Sarcopenia Among Older People in the Philippines: A Scoping Review.

Aims: This review aimed to identify and map the evidence about sarcopenia among older Filipinos. Methods: Studies about sarcopenia among Filipinos aged 60 and above were included. All studies regardless of type, setting, language, and timeframe were reviewed. The Cochrane Library, Cumulative Index of Nursing and Allied Health, Embase, PubMed, and Health Research and Development Information Network were searched. The study was conducted per an a priori protocol and utilized the Joanna Briggs Institute guidance for scoping reviews. Results: From the 87 records identified, 20 studies published from 2013 to 2023 were eligible (≥ 5424 participants). The studies were varied; 11 cross-sectional, 2 conference lectures, 2 consensus reports, 1 meta-analysis, cohort study, case series, posthoc analysis, and continuing education. As to setting, 11 studies were conducted in the hospital and 4 in the community. On the level of prevention, 5 studies addressed the primary level, 10 studies secondary, and 2 studies both tertiary and secondary. The studies focused on: sarcopenia in a specific group (13 studies), consensus (4 studies), and education (3 studies). Conclusions: Sarcopenia studies among older Filipinos were limited. Most were hospital-based and involved patients with comorbidities. Some studies used sarcopenia assessment guidelines with Filipino normative references. Sarcopenia impacts the overall well-being of older Filipinos; hence more studies and health promotion programs are necessary.

[The Hospice-Care Promotion Experiences of Multidisciplinary Care Providers in Residential Long-Term Care Facilities: A Qualitative Study].

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

Decision difficulties of long-term-care facility nurses in transferring residents to the emergency department: A cross-sectional nationwide study.

AIMS: To examine the level of decision difficulties of long-term-care facility (LTCF) nurses when transferring residents to the emergency department (ED) and associated influencing factors. DESIGN: A cross-sectional nationwide study. METHODS: The LTCFs were selected through random stratified sampling across the whole Taiwan during February 2018 to January 2019. LTCF nurses who met the selection criteria were invited to participate with two or three nurses selected from each LTCF. The Patient Transfer Decision Difficulty Scale (PTDDS) was used to measure the level of difficulty in making decisions related to the transfer of residents to the ED. Data were collected by mailing the questionnaires and asking the nurses to return the completed form in 2 weeks. Data were analysed using simple linear regression and multiple regression with stepwise methods. RESULTS: In total, 618 valid questionnaires with an 85.32% response rate from 319 LTCFs were used for the data analysis. Decision difficulties that LTCF nurses experienced were moderate, the nursing personnel-bed ratio, LTCF professional training and basic life support training were predictive factors of the level of difficulty experience (scores of PTDDS) for the LTCF nurse (F = 6.81, p < .001). CONCLUSIONS: Enhancing emergency training in LTCF can improve nurses' decision-making ability to refer LTCF residents to emergency treatment. IMPACT: What problem did the study address? The study addressed the difficult decision LTCF nurses may experience when transferring a resident to the emergency department. What were the main findings? All LTCF nurses faced a moderate level of difficulty in decision-making. 'Transfer timing' was most often considered in the decision-making process when a resident was transferred to the ED. Where and on whom will the research have impact? Results of this study have considerable reference value for LTCF managers and nurses in the decision-making ability and suitability of transferring residents for emergency treatment.

Analysis of daily goal sheets on physician-nurse collaboration attitude.

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

Satisfaction With the Quality Nursing Work Environment Among Psychiatric Nurses Working in Acute Care General Hospitals.

