Nursing Students’ Clinical Confidence In Caring Tuberculosis: Indonesian Version Of The U.S Tuberculosis Curriculum Consortium Survey Using Rasch Analysis

Background: Nursing students who are prepared in clinical practicums to comprehend the knowledge, reflect their beliefs about tuberculosis instruction, and perceive their abilities in caring for tuberculosis patients are also at risk. Nursing students’ clinical confidence in caring for tuberculosis patients is essential to be assessed. Knowledge, beliefs, and clinical confidence, as unidimensional constructs based on Bandura’s theory of self-efficacy, had been used in the US National Tuberculosis Curriculum Consortium (NTCC) survey for nursing students. This study's objective was to investigate the Indonesian version of the NTCC survey among nursing students' experiences caring for tuberculosis patients.   Methods: A quantitative study with cross-sectional using an online survey among 250 students 1st to 3rd-yearrd year students in one faculty of nursing in Banten, Indonesia. Prior to data collection, NTCC surveys were translated backward and forward, reviewed by experts, and tested in a pilot project.   Results: Internal consistency using Rasch analysis on each subscale showed good results and gave strong evidence that three subscales are unidimensional. There was an item separation index and reliability score, in that order: knowledge about tuberculosis (8.68 and 0.99), beliefs regarding tuberculosis instructions (6.50 and 0.98), and clinical confidence in caring for tuberculosis patients (6.29 and 0.98).   Conclusion: The Indonesian version of the NTCC survey has excellent internal consistency. This instrument might be improved since the original instrument is 13 years old and there is a cultural gap between the US and Indonesia. Moreover, this instrument might be needed for improving tuberculosis teaching in the nursing curriculum in Indonesia

Competition Conditions in Taiwan's Public Accounting Industry

[[abstract]]This paper investigates the degree of market competition in the public accounting industry of Taiwan over the period 1994-2008, using the ‘H statistic’ proposed by Panzar & Rosse (1987). Differing from previous works, this paper applies a newly developed model, i.e., the censored stochastic frontier (CSF) model, to test whether the audit market has achieved its long-run equilibrium. The model is superior to the conventional model that requires researchers adding a unity to the dependent variable of returns on assets (ROA) for all observations, forcing the transformed dependent variable to be non-negative. One can then take the natural logarithm of this dependent variable. Evidence shows that Taiwan’s accounting industry is characterized as monopolistic competition with a trend towards perfect competition. The result will help to build up the empirical model for public accounting industry. The CSF model confirms that this industry is already in a long-run equilibrium in the second half of the sample, which validates the use of the Panzar-Rosse model. Conversely, the employment of the conventional approach leads to a rejection of the long-run equilibrium over the entire sample period.[[notice]]補正完

Catheter Migration After Implantationan Intrathecal Baclofen Infusion Pump for Severe Spasticity: A Case Report

We report a case of intrathecal baclofen infusion pump implantation complicated by migration of the catheter tip. A 55-year-old man required an intrathecal baclofen infusion for severe spasticity 4 years after a cervical spinal cord injury with incomplete tetraparesis. Twelve months after initial implantation of the device, the patient began to experience a recurrence of trunk tightness and spasticity. Subsequent X-ray and computed tomography evaluations of the catheter system revealed pooling of contrast medium outside of the intrathecal distribution in the lumbar subcutaneous region of the back and therefore migration of the pump catheter tip. At surgical revision, emphasis was placed on minimizing the length of catheter outside of the spine and securing the catheter in the supraspinous fascia with a right-angled anchor. The distance between the anchors and the entry point of the catheter into the supraspinous fascia was also reduced to prevent slipping when the patient bends forward. After surgery, the patient's spasticity improved and, 1 year later, he has experienced no further complications during follow-up, requiring an average baclofen dose of 150 mg/day. Here, we describe several surgical methods intended to secure the intrathecal catheter and prevent catheter migration. Other complications related to catheter failure are also highlighted

EBV-encoded small RNA1 and nonresolving inflammation in rheumatoid arthritis

AbstractRheumatoid arthritis (RA) is a chronic autoimmune disease characterized by perpetuated inflammation in multiple joints. To date, there is no cure for RA, and the causal factor for non-resolving inflammation in RA remains unclear. In this study, we initially observed expression of Epstein–Barr virus-encoded small RNA1 (EBER1) in the synovial tissue of all five patients who showed nonresolving RA inflammation. By contrast, EBER1 was detected in the synovial tissue of only one out of seven patients with advanced osteoarthritis (OA; p < 0.01, Fisher’s exact test). To confirm this finding, we conducted a second study on synovial tissue samples taken from 23 patients with nonresolving RA inflammation and 13 patients with OA. All synovial samples from patients with nonresolving inflammation of RA showed positive expression of EBER1 (23/23, 100%), whereas none of the synovial samples from patients with OA showed expression of EBER1 (0/13, 0%; p < 0.001, by Fisher’s exact test). In vitro, transfection of RA synovial fibroblasts with EBER1 induced the production of interleukin-6. Taken together, these data strongly suggest that nonresolving RA inflammation is strongly related to the presence of EBER1, which might be, at least partially, responsible for synovial fibroblast interleukin-6 production

