Characterisation of the human embryonic and foetal epicardium during heart development.

The epicardium is essential for mammalian heart development. At present, our understanding of the timing and morphogenetic events leading to the formation of the human epicardium has essentially been extrapolated from model organisms. Here, we studied primary tissue samples to characterise human epicardium development. We reveal that the epicardium begins to envelop the myocardial surface at Carnegie stage (CS) 11 and this process is completed by CS15, earlier than previously inferred from avian studies. Contrary to prevailing dogma, the formed human epicardium is not a simple squamous epithelium and we reveal evidence of more complex structure, including novel spatial differences aligned to the developing chambers. Specifically, the ventricular, but not atrial, epicardium exhibited areas of expanded epithelium, preferential cell alignment and spindle-like morphology. Likewise, we reveal distinct properties ex vivo, such that ventricular cells spontaneously differentiate and lose epicardial identity, whereas atrial-derived cells remained 'epithelial-like'. These data provide insight into the developing human epicardium that may contribute to our understanding of congenital heart disease and have implications for the development of strategies for endogenous cell-based cardiac repair.

Cardiac lymphatics are heterogeneous in origin and respond to injury.

The lymphatic vasculature is a blind-ended network crucial for tissue-fluid homeostasis, immune surveillance and lipid absorption from the gut. Recent evidence has proposed an entirely venous-derived mammalian lymphatic system. By contrast, here we show that cardiac lymphatic vessels in mice have a heterogeneous cellular origin, whereby formation of at least part of the cardiac lymphatic network is independent of sprouting from veins. Multiple Cre­lox-based lineage tracing revealed a potential contribution from the putative haemogenic endothelium during development, and discrete lymphatic endothelial progenitor populations were confirmed by conditional knockout of Prox1 in Tie2+ and Vav1+ compartments. In the adult heart, myocardial infarction promoted a significant lymphangiogenic response, which was augmented by treatment with VEGF-C, resulting in improved cardiac function. These data prompt the re-evaluation of a century-long debate on the origin of lymphatic vessels and suggest that lymphangiogenesis may represent a therapeutic target to promote cardiac repair following injury.

Preparing for disasters: education and management strategies explored.

During the last half of the 20th century, the focus of nursing changed from home and field to high-tech clinics and hospitals. Nursing in the absence of technology due to man-made or natural disasters almost disappeared from the curriculum of many nursing schools. Numerous disaster events and threats in the early 21st century caused educators and practitioners to increase the emphasis on disaster nursing and those principles that guide the nurse's practice in response to disasters. This article chronicles tools used by nurse educators to integrate disaster nursing into the didactic and clinical experiences of baccalaureate nursing students. We represent two nursing schools about 90 miles apart that collaborated to provide students with practical application of disaster nursing concepts. Part 1: An educational journey toward disaster nursing competencies: A curriculum in action provides an overview of the curricular tools used to insure adequate coverage of disaster nursing concepts across the curriculum. Part 2: Collaborative learning in Community Health Nursing for emergency preparedness relates the steps taken to plan, implement, and evaluate two different collaborative disaster simulation events. In this manuscript we have attempted transparency so that others can learn from our successes and our failures.

Circadian rhythms in Mexican blind cavefish Astyanax mexicanus in the lab and in the field.

Biological clocks have evolved as an adaptation to life on a rhythmic planet, synchronising physiological processes to the environmental light-dark cycle. Here we examine circadian clock function in Mexican blind cavefish Astyanax mexicanus and its surface counterpart. In the lab, adult surface fish show robust circadian rhythms in per1, which are retained in cave populations, but with substantial alterations. These changes may be due to increased levels of light-inducible genes in cavefish, including clock repressor per2. From a molecular standpoint, cavefish appear as if they experience 'constant light' rather than perpetual darkness. Micos River samples show similar per1 oscillations to those in the lab. However, data from Chica Cave shows complete repression of clock function, while expression of several light-responsive genes is raised, including DNA repair genes. We propose that altered expression of light-inducible genes provides a selective advantage to cavefish at the expense of a damped circadian oscillator.

A regional academic partnership for the early identification and retention of at-risk nursing students.

UNLABELLED: In a 2006 Texas Higher Education Coordinating Board report (Increasing RN Graduates in Texas: A Report to the 79th Legislature), nursing programs in Texas were challenged to increase the number of graduates to deal with the nursing shortage. This article describes the East Texas region's efforts to identify and intervene in the nursing student attrition rates of participating partners nursing programs. The primary purpose of this study was to identify and intervene with students at risk for attrition. Nine nursing programs participated in the study. METHODS: Online surveys were used to assess variables associated with attrition. Online interventions and an intensive test review protocol were used as intervention methods. RESULTS: Across the nine nursing programs, 898 students participated in the study. Regression and categorical data analysis revealed that lack of reading comprehension was the best predictor of a student being off track or out of a nursing program (P < .0001). Two other highly predictive variables of attrition were entrance examination composite scores (P = .0271) and a student's grades in anatomy and physiology (P = .005). Grant intervention protocols were effective in reducing the attrition rate (P = .0002) between students who participated during the grant period and those prior to implementation of the grant.

