Objective:Acupuncture is an efficient treatment modality for many different training,but the technique can be challenging to master.Identification of the different acupuncture points can now be practiced in a standard...Objective:Acupuncture is an efficient treatment modality for many different training,but the technique can be challenging to master.Identification of the different acupuncture points can now be practiced in a standardized and patient-safe simulation-based environment.We aim to gather additional evidence regarding simulation-based training of acupuncture skills and hope that the simulation-based test developed and will be used for simulation-based mastery learning in future develop.Methods:The aim of this study was to develop a test of acupuncture skills using the TCM(Traditional Chinese Medicine) Meridians & Acupoints Anatomy Teaching Platform and gather validity evidence using Messick’s framework.Novice medical students without prior experience in acupuncture(n=43),intermediate medical students who had finished the mandatory acupuncture course(n=24),and skilled acupuncture doctors(n=17) were included in the study.One-hundred and seven acupuncture points were presented to the participants in identical randomized order and they were asked to identify each point by touching the correct anatomical location on the simulator.The simulator automatically registered the accuracy of participants’ answers.Results:The reliability of the final test(66 acupuncture points) was at a high level with a Cronbach’s alpha of 0.98 and only 16 acupuncture points were needed to ensure a reliability of 0.90.The test could discriminate significantly between all three groups and a credible pass/fail-score of 34 points was determined which resulted in eight out of 43(19%) novices passing the test and only two out of 17(12%)experienced failing the test.These consequences were statistically significant(P <0.001).Conclusion:Based on Messick’s framework we demonstrated strong validity evidence for a newly developed simulation-based test of acupuncture points localization skills.The test can be used as an aid to decide when trainees are ready to progress to more advanced training and clinical practice.Compared with the traditional point-point test,the point-point evaluation of the simulator can be more objective and reduce the effort of teachers.展开更多
Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was ...Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was conducted with 190 clinical nurses recruited from an oncology hospital in Central Vietnam.The self-administered Evidence-Based Practice Questionnaire(EBPQ)was employed to assess the nurses'knowledge/skills,attitudes,and implementation of EBP.Data analysis utilized descriptive statistics,the Mann-Whitney test,the Kruskal-Wallis test,and Spearman's rho correlation.Results:The mean total score for EBP implementation among the nurses was 29.52(SD=7.14)out of 42 scores.The most frequently undertaken activity was sharing evidence with colleagues,whereas finding relevant evidence was the least performed.The level of EBP implementation significantly varied based on the nurses'role types and their participation in related courses(P<0.05).Moreover,a strong positive correlation was observed between EBP implementation and both knowledge/skills(r=0.703,P<0.001)and attitudes toward EBP(r=0.536,P<0.001).Conclusions:The implementation of EBP by oncology nurses is generally moderate and is significantly positively correlated with their knowledge/skills and attitudes toward EBP.These findings underscore the importance of enhancing educational programs and facilitating suppor tive institutional policies to fur ther encourage the adoption of EBP among nurses.展开更多
With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative...With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.展开更多
Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before...Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.展开更多
Nitrogen(N)and phosphorus(P)are essential nutrients and can significantly impact primary productivity of the ecosystem causing water environmental problems.However,their cycling mechanisms are not well understood in a...Nitrogen(N)and phosphorus(P)are essential nutrients and can significantly impact primary productivity of the ecosystem causing water environmental problems.However,their cycling mechanisms are not well understood in alpine mountains with climate change.Hence,94 samples of river water were collected from 2018 to 2020 in the headwaters of the Shule River Basin to assess the nutrients spatiotemporal distribution and combined ap-proach of water quality index to assess water quality and potential sources.The findings depict that high nutrient concentrations were found to coincide with snowmelt and glacial meltwater and rainfall recharge periods,while total flux peaked from June to September due to increased runoff.Notably,total nitrogen(TN)concentrations were significantly higher near the town,primarily attributed to the replenishment of nitrate(NO_(3)^(‒)-N)from live-stock manure.The high total P(TP)was near the glacier,which was attributed to the transportation of glacial sediments into the river,and pH was another critical factor.N was the primary nutrient limiting factor for the growth of phytoplankton in river water.Although the migration and transport of nutrients have altered with climate change,river water quality is good in alpine mountains based on an overall evaluation.These findings contribute to enriching nutrient datasets and highlight the importance of water resource management and water quality assessment in sensitive and fragile alpine mountains.展开更多
Excessive levels of Fluoride(F−)and Cadmium(Cd)in drinking groundwater may pose health risks.This study assessed the health risks associated with F−and Cd contamination in rural drinking groundwater sources in Wutai C...Excessive levels of Fluoride(F−)and Cadmium(Cd)in drinking groundwater may pose health risks.This study assessed the health risks associated with F−and Cd contamination in rural drinking groundwater sources in Wutai County,Shanxi Province,China,to support population health protection,water resource management,and environmental decision-making.Groundwater samples were collected and analyzed,and a Human Health Risk Model(HHRA)was applied to evaluate groundwater quality.The results showed that both contents of F−and Cd in groundwater exceeded the Class III limits of China's national groundwater quality standard(GB/T 14848—2024).Fluoride levels met the Class V threshold,with enrichment area mainly located in the east part of the study area.Cadmium levels reached Class IV,with elevated concentrations primarily observed in the western and northwestern regions.Correlation analysis revealed that F−showed weak or no correlation with other measured substances,indicating independent sources.Health risk assessment results indicated that F−poses potential health risks to rural residents,while cadmium,due to its relatively low concentrations,does not currently present a significant health risk.Among different demographic groups,the health risk levels of F−exposure followed the order:Infants>children>adult females>adult males.The findings highlight that fluoride is the primary contributor to health risks associated with groundwater consumption in the study area.Strengthened monitoring and prevention of F−contamination are urgently needed.This research provides a scientific basis for the prevention and control of fluoride pollution in groundwater and offers practical guidance for safeguarding drinking water safety in rural China.展开更多
