Improving Critical Thinking and Clinical Reasoning With a Continuing Education Course

Background: Continuing education courses related to critical thinking and clinical reasoning are needed to improve the accuracy of diagnosis. Method: This study evaluated a 4-day, 16-hour continuing education course conducted in Brazil. Thirty-nine nurses completed a pretest and a posttest consisting of two written case studies designed to measure the accuracy of nurses` diagnoses. Results: There were significant differences in accuracy from pretest to posttest for case 1 (p = .008) and case 2 (p = .042) and overall (p = .001). Conclusion: Continuing education courses should be implemented to improve the accuracy of nurses` diagnoses. J Contin Educ Nurs 2009;40(3):121-127.

Hydration and N-acetylcysteine in acute renal failure caused by iodinated contrast medium: an experiment with rats

Background: The involvement of nephrotoxic agents in acute renal failure (ARF) has increased over the last few decades. Among the drugs associated with nephrotoxic ARF are the radiologic contrast media whose nephrotoxic effects have grown, following the increasing diagnostic use of these agents. Methods: We evaluated the effect of iodinated contrast (IC) medium, administered in combination, or not, with hyperhydration or N-acetylcysteine (NAC), on creatinine clearance, production of urinary peroxides and renal histology of rats. Adult Wistar rats treated for 5 days were divided into the following groups: control (saline, 3 ml/kg/day, intraperitoneally [i.p.]), IC (sodium iothalamate meglumine, 3 ml/kg/day i.p.), IC + water (12 mL water, orally + IC, 3 ml/kg/day i.p. after 1 hour), IC + NAC (NAC, 150 mg/kg/day, orally + IC, 3 ml/kg/day i.p. after 1 hour) and IC + water + NAC. Results: IC medium reduced renal function, with maintenance of urinary flow. Hyperhydration did not reduce the nephrotoxic effect of the IC agent, which was observed in the group IC + NAC. The combination of hyperhydration and NAC had no superior protective effect compared with NAC alone. An increase in urinary peroxides was observed in the IC group, with NAC or water or the combination of both reducing this parameter. Histopathologic analysis revealed no significant alterations. Conclusions: In summary, given 5 days previously, NAC was found to be more effective than hyperhydration alone in the prevention of contrast-induced acute renal failure.

Political Systems and the Perspective on Nursing Education during the Spanish Transition (from the Franco Regime to Democracy). A Contribution based on Nursing History

The aim of this study is to describe the changes in nursing education during the process prior to and after the establishment of democracy in Spain. It begins with the hypothesis that differences in social and political organization influenced the way the system of nursing education evolved, keeping it in line with neopositivistic schemes and exclusively technical approaches up until the advent of democracy. The evolution of a specific profile for nursing within the educational system has been shaped by the relationship between the systems of social and political organization in Spain. To examine the insertion of subjects such as the anthropology of healthcare into education programs for Spanish nursing, one must consider the cultural, intercultural and transcultural factors that are key to understanding the changes in nursing education that allowed for the adoption of a holistic approach in the curricula. Until the arrival of democracy in 1977, Spanish nursing education was solely technical in nature and the role of nurses was limited to the tasks and procedures defined by the bureaucratic thinking characteristic of the rational-technological paradigm. Consequently, during the long period prior to democracy, nursing in Spain was under the influence of neopositivistic and technical thinking, which had its effect on educational curricula. The addition of humanities and anthropology to the curricula, which facilitated a holistic approach, occurred once nursing became a field of study at the university level in 1977, a period that coincided with the beginnings of democracy in Spain.

