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Kung PC, Huang HL, Hsu WC, Huang HL, Chang HJ, Shyu YIL. Coexisting with anomie: Experiences of persons living with early-stage dementia: A grounded theory study. Int J Ment Health Nurs 2024; 33:452-462. [PMID: 37985929 DOI: 10.1111/inm.13256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/19/2023] [Accepted: 11/05/2023] [Indexed: 11/22/2023]
Abstract
Individuals in the early stages of dementia often endure elevated levels of stress and anxiety, which can hinder their ability to adapt to the progression of dementia. To mitigate the negative impacts of dementia more effectively, it is necessary to explore the trajectory of the adaptation process of persons living with dementia. This study aimed to construct a theoretical framework for the adaptation process of individuals in the early stages of dementia. Participants were dyads of persons diagnosed with mild dementia or mild cognitive impairment (≥ 60 years of age) and their primary family caregivers. This longitudinal study used a grounded theory approach to explore the adaptation trajectory changes in persons with mild dementia over a 3-year period. Data were collected from dyads with face-to-face interviews. Analysis of the interview data revealed the core category was 'Coexisting with anomie: Progressive disappointment and striving', which was comprised of three categories: awareness of alienation, unsettled feelings, and restorative avoidance coping. Categories changed depending on levels of cognition and constituted progressive and cyclical dynamic processes. Four contextual factors positively or negatively influenced adaptation: level of insight about dementia, personal traits, caregiving style of the caregiver, and level of social interactions. These findings provide a new perspective about the mental health of persons in early-stage dementia. Understanding coexisting with anomie and related influencing factors could facilitate the development of support interventions by mental health nursing staff, which could improve emotional safety, promote psychological well-being, and increase quality of life for persons living with dementia.
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Affiliation(s)
- Pen-Chen Kung
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
| | - Huei-Ling Huang
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
| | - Wen-Chuin Hsu
- Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Hong-Jer Chang
- National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Neurology, Dementia Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Li YT, Bai JX, He JM, Yang SW, Huang HL. The Mediating Role of Attitudes Towards Dementia on the Relationship Between Dementia Knowledge and Behaviors Towards Persons with Dementia: A Cross-Sectional Study. J Multidiscip Healthc 2023; 16:4213-4225. [PMID: 38156291 PMCID: PMC10752817 DOI: 10.2147/jmdh.s443189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
Purpose To examine the mediating effect of attitudes towards dementia on the relationship between dementia knowledge and behaviors towards persons with dementia. Participants and Methods A cross-sectional survey was conducted with 313 adults (age ≤ 20 years). Participants were recruited using non-probability convenience sampling from medical clinics, community centers, and supermarkets located in the Wanhua District of Taipei City. Data were collected with the following self-report questionnaires: a demographic survey, validated instruments for dementia knowledge and attitudes towards dementia (assessed using the Alzheimer's Disease Knowledge Scale and the Approaches to Dementia Questionnaire, respectively), and a researcher-developed survey on unfriendly behaviors towards persons with dementia. Results Pearson's correlation and multiple linear regression analysis indicated that higher scores for dementia knowledge and more positive attitudes about dementia were significantly associated with lower levels of unfriendly behaviors towards persons living with dementia. Mediation analysis using a robust bootstrap test with 5000 samples indicated that attitudes toward dementia had a partial mediating effect on the relationship between dementia knowledge and unfriendly behaviors. Conclusion Our findings suggest that increasing public awareness and knowledge about dementia could help the general population develop better attitudes towards dementia, which could subsequently help improve behaviors towards persons living with dementia.
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Affiliation(s)
- Yang-Tzu Li
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Jing-Xuan Bai
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Jia-Ming He
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shao-Wei Yang
- Department of Health Administration, College of Health Technology and Management, Tzu Chi University of Science and Technology, Hualien City, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Huang HL, Liu XM, Zhang Y, Huang YS. [Comparison of formulas for intraocular lens power calculation after corneal refractive surgery]. Zhonghua Yan Ke Za Zhi 2023; 59:1012-1018. [PMID: 38061902 DOI: 10.3760/cma.j.cn112142-20231015-00143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Objective: To evaluate the accuracy of five intraocular lens (IOL) power calculation formulas for calculating IOL power in patients with previous myopia-corrected corneal refractive surgery. Methods: In this case series study, a total of 30 eyes of 30 patients who had excimer laser corneal refractive surgery for myopia and subsequent cataract surgery in Qingdao Eye Hospital from April 2020 to October 2022 were included. The Pentacam anterior segment analysis system and IOLMaster were used to measure ocular parameters, including axial length, anterior chamber depth, keratometry, lens thickness, and mean true net power (mTNP). Five formulas were used for IOL power calculation: Shammas formula, Olsen formula, SRK/T (mTNP) formula, Haigis-L formula, and Barrett True-K formula. After cataract extraction, we obtained the actual postoperative refraction by measuring the objective refraction. The prediction error was determined as the difference between the actual postoperative refraction and the predicted refraction, and the absolute value of the prediction error was the absolute error. The differences in the calculation errors of the 5 formulas were compared. Results: Regarding the prediction errors, the results of the SRK/T (mTNP) and Olsen formulas were better than those of Shammas and Haigis-L, and the differences were statistically significant (all P<0.05). The proportion of eyes with an absolute error of 0.50 D for Barrett True-K was highest (70%, 21/30), followed by the SRK/T (mTNP) formula (67%, 20/30). The proportions of eyes with an absolute error within 1.00 D for Barrett True-K, SRK/T (mTNP), and Olsen were all over 80%, with 24 eyes, 24 eyes, and 25 eyes, respectively. Conclusions: The Barrett True-K formula showed high accuracy in predicting the refraction after cataract extraction in patients with a history of corneal refractive surgery for myopia. The calculation result of the Haigis-L formula was highly unstable.
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Affiliation(s)
- H L Huang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
| | - X M Liu
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
| | - Y Zhang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
| | - Y S Huang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
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Chen XH, Yang ZJ, Xu CJ, Chen YH, Huang HL, Li ZS, Lin T, Zhao ML, Chen T, Chen H, Liang YR, Zhu MS, Hu YF, Li GX, Yu J. [Application effect of the joint nasogastric tube for pairing overlap guiding tube (JNT) in esophagojejunostomy]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:986-989. [PMID: 37849270 DOI: 10.3760/cma.j.cn441530-20230105-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
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Huynh-Truong HL, Shyu YIL, Tran TKL, Huang HL, Do VA. Dementia care practices among community healthcare workers in Vietnam: a qualitative descriptive study. BMC Geriatr 2023; 23:562. [PMID: 37710164 PMCID: PMC10503002 DOI: 10.1186/s12877-023-04199-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 07/26/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Vietnam is one of the most rapidly aging countries in the world and the likelihood that someone may have dementia rises dramatically as the population ages. Although caring for persons living with dementia is important, little is known about the circumstances under which community healthcare professionals in Vietnam provide dementia care. This study aimed to describe the practice of caring for persons with dementia among community healthcare professionals in Vietnam. METHODS This qualitative descriptive study was conducted with 23 community healthcare professionals recruited from 10 primary healthcare centers, representing 10 of 24 districts in Ho Chi Minh City, Vietnam. Participants were physicians (n = 11), physician's assistants (n = 8) and community nurses (n = 4). Data were collected through in-depth face-to-face semi-structured interviews. Interview data were audio recorded, transcribed verbatim, and analyzed using content analysis. RESULTS The mean age of the 23 participants was 44.6 ± 8.8 years; most were female (n = 16, 69.6%); and the mean time of working in the field of dementia care was 15.9 ± 8.4 years. Analysis of the interview data revealed five categories, which informed how care was provided: 1) Knowledge about dementia and its prevalence among older adults; 2) Identification of dementia in Vietnam; 3) Lack of attention to early diagnosis of dementia and difficulty in providing continuous care; 4) Dependence on family members for prompt and continuous care; and 5) challenges to providing dementia care. Despite having knowledge about dementia, some healthcare professionals incorrectly viewed dementia as an inevitable part of the ageing process. Participants reported that their limited training and practical experience in caring for persons with dementia caused a lack of confidence in dementia care. CONCLUSIONS The quality of care provided to persons living with dementia was negatively impacted by the limited training of healthcare personnel. The diagnosis, treatment, and provision of supportive services to persons living with dementia and their families are substantial challenges for the Vietnamese healthcare system. It is crucial to initiate and cultivate dementia care education programs aimed at expanding curricula for physicians, physicians' assistants, and nurses.
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Affiliation(s)
- Hong Le Huynh-Truong
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- School of Nursing, Faculty of Nursing-Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Yea-Ing Lotus Shyu
- School of Nursing, College of Medicine, and Healthy Aging Research Center, Chang Gung University, Taoyuan City, Taiwan.
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
- School of Nursing, Chang Gung University, 259 Wenhua 1St Road, 33302, Taoyuan, Taiwan.
| | - Thuy Khanh Linh Tran
- School of Nursing, Faculty of Nursing-Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hsiu-Li Huang
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Viet Anh Do
- Head of Home Community Care, Royal Freemasons' Benevolent Institution, Suite 2, Level 12, 2 Park St, NSW, 2000, Sydney, Australia
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Weng LC, Huang HL, Tsai YH, Tsai HH, Lee WC, Shieh WY. The effect of a web-based self-care instruction on symptom experience and quality of life in living liver donors: A randomized controlled trial. Heliyon 2023; 9:e17333. [PMID: 37484234 PMCID: PMC10361383 DOI: 10.1016/j.heliyon.2023.e17333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 07/25/2023] Open
Abstract
Objective Living liver donors need help to manage symptom distress and improve their quality of life. This study aims to test the effectiveness of a web-based symptom self-care instruction on symptom experience and health-related quality of life of living liver donors. Methods This study was a randomized controlled trial. Participants were recruited from January 2019 to August 2020. Participants in the experimental group had access to a web-based symptom self-care instruction, which included text and video. The control group received routine care. The primary outcomes were symptom distress and quality of life. Results A total of 90 living liver donors recruited in this study were assigned randomly to the web group (n = 46) and control group (n = 44). The symptom distress was significantly negatively correlated with quality of life at each data collection time. There was an interaction effect with the participants in the web group experiencing more symptom distress at three months after surgery than the control group (B = 3.616, 95% CI: 7.163-3.990, p = 0.046). There was no significant effect on the quality of life. Conclusion Patients in the web-based self-care group had higher symptom distress than those in the control group three months after surgery, but there was no difference in quality of life. Future studies could add some interactive elements to the website and include a larger sample size. Registration This study was registered at the Chinese Clinical Trial Registry (ChiCTR1900020518).
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Affiliation(s)
- Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of General Surgery, Liver Transplantation, Chang Gung Medical Foundation, Linkuo Medical Center, Taoyuan, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Science, Taipei, Taiwan
| | - Yu-Hsia Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Cardiovascular Medicine, Chang Gung Medical Foundation, Linkuo Medical Center, Taoyuan, Taiwan
| | - Hsiu-Hsin Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Medical Foundation, Linkuo Medical Center, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Department of General Surgery, Liver Transplantation, Chang Gung Medical Foundation, Linkuo Medical Center, Taoyuan, Taiwan
| | - Wann-Yun Shieh
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
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Zhong WS, Xu Z, Cui J, Chen WX, Huang HL, Tan HL, Zhang PQ, Tan L, Xie L. [Application of lateral upper arm free flap in the repair of postoperative defects of oral cancer]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:1219-1224. [PMID: 36319128 DOI: 10.3760/cma.j.cn115330-20220406-00172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To explore the clinical application and efficacy of lateral upper arm free flap (LUAFF) for one-stage repairing of soft tissue defect after oral cancer surgery. Methods: This article was a retrospective analysis of clinical data of 46 patients receiving treatment of one-stage repairing of soft tissue defect with LUAFF after oral cancer surgery in Hunan Cancer Hospital, from June 2019 to June 2021. Among these cases, 40 were males, and 6 were females. The patients' ages were from 23 to 64 years old. The clinical data of patients were reviewed and outcomes were evaluated. SPSS 23.0 software was used for statistical analysis. Results: In the LUAFF of 46 patients, flap area ranged from 5.0 cm×3.5 cm to 15.0 cm×7.0 cm; the mean pedicle length was 8.15±1.42 cm; the mean artery diameter was 1.20±0.41 mm (range, 1.5 to 2.5 mm); the mean diameter of the largest veins was 2.15±0.52 mm; and the median number of perforators was 2.6 (range, 1 to 4). All donor sites were closed primarily. Two cases had arterial anastomosis thrombosis, but their flaps were successfully saved with urgent re-anastomosis of the vessels. The overall flap survival rate was 93.5%(43/46), with flap necroses after operation in three cases. No patient received tracheotomy. The average hospital stay time of patients after operation was 9.4 days. The follow-up time was 6-24 months, elbow and wrist movements on the operative side were normal, and the upper limb muscle strength was not affected. Conclusions: LUAFF is a suitable choice for the repairs of small-moderate tissue defects in oral cancer surgery, with consistent perforators in the flap, simple harvest method, concealed donor-site scar, and high survival rate.