Journey to a doctoral program.

Several nursing programs will be developing either doctor of philosophy or doctor of nursing practice programs in the near future. There is little literature available to advise and guide program planners about the challenges and rewards encountered when creating a new doctoral program. The intent of this article is to assist program planners in meeting some of the challenges associated with initiating a doctoral program by describing one institution's experiences in launching a doctoral program in nursing. Potential difficulties are identified, and recommended solutions are provided.

Hope in relation to nursing interventions for HIV-infected patients and their significant others.

This qualitative descriptive study explored what nurses can do to decrease hopelessness and enable hope in HIV-infected patients and their significant others. Using a sample of 10 HIV-infected patient and/or significant other dyads recruited from a support group, interview questions focused on specific nursing interventions that were helpful/not helpful in supporting hope. Clusters of common themes were identified in the areas of the nurse's existential presence, appreciation of personhood, professionalism, celebration of life, and consequences. Elements describing the essence of each category were presented to explain meaning in terms of nursing practice and education. The conclusions of this study reinforce the fact that patients consider enabling hope an essential component of nursing. Further study is needed to explore the effects of hope on long-term survivorship and quality of life for patients and their significant others as well as specific nursing interventions to enable hope for this population.

A collaborative model for preparing advanced nurse practitioners-a 10-year retrospective.

This article describes the collaborative model for preparing nurse practitioners that was developed in response to the need for an increased number of family nurse practitioners (FNPs) in rural East Texas. Beginning with a brief history of the development of the collaborative program, the collaborative model is described as it relates to the student, faculty, institution, and community. Based on evaluation of both the strengths and challenges of the collaborative model, the cooperative model was developed to better recognize the strengths of both institutions.

Incorporating cultural issues in education for ethical practice.

The population of most non-dominant ethnic groups in the USA is growing dramatically. Faculty members are challenged to develop curricula that adequately prepare our future nurses. An increased focus on clinical ethics has resulted from the use of sophisticated technology, changes in health care financing, an increasing elderly population and the shift of care from inpatient to outpatient settings. Nurses frequently face situations demanding resolution of ethical dilemmas involving cultural differences. Nursing curricula must include content on both ethics and cultural sensitivity. Active student participation is an important element providing a foundation for ethical practice. A proposed educational format was introduced with graduating baccalaureate students. In a pilot study, curricular content on cultural sensitivity and ethical practice was taught in separate modules. Students were then asked to identify and problem solve an ethical dilemma involving patients and professional caregivers from vastly different cultures. Course faculty members provided discussion questions to guide the students' thinking.

Longitudinal evaluation of a live interactive video baccalaureate nursing program.

Beginning with a brief history of a community-inspired distance education initiative, the authors describe how one college of nursing offers an entire generic bachelor of science in nursing program over live interactive video for nursing students at 2 distance sites. The 10-year longitudinal evaluation of student and program outcomes is presented. Student and program success is evidenced by congruence of grades and National Council Licensure Exam (NCLEX) pass rates between sites.

The Texas model of differentiated entry-level competencies of graduates of nursing programs.

The Board of Nurse Examiners and the Board of Vocational Nurse Examiners for the State of Texas updated the state's competency-based education model in collaboration with stakeholders in nursing service, state nursing organizations, and the deans and directors of the state's 82 board-accredited professional nursing programs. Based on this collaborative effort, 14 differentiated entry-level competencies with associated knowledge and clinical behaviors/judgments were identified that set standards for graduates of vocational, diploma, associate, and baccalaureate degree programs.

Institutional collaboration not competition: preparing family nurse practitioners to serve rural areas.

In response to the need for an increased number of family nurse practitioners in rural Texas, The University of Texas at Tyler, Texas Tech University Health Sciences Center, and Midwestern State University entered into a collaborative arrangement to provide advanced education to nurses in outlying areas of the state. The catchment area for the project encompassed 72 counties, representing half the land mass in Texas. This article presents the development of the collaborative model, strategies used for implementation, and evaluation of this collaborative effort. The collaborative family nurse practitioner program is based on collegiality rather than competition to better meet the needs of students and communities in a cost-effective manner. Communication between the institutions and faculty has been a key factor in the success of the program. The addition of nurse practitioners from this project has the potential to greatly increase access to health care in large, underserved populations.

Creating a collaborative partnership between academia and service.

This article discusses how the experience of instituting preceptored clinical experiences throughout an undergraduate baccalaureate nursing curriculum resulted in a partnership between academia and service. The collaboration between academia and service built on the strengths of each institution to reach a common goal. Integration of the preceptor clinical model is unique in that implementation occurs in the second semester of a four-semester curriculum. Advantages and disadvantages to the model for students, preceptors, and faculty are presented. Unanticipated benefits to both institutions and ideas to help other programs and facilities develop a collaborative partnership for the education of baccalaureate nursing students are provided.