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Introduction: Arteriovenous fistula or arteriovenous graft is essential to long‐term survival and quality of life in patients receiving hemodialysis. To date, no research has examined the clinical impacts of different puncture methods. This study compared the rope ladder and area puncture techniques in terms of vascular patency, pain, and quality of life among patients receiving hemodialysis. Methods: A prospective longitudinal study was performed with 6‐month follow‐up. A total of 98 participants recruited from a hemodialysis center in Taiwan were randomly assigned to receive the rope ladder technique (experimental group) or the area puncture technique (control group). Vascular patency was assessed by examining access flow and percutaneous transluminal angioplasty rate. Pain and quality of life were measured using the Numerical Pain Rating Scale (NPRS) and Kidney Disease Quality of Life Instrument (KDQOL‐36™), respectively. All outcome variables were measured repeatedly and analyzed using a generalized estimating equation. Results: Overall, quality of life was significantly better for the experimental group than for the control group (β = 47.23, p < 0.001). The percutaneous transluminal angioplasty rate was lower for the experimental group than for the control group (12.0% vs. 18.8%). However, no significant differences were found in access flow and pain level between the two groups over time. Conclusion: Hemodialysis patients who received the rope ladder puncture technique had a lower percutaneous angioplasty rate and better quality of life than patients who received the area puncture technique, suggesting that the rope ladder technique could be implemented as a routine cannulation method in hemodialysis clinics. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has significantly impacted everyone's lives, challenging us in ways that can be frustrating, daunting, and intensely emotive. This qualitative study explored the isolation experiences of patients with COVID‐19 in a hospital in northern Taiwan. We collected data from nine patients in June–July 2020, conducting semi‐structured, virtual face‐to‐face, in‐depth interviews to gather input on two topics: (1) the psychological effect of hospital isolation on patients, including the psychological burden, stress response, support, disease stigma, and fear of returning to society; and (2) the patients' cognition and behaviors, which included tracking epidemic information, monitoring disease progression, soliciting suggestions about hospital isolation, and gauging comprehension after recovery. The results confirmed that hospital isolation significantly impacts patients physically, psychologically, spiritually, and socially. Thus, the isolated patients faced the dual challenges of fighting, adapting to, and recovering from the disease itself and struggling in isolation to maintain positive beliefs, independently assess their condition, and gain strength from the knowledge of continuing social support. [ABSTRACT FROM AUTHOR]

A Gram-stain-negative, strictly aerobic, yellow-pigmented bacterial strain, designated as T28T, was isolated from seawater of the shallow-sea hydrothermal system, Kueishantao Islet, Taiwan, China. Cells were oxidase-negative and catalase-positive rods without gliding motility. Growth was observed at 10–40 °C (optimum, 30 °C), at pH 5.0–8.0 (optimum, pH 6.0) and in the presence of 0–5% (w/v) NaCl (optimum, 2.5%). Strain T28T contained menaquinone 6 as the only isoprenoid quinone. The main cellular fatty acids were iso-C15:0, iso-C15:1 G, and iso-C17:03-OH, summed feature 3 (C16:1ω7c/ω6c). Polar lipids contain diphosphatidylglycerol, phosphatidylethanolamine, two unidentified phospholipids, six unidentified lipids, an unidentified aminolipid, and one unidentified aminophospholipids. The genomic DNA G + C content was 34.4 mol%. The 16S rRNA gene sequence of strain T28T shared highest similarity with Maribacter arcticus (97.7%). Phylogenetic analysis based on 16S rRNA gene sequences revealed that the strain T28T belongs to the genus Maribacter. On the basis of phylogenetic data and several distinct phenotypic characteristics, strain T28T represents a novel species, for which the name Maribacter hydrothermalis sp. nov. is proposed. The type strain is T28T (=CGMCC 1.15788T = JCM 31510T). [ABSTRACT FROM AUTHOR]

