The association of hospital governance with innovation in Taiwan.

Hospitals in Taiwan are facing major changes and innovation is increasingly becoming a critical factor for remaining competitive. One determinant that can have a significant impact on innovation is hospital governance. However, there is limited prior research on the relationship between hospital governance and innovation. The purpose of this study is to propose a conceptual framework to hypothesize the relationship between governance mechanisms and innovation and to empirically test the hypotheses in hospital organizations. We examine the relationship between governance mechanisms and innovation using data on 102 hospitals in Taiwan from the Taiwan Joint Commission on Hospital Accreditation and Quality Improvement. We model governance mechanisms using board structure, information transparency and strategic decision-making processes. For our modeling and data analysis we use measurement and structural models. We find that in hospital governance, information transparency and strategic decision making did impact innovation. However, governance structure did not. To facilitate innovation, hospital boards can increase information transparency and improve the decision-making process when considering strategic investments in innovative initiatives. To remain competitive, hospital boards need to develop and monitor indices that measure hospital innovation to ensure ongoing progress.

Nurses' Satisfaction With Using Nursing Information Systems From Technology Acceptance Model and Information Systems Success Model Perspectives: A Reductionist Approach.

Nursing information systems can enhance nursing practice and the efficiency and quality of administrative affairs within the nursing department and thus have been widely considered for implementation. Close alignment of human-computer interaction can advance optimal clinical performance with the use of information systems. However, a lack of introduction of the concept of alignment between users' perceptions and technological functionality has caused dissatisfaction, as shown in the existing literature. This study provides insight into the alignment between nurses' perceptions and how technological functionality affects their satisfaction with Nursing Information System use through a reductionist perspective of alignment. This cross-sectional study collected data from 531 registered nurses in Taiwan. The results indicated that "perceived usefulness in system quality alignment," "perceived usefulness in information quality alignment," "perceived ease of use in system quality alignment," "perceived ease of use in information quality alignment," and "perceived ease of use in service quality alignment" have significantly affected nurses' satisfaction with Nursing Information System use. However, "perceived usefulness in service quality alignment" had no significant effect on nurses' satisfaction. This study also provides some meaningful implications for theoretical and practical aspects of design.

Impact of nurses' cross-cultural competence on nursing intellectual capital from a social cognitive theory perspective.

AIMS: To understand the relationships among certain key factors such as organizational climate, self-efficacy and outcome expectation on registered nurses, with regard to the development of registered nurses' cross-cultural competence. The focus is specifically on the use of a social cognitive framework for nurses for providing intercultural nursing care to international patients. This study also aims to examine the relationship between nurses' cross-cultural competence and nursing intellectual capital. BACKGROUND: Given the influence of globalization on healthcare services, healthcare providers need to have enough cross-cultural competence to effectively care for patients from different cultures. Thus, the development of cross-cultural competence in nursing care has become an important issue. DESIGN: A quantitative method and a cross-sectional design were employed in this study. METHODS: Data were collected from 309 RN working in 16 healthcare institutions in Taiwan from May to August 2013. Structural equation modelling, in combination with the smart partial least squares method, was used to measure the relationships in the research model. RESULTS: The results show that outcome expectation has a stronger impact on nurses' cross-cultural competence than self-efficacy. In addition, it was found that the cross-cultural competence of nurses has a positive impact on nursing intellectual capital. CONCLUSION: Nursing supervisors should promote a higher level of outcome expectation on nurses to enhance the improvement of their cross-cultural competence. Raising the cross-cultural competence of nurses will aid in the accumulation of nursing intellectual capital.

The Impact of National Cultural Differences on Nurses' Acceptance of Hospital Information Systems.

This study aims to explore the influence of national cultural differences on nurses' perceptions of their acceptance of hospital information systems. This study uses the perspective of Technology Acceptance Model; national cultural differences in terms of masculinity/femininity, individualism/collectivism, power distance, and uncertainty avoidance are incorporated into the Technology Acceptance Model as moderators, whereas time orientation is a control variable on hospital information system acceptance. A quantitative research design was used in this study; 261 participants, US and Taiwan RNs, all had hospital information system experience. Data were collected from November 2013 to February 2014 and analyzed using a t test to compare the coefficients for each moderator. The results show that individualism/collectivism, power distance, and uncertainty avoidance all exhibit significant difference on hospital information system acceptance; however, both masculinity/femininity and time orientation factors did not show significance. This study verifies that national cultural differences have significant influence on nurses' behavioral intention to use hospital information systems. Therefore, hospital information system providers should emphasize the way in which to integrate different technological functions to meet the needs of nurses from various cultural backgrounds.

