Nursing workforce allocation in the intensive care units of COVID-19-designated hospitals: A nationwide cross-sectional survey in China.

AIM: To explore the nursing workforce allocation in intensive care units (ICUs) of COVID-19-designated hospitals during the epidemic peak in China. DESIGN: A nationwide cross-sectional online survey. METHODS: A total of 37 head nurses and 262 frontline nurses in 37 ICUs of COVID-19-designated tertiary hospitals located in 22 cities of China were surveyed. The self-reported human resource allocation questionnaire was used to assess the nursing workforce allocation. RESULTS: The average patient-to-nurse ratio was 1.89 ± 1.14, and the median working hours per shift was 5 h. The top four majors of front-line nurses in ICUs were respiratory (31.30%), lemology (27.86%), intensive care (21.76%) and emergency (17.18%). We also found that a smaller average patient-to-nurse ratio (odds ratio [OR]: 0.328, 95% CI: 0.108, 1.000), longer average weekly rest time per person (OR: 0.193, 95% CI: 0.051, 0.729) and larger proportion of 6-9 working years (OR: 0.002, 95% CI: 0.001, 1.121) decreased the occurrence of nursing adverse events.

Preparation and photocatalytic performance study of dual Z-scheme Bi2Zr2O7/g-C3N4/Ag3PO4 for removal of antibiotics by visible-light.

At present, the high re-combination rate of photogenerated carriers and the low redox capability of the photocatalyst are two factors that severely limit the improvement of photocatalytic performance. Herein, a dual Z-scheme photocatalyst bismuthzirconate/graphitic carbon nitride/silver phosphate (Bi2Zr2O7/g-C3N4/Ag3PO4 (BCA)) was synthesized using a co-precipitation method, and a dual Z-scheme heterojunction photocatalytic system was established to decrease the high re-combination rate of photogenerated carriers and consequently improve the photocatalytic performance. The re-combination of electron-hole pairs (e- and h+) in the valence band (VB) of g-C3N4 increases the redox potential of e- and h+, leading to significant improvements in the redox capability of the photocatalyst and the efficiency of e--h+ separation. As a photosensitizer, Ag3PO4 can enhance the visible light absorption capacity of the photocatalyst. The prepared photocatalyst showed strong stability, which was attributed to the efficient suppression of photo-corrosion of Ag3PO4 by transferring the e- to the VB of g-C3N4. Tetracycline was degraded efficiently by BCA-10% (the BCA with 10 wt.% of AgPO4) under visible light, and the degradation efficiency was up to 86.2%. This study experimentally suggested that the BCA photocatalyst has broad application prospects in removing antibiotic pollution.

Nurse scheduling in COVID-19-designated hospitals in China: A nationwide cross-sectional survey.

AIM: This study aimed to investigate scheduling in COVID-19-designated hospitals, including working hours, rest days, adverse nursing outcomes and their relationship. BACKGROUND: Hospitals are at the forefront of COVID-19 prevention and control, and nurses are the main force on the frontline of the epidemic. Nursing shift is one of the most relevant and pressing issues for frontline nurses. However, there is a lack of national, large-sample surveys on scheduling and adverse nursing outcomes in COVID-19-designated hospitals. METHODS: Using a cross-sectional online survey, we used nurse-reported data to measure the characteristics of the work setting, samples and work schedule. A descriptive analysis was performed to assess the shift status and adverse outcomes of designated hospitals and frontline nurses. Logistic regression analysis was performed to determine the association between them. RESULTS: Basic data were collected from 217 departments of 69 COVID-19-designated hospitals in 31 provinces in China. Nurses in the severe isolation ward worked mainly for 4 h per shift, whereas those in the fever clinic and observation ward worked mainly for 6-8 h. Half of the nurses had only 1 day of rest per week. Long working hours, lack of adequate rest time and overtime can seriously affect the quality and safety of nurses' work, resulting in adverse outcomes. Frontline nurses hope that scheduling guarantees the time to rest while ensuring fairness. CONCLUSIONS: The current evidence showed that frontline nurses were faced with long working hours, insufficient rest and overtime, which has a negative impact on nurse satisfaction, physical and mental health and quality of care. The government, hospitals and administrators still face many problems to overcome in their nursing schedules. IMPLICATIONS FOR NURSING MANAGEMENT: Governments and hospitals should take these factors, such as the work setting characteristics and demographic features of the frontline nurses, into account when selecting nurses to fight COVID-19. Nurses have different working hours in different types of coronavirus unit; therefore, nursing managers should consider the working environment and nursing schedule needs, and in the future, we should pay attention to the fairness of nurses while ensuring their rest.

