Dahltyson9281

Policy changes that impact nursing occur at multiple levels. The scope and pace of policy changes make it impossible for one faculty member to fill the role of policy advocate. Faculty are frequently reticent to participate, yet, policy work can be very rewarding for faculty. When engaged in policy advocacy, nursing faculty can be a valuable resource to the university, to legislators, and to other stakeholders. This article discusses the team approach to policy advocacy activity and outlines key steps in the policy process. Strategies for overcoming barriers when merging academic and advocacy responsibilities are identified. An example of a college of nursing faculty policy team that utilized nursing presence and their combined intellectual, social, and political capital is provided. In this example, the policy team influences policy discussions on issues impacting both the university community and citizens throughout the state. The strategies provided and the policy process steps discussed are applicable to policy changes at the local, state, and federal levels. Nursing faculty are positioned to engage students, alumni, practice leaders, and community stakeholders in interdisciplinary and transdisciplinary efforts that influence policy initiatives.Background Thromboelastometry (TEM) is often used to guide transfusion therapy in patients with massive bleeding. The effect of testing incompletely filled samples and those stored for a prolonged time at 4°C was investigated. selleck screening library Methods Whole blood samples were collected from 15 healthy blood donors and were pooled according to ABO group. From these pools, aliquots were taken and diluted to produce final whole bloodcitrate buffer ratios ranging from 9010 (fully filled sample) to 4060 (extremely under filled samples). These samples were then tested by EXTEM, INTEM, and FIBTEM on calibrated ROTEM delta machines. Separately, the four samples at 9010 dilution were kept at 4°C for 16-20 hours and then retested on the ROTEM machines. Results All of the samples at the 9010 and 8020 (half-filled sample) whole bloodcitrate buffer dilutions demonstrated ROTEM parameters within their respective reference ranges, although the samples from the 8020 dilution tended to demonstrate slightly longer or slower times, depending on each ROTEM parameter, compared to the completely filled samples. All of the samples with more dilute whole blood to citrate buffer ratios (i.e., 7030 to 4060) yielded abnormal TEM results. The TEM results for the 9010 dilution samples exposed to 16-20 hours of storage at 4°C were within the reference intervals. Conclusion Completely and half-filled samples, and completely filled samples after prolonged cold storage, produced normal ROTEM results. Tubes that are less than half-filled should not be used for ROTEM testing.Liver-regulating herb compound (LRHC) has good effects on improving sperm quality and male fertility of varicocele (VC) patients. But the mechanism of LRHC on VC is still not clear. This study explored the effects of LRHC on histomorphological and ultrastructural changes and expression of stem cell factor (SCF) and C-KIT of VC rat testis. Twenty-four male rats were divided into three groups with eight rats in each group as sham, varicocele and LRHC groups. Testis specimens were collected for light microscopy and transmission electron microscopy respectively. The expression of SCF/C-KIT was detected with Western blot. Results showed that seminiferous tubules in VC rats were damaged and cell numbers were decreased. Ultrastructural alterations were observed, such as increased thickness of lamina propria, vacuolation in Sertoli cells, spermatocytes and spermatids, and abnormal head and mitochondria in spermatozoa. While in LRHC-treated rats, the architectures of seminiferous tubules were as organised and compact as that of sham animals, and ultrastructure of Sertoli, Leydig and germ cells developed well. LRHC ameliorated histological appearance and ultrastructure by VC. In addition, the abnormal expression of SCF and C-KIT were observed in testicular tissues from rats with VC, which were brought back to normal level by LRHC.Background Acute trauma coagulopathy (ATC) after military trauma has not been comprehensively studied. ATC is defined as a prolonged prothrombin time ratio (PTr) or reduced clot amplitude (A5) in viscoelastic testing. Compared to civilian trauma, military trauma has more injuries from explosions and gunshot wounds (GSWs), potentially leading to a different pathophysiology for traumatic coagulopathy. This study aimed to characterize military ATC on admission to a military hospital in Afghanistan and to explore any differences due to the mechanism of injury. Methods Severely injured military casualties were enrolled in the study. Blood samples were taken on admission and after routine testing, waste plasma was prepared, frozen, and transported to the United Kingdom for in-depth hemostatic analysis. Results Seventy-seven percent of casualties had ATC defined by a PTr greater than 1.2 and 19% when defined by rotational thromboelastometry (ROTEM) A5 less than 36 mm. Coagulation factor depletion correlated with degree of shock, particularly factor V (p less then 0.01), factor X (p less then 0.01), and fibrinogen levels (p less then 0.01). Thrombin generation was well preserved. Fibrinolytic biomarkers were raised correlating with the degree of shock (p less then 0.01), and 8% of casualties had hyperfibrinolysis on ROTEM analysis. Plasmin-antiplasmin complexes (p less then 0.01) and d-dimer levels (p = 0.01) were higher and clot firmness lower (p = 0.02) in those injured by explosion compared to GSW's. Conclusions ATC was present and correlated with shock, similar to civilian trauma. Thrombin generation remained adequate. Fibrinogen and factor V levels were disproportionately low but still sufficient to allow clot formation. Fibrinolysis is a key feature, probably due to a tissue plasminogen activator surge at the time of injury. Blast injuries are associated with a greater activation of fibrinolysis than GSWs.Background Visible light, in particular blue light, has been identified as an additional contributor to cutaneous photo-aging. However, clinical studies demonstrating the clear effect of blue light on photo-aging are still scarce and so far, most studies have focused on broad spectrum visible light. While there is evidence for increased skin pigmentation, the underlying mechanisms of photo-aging in vivo are still unclear. Furthermore, there is still a need for active ingredients to significantly protect against blue light induced hyperpigmentation in vivo. Our study had two aims to detect visible changes in skin pigmentation following repeated irradiation of the skin with LED-based blue light; and to reduce pigmentation using suitable active ingredients. Method We conducted a randomized, double-blind and placebo controlled clinical study on 33 female volunteers with skin phototypes III and IV. We used a repetitive blue light (4x 60 J cm-2 , 450 nm) irradiation protocol on the volunteers' inner forearms. Using hyperspectral imaging we assessed chromophore status.