Analysis of the current situation and trend of home-based individualized nursing for residents in a certain area in China.

OBJECTIVE: The aim of this study is to examine the perception, willingness to engage, and demand of community residents regarding the 'internet + nursing service' in a designated pilot area, aiming to offer insights for the widespread adoption of the 'internet + nursing service' throughout China. METHODS: A survey pertaining to the 'internet + nursing service' was conducted from March to April 2022. The study specifically targeted residents within two sub-districts of a city in the Jiangsu province. The sampling technique employed in this study was stratified random sampling. RESULTS: Out of a total of 400 community residents selected from two sub-districts in this region, 378 provided valid responses, resulting in an effective rate of 94.5%. Within the study cohort, 80 participants (21.16%) demonstrated familiarity with the concept of 'internet + nursing service.' Additionally, 231 participants (61.11%) conveyed their willingness to adopt such services. Regarding service preferences, the primary demands were for health guidance, vital sign monitoring, and basic care. Challenges in implementing the service were attributed to concerns related to medical risks, personal safety for both nurses and patients, and potential breaches of privacy. CONCLUSIONS: Residents in the pilot area exhibited a moderate awareness of the 'internet + nursing service,' with a relatively high willingness to embrace the program. There is a need for further refinement of pertinent laws, widespread dissemination of policies, and enhancements in the quality of nursing services. These measures aim to ensure that a greater number of community residents can avail themselves of improved home-based nursing services.

Current status of post-traumatic stress disorder among emergency nurses and the influencing factors.

Objective: To gain a better understanding of the current state of traumatic stress experienced by emergency nurses of Grade III Level A hospitals in Jiangsu Province, as well as their coping styles after experiencing such traumatic events. Additionally, this study aims to identify the primary factors that influence the responses of these nurses to traumatic events. Methods: Using a cluster random sampling method, we enrolled 265 nurses working in the emergency departments of five Grade III Level A hospitals in Jiangsu Province. These nurses participated in a questionnaire survey that included inquiries regarding general information, previous traumatic experiences, and a post-traumatic stress disorder self-assessment scale (PCL-C) for emergency department nurses. Results: A total of 290 questionnaires were distributed, resulting in 265 valid questionnaires and an effective rate of 91.38%. These findings indicated that emergency nurses who participated in public health emergencies such as the COVID-19 pandemic (45.66%) and sudden health deterioration and death of patients (43.77%) encountered the most traumatic events. The top two traumatic events that had a moderate or greater impact on emergency nurses were verbal abuse from patients or their family members (39.24%) and verbal or physical threats by patients or their family members (35.09%). The mean PCL-C score of nurses who experienced traumatic events was 33.62 ± 11.37, with a positive rate of 26.04%. Results from the one-way analysis of variance and multiple linear regression analysis demonstrated that the working years, monthly income, and personal health status of emergency nurses were the main factors contributing to post-traumatic stress disorder. Conclusion: Emergency nurses are susceptible to severe traumatic stress following traumatic events, and effective interventions are necessary to address the diverse factors that contribute to their psychological well-being.

The application value of the Modified Early Warning Score combined with age and injury site scores in the evaluation of injuries in emergency trauma patients.

Objective: To explore the application value of the Modified Early Warning Score (MEWS) combined with age and injury site scores in predicting the criticality of emergency trauma patients. Methods: The traditional MEWS was modified by combining it with age and injury site scores to form a new MEWS combined scoring standard. The clinical data were collected from a total of 372 trauma patients from the emergency department of the Nantong First People's Hospital between June and December 2019. A retrospective analysis was conducted, and the patients were scored using the MEWS combined with age and injury site scores. The patients were grouped according to their prognoses and clinical outcomes. A statistical analysis was conducted based on the ranges of the combined scores, and the results of the combined scores of the different groups were compared. Results: Among the 372 patients, the average score was 3.68 ± 1.25 points in the survival group, 8.33 ± 2.24 points in the death within 24 h group, and 8.38 ± 1.51 points in the death within 30 days of hospitalization group, and the differences were statistically significant (p < 0.05). The average score was 2.74 ± 0.69 points in the outpatient treatment group, 4.19 ± 0.72 points in the emergency stay group, 5.40 ± 0.70 points in the specialist inpatient group, 8.71 ± 2.31 points in the ICU group, and 7.82 ± 1.66 points in the specialist unplanned transfer to ICU group, with the differences between the groups being statistically significant (p < 0.05). The average length of hospital stay for patients with a joint score within the range of 6-8 points was 10.86 ± 2.47 days, with a direct ICU admission rate of 22.00% and an unplanned ICU admission rate of 16.00%. Patients with a joint score >8 points had an average length of hospital stay of 27.05 ± 4.85 days, with a direct ICU admission rate of 66.67% and an unplanned ICU admission rate of 33.33%. Conclusion: Age and injury site are important high-risk indicators for trauma assessment, and using them in combination with the MEWS could improve the assessment of emergency patients with trauma, increasing the accuracy of pre-screening triage and reducing rescue time. Therefore, this joint scoring method might be worthy of clinical promotion and application.