Perspectives of nursing directors on emergency nurse deployment during the pandemic of COVID-19: A nationwide cross-sectional survey in mainland China.

AIMS: The aim of this study is to investigate the situation and perceptions of nursing directors about emergency nursing staff deployment in designated hospitals during the pandemic of COVID-19 in mainland China. BACKGROUND: The pandemic of COVID-19 has significantly depleted health care resources, leading to increased burden of nursing care and staffing and exacerbating the crisis in health care facilities. Currently, how to effectively plan and schedule nursing staffing in the pandemic still remains unknown. METHODS: From 14 July 2020 to 8 September 2020, 62 nursing directors of designated hospitals in mainland China were invited to participate in a cross-sectional online survey for their perceptions of nursing human-resource allocation during the pandemic of COVID-19. RESULTS: A total of 55 valid questionnaires were collected, showing that 96.36% of the hospitals had emergency nursing organizations and management systems during the pandemic, 96.36% had well-established scheduling principles for nursing human resources and 54.55% of hospitals had human-resource scheduling platforms. All the hospitals had trained emergency nursing staff in infection control (55, 100%), work process (51, 92.73%) and emergency skills (50, 90.91%). Most of the participants were satisfied with the nursing staffing deployments at their institutions (52, 94.55%). However, more than two thirds of them believed that their human-resource deployment plans need further improvements (39, 70.91%). CONCLUSIONS: Most of the designated hospitals investigated had established emergency nursing organizations, and management systems, and related regulations for the epidemic. However, the contents mentioned above still need to be further standardized. IMPLICATIONS FOR NURSING MANAGEMENT: The surge of patients in the epidemic was considerable challenge for the emergency capacity of hospitals. In the future, we should pay more attention to the following aspects: building emergency nursing staffing platforms, increasing emergency human-resource reserves, establishing reliable communication channels for emergency response teams, improving the rules and regulations of emergency human-resource management, offering more training and drills for emergency-related knowledge and skills and giving more focus on bio-psycho-social wellbeing of nurses.

High-efficiency tunable femtosecond solitons generation from 1.9 to 2.35 µm in a thulium-doped fiber amplifier via precise seed-pulse management.

We demonstrate the tunable Raman femtosecond solitons generation with a record-breaking power of 1.2 W at 2.3 µm and an ever-reported highest Raman soliton energy conversion efficiency of 99% via precise seed-pulse management in the thulium-doped single-mode fiber amplifier. We find that the central wavelength and the chirp of the incident pulses could dramatically affect the red-shifted soliton energy, locations, conversion efficiency, and the threshold power in fundamental Raman soliton generation. For the first time, we experimentally illustrated how the seed pulse with Kelly sidebands could affect the Raman solitons generation in this amplifier, and obtained the detailed regularity between the parameters of incident pulses and the properties of the generated solitons. This work provides useful guidance for Raman soliton-based high-power mid-infrared femtosecond laser fabrication.

Nursing allocation in isolation wards of COVID-19 designated hospitals: a nationwide study in China.

BACKGROUND: Appropriate allocation of nursing staff is key to ensuring efficient nursing in hospitals, and is significantly correlated with patient safety, nursing quality, and nurse job satisfaction. However, there are few studies on nursing workforce allocation in the isolation wards of COVID-19 designated hospitals globally. This study aims to better understand the nursing workforce allocation in the isolation wards of COVID-19 designated hospitals in China, and provide a theoretical basis for efficiently deploying first-line nurses in China and across the world in the future. METHODS: An online survey was conducted among the head nurses (n = 229) and nurses (n = 1378) in the isolation wards of 117 hospitals (selected by stratified sampling), using a self-reported human resource allocation questionnaire. RESULTS: The average bed-to-nurse ratios of different isolation wards were different (Z = 36.742, P = 0.000). The bed-to-nurse ratios of the ICU, suspected COVID-19 cases ward, and confirmed COVID-19 cases ward, were 1:1.88, 1:0.56, and 1:0.45, respectively. The nurse work hours per shift in different isolation wards were also different (Z = 8.468, P = 0.014), with the specific values of the ICU, suspected COVID-19 cases ward, and confirmed COVID-19 cases ward, being 5, 6, and 6 h, respectively. A correlation analysis showed that the average work hours per shift was proportional to the overtime work of nurses (rs = 0.146), the proportion of nurse practitioners was proportional to the overall utilization rate of nursing human resources in the wards (rs = 0.136), and the proportion of nurses with college degrees was proportional to teamwork (rs = 0.142). The proportion of nurses above grade 10 was inversely proportional to teamwork and psychological problems (rs = 0.135, rs = 0.203). The results of multiple stepwise regression analyses showed that the work hours of nurses per shift was the main factor affecting nurse satisfaction and that the proportion of nurses and the work hours of nurses per shift were both independent factors affecting the length of stay (LOS) of patients. CONCLUSION: Hospitals in China have made good nursing workforce allocations during the COVID-19 pandemic, but there are certain shortcomings. Therefore, scientific and efficient nursing workforce allocation practice plans should be established to improve the ability of hospitals to deal with public health emergencies and are urgent problems that need to be addressed soon.

