874 research outputs found

    Disaster Ethics and Healthcare Personnel: A Model Case Study to Facilitate the Decision Making Process

    Get PDF
    The impact of Hurricane Katrina on the Gulf Coast signified the arrival of the most catastrophic natural disaster in United States history. Despite years of dire warnings, the absence of hurricane evacuation policies and disaster contingency plans highlighted not only staggering ineptitudes at all levels of government but at all levels of healthcare organization as well. Thousands of healthcare personnel and, in some instances, their families were stranded in New Orleans hospitals awaiting evacuation in rapidly deteriorating conditions. Many of these healthcare workers are not expected to return to New Orleans. Some of these decisions are infrastructure driven however, many are due to the psychological traumas experienced as a result of the ethically perpetuated conflicts they were, in some instances, forced to contend with. Familiarity with and utilization of a framework for ethical decision-making may facilitate healthcare professionals in maneuvering through disaster-instigated ethical dilemmas

    Innovative Lesson Plans for Active Learning: Teaching Nursing Research and Evidence-Based Practice

    Get PDF
    Innovative Lessons Plans for Active Learning: Teaching Research and Evidence-Based Practice is a resource in research and evidence-based practice for active learning in the undergraduate nursing classroom. It is meant to supplement any nursing research text. Designed to provide educators with creative teaching ideas, this text includes a variety of lessons on nursing research topics. Topics include bias, measurement, sampling, theory and more. Lessons provide active learning for in-class, hybrid, and online formats. Each lesson includes objectives, overview, and detailed steps. As an open access resource, the text is continuously in-process. Designed to be independent of any published text, the book compliments any nursing research and evidence-based course. This text is also a suitable resource for introductory research in other disciplines. Each chapter is an activity designed to supplement didactic andragogy. The activities develop creativity and facilitate engagement in the nursing research content. Through creative engagement, students access learning areas of the brain that otherwise remain unstimulated. Organized by the order in which they might be discussed in class, each chapter builds upon previous learning. In chapter two students are introduced by creating puppets to develop research questions and study ideas. Chapter three focuses specifically on generating problem and purpose statements. Culture shots in chapter five engages students in understanding theory generation, qualitative research and ethics in data collection. Chapters six and seven build upon and strengthen theory understanding through creating concepts and challenging assumptions. In chapter eight, biases and threats to validity are investigated through the use of parody. Sampling is addressed in chapters nine through eleven. Chapter twelve reinforces learning on measurement error. The last four chapters use creative games to help students pull it all together. Chapters thirteen and fourteen utilize existing free resources to enhance the learning experience. Chapters fifteen and sixteen allow students to work together to create understanding for themselves and other students. We hope you enjoy the book as much as we enjoyed creating it. We would love to hear your comment and ideas for improvement. Please also view our video introduction at https://youtu.be/x9NDv2H_Cdg.https://scholarworks.gvsu.edu/books/1016/thumbnail.jp

    Implementing an MSN Nursing Program at a Distance Through an Urban-Rural Partnership

    Get PDF
    Recruiting, retaining, and educating advanced practice nurses is essential to meet the growing need for advanced practice nurses in rural and urban communities. Through the support of Health Resources and Services Administration funding, the urban school of nursing expanded its MSN program and implemented the graduate curriculum on its rural campus by utilizing emerging online and distance education technologies. The purpose of this manuscript is to provide an overview of expanding an existing MSN program offered in an urban, traditional classroom setting to rural graduate nursing students via an online synchronous format. In addition, the article will describe the rural growth of the existing neonatal nurse practitioner program as an exemplar and the different methodologies that are being used in each program to engage the rural nurse practitioner students in clinical courses. In addition, strategies to address barriers related to rural nurse practitioner student recruitment and retention will be discussed

    Isolation of a wide range of minerals from a thermally treated plant: Equisetum arvense, a Mare’s tale

    Get PDF
    Silica is the second most abundant biomineral being exceeded in nature only by biogenic CaCO3. Many land plants (such as rice, cereals, cucumber, etc.) deposit silica in significant amounts to reinforce their tissues and as a systematic response to pathogen attack. One of the most ancient species of living vascular plants, Equisetum arvense is also able to take up and accumulate silica in all parts of the plant. Numerous methods have been developed for elimination of the organic material and/or metal ions present in plant material to isolate biogenic silica. However, depending on the chemical and/or physical treatment applied to branch or stem from Equisetum arvense; other mineral forms such glass-type materials (i.e. CaSiO3), salts (i.e. KCl) or luminescent materials can also be isolated from the plant material. In the current contribution, we show the chemical and/or thermal routes that lead to the formation of a number of different mineral types in addition to biogenic silica

    Neurospora from natural populations: Population genomics insights into the Life history of a model microbial Eukaryote

    Get PDF
    The ascomycete filamentous fungus Neurospora crassa played a historic role in experimental biology and became a model system for genetic research. Stimulated by a systematic effort to collect wild strains initiated by Stanford geneticist David Perkins, the genus Neurospora has also become a basic model for the study of evolutionary processes, speciation, and population biology. In this chapter, we will first trace the history that brought Neurospora into the era of population genomics. We will then cover the major contributions of population genomic investigations using Neurospora to our understanding of microbial biogeography and speciation, and review recent work using population genomics and genome-wide association mapping that illustrates the unique potential of Neurospora as a model for identifying the genetic basis of (potentially adaptive) phenotypes in filamentous fungi. The advent of population genomics has contributed to firmly establish Neurospora as a complete model system and we hope our review will entice biologists to include Neurospora in their research

