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

Carbon Dioxide Angiography in Lower Limbs: A Prospective Comparative Study With Selective Iodinated Contrast Angiography

This was a prospective comparison of the accuracy and image quality of carbon dioxide digital subtraction angiography (CO2 DSA) and iodinated contrast digital subtraction angiography (ICDSA) in evaluating lower extremity arteries and patient tolerance of the procedures. Selective DSA was performed in 14 Taiwanese patients who were diagnosed with peripheral artery occlusive disease (PAOD). Both contrast materials were administered through mechanical injectors. Post-processing of the image used pixel shifting. Images of vessels were divided into 22 anatomic segments and evaluated by two experienced radiologists. A four-point scale was used to classify diseased vessels. Two interpreters rated the CO2 DSA image against the ICDSA image on a three-point scale. Patient tolerance was assessed from verbal descriptions. Cohen's kappa was used to determine interobserver agreement and descriptive statistics were used to summarize patient experience. Interobserver agreement ranged from fair to excellent, with most being good or excellent. Three patients (21.4%) could not tolerate the whole procedure and nine patients (64.3%) reported discomfort during the CO2 DSA procedure. CO2 DSA image quality was better for the thigh than the distal runoff and pelvic regions. Our results showed that selective CO2 DSA cannot replace ICDSA as a routine diagnostic tool for PAOD because it does not give images of comparative quality

Dynamical Properties of Environmental High-Performance Composites with Calcined Clay

Concrete structures may be exposed to dynamic loadings within short periods such as earthquakes and vehicles load, resulting in substantial damage to human life and property because of the collapse of concrete structures. The research achievements on dynamic properties of high-performance composites with LC3 (HPC-LC3) are limited, although dynamic loadings are commonly encountered in infrastructure. The study aims to develop a new-green concrete product (HPC-LC3) with high dynamical properties and promote its mass use in a vibration service environment by investigating dynamical properties of HPC-LC3. Dynamical properties of structure can be promoted at material level by means of enhancing the inherent ability of cement-matrix materials to passively absorb the vibrational energy. Dynamic properties of traditional HPC may be improved by incorporated LC3 because of excellent mechanical properties. The fiber pull-out, thermogravimetric analysis (TGA), (nuclear magnetic resonance) NMR, and microstructure test were used to reveal the enhanced mechanism of dynamic properties in the HPC with LC3 (HPC-LC3), and the economic efficiency of HPC is also evaluated to promote its mass application. The results indicate that the dynamic properties of HPC-LC3 increased by 47% in damping capacity, 102% in storage modulus, 16% in energy dissipation, in comparison with the reference (HPC-OPC). Meanwhile, compared with the reference, the compressive and flexural strengths of LC3-50 increased by 14% and 27%. TGA and NMR results indicate that LC3-50 shows better hydration characteristics, longer alumina-silicate chain length (from 3.9 to 8) than HPC-OPC. The proposed composites reduced embodied energy, embedded CO2 emissions, and costs of HPC by up to 33%, 45%, and 7%, respectively. Thus, the green product (HPC-LC3) with 30%–40% calcined clay, high dynamic properties and more sustainable, will be recommended to mass use in a vibration service environment

Computer-modified paramedian approach technique reduces failures and alleviates pain in lumbar puncture: a prospective comparative study

BackgroundThe conventional midline approach for lumbar puncture (MAT-LP) has a relatively low success rate of 70%. The paramedian approach can increase the effective puncture area and success rate but lacks standardized guidelines. This study evaluated a computer-modified paramedian approach technique (CMPAT) to optimize lumbar puncture using computational techniques.MethodsIn this prospective study, 120 patients underwent CMPAT-LP (n = 60) or MAT-LP (n = 60). Puncture failure was defined after 6 attempts. Failure rate, number of attempts, pain score, and complications were compared. Subgroup analysis was conducted for age (≥ 50 years).ResultsNo significant demographic differences existed between groups. Failure rates were 3.3% for CMPAT vs. 13.3% for MAT. Puncture attempts averaged 2.0 vs. 3.5 and pain scores were 2.7 vs. 4.1 for CMPAT and MAT, respectively. All outcomes were significantly improved with CMPAT, especially in elderly patients. No significant difference in complications was observed.ConclusionCompared to MAT, CMPAT-LP demonstrated lower failure rates, fewer puncture attempts, and less pain, without compromising safety. CMPAT may be superior and should be more widely implemented in clinical practice

Antigen-Sparing and Enhanced Efficacy of Multivalent Vaccines Adjuvanted with Immunopotentiators in Chickens

We previously described that immunopotentiators, CVCVA5, increased the efficacy of H5 and H9 subtype avian influenza vaccines in chickens, ducks, and geese. In this study, we further investigated the effects of the CVCVA5 for improving the efficacy of other univalent or multivalent inactivated vaccines. The immune response administrated with half-dose of monovalent vaccine plus CVCVA5 were higher than those of one dose of monovalent vaccine without immunopotentiators as measured by levels of antibodies from serum, tears and bronchoalveolar lavage fluids, and cytokines of IFNγ and IL-4 from serum. Vaccines included the univalent vaccine of Newcastle Disease virus (ND), Egg Drop Syndrome virus (EDS), Infectious Bronchitis virus (IB), and Infectious Bursal Disease virus (IBD). The CVCVA5 also improved the immune response of both ND and IBD vaccines with less dosage. The sterile protective immunity was monitored with one- or a half-dose of adjuvanted ND vaccine or one dose of adjuvanted IBD vaccine, respectively. The improved immune efficacy was observed in a half-dose of adjuvanted bivalent vaccines compared to one dose of vaccines without CVCVA5 as measured by the antibody levels, including bivalent vaccine of ND-H9, ND-IB, and ND-IBD. The CVCVA5 also boosted the immune efficacy of the tetravalent vaccine (ND-IB-EDS-H9). A half-dose of adjuvanted commercial vaccine or 75% antigen-sparing adjuvanted vaccine elicited similar antibody levels to those of one dose non-adjuvanted commercial vaccines. The CVCVA5 improved the effect of a booster vaccination as measured by the antibody levels against H5 or H9 virus antigens, in which chickens primed with the adjuvanted ND-IB vaccines given a booster with H5–H9 bivalent vaccines without CVCVA5 using 5-day intervals. The inflammatory response may contribute to these additional effects by increasing the levels of IFNγ and IL-4 after the injection of the adjuvanted ND-IB vaccines. Results indicated that the CVCVA5 improved the serum and mucosal antibody levels, cytokine levels of the chickens given the univalent vaccine, and also improved serum antibody titers in bivalent and tetravalent vaccines. This has a potential as an improve vaccine