Dysmenorrhoea and self-care behaviours among hospital nurses: a questionnaire survey.

AIMS AND OBJECTIVES: To investigate self-care behaviours and its predictors for dysmenorrhoea among hospital nurses. BACKGROUND: Dysmenorrhoea is an important issue in hospital nurses for its influence on job performance and quality of patient care. Given the difficulties in reorganising work schedule for taking menstrual leave in Taiwan, it is necessary to improve the comfort level of nurses during menstruation. DESIGN: A cross-sectional correlation study using a structured questionnaire. METHODS: A convenience sampling method was used to select two hospitals in Southern Taiwan, and participants were recruited by random sampling method. Questionnaire used in the study contained personal information, Dysmenorrheic Knowledge Scale, Menstrual Attitude Scale and Dysmenorrheic Self-Care Behavior Scale (DSCBS). Two hundred and ninety-seven participants had experienced dysmenorrhoea in the last six months, with the prevalence rate of 70·7%. RESULTS: Results showed the average age of the participants was 30·3 years, and 252 participants (82·4%) self-perceived they were bothered by dysmenorrhoea. The score of DSCBS was 29·9 (±5·3). The results of stepwise multiple regression analysis revealed the predictors of DSCBS included whether the participants (1) were married, (2) had irregular menstruation, (3) had received health education on dysmenorrhoea, (4) visited doctor for dysmenorrhoea, (5) knew they may take menstrual leave and (6) were identified with menstruation as a natural event. The r(2) was 18·4%. CONCLUSIONS: Hospital nurses' self-care behaviour for dysmenorrhoea is suggested to be improved through enhanced peer support and caring. RELEVANCE TO CLINICAL PRACTICE: The prevalence rate of dysmenorrhoea among hospital nurses is high. Most of them take analgesics to reduce pain to return to work. We recommend hospitals to provide women-friendly workplace and empowerment activities to improve the self-care ability and comfort level of nurses during menstruation.

Gauze versus solid skin barrier for tracheostomy care: a crossover randomized clinical trial.

PURPOSE: The aim of this study was to compare gauze and a solid pectin-based skin barrier to evaluate clinical outcomes and cost-effectiveness of care for tracheostomy wounds. METHODS: A randomized clinical trial with crossover design was conducted to compare gauze to a solid skin barrier for management of patients with tracheostomies. The main study outcomes were skin integrity, dressing change frequency, time required for dressing changes, product costs, and nurses' satisfaction. SETTING AND SUBJECTS: A convenience sample was recruited from 2 medical centers in Taiwan. Using permuted block randomization, patients undergoing tracheostomy were randomly allocated to 1 of 2 groups. One group received tracheostomy care with gauze for the first 6 days and a solid pectin-based skin barrier for the following 6 days. This regimen was reversed in the second group. RESULTS: Skin integrity was significantly better among patients managed with a solid skin barrier as compared to management with gauze (Z=-2.75, P= .006). No significant differences in dressing change frequency, time required for dressing changes, or product costs between the 2 groups were found. Nurses' satisfaction was significantly higher for the solid skin barrier as compared to gauze (Z=-2.31, P= .021, for group 1, and T=-1.97, P= .048, for group 2). CONCLUSIONS: The use of a solid skin barrier for tracheostomy care was associated with lower occurrences of impaired skin integrity and higher satisfaction among nurses when compared to gauze.

Highly Efficient Dye-sensitized Solar Cells Based on Poly(vinylidene fluoride-co-hexafluoropropylene) and Montmorillonite Nanofiller-based Composite Electrolytes.

Highly efficient nanocomposite electrolytes were prepared by mixing the montmorillonite (MMT) clay nanofillers and iodide poly(vinylidene fluoride-co-hexafluoropropylene (PVDF-HFP) gel electrolytes for the purpose of measuring the performance of quasi-solid-state dye-sensitized solar cells (QS-DSSCs). The impacts of different amounts of MMT nanofillers on the ion diffusivity, conductivity of the polymer gel electrolytes (PGEs), and the photovoltaic performance of the cells using the PGEs were evaluated. The results indicated that the use of 5 wt.% MMT markedly increase the ion diffusivity and conductivity of the PVDF-HFP PGE. The introduction of 5 wt.% nanofillers considerably reduced the Warburg diffusion resistance, which made to the high performance of the QS-DSSCs. Cells utilizing 5 wt.% MMT nanofillers were shown to obtain a power conversion efficiency (PCE) (6.77%) higher than that obtained for cells using pure PGEs and identical to that obtained using liquid electrolytes (LEs) (6.77%). The high PCE was a result of an enhance in the current density in the presence of the 5 wt.% MMT nanofillers. The DSSC efficiency was found to maintain 99.9% of its initial value after 194 h of testing at 60℃ under dark environments. The stability of the DSSC using PGEs with the optimal amount of MMT nanofillers was higher than that for the cells using liquid electrolyte and pure PGE.

