Objective:To assess the teaching efficacy of clinical instructors for MNS postgraduates,this study aims to gather insights into clinical educators’perceptions concerning MNS postgraduate training and identify key com...Objective:To assess the teaching efficacy of clinical instructors for MNS postgraduates,this study aims to gather insights into clinical educators’perceptions concerning MNS postgraduate training and identify key competencies required for effective teaching.Methods:This study utilized a cross-sectional design.An online questionnaire survey was distributed among clinical faculty members engaged in the education of MNS postgraduates.The survey addressed 4 areas:general teaching conditions,perceptions regarding training for MNS postgraduates,core competencies expected from clinical teachers,and implementation strategies for delivering clinical instruction tailored to these graduates.Results:A total of 143 clinical teachers supervising MNS postgraduates completed the questionnaire.Of these respondents,101(70.62%)held a bachelor’s degree while 42(29.37%)possessed a master’s degree.Although these clinicians demonstrated certain core competencies,they exhibited lower proficiency in understanding trends related to scientific advancements and current research priorities along with limited research capabilities 4.00(3.00,4.00).Notably,>95.8%of teachers recognized differences between the 2 categories of postgraduate students;only 4.2%were completely unaware of such distinctions.There was no statistically significant relationship between the demographic data of clinical educators and their core competencies(P>0.05).Conclusions:This study revealed no significant correlation between the general characteristics of clinical teachers and the core competencies of MNS postgraduates.Additionally,we identified a lack of effective communication and collaboration between MNS postgraduate supervisors and clinical educators.The findings from this research offer valuable insights for further investigation into the factors that influence the core competencies of clinical teachers,as well as strategies to enhance the clinical teaching standards for MNS postgraduates.展开更多
BACKGROUND Global tumor incidence rises and therapies advance,driving oncology nursing specialization.Granting nurses prescriptive authority optimizes care but polarizes nurses'attitudes due to factors like risk a...BACKGROUND Global tumor incidence rises and therapies advance,driving oncology nursing specialization.Granting nurses prescriptive authority optimizes care but polarizes nurses'attitudes due to factors like risk and competence,hindering policy implementation.AIM To investigate the current status of the attitudes of oncology specialist nurses toward having prescribing authority,specifically concerning symptom management and supportive care in oncology practice,and we conducted a path analysis of their influencing factors.METHODS As participants in the survey,oncology specialist nurses working in hospitals of different grades in Jiangsu Province were selected from March 2025 to May 2025 using a stratified sampling method.The questionnaires were administered using the general information questionnaire,the beliefs and attitudes about nurses'prescriptive authority scale,the nurses'professional identity scale,and the selfefficacy scale.Pearson’s method was used to analyze the correlation between beliefs and attitudes about the prescriptive authority,professional identity,and self-efficacy of nurses.Multiple linear regression was performed to analyze the factors influencing the beliefs and attitudes of nurses’prescriptive authority.The Amos plug-in was used to construct structural equation models to analyze the influencing pathways.RESULTS A total of 329 questionnaires were distributed,and 328 valid questionnaires were returned(effective recovery rate:99.70%).The total score of the 328 oncology nurses on the beliefs and attitudes about nurses'prescriptive authority scale was 101.88±15.13,indicating a moderately high level.Univariate analysis revealed that gender and hospital grade were associated with this score(P<0.05).The Pearson correlation analysis revealed that self-efficacy was positively correlated with the scores of the beliefs and attitudes about nurses’prescriptive authority scale and the nurses’professional identity scale(r=0.4999,P<0.0001 and r=0.7048,P<0.05,respectively),whereas occupational identity was positively correlated only with the former(r=0.6209,P<0.05).Multiple linear regression analysis revealed occupational identity and self-efficacy as the factors influencing the scores of the beliefs and attitudes about nurses’prescriptive authority scale(P<0.05).The results of the path analysis revealed that selfefficacy significantly positively affected nurses’occupational identity and their beliefs and attitudes about having prescriptive authority;occupational identity played a mediating role between the two,with a mediating effect accounting for 54.46% of the total effect,and the structural equation model was well-fitted.CONCLUSION Oncology nurses have more positive attitudes toward prescriptive authority.In addition,self-efficacy positively and indirectly affects nurses’attitudes toward prescriptive authority through the mediating effect of occupational identity.This can be used as a basis for clinical practice to take targeted measures to improve nurses’self-efficacy and occupational identity,thus creating favorable conditions for effectively implementing the policy of prescriptive authority.展开更多
Objective:Through interviews with oral specialist nurses,to explore the influencing factors of training transfer for oral specialist nurses,and provide references for scientifically improving the effect of specialist ...Objective:Through interviews with oral specialist nurses,to explore the influencing factors of training transfer for oral specialist nurses,and provide references for scientifically improving the effect of specialist nurse training transfer.Methods:Using purposive sampling and descriptive qualitative research,15 oral specialist nurses from two tertiary hospitals in Guangdong Province were selected for semi-structured interviews,and data analysis was performed.Results:After collating and analyzing the interview data,three types of factors affecting the training transfer of oral specialist nurses were proposed,including personal characteristics,training management,and training transfer atmosphere.Conclusion:Managers should formulate a comprehensive and systematic plan based on the influencing factors of oral specialist nurse training transfer to effectively promote training transfer behavior and enhance training transfer effects.展开更多
