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The traditional biomedical care approach has been unsatisfactory to meet the complex needs of seniors with long‐term multimorbidity and irreversible disability, particularly for those living in residential LTC facilities. This study aimed to develop and evaluate the effectiveness of an 8‐week biopsychosocial‐spiritual (BPS‐S) group intervention with the attempt to enhance quality of life (QoL) and meaning in life among senior residents with disability. This single‐blind randomized controlled trail was conducted in eight residential LTC facilities. The primary outcome, 'participants' overall and subdomain QoL', and the secondary outcome, 'meaning in life', were repeatedly assessed, including four time points: before, mid‐ and post‐intervention, and at a 1‐month follow‐up. A generalized linear mixed model (GLMM) was used to assess between‐group differences over time. The post‐intervention differences indicated significant higher improvement on senior residents' overall and all 4 domains of QoL, as well as their meaning in life, between the baseline and both times of post‐intervention and 1‐month follow‐up. On the other hand, participants' family QoL have improved immediately in the midst of intervention. This study provides preliminary evidence to support the feasibility and effectiveness of an 8‐week BPS‐S group therapy. We recommend the BPS‐S be integrated into routine institutional care activities to help maximize senior residents' own capacity for self‐healing, achieve a state of harmonious balance between body, mind, social and spiritual relationships; and in turn, enhance holistic health of this group. [ABSTRACT FROM AUTHOR]

Background: Despite the need to incorporate seniors from various settings into mindfulness-based empirical research, issues of geriatric frailties and non-compliance remain. This study aimed to evaluate the effects of a mindfulness-based elder care (MBEC) program on mental health and spiritual well-being among seniors with disabilities in long-term care residential settings. Methods: This single-blind, randomized controlled trial (RCT) randomly assigned seventy-seven participants into an MBEC group or control group of an eight-week MBEC program. Participants were assessed every four weeks at baseline (T0), mid-intervention (T1), post-intervention (T2) and follow-up (T3) using the Geriatric Depression Scale Short Form (GDS-SF), the State-Trait Anxiety Inventory (STAI) and the Spiritual Well-Being Scale (SWBS), respectively. Results: Linear mixed model (LMM) showed that MBEC participants' mental health improved significantly after completing the intervention; compared with controls, the MBEC group exhibited significantly lower anxiety (state-anxiety at T2; trait-anxiety at T2 and T3) and fewer depressive symptoms. Spiritual well-being was also significantly enhanced compared to that in the control group. Conclusions: MBEC has positive effects on both mental health and spiritual well-being outcomes among seniors with disabilities. In long-term care facilities, seniors with abilities have the potential to adhere to and engage in activities of a mindfulness-based intervention. This low risk, easily accessible, and effective 8-week program is recommended to be integrated into regular long-term care institutional routines. Trial registration: This study was registered with Clinical Trial Registry (ClinicalTrials.gov – U.S. National Library of Medicine #NCT05123261. Retrospectively registered on 07/04/2021.). The CONSORT 2010 guidelines were used in this study for properly reporting how the randomized trial was conducted. [ABSTRACT FROM AUTHOR]

Periodontal disease during pregnancy affects maternal oral health and increases the risk of adverse pregnancy outcomes. However, studies on the risk factors for periodontal disease and its impact on oral health-related quality of life in pregnant women in Taiwan are lacking. This present study aimed to identify the risk factors associated with periodontal disease during pregnancy and examine the relationship of periodontal disease with oral health-related quality of life among pregnant women. This study was conducted in a large medical centre in northern Taiwan. Eighty-four participants completed a periodontal examination by dentists as well as structured questionnaires, including the Oral Health Impact Profile-14, demographics, obstetric history, dietary habits, and oral hygiene behaviours. Multivariate logistic regression was used to determine the risk factors associated with periodontal disease and a t-test was used to compare the difference in oral health-related quality of life between pregnant women with and without periodontal disease. Fifty participants (59.5%) had periodontal diseases. Risk factors for periodontal disease included eating out for lunch, consuming beverages, brushing less than three times per day, and not receiving regular professional dental cleanings. The oral health-related quality of life was significantly poorer in pregnant women with periodontal disease than in those without. The risk factors for periodontal disease, including eating out for lunch, drinking beverages, brushing teeth less, and not regular dental cleaning, provide convincing evidence for pregnant women to maintain good oral hygiene to prevent periodontal disease and improve oral health-related quality of life. Pregnancy can cause poor mouth health. Expectant mothers with gum disease might face problems such as low birth weight and premature birth. This study found that certain factors can worsen gum disease during pregnancy. These include eating out for lunch, drinking sugary or acidic drinks, brushing their teeth less than three daily, and skipping regular teeth cleaning by a dentist. Pregnant women with gum disease also reported a lower quality of life related to oral health compared to those without it. Healthcare providers should educate pregnant women about oral health maintenance. Emphasize the importance of professional dental cleanings every three months, frequent tooth brushing, avoiding sugary and acidic drinks, and reducing eating out for lunch. Future research should explore additional ways to support pregnant women in this regard. [ABSTRACT FROM AUTHOR]

