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

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

The Shifting Race-Consciousness Matrix and the Multiracial Category Movement: A Critical Reply to Professor Hernandez

In this article, the author posits that race as an idea begins with consciousness that reinforces that race is real and immutable. The Multiracial Category Movement can shift our race consciousness away from traditional ways of thinking, talking, and using race. The Movement moves us beyond binary race thinking, and this new thinking shifts the extant race consciousness matrix. It also frees our consciousness so that we can personally and politically acknowledge our biracial and multiracial identities, and it perforce alters the traditional political meaning of race. Legal scholars like Professor Tanya Hernandez argue for the political meaning of race against a remediating balm against the color-blind jurisprudence, weakening of civil right protections, and pigmentocracy. While these new identities can promote color-blind jurisprudence by conservatives and pigmentocracy by those fleeing the oppressive constraints of traditional racial categories, the author argues against Hernandez and for the Movement\u27s paradigm shifting possibilities

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

"Precious": A Tale of Three Explanations for Childhood Maltreatment

Precious describes a fictional child's life, in which the parents severely maltreat her. Historically, society gave parents the right to assault their children's bodies, if those assaults were not abuse but discipline. Traditionally, constitutional analysis enshrined those rights, and parents had autonomy to rear and discipline their children as they saw fit. Unfortunately, when parents abused their children and were prosecuted, few exculpatory and justificatory explanations were offered. Today, we know that parents who abuse have suffered abuse, too. Hence, Precious' parents' childhood histories help to explain her maltreatment and reveal the best framework for the etiology of her horrific suffering. This Essay proffers three explanations: Critical Race Theory's (CRT) race consciousness, Karl Marx' alienation theory, and Alice Miller's psycho-existential framework. Each approach may explain why parents maltreat their children. In brief, CRT and alienation theories operate at structural levels, well above the intergenerational transfer of actual suffering from parent to child. To be sure, structuralist theories may explain why black children like Precious suffered horrific maltreatment not by faulting the parents but by pointing to external, objective forces like white racism. CRT begins by analyzing slavery, Jim Crow, and the breakdown of the black family. Marxism likewise starts by critiquing an economic world in which capitalism's slavery exploited workers and black slaves. Yet, violent, physical assaults against children predate American Negro slavery and modern capitalism, which mean that neither of them would completely and persuasively explain childhood maltreatment. And neither approach takes us beyond believing that external, objective forces have constructed our abusive imaginations, which are enforced by the hegemonic workings of powerful whites and white structural oppression

The Spectroscopic Footprint of the Fast Solar Wind

We analyze a large, complex equatorial coronal hole (ECH) and its immediate surroundings with a focus on the roots of the fast solar wind. We start by demonstrating that our ECH is indeed a source of the fast solar wind at 1AU by examining in situ plasma measurements in conjunction with recently developed measures of magnetic conditions of the photosphere, inner heliosphere and the mapping of the solar wind source region. We focus the bulk of our analysis on interpreting the thermal and spatial dependence of the non-thermal line widths in the ECH as measured by SOHO/SUMER by placing the measurements in context with recent studies of ubiquitous Alfven waves in the solar atmosphere and line profile asymmetries (indicative of episodic heating and mass loading of the coronal plasma) that originate in the strong, unipolar magnetic flux concentrations that comprise the supergranular network. The results presented in this paper are consistent with a picture where a significant portion of the energy responsible for the transport of heated mass into the fast solar wind is provided by episodically occurring small-scale events (likely driven by magnetic reconnection) in the upper chromosphere and transition region of the strong magnetic flux regions that comprise the supergranular network.Comment: 25 pages, accepted to appear in the Astrophysical Journal. Supporting movies can be found in http://download.hao.ucar.edu/pub/mscott/papers/ECH