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Aim: To investigate whether education, tenure, being an advanced practice nurse, skill level, and time pressure impact perceptions of "having a place" and, further, turnover intentions. Background: Nursing shortages persist worldwide. Nurses' turnover intentions are negatively related to their perceptions of "having a place" (i.e., the feeling that the nursing workplace is their territory). However, the sources of nurses' perceptions of the perception of "having a place" remain unknown. Methods: Our research employed a cross‐sectional and correlational design. This research was conducted at a large‐scale hospital in northern Taiwan from December 2021 to January 2022. We used personnel data pertaining to 430 nurses as well as scales for time pressure, "having a place" and turnover intentions to assess nurses' intention to leave their place of employment. The inclusion criteria focused on full‐time nurses who worked for the hospital under investigation. Most of our participants were women. The STROBE statement was used as the EQUATOR checklist (supplemental file). Results: "Having a place" was positively related to educational level, tenure, and skill level, while being an advanced practice nurse was negatively associated with perceptions of "having a place," which in turn were negatively related to turnover intention among nurses. Conclusion: Our study is the first to examine the antecedents of nurses' perceptions of "having a place," which include education, tenure, and skill level. Implications for nursing policy: Nursing policymakers could encourage nurses to pursue higher degrees and update their nursing skills while instilling perceptions of "having a place" in nurses with a brief tenure and advanced practice nurses. [ABSTRACT FROM AUTHOR]

Background: The visibility of skin lesions significantly burdens people with psoriasis, leading to social hostility and numerous emotional and psychological problems. These issues adversely affect self‐esteem, can result in chronic mental health challenges and cause numerous life problems. This study aimed to explore patients' long‐term experiences with severe psoriasis. Methods: A qualitative study was conducted with 20 patients with psoriasis (PASI ≥12) recruited from general and specialist dermatology practices in a regional teaching hospital in Taiwan. Interviews lasted 60–90 min and data were analysed using content analysis. Findings: A core theme emerged: 'Embodied suffering—life worse than death'. This overarching concept comprised three interrelated themes: (i) Experiencing physical suffering, (ii) Experiencing psychological suffering and (iii) Experiencing the stigma of suffering. Conclusion: This study highlights the holistic nature of suffering among individuals with severe psoriasis. It emphasises the need for healthcare professionals to consider the entirety of a patient's circumstances when addressing their suffering. [ABSTRACT FROM AUTHOR]

Background: Feedback is a crucial element in learning. While studies in the field of healthcare professions education have highlighted the process of educators feeding back to learners, relatively little investigation exists on learners feeding back to educators in Asian cultures. Studies show that recipients of effective feedback develop educational skills and reflective practice, but the process of giving feedback seems to have been mainly studied through surveys and questionnaires. Such research offers little to no insights on feedback providers' and recipients' experiences of feedback. To fill the gap, in the context of multi‐source feedback, we investigate medical students, residents, and nurses feedback giving to clinical educators (and their receiving of this) following a case presentation training course. We aim to understand the facilitators and inhibitors that encourage and/or prevent feedback provision alongside educators' uptake and reactions. Methods: We used semi‐structured group interviews. Participants comprised five different categories of participants: year‐4 medical students (n = 6); residents (n = 5); nurses (n = 4); junior clinical educators (n = 9); senior clinical educators (n = 3). We asked them about their experiences of providing feedback to educators and educators receiving of feedback on their teaching. Group interviews were conducted in the largest healthcare institution in Taiwan. Data were analysed using thematic Framework Analysis and managed in ATLAS.ti 8.0. Results: We identified two major themes with respective sub‐themes: (1) Factors affecting feedback giving (including desire for improvement, feedback content, process of feedback, feedback fears, feedback prevention and medical hierarchy); and (2) Educators' reactions to receiving feedback (including validity of feedback, face‐saving and emotional reactions to receiving feedback). Conclusions: Feedback provision to educators on their teaching, and educators' receiving of this feedback in an Asian culture brings forth issues around medical hierarchy, in‐person feedback and face‐saving, which have important implications for effective and optimal delivery of feedback. Curricular developers should consider the context of feedback (e.g. anonymously online), facilitating students as active participants for the development of educational quality, and educators' mindful practice when engaging with student feedback. This study from Taiwan reports on how medical hierarchy, in‐person feedback and face‐saving all have important implications for effective feedback delivery to clinical educators. [ABSTRACT FROM AUTHOR]

Background: This study was motivated by the need to enhance Mandarin learning through embodied interactions and physical engagement methods. While most studies confirm the positive effects of touchscreen devices on learning, mixed findings suggest a need for more engaging methods. This research addresses these gaps by exploring the benefits of embodied interaction through the Shaking‐On game app, an embodied question‐response platform, in comparison to Kahoot. Objectives: To compare the learning effectiveness of the Shaking‐On app, which incorporates physical shaking interactions, with the conventional quiz platform Kahoot in promoting Mandarin learning and positive emotional experiences. Methods: A total of 158 junior high school students participated in the study, engaging in 15‐minute sessions once a week for 3 weeks in a formal classroom setting. Participants were divided into two groups: one using the Shaking‐On app and the other using Kahoot. The study employed a comparative analysis framework based on achievement emotion theory to evaluate learning outcomes and emotional responses. Furthermore, the classroom response system (CRS) analysis was used to assess the cognitive and affective parameters of the learning tasks in the Shaking‐On app and Kahoot, providing detailed insight into how different interactive tasks contributed to learning. Results and Conclusions: The results indicated that the Shaking‐On app significantly enhanced Mandarin learning and engagement compared with Kahoot. Participants using Shaking‐On experienced higher levels of interactive situational interest and flow, while test anxiety remained consistent across both groups. These findings suggest that incorporating embodied interactions into digital learning tools can substantially benefit student engagement and learning outcomes. The study indicated that such apps could be effectively integrated into classroom settings to enhance student learning. Educators and game developers are encouraged to integrate such interactive elements to improve the efficacy and appeal of educational applications. Lay Description: What Is currently known about this topic?: Digital game‐based learning enhances motivation, critical thinking and retention.Embodied cognition links bodily experiences to improved learning outcomes.Physical activities in learning can boost motivation, interest and performance.Engagement through physical interaction may help reduce test anxiety. What does this paper add?: Shaking‐On is more effective in Mandarin learning than Kahoot as classroom response system.Bodily engagement in Shaking‐On enhances situational interest and flow.No significant difference in test anxiety between Shaking‐On and Kahoot users.Embodied interactions provide substantial benefits in digital learning tools. Implications for practice: Educators should integrate embodied interactions to enhance student engagement.Game developers can design more effective learning apps with embodied elements.Future research should explore Shaking‐On's impact on other subjects.Policies should support the development of interactive digital learning tools. [ABSTRACT FROM AUTHOR]

Background: Team‐based learning (TBL) is a widely recognised pedagogical strategy used in diverse fields and courses. Despite the success of TBL, certain concerns have arisen regarding social loafing within group collaboration contexts; this loafing can reduce the overall effectiveness of learning. Objectives: This study addressed the aforementioned concerns by integrating group awareness (GA) information into each stage of TBL, resulting in a TBL + GA system designed to enhance TBL instruction. During online collaborative learning, GA information provides insights into the activities completed by peers and thus the peers' preparedness and achievement; this knowledge fosters motivation, participation, and reflection. Methods: A quasiexperiment was performed with students from two freshman classes (40 and 41 students, respectively) in a Taiwanese university; the control and experimental classes used the TBL only and TBL + GA systems, respectively. Student learning effort was evaluated in terms of preclass preparation, including the use of learning materials and online test scores. Learning achievement was evaluated by assessing the quality of students' assignments. Student feedback, including peer evaluations and students' perceptions of their TBL experience, was collected and compared for the two classes. Results and Conclusions: The TBL + GA system significantly enhanced the preclass preparation efforts of the participants, mitigating social loafing. This improvement manifested as higher practice engagement and better online assessment scores. The TBL + GA system also improved assignment quality and elicited more constructive and positive peer feedback. Implications: Integrating GA information into each stage of TBL may positively affect the effectiveness of instruction. The proposed TBL + GA system can serve as a practical model for instructors seeking to enhance TBL implementation and foster a more engaging and constructive learning environment. Lay Description: What is already known about this topic: Team‐Based Learning (TBL) has recently drawn much attention and has been successfully applied in many fields (different courses)While TBL requires students to learn autonomously and work together as a team, it also results in social loafing during collaborative learning, thus reducing its learning effectiveness.Group awareness (GA) information, which provides visual information about peers' learning contexts (activities) in online collaborative learning, can increase the interaction and participation What this paper adds: This study adds GA information to each learning stage in the TBL process.This study further proposes the TBL + GA system for facilitating TBL teaching.This study investigates whether student engagement on each TBL stages significantly differs between the traditional TBL and the proposed TBL + GA systems. Implications for practice and/or policy: The TBL + GA system significantly enhanced the preclass preparation efforts of the participants, mitigating social loafing. This improvement manifested as an increase in practice engagement and online assessment scores.The TBL + GA system also improved assignment quality and elicited more constructive and positive peer feedback, compared with the traditional TBL.Integrating GA information into each stage of TBL may positively affect the effectiveness of instruction. The proposed TBL + GA system can serve as a practical model for instructors seeking to enhance TBL implementation, thereby fostering a more engaging and constructive learning environment. [ABSTRACT FROM AUTHOR]

