Exploring the effects of sudden institutional coercive pressure on digital transformation in colleges from teachers' perspective.

While past technology acceptance studies focus on organization readiness, little is known about the acceptance behavior under sudden institutional coercive pressure. Against COVID-19 and distance teaching, this study explores the relationship between digital transformation readiness, adoption intention, digital transformation success, and sudden institutional coercive pressure based on the readiness research model and institutional theory. Surveying 233 college teachers who participated in distance teaching under COVID-19 in Taiwan for model and hypothesis validation using the partial least square structural equation modeling (PLS-SEM) approach. This result shows that (1) Teacher, social/public, and content readiness are crucial to distance teaching. Individuals, organizational resources, and external stakeholders influence distance teaching success and adoption; and (2) Sudden institutional coercive pressure has a negative moderated effect on teachers' readiness and adoption intention. When teachers are unprepared to implement distance teaching, this unanticipated epidemic and sudden institutional coercive pressure will accelerate and enhance their intention. The study provides government, educational policymakers, and teachers with a better understanding of distance teaching during the COVID-19 pandemic.

Which are the vital factors of mobile personal health records applications that promote continued usage? A perspective on technology fit and social capital.

Introduction: With the widespread use of mobile devices and the rapid development of mobile networks, connecting mobile personal health record (mPHR) apps to wearable devices to collect personal health data for analysis and community activities has become a trend for health promotion. Therefore, the present study aims to explore the vital factors that impact the sustained usage of mPHR apps. Objective: In this study, we identified social lock-in as a major research gap in the current era of social media and the Internet. Therefore, to explore the effects of mPHR apps on continued app usage intention, we combined technology fit (individual-technology, synchronicity-technology, and task-technology fit) and social capital (structural, relational, and cognitive capital) to develop a novel study model. Methods: The purpose of this research is to investigate the willingness to participate in the mPHR apps. It collected 565 valid users' responses through the online questionnaire with a structural equation modeling approach. Results: That technology and social lock-in significantly affected the willingness of users to continue using mPHR apps (ß = 0.38, P < 0.001) and that the effects of social lock-in (ß = 0.38, P < 0.001) were more pronounced than those of technology lock-in (ß = 0.22, P < 0.001). Conclusions: The technology and social lock-in generated by technology fit and social capital had positive effects on continued app usage and the effects of both types of lock-in on continued app usage varied among different participant groups.

How to observe business operations: An empirical study of family business.

The direct observation method is commonly used for data collection in family business case studies. Nevertheless, in research on family business succession that is mainly based on retrospective data, it is difficult to directly observe an event or situation at a given time. This paper thus first explores the application of observation data in the published research results of some family business case studies through a literature review. It then describes our observation methodology, i.e., sampling process, method, observation process, and reevaluation of our interview data, through a case study. Finally, the conclusion offers suggestions for using these observation methods, i.e., employing different types of observation, by considering running time and financial cost, familiarizing observers with various observation occasions, and seeking the assistance of relevant professionals for a research topic.

Observational study of a new strategy and management policy for measles prevention in medical personnel in a hospital setting.

BACKGROUND: At the end of March 2018, a clustered outbreak of measles associated with health care workers occurred in northern Taiwan. Prior to this study, the policy for measles vaccination for physicians and nurses in MacKay Memorial Hospital, Taiwan was encouragement of vaccination in medical personnel working in the emergency room or other high risk divisions without prior testing for measles antibody, and vaccination coverage was only 85.3%. It was important to urgently formulate a new strategy to achieve zero tolerance for intra-hospital transmission and epidemic prevention. This study aimed to explore the effectiveness of a new strategy for the prevention of an outbreak of measles. METHODS: This study was conducted from April 23, 2018 to May 22, 2018 in the MacKay Memorial Hospital, a medical center and tertiary teaching hospital with 2200 beds in northern Taiwan. First-line medical personnel in the hospital underwent a free screening for measles antibody as a new strategy for measles outbreak prevention. Susceptible medical personnel were advised to receive measles vaccination. RESULTS: A total of 719 first-line medical personnel were enrolled for the general survey. Measles seropositivity was 76.1% (287/377) in the generation born after 1978 (vaccinated), and 96.5% (330/342) in the generation born before 1978 (p < 0.001), while the overall seropositivity was 85.8% (617/719). Vaccination coverage of susceptible personnel under the new strategy reached 86.3% in the first month (88/102) following the survey. At the end of the first month after implementation of the new strategy, 98.1% of the medical personnel were seropositive or revaccinated, and reached 99.4% at the end of the second month. CONCLUSIONS: In this study, rapid, free antibody screening during a measles outbreak and subsequent vaccination of those susceptible resulted in most of the first-line medical personnel being seropositive or revaccinated. The new strategy was effective, time saving, used little manpower, and of low cost. Screening for measles antibody free of charge followed by vaccination of seronegative medical personnel can be regarded as an effective health management strategy to reduce and prevent the spread of measles infection.

