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The rapid development of information and communication technology and the popularization of the Internet have given a boost to digitization technologies. Since 2001, The National Science Council (NSC) of Taiwan has invested a large amount of funding in the National Digital Archives Program (NDAP) to develop digital content. Some studies have indicated that most respondents had no confidence in particular digital archive websites. Thus, with the Technology Acceptance Model (TAM) as a theoretical basis, the focus of the present study was to identify the factors influencing usage. Extension of the roles of perceived playfulness and interface design was also explored to identify the reasons that digital archives might not be accepted by some users. The present study used a random sampling method to distribute questionnaires to digital archive users via e-mail. The Structural Equation Modeling (SEM) method was used to verify the appropriateness of the study model and whether the hypotheses were confirmed. Study results indicated that the "interface design" is an important factor that influences people to use the digital archives, and that it is separate from the "human factor" and the "human-computer interface" (HCI). Moreover, the results showed that HCI had a significant impact on the "perceived ease of use" and on "usage intentions." However, the human factor interface showed a significant impact only on "perceived ease of use." With respect to the hypotheses regarding "usage intentions," the "perceived usefulness," "perceived ease of use," "attitude," and "perceived playfulness" were not related to "usage intentions." Therefore, it is necessary to consider the quality of interface design in the development of digital archives in order to promote usage. (Contains 3 tables and 5 figures.)

The aim of this study was to examine the psychometric properties of the Orientations to Happiness Questionnaire (OHQ; Peterson et al. in "J Happiness Stud" 6(1):25-41, 2005) in Taiwanese students. The participants were 578 undergraduate students (M[subscript age] = 18.64, SD = 1.02) and completed the OHQ, satisfaction with life scale (Diener et al. in "J Personality Assess" 49:71-75, 1985), and subjective happiness. Confirmation factor analysis indicated that a three-factor model with 17 items was the better fit model. Cross-validation also supported the modified Chinese version of the OHQ. Besides, the OHQ significantly predicted life satisfaction and subjective happiness with an exception of life of pleasure. Overall, it was concluded that the Chinese version of the OHQ would be useful for assessing individual's orientations to happiness.

The purpose of this study was to examine the psychometric properties of Wood's Job Satisfaction Questionnaire (JSQ) among Taiwanese workers. The participants were 341 nonprofit sport organization workers (M[subscript age] = 35.89, SD = 9.23) who completed the job satisfaction questionnaire, turnover intention scale, and organizational commitment. Confirmatory factor analysis was conducted to examine the validity of the JSQ. Results indicated that the model fit was satisfactory and a second-order factor accounts for the relationships among the first-order factors. In addition, the JSQ was, as expected, positively correlated with organizational commitment but is inversely correlated with turnover intention. The Cronbach's alpha was 76 for the JSQ, indicating a satisfactory validity and reliability in the Taiwanese worker sample. We conclude that the JSQ is useful for assessing an employee's satisfaction.

The purpose of this study was to investigate relationships between grade level, perceptual learning style preferences, and language learning strategies among Taiwanese English as a Foreign Language (EFL) students in grades 7 through 9. Three hundred and ninety junior high school students participated in this study. The instruments for data collection were the Perceptual Learning Style Preference Questionnaire (PLSPQ) and the Strategy Inventory for Language Learning (SILL). Results showed that statistically significant relationships were found to exist between grade level and kinesthetic learning style preference (p = 0.001), tactile learning style preference (p = 0.047), and individual learning style preference (p = 0.02). Results also showed that statistically significant relationships were found to exist between grade level and the use of memory strategies (p = 0.005), cognitive strategies (p = 0.02), metacognitive strategies (p = 0.000), affective strategies (p = 0.000) and social strategies (p = 0.000). Implications are that it is critical for classroom teachers to be more aware of the differences in their students and ensure that their courses present information that appeal to students in different grade levels. (Contains 3 tables.)

