were time, convenience and healthy food availability. Less than half exercised on four or more days each week. The leading reasons for exercising were to improve appearance, improve health and lose weight. Being physically active did not have a significant effect on healthy eating, nor did specific reason for exercising. Discussion. Most students did not eat healthy and their physical activity levels did not significantly affect their nutritional habits. Increased awareness campaigns are warranted. Conclusions. Strategies other than physical activity promotion are needed to positively impact students’ healthy eating behaviors. Students should continue to be educated about healthy nutrition and ways to reduce perceived barriers to healthy eating

A Photovoice Project: Urban Elementary Girls’ Perspectives on Physical Activity

Photovoice is a community-based participatory research method where participants can showcase their life experiences through photography. The objective of this study was to have adolescent girls attending an after-school program use photovoice to represent their perceptions of physical activity practices. Photovoice was used to allow adolescent girls to express their perspectives, through photographs and narratives, of their personal and community strengths and concerns related to their involvement in physical activity. The phenomenological methodology was used as a framework for the study. Qualitative analyses were conducted throughout the research process. Constant comparison was used to analyze the focus group, scrapbook data, and notes recorded by the author to determine key themes and ideas. Participants for the study included 14 girls attending a school in an urban area. Benefits of physical activity as provided by the girls in their personal lives and the community included: understanding activity contributed to wellness, increased social opportunities, and the school as a hub of activities. Personal and community barriers to physical activity included: lack of neighbourhood safety, being involved in other sedentary activities, parental rules restricting outside play, outside conditions, personal choices to not exercise, and a lack of opportunity to exercise. Potential ways to increase physical activity among these participants are to create more group games and activities at the after-school program daily. Involving parents in activities with the girls at home may increase physical activity levels while at home

Fragmentation and thresholds in hydrological flow‐based ecosystem services

Loss and fragmentation of natural land cover due to expansion of agricultural areas is a global issue. These changes alter the configuration and composition of the landscape, particularly affecting those ecosystem services (benefits people receive from ecosystems) that depend on interactions between landscape components. Hydrological mitigation describes the bundle of ecosystem services provided by landscape features such as woodland that interrupt the flow of runoff to rivers. These services include sediment retention, nutrient retention and mitigation of overland water flow. The position of woodland in the landscape and the landscape topography are both important for hydrological mitigation. Therefore, it is crucial to consider landscape configuration and flow pathways in a spatially explicit manner when examining the impacts of fragmentation. Here we test the effects of landscape configuration using a large number (>7,000) of virtual landscape configurations. We created virtual landscapes of woodland patches within grassland, superimposed onto real topography and stream networks. Woodland patches were generated with user‐defined combinations of patch number and total woodland area, placed randomly in the landscape. The Ecosystem Service model used hydrological routing to map the “mitigated area” upslope of each woodland patch. We found that more fragmented woodland mitigated a greater proportion of the catchment. Larger woodland area also increased mitigation, however, this increase was nonlinear, with a threshold at 50% coverage, above which there was a decline in service provision. This nonlinearity suggests that the benefit of any additional woodland depends on two factors: the level of fragmentation and the existing area of woodland. Edge density (total edge of patches divided by area of catchment) was the best single metric in predicting mitigated area. Distance from woodland to stream was not a significant predictor of mitigation, suggesting that agri‐environment schemes planting riparian woodland should consider additional controls such as the amount of fragmentation in the landscape. These findings highlight the potential benefits of fragmentation to hydrological mitigation services. However, benefits for hydrological services must be balanced against any negative effects of fragmentation or habitat loss on biodiversity and other services

Intérêt de la tussométrie dans les paralysies laryngées unilatérales

International audienceCough is a physiological gesture witch requires a perfect laryngeal competence. Tussometry was described as a reliable and reproducible method of analysis based on the measure of oral air flow rate during cough. This test allows to quantify the efficiency of laryngeal occlusion in normal situation and in case of unilateral laryngeal paralysis. The measure of the time lag between the beginning of the cough and the maximal air flow rate (peak value time) is the most reliable parameter (Murty G. E., Kelly P. J., Bradley P. J. Tussometry: an objective assessment of vocal cord function. Ann Otol Rhinol Laryngol. 1993;102:743-7). Present study is designed to asses the reproducibility of tussometry realized on a vocal analysis workstation EVA II (r) and to test the efficiency of intracordal injection of autologus fat in case of unilateral laryngeal paralysis following thoracotomy. 10 control subjects were recorded at two moments. 6 patients presenting unilateral laryngeal paralysis following thoracic surgery were recorded before and after injection of autologus fat in the paralysed vocal cord. Reproducibility of tussometry is good (r=0,96). The mean peak value time is significantly improved (p=0.048). In conclusion, tussometry is a reliable routine test on EVA II(r) workstation. Intracordal autologus fat injection improves occlusive function of larynx during cough in case of unilateral paralysis.La toux est un geste physiologique qui nécessite une parfaite compétence laryngée. La tussométrie a été décrite comme un examen fiable et reproductible basé sur la mesure du débit d'air buccal durant la toux. Cet examen permet de quantifier la capacité d'occlusion du larynx en situation normale et en cas de paralysie laryngée unilatérale. La mesure du temps entre le début de la toux et le pic du débit d'air buccal (temps de montée) est l'indice le plus fiable (Murty G. E., Kelly P. J., Bradley P. J. Tussometry: an objective assessment of vocal cord function. Ann Otol Rhinol Laryngol. 1993;102:743-7). Cette étude a pour objectif d'évaluer la reproductibilité de la tussométrie réalisée sur une station d'analyse vocale de type EVA II(r) et de tester l'efficacité de l'injection intracordale de graisse autologue en cas de paralysie laryngée unilatérale post thoracotomie. 10 sujets témoins ont été enregistré à deux instants. 6 patients présentant une paralysie laryngée unilatérale après chirurgie thoracique ont été enregistrés avant et après injection de graisse autologue dans la corde vocale paralysée. La reproductibilité de la tussométrie est bonne (r=0 ,96). La moyenne du temps de montée du débit de pointe est significativement améliorée (p = 0,048). En conclusion, la tussométrie est une examen fiable qui peut être réalisée en routine sur une station EVA II(r). L'injection de graisse intracordale en cas de paralysie laryngée unilatérale permet l'amélioration objective de la fonction occlusive du larynx durant la toux

