Lipid consumption in coral larvae differs among sites: a consideration of environmental history in a global ocean change scenario

PubMed Central

Chen, Chii-Shiarng; Fan, Tung-Yung; Li, Hsing-Hui

2017-01-01

The success of early life-history stages is an environmentally sensitive bottleneck for many marine invertebrates. Responses of larvae to environmental stress may vary due to differences in maternal investment of energy stores and acclimatization/adaptation of a population to local environmental conditions. In this study, we compared two populations from sites with different environmental regimes (Moorea and Taiwan). We assessed the responses of Pocillopora damicornis larvae to two future co-occurring environmental stressors: elevated temperature and ocean acidification. Larvae from Taiwan were more sensitive to temperature, producing fewer energy-storage lipids under high temperature. In general, planulae in Moorea and Taiwan responded similarly to pCO2. Additionally, corals in the study sites with different environments produced larvae with different initial traits, which may have shaped the different physiological responses observed. Notably, under ambient conditions, planulae in Taiwan increased their stores of wax ester and triacylglycerol in general over the first 24 h of their dispersal, whereas planulae from Moorea consumed energy-storage lipids in all cases. Comparisons of physiological responses of P. damicornis larvae to conditions of ocean acidification and warming between sites across the species' biogeographic range illuminates the variety of physiological responses maintained within P. damicornis, which may enhance the overall persistence of this species in the light of global climate change. PMID:28446693

Genetic diversity and stock identification of small abalone (Haliotis diversicolor) in Taiwan and Japan

PubMed Central

Hsu, Te-Hua; Gwo, Jin-Chywan

2017-01-01

Small abalone (Haliotis diversicolor) is a commercially valuable species for both fisheries and aquaculture. The production of annual farmed small abalone in Taiwan, once the highest in the world, has dramatically decreased in the past 15 years, and currently, the industry is close to collapse. Understanding the genetic diversity of small abalone and developing stock identification methods will be useful for genetic breeding, restoring collapsed stocks, managing stocks, and preventing illegal trade. We investigated 307 cultured and wild individuals from Taiwan, Japan, and Bali Island (Indonesia) by using the mitochondrial cytochrome c oxidase subunit I (COI) gene. Network analysis of mtDNA COI gene sequences revealed that the individuals collected from Taiwan, Japan, and Indonesia could be identified, and showed significant genetic divergence. In addition, the Indonesian population (Haliotis diversicolor squamata) was significantly different from the other populations and might need to be considered a separate species. We discovered a single nucleotide polymorphism marker in the mtDNA COI gene that can be used to distinguish the Taiwan population from the Japan population. We also developed a polymerase chain reaction-restriction fragment length polymorphism method for rapid detection. Furthermore, we could identify the cultured stocks, wild population, and hybrid stocks by using 6 microsatellites and amplified fragment length polymorphism. This study contributes useful tools for stock identification and the production of high-disease resistant small abalone strains (Japan × Taiwan or Taiwan × Japan). Efforts should be made to avoid unintentional random genetic mixing of the Taiwan population with the Japan population and subsequent breakdown of population differentiation, which impair local adaptation of the Taiwan wild population. Molecular markers revealed a split between the Taiwan and Japan populations, and the existence of a possible barrier to the free dispersal of small abalone is discussed. PMID:28662122

Genetic diversity and stock identification of small abalone (Haliotis diversicolor) in Taiwan and Japan.

PubMed

Hsu, Te-Hua; Gwo, Jin-Chywan

2017-01-01

Small abalone (Haliotis diversicolor) is a commercially valuable species for both fisheries and aquaculture. The production of annual farmed small abalone in Taiwan, once the highest in the world, has dramatically decreased in the past 15 years, and currently, the industry is close to collapse. Understanding the genetic diversity of small abalone and developing stock identification methods will be useful for genetic breeding, restoring collapsed stocks, managing stocks, and preventing illegal trade. We investigated 307 cultured and wild individuals from Taiwan, Japan, and Bali Island (Indonesia) by using the mitochondrial cytochrome c oxidase subunit I (COI) gene. Network analysis of mtDNA COI gene sequences revealed that the individuals collected from Taiwan, Japan, and Indonesia could be identified, and showed significant genetic divergence. In addition, the Indonesian population (Haliotis diversicolor squamata) was significantly different from the other populations and might need to be considered a separate species. We discovered a single nucleotide polymorphism marker in the mtDNA COI gene that can be used to distinguish the Taiwan population from the Japan population. We also developed a polymerase chain reaction-restriction fragment length polymorphism method for rapid detection. Furthermore, we could identify the cultured stocks, wild population, and hybrid stocks by using 6 microsatellites and amplified fragment length polymorphism. This study contributes useful tools for stock identification and the production of high-disease resistant small abalone strains (Japan × Taiwan or Taiwan × Japan). Efforts should be made to avoid unintentional random genetic mixing of the Taiwan population with the Japan population and subsequent breakdown of population differentiation, which impair local adaptation of the Taiwan wild population. Molecular markers revealed a split between the Taiwan and Japan populations, and the existence of a possible barrier to the free dispersal of small abalone is discussed.

The Study of Geographic Differences in the Prevalence of Disability among Taiwanese Population

ERIC Educational Resources Information Center

Lin, Jin-Ding; Li, Chien-De; Lin, Lan-Ping; Hsu, Shang-Wei

2012-01-01

The present study analyzes data of the governmental reported general population and population of persons with disabilities from 2002 to 2009, to describe the disability prevalence and to test the overtime change with particular focused on the geographic differences in Taiwan. In average, the disability prevalence was 42.06% (range = 31.06%-80.04%…

Population Structure and Historical Demography of the Oriental River Prawn (Macrobrachium nipponense) in Taiwan

PubMed Central

Chu, Ta-Jen; Wang, Daryi; Lee, Ying-Chou; Tzeng, Tzong-Der

2015-01-01

The oriental river prawn (Macrobrachium nipponense) is a non-obligatory amphidromous prawn, and it has a wide distribution covering almost the entire Taiwan. Mitochondrial DNA fragment sequences of the cytochrome oxidase subunit I (COI) and 16S rRNA were combined and used to elucidate the population structure and historical demography of oriental river prawn in Taiwan. A total of 202 individuals from six reservoirs and three estuaries were separately collected. Nucleotide diversity (π) of all populations was 0.01217, with values ranging from 0.00188 (Shihmen Reservoir, SMR, northern Taiwan) to 0.01425 (Mingte Reservoir, MTR, west-central Taiwan). All 76 haplotypes were divided into 2 lineages: lineage A included individuals from all sampling areas except SMR, and lineage B included specimens from all sampling locations except Chengching Lake Reservoir (CLR) and Liyu Lake Reservoir (LLR). All F ST values among nine populations were significantly different except the one between Jhonggang River Estuary (JGE, west-central Taiwan) and Kaoping River Estuary (KPE, southern Taiwan). UPGMA tree of nine populations showed two main groups: the first group included the SMR and Tamsui River Estuary (TSE) (both located northern Taiwan), and the second one included the other seven populations (west-central, southern and eastern Taiwan). Demographic analyses implied a population expansion occurred during the recent history of the species. The dispersal route of this species might be from China to west-central and west-southern Taiwan, and then the part individuals belonging to lineage A and B dispersed southerly and northerly, respectively. And then part individuals in west-central Taiwan fell back to and stay at estuaries as the sea level rose about 18,000 years ago. PMID:26716687

Population Structure and Historical Demography of the Oriental River Prawn (Macrobrachium nipponense) in Taiwan.

PubMed

Chen, Po-Cheng; Shih, Chun-Han; Chu, Ta-Jen; Wang, Daryi; Lee, Ying-Chou; Tzeng, Tzong-Der

2015-01-01

The oriental river prawn (Macrobrachium nipponense) is a non-obligatory amphidromous prawn, and it has a wide distribution covering almost the entire Taiwan. Mitochondrial DNA fragment sequences of the cytochrome oxidase subunit I (COI) and 16S rRNA were combined and used to elucidate the population structure and historical demography of oriental river prawn in Taiwan. A total of 202 individuals from six reservoirs and three estuaries were separately collected. Nucleotide diversity (π) of all populations was 0.01217, with values ranging from 0.00188 (Shihmen Reservoir, SMR, northern Taiwan) to 0.01425 (Mingte Reservoir, MTR, west-central Taiwan). All 76 haplotypes were divided into 2 lineages: lineage A included individuals from all sampling areas except SMR, and lineage B included specimens from all sampling locations except Chengching Lake Reservoir (CLR) and Liyu Lake Reservoir (LLR). All FST values among nine populations were significantly different except the one between Jhonggang River Estuary (JGE, west-central Taiwan) and Kaoping River Estuary (KPE, southern Taiwan). UPGMA tree of nine populations showed two main groups: the first group included the SMR and Tamsui River Estuary (TSE) (both located northern Taiwan), and the second one included the other seven populations (west-central, southern and eastern Taiwan). Demographic analyses implied a population expansion occurred during the recent history of the species. The dispersal route of this species might be from China to west-central and west-southern Taiwan, and then the part individuals belonging to lineage A and B dispersed southerly and northerly, respectively. And then part individuals in west-central Taiwan fell back to and stay at estuaries as the sea level rose about 18,000 years ago.

Urinary arsenic profiles and the risks of cancer mortality: A population-based 20-year follow-up study in arseniasis-endemic areas in Taiwan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chung, Chi-Jung; Department of Medical Research, China Medical Hospital, Taichung, Taiwan; Huang, Ya-Li

2013-04-15

Few studies investigated the association between chronic arsenic exposure and the mortality of cancers by estimating individual urinary arsenic methylation profiles. Therefore, we compared with the general population in Taiwan to calculate the standardized mortality ratio (SMR) in arseniasis-endemic area of Taiwan from 1996 to 2010 and evaluated the dose-response relationships between environmental arsenic exposure indices or urinary arsenic profiles and the mortality of cause-specific cancer. A cohort of 1563 residents was conducted and collected their urine sample and information regarding arsenic exposure from a questionnaire. All-cause death was identified using the National Death Registry of Taiwan. Urinary arsenic profilesmore » were measured using high performance liquid chromatography–hydride generator–atomic absorption spectrometry. We used Cox proportional hazard models to evaluate the mortality risks. In results, 193 all-site cancer deaths, and 29, 71, 43 deaths respectively for liver, lung and bladder cancers were ascertained. The SMRs were significantly high in arseniasis-endemic areas for liver, lung, and bladder cancers. People with high urinary InAs% or low DMA% or low secondary methylation index (SMI) were the most likely to suffer bladder cancer after adjusting other risk factors. Even stopping exposure to arsenic from the artesian well water, the mortality rates of the residents were higher than general population. Finally, urinary InAs%, DMA% and SMI could be the potential biomarkers to predict the mortality risk of bladder cancer. -- Highlights: ► The SMRs were significantly high in arseniasis-endemic areas for liver, lung, and bladder cancers. ► People with high urinary InAs% were the most likely to suffer bladder cancer. ► People with low DMA% or low SMI were the most likely to suffer bladder cancer.« less

Acute myocardial infarction: a comparison of the risk between physicians and the general population.

PubMed

Chen, Yen-ting; Huang, Chien-Cheng; Weng, Shih-Feng; Hsu, Chien-Chin; Wang, Jhi-Joung; Lin, Hung-Jung; Su, Shih-Bin; Guo, How-Ran; Juan, Chi-Wen

2015-01-01

Physicians in Taiwan have a heavy workload and a stressful workplace, both of which may contribute to cardiovascular disease. However, the risk of acute myocardial infarction (AMI) in physicians is not clear. This population-based cohort study used Taiwan's National Health Insurance Research Database. We identified 28,062 physicians as the case group and randomly selected 84,186 nonmedical staff patients as the control group. We used a conditional logistic regression to compare the AMI risk between physicians and controls. Subgroup analyses of physician specialty, age, gender, comorbidities, area, and hospital level were also done. Physicians have a higher prevalence of HTN (23.59% versus 19.06%, P < 0.0001) and hyperlipidemia (21.36% versus 12.93%, P < 0.0001) but a lower risk of AMI than did the controls (adjusted odds ratio (AOR): 0.57; 95% confidence interval (CI): 0.46-0.72) after adjusting for DM, HTN, hyperlipidemia, and area. Between medical specialty, age, and area subgroups, differences in the risk for having an AMI were nonsignificant. Medical center physicians had a lower risk (AOR: 0.42; 95% CI: 0.20-0.85) than did local clinic physicians. Taiwan's physicians had higher prevalences of HTN and hyperlipidemia, but a lower risk of AMI than did the general population. Medical center physicians had a lower risk than did local clinic physicians. Physicians are not necessary healthier than the general public, but physicians, especially in medical centers, have a greater awareness of disease and greater access to medical care, which permits timely treatment and may prevent critical conditions such as AMI induced by delayed treatment.

Characterization of the genetic diversity and population structure for the yellow cattle in Taiwan based on microsatellite markers.

PubMed

Tu, Po-An; Lin, Der-Yuh; Li, Guang-Fu; Huang, Jan-Chi; Wang, De-Chi; Wang, Pei-Hwa

2014-01-01

In recent years, the population size of Taiwan yellow cattle has drastically declined, even become endangered. A preservation project, Taiwan Yellow Cattle Genetic Preservation Project (TYCGPP), was carried out at the Livestock Research Institute (LRI) Hengchun branch (1988-present). An analysis of intra- and inter- population variability was performed to be the first step to preserve this precious genetic resource. In this work, a total number of 140 individuals selected from the five Taiwan yellow cattle populations were analyzed using 12 microsatellite markers (loci). These markers determined the level of genetic variation within and among populations as well as the phylogenetic structure. The total number of alleles detected (122, 10.28 per locus) and the expected heterozygosity (0.712) indicated that these five populations had a high level of genetic variability. Bayesian cluster analysis showed that the most likely number of groups was 2 (K = 2). Genetic differentiation among clusters was moderate (F ST = 0.095). The result of AMOVA showed that yellow cattle in Taiwan had maintained a high level of within-population genetic differentiation (91%), the remainder being accounted for by differentiation among subpopulations (4%), and by differentiation among regions (5%). The results of STRUCTURE and principal component analysis (PCA) revealed two divergent clusters. The individual unrooted phylogenetic tree showed that some Kinmen yellow cattle in the Hengchun facility (KMHC individuals) were overlapped with Taiwan yellow cattle (TW) and Taiwan yellow cattle Hengchun (HC) populations. Also, they were overlapped with Kinmen × Taiwan (KT) and Kinmen yellow cattle (KM) populations. It is possible that KMHC kept similar phenotypic characteristics and analogous genotypes between TW and KM. A significant inbreeding coefficient (F IS = 0.185; P < 0.01) was detected, suggesting a medium level of inbreeding for yellow cattle in Taiwan. The hypothesis that yellow cattle in Taiwan were derived from two different clusters was also supported by the phylogenetic tree constructed by the UPGMA, indicating that the yellow cattle in Taiwan and in Kinmen should be treated as two different management units. This result will be applied to maintain a good level of genetic variability and rusticity (stress-resistance) and to avoid further inbreeding for yellow cattle population in Taiwan.

Origins of Semisulcospira libertina (gastropoda: semisulcospiridae) in Taiwan.

PubMed

Chiu, Yuh-Wen; Bor, Hor; Kuo, Po-Hsun; Hsu, Kui-Ching; Tan, Mian-Shin; Wang, Wei-Kuang; Lin, Hung-Du

2017-07-01

The most accepted hypothesis has suggested that the fauna in Taiwan Island originated from South China, but some studies supported the Japan, Ryukyu Archipelago, and Taiwan Islands as a unique biogeographical district. This study examines whether the populations of freshwater snail Semisulcospira libertina in Taiwan are closer to those in Japan based on the mitochondrial cytochrome c oxidase subunit I (COI) gene sequences. Our study shows the populations in North Taiwan originated from Japan and the cyclic glacial caused the migrations among islands and continent repeatedly; the populations in South Taiwan might originate from South China or South Asia. Our results will not only affect the conclusions in phylogeography of freshwater species in Taiwan but also change the sampling plans in the future studies about evolutionary of freshwater species in East Asia.

Paternal genetic affinity between Western Austronesians and Daic populations.

PubMed

Li, Hui; Wen, Bo; Chen, Shu-Juo; Su, Bing; Pramoonjago, Patcharin; Liu, Yangfan; Pan, Shangling; Qin, Zhendong; Liu, Wenhong; Cheng, Xu; Yang, Ningning; Li, Xin; Tran, Dinhbinh; Lu, Daru; Hsu, Mu-Tsu; Deka, Ranjan; Marzuki, Sangkot; Tan, Chia-Chen; Jin, Li

2008-05-15

Austronesian is a linguistic family spread in most areas of the Southeast Asia, the Pacific Ocean, and the Indian Ocean. Based on their linguistic similarity, this linguistic family included Malayo-Polynesians and Taiwan aborigines. The linguistic similarity also led to the controversial hypothesis that Taiwan is the homeland of all the Malayo-Polynesians, a hypothesis that has been debated by ethnologists, linguists, archaeologists, and geneticists. It is well accepted that the Eastern Austronesians (Micronesians and Polynesians) derived from the Western Austronesians (Island Southeast Asians and Taiwanese), and that the Daic populations on the mainland are supposed to be the headstream of all the Austronesian populations. In this report, we studied 20 SNPs and 7 STRs in the non-recombining region of the 1,509 Y chromosomes from 30 China Daic populations, 23 Indonesian and Vietnam Malayo-Polynesian populations, and 11 Taiwan aboriginal populations. These three groups show many resemblances in paternal lineages. Admixture analyses demonstrated that the Daic populations are hardly influenced by Han Chinese genetically, and that they make up the largest proportion of Indonesians. Most of the population samples contain a high frequency of haplogroup O1a-M119, which is nearly absent in other ethnic families. The STR network of haplogroup O1a* illustrated that Indonesian lineages did not derive from Taiwan aborigines as linguistic studies suggest, but from Daic populations. We show that, in contrast to the Taiwan homeland hypothesis, the Island Southeast Asians do not have a Taiwan origin based on their paternal lineages. Furthermore, we show that both Taiwan aborigines and Indonesians likely derived from the Daic populations based on their paternal lineages. These two populations seem to have evolved independently of each other. Our results indicate that a super-phylum, which includes Taiwan aborigines, Daic, and Malayo-Polynesians, is genetically educible.

The linear relationship between the Vulnerable Elders Survey-13 score and mortality in an Asian population of community-dwelling older persons.

PubMed

Wang, Jye; Lin, Wender; Chang, Ling-Hui

2018-01-01

The Vulnerable Elders Survey-13 (VES-13) has been used as a screening tool to identify vulnerable community-dwelling older persons for more in-depth assessment and targeted interventions. Although many studies supported its use in different populations, few have addressed Asian populations. The optimal scaling system for the VES-13 in predicting health outcomes also has not been adequately tested. This study (1) assesses the applicability of the VES-13 to predict the mortality of community-dwelling older persons in Taiwan, (2) identifies the best scaling system for the VES-13 in predicting mortality using generalized additive models (GAMs), and (3) determines whether including covariates, such as socio-demographic factors and common geriatric syndromes, improves model fitting. This retrospective longitudinal cohort study analyzed the data of 2184 community-dwelling persons 65 years old or older from the 2003 wave of the national-wide Taiwan Longitudinal Study on Aging. Cox proportional hazards models and Generalized Additive Models (GAMs) were used. The VES-13 significantly predicted the mortality of Taiwan's community-dwelling elders. A one-point increase in the VES-13 score raised the risk of death by 26% (hazard ratio, 1.26; 95% confidence interval, 1.21-1.32). The hazard ratio of death increased linearly with each additional VES-13 score point, suggesting that using a continuous scale is appropriate. Inclusion of socio-demographic factors and geriatric syndromes improved the model-fitting. The VES-13 is appropriate for an Asian population. VES-13 scores linearly predict the mortality of this population. Adjusting the weighting of the physical activity items may improve the performance of the VES-13. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence of Depressive Disorder in Persons With Type 2 Diabetes: A National Population-Based Cohort Study 2000-2010.

PubMed

Tu, Hung-Pin; Hsieh, Hui-Min; Liu, Tai-Ling; Jiang, He-Jiun; Wang, Peng-Wei; Huang, Chun-Jen

Diabetes mellitus, a chronic and disabling disease, is epidemic worldwide. Depressive disorder affects the productivity of workers and leads to disability. This study investigated the prevalence of depressive disorder among persons with type 2 diabetes in Taiwan. We extracted service claims data for subjects who had at least 2 ambulatory care service claims or 1 inpatient service claim with a principal diagnosis of type 2 diabetes and at least 1 ambulatory or inpatient service claim with a principal diagnosis of depressive disorder from Taiwan's National Health Insurance Database. From 2000-2010, the prevalence of depressive disorder increased from 3.50-4.07% in people with type 2 diabetes, and from 1.05-2.27% in the general population. The higher prevalence of depressive disorder in persons with type 2 diabetes was associated with being female; residence in central, southern, and eastern Taiwan; residence in urban areas; the comorbidities of hemiplegia or paraplegia, cerebrovascular disease, and anxiety disorder; Charlson Comorbidity Index scores ≥1; diabetes duration >9 years; and the use of rapid-acting insulin injection therapy. The prevalence of depressive disorder is higher among persons with type 2 diabetes than the general population. Consequently, more public health attention should be devoted to the prevention and treatment of this debilitating disease in persons with type 2 diabetes, especially those with the earlier mentioned risk factors. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Acute Myocardial Infarction: A Comparison of the Risk between Physicians and the General Population

PubMed Central

Chen, Yen-ting; Huang, Chien-Cheng; Weng, Shih-Feng; Hsu, Chien-Chin; Wang, Jhi-Joung; Lin, Hung-Jung; Su, Shih-Bin; Guo, How-Ran; Juan, Chi-Wen

2015-01-01

Physicians in Taiwan have a heavy workload and a stressful workplace, both of which may contribute to cardiovascular disease. However, the risk of acute myocardial infarction (AMI) in physicians is not clear. This population-based cohort study used Taiwan's National Health Insurance Research Database. We identified 28,062 physicians as the case group and randomly selected 84,186 nonmedical staff patients as the control group. We used a conditional logistic regression to compare the AMI risk between physicians and controls. Subgroup analyses of physician specialty, age, gender, comorbidities, area, and hospital level were also done. Physicians have a higher prevalence of HTN (23.59% versus 19.06%, P < 0.0001) and hyperlipidemia (21.36% versus 12.93%, P < 0.0001) but a lower risk of AMI than did the controls (adjusted odds ratio (AOR): 0.57; 95% confidence interval (CI): 0.46–0.72) after adjusting for DM, HTN, hyperlipidemia, and area. Between medical specialty, age, and area subgroups, differences in the risk for having an AMI were nonsignificant. Medical center physicians had a lower risk (AOR: 0.42; 95% CI: 0.20–0.85) than did local clinic physicians. Taiwan's physicians had higher prevalences of HTN and hyperlipidemia, but a lower risk of AMI than did the general population. Medical center physicians had a lower risk than did local clinic physicians. Physicians are not necessary healthier than the general public, but physicians, especially in medical centers, have a greater awareness of disease and greater access to medical care, which permits timely treatment and may prevent critical conditions such as AMI induced by delayed treatment. PMID:25802869

Paternal genetic affinity between western Austronesians and Daic populations

PubMed Central

2008-01-01

Background Austronesian is a linguistic family spread in most areas of the Southeast Asia, the Pacific Ocean, and the Indian Ocean. Based on their linguistic similarity, this linguistic family included Malayo-Polynesians and Taiwan aborigines. The linguistic similarity also led to the controversial hypothesis that Taiwan is the homeland of all the Malayo-Polynesians, a hypothesis that has been debated by ethnologists, linguists, archaeologists, and geneticists. It is well accepted that the Eastern Austronesians (Micronesians and Polynesians) derived from the Western Austronesians (Island Southeast Asians and Taiwanese), and that the Daic populations on the mainland are supposed to be the headstream of all the Austronesian populations. Results In this report, we studied 20 SNPs and 7 STRs in the non-recombining region of the 1,509 Y chromosomes from 30 China Daic populations, 23 Indonesian and Vietnam Malayo-Polynesian populations, and 11 Taiwan aboriginal populations. These three groups show many resemblances in paternal lineages. Admixture analyses demonstrated that the Daic populations are hardly influenced by Han Chinese genetically, and that they make up the largest proportion of Indonesians. Most of the population samples contain a high frequency of haplogroup O1a-M119, which is nearly absent in other ethnic families. The STR network of haplogroup O1a* illustrated that Indonesian lineages did not derive from Taiwan aborigines as linguistic studies suggest, but from Daic populations. Conclusion We show that, in contrast to the Taiwan homeland hypothesis, the Island Southeast Asians do not have a Taiwan origin based on their paternal lineages. Furthermore, we show that both Taiwan aborigines and Indonesians likely derived from the Daic populations based on their paternal lineages. These two populations seem to have evolved independently of each other. Our results indicate that a super-phylum, which includes Taiwan aborigines, Daic, and Malayo-Polynesians, is genetically educible. PMID:18482451

Mitochondrial diversity and phylogeography of Acrossocheilus paradoxus (Teleostei: Cyprinidae).