The objective of the article is identification of similarities in behavior and work attitude toward remote working in times of COVID-19 pandemic.Evaluation is concerned on employees of creative employees from differen...The objective of the article is identification of similarities in behavior and work attitude toward remote working in times of COVID-19 pandemic.Evaluation is concerned on employees of creative employees from different countries and business sectors.The author conducted research on Polish and American creative specialists,including software developers.Research conducted for this article in the first stage was qualitative,and in the second stage is based on quantitative methodology and secondary data from American research.The qualitative research conducted in Poland and was based on unstructured interviews with open-ended questions in the form of self-report concerning workflows during remote working.The first stage can be used as the starting point to next research of creative specialists from other countries.The quantitative research is based on secondary data from a study conducted among American employees of Microsoft Corporation.It was research made in the form of survey during COVID-19 pandemic(March-May 2020).The conclusions from each of the stages of research were used to create universal conclusions in the form of gathered key similarities and differences in behavior and wellbeing of creative specialist from different countries during remote working.The analysis included Industry 4.0 perspective-like market needs(e.g.building innovation which require a combination of creativity and technical skills)or condition of constant change.The research and analysis also reveals the potential for future research in the other countries and business sectors.展开更多
Objectives:To explore the current admittance situation of clinical teachers for masters of nursing specialist(MNS)postgraduates and to test the competence of clinical teachers in self-evaluation and other evaluations....Objectives:To explore the current admittance situation of clinical teachers for masters of nursing specialist(MNS)postgraduates and to test the competence of clinical teachers in self-evaluation and other evaluations.Methods:In this cross-sectional study,using a random number table,we chose 80 MNS postgraduates under clinical practice,their clinical teachers,and head nurses each from six hospitals in Hunan and Guangdong.The participants were tested on the basis of the Clinical Teachers'Competence Inventory of MNS Postgraduates.The competences of clinical teachers were evaluated by the three groups of participants.Results:The aggregated scores of teacher competence as evaluated by the MNS postgraduates(181.33±24.95)were lower than those assigned by both clinical teachers(190.75±24.30)and their head nurses(198.53±18.90),with significant differences in all dimensions except for clinical managing ability.The five highest rated items from all participants focused on the teachers'clinical nursing ability,and the five lowest rated items were mainly about their clinical research ability.Conclusion:The evaluation from MNS postgraduates is obviously lower than the self-evaluation of clinical teachers,and all participants are aware of the deficiency in research ability of the teachers.Thus,the admittance and examination of clinical teachers should be controlled strictly.Training should be carried out immediately to strengthen their comprehensive abilities,especially their research ability.展开更多
The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger dis...The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger discipline of nursing.A large number of studies consistently conclude that the CNS is a valuable healthcare resource that provides highquality clinical and evidence-based nursing practice and improves patient outcome.The CNS has been involved in healthcare practices for many years,with an increasingly diverse role.However,the training for the CNS in China is only in a preliminary developmental stage.The aim of this article is to review the history and development of the CNS role.Furthermore,the epidemiologic status of osteoporosis,as well as the feasibility and necessity of developing training programs in China for the osteoporosis CNS,will be discussed.展开更多
Objective: To establish an evaluation index system for the first-time certification of diabetes specialist nurses in line with the clinical nursing practice in China, and to provide a reference basis for government ad...Objective: To establish an evaluation index system for the first-time certification of diabetes specialist nurses in line with the clinical nursing practice in China, and to provide a reference basis for government administrations and hospitals to formulate unified standards. Methods: After the research team has determined the theme, it will consult the development of A) specialist nursing through the library, Internet and electronic literature database;B) the history of the development of specialist nurses in diabetes and other fields;C) the selection criteria of specialist nurses;D) the training of specialist nurses system, assessment method;E) Specialist nurse certification body, evaluation standards and certification standards and other related documents, literature, books and report materials. The author established the preliminary index system through literature review, specialist interview and group discussion and used Delphi method to organize three rounds of 30 experts’ consultations. Results: A first certification evaluation index system including 8 fundamental indicators, 5 first-level indicators, 19 second-level indicators and 99 third-level indicators was constructed for diabetes nurses. Conclusion: The results of three rounds of expert consultation and demonstration are reliable, and the constructed index system is suitable for comprehensive evaluation of diabetes specialist nurses, which provides a basis for the effective management of nursing resources.展开更多
Although liver transplantation(LT) is performed increasingly for patients with end-stage alcoholic liver disease(ALD), the topic remains controversial. Traditionally, the role of an addiction specialist focused on the...Although liver transplantation(LT) is performed increasingly for patients with end-stage alcoholic liver disease(ALD), the topic remains controversial. Traditionally, the role of an addiction specialist focused on the screening and identification of patients with a high risk on relapse in heavy alcohol use. These patients were in many cases subsequently excluded from a further LT procedure.Recently, awareness is growing that not only screening of patients but also offering treatment, helping patients regain and maintain abstinence is essential, opening up a broader role for the addiction specialist(team)within the whole of the transplant procedure. Within this context, high-risk assessment is proposed to be an indication of increasing addiction treatment intensity,instead of being an exclusion criterion. In this review we present an overview regarding the state of the art on alcohol relapse assessment and treatment in patients with alcohol use disorders, both with and without ALD.Screening, treatment and monitoring is suggested as central roles for the addiction specialist(team) integrated within transplant centers.展开更多
