A modest start, but a steady rise in research use : A longitudinal study of nurses during the first five years in professional life

Background: Newly graduated nurses are faced with a challenging work environment that may impede theirability to provide evidence-based practice. However, little is known about the trajectory of registered nurses’ use ofresearch during the first years of professional life. Thus, the aim of the current study was to prospectively examinethe extent of nurses’ use of research during the first five years after undergraduate education and specifically assesschanges over time.Method: Survey data from a prospective cohort of 1,501 Swedish newly graduated nurses within the nationalLANE study (Longitudinal Analyses of Nursing Education and Entry in Worklife) were used to investigate perceiveduse of research over the first five years as a nurse. The dependent variables consisted of three single itemsassessing instrumental, conceptual, and persuasive research use, where the nurses rated their use on a five-pointscale, from ‘never’ (1) to ‘on almost every shift’ (5). These data were collected annually and analyzed bothdescriptively and by longitudinal growth curve analysis.Results: Instrumental use of research was most frequently reported, closely followed by conceptual use, withpersuasive use occurring to a considerably lower extent. The development over time showed a substantial generalupward trend, which was most apparent for conceptual use, increasing from a mean of 2.6 at year one to 3.6 atyear five (unstandardized slope +0.25). However, the descriptive findings indicated that the increase started onlyafter the second year. Instrumental use had a year one mean of 2.8 and a year five mean of 3.5 (unstandardizedslope +0.19), and persuasive use showed a year one mean of 1.7 and a year five mean of 2.0 (unstandardized slope+0.09).Conclusion: There was a clear trend of increasing research use by nurses during their first five years of practice.The level of the initial ratings also indicated the level of research use in subsequent years. However, it took morethan two years of professional development before this increase ‘kicked in.’ These findings support previousresearch claiming that newly graduated nurses go through a ‘transition shock,’ reducing their ability to useresearch findings in clinical work.

Um modelo numerico para analise de estruturas de materiais compostos considerando efeitos viscoelasticos e falhas progressivas

Neste trabalho apresentam-se pocedimentos para análise não linear de estruturas de materiais compostos laminados reforçados por fibras. A formulação é baseada em uma descrição cinemática incremental Lagrangeana Total, que permite o tratamento de deslocamentos arbitrariamente grandes com pequenas deformações, utilizando elementos finitos tridimensionais degenerados deduzidos para a análise de cascas. As estruturas são consideradas como submetidas a cargas mecânicas e a ações de temperatura e de umidade. O material é suposto elástico linear com propriedades dependentes, ou não, dos valores da temperatura e da concentração de umidade, ou viscoelástico linear com uma relação constitutiva em integral hereditária , e com comportamento higrotermo-reologicamente simples. As lâminas são consideradas como sujeitas a falhas, as quais são detectadas através de critérios macroscópicos, baseados em tensões ou em deformações. As equações não lineares de equilíbrio são resolvidas através de procedimentos iterativos e as deformações dependentes do tempo são avaliadas pelo método das variáveis de estado. Diversos exemplos numéricos de estruturas submetidas à flexão, flambagem elástica e viscoelástica e falhas são apresentados.

Imperfectly credible disinflation under endogenous time-ependent pricing

The real effects of an imperfectly credible disinflation depend critically on the extent of price rigidity. Therefore, the study of how policymakers’ credibility affects the outcome of an announced disinflation should not be dissociated from the analysis of the determinants of the frequency of price adjustments. In this paper we examine how credibility affects the outcome of a disinflation in a model with endogenous timedependent pricing rules. Both the initial degree of price ridigity, calculated optimally, and, more notably, the changes in contract length during disinflation play an important role in the explanation of the effects of imperfect credibility. We initially evaluate the costs of disinflation in a setup where credibility is exogenous, and then allow agents to use Bayes rule to update beliefs about the “type” of monetary authority that they face. In both cases, the interaction between the endogeneity of time-dependent rules and imperfect credibility increases the output costs of disinflation, but the pattern of the output path is more realistic in the case with learning.

