Competency and Capability: Imperative for Nurse Practitioner Education

Objective The objective of this study was to conduct research to inform the development of standards for nurse practitioner education in Australia and New Zealand and to contribute to the international debate on nurse practitioner practice. Setting The research was conducted in all states of Australia where the nurse practitioner is authorised and in New Zealand Subjects The research was informed by multiple data sources including nurse practitioner program curriculae documents from all relevant universities in Australia and New Zealand, interviews with academic convenors of these programs and interviews with nurse practitioners. Primary argument Findings from this research include support for masters level of education as preparation for the nurse practitioner. These programs need to have a strong clinical learning component and in-depth education for the sciences of specialty practice. Additionally an important aspect of education for the nurse practitioner is the centrality of student directed and flexible learning models. This approach is well supported by the literature on capability. Conclusions There is agreement in the literature about the lack of consistent standards in nurse practitioner practice, education and nomenclature. The findings from this research contribute to the international debate in this area and bring research informed standards to nurse practitioner education in Australia and New Zealand

Nurse Practitioner Competency Standards: Findings from Collaborative Australian and New Zealand Research

Background: The title, Nurse Practitioner, is protected in most jurisdictions in Australia and in New Zealand and the number of nurse practitioners is increasing in health services in both countries. Despite this expansion of the role there is scant national or international research to inform development of nurse practitioner competency standards. Objectives: The aim of the study was to research nurse practitioner practice to inform development of generic standards that could be applied for the education, authorisation and practice of nurse practitioners in both countries. Design: The research used a multi-methods approach to capture a range of data sources including research of policies and curricula, and interviews with clinicians. Data were collected from relevant sources in Australia and New Zealand Settings: The research was conducted in New Zealand and the five states and territories in Australia where, at the time of the research, the title of nurse practitioner was legally protected. Participants: The research was conducted with a purposeful sample of nurse practitioners from diverse clinical settings in both countries. Interview and material data were collected from a range of sources and data were analysed within and across these data modalities. Results: Findings included identification of three generic standards for nurse practitioner practice namely, Dynamic Practice, Professional Efficacy and Clinical Leadership. Each of these standards has a number of practice competencies, each of these competencies with their own performance indicators. Conclusions: Generic Standards for nurse practitioner practice will support a standardised approach and mutual recognition of nurse practitioner authorisation across the two countries. Additionally these research outcomes can more generally inform education providers, authorising bodies and clinicians on the standards of practice for the nurse practitioner whilst also contributing to the current international debate on nurse practitioner standards and scope of practice

Kennedy Space Center's Partnership with Graftel Incorporated

NASA Kennedy Space Center (KSC) has recently partnered with Graftel Incorporated under an exclusive license agreement for the manufacture and sale of the Smart Current Signature Sensor. The Smart Current Signature Sensor and software were designed and developed to be utilized on any application using solenoid valves. The system monitors the electrical and mechanical health of solenoids by comparing the electrical current profile of each solenoid actuation to a typical current profile and reporting deviation from its learned behavior. The objective of this partnership with Graftel is for them to develop the technology into a hand-held testing device for their customer base in the Nuclear Power Industry. The device will be used to perform diagnostic testing on electromechanical valves used in Nuclear Power plants. Initially, Graftel plans to have working units within the first year of license in order to show customers and allow them to put purchase requests into their next year's budget. The subject technology under discussion was commercialized by the Kennedy Space Center Technology Programs and Partnerships Office, which patented the technology and licensed it to Graftel, Inc., a company providing support, instrumentation, and calibration services to the nuclear community and private sector for over 10 years. For the nuclear power industry, Graftel designs, manufacturers, and calibrates a full line of testing instrumentation. Grafters smart sensors have been in use in the United States since 1993 and have proved to decrease set-up time and test durations. The project was funded by Non-Destructive Engineering, and it is felt that this technology will have more emphasis on future vehicles. Graftel plans to market the Current Signature Sensor to the Electric Utility industry. Graftel currently supplies product and services to the Nuclear Power Industry in the United States as well as internationally. Product and services sold are used in non-destructive testing for valves, penetrations and other applications. Graftel also supplies testing services to an industrial customer base. The customer base includes 90 percent of the U.S. Nuclear plants and plants in Brazil, Europe, and Asia. Graftel works internationally with two representative groups and employees and has ten people at the principle location and a group of contract engineers around the country

How the brain constructs stable visual representations: Cortical and subcortical mechanims

