Background China is currently piloting a “Sharing Nurse” program that aims to increase the accessibility of nursing services to at-home patients by enabling patients to order nursing services using mobile apps or online platforms. Objective This study aims to assess nurses’ perceptions of the Sharing Nurse program, including their acceptance, concerns, needs, and willingness to take part in the program. Methods A total of 694 nurses participated in the questionnaire survey. The survey collected their sociodemographic and work-related information and their perceptions of the Sharing Nurse program using a self-developed questionnaire. Results The 694 respondents agreed that the Sharing Nurse program could provide patients with better access to nursing care (n=483, 69.6%). Their main concerns about the program were unclear liability division when medical disputes occur (n=637, 90.3%) and potential personal safety issues (n=604, 87%). They reported that insurance (n=611, 88%), permits from their affiliated hospital (n=562, 81.0%), clear instructions concerning rights and duties (n=580, 83.6%), real time positioning while delivering the service (n=567, 81.7%), and one-key alarm equipment (n=590, 85.0%) were necessary for better implementation of the program. More than half of the respondents (n=416, 60%) had an optimistic attitude toward the development of the Sharing Nurse program in China. However, only 19.4% (n=135) of the respondents expressed their willingness to be a “shared nurse.” Further analyses found that nurses with a master’s degree or above (χ23=28.835, P<.001) or from tertiary hospitals (χ23=18.669, P<.001) were more likely to be aware of the Sharing Nurse program and that male nurses were more willing to be shared nurses (Z=–2.275, P=.02). Conclusions The Chinese Sharing Nurse program is still in its infancy and many refinements are needed before it can be implemented nationwide. Generally, Chinese nurses are positive about the Sharing Nurse program and are willing to participate if the program is thoroughly regulated and supervised.

Background Due to the increasingly ageing society and the shortage of nursing human resources in China, the imbalance between the home care needs of older patients and the inadequate supply of nursing services is increasing. Based on this medical situation, China is implementing internet-based home care (with the nurses who provide this care called online nurses or sharing nurses) based on the concept of the sharing economy, internet technology and knowledge from the home care experience in other countries. Internet-based home care follows an online application/offline service model. Patients place orders through an app, nurses grab orders instantly, and managers dispatch orders through a web platform based on various factors such as nurses’ qualifications, professionalism and distance from the patient. In this way, home care is provided for patients with limited mobility, such as older or disabled patients, patients in rehabilitation and terminal patients. Only by fully understanding the barriers to accessing internet-based home care can we provide quality nursing services to older patients and achieve the sustainable development of internet-based home care. Objective The goal of this study was to use qualitative methods to explore barriers to accessing internet-based home care for older patients. Methods Based on Levesque’s access to health care framework, semi-structured personal interviews were conducted with 19 older patients in a descriptive qualitative study using directed content analysis. Results We identified four barriers to accessing internet-based home care for older patients: barriers to perceiving, seeking, paying for, and engaging in internet-based home care. Specific barriers included traditional perceptions, barriers to internet use, high payment costs, uneven quality of services, and concerns about privacy and patient safety. Conclusions Internet-based home care brings new risks and challenges. In order to enable older patients to better enjoy it, it is necessary to strengthen publicity, optimize the network application process, improve the health insurance system, formulate unified nursing service standards, and address safety risks.

A simple and accurate evaluation method of broken rock zone thickness (BRZT), which is usually used to describe the broken rock zone (BRZ), is meaningful, due to its ability to provide a reference for the roadway stability evaluation and support design. To create a relationship between various geological variables and the broken rock zone thickness (BRZT), the multiple linear regression (MLR), artificial neural network (ANN), Gaussian process (GP) and particle swarm optimization algorithm (PSO)-GP method were utilized, and the corresponding intelligence models were developed based on the database collected from various mines in China. Four variables including embedding depth (ED), drift span (DS), surrounding rock mass strength (RMS) and joint index (JI) were selected to train the intelligence model, while broken rock zone thickness (BRZT) is chosen as the output variable, and the k-fold cross-validation method was applied in the training process. After training, three validation metrics including variance account for (VAF), determination coefficient (R2) and root mean squared error (RMSE) were applied to describe the predictive performance of these developed models. After comparing performance based on a ranking method, the obtained results show that the PSO-GP model provides the best predictive performance in estimating broken rock zone thickness (BRZT). In addition, the sensitive effect of collected variables on broken rock zone thickness (BRZT) can be listed as JI, ED, DS and RMS, and JI was found to be the most sensitive factor.

