[Workplace Violence Against Nurses in Northern Taiwan: A Cross-Sectional Study].

BACKGROUND: Nurses comprise a group in the healthcare team that is exposed to the highest levels of workplace violence. This not only causes negative emotions in nurses and adversely impacts the institution and the body and spirit of the nurses but also affects the quality of nursing care. PURPOSE: The aim of this study was to determine the prevalence of physical and psychological workplace violence experienced by the nursing staff and to identify the perpetrators of violence, the reactions of the victims, and the policies developed by employers to prevent violence. METHODS: This cross-sectional study was conducted using a stratified sampling method across different levels of healthcare institutions on the nursing personnel registered with the Taipei Nurses Association. The number of subjects was allocated according to hospital level. A total of 2,931 subjects were recruited, of whom 2,627 participated in this study. RESULTS: Over two-thirds (70.6% ) of participants had experienced workplace violence, of whom 31.0% had experienced physical violence and 66.0% had experienced psychological violence. A multiple logistic regression analysis showed that nurses who were married, who had less than one year of work experience, or were over 50 years of age were at lower risk of physical and psychological violence. Those who had a university education or higher faced a higher risk of psychological violence. The most common perpetrators were identified as patients. The aftermath reactions from the victims were varied, with the most prevalent being "telling the perpetrator to stop the violence", "telling friends or family," and "reporting the incident to a senior staff member". The perpetrators were mostly dealt with using a verbal warning, while the second-most common strategy was taking no action. Only 2.3% ‡6.8% of the victims notified the authorities about the violence because of the following primary reasons: "useless," "not important," and "fear of negative consequences." The major strategies that were adopted by employers to prevent violence included "security measures," "improvement of surroundings," and "training." CONCLUSIONS: Prevention of violence must be improved comprehensively using the strategies of physical facilities, management, education, and policies.

White matter hyperintensities in cholinergic pathways are associated with dementia severity in e4 carriers but not in non-carriers.

Background and objectives: Among individuals with Alzheimer's disease (AD), APOE e4 carriers with increased white matter hyperintensities (WMHs) may selectively be at increased risk of cognitive impairment. Given that the cholinergic system plays a crucial role in cognitive impairment, this study aimed to identify how APOE status modulates the associations between dementia severity and white matter hyperintensities in cholinergic pathways. Methods: From 2018 to 2022, we recruited participants (APOE e4 carriers, n = 49; non-carriers, n = 117) from the memory clinic of Cardinal Tien Hospital, Taipei, Taiwan. Participants underwent brain MRI, neuropsychological testing, and APOE genotyping. In this study, we applied the visual rating scale of the Cholinergic Pathways Hyperintensities Scale (CHIPS) to evaluate WMHs in cholinergic pathways compared with the Fazekas scale. Multiple regression was used to assess the influence of CHIPS score and APOE carrier status on dementia severity based on Clinical Dementia Rating-Sum of Boxes (CDR-SB). Results: After adjusting for age, education and sex, higher CHIPS scores tended to be associated with higher CDR-SB in APOE e4 carriers but not in the non-carrier group. Conclusions: Carriers and non-carriers present distinct associations between dementia severity and WMHs in cholinergic pathways. In APOE e4 carriers, increased white matter in cholinergic pathways are associated with greater dementia severity. In non-carriers, WMHs exhibit less predictive roles for clinical dementia severity. WMHs on the cholinergic pathway may have a different impact on APOE e4 carriers vs. non-carriers.

White matter hyperintensities in cholinergic pathways may predict poorer responsiveness to acetylcholinesterase inhibitor treatment for Alzheimer's disease.

BACKGROUND: Acetylcholinesterase inhibitor (AChEI) drug regimens are the mainstay treatment options for patients with Alzheimer's disease (AD). Herein, We examined the association between clinical response to AChEI and white matter hyperintensities on magnetic resonance imaging (MRI) scan at baseline. METHODS: Between 2020 and 2021, we recruited 101 individuals with a clinical diagnosis of probable AD. Each participant underwent complete neuropsychological testing and 3T (Telsa) brain magnetic resonance imaging. Responsiveness to AChEI, as assessed after 12 months, was designated as less than two points of regression in Mini-Mental State Examination scores (MMSE) and stable clinical dementia rating scale. We also evaluated MRI images by examining scores on the Cholinergic Pathways Hyperintensities Scale (CHIPS), Fazekas scale, and medial temporal atrophy (MTA) scale. RESULTS: In our cohort, 52 patients (51.4%) were classified as responders. We observed significantly higher CHIPS scores in the nonresponder group (21.1 ± 12.9 vs. 14.9 ± 9.2, P = 0.007). Age at baseline, education level, sex, Clinical Dementia Rating sum of boxes scores, and three neuroimaging parameters were tested in regression models. Only CHIPS scores predicted clinical response to AChEI treatment. CONCLUSION: WMHs in the cholinergic pathways, not diffuse white matter lesions or hippocampal atrophy, correlated with poorer responsiveness to AChEI treatment. Therefore, further investigation into the role of the cholinergic pathway in AD is warranted.

Combinations of action observation and motor imagery on golf putting's performance.

