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Background: The purpose of the study was to explore the job stress and job satisfaction of nursing assistants (NAs) in Taiwan. The research took place in a public hospital where NAs were supplied by a contracting agency that tendered every two years for the business of supplying personnel. The performance of the NAs was appraised every month, with the results being subsequently reported to the contractor and to hospital administrators. The NAs had to tackle a wide range of complex tasks, resulting in a heavy workload with high pressure. They were paid 30,000 Taiwanese Dollars per month (about 836 GBP). Lack of employment protection sometimes resulted in high turnover rates with concomitant difficulty in recruiting new workers. Methods: This study adopted a cross-sectional research design and used the Minnesota Satisfaction Questionnaire in conjunction with the Chinese variant of the Job Content Questionnaire to explore the relationship between job satisfaction and job stressors of NAs. A total of 172 valid questionnaires were received, with an effective response rate of 89%; 84% of the respondents were female, and 71% of the sample possessed more than 6 years of professional experience. The data were statistically analyzed including SPSS For Windows 20.0, independent sample t-tests, and regression analysis to calculate the correlation between job stressors and job satisfaction. Results: Respondents’ level of intrinsic, extrinsic and general satisfaction was enhanced by “skill discretion” (i.e., job creativity), work autonomy and social support from management and colleagues. The nursing assistants in this study had relatively low job stress and high job satisfaction. Conclusions: Despite some encouraging findings, the unstable working environment of NAs constitutes a hidden worry for the development of long-term care in Taiwan. Social support is crucial to satisfaction; on-the-job training, and work in interdisciplinary teams, would help establish sustainable professional development; and a career path with promotion opportunities would further increase job satisfaction. Trial Registration: not applicable though ethical approval was granted for implementation of the study.

Heart rate variability (HRV) and pulse-wave velocity (PWV), indicators of cardiac function, are altered in patients with spinal cord injury (SCI), suggesting that autonomic cardiac function and arterial stiffness may underlie the high risk of cardiovascular complications in these patients. No study has simultaneously investigated HRV and PWV in the same patients.To evaluate cardiovascular complications in SCI patients by comparing HRV and PWV between patients with and without SCI.In this cross-sectional pilot study, patients with (We observed a significant difference between participants with and without SCI with respect to the standard deviation of all normal-to-normal intervals, square root of the mean sum of squared successive risk ratio interval differences, physical stress index, total power, very-low frequency, low frequency, high frequency, and arterial elasticity.Patients with SCI have weaker sympathetic and parasympathetic activity as well as lower arterial elasticity compared to those without, suggesting that SCI may increase cardiac function loading.

Taiwan is an aging society, but the appropriate designs must be considered in senior care spaces. Universal design knowledge has been addressed in universities, but students cannot imagine how age affects the needs of senior citizens physically and psychologically. The teaching practice in this study adopted a dyadic teaching method whereby students observed the needs of individuals in a nursing care center for elderly people. It also used cooperative learning methods for nursing students to discuss the needs of senior citizens and to help design students understand the lifestyles of senior citizens through the use of simulation devices. Through the feedback from the learning process, statistical analysis was used to assess the learning performance of students. The design studio used these two teaching methods, and the respective work was entered into an open design competition to verify whether teaching performance was successful. Approximately 70% of the works earned design awards. This provided a preliminary validation of the success of the respective teaching practice method.

Taiwan is an aging society, but the appropriate designs must be considered in senior care spaces. Universal design knowledge has been addressed in universities, but students cannot imagine how age affects the needs of senior citizens physically and psychologically. The teaching practice in this study adopted a dyadic teaching method whereby students observed the needs of individuals in a nursing care center for elderly people. It also used cooperative learning methods for nursing students to discuss the needs of senior citizens and to help design students understand the lifestyles of senior citizens through the use of simulation devices. Through the feedback from the learning process, statistical analysis was used to assess the learning performance of students. The design studio used these two teaching methods, and the respective work was entered into an open design competition to verify whether teaching performance was successful. Approximately 70% of the works earned design awards. This provided a preliminary validation of the success of the respective teaching practice method.