Introduction:Nurse specialists are being cultivated and trained in China to cope with the international development of nursing discipline.However,an empirical summary and reviews of literature have shown a lack of cor...Introduction:Nurse specialists are being cultivated and trained in China to cope with the international development of nursing discipline.However,an empirical summary and reviews of literature have shown a lack of core competence evaluation standards for emergency nurse specialists(ENSs)in China.ENS training has been conducted in several regions without any effective competence evaluation standards.This paper describes the development and psychometric testing of the Core Competence Evaluation Standards for Emergency Nurse Specialists(CCESENS)in the Chinese context.Methods:Several rigorous research methods were applied.The proposed evaluation process consisted of two phases with seven steps.First,the Core Competence Framework Model for Emergency Nurse Specialist(CCFMENS)was established,and 118 items were generated through a review of literature,theoretical analysis,and expert interviews.Drafts of the dimensions and items were evaluated by two-round Delphi methods.Analysis hierarchy process was used to determine the weight of each dimension.Second,field testing was performed among 138 senior emergency nurses.Internal consistency and correlation analysis were applied to test the reliability and validity of the model.Results:The CCESENS consisted of five first-level dimensions,16 second-level dimensions,and 55 items.Cronbach's a coefficient of overall standards was 0.972,and each dimension ranged from 0.508 to 0.972.Expert content validity index was 0.818,and the correlation coefficients of the five first-level dimensions with the overall standards CCESENS ranged from 0.701 to 0.886(P<0.05).Discussion:The CCESENS demonstrated sound internal consistency reliability,content validity,and construct validity.The proposed standard provides an objective standard and reference for assessing,training,and evaluating core competence of ENS.展开更多
Since domestic corporations firstly introduced into and implemented the Advanced Manufacturing Technology (AMT),how to scientifically evaluate the implementation effects of AMT has been an urgent problem.Through the r...Since domestic corporations firstly introduced into and implemented the Advanced Manufacturing Technology (AMT),how to scientifically evaluate the implementation effects of AMT has been an urgent problem.Through the review of for- eign relative studies,this paper constructs an indicator system used to evaluate the implementation effects of AMT.Operational performance,Organizational or managerial performance,Satisfactory performance,and Competitive performance are indicators of first level in the system,and 19 indicators of second level have been selected to estimate the implementation effects of AMT.In this study,a model based on Minkowski distance discriminance to select the specialists’ opinion was designed to evaluate the indica- tor system,and the measure’s validity and practicability was proved by a case study to a diesel engine factory.展开更多
Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects p...Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.展开更多
AIM：To obtain information on the prevailing practice patterns of glaucoma specialists in India.METHODS：Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India（GSI）were surveyed.This s...AIM：To obtain information on the prevailing practice patterns of glaucoma specialists in India.METHODS：Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India（GSI）were surveyed.This survey,conducted in 2013,was based on an interactive audience response system.RESULTS：The information was obtained from 146 glaucoma specialists.Approximately half（n=83;57%）had≥10y of experience in managing glaucoma and were in institutional practice（n=74,51%）.Goldmann applanation tonometry was preferred by 103（72%）specialists whilst n=25（17.4%）used non-contact tonometer.Indentation gonioscopy was favoured by two-thirds（n=90,66%）whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed（n=115,86%and n=114;83%respectively）.Nearly three quarter specialists（n=96;72%）preferred optical coherence tomography for imaging.The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser（iridotomy,n=117;93%）and medical management（prostaglandin analogue,n=104;78%）,respectively.Approximately only a third of the specialists surveyed（n=37;28%）were performing both trabeculectomy and implantation of a glaucoma drainage device and about half（n=64;47%）were not operating on congenital glaucoma at all.CONCLUSION：This survey has found conformance with preferred practice patterns in several areas of diagnosisand management of glaucoma,but there was diversity in a few areas.The information is a significant step towards improvement of glaucoma care in India,including planning for future strategies.展开更多
Cholangiocarcinoma refers to malignant tumors that develop in epithelial lining of biliary system, and it is divided into two categories according to tumor location, intrahepatic cholangiocarcinoma （ICC） and extrahe...Cholangiocarcinoma refers to malignant tumors that develop in epithelial lining of biliary system, and it is divided into two categories according to tumor location, intrahepatic cholangiocarcinoma （ICC） and extrahepatic cholangiocarcinoma （ECC）. ICC occurs from the epithelial cells of the intrahepatic bile duct, its branches and interlobular biliary tree; and ECC is divided into hilar cholangiocarcinoma and distal cholangiocarcinoma by the circumscription at the confluence of cystic duct and the common hepatic duct.展开更多
Pancreatic surgery units undertake several complex operations,albeit with consi-derable morbidity and mortality,as is the case for the management of complicated acute pancreatitis or chronic pancreatitis.The centralis...Pancreatic surgery units undertake several complex operations,albeit with consi-derable morbidity and mortality,as is the case for the management of complicated acute pancreatitis or chronic pancreatitis.The centralisation of pancreatic surgery services,with the development of designated large-volume centres,has contribu-ted to significantly improved outcomes.In this editorial,we discuss the complex associations between diabetes mellitus(DM)and pancreatic/periampullary disease in the context of pancreatic surgery and overall management of complex pancreatitis,highlighting the consequential needs and the indispensable role of specialist diabetes teams in support of tertiary pancreatic services.Type 3c pan-creatogenic DM,refers to DM developing in the setting of exocrine pancreatic disease,and its identification and management can be challenging,while the glycaemic control of such patients may affect their course of treatment and outcome.Adequate preoperative diabetes assessment is warranted to aid identification of patients who are likely to need commencement or escalation of glucose lowering therapy in the postoperative period.The incidence of new onset diabetes after pancreatic resection is widely variable in the literature,and depends on the type and extent of pancreatic resection,as is the case with pancreatic parenchymal loss in the context of severe pancreatitis.Early