Iron Oxyhydroxide Hierarchical Micro/Nanostructured Film as Catalyst for Electrochemical Oxygen Evolution Reaction.

A key requirement in developing oxygen evolution reaction (OER) electrocatalysts is increasing their surface area. Herein, we report the design of a hierarchical micro/nanostructured catalyst. Based on polystyrene colloidal template electrodeposition, an ordered microcup array surrounded by nanoflakes was fabricated. The effect of the deposition time on the formation of the catalyst and the corresponding OER performance of the catalyst were investigated using scanning electron microscopy, in situ X-ray absorption fine structure (XAFS) spectroscopy, and electrochemical analysis. The in situ XAFS measurements indicate that the structure of the hierarchical structured catalyst is similar to that of γ-FeOOH. The electrochemical analysis indicates that the hierarchical catalyst has a large surface area and a low charge transfer resistance, which lead to its excellent catalytic performance for the OER. Our study provides new insights in designing high-performance OER catalysts. Moreover, the synthesized hierarchical micro/nanostructured catalyst could be used as a platform for further studies on low-cost iron-based electrocatalysts.

Importance of Compact Blocking Layers to the Performance of Dye-Sensitized Solar Cells under Ambient Light Conditions.

Power generation in indoor environments is the next step in dye-sensitized solar cell (DSSC) evolution. To achieve this goal, a critical recombination route which is usually inhibited by the TiCl4-derived blocking layers (BLs), that is, charge transfer at the fluorine-doped tin oxide substrate/electrolyte interface, is of concern. In this study, we demonstrate that because of low surface coverage, the conventional TiCl4 BLs are unable to suppress such electron leakage, thus limiting the photovoltaic performance of Co(bpy)32+/3+-mediated DSSCs (bpy = 2,2'-bipyridine) under ambient lighting. On the other hand, by introducing compact BLs prepared by spray pyrolysis, the DSSCs show lower dark current and operate efficiently not only under high-intensity sunlight but also under ambient light conditions. The better blocking function of the compact BL is verified by the cyclic voltammetry; other thin-film preparation methods, except for the common TiCl4 treatment, are anticipated to realize a similar blocking effect. This study illustrates that dense thin film with a predominant blocking function is highly required as the BL for DSSCs under low-light conditions, and this concept will pave the way for more development of indoor DSSCs.

Effects of TiO2 and TiC Nanofillers on the Performance of Dye Sensitized Solar Cells Based on the Polymer Gel Electrolyte of a Cobalt Redox System.

Polymer gel electrolytes (PGEs) of cobalt redox system are prepared for dye sensitized solar cell (DSSC) applications. Poly(vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) is used as a gelator of an acetonitrile (ACN) liquid electrolyte containing tris(2,2'-bipyridine)cobalt(II/III) redox couple. Titanium dioxide (TiO2) and titanium carbide (TiC) nanoparticles are utilized as nanofillers (NFs) of this PGE, and the effects of the two NFs on the conductivity of the PGEs, charge-transfer resistances at the electrode/PGE interface, and the performance of the gel-state DSSCs are studied and compared. The results show that the presence of TiC NFs significantly increases the conductivity of the PGE and decreases the charge-transfer resistance at the Pt counter-electrode (CE)/PGE interface. Therefore, the gel-state DSSC utilizing TiC NFs can achieve a conversion efficiency (6.29%) comparable to its liquid counterpart (6.30%), and, furthermore, the cell efficiency can retain 94% of its initial value after a 1000 h stability test at 50 °C. On the contrary, introduction of TiO2 NFs in the PGE causes a decrease of cell performances. It shows that the presence of TiO2 NFs increases the charge-transfer resistance at the Pt CE/PGE interface, induces the charge recombination at the photoanode/PGE interface, and, furthermore, causes a dye desorption in a long-term-stability test. These results are different from those reported for the iodide redox system and are ascribed to a specific attractive interaction between TiO2 and cobalt redox ions.

A Decade of Changes in Family Caregivers' Preferences for Life-Sustaining Treatments for Terminally Ill Cancer Patients at End of Life in the Context of a Family-Oriented Society.