Aims and objectives: To compare the frequency of nurse‐provided spiritual care across diverse cultures. Background: Given an ethical imperative to respect patient spirituality and religiosity, nurses are increasingly taught and expected to provide spiritual care. Although nurses report positive attitudes toward spiritual care, they typically self‐report providing it infrequently. Evidence about the reported frequency of spiritual care is constrained by substantial variation in its measurement. Design: This cross‐sectional, descriptive study involved secondary analysis of data collected in multiple sites globally using one quantitative instrument. Methods: Data were collected from practicing nurses using the Nurse Spiritual Care Therapeutics Scale and analysed using descriptive statistics and a meta‐analysis procedure with random‐effect modelling. Datasets from 16 studies completed in Indonesia, Iran, Malaysia, Philippines, Portugal, Taiwan, Turkey and the United States contributed to a pooled sample (n = 4062). STROBE guidelines for cross‐sectional observational studies were observed. Results: Spiritual care varied between countries and within countries. It was slightly more frequent within Islamic cultures compared with predominantly Christian cultures. Likewise, frequency of spiritual care differed between nurses in palliative care, predominantly hospital/inpatient settings, and skilled nursing homes. Overall, "Remaining present..." was the most frequent therapeutic, whereas documenting spiritual care and making arrangements for the patient's clergy or a chaplain to visit were among the most infrequent therapeutics. Conclusions: In widely varying degrees of frequency, nurses around the world provide care that is cognisant of the spiritual and religious responses to living with health challenges. Future research should be designed to adjust for the multiple factors that may contribute to nurses providing spiritual care. Relevance to clinical practice: Findings offer a benchmark and begin to inform nurse leaders about what may be normative in practice. They also encourage nurses providing direct patient care that they are not alone and inform educators about what instruction future nurses require. [ABSTRACT FROM AUTHOR]

Background: Nursing competence refers to the core abilities that are required for fulfilling one's role as a nurse. A specific instrument comprehensively measuring competence among nursing students has not yet been developed. The purpose of the study was to develop and validate a nursing competence instrument for nursing students in bachelor training. Methods: A descriptive and explorative study design was used. Data were collected from students at one medical college in Taiwan in 2020 and 2021. A total of 241 nursing students participated in this study. We developed the initial instrument through systematic review, expert evaluations, and pilot versions. Its validity was then tested using confirmatory factor analysis (CFA) and criterion-related validity, while its reliability was tested using Cronbach's alpha and test–retest analysis. Results: The final fit indexes of CFA were as follows: chi-square = 860.1 (p < 0.01), normed chi-square = 2.24, SRMR = 0.04, RMSEA = 0.07, CFI = 0.94, and TLI = 0.94. Cronbach's alpha values for the subscales observed ranged from 0.91 to 0.98. The test–retest reliability coefficient for the Nurse Competence Scale was 0.515 (n = 30, p < 0.01). Conclusions: The instrument exhibited acceptable psychometric properties, thereby proving itself a valuable tool for evaluating nursing students' competence at bachelor training. Further assessments of its reliability, validity, and generality from mentors' and scholars' views in different contexts and cultures are recommended. [ABSTRACT FROM AUTHOR]

Aims: To identify key factors influencing institutional nurses' self‐perceived competencies in spiritual care. Background: In the past decade, interest in spiritual care has been increasing; however, in long‐term care facilities, limited knowledge is available about nurses' competencies in spiritual care. Methods: The cross‐sectional study was conducted with 202 nurses in 11 long‐term care facilities. Data were collected in a survey using the Spirituality and Spiritual Care Rating Scale, the Nurse Spiritual Care Therapeutics Scale, the Spiritual Care Competence Scale and demographic questions. Data were analysed using stepwise linear regression. Results: Study findings revealed that nurses' perceptions of spirituality and spiritual care, frequency of spiritual care provision and self‐satisfaction with the spiritual care given all significantly predicted overall spiritual care competence, which together explain 58% of the total variance. Conclusions: Improving nurses' perceptions of spirituality and spiritual care and encouraging the performance of spiritual care may be an effective pathway to enhance the spiritual care competence of institutional nurses. Implications for Nursing Management: Additional continuing education on spiritual care topics and the establishment of clear guidance and support from institutional administrators are required to enable nurses to deal with spiritual issues as they arise and improve the quality of holistic care. [ABSTRACT FROM AUTHOR]

