Nurses as educators: creating teachable moments in practice

Effective workplace teaching is increasingly important in healthcare, with all staff being potential educators. The introduction of new roles and the need to create capacity for increased numbers of students can make it difficult to create a good learning experience. Despite the richness of clinical practice as a learning environment, creating capacity for teaching can be challenging. This article explores the possibilities for identifying and creating teachable moments in busy clinical environments and suggests a developmental model for incorporating these learning opportunities. Teachable moments linked directly to optimal patient care can potentially influence and shape a positive learning culture in clinical environments

WHAM Observations of H-Alpha, [S II], and [N II] toward the Orion and Perseus Arms: Probing the Physical Conditions of the Warm Ionized Medium

A large portion of the Galaxy (l = 123 deg to 164 deg, b = -6 deg to -35 deg), which samples regions of the Local (Orion) spiral arm and the more distant Perseus arm, has been mapped with the Wisconsin H-Alpha Mapper (WHAM) in the H-Alpha, [S II] 6716, and [N II] 6583 lines. Several trends noticed in emission-line investigations of diffuse gas in other galaxies are confirmed in the Milky Way and extended to much fainter emission. We find that the [S II]/H-Alpha and [N II]/H-Alpha ratios increase as absolute H-Alpha intensities decrease. For the more distant Perseus arm emission, the increase in these ratios is a strong function of Galactic latitude and thus, of height above the Galactic plane. The [S II]/[N II] ratio is relatively independent of H-Alpha intensity. Scatter in this ratio appears to be physically significant, and maps of it suggest regions with similar ratios are spatially correlated. The Perseus arm [S II]/[N II] ratio is systematically lower than Local emission by 10%-20%. With [S II]/[N II] fairly constant over a large range of H-Alpha intensities, the increase of [S II]/H-Alpha and [N II]/H-Alpha with |z| seems to reflect an increase in temperature. Such an interpretation allows us to estimate the temperature and ionization conditions in our large sample of observations. We find that WIM temperatures range from 6,000 K to 9,000 K with temperature increasing from bright to faint H-Alpha emission (low to high [S II]/H-Alpha and [N II]/H-Alpha) respectively. Changes in [S II]/[N II] appear to reflect changes in the local ionization conditions (e.g. the S+/S++ ratio). We also measure the electron scale height in the Perseus arm to be 1.0+/-0.1 kpc, confirming earlier, less accurate determinations.Comment: 28 pages, 10 figures. Figures 2 and 3 are full color--GIFs provided here, original PS figures at link below. Accepted for publication in ApJ. More information about the WHAM project can be found at http://www.astro.wisc.edu/wham/ . REVISION: Figure 6, bottom panel now contains the proper points. No other changes have been mad

Network Regulation Using an Agent

This paper introduces a new regulatory concept: the independent profit-maximising regulatory agent, as a possible model for regulating network industries where complex demand interdependencies, in particular demand complementarities, make traditional methods of regulation difficult. We derive a simple theoretical network model with differentiated demands and explore alternative competitive and regulatory strategies. We show that the employment of an independent profit-maximising agent may offer a partial solution to the problem of network regulation, yielding outcomes which involve all parties pursuing their own interests yet are relatively desirable to both firms and society

On the problem of network monopoly

We introduce a new regulatory concept: the independent profit-maximising agent, as a model for regulating a network monopoly. The agent sets prices on cross-network goods taking either a complete, or arbitrarily small, share of the associated profit. We examine welfare and profits with and without each agent type under both network monopoly and network duopoly. We show that splitting up the network monopoly (creating network duopoly) may be inferior for both firm(s) and society compared with a network monopoly "regulated" by an agent and that society always prefers any of the four agent regimes over network monopoly and network duopoly

On the Economics of Integrated Ticketing

In this paper we explore alternative pricing and regulatory strategies within a simple transport network with Cournot duopoly and differentiated demands. We show that whilst firms always prefer to offer integrated ticketing, a social planner will not. With integrated ticketing, the firms always prefer complete collusion but there is not a uniform ranking of some of the less collusive regimes. Society generally prefers the less collusive regimes to complete collusion but prefers some collusion to independent pricing

Design degrees of freedom and mechanisms for complexity

We develop a discrete spectrum of percolation forest fire models characterized by increasing design degrees of freedom (DDOF’s). The DDOF’s are tuned to optimize the yield of trees after a single spark. In the limit of a single DDOF, the model is tuned to the critical density. Additional DDOF’s allow for increasingly refined spatial patterns, associated with the cellular structures seen in highly optimized tolerance (HOT). The spectrum of models provides a clear illustration of the contrast between criticality and HOT, as well as a concrete quantitative example of how a sequence of robustness tradeoffs naturally arises when increasingly complex systems are developed through additional layers of design. Such tradeoffs are familiar in engineering and biology and are a central aspect of the complex systems that can be characterized as HOT

The nurses that roared: nurses from history who found their voices and challenged the status quo

In this article we explore how nurses from history challenged norms of nursing and society, and consider how they can influence and inspire nurses today. We discuss the role of nurses in the fight for women’s suffrage, campaigning for the vote and caring for women who suffered in their fight to achieve it, and present examples of outstanding bravery in the past and present day. The article contains examples of the bravery of some relatively unknown nurses in wartime, who also fought for equality and inclusion, and nurses who challenged the care of marginalised groups, campaigning for improved treatment, sometimes at great personal cost. Finally we consider the courage of present-day nurses. Drawing on the global campaign of “Nursing Now”, we suggest that learning from these exceptional nurses and acknowledging and highlighting their contribution can inspire us to strengthen and promote nursing and to empower women globally

The Angular Momenta of Neutron Stars and Black Holes as a Window on Supernovae

It is now clear that a subset of supernovae display evidence for jets and are observed as gamma-ray bursts. The angular momentum distribution of massive stellar endpoints provides a rare means of constraining the nature of the central engine in core-collapse explosions. Unlike supermassive black holes, the spin of stellar-mass black holes in X-ray binary systems is little affected by accretion, and accurately reflects the spin set at birth. A modest number of stellar-mass black hole angular momenta have now been measured using two independent X-ray spectroscopic techniques. In contrast, rotation-powered pulsars spin-down over time, via magnetic braking, but a modest number of natal spin periods have now been estimated. For both canonical and extreme neutron star parameters, statistical tests strongly suggest that the angular momentum distributions of black holes and neutron stars are markedly different. Within the context of prevalent models for core-collapse supernovae, the angular momentum distributions are consistent with black holes typically being produced in GRB-like supernovae with jets, and with neutron stars typically being produced in supernovae with too little angular momentum to produce jets via magnetohydrodynamic processes. It is possible that neutron stars are imbued with high spin initially, and rapidly spun-down shortly after the supernova event, but the available mechanisms may be inconsistent with some observed pulsar properties.Comment: ApJ Letters, accepte