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Introduction: Integrating assistive technology (AT) into occupational therapy (OT) education is critical to educating students to utilize AT to enhance individual independence. This study aims to describe the development of a science, technology, engineering, arts, and mathematics (STEAM)-based AT curriculum in OT and evaluate its effectiveness using the Kirkpatrick model. Methods: An 18-week STEAM-based AT curriculum was created with lectures, hands-on activities, and a simulation exam. A one-group pretest–posttest observational study was undertaken with 40 undergraduate students to gauge its effectiveness. Their professionalism was evaluated using a multidimensional checklist, whereas a satisfaction survey gathered their feedback on the curriculum experience. Results: Level 1: Participants reported high satisfaction (mean = 4.61, SD = 0.36), with a 97.5% agreement. Level 2: 95% (n = 38) passed the AT curriculum exam. Level 3: Therapists and patients expressed satisfaction with participants' AT skills (therapists: t (39) = 12.22, p < 0.001; patients: t (39) = 8.84, p < 0.001). Level 4: Participants showed significant improvement in professionalism (t (39) = 16.45, p < 0.001). Lastly, using the Kirkpatrick model, the STEAM-based AT curriculum passed the evaluation. Conclusions: The STEAM-based AT curriculum in OT enhances professionalism and potentially boosts patient satisfaction with AT services provision. [ABSTRACT FROM AUTHOR]

Aims: To assess the effectiveness of an unsupervised home‐based pulmonary rehabilitation with self‐management program in patients with chronic obstructive pulmonary disease (COPD). Background: A few recent studies have shown that unsupervised home‐based pulmonary rehabilitation can improve the clinical outcome of patients with COPD. More studies are needed to prove its benefits. Design: This study used a quasi‐experimental design. Methods: Seventy‐two admitted COPD patients were assigned to experimental group or control group through purposeful sampling. Data were collected from March 2016 to November 2017 in the Thoracic Intensive Care Unit of a Medical Center in Taiwan. The Medical Research Council dyspnea scale, the COPD Self‐Efficacy Scale and the Clinical COPD Questionnaire were measured before education and at the first, second and third months after discharge. Results: The Medical Research Council dyspnea scale and COPD Self‐Efficacy Scale results in the experimental group were significantly improved compared with the control group in the third month after discharge. The Clinical COPD Questionnaire score continued to improve in both groups in the third month after discharge, and there was no difference between the two groups. Conclusion: A short‐term unsupervised home‐based pulmonary rehabilitation with self‐ management program had significant benefits for patients with COPD. The long‐term effects need to be confirmed. Summary statement: What is already known about this topic? The literature emphasizes the importance of alternative supervision of home‐based pulmonary rehabilitation rather than center‐based pulmonary rehabilitation for patients who find this inconvenient to access.Few studies have shown that unsupervised home‐based pulmonary rehabilitation can improve the clinical outcome of patients with chronic obstructive pulmonary disease (COPD). What this paper adds? This study demonstrates that a short‐term unsupervised home‐based pulmonary rehabilitation with self‐management program can improve dyspnea during physical activity, self‐care efficacy in certain activities and quality of life after discharge in patients with COPD. The implications of this paper: The findings of this study can be used as the basis for providing a short‐term unsupervised home‐based pulmonary rehabilitation with self‐management program for patients with COPD after discharge.We recommend that patients with COPD undergo unsupervised home‐based pulmonary rehabilitation with self‐management for 3 months after discharge, especially if regular hospital visits for this are not convenient.The effect of longer‐term unsupervised home‐based pulmonary rehabilitation can be further studied in the future. [ABSTRACT FROM AUTHOR]

Background: Duchenne muscular dystrophy (DMD) is a rare hereditary muscular disease. The role of eosinophils in DMD has not been clarified. This study aims to evaluate the association between peripheral blood eosinophil count and severity and prognosis of DMD. Methods: A retrospective cohort study was performed for 145 DMD patients between January 2012 and December 2020. Clinical data of 150 healthy children were collected as a control group. Logistic regression and Cox regression analyses were used to explore the influences of eosinophil count on DMD severity and prognosis. Results: Eosinophil count in DMD group was lower than the control group (Z = 2.163, P = 0.031). It was negatively correlated with Vignos scale score, Spearman correlation coefficient was p = 0.245, P = 0.040 (at admission),p = 0.137, P = 0.032 (at follow-up); was a protective factor for high Vignos scale score at admission [odds ratio (OR) = 0.038, 95%CI: 0.002–0.752, P = 0.032] and follow-up (OR = 0.033,95%CI: 0.001–0.121, P = 0.039). The Cox regression analysis indicated that elevated eosinophil count was correlated with better therapeutic efficacy for DMD patients [hazard ratio (HR) = 2.218, 95%CI: 1.154–3.924, P = 0.016]. Conclusion: Eosinophil count in peripheral blood was correlated with the severity of DMD. It could indicate the therapeutic efficacy and prognosis of DMD patients to a certain extent. Eosinophils may be a potentially valuable biomarker or therapeutic target for DMD. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of dose calculation accuracy on inverse linear energy transfer (LET) optimization for intensity‐modulated proton therapy, and to determine whether adding more beams would improve the plan robustness to different dose calculation engines. Methods: Two sets of intensity‐modulated proton therapy plans using two, four, six, and nine beams were created for 10 prostate cancer patients: one set was optimized with dose constraints (DoseOpt) using the pencil beam (PB) algorithm, and the other set was optimized with additional LET constraints (LETOpt) using the Monte Carlo (MC) algorithm. Dose distributions of DoseOpt plans were then recalculated using the MC algorithm, and the LETOpt plans were recalculated using the PB algorithm. Dosimetric indices of targets and critical organs were compared between the PB and MC algorithms for both sets of plans. Results: For DoseOpt plans, dose differences between the PB and MC algorithms were minimal. However, the maximum dose differences in LETOpt plans were 11.11% and 15.85% in the dose covering 98% and 2% (D2) of the clinical target volume, respectively. Furthermore, the dose to 1 cc of the bladder differed by 11.42 Gy (relative biological effectiveness). Adding more beams reduced the discrepancy in target coverage, but the errors in D2 of the structure were increased with the number of beams. Conclusion: High modulation of LET requires high dose calculation accuracy during the optimization and final dose calculation in the inverse treatment planning for intensity‐modulated proton therapy, and adding more beams did not improve the plan robustness to different dose calculation algorithms. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer mortality worldwide. However, efficient markers for CRC diagnosis are limited. Accumulating evidence reveals that long noncoding RNAs (lncRNAs) are related to the genesis and developments of many tumors. In this study, we aimed to explore the diagnostic and prognostic value of LINC02257 in CRC patients. TCGA datasets were utilized to examine LINC02257 expression in a variety of human malignancies. The Kaplan–Meier method analysis was then used to study the link between LINC02257 expression and patient prognosis. Multivariate assays were applied for the determination of the associations of the variables and patients' survivals. RT-PCR was used to examine the level of LINC02257 expression in 14 pairs of clinical CRC tissues as well as many distinct CRC cell lines. CCK-8 assay was used to assess cell proliferation. We found that the expression of LINC02257 exhibited variable patterns of upregulation or downregulation in the various forms of cancer. In CRC, LINC02257 expression was distinctly increased in CRC specimens compared with normal specimens. The results of ROC curves revealed that the AUC was 0.886 (0.862 to 0.909, 95% CI, p < 0.001) in a comparison between CRC specimens and matched normal specimens. Survival studies revealed that high LINC02257 expression was associated with shorter overall survival and disease specific survival. More importantly, multivariate assays confirmed that high expression of LINC02257 was an independent prognostic factor for CRC patients. The results of RT-PCR indicated that LINC02257 expression was distinctly overexpressed in both CRC specimens and cell lines. Functionally, silence of LINC02257 distinctly suppressed the proliferation of CRC cells. In conclusion, our research showed that LINC02257 is an intriguing candidate as a diagnostic and prognostic indicator for patients diagnosed with CRC. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore whether dual‐lumen power injectable peripherally inserted central catheters (PICCs) could be effectively and safely applied in allogeneic hematopoietic stem cell transplantation (allo‐HSCT) and for serum cyclosporine level monitoring. Background: Compared to conventional central venous access devices, PICC provides a feasible route not only for fluid infusion, but also for blood sample collection in patients undergoing oncological treatments. Design: A prospective observational study was conducted according to the STROBE guidelines. Methods: We prospectively evaluated the applications and complications of power injectable PICCs in 52 consecutive allo‐HSCT recipients. We also compared the cyclosporine levels in 188 paired blood samples, simultaneously obtained via power injectable PICCs and percutaneous venous puncture, to investigate whether power injectable PICC is a feasible route for cyclosporine concentration monitoring in allo‐HSCT. Results: The median PICC placement duration was 29 days. The insertion‐site blood oozing and central line‐associated bloodstream infection rates were 36.5% (19/52) and 26.9% (14/52), respectively, indicating the feasibility of these PICCs for various applications in allo‐HSCT. No power injectable PICC‐related thrombotic adverse events were identified; 90.4% (47/52) of cases with power injectable PICC removal occurred because of lack of medical utility, suggesting that power injectable PICC‐related complications were manageable. However, cyclosporine levels in samples obtained via these PICCs were significantly higher than those in samples obtained via percutaneous venous puncture (261.5 ± 139.2 vs. 232.4 ± 253.6 ng/ml; p = 0.019 [set 1]; 254.8 ± 89.3 vs. 225.1 ± 233.3 ng/ml; p<0.001 [set 2]; 283.6 ± 103.9 vs. 238.0 ± 254.7 ng/ml; p = 0.006 [set 3]; 291.0 ± 94.9 vs. 266.0 ± 274.7 ng/ml; p = 0.016 [set 4]). Conclusion: The power injectable PICC is a feasible venous access device for allo‐HSCT. Relevance to clinical practice: The dual‐lumen power injectable PICCs provided a reliable access for blood sample collection, decreasing the number of blind percutaneous venous punctures in allo‐HSCT. However, its application in cyclosporine level monitoring needs further investigation. [ABSTRACT FROM AUTHOR]

