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Open AccessArticle
Weed Infestation and Health of the Soybean Crop Depending on Cropping System and Tillage System
Agriculture 2020, 10(6), 208; https://doi.org/10.3390/agriculture10060208 (registering DOI) - 07 Jun 2020
Abstract
This study evaluated weed infestation and health of the soybean crop grown in crop rotation (CR) and monoculture (CM) under conventional tillage (CT) and no-tillage (NT) conditions. The research proved that growing soybean in monoculture and under no-tillage conditions increases weed infestation and [...] Read more.
This study evaluated weed infestation and health of the soybean crop grown in crop rotation (CR) and monoculture (CM) under conventional tillage (CT) and no-tillage (NT) conditions. The research proved that growing soybean in monoculture and under no-tillage conditions increases weed infestation and infection of soybean with fungal diseases. In these treatments, increased numbers of most of the dominant species were also found. A significantly higher percentage of monocotyledonous species and a much lower percentage of dicotyledonous ones in total weed dry weight were shown in the CR treatment relative to CM and in the NT system compared to CT. The biodiversity of the weed community was similar in monoculture and crop rotation, and slightly greater in the NT system in comparison with CT conditions. In both tillage systems, Amaranthus retroflexus was the weed species that most infested the soybean crop. In soybean grown after itself, Amaranthus retroflexus was the weed that occurred in the greatest numbers, while, in crop rotation, this was Echinochloa crus-galli. In all years of the study, soybean was infected with Septoria glycines to the highest degree, which was followed by Cercospora sojina, whereas infection with Ascochyta sp. was the lowest. Weather conditions in individual years of the study were proven to affect weed infestation and infection of soybean with fungal diseases. The study results prove that cropping systems and tillage systems significantly affect weed infestation and health of the soybean crop. Full article
(This article belongs to the Special Issue Weed Ecology and New Approaches for Management)
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Open AccessArticle
Quantitative Phosphoproteomics Reveals Cell Alignment and Mitochondrial Length Change under Cyclic Stretching in Lung Cells
Int. J. Mol. Sci. 2020, 21(11), 4074; https://doi.org/10.3390/ijms21114074 (registering DOI) - 07 Jun 2020
Abstract
Lung cancer is a leading cause of death. Most previous studies have been based on traditional cell-culturing methods. However, lung cells are periodically subjected to mechanical forces during breathing. Understanding the mechanisms underlying the cyclic stretching induced in lung cells may be important [...] Read more.
Lung cancer is a leading cause of death. Most previous studies have been based on traditional cell-culturing methods. However, lung cells are periodically subjected to mechanical forces during breathing. Understanding the mechanisms underlying the cyclic stretching induced in lung cells may be important for lung cancer therapy. Here, we applied cyclic stretching to stimulate the continual contraction that is present under physiological conditions in lung cells. We first uncovered the stretching-induced phosphoproteome in lung cancer cell line A549 and fibroblast cell line IMR-90. We identified 2048 and 2604 phosphosites corresponding to 837 and 1008 phosphoproteins in A549 and IMR-90, respectively. Furthermore, we combined our phosphoproteomics and public gene expression data to identify the biological functions in response to cyclic stretching. Interestingly, cytoskeletal and mitochondrial reorganization were enriched. We further used cell imaging analysis to validate the profiling results and found that this physical force changed cell alignment and mitochondrial length. This study not only reveals the molecular mechanism of cyclic stretching but also provides evidence that cell stretching causes cellular rearrangement and mitochondrial length change. Full article
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Open AccessArticle
Will China Achieve Its Ambitious Goal?—Forecasting the CO2 Emission Intensity of China towards 2030
Energies 2020, 13(11), 2924; https://doi.org/10.3390/en13112924 (registering DOI) - 07 Jun 2020
Abstract
China has set out an ambitious target of emission abatement; that is, a 60–65% reduction in CO2 emission intensity by 2030 compared with the 2005 baseline level and emission peak realisation. This paper aimed to forecast whether China can fulfil the reduction [...] Read more.