Background: The motivation and emotions of students are context dependent. There are specific moments when students may find their coursework more or less motivating, resulting in stronger or milder emotional responses. Identifying factors directly controllable by teachers empowers them to effectively address challenging situations characterized by lower motivation and increased negative emotions. Aims: We aimed to investigate how learning activities and students' perception of teaching practices fostering autonomy relate to competence and value beliefs, and emotions in the context of course participation within higher education. Sample: Seventy‐seven Taiwanese university students provided 762 learning reports associated with their course participation experiences. Methods: The experience sampling method (ESM) was used. Participants responded to ESM surveys on their phones for 14 days, reporting motivational beliefs, emotions and contextual characteristics of the course if they indicated active participation in a course upon receiving notifications from their phones. Results: A significant portion of the variation is attributed to situational fluctuation, suggesting that academic emotions and competence and value beliefs vary within students across measurements. An increase in students' perception of an autonomy‐supportive learning climate correlates with higher competence beliefs, intrinsic value and positive emotions, coupled with reduced perceived costs and negative emotions. In contrast to lectures, engaging in independent hands‐on work, participating in group collaborative projects or interactive discussions appear to inspire motivation or evoke stronger emotional responses in students. Conclusions: Teachers' teaching practices and classroom learning activities play a pivotal role in shaping students' situational motivation and emotions. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease‐associated pruritus is a distressing symptom and has a far‐reaching impact on patients' sleep and quality of life for most patients receiving haemodialysis. Traditional therapies have limited effectiveness. Objectives: This study aimed to invent a self‐operated ice roller and evaluate its efficacy in relieving pruritus, sleep quality, and quality of life. Design: This study was experimental with a two‐arm parallel group design. Participants: A convenient sampling method was used to recruit 60 patients receiving haemodialysis who reported pruritus (5D‐Itch Scale score >5) lasting over 4 weeks in Taiwan. The participants were randomly assigned to one of two groups: the intervention group used an ice roller for 7 days, while the control group received no anti‐pruritus treatment. Measurements: This study was experimental with a two‐arm parallel group design. The measurement instruments included the 5D‐Itch Scale, Pittsburgh Sleep Quality Index and WHOQOL‐BREF‐Taiwan Version. The analysis of covariance, chi‐square, Independent t tests, and partial Eta2 (η2p) were used to analyse the data. Results: The participants' mean age was 62.77 years. Application of the ice roller significantly decreased overall pruritus (p <.05; η2p =.09) and distribution of pruritus‐associated bodily parts (p =.03; η2p =.08). There were no statistically significant differences in sleep quality and related indicators between the experimental and control groups at the study endpoint. Regarding quality of life, only the social relationship domain significantly differed between the two groups (p =.02; η2p =.08). Conclusions: The ice roller can decrease pruritus and its distribution in patients receiving haemodialysis, serving as an adjunct therapy alongside conventional anti‐pruritus treatments. [ABSTRACT FROM AUTHOR]

Background: Health literacy, self‐efficacy and self‐management are known to influence health‐related well‐being. However, the precise influence of self‐management, health literacy and self‐efficacy on health outcomes in Asian countries is under‐researched. Objectives: To examine the impact of health literacy and self‐efficacy (independent variables) and self‐management (mediator) on patients' health outcomes (dependent variable). Design: An observational, cross‐sectional design was conducted between 1 March 2022 and 31 August 2022. Participants: Outpatients receiving haemodialysis (n = 200) at a Taiwanese medical centre were assessed. Measurements: The survey included demographic questions and standardised scales: the 3‐item Brief Health Literacy Screen, the 8‐item Perceived Kidney/Dialysis Self‐Management Scale as a measure of self‐efficacy, and the 20‐item Haemodialyses Self‐Management Instrument. Health outcomes were responses on the 12‐item Short‐Form Health Survey version 2 and clinical blood results from the past 3 months. Results: Participants aged over 60 exhibited common comorbidities, with 34% showing low health literacy. Biochemical markers (e.g., haemoglobin and albumin) significantly correlated with physical and mental health scores. Mediating coefficients revealed that self‐management significantly influenced associations between health outcomes, health literacy (β = 0.31; p < 0.01), and self‐efficacy (β = 0.19; p < 0.01). Implications for Practice: Self‐management can modify the overall influence of health literacy and self‐efficacy on patients' quality of physical and emotional health. When managing a chronic condition, 'knowing' how to self‐manage does not always result in 'doing so' by the patient. Continuous monitoring and promoting self‐management behaviours and support by nurses are crucial to enhance health outcomes. [ABSTRACT FROM AUTHOR]

Background: Herniated intervertebral disc (HIVD) with radiculopathy is a common degenerative spine disorder. Transforaminal epidural steroid injection (TFESI) is one of the pain relief treatments for lumbar radiculopathy recommended by evidence‐based guidelines. Adequate contrast distribution is correlated with better pain control, but the best approach has not been confirmed yet. Aim: To confirm the distribution of contrast medium injected with a new approach of TFESI, that is, far lateral lateral recess approach (FLLR‐TFESI). Methods: Patients receiving TFESI due to HIVD with radiculopathy between 2010 January and 2020 August were retrospectively enrolled. While the FLLR‐TFESI was taken as the experimental group, the conventional approach was viewed as the control group. The baseline characteristics, the pattern of contrast enhancement under fluoroscopic guidance, and the complications of these patients were collected and analyzed. Results: A total of 380 patients were analyzed (143 in control group and 237 in experimental group). The two groups were balanced in most baseline characteristics, except disc extrusion (p = 0.01) and scoliosis (p = 0.04). The FLLR‐TFESI have a better contrast distribution (p < 0.01), even after adjustment (p < 0.001). No intrathecal injection was noted, but higher rate of intra‐disc injection was noted in FLLR‐TFESI group (10% vs. 3%, p = 0.008). Conclusion: The FLLR‐TFESI has a superior contrast enhancement and distribution in comparison to conventional approach. Prospective study to confirm the study result as well as the clinical benefits is suggested in the future. [ABSTRACT FROM AUTHOR]

This study proposed and statistically examined a research model to understand university learners' satisfaction with online English as a foreign language (EFL) courses during the pandemic. Variables including e‐learning anxiety, positive coping, and gender were under investigation. These variables did not receive much attention in the previous literature, and yet they are considered essential to understanding satisfaction with online EFL courses. A total of 439 undergraduate EFL learners from a university in Taiwan participated in the present study. The technique of structural equation modeling was adopted to test the hypotheses in the moderated mediation model. This study discovered: (1) e‐learning anxiety had a negative impact on EFL learners' satisfaction with online EFL courses; (2) positive coping was able to reduce the negative impact of e‐learning anxiety on satisfaction with online EFL courses; (3) males used more positive coping strategies than females, and they had better satisfaction scores as well. The results can enrich the current applied linguistics literature by providing an insight into the dynamics of these variables. [ABSTRACT FROM AUTHOR]