Purpose.To determine whether unilateral pedicle screw fixation is comparable with unilateral pedicle screw and contralateral percutaneous transfacet screw fixation in single-level lumbar spinal fusion.Methods.Fifty-eight patients were divided into either unilateral (n = 32) or unilateral pedicle screw and contralateral percutaneous transfacet screw fixation (n = 26) instrumentation groups. The operating time, blood loss, length of hospital stay, clinical outcomes, total lumbar scoliotic changes, and fusion and complication rates were compared between the two groups.Results.There were no significant differences between the two groups in blood loss, length of hospital stay, clinical results, total lumbar scoliotic changes, and fusion and complication rates. There were significant differences in duration of operating time between 2 groups.Conclusions.Unilateral pedicle screw fixation may be as effective as unilateral PS with contralateral percutaneous transfacet screw fixation for the treatment of lumbar degenerative disorders. [ABSTRACT FROM AUTHOR]

User generated content on social media has attracted much attention from service/product providers, as it contains plenty of potential commercial opportunities. However, previous work mainly focuses on user consumption intention (CI) identification, and little effort has been spent to mine intention-related products. In this paper, focusing on the Baby & Child Care domain, we propose a novel approach to mine intention-related products on online question and answer (Q&A) community. Making use of the question-answering pairs as data source, we first automatically extract candidate products based on dependency parser. And then by means of the collocation extraction model, we identify the real intention-related products from the candidate set. The experimental results on our carefully constructed evaluation dataset show that our approach achieves better performance than two natural baseline methods. [ABSTRACT FROM AUTHOR]

Objectives: To examine adherence to relaxation guided imagery in women experiencing preterm labor as well as predictors influencing adherence. Methods: This study used a longitudinal follow-up approach. Each of the 57 participating women received a mini-MP3 player containing a 13-minute relaxation guided imagery audio program that they were instructed to follow daily until giving birth. Follow-up interviews were conducted weekly. A generalized estimating equation was used to predict adherence. Results: The total adherence rate was 58%. Higher adherence was predicted by the presence of at least a college degree ( p=0.006), greater perceived stress ( p=0.006), a higher risk of preterm delivery ( p<0.001), and greater relaxation effects ( p=0.028). Older maternal age was associated with lower adherence ( p=0.001). In addition, adherence decreased significantly over time ( p<0.001). Adherence was not related to marital status, employment, parity, the baseline level of anxiety, or hospitalization. Conclusions: Pregnant women with a high risk for preterm birth and greater perceived stress showed higher adherence to relaxation guided imagery. For women with a lower adherence to relaxation guided imagery, health care professionals may consider individual preferences regarding relaxation techniques. [ABSTRACT FROM AUTHOR]

This article provides the first empirical evidence by employing an endogenous switching regression model to investigate whether the adoption of inflation targeting (IT) alters the relationships between inflation and inequality as well as between openness and inequality. Using a large panel of countries over the 1980-2010 period, we find that policies aiming at stabilizing prices and opening to trade will benefit more from the reduction of income inequality, and the inequality-reducing effects are more pronounced in the IT countries. As a by-product, we find that the inverted-U relationship between inequality and development, that is, the Kuznets' hypothesis, holds only in the Non-IT countries, not in the IT economies. The findings are unlikely to be driven by the presence of outliers, the use of estimators and the assumptions of errors distribution. [ABSTRACT FROM AUTHOR]

The aim of this study was to test a causal model of the predictors of agitation among 405 nursing home residents in Taiwan with varying degrees of cognitive impairment. Chart review and behavioral observations were used to assess residents' physical and psychosocial condition. The final version of the model had a good fit. Cognitive function and depression had direct effects on agitation, and pain and functional ability had indirect effects on agitation via depression. Additionally, cognitive function and pain influenced functional ability directly, which in turn influenced depression and ultimately influenced agitation. The results suggest that effective management of agitation in demented residents requires identifying the needs underlying the behavior rather than directly treating the behavior itself. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

