[Subverting the Future of Teaching: Artificial Intelligence Innovation in Nursing Education].

Artificial intelligence (AI) technologies, including machine learning, deep learning, natural language processing, generative AI, the metaverse and other iterations, are rapidly changing the landscape of education. Related technologies not only enhance the teaching and learning process but also improve the quality and availability of educational content. AI facilitates educational transformation, reshapes teaching models, and helps students achieve their personalized learning needs, thus improving learning outcomes, learning efficiencies, and teaching practices. Despite the many AI application cases in nursing management and clinical practice, the application of AI in nursing education remains in its infancy. Machine learning has been used to predict the academic performance and graduation results of nursing students, thereby facilitating the early identification of additional support needs. Natural language processing technology has been used to develop chatbots and virtual teachers to assist learning, providing personalized learning support to help students overcome learning obstacles. Also, generative AI technologies such as ChatGPT (chat generative pre-trained transformer) have been used to create simulated patient cases and as a tool for grading academic writing automatically. Moreover, the combination of generative AI technology and the metaverse has introduced new possibilities to nursing education, allowing students to learn in a more-immersive virtual environment. Despite the significant benefits brought by AI to nursing education, its implementation and integration still face multiple challenges, including high costs, the need to provide technical training to teachers, and the need to address issues such as academic integrity and data privacy. The authors hope this article will help promote interdisciplinary cooperation between nursing educators and information and communication experts and the development of AI-assisted teaching to open a new chapter in nursing education.

Correlates of health-promoting lifestyle behaviors among Vietnamese female immigrants in Taiwan.

Immigration is a demanding and challenging life event that may cause married immigrant women to be likely to adopt unhealthy lifestyle behaviors. The aim of the authors of this study was to assess the prevalence of health-promoting lifestyle behaviors and their correlates among Vietnamese female immigrants in Taiwan. A cross-sectional study was conducted with 140 Vietnamese female immigrants from November 2012 to October 2013. Measures included demographic information, the Chinese Health Questionnaire, the General Functioning Scale of the Family Assessment Device, and a short version of the Chinese Health-Promoting Lifestyle Profile. Data analyses included descriptive statistics, Pearson's product-moment correlation coefficients, t-tests, one-way analysis of variance, and a hierarchical multiple regression analysis. Vietnamese female immigrants with better individual health status, higher education from their original country, greater communication ability, better health status of the husband, and adaptive family functioning demonstrated greater participation in health-promoting lifestyle behaviors. Particularly, better husband's health status and family functioning correlated with greater practices of health-promoting lifestyle behaviors after controlling for individual characteristics and experiences, with 38% of the total variance explained. Findings may serve to guide and design culturally specific, family-focused health promotion interventions to assist Vietnamese female immigrants and their families.

The development and psychometric analysis of the Chinese HIV-Related Fatigue Scale.

AIMS AND OBJECTIVES: To develop a Chinese version of the human immunodeficiency virus-related Fatigue Scale and examine its reliability and validity. BACKGROUND: Fatigue is found in more than 70% of people infected with human immunodeficiency virus. However, a scale to assess fatigue in human immunodeficiency virus-positive people has not yet been developed for use in Chinese-speaking countries. DESIGN: A methodologic study involving instrument development and psychometric evaluation was used. METHODS: The human immunodeficiency virus-related Fatigue Scale was examined through a two-step procedure: (1) translation and back translation and (2) psychometric analysis. A sample of 142 human immunodeficiency virus-positive patients was recruited from the Infectious Disease Outpatient Clinic in central Taiwan. Their fatigue data were analysed with Cronbach's α for internal consistency. Two weeks later, the data of a random sample of 28 patients from the original 142 were analysed for test-retest reliability. The correlation between the World Health Organization Quality of Life Assessment-Human Immunodeficiency Virus and the Chinese version of the human immunodeficiency virus-related Fatigue Scale was analysed for concurrent validity. The Chinese version of the human immunodeficiency virus-related Fatigue Scale scores of human immunodeficiency virus-positive patients with highly active antiretroviral therapy and those without were compared to demonstrate construct validity. RESULTS: The internal consistency and test-retest reliability of the Chinese version of the human immunodeficiency virus-related Fatigue Scale were 0·97 and 0·686, respectively. In regard to concurrent validity, a negative correlation was found between the scores of the Chinese version of the human immunodeficiency virus-related Fatigue Scale and the World Health Organization Quality of Life Assessment-Human Immunodeficiency Virus. Additionally, the Chinese version of the human immunodeficiency virus-related Fatigue Scale could be used to effectively distinguish fatigue differences between the human immunodeficiency virus-positive patients with highly active antiretroviral therapy and those without. CONCLUSIONS: The Chinese version of the human immunodeficiency virus-related Fatigue Scale presents good reliability and validity through a robust psychometric analysis. This scale can be appropriately applied to human immunodeficiency virus-positive patients by clinical staff and case managers in Chinese-speaking countries. RELEVANCE TO CLINICAL PRACTICE: The Chinese version of the human immunodeficiency virus-related Fatigue Scale is an effective and comprehensive tool that can help clinical professionals measure the frequency, strength and impact on the quality of life of fatigue in Chinese human immunodeficiency virus-positive patients.

