Central Taiwan Research Articles

Estimating Canopy Resistance Using Machine Learning and Analytical Approaches

Canopy resistance is a key parameter in the Penman–Monteith (P–M) equation for calculating evapotranspiration (ET). In this study, we compared a machine learning algorithm–support vector machine (SVM) and an analytical solution (Todorovic, 1999) for estimating canopy resistances. Then, these estimated canopy resistances were applied to the P–M equation for estimating ET; as a benchmark, a constant (fixed) canopy resistance was also adopted for ET estimations. ET data were measured using the eddy-covariance method above three sites: a grassland (south Ireland), Cypress forest (north Taiwan), and Cryptomeria forest (central Taiwan) were used to test the accuracy of the above two methods. The observed canopy resistance was derived from rearranging the P–M equation. From the measurements, the average canopy resistances for the grassland, Cypress forest, and Cryptomeria forest were 163, 346, and 321 (s/m), respectively. Our results show that both methods tend to reproduce canopy resistances within a certain range of intervals. In general, the SVM model performs better, and the analytical solution systematically underestimates the canopy resistances and leads to an overestimation of evapotranspiration. It is found that the analytical solution is only suitable for low canopy resistance (less than 100 s/m) conditions.

Impacts of Huddle Intervention on the Patient Safety Culture of Medical Team Members in Medical Ward: One-Group Pretest-Posttest Design.

A huddle is a short, regular meetings to discuss existing or emerging patient safety issues. Hospital administrators can encourage healthcare staff to voluntarily examine the potential occurrence and severity of risks, thereby enhancing awareness of patient safety. The purpose of this study is to explore the effects of huddle intervention on patient safety culture among medical team members and related factors. We used a one-group pretest-posttest research design and convenience sampled 109 members of the general internal medicine ward team members from a medical center in central Taiwan. They participated 2 times per week in 15-min huddles from 08:15 to 08:30 in the morning, which lasted for a total of 4 weeks. The process was based on submitted ideas, approved ideas, research ideas and standardization, and data on the safety attitudes questionnaire (SAQ) were collected during the huddles' intervention pretest and posttest. After the huddle intervention, we found significantly improved scores for safety attitude, teamwork climate (76.49±16.13 vs 83.26±13.39, p < 0.001), safety climate (75.07±16.07 vs 82.63±13.72, p < 0.001), job satisfaction (73.67±19.84 vs 83.39±17.21, p < 0.001), perceptions of management (77.87±19.99 vs 84.86±16.03, p < 0.001) and working conditions (78.96±18.16 vs 86.18±14.90, p < 0.001). Correlation analyses on the differences between pretest and posttest showed that age had a significant correlation with safety climate (r = 0.22, p = 0.022) and working conditions (r = 0.20, p = 0.035). The number of times to participate in a huddle had a significant correlation with teamwork climate (r = 0.33, p =<.001), safety climate (r = 0.30, p = 0.002), job satisfaction (r = 0.19, p = 0.043), and work conditions (r = 0.28, p = 0.003). Huddles improve clinical team members' understanding of different dimensions and relate factors of safety attitudes. Implementation of the huddles involved standardized process will help hospital administrators understand the steps to parallel expansion to other wards.

Utilizing Numerical Models and GIS to Enhance Information Management for Oil Spill Emergency Response and Resource Allocation in the Taiwan Waters

This study aims to establish a comprehensive workflow for developing emergency response plans for both actual and scenario oil spill incidents in the Taiwan waters while addressing the resource allocation for oil spill containment as well. This workflow comprises two vital components. The first component involves the integration of numerical tools and observational data, which includes the incorporation of wind data from sources such as the National Centers for Environmental Prediction (NCEP) or meteorological stations. Additionally, it incorporates ocean current data simulated by the semi-implicit cross-scale hydroscience integrated system model (SCHISM) into the general NOAA operational modeling environment (GNOME) model, which is a new approach for this purpose. In order to assess the efficacy of this component, two distinct case studies were conducted. The first case study focused on an incident in a northern coastal area of Taiwan under open sea conditions, whereas the second case study examined an incident within a major commercial harbor in central Taiwan. The second component of this workflow involves creating oil risk maps by integrating the results from the first component with specific geographical factors into Google Earth. These oil risk maps serve multiple purposes. They offer real-time information to emergency response commanders regarding oil spill hazard prediction, and they also enable the effective development of emergency response strategies and disposal plans for potential oil spill incidents. This is achieved by generating risk maps for various scenarios using the approach outlined in the first component. Additionally, these maps assist in the assessment and planning of resource allocation for oil containment.