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]

Aim: Repeated occupational exposure and increased stress and fatigue levels contribute to a high risk of coronavirus disease 2019 (COVID‐19) infection among frontline nurses. This study aimed to explore the relationships among teamwork, work environment and resources, work–life balance, stress perception and burnout among nurses working at a dedicated infectious disease control hospital. Methods: The participants were 389 nurses at a dedicated infectious disease control hospital in Taipei City, Taiwan. This study adopted survey design with a questionnaire using the Safety Attitude Questionnaire. Results: The work–life balance among nurses at the dedicated hospital significantly mediated the effects of teamwork and work environment and resources on burnout. In addition, stress perception had interaction effects on work–life balance and burnout. Conclusion: This study's results provide important recommendations for managing teamwork, work environment and resources, work–life balance, stress perception and burnout prevention in nurses to help them better prepare and cope with emergencies. Findings can serve as a reference for developing relevant hospital management policies. Summary statement: What is known about the topic? Organizational changes, information scarcity and shortages of personal protective equipment were the primary factors driving uncertainty when the pandemic began.Work environments can significantly affect burnout, job satisfaction and perceived stress among nurses.Teamwork is an important factor affecting nurse burnout. What this paper adds? Repeated occupational exposure and increased stress and fatigue levels contribute to a high risk of COVID‐19 infection among frontline nurses.Healthcare systems should emphasize the issues of teamwork, work environment and resources and work–life balance among nurses to help them prepare for and cope with emergencies.Nurse supervisors should constantly monitor for burnout among subordinates and eliminate their stressors. The implications of this paper: When teaching nursing management skills during an epidemic, it is essential to focus on strengthening the nursing supervisors' communication role, particularly during an outbreak.To reduce nurse burnout, key leadership and culture aspects in the work environment include prioritizing infection control measures, providing social support, encouraging strong multidisciplinary teamwork, ensuring adequate resources are available and receiving support from hospital superiors and the government. By addressing these factors, healthcare organizations can create a positive work environment that supports nurses' well‐being and promotes better patient outcomes.To manage nurses in the postpandemic era, healthcare organizations can implement routine training programs, new models of cross‐teamwork, emergency response plans, effective systematic monitoring and mental health intervention programs. These strategies can help promote collaboration, support nurses' mental health and ensure preparedness for future crises. Healthcare organizations can create a more effective healthcare system by adopting these measures. [ABSTRACT FROM AUTHOR]

Aim and Objectives: This study explored the effect of transdermal buprenorphine on quality of life and six symptoms in cancer patients with pain. Background: Transdermal opioids offer advantages over traditional routes of administration. The impact of transdermal buprenorphine on quality of life for patients with cancer in Asian populations is unknown. Design: This study employed a single‐arm observational repeated measures design. Cancer patients with pain were evaluated prior to treatment (baseline). Over a 4‐week treatment period, quality of life and symptoms were assessed at 2 and 4 weeks. This study adhered to the recommendations of STROBE guidelines. Methods: This multi‐site study was conducted in six hospitals located across northern, middle and southern Taiwan. Adult cancer patients whose pain was previously stable with opioid analgesics and, based on clinical judgement, were able to convert to transdermal buprenorphine treatment were invited to participate. Quality of life was measured with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ‐C30). Results: Generalised estimating equations showed participants who completed at least one follow‐up measurement (N = 80) over 4‐weeks had a significant improvement in overall quality of life. Functional status only improved for social functioning. However, symptom severity decreased significantly for nausea/vomiting, pain, insomnia and constipation. Conclusions: The study provides initial evidence supporting transdermal buprenorphine for providing beneficial effects of improving quality of life and reducing severity of symptoms in Asian patients with cancer. Relevance to clinical practice: The findings of this study can inform the clinical practice that the use of transdermal buprenorphine in cancer patients with pain may also reduce the severity of other symptoms and improve overall quality of life. Trial registration details: This study was registered in ClinicalTrials.gov. Identifier: NCT04315831. [ABSTRACT FROM AUTHOR]

