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Practice Rationale Care Model: The Art and Science of Clinical Reasoning, Decision Making and Judgment in the Nursing Process  [PDF]
Jefferson Garcia Guerrero
Open Journal of Nursing (OJN) , 2019, DOI: 10.4236/ojn.2019.92008
Abstract: Nurses must be enlightened that clinical reasoning, clinical decision making, and clinical judgement are the key elements in providing safe patient care. It must be incorporated and applied all throughout the nursing process. The impact of patients’ positive outcomes relies on how nurses are effective in clinical reasoning and put into action once clinical decision making occurs. Thus, nurses with poor clinical reasoning skills frequently fail to see and notice patient worsening condition, and misguided decision making arises that leads to ineffective patient care and adding patients suffering. Clinical judgment on the other hand denotes on the outcome after the cycle of clinical reasoning. Within this context, nurses apply reflection about their actions from the clinical decision making they made. The process of applying knowledge, skills and expertise in the clinical field through clinical reasoning is the work of art in the nursing profession in promoting patient safety in the course of delivering routine nursing interventions. Nurses must be guided with their sound clinical reasoning to have an optimistic outcome and prevent iatrogenic harm to patients. Nurses must be equipped with knowledge, skills, attitude and values but most importantly prepared to face the bigger picture of responsibility to care for every patient in the clinical field.
Nurses’ Care Approach (NCAp): Connecting Differences to Islamic Believer Patients in the Arab World  [PDF]
Jefferson Garcia Guerrero
Open Journal of Nursing (OJN) , 2019, DOI: 10.4236/ojn.2019.93022
Abstract: Background: Nursing care approaches may vary from one patient to another. In the nursing profession, nurses are imbibed with the attributes of multicultural care competencies that would empower the nurses to be adaptive and mindful of how they provide and go with their carative nursing managements. This would entail that the non-Muslim nurses must be aware and be sensitive enough in their approaches and communicative exchanges with their Muslim patients. Objective: The study aims to identify the care approaches given by non-Muslim nurses working in the Arab world and how they elicit and provide a universal approach in caring Muslim patients. Methods: The study utilized a mixed methodology, specifically the explanatory sequential design, which involved a descriptive-comparative quantitative research design and eidetic qualitative research design. Results: Based on the result with the highest mean 3.63%, the respondents strongly agree that the non-Muslim nurse is aware of her own culture, 3.60% strongly agree that the non-Muslim Nurse does not discriminate the decisions of the patients regardless of gender, race, culture or belief and 3.58% still strongly agree that the non-Muslim nurse encourages patients to communicate as need arises. Here are three themes emerged from the study: understanding and respect of cultures, caring across borders, and caring calmness. In connecting the differences, non-Muslim nurses must be aware of their own culture, must not discriminate the decisions of the patients regardless of gender, race, culture or belief and must encourages patients to communicate as need arises. Conclusion: Knowing and understanding the scope of nursing practice with a high regard of respect to patients without discrimination will promote and provide holistic, safe and high-quality nursing care.
Scientific Inquiry Level of Nursing Students: Clinching Clinical Performance Expertise  [PDF]
Jefferson Garcia Guerrero
Open Journal of Nursing (OJN) , 2019, DOI: 10.4236/ojn.2019.93026
Abstract: Background: The status of inquisition by the nursing students shall be determined as it will be utilized as a tool to measure their clinical performance expertise as future nursing practitioners. The element of scientific inquiry is essential in providing standard fillers to give meaning to the various practical nursing gaps in the actual field, the hospital ward to be specific. Objective: This research study aims to establish the level of scientific inquiry and clinical performance of undergraduate Arab nursing students. Methods: The researcher utilized descriptive-correlational study as the research design. This is a descriptive study because it describes the level of scientific inquiry and level of clinical performance of the undergraduate Arab nursing students. Results: The finding of the study is that “the majority of the Arab student nurses demonstrate a guided inquiry in their scientific inquiry level”. Most of the Arab student nurses demonstrate a guided inquiry (\"\"?= 2.74, SD ± 0.99) in terms of their level of scientific inquiry. Largely, the Arab student nurses have proficient level in their level of clinical performance (\"\"?= 87.32, SD ± 12.36). Regression analysis revealed a no significant relationship (r2 = 0.57; adjusted r2 = 0.57; p > 0.005) between the level of scientific inquiry and clinical performance among Arab student nurses. Conclusions: The study concluded that the majority of the Arab student nurses demonstrated a guided inquiry in their scientific inquiry level and a moderately proficient level of clinical performance. Furthermore, the study concluded that the level of scientific inquiry was not significantly related to clinical performance.
