Rounding with Purpose: Improving Communication, Safety and Collaboration with Nurse Driven, Multidisciplinary Family Rounds

Malaria in the First World War was an unexpected adversary. In 1914, the scientific community had access to new knowledge on transmission of malaria parasites and their control, but the military were unprepared, and underestimated the nature, magnitude and dispersion of this enemy. In summarizing available information for allied and axis military forces, this review contextualizes the challenge posed by malaria, because although data exist across historical, medical and military documents, descriptions are fragmented, often addressing context specific issues. Military malaria surveillance statistics have, therefore, been summarized for all theatres of the War, where available. These indicated that at least 1.5 million solders were infected, with case fatality ranging from 0.2 -5.0%. As more countries became engaged in the War, the problem grew in size, leading to major epidemics in Macedonia, Palestine, Mesopotamia and Italy. Trans-continental passages of parasites and human reservoirs of infection created ideal circumstances for parasite evolution. Details of these epidemics are reviewed, including major epidemics in England and Italy, which developed following home troop evacuations, and disruption of malaria control activities in Italy. Elsewhere, in sub-Saharan Africa many casualties resulted from high malaria exposure combined with minimal control efforts for soldiers considered semi-immune. Prevention activities eventually started but were initially poorly organized and dependent on local enthusiasm and initiative. Nets had to be designed for field use and were fundamental for personal protection. Multiple prevention approaches adopted in different settings and their relative utility are described. Clinical treatment primarily depended on quinine, although efficacy was poor as relapsing Plasmodium vivax and recrudescent Plasmodium falciparum infections were not distinguished and managed appropriately. Reasons for this are discussed and the clinical trial data summarized, as are controversies that arose from attempts at quinine prophylaxis (quininization). In essence, the First World War was a vast experiment in political, demographic, and medical practice which exposed large gaps in knowledge of tropical medicine and unfortunately, of malaria. Research efforts eventually commenced late in the War to address important clinical questions which established a platform for more effective strategies, but in 1918 this relentless foe had outwitted and weakened both allied and axis powers

An examination of the endogenous region

Growing social and economic linkages among Iowa\u27s rural communities have blurred traditional community boundaries. Stronger linkages between urban centers and surrounding rural communities have also developed as more services relocate to urban centers. The farm crisis of the 1980\u27s exacerbated these trends as the capacity of rural governments and enterprises to maintain local services was reduced. While some consolidation of institutions and services has taken place in rural Iowa, a trend toward multicommunity voluntary collaboration is noted;This research focuses upon endogenous regions and the multicommunity development organizations (MDOs) that have emerged to promote joint community economic development efforts. Endogenous regions represent an emerging form of social structure as communities develop closer ties to one another. They are endogenous as they are spatially created through local voluntary processes rather than the mandate of extra-local institutions;An inventory of MDOs was taken using information gathered from economic development professionals at both the state and sub-state regional level. MDOs are defined as formally organized community development organizations involving two or more rural communities, covering a relatively small geographic area (county size or less) and addressing multiple issue areas. MDOs were clustered into three classifications based upon their substantive organizational activities. A descriptive analysis compares the ecology, structure and output of the MDOs as classified. A path analysis is used to determine the effects of organizational variables and the aggregated local ecology upon MDO output as measured through job creation;Three key variables found to influence MDO output were the size of population aggregated, the annual budget of the MDO and the activities in which the MDO was involved. MDOs taking a broad, holistic approach to community economic development tended to help generate more local job creation than MDOs focusing solely upon business development activities. It is concluded that how MDOs are organized both institutionally and spatially effects MDO output within their endogenous regional community

3D Visualization in Community-Based Planning

A new wave of recently developed Geographic Information Systems (GIS) software provides for higher levels of analysis, modeling, and visualization for community development and planning. Beyond the typical 2D static map produced through most GIS software, more recent developments allow for much more detailed 3D visual graphics. CommunityViz allows for predictive modeling, data integration, and 3D visualization. It is the utility of this last capability that is examined in an Extension pilot program in an Iowa community. Based upon this application, the potential of this type of software for Extension education is discussed

On the nonlinear NMR and magnon BEC in antiferromagnetic materials with coupled electron-nuclear spin precession

We present a new study of nonlinear NMR and Bose-Einstein Condensation (BEC) of nuclear spin waves in antiferromagnetic MnCO3 with coupled electron and nuclear spins. In particular, we show that the observed behaviour of NMR signals strongly contradicts the conventional description of paramagnetic ensembles of noninteracting spins based on the phenomenological Bloch equations. We present a new theoretical description of the coupled electron-nuclear spin precession, which takes into account an indirect relaxation of nuclear spins via the electron subsystem. We show that the magnitude of the nuclear magnetization is conserved for arbitrary large excitation powers, which is drastically different from the conventional heating scenario derived from the Bloch equations. This provides strong evidence that the coherent precession of macroscopic nuclear magnetization observed experimentally can be identified with BEC of nuclear spin waves with k=0.Comment: 12 pages, 8 figure

Insights and Perspectives on Sensory-Motor Integration and Rehabilitation

The present review focuses on the flow and interaction of somatosensory-motor signals in the central and peripheral nervous system. Specifically, where incoming sensory signals from the periphery are processed and interpreted to initiate behaviors, and how ongoing behaviors produce sensory consequences encoded and used to fine-tune subsequent actions. We describe the structure-function relations of this loop, how these relations can be modeled and aspects of somatosensory-motor rehabilitation. The work reviewed here shows that it is imperative to understand the fundamental mechanisms of the somatosensory-motor system to restore accurate motor abilities and appropriate somatosensory feedback. Knowledge of the salient neural mechanisms of sensory-motor integration has begun to generate innovative approaches to improve rehabilitation training following neurological impairments such as stroke. The present work supports the integration of basic science principles of sensory-motor integration into rehabilitation procedures to create new solutions for sensory-motor disorders

Understanding the role of the primary somatosensory cortex: Opportunities for rehabilitation.

Emerging evidence indicates impairments in somatosensory function may be a major contributor to motor dysfunction associated with neurologic injury or disorders. However, the neuroanatomical substrates underlying the connection between aberrant sensory input and ineffective motor output are still under investigation. The primary somatosensory cortex (S1) plays a critical role in processing afferent somatosensory input and contributes to the integration of sensory and motor signals necessary for skilled movement. Neuroimaging and neurostimulation approaches provide unique opportunities to non-invasively study S1 structure and function including connectivity with other cortical regions. These research techniques have begun to illuminate casual contributions of abnormal S1 activity and connectivity to motor dysfunction and poorer recovery of motor function in neurologic patient populations. This review synthesizes recent evidence illustrating the role of S1 in motor control, motor learning and functional recovery with an emphasis on how information from these investigations may be exploited to inform stroke rehabilitation to reduce motor dysfunction and improve therapeutic outcomes