ORCID Profile
0000-0002-9443-4082
Current Organisations
New Zealand Institute for Plant and Food Research Ltd
,
The University of Hong Kong
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Publisher: Elsevier BV
Date: 08-2022
Publisher: Wiley
Date: 15-04-2009
Publisher: Public Library of Science (PLoS)
Date: 21-07-2015
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.NEDT.2021.105161
Abstract: This review aimed to examine the changes of knowledge, attitude and working intention in nursing students after an undergraduate geriatric nursing education. A systematic review of the literature. Five databases which included CINAHL, MEDLINE, PubMed, Scopus and Web of Science were searched for this literature review from January 2010 to October 2020. The review was registered in PROSPERO registry with registration number CRD42020215703. The review examined undergraduate nursing education programs in terms of knowledge, attitude and working intention towards geriatric care among undergraduate nursing students as outcomes. We used JBI critical appraisal tools and Mixed Methods Appraisal Tool to evaluate and assess the quality of the retrieved research papers. The search yielded 19 studies included in the final review, 14 of which were quantitative studies and five were qualitative studies. Four types of education programs were identified. These were type 1, a four-year undergraduate gerontology program consisting of geriatric theory and geriatric care clinical placement type 2, stand-alone geriatric subject and geriatric clinical placement program type 3, integrated geriatric subject and geriatric clinical placement program type 4, solely geriatric clinical placement program. The review found that the type 2 program demonstrated the best educational outcomes in undergraduate students. This review provided the most recent literature evidence pertaining to undergraduate geriatric education program and its educational outcomes. Future research should focus on the evaluating the content of each type of geriatric education program to inform the development of undergraduate geriatric nursing education.
Publisher: Elsevier BV
Date: 08-2022
Publisher: Informa UK Limited
Date: 03-09-2021
Publisher: Wiley
Date: 16-10-2023
DOI: 10.1111/AJAG.13250
Publisher: Springer Science and Business Media LLC
Date: 21-01-2023
DOI: 10.1038/S41531-023-00452-W
Abstract: Clinical practice guidelines support resilience training and exercise for patients with Parkinson’s disease (PD). This assessor-blinded, randomized clinical trial aimed to compare the effects of a modified mindfulness meditation program versus stretching and resistance training exercise (SRTE) in patients with mild-to-moderate PD. A total of 126 potential participants were enrolled via convenience s ling, of which 68 eligible participants were randomized 1:1 to receive eight weekly 90-min sessions of mindfulness meditation or SRTE. Compared to the SRTE group, generalized estimating equation analyses revealed that the mindfulness group had significantly better improvement in outcomes, particularly for improving depressive symptoms ( d , −1.66 95% CI, −3.31 to −0.02) at week 8 and maintaining emotional non-reactivity at week 20 ( d , 2.08 95% CI, 0.59 to 3.56). Both groups demonstrated significant immediate, small-moderate effects on cognition (effect size [ d ] = 0.36–0.37, p = 0.006–0.011). Compared with the SRTE, mindfulness meditation appeared to be a feasible and promising strategy for managing depressive symptoms and maintaining emotional stability, with comparable benefits on cognitive performance. To combat the psychospiritual and cognitive sequelae of social unrest and COVID-19 pandemic, the integration of mindfulness training into motor-oriented PD rehabilitation protocols is recommended to strengthen the resilience and minimize the psycho-cognitive comorbidities among patients with mild-to-moderate PD. Trial Registration: HKU Clinical Trials Registry identifier: HKUCTR-2681.
Publisher: JMIR Publications Inc.
Date: 30-08-2022
Abstract: ser-centered design is essential for promoting the acceptance and use of robots. his study aimed to examine the robot appearance and function preferences among older Chinese immigrants in New Zealand. he study was undertaken between March and May 2020, a total of 103 participants completed the online survey. he average age was 62.16 (SD=9.42). Results suggest that 41.7% participants (n=43) desired adult human-like appearance, and 32% of them preferred animal-like appearance (n=33), and these participants reported higher scores in rigorousness and friendliness than other personalities. Participants’ most preferred six functions of robot were housework assistance (n=86, 83.5%), language translation (n=79, 76.7%), health monitor (n=78, 75.7%), facial expressions (n=77, 74.8%), news reading (n=66, 64.1%) and security monitor (n=65, 63.1%), which were significantly associated with marital status, financial status and length of immigration. he obtained findings serve as a basis for the implementation of concrete design principles for reliable robotic technology services.
Publisher: Wiley
Date: 08-2020
DOI: 10.1111/WVN.12462
Abstract: Critical care nurses are in the best position to detect and monitor delirium in critically ill patients. Therefore, an optimum delirium assessment tool with strong evidence should be identified with critical care nurses to perform in the daily assessment. To evaluate and compare the diagnostic performance of delirium assessment tools in diagnosing delirium in critically ill patients. We searched five electronic databases including the Cochrane Library, PubMed, Embase, CINAHL, and a Chinese database for eligible diagnostic studies published in English or Mandarin up to December 2018. This diagnostic test accuracy meta-analysis was limited to studies in intensive care unit (ICU) settings, using the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a standard reference to test the accuracy of delirium assessment tools. Eligible studies were critically appraised by two investigators independently. The summary of evidence was conducted for pooling and comparing diagnostic accuracy by a bivariate random effects meta-analysis model. The pooled sensitivities and specificities, summary receiver operating characteristic curve (sROC), the area under the curve (AUC), and diagnostic odds ratio (DOR) were calculated and plotted. The possibility of publication bias was assessed by Deeks' funnel plot. We identified and evaluated 23 and 8 articles focused on CAM-ICU and ICDSC, respectively. The summary sensitivities of 0.85 and 0.87, and summary specificities of 0.95 and 0.91 were found for CAM-ICU and ICDSC, respectively. The AUC of the CAM-ICU was 0.96 (95% CI, 0.94-0.98), with DOR at 99 (95% CI, 55-177). The AUC of the ICDSC was 0.95 (95% CI, 0.92-0.96), and the DOR was 65 (95% CI, 27-153). CAM-ICU demonstrated higher diagnostic test accuracy and is recommended as the optimal delirium assessment tool. However, the results should be interpreted with caution due to the between-study heterogeneity of this diagnostic test accuracy meta-analysis.
Publisher: Informa UK Limited
Date: 18-09-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-08-2023
DOI: 10.1097/NCC.0000000000001268
Abstract: Patients with advanced lung cancer commonly experience a high prevalence of physical and psychological symptoms, which tend to co-occur as a symptom cluster. Cortisol rhythm has the potential to influence psychoneurological symptom cluster based on neuroendocrine-immune models however, little is known about the relationship between them. To examine the intercorrelation among symptoms in psychoneurological symptom cluster and the factors influencing the severity of psychoneurological symptom cluster. One hundred sixty-one patients with advanced lung cancer were recruited from 2018 to 2020 as part of a large study. Data on sleep disturbances, fatigue, and psychological distress were collected via self-report questionnaires, and the diurnal cortisol slope was analyzed using saliva s les. Linear regression analyses were adopted to examine the association between cortisol rhythm and demographic and clinical variables with psychoneurological symptom cluster. Psychoneurological symptoms (including sleep disturbances, fatigue, anxiety, and depression) were significantly correlated. Poor physical performance status ( β = −0.061, P .001), increased number of comorbidities ( β = 0.533, P .001), and flatter cortisol rhythm ( β = 545.092, P .001) were significantly associated with higher-severity psychoneurological symptom cluster. Diurnal cortisol slope ( β = 328.829, P = .025) was identified as the most critical factor influencing the psychoneurological symptom cluster in multiple linear regression model after adjusting for covariates. Patients with flatter diurnal cortisol slopes were found to experience more severe psychoneurological symptom cluster, after controlling for demographic and clinical factors. Interventions targeting the improvement of associated factors, such as comorbidities and physical performance status, could potentially alleviate the severity of the psychoneurological symptom cluster.
Publisher: Cold Spring Harbor Laboratory
Date: 20-01-2021
DOI: 10.1101/2021.01.16.21249923
Abstract: To develop and psychometrically test a multiple choice questions (MCQs)-based quiz of delirium care knowledge for critical care nurses. Instrument development and psychometric evaluation study. The development and validation process including two phases. Phase I focused on the quiz development, conducted by the following steps: (1) generated initial 20-item pool (2) examined content validity and (3) face validity (4) conducted pilot testing, data were collected from 217 critical care nurses via online survey during 01 October to 07 November, 2020 (5) performed item analysis and eliminated items based on the item difficulty and discrimination indices. The MCQs quiz was finalised through the development process. Then, phases II emphasised the quiz validation, to estimate the internal consistency, split-half and test-retest reliability, and construct validity using parallel analysis with the exploratory factor analysis (EFA). A final 16-item MCQs quiz was emerged from the item analysis. The Kuder– Richardson Formula 20 coefficient for the overall quiz showed good internal consistency (0.85), and the intraclass correlation coefficient with a 30-day interval also indicated that the questionnaire had satisfactory stability (0.96). The EFA confirmed appropriate construct validity for the quiz, four factors could explain the total variance of 60.87%. This study developed the first MCQs quiz for delirium care knowledge and it is a reliable and valid tool that can be implemented to assess the level of delirium care knowledge. This study offers an evidence-based quiz designed for future research and education purposes in delirium care that has significant implications for knowledge test by using MCQs in clinical practice.
