Achieving Healthequity: A Role For Nurse Leaders On Nonprofit Boards

Diverse board leadership plays a key role in effective local and community nonprofit organizations. Nurses with core governance competencies are uniquely positioned to serve on boards of the nonprofit organizations in the communities that they already live and work in, especially but not exclusively when those organizations focus on improving health care outcomes and advancing health promotion. While the nurse of the future (IOM, 2010) is called on to lead, nurses often do not perceive themselves as being successful in governance roles (Sundean et al., 2019). This paper describes a pilot project with the Connecticut Nurses Association (SpringBoard to Board Service) that supplemented an asynchronous online governance competencies curriculum (Best on Board) with in-person experiential learning vignettes; the pilot included an intensive, customize board match process which relied on extensive knowledge of and partnership with local and regional philanthropies and their nonprofit organization collaborators. Participant experience and readiness for board service during and after pilot was measured using the Sundean Healthcare Index for Preparedness in Board Competency (SHIP-BC); relationships among nurse leaders and community organizations facilitated successful board match. Keywords: Nurses on boards, governance, nursing education, board matc

Development of Web GIS-Based VFSMOD System with Three Modules for Effective Vegetative Filter Strip Design

In recent years, Non-Point Source Pollution has been rising as a significant environmental issue. The sediment-laden water problem is causing serious impacts on river ecosystems not only in South Korea but also in most countries. The vegetative filter strip (VFS) has been thought to be one of the most effective methods to reduce the transport of sediment to down-gradient area. However, the effective width of the VFS first needs to be determined before VFS installation in the field. To provide an easy-to-use interface with a scientific VFS modeling engine, the Web GIS-based VFSMOD system was developed in this study. The Web GIS-based VFSMOD uses the UH and VFSM executable programs from the VFSMOD-w model as core engines to simulate rainfall-runoff and sediment trapping. To provide soil information for a point of interest, the Google Map interface to the MapServer soil database system was developed using the Google Map API, Javascript, Perl/CGI, and Oracle DB programming. Three modules of the Web GIS-based VFSMOD system were developed for various VFS designs under single storm, multiple storm, and long-term period scenarios. These modules in the Web GIS-based VFSMOD system were applied to the study watershed in South Korea and these were proven as efficient tools for the VFS design for various purposes

Development of Web GIS-Based VFSMOD System with Three Modules for Effective Vegetative Filter Strip Design

In recent years, Non-Point Source Pollution has been rising as a significant environmental issue. The sediment-laden water problem is causing serious impacts on river ecosystems not only in South Korea but also in most countries. The vegetative filter strip (VFS) has been thought to be one of the most effective methods to reduce the transport of sediment to down-gradient area. However, the effective width of the VFS first needs to be determined before VFS installation in the field. To provide an easy-to-use interface with a scientific VFS modeling engine, the Web GIS-based VFSMOD system was developed in this study. The Web GIS-based VFSMOD uses the UH and VFSM executable programs from the VFSMOD-w model as core engines to simulate rainfall-runoff and sediment trapping. To provide soil information for a point of interest, the Google Map interface to the MapServer soil database system was developed using the Google Map API, Javascript, Perl/CGI, and Oracle DB programming. Three modules of the Web GIS-based VFSMOD system were developed for various VFS designs under single storm, multiple storm, and long-term period scenarios. These modules in the Web GIS-based VFSMOD system were applied to the study watershed in South Korea and these were proven as efficient tools for the VFS design for various purposes

A Spitzer Space Telescope far-infrared spectral atlas of compact sources in the Magellanic Clouds. I. The Large Magellanic Cloud

