Physician workforce in the United States of America: forecasting nationwide shortages.

Background: Physicians play a critical role in healthcare delivery. With an aging US population, population growth, and a greater insured population following the Affordable Care Act (ACA), healthcare demand is growing at an unprecedented pace. This study is to examine current and future physician job surplus/shortage trends across the United States of America from 2017 to 2030.

United States Registered Nurse Workforce Report Card and Shortage Forecast.

Registered nurses (RNs) play a critical role in health care delivery. With an aging US population, health care demand is growing at an unprecedented pace. Using projected changes in population size and age, the authors developed demand and supply models to forecast the RN job shortage in each of the 50 states.

United States Registered Nurse Workforce Report Card and Shortage Forecast: A Revisit.

This is a reevaluation of registered nurse (RN) supply and demand from 2016 to 2030 using a previously published work forecast model and grading methodology with more recent workforce data. There will be a shortage of 154 018 RNs by 2020 and 510 394 RNs by 2030; the South and West regions will have higher shortage ratios than Northeast and Midwest regions. This reflects a nearly 50% overall improvement when compared with the authors' prior study, and the low-performing states have improved from 18 "D" and 12 "F" grades as published earlier to 13 "D" and 1 "F" in this study.

U.S. Social Worker Workforce Report Card: Forecasting Nationwide Shortages.

Using age-based projected changes in population, the authors developed demand and supply models of the social worker workforce to project the shortage of social workers in all 50 states and assigned letter grades based on shortage ratios. According to the projections, the number of states with shortage ratios more severe than the current national ratio will increase from 11 states in 2012 to 30 states by 2030 and the nation will experience a total shortfall of over 195,000 social workers, with the most severe shortages occurring in the western and southern regions of the United States. Further efforts are recommended to investigate shortage dynamics and develop strategies to counter its causes.

Differential intensity-dependent effects of magnetic stimulation on the longest neurites and shorter dendrites in neuroscreen-1 cells.

Objective: Magnetic stimulation (MS) is a potential treatment for neuropsychiatric disorders. This study investigates whether MS-regulated neuronal activity can translate to specific changes in neuronal arborization and thus regulate synaptic activity and function.

Approach: To test our hypotheses, we examined the effects of MS on neurite growth of neuroscreen-1 (NS-1) cells over the pulse frequencies of 1, 5 and 10 Hz at field intensities controlled via machine output (MO).

Frequency-dependent effects of contralateral repetitive transcranial magnetic stimulation on penicillin-induced seizures.

Transcranial magnetic stimulation (TMS) has been shown to modulate multiple brain functions, warranting further exploration in clinical applications. TMS treatment for epilepsy is particularly promising because of its anti-convulsive capabilities. However, TMS has been found to both inhibit and facilitate various experimental and clinical seizures, depending on the TMS parameters used.

Nerve regeneration restores supraspinal control of bladder function after complete spinal cord injury.

A life-threatening disability after complete spinal cord injury is urinary dysfunction, which is attributable to lack of regeneration of supraspinal pathways that control the bladder. Although numerous strategies have been proposed that can promote the regrowth of severed axons in the adult CNS, at present, the approaches by which this can be accomplished after complete cord transection are quite limited. In the present study, we modified a classic peripheral nerve grafting technique with the use of chondroitinase to facilitate the regeneration of axons across and beyond an extensive thoracic spinal cord transection lesion in adult rats.

Transcranial magnetic stimulation after spinal cord injury.

Objective: To review the basic principles and techniques of transcranial magnetic stimulation (TMS) and provide information and evidence regarding its applications in spinal cord injury clinical rehabilitation.

Methods: A review of the available current and historical literature regarding TMS was conducted, and a discussion of its potential use in spinal cord injury rehabilitation is presented.

Results: TMS provides reliable information about the functional integrity and conduction properties of the corticospinal tracts and motor control in the diagnostic and prognostic assessment of various neurological disorders.

United States registered nurse workforce report card and shortage forecast.

Registered nurses (RNs) play a critical role in health care delivery. With an aging US population, health care demand is growing at an unprecedented pace. Using projected changes in population size and age, the authors developed demand and supply models to forecast the RN job shortage in each of the 50 states.