The effects of spaced retrieval combined with errorless learning in institutionalized elders with dementia: recall performance, cognitive status, and food intake.

The purpose of this study was to explore the effects on recall performance, cognitive status, and food intake when using accumulating cues in a spaced retrieval (SR) paradigm. In a double-blinded experimental design, 32 participants in the SR combined with errorless learning (SR/EL) group and 29 participants in the SR-only group were trained in a variety of eating-related actions. Accumulating cues were used within each SR trial in the SR/EL group. The participants' recall performance, the Mini-Mental State Examination (MMSE) scores, and the portion of a meal that participants had eaten were measured. After the 8-week training period, results showed significantly improved recall performances (P<0.0031) and food intake (t=2.140, P=0.038) in the SR/EL group compared with the SR-only group. MMSE scores showed no significant differences after the 8-week intervention (t=1.315, P=0.194). Results suggest that an SR/EL intervention could create optimal learning conditions for the self-regulation of common eating difficulties in people with dementia.

The effectiveness of spaced retrieval combined with Montessori-based activities in improving the eating ability of residents with dementia.

AIMS: To explore the long-term effects of standardized and individualized spaced retrieval combined with Montessori-based activities on the eating ability of residents with dementia. BACKGROUND: Eating difficulty is common in residents with dementia, resulting in low food intake, followed by eating dependence, weight loss and malnutrition. DESIGN: A single-blinded and quasi-experimental design with repeated measures. METHODS: Ninety residents with dementia from four veterans' homes in Taiwan took part in this study. The intervention consisted of spaced retrieval combined with Montessori-based activities. Twenty-five participants in the standardized group received 24 intervention sessions over 8 weeks. Thirty-eight participants in the individualized group received tailored intervention sessions. The number of intervention sessions was adjusted according to the participant's recall responses in spaced retrieval. Twenty-seven participants in the control group received no treatment. The Chinese version of the Edinburgh Feeding Evaluation in Dementia was used, and eating amounts and body weight were measured pre-test, posttest and at 1-, 3- and 6-month follow-ups. Data were collected between July 2008-February 2010. Repeated measures of all dependent variables for the three groups were analysed by the linear mixed model. RESULTS: The standardized and individualized interventions could significantly decrease the scores for the Chinese version of the Edinburgh Feeding Evaluation in Dementia and increase the eating amount and body weight over time. CONCLUSION: Trained nurses in institutions can schedule the standardized or individualized intervention in usual activity time to ameliorate eating difficulty and its sequels.

The moderating effect of nutritional status on depressive symptoms in veteran elders with dementia: a spaced retrieval combined with Montessori-based activities.