Differences in the healthcare needs of older adults attending primary health centers in urban and rural areas of Taiwan

PurposeAs the older adult population in Taiwan continues to increase, primary health centers (PHCs) play a crucial role in geriatric care. This study explored the differences in the PHC experiences and usage needs of older adults in urban versus rural areas.MethodsA qualitative study was conducted. Twenty-one older adults were recruited from PHCs in northern, central, southern, and eastern Taiwan. Semistructured interviews were used to collect data, and the interview guidelines included their reasons for visiting PHCs, the health-care services they received, their evaluation of the services, and the advantages and disadvantages of these centers. The data were analyzed using thematic content analysis.ResultsThe PHC usage needs of older adults in urban areas differ from those of older adults in rural areas in the following 3 aspects: (1) Medical services: older adults in rural areas demand clinics specializing in various medical domains, mobile and home medical care, and case management, whereas those in urban areas demand mobile health examinations. (2) Environment and transportation: older adults in rural areas demand diverse medical equipment, shuttle services, and accessible facilities, whereas those in urban areas demand recreational facilities. (3) Active aging: older adults in rural areas demand health education courses, and those in urban areas demand diverse senior citizen courses as well as opportunities to volunteer and build interpersonal relationships.ConclusionThe older adults in urban and rural areas had different PHC usage needs. The older adults in rural areas generally focused on medical care and transportation services in PHCs, whereas those in urban areas generally focused on health promotion as a means of social participation and active aging.

Seasonal dynamics of floral composition and flower visitors in a subtropical alpine ecosystem in Taiwan

AbstractFlowering phenology of alpine plant communities and seasonal dynamics of flower visitors have been scarcely studied in the tropical/subtropical alpine regions. We report flowering phenology, flower production, and flower‐visiting insects in an alpine site of central Taiwan. Throughout the research period (2017–2018), we recorded flowering phenology of 130 plant species, flower production of 81 species, and 15,127 insects visiting alpine flowers. Most of the alpine plants were visited by dipteran insects and/or hymenopteran insects. The seasonal patterns of flowering were more apparent in bee‐visited plants compared to fly‐visited plants in which the flowering of bee‐visited plants clearly increased as the season progressed. About 63% of flower visitors were dipteran insects (syrphid and non‐syrphid flies), and 30% were hymenopteran insects (mostly bumble‐bee workers). Although the seasonal trend in fly abundance was less clear between years, bumble‐bee abundance consistently increased in the middle to late seasons, reflecting colony development. There was a positive correlation between bee abundance and the number of flowering species of bee‐visited plants, but there was no correlation between fly abundance and the number of flowering species of fly‐visited plants throughout the season. These results suggest that the flowering phenology of subtropical alpine communities is influenced by the seasonal availability of pollinators. Bumble bees, syrphid flies, and non‐syrphid flies had wide ranges of foraging flowers, but their niche overlap was relatively small. Because cold‐adapted bumble bees are threatened by climate change in Taiwan, plant–pollinator interactions may be disturbed by global warming.

Effects of land use change and crop rotation practices on farmland ecosystem service valuation

