Search

Abstract Background Weight control behaviors are commonly observed among adolescents and emerging adults. However, the high prevalence of overweight and obesity in both these age groups remains an imperative health concern. Adolescents and emerging adults represent the most vulnerable groups facing the health burden of obesity. Methods This study was designed to articulate the underlying beliefs concerning weight control behaviors among adolescents and emerging adults living with obesity by an elicitation qualitative study based on the integrated behavioral model (IBM). Semi-structured and individual interviewing was utilized. Eligible participants were recruited during September and November 2020. All interviews were audio-recorded, transcribed verbatim, and analyzed using a hybrid inductive and deductive content analysis approach. Results Twenty-seven participants, comprising 12 adolescents and 15 emerging adults living with obesity, were interviewed to explore their beliefs and strategies regarding weight control behaviors. Emerging adults were more likely to engage in extreme weight control methods. Three overarching themes emerged across both age groups: eating-centered concerns, focus on physical appearance, and social interference. Significant differences were noted while adolescents and emerging adults shared some common beliefs. Emerging adults expressed more economic concerns about weight control, whereas adolescents identified food restriction as the primary barrier to their weight management efforts. These findings highlight the nuanced differences in beliefs about the weight control practice of these two developmental groups. Conclusion More beliefs-tailored and theoretically driven interventions are needed for these two unique age groups. Healthcare providers should address dietary and economic concerns while engaging adolescents and emerging adults in weight management. Future obesity interventions should incorporate shared and unique beliefs identified in each group to promote healthy weight management effectively.

Summary: Purpose: During the COVID-19 pandemic, nurses have faced many professional and ethical dilemmas and challenges along with bearing physical, mental, and emotional stress resulting from worrying about themselves or their family being infected and stigmatized. This stress can potentially lead to burnout and resignation. Professional resilience is crucial for nurses to cope with these adverse situations. This study aimed to investigate the process by which nurses adapt, change, and overcome challenges during the COVID-19 pandemic and ultimately demonstrate professional resilience. Methods: Descriptive phenomenology was applied. Semi-structured interviews were conducted with 11 nurses working in COVID-19 wards and intensive care units to collect data. Giorgi's phenomenological analysis method was employed. Results: Based on the interview responses, four major themes were identified: 1) balancing patient care, self-protection, and passing on experience; 2) providing timely pandemic team resources and social support; 3) nurses' perseverance amid social discourse and constrained lives; and 4) selfless dedication shaping nursing's pinnacle experiences. Conclusions: In the face of a sudden pandemic, frontline nurses play a critical role in maintaining medical capacity. Consequently, they must balance their families, lives, and work while adapting to the impact of the pandemic and changing practices and procedures based on the development of the pandemic and policy demands. The study findings provide insights into the challenges and emotional experiences encountered by nurses during a sudden pandemic outbreak and can serve as a reference for developing strategies to help nurses overcome these challenges and enhance their professional resilience.

Abstract Landslides are an example of severe natural disasters that occur worldwide and generate many harmful effects that can affect the stability and development of society. A better-quality susceptibility mapping technique for the landslide risk is crucial for mitigating landslides. However, the use of assemblages of multivariate statistical methods is still uncommon in Indonesia, particularly in the Kepahiang Regency of Bengkulu Province. Therefore, the objective of this study was to provide an improved framework for creating landslide susceptibility map (LSM) using multivariate statistical methods, i.e., the analytical hierarchy process (AHP) method, the simple additive weighting (SAW) method and the frequency ratio (FR) method. In this study, we established a landslide inventory considering 15 causative factors using the area under the curve (AUC) validation method and another evaluation technique. The performance of each causative factor was evaluated using multicollinearity and Pearson correlation analysis with regression-based ranking. The LSM results showed that the most susceptible areas were located in the districts of Kabawetan, Kepahiang, and Tebat Karai. The high landslide risk in these areas could be attributed to the slope conditions in mountainous regions, which are characterized by high annual rainfall and seismic activity. The AUC training values of the AHP, SAW, and FR methods were 0.866, 0.838, and 0.812, respectively. Then, on the validation dataset, the AHP method yielded the highest AUC value (0.863), followed by the SAW (0.833) and FR (0.807) methods. Moreover, the AHP method provided a higher accuracy value, which suggests that the AHP method is more suitable than the other methods. Therefore, our research indicated that all algorithm methods generate a positive impact and greatly improve landslide susceptibility evaluation, especially for the preparation of landslide damage assessments in this study area. Finally, the method proposed in this study could improve the feasibility of LSM and provide support for Indonesian government decision-makers in arranging hazard mitigation measures in the Kepahiang Regency, Indonesia.