AIM: To examine the long-term effects of fixed/individualized spaced retrieval combined with Montessori-based activities on nutritional status and body mass index and nutritional improvement's moderating effect on depressive symptoms for people with dementia during a specific follow-up period. BACKGROUND: The decrease in food intake, often combined with poor nutrition, may induce depressive symptoms in people with dementia. DESIGN: A single-blind, quasi-experimental study with repeated measures. METHODS: Twenty-five fixed group participants received spaced retrieval combined with Montessori-based activities over 24 sessions. Thirty-eight individualized group participants received the same intervention with different sessions, which was adjusted according to each participant's learning response. Twenty-seven control group participants just received routine care. The Chinese version of the Mini-Nutritional Assessment and Cornell Scale for Depression in Dementia scores and body mass index were recorded at pre-test, posttest and 1-, 3- and 6-month follow-ups. Data were collected between July 2008-February 2010. RESULTS: The Mini-Nutritional Assessment scores and body mass index of the fixed and individualized groups could be significantly increased over time. Additionally, the Cornell Scale for Depression in Dementia scores could be significantly reduced as a result of the improvement of the Mini-Nutritional Assessment scores arising from the individualized intervention. CONCLUSION: The depressive symptoms of residents with dementia could be moderated by the individualized intervention through nutritional improvement. Trained clinical nurse specialists can use this individualized intervention for residents with dementia who also have poor nutrition and depressive symptoms.

Exploring the Effectiveness of Group Cognitive Stimulation Training in People With Schizophrenia: A Randomized Controlled Trial.

BACKGROUND: Schizophrenia is a chronic degenerative brain disease. Cognitive impairment, the core symptom of this disease, affects the mood and social functioning of patients severely. Nonpharmacological therapies that both improve cognitive function and are suitable for patients with schizophrenia remain underdeveloped. PURPOSE: This article was designed to explore the effects of group cognitive stimulation training (GCST) on cognitive function and social function in people with schizophrenia. METHODS: A randomized controlled trial was conducted. The 76 participants were allocated into either the experimental or control group using blocked randomization. The participants were all patients with chronic schizophrenia recruited from seven rehabilitation units in northern Taiwan who were 20-65 years old and scored 10-25 on the Montreal Cognitive Assessment Taiwan Version. The experimental group received the 60-minute GCST twice a week for 7 weeks, whereas the control group received standard treatment. All outcome indicators were analyzed at baseline and after intervention using generalized estimating equations. The primary outcome indicators included cognitive function assessed using the Taiwan version of the Montreal Cognitive Assessment, working memory assessed using the Wechsler Memory Scale-Third Edition, and executive function assessed using the Taiwanese version of the Frontal Assessment Battery. The secondary outcome indicator was social function assessed using the Social Function Scale-Taiwan short version. RESULTS: Generalized estimating equation modeling revealed the experimental group exhibited significant improvement in Montreal Cognitive Assessment total score ( B = 1.33, SE = 0.65, p = .040) and Social Function Scale-Taiwan short version ( B = 9.55, SE = 2.38, p < .001) after adjusting for nine covariates. No significant differences between the two groups in terms of working memory ( B = 4.79, SE = 2.66, p = .071) or executive function ( B = 0.53, SE = 0.63, p = .399) were found. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results indicate that GCST positively impacts overall cognitive and social functions but not higher-order cognitive function (working memory and executive function). In clinical settings, GCST may be applied to improve cognitive function in people with schizophrenia. The findings of this study may inform the practice of mental health nurses to improve cognitive function in patients in clinical care.

[Application of spaced retrieval training on patients with dementia].

Dementia causes semantic and episodic memory impairments that limit patients' activities of daily living (ADL) and increase caregiver burden. Spaced retrieval training uses repetitive retrieval to strengthen cognitive and motor skills intuitively in mild / moderate dementia patients who retain preserved implicit / non-declarative memory. This article describes and discusses the operative mechanism, influencing variables, and practical applications of spaced retrieval training. We hope this article increases professional understanding and application of this training approach to improve dementia patient ADL and improve quality of life for both caregivers and patients.

Psychometric Evaluation of the Chinese Respiratory Distress Observation Scale on Critically Ill Patients With Cardiopulmonary Diseases.