China has set out an ambitious target of emission abatement; that is, a 60–65% reduction in CO2 emission intensity by 2030 compared with the 2005 baseline level and emission peak realisation. This paper aimed to forecast whether China can fulfil the reduction target of CO2 emission intensity and peak by 2030 based on the historical time series data from 1990 to 2018. Four different forecasting techniques were used to improve the accuracy of the forecasting results: the autoregressive integrated moving average (ARIMA) model and three grey system-based models, including the traditional grey model (1,1), the discrete grey model (DGM) and the rolling DGM. The behaviours of these techniques were compared and validated in the forecasting comparisons. The forecasting performance of the four forecasting models was good considering the minimum mean absolute percentage error (MAPE), demonstrating MAPE values lower than 2%. ARIMA showed the best forecasting performance over the historical period with a MAPE value of 0.60%. The forecasting results of ARIMA indicate that China would not achieve sufficient reductions despite its projected emission peak of 96.3 hundred million tons by 2021. That is, the CO2 emission intensity of China will be reduced by 57.65% in 2030 compared with the 2005 levels. This reduction is lower than the government goal of 60–65%. This paper presents pragmatic recommendations for effective emission intensity reduction to ensure the achievements of the claimed policy goals. Full article
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Open AccessArticle
Mechanical Properties of DO3 Based on First Principles
Crystals 2020, 10(6), 488; https://doi.org/10.3390/cryst10060488 (registering DOI) - 07 Jun 2020
Abstract
The elastic constants, ideal strength, band structure and electronic density state of Fe3Si (DO3) under triaxial tension and triaxial compression were studied using the first principle. The structural parameters calculated at zero pressure are consistent with the experimental results. The dependence [...] Read more.
The elastic constants, ideal strength, band structure and electronic density state of Fe3Si (DO3) under triaxial tension and triaxial compression were studied using the first principle. The structural parameters calculated at zero pressure are consistent with the experimental results. The dependence of elastic constant and strain can be obtained using static finite strain technique. The ideal triaxial tensile and compressive strength of DO3 were studied by calculating the stress–strain relationship. The micro mechanism that affects the stability of the structure was analyzed using the results of electronic structure calculation. The results showed that the compressive strength of DO3 structure is higher than the tensile strength. When the stress of cell structure exceeds a limit, the covalent bond of Fe–Si is destroyed, resulting in the sudden decrease of G and E and the abnormal change of electronic density of state. Full article
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Open AccessEditorial
Predicting Acute Kidney Injury after Cardiac Surgery by Machine Learning Approaches
J. Clin. Med. 2020, 9(6), 1767; https://doi.org/10.3390/jcm9061767 (registering DOI) - 07 Jun 2020
Abstract
Cardiac surgery-associated AKI (CSA-AKI) is common after cardiac surgery and has an adverse impact on short- and long-term mortality. Early identification of patients at high risk of CSA-AKI by applying risk prediction models allows clinicians to closely monitor these patients and initiate effective [...] Read more.
Cardiac surgery-associated AKI (CSA-AKI) is common after cardiac surgery and has an adverse impact on short- and long-term mortality. Early identification of patients at high risk of CSA-AKI by applying risk prediction models allows clinicians to closely monitor these patients and initiate effective preventive and therapeutic approaches to lessen the incidence of AKI. Several risk prediction models and risk assessment scores have been developed for CSA-AKI. However, the definition of AKI and the variables utilized in these risk scores differ, making general utility complex. Recently, the utility of artificial intelligence coupled with machine learning, has generated much interest and many studies in clinical medicine, including CSA-AKI. In this article, we discussed the evolution of models established by machine learning approaches to predict CSA-AKI. Full article
(This article belongs to the Section Nephrology & Urology)
Open AccessEditorial
Engineering-Aided Inventive Surgery
Appl. Sci. 2020, 10(11), 3957; https://doi.org/10.3390/app10113957 (registering DOI) - 07 Jun 2020
Abstract
This Editorial presents a new Special Issue dedicated to some old and new interdisciplinary areas of cooperation between engineering and surgery. The first two sections offer some food for thought, in terms of a brief introductory and general review of the past, present, [...] Read more.
This Editorial presents a new Special Issue dedicated to some old and new interdisciplinary areas of cooperation between engineering and surgery. The first two sections offer some food for thought, in terms of a brief introductory and general review of the past, present, future and visionary perspectives of the synergy between engineering and surgery. The last section presents a very short and reasoned review of the contributions that have been included in the present Special Issue. Given the vastness of the topic that this Special Issue deals with, we hope that our effort may have offered a stimulus, albeit small, to the development of cooperation between engineering and surgery. Full article
(This article belongs to the Special Issue Engineering for Surgery)
Open AccessArticle
A Blockchain-Based Framework for Green Logistics in Supply Chains
Sustainability 2020, 12(11), 4656; https://doi.org/10.3390/su12114656 (registering DOI) - 07 Jun 2020
Abstract
The logistics industry around the world has proliferated over recent years as a large number of business organizations have come to recognize the importance of logistics. Cost control used to be emphasized to remain competitive, but recently green logistics has gained attention with [...] Read more.
