Pre-screening for osteoporosis with calcaneus quantitative ultrasound and dual-energy X-ray absorptiometry bone density.

Calcaneal quantitative ultrasonography (QUS) is a useful prescreening tool for osteoporosis, while the dual-energy X-ray absorptiometry (DXA) is the mainstream in clinical practice. We evaluated the correlation between QUS and DXA in a Taiwanese population. A total of 772 patients were enrolled and demographic data were recorded with the QUS and DXA T-score over the hip and spine. The correlation coefficient of QUS with the DXA-hip was 0.171. For DXA-spine, it was 0.135 overall, 0.237 in females, and 0.255 in males. The logistic regression model using DXA-spine as a dependent variable was established, and the classification table showed 66.2% accuracy. A receiver operating characteristic (ROC) analyses with Youden's Index revealed the optimal cut-off point of QUS for predicting osteoporosis to be 2.72. This study showed a meaningful correlation between QUS and DXA in a Taiwanese population. Thus, it is important to pre-screen for osteoporosis with calcaneus QUS.

Measuring Nurses' Transition to Electronic Handover: Validation of the Perception and Adaptation Readiness of Electronic Handover Systems Scales.

The transition from traditional handover methods to electronic handover is extremely stressful to nurses. This psychometric evaluation study tested the validity and reliability of the perception and adaptation readiness of electronic handover system scales for hospital nurses. A total of 253 Taiwanese nurses from a medical center participated in this study from January to March 2018. The perception and adaptation readiness of electronic handover system scales were self-developed, and content validity was tested via content validity index of the scale. Exploratory factor analysis and confirmatory factor analysis were utilized to test construct validity, while reliability was tested by Cronbach's α coefficient. Four factors explained 50.77% of the total variance in the perception of electronic handover system scale. Three factors accounted for 53.43% of the total variance in the adaptation readiness of electronic handover system scale. The confirmatory factor analysis results indicated a three-factor construct for both scales. Cronbach's α coefficients were 0.83 and 0.91 for the perception and adaptation readiness of the electronic handover system scale, respectively. The scales could be used to assess nurses' perceptions and adaptation readiness of electronic handover, while the assessing result serves as a reference for implementing educational and supportive interventions to facilitate adaptation in nurses.

Decreased plasma riboflavin is associated with poor prognosis, invasion, and metastasis in esophageal squamous cell carcinoma.

BACKGROUND: Riboflavin deficiency confers a predisposition for esophageal cancer. The role of plasma riboflavin levels in development and prognosis of individuals with digestive tract inflammation and ulcer (DTIU), digestive tract polyps (DTPs), and ESCC is not well understood. METHODS: We performed a cross-sectional study, including 177 DTIU, 80 DTP, and 324 ESCC cases, to measure the plasma riboflavin levels among the three populations. Correlation between plasma riboflavin levels (categorized as ≥31.8, 6.5-31.8 and ≤6.5 nmol/L groups) and clinical characteristics, as well as survival of ESCC patients (556 cases) was analyzed. RESULTS: There was no difference in plasma riboflavin levels between DTIU, DTP, and ESCC cases (P > 0.05). Plasma riboflavin levels were inversely correlated with invasive depth (correlation coefficient = -0.09, P = 0.026) and lymph node metastasis (correlation coefficient = -0.11, P = 0.010) of ESCC, and ESCC patients with low riboflavin levels had poor recurrence-free survival (P = 0.035) and overall survival (P = 0.003). Decreased riboflavin was a prognostic factor for poor overall survival (HR = 1.91, 95% CI = 1.19-3.07, P = 0.007). CONCLUSIONS: Plasma riboflavin levels in DTIU, DTP, and ESCC patients are similar. Plasma riboflavin levels are associated with the development and prognosis of ESCC.

Perceptions and Experiences of Hospital Nurses During Transition to an Electronic Handover Informatics System.

An effective patient transfer, or handover, among healthcare professionals can help prevent communication-related medical errors, and a reliable electronic handover informatics system can standardize the handoff process. Adapting to a new handover system may cause stress for nurses. This descriptive qualitative study aimed to explore the perceptions and transition experiences of hospital nurses in adopting and adapting to a new handover informatics system. Thirty-eight nurses at a medical center in Taiwan participated in the study from December 2016 to January 2017. The researcher conducted five focus group interviews and analyzed all responses using content analysis. Results showed three major themes: "Perceptions of challenges and barriers related to the transition to a new handover informatics system," "Perceptions of benefits and strategies to the transition to a new handover informatics system," and "Suggestions for successful implementation of a new handover informatics system." Five subthemes emerged from the first theme, and six subthemes emerged from the second theme. The results of this study could enhance our understanding of nurses' perceptions and experiences with transition to a new handover informatics system and could provide a reference for hospitals to develop individualized strategies to facilitate the implementation of a handover informatics system.

Stress and other factors associated with colorectal cancer outpatients with temporary colostomies.

This study investigated stress and other factors associated with colorectal cancer (CRC) outpatients with temporary colostomies in Taiwan. Temporary colostomies have been incorporated as a defecation alternative to maintain physical function and are accompanied by chemotherapy/radiotherapy in CRC patients. A cross-sectional study was conducted, and a convenience sampling approach was adopted to recruit 110 discharged CRC patients with temporary colostomies from a medical centre in southern Taiwan. The mean score of the Stress of Colostomy Patients Scale was 66.49 (out of 120). Demographic attributes were found to have an impact on different stress types. Stress of changes in familial and social interaction was affected by age, employment status, educational level and colostomy assistant caregiver. The stress of colostomy care was impacted by the factor of employment status, and the stress of changes of self-concept was impacted by the factors of educational level and self-perception of disease. The results provide post-operative information regarding stress and stress types among CRC patients with temporary colostomies, serve as a reference for clinical assessment, practice and care, and generate up-to-date knowledge and comprehension of learning how to live with a temporary colostomy.