Fibronectin inhibits chronic pain development after spinal cord injury.

Chronic pain following spinal cord injury (SCI) is a highly prevalent clinical condition that is difficult to treat. Using both von Frey filaments and radiant infrared heat to assess mechanical allodynia and thermal hyperalgesia, respectively, we have demonstrated that a one-time injection of fibronectin (50 μg/mL) into the spinal dorsal column (1 μL/min each injection for a total of 5 μL) immediately after SCI inhibits the development of mechanical allodynia (but not thermal hyperalgesia) over an 8-month observation period following spinal cord dorsal column crush (DCC). DCC will only induce mechanical Allodynia, but not thermal hyperalgesia or overt motor deficits.

Physical therapy workforce in the United States: forecasting nationwide shortages.

Objective: To examine current and future physical therapy (PT) job surplus/shortage trends across the United States.

Design: Forecast models and grading methodology previously published for nursing were used to evaluate individual state PT job shortages from 2008 to 2030.

Setting: Not applicable.

Improvement of gait patterns in step-trained, complete spinal cord-transected rats treated with a peripheral nerve graft and acidic fibroblast growth factor.

The effects of peripheral nerve grafts (PNG) and acidic fibroblast growth factor (alpha FGF) combined with step training on the locomotor performance of complete spinal cord-transected (ST, T8) adult rats were studied. Rats were assigned randomly to five groups (N=10 per group): sham control (laminectomy only), ST only, ST-step-trained, repaired (ST with PNG and alpha FGF treatment), or repaired-step-trained. Step-trained rats were stepped bipedally on a treadmill 20 min/day, 5 days/week for 6 months.

Stimulation of the expiratory muscles using microstimulators.

Respiratory complications constitute a major cause of morbidity and mortality in patients with spinal cord injury. These complications arise in part due to the loss of supraspinal control over the expiratory muscles and the resultant difficulties in clearing airway secretions effectively. The purpose of the present study is to evaluate the efficacy of lower thoracic spinal nerve stimulation using wireless microstimulators in activating the expiratory muscles.

California regional registered nurse workforce forecast.

Objective: To forecast the shortage of registered nurses (RNs) of the 24 Primary Metropolitan Statistical Areas (PMSA) and Metropolitan Statistical Areas (MSA) in California.

Background: A nursing shortage prevails nationally and is most serious in the state of California. Successful interventions in the alleviation of the RN shortage will require effective resource allocation and academic program development in various regions throughout the state.

Repair of spinal cord transection and its effects on muscle mass and myosin heavy chain isoform phenotype.

A number of significant advances have been developed for treating spinal cord injury during the past two decades. The combination of peripheral nerve grafts and acidic fibroblast growth factor (hereafter referred to as PNG) has been shown to partially restore hindlimb function. However, very little is known about the effects of such treatments in restoring normal muscle phenotype.

California regonal regstered nurse workforce report card.

Various reports and opinion papers have offered suggestions to alleviate the national and California RN shortages. The methodology of using the report card concept for comparing the number of RN jobs per 100,000 populations regionally with the national database further highlights the severe shortage of RN's in various regions in California. This report card method may potentially be used as a planning or forecasting tool, as well as a monitoring tool to initiate workforce development strategies and projects, and to evaluate their effectiveness over time.

Re-growth of catecholaminergic fibers and protection of cholinergic spinal cord neurons in spinal repaired rats.

The extent of re-growth of catecholaminergic fibers, the survival of cholinergic neurons and the degree of autonomic dysreflexia were assessed in complete spinal cord-transected adult rats that received a repair treatment of peripheral nerve grafts and acidic fibroblast growth factor (aFGF). The rats were randomly divided into three groups: (1) sham control group (laminectomy only); (2) spinal cord transection at T8 (transected group); and (3) spinal cord transection at T8, followed by aFGF treatment and peripheral nerve graft (repaired group). The spinal cords and brains of all rats were collected at 6 months post-surgery.

Optimal arrangement of magnetic coils for functional magnetic stimulation of the inspiratory muscles in dogs.

