Role Development in the Managed Care Era: A Case of Hospital-Based Nursing

Managed care poses numerous opportunities and challenges for today's health care organizations and their employees. This article investigates the ways that hospital nurses develop and make sense of their professional roles and organizational environments in a changing and often uncertain managed care setting. The case study approach used in this research combined qualitative methodologies to gain a rich, detailed, and contextual understanding of nurses' work roles and organizational experiences. After an analysis of interviews with 24 nurses and observations of nurses' communicative activities on one inpatient unit, the complexity of sensemaking and role development in a managed care environment is considered. Conclusions are then drawn regarding the theoretical and pragmatic implications of nurses' communicative processes, as they attempted to develop and understand their roles in a changing organizational context.     

Early Literacy Skills in African-American Children: Research Considerations

The poor reading achievement of African-American children in urban schools is well established. African-American children from low-income homes may be at particular risk for reading difficulties, although middle-income children often fare poorly as well. Intervention efforts have focused on children in kindergarten through fifth grade. This article suggests that prevention efforts must begin prior to kindergarten entry. Several key variables that may influence young children's performance, including poverty, general oral language skills, dialectal variations, home literacy practices, standardized testing bias, and teacher expectations, are explored. Future directions for research addressing emergent literacy in African-American children are discussed throughout.     

Indianapolis I3: the third generation Integrated Advanced Information Management Systems.

In 2001, the Regenstrief Institute for Health Care and the Indiana University School of Medicine (IUSM) began an IAIMS planning effort to create a vision and a tactical plan for the first Integrated Advanced Information Management Systems (IAIMS) implementation to cross a large area and include unaffiliated institutions. A number of elements made this planning effort unique. Among these elements were the existence of a network infrastructure that supported the Indianapolis Network for Patient Care, the existence of a mature medical informatics program at the Regenstrief Institute, and the existence of a wide-area knowledge network fostered by the IUSM libraries. However, the leadership for a strong information technology role in the IUSM that could promote collaboration in support of education and research across the diverse Indianapolis hospital systems had been lacking. By bringing together various groups, each with a commitment to improve health care quality and public health across the Indianapolis metropolitan area, regardless of individual institutional affiliation, the strategic directions for I3-Indianapolis IAIMS Initiative have been defined and the foundations for a third generation IAIMS construct have been laid in Indianapolis, Indiana.     

Design and evaluation of a personal digital assistant- based alerting service for clinicians.

PURPOSE: This study describes the system architecture and user acceptance of a suite of programs that deliver information about newly updated library resources to clinicians' personal digital assistants (PDAs). DESCRIPTION: Participants received headlines delivered to their PDAs alerting them to new books, National Guideline Clearinghouse guidelines, Cochrane Reviews, and National Institutes of Health (NIH) Clinical Alerts, as well as updated content in UpToDate, Harrison's Online, Scientific American Medicine, and Clinical Evidence. Participants could request additional information for any of the headlines, and the information was delivered via e-mail during their next synchronization. Participants completed a survey at the conclusion of the study to gauge their opinions about the service. RESULTS/OUTCOME: Of the 816 headlines delivered to the 16 study participants' PDAs during the project, Scientific American Medicine generated the highest proportion of headline requests at 35%. Most users of the PDA Alerts software reported that they learned about new medical developments sooner than they otherwise would have, and half reported that they learned about developments that they would not have heard about at all. While some users liked the PDA platform for receiving headlines, it seemed that a Web database that allowed tailored searches and alerts could be configured to satisfy both PDA-oriented and e-mail-oriented users.     

Spaces of emergent memory: Detroit’s 8 Mile wall and public memories of civil rights injustice

This article introduces emergent memory, a conceptual extension to rhetorics of public memory, to describe memory’s genesis in sites built without commemorative commitments. Examining Detroit’s “8 Mile Wall,” a site built to reinforce segregated housing, this project argues the rhetorical tenets of emergent memory present in this space. As a relic of segregated history, the wall symbolically recalls the city’s controversial past, but has recently been the subject of a local mural project to redefine the wall’s purpose. Some consider this a step toward reclamation, as it visually repositions the disturbing remnant. For others, the murals simply cannot overwrite troubling memories of the city’s discriminatory history. This essay uses emergent memory to describe how the wall’s complicated mnemonic legacy simultaneously harkens to a difficult history and how the mural additions use that same legacy to convey an optimistic future for Detroit and those marked by this urban space.     

Nullis in Verba: Advancing Research through Transparency and Openness

Nullis in verba was chosen as the motto of the Royal Society, as it embodied the culture of transparency and collaboration that were the hallmarks of the Royal Society and of the scientific method it promoted. Communication, using the tools of the day, was essential to this community of scientists as they created and shared new knowledge. Almost three hundred years later, libraries continue to advance principles relating to the importance of collaboration and transparency. This two-part article series, published jointly in International Information and Library Review and Technical Services Quarterly explores notions of transparency and collaboration in research and how these ideas are impacting the world of librarianship – from information creation, organization and access perspectives.     

Guiding Low Spatial Ability Individuals through Visual Cueing: The Dual Importance of Where and When to Look

Research suggests that spatial ability may predict success in complex disciplines including anatomy, where mastery requires a firm understanding of the intricate relationships occurring along the course of veins, arteries, and nerves, as they traverse through and around bones, muscles, and organs. Debate exists on the malleability of spatial ability, and some suggest that spatial ability can be enhanced through training. It is hypothesized that spatial ability can be trained in low-performing individuals through visual guidance. To address this, training was completed through a visual guidance protocol. This protocol was based on eye-movement patterns of high-performing individuals, collected via eye-tracking as they completed an Electronic Mental Rotations Test (EMRT). The effects of guidance were evaluated using 33 individuals with low mental rotation ability, in a counterbalanced crossover design. Individuals were placed in one of two treatment groups (late or early guidance) and completed both a guided, and an unguided EMRT. A third group (no guidance/control) completed two unguided EMRTs. All groups demonstrated an increase in EMRT scores on their second test (P < 0.001); however, an interaction was observed between treatment and test iteration (P = 0.024). The effect of guidance on scores was contingent on when the guidance was applied. When guidance was applied early, scores were significantly greater than expected (P = 0.028). These findings suggest that by guiding individuals with low mental rotation ability “where” to look early in training, better search approaches may be adopted, yielding improvements in spatial reasoning scores. It is proposed that visual guidance may be applied in spatial fields, such as STEMM (science, technology, engineering, mathematics and medicine), surgery, and anatomy to improve student's interpretation of visual content. Anat Sci Educ. © 2018 American Association of Anatomists.