High-sensitivity micro-strain sensing using a broadband wavelength-tunable thulium-doped all-fiber structured mode-locked laser.

We demonstrate a thulium-doped mode-locked fiber laser with ultra-broadband wavelength tunability for micro-strain sensing based on the multimode interference (MMI) effect in single-mode-multimode-single-mode (SMS) fiber configuration. The homemade SMS device with high performance is fusion spliced in the laser cavity, and the developed dispersion precisely managed the all-fiber structured mode-locked picosecond laser with a record-breaking wavelength tuning range from 1976 to 1916 nm while exerting axial strain on this SMS device. We experimentally explored the regularity between the strain and the central-wavelength shift of the mode-locked pulse, and for the first time to the best of the authors' knowledge, achieved the precise in-line axial strain measurement from 0 to 5385 µÉ› by using the tunable ultrafast-laser-based sensor, and sensitivity is up to -11.5 pm/µÉ›. With high compactness and durability, this sensor has advantages in real-time dynamic measurement over other passive devices, thus will undoubtedly find various application scenarios.

Effective mineralization of p-nitrophenol by catalytic ozonation using Ce-substituted La1‒xCexFeO3 catalyst.

In this study, cerium-doped lanthanum ferrite perovskite oxides (La1‒xCexFeO3) with different A-site were synthesized using a sol-gel method and they were used as ozonation catalyst for p-nitrophenol (PNP) mineralization for the first time. Catalytic activity in terms of total organic carbon (TOC) removal followed the order of La0.8Ce0.2FeO3 > La0.4Ce0.6FeO3 > La0.6Ce0.4FeO3 > La0.2Ce0.8FeO3 > LaFeO3 with 77, 66, 61, 60 and 56% respectively. The synthesized catalysts were characterized by diffraction of X-ray (XRD), Raman spectroscopy, Brunauer-Emmett-Teller (BET) and scanning electronic microscopy (SEM). Moreover, electron spin resonance (ESR) and radicals quenching experiments showed that the active oxygen species in the ozone decomposition process are mainly hydroxyl radical (·OH), and also include superoxide radical (O2-) and singlet oxygen (1O2). Furthermore, the superior activity of La0.8Ce0.2FeO3 could be attributed to the higher surface area, the richer lattice oxygen, richer surface -OH groups and the facilitated redox Ce3+/Ce4+ and Fe2+/Fe3+ cycling. In addition, this study provides an insight to use metal-doped perovskite catalysts for catalytic ozonation.

Strategies and criteria targeting the reform and development for the teaching resource of nursing undergraduate: A multi-center cross-sectional study.

ABSTRACT: Teaching resource of nursing students play an important role in improving clinical performance, while there is a little know and dearth of the access and development criteria or guidance of teaching resources for nursing undergraduates.To develop the admission and development criteria of education resources for nursing undergraduates, and to explore and determine its composition and connotation.A cross-sectional survey has been used.A total of 22 Chinese nursing schools and affiliated teaching bases (hospitals and community health centers).A total of 20 nursing experts were consulted to develop the questionnaire of admission and development criteria of teaching resource for nursing undergraduates in China, and then 285 valid experts from 22 Chinese nursing schools and affiliated teaching bases (hospitals and community health centers) conducted the questionnaire survey to evaluate experts' consensus rate and view on the composition and connotation of the developed criteria.There were 6 domains and 43 items included in the admission and development criteria of teaching resource for nursing undergraduates, which domains included educational budget and allocation of resources, infrastructure, clinical teaching bases, books and information services, educational experts, and educational exchanges. The experts' consensus rate was more than 90.2%.The standard is helpful to guide the future admission and development of teaching resource for nursing undergraduates, and favor the education quality improvement of nursing undergraduates.

