Nursing and the Future of Health Care: The Independent Practice Imperative

In recent years an ever increasing problem has emerged within the health care delivery system in the United States: there is a shortage of registered nurses to meet patient care needs. This shortage raises serious public policy concerns about how society will be assured of quality health care and who will provide that care in the future. An awareness of the problems that have led to the nursing shortage and exploration of alternatives to the present health care delivery system are required in order to remedy the problem. The efforts of the nursing profession to overcome the effects of the shortage could well dictate the future of health care into the next century. As a society, we must be willing to assist by examining alternatives to the present health care delivery system so that nurses continue to provide competent health care, the basis of the public concern

Prevalence of Virulence Factors Among Hemolytic Escherichia coli

A polymerase chain reaction (PCR) assay was used to characterize 309 hemolytic E. coli isolates. The isolates were obtained from swine specimens presented to the diagnostic laboratory between August of 1996 and August of 1997. About one-half of the isolates contained genes for enterotoxin and/or Shiga toxin. Enterotoxigenic E. coli (ETEC), which cause diarrhea, were much more prevalent than Shigatoxigenic E. coli (STEC), which cause edema disease. K88 was the most common pilus type among ETEC and F18 was the only pilus type identified among STEC. These data are consistent with the notion that E. coli induced diarrheal disease is more prevalent than edema disease. However, they demonstrate that STEC persist in the swine population in spite of the low prevalence of clinical edema disease in recent years. The data suggest that vaccination and vaccine development based on K88 and F18 pilus antigens continue to be relevant for hemolytic E. coli infections. Some of the isolates that did not have genes for either enterotoxin or Shiga toxin, had genes for K88 or F18 pili. Such nontoxigenic isolates (NTEC) are probably not pathogenic and were speculated to act as naturally occurring K88 and F18 vaccines in some herds

Prevalences of Some Virulence Genes among Escherichia Coli Isolates from Swine Presented to a Diagnostic Laboratory in Iowa

Escherichia coli strains that carry genes encoding for specific virulence attributes cause diarrhea and edema disease in swine. Enterotoxigenic E. coli (ETEC) have genes for enterotoxins that stimulate secretion of electrolytes and water by the small intestine. To colonize the small intestine and cause diarrhea, ETEC must also produce fimbriae (pili). Escherechia coli strains that cause edema disease produce E. coli Shiga toxin (Verotoxin) and are designated as STEC.Shiga toxin is absorbed from the intestine into blood and causes systemic vascular damage resulting in edema disease. STEC must also produce fimbriae to colonize the small intestine and cause disease. Some E. coli strains are designated as attaching/effacing E. coli (AEEC) because of their ability to attach intimately to the surface of intestinal epithelial cells and efface microvilli.10 The attaching/effacing attribute is encoded by a series of chromosomal genes located in a pathogenicity island called the locus of enterocyte effacement. ETEC, STEC, and AEEC are considered to be different pathotypes of E. coli. However, some of the virulence genes that characterize them can be located on mobile genetic elements (plasmids, transposons, bacteriophages), and combinations of pathotypes occur. For example, some AEEC such as the human pathogen E. coli O157:H7 also have genes for Shiga toxin production, and some strains associated with edema disease of swine have genes for both Shiga toxin and enterotoxin production

White Woman, Black Women: Inventing an Adequate Pedagogy

As a white woman teaching literature written by black women for some years now, my experience has begun to make sense, to add up to some principles and some observations which may be useful to other teachers. I teach older, urban students who are or will become human service workers. We do little by way of formal literary criticism; we read literature to learn about American values, about problems of race and class, to understand the choices of characters, and to reflect on our own lives. Particularly because students work in intercultural settings, we use the classroom to approximate as much as it can the diversity students encounter on their jobs. Nearly sixty percent of our students are women, and I teach black novels and poetry by women because that is where you find portraits of strong, independent women; that is also where you find good literature unencumbered by the burden of prior critical judgment. I teach literature by whites in my courses as well. I myself am in the midst of a research project on an aspect of the history of relationships between black and white women, so I learn from my teaching

