Evidence-Based Nursing Practice of Reducing Immune-Related Skin Toxicity of Tumor Patients Guided by Sensitive Indicators

Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.

Are case reports valuable?Exploring their role in evidence based medicine and patient care

Case reports,often overlooked in evidence-based medicine(EBM),play a pivotal role in healthcare research.They provide unique insights into rare conditions,novel treatments,and adverse effects,serving as valuable educational tools and generating new hypothesis.Despite their limitations in generalizability,case reports contribute significantly to evidence-based practice by offering detailed clinical information and fostering critical thinking among healthcare professionals.By acknowledging their limitations and adhering to reporting guidelines,case reports can contribute significantly to medical knowledge and patient care within the evolving landscape of EBM.This editorial explores the intrinsic value of case reports in EBM and patient care.

Preceptors'experiences in guiding nursing students to use research findings and to implement evidence-based practice

Objective:Evidence-based practices(EBPs)have been taught to students by identifying the best evidence/evidence from research results.However,the experiences of Indonesian nurse preceptors in helping students implement research findings have not been explored thoroughly.This study aimed to explore Indonesian nurse preceptors in guiding nursing students to use research findings.Methods:This study used interpretive phenomenology analysis that involves 9 nurse preceptors from hospitals in West Kalimantan,Indonesia.Semi-structured in-depth interviews were recorded and then transcribed verbatim.Results:Three themes were generated during the analysis:“types of student supervision,”“issues during supervision,”and“the need for research literacy and supervision.”Conclusions:Nurse preceptors need support to supervise the nursing students to use research findings.In addition to upgrading nursing skills,nurse preceptors must receive training in research and its utilization.Developing an appropriate strategy to assist students in using research findings will enhance the promotion of evidence-based nursing practices on a daily basis.

Clinical Practice of Evidence-Based PDCA Cycle Management Model in Accelerated Recovery of Lung Cancer Patients

Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.

Research on the Application of Evidence-Based Quality Control Circle to Improve the Implementation Rate of Airway Management Measures in Adult Critically Ill Patients

Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs Institute (JBI) evidence-based health care model, the best evidence of airway management in adult critically ill patients was obtained and applied to the clinic. Results: The total implementation rate of airway management measures in adult critically ill patients increased from 23.62% before the implementation of quality control circle to 88.82%, and the pulmonary infection rate in critically ill patients decreased from 42.31% to 21.74%, with statistical significance between the two groups (P 0.05). Conclusion: Evidence-based quality control circle activities can standardize the practice standards of airway management in critically ill patients, reduce the occurrence of patients’ airway related complications, and improve clinical outcomes.

Effects of Health Education with Problem-Based Learning Approaches on the Knowledge, Attitude, Practice and Coping Skills of Women with High-Risk Pregnancies in Plateau Areas

Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification.

Discussion on Construction and Mechanism of Practice Bases for Professional Degree Postgraduates Based on the Integration of Production and Education in Local Universities

Under the background of emerging agricultural education,practice bases are an important place to train profession talented person that match social needs,so it is very important to build stable and long-term practice bases.At present,the main problems in the construction of practice bases for postgraduates in local colleges and universities are mainly focusing on construction and neglecting management,imperfect cooperation mechanism and lack of teaching management effectively.It is of great significance to build a long-term management mechanism to ensure the education quality of practice bases.Therefore,constructing the mode of"double integration and double promotion of production and education"with practice bases as the carrier and realizing the organic combination of industrial needs and postgraduate projects is an important idea for local colleges and universities to train professional degree postgraduates to"know agriculture,love agriculture,strengthen agriculture and promote agriculture",and it also provides a reference for the mechanism construction of postgraduate bases.

A Research of the Course “Taishan Cultural Communication with the World” under Blended Learning Model and Outcome-Based Education Concept

The course “Taishan Cultural Communication with the World” has been online and offline teaching and learning for two terms based on the theoretical ideas: Blended Learning and Outcome-Based Education. This paper uses the data from one semester to state how to carry out the program and the good results. At the same time disadvantages are also the points that should be taken into consideration. From the teaching and learning practice, students have benefited from the online videos, complementary materials and discussions;they need to be guided as well, especially the guidance offline to make up. Furthermore, the balance of time online and offline is a great challenge.

