997 resultados para nursing grand rounds


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One of the most striking aspects of the 11-year sunspot cycle is that there have been times in the past when some cycles went missing, a most well-known example of this being the Maunder minimum during 1645-1715. Analyses of cosmogenic isotopes (C-14 and Be-10) indicated that there were about 27 grand minima in the last 11 000 yrs, implying that about 2.7% of the solar cycles had conditions appropriate for forcing the Sun into grand minima. We address the question of how grand minima are produced and specifically calculate the frequency of occurrence of grand minima from a theoretical dynamo model. We assume that fluctuations in the poloidal field generation mechanism and in the meridional circulation produce irregularities of sunspot cycles. Taking these fluctuations to be Gaussian and estimating the values of important parameters from the data of the last 28 solar cycles, we show from our flux transport dynamo model that about 1-4% of the sunspot cycles may have conditions suitable for inducing grand minima.

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The parameters of a special type of alpha-effect known in dynamo theory as the Babcock-Leighton mechanism are estimated using the data of sunspot catalogs. The estimates support the presence of the Babcock-Leighton alpha-effect on the Sun. Fluctuations of the alpha-effect are also estimated. The fluctuation amplitude appreciably exceeds themean value, and the characteristic time for the fluctuations is comparable to the period of the solar rotation. Fluctuations with the parameters found are included in a numericalmodel for the solar dynamo. Computations show irregular changes in the amplitudes of the magnetic cycles on time scales of centuries and millennia. The calculated statistical characteristics of the grand solar minima and maxima agree with the data on solar activity over the Holocene.

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We study the production of the lightest neutralinos in the process e(+)e(-) -> chi(0)(1)chi(0)(1)gamma in supersymmetric grand unified models for the International Linear Collider energies with longitudinally polarized beams. We consider cases where the standard model gauge group is unified into the grand unified gauge groups SU(5), or SO(10). We have carried out a comprehensive study of this process in the SU(5) and SO(10) grand unified theories which includes the QED radiative corrections. We compare and contrast the dependence of the signal cross section on the grand unified gauge group, and on the different representations of the grand unified gauge group, when the electron and positron beams are longitudinally polarized. To assess the feasibility of experimentally observing the radiative production process, we have also considered in detail the background to this process coming from the radiative neutrino production process e(+)e(-)-> nu(nu) over bar gamma with longitudinally polarized electron and positron beams. In addition we have also considered the supersymmetric background coming from the radiative production of scalar neutrinos in the process e(+)e(-) -> (nu) over tilde(nu) over tilde*gamma with longitudinally polarized beams. The process can be a major background to the radiative production of neutralinos when the scalar neutrinos decay invisibly.

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We propose that grand minima in solar activity are caused by simultaneous fluctuations in the meridional circulation and the Babcock-Leighton mechanism for the poloidal field generation in the flux transport dynamo model. We present the following results: (a) fluctuations in the meridional circulation are more effective in producing grand minima; (b) both sudden and gradual initiations of grand minima are possible; (c) distributions of durations and waiting times between grand minima seem to be exponential; (d) the coherence time of the meridional circulation has an effect on the number and the average duration of grand minima, with a coherence time of about 30 yr being consistent with observational data. We also study the occurrence of grand maxima and find that the distributions of durations and waiting times between grand maxima are also exponential, like the grand minima. Finally we address the question of whether the Babcock-Leighton mechanism can be operative during grand minima when there are no sunspots. We show that an alpha-effect restricted to the upper portions of the convection zone can pull the dynamo out of the grand minima and can match various observational requirements if the amplitude of this alpha-effect is suitably fine-tuned.

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The density wave theory for the grand-design two-armed spiral pattern in galaxies is successful in explaining several observed features. However, the long-term persistence of this spiral structure is a serious problem since the group transport would destroy it within about a billion years as shown in a classic paper by Toomre. In this paper, we include the low-velocity dispersion component, namely gas, on an equal footing with stars in the formulation of the density wave theory, and obtain the dispersion relation for this coupled system. We show that the inclusion of gas makes the group transport slower by a factor of few, thus allowing the pattern to persist longer - for several billion years. Though still less than the Hubble time, this helps in making the spiral structure more long-lived. Further we show that addition of gas is essential to get a stable wave for the observed pattern speed for the Galaxy, which otherwise is not possible for a one-component stellar disc.

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In this paper we derive an approach for the effective utilization of thermodynamic data in phase-field simulations. While the most widely used methodology for multi-component alloys is following the work by Eiken et al. (2006), wherein, an extrapolative scheme is utilized in conjunction with the TQ interface for deriving the driving force for phase transformation, a corresponding simplistic method based on the formulation of a parabolic free-energy model incorporating all the thermodynamics has been laid out for binary alloys in the work by Folch and Plapp (2005). In the following, we extend this latter approach for multi-component alloys in the framework of the grand-potential formalism. The coupling is applied for the case of the binary eutectic solidification in the Cr-Ni alloy and two-phase solidification in the ternary eutectic alloy (Al-Cr-Ni). A thermodynamic justification entails the basis of the formulation and places it in context of the bigger picture of Integrated Computational Materials Engineering. (C) 2015 Elsevier Ltd. All rights reserved.

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(4 p.)

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(4 pp.)

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(4 p.)

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(4 pp.)