Compared with traditional energy sources,wind power has a lower environmental impact.However,emissions are still generated across the life cycle of wind turbines,from production to recycling.As wind power rapidly deve...Compared with traditional energy sources,wind power has a lower environmental impact.However,emissions are still generated across the life cycle of wind turbines,from production to recycling.As wind power rapidly develops and deployment increases,these impacts are becoming increasingly evident.A comprehensive understanding of these impacts is crucial for sustainable development.Based on the harmonization of previous detailed life cycle assessment(LCA)studies,this study develops a simplified LCA model that estimates the life cycle environmental impacts of wind turbines based on their nominal power.Using this simplified LCA model,we assess the global warming potential(GWP),acidification potential(AP),and cumulative energy demand(CED)of wind power at the regional scale for 2022 and under three future scenarios(high-power wind turbine promotion,reduced wind curtailment,and a comprehensive development scenario).The results indicate that in 2022,the life cycle GWP,AP,and CED of wind power in western China were 10.76 g CO_(2) eq/kWh,0.177 g SO_(2) eq/kWh,and 17.6 kJ/kWh,respectively.Scenario simulations suggest that reducing wind curtailment is the most effective approach for reducing emissions in Inner Mongolia,Gansu,Qinghai,Ningxia,and Xinjiang,producing average decreases of 8.64%in GWP,8.39%in AP,and 9.26%in CED.In contrast,for Guangxi,Chongqing,Sichuan,Guizhou,Yunnan,Xizang,and Shaanxi,the promotion of high-power wind turbines provides greater environmental benefits than reducing curtailment,producing average decreases of 3.45%,3.09%,and 4.29%in GWP,AP,and CED,respectively.These findings help clarify the environmental impact of wind power across its life cycle at the regional scale and provide theoretical references for the direction of future wind power development and the formulation of related policies.展开更多
Plants constitute nearly 80%of the planet’s total biomass(Bar-On et al.,2018);however,this vital group is experiencing severe threats,and recent evaluations indicate that approximately 45%of the world's described...Plants constitute nearly 80%of the planet’s total biomass(Bar-On et al.,2018);however,this vital group is experiencing severe threats,and recent evaluations indicate that approximately 45%of the world's described plant species are at risk of extinction(Bachman et al.,2024).The number of plant extinctions has increased by 60%in the last 100 years(Di Marco et al.,2017).Over the past 250 years,571 plant species have gone extinct—more than twice the combined total of extinct birds,mammals,and amphibians(217 species)(Briggs,2019).展开更多
This study compares the environmental sustainability of five alternatives for the remediation of marine sediments of one of the most polluted coastal sites in Europe(Bagnoli-Coroglio bay,Mediterranean Sea),using the L...This study compares the environmental sustainability of five alternatives for the remediation of marine sediments of one of the most polluted coastal sites in Europe(Bagnoli-Coroglio bay,Mediterranean Sea),using the Life Cycle Assessment(LCA)methodology.The treatments are either in-situ or exsitu,the latter requiring an initial dredging to transport the contaminated sediments to the management site.More in detail,four ex-situ remediation technologies based on landfilling,bioremediation,electrokinetic technique and soil washing were identified.These technologies are compared to an in-situ strategy currently under validation for enhancing bioremediation of the polluted sediments of the Bagnoli-Coroglio site.Our results indicate that the disposal in landfilling site is the worst option in most categories(e.g.,650 kg CO_(2) eq./t of treated sediment,considering the nearest landfilling site),followed by the bioremediation,mainly due to the high energy demand.Electrokinetic remediation,soil washing,and innovative in-situ technology represent the most sustainable options.In particular,the new in-situ technology appears to be the least impacting in all categories(e.g.,54 kg CO_(2) eq./t of treated sediment),although it is expected to require longer treatment time(estimated up to 12 months based on its potential efficiency).It can reduce the impact on climate change more than 12 times compared to the disposal and 7 times compared to bioremediation in addition to the possibility to avoid/reduce the dredging operations and the consequent dispersion of pollutants.The results open relevant perspectives towards more eco-sustainable and costly effective actions for the reclamation of contaminated marine sediments.展开更多
Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure f...Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure from the living environment.This study included 1311 women in late pregnancy from the Zunyi birth cohort and measured the urinary concentrations of 10 hydroxylated PAH metabolites(OH-PAHs).Risk assessment was conducted based on the estimated daily intake to calculate the hazard quotient and hazard index(HI).A linear regression model was used to analyze the relationship between creatinine-adjusted OH-PAHs concentrations and living environment and lifestyle factors,while principal component analysis was applied to trace the sources of PAHs exposure.1-OHPYR was detected in all participants’urine,with naphthalene metabolites having the highest concentrations among creatinine-adjusted PAHs.OH-PAHs concentrations were associated with housing type,room number,cooking frequency,household size,exercise frequency,fuel type,distance from main road,and drinking water source.Pregnant women using traditional fuels and living in bungalows had higher health risks than those using clean energy and living in buildings.Those living within 100 m of a main road had higher HI than those farther away.Coal combustion was identified as the primary source of PAHs exposure.The study emphasizes the importance of reducing PAHs exposure,especially for pregnant women living in polluted environments.It recommends public health interventions such as improving indoor ventilation and providing clean energy to reduce related health risks.展开更多
Integrated environmental management is important for sustainable development.Under China’s“Three Lines One Permit”(TLOP)policy,three types of management zones—priority protection,critical control,and general contr...Integrated environmental management is important for sustainable development.Under China’s“Three Lines One Permit”(TLOP)policy,three types of management zones—priority protection,critical control,and general control zones—are established based on the ecological red line,the lower-limit line for environmental quality,and the resource use line.Human activities are regulated through a permit system.Integrated and multifactorial protection of soil,plant,hydrological,and atmospheric elements is promoted at the regional level.A follow-up assessment contributes to the improvement of policy implementation and effectiveness.This study demonstrates the achievements of the TLOP policy in Sichuan Province.Results show that(1)276 protection zones have been established under the ecological red line,covering key ecosystems and protected areas to ensure environmental security.Under the lower-limit line,1,626 functional(priority,key,and general control)zones have been designated to regulate air,water,and soil quality,enhancing environmental capacity and pollution control.(2)Through the integration and merging of the three lines,1,128 integrated management zones have been established,including 375,625,and 128 priority protection,critical control,and general control zones,respectively.Each zone has its own list of environmental permits to regulate human activities according to different environmental protection and natural resource development regimes.(3)The design of the follow-up assessment index system was informed by regional primary functions and industrial structure.The index system for provinces and cities is structured around three primary indicators—implementation updating,application,and guarantees—and 15 secondary indicators.The system for critical control zones is structured around environmental access,management,and effectiveness and 14 secondary indicators.A stringent environmental zoning system has been established through the TLOP policy,thereby safeguarding environmental security,promoting harmonious existence between humans and nature,and supporting the vision of Beautiful China.展开更多