We present a physically accurate low-order elastic shell model that incorporates active material response to dynamically changing stimuli such as heat, moisture, and growth. Our continuous formulation of the geometrically non-linear elastic energy derives from the principles of differential geometry, and as such naturally incorporates shell thickness, non-zero rest curvature, and physical material properties. By modeling the environmental stimulus as local, dynamic changes in the rest metric of the material, we are able to solve for the corresponding shape changes by integrating the equations of motions given this non-Euclidean rest state. We present models for differential growth and shrinking due to moisture and temperature gradients along and across the surface, and incorporate anisotropic growth by defining an intrinsic machine direction within the material. Comparisons with experiments and volumetric finite elements show that our simulations achieve excellent qualitative and quantitative agreement. By combining the reduced-order shell theory with appropriate physical models, our approach accurately captures all the physical phenomena while avoiding expensive volumetric discretization of the shell volume.

Background Clients with a spinal cord injury (SCI) must learn to manage their disabilities and may never be able to resume their previous lifestyle. Therefore, receiving relevant information and support from care practitioners and institutions is essential for clients with long-term SCI. Purpose This study investigated the long-term homecare needs of clients with SCIs. Methods A qualitative approach was used in this study. Data were collected from March to May 2013. Four SCI associations were selected using purposive sampling, and four focus group interviews were conducted in Northern, Central, Southern, and Eastern Taiwan. Each focus group was composed of 7-12 participants. In-depth interviews (1.5-2.5 hours) were conducted. A content analysis method was adopted for data analysis. Results Thirty-eight participants took part in the study. The long-term care needs of clients with SCI require the following dynamic processes for rebuilding their lives: physical care and complication prevention, life planning, social support, discovery of the value of existence, and sexual satisfaction. Conclusions/implications for practice The results reveal the long-term care needs of clients with SCI. Nurses are expected to provide client-centered care, emphasize prevention rather than treatment of complications, initiate life planning at the early stages of a client's rehabilitation, enhance a client's social support, encourage a client's search for companionship and search for the value of existence and a life purpose, and be attentive to the sexual concerns of people with physical disabilities.

Electrical evaluation along with the material analysis and reliability investigation of cosputtered Cu/Ti bonded interconnect in 3-D integration is presented in this paper. Diffusion behavior of cosputtered metals under different bonding ambient is evaluated as well. This paper shows that the bonded structure exhibits several interesting features under atmospheric bonding ambient, including self-formed adhesion layer, Cu-Cu bonding, and Ti oxide sidewall passivation. Electrical and reliability investigations of cosputtered Cu/Ti bonded interconnects show an excellent electrical performance and a high stability under a large variety of reliability tests, indicating the potential of using cosputtered Cu/Ti bonded interconnects for 3-D integration applications.

Background: In numerous countries worldwide, fall prevention among older adults is a major public health issue. For older adults, regular participation in moderate physical activity or exercise lowers the risks of falls. However, scant information is available regarding the prevention strategies that the most at-risk groups may undertake. The purpose of this study is to examine the effects of a fall prevention strategy, eight forms of moving meditation (EFMM), on community-dwelling middle-aged and older adults in Taiwan. Methods: This was a quasi-experimental study; 84 participants were recruited from Taipei in Taiwan. For 12 weeks, participants in the experimental group performed 30-min EFMM 3 times per week. The measurements included a Functional Reach Test (FRT), Timed Get-up-and-Go Test (TGUG), and a One-Leg Stance Test (OLST) with eyes both opened and closed. All were conducted at the baseline and 12 weeks after intervention. Results: The participants who performed EFMM showed a significant and positive performance on FRT, TGUG, and OLST with eyes opened and eyes closed compared to those in the control group. Conclusion: The results suggest that EFMM is an effective strategy for enhancing balance and functional mobility and preventing falls among community-dwelling middle-aged and older adults.

