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Symptoms and medication use in patients with Parkinson's disease (PD) affect the quality of life of patients and caregivers, yet prior research seldom focused on their experiences with medications. This study explored comprehensive living and medication experience from patients with PD and their caregivers. Patients diagnosed with PD for ≥2 years, with or without their caregivers, were recruited from an outpatient clinic in Taiwan. Semi-structured in-depth interviews were conducted based on the Common Sense Model. A qualitative content analysis was used to identify salient themes from verbatim transcripts. In total, 15 patients and eight caregivers were interviewed. Five themes were derived: (1) symptoms and help-seeking behaviours before a diagnosis, (2) emotional impacts and life adaptations after a PD diagnosis, (3) life affected by medications, (4) experiences of caregivers in taking care of PD patients, and (5) communication between doctors and patients. Patients frequently adjusted their daily schedules to live with PD and the medication side effects. Caregivers struggle to overcome caring burdens and to stay positive to support patients. More attention on providing medication information, mental support, and communication between stakeholders is needed to improve the quality of life of patients and caregivers. [ABSTRACT FROM AUTHOR]

Training medical students to speak up when they witness a potential error is an important competency for patient safety, but details regarding the barriers that prevent medical students from effectively communicating are lacking. Therefore, this study aimed at exploring the factors affecting medical students' willingness to speak up for patient safety when a medical error was observed. This is a cross-sectional study at a medical university in Taiwan, and 151 medical students in clinical clerkship completed a survey including demographic characteristics, conflict of interests/social relationship, personal capability, and personality and characteristics of senior staff domains. Data were analyzed using t-test. Three of five items in the conflict of interests/social relationship domain showed statistically significant importance, including 'I am afraid of being punished' (Mean difference, MD = 0.37; p < 0.01), 'I do not want to break unspoken rules' (MD = 0.55; p < 0.01), and 'I do not want to have bad team relationship' (MD = 0.58; p < 0.01). Two items (perception of knowledge/understanding and communication skills) in the personal capability domain were significantly important to speaking up. Six of 10 items in personality and characteristics of senior staff domain were rated significantly important in deciding to speak up. The top three factors of them were senior personnel with 'Grumpy' personality (MD = 1.20; p < 0.01), 'hierarchy gap' (MD = 1.12; p < 0.01), and senior personnel with 'Stubborn' personality (MD = 1.06; p < 0.01). Our findings demonstrated medical students' perspectives on barriers to speaking up in the event of medical error. Some factors related to characteristics of senior staff could compromise medical students' ability to speak up in the event of medical error. These results might be important for medical educators in designing personalized educational activities related to medical students' ability to speak up for patient safety. [ABSTRACT FROM AUTHOR]

A pair of new enantiomeric trinorsesquiterpenes, (+)-genpenterpene A (1a) and (-)-genpenterpene A (1b), together with seven known compounds (2–8), were isolated from the aerial parts of Justicia gendarussa Burm.f.. All of these known compounds were isolated from this plant for the first time. Racemic genpenterpene A was separated by chiral HPLC column. Their chemical structures were elucidated based on extensive spectroscopic analysis, single crystal X-ray diffraction, and ECD calculations. (+)-genpenterpene A (1a) exhibited potent inhibitory effect against nitric oxide production in lipopolysaccharide-activated RAW 264.7 mouse macrophage cells with an IC50 value of 9.54 ± 1.02 μM. [ABSTRACT FROM AUTHOR]