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Affiliation(s)
- W S Zhong
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - Z Xu
- Department of Head and Neck Radiation Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - J Cui
- Department of Head and Neck Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China
| | - W X Chen
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - H L Huang
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - H L Tan
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - P Q Zhang
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - L Tan
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - Li Xie
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
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Wu PY, Peng LM, Tai CM, Wei PM, Huang HL, Hsu WC, Lee SH, Chiu YC. [Effects of Multicomponent Case Management on the Problem Behaviors of Patients With Dementia and Family Caregivers' Distress, Self-Efficacy, Depression, Burden and Health Promotion Behaviors]. Hu Li Za Zhi 2022; 69:68-85. [PMID: 36127760 DOI: 10.6224/jn.202210_69(5).09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Few of the interventions currently available for family caregivers (FCGs) of persons with dementia (PWDs) with long-term follow-ups have a grounding in theory and incorporate multicomponent case management formats. PURPOSE Based on Pearlin's Caregiving and Stress Process model, this study was developed to examine the effectiveness of a family-centered case management program for PWDs with early to moderate dementia in terms of reducing PWDs behavioral problems and improve FCG outcomes, including distress, self-efficacy, depression, caregiver burden, and health-promoting behaviors. METHODS This randomized, single-blind, parallel-controlled trial included 76 dyads of PWDs and their FCGs. The dyads were recruited from outpatient clinics at dementia centers in three district hospitals in northern Taiwan. The dyads were randomly assigned to the intervention group (IG, n = 39) and control group (CG, n = 37). The dyads in the IG received a four-month intervention with two home or clinic visits and two telephone interviews. The multi-component interventions provided assessment, education, consultations, support, and referrals to long-term care resources. The CG received routine care and two social phone calls. Data were collected upon enrollment (T0 = baseline) and at 4-,6-, and 12-months post-intervention (T1, T2, and T3, respectively). Generalized estimating equations were conducted to analyze the effects of the intervention. RESULTS By controlling for the interaction between group and time, we made a comparison between IG and the CG. The results showed significant improvements from baseline measures in behavioral problems in the PWDs for mood, psychosis, and social engagement, and improvements in the FCGs for distress and self-efficacy for obtaining respite as well as for better control of distressing thoughts, feelings of depression, caregiver burden, and overall health promoting behaviors at T1 and T2 (p < 0.5). Significant improvements were also found in the IG for psychomotor regulation among PWDs and the self-efficacy of FCGs in managing the PWDs' disturbing behaviors and health promotion behaviors for nutrition at T1 (p < 0.5). There were no significant improvements in the outcome variables at T3. CONCLUSIONS / IMPLICATIONS FOR PRACTICE Significant interactions between group and time were found at the 6-month assessment (T2) for improvements in problem behaviors of PWDs and depression, caregiver burden, and distress in the FCGs. Positive effects on self-efficacy and health promotion behaviors among the FCGs were also achieved. The results suggest that a multicomponent case management intervention should be referenced in dementia care policymaking for FCGs and PWDs.
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Affiliation(s)
- Pei-Yi Wu
- MSN, RN, Health Center, National Chu-Pei Senior High School, Taiwan, ROC
| | - Li-Min Peng
- PhD, RN, Assistant Professor, Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taiwan, ROC
| | - Chiu-Mei Tai
- AHA, CDE, Case Manager, Dementia Center, Catholic Mercy Hospital, Hsinchu, Taiwan, ROC
| | - Pi-Mei Wei
- BS, RN, Technologist, Department of Neurology, New Taipei Municipal TuCheng Hospital, Taiwan, ROC
| | - Hsiu-Li Huang
- PhD, RN, Associate Professor, Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taiwan, ROC
| | - Wen-Chuin Hsu
- MD, MPH, Director, Dementia Center & Associate Professor, Taoyuan Chang Gung Memorial Hospital, and Adjunct Associate Professor, School of Medicine, Chang Gung University, Taiwan, ROC
| | - Shwu-Hua Lee
- MD, Director, Department of Psychiatry, Chang Gung Memorial Hospital, and Adjunct Associate Professor, School of Medicine, Chang Gung University, Taiwan, ROC
| | - Yi-Chen Chiu
- PhD, RN, Associate Professor, School of Nursing, Chang Gung University, Taiwan, ROC.
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Huang HL, Lu WR, Huang HL, Liu CL. The effect of a family-centered advance care planning intervention for persons with cognitive impairment and their family caregivers on end-of-life care discussions and decisions. PLoS One 2022; 17:e0274096. [PMID: 36067182 PMCID: PMC9447906 DOI: 10.1371/journal.pone.0274096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/21/2022] [Indexed: 11/19/2022] Open
Abstract
Advanced care planning (ACP) includes advance directives (AD), which can specify provisions for palliative care and types of life-sustaining treatments for an individual requiring end-of-life (EoL) care. ACP for persons in the early stages of cognitive decline can decrease anxiety and conflict for family members needing to make decisions about EoL-care, which is especially critical for family caregivers (FCGs) if they play a role as a surrogate regarding healthcare decisions. However, ACP for persons with cognitive impairment (PWCIs) is often overlooked. This study explored the effects of a family-centered ACP intervention on decisions about EoL-care, life-sustaining treatment decisions, and discussions of related topics among PWCIs and FCGs. The study was conducted in outpatient clinics of regional teaching hospitals in northern Taiwan. Participants were dyads consisting of persons diagnosed with mild cognitive impairment or mild dementia and their FCGs. The family-centered ACP intervention was provided by an ACP-trained senior registered nurse. A one-group, pretest–posttest design was used to evaluate the effect of the intervention on 44 dyads. Four structured questionnaires collected data regarding familiarity with ACP, intention to engage in ACP, participation in personal discussions between the dyads about ACP, and consistency between PWCIs and FCGs for decisions about life-sustaining treatments at EoL. Paired t, Kappa, and McNemar tests were used to compare differences between pre-intervention data (pretest) and post-intervention data (posttest). There were significant increases in familiarity with ACP, components of ACP, and the number of topics PWCIs and FCGs personally discussed surrounding EoL-care decisions. There was no change for either group in wanting to have a formal ACP consultation and only modest increases in consistency between PWCIs and FCGs for life-sustaining treatment decisions after completion of the family-centered ACP intervention. Clinicians caring for PWCIs should incorporate family-centered ACP interventions and support ongoing discussions about life-sustaining medical treatments to ensure their preferences regarding EoL-care are respected. The accessibility and availability of consultations about ACP should also be provided.
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Affiliation(s)
- Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- * E-mail:
| | - Wei-Ru Lu
- Department of Nursing, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Huei-Ling Huang
- Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Chien-Liang Liu
- Dementia Center, Department of Internal Medicine, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan
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Chen YY, Weng LC, Li YT, Huang HL. Mediating effect of self-efficacy on the relationship between social support and self-management behaviors among patients with knee osteoarthritis: a cross-sectional study. BMC Geriatr 2022; 22:635. [PMID: 35918645 PMCID: PMC9344710 DOI: 10.1186/s12877-022-03331-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 07/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Good self-management behaviors in patients with knee osteoarthritis can improve disease awareness, treatment effectiveness, quality of life, and reduce medical costs. However, there is a paucity of studies focusing on patients with knee osteoarthritis. Therefore, the purpose of this study was to explore the mediating effect of self-efficacy on aspects of social support and self-management behaviors in this population. METHODS This study employed a cross-sectional design and convenience sampling to survey patients with knee osteoarthritis in an outpatient department of a regional hospital in northern Taiwan from February 22, 2021, to April 15, 2021. The inclusion criteria for patients were (1) those diagnosed by a physician with knee osteoarthritis and (2) who could communicate in Chinese or Taiwanese. Participants were asked to complete a demographic questionnaire, the Arthritis Self-Efficacy Scale (ASE), the Inventory of Socially Supportive Behavior (including enacted support and perceived social support), and the Arthritis Self-Management Assessment Tool (ASMAT). In addition, the Kellgren-Lawrence Grading Scale was obtained from a chart review. Data were analyzed with descriptive statistics, t-test, one-way analysis of variance, Pearson product-moment correlation, and mediation analysis. RESULTS A total of 140 patients met the inclusion criteria. The mean age of participants was 70.21 ± 10.84years; most (73.6%) were female. The mean total score of the ASMAT was 64.27 ± 14.84. Scores for the ASE, enacted support, and perceived social support were significantly positively correlated with ASMAT (all p < .001). The standardized coefficient for total effect and direct effect of perceived social support on ASMAT was 0.899 (p < .001) and 0.754 (p < .05), respectively. After introducing the ASE into the model, the indirect effect was 0.145 (p < .05), which indicated that ASE had a partial mediating effect on the relationship between perceived social support and ASMAT. CONCLUSION Our findings might suggest that perceived social support indirectly affected ASMAT through ASE. Therefore, interventions designed to increase self-efficacy and social support could enhance self-management behaviors for patients with knee osteoarthritis.
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Affiliation(s)
- Yi-Yi Chen
- Department of Preventive Healthcare and Community Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Yang-Tzu Li
- Department of Long Term Care, College of Health Technology, National Taipei University of Nursing and Health Science, Taipei, Taiwan
| | - Hsiu-Li Huang
- Department of Long Term Care, College of Health Technology, National Taipei University of Nursing and Health Science, Taipei, Taiwan.
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Liu HY, Huang HL, Chiu YC, Tang LY, Hsu JL, Wu SM, Lin YH, Lin HY, Su IC, Shyu YIL. Perceptions of community dementia friendliness: A cross-sectional study of people with dementia, family caregivers, service providers, and the general public in Taiwan. Health Soc Care Community 2022; 30:1578-1588. [PMID: 34254381 DOI: 10.1111/hsc.13490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 05/27/2021] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
Promoting dementia-friendly communities is an important strategy for improving quality of life for people with dementia and dementia-family caregivers. The process of building dementia-friendly communities should include all people living in the community. The objective of this study was to compare perceived dementia friendliness in the community among people with dementia, family caregivers, service providers, and the general public. In Taiwan, we surveyed 60 people with dementia, 140 family caregivers, and 200 members of the general public face to face, with 200 service providers surveyed by mail. Participants completed the Perceived Community Dementia Friendliness measure, consisting of seven subscales: care services, community members, community environment, community interactions, transportation, hospitals, and stores and organisations. This measure has acceptable convergent validity, construct validity, and internal consistency reliability for use in Taiwan. Differences in perceived dementia friendliness were examined by chi-square tests/analysis of variance. Among the seven subscales, hospitals were rated with good dementia friendliness by 70% of people with dementia (n = 42); however, care services were rated poor by 23.3% of people with dementia (n = 14). Hospitals were also rated with good dementia friendliness by 39.2% of family caregivers (n = 54). Care services were rated as having good dementia friendliness by 43.5% of service providers (n = 87) and 47% of the general public (n = 86). Furthermore, community interactions were rated as good by small percentages of family caregivers (11.4%, n = 16), service providers (22.2%, n = 44), and the general public (30.9%, n = 58). Family caregivers, service providers, and the general public rated hospitals with the highest mean dementia-friendliness score and community interactions with the lowest. Perceived community-dementia friendliness among participants with dementia differed from that of participants without. People with dementia prioritised improving care services, while people without dementia rated facilitating community interactions as more vital. These differences provide vital insights into understanding the policies and administration of dementia-friendly communities.
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Affiliation(s)
- Hsin-Yun Liu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (ROC)
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan (ROC)
| | - Yi-Chen Chiu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan (ROC)
| | - Li-Yu Tang
- Taiwan Alzheimer's Disease Association, Taipei, Taiwan (ROC)
| | - Jung-Lung Hsu
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan (ROC)
- College of Medicine, Chang Gung University, Taoyuan, Taiwan (ROC)
- Graduate Institute of Humanities in Medicine and Research Center for Brain and Consciousness, Taipei Medical University, New Taipei City, Taiwan (ROC)
| | - Suh-Mian Wu
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan (ROC)
| | - Yi-Hui Lin
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan (ROC)
| | - Hsin-Yi Lin
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan (ROC)
| | - I-Ching Su
- Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan (ROC)
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan (ROC)
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan (ROC)
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (ROC)
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12
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Huang HL, Wang KD, Sun XH. [Relative factors analysis of visual field defect in advanced primary glaucoma]. Zhonghua Yan Ke Za Zhi 2022; 58:22-27. [PMID: 34979789 DOI: 10.3760/cma.j.cn112142-20210608-00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To explore the relative factors of visual field defect in advanced primary glaucoma. Methods: A retrospective case-control study. The data of patients with primary advanced glaucoma who had the central 5 to 10 degrees of the visual field or the temporal peripheral field and were treated at Eye & ENT Hospital of Fudan University from January 2014 to December 2019 were reviewed. The patients were divded into the central visual field group and the temporal peripheral field group according to the type of visual field defect. Statistical analyses of single-factor (Chi square test or independent sample t test) and multivariate logistic regression were performed to analyze the correlation between the remaining visual field and the risk factors including age, gender, left/right eye, type of glaucoma, baseline glaucoma stage, peak intraocular pressure (IOP), mean IOP, number of operations, family history, high myopia, diabetes, hypertension, hypotension and migraine. Results: A total of 287 patients (287 eyes) were included. There were 101 patients [mean age, (61±15) years; 48 males, 53 females] with the central 5 to 10 degrees of the visual field and 186 patients [mean age, (59±17) years; 107 males, 79 females] with the temporal peripheral field. There was no statistically significant difference between the two groups with respect to age, gender, left/right eye, age of onset, number of operations, family history and history of combined systemic diseases (all P>0.05). Primary open-angle glaucoma, chronic primary angle-closure glaucoma (CPACG) and acute primary angle-closure glaucoma were found in 26, 34 and 41 patients, respectively, in the central visual field group, and in 61, 78 and 47 patients, respectively, in the temporal peripheral field group. The baseline glaucoma was in the moderate stage in 30 and 32 patients, and in the advanced stage in 71 and 154 patients, respectively, in the two groups. The peak IOP was (31.94±4.11) mmHg (1 mmHg=0.133 kPa) and (34.58±6.47) mmHg, and the mean IOP was (22.48±3.99) mmHg and (24.01±4.30) mmHg, respectively, in the two groups. High myopia occurred in 5 and 28 patients, respectively, in the two groups. The differences in the type of glaucoma (χ²=7.24), baseline glaucoma stage (χ²=6.04), peak IOP (t=4.22), mean IOP (t=2.96) and high myopia (χ²=6.57) between the two groups were statistically significant (all P<0.05). In the multivariable model, CPACG (OR=2.021, 95%CI: 1.020 to 4.001), higher peak IOP (OR=1.128, 95%CI: 1.038 to 1.226) and high myopia (OR=5.090, 95%CI: 1.556 to 16.651) increased the risks for the progression to the temporal peripheral field. Conclusion: CPACG, higher peak IOP and concurrent high myopia are all relative factors for the progression to the temporal peripheral field in advanced primary glaucoma.