Catheter ablation for tachyarrhythmia via superior approach has been used in patients without possible inferior vena cava access such as in cases of venous occlusion or complex anomaly. Difficulty in catheter manipulation, instability, number of required vascular access, and radiation exposure of operator had been described in the procedure. Application of three‐dimensional (3‐D) mapping system in catheter ablation via superior approach could navigate the guiding catheter and provide more precise ablation. We reported four cases receiving catheter ablation due to atrioventricular nodal reentry tachycardia, atrial fibrillation, and right ventricular arrhythmia via superior approach facilitated by 3‐D mapping system with fewer vascular access and catheters. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the impact of physical activity on health among older adults in urban and rural areas in Taiwan. Methods: This study employed a cross‐sectional design and data were analyzed from 2015 to 2019 from the Hualien County Health Bureau. Participants were divided into urban (n = 4780) and rural groups (n = 4983), and logistic regression models were employed to examine how physical activity relates to their health condition in urban and rural older adults. Results: Results indicated lower physical activity levels and higher unhealthy behavior rate in rural older adults compared to their urban counterparts. Rural older adults had higher rates of cardiovascular diseases and diabetes but lower rates of mental illness. Physical activity demonstrated greater physical health benefits for urban older adults than rural older people. Conversely, rural individuals who engaged in physical activity 150 min/week exhibited greater mental health benefits than their urban counterparts. Conclusions: Physical activity offers significant mental health benefits for both urban and rural older adults; however, notable improvements in physical health among urban older adults was found. If in the presence of unhealthy behaviors, regular physical activity may not effectively prevent chronic diseases. It is crucial to promote physical activity and healthy behaviors in rural areas. [ABSTRACT FROM AUTHOR]

Background: Thiopurine co‐therapy with anti‐tumour necrosis factor‐alpha (anti‐TNFα) agents is associated with higher anti‐TNFα drug levels and reduced immunogenicity in inflammatory bowel disease (IBD). Aims: We aimed to evaluate the association between 6‐thioguanine nucleotide (6‐TGN) and anti‐TNFα levels and the optimal 6‐TGN threshold level associated with higher anti‐TNFα levels in combination therapy. Methods: We performed a retrospective cross‐sectional multicentre study of patients with IBD on combination anti‐TNFα and thiopurine maintenance therapy between January 2015 and August 2021. Primary outcomes were infliximab and adalimumab levels. Secondary outcomes were antibodies to infliximab (ATI) or adalimumab (ATA). Univariable and multivariable linear regression were performed to identify variables associated with anti‐TNFα levels. Receiver operator characteristic curves were used to define the optimal 6‐TGN cut‐off levels associated with therapeutic anti‐TNFα levels. Results: The study included 743 paired 6‐TGN and anti‐TNFα levels (640 infliximab and 103 adalimumab). 6‐TGN levels were associated with infliximab levels, but not adalimumab levels, on univariable and multivariable regression. The optimal 6‐TGN cut‐off associated with therapeutic infliximab levels (≥5 mcg/mL) was 261 pmol/8 × 108 red blood cell (RBC) (area under the curve (AUC) = 0.57) for standard infliximab dosing and 227.5 pmol/8 × 108 RBC (AUC = 0.58) for escalated dosing. For therapeutic adalimumab levels (≥7.5 mcg/mL), the 6‐TGN cut‐off was 218.5 pmol/8 × 108 RBC (AUC = 0.59) for standard adalimumab dosing and 237.5 pmol/8 × 108 RBC (AUC = 0.63) for escalated dosing. Conclusion: 6‐TGN levels were weakly associated with infliximab but not adalimumab levels in combination therapy. 6‐TGN levels in the lower end of the therapeutic range (230–260 pmol/8 × 108 RBC) may be adequate to maintain higher infliximab levels, particularly with escalated infliximab dosing. [ABSTRACT FROM AUTHOR]

Background: Older‐age bipolar disorder (OABD) is commonly defined as bipolar disorder in individuals aged 60 or more. There have been no studies to examine temporal trends in the pharmacological treatment of OABD. We aimed to investigate prescription changes among OABD patients discharged from two public mental hospitals in Taiwan from 2006 to 2019. Methods: OABD patients discharged from the two study hospitals, from 1 January 2006 to 31 December 2019 (n = 1072), entered the analysis. Prescribed drugs at discharge, including mood stabilisers (i.e., lithium, valproate, carbamazepine, and lamotrigine), antipsychotics (i.e., second‐ and first‐generation antipsychotics (SGAs and FGAs)), and antidepressants, were investigated. Complex polypharmacy was defined as the use of three or more agents among the prescribed drugs. Temporal trends of each prescribing pattern were analyzed using the Cochran‐Armitage Trend test. Results: The most commonly prescribed drugs were SGAs (72.0%), followed by valproate (48.4%) and antidepressants (21.7%). The prescription rates of SGAs, antidepressants, antidepressants without mood stabilisers, and complex polypharmacy significantly increased over time, whereas the prescription rates of mood stabilisers, lithium, FGAs, and antidepressants plus mood stabilisers significantly decreased. Conclusions: Prescribing patterns changed remarkably for OABD patients over a 14‐year period. The decreased use of lithium and increased use of antidepressants did not reflect bipolar treatment guidelines. Future research should examine whether such prescribing patterns are associated with adverse clinical outcomes. [ABSTRACT FROM AUTHOR]

In the montane flora of Taiwan, Anaphalis nepalensis is the most widely present species of Anaphalis (Compositae), yet its taxonomic status is uncertain. In the present study, we employed both morphological and molecular data to demonstrate that A. nepalensis is misidentified and does not occur in Taiwan. In contrast, the name has been misapplied in Taiwan to the previously described endemic species, A. nagasawae, which can be further divided into two varieties based on the number of heads in the inflorescence: A. nagasawae var. nagasawae has one or two heads, while A. nagasawae var. niitakayamensis has three to five heads. Furthermore, the typification of A. nagasawae, A. nepalensis and Gnaphalium niitakayamense are discussed here. [ABSTRACT FROM AUTHOR]

This paper examines the migration aspirations of young people from the remote border area of Kinmen, Taiwan and their migratory trajectories—internal migration to the main island of Taiwan and cross‐border migration to China. Located between Taiwan and China, Kinmen is an offshore island with a long history of migration. Based on multi‐site ethnographic data from 30 young people, this paper explores their migratory trajectories and aspirations concerning the instability of socio‐political context and the growing social and cultural inequalities of today's globalised world, China's rise in particular. It contributes to the population geography literature by using migration aspiration as a critical lens to analyse how young people negotiate their borderland identity through mobility under the changing cross‐strait political economy. The paper emphasises the importance of considering the transformation of regional economy and culture when analysing youth migration experiences. In recognising the socially grounded aspects of migration aspiration, it highlights the fluid and transformative nature of migration to enrich our knowledge of how marginalised youth form subjectivities and negotiate complex identities through migration. The distinctive experiences of peripheral youth shed new light on the conceptualisation of border crossing, place and desires under the sway of globalisation. [ABSTRACT FROM AUTHOR]

On 2 April 2024, an MW 7.4 earthquake struck the northern Longitudinal Valley in eastern Taiwan, about 18 km SSW of Hualien, causing damage and casualties. In this study, we investigated a comprehensive geodetic data set, employing Global Navigation Satellite Systems (GNSS) and Interferometric Synthetic Aperture Radar (InSAR) measurements to assess the rupture geometry associated with earthquake sequence. Although geodetic data can be satisfactorily reproduced by simple single‐fault models (i.e., a high‐angle E‐dipping plane related to the Longitudinal Valley Fault (LVF), or a gentle W‐dipping surface associated with the Central Range Fault, CRF), a composite model involving the rupture of different fault segments (a major CRF‐related W‐dipping fault, a deep segment of the E‐dipping LVF, and the Milun Fault) is able to explain the observations, the distribution of seismicity, and the complex structural arrangement of the northernmost sector of the Longitudinal Valley. Plain Language Summary: On 2 April 2024, a powerful magnitude 7.4 earthquake hit the northern Longitudinal Valley in eastern Taiwan, near Hualien, causing significant damage and loss of life. This study examined a detailed set of geodetic data, including measurements from Global Navigation Satellite Systems (GNSS) and Interferometric Synthetic Aperture Radar (InSAR), to understand the geometry of the earthquake's rupture. While simple models focused on single faults (like the Longitudinal Valley Fault (LVF) or the Central Range Fault) can replicate the geodetic data to some extent, a more complex model involving the rupture of different fault segments (including a major Central Range Fault segment, a deep segment of the LVF, and the Milun Fault) better explains the data, seismic activity distribution, and the intricate structural layout of the northern part of the Longitudinal Valley. Key Points: We developed a composite rupture geometry of the MW 7.4 2024 Hualien (eastern Taiwan) earthquake sequenceThe earthquake primarily ruptured a major W‐dipping fault, while secondary affecting both deep and shallow segments of an E‐dipping faultOur results support the clear partitioning of the seismic release on different structures [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion The aim of the cohort research was to study the association between chronic prostatitis and the probability of herpes zoster in Taiwan.Using the National Health Insurance Research Database (NHIRD) of Taiwan, we selected male persons newly diagnosed with chronic prostatitis aged 20–84 years between 2013 and 2020. These male persons were then matched with a non‐prostatitis group who did not have a diagnosis of prostatitis by using 1:1 propensity score matching on age and relevant comorbidities. All participants were observed either until a new diagnosis of herpes zoster was noted or until the completion of the study period in 2020. Cox proportional hazards regression analysis was employed to study the hazard ratio (HR) and 95% confidence interval (CI) for the risk of herpes zoster associated with chronic prostatitis.A total of 69 239 participants with chronic prostatitis and 69 239 participants with non‐prostatitis were included in the analysis. The incidence rate of herpes zoster was higher in participants with chronic prostatitis compared to the non‐prostatitis group (8.03 per 1000 person‐years for chronic prostatitis group versus 4.74 per 1000 person‐years for non‐prostatitis group, incidence rate ratio = 1.69, and 95%CI = 1.59–1.81). After adjusting for co‐variables, participants with chronic prostatitis were found to have a higher risk of developing herpes zoster compared to the non‐prostatitis group (adjusted HR = 1.69, 95%CI = 1.59–1.81, and p < 0.001).This cohort research suggests that people with chronic prostatitis may have a greater risk of developing herpes zoster compared to the non‐prostatitis group in Taiwan. Preventive strategies, such as the administration of the herpes zoster vaccine, might be beneficial in people with chronic prostatitis. [ABSTRACT FROM AUTHOR]

