Association between Marital Status and Cognitive Impairment in a Multi-Ethnic Asian Population.

OBJECTIVE: This study aims to examine the potential factors associated with marital status and determine the association between marital status and cognitive impairment in a multi-ethnic Asian population. METHOD: This study included 2321 participants from Singapore Multi-Ethnic Cohort revisit study (aged 40-89). Participants were classified into married and unmarried group at baseline and follow-up according to self-reported marital status. Mini-Mental Status Examination (MMSE) was administered, and cognitive impairment was defined as a MMSE <26. We conducted both cross-sectional and longitudinal analyses to examine the association of marital status at one time point as well as marital transition with cognitive impairment. RESULTS: Of the 2321 participants, a total of 1914 (82.5%) were married. The factors associated with marital status included younger age, male sex, higher household income, higher education, and higher physical activity levels. Additionally, married participants also had higher alternative healthy eating index (AHEI-2010) scores, and a lower burden of hypertension and diabetes. Among those who were married, the median (Q1, Q3) MMSE score was 29 (28,30) while those who were unmarried was 29 (27, 30) (p <0.01). Participants who had never been married had the highest odds of cognitive impairment compared to their married counterparts (Model III: OR=1.48, 95% CI: 1.03, 2.14). Older age (p-interaction value=0.003) and Indian ethnicity (p-interaction value=0.028) further strengthened these associations. CONCLUSION: Marriage was associated with lower odds of cognitive impairment. Marriage provides social support, companionship, and engagement in mentally stimulating activities contributing to better cognitive health. By identifying risk factors such as marital status, interventions and support systems can be developed to promote healthy cognitive aging.

Workplace Violence Against Emergency Nurses in Taiwan: A Cross-Sectional Study.

INTRODUCTION: Workplace violence against emergency nurses is common worldwide. This study aimed to gain a more thorough overview of the point prevalence of workplace violence against emergency nurses and the preventive measures used in emergency departments in Taiwan. METHODS: In this multicenter, descriptive, cross-sectional study, the questionnaire, Violence Against Nurses Working in Emergency Departments, was used to collect data from 407 nurses working at 5 emergency departments in Taiwan from May to October 2015. RESULTS: The results revealed that 378 emergency nurses (92.9%) experienced workplace violence over the last 2 years. The average visual analog scale score (1-10) of security effectiveness in preventing workplace violence was 5.0 (SD = 1.97). The average visual analog scale score of perceived safety level in terms of workplace violence was 4.38 (SD = 2.06). The average visual analog scale score of meeting nurses' needs was 5.72 (SD = 2.23). DISCUSSION: This questionnaire survey revealed that the current preventive measures for workplace violence against emergency nurses in Taiwan were not effective. The relevant measures should be improved, thereby reducing the prevalence and severity of workplace violence against emergency nurses.

Community-based postpartum exercise program.

AIMS AND OBJECTIVES: To evaluate the effectiveness of an exercise programme for postpartum women to lose weight and relieve fatigue and depression. BACKGROUND: The optimal period for weight loss is six months postpartum. However, most women cannot return to their pre-pregnancy fitness level within that period of time. DESIGN: A quasi-experimental one-group pretest-post-test design was carried out. METHODS: A convenience sampling method was used to recruit 28 women at 2-6 months postpartum. The 'Yoga and Pilates Exercise Programme for Postpartum Woman' was designed for this study and was delivered in group sessions once a week for three months (12 times total) for 60 minutes each time by a professional coach. Of the participants, 23 completed the entire program. The participants' body composition and levels of depression and fatigue were measured before and after the programme to identify differences. RESULTS: Women in the high-score group showed a significant decrease of 6·71 ± 5·71 points (t = 3·113, p = 0·021) in the depression score after participating in the exercise programme. No significant difference was found for the level of fatigue before and after the exercise programme (p > 0·05). Significant reductions in the participants' body weight, body fat percentage, fat mass and basic metabolic rate were observed after the exercise programme (p < 0·001). CONCLUSIONS: These physical activities benefited the physical and mental health of postpartum women and enhanced their quality of life. RELEVANCE TO CLINICAL PRACTICE: It is worthwhile promoting a yoga and Pilates exercise programme for postpartum women in communities.

The Role of NK Cells in EBV Infection and EBV-Associated NPC.

A vast majority of the population worldwide are asymptomatic carriers of Epstein-Barr Virus (EBV). However, some infected individuals eventually develop EBV-related cancers, including Nasopharyngeal Carcinoma (NPC). NPC is one of the most common EBV-associated epithelial cancers, and is highly prevalent in Southern China and Southeast Asia. While NPC is highly sensitive to radiotherapy and chemotherapy, there is a lack of effective and durable treatment among the 15%-30% of patients who subsequently develop recurrent disease. Natural Killer (NK) cells are natural immune lymphocytes that are innately primed against virus-infected cells and nascent aberrant transformed cells. As EBV is found in both virally infected and cancer cells, it is of interest to examine the NK cells' role in both EBV infection and EBV-associated NPC. Herein, we review the current understanding of how EBV-infected cells are cleared by NK cells, and how EBV can evade NK cell-mediated elimination in the context of type II latency in NPC. Next, we summarize the current literature about NPC and NK cell biology. Finally, we discuss the translational potential of NK cells in NPC. This information will deepen our understanding of host immune interactions with EBV-associated NPC and facilitate development of more effective NK-mediated therapies for NPC treatment.