PubMed

Ju, Yu-Min; Hsu, Kui-Ching; Yang, Jin-Quan; Wu, Jui-Hsien; Li, Shan; Wang, Wei-Kuang; Ding, Fang; Li, Jun; Lin, Hung-Du

2018-01-31

Mitochondrial DNA cytochrome b sequences (1141 bp) in 229 specimens of Acrossocheilus paradoxus from 26 populations were identified as four lineages. The pairwise genetic distances among these four lineages ranged from 1.57 to 2.37% (mean= 2.00%). Statistical dispersal-vicariance analysis suggests that the ancestral populations were distributed over mainland China and Northern and Western Taiwan. Approximate Bayesian computation approaches show that the three lineages in Taiwan originated from the lineage in mainland China through three colonization routes during two glaciations. The results indicated that during the glaciation and inter-glacial periods, the Taiwan Strait was exposed and sank, which contributed to the dispersion and differentiation of populations. Furthermore, the populations of A. paradoxus colonized Taiwan through a land bridge to the north of the Formosa Bank, and the Miaoli Plateau in Taiwan was an important barrier that limited gene exchange between populations on both the sides.

Introgression between cultivars and wild populations of Momordica charantia L. (Cucurbitaceae) in Taiwan.

PubMed

Liao, Pei-Chun; Tsai, Chi-Chu; Chou, Chang-Hung; Chiang, Yu-Chung

2012-01-01

The landrace strains of Momordica charantia are widely cultivated vegetables throughout the tropics and subtropics, but not in Taiwan, a continental island in Southeast Asia, until a few hundred years ago. In contrast, the related wild populations with smaller fruit sizes are native to Taiwan. Because of the introduction of cultivars for agricultural purposes, these two accessions currently exhibit a sympatric or parapatric distribution in Taiwan. In this study, the cultivars and wild samples from Taiwan, India, and Korea were collected for testing of their hybridization and evolutionary patterns. The cpDNA marker showed a clear distinction between accessions of cultivars and wild populations of Taiwan and a long divergence time. In contrast, an analysis of eight selectively neutral nuclear microsatellite loci did not reveal a difference between the genetic structures of these two accessions. A relatively short divergence time and frequent but asymmetric gene flows were estimated based on the isolation-with-migration model. Historical and current introgression from cultivars to wild populations of Taiwan was also inferred using MIGRATE-n and BayesAss analyses. Our results showed that these two accessions shared abundant common ancestral polymorphisms, and the timing of the divergence and colonization of the Taiwanese wild populations is consistent with the geohistory of the Taiwan Strait land bridge of the Last Glacial Maximum (LGM). Long-term and recurrent introgression between accessions indicated the asymmetric capacity to receive foreign genes from other accessions. The modern introduction of cultivars of M. charantia during the colonization of Taiwan by the Han Chinese ethnic group enhanced the rate of gene replacement in the native populations and resulted in the loss of native genes.

Introgression Between Cultivars and Wild Populations of Momordica charantia L. (Cucurbitaceae) in Taiwan

PubMed Central

Liao, Pei-Chun; Tsai, Chi-Chu; Chou, Chang-Hung; Chiang, Yu-Chung

2012-01-01

The landrace strains of Momordica charantia are widely cultivated vegetables throughout the tropics and subtropics, but not in Taiwan, a continental island in Southeast Asia, until a few hundred years ago. In contrast, the related wild populations with smaller fruit sizes are native to Taiwan. Because of the introduction of cultivars for agricultural purposes, these two accessions currently exhibit a sympatric or parapatric distribution in Taiwan. In this study, the cultivars and wild samples from Taiwan, India, and Korea were collected for testing of their hybridization and evolutionary patterns. The cpDNA marker showed a clear distinction between accessions of cultivars and wild populations of Taiwan and a long divergence time. In contrast, an analysis of eight selectively neutral nuclear microsatellite loci did not reveal a difference between the genetic structures of these two accessions. A relatively short divergence time and frequent but asymmetric gene flows were estimated based on the isolation-with-migration model. Historical and current introgression from cultivars to wild populations of Taiwan was also inferred using MIGRATE-n and BayesAss analyses. Our results showed that these two accessions shared abundant common ancestral polymorphisms, and the timing of the divergence and colonization of the Taiwanese wild populations is consistent with the geohistory of the Taiwan Strait land bridge of the Last Glacial Maximum (LGM). Long-term and recurrent introgression between accessions indicated the asymmetric capacity to receive foreign genes from other accessions. The modern introduction of cultivars of M. charantia during the colonization of Taiwan by the Han Chinese ethnic group enhanced the rate of gene replacement in the native populations and resulted in the loss of native genes. PMID:22754378

Plasticity and diversity of the phenology of dioecious Ficus species in Taiwan

NASA Astrophysics Data System (ADS)

Bain, Anthony; Chou, Lien-Siang; Tzeng, Hsy-Yu; Ho, Yi-Chiao; Chiang, Yun-Peng; Chen, Wen-Hsuan; Chio, Yu-Ting; Li, Guan-Yi; Yang, Hui-Wen; Kjellberg, Finn; Hossaert-McKey, Martine

2014-05-01

While Ficus present a series of traits often associated with dioecy, the prevalence of dioecy in Ficus is atypical. In Asian floras, dioecious Ficus species generally outnumber monoecious ones. Further this is also true in relatively northerly locations for Ficus such as the island of Taiwan. Ficus are pollinated by species-specific wasps that use fig flowers as breeding sites. In dioecious fig species, pollinators develop only in the inflorescences of male fig trees. In this study, we investigated the reproductive phenology of four dioecious Ficus species with distinct ecologies in several locations in northern and southern Taiwan. The two first species (Ficus erecta and Ficus septica) were investigated in four locations. Reproductive phenology was quite different among sites, even within a single species. For example, F. erecta presented well-defined crops at the population level in its usual high-elevation habitat but continuous fig production at low elevations, especially in South Taiwan. The two other fig species (Ficus pedunculosa var. mearnsii and Ficus tinctoria subsp. swinhoei), are shrubs growing together along seashores in exposed locations on coral reef remnants. These two species presented quite different traits allowing the survival of pollinating wasp populations. Ficus pedunculosa var. mearnsii produced figs continuously so that fresh receptive figs were always available for the pollinating wasps while F. tinctoria subsp. swinhoei extended the period of receptivity of its figs, so that receptive figs that had been waiting for pollinating wasps were almost always available. In summary, dioecious figs in Taiwan showed remarkable variation in their phenology, within species among locations or among species within location. Nevertheless, despite this variation, the phenology of the trees always allowed survival of pollinating wasp populations. Dioecious figs seem to have adopted a differentiated set of strategies which result in high resilience of pollinator populations. This resilience could help explain the atypical prevalence of dioecy in Ficus.

Physics teaching in the medical schools of Taiwan.

PubMed

Hsu, Jiann-wien; Hsu, Roy

2012-02-01

We describe and analyze the statistics of general physics and laboratory courses in the medical schools of Taiwan. We explore the development of the general physics curriculum for medical students of Taiwan. Also, an approach to designing a general physics course in combination with its application to medical sciences is proposed. We hope this preliminary study can provide a useful reference for physics colleagues in the medical schools of Taiwan to revolutionize the dynamics of teaching physics to the medical students of Taiwan. Copyright © 2011. Published by Elsevier B.V.

Risk of cancer in patients with genital warts: A nationwide, population-based cohort study in Taiwan

PubMed Central

Cho, Ching-Yi; Lo, Yu-Cheng; Hung, Miao-Chiu; Lai, Chou-Cheng; Chen, Chun-Jen

2017-01-01

Background Condyloma acuminata currently affects around 1% of sexually active adults, and its incidence is increasing. The coexistence of genital warts (GW) and certain cancers and an association between human papillomavirus (HPV) and various malignancies have been reported. Therefore, we conducted this large national study to analyze the risk of malignancies among men and women with GW in Taiwan. Methods and findings Between January 2000 and December 2013, approximately 3 million patients were reported to the National Health Insurance Research Database of Taiwan. Of these patients, 21,763 were diagnosed with GW. In the same time period, a total of 213,541 cancer cases were reported to the registry, of which 1002 were recorded among patients with GW. The age-specific incidence rates of GW and standardized incidence ratios (SIRs) of malignancies compared to the general population were calculated. Women acquired GW earlier than men, with a mean age at diagnosis of 32.63±12.78 years. The highest incidence rate for both genders peaked at 20–29 years. Of the 1002 patients with GW and malignancies, the SIR was 1.95 (95%CI 1.83–2.07). The most markedly increased risk was found for HPV-related cancers, with a SIR of 9.74 (95%CI 3.70–15.77). Significantly elevated risks were also noted for smoking-related cancers, anogenital cancers, cervix in situ, colon, rectum, lung, kidney, and prostate cancers. Most cancers developed within 10 years after the diagnosis of GW. Conclusions Patients with GW have an increased risk of HPV-related cancers, especially anogenital malignancies in Taiwan. The elevated risk of other cancers highlights differences in exposure and risk factors among patients with GW compared to the general population. Cancer screening and HPV vaccination programs should be emphasized for at-risk patients. PMID:28806741

Age, gender, and socioeconomic gradients in metabolic syndrome: biomarker evidence from a large sample in Taiwan, 2005-2013.

PubMed

Wu, Hania F; Tam, Tony; Jin, Lei; Lao, Xiang Q; Chung, Roger Yat-Nork; Su, Xue F; Zee, Benny

2017-05-01

To examine the age and gender heterogeneities in the association between socioeconomic status (SES) and the risk of metabolic syndrome (MetS) with biomarker data from Taiwan. Subjects included 102,201 men and 112,015 women aged 25 and above, from the 2005-2013 MJ Health Survey in Taiwan. SES was measured by education and family income. MetS was defined by the Adult Treatment Panel III criteria for Asian population. Logistic regression analyses were performed by age and gender groups. (1) Higher education level was associated with significantly lower risk of MetS. (2) Higher income was associated with lower MetS risk among women aged under 65, but no association among men of all ages. (3) SES gradients were generally much stronger among women than among men of the same age group. (4) SES gradients reduced over the life course with the exception that income gradient remains flat among men of all ages. Among Chinese in Taiwan, the gender and age heterogeneities in the SES gradients in MetS are similar to those reported for Western societies. This cross-cultural convergence is broadly consistent with the general hypothesis that social conditions are fundamental causes of diseases and health disparities. Copyright © 2017 Elsevier Inc. All rights reserved.

Longitudinal analysis of inpatient care utilization among people with intellectual disabilities: 1999-2002.

PubMed

Loh, C-H; Lin, J-D; Choi, I-C; Yen, C-F; Hsu, S-W; Wu, J-L; Tang, C C

2007-02-01

There has been no longitudinal study in Taiwan to identify the nature and the scale of medical care utilization of people with intellectual disabilities (IDs) up to the present. The aim of this study is to describe inpatient utilization among people under ID care in institutions in order to identify the pattern of medical care needs and the factors affecting utilization in Taiwan. The subject cohort was 168 individuals with ID who were cared for by a large public disability institution from 1999 to 2002 in Taipei, Taiwan. On the examination of the inpatient care that these persons underwent, it was found that these individuals had a heightened need (inpatient rate: 10.1-14.9%) for inpatient care compared with the general population with disabilities (9.37%) in Taiwan. The main reasons for hospitalization were pneumonia, gastrointestinal disorders, cellulites, orthopaedic problems, epilepsy and bronchitis. Using the full model of Generalized Estimating Equations for inpatient care utilization, the factors including low income family, living in an institution, being a subject with cerebral palsy and being a high outpatient user all influenced the use of inpatient care. This study highlights that health authorities need to promote health planning more in order to ensure an excellent quality of health monitoring and health promotion among people with ID cared for by institutions.

Childlessness patterns in Taiwan.

PubMed

Poston Dl

1988-06-01

Taiwan is a newly developed and industrialized area, and along with Korea, Brazil, Argentina, and a few other countries, belongs in a special class of recently industrialized areas. Taiwan has been undergoing large-scale modernization since the 1950s when the Nationalist government 1st began to implement land reform programs and today is 1 of the showcase of newly developed areas of the world. Demographic transition theory shows that fertility is negatively associated with modernization. During the past 3 decades, fertility in Taiwan has followed this pattern in a dramatic manner. Studies of childlessness conducted in Western countries have shown also that as the modernizing influences continue, fertility declines, and childlessness increases as it becomes more and more voluntary. Subregions with the highest levels of modernization and the lowest fertility rates should therefore be characterized by the highest levels of childlessness, particularly among younger women, and vice versa. Given the levels of socioeconomic and demographic development in Taiwan and its subregions circa 1980, as well as its variability among the hsiens and major cities, the author would expect to find higher levels of childlessness in the more developed localities, and lower levels in the less developed subregions. This hypothesis is tested with data from the 1980 Census of Population and Housing: General Report, Taiwan--Fukien Area (Republic of China, 1982) and the 1980 Taiwan--Fukien Demographic Fact Book (Republic of China, 1980).

Frailty and Its Contributory Factors in Older Adults: A Comparison of Two Asian Regions (Hong Kong and Taiwan).

PubMed

Yu, Ruby; Wu, Wan-Chi; Leung, Jason; Hu, Susan C; Woo, Jean

2017-09-21

This study aimed to compare the prevalence of frailty across three Chinese populations: Hong Kong, Taiwan-urban and Taiwan-rural. Contributing factors to disparities in frailty were also examined. Data were derived from the Osteoporotic Fractures in Men (MrOs) and Women (MsOs) (Hong Kong) Study ( n = 4000) and the Taiwan Longitudinal Study on Aging ( n = 2392). Frailty was defined as an index calculated from 30 multiple deficits. The ratio of the frailty index to life expectancy at birth (FI/LE) was used as an indicator of compression of morbidity. Frailty was more prevalent in Taiwan-urban (33.1%) and Taiwan-rural (38.1%) compared to Hong Kong (16.6%, p < 0.05) and was higher in women (22.6-49.7%) than in men (10.5-27.5%, p < 0.05). The ratios of FI/LE were higher in Taiwan-urban and Taiwan-rural (both 0.27) compared to Hong Kong (0.20, p < 0.05). Multivariate analyses revealed that older age, being a woman and low levels of physical activity were common risk factors for frailty across the three populations. Alcohol use was inversely associated with frailty in both Hong Kong and Taiwan-urban populations, but not in Taiwan-rural. Living alone was associated with frailty in Hong Kong men, but not in Hong Kong women or Taiwanese people. For all study populations, older age and being a woman constituted the highest attributable factor. This comparison provides useful data to inform government policies.

Frailty and Its Contributory Factors in Older Adults: A Comparison of Two Asian Regions (Hong Kong and Taiwan)

PubMed Central

Yu, Ruby; Wu, Wan-Chi; Leung, Jason

2017-01-01

This study aimed to compare the prevalence of frailty across three Chinese populations: Hong Kong, Taiwan-urban and Taiwan-rural. Contributing factors to disparities in frailty were also examined. Data were derived from the Osteoporotic Fractures in Men (MrOs) and Women (MsOs) (Hong Kong) Study (n = 4000) and the Taiwan Longitudinal Study on Aging (n = 2392). Frailty was defined as an index calculated from 30 multiple deficits. The ratio of the frailty index to life expectancy at birth (FI/LE) was used as an indicator of compression of morbidity. Frailty was more prevalent in Taiwan-urban (33.1%) and Taiwan-rural (38.1%) compared to Hong Kong (16.6%, p < 0.05) and was higher in women (22.6–49.7%) than in men (10.5–27.5%, p < 0.05). The ratios of FI/LE were higher in Taiwan-urban and Taiwan-rural (both 0.27) compared to Hong Kong (0.20, p < 0.05). Multivariate analyses revealed that older age, being a woman and low levels of physical activity were common risk factors for frailty across the three populations. Alcohol use was inversely associated with frailty in both Hong Kong and Taiwan-urban populations, but not in Taiwan-rural. Living alone was associated with frailty in Hong Kong men, but not in Hong Kong women or Taiwanese people. For all study populations, older age and being a woman constituted the highest attributable factor. This comparison provides useful data to inform government policies. PMID:28934150

Clinical characteristics of acute hepatitis A outbreak in Taiwan, 2015-2016: observations from a tertiary medical center.

PubMed

Chen, Nan-Yu; Liu, Zhuo-Hao; Shie, Shian-Sen; Chen, Tsung-Hsing; Wu, Ting-Shu

2017-06-20

Acute hepatitis A is a fecal-oral transmitted disease related to inadequate sanitary conditions. In addition to its traditional classification, several outbreaks in the men who have sex with men (MSM) population have resulted in acute hepatitis A being recognized as a sexually transmitted disease. However, few studies have clarified the clinical manifestations in these outbreaks involving the MSM population. Beginning in June 2015, there was an outbreak of acute hepatitis A involving the MSM population in Northern Taiwan. We conducted a 15-year retrospective study by recruiting 207 patients with the diagnosis of acute hepatitis A that included the pre-outbreak (January 2001 to May 2015) and outbreak (June 2015 to August 2016) periods in a tertiary medical center in Northern Taiwan. Using risk factors, comorbidities, presenting symptoms, laboratory test results and imaging data, we aimed to evaluate the clinical significance of acute hepatitis A in the MSM population, where human immunodeficiency virus (HIV) coinfection is common. There was a higher prevalence of reported MSM (p < 0.001), HIV (p < 0.001) and recent syphilis (p < 0.05) coinfection with acute hepatitis A during the outbreak period. The outbreak population had more prominent systemic symptoms, was more icteric with a higher total bilirubin level (p < 0.05) and had a 7-times higher tendency (p < 0.05) to have a hepatitis A relapse. The clinical course of acute hepatitis A during an outbreak involving the MSM and HIV-positive population is more symptomatic and protracted than in the general population.

Seroprevalence and Associated Risk Factors of Toxocariasis among College Students in Taipei City, Taiwan

PubMed Central

FU, Chung-Jung; KAO, Cheng-Yan; LEE, Yueh-Lun; LIAO, Chien-Wei; CHEN, Po-Ching; CHUANG, Ting-Wu; WANG, Ying-Chin; CHOU, Chia-Mei; HUANG, Ying-Chie; NAITO, Toshio; FAN, Chia-Kwung

2015-01-01

Background: Infection by Toxocara spp. is known to be significantly associated with partial epilepsy. It has become popular for people to raise dogs/cats as pets and consume roasted meat/viscera, and the status of Toxocara spp. infection, epilepsy awareness, and associated risk factors among the general population are currently unknown in Taiwan. Methods: A seroepidemiological investigation among 203 college students (CSs), consisting of 110 males and 93 females with an average age of 21.5 ± 1.2 years, was conducted in 2009 in Taipei City. A Western blot analysis based on excretory-secretory antigens derived from Toxocara canis larvae (TcESs) was applied to determine the positivity of serum immunoglobulin G antibodies. A self-administered questionnaire was also given to obtain information about demographic characteristics, epilepsy awareness, and risk factors. A logistic regression model was applied for the statistical analysis using SPSS software. Results: The overall seropositive rate of Toxocara spp. infection was 8.4% (17/203). As to epilepsy awareness, a non-significantly higher seroprevalence was found in CSs who claimed to "know" about epilepsy compared to those who did not know (P > 0.05). Conclusions: It appears that appropriate educational programs are urgently needed to provide correct knowledge related to the prevention and control measures against Toxocara spp. infections to avoid potential threats by this parasite to the general population in Taiwan. PMID:26622304

Traces of archaic mitochondrial lineages persist in Austronesian-speaking Formosan populations.

PubMed

Trejaut, Jean A; Kivisild, Toomas; Loo, Jun Hun; Lee, Chien Liang; He, Chun Lin; Hsu, Chia Jung; Lee, Zheng Yan; Li, Zheng Yuan; Lin, Marie

2005-08-01

Genetic affinities between aboriginal Taiwanese and populations from Oceania and Southeast Asia have previously been explored through analyses of mitochondrial DNA (mtDNA), Y chromosomal DNA, and human leukocyte antigen loci. Recent genetic studies have supported the "slow boat" and "entangled bank" models according to which the Polynesian migration can be seen as an expansion from Melanesia without any major direct genetic thread leading back to its initiation from Taiwan. We assessed mtDNA variation in 640 individuals from nine tribes of the central mountain ranges and east coast regions of Taiwan. In contrast to the Han populations, the tribes showed a low frequency of haplogroups D4 and G, and an absence of haplogroups A, C, Z, M9, and M10. Also, more than 85% of the maternal lineages were nested within haplogroups B4, B5a, F1a, F3b, E, and M7. Although indicating a common origin of the populations of insular Southeast Asia and Oceania, most mtDNA lineages in Taiwanese aboriginal populations are grouped separately from those found in China and the Taiwan general (Han) population, suggesting a prevalence in the Taiwanese aboriginal gene pool of its initial late Pleistocene settlers. Interestingly, from complete mtDNA sequencing information, most B4a lineages were associated with three coding region substitutions, defining a new subclade, B4a1a, that endorses the origin of Polynesian migration from Taiwan. Coalescence times of B4a1a were 13.2 +/- 3.8 thousand years (or 9.3 +/- 2.5 thousand years in Papuans and Polynesians). Considering the lack of a common specific Y chromosomal element shared by the Taiwanese aboriginals and Polynesians, the mtDNA evidence provided here is also consistent with the suggestion that the proto-Oceanic societies would have been mainly matrilocal.

Prevalence of functional gastrointestinal disorders in Taiwan: questionnaire-based survey for adults based on the Rome III criteria.

PubMed

Chang, Fang-Yuan; Chen, Po-Hon; Wu, Tzee-Chung; Pan, Wen-Harn; Chang, Hsing-Yi; Wu, Shin-Jiuan; Yeh, Nai-Hua; Tang, Ren-Bin; Wu, Lite; James, Frank E

2012-01-01

Functional gastrointestinal disorders (FGID) are a group of disorders of the digestive system in which the chronic or recurrent symptoms cannot be explained by the presence of structural or tissue abnormality. This survey used a modified Rome III questionnaire on the health and nutrition status of a general population in Taiwan during 2005-2008. A total of 4,275 responders completed the questionnaire. The sample was evenly distributed for men (n=2,137) and women (n=2,138). The prevalence of FGID was 26.2%. Unspecified functional bowel disorder was the most prevalent (8.9%). The second was functional dyspepsia (5.3%), and the third were irritable bowel syndrome (4.4%) and functional constipation (4.4%). Women had a greater prevalence than males (33.2% compared to 22.4%, p<0.05) with regards to total FGID. Most categories of FGID were significantly prominent in women, except functional diarrhea. The FGID groups took fewer servings of vegetables and fruits than the non-FGID group each day (vegetables 2.51 vs 2.70, p<0.001; fruits 0.82 vs 0.91, p<0.001). Smoking, alcohol consumption, and betel nut chewing had no significant impaction on prevalence of FGID. The mean BSRS (brief-symptom rating scale) for screening depression and suicide ideation was higher in the FGID group (2.86 vs 1.63, p<0.001). In conclusion, FGID diagnosed with Rome III criteria are not uncommon in Taiwan's general population. Subjects who met the Rome III criteria for FGID in Taiwan were younger, had less vegetables and fruits intake, higher BSRS scores and were of greater female predominance.