Sustained and spatially explicit monitoring of the United Nations 2030 Agenda for Sustainable Development is critical for effectively tracking progress toward the global Sustainable Development Goals(SDGs).Although la...Sustained and spatially explicit monitoring of the United Nations 2030 Agenda for Sustainable Development is critical for effectively tracking progress toward the global Sustainable Development Goals(SDGs).Although land cover information has long been recognized as an essential component for monitoring SDGs,a standardized scientific framework for identifying and prioritizing land cover related essential variables does not exist.Therefore,we propose a novel expert-and data-driven framework for identifying,refining,and selecting a priority list of Essential Land cover-related Variables for SDGs(ELcV4SDGs).This framework integrates methods including expert knowledge-based analysis,clustering of variables with similar attributes,and quantified index calculation to establish the priority list.Applying the framework to 15 specific SDG indicators,we found that the ELcV4SDGs priority list comprises three main categories,type and structure,pattern and intensity,and process and evolution of land cover,which are further divided into 19 subcategories and ultimately encompass 50 general variables.The ELcV4SDGs will support detailed spatial monitoring and enhance their scientific applications for SDG monitoring and assessment,thereby guiding future SDG priority actions and informing decision-making to advance the 2030 SDGs agenda at local,national,and global levels.展开更多
Rock mass stability is significantly influenced by the heterogeneity of rock joint roughness and shear strength.While modern technology facilitates assessing roughness heterogeneity,evaluating shear strength heterogen...Rock mass stability is significantly influenced by the heterogeneity of rock joint roughness and shear strength.While modern technology facilitates assessing roughness heterogeneity,evaluating shear strength heterogeneity remains challenging.To address this,this study first captures the morphology of large-scale(1000 mm × 1000 mm) slate and granite joints via 3D laser scanning.Analysis of these surfaces and corresponding push/pull tests on carved specimens revealed a potential correlation between the heterogeneity of roughness and shear strength.A comparative evaluation of five statistical metrics identified information entropy(Hs) as the most robust indicator for quantifying rock joint heterogeneity.Further analysis using Hsreveals that the heterogeneity is anisotropic and,critically,that shear strength heterogeneity is governed not only by roughness heterogeneity but is also significantly influenced by the mean roughness value,normal stress,and intact rock tensile strength.Consequently,a simple comparison of roughness Hsvalues is insufficient for reliably comparing shear strength heterogeneity.To overcome this limitation,a theoretical framework is developed to explicitly map fundamental roughness statistics(mean and heterogeneity) to shear strength heterogeneity.This framework culminates in a practical workflow that allows for the rapid,field-based assessment of shear strength heterogeneity using readily obtainable rock joint roughness data.展开更多
Correction to:Journal of Forestry Research(2025)36:124 https://doi.org/10.1007/s11676-025-01918-8 In this article the author’s name Yasutomo Hoshika was incorrectly written as Yasutoma Hoshika.The original article ha...Correction to:Journal of Forestry Research(2025)36:124 https://doi.org/10.1007/s11676-025-01918-8 In this article the author’s name Yasutomo Hoshika was incorrectly written as Yasutoma Hoshika.The original article has been corrected.展开更多
This study developed a modeling methodology for statistical optimization-based geologic hazard susceptibility assessment,aiming to enhance the comprehensive performance and classification accuracy of the assessment mo...This study developed a modeling methodology for statistical optimization-based geologic hazard susceptibility assessment,aiming to enhance the comprehensive performance and classification accuracy of the assessment models.First,the cumulative probability method revealed that a low probability(15%)of geologic hazards between any two geologic hazard points occurred outside a buffer zone with a radius of 2297 m(i.e.,the distance threshold).The training dataset was established,consisting of negative samples(non-hazard points)randomly generated based on the distance threshold,positive samples(i.e.,historical hazards),and 13 conditioning factors.Then,models were built using five machine learning algorithms,namely random forest(RF),gradient boosting decision tree(GBDT),naive Bayes(NB),logistic regression(LR),and support vector machine(SVM).The comprehensive performance of the models was assessed using the area under the receiver operating characteristic curve(AUC)and overall accuracy(OA)as indicators,revealing that RF exhibited the best performance,with OA and AUC values of 2.7127 and 0.981,respectively.Furthermore,the machine learning models constructed by considering the distance threshold outperformed those built using the unoptimized dataset.The characteristic factors were ranked using the mutual information method,with their scores decreasing in the order of rainfall(0.1616),altitude(0.06),normalized difference vegetation index(NDVI;0.04),and distance from roads(0.03).Finally,the geologic hazard susceptibility classification was assessed using the natural breaks method combined with a clustering algorithm.The results indicate that the clustering algorithm exhibited higher classification accuracy than the natural breaks method.The findings of this study demonstrate that the proposed model optimization scheme can provide a scientific basis for the prevention and control of geologic hazards.展开更多
For mission-oriented unmanned aerial vehicle(UAV)swarms,mission capability assessment provides an important reference in the design and development process,and is a precondition for mission success.For this multi-crit...For mission-oriented unmanned aerial vehicle(UAV)swarms,mission capability assessment provides an important reference in the design and development process,and is a precondition for mission success.For this multi-criteria decisionmaking(MCDM)problem,the current literature lacks a way to unambiguously present criteria and the popular fuzzy analytic network process(ANP)approaches neglect the hesitancy of subjective judgments.To fill these research gaps,an MCDM method based on unified architecture framework(UAF)and interval-valued spherical fuzzy ANP(IVSF-ANP)is proposed in this paper.Firstly,selected viewpoints in UAF are extended to construct criteria models with standardized representation.Secondly,interval-valued spherical fuzzy sets are introduced to ANP to weight interdependent criteria,handling fuzziness and hesitancy in pairwise comparisons.A method of adjusting weights of experts based on their decision similarities is also included in this process to reduce ambiguity brought by multiple experts.Next,performance characteristics are non-linearly transformed regarding to expectations to get final results.This proposition is applied to assess the mission capability of UAV swarms to search and strike surface vessels.Comparative analysis shows that the proposed method is valid and reasonable.展开更多