循证医学(Evidence-based Medicine)——临床研究与实践的新时代

80年代以来的大规模、随机、双盲、多中心、安慰剂对照临床试验证明,以经验和推论,如以一些临床化验指标为依据的传统临床试验不能反映病人的长期预后。为了对新药和已上市药物作出恰当的评价,应当从所谓“众说纷坛”转向注重和评价病人预后,包括总死亡率、重要心脑血管事件、生活质量、卫生经济学等的“循证医学”。反过来,“循证医学”和临床治疗指南的发展将对新药的研究与开发、医生的临床实践、药物经济学、医疗保健服务决策等带来积极和正面的影响。

Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education

Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

ChatGPT: Application in Chemistry Education and Challenges

The paper discusses the advancements and applications of neural networks, specifically ChatGPT, in various fields, including chemistry education and research. It examines the benefits of AI and ChatGPT, such as their ability to process and analyze large amounts of data, create personalized training systems, and offer problem-solving recommendations. The paper delves into practical applications, showcasing how ChatGPT can be utilised to augment chemistry learning. It provides examples of using ChatGPT for creating tests, generating multiple-choice questions, and studying chemistry in general. Concerns are voiced about the ethical and societal impact of AI development. In conclusion, it explores the exciting potential of AI to tackle challenges that may exceed human capabilities alone, paving the way for further exploration and collaboration between humans and intelligent machines.

Corticosteroid-free immunosuppression in liver transplantation: An evidence-based review

Thirty-six randomized controlled trials and two metaanalyses were reviewed. With respect to adult patients undergoing first orthotopic liver transplantation(OLT), steroid replacement resulted in fewer cases of overall acute rejection in the corticosteroid free-immunosuppression arm. Initial steroid administration for two weeks and early tacrolimus monotherapy is a feasible immunosuppression regimen without steroid replacement, although further investigations are needed in view of chronic rejections. No significant differences were noted between the treatment groups in terms of patient and graft survival independently of steroid replacement. Renal insufficiency, de novo hypertension, neurological disorders and infectious complications did not differ significantly among steroid and steroidfree groups. Diabetes mellitus, cholesterol levels and cytomegalovirus infection are more frequent in patients within the steroid group. With respect to diabetes mellitus and hypercholesterolemia, the difference was independent of steroid replacement. In relation to transplanted hepatitis C virus patients, mycophenolate mofetil does not appear to have a significant antiviral effect despite early reports. Male gender of donors and recipients, living donors, cold ischemia times, acute rejection, and early histological recurrence were related to the development of advanced hepatitis. There is sufficient scientific clinical evidence advocating avoidance of the ab initio use of steroids in OLT.

Effects of daily telephone-based re-education before taking medicine on Helicobacter pylori eradication

We read the article "Effects of daily telephone-based re-education before taking medicine on Helicobacter pylori(H. pylori) eradication: A prospective singlecenter study from China" written by Wang et al with great interest. It is reported in American and European guidelines that there is no sufficient test for the diagnosis of H. pylori except culture and that using at least two different tests for diagnosis of H. pylori is recommended. Patients who used antibiotics or bismuth salts in the previous 2 wk were excluded from study. But patients who used probiotics and antioxidant vitamins such as vitamins C and E were not excluded.

Hepatocellular carcinoma: From clinical practice to evidence-based treatment protocols