BACKGROUND: Respiratory distress is a common and distressing experience that strikes most critically ill patients with cardiopulmonary diseases. Now, most dyspnea assessment tools rely on patient's self-report. Only one instrument, the Respiratory Distress Observation Scale (RDOS), is valid for assessing respiratory distress when the patient cannot provide a dyspnea self-report. PURPOSE: The aims of this study were to develop the Chinese version of RDOS through two-way translation and examine its reliability and validity. METHODS: The first step was the translation and back-translation to establish the Chinese RDOS and examine the semantic equivalence between the back-translation version and the original one. The second step was the psychometric testing of the Chinese RDOS including internal reliability, interrater reliability, concurrent validity, convergent validity, and content and construct validity. RESULTS: The Chinese RDOS was reported with an internal consistency (Cronbach's α value) of .73, an interobserver reliability of .97, and a content validity index of .97. In the conscious critically ill patients, significant correlations were found between the Chinese RDOS and Spielberger State Anxiety Inventory scores or Dyspnea Vertical Visual Analog Scale scores (r = .69 and r = .76, respectively; p < .001). In the unconscious critically ill patients, there was a significantly positive correlation between the Chinese RDOS scores and fraction of inspiration O2 (r = .26, p < .05) and a significantly negative correlation between the Chinese RDOS scores and saturation peripheral oxygen (SpO2; r = -.42, p = .001). In addition, it also could effectively identify the dyspnea differences between the first and last days in the intensive care units (p < .001). CONCLUSIONS: The Chinese RDOS showed good reliability and validity in conscious critically ill patients. The assessment with the Chinese RDOS could be completed within a short period no matter whether the assessor has nursing background in respiratory care or not. It could help the professionals systematically manage and track the change of respiratory distress in patients.

The Effects of White Noise on Agitated Behaviors, Mental Status, and Activities of Daily Living in Older Adults With Dementia.

BACKGROUND: The aging of society is a global trend, and care of older adults with dementia is an urgent challenge. As dementia progresses, patients exhibit negative emotions, memory disorders, sleep disorders, and agitated behavior. Agitated behavior is one of the most difficult problems for family caregivers and healthcare providers to handle when caring for older adults with dementia. PURPOSE: The aim of this study was to investigate the effectiveness of white noise in improving agitated behavior, mental status, and activities of daily living in older adults with dementia. METHODS: An experimental research design was used to study elderly participants two times (pretest and posttest). Six dementia care centers in central and southern Taiwan were targeted to recruit participants. There were 63 participants: 28 were in the experimental group, and 35 were in the comparison group. Experimental group participants received 20 minutes of white noise consisting of ocean, rain, wind, and running water sounds between 4 and 5 P.M. daily over a period of 4 weeks. The comparison group received routine care. Questionnaires were completed, and observations of agitated behaviors were collected before and after the intervention. RESULTS: Agitated behavior in the experimental group improved significantly between pretest and posttest. Furthermore, posttest scores on the Mini-Mental Status Examination and Barthel Index were slightly better for this group than at pretest. However, the experimental group registered no significant difference in mental status or activities of daily living at posttest. For the comparison group, agitated behavior was unchanged between pretest and posttest. CONCLUSIONS: The results of this study support white noise as a simple, convenient, and noninvasive intervention that improves agitated behavior in older adults with dementia. These results may provide a reference for related healthcare providers, educators, and administrators who care for older adults with dementia.

Simvastatin Therapy for Drug Repositioning to Reduce the Risk of Prostate Cancer Mortality in Patients With Hyperlipidemia.

Prostate cancer (PCa) is one of the most commonly diagnosed cancers in the western world, and the mortality rate from PCa in Asia has been increasing recently. Statins are potent inhibitors of 3-hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) reductase and are commonly used for treating hyperlipidemia, with beneficial effects for cardiovascular disease and they also exhibit anti-cancer activity. However, the protective effects of statins against PCa are controversial. In this study, we investigated the effect of two types of statins (simvastatin and lovastatin) and the mortality rate of PCa patients by using the Taiwan National Health Insurance Research Database (NHIRD). A total of 15,264 PCa patients with hyperlipidemia records and medical claims from the Registry of Catastrophic Illness were enrolled. The patients were divided into two cohorts based on their statin use before the diagnosis of PCa: statin users (n = 1,827) and non-statin users (n = 1,826). The results showed that patients who used statins exhibited a significantly reduced risk of mortality from PCa [adjusted hazard ratio (HR) = 0.84, 95% CI = 0.73-0.97]. Analysis of the cumulative defined daily dose (DDD) indicated that patients who were prescribed simvastatin ≥ 180 DDD had a dramatically decreased risk of death from PCa (adjusted HR = 0.63; 95% CI = 0.51-0.77). This population-based cohort study demonstrated that statin use significantly decreased the mortality of PCa patients, and that this risk was inversely associated with the cumulative DDD of simvastatin therapy. The results of this study revealed that statins may be used for drug repositioning and in the development of a feasible approach to prevent death from PCa.