    Lifestyle variables and the risk of myocardial infarction in the General Practice Research Database

    Get PDF
    <p>Abstract</p> <p>Background</p> <p>The primary objective of this study is to estimate the association between body mass index (BMI) and the risk of first acute myocardial infarction (AMI). As a secondary objective, we considered the association between other lifestyle variables, smoking and heavy alcohol use, and AMI risk.</p> <p>Methods</p> <p>This study was conducted in the general practice research database (GPRD) which is a database based on general practitioner records and is a representative sample of the United Kingdom population. We matched cases of first AMI as identified by diagnostic codes with up to 10 controls between January 1<sup>st</sup>, 2001 and December 31<sup>st</sup>, 2005 using incidence density sampling. We used multiple imputation to account for missing data.</p> <p>Results</p> <p>We identified 19,353 cases of first AMI which were matched on index date, GPRD practice and age to 192,821 controls. There was a modest amount of missing data in the database, and the patients with missing data had different risks than those with recorded values. We adjusted our analysis for each lifestyle variable jointly and also for age, sex, and number of hospitalizations in the past year. Although a record of underweight (BMI <18.0 kg/m<sup>2</sup>) did not alter the risk for AMI (adjusted odds ratio (OR): 1.00; 95% confidence interval (CI): 0.87–1.11) when compared with normal BMI (18.0–24.9 kg/m<sup>2</sup>), obesity (BMI ≥30 kg/m<sup>2</sup>) predicted an increased risk (adjusted OR: 1.41; 95% CI: 1.35–1.47). A history of smoking also predicted an increased risk of AMI (adjusted OR: 1.81; 95% CI: 1.75–1.87) as did heavy alcohol use (adjusted OR: 1.15; 95% CI: 1.06–1.26).</p> <p>Conclusion</p> <p>This study illustrates that obesity, smoking and heavy alcohol use, as recorded during routine care by a general practitioner, are important predictors of an increased risk of a first AMI. In contrast, low BMI does not increase the risk of a first AMI.</p

    Validation of a multifactorial risk factor model used for predicting future caries risk with nevada adolescents

    Get PDF
    <p>Abstract</p> <p>Background</p> <p>The objective of this study was to measure the validity and reliability of a multifactorial Risk Factor Model developed for use in predicting future caries risk in Nevada adolescents in a public health setting.</p> <p>Methods</p> <p>This study examined retrospective data from an oral health surveillance initiative that screened over 51,000 students 13-18 years of age, attending public/private schools in Nevada across six academic years (2002/2003-2007/2008). The Risk Factor Model included ten demographic variables: exposure to fluoridation in the municipal water supply, environmental smoke exposure, race, age, locale (metropolitan vs. rural), tobacco use, Body Mass Index, insurance status, sex, and sealant application. Multiple regression was used in a previous study to establish which significantly contributed to caries risk. Follow-up logistic regression ascertained the weight of contribution and odds ratios of the ten variables. Researchers in this study computed sensitivity, specificity, positive predictive value (PVP), negative predictive value (PVN), and prevalence across all six years of screening to assess the validity of the Risk Factor Model.</p> <p>Results</p> <p>Subjects' overall mean caries prevalence across all six years was 66%. Average sensitivity across all six years was 79%; average specificity was 81%; average PVP was 89% and average PVN was 67%.</p> <p>Conclusions</p> <p>Overall, the Risk Factor Model provided a relatively constant, valid measure of caries that could be used in conjunction with a comprehensive risk assessment in population-based screenings by school nurses/nurse practitioners, health educators, and physicians to guide them in assessing potential future caries risk for use in prevention and referral practices.</p

    Simulating Food Web Dynamics along a Gradient: Quantifying Human Influence

    Get PDF
    Realistically parameterized and dynamically simulated food-webs are useful tool to explore the importance of the functional diversity of ecosystems, and in particular relations between the dynamics of species and the whole community. We present a stochastic dynamical food web simulation for the Kelian River (Borneo). The food web was constructed for six different locations, arrayed along a gradient of increasing human perturbation (mostly resulting from gold mining activities) along the river. Along the river, the relative importance of grazers, filterers and shredders decreases with increasing disturbance downstream, while predators become more dominant in governing eco-dynamics. Human activity led to increased turbidity and sedimentation which adversely impacts primary productivity. Since the main difference between the study sites was not the composition of the food webs (structure is quite similar) but the strengths of interactions and the abundance of the trophic groups, a dynamical simulation approach seemed to be useful to better explain human influence. In the pristine river (study site 1), when comparing a structural version of our model with the dynamical model we found that structurally central groups such as omnivores and carnivores were not the most important ones dynamically. Instead, primary consumers such as invertebrate grazers and shredders generated a greater dynamical response. Based on the dynamically most important groups, bottom-up control is replaced by the predominant top-down control regime as distance downstream and human disturbance increased. An important finding, potentially explaining the poor structure to dynamics relationship, is that indirect effects are at least as important as direct ones during the simulations. We suggest that our approach and this simulation framework could serve systems-based conservation efforts. Quantitative indicators on the relative importance of trophic groups and the mechanistic modeling of eco-dynamics could greatly contribute to understanding various aspects of functional diversity
    corecore