The frequency and function of passive voice use in nurses' notes

Health care providers of all professions depend on written information to communicate with those not co-present during various phases of patient care, thus making communications about patients of key importance to understanding what sorts of discourses are prevalent and valued in hospitals. While physicians’ written discourse has enjoyed some attention, there has been very little research done on written nursing discourse, a critical component of patient care, from the perspective of organizational communication. For this pilot study of nurses’ written communications, I examined 34 nurses' patient progress notes from computer-based in-patient records obtained from a local regional medical center. Because extensive use of the passive voice is a defining characteristic of medical discourse, I chose to focus my discourse analysis of nurses’ notes on the frequency and function of its use. Furthermore, an analysis of passive voice use is salient because the passive voice has for so long been an object of hotly contested debate in the fields of English composition and technical and organizational communications. Of 335 transitive verb phrases, with human agents, in the notes, I found that 48.96% were in the passive voice. Of the passive verbs, 85.98% of them refer to actions performed by the nurse writing the note, only 2.74% of them refer to patients’ actions, and 10.37% of them refer to actions performed by other hospital personnel. The passive voice appears to serve the rhetorical function of deferring attention away from the agent, the nurse, and towards the patient or the materials being used to treat the patient, much as it is used in scientific writing. However, I also found that the passive voice is sometimes used inconsistently, and its use varies from nurse to nurse, even within the same unit. It is my hope that this pilot study, having revealed the inconsistency and complexity of passive voice use in nurses’ notes, will lead to more, comprehensive studies of writing in the nursing discourse community

Invitation to the Table Conversation: A Few Diverse Perspectives on Integration

This article represents an invitation to the integration table to several previously underrepresented perspectives within Christian psychology. The Judeo-Christian tradition and current views on scholarship and Christian faith compel us to extend hospitality to minority voices within integration, thereby enriching and challenging existing paradigms in the field. Contributors to this article, spanning areas of cultural, disciplinary, and theological diversity, provide suggestions for how their distinct voices can enhance future integrative efforts

Precision mass measurements on neutron-rich rare-earth isotopes at JYFLTRAP - reduced neutron pairing and implications for the rr-process calculations

The rare-earth peak in the $r$-process abundance pattern depends sensitively on both the astrophysical conditions and subtle changes in nuclear structure in the region. This work takes an important step elucidating the nuclear structure and reducing the uncertainties in $r$-process calculations via precise atomic mass measurements at the JYFLTRAP double Penning trap. $^{158}$Nd, $^{160}$Pm, $^{162}$Sm, and $^{164-166}$Gd have been measured for the first time and the precisions for $^{156}$Nd, $^{158}$Pm, $^{162,163}$Eu, $^{163}$Gd, and $^{164}$Tb have been improved considerably. Nuclear structure has been probed via two-neutron separation energies $S_{2n}$ and neutron pairing energy metrics $D_n$. The data do not support the existence of a subshell closure at $N=100$. Neutron pairing has been found to be weaker than predicted by theoretical mass models. The impact on the calculated $r$-process abundances has been studied. Substantial changes resulting in a smoother abundance distribution and a better agreement with the solar $r$-process abundances are observed.Comment: 8 pages, 4 figures, accepted for publication in Physical Review Letter

Impact of Improved Heat Sinking of an X-Ray Calorimeter Array on Crosstalk, Noise, and Background Events

The x-ray calorimeter array of the Soft X-ray Spectrometer (SXS) of the Astro-H satellite will incorporate a silicon thermistor array produced during the development of the X-Ray Spectrometer (XRS) of the Suzaku satellite. On XRS, inadequate heat sinking of the array led to several non-ideal effects. The thermal crosstalk, while too small to be confused with x-ray signals, nonetheless contributed a noise term that could be seen as a degradation in energy resolution at high flux. When energy was deposited in the silicon frame around the active elements of the array, such as by a cosmic ray, the resulting pulse in the temperature of the frame resulted in coincident signal pulses on most of the pixels. In orbit, the resolution was found to depend on the particle background rate. In order to minimize these effects on SXS, heat-sinking gold was applied to areas on the front and back of the array die, which was thermally anchored to the gold of its fanout board via gold wire bonds. The thermal conductance from the silicon chip to the fanout board was improved over that of XRS by an order of magnitude. This change was sufficient for essentially eliminating frame events and allowing high-resolution to be attained at much higher counting rates. We will present the improved performance, the measured crosstalk, and the results of the thermal characterization of such arrays