Abstract Aim To develop and test a mobile application that supports the disease self‐management of adolescents with type 1 diabetes during their transition to early adulthood. Design A sequential mixed‐methods design was employed. Methods The application content was designed according to previously identified care needs and expectations, followed by application development on the Android operating system. From the outpatient clinic of the Department of Paediatric Endocrinology and Metabolism at a medical centre in northern Taiwan, 35 individuals aged between 16–25 years participated in application testing. Results The overall median score of the QUIS was 4–5, most of the 25% quartile was 4–5, and all of the 75% quartile was 5, indicating adequate user interaction satisfaction.

In recent years, the escalating electricity demand in Taiwan has heightened the prominence and discourse surrounding the issue of power supply. With the enactment of the European climate law, global commitment to achieving net-zero emissions has gained momentum. Concurrently, the Taiwanese government has articulated the Taiwan 2050 net-zero emissions policy. To realize this objective, Taiwan has vigorously promoted renewable energy in recent years, increasing the proportion of renewable energy in its energy mix. However, confronted with the intermittent and unpredictable nature of renewable energy generation, challenges arise concerning the stability and quality of power supply. In response to the impact of integrating renewable energy into the grid, the Taiwan Power Company (Taipower) has introduced the day-ahead ancillary service market. Through this platform, power generation and battery energy storage systems (BESSs) engage in competitive bidding, fostering the integration of diverse distributed energy resources into the system. These resources serve as dispatchable assets for Taipower, contributing to grid stability by providing ancillary services. This study has developed an advanced dynamic regulation reserve controller by employing an industrial PC (IPC) in conjunction with a multifunctional power meter. Through real-time measurement of the power grid frequency by the multifunctional power meter, a sophisticated dynamic frequency reserve control strategy has been devised, taking into account the charging state of energy storage systems. This strategy exhibits high operational quality, effectively regulating the charging and discharging of energy storage systems. In addition to swiftly adjusting the current grid frequency, it encompasses the capability to facilitate the transfer of peak electrical energy. This effectively stabilizes the power grid, alleviating supply pressures during nighttime peaks and enhancing the overall supply stability of the power system.

Summary: Purpose: Nowadays most children with congenital heart disease (CHD) are expected to survive to adulthood. The healthcare focus needs to pay close attention to the important developmental tasks during their growth process. The women with CHD face some challenges in their critically developmental stages during pregnancy, delivery, and even motherhood. The lived experience of being a mother needs to be further concerned. This study aimed to explore the lived experience of first-time mothers with CHD. Methods: Descriptive phenomenological design was adopted. Semi-structured interviews were conducted from April to August 2018 with 11 primiparous women with CHD, who were recruited from the pediatric and adult cardiology outpatient departments at a medical center and who had a child aged between 6 months and 3 years. Giorgi's phenomenological analysis method was employed. Results: Six main themes arose from the analysis: (1) recognizing pregnancy risks, (2) performing self-care for health, (3) building self-worth from my baby, (4) adapting to postpartum life and adjusting priorities, (5) enjoying being a first-time mother, and (6) the factors contributing to success in high-risk childbirth. Conclusions: The experiences that occurred prior to and after labor that were identified in this study can assist women with CHD to more capably prepare for and understand the process of becoming a mother, including recognition of the importance of a prepregnancy evaluation. The findings of this study can help women with CHD to better understand the path to becoming a mother and prepare themselves for the challenges that lie ahead.

Summary: Purpose: This study aimed to evaluate the effectiveness of an interactive virtual reality (VR) play intervention including instructional play and emotional catharsis play sessions in reducing children's pain and fear during intravenous placement. Methods: A randomized controlled trial with parallel groups was conducted. The sample consisted of 134 hospitalized children aged 6–12 years (intervention group: n = 69; comparison group: n = 65). The intervention involved one immersive intravenous scene in VR before the actual intravenous placement and one emotional catharsis VR play after injection. The comparison group received an educational photo book about intravenous placement before receiving intravenous placement. The children and their caregivers rated their pain and fear by using the Wong–Baker FACES Pain Rating Scale and the Children's Fear Scale. The time required for successful intravenous insertion was also compared between the two groups. Results: Children's pain (p = .028) and fear scores (p = .004) were significantly lower in the intervention group than in the comparison group. Their caregivers' pain and fear scores (both p