Background: Examining student attention in physical classrooms is crucial, but it faces challenges due to the lack of accurate monitoring. Constraints posed by device limitations and the design of educational materials impede the integration of eye‐tracking technology in these settings. Objectives: This study aims to (1) develop a wearable eye‐tracking system specifically designed to monitor students' eye movements and gaze points on the projector screen within a physical classroom setting; (2) explore the impact of instructor gestures (by compare live instruction by an instructor and video‐recorded instruction) on student attention and examine the effectiveness of directing students' attention from text to image through instructor intervention. Methods: An innovative wearable eye‐tracking system was developed to monitor learners' eye movements within the physical classroom. Twenty‐five students participated in the experiment, which included two approaches: classroom lectured by the instructor and by a video presentation. Results and Conclusions: The results indicate that participants exhibit a stronger inclination to allocate additional time to text content than image content when receiving instruction through video presentations with a laser pointer in the physical classroom. This tendency can be attributed to the participants' requirement for longer reading and comprehension time in the absence of an instructor. Additionally, the instructor's gestures and body movements significantly impacted participants' fixation on text slides compared to the image slides. The heatmap analyses support these findings and further indicate that participants focus on the instructor's face rather than other body parts. Takeaways: The wearable eye‐tracking technology developed in this study holds promise for future educational research, offering further exploration and analysis opportunities. Lay Description: What is already known about this topic: Instructors play a pivotal role in capturing learners' attention during learning.The instructor's presence influences learners' attention in the physical classroom.Eye‐tracking offers a valuable advantage in measuring learning behaviours. What this paper adds: Utilizing eye‐tracking proves both feasible and effective for measuring classroom learning behaviours.Evidence shows that the instructor affects the participants' attention to text‐based slides.Evidence shows that the instructor's gestures and body movements significantly impact the participants' focus on text slides, as compared to image slides.Evidence indicates that participants focus more on the instructor's face than other body parts. Implications for practice and/or policy: Facial expressions play a vital role in capturing learners' attention.The wearable eye‐tracking technology developed in this study has great potential for future educational research, providing new avenues for exploration and analysis. [ABSTRACT FROM AUTHOR]

Background: Numerous higher education institutions worldwide have adopted English‐language‐medium computer science courses and integrated online problem‐solving competitions to bridge gaps in theory and practice (Alhamami Education and Information Technologies, 2021; 26: 6549–6562). Objectives: This study aimed to investigate the factors influencing the use of online competitions in machine learning courses and their impact on student learning. We also analyse disparities in learning outcomes and instructional language effects (Chinese vs. English). Methods: Among 123 participants at northern Taiwan university, 74 chose Chinese instruction (CMI), and 49 opted for English instruction (EMI). The course spanned 18 weeks: team formation in week one, data analysis, machine learning, and deep learning from week 2 to 8, draft proposals and oral presentations by week 9, instructor guidance in weeks 9–17, followed by off‐campus competitions. In week 18, students presented projects for evaluation by judges. Results: The results showed improved scores in competition proposal writing and oral presentations, especially for CMI students, who excelled in these areas and in terms of creativity. CMI students emphasized domain knowledge, implementation completeness, and technical depth in proposals. The EMI students focused on implementation completeness and artificial intelligence model accuracy, along with creativity. Conclusion: CMI students achieved superior outcomes in machine learning courses, particularly in terms of competition proposals, oral presentations, and increased creativity. Instructional language choice significantly influenced learning trajectories, leading to distinct knowledge development focuses for CMI and EMI. Lay Description: What is already known about this topic: Historically, artificial intelligence (AI) education focused on theory and skills, but now there are AI competitions that encourage real‐world problem‐solving (AIdea. Competitions. 2023. https://aidea-web.tw/about?lang=zh).Competition‐based learning bridges the gap between academia and industry, fostering creativity and talent discovery (Abou‐Warda and Roberts. International Journal of Educational Management. 2016; 30(5): 698).Computer science education globally uses English as the primary language (Alhamami. Education and Information Technologies, 2021; 26: 6549–6562).Non‐English speaking nations are adopting English as the medium of instruction, impacting teaching effectiveness (Alhamami. Education and Information Technologies, 2021; 26: 6549–6562). What this paper adds: This study combines online problem‐solving competitions with machine learning courses, using both Chinese and English instruction.Individual tutoring tailored to each team's competition topic provided real‐world problem‐solving experience and fostered school‐enterprise interactions.A rubric was created for evaluating domain knowledge, proposal writing, presentation skills, AI model accuracy, and competition outcomes by external experts, instructors, TAs, and peers. Implications for practice and/or policy: Combining competition‐based learning with machine learning courses can boost students' domain knowledge, competition skills, and outcomes.This study confirms that using Chinese instruction in machine learning benefits non‐native English‐speaking students more than English instruction.Our teaching approach for information technology courses can be applied to develop students' relevant skills in this field. [ABSTRACT FROM AUTHOR]

Suicide management skills are essential for nursing students, as they are often the initial healthcare contact for individuals at risk of suicide. Recognising signs of suicidal ideation and behaviour is critical for initiating timely interventions. This study aimed to develop and access the psychometric evaluation of the Suicide Management Competency Scale (SMCS) for nursing students. A first draft of the SMCS was initially developed following literature and focus group, and a scale containing 28 items was constructed. We recruited 216 participants from two nursing schools. Construct validity was evaluated with exploratory factor analysis (EFA). Internal consistency reliability was determined with Cronbach's alpha, and test–retest reliability was examined with intra‐class correlation. After four rounds of EFA and item analysis, we reduced the number of items to 16. We deleted 12 items, including 4 items for communalities less than 0.40, 3 items for cross‐loading, 3 items for factor loading less than 0.40, and 2 items for low corrected item–total correlation. The final 16‐item SMCS resulted in three subscales, which explained 55.813% of the total variance: emotional challenges in suicide risk assessment, delivering suicide interventions, and suicide risk nursing competence and confidence. Cronbach's alpha was 0.854 for the total score and 0.748 to 0.847 for the subscales. The newly developed SMCS was found to have good reliability and validity, suggesting that this scale could be used to evaluate nursing students' perceived competency in managing suicide, which might help cultivate competence in nurses' ability to effectively manage and prevent suicide, thus contributing to saving lives. [ABSTRACT FROM AUTHOR]

Objectives: Long sleep duration predicts adverse health outcomes in older adults. Impaired cardiac autonomic control (CAC) is a potential pathomechanism that links this relationship; however, the causal relationship between long sleep duration and CAC remains unclear. This study aimed to determine the temporal relationship between long sleep duration and poor CAC. Methods: This is a community‐based, fixed‐cohort, follow‐up study that recruited community‐dwelling older adults aged ≥ 65 years. Self‐reported sleep duration was categorized as short (≤ 5 h), mid‐range (6–7 h), and long (≥ 8 h). Participants with short or long sleep duration were defined as cases. CAC was measured using heart rate variability (HRV), and cases were classified using cutoffs defined by the lowest quintiles of four HRV parameters. Non‐case participants for sleep duration or CAC at baseline were followed. Binary and multinomial logistic regression analyses were conducted to examine baseline variables that predicted incident CAC decline and changes in sleep duration, respectively. Results: A total of 772 individuals were recruited, with a mean follow‐up period of 5.8 ± 1.7 years. In multivariable analyses, long sleep duration at baseline predicted a higher risk of cardiac vagal control decline in the follow‐up visit (odds ratio: 1.86, 95% confidence interval: 1.00–3.44). Conversely, all HRV parameters at baseline failed to predict changes in sleep duration at the follow‐up visit. Conclusions: Long sleep duration seems to precede the decline in CAC in community‐dwelling older adults. [ABSTRACT FROM AUTHOR]