This study investigates the subjective experiences of terminal cancer patients who expedite their corneal donation decisions. The percentage of cancer patients who donate their corneas postmortem is low in Taiwan. The reasons are complex and needs further exploration. A qualitative design using content analysis was used. A semistructured interview approach was adopted to interview cancer patients recruited from a cancer ward in northern Taiwan. The study findings show that the factors contributing to an aversive preference of cancer patients included the necessity to consider the emotions of family members, traditional perceptions, religious reasons, disease, and no reason at all. Most cancer patients maintain a negative stance toward corneal donation. The results obtained in the present study can be used as a reference for future in-service education and promotional efforts regarding corneal donation. Discussing cornea donation needs to become a routine end-of-life care discussion. [ABSTRACT FROM AUTHOR]

Objectives: Patient satisfaction can provide a measure of service quality and serve as a predictor of health-related behaviors. Little is known about how patients' satisfaction with clinician-patient interactions affects their adherence to taking analgesics. The purposes of this study were to (1) investigate the predictors of patients' satisfaction with clinicians, and (2) examine whether patients' satisfaction with their clinicians can improve adherence to analgesic use.Design: A cross-sectional and descriptive design was used.Setting: Outpatient oncology clinic at a medical center in Taiwan.Participants: A convenience sample (N = 309) was recruited.Main Outcome Measures: The Medical Interview Satisfaction Scale 21 - Chinese Version, Short Version of the Barriers Questionnaire - Taiwan Form, Taiwanese version of the Morisky Medication Adherence Measure, and Interpersonal Physician Trust Scale - Chinese version, and Brief Pain Inventory Chinese Version.Results: Variables that could significantly predict patients' satisfaction were patient age and trust in clinicians, which together accounted for 33% of the total variance. Patients' satisfaction with their clinicians significantly predicted patients' adherence to medication use (OR = 3.10, P < 0.05). There was an interactive effect (OR = 0.12, P < 0.05) between patients' satisfaction and barriers to analgesic use. Correlation coefficients between barriers to analgesic use and patients' adherence are -0.52 (P < 0.001) and -0.13 (P = 0.20) in the higher satisfaction and lower satisfaction patients, respectively.Conclusions: Patients' satisfaction with their clinicians can have a positive effect on changing analgesics adherence behaviors when patients hold incorrect beliefs about analgesics. Patients' satisfaction has an important role in enhancement of analgesics adherence behaviors. [ABSTRACT FROM AUTHOR]

With the development of information technology and Internet, the criminal model has been changed. The Internet has become an instrument of crime as a new type of criminal means, which is called cybercrime. Since the implementation methods are different between cybercrime and traditional crime, the crime evidences will also different. And the court judgments will be affected by the evidences, the results of judgment will also be different. Furthermore, the litigation proceedings used in the cybercrime and traditional crime are slightly different. It will affect the results of court judgment whether it is guilt or innocence. In this paper, we describe the common cybercrimes and the results of actual court judgement in Taiwan, collate the common evidence types of cybercrime, propose a cybercrime selection method used for court judgements to collect the judgements, analyze the statistics results, and compare the litigation processes between the traditional crime and cybercrime. According to the above results, we wish the judges process the cybercrime cases will be more careful to avoid misjudgements. [ABSTRACT FROM AUTHOR]