BackgroundPreschool-aged children with acute lymphoblastic leukemia (ALL) receive long-term treatment according to the Taiwan Pediatric Oncology Group (TPOG)–ALL 2013 protocol. Severe anxiety and noncompliance ahead of frequent invasive therapies leads to an increase in health care costs. Previous studies have shown that therapeutic video games (TVGs) can decrease the anxiety experienced by children who are ill. To our knowledge, no existing TVG has been designed specifically for preschool-aged children with ALL in Taiwan. ObjectiveThe purpose of this study was to develop a TVG using the popular Mechanics, Dynamics, and Aesthetics (MDA) framework for game design and to investigate the effect of this TVG on the reduction of therapy-related anxiety among preschool-aged children with ALL. MethodsThis study used a mixed methods approach over three phases: (1) develop a TVG using the MDA framework, (2) test the reliability of the TVG among three certified children’s art therapists, and (3) evaluate the reduction of therapy-related anxiety among participants after using the TVG for 6 weeks, using a two-group, stratified randomized controlled trial at a medical center in northern Taiwan. Eligible preschool-aged children with ALL were randomly assigned 1:1 into an experimental group or a control group. The two groups of subjects received the same usual care, and only the experimental group had access to and used the TVG. The children’s anxiety responses were reported by their family caregivers using the face rating scale (FRS). Descriptive analyses, the Fisher exact test, the Pearson chi-square test, and the Mann-Whitney U test were used to statistically analyze the variables. ResultsSix mechanics rules supported the dynamics of the TVG using four main features—character, nursery, tasks, and market—in order to complete all of the therapy-related anxiety reduction scenarios and to achieve eight aesthetics goals. The results of reliability test showed that participants found the TVG to be useful and trustworthy for preschool-aged children with ALL (Cronbach α=.98). A total of 15 participants were enrolled and randomly allocated to the experimental group (n=7) or the control group (n=8). The average number of TVG log-ins was 37.9 (SD 15.30, range 14-62) in the experimental group. The demographic data showed homogeneity across the two groups regarding age (3 to 5 years), sex (male), risk classification (standard risk), and treatment status (continuation therapy). The mean FRS score was 6.16 (SD 3.31) for the experimental group as compared to 7.45 (SD 2.71) for the control group (P=.04), which represented a significant difference between the groups at the 6-week follow-up. ConclusionsThis research provides evidence that using a TVG can decrease anxiety in preschool-aged children with ALL in Taiwan. The TVG could be used to support clinical professionals before they perform invasive therapies. However, it is recommended to increase the statistical power for inference. Trial RegistrationClinicalTrials.gov NCT04199637; https://www.clinicaltrials.gov/ct2/show/NCT04199637

Recently, two-dimensional materials have attracted attention owing to their special optical characteristics and miniaturization, with low thickness as well as extremely high responsivity. Additionally, Tamm plasmon polariton (TPP) resonance can be observed by combining a metal film and a one-dimensional (1D) photonic crystal (PC), where an electric field confinement is located at the metal–1D PC interface. In this study, a graphene layer combined with a TPP is proposed as a wavelength- and angle-selective photodetector. The graphene layer is located where the strong field confinement occurs, and the photocurrent response is significantly enhanced with increasing absorption by over four times (from 62.5 μA⋅W−1 to 271 μA⋅W−1 and undetected state to 330 μA⋅W−1 in two different samples). Moreover, the graphene–TPP photodetector has wavelength and angle selectivity, which can be applied in LiDAR detecting, sun sensors, laser beacon tracking, and navigational instruments in the future.

Purpose: To explore the life experiences of patients with type 1 diabetes transition from adolescence into adulthood in Taiwan. Methods: Descriptive phenomenological design was used. Fourteen participants were individually interviewed using a semi-structured interview. Results: The life experiences of patients with type 1 diabetes transition from adolescence into adulthood experience a metamorphosis from awareness of responsibility to figuring out a way to care for themselves. Six themes emerged: (1) hibernation: awareness of responsibility; (2) emergence: attempts to take responsibility; (3) perseverance: encountering difficulties; (4) anxiety: multiple worries; (5) hesitation: back-and-forth,” and (6) exit: finding a way out.” Conclusions: During the transition phase, the participants experienced the trials of various situations. Regardless of whether they are able to independently bear the responsibilities of self-management, they all hope to turn around the challenges of disease control and take ownership of their disease. Like a butterfly that emerges from a cocoon, they hoped to overcome the dangers of taking flight through trial and error and navigating the world. The results of this study can serve as a reference for clinical care and developing localized intervention strategies targeted to the transition period between adolescence and young adulthood.