Globally, one in three students are now enrolled in private higher education institutions (PHEIs), with the total reaching almost 70 million enrolments. This pattern is similar across a highly diverse Asia: more than 35% of students are enrolled in the private sector, and around 60% of higher education institutions (usually much smaller than their public counterparts) are private. But in East Asia, a combination of high participation rates and a rapidly ageing demographic has led to a complex, developing crisis, particularly in a much‐expanded private sector. Adding to the existing suite of problems – finance, over‐supply, declining standards, regulatory issues, and in some cases, corruption – the combined effect of recent COVID disruptions, regional economic reversals, and a rapidly ageing demographic has intensified existing problems, constituting a major crisis for the sector, especially more marginal private institutions. The analysis charts the various responses of governments in Japan, South Korea, Taiwan, and China, draws out some of the limits to reform, and poses the dilemma for the future of private higher education in the region. [ABSTRACT FROM AUTHOR]

Hair cortisol concentration (HCC) is a valuable biomarker for evaluating chronic stress in preschoolers. However, few studies have explored early life HCC and its associated factors. This prospective cohort study analysed the HCC in children aged 6–48 months and its associations with parental HCC as well as positive and negative parental mental health outcomes. We used data from the ongoing Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan (LEAPP‐HIT) project, conducted in Taipei between 2020 and 2024. Hair samples were collected from both parents and children in 177 families (91 samples obtained during pregnancy and 86 during the postpartum period). The parents also completed self‐reported questionnaires. Multiple linear regression was conducted to analyse the data. We observed a significant positive correlation between parents' and preschoolers' HCC. Furthermore, maternal depression (adjusted beta coefficient [aβ] = 0.09, 95% confidence interval [CI] = 0.02, 0.16) and perceived stress (aβ = 0.15, 95% CI = 0.02, 0.26) were positively associated with preschoolers' HCC. By contrast, higher maternal eudaimonia was associated with lower HCC in preschoolers (aβ = −0.11, 95% CI = −0.20, −0.01). For parents, maternal depression, anxiety, and perceived stress were independently associated with an increased HCC during the postnatal period, whereas maternal eudaimonia was negatively associated with HCC. Our results indicate that both mothers and fathers affect children's responses to stress. Assessment of cortisol stress hormone concentrations through hair samples can be a key means of detecting preschoolers' stress levels and enabling early intervention. [ABSTRACT FROM AUTHOR]

Maintaining the good mental health of Taiwanese military personnel is crucial, especially in light of incidents such as the Taiwan Strait crisis. Suicide is a leading cause of death among military personnel and alexithymia is a significant risk factor for suicidal ideation. However, the mechanisms linking alexithymia and suicidal ideation in this psychologically burdened population remain poorly understood. In total, 863 voluntary army military personnel from Taiwanese reserve brigades and combined‐arms brigades were enroled between May 2020 and February 2021. Structured questionnaires about alexithymia, perceived stress, depression, suicidal ideation, and background characteristics were used. Mediation analyses were conducted to examine the serial mediation roles of perceived stress and depression in the relationship between alexithymia and suicidal ideation. Significant positive correlations were observed between alexithymia, perceived stress, depression, and suicidal ideation in bivariate analyses. Serial mediation analyses revealed that alexithymia significantly predicted higher levels of perceived stress, subsequently leading to depressive symptoms, which were associated with suicidal ideation. Depression served as a significant mediator between alexithymia and suicidal ideation. The strongest mediating effect (71.4%) was observed in the pathway from alexithymia through perceived stress and depression to suicidal ideation. Limitations included the utilization of cross‐sectional data and a reliance on retrospective self‐report measures. Perceived stress and depression were identified as serial mediators in the association between alexithymia and suicidal ideation. Clinically, it is crucial to prioritise interventions that target emotional regulation skills and assess the presence of alexithymia to effectively reduce suicidal ideation in military personnel. [ABSTRACT FROM AUTHOR]

Objective: Immune checkpoint inhibitors (ICI) are recommended as the first‐line therapy for platinum‐refractory head and neck squamous cell carcinoma (HNSCC), a disease with a poor prognosis. However, biomarkers in this situation are rare. The objective was to identify radiomic features‐associated biomarkers to guide the prognosis and treatment opinions in the era of ICI. Methods: A total of 31 platinum‐refractory HNSCC patients were retrospectively enrolled. Of these, 65.5% (20/31) received ICI‐based therapy and 35.5% (11/31) did not. Radiomic features of the primary site at the onset of recurrent metastatic (R/M) status were extracted. Prognostic and predictive radiomic biomarkers were analysed. Results: The median overall survival from R/M status (R/M OS) was 9.6 months. Grey‐level co‐occurrence matrix‐associated texture features were the most important in identifying the patients with or without 9‐month R/M death. A radiomic risk‐stratification model was established and equally separated the patients into high‐, intermittent‐ and lower‐risk groups (1‐year R/M death rate, 100.0% vs. 70.8% vs. 27.1%, p = 0.001). Short‐run high grey‐level emphasis (SRHGE) was more suitable than programmed death ligand 1 (PD‐L1) expression in selecting whether patients received ICI‐based therapy. Conclusions: Radiomic features were effective prognostic and predictive biomarkers. Future studies are warranted. [ABSTRACT FROM AUTHOR]

The 108 Curriculum Guidelines (108CG) were implemented in high schools in Taiwan in 2019 and have increased the flexibility of curriculum offerings. Schools must now offer diverse curricula, flexible options and self‐directed learning courses based on students' needs and teachers' expertise. This study explores how rural high schools in Taiwan promote curriculum leadership following the implementation of the 108CG. Using a case school in southern Taiwan as the study site, it examines the current implementation of the 108CG in rural high schools, the processes and strategies that school members employ in applying curriculum leadership and the challenges they encounter. Six participants from the case school were interviewed, from August 2021 to May 2022. We also conducted observations and document analyses. The results show that the principal and mid‐level leaders' collaborative efforts are integral to advancing the 108CG. However, the school faces challenges in implementing the 108CG due to its environmental context. The principal's major challenge stems from the differing curriculum interpretations by tribal chiefs and families in the community. Mid‐level leaders also grapple with students' passive learning attitudes and the need for preparedness among teachers for curriculum reform. Although the 108CG have been in operation for more than 4 years, rural high schools continue to face challenges in implementing them. Introducing collaborative lesson planning and using checklists during curriculum review meetings could help track curriculum progress. [ABSTRACT FROM AUTHOR]

Taiwan plans to rapidly increase its industrial production capacity of electronic components while concurrently setting policies for its ecological transition. Given that the island is responsible for the manufacturing of a significant part of worldwide electronics components (including the most advanced CMOS technology nodes), the sustainability of the Taiwanese electronics industry is of critical interest. In this paper, we survey the environmental footprint of 16 Taiwanese electronic components manufacturers (ECMs) using corporate sustainability responsibility reports. Based on data from 2015 to 2020, we find out that the sample of ECMs in this study increased its greenhouse gas emissions by 7.5% per year, its final energy and electricity consumption by 8.8% and 8.9%, and its water usage by 6.1%. We show that the volume of manufactured electronic components and the environmental footprint compiled in this study are strongly correlated, which suggests that relative efficiency gains are not sufficient to curb the overall environmental footprint of ECMs on the island. Given the critical nature of the electronics industry for Taiwan's geopolitics and economics, the observed increase of energy consumption, and the slow renewable energy roll‐out, Taiwan could face a carbon lock‐in situation which will most likely prevent the achievement of carbon reduction goals and sustainability policies on the island. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusion Decreases in suicide rates during the coronavirus disease 2019 (COVID‐19) pandemic were found in several countries, including Taiwan and South Korea. We investigated the pattern of the reduction in suicide by sex, age, method, and outbreak period in the two countries.Suicide data for Taiwan (2015–2021) and South Korea (2017–2021) stratified by sex, age, method, and month were extracted from national mortality data files in the two countries. Negative binomial regression was used to estimate suicide rate ratios and 95% confidence intervals across outbreak and inter‐outbreak periods during the pandemic, relative to that expected based on pre‐pandemic trends, and their associations with economic and outbreak control stringency indicators.There were fewer‐than‐expected suicides in Taiwan (7%–16% fewer suicides over outbreaks and inter‐outbreaks) and South Korea (17% fewer suicides in outbreaks III and IV). Fewer‐than‐expected suicides were found primarily in the working‐age populations aged 25 to 64 years in Taiwan and those aged 45 to 64 years in South Korea. In both countries, fewer‐than‐expected suicides by charcoal burning during the pandemic were consistently found; the greatest reduction occurred when the outbreak control measures were most restricted. Increased time at residence was associated with decreased suicide rates in South Korea.Taiwan and South Korea showed reduced suicide rates during the COVID‐19 pandemic in 2020–2021. Potential reasons for the decrease in suicides may include reduced access to suicide means during outbreaks in the two countries. [ABSTRACT FROM AUTHOR]