BACKGROUND: The objective of this study was to investigate the impact on patient care quality of a positive, high-quality environment that is tailored to the practice of nursing. This study enabled nurses to show their professional skills and knowledge, which may help enhance job satisfaction. To date, little research has been done to assess the relationship between the nursing work environment and the job satisfaction of psychiatric nurses employed in acute wards of general hospitals. PURPOSE: This study was designed to explain the relationship between job satisfaction and the perceived indicators of a quality nursing work environment (QNWE) after adjusting for demographic characteristics and work characteristics. METHODS: A cross-sectional correlational design was employed, and a stratified random sample of 185 psychiatric nurses (99% response rate) working in acute wards in Taiwan was surveyed in 2013. Nurses were asked to complete a self-administered questionnaire that included measures of perceived QNWE and job satisfaction and demographic variables. RESULTS: A statistically significant, positive relationship was found between perceived indicators of QNWE and job satisfaction (r = .813, p < .001). In the hierarchical multiple linear regression model, for the subdimensions of QNWE, the variables "perceived indicators of professional specialization and teamwork" and "support and caring" showed a significant and positive association with job satisfaction, after adjusting for personal demographic characteristics. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Job satisfaction is related to the perception of nurses regarding their work environment. Therefore, nursing managers should improve workplace satisfaction by supporting and caring for nurses and creating better career development and teamwork opportunities for nurses through job training and planning.

Effects of Blackcurrant Anthocyanin on Endothelial Function and Peripheral Temperature in Young Smokers.

BACKGROUND: Blackcurrant anthocyanin (BCA) is expected to repair endothelial dysfunction, but it remains unclear whether beneficial effects are present in young healthy persons. This study examines whether supplements containing blackcurrant anthocyanin improve endothelial function and peripheral temperature in young smokers. METHODS: Young, healthy male nonsmokers (N group: n = 11; mean age 22 ± 2 years) and smokers (S group: n = 13; mean age 21 ± 1 years) were enrolled. A randomized and double-blind trial was designed to compare the effects of no supplement, a supplement containing 50 mg of blackcurrant anthocyanin (supplement A), and a supplement containing 50 mg of blackcurrant anthocyanin plus vitamin E (supplement B) on flow-mediated dilatation (FMD) and skin temperature. RESULTS: Under no supplement, FMD was unchanged during the 2 h period after smoking in the N group, whereas it was decreased during the 2 h period after smoking in the S group. Under the A supplement, FMD was decreased 1 h after smoking and returned to the baseline level 2 h after smoking in the S group. The skin temperature in the area of the foot dorsum was decreased in the S group after smoking compared with that in the N group, who did not smoke, whereas under A and B supplements, it was higher in the S group compared with that in the N group. CONCLUSIONS: BCA could attenuate the smoking-induced acute endothelial dysfunction and improve peripheral temperature in young smokers.

Sintering Pmperature-Dependence on Radiopacity of Bi(2-x) ZrxO(3+x/2) Powders Prepared by Sol-Gel Process.

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

Effects of a skill demonstration video delivered by smartphone on facilitating nursing students' skill competencies and self-confidence: A randomized controlled trial study.

BACKGROUND: The correct and appropriate performance of nursing skills by students can ensure patient safety and care quality. However, developing appropriate teaching and learning strategies to enhance nursing students' nursing skills and knowledge are challenging tasks for nursing faculty members. Nowadays, smartphones are popular mobile devices that are used on campuses by students and could be considered a potential tool to deliver learning materials to nursing students. OBJECTIVES: This study aimed to examine the effects of a skill demonstration video delivered by smartphone on facilitating nursing students' nursing skill competency and confidence. DESIGN: A randomized controlled trial study design was used. SETTINGS AND PARTICIPANTS: A convenience sample of nursing students at a university was recruited. METHODS: After receiving a regular nursing skills lab demonstration, pre-test data were collected from nursing students in an intervention group (n = 44) and a comparison group (n = 43). Then, students in the intervention group downloaded the skill demonstration video onto their smartphones, while the comparison group did not. Post-test data were collected at 2 weeks after the intervention. RESULTS: There were significant differences in students' urinary catheterization knowledge (F = 4.219, p = 0.04) and skills (F = 6.739, p = 0.013), but there was no difference in students' confidence level (F = 2.201, p = 0.142) between the two groups after the intervention. Furthermore, the average score of the satisfaction level regarding the intervention was 4.46 (SD = 0.43) on a scale of 1-5. CONCLUSIONS: This study found that delivering learning materials through smartphones to nursing students is suitable. Although there was no significant difference in students' self-confidence level, students' knowledge and skills were improved by the intervention. Smartphones can serve as a supplemental tool for learning nursing skills.