Publisher: Wiley
Date: 21-03-2023
DOI: 10.1111/WVN.12637
Abstract: The coronavirus disease‐2019 (COVID‐19) pandemic caused unprecedented disruption to healthcare delivery worldwide. The use of telehealth practices rapidly expanded during the pandemic, while its application in palliative care remains a conflicted issue. The aims of this study were to evaluate users' reports of their satisfaction with telehealth palliative care during COVID‐19 and to identify facilitators and barriers to telehealth implementation in palliative care during COVID‐19. A systematic search of the literature, including studies between January 2020 and June 2022, was conducted using PubMed, MEDLINE, CINAHL Plus, Embase, and Google Scholar. Empirical studies of telehealth in palliative care during COVID‐19 were included. A total of 18 studies were included in the review, of which nine were outpatient consultations, four were family meetings, two were remote volunteering programs, two were inpatient care, and one was a residential care home needs assessment. The satisfaction rates were high (66%–99%) among patients and family members who participated in telehealth consultations, but the satisfaction with family meetings was mixed. Compared with their clients, healthcare professionals were less likely to assess telehealth as satisfactory. The authors identified four barriers and four facilitators. The barriers were technological challenges, lack of nonverbal communication, ethical concerns, and limitations for clinical practice. The facilitators were accessibility and convenience, visual cues, facilitation and training, and family engagement. This systematic mixed studies review suggests that current evidence supports the feasibility of telehealth implementation in palliative care for outpatient consultations and routine follow‐up appointments. This review also identified facilitators and barriers to telehealth in palliative care, and the findings can inform the implementation of future palliative care services. Future attention should be paid to the effectiveness of telehealth implementation in palliative care patients.
Publisher: Wiley
Date: 02-12-2016
DOI: 10.1111/JOCN.13510
Abstract: To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients. Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high-risk inpatients. Secondary data analysis. A subset of inpatient data for the period from June 2011-June 2014 was extracted from the nursing information system and adverse event reporting system of an 818-bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis. During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut-off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive predictive value of 2·0% and a negative predictive value of 99%. The receiver operating characteristic curve analysis revealed an area under the curve of 0·805 (sensitivity, 71·8% specificity, 78%). To increase the sensitivity values, the Youden index suggests at least 1·5 points to be the most suitable cut-off point for the inpatient fall risk screening tool. Multivariate logistic regression analysis revealed a considerably increased fall risk in patients with impaired balance and impaired elimination. The fall risk factor was also significantly associated with days of hospital stay and with admission to surgical wards. The findings can raise awareness about the two most critical risk factors for falls among future clinical nurses and other healthcare professionals and thus facilitate the development of fall prevention interventions. This study highlights the needs for redefining the cut-off points of the inpatient fall risk screening tool to effectively identify inpatients at a high risk of falls. Furthermore, inpatients with impaired balance and impaired elimination should be closely monitored by nurses to prevent falling during hospitalisations.
Publisher: Springer Science and Business Media LLC
Date: 25-05-2022
DOI: 10.1186/S12903-022-02237-8
Abstract: Poor oral health affects quality of life oral health literacy studies are increasing as it plays an essential role in promoting oral health. However, little is known regarding the gender differences in oral health literacy and oral health-related quality of life (OHRQoL) among older adults. This study aimed to explore the gender differences in oral health literacy and OHRQoL among community-dwelling older adults in Taiwan. A cross-sectional study design with convenience s ling was undertaken to recruit participants at two community service centres. Data were collected using a structured survey consisted of the demographic characteristics, instrumental activities of daily living, nutrition assessment, oral health literacy and OHRQoL. The logistic regression was used to examine the gender differences in the relationship between oral health literacy and OHRQoL. A total of 202 participants completed the survey. Of which 56.4% (n = 114) were female. Logistic regression analyses showed that after controlling for age, instrumental activities of daily living, nutrition, education level, and average monthly income, better oral health literacy was associated with better oral health quality of life ( p = 0.006) in men. The relationship between oral health literacy and OHRQoL was only significant for men. No significant relationship between women’s oral health literacy and their OHRQoL. However, good OHRQoL is an integral part of overall health, but it is affected by differences in oral health and the accessibility of healthcare services. We suggest that gender-specific oral health literacy education should be offered through community health-education programs.
Publisher: New Zealand Plant Protection Society
Date: 27-01-2020
DOI: 10.30843/NZPP.2020.73.11012
Abstract: Taro leaf blight (TLB), caused by Phytophthora colocasiae, is normally characterised by leaf lesions. There are isolated reports of P. colocasiae causing a corm rot but the symptoms are not well defined and have not been recorded in Samoa. Here we report on an inoculation method and describe the symptoms of corm rot caused by P. colocasiae. In this study, a corm inoculation method was developed in physical containment laboratories in New Zealand and subsequent symptom development studies were undertaken on TLB-tolerant taro cultivars in Apia, Samoa. The Samoan TLB-tolerant taro cultivars were able to be wound-infected with P. colocasiae and the results confirm previous descriptions of P. colocasiae infection giving rise to light brown firm rots in corms. This work has allowed the pictorial record of corm rots to be updated, potentially providing for better distinction between corm rots caused by P. colocasiae and those caused by other pathogens, such as Fusarium spp.
Publisher: Elsevier BV
Date: 06-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 22-04-2022
DOI: 10.1097/JNR.0000000000000487
Abstract: Delirium remains significantly undetected in the intensive care unit (ICU). Little is known regarding the level of delirium care knowledge among critical care nurses in Taiwan. This study was designed to investigate the level of knowledge about delirium care among critical care nurses using a multiple-choice question quiz. A descriptive, cross-sectional approach was used, and data were collected using a web-based survey. The demographic characteristics including age, years worked as critical care nurse, gender, advanced ICU training, educational level, and type of ICU, along with a delirium care knowledge quiz, were collected. The quiz consisted of 16 items measuring (a) symptoms, types, and outcomes (b) high-risk groups (c) predisposing and precipitating factors and (d) assessment and detection of delirium. Data were collected between October 6 and November 16, 2020. In total, 324 critical care nurses completed the survey. The rate of correct response on the delirium care quiz for each domain was measured: (a) symptoms, types, and outcomes: 67.1% (b) high-risk groups: 76.2% (c) predisposing and precipitating factors: 78.9% and (d) assessment and detection: 41.5%. The item with the lowest correct response rate was related to the interpretation of delirium assessments. The findings of this study suggest that future studies and education should focus on the use and interpretation of the assessment using a valid delirium assessment tool to improve the ability of critical care nurses to detect delirium in ICU settings.
Publisher: Elsevier BV
Date: 12-2023
Publisher: Elsevier BV
Date: 12-2022
Publisher: SAGE Publications
Date: 28-12-2020
Abstract: This review aimed to summarise the validity and reliability of feeding difficulties assessment tools for In idual with dementia. PubMed, PsycINFO, MEDLINE, CINAHL and Scopus were searched for feeding difficulty measurements studies published between 1990 and 2019. Sixteen publications were included and identified three tools: Edinburgh Feeding Evaluation in Dementia (EdFED), Feeding Behaviour Inventory (FBI), and Feeding Difficulty Index (FDI). Results showed the EdFED was translated and tested in various languages. The EdFED and FDI demonstrated high content and construct validity. The FBI was not validated. The EdFED had high inter-rater reliability, with Cronbach’s alpha ranging from 0.75 to 0.90. The FDI and FBI showed moderate inter-rater reliability. Although the EdFED has been tested and widely used, unlike FDI, which addresses multi-aspects of feeding difficulty. The FDI have higher clinical utility but future research needs to test the psychometric properties of FDI to determine its effectiveness in assessing feeding difficulties.
Publisher: Wiley
Date: 20-05-2023
DOI: 10.1111/OPN.12551
Abstract: Existing gerontological nursing competencies include the requisite knowledge and skills required for aged care nursing. What were not previously considered were legal and ethical aspects and access to technology, e‐health and social media. This study aimed to validate an Australian gerontological nursing competencies scale and assess the factors associated with for aged care nurses in Taiwan. A methodological study design was used to validate the scale with a s le of 369 aged care nurses from aged care settings including nursing homes, long‐term care facilities and aged care wards in Taiwan. The cultural adaptation and psychometric validation were evaluated. The content validity, construct validity through exploratory factor analysis and the internal consistency of the scale were assessed. The exploratory factor analysis extracted two levels of gerontological nursing practice, ‘essential’ and ‘enhanced’, which accounted for 80.8% of the total variance. The internal consistency, split‐half reliability and test–retest reliability were excellent. Aged care nurses with higher levels of education, aged care education as their highest degree and continued education within 6 months, and certified long‐term care education had higher gerontological nursing competencies scores than those who did not. This validated gerontological nursing competencies scale is a reliable and valid tool that can be implemented in future workforce planning, research and postgraduate and undergraduate curriculum and education in Taiwan and other Mandarin‐speaking locales. Using validated gerontological nursing competencies scales to explain different levels of specialist practice is crucial for addressing negative views about aged nursing and explicitly demonstrate the possibilities for career pathways in gerontological nursing.