Objectives Evidence-based healthcare contributes to the improvement of healthcare quality and informs healthcare decision-making.The provision of timely high-quality evidence is always required to fulfil the ever-chan...Objectives Evidence-based healthcare contributes to the improvement of healthcare quality and informs healthcare decision-making.The provision of timely high-quality evidence is always required to fulfil the ever-changing needs and expectations of healthcare personnel.This study aimed to assess the needs and expectations of healthcare personnel regarding evidence-based healthcare in China.Methods We conducted a cross-sectional online survey from December 8,2020 to January 15,2021 involving 901 participants across China.Healthcare providers,policy makers,researchers and educators,and full-time postgraduate medical and nursing students working/living in China were eligible to participate.A self-developed questionnaire was used.Results Participants generally agreed that health-related research evidence was beneficial.Evidence-based resources,such as Cochrane resources,were only known or used by about half of the respondents due to difficulties related to availability and accessibility.Various types of resources,topics of evidence,and themes of workshops were of particular interest to most of the participants.Conclusions The dissemination and translation of evidence,provision of more support in evidence availability,offering evidence-based training,and determining the most in-demand research areas have been identified as priority areas of work which could fulfil the needs and expectations of healthcare personnel in China.展开更多
Objective: Postpartum hemorrhage(PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an ear...Objective: Postpartum hemorrhage(PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an early assessment and intervention protocol as a toolkit for PPH for midwives and obstetrical nurses.Methods: Employing the evidence-based method, a systematic Internet search of guidelines was conducted and appraisal of literatures was conducted with AGREE system and Oxman-Guyatt Overview Quality Assessment Questionnaire(OQAQ), according to which a protocol draft was therefore developed. Then, a two-round modified Delphi method was utilized to reach a consensus of the protocol built on best practices. Selection criteria for each intervention measure included consensus level with a threshold of 70%, mean of importance(M) >3.5, and coefficient of variation(CV) <0.25. Reliability of experts' opinion was calculated by positive coefficient and authoritative coefficient. Items without consistency were enlisted in the second-round consult. When all items met the selection criteria, the protocol would be finally formulated.Results: A 122-measure protocol was established, including prevention, assessment, and intervention of PPH. With a panel of 14 experts participated in the consult, the positivity coefficient was 0.93 and 1.00 for two rounds, respectively, and the authority coefficient was 0.88. After a two-round consult and revision of the draft, the final program was formulated, containing 5 first-level indexes and 14 second-level indexes with a total item of 120.Conclusions: The PPH protocol, based on high-quality evidences, was formulated with a two-round Delphi method, which can provide insight for midwives and obstetrical nurses to effectively deal with PPH.展开更多
Acupuncture originated in China several thousand years ago, and this therapeutic approach has been shown to be an effective treatment of many diseases and the maintenance of health in China and other countries all ove...Acupuncture originated in China several thousand years ago, and this therapeutic approach has been shown to be an effective treatment of many diseases and the maintenance of health in China and other countries all over the world. However, there is little study into how the important skills of acupuncture should optimally be taught and how competence at this skill should be evaluated. The current competency assessment of acupuncture skills is primarily based on evaluations by experts, which can be subjective with large variations and potentially inaccurate. Developing evidence-based assessment standards for acupuncture skills is required to move the assessment of the clinical practice of acupuncture forward, and this performance evaluation could be based on standardized expert evaluation, computer-based measurements such as motion analysis , and high-fidelity simulators or standardized patients.展开更多
基金Supported by Guangdong Higher Education Teaching Reform Project (2020)No.20National Examination of Traditional Chinese Medicine Scientific Research Project (TB2021002)。
文摘Objective:Acupuncture is an efficient treatment modality for many different training,but the technique can be challenging to master.Identification of the different acupuncture points can now be practiced in a standardized and patient-safe simulation-based environment.We aim to gather additional evidence regarding simulation-based training of acupuncture skills and hope that the simulation-based test developed and will be used for simulation-based mastery learning in future develop.Methods:The aim of this study was to develop a test of acupuncture skills using the TCM(Traditional Chinese Medicine) Meridians & Acupoints Anatomy Teaching Platform and gather validity evidence using Messick’s framework.Novice medical students without prior experience in acupuncture(n=43),intermediate medical students who had finished the mandatory acupuncture course(n=24),and skilled acupuncture doctors(n=17) were included in the study.One-hundred and seven acupuncture points were presented to the participants in identical randomized order and they were asked to identify each point by touching the correct anatomical location on the simulator.The simulator automatically registered the accuracy of participants’ answers.Results:The reliability of the final test(66 acupuncture points) was at a high level with a Cronbach’s alpha of 0.98 and only 16 acupuncture points were needed to ensure a reliability of 0.90.The test could discriminate significantly between all three groups and a credible pass/fail-score of 34 points was determined which resulted in eight out of 43(19%) novices passing the test and only two out of 17(12%)experienced failing the test.These consequences were statistically significant(P <0.001).Conclusion:Based on Messick’s framework we demonstrated strong validity evidence for a newly developed simulation-based test of acupuncture points localization skills.The test can be used as an aid to decide when trainees are ready to progress to more advanced training and clinical practice.Compared with the traditional point-point test,the point-point evaluation of the simulator can be more objective and reduce the effort of teachers.