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Affiliation(s)
- H L Huang
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - K D Wang
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - X H Sun
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
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Li JK, Huang HL, Zhu YH, Lei JQ. [Research progress of cirrhotic portal hypertension in diagnostic imaging methods]. Zhonghua Gan Zang Bing Za Zhi 2021; 29:1224-1228. [PMID: 35045646 DOI: 10.3760/cma.j.cn501113-20200116-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Hepatic venous pressure gradient measurement via jugular vein catheterization is still currently the gold standard for evaluating portal hypertension. However, how to accurately and reproducibly assess whether there is portal hypertension has always been a concern in patients with liver cirrhosis. In recent years, imaging methods have made significant progress in the non-invasive diagnosis of portal hypertension. This paper reviews the current different diagnostic value of imaging methods and related research progress in an attempt to evaluate patients with cirrhotic portal hypertension.
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Affiliation(s)
- J K Li
- Department of Radiology, the First Hospital of Lanzhou University & Intelligent Imaging Medical Engineering Research Center of Gansu Province & Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 73000, China
| | - H L Huang
- Department of Radiology, the First Hospital of Lanzhou University & Intelligent Imaging Medical Engineering Research Center of Gansu Province & Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 73000, China
| | - Y H Zhu
- Department of Radiology, the First Hospital of Lanzhou University & Intelligent Imaging Medical Engineering Research Center of Gansu Province & Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 73000, China
| | - J Q Lei
- Department of Radiology, the First Hospital of Lanzhou University & Intelligent Imaging Medical Engineering Research Center of Gansu Province & Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 73000, China
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14
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Hsiung TL, Wei LW, Huang HL, Wang HP. In situ X-ray absorption spectroscopic studies of TiO 2 photocatalytic active sites for degradation of trace CHCl 3 in drinking water. J Synchrotron Radiat 2021; 28:1839-1844. [PMID: 34738937 DOI: 10.1107/s1600577521008973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/29/2021] [Indexed: 06/13/2023]
Abstract
Toxic disinfection byproducts such as trihalomethanes (e.g. CHCl3) are often found after chlorination of drinking water. It has been found that photocatalytic degradation of trace CHCl3 in drinking water generally lacks an expected relationship with the crystalline phase, band-gap energy or the particle sizes of the TiO2-based photocatalysts used such as nano TiO2 on SBA-15 (Santa Barbara amorphous-15), TiO2 clusters (TiO2-SiO2) and atomic dispersed Ti [Ti-MCM-41 (Mobil Composition of Matter)]. To engineer capable TiO2 photocatalysts, a better understanding of their photoactive sites is of great importance and interest. Using in situ X-ray absorption near-edge structure (XANES) spectroscopy, the A1 (4969 eV), A2 (4971 eV) and A3 (4972 eV) sites in TiO2 can be distinguished as four-, five- and six- coordinated Ti species, respectively. Notably, the A2 Ti sites that are the main photocatalytic species of TiO2 are shown to be accountable for about 95% of the photocatalytic degradation of trace CHCl3 in drinking water (7.2 p.p.m. CHCl3 gTiO2-1 h-1). This work reveals that the A2 Ti species of a TiO2-based photocatalyst are mainly responsible for the photocatalytic reactivity, especially in photocatalytic degradation of CHCl3 in drinking water.
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Affiliation(s)
- T L Hsiung
- Department of Environmental Engineering, National Cheng Kung University, Tainan, 70101, Taiwan
| | - L W Wei
- Department of Environmental Engineering, National Cheng Kung University, Tainan, 70101, Taiwan
| | - H L Huang
- Department of Safety, Health and Environmental Engineering, National United University, Miaoli 36063, Taiwan
| | - H Paul Wang
- Department of Environmental Engineering, National Cheng Kung University, Tainan, 70101, Taiwan
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15
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Huang HL, Cai MY, Lin N, Wang Y, Xu LP. [Analysis of genetic abnormalities and clinical outcome of fetus with ultrasonic nonstructural abnormality]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:1094-1099. [PMID: 34619927 DOI: 10.3760/cma.j.cn112150-20210326-00307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analysis the incidence of abnormal genetics and the clinical outcome of fetuses with ultrasonic nonstructural abnormality. Methods: This study was conducted retrospectively. 631 pregnant women were enrolled in the Prenatal Diagnostic Center of Fujian Maternal and Child Health Hospital due to ultrasonic nonstructural abnormality from January 2016 to January 2019. According to different gestational weeks, amniotic fluid or umbilical cord blood samples were collected for chromosome karyotype analysis and SNP-array. According to the number of nostructural abnormalities, they were divided into 1 nostructural abnormality group, 2 nostructural abnormalities group, and ≥3 nostructural abnormalities group. Chi-square test was used for comparison between groups. Results: Of the 631 cases, 34 cases (5.4%, 34/631) had abnormal karyotypes, including 20 cases with abnormal chromosome number and 14 cases with abnormal chromosome structure. In results of SNP-array, there were 53 abnormal results (8.4%, 53/631), including 32 cases of pathogenic copy number variations (CNV) and 21 cases of variations of uncertain clinical significance (VOUS). The rates of pathogenic CNV were 4.57% (21/260), 4.76% (7/147) and 16.67% (4/24) in the group of 1, 2 and ≥3 nostructural abnormalities, respectively. The rate of the three groups showed a linear trend, and the difference was statistically significant (χ²=7.419,P<0.05). In the single nostructural abnormality group, the rate of pathogenic CNV of nasal bone dysplasia, fetal growth restriction (FGR) and thickened nuchal translucency (NT) were 8.11% (3/37), 7.04% (5/71) and 5.60% (7/125), respectively. Conclusions: Compared with the karyotype analysis, SNP-array can significantly improve the detection rate of genetic abnormalities in ultrasonic nonstructural abnormality. When multiple ultrasonic nonstructural abnormality were combined, the risk of genetic abnormalities showed an upward trend.
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Affiliation(s)
- H L Huang
- Fujian Maternity and Child Health Hospital, Fujian Maternity and Child Health Hospital Affiliated to Fujian Medical University, Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
| | - M Y Cai
- Fujian Maternity and Child Health Hospital, Fujian Maternity and Child Health Hospital Affiliated to Fujian Medical University, Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
| | - N Lin
- Fujian Maternity and Child Health Hospital, Fujian Maternity and Child Health Hospital Affiliated to Fujian Medical University, Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
| | - Y Wang
- Fujian Maternity and Child Health Hospital, Fujian Maternity and Child Health Hospital Affiliated to Fujian Medical University, Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
| | - L P Xu
- Fujian Maternity and Child Health Hospital, Fujian Maternity and Child Health Hospital Affiliated to Fujian Medical University, Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
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Hsiung TL, Wei LW, Huang HL, Tuan YJ, Wang HP. In situ X-ray absorption spectroscopic studies of photocatalytic oxidation of As(III) to less toxic As(V) by TiO 2 nanotubes. J Synchrotron Radiat 2021; 28:849-853. [PMID: 33949992 DOI: 10.1107/s1600577521003076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
Arsenic in groundwater caused the black-foot disease (BFD) in many countries in the 1950-1960s. It is of great importance to develop a feasible method for removal of arsenic from contaminated groundwater in BFD endemic areas. Photocatalytic oxidation of As(III) to less toxic As(V) is, therefore, of significance for preventing any arsenic-related disease that may occur. By in situ synchrotron X-ray absorption spectroscopy, the formation of As(V) is related to the expense of As(III) disappearance during photocatalysis by TiO2 nanotubes (TNTs). Under UV/Vis light irradiation, the apparent first-order rate constant for the photocatalytic oxidation of As(III) to As(V) is 0.0148 min-1. It seems that As(III) can be oxidized with photo-excited holes while the not-recombined electrons may be scavenged with O2 in the channels of the well defined TNTs (an opening of 7 nm in diameter). In the absence of O2, on the contrary, As(III) can be reduced to As(0), to some extent. Cu(II) (CuO), as an electron acceptor, was impregnated on the TNTs surfaces in order to gain a better understanding of electron transfer during photocatalysis. It appears that As(III) can be oxidized to As(V) while Cu(II) is reduced to Cu(I) and Cu(0). The molecular-scale data are very useful in revealing the oxidation states and interconversions of arsenic during the photocatalytic reactions. This work has implications in that the toxicity of arsenic in contaminated groundwater or wastewater can be effectively decreased via solar-driven photocatalysis, which may facilitate further treatments by coagulation.
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Affiliation(s)
- T L Hsiung
- Department of Environmental Engineering, National Cheng Kung University, Tainan 70101, Taiwan
| | - L W Wei
- Department of Environmental Engineering, National Cheng Kung University, Tainan 70101, Taiwan
| | - H L Huang
- Department of Safety, Health and Environmental Engineering, National United University, Miaoli 36003, Taiwan
| | - Y J Tuan
- Department of Environmental Engineering, National Cheng Kung University, Tainan 70101, Taiwan
| | - H Paul Wang
- Department of Environmental Engineering, National Cheng Kung University, Tainan 70101, Taiwan
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Weng LC, Chiang YJ, Huang HL, Tsai YH, Chen KH, Wang WS, Lin MH. Factors associated with registration for organ donation among clinical nurses. PLoS One 2021; 16:e0247424. [PMID: 33606803 PMCID: PMC7895373 DOI: 10.1371/journal.pone.0247424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/05/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Healthcare professionals play an important role in the organ donation process. The aim of this study was to examine the organ donation registration rate and related factors among clinical nurses. MATERIAL AND METHODS In this cross-sectional, correlational study, we used mailed questionnaires to collect data from four geographical areas and three hospital levels in Taiwan from June 6 to August 31, 2018. Two thousand and thirty-three clinical nurses participated in this study. RESULTS Participants' mean age was 34.47 years, and 95.7% were women. Of them, 78.3% were willing to donate their organs and 20.6% had registered for organ donation after death. The results of logistic regression showed that in the personal domain, higher age (odds ratio (OR) = 1.03, p < 0.001), better knowledge of organ donation (OR = 1.09, p < 0.001), and a positive attitude toward organ donation (OR = 2.91, p < 0.001) were positively associated with organ donation registration, while cultural myths (OR = 0.69, p < 0.001) were negatively correlated. In the policy domain, the convenience of the registration procedure (OR = 1.45, p < 0.001) was positively associated with registration. A gap between willingness to donate and actual registration was observed. CONCLUSIONS Personal factors played an important role in organ donation registration. Therefore, efforts to improve knowledge and inculcate positive cultural beliefs about organ donation among clinical nurses are recommended. There is also a need to cooperate with government policies to provide appropriate in-service training and policy incentives and establish an efficient registration process.