involvement of a specialist diabetes team is essential to ensure a holistic management.In the current era,large volume pancreatic surgery services commonly abide by the principles of enhanced recovery after surgery,with inclusion of provisions for optimisation of the perioperative glycaemic control,to improve outcomes.While various guidelines are available to aid perioperative management of DM,auditing and quality improvement platforms have highlighted deficiencies in the perioperative management of diabetic patients and areas of required improvement.The need for perioperative support of diabetic patients by specialist diabetes teams is uniformly underlined,a fact that becomes clearly more prominent at all different stages in the setting of pancreatic surgery and the management of complex pancreatitis.Therefore,pancreatic surgery and tertiary pancreatitis services must be designed with a provision for support from specialist diabetes teams.With the ongoing accumulation of evidence,it would be reasonable to consider the design of specific guidelines for the glycaemic management of these patients.展开更多
Objective： By constructing a training system of quality evaluation standards for emergency nurse specialist（ENS）, we can ensure smooth operations and quality training for ENS.Methods： First, the frame structure of...Objective： By constructing a training system of quality evaluation standards for emergency nurse specialist（ENS）, we can ensure smooth operations and quality training for ENS.Methods： First, the frame structure of indicators was designed on the basis of system theory and the balanced scorecard method. Meanwhile, corresponding quantitative standard indicators were compiled through literature analysis and a review of training characteristics. Next, screening indicators were collected through consultation with experts and statistical calculations. The indicators weight coefficient was calculated using the analytic hierarchy process（AHP）. Finally, indicators were validated in two groups of nurses in two different training courses.Results：（1） We created a three-level indicator system： level-Ⅰ dimensions have 4 indicators, while level-Ⅱ dimensions and level-Ⅲ dimensions have 13 and 34 indicators, respectively;（2） The coefficient of expert＇s judgment is 0.840, familiarity is 0.914 and authority is 0.877, and the three rounds of coordination coefficient are 0.456, 0.553 and 0.715, respectively;（3） There are at least 56 indicators in alternative quantitative standards; and（4） The alpha reliability value of the indicator system in the two training course had no significant difference（P 〉 0.05）. The same result was observed when examining two groups of nurses in one training course（P 〉 0.05）.Conclusions： This study established a training system of quality evaluation standards for emergency nurse specialists that is objective, reliable, easy to operate and representative according to scientific selection and verification. This system can therefore provide a basis for quality evaluation and targeted improvement for ENS training in addition to promoting health.展开更多
Prey choice is often evaluated at the species or population level. Here, we analyzed the diet of octopuses of different populations with the aim to assess the importance of individual feeding habits as a factor affect...Prey choice is often evaluated at the species or population level. Here, we analyzed the diet of octopuses of different populations with the aim to assess the importance of individual feeding habits as a factor affecting prey choice. Two methods were used, an assessment of the extent to which an individual octopus made choices of species representative of those population （PSi and IS） and 25% cutoff values for number of choices and percentage intake of individual on their prey. In one population of Octopus cfvulgaris in Bermuda individuals were generalist by IS=0.77, but most chose many prey of the same species, and were specialists on it by 〉75% intake. Another population had a wider prey selection, still generalist with PSi=0.66, but two individuals specialized by choices. In Bonaire, there was a wide range of prey species chosen, and the population was specialists by IS=0.42. Individual choices revealed seven specialists and four generalists. A population of Octopus cyanea in Hawaii all had similar choices of crustaceans, so the population was generalist by IS with 0.74. But by individual choices, three were considered a spe-cialist. A population of Enteroctopus dofleini from Puget Sound had a wide range of preferences, in which seven were also spe-cialists, IS=0.53, By individual choices, thirteen were also specialists. Given the octopus specialty of learning during foraging, we hypothesize that both localized prey availability and individual personality differences could influence the exploration for prey and this translates into different prey choices across individuals and populations showed in this study.展开更多
Human-dominated landscapes provide heterogeneous wildlife habitat. Conservation of habitat specialists, like red pandas Ailurus fulgens, inhabiting such landscapes is challenging. Therefore, information on resource us...Human-dominated landscapes provide heterogeneous wildlife habitat. Conservation of habitat specialists, like red pandas Ailurus fulgens, inhabiting such landscapes is challenging. Therefore, information on resource use across spatial and temporal scales could enable informed-decisionmaking with better conservation outcomes. We aimed to examine the effect of geo-physical, vegetation, and disturbance variables on fine-scalehabitat selection of red pandas in one such landscape. We equipped 10 red pandas with GPS collars in eastern Nepal in 2019 and monitoredthem for 1 year. Our analysis was based on a generalized-linear-mixed model. We found the combined effect of geo-physical, vegetation, anddisturbance variables resulted in differences in resource selection of red pandas and that the degree of response to these variables variedacross seasons. Human disturbances, especially road and cattle herding activities, affected habitat utilization throughout the year whereas othervariables were important only during restricted periods. For instance, geo-physical variables were influential in the premating and cub-rearingseasons while vegetation variables were important in all seasons other than premating. Red pandas selected steeper slopes with high solarinsolation in the premating season while they occupied elevated areas and preferred specific aspects in the cub-rearing season. Furthermore,the utilized areas had tall bamboo in the birthing and cub-rearing seasons while they also preferred diverse tree species and high shrub coverin the latter. Our study demonstrates the significance of season-specific management, suggests the importance of specific types of vegetationduring biologically crucial periods, and emphasizes the necessity to minimize disturbances throughout the year.展开更多
基金supported by the Medical Education Research Initiative of Henan Province,grant funded by the Henan Provincial Health Commission(No.Wjlx2022186).