Our eyes are constantly moving yet our perception remains stable. Neurons in lateral intraparietal cortex (LIP) update spatial representations by "remapping" visual information at the time of an eye movement. In order for remapping to occur over a wide range of eye movements, neurons must have access to visual information from the entire visual scene. The forebrain commissures appear to be the primary pathway for the transfer of visual information across hemispheres but they are not necessary. If the forebrain commissures are transected, behavior dependent on accurate spatial updating is impaired, but recovers. In three sets of experiments we examined different mechanisms of spatial updating in split brain monkeys. First, we studied the relationship between neural activity in LIP and the behavior of the monkey. We found across the population a small but significant relationship between the activity in LIP and the performance of the split brain monkey on the double-step task. This result showed that information about the opposite visual field still reaches LIP, and this activity contributes to the overall behavior of the monkey.Second, we determined if LIP neurons in the split brain monkeys have bilateral receptive fields. One explanation for the observed across-hemifield remapping is that information from both visual fields are represented in a single hemisphere. We found no neurons in the split brain monkeys with ipsilateral representations. We concluded that there must be a subcortical source for the across-hemifield remapping observed in the split brain monkeys.Third, we examined the difference in spatial updating between intact and split brain monkeys in the superior colliculus (SC). In both the intermediate layers of the SC and LIP, neural activity is selectively reduced for the across-hemifield condition in split brain compared to intact animals. This suggest that remapping activity is passed from LIP to the intermediate layers of the SC. In contrast, remapping activity in the superfical layers did not differ between the intact and split brain monkeys. It may be that the superfical neurons contribute to recovered remapping activity observed in LIP

Featured Invention: Laser Scaling Device

In September 2003, NASA signed a nonexclusive license agreement with Armor Forensics, a subsidiary of Armor Holdings, Inc., for the laser scaling device under the Innovative Partnerships Program. Coupled with a measuring program, also developed by NASA, the unit provides crime scene investigators with the ability to shoot photographs at scale without having to physically enter the scene, analyzing details such as bloodspatter patterns and graffiti. This ability keeps the scene's components intact and pristine for the collection of information and evidence. The laser scaling device elegantly solved a pressing problem for NASA's shuttle operations team and also provided industry with a useful tool. For NASA, the laser scaling device is still used to measure divots or damage to the shuttle's external tank and other structures around the launchpad. When the invention also met similar needs within industry, the Innovative Partnerships Program provided information to Armor Forensics for licensing and marketing the laser scaling device. Jeff Kohler, technology transfer agent at Kennedy, added, "We also invited a representative from the FBI's special photography unit to Kennedy to meet with Armor Forensics and the innovator. Eventually the FBI ended up purchasing some units. Armor Forensics is also beginning to receive interest from DoD [Department of Defense] for use in military crime scene investigations overseas.

Kennedy's Biomedical Laboratory Makes Multi-Tasking Look Easy

If it is one thing that Florida has in abundance, it is sunshine and with that sunshine heat and humidity. For workers at the Kennedy Space Center that have to work outside in the heat and humidity, heat exhaustion/stroke is a real possibility. It might help people to know that Kennedy's Biomedical Laboratory has been testing some new Koolvests(Trademark) that can be worn underneath SCAPE suits. They have also been working on how to block out high noise levels; in fact, Don Doerr, chief of the Biomedical Lab, says, "The most enjoyable aspect is knowing that the Biomedical Lab and the skills of its employees have been used to support safe space flight, not only for the astronaut flight crew, but just as important for the ground processing personnel as well." The NASA Biomedical Laboratory has existed in the John F. Kennedy's Operations and Checkout Building since the Apollo Program. The primary mission of this laboratory has been the biomedical support to major, manned space programs that have included Apollo, Apollo-Soyuz, Skylab, and Shuttle. In this mission, the laboratory has been responsible in accomplishing much of the technical design, planning, provision, fabrication, and maintenance of flight and ground biomedical monitoring instrumentation. This includes the electronics in the launch flight suit and similar instrumentation systems in the spacecraft. (Note: The Lab checked out the system for STS-128 at Pad A using Firing room 4 and ground support equipment in the lab.) During Apollo, there were six engineers and ten technicians in the facility. This has evolved today to two NASA engineers and two NASA technicians, a Life Science Support contract physiologist and part-time support from an LSSC nurse and physician. Over the years, the lab has enjoyed collaboration with outside agencies and investigators. These have included on-site support to the Ames Research Center bed rest studies (seven years) and the European Space Agency studies in Toulouse, France (two years). The lab has also actively collaborated with the US Army Institute for Surgical Research, the USAF School of Aerospace Medicine, and the USN Naval Experimental Diving Unit. Because the lab often evaluates various forms of commercial-off-the-shelf life support equipment, the laboratory works closely with private companies, both domestic and foreign. The European companies seem to be more proactive and participatory with the advancement of personal protective equipment. Because these companies have viewed the space program's unique need for advanced forms of personal protective equipment, some have responded with new designs based on the prediction that these advances will soon find markets in the commercial sector. Using much of the same skills and equipment, the laboratory also addresses physiological testing of humans by supporting flight experiments and personnel involved with ground processing. While Johnson Space Center is primarily responsible for flight experiments, the Kennedy's Biomedical Lab provides the local support. However, as stated above, there are many challenges facing KSC workers that gain the attention of this lab in the measurement of the problem and the selection and testing of countermeasures. These include respiratory protection, whole body suits, hearing protection and heat stress, among many others