Mysticism and allegory in Porphyry's De antro nympharum

textThis report examines Porphyry’s De antro nympharum and its eclectic mixture of philosophy, allegory, and mysticism in the form of a Homeric commentary. The paper situates Porphyry’s commentary in the broader tradition of Homeric interpretation with special attention to Stoic exegesis and Platonic views on poetry and myth. It also contextualizes Porphyry’s philosophy in terms of the mystery cults, particularly Mithraism, that had grown very popular by Porphyry’s time. The paper argues that Porphyry devised a practice of reading intended to promote a level of philosophical contemplation beyond the level of rational discourse, in keeping with the Neoplatonic philosophy of his teacher, Plotinus, and that this practice is especially evident in the De antro nympharum.Classic

How It Works out: The Women\u27s Studies Graduate

We\u27re all so busy developing our own women\u27s studies programs, creating new curriculum, hassling over funding, over internal governance and community-related programs, that most of us rarely have time to ask how women\u27s studies affects the work lives of students once they leave the university for full-time participation in the real anti-feminist world. But a program that has been functioning for several years produces graduates: what are they up to? Historically, women in America have been the temporaries in the labor force—though one can be temporary 40 hours a week, for 40 years of one\u27s life. Has women\u27s studies begun to bring to center stage the shadowy figure of the woman worker? Are women beginning to choose deliberately the shape of their work lives, to create strong identities

REFRAMING CULTURAL COMPETENCE AND CIVIC ENGAGEMENT: A REPLICATION STUDY OF HIGH IMPACT PRACTICES IN UNDERGRADUATE PSYCHOLOGY COURSES

Institutions of higher education require diversity courses so that students can increase their multicultural awareness, knowledge, and skills. Multicultural Psychology courses play a pivotal role in instilling cultural competence in students. The study examined differences in cultural competence and civic engagement for 1,053 undergraduate students exposed to different types of high-impact practices enrolled in educational psychology, multicultural psychology, and psychology internship courses. There was a significant Group x Time interaction effect for cultural skills. Post hoc analyses revealed that students exposed to diversity service-learning in a multicultural psychology course acquired cultural skills compared to students exposed to academic service-learning in the educational psychology course and those students exposed to fieldwork in an internship from the beginning to the end of the semester. Students in the multicultural psychology course were also intellectually challenged, reflected on the course concepts, and gained a deeper understanding of the course content more than students in the educational psychology course. Recommendations for teaching diversity courses are discussed.  Article visualizations

Population Inference with Mortality and Attrition in Longitudinal Studies on Aging: A Two-Stage Multiple Imputation Method

First paragraph: Although there are numerous challenges for the investigation of aging-related changes in older adults, statistical analysis with incomplete data and the conceptualization of population processes related to mortality is one of the most difficult. Selective attrition and mortality selection within longitudinal studies on aging are intrinsically related to many aging-related changes and must be carefully considered in the analysis and interpretation of results (e.g., Baltes, 1968; Hofer & Sliwinski, 2006; Schaie, Labouvie, & Barrett, 1973). A key distinction is made between attrition (i.e., selective dropout) and mortality selection (i.e., selective survival) in that attrition affects characteristics of the particular sample under investigation, whereas mortality selection affects both the definition of the population as well as the sample under study (Baltes, 1968). Including time-to-death as a predictor in models for estimating change in outcomes of interest permits conditional inferences to defined populations based on age and survival (and their interaction) and is easily performed when complete data are available for both chronological age and age of death. In most studies, however, complete data for all individuals are not currently available and may not be available for a substantial period of time. The purpose of the current work is to present a two-stage multiple-imputation approach for treating mortality and attrition as distinct processes leading to incomplete data and which permit the use of time-to-death in the predictive models when follow-up is incomplete