In this paper, the L-integral analysis for two nano-sized voids in plane elasticity under uniaxial loading is present. Three surface parameters are considered including the surface tension and two surface Lamé constants. Attention is focused on the mutual influence on the L-integral from both the surface effect at voids' rims and the interacting effect between voids. A close-form expression of L-integral for multiple nano voids is obtained. Comparing with those in macro fracture mechanics, the L-integral shows some different features when the surface effect is taken into account. It is concluded that under tensile loading and due to the mutual influence, the L-integral might be either positive or negative, depending on the loading level. The numerical results show that the surface tension is the dominant one in surface parameters on impacting the L-integral. It is also concluded that the surface effect shields the energy release (positive L-integral value) while enhances the energy absorption (negative L-integral value). The two-state L-integral analysis is performed to clarify the way that the surface effect impacts the L-integral. It is concluded that the contribution to L-integral from the voids' configuration could either be negative or positive, while that from the surface effect is always negative. Besides, the size dependence in the present problem is studied in detail. [ABSTRACT FROM AUTHOR]

This paper provides an explanation for the authors' recent conclusions as why the M-integral could be negative for a nano-void (hole) in elastic materials under tensile, bi-axes tensile, and bi-axes tensile-compress loadings (Hui T, Chen YH, in ASME J Appl Mech 77:021019-1-9, ; 024505-1-5, ). Attention is focused on whether the area of the nano-void under each of four different kinds of loading is contractive when compared to the original geometrical area without loading. The four kinds of loading are as follows: (1) simple tensile loading; (2) bi-axes tensile loading; (3) bi-axes tensile-compression loading; and (4) purely shear loading. It is concluded that, unlike those for a macro/micro hole, the area of the nano-void under relatively lower amplitude of the loadings (1) and (2) is always smaller than the original area of the same void before loading. This reduction in the nano-void area is induced from the surface effect including the surface tension and the surface Lamé constants along the nano-void rim. Thus, these two kinds of loading can either decrease or increase the nano-void area depending on the amplitude of the loading. Under a relatively lower tensile loading, the area contraction occurs but not always corresponding to the negative value of the M-integral, whereas under a relatively higher tensile loading, the area expansion occurs but not always corresponding to the positive value of the M-integral. This again verifies that the positive value of the M-integral does not always correspond to the energy release due to the nano-hole expansion, rather, the area contraction might yield the energy release either. Under bi-axes tensile compression or purely shear loading, this feature disappears. [ABSTRACT FROM AUTHOR]

Treatment of pancreatic cancer by inhibiting the aberrant activation of the survival signaling pathways has received considerable attention. We investigated the probable action of DHA on the suppression of cell proliferation in human pancreatic ductal adenocarcinoma (PDAC) cells. Our results demonstrated that DHA dose-dependently inhibited cell proliferation through an induction of cell cycle arrest in human PDAC cells. DHA suppressed the expression of phosphorylated-Rb (p-Rb), cyclin D1, cyclin E, cyclin A, E2F1 and c-Myc proteins. Blocking the activation of STAT3 signaling pathway led to an inactivation of CAMKII and increased phosphorylation of c-Myc (T58) protein accompanied with decreased expression of c-Myc protein. Treatment of DHA effectively inhibited cell survival through decreased phosphorylation levels of EGFR, STAT3 and CAMKII proteins. The mechanisms of action were associated with increased phosphorylation levels of c-Myc (T58) and instability of c-Myc proteins. DHA inhibited cell survival through an increased GSSG/GSH ratio and oxidative stress level in HPAF-II cells. DHA induced cell apoptosis through increased expression of Bax, c-caspase 3 and c-PARP proteins in HPAF-II cells. Moreover, treatment of DHA significantly inhibited nucleotide synthesis. In conclusion, DHA might significantly suppress the proliferation of PDAC cells and therefore have potential as an anti-cancer therapeutic agent. [ABSTRACT FROM AUTHOR]