Farmland can provide various ecosystem services such as food production, groundwater recharge, and carbon storage. However, the overall value of farmland ecosystem services and differences in their spatial distribution are rarely studied, particularly with regard to farmland with crop rotations. In this study, we developed an assessing framework for appraising the overall value of ecosystem services of farmland with crop rotations on the basis of Costanza’s global ecosystem service valuation method. Changhua County in central Taiwan is used as a case study to estimate the impact of land use change on its farmland ecosystem services. We also applied the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model to analyze the spatial distribution of individual ecosystem services. Results from the global ecosystem service value method indicates that land use change in the study area caused a steady decline in overall farmland ecosystem service value between 1981 and 2021. However, if the practice of farmland crop rotation is included, the proposed method for evaluating ecosystem services of farmland indicate an increase in total ecosystem service value (ESV). The overall ecosystem services of farmland with crop rotations assessed was between 1.27 and 1.69-fold higher than the gross domestic product (GDP) for farming in the region and between 17 and 45.3-fold higher than the agricultural expenditure reported by the local government. The findings of this study also suggest local government can reference the spatial distributions of ecosystem service to dynamically adjust subsidies and resources for farmland, thereby enhancing agricultural governance and achieving sustainability goals.

The effect of exercise on the risk of metabolic syndrome associated with sleep insufficiency: a cross-sectional study.

Sleep disturbance and insufficient sleep have been linked to metabolic syndrome, increasing cardiovascular disease and mortality risk. However, few studies investigate the joint effect of sleep and exercise on metabolic syndrome. We hypothesized that regular exercise can mitigate the exacerbation of metabolic syndrome by sleep insufficiency. The aim of this study was to investigate whether exercise can attenuate or eliminate the relationship between sleep insufficiency and metabolic syndrome. A total of 6,289 adults (mean age = 33.96 years; women: 74.81%) were included in the study, a cross-sectional study conducted based on the results of employee health screening questionnaires and databases from a large healthcare system in central Taiwan. Participants reported sleep insufficiency or not. Self-reported exercise habits were classified into 3 levels: no exercise, exercise <150 min/week, and exercise ≧150 min/week. Multiple logistic regression and sensitivity analyses were conducted to understand the joint associations of sleep patterns and exercise with metabolic syndrome with exposure variables combining sleep duration/disturbances and PA. Compared with the reference group (sufficient sleep), individuals with sleep insufficiency had a higher risk for metabolic syndrome [adjusted odds ratio (AOR) = 1.40, 95% confidence interval (95% CI): 1.01-1.94, p < 0.05] in females aged 40-64 years, but not in other populations. Sleep insufficiency was not associated with the risk of metabolic syndrome among individuals achieving an exercise level of <150 min/week, and in particular among those achieving ≧150 min/week in all populations in our study. Sleep insufficiency was related to a higher risk of metabolic syndrome in female healthcare staff aged 40-64 years. Being physically active with exercise habits in these individuals, the risk of metabolic syndrome was no longer significant.

Health Risk Analysis of Air Pollution and Related Risk Factors on Residents Living near a Power Plant in Central Taiwan

Health Risk Analysis of Air Pollution and Related Risk Factors on Residents Living near a Power Plant in Central Taiwan

Energy Management and Environmental Protection in Industrial Parks: A Comparative Study of Central Taiwan Science Park and Silicon Glen

This manuscript focuses on analyzing the growth dynamics of the Central Taiwan Science Park (CTSP) and Silicon Glen in Scotland with a specific emphasis on their approaches to energy, environmental conservation, and economic management. The objective is to provide insights into their sustainable development strategies. In terms of energy, CTSP addresses Taiwan’s energy security and green transformation challenges, while Silicon Glen concentrates on Scotland’s wind energy generation technologies. Both regions prioritize the advancement of renewable energy sources and smart grid technologies. In the realm of environmental conservation, both CTSP and Silicon Glen prioritize environmental protection and sustainability by implementing rigorous environmental monitoring measures. Regarding economic management, CTSP and Silicon Glen serve as vital technology industry hubs in Taiwan and Scotland, respectively, attracting a multitude of high-tech and startup enterprises. This growth is facilitated through various means, including policy support, access to research resources, and robust infrastructure. This manuscript presents a comparative analysis of these two industrial parks, focusing on their environmental and economic management strategies. It aims to elucidate the principles underpinning the sustainable development and economic growth of industrial parks, offering valuable insights to decision-makers and stakeholders involved in the planning of sustainable industrial parks.