Measuring Pinhole Leaks - A Novel Method

Both of the shuttle pads have one of these large liquid hydrogen tanks and the Shuttle program is currently using both pads. However, just recently, there has been increasing concerns over possible air leaks from the outside into the evacuated region. A method to detect leaks involving measuring the change in the boil-off rate of the liquid hydrogen in the tank

DEM Solutions Develops Answers to Modeling Lunar Dust and Regolith

With the proposed return to the Moon, scientists like NASA-KSC's Dr. Calle are concerned for a number of reasons. We will be staying longer on the planet's surface, future missions may include dust-raising activities, such as excavation and handling of lunar soil and rock, and we will be sending robotic instruments to do much of the work for us. Understanding more about the chemical and physical properties of lunar dust, how dust particles interact with each other and with equipment surfaces and the role of static electricity build-up on dust particles in the low-humidity lunar environment is imperative to the development of technologies for removing and preventing dust accumulation, and successfully handling lunar regolith. Dr. Calle is currently working on the problems of the electrostatic phenomena of granular and bulk materials as they apply to planetary surfaces, particularly to those of Mars and the Moon, and is heavily involved in developing instrumentation for future planetary missions. With this end in view, the NASA Kennedy Space Center's Innovative Partnerships Program Office partnered with OEM Solutions, Inc. OEM Solutions is a global leader in particle dynamics simulation software, providing custom solutions for use in tackling tough design and process problems related to bulk solids handling. Customers in industries such as pharmaceutical, chemical, mineral, and materials processing as well as oil and gas production, agricultural and construction, and geo-technical engineering use OEM Solutions' EDEM(TradeMark) software to improve the design and operation of their equipment while reducing development costs, time-to-market and operational risk. EDEM is the world's first general-purpose computer-aided engineering (CAE) tool to use state-of-the-art discrete element modeling technology for the simulation and analysis of particle handling and manufacturing operations. With EDEM you'can quickly and easily create a parameterized model of your granular solids system. Computer-aided design (CAD) models of real particles can be imported to obtain an accurate representation of their shape. EDEM(TradeMark) uses particle-scale behavior models to simulate bulk solids behavior. In addition to particle size and shape, the models can account for physical properties of particles along with interaction between particles and with equipment surfaces and surrounding media, as needed to define the physics of a particular process

Phylogenetic surveillance of viral genetic diversity and the evolving molecular epidemiology of human immunodeficiency virus type 1

With ongoing generation of viral genetic diversity and increasing levels of migration, the global human immunodeficiency virus type 1 (HIV-1) epidemic is becoming increasingly heterogeneous. In this study, we investigate the epidemiological characteristics of 5,675 HIV-1 pol gene sequences sampled from distinct infections in the United Kingdom. These sequences were phylogenetically analyzed in conjunction with 976 complete-genome and 3,201 pol gene reference sequences sampled globally and representing the broad range of HIV-1 genetic diversity, allowing us to estimate the probable geographic origins of the various strains present in the United Kingdom. A statistical analysis of phylogenetic clustering in this data set identified several independent transmission chains within the United Kingdom involving recently introduced strains and indicated that strains more commonly associated with infections acquired heterosexually in East Africa are spreading among men who have sex with men. Coalescent approaches were also used and indicated that the transmission chains that we identify originated in the late 1980s to early 1990s. Similar changes in the epidemiological structuring of HIV epidemics are likely to be taking in place in other industrialized nations with large immigrant populations. The framework implemented here takes advantage of the vast amount of routinely generated HIV-1 sequence data and can provide epidemiological insights not readily obtainable through standard surveillance methods