Aging causes various changes in body composition, which are critical implications for health and physical functioning in aging adults. The aim of this study was to explore the body composition outcomes of a qigong intervention among community-dwelling aging adults. This was a quasi-experimental study in which 90 participants were recruited. Forty-eight participants (experimental group) attended a 30-min qigong program 3 times per week for 12 weeks, whereas 42 participants (control group) continued performing their usual daily activities. The experimental group achieved a greater reduction in the fat mass percentage at the posttest, and exhibited increased fat-free mass, lean body mass percentage, and lean body mass to fat mass ratio compared with the controls. No difference between the two groups in body mass index, fat mass, and lean body mass was observed. These results indicated that the qigong intervention showed beneficial outcomes of body composition among community-dwelling aging adults.

Purpose The purpose of this study was to integrate and evaluate the spinal cord injury rehabilitation nursing theory named Super-Link System Theory using participatory action research. Method Data were collected from October 2007 to September 2008 in a rehabilitation hospital by means of interviews, participant observations, documentary resources, case conferences and reports, and participants’ self-reflective inquiries. The Super-Link System Theory was introduced to 31 rehabilitation nurses. The nurses selected a key reference group including the researcher to facilitate the participatory action research process to implement and evaluate the theory. Data were analyzed using content analysis. Results The findings shows that several key concepts were clarified and specific nursing interventions were identified. Furthermore, an integrated link system from the hospital to the community through both rehabilitation nurses and discharge planners was established. Conclusion The study demonstrated an evidence base for an evolving theory of care, and empowered nurses to make sustainable changes to their practice.

Enhancing self-efficacy, self-perception, and social support can be an effective way for people with spinal cord injury (SCI) to move forward. The purpose of this study was to explore relationships between "moving-forward behavior" and demographic and disease characteristics, self-efficacy, self-perception, and social support among people with SCI. The study was designed as a descriptive-correlation, cross-sectional study. The participants were selected using cluster random sampling (n = 210) through the Spinal Injury Association in Taiwan. A statistically significant relationship was found between moving-forward behavior and age (t = -2.30, p < .05), self-efficacy (gamma = -0.25, p < .01), and self-perception (gamma = -0.39, p < .01). Age (odds ratio [OR] = 0.964, p < .05) and self-perception (OR = 0.824, p < .05) were both significant predictors of moving-forward behavior.

Aims. To examine the effects of the procedure of translation and the techniques used on the collection and interpretation of original language qualitative data for English presentation. Background. Nursing and health research increasingly use qualitative research for a broadened perspective on practice and research. In numerous qualitative nursing research papers, data are collected in the original language (example Chinese) and the findings are presented in English. No standardised procedures exist for evaluating the influences of translation on the trustworthiness of qualitative data in nursing research. Design. Translation and back-translation related literature review was conducted. Methods. This is a methodological review paper. Discussion. This paper discusses the factors influencing the quality of translation including translator, back-translation, culture and language. Additionally, the translation procedures reported in the literature and the author’s experiences are considered. Conclusions. The translation procedures described in qualitative nursing research can be summarised as: 1 Verbatim transcription of the content in original language, and then analysis of content; 2 Two bilingual translators are necessary to translate the emerged concepts and categories; 3 Back translate is employed; 4 An expert panel committee is involved in reaching final agreement on the translation. Relevance to clinical practice. Development of the translation procedures could provide qualitative nursing researchers with a guide when collecting data in one language and presenting results in another language. In this way, the necessary rigour in qualitative nursing research could be achieved.

Aims. To introduce a synthesised technique for using grounded theory in nursing research. Background. Nursing increasingly uses grounded theory for a broadened perspective on nursing practice and research. Nurse researchers have choices in how to choose and use grounded theory as a research method. These choices come from a deep understanding of the different versions of grounded theory, including Glaser’s classic grounded theory and Strauss and Corbin’s later approach. Design. Grounded theory related literature review was conducted. Methods. This is a methodological review paper. Results. Nursing researchers intent on using a grounded theory methodology should pay attention to the theoretical discussions including theoretical sampling, theoretical sensitivity, constant comparative methods and asking questions, keeping memoranda diagramming, identification of a core category and a resultant explanatory theory. A synthesised approach is developed for use, based on Strauss and Corbin’s style of sampling and memoranda writing, but selecting theoretical coding families, that differ from the paradigm model of Strauss and Corbin, from the wide range suggested by Glaser. This led to the development of a multi-step synthesised approach to grounded theory data analysis based on the works of Glaser, Charmaz and Strauss and Corbin. Conclusions. The use of this synthesised approach provides a true reflection of Glaser’s idea of ‘emergence of theory from the data’ and Strauss and Corbin’s style of sampling and memoranda writing is employed. This multi-step synthesised method of data analysis maintains the philosophical perspective of grounded theory. Relevance to clinical practice. This method indicates how grounded theory has developed, where it might go next in nursing research and how it may continue to evolve.