Validity of EQ-5D in general population of Taiwan: results of the 2009 National Health Interview and Drug Abuse Survey of Taiwan.

PubMed

Yu, Sheng-Tsung; Chang, Hsing-Yi; Yao, Kai-Ping; Lin, Yu-Hsuan; Hurng, Baai-Shyun

2015-10-01

The aim of this study was to examine the validity of the EuroQOL five dimensions questionnaire (EQ-5D) using a nationally representative data from the National Health Interview Survey (NHIS) through comparison with short-form 36 (SF-36). Data for this study came from the 2009 NHIS in Taiwan. The study sample was the 4007 participants aged 20-64 years who completed the survey. We used SUDAAN 10.0 (SAS-Callable) to carry out weighed estimation and statistical inference. The EQ index was estimated using norm values from a Taiwanese study as well as from Japan and the United Kingdom (UK). The SF-36 score was standardized using American norm values. In terms of concurrent validity, the EQ-5D met the five hypotheses. The results did not fulfill hypothesis that women would have lower visual analogue scale (EQ-VAS) scores. In terms of discriminant validity, the EQ-5D fulfilled two hypotheses. Our results approached but did not fulfill hypothesis that there would be a weak association between the physical and psychological dimensions of the EQ-5D and the mental component summary score of the SF-36. Results were comparable regardless of whether the Japanese or UK norm value sets were used. We were able to fulfill many, not all of our validity hypotheses regardless of whether the established Japanese or UK norm value sets or the Taiwanese norm values were used. The EQ-5D is an effective and simple instrument for assessing health-related quality of life of general population in Taiwan.

The prevalence and bother of lower urinary tract symptoms in men and women aged 40 years or over in Taiwan.

PubMed

Liu, Shih-Ping; Chuang, Yao-Chi; Sumarsono, Budiwan; Chang, Hui-Chen

2018-04-11

The prevalence of lower urinary tract symptoms (LUTS) in men and women in the general population in Taiwan is unclear. Community-based data on the epidemiology and effects of LUTS would therefore help improve understanding of the condition in this country. This study was an internet-based, self-administered survey, conducted in randomly selected adults aged ≥40 years. Participants answered questions on International Continence Society (ICS) symptom definitions, the International Prostate Symptom Score (IPSS) and the overactive bladder (OAB) symptom score. The study population comprised 2068 adults (51.4% women) with a mean age of 55 years. Using criteria from the ICS, LUTS were present in 60% of men and 57% of women. The prevalence of LUTS increased with age in both men and women. The most bothersome symptoms were terminal dribble, incomplete emptying and nocturia in men, and nocturia, perceived frequency and urgency in women. In the overall population, according to IPSS, 30% had at least moderate symptoms. OAB prevalence was 16% in both men and women. The likelihood of consulting a healthcare professional about urinary symptoms was low and not significantly different between men and women with LUTS (17% and 14%, respectively). More than half of men and women aged ≥40 years in Taiwan are affected by LUTS, and these symptoms are often bothersome. However, few individuals with LUTS consult healthcare professionals about their symptoms. Improved diagnosis and treatment of LUTS in Taiwan are needed to reduce the deleterious effects of the condition. CLINICALTRIALS. NCT02618421. Copyright © 2018. Published by Elsevier B.V.

The impacts of the global financial crisis on hospitalizations due to depressive illnesses in Taiwan: A prospective nationwide population-based study.

PubMed

Bonnie Lee, Chiachi; Liao, Chen-Mao; Lin, Chih-Ming

2017-10-15

In the third quarter of 2008, a major financial crisis hit many developed countries. Taiwan suffered its own share: a rise in unemployment and a severe decline in gross domestic product. This study is to address the health consequences of this crisis on different socioeconomic populations in Taiwan. A sample of 6,225,766 men and 5,417,651 women, was obtained and their admissions data over 2007-2012 were retrieved. Stratified into three income levels, the sample was examined on the 147,921 episodes of hospitalization due to depressive illnesses (DIs) over that period by an interrupted time series analysis for monthly incidence rates of DI hospitalizations RESULTS: The adjusted incidence rates of hospitalization (AIRH) for DIs among the low income were 10 times that of the high income group. The AIRHs were generally higher in all of three female income groups than they were in the three male income groups. The low income men and women showed increases (of 18.0% and 14.2%, respectively) beginning in April 2008 that sustained for two years. The high income women exhibited a 5.0% monthly rise in the rate of DI hospitalizations. Our time series models can control some confounding factors, but the ecological fallacy remained. This study provides evidence that the economic recession resulted in increased rates of DI hospitalization in Taiwan, especially among the low income population. Women of higher incomes may have suffered a more enduring impact. Copyright © 2017 Elsevier B.V. All rights reserved.

Cancer Incidence in Physicians: A Taiwan National Population-based Cohort Study.

PubMed

Lee, Yu-Sung; Hsu, Chien-Chin; Weng, Shih-Feng; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

2015-11-01

Cancer has been the leading cause of death in Taiwan since 1982. Physicians have many health-related risk factors which may contribute to cancer, such as rotating night shift, radiation, poor lifestyle, and higher exposure risk to infection and potential carcinogenic drugs. However, the cancer risk in physicians is not clear. In Taiwan's National Health Insurance Research Database, we identified 14,889 physicians as the study cohort and randomly selected 29,778 nonmedical staff patients as the comparison cohort for this national population-based cohort study. Cox proportional-hazard regression was used to compare the cancer risk between physicians and comparisons. Physician subgroups were also analyzed. Physicians had a lower all-cancer risk than did the comparisons (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.76-0.97). In the sex-based analysis, male physicians had a lower all-cancer risk than did male comparisons (HR 0.82, 95% CI 0.73-0.94); and female physicians did not (HR 1.29, 95% CI 0.88-1.91). In the cancer-type analysis, male physicians had a higher risk of prostate cancer (HR 1.72, 95% CI 1.12-2.65) and female physicians had twice the risk of breast cancer (HR 2.00, 95% CI 1.11-3.62) than did comparisons. Cancer risk was not significantly associated with physician specialties. Physicians in Taiwan had a lower all-cancer risk but higher risks for prostate and breast cancer than did the general population. These new epidemiological findings require additional study to clarify possible mechanisms.

Primary Sjogren's syndrome and the risk of acute pancreatitis: a nationwide cohort study.

PubMed

Chang, Chi-Ching; Chang, Yu-Sheng; Wang, Shu-Hung; Lin, Shyr-Yi; Chen, Yi-Hsuan; Chen, Jin Hua

2017-08-11

Studies on the risk of acute pancreatitis in patients with primary Sjogren's syndrome (pSS) are limited. We evaluated the effects of pSS on the risk of acute pancreatitis in a nationwide, population-based cohort in Taiwan. Population-based retrospective cohort study. We studied the claims data of the >97% Taiwan population from 2002 to 2012. We identified 9468 patients with pSS by using the catastrophic illness registry of the National Health Insurance Database in Taiwan. We also selected 37 872 controls that were randomly frequency matched by age (in 5 year bands), sex and index year from the general population. We analysed the risk of acute pancreatitis by using Cox proportional hazards regression models including sex, age and comorbidities. From 23.74 million people in the cohort, 9468 patients with pSS (87% women, mean age=55.6 years) and 37 872 controls were followed-up for 4.64 and 4.74 years, respectively. A total of 44 cases of acute pancreatitis were identified in the pSS cohort versus 105 cases in the non-pSS cohort. Multivariate Cox regression analysis indicated that the incidence rate of acute pancreatitis was significantly higher in the pSS cohort than in the non-pSS cohort (adjusted HR (aHR) 1.48, 95% CI 1.03 to 2.12). Cyclophosphamide use increased the risk of acute pancreatitis (aHR 5.27, 95% CI 1.16 to 23.86). By contrast, hydroxychloroquine reduced the risk of acute pancreatitis (aHR 0.23, 95% CI 0.09 to 0.55). This nationwide, retrospective cohort study demonstrated that the risk of acute pancreatitis was significantly higher in patients with pSS than in the general population. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Exploring the motivations of Facebook use in Taiwan.

PubMed

Alhabash, Saleem; Park, Hyojung; Kononova, Anastasia; Chiang, Yi-hsuan; Wise, Kevin

2012-06-01

The current study explored the motivations of online social network use among a sample of the general population in Taiwan (N=4,346). It investigated how seven different motivations to use Facebook predicted the intensity of Facebook use and content-generation behaviors on Facebook. Results showed that the motivation to use Facebook for posting and viewing status updates was the strongest predictor of Facebook intensity, while the motivation to view and share photographs was the strongest predictor of content-generation behavior on the site. Results are discussed in terms of expanding motivations to use Facebook to the study of social networking sites and other new and social media.

Causes of death and expected years of life lost among treated opioid-dependent individuals in the United States and Taiwan

PubMed Central

Chang, Kun-Chia; Wang, Jung-Der; Saxon, Andrew; Matthews, Abigail G.; Woody, George; Hser, Yih-Ing

2017-01-01

Aims This study compared the cause-specific standardized mortality ratios (SMRs) and expected years of life lost (EYLL) among opioid-dependent individuals in the United States and Taiwan. Methods Survival data came from two cohorts followed until 2014: The U.S. data were based on a randomized trial of 1,267 opioid-dependent participants enrolled between 2006 and 2009; the Taiwan data were from a study of 983 individuals that began in 2006, when opioid agonist treatment (OAT) was implemented in Taiwan. SMRs were calculated for each national cohort and compared. Kaplan-Meier estimation was performed on the survival data, then lifespans were extrapolated to 70 years (840 months) to estimate life expectancy using a semi-parametric method. EYLLs for both cohorts were estimated by subtracting their life expectancies from the age- and gender-matched referents within the general population of their respective country. Results Compared with age- and gender- matched referents, the SMRs were 3.2 for the U.S. sample and 7.8 for the Taiwan sample; the EYLLs were 7.7 and 16.4 years, respectively. Half of decedents died of unnatural causes in both cohorts; overdose deaths predominated in the U.S. and suicide in Taiwan. Conclusions Our study identified differences by country in EYLL and causes of deaths. These findings suggest that intervention strategies to reduce mortality risk by overdose (particularly in the U.S.) and suicide (particularly in Taiwan) are urgently needed in these countries. PMID:28160734

Urinary tract infection in infants: a single-center clinical analysis in southern Taiwan.

PubMed

Wu, Jen-Hsi; Chiou, Yee-Hsuan; Chang, Jenn-Tzong; Wang, Hsiao-Ping; Chen, Ying-Yao; Hsieh, Kai-Sheng

2012-10-01

This study summarized the epidemiology, etiology, and susceptibility of pathogens to antibiotics, and specific characteristics in infants aged less than 4 months diagnosed with urinary tract infection in the past decade in Taiwan. The medical charts of patients aged less than 4 months admitted for urinary tract infection to Kaohsiung Veterans General Hospital between January 2001 and December 2009 were retrospectively reviewed. A total of 132 patients, with male predominance (68.9%), were enrolled. The top three pathogens were similar to those identified in previous studies in Taiwan. The most common pathogen, Escherichia coli (85.3%), was resistant to ampicillin (75.9%), followed by sulfamethoxazole/trimethoprim (31.7%), and cefazolin (28.5%). Dimercaptosuccinic acid (DMSA) renal scan revealed 34.5% positive findings, while the vesicoureteral reflux (VUR) rate was 37.8% by direct radionuclide voiding cystography and/or voiding cysto-urethrography. Positive DMSA findings significantly correlated with VUR (p<0.001) and higher C-reactive protein level (p<0.05). E coli was the most common pathogen in the present cohort, and the top three pathogens were similar to those found in general pediatric population in Taiwan. VUR was the most common genitourinary tract anomaly in this age group. Positive DMSA was well correlated with VUR and higher C-reactive protein level. Copyright © 2012. Published by Elsevier B.V.

The Administrative Population Report on Children with Developmental Delays in Taiwan, 2003 through 2007

ERIC Educational Resources Information Center

Lin, Jin-Ding; Yen, Chia-Feng; Wu, Jia-Ling; Kang, Shih-Wan

2009-01-01

This paper was a population study with developmental delays and it included an examination of the trends the overtime change trend and reported channels of this group of people in Taiwan. We analyzed data for the present study mainly from the Department of Statistics, Ministry of the Interiors, Taipei, Taiwan: "Number of early intervention…

Prevalence of Mycobacterium tuberculosis strain genotypes in Taiwan reveals a close link to ethnic and population migration.

PubMed

Dou, Horng-Yunn; Chen, Yih-Yuan; Kou, Shu-Chen; Su, Ih-Jen

2015-06-01

Taiwan is a relatively isolated island, serving as a mixing vessel for colonization by different waves of ethnic and migratory groups over the past 4 centuries. The potential transmission pattern of Mycobacterium tuberculosis in different ethnic and migratory populations remains to be elucidated. By using mycobacterial tandem repeat sequences as genetic markers, the prevalence of M. tuberculosis strains in Taiwan revealed a close link to the historical migration. Interestingly, the M. tuberculosis strain in the aborigines of Eastern and Central Taiwan had a dominance of the Haarlem (Dutch) strain while those in Southern Taiwan had a dominance of the East-African Indian (EAI) strain. The prevalence of different M. tuberculosis strains in specific ethnic populations suggests that M. tuberculosis transmission is limited and restricted to close contact. The prevalence of the Beijing modern strain in the young population causes a concern for M. tuberculosis control, because of high virulence and drug resistance. Furthermore, our data using molecular genotyping should provide valuable information on the historical study of the origin and migration of aborigines in Taiwan. Copyright © 2014. Published by Elsevier B.V.

Cancer incidence in a Nationwide HIV/AIDS patient cohort in Taiwan in 1998-2009.

PubMed

Chen, Marcelo; Jen, Ian; Chen, Yi-Hsien; Lin, Ming-Wei; Bhatia, Kishor; Sharp, Gerald B; Law, Matthew G; Arthur Chen, Yi-Ming

2014-04-01

The aims of this study were to investigate the cancer incidence and risk in HIV/AIDS patients relative to the general population in Taiwan. Using Taiwan's National Health Insurance Research Database, 15,269 HIV/AIDS patients were identified between 1998 and 2009. Gender-specific incidence densities (IDs) of both AIDS-defining cancers (ADC) and non-AIDS-defining cancers (NADC) after HIV infection were calculated. Age-, sex-, and period-adjusted standardized incidence rates (SIRs) were obtained using 1.8 million people from the general population as controls. A total of 1117 male and 165 female HIV/AIDS patients were diagnosed with cancer. Non-Hodgkin lymphoma (n = 196; ID = 328.79/100,000 person-years) and cervical cancer (n = 50; ID = 712.08/100,000 person-years) were the most common ADCs, whereas liver cancer (n = 125; ID = 184.52/100,000 person-years) and colon cancer (n = 11; ID = 156.66/100,000 person-years) were the most common NADCs in males and females, respectively. Period-adjusted gender-specific ADC and NADC rates decreased from more than 1500 cases/100,000 person-years to less than 500 cases/100,000 person-years (P < 0.001 for trend). SIRs of ADCs and NADCs also decreased. However, relative to the general population, increased SIRs were still seen for most cancers, many of which had an infectious etiology. The highest SIRs in ADCs and NADCs were seen in Kaposi sarcoma [SIR = 298.0, 95% confidence interval (CI): 258.16 to 343.85] and anal cancer (SIR = 19.10, 95% CI: 12.80 to 27.50). This study showed that although the cancer incidence rates have significantly decreased in the highly active antiretroviral therapy era, HIV/AIDS patients were still at increased risk of ADCs and most NADCs. Cancer screening, especially for infection-related NADCs, should therefore be promoted.

Prevalence of Self-Reported Work-Related Injuries and Their Association with Psychological Symptoms in General Working Population of Taiwan.

PubMed

Chung, Pei-Hua; Cheng, Yawen

2017-06-01

Objectives This study investigated the prevalence of self-reported work-related injuries across occupational groups and examined their association with the risk of psychological symptoms in general working population of Taiwan. Methods Data from a national survey conducted in 2013 of a representative sample of general working people of Taiwan was analyzed, consisting of 12,528 male and 8396 female workers aged 25~65 years. Information about work-related injuries including work-related disease occurred over the previous 12 months prior to the survey was obtained by a standardized questionnaire. The presence of psychological symptoms was assessed by the Brief Symptom Rating Scale (BSRS). Also obtained were participants' socio-demographic characteristics, working hours, job control, psychological job demands, physical job demands and job insecurity. Results Over a year, 14.91 % of male and 11.53 % of female working people had experienced work-related injuries. Workers with lower educational level, manual workers, the self-employed as well as employers of small enterprise were at higher risks for work-related injuries. Findings from multivariate logistic regression analyses with adjustment of gender, age, working hours and psychosocial work conditions showed that employees with experiences of work-related injuries over the past year were at a substantially higher risk for psychological symptoms (OR = 2.42) as compared to employees who had no experiences of work-related injuries. Conclusion A sizable proportion of workers are affected by work-related injuries and these workers are at higher risk for psychological symptoms. The psychosocial consequences of work-related injuries deserve further investigation and interventions.

Use of Facebook by Hospitals in Taiwan: A Nationwide Survey.

PubMed

Yang, Po-Chin; Lee, Wui-Chiang; Liu, Hao-Yen; Shih, Mei-Ju; Chen, Tzeng-Ji; Chou, Li-Fang; Hwang, Shinn-Jang

2018-06-06

Background : Social media advertising has become increasingly influential in recent years. Because Facebook has the most active users worldwide, many hospitals in Taiwan have created official Facebook fan pages. Our study was to present an overview of official Facebook fan pages of hospitals in Taiwan. Methods : All 417 hospitals were surveyed about their use of Facebook fan pages in December 2017. The last update time, posts in the past 30 days, number of “Likes”, and other features were analyzed and stratified according to the accreditation statuses of the hospitals. Results : In Taiwan, only 51.1% ( n = 213) of the hospitals had an official Facebook fan page. Among these hospitals, 71.8% ( n = 153) had updated their pages in the past 30 days, although 89.2% ( n = 190) provided online interactions. Academic medical centers tended to have more “Likes” than regional and local community hospitals (on average 5947.4, 2644.8, and 1548.0, respectively). Conclusions : In spite of the popularity of Facebook among the general population, most hospitals in Taiwan do not seem to make good use of this kind of social media. The reasons for the use and nonuse of Facebook on the part of both hospitals and patients deserve further investigation.

Causes of death and expected years of life lost among treated opioid-dependent individuals in the United States and Taiwan.

PubMed

Chang, Kun-Chia; Wang, Jung-Der; Saxon, Andrew; Matthews, Abigail G; Woody, George; Hser, Yih-Ing

2017-05-01

This study compared the cause-specific standardized mortality ratios (SMRs) and expected years of life lost (EYLL) among opioid-dependent individuals in the United States and Taiwan. Survival data came from two cohorts followed until 2014: The U.S. data were based on a randomized trial of 1267 opioid-dependent participants enrolled between 2006 and 2009; the Taiwan data were from a study of 983 individuals that began in 2006, when opioid agonist treatment (OAT) was implemented in Taiwan. SMRs were calculated for each national cohort and compared. Kaplan-Meier estimation was performed on the survival data, then lifespans were extrapolated to 70 years (840 months) to estimate life expectancy using a semi-parametric method. EYLLs for both cohorts were estimated by subtracting their life expectancies from the age- and gender-matched referents within the general population of their respective country. Compared with age- and gender-matched referents, the SMRs were 3.2 for the U.S. sample and 7.8 for the Taiwan sample; the EYLLs were 7.7 and 16.4 years, respectively. Half of decedents died of unnatural causes in both cohorts; overdose deaths predominated in the U.S. and suicide in Taiwan. Our study identified differences by country in EYLL and causes of deaths. These findings suggest that intervention strategies to reduce mortality risk by overdose (particularly in the U.S.) and suicide (particularly in Taiwan) are urgently needed in these countries. Copyright © 2016 Elsevier B.V. All rights reserved.

Dairy foods and health in Asians: Taiwanese considerations.

PubMed

Lee, Meei-Shyuan; Wahlqvist, Mark L; Peng, Cheau-Jane

2015-01-01

The health relevance of dairy products has mostly been judged by their abundant nutrients (protein, calcium and riboflavin) and recommendations for these derived in lactase-persistent Caucasian populations. Extrapolation to Asians who are generally lactase non-persisters may not be biologically, culturally or environmentally sound. A number of studies, especially among north-east Asians as in Taiwan, provide guidance for their optimal dairy intakes. In Taiwan, the NAHSIT (Nutrition and Health Surveys in Taiwan) linked to the National Health Insurance and Death Registry data bases provide most of the evidence. Cultural and socio-economic barriers create population resistance to increase dairy consumption beyond one serving per day as reflected in food balance sheet and repeat survey trend analyses. For the morbidity and mortality patterns principally seen in Asia, some, but not too much, dairy is to be preferred. This applies to all-cause and cardiovascular, especially stroke, mortality, to the risk of overfatness (by BMI and abdominal circumference) and diabetes and very likely to fracture and its sequelae. In Taiwan, there is no apparent association with total cancer mortality, but among Europeans, there may be protection. Historically, while fermented mammalian milks have been consumed in south Asia and various Asian subgroups and regions, most of the uptake of dairy in Asia after World War 2 has been from imported powdered milk or fresh liquid milk, encouraged further by the use of yogurts and popularization of milk teas and coffee. Asian dietary guidelines and clinical nutrition protocols need to encourage a modest, asymptomatic dairy intake.

Taiwan Regulation of Biobanks.

PubMed

Fan, Chien-Te; Hung, Tzu-Hsun; Yeh, Chan-Kun

2015-01-01

This paper introduces legal framework and governance structure in relation to the management and development of biobanks in Taiwan. At first, we briefly describe Taiwan's population, political system and health care system. Secondly, this research introduces biobanking framework of Taiwan including 25 biobanks established with the approval of the Ministry of Health and Welfare. In those biobanks, "Taiwan Biobank" is the first and the largest government-supported biobank which comprises population-based cohort study and disease- oriented study. Since the collection of information, data, and biological specimen of biobanks often involve highly sensitive personal information, in the legal framework of Taiwan, there is a specific regulation, "Human Biobank Management Act" (HBMA), which plays an important role in regulating biobanks in Taiwan. HBMA, the Personal Information Act and other regulations constitute a comprehensive legal and regulatory privacy framework of biobanks. Through the introduction and analysis of the current legal framework applicable to biobanks, we found that there are several challenges that need to be solved appropriately that involve duplicate review systems, the obstacles in the international collaboration, and data sharing between biobanks in Taiwan. © 2015 American Society of Law, Medicine & Ethics, Inc.

[The Use of Telemedicine Interventions to Improve Hypertension Management Among Racial Ethnic Minorities: A Systematic Review].

PubMed

Li, Wen-Wen; Lai, Wei-Shu

2016-08-01

Racial ethnic minorities are one of the fastest growing populations in Taiwan. In recent years, there has been an increase in literature addressing the efficacy of home blood-pressure (BP) management that uses telemedicine interventions in general healthcare and community settings. However, no study or systematic literature review has yet assessed the effectiveness of using telemedicine HTN interventions in Taiwan's indigenous, new-immigrant, and other minority populations. The purpose of the present paper is to review the current literature on the use of telemedicine interventions to assist HTN management among racial ethnic minorities. A comprehensive literature search was conducted for full-text articles that were published between January 2000 and December 2015 using the following databases: PubMed, WEB of Science, CINAHL (Cumulative Index to Nursing & Allied Health Literature), PsycINFO, Science Direct, ProQuest, Medline, Cochrane Library, National Dissertations and Theses, and airiti Library. The search used the following key search terms both alone and in combination: hypertension, blood pressure, management, telemedicine, telehealth, ehealth, and digital health. The studies were thoroughly assessed under the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A total of 6 articles met the criteria for using keywords related to racial ethnic minority populations and were used in the present review. Findings of this systematic review show that telemedicine interventions significantly improve HTN management. The intervention that combined home telemonitoring with culturally competent nurse counseling calls was identified as the best intervention for reducing BP. As the current literature on this topic is limited to African-Americans, more research is necessary to validate our findings. Future studies should target racial ethnic minorities in Taiwan in order to better understand how to provide culturally appropriate, telemedicine-based HTN management to Taiwan's minority populations. Further studies with a long-term follow-up plan, randomized controlled trials, and larger sample sizes are required to support these results.