Background: Performance goal orientations are influential motivational factors for predicting learning performance. However, a lack of attention has been paid to investigating the effects of performance goal orientations on learning performance and in‐game performance in the context of digital game‐based learning. Objectives: This study implemented a game‐based English vocabulary learning system and investigated how performance goal orientations affected learners' learning performance and in‐game performance. Methods: A total of 59 non‐English major university students participated in this study, divided into performance‐approach learners (PAPL) and performance‐avoidance learners (PAVL) based on their performance goal orientations. The English vocabulary listening test and log data were collected for conducting quantitative analyses. Results and conclusions: The results showed that the PAPL outperformed the PAVL in learning performance, whereas the two groups demonstrated similar gain scores and overall in‐game performance. Moreover, the results showed that the PAVL's learning performance was strongly associated with all aspects of in‐game performance in the learning activities. Conversely, the PAPL's learning performance was only associated with two aspects of in‐game performance in the competition activities. Implications: The findings of this study suggest that performance goal orientations play significant roles in both learning performance and in‐game performance, which could benefit the PAVL's in‐game performance, which is a substantial factor in promoting their learning performance via DGBL. Lay Description: What is already known about this topic: Digital game‐based learning (DGBL) has been widely adopted in various subject areas.DGBL is an effective learning approach for language learning.Performance goal orientations are influential motivational factors in predicting learning performance.Relevant empirical research on performance goal orientations in DGBL is scarce and inconclusive. What this paper adds: A game‐based English vocabulary learning system was developed based on the considerations of different characteristics of performance goal orientations.This study provides understandings of the impact of performance goal orientations on both learning performance and in‐game performance in DGBL.Performance‐approach learners outperformed performance‐avoidance learners, whereas the two groups demonstrated similar gain scores and overall in‐game performance.Performance‐avoidance learners' in‐game performance is a substantial factor in promoting their learning performance via DGBL. Implications for practice and/or policy: Educators should consider adopting game‐based assessment to reduce the gap between learners with different performance goal orientations.DGBL can be a potential approach to supporting different performance goal orientations, but it is particularly beneficial to learners with performance‐avoidance goals.Learners with different performance goal orientations need different types of learning activities to achieve better performance.A personalized DGBL system should be developed to accommodate the needs and preferences of learners with performance‐approach and performance‐avoidance goals. [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]

Objective To investigate the autonomic nervous dysfunction in patients with Alzheimer's disease (AD) and its relationship with cognitive function. Methods A total of 160 AD patients were enrolled in Shanghai Jinshan Zhongren Aged Care Hospital from July 2020 to June 2021. Mini - Mental State Examination (MMSE), Montreal Cognitive Assessment - Basic (MoCA - B) and Scale for Outcomes in Parkinson's Disease - Autonomic (SCOPA - AUT) were used to assess the cognitive and autonomic nervous function of AD patients, and the occurrence of orthostatic hypotension (OH) in AD were evaluated with the lying and standing blood pressure testing. Spearman rank correlation analysis was used to analyze the correlation between autonomic nervous function and cognitive function. Results Compared with the mild AD group, the scores of MMSE, MoCA-B and their subitems were lower (P = 0.000, for all), and SCOPA - AUT score (P = 0.000) and its subitem of digestive system (P = 0.000), urinary system (P = 0.000) and body temperature (P = 0.001) were increased in the severe AD group. The incidence of OH was 32.22% (29/90). Spearman rank correlation analysis showed that the SCOPA-AUT sore (rs = - 2.980, P = 0.000; rs = - 3.580, P = 0.000) and its subitem of digestive system (rs = - 2.730, P = 0.000; rs = - 3.160, P = 0.000), urinary system (rs = - 3.000, P = 0.000; rs = - 3.240, P = 0.000) and body temperature (rs = - 0.244, P = 0.005; rs = - 3.270, P = 0.000) were negatively correlated with MMSE and MoCA - B scores. Conclusions The autonomic nervous dysfunction and its subitem of digestive system, urinary system and body temperature were significant correlated with the cognitive impairment in AD patients. However, there is a lower incidence of OH in AD. [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]