Publisher: American Chemical Society (ACS)
Date: 09-07-2014
DOI: 10.1021/PR500176C
Abstract: A proteogenomic analysis is presented for Venturia pirina, a fungus that causes scab disease on European pear (Pyrus communis). V. pirina is host-specific, and the infection is thought to be mediated by secreted effector proteins. Currently, only 36 V. pirina proteins are catalogued in GenBank, and the genome sequence is not publicly available. To identify putative effectors, V. pirina was grown in vitro on and in cellophane sheets mimicking its growth in infected leaves. Secreted extracts were analyzed by tandem mass spectrometry, and the data (ProteomeXchange identifier PXD000710) was queried against a protein database generated by combining in silico predicted transcripts with six frame translations of a whole genome sequence of V. pirina (GenBank Accession JEMP00000000 ). We identified 1088 distinct V. pirina protein groups (FDR 1%) including 1085 detected for the first time. Thirty novel (not in silico predicted) proteins were found, of which 14 were identified as potential effectors based on characteristic features of fungal effector protein sequences. We also used evidence from semitryptic peptides at the protein N-terminus to corroborate in silico signal peptide predictions for 22 proteins, including several potential effectors. The analysis highlights the utility of proteogenomics in the study of secreted effectors.
Publisher: Wiley
Date: 21-10-2022
DOI: 10.1002/NOP2.1420
Abstract: This study aimed to examine the differences in health status between patients with confirmed COVID‐19 and those suspected (other diagnosis) and to identify nursing diagnoses using a structured checklist from a hospital in China. Cross‐sectional study design was used. One hundred sixty COVID‐19 confirmed, and suspected patients were conveniently selected. A structured survey and checklist were utilized. Independent t test and chi‐square test were employed to compare the mean between patients with confirmed coronavirus infection and others. A two‐sided p ‐value of .05 or less is considered statistically significant. The study yielded a response rate of 93.6%. The result indicated that patients with confirmed coronavirus infection have a higher proportion of perceived General Health Status than inpatients with suspected (other) diagnoses. The finding also indicated that ineffective airway clearance, hyperthermia, imbalanced nutrition less than body requirement and sleep pattern disturbance were the main nursing diagnoses identified.
Publisher: Wiley
Date: 04-09-2021
DOI: 10.1111/WVN.12536
Abstract: Postoperative delirium is the most common complication of surgery particularly in older patients. The current study aimed to summarize the commonly used delirium assessment tools in assessing postoperative delirium (POD) and to estimate the incidence rates of POD. A systematic review that included empirical cohort studies reporting the use of delirium assessment tools in assessing POD between 2000 and 2019. Five core databases were searched for eligible studies. The methodological quality assessment of the included studies was undertaken using the Joanna Briggs Institute (JBI) critical appraisal checklist to examine the risk of bias. Pooled incidence estimates were calculated using a random effects model. Nineteen studies with a total of 3,533 postsurgery older patients were included in this review. The confusion assessment method (CAM) and CAM‐ICU were the most commonly used tools to assess POD among older postoperative patients. The pooled incidence rate of POD was 24% (95% CI [0.20, 0.29]). The pooled incidence estimates for mixed (noncardiac) surgery, orthopedic surgery, and tumor surgery were 23% (95% CI [0.15, 0.31]), 27% (95% CI [0.20, 0.33]), and 19% (95% CI [0.15, 0.22]), respectively. More than 50% of included studies used CAM to assess POD in different types of postoperative patients. Using CAM to assess delirium is less time‐consuming and it was suggested as the most efficient tool for POD detection. We identified that CAM could be implemented in different settings for assessing POD. The incidence and risk factors for POD introduced can be used for future research to target these potential indicators. The incidence rate, risk factors, and predictors of POD explored can provide robust evidence for clinical practitioners in their daily practice.
Publisher: Springer Science and Business Media LLC
Date: 02-06-2023
Publisher: Springer Science and Business Media LLC
Date: 25-05-2023
DOI: 10.1186/S12877-023-04019-5
Abstract: World Health Organization (WHO) has defined healthy ageing by highlighting five functional ability domains to (meet basic needs, make decisions, be mobile, build and maintain relationships, and contribute to society), which also emphasized the importance of addressing loneliness as priorities within United Nations Decade of Healthy Ageing initiative. However, the level and determinants of healthy ageing and its association with loneliness are rarely examined. This study aimed to construct a healthy ageing index to verify the WHO healthy ageing framework, measure five domains of functional ability of older adults and examine the relationship between functional ability domains and loneliness. A total of 10,746 older adults from the 2018 China Health and Retirement Longitudinal Study (CHARLS) were included. A healthy ageing index ranging from 0 to 17 was constructed using 17 components related to functional ability domains. Univariate and multivariate logistic regression analyses were utilized to determine the association between loneliness and healthy ageing. The STROBE guidelines with the RECORD statement for observational studies using routinely collected health data were observed. The factor analysis verified the five functional ability domains for healthy ageing. After adjusting for confounders, being mobile, building and maintaining relationships, and learning, growing and making decisions were significantly associated with lesser loneliness among participants. The healthy ageing index of this study can be utilized and further modified with respect to large-scale research with relevant healthy ageing topics. Our findings will support healthcare professionals to provide patient-centered care when identifying their comprehensive abilities and needs.
Publisher: Frontiers Media SA
Date: 06-03-2023
DOI: 10.3389/FPSYG.2023.993143
Abstract: Manufacturing facilities and factories are stressful work environments. Interventions to improve factory workers’ stress is necessary to promote occupational health. This study aimed to examine the effects of virtual reality natural experiences on furniture factory employees’ psychological and physiological stress. A single-blinded, non-randomised quasi-experimental study was conducted between July and December 2021. Factory workers were recruited from two factories, and all participants at a given factory were assigned to either an experimental group or a comparison group. The intervention was conducted in a clean conference room once a week for 12 weeks during the worker’s break time. The experimental group received virtual reality natural experiences consisting of 30-minute nature-based 360° videos which were played in a headset. The generalised estimating equations were performed for the statistical analyses. In total, 35 participants completed the intervention. As to psychological stress, the experimental group showed improvements in distress, depression, and anxiety, and a positive affect after the intervention compared to the comparison group. As to physiological stress, the experimental group showed improvements in indicators of heart rate variability compared to the comparison group, including standard deviations of all normal-to-normal intervals, low-frequency power, and high-frequency power. Virtual reality is an innovative platform to bring the natural environment into an indoor environment to create similar health effects.
Publisher: Springer Science and Business Media LLC
Date: 03-11-2022
DOI: 10.1186/S12915-022-01442-9
Abstract: Scab, caused by the biotrophic fungus Venturia inaequalis , is the most economically important disease of apples worldwide. During infection, V. inaequalis occupies the subcuticular environment, where it secretes virulence factors, termed effectors, to promote host colonization. Consistent with other plant-pathogenic fungi, many of these effectors are expected to be non-enzymatic proteins, some of which can be recognized by corresponding host resistance proteins to activate plant defences, thus acting as avirulence determinants. To develop durable control strategies against scab, a better understanding of the roles that these effector proteins play in promoting subcuticular growth by V. inaequalis , as well as in activating, suppressing, or circumventing resistance protein-mediated defences in apple, is required. We generated the first comprehensive RNA-seq transcriptome of V. inaequalis during colonization of apple. Analysis of this transcriptome revealed five temporal waves of gene expression that peaked during early, mid, or mid-late infection. While the number of genes encoding secreted, non-enzymatic proteinaceous effector candidates (ECs) varied in each wave, most belonged to waves that peaked in expression during mid-late infection. Spectral clustering based on sequence similarity determined that the majority of ECs belonged to expanded protein families. To gain insights into function, the tertiary structures of ECs were predicted using AlphaFold2. Strikingly, despite an absence of sequence similarity, many ECs were predicted to have structural similarity to avirulence proteins from other plant-pathogenic fungi, including members of the MAX, LARS, ToxA and FOLD effector families. In addition, several other ECs, including an EC family with sequence similarity to the AvrLm6 avirulence effector from Leptosphaeria maculans , were predicted to adopt a KP6-like fold. Thus, proteins with a KP6-like fold represent another structural family of effectors shared among plant-pathogenic fungi. Our study reveals the transcriptomic profile underpinning subcuticular growth by V. inaequalis and provides an enriched list of ECs that can be investigated for roles in virulence and avirulence. Furthermore, our study supports the idea that numerous sequence-unrelated effectors across plant-pathogenic fungi share common structural folds. In doing so, our study gives weight to the hypothesis that many fungal effectors evolved from ancestral genes through duplication, followed by sequence ersification, to produce sequence-unrelated but structurally similar proteins.
