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Purpose: To assess the validity of a Written Clinical Reasoning Prompt (WCRP) to help nursing students' clinical reasoning (CR)., Method: This is a methodological study of translation and cross-cultural adaptation into Brazilian Portuguese of instruments that aim to promote CR improvement, composed of (1) WCRP; (2) two case studies; (3) a questionnaire about students' perceptions during decision-making in case studies; (4) a scoring rubric for correcting case studies. For translation and cross-cultural adaptation, stages 1-8 of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Consortium Network were adopted. Agreement values among experts >80% and content validity coefficient (CVC) > 0.8 were considered satisfactory. For the pretest, a randomized clinical trial was carried out with 24 nursing students (intervention group, n = 14, using the WCRP to solve case studies; control group, n = 10, without using the WCRP)., Findings: The WCRP was translated and adapted into Brazilian Portuguese, requiring minimal adjustments to obtain agreement among the judges above 80% and CVC above 0.80. Regarding face validation, an adequate agreement was obtained in the assessment by students. There was no difference in the accuracy of nursing diagnoses between the intervention and control groups in the pretest., Conclusion: The WCRP was translated and adapted into Brazilian Portuguese and had adequate face and content validity estimates; however, there was no association with improving nursing students' diagnostic accuracy., Implications for Nursing Practice: The translated and adapted versions of all instruments into Brazilian Portuguese had adequate evidence of content and face validity. The use of WCRP was not associated with a significant improvement in nursing students' diagnostic accuracy. New studies with larger samples, a sample power of at least 80%, and a level of significance of 5% are needed., (© 2021 NANDA International, Inc.)

Purpose: To test the effects of clinical reasoning prompts on students' clinical judgment of a written case study., Methods: An experimental pre- and posttest study with second semester nursing students (N = 163)., Findings: The intervention was insufficient to significantly improve clinical judgment. Students identified that the prompts would help them "narrow… down the problem" and "slow… the decision-making process" to improve analysis. The most accurate patient problem was identified by 28% of students in pretest and 35% in posttest., Conclusions: This study provides evidence of variations in nursing students' clinical judgment and students' desire to use decision-making algorithms., Nursing Implications: Nurse educators should provide students with additional education and practice to identify and solve these types of problems., (© 2020 NANDA International, Inc.)

Premise: Photosynthetic stems represent a source of extra carbon in plants from hot and dry environments, but little is known about how leaves and photosynthetic stems differ in terms of photosynthetic capacity, trait coordination, and responses to seasonal drought in subtropical systems., Methods: We studied photosynthetic, hydraulic, morphometric (specific leaf area [SLA], wood density [WD]), and biochemical (C and N isotopes) traits in leaves and photosynthetic stems of 12 plant species from a sarcocaulescent scrub in the southern Baja California Peninsula, Mexico, in wet and dry seasons., Results: Leaves and stems had similar mean photosynthetic capacity, as evaluated by chlorophyll fluorescence traits, indicating similar investment in leaf and stem photosynthesis. We did not find a relationship between stem hydraulic conductivity and leaf or stem photosynthetic traits. However, we found resource allocation trade-offs, between WD and both stem hydraulic conductivity and SLA. Leaf and stem photosynthetic traits did not change with season, but specific stem area was one of the few traits that changed the most between seasons-it increased during the dry season by as much as 154% indicating substantial water storage., Conclusions: Our results indicate the same proportional investment in photosynthetic capacity and dry matter in both leaves and photosynthetic stems across all 12 species. We identified multiple strategies at this seasonal site, with species ranging from high WD, low SLA, low hydraulic conductivity, and high specific bark area on one end of the spectrum and opposite traits on the other end., (© 2020 Botanical Society of America.)

Premise of the Study: Plant water status during flowering is important for plant reproduction, but the physiology of floral water use is not well understood. We investigated plant water status in relation to leaf and floral physiology in naturally occurring individuals of a semiarid shrub, Salvia mellifera E. Greene., Methods: We measured stomatal (g(s)) and corolla (g(c)) conductance to water vapor, transpiration from leaves (E(leaf)) and corollas (E(corolla)), leaf-specific hydraulic conductance (K(H)), bulk shoot water potential (Ψ(shoot)), and shoot water content on irrigated and control plants to analyze whether water was limiting to leaf and floral water use., Key Results: Experimental irrigation caused a 203% increase in soil moisture content, a 20% increase in predawn Ψ(shoot), a 29% increase in midday Ψ(shoot), and a 92% increase in K(H). Floral and leaf gas exchange did not respond significantly to water addition, indicating that rates were at seasonal maxima and not limited by water availability. Total daily water use by corollas was ∼20% of total shoot water use. There were no significant differences in total daily shoot water use with water addition. Mean shoot water content (5.07 g) was close to mean daily shoot water use (6.71 g), indicating that the equivalent of total shoot water content turned over every 0.76 d., Conclusions: These results demonstrate that although irrigation improved whole-plant hydraulic conductance, gas exchange was not limited by water availability. Additionally, the high water use of flowers in this species might limit future flowering and reproductive success during dry years.