To examine the relationships among therapist-reported, patient-reported, and objective assessment scores of balance function. Inpatients with stroke and occupational therapists were recruited. The objective balance scores were measured using the Balance Computerized Adaptive Testing (Balance CAT) system. The therapist and patient-reported scores were evaluated using a visual analogue scale (VAS) and Likert-type scale. Eighty-eight patients and 16 therapists participated. The correlations (r= 0.64 and 0.65; R-squared about 0.42 at baseline and follow-up assessments, respectively) between the therapist-reported VAS scores and the Balance CAT system were larger than those (r = 0.31 and 0.21) between the patient-reported VAS scores and the Balance CAT system. Low correlations (r = 0.27 and 0.26 for VAS and Likert-type scores, respectively) were found between the therapist-reported and patient-reported change scores. Low correlations (r = 0.12–0.17) were found between the change scores of therapist- and patient-reported ratings and those of the Balance CAT system. The therapists' judgments explained <50% of variance of the Balance CAT system scores. Neither therapist-reported nor patient-reported change scores reflected the changes demonstrated by the objective assessments. Further studies are warranted to confirm our findings. Neither therapist- nor patient-reported balance function and change could effectively reflect the scores resulting from objective assessments. The routine use of objective balance assessments should not be replaced by therapists' subjective judgments. Communications regarding the balance function measured by objective assessments between therapists and patients can help patients to better understand their balance function and progress. [ABSTRACT FROM AUTHOR]

In response to population aging, there is an increase in demand for the coverage of and the necessary services provided by home health care and home care for socially vulnerable groups. This study explored whether the instructions and recommendations offered by pharmacists during their home visits play a key role in the factors that influence a patient's prognosis. A home health care database was analyzed in this study. The subjects received home visits from pharmacists. There were 262 subjects following the exclusion of closed cases that were not due to improved outcomes or death. To validate the research framework, multiple regression analysis was employed for model validation. The level of consciousness and Barthel Index score mediated the effects of multimorbidities, and these mediating effects significantly affected patient outcomes (improvement or death). The medication-related knowledge and instructions for correct medication use provided by pharmacists did not exhibit significant moderating effects on the influence of a patient's level of consciousness and Barthel Index score on their improved outcomes. However, the pharmacists' provision of instructions and recommendations for patient self-care had significant moderating effects on the path by which patients with multimorbidities experienced improved outcomes through higher total Barthel Index scores. In comparison with physician home visits, which merely cover the treatments for diseases, pharmacists also play a vital role in home health care. Pharmacists provide patients with medication-related knowledge and instructions for correct medication use. This study addressed aspects that have not been considered in previous studies. [ABSTRACT FROM AUTHOR]

Aim: To develop an instrument to investigate geropsychiatric psychological symptoms, health problem nursing knowledge (GPN‐K), geropsychiatric psychological symptoms and health problem nursing attitude scale (GPN‐A) in clinical practice for nursing students. Design: Instrument development and cross‐sectional study for psychometric testing. Methods: Construct validity was evaluated using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA), and internal consistency was calculated using Cronbach's α. Results: A total of 300 students have completed the questionnaires (85.71% response rate). The CFA of GPN‐K showed good fitness and validity. The Kuder‐Richardson 20 (KR‐20) value of the internal consistency reliability is 0.64. The GPN‐A overall content validity index is 0.95. A three‐factor structure was shown by exploratory factor analysis. The three factors are communication and care, helping others improve and problem evaluation tendency. The total variance explained is 59.01%. Cronbach's alpha of GPN‐A equals 0.84, which represents good internal consistency. [ABSTRACT FROM AUTHOR]

