Key determinates of job satisfaction for acute care nurse practitioners in Taiwan.

BACKGROUND: Taiwan is a super-aged society, and the shortage of hospital doctors; nurse practitioners (NPs) became vital healthcare providers to fulfill the healthcare demands of the population. The purpose of this study was to explore the key determinates of job satisfaction for NPs in acute care practices using significant practice variables, such as empowerment and burnout. METHODS: Participants of this descriptive survey study were recruited from a national sample of NPs with membership in the Taiwan Association of Nurse Practitioners. The data were collected utilizing an online questionnaire based on demographic and practice variables, the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), the Condition for Work Effectiveness Questionnaire II (CWEQ II), and the Copenhagen Burnout Inventory (CBI). A total of 1,211 NPs completed the online survey. A multiple regression model with the stepwise selection was used to explore job satisfaction. RESULTS: The mean overall satisfaction score indicated that the level of satisfaction was between slightly dissatisfied and slightly satisfied. Regression results indicated that formal power, work-related burnout, access to information, and needed resources were critical components of job satisfaction, and accounted for 63% of the variance. Moreover, NPs who were married, had a higher annual salary, worked only during the day shift, and had lower patients-related burnout showed better job satisfaction. CONCLUSIONS: This study provides evidence for healthcare organizations to formulate policies to strengthen NP job satisfaction. Empowerment and burnout are vital factors in NPs' job satisfaction. Healthcare organizations have an obligation to implement policies to empower NPs in practice and provide interventions to mitigate burnout. Implementing these changes will improve job satisfaction and with it the quality of patient care.

Design to Assist Better Youthhood for Adolescents with Lower-Limb Disability through Virtual Reality Sports.

Background: Youths with lower limb dysfunction display low levels of sports participation, which limits their growth and self-development, both physically and mentally. Recently, VR technology has proven its profound value in the psychological evaluation and treatment, rehabilitation, and immersive training of people in need. We have proposed, designed, and developed a VR rock-climbing game for youths with lower-limb dysfunction that allows them to engage in enjoyable and purposeful in-game tasks that simultaneously bring about intensive real-world exercise. Methods: Pilot studies were conducted on college students whose lower limbs were fixed to chairs. Heart rate monitoring, a flow questionnaire, interviews, and observation were conducted for each participant to evaluate the impact of the VR rock-climbing game. The collected data were trimmed on the basis of Cronbach's alpha and corrected item−total correlation (CITC) to guarantee the data's reliability. Results: The average value of each flow experience dimension was greater than 4 (0.76 < SD < 0.91). According to the flow-based analysis and the whole-process feeling distribution (WPFD), the evaluated study brought about the participants' happiness and a sense of mastery and achievement. Conclusions: By bringing about a deep and enjoyable immersion in VR, it remarkably promotes the participants' intention to participate in exercises.

Improvement of serum prolactin and sexual function after switching to aripiprazole from risperidone in schizophrenia: a case series.

This study examined prolactin levels, sexual function and clinical improvement after switching to aripiprazole from risperidone. Nine schizophrenic male Chinese patients who reported risperidone-induced sexual dysfunction were studied. Clinical Global Impression Scale Scores for Severity (CGI-S), Clinical Global Impression Scale Scores for Improvement (CGI-I), Arizona Sexual Experience Scale results and serum prolactin concentrations were determined over 16 weeks. After treatment with aripiprazole, all patients showed reduced serum prolactin (26.54 ± 17.03 ng/mL to 3.71 ± 1.87 ng/mL, P=0.008) and five reported improved sexual function. Mean baseline CGI-S (5.11 ± 0.93) decreased to 3.78 ± 1.39 (P=0.010) by week 16. Compared to baseline (4.0), the mean CGI-I significantly declined by the end of the study (3.44 ± 0.53, P=0.025).

Flow visualization and density measurement of the supersonic molecular beam for fusion plasma fueling.

The supersonic molecular beam injection (SMBI) technique is widely used in magnetic fusion devices for plasma fueling and active control of particles. The beam flow formed by the SMBI system is directly visualized by a newly established schlieren diagnostic system on the SMBI testing platform. This schlieren system could provide a 2D density distribution of the beam with the sub-mm spatial resolution by detecting the change in the refractive index of the medium caused by the SMBI in the low-pressure vacuum chamber. The structure and the divergence angle of the supersonic molecular beam for fusion plasma fueling are first measured. Additionally, the density profile of the supersonic molecular beam is reconstructed from the measured light intensity by the schlieren system. The experimental comparison between the standard nozzle and the optimized nozzle of the SMBI system shows the great potential of the diagnostic system in optimizing the beam characteristics.