Multimodal digital storytelling presentations in EFL contexts: learning outcomes, positive/negative affects, and perception between high-/low-achieving learners

ABSTRACT Purpose: Despite the acknowledged benefits of digital storytelling in fostering language development, investigations into its cognitive and affective dimensions in English-as-a-Foreign-Language (EFL) education, especially concerning high and low achievers, have been scarce. This study, therefore, aimed to scrutinize the effects of multimodal digital storytelling presentations on storytelling outcomes and emotional responses of high and low achievers within an EFL context. Design/methodology/approach: The study enlisted 52 sophomore students from a private university in central Taiwan. Over a 14-week research period, participants were tasked with creating two digital storytelling presentations: the first employing PowerPoint and the second utilizing Book Creator. Data collection encompassed two questionnaires gauging positive/negative affective states and enjoyment in digital storytelling, along with reflective journals. Findings: The results underscored the superiority of Book Creator over PowerPoint in enhancing digital storytelling presentation quality. High-achieving students reported heightened positive affective experiences and a greater sense of enjoyment compared to their low-achieving peers. However, both groups exhibited comparable levels of negative affect, suggesting the existence of anxiety despite the presence of positive emotions during the learning process. Originality/value: This study contributes by emphasizing the equitable significance of cognitive and affective facets within technological multimodality, thereby illuminating the multifaceted essence of EFL learning.

To know, feel and do: an instructional practice of higher education for sustainable development

Purpose The importance of multidimensional and engaging instruction for sustainable development goals (SDGs) in higher education cannot be overstated. Such instructions should motivate students not only to memorize and contemplate these goals but also to actively participate in addressing SDG-related challenges. Consequently, this study aims to develop practical and appropriate instructional approaches to education for sustainable development (ESD) in higher education to enhance students’ knowledge, attitudes and behaviors concerning sustainability. Design/methodology/approach By using a quasi-experimental design, this ESD study was conducted at a university in central Taiwan. A total of 121 students from diverse academic backgrounds participated in the 16-week experiment, which was divided into three groups. Lecturing, thematic teaching and design-thinking strategies were applied to these respective groups. Findings The thematic-teaching and design-thinking groups displaying improved cognitive performance. However, the quantity results revealed that the design-thinking group surpassed the other two groups in sustainability knowledge, attitudes, behaviors and mind map tasks. The qualitative findings further indicated that design thinking – through multiple practical problem-solving activities – guided college students to think independently and sustainably, as well as enabled them to internalize the value of sustainable development. By implementing these effective approaches, the core goals of ESD-related personal and societal transformations may be realized. Practical implications This study proposed a goal-oriented ESD instructional model for educators, demonstrating the efficacy of design thinking in cultivating higher-order thinking and affection for ESD in students. Additionally, this study introduced an innovative evaluation approach – mind mapping – to the ESD domain, which may compensate for the limitations of the survey method. Originality/value This study provides empirical evidence for the effectiveness of design thinking and thematic-based pedagogies in sustainable development higher education. Additionally, it also offers a practical ESD instructional model with reference value for scholars and multi-domain instructors. Moreover, the study highlights that by examining organizational governance from the perspectives of design thinking and higher-order affection, sustainable and economic development need not be mutually exclusive concepts. Instead, pursuing SDGs can be viewed as investment opportunities for organizations rather than mere costs.

Correlation Among Workplace Burnout, Resilience, and Well-Being in Nursing Staff: A Cross-Sectional Study in Taiwan.

Because nurses often work in medical environments characterized by high workloads and high levels of stress and pressure, they are particularly vulnerable to workplace burnout and their well-being may suffer. Related studies on burnout, resilience, and well-being have focused primarily on teachers, social workers, and students, with few studies addressing the situation faced by nursing staff. It is important to understand the factors affecting the well-being of nursing staff. This study explores the status quo and correlations among nursing-staff demographic characteristics, workplace burnout, well-being-related resilience, and the predictive factors of well-being in nurses. A cross-sectional, descriptive, correlational research design and purposive sampling were used in this study. Nursing staff who had worked for more than 6 months at a medical center in central Taiwan were recruited as participants, with data from 289 participants collected. A structured questionnaire was used to collect data on demographic characteristics, workplace burnout, resilience, and well-being. The average scores for workplace burnout, resilience, and well-being were 40.40/(0- to 100-point scale), 26.79/(10- to 50-point scale), and 43.25/(24- to 96-point scale), respectively. The result of the regression analysis explained about 51.6% of the variance in well-being. Furthermore, resilience (28.4%), self-perceived health (14.3%), workplace burnout (4.5%), exercise frequency (1.8%), job title (1.2%), interpersonal pressure relief resilience (0.9%), and marital status (0.5%) were other important predictive factors of well-being in the participants. Medical institutions should provide appropriate resilience-enhancing countermeasures to reduce workplace burnout as well as pay greater attention to the exercise frequency, self-perceived health, job title, and marital status of their nurses to help them achieve physical, mental, and overall well-being.