The influences of computer system success and informatics competencies on organizational impact in nursing environments.

The previous literature provides evidence that the characteristics of a successful computer system and the informatics competencies of individuals play a critical role in the adoption of information technology. However, while the combined effects of the two may provide a comprehensive view in understanding nursing informatics research, they have rarely been studied simultaneously. Therefore, this study aimed to examine the influences of computer system success and informatics competencies on nursing organizational impact. We surveyed 454 nurses who worked at international patient centers in Taiwan. The results show that both nurses' informatics competencies and nursing computer system success do have influence on nursing organizational impact. Moreover, nurses' informatics competencies have a greater effect than the superior characteristics of a nursing computer system on nursing organizational performance. Finally, implications for practitioners complete this study.

Disease Prevention Behavior During the COVID-19 Pandemic and the Role of Self-Esteem: An Extended Parallel Process Model.

OBJECTIVE: The COVID-19 outbreak has become a serious public health problem worldwide. The purpose of this study was to use an extended parallel process model (EPPM) to understand factors in COVID-19 prevention behaviors. METHODS: This cross-sectional and analytical study was conducted on 1012 participants in Taiwan. A structured questionnaire and an online survey were used to collect data. RESULTS: The EPPM revealed that the severity of the COVID-19 threat perceived by respondents directly affected the arousal of fear in the respondents (ß=0.268, t=9.007, p<0.001), but perceived efficacy did not (ß=-0.019, t=-0.619, p>0.05); additionally, fear arousal was significantly associated with COVID-19 prevention behaviors (ß=0.119, t=4.603, p<0.001). Regarding personal characteristics, self-esteem moderated the relationship between perceived threat and fear arousal. However, the moderating effect of self-esteem was stronger in people with low self-esteem compared to those with high self-esteem (ß=0.606, -0.472; t=26.303, -17.694; p<0.001, p<0.001; respectively). The results of this study also indicated that two demographic characteristics (age and gender) affect COVID-19 prevention behaviors. CONCLUSION: When developing healthcare policies and community interventions for improving COVID-19 prevention behaviors during an outbreak, healthcare administrators should carefully consider the main constructs of the EPPM, particularly personal characteristics (ie, self-esteem) and demographic characteristics (ie, age and gender).

Inverted-Type InAlAs/InAs High-Electron-Mobility Transistor with Liquid Phase Oxidized InAlAs as Gate Insulator.

An inverted-type InAlAs/InAs metal-oxide-semiconductor high-electron-mobility transistor (MOS-HEMT) with liquid phase oxidized (LPO) InAlAs as the gate insulator is demonstrated. A thin InAs layer is inserted in the sub-channel layers of InGaAs to enhance the device performance. The proposed inverted-type InAlAs/InAs MOS-HEMT exhibits an improved maximum drain current density, higher transconductance, lower leakage current density, suppressed noise figures, and enhanced associated gain compared to the conventional Schottky-gate HEMT. Employing LPO to generate MOS structure improves the surface states and enhances the energy barrier. These results reveal that the proposed inverted-type InAlAs/InAs MOS-HEMT can provide an alternative option for device applications.

Antioxidant status and superoxide anion radical generation in acute myeloid leukemia.

OBJECTIVES: This study was undertaken to investigate if there is a disparity in the antioxidant status and the ability of superoxide anion (O(2)(-)) generation in the patients with acute myeloid leukemia (AML). DESIGN AND METHODS: The peripheral blood samples from thirty AML patients and thirty-six healthy subjects were collected and leukocytes, erythrocytes and plasma were separated for use in various parameter measurements. RESULTS: The generation of O(2)(-), as reflected by lucigenin-based CL (LBCL), by the leukocytes of patients with AML was found to be significantly elevated either in resting or stimuli-elicited condition as compared with that of healthy controls (p<0.05). Coincidentally, these data were matched up with the suppressed SOD activities, notably in Cu/Zn SOD isoform found in AML patients (p<0.05). Conversely, SOD and GPx activities in erythrocytes of patients with AML were shown to be significantly higher than their normal counterparts (p<0.05). CONCLUSIONS: These data suggest that altered expression of antioxidant enzymes and higher capability of O(2)(-) generation by leukocytes seem to be a distinct feature of AML.

