Core competence evaluation standards for emergency nurse specialist: Developing and testing psychometric properties

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.

Primary percutaneous coronary intervention on older patients with acute ST-segment elevation myocardial infarction: analysis of its risk factors

Objective: The aim of the present study was to assess the early clinical outcome and risk factors in old patients with acute ST elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (PCI). Methods: A total of 136 patients older than 60 years with STEMI who received successful PCI were included in this study. The patients were classified in 2 age groups: patients ≥75 years and <75 years of age. The extent of coronary artery lesions was measured by quantitative coronary artery angiography (QCA). Subjects were tracked for subsequent cardiovascular events: cardiac death, myocardial infarction, heart failure, percutaneous coronary intervention, coronary artery bypass and stroke. Results: Though the older group had a higher prevalence of adverse baseline characteristics and lower final TIMI flow than patients<75y (P<0.05), the procedural success did not make difference between the two groups. In 12 months follow-up of 136 study participants, there occurred 39 CV events : cardiac death (five patients), heart failure (nineteen patients), and stroke (six patients). Three patients received coronary bypass grafts and six patients underwent PCI. Heart failure and overall cardiovascular event rates were higher in older patients compared with those in patients<75y. The main adverse clinical events (MACE) for the old group were a little higher comparing with the younger in 12-month follow-up (P=0.029 6 and P=0.043 4). Multivariate cox analysis identified that a diagnosis of diabetes (HR 2.495, 95%CI 1.224 to 5.083, P= 0.011 8) and time from symptom(HR 1.450, 95%CI 1.143 to 1.841, P= 0.008 2) to PCI as independent predictors of CV events after adjustment of all entered baseline variables. Conclusion: Our study suggests that drug-eluting stent implantation in older patients with acute ST elevation myocardial infarction has high initial procedural success rates despite having more severe baseline risk characteristics, and to shorten the time from symptom onset to PCI may decrease cardiovascular events in old patients following PCI.

The role of autophagy in cell survival from heavy ion irradiation in the plateau region

To study cytotoxic effect of heavy ion irradiation in the plateau region, and investigate whether autophagy induced by heavy ion irradiation is cytoprotective, HeLa cells were irradiated with 350 MeV/u carbon ions beams,and the clonogenic survival was analyzed. The results showed that cell survival decreased with increasing doses.It was also found that G2/M-phase cells increased, and the autophagy-related activity was significantly higher than the control. When autophagy was blocked by 3-methyladenine in carbon-ion irradiated cells, G2/M phase arrest and the percentage of apoptosis cells were further elevated, and cell survival decreased significantly, indicating the induction of cytoprotective autophagy by carbon-ion irradiation. Our results demonstrated that autophagy induced by carbon ion irradiation provided a self-protective mechanism in HeLa cells, short-time inhibition of autophagy before carbon-ion irradiation could enhance radiation cytotoxicity in HeLa cells.

Impact of primary hypertension on hematuria of the patients with benign prostatic hyperplasia

Background Both benign prostatic hyperplasia （BPH） and primary hypertension are common in the elderly men. The purpose of this study was to investigate the possible effect of primary hypertension on the hematuria in patients with BPH.Methods All patients who underwent transurethral resection of prostate or opening operation had confirmed diagnoses of BPH histologically. comparative analysis of packet was used to analyze the incidence of hematuria in 423 BPH patients with or without hypertension. Immunostaining of CD34 and vascular endothelial growth factor （VEGF） was carried out in tissues of 50 cases of simple BPH and 50 cases of BPH accompanied with hypertension. Results The incidence of hematuria in the BPH with hypertension was significantly higher than that in the simple BPH （P〈0.01）. Furthermore, the incidence of hematuria in patients who had hypertension for more than 10 years was clearly higher than that in the patients who had hypertension for less than 10 years （P 〈0.01）. Both microvessel density （MVD） based on CD34 immunostaining and VEGF expression were significantly higher in the BPH tissues of patients with hypertension than that in the simple BPH （P〈0.01, P〈0.05）.Conclusions Long-term hypertension may significantly increase the incidence of hematuria in patients with both BPH and hypertension. Increased MVD level and VEGF expression may account for the higher incidence of hematuria in these patients.