Publisher: Wiley
Date: 11-10-2023
DOI: 10.1002/OHN.557
Publisher: Wiley
Date: 22-06-2021
DOI: 10.1111/JAN.14938
Abstract: To evaluate the effects of a simulation‐based education programme on critical care nurses’ knowledge, confidence, competence and clinical performance in providing delirium care. Single‐blinded randomized controlled trial. Registered nurses who work in intensive care units were recruited from a university‐affiliated acute major metropolitan teaching hospital. The intervention group received: (i) five online‐learning delirium care videos, (ii) one face‐to‐face delirium care education session and (iii) a simulation‐based education programme with a role‐play scenario‐based initiative and an objective structured clinical examination. The control group received only online videos which were the same as those provided to the intervention group. Delirium care knowledge, confidence, competence, and clinical performance as outcomes were collected at: baseline, immediately after intervention, and within 6 weeks post‐intervention to test whether there were any changes and if they were sustained over time. Data were collected between 2 October and 29 December 2020. The repeated‐measures analysis of variance was used to examine for changes in delirium care knowledge, confidence, and competence within groups. Seventy‐two critical care nurses participated with 36 each allocated to the intervention group and control group. No statistically significant difference was observed between the two groups in outcome variables at 6 weeks post‐intervention. In the intervention group, significant within‐group changes were observed in terms of delirium care knowledge, confidence, and competence over time. By contrast, no significant changes were observed in outcome measures over time in the control group. The simulation‐based education programme is an effective and feasible strategy to improve delirium care by enhancing the knowledge, confidence, competence and clinical performance of critical care nurses. Our findings provide evidence regarding the development and implementation of a simulation‐based education programme in hospitals for health professional education in Taiwan.
Publisher: Springer Science and Business Media LLC
Date: 05-2023
Publisher: Elsevier BV
Date: 02-2021
Publisher: Elsevier BV
Date: 05-2023
Publisher: Elsevier BV
Date: 12-2023
Publisher: Springer Science and Business Media LLC
Date: 16-11-2022
DOI: 10.1186/S12877-022-03493-7
Abstract: Studies on examining the relationship between physical activity patterns and frailty are lacking. This study examined physical activity patterns in older people and investigated the relationship between physical activity and frailty as well as identifying the predictors of frailty. We used a nationally representative longitudinal database, the Taiwan Longitudinal Study of Aging (TLSA) database, and data for a 20-year period were extracted and analyzed. A total of 5131 participants aged ≥ 60 years in 1996 were included in the current analysis. Information regarding demographic characteristics, frailty, physical activity, comorbidities, oral health, and depressive symptoms was extracted from the TLSA database. Physical activity patterns were examined using group-based trajectory modeling from 1996 to 2015. Potential predictors were examined by performing multivariate logistic regression. Four trajectories of the physical activity pattern were found: consistently physically inactive (33.7%), consistently physically active (21.5%), incline (21.6%), and decline (23.2%). Throughout the period, the trajectories of the four groups significantly differed from each other at year 2015, with the incline and decline groups exhibiting the lowest and highest frailty scores, respectively ( p 0.001). Older age, male, poor oral health, diabetes, chronic kidney disease, and depressive symptoms were identified as risk factors for frailty. Physical activity reduces the risk of chronic conditions, which contributes to healthy longevity. This study can guide the development of future research and interventions to manage frailty in older people, particularly in considering previous physical activity trajectories within the life course.
Publisher: Elsevier BV
Date: 10-2023
Publisher: BMJ
Date: 19-10-2023
Publisher: Informa UK Limited
Date: 04-05-2022
Publisher: Wiley
Date: 26-07-2019
DOI: 10.1111/PHN.12646
Abstract: This study evaluated the Integrated Behavioral Model and examined oral self-care behavior of community-dwelling middle-aged and older people. A cross-sectional design was used. Purposive s ling was employed to recruit middle and older age community-dwelling in iduals, with research locations in public health centers in northern Taiwan. Structured questionnaires comprised: participant demographics, oral health literacy, oral self-care attitude, self-efficacy, intention, and behavior, and significant others' perceptions and beliefs as well as environmental constraints. The Model verification was evaluated by path analysis. Two hundred and sixty-three participants (N = 263) completed the questionnaire survey. Results identified significant direct effects of the independent variables of oral health care literacy, intention of oral self-care, and perception of environmental constraints on the dependent variable of oral self-care behavior and significant indirect effects on attitude of oral self-care, perception of significant other beliefs, self-efficacy of oral self-care. Public health nurses work with the whole community and can potentially improve the oral self-care behavior of middle-aged and older adults by enhancing their oral health knowledge, maintaining their positive attitudes, assisting acceptance of recognition and support from others, increasing their ability to perform oral self-care, reducing environmental constraints, and thereby enhancing their oral self-care awareness.
Publisher: SLACK, Inc.
Date: 06-2020
DOI: 10.3928/00989134-20200504-01
Abstract: The current integrative review explored the prevalence of delirium among Thai older adults and the role of nurses and physicians in detecting delirium. Several academic databases were searched for relevant studies using a set of predetermined search terms and limits. Study quality was assessed using the National Health and Medical Research Council's Principles of Peer Review. Thirteen studies were reviewed, and three themes were identified: (a) Epidemiology ( n = 9), (b) Detection ( n = 5), and (c) Role of Nurses and Physicians ( n = 4). Higher priority cases were treated for immediate problems by physicians, but they did not routinely screen for delirium, which remained underdiagnosed. Lack of delirium screening guidelines or protocols was found to be the greatest barrier to detection. The ability of nurses to perform delirium screening was disregarded in most studies. There is limited research exploring delirium in Thai older adults, including lack of guidelines or protocols for health care professionals and lack of knowledge of delirium detection, management, and prevention. Further validation of screening tools and developing the training of health care professionals, specific to detecting delirium, is required. [ Journal of Gerontological Nursing, 46 (6), 43–52.]
Publisher: Wiley
Date: 19-11-2019
DOI: 10.1111/PHN.12688
Abstract: This study aimed to translate the Oral Health Literacy Adult Questionnaire into a Mandarin version (MOHL-AQ) and to examine its psychometric properties. A methodological research using psychometric testing and evaluation of a translated instrument. A convenience s le of 402 participants from northern Taiwan were recruited for the validation of the MOHL-AQ. Internal consistency reliability, split-half reliability, inter-rater reliability, face validity, content validity, and construct validity were evaluated. The value of internal consistency and split-half reliability of the MOHL-AQ were 0.77 and 0.78, respectively. Content validity reported a high content validity index (CVI = 95%). Exploratory factor analysis (EFA) and parallel analysis (PA) were used to determine a unidimensional model and confirmatory factor analysis (CFA) was employed to confirm the model. The indices of good fit model were achieved at GFI = 0.93, AGFI = 0.92, RMSEA = 0.04, CFI = 0.90, PGFI = 0.73, χ MOHL-AQ demonstrates adequate psychometric properties for measuring the oral health literacy in Mandarin-speaking population. Public health nurses can use MOHL-AQ to assess oral health literacy in the community settings and further screen potential population with inadequate oral health literacy.
Publisher: Wiley
Date: 20-05-2022
DOI: 10.1111/PHN.13095
Abstract: This study aimed to retrospectively examine the contribution of nurses to population health outcomes with reference to nurse visits and blood pressure measurement in primary health settings. A retrospective study was conducted using New Zealand Health Survey (NZHS) from 2012 to 2017. Adult population who are 18 years old and over living in New Zealand. Age, gender, and ethnicity, the service utilization of primary health care nurse visit and blood pressure measurement were extracted from the NZHS (2012-2017) to compare with the service utilization of primary health care nurses by different demographic groups. Females who have treated hypertension shows higher utilization of nurse visit than males. From 2015 to 2017, the participants in this cohort have visited a primary health care nurse at least more than once within a year. With blood pressure control, the overall pooled results show the impact of visiting primary health nurses on systolic and diastolic blood pressure control. Our study at a national scale, demonstrated the impact of nurse's contribution to population health outcomes among people living with hypertension in New Zealand. Nurses are key to improving population health outcomes and to achieve universal health coverage.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Wiley
Date: 26-08-2011
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1016/J.ICCN.2019.102784
Abstract: To review and examine the evidence on diagnostic test accuracy of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) for predicting delirium risk in critically ill patients. This meta-analysis included studies reporting the diagnostic performance of PRE-DELIRIC between 2012 and 2019. The Cochrane Library, MEDLINE, Embase, CINAHL and Chinese Electronic Periodical Services databases were searched for eligible diagnostic studies. Risk of bias was assessed using a standard procedure according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria. We included seven studies involving a total of 7941 critically ill patients in intensive care units settings. Results indicated that PRE-DELIRIC had a summary sensitivity of 0.76 (95% CI 0.60-0.87), and specificity of 0.66 (95% CI 0.45-0.82), suggesting that diagnostic performance of PRE-DELIRIC is useful to predict delirium risk in ICU patients. The area under the summary receiver operator characteristics (SROC) curve was 0.78 (95% CI 0.74-0.81), which also confirmed good accuracy of PRE-DELIRIC. We suggest that the PRE-DELIRIC model can be applied in the intensive care unit according to its good diagnostic test accuracy. However, this finding should be interpreted with caution due to the heterogeneity of this meta-analysis.