Psychometric Evaluation of the Vietnamese Hemodialysis Stressor Scale.

The lack of a suitable assessment tool may limit optimal stress management and impair the health-related quality of life of patients undergoing hemodialysis. The purpose of the study was to examine latent constructs and psychometric properties of the Vietnamese Hemodialysis Stressor Scale (HSS-V). In total, 180 patients receiving hemodialysis were recruited. Psychometric properties of the HSS-V, including the construct validity, internal consistency, and test-retest reliability, were tested after the instrument translation. The exploratory factor analysis resulted in a 24-item HSS-V with four extracted factors, which explained 58.32% of the total variance. The construct validity was confirmed by significant negative correlations between scores on the HSS-V and Vietnamese-version Short Form-36. The internal consistency (Cronbach's α = .82-.91) and test-retest reliability (intra-class correlations coefficient = .91-.94) of the 24-item HSS-V were satisfactory. A simple structure and preliminary acceptable psychometric properties of the HSS-V were established and can serve as a basis for further studies.

Substantial effects of empowerment case management on physical health of type 2 diabetic patients.

AIMS AND OBJECTIVES: To evaluate the effects of empowerment case management on the physical health of patients with type 2 diabetes. BACKGROUND: Diabetes is a global health issue. Case management is often used on diabetes management at various levels. Empowerment has been used for chronic situation management, but its effects have not been widely studied in diabetic populations. DESIGN: Purposive sampling was used to recruit 125 participants with type 2 diabetes aged 18 years or older from a regional teaching hospital in Taiwan. METHODS: Empowerment case management was applied for 42 participants, while the other 83 received normal case management. Survey items included demographics, preprandial (AC) and postprandial (PC) blood sugar levels, glycated haemoglobin (HbA1C), systolic and diastolic blood pressure, total cholesterol, and the presence or absence of acute and chronic complications. Descriptive statistics and a generalised estimating equation were used to analyse the model's effects on the two groups. RESULTS: The PC blood sugar levels of patients receiving empowerment case management declined at 3 months (B = -34.26, p < .01), and this decrease was maintained at 6 months (B = -83.66, p < .001). As of 6 months after starting the intervention, patients receiving empowerment case management enjoyed better physical health. These patients' AC blood sugar levels (B = -50.16, p < .001), HbA1C (B = -0.98, p < .001), systolic blood pressure (B = -8.24, p < .001), diastolic blood pressure (B = -5.73, p < .01) and total cholesterol (B = -13.74, p < .05) all experienced a continuous drop and were controlled well, and no diabetes-related acute or chronic complications were observed either. Patients with type 2 diabetes who received empowerment case management managed their physical health better. Moreover, its greatest effect was that patients were able to form exercise groups and continue to maintain their health. CONCLUSIONS: Empowerment case management was shown to have a substantial effect on the physical health and self-care of patients with diabetes, thus making it a suitable intervention tool for managing diabetes cases. RELEVANCE TO CLINICAL PRACTICE: The study results showed that empowerment case management is suitable for managing diabetes cases. It has a substantial effect on the maintenance of physical health, occurrence of complications and effectiveness of self-care among patients with diabetes. For better care outcomes, empowerment case management should be integrated into the guidelines of diabetes management.

Combinations of SERPINB5 gene polymorphisms and environmental factors are associated with oral cancer risks.