The logistics industry around the world has proliferated over recent years as a large number of business organizations have come to recognize the importance of logistics. Cost control used to be emphasized to remain competitive, but recently green logistics has gained attention with the awareness of the integration of economy and society as a whole. Nowadays, green logistics is a useful concept to improve the sustainability of logistics operations, and its related policies and theoretical research have been investigated and explored. However, the practical applications of green logistics are impeded by real-time data sharing, which is common in the logistics industry. Blockchain technology is adopted to address this challenge and enable data sharing among related stakeholders. This paper presents a reference framework for green logistics based on blockchain to reach the sustainable operations of logistics, with the integration of the Internet of Things and big data. Finally, potential benefits and limitations are analyzed when implementing this framework. Full article
(This article belongs to the Special Issue Intelligent Transportation and Green Logistics with Big Data)
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Open AccessArticle
Influence of Nitrogen Content and Bias Voltage on Residual Stress and the Tribological and Mechanical Properties of CrAlN Films
Coatings 2020, 10(6), 546; https://doi.org/10.3390/coatings10060546 (registering DOI) - 07 Jun 2020
Abstract
This study deposited CrAlN coatings from Al50Cr50 targets using high-power impulse magnetron sputtering, with a focus on the effects of nitrogen content and substrate bias voltage on the deposition rate, microstructure, crystal orientation, residual stress, and mechanical properties of the [...] Read more.
This study deposited CrAlN coatings from Al50Cr50 targets using high-power impulse magnetron sputtering, with a focus on the effects of nitrogen content and substrate bias voltage on the deposition rate, microstructure, crystal orientation, residual stress, and mechanical properties of the coating. The nitrogen content was adjusted by varying the N2/Ar flow ratio between 20% and 140%. Increasing the nitrogen flow rate during deposition led to corresponding decreases in the deposition rate and film thickness. X-ray diffractometer (XRD) analysis revealed that a low N2/Ar flow ratio (<40%) resulted in amorphous CrAlN, whereas a higher ratio (>40%) resulted in an face-centered cubic (FCC) phase. Bias voltage also had considerable influence on the residual stress and grain size. A refined grain structure and high internal stress resulted in hard CrAlN coatings. Among the various parameter combinations evaluated in this study, the highest hardness (35.4 GPa) and highest elastic modulus (426 GPa) were obtained using an N2/Ar flow ratio of 100% and a bias voltage of −120 V. Full article
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Open AccessArticle
Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults
Int. J. Environ. Res. Public Health 2020, 17(11), 4065; https://doi.org/10.3390/ijerph17114065 (registering DOI) - 07 Jun 2020
Abstract
The novel coronavirus (COVID-19) has enforced dramatic changes to daily living including economic and health impacts. Evidence for the impact of these changes on our physical and mental health and health behaviors is limited. We examined the associations between psychological distress and changes [...] Read more.
The novel coronavirus (COVID-19) has enforced dramatic changes to daily living including economic and health impacts. Evidence for the impact of these changes on our physical and mental health and health behaviors is limited. We examined the associations between psychological distress and changes in selected health behaviors since the onset of COVID-19 in Australia. An online survey was distributed in April 2020 and included measures of depression, anxiety, stress, physical activity, sleep, alcohol intake and cigarette smoking. The survey was completed by 1491 adults (mean age 50.5 ± 14.9 years, 67% female). Negative change was reported for physical activity (48.9%), sleep (40.7%), alcohol (26.6%) and smoking (6.9%) since the onset of the COVID-19 pandemic. Significantly higher scores in one or more psychological distress states were found for females, and those not in a relationship, in the lowest income category, aged 18–45 years, or with a chronic illness. Negative changes in physical activity, sleep, smoking and alcohol intake were associated with higher depression, anxiety and stress symptoms. Health-promotion strategies directed at adopting or maintaining positive health-related behaviors should be utilized to address increases in psychological distress during the pandemic. Ongoing evaluation of the impact of lifestyle changes associated with the pandemic is needed. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle
Anionic Copolymerization of Styrene Sulfide with Elemental Sulfur (S8)
Materials 2020, 13(11), 2597; https://doi.org/10.3390/ma13112597 (registering DOI) - 07 Jun 2020
Abstract
The superior ability of thiiranes (episulfides) to undergo ring-opening polymerization (ROP) in the presence of anionic initiators allows the preparation of chemically stable polysulfide homopolymers. Incorporation of elemental sulfur (S8) by copolymerization below the floor temperature of S8 permits the [...] Read more.
