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Background: Shift‐work schedules can cause sleep and psychological problems among nurses, negatively affecting their health and quality of life. This trial examined the effects of low‐energy light therapy on sleep, psychological symptoms, and heart rate variability among shift‐work nurses. Methods: This randomized controlled trial was conducted from July 2021 to June 2022. The inclusion criteria were nurses with self‐reported insomnia who worked in shifts in the last 6 months in a medical center in northern Taiwan. Block randomization was used to assign the study participants to two groups: experimental ( n = 32) and control ( n = 32). A portable Meridian Aura Cap equipped with a low‐level light‐emitting diode was used to provide red and near‐infrared light (660 and 850 nm) for 30 min, three times a week for 4 weeks; the control group did not receive any intervention. The Depression Anxiety Stress Scale‐21 and Insomnia Severity Index were used to measure psychological symptoms and sleep problems, respectively. Heart rate variability was measured by the ANSWatch. Results: No significant differences were reported in preintervention scores. After the 4‐week intervention, the intervention group scored significantly lower in insomnia (4.3 vs. 12.6, respectively; p < 0.001), depression (2.5 vs. 7.9, p < 0.001), anxiety (3.1 vs. 9.2, p < 0.001), and stress (5.6 vs. 12, p < 0.001) than those in the controls. No significant differences were observed in heart rate variability between the two groups. Conclusion: Low‐level light‐emitting diode light therapy improved sleep quality in shift‐work nurses with insomnia and alleviated depression, anxiety, and stress symptoms; however, it did not improve heart rate variability, possibly because of the short intervention duration and the ongoing shift‐work schedule. Implications for Nursing Management: Employers could consider providing phototherapy for shift nurses to improve their health. Trial Registration: ClinicalTrials.gov identifier: NCT05146596

Generation X nurse managers (NMs) face challenges arising from the unique work values and needs presented by Generation Z nurses, who are the newest members of the nursing workforce. However, research on how they adapt to and lead Generation Z nurses remains limited. This study aimed to explore and gain an in-depth understanding of the experiences and growth of Generation X NMs in Taiwan as they lead Generation Z nurses. This study employed a qualitative approach, using purposive sampling to recruit participants and conducting in-depth semistructured interviews with 11 NMs. All interviews were audiorecorded with participant consent, transcribed verbatim, and analyzed using an inductive thematic approach. The Generation X NMs described the challenges and growth they experienced while leading Generation Z nurses, which included four main themes: comparative experiences, dialectics of value, sense of mission and social responsibility, and support system. This study highlights the complex and meaningful journey undertaken by Generation X NMs in Taiwan as they lead Generation Z nurses. Despite notable differences in work attitudes and values between the two generations, these NMs actively promote generational reconciliation and integration. Motivated by a strong sense of mission and social responsibility, their efforts focus on improving the retention rate of Generation Z nurses. The NMs' initial intentions, along with the support they receive from their superiors, serve as key enablers in facilitating this process. Healthcare organizations and policymakers should consider the experiences and needs of NMs while formulating nurse retention policies. By providing essential training programs and emotional support to enhance their management skills, they can effectively promote the retention and development of Generation Z nurses.

Background: Effectively predicting and reducing readmission in long-term home care (LTHC) is challenging. We proposed, validated, and evaluated a risk management tool that stratifies LTHC patients by LACE predictive score for readmission risk, which can further help home care providers intervene with individualized preventive plans. Method: A before-and-after study was conducted by a LTHC unit in Taiwan. Patients with acute hospitalization within 30 days after discharge in the unit were enrolled as two cohorts (Pre-Implement cohort in 2017 and Post-Implement cohort in 2019). LACE score performance was evaluated by calibration and discrimination (AUC, area under receiver operator characteristic (ROC) curve). The clinical utility was evaluated by negative predictive value (NPV). Results: There were 48 patients with 87 acute hospitalizations in Pre-Implement cohort, and 132 patients with 179 hospitalizations in Post-Implement cohort. These LTHC patients were of older age, mostly intubated, and had more comorbidities. There was a significant reduction in readmission rate by 44.7% (readmission rate 25.3% vs. 14.0% in both cohorts). Although LACE score predictive model still has room for improvement (AUC = 0.598), it showed the potential as a useful screening tool (NPV, 87.9%; 95% C.I., 74.2–94.8). The reduction effect is more pronounced in infection-related readmission. Conclusion: As real-world evidence, LACE score-based risk management tool significantly reduced readmission by 44.7% in this LTHC unit. Larger scale studies involving multiple homecare units are needed to assess the generalizability of this study.

The goal of this study was to verify that a fully implanted microelectrode with modulated surface may have a reduced rising rate of total impedance and a longer life time. In the previous work, alkanethiolate self-assembled monolayers (SAMs) surface as protein-resistant spacer or cell-repulsive dense-packed spacer has been verified from in vitro experiments. In this study, microelectrodes with the same surface modulation were implanted into the subcutaneous layers of Wistar rats. Nine rats were implanted with the microelectrodes and the total impedance data were measured every 24 h for 2 weeks after implantation. An equivalent electrical circuit model of the electrode-tissue interface was established and parameters were estimated by using an optimization algorithm. Four out of nine rats had manifested acute inflammation reaction and the rests revealed only slight tissue response. Histological examination for the inflammatory group showed fibroblasts, macrophages, and polymorphonuclear leukocytes in adjacent to the electrode contact surface. In the inflammatory group, no significantly difference in total impedance was found in both types of electrodes. However, the trend of total impedance of SAMs-treated electrodes could maintain a steady state value after 1 week. For the non-inflammatory group, both types of electrodes could reduce the impedance value within implanted days. The tissue resistance might be related to the thickness of cells adhered upon the electrode contacts.

In late 1976 a numerical wave hindcast model was developed by the Wave Information Study (WIS) at the U.S. Army Engineer Waterways Experiment Station (WES) and it was employed to generate 20 years of wave conditions in 10-meter water depth along the eastern seaboard of the United States. The model comprises of deepwater and shallow water submodels. The significant nonlinear wave-wave interaction process is included in the deepwater submodel based on the study of parametric model. Recently, more detailed field wave information became available in both offshore and nearshore regions, particularly shallow water directional wave information reduced from data collected along the Florida Coast. Based upon those data, the WIS model is reexamined. A new wave model, named here as the Unified Coastal Wave Prediction (UCWP) model, is developed. This model is of a discrete type and it links a wind field model to a combined deepwater and shallow water wave prediction model. The deepwater wave submodel follows the WIS model but with revised source terms and dissipation terms. The shallow water wave submodel utilizes the refraction law and the equation of conservation of energy to solve for the shallow water waves. The UCWP represents a significant improvement over existing models, at least for applications to the southeastern region of the United States. The improvement is particularly evident in wave period and wave direction. In addition to the development of the new numerical model, a number of fundamental aspects of air-sea interactions are also examined in light of the field data. New semi-empirical formulas are proposed for a number of important parameters, including the JON-SWAP spectral parameters, required to define wind wave spectra.