Relationship between Walking Activity and Sleep Quality among Community-Dwelling Older Adults.

PURPOSE: To explore the relationship between walking activity and sleep quality among elderly. DESIGN: A cross-sectional, correlation study with purposive sampling was conducted on participants with a walking habit but not regular moderate-intensity exercise. METHODS: Data were collected by structured questionnaires, including the Walking Activity Questionnaire and the Pittsburgh Sleep Quality Index. FINDINGS: The total walking time per week and frequency of walking per day were significant predictors of sleep quality. CONCLUSIONS: Walking can help older community-dwelling adults improve their sleep quality. CLINICAL EVIDENCE: Walking more than once per day and total walking time per week ≥210 minutes were associated with good sleep quality.

Oxidative Stress-Induced Alterations of Cellular Localization and Expression of Aquaporin 1 Lead to Defected Water Transport upon Peritoneal Fibrosis.

Being one of the renal replacement therapies, peritoneal dialysis (PD) maintains around 15% of end-stage kidney disease patients' lives; however, complications such as peritoneal fibrosis and ultrafiltration failure during long-term PD compromise its application. Previously, we established a sodium hypochlorite (NaClO)-induced peritoneal fibrosis porcine model, which helped to bridge the rodent model toward pre-clinical human peritoneal fibrosis research. In this study, the peritoneal equilibration test (PET) was established to evaluate instant functional changes in the peritoneum in the pig model. Similar to observations from long-term PD patients, increasing small solutes transport and loss of sodium sieving were observed. Mechanistic investigation from both in vivo and in vitro data suggested that disruption of cytoskeleton induced by excessive reactive oxygen species defected intracellular transport of aquaporin 1, this likely resulted in the disappearance of sodium sieving upon PET. Functional interference of aquaporin 1 on free water transport would result in PD failure in patients.

Effects of situational simulation and online first-aid training programs for nurses in general medical wards: A prospective study.

BACKGROUND: To maintain patient safety, effective first-aid skills are necessary during emergencies. It is important to develop in-service education programs to equip clinical nurses with first-aid skills. OBJECTIVES: This study explored the effects of first-aid skills and knowledge between situational simulation training and online teaching. It also examined the different effects of two training programs associated with nurses' baseline first-aid ability. DESIGN: This was a randomized, single-blind controlled study. SETTING: The study was conducted from December 15, 2016 to May 28, 2018, in the nursing department of a medical center in Taiwan. PARTICIPANTS: Participants were 92 general ward nurses. METHODS: Participants were randomly assigned to either a situational simulation training or an online teaching group. We used a first-aid knowledge test (FAKT) and a first-aid skills test (FAST) to measure the participants' learning outcomes after intervention and we did cost comparisons between groups. RESULTS: There were no significant differences in the changes in FAKT and FAST scores after intervention between situational simulation training and online teaching groups (p = 0.76, p = 0.45). All the participants in both training programs showed improvements via increased scores on FAST (M ± SD = 35.27 ± 12.08 for online teaching, M ± SD = 36.08 ± 10.78 for situational simulation training) and FAKT (M ± SD = 21.09 ± 18.59 for online teaching, M ± SD = 23.39 ± 15.36 for situational simulation training). However, for the subgroup of participants who scored <75% on the FAST pretest, better improvements only occurred in the situational simulation training, but the situational simulation training program had higher costs than the online teaching program. CONCLUSIONS: The improvement was greater in the situational simulation training group among nurses who could not exceed scores of 75% for first-aid skills. First-aid skill scores below 75% are likely a sign of nurses who need more assistance, discussion, and debriefing from situational simulation training.

Geriatric syndromes and quality of life in older adults with diabetes.

AIM: To describe geriatric syndromes and their relationships with quality of life in older adults with diabetes. METHODS: Community-dwelling older adults (aged >60 years) with diabetes (n = 316) participated in the present study. Eight geriatric syndromes, including polypharmacy (number of medications), pain (Brief Pain Inventory), urinary incontinence (International Consultation on Incontinence Questionnaire), sleep disturbance (hours of sleep), lower cognitive level (Mini-Mental State Examination), falls, depressive symptoms (Geriatric Depression Scale short form) and functional limitation (Barthel Index and Instrumental Activity of Daily Living), were assessed. The WHOQOL-BREF Taiwan version was used to measure physical, psychological, social and environmental domains of quality of life. RESULTS: Polypharmacy was the most common geriatric syndrome (46.6%), followed by pain (41.5%). Participants with any of the geriatric syndromes, except for polypharmacy and sleep disturbance, had significantly poorer quality of life than those without. The Geriatric Depression Scale score was the only common and significant contributor to all four domains of quality of life, explaining 16~29% of the variance. Number of medications, pain level and cognitive level were also significant contributors, although they explained a small amount (<5%) of the variance. The number of geriatric syndromes (mode = 2) was significantly correlated with all four domains of quality of life (partial correlation r = -0.278~0.460, all P < 0.001). CONCLUSIONS: Geriatric syndromes, especially polypharmacy and pain, were common among older adults with diabetes. A greater number of geriatric syndromes or a higher Geriatric Depression Scale score were associated with poorer quality of life. Further studies focusing on combinations of different geriatric syndromes or comorbidities are required. Geriatr Gerontol Int 2019; 19: 518-524.