Exposure and risk assessment of urinary trans, trans-Muconic acid in school-age children in the vicinity of a petrochemical complex in Central Taiwan.

School-age children living near large petrochemical factories may be at high risk of exposure to benzene released during manufacturing processes. We aimed to investigate the urinary concentrations of trans, trans-muconic acid (t,t-MA) in school-age children living near a petrochemical complex and to estimate their cumulative risk of benzene exposure. We examined an established cohort (Taiwan Petrochemical Complex Cohort for Children, TPE3C) of school-age children (aged 6-13 years) who lived near large petrochemical factories in central Taiwan between October 2013 and September 2014. The cohort comprised 297 children from five elementary schools, namely S.-C. Branch (n = 63, school A, ~0.9 km), F.-A. (n = 51, school B, ~2.7 km), C.-T. (n = 63, school C, ~5.5 km), M.-L. (n = 54, school D, ~6.9 km), and L.-F. (n = 66, school E, ~8.6 km). We analyzed the urinary t,t-MA levels of each participant and estimated their daily intake of benzene. We also performed multiple regression analysis to investigate potential risk factors for a high urinary t,t-MA level in the study cohort. The median urinary t,t-MA levels and median estimated benzene daily intake of the children from each school were as follows: school A, 64.07 ng/mL, 11.13 μg/kg/day; school B, 61.01 ng/mL, 15.32 μg/kg/day; school C, 59.38 ng/mL, 14.81 μg/kg/day; school D, 42.35 ng/mL, 11.67 μg/kg/day; school E, undetected, 0.14 μg/kg/day. The distance between a school and a petrochemical complex (greater distance: β = -0.26, 95% confidence interval [CI] = -0.52 to 0.00, p = 0.053), and the age of the children (older age: β = -3.44, 95% CI = -5.90 to -1.46, p < 0.001) were identified as potential risk factors. After confounders were adjusted for, the creatinine adjusted urinary t,t-MA levels of the school-age children tended to be lower when the distance between their school and a petrochemical complex was greater.

Impact of public health measures and new introducing variants on Respiratory syncytial virus recrudescence in Taiwan during the COVID-19 pandemic.

Respiratory syncytial virus (RSV) causes clinically significant distress in children and adults. Non-pharmaceutical interventions against SARS-CoV-2 have affected the seasonal activity of common respiratory pathogens. This seems exceptionally true regarding RSV's seasonal circulation, hence we have investigated the changes in the epidemiology of RSV in Taiwan during the pandemic. A prospective surveillance of RSV among hospitalized children was carried out between 2020 and 2022 in central Taiwan. Of all PCR-detected RSV, genotype and evolutionary analysis were further investigated. Demographics and clinical features were compared between each outbreak. Throughout the consecutive three years of the SARS-CoV-2 pandemic, RSV outbreaks took place in Taiwan first in 2020 and a second time in 2022. We enrolled 80 and 105 hospitalized child cases, in each surge respectively. The RSV G protein genomic analysis revealed that RSV ON1 and RSV BA9 were separately contributing to these two outbreaks, and evolutionary evidence indicated these RSV variants are new to Taiwan, with their own featured sets of mutations. Clinically, a shift in age of RSV infected children was found, but the clinical severity was not worse and remained independent of RSV genotype. There were two delayed RSV surges after the relaxation of public measures during the pandemic in Taiwan, and both outbreaks were driven by new RSV genetic variants rather than cryptic circulation of the previous genetic clusters in Taiwan. These findings highlight the importance of continued surveillance on the trend and evolution of RSV after the COVID-19 pandemic.

