UNDERSTANDING NURSE CREATED COGNITIVE ARTIFACTS: PERSONALLY-CREATED-COGNITIVE-ARTIFACTS AS EXTERNAL REPRESENTATIONS OF DISTRIBUTED COGNITION

Manuscript 1: “Conceptual Analysis: Externalizing Nursing Knowledge” We use concept analysis to establish that the report tool nurses prepare, carry, reference, amend, and use as a temporary data repository are examples of cognitive artifacts. This tool, integrally woven throughout the work and practice of nurses, is important to cognition and clinical decision-making. Establishing the tool as a cognitive artifact will support new dimensions of study. Such studies can characterize how this report tool supports cognition, internal representation of knowledge and skills, and external representation of knowledge of the nurse. Manuscript 2: “Research Methods: Exploring Cognitive Work” The purpose of this paper is to describe a complex, cross-sectional, multi-method approach to study of personal cognitive artifacts in the clinical environment. The complex data arrays present in these cognitive artifacts warrant the use of multiple methods of data collection. Use of a less robust research design may result in an incomplete understanding of the meaning, value, content, and relationships between personal cognitive artifacts in the clinical environment and the cognitive work of the user. Manuscript 3: “Making the Cognitive Work of Registered Nurses Visible” Purpose: Knowledge representations and structures are created and used by registered nurses to guide patient care. Understanding is limited regarding how these knowledge representations, or cognitive artifacts, contribute to working memory, prioritization, organization, cognition, and decision-making. The purpose of this study was to identify and characterize the role a specific cognitive artifact knowledge representation and structure as it contributed to the cognitive work of the registered nurse. Methods: Data collection was completed, using qualitative research methods, by shadowing and interviewing 25 registered nurses. Data analysis employed triangulation and iterative analytic processes. Results: Nurse cognitive artifacts support recall, data evaluation, decision-making, organization, and prioritization. These cognitive artifacts demonstrated spatial, longitudinal, chronologic, visual, and personal cues to support the cognitive work of nurses. Conclusions: Nurse cognitive artifacts are an important adjunct to the cognitive work of nurses, and directly support patient care. Nurses need to be able to configure their cognitive artifact in ways that are meaningful and support their internal knowledge representations.

Executive Managers in Peru's Family Businesses

As in many other developing countries, family businesses are major players in the Peruvian economy. Despite their growth into large-scale groups spanning a wide range of businesses, the owner families still have strong control over their ownership and management. However, Peru's liberal economic reforms in the 1990s brought intense competition into the national market. Not only have these family businesses been forced to compete against large-scale foreign capital that entered the national market through the privatization of state enterprises, but also against cheap goods imported from foreign countries. In order to compete, family businesses have had to move beyond the limited human resources available within the family. The advancement within owner families of new generations with better education and training together with the promotion to top managerial positions of professional salaried managers from outside the family are some of the measures owner families are taking to overcome their human resource limitations.

Executive Managers in Large Mexican Family Businesses

The involvement of members of owners' families in the running of large family businesses in Mexico is decreasing. Although family members still hold key posts such as that of CEO, other executive posts tend to be delegated to professional salaried managers. Top managers, including family members, share some common characteristics. They are young compared with managers in other developed countries, their quality as human resources is high, and many of them are graduates of overseas MBA courses. Most of them are sufficiently experienced. Improvement of quality among top managers is a recent phenomenon in Mexico, and has been encouraged mainly by the following two factors. First, globalization of business activities was promoted by intense competition among firms under conditions of market liberalization. In order to equip themselves with the ability to cope with the globalization of their operations, large family businesses tried hard to improve the quality of top management, by training and educating existing managers, and/or by recruiting managers in the outside labor market. Second, developments in the Mexican economy during the 1990s led to a growth in the labor market for top managers Thus, business restructuring caused by bankruptcy, as well as mergers and acquisitions, privatization and so on, led to the dismissal of business managers who then entered the labor market in large numbers. The increasing presence of these managers in the labor market helped family businesses to recruit well-qualified senior executives.

Atenea for managers

De distintas formas y en diferentes momentos he intervenido activamente en cursos de informática para ejecutivos. Mi impresión es que tenían el mismo efecto sobre el auditorio que el que tiene representar una sesión de juegos malabares ante una asamblea de invidentes.

Climate and grazing control nurse effects in an Ecuadorian dry shrubby community

Positive plant interactions have strong effects on plant diversity at several spatial scales, expanding species distribution under stressful conditions. We evaluated the joint effect of climate and grazing on the nurse effect of Croton wagneri, by monitoring several community attributes at two spatial scales: microhabitat and plant community. Two very close locations that only differed in grazing intensity were surveyed in an Ecuadorian dry scrub ecosystem. At each location, two 30 × 30-m plots were established at four altitudinal levels (1500, 2630, 1959 and 2100 m asl) and 40 microsites were surveyed in each plot. Croton wagneri acted as community hubs, increasing species richness and plant cover at both scales. Beneath nurses mean richness and cover values were 3.4 and 21.9%, and in open areas 2.3 and 4.5%, respectively. Magnitude of nurse effect was dependent on climate and grazing conditions. In ungrazed locations, cover increased and diversity reduced with altitude, while grazed locations showed the opposite trend. In ungrazed plots the interactions shifted from positive to negative with altitude, in grazed locations interactions remained positive. We conclude that the nurse effect is a key mechanism regulating community properties not only at microsite but also at the entire community scale.

