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Development of a Mortality Risk Model in Elderly Hip Fracture Patients by Different Analytical Approaches
No full textHip fracture is a major health issue that accompanies community aging. The most critical time after a hip fracture should be the first year. Care systems and surgical techniques for hip fractures have improved, so the trend of mortality in elderly hip fracture could be changed with them. Therefore, we observed the changes in the trend and critical factors for first-year mortality for the hip fractures in an elderly population in Taiwan, and mortality of prognosis prediction model was developed for the early diagnosis using a population-based database in Taiwan (National Health Insurance Research Database, NHIRD). A total of 166,274 elderly subjects with an age greater than 60-years-old from 2001 to 2010 were collected for this study. Cox proportional-hazards (PH) regression and logistic regression were calculated to odds ratio and hazard ratio for mortality of those patients and compared it. Data mining algorithms were also used to generate a risk stratification prediction model. The first-year mortality rate of the overall study group was 21.5% in 2001 and 15.0% in 2010 (p for trend < 0.001). In the male subgroup, the first-year mortality rate was 29.3% in 2001 and decreased to 17.3% in 2010; the trend of standardized mortality ratio was significantly decreased from 4.4 to 2.6 (p for trend < 0.001). By logistic regression, mortality significantly increased with age and male gender. Furthermore, gender, age, patients with diabetes mellitus (DM), cardiovascular (CV), and renal comorbidity, and surgical intervention can be variables for constructing the risk stratification model. The findings of the study will be used for helping related field physicians to predict the prognosis risk of hip fracture patients, and provide evidence-based tailored treatment recommendations for those patients. It may consider to build various models for predicting the prognosis of hip fracture or integrating prediction algorithms into the computerized physician order entry system, thus creating a practical clinical decision support system with warning functions
A Preliminary Study on the Effectiveness of Application of Board Games in Nursing Students’ Learning [Prenatal checkup]
No full textNursing Students’ Meaning of Life, Positive Beliefs, and Well-being with Respect to Beliefs, Attitudes, Self-efficacy, and Behavior: A Cross-sectional Survey
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The Effects of Group-Based Horticultural Therapy for Physiological and Empowerment Perception in Depressive Patients
No full text指導教授:陳靜修背景：憂鬱症是易復發且需要長期追蹤的精神疾病，由於生理機能降低，導致病患無法行使日常生活活動，嚴重時甚會出現自殺意念、反覆自傷行為，繼而威脅生命。
