Routine measurements of inorganic phosphorus concentration are frequently made on standard oceanographic stations to ascertain the potential productivity of marine waters. In quantitative, ecological studies on diatom populations in the Atlantic Ocean, Riley, Stommel and Bumpus (1949) have utilized the phosphate concentration as a nutrient index. Their equation of productivity depends upon the experimental results of Ketchum (1939), who found that phosphate concentrations helow 0.55 microgram-atoms per liter limited the growth of Nitsschia clostcriitin.Riley, Stommel and Bumpus (1949) further checked the validity of this index in their photosynthetic rate equation by calculating the phosphate requirements of a growing plankton population, assuming that 100 carbon atoms to one atom of phosphorus are needed for normal metabolism. However, in studies on the fresh water diatom Astcrionella fonnosa, Lund (1950) found that the phosphate content of the plant varied by a factor of seventy in both natural and cultural populations. He stated that the cells are able to store phosphorus in excess of their immediate requirements even at very low levels of phosphate concentration.The data on the amount of phosphate contained in marine phytoplankton, as found by Ketchum and Redfield (1949), show considerable variation, making the determination of phosphate requirement difficult and uncertain. The use of phosphate as a parameter in the computation of productivity would appear to be premature therefore, until such time as definitive values of the phosphate requirement shall have been established. Even then the total mineral requirements relative to one another must be known and their seasonal and geographic abundances must be shown to vary with biological activity. The use of an arbitrary and easily measured nutrient index for correlation with diatom abundances seems to be unwarranted.The release of phosphate by marine plankton is an important factor in ecological investigations. Cooper (1935) found that one-fourth to one-half of the phosphate added as phytoplankton in sea water was set free to the environment as inorganic phosphate after one month. Seiwell and Seiwell (1938) reported similar results.

The two most critical lessons learned for the MHS during the PfP initiative are (1) continuous leadership engagement and inspection is vital to ensure field workers are engaged with safety and quality expectations and (2) applying a "one-size-fits-all" approach to improve a large delivery system is not effective. In addition, it is most impactful when local military treatment facility-level teams are involved in determining strategies to implement evidence-based standard processes and protocols that reduce variation when integrating practice change into daily operations. The MHS will continue to integrate PfP efforts into improvement activities by leveraging lessons learned from this initiative and determining how they can be applied to other areas of care and/or patient safety and quality initiatives. The Patient Safety Improvement Collaborative has committed to oversee and support the establishment and implementation of ongoing, focused patient safety and quality initiatives across the MHS using a collaborative vision to engage all levels of leadership and staff, and to ensure sustained improvements.

Public reporting burden tor this collection ot intormation is estimated to average 1 hour per response, including the time Tor reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington. DC 20503. Purpose: The purpose of this study was to provide recommendations for a delineated role of the PCNS that will provide role clarity and practice guidance. AGENCY USE ONLY (Leave blank)Methods: A systematic review of the literature was conducted utilizing an adaptation of Rheiner's "Role Theory Framework for Change". The initial search yielded 6374 articles.Thirteen percent (859) of the articles met inclusion criteria. In order to ensure consistency and confirmability, two members read each article and entered a synopsis into a review summary table. Synopses were analyzed using both deductive and inductive techniques.Results: There was no uniform role for the CNS identified through the literature, Conclusions: Competencies and educational preparation of the CNS are well defined by professional organizations however many nurses use the title without the credentials.Versatility of CNS practice, the lack of core or specialty certification, and the variance of state recognition all contribute to role confusion. Future research should evaluate the merging of the CNS and NP titles; the presence of PCNSs, their functions, spheres of influence, and patient outcomes. All authors are military members and are in transit at the time this manuscript is being submitted. Current addresses and duty assignments will be forwarded to AORN as soon as the members secure housing at their new duty stations. As we previously discussed, I will keep in contact with you during my travel. Tables Table 1 Keyword Phrases Table 2 The purpose of this study was to utilize an evidence-based approach to provide recommendations for a delineated role of the PCNS that would provide role clarity and practice guidance. Using a systematic review of the literature, the researchers analyzed the defined roles of the CNS in perioperative and non-perioperative practice and compared these roles to those of the Registered Nurse (RN) and Nurse Practitioner (NP) within the perioperative environment to answer the research question: What is a Perioperative Clinical Nurse Specialist? The specific study objectives are to compare and contrast the roles, competencies, and educational preparation of the previously stated specialties. As well as to identify and describe organizations/systems that influence their utilization and professional organizations that develop/recommend c...

Public reporting burden tor this collection ot intormation is estimated to average 1 hour per response, including the time Tor reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington. DC 20503. Purpose: The purpose of this study was to provide recommendations for a delineated role of the PCNS that will provide role clarity and practice guidance. AGENCY USE ONLY (Leave blank)Methods: A systematic review of the literature was conducted utilizing an adaptation of Rheiner's "Role Theory Framework for Change". The initial search yielded 6374 articles.Thirteen percent (859) of the articles met inclusion criteria. In order to ensure consistency and confirmability, two members read each article and entered a synopsis into a review summary table. Synopses were analyzed using both deductive and inductive techniques.Results: There was no uniform role for the CNS identified through the literature, Conclusions: Competencies and educational preparation of the CNS are well defined by professional organizations however many nurses use the title without the credentials.Versatility of CNS practice, the lack of core or specialty certification, and the variance of state recognition all contribute to role confusion. Future research should evaluate the merging of the CNS and NP titles; the presence of PCNSs, their functions, spheres of influence, and patient outcomes. All authors are military members and are in transit at the time this manuscript is being submitted. Current addresses and duty assignments will be forwarded to AORN as soon as the members secure housing at their new duty stations. As we previously discussed, I will keep in contact with you during my travel. Tables Table 1 Keyword Phrases Table 2 The purpose of this study was to utilize an evidence-based approach to provide recommendations for a delineated role of the PCNS that would provide role clarity and practice guidance. Using a systematic review of the literature, the researchers analyzed the defined roles of the CNS in perioperative and non-perioperative practice and compared these roles to those of the Registered Nurse (RN) and Nurse Practitioner (NP) within the perioperative environment to answer the research question: What is a Perioperative Clinical Nurse Specialist? The specific study objectives are to compare and contrast the roles, competencies, and educational preparation of the previously stated specialties. As well as to identify and describe organizations/systems that influence their utilization and professional organizations that develop/recommend c...

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