A confusão no processo de escolha do consumidor

Dentro da literatura de Comportamento do Consumidor e Teoria da Decisão existe considerável corpo teórico que analisa sentimentos negativos e reações adversas no processo decisório de compras de produtos de alto e baixo envolvimento. Vários fenômenos são identificados como negativos no processo, principalmente a Confusão do Consumidor, que compreende três dimensões: i) muitas informações similares sobre produtos, ii) muitas informações sobre diferentes produtos e iii) informações falsas e ambíguas. Tal fenômeno, no entanto, parece ser moderado por um conjunto de variáveis, como o Envolvimento, a Experiência e a Restrição de Tempo (moderadoras da relação entre Confusão do Consumidor e Intenção de Compra). Este fato foi identificado através de entrevistas em profundidade. Os resultados das entrevistas permitiram identificar as variáveis moderadoras, assim como a existência do fenômeno e sua relação com a decisão final de compra. Na segunda fase da pesquisa, supõe-se que indivíduos com baixo Envolvimento e Restrição de Tempo possuam uma propensão maior à confusão. No Estudo 2 foram utilizados como moderadores o Envolvimento e a Restrição de Tempo, ambos manipulados por instrução, sendo as variáveis dependentes a Intenção de Compra e a Confusão do Consumidor. Os resultados do Estudo 2 permitiram inferir que existem diferenças significativas entre os grupos, quando analisada a variável Confusão do Consumidor, mas, em alguns grupos, a Intenção de Compra não era significativamente diferente. No Estudo 3 foram manipuladas a Experiência (forte e fraca) e a Confusão do Consumidor, sendo a variável dependente a Intenção de Compra. Os resultados do Estudo 3 também permitiram inferir que existem diferenças significativas entre os grupos na Intenção de compra, quando consideradas baixa ou alta confusão, assim como Experiência forte ou fraca. Na última fase da pesquisa foram destacadas as estratégias dos consumidores para lidar com o fenômeno Confusão do Consumidor. Tais estratégias, muitas vezes, são mediadoras de comportamentos posteriores, como a compra do produto. No Estudo 4 manipulou-se a Confusão do Consumidor em duas de suas dimensões. Foi possível destacar a preponderância da estratégia por busca de informações e postergação da decisão, quando o consumidor se depara com situações confusas.

Criação de valor no relacionamento entre empresas químicas e seus clientes

Relacionamentos entre fornecedores e compradores são fatores importantes para a melhoria do desempenho das empresas. A literatura nem sempre confirma que a relação entre relacionamento e desempenho é positiva. Alguns estudos demonstram que uma empresa pode ter vantagem competitiva e não apresentar desempenho financeiro superior. A falta de um modelo integrativo para os benefícios do relacionamento, as diferentes formas de captura de valor pelas partes e a influência do contexto no relacionamento podem ser apontadas como causas destes resultados inconclusivos. Para contribuir nesta discussão, o presente estudo propõe e testa um modelo de criação e captura de valor como forma de avaliar os benefícios dos relacionamentos de forma integrada, na presença de incerteza e competição. O uso do valor como variável dependente em estudos sobre relacionamentos comprador-fornecedor é uma inovação, mas mostra-se mais adequado, pois é mais abrangente que a medição de desempenho, a qual enfoca somente a captura de valor pelas partes, e não o valor total criado no relacionamento. Para o teste do modelo, a Visão Relacional da Estratégia foi adotada como perspectiva teórica. Ela tem grande aderência aos conceitos de criação de valor, embora a operacionalização de seus quatro construtos, chamados de recursos relacionais, não encontre um padrão na literatura. Desta forma, outra contribuição a que o estudo se propôs foi testar esses construtos separadamente. Uma survey foi conduzida junto a empresas químicas com operação no Brasil. Foi testada uma nova forma de operacionalização da criação de valor, com três variáveis dependentes distintas (valor capturado pelo fornecedor, valor capturado pelo comprador e valor gerado ao longo do tempo). Este modelo possibilitou observar a existência de benefícios capturados pelas partes e advindos do relacionamento, além de fornecer evidências de que há diferenças entre a captura de valor pelo comprador e pelo fornecedor. Não foi possível comprovar a validade discriminante de três dos construtos da visão relacional, o que confirma a necessidade de uma evolução de sua operacionalização. Por fim, observou-se que os recursos relacionais impactam na criação de valor e que a incerteza e a competição influenciam a captura de valor pelas partes e o valor criado no relacionamento.