文摘Objective:To assess the teaching efficacy of clinical instructors for MNS postgraduates,this study aims to gather insights into clinical educators’perceptions concerning MNS postgraduate training and identify key competencies required for effective teaching.Methods:This study utilized a cross-sectional design.An online questionnaire survey was distributed among clinical faculty members engaged in the education of MNS postgraduates.The survey addressed 4 areas:general teaching conditions,perceptions regarding training for MNS postgraduates,core competencies expected from clinical teachers,and implementation strategies for delivering clinical instruction tailored to these graduates.Results:A total of 143 clinical teachers supervising MNS postgraduates completed the questionnaire.Of these respondents,101(70.62%)held a bachelor’s degree while 42(29.37%)possessed a master’s degree.Although these clinicians demonstrated certain core competencies,they exhibited lower proficiency in understanding trends related to scientific advancements and current research priorities along with limited research capabilities 4.00(3.00,4.00).Notably,>95.8%of teachers recognized differences between the 2 categories of postgraduate students;only 4.2%were completely unaware of such distinctions.There was no statistically significant relationship between the demographic data of clinical educators and their core competencies(P>0.05).Conclusions:This study revealed no significant correlation between the general characteristics of clinical teachers and the core competencies of MNS postgraduates.Additionally,we identified a lack of effective communication and collaboration between MNS postgraduate supervisors and clinical educators.The findings from this research offer valuable insights for further investigation into the factors that influence the core competencies of clinical teachers,as well as strategies to enhance the clinical teaching standards for MNS postgraduates.
文摘BACKGROUND Global tumor incidence rises and therapies advance,driving oncology nursing specialization.Granting nurses prescriptive authority optimizes care but polarizes nurses'attitudes due to factors like risk and competence,hindering policy implementation.AIM To investigate the current status of the attitudes of oncology specialist nurses toward having prescribing authority,specifically concerning symptom management and supportive care in oncology practice,and we conducted a path analysis of their influencing factors.METHODS As participants in the survey,oncology specialist nurses working in hospitals of different grades in Jiangsu Province were selected from March 2025 to May 2025 using a stratified sampling method.The questionnaires were administered using the general information questionnaire,the beliefs and attitudes about nurses'prescriptive authority scale,the nurses'professional identity scale,and the selfefficacy scale.Pearson’s method was used to analyze the correlation between beliefs and attitudes about the prescriptive authority,professional identity,and self-efficacy of nurses.Multiple linear regression was performed to analyze the factors influencing the beliefs and attitudes of nurses’prescriptive authority.The Amos plug-in was used to construct structural equation models to analyze the influencing pathways.RESULTS A total of 329 questionnaires were distributed,and 328 valid questionnaires were returned(effective recovery rate:99.70%).The total score of the 328 oncology nurses on the beliefs and attitudes about nurses'prescriptive authority scale was 101.88±15.13,indicating a moderately high level.Univariate analysis revealed that gender and hospital grade were associated with this score(P<0.05).The Pearson correlation analysis revealed that self-efficacy was positively correlated with the scores of the beliefs and attitudes about nurses’prescriptive authority scale and the nurses’professional identity scale(r=0.4999,P<0.0001 and r=0.7048,P<0.05,respectively),whereas occupational identity was positively correlated only with the former(r=0.6209,P<0.05).Multiple linear regression analysis revealed occupational identity and self-efficacy as the factors influencing the scores of the beliefs and attitudes about nurses’prescriptive authority scale(P<0.05).The results of the path analysis revealed that selfefficacy significantly positively affected nurses’occupational identity and their beliefs and attitudes about having prescriptive authority;occupational identity played a mediating role between the two,with a mediating effect accounting for 54.46% of the total effect,and the structural equation model was well-fitted.CONCLUSION Oncology nurses have more positive attitudes toward prescriptive authority.In addition,self-efficacy positively and indirectly affects nurses’attitudes toward prescriptive authority through the mediating effect of occupational identity.This can be used as a basis for clinical practice to take targeted measures to improve nurses’self-efficacy and occupational identity,thus creating favorable conditions for effectively implementing the policy of prescriptive authority.
