Psychiatric Nurses' Knowledge and Practice Barriers to Administering Long-Acting Injectable (LAI) Antipsychotics in Taiwan: A Mixed-Methods Study.

Long-acting antipsychotic injections require that psychiatric nurses choose the proper injection site and technique to avoid harming patients. This research conducted a mixed-method study to examine the long-acting injectable antipsychotic (LAI) knowledge, practice, and administrative barriers in a sample of 269 psychiatric nurses from 3 public psychiatric hospitals in Taiwan. Self-report questionnaires showed female nurses exhibiting higher scores and older nurses demonstrating more knowledge. The dorsogluteal (DG) site was the most widely used for injections, with 57.6% of nurses using the Z-track method. Qualitative data analysis was performed on 20 psychiatric nurses who chose the DG site as their preferred injection site. There were two key themes. The first was a gap between the nurses' knowledge of LAI administration and their actual practice. The second needed more confidence and training in using the ventrogluteal injection site. These results highlight the need for continued education and training to improve LAI practice among psychiatric nurses.

[Research methods and progress on the reduction effects of vehicle emission pollutants by street canyon greening.] / è¡—è°·ç»¿åŒ–æ¶ˆå‡æœºåŠ¨è½¦æŽ’æ”¾æ±¡æŸ“ç‰©çš„ç ”ç©¶æ–¹æ³•ä¸Žè¿›å±•.

With the development of high-density and high-rise buildings on both sides of the street, widespread attention has been paid to the applicability of the traditional greening model of 'the more trees, the better atmospheric environment' in dealing with air pollution in urban street canyons. Clarifying the characteristics of street canyons greening and its planting design pattern on the reduction of emission pollutants by vehicles is an important prerequisite for the improvement of air quality in the street canyons. Based on literature review, we compared the applicability and limitations of the three methods, including field observation, wind tunnel test, and numerical simulation. We further analyzed the effects of roadside trees and hedges on the dispersion and deposition of air pollutants, and put forward a framework of adaptive greening design for air quality improvement. Finally, we proposed that future studies should address the creation of graphic languages for roadside greening design, the development of technical guidelines for evaluating the exposure of air pollution, and the optimization of parameterization schemes for the physical processes of greening effect in computational fluid dynamics models. Overall, our review could provide ideas and reference for the subsequent research.

Mental Health Nurses' Tacit Knowledge of Strategies for Improving Medication Adherence for Schizophrenia: A Qualitative Study.

Non-adherence to medication among patients with schizophrenia is an important clinical issue with very complex reasons. Since medication administration is an essential nursing responsibility, improving strategies for patient medication compliance must be fully understood. This study aimed to explore the strategies mental health nurses (MHNs) implement in clinically improving patients with schizophrenia and to describe the nurses' tacit knowledge of application strategies. A qualitative study with purposeful sampling was used. Twenty-five experienced MHNs in a psychiatric hospital in central Taiwan were given an in-depth interview. The texts were content-analyzed using NVivo 12 Pro software. MHNs promote medication adherence among patients with schizophrenia using the following strategies: establishing a conversational relationship, overall assessment of non-adherence to medication, understanding the disease and adjusting the concept of medication, incorporating interpersonal connection feedback, and building supportive resources. This study explored the strategies of MHNs that incorporated knowledge in managing treatment adherence in patients with schizophrenia. The findings add knowledge to clinical nursing practice about medication adherence among patients with schizophrenia.

Effects of Rehabilitation Models on Self-Stigma among Persons with Mental Illness.

Social stigma is inevitable for mentally ill patients, but how patients treat themselves is a priority for rehabilitation and an important buffer mechanism. This study thus aimed to measure the effectiveness of rehabilitation models for improving self-stigma. This quasi-experimental research design applied purposeful sampling. The participants (n = 250) were persons with mental illness who received rehabilitation treatment in central Taiwan. They were divided into community- (n = 170) and institution-based (n = 80) rehabilitation groups. The Internalized Stigma of Mental Illness Scale was evaluated at the time of recruitment, and a follow-up was conducted after 1 and 3 months. A generalized estimation equation was used in data analysis to measure whether self-stigma improved with the rehabilitation model and time, and to test the effect of different rehabilitation models on participants' self-stigma improvement. The study found that the self-stigma of patients receiving CBR improved more than that of those receiving IBR when behavioral problems, education, OT level, sex, and first-time self-stigma were controlled. Returning to the community is the goal of rehabilitation for patients with mental illness, but IBR still dominates the rehabilitation model in Taiwan. Thus, it is necessary to continue promoting CBR plans for future mental health policies.

