National Tainan Institute of Nursing

This study draws on archival materials from Academia Historica to examine how, after the Korean War, Taiwan’s Nationalist government used the party–state–military apparatus to promote martial arts as part of its Cold War cultural strategy. This effort aimed to assert ideological legitimacy, construct cultural orthodoxy, and counteract diplomatic marginalization amid geopolitical isolation. In the post–Cold War era, as martial arts administration in Taiwan gradually shed its overt ties to the military and the ruling party, martial arts evolved into a more civilian-oriented national movement. Nevertheless, Taiwan’s efforts to internationalize martial arts have yielded limited results. In addition to internal challenges such as disputes over leadership and institutional reform, these efforts have also been hindered by external factors, notably the dominance of international frameworks favoring Olympic-standardized martial arts competition.

ABSTRACT This study investigated the impact of an AI-driven VTuber brand management teaching model on students’ learning outcomes and entrepreneurial self-efficacy in a Taiwan-based e-commerce course. A mixed-methods design was used with an experimental group (40 students) and a control group (42 students). The experimental group used AI tools for their VTuber entrepreneurship project, while the control group used a traditional teaching model. The results showed that the experimental group significantly outperformed the control group in e-commerce knowledge, brand management skills, and entrepreneurial self-efficacy. Findings provide a concrete instructional framework for integrating emerging technologies into higher education.

Abstract With the rapid adoption of “Internet Plus” technologies in the tourism industry, online purchasing of travel products has become increasingly common, and user-generated reviews now play a vital role in consumer decision-making. This study develops a customer satisfaction evaluation model for customized online tour packages by combining text mining, Latent Dirichlet Allocation (LDA), and focus group interviews. The DEMATEL and DANP methods are used to examine the relationships and relative importance among key factors. Results show that product experience is the most influential factor affecting customer satisfaction, with product attributes and service quality having a significant impact on the overall experience. Based on these findings, the study provides targeted recommendations for product improvement. It suggests future research directions, including the integration of data from multiple platforms and the conduct of behavioral validation to enhance the model’s usefulness.

To investigate the effectiveness of multimedia-based hypoglycemia education compared to conventional hypoglycemia education on knowledge, self-care behavior, fear of hypoglycemia, social support, quality of life, nursing hours, education satisfaction, and the recurrence rate of hypoglycemic events among elderly individuals with type 2 diabetes who have experienced hypoglycemic events. A randomized controlled trial with a repeated-measures design was conducted on 82 elderly patients with type 2 diabetes who had experienced hypoglycemic events. Participants in the experimental group received multimedia-based hypoglycemia education, while those in the contrast group received lecture-based hypoglycemia education. Data were analyzed using descriptive statistics, chi-square tests, t-tests, and Generalized Estimating Equations (GEE). The experimental group showed significantly higher mean scores in hypoglycemia knowledge (p < .001), hypoglycemia self-care behavior (p = .034), and education satisfaction (p < .001). The nursing hours spent by the experimental group were significantly lower than those of the contrast group (p < .001). Within 6 months after receiving hypoglycemia education, the recurrence rate of hypoglycemic events decreased by 61% in the experimental group and 53.70% in the contrast group. Multimedia-based hypoglycemia education can enhance knowledge and self-care behavior and reduce the recurrence rate of hypoglycemia among elderly patients with type 2 diabetes. Healthcare professionals can utilize multimedia education for hypoglycemia in elderly individuals with diabetes to improve their ability for home hypoglycemia care, thereby reducing the recurrence rate of hypoglycemic events.