CONTEXT: Temporal changes in different family caregiver cohorts' preferences for life-sustaining treatments (LSTs) at end of life (EOL) have not been examined nor have the concept of whether caregivers' LST preferences represent a homogeneous or heterogeneous construct. Furthermore, LST preferences are frequently assessed from multiple treatments, making clinical applications difficult/infeasible. OBJECTIVES: To identify parsimonious patterns and changes in the pattern of LST preferences for two independent cohorts of family caregivers for terminally ill Taiwanese cancer patients. METHODS: Preferences for cardiopulmonary resuscitation, intensive care unit care, cardiac massage, intubation with mechanical ventilation, intravenous nutritional support, tube feeding, and dialysis were assessed among 1617 and 2056 family caregivers in 2003-2004 and 2011-2012, respectively. Patterns and changes in LST preferences were examined by multigroup latent class analysis. RESULTS: Five distinct classes were identified: uniformly preferring, uniformly rejecting, uniformly uncertain, and favoring nutritional support but rejecting or uncertain about other treatments. Class probability significantly decreased from 29.3% to 23.7% for the uniformly rejecting class, remained largely unchanged for the uniformly preferring (16.9%-18.6%), and favoring nutritional support but rejecting (37.1%-37.5%) or uncertain about other treatments (8.0%-10.4%) classes, but significantly increased from 7.0% to 11.5% for the uniformly uncertain class over time. CONCLUSION: Family caregivers' LST preferences for terminally ill cancer patients are a heterogeneous construct and shifted from uniformly rejecting all LSTs toward greater uncertainty. Surrogate EOL-care decision making may be facilitated by earlier and thorough assessments of caregivers' LST preferences and tailoring interventions to the unique needs of caregivers in each class identified in this study.

Performance enhancement of quantum-dot-sensitized solar cells by potential-induced ionic layer adsorption and reaction.

Successive ionic layer adsorption and reaction (SILAR) technique has been commonly adopted to fabricate quantum-dot-sensitized solar cells (QDSSCs) in the literature. However, pore blocking and poor distribution of quantum dots (QDs) in TiO2 matrices were always encountered. Herein, we report an efficient method, termed as potential-induced ionic layer adsorption and reaction (PILAR), for in situ synthesizing and assembling CdSe QDs into mesoporous TiO2 films. In the ion adsorption stage of this process, a negative bias was applied on the TiO2 film to induce the adsorption of precursor ions. The experimental results show that this bias greatly enhanced the ion adsorption, accumulating a large amount of cadmium ions on the film surface for the following reaction with selenide precursors. Furthermore, this bias also drove cations deep into the bottom region of a TiO2 film. These effects not only resulted in a higher deposited amount of CdSe, but also a more uniform distribution of the QDs along the TiO2 film. By using the PILAR process, as well as the SILAR process to replenish the incorporated CdSe, an energy conversion efficiency of 4.30% can be achieved by the CdSe-sensitized solar cell. This performance is much higher than that of a cell prepared by the traditional SILAR process.

Gene-environment interaction between interleukin-4 promoter and molds in childhood asthma.

PURPOSE: To assess the role of gene-environment interaction between interleukin (IL)-4 promoter and mold exposure on the development of asthma. METHODS: We conducted a cohort-based, incident, case-control study. The case group consisted of 188 children with new asthma and the control group (n = 376) was matched for age and gender. The outcome of interest was the development of asthma over the 6-year study period. The studied determinants were three polymorphisms of IL-4 promoter (TT, CT, and CC) and three indicators of exposure including histories of water damage, presence of visible molds, and perceived mold odor in the home. RESULTS: Apparent joint effects between IL-4 promoter and mold exposure were observed on both additive and multiplicative scales. Specially, the risk of asthma was significantly associated with children carrying the CT genotype and visible mold exposure comparing with those carrying the TT genotype without any exposure indicator (adjusted odds ratio [OR], 2.14; 95% confidence interval [CI], 1.05-4.34; modified Rothman synergy index for directly use of odds and OR [s] = 1.41; P for interaction = .03). A similar tendency was found (s = 1.30; P for interaction = .04) for children who were exposed to mold odor and carried CT genotype (adjusted OR, 1.99; 95% CI, 1.03-4.41). CONCLUSIONS: The results of this study suggest that gene-environment interactions between the IL-4 promoter and an indoor mold problem may play an important role in childhood asthma.

A prospective study of pain treatment for patients with advanced cancer who receive hospice home care.

BACKGROUND: Pain is often inadequately treated in patients with cancer. Previous studies have demonstrated the effectiveness of the World Health Organization (WHO) analgesic ladder in cancer pain management. METHODS: A total of 131 consecutive patients with advanced cancer referred to a hospice home care program were enrolled over one year period from Jan. 1 to Dec. 31, 2000. We assessed the adequacy of prescribed analgesic drugs using guidelines developed by the WHO. Age, gender, Eastern Cooperative Oncology Group performance status, pain mechanism at referral, pain and symptom intensity, and doses and days of drug administration during the course of treatment were recorded at regular intervals. RESULTS: Eighty-two percent of the patients (107 of 131) had pain symtoms at referral. Forty-seven patients were excluded from this study due to inadequate follow-up times or inability to express the pain intensity. Sixty patients who had measurable pain intensity requiring analgesic therapy were followed up until death for a mean duration of 65 days. At referral, 46% of the patients (28 of 60) received inadequate treatment. In the last week of life, 2%, 26% and 70% of patients were taking non-opioid drugs, moderate opioids and strong opioids, respectively. A significant improvement in pain and symptom intensity was achieved after referral. A minority of the patients (10%) had inadequate pain control in the last week of life. CONCLUSIONS: This study demonstrates that a managed hospice home care system enables patients to receive adequate pain treatment, according to WHO guidelines.