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Bismuth oxide (Bi2O3) is an effective additive used to enhance radiography resolution for dental materials. However, there are potential concerns regarding its biocompatibility and connection to tissue discoloration. In the present study, we modified the radiopacity properties of Bi2O3 with zirconium oxide (ZrO2) using a sol-gel process and investigated the composition, as well as the effects of heat treatment temperature using Thermogravimetry analysis (TGA), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FT-IR), transmission electron microscopy (TEM), and X-ray diffraction (XRD). The harvested Bi2−xZrxO3+x/2 particles showed that the dominant phase transferred from α-Bi2O3 to β-Bi7.38Zr0.62O12.31 after a heat treatment of over 750 °C for 2 h. As the x values of Bi2−xZrxO3+x/2 increased from 0.2 to 1.0, more zirconium oxide precipitated onto the particle surface, thus enhancing the surface roughness of particles. For sol-gel Bi1.8Zr0.2O3.1 powders (x = 0.2), the radiopacity values became 4.90 ± 0.23 and 5.83 ± 0.22 mmAl after a heat treatment of 500 °C and 750 °C, respectively. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to explore the perceptions and experiences of family caregivers and nurses after the signing of a do-not-resuscitate (DNR) order for patients in respiratory care wards (RCWs). The goal was to facilitate nurses' preparedness for responding to family reactions and feelings in future DNR situations. Methods: The study employed semi-structured interviews with ventilator-dependent patients' families and nurses recruited from RCWs in regional and district hospitals in New Taipei City. It explored the feelings, motivations, and decision-making processes concerning DNR orders. Thematic analysis identified key themes and patterns. Results: Twenty-two family members and 12 nurses, caring for 22 patients, participated in the interviews, resulting in 44 interview transcripts. The majority of family members were male (54.5%), whereas all nurses were female. Family caregivers and nurses had nuanced perceptions and showed emotional responses after the signing of DNR orders. Family caregivers grappled with feelings of guilt, uncertainty, and the weight of decision-making, while nurses navigated ethical dilemmas and sought to support families through the process. Common themes included the desire to minimize the patient's suffering, concerns about quality of life, and the need for clear communication and support. Conclusion: The understanding of family caregivers' and nurses' perceptions of DNR orders for patients in RCWs illuminates complex end-of-life care challenges. A key gap in the study was its limited generalizability due to focusing on specific RCWs. Nonetheless, the insights gained may enable health care providers to tailor support, facilitate informed decision-making, and promote compassionate care for ventilator-dependent patients and their families.

Background: In aging societies, residents of residential long-term care facilities (RLTCF) are a population that can significantly influence the success of efforts to promote hospice care and to achieve societal goals of domestic aging in place and good death. Multidisciplinary healthcare providers in RLTCF play vital roles in assessing, coordinating, and implementing the "five whole concepts" of hospice care., Purpose: To explore multidisciplinary healthcare providers' experiences with implementing hospice care in RLTCF. Study results may be referenced for future research into hospice care in RLTCF., Methods: In this qualitative study, one-on-one interviews were conducted with 14 multidisciplinary healthcare providers working for three hospital-affiliated RLTCFs in Northern Taiwan from April to July 2019. Each interview lasted between 40 and 68 minutes. Data were transcribed and then analyzed using the content analysis technique., Results: The emergent themes derived from participant experiences were "lack of hospice care literacy and multidisciplinary communication", "insufficient resources for hospice care implementation", "a dilemma between reasonability and sensibility", "quandary about and bearing from facing family dying", and "expectation of mental and physical well-being for family and residents"., Conclusions / Implications for Practice: The experiences of the participants illuminate the importance of strengthening hospice care training for multidisciplinary RLTCF healthcare providers; establishing standard operating procedures; and increasing the manpower, environmental, and equipment resources available for implementing hospice care in RLTCF.