The psychologic consequences of chronic dyspnea in chronic pulmonary obstruction disease: the effects of acupressure on depression.

OBJECTIVES: The onset of depression is often triggered by breathlessness in persons with chronic obstructive pulmonary disease (COPD). It is hypothesized that these are the psychologic consequences of chronic dyspnea. Lessening dyspnea might alleviate depressive symptoms. Acupressure has been shown in other studies to produce relaxation. The aim of this study was to determine if it would lessen dyspnea and reduce depression in patients with COPD. SUBJECTS AND DESIGN: Subjects diagnosed with COPD were chosen from one medical center and three regional hospitals in Taipei, Taiwan. A randomized, block experimental design was used, with subjects and the data collector blinded. Using age, gender, pulmonary function, smoking, and steroid use as matching factors, 44 subjects were randomly assigned to either the true acupressure or the sham acupressure groups. The true acupressure group received a program of acupressure using appropriate acupoints that promote relaxation and relieve dyspnea. The sham acupressure group received acupressure using sham acupoints different from the meridians and ganglionic sections of the true acupressure group. Both acupressure programs lasted 4 weeks, with five sessions per week that lasted 16 minutes per session. OUTCOME MEASURES: The Geriatric Depression Scale (GDS) and Dyspnea Visual Analogue Scale (DVAS) were administered prior to the program as a baseline, and again following the completion of the 4-week program. Oxygen saturation and other physiological indicators were measured before and after each session. RESULTS: The results of this study showed that the GDS scores, DVAS scores, oxygen saturation, and physiological indicators of the true acupressure group were significantly improved, compared to those of the sham acupressure group. CONCLUSIONS: These findings provide health professionals with an evidence-based intervention to use with persons with COPD. Applying this acupressure program in clinical practice, communities, and long-term care units may lessen chronic dyspnea and depression in persons with COPD.

Modulation of T cell response by Phellinus linteus.

Phellinus linteus, a species of mushroom, has been shown to contribute to health benefits, such as anti-inflammatory activity and immunomodulatory efficacy. The aim of this study was to analyze the most effective constituents of P. linteus fermented broths, polysaccharides, and to evaluate their immunoregulatory effects on T cells. Four fermented broths (PL1-4) and the dialyzate medium (MD) were prepared from P. linteus mycelia, and the polysaccharide contents of each were analyzed. The P. linteus samples were tested for biological activity in the regulation of T cell activation. In T cells, the production of mitogen-induced interleukin (IL)-2 and cell cycle progression were dose-responsively inhibited by PL3 and MD, primarily through cell-cycle arrest in S phase. PL3 broth, which contained large quantities of polysaccharides, significantly decreased the ratio of interferon-gamma (IFN-γ) to interleukin 4 (IL-4) in T cells. Thus, P. linteus fermented broths produced additive effects on the regulation of the Th1/Th2 balance and show promise for the development of immunomodulatory therapeutics.

Mixed Infections of Helicobacter pylori Isolated from Patients with Gastrointestinal Diseases in Taiwan.

Background. Persistent Helicobacter pylori infection may induce several upper gastrointestinal diseases. Two major virulence factors of H. pylori, vacuolating cytotoxin A (VacA) and cytotoxin-associated gene A (CagA), are thought to be associated with the severity of disease progression. The distribution of vacA and cag-pathogenicity island (cag-PAI) alleles varies in H. pylori isolated from patients in different geographic regions. Aim. To assess the association between mixed infection of H. pylori clinical isolates from Taiwanese patients and the severity of gastrointestinal diseases. Methods. A total of 70 patients were enrolled in this study. Six distinct and well-separated colonies were isolated from each patient and 420 colonies were analyzed to determine the genotypes of virulence genes. Results. The prevalence of mixed infections of all H. pylori-infected patients was 28.6% (20/70). The rate of mixed infections in patients with duodenal ulcer (47.6%) was much higher than that with other gastrointestinal diseases (P < 0.05). Conclusions. H. pylori mixed infections show high genetic diversity that may enhance bacterial adaptation to the hostile environment of the stomach and contribute to disease development.

Comparing cognition, mealtime performance, and nutritional status in people with dementia with or without ideational apraxia.