Objective. Tripterygium wilfordii polyglycosides tablet (TGt) is an oral preparation extracted from plant Tripterygium wilfordii. It has the effects of anti-inflammation and inhibition of cellular and humoral immunity. However, many reports of adverse reactions caused by TGt have limited its application. In this paper, the clinical efficacy and safety of TGt in the treatment of chronic kidney disease (CKD) were verified by data mining and analysis, so as to provide theoretical data support for the application and development of TGt. Methods. A computer search of the following databases was conducted: PubMed, Web of Science, CBM, VIP, Wanfang Data, and CNKI. The search time limit is from the establishment of the database to September 2020. We searched for clinical randomized controlled trials of TGt in the treatment of CKD. The main types of CKD involved are nephrotic syndrome (NS), primary nephrotic syndrome (PNS), refractory nephrotic syndrome (RNS), and IgA nephropathy (IgAN). RevMan 5.2 and Stata 12.0 software were used to evaluate the literature quality and analyze the data. Finally, GRADEpro software was used to evaluate the quality of evidence. Results. According to the inclusion and exclusion criteria, 75 articles with a total of 6418 subjects were included. The results of the meta-analysis showed that TGt could reduce 24-hour urinary protein, increase serum albumin, improve clinical efficacy, and reduce disease recurrence rate in patients (P < 0.05) with CKD compared with adrenocortical hormones or immunosuppressants. TGt could significantly reduce the level of serum creatinine (Scr) in patients with CKD (P < 0.05), but it was not significant in reducing the level of blood urea nitrogen (P > 0.05). In terms of safety evaluation, in patients with CKD, it could significantly reduce the incidence of gastrointestinal adverse reactions and neurogenic dizziness and headache (P < 0.05). However, in terms of adverse reactions such as liver injury, respiratory infection, and leukopenia, TGt was as harmful as corticosteroids or immunosuppressants (P < 0.05). The quality of the evidence was evaluated with GRADEpro software, and the results showed that TGt was strongly recommended for the treatment of CKD. Conclusion. TGt has certain efficacy in the treatment of CKD and has fewer side effects in certain types of diseases. The effect of TGt combined with other drugs is better than that of single use. This paper also has some limitations. Due to the limited number of the included studies, with all being from China, there may be methodological differences. Therefore, more high-quality literature data from different countries are needed. [ABSTRACT FROM AUTHOR]

Aims: To identify different classes of change pattern/ trajectory of tobacco smoking behaviour after diagnosis of lung cancer using multi‐wave data and to explore factors associated with the class membership. Design: This is a multi‐wave observational study. Methods: Smoking behaviour data were collected at diagnosis and then every month for 6 months from 133 newly diagnosed people with lung cancer who had recently quit smoking or continued to smoke at diagnosis. These patients were recruited from three medical centres and data were collected from May 2014 to January 2017. Smoking behaviour was assessed based on patients' self‐reports on whether they smoked during the last month (yes/no) for a total of seven times. Mixture latent Markov model and logistic regression were used to analyse data. Results: Two latent classes of smoking trajectory were identified among recent quitters or current smokers of people with lung cancer, namely "perseverance for abstinence" and "indecisive for abstinence." Patients who were younger age (OR = 0.95, p = 0.026), exposure to second‐hand smoke (OR = 3.35, p = 0.012) and lower self‐efficacy for not smoking (OR = 0.96, p = 0.011) were more likely to belong to the class of "indecisive for abstinence." Conclusions: Heterogeneous classes of smoking trajectory existed in newly diagnosed people with lung cancer. The risk factors associated with a less favourable smoking trajectory can be incorporated into tailored smoking‐cessation programs for patients newly diagnosed with lung cancer. Impact: The dynamic trajectory of smoking behaviour had not been adequately explored among newly diagnosed people with lung cancer. Two classes of smoking trajectory and the predictors associated with the class membership were identified. These findings suggest that the diagnosis of cancer is a teachable moment for smoking cessation. Patients with younger age, lower self‐efficacy of not smoking and exposure to second‐hand smoke at home need special attention. [ABSTRACT FROM AUTHOR]

Aims : Many people work in agriculture and aquaculture. Owing to the specific working environments and climate changes, some literatures indicated that agriculture and aquaculture workers have cardiovascular diseases. It is important to attain sustainable development goal for these workers. However, few studies have investigated the factors associated with cardiometabolic risks and their perception among these workers. To explore the health needs and perception of cardiometabolic risks and associated factors among agriculture and aquaculture workers. Methods and results : A community-based, cross-sectional study design was used. This study was part of a nurse-led health-promotion programme designed to examine the health needs of agriculture and aquaculture workers between March and December 2019 in Yunlin County, Taiwan. This study was conducted in 30 rural villages. Health screening for five cardiometabolic risks was identified by a local hospital collaborated with the study. Six hundred and fifty-six participants with a mean age of 66 years completed this study. The mean number of cardiometabolic risk factors was 2.6, and the prevalence of metabolic syndrome was 54.1%. Most participants had misperceptions regarding their abnormal biomarkers. Age, education level, female gender, increased biomarker misperception (P < 0.001), and betel nut chewing (P < 0.01) were the determinant factors associated with cardiometabolic risks. Conclusion : These findings demonstrated a high prevalence of cardiometabolic risks, unhealthy behaviours, and misperceptions of cardiometabolic risk among the study population. This study highlights the need for clinicians and primary healthcare providers to attempt to increase the level of cardiometabolic risk literacy by initiating culturally tailored health-promotion programmes. [ABSTRACT FROM AUTHOR]

Objective The Fugl-Meyer motor scale (FM) is a well-validated measure for assessing upper extremity and lower extremity motor functions in people with stroke. The FM contains numerous items (50), which reduces its clinical usability. The purpose of this study was to develop a short form of the FM for people with stroke using a machine-learning methodology (FM-ML) and compare the efficiency (ie, number of items) and psychometric properties of the FM-ML with those of other FM versions, including the original FM, the 37-item FM, and the 12-item FM. Methods This observational study with follow-up used secondary data analysis. For developing the FM-ML, the random lasso method of ML was used to select the 10 most informative items (in terms of index of importance). Next, the scores of the FM-ML were calculated using an artificial neural network. Finally, the concurrent validity, predictive validity, responsiveness, and test–retest reliability of all FM versions were examined. Results The FM-ML used fewer items (80% fewer than the FM, 73% fewer than the 37-item FM, and 17% fewer than the 12-item FM) to achieve psychometric properties comparable with those of the other FM versions (concurrent validity: Pearson r  = 0.95–0.99 vs 0.91–0.97; responsiveness: Pearson r  = 0.78–0.91 vs 0.33–0.72; and test–retest reliability: intraclass correlation coefficient = 0.88–0.92 vs 0.93–0.98). Conclusion The findings preliminarily support the efficiency and psychometric properties of the 10-item FM-ML. Impact The FM-ML has potential to substantially improve the efficiency of motor function assessments in patients with stroke. [ABSTRACT FROM AUTHOR]