Publisher: Wiley
Date: 02-05-2023
DOI: 10.1111/WVN.12649
Abstract: With the increase in life expectancy around the globe, the incidence of postoperative delirium (POD) among older people (≥65 years) is growing. Previous studies showed a wide variation in the incidence of POD, from 4% to 53%, with a lack of specific evidence about the incidence of POD by specific surgery type among older people. The aim of this systematic review and meta‐analysis was to determine the incidence of POD by surgery type within populations 65 years and over. Databases including PubMed, Cochrane library, Embase, and CINAHL were searched until October 2020. Due to the relatively higher number of meta‐analyses undertaken in this area of research, a streamlined systematic meta‐analysis was proposed. A total of 28 meta‐analyses (comprising 284 in idual studies) were reviewed. Data from relevant in idual studies ( n = 90) were extracted and included in the current study. Studies were grouped into eight surgery types and the incidence of POD for orthopedic, vascular, spinal, cardiac, colorectal, abdominal, urologic, and mixed surgeries was 20%, 14%, 13%, 32%, 14%, 30%, 10%, and 26%, respectively. POD detection instruments were different across the studies, with Confusion Assessment Method (CAM & CAM‐ICU) being the most frequently adopted. This study showed that POD incidence in older people undergoing surgery varied widely across surgery type. The more complex surgeries like cardiac and abdominal surgeries were associated with a higher risk of POD. This highlights the need to include the level of surgery complexity as a risk factor in preoperative assessments.
Publisher: Elsevier BV
Date: 2021
Publisher: Wiley
Date: 19-04-2022
DOI: 10.1111/AJAG.13075
Abstract: To examine loneliness experienced by middle‐aged and older Chinese immigrants and its association with accepting technology as a companion (apps, Internet and robots) versus owning pets, when social distancing measures were implemented in New Zealand during the first COVID‐19 outbreak. This study conducted a community‐based cross‐sectional survey. Chinese immigrants who were 45–87 years old ( n = 173) were invited to answer an online survey in the Chinese language, collecting demographic data, responses to the 6‐item De Jong Gierveld Loneliness Scale and experiences in using technology and pet ownership. Descriptive analyses and inferential statistics tests were utilised in the data analysis. A moderate level of overall loneliness with a mean score of 3.68 (SD 1.84), ranging from 0 to 6, was reported by participants. Emotional and social loneliness ranged from 0 to 3 with mean scores of 1.69 (SD 0.98) and 1.99 (SD 1.24), respectively. Self‐reported health, financial status, English language abilities, transportation and experiences of using the Internet and apps were significantly related to experiencing loneliness. Loneliness had a weak association with acceptance of robots and pets, but 67.8% and 58.3% of participants who felt lonely, accepted companionship of robots and pets, respectively. The level of loneliness among older and middle‐aged immigrants increased during the COVID‐19 pandemic. Further evidence of the specific dimensions of loneliness and the utility of technology to alleviate loneliness among immigrant groups is needed. Interventions tailored for older people with specific cultural requirements to address loneliness are needed.
Publisher: Public Library of Science (PLoS)
Date: 22-02-2017
Publisher: Elsevier BV
Date: 07-2023
Publisher: Elsevier BV
Date: 09-2023
Publisher: Wiley
Date: 28-03-2023
DOI: 10.1111/AJAG.13192
Abstract: This systematic review and meta‐analysis aimed to examine non‐pharmacological interventions for helping people with dementia who experience feeding difficulties in order to improve their nutritional status. The articles were searched using PsycINFO, Medline, PubMed, CINAHL and Cochrane. Two independent investigators critically appraised eligible studies. The PRISMA guidelines and checklist were used. The possibility of risk of bias was assessed using a tool to assess the quality of randomised control trials (RCT) and non‐RCT studies. A narrative synthesis was conducted as a method of synthesis. The Cochrane Review Manager (RevMan 5.4) was used for meta‐analysis. The systematic review and meta‐analysis included seven publications. Six interventions were identified and categorised as: eating ability training for people with dementia, staff training and feeding assistance and support. The meta‐analysis found evidence of the effect of eating ability training on feeding difficulty, quantified by the Edinburgh Feeding Evaluation in Dementia scale (EdFED) with a weighted mean difference of −1.36 (95% confidence interval: −1.84 to −0.89, p 0.001) and on self‐feeding time. A spaced retrieval intervention showed a positive effect on EdFED. The systematic review discovered that while feeding assistance had a positive effect on feeding difficulty, staff training had no effect. According to the meta‐analysis, these interventions had no effect on improving the nutritional status of people with dementia. None of the included RCTs met the Cochrane risk‐of‐bias criteria for randomised trials. This review found that direct training for people with dementia and indirect feeding support from care staff resulted in fewer mealtime difficulties. More RCT studies are needed to determine the efficacy of such interventions.
Publisher: Wiley
Date: 27-02-2021
DOI: 10.1111/NICC.12608
Publisher: Elsevier BV
Date: 11-2021
Publisher: MDPI AG
Date: 16-03-2022
Abstract: Early preventive strategies for improving cognitive function are crucial for people with mild cognitive impairment (MCI). Cognitive training exercises may improve cognitive functioning. However, there was limited evidence from training programs that combined cognitive-specific and physical activities, particularly in using interactive video games as interventions. This study aimed to evaluate the feasibility and effects of the interactive-video games on cognitive function, physical function, mood status and quality of life in community-dwelling people with MCI. A quasi-experimental study was undertaken. Participants in the intervention group received 60 min group-based training program once per week for 12 weeks. A generalised estimating equation (GEE) was used to examine the main effect, interactions and changes in outcomes over time. Sixteen participants completed the trial with eight in the intervention group and eight in the comparison group. The tolerable acceptance rate, perfect attendance rate, high satisfaction with the training content, and no injuries or falls demonstrated the feasibility of this program. The scores of cognitive function increased in both groups and the interaction between time and groups were significant over 12 weeks of training (p 0.05). As the result, we determined that interactive-video games can be a safe, feasible, enjoyable intervention and user-friendly among people with MCI in community settings.
Publisher: Cold Spring Harbor Laboratory
Date: 23-03-2022
DOI: 10.1101/2022.03.22.482717
Abstract: Scab, caused by the biotrophic fungus Venturia inaequalis , is the most economically important disease of apples worldwide. During infection, V. inaequalis occupies the subcuticular environment, where it secretes virulence factors, termed effectors, to promote host colonization. Consistent with other plant-pathogenic fungi, many of these effectors are expected to be non-enzymatic proteins, some of which can be recognized by corresponding host resistance proteins to activate plant defences, thus acting as avirulence determinants. To develop durable control strategies against scab, a better understanding of the roles that these effector proteins play in promoting subcuticular growth by V. inaequalis , as well as in activating, suppressing or circumventing resistance protein-mediated defences in apple, is required. We generated the first comprehensive RNA-seq transcriptome of V. inaequalis during colonization of apple. Analysis of this transcriptome revealed five temporal waves of gene expression that peaked during early, mid or mid-late infection. While the number of genes encoding secreted, non-enzymatic proteinaceous effector candidates (ECs) varied in each wave, most belonged to waves that peaked in expression during mid-late infection. Spectral clustering based on sequence similarity determined that the majority of ECs belonged to expanded protein families. To gain insights into function, the tertiary structures of ECs were predicted using AlphaFold2. Strikingly, despite an absence of sequence similarity, many ECs were predicted to have structural similarity to avirulence proteins from other plant-pathogenic fungi, including members of the MAX, LARS, ToxA and FOLD effector families. In addition, several other ECs, including an EC family with sequence similarity to the AvrLm6 avirulence effector from Leptosphaeria maculans , were predicted to adopt a KP6-like fold. Thus, proteins with a KP6-like fold represent another structural family of effectors shared among plant-pathogenic fungi. Our study reveals the transcriptomic profile underpinning subcuticular growth by V. inaequalis and provides an enriched list of ECs that can be investigated for roles in virulence and avirulence. Furthermore, our study supports the idea that numerous sequence-unrelated effectors across plant-pathogenic fungi share common structural folds. In doing so, our study gives weight to the hypothesis that many fungal effectors evolved from ancestral genes through duplication, followed by sequence ersification, to produce sequence-unrelated but structurally similar proteins.