A systematic review and meta-analysis of the comparison of performance among step-tip, split-tip, and symmetrical-tip hemodialysis catheters.

OBJECTIVE: Patients with end-stage renal disease need vascular access to ensure sufficient blood flow during hemodialysis (HD). Patients who are poor candidates for arteriovenous access creation require long-term catheter placement. Problems such as dialysate recirculation, thrombosis, catheter-related infections, and malfunction can occur with HD catheters. Different tip designs (step, split, and symmetrical) have been developed to ameliorate the catheter-related problems. The aim of the study was to compare the efficacy and safety of split-tip, step-tip, and symmetrical-tip HD catheters. METHODS: The PubMed, Embase, Cochrane Library, and Scopus databases and the ClinicalTrials.gov registry were searched for studies published before November 2017. Studies comparing the clinical and rheologic outcomes of step-, split-, or symmetrical-tip catheters in patients undergoing HD were included in this meta-analysis. We conducted meta-analyses using random-effects models. The primary outcomes were catheter survival time and incidence of functioning catheters. The secondary outcomes were delivered blood flow rate, blood recirculation rate, and incidence of catheter-related complications. RESULTS: Seven randomized controlled trials and one retrospective study with a total of 988 patients were included. No significant differences were observed in the delivered blood flow rate (weighted mean difference, -5.37 mL/min; 95% confidence interval [CI], -23.75 to 13.02), incidence of catheter-related infections (risk ratio [RR], 1.18; 95% CI, 0.63-2.22), or incidence of catheter-related thrombosis (RR, 1.29; 95% CI, 0.64-2.59) between step-tip catheters and advanced (both split-tip and symmetrical-tip) catheters. Moreover, a meta-analysis of the incidence of functioning catheters at 1 month, 6 months, and 12 months revealed that the outcome of step-tip catheter use was better than that of split-tip catheter use, but with a significant difference only at 6 months (RR, 1.22; 95% CI, 1.02-1.46). CONCLUSIONS: None of the catheter types exhibited unique features that can enhance their suitability for application. Hence, catheters can be selected by also considering different factors, including costs, ease of procedures, expertise of the clinician, and education and preference of the patient.

Clonal relationship and the association of the ST218 strain harboring blaOXA-72 gene to mortality in carbapenem-resistant Acinetobacter baumannii bacteremia.

BACKGROUND/PURPOSE: In 2017, the World Health Organization categorized carbapenem-resistant Acinetobacter baumannii (CRAB) as a priority 1, critical antibiotic-resistant bacteria. This study analyzed the clinical outcomes and investigated the molecular epidemiology of CRAB bacteremia in a medical center in Northern Taiwan. METHODS: We collected 62 blood isolates from patients with CRAB bacteremia from January 2014 to December 2015 at MacKay Memorial Hospital and determined the clonal relationship using the PCR-based technique for molecular epidemiology. Medical charts were reviewed for clinical outcomes. RESULTS: Fifty-six isolates harbored the blaOXA-51-like and blaOXA-23-like carbapenemase genes, 4 isolates harbor the blaOXA-51-like and blaOXA-24-like carbapenemase genes and 2 isolates harbored only the blaOXA-51-like gene. After sequencing, all four isolates of blaOXA-24-like carbapenemase gene were confirmed to be isolates of blaOXA-72 carbapenemase genes. In multivariate analysis in the 60 patients, the independent mortality risk factors of CRAB bacteremia included ≥65 years (elderly) (Odds ratio, 4.04, 95% CI, 1.10-14.83, p = 0.035), chronic kidney disease (4.36, 1.14-16.72, p = 0.032). Isolates harboring the blaOXA-72 gene had the same sequence type (ST218) and PFGE pulsotype raising the possibility of intra-hospital transmission, and all infected patients died. CONCLUSION: This study showed the clonal relationship of isolates harboring the carbapenemase gene in CRAB bacteremia. Patients with the ST218 strain harboring blaOXA-72 gene had high mortality. This warrants further research to determine the mechanism of virulence and risk factors in order to reduce mortality.