Abstract: Context: It is well known that insomnia is highly prevalent in cancer patients. Although various studies have used the Athens Insomnia Scale (AIS) for insomnia assessment, it has never been applied to cancer patients with insomnia. Objectives: The purpose of this study was to establish the reliability and validity of the Taiwanese AIS version (AIS-T) and evaluate the severity of insomnia among cancer patients in Taiwan. Methods: Using a cross-sectional research design, 195 cancer patients (n =195) were recruited from outpatient oncology clinics. Results: Cronbach’s alpha for internal consistency was 0.83, and the test-retest reliability was 0.94 over an interval of three days, based on a sample of 30 patients. Moreover, concurrent validity could be evaluated by significant correlations of the AIS-T with the Pittsburgh Sleep Quality Index-Taiwan form (PSQI-T) (r =0.82, P <0.001) and sleep efficiency measured by Actiwatch parameters (r =−0.54, P <0.001). Construct validity could be established by the Brief Fatigue Inventory-Taiwan form (r =0.56, P <0.001) and Medical Outcomes Study Short Form-36-Taiwanese version (physical component summary: r =−0.52, P <0.001; mental component summary: r =−0.53, P <0.001). The AIS-T could detect significant known-group validity from sleep quality (PSQI-T ≥5 or <5, respectively). The Actiwatch parameters are consistent with the results of the AIS-T, and both data sets indicate that patients experienced sleep disturbances. The prevalence of insomnia, as defined by the criteria of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 4th ed., was 22.56%; 49.2% subjects had significant insomnia at the score ≥6 at AIS-T. Conclusion: This study concludes that the AIS-T is a reliable and valid instrument for assessing insomnia among cancer patients in Taiwan. [Copyright &y& Elsevier]

Background: Binge-watching refers to the watching of several episodes of a TV series or program in rapid succession. This study aims to investigate the associations of binge-watching behavior with depression, social interaction anxiety, and loneliness risks among adults in Taiwan., Methods: A cross-sectional online survey was conducted in October 2018, in which data from 1488 participants were collected using a self-administered questionnaire comprising four valid and reliable scales: the Center for Epidemiologic Studied Depression Scale (CES-D), the Chinese version of the Social Interaction Anxiety Scale (SIAS-C), the UCLA Loneliness Scale (version 3), and the Problematic Series Watching Scale (PSWS)., Results: Among the surveyed participants, the mean age was 28.3, and most participants were women who had completed undergraduate education. Multiple regression analysis demonstrated that, after adjustments for sociodemographic characteristics and self-reported health statuses, the score on the problematic binge-watching scale was positively associated with the scores on the depression, social interaction anxiety, and loneliness scales ( p < 0.001 for each model)., Conclusions: Problematic binge-watching was associated with increased depression, social interaction anxiety, and loneliness risks among adults in Taiwan. Additional studies on the relationship between problematic binge-watching and mental health problems, as well as its potential mechanism, are warranted.

Background: Clinical teaching is the most important element in the development of students' nursing competencies. However, students' learning modalities in clinical settings are unclear., Objective: To analyse path relationships affecting students' learning outcomes in clinical practicum using LISREL software., Design: A cross-sectional survey was administered., Settings and Participants: Participants were 392 senior students who had completed their final internship recruited from two nursing programmes in central Taiwan., Methods: Administration and completion of the following structured questionnaires: the Competency Inventory of Nursing Students, the Teaching Competence of Nurse Preceptor questionnaire, the Student Evaluation of the Clinical Education Environment, Level of Reflective Thinking, and the Metacognitive Inventory for Nursing Students., Results: The results suggested that teaching competence may indirectly affect nursing competence through metacognition and reflection. The clinical learning environment may directly affect nursing competence or indirectly affect nursing competence through metacognition. Both metacognition and reflection have direct effects on nursing competence, and reflection exerts indirect effects on nursing competence through metacognition. The path relationships differed according to the employment plan group., Conclusions: Reflection and metacognition are essential skills for the development of nursing competence in clinical settings. Clinical instructors must facilitate student learning by fostering a positive learning environment and teach students the reflective and self-regulation skills necessary to achieve favourable learning outcomes in clinical settings., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