The game inside the school: a representation of 5(th) graders physical education classes

Since the beginning of Physical Education entrance in the brazilin public schools, the game has been frequently used as content, and in the course of time that practice seems to be intensified. In spite of many approaches of different purposes to justify its pedagogic usefulness, the game has been used as an indiscriminate way due to the fascination that it provides to the students. The present study searches for a description and analysis of children`s (10-12 years old) attitudes behaviors in games, on Physical Education classes, inside a public school. The study was accomplished with the researcher also attending as a teacher (action research). For the accomplishment of the study 55 children were filmed in four different games, of different kinds (exposed, transformed, and spontaneous). The classes` description and analysis were focused in the attitude axis and it was defined four topics for the discussion: Conflicts, Respect of rules, Expressiveness, and Competitiveness. The relationship between the individual with the game and its culture were pointed as the main characteristics in the configuration of the ludicrous activity atmosphere. It was also possible to observe specific situations of this relationship, once the games were limited to the social games (Piaget category), in a school atmosphere where children have students roles. Due to the obtained results, the study proposes a reflexive practice in which the students notice their own attitudes and try to adapt the game to their needs and not he other way around. In this perspective, the teacher has an important mediator roll, once he will be responsible to point out the students` difficulties and promote discussions in favor to provide teamwork.

The physical education teacher's competences and professional formation

This study has as objective identifies the necessary competences to the physical education teachers of the basic education, in the teachers` of the public network of teaching of the Sao Paulo state perspective, licentiates and exits of the Physical Education School and Sport of the Sao Paulo University starting from 1995. It is a qualitative research, of nature no experimental, consisting of two studies (diagnostic and deepening). As instruments, questionnaire and semi-structured interview were used. It happened what the teachers judge importantly mobilize determined knowledges placed in a hierarchy or associated during the teaching practice, such as: knowledges pedagogic-educational, technical knowledges and cultural luggage, inserted in the current context and considering the cultural, social, political, economical and education transformations occurred along the history. There was shown up in this study the relevance of the formation continued for the teachers of Physical Education, who found her essential and basic added to the initial formation.

Effects of medium supplementation and pH control on lactic acid production from brewer`s spent grain

A cellulose pulp obtained by chemical pre-treatment of brewer`s spent grain was saccharified by a commercial cellulase preparation and the produced hydrolysate (50 g/l glucose) was fermented to lactic acid by Lactobacillus delbrueckii. The effects of pH control and nutrient supplementation of the hydrolysate on fermentation performance were investigated. Addition of 5g/l yeast extract enhanced the lactic acid volumetric productivity that attained 0.53 g/l h, value 18% higher than that obtained from non-supplemented hydrolysate. Addition of the MRS broth medium components (except the carbon source) was still better, providing a productivity of 0.79 g/l h. In all the cases, the lactic acid yield factor was of 0.7 g/g glucose consumed, but the fermentations stopped after 24 h due to the pH drop from 6.0 to 4.2, resulting in large amounts of residual glucose (38-41 g/l). Fermentation runs pH-controlled at 6.0 gave better results than those where the initial pH was not further controlled. The best result, 35.54 g/l lactic acid (0.99 g/g glucose consumed) was obtained during the pH-controlled fermentation of hydrolysate medium supplemented with MRS components. The volumetric productivity at the end of this fermentation was 0.59 g/l h, with a maximum of 0.82 g/l h during the first 12 h. (c) 2008 Elsevier B.V. All rights reserved.

Clarification of a wheat straw-derived medium with ion-exchange resins for xylitol crystallization

BACKGROUND: Xylitol bioproduction from lignocellulosic residues comprises hydrolysis of the hemicellulose, detoxification of the hydrolysate, bioconversion of the xylose, and recovery of xylitol from the fermented hydrolysate. There are relatively few reports on xylitol recovery from fermented media. In the present study, ion-exchange resins were used to clarify a fermented wheat straw hemicellulosic hydrolysate, which was then vacuum-concentrated and submitted to cooling in the presence of ethanol for xylitol crystallization. RESULTS: Sequential adsorption into two anion-exchange resins (A-860S and A-500PS) promoted considerable reductions in the content of soluble by-products (up to 97.5%) and in medium coloration (99.5%). Vacuum concentration led to a dark-colored viscous solution that inhibited xylitol crystallization. This inhibition could be overcome by mixing the concentrated medium with a commercial xylitol solution. Such a strategy led to xylitol crystals with up to 95.9% purity. The crystallization yield (43.5%) was close to that observed when using commercial xylitol solution (51.4%). CONCLUSION: The experimental data demonstrate the feasibility of using ion-exchange resins followed by cooling in the presence of ethanol as a strategy to promote the fast recovery and purification of xylitol from hemicellulose-derived fermentation media. (c) 2008 Society of Chemical Industry.

