The Electronic Health Record Scorecard: A Measure of Utilization and Communication Skills

As the adoption rate of electronic health records (EHRs) in the United States continues to grow, both providers and patients will need to adapt to the reality of a third actor being present during the visit encounter. The purpose of this project is to provide insight on “best” practice patterns for effective communication and efficient use of the EHR in the clinical practice setting. Through the development of a comprehensive scorecard, this project assessed current status of EHR use and communication skills among health care providers in various clinical practice settings. Anticipated benefits of this project are increased comfortability in interfacing with the EHR and increased satisfaction on the part of the provider as well as the patient. Serving as a benchmark, this assessment has the potential to help guide future health information technology development, training, and education for both students and health care providers

A Documentary Analysis of Nursing Degree Curricula

This twelve month study was undertaken by a research team based at University College Suffolk and aimed to compare the learning outcomes and content of pre and post registration nursing degrees. Curriculum doccuments from 50 pre and post registration degree programmes from 32 instutions were catalogued and coded for descriptive characteristics. A subset of 15 doccuments was subject to in-depth analysis. This subset was selected to reflect the characteristics of the main sample of doccuments. The Research Highlights outline the context in which this study was undertaken and presents summaries of both the descriptive , and categorical data and the findings of the indepth analysis. Finally, the major implications of these findings are summarised

Deciphering Solar Magnetic Activity: On Grand Minima in Solar Activity

The Sun provides the energy necessary to sustain our existence. While the Sun provides for us, it is also capable of taking away. The weather and climatic scales of solar evolution and the Sun-Earth connection are not well understood. There has been tremendous progress in the century since the discovery of solar magnetism - magnetism that ultimately drives the electromagnetic, particulate and eruptive forcing of our planetary system. There is contemporary evidence of a decrease in solar magnetism, perhaps even indicators of a significant downward trend, over recent decades. Are we entering a minimum in solar activity that is deeper and longer than a typical solar minimum, a "grand minimum"? How could we tell if we are? What is a grand minimum and how does the Sun recover? These are very pertinent questions for modern civilization. In this paper we present a hypothetical demonstration of entry and exit from grand minimum conditions based on a recent analysis of solar features over the past 20 years and their possible connection to the origins of the 11(-ish) year solar activity cycle.Comment: 9 pages - submitted to Frontiers in Solar and Stellar Physic

MHD‐driven kinetic dissipation in the solar wind and corona

Mechanisms for the deposition of heat in the lower coronal plasma are discussed, emphasizing recent attempts to reconcile the fluid and kinetic perspectives. Structures at magnetohydrodynamic (MHD) scales may drive a nonlinear cascade, preferentially exciting high perpendicular wavenumber fluctuations. Relevant dissipative kinetic processes must be identified that can absorb the associated energy flux. The relationship between the MHD cascade and direct cyclotron absorption, including cyclotron sweep, is discussed. We conclude that for coronal and solar wind parameters the perpendicular cascade cannot be neglected and may be more rapid than cyclotron sweep. Solar wind observational evidence suggests the relevance of the ion inertial scale, which is associated with current sheet thickness during reconnection. We conclude that a significant fraction of dissipation in the corona and solar wind likely proceeds through a perpendicular cascade and small-scale reconnection, coupled to kinetic processes that act at oblique wavevectors

On the Interpretation of Magnetic Helicity Signatures in the Dissipation Range of Solar Wind Turbulence

Measurements of small-scale turbulent fluctuations in the solar wind find a non-zero right-handed magnetic helicity. This has been interpreted as evidence for ion cyclotron damping. However, theoretical and empirical evidence suggests that the majority of the energy in solar wind turbulence resides in low frequency anisotropic kinetic Alfven wave fluctuations that are not subject to ion cyclotron damping. We demonstrate that a dissipation range comprised of kinetic Alfven waves also produces a net right-handed fluctuating magnetic helicity signature consistent with observations. Thus, the observed magnetic helicity signature does not necessarily imply that ion cyclotron damping is energetically important in the solar wind.Comment: Accepted to Astrophysical Journal Letters, 5 pages, 2 figure

The French at Pentagoet, 1635-1674: An Archaeological Portrait of the Acadian Frontier

Review of The French at Pentagoet, 1635-1674: An Archaeological Portrait of the Acadian Frontier by Alaric Faulkner and Gretchen Fearon Faulkne

Student midwives'views of caseloading: the BUMP study

In 2007 the Nursing and Midwifery Council recommended that across the UK all pre-registration, undergraduate student midwives should, as part of their education, have the opportunity to experience continuity of care through caseloading practice. This article reports on a qualitative exploration of student midwives’ views of caseloading a known group of women, which formed part of a larger action research project through Bournemouth University’s pre-registration, undergraduate midwifery programme. Analysis of the caseloading data revealed four themes: preparation to undertake a caseload; knowing your mentor; tri-partite meetings; and relevance of caseloading to their learning in becoming midwives. Caseloading was identified by the students as being a highly valuable learning experience. Attitudes of the midwife mentor and link tutor were seen as important and impacted on student confidence in preparing for, and learning from, their caseloading experience. Findings of this study highlight the importance of developing a shared understanding and commitment to agreed support mechanisms, which sustains and enriches the experience of the student through their caseloading

Gastrointestinal Alterations in Two Mouse Models Associated with Social Behavior Deficits

The gastrointestinal (GI) tract is a diverse habitat for multiple microorganisms. Disturbances in the microbiome of the GI tract have been associated with psychiatric disorders including autism spectrum disorder (ASD). Individuals with ASD, when compared to neurotypical individuals, have demonstrated differing gut species. Also, it has been shown that microbial transplant therapies impact ASD symptoms in patients. Animal models of behaviors associated with ASD might offer insight for the actual role these microbial differences may occupy regarding symptoms. Unfortunately, ASD does not have an accepted animal model where the GI alterations have been thoroughly explored. In this study, we sought to determine if the microbiome and other GI alterations were observed in two potential mouse models of social behavior deficits, the genetic BTBR T+Itpr3tf/J (BTBR) mouse strain and an environmental mouse strain consisting of offspring of valproic acid (VA) treated pregnant controls. Both mouse models have been shown to exhibit social and repetitive behaviors that are found in human ASD. Using the Illumina MiSeq, we were able to identify taxonomy associated with 16S ribosomal DNA sequences extracted from fecal matter. We were able to compare the sequencing results from the two affected strains and a control C5BL/6J mouse strain for both female and male animals using the Qiagen CLC Genomics Workbench software. Overall, microbiome composition was found to be significantly different between the male control animals (N=6) when compared to the VA (N=5; p-value=.00216; F-score 11.20904) or the BTBR (N=7; p-value=.00216; F-score 18.47839) males using a PERMANOVA analysis. This was replicated in female groups where composition significantly differed between the control (N=14) and VA (N=14; p-value=.00001; F-score 3.53307) or BTBR (N=14; p-value=.00001; F-score 11.23443) females. Additionally, short-chain fatty acid analysis using gas capillary-based chromatography was used to examine acetate, butyrate, propionate, and valerate levels in feces. Only valerate levels were significantly lower (