O conhecimento e as atitudes das famílias de pacientes em tratamento em tuberculose na atenção primária à saúde

This study thus sought to examine knowledge about TB and attitudes of patients families in disease treatment in Primary Health Care in Natal- RN. To this end, a cross-sectional study was undertaken through a questionnaire with families of patients diagnosed with TB and follow up by APS from Natal. The study subjects were recruited from a non-probabilistic way, by convenience, contemplating a sample of 50 families. Among the criteria considered for inclusion of subjects, older than 18 years were considered, as well as residing with the TB patient and in Natal and availability to participate in the research. Data collection was performed by own researcher and an assistant, through a questionnaire with families of patients diagnosed with TB following the double independent digitalization of data. In the analytical phase, was initially conducted an exploratory phase and univariate data, with description of the position measurements (mean, median, mode) and dispersion (confidence interval and standard deviation). In bivariate analysis, it was conducted an intersection of dependent variables of knowledge e and changes of attitude dichotomous, with each of the independent variables, using contingency tables and calculating the chi-square test and, when appropriate, the Fisher exact test. In 2x2 tables, calculated the odds ratio (OR) with confidence intervals of 95% (95% CI). From the selected sample, 43 (86%) subjects were female, average age and median respectively of 46.64 and 46.50 years, 25 (50%) had elementary school. The knowledge expressed by family members about TB was considered satisfactory. However, the lack of interest of the family (54%) in seeking information about tuberculosis; the wrong way of reply in relation to the organism causing the disease (64%); the water content (62%) and contaminated food (54% ) as a means of spreading TB was a weakness identified in the investigation. Regarding the time of transmission, 90% of respondents indicated not know or answered wrong. From investigated independent variables, only two were associated with lack of knowledge of TB, and they did not have religion (OR: 0.146, 95% CI: 0.027 to 0.800) and income below 1, 7 minimum wages (OR: 0.155, 95% CI: 0.029 to 0.813). Thus they seem to exercise a protective effect on this outcome. As for the changes in attitude, most of the found variables had no association with statistical significance, except no internet access (OR: 0.212, 95% CI: 0,048-0, 935). Most attitudes were positive in relation to TB patient. Results have demonstrated weaknesses in TB care, which has taken on a more individual and welfare character. Data not only express health outcomes produced by health services, but also the political and social situation of the families that are affected by TB

Valores de referência para pressão inspiratória nasal SNIFF na população brasileira

The strength of respiratory muscle are frequently assessed by maximal inspiratory and expiratory pressure, however, the maneuvers to assess PImax and PEmax are difficult for many patients. The sniff nasal inspiratory pressure (SNIP) is a simple and noninvasive technique use to assess inspiratory muscles strength. Reference values have been previous established for SNIP in adults but no previous studies have provided reference values for SNIP in adult Brazilian population. The main objective of this study were propose reference values of SNIP for Brazilian population through establishment of relationship between anthropometric measurements, physical activity profile and SNIP and at the same time compare the values obtained with reference values previously published. We studied 117 subjects (59 male and 58 female) distributed in different age grouped 20-80 years old. The results showed on significant positive relationship between SNIP and height and negative correlation with age (p<0.05). In the multiple linear regression analysis only age continued to have an independent predictive role for the two dependent variables that correlated with SNIP. The values of SNIP found in Brazilian population were higher when compared with predict values of previous studies. The results of this study provide reference equations of SNIP for health Brazilian population from 20 to 80 years old

Superconducting boundary conditions for mesoscopic circular samples

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Vortices in a mesoscopic superconducting circular sector

In the present paper we develop an algorithm to solve the time dependent Ginzburg-Landau equations, by using the link variables technique, for circular geometries. In addition, we evaluate the Helmholtz and Gibbs free energy, the magnetization, and the number of vortices. This algorithm is applied to a circular sector. We evaluate the superconduting-normal magnetic field transition, the magnetization, and the superconducting density. Our results point out that, as we reduce the superconducting area, the nucleation field increases. Nevertheless, as the angular width of the circular sector goes to small values the asymptotic behavior is independent of the sample area. We also show that the value of the first nucleation field is approximately the same independently of the form of the circular sector. Furthermore, we study the nucleation of giant and multivortex states for the different shapes of the present geometry.