Summary: Purpose: This study aimed to evaluate the effects of cognitive-behavioral program on pain and medical fear in hospitalized school-aged children receiving intravenous (IV) placement. Methods: This study used an quasi-experimental design. Thirty-five participants were assigned to the experimental group and 33 to the control group in the acute internal medicine ward of a children's hospital. The cognitive-behavioral program entailed having the patients read an educational photo book about IV placement before the procedure and having them watch their favorite music video during the procedure. The outcome measures were numeric rating scales for pain intensity and fear during the procedure. Results: After applying the cognitive-behavioral program, the mean scores on pain and fear decreased in the experimental group. However, the difference in pain intensity between these two groups was nonsignificant. The intensity of fear in the experimental group was significantly lower than that in the control group. Conclusion: In this study, the cognitive-behavioral program used with school-aged hospitalized children promoted less fear during IV placement. The results of this study can serve as a reference for empirical nursing care and as care guidance for clinical IV injections involving children. Keywords: children, fear, needle, pain

This paper proposes a method to detect air pollution by applying a hyperspectral imaging algorithm for visible light, near infrared, and far infrared. By assigning hyperspectral information to images from monocular, near infrared, and thermal imaging, principal component analysis is performed on hyperspectral images taken at different times to obtain the solar radiation intensity. The Beer–Lambert law and multivariate regression analysis are used to calculate the PM2.5 and PM10 concentrations during the period, which are compared with the corresponding PM2.5 and PM10 concentrations from the Taiwan Environmental Protection Agency to evaluate the accuracy of this method. This study reveals that the accuracy in the visible light band is higher than the near-infrared and far-infrared bands, and it is also the most convenient band for data acquisition. Therefore, in the future, mobile phone cameras will be able to analyze the PM2.5 and PM10 concentrations at any given time using this algorithm by capturing images to increase the convenience and immediacy of detection.

Fluctuations in the sediment yielding rate within mountainous areas are found after extreme precipitations. These changes are associated with rainfall-driven landslides and can be evaluated through observations of sediment transported in river water. In this study, we assess the differential impact level and duration of an extreme rainfall event caused by the 2009 Typhoon Morakot in Taiwan. Using a time series of suspended sediment data and landslide inventories within three affected catchments, our results found that the proportion of the typhoon-generated sediment discharges reached 58% of the 2009 annual sediment discharges, and the annual sediment discharges could be 15-fold higher than the average annual sediment discharges prior to the typhoon. The impact of the typhoon on suspended sediment discharge lasted for around four months. It is further revealed that a significant increase in the number of landslides was attributed to the impact of the extreme typhoon event, and the critical rainfall condition triggering landslides, based on the relationship between rainfall and landslide number and the rainfall intensity-duration thresholds, declined for 4–5 years.

Landslides are typically triggered by earthquakes or rainfall occasionally a rainfall event followed by an earthquake or vice versa. Yet, most of the works presented in the past decade have been largely focused at the single event-susceptibility model. Such type of modeling is found insufficient in places where the triggering mechanism involves both factors such as one found in the Chuetsu region, Japan. Generally, a single event model provides only limited enlightenment of landslide spatial distribution and thus understate the potential combination-effect interrelation of earthquakes- and rainfall-triggered landslides. This study explores the both-effect of landslides triggered by Chuetsu-Niigata earthquake followed by a heavy rainfall event through examining multiple traditional statistical models and data mining for understanding the coupling effects. This paper aims to compare the abilities of the statistical probabilistic likelihood-frequency ratio (PLFR) model, information value (InV) method, certainty factors (CF), artificial neural network (ANN) and ensemble support vector machine (SVM) for the landslide susceptibility mapping (LSM) using high-resolution-light detection and ranging digital elevation model (LiDAR DEM). Firstly, the landslide inventory map including 8459 landslide polygons was compiled from multiple aerial photographs and satellite imageries. These datasets were then randomly split into two parts: 70% landslide polygons (5921) for training model and the remaining polygons for validation (2538). Next, seven causative factors were classified into three categories namely topographic factors, hydrological factors and geological factors. We then identified the associations between landslide occurrence and causative factors to produce LSM. Finally, the accuracies of five models were validated by the area under curves (AUC) method. The AUC values of five models vary from 0.77 to 0.87. Regarding the capability of performance, the proposed SVM is promising for constructing the regional landslide-prone potential areas using both types of landslides. Additionally, the result of our LSM can be applied for similar areas which have been experiencing both rainfall-earthquake landslides.

