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Chen, Hsin-Hao,Chiu, Hsiao-Hui,Yeh, Tzu-Lin,Lin, Chi-Min,Huang, Hsin-Yi,Wu, Shang-Liang Occupational Safety and Health Research Institute 2021 Safety and health at work Vol.12 No.3
Background: Health-care providers typically undergo shift work and are subjected to increased stress. Night shift work may induce disturbed sleep cycles and circadian rhythm. The objective of this study was to explore if night shift workers (NSWs) show an increased risk of abnormal thyroid-stimulating hormone (TSH). Methods: We conducted a retrospective cohort study of 574 employees without thyroid disease and abnormal TSH at baseline who underwent annual check-ups between 2007 and 2016 in a medical center. NSWs were defined as those with working time schedules other than daytime hours. We calculated the incidence rate and estimated the adjusted hazard ratio (HR) for incident abnormal TSH and subclinical hypothyroidism compared with non-NSWs using a Cox regression model. Results: A total of 56 incident abnormal TSH cases and 39 subclinical hypothyroidism cases in NSWs were identified during 3000 person-years of follow-up. In models adjusted for age, sex, obesity, and working departments, we found no increased relative risk for incident abnormal TSH (HR: 0.72, 95% confidence interval: 0.33-1.60) or subclinical hypothyroidism (HR: 0.52, 95% confidence interval: 0.19-1.45) when comparing NSWs to non-NSWs; nor were incidence rates significantly different among exclusively medical employees after excluding administrative staff. Conclusion: In this hospital-based nine-year follow-up retrospective cohort study, NSWs were not associated with increased relative risk of incident abnormal TSH and subclinical hypothyroidism, in contrast to previous cross-sectional studies.
I-Mei Lin,Sheng-Yu Fan,Cheng-Fang Yen,Yi-Chun Yeh,Tze‐Chun Tang,Mei-Feng Huang,Tai-Ling Liu,Peng-Wei Wang,Huang-Chi Lin,Hsin-Yi Tsai,Yu-Che Tsai 대한정신약물학회 2019 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.17 No.2
Objective: Autonomic imbalance is considered a psychopathological mechanism underlying major depressive disorder (MDD). Heart rate variability (HRV) is an index for autonomic activation. Poor sleep quality is common among patients with MDD. HRV biofeedback (BF) has been used for regulating autonomic balance among patients with physical illness and mental disorders. The purpose of present study was to examine the effects of HRV-BF on depressive symptoms, sleep quality, pre-sleep arousal, and HRV indices, in patients with MDD and insomnia. Methods: In this case-controlled study, patients with MDD and Pittsburgh Sleep Quality Index (PSQI) score higher than 6 were recruited. The HRV-BF group received weekly 60-minute protocol for 6 weeks, and the control group who have matched the age and sex received medical care only. All participants were assessed on Beck Depression Inventory-II, Back Anxiety Inventory, PSQI, and Pre-Sleep Arousal Scale. Breathing rates and electrocardiography were also performed under resting state at pre-testing, and post-testing conditions and for the HRV-BF group, also at 1-month follow-up. Results: In the HRV-BF group, symptoms of depression and anxiety, sleep quality, and pre-sleep arousal were significantly improved, and increased HRV indices, compared with the control group. Moreover, in the HRV-BF group, significantly improved symptoms of depression and anxiety, decreased breathing rates, and increased HRV indices were detected at post-testing and at 1-month follow-up, compared with pre-testing values. Conclusion: This study confirmed that HRV-BF is a useful psychosocial intervention for improving autonomic balance, baroreflex, and symptoms of depression and insomnia in MDD patients.
Combined Assessment of Serum Alpha-Synuclein and Rab35 is a Better Biomarker for Parkinson’s Disease
Hung-Li Wang,Chin-Song Lu,Tu-Hsueh Yeh,Yu-Ming Shen,Yi-Hsin Weng,Ying-Zu Huang,Rou-Shayn Chen,Yu-Chuan Liu,Yi-Chuan Cheng,Hsiu-Chen Chang,Ying-Ling Chen,Yu-Jie Chen,Yan-Wei Lin,Chia Chen Hsu,Huang-Li 대한신경과학회 2019 Journal of Clinical Neurology Vol.15 No.4
Background and Purpose It is essential to develop a reliable predictive serum biomarker for Parkinson’s disease (PD). Te accumulation of alpha-synuclein (αSyn) and up-regulated expression of Rab35 participate in the etiology of PD. Te purpose of this investigation was to determine whether the combined assessment of serum αSyn and Rab35 is a useful predictive biomarker for PD. Methods Serum levels of αSyn or Rab35 were determined in serum samples from 59 sporadic PD patients, 19 progressive supranuclear palsy (PSP) patients, 20 multiple system atrophy (MSA) patients, and 60 normal controls (NC). Receiver operating characteristics (ROC) curves were calculated to determine the diagnostic accuracy of αSyn or/and Rab35 in discriminating PD patients from NC or atypical parkinsonian patients. Results The levels of αSyn and Rab35 were increased in PD patients. The serum level of Rab35 was positively correlated with that of αSyn in PD patients. Compared to analyzing αSyn or Rab35 alone, the combined analysis of αSyn and Rab35 produced a larger area under the ROC curve and performed better in discriminating PD patients from NC, MSA patients, or PSP patients. When age was dichotomized at 55, 60, 65, or 70 years, the combined assessment of αSyn and Rab35 for classifying PD was better in the group below the cutof age than in the group above the cutof age. Conclusions Combined assessment of serum αSyn and Rab35 is a better biomarker for discriminating PD patients from NC or atypical parkinsonian patients, and is a useful predictive biomarker for younger sporadic PD patients.