Objective: In the present study, the cognitive theory of stress and coping was adopted as a framework and a mediation model was developed to investigate the long‐term effect of fathers' involvement in child care and mothers' appraisal of a supportive coparenting partnership (SCP) on postpartum depressed mood (PDM) and parenting self‐efficacy (PSE) in Taiwanese new mothers. Background: Due to the risk of PDM and low PSE, many new mothers struggle with first‐time motherhood. It is therefore meaningful to investigate the benefits of potential protective factors that can reduce the risk of PDM and enhance PSE, such as fathers' involvement in child care and mothers' appraisal of an SCP, to improve new mothers' postpartum adjustment. Method: Using secondary data from the nationwide longitudinal project Kids in Taiwan, we analyzed data provided by 2,020 Taiwanese new mothers at 3 and 6 months after delivery. We conducted structural equation modeling to test our hypothetical mediation model. Results: Fathers' involvement in child care was significantly positively related to mothers' appraisal of an SCP, which in turn had a significant effect on reducing the risk of PDM and increasing PSE in Taiwanese new mothers both concurrently and 3 months later. Conclusion: This study highlighted the concurrent and long‐term benefits of fathers' involvement in child care for new mothers' postpartum adjustment and the importance of new mothers' appraisal of an SCP as a significant mediator. Implications: These findings warrant the attention and efforts of family life educators, marriage counselors, and other experts in related fields to promote better parenting experiences for new parents. [ABSTRACT FROM AUTHOR]

With the ongoing implementation of personal insolvency practices in China's mainland, the realization of a nationwide personal insolvency system in China's mainland no longer appears distant. In the design of specific personal insolvency schemes, key elements to consider are establishing entry criteria, assessing the integrity of debtors, determining the duration of the discharge examination period, setting the length of the blocking period for subsequent insolvencies. Additionally, the availability of a simplified procedure for personal insolvency should also be considered. By analysing 12 official documents from regional practices in China's mainland and comparing them with corresponding regulations in Taiwan Region ("Taiwan") and Hong Kong, we can draw valuable experiences and identify shortcomings. This effort aims to lay the foundation for a unified personal insolvency system in the future of China's mainland. [ABSTRACT FROM AUTHOR]

This cross‐sectional study examined sleep disturbance associations between parents and their school‐age children with overweight and obesity. A 7‐day wrist‐worn actigraph recording was performed on 246 children aged 6–9 years with overweight and obesity recruited from 10 public elementary schools in Taipei, Taiwan. Children's sleep disturbance was assessed using the Children's Sleep Habits Questionnaire. Parental subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index, with parental depressive symptoms measured using the Epidemiologic Studies‐Depression Scale. General linear models were used to examine sleep disturbance associations within parent‐child dyads. The results showed that 208 (84.6%) children had a clinically significant sleep disturbance score, and 123 (50%) parents had poor sleep quality. Higher children's sleep disturbance scores significantly predicted poorer parental sleep quality (b = 0.11, p < 0.001). Poorer parental sleep quality was associated with more severe sleep disturbances in children (b = 0.46, p < 0.001). This association was independent of children's actigraphic sleep (all p > 0.05) and was not attenuated by adjustment for parental depressive symptoms (b = 0.14, p < 0.001). Findings from our study suggest that sleep disturbances occur in both parents and their school‐age children with overweight and obesity, with a significant bidirectional association between the two. Nurses and healthcare professionals should proactively assess and screen for sleep disturbances in parent‐child dyads of children with overweight and obesity. Future studies should develop family‐based sleep interventions and evaluate their effects on the sleep, health, and well‐being of children with overweight and obesity and their parents. [ABSTRACT FROM AUTHOR]

To assess a quality improvement project using alternating pressure air mattresses' impact on reducing full‐thickness pressure injuries by enhancing setting accuracy and device utilization. We retrospectively evaluated adult acute care unit patients with inclusion criteria (Braden scores ≤12 or existing full‐thickness pressure injuries) between May 2020 and August 2023. A wound team attempted to enhance the accuracy, utilization and effectiveness of alternating pressure air mattress implementation. The implementation outcomes were setting accuracy and accurate utilization rates. The clinical outcome was the full‐thickness pressure injury proportion. Utilization and allocation gaps were also calculated. The setting accuracy and accurate utilization rates increased (0.59 to 0.88 and 0.15 to 0.37, respectively). The full‐thickness pressure injury proportion decreased (0.17 to 0.06), with a strong negative correlation coefficient (−0.789) (p < 0.001) with accurate utilization rates. The full‐thickness pressure injury proportion declined faster during the project's complete phase than the partial phase (−0.0046 vs. −0.0016; p < 0.05). The utilization gap narrowed (99 to 60); however, the allocation gap increased (1 to 13), suggesting increased alternating pressure air mattress usage among ineligible patients. Targeting high‐risk patients for alternating pressure air mattress utilization and ensuring correct settings, both performed by a dedicated team, substantially reduces the full‐thickness pressure injury incidence. [ABSTRACT FROM AUTHOR]

This study investigated sex differences perceived relocation stress and glycemic control among older adults with type 2 diabetes in long‐term care facilities. A cross‐sectional correlation design was used to recruit 120 residents during their first year after moving into the facilities in southern Taiwan. The results showed that almost two‐thirds of the participants (64.2%) were women. The mean age was 79.62 (SD = 1.71). Older women with diabetes were reported to have significantly lower levels of education and poor glycemic control but higher levels of perceived relocation stress than men; however, functional independence was significantly higher in men. Although perceived relocation stress significantly predicted HbA1c levels in both women and men, length of stay was also significant in predicting HbA1c levels in women. These findings indicate the need for effective physical and psychological measures to improve glycemic control during the first year of stay in long‐term care facilities. [ABSTRACT FROM AUTHOR]

Moderate physical activity is related to reduced mortality in hemodialysis patients. However, most hemodialysis patients have low physical activity levels for complex reasons. This study investigated the determinants of moderate‐to‐high physical activity levels and whether psychosocial correlates are associated with engagement in moderate‐to‐high physical activity among hemodialysis patients. A cross‐sectional survey was conducted with 134 hemodialysis outpatients, aged 64.7 years, in three hemodialysis centers in Taiwan. Data on sociodemographics, comorbidities, lifestyles, and psychosocial correlates, including perceived benefits, barriers, and self‐efficacy of physical activity, were collected. Multiple logistic regression analyses were performed. Results showed that patients with moderate‐to‐high physical activity levels constituted a significantly lower proportion of current smokers and had fewer perceived physical activity barriers and higher self‐efficacy of physical activity compared with those with low levels. After adjusting for potential sociodemographic covariates, current employment, nonsmoking status, and high self‐efficacy of physical activity were significantly associated with moderate‐to‐high physical activity levels. Developing strategies to improve the self‐efficacy of physical activity, support employment, and enhance anti‐smoking campaigns in hemodialysis patients can help them engage in moderate‐to‐high levels of physical activity. [ABSTRACT FROM AUTHOR]

The public's perception of the nursing image deeply influences nurses' work and professional development. However, the Taiwanese public's perception of nursing remains unclear. This study aimed to determine the validity and reliability of a Chinese version of the Nursing Image Scale (NIS) in Taiwan. This was a psychometric study using a cross‐sectional survey. Participants were recruited via the snowball sampling method through the online community software LINE from August 1 to 13, 2019. After data collection, the construction and validation of the NIS to measure public opinion were assessed, including content validity, corrected item‐total correlation, exploratory factor analysis (EFA), and reliability. A total of 1331 valid responses were included in the analysis. After EFA analysis, the 20 scale items were divided across the four domains of prudence and care, innovation and cooperation, efficiency and division, and professionalism and respect. The NIS (Chinese version) was valid and reliable for measuring public opinion and may be used to examine changes in public perceptions of nursing. [ABSTRACT FROM AUTHOR]