Mucin (MUC)1 is a multifunctional mucin expressed by a variety of reproductive tract epithelia. Trophoblast invasion is essential for normal placental development. However, MUC1 expression in the human placenta throughout pregnancy and the role of MUC1 in trophoblast-like cell invasion are still unclear. In the present study, results from quantitative RT-PCR and Western blot demonstrated that MUC1 mRNA and MUC1 protein expression, respectively, increased with gestational age of the human placenta. Immunohistochemistry revealed that MUC1 in placental villi was mainly expressed by syncytiotrophoblasts throughout pregnancy and increased with gestational age. Interestingly, we found two populations of extravillous trophoblasts, MUC1-positive and MUC1-negative cells, in decidua. The numbers of MUC1-positive extravillous trophoblasts were increased during placental development. Furthermore, MUC1 overexpression significantly (P < 0.01) suppressed matrigel invasion of trophoblast-like JAR cells by 34.6% ...

In this study, the effects of ammonium hydroxide extracts from black tea on colon cancer cells were analyzed. Here we showed that black tea extracts decreased the growth of SW480 and HCT116 cells in a dose-dependent manner. The increase of subG1 population indicated that the black tea extracts induced cancer cell death. In addition, cell migration and invasion were significantly inhibited by the black tea extracts. We also found that tyrosine phosphorylation of focal adhesion kinase and paxillin was decreased in these cells, suggesting that integrin signaling pathways were affected by the extracts. In addition, decreased phosphorylation of extracellular signal-regulated kinase and increased phosphorylation of p38 and c-Jun N-terminal kinase were observed, indicating that the extracts can modulate mitogen-activated protein kinase (MAPK) signaling pathways. These results suggest that the crude ammonium hydroxide extracts from black tea can significantly inhibit malignant phenotypes of colon cancer cells and that integrin and MAPK signaling pathways could be involved. PRACTICAL APPLICATIONS Ammonium hydroxide extracts of black tea can significantly suppress colon cancer cell growth, migration and invasion in vitro. These findings suggest that the ammonium hydroxide extracts of black tea may be applied for cancer treatment and prevention.

Journal of Nursing and Healthcare of ChronicIllness in association with Journal of Clinical Nursing 17, 5a, 116–124Living with a spinal cord injury: a grounded theory approachAims. This paper reports a study which examined patients’ experiences of sufferinga spinal cord injury.Background. Spinal cord injury has major bio-psycho-social and spiritual implica-tions for patients. However, very limited research exists regarding the experience ofpatients with spinal cord injury in Taiwan or other countries worldwide.Method. Grounded theory was used to explore the psychosocial implications forpatients of spinal cord injury.Data collection and analysis. Data were collected from October 2002 – March 2003through tape-recorded, semi-structured interviews and complete observation ofa group discussion focusing on patients with tetraplegia, in a rehabilitation hospitalin Taiwan. The number of patients with spinal cord injury interviewed for thisstudy was 15, involving 18 interviews. Data collection and analysis occurredconcurrently.Results. The findings resulted in the core category ‘living with a spinal cord injury’and identify the experiences of suffering a spinal cord injury. Three stages wereidentified as the individual experience, including four categories: stage 1 A cata-strophic life event, stage 2 Confront challenges and stage 3 Moving forward orWithdraw from society.Conclusions. This study shows that patients suffering a spinal cord injury have tofind their own way and learn to live with their disability. Patients who did better inliving with spinal cord injury point could move forward, otherwise, they maywithdraw from society.Relevance to clinical practice. Health professionals need to recognize patients’experiences, perceptions and needs, to provide better nursing care.Key words: grounded theory, nurses, nursing, qualitative research, rehabilitation,spinal cord injury