Cigarette smoking and related factors among type 2 diabetic patients in Taiwan

ABSTRACT Objective This study aims to investigate smoking behavior among individuals with diabetes and assess the differences of total cholesterol to HDL-C ratio based on smoking status. Methods A retrospective cohort study included 1082 diabetic patients from a regional hospital in central Taiwan between 2016 and 2020. Chi-square, McNemar test, and logistic regression analysis were conducted for the inferential statistical analysis. Results About 15.2% were current tobacco smokers. There are several risk factors related to cigarette smoking, including being male (OR = 9.780), younger than 55 years old (OR = 3.649), having lower levels of education (≦9 years and 10–12 years) (OR = 3.001 and 2.097, respectively), being a current alcohol drinker (OR = 3.366), and being a non-regular exerciser (OR = 1.968). Diabetic patients who were current cigarette smokers had a higher distribution of TC/HDL-C ratio≧5 compared to ex-smokers or nonsmokers (14.6% vs. 7.0%, p = .002). More nonsmokers or abstainers changed their TC/HDL-C ratio from abnormal (≧5) to normal (<5) compared to current smokers (67 vs. 39, p = .008). Conclusions Cigarette smoking has been shown to have negative effects on the body’s metabolism and lead to complications in diabetic patients. Therefore, it is crucial to design intervention strategies that encourage current smokers to quit smoking and evaluate the effectiveness of these interventions.

Experiences and Views on Interdisciplinary Project-based Learning Program for Teachers and Students

This two-year study investigated the impact of professional development interventions for teachers on students’ learning. In the first year, this study focused on designing, implementing, and evaluating the teachers' professional development program of interdisciplinary project-based Learning (T-IPjBLP). In the second year, this study focused on the experimental teaching of the student learning program of interdisciplinary project-based learning (S-IPjBLP) that teachers designed. Further, the author assessed the impact of S-IPjBLP on students’ capacities for critical thinking, communication, creativity, and collaboration (i.e., the 4Cs) and technological application from teachers’ and students’ views. The participants comprised seven teachers who taught natural science and technology subjects at the same junior high school in central Taiwan and their 26 eighth-graders. The results revealed that after attending the T-IPjBLP, the teachers' beliefs changed from a teacher-centered approach to a learner-centered approach, and their knowledge of PjBL improved significantly. After implementing the S-IPjBLP in class, teachers affirmed that PjBL pedagogy was a practical approach for increasing the students’ 4Cs capacities and technological application. The barriers that they encountered included time constraints and mandated curriculum pacing. Regarding student learning, students had positive experiences and feelings toward the S-IPjBLP. Most perceived that S-IPjBLP could improve their capacities for 4Cs and technological applications.

Impact of physical and social living environments on pro-environmental intentions

The living environment might play an important role in shaping the pro-environmental intentions of the people. However, there was limited research on how the living environments influenced the pro-environmental intentions of people. The objectives of this study are to evaluate the direct effects of physical and social environments on pro-environmental intentions as well as the mediating effects of environmental attitudes and life satisfaction. Structural Equation Modeling was used with data extracted from the 2020 Taiwan Social Change Survey database (n = 1671). Results showed direct positive associations of both physical and social environments with pro-environmental intentions (β = 0.133 and β = 0.076, respectively) as well as indirect positive associations via the life satisfaction-mediating pathway (β = 0.031 and β = 0.044, respectively). The physical environment negatively influenced pro-environmental intentions through the environmental attitude pathway (β = − 0.255) with unpleasant neighborhood enhancing the pro-environmental intentions of residents. Taken together, the overall effect of the physical environment was negative (β = − 0.093) while that of the social environment was positive (β = 0.109). The most important factors for the physical and social environments were disturbance and livability in north, central and south Taiwan, neighborhood pollution and interestingness in east Taiwan. Accordingly, minimizing disturbance and neighborhood pollution of the physical environment could have the highest effect on pro-environmental intentions enhancement in western and eastern Taiwan, respectively. For the social environment, improving livability in the west and interestingness in the east would have an even larger impact on pro-environmental intentions. This study emphasized the importance of neighborhood environment on the environmental intentions of the people. The study also identified the important factors for policymakers to target to achieve the best effect on improving environmental intentions.