文摘Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was conducted with 190 clinical nurses recruited from an oncology hospital in Central Vietnam.The self-administered Evidence-Based Practice Questionnaire(EBPQ)was employed to assess the nurses'knowledge/skills,attitudes,and implementation of EBP.Data analysis utilized descriptive statistics,the Mann-Whitney test,the Kruskal-Wallis test,and Spearman's rho correlation.Results:The mean total score for EBP implementation among the nurses was 29.52(SD=7.14)out of 42 scores.The most frequently undertaken activity was sharing evidence with colleagues,whereas finding relevant evidence was the least performed.The level of EBP implementation significantly varied based on the nurses'role types and their participation in related courses(P<0.05).Moreover,a strong positive correlation was observed between EBP implementation and both knowledge/skills(r=0.703,P<0.001)and attitudes toward EBP(r=0.536,P<0.001).Conclusions:The implementation of EBP by oncology nurses is generally moderate and is significantly positively correlated with their knowledge/skills and attitudes toward EBP.These findings underscore the importance of enhancing educational programs and facilitating suppor tive institutional policies to fur ther encourage the adoption of EBP among nurses.
文摘With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.
基金Hospital Quality Management Research Fund Project of China Medical Quality Management Association(Project No.:YLZG202511)。
文摘Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.
基金supported by the Second Tibetan Plateau Scientific Expedition and Research Program(STEP)(No.2019QZKK0208)the National Natural Science Foundation of China(Nos.42171148 and 42330512)the Key R&D Project from the Science and Technology Department of Tibet(No.XZ202501ZY0030).
文摘Nitrogen(N)and phosphorus(P)are essential nutrients and can significantly impact primary productivity of the ecosystem causing water environmental problems.However,their cycling mechanisms are not well understood in alpine mountains with climate change.Hence,94 samples of river water were collected from 2018 to 2020 in the headwaters of the Shule River Basin to assess the nutrients spatiotemporal distribution and combined ap-proach of water quality index to assess water quality and potential sources.The findings depict that high nutrient concentrations were found to coincide with snowmelt and glacial meltwater and rainfall recharge periods,while total flux peaked from June to September due to increased runoff.Notably,total nitrogen(TN)concentrations were significantly higher near the town,primarily attributed to the replenishment of nitrate(NO_(3)^(‒)-N)from live-stock manure.The high total P(TP)was near the glacier,which was attributed to the transportation of glacial sediments into the river,and pH was another critical factor.N was the primary nutrient limiting factor for the growth of phytoplankton in river water.Although the migration and transport of nutrients have altered with climate change,river water quality is good in alpine mountains based on an overall evaluation.These findings contribute to enriching nutrient datasets and highlight the importance of water resource management and water quality assessment in sensitive and fragile alpine mountains.
基金supported by the Northeast Geological Science and Technology Innovation Center of China Geological Survey(Grant NO.QCJJ2022-43)the Natural Resources Comprehensive Survey Project(Grant Nos.DD20230470,DD20230508)the National Groundwater Monitoring Network Operation and Maintenance Program(Grant No.DD20251300109).
文摘Excessive levels of Fluoride(F−)and Cadmium(Cd)in drinking groundwater may pose health risks.This study assessed the health risks associated with F−and Cd contamination in rural drinking groundwater sources in Wutai County,Shanxi Province,China,to support population health protection,water resource management,and environmental decision-making.Groundwater samples were collected and analyzed,and a Human Health Risk Model(HHRA)was applied to evaluate groundwater quality.The results showed that both contents of F−and Cd in groundwater exceeded the Class III limits of China's national groundwater quality standard(GB/T 14848—2024).Fluoride levels met the Class V threshold,with enrichment area mainly located in the east part of the study area.Cadmium levels reached Class IV,with elevated concentrations primarily observed in the western and northwestern regions.Correlation analysis revealed that F−showed weak or no correlation with other measured substances,indicating independent sources.Health risk assessment results indicated that F−poses potential health risks to rural residents,while cadmium,due to its relatively low concentrations,does not currently present a significant health risk.Among different demographic groups,the health risk levels of F−exposure followed the order:Infants>children>adult females>adult males.The findings highlight that fluoride is the primary contributor to health risks associated with groundwater consumption in the study area.Strengthened monitoring and prevention of F−contamination are urgently needed.This research provides a scientific basis for the prevention and control of fluoride pollution in groundwater and offers practical guidance for safeguarding drinking water safety in rural China.