Examining geographical disparities in the incubation period of the COVID-19 infected cases in Shenzhen and Hefei, China.

BACKGROUND: Current studies on the COVID-19 depicted a general incubation period distribution and did not examine whether the incubation period distribution varies across patients living in different geographical locations with varying environmental attributes. Profiling the incubation distributions geographically help to determine the appropriate quarantine duration for different regions. METHODS: This retrospective study mainly applied big data analytics and methodology, using the publicly accessible clinical report for patients (n = 543) confirmed as infected in Shenzhen and Hefei, China. Based on 217 patients on whom the incubation period could be identified by the epidemiological method. Statistical and econometric methods were employed to investigate how the incubation distributions varied between infected cases reported in Shenzhen and Hefei. RESULTS: The median incubation period of the COVID-19 for all the 217 infected patients was 8 days (95% CI 7 to 9), while median values were 9 days in Shenzhen and 4 days in Hefei. The incubation period probably has an inverse U-shaped association with the meteorological temperature. The warmer condition in the winter of Shenzhen, average environmental temperature between 10 °C to 15 °C, may decrease viral virulence and result in more extended incubation periods. CONCLUSION: Case studies of the COVID-19 outbreak in Shenzhen and Hefei indicated that the incubation period of COVID-19 had exhibited evident geographical disparities, although the pathological causality between meteorological conditions and incubation period deserves further investigation. Methodologies based on big data released by local public health authorities are applicable for identifying incubation period and relevant epidemiological research.

Palladium-Catalyzed Regiospecific peri- and ortho-C-H Oxygenations of Polyaromatic Rings Mediated by Tunable Directing Groups.

An efficient divergent approach of Pd-catalyzed C-H oxygenation of polyaromatic rings is described. Reversible directing groups enable regiospecific peri- and ortho-oxygenation to readily access a wide array of polyaromatic phenols without pre- and postmanipulation of directing groups. The systematic mechanistic investigation, including deuterium-labeling experiments, palladacycle trapping, and DFT calculations, reveals that the tunable ligand-assisted C-H bond cleavage played a crucial role during the reaction process.

Measuring the Destination Accessibility of Cycling Transfer Trips in Metro Station Areas: A Big Data Approach.

Cycling is a green, sustainable, and healthy choice for transportation that has been widely advocated worldwide in recent years. It can also encourage the use of public transit by solving the "last-mile" issue, because transit passengers can cycle to and from transit stations to achieve a combination of speed and flexibility. Cycling as a transfer mode has been shown to be affected by various built environment characteristics, such as the urban density, land-use mix, and destination accessibility, that is, the ease with which cyclists can reach their destinations. However, cycling destination accessibility is loosely defined in the literature and the methods of assessing cycling accessibility is often assumed to be equivalent to walking accessibility using the same decay curves, such as the negative exponential function, which ignores the competitive relationship between cycling and walking within a short distance range around transit stations. In this study, we aim to fill the above gap by measuring the cycling destination accessibility of metro station areas using data from more than three million bicycle-metro transfer trips from a dockless bicycle-sharing program in Shenzhen, China. We found that the frequency of bicycle-metro trips has a positive association with a trip distance of 500 m or less and a negative association with a trip distance beyond 500 m. A new cycling accessibility metric with a lognormal distribution decay curve was developed by considering the distance decay characteristics and cycling's competition with walking. The new accessibility model outperformed the traditional model with an exponential decay function, or that without a distance decay function, in predicting the frequency of bicycle-metro trips. Hence, to promote bicycle-metro integration, urban planners and government agencies should carefully consider the destination accessibility of metro station areas.

[A Correlational Study of the Recovery Process in Patients With Mental Illness].

BACKGROUND: The ideology of recovery addresses the autonomy of patients with mental illness and their ability to reconstruct a normal life. Empirical knowledge of this process of recovery and related factors remains unclear. PURPOSE: To assess the process of recovery and related factors in patients with mental illness. METHODS: This cross-sectional, correlational study was conducted on a convenience sample in a psychiatric hospital. Two-hundred and fifty patients with mental illness were recruited and were assessed using 3 instruments: Questionnaire about the Process of Recovery (QPR), Perceived Psychiatric Stigma Scale (PPSS), and Personal and Social Performance Scale (PSP). Data were analyzed using descriptive statistics, χ2, analysis of variance, and multiple linear regression analysis. RESULTS: Most of the participants were male, middle-aged, unmarried, educated to the senior high school level, employed, receiving home-care treatment, and diagnosed with schizophrenia. Those who were unemployed, living in a community rehabilitative house, and living in the community, respectively, earned relatively higher recovery scores (p < .05). The total scores of QPR and the 3 subscales were negatively correlated with PPSS (p < .01) and positively correlated with PSPS (p < .01; p < .05). Multiple regression analysis indicated that the factors of education, employment, having received community rehabilitative models, and stigma, respectively, significantly explained the recovery capacity of patients with mental illness. CONCLUSIONS: Community psychiatric nurses should provide care to help employed patients adapt to stresses in the workplace, strengthen their stigma-coping strategies, and promote public awareness of mental health issues by increasing public knowledge and acceptance of mental illness in order to minimize patient-perceived stigma and facilitate their recovery.