The superior ability of thiiranes (episulfides) to undergo ring-opening polymerization (ROP) in the presence of anionic initiators allows the preparation of chemically stable polysulfide homopolymers. Incorporation of elemental sulfur (S8) by copolymerization below the floor temperature of S8 permits the placement of a large quantity of sulfur atoms in the polysulfide mainchain. The utility of styrene sulfide (2-phenylthiirane; StS) for copolymerization with elemental sulfur is reported here. A few polysulfides differing depending on the initial ratio of S8 to StS and copolymerization time were synthesized. Various spectroscopic methods (1H NMR, 13C NMR, Raman spectroscopy and FTIR spectroscopy) were applied to characterize the chemical structure of the copolymers. Additionally, the phase structure and thermal stability of the synthesized polysulfides were investigated using DSC and TGA, respectively. The successful anionic copolymerization of styrene sulfide and elemental sulfur has been demonstrated. Full article
(This article belongs to the Special Issue Current Problems of the Organic Chemistry of Sulfur and Selenium)
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Open AccessArticle
The Role of Eco-Friendly Edible Insect Restaurants in the Field of Sustainable Tourism
Int. J. Environ. Res. Public Health 2020, 17(11), 4064; https://doi.org/10.3390/ijerph17114064 (registering DOI) - 07 Jun 2020
Abstract
The purpose of this study is to apply the concept of a green image in order to explore how to form behavioral intentions in the context of eco-friendly edible insect restaurants. This study analyzed 444 samples collected in South Korea in order to [...] Read more.
The purpose of this study is to apply the concept of a green image in order to explore how to form behavioral intentions in the context of eco-friendly edible insect restaurants. This study analyzed 444 samples collected in South Korea in order to evaluate the theoretical model including 12 hypotheses. The data analysis results showed that a green image has a positive influence on attitude. In addition, attitude helps to increase desire, which in turn positively affects two sub-dimensions of behavioral intentions, such as intentions to use and word-of-mouth intentions. Full article
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Open AccessArticle
Diversity, Chemical Constituents and Biological Activities of Endophytic Fungi Isolated from Schinus terebinthifolius Raddi
Microorganisms 2020, 8(6), 859; https://doi.org/10.3390/microorganisms8060859 (registering DOI) - 07 Jun 2020
Abstract
Schinus terebinthifolius Raddi is a medicinal plant widely used for the treatment of various diseases. The secondary metabolites responsible for the pharmacological properties can be produced directly by the plant or by endophytic fungi. The objective of this study was to evaluate the [...] Read more.
Schinus terebinthifolius Raddi is a medicinal plant widely used for the treatment of various diseases. The secondary metabolites responsible for the pharmacological properties can be produced directly by the plant or by endophytic fungi. The objective of this study was to evaluate the diversity of endophytic fungi of different parts of S. terebinthifolius and to identify chemical compounds produced by endophytes and their antioxidant and antibacterial activities. For this, fruits, stem bark and roots were dried, ground and placed in fungal growth medium. The selected endophytes were grown and subjected to extraction with ethyl acetate. DPPH, FRAP, β-carotene bleaching and antimicrobial assays were performed. The phylogenetic tree was elaborated, encompassing 15 different species. The fungal extracts showed hydroxybenzoic acids and 1-dodecanol as predominant compounds. All fungal extracts exhibited antioxidant activity. The fungal extracts exhibited bactericidal and bacteriostatic activities against Gram-positive and Gram-negative bacterial ATCC strains and against methicillin-resistant nosocomial bacteria. Among the 10 endophytic fungi evaluated, the extract of the fungus Ochrocladosporium elatum showed higher phenolic content and exhibited higher antioxidant and antibacterial activities in all tests. Together, the results increase the known diversity of S. terebinthifolius endophytic fungi, secondary metabolites produced and their antioxidant and antibacterial activities. Full article
(This article belongs to the Special Issue Recent Advances in Applied Microbiology)
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Open AccessArticle
Time-Adaptive Statistical Test for Random Number Generators
Entropy 2020, 22(6), 630; https://doi.org/10.3390/e22060630 (registering DOI) - 07 Jun 2020
Abstract
The problem of constructing effective statistical tests for random number generators (RNG) is considered. Currently, there are hundreds of RNG statistical tests that are often combined into so-called batteries, each containing from a dozen to more than one hundred tests. When a battery [...] Read more.
