Using 81Kr and isotopic tracers to characterise old groundwater in the Bangkok metropolitan and vicinity areas.

Krypton-81 was applied to investigate the age of groundwater in the aquifer system in the Bangkok metropolitan and vicinity areas. Stable (2H, 18O and 13C) and radioactive (3H, 85Kr and 14C) isotopes and noble gases were applied in parallel. Low levels of 14C and significant radiogenic 4He confirm that groundwater in the deep aquifers is older than 30 ka. 81Kr analysis identified groundwater with ages ranging from 17 to 300 ka. At some sites, large age discrepancies between 81Kr and 14C indicated that inter-aquifer mixing is likely occurring. The interpretation of the noble gases suggests that groundwaters in the deeper aquifers, with apparent ages of 300 to 10 ka, have recharged in slightly colder and wetter climates than those found in the upper aquifers with apparent ages < 10 ka. Degradation of water quality from seawater intrusion was identified in the upper four aquifers. This was also evidenced by higher δ18O and δ2H values, typical of seawater. The four deeper aquifers contain high quality water characterised by less enriched 18O and 2H. This work presents new findings of very old groundwater in the Bangkok aquifer system.

Developments of a field gas extraction device and krypton purification system for groundwater radio-krypton dating at the IAEA.

The long-lived radio-krypton isotope 81Kr (t1/2 = 2.29 × 105 yr) is an ideal tracer for old groundwater age dating in the range of 105-106 years which goes beyond the reach of radio-carbon (14C) age dating. Analytical breakthrough made over the last two decades in Atom Trap Trace Analysis (ATTA) has enabled the use of this isotope with extremely low abundance (81Kr/Kr = 6 × 10-13) to be used as a practical dating tool for very old groundwater. The International Atomic Energy Agency aims to provide this new isotope tool for better groundwater resource management of Member States and developed a field sampling device to collect dissolved gas samples from groundwater and a system to separate and purify trace amounts of krypton from the gas samples for the ATTA analysis. The design, setup and performances of our sampling and purification systems are described here. Our system can produce a high purity aliquot of about 5 µL of krypton from 5 L of air sample (recovery yield of >90%). The samples made by our system were confirmed to be acceptable for the ATTA analysis.

Development of the Simulation-Positive Learning Evaluation (SIM-PLE) rubric for use in medical-surgical nursing high fidelity simulations.

Clinical nurse educators in a BSN program developed the SIM-PLE (Simulation-Positive Learning Evaluation) rubric to evaluate student performance in simulation. A pilot study was conducted over two semesters with junior level medical-surgical classes made up of approximately 110-130 students each semester, and the tool was revised and re-evaluated. Inter-rater reliability testing utilized 69 SIM-PLE rubric student evaluations (N = 69). Inter-rater reliability was assessed with comparison of lead faculty with three other instructors utilizing two raters for each simulation experience. The intraclass correlation coefficient (ICC) suggested high inter-rater reliability. The t-test difference was not significant. One-way analysis of variance (ANOVA) showed a significant difference in the Collaboration subcategory score. Univariate ANOVA indicated both raters scored consistently with each other overall and that they both scored JR1 differently than JR2. The pilot study and testing of interrater reliability of the rubric revealed positive findings. The role of the rubric in providing formative feedback during debrief sessions empowered students to analyze their own performance and/or experience to self-correct or improve their future practice based on these experiences.

Virtual Simulation to Increase Self-efficacy Through Deliberate Practice.

BACKGROUND: To reduce performance anxiety and increase engagement in medical-surgical simulations, virtual simulation (VS) was introduced prior to complex high-fidelity simulation to increase students' self-efficacy. PROBLEM: A presimulation preparation needed to be expanded for high-fidelity simulation involving emergent clinical situations. APPROACH: Combined frameworks of Ericsson's theory of deliberate practice and Bandura's self-efficacy theory were applied. Students completed VS scenarios until a specific score of mastery was obtained, and then the same scenario was repeated in the high-fidelity simulation laboratory. A modified self-efficacy scale survey was administered presimulation and postsimulation. Data were collected on 3 cohorts of students (n = 151) over an academic year. OUTCOMES: VS followed by high-fidelity simulation significantly increased student perception of self-efficacy in all 3 cohorts (P = .001, P = .037, P = .005). CONCLUSION: Preparation for high-fidelity simulation using VS increases self-efficacy and allows students to engage in the simulation experience, thus achieving higher levels of mastery through deliberate practice.

Emotional Intelligence: A Critical Evaluation of the Literature with Implications for Mental Health Nursing Leadership.