OBJECTIVE: To describe the prevalence rate of ideational apraxia (IA) affecting self-feeding in people with dementia, confirm the stage of dementia at which IA most commonly occurs, and compare mealtime performance and nutritional status between people with dementia (PWD) with and without IA. METHOD: A cross-sectional design with between-subject comparison was used. Among the 395 potential participants recruited from dementia special care units at nine long-term care facilities in central and northern Taiwan, 98 met the operational definition of IA and were included in the PWD with IA group. From the remaining pool, 98 participants, matched for age and sex with the PWD with IA group, were randomly allocated to the PWD without IA group. Eating Behavior Scale (EBS) scores, food intake, total eating time, meal assistance, body mass index, Mini-Nutritional Assessment (MNA), and Mini-Mental State Examination scores were collected. RESULTS: The prevalence rate of IA affecting self-feeding in our study population of PWD was 24.8%. PWD with IA had significantly lower EBS scores, had more food intake (p < .001), spent more time being fed by caregivers, needed more verbal and feeding assistance, and had lower MNA scores than PWD without IA. Decline in the self-feeding ability of PWD affected by IA most commonly occurred in the severe stage of dementia. CONCLUSION: When dementia progresses to the late stage, staff should pay special attention to residents' mealtime performance and nutritional status. For PWD with IA, reassigning staff at mealtimes based on eating ability and providing memory training are recommended.

Factors Associated With Hyperphagic Behavior in Patients With Dementia Living at Home.

OBJECTIVE: To investigate the prevalence and patterns of and factors associated with hyperphagic behavior in Taiwanese patients with dementia living at home. METHODS: A cross-sectional and correlational design was used. A total of 104 patients with dementia and their primary caregivers were recruited from the geriatric, neurology, and memory clinics of a regional hospital, a medical center and two day-care centers in central Taiwan. The data related to hyperphagic behavior, functional abilities, medical conditions, body weight, and demographic characteristics of patients as well as the demographic characteristics of their primary caregivers were collected between January and May 2013. RESULTS: Based on a strict criterion (a median score of 3 for the hyperphagic subscale), the prevalence of hyperphagia in patients with dementia was 53.8%. Specific hyperphagic patterns exhibited included increased food intake (49% of patients with dementia), hoarding (8.7%), oral exploration (6.8%), and pica (3.9%). Years of education of the patient, the use of antipsychotics in patients, and the age of primary caregivers explained 16.3% of the variance in hyperphagic behavior subscale scores (F = 6.47, p < .001). CONCLUSIONS: For the early identification and treatment of hyperphagic behavior in patients with dementia in home care or in clinic services provided by health professionals, specific attention should be paid to the usual eating behaviors of patients with lower levels of education or who are taking antipsychotic medication or those who have a female primary caregiver.

The bacterial interactions in the nasopharynx of children receiving adenoidectomy.

Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae are the common pathogens that colonize in the nasopharynx of children. Polymicrobial interactions are thought to play an important role in different sites throughout the human body. However, there are currently very few studies that investigate the interactions between S. aureus, S. pneumoniae, and H. influenzae in the nasopharynx. We retrospectively analyzed the adenoid tissue culture from 269 children who received adenoidectomy. S. aureus, S. pneumoniae, and H. influenzae constituted the major microorganisms which were cultured from these adenoidectomies, at 23.4%, 21.6%, and 18.2%, respectively. S. pneumoniae and H. influenzae were the most prevalent in the preschool-aged children (3 < age ≤ 6), whereas S. aureus was more prevalent in infants and toddlers (age ≤ 3) and school-aged children (age > 6). Bacterial interference was found between S. aureus and S. pneumoniae and between S. aureus and H. influenzae, whereas there was an association found between S. pneumoniae and H. influenzae. The synergism and antagonism among these three species are investigated in the following paper, with the possible mechanisms involved in these interactions also discussed.

Association of ß-Lactam-Sensitive Haemophilus influenzae Type B with Adenoid Biofilm Formation in Patients with Adenoidectomy Surgery.

