Examining Nurse Leader/Manager-Physician Communication Strategies: A Pilot Study

A shared goal of all health care providers is to provide safe and quality care (IOM, 1972). In order to provide this there needs to be an understanding of how the communication of that care is delivered (IPEC, 2011). After a literature review we found no existing studies that described specific communication strategies used by nurse leaders to navigate nurse-physician communication and collaboration. Therefore, in this study we sought to gain initial insight from nurse leaders about how they were able to successfully navigate effective communication and collaboration with physicians. This pilot study used a qualitative approach to generate nurse leader/manager-reported strategies, using an interview guide developed from a literature review of the nurse-physician communication and collaboration literature. A convenience sample of six nurse leaders/managers at a large, Midwestern hospital was interviewed. Five themes, teamwork, respect, being direct, building relationships and role modeling were generated from the interview responses that provide initial direction for understanding effective nurse-physician communication.University of Kansas School of Nursing. Bachelor of Science in Nursing Honors Progra

Rhetorical Strategies Implemented By The American Medical Association To Identify Roles Within The Interprofessional Healthcare Team

PURPOSE: Healthcare reform is introducing new models of care to serve complex patient needs, including expanded roles for nursing. This has resulted in interested parties debating formal definitions of provider roles in healthcare teams. The purpose of this study is to conduct a rhetorical criticism of content produced by the American Medical Association (AMA) concerning the role of providers within the healthcare team. THEORETICAL/CONCEPTUAL FRAMEWORK: This study’s framework uses rhetorical criticism, an analysis of an organization’s “strategic use of symbols to generate meaning” (Hoffman & Ford, 2010). This analysis evaluates the rhetoric on its potential function both to influence the definition of provider roles and to critique how the organization’s potential power may be implemented. By understanding what the organization displays in its public texts, one can potentially infer the intentions of the organization. METHOD: Press releases and newsletter articles publicly available from the AMA website from 2010 to 2014 were selected based on their relevance to the discussion of healthcare team leadership. The texts were analyzed using a systematic approach to identify and describe rhetorical strategies. This is a systematic, rigorous method for deconstructing texts in order to draw conclusions about the choices a rhetor made in achieving a goal. The analysis was then further enhanced with relevant contextual and historical research, analyzing the development of health care professions as disciplines in the US, and the organization’s history itself in its development as a trade association. RESULTS: Rhetorical strategies used by the AMA include: Appealing to the values of patient safety, teamwork, and competent leaders of teams; and making logical arguments based on contradictions in lay definitions of teamwork and independence. These are used to argue for maintaining legal and financial interests for physicians within healthcare systems. Limitations include analyzing select materials publicly available without an AMA membership. CONCLUSIONS: Defining the role of members within the interprofessional team is of interest to healthcare providers and their representative organizations as new models of care attempt to increase quality, access, and value within the system. As nursing organizations attempt to expand nursing scope of practice at the state level, oppositional views of these bills should be understood to provide counterarguments and effectively engage stakeholders

The 55 Cancri Planetary System: Fully Self-Consistent N-body Constraints and a Dynamical Analysis

We present an updated study of the planets known to orbit 55 Cancri A using 1,418 high-precision radial velocity observations from four observatories (Lick, Keck, Hobby-Eberly Telescope, Harlan J. Smith Telescope) and transit time/durations for the inner-most planet, 55 Cancri "e" (Winn et al. 2011). We provide the first posterior sample for the masses and orbital parameters based on self-consistent n-body orbital solutions for the 55 Cancri planets, all of which are dynamically stable (for at least $10^8$ years). We apply a GPU version of Radial velocity Using N-body Differential evolution Markov Chain Monte Carlo (RUN DMC; B. Nelson et al. 2014) to perform a Bayesian analysis of the radial velocity and transit observations. Each of the planets in this remarkable system has unique characteristics. Our investigation of high-cadence radial velocities and priors based on space-based photometry yields an updated mass estimate for planet "e" ($8.09\pm0.26$ M$_\oplus$), which affects its density ($5.51\pm^{1.32}_{1.00}$ g cm$^{-3}$) and inferred bulk composition. Dynamical stability dictates that the orbital plane of planet "e" must be aligned to within $60^o$ of the orbital plane of the outer planets (which we assume to be coplanar). The mutual interactions between the planets "b" and "c" may develop an apsidal lock about $180^o$. We find 36-45% of all our model systems librate about the anti-aligned configuration with an amplitude of $51^o\pm^{6^o}_{10^o}$. Other cases showed short-term perturbations in the libration of $\varpi_b-\varpi_c$, circulation, and nodding, but we find the planets are not in a 3:1 mean-motion resonance. A revised orbital period and eccentricity for planet "d" pushes it further toward the closest known Jupiter analog in the exoplanet population.Comment: 12 pages, 5 figures, 4 tables, accepted to MNRAS. Figure 2 (left) is updated from published version. Posterior samples available at http://www.personal.psu.edu/ben125/Downloads.htm