The enzyme β1,4-N-acetylgalactosaminyltransferase III (β4GalNAc-T3) exhibits in vitro activity of synthesizing N,N′-diacetyllactosediamine, GalNAcβ1,4GlcNAc. Here, we investigate the expression of β4GalNAc-T3 in primary colon tumors and the effects of its overexpression on HCT116 colon cancer cells. Real-time reverse transcription-PCR showed that the expression of β4GalNAc-T3 was up-regulated in 72.5% (n = 40) of primary colon tumors compared with their normal counterparts. β4GalNAc-T3 overexpression resulted in enhanced cell-extracellular matrix adhesion, migration, anchorage-independent cell growth, and invasion of colon cancer cells. Moreover, β4GalNAc-T3 overexpression increased tumor growth and metastasis and decreased survival of tumor-bearing nude mice. β4GalNAc-T3 overexpression showed increased tyrosine phosphorylation of focal adhesion kinase and paxillin Y118 as well as increased extracellular signal–regulated kinase phosphorylation. These results suggest that up-regulation of β4GalNAc-T3 may play a critical role in promoting tumor malignancy and that integrin and mitogen-activated protein kinase signaling pathways could be involved in the underlying mechanism. (Mol Cancer Res 2007;5(6):543–52)

Spinal cord injury has a wide variety of severe physiological and psychological consequences for those affected and changes a person′s accustomed life style significantly. Nurses involved in the rehabilitation of such patients need to consider a variety of issues, including the physical, psychological, social, sexual, and spiritual needs of clients. Relationships with family members and intimate partners are also critical to the success of rehabilitation. This article considers the physiological and psychological effects of a spinal cord injury. A discussion of approaches to care delivery that can maximize a client′s ability to adapt his/her life style to the injury is set in the context of nursing as practised in the authors′ respective countries, Taiwan and the UK.

A novel 3-D bonding technology with cosputtered copper and titanium as bonding material is proposed and investigated based on the diffusion mechanism of cosputtered metal during bonding. This technology features a self-formed adhesion layer for Cu metal layers and interconnects. In addition, cosputtered Cu/Ti bonding exhibits good electrical performance as well as high resistance to multiple current stressing. With the advantages of fabrication efficiency and reliable bond quality, cosputtered Cu/Ti bonding technology presents the potential to be applied in 3-D integration.

Aims and objectives We assessed the effects of a spinal cord injury home rehabilitation DVD on patients with spinal cord injury. Background Multimedia have been used widely in health care in the digital age. The provision of rehabilitation instructions is a major responsibility of the rehabilitation staff. Design This study adopted a quasi-experimental pretest–posttest control group design. Methods We collected data from a rehabilitation nursing ward at a medical centre between October 2011–April 2012. The participants were recruited before being discharged from the hospital. The experimental group (n = 28) received multimedia DVD instructions for three months, in addition to teaching sessions conducted by the researcher, whereas the control group (n = 31) received instructions without a DVD. Both groups completed the self-perception and self-efficacy scales used in this study before and after the intervention. Results The results indicated that, after the multimedia DVD intervention, the experimental group exhibited a considerably greater improvement in self-perception than did the control group. Although we recorded increased scores for both self-perception and self-efficacy for both groups, no marked differences emerged between the control and the intervention groups by using a generalised estimating equation. Conclusion These results suggest that the home rehabilitation DVD is an effective instrument for improving self-perception and self-efficacy in patients with spinal cord injury. However, monitoring these patients over the long term is necessary. Relevance to clinical practice Our study results confirmed that the spinal cord injury home rehabilitation DVD is a practical health education tool. We plan to use the proposed DVD intervention with a larger number of hospitalised patients, and to continuously monitor their improvement.