On Establishing a New Fee Schedule for General Surgical Procedure Using Fuzzy MCDM
Hung, Chih-Young,Huang, Yuan-Huei,Chang, Pei-Yeh,Wang, Kuei-Ing,Chang, King-Jen,Liu, Yi-Hsin Korean Institute of Industrial Engineers 2005 Industrial Engineeering & Management Systems Vol.4 No.2
In this research a model for establishing a new, rational fee schedule for general surgical procedures in a national health insurance program is developed. A fuzzy multiple criteria decision-making (FMCDM) model is proposed. The relative values of eleven surgical procedures were obtained through an empirical study based on the FMCDM model. Consequently, a new fee schedule obtained from the FMCDM model. This new fee schedule is more convincing than previous schedule and more persuasive to the references for the policy setting.
Suh-Ing Hsieh,Li-Ling Hsu,Hui-Ling Lin,Chen-Yi Kao,Yi-Ping Tseng,Li-Yun Szu,Ching-Yun Lee,Lun-Hui Ho,Shu-Ling Yeh,Shu-Hua Kao,Yen-Fang Chou,Tzu-Hsin Huang 한국성인간호학회 2021 성인간호학회 학술대회 Vol.2021 No.8
Aim(s): Clinical nurses are facing patients’ biopsychosocial and spiritual problems at diverse clinical settings, but they are lack of knowledge, skills, and confidence on providing spiritual care. However, no studies adopted simulated educational program and objective structure clinical examination (OSCE) to educate nurses and to assess the outcomes. Therefore, this study was to validate the effect of a scenario-based spiritual care course on spiritual care competence in clinical nurses. Methods: This non-equivalent quasi-experimental study with a pre-test and two post-tests (end of the intervention and three months later) was conducted between August 2019 and February 2021 (11 sessions). The recruitment posters with a QR code were distributed to different units at three branches of a large medical institute for recruiting clinical nurses, who provided direct patient care. The attendees of one-day scenario-based spiritual care course are the experimental group (n=53) and the control group (n=85) was matched with the experimental group (1:1-3 ratio) by similar units, ages, working experience, and clinical ladder. Instruments include basic information, self-evaluated and head nurses evaluated spiritual care competence scale (SCCS), spiritual perspective scale (SPS), and spiritual care perspective scale-revised (SCPSR) for both groups and reflective log, course satisfaction scale, OSCE checklist, and standardized patient feedback scale for the experimental group. The data were analyzed using descriptive statistics, repeated measures ANOVA, linear regression, and paired t test. Results: After controlling for pre-test scores and interest in attending spirituality/spiritual care, the experimental group showed significant higher SPS (p=0.012) and self-evaluated SCCS (p=0.002) and lower SCPSR (p=0.015) than the control group at the 2nd post-test. Repeated measure ANOVA also showed significant within-subject effects across three time points of the experimental group on SPS (p<0.001), SCPSR (p<0.001), and self-evaluated SCCS (p<0.001), but paired t test showed non-significant differences on SPS, SCPSR, and self-evaluated SCCS between pre-test and post-test with an exception of head nurse evaluated SCCS (p=0.035). The mean overall course satisfaction of the experimental group was 4.34±0.62. The mean global performance of OSCE was 3.40±0.91 and the majority of experimental group was pass (43.4%) and good (35.8%). 64.5% and 26.1% of standardized patients were partial and strongly agreed with examinees’ performance in spiritual care assessment respectively. Conclusions: The scenario-based spiritual care course is effectively to enhance clinical nurses’ spiritual care competence. It may cultivate clinical preceptors with better spiritual care pedagogy through simulation and OSCE for bedside teaching of nurse post-graduate year.