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Affiliation(s)
- Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of General Surgery, Chang Gung Medical Foundation, Linkuo Medical Center, Taoyuan, Taiwan
- * E-mail:
| | - Yang-Jen Chiang
- Division of Transplant Urology, Department of Surgery, Chang Gung Medical Foundation, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Science, Taipei, Taiwan
| | - Yu-Hsia Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Cardiovascular Medicine, Chang Gung Medical Foundation, Linkou Medical Center, Taoyuan, Taiwan
| | - Kang-Hua Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Chang Gung Medical Foundation, Linkou Medical Center, Taoyuan, Taiwan
| | - Woan-Shyuan Wang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Mei-Hsiu Lin
- Division of Transplant Urology, Department of Surgery, Chang Gung Medical Foundation, Linkou Medical Center, Taoyuan, Taiwan
- Department of Nursing, Chang Gung Medical Foundation, Linkou Medical Center, Taoyuan, Taiwan
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18
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Lu WR, Liu CL, Zeng YF, Chang HJ, Liao W, Huang HL. [The Impact of Family-Centered Advance Care Planning for Persons With Dementia and Family Caregivers on Decision-Making Conflicts in End-of-Life Care]. Hu Li Za Zhi 2021; 68:30-42. [PMID: 33521917 DOI: 10.6224/jn.202102_68(1).06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Participating in advance care planning (ACP) discussions during the early stages of dementia is crucial to ensuring the quality of end-of-life (EoL) care. Inadequate discussions regarding ACP and EoL care between persons with dementia and family caregivers often lead to decisional conflicts when persons with dementia are in the later stages of their disease. PURPOSE To explore the impact of a family-centered ACP information intervention on the EoL care decision-making conflicts between persons with dementia and their family caregivers. METHODS A one-group, pretest-posttest, pre-experimental design was applied. Data were collected at outpatient clinics in regional teaching hospitals in northern Taiwan. Participants included 43 dyads of persons diagnosed with mild cognitive impairment or mild dementia and their family caregivers. The intervention was implemented by an ACP-trained senior registered nurse and was guided using ACP manuals and family-centered strategies. The decisional conflict scale was the main measure used. Paired t tests were used to compare differences between pre-intervention data and 4-weeks' post-intervention data. RESULTS The ACP information intervention significantly reduced the decisional conflict score for end-of-life decision making in the participants with mild dementia (p < .001). In addition, significant declines were observed in all aspects of decision-making conflicts, including value clarification, uncertainty, and effective decision-making. The mean total conflict score of the family caregivers was also significantly reduced (p < .001), but no significant difference was found in the aspect of support. CONCLUSIONS Family-centered care strategies provide knowledge about end-of-life care for persons with dementia. These strategies also facilitate regular and continuous communication between family caregivers, persons with dementia, and medical professionals, reducing decisional conflicts in EoL care.
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Affiliation(s)
- Wei-Ru Lu
- MS, RN, Department of Nursing, Sijhih Cathay General Hospital, Taiwan, ROC
| | - Chien-Liang Liu
- MD, Director, Dementia Center, Taipei City Hospital, Heping Fuyou Branch, Taiwan, ROC
| | - Yuan-Fu Zeng
- MD, Attending Physician, Department of Neurology, Sijhih Cathay General Hospital, Taiwan, ROC
| | - Hong-Jer Chang
- PhD, Associate Professor, Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taiwan, ROC
| | - Wen Liao
- BS, Graduate Student, Department of Educational Psychology and Counseling, National Taiwan Normal University, Taiwan, ROC
| | - Hsiu-Li Huang
- PhD, RN, Associate Professor, Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taiwan, ROC.
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Huang HL, Lu WR, Liu CL, Chang HJ. Advance care planning information intervention for persons with mild dementia and their family caregivers: Impact on end-of-life care decision conflicts. PLoS One 2020; 15:e0240684. [PMID: 33052970 PMCID: PMC7556500 DOI: 10.1371/journal.pone.0240684] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/30/2020] [Indexed: 01/08/2023] Open
Abstract
Persons with dementia are at high risk for loss of decision-making ability due to increased cognitive decline as the disease progresses. Participation in advance care planning (ACP) discussions in the early stages of dementia is crucial for end-of-life (EoL) decision-making to ensure quality of EoL care. A lack of discussions about ACP and EoL care between persons with dementia and family caregivers (FCGs), can lead to decisional conflicts when persons with dementia are in the later stages of the disease. This study explored the effects of a family-centered ACP information intervention among persons with dementia and FCGs. The study was conducted in outpatient clinics in Taiwan. Participants were dyads (n = 40) consisting of persons diagnosed with mild cognitive impairment or mild dementia and their FCGs. A one-group, pretest–posttest, pre-experimental design was employed. The intervention was provided by an ACP-trained senior registered nurse and was guided by ACP manuals and family-centered strategies. Outcome data were collected with four structured questionnaires regarding knowledge of end-stage dementia treatment, knowledge of ACP, attitude towards ACP, and EoL decisional conflict about acceptance or refusal of cardiopulmonary resuscitation, ventilators, and tracheostomy. Paired t tests compared differences between pre-intervention data and 4-weeks’ post-intervention data. The intervention resulted in significant improvements among persons with dementia and FCGs for knowledge of end-stage dementia treatment (p = .008 and p < .001, respectively), knowledge of ACP (both p < .001), and significant reductions in decisional conflicts (both p < .001). Scores for positive and negative attitude toward ACP did not change for persons with dementia; however, there was a reduction in negative attitude for FCGs (p = .001). Clinical care for persons with dementia should incorporate ACP interventions that provide knowledge about EoL dementia care using family-centered care strategies that facilitate regular and continuous communication between FCGs, persons with dementia, and medical personnel to reduce decisional conflicts for EoL care.
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Affiliation(s)
- Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- * E-mail:
| | - Wei-Ru Lu
- Department of Nursing, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Chien-Liang Liu
- Dementia Center, Taipei City Hospital, Taipei, Taiwan
- University of Taipei, Taipei, Taiwan
| | - Hong-Jer Chang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Huang HL, Gnanasegaran G, Paez D, Fanti S, Hacker M, Sathekge M, Bom HS, Cerci JJ, Chiti A, Lan X, Herrmann K, Scott AM, Vinjamuri S, Dorbala S, Estrada E, Pellet O, Orellana P, El-Haj N, Giammarile F, Abdel-Wahab M, Bomanji J. Nuclear medicine services after COVID-19: gearing up back to normality. Eur J Nucl Med Mol Imaging 2020; 47:2048-2053. [PMID: 32367256 PMCID: PMC7197920 DOI: 10.1007/s00259-020-04848-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- H L Huang
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK.,Department of Nuclear Medicine and Molecular Imaging, Division of Radiological Sciences, Singapore General Hospita, Bukit Merah, Singapore
| | | | - D Paez
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - S Fanti
- Department of Oncology, Division of Nuclear Medicine, University of Bologna, Bologna, Italy
| | - M Hacker
- Department of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - M Sathekge
- Nuclear Medicine Department, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - H S Bom
- Department of Nuclear Medicine, Chonnam National University, Seoul, South Korea
| | - J J Cerci
- PET/CT Department at Quanta Diagnostics and Therapy, Curitiba, Brazil
| | - A Chiti
- Humanitas University and Humanitas Research Centre, Milan, Italy
| | - X Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - K Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - A M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - S Vinjamuri
- Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - S Dorbala
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - E Estrada
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - O Pellet
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - P Orellana
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - N El-Haj
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - F Giammarile
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - M Abdel-Wahab
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK.
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Lin YN, Tsai HH, Huang HL, Chang YC, Shieh WY. Rethinking potentially inappropriate medication use in nursing homes within the Chinese population. Geriatr Nurs 2020; 41:724-729. [PMID: 32456974 DOI: 10.1016/j.gerinurse.2020.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 11/20/2022]
Abstract
This study aimed to understand the prevalence of Chinese medicine and other potentially inappropriate medications and to examine if there are relationships with emergency room visits, hospital admissions, and falls in a Chinese nursing home population. This cross-sectional descriptive study was a secondary analysis of data from 531 nursing home residents in Taiwan. Cox proportional hazard regression models were used in the analysis. Use of Chinese medicine in combination with Western medicine was observed in approximately 1% of residents. For every additional Chinese medicine used, the hazard ratio was 3.09 (p=.26) for emergency room visits and 3.22 (p=.21) for hospital admissions. For every additional nonsteroidal antiinflammatory agent used, the hazard ratio for falls was 5.42 (p=.006). Further studies with larger sample sizes are required to understand the appropriate time intervals required between administration of Chinese and Western medicine as well as to understand the drug-drug interactions.
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Affiliation(s)
- Yu-Ning Lin
- Department of Nursing, Nurse Practitioner, Cheng Hsin General Hospital, Taipei, Republic of China
| | - Hsiu-Hsin Tsai
- School of Nursing, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 33302, Republic of China; Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Republic of China.
| | - Hsiu-Li Huang
- College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Republic of China
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, New Taipei city, Republic of China
| | - Wann-Yun Shieh
- Department of Computer Science and Information Engineering, Chang Gung University, Tao-Yuan, Republic of China
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Huang HL, Gnanasegaran G, Paez D, Fanti S, Hacker M, Sathekge M, Bom HS, Cerci JJ, Chiti A, Lan X, Herrmann K, Scott AM, Vinjamuri S, Dorbala S, Estrada E, Pellet O, Orellana P, El-Haj N, Giammarile F, Abdel-Wahab M, Bomanji J. Correction to: Nuclear medicine services after COVID-19: gearing up back to normality. Eur J Nucl Med Mol Imaging 2020; 47:2220. [PMID: 32462399 PMCID: PMC7252414 DOI: 10.1007/s00259-020-04884-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The authors P. Orellana and N. El-Haj were inadvertently deleted in the original paper.
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Affiliation(s)
- H L Huang
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK
- Department of Nuclear Medicine and Molecular Imaging, Division of Radiological Sciences, Singapore General Hospital, Bukit Merah, Singapore
| | | | - D Paez
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - S Fanti
- Department of Oncology, Division of Nuclear Medicine, University of Bologna, Bologna, Italy
| | - M Hacker
- Department of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - M Sathekge
- NuclearMedicine Department, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - H S Bom
- Department of Nuclear Medicine, Chonnam National University, Seoul, South Korea
| | - J J Cerci
- PET/CT Department at Quanta Diagnostics and Therapy, Curitiba, Brazil
| | - A Chiti
- Humanitas University and Humanitas Research Centre, Milan, Italy
| | - X Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - K Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - A M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - S Vinjamuri
- Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - S Dorbala
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - E Estrada
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - O Pellet
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - P Orellana
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - N El-Haj
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - F Giammarile
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - M Abdel-Wahab
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK.
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Chen MC, Huang HL, Chiu YC, Yip PK, Wu SM, Hsu WC, Wang WS, Huang YF, Shyu YIL. Experiences of Living in the Community for Older Aboriginal Persons With Dementia Symptoms in Taiwan. Gerontologist 2020; 60:525-534. [PMID: 31091307 DOI: 10.1093/geront/gnz013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Improving quality of life for community-dwelling older persons with dementia symptoms (PWDS) and family caregivers requires promoting dementia-friendly communities (DFC). However, little is known regarding older Taiwanese Aboriginal PWDS' experiences of living in the community. We explored these experiences for older Atayal PWDS and their families in Taiwan. RESEARCH DESIGN AND METHODS This grounded theory research used in-depth interviews to explore the perspectives of older PWDS (n = 4), their family members (n = 3), and key persons (n = 10) in an Atayal community in northern Taiwan. Data were analyzed using constant comparative analysis. Participants were interviewed between January and May 2015. RESULTS Participants' experiences were captured by the overarching concept of "low dementia awareness, high family-like ambience in the community." Despite the low/absent community awareness of dementia, older Atayal PWDS functioned as freely in the community as at home due to a family-like supportive environment. Aboriginal PWDS and their families also faced environmental challenges, e.g., environmental constraints and barriers to transportation access. DISCUSSION AND IMPLICATIONS Our results suggest that this Aboriginal community and culture offer important DFC components, and these strengths could be further studied to enhance DFC models elsewhere. Despite these strengths in supporting PWDS, environmental challenges to transportation access still cause difficulties for PWDS and their families and need improvement. The Atayal community's low dementia awareness suggests that services introduced must be culturally appropriate and nondisruptive to existing supportive helping systems. Our study can be a model for future studies to understand and identify PWDS' needs in Indigenous communities.
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Affiliation(s)
- Mei-Chen Chen
- Department of Public Health, Taoyuan City Government, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taiwan
| | - Yi-Chen Chiu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ping-Keung Yip
- Neurological Center, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Suh-Mian Wu
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Wen-Chuin Hsu
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Woan-Shyuan Wang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yueh-Fang Huang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Shang Q, Wu P, Huang HL, Zhang SL, Tang XD, Guo XJ. Inhibition of heat shock protein 90 suppresses Bombyx mori nucleopolyhedrovirus replication in B. mori. Insect Mol Biol 2020; 29:205-213. [PMID: 31621968 DOI: 10.1111/imb.12625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/02/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
Heat shock protein 90 (Hsp90) plays a very important role in facilitating the replication of many viruses. Until now, little has been known about the role of Hsp90 in Bombyx mori virus infection. In this study, we explored the role of BmHsp90 in B. mori nucleopolyhedrovirus (BmNPV) replication. We found that BmHsp90 inhibition by geldanamycin (GA) significantly reduced the BmNPV titre, the protein expression level of BmNPV nucleocapsid protein 39 (VP39) and the transcript level of BmNPV genes. Silencing the hsp90 gene in BmN cells by small interfering RNA suppressed BmNPV replication whereas overexpression of hsp90 promoted the replication of BmNPV. After inhibition of Hsp90, the expression of three key genes [signal transducing activator of transcription (stat), suppressor of cytokine signalling protein 2 (socs2), socs6] involved in the Janus kinase/STAT pathway significantly changed, with up-regulation of stat and down-regulation of socs2 and socs6. In addition, the expression of two antiapoptosis genes, BmNPV inhibitor of apoptosis protein1 (BmNPV-iap1) and Bmiap2, was greatly decreased in GA-treated cells, whereas their expression was significantly increased in hsp90-overexpressed silkworm larvae. Our results indicated that inhibition of Hsp90 can suppress BmNPV proliferation in B. mori. Our findings may provide new clues to elucidate the molecular mechanisms of silkworm-virus interactions.