Gender differences in the relationship between walking activity and sleep disturbance among community-dwelling older adult with diabetes in Taiwan.

This study explored the gender differences in the relationship between walking activity and sleep disturbances. A cross-sectional study of 201 community-dwelling older adults with diabetes was conducted in southern Taiwan. Using the Taiwanese version of the International Physical Activity Questionnaire, self-administered short version (IPAQ-SS), information on physical activity and sleep disturbance conditions was collected. Among older female adults with diabetes, 54.2% reported sleep disturbance significantly higher than males (38.1%). Logistic regression analysis suggested that for women, in addition to the active group, older adults in the low-active, high-walking group exhibited a significantly lower rate of sleep disturbance than did those who walked less.

[Nurses' Innovation Acceptance of Barcode Technology].

BACKGROUND: Healthcare organizations have increasingly adopted barcode technology to improve care quality and work efficiency. Barcode technology is simple to use, so it is frequently used in patient identification, medication administration, and specimen collection processes. PURPOSE: This study used a technology acceptance model and innovation diffusion theory to explore the innovation acceptance of barcode technology by nurses. METHODS: The data were collected using a structured questionnaire with open-ended questions that was based on the technology acceptance model and innovation diffusion theory. The questionnaire was distributed to and collected from 200 nurses from March to May 2014. Data on laboratory reporting times and specimen rejection rates were collected as well. RESULTS: Variables that were found to have a significant relationship (p<.001) with innovation acceptance included (in order of importance): perceived usefulness (r=.722), perceived ease of use (r=.720), observability (r=.579), compatibility (r=.364), and trialability (r=.344). N-level nurses demonstrated higher acceptance than their N1 and N2 level peers (F=3.95, p<.05). Further, the mean laboratory reporting time decreased 109 minutes (t=10.03, p<.05) and the mean specimen rejection rate decreased from 2.18% to 0.28%. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results revealed that barcode technology has been accepted by nurses and that this technology effectively decreases both laboratory reporting times and specimen rejection rates. However, network speed and workflow should be further improved in order to benefit clinical practice.

Association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent.

INTRODUCTION: The aim of this study is to investigate the association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent. METHODS: We recruited 607 students (grades 5-9) to fill out the investigation of basic data and sleep disturbance. Psychiatrists then used the Mini International Neuropsychiatric Interview-Kid to interview these students to assess their suicidal ideation and psychiatric diagnosis. Multiple logistic regression with forward conditionals was used to find the risk factors for multivariate analysis. RESULTS: Female, age, depressive disorder, adjustment disorder, and poor sleep all contributed to adolescent suicidal ideation in univariate analysis. However, poor sleep became non-significant under the control of depressive disorder and adjustment disorder. DISCUSSION: We found that both depressive disorder and adjustment disorder play important roles in sleep and adolescent suicidal ideation. After controlling both depressive disorder and adjustment disorder, sleep disturbance was no longer a risk of adolescent suicidal ideation. We also confirm the indirect influence of sleep on suicidal ideation in adolescent.

[Species differentiation and quality assessment of Ziziphus jujuba var. spinosa based on the HPLC fingerprint and quantitative analysis].

OBJECTIVE: To establish an HPLC method of a characteristical chemical fingerprint analysis in combination with simultaneous determination of four bioactive components for species differentiation and quality assessment of Ziziphus jujuba var. spinosa. METHODS: The chromatographic separation was performed on an Agilent TC-C18 BDS (250 mm x 4.6 mm, 5 microm) column. The mobile phase consisted of acetonitrile and water in a linear gradient elution procedure. The evaporator tube temperature of ELSD was set at 110.5 degrees C with the nebulizing gas flow rate of 3.1 mL/min and the flow rate of mobile phase was 1.0 mL/min. The column was maintained at 30 degrees C. The injection volume was 20 microL. RESULTS: HPLC methodology for both chemical fingerprint analysis and quantitative determination of four active ingredients were validated, respectively. According to the contents of the four ingredients and the chemical fingerprints of Ziziphus jujuba var. spinosa using principal component analysis, Ziziphus jujuba var. spinosa was different from the fake derived from the seeds of Ziziphus mauritiana. CONCLUSION: The developed HPLC method is exclusive and repetitive for the species identification and quality evaluation of Ziziphus jujuba var. spinosa.