文摘Objective:Through interviews with oral specialist nurses,to explore the influencing factors of training transfer for oral specialist nurses,and provide references for scientifically improving the effect of specialist nurse training transfer.Methods:Using purposive sampling and descriptive qualitative research,15 oral specialist nurses from two tertiary hospitals in Guangdong Province were selected for semi-structured interviews,and data analysis was performed.Results:After collating and analyzing the interview data,three types of factors affecting the training transfer of oral specialist nurses were proposed,including personal characteristics,training management,and training transfer atmosphere.Conclusion:Managers should formulate a comprehensive and systematic plan based on the influencing factors of oral specialist nurse training transfer to effectively promote training transfer behavior and enhance training transfer effects.
文摘The objective of the article is identification of similarities in behavior and work attitude toward remote working in times of COVID-19 pandemic.Evaluation is concerned on employees of creative employees from different countries and business sectors.The author conducted research on Polish and American creative specialists,including software developers.Research conducted for this article in the first stage was qualitative,and in the second stage is based on quantitative methodology and secondary data from American research.The qualitative research conducted in Poland and was based on unstructured interviews with open-ended questions in the form of self-report concerning workflows during remote working.The first stage can be used as the starting point to next research of creative specialists from other countries.The quantitative research is based on secondary data from a study conducted among American employees of Microsoft Corporation.It was research made in the form of survey during COVID-19 pandemic(March-May 2020).The conclusions from each of the stages of research were used to create universal conclusions in the form of gathered key similarities and differences in behavior and wellbeing of creative specialist from different countries during remote working.The analysis included Industry 4.0 perspective-like market needs(e.g.building innovation which require a combination of creativity and technical skills)or condition of constant change.The research and analysis also reveals the potential for future research in the other countries and business sectors.
基金Postgraduates Research Innovation Project in Hunan Province(CX2016B484)
文摘Objectives:To explore the current admittance situation of clinical teachers for masters of nursing specialist(MNS)postgraduates and to test the competence of clinical teachers in self-evaluation and other evaluations.Methods:In this cross-sectional study,using a random number table,we chose 80 MNS postgraduates under clinical practice,their clinical teachers,and head nurses each from six hospitals in Hunan and Guangdong.The participants were tested on the basis of the Clinical Teachers'Competence Inventory of MNS Postgraduates.The competences of clinical teachers were evaluated by the three groups of participants.Results:The aggregated scores of teacher competence as evaluated by the MNS postgraduates(181.33±24.95)were lower than those assigned by both clinical teachers(190.75±24.30)and their head nurses(198.53±18.90),with significant differences in all dimensions except for clinical managing ability.The five highest rated items from all participants focused on the teachers'clinical nursing ability,and the five lowest rated items were mainly about their clinical research ability.Conclusion:The evaluation from MNS postgraduates is obviously lower than the self-evaluation of clinical teachers,and all participants are aware of the deficiency in research ability of the teachers.Thus,the admittance and examination of clinical teachers should be controlled strictly.Training should be carried out immediately to strengthen their comprehensive abilities,especially their research ability.
基金The work was supported by the Comprehensive investment strategic emerging industries related construction projects in“twelfth five-year”for Tianjin(Tianjin Education Committee[2011]no.61).
文摘The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger discipline of nursing.A large number of studies consistently conclude that the CNS is a valuable healthcare resource that provides highquality clinical and evidence-based nursing practice and improves patient outcome.The CNS has been involved in healthcare practices for many years,with an increasingly diverse role.However,the training for the CNS in China is only in a preliminary developmental stage.The aim of this article is to review the history and development of the CNS role.Furthermore,the epidemiologic status of osteoporosis,as well as the feasibility and necessity of developing training programs in China for the osteoporosis CNS,will be discussed.
文摘Objective: To establish an evaluation index system for the first-time certification of diabetes specialist nurses in line with the clinical nursing practice in China, and to provide a reference basis for government administrations and hospitals to formulate unified standards. Methods: After the research team has determined the theme, it will consult the development of A) specialist nursing through the library, Internet and electronic literature database;B) the history of the development of specialist nurses in diabetes and other fields;C) the selection criteria of specialist nurses;D) the training of specialist nurses system, assessment method;E) Specialist nurse certification body, evaluation standards and certification standards and other related documents, literature, books and report materials. The author established the preliminary index system through literature review, specialist interview and group discussion and used Delphi method to organize three rounds of 30 experts’ consultations. Results: A first certification evaluation index system including 8 fundamental indicators, 5 first-level indicators, 19 second-level indicators and 99 third-level indicators was constructed for diabetes nurses. Conclusion: The results of three rounds of expert consultation and demonstration are reliable, and the constructed index system is suitable for comprehensive evaluation of diabetes specialist nurses, which provides a basis for the effective management of nursing resources.
文摘Although liver transplantation(LT) is performed increasingly for patients with end-stage alcoholic liver disease(ALD), the topic remains controversial. Traditionally, the role of an addiction specialist focused on the screening and identification of patients with a high risk on relapse in heavy alcohol use. These patients were in many cases subsequently excluded from a further LT procedure.Recently, awareness is growing that not only screening of patients but also offering treatment, helping patients regain and maintain abstinence is essential, opening up a broader role for the addiction specialist(team)within the whole of the transplant procedure. Within this context, high-risk assessment is proposed to be an indication of increasing addiction treatment intensity,instead of being an exclusion criterion. In this review we present an overview regarding the state of the art on alcohol relapse assessment and treatment in patients with alcohol use disorders, both with and without ALD.Screening, treatment and monitoring is suggested as central roles for the addiction specialist(team) integrated within transplant centers.