Background: Patients with traumatic injuries are often accompanied by emotional disorders, which seriously impede functional gains. The objective of this study was to identify the prevalence and risk factors associated with underlying anxiety and depression in orthopaedic trauma patients. Methods: From July 2015 to December 2017, all orthopaedic trauma patients were included in the retrospective study. Patients with conditions that might affect cognitive impairment were excluded from the study. Basic demographic data were collected. All patients were screened for emotional disorders on admission using a simple questionnaire called "Huaxi Emotional-Distress Index" (HEI). Bivariate analyses and logistic regression were used to identify the factors associated with a HEI score of > 8. Results: One hundred and sixty-two patients (8.1%) had a HEI score of > 8. About 1.0% of enrolled patients had severe emotional disorders (HEI score ≥ 17). The reasons caused by emotional disorders in patients with orthopaedic trauma were a higher Injury Severity Score (ISS), a higher visual analogue score (VAS) and type of surgery. On logistic regression, marital status was a protective factor for emotional disorders, while VAS and ISS were the risk factors for emotional disorders. Conclusions: Although a significantly low percentage of orthopaedic trauma patients in our setting have emotional disorders, traumatic orthopaedic surgeons still need to pay attention to the risk of emotional disorders and integrate effective screening tools into clinical practice to screen for these factors and stratify emotional disorders. Appropriate targeted psychological intervention and treatment should be adopted according to the stratification of emotional disorders. [ABSTRACT FROM AUTHOR]

Background: Sedentary behaviours may be related to factors such as self-efficacy, mood and social support. However, there is a paucity of longitudinal follow-up studies examining factors related to sedentary behaviour from physical-psychosocial perspectives in patients with heart failure. Aims: The purpose of this study was to explore the multidimensional associated factors and impacts of sedentary behaviour in heart failure patients. Methods: A longitudinal design was used. A convenience sample of 128 heart failure patients recruited from two large medical centres in northern Taiwan was obtained. Patients were interviewed with structured questionnaires to assess physical activity, symptom distress, exercise self-efficacy, anxiety and depression, social support, sleep quality and quality of life before discharge and at 3 and 6 months after discharge. Results: Heart failure patients reported low physical activity and tended to be sedentary. Sedentary behaviour was gradually reduced from hospitalization to 6 months after discharge. Sleep quality, quality of life, analgesic use, symptom distress and exercise self-efficacy were significant associated factors that explained 42.1–51% of the variance in sedentary behaviour. Patients with high sedentary behaviour had significantly greater depression and poorer sleep and quality of life than those with low sedentary behaviour at hospitalization and showed a significant improvement in depression at 3 and 6 months after discharge. Conclusion: Sedentary behaviour is common in heart failure patients and has impacts on depression and quality of life. An appropriate physical activity programme focusing on disease self-management and enhancing self-efficacy is needed for heart failure patients to improve their sedentary behaviour and quality of life. [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]

The prevalence of metabolic syndrome and its components continue to increase among patients with serious mental illness. This cross‐sectional study investigated whether metabolic syndrome prevalence and risk factors differ between male and female patients with serious mental illness. In total, 260 eligible patients were recruited from two hospitals. The data on demographic characteristics, lifestyle behaviour factors, biochemistry, and anthropometry were collected. Analyses were performed using multivariate logistic regression. Metabolic syndrome prevalence was 40.8% (35.1% in men and 46.8% in women). Among patients aged 40–49 years, metabolic syndrome prevalence was higher in men; however, the trend was reversed among patients aged 50 years or older. Notably, gender‐specific metabolic syndrome risk factors were observed. In men, they included low education level, high body mass index (BMI), prolonged illness, comorbid physical illness, and diagnosis of bipolar disorder, whereas they included being married, old age, and high BMI in women. Our findings suggest that mental health professionals should consider the gender‐ and age‐based metabolic syndrome prevalence trend in patients with serious mental illness when designing interventions for the study population to minimize metabolic syndrome prevalence. [ABSTRACT FROM AUTHOR]

Purpose: To explore the prevalence of hepatitis C virus (HCV) infection as well as the levels of liver health literacy and association with the health status of people with HCV through the nurse‐led community health development goal of global elimination. Methods: A community‐based, cross‐sectional study was conducted between July 2018 and June 2019 in coastal Western Yunlin County, Taiwan. This study was conducted at five townships, and serum HCV antibody (anti‐HCV) screening was used for the identification of potentially infected people by a collaborating local hospital. Results: Of the 1,963 adults from rural areas enrolled in this study, 321 (16.4%) were anti‐HCV positive, 237 (73.8%) reported that they were unaware of their HCV positivity, and none of them were provided information on direct‐acting antiviral agent therapy. The levels of anti‐HCV positivity were higher among female patients (p <.05), elderly people (p <.001), those with a low education level (p <.001), and those from the Sihu Township within Yunlin County (p <.001). Participants with anti‐HCV positivity tended to have lower intakes of vegetables (p <.01) and fruit (p <.05), a greater number of comorbidities (p <.05), as well as a greater incidence of abnormal liver (p <.001) and renal function (p <.001) compared to those with anti‐HCV negativity. Multivariable linear regression analysis showed that the presence of HCV infection and a greater number of metabolic syndrome components were associated with poor liver and renal function. Conclusions: These findings showed a high prevalence of HCV infection among adults living in rural areas, who had low literacy levels on hepatitis, unhealthy lifestyles, and abnormal liver and renal function. Clinical Relevance: Clinicians and primary healthcare providers should initiate efforts to increase the levels of liver health literacy by increasing the accessibility to infection confirmation tests and reducing the number of barriers to the reception of antiviral treatment. [ABSTRACT FROM AUTHOR]

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Background: Individuals with disabilities have health needs similar to the general population. Smoking and metabolic syndrome have emerged as major cardiovascular risks that contribute to systemic inflammation and mortality. However, few studies have focused on the association between smoking and cardiometabolic risks in adult men with disabilities. Aims: This study explored the prevalence of smoking and its association with cardiometabolic risk and associated factors among male adults with disabilities. Methods: This study was part of a nurse-led health-promotion program designed to examine the health needs in health programs for adults with disabilities. A community-based, cross-sectional study was conducted between July 2013–December 2014, in Chiayi County, Taiwan. Results: Of the total of 964 male participants enrolled in this study, 874 (90.7%) participants had complete data sets. The prevalence of cigarette smoking and metabolic syndrome were 42%, and 33.3%, respectively. More than half (62.7%) had high blood pressure and 43.5% had central obesity. Compared with non-smokers, smokers tended to engage in less frequent regular exercise (p<0.001), eat fewer vegetables and fruit (p<0.05), and drink less water (p<0.05). After adjusting for potential confounding variables, multivariable logistic regression analysis showed that smoking was an independent factor for cardiometabolic risk. Conclusion: The present findings show a high prevalence of cigarette smoking, unhealthy lifestyle, and cardiometabolic risk among adult men with disabilities. Clinicians and primary healthcare providers should reduce the consequences thereof by initiating innovative health promotion programs. [ABSTRACT FROM AUTHOR]