Hepatocellular carcinoma(HCC) is one of the major malignant diseases in many healthcare systems. The growing number of new cases diagnosed each year is nearly equal to the number of deaths from this cancer. Worldwide, HCC is a leading cause of cancerrelated deaths, as it is the fifth most common cancer and the third most important cause of cancer related death in men. Among various risk factors the two are prevailing: viral hepatitis, namely chronic hepatitis C virus is a well-established risk factor contributing to the rising incidence of HCC. The epidemic of obesity and the metabolic syndrome, not only in the United States but also in Asia, tend to become the leading cause of the long-term rise in the HCC incidence. Today, the diagnosis of HCC is established within the national surveillance programs in developed countries while the diagnosis of symptomatic, advanced stage disease still remains the characteristic of underdeveloped countries. Although many different staging systems have been developed and evaluated the BarcelonaClinic Liver Cancer staging system has emerged as the most useful to guide HCC treatment. Treatment allocation should be decided by a multidisciplinary board involving hepatologists, pathologists, radiologists, liver surgeons and oncologists guided by personalized-based medicine. This approach is important not only to balance between different oncologic treatments strategies but also due to the complexity of the disease(chronic liver disease and the cancer) and due to the large number of potentially efficient therapies. Careful patient selection and a tailored treatment modality for every patient, either potentially curative(surgical treatment and tumor ablation) or palliative(transarterial therapy, radioembolization and medical treatment, i.e., sorafenib) is mandatory to achieve the best treatment outcome.

NETLAB-An Internet based laboratory for electrical engineering education

This article describes an Internet based laboratory (NETLAB) developed at Zhejiang University for electrical engi- neering education. A key feature of the project is the use of real experimental systems rather than simulation or virtual reality. NELTAB provides remote access to a wide variety of experiments, including not only basic electrical and electronic experiments but also many innovative control experiments. Students can effectively use the laboratory at any time and from anywhere. NETLAB has been in operation since July 2003.

Traditional Chinese Medicine as a Treatment for Rheumatoid Arthritis:From Empirical Practice to Evidence-Based Therapy

Rheumatoid arthritis(RA)is a common autoimmune condition with an elusive etiology.Conventional and biological disease-modifying drugs sometimes fail or produce only partial responses.Traditional Chinese medicine(TCM)has long been used in China as a treatment for RA and is achieving everincreasing acceptance worldwide.TCM treatments are traditionally guided by the theory of treatment based on TCM syndrome differentiation;however,they remain a matter of empirical practice relying on TCM theories and doctors’own experience,which places severe restrictions on worldwide TCM application.Nevertheless,TCM is a treasure trove for drug discovery,particularly as a treatment for complicated human conditions.The discoveries of artemisinin as a treatment for malaria and of TCM–arsenic trioxide(As2O3)combination therapy as a treatment for acute promyelocytic leukemia(APL)are excellent examples of the great value of TCM.Regarding RA treatments,many Chinese medicinal herbs and their formulas,extracts,ingredients,and even single compounds have been used in clinical applications.Several Chinese proprietary medicines(CPMs)derived from TCM formulas or herbal bioactive components,such as the controlled-release ZhengQingFengTongNing(ZQFTN)Tablets,Tripterygium Glycoside Tablets,and Total Glucosides of Peony(TGP)Capsules,have been included in the National Health Insurance Directory of China,and show comparable therapeutic efficacies to those of western chemical drugs with fewer side effects.As TCM research has advanced,particularly in the use of multidisciplinary technologies,the scientific foundations and characteristics of the use of TCM to treat RA have been revealed,and the quality of TCM treatments have been increasingly enhanced.However,TCM generally lacks sufficient clinical and laboratory data to be consistent with international standards for quality,safety,and efficacy in order to support its application worldwide.Therefore,intensive basic and clinical studies on TCM are required.In particular,investigations that use cutting-edge technologies in analytical chemistry,biology,and biomedical sciences,and the development of randomized clinical trials(RCTs)and personalized pragmatic randomized controlled trials(PPRCTs)are necessary.Researchers should also collaborate to advance TCM from empirical practice to evidence-based therapy,thus consistently promoting TCM development and globalization in a vital,beneficial,and contributable manner.

Landscape Design Elements in Rehabilitation Environment Founded on Evidence-based Design

The concept and development history of rehabilitation environment were summarized in this study,principles and techniques of applying evidence-based design in the design of rehabilitation environment were analyzed,classification and functions of landscape elements in rehabilitation environment were particularly discussed.