Application of the Modified Basic Life Support Training Model in Improving Community Residents' Rescue Willingness in Nantong City in China.

Objective: This study explores the application and effect of the modified basic life support training in improving the first-aid level and rescue willingness of community residents in China. Methods: A total of 94 residents of a community in Nantong city were selected as the subjects by cluster sampling to receive the modified basic life support (BLS) training. The BLS knowledge, attitudes, and behaviors of all recruited subjects were evaluated by a questionnaire before and after training. A skill operation assessment was used to evaluate the effectiveness of the modified BLS training. Results: There were statistically significant differences in the BLS rescue willingness, theory, and skill scores before and after the training (P < 0.01). A total of 93.62% of the residents considered the modified BLS training model easier to learn and acceptable than the traditional model, and 92.55% of them thought the training content and teaching arrangement were reasonable. Conclusion: The modified BLS training model could improve the community residents' rescue willingness and skill mastery rates, enhance their first-aid skills and awareness, reduce the risk of disease transmission to a certain extent, and improve the success rate of prehospital first aid to ensure the safety of rescuers and patients.

Analysis of the Status Quo and Influencing Factors of Community Residents' Awareness of Basic Life Support and Willingness to Attempt Rescue.

OBJECTIVE: This study aimed to investigate community residents' awareness of basic life support (BLS) and their willingness to attempt rescue. METHODS: From October to December 2020, in the communities of Nantong City, a stratified three-stage random sampling method was adopted to select residents from 12 neighborhood committees over the age of 18 with whom to conduct a cross-sectional questionnaire survey. A self-designed questionnaire was adopted, the contents of which included the general situation of the respondent, knowledge, attitude, and behavior in relation to BLS; the Cronbach's α coefficient of the questionnaire was 0.719. RESULTS: A total of 3000 questionnaires were distributed, of which 2812 were valid, with a valid response rate of 93.73%. Of the 2812 respondents, 41.18% had seen an automatic external defibrillator (AED), 48.83% had experience of' cardiopulmonary resuscitation (CPR), and 25.07% of the respondents had experience of' AEDs. When an accident occurred, 50.50% of residents were willing to attempt rescue, 70.80% were willing to attempt rescue under professional guidance, and 71.23% were willing to attempt rescue after learning BLS techniques. Of the residents who were unwilling to attempt rescue, 32.75% were worried about their lack of ability, 27.91% were concerned about legal issues, 14.01% feared infectious diseases, and 10.35% were unwilling to perform mouth-to-mouth artificial respiration. Age, occupation, education level, and whether they had participated in first aid training were the influencing factors. CONCLUSION: Residents in Nantong have less knowledge of BLS, and their knowledge of CPR is better than that of AEDs. Residents have a strong willingness to learn BLS. Measures need to be taken to improve their understanding of BLS and their application skills. Residents have high levels of willingness to attempt rescue, but a certain percentage of residents have concerns. Interventions can be made to target the different reasons.

[Effects of Water Vapor Source and Local Evaporation on the Stable Hydrogen and Oxygen Isotopic Compositions of Precipitation].

Stable hydrogen and oxygen isotopic compositions in precipitation are good tracers and can provide unique information about the water cycle. Precipitation samples were collected at the Nanjing, Liyang, Yixing, and Dongshan sites in 2016, and the HDO and H218O compositions of precipitation were measured. The temporal variability of HDO and H218O compositions and deuterium-excess of precipitation were analyzed, and the influence of the water vapor source and local evaporation on stable isotopic composition of precipitation were discussed. The results indicated that:① Seasonal variations in the HDO composition, H218O composition, and deuterium-excess of precipitation occurred due to different water vapor sources during the summer and winter monsoon seasons. The HDO and H218O compositions were depleted during the summer monsoon season and enriched during the winter monsoon season. The deuterium-excess during the summer monsoon season was lower compared to the winter monsoon season. ② During the summer monsoon, the evaporation of Lake Taihu made the deuterium-excess of downwind precipitation and the downwind intercept of the local meteoric water line higher. During the winter monsoon season, local evaporation had little influence on HDO and H218O components in precipitation. ③ Both of the intercepts and slopes of the local meteoric water line were higher than those of the global meteoric water line, due to moisture recycling during the winter monsoon season and different water vapor sources between the summer and winter monsoon seasons.

[Experimental study on Shuigou (GV 26) of inhibiting effect for neuronal necrosis in rats: morphological evidence of the specificity of acupoint].

