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The Revised International Staging System (R-ISS) stratifies patients affected by Multiple Myeloma (MM) into three distinct risk groups R-ISS I [ISS Stage I, Standard-Risk cytogenetics and normal Lactase DeHydrogenase (LDH)], R-ISS III (ISS stage III and either high-risk cytogenetics or high LDH) and R-ISS II (any other characteristics). With the aim to verify whether the three R-ISS groups could be divided into subgroups with different prognostic factors based on the detection of Circulating Plasma Cells (CPCs) at diagnosis, in this retrospective analysis, we evaluated 161 patients with MM treated at our centre between 2005 and 2017. In all, 57 patients (33·9%) were staged as R-ISS III, 98 (58·3%) as R-ISS II and six (3·6%) as R-ISS I. CPCs were detected in 125 patients (74·4%), while in 43 patients (25·6%) no CPCs were seen. Our analysis revealed that Overall Survival (OS) and progression-free survival (PFS) rates in R-ISS II patients were higher in the subgroup without CPCs compared to the subgroup with ≥1 CPCs (OS 44·7% vs. Cevidoplenib 16·3%, P = 0·0089; PFS 27·8% vs. 8·1%, P = 0·0118). Our present findings suggest that the detection of CPCs at diagnosis may be used as a further prognostic biomarker to improve the risk stratification of patients with MM staged as R-ISS II.This article describes an experience providing nursing care to a patient under hemodialysis with the end-stage renal disease who had developed depression, loathing, and other, negative personal perceptions and gradually gave up on life goals due to hopelessness. The duration of nursing care, from August 23rd through August 29th, 2019, was revisited to identify the patient`s hopelessness in the dimensions of physiology, mental status, society, and spirituality. The author applied Swanson`s Caring Theory to facilitate the process of “knowing” and “being with” while performing direct nursing care and attentive listening to assist the patient to become more open-minded and to express personal perceptions toward the disease with the goal of further engaging the patient to increase self-awareness recognition, sense of loss, and negative perceptions. Through “doing for” and “enabling,” the author reinforced infection control and identified the symptoms of fluid-overload, moisture, and salinity to raise the patient`s self-awareness and self-caring techniques and to lower the risk of hospitalization. Meanwhile, by “maintaining the patient`s belief,” accompanied by the encouragement and attention from family members and providing linkages to patient-support communities, the patient was guided to identify and aggregate to foster positive thinking and self-worth to increase acceptance of living with the disease. Nursing personnel may apply Swanson`s Caring Theory to better consider the patient`s perspective, provide individual caring schemes, and strengthen the recognition, self-caring techniques and supportive systems of patients, increasing patient perceptions of self-worth, restoring their confidence, promoting their adaption to their disease, and improving attentiveness.Cases in the current novel coronavirus (COVID-19) pandemic continue to increase, bringing tremendous psychological pressures to frontline caregivers and threating the ability of existing medical care systems in many countries to cope with related demands. In this situation, nursing leaders have a heightened responsibility to assist nursing staff to remain at their jobs and feel secure, to strengthen safety systems, to provide adequate equipment and personnel training, and to proactively lead nursing staff. In this article, leadership strategies implemented under the COVID-19 pandemic are presented from the perspective of transformational leadership in nursing practice. This article is divided into the following five themes 1. Leadership makes the vision more vivid; 2. Demonstrating charismatic leadership; 3. Leaders who stimulate intellectual potential; 4. Paying attention to spiritual inspiration; 5. Providing individualized sincere care. Leaders should promote the professional role of nursing staff and provide a safe and secure practice environment.The Cochrane risk of bias (RoB) tool is used widely in systematic review studies and evidence-based healthcare. However, how this tool is used and how domains and signaling questions are interpreted may vary significantly across studies. This article was written to illustrate the limitations of the Risk of Bias tool version 1, which have been addressed in the new version of this tool, Risk of Bias version 2 (RoB 2). In addition to introducing the five domains (including risk of bias due to the randomization process, deviations from the intended interventions, missing outcome data, measurement of the outcome, and selection of reported results) and the assessment of overall bias risk, the procedure of using the RoB 2 tool to assess randomized controlled trials when conducting a systematic review study and evidence-based practice is also introduced. The structure of pre-, during-, and post-assessment is used in this article to describe clearly the procedure of bias assessment. An overall introduction to the relevant resources related to RoB 2 (such as guidance, software, and websites) is also addressed, to further enhance the familiarity with RoB 2 of nursing staffs and systematic review researchers and to increase their ability to use this tool effectively.

Medical management protocols prioritize the safety of patients during emergency resuscitation situations. According to a medical center in Taiwan statistics gathered in 2017, the unnecessary activation of resuscitation teams by new nurses because of their improper assessment of patient conditions was a significant cause of anxiety in patient relatives and source of complaints directed at the medical center. In June 2018, 18.7% of the emergency resuscitation calls in the emergency department (ED) were false alarms or absent treatment incidents. After investigation, lack of clearly stated resuscitation team member responsibilities and insufficient practical training for new nurses were primary factors associated with the high rate of false alarm/absent treatment incidents in the ED.

To decrease the rate of absent treatment by nurses during resuscitation from 18.7% to 0% in the ED.

The assignments of emergency team members were revised, a new “Emergency app” was introduced, the assignment schedule of the emergency resuscitation team was distributed, SIM realistic education training was held, stronger team work was promoted, and a standard assignment review schedule was established and regularly monitored.