The Curiosity Rover's Exploration of Glen Torridon, Gale Crater, Mars: An Overview of the Campaign and Scientific Results.

The Mars Science Laboratory rover, Curiosity, explored the clay mineral-bearing Glen Torridon region for 1 Martian year between January 2019 and January 2021, including a short campaign onto the Greenheugh pediment. The Glen Torridon campaign sought to characterize the geology of the area, seek evidence of habitable environments, and document the onset of a potentially global climatic transition during the Hesperian era. Curiosity roved 5 km in total throughout Glen Torridon, from the Vera Rubin ridge to the northern margin of the Greenheugh pediment. Curiosity acquired samples from 11 drill holes during this campaign and conducted the first Martian thermochemolytic-based organics detection experiment with the Sample Analysis at Mars instrument suite. The lowest elevations within Glen Torridon represent a continuation of lacustrine Murray formation deposits, but overlying widespread cross bedded sandstones indicate an interval of more energetic fluvial environments and prompted the definition of a new stratigraphic formation in the Mount Sharp group called the Carolyn Shoemaker formation. Glen Torridon hosts abundant phyllosilicates yet remains compositionally and mineralogically comparable to the rest of the Mount Sharp group. Glen Torridon samples have a great diversity and abundance of sulfur-bearing organic molecules, which are consistent with the presence of ancient refractory organic matter. The Glen Torridon region experienced heterogeneous diagenesis, with the most striking alteration occurring just below the Siccar Point unconformity at the Greenheugh pediment. Results from the pediment campaign show that the capping sandstone formed within the Stimson Hesperian aeolian sand sea that experienced seasonal variations in wind direction.

Orbital and In-Situ Investigation of Periodic Bedrock Ridges in Glen Torridon, Gale Crater, Mars.

Gale crater, the field site for NASA's Mars Science Laboratory Curiosity rover, contains a diverse and extensive record of aeolian deposition and erosion. This study focuses on a series of regularly spaced, curvilinear, and sometimes branching bedrock ridges that occur within the Glen Torridon region on the lower northwest flank of Aeolis Mons, the central mound within Gale crater. During Curiosity's exploration of Glen Torridon between sols ∼2300-3080, the rover drove through this field of ridges, providing the opportunity for in situ observation of these features. This study uses orbiter and rover data to characterize ridge morphology, spatial distribution, compositional and material properties, and association with other aeolian features in the area. Based on these observations, we find that the Glen Torridon ridges are consistent with an origin as wind-eroded bedrock ridges, carved during the exhumation of Mount Sharp. Erosional features like the Glen Torridon ridges observed elsewhere on Mars, termed periodic bedrock ridges (PBRs), have been interpreted to form transverse to the dominant wind direction. The size and morphology of the Glen Torridon PBRs are consistent with transverse formative winds, but the orientation of nearby aeolian bedforms and bedrock erosional features raise the possibility of PBR formation by a net northeasterly wind regime. Although several formation models for the Glen Torridon PBRs are still under consideration, and questions persist about the nature of PBR-forming paleowinds, the presence of PBRs at this site provides important constraints on the depositional and erosional history of Gale crater.

Liminal Space of First-Episode Psychosis: Health Management and Its Effect on Social Participation.

IMPORTANCE: Managing health requires extensive time and effort, especially in the early stages of a new illness. Although important, health management occupations contribute to treatment burden, disrupt engagement in other occupations, and galvanize the incorporation of the illness into identity. This is especially true for young adults after first-episode psychosis (FEP). OBJECTIVE: To explore the impact of health management occupations on the social participation of young adults after FEP. DESIGN: Qualitative study. SETTING: Community with participants from primarily urban environments. PARTICIPANTS: Five adults between 18 and 30 yr old who experienced FEP within the previous 5 yr. Data collection occurred through semistructured interviews, participant observations, and discourse elicitation. Outcomes and Measures: Two participant observations per month for 6 mo with 4 study participants; six observations total for a 5th participant. RESULTS: Health management dominated participants' occupations immediately after FEP and hindered their social participation as they experienced a liminal space (i.e., transition space) in their life trajectory. Some participants were "stuck" in this space and deferred life goals to focus on illness management, whereas others used the liminal space as a space for growth and transformation. CONCLUSIONS AND RELEVANCE: Health management occupations are essential; however, overemphasizing health management can hinder social participation and quality of life. Occupational therapy practitioners can assist clients with moving through liminal spaces after diagnosis by supporting participation beyond mental health treatment environments, helping clients to imagine alternative life trajectories, and finding strategies to reduce overall treatment burden. What This Article Adds: The concept of liminality holds promise for understanding and supporting health management and social participation after FEP.

Beyond Thiamine: Treatment for Cognitive Impairment in Korsakoff's Syndrome.