Background: Optimal communication and collaboration between inter-disciplinary health care providers is critical to ensuring high quality patient care. We aimed to quantify the impact on physician-nurse collaboration (PNC) of implementing daily goal sheets (DGSs) in emergency settings., Methods: The usage of a DGS was administered in morning rounds in an emergency intensive care unit (ICU) for four consecutive months. A Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (JSAPNC) form was used before (n=113) and after (n=107) the intervention to evaluate the attitudes of PNCs from the perspective of both physicians and nurses., Results: There is a significant positive relation between the attitude to PNC and the participant age, educational background, and professional rank and title before DGS application (P<0.01 for each), whereas there was no significant difference observed after the initiation of the DGS., Conclusions: The use of a DGS improves physician-nurse collaborations in emergency care settings.

Bismuth oxide (Bi₂O₃) is an effective additive used to enhance radiography resolution for dental materials. However, there are potential concerns regarding its biocompatibility and connection to tissue discoloration. In the present study, we modified the radiopacity properties of Bi₂O₃ with zirconium oxide (ZrO₂) using a sol-gel process and investigated the composition, as well as the effects of heat treatment temperature using Thermogravimetry analysis (TGA), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FT-IR), transmission electron microscopy (TEM), and X-ray diffraction (XRD). The harvested Bi 2-x Zr x O 3+x/2 particles showed that the dominant phase transferred from α -Bi₂O₃ to β -Bi 7.38 Zr 0.62 O 12.31 after a heat treatment of over 750 °C for 2 h. As the x values of Bi 2-x Zr x O 3+x/2 increased from 0.2 to 1.0, more zirconium oxide precipitated onto the particle surface, thus enhancing the surface roughness of particles. For sol-gel Bi 1.8 Zr 0.2 O 3.1 powders (x = 0.2), the radiopacity values became 4.90 ± 0.23 and 5.83 ± 0.22 mmAl after a heat treatment of 500 °C and 750 °C, respectively.

Background: Pain has been integrated as the fifth vital sign that is a common health problem for emergency room patients. Although prior studies have addressed the effects of the pain-management knowledge of emergency room staffs on the quality of pain care, there is a dearth of research on pain management knowledge and on the factors that influence this knowledge., Purpose: To explore the knowledge of emergency room staffs regarding pain management and the factors that influence this knowledge., Methods: This cross-sectional study used a self-developed questionnaire to survey a convenience sample of 201 physicians and nurses from three emergency rooms in northern Taiwan., Results: The average score for pain-management knowledge was 63.28 out of 100. Demographic variables including education level, professional specialty, and sources of pain education had significant effects on participants' pain-management knowledge., Conclusions/implications for Practice: The knowledge of emergency room staffs regarding pain management must be reinforced further in order to improve care quality. The factors identified that influence this knowledge may be referenced by hospitals in developing / revising pain-related continuing education, in developing pain management guidelines, and in setting the directions for future research on pain management.

The World Bank has ranked Taiwan as the 5th highest risk country in the world in terms of full-spectrum disaster risk. With volatile social, economic, and geologic environments and the real threat of typhoons, earthquakes, and nuclear disasters, the government has made a public appeal to raise awareness and reduce the impact of disasters. Disasters not only devastate property and the ecology, but also cause striking and long-lasting impacts on life and health. Thus, healthcare preparation and capabilities are critical to reducing their impact. Relevant disaster studies indicate children as a particularly vulnerable group during a disaster due to elevated risks of physical injury, infectious disease, malnutrition, and post-traumatic stress disorder. Primary school teachers are frontline educators, responders, and rehabilitators, respectively, prior to, during, and after disasters. The disaster prevention project implemented by the Taiwan Ministry of Education provides national guidelines for disaster prevention and education. However, within these guidelines, the focus of elementary school disaster prevention education is on disaster prevention and mitigation. Little guidance or focus has been given to disaster nursing response protocols necessary to handle issues such as post-disaster infectious diseases, chronic disease management, and psychological health and rehabilitation. Disaster nursing can strengthen the disaster healthcare response capabilities of school teachers, school nurses, and children as well as facilitate effective cooperation among communities, disaster relief institutes, and schools. Disaster nursing can also provide healthcare knowledge essential to increase disaster awareness, preparation, response, and rehabilitation. Implementing proper disaster nursing response protocols in Taiwan's education system is critical to enhancing disaster preparedness in Taiwan.