Senior nursing students' attitudes toward elderly persons and implications for curriculum design in baccalaureate nursing schools

Thesis (Ph. D.)--Michigan State University, 1991Includes bibliographical references (pages 115-119

Evaluation of a Hydrologic Model Applied to a Headwater Basin in the Rio Grande (USA) Using Observed and Modelled Land Surface Fluxes and States

Researchers at the Desert Research Institute are conducting research aimed at developing andcalibrating both operational and physically based numerical models that can be used to predict the quantityand timing of runoff in semi-arid regions where the majority of runoff originates in the seasonal snow pack.Unfortunately, observations of hydrologic variables (precipitation, streamflow, evapotranspiration, snowwater equivalent, etc.) are sparse in the semi-arid regions of the western United States and, therefore, theevaluation of model accuracy (usually in terms of streamflow) is often very limited. However, comparisonsof model output with newly developed high-resolution estimates of hydrologically based land surface fluxesand states may provide insight to model accuracy in areas with little or no observed information. In thisstudy, we apply a hydrologic model to a watershed in the headwaters of the Rio Grande to simulate thestreamflow generated at the watershed outlet and several internal subwatersheds. The model simulations ofstreamflow are compared to values from long term land surface model studies and observations at streamflowsurface water stations. Additional comparisons of model snow water equivalent (SWE) estimates are madewith the SWE values from the long term land surface model studies and SWE observations at three pointlocations within the watershed

USGS National Hydrologic Model: Continental Scale Modeling for Decision-making, Research, and Education

A comprehensive understanding of physical processes that affect streamflow is required to effectively manage water resources to meet present and future human and environmental needs. Water resources management from local to national scales can benefit from a consistent, process-based watershed modeling capability. The National Hydrologic Model (NHM), which was developed by the U.S. Geological Survey to support coordinated, comprehensive, and consistent hydrologic modeling at multiple scales for the conterminous United States, provides this essential capability. The NHM fills knowledge gaps in ungaged areas to disseminate nationally-consistent, locally informed, stakeholder relevant results. The NHM provides scientists, water resource managers, and the public knowledge to advance basic scientific inquiry, enable more informed and effective decision-making, and provide an educational resource to learn about all components of the water balance. In the future, as understanding of hydrologic processes allows for improved algorithms and data sets, the NHM will continue to evolve to better support the nation’s water-resources research, decision making, and education needs

Simulating future salinity dynamics in a coastal marshland under different climate scenarios

Salinization is a well‐known problem in agricultural areas worldwide. In the last 20–30 yr, rising salinity in the upper, unconfined aquifer has been observed in the Freepsumer Meer, a grassland near the German North Sea coast. For investigating long‐term development of salinity and water balance during 1961–2099, the one‐dimensional Soil–Water–Atmosphere–Plant (SWAP) model was set up and calibrated for a soil column in the area. The model setup involves a deep aquifer as the source of salt through upward seepage. In the vertical salt transport equation, dispersion and advection are included. Six different regional outputs of statistical downscaling methods were used as climate scenarios. These comprise different rates of increasing surface temperature and different trends in seasonal rainfall. The simulation results exhibit opposing salinity trends for topsoil and deeper layers. Although projections of some scenarios entail decreasing salinities near the surface, most of them project a rise in subsoil salinity, with the strongest trends of up to +0.9 mg cm−3 100 yr−1 at −65 cm. The results suggest that topsoil salinity trends in the study area are affected by the magnitude of winter rainfall trends, whereas high subsoil salinities correspond to low winter rainfall and high summer temperature. How these projected trends affect the vegetation and thereby future land use will depend on the future management of groundwater levels in the area

Health-related quality of life and long-term prognosis in chronic hypercapnic respiratory failure: a prospective survival analysis

<p>Abstract</p> <p>Background</p> <p>Health-related quality of life (HRQL) is considered as an important outcome parameter in patients with chronic diseases. This study aimed to assess the role of disease-specific HRQL for long-term survival in patients of different diagnoses with chronic hypercapnic respiratory failure (CHRF).</p> <p>Methods</p> <p>In a cohort of 231 stable patients (chronic obstructive pulmonary disease (COPD), n = 98; non-COPD (obesity-hypoventilation syndrome, restrictive disorders, neuromuscular disorders), n = 133) with CHRF and current home mechanical ventilation (HMV), HRQL was assessed by the disease-specific Severe Respiratory Insufficiency (SRI) questionnaire and its prognostic value was prospectively evaluated during a follow-up of 2–4 years, using univariate and multivariate regression analysis.</p> <p>Results</p> <p>HRQL was more impaired in COPD (mean ± SD SRI-summary score (SRI-SS) 52.5 ± 15.6) than non-COPD patients (67.6 ± 16.4; p < 0.001). Overall mortality during 28.9 ± 8.8 months of follow-up was 19.1% (31.6% in COPD, 9.8% in non-COPD). To identify the overall role of SRI, we first evaluated the total study population. SRI-SS and its subdomains (except attendance symptoms and sleep), as well as body mass index (BMI), leukocyte number and spirometric indices were associated with long-term survival (p < 0.01 each). Of these, SRI-SS, leukocytes and forced expiratory volume in 1 s (FEV₁) turned out to be independent predictors (p < 0.05 each). More specifically, in non-COPD patients SRI-SS and most of its subdomains, as well as leukocyte number, were related to survival (p < 0.05), whereas in patients with COPD only BMI and lung function but not SRI were predictive.</p> <p>Conclusion</p> <p>In patients with CHRF and HMV, the disease-specific SRI was an overall predictor of long-term survival in addition to established risk factors. However, the SRI predominantly beared information regarding long-term survival in non-COPD patients, while in COPD patients objective measures of the disease state were superior. This on one hand highlights the significance of HRQL in the long-term course of patients with CHRF, on the other hand it suggests that the predictive value of HRQL depends on the underlying disease.</p