A combination of implicit and adaptative upwind tools for the numerical solution of incompressible free surface flows

This paper is concerned with the numerical solutions of time dependent two-dimensional incompressible flows. By using the primitive variables of velocity and pressure, the Navier-Stokes and mass conservation equations are solved by a semi-implicit finite difference projection method. A new bounded higher order upwind convection scheme is employed to deal with the non-linear (advective) terms. The procedure is an adaptation of the GENSMAC (J. Comput. Phys. 1994; 110: 171-186) methodology for calculating confined and free surface fluid flows at both low and high Reynolds numbers. The calculations were performed by using the 2D version of the Freeflow simulation system (J. Comp. Visual. Science 2000; 2:199-210). In order to demonstrate the capabilities of the numerical method, various test cases are presented. These are the fully developed flow in a channel, the flow over a backward facing step, the die-swell problem, the broken dam flow, and an impinging jet onto a flat plate. The numerical results compare favourably with the experimental data and the analytical solutions. Copyright (c) 2006 John Wiley & Sons, Ltd.

Satisfação dos usuários e qualidade dos tratamentos protéticos realizados nos centros de especialidades odontológicas da grande Natal RN

Aim: To evaluate user satisfaction and quality of prosthetic treatments performed in specialized dental clinics (CEOs) of Natal Metropolitan Region - RN. Methods: Cross-sectional study with subjects who underwent prosthetic CEOs in the cities of Natal, Macaíba, Parnamirim and Sao Goncalo do Amarante in the period 2007 to 2009. Data collection was performed by questionnaire, clinical examination of the oral cavity and examination of fabricated denture. This analysis involved the following aspects: retention, stability, aesthetics and prosthesis fixation. The variables are presented by means of absolute numbers and proportions. The determination of the association between the independent and dependent variables was conducted by the association of Chi-square test and Fisher exact test. Results: A total of 149 users, totaling 233 conventional dentures (148 upper and 85 lower). Most patients (56.4%) were rehabilitated with conventional complete dentures. The technical quality of the denture was regarded as satisfactory in the majority (52.7%), whereas the inferior dentures were rated as unsatisfactory in 90.5% of cases. Satisfaction with the prosthesis was 69.1% (N = 103). The average time to begin treatment was 3 months to receive while the prosthesis was 4 months old. The presence of injury from the upper prosthesis occurred in 21.5% of cases (N = 32), candidiasis being the most frequent (N = 18). The technical quality of the upper prosthesis (p=0,041), as well as retention (p=0,002) and stability (p<0,001) were significantly associated with user satisfaction. Conclusions: The specialized Dental clinics has been fulfilling its role of providing treatment of intermediate complexity for low-income population with the majority of satisfield patients, even when their dentures have problems of technical quality

Avaliação clínica longitudinal do periodonto de dentes pilares e não pilares de próteses parciais removíveis

The literature has shown a relation between periodontics and the removable partial denture (RPD), with progressive destruction observed in the support structures. The aim of this study was to clinically assess periodontal condition in users of removal partial denture (RPD), and compare right abutments teeth, indirect abutments and controls before installation and after 1 year, in addition to comparing tooth-supported and tooth mucosa-supported abutments. A total of 50 patients, 32 women and 18 men, mean age of 45 years, took part in the study. The patients were examined by a single examiner at prosthesis installation and after 3, 6, 9 and 12 months. The following were verified at each examination: Probe Depth (PD), Plaque Index (PI), Gingival Index (GI), the amount of Keratinized Mucosa (KM), Gingival Recession (GR) and Dental Mobility (DM); in addition patients received oral hygiene orientation, accompanied by prophylaxis, periodontal scaling and root planing (PSRP), when necessary. Analysis of Variance (ANOVA) with Tukey-Kramer post test was used to assess the dependent variables (PD, PI, KM, GR) of the three groups over time while Friedman s test was used for GI. To assess the outcomes of prosthesis type in the right abutment group, a confidence interval-based analysis was performed. The results showed that the control group was the least compromised in all the variables studied. With respect to development of the groups over time, it was verified that the measures for GR, PD, GI and KM increased from initial examination to 1 year of use in all the groups, but only PI showed a significant increase. There was a non-discriminatory low prevalence of dental mobility. The tooth mucosa-supported prosthesis had significantly higher values for GR, GI and PI and significantly lower ones for KM when compared to tooth-supported. Over time, both types of prostheses showed no significant differences from initial to final examination for the variables GR, PD, KM and GI, with PI significant only for tooth-supported. The results showed that the teeth most involved in RPD design had greater potential of periodontal damage, probably because of greater dental biofilm accumulation. Abutments elements adjacent to the free extremities had less favorable periodontal condition than those adjacent to interpolated spaces, but the use of RPD did not worsen the initial condition

