Charge-Induced Force Noise on Free-Falling Test Masses: Results from LISA Pathfinder.

We report on electrostatic measurements made on board the European Space Agency mission LISA Pathfinder. Detailed measurements of the charge-induced electrostatic forces exerted on free-falling test masses (TMs) inside the capacitive gravitational reference sensor are the first made in a relevant environment for a space-based gravitational wave detector. Employing a combination of charge control and electric-field compensation, we show that the level of charge-induced acceleration noise on a single TM can be maintained at a level close to 1.0 fm s^{-2} Hz^{-1/2} across the 0.1-100 mHz frequency band that is crucial to an observatory such as the Laser Interferometer Space Antenna (LISA). Using dedicated measurements that detect these effects in the differential acceleration between the two test masses, we resolve the stochastic nature of the TM charge buildup due to interplanetary cosmic rays and the TM charge-to-force coupling through stray electric fields in the sensor. All our measurements are in good agreement with predictions based on a relatively simple electrostatic model of the LISA Pathfinder instrument.

Sofosbuvir and Simeprevir for the Treatment of Recurrent Hepatitis C with Fibrosing Cholestatic Hepatitis after Liver Transplantation.

Fibrosing cholestatic hepatitis (FCH) is an aggressive form of hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT), which frequently results in graft failure and death. Treatment of FCH remains challenging, and the optimal antiviral therapy is yet to be determined. Between November 2013 and early 2015, 62 patients with HCV cirrhosis underwent OLT at our transplant center, of whom, 5 patients developed recurrence HCV in the form of severe FCH and were treated with sofosbuvir and simeprevir (SOF-SMV) for 24 weeks. All patients achieved significant improvement of HCV viral load and had undetectable viral PCR at 6-8 week of treatment. The HCV RNA remained undetectable throughout treatment course. The first two patients achieved SVR at week 12 after completion of the treatment. There were significant histologic and biomarkers improvements after initiation of the treatment. One patient developed refractory pruritus and acute pancreatitis. The second, fourth and fifth patients had very benign treatment courses with no side effects recorded. The third patient was starting the treatment with multiple comorbid conditions. His course was complicated with hepatic artery thrombosis, and later developed sepsis and renal failure. Therefore, it seems that the combination of SOF-SMV is an efficacious oral regimen in OLT recipient with recurrent hepatitis C and FCH. However, safety profile needs to be carefully evaluated.

Stability of cardiac troponins and CK-MB mass isoenzyme.

The stability of an analyte can have an important influence on its diagnostic performance and therefore should be documented before an analyte is introduced into routine practice. The stability of creatine kinase MB isoenzyme (CK-MB), troponin I and troponin T was studied by incubating samples at temperatures between 26 degrees C and 39 degrees C for periods up to 5400 min. Arrhenius plots were made which showed that all three proteins demonstrated a rapid decrease in stability between 15 degrees C and 20 degrees C. The activation energies for CK-MB, troponin I and troponin T were 7.7, 6.34 and 6.34 cal/mol, respectively.

Ethanol labeling: detection of early fluid absorption in endometrial resection.

A study is presented of ethanol labeling of irrigation fluid in endometrial resection. The introduction of ethanol labeling and intraoperative breath ethanol analysis provided an inexpensive and potentially useful means of detecting early fluid absorption during uterine surgery. The breath ethanol analyzer used was a hand-held meter; the irrigant solution was 5% dextrose with 1% ethanol. Simultaneous breath and venous samples were taken from women undergoing endometrial resection. An increase in breath ethanol was positively correlated with fluid absorption, blood ethanol, and serum glucose. This technique may prove valuable in preventing fluid overload during endometrial resection.

Building a professional environment in long-term care. The role of clinical career development.

1. To be successful, an organizational career development program must include a differentiation of the responsibilities for which the various parties (employer, employee, career counselor) will be held accountable. 2. Project outcomes revealed that the career mobility program was attractive to nursing personnel and facility management personnel alike. However, it was more attractive to nonlicensed than licensed personnel. 3. Of the staff who participated and were promoted, the majority remained in their jobs. The program was most successful in enhancing retention with personnel who received within-level promotions. 4. The process of career development requires collaboration and support from all levels of leadership and staff throughout the organization. A career development program, including a career mobility program with a strong career counseling component, can serve as a catalyst in professionalizing the long-term care work environment.

Social policy statements: guidelines for decisionmaking.

As healthcare providers, nurses have a professional responsibility to act on behalf of the public they serve by influencing health policy. One tool that can direct nurses in this political activity is a social policy statement. Its importance and strategies for use are described below.

A career mobility program for skilled nursing facilities.

This article reports the results of a 3-year demonstration project in career mobility for nursing personnel in skilled nursing facilities. The goal of the project was to demonstrate the effectiveness of a career mobility program in addressing service delivery challenges such as recruitment, retention, and satisfaction of nursing personnel in skilled nursing facilities. The project was a joint effort between an educational department of a large university and a major long-term care corporation. The project evaluation addressed the effectiveness of this career mobility program in attracting and retaining nursing personnel, the satisfaction of nursing personnel with their jobs, and whether the additional training affected the quality of care. Five pilot and three comparison sites were designated in Southern California. Survey, self-report, and interview data were collected at yearly intervals and at the completion of the project. Descriptive statistics and analysis of variance formed the basis for data analysis and interpretation. Overall, the findings suggested that the career mobility program has the potential to retain staff who benefit from a career development program. The career mobility program was a valuable strategy, but its success was only as good as the management team's authority to support the program and emphasize its goals.

The coming of age in nursing care of the elderly.

Worldwide trends and developments point the way toward a restructuring of health care delivery systems to meet increased demands from the elderly and disabled. As nursing, by virtue of its unique position, can play a major role in gerontological care, below the authors present three models that optimize nursing care to ensure effective and efficient service.

Facilitating research utilization: a model for nurse managers.

Nursing research utilization has been studied and models have been developed by many nursing groups. However, the important role of the nurse administrator or manager in promoting utilization of research has been neglected. This pilot study used a nursing diagnosis--alterations in comfort (pain)--to identify common and expected variables in selected studies. Findings from this research together with the literature on research utilization models provided the foundation for the development of a preliminary model for nurse managers. The authors discuss this process and make recommendations for implementation.

The tools of management: keeping high touch in a high tech world.

Three of Naisbitt's Megatrends: information processing, high tech/high touch and participatory management--welded into tools of management--have particular relevance for nurses throughout the world. Their use is explored in this paper delivered at a Special Interest Session in Tel Aviv at the ICN Congress.