An improved continuous medium technique for structural frame analysis

This paper presents an improved constitutive equation of frame in the context of continuous medium technique. This improved constitutive equation, which is a consistent formulation of column global bending, is applicable to a complete class of frameworks including the ideal shear frame panel, for which the beams are assumed to be rigid, and the associated column system, for which the rigidity of beams is negligible. Global buckling and second-order effects of the frame structure are discussed. The main results can be extended to other types of lateral stiffening elements as built-up columns. A worked example is presented in order to compare the main results with those obtained by the classic matrix method. Copyright (C) 2007 John Wiley & Sons, Ltd.

Feasibility of Electronic Tap-Changing Stabilizers for Medium Voltage Lines-Precedents and New Configurations

Thyristor-based onload tap-changing ac voltage stabilizers are cheap and robust. They have replaced most mechanical tap-changers in low voltage applications from 300 VA to 300 M. Nevertheless, this replacement hardily applies to tap-changers associated to transformers feeding medium-voltage lines (typically 69 kV primary, 34.5 kV line, 10 MVA) which need periodical maintenance of contacts and oil. The Electric Power Research Institute (EPRI) has studied the feasibility of this replacement. It detected economical problems derived from the need for series association of thyristors to manage the high voltages involved, and from the current overload developed under line fault. The paper reviews the configurations used in that field and proposes new solutions, using a compensating transformer in the main circuit and multi-winding coils in the commutating circuit, with reduced overload effect and no series association of thyristors, drastically decreasing their number and rating. The stabilizer can be installed at any point of the line and the electronic circuit can be fixed to ground. Subsequent works study and synthesize several commutating circuits in detail.

Efficient Modeling of Thin Wires in a Lossy Medium by Finite Elements Applied to Grounding Systems

A procedure is proposed to accurately model thin wires in lossy media by finite element analysis. It is based on the determination of a suitable element width in the vicinity of the wire, which strongly depends on the wire radius to yield accurate results. The approach is well adapted to the analysis of grounding systems. The numerical results of the application of finite element analysis with the suitably chosen element width are compared with both analytical results and those computed by a commercial package for the analysis of grounding systems, showing very good agreement.

Knowledge transfer in product development processes: A case study in small and medium enterprises (SMEs) of the metal-mechanic sector from Sao Paulo, Brazil

This paper reports a research that evaluated the product development methodologies used in Brazilian small and medium-sized metal-mechanic enterprises (SMEs), in a specific region of Sao Paulo. The tool used for collecting the data was a questionnaire, which was developed and applied through interviews conducted by the researchers in 32 companies. The main focus of this paper can be condensed in the synthesis-question ""Is only the company responsible for the development?"" which was analyzed thoroughly. The results obtained from this analysis were evaluated directly (through the respective percentages of answers) and statistically (through the search of an index which demonstrates if two questions are related). The results point to a degree of maturity in SMEs, which allows product development to be conducted in cooperation networks. (C) 2007 Elsevier Ltd. All rights reserved.

Effect of precracking method on K(Ic) results for medium-density polyethylene tested under cryogenic condition

The effect of different precracking methods on the results of linear elastic K(Ic) fracture toughness testing with medium-density polyethylene (MDPE) was investigated. Cryogenic conditions were imposed in order to obtain valid K(Ic) values from specimens of suitable size. Most conservative K(Ic) values were obtained by slow pressing a fresh razor blade at the notch root of the specimen. Due to the low deformation level imposed on the crack tip region, the slow pressing razor blade technique also produced less scatter in fracture toughness results. It has been shown that the slow stable crack growth preceding catastrophic brittle failure during K(Ic) tests in MOPE under cryogenic conditions should not be disregarded as it has relevant physical meaning and may affect the fracture toughness results. (C) 2010 Elsevier Ltd. All rights reserved.