Nurses towards End-of-Life Situations: Sympathy vs. Empathy  [PDF]
Jefferson Garcia Guerrero
Open Journal of Nursing (OJN) , 2019, DOI: 10.4236/ojn.2019.93027
Abstract: Background: Nurses providing end-of-life care play an important role in providing support to both the patient and his/her family during one of their most difficult time. Patients in this stage do not only require physical care but emotional support as well. Aside from being a care provider, nurses should be able to utilize their knowledge in therapeutic communication in order for the patients and his/her family members to verbalize their feelings and concerns. Objective: The purpose of this study is to identify whether nurses project sympathy or empathy while providing end-of-life care. It also aims to determine their lived experiences while proving care at this stage. Methodology: This study utilized the mixed convergent parallel design wherein both the quantitative research and qualitative research were employed. Result and Discussion: A factor analysis was conducted on 12 items with maximum likelihood extraction method and oblique (Promax) rotation method. The Kaiser-Meyer-Olkin (KMO) measure verified the sampling adequacy for the analysis, KMO = 0.792 (“meritorious” according to Kaiser (1974)). Bartlett’s Test of Sphericity (χ2 (66) = 1007.294, p < 0.001) indicated that correlations among items were sufficiently large for factor analysis. The newly formed four-itemed factors were proven to be internally consistent (affective empathy α = 0.881, sympathy α = 0.804, and cognitive empathy α = 0.728). Correlations among the factors were r = 0.315 for affective empathy and sympathy, r = 0.295 for sympathy and cognitive empathy, and r = 0.356 for affective empathy and cognitive empathy. Emergent key themes and subthemes are based on participants’ responses. The key themes are heart-touching moments of nurses in providing end-of-life care, challenges encountered by nurses in providing end-of-life care and adaptive strategies used by nurses to the challenges they face in providing end-of-life care. Conclusion: Most nurses during end-of-life care express affective empathy, followed by sympathy and lastly cognitive empathy. Nurses are encouraged to show and practice affective and cognitive empathy rather than using sympathy in caring patient and dealing with family member in the end-of-life situations. Despite the challenges that nurses faced, they are able to provide quality care by utilizing several adaptive strategies such as listening and understanding, showing empathy, providing holistic care, being spiritual and being
Rubber Tree Distribution Mapping in Northeast Thailand  [PDF]
Zhe Li, Jefferson M. Fox
International Journal of Geosciences (IJG) , 2011, DOI: 10.4236/ijg.2011.24060
Abstract: In many parts of mainland Southeast Asia rubber plantations are expanding rapidly in areas where the crop was not historically found. Monitoring and mapping the distribution of rubber trees in the region is necessary for developing a better understanding of the consequences of land-cover and land-use change on carbon and water cycles. In this study, we conducted rubber tree growth mapping in Northeast Thailand using Landsat 5 TM data. A Mahalanobis typicality method was used to identify different age rubber trees. Landsat 5 TM 30 m non-thermal reflective bands, NDVI and tasseled cap transformation components were selected as the model input metrics. The validation was carried out using provincial level agricultural statistical data on the rubber tree growth area. At regional (Northeast Thailand) and provincial scales, the estimates of mature and middle-age rubber stands produced from 30 m Landsat 5 TM data compared well (high statistical significance) with the provincial rubber tree growth statistical data.