Predicting Cognitive Function Impairment through Game-based Intelligence Tests Combined with Heart Rate Variability in Older Adults

Objectives: In this study, we explored the feasibility of predicting the risks of older adults′ cognitive function impairment using game-based intelligence tests combined with heart rate variability. Methods: We recruited 110 elderly participants from a dementia center in central Taiwan using cluster sampling. The research tools included the Mini-Mental State Examination (MMSE), the Game-based Intelligence Test (GBIT), and dynamic and static heart rate variability (HRV). Results: Multivariate stepwise regression analysis was performed for the GBIT on MMSE scores (65.1%). The key factors included the correct number of memory recalls and average attention time. Moreover, logistic regression analysis was conducted for GBIT combined with HRV to predict the high-risk group for cognitive function impairment. Key factors included the correct number of reactions, the correct number of memory recalls, and a very low-frequency power peak. The probability of correct classification was 78.18%. Conclusions: GBIT combined with HRV has predictive power on the risk of elderly cognitive function impairment. Hence, this study recommends that GBIT combined with HRV could be used at home or community bases as a feasible tool in predicting older adults′ cognitive function impairment.

Psychological insulin resistance and its impact on self-management in type II diabetes mellitus patients treated with insulin therapy.

Psychological insulin resistance is a common barrier to initiation and persistence with insulin therapy that affects approximately 42.7% of people living with type II diabetes mellitus, which may negatively impact self-management. This study aimed to assess patients' levels of psychological insulin resistance and to identify factors associated with self-management in patients with type II diabetes mellitus treated with insulin therapy. We adopted a cross-sectional design. Subjects from the metabolism and endocrinology outpatient departments of a regional teaching hospital in central Taiwan were recruited by consecutive sampling. Patients were assessed for psychological insulin resistance and self-management using the barriers to insulin treatment questionnaire and the partners in health scale. A total of 222 patients with type II diabetes mellitus were recruited. Patients had an average psychological insulin resistance score of 3.14 (maximum of 8). Positive self-management was associated with insulin therapy injection by patient, fewer expectations regarding positive insulin-related outcomes, no diabetes-related complications, less fear of injection and self-testing, no hypoglycaemia within the previous year, and younger age. Insulin therapy injection by patient and no diabetes-related complications were the most common factors associated with overall self-management and with each domain of self-management in patients with type II diabetes mellitus treated with insulin therapy. Insulin therapy education should be offered to improve patients' beliefs about insulin therapy and enhance patients' ability to perform self-management.

The experience of eating for older nursing home residents with dysphagia: A qualitative descriptive study.

Understanding the experience of eating for nursing home residents with dysphagia is essential for developing effective and holistic compensatory intervention programmes for older adults with dysphagia. However, there is a lack of studies on the experience of eating for older adults with dysphagia, especially for individuals in Asian cultures. This study aimed to understand the experience of eating for older nursing home residents who have difficulty swallowing (dysphagia), which is often a problem for this population. This qualitative descriptive study recruited older nursing home residents with dysphagia from facilities in central Taiwan. Residents were recruited by purposive sampling. Data were collected through individual in-depth semistructured face-to-face interviews. Interviews were audio-recorded and transcribed interview data were analysed with content analysis. A total of 20 residents participated in the study; the mean age was 78.7 years (standard deviation = 8.54 years); male and female residents were equally represented. The main core theme describing the experience of eating for nursing home residents with dysphagia was irregular coughing, which often occurred spontaneously. Three subthemes described how residents responded: making adjustments to eating and swallowing, receiving assistance from NH staff and fear of eating. Our findings can serve as an evidence-based reference for clinical care aimed at nursing home residents with dysphagia. Support programmes that provide safe swallowing skills and emotional support for managing dysphagia are recommended. Nursing home residents with dysphagia should receive interventions focussed on self-supporting care, training in swallowing skills and emotional support.