The problem of constructing effective statistical tests for random number generators (RNG) is considered. Currently, there are hundreds of RNG statistical tests that are often combined into so-called batteries, each containing from a dozen to more than one hundred tests. When a battery test is used, it is applied to a sequence generated by the RNG, and the calculation time is determined by the length of the sequence and the number of tests. Generally speaking, the longer is the sequence, the smaller are the deviations from randomness that can be found by a specific test. Thus, when a battery is applied, on the one hand, the “better” are the tests in the battery, the more chances there are to reject a “bad” RNG. On the other hand, the larger is the battery, the less time it can spend on each test and, therefore, the shorter is the test sequence. In turn, this reduces the ability to find small deviations from randomness. To reduce this trade-off, we propose an adaptive way to use batteries (and other sets) of tests, which requires less time but, in a certain sense, preserves the power of the original battery. We call this method time-adaptive battery of tests. The suggested method is based on the theorem which describes asymptotic properties of the so-called p-values of tests. Namely, the theorem claims that, if the RNG can be modeled by a stationary ergodic source, the value l o g π ( x 1 x 2 . . . x n ) / n goes to 1 h when n grows, where x 1 x 2 . . . is the sequence, π ( ) is the p-value of the most powerful test, and h is the limit Shannon entropy of the source. Full article
(This article belongs to the Special Issue Information Theory, Forecasting, and Hypothesis Testing)
Open AccessCase Report
A Case Study of Soil Moisture and Infiltration after an Urban Fire
Fire 2020, 3(2), 22; https://doi.org/10.3390/fire3020022 (registering DOI) - 07 Jun 2020
Abstract
There is an increased risk of future fire disturbances due to climate change and anthropogenic activity. These disturbances can impact soil moisture content and infiltration, which are important antecedent conditions for predicting rainfall–runoff processes in semi-arid regions. Yet these conditions are not well [...] Read more.
There is an increased risk of future fire disturbances due to climate change and anthropogenic activity. These disturbances can impact soil moisture content and infiltration, which are important antecedent conditions for predicting rainfall–runoff processes in semi-arid regions. Yet these conditions are not well documented. This case study provides critical field measurements and information, which are needed to improve our understanding of mechanisms such as precipitation and temperature that lead to the variability of soil properties and processes in urban and burned landscapes. In June 2018, a fire burned a portion of the riparian zone in Alvarado Creek, an urban tributary of the San Diego River in California, United States. This fire provided an opportunity to observe soil moisture content and infiltration for one year after the fire. Three transects (one burned and two unburned) were monitored periodically to evaluate the complex spatial and temporal dynamics of soil moisture and infiltration patterns. Average dry season soil moisture content was less than five percent volume water content (%VWC) for all transects, and the burned transect exhibited the lowest %VWC during the wet season. Infiltration rates displayed a high degree of spatial and temporal variability. However, the location with the highest burn severity had the lowest average infiltration rate. The observed differences between the burned and unburned transects indicate that the fire altered hydrologic processes of the landscape and reduced the ability of the soil to retain water during the wet season. This research provides the first high-resolution soil moisture and infiltration field analysis of an urban fire-disturbed stream in southern California and a method to characterize post-fire hydrologic conditions for rainfall–runoff processes. Full article
Open AccessArticle
In the Name of Family Medicine: A Nationwide Survey of Registered Names of Family Medicine Clinics in Taiwan
Int. J. Environ. Res. Public Health 2020, 17(11), 4062; https://doi.org/10.3390/ijerph17114062 (registering DOI) - 07 Jun 2020
Abstract
Family medicine is officially a specialty, but is often not regarded as a specialty by the general public. Past studies have usually investigated the opinions of medical students and resident physicians regarding family medicine, whereas few have focused on practicing family physicians themselves, [...] Read more.