Texture and mechanical properties evolution of a deep drawing medium carbon steel during cold rolling and subsequent recrystallization

Medium carbon steels are mostly used for simple applications; however, new applications have been developed for which good sheet metal formability is required. These types of steels have an inherent low formability. A medium-carbon hot-rolled SAE 1050 steel was selected for this study. It has been cold rolled with thickness reductions varying between 7 and 80%. The samples obtained were used to evaluate the strain hardening curve. For samples with a 50 and 80% thickness reduction, an annealing heat treatment was performed to achieve recrystallization. The material was characterized in the ""as-received"", cold rolled and annealed conditions using several methods: optical metallography, X-ray diffraction (texture), Vickers hardness, and tensile testing. For large thickness reductions, the SAE 1050 steel presented low elongation, less than 2%, and yield strength (YS) and tensile strength (TS) around 1400 MPa. Texture in the ""as-received"" condition showed strong components on the {001} plane, in the < 100 >, < 210 > and (110) directions. After cold rolling, the texture did not present any significant changes for small thickness reductions, however. It changed completely for large ones, where gamma, < 111 >//ND, alpha, < 110 > HRD, and gamma prime, < 223 >//ND, fibres were strengthened. After annealing, the microstructure of the SAE 1050 steel was characterized by recrystallized ferrite and globular cementite. There was little change in the alpha fibre for the 50% reduction, whereas for the 80% reduction, its intensity increased. Both gamma and gamma prime fibres vanished upon annealing for 50 and 80% reductions alike. (c) 2008 Elsevier B.V. All rights reserved.

Medium carbon steel deep drawing: A study on the evolution of mechanical properties, texture and simulations, from cold rolling to the end product

Medium carbon steels are mostly used for simple applications; nevertheless new applications have been developed for which good sheet formability is required. This class of steels has an inherent low formability. A medium carbon hot rolled SAE 1050 steel has been selected for this study. It has been cold rolled with reductions in the 7-80% range. Samples have been used to assess the cold work hardening curve. For samples with a 50 and 80% thickness reduction, an annealing heat treatment has been performed to obtain recrystallization. The material has been characterized in the ""as received"", cold rolled and annealed conditions, using several methods: optical microscopy, X-ray diffraction (texture), Vickers hardness and tensile testing. The 50% cold rolled and recrystallized material has been further studied in terms of sheet metal formability and texture evolution during the actual stamping of a steel toecap that has been used to validate the finite element simulations. (C) 2008 Elsevier B.V. All rights reserved.

Nisin expression production from Lactococcus lactis in milk whey medium

BACKGROUND: Nisin is a commercially available bacteriocin produced by Lactococcus lactis ATCC 11454 and used as a natural agent in the biopreservation of food. In the current investigation, milk whey, a byproduct from dairy industries was used as a fermentation substrate for the production of nisin. Lactococcus lactis ATCC 11454 was developed in a rotary shaker (30 degrees C/36 h/100 rpm) using two different media with milk whey (i) without filtration, pH 6.8, adjusted with NaOH 2 mol L-1 and without pH adjustment, both autoclaved at 121 degrees C for 30 min, and (ii) filtrated (1.20 mu m and 0.22 mu m membrane filter). These cultures were transferred five times using 5 mL aliquots of broth culture for every new volume of the respective media. RESULTS: The results showed that culture media composed of milk whey without filtration supplied L. lactis its adaptation needs better than filtrated milk whey. Nisin titers, in milk whey without filtration (pH adjusted), was 11120.13 mg L-1 in the second transfer, and up to 1628-fold higher than the filtrated milk whey, 6.83 mg.L-1 obtained in the first(t) transfer. CONCLUSIONS: Biological processing of milk byproducts (milk whey) can be considered a profitable alternative, generating high-value bioproducts and contributing to decreasing river disposals by dairy industries. (C) 2008 Society of Chemical Industry.