[abridged] We present 52-93 micron spectra obtained with Spitzer in the MIPS-SED mode, of a representative sample of luminous compact far-IR sources in the LMC. These include carbon stars, OH/IR AGB stars, post-AGB objects and PNe, RCrB-type star HV2671, OH/IR red supergiants WOHG064 and IRAS05280-6910, B[e] stars IRAS04530-6916, R66 and R126, Wolf-Rayet star Brey3a, Luminous Blue Variable R71, supernova remnant N49, a large number of young stellar objects, compact HII regions and molecular cores, and a background galaxy (z~0.175). We use the spectra to constrain the presence and temperature of cold dust and the excitation conditions and shocks within the neutral and ionized gas, in the circumstellar environments and interfaces with the surrounding ISM. Evolved stars, including LBV R71, lack cold dust except in some cases where we argue that this is swept-up ISM. This leads to an estimate of the duration of the prolific dust-producing phase ("superwind") of several thousand years for both RSGs and massive AGB stars, with a similar fractional mass loss experienced despite the different masses. We tentatively detect line emission from neutral oxygen in the extreme RSG WOHG064, with implications for the wind driving. In N49, the shock between the supernova ejecta and ISM is revealed by its strong [OI] 63-micron emission and possibly water vapour; we estimate that 0.2 Msun of ISM dust was swept up. Some of the compact HII regions display pronounced [OIII] 88-micron emission. The efficiency of photo-electric heating in the interfaces of ionized gas and molecular clouds is estimated at 0.1-0.3%. We confirm earlier indications of a low nitrogen content in the LMC. Evidence for solid state emission features is found in both young and evolved object; some of the YSOs are found to contain crystalline water ice.Comment: Accepted for publication in The Astronomical Journal. This paper accompanies the Summer 2009 SAGE-Spec release of 48 MIPS-SED spectra, but uses improved spectrum extraction. (Fig. 2 reduced resolution because of arXiv limit.

Systematic review and cumulative analysis of oncologic and functional outcomes after robot-assisted radical cystectomy

CONTEXT: Although open radical cystectomy (ORC) is still the standard approach, laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) are increasingly performed. OBJECTIVE: To report on a systematic literature review and cumulative analysis of pathologic, oncologic, and functional outcomes of RARC in comparison with ORC and LRC. EVIDENCE ACQUISITION: Medline, Scopus, and Web of Science databases were searched using a free-text protocol including the terms robot-assisted radical cystectomy or da Vinci radical cystectomy or robot* radical cystectomy. RARC case series and studies comparing RARC with either ORC or LRC were collected. A cumulative analysis was conducted. EVIDENCE SYNTHESIS: The searches retrieved 105 papers, 87 of which reported on pathologic, oncologic, or functional outcomes. Most series were retrospective and had small case numbers, short follow-up, and potential patient selection bias. The lymph node yield during lymph node dissection was 19 (range: 3-55), with half of the series following an extended template (yield range: 11-55). The lymph node-positive rate was 22%. The performance of lymphadenectomy was correlated with surgeon and institutional volume. Cumulative analyses showed no significant difference in lymph node yield between RARC and ORC. Positive surgical margin (PSM) rates were 5.6% (1-1.5% in pT2 disease and 0-25% in pT3 and higher disease). PSM rates did not appear to decrease with sequential case numbers. Cumulative analyses showed no significant difference in rates of surgical margins between RARC and ORC or RARC and LRC. Neoadjuvant chemotherapy use ranged from 0% to 31%, with adjuvant chemotherapy used in 4-29% of patients. Only six series reported a mean follow-up of >36 mo. Three-year disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) rates were 67-76%, 68-83%, and 61-80%, respectively. The 5-yr DFS, CSS, and OS rates were 53-74%, 66-80%, and 39-66%, respectively. Similar to ORC, disease of higher pathologic stage or evidence of lymph node involvement was associated with worse survival. Very limited data were available with respect to functional outcomes. The 12-mo continence rates with continent diversion were 83-100% in men for daytime continence and 66-76% for nighttime continence. In one series, potency was recovered in 63% of patients who were evaluable at 12 mo. CONCLUSIONS: Oncologic and functional data from RARC remain immature, and longer-term prospective studies are needed. Cumulative analyses demonstrated that lymph node yields and PSM rates were similar between RARC and ORC. Conclusive long-term survival outcomes for RARC were limited, although oncologic outcomes up to 5 yr were similar to those reported for ORC. PATIENT SUMMARY: Although open radical cystectomy (RC) is still regarded as the standard treatment for muscle-invasive bladder cancer, laparoscopic and robot-assisted RCs are becoming more popular. Templates of lymph node dissection, lymph node yields, and positive surgical margin rates are acceptable with robot-assisted RC. Although definitive comparisons with open RC with respect to oncologic or functional outcomes are lacking, early results appear comparable