BACKGROUND: We identified rs17071138 T/C, rs3744941 C/T, and rs8089104 T/C gene polymorphisms of SERPINB5 (mammary serine protease inhibitor) that are specific to patients with oral cancer susceptibility and their clinicopathological status. METHODOLOGY/PRINCIPAL FINDINGS: In total, 1342 participants, including 601 healthy controls and 741 patients with oral cancer, were recruited for this study. Allelic discrimination of rs17071138 T/C, rs3744941 C/T, and rs8089104 T/C of the SERPINB5 gene was assessed by a real-time PCR with a TaqMan assay. We found that individuals carrying the polymorphic rs17071138 and rs8089104 are more susceptible to oral cancer (OR, 1.57; 95% CI, 1.07~2.31 and OR, 1.58; 95% CI, 1.04~2.39, respectively). Among oral cancer-related risk factor exposures, the individuals carrying the polymorphic rs17071138 had 4.26- (95% CI: 1.65~11.01; p = 0.002), 2.34- (95% CI: 1.19~4.61; p = 0.01), and 2.34-fold (95% CI: 1.38~3.96; p = 0.001) higher risks of developing oral cancer. CONCLUSIONS: Heterozygous TC of the SERPINB5 rs17071138 polymorphism may be a factor that increases susceptibility to oral cancer. Interactions of gene-to-gene and gene-to-oral cancer-related environmental risk factors have a synergetic effect that can further enhance oral cancer development.

Acupressure, Sleep, and Quality of Life in Institutionalized Older Adults: A Randomized Controlled Trial.

OBJECTIVES: Nursing home (NH) residents suffer from sleep disturbances which are associated with a low quality of life (QoL). The purpose of this study was to explore the effectiveness of comparing acupressure on specific acupoints with acupressure on non-specific acupoints in older NH residents with sleep disturbances. DESIGN: A randomized control trial with a pre- and post-test design. SETTING: One NH in Taiwan. PARTICIPANTS: Sixty-two older NH residents were randomly assigned to an experimental group (n = 31) and a sham-controlled group (n = 31). INTERVENTION: The experimental group received acupressure on the Tian-Zhu, Ju-Que, Yong-Quan, Bai-Hui, and Nei-Guan acupoints three times a week for 8 weeks, for 24 minutes each time, while the control group received a massage at locations with no acupoints, which were 10 mm from the true points, at the same frequency as the experimental group. MEASUREMENTS: The primary outcome was measured using the Pittsburgh Sleep Quality Index (PSQI) and the secondary outcome was measured using the Short-form 36 (SF-36). Data were collected at baseline, the end of treatment, and 4 weeks after completion of treatment. RESULTS: Compared to the control group, the experimental group had significantly better scores on the PSQI (t = -7.72, P < 0.001) and SF-36 (t = 1.34, P < 0.001) during the intervention period. The improvements in the PSQI and SF-36 scores were still significant (P < 0.001) after adjusting for confounding variables by generalized estimating equations. CONCLUSIONS: Results suggest that acupressure on the Tian-Zhu, Ju-Que, Yong-Quan, Bai-Hui, and Nei-Guan acupoints can improve the quality of sleep and life among NH residents. Acupressure is a promising intervention that may improve well-being for NH residents with sleep disturbances.

Lifestyle changes in heart transplant recipients.

The purpose of this study was to understand the lifestyle; examine the relationships among lifestyle, medical factors, and stress status; and determine the predictors of better lifestyle in heart transplant recipients in Taiwan. A prospective design with convenience sampling was used. Data were collected through the Health-Promoting Lifestyle Profile-II and demographic questionnaires, which included personal information, stress status, and medical information. Pearson correlations, 1-way analysis of variance, independent t tests, paired t tests, and hierarchical regression were used to analyze the factors related to better lifestyle. A total of 80 heart transplant recipients participated. The mean score for lifestyle decreased from baseline to 3 months and was even lower at 6 months. Nevertheless, the trend for some participants was the opposite-their lifestyle improved over the 6-month period after baseline. Notably, the trend for each of the 6 subscales was not consistent with the mean of the total score. Stress status accounted for 12.8% of lifestyle. When stress status was combined with family income and creatinine, the 3 factors accounted for 32.2% of lifestyle. This study demonstrated that maintenance of a healthy lifestyle fluctuates after transplantation. Demographic factors and stress status can help to identify people who are more likely to have a poor lifestyle.