基金supported by the National Key Research and Development Program of China(Grant No.2022YFF1303405).
文摘Compared with traditional energy sources,wind power has a lower environmental impact.However,emissions are still generated across the life cycle of wind turbines,from production to recycling.As wind power rapidly develops and deployment increases,these impacts are becoming increasingly evident.A comprehensive understanding of these impacts is crucial for sustainable development.Based on the harmonization of previous detailed life cycle assessment(LCA)studies,this study develops a simplified LCA model that estimates the life cycle environmental impacts of wind turbines based on their nominal power.Using this simplified LCA model,we assess the global warming potential(GWP),acidification potential(AP),and cumulative energy demand(CED)of wind power at the regional scale for 2022 and under three future scenarios(high-power wind turbine promotion,reduced wind curtailment,and a comprehensive development scenario).The results indicate that in 2022,the life cycle GWP,AP,and CED of wind power in western China were 10.76 g CO_(2) eq/kWh,0.177 g SO_(2) eq/kWh,and 17.6 kJ/kWh,respectively.Scenario simulations suggest that reducing wind curtailment is the most effective approach for reducing emissions in Inner Mongolia,Gansu,Qinghai,Ningxia,and Xinjiang,producing average decreases of 8.64%in GWP,8.39%in AP,and 9.26%in CED.In contrast,for Guangxi,Chongqing,Sichuan,Guizhou,Yunnan,Xizang,and Shaanxi,the promotion of high-power wind turbines provides greater environmental benefits than reducing curtailment,producing average decreases of 3.45%,3.09%,and 4.29%in GWP,AP,and CED,respectively.These findings help clarify the environmental impact of wind power across its life cycle at the regional scale and provide theoretical references for the direction of future wind power development and the formulation of related policies.
基金support of the ORG.one project of Oxford Nanopore Technologies(ONT),the Rufford Grants(45249-1)the Idea Wild Grants(Project ID-KJOSINDI0125-00)the Mohamed Bin Zyed Species Conservation(MBZ)(GEF Grant no-240535253)Funds in our efforts to conserve threatened trees in the Western Ghats Biodiversity Hotspot Forest regions.
文摘Plants constitute nearly 80%of the planet’s total biomass(Bar-On et al.,2018);however,this vital group is experiencing severe threats,and recent evaluations indicate that approximately 45%of the world's described plant species are at risk of extinction(Bachman et al.,2024).The number of plant extinctions has increased by 60%in the last 100 years(Di Marco et al.,2017).Over the past 250 years,571 plant species have gone extinct—more than twice the combined total of extinct birds,mammals,and amphibians(217 species)(Briggs,2019).
基金support in the literature analysis.This study has been carried out in the framework of the project funded by EU entitled“Bioremediation of contaminated sediments in coastal areas of exindustrial sites-LIFE SEDREMED”(No.LIFE20 ENV/IT/000572).
文摘This study compares the environmental sustainability of five alternatives for the remediation of marine sediments of one of the most polluted coastal sites in Europe(Bagnoli-Coroglio bay,Mediterranean Sea),using the Life Cycle Assessment(LCA)methodology.The treatments are either in-situ or exsitu,the latter requiring an initial dredging to transport the contaminated sediments to the management site.More in detail,four ex-situ remediation technologies based on landfilling,bioremediation,electrokinetic technique and soil washing were identified.These technologies are compared to an in-situ strategy currently under validation for enhancing bioremediation of the polluted sediments of the Bagnoli-Coroglio site.Our results indicate that the disposal in landfilling site is the worst option in most categories(e.g.,650 kg CO_(2) eq./t of treated sediment,considering the nearest landfilling site),followed by the bioremediation,mainly due to the high energy demand.Electrokinetic remediation,soil washing,and innovative in-situ technology represent the most sustainable options.In particular,the new in-situ technology appears to be the least impacting in all categories(e.g.,54 kg CO_(2) eq./t of treated sediment),although it is expected to require longer treatment time(estimated up to 12 months based on its potential efficiency).It can reduce the impact on climate change more than 12 times compared to the disposal and 7 times compared to bioremediation in addition to the possibility to avoid/reduce the dredging operations and the consequent dispersion of pollutants.The results open relevant perspectives towards more eco-sustainable and costly effective actions for the reclamation of contaminated marine sediments.
基金supported by the National Key R&D Program of China(Nos.2018YFC1004300 and 2018YFC1004302)the Science&Technology Program of Guizhou Province(Nos.QKHHBZ[2020]3002,QKHPTRC-GCC[2022]039-1 and QKHPTRCCXTD[2022]014)the Scientific Research Program of Guizhou Provincial Department of Education(No.QJJ[2023]019).
文摘Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure from the living environment.This study included 1311 women in late pregnancy from the Zunyi birth cohort and measured the urinary concentrations of 10 hydroxylated PAH metabolites(OH-PAHs).Risk assessment was conducted based on the estimated daily intake to calculate the hazard quotient and hazard index(HI).A linear regression model was used to analyze the relationship between creatinine-adjusted OH-PAHs concentrations and living environment and lifestyle factors,while principal component analysis was applied to trace the sources of PAHs exposure.1-OHPYR was detected in all participants’urine,with naphthalene metabolites having the highest concentrations among creatinine-adjusted PAHs.OH-PAHs concentrations were associated with housing type,room number,cooking frequency,household size,exercise frequency,fuel type,distance from main road,and drinking water source.Pregnant women using traditional fuels and living in bungalows had higher health risks than those using clean energy and living in buildings.Those living within 100 m of a main road had higher HI than those farther away.Coal combustion was identified as the primary source of PAHs exposure.The study emphasizes the importance of reducing PAHs exposure,especially for pregnant women living in polluted environments.It recommends public health interventions such as improving indoor ventilation and providing clean energy to reduce related health risks.
