Hospital-Based Nurse Practitioner Practice: An Exploration of Interprofessional Teams.

Nurse practitioner (NP) roles within hospital teams are evolving worldwide. However, understanding of their practice within the context of interprofessional (IP) teamwork remains limited. This two-phase study undertaken within Ontario, Canada provides a new multi-perspective understanding of the value of NP practice within IP hospital teams. Constructivist grounded theory, a modification of the classic methodology, guided an interpretive approach based in exploration of process and meaning construction, privilege and power exposure, and juxtaposition with extant theory. A conceptual rendering of NP practice was determined through supplemental analysis of 30 team member focus groups. This new perspective emerged as three practice foci: easing others’ workload, holding patient care together, and evolving practice. Phase two substantiated and expanded the team member rendering through exploration of perceptions of 17 hospital-based (HB) NPs, exposure of privilege and power influences, and congruence with theoretical aspects of IP teamwork and collaboration. The study offers four new discoveries: a team perspective framework of HB NP practice, dimensions of the HB NP role position within hospital teams, explanation of why HB NP role clarity remains elusive, and an emerging theory of HB NP IP practice. The emerging theory illuminates three practice foci that are distinct yet hold relationships of interest: evolving NP role and advancing the specialty, focus on team working, and holding patient care together. The emerging theory provides understanding of HB NP actions deemed of value within IP teams and identifies the HB NP role as pivotal in promoting IP work. The study provides pragmatic and useful new knowledge that is of interest to NPs, healthcare providers, hospital leaders, and academics. The categories provide foci that may aid in assessing needs, envisioning role enactment or change, and considering role outcome measures. Sub-categories emphasize how HB NPs can practice to the full extent of their value, including promotion of IP practice. Privilege and power awareness may aid in effective role integration and conflict resolution. The emerging theory provides a new perspective to enhance NP curricula. Further research may use or test the framework to continue building knowledge of this expanded nursing role

Identifying Retweetable Tweets with a Personalized Global Classifier

In this paper we present a method to identify tweets that a user may find interesting enough to retweet. The method is based on a global, but personalized classifier, which is trained on data from several users, represented in terms of user-specific features. Thus, the method is trained on a sufficient volume of data, while also being able to make personalized decisions, i.e., the same post received by two different users may lead to different classification decisions. Experimenting with a collection of approx.\ 130K tweets received by 122 journalists, we train a logistic regression classifier, using a wide variety of features: the content of each tweet, its novelty, its text similarity to tweets previously posted or retweeted by the recipient or sender of the tweet, the network influence of the author and sender, and their past interactions. Our system obtains F1 approx. 0.9 using only 10 features and 5K training instances.Comment: This is a long paper version of the extended abstract titled "A Personalized Global Filter To Predict Retweets", of the same authors, which was published in the 25th ACM UMAP conference in Bratislava, Slovakia, in July 201

Assessor Differences and User Preferences in Tweet Timeline Generation

In information retrieval evaluation, when presented with an effectiveness difference between two systems, there are three relevant questions one might ask. First, are the differences statistically significant? Second, is the comparison stable with respect to assessor differences? Finally, is the differ-ence actually meaningful to a user? This paper tackles the last two questions about assessor differences and user prefer-ences in the context of the newly-introduced tweet timeline generation task in the TREC 2014 Microblog track, where the system’s goal is to construct an informative summary of non-redundant tweets that addresses the user’s informa-tion need. Central to the evaluation methodology is human-generated semantic clusters of tweets that contain substan-tively similar information. We show that the evaluation is stable with respect to assessor differences in clustering and that user preferences generally correlate with effectiveness metrics even though users are not explicitly aware of the semantic clustering being performed by the systems. Al-though our analyses are limited to this particular task, we believe that lessons learned could generalize to other eval-uations based on establishing semantic equivalence between information units, such as nugget-based evaluations in ques-tion answering and temporal summarization

Nurse practitioner interactions in acute and long-term care : an exploration of the role of knotworking in supporting interprofessional collaboration