基金the support from the Shanghai Nursing Association and the Second Military Medical University.
文摘Introduction:Nurse specialists are being cultivated and trained in China to cope with the international development of nursing discipline.However,an empirical summary and reviews of literature have shown a lack of core competence evaluation standards for emergency nurse specialists(ENSs)in China.ENS training has been conducted in several regions without any effective competence evaluation standards.This paper describes the development and psychometric testing of the Core Competence Evaluation Standards for Emergency Nurse Specialists(CCESENS)in the Chinese context.Methods:Several rigorous research methods were applied.The proposed evaluation process consisted of two phases with seven steps.First,the Core Competence Framework Model for Emergency Nurse Specialist(CCFMENS)was established,and 118 items were generated through a review of literature,theoretical analysis,and expert interviews.Drafts of the dimensions and items were evaluated by two-round Delphi methods.Analysis hierarchy process was used to determine the weight of each dimension.Second,field testing was performed among 138 senior emergency nurses.Internal consistency and correlation analysis were applied to test the reliability and validity of the model.Results:The CCESENS consisted of five first-level dimensions,16 second-level dimensions,and 55 items.Cronbach's a coefficient of overall standards was 0.972,and each dimension ranged from 0.508 to 0.972.Expert content validity index was 0.818,and the correlation coefficients of the five first-level dimensions with the overall standards CCESENS ranged from 0.701 to 0.886(P<0.05).Discussion:The CCESENS demonstrated sound internal consistency reliability,content validity,and construct validity.The proposed standard provides an objective standard and reference for assessing,training,and evaluating core competence of ENS.
文摘Since domestic corporations firstly introduced into and implemented the Advanced Manufacturing Technology (AMT),how to scientifically evaluate the implementation effects of AMT has been an urgent problem.Through the review of for- eign relative studies,this paper constructs an indicator system used to evaluate the implementation effects of AMT.Operational performance,Organizational or managerial performance,Satisfactory performance,and Competitive performance are indicators of first level in the system,and 19 indicators of second level have been selected to estimate the implementation effects of AMT.In this study,a model based on Minkowski distance discriminance to select the specialists’ opinion was designed to evaluate the indica- tor system,and the measure’s validity and practicability was proved by a case study to a diesel engine factory.
文摘Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.
文摘AIM：To obtain information on the prevailing practice patterns of glaucoma specialists in India.METHODS：Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India（GSI）were surveyed.This survey,conducted in 2013,was based on an interactive audience response system.RESULTS：The information was obtained from 146 glaucoma specialists.Approximately half（n=83;57%）had≥10y of experience in managing glaucoma and were in institutional practice（n=74,51%）.Goldmann applanation tonometry was preferred by 103（72%）specialists whilst n=25（17.4%）used non-contact tonometer.Indentation gonioscopy was favoured by two-thirds（n=90,66%）whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed（n=115,86%and n=114;83%respectively）.Nearly three quarter specialists（n=96;72%）preferred optical coherence tomography for imaging.The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser（iridotomy,n=117;93%）and medical management（prostaglandin analogue,n=104;78%）,respectively.Approximately only a third of the specialists surveyed（n=37;28%）were performing both trabeculectomy and implantation of a glaucoma drainage device and about half（n=64;47%）were not operating on congenital glaucoma at all.CONCLUSION：This survey has found conformance with preferred practice patterns in several areas of diagnosisand management of glaucoma,but there was diversity in a few areas.The information is a significant step towards improvement of glaucoma care in India,including planning for future strategies.
文摘Cholangiocarcinoma refers to malignant tumors that develop in epithelial lining of biliary system, and it is divided into two categories according to tumor location, intrahepatic cholangiocarcinoma （ICC） and extrahepatic cholangiocarcinoma （ECC）. ICC occurs from the epithelial cells of the intrahepatic bile duct, its branches and interlobular biliary tree; and ECC is divided into hilar cholangiocarcinoma and distal cholangiocarcinoma by the circumscription at the confluence of cystic duct and the common hepatic duct.
文摘Pancreatic surgery units undertake several complex operations,albeit with consi-derable morbidity and mortality,as is the case for the management of complicated acute pancreatitis or chronic pancreatitis.The centralisation of pancreatic surgery services,with the development of designated large-volume centres,has contribu-ted to significantly improved outcomes.In this editorial,we discuss the complex associations between diabetes mellitus(DM)and pancreatic/periampullary disease in the context of pancreatic surgery and overall management of complex pancreatitis,highlighting the consequential needs and the indispensable role of specialist diabetes teams in support of tertiary pancreatic services.Type 3c pan-creatogenic DM,refers to DM developing in the setting of exocrine pancreatic disease,and its identification and management can be challenging,while the glycaemic control of such patients may affect their course of treatment and outcome.Adequate preoperative diabetes assessment is warranted to aid identification of patients who are likely to need commencement or escalation of glucose lowering therapy in the postoperative period.The incidence of new onset diabetes after pancreatic resection is widely variable in the literature,and depends on the type and extent of pancreatic resection,as is the case with pancreatic parenchymal loss in the context of severe pancreatitis.Early involvement of a specialist diabetes team is essential to ensure a holistic management.In the current era,large volume pancreatic surgery services commonly abide by the principles of enhanced recovery after surgery,with inclusion of provisions for optimisation of the perioperative glycaemic control,to improve outcomes.While various guidelines are available to aid perioperative management of DM,auditing and quality improvement platforms have highlighted deficiencies in the perioperative management of diabetic patients and areas of required improvement.The need for perioperative support of diabetic patients by specialist diabetes teams is uniformly underlined,a fact that becomes clearly more prominent at all different stages in the setting of pancreatic surgery and the management of complex pancreatitis.Therefore,pancreatic surgery and tertiary pancreatitis services must be designed with a provision for support from specialist diabetes teams.With the ongoing accumulation of evidence,it would be reasonable to consider the design of specific guidelines for the glycaemic management of these patients.
