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Practice Rationale Care Model: The Art and Science of Clinical Reasoning, Decision Making and Judgment in the Nursing Process

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Open Journal of Nursing 2019年第2期9卷 79-88页

作者： jefferson Garcia Guerrero Fakeeh College for Medical Sciences Jeddah Saudi Arabia

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.

关键词： Clinical Reasoning Decision Making Judgement Practice Rationale Competency

Scientific Inquiry Level of Nursing Students: Clinching Clinical Performance Expertise

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Open Journal of Nursing 2019年第3期9卷 268-277页

作者： jefferson Garcia Guerrero Fakeeh College for Medical Sciences Jeddah Saudi Arabia

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.

关键词： Scientific Inquiry Clinical Performance Proficiency Expertise

Nurses’ Care Approach (NCAp): Connecting Differences to Islamic Believer Patients in the Arab World

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Open Journal of Nursing 2019年第3期9卷 221-230页

作者： jefferson Garcia Guerrero Fakeeh College for Medical Sciences Jeddah Saudi Arabia

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.

关键词： Nurses’ Care Approach Multicultural Care Holistic Care Connecting Differences

Percutaneous nephrolithotomy for staghorn calculi: Troubleshooting and managing complications

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Asian Journal of Urology 2020年第2期7卷 139-148页

作者： Nariman Gadzhiev Vigen Malkhasyan Gagik Akopyan Sergei Petrov Francis jefferson Zhamshid Okhunov Department of Urology Pavlov First Saint Petersburg State Medical UniversityRussia Institute for Urology and Reproductive Health Sechenov UniversityMoscowRussia Department of Urology Sechenov First Moscow State Medical UniversityRussia Department of Urology University of CaliforniaOaklandCAUSA

Staghorn calculi comprise a unique subset of complex kidney stone disease. Percutaneousnephrolithotomy (PCNL) is the gold standard treatment for staghorn stones. Despitecontinuous refinements to the technique and instrumentation of PCNL, these stones remaina troublesome challenge for endourologists and are associated with a higher rate of perioperativecomplications than that for non-staghorn stones. Common and notable intraoperativecomplications include bleeding, renal collecting system injury, injury of visceral organs, pulmonarycomplications, thromboembolic complications, extrarenal stone migration, andmisplacement of the nephrostomy tube. Postoperative complications include infection and urosepsis,bleeding, persistent nephrocutaneous urine leakage, infundibular stenosis, and *** this review, we report recommendations regarding troubleshooting measures that can beused to identify and characterize these complications. Additionally, we include informationregarding management strategies for complications associated with PCNL for staghorn calculi.

关键词： Percutaneous nephrolithotomy Staghorn Complications Management Urolithiasis

Tropical-Antarctic connections of an explosive cyclone in southern Brazil:rainfall stable isotope ratios and atmospheric analysis

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Advances in Polar Science 2020年第2期31卷 103-111页

作者： Pedro Amaral REIS Francisco Eliseu AQUINO Venisse SCHOSSLER Ronaldo Torma BERNARDO jefferson Cardia SIMOES Centro Polar e Climático Instituto de GeociênciasUniversidade Federal do Rio Grande do Sul91501-970Porto AlegreRio Grande do SulBrazil Climatic Change Institute University of MaineOronoMEUSA

This study analyzes the stable isotopic ratio(δ18 O)and the synoptic characteristics of a precipitation event that occurred in the southernmost state of Brazil,Rio Grande do Sul,a region sensitive to explosive cyclogenesis in years with enhanced tropic-pole *** main objective was to evaluate the influence of tropical and Antarctic climate systems on the *** ring-down spectroscopy was used for the water isotopic analysis,and NCEP CFSv2 data were employed for the synoptic analysis of rainfall over a 48-h *** Amazonian isotopic signature on precipitated water was identified.A strong,low-level meridional flow from the Amazon Basin,combined with the development of a frontal system,resulted in intense cyclogenesis that generated an explosive cyclone.

关键词： Antarctica Amazon South American low-level jet(SALLJ) cyclogenesis

Direct identification of HMX via guest-induced fluorescence turn-on of molecular cage

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Chinese Chemical Letters 2021年第12期32卷 4006-4010页

作者： Chen Wang Jin Shang Li Tian Hongwei Zhao Peng Wang Kai Feng Guokang He jefferson Zhe Liu Wei Zhu Guangtao Li Department of Chemistry Tsinghua UniversityBeijing 100084China School of Energy and Environment City University of Hong KongHong KongChina Department of Mechanical Engineering The University of MelbourneParkvilleVIC 3010Australia School of Biology and Biological Engineering South China University of TechnologyGuangzhou 510006China Institute of chemistry Hebrew University of JerusalemJerusalem 91904Israel

Octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine(HMX) is one of the most widely used powerful explosives. The direct and selective detection of HMX, without the requirement of specialized equipment, remains a great challenge due to its extremely low volatility, unfavorable reduction potential and lack of aromatic rings. Here, we report the first chemical probe of direct identification of HMX at ppb sensitivity based on a designed metal-organic cage(MOC). The cage features two unsaturated dicopper units and four electron donating amino groups inside the cavity, providing multiple binding sites to selectively enhance host-guest events. It was found that compared to other explosive molecules the capture of HMX inside the cavity would strongly modulate the emissive behavior of the host cage, resulting in highly induced fluorescence “turn-on”(160 folds). Based on the density functional theory(DFT) simulation, the mutual fit of both size and binding sites between host and guest leads to the synergistic effects that perturb the ligand-to-metal charge-transfer(LMCT) process, which is probably the origin of such selective HMX-induced turn-on behavior.

关键词： Chemical sensing Explosive detection HMX Molecular cage Host-guest chemistry Fluorescence turn-on

A GIS-BASED GLACIER INVENTORY FOR THE ANTARCTIC PENINSULA AND THE SOUTH SHETLAND ISLANDS——A FIRST CASE STUDY ON KING GEORGE ISLAND

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Geo-Spatial Information Science 2001年第2期4卷 15-24页

作者： Matthias Braun F.Rau jefferson Cardia Si"非汉字字符"mes Institut für Physische Geographie

The aim of the international project “Global Land Ice Measurements from Space (GLIMS)" headed by the US Geological Survey is to establish a world wide glacier inventory based on satellite *** data set will form a first digital baseline study for future glacier *** presented GIS_based glacier inventory for King George Island is a case study for the area of the Antarctic *** the database of the glacier inventory topographic information,specific glaciological parameters as well as metadata will be *** topographic data consists of drainage basin limits,basin areas,altitudinal ranges,perimeters and mean *** data sets should comprise information on glacier retreat in different periods,glacier velocities,ice thickness and bedrock topography as well as derived *** and measured mass balance parameters could be included as additional data *** particular,these metadata records must comprise background information on data accuracy and data sources and should be compatible with a future data model for the King George Island GIS (KGIS).Three examples illustrate that the GLIMS database will not only contain information valuable for glaciological applications,but also other environmental studies on the island will benefit from this standardised remote sensing data ***,a very close link between the data models of KGIS and GLIMS has to be established to enable these ***,better access to historic aerial photography would enable a continuous record of glacier retreat from the beginning of the 1950’s onward.

关键词： King George Island South Shetland Islands geographic information system glacier inventory glacier retreat glacier parameters

Interlayer shear strength of single crystalline graphite

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Acta Mechanica Sinica 2012年第4期28卷 978-982页

作者： Ze Liu Shou-Mo Zhang Jia-Rui Yang jefferson Zhe Liu Yan-Lian Yang Quan-Shui Zheng Department of Engineering Mechanics and Center for Nano and Micro Mechanics Tsinghua University100084 BeijingChina Department of Mechanical and Aerospace Engineering Monash UniversityClayton3800 VICAustralia National Center for Nanoscience and Technology Beijing 100190China

Reported values （0.2 MPa-7.0 GPa） of the interlayer shear strength （ISS） of graphite are very dispersed. The main challenge to obtain a reliable value of the ISS using conventional measuring methods was the unavailability of sufficiently large single crystalline graphite. Here we present a novel experimental method to measure the ISS, and obtain the value as -0.14 GPa. Our result can serve as an important basis for understanding mechanical behavior of graphite or graphene-based materials.

关键词： Shear strength Single crystalline graphite

Evaluation of Key Players of Longganisa (Pork Sausage) Industry in Cabanatuan City, Nueva Ecija, Philippines

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Open Journal of Ecology 2023年第10期13卷 659-670页

作者： Johnah jefferson S. Mercado University Extension Program Office Central Luzon State University Science City of Muñoz Philippines

The objective of the research was to assess the major participants in the Longganisa (Pork Sausage) industry in Cabanatuan City, Nueva Ecija. The study employed direct interviews using a structured survey questionnaire, targeting input providers, growers, hog dealers/traders, processors, vendors, and consumers. These interviews helped to map out the specific value chain for Longganisa in Cabanatuan City, Nueva Ecija. Recommendations were provided to address the identified gaps and enhance the Longganisa industry in Cabanatuan City. The Longganisa industry serves as a valuable means of livelihood and income for small-scale meat processors and vendors in the city. The support provided by the Local Government Unit (LGU), Department of Trade and Industry (DTI), and Cabanatuan City Supermarket Vendors Multi-Purpose Cooperative (C2SVMPC) has proven immensely beneficial to the Longganisa industry. This support encompasses technical assistance, financial aid, promotional activities, and the provision of facilities, all aimed at enhancing the industry’s adherence to Good Manufacturing Practices (GMP) and overall improvement.

关键词： Value Addition Meat Processing Support