Background: Lifestyle is among the most important factors affecting individual health status. Limited access to health information may limit the ability of people with visual impairment or blindness to practice healthy lifestyles. However, no studies have investigated how lifestyle practices affect health specifically in visually impaired and blind populations. Purpose: The aim of this study was to investigate the lifestyle behaviors of visually impaired and blind massage therapists (VIBMTs) in Taiwan. Methods: This exploratory study used a purposive sampling technique to recruit 50 VIBMTs who were employed at massage stations in southern Taiwan. All of the participants completed the Health-Promoting Lifestyle Profile II (HPLP-II) and a survey of demographic characteristics. Descriptive and inferential statistical tests, including the Mann–Whitney U test and the Kruskal–Wallis H test, were used. Statistical significance was defined as p <.05 in two-tailed tests. Results: Fifty participants completed both the HPLP-II and the demographic survey. The mean subscale score for the HPLP-II was 2.52 ± 0.37. The lowest scores were on the physical activity (2.09 ± 0.67) and nutrition (2.35 ± 0.39) subscales, and the highest scores were on the spiritual growth (2.89 ± 0.56) and interpersonal relations (2.79 ± 0.46) subscales. Scores on the stress management and physical activity subscales were significantly higher in men than in women (p <.05). In addition, mean HPLP-II scores were significantly higher in VIBMTs who exercised regularly compared with those who did not (p <.05). Compared with nonsmokers, current smokers had significantly higher scores on the stress management subscale (p <.05). Conclusions/Implications for Practice: The low physical activity scores in this population may be improved by developing physical activity programs for the home and workplace and by establishing community recreational and exercise facilities for visually impaired populations. The low scores for nutrition may be improved by establishing nutrition education programs that are designed specifically for VIBMTs to increase their consumption of fresh produce and other healthy foods and by requiring food manufacturers to use labels that may be easily read or understood by visually impaired populations. [ABSTRACT FROM AUTHOR]

Abstract: Family interventions have been emphasized in the treatment of bipolar disorder (BPD) due to the bidirectional and entangled relationships between patients and the family system, and have benefits for patients’ symptoms and health; however, the effects of family interventions on family function and caregivers’ health‐related outcomes have not been well investigated. This randomized, controlled trial with 47 hospitalized patients with BPD/family caregiver dyads at a medical centre in northern Taiwan compared the effects of a brief family‐centred care (BFCC) programme with treatment as usual (TAU). All of the family caregivers in two groups were invited to attend a routine 60‐min family discussion group about violence and suicide prevention. The TAU group without specific family interview for patient and family caregiver dyad. In the BFCC group, four 90‐min BFCC programme sessions were additionally provided twice a week for each hospitalized family dyad. We hypothesized that, first, family caregivers in the BFCC group could increase their family function, and second, improve perceived health status and reduce caregiver's burdens compared to the TAU. The results showed that family caregivers in the BFCC group significant interaction effects in overall family function (P = 0.03) and subscale conflict (P = 0.04), communication (P = 0.01), and problem‐solving (P = 0.04), but there were no significant interaction effects on the caregivers’ perceived health status and caregivers’ burdens. Our findings support both the feasibility of using the BFCC programme for inpatients and its specific benefits for family function. An intensive family intervention during hospitalization has been suggested in psychiatric practice to support patients with BPD and family caregivers. [ABSTRACT FROM AUTHOR]

Objective. This review is to assess the efficacy and safety of acupotomy therapy in chronic nonspecific neck pain. Methods. We searched six computerised databases. Randomized controlled trials incorporating acupotomy therapy alone or combined with other conventional treatments for chronic nonspecific neck pain were included. Two reviewers screened each literature and extracted data independently according to Cochrane Reviews’ Handbook (5.1). The Cochrane Collaboration’s RevMan 5.3 software was applied for meta-analysis. Results. A total of ten trials involving 433 patients were enrolled. The pooled analysis indicated that acupotomy therapy showed a significant improving short-term and long-term effect on effective rate and cure rate. Meta-analysis demonstrated that acupotomy therapy group was superior to control group in restoring cervical lordosis and debasing VAS score. The result of continuous data did not support statistical significance of acupotomy therapy in adjusting clinical symptom score. For adverse events, acupotomy group did not reveal obvious superiority compared to control group. Conclusions. Acupotomy therapy may be beneficial to chronic nonspecific neck pain patients. To strengthen supportive evidence, future, more rigorously designed clinical trials, adequate adverse events, and follow-up project are recommended. [ABSTRACT FROM AUTHOR]

Background: Oral health status is associated with many chronic ailments, including diseases of the cardiovascular system, diabetes, as well as pregnancy complications, such as low birth weight, preterm delivery, preeclampsia, and early pregnancy loss. The health status of reproductive-aged women is important, not only for the women themselves, but also for the health of fetus. Objectives: The purpose of this study was to explore cardiometabolic risk factors, oral health status, and associated factors among reproductive-aged women. Methods: The current study is a preliminary report from a nurse-led longitudinal study, examining a health promotion program for women in a rural region of Taiwan. Participants consisted of a community-based, cross-sectional sample, involving 2547 women aged 20–49 years. Results: A high percentage of participants were found to have cardiometabolic risk factors. More than one-quarter had ⩽24 remaining teeth. Many participants reported that they did not regularly attend dental checkups and tooth scaling, did not brush at least twice a day after meals, did not have a healthy diet, and did not exercise regularly. The results also indicated that women with <20 remaining teeth tended to be older, engaged in substance use, and displayed increased cardiometabolic risk factors. Conclusions: The findings indicate that reproductive-aged women show a high prevalence of tooth loss, cardiometabolic risk factors, and unhealthy habits. Nurses in the primary health sectors could reduce the consequences of these risk factors and improve oral health through the early detection and initiation of health-promoting programs that reduce risky behavior associated with cardiometabolic diseases. [ABSTRACT FROM AUTHOR]