BACKGROUND: Wernicke's encephalopathy is a condition whose treatment many consultation-liaison psychiatrists know quite well. Less clear, however, is the treatment of its dementia disorder descendent, the Korsakoff's syndrome (KS). OBJECTIVE: This article seeks to review treatment options and provide recommendations for consultation-liaison psychiatrists treating cognitive impairment in KS. METHODS: In this nonsystematic review, we reviewed PubMed, CINAHL Plus, and Google Scholar for published reports and studies regarding treatment of KS. RESULTS: The literature revealed case reports and placebo-controlled trials of various medications for treatment of KS, though the samples sizes were small and were mostly case reports. There is more attention devoted toward medications used in other dementia disorders, such as donepezil and memantine. The literature revealed more studies around behavioral interventions recommended for treatment of memory impairment in KS and they focused on cognitive remediation and environmental adaptation, such as the use of PDAs or alarms. CONCLUSIONS: There is no single, well-studied intervention proven effective as a primary treatment for cognitive impairment in KS. An approach of using environmental modifications in a well-structured living environment, combined with various cognitive interventions, such as pictorial associations, and perhaps a trial of donepezil or memantine, likely represents the best strategy for treating long-term cognitive impairment in KS.

Bag Valve Mask Ventilation as a Perceptual-Cognitive Skill.

Objective This study used a high-fidelity infant mannequin to examine the relationship between the quality of bag valve mask ventilation (BVMV) and how providers of varying levels of experience use visual feedback (e.g., electronic vital signs) to guide their performance. Background BVMV is a common and critical procedure for managing pediatric respiratory emergencies. However, providers do not consistently deliver effective BVMV. Efforts to improve BVMV have ignored the question of how providers effectively use feedback often available during BVMV. Method Six expert and six novice respiratory therapists completed two simulations of an infant requiring BVMV. In one, the technology failed to display SpO2, an important but somewhat redundant visual cue. Eye movements, verbal reports, and ventilation rate (in breaths per minute) were measured in each simulation. Results Regardless of SpO2 availability, eye movements and verbal reports suggested that novices depended strongly on electronic vital signs and when SpO2 was absent ventilated at a faster rate (exceeding the recommended range of ventilation rates) than when SpO2 was present. Experts' ventilation rates were comparable and within the recommended range in both conditions. When SpO2 was absent, experts emphasized information from direct observation of the patient that novices neglected. Conclusion Individual differences in the use of feedback during BVMV contribute to the quality of BVMV. This work bears on the theoretical discussions involving the use of automation and nontechnological cues to guide performance. Application These results have the potential to expand the current understanding of factors underlying effective BVMV with implications for training novice providers.

Caring Across the Continuum: A Call to Nurse Leaders to Manifest Values Through Action With Community Outreach.

As health reform continues to advance, there is a need for nurse leaders to broaden their perspective related to possible nursing practice models and potential community partners in order to successfully address caring, accomplish the triple aim mandate, and achieve suitable metrics for maximum reimbursement. Intentional efforts must be made by nurse leaders to maximize caring and ensure that professional nurses are responding to the key drivers shifting health care delivery in the 21st century. Academic-practice collaboration (APC) and community-based participatory action research (CBPAR) align well. Together, they provide an ideal mechanism to pursue endeavors that extend evidence for caring services across the health care continuum. One APC/CBPAR model for community outreach that can maximize individual and population health outcomes is highlighted in this article. Furthermore, useful action steps are offered that could be taken by a nurse leader to develop and maintain any form of APC/CBPAR in order to manifest values through caring action across the health care continuum.

Transitional Care Partners: a hospital-to-home support for older adults and their caregivers.

PURPOSE: To describe the development, implementation, and preliminary results of the Transitional Care (TLC) Partners, a clinical demonstration program that supports the transition from hospital to home of older veterans. DATA SOURCES: Hospital records of TLC patients to track their hospital and emergency department visits before and after the TLC Partners enrollment. Caregivers of patients completed Preparedness in Caregiving and the Short Form Zarit Burden Scale during the first week of the TLC Partners enrollment and on the week when the services ended. CONCLUSIONS: The proportion of patients with one or more emergency department visits and rehospitalization is consistently lower among TLC patients compared to non-TLC patients at 30 and 60 days of hospital discharge. The mean preparedness and burden scores before and after the program essentially remained the same. IMPLICATIONS FOR PRACTICE: The description of the implementation of the TLC Partners offers an example of how nurse practitioner-led interprofessional care models can be adapted to the needs of specific healthcare systems, and how they can be monitored to evaluate their reach, effectiveness, and fidelity to the core components of proved care models.

"Medication".