The role of visualizations in urban forestry. Conclusions from managers’ perspectives

La presente tesis examina el uso potencial y actual de las técnicas de simulación visual aplicadas al campo de la gestión y la planificación del arbolado urbano. El estudio incluye las aplicaciones potenciales de las visualizaciones por ordenador, así como los beneficios que esto acarrearía. También se analizan las posibles barreras que surgirían de la implementación de esta nueva herramienta y se ofrece una lista de recomendaciones para superarlas. La investigación tiene un carácter exploratorio que utiliza una combinación de técnicas de investigación cuantitativas y cualitativas, dónde se emplean cuestionarios y entrevistas personales semi-estructuradas para estudiar y analizar las opiniones y reacciones de los gestores de arbolado urbano de los distritos de la ciudad de Londres (Reino Unido), denominados Tree Officers (LTOs). Para el desarrollo de la tesis se recopilaron y analizaron las respuestas al cuestionario del 41 por ciento de los LTOs pertenecientes al 88 por ciento de los distritos de Londres y se realizaron un total de 17 entrevistas personales. Los resultados del análisis estadístico de las respuestas del cuestionario y los análisis cruzados de las distintas variables se complementaron con las conclusiones obtenidas del análisis temático de los datos cualitativos recopilados durante las entrevistas. Los usos potenciales de las técnicas de simulación visual aplicadas a la gestión y planificación del arbolado urbano sugeridos fueron obtenidos combinado las conclusiones de, primero, la comparación de las cuestiones que los LTOs consideraron que más tiempo y recursos necesitaban y que actualmente no era posible resolverlas satisfactoriamente con las herramientas y los procesos disponibles, con la información acerca de cómo se habían empleado las visualizaciones en situaciones similares en otros campos tales como planificación urbano, el paisajismo o la gestión forestal. Segundo, se analizaron las reacciones y opiniones de los LTOs ante un conjunto de visualizaciones presentadas durante las entrevistas, desarrolladas ad hoc para mostrar un abanico representativo de ejemplos de utilización de las técnicas de simulación visual, que, a su vez se complementaron con los usos adicionales que los propios LTOs sugirieron tras ver las visualizaciones presentadas. Los resultados muestran que el uso actual de simulaciones visuales por parte de los LTOs es muy limitado pero si que reciben un gran número de visualizaciones de otros departamentos y como parte de la documentación presentada en las solicitudes de permisos para edificación o desarrollo urbanístico. Los resultados indican que las visualizaciones que son presentadas a los LTOs no son objetivas ni precisas por lo que se argumenta que esta situación es un factor importante que impide una toma de decisiones adecuada y una correcta transmisión de infracción al público y al resto de partes implicadas. Se sugiere la creación de un código que regule el uso de visualizaciones en el campo de la gestión y planificación del arbolado urbano. ABSTRACT This thesis examined the use of computer visualizations in urban forestry management and planning. Potential roles of visualizations were determined the benefits that its use would provide. Additionally, the possible barriers in the implementation of visualizations in urban forestry management and planning were also studied and recommendations on how to overcome them were provided The research conducted was an exploratory study using survey research methods and personal semi-structured interviews. The perspectives and reactions of London (UK) boroughs’ tree officers (LTOs) were analysed combining quantitative and qualitative research methods. The study surveyed 41 percent of all Tree Officers in London, obtaining responses from 88 percent of the boroughs and performed 17 personal interviews. Statistical analysis of the data and cross-variables analysis provided rich information that was then complemented with the conclusions from thematic analysis of the qualitative data from the interviews. Potential roles of visualizations were determined first by understanding the challenges that LTOs are facing today and comparing them with how visualizations have helped in similar situations in urban forestry and other related fields like landscape architecture, urban planning and forestry; second, the reactions of LTOs to a set of examples of proposed uses of visualizations were also complemented with the additional uses proposed by LTOs after seeing the visualizations. The visualizations were created ad hoc to show a variety of representative examples of the sue of visualization in urban forestry management and planning and were presented during the interviews to LTOS. Results show that the current production of visualizations is very reduced among tree officers but that they are frequent receptors of visualizations coming from other departments and as part of the documentation of planning applications. Findings show that the current visualizations that get to Tree Officers are biased and inaccurate and therefore it is argued the the current use of visualizations is a threat to legitimate informed decision making and public information. The development of a code for the use of visualizations in urban forestry management and planning is suggested.

Somatic hypermutation of the new antigen receptor gene (NAR) in the nurse shark does not generate the repertoire: Possible role in antigen-driven reactions in the absence of germinal centers

The new antigen receptor (NAR) gene in the nurse shark diversifies extensively by somatic hypermutation. It is not known, however, whether NAR somatic hypermutation generates the primary repertoire (like in the sheep) or rather is used in antigen-driven immune responses. To address this issue, the sequences of NAR transmembrane (Tm) and secretory (Sec) forms, presumed to represent the primary and secondary repertoires, respectively, were examined from the peripheral blood lymphocytes of three adult nurse sharks. More than 40% of the Sec clones but fewer than 11% of Tm clones contained five mutations or more. Furthermore, more than 75% of the Tm clones had few or no mutations. Mutations in the Sec clones occurred mostly in the complementarity-determining regions (CDR) with a significant bias toward replacement substitutions in CDR1; in Tm clones there was no significant bias toward replacements and only a low level of targeting to the CDRs. Unlike the Tm clones where the replacement mutational pattern was similar to that seen for synonymous changes, Sec replacements displayed a distinct pattern of mutations. The types of mutations in NAR were similar to those found in mouse Ig genes rather than to the unusual pattern reported for shark and Xenopus Ig. Finally, an oligoclonal family of Sec clones revealed a striking trend toward acquisition of glutamic/aspartic acid, suggesting some degree of selection. These data strongly suggest that hypermutation of NAR does not generate the repertoire, but instead is involved in antigen-driven immune responses.

Safety and effectiveness of nurse telephone consultation in out of hours primary care: randomised controlled trial

Objective To determine the safety and effectiveness of nurse telephone consultation in out of hours primary care by investigating adverse events and the management of calls.