Background The coronavirus disease 2019 (COVID-19) severely hindered the timely receipt of health care for patients with cancer, especially female patients. Depression and anxiety were more pronounced in female patients than their male counterparts with cancer during treatment wait-time intervals. Herein, investigating the impact of treatment delays on the survival outcomes of female patients with early-stage cancers can enhance the rational and precise clinical decisions of physicians. Methods We analyzed five types of cancers in women from the Surveillance, Epidemiology, and End Results (SEER) program between Jan 2010 and Dec 2015. Univariate and multivariate Cox regression analyses were used to determine the impacts of treatment delays on the overall survival (OS) and cancer-specific survival (CSS) of the patients. Results A total of 241,661 females with early-stage cancer were analyzed (12,617 cases of non-small cell lung cancer (NSCLC), 166,051 cases of infiltrating breast cancer, 31,096 cases of differentiated thyroid cancer, 23,550 cases of colorectal cancer, and 8347 cases of cervical cancer). Worse OS rates were observed in patients with treatment delays ≥ 3 months in stage I NSCLC (adjustedHazard ratio (HR) = 1.11, 95% Confidence Interval (CI): 1.01–1.23, p = 0.044) and stage I infiltrating breast cancer (adjustedHR = 1.23, 95% CI 1.11–1.37, p < 0.001). When the treatment delay intervals were analyzed as continuous variables, similar results were observed in patients with stage I NSCLC (adjustedHR = 1.04, 95% CI 1.01–1.06, p = 0.010) and in those with stage I breast cancer (adjustedHR = 1.03, 95% CI 1.00–1.06, p = 0.029). However, treatment delays did not reduce the OS of patients with differentiated thyroid cancer, cervical cancer, or colorectal cancer in the early-stage. Only intermediate treatment delays impaired the CSS of patients with cervical cancer in stage I (adjustedHR = 1.31, 95% CI 1.02–1.68, p = 0.032). Conclusion After adjusting for confounders, the prolonged time from diagnosis to the initiation of treatment (< 6 months) showed limited negative effects on the survival of most of the patients with early-stage female cancers. Whether our findings serve as evidence supporting the treatment deferral decisions of clinicians for patients with different cancers in resource-limited situations needs further validation.

The demand for tunnel construction continues to grow by leaps and bounds. Therefore, tunnel mechanization construction is receiving more and more attention for improving excavation ergonomics. To enhance the scientific and comprehensive evaluation results of tunnel drilling and blasting method excavation ergonomics, a set of evaluation methods of tunnel drilling and blasting method excavation ergonomics based on the game theory G2-EW-TOPSIS model is proposed. From the three dimensions of drilling efficiency, construction process duration, and synergistic influence factors, a tunnel drilling and blasting construction ergonomics evaluation index system consisting of 11 indicators such as perimeter hole drilling efficiency, drilling duration, construction quality, and comprehensive cost is constructed. The subjective and objective weights of evaluation indicators are calculated by using the improved sequential relationship analysis method (G2 method) and entropy weight method, respectively, and the combination weights are carried out by using game theory method (GTM) with the Nash equilibrium as the goal. The indices are classified into five grades: excellent (I), good (II), average (III), rather poor (IV), and poor (V), according to the daily tunnel construction. The excavation ergonomics index to be evaluated is calculated using the combined weights, and the comprehensive evaluation index of excavation ergonomics to be evaluated is calculated using the technique for order preference by similarity to an ideal solution (TOPSIS). The proposed rating model was used to analyze the excavation ergonomics of the Shangtianling Tunnel in the Chizhou–Huangshan High-Speed Railway using jumbo drills (JD) and drilling machines (DM) in large- and small-mileage construction, respectively, and to obtain the excavation ergonomics rating and comprehensive evaluation rating of each evaluation object. The research results show that the established excavation ergonomics evaluation model can effectively identify the main factors affecting the excavation ergonomics of the drill and blast method, and has a certain reference value.