Subtypes and case-fatality rates of stroke: a hospital-based stroke registry in Taiwan (SCAN-IV).

PubMed

Jeng, J S; Lee, T K; Chang, Y C; Huang, Z S; Ng, S K; Chen, R C; Yip, P K

1998-04-01

Stroke data bank can afford important information regarding risk factors, pathogenesis, prognosis, etc. By means of hospital-based stroke registry, we investigated the risk factors and case-fatality rates in different types of stroke and transient ischemic attack (TIA) patients at the National Taiwan University Hospital in 1995. After excluding ineligible patients, 995 patients aged 1-98 years (575 men and 420 women) were recruited. Men predominated in all age groups for stroke and TIA in general except for cerebral hemorrhage (CH) in patients aged < 35 years and subarachnoid hemorrhage (SAH) in patients aged > or = 45 years. Of these, 676 (67.9%), 41 (4.1%), 228 (22.9%) and 50 (5%) patients were classified in the categories of cerebral infarction (CI), TIA, CH and SAH, respectively. The CI/CH ratio was 2.96. Hypertension remained one of the most important risk factors for CI, CH and TIA patients. Severe extracranial carotid artery stenosis (> or = 50%) was found in 12% of the CI patients and 27% of the TIA patients, but not found in the CH and SAH patients. Of these patients, the 30-day case-fatality rate was 10.9%, highest in SAH (30%), followed by CH (24.1%) and CI (5.6%). There were 41 in-hospital stroke patients who had significantly higher case-fatality rates than the other stroke patients (P<0.001 for all stroke, CI and CH patients by chi2 test). As compared to the previous stroke registries in Taiwan, there is a secular trend of increasing CI/CH ratios. These findings in Taiwan were compared with those in other populations, including other Asian, Caucasian and black populations. The CI/CH ratios in Asian populations, including Chinese, Japanese and Korean, were much lower than those in Caucasian and black populations. Dietary, environmental and genetic factors probably play important roles in these differences.

Scrub typhus islands in the Taiwan area and the association between scrub typhus disease and forest land use and farmer population density: geographically weighted regression.

PubMed

Tsai, Pui-Jen; Yeh, Hsi-Chyi

2013-04-29

The Taiwan area comprises the main island of Taiwan and several small islands located off the coast of the Southern China. The eastern two-thirds of Taiwan are characterized by rugged mountains covered with tropical and subtropical vegetation. The western region of Taiwan is characterized by flat or gently rolling plains. Geographically, the Taiwan area is diverse in ecology and environment, although scrub typhus threatens local human populations. In this study, we investigate the effects of seasonal and meteorological factors on the incidence of scrub typhus infection among 10 local climate regions. The correlation between the spatial distribution of scrub typhus and cultivated forests in Taiwan, as well as the relationship between scrub typhus incidence and the population density of farm workers is examined. We applied Pearson's product moment correlation to calculate the correlation between the incidence of scrub typhus and meteorological factors among 10 local climate regions. We used the geographically weighted regression (GWR) method, a type of spatial regression that generates parameters disaggregated by the spatial units of analysis, to detail and map each regression point for the response variables of the standardized incidence ratio (SIR)-district scrub typhus. We also applied the GWR to examine the explanatory variables of types of forest-land use and farm worker density in Taiwan in 2005. In the Taiwan Area, scrub typhus endemic areas are located in the southeastern regions and mountainous townships of Taiwan, as well as the Pescadore, Kinmen, and Matou Islands. Among these islands and low-incidence areas in the central western and southwestern regions of Taiwan, we observed a significant correlation between scrub typhus incidence and surface temperature. No similar significant correlation was found in the endemic areas (e.g., the southeastern region and the mountainous area of Taiwan). Precipitation correlates positively with scrub typhus incidence in 3 local climate regions (i.e., Taiwan's central western and southwestern regions, and the Kinmen Islands). Relative humidity correlates positively with incidence in Southwestern Taiwan and the Kinmen Islands. The number of wet days correlates positively with incidence in Southwestern Taiwan. The duration of sunshine correlates positively with incidence in Central Western Taiwan, as well as the Kinmen and Matou Islands. In addition, the 10 local climatic regions can be classified into the following 3 groups, based on the warm-cold seasonal fluctuations in scrub typhus incidence: (a) Type 1, evident in 5 local climate regions (Taiwan's northern, northwestern, northeastern, and southeastern regions, as well as the mountainous area); (b) Type 2 (Taiwan's central western and southwestern regions, and the Pescadore Islands); and (c) Type 3 (the Kinmen and Matou Islands). In the GWR models, the response variable of the SIR-district scrub typhus has a statistically significantly positive association with 2 explanatory variables (farm worker population density and timber management). In addition, other explanatory variables (recreational forests, natural reserves, and "other purpose" areas) show positive or negative signs for parameter estimates in various locations in Taiwan. Negative signs of parameter estimates occurred only for the explanatory variables of national protectorates, plantations, and clear-cut areas. The results of this study show that scrub typhus in Taiwan can be classified into 3 types. Type 1 exhibits no climatic effect, whereas the incidence of Type 2 correlates positively with higher temperatures during the warm season, and the incidence of Type 3 correlates positively with higher surface temperatures and longer hours of sunshine. The results also show that in the mountainous township areas of Taiwan's central and southern regions, as well as in Southeastern Taiwan, higher SIR values for scrub typhus are associated with the following variables: farm worker population density, timber management, and area type (i.e., recreational forest, natural reserve, or other purpose).

DNA barcoding reveals that the common cupped oyster in Taiwan is the Portuguese oyster Crassostrea angulata (Ostreoida; Ostreidae), not C. gigas

NASA Astrophysics Data System (ADS)

Hsiao, Sheng-Tai; Chuang, Shin-Chang; Chen, Kao-Sung; Ho, Ping-Ho; Wu, Chi-Lun; Chen, Chaolun Allen

2016-09-01

The Pacific cupped oyster, Crassostrea gigas, is one of the major aquacultural shellfish species that has been introduced to Europe and America from its native source in the West Pacific. In Taiwan, the cultivated cupped oysters along the west coast have been identified as C. gigas for over centuries; however, several molecular phylogenetic studies have cast doubt upon the existence of this species in Taiwan and adjacent waters. Indeed, our analyses of mitochondrial cytochrome oxidase I (COI) sequences from 313 Crassostrea collected from 12 locations along Taiwanese and southern Chinese coastlines confirm that all samples were the Portuguese oyster, C. angulata, rather than C. gigas. Multiple lines of evidence, including haplotypic and nucleotide diversity of the COI gene, demographic history, and population genetics, suggest that Taiwanese C. angulata is unique, probably experienced a sudden population expansion after the Last Glacial Maxima around 20,000 years ago, and has a significantly limited genetic connectivity across the Taiwan Strait. Our study applies an extended sampling and DNA barcoding to confirm the absence of C. gigas in natural and cultivated populations in Taiwan and southern China, where we only found C. angulata. We highlight the importance of conserving the gene pool of the C. angulata population in Taiwan, particularly considering the current threats by large-scale environmental disturbances such as marine pollution, habitat destruction, and climate change.

DNA barcoding reveals that the common cupped oyster in Taiwan is the Portuguese oyster Crassostrea angulata (Ostreoida; Ostreidae), not C. gigas

PubMed Central

Hsiao, Sheng-Tai; Chuang, Shin-Chang; Chen, Kao-Sung; Ho, Ping-Ho; Wu, Chi-Lun; Chen, Chaolun Allen

2016-01-01

The Pacific cupped oyster, Crassostrea gigas, is one of the major aquacultural shellfish species that has been introduced to Europe and America from its native source in the West Pacific. In Taiwan, the cultivated cupped oysters along the west coast have been identified as C. gigas for over centuries; however, several molecular phylogenetic studies have cast doubt upon the existence of this species in Taiwan and adjacent waters. Indeed, our analyses of mitochondrial cytochrome oxidase I (COI) sequences from 313 Crassostrea collected from 12 locations along Taiwanese and southern Chinese coastlines confirm that all samples were the Portuguese oyster, C. angulata, rather than C. gigas. Multiple lines of evidence, including haplotypic and nucleotide diversity of the COI gene, demographic history, and population genetics, suggest that Taiwanese C. angulata is unique, probably experienced a sudden population expansion after the Last Glacial Maxima around 20,000 years ago, and has a significantly limited genetic connectivity across the Taiwan Strait. Our study applies an extended sampling and DNA barcoding to confirm the absence of C. gigas in natural and cultivated populations in Taiwan and southern China, where we only found C. angulata. We highlight the importance of conserving the gene pool of the C. angulata population in Taiwan, particularly considering the current threats by large-scale environmental disturbances such as marine pollution, habitat destruction, and climate change. PMID:27666088

DNA barcoding reveals that the common cupped oyster in Taiwan is the Portuguese oyster Crassostrea angulata (Ostreoida; Ostreidae), not C. gigas.

PubMed

Hsiao, Sheng-Tai; Chuang, Shin-Chang; Chen, Kao-Sung; Ho, Ping-Ho; Wu, Chi-Lun; Chen, Chaolun Allen

2016-09-26

The Pacific cupped oyster, Crassostrea gigas, is one of the major aquacultural shellfish species that has been introduced to Europe and America from its native source in the West Pacific. In Taiwan, the cultivated cupped oysters along the west coast have been identified as C. gigas for over centuries; however, several molecular phylogenetic studies have cast doubt upon the existence of this species in Taiwan and adjacent waters. Indeed, our analyses of mitochondrial cytochrome oxidase I (COI) sequences from 313 Crassostrea collected from 12 locations along Taiwanese and southern Chinese coastlines confirm that all samples were the Portuguese oyster, C. angulata, rather than C. gigas. Multiple lines of evidence, including haplotypic and nucleotide diversity of the COI gene, demographic history, and population genetics, suggest that Taiwanese C. angulata is unique, probably experienced a sudden population expansion after the Last Glacial Maxima around 20,000 years ago, and has a significantly limited genetic connectivity across the Taiwan Strait. Our study applies an extended sampling and DNA barcoding to confirm the absence of C. gigas in natural and cultivated populations in Taiwan and southern China, where we only found C. angulata. We highlight the importance of conserving the gene pool of the C. angulata population in Taiwan, particularly considering the current threats by large-scale environmental disturbances such as marine pollution, habitat destruction, and climate change.

'Hidden' suicides amongst deaths certified as undetermined intent, accident by pesticide poisoning and accident by suffocation in Taiwan.

PubMed

Chang, Shu-Sen; Sterne, Jonathan A C; Lu, Tsung-Hsueh; Gunnell, David

2010-02-01

To identify cause-of-death categories in which suicides might be misclassified in Taiwan. We plotted secular trends (1971-2007) in sex- and method-specific rates of deaths classified as suicide, undetermined intent and accident for the Taiwanese population aged 15+ and compared the sex, age and marital status profiles of deaths in these three categories by method of death. The demographic profiles of registered suicides generally resembled those for deaths of undetermined intent and accidents by pesticide poisoning/suffocation but differed from those for accidents from non-pesticide poisoning/drowning/falling/poisoning by non-domestic gas. For the period 1990-2007, suicide rates based on suicides alone (14.8 per 100,000) would increase by 23, 7 and 1%, respectively, when including deaths of undetermined intent, accidental pesticide poisonings and accidental suffocations. Suicide rates may be underestimated by more than 30% in Taiwan because some suicides are 'hidden' amongst deaths certified as due to other causes.

Stock or stroke? Stock market movement and stroke incidence in Taiwan.

PubMed

Chen, Chun-Chih; Chen, Chin-Shyan; Liu, Tsai-Ching; Lin, Ying-Tzu

2012-12-01

This paper investigates the impact of stock market movement on incidences of stroke utilizing population-based aggregate data in Taiwan. Using the daily data from the Taiwan Stock Exchange Capitalization Weighted Stock Index and from the National Health Insurance Research Database during 2001/1/1-2007/12/31, which consist of 2556 observations, we examine the effects of stock market on stroke incidence - the level effect and the daily change effects. In general, we find that both a low stock index level and a daily fall in the stock index are associated with greater incidences of stroke. We further partition the data on sex and age. The level effect is found to be significant for either gender, in the 45-64 and 65 ≥ age groups. In addition, two daily change effects are found to be significant for males and the elderly. Although stockholdings can increase wealth, they can also increase stroke incidence, thereby representing a cost to health. Copyright © 2012 Elsevier Ltd. All rights reserved.

Country Profiles, Taiwan.

ERIC Educational Resources Information Center

Keeny, S. M.; And Others

A profile of Taiwan is sketched in this paper. Emphasis is placed on the nature, scope, and accomplishments of population activities in the country. Topics and sub-topics include: location and description of the country; population (size, growth patterns, age structure, urban/rural distribution, ethnic and religious composition, migration,…

Effects of Global Budgeting on the Distribution of Dentists and Use of Dental Care in Taiwan

PubMed Central

Hsueh, Ya-Seng A; Lee, Shoou-Yih D; Huang, Yu-Tung A

2004-01-01

Objective To examine the effects of global budgeting on the distribution of dentists and the use and cost of dental care in Taiwan. Data Sources (1) Monthly dental claim data from January 1996 to December 2001 for the entire insured population in Taiwan. (2) The 1996–2001 population information for the cities, counties and townships in Taiwan, abstracted from the Taiwan-Fukien Demographic Fact Book. Study Design Longitudinal, using the autocorrelation model. Principal Findings Results indicated decline in dental care utilization, particularly after the implementation of dental global budgeting. With few exceptions, dental global budgeting did not improve the distribution of dental care and dentist supply. Conclusions The experience of the dental global budget program in Taiwan suggested that dental global budgeting might contain dental care utilization and that several conditions might have to be met in order for the reimbursement system to have effective redistributive impact on dental care and dentist supply. PMID:15544648

Trends and Comparisons of Utilization of Emergency Departments Due to Traumatic or Non-Traumatic Causes among the HIV-Positive Population in Taiwan, 2006–2011

PubMed Central

Lin, Ching-Heng; Lin, Ting; Chou, Pesus

2017-01-01

It is important that the utilization of emergency departments (EDs) among people living with the human immunodeficiency virus (HIV) be epidemiologically evaluated in order to assess and improve the HIV care continuum. All participants newly-diagnosed with HIV in Taiwan registered in the National Health Insurance Database from 2000 to 2005 were enrolled in this study and followed-up from 2006 to 2011. In total, 3500 participants newly-diagnosed with HIV in 2000–2005 were selected as a fixed-cohort population and followed-up from 2006 to 2011. Overall, 704, 645, 591, 573, 578, and 568 cases made 1322, 1275, 1050, 1061, 1136, and 992 ED visits in 2006, 2007, 2008, 2009, 2010 and 2011, respectively, with an average number of ED visits ranging from 1.75 to 1.98 per person, accounting for 20.1–22.6% of the whole HIV-positive population. Fewer ED visits were due to traumatic reasons, accounting for 19.6–24.4% of all cases. The incidence of traumatic and non-traumatic ED visits among the HIV-positive participants ranged from 7.2–9.3 and 27.0–33.9 per 100 people, respectively. The average direct medical cost of traumatic and non-traumatic ED visits ranged from $89.3–112.0 and $96.6–120.0, respectively. In conclusion, a lower incidence of ED visits for all reasons and fewer ED visits owing to traumatic causes were observed in the population living with HIV in comparison with the general population; however, the direct medical cost of each ED visit owing to both traumatic and non-traumatic causes was greater among those living with HIV than in the general population. PMID:29019947

Values and Context: Taiwan Principal Preparation and Practice from an American Perspective

ERIC Educational Resources Information Center

Vogel, Linda R.

2015-01-01

This qualitative study explores the preparation and practice of school leaders in Taiwan based on indepth interviews and observations with six Taiwan school directors serving geographically diverse student populations. The journey leading to school leadership and the challenges that this representative group of educational leaders face are…

Scrub typhus islands in the Taiwan area and the association between scrub typhus disease and forest land use and farmer population density: geographically weighted regression

PubMed Central

2013-01-01

Background The Taiwan area comprises the main island of Taiwan and several small islands located off the coast of the Southern China. The eastern two-thirds of Taiwan are characterized by rugged mountains covered with tropical and subtropical vegetation. The western region of Taiwan is characterized by flat or gently rolling plains. Geographically, the Taiwan area is diverse in ecology and environment, although scrub typhus threatens local human populations. In this study, we investigate the effects of seasonal and meteorological factors on the incidence of scrub typhus infection among 10 local climate regions. The correlation between the spatial distribution of scrub typhus and cultivated forests in Taiwan, as well as the relationship between scrub typhus incidence and the population density of farm workers is examined. Methods We applied Pearson’s product moment correlation to calculate the correlation between the incidence of scrub typhus and meteorological factors among 10 local climate regions. We used the geographically weighted regression (GWR) method, a type of spatial regression that generates parameters disaggregated by the spatial units of analysis, to detail and map each regression point for the response variables of the standardized incidence ratio (SIR)-district scrub typhus. We also applied the GWR to examine the explanatory variables of types of forest-land use and farm worker density in Taiwan in 2005. Results In the Taiwan Area, scrub typhus endemic areas are located in the southeastern regions and mountainous townships of Taiwan, as well as the Pescadore, Kinmen, and Matou Islands. Among these islands and low-incidence areas in the central western and southwestern regions of Taiwan, we observed a significant correlation between scrub typhus incidence and surface temperature. No similar significant correlation was found in the endemic areas (e.g., the southeastern region and the mountainous area of Taiwan). Precipitation correlates positively with scrub typhus incidence in 3 local climate regions (i.e., Taiwan’s central western and southwestern regions, and the Kinmen Islands). Relative humidity correlates positively with incidence in Southwestern Taiwan and the Kinmen Islands. The number of wet days correlates positively with incidence in Southwestern Taiwan. The duration of sunshine correlates positively with incidence in Central Western Taiwan, as well as the Kinmen and Matou Islands. In addition, the 10 local climatic regions can be classified into the following 3 groups, based on the warm-cold seasonal fluctuations in scrub typhus incidence: (a) Type 1, evident in 5 local climate regions (Taiwan’s northern, northwestern, northeastern, and southeastern regions, as well as the mountainous area); (b) Type 2 (Taiwan’s central western and southwestern regions, and the Pescadore Islands); and (c) Type 3 (the Kinmen and Matou Islands). In the GWR models, the response variable of the SIR-district scrub typhus has a statistically significantly positive association with 2 explanatory variables (farm worker population density and timber management). In addition, other explanatory variables (recreational forests, natural reserves, and “other purpose” areas) show positive or negative signs for parameter estimates in various locations in Taiwan. Negative signs of parameter estimates occurred only for the explanatory variables of national protectorates, plantations, and clear-cut areas. Conclusion The results of this study show that scrub typhus in Taiwan can be classified into 3 types. Type 1 exhibits no climatic effect, whereas the incidence of Type 2 correlates positively with higher temperatures during the warm season, and the incidence of Type 3 correlates positively with higher surface temperatures and longer hours of sunshine. The results also show that in the mountainous township areas of Taiwan’s central and southern regions, as well as in Southeastern Taiwan, higher SIR values for scrub typhus are associated with the following variables: farm worker population density, timber management, and area type (i.e., recreational forest, natural reserve, or other purpose). PMID:23627966

Effects of Cobalt-60 Exposure on Health of Taiwan Residents Suggest New Approach Needed in Radiation Protection

PubMed Central

Chen, W.L.; Luan, Y.C.; Shieh, M.C.; Chen, S.T.; Kung, H.T.; Soong, K.L; Yeh, Y.C.; Chou, T.S.; Mong, S.H.; Wu, J.T.; Sun, C.P.; Deng, W.P.; Wu, M.F.; Shen, M.L.

2007-01-01

The conventional approach for radiation protection is based on the ICRP's linear, no threshold (LNT) model of radiation carcinogenesis, which implies that ionizing radiation is always harmful, no matter how small the dose. But a different approach can be derived from the observed health effects of the serendipitous contamination of 1700 apartments in Taiwan with cobalt-60 (T1/2 = 5.3 y). This experience indicates that chronic exposure of the whole body to low-dose-rate radiation, even accumulated to a high annual dose, may be beneficial to human health. Approximately 10,000 people occupied these buildings and received an average radiation dose of 0.4 Sv, unknowingly, during a 9–20 year period. They did not suffer a higher incidence of cancer mortality, as the LNT theory would predict. On the contrary, the incidence of cancer deaths in this population was greatly reduced—to about 3 per cent of the incidence of spontaneous cancer death in the general Taiwan public. In addition, the incidence of congenital malformations was also reduced—to about 7 per cent of the incidence in the general public. These observations appear to be compatible with the radiation hormesis model. Information about this Taiwan experience should be communicated to the public worldwide to help allay its fear of radiation and create a positive impression about important radiation applications. Expenditures of many billions of dollars in nuclear reactor operation could be saved and expansion of nuclear electricity generation could be facilitated. In addition, this knowledge would encourage further investigation and implementation of very important applications of total-body, low-dose irradiation to treat and cure many illnesses, including cancer. The findings of this study are such a departure from expectations, based on ICRP criteria, that we believe that they ought to be carefully reviewed by other, independent organizations and that population data not available to the authors be provided, so that a fully qualified epidemiologically-valid analysis can be made. Many of the confounding factors that limit other studies used to date, such as the A-bomb survivors, the Mayak workers and the Chernobyl evacuees, are not present in this population exposure. It should be one of the most important events on which to base radiation protection standards. PMID:18648557

Betel quid chewing leads to the development of unique de novo malignancies in liver transplant recipients, a retrospective single center study in Taiwan.

PubMed

Chen, Yi-Chan; Cheng, Chih-Hsien; Wang, Yu-Chao; Wu, Ting-Jun; Chou, Hong-Shiue; Chan, Kun-Ming; Lee, Wei-Chen; Lee, Chen-Fang; Soong, Ruey Shyang

2016-09-01

Orthotopic liver transplantation (OLT) is the choice of treatment not only for end-stage liver disease and acute liver failure but also for hepatocellular carcinoma (HCC). The development of de novo malignancies after liver transplantation plays an important role in late mortality; the incidence of late mortality has increased owing to improved survival. The incidence of de novo malignancies is 2.3% to 25%, which is 2 to 3 times that of malignancies in the general population. The most commonly reported de novo malignancies in solid organs are skin cancer, Karposi sarcoma, and colon cancer according to the frequency of exposure to a specific carcinogen. We hypothesized that exposure to different carcinogens would change the distribution of de novo malignancies among patients after OLT. In Taiwan, 10% of the population is exposed to a unique carcinogen, the betel quid, which is associated with a high incidence of head and neck cancer (HNC) among the Taiwanese population.From 2004 to 2014, we retrospectively reviewed 484 cases post-OLT at our institution and 16 patients with 17 de novo malignancies were identified. Most of the patients had HNC, which is in contrast to previous literature reports.Univariate and multivariate analyses identified betel quid chewing as the main leading factor for HNC in the Taiwanese population.Routine screening of the oral mucosa in patients with the habit of betel quid chewing is recommended in Taiwan for the early detection of HNC. Routine screening with aggressive treatment after diagnosis of HNC in patients with the habit of chewing betel quid, who underwent OLT, resulted in good patient prognosis.

