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A cross-sectional study on the nurses’attitude towards rapid response system activation for clinically deteriorated patients

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Nursing Communications 2024年第6期8卷 1-8页

作者： Salamah Ahmed Taher Alnajei jefferson garcia guerrero East Jeddah General Hospital/Jeddah First cluster Jeddah 22253Saudi Arabia Fakeeh College for Medical Sciences Jeddah 22253 Saudi Arabia

Background:Hospitals have reported that implementing rapid response system activation(RRS)activation has increased patient *** a result,there has been growing interest in identifying factors that lead to successful RRS *** introducing an automated RRS activation system has prompted nurses to be more vigilant about monitoring vital signs,it has not necessarily encouraged them to conduct thorough patient assessments to identify early signs of ***:The current study aimed to assess nurses’attitudes towards RRS activation for clinically deteriorated patients in the clinical units of King Abdul-Aziz ***:A descriptive cross-sectional research design was utilised in the study,and 144 nurses working in the medical and surgical units of King Abdul-Aziz Hospital were recruited to participate using a convenient non-probability sampling ***:The study’s findings reported that nurses have a positive attitude towards RRS benefits(Mean=3.70;SD=0.70).Their overall attitude towards RRS activation among clinically deteriorated patients is still low positive(Mean=2.71;SD=0.61).The nurses’attitudes towards RRS benefits significantly differ among nationalities and the clinical area/unit where they were assigned,with a P-value of 0.0194 and 0.000,*** towards RRS barriers significantly differ among nationality(P-value=0.0037),education level(P-value=0.0032),area of assignment(P-value=0.020),and whether they have a good understanding of abnormal observations(P-value=0.0122).Regarding the nurses’attitude towards management belief,the significant result is only with the clinical area/unit of assignment with a P-value of ***:The current study found a low positive attitude towards RRS activation among ward nurses,especially given that monitoring vital signs is critical to their *** may fear being perceived as clinically inept for redundant activations caused by poor quality,but their attitude t

关键词： rapid response team rapid response system clinically deteriorated patients cardiopulmonary arrest medical-surgical nurses

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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

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Nurses towards End-of-Life Situations: Sympathy vs. Empathy

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Open Journal of Nursing 2019年第3期9卷 278-293页

作者： jefferson garcia guerrero Fakeeh College for Medical Sciences Jeddah Saudi Arabia

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 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

关键词： Sympathy Empathy End-of-Life Care Challenges Adaptive Strategies

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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

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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

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Synthesis of coral-like structures of Pr-Yb co-doped YIG: Structural,optical, magnetic and antimicrobial properties

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Journal of Rare Earths 2024年第3期42卷 543-554,I0004页

作者： A.Fernandez Francisca P.Araujo Y.Guerra S.Castro-Lopes J.Matilla-Arias Idglan S.de Lima Edson C.Silva-Filho Josy A.Osajima F.guerrero R.Pena-garcia Federal University of Piau Graduate Program in Materials Science and EngineeringTeresinaPIBrazil Federal Rural University of Pernambuco Academic Unit of Cabo de Santo AgostinhoCabo de Santo AgostinhoPEBrazil Federal University of Piaui Department of PhysicTeresinaPBrazil Federal University of Pernambuco Graduate Program in Materials ScienceRecifePEBrazil University of Granma Departmentof Basic Sciences and Applied InformaticsFaculty of Technical SciencesBayamoCuba Federal University of Amazonas Department of PhysicManausAMBrazil Federal University of Pernambuco Department of PhysicRecifePEBrazil