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]

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]

Drawing upon social cognitive theory, this research postulates cultural intelligence as a key driver of knowledge sharing among culturally diverse teams. An empirical testing of the proposed model, by investigating team leaders from high-tech industries, reveals the applicability of social cognitive theory in understanding cultural intelligence, perceived team efficacy, and knowledge sharing. Specifically, the test results herein show that knowledge sharing is directly influenced by metacognitive, cognitive, and motivational cultural intelligence. At the same time, knowledge sharing is indirectly impacted by metacognitive and behavioral cultural intelligence through the mediation of perceived team efficacy. Lastly, this research provides managerial implications and limitations. © 2013 Wiley Periodicals, Inc. [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]

Self‐management helps patients understand their illnesses and learn about disease‐related skills so they can better manage their situation. However, published studies on the effectiveness of self‐management for chronic obstructive pulmonary disease (COPD) are heterogeneous. Quasi‐experimental design was used to investigate the effectiveness of a self‐management program in self‐care efficacy and quality of life in patients with COPD. Sixty participants who had experienced COPD were assigned to control group (usual care) or experimental group (self‐care program) (1:1 ratio) according to a purposeful sampling at a Medical Center in Taiwan. The Medical Research Council dyspnea scale, the COPD Self‐Efficacy Scale, the Clinical COPD Questionnaire were used to analyze data. The Medical Research Council dyspnea scale was more significant improvement in the 2 months after discharge in the experimental group than in the control group. The COPD Self‐Efficacy Scale and Clinical COPD Questionnaire scores in the experimental group within 3 months after discharge were significantly improved compared with the control group. These findings demonstrate the application and initial effect of this self‐management program. [ABSTRACT FROM AUTHOR]

Aim: To examine the effects of a simplified reablement program on physical function and quality of life in hospitalized older patients. Methods: The randomized controlled trial enrolled 114 older patients aged ≥65 years who, 2 weeks before admission, had been able to walk independently. Patients randomized to the reablement group received supervision and assistance to carry out the simplified reablement program 30 min daily during their hospital stay. Patients in the reminding group received only oral encouragement to continue the reablement program for 30 min daily. The control group received only usual care that included medical intervention consistent with the patient's diagnosis. The main outcome was improvement in physical function, including the modified version of the Katz Activities of Daily Living (ADL) score, Timed Up and Go test (TUG) and Hand Grip Strength (HGS). Secondary outcomes included the EuroQoL 5 Dimension (EQ‐5D) Questionnaire and Visual Analog Scale (VAS). Results: The intervention had no significant effect on the Katz ADL score. However, a significant within‐group improvement in TUG occurred in the reminding group and reablement group. In addition, a significant time‐dependent improvement in HGS occurred only in the reablement group. With respect to secondary outcomes, the EQ5D score improved significantly only in the reablement group at 3 months after discharge. Conclusions: The simplified reablement program may be beneficial to optimize physical function and improve quality of life in hospitalized older patients. It is recommended that health professionals should assist or encourage older patients to do simplified reablement during their hospital stay. Geriatr Gerontol Int 2020; 20: 436–442. [ABSTRACT FROM AUTHOR]