Do biological measures mediate the relationship between education and health: a comparative study

PubMed Central

Goldman, Noreen; Turra, Cassio; Rosero-Bixby, Luis; Weir, David; Crimmins, Eileen

2010-01-01

Despite a myriad of studies examining the relationship between socioeconomic status and health outcomes, few have assessed the extent to which biological markers of chronic disease account for social disparities in health. Studies that have examined this issue have generally been based on surveys in wealthy countries that include a small set of clinical markers of cardiovascular disease. The availability of recent data from nationally representative surveys of older adults in Costa Rica and Taiwan that collected a rich set of biomarkers comparable to those in a recent US survey permits us to explore these associations across diverse populations. Similar regression models were estimated on three data sets – the Social Environment and Biomarkers of Aging Study in Taiwan, the Costa Rican Study on Longevity and Healthy Aging, and the Health and Retirement Study in the USA – in order to assess (1) the strength of the associations between educational attainment and a broad range of biomarkers; and (2) the extent to which these biomarkers account for the relationships between education and two measures of health status (self-rated health, functional limitations) in older populations. The estimates suggest non-systematic and weak associations between education and high risk biomarker values in Taiwan and Costa Rica, in contrast to generally negative and significant associations in the US, especially among women. The results also reveal negligible or modest contributions of the biomarkers to educational disparities in the health outcomes. The findings are generally consistent with previous research suggesting stronger associations between socioeconomic status and health in wealthy countries than in middle income countries and may reflect higher levels of social stratification in the US. With access to an increasing number of longitudinal biosocial surveys, researchers may be better able to distinguish true variations in the relationship between socioeconomic status and health across different settings from methodological differences. PMID:21159415

Trend and geographic analysis of the prevalence of dengue in Taiwan, 2010-2015.

PubMed

Hsu, Jason C; Hsieh, Chin-Lin; Lu, Christine Y

2017-01-01

Dengue is the most rapidly spreading disease caused by a mosquito-borne virus in the world. The incidence of dengue globally has increased 30-fold in the last 50 years. Understanding the prevalence of dengue and its longitudinal trends can improve prevention and control strategies. This study assessed the trends in prevalence of dengue in Taiwan by population characteristics and geographical region. Dengue and population data for the years 2010-2015 were obtained from the public statistics databases of the Taiwan Centers for Disease Control and Department of Statistics, Taiwan Ministry of Interior. Yearly prevalence rates of dengue were calculated by age group, sex, and administrative area within five geographic regions (northern, mid-western, southern, and eastern regions, and outer islands). The national prevalence rate of dengue decreased gradually from 8 to 4 per 100000 population between 2010 and 2013, but it increased substantially in 2014 and 2015 to 67 and 187 per 100000 population, respectively. There was no significant difference in prevalence rate between males and females. People aged 60-69 years had a significantly higher prevalence rate than those in the other age groups during 2010-2014, and people aged over 70 years had the highest rate in 2015 (309 per 100000 population). The southern region had the highest yearly dengue prevalence rate (the rate decreased from 23 to 9 per 100000 population between 2010 and 2013, but increased to 220 and 616 per 100000 population in 2014 and 2015, respectively). Three unexpected outbreaks of dengue were observed during the study period: the first outbreak occurred in Penghu County in 2011 (prevalence rate 101 per 100000 population), the second in Kaohsiung City in 2014 (prevalence rate 540 per 100000 population), and the third in Tainan City in 2015 (prevalence rate 1208 per 100000 population). More efforts are still needed to prevent and control dengue in Taiwan. The government should direct resources and interventions to southern Taiwan, which has a tropical climate and a high population density, and should target older people who are more likely to be infected. Strategies are also needed to respond quickly to unexpected incidents to prevent dengue outbreaks. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Active job, healthy job? Occupational stress and depression among hospital physicians in Taiwan.

PubMed

Wang, Liang-Jen; Chen, Chih-Ken; Hsu, Shih-Chieh; Lee, Sheng-Yu; Wang, Chin-Sheng; Yeh, Wan-Yu

2011-01-01

This study assessed the levels and association of occupational stress and depression rate among physicians, and to compare physicians' occupational stress with that of Taiwanese employees in other occupations. The subjects were physicians employed at 14 participating regional hospitals in the Around Taiwan Health Care Alliance. Self-administered questionnaires capturing data on demographics, occupational characteristics, occupational stress measured using Job Content Questionnaire (C-JCQ), and health status measured using Taiwanese Depression Questionnaire (TDQ) were sent to eligible physicians. Results revealed that the depression rate (13.3%) was higher than that found in the general population (3.7%) of Taiwan. The mean scores of the JCQ dimensions "work demands" and "job control" were both much higher than those in most occupations in Taiwan. Higher depression scores were found in subjects with higher work demands, 8-10 d of being on duty per month, and more frequent alcohol consumption, while lower depression scores were found in subjects working in the east Taiwan area, with higher job control and with greater workplace social support. On the other hand, gender, smoking, and working hour were not independently correlated with depression, but the interaction of gender and job control also had an independent effect on depression. This study suggests that job stress plays an important role in depression in physicians; it is necessary to pay attention to physicians at high risk of depression, as well as their work environments, for early detection and intervention.

An Investigation of Taiwan's Education Regulations and Policies for Pursuing Environmental Sustainability

ERIC Educational Resources Information Center

Tsai, Wen-Tien

2012-01-01

With the rapid industrialization and economic development in the past decades, heavy environmental loads caused some serious environmental scenarios in Taiwan, an island country with a dense population and only limited natural resources. As a result, environmental education in Taiwan has been a leading tool to promote sustainable development since…

The Development of Educational Gerontology in Taiwan: An Interpretive and Critical Perspective

ERIC Educational Resources Information Center

Huang, Chin-Shan

2010-01-01

Educational gerontology is increasingly becoming a global phenomenon. Taiwan, a small island in the western Pacific Ocean, has responded to its aging population with the development of the studies and practices of educational gerontology. This study, first, traces the development of educational gerontology in Taiwan, based on Peterson's definition…

Growing concerns and controversies to Taiwan's National Health Insurance-what are the lessons from mainland China, South Korea and Singapore?

PubMed

Lee, Yen-Han; Ang, Ting Fang Alvin; Chiang, Timothy C; Kaplan, Warren A

2018-01-01

It has been over 20 years since Taiwan's implementation of its National Health Insurance (NHI) program. Under this program, the health insurance coverage rate has reached approximately 99% of the population. Despite guaranteeing the residents of Taiwan equal access regardless of socioeconomic status and background, critical problems and controversies persist, and they continue to challenge the NHI. We analyze the primary issues facing the NHI program with emphasis on financial and consumer behavioral aspects. Furthermore, we apply models from mainland China, South Korea and Singapore to discuss what Taiwan could learn from the systems employed by these countries to modify the NHI. Targeting the needs of the NHI, we have three policy recommendations: separating the NHI scheme into different target populations, strengthening the NHI referral system and regulating the access of overseas citizens to health services while in Taiwan. After two decades in existence, problems persist and there is a continuing need to improve Taiwan's NHI. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Does Marital Status Predict the Odds of Suicidal Death in Taiwan? A Seven-Year Population-Based Study

ERIC Educational Resources Information Center

Yeh, Jui-Yuan; Xirasagar, Sudha; Liu, Tsai-Ching; Li, Chong-Yi; Lin, Herng-Ching

2008-01-01

Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups--total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly…

Taiwan Biobank: a project aiming to aid Taiwan's transition into a biomedical island.

PubMed

Fan, Chien-Te; Lin, Jui-Chu; Lee, Chung-His

2008-02-01

Essentially, the term 'biobank' can be defined in different ways. Taking the UK Biobank's experience as the main example, the Taiwan Biobank aims to collect the DNA of a large group of people on the population base and track their health and lifestyle for at least 10 years. It is hoped that the information collected, regarding the mechanisms underlying how genes and environmental factors interact with each other to make us ill, will benefit the society in various ways, including the exploration of a new generation of treatments, support to preventive medicine discovery and also the possible benefits for the promotion of evolving public health-related industries in Taiwan. However, the involvement of large-scale population base gene data collection also triggered serious ethical, legal and social issues. In Taiwan, the challenge is even more serious than for any other biobanking experiences that have occurred previously. Among all the ethical, legal and social issues, the convergence of aboriginal people protection provided under Taiwan's Constitution imposes on the research team an obligation to create an innovative Ethical & Legal Governance Framework adaptable to the unique social background of Taiwan, including a workable public consultation/communication mechanism. In early 2005, the creation of the 'Taiwan Biobank' has been included as a part of Taiwan's strategic development in promoting the country as an island of biomedicine. In this report, the ideology, the goals and special features, government strategy, visions and, in particular, the ethical, legal and social issue planning of the Taiwan Biobank will be briefly introduced and reviewed.

History and development of ophthalmology in Taiwan.

PubMed

Hou, Yu-Chih; Oren, Gale A; Chen, Muh-Shy; Hu, Fung-Rong

2016-12-01

Western medicine was first introduced to Taiwan by medical missionaries in the mid-19 th century. Modernization of medicine was systematically transplanted to Taiwan in the Japanese colonial period, and ophthalmology was established third among hospital departments, following internal medicine and surgery. Dr Hidetaka Yamaguchi, an ophthalmologist, was the first head of the Taihoku Hospital, later known as National Taiwan University Hospital (NTUH; Taipei, Taiwan). Ophthalmologists during the colonial period conducted studies on tropical and infectious eye diseases. After World War II, ophthalmologists at NTUH played an important role in medical education, residency training, studies, and teaching. Dr Yan-Fei Yang established the Taiwan Ophthalmological Society in 1960 and instituted its official journal in 1962. Dr Ho-Ming Lin established the Department of Ophthalmology at the Tri-Service General Hospital in the 1950s and the Veterans General Hospital in the 1960s. Taiwan ophthalmologists eradicated trachoma by 1971. Cataract surgery and penetrating keratoplasty were initially performed in the 1960s. Currently, there are about 1600 ophthalmologists in Taiwan conducting an estimated 120,000 cataract surgeries and 600 corneal transplantations annually. Many subspecialty societies have been established recently that serve to educate Taiwanese ophthalmologists and to connect with international ophthalmic societies. Taiwan ophthalmologists continue to contribute to the advancement of ophthalmic knowledge globally. Copyright © 2016. Published by Elsevier B.V.

A New Phylogeographic Pattern of Endemic Bufo bankorensis in Taiwan Island Is Attributed to the Genetic Variation of Populations

PubMed Central

Yu, Teng-Lang; Lin, Hung-Du; Weng, Ching-Feng

2014-01-01

Aim To comprehend the phylogeographic patterns of genetic variation in anurans at Taiwan Island, this study attempted to examine (1) the existence of various geological barriers (Central Mountain Ranges, CMRs); and (2) the genetic variation of Bufo bankorensis using mtDNA sequences among populations located in different regions of Taiwan, characterized by different climates and existing under extreme conditions when compared available sequences of related species B. gargarizans of mainland China. Methodology/Principal Findings Phylogenetic analyses of the dataset with mitochondrial DNA (mtDNA) D-loop gene (348 bp) recovered a close relationship between B. bankorensis and B. gargarizans, identified three distinct lineages. Furthermore, the network of mtDNA D-loop gene (564 bp) amplified (279 individuals, 27 localities) from Taiwan Island indicated three divergent clades within B. bankorensis (Clade W, E and S), corresponding to the geography, thereby verifying the importance of the CMRs and Kaoping River drainage as major biogeographic barriers. Mismatch distribution analysis, neutrality tests and Bayesian skyline plots revealed that a significant population expansion occurred for the total population and Clade W, with horizons dated to approximately 0.08 and 0.07 Mya, respectively. These results suggest that the population expansion of Taiwan Island species B. bankorensis might have resulted from the release of available habitat in post-glacial periods, the genetic variation on mtDNA showing habitat selection, subsequent population dispersal, and co-distribution among clades. Conclusions The multiple origins (different clades) of B. bankorensis mtDNA sequences were first evident in this study. The divergent genetic clades found within B. bankorensis could be independent colonization by previously diverged lineages; inferring B. bankorensis originated from B. gargarizans of mainland China, then dispersal followed by isolation within Taiwan Island. Highly divergent clades between W and E of B. bankorensis, implies that the CMRs serve as a genetic barrier and separated the whole island into the western and eastern phylogroups. PMID:24853679

Arsenic Exposure and Type 2 Diabetes: A Systematic Review of the Experimental and Epidemiologic Evidence

PubMed Central

Navas-Acien, Ana; Silbergeld, Ellen K.; Streeter, Robin A.; Clark, Jeanne M.; Burke, Thomas A.; Guallar, Eliseo

2006-01-01

Chronic arsenic exposure has been suggested to contribute to diabetes development. We performed a systematic review of the experimental and epidemiologic evidence on the association of arsenic and type 2 diabetes. We identified 19 in vitro studies of arsenic and glucose metabolism. Five studies reported that arsenic interfered with transcription factors involved in insulin-related gene expression: upstream factor 1 in pancreatic β-cells and peroxisome proliferative-activated receptor γ in preadipocytes. Other in vitro studies assessed the effect of arsenic on glucose uptake, typically using very high concentrations of arsenite or arsenate. These studies provide limited insight on potential mechanisms. We identified 10 in vivo studies in animals. These studies showed inconsistent effects of arsenic on glucose metabolism. Finally, we identified 19 epidemiologic studies (6 in high-arsenic areas in Taiwan and Bangladesh, 9 in occupational populations, and 4 in other populations). In studies from Taiwan and Bangladesh, the pooled relative risk estimate for diabetes comparing extreme arsenic exposure categories was 2.52 (95% confidence interval, 1.69–3.75), although methodologic problems limit the interpretation of the association. The evidence from occupational studies and from general populations other than Taiwan or Bangladesh was inconsistent. In summary, the current available evidence is inadequate to establish a causal role of arsenic in diabetes. Because arsenic exposure is widespread and diabetes prevalence is reaching epidemic proportions, experimental studies using arsenic concentrations relevant to human exposure and prospective epidemiologic studies measuring arsenic biomarkers and appropriately assessing diabetes should be a research priority. PMID:16675414

The bidirectional association between oral cancer and esophageal cancer: A population-based study in Taiwan over a 28-year period

PubMed Central

Lu, Chang-Hsien; Huang, Cih-En; Chen, Min-Chi

2017-01-01

Previous studies have revealed that patients with oral or esophageal cancer are at higher risk for subsequently developing a second primary malignancy. However, it remains to be determined what association exists between oral cancer and esophageal cancer particularly in Asian countries where squamous cell carcinoma is the predominant type of esophageal cancer. A population-based study was carried out in Taiwan, where the incidence rates of both oral and esophageal squamous cell carcinomas are high, to test the hypothesis that oral cancer or esophageal cancer predisposes an individual to developing the other form of cancer. Our results showed that patients with primary oral cancer (n=45,859) had ten times the risk of second esophageal cancer compared to the general population. Within the same cohort, the reciprocal risk of oral cancer as a second primary in primary esophageal cancer patients (n=16,658) was also increased seven-fold. The bidirectional relationship suggests common risk factors between these two cancers. The present study is not only the first population-based study in Asia to validate the reciprocal relationship between oral and esophageal squamous cell carcinomas, but also will aid in the appropriate selection of high-risk patients for a future follow-up surveillance program. PMID:28562351

The bidirectional association between oral cancer and esophageal cancer: A population-based study in Taiwan over a 28-year period.

PubMed

Lee, Kuan-Der; Wang, Ting-Yao; Lu, Chang-Hsien; Huang, Cih-En; Chen, Min-Chi

2017-07-04

Previous studies have revealed that patients with oral or esophageal cancer are at higher risk for subsequently developing a second primary malignancy. However, it remains to be determined what association exists between oral cancer and esophageal cancer particularly in Asian countries where squamous cell carcinoma is the predominant type of esophageal cancer. A population-based study was carried out in Taiwan, where the incidence rates of both oral and esophageal squamous cell carcinomas are high, to test the hypothesis that oral cancer or esophageal cancer predisposes an individual to developing the other form of cancer. Our results showed that patients with primary oral cancer (n=45,859) had ten times the risk of second esophageal cancer compared to the general population. Within the same cohort, the reciprocal risk of oral cancer as a second primary in primary esophageal cancer patients (n=16,658) was also increased seven-fold. The bidirectional relationship suggests common risk factors between these two cancers. The present study is not only the first population-based study in Asia to validate the reciprocal relationship between oral and esophageal squamous cell carcinomas, but also will aid in the appropriate selection of high-risk patients for a future follow-up surveillance program.

Cancer Incidence among Heart, Kidney, and Liver Transplant Recipients in Taiwan.

PubMed

Lee, Kwai-Fong; Tsai, Yi-Ting; Lin, Chih-Yuan; Hsieh, Chung-Bao; Wu, Sheng-Tang; Ke, Hung-Yen; Lin, Yi-Chang; Lin, Feng-Yen; Lee, Wei-Hwa; Tsai, Chien-Sung

2016-01-01

Population-based evidence of the relative risk of cancer among heart, kidney, and liver transplant recipients from Asia is lacking. The Taiwan National Health Insurance Research Database was used to conduct a population-based cohort study of transplant recipients (n = 5396), comprising 801 heart, 2847 kidney, and 1748 liver transplant recipients between 2001 and 2012. Standardized incidence ratios and Cox regression models were used. Compared with the general population, the risk of cancer increased 3.8-fold after heart transplantation, 4.1-fold after kidney transplantation and 4.6-fold after liver transplantation. Cancer occurrence showed considerable variation according to transplanted organs. The most common cancers in all transplant patients were cancers of the head and neck, liver, bladder, and kidney and non-Hodgkin lymphoma. Male recipients had an increased risk of cancers of the head and neck and liver, and female kidney recipients had a significant risk of bladder and kidney cancer. The adjusted hazard ratio for any cancer in all recipients was higher in liver transplant recipients compared with that in heart transplant recipients (hazard ratio = 1.5, P = .04). Cancer occurrence varied considerably and posttransplant cancer screening should be performed routinely according to transplanted organ and sex.

Utilization of and Direct Expenditure for Emergency Medical 
Care in Taiwan: A Population-based Descriptive Study

PubMed Central

Yang, Nan-Ping; Lee, Yi-Hui; Lin, Ching-Heng; Chung, Yuan-Chang; Chen, Wen-Jone; Chou, Pesus

2009-01-01

Background We surveyed the emergency medical system (EMS) in Taiwan to provide information to policymakers responsible for decisions regarding the redistribution of national medical resources. Methods A systematic sampling method was used to randomly sample a representative database from the National Health Insurance (NHI) database in Taiwan, during the period from 2000 to 2004. Results We identified 10,124, 10,408, 11,209, 10,686, and 11,914 emergency room visits in 2000, 2001, 2002, 2003, and 2004, respectively. There were more males than females, and the majority of adults were younger than 50 years. Diagnose of injury/poisoning was the most frequently noted diagnostic category in emergency departments (EDs) in Taiwan. There were 13,196 (24.3%) and 2,952 (5.4%) patients with 2 and 3 concomitant diagnoses, respectively. There was a significant association between advanced age and the existence of multiple diagnoses (P < 0.001). With the exception of the ill-defined symptoms/signs/conditions, the two most frequent diagnoses were diseases of the circulatory system and diseases of the respiratory system in patients aged 65 years or older. On average, treatment-associated expenditure and drug-associated expenditure in Taiwan EDs averaged NT$1,155 ($35.0) and NT$190 ($5.8), respectively, which was equal to 64.5% and 10.6% of the total ED-associated cost. General ED medical expenditure increased with patient age; the increased cost ratio due to age was estimated at 8% per year (P < 0.001). Conclusions The frequency of major health problems diagnosed at ED visits varied by age: more complicated complaints and multiple diagnoses were more frequent in older patients. In Taiwan, the ED system remains overloaded, possibly because of the low cost of an ED visit. PMID:19164870

Seroepidemiology of Toxoplasma gondii Infection among healthy blood donors in Taiwan.

PubMed

Chiang, Ting-Yi; Hsieh, Hwei-Ho; Kuo, Ming-Chu; Chiu, Kai-Tse; Lin, Wei-Chen; Fan, Chia-Kwung; Fang, Chi-Tai; Ji, Dar-Der

2012-01-01

Toxoplasma gondii is an opportunistic, zoonotic pathogen with a worldwide distribution. There are large variations in the seroprevalence of T. gondii infection in different regions of the world. Although toxoplasmosis became a notifiable communicable disease in Taiwan in 2007, little is known about its epidemiology among the general population. This cross-sectional study aimed to survey the seroprevalence of T. gondii infection and its risk factors among healthy blood donors in Taiwan. Through collaborating with the Taiwan Blood Services Foundation, a total of 1,783 healthy blood donors from all six-branch blood service centers participated in this study. The blood samples were tested for the presence of T. gondii antibodies and DNA using enzyme immunoassays and real-time PCR, respectively. Structured questionnaires were used to gather information on risk factors for T. gondii infection. Of the 1,783 participants, 166 (9.3%) tested positive for anti-Toxoplasma IgG, while 5 (0.28%) tested positive for anti-Toxoplasma IgM. The five IgM positive donors had high avidity antibodies suggestive of past infection. No active parasitemia was detected by real-time PCR assays. Multivariate logistic regression showed that undercooked pork meat consumption (adjusted odds ratio [OR] = 2.9; 95% confidence interval [CI]: 1.3-6.5), raw mussels consumption (adjusted OR = 5.3; 95% CI: 1.5-19.1), having a cat in the household (adjusted OR = 2.0; 95% CI: 1.2-3.2), a lower education level (adjusted OR = 1.6; 95% CI: 1.1-2.3), and donation place in eastern Taiwan (adjusted OR = 2.5; 95% CI: 1.6-3.9) were independent risk factors for Toxoplasma seropositivity. These findings provide information on the seroprevalence and epidemiology of T. gondii infection among healthy blood donors in Taiwan.

Pyogenic Liver Abscess as Endemic Disease, Taiwan

PubMed Central

Tsai, Feng-Chiao; Huang, Yu-Tsung; Chang, Luan-Yin

2008-01-01

Pyogenic liver abscess has become a health problem in Taiwanese society. However, the extent of this problem has remained unclear because of the lack of a population-based study. We therefore performed a nationwide analysis of pyogenic liver abscess in Taiwan from 1996 through 2004. We analyzed 29,703 cases from the Taiwan National Health Insurance database and 506 cases from National Taiwan University Hospital. Our analysis showed that the annual incidence of pyogenic liver abscess increased steadily from 11.15/100,000 population in 1996 to 17.59/100,000 in 2004. Diabetes, malignancy, renal disease, and pneumonia were associated with a higher risk for the disease. By contrast, death due to pyogenic liver abscess decreased over time, although population-based abscess-related death increased slightly. Renal disease, malignancy, pneumonia, and heart disease correlated with higher death rates; Klebsiella pneumoniae infection and therapeutic procedures were related to lower death rates. Diabetes did not significantly change death rates for the 506 patients from the hospital. PMID:18826824

Role of Aedes aegypti (Linnaeus) and Aedes albopictus (Skuse) in local dengue epidemics in Taiwan.

