Uncovering Local Absorbed Active Galactic Nuclei with Swift and Suzaku

Detection of absorbed active galactic nuclei and their properties remains an elusive and important problem in understanding the evolution and activation of black holes. With the very hard X-ray survey conducted by Swift's Burst Alert Telescope - the first all-sky survey in 30 years - we are beginning to uncover the characteristics of obscured AGN. The synergy between Suzaku and Swift has been crucial in pinning down the X-ray properties of newly detected heavily obscured but bright hard X-ray sources. We review the X-ray and optical spectroscopic properties of obscured AGN in the local Universe, as detected in the Swift survey. We discuss the relative distribution of absorbed/unabsorbed sources, including "hidden" and Compton thick AGN populations. Among the results from the survey, we find that absorbed AGN are less luminous than unabsorbed sources. Optical spectra reveal that sources with emission line ratios indicative of LINERs/H II galaxies/composites are the least luminous objects in the sample, while optical absorbed and unabsorbed Seyferts have the same luminosity distributions. Thus, the least luminous sources are likely accreting in a different mode than the Seyferts.Comment: 8 pages, 5 figures, To appear in the conference proceedings for "Exploring the X-ray Universe: Suzaku and Beyond", the July 2011 Suzaku Science Conferenc

The Complex X-ray Spectrum of the Sefyert 1.5 Source NGC 6860

The X-ray spectrum of the Seyfert 1.5 source NGC 6860 is among the most complex of the sources detected in the Swift Burst Alert Telescope all-sky survey. A short XMM-Newton follow-up observation of the source revealed a flat spectrum both above and below 2 keV. To uncover the complexity of the source, in this paper we analyze both a 40 ks Suzaku and a 100 ks XMM-Newton observation of NGC 6860. While the spectral state of the source changed between the newer observations presented here and the earlier short XMM-Newton spectrum - showing a higher flux and steeper power law component - the spectrum of NGC 6860 is still complex with clearly detected warm absorption signatures. We find that a two component warm ionized absorber is present in the soft spectrum, with column densities of about 10^20 and 10^21 cm$^-2, ionization parameters of xi = 180 and 45 ergs cm s^-1, and outflow velocities for each component in the range of 0-300 km s^-1. Additionally, in the hard spectrum we find a broad (approx 11000 km s^-1) Fe K-alpha emission line, redshifted by approx 2800 km s^-1.Comment: 35 pages, 9 figures, Accepted to Ap

Throughput and Nurses\u27 Workloads: Influences on Nurse and Patient Outcomes

Patient turnover, or throughput, through nursing units can significantly impact the workloads of nurses. However, very few staffing measures account for patient throughput, thus underestimating nurses\u27 workloads. Research has shown that when nurse staffing is more favorable, patient and nurse outcomes are more favorable. What is not known, and what this study examined, was how adjusting nurse staffing measures for patient throughput influenced the relationship between staffing and patient and nurse outcomes while also accounting for the nurse work environment, which also has significant relationships with patient and nurse outcomes. This study was a secondary analysis of hospital administrative data, patient discharge data, and nurse survey data in four states. Nurse survey data from more than 25,000 nurses were merged with administrative data from nearly 600 hospitals to study nurse outcomes, which included burnout, job dissatisfaction, and intent to leave. These data were then merged with patient discharge data from over 1.6 million surgical patients to study patient outcomes, which included 30-day mortality and failure to rescue. The novel nurse survey data provided information on hospital system-related factors, such as staffing, throughput, and the nurse work environment. Three measures of throughput-adjusted staffing were described, developed, and compared to unadjusted staffing measures as well as acuity-adjusted staffing and patient length of stay-adjusted staffing. Contrary to the hypotheses, the adjusted staffing measures did not have stronger relationships with patient or nurse outcomes compared to unadjusted staffing measures. The nurse work environment was a significant predictor of both patient and nurse outcomes. Patients treated in hospitals with the most favorable nurse work environments had about 14% lower odds of death and 16% lower odds of failure to rescue compared to patients treated in hospitals with the least favorable work environments. Compared to nurses working in hospitals with the least favorable work environments, nurses in hospitals with mixed work environments were about 30% less likely to be burned out, 40% less likely to report job dissatisfaction, and 38% less likely to intend to leave their jobs. These differences were even more pronounced for nurses working in hospitals with the best work environments. Compared to nurses working in hospitals with the least favorable work environments, nurses in hospitals with the best work environments were about 46% less likely to be burned out, 60% less likely to report job dissatisfaction, and 55% less likely to intend to leave their jobs. The work environment also moderated the influence of staffing on both patient and nurse outcomes. This study was the largest study of throughput and nurse workloads to date and the first to explore throughput in relation to nurse outcomes. Although throughput-adjusted staffing did not provide significantly more information than unadjusted staffing in relation to patient and nurse outcomes, further research is needed to explore how throughput influences nurse workloads across different nursing units or work environments. Improvements in nurse work environments are promising approaches to improve both patient and nurse outcomes in hospitals

Fostering Student Agency to Build a Whole Child, Whole School, Whole Community Approach

In this practitioner perspective, we explore the concept of student agency through the implementation of a student government association in a laboratory middle school. Interviews with a social studies teacher and her students offer perspectives of the impact of student voice and choice for student experiences. We describe three major lessons learned through this implementation process: students learn to have healthy conflict and cooperative skills; students learn the appropriate processes to enact change in a democratic society; and students learn to conduct service for their peers, school, and community

Representing suicide: Giving voice to a desire to die?

Drawing on interview and online ethnographic data from a study of suicide on the railways, this paper describes the ways in which many of the concepts, assumptions and practices of mainstream suicide prevention are challenged in the accounts of those who are planning, or have enacted, a suicide attempt. We reflect on the ethical dilemmas which can arise for researchers (and practitioners) when lived experience accounts diverge – theoretically, morally and in terms of practical implications – from present-day expert ones. In online, ‘pro-choice’ suicide discussions, people describe beliefs, attitudes, ways of thinking and acting which stand in contrast to existing professional and clinical descriptions of suicide and suicidal behaviour. Most obviously, there is often a rejection of ‘pro-life’ positions, which are framed as ideological, oppressive and naïve. For researchers engaging in online ethnography of ‘pro-choice’ spaces, dilemmas can arise in relation to the representation of perspectives which fundamentally challenge not only prevailing norms within suicide research and prevention practice but socio-cultural norms more widely. Similar issues can arise when considering how best to represent research participants when their accounts diverge from accepted ‘expert’ knowledge and beliefs. In-depth qualitative interviews with those who have thought about or attempted to take their own life indicate that existing theories and models of suicide which start from assumptions of deficit and pathology underestimate the extent to which suicide, as the end result of an often-complex series of actions, requires a person to engage in logistical processes of planning, decision-making, imagination and adaptation. The accounts described here, gathered using two different methodological approaches, highlight the ethical issues which can surface when there are competing claims to (expert) knowledge, as well as differences in beliefs, attitudes and moral stance towards life and death. We argue that researchers need to reflect on their own ethical-moral position in relation to suicide, and on the practical consequences of their privileging of some voices at the expense of other, less well represented, ones