基金supported by the nursing special items of Health and Family Planning Commission Research Fund in Hubei province(No.HL2012-15)
文摘Objective： By constructing a training system of quality evaluation standards for emergency nurse specialist（ENS）, we can ensure smooth operations and quality training for ENS.Methods： First, the frame structure of indicators was designed on the basis of system theory and the balanced scorecard method. Meanwhile, corresponding quantitative standard indicators were compiled through literature analysis and a review of training characteristics. Next, screening indicators were collected through consultation with experts and statistical calculations. The indicators weight coefficient was calculated using the analytic hierarchy process（AHP）. Finally, indicators were validated in two groups of nurses in two different training courses.Results：（1） We created a three-level indicator system： level-Ⅰ dimensions have 4 indicators, while level-Ⅱ dimensions and level-Ⅲ dimensions have 13 and 34 indicators, respectively;（2） The coefficient of expert＇s judgment is 0.840, familiarity is 0.914 and authority is 0.877, and the three rounds of coordination coefficient are 0.456, 0.553 and 0.715, respectively;（3） There are at least 56 indicators in alternative quantitative standards; and（4） The alpha reliability value of the indicator system in the two training course had no significant difference（P 〉 0.05）. The same result was observed when examining two groups of nurses in one training course（P 〉 0.05）.Conclusions： This study established a training system of quality evaluation standards for emergency nurse specialists that is objective, reliable, easy to operate and representative according to scientific selection and verification. This system can therefore provide a basis for quality evaluation and targeted improvement for ENS training in addition to promoting health.
文摘Prey choice is often evaluated at the species or population level. Here, we analyzed the diet of octopuses of different populations with the aim to assess the importance of individual feeding habits as a factor affecting prey choice. Two methods were used, an assessment of the extent to which an individual octopus made choices of species representative of those population （PSi and IS） and 25% cutoff values for number of choices and percentage intake of individual on their prey. In one population of Octopus cfvulgaris in Bermuda individuals were generalist by IS=0.77, but most chose many prey of the same species, and were specialists on it by 〉75% intake. Another population had a wider prey selection, still generalist with PSi=0.66, but two individuals specialized by choices. In Bonaire, there was a wide range of prey species chosen, and the population was specialists by IS=0.42. Individual choices revealed seven specialists and four generalists. A population of Octopus cyanea in Hawaii all had similar choices of crustaceans, so the population was generalist by IS with 0.74. But by individual choices, three were considered a spe-cialist. A population of Enteroctopus dofleini from Puget Sound had a wide range of preferences, in which seven were also spe-cialists, IS=0.53, By individual choices, thirteen were also specialists. Given the octopus specialty of learning during foraging, we hypothesize that both localized prey availability and individual personality differences could influence the exploration for prey and this translates into different prey choices across individuals and populations showed in this study.
基金the University of Queensland’s Animal Ethics Committee(SAFS/133/19/NEPAL)the Department of Forests and Soil Conservation,Government of Nepal(DFSC-521/075/076 and DFSC-244/076/077).
文摘Human-dominated landscapes provide heterogeneous wildlife habitat. Conservation of habitat specialists, like red pandas Ailurus fulgens, inhabiting such landscapes is challenging. Therefore, information on resource use across spatial and temporal scales could enable informed-decisionmaking with better conservation outcomes. We aimed to examine the effect of geo-physical, vegetation, and disturbance variables on fine-scalehabitat selection of red pandas in one such landscape. We equipped 10 red pandas with GPS collars in eastern Nepal in 2019 and monitoredthem for 1 year. Our analysis was based on a generalized-linear-mixed model. We found the combined effect of geo-physical, vegetation, anddisturbance variables resulted in differences in resource selection of red pandas and that the degree of response to these variables variedacross seasons. Human disturbances, especially road and cattle herding activities, affected habitat utilization throughout the year whereas othervariables were important only during restricted periods. For instance, geo-physical variables were influential in the premating and cub-rearingseasons while vegetation variables were important in all seasons other than premating. Red pandas selected steeper slopes with high solarinsolation in the premating season while they occupied elevated areas and preferred specific aspects in the cub-rearing season. Furthermore,the utilized areas had tall bamboo in the birthing and cub-rearing seasons while they also preferred diverse tree species and high shrub coverin the latter. Our study demonstrates the significance of season-specific management, suggests the importance of specific types of vegetationduring biologically crucial periods, and emphasizes the necessity to minimize disturbances throughout the year.