Adolescent obesity is a crucial public health concern, and understanding its risk factors can facilitate the establishment of prevention policies. In this study we investigated the prevalence of adolescent obesity in Taiwan, determined the influential factors, and compared the prevalence of obesity in our study population with international indices. The cross‐sectional study was an analysis of data from the 2010–2011 Nutrition and Health Survey in Taiwan, an anthropometric measurement and questionnaire survey of adolescents aged 11–18 years. Our sample was 1,826 adolescents (910 males and 916 females). Data were analyzed using logistic regression modeling. Based on body mass index standards specific to Taiwan norms, the prevalence of overweight and obesity in Taiwan adolescents was 12.4% and 16.8%, respectively. The prevalence was lower when international indices of overweight and obesity were applied. In logistic regression, obesity was linked to male gender, an obese father, overweight or obese mother, poor dietary attitudes, and perceived low dietary benefits. Monitoring and preventing adolescent obesity should focus on both adolescents and their parents. When planning behavioral change and education for adolescent obesity, health professionals and policy‐makers should view the family as a unit. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Aims and objectives. To explore cigarette smoking and health-promoting behaviours among disadvantaged adults before their tuberculosis diagnosis and after their tuberculosis treatment. Background. Although tuberculosis infection is associated with impaired immune function, healthy lifestyle habits can play a role in improving the immune system. However, limited research has explored the health-promoting behaviours and cigarette smoking habits among tuberculosis patients in Taiwan. Design. A cross-sectional retrospective study with a convenience sample. Methods. This study was conducted between May 2013-June 2014 with 123 patients at a rural district hospital in Chiayi County, Taiwan. Statistical analyses included descriptive statistics, univariate analysis and stepwise regression analysis. Results. Tuberculosis tended to be associated with less education, male sex, malnutrition, cigarette smoking and unhealthy lifestyle habits before the tuberculosis diagnosis. The percentage of smoking decreased from 46-9% before to 30-2% after the tuberculosis diagnosis. Body mass index and health-promoting behaviours also significantly improved after tuberculosis treatment. After controlling for potential confounding factors, multivariate analysis identified chronic disease and completed treatment as significant factors that were associated with current health-promoting behaviours. Conclusions. A high prevalence of cigarette smoking and low levels of health-promoting behaviours were observed before the diagnosis and during or after completing tuberculosis treatment. Relevance to clinical practice. This study's findings indicate the importance of promoting healthy lifestyle changes among tuberculosis patients; aggressive measures should be implemented immediately after the first diagnosis of tuberculosis. Furthermore, health promotion and smoking cessation programmes should be initiated in the general population to prevent activation of latent tuberculosis infection, and these programmes should specifically target men and rural residents. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore gene expression changes in fatigued men with nonmetastatic prostate cancer receiving localized external beam radiation therapy (EBRT). Methods: Fatigue was measured in 40 men with prostate cancer (20 receiving EBRT and 20 controls on active surveillance) using the Functional Assessment of Cancer Therapy–Fatigue (FACT-F). EBRT subjects were followed from baseline to midpoint and end point of EBRT, while controls were seen at one time point. EBRT subjects were categorized into high- and low-fatigue groups based on change in FACT-F scores from baseline to EBRT completion. Full genome microarray was performed from peripheral leukocyte RNA to determine gene expression changes related to fatigue phenotypes. Real-time polymerase chain reaction and enzyme-linked immunosorbent assay confirmed the most differentially expressed gene in the microarray experiment. Results: At baseline, mean FACT-F scores were not different between EBRT subjects (44.3 ± 7.16) and controls (46.7 ± 4.32, p = .24). Fatigue scores of EBRT subjects decreased at treatment midpoint (38.6 ± 9.17, p = .01) and completion (37.6 ± 9.9, p = .06), indicating worsening fatigue. Differential expression of 42 genes was observed between fatigue groups when EBRT time points were controlled. Membrane-spanning four domains, subfamily A, member (MS4A1) was the most differentially expressed gene and was associated with fatigue at treatment end point (r = −.46, p = .04). Conclusion: Fatigue intensification was associated with MS4A1 downregulation, suggesting that fatigue during EBRT may be related to impairment in B-cell immune response. The 42 differentially expressed fatigue-related genes are associated with glutathione biosynthesis, γ-glutamyl cycle, and antigen presentation pathways. [ABSTRACT FROM AUTHOR]

Aim This study examined the effect of underlying contextual factors on the intention to stay in nurses. Background Workplace promotion, social support, work stress, job satisfaction and organisation-based self-esteem (OBSE) are psychosocial factors influencing the intention to stay in nurses. However, few studies have analysed the relationships among these factors. Method A cross-sectional survey was conducted and a sample was recruited in convenience sampling method from a medical centre in Taiwan. A total of 791 nurses completed a self-report questionnaire over a 3-month period in 2013. Results Social support, work stress, job satisfaction and OBSE significantly affected the intention to stay in nurses. Furthermore, social support and job satisfaction showed a positive direct effect on the intention to stay and an indirect effect on the intention to stay; the indirect effect was mediated by OBSE. Conclusion Organisation-based self-esteem mediates the effects of social support and job satisfaction on the intention to stay in nurses. Implications for Nursing Management The results showing the influence of OBSE on the intention to stay in nurses can serve as insight for hospital managers to make decisions when encouraging and managing employees. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to (a) test the fit of the hypothesized model for new nurses' intent to leave and (b) determine the extent to which personal characteristics, work conditions, and work-related fatigue predict intent to leave among new nurses. Design and Methods This study was a cross-sectional survey study. A total of 162 new nurses were recruited. A hypothesized model was proposed for model testing. Structural equation modelling was used for data analysis. Findings Work conditions only had an effect through work-related fatigue on new nurses' intent to leave. Personal characteristics did not have a significant effect on new nurses' intent to leave. The final model showed a good fit. Work-related fatigue, work conditions, and health explained 65% of the variance in new nurses' intent to leave. Conclusions Work-related fatigue was a major determinant of new nurses' intent to leave. More attention should be paid to fatigue reduction strategies among new nurses. Clinical Relevance Work-related fatigue should be monitored, particularly for new nurses who work more than 10 hr per day and who have greater workloads. [ABSTRACT FROM AUTHOR]

Pin site infection is a common complication after fracture fixation and bone lengthening, and daily pin site care is recommended. Weather is a strong environmental factor of infection, but few articles studied the issue of weather and pin site infection. We performed a prospective comparative study of 61 children with supracondylar humeral fractures treated by closed reduction and percutaneous pinning. The patients were divided into high-temperature season or low-temperature season by the months they received surgery. The patients within each season were further allocated to 2 groups by the different postoperative pin site care methods of daily care or noncare. The infection rate per patient was significantly higher in the high-temperature season compared to low-temperature season (45% versus 19%, P = 0.045). In the high-temperature season, the infection rate per patient was significantly higher in the daily care group versus the noncare group (70% versus 20%, P = 0.001). In the low-temperature season, the infection rate per patient was not significantly different in the daily care group versus the noncare group (10% versus 27.3%, P = 0.33). We recommend that careful monitoring of infection signs, rather than pin site cleaning, would be appropriate in the treatment of pediatric supracondylar humeral fractures, especially during the summer months. [ABSTRACT FROM AUTHOR]

Background Exposure to paraquat results in acute lung injury. A systemic inflammatory response has been widely established as a contributor to paraquat-induced acute lung injury. Recent studies have reported that consumption of Xuebijing prevents inflammatory response-induced diseases. This study investigated whether consumption of Xuebijing protected rats against paraquatinduced acute lung injury. Methods Adult male Sprague Dawley rats were randomly divided into four groups: control group; paraquat group; paraquat + Xuebijing group; and paraquat + dexamethasone group. Rats in the paraquat, paraquat + Xuebijing and paraquat + dexamethasone groups were intraperitoneally injected with paraquat (30 mg/kg) or administered paraquat and Xuebijing at 8 mL/kg or dexamethasone at 5 mg/kg, respectively, via an injection into the tail vein. Lung p38 MAPK, NF-κB65, IkB, p-IκB-α, HIF-1α, Nrf2 and TGF-β1 expression were essayed using western blotting. IL-6, TNF-α, IL-1β, IL-10, TGF-β1 and PIIIP were measured using ELISA. ROS, oxidised glutathione and glutathione activity were measured. Results After inducing acute lung injury with paraquat for 24 h, Xuebijing was observed to block lung p-p38 MAPK, NF-κB65, HIF-1α, p-IκB-α and TGF-β1 expression, and increased Nrf2 and IkB expression. The numbers of neutrophils and lymphocytes and total number of cells were significantly lower in the Xuebijing group compared with the control group. IL-6, TNF- α, IL-1β, TGF-β1 and PIIIP levels were significantly decreased in the Xuebijing group. ROS and oxidised glutathione activity were markedly inhibited by Xuebijing. Histological evaluation showed attenuation of the effects of Xuebijing on paraquat-induced lung injury. Compared with the paraquat + dexamethasone group, the Xuebijing + paraquat group showed no significant differences. Conclusions Inhibiting the expression of p38 MAPK and NF-κB65 was crucial for the protective effects of Xuebijing on paraquat-induced acute lung injury. The findings suggest that Xuebijing could effectively ameliorate paraquat-induced acute lung injury in rats. Xuebijing was as effective as dexamethasone at improving paraquat-induced lung injury by regulating lung inflammation, lung function and oxidative stress responses. [ABSTRACT FROM AUTHOR]