A High Eccentricity Component in the Double Planet System Around HD 163607 and a Planet Around HD 164509

We report the detection of three new exoplanets from Keck Observatory. HD 163607 is a metal-rich G5IV star with two planets. The inner planet has an observed orbital period of 75.29 $\pm$ 0.02 days, a semi-amplitude of 51.1 $\pm$ 1.4 \ms, an eccentricity of 0.73 $\pm$ 0.02 and a derived minimum mass of \msini = 0.77 $\pm$ 0.02 \mjup. This is the largest eccentricity of any known planet in a multi-planet system. The argument of periastron passage is 78.7 $\pm$ 2.0$^{\circ}$; consequently, the planet's closest approach to its parent star is very near the line of sight, leading to a relatively high transit probability of 8%. The outer planet has an orbital period of 3.60 $\pm$ 0.02 years, an orbital eccentricity of 0.12 $\pm$ 0.06 and a semi-amplitude of 40.4 $\pm$ 1.3 \ms. The minimum mass is \msini = 2.29 $\pm$ 0.16 \mjup. HD 164509 is a metal-rich G5V star with a planet in an orbital period of 282.4 $\pm$ 3.8 days and an eccentricity of 0.26 $\pm$ 0.14. The semi-amplitude of 14.2 $\pm$ 2.7 \ms\ implies a minimum mass of 0.48 $\pm$ 0.09 \mjup. The radial velocities of HD 164509 also exhibit a residual linear trend of -5.1 $\pm$ 0.7 \ms\ per year, indicating the presence of an additional longer period companion in the system. Photometric observations demonstrate that HD 163607 and HD 164509 are constant in brightness to sub-millimag levels on their radial velocity periods. This provides strong support for planetary reflex motion as the cause of the radial velocity variations.Comment: 10 pages, 8 figures, accepted to Ap

Psychiatric intensive care units: A literature review

Background: Psychiatric Intensive Care Units (PICU) have been part of most inpatient psychiatric services for some time, however information about their functioning and outcome has not previously been collated. Aim: To conduct a systematic literature review to assess the current state of knowledge about such services. Method: A search of electronic databases was undertaken, followed by obtaining additional references from items obtained. Results: Over 50 papers in English containing some empirical data were identified. Most studies were retrospective. Typical PICU patients are: male; younger; single; unemployed; suffering from schizophrenia or mania; from a black Caribbean or African background; legally detained; with a forensic history. The most common reason for admission is for aggression management, and most patients stay a week or less. Evidence of the efficacy of PICU care is very poor. Conclusions: Most research so far has been small scale, and more substantial work using better methodologies is clearly required

Kepler-16: A Transiting Circumbinary Planet

We report the detection of a planet whose orbit surrounds a pair of low-mass stars. Data from the Kepler spacecraft reveal transits of the planet across both stars, in addition to the mutual eclipses of the stars, giving precise constraints on the absolute dimensions of all three bodies. The planet is comparable to Saturn in mass and size, and is on a nearly circular 229-day orbit around its two parent stars. The eclipsing stars are 20% and 69% as massive as the sun, and have an eccentric 41-day orbit. The motions of all three bodies are confined to within 0.5 degree of a single plane, suggesting that the planet formed within a circumbinary disk.Comment: Science, in press; for supplemental material see http://www.sciencemag.org/content/suppl/2011/09/14/333.6049.1602.DC1/1210923.Doyle.SOM.pd

Kepler-20: A Sun-like Star with Three Sub-Neptune Exoplanets and Two Earth-size Candidates