Objectives: Pharmacological and non‐pharmacological interventions are mostly designed for patients with early Alzheimer's disease (AD) dementia. Long‐term case management and planning for the remainder of life with disability require an estimation of the survival duration. Methods: This cohort study utilized data from the National Health Insurance Research Database, Taiwan, to identify incident cases of mild‐to‐moderate AD dementia diagnosed from 2000 to 2002, followed through December 31, 2017. A multivariate Cox proportional hazards regression model was constructed to compare the independent effects of age, sex, and comorbidities on all‐cause mortality risk. Cumulative survival rates and survival times were estimated. Results: A total of 5258 incident cases were identified, all treated with cholinesterase inhibitors after diagnosis confirmation by an expert committee. During the 15‐year follow‐up period, 4331 deaths occurred. The 1‐, 3‐, 5‐, 10‐, and 15‐year cumulative survival rates were 95, 92, 67, 37, and 18, respectively. The median (95% CI) survival time after diagnosis was 7.69 (7.46–7.90) years overall, 6.37 (6.06–6.65) years in men, and 8.81 (8.49–9.12) years in women. After stratification by age and number of comorbidities, the median survival time ranged from 13.72 (ages 40–64) to 5.29 (ages ≥ 80) years among those without comorbidities. For those with ≥ 3 comorbidities, the median survival times decreased to 6.43 for individuals diagnosed at ages 40–64 and to 2.98 years for those diagnosed at age 80 or older. Conclusions: This nationwide, large, long‐term cohort study provided survival rates and durations from diagnosis to death, varying by sex, age group, and presence/number of comorbidities. This information can serve as a foundation for further cost‐effectiveness studies on new treatments, and may aid clinicians, patients, and families in shared decision‐making and advance personalized care planning for early dementia cases. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is a major health issue worldwide. As the population ages, more older patients including octogenarians will require CRC treatment. However, this vulnerable group has decreased functional reserves and increased surgical risks. Enhanced recovery after surgery (ERAS) pathways aim to reduce surgical stress and complications, but concerns remain about applying ERAS protocols to older patients. We assessed whether a modified ERAS (mERAS) protocol combined would improve outcomes in octogenarian CRC patients undergoing minimally invasive surgery. Methods: In this retrospective cohort study, we compared 360 non‐octogenarians aged 50–64 years and 114 octogenarians aged 80–89 years before and after mERAS protocol implementation. Outcomes including postoperative functionary recovery, length of stay, complications, emergency department visits, and readmissions were analyzed. Results: Despite comparable tumor characteristics, octogenarians had poorer nutrition, American Society of Anesthesiologists status, and more comorbidities. After mERAS, octogenarians had reduced complications, faster return of bowel function, and shorter postoperative length of stay, similar to non‐octogenarians. mERAS implementation improved recovery in both groups without increasing emergency department visits or readmissions. Conclusion: Although less remarkable than in non‐octogenarians, mERAS protocols mitigated higher complication rates and improved recovery in octogenarians after minimally invasive surgery for CRC, confirming protocol feasibility and safety in this vulnerable population. [ABSTRACT FROM AUTHOR]

Objectives: To investigate community health centers' (CHCs) health literacy. Design: A cross‐sectional study. Sample: A total of 374 CHCs were surveyed and 258 CHCs responded, with an effective questionnaire response rate of 69.0%. Measurements: Data were collected by using a self‐developed health literacy assessment tool to survey CHCs' health literacy throughout Taiwan from January to December 2019. Results: The item of organizational health literacy (OHL) with the highest proportion of CHCs not implementing them was "Design of easy‐to‐use computer applications and new media" (47.3% not yet achieved), followed by "Involving target audiences in document and service development" (34.9% not yet achieved). CHCs located in northern Taiwan had higher health literacy achievement scores than those in other regions, and those in urban areas had higher health literacy achievement scores than those in general and remote areas. Conclusions: This study identified items with poor implementation of OHL and found regional differences in health literacy among CHCs. The findings can inform the development of targeted interventions to improve health literacy in underperforming CHCs and guide policymakers in allocating resources to regions and areas in need of. [ABSTRACT FROM AUTHOR]

Aim: To determine the effect of nurses' mood at work (positive and negative) on work engagement and whether work morale mediates this relationship. Background: Nurses' work engagement is a key research area, yet limited data regarding the relationship between nurses' mood at work and work engagement are available. Therefore, how nurses' positive or negative mood at work affects their work engagement remains unclear. Methods: This study analyzed nurses from a medical center in Taipei City. A total of 279 completed questionnaires were returned. The data were analyzed using two‐stage structural equation modeling to test the hypothesized relationships. Findings: Nurses' positive mood had a significantly positive effect on work morale, whereas their negative mood had a significantly negative effect on work morale. Additionally, work morale played a mediating role in the relationship between mood at work and work engagement. Conclusion: The results revealed that nurses' moods affected their work engagement and that this relationship was affected by work morale. Implications for nursing and health policy: Healthcare institutions and hospitals could develop a positive work environment to help nurses maintain their good mood and reduce negative affectivity. They should also provide nurses with counseling services, offer morale‐boosting activities, and adopt an inspirational leadership style to maintain their work morale. [ABSTRACT FROM AUTHOR]

Face culture is a crucial facet of East Asia. The most common self‐report measure for face concern is the unidimensional Loss of Face Scale. In this study, we examined the dimensionality, factor structure, and validity of the Loss of Face Scale in two samples. Sample 1 (N = 602) consisted of 303 Taiwanese mothers and 299 U.S. mothers. Sample 2 (N = 602) was an independent sample from Sample 1, consisting of 294 Taiwanese mothers and 308 U.S. mothers. We proposed a modified 15‐item four‐dimensional factor structure to better capture the complexity of face. Four sub‐domains emerged from the results of exploratory structural equation modelling: Low‐Profile, Over‐Preparation, Harmony Seeking, and Non‐Aggression. Multigroup confirmatory factor analysis indicated configural and metric invariance but failed to establish full scalar invariance across countries. Convergent validity was supported by positive correlations with other Asian cultural values. While all four domains of face showed small to moderate correlations with depression in the U.S., only Low‐Profile was associated with depression in Taiwan, suggesting that not all aspects of face concern are non‐adaptive in East Asian contexts. Future studies should consider the multidimensional nature of face as well as how different dimensions affect mental and social well‐being across cultures. [ABSTRACT FROM AUTHOR]

Societal Impact Statement: Multiple cropping, the cultivation of several crops on the same land in a year, occupied an important part of Taiwan's agricultural research from 1950 to 1970. This research originated in the context of Taiwan's land reform and diversification programs and their connections to the government's political ambition to maximize food production. The study of how multiple cropping was politicized and depoliticized by different actors helps to expand the narratives of the Green Revolution in Asia, analyze their legacies, and highlight Taiwan's role in the international exchange of visions of agricultural development during the Cold War. Summary: Scholars have recently expanded the history of the Green Revolution to move beyond the narrative of North–South technological diffusion. This article enriches the scholarship with the case of multiple cropping in Taiwan and its connection to Cold War geopolitics.Rice productivity in postwar Taiwan was boosted through a land reform launched by the Sino‐American Joint Commission on Rural Reconstruction (JCRR) in the 1950s. Backed by American aid and staffed by scientists from the Republic of China (ROC) government, the JCRR envisioned to turn tenant farmers into landowners so as to encourage labor input and adoption of seeds and fertilizers.By 1960, the JCRR presented its reform as a "bloodless social revolution" and extended its focus to multiple cropping through a diversification program. The JCRR further created the Asian Vegetable Research and Development Center (AVRDC) in 1971 to spread Taiwan's breeding and cropping techniques. The ROC's diplomatic isolation in the 1970s, however, prompted the center to reinterpret Taiwan's success in multiple cropping from a political achievement to a technological triumph, thus reinforcing the technology‐driven narrative used by the International Rice Research Institute (IRRI).Through Taiwan's influences on IRRI's rice breeding and multiple cropping research, this paper illustrates that the history of the Green Revolution requires more complex narratives. In addition, with Taiwan's political and economic transition since the 1980s, farmers began to reclaim their voice and influence agricultural policies. The case thus highlights the need of democratic participation in agricultural research, a concern that remains relevant today. [ABSTRACT FROM AUTHOR]