Continued use of an interactive computer game-based visual perception learning system in children with developmental delay.

This study developed an interactive computer game-based visual perception learning system for special education children with developmental delay. To investigate whether perceived interactivity affects continued use of the system, this study developed a theoretical model of the process in which learners decide whether to continue using an interactive computer game-based visual perception learning system. The technology acceptance model, which considers perceived ease of use, perceived usefulness, and perceived playfulness, was extended by integrating perceived interaction (i.e., learner-instructor interaction and learner-system interaction) and then analyzing the effects of these perceptions on satisfaction and continued use. Data were collected from 150 participants (rehabilitation therapists, medical paraprofessionals, and parents of children with developmental delay) recruited from a single medical center in Taiwan. Structural equation modeling and partial-least-squares techniques were used to evaluate relationships within the model. The modeling results indicated that both perceived ease of use and perceived usefulness were positively associated with both learner-instructor interaction and learner-system interaction. However, perceived playfulness only had a positive association with learner-system interaction and not with learner-instructor interaction. Moreover, satisfaction was positively affected by perceived ease of use, perceived usefulness, and perceived playfulness. Thus, satisfaction positively affects continued use of the system. The data obtained by this study can be applied by researchers, designers of computer game-based learning systems, special education workers, and medical professionals.

Antiplatelet prenylflavonoids from Artocarpus communis.

Four flavonoids, dihydroartomunoxanthone (1), artomunoisoxanthone (2), cyclocomunomethonol (3) and artomunoflavanone (4), together with three known compounds, artochamins B (5), D and artocommunol CC (6) were isolated from the cortex of the roots of Artocarpus communis. The structures of 1-4 were determined by spectroscopic methods. The antiplatelet effects of the flavonoids, 1-3, 5 and 6 on human platelet-rich plasma (PRP) were evaluated. Of the compounds tested in human PRP, compounds 1, 5 and 6 showed significant inhibition of secondary aggregation induced by adrenaline. It is concluded that the antiplatelet effect of 1, 5 and 6 is mainly owing to an inhibitory effect on thromboxane formation.

Antiplatelet effect and selective binding to cyclooxygenase by molecular docking analysis of 3-alkylaminopropoxy-9,10-anthraquinone derivatives.

In an effort to develop potent cytotoxic inhibitors of cyclooxygenase (COX), a series of cytotoxic 3-alkylaminopropoxy-9,10-anthraquinone derivatives was screened to evaluate their antiplatelet effect on washed rabbit platelets and human platelet-rich plasma (PRP). Thrombin, arachidonic acid (AA), collagen, and platelet-activating factor (PAF) induced platelet aggregations were potently inhibited by compounds 1, 2, and 3 (each at 300 microM). Of the compounds tested in human PRP, compounds 1, 8, and 10 showed significant inhibition of primary and secondary aggregation induced by epinephrine and had a weak inhibitory effect on cyclooxygenase-1 (COX-1). Molecular docking studies revealed that compounds, 1, 8, and 10 were bound in the active sites of COX-1. This indicated that the antiplatelet effect of these three compounds was partially mediated through the suppression of COX-1 activity and reduced thromboxane formation. It is concluded that the cytotoxic compounds 1, 8, and 10 may interfere the conversion of arachidonic acid to prostaglandin (PG)H(2) in the active site of COX-1.

Two new arylnaphthalide lignans and antiplatelet constituents from Justicia procumbens.

Two new arylnaphthalide lignans, procumphthalide A (1) and 4-O-beta-D-glucopyranosyl-(1"'-->2")-beta-D-apiofuranosyldiphyllin, named procumbenoside B (2), along with cilinaphthalide B (3) and several other known compounds were isolated from the methanolic extracts of Justicia procumbens. By using NMR and other spectral methods, the structures of 1 and 2 were elucidated. Cilinaphthalide B (3), justicidin A (4), and taiwan E methyl ether (5) were shown to have an antiplatelet effect in human plateletrich plasma. In human citrated PRP, 5 showed a strong inhibitory effect on platelet aggregation induced by adrenaline in a concentration-dependent manner, with an IC(50) value of about 27.6 microM.