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.FGB.2008.07.010
Abstract: Venturia inaequalis is a hemibiotrophic ascomycete that causes apple scab. Germ tubes, from conidia or ascospores, penetrate the leaf or fruit surface directly via appressoria-like swellings subsequently the hyphae ide laterally to form a stroma between the cuticle and the outer wall of the epidermal cells. This morphological switch can be mimicked by growing the fungus in vitro on cellophane discs. The aim of this work was to identify genes upregulated in planta using growth on cellophane as a model. Four cDNA clones were found to be induced by growth on cellophane, and qRT-PCR showed two of these genes were up-regulated over a thousand fold in infected apple leaves compared to liquid culture. The predicted proteins for both genes possess putative signal peptides for secretion but have no similarity to sequences in publicly available databases. Both genes encode proteins with novel, imperfect repeat domain structures, the number of which vary in an isolate-specific fashion. Cin1 has seven or eight repeats of about 60 amino acids with four conserved cysteine residues per repeat, while Cin3 has four or five repeats of 32 amino acids with no cysteines. Both proteins appear to have evolved through internal duplication. Cin3, in particular, shows considerable between-strain variation in domain structure, indicating a high degree of recombination at this locus and revealing that the repeat structure has most likely arisen by unequal crossing-over. Results of this study support the hypothesis that cellophane-grown V. inaequalis mimics aspects of biotrophic infection and provide the first insights into novel fungal genes expressed during apple scab infection and their mechanisms of evolution.
Publisher: Springer Science and Business Media LLC
Date: 13-10-2022
DOI: 10.1186/S12912-022-01066-Y
Abstract: End-of-life care can be a difficult and challenging process for critical care nurses in intensive care units (ICUs) due to the care plan shifts from providing life-sustaining measures to end-of-life care. The aims of this study were to assess critical care nurses' perceived knowledge and attitudes toward end-of-life care, as well as their perspectives on promoting advance directives and the associated factors. A cross-sectional study was undertaken in an acute major metropolitan medical center in northern Taiwan between February and March 2020, and 250 critical care nurses were invited to participate in the study. Data on demographics, self-perceived knowledge of end-of-life care, attitudes toward end-of-life care, and perspectives of promoting advance directives were collected. A multiple linear regression model with stepwise selection was used to identify factors associated with their perspectives of promoting advance directives. The law related to end-of-life care was rated as the least familiar part of the self-perceived end-of-life care knowledge, while ‘I have sufficient knowledge to care for patients who have accepted end-of-life care’ was the lowest level of agreement in attitude scores among critical care nurses. Increased levels of perceived knowledge ( β = 0.134 p = 0.045) and attitudes ( β = 0.423 p 0.001) toward end-of-life care were associated with the perspectives of promoting advance directives. Nurses who worked in cardiac ( β = -0.234 p 0.001) and respiratory ICUs ( β = -0.135 p = 0.024) had less motivation to promote advance directives ( F = 16.943 p 0.001). Given their important contributions to ICU care services, appropriate and meaningful support is required to optimize critical care nurses' involvement in end-of-life care. This study demonstrated a significant impact on perspectives of promoting advance directives of critical care nurse participants. Findings from this study can inform the design of effective nurse support programs to enhance the promotion of advance directives in intensive care settings.
Publisher: Springer Science and Business Media LLC
Date: 06-07-2023
Publisher: Elsevier BV
Date: 12-2022
Publisher: Elsevier BV
Date: 05-2021
Publisher: Wiley
Date: 28-04-2023
DOI: 10.1111/JOCN.16729
Abstract: To understand the nutritional status, observing eating difficulties during mealtimes for people living with dementia in acute care settings. Changed eating behaviours caused by declining cognitive function is common in people living with dementia which can lead to malnutrition. Malnutrition is associated with prolonged hospitalisation and increased mortality. People living with dementia in acute care settings are at high risk of malnutrition. This highlights the importance of better understanding the nutritional intake and eating behaviours of people living with dementia in acute care settings. This study is a cross‐sectional, observational study. Data of mealtime difficulties and nutritional status of people living with dementia were collected in four geriatric care wards (in acute or sub‐acute hospitals) by using Feeding Difficulty Index and Mini Nutritional Assessment Short‐Form. The STROBE checklist was used throughout this study. The study included 94 people living with dementia. The median age of the participants was 85.86 years old, with a Feeding Difficulty Index of 8.27 and had stayed in hospitals for average 14.46 days, with an average total feeding time of 24.61 min. Only 1.2% of participants were considered to be in normal nutritional status, whereas 72.1% were malnourished. All participants required partial or full assistance during mealtime. Participants with higher scores on the Feeding Difficulty Index have longer total feeding times, compared to those with lower scores. Malnutrition is prevalent in people living with dementia. People living with dementia demonstrate varying mealtime difficulties depending on the level of dependence. Mealtime assistance training programs are warranted and are beneficial for nursing staff and family members to improve their feeding skills and knowledge. This study did not involve patients, service users, caregivers or members of the public. The study is relevant to clinical practice by identifying changed eating behaviours or mealtime difficulties in people living with dementia in acute care settings can significantly decrease the risk of malnutrition.
Publisher: Cold Spring Harbor Laboratory
Date: 05-02-2021
DOI: 10.1101/2021.02.04.428760
Abstract: Scab, or black spot, caused by the filamentous fungal pathogen Venturia inaequalis , is the most economically important disease of apple ( Malus x domestica ) worldwide. To develop durable control strategies against this disease, a better understanding of the genetic mechanisms underlying the growth, reproduction, virulence and pathogenicity of V. inaequalis is required. A major bottleneck for the genetic characterization of V. inaequalis is the inability to easily delete or disrupt genes of interest using homologous recombination. Indeed, no gene deletions or disruptions in V. inaequalis have yet been published. Recently, CRISPR-Cas9 has emerged as an efficient tool for gene editing in filamentous fungi. With this in mind, we set out to establish CRISPR-Cas9 as a gene editing tool in V. inaequalis . We showed that CRISPR-Cas9 can be used for gene inactivation in the apple scab fungus. As a proof of concept, we targeted the melanin biosynthesis pathway gene trihydroxynaphthalene reductase ( THN ), which has previously been shown to result in a light-brown colony phenotype when transcriptionally silenced using RNA interference. Using one of two CRISPR-Cas9 single guide RNAs (sgRNAs) targeted to the THN gene, delivered by a single autonomously replicating Golden Gate-compatible plasmid, we were able to identify six of 36 stable transformants with a light-brown phenotype, indicating an ~ 16.7% gene inactivation efficiency. Notably, of these six THN mutants, five had an independent mutation. As part of our pipeline, we also report a high-resolution melting (HRM) curve protocol for the rapid detection of CRISPR-Cas9 gene-edited mutants of V. inaequalis . This protocol identified a single base pair deletion mutation in a s le containing only 5% mutant genomic DNA, indicating high sensitivity for mutant screening. In establishing CRISPR-Cas9 as a tool for gene editing in V. inaequalis , we have provided a strong starting point for studies aiming to decipher the function of genes associated with the growth, reproduction, virulence and pathogenicity of this fungus. The associated HRM curve protocol will enable CRISPR-Cas9 transformants to be screened for gene inactivation in a high-throughput and low-cost manner, which will be particularly powerful in cases where the CRISPR-Cas9-mediated gene inactivation efficiency is low.
Publisher: S. Karger AG
Date: 03-08-2023
DOI: 10.1159/000532109
Abstract: Background: Clinical guidelines recommend exercise training for patients undergoing maintenance hemodialysis (MHD). However, the effectiveness of different types of exercise remains uncertain. Objectives: To compare and rank the effect of different types of exercise on walking capacity, cardiorespiratory fitness, dialysis adequacy, and health-related quality of life (HRQOL) in patients undergoing MHD. Methods: Eight databases (four English and four Chinese) were searched from inception to January 1, 2022. Randomized controlled trials evaluating the efficacy of different exercises for patients undergoing MHD were included. Two independent reviewers screened the literature, extracted data, assessed the risk of bias, and evaluated the certainty of evidence. A frequentist random-effect network meta-analysis was conducted. Results: Ninety trials with 4,084 participants comparing 15 types of exercise were included, reporting on the six-minute walking test (45 trials), peak oxygen uptake (22 trials), dialysis adequacy (30 trials), and HRQOL (23 trials). Network meta-analysis showed that the most effective intervention for walking capacity was intradialytic aerobic exercise combined with blood flow restriction with a mean difference and 95% confidence interval of 97.35 [11.89-182.81], for peak oxygen uptake it was non-intradialytic combined aerobic and resistance exercise (4.35 [2.25-6.44]), for dialysis adequacy it was intradialytic combined aerobic and resistance exercise (0.17 [0.06-0.28]), for the physical component summary of HRQOL it was intradialytic aerobic exercise (4.93 [2.31-7.54]), and for the mental component summary of HRQOL it was non-intradialytic combined aerobic and resistance exercise (6.36 [0.45-12.27]). Ultimately, intradialytic combined aerobic and resistance exercise could improve all the above outcomes compared to usual care. Conclusions: This study concluded that intradialytic combined aerobic and resistance exercise is optimal for MHD patients due to its significant positive effects on multiple outcomes. Walking capacity can be further enhanced by combining blood flow restriction with exercise. For improving dialysis adequacy, intradialytic exercise proves to be more effective than non-intradialytic exercise. Further well-designed clinical trials are needed to investigate the effects of exercise with varying durations, intensities, and frequencies.