Culture influence and predictors for behavioral involvement in patient safety among hospital nurses in Taiwan.

This study explored the effects of incident reporting culture and willingness of incident reporting on behavioral involvement in patient safety (BIPS) by surveying 1049 hospital nurses in Taiwan. The highest areas of BIPS were handoff communication and discussion on error prevention. Yet, sharing information about human factors toward safety awareness was less frequent. Results indicated that the reporting culture, willingness to report, tenure of work, and reporting rate contributed positively to BIPS.

[Perceived barriers to taking a Pap smear: predictors in immigrant women].

BACKGROUND: New immigrant women in Taiwan are believed to generally perceive that "no illness" infers good health. Because medical inspection induces feelings of discomfit and due to language barriers, limited/no insurance coverage and more limited access to medical resources, understanding better the motivation of immigrant women to take Pap smears, the actual examination rate and key factors that influence willingness is important. Coverage of this issue, however, is extremely limited in domestic research. PURPOSE: This study aimed to investigate: (i) The Pap smear screening rate amongst immigrant women; (ii) Immigrant women's perception of cervical cancer susceptibility and severity as well as cues to action and perceived barriers to taking a Pap smear; and (iii) Predictors of perceived barriers to taking Pap smears in this target population. METHODS: Using a cross-sectional descriptive correlation study design, 100 immigrant women were recruited from the outpatient clinic and inpatient wards of a regional teaching hospital in Kaohsiung. Structured questionnaires included a demographic survey, scales of susceptibility and cervical cancer severity, scales of cues to action and barriers to receiving a Pap smear. RESULTS: One-quarter (25%) of the surveyed population had never taken a Pap smear. Immigrant women perceived their knowledge somewhat insufficient with regard to cervical cancer susceptibility and severity. Level of education, previous Pap smear experience, and number of children represented significant predictors of perceived barriers in taking Pap smears, accounting collectively for 26.1% perceived variance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Findings suggest that appropriate interventions should be targeted on the general healthcare population as well as tailored to specific immigrant national populations in order to improve Pap smear screening rates amongst immigrant women.

Corrosion resistance of different nickel-titanium archwires in acidic fluoride-containing artificial saliva.

OBJECTIVE: To test the hypothesis that different nickel-titanium (NiTi) archwires may have dissimilar corrosion resistance in a fluoride-containing oral environment. MATERIALS AND METHODS: Linear polarization test, a fast electrochemical technique, was used to evaluate the corrosion resistance, in terms of polarization resistance (R(p)), of four different commercial NiTi archwires in artificial saliva (pH 6.5) with various NaF concentrations (0%, 0.01%, 0.1%, 0.25%, and 0.5%). Two-way analysis of variance was used to analyze R(p) with the factors of archwire manufacturer and NaF concentration. Surface characterizations of archwires were analyzed using scanning electron microscopy, atomic force microscopy, and x-ray photoelectron spectroscopy. RESULTS: Both archwire manufacturer and NaF concentration had a significant influence on R(p) of NiTi archwires. Different surface topography was present on the test NiTi archwires that contained the similar surface chemical structure (TiO(2) and trace NiO). The surface topography did not correspond to the difference in corrosion resistance of the NiTi archwires. Increasing the NaF concentration in artificial saliva resulted in a decrease in R(p), or corrosion resistance, of all test NiTi archwires. The NiTi archwires severely corroded and showed similar corrosion resistance in 0.5% NaF-containing environment. CONCLUSIONS: Different NiTi archwires had dissimilar corrosion resistance in acidic fluoride-containing artificial saliva, which did not correspond to the variation in the surface topography of the archwires. The presence of fluoride in artificial saliva was detrimental to the corrosion resistance of the test NiTi archwires, especially at a 0.5% NaF concentration.

[Exploring uncertainty, quality of life and related factors in patients with liver cancer].

Liver cancer is the leading cause of cancer death for both males and females in Taiwan. Because of its high rate of reoccurrence, liver cancer patients experience uncertainty that seriously affects their quality of life. The purpose of this study was to explore the relationships between demographic and disease characteristics, uncertainty and quality of life (QOL), and to find the predictors of QOL in liver cancer patients. The study used a cross-sectional descriptive correlational design with the purposive sampling method to select 110 liver cancer patients who had received treatment within the previous six months at a medical center and a regional teaching hospital in Kaohsiung. The questionnaires used in the study included questions on personal and disease characteristics, the Chinese version of the Mishel Uncertainty in Illness Scale, and Chinese versions of QOL scales (FACT-Hep). The results were: The mean of QOL was 125.36 and the mean of uncertainty was 61.69 in liver cancer patients. Uncertainty was negatively associated with QOL (r = -.51, p < .01). Patients, who were male, aged over 65, had been diagnosed more than three years previously, had liver function in class of Child's A, had no complications or pain, had better QOL. The predictors of QOL were uncertainty, Child-Pugh classification, pain, and gender, and it accounted for 44% of the variance in QOL. The study suggests that clinicians need to assess the degree of patients' uncertainty and strengthen communication skills to improve uncertainty and QOL in liver cancer patients.