Reciprocal Reinforcement Between Wearable Activity Trackers and Social Network Services in Influencing Physical Activity Behaviors.

BACKGROUND: Wearable activity trackers (WATs) are emerging consumer electronic devices designed to support physical activities (PAs), which are based on successful behavior change techniques focusing on goal-setting and frequent behavioral feedbacks. Despite their utility, data from both recent academic and market research have indicated high attrition rates of WAT users. Concurrently, evidence shows that social support (SS), delivered/obtained via social network services or sites (SNS), could increase adherence and engagement of PA intervention programs. To date, relatively few studies have looked at how WATs and SS may interact and affect PAs. OBJECTIVE: The purpose of this study was to explore how these two Internet and mobile technologies, WATs and SNS, could work together to foster sustainable PA behavior changes and habits among middle-aged adults (40-60 years old) in Taiwan. METHODS: We used purposive sampling of Executive MBA Students from National Taiwan University of Science and Technology to participate in our qualitative research. In-depth interviews and focus groups were conducted with a total of 15 participants, including 9 WAT users and 6 nonusers. Analysis of the collected materials was done inductively using the thematic approach with no preset categories. Two authors from different professional backgrounds independently annotated and coded the transcripts, and then discussed and debated until consensus was reached on the final themes. RESULTS: The thematic analysis revealed six themes: (1) WATs provided more awareness than motivation in PA with goal-setting and progress monitoring, (2) SS, delivered/obtained via SNS, increased users' adherence and engagement with WATs and vice versa, (3) a broad spectrum of configurations would be needed to deliver WATs with appropriately integrated SS functions, (4) WAT design, style, and appearance mattered even more than those of smartphones, as they are body-worn devices, (5) the user interfaces of WATs left a great deal to be desired, and (6) privacy concerns must be addressed before more mainstream consumers would consider adopting WATs. CONCLUSIONS: Participants perceived WATs as an awareness tool to understand one's PA level. It is evident from our study that SS, derived from SNS and other pertinent vehicles such as the LINE social messaging application (similar to WhatsApp and WeChat), will increase the engagement and adherence of WAT usage. Combining WATs and SNS enables cost-effective, scalable PA intervention programs with end-to-end services and data analytics capabilities, to elevate WATs from one-size-fits-all consumer electronics to personalized PA assistants.

Exploring the critical quality attributes and models of smart homes.

Research on smart homes has significantly increased in recent years owing to their considerably improved affordability and simplicity. However, the challenge is that people have different needs (or attitudes toward smart homes), and provision should be tailored to individuals. A few studies have classified the functions of smart homes. Therefore, the Kano model is first adopted as a theoretical base to explore whether the functional classifications of smart homes are attractive or necessary, or both. Second, three models and test user attitudes toward three function types of smart homes are proposed. Based on the Kano model, the principal results, namely, two "Attractive Quality" and nine "Indifferent Quality" items, are found. Verification of the hypotheses also indicates that the entertainment, security, and automation functions are significantly correlated with the variables "perceive useful" and "attitude." Cost consideration is negatively correlated with attitudes toward entertainment and automation. Results suggest that smart home providers should survey user needs for their product instead of merely producing smart homes based on the design of the builder or engineer.

A study of renal function influence by integrating cloud-based manometers and physician order entry systems.

BACKGROUND: No evidence exists from randomized trials to support using cloud-based manometers integrated with available physician order entry systems for tracking patient blood pressure (BP) to assist in the control of renal function deterioration. We investigated how integrating cloud-based manometers with physician order entry systems benefits our outpatient chronic kidney disease patients compared with typical BP tracking systems. METHODS: We randomly assigned 36 chronic kidney disease patients to use cloud-based manometers integrated with physician order entry systems or typical BP recording sheets, and followed the patients for 6 months. The composite outcome was that the patients saw improvement both in BP and renal function. RESULTS: We compared the systolic and diastolic BP (SBP and DBP), and renal function of our patients at 0 months, 3 months, and 6 months after using the integrated manometers and typical BP monitoring sheets. Nighttime SBP and DBP were significantly lower in the study group compared with the control group. Serum creatinine level in the study group improved significantly compared with the control group after the end of Month 6 (2.83 ± 2.0 vs. 4.38 ± 3.0, p = 0.018). Proteinuria improved nonsignificantly in Month 6 in the study group compared with the control group (1.05 ± 0.9 vs. 1.90 ± 1.3, p = 0.09). Both SBP and DBP during the nighttime hours improved significantly in the study group compared with the baseline. CONCLUSION: In pre-end-stage renal disease patients, regularly monitoring BP by integrating cloud-based manometers appears to result in a significant decrease in creatinine and improvement in nighttime BP control. Estimated glomerular filtration rate and proteinuria were found to be improved nonsignificantly, and thus, larger population and longer follow-up studies may be needed.

