Performance comparison of a pilot-scale membrane bioreactor and a full-scale sequencing batch reactor with sand filtration: treatment of low strength wastewater from a northern Canadian Aboriginal Community.

Northern Aboriginal communities in Canada suffer from poor wastewater treatment. Treatment systems on 75% of Manitoban Aboriginal communities produce substandard effluent despite the presence of sophisticated treatment systems. A 200-litre, pilot-scale membrane bioreactor (MBR) was established on the Opaskwayak Cree Nation to investigate the feasibility of MBRs in mitigating Aboriginal wastewater treatment issues. The pilot system was remote controlled and monitored via the Internet using the program pcAnywhere. The community utilized two existing sequencing batch reactors (SBR) and three sand filters for wastewater treatment. The community wastewater was relatively weak and highly fluctuating which led to poorly settling sludge that readily fouled the sand filters. A comparison study between the MBR and SBR was undertaken from September to December 2003. Operated at a 10-hour hydraulic retention time and 20-day solids residence time, the MBR outperformed the SBR and sand filtration on BOD and suspended solids removal. Furthermore, the MBR showed high levels of nitrification despite relatively cold water temperatures.

Nursing knowledge development through research: using the Roy adaptation model.

Almost half of the ancillary propositions tested in the metaparadigm category were related to the concept of person, and 94% were supported. Theoretically and empirically, there is support for Roy's conceptualization of the person as an adaptive system. Almost 25% of the ancillary propositions tested were related to the concept of health, of which the great majority were supported. Theoretically and empirically, there is support for Roy's conceptualization of health as an outcome of adaptation. Approximately 75% of the ancillary propositions tested were related to the concept of person or health. Of these, only 5 out of 55 ancillary propositions were not supported, or less than 10%. Less than 13% of the ancillary propositions that were tested focused on the metaparadigm concepts of environment or nursing. Of these, 15% were not supported. These findings are not surprising, because conceptual clarity is the foundation of practice theory. The hierarchy of research, according to the classic work by Dickoff and James (1968), progresses from understanding and describing phenomena to situation-producing theory. Nursing models are relatively young. Research is required to validate the concepts within the models. Situation-producing theory, based on the concepts, guides nursing actions and is necessary for a practice discipline to maintain its status as a profession. Based on the findings of the integrative research review, adequate research has provided support for Roy's conceptualization of the metaparadigm concepts of person and health. Future research needs to be directed toward testing propositions derived from the RAM concepts of environment and nursing. Intervention studies need to be designed based on concepts that have been supported. Knowledge development through research and testing of propositions based on the RAM continues to contribute to nursing science. Future directions for RAM research are clear.

Columbia-Presbyterian nursing alumni: a case study in American social history.

Using survey data obtained from 2,601 undergraduate nursing alumni, this descriptive study demonstrates the ways nursing's development has reflected America's social history.

Contributions to nursing science: synthesis of findings from adaptation model research.

Researchers who had used the Roy Adaptation Model (RAM) to guide their individual investigations collaborated to enhance knowledge development about adaptation of adults to actual and potential health problems. The purpose of this article is to present the synthesis of findings across selected studies that used the RAM. From this synthesis, middle-range theories were identified that in turn provided the scientific rationale for development and testing of clinical interventions. Contributions to the advancement of nursing science include a method to strengthen the relationships between research, theory, and practice; and increased understanding of the process of adaptation in adults; support for the efficacy of the RAM for nursing practice; and the benefit of collaboration between nursing researchers using the same model to guide their work.

Precise ablation of skin with reduced collateral damage using the femtosecond-pulsed, terawatt titanium-sapphire laser.

BACKGROUND AND DESIGN: The precise ablation of skin was studied using an ultrashort-pulsed, high-intensity titanium-sapphire (Ti:Al2O3) laser capable of peak intensities of tens of terawatts (TW; 1 TW = 10(12) watts [W]) per square centimeter. Rat skin was exposed in vitro to femtosecond-pulsed Ti:Al2O3 laser radiation at 800 nm, while varying the number of pulses and the intensity up to 46 TW/cm2. Ablation was evaluated by monitoring the amount of tissue removed per pulse as a function of energy, and by light microscopic examination of damage to adjacent, nonirradiated tissue. OBSERVATIONS: Ablation depth per pulse was 0.1 micron at threshold intensity, and it was increased with both the energy per pulse and the number of pulses. Minimal damage to adjacent healthy tissue was observed, varying 0 to 30 microns. CONCLUSION: The results suggest that ablation of skin with femtosecond-pulsed, terawatt Ti:Al2O3 laser may have potential for precision cutaneous surgery, and in vivo studies are indicated.

Long-term biopsychosocial effects of interleukin-2 therapy.

This three-year project evaluates the biopsychosocial effects of interleukin-2 (IL-2) therapy on the first 45 patients treated with the therapy at the Moses Division of the Montefiore Medical Center in Bronx, NY, starting in April 1986. Therapy with IL-2 and lymphokine-activated killer (LAK) cells is a promising new development but requires an extensive amount of supportive care. Various important issues must be considered in planning the care of patients being treated with IL-2, including the effects of the treatment on quality of life, the cost of resources necessary for providing therapy, and the emotional effects of treatments. The instruments used to measure the various aspects of quality of life were the Sickness Impact Profile, the Inventory of Current Concerns, the Symptom Distress Scale, the Acute Physiology and Chronic Health Evaluation Scale, and the Therapeutic Intervention Scoring System. The researchers believe that, in addition to tumor response, the biopsychosocial and financial effects of treatment should be understood.

Testing hypotheses derived from the Roy Adaptation Model.

This study investigated the role of perception and biopsychosocial adaptation in patients with cancer entering an aggressive cancer treatment program. The Roy adaptation model provided the framework from which hypotheses were derived and tested. The hypotheses proposed that physiological stimuli are translated by the cognator through perception that alters the biopsychosocial responses. Forty-five patients were tested as they entered into the chemotherapy program. The APACHE II was used to measure actual physiological status; the Symptom Distress Profile was used to measure subjects' perceived physiological discomfort, and the Sickness Impact Profile was used to measure subjects' perceived effect of the cancer on their psychosocial adaptation. The results supported the theoretical predictions that perception of symptoms is positively correlated with psychosocial adaptation and not with actual physiological status. In addition, perception of symptoms and psychosocial adaptation were correlated with survival at six months and not with actual physiological status. Discussion of findings addresses theoretical and practice issues.

Anxiety transmission in the patient with myocardial infarction.

The purpose of this study was to examine and document the transmission of anxiety between the family of the patient with cardiac disease and the nurse and between the family and the patient in the coronary care unit (CCU). A nonrandomized sample of 23 patients with an acute myocardial infarction were recruited from two CCUS. An interaction between the CCU nurse and the patient's family member was tape recorded, and immediately thereafter a conversation between the patient and the family member was recorded. Statistical analysis of the data did not support a relationship between the anxiety of the family member and the nurse but did support a positive relationship between the anxiety of the family member and the CCU patient. The study represents a preliminary investigation of the phenomenon of anxiety contagion.