Design, Modeling, and Fabrication of High-Speed VCSEL with Data Rate up to 50 Gb/s.

We have studied the characteristics of frequency response at 850-nm GaAs high-speed vertical-cavity surface-emitting lasers (VCSELs) with different kinds of oxide aperture sizes and cavity length using the PICS3D simulation program. Using 5-µm oxide aperture sizes, the frequency response behavior can be improved from 18.4 GHz and 15.5 GHz to 21.2 GHz and 19 GHz in a maximum of 3 dB at 25 °C and 85 °C, respectively. Numerical simulation results also suggest that the frequency response performances improved from 21.2 GHz and 19 GHz to 30.5 GHz and 24.5 GHz in a maximum of 3 dB at 25 °C and 85 °C due to the reduction of cavity length from 3λ/2 to λ/2. Consequently, the high-speed VCSEL devices were fabricated on a modified structure and exhibited 50-Gb/s data rate at 85 °C.

A multiplexer-based multi-channel microwave Doppler backward scattering reflectometer on the HL-2A tokamak.

The Doppler backward scattering (DBS) reflectometer has become a well-established and versatile diagnostic technique for the measurement of density fluctuations and flows in magnetically confined fusion experiments. In this work, a novel multiple fixed-frequency array source with a multiplexer technique is developed and applied in the multi-channel DBS system. The details of the system design and laboratory tests are presented. Preliminary results of Doppler shift frequency spectra measured by the multi-channel DBS reflectometer systems are obtained. Characteristics of plasma rotation and turbulence before and after supersonic molecular beam injection are analyzed.

A novel multi-channel quadrature Doppler backward scattering reflectometer on the HL-2A tokamak.

A novel 16-channel fixed frequency Doppler backward scattering (DBS) reflectometer system has been developed on the HL-2A tokamak. This system is based on the filter-based feedback loop microwave source (FFLMS) technique, which has lower phase noise and lower power variation compared with present tunable frequency generation and comb frequency array generation techniques [J. C. Hillesheim et al. Rev. Sci. Instrum. 80, 083507 (2009) and W. A. Peebles et al. Rev. Sci. Instrum. 81, 10D902 (2010)]. The 16-channel DBS system is comprised of four × four-frequency microwave transmitters and direct quadrature demodulation receivers. The working frequencies are 17-24 GHz and 31-38 GHz with the frequency interval of 1 GHz. They are designed to measure the localized intermediate wave-number (k⊥ρ ∼ 1-2, k⊥ ∼ 2-9 cm-1) density fluctuations and the poloidal rotation velocity profile of turbulence. The details of the system design and laboratory tests are presented. Preliminary results of Doppler spectra measured by the multi-channel DBS reflectometer systems are obtained. The plasma rotation and turbulence distribution during supersonic molecular beam injection are analyzed.

Voiding dysfunction in women with systemic lupus erythematosus.

OBJECTIVE: We sought to explore bladder dysfunction in a cohort of women with systemic lupus erythematosus (SLE). METHODS: We conducted a prospective study of 152 female patients with SLE during a 15-month period. The clinical status of SLE was determined according to the SLE Disease Activity Index (SLEDAI), and bladder function was evaluated by lower urinary tract symptoms and urodynamic studies. We adapted the American Urological Association (AUA) index questionnaire to assess lower urinary tract symptoms in patients, which were compared with those in 227 age-matched healthy women. RESULTS: The proportion of individuals reporting urinary frequency, urgency, weak urinary stream, and incomplete emptying, as well as severe lower urinary tract symptoms (AUA index score >/=20), was significantly higher in the SLE group when compared with the control group. The AUA index score showed a modest correlation with the SLEDAI score (r = 0.35, P < 0.001) but not with patient age or disease duration. There was a significant relationship between central nervous system involvement and the AUA index score. The most common urodynamic finding was a small cystometric bladder capacity (<150 ml; n = 7 patients), followed by a subnormal urinary flow rate (<12 ml/second; n = 6 patients). In 3 of 7 patients with small cystometric bladder capacities, imaging studies documented a contracted bladder with marked hydroureteronephrosis. CONCLUSION: Patients with SLE experience an increased prevalence of voiding dysfunction compared with healthy individuals. Voiding dysfunction can be attributable to either direct bladder involvement or other disease-related factors.