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

A Web-Based Tool to Interpolate Nitrogen Loading Using a Genetic Algorithm

Water quality data may not be collected at a high frequency, nor over the range of streamflow data. For instance, water quality data are often collected monthly, biweekly, or weekly, since collecting and analyzing water quality samples are costly compared to streamflow data. Regression models are often used to interpolate pollutant loads from measurements made intermittently. Web-based Load Interpolation Tool (LOADIN) was developed to provide user-friendly interfaces and to allow use of streamflow and water quality data from U.S. Geological Survey (USGS) via web access. LOADIN has a regression model assuming that instantaneous load is comprised of the pollutant load based on streamflow and the pollutant load variation within the period. The regression model has eight coefficients determined by a genetic algorithm with measured water quality data. LOADIN was applied to eleven water quality datasets from USGS gage stations located in Illinois, Indiana, Michigan, Minnesota, and Wisconsin states with drainage areas from 44 km2 to 1,847,170 km2. Measured loads were calculated by multiplying nitrogen data by streamflow data associated with measured nitrogen data. The estimated nitrogen loads and measured loads were evaluated using Nash-Sutcliffe Efficiency (NSE) and coefficient of determination (R2). NSE ranged from 0.45 to 0.91, and R2 ranged from 0.51 to 0.91 for nitrogen load estimation

Identifying the Correlation between Water Quality Data and LOADEST Model Behavior in Annual Sediment Load Estimations

Water quality samples are typically collected less frequently than flow since water quality sampling is costly. Load Estimator (LOADEST), provided by the United States Geological Survey, is used to predict water quality concentration (or load) on days when flow data are measured so that the water quality data are sufficient for annual pollutant load estimation. However, there is a need to identify water quality data requirements for accurate pollutant load estimation. Measured daily sediment data were collected from 211 streams. Estimated annual sediment loads from LOADEST and subsampled data were compared to the measured annual sediment loads (true load). The means of flow for calibration data were correlated to model behavior. A regression equation was developed to compute the required mean of flow in calibration data to best calibrate the LOADEST regression model coefficients. LOADEST runs were performed to investigate the correlation between the mean flow in calibration data and model behaviors as daily water quality data were subsampled. LOADEST calibration data used sediment concentration data for flows suggested by the regression equation. Using the mean flow calibrated by the regression equation reduced errors in annual sediment load estimation from −39.7% to −10.8% compared to using all available data

A Web-Based Model to Estimate the Impact of Best Management Practices

The Spreadsheet Tool for the Estimation of Pollutant Load (STEPL) can be used for Total Maximum Daily Load (TMDL) processes, since the model is capable of simulating the impacts of various best management practices (BMPs) and low impact development (LID) practices. The model computes average annual direct runoff using the Soil Conservation Service Curve Number (SCS-CN) method with average rainfall per event, which is not a typical use of the SCS-CN method. Five SCS-CN-based approaches to compute average annual direct runoff were investigated to explore estimated differences in average annual direct runoff computations using daily precipitation data collected from the National Climate Data Center and generated by the CLIGEN model for twelve stations in Indiana. Compared to the average annual direct runoff computed for the typical use of the SCS-CN method, the approaches to estimate average annual direct runoff within EPA STEPL showed large differences. A web-based model (STEPL WEB) was developed with a corrected approach to estimate average annual direct runoff. Moreover, the model was integrated with the Web-based Load Duration Curve Tool, which identifies the least cost BMPs for each land use and optimizes BMP selection to identify the most cost-effective BMP implementations. The integrated tools provide an easy to use approach for performing TMDL analysis and identifying cost-effective approaches for controlling nonpoint source pollution