Muscles serve as a critical regulator of locomotion and damping, resulting in changes of soft tissue vibration. However, whether muscle fibre compositions of different individuals will cause different extents of soft tissue vibration during gait is unclear. Therefore, this study investigated the differences in lower extremity vibration frequencies among power-trained and non-power-trained athletes during walking and running. Twelve weightlifting athletes were assigned to the power-trained group and twelve recreational runners were assigned to the non-power-trained group. Accelerometers were used to detect soft tissue compartment vibration frequencies of the rectus femoris (RF) and gastrocnemius medialis (GMS) during walking and running. Results indicated that power-trained athletes, as compared to the non-power-trained, induced significantly (p < 0.05) higher vibration frequencies in their soft tissue compartments during walking and running. This suggests that power-trained athletes, who have higher ratios of fatigable fast-twitch muscle fibres, may have induced higher soft tissue compartment vibration frequencies. As a result, there is a likelihood that power-trained athletes may recruit more fatigable fast-twitch muscle fibres during muscle tuning, causing dysfunctions during prolonged exercises. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to identify determinants within the International Classification of Functioning, Disability and Health as a conceptual framework regarding the quality of life of older long-term care facility residents. Methods: A questionnaire-based cross-sectional design was conducted. All participants (n = 210) completed a questionnaire that included the Sheltered Care Environmental Scale, the Beck Depression Inventory, the Short Physical Performance Battery, the Mini-Mental State Examination, the World Health Organization Disability Assessment Schedule, and the World Health Organization Quality of Life Scale. The outcome was assessed using mixed-design multiple regression with a covariance model and hierarchical regression. Results: Personal factors, environmental factors, body function and structures, and activity and participation explained 35.9%, 18.5%, 25.2%, and 52.1% of the variability in quality of life, respectively. The hierarchical model included 10 variables and explained 84.3% of the total variability in quality of life. Conclusions: Activity and participation showed high explanatory power for the quality of life of older long-term care facility residents. The influence of activity and participation in the older population is an important issue, although these factors remain relatively unexplored. This exploratory study used the International Classification of Functioning, Disability and Health as a conceptual framework to provide a more sophisticated understanding of quality of life. Although the viewpoint of quality of life involves many more factors than an understanding of an individual disease or disability condition, activity and participation were found to be the most important factors. Simple clinical measures, such as activity limitations and participation restrictions, can be used as clinical markers of quality of life, thus enabling rehabilitation professionals to determine the quality of life of older people in institutions. The conceptual framework of determinants of quality of life that this study reports may be helpful for rehabilitation professionals to explore with patients to implement interventions. [ABSTRACT FROM AUTHOR]

Background: There is currently no information about the prevalence of, and factors contributing to psychological distress experienced by re-education through labour camp detainees in China. Methods: A cross-sectional face-to-face survey was conducted in three labour camps in Guangxi, China. The questionnaire covered socio-demographic characteristics; sexually transmissible infections (STIs); drug use; psychological distress (K-10); and health service usage and access inside the labour camps. K-10 scores were categorised as ≤30 (low to moderate distress) and >30 or more (highly distressed). Univariate and multivariate logistic regression models identified factors independently associated with high K-10 scores for men and women separately. Results: In total, 755 detainees, 576 (76%) men and 179 (24%) women, participated in the health survey. The study found 11.6% men versus 11.2% women detainees experienced high psychological distress, but no significant gender differences were observed (p> 0.05). Multivariate logistic regression showed that multiple physical health problems were significantly associated with high psychological distress among men. Conclusion: Drug treatment and forensic mental health services need to be established in detention centres in China to treat more than 10% of detainees with drug use and mental health disorders. [ABSTRACT FROM AUTHOR]

Background: There are few published studies addressing multiple substance uses and their effects on subsequent cessation of betel quid (BQ) chewing in the Asia Pacific region. Objectives: This study aims to investigate the usage patterns of BQ chewing, cigarette smoking, and alcohol drinking, and their correlates with subsequent BQ cessation among a male inmate population. Methods: Data from 473 male inmates with a history of BQ use who were incarcerated in Taiwan Kaohsiung Prison was used for this analysis. Participants were asked to report their lifetime usage patterns of cigarette, alcohol, and BQ, and their cessation status of each substance. A stepwise logistic regression analysis was performed to identify predictors of voluntary BQ cessation. Results: Seventy-five percent of all participants reported habitual use of all three substances. A total of 185 (39%) participants reported voluntary cessation of BQ prior to incarceration, and 288 (61%) reported cessation because of incarceration. Inmates who quit smoking before incarceration were more likely to voluntarily quit BQ. Inmates who had drinking habits were less likely to quit BQ, but those who quit drinking before incarceration were more likely to quit BQ. Inmates who preferred the type of BQ known as lao-hwa quid were more likely to quit BQ, and a longer chewing history correlated with a lower likelihood of quitting BQ. Conclusions Importance: Our data suggest that coexisting habitual use of cigarette, alcohol, and BQ is very common in this inmate population. BQ cessation is significantly associated with not only inmates' usage patterns of cigarette and alcohol, but also their cessation status of these substances. [ABSTRACT FROM AUTHOR]