BACKGROUND: Interprofessional care ensures high quality healthcare. Effective interprofessional collaboration is required to enable interprofessional care, although within the acute care hospital setting interprofessional collaboration is considered suboptimal. The integration of nurse practitioner roles into the acute and long-term care settings is influencing enhanced care. What remains unknown is how the nurse practitioner role enacts interprofessional collaboration or enables interprofessional care to promote high quality care. The study aim was to understand how nurse practitioners employed in acute and long-term care settings enable interprofessional collaboration and care. METHOD: Nurse practitioner interactions with other healthcare professionals were observed throughout the work day. These interactions were explored within the context of "knotworking" to create an understanding of their social practices and processes supporting interprofessional collaboration. Healthcare professionals who worked with nurse practitioners were invited to share their perceptions of valued role attributes and impacts. RESULTS: Twenty-four nurse practitioners employed at six hospitals participated. 384 hours of observation provided 1,284 observed interactions for analysis. Two types of observed interactions are comparable to knotworking. Rapid interactions resemble the traditional knotworking described in earlier studies, while brief interactions are a new form of knotworking with enhanced qualities that more consistently result in interprofessional care. Nurse practitioners were the most common initiators of brief interactions. CONCLUSIONS: Brief interactions reveal new qualities of knotworking with more consistent interprofessional care results. A general process used by nurse practitioners, where they practice a combination of both traditional (rapid) knotworking and brief knotworking to enable interprofessional care within acute and long-term care settings, is revealed

Stochastic `Beads on a String' in the Accretion Tail of Arp 285

We present Spitzer infrared, GALEX UV, and SDSS and SARA optical images of the peculiar interacting galaxy pair Arp 285 (NGC 2856/4), and compare with a new numerical model of the interaction. We estimate the ages of clumps of star formation in these galaxies using population synthesis models, carefully considering the uncertainties on these ages. This system contains a striking example of `beads on a string': a series of star formation complexes ~1 kpc apart. These `beads' are found in a tail-like feature that is perpendicular to the disk of NGC 2856, which implies that it was formed from material accreted from the companion NGC 2854. The extreme blueness of the optical/UV colors and redness of the mid-infrared colors implies very young stellar ages (~4 - 20 Myrs) for these star forming regions. Spectral decomposition of these `beads' shows excess emission above the modeled stellar continuum in the 3.6 micron and 4.5 micron bands, indicating either contributions from interstellar matter to these fluxes or a second older stellar population. These clumps have -12.0 < M(B) < -10.6, thus they are less luminous than most dwarf galaxies. Our model suggests that bridge material falling into the potential of the companion overshoots the companion. The gas then piles up at apo-galacticon before falling back onto the companion, and star formation occurs in the pile-up. A luminous (M(B) ~ -13.6) extended (FWHM ~ 1.3 kpc) `bright spot' is visible at the northwestern edge of the NGC 2856 disk, with an intermediate stellar population (400 - 1500 Myrs). Our model suggests that this feature is part of a expanding ripple-like `arc' created by an off-center ring-galaxy-like collision between the two disks.Comment: Accepted by the Astronomical Journal. For color figures and appendix material, go tohttp://www.etsu.edu/physics/bsmith/research/sg/arp285/arp285.htm

Finding information about mental health in microblogging platforms: a Case study of depression

Searching for online health information has been well studied in web search, but social media, such as public microblogging services, are well known for different types of tacit information: personal experience and shared information. Finding useful information in public microblogging platforms is an on-going hard problem and so to begin to develop a better model of what health information can be found, Twitter posts using the word “depression” were examined as a case study of a search for a prevalent mental health issue. 13,279 public tweets were analysed using a mixed methods approach and compared to a general sample of tweets. First, a linguistic analysis suggested that tweets mentioning depression were typically anxious but not angry, and were less likely to be in the first person, indicating that most were not from individuals discussing their own depression. Second, to un-derstand what types of tweets can be found, an inductive thematic analysis revealed three major themes: 1) dissemi-nating information or link of information, 2) self-disclosing, and 3) the sharing of overall opinion; each had significantly different linguistic patterns. We conclude with a discussion of how different types of posts about mental health may be retrieved from public social media like Twitter