Dose-response relationship between lung function and chest imaging response to silica exposures in artificial stone manufacturing workers.

BACKGROUND: Occupational exposure to artificial stone, a popular material used for countertops, can cause accelerated silicosis, but the precise relationship between silica dose and disease development is unclear. OBJECTIVES: This study evaluated the impact of silica exposure on lung function and chest imaging in artificial stone manufacturing workers. METHODS: Questionnaire and spirometry assessments were administered to workers in two plants. A high-exposure subset underwent further evaluation, including chest CT and DLco. Weighting factors, assigned as proxies for silica exposure, were based on work tasks. Individual cumulative exposures were estimated using area concentration measurements and time spent in specific areas. Exposure-response associations were analyzed using linear and logistic regression models. RESULTS: Among 65 participants, the mean cumulative silica exposure was 3.61 mg/m3-year (range 0.0001 to 44.4). Each 1 mg/m3-year increase was associated with a 0.46% reduction in FVC, a 0.45% reduction in FEV1, and increased lung function abnormality risk (aOR = 1.27, 95% CI = 1.03-1.56). Weighting factors correlated with cumulative exposures (Spearman correlation = 0.59, p < 0.0001), and weighted tenure was associated with lung function abnormalities (aOR = 1.04, 95% CI = 1.01-1.09). Of 37 high-exposure workers, 19 underwent chest CT, with 12 (63%) showing abnormal opacities. Combining respiratory symptoms, lung function, and chest X-ray achieved 91.7% sensitivity and 75% specificity for predicting chest CT abnormalities. CONCLUSION: Lung function and chest CT abnormalities occur commonly in artificial stone workers. For high-exposure individuals, abnormalities on health screening could prompt further chest CT examination to facilitate early silicosis detection.

The mediating effect of shared decision-making in enhancing patient satisfaction with participation in cancer clinical trials.

Objective: The participation of patients with advanced cancer(s) in clinical trials is vital for new drug development. We aimed to investigate patients' decision-making processes and satisfaction with their decision (SWD) to participate; the study's purpose was to provide results that can help support high-quality research in clinical trials. In addition, we explored how shared decision-making (SDM) mediates the relationship between understanding informed consent forms and SWD to participate in a clinical trial. Methods: A cross-sectional study was conducted. A purposive sample of 111 cancer patients was recruited, and they completed a questionnaire on demographic characteristics, SDM, and decision-making satisfaction to participate in a clinical trial. Correlation and mediation analyses were used. Results: Participants aged under 65 years and with higher education reported high SWDs, and SDM significantly mediated the relationship between self-assessed understanding of informed consent forms and SWDs related to clinical trials. Conclusions: SDM in patients with lung or liver cancer was a significant mediator between understanding the informed consent form and the patient's SWD. The higher the SWD level of participating in clinical trials, the better study team members' SDM involvement and the better the comprehension of informed consent forms. In addition, patients' age and education level should also be considered as influencing factors in SWD. This survey is the first in Taiwan to examine SDM in drug-related clinical trials. The study results provide evidence to support SDM in a clinical trial model and develop informed consent process policies in research facilities.

Incidence of Respiratory Symptoms for Residents Living Near a Petrochemical Industrial Complex: A Meta-Analysis.

The air pollution emitted by petrochemical industrial complexes (PICs) may affect the respiratory health of surrounding residents. Previous meta-analyses have indicated a higher risk of lung cancer mortality and incidence among residents near a PIC. Therefore, in this study, a meta-analysis was conducted to estimate the degree to which PIC exposure increases the risk of the development of nonmalignant respiratory symptoms among residents. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to systematically identify, select, and critically appraise relevant research. Finally, we identified 16 study groups reporting 5 types of respiratory symptoms: asthma, bronchitis, cough, rhinitis, and wheezing. We estimated pooled odds ratios (ORs) using random-effect models and investigated the robustness of pooled estimates in subgroup analyses by location, observation period, and age group. We determined that residential exposure to a PIC was significantly associated with a higher incidence of cough (OR = 1.35), wheezing (OR = 1.28), bronchitis (OR = 1.26), rhinitis (OR = 1.17), and asthma (OR = 1.15), although the latter two associations did not reach statistical significance. Subgroup analyses suggested that the association remained robust across different groups for cough and bronchitis. We identified high heterogeneity for asthma, rhinitis, and wheezing, which could be due to higher ORs in South America. Our meta-analysis indicates that residential exposure to a PIC is associated with an increased risk of nonmalignant respiratory symptoms.

[Global Health Issues and Trends in Nursing Research].

Research is an indispensable element that shapes every profession and discipline. "Employ evidence-based research into practice" is one of the five core competences highlighted by the American Institute of Medicine (IOM) in 2001 that all healthcare professionals should possess. With the development of evidence-based medicine, "Nursing research competence" has gradually become a core competence that all nurses must have. In light of the major demographic changes and multicultural social revolution underway worldwide, nursing research trends must be adapted to meet new, global challenges rooted in changing environmental, populational, geographical, and ethnic conditions. This paper analyzed the Web of Science database using VOSviewer and inputting the names of schools and departments as key words in consideration of QS rankings among European, American, and Asia regions for the years 2014 - 2018. Analyses of keywords, themes, and countries of international cooperation were conducted on 6333 original nursing articles published in journals indexed on the Science Citation Index (SCI) and/or Social Science Citation Index (SSCI). The results indicate that the cooperation between scholars from Taiwan and scholars from the United States, the United Kingdom, and China is relatively common. With regard to both global and Asia-specific research study trends, the top-five key words used to describe nursing research papers were health, care, depression, prevalence, and quality of life. The differences between Europe and the United States and Taiwan were the "risk, intervention, experience, adolescent" and "risk and impact" depicted by visual analysis. In addition, this research examined the themes of academic nursing conferences announced online for 2020, and found that a majority highlighted "nursing and healthcare" as a major theme. In twenty-two Chinese nursing journals indexed on the Huayi Online Database (2017-2020), geriatric nursing, long-term care and improvement in nursing care quality were the most commonly used research topics. In general, the aims of nursing research are to enhance the professional image and status of global nurses and to achieve the goals of global health. To create a better nursing research environment in Taiwan, nurses should improve their research abilities and cultivate cultural nursing sensitivity with the goals of maximizing the quality and quantity of research and of strengthening international cooperation, with the ultimate aim of enhancing the health and well-being of all. The international visibility of nursing in Taiwan must be increased to improve our international profile.