Coral-like structures of the Y_(3-x)Pr_(x)Fe_(5-y)Yb_(y)O_(12),(0.00 ≤ x ≤ 0.04, 0.00 ≤ y ≤ 0.02) compound were synthesized using the sol-gel method. Structural investigation certified the YIG cubic crystal structure formation, without any secondary phase. It is shown that, the relatively large ionic radius of the dopant cations results in an expansion of the lattice parameter, variations in the Iona-O-Iondangle, Iona-O,Iond-O and Ionc-O bond distances and decrease in the average crystallite size. Fourier transform infrared(FTIR) and Raman measurements are essential to testify the single-phase formation of YIG crystal structure and are observed changes in the stretching and vibrational modes, respectively. The morphological study, energy dispersive spectroscopy(EDS) spectra and textural properties show corallike structures, peaks associated with Pr^(3+) and Yb^(3+) atoms and the effect of dopants on surface area,diameter, and pore volume, respectively. The optical analysis from diffuse reflectance spectra witnessed an increase in the optical gap band, a decrease in Urbach energy and blue shift in the charge transfer,correlated with the expansion of the unit cell due to the dopant's insertion in the YIG structure. A typical ferrimagnetic behavior is exhibited by the Y_(3-x)Pr_(x)Fe_(5-y)Yb_(y)O_(12)compound. The saturation magnetization(M_(s)), cubic anisotropy constant(K_(1)) and coercive field(H_(c)) increase with the Pr^(3+)cations content, as consequence of their magnetic nature and distribution around of Fe^(3+)ions due to the coexistence with the Yb^(3+). Finally, for the first time, antibacterial tests by mean of the direct contact method were performed for YIG co-doped with Pr^(3+)and Yb^(3+)and it is shown that, relatively high dosages of Pr^(3+) cations favored the activity against S. aureus, therefore, a new biological property for YIG doped with rare earths is presented.

关键词： Yttrium iron garnet(YIG) Coral-like structures Rare earths Band gap energy Magnetic properties Antimicrobial properties

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Recent Advances to Understand Morphology Stability of Organic Photovoltaics

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Nano-Micro Letters 2017年第1期9卷 39-54页

作者： Antonio guerrero Germà garcia-Belmonte Institute of Advanced Materials(INAM) Universitat Jaume I12006 Castello´Spain

Organic photovoltaic devices are on the verge of commercialization with power conversion efficiencies exceeding 10 % in laboratory cells and above 8.5 % in modules. However, one of the main limitations hindering their mass scale production is the debatable inferior stability of organic photovoltaic devices in comparison to other *** donor/acceptor morphology of the active layer is required to provide carrier separation and transport to the electrodes. Unfortunately, the beneficial morphology for device performance is usually a kinetically frozen state which has not reached thermodynamic equilibrium. During the last 5 years, special efforts have been dedicated to isolate the effects related to morphology changes taking place within the active layer and compare to those affecting the interfaces with the external electrodes. The current review discusses some of the factors affecting the donor/acceptor morphology evolution as one of the major intrinsic degradation pathways. Special attention is paid to factors in the nano- and microscale *** example, phase segregation of the polymer and fullerene domains due to Ostwald ripening is a major factor in the microscale domain and is affected by the presence of additives, glass transition temperature of the polymers or use of crosslinkers in the active layer. Alternatively, the role of vertical segregation profile toward the external electrodes is key for device operation, being a clear case of nanoscale morphology evolution. For example, donor and acceptor molecules actually present at the external interfaces will determine the leakage current of the device, energy-level alignment, and interfacial recombination processes. Different techniques have been developed over the last few years to understand its relationship with the device efficiency. Of special interest are those techniques which enable in situ analysis being nondestructive as they can be used to study accelerated degradation experiments and

关键词： Organic photovoltaics Intrinsic degradation Morphology Thermal degradation Interface

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Use of new technologies for the promotion of physical activity in patients with mental illness:A systematic review

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World Journal of Psychiatry 2023年第4期13卷 182-190页

作者： Margarita guerrero-Jiménez Marta Ruiz Luis Gutiérrez-Rojas Laura Jiménez-Muñoz Enrique Baca-garcia Alejandro Porras-Segovia Department of Psychiatry Hospital Clínico San CecilioGranada 18014Spain Department of Psychiatry Hospital Rey Juan CarlosMóstoles 28933MadridSpain Department of Psychiatry Hospital Universitario Jiménez DíazMadrid 28040Spain Department of Psychiatry Fundación Jiménez DiazMadrid 28040Spain

BACKGROUND Physical exercise is an underutilized tool for the management of mental *** technologies have made a breakthrough in health care,and one of its possible applications(apps)could be that of customizing exercise programs for special populations,such as patients with mental ***,the app of the so-called e-health to mental health care is still *** To know the efficacy of apps to promote physical activity in patients with mental *** We conducted a systematic review of the PubMed and Embase databases with the aim of exploring the use of new technologies for the enhancement of physical exercise in patients with a psychiatric *** the selection process,10 articles were included in the *** The most commonly used devices in this type of intervention are wearable devices and web *** results in terms of effectiveness and acceptability were obtained in most of the *** Our findings suggest that the use of new technologies in mental health represents a feasible strategy with great potential in clinical practice.