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Affiliation(s)
- Q Shang
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
| | - P Wu
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
- The Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Research Institute, Chinese Academy of Agricultural Sciences, Zhenjiang, China
- Quality inspection center for sericultural products, Ministry of Agriculture and Rural Affairs, Zhenjiang, China
| | - H L Huang
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
| | - S L Zhang
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
| | - X D Tang
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
- The Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Research Institute, Chinese Academy of Agricultural Sciences, Zhenjiang, China
| | - X J Guo
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
- The Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Research Institute, Chinese Academy of Agricultural Sciences, Zhenjiang, China
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Ge FF, Yang XQ, Chen YX, Huang HL, Shen XC, Li Y, Hu JM. Application of Eye Tracker in Lie Detection. Fa Yi Xue Za Zhi 2020; 36:229-232. [PMID: 32530172 DOI: 10.12116/j.issn.1004-5619.2020.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Indexed: 06/11/2023]
Abstract
Objective To investigate the application value of eye tracking in lie detection. Methods The 40 subjects were randomly divided into two groups. The pupil diameter, fixation duration, points of fixation and blink frequency of the subjects in the experimental group in observing target stimulation and non-target stimulation were recorded with eye tracker after they accomplished the mock crime. The eye movement parameters of subjects in the control group were directly collected. The differences in eye movement parameters of the experimental group and the control group in observing target stimulation and non-target stimulation were analyzed by t-test. Pearson coefficient analysis of correlation between eye movement parameters that had differences was conducted. The effectiveness of eye movement parameters to distinguish between the experimental group and the control group was calculated by the receiver operator characteristic (ROC) curve. Results Participants from the experimental group had shorter average pupil diameter, longer average fixation duration and fewer fixation points (P<0.05), but the differences in blink frequency had no statistical significance. The differences in the above indicators of the control group in observing target stimulation and non-target stimulation had no statistical significance. The average fixation duration showed a negative correlation with fixation points (r=-0.255, P<0.05); the average fixation duration showed a negative correlation with average pupil diameter (r=-0.218, P<0.05); the fixation points showed a positive correlation with average pupil diameter (r=0.09, P<0.05). The area under the curve of average pupil diameter, average fixation duration and fixation points was 0.603, 0.621 and 0.580, respectively. Conclusion The average pupil diameter, average fixation duration and fixation points obtained by the eye tracker under laboratory conditions can be used to detect lies.
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Affiliation(s)
- F F Ge
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
- West China School of Medicine, Sichuan University, Chengdu 610000, China
| | - X Q Yang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Y X Chen
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
| | - H L Huang
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
| | - X C Shen
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
| | - Y Li
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
| | - J M Hu
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
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Chuang IF, Shyu YIL, Weng LC, Huang HL. Consistency in End-of-Life Care Preferences Between Hospitalized Elderly Patients and Their Primary Family Caregivers. Patient Prefer Adherence 2020; 14:2377-2387. [PMID: 33299304 PMCID: PMC7721293 DOI: 10.2147/ppa.s283923] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/17/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE This study explored the consistency between preferences for end-of-life care for elderly hospitalized patients and their primary caregivers and predictors of consistency. PATIENTS AND METHODS This cross-sectional correlational study recruited 100 dyads of elderly hospitalized patients and their primary caregivers from a medical center in Central Taiwan. A structural questionnaire about preferences for seven end-of-life medical treatment options involved cardiopulmonary resuscitation, intravenous therapy, nasogastric tube feeding, intensive care unit, blood transfusion, tracheotomy, and hemodialysis. RESULTS The consistency was 42.28% for preferences of end-of-life medical care between patients and caregivers. The Kappa values for seven life-sustaining medical treatments ranged from 0.001 to 0.155. Logistic regression showed that the predictors of consistency for preferences of treatment were: a patient with a signed living will (odds ratio [OR] = 6.20, p<0.01) and a male family caregiver (OR= 0.23, p<0.01) for cardiopulmonary resuscitation; a patient who visited relatives in the intensive care unit (OR= 2.94, p< 0.05) and a spouse caregiver (OR= 3.07, p< 0.05) for nasogastric tube feeding; a spouse caregiver (OR=3.12, p<0.05) and a caregiver who visited the intensive care unit (OR= 5.50, p<0.01) for tracheotomy; and a spouse caregiver (OR= 2.76, p<0.05) and a caregiver who visited the intensive care unit (OR= 4.42, p<0.05) for hemodialysis. CONCLUSION End-of-life medical treatment preferences were inconsistent between patients and family caregivers, which might be influenced by Asian culture, the nature of the relationship and individual experiences. Implementation of advance care planning that respects the patient's autonomy and preferences about end-of-life care is recommended.
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Affiliation(s)
- I-Fei Chuang
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yea-Ing Lotus Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Healthy Aging Research Center, Chang Gung University, TaoyuanCity, Taiwan
- Traumatological Division, Department of Orthopedics, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Department of General Surgery, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Hsiu-Li Huang
- Department of Long-TermCare, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Correspondence: Hsiu-Li Huang No. 83-1, Nei-Chiang St, Wan-Hwa Dist, Taipei10845, TaiwanTel +886-2-28227101 Ext. 6134Fax +886-2-23891464 Email
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Huang HL, Ke YJ, Yang L, Yan Q, He BC, Zhou K, Chen ZR, Guo HM, Lu C, Liu J, Huang JS. [The mid-term outcomes of minimally invasive plasty for severe tricuspid regurgitation after cardiac surgery]. Zhonghua Wai Ke Za Zhi 2019; 57:902-907. [PMID: 31826593 DOI: 10.3760/cma.j.issn.0529-5815.2019.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objectives: To evaluate the efficacy of minimally invasive surgery in patients with late severe tricuspid regurgitation after cardiac surgery, and to evaluate the role of leaflets augmentation technique in tricuspid valvuloplasty. Methods: From January 2015 to June 2019, 85 patients undergoing tricuspid valve repair procedure with minimally invasive approach at Department of Cardiovascular Surgery, Guangdong provincial People's Hospital were enrolled. There were 22 males and 63 females, aging of (53.6±12.4) years (range: 15 to 75 years). The interval between the prior and current operations was (16.0±7.3) years (range: 0.2 to 35.0 years). The diameter of right atrium and right ventricle was (77.3±17.2) mm and (61.0±8.4) mm, respectively. Tricuspid regurgitation was severe or extremely severe, the tricuspid regurgitation area was (19.0±10.3) cm(2). All patients underwent minimally invasive tricuspid valvuloplasty or tricuspid valve replacement on beating-heart with totally endoscopic technique and port-access approach through right chest wall. The operations included tricuspid valve replacement and tricuspid valvuloplasty, the technique of tricuspid valvuloplasty including leaflets augmentation with patch, ring implantation, chordae tendineaes reconstruction, release of papillary muscle, edge to edge method, etc. Postoperative hospitalization days, the time of ICU stay, blood transfusion rate, ventilator time and the results of echocardiography were recorded. Follow-up was completed regularly by WeChat, telephone and outpatient visit. Results: Sixty-five patients underwent tricuspid valve repair, and 20 patients underwent tricuspid valve replacement because of prosthetic failure and plasty failure. Five patients died during hospitalization, with mortality rate 5.9%. One patient was transferred to local hospital for anti-infection treatment, the other 79 patients were discharged from hospital in well condition and followed-up. The postoperative hospitalization time was 7.0 (5.5) days (M(Q(R))) days, the mean ventilator time was 18.0 (16.2) hours, and the mean ICU stay time was 68.0 (75.5) hours. There were 35 patients without blood conduction transfusion, the transfusion rate was only 58.9% (50/85). Four cases of severe, 9 cases of moderate and 67 cases of mild to zero tricuspid regurgitation were examined before being discharged, with tricuspid regurgitation area of (2.8±3.5) cm(2) (range: 0 to 19.1 cm(2)). The follow-up time was 1 to 38 months. Two patients died during follow-up, one patient died from infective endocarditis and mitral perivalvular leakage, the other one died of intractable right heart failure. One patient was implanted with permanent pacemaker due to Ⅲ atrioventricular block. Valvular re-replacement was performed in 2 patients who were re-admitted for the artificial valve infection and mechanical valve obstruction. No re-operation of tricuspid valve. Conclusions: Totally endoscopic minimally invasive technique provided satisfactory surgical outcomes for critically sick patients with severe tricuspid regurgitation following cardiac surgery. The application of leaflets augmentation technique achieved ideal repair effect for previously unrepairable lesions.
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Affiliation(s)
- H L Huang
- Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou 510100, China
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Fang ML, Wu CS, Weng LC, Huang HL. Factors associated with depressive symptoms in patients with ankylosing spondylitis in Northern Taiwan. PLoS One 2019; 14:e0224298. [PMID: 31648243 PMCID: PMC6812870 DOI: 10.1371/journal.pone.0224298] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/09/2019] [Indexed: 12/17/2022] Open
Abstract
Patients with ankylosing spondylitis (AS) experience impaired physical function and reduced quality of life, which puts this group at high risk for depression. Identifying factors associated with depressive symptoms could improve outcomes for this at-risk group. However, few studies have examined the relationship between demographic and clinical variables and depressive symptoms in patients with AS. This cross-sectional correlation study recruited patients with AS by convenience sampling from the division of immunology and rheumatology of a medical center in Northern Taiwan. Participants (N = 120) included 91 males and 29 females, age ≥ 20 years. Data were collected from chart reviews, and structural questionnaires, which included demographic information regarding employment status, history of falls, impact of AS on work; clinical information relative to AS was obtained from structural questionnaires: the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and functional index (BASFI), Numerical Rating Scale (NRS), Body Image Scale (BIS), and Beck Depression Inventory-II (BDI-II). Multiple regression analysis identified predictors of depression. The mean BDI-II score was 9.50 ± 8.30; 25% had scores indicating mild to severe depressive symptoms. Mean score on the BIS was 68.17 ± 16.14; 14.2% had fallen within the previous year; and 57.5% reported AS affected their work. Variables associated with depressive symptoms were work affected by AS (β = 0.14, p = .049), occurrence of a fall within the previous year (β = 0.14, p = .032), higher scores on the BASDAI (β = 0.21, p = .032), and lower body image (β = −0.38, p < .001). Clinical professionals should regularly assess patients with AS for depressive symptoms. Health care planning should provide instruction in fall prevention and control of disease activity, and strategies to improve body image, which could improve patients’ self-management capabilities and body image as well as mitigate depressive symptoms.
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Affiliation(s)
- Mei-Ling Fang
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chien-Sheng Wu
- Division of Allergy, Immunology and Rheumatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Li Huang
- Department of Long-term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- * E-mail:
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Schlaeger JM, Weng LC, Huang HL, Tsai HH, Takayama M, Ngamkham S, Yao Y, Wilkie DJ. Pain Quality by Location in Outpatients with Cancer. Pain Manag Nurs 2019; 20:425-431. [PMID: 31160180 DOI: 10.1016/j.pmn.2019.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/21/2019] [Accepted: 04/24/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND The McGill Pain Questionnaire (MPQ) pain quality descriptors have been analyzed to characterize the sensory, affective, and evaluative domains of pain, but have not been differentiated by pain location. AIM To examine MPQ pain quality descriptors by pain location in outpatients with lung or prostate cancer. DESIGN Cross sectional. SETTINGS Eleven oncology clinics or patients' homes. SUBJECTS 264 adult outpatients (80% male; mean age 62.2 ± 10.0 years, 85% White). METHODS Subjects completed a 100 mm visual analogue scale of pain intensity and MPQ clinic or home visit, marking sites where they had pain on a body outline and circling from 78 verbal descriptors those that described their pain. A researcher noted next to the descriptor spontaneous comments about sites feeling like a selected word and queried the subjects about any other words to obtain the site(s). RESULTS Pain quality descriptors were assigned to all 7 pain locations marked by ≥ 20% of 198 lung or 66 prostate cancer patients. Four pain locations were marked with pain quality descriptors significanlty (p < .05) more frequently for lung cancer (53% chest-aching, burning; 58% back-aching, stabbing; 48% head-aching, sharp; and 19% arms-aching, stabbing) than for prostate cancer, which had significantly more frequent pain locations in the abdomen (64%-aching, burning) and lower back/buttocks (55%-aching, burning). CONCLUSIONS This type of pain characterization is innovative and has the potential to help implement targeted treatments for patients with cancer and other chronic pain conditions.
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Affiliation(s)
- Judith M Schlaeger
- Department of Women, Children and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, Illinois
| | - Li-Chueh Weng
- Chang Gung University School of Nursing, College of Medicine, Taoyuan, Taiwan, ROC
| | - Hsiu-Li Huang
- National Taipei University of Nursing and Health Sciences, Department of Long-term Care, College of Health Technology, Taipei, Taiwan, ROC
| | - Hsiu-Hsin Tsai
- Chang Gung University School of Nursing, College of Medicine, Taoyuan, Taiwan, ROC
| | - Miho Takayama
- Tokyo Ariake University of Medical and Health Sciences, Department of Acupuncture and Moxibustion, Tokyo, Japan
| | - Srisuda Ngamkham
- Boromarajonani College of Nursing Sawanpracharak Nakhonsawan, Paknampho, Maung, Nakhonsawan, Thailand
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, Florida
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, Florida.