Differences Between Men and Women Aged 65 and Older in the Relationship Between Self-Reported Sleep and Cognitive Impairment: A Nationwide Survey in Taiwan.

OBJECTIVES: To examine the prevalence of self-reported sleep disturbances and cognitive impairment in men and women aged 65 and older and to determine sex-specific effects on the relationship between self-reported sleep and cognitive impairment. DESIGN: A secondary data analysis from the 2009 Taiwan National Health Interview Survey. PARTICIPANTS: Individuals aged 65 and older (N = 2,413, n = 1,094 men, n = 1,319 women). MEASUREMENTS: Subjective sleep characteristics including sleep duration, difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening, daytime sleepiness, difficulty breathing during sleep, habitual snoring, and daytime napping were measured using survey questions. The Mini-Mental State Examination was used to identify cognitive impairment. RESULTS: The prevalence of cognitive impairment was 16.3% for men and 27.1% for women. Men and women with cognitive impairment had higher prevalence of self-reported sleep disturbances than those without. There was a significant effect of the interaction between sex and difficulty breathing during sleep on cognitive impairment (adjusted odds ratio (aOR) = 0.39, 95% confidence interval (CI) = 0.20-0.77). In men, difficulty breathing during sleep (aOR = 2.31, 95% CI = 1.39-3.84), habitual snoring (aOR = 2.30, 95% CI = 1.49-3.54), and prolonged sleep duration (> 8.5 hours) (aOR = 1.95, 95% CI = 1.11-3.43) correlated significantly with cognitive impairment. In women, only prolonged sleep duration (>8.5 hours) was associated with higher likelihood of cognitive impairment (aOR = 2.32, 95% CI = 1.33-4.03). CONCLUSION: This nationwide survey confirmed sex differences in the association between various self-reported sleep disturbances and cognitive impairment in people aged 65 and older.

The effect of an integrated education model on anxiety and uncertainty in patients undergoing cervical disc herniation surgery.

BACKGROUND: Educating patients about receiving surgical procedures is becoming an important issue, as it can reduce anxiety and uncertainty while helping to hasten decisions for undergoing time sensitive surgeries. We evaluated a new integrated education model for patients undergoing cervical disc herniation surgery using a quasi-experimental design. METHODS: The participants were grouped into either the new integrated educational model (n = 32) or the standard group (n = 32) on the basis of their ward numbers assigned at admission. Anxiety, uncertainty, and patient satisfaction were measured before (pre-test) and after the educational intervention (post-test-1) and post-surgery (post-test-2) to assess the effectiveness of the model in this intervention. RESULTS: We found that the generalized estimating equation modeling demonstrated this new integrated education model was more effective than the conventional model in reducing patients' anxiety and uncertainty (p <0.05). Patients were also more satisfied with our newly developed model as it takes a more holistic approach to individual health. CONCLUSION: This novel systemic educational model enhances patient's understanding of the medical condition and surgery while promoting patient-caregiver interaction for optimal patient health outcomes. We present a comprehensive and consistent platform for educational purposes in patients undergoing surgery as well as reducing the psychological burden from anxiety and uncertainty. Integrating medicine, nursing, and new technologies into an e-practice and e-learning platform offers the potential of easier understanding and usage. It could revolutionize patient education in the future.

Beneficial effects of biofeedback-assisted pelvic floor muscle training in patients with urinary incontinence after radical prostatectomy: A systematic review and metaanalysis.