Control of Stress-Induced Persistent Anxiety by an Extra-Amygdala Septohypothalamic Circuit

The extended amygdala has dominated research on the neural circuitry of fear and anxiety, but the septohippocampal axis also plays an important role. The lateral septum (LS) is thought to suppress fear and anxiety through its outputs to the hypothalamus. However, this structure has not yet been dissected using modern tools. The type 2 CRF receptor (Crfr2) marks a subset of LS neurons whose functional connectivity we have investigated using optogenetics. Crfr2^+ cells include GABAergic projection neurons that connect with the anterior hypothalamus. Surprisingly, we find that these LS outputs enhance stress-induced behavioral measures of anxiety. Furthermore, transient activation of Crfr2^+ neurons promotes, while inhibition suppresses, persistent anxious behaviors. LS Crfr2^+ outputs also positively regulate circulating corticosteroid levels. These data identify a subset of LS projection neurons that promote, rather than suppress, stress-induced behavioral and endocrinological dimensions of persistent anxiety states and provide a cellular point of entry to LS circuitry

An Evaluation of Fitspiration Viewing and Exercise Behavior in College Students

Social media is widely used by college students, and is used for retrieving health information. “Fitspiration” (fitness and inspiration) pages are common on many popular social networking sites. Fitspiration pages have been previously associated with short term motivation for exercise and decreased body satisfaction. The purpose of this study was to explore ways in which viewing fitspiration pages may influence exercise behaviors for college students. Additionally, this study sought to explore if particular types of fitspiration pages can encourage increased exercise. This study utilized a cross-sectional survey approach and was distributed to college students at a large Midwestern university. About half of the students viewed fitspiration pages, and students who viewed fitness pages reported exercising more than those who did not. Students who viewed fitspiration pages also reported exercising for muscle-gain, enjoyment, fitness, reduced stress, and feeling better. CrossFit pages and professional fitness organization pages were associated with increased exercise. Students did not report feeling motivated by fitspiration. Additional research is needed to explore the relationships between fitspiration page viewing and fitness goals, and identify additional reasoning for viewing these pages

Development and Validation of a Global Competency Framework for Preparing New Graduates for Early Career Professional Roles

Objectives: The current objectives include the development of a global competency model applicable across a wide range of jobs, industries, and geographies for university graduates entering the workplace. Method: The competency model was developed utilizing a global panel of subject matter experts and a validation survey of over 25,000 students, faculty, staff, and employers across more than 30 countries. Results: The results showed substantial consistency for the importance and criticality ratings of the competencies, with Achieving Objectives, Analyzing and Solving Problems, Adapting to Change, Communicating Orally, Learning and Self-Development, Making Decisions, Planning and Organizing, and Working Well with Others as the highest-rated competencies across regions, roles, and industries. Conclusions: The most important competencies for students entering the workforce were consistent across different jobs, different industries, and different countries. The diversity and varied experience levels of the sample provide greater generalizability than most competency modeling projects that are often idiosyncratic to specific roles, industries, subjects, or levels. Implication for Theory and/or Practice: University faculty and staff can use the results of the validation study to develop curricula and programs that will be better able to foster important competencies to ensure that their students are better prepared to enter the workplace. Although some organizations emphasize leadership as important for all professional employees, Managing the Work of Others, Leading Others, and Influencing Others were consistently rated lower in importance by employers across all roles and regions and may not be appropriate as the primary focus of skill development for new graduates

Viewpoint: Evaluating the impact of malaria control efforts on mortality in sub-Saharan Africa

OBJECTIVE To describe an approach for evaluating the impact of malaria control efforts on malaria-associated mortality in sub-Saharan Africa, where disease-specific mortality trends usually cannot be measured directly and most malaria deaths occur among young children. METHODS Methods for evaluating changes in malaria-associated mortality are examined; advantages and disadvantages are presented. RESULTS All methods require a plausibility argument - i.e., an assumption that mortality reductions can be attributed to programmatic efforts if improvements are found in steps of the causal pathway between intervention scale-up and mortality trends. As different methods provide complementary information, they can be used together. We recommend following trends in the coverage of malaria control interventions, other factors influencing childhood mortality, malaria-associated morbidity (especially anaemia), and all-cause childhood mortality. This approach reflects decreases in malaria's direct and indirect mortality burden and can be examined in nearly all countries. Adding other information can strengthen the plausibility argument: trends in indicators of malaria transmission, information from demographic surveillance systems and sentinel sites where malaria diagnostics are systematically used, and verbal autopsies linked to representative household surveys. Health facility data on malaria deaths have well-recognized limitations; however, in specific circumstances, they could produce reliable trends. Model-based predictions can help describe changes in malaria-specific burden and assist with program management and advocacy. CONCLUSIONS Despite challenges, efforts to reduce malaria-associated mortality in Africa can be evaluated with trends in malaria intervention coverage and all-cause childhood mortality. Where there are resources and interest, complementary data on malaria morbidity and malaria-specific mortality could be added