Emotional intelligence (EI) is necessary for the development of interpersonal and professional competence in nurses. We argue that the concept of emotional intelligence has particular relevance for mental health nursing leadership. In this critique, we examine the recent empirical evidence (2010-2014) related to emotional intelligence, in general, and nursing, specifically. Correlations between emotional intelligence and better overall health, increased work satisfaction, higher spiritual well-being, and decreased risk of job burnout are noted. We offer suggestions for mental health nurse leaders in developing successful project management teams and improving retention of current leaders. We also provide suggestions for future research.

Assessing the relationship between the WNSSP and therapeutic participation in adolescents in low response states following severe traumatic brain injury.

PRIMARY OBJECTIVE: This study examines the relationship between scores on the Western Neuro Sensory Stimulation Profile (WNSSP) and therapeutic participation as it relates to rehabilitation readiness (RR) in adolescents with low response following severe traumatic brain injury (TBI). RESEARCH DESIGN: This is a serial observational design using multiple measures of clinical status and participation. METHODS AND PROCEDURES: Ten children, mean age 16.7 years, who remained in a low response state (30 days or more) were assessed with the WNSSP and videotaped during physical and occupational therapy sessions. Associations were evaluated between WNSSP scores and participation scores related to arousal, awareness and communication. MAIN OUTCOMES AND RESULTS: The WNSSP was only associated with the communication score (p < 0.0001). The arousal and awareness scores had no significant impact on the WNSSP score. CONCLUSIONS: These results suggest that scores on the WNSSP may be related to the return of communication skills in adolescents in low response states as one part of assessing their therapeutic participation and ultimate rehabilitation readiness. This ability may assist in making decisions regarding care planning.

Constraints on neon and argon isotopic fractionation in solar wind.

To evaluate the isotopic composition of the solar nebula from which the planets formed, the relation between isotopes measured in the solar wind and on the Sun's surface needs to be known. The Genesis Discovery mission returned independent samples of three types of solar wind produced by different solar processes that provide a check on possible isotopic variations, or fractionation, between the solar-wind and solar-surface material. At a high level of precision, we observed no significant inter-regime differences in 20Ne/22Ne or 36Ar/38Ar values. For 20Ne/22Ne, the difference between low- and high-speed wind components is 0.24 +/- 0.37%; for 36Ar/38Ar, it is 0.11 +/- 0.26%. Our measured 36Ar/38Ar ratio in the solar wind of 5.501 +/- 0.005 is 3.42 +/- 0.09% higher than that of the terrestrial atmosphere, which may reflect atmospheric losses early in Earth's history.

MRI patterns in prolonged low response states following traumatic brain injury in children and adolescents.

OBJECTIVES: To explore the relationship between location and pattern of brain injury identified on MRI and prolonged low response state in children post-traumatic brain injury (TBI). METHODS: This observational study compared 15 children who spontaneously recovered within 30 days post-TBI to 17 who remained in a prolonged low response state. RESULTS: 92.9% of children with brain stem injury were in the low response group. The predicted probability was 0.81 for brain stem injury alone, increasing to 0.95 with a regional pattern of injury to the brain stem, basal ganglia, and thalamus. CONCLUSIONS: Low response state in children post-TBI is strongly correlated with two distinctive regions of injury: the brain stem alone, and an injury pattern to the brain stem, basal ganglia, and thalamus. This study demonstrates the need for large-scale clinical studies using MRI as a tool for outcome assessment in children and adolescents following severe TBI.

Dopamine agonist therapy in low-response children following traumatic brain injury.

The objective of this study was to determine whether a dopamine agonist could improve mental status among children in a low-response state following traumatic brain injury. In an 8-week, prospective, double-blind, randomized trial, 10 children and adolescents ages 8 to 21 years (X = 16.7 years) with traumatic brain injury sustained at least 1 month previously and remaining in a low-response state (Rancho Los Amigos Scale level pound 3) received pramipexole or amantadine. Medication dosage was increased over 4 weeks, weaned over 2 weeks, and then discontinued. At baseline and weekly during the study, subjects were evaluated with the Coma Near Coma Scale, Western NeuroSensory Stimulation Profile, and Disability Rating Scale. Scores improved significantly from baseline to the medication phase on the Coma Near Coma Scale, Western NeuroSensory Stimulation Profile, and Disability Rating Scale (P < .005). The weekly rate of change was significantly better for all three measures on medication than off medication (P < .05). Rancho Los Amigos Scale levels improved significantly on medication as well (P < .05). There was no difference in efficacy between amantadine and pramipexole. No unexpected or significant side effects were observed with either drug. This clinical trial supports the benefit of two dopamine agonists in the restoration of functional arousal, awareness, and communication. These drugs can be helpful in accelerating eligibility for acute rehabilitation among children and adolescents who have sustained significant brain injuries.