PubMed

Tsai, Pui-Jen; Teng, Hwa-Jen

2016-11-09

Aedes mosquitoes in Taiwan mainly comprise Aedes albopictus and Ae. aegypti. However, the species contributing to autochthonous dengue spread and the extent at which it occurs remain unclear. Thus, in this study, we spatially analyzed real data to determine spatial features related to local dengue incidence and mosquito density, particularly that of Ae. albopictus and Ae. aegypti. We used bivariate Moran's I statistic and geographically weighted regression (GWR) spatial methods to analyze the globally spatial dependence and locally regressed relationship between (1) imported dengue incidences and Breteau indices (BIs) of Ae. albopictus, (2) imported dengue incidences and BI of Ae. aegypti, (3) autochthonous dengue incidences and BI of Ae. albopictus, (4) autochthonous dengue incidences and BI of Ae. aegypti, (5) all dengue incidences and BI of Ae. albopictus, (6) all dengue incidences and BI of Ae. aegypti, (7) BI of Ae. albopictus and human population density, and (8) BI of Ae. aegypti and human population density in 348 townships in Taiwan. In the GWR models, regression coefficients of spatially regressed relationships between the incidence of autochthonous dengue and vector density of Ae. aegypti were significant and positive in most townships in Taiwan. However, Ae. albopictus had significant but negative regression coefficients in clusters of dengue epidemics. In the global bivariate Moran's index, spatial dependence between the incidence of autochthonous dengue and vector density of Ae. aegypti was significant and exhibited positive correlation in Taiwan (bivariate Moran's index = 0.51). However, Ae. albopictus exhibited positively significant but low correlation (bivariate Moran's index = 0.06). Similar results were observed in the two spatial methods between all dengue incidences and Aedes mosquitoes (Ae. aegypti and Ae. albopictus). The regression coefficients of spatially regressed relationships between imported dengue cases and Aedes mosquitoes (Ae. aegypti and Ae. albopictus) were significant in 348 townships in Taiwan. The results indicated that local Aedes mosquitoes do not contribute to the dengue incidence of imported cases. The density of Ae. aegypti positively correlated with the density of human population. By contrast, the density of Ae. albopictus negatively correlated with the density of human population in the areas of southern Taiwan. The results indicated that Ae. aegypti has more opportunities for human-mosquito contact in dengue endemic areas in southern Taiwan. Ae. aegypti, but not Ae. albopictus, and human population density in southern Taiwan are closely associated with an increased risk of autochthonous dengue incidence.

[The internationalization of the nursing profession in Taiwan].

PubMed

Chuang, Hsiao-Ling; Wang, Cheng-Ching; Kuo, Pi-Chao

2011-06-01

Globalization, nursing manpower migration, and the multinational nature of the medical industry have increased the level of internationalization in Taiwan's nursing profession. In nursing practice, competencies for the general nursing list (Taiwan version) and ICNP (International Classification for Nursing Practice) have been clinically tested and revised. In academic nursing, significant effort is invested toward achieving the three general objectives of internationalized teaching, internationalized campuses, and international academic exchanges. We should further test and revise Taiwan's competencies for the general nursing list, and the ICNP should be continually tested and revised. Additionally, nursing personnel should strengthen foreign language competencies, appreciate different nursing practice cultures, participate in international exchange activities, and place increasing emphasis on international cooperation in research and nursing education accreditation. Such should further enhance and strengthen international cooperation, which should further encourage internationalization in the domestic nursing profession.

A Comparison of Food Supply from 1984 to 2009 and Degree of Dietary Westernization in Taiwan with Asian Countries and World Continents

PubMed Central

Peng, Cheau-Jane; Lin, Cheng-Yao; Guo, How-Ran

2015-01-01

Objective. To compare quality, quantity, and trends of food supply from 1984 to 2009 and degree of food westernization in Taiwan with Asian countries and world continents by using food balance data. Methods. We compiled data from food balance sheets of Taiwan and Food and Agriculture Organization, including five continents and three most populated countries each in Eastern, Southern, and Southeastern Asia over the period 1984–2009. Quantity of food supply per capita was referenced to Taiwan food guides. The population-weighted means of food supply from Europe, North America, South America, and Australia and New Zealand continents in terms of energy and nutrient distributions, animal/plant sources, and sugar/alcohol contribution were used as indicators of westernization. Trends of food supply per capita of six food groups were plotted, and linear regression was applied to evaluate food changes. Findings. Taiwan's food supply provided sufficient quantity in food energy, with the lowest cereals/roots supply and rice to wheat ratio, but the highest meat and oil supplies per capita among the 10 studied Asian countries. Taiwan food supply showed the most westernization among these countries. Conclusion. Food supply of Taiwan, although currently sufficient, indicated some security problems and high tendency of diet westernization. PMID:26295045

A Comparison of Food Supply from 1984 to 2009 and Degree of Dietary Westernization in Taiwan with Asian Countries and World Continents.

PubMed

Peng, Cheau-Jane; Lin, Cheng-Yao; Guo, How-Ran

2015-01-01

To compare quality, quantity, and trends of food supply from 1984 to 2009 and degree of food westernization in Taiwan with Asian countries and world continents by using food balance data. We compiled data from food balance sheets of Taiwan and Food and Agriculture Organization, including five continents and three most populated countries each in Eastern, Southern, and Southeastern Asia over the period 1984-2009. Quantity of food supply per capita was referenced to Taiwan food guides. The population-weighted means of food supply from Europe, North America, South America, and Australia and New Zealand continents in terms of energy and nutrient distributions, animal/plant sources, and sugar/alcohol contribution were used as indicators of westernization. Trends of food supply per capita of six food groups were plotted, and linear regression was applied to evaluate food changes. Taiwan's food supply provided sufficient quantity in food energy, with the lowest cereals/roots supply and rice to wheat ratio, but the highest meat and oil supplies per capita among the 10 studied Asian countries. Taiwan food supply showed the most westernization among these countries. Food supply of Taiwan, although currently sufficient, indicated some security problems and high tendency of diet westernization.

A study of assessment indicators for environmental sustainable development of science parks in Taiwan.

PubMed

Chen, Han-Shen; Chien, Li-Hsien; Hsieh, Tsuifang

2013-08-01

This study adopted the ecological footprint calculation structure to calculate the ecological footprints of the three major science parks in Taiwan from 2008 to 2010. The result shows that the ecological footprints of the Hsinchu Science Park, the Central Taiwan Science Park, and the Southern Taiwan Science Park were about 3.964, 2.970, and 4.165 ha per capita. The ecological footprint (EF) of the Central Taiwan Science Park was the lowest, meaning that the influence of the daily operations in the Central Taiwan Science Park on the environment was rather low. Secondly, the population density was relatively high, and the EF was not the highest of the Hsinchu Science Park, meaning that, while consuming ecological resources, the environmental management done was effective. In addition, the population density in Southern Taiwan Science Park is 82.8 units, lower than that of Hsinchu Science Park, but its ecological footprint per capita is 0.201 units, higher than Hsinchu, implying its indicator management has space for improvement. According to the analysis result above, in the science parks, the percentages of high-energy-consuming industries were rather high. It was necessary to encourage development of green industries with low energy consumption and low pollution through industry transformation.

Cancer incidence patterns among children and adolescents in Taiwan from 1995 to 2009: A population-based study

PubMed Central

Hung, Giun-Yi; Horng, Jiun-Lin; Lee, Yu-Sheng; Yen, Hsiu-Ju; Chen, Chao-Chun; Lee, Chih-Ying

2014-01-01

BACKGROUND Currently, little information is available on childhood cancer incidence rates in Eastern Asia. The objective of this study was to report the first population-based cancer surveillance of children and adolescents in Taiwan. METHODS Data from the Taiwan Cancer Registry were examined for cancer frequencies and incidence rates among individuals ages birth to 19 years from 1995 to 2009. Types of cancers were grouped according to the International Classification of Childhood Cancer. Rates were compared by sex and age. For further comparisons with other countries, rates were age standardized to the 2000 world standard population in 5-year age groups. Trends in incidence rates also were evaluated. RESULTS In total, 12,315 individuals were diagnosed with childhood cancers, for an age-standardized incidence rate (ASR) of 132.1 per million person-years from 1995 to 2009. The male-to-female incidence rate ratio was 1.19. Overall, leukemias were the most common cancer (ASR, 39.1 per million person-years), followed by central nervous system neoplasms (15.8 per million person-years), and lymphomas (15.3 per million person-years). During the 15-year study period, the incidence rates increased by 1% annually. Compared with other countries, the rate of hepatic tumors was 2 times greater in Taiwan. The rate of germ cell neoplasms in Taiwan was similar to that in the United States and was 1.3 to 1.9 times greater compared with Canada, Brazil, Israel, and Japan. CONCLUSIONS Based on the current data, the observed increase in overall incidence rates was attributable only marginally to improvements in case ascertainment and diagnostic procedures. The high rates of malignant hepatic tumors and germ cell neoplasms in Taiwan suggest variations in the background risk factors. Cancer 2014;120:3545–3553. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. The authors examine cancer incidence patterns in children and adolescents based on a national, population-based cancer registry of 12,315 individuals in Taiwan from 1995 to 2009. The high rates of malignant hepatic tumors and germ cell neoplasms in Taiwan suggest variations in background risk factors. PMID:25043411

Comparison of annual percentage change in breast cancer incidence rate between Taiwan and the United States-A smoothed Lexis diagram approach.

PubMed

Chien, Li-Hsin; Tseng, Tzu-Jui; Chen, Chung-Hsing; Jiang, Hsin-Fang; Tsai, Fang-Yu; Liu, Tsang-Wu; Hsiung, Chao A; Chang, I-Shou

2017-07-01

Recent studies compared the age effects and birth cohort effects on female invasive breast cancer (FIBC) incidence in Asian populations with those in the US white population. They were based on age-period-cohort model extrapolation and estimated annual percentage change (EAPC) in the age-standardized incidence rates (ASR). It is of interest to examine these results based on cohort-specific annual percentage change in rate (APCR) by age and without age-period-cohort model extrapolation. FIBC data (1991-2010) were obtained from the Taiwan Cancer Registry and the U.S. SEER 9 registries. APCR based on smoothed Lexis diagrams were constructed to study the age, period, and cohort effects on FIBC incidence. The patterns of age-specific rates by birth cohort are similar between Taiwan and the US. Given any age-at-diagnosis group, cohort-specific rates increased overtime in Taiwan but not in the US; cohort-specific APCR by age decreased with birth year in both Taiwan and the US but was always positive and large in Taiwan. Given a diagnosis year, APCR decreased as birth year increased in Taiwan but not in the US. In Taiwan, the proportion of APCR attributable to cohort effect was substantial and that due to case ascertainment was becoming smaller. Although our study shows that incidence rates of FIBC have increased rapidly in Taiwan, thereby confirming previous results, the rate of increase over time is slowing. Continued monitoring of APCR and further investigation of the cause of the APCR decrease in Taiwan are warranted. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Examination of Attitudes towards Teaching Online Courses Based on Theory of Reasoned Action of University Faculty in Taiwan

ERIC Educational Resources Information Center

Chen, Tzy-Ling; Chen, Tzu-Jung

2006-01-01

This study examined attitudes of university faculty specialising in the field of human resource (HR) in Taiwan towards participation in the teaching of online courses using the theory of reasoned action (TRA). The population targeted for investigation consisted of the full-time university faculty in the HR field in Taiwan regardless of their…

Incidence of eye cancer in Taiwan: an 18-year review.

PubMed

Cheng, C-Y; Hsu, W-M

2004-02-01

To describe the incidence and histologic patterns of eye cancers in Chinese in Taiwan. Beginning in 1979, cases of cancer in Taiwan were reported to the Taiwan National Cancer Registry. Information on all Chinese patients diagnosed with eye malignancies under the International Classification of Disease, Ninth Revision, site 190, was retrieved for analysis from the data bank of the Taiwan National Cancer Registry. In all, 733 cases with primary eye cancers were identified from 1979 to 1996, an 18-year period. The average annual age-standardized incidence of eye cancers was 2.46 per million population (2.57 for male and 2.33 for female). For cases less than 15 years of age, the most common eye malignancy was retinoblastoma (86.0%), followed by rhabdomyosarcoma (3.9%) and lymphoma (2.8%). For cases 15 years of age or older, the most common eye malignancy was melanoma (28.6%), followed by squamous cell sarcoma (21.0%) and lymphoma (20.8%). The time trends of the incidence of eye cancers were relatively stable over the 18-year period in Taiwan. Retinobalstoma, melanoma, and lymphoma were the three most common eye cancers in this Chinese population.

Social connections and happiness among the elder population of Taiwan.

PubMed

Hsu, H-C; Chang, W-C

2015-01-01

The purpose of this study was to examine the association between social connections and happiness among members of the elder population of Taiwan. Longitudinal panel data collected in three waves from 1999 to 2007 that are selected from national samples of Taiwanese older people were used for the analysis (n = 4731 persons). Happiness was defined as a dichotomous variable. Social connection variables included living arrangements, contacts with children/grandchildren/parents/relatives/friends, telephone contacts, providing instrumental and informational support, receiving instrumental and emotional support, and social participation. We controlled for the variables demographics, physical and mental health, economic satisfaction, and lifestyle. A generalized linear model (GLM) was applied in the analysis. Happiness remained stable over time. Receiving more emotional support and participating in social events were related to happiness at the beginning, while the effect of social participation was offset over time. Living arrangements, telephone contacts, providing social support, and receiving instrumental support were not significant. The quality of social relationships experienced is possibly more important than the quantity of social interaction for older people, and having social relationships outside the informal social network may increase happiness.

Chromosome numbers of populations of three varieties of Bidens pilosa in Taiwan.

PubMed

Huang, Ya-Lun; Kao, Wen-Yuan

2015-12-01

Hairy beggar-ticks (Bidens pilosa L.) is a common invasive plant in tropical and subtropical regions. The Flora of Taiwan listed three varieties of B. pilosa in Taiwan, var. minor, var. pilosa and var. radiata. Among the three varieties, var. radiata was the most recently, in 1970s, introduced into Taiwan. However, after its introduction into Taiwan, var. radiata has become dominant over the other two varieties and is considered a serious invasive plant in lowland of Taiwan. Our previous study showed that var. radiata is self-incompatible and the other two varieties are self-fertile. Could it be possible that different chromosome numbers contribute to the different breeding systems of these three varieties? In addition, the heterogeneities of traits of var. radiata were found higher than those of var. minor and var. pilosa. Is the phenomenon resulting from the hybridization between var. radiata with other varieties? We counted chromosome numbers of populations of these three varieties distributed in Taiwan and conducted hand pollination treatment between var. radiata (as pollen receiver) and var. minor or var. pilosa (as pollen donor) to provide answer for the aforementioned questions. No difference was found in chromosome numbers among populations of the same variety. Forty-eight chromosomes (2n = 48) were counted for var. radiata while 72 (2n = 72) chromosomes for var. minor and var. pilosa. Therefore, var. radiata is tetraploid and var. minor and var. pilosa are hexaploid. No successful hybridization was found between var. radiata and var. minor or between var. radiata and var. pilosa. This study provided the evidence that the invasive plant (B. pilosa var. radiata) has different chromosome numbers from the other two varieties and is unlikely to hybridize with the other two varieties.

The Intention of General Education in Taiwan's Universities: To Cultivate the Holistic Person

ERIC Educational Resources Information Center

Shih, Yi-Huang; Hsu, Jen-Pin; Ye, Yan-Hong

2018-01-01

The cultivation of the holistic person has always been a topic of concern for general education in Taiwan's universities. Hopefully students can attain a more perfect human nature. So the question is how to practice general education to cultivate the holistic person. This is the focus of this article. After reading and analyzing related studies,…

Increased risk of acute pancreatitis in patients with chronic hemodialysis: a 4-year follow-up study.

PubMed

Hou, Sheng-Wen; Lee, Yi-Kung; Hsu, Chen-Yang; Lee, Ching-Chih; Su, Yung-Cheng

2013-01-01

The risk of acute pancreatitis in patients on long-term peritoneal dialysis is higher as compared to the general population. However, the relationship between long-term hemodialysis and acute pancreatitis has never been established. We investigated the incidence of acute pancreatitis among patients on long-term hemodialysis in Taiwan to evaluate if there is a higher risk of acute pancreatitis in comparison to the general population. We utilized a National Health Insurance (NHI) claims data sample containing one million beneficiaries. We followed all adult beneficiaries from January 1, 2007 until December 31, 2010 to see if they had been hospitalized for acute pancreatitis during this period. We further identified patients on chronic hemodialysis and compared their risk of acute pancreatitis with the general population. This study included 2603 patients with long-term hemodialysis and 773,140 patients without hemodialysis. After controlling for age, gender, Charlson Comorbidity Index Score, geographic region, socioeconomic status and urbanization level, the adjusted hazard ratio was 3.44 (95% Confidence interval, 2.5-4.7). The risk of acute pancreatitis in patients on long-term hemodialysis is significantly higher in comparison to the general population.

Incidence of Second Primary Malignancies Following Colorectal Cancer: A Distinct Pattern of Occurrence Between Colon and Rectal Cancers and Association of Co-Morbidity with Second Primary Malignancies in a Population-Based Cohort of 98,876 Patients in Taiwan

PubMed Central

Lee, Yu-Ting; Liu, Chia-Jen; Hu, Yu-Wen; Teng, Chung-Jen; Tzeng, Cheng-Hwai; Yeh, Chiu-Mei; Chen, Tzeng-Ji; Lin, Jen-Kou; Lin, Chun-Chi; Lan, Yuan-Tzu; Wang, Huann-Sheng; Yang, Shung-Haur; Jiang, Jeng-Kai; Chen, Wei-Shone; Lin, Tzu-Chen; Chang, Shih-Ching; Chen, Ming-Huang; Teng, Hao-Wei; Liu, Jin-Hwang; Yen, Chueh-Chuan

2015-01-01

Abstract The purpose of this study is to determine the features of second primary malignancies (SPMs) among patients with prior colorectal cancer (CRC) using a nationwide population-based dataset. Patients with CRC newly diagnosed between 1996 and 2011, and >1 year of follow-up were recruited from the Taiwan National Health Insurance database. Standardized incidence ratios (SIRs) of SPMs in patients with CRC were calculated. During the 16-year study period, 4259 SPMs developed among 98,876 CRC patients. The median duration of follow-up was 4.03 years. The SIR for all SPMs was 1.13 (95% confidence interval = 1.10–1.17). Compared with the general population, a higher incidence of thyroid, prostate, ovarian, and hematologic malignancies developed among patients with colon cancer, whereas the risk for bone and soft tissue cancers increased among patients with rectal cancer. The risk for breast, bladder, kidney, lung, and uterine cancers was significantly higher in patients with colon and rectal cancers than the general population. The risk for liver and biliary tract cancers declined in patients with rectal cancer. Based on multivariate analysis among patients with CRC, age ≥70 years, men, chronic obstructive pulmonary disease (COPD), cirrhosis, and dyslipidemia were independent predictors of an SPM. In conclusion, patients with CRC were at increased risk for a second cancer. The pattern of SPMs was distinct between patients with colon and rectal cancer. Age, men, COPD, cirrhosis, and dyslipidemia were independent risk factors for SPMs. Surveillance and education should be provided for survivors with respect to risk for SPMs. PMID:26131831

The Development of a University for Older Adults in Taiwan: An Interpretive Perspective

ERIC Educational Resources Information Center

Huang, Chin-Shan

2005-01-01

Education for older adults is increasingly becoming a global phenomenon. Taiwan, a small island in the western Pacific Ocean, has responded to the educational needs of its aging population with the development of its version of the University of the Third Age (U3A). However, the title of U3A has never been used in Taiwan. Taiwanese people call…

Culturally Diverse and Underserved Populations of Gifted Students in the United States and in Taiwan: Equitable Access to Gifted Education

ERIC Educational Resources Information Center

Ho, Ya-Ting

2014-01-01

There is a continuing increase in the African American and Hispanic student populations in public schools. The students who are invited to gifted programs are overwhelmingly White. This is the situation in schools in the United States and also in Taiwan. Misunderstanding or unawareness of culture difference among educators might contribute to…

Why Taiwanese Companies and Foundations Donate to Public Colleges and Universities in Taiwan: An Investigation of Donation Incentives, Strategies, and Decision-Making Processes

ERIC Educational Resources Information Center

Lin, Hsien Hong

2009-01-01

The purpose of this investigation was to build the blueprint of Taiwanese public higher education's fundraising. This study applied three surveys (NSH, NSC, and NSF) to three populations' samples (public universities, corporations, and foundations in Taiwan) as well as qualitative interviews toward these three populations in order to explore…

Physician characteristics and prescription drug use during pregnancy: a population-based study.

PubMed

Weng, Sung-Shun; Chen, Yi-Hua; Lin, Ching-Chun; Keller, Joseph J; Wang, I-Te; Lin, Herng-Ching

2013-02-01

We aimed to explore the relationship between physician characteristics and their prescribing behavior regarding category D and X drugs for pregnant women by using a population-based data set in Taiwan. The sampled population for the study included 14,430 women. These women received a total of 198,420 prescriptions during pregnancy. We performed multivariate logistic regression analysis by using generalized estimated equations to assess the odds ratio (OR) of the prescription for categories D and X drugs among doctors after adjusting for maternal age and chronic disease. Of the total 198,420 prescriptions, 4.2% were prescribed category D and X drugs. The covariate-adjusted odds for physicians aged between 40 and 49 years and 50 and 59 years for prescribing category D and X drugs to pregnant women were 1.22 (95% confidence interval [95% CI], 1.15-1.31) and 1.51 (95% CI, 1.40-1.64) times that of physicians aged between 30 and 39 years, respectively. Male physicians were less likely to prescribe category D and X drugs to pregnant women than female physicians (OR, 0.69; 95% CI, 0.63-0.75). In addition, physicians specializing in "other" specialties were more likely (OR, 1.46; 95% CI, 1.41-1.54) to prescribe category D and X drugs compared with those specializing in obstetrics/gynecology, whereas physicians practicing in central Taiwan were less likely (OR, 0.85; 95% CI, 0.80-0.89) than their counterparts in other regions of Taiwan to prescribe category D and X drugs. We conclude that physician characteristics, including sex, age, specialty, and practice location, were associated with the prescription of category D and X drugs for pregnant women. Copyright © 2013 Elsevier Inc. All rights reserved.

Prehospital Predictors of Initial Shockable Rhythm in Out-of-Hospital Cardiac Arrest: Findings From the Taichung Sudden Unexpected Death Registry (THUNDER).

PubMed

Lin, Yen-Nien; Chang, Shih-Sheng; Wang, Lee-Min; Chi, Hwan-Ting; Ueng, Kwo-Chang; Tsai, Chin-Feng; Phan, Chee-Seong; Lu, Li-Hua; Hii, Choon-Hoon; Chung, Yu-Ting; Chugh, Sumeet S; Chen, Ming-Fong; Wu, Tsu-Juey; Chang, Kuan-Cheng

2017-03-01

To identify the incidence and prehospital predictors of ventricular tachycardia/ventricular fibrillation (VT/VF) as the initial arrhythmia in patients with out-of-hospital cardiac arrest (OHCA) in central Taiwan. The Taichung Sudden Unexpected Death Registry program encompasses the Taichung metropolitan area in central Taiwan, with a population of 2.7 million and 17 destination hospitals for patients with OHCA. We performed a detailed analysis of demographic characteristics, circumstances of cardiac arrest, and emergency medical service records using the Utstein Style. From May 1, 2013, through April 30, 2014, resuscitation was attempted in 2013 individuals with OHCA, of which 384 were excluded due to trauma and noncardiac etiologies. Of the 1629 patients with presumed cardiogenic OHCA, 7.9% (n=129) had initial shockable rhythm; this proportion increased to 18.8% (61 of 325) in the witnessed arrest subgroup. Male sex (odds ratio [OR], 2.45; 95% CI, 1.46-4.12; P<.001), age younger than 65 years (OR, 2.39, 95% CI, 1.58-3.62; P<.001), public location of arrest (OR, 4.61; 95% CI, 2.86-7.44; P<.001), and witnessed status (OR, 3.98; 95% CI, 2.62-6.05; P<.001) were independent predictors of VT/VF rhythm. The proportion of patients with OHCA presenting with VT/VF was generally low in this East Asian population. Of the prehospital factors associated with VT/VF, public location of OHCA was the strongest predictor of VT/VF in this population, which may affect planning and deployment of emergency medical services in central Taiwan. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Serotypes, surface proteins, and clinical syndromes of invasive Group B streptococcal infections in northern Taiwan, 1998-2009.