Trends in and contributions to entrepreneurship research: a broad review of literature from 1996 to June 2012.

This article, which began as an effort to gauge trends in and contributions to the broad field of "entrepreneur/entrepreneurship," reviews 5,476 academic articles on entrepreneurship that were published in 522 Social Sciences Citation Index and Science Citation Index journals from 1996 to June 2012. This survey identifies keywords and conducts a review to search for and identify related articles in the Institute for Scientific Information Web of Science database. We then present our findings, including the number of publications by year, categorization of article types, main academic journals, authors, and most-cited articles. The citation counts for authors, journals, and articles are also analyzed. This study indicates that the number of articles related to the keyword entrepreneur increased from 1996 to the end of 2011, which is a sign of an upward trend in the influence of entrepreneurs. Entrepreneur research fascinated numerous scholars during the study period covering 16.5 years. In particular, researchers from the USA, England, Canada, Germany, and the Netherlands have made the most contributions to this field. This literature review provides evidence that the concept of entrepreneur attracted academic researchers, resulting in significant contributions to the field of entrepreneur research.

First drive-through pharmacy services in Taiwan.

BACKGROUND: Taiwan has separated drug prescribing and drug dispensing services since 1997. Because of this, patients with chronic illness as well as those with diseases that have a relatively stable status may have their prescriptions refilled in nearby clinic pharmacies without having to go to hospitals. METHODS: Shuang-Ho Hospital in Taipei, Taiwan, implemented a drive-through pharmacy service as a more convenient refilling system to provide patients in need with a more effective way to refill their prescriptions. To assess the efficacy of this new refilling system, changes in patient drug prescription behavior were compared 6 months before and 6 months after the system was deployed. RESULTS: We found an increase in the overall refilling prescription rate, with an increased use of online reservations (7.9% vs. 4.9%, p < 0.001), an increased proportion of medications picked up (93.0% vs. 88.1%, p < 0.001) after the implementation period, and an elevation in the percentage of patients using drive-through pharmacy services (45.4% vs. 28.9%, p < 0.001; second vs. first quarter, respectively) during the 6 months after the implementation period. Generally, the prescription refilling rate for all population categories at Shuang-Ho Hospital increased significantly after the drive-through service was provided (51.1% vs. 50.2%, p < 0.01). The middle-aged population group (40-65 years of age) was found to utilize the drive-through prescription service more than other age groups. CONCLUSION: The drive-through pharmacy provides patients with convenient access to pick up refilling prescriptions in a shorter time than ordinary pharmacy service. During a short-term follow-up, an overall increase in the prescription refilling rate was noted after the drive-through service was put into place. Our survey revealed that an upward of 90% of the patients were satisfied with the drive-through service. Future promotion of the service may help patients effectively utilize drive-through pharmacy prescription refilling and enhance disease control.

Intention to continue using Facebook fan pages from the perspective of social capital theory.

Social network sites enable users to express themselves, establish ties, and develop and maintain social relationships. Recently, many companies have begun using social media identity (e.g., Facebook fan pages) to enhance brand attractiveness, and social network sites have evolved into social utility networks, thereby creating a number of promising business opportunities. To this end, the operators of fan pages need to be aware of the factors motivating users to continue their patronization of such pages. This study set out to identify these motivating factors from the point of view of social capital. This study employed structural equation modeling to investigate a research model based on a survey of 327 fan pages users. This study discovered that ties related to social interaction (structural dimension), shared values (cognitive dimension), and trust (relational dimension) play important roles in users' continued intention to use Facebook fan pages. Finally, this study discusses the implications of these findings and offers directions for future research.