BACKGROUND: Chronic adenoid infection by ß-lactam-resistant Haemophilus influenzae type b (Hib) and biofilm formation contribute to adenoid hyperplasia. Middle ear disease consequently remains a critical issue in the pediatric population. The aim of this study was to investigate the correlation of Hib biofilm formation with middle ear effusion with adenoid hyperplasia (MEE-AH) and with pediatric obstructive sleep apnea (OSA). METHODS: A total of 384 patients with adenoidectomy from January 2008 to December 2012 were recruited in this investigation. Thirty-two patients (14 female and 18 male; age 4-13 years) who obtained routine adenoidectomy surgery had Hib-positive cultures were enrolled in a retrospective manner. By using polysomnography, 18 patients were diagnosed as having MEE-AH with chronic adenotonsillitis, and 14 patients were diagnosed as having pediatric OSA. The results of the Hib biofilm, antibiotic resistance profiles, and scanning electron microscopy observation, which correlated with the clinical diagnosis, were analyzed by the chi-square test and Fisher exact test. RESULTS: Biofilm formation by Hib was significantly present in the patients with MEE-AH rather than patients with OSA. ß-lactam-sensitive Hib were resistant to augmentin because of the adenoid biofilm formation. However, this finding was uncommon in the pediatric OSA group. CONCLUSIONS: Properly treating ß-lactam-sensitive Hib infection may be an important issue in reducing MEE-AH and adenoid vegetation in the pediatric population. Further research is warranted to elucidate the association of Hib-related biofilm formation with treatment failure and the need to consider earlier surgical intervention.

Predictors of hyperphagia in institutionalized patients with dementia.

BACKGROUND: Hyperphagia, a common eating behavioral change in patients with dementia, is one of the risk factors for institutional placement. No study of hyperphagia has yet been conducted on institutionalized patients with dementia. There is currently no academic consensus over the correlations among hyperphagic behaviors, agitated behaviors, cognitive function, and demographic characteristics in this patient group. PURPOSE: This study explores the prevalence and predictors of hyperphagic behaviors in institutionalized patients with dementia. METHODS: A cross-sectional and correlational design was used. The participants were recruited from seven dementia special care units and assisted living facilities in Taiwan. One hundred seventy-nine patients with dementia agreed to participate. Two research assistants were trained to collect data using the subscale for hyperphagic behaviors, the Cohen-Mansfield Agitation Inventory, the Cognitive Abilities Screening Instrument, and a dementia patient demographic characteristics datasheet. RESULTS: The prevalence of hyperphagic behaviors in institutionalized patients with dementia was 50.8% (91/179). After excluding the variables from the long-term memory, short-term memory, attention, abstraction and judgment, and verbally nonaggressive behavior subscales scores, we found gender, length of institutionalization, category fluency, and physically nonaggressive behavior subscale scores to be significant predictors of hyperphagic behaviors (p < .05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Findings suggest that institutionalized male patients with dementia with longer institutionalization who have either a relatively low-fluency task score or a relatively high frequency of physically nonaggressive behaviors are at greater risk for exhibiting hyperphagic behaviors. Once hyperphagic behaviors are found in a patient, a transdisciplinary case meeting should be held to develop an appropriate dietary management plan, and further identification and treatment should be done by a neurologist or a psychiatrist.

[Time-spatial variability of ammonium and nitrate in farmland soil of Taihu Lake region].

Time-spatial variability of ammonium and nitrate in soil profiles of farmland soil (three main paddy soils: White soil, Huangni soil and Wushan soil) during wheat and rice growth was studied. The results were as follows: the ammonium content was high in February and September and low in April and November in 2004. The spatial variability of ammonium content in soil profiles was gradually decreased from surface soil layer to bottom soil layer. It was stable below 40 cm. The nitrate content was lower than the ammonium content. The nitrate content of the wheat growth season (dry cultivation) was higher than that of the rice growth season (water cultivation) in a year. The spatial variability of the nitrate content in soil profiles was quickly decreased from surface soil layer to bottom soil layer during dry cultivation. But during the rice growth season, the nitrate content of the surface soil layer in soil profiles was lower than that of bottom soil layer. It was leaching phenomenon of nitrate. The nitrate content was in a sharp positive relation with the ammonium and changed with exponential function during dry cultivation. But there was not this relationship during water cultivation. The ammonium and nitrate were significant relation with soil organic matter in straight line. But the ammonium and nitrate content decreased with the soil clay content and pH value increased and changed with logarithmic function.