Expenditure, Coping, and Academic Behaviors Among Food-Insecure College Students at 10 Higher Education Institutes in the Appalachian and Southeastern Regions

Background A number of studies have measured college student food insecurity prevalence higher than the national average; however, no multicampus regional study among students at 4-y institutions has been undertaken in the Appalachian and Southeast regions of the United States. Objectives The aims of this study were to determine the prevalence of food insecurity among college students in the Appalachian and Southeastern regions of the United States, and to determine the association between food-insecurity status and money expenditures, coping strategies, and academic performance among a regional sample of college students. Methods This regional, cross-sectional, online survey study included 13,642 college students at 10 public universities. Food-insecurity status was measured through the use of the USDA Adult Food Security Survey. The outcomes were associations between food insecurity and behaviors determined with the use of the money expenditure scale (MES), the coping strategy scale (CSS), and the academic progress scale (APS). A forward-selection logistic regression model was used with all variables significant from individual Pearson chi-square and Wilcoxon analyses. The significance criterion α for all tests was 0.05. Results The prevalence of food insecurity at the universities ranged from 22.4% to 51.8% with an average prevalence of 30.5% for the full sample. From the forward-selection logistic regression model, MES (OR: 1.47; 95% CI: 1.40, 1.55), CSS (OR: 1.19; 95% CI: 1.18, 1.21), and APS (OR: 0.95; 95% CI: 0.91, 0.99) scores remained significant predictors of food insecurity. Grade point average, academic year, health, race/ethnicity, financial aid, cooking frequency, and health insurance also remained significant predictors of food security status. Conclusions Food insecurity prevalence was higher than the national average. Food-insecure college students were more likely to display high money expenditures and exhibit coping behaviors, and to have poor academic performance

Expenditure, Coping, and Academic Behaviors Among Food-Insecure College Students at 10 Higher Education Institutes in the Appalachian and Southeastern Regions

Background A number of studies have measured college student food insecurity prevalence higher than the national average; however, no multicampus regional study among students at 4-y institutions has been undertaken in the Appalachian and Southeast regions of the United States. Objectives The aims of this study were to determine the prevalence of food insecurity among college students in the Appalachian and Southeastern regions of the United States, and to determine the association between food-insecurity status and money expenditures, coping strategies, and academic performance among a regional sample of college students. Methods This regional, cross-sectional, online survey study included 13,642 college students at 10 public universities. Food-insecurity status was measured through the use of the USDA Adult Food Security Survey. The outcomes were associations between food insecurity and behaviors determined with the use of the money expenditure scale (MES), the coping strategy scale (CSS), and the academic progress scale (APS). A forward-selection logistic regression model was used with all variables significant from individual Pearson chi-square and Wilcoxon analyses. The significance criterion α for all tests was 0.05. Results The prevalence of food insecurity at the universities ranged from 22.4% to 51.8% with an average prevalence of 30.5% for the full sample. From the forward-selection logistic regression model, MES (OR: 1.47; 95% CI: 1.40, 1.55), CSS (OR: 1.19; 95% CI: 1.18, 1.21), and APS (OR: 0.95; 95% CI: 0.91, 0.99) scores remained significant predictors of food insecurity. Grade point average, academic year, health, race/ethnicity, financial aid, cooking frequency, and health insurance also remained significant predictors of food security status. Conclusions Food insecurity prevalence was higher than the national average. Food-insecure college students were more likely to display high money expenditures and exhibit coping behaviors, and to have poor academic performance