Health and economic benefits of building ventilation interventions for reducing indoor PM2.5 exposure from both indoor and outdoor origins in urban Beijing, China.

China is confronted with serious PM2.5 pollution, especially in the capital city of Beijing. Exposure to PM2.5 could lead to various negative health impacts including premature mortality. As people spend most of their time indoors, the indoor exposure to PM2.5 from both indoor and outdoor origins constitutes the majority of personal exposure to PM2.5 pollution. Different building interventions have been introduced to mitigate indoor PM2.5 exposure, but always at the cost of energy expenditure. In this study, the health and economic benefits of different ventilation intervention strategies for reducing indoor PM2.5 exposure are modeled using a representative urban residence in Beijing, with consideration of different indoor PM2.5 emission strengths and outdoor pollution. Our modeling results show that the increase of envelope air-tightness can achieve significant economic benefits when indoor PM2.5 emissions are absent; however, if an indoor PM2.5 source is present, the benefits only increase slightly in mechanically ventilated buildings, but may show negative benefit without mechanical ventilation. Installing mechanical ventilation in Beijing can achieve annual economic benefits ranging from 200yuan/capita to 800yuan/capita if indoor PM2.5 sources exist. If there is no indoor emission, the annual benefits above 200yuan/capita can be achieved only when the PM2.5 filtration efficiency is no <90% and the envelope air-tightness is above Chinese National Standard Level 7. Introducing mechanical ventilation with low PM2.5 filtration efficiency to current residences in urban Beijing will increase the indoor PM2.5 exposure and result in excess costs to the residents.

The lived experiences of brokered brides who have attempted suicide in Taiwan.

AIMS AND OBJECTIVES: The purpose of this study was to explore the lived experiences of brokered brides who have attempted suicide in Taiwan. BACKGROUND: There has been a significant rise in number of brokered brides since the 1970s in Western world and since the 1990s in several Asian countries. However, there is a great lack of research on brokered brides' suicide around the world. DESIGN: A descriptive phenomenological study was used to explore the lived experiences of brokered brides who have attempted suicide. METHODS: Purposive sampling, one-on-one, in-depth with semi-structural interviews were conducted to collect data. Narratives were analysed by Colaizzi's (1978) seven-step method. RESULTS: Data saturation was achieved after interviewing 12 brokered brides. The study group was comprised of females whose average age was 33. Three themes and the sub-themes were: being a chrysalis (loss of support, loneliness, suffering abused experience, loss of self-esteem), death of a chrysalis (loss of hope and seeking salvation) and birth of a chrysalis (regaining hope and sense of self-worth). CONCLUSIONS: These brokered brides suffered from numerous pressures and difficulties in life. Their hopelessness led to suicidal behaviours as a way to get out of trouble. Hence, the need to provide brokered brides with substantial assistance and support in their lives is an issue that cannot be neglected. The results of this study could be used as a reference to provide professionals and the public with a deeper understanding of suicide in this vulnerable group, and provide more appropriate help and care. Relevance to clinical practice. The suffering may be alleviated by giving brokered brides a reliable support system that they so obviously need. Several recommendations have been made, including amendments in terms of policy, society and the services offered by healthcare professionals.

[Community care for a foreign bride who had attempted suicide].

Cultural maladjustment of foreign brides is an important social problem. In order to elucidate effective community nursing intervention, a 27 year-old Indonesian bride who had attempted suicide was adopted as a subject presented. In four months of community nursing care, the client's cooperation was won the client's and family's knowledge of suicide was improved, the client's coping skills were improved, communication between the couple was improved and the client's social interaction was improved, and religious tension with the family was moderated. The client's attitude was changed from rejecting to accepting. There was no suicide attempt in the subsequent 6 months and the client's ability to use social resources was significantly improved.