Resultados Perinatais de Gêmeos com Pesos Discordantes ao Nascer

Objetivo: estudar as influências da diferença de pesos entre gêmeos, no nascimento, sobre o resultado perinatal. Métodos: analisaram-se, retrospectivamente, as informações referentes aos partos gemelares ocorridos na Maternidade do Hospital Regional de Clínicas de Sorocaba, SP, de julho de 1997 a junho de 1998. A amostragem foi composta de 89 mães e seus gêmeos, divididos em três classes de diferença de pesos ao nascer: com concordância (diferença <15%), discordância leve (de 15 a 25%) e discordância grave (>25%). As variáveis independentes analisadas foram essas três classes e as dependentes foram: baixo peso ao nascer, índice de Apgar menor que 7 no primeiro e quinto minuto, nascimentos pré-termo, tempo médio de internação do recém-nascido no berçário e coeficiente de mortalidade perinatal I. Para análise estatística utilizaram-se o teste de Kruskal-Wallis, complementado pelo teste de Hollander, e o teste de Blackwell. Resultados: a incidência de discordância de pesos entre pares de gêmeos foi de 30,3%, sendo 19,1% de discordância leve e 11,2% de discordância grave. Observamos nas classes, respectivamente, os números de gestações (62, 17 e 10) e de nascimentos pré-termo (32, 9 e 7). Para o primeiro e o segundo gêmeo, observamos: baixo peso ao nascer (39/41, 13/12 e 8/9), Apgar <7 no primeiro minuto (16/13, 3/7 e 2/3), Apgar menor que 7 no quinto minuto (4/4, 0/2 e 1/2), tempo médio (dias) de internação no berçário (3,7/3,7, 4,6/6,0 e 7,3/8,7) e coeficiente de mortalidade perinatal I (22,4/16,8, 0/16,8 e 5,6/5,6). Conclusões: o baixo peso ao nascer e nascimentos pré-termo foram mais freqüentes nos gêmeos da classe com discordância grave. Houve tendência ao agravamento progressivo do resultado perinatal, respectivamente, nas classes com concordância, discordância leve e discordância grave.

Effect of Drilling Technique on the Early Integration of Plateau Root Form Endosteal Implants: An Experimental Study in Dogs

Purpose: This study tested the hypothesis that early integration of plateau root form endosseous implants is significantly affected by surgical drilling technique.Materials and Methods: Sixty-four implants were bilaterally placed in the diaphysial radius of 8 beagles and remained 2 and 4 weeks in vivo. Half the implants had an alumina-blasted/acid-etched surface and the other half a surface coated with calcium phosphate. Half the implants with the 2 surface types were drilled at 50 rpm without saline irrigation and the other half were drilled at 900 rpm under abundant irrigation. After euthanasia, the implants in bone were nondecalcified and referred for histologic analysis. Bone-to-implant contact, bone area fraction occupancy, and the distance from the tip of the plateau to pristine cortical bone were measured. Statistical analyses were performed by analysis of variance at a 95% level of significance considering implant surface, time in vivo, and drilling speed as independent variables and bone-to-implant contact, bone area fraction occupancy, and distance from the tip of the plateau to pristine cortical bone as dependent variables.Results: The results showed that both techniques led to implant integration and intimate contact between bone and the 2 implant surfaces. A significant increase in bone-to-implant contact and bone area fraction occupancy was observed as time elapsed at 2 and 4 weeks and for the calcium phosphate-coated implant surface compared with the alumina-blasted/acid-etched surface.Conclusions: Because the surgical drilling technique did not affect the early integration of plateau root form implants, the hypothesis was refuted. (C) 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69: 2158-2163, 2011

Anti-poliovirus activity of Baccharis dracunculifolia and propolis by cell viability determination and real-time PCR

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)