Evidence based practice competence of future traditional Chinese medicine nurses: A cross-sectional online study.

BACKGROUND: Previous studies demonstrated the low evidence-based practice competence of nurses in traditional Chinese medicine hospitals. University education may enhance nursing students' evidence-based practice competence. Few studies have investigated traditional Chinese Nursing Bachelor students' evidence-based practice competence. OBJECTIVES: To investigate the evidence-based practice competence of traditional Chinese Nursing Bachelor students across all grades and their influencing factors. DESIGN: A cross-sectional online study. SETTINGS: A traditional Chinese medicine university offering an evidence-based nursing curriculum in Beijing, China. PARTICIPANTS: A total of 601 traditional Chinese Nursing Bachelor students were recruited, with a response rate of 70.05%. The junior and senior groups consisted of first- and second-year students, and third- and fourth-year students, respectively. METHODS: An online survey was conducted in 2019 using a self-administered questionnaire encompassing attitude, knowledge, and skill. A t-test, non-parametric test, and correlation analysis were used for data analysis. RESULTS: Evidence-based practice attitude mean scores were the highest in both groups (3.87 ± 0.48 junior; 3.97 ± 0.45 senior), followed by skill (3.33 ± 0.46 junior; 3.48 ± 0.46 senior) and knowledge (3.21 ± 0.55 junior; 3.52 ± 0.47 senior). In the senior group, attitude decreased (from 4.02 to 3.86). The two groups reported the same items with the lowest scores in all three dimensions. The influencing factors were 1) scientific research experience (Z = -2.87) and a medical literature retrieval course (t = -3.40) for the junior group, 2) completion of the evidence-based nursing course (Z = -2.59) for the senior group, and 3) student admission level (Zjunior = -2.55, Zsenior = -3.85) and English language proficiency (chi-squarejunior = 2.80, chi-squaresenior = 16.37) for both groups. CONCLUSIONS: Deficiencies in evidence implementation and decreasing evidence-based practice attitudes among fourth-year students warrant attention. Evidence-based nursing courses could be optimised, and research and English activities enriched to improve evidence-based practice competence.

Graft copolymer nanoparticles with pH and reduction dual-induced disassemblable property for enhanced intracellular curcumin release.

Nanoparticle (NP)-assisted drug delivery systems with disassemblable behaviors in response to intracellular microenvironment are urgently demanded in systemic cancer chemotherapy for enhanced intracellular drug release. Curcumin (CUR), an effective and safe anticancer agent, was limited by its water insolubility and poor bioavailability. Herein, pH and reduction dual-induced disassemblable NPs for high loading efficiency and improved intracellular release of CUR were developed based on an acid degradable cyclic benzylidene acetal groups (CBAs)-functionalized poly(2,4,6-trimethoxybenzylidene-1,1,1-tris(hydroxymethyl)ethane methacrylate)-g-SS-poly(ethylene glycol) (PTTMA-g-SS-PEG) graft copolymer, which was readily prepared via RAFT copolymerization and coupling reaction. The NPs self-assembled from PTTMA-g-SS-PEG copolymers were stable at physiological pH, and quickly disassembled in mildly acidic and reductive environments because of the hydrolysis of CBAs in hydrophobic PTTMA core and the cleavage of disulfide-linked detachable PEG shell. PTTMA-g-SS-PEG NPs exhibited excellent CUR loading capacity with drug loading content up to 19.2% and entrapment efficiency of 96.0%. Within 20 h in vitro, less than 15.0% of CUR was released from the CUR-loaded NPs in normal physiological conditions, whereas 94.3% was released in the presence of reductive agent and mildly acidic conditions analogous to the microenvironment in endosome/lysosome and cytoplasm. Confocal fluorescence microscopies revealed that the CUR-loaded PTTMA-g-SS-PEG NPs exhibited more efficiently intracellular CUR release for EC-109 cells than that of CUR-loaded reduction-unresponsive PTTMA-g-PEG NPs and free CUR. In vitro cytotoxicity studies displayed blank PTTMA-g-SS-PEG NPs showed low toxicity at concentrations up to 1.0 mg/mL, whereas CUR-loaded PTTMA-g-SS-PEG NPs demonstrated more efficient growth inhibition toward EC-109 and HepG-2 cells than reduction-unresponsive controls and free CUR. Therefore, the above results indicated that pH and reduction dual-induced disassemblable PTTMA-g-SS-PEG NPs may have emerged as superior nanocarriers for active loading and promoted intracellular drug delivery in systemic cancer chemotherapy.