Background: Substance abuse among young people has become a serious public health problem for years. The risk of relapse among illicit drug use is essential for developing adequate substance reuse prevention policies. The purpose of the current study is to investigate the potential predictor in long-term relapse rates among young patients that underwent a family-based treatment program. Methods: To perform this study, 103 young patients with substance use (mean age: 16.2 years, 78.6% male) were referred to participate in a 10-week family-based treatment program. At the beginning and at the end of the treatment, the patients were required to fill out the Chinese Craving Beliefs Questionnaire (CCBQ), the Adolescents' Behavior-problem Scale (ABS), and the Family APGAR. Furthermore, the patients' caregivers had to fill out the Family APGAR, the 12-item version of the Chinese Health Questionnaire (CHQ), and the Parenting Stress Index (PSI). All patients were followed up for 5 years in order to observe their long-term outcomes regarding substance use relapse. Results: During the 10-week family-oriented programs, the CCBQ scores, the CHQ scores and the Child-domain of PSI significantly decreased. Better changes in patients' behavioral problems during the treatment program predicted a lesser likelihood of substance use relapse in the subsequent 5 years. Furthermore, methamphetamine or 3,4-methylenedioxy-methamphetamine use and living in single-parent families were two factors associated with higher relapse rates. Conclusions: The changes in patients' behavioral problems during the treatment program may serve as a predictor of substance use relapse over the subsequent 5 years. This study's findings provide insight about substance use prevention and serve as a reference for policy-making. [ABSTRACT FROM AUTHOR]

Background: Surrogates often do not accurately predict older people's preferences about end-of-life (EOL) care. Few studies have examined the impact of advance care planning (ACP) on EOL decision-making consistency between older people and their surrogates, and these studies have yielded conflicting results. Objectives: To evaluate the effectiveness of ACP in improving EOL decision-making consistency between older people and their surrogates. Design: The intervention in this pre–post quasi-experimental design included an informative video, a brochure about ACP, and a guided discussion about EOL wishes. Setting: Two geriatric wards in a medical center in northern Taiwan. Subjects: One hundred eight participants, as 54 pairs of older people and their surrogates, were randomly assigned to either the experimental or control group. The experimental group received an intervention, while the control group received usual care. Measurements: Life-Support Preferences Questionnaire. Results: The intervention did not improve decision-making consistency between older people and their surrogates. This was the first time that most pairs discussed specific EOL decisions, so additional preparation may improve comfort with this topic. This study also found that some older people had difficulty concentrating on the educational brochure or understanding the related terms. Conclusions: Preparation for ACP discussion is needed for older people and their surrogates. Longer-term effects of ACP should be monitored because ACP interventions may have enhanced empathy between older people and their surrogates. Additionally, a culturally sensitive illustrated questionnaire that explains life-support preferences and ACP topics may improve communication between older people and their surrogates. [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]

Purpose: Despite a growing understanding of health-related quality of life (HRQOL) and its determinants in hemodialysis (HD) patients, little is known about the effects and interrelationships concerning the perception of autonomy support and basic need satisfaction of HD patients on their HRQOL. Based on self-determination theory (SDT), this study examines whether HD patients' perceived autonomy support from health care practitioners (physicians and nurses) relates to the satisfaction of HD patients' basic needs and in turn influences their HRQOL.Methods: A questionnaire was administered to 250 Taiwanese HD patients recruited from multiclinical centers and regional hospitals in northern Taiwan. Structural equation modeling (SEM) analysis was conducted to examine the causal relationships between patient perceptions of autonomy support and HRQOL through basic need satisfaction.Results: The empirical results of SEM indicated that the HD patients' perceived autonomy support increased the satisfaction of their basic needs (autonomy, competency, and relatedness), as expected. The higher degree of basic need satisfaction led to higher HRQOL, as measured by physical and mental component scores.Conclusion: Autonomy support from physicians and nurses contributes to improving HD patients' HRQOL through basic need satisfaction. This indicates that staff caring for patients with severe chronic diseases should offer considerable support for patient autonomy. [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]