A Gram-stain-negative and aerobic bacterial strain, designated as JL3514 T , was isolated from surface water of the hydrothermal system around Kueishan Island. The isolate formed red colonies and cells were non-flagellated, rod-shaped and contained methanol-soluble pigments. Growth was observed at 10-50 °C (optimum, 30 °C), at pH 5.0-9.0 (optimum, pH 7.0) and in the presence of 0-9 % (w/v) NaCl (optimum, 2 %). Strain JL3514 T was positive for catalase and weakly positive for oxidase. Results of 16S rRNA gene sequence analyses showed highest similarities to species in the family Erythrobacteraceae , namely Croceibacterium atlanticum (96.1 %), Pelagerythrobacter marensis (96.0 %), Tsuneonella rigui (96.0 %) and Altericroceibacterium xinjiangense (96.0 %). Phylogenetic analysis based on core gene sequences revealed that the isolate formed a distinct branch with the related species and it had a lower average amino acid identity value than the suggested threshold for genera boundaries. The major fatty acids (>5 %) were summed feature 8 (C 18 : 1  ω 7 c and/or C 18 : 1  ω 6 c ), summed feature 3 (C 16 : 1  ω 7 c and/or C 16 : 1  ω 6 c ), C 16 : 0 , C 17 : 1  ω 6 c , C 14 : 0 2-OH and C 12 : 0 . The dominant polar lipids comprised diphosphatidylglycerol, sphingoglycolipid, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylcholine, glycolipid, two unidentified lipids and one unidentified phospholipid. The main respiratory quinones were ubiquinone-10 (95.7 %) and ubiquinone-9 (4.3 %). The DNA G+C content from the genome was 63.0 mol%. Based on the presented data, we consider strain JL3514 T to represent a novel genus of the family Erythrobacteraceae , with the name Pseudopontixanthobacter vadosimaris gen. nov., sp. nov. The type strain is JL3514 T (=KCTC 62623 T =MCCC 1K03561 T ).

An orange-pigmented, short-rod-shaped, aerobic and non-motile bacterial strain, designated TK008 T , was isolated from the shallow-sea hydrothermal systems off Kueishantao Island in Taiwan, China, and it was studied by using a polyphasic taxonomic approach. Cells were Gram-stain-negative, and catalase- and oxidase-positive. Strain TK008 T exhibited highest 16S rRNA gene sequence similarity of 97.1 % to Paracoccus pacificus F14 T . The phylogenetic trees based on 16S rRNA gene sequences showed that strain TK008 T was a member of the genus Paracoccus . Digital DNA-DNA hybridization values between strain TK008 T and two closely related species ( Paracoccus zhejiangensis and Paracoccus tegillarcae ) were 20.6 and 20.9 %. The average nucleotide identity values of strain TK008 T compared with P. zhejiangensis and P. tegillarcae were 75.2 and 74.6 % respectively. The major isoprenoid quinone was ubiquinone-10. The predominant fatty acids (>10 %) were summed feature 8 (C 18 : 1 ω6 c and/or C 18 : 1 ω7 c ). The polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, three unidentified phospholipids, two unidentified lipids and an unidentified glycolipid. The DNA G+C content of strain TK008 T from genomic sequence data was 62.54 mol%. On the basis of polyphasic analysis, strain TK008 T represents a novel species, for which the name Paracoccus aurantiacus sp. nov. is proposed. The type strain is TK008 T (=CGMCC 1.13898 T =JCM 33630 T ).

Background: Although the Taiwan government has subsidized the provision of palliative care at home since 2000, the utilization rate of this service has been low., Purpose: The purpose of this research is to explore the experiences of palliative care at home as perceived by family caregivers., Methods: This qualitative study used semi-structured interviews to collect the data. Six family caregivers who had been providing home-based palliative care services for at least 2 weeks were invited to participate., Results: Four themes related to the care experiences of the participants emerged: (1) Choosing palliative care at home for the end-of-life journey: Considering the wishes of patients and the capacities of caregivers, with hospitals providing powerful support to caregivers; (2) Facing the burdens of providing palliative care in a home setting: Determining the caring skills while feeling fear and stress, and needing to resolve this stress and achieve a respite; (3) Pursuing stable home palliative care: Relying on consultations with the professional palliative care team for information, support, and insights regarding the value of home palliative care; and (4) Fulfilling the promise of a good death at home: Preparing the patient to say goodbye and to experience a peaceful death and family members to express their sadness and adapt to a new life., Conclusions / Implications for Practice: Home palliative care services help provide patients and their families convenience, intimate care, and reassurance at home. However, all caregivers must be properly trained in caring skills and the skills necessary to sustain their long-term care responsibilities. Home palliative care services have been described as the internal and external needs that patients and families require to maintain a stable quality of life and as the comfort required by the bereaved family members. The findings of this study demonstrate the value of home palliative care and of promoting home palliative care at the end of life.