OBJECTIVE: To investigate the effect of acupoint Shuigou (GV 26) and non-acupoint on inhibiting the neuronal necrosis induced by the middle cerebral artery obstruction (MCAO) in rats through the morphological observation. METHODS: Forty two healthy adult male Wistar rats were randomly divided into a normal group, false-ope ration group, model control group, non-acupuncture group, Shuigou-acupuncture group and non-acupoint acupuncture group, 7 rats in each group. Besides the normal and false-operation groups, the experimental modal of MCAO was established in the other groups by using the Zea-Longa thread method. Acupoint Shuigou (GV 26) and non-acupoint (below the costal region) were selected respectively in the Shuigou-acupuncture group and non-acupoint acupuncture group for puncturing at 180 times/min for 5 seconds. Its effect was estimated by measuring the rate of the neuronal necrosis at the level of the light microscope and the degree of the neuronal necrosis at the level of the electron microscope. RESULTS: (1) At the level of the light microscope, comparing with the model control group (0.66 +/- 0.18), of the neuronal necrosis there were no significant differences in the rate of neuronal necrosis in the non-acupuncture group (0.67 +/- 0.34) and non-acupoint acupuncture group (0.59 +/- 0.11) (both P > 0.05), while it was significantly decreased in the Shuigou-acupuncture group (0.200 +/- 12) (P < 0.05). It indicates that no intervention and wrong (non-acupoint) intervention could light the damage of the neurons, however, only right intervention (Shuigou, GV 26) can obviously decrease the rate of the neuronal necrosis, showing with the specificity of acupoint. (2) At the level of the electron microscope, the ultrastructure of the involved neurons in the non-acupuncture group and non-acupoint acupuncture group is similar to that of the model control group, showing with the serious edema and structure damage. In contrast, the ultrastructure of the involved neurons in the Shuigou-acupuncture group is similar to that of the normal group and false-operation group, showing with light neuronal damage. CONCLUSION: Acupuncturing Shuigou (GV 26) could protect the involved neurons and inhibit the neuronal necrosis induced by the MCAO in rats, but acupuncturing the non-acupoint couldn't, which imply that there is the specificity of acupoint in the acupuncture.

[Effects of acupuncture at different acupoints on cerebral blood flow in cerebral ischemia model rats].

OBJECTIVE: To probe into effective methods for treatment of ischemic cerebral infarction and specificity of acupoints in the acupuncture treatment. METHODS: The rat model of middle cerebral artery occlusion (MCAO) was established with thread ligation according to Zea-Longa's method. They were divided into normal group, non-operation group, model control group, non-acupuncture group and acupuncture group, and the acupuncture group was divided into sham-acupuncture group and four Xingnao Kaiqiao groups (contain Shuigou group, Neiguan group, Chize group, Sanyinjiao group and Weizhong group). Then they were treated by acupuncture at "Shuigou" (GV 26), "Neiguan" (PC 6), "Chize" (LU 5), "Sanyinjiao" (SP 6), "Weizhong" (BL 40) and non-acupoints, 3 times/second, for 5 seconds. Cerebral blood blow (CBF) was used for assessment of the effect. RESULTS: As compared with the model control group, in the non-acupuncture group CBF did not significantly change (P>0.05); compared with the non-acupuncture group, after acupuncture CBF was significantly increased in the Shuigou group and the Neiguan groups (all P<0.05), but did not significantly increased in the Chize group, Sanyinjiao group and Weizhong group (all P>0.05). CONCLUSION: CBF has a tendency of spontaneous cure within 72 h after cerebral infarction in the MCAO rat; acupuncture can significantly improve CBF in the MCAO rat, so it is an effective method for treatment of ischemic stroke; among the acupoints in the "Xingnao Kaiqiao" needling method, "Shuigou" (GV 26) and "Neiguan" (PC 6) have obvious effect in improvement of CBF, indicating acupoint specificity of "Shuigou" (GV 26) and "Neiguan" (PC 6) in treatment of ischemic stroke.

[Study on optimum stimulation parameter for Shuigou (GV 26) in Xingnao Kaiqiao needling method].

OBJECTIVE: to investigate the influence of acupuncture parameter on acupuncture effect and to probe the optimum stimulation parameter for Shuigou (GV 26) in Xingnao Kaiqiao needling method. METHODS: The rat model of middle cerebral artery obstruction (MCAO) was replicated and "Shuigou" (GV 26) was stimulated by 9 acupuncture parameters combined by two factors at 3 levels, i. e. frequency 1, 2, 3 times/second, and needling duration 5 s, 60 s, 180 s. The effects of acupuncture at "Shuigou" (GV 26) with the 9 different acupuncture parameters on cerebral blood flow (CBF) in the MCAO rat were investigated by orthogonal test, factor analysis and one-way ANOVA. RESULTS: Acupuncture effect was influenced by acupuncture frequency, acupuncture duration and their combination. Among them, the acupuncture duration was the most important factor. The best acupuncture effect could be attained by using as long acupuncture duration as possibly with the fastest acupuncture frequency. CONCLUSION: In the Xingnao Kaiqiao needling method, acupuncture at "Shuigou" (GV 26) with fastest frequency and enough long duration can get the best acupuncture effect, which are the optimum stimulation parameters for "Shuigou" (GV 26).