Background: The postpartum period is a physiologically and psychologically crucial transition phase for every woman who gives birth. Aromatherapy may improve mood and alleviate sleep challenges. However, few randomized controlled clinical trials have focused on the effect of aromatherapy in postpartum women. Purpose: This study was designed to explore the effect of a bergamot essential oil aromatherapy intervention on depressive mood and sleep quality in postpartum women. Methods : This randomized controlled trial used consecutive sampling. The participants were all women in a postpartum care center in eastern Taiwan and were randomly assigned to either the experimental (n = 29) or control (n = 31) group. Bergamot essential oil aroma was used in the experimental group, and pure water aroma was used in the control group. The experimental and control interventions were both performed while the participants were residents at the postpartum care center in the afternoon for 15 minutes each day. Before the aroma intervention, pretests were conducted using the Edinburgh Postnatal Depression Scale and the Postpartum Sleep Quality Scale. The first and second posttests were conducted using the same two scales at 2 and 4 weeks after the intervention, respectively. Results : At both the first and second posttests, depressive mood was significantly lower (p <.001) in the experimental group than in the control group, supporting the positive effect of the bergamot essential oil aroma intervention on depressive mood in postpartum women. No significant intergroup difference in sleep quality (p >.05) was observed at either the first or second posttest, indicating an uncertain effect of the bergamot essential oil aroma intervention on sleep quality. Conclusions/Implications for Practice: The results of this study support the effectiveness of bergamot essential oil aromatherapy in alleviating depressive mood in postpartum women. In addition, the results provide a practical reference for clinical postpartum nursing care. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to describe the current state of nurses' shift work in Taiwan and how it affects nurses' stress, sleep quality and self-perceived health status. Background To enable the provision of 24-hour patient care, nurses need to work various shifts. Long-term shift work significantly affects nurses' overall physical and mental health. Method Nurses from four Chiayi County district hospitals in Taiwan ( n = 266) participated in this cross-sectional study from August to September 2010. Demographics, work schedule forms, a stress checklist, a sleep-quality measure and a health-status measure were used to collect data. Independent t-test, one-way anova, Pearson's r, and hierarchical regression were applied for analysis. Results The results showed that regardless of the amount of shift work they performed, nurses reported moderate job stress, poor sleep quality and moderate self-perceived health. The following significant relationships were observed: job stress was inversely related to sleep quality, which was directly related to self-perceived health status. Conclusion and implications for nursing management Hospital managers need to ensure more healthy shift work scheduling in order to improve nurses' clinical performance and personal health status, thereby also improving the quality of patient care. [ABSTRACT FROM AUTHOR]

Objective To determine the prevalence of impaired fasting glucose ( IFG) in Taiwanese adolescents and important related variables. Subjects and Methods This analysis was based on the Nutrition and Health Survey in Taiwan ( NAHSIT) data during 2010 and 2011. The original study was a cross-sectional and national representative survey. A total of 1949 subjects (965 males and 984 females) aged 11-20 years participated. Research tools consisted of questionnaires, anthropometry parameters, and blood biochemical indicators. The acquired data were analyzed using descriptive and inferential statistics. Results The prevalence of IFG in Taiwanese adolescents was 22% (a fasting glucose level between 100 and 125 mg/dL is considered abnormal). Factors that significantly affected IFG levels included sex, age, quality of family dietary environment, overweight, obesity, and the number of cardio-metabolic risk factors. Conclusion The prevalence of IFG in Taiwanese adolescents is a public health issue that should not be ignored. The prevalence may be reduced by adjusting lifestyles. Healthy family environments should be encouraged and appropriate healthy lifestyle counseling plans offered specifically to male adolescents with overweight, obesity, and cardio-metabolic risk factors. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether pinching spine (PS, i.e. 捏脊, a traditional Chinese manipulative therapy) is beneficial to ameliorating the depressive state (including behavioral deficit, retardative weight gain and decreased sucrose consumption) in a rat model of depression induced by chronic unpredictable stress (CUS) and to explore the candidate mechanism of action. Methods: PS was performed on rats' spine once daily for 1 week after exposure to CUS. The open-field test, body weight measuring, and sucrose intake test were applied on different dates: before stress (d0), at the end of stress (d21) and after PS treatment (d28), respectively. Then the rats' hippocampuses were performed genome-wide microarray analysis, and the expression levels of several genes were evaluated by real-time polymerase chain reaction (PCR). Results: Exposure to CUS resulted in decreases of behavioral activity and sucrose consumption, which were reversed significantly after PS treatment. The expression of several genes relevant to energy metabolism, anti-oxidation, and olfactory receptor, etc., were down-regulated, while the expression of those relevant to hemostasis, immunity-inflammation, and restriction of activities and ingestion, etc., were up-regulated in hippocampuses of rats exposed to CUS. PS treatment significantly inverted these changes. Furthermore, increase or decrease in gene expression evaluated by realtime PCR was concordant with up-regulated or down-regulated expression evaluated by microarray analysis. Conclusion: PS showed a potential antidepressant-like effect, of which the action mechanism might be due to gene expression regulation in hippocampus. [ABSTRACT FROM AUTHOR]