PubMed

Wong, Swee Siang; Tsui, Kochung; Liu, Qin-Dong; Lin, Li-Chen; Tsai, Chim Ren; Chen, Li-Chun; Huang, Cheng Hua

2011-02-01

The incidence of invasive Group B streptococcal (GBS) infections is increasing in the elderly and immunocompromised adults in many countries worldwide. There are, however, few reports regarding the current status of the infection in northern Taiwan. This study investigated retrospectively the molecular epidemiology and clinical syndromes of the invasive GBS diseases in a tertiary care hospital in northern Taiwan over the past decade. One hundred twenty episodes of invasive GBS disease were recorded at Cathay General Hospital, a tertiary care, teaching hospital in northern Taiwan, from January 1998 to June 2009. Clinical information was acquired from medical records. Capsular serotypes and alpha family of surface proteins were genotyped with multiplex and specific polymerase chain reaction. Of all episodes, 58.3% was found in the elderly (age ≥ 65), 36.1% in nonpregnant women and young adults (age 18-64), and 5.9% in the neonates (0-90 days). Case-fatality rate was 6.7%. Eighty-three (69%) of the invasive isolates were available for genotyping. In sharp contrast to the studies in southern Taiwan (1991-2004), Type Ib (26.5%) was the most frequent invasive isolate, followed by V (22.9%), III (18.1%), VI (12%), Ia (10.8%), II (6%), VIII (2.4%), and nontypable strain (1.2%). In particular, Serotype VI, which had been rarely implicated in invasive infection, emerged as a significant pathogen. A significant trend of increase in incidence was observed for the infection (p<0.0001), with concurrent increase of cases in the elderly and of Serotype Ib and VI. There was significant association with young adults of Type II and III and chronic skin conditions and older adults with Type Ia and V and chronic cardiovascular diseases. Type V was closely associated with skin and soft tissue infection. Recurrent episodes (10%) occurred most often in patients with concomitant malignancy, with an average of 314 days for recurrence. The incidence of GBS invasive infection among nonpregnant women and adults is rising in northern Taiwan, particularly in the elderly caused by Serotype Ib and VI. Population-based surveillance program should be implanted for assessment of the disease burden to the susceptible adult population. Copyright © 2011. Published by Elsevier B.V.

Seasonal variations in sleep disorders of nurses.

PubMed

Chang, Yuanmay; Lam, Calvin; Chen, Su-Ru; Sithole, Trevor; Chung, Min-Huey

2017-04-01

To investigate the difference between nurses and the general population regarding seasonal variations in sleep disorders during 2004-2008. The effects of season and group interaction on sleep disorders with regard to different comorbidities were also examined. Studies on seasonal variations in sleep disorders were mainly conducted in Norway for the general population. Furthermore, whether different comorbidities cause seasonal variations in sleep disorders in nurses remains unknown. A retrospective study. Data from the Taiwan National Health Insurance Research Database were used in generalised estimating equation Poisson distribution models to investigate the differences in sleep disorders between nurses and the general population diagnosed with sleep disorders (each n = 7643) as well as the interaction effects of sleep disorders between the groups with respect to different seasons. Furthermore, the interaction effects between groups and seasons on sleep disorders in the subgroups of comorbid anxiety disorders and depressive disorders were studied. Both the nurses and the general population had fewer outpatient visits for sleep disorders in winter than in other seasons. The nurses had fewer outpatient visits for sleep disorders than the general population did in each season. The nurses had more outpatient visits for sleep disorders in winter than in summer compared with the general population in the comorbid depressive disorder subgroup but not in the comorbid anxiety disorder subgroup. Nurses and the general population exhibited similar seasonal patterns of sleep disorders, but nurses had fewer outpatient visits for sleep disorders than the general population did in each season. For nurses with comorbid depressive disorders, outpatient visits for sleep disorders were more numerous in winter than in summer, potentially because nurses with comorbid depressive disorders are affected by shorter daylight exposure during winter. Depression and daylight exposure may be considered in mitigating sleep disorders in nurses. © 2016 John Wiley & Sons Ltd.

Evolutionary history of continental southeast Asians: "early train" hypothesis based on genetic analysis of mitochondrial and autosomal DNA data.

PubMed

Jinam, Timothy A; Hong, Lih-Chun; Phipps, Maude E; Stoneking, Mark; Ameen, Mahmood; Edo, Juli; Saitou, Naruya

2012-11-01

The population history of the indigenous populations in island Southeast Asia is generally accepted to have been shaped by two major migrations: the ancient "Out of Africa" migration ∼50,000 years before present (YBP) and the relatively recent "Out of Taiwan" expansion of Austronesian agriculturalists approximately 5,000 YBP. The Negritos are believed to have originated from the ancient migration, whereas the majority of island Southeast Asians are associated with the Austronesian expansion. We determined 86 mitochondrial DNA (mtDNA) complete genome sequences in four indigenous Malaysian populations, together with a reanalysis of published autosomal single-nucleotide polymorphism (SNP) data of Southeast Asians to test the plausibility and impact of those migration models. The three Austronesian groups (Bidayuh, Selatar, and Temuan) showed high frequencies of mtDNA haplogroups, which originated from the Asian mainland ∼30,000-10,000 YBP, but low frequencies of "Out of Taiwan" markers. Principal component analysis and phylogenetic analysis using autosomal SNP data indicate a dichotomy between continental and island Austronesian groups. We argue that both the mtDNA and autosomal data suggest an "Early Train" migration originating from Indochina or South China around the late-Pleistocene to early-Holocene period, which predates, but may not necessarily exclude, the Austronesian expansion.

Workplace sexual harassment in two general hospitals in Taiwan: the incidence, perception, and gender differences.

PubMed

Wang, Liang-Jen; Chen, Chih-Ken; Sheng, Yi-Chen; Lu, Pei-Wen; Chen, Yi-Ting; Chen, Huei-Jun; Lin, Jyh-Sheng

2012-01-01

The aims of this study were to examine sexual harassment (SH) among hospital staffs in Taiwan, in terms of three-month incidence rate, the frequency of each type and the perception of SH, perpetrated by coworkers, patients and patients' families and to investigate the gender differences for these issues. The subjects were employees at two general hospitals in Taiwan. The self-administered "Hospital Sexual Harassment Questionnaire" was sent to eligible staff, and the voluntary respondents answered the questionnaire anonymously. There were 536 respondents available for analysis, with an overall response rate of 43.4%. The three-month incidence rates of SH by coworkers, patients, and patients' families in our study population were 2.4, 4.3, and 1.7%, respectively. Telling sexual jokes was the most common type of SH. The males had greater opportunities to be exposed to porn videos by their coworkers. The females were more frequently exposed to sex jokes and remarks made by patients and their family members and unwanted physical touching by patients in the workplace. There were significant differences with regard to the perception of sex jokes and sexually explicit verbal descriptions as SH or not between genders. The information in this study can be a helpful reference for administrators in hospitals when they are establishing education plans and policies. It might be possible to prevent sexual harassment and misunderstandings between genders and to further avoid the negative impact on the emotional well-being of workers in hospitals.

Health risk perception and betel chewing behavior--the evidence from Taiwan.

PubMed

Chen, Chiang-Ming; Chang, Kuo-Liang; Lin, Lin; Lee, Jwo-Leun

2013-11-01

In this study, we provided an empirical examination of the interaction between people's health risk perception and betel chewing. We hypothesized that a better knowledge of possible health risks would reduce both the number of individuals who currently chew betel and the likelihood of those who do not yet chew betel to begin the habit. We constructed a simultaneous equation model with Bayesian two-stage approach to control the endogeneity between betel chewing and risk perception. Using a national survey of 26,684 observations in Taiwan, our study results indicated that better health knowledge reduced the possibility that people would become betel chewers. We also found that, in general, betel chewers have a poorer health risk perception than other population. Overall, the empirical evidence suggested that health authorities could reduce the odds of people becoming betel chewers by improving their knowledge of betel-chewing's harmful effects. © 2013 Elsevier Ltd. All rights reserved.

Estimation of Life-Year Loss and Lifetime Costs for Different Stages of Colon Adenocarcinoma in Taiwan

PubMed Central

Chen, Po-Chuan; Lee, Jenq-Chang; Wang, Jung-Der

2015-01-01

Backgrounds and aims Life-expectancy of colon cancer patients cannot be accurately answered due to the lack of both large datasets and long-term follow-ups, which impedes accurate estimation of lifetime cost to treat colon cancer patients. In this study, we applied a method to estimate life-expectancy of colon cancer patients in Taiwan and calculate the lifetime costs by different stages and age groups. Methods A total of 17,526 cases with pathologically verified colon adenocarcinoma between 2002 and 2009 were extracted from Taiwan Cancer Registry database for analysis. All patients were followed-up until the end of 2011. Life-expectancy, expected-years-of-life-lost and lifetime costs were estimated, using a semi-parametric survival extrapolation method and borrowing information from life tables of vital statistics. Results Patients with more advanced stages of colon cancer were generally younger and less co-morbid with major chronic diseases than those with stages I and II. The LE of stage I was not significantly different from that of the age- and sex-matched general population, whereas those of stages II, III, and IV colon cancer patients after diagnosis were 16.57±0.07, 13.35±0.07, and 4.05±0.05 years, respectively; the corresponding expected-years-of-life-lost were 1.28±0.07, 5.93±0.07 and 16.42±0.06 years, significantly shorter than the general population after accounting for lead time bias. Besides, the lifetime cost of managing stage II colon cancer patients would be US $8,416±1939, 14,334±1,755, and 21,837±1,698, respectively, indicating a big saving for early diagnosis and treatment after stratification for age and sex. Conclusions Treating colon cancer at younger age and earlier stage saves more life-years and healthcare costs. Future studies are indicated to apply these quantitative results into the cost-effectiveness evaluation of screening program for colon cancers. PMID:26207912

The Formation of Gender Education Policies in Taiwan, 1995-1999

ERIC Educational Resources Information Center

Hsiao-Chin, Hsieh; Shu-Ching, Lee

2014-01-01

This article discusses the formation of gender equity education policies in Taiwan between 1995 and 1999. The first part of the article presents a general description of Taiwan's women's movement, the education reform movement, and the development of women's/gender studies after the lifting of martial law in 1987. The second part of the article…

The relationship between population density and cancer mortality in Taiwan.

PubMed

Yang, C Y; Hsieh, Y L

1998-04-01

Many investigators have examined urbanization gradients in cancer rates. The purpose of this report was to identify urban-rural trends in cancer mortality rates (1982-1991) for municipalities in Taiwan. For this purpose, Taiwan's municipalities were classified as rural, suburban, urban, or metropolitan, using population density as an ordinal indicator of the degree of urbanization. Average annual age-adjusted, site-specific cancer mortality rates were calculated for both sexes within each population density group. Significant increasing trends with more urbanization were observed in mortality rates for cancers of the lung, pancreas, and kidney among both males and females, as well as male prostate cancer, and female breast and ovary cancer. In addition, this study revealed a significant rural excess for nonmelanoma skin cancer among both males and females, as well as male non-Hodgkin's lymphoma, and cancers of the female bone, and female connective tissue. Analytic studies for sites with consistent urban-rural trends may be fruitful in identifying the aspect of population density, or other unmeasured factors, that contribute to these trends.

Fast-food outlets and walkability in school neighbourhoods predict fatness in boys and height in girls: a Taiwanese population study.

PubMed

Chiang, Po-Huang; Wahlqvist, Mark L; Lee, Meei-Shyuan; Huang, Lin-Yuan; Chen, Hui-Hsin; Huang, Susana Tzy-Ying

2011-09-01

There is increasing evidence that the school food environment contributes to childhood obesity and health in various locations. We investigated the influence of fast-food stores and convenience food stores (FS and CS, respectively) on growth and body composition in a range of residential densities for North-east Asian food culture. Anthropometrics and birth weight of schoolchildren were obtained. Geocoded mapping of schools and food outlets was conducted. Multivariable linear regression models, adjusted for father's ethnicity and education, as well as for household income, pocket money, birth weight, physical activity, television watching, food quality and region, were used to predict body composition from school food environments. Elementary schools and school neighbourhoods in 359 townships/districts of Taiwan. A total of 2283 schoolchildren aged 6-13 years from the Elementary School Children's Nutrition and Health Survey in Taiwan conducted in 2001-2002. Remote and socially disadvantaged locations had the highest prevalence of lower weight, BMI, waist circumference and triceps skinfold thickness. Food store densities, FS and CS, were highest in urban Taiwan and lowest in remote Taiwan. In the fully adjusted models, FS densities predicted weight and BMI in boys; there was a similar association for waist circumference, except when adjusted for region. FS densities also predicted height for girls. Except for weight and BMI in boys, CS did not have effects evident with FS for either boys or girls. A high FS density, more than CS density, in Taiwan increased the risk of general (BMI) and abdominal (waist circumference) obesity in boys and stature in girls. These findings have long-term implications for chronic disease in adulthood.

Seroepidemiology of Toxoplasma gondii Infection among Healthy Blood Donors in Taiwan

PubMed Central

Chiang, Ting-Yi; Hsieh, Hwei-Ho; Kuo, Ming-Chu; Chiu, Kai-Tse; Lin, Wei-Chen; Fan, Chia-Kwung; Fang, Chi-Tai; Ji, Dar-Der

2012-01-01

Toxoplasma gondii is an opportunistic, zoonotic pathogen with a worldwide distribution. There are large variations in the seroprevalence of T. gondii infection in different regions of the world. Although toxoplasmosis became a notifiable communicable disease in Taiwan in 2007, little is known about its epidemiology among the general population. This cross-sectional study aimed to survey the seroprevalence of T. gondii infection and its risk factors among healthy blood donors in Taiwan. Through collaborating with the Taiwan Blood Services Foundation, a total of 1,783 healthy blood donors from all six-branch blood service centers participated in this study. The blood samples were tested for the presence of T. gondii antibodies and DNA using enzyme immunoassays and real-time PCR, respectively. Structured questionnaires were used to gather information on risk factors for T. gondii infection. Of the 1,783 participants, 166 (9.3%) tested positive for anti-Toxoplasma IgG, while 5 (0.28%) tested positive for anti-Toxoplasma IgM. The five IgM positive donors had high avidity antibodies suggestive of past infection. No active parasitemia was detected by real-time PCR assays. Multivariate logistic regression showed that undercooked pork meat consumption (adjusted odds ratio [OR] = 2.9; 95% confidence interval [CI]: 1.3–6.5), raw mussels consumption (adjusted OR = 5.3; 95% CI: 1.5–19.1), having a cat in the household (adjusted OR = 2.0; 95% CI: 1.2–3.2), a lower education level (adjusted OR = 1.6; 95% CI: 1.1–2.3), and donation place in eastern Taiwan (adjusted OR = 2.5; 95% CI: 1.6–3.9) were independent risk factors for Toxoplasma seropositivity. These findings provide information on the seroprevalence and epidemiology of T. gondii infection among healthy blood donors in Taiwan. PMID:23133557

Taiwan's population and family planning efforts: an historical perspective.

PubMed

Cernada, G; Sun, T H; Chang, M C; Tsai, J F

The unprecedented decline of Taiwan's natural population increase rate from 3% in 1963 to 1.9% in 1973, attributed primarily to an increasing use of contraception, brought universal attention to one of the first and most successful national family planning programs, at a time when successes were few. Taiwan met its goal of decreasing its natural increase rate despite its young population, increasing numbers of women of childbearing ages, a strong preference for sons and a per capita income at the outset in 1963 of less than U.S.$200. Recognition of this achievement brought thousands of professionals, particularly from developing countries, to study the program firsthand: more than 3,000 during 1970--73 alone. This was matched by an avalanche of publications about the program that appeared around the world, written by practitioners, academics and others. This article tells the story of this success.

Higher Education Institutional and Program Evaluations in Taiwan and the Emerging Roles of Higher Education Evaluation and Accreditation Council of Taiwan (HEEACT)

ERIC Educational Resources Information Center

Lee, Lung-Sheng; Wei, Yen-Shun; Wang, Li-Yun

2013-01-01

Post-secondary education institutions in Taiwan are divided into two tracks, general higher education (HE) and technological and vocational education (TVE). The evaluation of all universities/colleges is mandated by the University Act. Higher education institutions receive mandated institutional evaluation every six years and program evaluation…

Association between Atmospheric Fine Particulate Matter and Hospital Admissions for Chronic Obstructive Pulmonary Disease in Southwestern Taiwan: A Population-Based Study

PubMed Central

Hwang, Su-Lun; Guo, Su-Er; Chi, Miao-Ching; Chou, Chiang-Ting; Lin, Yu-Ching; Lin, Chieh-Mo; Chou, Yen-Li

2016-01-01

Objectives: This paper reports on the findings of a population-based study to evaluate the relationship between atmospheric fine particulate matter (PM2.5) levels and hospital admissions for chronic obstructive pulmonary disease (COPD) in southwestern Taiwan over a three-year period, 2008–2010. Methods: Data on hospital admissions for COPD and PM2.5 levels were obtained from the National Health Insurance Research database (NHIRD) and the Environmental Protection Administration from 2008 to 2010, respectively. The lag structure of relative risks (RRs) of hospital admissions for COPD was estimated using a Poisson regression model. Results: During the study period, the overall average hospitalization rate of COPD and mean 24-h average level of PM2.5 was 0.18% and 39.37 μg/m3, respectively. There were seasonal variations in PM2.5 concentrations in southwestern Taiwan, with higher PM2.5 concentrations in both spring (average: 48.54 μg/m3) and winter (49.96 μg/m3) than in summer (25.89 μg/m3) and autumn (33.37 μg/m3). Increased COPD admissions were significantly associated with PM2.5 in both spring (February–April) and winter (October–January), with the relative risks (RRs) for every 10 μg/m3 increase in PM2.5 being 1.25 (95% CI = 1.22–1.27) and 1.24 (95% CI = 1.23–1.26), respectively, at a lag zero days (i.e., no lag days). Lag effects on COPD admissions were observed for PM2.5, with the elevated RRs beginning at lag zero days and larger RRs estimates tending to occur at longer lags (up to six days, i.e., lag 0–5 days). Conclusions: In general, findings reveal an association between atmospheric fine particulate matter (PM2.5) and hospital admissions for COPD in southwestern Taiwan, especially during both spring and winter seasons. PMID:27023589

The administrative population report on children with developmental delays in Taiwan, 2003 through 2007.

PubMed

Lin, Jin-Ding; Yen, Chia-Feng; Wu, Jia-Ling; Kang, Shih-Wan

2009-01-01

This paper was a population study with developmental delays and it included an examination of the trends the overtime change trend and reported channels of this group of people in Taiwan. We analyzed data for the present study mainly from the Department of Statistics, Ministry of the Interiors, Taipei, Taiwan: "Number of early intervention for children with developmental delays in Taiwan" from 2003 through 2007. The reported number of children with developmental delays slightly increased from 13,231 to 14,250 (increase rate=7.7%) from the year of 2003 through 2007 in Taiwan. More than one-half of children with developmental delays were reported during the age 3-5 years. Aged 0-2 group has the highest increasing reported numbers in the previous 5 years which changed dramatically increased from 4139 (31.3%) in 2003 to 6201 (43.5%) in 2007 (increase rate=49.8%). The medical care setting was the main reported channel of the children with developmental delays and the results also showed that the reported prevalence of the aged 0-2 developmentally delayed children was 57.4-102.2 per 10,000 children; aged 3-5 was 79.0-105.1 per 10,000 children from the year 2003-2007 in Taiwan. The present concluded that early intervention based on the precise affected population would provide important supports for families of children with developmental delays. Therefore, the health care system should be strengthened to increase the proportion of children identified at the earlier age and to decrease the variability in the age at identification for most of the conditions of children with developmental delays.

Relationship between arsenic-containing drinking water and skin cancers in the arseniasis endemic areas in Taiwan.

PubMed

Cheng, Pai-Shan; Weng, Shih-Feng; Chiang, Chi-Hsuan; Lai, Feng-Jie

2016-02-01

Artesian well-water had high concentrations of arsenic that led to the well-known black foot disease in Taiwan around the 1950s, and the associated cancers including skin cancer, bladder cancers and lung cancers. We sought to estimate the standardized morbidity ratio (SMR) and age-standardized incidence rate (ASIR) of cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in the black foot disease endemic areas (BFDEA) in Taiwan. A nationwide retrospective population-based survey was done with the data from the National Taiwan Cancer Registry Center between 1979 and 2007. Among the 29-year period, there were 11 191 cases with SCC and 13 684 cases with BCC diagnosed pathologically. The incidence rates were 4-6-fold higher for SCC and 3-4-fold higher for BCC in the BFDEA compared with the rest of Taiwan. The SMR decreased after stopping arsenic-containing well-water drinking in the 1970s. The arsenic level in the drinking water, amount of contaminated water intake, occupation and sun-exposure time were not documented. This is the first nationwide, population-based study that shows the relationship between arsenic intoxication and non-melanoma skin cancers (SCC and BCC) through comparing the data in people living in the BFDEA and non-BFDEA in Taiwan. © 2015 Japanese Dermatological Association.

Northward dispersal of sea kraits (Laticauda semifasciata) beyond their typical range

PubMed Central

Park, Jaejin; Kim, Il-Hun; Fong, Jonathan J.; Koo, Kyo-Soung; Choi, Woo-Jin; Tsai, Tein-Shun

2017-01-01

Marine reptiles are declining globally, and recent climate change may be a contributing factor. The study of sea snakes collected beyond their typical distribution range provides valuable insight on how climate change affects marine reptile populations. Recently, we collected 12 Laticauda semifasciata (11 females, 1 male) from the waters around southern South Korea—an area located outside its typical distribution range (Japan, China including Taiwan, Philippines and Indonesia). We investigated the genetic origin of Korean specimens by analyzing mitochondrial cytochrome b gene (Cytb) sequences. Six individuals shared haplotypes with a group found in Taiwan-southern Ryukyu Islands, while the remaining six individuals shared haplotypes with a group encompassing the entire Ryukyu Archipelago. These results suggest L. semifasciata moved into Korean waters from the Taiwan-Ryukyu region via the Taiwan Warm Current and/or the Kuroshio Current, with extended survival facilitated by ocean warming. We highlight several contributing factors that increase the chances that L. semifasciata establishes new northern populations beyond the original distribution range. PMID:28644894

Resolving the ancestry of Austronesian-speaking populations.

PubMed

Soares, Pedro A; Trejaut, Jean A; Rito, Teresa; Cavadas, Bruno; Hill, Catherine; Eng, Ken Khong; Mormina, Maru; Brandão, Andreia; Fraser, Ross M; Wang, Tse-Yi; Loo, Jun-Hun; Snell, Christopher; Ko, Tsang-Ming; Amorim, António; Pala, Maria; Macaulay, Vincent; Bulbeck, David; Wilson, James F; Gusmão, Leonor; Pereira, Luísa; Oppenheimer, Stephen; Lin, Marie; Richards, Martin B

2016-03-01

There are two very different interpretations of the prehistory of Island Southeast Asia (ISEA), with genetic evidence invoked in support of both. The "out-of-Taiwan" model proposes a major Late Holocene expansion of Neolithic Austronesian speakers from Taiwan. An alternative, proposing that Late Glacial/postglacial sea-level rises triggered largely autochthonous dispersals, accounts for some otherwise enigmatic genetic patterns, but fails to explain the Austronesian language dispersal. Combining mitochondrial DNA (mtDNA), Y-chromosome and genome-wide data, we performed the most comprehensive analysis of the region to date, obtaining highly consistent results across all three systems and allowing us to reconcile the models. We infer a primarily common ancestry for Taiwan/ISEA populations established before the Neolithic, but also detected clear signals of two minor Late Holocene migrations, probably representing Neolithic input from both Mainland Southeast Asia and South China, via Taiwan. This latter may therefore have mediated the Austronesian language dispersal, implying small-scale migration and language shift rather than large-scale expansion.

Ophthalmic plastic and orbital surgery in Taiwan.