Background: A considerable number of studies have identified the risk factors attributable to job-related stress among nurses. However, studies investigating psychological symptoms among hospital nurses is still lacking, especially in Taiwan, where the average patient to nurse ratio is among the highest in the world. This study aimed to investigate the potential role of self-rated health status, self-reported diseases, and utilization of occupational health checks in psychological symptoms among Taiwanese nurses.Methods: A cross-sectional design was conducted from September through December 2013. Data were collected through online self-administered questionnaire among 697 registered nurses in seven regional hospitals governed by the Taipei City Government.Results: Nurses with fair or poor self-rated health, lower education, <30 years of age, and low back pain were more likely to suffer from psychological symptoms. A trend toward significance was also noticed for those aged 30-39. Importantly, low back pain was the most common disease among nurses in self-reported diseases and half of the nurses reported not utilizing the occupational health examination for the last 5 years.Conclusions: To alleviate or prevent the psychological symptoms, psychosocial support, and awareness program on prevention of occupational injuries should be offered to nurses younger than 39 years old and having lower educational levels. Moreover, underutilization of occupational health examination among nurses deserves more attention. [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]

Background: In May 2011, di(2-ethylhexyl) phthalates (DEHP) and, to a lesser extent, di-iso-nonyl phthalate (DiNP) were found to have been illegally used for many years in Taiwan as clouding agents in foods including sports drinks, juice beverages, tea drinks, fruit jam/nectar/jelly, and health or nutrient supplements. Objective: To estimate the DEHP exposure for the study participants for the follow-up epidemiological study and health risk assessment. Methods: A total of 347 individuals possibly highly exposed to phthalate-tainted foods participated in the study. Exposure assessment was performed based on the participants' responses to a structured questionnaire, self-report of exposure history, urinary metabolite concentrations, and DEHP concentration information in 2449 food records. A Bayesian statistical approach using Markov chain Monte Carlo simulation was employed to deal with the uncertainties in the DEHP concentrations of the contaminated foods and the participants' likelihood of being exposed. Results: An estimated 37% and 15% of children younger than 12 years old were exposed to DEHP at medium (20–50 μg / kg_bw / day) and high AvDIs (50–100 μg / kg_bw / day), respectively, prior to the episode (9% and 3% in adults, respectively). Moreover, 11% of children and 1% of adults were highly exposed (> 100 μg / kg_bw / day), with a maximum of 414.1 μg / kg_bw / day and 126.4 μg / kg_bw / day, respectively. Conclusions: The phthalate exposure-associated adverse health effects for these participants warrant further investigation. The estimation procedure may be applied to other exposure assessment with various sources of uncertainties. [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]

Stern's value-belief-norm ( VBN) theory of environmentalism suggests that perceiving adverse effects from global warming could promote mitigation behaviour. The VBN theory of environmentalism postulates a causal chain of five variables: values, the New Environmental (or Ecological) Paradigm ( NEP), awareness of consequences ( AC), ascription of responsibility ( AR) to self-beliefs, and personal norms ( PN). Given a limited number of studies with East Asian participants, this study examines the applicability of the VBN theory model in predicting pro-environmental behaviour in Taiwan to enhance the intercultural validation. A questionnaire study was conducted among 757 Taiwanese respondents. The results of structural equation modelling analysis and Sobel tests confirm the direct and mediatory effects of the causal sequence of the variables in the VBN theory of pro-environmental behaviour, with NEP, AC beliefs, AR beliefs, and PN all bearing a mediating relationship between their antecedent and outcome variables in the causal chain. We elucidate the research results of the intercultural validation of the VBN theory model in this empirical study to clarify pro-environmental behaviour. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate the trajectory of weight change in Taiwanese women with breast cancer after starting chemotherapy and the impact of chemotherapy regimens on weight change while controlling for age, menopausal status, body mass index, lymph node involvement and changes in habits of dietary fat intake and exercise. Background Weight gain after adjuvant chemotherapy in women with breast cancer has negative impact on health outcomes. Design Longitudinal, clinical observational study. Methods Weights were repeatedly measured in 147 women with breast cancer stages I- III. Hierarchical linear modelling was used to analyse these longitudinal data. Results The overall pattern of weight change was a cubic form beginning with a mean of 56·9 kg before chemotherapy. It gradually increased to 59·4 kg at 8·5 months after the first chemotherapy followed by a decrease to 58·5 kg at 21·5 months. During the last 2·5 months, weight increased slightly and never returned to the initial level. After controlling for confounders, steeper weight change was observed among women receiving cyclophosphamide, methotrexate and fluorouracil. The highest weight gain in the cyclophosphamide, methotrexate and fluorouracil group was 2·9 kg (5%) vs. 0·9 kg (1%) in the anthracycline-based group. Conclusion The trajectory of body weight change within two years after chemotherapy shows a trend of gradual ascent, followed by a small decline and a slight increase in the last 2·5 months. The chemotherapy regimen can predict the trend after controlling for other confounders; women on cyclophosphamide, methotrexate and fluorouracil have a steeper weight change. Relevance to clinical practice Nurses can inform women with breast cancer about the expected changes in body weight after chemotherapy to reduce their uncertainty. Future studies on effective interventions to minimise chemotherapy-induced weight gain are needed. [ABSTRACT FROM AUTHOR]

