Applying Theory of Planned Behavior to Predict Nurses' Intention and Volunteering to Care for Sars Patients in Southern Taiwan

Severe acute respiratory syndrome (SARS) spread worldwide after an outbreak in Guangdong Province, China, in mid-November 2002. Health care workers were at highest risk of infection. The purpose of this study, which was based on Ajzen's theory of planned behavior (TPB), was to determine the extent to which personal attitudes, subjective norms, and perceived control influence nurses' intention and volunteering to care for SARS patients. After the SARS outbreak, a total of 750 staff nurses (response rate 90%) at one hospital completed a questionnaire assessing their intention to provide care to SARS patients. Overall, 42.7% of nurses had a positive intention to provide care to SARS patients, and 25.4% of nurses would volunteer to care for SARS patients. Four factors explaining 35% of the variance in nurses' intention to care for SARS patients were self-efficacy (β = 0.39, p < 0.001), attitude (β = 0.25, p < 0.001), years of working in the study hospital (β = −0.15, p < 0.001), and receiving resources from the hospital (β = 0.13, p < 0.001). Two factors explaining 15% of the variance in nurses' volunteering to care for SARS patients were intention (β = 0.31, p < 0.001) and attitude (β = 0.15, p < 0.001). The final model shows that the variables of the TPB contributed significantly to the explanation of a portion of variance in nurses' intention and volunteering to care for SARS patients. The results are helpful for human resources managers facing a new contagious disease

Design, Synthesis, Mechanisms of Action, and Toxicity of Novel 20( S )-Sulfonylamidine Derivatives of Camptothecin as Potent Antitumor Agents

Twelve novel 20-sulfonylamidine derivatives (9a–9l) of camptothecin (1) were synthesized via a Cu-catalyzed three-component reaction. They showed similar or superior cytotoxicity compared with that of irinotecan (3) against A-549, DU-145, KB, and multidrug-resistant (MDR) KBvin tumor cell lines. Compound 9a demonstrated better cytotoxicity against MDR cells compared with that of 1 and 3. Mechanistically, 9a induced significant DNA damage by selectively inhibiting Topoisomerase (Topo) I and activating the ATM/Chk related DNA damage-response pathway. In xenograft models, 9a demonstrated significant activity without overt adverse effects at 5 and 10 mg/kg, comparable to 3 at 100 mg/kg. Notably, 9a at 300 mg/kg (i.p.) showed no overt toxicity in contrast to 1 (LD50 56.2 mg/kg, i.p.) and 3 (LD50 177.5 mg/kg, i.p.). Intact 9a inhibited Topo I activity in a cell-free assay in a manner similar to that of 1, confirming that 9a is a new class of Topo I inhibitor. 20-Sulfonylamidine 1-derivative 9a merits development as an anticancer clinical trial candidate

Mining time dependency patterns in clinical pathways

Clinical pathways are widely adopted by many large hospitals around the world in order to provide high-quality patient treatment and reduce the length of hospital stay of each patient. The development of clinical pathways is a lengthy process, and may require the collaboration among physicians, nurses, and staffs in a hospital. However, the individual differences cause great variances in the execution of clinical pathways. It calls for a more dynamic and adaptive process to improve the performance of clinical pathways. This paper reports a data mining technique we have developed to discover the time dependency pattern of clinical pathways for managing brain stroke. The mining of time dependency pattern is to discover patterns of process execution sequences and to identify the dependent relation between activities in a majority of cases. By obtaining the time dependency patterns, we can predict the paths for new patients when he/she is admitted into a hospital; in turn, the health care procedure will be more effective an

Stimulation phosphatidylinositol 3-kinase/protein kinase B signaling by Porphyromonas gingivalis lipopolysacch aride mediates interleukin-6 and interleukin-8 mRNA/protein expression in pulpal inflammation