OBJECTIVES: This systematic review and metaanalysis compared the effects of biofeedback-assisted pelvic floor muscle training with those of pelvic floor muscle training alone in patients with urinary incontinence after radical prostetactomy. DESIGN: A review and metaanalysis study design. DATA SOURCES: The metaanalysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses guidelines. A systematic search of PubMed/Medline OVID, the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, BioMed Central, Web of Science, Chinese Electronic Periodical Services, Chinese Journal and Thesis Database, and China National Knowledge Infrastructure was performed for retrieving records. REVIEW METHODS: For determining the effects of training type on urinary incontinence, randomized controlled trials on biofeedback-assisted pelvic floor muscle training with or without electrical stimulation were compared with those on pelvic floor muscle training with or without electrical stimulation, respectively, in the metaanalysis. The Cochrane Collaboration tool in the Cochrane Handbook for Systematic Review of Interventions 5.1.0 was used to assess the methodological quality of the included trials. Subjective and objective measurement of urinary incontinence improvement and the quality of life were the primary and secondary outcome measures, respectively. Data were analyzed using Comprehensive Meta-Analysis software 2.0. In addition, subgroup analyses and metaregression were performed to explore the possible sources of heterogeneity. RESULTS: Thirteen randomized controlled trials involving 1108 patients with prostatectomy incontinence were included. The immediate-, intermediate-, and long-term effects of objectively measured biofeedback-assisted pelvic floor muscle training on urinary incontinence were significant (mean effect size=-0.316, -0.335, and -0.294; 95% CI: -0.589 to -0.043, -0.552 to -0.118 and -0.535 to -0.053; p=0.023, 0.002, and 0.017, respectively) when compared with those of pelvic floor muscle training alone. However, when urinary incontinence was measured subjectively, only the intermediate and long-term effects of biofeedback were found (p=0.034 and 0.005, respectively). Small-to-moderate immediate- and intermediate-term effects on the quality of life were observed when biofeedback-assisted pelvic floor muscle training was compared with pelvic floor muscle training alone. No publication bias was observed among studies. CONCLUSIONS: Biofeedback can be an adjunct treatment to pelvic floor muscle training for reducing urinary incontinence in patients who have undergone radical prostatectomy.

Text Mining of Journal Articles for Sleep Disorder Terminologies.

OBJECTIVE: Research on publication trends in journal articles on sleep disorders (SDs) and the associated methodologies by using text mining has been limited. The present study involved text mining for terms to determine the publication trends in sleep-related journal articles published during 2000-2013 and to identify associations between SD and methodology terms as well as conducting statistical analyses of the text mining findings. METHODS: SD and methodology terms were extracted from 3,720 sleep-related journal articles in the PubMed database by using MetaMap. The extracted data set was analyzed using hierarchical cluster analyses and adjusted logistic regression models to investigate publication trends and associations between SD and methodology terms. RESULTS: MetaMap had a text mining precision, recall, and false positive rate of 0.70, 0.77, and 11.51%, respectively. The most common SD term was breathing-related sleep disorder, whereas narcolepsy was the least common. Cluster analyses showed similar methodology clusters for each SD term, except narcolepsy. The logistic regression models showed an increasing prevalence of insomnia, parasomnia, and other sleep disorders but a decreasing prevalence of breathing-related sleep disorder during 2000-2013. Different SD terms were positively associated with different methodology terms regarding research design terms, measure terms, and analysis terms. CONCLUSION: Insomnia-, parasomnia-, and other sleep disorder-related articles showed an increasing publication trend, whereas those related to breathing-related sleep disorder showed a decreasing trend. Furthermore, experimental studies more commonly focused on hypersomnia and other SDs and less commonly on insomnia, breathing-related sleep disorder, narcolepsy, and parasomnia. Thus, text mining may facilitate the exploration of the publication trends in SDs and the associated methodologies.

[An Exploration of the Pain Management Knowledge of Emergency Room Staffs and Factors of Influence].

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