I have written this article because medication is a very important part of dealing with mental illness. I have not read other articles on this subject and have wanted to write about it for at least a year. Perhaps a better title would have been "Over-Medication." My concern with medications is that high doses, sometimes with more than one antipsychotic medication plus other pills, are prescribed. I wanted to raise consciousness about the ability to function when a person is so heavily medicated. In my journey of mental illness, on two occasions I was heavily medicated and found it very difficult to stay awake--let alone function. Another area touched on is the new concept of patient/therapist partnership. Therapeutic relationships in the past had been more a case of the therapist knew what was best. Today therapeutic relationships, I believe, must be partnerships, especially in the area of medication. Patients know when they feel poorly on a medication. Are their feelings listened to?

First person account: schizophrenia and motherhood.

With this article I want to give insight into what having children and dealing with schizophrenia is like. I go from a young woman wanting to experience motherhood, to being diagnosed with schizophrenia, to marrying and having two children. It is not easy dealing with schizophrenia and mothering, but the rewards are wonderful. In my case, I had one very serious schizophrenia episode, and I became homeless and my children went to live with their father. I eventually got better and reunited with my children, but our lives had changed. In this article I describe the adjustments we all had to make, the heartaches, the struggles, and finally the love that has prevailed. Today, especially with the newer medications, more persons suffering with mental illness are marrying, and the possibility of starting families is very real. Perhaps a young person with a diagnosis of mental illness will read my factual account, and it will help her to make a decision that will change the rest of her life. In closing the article, I raise the question, "If I had to do it over again, would I?" I also share the reason for my decision.

Phase II trial of temozolomide in patients with progressive low-grade glioma.

PURPOSE: Temozolomide (Temodar; Schering-Plough Corp, Kenilworth, NJ) is an imidazole tetrazinone that undergoes chemical conversion to the active methylating agent 5-(3-methyltriazen-1yl)imidazole-4-carboximide under physiologic conditions. Previous studies have confirmed activity of Temodar in the treatment of progressive and newly diagnosed malignant gliomas. We have extended these results, and now we report results of a phase II trial of Temodar for patients with progressive, low-grade glioma. PATIENTS AND METHODS: Temodar was administered orally once a day for five consecutive days (in a fasting state) at a starting dose of 200 mg/m(2)/d. Treatment cycles were repeated every 28 days following the first daily dose of Temodar. Response criteria used a combination of magnetic resonance imaging and physical examination to evaluate activity. RESULTS: Forty-six patients with low-grade glioma have been treated to date. The objective response rate was 61% (24% complete response and 37% partial response), with an additional 35% of patients having stable disease. Median progression-free survival (PFS) was 22 months (95% confidence interval [CI], 15 to infinity months) with a 6-month PFS of 98% (95% CI, 94% to 100%) and a 12-month PFS of 76% (95% CI, 63% to 92%). Toxicity observed during the study was limited to only six patients. Three patients experienced grade 3 neutropenia, with a duration greater than 3 weeks in one patient, and two patients experienced grade 3 thrombocytopenia. One patient experienced > or = grade 4 toxicity, with intracerebral hemorrhage, neutropenia, thrombocytopenia, sepsis, and death. CONCLUSION: Initial results indicate that Temodar may be active in the treatment of low-grade glioma, and thus, further evaluation of this agent in the treatment of these tumors is warranted.

Therapeutic alliance.

I have been very fortunate in my journey of mental illness. I respond well to medication, but I don't think that is the complete answer to living successfully with serious, persistent mental illness. I believe a person's environment is also of utmost importance, enabling the person suffering with mental illness to continually grow in life. I found early in my struggle with mental illness a psychiatrist with whom I have always had a very good rapport. Until recently I didn't know that what I have with this psychiatrist is professionally known as a therapeutic alliance. Over the years, when I need someone to talk over anything that is troubling to me, I seek my psychiatrist. A therapeutic alliance is non-judgmental; it is nourishing; and finally it is a relationship of complete trust. Perhaps persons reading this article who have never experienced this alliance will seek it. I believe it can make an insecure person secure; a frightened person less frightened; and allow a person to continue the journey of mental health with a sense of belief in oneself.

I am a mental health professional; my credential: life experience.

History is in the making in the mental health movement, with persons who live with a mental illness, are stable, and work in the mental health field as professionals (known as Consumer Providers). It is a new concept; and as with anything new, there is some resistance, some doubt about the wisdom of such a concept. With this article, I want to educate those who read it and hopefully gain enthusiasm for the growth of the Consumer Provider movement. I have lived with mental illness for many years and have only received mental health services from traditional mental health professionals; there were no Consumer Providers when I was ill. I was pleased with my services. However, I believe very strongly in the Consumer Provider movement because the same concept has been ongoing in Alcoholics Anonymous with great success. In AA settings, life-experience professionals have worked side by side with traditionally educated professionals to counsel persons with substance abuse problems. I would like to see Consumer Providers be included in all areas of mental health treatment. Today I know of Consumer Providers on PACT teams, ICMS teams, at Drop-in Centers, and on some Warm Lines. My vision is to see Consumer Providers work throughout the mental health system, including crisis teams, inpatient hospital settings, residential settings, and outpatient programs.