Publisher: Elsevier BV
Date: 02-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2022
Publisher: Wiley
Date: 21-03-2023
DOI: 10.1111/WVN.12637
Abstract: The coronavirus disease‐2019 (COVID‐19) pandemic caused unprecedented disruption to healthcare delivery worldwide. The use of telehealth practices rapidly expanded during the pandemic, while its application in palliative care remains a conflicted issue. The aims of this study were to evaluate users' reports of their satisfaction with telehealth palliative care during COVID‐19 and to identify facilitators and barriers to telehealth implementation in palliative care during COVID‐19. A systematic search of the literature, including studies between January 2020 and June 2022, was conducted using PubMed, MEDLINE, CINAHL Plus, Embase, and Google Scholar. Empirical studies of telehealth in palliative care during COVID‐19 were included. A total of 18 studies were included in the review, of which nine were outpatient consultations, four were family meetings, two were remote volunteering programs, two were inpatient care, and one was a residential care home needs assessment. The satisfaction rates were high (66%–99%) among patients and family members who participated in telehealth consultations, but the satisfaction with family meetings was mixed. Compared with their clients, healthcare professionals were less likely to assess telehealth as satisfactory. The authors identified four barriers and four facilitators. The barriers were technological challenges, lack of nonverbal communication, ethical concerns, and limitations for clinical practice. The facilitators were accessibility and convenience, visual cues, facilitation and training, and family engagement. This systematic mixed studies review suggests that current evidence supports the feasibility of telehealth implementation in palliative care for outpatient consultations and routine follow‐up appointments. This review also identified facilitators and barriers to telehealth in palliative care, and the findings can inform the implementation of future palliative care services. Future attention should be paid to the effectiveness of telehealth implementation in palliative care patients.
Publisher: Wiley
Date: 06-12-2021
DOI: 10.1111/AJAG.13021
Abstract: With longer life expectancies, cardiovascular diseases are increasingly common among older adults, which also leads to functional changes that severely impact their quality of life. This study aimed to identify the predictors of health‐related quality of life (HRQOL) among older New Zealanders with cardiovascular health problems. A cross‐sectional data analysis of the 2015/16 New Zealand Health Survey was performed. In total, 2203 older New Zealanders with cardiovascular health problems were identified and included in the final analyses. The association between demographics, physical activity, health measurements, and HRQOL was examined using a multiple linear regression model. Significant differences in HRQOL were identified between the demographics and cardiovascular risk factors. Predictors of higher HRQOL among older New Zealanders with cardiovascular conditions were increased physical activity ( β = 0.218), age ( β = −0.067), employed ( β = 0.137), lower waist circumference ( β = −0.261), male ( β = 0.127), and being without a history of diabetes ( β = −0.071). Physical activity is the strongest predictor of HRQOL in older adults with cardiovascular problems. Older female New Zealanders with cardiovascular health problems have lower perceptions of their health status. These predictors should be considered while designing and developing intervention and health education that aims to improve the HRQOL of older adults.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Elsevier BV
Date: 10-2021
Publisher: Frontiers Media SA
Date: 15-09-2016
Abstract: Apple canker caused by the phytopathogenic fungus
Publisher: Wiley
Date: 03-11-2021
DOI: 10.1002/NUR.22194
Abstract: The nursing delirium screening scale (Nu‐DESC) was developed for the rapid assessment of delirium, but little is known regarding the performance of the Nu‐DESC in assessing postoperative delirium. The purpose of this systematic review and meta‐analysis was to review and summarize the evidence of the diagnostic accuracy of the Nu‐DESC in assessing postoperative delirium. The EMBASE, MEDLINE, Cochrane Library, CINAHL, and a Chinese e‐Journal database were searched from the period of the inception of the Nu‐DESC to June 18, 2020. Participants were adult (age ≥ 18 years) postoperative patients who received any type of surgery and any method of anesthesia. The quality assessment of diagnostic accuracy studies‐2 was employed to assess the risk of bias among the selected studies, and meta‐regression analyses were used to detect sources of between‐study heterogeneity. Eleven studies involving 2062 postoperative patients in surgical settings were included. The Nu‐DESC revealed a pooled sensitivity of 0.73 (95% confidence interval, 0.44–0.90) and a specificity of 0.93 (0.87–0.96). The area under the summary receiver operating characteristics curve was 0.94 (0.91–0.96), which also confirmed the accuracy of the Nu‐DESC. Covariates, including the region of study and the standard reference used, were identified as possible sources of heterogeneity in the meta‐regression. The findings of this review can update existing clinical guidelines for postoperative delirium. On the basis of its satisfactory diagnostic performance, we suggest that the Nu‐DESC could be considered for nurses and allied health professionals for assessing postoperative delirium. However, because of the heterogeneity, the result of this meta‐analysis should be considered with caution.
Publisher: Public Library of Science (PLoS)
Date: 09-03-2023
DOI: 10.1371/JOURNAL.PONE.0282589
Abstract: COVID-19-related fear negatively affects the public’s psychological well-being and health behaviours. Although psychological distress including depression and anxiety under COVID-19 is well-established in literature, research scarcely evaluated the fear of COVID-19 with a large s le using validated scale. This study aimed to validate a Korean version of fear scale(K-FS-8) using an existing fear scale(Breast Cancer Fear Scale 8 items) and to measure the fear of COVID-19 in South Korea. A cross-sectional online survey was conducted with 2235 Korean adults from August to September 2020. The Breast Cancer Fear Scale was translated from English into Korean using forward-backward translation, and then face validity was assessed. Patient Health Questionnaire-4 and Primary Care Post-Traumatic Stress Disorder Screen for DSM-5 were used for assessing convergent validity of K-FS-8, and item response theory analysis was also conducted to further validate the K-FS-8. This study confirmed the validity and reliability of the K-FS-8. The validity of the scale was confirmed by convergent validity, known-group validity and item response theory analysis, and internal consistency was also examined(Cronbach’s α coefficient = 0.92). This study also identified that 84.6% participants had high COVID-19 fear whilst 26.3%, 23.2% and 13.4% participants had high risk of post-traumatic stress disorder, depressive and anxiety symptoms, respectively. The K-FS-8 showed the acceptability measuring the fear of COVID-19 in the Korean population. The K-FS-8 can be applied to screen for fear of COVID-19 and related major public health crises identifying in iduals with high levels of fear in primary care settings who will benefit from psychological support.
Publisher: Wiley
Date: 29-03-2023
DOI: 10.1111/WVN.12636
Abstract: Primary dysmenorrhea (PD) is a global public health concern affecting women's health and quality of life, leading to productivity loss and increased medical expenses. As a non‐pharmacological intervention, auricular acupoint therapy (AAT) has been increasingly applied to treat PD, but the overall effectiveness remains unclear. The aim of this review was to synthesize the effects of AAT targeting menstrual pain among females with PD. Eight databases (PubMed, EMBASE, AMED, CINAHL Plus, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wanfang Data) and three registries (ClinicalTrials.gov, ISRCTN Registry and the Chinese Clinical Trial Registry) were searched to identify existing randomized controlled trials (RCTs) from inception to 21 August 2022. Two reviewers independently screened, extracted the data, and appraised the methodological quality and the evidence strength using the Cochrane risk‐of‐bias tool for randomized trials (RoB 2) and the GRADE approach. A total of 793 participants from 11 RCTs were included. Despite substantial heterogeneity, AAT was more effective in reducing menstrual pain and related symptoms than placebo and nonsteroidal anti‐inflammatory medications (NSAIDs). No significant subgroup differences were found between study locations as well as invasiveness, duration, type, acupoints number, ear selection and provider of AAT. Only minor adverse effects of AAT were reported. AAT can help women with PD, particularly those who are refrained from pharmaceuticals. Primary healthcare professionals, including nurses, can be well‐equipped to provide evidence‐based and effective AAT for people with PD. AAT can be used in a broader global clinical community. To provide an optimal effect and have wider usability, a unified practice standard is required, which would necessitate further adaptation of clinical care of people with PD. AAT effectively decreased menstrual pain and other accompanying symptoms of PD. More research is needed to identify effective AAT features and explore optimal therapy regimes for PD.