Objective: Methamphetamine (MAMP) and ketamine are neurotoxic drugs whose chronic use has been linked with a cognitive decline in some users. This paper aims to assess the possible effect of concomitant ketamine use on the neurocognitive performance of MAMP users. Methods: This study divides 42 MAMP users into MAMP users who use ketamine (MAMP+K, n = 16) and MAMP users who do not use ketamine (MAMP–K, n = 26). The performance of these two groups was compared using the Brief Assessment of Cognition in Schizophrenia (BACS), Conners' Continuous Performance Tests (CPT), the Wisconsin Card Sorting Test (WCST), the Iowa Gambling Task (IGT), and the Barratt Impulsiveness Scale (BIS). Results: In comparison to the MAMP-K group, the MAMP+K group showed worse performances in verbal fluency, executive function and composite score in BACS; worse performances in total errors, perseverative errors, nonperseverative errors and conceptual level response in WCST; and greater levels of total scores and novelty-seeking in BIS. Neither the attention function evaluated with CPT nor the decision-making behavior evaluated with IGT was associated with previous ketamine use. Conclusion: This study detected worse executive function and higher impulsivity level among MAMP users with additional ketamine use versus their counterparts without ketamine use. Further studies with a longitudinal design and a large sample size are necessary to clarify the connection between cognitive deficits and concomitant use of MAMP and ketamine. [ABSTRACT FROM AUTHOR]

Facebook is a computer-mediated social network site (SNS) that has become a popular communication medium. Facebook permits individuals to construct a public profile within a bounded system, articulate a list of other users with whom they share a connection, and view their list of connections within the system. This study examines influences on Facebook continuous usage in Taiwan. An online survey was performed on a sample of 409 Facebook users. Structural equation models are used to examine hypotheses within the theoretical framework. Analytical results indicate that personal innovativeness, attachment motivation, and subjective norm (SN) positively affect perceived enjoyment (PE) and user attitude (ATT) towards Facebook. PE is positively related to user ATT. Furthermore, users are willing to continuously use Facebook when SN, PE, and user ATT are high. [ABSTRACT FROM PUBLISHER]

Objectives: This study evaluated the effect of long-term conventional physical therapy (PT) on cerebral palsy (CP) children and to identify the predictors of therapy's response. Methods: We performed a retrospective review of CP children treated with PT, and their motor function was assessed every 3 months between 2008 and 2011. Results: Fifty-six children with a mean age of 4.2 ± 2.8 years, gross motor function classification system (GMFCS) levels were level I ( n = 14), level II ( n = 20), level III ( n = 5), level IV ( n = 8), and level V ( n = 9). In the generalized estimating equations model, there was a significant improvement in the Gross Motor Function Measure (GMFM-66) score ( p < 0.001); the improvement was different in five GMFCS levels ( p < 0.001) and GMFCS level II had faster progression. The younger CP children had better PT efficacy, and the GMFM-66 score continued improving until 8.4 years old in the older group. Conclusion: The long-term conventional PT is effective even in older CP children, and PT was most efficient in younger children and GMFCS level II [ABSTRACT FROM AUTHOR]

Two new coumarins, clauexcavatins A (1) and B (2), along with seven known ones (3–9), were isolated from the roots of Clausena excavata Burm. f. (Rutaceae). Their structures were elucidated on the basis of spectral data. [ABSTRACT FROM AUTHOR]

Conclusion: There is no increased risk for sudden sensorineural hearing loss (SSNHL) among people who have experienced a recent herpes zoster attack, compared with a matching population. Objective: The pathogenesis of SSNHL remains unknown, but viral infection is considered to be one of the main causes. The objective of this case-cohort study was to investigate the frequency and risk for SSNHL following a recent herpes zoster attack in the general population. Methods: We extracted 313 612 patients with herpes zoster from a nationwide health registry in Taiwan, and also randomly selected 313 612 matched control subjects. Each participant was individually tracked for 2 months from their index ambulatory care visit to identify those who developed SSNHL. Stratified Cox proportional hazard regressions were conducted to analyze the risk of SSNHL for the sampled patients. Results: Of the sample of 627 224 patients, 121 (0.02%) had SSNHL during the 2-month follow-up period, 59 from the study group (0.02% of the herpes zoster patients) and 62 from the comparison group (0.02% of patients without herpes zoster). Regression analysis revealed no increased adjusted hazard of SSNHL during the 2-month follow-up period for patients with herpes zoster as compared to those without (hazard ratio = 0.89, 95% confidence interval (CI) = 0.63-1.28, p = 0.540) [ABSTRACT FROM AUTHOR]