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Abstract
Background Improving the health-related quality of life (HRQOL) of living liver donors post-donation is an important aspect of care quality. Analyzing the HRQOL of living liver donors prospectively could help improve our understanding of the recovery of HRQOL and help improve the quality of donor care. In this study, we examined the HRQOL of living liver donors at pre-donation and at 1-year post-donation and analyzed the effect of pre- and post-donation factors on the donors' physical and mental HRQOL. Methods This was a prospective study. During the enrollment period (August 2013 to December 2015), 68 living liver donors completed the study questionnaires 5 times: at pre-donation and at 1, 3, 6, and 12 months post-donation. The Medical Outcomes Study Questionnaire Short Form-36, which yields both physical (PCS) and mental (MCS) component summary scores, was used to measure the HRQOL. The pre- and post-donation factors included donation ambivalence, recipients' physical condition, post-donation complications, and recipients' survival status. Results Participants' mean PCS scores were 43.59 and 56.50 at 1 and 12 months after donation, respectively, whereas their mean MCS scores were 46.89 and 46.28, respectively. The mean PCS score was worse at 1 month after donation but improved significantly over time (P<0.05); conversely, the MCS was quite stable over time (P>0.05). A good PCS score was associated with no surgical complications of donation (coefficient =2.87, P=0.02), whereas a poor MCS score was associated with an education of less than a bachelor's degree (coefficient =-3.60, P=0.004), a higher Model for End-Stage Liver Disease (MELD) score in the recipient (coefficient =-0.13, P=0.03), and recipient death (coefficient =-3.48, P=0.03). Pre-donation ambivalence and sense of coherence were not significant predictors of the PCS or MCS scores. Conclusions The impact of living liver donation on HRQOL was strongest in the early stages of the post-surgery period for the physical domain. Health-care professionals should carefully manage and monitor the progress of surgical outcomes, particularly in high-risk groups such as donors with a low education level or donors whose recipients have severe illness or end up dying after the surgery. Doing so may allow for suitable intervention opportunities to improve the HRQOL of living liver donors.
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Affiliation(s)
- Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of General Surgery, Transplantation Center, Chang Gung Memorial Hospital Linkou, Taoyuan, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Science, Taipei, Taiwan
| | - Wei-Chen Lee
- Department of General Surgery, Transplantation Center, Chang Gung Memorial Hospital Linkou, Taoyuan, Taiwan
| | - Yu-Hsia Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Cardiovascular Medicine, Chang Gung Memorial Hospital Linkou, Taoyuan, Taiwan
| | - Woan-Shyuan Wang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kang-Hua Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nursing, Chang Gung Memorial Hospital Linkou, Taoyuan, Taiwan
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Abstract
Living donor liver transplantation has advantages over deceased organ liver transplantation. However, the living liver donor candidates must be carefully assessed before surgery. Candidates may be excluded for various reasons. The purpose of this study was to evaluate the psychological profiles of excluded living liver donor candidates according to the reason for exclusion.A descriptive and cross-sectional study was conducted. Donor candidates were invited to participate if they were at least 20 years of age, related biologically or by marriage to the recipient (within 5 degrees), and had undergone living donor evaluation. Among the 338 participants recruited from August 2013 to December 2015, 116 were excluded for the following reasons: a medical condition (n = 35), failure to be chosen (n = 63), or withdrawal from the selection process (n = 18). The psychological profiles of these 3 exclusion groups were evaluated.There were no significant group differences in age, sex, education level, religion, marital status, and consanguinity (P > .05). The withdrawal group had fewer recipients with an hepatitis B virus infection than did the other groups (χ = 9.28, P = .01). Additionally, compared with the unchosen group, the withdrawal group had lower intimacy with the recipient (F = 5.32, P = .006) and higher ambivalence (F = 5.53, P = .005). In terms of family relationship parameters, the withdrawal group had lower family cohesion than the medical condition and unchosen groups (F = 4.44, P = .01), lower family expressiveness than the medical condition group (F = 3.76, P = .03), and higher family conflict than the medical condition and unchosen groups (F = 7.05, P = .001). The withdrawal group also had lower emotional social support than the medical condition group (F = 3.55, P = .03). There were no significant group difference in motivation, expectations, donation-related concerns, informational social support, value social support, instrumental social support, and health-related quality of life.The living donor candidates who withdrew from the selection process had obvious ambivalence, poorer family relationships, and insufficient emotional social support. The transplantation team should respect the autonomy of the candidate's decision and mitigate the impact of the donation decision on living liver donor candidates.
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Affiliation(s)
- Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan
- Department of General Surgery, Chang Gung Memorial Hospital Linkuo
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing Health Science
| | - Wei-Chen Lee
- Department of General Surgery, Chang Gung Memorial Hospital Linkuo
| | - Yu-Hsia Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan
- Department of Cardiovascular Medicine
| | - Ching-Rong Lin
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan
- Department of Radiation Oncology
- Proton and Radiation Therapy Center
| | - Woan-Shyuan Wang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan
| | - Yi-Wen Wang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan
| | - Tsui-Yun Yang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan
| | - Li-Chuan Tseng
- Department of Nursing, Chang Gung Memorial Hospital (Linkuo), Taoyuan, Taiwan
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Liang JH, Luo HL, Long F, Li L, Huang HL, Huang M, Zhang X, Mao WD. [Expression and significance of Survivin and Bcl-2 in nasal aquamous cell carcinoma]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 30:529-531. [PMID: 29871061 DOI: 10.13201/j.issn.1001-1781.2016.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Indexed: 11/12/2022]
Abstract
Objective:To investigate the expression and it's clinical significance of Survivin and Bcl-2 in nasal squamous cell carcinoma (SNSCC). Method:The immunohistochemical Envision two step method was used to measure the expression of Survivin and Bcl-2 in 35 cases of SNSCC, 20 cases of normal inferior concha tissues. Result:The expression of Survivin in SNSCC was 88.6%, significantly higher than the normal inferior turbinate mucosal tissue expression of 0% (P<0.01). The expression of Bcl-2 in SNSCC was 71.4%, significantly higher than the normal inferior turbinate mucosal tissue expression of 25% (P<0.01). Expression of Bcl-2 was significantly higher in SNSCC than in normal tissue. The expression of Survivin was positively correlated with Bcl-2 expression (P<0.01). The higher the grade of tumor, the lower expressions of Survivin and Bcl-2. Conclusion:Survivin and Bcl-2 may play an promoting role in the development and progression process of SNSCC. Survivin may become a target spot of SNSCC gene therapy.
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Affiliation(s)
- J H Liang
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - H L Luo
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - F Long
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - L Li
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - H L Huang
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - M Huang
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - X Zhang
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - W D Mao
- Department of Pathology,Hanzhong Central Hospital
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Chen HH, Sun FJ, Yeh TL, Liu HE, Huang HL, Kuo BIT, Huang HY. The diagnostic accuracy of the Ascertain Dementia 8 questionnaire for detecting cognitive impairment in primary care in the community, clinics and hospitals: a systematic review and meta-analysis. Fam Pract 2018; 35:239-246. [PMID: 29045636 PMCID: PMC5965102 DOI: 10.1093/fampra/cmx098] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background The prevalence of cognitive impairment is increasing due to the aging population, and early detection is essential clinically. The Ascertain Dementia 8 (AD8) questionnaire is a brief informant-based measure recently developed to assess early cognitive impairment, however, its overall diagnostic performance is controversial. The objective of this meta-analysis was to assess the diagnostic accuracy of the AD8 for cognitive impairment. Methods All relevant studies were collected from databases including MEDLINE, EMBASE and the Cochrane Library up to April 2017. We used QUADAS-2 to assess the methodological quality after the systematic search. The accuracy data and potential confounding variables were extracted from the eligible studies which included those in English and non-English. All analyses were performed using the Midas module in Stata 14.0 and Meta-DiSc 1.4 software. Results Seven relevant studies including 3728 subjects were collected, and classified into two subgroups according to the severity of cognitive impairment. The overall sensitivity (0.72, 0.91) was superior to specificity (0.67, 0.78). The pooled negative likelihood ratio (0.17, 0.13) was better than the positive likelihood ratio (2.52, 3.94). The areas under the summary receiver operating characteristic curve were 0.83 and 0.92, respectively. Meta-regression analysis showed that location (community versus non-community) may be the source of heterogeneity. The average administration time was less than 3 minutes. Conclusion Our findings suggest that the AD8 is a competitive tool for clinically screening cognitive impairment and has an optimal administration time in the busy primary care setting. Subjects with an AD8 score ≧2 should be highly suspected to have cognitive impairment and a further definite diagnosis is needed.
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Affiliation(s)
- Hsin-Hao Chen
- Family Medicine Department, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan
| | - Fang-Ju Sun
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Tzu-Lin Yeh
- Family Medicine Department, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan
| | - Hsueh-Erh Liu
- Degree Program in Healthcare Industry, Chang Gung University, Taoyuan City, Taiwan
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Department of Rheumatology, Chang Gung Memorial Hospital, LinKou, Taiwan
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Benjamin Ing-Tiau Kuo
- Laboratory of Epidemiology and Biostatics, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsin-Yi Huang
- Laboratory of Epidemiology and Biostatics, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
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Wang N, Zhou H, Huang HL. Comparison of automatic and manual reposition treatment for horizontal semicircular canal benign paroxysmal positional vertigo. J BIOL REG HOMEOS AG 2018; 32:719-723. [PMID: 29921405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The purpose of this investigation was to compare the efficacy of automatic to manual reposition treatment for patients with horizontal semicircular canal paroxysmal positional vertigo (BPPV). Sixty patients diagnosed with BPPV were equally and randomly divided into either a manual reposition treatment group or an automatic reposition treatment group. The groups were compared regarding difference in pain [visual analog scale (VAS)], extent of vertigo disorder [dizziness handicap inventory (DHI)], quality of life (SF-36), and therapeutic effect. Improved VAS, DHI and SF-36 were observed in both groups, however the efficacious rate of the automatic reposition group (96.7%) was 13.4% higher than that of the manual reposition group, reaching a statistical significance (p less than 0.05). In conclusion, in the treatment of BPPV patients, automatic reposition is more effective than manual reposition and can improve the patients quality of life.
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Affiliation(s)
- N Wang
- Department of Neurology, Xuzhou First Peoples Hospital, Xuzhou, Jiangsu, PR China
| | - H Zhou
- Department of Neurology, Xuzhou First Peoples Hospital, Xuzhou, Jiangsu, PR China
| | - H L Huang
- Department of Neurology, Xuzhou First Peoples Hospital, Xuzhou, Jiangsu, PR China
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Chen MM, Chou CC, Hsu KY, Yen YF, Yang YT, Huang HL. [An Experience of Providing Palliative Care in a Long-Term Care Facility: Let Good Death in Place Become a Feasible Reality]. Hu Li Za Zhi 2017; 64:130-135. [PMID: 28393347 DOI: 10.6224/jn.000032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
As the number of elderly in long-term care facilities (LTCFs) continues to increase, the number of resident deaths in these facilities is expected to increase. Thus, LTCFs may become a main focus for end-of-life (EoL) care in the future. Therefore, promoting quality EoL care in LTCFs should be a priority issue. Currently, the four types of hospice services include hospice wards and hospice-share-services in hospitals and home hospice care and community hospice care in patient homes. However, to date, there has been limited discussion regarding promoting palliative care in LTCFs. The present article describes the LTCF nursing process that was used in caring for an EoL resident. Several interventions were used to assist this EoL resident to experience a dignified and peaceful death. These interventions included promoting the advance directive on hospice palliative care, linking community hospice palliative teams, ceating a warm environment, integrating the multidisciplinary team to alleviate the resident's distress symptoms, supporting the resident's psycho-social-spiritual needs, and accompanying family members through the process of anticipatory grief. This experience illustrates the feasibility of maintaining EoL residents in familiar LTCF environs in order to help them experience a good death in place.
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Affiliation(s)
| | | | | | - Yung-Feng Yen
- Section of Infectious Diseases, Taipei City Hospital Yang-Ming Branch, Taiwan, ROC
| | - Ya-Ting Yang
- Department of Nursing, Taipei City Hospital Yang-Ming Branch, Taiwan, ROC
| | - Hsiu-Li Huang
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taiwan, ROC
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Weng LC, Huang HL, Tsai HH, Lee WC. Predictors of decision ambivalence and the differences between actual living liver donors and potential living liver donors. PLoS One 2017; 12:e0175672. [PMID: 28520727 PMCID: PMC5435180 DOI: 10.1371/journal.pone.0175672] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 03/29/2017] [Indexed: 01/10/2023] Open
Abstract
Background The decision to become a living liver donor is a stressful event. Ambivalence in decision making may result in psychological distress. Thus, the purpose of this study was to provide a description of the ambivalence of potential living liver donors, to examine the predictors of ambivalence, and to compare the ambivalence of potential living liver donors with that of actual living liver donors. Methods This descriptive and correlational study was conducted in a medical center from August 2013 to December 2015. Self-reported questionnaires were used to collect data. A total of 263 potential living liver donors who were assessed for donation to their parents were included in this study. Results The mean age of the total sample was 30.7 years (SD = 6.39, range = 20–47), and males comprised 53.6% of the sample. The majority of the potential donors had a college education (70.8%) and were single (63.5%). Of the total sample, the mean score for ambivalence was 4.27 (SD = 1.87, range = 0–7). Multivariate analysis revealed that the Mental Component Summary (MCS) of quality of life (β = -0.24, p < 0.01), family support (β = -0.17, p = 0.007), and intimacy (β = -0.13, p = 0.04) were significant protective predictors of ambivalence. Actual living liver donors had significantly lower ambivalence (3.82 versus 4.60), higher intimacy with recipients (3.55 versus 3.34), higher MCS (45.26 versus 42.80), and higher family support (34.39 versus 29.79) than did the remaining potential living liver donors. Conclusion Ambivalence is common in potential living liver donors. The MCS of quality of life, family support, and intimacy were protective predictors in terms of ambivalence. Future research should explore other factors and design interventions targeted toward reducing ambivalence, promoting family support, and enhancing the mental dimensions of quality of life in potential living liver donors.