This paper presents an investigation on the approach of the crack tip energy release rate (ERR) for a semi-permeable crack full with air/vacuum or Silicon oil when the electromechanical loads become very large. Numerical results for a central semi-permeable crack, respectively, in seven kinds of piezoelectric ceramics are compared with those for a central impermeable crack when the mechanical loads vary from 50 to 100 MPa and the electric loads are fixed to be 1 MV/m, 0, and -1 MV/m, respectively, within the range of practical interest. It is verified that McMeeking’s statement (2004): ‘as the electromechanical loads become very large, the crack tip ERR approaches the values associated with an impermeable crack’ is actually valid under very large mechanical and positive electric loads. However, under very large mechanical and negative electric loads, the approach is quite different showing large discrepancies between the calculated values for the semi-permeable crack and those for an impermeable crack in all seven kinds of piezoelectric ceramics. This means that his statement is not valid when the electric loads are negative even though the mechanical loads still remain very large although, mathematically, McMeeking’s statement is correct if McMeeking’s statement: “very large” is replaced by “infinitely large”. Moreover, under purely mechanical loads his statement is uncertain, depending on which kind of piezoelectric ceramic is used. It is concluded that, generally speaking, the crack tip ERR for a semi-permeable crack does not approach the values associated with an impermeable crack, depending on the direction of the electric loads with respect to the poling axis. Physically, this is because of the inherent piezoelectric effect that yields the surface charges distributed on the crack surfaces for a semi-permeable crack under the mechanical loads, whereas on the surfaces of an impermeable crack the unphysical charge-free condition leads to incorrect estimations: the applied mechanical loads do not yield any surface charges on the crack surfaces. The influence of the permittivity of medium inside the semi-permeable crack gap on McMeeking’s statement is discussed too. It is found that Silicon oil yields larger discrepancies than air from those for an impermeable crack. [ABSTRACT FROM AUTHOR]

By considering an isotropic elastic dielectric material as a transversely isotropic piezoelectric material with little piezoelectricity, the interface crack problem in elastic/piezoelectric bimaterials is treated in this paper based on Stroh's complex potential theory (1958) with the impermeable crack model. In order to obtain universal results, Numerical results of the near tip stress field and the electric field for 35 kinds of dissimilar bimaterials constructed by five kinds of elastic dielectric materials, namely Epoxy, Polymer, Al2O3, SiC and Si3N4, and seven kinds of piezoelectric ceramics, namely PZT-4, BaTiO3, PZT-5H, PZT-6B, PZT-7A, P-7, and PZT-PIC151, are presented. It is concluded that all the combinations lead to the same results: in which the first crack tip singularity parameter e does not vanish whereas the second parameter ? always vanishes. From the physical point of view, an interface crack in such a dissimilar material shows a similar oscillating singularity as that in dissimilar elastic bimaterials. Moreover, by using a maximization value technique, the regular inverse square root singularityr-1/2 of the stress and the electric field at the crack tip can be realized, although, theoretically, an interface crack in such bimaterials possesses the well-known oscillating singularityr-1/2± ie. Of great significance is that, in the absence of mechanical loadings, a purely electric loading can induce relative large model I or II stress intensity factor for a interface crack in some elastic/piezoelectric bimaterials, which implies that the electric-induced failure may be realized in such bimaterials. [ABSTRACT FROM AUTHOR]

general solution is derived for the plane problem of multiple microcracks near the tip in process zone of a semi-infinite macrocrack in an anisotropic elastic solid. The pseudo-traction method, addressed thoroughly in isotropic cases, is extended to anisotropic cases. A system of Fredholm integral equations, with difficulty in evaluation of the singular integrals, is solved by invoking the asymptotic behavior of the pseudo-tractions on the macrocrack faces. The interaction effect of the release of residual stresses due to near-tip microcracking is then evaluated. The J-integral analysis is also performed to give a consistency check of the solution and some useful conclusions. [ABSTRACT FROM AUTHOR]

In this study, indium gallium zinc oxide (InGaZnO [IGZO]) active layer capped with an ultrathin p‐type stannous oxide (SnO) is demonstrated to be a thin film transistor (TFT) for color scanning and photosensing device applications. Typically, the sole IGZO‐based TFT is blind to visible light and hard to be developed for visible light sensing. The combination of IGZO and SnO layers can extend the light detection spectrum into visible light wavelengths and ameliorate the photosensing characteristics. The optical responsivity and signal to noise ratio can even be enhanced from 1.05 × 10−2 to 398.02 A W−1 and from 2.1 × 101 to 6.8 × 105 with at least four orders of magnitude, respectively. With the detailed material analysis and physical model discussed, it suggests that the large amount of additional light‐excited carrier generated in the capping layer is the key factor for the significant improvement. Furthermore, the phenomenon of persistent photoconductivity can be effectively suppressed by its natural recombination under the heterojunction structure without applying charge‐pumping method. The electrical uniformity of the sensor device is also highly potential for the next‐generation displays integrating the photosensing functions. An ultrathin p‐type stannous oxide with suitable bandgap, high stability, good process compatibility, and uniformity is proposed to be the light‐absorbing layer, that improves the optical responsivity and signal to noise ratio of an amorphous indium gallium zinc oxide based sensor thin film transistor by at least four orders of magnitude. Besides, the persistent photoconductivity effect can also be suppressed by its heterojunction structure. [ABSTRACT FROM AUTHOR]