Family medicine is officially a specialty, but is often not regarded as a specialty by the general public. Past studies have usually investigated the opinions of medical students and resident physicians regarding family medicine, whereas few have focused on practicing family physicians themselves, especially in terms of analyzing how they represent themselves. This study aimed to investigate the patterns of clinic names to better apprehend whether general practitioners see themselves as being on an equal footing with other medical specialists. The registered names, medical specialties, and levels of urbanization of all clinics of Western medicine in Taiwan were collected. For clinics of each specialty, we examined whether their names contained the corresponding specialty designation. For example, a family medicine clinic was checked to determine whether its name contained the term “family medicine” or its abbreviation. The naming of family medicine clinics was then compared with that of clinics with other specialties. Of the 9867 Western medicine clinics included in this study, two-thirds (n = 6592) were single-specialty clinics. In contrast to the high percentages of single-specialty clinics of other specialties with specialty-containing names (97.5% for ophthalmology, 94.8% for dermatology, and 94.7% for otolaryngology), only 13.3% (132/989) of the family medicine clinics had such names. In addition, the urban family medicine clinics had a higher proportion (15.2%, 74/487) of specialty-containing names than the suburban (12.6%, 44/349) and rural family medicine clinics (9.2%, 14/153). Overall, a low percentage of family medicine clinics in Taiwan included “family medicine” in their names. This issue of professional identity deserves further qualitative investigation. Full article
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Open AccessArticle
Flavonoids from Mulberry Leaves Alleviate Lipid Dysmetabolism in High Fat Diet-Fed Mice: Involvement of Gut Microbiota
Microorganisms 2020, 8(6), 860; https://doi.org/10.3390/microorganisms8060860 (registering DOI) - 07 Jun 2020
Abstract
Here, we investigated the roles and mechanisms of flavonoids from mulberry leaves (FML) on lipid metabolism in high fat diet (HFD)-fed mice. ICR mice were fed either a control diet (Con) or HFD with or without FML (240 mg/kg/day) by oral gavage for [...] Read more.
Here, we investigated the roles and mechanisms of flavonoids from mulberry leaves (FML) on lipid metabolism in high fat diet (HFD)-fed mice. ICR mice were fed either a control diet (Con) or HFD with or without FML (240 mg/kg/day) by oral gavage for six weeks. FML administration improved lipid accumulation, alleviated liver steatosis and the whitening of brown adipose tissue, and improved gut microbiota composition in HFD-fed mice. Microbiota transplantation from FML-treated mice alleviated HFD-induced lipid metabolic disorders. Moreover, FML administration restored the production of acetic acid in HFD-fed mice. Correlation analysis identified a significant correlation between the relative abundances of Bacteroidetes and the production of acetic acid, and between the production of acetic acid and the weight of selected adipose tissues. Overall, our results demonstrated that in HFD-fed mice, the lipid metabolism improvement induced by FML administration might be mediated by gut microbiota, especially Bacteroidetes-triggered acetic acid production. Full article
(This article belongs to the Special Issue Gut Microbiota: Its Role in Diabetes and Obesity)
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Open AccessArticle
Effectiveness of an Evidence-Based Practice Educational Intervention among School Nurses
Int. J. Environ. Res. Public Health 2020, 17(11), 4063; https://doi.org/10.3390/ijerph17114063 (registering DOI) - 07 Jun 2020
Abstract
The evidence-based practice (EBP) approach to high-quality care is designed to improve patient outcomes. However, little research has been conducted to determine how EBP is adopted and implemented among school nurses in Taiwan. This study evaluated an EBP training program implemented among school [...] Read more.
The evidence-based practice (EBP) approach to high-quality care is designed to improve patient outcomes. However, little research has been conducted to determine how EBP is adopted and implemented among school nurses in Taiwan. This study evaluated an EBP training program implemented among school nurses in Taiwan to determine whether and how effectively it improved their knowledge levels, attitudes, skills, and self-efficacy. A pretest-posttest research design was employed. Participants were recruited via convenience sampling from among 193 primary schools throughout Tao-Yuan and New Taipei City in Taiwan. The EBP program implemented both mobile learning technology and the flipped classroom format. The learning outcomes were evaluated before, immediately after, and at a 3-month follow-up. In this regard, the data were collected using the School Nurse Evidence-Based Practice Questionnaire. The results showed that the participant scores for the items of knowledge and self-efficacy significantly increased over the study period. Somewhat differently, scores for the skill items significantly increased from the pre-test to the immediate post-test, but significantly decreased from the immediate post-test to the final follow-up. Overall, however, the EBP program led to marked improvements in knowledge, skills, and self-efficacy. These findings can help guide the development of a creative evidence-based school nursing curriculum. Full article

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