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Introduction: Patients require prolonged mechanical ventilation to overcome respiratory failure in the chronic respiratory care ward; however, how to facilitate ventilator weaning using a nurse-led strategy is limited. Objectives: This study aimed to examine the impact of adjusting ventilator trigger sensitivity as inspiratory muscle training on weaning parameters in patients with prolonged ventilator dependence. Methods: Multiple pre-test-post-test with a non-equivalent control group design was conducted at a chronic respiratory care ward in southern Taiwan. A convenience sampling method was used to recruit patients who received prolonged mechanical ventilation for more than 21 days into control (n = 20) and intervention groups (n = 22). Adjustment of ventilator trigger sensitivity started from 10% of the initial maximum inspiratory pressure and increased to 40% after a training period of six weeks. The weaning parameters were collected for pre-test and multiple post-tests, and statistical analysis of treatment effects was performed using the generalized estimating equation. Results: Magnitude of weaning parameters was significantly higher in the intervention group after the six-week training, including maximum inspiratory pressure, rapid shallow breathing index, tidal volume, and ratio of arterial-to-inspired oxygen. Conclusion: Adjustment of ventilator trigger sensitivity as inspiratory muscle training can help prolonged ventilator-dependent patients improve their respiratory muscle strength, breathing patterns, and oxygenation. [ABSTRACT FROM AUTHOR]

Background: Supportive care is a primary method for treating dengue fever. Understanding the symptoms of dengue fever and its related nursing diagnosis is crucial for nurses as references for individual care. This research study was motivated by the few literature reviews available on this topic. Purpose: This study was developed to elucidate the symptoms experienced by hospitalized patients with dengue fever and to compare the consistency between symptoms and nursing diagnoses. Methods: A retrospective descriptive research method was employed. The data were collected from the electronic medical records of patients in the data pools of two regional hospitals in Kaohsiung City. A total of 105 patient records were acquired covering the period 2014-2016. IBM SPSS Statistics v22 was used to examine the descriptive statistics of patient attributes and symptoms of dengue fever using averages and percentages and the inferential statistics of symptoms, hospitalization days, and nursing diagnosis using the Chi-square test and Kappa consistency coefficient. Results: The average age of inpatients was 51.0 ± 27.3 years and the average length of hospital stays was 6.1 ± 3.6 days. The common symptoms were fever and headache. The consistency between nursing diagnosis and symptoms ranged up to 45.4%, including hyperthermia, acute pain, nausea, risk of ineffective gastrointestinal perfusion, and risk of bleeding. Inconsistency of nursing diagnosis was found to be 27.3%, including anxiety, deficient fluid volume, and risk of falls. The rate of undiagnosed symptoms was found to be 27.3%, including diarrhea, risk of infection, and impaired oral mucous membrane. Conclusions / Implications for Practice: The reasons for the inconsistency between symptoms and nursing diagnoses may relate to insufficient nursing knowledge of dengue fever and inadequate nursing diagnosis education resulting in insufficient clinical experience / poor judgment amongst nursing staff. The findings of this study suggest the need for continuity of education to make the use of a dengue-fever-symptom checklist more widespread in patient care. [ABSTRACT FROM AUTHOR]

Background: The advancements in medicine have brought about a greater increase in aging population. In Taiwan, one in 10 people is elderly. Being elderly is the greatest risk factor for bloodstream infections in the intensive care units (ICU). It has been associated with increased length of stay in the ICU and increased mortality. Methods: This retrospective case-control study was conducted to identify the risk factors and pathogens associated with bloodstream infections (BSIs) among elderly ICU patients. We collected data from 132 ICU patients above 65 years old that were matched with 132 controls in ICUs in Taiwan from 2006 to 2011. Results: The risk factors associated with bloodstream infections in this population were central venous catheter placement (OR, 7.219; 95%CI, 0.843-61.842),central venous catheter replacement (OR, 6.278; 95%CI, 2.054-19.190), hemodialysis (OR, 6.010; 95%CI, 1.516-23.833), blood transfusion (OR,3.171; 95%CI, 1.161-8.659), and other infections (OR,9.440; 95%CI, 1.075-82.897). The most common pathogens were Candida species (22.7%), Klebsiella pneumoniae (10.6%), Acinetobacter baumannii complex (9.9%), and Staphylococcus aureus (9.9%). Conclusion: Our study supports the need for care bundle procedures during the implementation of intravascular catheterization, during catheter use, replacement of catheter equipment, and quality of catheter care, to prevent bloodstream infections among elderly patients in ICUs. [ABSTRACT FROM AUTHOR]

The article presents information on a study which analyzes the effect of pitching training with appropriate baseball weights on the performance of adolescent players. The study measured throwing accuracy, throwing velocity, arm swing velocity, and maximum shoulder external rotation (MSER) from 10 maximum efforts throws.

Background: There is little understanding of the reasons for the limited communication between patients and conventional healthcare professionals regarding patients' use of complementary and alternative medicine (CAM). The purpose of this study is to explore the predictors of outpatients' decision to disclose their use of natural products to conventional healthcare professionals. Methods: A mixed method design was used. Quantitative data were obtained through a survey and qualitative data were obtained from semi-structured interviews. A total of 257 outpatients who fulfilled the criteria of having used natural products prior to the interview were recruited for this study. Subsequently, 39 patients of those who completed the survey were further selected to take part in an in-depth qualitative interview. Results: Predictors of the decision to disclose the use of natural products to conventional healthcare professionals included age, frequency of clinic visits, knowledge of the natural products and the attitude towards the benefits of CAM use. The themes that emerged from the qualitative data included safeness of the natural products, consulting alternative sources of information, apprehension regarding the development of negative relationships with healthcare professionals and reactions from the healthcare professionals. Conclusions: Understanding the factors and reasons affecting patients' decision as to whether to disclose their use of natural products provides an opportunity for conventional healthcare professionals to communicate better with patients. It is important to encourage patients to disclose their use of natural products in order to provide responsible health care as well as increasing patient safety regarding medication usage. [ABSTRACT FROM AUTHOR]