Exploring the impact of mentoring functions on job satisfaction and organizational commitment of new staff nurses.

BACKGROUND: Although previous studies proved that the implementation of mentoring program is beneficial for enhancing the nursing skills and attitudes, few researchers devoted to exploring the impact of mentoring functions on job satisfaction and organizational commitment of new nurses. In this research we aimed at examining the effects of mentoring functions on the job satisfaction and organizational commitment of new nurses in Taiwan's hospitals. METHODS: We employed self-administered questionnaires to collect research data and select new nurses from three regional hospitals as samples in Taiwan. In all, 306 nurse samples were obtained. We adopted a multiple regression analysis to test the impact of the mentoring functions. RESULTS: Results revealed that career development and role modeling functions have positive effects on the job satisfaction and organizational commitment of new nurses; however, the psychosocial support function was incapable of providing adequate explanation for these work outcomes. CONCLUSION: It is suggested in this study that nurse managers should improve the career development and role modeling functions of mentoring in order to enhance the job satisfaction and organizational commitment of new nurses.

Unlocking the Mystery of the Therapeutic Effects of Chinese Medicine on Cancer.

Over the past decade, the rise of cancer immunotherapy has coincided with a remarkable breakthrough in cancer therapy, which attracted increased interests in public. The scientific community clearly showed that the emergence of immunotherapy is an inevitable outcome of a holistic approach for cancer treatment. It is well established that traditional Chinese medicine (TCM) utilizes the principle of homeostasis and balance to adjust the healthy status of body. TCM treatment toward cancer has a long history, and the diagnosis and treatment of tumors were discussed in the ancient and classical literatures of Chinese medicine, such as the Yellow Emperor's Inner Canon. Precious heritage has laid the foundation for the innovation and development of cancer treatment with TCM. The modern study indicated that TCM facilitates the treatment of cancer and enhances the survival rate and life expectancy of patients. However, the pharmacological mechanisms underlying these effects are not yet completely understood. In addition, physicians cannot always explain why the TCM treatment is effective and the mechanism of action cannot be explained in scientific terms. Here, we attempted to provide insights into the development of TCM in the treatment and interpret how TCM practitioners treat cancer through six general principles of TCM by using modern scientific language and terms based on newly discovered evidence.

[Using the transtheoretical model to develop educational media to promote smoking cessation in pregnant and postpartum women].

Smoking endangers the health of pregnant and postpartum women. However, there is lack of health education materials related to smoking cessation that targets this particular group - especially such developed based on behavior change theory. This paper describes how to develop smoking cessation educational materials for pregnant and postpartum women based on the Transtheoretical Model (TTM). The theoretical foundations of various educational materials were presented using tables and figures. Demonstrations and examples were provided for clinical nurses to conduct smoking cessation educational counseling and to develop theoretically-based educational materials. The effectiveness of nursing education may be improved by applying effective components of the theory to educational materials.

Orally disintegrating olanzapine for the treatment of a manic patient with esophageal stricture plus chronic pharyngitis.

An orally disintegrating tablet formulation of olanzapine (ODT olanzapine) is designed to dissolve rapidly upon contact with saliva. We describe a manic patient who has an esophageal stricture and chronic pharyngitis, two conditions that impede the swallowing of medications. She was successfully treated for her mania with this orally disintegrating formulation. This case report shows that ODT olanzapine may be useful in the psychiatric management of manic and other patients for whom olanzapine is appropriate, and who have an underlying medical condition that impedes swallowing oral medications.

Long-term video-EEG monitoring for paroxysmal events.

BACKGROUND: Long term video-electroencephalography monitoring (VEM) has been widely used for the diagnosis, classification, and management of seizures. Few studies have systemically examined its safety issues and clinical utility. This prospective study investigates the general clinical application of long term VEM in the management of paroxysmal events. METHODS: This study cohort consisted of patients admitted to the inpatient VEM unit at Chang Gung Memorial Hospital (Lin-Kou). Standard 19 channel scalp electroencephalography (EEG), electrocardiography (ECG), and simultaneous video images were recorded continuously for 2 full days. Patient characteristics, and clinical, video-EEG and safety data were obtained and analyzed. The diagnosis and management of paroxysmal events before VEM were compared with those after VEM. RESULTS: Habitual events were recorded in 54.3% of the 129 patients, and VEM had a yield rate of 76% (events recorded or newly recorded interictal discharges) indetermining the nature of the events. Eleven patients had seizure clusters, but there was no status epilepticus or electrode-related injury. After VEM, the diagnostic categories were changed in 41.1% of the patients, and 40.3% had revisions in management. CONCLUSIONS: Long term VEM is a safe diagnostic tool providing a high diagnostic yield rate and directing adjustment of management for patients with paroxysmal events.