The Experience of a WWII Nurse Anesthetist: Lessons Learned and Relevance Today

2023 Annual Friends of Nursing History Lecture, "The Experience of a WWII Nurse Anesthetist: Lessons Learned and Relevance Today", featuring Carolyn Nicholson, CRNA, BSEd, May 4, 2023, The Ohio State University Richard M. Ross Heart Hospital Auditorium, Columbus, Ohio.Until recently, very little information was published about the vital contributions of our nurse anesthetists who served during World War II (WWII). Neither the Veteran's Administration nor historical societies kept any records. Most of these brave women are no longer alive today to relay their stories. After researching the story of one nurse anesthetist, 1st Lt. Adeline H. Simonson, Carolyn Nicholson, CRNA, BSEd, discusses the impact the nurses made and shares the experiences and dangers Simonson experienced while serving with a 400-bed med evac hospital in the European Theater during WWII. Carolyn Nicholson, CRNA, BSEd, graduated from the Cincinnati General Hospital School of Nurse Anesthesia in 1972. Following graduation, Nicholson remained on staff at the University of Cincinnati (UC) Nurse Anesthesia Program as a clinical and didactic instructor for 42 years. She later obtained her BSEd from UC in 1986 and continued teaching at UC Medical Center until her retirement in 2014. Throughout her career, she was an invited speaker for local, state, national and international nurse anesthesia professional meetings. Nicholson's involvement in alumni activities and interest in history has continued in her retirement

The Most Important Educational Problems Affecting the Growth of Elementary Schools of Texas, 1972

The problem with which this investigation is concerned is the identification of conditions, situations, and events that are important problems faced in the public elementary schools of Texas. Problems are categorized into sixteen areas: finance, desegregation and busing, school organization, school personnel, preschool and kindergarten, instructional improvement, reporting systems, pupil behavior, curriculum, in-service staff training, humanizing the schools, public relations, minority groups, migrant children, special education, and recent trends. The purpose of the study is to determine perceived importance of problems and to establish priorities of current issues from information obtained from education leaders of elementary schools

Habitual physical activity and the risk for depressive and anxiety disorders among older men and women

Background: Regular physical activity is generally associated with psychological well-being, although there are relatively few prospective studies in older adults. We investigated habitual physical activity as a risk factor for de novo depressive and anxiety disorders in older men and women from the general population.Methods: In this nested case-control study, subjects aged 60 years or more were identified from randomly selected cohorts being followed prospectively in the Geelong Osteoporosis Study. Cases were individuals with incident depressive or anxiety disorders, diagnosed using the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP); controls had no history of these disorders.Habitual physical activity,measured using a validated questionnaire, and other exposures were documented at baseline, approximately four years prior to psychiatric interviews. Those with depressive or anxiety disorders that pre-dated baseline were excluded.Results: Of 547 eligible subjects, 14 developed de novo depressive or anxiety disorders and were classified as cases; 533 controls remained free of disease. Physical activity was protective against the likelihood of depressive and anxiety disorders; OR = 0.55 (95% CI 0.32&ndash;0.94), p = 0.03; each standard deviation increase in the transformed physical activity score was associated with an approximate halving in the likelihood of developing depressive or anxiety disorders. Leisure-time physical activity contributed substantially to the overall physical activity score. Age, gender, smoking, alcohol consumption, weight and socioeconomic status did not substantially confound the association.Conclusion: This study provides evidence consistent with the notion that higher levels of habitual physical activity are protective against the subsequent risk of development of de novo depressive and anxiety disorders.<br /

Melting Himalayan Glaciers Threaten Domestic Water Resources in the Mount Everest Region, Nepal

Retreating glaciers and snowpack loss threaten high-altitude communities that rely upon seasonal melt for domestic water resources. But the extent to which such communities are vulnerable is not yet understood, largely because melt contribution to water supplies is rarely quantified at the catchment scale. The Khumbu Valley, Nepal is a highly glaciated catchment with elevations ranging from 2,000 to 8,848 m above sea level, where more than 80% of annual precipitation falls during the summer monsoon from June to September. Samples were collected from the rivers, tributaries, springs, and taps along the major trekking route between Lukla and Everest Base Camp in the pre-monsoon seasons of 2016–2017. Sources were chosen based upon their use by the communities for drinking, cooking, bathing, and washing, so the sample suite is representative of the local domestic water supply. In addition, meltwater samples were collected directly from the base of the Khumbu Glacier, and several rain samples were collected throughout the study site. Meltwater contribution was estimated from δ18O isotopic data using a two-component mixing model with the Khumbu glacial melt and pre-monsoon rain as endmembers. Results indicate between 34 and 90% of water comes from melt during the dry, pre-monsoon season, with an average meltwater contribution of 65%. With as much as two-thirds of the dry-season domestic water supply at risk, the communities of the Khumbu Valley are extremely vulnerable to the effects of climate change as glaciers retreat and snowpack declines