Motor imagery (MI) and action observation (AO) have been found to enhance motor performance, but recent research found that a combination of action observation and motor imagery (AOMI) together is even better. Despite this initial finding, the most effective way to combine them is unknown. The present study examined the effects of synchronized (i e., concurrently doing AO and MI), asynchronised (i.e., first doing AO then MI), and progressive (first asynchronised approach, then doing synchronized approach) AOMI on golf putting performance and learning. We recruited 45 university students (Mage = 20.18 + 1.32 years; males = 23, females = 22) and randomly assigned them into the following four groups: synchronized group (S-AOMI), asynchronised group (A-AOMI), progressive group (A-S-AOMI), and a control group with a pre-post research design. Participants engaged in a 6-week (three times/per-week) intervention, plus two retention tests. A two-way (group × time) mixed ANOVA statistical analysis found that the three experimental groups performed better than the control group after intervention. However, we found progressive and asynchronised had better golf putting scores than synchronized group and the control group on the retention tests. Our results advance knowledge in AOMI research, but it needs more research to reveal the best way of combining AOMI in the future. Theoretical implications, limitations, applications, and future suggestions are also discussed.

Interaction of mindfulness disposition and instructional self-talk on motor performance: a laboratory exploration.

In considering that high mindfulness disposition individuals possess a unique ability to maintain attention and awareness, and attention is one of the key mechanisms of instructional self-talk, the purpose of this study was to examine the interaction of mindfulness disposition and instructional self-talk on motor performance. Forty-nine college students (M age = 18.96 ± 1.08) with high/low mindfulness disposition (high n = 23; low n = 26) selected out of 126 college students performed a discrete motor task (standing long jump) and a continuous motor task (line tracking task) under instructional and unrelated self-talk conditions. Two separate 2 (self-talk type) X 2 (high/low mindfulness) mixed design ANOVA statistical analyses indicated that mindfulness disposition interacted with unrelated self-talk in the line tracking task. Specifically, low mindfulness participants performed poorer than high mindfulness participants in line tracking task under unrelated self-talk. Further, participants performed better in both standing long jump and line tracking under instructional self-talk than unrelated self-talk. Results not only revealed the triangular relationships among mindfulness, self-talk, and motor performance but also indirectly support the role of attention in self-talk effectiveness. Limitations, future research directions, and practical implications were discussed.

Opioid-sparing effects of ketorolac and its correlation with the recovery of postoperative bowel function in colorectal surgery patients: a prospective randomized double-blinded study.

OBJECTIVES: Postoperative ileus (PI) is one of many common complications in major abdominal surgery. PI results in patient discomfort, increased gastrointestinal leakage, prolonged hospital stay, and increased medical expenses. In this study, we have investigated the morphine-sparing effects of ketorolac and its correlation with the duration of PI in patients with colorectal surgeries. METHODS: We collected data from 102 patients who had received elective colorectal resection. The patients were randomly allocated into 2 groups and received intravenous patient-controlled analgesia (IVPCA) morphine (M group) or IVPCA morphine plus ketorolac (M+K group). Time-scale morphine consumption (per 12 h), recovery of bowel functions (the first bowel movement and passage of flatus), pain scores, and opioid-related side effects were then recorded. RESULTS: Patients in the M+K group received 18.3% less morphine than those in the M group within 72 postoperative hours. The maximal opioid-sparing effects of ketorolac appeared in 12 to 24 postoperative hours. The onset of the first bowel movement and passage of flatus was significantly less in the M+K group than in the M group. The M group showed a 5.25 times greater risk of inducing PI, a result comparable with the M+K group in colorectal surgery patients. DISCUSSION: The addition of ketorolac to IVPCA morphine has demonstrated a clear opioid-sparing effect and benefits in regards to the shortening of the duration of bowel immobility. We suggest that adding ketorolac to morphine IVPCA be included in the multimodal postoperative rehabilitation program for the early restoration of normal bowel function.

Insecticide resistance in German cockroaches (Blattella germanica) from hospitals and households in Taiwan.

Since a high percentage of cockroach infestation has been determined in hospitals in Kaohsiung, South Taiwan, insecticide resistances may have developed in the cockroach populations. To determine the resistances in cohorts of German cockroach (Blattella germanica) from hospitals and households to organophosphates, carbamates and pyrethroids, cockroaches were trapped from 30 hospitals and 30 households in this area. Bioassays by topical application were then carried out on the first generation bred in the laboratory. Resistance ratio (RR) was determined by comparing the LD50 of the collected cohorts with that of a susceptible cohort. RR ranges of chlorpyrifos, propoxur and cypermethrin in the hospitals were 2.04 - 28.80, 2.86 - 30.86 and 1.95 - 14.05 and those in the household were 1.92 - 17.72, 6.93 - 62.50 and 2.80 - 27.35 respectively. Significant correlations among the RRs of the three insecticides were separately found in the hospitals and households, indicating the existence of cross resistance among the three groups of insecticides. The patterns of propoxur > chlorpyrifos > cypermethrin in hospitals and propoxur > cypermethrin > chlorpyrifos in households reflect that chlorpyrifos is more frequently used in hospitals than in households. In contrast, cypermethrin is used more frequently in households.