Publisher: Wiley
Date: 07-08-2022
DOI: 10.1111/JOCN.16483
Abstract: To assess (1) the experience, knowledge and preferences of end-of-life care among frail nursing home residents and (2) the preferences of residents' family caregivers. Globally, nursing homes are becoming an important place where many older people will receive their end-of-life care. Thus, assessing the end-of-life care preferences among nursing home residents is crucial. Cross-sectional survey. Residents aged ≥65 years, with frail or pre-frail status (n = 286) in 34 nursing homes were interviewed using a structured questionnaire. Descriptive statistics were used to describe the outcomes and regression analyses were used to evaluate factors related to the outcomes. Kappa statistics were used to examine the agreement between the preferences among 21 residents and their family caregivers. The manuscript was guided by the STROBE checklist. 5.9% and 10.5% of the participants had heard of advance care planning and advance directive respectively. After explanations of the terms by the research team, 42.3% of the participants preferred advance care planning, whereas 22.0% preferred advance directive. The top reason for not preferring advance care planning/advance directive is perceiving them as 'not necessary'. Nursing homes were the most preferred place to receive end-of-life care (41.6%). Whereas hospitals were the most preferred place for death (36.0%). The agreement among resident and family caregiver dyads ranged from none to minimal in most outcomes. This study revealed the lack of awareness around advance care planning and advance directive among frail nursing home residents. Future research should focus on developing effective educational interventions to enhance the residents' awareness of these topics. To increase awareness among nursing home residents, more educational programs should be implemented. Frail older residents might not see the relevance of advance care planning interventions need to include both current and future care to increase its relevance.
Publisher: Wiley
Date: 17-02-2021
DOI: 10.1111/OPN.12370
Publisher: Springer Science and Business Media LLC
Date: 30-09-2022
DOI: 10.1007/S00520-022-07377-9
Abstract: Perceived cognitive impairment refers to cognitive dysfunction that particularly involves impairment in working or short-term memory, and inattention. This study aimed to identify factors associated with perceived cognitive impairment in patients with advanced lung cancer. This cross-sectional analysis used pooled data from a prospective, ongoing randomized controlled trial examining the effectiveness of exercise in patients with advanced lung cancer (Trial Registration: NCT04119778). Patients diagnosed with stage IIIB or IV non-small cell lung cancer were recruited from three public hospitals in Hong Kong between December 2018 and December 2021. Demographics, daily step count, sleep quality, fatigue, depression, anxiety, and perceived cognitive impairment were included in the analyses. Multivariate logistic regression analysis was used to determine the most critical risk factors associated with perceived cognitive impairments in attention and memory. A total of 226 patients were included and analyzed, 35.4% of patients had perceived attention impairment and 58.4% had perceived memory impairment. The daily step count (adjusted odds ratio [aOR] = 0.496 confidence interval [CI] = 0.258-0.954), fatigue (aOR = 1.342 CI = 1.903-1.648), and anxiety (aOR = 1.179 CI = 1.042-1.335) were associated with a significantly increased risk of perceived attention impairment, while anxiety (aOR = 1.126 CI = 1.008-1.257) was identified as the most significant factor for perceived memory impairment. The findings of this study can inform the design of effective interventions to reduce perceived cognitive impairment and promote the quality of life and well-being of patients with advanced lung cancer.
Publisher: Informa UK Limited
Date: 03-10-2022
Publisher: Wiley
Date: 22-02-2022
DOI: 10.1111/NHS.12926
Abstract: This study aimed to explore the experiences of nurses in Wuhan Hospital as front‐line workers during the COVID‐19 pandemic. A descriptive qualitative study of such nurses was conducted from a tertiary hospital in Wuhan. Semi‐structured in idual interviews were undertaken with 8 registered nurses who were front‐line health workers in one of the COVID‐19 wards and 3 nursing managers from the response team. Five discrete themes were identified from the narratives of nurses' experiences during the COVID‐19 outbreak in Wuhan: “content of fundamental care,” “teamwork,” “reciprocity,” “nurses’ own worries,” and “lifelong learning and insights.” Nurses in the front line of care during the COVID‐19 pandemic can contribute important information from their hands‐on experience for providing a holistic response to an infectious outbreak like COVID‐19. The concerns nurses raised at both personal and professional levels have implications for nursing education and clinical practice settings, particularly in the time of a pandemic when nurses' well‐being requires attention, and at the same time for considering organizational factors that enable nurses to provide care to patients with confidence. Hospital policies and nursing management need to be ready and adhere to flexible work planning systems and approaches during a pandemic.
Publisher: Cold Spring Harbor Laboratory
Date: 21-09-2022
DOI: 10.1101/2022.09.21.508768
Abstract: Scab, caused by the biotrophic fungal pathogen Venturia inaequalis , is the most economically important disease of apples. During infection, V. inaequalis colonizes the subcuticular host environment, where it develops specialized infection structures called runner hyphae and stromata. These structures are thought to be involved in nutrient acquisition and effector (virulence factor) delivery, but also give rise to conidia that further the infection cycle. Despite their importance, very little is known about how these structures are differentiated. Likewise, nothing is known about how these structures are protected from host defences or recognition by the host immune system. To better understand these processes, we first performed a glycosidic linkage analysis of sporulating tubular hyphae from V. inaequalis developed in culture. This analysis revealed that the V. inaequalis cell wall is mostly composed of glucans (44%) and mannans (37%), whereas chitin represents a much smaller proportion (4%). Next, we used transcriptomics and confocal laser scanning microscopy to provide insights into the cell wall carbohydrate composition of runner hyphae and stromata. These analyses revealed that, during subcuticular host colonization, genes of V. inaequalis putatively associated with the biosynthesis of immunogenic carbohydrates, such as chitin and β-1,6-glucan, are down-regulated relative to growth in culture, while on the surface of runner hyphae and stromata, chitin is deacetylated to the less immunogenic carbohydrate, chitosan. These changes are anticipated to enable the subcuticular differentiation of runner hyphae and stromata by V. inaequalis , as well as to protect these structures from host defences and recognition by the host immune system. Plant-pathogenic fungi are a major threat to food security. Among these are subcuticular pathogens, which often cause latent asymptomatic infections, making them difficult to control. A key feature of these pathogens is their ability to differentiate specialized subcuticular infection structures that, to date, remain largely understudied. This is typified by Venturia inaequalis , which causes scab, the most economically important disease of apples. In this study, we show that, during subcuticular host colonization, V. inaequalis down-regulates genes associated with the biosynthesis of two immunogenic cell wall carbohydrates, chitin and β-1,6-glucan, and coats its infection structures with a less-immunogenic carbohydrate, chitosan. These changes are anticipated to enable subcuticular host colonization by V. inaequalis and provide a foundation for understanding subcuticular host colonization by other plant-pathogenic fungi. Such an understanding is important, as it may inform the development of novel control strategies against subcuticular plant-pathogenic fungi.
Publisher: Elsevier BV
Date: 12-2022
Publisher: SAGE Publications
Date: 11-08-2022
DOI: 10.1177/10547738221114013
Abstract: This study aimed to compare the Kessler Psychological Distress Scale (K10) and Short-Form 12-Item Health Survey Mental Component Score (SF-12 MCS) for the effectiveness as screening tools for depression in Asian New Zealanders. A national, representative New Zealand Health Survey (NZHS) data set was used. In total, 1,277 participants were included in the analyses. The sensitivity and specificity values, as well as the areas under the receiver operating characteristics curves (AUROC), for the K10 and the SF-12 MCS scores were examined. The AUROCs for K10 and SF-12 MCS were 0.787 (95% CI [0.736, 0.837]) and 0.725 (95% CI [0.656, 0.793]), respectively. A less than optimal sensitivity and positive predictive value of K10 support the need to reexamine the optimal cut-off point according to the results of the Youden index. Strengthening the K10 predictive accuracy will increase the practical application among Asian populations.
Publisher: American Society for Microbiology
Date: 15-06-2023
DOI: 10.1128/SPECTRUM.04219-22
Abstract: Plant-pathogenic fungi are a major threat to food security. Among these are subcuticular pathogens, which often cause latent asymptomatic infections, making them difficult to control.
Publisher: SLACK, Inc.
Date: 05-2019
DOI: 10.3928/00989134-20190404-02
Abstract: A cross-sectional research study was conducted to explore factors associated with and predictors of emergency department (ED) use among community-dwelling older adults. Data were collected using questionnaires regarding demographic characteristics, health literacy, comprehensive assessment instruments, and ED use. Age, fall frequency, number of diseases, number of medications, health literacy, nutritional status, cognitive function, and activities of daily living were associated with ED use. Age (adjusted odds ratio [aOR] = 1.04, 95% confidence interval [CI] [1.00, 1.07]), health literacy (aOR = 0.89, 95% CI [0.79, 0.99]), number of diseases (aOR = 1.34, 95% CI [1.01, 1.78]), and cognitive function (aOR = 0.73, 95% CI [0.55, 0.96]) were significant predictors of ED use. Health care professionals, researchers, and education providers need to assess patients' health literacy, number of diseases, and cognitive function and take approaches to improve health literacy in older adults to maintain their health as well as reduce ED use. [ Journal of Gerontological Nursing, 45 (5), 31–38.]
Location: New Zealand
Start Date: 2014
End Date: 2014
Funder: Health and Medical Research Fund
View Funded ActivityStart Date: 2014
End Date: 2014
Funder: Ministry of Science and Technology
View Funded Activity