Background: Medication‐related problem is a concerning issue in older adults with multimorbidity due to complexity of disease conditions and polypharmacy, and may lead to increase in risk for adverse health outcomes. This study aims to investigate the prevalence and associated factors of potentially inappropriate medication use among the growing population of older adults with multimorbidity in Taiwan. Method: The study population was composed of patients who were aged 65 years or older with multimorbidity (two or more chronic diseases) and had at least one outpatient clinic visit with drug prescription in 2018 identified from the Taiwan National Health Insurance Research Database. Potentially inappropriate medication use was defined using the 2019 Beers criteria for drugs to be avoided for older adults. Multiple logistic regression model was conducted to examine patient‐related and prescriber‐related factors associated with PIM use. Results: A total of 2 432 416 patients (69.7% of the entire older adult population) had multimorbidity and received at least one drug prescription at the outpatient clinic in Taiwan in 2018. The prevalence of having at least one PIM in this population was found to be 85.6%. Patient‐related factors (age, sex, specific chronic diseases, frequency of outpatient visits) and prescriber‐related factors (physician characteristics, healthcare setting, total number of medications, prior PIM use) were found to be associated with use of PIM. Conclusion: High prevalence of PIM use was found in older patients with multimorbidity in Taiwan. Both patient‐related and prescriber‐related factors had been found to be predictors of PIM use, and should be addressed when trying to improve the medication quality in this population. [ABSTRACT FROM AUTHOR]

Introduction: The use of stereotactic ablative radiotherapy (SABR) over conventional fractionated radiotherapy (CFRT) for early‐stage non‐small‐cell lung cancer (NSCLC) has been advocated, but is also debated in the literature. Methods: In this retrospective cohort study, we adopted a target trial emulation framework to identify eligible patients diagnosed between 2011 and 2021 using the Taiwan Cancer Registry. In the primary analysis, the overall survival (OS) was the primary endpoint, whereas incidences of lung cancer mortality and radiation pulmonary toxicity were the secondary endpoints. Extensive supplementary analyses were also conducted. Results: We included 351 patients in the primary analysis and found that the OS was not significantly different between the SABR (n = 290) and CFRT (n = 61) groups. The propensity score weighting adjusted hazard ratio of death was 0.75 (95% confidence interval 0.53–1.07, p = 0.118). The secondary endpoints and supplementary analyses showed no significant differences. Conclusions: The OS of patients with early‐stage NSCLC treated with SABR was not significantly different from that of patients treated with CFRT alone. The results of the relevant ongoing clinical trials are eagerly awaited. [ABSTRACT FROM AUTHOR]

This paper explores how non‐Indigenous teachers understand challenges and barriers to academic progress and success for Indigenous students in Taiwan. Drawing on data from a study with 17 teachers of Han Taiwanese and Hakka background who had worked closely with Indigenous students from elementary to high school across Taiwan, we utilise Expectancy‐Value Theory to explore teacher participants’ views of the barriers and challenges to educational success for their Indigenous students. Previous research suggests a deficit view among majority background teachers, depicting them as biased against Indigenous peoples and lacking relevant knowledge that would allow them to teach Indigenous students and about Indigenous cultures and histories. In contrast with this previous research, the teachers we interviewed exhibited a good and nuanced understanding of the obstacles and challenges of Indigenous students, families and communities which prevent their success. The teachers in our study indicated that they lack agency and are limited by structural forces in effecting meaningful change. Far from holding deficit views, the teachers interviewed pointed to the importance of working together with Indigenous families and communities to support the learning of Indigenous students. In our conclusion we point to ways of capitalising on the non‐deficit positive views captured here to effect long‐term sustainable change to support teachers to, in turn, support the learning of Indigenous students. [ABSTRACT FROM AUTHOR]

Aim: Chronic diseases are influential components of stroke, one of the dominant reasons for dementia and premature mortality. Environmental risks are risk factors for transitioning from stroke to dementia. This study addresses the transition behaviors in stroke and dementia development associated with chronic diseases and environmental risks. Methods: This study is an integrated survey of medical and environmental informatics concerning stroke patients' quality of life. A total of 10 627 stroke patients diagnosed in Taiwan were surveyed in this study. A covariate model and subgroup analysis were used to evaluate the influence of chronic diseases and environmental risk factors (i.e., divorce rate, unemployment rate, solitariness rate, temperature, and air pollution rate) on stroke and the corresponding dementia transition behaviors. Results: This study constructed a total of 98 covariate analysis models, consisting of 14 transition types [10 transitions from chronic diseases to stroke (5 metabolic risk states × 2 stroke states) and 4 transitions from stroke to dementia (2 stroke states × 2 dementia states)] by 7 covariates (i.e., sex, age, divorce rate, unemployment rate, temperature, air pollution, and solitariness rate). Among the 98 transitions, 26 were statistically significant. Conclusions: Sex, age, divorce rate, unemployment rate, temperature, and air pollution rate exerted a partially significant influence on the transition from chronic diseases to stroke. Sex, age, unemployment rate, and temperature partially influenced the transition from stroke to dementia. This study also considered high‐risk sub‐populations of stroke patients, particularly males aged 65 years and below. Geriatr Gerontol Int 2024; 24: 766–772. [ABSTRACT FROM AUTHOR]

This research deals with issues of Indigeneity and autonomy in Taiwan by notionally turning things inside‐out. We aim to contextualise international geopolitics and local polity by considering the Tayal people, one of 16 nationally recognised Indigenous groups living in northern Taiwan. We reject the conventional geopolitical lens of Great Power claims as the only and best way to understand contemporary Taiwan and chooses to refocus and rescale the geopolitical lens. We seek to reconsider Taiwan's history, geography, and territory by reference to the conceptual lenses that apply to Tayal peoples' experiences. The research methods employed include geographical fieldwork, literature reviews, and archival studies. The research acknowledges Tayal people's custodianship over their territory and provides an in‐depth discussion on the colonial history and geography of Taiwan. In the process, we unsettle what is taken‐for‐granted and rescale erasure, violence, and resistance in Indigenous Taiwan. In building a Tayal‐centred positionality, we reframe geopolitical dynamics as connections within territories and across boundaries rather than as disputes over deeply contested boundaries. Neither Tayal people nor other Indigenous peoples in Taiwan ever ceded their sovereignty. Regardless of any broader geopolitics shifts, Tayal territory remains just the way it always has—Tayal territory. [ABSTRACT FROM AUTHOR]

This study investigated the ability of a sarcopenia screening test to predict mortality among cancer inpatients. We conducted a prospective study of patients admitted to the oncology ward of a teaching hospital in southern Taiwan. Over a 5‐month period, 82 patients were enrolled for evaluation and were followed for 3 years. All participants received a comprehensive assessment at the time of admission, including Eastern Cooperative Oncology Group (ECOG) performance status, cognitive ability, nutrition index, body mass index, and short physical performance battery (SPPB). Age, ECOG performance status, dementia, SPPB score, and albumin level were associated with sarcopenia. Of the enrolled participants, 53 (64.6%) were diagnosed with sarcopenia. Patients with sarcopenia were associated with worse overall survival (OS) than patients without sarcopenia (28.8% vs. 82%, p = 0.01). Metastasis (hazard ratio [HR]: 5.166; 95% confidence interval [CI]: 1.358–19.656) and albumin level (HR: 4.346; 95% CI: 1.493–12.654) were independent and significant predictors of OS for the whole study population. Age was a predictor of 2‐year all‐cause mortality among patients aged ≥65 years but not among those aged <65 years (OS: 25.6% vs. 100%, p = 0.04). To summarize, the sarcopenia screening results were found to predict OS and all‐cause mortality and may be helpful for patient stratification during in‐hospital care. [ABSTRACT FROM AUTHOR]

Aim: To determine the significant risk factors of cerebral palsy (CP) in Taiwanese children and the associations between infant‐related and parent‐related factors. Method: Data from 1 459 093 infants and their parents in Taiwan's national databases collected between 2009 and 2016 were used. The cohort with CP included children diagnosed with CP between birth and age 3 years; a total of 3254 children with CP were included in the final analysis. Hierarchical logistic regression models were used to estimate the odds ratio for the risk factors of CP. Results: The hierarchical logistic regression models indicated that significant risk factors associated with CP are suburban location, low income, maternal and paternal diabetes mellitus, paternal substance abuse, paternal seizure disorder, male sex, birth by Cesarean section, singleton birth, low birthweight, being born extremely and very preterm, intraventricular hemorrhage, and periventricular leukomalacia, as well as tube feeding, ventilator use, and dopamine administration within 6 months of age. Interpretation: In addition to common maternal and infant risk factors, we identified significant paternal risk factors associated with CP, including diabetes mellitus, seizure disorder, and substance abuse. The combination of maternal, paternal, and infant risk factors in CP holds great promise for early identification and intervention. [ABSTRACT FROM AUTHOR]