Purpose The Frenchay Activities Index (FAI) is a frequently used measure that assesses instrumental activities of daily living (IADL). However, the measurement properties of the FAI are largely unknown for patients with traumatic limb injuries. The purpose of this study was to examine the measurement properties of a Chinese version of the FAI, including score distribution, internal consistency, construct validity, predictive validity, and responsiveness in patients with traumatic limb injuries. Methods We performed a secondary data analysis, primarily using non-parametric item response theory, on a data set. The FAI and the World Health Organization Quality of Life Assessment (WHOQOL-BREF) were administered via telephone interview to a cohort of patients at 3, 6, and 12 months after injury. Totals of 342 patients' data (at 3 months after injury), 1,010 patients' data (6 months), and 987 patients' data (12 months) were available for analysis. Results After the deletion of 5 items (i.e., travel outings, gardening, household/car maintenance, reading books, and gainful work), the 10-item revised FAI (R-FAI) formed a unidimensional construct. The R-FAI exhibited a unidimensional construct at each of the 3 time points. The R-FAI had sufficient score distribution, internal consistency, predictive validity, and responsiveness in patients with limb injuries. Conclusions Our results support the conclusion that the R-FAI has satisfactory measurement properties. The R-FAI is useful for assessing IADL in patients with limb injuries. [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]

Background: The aim was to examine the associations among empowerment processes, health outcomes, and related factors in patients living with diabetes. Methods: This cross-sectional study analyzed a convenience sample of 144 patients with diabetes in Taiwan. Data were collected with questionnaires, HbA1C, blood pressure, and total cholesterol. Findings: Empowerment processes were significantly associated with health outcomes, including self-care behaviors, quality of life, and HbA1C. Diabetes-related complications and treatment variables were associated with empowerment processes and health outcomes. Conclusions: To optimize the empowerment processes needed to promote the health of patients with diabetes, healthcare professionals should consider patient perceptions of empowerment processes and related factors. [ABSTRACT FROM AUTHOR]

Abstract: This study aims to ascertain whether or not the Food Traceability System (FTS) can decrease an individual's perceived uncertainty and strengthen his/her purchase intention regarding fast foods. A website-based questionnaire study was conducted in Taiwan and a total of 435 valid subjects collected. The empirical results of structural equation modeling (SEM) analysis indicate that when a fast food store adopts FTS then consumers' perceived uncertainty can be reduced because both their perceived information asymmetry and fears of seller opportunism are also reduced, which in turn strengthen their purchase intentions regarding fast foods. In addition, with FTS, not only are both consumers' perceived product diagnosticity and informativeness are increased but consumers' trust in the farmer's records kept for this system is also increased, which in turn mitigate both consumers' perceived information asymmetry and fears of seller opportunism. Finally, the higher the degree of involvement an individual has and the more FTS mitigates his/her perceived uncertainty, the higher his/her purchase intention regarding fast foods than otherwise. Based on the findings from this study, attempts are made to provide some suggestions to the public health sector and the fast food marketers to promote FTS. [Copyright &y& Elsevier]