A rapid screening test for depression in junior high school children.

BACKGROUND: Depression generates a remarkable disease burden. Early onset of depression in young people is associated with a poor prognosis. This has precipitated developing a screening instrument for early detection of depression in Taiwan adolescents. METHODS: We recruited 662 junior high school students who completed the Screening Test for Depression (STD) designed using diagnostic and statistical manual-IV diagnostic criteria of major depressive disorder for assessing depressive symptoms. The students were then interviewed by psychiatrists who used the Mini International Neuropsychiatric Interview-Kid to verify the validity of the soon-to-be-developed Rapid STD (RSTD). Multiple logistic regression analysis of the STD results was used to extract items for the RSTD. RESULTS: We extracted four items for the RSTD: "insomnia or hypersomnia", "recurrent thoughts of death or recurrent suicidal ideation", "feelings of worthlessness or excessive or inappropriate guilt", and "psychomotor agitation or retardation". Any two of the first three yielded the best-balanced algorithm for major depressive disorder, which had a sensitivity of 75.0%, specificity of 92.9%, positive predictive value of 28.6%, and negative predictive value of 99.0%. Any two of the four yielded the best-balanced algorithm for depressive disorders, which had a sensitivity of 71.4%, specificity of 92.0%, the positive predictive value of 33.3%, and the negative predictive value of 98.3%. CONCLUSION: The RSTD, a 4-item tool for junior high school children, can be easily used to assess fluctuating risks of major depressive disorder and depressive disorders at any time.

Using hybrid method to evaluate the green performance in uncertainty.

Green performance measure is vital for enterprises in making continuous improvements to maintain sustainable competitive advantages. Evaluation of green performance, however, is a challenging task due to the dependence complexity of the aspects, criteria, and the linguistic vagueness of some qualitative information and quantitative data together. To deal with this issue, this study proposes a novel approach to evaluate the dependence aspects and criteria of firm's green performance. The rationale of the proposed approach, namely green network balanced scorecard, is using balanced scorecard to combine fuzzy set theory with analytical network process (ANP) and importance-performance analysis (IPA) methods, wherein fuzzy set theory accounts for the linguistic vagueness of qualitative criteria and ANP converts the relations among the dependence aspects and criteria into an intelligible structural modeling used IPA. For the empirical case study, four dependence aspects and 34 green performance criteria for PCB firms in Taiwan were evaluated. The managerial implications are discussed.

[Determination of effective components in different positions of Panax notoginseng by HPLC].

OBJECTIVE: A quantitative method was developed by gradient elution for the determination of notoginsenoside R1, ginsenoside Rg1, ginsenoside Re and ginsenoside Rb1 in different positions of Panax Notoginseng by HPLC. The content of 4 kinds saponins in different positions of Panax Notoginseng were compared. METHODS: The different positions of Panax notoginseng (including root, rhizome, branch root, leaf, flower) were extracted with methanol. The HPLC condition was as following: Kromasil C18 column (250 mm x 4.6 mm, 5 microm), acetonitrile and water linearity gradient elution, flow rate at 1.0 mL/min, column temperature at 25 degrees C, wavelength 203 nm. RESULTS: The linear ranges of notoginsenoside R1, ginsenoside Rg1, ginsenoside Re and ginsenoside Rb1 were 4.4-440 microg/mL, 4.32-1080 microg/mL, 4.24-212 microg/mL and 4.48-1120 microg/mL, respectively. The RSD (n=5) of average contents of intra-day and inter-day of 4 kinds saponins were 0.46%, 0.24%, 0.77%, 0.68% and 1.64%, 0.69%, 0.52%, 0.65%, respectively. The average recoveries were (102.93 +/- 1.22)%, (103.18 +/- 0.49)%, (103.20 +/- 1.58)%, (103.86 +/- 0.39)%, respectively. The content of 4 kinds saponins in different position of Panax notoginseng was: rhizome > root > branch root > flower > leaf; the content of 4 kinds saponin in the root of Panax notoginseng was: 80 pieces in 500 g >60 pieces in 500 g >20 pieces in 500 g >40 pieces in 500 g >100 pieces in 500 g. CONCLUSION: This method is simple, sensitive, accurate and repeat, and is suitable in determination of the content of 4 kinds saponins in different positions of Panax notoginseng.