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Affiliation(s)
- Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of General Surgery, Chang Gung Medical Foundation-Linkuo, Taoyuan, Taiwan
- * E-mail:
| | - Hsiu-Li Huang
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Hsiu-Hsin Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Medical Foundation-Linkuo, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Department of General Surgery, Chang Gung Medical Foundation-Linkuo, Taoyuan, Taiwan
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Dong L, Shi YK, Xu JP, Zhang EY, Liu JC, Li YX, Ni YM, Yang Q, Han T, Fu B, Chen J, Ren L, Wei SL, Chen H, Liu KX, Yu FX, Liu JS, Xiao MD, Wu SM, Zhang KL, Huang HL, Jiang SL, Qiao CH, Wang CS, Xu ZY, Zhou XM, Wang DJ, Ni LX, Xiao YB, Jiang SL, Zhang GM, Liang GY, Yang SY, Bo P, Zhong QJ, Zhang JB, Zhang X, Zhu YB, Teng X, Zhu P, Huang F, Xiao YM, Cao GQ, Tian H, Xia LM, Lu FL, Liu YQ, Liu DX, Xu H, Yuan Y, Li M, Chang C, Wu XC, Xu Z, Guo P, Bai YJ, Xue WB, Jiang XY, Na ZH, Zeng QY, Cai H, Wang YL, Xiong R, Jin S, Zheng XM, Wu D. [The multicenter study on the registration and follow-up of low anticoagulation therapy for the heart valve operation in China]. Zhonghua Yi Xue Za Zhi 2017; 96:1489-94. [PMID: 27266493 DOI: 10.3760/cma.j.issn.0376-2491.2016.19.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the optimal anticoagulation methods and monitoring strategy for Chinese patients undergoing heart valve replacement, which is potentially quite different from western populations. METHODS In this multicenter prospective cohort study, the anticoagulation and monitoring strategy data was acquired from 25 773 in-hospital patients in 35 medical centers and 20 519 patients in outpatient clinic in 11 medical centers from January 1st, 2011 to December 31th, 2015. RESULTS As for in-hospital patients, mean age of study population was (48.6±11.2) years old; main etiology of valve pathology was rheumatic (87.5%) origin among study cohort; 94.8% of study population received mechanical valve implantation; international normalized ratio (INR) monitoring (in all the study centers) and low-intensity anticoagulation strategy (31 hospitals chose target INR range of 1.5-2.5, and actual values of INR among 89.2% of 100 069 in-hospital monitoring samples were 1.5-2.5), with mean actual INR values of 1.84±0.53, and warfarin dosage of (2.82±0.93) mg/d were widely adopted among the study centers; strategies of in-hospital warfarin administration were similar in all the study centers; complication rates of low-intensity anticoagulation strategy were low in severe hemorrhage (0.02%), thrombosis (0.05%), and thromboembolism (0.05%) events, without anticoagulation-related death.As for 18 974 outpatient clinic patients, the follow-up rate was 92.47%, with a total of 30 012 patient-years (Pty). Anticoagulation-related morbidity and mortality rates were 0.67% and 0.15% Pty; major hemorrhage morbidity and mortality rates were 0.25% and 0.13% Pty; thromboembolism morbidity and mortality rates were 0.45% and 0.03% Pty.The mean dosage of warfarin daily dosage was (2.85±1.23) mg/d and INR value was 1.82±0.57.No significant regional difference in the intensity of anticoagulation therapy was noted during the study. CONCLUSIONS INR can be used as a normalized indicator for intensity of anticoagulation therapy in China.The optimal anticoagulation intensity with INR range from 1.5 to 2.5 is safe and effective for Chinese patients with heart valve replacement, and there is no significant regional difference in the intensity of anticoagulation therapy.
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Affiliation(s)
- L Dong
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
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Chen HF, Yao ZH, Yan XH, Zhao L, Wang S, Lin J, Huang HL. [Comparison and application of two risk assessment methods for occupational lead exposure risk classification in a lead-acid battery enterprise]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2017; 35:130-133. [PMID: 28355703 DOI: 10.3760/cma.j.issn.1001-9391.2017.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To apply and compare two risk assessment methods for occupational lead exposure risk classification in a lead-acid battery enterprise. Methods: In April 2013, an occupational health survey was carried out in a lead-acid battery enterprise. Lead smoke and lead dust were tested in the workplace. The risk assessment index system for occupational chemical hazards that was established and optimized by the research group (referred to as "optimized index system" ) , as well as the Singapore semi-quantitative risk assessment model, was used for occupational lead exposure risk classification in the lead-acid battery enterprise. The two risk classification results were analyzed and compared. Results: In the lead smoke risk classification results, the optimized index system classified the raw material group and foundry group workshops as Class I hazardous and the assembling group workshop as Class II hazardous. The Singapore semi-quantitative risk assessment model classified the raw material group workshop as high risk and foundry group and assembling group workshops as extremely high risk. In the lead dust risk classification results, the optimized index system classified the raw material group workshop as Class I hazardous, while the plate painting group, plate cutting group, and assembling group workshops were classified as Class II hazardous. The Singapore semi-quantitative risk assessment model classified the raw material group workshop as medium risk, the plate painting group and plate cutting group workshops as high risk, and the assembling group workshop as extremely high risk. Conclusion: There are some differences in risk assessment of occupational lead exposure between the two risk assessment methods. The optimized index system is comparably more reasonable and feasible, and is highly operable.
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Affiliation(s)
- H F Chen
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangdong Provincial Key Laboratory of Occupational Diseases Prevention and Treatment, Guangzhou 510300, China
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Weng LC, Yang YC, Huang HL, Chiang YJ, Tsai YH. Factors that determine self-reported immunosuppressant adherence in kidney transplant recipients: a correlational study. J Adv Nurs 2016; 73:228-239. [DOI: 10.1111/jan.13106] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2016] [Indexed: 01/10/2023]
Affiliation(s)
- Li-Chueh Weng
- School of Nursing; College of Medicine; Chang Gung University; Taoyuan Taiwan
- Department of General Surgery; Chang Gung Medical Foundation-Linkuo; Taoyuan Taiwan
| | - Ya-Chen Yang
- School of Nursing; College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Hsiu-Li Huang
- School of Nursing; College of Medicine; Chang Gung University; Taoyuan Taiwan
- Department of Neurology; Chang Gung Medical Foundation-Linkuo; Taoyuan; Taiwan
| | - Yang-Jen Chiang
- Transplantation Center and Urology Surgery; Chang Gung Medical Foundation-Linkuo Medical Center; Taoyuan Taiwan
| | - Yu-Hsia Tsai
- School of Nursing; College of Medicine; Chang Gung University; Taoyuan Taiwan
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Liu J, Guo HM, Gao Q, Chen B, Xie B, Huang HL, Liu J, Lu C, Chen JM, Zhuang J. [Clinical experience of 60 patients underwent three-dimensional video assisted thoracoscopic mitral valvuloplasty]. Zhonghua Wai Ke Za Zhi 2016; 54:605-8. [PMID: 27502135 DOI: 10.3760/cma.j.issn.0529-5815.2016.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To summarize the clinical experience of 60 patients underwent three-dimensional video assisted thoracoscopic mitral valvuloplasty. METHODS Sixty patients were enrolled retrospectively from March 2014 to January 2016 in Department of Cardiacvascular Surgery, Guangdong Cardiovascular Institute. They underwent three-dimensional video assisted thoracoscopic mitral valvuloplasty. There were 37 male and 23 female patients. The range of age was 15 to 78 years (the median age was 47 years). The techniques of mitral valvuloplasty included chordae tendineae transplantation (53 patients), annuloplasty (58 patients), posterior leaflet resection (13 patients), anterior leaflet resection (2 patients), commissure resection (1 patient). Their information from charts were collected. The follow-up time was lasting 3 to 25 months by telephone or outpatient department interview. The data was analyzed via paired t test or Wilcoxon signed-rank test. RESULTS Conversions to mitral valve replacement were performed for two patients. No patients underwent thoracotomy. The operation time was (213±37) minutes, cardiopulmonary bypass time was (129±31) minutes, aortic cross clamping time was (81±21) minutes. Postoperative hospital stay was (7±3) days. During follow-up period, there were no re-operation and no death. Mitral regurgitation level and New York Heart Association class were both improved (Z=-6.286, P=0.000, Z=-6.237, P=0.000), respectively. Besides, there was also no new atrial fibrillation patients. CONCLUSIONS Not only does three-dimensional video assisted thoracoscopic mitral valvuloplasty maintain the advantages of 2-Dimensional thoracoscopy, but also have the similar view of median thoracotomy. This technique showed promising clinical value in the future.
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Affiliation(s)
- J Liu
- Department of Cardiacvascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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Lin N, Lin Y, Huang HL, Lin XL, He DQ, He SQ, Guo DH, Li Y, Xu LP. [Prenatal diagnosis of Thailand deletion of α-thalassemia 1 families]. Zhonghua Yi Xue Za Zhi 2016; 96:1919-22. [PMID: 27373361 DOI: 10.3760/cma.j.issn.0376-2491.2016.24.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To conduct analysis and prenatal diagnosis on 11 couples carrying Thailand deletion (--(THΑI)) α-thalassemia 1, so as to provide information for clinical genetic counseling on α-thalassemia 1. METHODS Altogether 11 Thailand deletion (--(THΑI)) α-thalassemia 1 families were collected from Fujian Maternal and Children Health Hospital from May 2009 to September 2015. Gap-polymerase chain reaction (gap-PCR) and reverse dot blot (RDB) technology were used to detect the thalassemia mutations in the couples and fetuses. RESULTS In one family, Thailand deletion α-thalassemia 1 was detected in both the pregnant woman and her husband. In 10 families, Thailand deletion α-thalassemia 1 was detected in either the pregnant women or the husband, while the spouses had α-thalassemia heterozygote (1 combined with β thalassemia heterozygote). Thailand deletion α-thalassemia 1 family members all had lower mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH). In prenatal diagnosis of the 12 fetuses, 4 fetuses were found with hemoglobin(Hb) Bart's hydrops fetalis syndrome, 5 were with α-thalassemia heterozygote, and 3 were normal. CONCLUSIONS For couples with positive hematological phenotype but normal results in routine genetic examination of α-thalassemia, attention should be paid especially for with a history of having babies of hydrops fetalis syndrome or hemoglobin H disease. It is necessary to consider the possibility of the rare Thailand deletion (--(THΑI)) α-thalassemia 1. Prenatal diagnosis for high-risk families plays an important role.
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Affiliation(s)
- N Lin
- Center of Prenatal Diagnosis, Fujian Matenal and Children Health Hospital, Fujian Medical University Teaching Hospital, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
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Tsai HH, Tsai YF, Huang HL. Nursing home nurses’ experiences of resident transfers to the emergency department: no empathy for our work environment difficulties. J Clin Nurs 2016; 25:610-8. [DOI: 10.1111/jocn.13084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2015] [Indexed: 01/15/2023]
Affiliation(s)
- Hsiu-Hsin Tsai
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Yun-Fang Tsai
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
- Department of Nursing; Chang Gung Memorial Hospital at Keelung; Keelung Taiwan
| | - Hsiu-Li Huang
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
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Zhu P, Zhao MY, Li XH, Fu Q, Zhou ZF, Huang CF, Zhang XS, Huang HL, Tan Y, Li JX, Li JN, Huang S, Ashraf M, Lu C, Chen JM, Zhuang J, Guo HM. Effect of low temperatures on BAX and BCL2 proteins in rats with spinal cord ischemia reperfusion injury. Genet Mol Res 2015; 14:10490-9. [PMID: 26400280 DOI: 10.4238/2015.september.8.10] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We evaluated changes in BAX and BCL2 expression levels after spinal cord ischemia/reperfusion injury (SCII) and hypothermia during operations in rats. Eighty rats were divided into four groups: Group A (N = 20, 18°C); Group B (N = 20, 28°C); Group C (N = 20, room temperature); and Group D (N = 20, sham operation control). Spinal cord ischemia was induced for 90 min. Hypothermia was induced 15 min before, and maintained during ischemia, followed by heating to normothermia for 30 min after reperfusion. Motor function of the lower limbs was evaluated according to the Tarlov score at 72 and 168 h. For each rat, spinal cord samples were taken at 6, 24, 72 h, and 1 week to evaluate the histopathological changes, neuronal apoptosis, and BAX and BCL2 expression levels. Compared with normothermia, hypothermia significantly improved hind limb function; Group B achieved a higher score than Group A. Group D showed no neurologic deficiency, while the other groups showed various degrees. Group C exhibited greater neuronal apoptosis, higher BAX expression, but lower BCL2 expression than the other groups. Compared with Group A, BAX was expressed less and BCL2 more in Group B, and there was less apoptosis in Group B. Hypothermia preserves hind limb motor function and reduces neuronal death, thereby protecting rats from SCII. The spinal cord may be protected from SCII by inhibition of BAX and activation of BCL2. However, deep hypothermia may inhibit the expression of BCL2, resulting in a worse outcome than mild hypothermia.