The purpose of this study was to survey occupational therapists for the usage problems and for their improvement needs for upper extremity rehabilitation equipment (UERE). A questionnaire was given to experienced occupational therapists from 113 hospitals that provide occupational therapy services with three or more professional full-time therapists. A total of 48 hospitals sent back questionnaires, and 184 valid questionnaires were received. Most of the UERE had two major problems: The base of the equipment was unstable, and the equipment was uninteresting to use. The therapists reported that three major needs for design improvement in the UERE were adjustability of functions, exchangeability of components and recording of movement data. Some therapists had suggestions for designing new types of UERE, such as manual dexterity training equipment, activities of daily living oriented equipment, sensory re-education equipment, arm supination and pronation training equipment, and wrist extension training equipment. These findings reveal the genuine user needs of upper extremity devices and provide useful applications to the development and re-design of these devices. However, obtaining opinions primarily from experienced occupational therapists may pose a methodological limitation of this study. In future research, it is advised to include patients' opinions and also investigate whether a clinician's years of experience would affect his or her viewpoint of usage problems and improvement needs of the UERE. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims To evaluate the self-perception of diabetes control associated with physical indicators and with practicing exercise and a healthy diet, among rural residents. Background It remains unclear whether a subject's self-perception of diabetes control increases its deleterious effects. Design Cross-sectional, correlational. Methods We recruited 715 participants from 18 primary healthcare centres in the rural regions of Chiayi County, Taiwan. Data were collected between 1 January 2009-30 June 2010. Logistic regression was conducted to identify the determinant factors associated with perceptions of diabetes control. Results A high percentage of participants overestimated their fasting blood glucose and HbA1C status. Total cholesterol, triglyceride, low density lipoprotein cholesterol, blood pressure, and waist circumference exceeded the medical standard in the 'feel good' group, and many did not adopt a healthy diet and undertake physical activity. The final logistic regression model demonstrated that residents with diabetes who exercised frequently had normal fasting glucose, and normal HbA1C tended to perceive 'feel good' control. Conclusion Misperception and unawareness of diabetes control were prevalent among rural residents. Addressing misperceptions among rural residents with diabetes and increasing their knowledge of professional advice could be important steps in improving diabetes control in an elder population. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether listening to pleasant music improves visual attention to and awareness of contralesional stimuli in patients with unilateral neglect after stroke. Methods: A within-subject design was used with 19 participants with unilateral neglect following a right hemisphere stroke. Participants were tested in three conditions (pleasant music, unpleasant music and white noise) within 1 week. All musical pieces were chosen by the participants. In each condition, participants were asked to complete three sub-tests of the Behavioural Inattention Test (the Star Cancellation Test, the Line Bisection Test and the Picture Scanning test) and a visual exploration task with everyday scenes. Eye movements in the visual exploration task were recorded simultaneously. Mood and arousal induced by different auditory stimuli were assessed using visual analogue scales, heart rate and galvanic skin response. Results: Compared with unpleasant music and white noise, participants rated their moods as more positive and arousal as higher with pleasant music, but also showed significant improvement on all tasks and eye movement data, except the Line Bisection Test. Conclusion: The findings suggest that pleasant music can improve visual attention in patients with unilateral neglect after stroke. Additional research using randomized controlled trials is required to validate these findings. [ABSTRACT FROM AUTHOR]

The article presents a study which assessed the effectiveness of the implementation of an enhanced storage label and error-reducing process in avoiding drug-dispensing errors. Also cited are the principle of "read three times and verify five times" in drug dispensing, and the evaluation on the degree of satisfaction of pharmacists on the new storage label aimed at reducing errors in the dispensing process.

Background: Cancer-related fatigue (CRF) is a highly prevalent, debilitating, and persistent symptom experienced by patients receiving cancer treatments. Up to 71% of men with prostate cancer receiving radiation therapy experience acute and persistent CRF. There is neither an effective therapy nor a diagnostic biomarker for CRF. This pilot study aimed to discover potential biomarkers associated with chronic CRF in men with prostate cancer receiving radiation therapy. Methods : We used a longitudinal repeated-measures research design. Twenty men with prostate cancer undergoing radiation therapy completed all study visits. CRF was evaluated by a well-established and validated questionnaire, the Patient-Reported Outcomes Measurement Information System for Fatigue (PROMIS-F) Short Form. In addition, peripheral blood mononuclear cells were harvested to quantify ribonucleic acid (RNA) gene expression of mitochondria-related genes. Data were collected before, during, on completion, and 24 months postradiation therapy and analyzed using paired t -tests and repeated-measures analysis of variance. Results : The mean of the PROMIS-F T score was significantly increased over time in patients with prostate cancer, remaining elevated at 24 months postradiation therapy compared to baseline. A significant downregulated BC1 ubiquinol-cytochrome c reductase synthesis-like (BCS1L) was observed over time during radiation therapy and at 24 months postradiation therapy. An increased PROMIS-F score was trended with downregulated BCS1L in patients 24 months after completing radiation therapy. Discussion : This is the first evidence to describe altered messenger RNA for BCS1L in chronic CRF using the PROMIS-F measure with men receiving radiation therapy for prostate cancer. Conclusion : Our results suggest that peripheral blood mononuclear cell messenger RNA for BCS1L is a potential biomarker and therapeutic target for radiation therapy-induced chronic CRF in this clinical population. [ABSTRACT FROM AUTHOR]

Background: Hip fractures are one of the most serious injuries affecting older adults. Evidence-based knowledge regarding the functional status of older persons after hip fracture can provide information critical for developing effective continuous-care and rehabilitation programs. Purpose: This study was developed to examine the post-hospital-discharge outcome measures and predictors of functional status in older adults in Indonesia after hip fracture surgery. Methods: The functional status of 109 patients discharged from an orthopedic hospital in Indonesia after hip fracture surgery was evaluated in this prospective cohort study. Functional status was evaluated using measures of physical and independent activities of daily living (PADL and IADL, respectively) at 1, 3, and 6 months postdischarge. Predictors of changes in functional status, including age, length of hospital stay, comorbidity, prefracture walking ability, type of surgery, status of depression and nutrition, type of insurance, and residential status (urban vs. rural), were also examined. Data were analyzed using generalized estimating equations. Results: Significant improvements in PADL were found at 3 and 6 months, and significant improvements in IADL were found at 6 months. Predictors of poor outcomes found in this study included age, a dependent prefracture walking ability, depression, and having public health insurance. Conclusions/Implications for Practice: The findings of this study support the effectiveness of using presurgery assessments to identify individuals at a higher postdischarge risk of having poor PADL and IADL outcomes. Home nursing or subacute rehabilitation is recommended to improve and maintain functional status in older persons after hip fracture surgery. In addition, interventions and rehabilitation should take into consideration different recovery periods for PADL and IADL after hospital discharge after hip fracture surgery. [ABSTRACT FROM AUTHOR]

Background: Continued smoking after receiving a diagnosis of cancer seriously affects disease prognosis and survival. The prevalence and risk factors of continued smoking among patients with newly diagnosed lung cancer are unknown in Taiwan. Purpose: The aims of this study were to assess the smoking status of patients with newly diagnosed lung cancer and to identify the characteristics that are associated with different smoking statuses. Methods: Baseline data of a longitudinal study on smoking behaviors after lung cancer diagnosis were analyzed in this study. Patients were consecutively recruited from three medical centers in northern Taiwan. A structured questionnaire and medical chart reviews were used to collect data. Multinomial logistic regression analysis was used to examine the factors associated with continuing to smoke after being diagnosed with lung cancer. Results: Among the 406 patients with newly diagnosed lung cancer who were recruited, 47.0% were never-smokers and 53.0% were ever-smokers. Among the second group, 38% were former smokers, 18% were recent quitters, and 44% were current smokers. Compared with former smokers, current smokers were more likely to be younger (OR = 1.05), to not exercise regularly (OR = 2.74), to currently live with smokers (OR = 2.48), and to have lower self-efficacy for refusing to smoke (OR = 0.95). Compared with recent quitters, current smokers were more likely to have lower self-efficacy for refusing to smoke. Conclusions/Implications for Practice: A significant proportion of ever-smoker lung cancer patients in Taiwan will continue to smoke after receiving their diagnosis. Variables known to modify the risk factors associated with continued smoking such as regular exercise and better refusal self-efficacy should be considered and incorporated into future smoking cessation programs for patients with lung cancer. [ABSTRACT FROM AUTHOR]