Abordagem do ciclo de políticas: uma contribui??o para a análise de políticas educacionais
Mainardes, Jefferson;
Educa??o & Sociedade , 2006, DOI: 10.1590/S0101-73302006000100003
Abstract: this paper discusses the contributions of the 'policy cycle approach' to analyze educational policies. formulated by stephen ball and richard bowe, such approach has been applied in different contexts as a theoretical and analytical framework to examine educational policies. this paper presents the main ideas of this approach, the debate surrounding it, and its contribution to the analysis of educational policies. based on the five contexts of the policy cycle, namely: influence, text production, practice, outcomes and the political strategy; this paper also presents a set of questions to the trajectory analysis of educational policies or programs. it argues that this approach is a useful analytical framework that allows a critical and contextualized analysis of programs and educational policies from their formulation to their implementation in the context of practice as well as the policy effects.
Organiza??o da escolaridade em ciclos no Brasil: revis?o da literatura e perspectivas para a pesquisa
Mainardes, Jefferson;
Educa??o e Pesquisa , 2006, DOI: 10.1590/S1517-97022006000100002
Abstract: this article offers a review of the literature about the organization of schooling in cycles in brazil, pointing out the aspects that have been emphasized, the limitations and perspectives for the research on this topic. the review covered 147 texts, which were classified into five categories: (a) discussions of theoretical aspects related to cycles in school; (b) production and formulation of policies; (c) implementation of policies; (d) analysis of results of policies and impact on the performance of pupils; and (e) literature review. it is argued that the nature of policies and the analysis of the development of the discourse of these policies are aspects that have been neglected by the research about cycles. apart from that, it is argued that the following aspects have been little explored: (a) the analysis of the implementation of the policy at school and in the classroom through observations and ethnographic research; (b) the analysis of the trajectory of the policies from their formulation to their implementation in the classroom; (c) studies including the opinion of managers and policymakers involved with schooling in cycles. the conclusion presents aspects that deserve to be studied in greater depth to bring about a clearer, wider, and more critical understanding of the cycles at brazilian schools.
A pesquisa sobre a organiza??o da escolaridade em ciclos no Brasil (2000-2006): mapeamento e problematiza??es
Mainardes, Jefferson;
Revista Brasileira de Educa??o , 2009, DOI: 10.1590/S1413-24782009000100002
Abstract: this paper presents an analysis of 123 theses and dissertations, defended between 2000 and 2006, related to the organization of schooling in cycles in brazil. it constitutes an attempt to carry out a systematic review of the research on this topic, with the aim of identifying the main trends, contributions to the debate, gaps and related problems. based on an analysis of these studies, the article explores two specific aspects: the macro-and micro-perspectives, and the discussion of the premises of the policy of schooling in cycles. it points out that it is necessary to study further the theoretical and methodological aspects of research on cycles, and to consider the broader issues related to policy, as well as to analyze the range of aspects which mediate the policy investigated.
Empirical estimates of CCN from aerosol optical properties at four remote sites
A. Jefferson
Atmospheric Chemistry and Physics (ACP) & Discussions (ACPD) , 2010,
Abstract: This study presents an empirical method to estimate the CCN concentration as a function of percent supersaturation. The aerosol optical properties, backscatter fraction and single scatter albedo, function as proxies for the aerosol size and composition in a power law relationship to CCN. This method is tested at four sites with aged aerosol: SGP (Oklahoma, USA), FKB (Black Forest, Germany), HFE (Hefei, China) and GRW (Graciosa, Azores). Each site represents a different aerosol type and thus demonstrates the method robustness and limitations. Good agreement was found between the calculated and measured CCN with slopes between 0.81 and 1.03 and correlation coefficients (r2 values) between 0.59 and 0.67. The fit quality declined at low CCN concentrations.
El imperativo social y político
Jaramillo Jefferson
Revista Colombiana de Sociología , 2010,
Abstract: El artículo propone tres interpretaciones, distintas y complementarias, sobre el concepto de memoria. La primera la presenta como un marco colectivo que permite la cohesión social. La segunda enfatiza su condición de dispositivo cultural para pensar el presente. La tercera la muestra en cuanto campo de disputa y resistencia política. La discusión se enmarca dentro de la tradición clásica y contemporánea de los estudios sociales e históricos sobre la memoria.
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