基金supported by the National Natural Science Foundation of China(grant numbers 42171085)and the National Key R&D Program of China(Grant No.2024YFF1307801,2024YFF1307804).
文摘Integrated environmental management is important for sustainable development.Under China’s“Three Lines One Permit”(TLOP)policy,three types of management zones—priority protection,critical control,and general control zones—are established based on the ecological red line,the lower-limit line for environmental quality,and the resource use line.Human activities are regulated through a permit system.Integrated and multifactorial protection of soil,plant,hydrological,and atmospheric elements is promoted at the regional level.A follow-up assessment contributes to the improvement of policy implementation and effectiveness.This study demonstrates the achievements of the TLOP policy in Sichuan Province.Results show that(1)276 protection zones have been established under the ecological red line,covering key ecosystems and protected areas to ensure environmental security.Under the lower-limit line,1,626 functional(priority,key,and general control)zones have been designated to regulate air,water,and soil quality,enhancing environmental capacity and pollution control.(2)Through the integration and merging of the three lines,1,128 integrated management zones have been established,including 375,625,and 128 priority protection,critical control,and general control zones,respectively.Each zone has its own list of environmental permits to regulate human activities according to different environmental protection and natural resource development regimes.(3)The design of the follow-up assessment index system was informed by regional primary functions and industrial structure.The index system for provinces and cities is structured around three primary indicators—implementation updating,application,and guarantees—and 15 secondary indicators.The system for critical control zones is structured around environmental access,management,and effectiveness and 14 secondary indicators.A stringent environmental zoning system has been established through the TLOP policy,thereby safeguarding environmental security,promoting harmonious existence between humans and nature,and supporting the vision of Beautiful China.
基金supported by the Key Program of National Natural Science Foundation of China(Grant No.41930650)Young Scientists Fund of the National Natural Science Foundation of China(Grant No.42301310).
文摘Sustained and spatially explicit monitoring of the United Nations 2030 Agenda for Sustainable Development is critical for effectively tracking progress toward the global Sustainable Development Goals(SDGs).Although land cover information has long been recognized as an essential component for monitoring SDGs,a standardized scientific framework for identifying and prioritizing land cover related essential variables does not exist.Therefore,we propose a novel expert-and data-driven framework for identifying,refining,and selecting a priority list of Essential Land cover-related Variables for SDGs(ELcV4SDGs).This framework integrates methods including expert knowledge-based analysis,clustering of variables with similar attributes,and quantified index calculation to establish the priority list.Applying the framework to 15 specific SDG indicators,we found that the ELcV4SDGs priority list comprises three main categories,type and structure,pattern and intensity,and process and evolution of land cover,which are further divided into 19 subcategories and ultimately encompass 50 general variables.The ELcV4SDGs will support detailed spatial monitoring and enhance their scientific applications for SDG monitoring and assessment,thereby guiding future SDG priority actions and informing decision-making to advance the 2030 SDGs agenda at local,national,and global levels.
基金supported by the National Natural Science Foundation of China (Nos.42422705,42207175,42177117 and 42577170)the Ningbo Youth Leading Talent Project (No.2024QL051)+1 种基金the Chinese Academy of Engineering Science and Technology Strategy Consulting Project (No.2025-XZ-57)the Central Government Funding Program for Guiding Local Science and Technology Development (No.2025ZY01028)。
文摘Rock mass stability is significantly influenced by the heterogeneity of rock joint roughness and shear strength.While modern technology facilitates assessing roughness heterogeneity,evaluating shear strength heterogeneity remains challenging.To address this,this study first captures the morphology of large-scale(1000 mm × 1000 mm) slate and granite joints via 3D laser scanning.Analysis of these surfaces and corresponding push/pull tests on carved specimens revealed a potential correlation between the heterogeneity of roughness and shear strength.A comparative evaluation of five statistical metrics identified information entropy(Hs) as the most robust indicator for quantifying rock joint heterogeneity.Further analysis using Hsreveals that the heterogeneity is anisotropic and,critically,that shear strength heterogeneity is governed not only by roughness heterogeneity but is also significantly influenced by the mean roughness value,normal stress,and intact rock tensile strength.Consequently,a simple comparison of roughness Hsvalues is insufficient for reliably comparing shear strength heterogeneity.To overcome this limitation,a theoretical framework is developed to explicitly map fundamental roughness statistics(mean and heterogeneity) to shear strength heterogeneity.This framework culminates in a practical workflow that allows for the rapid,field-based assessment of shear strength heterogeneity using readily obtainable rock joint roughness data.
文摘Correction to:Journal of Forestry Research(2025)36:124 https://doi.org/10.1007/s11676-025-01918-8 In this article the author’s name Yasutomo Hoshika was incorrectly written as Yasutoma Hoshika.The original article has been corrected.