Activation of peroxymonosulfate using metal-free in situ N-doped carbonized polypyrrole: A non-radical process.

Metal-free catalysts are widely considered as promising alternatives to traditional metal-based catalysts, which can effectively activate peroxymonosulfate (PMS). In this study, a novel metal-free catalyst, carbonized polypyrrole (CPPy) was synthesized through high-temperature carbonization of PPy, easily achieving the in situ N doping without the addition of nitrogen sources. Tetracycline (TC) was selected as the target contaminant to assess the catalytic activity of the CPPy/PMS system. Enhanced catalytic activity was observed in CPPy/PMS over a wide pH range (3.0-9.0), and the removal rate of TC by CPPy-3/PMS reached 91.3% after 10 min. After regenerating the used catalyst, the catalytic activity was refreshed, implying its stability and recyclability. The catalytic degradation of TC by CPPy/PMS was mainly attributed to a non-radical process. CPPy, as an intermediary, grabbed electrons from the electron-donating groups of TC and transferred them to the PMS molecule. Thereafter, TC that lost electrons was oxidized and degraded, and the O-O bonds of PMS were destroyed by the transferred electrons to form SO42- and OH-. Moreover, O⋅2- and 1O2 were involved in TC degradation. TC degradation pathway was investigated through HPLC-MS analysis. These findings provide a promising strategy for the construction of catalysts for PMS and environmental remediation.

Core Competencies Required for Gastroenterology Nursing Specialists in China.

Healthcare professionals responsible for patients with gastrointestinal diseases need a particular level of nursing knowledge and abilities to ensure excellent care. This study aims to propose a set of core competencies for the gastroenterology nursing specialists (GNS) in China. This research integrates quantitative and qualitative research methods. Literature review, semistructured interview, and the Delphi approach were used to develop the core competency items of GNS in China. SPSS 16.0 was used to analyze the data. Finally, 28 of 30 experts participated in the study resulting in a consensual list containing 7 domains (clinical nursing practice, communication and collaboration, education and counseling, critical thinking, leadership, ethical and legal practice, and professional development), 23 aspects, and 66 competencies required for GNS. The authority coefficient (Cr) of the consensus was 0.77, and the Kendall (W) value of each level of competencies all scored above 0.5. Results of the study can serve as a foundation of work performance evaluation for GNS as well as promote nurses' professional development.

Self-perceived Burden in the Young and Middle-aged Inpatients with Stroke: A Cross-sectional Survey.

PURPOSE: The aims of this study are to explore the prevalence and the features of self-perceived burden (SPB) in the young and middle-aged inpatients with stroke and to identify predictors of SPB. DESIGN: A cross-sectional survey. METHODS: One hundred fifty-five patients were recruited from the Neural Medical and Neural Comprehensive wards of a comprehensive hospital in Chengdu city from January to April 2013. Data consisted of survey interviews, medical records, and a series of questionnaires a week after the patients' hospitalization. Relevant statistical analyses were conducted using SPSS 16.0. FINDINGS: We found SPB was a prevalent experience among young and middle-aged inpatients with stroke. The exploratory analyses (independent samples t tests or one-way ANOVAs) indicated that significant influencing factors of SPB were marital status, self-care ability, caregivers' health, knowledge of the illness, and monthly income. Moreover, patients' SPB scores were positively and significantly correlated with anxiety and depression, but they were negatively and significantly associated with social support and quality of life. A multiple stepwise regression analysis revealed that social support score and knowledge of the illness significantly predicted SPB. CONCLUSIONS: The present study indicates that SPB is a prevalent inner feeling among young and middle-aged inpatients with stroke in China and that it is associated with an array of variables, including social support, quality of life, distressful mood, and several demographic characteristics. CLINICAL RELEVANCE: The findings of this study may help rehabilitation nurses plan and implement health education, effectively and efficiently use healthcare resources, so as to better care the young and middle-aged stroke patients as well as promote their rehabilitation.

Predictors for quality of life of bladder cancer patients with ileal conduit: A cross-sectional survey.