The Application of Problem Based Learning in Undergraduate Nursing Education: A Strategy for Curriculum Reform

Background: Problem based learning (PBL) is an innovative way of delivering instruction in which problems are used as the basis of learning. Problem based learning was developed in the 1960s by Harold Barrows at McMaster University Medical School in Canada. Since then, PBL had been im-plemented as a teaching method in other reputable education institutions internationally, includ-ing nursing education. Curriculum reform is proposed through PBL in conjunction with patient simulation in undergraduate nursing education. The first author, Tan Kan Ku, PhD Candidate, MHS (Transcultural Mental Health—by Research) worked as a Registered Nurse for more than two decades internationally in England, New Zealand, Saudi Arabia and Australia, where she worked as a Case Manager in Community Mental Health Rehabilitation Program. Since 2001, she focused on nurse education and research into the stigma of mental illness from a cross-cultural perspective. Currently, she teaches Mental Health, Cultural Diversity and Research in the Diploma of Nursing course at Victoria University in Melbourne, Australia, while completing her PhD thesis for examination at Charisma University. The second author, Dr. Michael Ha, FSA, MAAA, CFA, CPA (Australia) FRM, PRM, LLM, is the Founding Director of the MSc Financial Mathematics programme at Xian Jiaotong-Liverpool University. He was previously Vice President of Strategic Business In-itiatives Units at ING Life Insurance in its Taiwan operation. Ninety percent of his students are enrolled in the Financial Mathematics programme. They learn not only mathematics and statistics theories but also their applications in the Finance and Investment areas, especially Portfolio Con-struction and Financial Risk Management. Creating a real-world Finance work environment in university lecture-halls embracing theories and practice, Dr. Ha strongly believes the PBL method can be employed in the Financial Mathematics training agenda so students can be better-prepared for work. Students are no longer instructed-learners but active thinkers and problem-solvers. Conclusion: Educators in fields such as Medical, Nursing, Engineering, Financial Mathematics, Ac-counting, Computing, etc., need to be prepared to change their teaching philosophy from didactic to problem solving for PBL to be implemented. Constructive alignment is recommended for curri-culum reform.

New Concepts and Evidence Based Practice in Physiotherapy：Examples from Stroke Rehabilitation

Objective:The purpose of this paper is to give an overview of new concepts and evidence based physiotherapy practice in stroke rehabilitation in the acute,post acute and chronic stage of stroke. Background:Historically physiotherapy has developed through the years from a focus on health,beauty,and equilibrium between spiritual,moral and physical powers,to a client centered service to people and populations to develop,to maintain and to restore maximum movement and functional ability throughout the lifespan. Still the health perspective is strong and divided into first,second and third prophylaxis. New concepts like Evidence Based Medicine,Evidence Based Practice,International Classification of Function and research within neurophysiology have had a deep impact on physiotherapy services,practice and education. The highest levels of documentation are Meta analyses and Randomised Controlled Trials,and today many of the physiotherapy methods used in rehabilitation of neurological conditions are tried out in different trials,bringing up-to date knowledge into practice. This paper focuses on rehabilitation of persons with stroke and physiotherapy methods in particular. Result:Physiotherapy in the acute stage improves motor function and enhances mobility. Rehabilitative efforts within the first few weeks as opposed to later favors better recovery. Type of physiotherapy in the acute stage is task oriented training with a focus on intensity and variability. Post acute therapy-based rehabilitation services targeted towards stroke patients living at home appear to improve independence in personal activities of daily living. In the chronic stage there is good evidence that aerobic exercise is beneficial for improving aerobic capacity in people with mild and moderate stroke. Progressive resistance strength training programmes reduce musculoskeletal impairment after stroke,without increasing tone or spasticity.

EVIDENCE-BASED MEDICINE AND THE CLINICAL STUDY ON ACUPUNCTURE AND MOXIBUSTION

In this article, the authors hold that the evidence based medicine(EBM) is a new medical action produced at the historic moment in clinical practice, which is promoting development of the medicine and even the whole life science in a fully new train of thought and method. Further the briefly introduced contents are the effect of EBM, the difficulty of utilizing in the acupuncture clinical practice and how to resolve them. It is highly recommended that the doctors of the acupuncture science field should study EBM and its effect and difficulties in practice as earlier as possible, insistently assimilate new knowledge and keep abreast of the times’ progress to facilitate the further development of acupunctology.