Inappropriate dietary, exercise, and medication self-care behaviors among persons with diabetes can easily trigger hypoglycemia. Clinically, it is necessary to quickly identify high-risk groups for hypoglycemic events to provide targeted hypoglycemia education. However, there is currently a lack of precise tools to assess self-care behaviors related to hypoglycemia. The aim of the study was to develop and validate a hypoglycemia self-care behavior scale for evaluating the behaviors of persons with diabetes in handling and preventing hypoglycemic events. A cross-sectional study with purposive sampling was conducted to recruit 300 persons with Type 2 diabetes who had experienced hypoglycemic events from a medical center and a primary care clinic in southern Taiwan. Data were collected using a structured questionnaire from December 2021 to September 2023. The original Hypoglycemia Self-Care Behavior Scale, comprising 26 items, was reduced to 17 items, measuring six factors after exploratory factor analysis. Subsequently, the scale was further refined to 10 items covering four factors through structural equation modeling. Validity and reliability were assessed during this process, and the developed scale was subsequently verified for both. Factor loadings ranged from .50-.97, explaining 76% of the total variance. The four factors included "hypoglycemia recognition and carbohydrate supplementation," "prevention of hypoglycemia during exercise," "carbohydrate assessment," and "seeking medical assistance." The Hypoglycemia Self-Care Behavior Scale-developed and validated through structural equation modeling-demonstrates satisfactory model fit, convergent validity, and discriminant validity. Internal consistency was within the range of .73-.94, indicating strong reliability. The Hypoglycemia Self-Care Behavior Scale not only functions as a tool for the rapid assessment of self-care behaviors during hypoglycemic events by clinical healthcare professionals but can also serve as reference for hypoglycemia-related health education.

Research on the relationship between stress, professional commitment, and resilience among nursing students is lacking. To examine the mediating effect of resilience on the relationship between stress and professional commitment among nursing students during their fundamental nursing practicum. A cross-sectional design was used. Nursing students who were aged 17 to 20years and had completed fundamental nursing practicum within 1week were recruited. The survey covered stress, resilience, and professional commitment. The mediation analysis was conducted using the PROCESS macro with a bootstrap approach. This study recruited 485 nursing students. Stress was significantly negatively correlated with resilience and professional commitment, whereas resilience was significantly positively correlated with professional commitment. Furthermore, resilience partially mediated the relationship between stress and professional commitment. Appropriate interventions should be implemented to help nursing students reduce stress and improve their resilience, which can thus enhance their professional commitment to the nursing profession.

IntroductionInsulin, the key hormone for glucose regulation, has garnered attention for its role as an immune modulator. Impaired insulin signaling in the central nervous system is linked to neuroinflammation and neurodegenerative diseases. Microglia, the resident macrophage-like immune cells in the brain, are key regulators of neuroinflammation. However, the mechanisms by which insulin influences microglial immune responses remain relatively unknown.MethodsThis study aimed to assess the effects of post-treatment with insulin [30 minutes after lipopolysaccharide (LPS) exposure] on LPS-induced inflammatory responses in BV2 microglial cells.ResultsPost-treatment with insulin potentiated LPS-induced production of nitric oxide and pro-inflammatory cytokines, such as TNF and IL-6, through activation of the Akt/NF-κB pathway. Insulin also enhanced the ability of BV2 cells to phagocytose bacteria particles and β-amyloid fibrils. Conversely, insulin inhibited activation of NADPH oxidase and reduced intracellular levels of reactive oxygen species in LPS-treated BV2 cells.ConclusionInsulin enhances microglial immune competence when challenged by endotoxins but mitigates oxidative stress in these cells.

ObjectiveThis study compared the differences in the rates of maltreatment and homicide deaths between children and young adults with and without a life-limiting condition (LLC) and determined whether this affects the likelihood of receiving specialised palliative care (SPC) services before death.DesignA nationwide retrospective observational study.SettingTaiwan.PatientsChildren and young adults aged 0–25 years with LLCs and maltreatment were identified within the Health and Welfare Data Science Centre by International Classification of Diseases codes. Deaths were included within the Multiple Causes of Death Data if they occurred between 2016 and 2017.Main outcome measuresRates of maltreatment, homicide deaths and SPC referrals.ResultsChildren and young adults with underlying LLCs experienced a similar rate of maltreatment (2.2 per 10 000 vs 3.1 per 10 000) and had a 68% decrease in the odds of homicide death (19.7% vs 80.3%, OR, 0.32; 95% CI 0.18 to 0.56) than those without such conditions. Among those with LLCs who experienced maltreatment, 14.3% (2 out of 14) had received SPC at least 3 days before death. There was no significant difference in SPC referrals between those who experienced maltreatment and those who did not.ConclusionsThe likelihood of being referred to SPC was low with no significant statistical differences observed between children and young adults with maltreatment and without. These findings suggest a need for integrating SPC and child protection services to ensure human rights are upheld.