以支應性理論探討環境屬性與使用者行為關係之研究

本研究旨在以Gibson(1979)所提出的「支應性」理論，探討於開放空間中「環境物理特性」與「活動支應性」兩者之間的對應關係。研究以「台灣美術館前開放空間」作為調查樣區，對此開放空間中的使用者進行問卷調查．共得有效問卷400份。研究透過敘述性統計了解使用者之特性與使用情形，由平面照片所分析出來的結果發現，環境物理性質的確與支應的活動類型有一定程度的關聯性，使用者也能夠輕易的在特定環境外觀配受的地點，感知潛在的活動而促成行動，即使是透過2D介面展現出物理特徵，亦能讓人聯想到可能支應的活動，能夠有效的掌握關鍵使用者對環境的感知與使用行為。The major purpose of this study was to explore the relationship between environmental attributes and users' behavior by applying the affordance concept proposed by Gibson (1979). The study selected open spaces around Taiwan Art Museum as a survey area and employed questionnaire survey to obtain 400 valid samples. By using descriptive statistics and two-dimension photo analysis, the results showed that there was a certain association between environmental characteristics and types of affordance activity. Users could easily perceive potential activities in specified locations with different environmental attributes, and therefore enhance their real actions. The study also found out that even using two-dimension interface to display environmental characteristics could make users think about the potential affordance activities and understand users' environmental perception and use behavior

Impaired Efficiency and Resilience of Structural Network in Spinocerebellar Ataxia Type 3

Background: Recent studies have shown that the patients with spinocerebellar ataxia type 3 (SCA3) may not only have disease involvement in the cerebellum and brainstem but also in the cerebral regions. However, the relations between the widespread degenerated brain regions remains incompletely explored.Methods: In the present study, we investigate the topological properties of the brain networks of SCA3 patients (n = 40) constructed based on the correlation of three-dimensional fractal dimension values. Random and targeted attacks were applied to measure the network resilience of normal and SCA3 groups.Results: The SCA3 networks had significantly smaller clustering coefficients (P &lt; 0.05) and global efficiency (P &lt; 0.05) but larger characteristic path length (P &lt; 0.05) than the normal controls networks, implying loss of small-world features. Furthermore, the SCA3 patients were associated with reduced nodal betweenness (P &lt; 0.001) in the left supplementary motor area, bilateral paracentral lobules, and right thalamus, indicating that the motor control circuit might be compromised.Conclusions: The SCA3 networks were more vulnerable to targeted attacks than the normal controls networks because of the effects of pathological topological organization. The SCA3 revealed a more sparsity and disrupted structural network with decreased values in the largest component size, mean degree, mean density, clustering coefficient, and global efficiency and increased value in characteristic path length. The cortico-cerebral circuits in SCA3 were disrupted and segregated into occipital-parietal (visual-spatial cognition) and frontal-pre-frontal (motor control) clusters. The cerebellum of SCA3 were segregated from cerebellum-temporal-frontal circuits and clustered into a frontal-temporal cluster (cognitive control). Therefore, the disrupted structural network presented in this study might reflect the clinical characteristics of SCA3

Non-invasive and transdermal measurement of blood uric acid level in human by electroporation and reverse iontophoresis

The aim of this study was to find out the optimum combination of electroporation (EP) and reverse iontophoresis (RI) on noninvasive and transdermal determination of blood uric acid level in humans. EP is the use of high-voltage electric pulse to create nano-channels on the stratum corneum, temporarily and reversibly. RI is the use of small current to facilitate both charged and uncharged molecule transportation across the skin. It is believed that the combination of these two techniques has additional benefits on the molecules’ extraction across the human skin. In vitro studies using porcine skin and diffusion cell have indicated that the optimum mode for transdermal uric acid extraction is the combination of RI with symmetrical biphasic direct current (current density = 0.3 mA/cm2; phase duration = 180 s) and EP with 10 pulses per second (voltage = 100 V/cm2; pulse width = 1 ms). This optimum mode was applied to six human subjects. Uric acid was successfully extracted through the subjects’ skin into the collection solution. A good correlation (r2 = 0.88) between the subject’s blood uric acid level and uric acid concentrations in collection solutions was observed. The results suggest that it may be possible to noninvasively and transdermally determine blood uric acid levels