We present the discovery of the Kepler-20 planetary system, which we initially identified through the detection of five distinct periodic transit signals in the Kepler light curve of the host star 2MASSJ19104752+4220194. We find a stellar effective temperature Teff=5455+-100K, a metallicity of [Fe/H]=0.01+-0.04, and a surface gravity of log(g)=4.4+-0.1. Combined with an estimate of the stellar density from the transit light curves we deduce a stellar mass of Mstar=0.912+-0.034 Msun and a stellar radius of Rstar=0.944^{+0.060}_{-0.095} Rsun. For three of the transit signals, our results strongly disfavor the possibility that these result from astrophysical false positives. We conclude that the planetary scenario is more likely than that of an astrophysical false positive by a factor of 2e5 (Kepler-20b), 1e5 (Kepler-20c), and 1.1e3 (Kepler-20d), sufficient to validate these objects as planetary companions. For Kepler-20c and Kepler-20d, the blend scenario is independently disfavored by the achromaticity of the transit: From Spitzer data gathered at 4.5um, we infer a ratio of the planetary to stellar radii of 0.075+-0.015 (Kepler-20c) and 0.065+-0.011 (Kepler-20d), consistent with each of the depths measured in the Kepler optical bandpass. We determine the orbital periods and physical radii of the three confirmed planets to be 3.70d and 1.91^{+0.12}_{-0.21} Rearth for Kepler-20b, 10.85 d and 3.07^{+0.20}_{-0.31} Rearth for Kepelr-20c, and 77.61 d and 2.75^{+0.17}_{-0.30} Rearth for Kepler-20d. From multi-epoch radial velocities, we determine the masses of Kepler-20b and Kepler-20c to be 8.7\+-2.2 Mearth and 16.1+-3.5 Mearth, respectively, and we place an upper limit on the mass of Kepler-20d of 20.1 Mearth (2 sigma).Comment: accepted by ApJ, 58 pages, 12 figures revised Jan 2012 to correct table 2 and clarify planet parameter extractio

The Journal of BSN Honors Research, Volume 5, Issue 1, Summer 2012

University of Kansas School of Nursing. Bachelor of Science in Nursing Honors ProgramExploration Of Health Care Needs Among Sudanese Refugee Women - Albin, J M, Domian, E. Is There An App For That? Developing An Evaluation Rubric For Apps For Use With Adults With Special Needs - Buckler, T, Peterson, M. The Relationship Between Nursing Characteristics And Pain Care Quality - Davis, E, Dunton, N. The Relationship Between Sleep And Night Eating On Weight Loss In Individuals With Severe Mental Illness - Huynh, Thu Nhi, Hamera, E. Examining Nurse Leader/Manager-Physician Communication Strategies: A Pilot Study - Jantzen, M, Ford, D J. Comparison Of Personal, Health And Family Characteristic Of Children With And Without Autism - Martin, A, Bott, M J. Association Between Obstructive Sleep Apnea And Postoperative Adverse Events - Nielsenshultz, Y, Smith, C, Bott, M, Schultz, M P, Cole, C. Challenges Associated With Partnering With Sudanese Refugee Women In Addressing Their Health Issues - Pauls, K L, Baird, M B. Complementary Therapy To Relieve Pediatric Cancer Therapy-Related Symptoms In The Usa - Slaven, A, Williams, P D

Characteristics of Kepler Planetary Candidates Based on the First Data Set: The Majority are Found to be Neptune-Size and Smaller

In the spring of 2009, the Kepler Mission commenced high-precision photometry on nearly 156,000 stars to determine the frequency and characteristics of small exoplanets, conduct a guest observer program, and obtain asteroseismic data on a wide variety of stars. On 15 June 2010 the Kepler Mission released data from the first quarter of observations. At the time of this publication, 706 stars from this first data set have exoplanet candidates with sizes from as small as that of the Earth to larger than that of Jupiter. Here we give the identity and characteristics of 306 released stars with planetary candidates. Data for the remaining 400 stars with planetary candidates will be released in February 2011. Over half the candidates on the released list have radii less than half that of Jupiter. The released stars include five possible multi-planet systems. One of these has two Neptune-size (2.3 and 2.5 Earth-radius) candidates with near-resonant periods.Comment: Paper to accompany Kepler's June 15, 2010 data release; submitted to Astrophysical Journal Figures 1,2,& 3 revised. Improved labeling on all figures. Slight changes to planet frequencies in result