目的：本研究旨在發展一套適合憂鬱症病患之團體園藝療法，並檢視其對於憂鬱症病患之使用情形、生理效益、賦權感受及園藝福祉效益。
方法：本研究採準實驗性研究（quasi-experimental research）、單組前後測設計（one group, before and after design）。選取高雄某醫學中心精神科日間病房之憂鬱症病患共20名，進行每次60分鐘、每週2次、為期6週之團體園藝療法。分別於介入措施前、介入措施後的第三週、第六週、第九週進行資料收集和心率變異測量。統計方法採用廣義估計方程式（generalized estimating equations, GEE）檢視介入措施的成效。
結果：研究對象有男性3人（15%）、女性17人（85%），平均年齡53.20±11.55歲。在團體園藝療法介入六週後，自律神經總活性指標（β = 6.363, p = 0.012）、焦慮程度（β = -7.70, p = 0.001）、憂鬱狀態（β= -10.75, P = 0.000）、園藝福祉效益（β= 10.95, p = 0.000）等皆達統計之顯著差異；然而在賦權感受（β= 1.350, p = 0.381）則未達統計上之差異。
結論：本研究顯示經過六週團體園藝療法後，可以改善憂鬱症病患之自律神經、焦慮程度、憂鬱狀態及提升園藝福祉效益，建議未來可持續追蹤其延宕效益，並推廣至門診或急性住院期之憂鬱症病患，以提升日常生活之活動能力
Effectiveness of Biofeedback in adults with Diabetes: A Systematic Review and Meta-analysis
No full text指導教授:張曉雲背景：糖尿病是一種無法根治的慢性病，患者經常面臨血糖控制不良，進而增加心理困擾之風險，探討多篇研究發現，生物回饋介入措施於糖尿病患者生心成效效果顯著，能提供患者一項有效益非藥物療法之選擇，本文透過系統性回顧及統合分析以檢視其真實效果。
目的：本研究藉由系統性回顧與統合分析法，檢視隨機控制實驗中生物回饋介入措施對於糖尿病之生心成效。
方法：搜尋日期起始時間為各資料庫的收錄年份至2021年04月，使用PICO作為研究方法，P(patient population)：糖尿病患者；I(intervention or issue)：生物回饋；C(comparison of intervention or issue)：常規照護；O(outcome)：降低血糖、憂鬱、焦慮症狀。搜尋華藝線上圖書館(CEPS)、台灣博碩士論文知識加值資料庫、中國期刊全文數據庫、萬芳數據庫、EMBASE、CINAHL、Cochrane Library、Medline Complete生物醫學全文期刊資料庫、PudMed、Science Direct等資料庫，並用CMA3.0進行統合分析。
結果：從135篇相關研究文獻篩選後，共納入13篇之研究文獻資料，其中11篇符合納入統合分析標準對照實驗。統合分析結果顯示糖化血色素統合顯示整體的綜合效果量為0.372 (95%CI＝0.06~0.684) 自我血糖監測統合顯示整體的綜合效果量為0.682 (95%CI＝0.260~1.105)，空腹血糖統合顯示整體的綜合效果量為0.084 (95%CI＝-0.167~0.335)，前額肌肉緊張統合顯示整體的綜合效果量為0.609(95%CI＝0.106~1.110)，手指溫度統合顯示整體的綜合效果量為0.609(95%CI＝0.106~1.110)達統計上的顯著差異。
結論/臨床應用：糖尿病患者，除藥物治療、運動、飲食控制，還可以藉由生物回饋，改善血糖及心理困擾，本結果可以做為醫護人員改善糖尿病患者血糖控制及心理困擾臨床實務的選擇之一，以提升護理照護品質
Is it sufficiency of protein daily intake after bariatric surgery? A Meta-analysis
No full text背景 了解患者在手術後蛋白質攝取量的變化利於調整維持術後身體組成及長期減重照護策略。接受減重手術後，由於食物和蛋白質的攝取限制，可能會影響營養狀況。進行這項統合研究的目的在胃繞道手術(Roux-en-y gastric bypass; RYGB)或袖狀胃切除術(Sleeve gastrectomy; SG)後蛋白質攝取量的變化和血清白蛋白的相關性。
方法 電子文獻檢索使用了 PubMed、Embase、MEDLINE Complete、Cochrane Library 和 Web of science 數據庫中搜索了符合條件的文獻，文獻檢索搜尋2010年至 2020 年12月發表的文獻。統合分析使用隨機效應模式分析。
結果 這篇統合分析中納入15篇文獻研究（n = 1169）。在大多數這些研究中，觀察到術後12個月蛋白質攝入量低於建議量60克/天。蛋白質在術後一年的攝取總克數與手術前相比，減少29.36克／天 (95%CI -37.84 to -20.89; p<0.001) （I2 = 88.66 %，p < 0.001）。而在次群組分析中，所有手術類型包括RYGB (平均效果量std difference in means =-29.66克/天，95% CI -42.56 to 16.75; p<0.001)、SG (std difference in means =-41.96克/天，95% CI -61.91 to 22.02; p<0.001) 術後蛋白質攝取量顯著減少。與手術前相比，術後每天每公斤體重蛋白質攝取減少 0.334克/公斤/天(95%CI -0.440 to -0.229; p<0.001) （I2 =96.254，p < 0.001）。
結論 此論文研究結果呈現減重手術術後患者對於蛋白質的攝取量明顯不足，且接受袖狀胃切除手術患者的蛋白質攝取低於胃繞道手術患者
Protective effects of Inonotus sp. crude polysaccharide extract on Pseudomonas aeruginosa PAO1 infection of Caenorhabditis elegans
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應用校院研發成果-微型化採樣器進行社區室內空氣有機汙染物測定與健康風險評估
No full text計畫編號FH-HR-109-03執行機構:輔英科技大學 職業安全衛生系研究期間2020/08/01-2021/07/3