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Affiliation(s)
- P Zhu
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - M Y Zhao
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - X H Li
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Q Fu
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Z F Zhou
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - C F Huang
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - X S Zhang
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - H L Huang
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Y Tan
- Department of Pharmacology, UIC College of Medicine, Chicago, IL, USA
| | - J X Li
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - J N Li
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - S Huang
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - M Ashraf
- Department of Pharmacology, UIC College of Medicine, Chicago, IL, USA
| | - C Lu
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - J M Chen
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - J Zhuang
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - H M Guo
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
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Cui JJ, Tian Y, Liu Y, Huang HL, Jin Y. Proacrosin activation mechanisms in capacitated and frozen-thawed boar spermatozoa. Genet Mol Res 2014; 13:9915-20. [PMID: 25501202 DOI: 10.4238/2014.november.27.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The main objective of the current study was to explore the different activation mechanisms of capacitation and freeze-thawed spermatozoa. Using SDS-PAGE and Western blotting, the conversion process of boar proacrosin during freeze-thawing and capacitation of spermatozoa was analyzed. The results revealed that capacitated spermatozoa exhibited a greater fluorescence area than that of the freeze-thawed spermatozoa, which were smaller than those of the fresh group. Fresh spermatozoa displayed 45- and 35- kDa protein bands, while those of freeze-thawed andcapacitated spermatozoa displayed 45-, 35- and 28-kDa bands. In summary, these data indicate that proacrosin is activated, thus becoming α- and β-acrosins and a 28-kDa protein during capacitation and freeze-thawing.
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Affiliation(s)
- J J Cui
- Agricultural College of Yanbian University, Yanji, Jinlin, China
| | - Y Tian
- Agricultural College of Yanbian University, Yanji, Jinlin, China
| | - Y Liu
- Agricultural College of Yanbian University, Yanji, Jinlin, China
| | - H L Huang
- Agricultural College of Yanbian University, Yanji, Jinlin, China
| | - Y Jin
- Agricultural College of Yanbian University, Yanji, Jinlin, China
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Abstract
To explore the relationship between Myf5 gene polymorphisms and production performance traits in Songliao white geese, we used the chicken Myf5 sequence to design primers and amplified part of the exon 1 sequence of the Songliao white goose Myf5 gene. Results of single-strand conformation polymorphism polymerase chain reaction analysis revealed polymorphisms of the amplified fragment, including three genotypes (AA, AB, and BB). Three varieties were dominated by allele A and were mainly expressed in AA genotypes. We also identified that the Myf5 gene has one single nucleotide change (A→G) on exon 1 at locus 1344, and another (G→C) at locus 1410. Analysis of variance showed significant differences between genotypes before slaughter in live weight, carcass weight, eviscerated weight, leg muscle weight, weight of the wings, and slaughter rate. There were no significant differences with respect to other growth and carcass traits evaluated.
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Affiliation(s)
- J B Wu
- Agricultural College of Yanbian University, Yanji, China
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Weng LC, Huang HL, Wang YW, Lee WC, Chen KH, Yang TY. The effect of self-efficacy, depression and symptom distress on employment status and leisure activities of liver transplant recipients. J Adv Nurs 2013; 70:1573-83. [PMID: 24237349 DOI: 10.1111/jan.12315] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2013] [Indexed: 01/01/2023]
Abstract
AIM To examine the effect of self-efficacy, subjective work ability, depression and symptom distress on and to provide a description of, the employment and leisure activities of liver transplant recipients. BACKGROUND Return to work and leisure activities have become an important aspect of life for liver transplant recipients worldwide. An investigation of the factors that influence the employment status and leisure activities has been recommended as a means to help transplant recipients restore their productivity. DESIGN This was a cross-sectional, descriptive and correlational study in 2010. METHODS A convenience sampling method was used. Data were collected using a set of questionnaires that were administered retrospectively. A total of 106 liver transplant patients were included in this study. RESULTS The post-transplantation employment rate was 45.2%. The positive predictors of employment were higher subjective work ability and higher symptom distress. Gender (female), monthly family income (<US $2,000), depression and unemployment pre-transplantation were negatively associated with employment status. Of the 106 patients, 62 (58.5%) were in the low-diversity group (score of less than 3) of leisure activities. Monthly family income of <US $2,000 was associated with a low diversity of participation in leisure activities. CONCLUSION Subjective work ability and symptom distress were positive predictors of employment, while depression was a negative predictor. Nurses in the transplant team should focus on increasing a sense of confidence, decreasing depressive symptoms and monitoring the severity of symptoms to improve the employment status of liver transplant recipients.
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Affiliation(s)
- Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Huang HL, Kuo LM, Chen YS, Liang J, Huang HL, Chiu YC, Chen ST, Sun Y, Hsu WC, Shyu YIL. A home-based training program improves caregivers' skills and dementia patients' aggressive behaviors: a randomized controlled trial. Am J Geriatr Psychiatry 2013; 21:1060-70. [PMID: 23933422 DOI: 10.1016/j.jagp.2012.09.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 08/28/2012] [Accepted: 09/26/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the effects of an individualized, home-based caregiver-training program for caregivers of elderly patients with dementia and behavioral problems. METHODS Using a randomized clinical trial in the neurologic clinics of two hospitals and a community care management center in northern Taiwan, we tested an individualized home-based caregiver-training program for managing behavioral problems, with referrals to community services and telephone consultation. Participants were patients with dementia and their caregivers (N = 129): 63 in the intervention group and 66 in the control group. The control group received only written instructions and social telephone follow-ups. Behavioral problems of elderly dementia patients were assessed by the Chinese version of the Cohen-Mansfield Agitation Inventory, community form. Family caregivers' outcomes were measured by the Agitation Management Self-efficacy Scale and the Preparedness and Competence Scales. These instruments were administered before the program and 2 weeks, 3 months, and 6 months afterward. RESULTS Family caregivers who received the individualized home-based training program had better preparedness (t = 2.72, df = 127, p <0.01), competence (t = 4.77, df = 126, p <0.001), and overall self-efficacy (t = 3.81, df = 127, p <0.001) at 3 months than those in the control group. Moreover, the growth rate by treatment interaction effect was significant for caregiver competence (t = 2.25, df = 127, p <0.05) and overall self-efficacy for managing behavioral problems (t = 2.16, df = 127, p <0.05). The probability of physically aggressive behavior for patients in the intervention group decreased from 0.27 to 0.12. CONCLUSION Our individualized home-based caregiver-training program improved caregivers' preparedness, competence, and self-efficacy for managing problematic behaviors and decreased physical aggressiveness of elderly patients with dementia.
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Affiliation(s)
- Huei-Ling Huang
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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Kuo LM, Huang HL, Huang HL, Liang J, Chiu YC, Chen ST, Kwok YT, Hsu WC, Shyu YIL. A home-based training program improves Taiwanese family caregivers' quality of life and decreases their risk for depression: a randomized controlled trial. Int J Geriatr Psychiatry 2013; 28:504-13. [PMID: 22778053 DOI: 10.1002/gps.3853] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 06/08/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Little is known about the longitudinal effects of training programs on family caregivers' health-related quality of life (HRQoL) and depressive symptoms over time. Therefore, the purpose of this study was to examine the effects of a home-based caregiver training program on HRQoL and depressive symptoms for family caregivers of older persons with dementia. METHODS Outcomes (caregivers' HRQoL and depressive symptoms) were assessed before the training program (baseline), and at 2 weeks, 3 months, and 6 months afterwards. HRQoL was measured using the Medical Outcomes Study 36-item Short Form Survey, Taiwan version. Depressive symptoms were measured using the Chinese version Center for Epidemiologic Studies Depression Scale. RESULTS Family caregivers who received the individualized home-based training program had better health outcomes in bodily pain (b = 12.37, p < 0.013), role disability due to emotional problems (b = 17.74, p < 0.013), vitality (b = 12.40, p < 0.001), better mental summary score (b = 5.14, p < 0.003), and decreased risk for depression (odds ratio = 0.15, confidence interval = 0.04-0.65, p < 0.013) than those in the control group during the 6 months following the training program. CONCLUSION Our home-based caregiver training program improved caregivers' HRQoL, especially role limitations due to emotional problems, and decreased their risk for depression.
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Affiliation(s)
- Li-Min Kuo
- School of Nursing, Hsin Sheng College of Medical Care and Management, Taoyuan, Taiwan
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Chiu YC, Huang CY, Kolanowski AM, Huang HL, Shyu YL, Lee SH, Lin CR, Hsu WC. The effects of participation in leisure activities on neuropsychiatric symptoms of persons with cognitive impairment: a cross-sectional study. Int J Nurs Stud 2013; 50:1314-25. [PMID: 23411009 DOI: 10.1016/j.ijnurstu.2013.01.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 01/12/2013] [Accepted: 01/12/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND People with cognitive impairment have been shown to engage in few structured activities. During periods of unoccupied time or boredom, these patients most likely manifest neuropsychiatric symptoms. OBJECTIVE The purposes of this study were to (1) describe the leisure-activity indicators (variety in leisure activities, appraisal of each activity's restorative function, and leisure dysfunction, i.e. failure to appreciate the importance of restorative aspects of leisure activity), of community-dwelling older Taiwanese adults with cognitive impairment, and (2) explore the relationships between these indicators and neuropsychiatric symptoms in this population. DESIGN Cross-sectional. SETTING Memory disorder and geriatric psychiatric clinics of two hospitals in northern Taiwan. PARTICIPANTS Patient-family caregiver dyads (N=60). METHOD Patients' dementia severity, based on Clinical Dementia Rating scores, was 0.5-2.0. Family caregivers completed the Chinese Neuropsychiatric Inventory to assess patients' behavioral problems and the Restorative Activity Questionnaire to assess patients' participation in leisure activities, restorative experience, and leisure dysfunction. RESULTS On average, patients participated in approximately five individual leisure activities, but very few group leisure activities. The top three leisure activities were watching TV, taking a walk, and talking to relatives and friends. The leisure activities in which participants least commonly engaged were fishing, attending cultural exhibitions, and chess/card playing. All leisure-activity indicators were significantly correlated with disease stage, global cognitive function, and neuropsychiatric symptoms. Two leisure-activity indicators (leisure dysfunction and restorative experiences) were significantly correlated with depressive symptoms. Only leisure dysfunction significantly and consistently predicted neuropsychiatric symptoms. CONCLUSION These results can be used by home health or community health nurses to design tailored leisure-activity plans for improving the care quality of patients with cognitive impairment. Health professionals can develop leisure-education programmes to emphasize the value of leisure pursuit and to modify attitudes toward participating in leisure activities. Finally, parks and recreational agencies may re-examine their services and facilities to meet the increasing needs of this population.
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Affiliation(s)
- Yi-Chen Chiu
- School of Nursing and Healthy Aging Research Center, College of Medicine, Chung Gung University,Taoyuan, Taiwan, ROC.
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Abstract
BACKGROUND Returning to work has been recognized as an indicator of functional recovery. Few studies have aimed to explore whether one's type of work changes after transplantation. PURPOSE This study aims to describe the change in types of work in liver transplant patients. METHODS A retrospective and descriptive study was conducted at a medical center in northern Taiwan. The data were collected by a self-report questionnaire between July and September 2010. Descriptive statistics an correlational analysis were used to analyze the data. RESULTS A convenience sample of 111 adult liver transplant patients was included in this study. Of the sample, 20 patients remained unemployed, 44 had a change in status by becoming unemployed (n=42) or employed (n=2), and 47 patients remained employed after transplantation. At the time of data collection, 49 (44.1%) liver transplant patients were gainfully employed, a rate that was lower than that of the pretransplantation stage (n=89, 80.2%). The number of workers engaged in manual labor decreased from 40 to 18 between pre- and posttransplantation. Of the 47 still-employed patients, 6 (12.8%) changed their occupation after transplantation. CONCLUSION The rate of gainful employment after liver transplantation was low, and those patients who had done manual labor pretransplantation were no longer able to do this type of work and were unemployed. The still-employed patients who worked in management or were professionals did not change their type of work after transplantation; however, service and labor workers did change their type of work.
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Affiliation(s)
- L-C Weng
- School of Nursing, Chang Gung University, and Liver Research Center, Department of General Surgery, Chang Gung Medical Foundation-Chang Gung Memorial Hospital, Taoyuan, Taiwan
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