PURPOSE: To assess quality of life (QOL) and its influencing factors of bladder cancer patients after ileal conduit. METHODS: From January 2012 to December 2013, a cross-sectional survey with questionnaires was performed in West China hospital, in which the effect of patient characteristics on their QOL was evaluated, and then the correlation of stomal self-management, social support and QOL of the patients were also explored. RESULTS: A total of 188 patients were included. Poor sexual life satisfaction was common among responders. There was a positive correlation between QOL and social support as well as the stomal self-management (all p ≤ 0.002). Additionally, the patients who were female, aged less than 60, participated in work, family income more than 4000¥ per month, a longer postoperative period, and without any stomal complications (all p < 0.05) would have a better QOL. CONCLUSIONS: The overall QOL of the patients was good except the satisfaction with sexual life. The better the stomal self-management and social support, the better the QOL. Personalized nursing care and health guidance should be provided to the patients, so as to improve their QOL and promote their health.

Effects of intermedin on proliferation, apoptosis and the expression of OPG/RANKL/M-CSF in the MC3T3-E1 osteoblast cell line.

Bone remodeling is a vital physiological process of healthy bone tissue in humans. It is characterized by the formation of bone by osteoblasts and its resorption by osteoclasts, and the bone resorbed by osteoclasts is replaced through the differentiation and activity of osteoblasts. Imbalances in this vital process lead to pathological conditions, including osteoporosis. Intermedin (IMD) as a newly discovered peptide in the calcitonin (CT) family of peptides, which shares similar functions with CT, calcitonin gene­related peptide and amylin in bone resorption. However, the mechanism underlying its effect remains to be elucidated. This was investigated in the present study using the osteoblastic MC3T3­E1 cell line, which was treated with different doses of IMD (0, 1, 10 and 100 nM). Cell proliferation, apoptosis and the expression of receptor activator of NF­κB ligand (RANKL), osteoprotegerin (OPG) and macrophage colony­stimulating factor (M­CSF) were measured following treatment using multiple detection techniques, including an MTT assay, flow cytometry, reverse transcription­quantitative polymerase chain reaction and western blot analysis. The resulting data demonstrated that IMD significantly inhibited the apoptosis of MC3T3­E1 cells induced by serum­free culture and dexamethasone, however, no significant effects on MC3T3­E1 cell proliferation were observed. IMD had additional functions on the MC3T3­E1 cells, including inhibition of the expression of RANKL and M­CSF, and promotion of the expression of OPG. Previous studies have also demonstrated that RANKL and M­CSF are two vital factor produced by osteoblasts to promote the maturation and differentiation of osteoclasts, and it has been reported that IMD can inhibit the osteoclast formation stimulated by RANKL and M­CSF. Together with these findings, the present study concluded that IMD reduces bone resorption by inhibiting osteoblast apoptosis, decreasing the RANKL/OPG ratio and the expression of M-CSF, and inhibiting osteoclast maturation and differentiation.

Puerarin attenuates glucocorticoid-induced apoptosis of hFOB1.19 cells through the JNK- and Akt-mediated mitochondrial apoptotic pathways.

Puerarin is an active component of Pueraria lobata, which is a commonly used Chinese herbal medicine for the treatment of osteoporosis. The present study aimed to evaluate the osteoprotective effect of puerarin on glucocorticoid (GC)-induced apoptosis of osteoblasts in vitro. The effects of puerarin on dexamethasone (DEX)-induced cell apoptosis were assessed using enzyme-linked immunosorbent assay and a terminal deoxynucleotidyl transferase dUTP nick-end labeling assay, and found that the viability of hFOB1.19 cells was significantly increased following exposure to between 10(-6) and 10(-10) M puerarin, with a maximal anti-apoptotic effect at a concentration of 10(-8) M. In addition, compared with the control group, puerarin upregulated the transcription and protein levels of B-cell lymphoma-2 and downregulated B-cell-associated X protein in the hFOB1.19 cells. Puerarin attenuated the DEX-induced release of cytochrome c and cleavage of caspase-3, and treatment with puerarin inhibited the c-Jun N-terminal kinase (JNK) pathway and activated the phosphoinositide 3-kinase (PI3K)/Akt pathway in the hFOB1.19 cells. Furthermore, the Akt inhibitor, LY294002, partly eliminated the protective effect of puerarin on DEX-induced apoptosis, and puerarin combined with the JNK inhibitor, SP600125, suppressed DEX-induced apoptosis to a lesser extent than in the cells treated with SP600125 alone. These results suggested that the JNK and PI3K/Akt signaling pathways mediate the inhibitory effects of puerarin on apoptosis in the hFOB1.19 cells. In conclusion, puerarin prevented DEX-induced apoptosis of hFOB1.19 cells via inhibition of the JNK pathway and activation of the PI3K/Akt signaling pathway in the cells, dependent on the mitochondrial apoptotic pathway. These results support puerarin as a promising target in the treatment of GC-induced osteoporosis.