Introduction and objectives: Functional decline frequently occurs in older adults in hospitals. The aim of this project was to promote evidence-based strategies for physical activity to prevent functional decline in hospitalized older adults in a medical center in southern Taiwan. Methods: This project was guided by the JBI Evidence Implementation Framework. Seven audit criteria were derived from a JBI evidence summary and a baseline audit involving 25 nurses and 30 hospitalized older adults was conducted to compare current practice with best practice recommendations. The JBI Getting Research into Practice (GRiP) approach was used to identify barriers to implementation, and strategies were developed to overcome those barriers. A follow-up audit was conducted to measure any changes in compliance. Results: After implementing the strategies, the pass rate of nursing staff improved in the physical activity knowledge test, rising from 56% to 88%. Compliance of nursing staff with providing physical activity instructions using evidence-based guidelines to hospitalized older adults reached 80%. The incidence of functional decline among hospitalized older adults decreased from 36.7% to 20%. Conclusions: The results of this best practice implementation project suggest that initiating physical activity as early as possible for hospitalized older adults once their medical condition has stabilized can help prevent functional decline. [ABSTRACT FROM AUTHOR]

Recent, rapid advancements in technology have enabled the introduction and integration of robots into everyday life. Different from the traditional image of robots as cold and mechanical, social robots are designed to emulate human interaction patterns, improving the user experience and facilitating social interactivity. Thus, social robots represent a promising new care intervention. In this article, after defining social robots and explaining the factors influencing "human-robot interaction", the authors discuss the effectiveness of social robots in the context of providing care to patients with dementia and autism as well as to pediatric patients. Finally, current cases in which PARO, a social robot, has been used in nursing are described, and key challenges and suggestions for future social robot applications are given. Current evidence indicates social robots must be developed and designed to adhere to a people-centered approach to achieve better robot-assisted care outcomes, be better accepted by patients, and better enable patients to open up emotionally and maintain good physical, mental, and social well-being. [ABSTRACT FROM AUTHOR]

Background: Most children with complex congenital heart disease (CHD) require open-heart surgery within one year of birth to survive. Thus, new mothers of infants with CHD are faced with making unexpected and difficult decisions. Purpose: This study was designed to explore the essence of the maternal uncertain experience prior to infants with CHD undergoing open-heart surgery. Methods: In this study, a phenomenological approach was used and data were collected using open-ended interview guidelines structured around the Uncertainty in Illness Theory. Nine mothers of infants with CHD who had received open-heart surgery were interviewed in a hospital interview room within two weeks the operation. Colaizzi's (1978) data processing procedure was applied in the post-interview analysis. Results: Five themes emerged: (1) Hit bottom and felt helpless; (2) Hit the road - An overwhelming sense of emergency; (3) The crunch - Do your best to accept destiny (4) Disease brought the unknown; (5) Hope in uncertainty. Conclusions/ Implications for Practice: The high-risk nature of and their unfamiliarity with the surgery made the participants experience illness uncertainty. The medical system should develop more-structured CHD information and provide emotional support in a timely manner to alleviate illness uncertainty in mothers of infants with CHD. [ABSTRACT FROM AUTHOR]

Emergency nurses, especially when caring for pediatric patients, typically establish relationships with their patients under hectic and busy conditions. Thus, these nurses often rely on semi-coaxing / slightly stressful methods to quickly prepare patients to undergo necessary medical procedures. However these approaches cause tense relationships. To establish friendly bridges with pediatric patients, emergency nurses should adopt sincere and caring approaches. An approach based on Swanson's caring theory for applying child-friendly healthcare in the emergency department is proposed in this article. It is important to establish a friendly bridge with pediatric patients with emergency treatment needs and their families in a sincere and caring manner; to understand the needs of these children and their families when seeking medical treatment; to be present, listen, and respond to these patients and provide decision-making power when appropriate; and to provide professional care and method knowledge to empower families to care for their children. Accomplishing this may be expected to improve trust in both children with emergency medical needs and their families and thus decrease their anxiety, negative emotions, and stress. We hope that reflecting on the relationship between nurses and patients may further promote the practice of friendly healthcare in pediatric emergency departments. [ABSTRACT FROM AUTHOR]