Background/purpose: The signaling mechanisms for Porphyromonas gingivalis lipopolysaccharide (PgLPS)-induced inflammation in human dental pulp cells are not fully clarified. This in vitro study aimed to evaluate the involvement of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) pathway in PgLPS-induced pulpal inflammation. Methods: Human dental pulp cells (HDPCs) were challenged with PgLPS with or without pretreatment and coincubation with a PI3K/Akt inhibitor (LY294002). The gene or protein levels of PI3K, Akt, interleukin (IL)-6, IL-8, alkaline phosphatase (ALP), osteocalcin and osteonectin were analyzed by reverse transcription polymerase chain reaction (PCR), real-time PCR, western blotting, and immunofluorescent staining. In addition, an enzyme-linked immunosorbent assay was used to analyze IL-6 and IL-8 levels in culture medium. Results: In response to 5 μg/ml PgLPS, IL-6, IL-8, and PI3K, but not Akt mRNA expression of HDPCs, was upregulated. IL-6, IL-8, PI3K, and p-Akt protein levels were stimulated by 10–50 μg/ml of PgLPS in HDPCs. PgLPS also induced IL-6 and IL-8 secretion at concentrations higher than 5 μg/ml. Pretreatment and co-incubation by LY294002 attenuated PgLPS-induced IL-6 and IL-8 mRNA expression in HDPCs. The mRNA expression of ALP, but not osteocalcin and osteonectin, was inhibited by higher concentrations of PgLPS in HDPCs. Conclusion: P. gingivalis contributes to pulpal inflammation in HDPCs by dysregulating PI3K/Akt signaling pathway to stimulate IL-6 and IL-8 mRNA/protein expression and secretion. These results are useful for understanding the pulpal inflammation and possible biomarkers of inflamed pulp diagnosis and treatment

Correlates of Attitudes Toward Homosexuality and Intention to Care for Homosexual People Among Psychiatric Nurses in Southern Taiwan

This study examined the association between attitudes toward homosexual individuals and intention to provide care and demographic and occupational factors, sexual orientation, knowledge about homosexuality, and experiences of contact with homosexual people among psychiatric nurses in southern Taiwan. In total, 133 psychiatric nurses from a medical center, three regional teaching hospitals, and one psychiatric hospital in southern Taiwan were recruited into this study. Their attitudes toward homosexual people as recorded on the Attitudes Toward Homosexuality Questionnaire, intention to provide care to homosexual individuals, and related factors were examined. The results revealed that psychiatric nurses who had a bachelor's or master's degree, higher level of knowledge about homosexuality, and friends or relatives with a homosexual orientation had a more positive attitude toward homosexuality. These psychiatric nurses, with more positive attitudes, and who worked in the medical center or regional teaching hospitals had a higher intention to care for homosexual people. The factors related to attitudes toward homosexuality and intention to care for homosexual people identified in this study should be taken into consideration when intervening in psychiatric nurses' attitudes toward homosexuality and intention to care for homosexual people

Design, Synthesis, Mechanisms of Action, and Toxicity of Novel 20(<i>S</i>)‑Sulfonylamidine Derivatives of Camptothecin as Potent Antitumor Agents

Twelve novel 20-sulfonylamidine derivatives (<b>9a</b>–<b>9l</b>) of camptothecin (<b>1</b>) were synthesized via a Cu-catalyzed three-component reaction. They showed similar or superior cytotoxicity compared with that of irinotecan (<b>3</b>) against A-549, DU-145, KB, and multidrug-resistant (MDR) KBvin tumor cell lines. Compound <b>9a</b> demonstrated better cytotoxicity against MDR cells compared with that of <b>1</b> and <b>3</b>. Mechanistically, <b>9a</b> induced significant DNA damage by selectively inhibiting Topoisomerase (Topo) I and activating the ATM/Chk related DNA damage-response pathway. In xenograft models, <b>9a</b> demonstrated significant activity without overt adverse effects at 5 and 10 mg/kg, comparable to <b>3</b> at 100 mg/kg. Notably, <b>9a</b> at 300 mg/kg (i.p.) showed no overt toxicity in contrast to <b>1</b> (LD₅₀ 56.2 mg/kg, i.p.) and <b>3</b> (LD₅₀ 177.5 mg/kg, i.p.). Intact <b>9a</b> inhibited Topo I activity in a cell-free assay in a manner similar to that of <b>1</b>, confirming that <b>9a</b> is a new class of Topo I inhibitor. 20-Sulfonylamidine <b>1</b>-derivative <b>9a</b> merits development as an anticancer clinical trial candidate