Evaluation of effective resistances in pseudo-distance-regular resistor networks

In Refs.[1] and [2], calculation of effective resistances on distance-regular networks was investigated, where in the first paper, the calculation was based on the stratification of the network and Stieltjes function associated with the network, whereas in the latter one a recursive formula for effective resistances was given based on the Christoffel-Darboux identity. In this paper, evaluation of effective resistances on more general networks called pseudo-distance-regular networks [21] or QD type networks \cite{obata} is investigated, where we use the stratification of these networks and show that the effective resistances between a given node such as $\alpha$ and all of the nodes $\beta$ belonging to the same stratum with respect to $\alpha$ ($R_{\alpha\beta^{(m)}}$, $\beta$ belonging to the $m$-th stratum with respect to the $\alpha$) are the same. Then, based on the spectral techniques, an analytical formula for effective resistances $R_{\alpha\beta^{(m)}}$ such that $L^{-1}_{\alpha\alpha}=L^{-1}_{\beta\beta}$ (those nodes $\alpha$, $\beta$ of the network such that the network is symmetric with respect to them) is given in terms of the first and second orthogonal polynomials associated with the network, where $L^{-1}$ is the pseudo-inverse of the Laplacian of the network. From the fact that in distance-regular networks, $L^{-1}_{\alpha\alpha}=L^{-1}_{\beta\beta}$ is satisfied for all nodes $\alpha,\beta$ of the network, the effective resistances $R_{\alpha\beta^{(m)}}$ for $m=1,2,...,d$ ($d$ is diameter of the network which is the same as the number of strata) are calculated directly, by using the given formula.Comment: 30 pages, 7 figure

Common health assets protocol: a mixed-methods, realist evaluation and economic appraisal of how community-led organisations (CLOs) impact on the health and well-being of people living in deprived areas

Introduction: This research investigates how community-led organisations’ (CLOs’) use of assets-based approaches improves health and well-being, and how that might be different in different contexts. Assets-based approaches involve ‘doing with’ rather than ‘doing to’ and bring people in communities together to achieve positive change using their own knowledge, skills and experience. Some studies have shown that such approaches can have a positive effect on health and well-being. However, research is limited, and we know little about which approaches lead to which outcomes and how different contexts might affect success. Methods and analysis: Using a realist approach, we will work with 15 CLOs based in disadvantaged communities in England, Scotland and Northern Ireland. A realist synthesis of review papers, and a policy analysis in different contexts, precedes qualitative interviews and workshops with stakeholders, to find out how CLOs’ programmes work and identify existing data. We will explore participants’ experiences through: a Q methodology study; participatory photography workshops; qualitative interviews and measure outcomes using a longitudinal survey, with 225 CLO participants, to assess impact for people who connect with the CLOs. An economic analysis will estimate costs and benefits to participants, for different contexts and mechanisms. A ‘Lived Experience Panel’ of people connected with our CLOs as participants or volunteers, will ensure the appropriateness of the research, interpretation and reporting of findings. Ethics and dissemination: This project, research tools and consent processes have been approved by the Glasgow Caledonian University School of Health and Life Sciences Ethics Committee, and affirmed by Ethics Committees at Bournemouth University, Queen’s University Belfast and the University of East London. Common Health Assets does not involve any National Health Service sites, staff or patients. Findings will be presented through social media, project website, blogs, policy briefings, journal articles, conferences and visually in short digital stories, and photographic exhibitions

Massive Black Hole Binary Inspirals: Results from the LISA Parameter Estimation Taskforce

The LISA Parameter Estimation (LISAPE) Taskforce was formed in September 2007 to provide the LISA Project with vetted codes, source distribution models, and results related to parameter estimation. The Taskforce's goal is to be able to quickly calculate the impact of any mission design changes on LISA's science capabilities, based on reasonable estimates of the distribution of astrophysical sources in the universe. This paper describes our Taskforce's work on massive black-hole binaries (MBHBs). Given present uncertainties in the formation history of MBHBs, we adopt four different population models, based on (i) whether the initial black-hole seeds are small or large, and (ii) whether accretion is efficient or inefficient at spinning up the holes. We compare four largely independent codes for calculating LISA's parameter-estimation capabilities. All codes are based on the Fisher-matrix approximation, but in the past they used somewhat different signal models, source parametrizations and noise curves. We show that once these differences are removed, the four codes give results in extremely close agreement with each other. Using a code that includes both spin precession and higher harmonics in the gravitational-wave signal, we carry out Monte Carlo simulations and determine the number of events that can be detected and accurately localized in our four population models.Comment: 14 pages, 2 figures, 5 tables, minor changes to match version to be published in the proceedings of the 7th LISA Symposium. For more information see the Taskforce's wiki at http://www.tapir.caltech.edu/dokuwiki/lisape:hom