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]

Abstract: Eight trigrams (BaGua) is a philosophy that has played an essential role in Chinese life. The purpose of the present study is to extend the theory to organizational problem-solving, so that individuals can engage in creative problem solving and justification to discover the most effective approaches. Questionnaires were returned by 259 research and development managers, and were analyzed using the SEM statistical method. The results indicate that the interaction among each trigram in the model of BaGua was significantly correlated. Most of the hypotheses were supported. The more an individual interacted with others, with data and with devices, the higher the problem sensitivity and evaluation performance. Despite the finding that the Tui trigram was not significantly related to the Ken trigram, all other trigram elements significantly affected each other. This finding is discussed in terms of the confirmatory situation and the conceptualization of epistemology in problem-solving. [Copyright &y& Elsevier]

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.

Aim. The aim of this study was to evaluate the interview version of the screening of risk for suicide with redefined items for the hospitalised patients. Background. Patients hospitalised in general hospitals with physical illnesses performed suicidal acts more rapidly after admission. Design. A two-hour screening skills training course was provided to general nurses caring for hospitalised patients. The patients were rated by trained nurses according to the screening of risk for suicide. Then, patients did self-rating of repulsion of life scale and symptom distress. The participants were 54 trained nurses and 205 patients, 76 of whom had chronic obstructive pulmonary disease and 129 had lung cancer. Methods. The trained nurses used the screening of risk for suicide to screen patients and compared their results with their trainers within 24 hours for inter-rater consistency, followed by patients' self-rating. Results. The inter-rater reliability between nurses and their trainers was 0·85. The screening of risk for suicide rated by nurses correlated significantly with repulsion to life and symptom distress rated by patients. There were 26·3% (20) of patients with chronic obstructive pulmonary disease and 14·0% (18) of patients with lung cancer who showed moderate-to-high suicide risk, most of them having poor social support. The nurse's score on patient with chronic obstructive pulmonary disease was higher than patient's self-rating. Conclusions. The screening of risk for suicide was useful in alerting the general nurses to high-risk patients and the nurse' screening collected more in-depth data than patients' self-rating. It is suggested that this suicide risk-screening training should incorporate into continuing education in general hospital and the use of Screening of Risk for Suicide incorporating into new patient nursing assessment. Relevance to clinical practice. The two-hour suicide risk-screening training could renew the general nurse skill of risk screening for the hospitalised patients. [ABSTRACT FROM AUTHOR]

Abstract: Previous studies have reported that p-nonylphenol (NP) can advance the age at vaginal opening in prepubertal rats. A significant exposure levels of NP was found in Taiwanese population even from the prenatal stage. The purposes of this study are to examine the urinary NP concentration of pubertal students in Taiwan and to explore its association with the development of secondary sexual characteristics. 786 pubertal students were recruited. The NP was determined using solid-phase extraction and high-performance liquid chromatography with fluorescent detection. A self-administered questionnaire was used to collect the data on occurrence of secondary sexual characteristics in the subjects. About 30% of the urine samples were positively detected. The NP concentrations ranged from ND to 178.25μgg−1 cr. Fifteen percent of the Taiwanese girls between 10.5 and 10.9years old reported having undergone menarche, which was higher than the white girls (4.6%) and the black girls (8%). There was no significant difference of urinary NP levels between groups of having and not having secondary sexual characteristics because body mass index (BMI) had significant effects on sexual development. After adjusting the effect of age and BMI, the menarcheal age remained inversely correlated with the increase of urinary NP levels. Nonylphenol exposure could disturb pubertal development and the pubertal girls seem more sensitive than pubertal boys to the exposure of endocrine disruption chemicals (EDCs). The effects of early maturation as well as the health implications need further study. [Copyright &y& Elsevier]

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]