基金supported by a project entitled Loess Plateau Region-Watershed-Slope Geological Hazard Multi-Scale Collaborative Intelligent Early Warning System of the National Key R&D Program of China(2022YFC3003404)a project of the Shaanxi Youth Science and Technology Star(2021KJXX-87)public welfare geological survey projects of Shaanxi Institute of Geologic Survey(20180301,201918,202103,and 202413)。
文摘This study developed a modeling methodology for statistical optimization-based geologic hazard susceptibility assessment,aiming to enhance the comprehensive performance and classification accuracy of the assessment models.First,the cumulative probability method revealed that a low probability(15%)of geologic hazards between any two geologic hazard points occurred outside a buffer zone with a radius of 2297 m(i.e.,the distance threshold).The training dataset was established,consisting of negative samples(non-hazard points)randomly generated based on the distance threshold,positive samples(i.e.,historical hazards),and 13 conditioning factors.Then,models were built using five machine learning algorithms,namely random forest(RF),gradient boosting decision tree(GBDT),naive Bayes(NB),logistic regression(LR),and support vector machine(SVM).The comprehensive performance of the models was assessed using the area under the receiver operating characteristic curve(AUC)and overall accuracy(OA)as indicators,revealing that RF exhibited the best performance,with OA and AUC values of 2.7127 and 0.981,respectively.Furthermore,the machine learning models constructed by considering the distance threshold outperformed those built using the unoptimized dataset.The characteristic factors were ranked using the mutual information method,with their scores decreasing in the order of rainfall(0.1616),altitude(0.06),normalized difference vegetation index(NDVI;0.04),and distance from roads(0.03).Finally,the geologic hazard susceptibility classification was assessed using the natural breaks method combined with a clustering algorithm.The results indicate that the clustering algorithm exhibited higher classification accuracy than the natural breaks method.The findings of this study demonstrate that the proposed model optimization scheme can provide a scientific basis for the prevention and control of geologic hazards.
基金supported by the National Natural Science Foundation of China(62073267,61903305)the Fundamental Research Funds for the Central Universities(HXGJXM202214)。
文摘For mission-oriented unmanned aerial vehicle(UAV)swarms,mission capability assessment provides an important reference in the design and development process,and is a precondition for mission success.For this multi-criteria decisionmaking(MCDM)problem,the current literature lacks a way to unambiguously present criteria and the popular fuzzy analytic network process(ANP)approaches neglect the hesitancy of subjective judgments.To fill these research gaps,an MCDM method based on unified architecture framework(UAF)and interval-valued spherical fuzzy ANP(IVSF-ANP)is proposed in this paper.Firstly,selected viewpoints in UAF are extended to construct criteria models with standardized representation.Secondly,interval-valued spherical fuzzy sets are introduced to ANP to weight interdependent criteria,handling fuzziness and hesitancy in pairwise comparisons.A method of adjusting weights of experts based on their decision similarities is also included in this process to reduce ambiguity brought by multiple experts.Next,performance characteristics are non-linearly transformed regarding to expectations to get final results.This proposition is applied to assess the mission capability of UAV swarms to search and strike surface vessels.Comparative analysis shows that the proposed method is valid and reasonable.
文摘Objectives Evidence-based healthcare contributes to the improvement of healthcare quality and informs healthcare decision-making.The provision of timely high-quality evidence is always required to fulfil the ever-changing needs and expectations of healthcare personnel.This study aimed to assess the needs and expectations of healthcare personnel regarding evidence-based healthcare in China.Methods We conducted a cross-sectional online survey from December 8,2020 to January 15,2021 involving 901 participants across China.Healthcare providers,policy makers,researchers and educators,and full-time postgraduate medical and nursing students working/living in China were eligible to participate.A self-developed questionnaire was used.Results Participants generally agreed that health-related research evidence was beneficial.Evidence-based resources,such as Cochrane resources,were only known or used by about half of the respondents due to difficulties related to availability and accessibility.Various types of resources,topics of evidence,and themes of workshops were of particular interest to most of the participants.Conclusions The dissemination and translation of evidence,provision of more support in evidence availability,offering evidence-based training,and determining the most in-demand research areas have been identified as priority areas of work which could fulfil the needs and expectations of healthcare personnel in China.
基金supported by Nursing Research Program of Shanghai Nursing Association(No.2016SD-B03)
文摘Objective: Postpartum hemorrhage(PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an early assessment and intervention protocol as a toolkit for PPH for midwives and obstetrical nurses.Methods: Employing the evidence-based method, a systematic Internet search of guidelines was conducted and appraisal of literatures was conducted with AGREE system and Oxman-Guyatt Overview Quality Assessment Questionnaire(OQAQ), according to which a protocol draft was therefore developed. Then, a two-round modified Delphi method was utilized to reach a consensus of the protocol built on best practices. Selection criteria for each intervention measure included consensus level with a threshold of 70%, mean of importance(M) >3.5, and coefficient of variation(CV) <0.25. Reliability of experts' opinion was calculated by positive coefficient and authoritative coefficient. Items without consistency were enlisted in the second-round consult. When all items met the selection criteria, the protocol would be finally formulated.Results: A 122-measure protocol was established, including prevention, assessment, and intervention of PPH. With a panel of 14 experts participated in the consult, the positivity coefficient was 0.93 and 1.00 for two rounds, respectively, and the authority coefficient was 0.88. After a two-round consult and revision of the draft, the final program was formulated, containing 5 first-level indexes and 14 second-level indexes with a total item of 120.Conclusions: The PPH protocol, based on high-quality evidences, was formulated with a two-round Delphi method, which can provide insight for midwives and obstetrical nurses to effectively deal with PPH.
基金Jiangsu Government Scholarship for Overseas Studies (JS-2009)
文摘Acupuncture originated in China several thousand years ago, and this therapeutic approach has been shown to be an effective treatment of many diseases and the maintenance of health in China and other countries all over the world. However, there is little study into how the important skills of acupuncture should optimally be taught and how competence at this skill should be evaluated. The current competency assessment of acupuncture skills is primarily based on evaluations by experts, which can be subjective with large variations and potentially inaccurate. Developing evidence-based assessment standards for acupuncture skills is required to move the assessment of the clinical practice of acupuncture forward, and this performance evaluation could be based on standardized expert evaluation, computer-based measurements such as motion analysis , and high-fidelity simulators or standardized patients.