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[EN] The objective of this study was to test the hypothesis that cooperative learning strategies will help to increase nutrition knowledge of nurses and nursing assistants caring for the elderly in different institutional communities of the Basque Country, Spain. The target population was a sample of volunteers, 16 nurses and 28 nursing assistants. Training consisted of 12 nutrition education sessions using cooperative strategies conducted over a period of 3 consecutive weeks. The assessment instruments included two pretest and two posttest questionnaires with questions selected in multiplechoice format. The first questionnaire was about general knowledge of applied nutrition (0-88 point scale) and the second one on geriatric nutrition knowledge (0-18 point scale). Data were analyzed using SPSS vs. 11.0. The outcomes indicated a significant increase in general nutrition knowledge (difference between the pre- and posttest mean score: 14.5±10.1; P<0.001) and in geriatric nutrition knowledge for all participants (difference between the pre- and post-test mean score: 4.6±4.6; P<0.001). So the results indicated that cooperative learning strategies could improve the nutrition knowledge of nursing staff. Additionally, the results of this study provide direction to continuing nutrition education program planners regarding appropriate content and methodology for programs.

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Numerous problems are frequently observed when nursing competency assessment systems (NCAS) are implemented. How to effectively implement a nursing competency assessment system, according to academic and practical contributions, is poorly reported in the literature. The purpose of this paper is to present a set of recommendations for public hospitals and nursing management in order to facilitate the implementation of a NCAS. To achieve this objective we have revised the existing literature and conducted a Delphi study with nursing managers and human resource managers of the public hospitals of the Basque Health Service. The results are that the implementation of a NCAS requires a well-planned strategy that managers must consider before implementing any NCAS. This strategy must include, at minimum, the following aspects: communication, training, leadership, and content where the NCAS is concerned. The context of the organisations and the cultural dimensions may also influence the results of the application of the system.

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Este estudo tem como objeto a carga de trabalho de enfermeiros que trabalham em unidades de cuidados semi-intensivos. Seu objetivo geral foi identificar e analisar a percepção dos enfermeiros de uma unidade semi-intensiva acerca do instrumento Nursing Activities Score - NAS, tendo como foco o conceito de carga de trabalho. Os objetivos específicos foram: identificar domínios do NAS considerados pelos enfermeiros como capazes de avaliar a carga de trabalho; identificar os itens que os enfermeiros consideram relevantes e manteriam no instrumento, os itens que excluiriam e os que acrescentariam; identificar itens que os enfermeiros consideram subdimensionados, para os quais aumentariam a pontuação, os superdimensionados, para os quais diminuiriam a pontuação; e, ao final, discutir implicações dessa avaliação para a organização do trabalho e seus impactos na saúde do trabalhador de enfermagem. Estudo de abordagem quantitativa do tipo descritivo exploratória, com breve aporte qualitativo, utilizando a triangulação metodológica. O local de estudo foi uma unidade de média complexidade com 35 leitos em um hospital privado do Rio de Janeiro. Participaram do estudo 28 enfermeiros e os dados foram coletados por meio de um questionário com perguntas fechadas e abertas no período de abril a maio de 2008. O tratamento dos dados foi realizado com apoio do software Excel, utilizando estatística descritiva. O material qualitativo foi organizado em categorias, usando elementos da Análise de Conteúdo Temática. Entre os domínios, verificou-se que os enfermeiros consideram o que mais avalia a carga real de trabalho o Suporte Ventilatório, com 89%, e o domínio que não avalia a carga de trabalho foi o Suporte Neurológico, com 25%. Os três domínios mais citados para serem acrescidos de atividades foram o Suporte Renal, com 25%, seguido Intervenção Especificas, com 21%, e Suporte Metabólico, respectivamente. Quanto à exclusão de atividades, só dois domínios foram mencionados: Suporte Ventilatório, com 25%, e Atividade Básica, com 21%. Os enfermeiros acham que 69% da pontuação era adequada aos itens e 31% acreditam não estar adequada. No grupo, 27% aumentariam a pontuação em alguns itens e 4% diminuiriam a pontuação. Sobre a mensuração da carga de trabalho, acreditam que essa colabora no processo de trabalho, 79%, e 57% acham que mensurar a carga de trabalho através do NAS pode auxiliar na preservação de sua saúde. Concluímos que esse instrumento mensura a carga de trabalho na opinião dos enfermeiros, mas precisa ser adaptado à realidade da unidade onde está sendo aplicada. Além disso, os enfermeiros alteraram mais os itens relacionados à carga física sem identificar a carga psíquica de trabalho como relevante, evidenciando que o trabalho de enfermagem precisa ser mais bem conhecido pelos enfermeiros no que se refere às dimensões de impacto na sua saúde.

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Objective: to analyze what nursing models and nursing assessment structures have been used in the implementation of the nursing process at the public and private centers in the health area Gipuzkoa (Basque Country). Method: a retrospective study was undertaken, based on the analysis of the nursing records used at the 158 centers studied. Results: the Henderson model, Carpenito's bifocal structure, Gordon's assessment structure and the Resident Assessment Instrument Nursing Home 2.0 have been used as nursing models and assessment structures to implement the nursing process. At some centers, the selected model or assessment structure has varied over time. Conclusion: Henderson's model has been the most used to implement the nursing process. Furthermore, the trend is observed to complement or replace Henderson's model by nursing assessment structures.

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The Bassam artificial inlet was opened (in September 22, 1987) in order to revacuate offshore invasive aquatic plants. This has considerably modified the hydro-sedimentary environment of the lagoonal domain at Grand-Bassam. Tidal currents effect has confered the lagoonal waters an estuarine feature, the saline intrusion (25-35%o) increased beyond the Moossou bridges up to the confluence of the Comoe river. This has led to a cleaning of the river lower course and above all to the bottoms of the lagoon, which were previously confined. The remobilization of mud (from lagoonal bottoms around Bouet Island) evacuated offshore, has exposed lagoonal and oceanic sandy features. This new system remains fragile, with the seasonal (low river-flow) clogging.