Background: Males and females have significant differences in certain medical outcomes. However, little research has explored the gender differences in cancer patient perceptions of analgesics, the relationship between gender and analgesic adherence, or the effectiveness of pain management., Objective: The objectives of this study were to compare gender differences associated with hesitancy to use analgesics, analgesic adherence, or pain management effectiveness and to examine whether gender can precisely predict analgesic adherence., Methods: The study was conducted in the outpatient oncology department of a medical center in Taiwan. A descriptive and cross-sectional design was used. The study samples were collected from 362 cancer patients. The participants completed the short version of the Barriers Questionnaire-Taiwan, the Morisky Analgesics Adherence Measure-Taiwan version, the Brief Pain Inventory-Chinese version, the Pain Management Index, and a demographic and disease questionnaire., Results: The pain intensity and hesitancy to use analgesics scores were significantly higher among females than among males. The Pain Management Index results indicated that a larger percentage of males had adequate pain management. In addition, being male was a significant predictor of higher analgesic adherence (odds ratio, 1.93; P < .05)., Conclusions: Gender could precisely predict cancer patients' medication adherence. Women experienced significantly greater pain than did men but also had more hesitancy to use analgesics, lower adherence, and inadequate pain management., Implications for Practice: Healthcare professionals should consider women as a high-risk group for inadequate pain control. It is crucial for health providers to consider the gender discrepancy when attempting to improve cancer pain management.

The multidisciplinary team (MDT) model involves multiple medical professionals providing integrated medical care. Colorectal cancer (CRC) has the highest prevalence of cancer in Taiwan. This study examines and evaluates the survival rates of CRC patients treated under the MDT model. In this retrospective and prospective study, 651 CRC patients were recruited. They were divided into 2 groups: the MDT group and the traditional care (TC) group. The MDT group comprised 326 patients who received care from a MDT. The TC group comprised 325 patients who received care from a TC. The outcome variables were survival rates, follow-up appointment compliance, and 14-day readmission rates. Adopting the MDT model for CRC care increased patient follow-up appointment compliance rates at the first week, first month, and third month (p = .032, p = .007, p = .001, respectively). The model also effectively reduced patients' 14-day readmission rates. The results indicated that the survival rates of the MDT care were superior to those of TC. The adoption of the MDT model to treat CRC effectively enhanced clinical treatment adherence, increased survival rates, and reduced the 14-day readmission rate.

Background: Gastric cancer is one of the most common causes of cancer death in Taiwan. The literature has previously shown that age, tumor site, T categories, and number of metastatic nodes significantly affect prognosis. The aim of this study was to determine the long-term survival of patients with gastric cancer, as well as the effect of particular prognostic factors on survival., Materials and Methods: This was a survival analysis study with retrospective design. We reviewed the records of 64 patients with adenocarcinoma of the stomach who had undergone gastrectomy with curative intent between 2009 and 2012 at a teaching hospital in southern Taiwan. Data extracted from patient documents included age, gender distribution, tumor location, and pathological grading., Results: The median follow-up time was 4 years, and there were 31 deaths attributed to gastric cancer. Kaplan-Meier analysis revealed that retrieval of less than 15 lymph nodes from a patient was a significant predictor of survival. A significant predictor of poorer survival was higher pathological grading., Conclusions: Our results indicate that the number of lymph nodes retrieved and pathological grading could be viewed as crucial prognostic factors affecting the survival of individuals with gastric cancer.