关键词： e-health m-health Physical exercise Mobile applications Wearable device

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Evaluation of pig oocyte in vitro maturation and fertilization using three gonadotropin-based hormonal compounds

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Asian pacific Journal of Reproduction 2021年第2期10卷 90-97页

作者： Rosario Santiago-Rodriguez Alma L.Alvarez-guerrero Fernando garcia-Gonzalez Alicia Alcantar-Rodriguez Alfredo Medrano Autonomous University of Mexico State AmecamecaMexico Faculty of Sciences National Autonomous University of MexicoMexico National Autonomous University of Mexico FES Cuautitlan:Km 2.5 Carretera Cuautitlan-Teoloyucan54714 Cuautitlan IzcalliEstado de MexicoMexico

Objective:To evaluate the effect of human chorionic gonadotropins(hCG)and equine chorionic gonadotropins(eCG)on in vitro gilt oocyte maturation and embryonic development,using frozen semen for ***:Two independent experiments(6 replicates each)were carried out to evaluate gilt oocyte maturation,and fertilization and embryonic development by using ovaries from a local ***,712 oocytes were randomly distributed in four-well dishes to receive Novormon(eCG 5.0 IU),PG600(eCG 5.0 IU and hCG 2.5 IU),Chorulon(hCG 5.0 IU),or no *** were incubated with 5%CO2,95%air and saturation humidity at 39℃for 44 *** of the oocytes to metaphaseⅡwas assessed by using the aceto-orcein *** addition,741 oocytes were used and randomly distributed in four-well dishes,and then oocyte maturation was carried out as mentioned,but matured oocytes were washed and placed in fertilization medium with frozen-thawed *** were co-incubated for 7 h,and then washed and placed in development medium,and incubated for further 7 days,at which time embryonic development was *** and embryo development media were not supplemented with the studied ***:Novormon(eCG)and PG600(eCG+hCG)treatments significantly improved the percentages of metaphaseⅡoocytes compared to the control group(P<0.05).Furthermore,a significant increase was also observed in the young blastocyst stage between the control group and the PG600 treatment group(P<0.05).Conclusions:Hormonal products Novormon(eCG)and PG600(eCG+hCG)can obtain the highest percentages of in vitro maturation in gilt oocytes;however,this effect is not transferred to fertilization rates.

关键词： Chorionic gonadotropins Embryo Oocyte maturation In vitro fertilization

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A novel elemental composition based prediction model for biochar aromaticity derived from machine learning

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Artificial Intelligence in Agriculture 2021年第1期5卷 133-141页

作者： Hongliang Cao Yaime jefferson Milan Sohrab Haghighi Mood Michael Ayiania Shu Zhang Xuzhong Gong Electo Eduardo Silva Lora Qiaoxia Yuan Manuel garcia-Perez Key Laboratory of Agricultural Equipment in Mid-lower Yangtze River College of EngineeringHuazhong Agricultural UniversityNo.1Shizishan StreetHongshan DistrictWuhan 430070PR China Department of Biological Systems Engineering Washington State UniversityPullmanWA 99164USA College of Materials Science and Engineering Nanjing Forestry UniversityNanjing 210037PR China Key Laboratory of Green Process and Engineering National Engineering Laboratory for Hydrometallurgical Cleaner Production TechnologyInstitute of Process EngineeringChinese Academy of SciencesBeijing 100190PR China Excellence Group in Thermal Power and Distributed Generation Federal University of ItajubáBrazil

The measurement of aromaticity in biochars is generally conducted using solid state 13C nuclear magnetic resonance spectroscopy,which is expensive,time-consuming,and only accessible in a small number of researchintensive *** modelling could be a viable alternative to predict biochar aromaticity from other much easier accessible parameters(*** composition).In this research,Genetic Programming(GP),an advancedmachine learning method,is used to develop *** order to identify and evaluate the performance of prediction models,an experimental data set with 98 biochar samples collected from the literature was *** to the benefits of the intelligence iteration and learning of GP algorithm,a kind of underlying exponential relationship between the elemental compositions and the aromaticity of biochars is disclosed *** exponential relationship is clearer and simpler than the polynomial mapping relationships implicated by Maroto-Valer,Mazumdar,and Mazumdar-Wang *** this case,a novel exponential model is proposed for the prediction of biochar *** proposed exponential model appears better prediction accuracy and generalization ability than existing polynomial models during the statistical parameter evaluation.

关键词： Biochar C aromaticity Prediction model Machine learning Genetic programming

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