In an attempt to maximize inspiratory pressure and volume, the optimal position of a single or of dual magnetic coils during functional magnetic stimulation (FMS) of the inspiratory muscles was evaluated in twenty-three dogs. Unilateral phrenic magnetic stimulation (UPMS) or bilateral phrenic magnetic stimulation (BPMS), posterior cervical magnetic stimulation (PCMS), anterior cervical magnetic stimulation (ACMS) as well as a combination of PCMS and ACMS were performed. Trans-diaphragmatic pressure (Pdi), flow, and lung volume changes with an open airway were measured.

Modulation of cardiovascular excitatory responses in rats by transcutaneous magnetic stimulation: role of the spinal cord.

This study investigated the efficacy of magnetic stimulation on the reflex cardiovascular responses induced by gastric distension in anesthetized rats and compared these responses to those influenced by electroacupuncture (EA). Unilateral magnetic stimulation (30% intensity, 2 Hz) at the Jianshi-Neiguan acupoints (pericardial meridian, P 5-6) overlying the median nerve on the forelimb for 24 min significantly decreased the reflex pressor response by 32%. This effect was noticeable by 20 min of magnetic stimulation and continued for 24 min.

Functional magnetic ventilation in dogs.

Objective: To investigate the efficacy of the magnetic stimulation of inspiratory muscles as an alternative to mechanical ventilation and functional electric stimulation.

Design: A prospective before-after trial.

Setting: Functional magnetic stimulation laboratory in a Veterans Administration health care system.

Motor recovery and anatomical evidence of axonal regrowth in spinal cord-repaired adult rats.

Behavioral assessments of hindlimb motor recovery and anatomical assessments of extended axons of long spinal tracts were conducted in adult rats following complete spinal cord transection. Rats were randomly divided into 3 groups: 1) sham control group (laminectomy only; n = 12); 2) transection-only group, spinal cord transection at T8 (n = 20); and 3) experimental treatment group, spinal cord transection at T8, with peripheral nerve grafts (PNG) and application of acidic fibroblast growth factor (aFGF) (n = 14). The locomotor behavior and stepping of all rats were analyzed over a 6-month survival time using the Basso, Beattie, Bresnahan (BBB) open field locomotor test and the contact placing test.

Effects of nerve graft on nitric oxide synthase, NAD(P)H oxidase, and antioxidant enzymes in chronic spinal cord injury.

Oxidative stress and nitrosative stress play important roles in the pathogenesis of secondary spinal cord injury. Recently, we demonstrated that peripheral nerve grafts (PNG) with acidic fibroblast growth factor (aFGF) partially restore hind limb locomotion in adult rats with completely transected spinal cords. This study investigated the protein abundances of the superoxide (O2*)-generating enzyme nicotinamide adenine dinucleotide (phosphate) oxidase (NAD(P)H oxidase; gp91phox subunit), nitric oxide synthases (NOS), antioxidant enzymes, superoxide dismutases (Cu Zn SOD, Mn SOD), catalase, and glutathione peroxidase (GPX) as well as nitrotyrosine in the spinal cord tissue 4 months after spinal cord transection in rats with and without PNG and aFGF.

NAD(P)H oxidase, superoxide dismutase, catalase, glutathione peroxidase and nitric oxide synthase expression in subacute spinal cord injury.

Primary trauma to the spinal cord triggers a cascade of cellular and molecular events that promote continued tissue damage and expansion of the lesion for extended periods following the initial injury. Oxidative and nitrosative stresses play an important role in progression of spinal cord injury (SCI). In an attempt to explore the biochemical origin of oxidative/nitrosative stress associated with secondary SCI, we studied expression of the superoxide (O2*-)-generating enzyme, NAD(P)H oxidase, antioxidant enzymes [superoxide dismutase (CuZn SOD, Mn SOD), catalase, glutathione peroxidase (GPX)], nitric oxide synthases (NOS) and a byproduct of NO-O2*- interaction (nitrotyrosine) in the spinal cord tissues of rats 16 h and 14 days after surgical resections of a 5-mm segment of the cord below T8 or sham-operation.