Background: The number of colorectal cancer (CRC) patients in Taiwan has increased in recent years; therefore, the effective dissemination of information related to symptom care has become especially important. Previous studies indicated that the physical and psychological status of cancer patients can be effectively improved by telephone counseling services (TCS). Thus, determining the most effective means of establishing a TCS to support the clinical practice of oncology has become a crucial goal for nursing. The purposes of this study were to analysis the content of the TCS for CRC and explore stratification of the TCS., Materials and Methods: The study design was retrospective. A total of 850 calls were made to CRC patients in the cancer center of Southern Taiwan during the period of January 2007- December 2011. A structure questionnaire was adopted to analysis satisfaction., Results: Responses provided by the TCS included information regarding nutrition, side effects resulting from chemotherapy and pain. Moreover, 28.7% of CRC patients needed advanced treatment. More than 90% satisfaction with all aspects of the calls was found., Conclusions: The TCS coulkd be shown to provide an effective means by which to expand the reach of nursing care to different times, places and patients, allowing for greater cost efficiency and more rapid service.

Purpose: Discussing end-of-life care with patients is often considered taboo, and signing a do-not-resuscitate (DNR) order is difficult for most patients, especially in Chinese culture. This study investigated distributions and details related to the signing of DNR orders, as well as the completeness of various DNR order forms., Methods: Retrospective chart reviews were performed. We screened all charts from a teaching hospital in Taiwan for patients who died of cancer during the period from January 2010 to December 2011. A total of 829 patient records were included in the analysis. The details of the DNR order forms were recorded., Results: The DNR order signing rate was 99.8%. The percentage of DNR orders signed by patients themselves (DNR-P) was 22.6%, while the percentage of orders signed by surrogates (DNR-S) was 77.2%. The percentage of signed DNR forms that were completely filled out was 78.4%. The percentage of DNR-S forms that were completed was 81.7%, while the percentage of DNR-P forms that were completely filled out was only 67.6%., Conclusion: Almost all the cancer patients had a signed DNR order, but for the majority of them, the order was signed by a surrogate. Negative attitudes of discussing death from medical professionals and/or the family members of patients may account for the higher number of signed DNR-S orders than DNR-P orders. Moreover, early obtainment of signed DNR orders should be sought, as getting the orders earlier could promote the quality of end-of-life care, especially in non-oncology wards.

Aims: The purpose of this study was to investigate the effects of a breast cancer screening educational program on women's knowledge and intention to seek breast cancer screening in Taiwan., Materials and Method: This study describes the knowledge and intention of breast cancer screening changes during the period pre and post group education. A pre-test and post-test were used in both the experimental and the control groups. A convenience sampling was used. Two structured questionnaires were used., Results: The mean knowledge of breast cancer screening scores (pre-test and post-test) of the experimental group participants were 12.6 and 14.0. Then the mean knowledge of breast cancer screening scores (pre-test and post-test) of the control group participants were 11.8 and 12.1. The mean intention of breast cancer screening scores (pre-test and post-test) of the experimental group participants were 11.4 and 13.5. And the mean intention of breast cancer screening scores (pre-test and post-test) of the control group participants were 11.6 and 12.4. An independent-t test was applied to examine the differences among the two groups, revealing that the average post-test knowledge score differ significantly between the two groups (t=4.18, p<.00); and the post-test intention also demonstrate a marked statistical difference (t=2.07, p<.05). A paired-t test was applied to examine the differences of each group, revealing that the total average scores of the experimental group participants on the knowledge of breast cancer screening scale clearly differ statistically (t=-5.54, p<.00); and the pre-test and post-test intention testing also demonstrate a marked statistical difference (t=-7.70, p<.00)., Conclusions: These findings are helpful in understanding the knowledge and intention of breast cancer screening changes during the period pre and post group education. It is expected that these results can offer a reference for clinical breast cancer prevention.