Emulator-based Bayesian calibration of the CISNET colorectal cancer models

PURPOSE: To calibrate Cancer Intervention and Surveillance Modeling Network (CISNET) 's SimCRC, MISCAN-Colon, and CRC-SPIN simulation models of the natural history colorectal cancer (CRC) with an emulator-based Bayesian algorithm and internally validate the model-predicted outcomes to calibration targets.METHODS: We used Latin hypercube sampling to sample up to 50,000 parameter sets for each CISNET-CRC model and generated the corresponding outputs. We trained multilayer perceptron artificial neural networks (ANN) as emulators using the input and output samples for each CISNET-CRC model. We selected ANN structures with corresponding hyperparameters (i.e., number of hidden layers, nodes, activation functions, epochs, and optimizer) that minimize the predicted mean square error on the validation sample. We implemented the ANN emulators in a probabilistic programming language and calibrated the input parameters with Hamiltonian Monte Carlo-based algorithms to obtain the joint posterior distributions of the CISNET-CRC models' parameters. We internally validated each calibrated emulator by comparing the model-predicted posterior outputs against the calibration targets.RESULTS: The optimal ANN for SimCRC had four hidden layers and 360 hidden nodes, MISCAN-Colon had 4 hidden layers and 114 hidden nodes, and CRC-SPIN had one hidden layer and 140 hidden nodes. The total time for training and calibrating the emulators was 7.3, 4.0, and 0.66 hours for SimCRC, MISCAN-Colon, and CRC-SPIN, respectively. The mean of the model-predicted outputs fell within the 95% confidence intervals of the calibration targets in 98 of 110 for SimCRC, 65 of 93 for MISCAN, and 31 of 41 targets for CRC-SPIN.CONCLUSIONS: Using ANN emulators is a practical solution to reduce the computational burden and complexity for Bayesian calibration of individual-level simulation models used for policy analysis, like the CISNET CRC models.</p

Maternal risk factors for abnormal placental growth: The national collaborative perinatal project

<p>Abstract</p> <p>Background</p> <p>Previous studies of maternal risk factors for abnormal placental growth have focused on placental weight and placental ratio as measures of placental growth. We sought to identify maternal risk factors for placental weight and two neglected dimensions of placental growth: placental thickness and chorionic plate area.</p> <p>Methods</p> <p>We conducted an analysis of 24,135 mother-placenta pairs enrolled in the National Collaborative Perinatal Project, a prospective cohort study of pregnancy and child health. We defined growth restriction as < 10^thpercentile and hypertrophy as > 90^thpercentile for three placental growth dimensions: placental weight, placental thickness and chorionic plate area. We constructed parallel multinomial logistic regression analyses to identify (a) predictors of restricted growth (vs. normal) and (b) predictors of hypertrophic growth (vs. normal).</p> <p>Results</p> <p>Black race was associated with an increased likelihood of growth restriction for placental weight, thickness and chorionic plate area, but was associated with a reduced likelihood of hypertrophy for these three placental growth dimensions. We observed an increased likelihood of growth restriction for placental weight and chorionic plate area among mothers with hypertensive disease at 24 weeks or beyond. Anemia was associated with a reduced likelihood of growth restriction for placental weight and chorionic plate area. Pre-pregnancy BMI and pregnancy weight gain were associated with a reduced likelihood of growth restriction and an increased likelihood of hypertrophy for all three dimensions of placental growth.</p> <p>Conclusion</p> <p>Maternal risk factors are either associated with placental growth restriction or placental hypertrophy not both. Our findings suggest that the placenta may have compensatory responses to certain maternal risk factors suggesting different underlying biological mechanisms.</p

Understanding maternal intentions to engage in home visiting programs

Little is known as to why some parents choose to engage in voluntary home visitation services while others refuse or avoid services. To address this knowledge gap, this study tests several hypotheses about the factors that influence maternal intentions to engage in home visitation services and the link between these intentions and the receipt of a home visit. The sample consists of an ethnically diverse group of mothers identified as at-risk for parenting difficulties (N = 343). These mothers were offered home visitation services from nine home visiting programs located across six states. Regardless of service acceptance or refusal, all mothers were interviewed within 2 weeks of the service offer and 3 months later. The findings suggest that mothers who intend to use services look substantially different from those who do not state an intention to participate in home visitation. The results indicate that lower infant birth weight and greater comfort with a provider in one\u27s home are significant predictors of maternal intentions to utilize home visiting services. The study results also support the connection between intent and behavior as the expressed intention to engage in home visitation services was a key predictor of the receipt of a visit

Ovarian cancer immunotherapy: opportunities, progresses and challenges

Due to the low survival rates from invasive ovarian cancer, new effective treatment modalities are urgently needed. Compelling evidence indicates that the immune response against ovarian cancer may play an important role in controlling this disease. We herein summarize multiple immune-based strategies that have been proposed and tested for potential therapeutic benefit against advanced stage ovarian cancer. We will examine the evidence for the premise that an effective therapeutic vaccine against ovarian cancer is useful not only for inducing remission of the disease but also for preventing disease relapse. We will also highlight the questions and challenges in the development of ovarian cancer vaccines, and critically discuss the limitations of some of the existing immunotherapeutic strategies. Finally, we will summarize our own experience on the use of patient-specific tumor-derived heat shock protein-peptide complex for the treatment of advanced ovarian cancer