PubMed

Hsu, Chi-Hsin; Lin, I-Chan; Shen, Yun-Dun; Hsu, Wen-Ming

2014-06-01

We describe in this paper the current status of ophthalmic plastic and orbital surgery in Taiwan. Data were collected from the Bureau of National Health Insurance of Taiwan, the Bulletin of the Taiwan Ophthalmic Plastic and Reconstructive Society, and the Statistics Yearbook of Practicing Physicians and Health Care Organizations in Taiwan by the Taiwan Medical Association. We ascertained that 94 ophthalmologists were oculoplastic surgeons and accounted for 5.8% of 1621 ophthalmologists in Taiwan. They had their fellowship training abroad (most ophthalmologists trained in the United States of America) or in Taiwan. All ophthalmologists were well trained and capable of performing major oculoplastic surgeries. The payment rates by our National Health Insurance for oculoplastic and orbital surgeries are relatively low, compared to Medicare payments in the United States. Ophthalmologists should promote the concept that oculoplastic surgeons specialize in periorbital plastic and aesthetic surgeries. However, general ophthalmologists should receive more educational courses on oculoplastic and cosmetic surgery. Copyright © 2014. Published by Elsevier B.V.

Cancer Incidence in Physicians

PubMed Central

Lee, Yu-Sung; Hsu, Chien-Chin; Weng, Shih-Feng; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

2015-01-01

Abstract Cancer has been the leading cause of death in Taiwan since 1982. Physicians have many health-related risk factors which may contribute to cancer, such as rotating night shift, radiation, poor lifestyle, and higher exposure risk to infection and potential carcinogenic drugs. However, the cancer risk in physicians is not clear. In Taiwan's National Health Insurance Research Database, we identified 14,889 physicians as the study cohort and randomly selected 29,778 nonmedical staff patients as the comparison cohort for this national population-based cohort study. Cox proportional-hazard regression was used to compare the cancer risk between physicians and comparisons. Physician subgroups were also analyzed. Physicians had a lower all-cancer risk than did the comparisons (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.76–0.97). In the sex-based analysis, male physicians had a lower all-cancer risk than did male comparisons (HR 0.82, 95% CI 0.73–0.94); and female physicians did not (HR 1.29, 95% CI 0.88–1.91). In the cancer-type analysis, male physicians had a higher risk of prostate cancer (HR 1.72, 95% CI 1.12–2.65) and female physicians had twice the risk of breast cancer (HR 2.00, 95% CI 1.11–3.62) than did comparisons. Cancer risk was not significantly associated with physician specialties. Physicians in Taiwan had a lower all-cancer risk but higher risks for prostate and breast cancer than did the general population. These new epidemiological findings require additional study to clarify possible mechanisms. PMID:26632715

The relationship between economic conditions and postpartum depression in Taiwan: a nationwide population-based study.

PubMed

Chang, Fung-Wei; Lee, Wen-Ying; Liu, Yueh-Ping; Yang, Jing-Jung; Chen, Shu-Pin; Cheng, Kuan-Chen; Lin, Yan-Cen; Ho, Te-Wei; Chiu, Feng-Hsiang; Hsu, Ren-Jun; Liu, Jui-Ming

2016-11-01

Understanding mothers' economic conditions and postpartum depression (PPD) is important for determining how they will take care of themselves and their infants during the postnatal period, especially for low-income families. This study examined the relationship between economic conditions and PPD to elucidate the effect of economic contraction on PPD. Our population-based nationwide study used 2000-2013 the National Health Insurance Research Database of Taiwan. A total of 1240 newly diagnosed PPD patients were recruited. We used the database of the Directorate General of Budget, Accounting, and Statistics of Executive Yuan of Taiwan for national economic indicators. The correlation between economic indicators and PPD was examined. The PPD incidence was positively correlated with yearly unemployment rate, consumer price index, and gross domestic product. During the great recession of 2008-2009, PPD was positively correlated with inflation rate. Consumer price index had a positive correlation with PPD incidence per month when comparing PPD in 2010 with the economic indicators during the great recession. As this retrospective study evaluated macroeconomic indicators, it is unclear whether the macroeconomic indicators' effect on PPD totally reflects the effect of true personal economic status on PPD. There was a significant association between PPD and economic conditions. This study shows that mothers' familial environment plays an important role in the development of PPD. The impact of the worldwide economic downturn of the great recession on women is persistent. This useful finding may give health policy planners a hint of early discovering and dealing with PPD when worldwide economic downturn. Copyright © 2016 Elsevier B.V. All rights reserved.

Reported Numbers of Patients with Rare Diseases Based on Ten-Year Longitudinal National Disability Registries in Taiwan

ERIC Educational Resources Information Center

Lin, Jin-Ding; Lin, Lan-Ping; Hung, Wen-Jiu

2013-01-01

This paper aims to describe a general demographic picture of patients with rare diseases in Taiwan and particularly focuses on the prevalence of rare diseases over time, age and gender distributions. We analyzed data mainly from the national disability registry from 2002 to 2011 in Taiwan, Republic of China. The results showed that the number of…

Opportunity, Choice, and Burglary Victimization in Taiwan.

PubMed

Kuo, Shih-Ya

2015-07-01

This study examined burglary victimization in Taiwan with an application of the structure-choice model that included four theoretical dimensions: proximity to crime, exposure to crime, target attractiveness, and guardianship. Drawing on the 2000 Taiwan Areas Criminal Victimization Survey, the results of the current study showed a moderate effect of the opportunity model on Taiwan's burglary victimization. Also, this study found both consistent and conflicting findings in the current data. The null effect of motorcycles (including scooters) that represented the concept of target attractiveness in relation to burglary risk reflected a difference in population density and transportation needs between Taiwan and the West. Clearly, the role of social context needs to be understood when studies apply a Western model to a non-Western context. © The Author(s) 2014.

Peptic Ulcer Disease in Healthcare Workers: A Nationwide Population-Based Cohort Study.

PubMed

Lin, Hong-Yue; Weng, Shih-Feng; Lin, Hung-Jung; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Guo, How-Ran; Huang, Chien-Cheng

2015-01-01

Health care workers (HCWs) in Taiwan have heavy, stressful workloads, are on-call, and have rotating nightshifts, all of which might contribute to peptic ulcer disease (PUD). We wanted to evaluate the PUD risk in HCWs, which is not clear. Using Taiwan's National Health Insurance Research Database, we identified 50,226 physicians, 122,357 nurses, 20,677 pharmacists, and 25,059 other HCWs (dieticians, technicians, rehabilitation therapists, and social workers) as the study cohort, and randomly selected an identical number of non-HCW patients (i.e., general population) as the comparison cohort. Conditional logistical regression analysis was used to compare the PUD risk between them. Subgroup analysis for physician specialties was also done. Nurses and other HCWs had a significantly higher PUD risk than did the general population (odds ratio [OR]: 1.477; 95% confidence interval [CI]: 1.433-1.521 and OR: 1.328; 95% CI: 1.245-1.418, respectively); pharmacists had a lower risk (OR: 0.884; 95% CI: 0.828-0.945); physicians had a nonsignificantly different risk (OR: 1.029; 95% CI: 0.987-1.072). In the physician specialty subgroup analysis, internal medicine, surgery, Ob/Gyn, and family medicine specialists had a higher PUD risk than other physicians (OR: 1.579; 95% CI: 1.441-1.731, OR: 1.734; 95% CI: 1.565-1.922, OR: 1.336; 95% CI: 1.151-1.550, and OR: 1.615; 95% CI: 1.425-1.831, respectively). In contrast, emergency physicians had a lower risk (OR: 0.544; 95% CI: 0.359-0.822). Heavy workloads, long working hours, workplace stress, rotating nightshifts, and coping skills may explain our epidemiological findings of higher risks for PUD in some HCWs, which might help us improve our health policies for HCWs.

Intraspecific karyotypic polymorphism is highly concordant with allozyme variation in Lysimachia mauritiana (Primulaceae: Myrsinoideae) in Taiwan: implications for the colonization history and dispersal patterns of coastal plants

PubMed Central

Kono, Yoshiko; Chung, Kuo-Fang; Chen, Chih-Hui; Hoshi, Yoshikazu; Setoguchi, Hiroaki; Chou, Chang-Hung; Oginuma, Kazuo; Peng, Ching-I

2012-01-01

Background and Aims Investigating intraspecific karyotypic and genetic variations jointly can provide unique insights into how historical, ecological and cytogenetic factors influence microevolution. A coastal herb, Lysimachia mauritiana, exhibits extensive karyotypic polymorphism and displays a complex cytogeographic pattern across the Ryukyus. To explore whether a similar degree of chromosomal variation exists south of the Ryukyus, and in an attempt to ascertain the mechanisms that may have generated the patterns, comprehensive sampling was conducted in Taiwan. Methods Karyotypes were analysed at mitotic metaphase for 550 individuals from 42 populations throughout Taiwan Proper and its adjacent islands. In addition, genetic variation was estimated using 12 allozymes (21 loci) of 314 individuals sampled from 12 localities. Key Results Four chromosome numbers and eight cytotypes, including four endemic cytotypes, were detected. Cytotype distributions were highly structured geographically, with single cytotypes present in most populations and four major cytotypes dominating the north, east and south of Taiwan and the Penghu Archipelago. Allozyme variation was very low and F-statistics indicated an extremely high level of population differentiation, implying limited gene flow among populations. Cluster analysis of allozyme variation uncovered four geographic groups, each corresponding perfectly to the four dominant cytotypes. The geographic structure of cytotype distribution and allozyme variation probably resulted from severe genetic drift triggered by genetic bottlenecks, suggesting that Taiwanese populations were likely to be derived from four independent founder events. In the few localities with multiple cytotypes, cytogeographic patterns and inferences of chromosomal evolution revealed a trend of northward dispersal, consistent with the course of the Kuroshio Current that has been influential in shaping the coastal biota of the region. Conclusions The data elucidate the patterns of colonization and the effects of the Kuroshio Current on the distribution of L. mauritiana in Taiwan. These inferences are highly relevant to other coastal plant species in the region and will stimulate further studies. PMID:23022678

International differences in the links between obesity and physiological dysregulation: the United States, England, and Taiwan.

PubMed

Vasunilashorn, Sarinnapha; Kim, Jung Ki; Crimmins, Eileen M

2013-01-01

Excess weight has generally been associated with adverse health outcomes; however, the link between overweight and health outcomes may vary with socioeconomic, cultural, and epidemiological conditions. We examine associations of weight with indicators of biological risk in three nationally representative populations: the US National Health and Nutrition Examination Survey, the English Longitudinal Study of Ageing, and the Social Environment and Biomarkers of Aging Study in Taiwan. Indicators of biological risk were compared for obese (defined using body mass index (BMI) and waist circumference) and normal weight individuals aged 54+. Generally, obesity in England was associated with elevated risk for more markers examined; obese Americans also had elevated risks except that they did not have elevated blood pressure (BP). Including waist circumference in our consideration of BMI indicated different links between obesity and waist size across countries; we found higher physiological dysregulation among those with high waist but normal BMI compared to those with normal waist and normal BMI. Americans had the highest levels of biological risk in all weight/waist groups. Cross-country variation in biological risk associated with obesity may reflect differences in health behaviors, lifestyle, medication use, and culture.

International Differences in the Links between Obesity and Physiological Dysregulation: The United States, England, and Taiwan

PubMed Central

Vasunilashorn, Sarinnapha; Kim, Jung Ki; Crimmins, Eileen M.

2013-01-01

Excess weight has generally been associated with adverse health outcomes; however, the link between overweight and health outcomes may vary with socioeconomic, cultural, and epidemiological conditions. We examine associations of weight with indicators of biological risk in three nationally representative populations: the US National Health and Nutrition Examination Survey, the English Longitudinal Study of Ageing, and the Social Environment and Biomarkers of Aging Study in Taiwan. Indicators of biological risk were compared for obese (defined using body mass index (BMI) and waist circumference) and normal weight individuals aged 54+. Generally, obesity in England was associated with elevated risk for more markers examined; obese Americans also had elevated risks except that they did not have elevated blood pressure (BP). Including waist circumference in our consideration of BMI indicated different links between obesity and waist size across countries; we found higher physiological dysregulation among those with high waist but normal BMI compared to those with normal waist and normal BMI. Americans had the highest levels of biological risk in all weight/waist groups. Cross-country variation in biological risk associated with obesity may reflect differences in health behaviors, lifestyle, medication use, and culture. PMID:23781331

Predictive susceptibility analysis of typhoon induced landslides in Central Taiwan

NASA Astrophysics Data System (ADS)

Shou, Keh-Jian; Lin, Zora

2017-04-01

Climate change caused by global warming affects Taiwan significantly for the past decade. The increasing frequency of extreme rainfall events, in which concentrated and intensive rainfalls generally cause geohazards including landslides and debris flows. The extraordinary, such as 2004 Mindulle and 2009 Morakot, hit Taiwan and induced serious flooding and landslides. This study employs rainfall frequency analysis together with the atmospheric general circulation model (AGCM) downscaling estimation to understand the temporal rainfall trends, distributions, and intensities in the adopted Wu River watershed in Central Taiwan. To assess the spatial hazard of the landslides, landslide susceptibility analysis was also applied. Different types of rainfall factors were tested in the susceptibility models for a better accuracy. In addition, the routes of typhoons were also considered in the predictive analysis. The results of predictive analysis can be applied for risk prevention and management in the study area.

Resilience of aging populations after devastating earthquake event and its determinants - A case study of the Chi-Chi earthquake in Taiwan

NASA Astrophysics Data System (ADS)

Hung, Chih-Hsuan; Hung, Hung-Chih

2016-04-01

1.Background Major portions of urban areas in Asia are highly exposed and vulnerable to devastating earthquakes. Many studies identify ways to reduce earthquake risk by concentrating more on building resilience for the particularly vulnerable populations. By 2020, as the United Nations' warning, many Asian countries would become 'super-aged societies', such as Taiwan. However, local authorities rarely use resilience approach to frame earthquake disaster risk management and land use strategies. The empirically-based research about the resilience of aging populations has also received relatively little attention. Thus, a challenge arisen for decision-makers is how to enhance resilience of aging populations within the context of risk reduction. This study aims to improve the understanding of the resilience of aging populations and its changes over time in the aftermath of a destructive earthquake at the local level. A novel methodology is proposed to assess the resilience of aging populations and to characterize their changes of spatial distribution patterns, as well as to examine their determinants. 2.Methods and data An indicator-based assessment framework is constructed with the goal of identifying composite indicators (including before, during and after a disaster) that could serve as proxies for attributes of the resilience of aging populations. Using the recovery process of the Chi-Chi earthquake struck central Taiwan in 1999 as a case study, we applied a method combined a geographical information system (GIS)-based spatial statistics technique and cluster analysis to test the extent of which the resilience of aging populations is spatially autocorrelated throughout the central Taiwan, and to explain why clustering of resilient areas occurs in specific locations. Furthermore, to scrutinize the affecting factors of resilience, we develop an aging population resilience model (APRM) based on existing resilience theory. Using the APRM, we applied a multivariate regression analysis to identify and examine how various factors connect to the resilience of aging populations. To illustrate the proposed methodology, the study collected data on the resilience attributes, the disaster impacts and damages due to the Chi-Chi earthquake. The data were offered by the National Science and Technology Center for Disaster Reduction, Taiwan, as well as collected from the National Land Use Investigation, official census statistics and questionnaire surveys. 3.Results Integrating cluster analysis with GIS-based spatial statistical analysis, the resilience of aging populations were divided into five clusters of distribution patterns over the 10 years after the Chi-Chi earthquake. It shows that both population and elderly distributions were highly heterogeneous and spatial correlated across the study areas. We also demonstrated the 'hot spots' areas of the highly concentrated aging population across central Taiwan. Results of regression analysis disclosed the major factors that caused low resilience and changes of aging population distributions over time. These factors included the levels of seismic damage, infrastructure investments, as well as the land-use and socioeconomic attributes associated with the disaster areas. Finally, our findings provide stakeholders and policy-makers with better adaptive options to design and synthesize appropriate patchworks of planning measures for different types of resilience areas to reduce earthquake disaster risk.

The Relationship between Population Density and Cancer Mortality in Taiwan

PubMed Central

Hsieh, Ya‐Lun

1998-01-01

Many investigators have examined urbanization gradients in cancer rates. The purpose of this report was to identify urban‐rural trends in cancer mortality rates (1982–1991) for municipalities in Taiwan. For this purpose, Taiwan's municipalities were classified as rural, suburban, urban, or metropolitan, using population density as an ordinal indicator of the degree of urbanization. Average annual age‐adjusted, site‐specific cancer mortality rates were calculated for both sexes within each population density group. Significant increasing trends with more urbanization were observed in mortality rates for cancers of the lung, pancreas, and kidney among both males and females, as well as male prostate cancer, and female breast and ovary cancer. In addition, this study revealed a significant rural excess for nonmelanoma skin cancer among both males and females, as well as male non‐Hodgkin's lymphoma, and cancers of the female bone, and female connective tissue. Analytic studies for sites with consistent urban‐rural trends may be fruitful in identifying the aspect of population density, or other unmeasured factors, that contribute to these trends. PMID:9617339

Elementary School Teachers' Beliefs and Instructional Behaviors Regarding Biethnic Students in Taiwan

ERIC Educational Resources Information Center

Yang, Hui-Ching

2011-01-01

In recent years, the increasing biethnic population, called the "new Taiwanese" or "children of new immigrants" has impacted the education system in Taiwan, which is not fully acknowledged. The particular ethnic, linguistic, and cultural backgrounds of these biethnic students are not used as resources or knowledge foundations…

Development of University Counseling Profession in Taiwan

ERIC Educational Resources Information Center

Lin, Yii-nii; Chiu, Yi-Hsing Claire; Hsieh, Hui-Hsing; Chen, Yien-Hua; Lai, Pi-hui

2015-01-01

This article was to elaborate the development of the university counseling profession in Taiwan through an intensive literature review. The university student body has been expanding radically in the last three decades, and the student population, as well as their problems, have become more diverse and complex. Thus, the importance of university…

Determinants of Prescription Drug Use by Adolescents with Intellectual Disabilities in Taiwan

ERIC Educational Resources Information Center

Yen, Chia-Feng; Lin, Jin-Ding; Loh, Ching-Hui; Shi, Leiyu; Hsu, Shang-Wei

2009-01-01

Direct family caregivers of population-based adolescents with intellectual disabilities in Taiwan were surveyed regarding their perceptions of the use of prescribed medication and its relationship with health-related behaviors, medical care and preventive health utilization of people with intellectual disabilities. Cross-sectional data on 1419…

Disease burden and epidemiology of herpes zoster in pre-vaccine Taiwan.

PubMed

Lin, Yung-Hsiu; Huang, Li-Min; Chang, I-Shou; Tsai, Fang-Yu; Lu, Chun-Yi; Shao, Pei-Lan; Chang, Luan-Yin

2010-02-03

Herpes zoster, a common disease, has an important impact on the health of adults, particularly the elderly, and the health system. This study evaluated the disease burden and epidemiological characteristics of herpes zoster in Taiwan. Using herpes zoster-related ICD-9-CM codes used on Taiwan's National Health Insurance claims, we analyzed overall and age group differences in incidence, complications, utilization of healthcare facilities, lengths of stay, and cost of their medical care in Taiwan's population from 2000 to 2005. The overall annual incidence of zoster was 4.97 cases per 1000 people, with women having a significantly higher incidence than men (5.20 per 1000 vs. 4.72 per 1000, p<0.001). The incidence increased stepwise with age, with 5.18 cases per 1000 in people 40-50 years old, 8.36 in those 50-60, 11.09 in those 60-70, and 11.77 in those above 70 years old. The estimated lifetime risk of developing herpes zoster was 32.2%. Zoster-related hospitalizations and medical cost per patient increased with age. In conclusion, about two-thirds of Taiwan's zoster cases occur in adults older than 40 years old and about one-third of the population would develop zoster within their lifetime. (c) 2009 Elsevier Ltd. All rights reserved.

Roles of General Practitioners in the Provision of Health Care Services for People with Intellectual Disabilities: A National Census in Taiwan

ERIC Educational Resources Information Center

Lin, Jin-Ding; Hsu, Shang-Wei; Yen, Chia-Feng; Chou, Ying-Ting; Wu, Chia-Ling; Chu, Cordia M.; Loh, Ching-Hui

2009-01-01

Aims: The aims of the present study were to explore the perceptions of general practitioners (GPs) in the provision of health care services for people with intellectual disabilities and to analyse GPs' priorities in the delivery of health care services to this group of people in Taiwan. Methods: The study employed a cross-sectional design and was…

The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis

PubMed Central

2012-01-01

Background Pesticide self-poisoning is the most commonly used suicide method worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a major public health problem. This study aims to investigate geographic variations in pesticide suicide and their impact on the spatial distribution of suicide in Taiwan. Methods Smoothed standardized mortality ratios for pesticide suicide (2002-2009) were mapped across Taiwan's 358 districts (median population aged 15 or above = 27 000), and their associations with the size of agricultural workforce were investigated using Bayesian hierarchical models. Results In 2002-2009 pesticide poisoning was the third most common suicide method in Taiwan, accounting for 13.6% (4913/36 110) of all suicides. Rates were higher in agricultural East and Central Taiwan and lower in major cities. Almost half (47%) of all pesticide suicides occurred in areas where only 13% of Taiwan's population lived. The geographic distribution of overall suicides was more similar to that of pesticide suicides than non-pesticide suicides. Rural-urban differences in suicide were mostly due to pesticide suicide. Areas where a higher proportion of people worked in agriculture showed higher pesticide suicide rates (adjusted rate ratio [ARR] per standard deviation increase in the proportion of agricultural workers = 1.58, 95% Credible Interval [CrI] 1.44-1.74) and overall suicide rates (ARR = 1.06, 95% CrI 1.03-1.10) but lower non-pesticide suicide rates (ARR = 0.91, 95% CrI 0.87-0.95). Conclusion Easy access to pesticides appears to influence the geographic distribution of suicide in Taiwan, highlighting the potential benefits of targeted prevention strategies such as restricting access to highly toxic pesticides. PMID:22471759

The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis.

PubMed

Chang, Shu-Sen; Lu, Tsung-Hsueh; Sterne, Jonathan Ac; Eddleston, Michael; Lin, Jin-Jia; Gunnell, David

2012-04-02

Pesticide self-poisoning is the most commonly used suicide method worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a major public health problem. This study aims to investigate geographic variations in pesticide suicide and their impact on the spatial distribution of suicide in Taiwan. Smoothed standardized mortality ratios for pesticide suicide (2002-2009) were mapped across Taiwan's 358 districts (median population aged 15 or above = 27 000), and their associations with the size of agricultural workforce were investigated using Bayesian hierarchical models. In 2002-2009 pesticide poisoning was the third most common suicide method in Taiwan, accounting for 13.6% (4913/36 110) of all suicides. Rates were higher in agricultural East and Central Taiwan and lower in major cities. Almost half (47%) of all pesticide suicides occurred in areas where only 13% of Taiwan's population lived. The geographic distribution of overall suicides was more similar to that of pesticide suicides than non-pesticide suicides. Rural-urban differences in suicide were mostly due to pesticide suicide. Areas where a higher proportion of people worked in agriculture showed higher pesticide suicide rates (adjusted rate ratio [ARR] per standard deviation increase in the proportion of agricultural workers = 1.58, 95% Credible Interval [CrI] 1.44-1.74) and overall suicide rates (ARR = 1.06, 95% CrI 1.03-1.10) but lower non-pesticide suicide rates (ARR = 0.91, 95% CrI 0.87-0.95). Easy access to pesticides appears to influence the geographic distribution of suicide in Taiwan, highlighting the potential benefits of targeted prevention strategies such as restricting access to highly toxic pesticides.

Different gene preferences of maple syrup urine disease in the aboriginal tribes of Taiwan.

PubMed

Hou, Jia-Woei; Hwang, Tsann-Long

2014-06-01

Maple syrup urine disease (MSUD) is a rare inborn error of metabolism caused by a deficiency of the branched-chain α-ketoacid dehydrogenase (BCKD) complex. Mutations in any one of the three different genes encoding for the BCKD components, namely, BCKDHA, BCKDHB, and DBT, may be responsible for this disease. In Taiwan, few MSUD cases were diagnosed clinically, and most of these patients are from Aboriginal tribes. To identify and detect the carrier frequency of MSUD in Taiwanese Aboriginal tribes, we performed biochemical and molecular studies from peripheral blood in MSUD patients and dried blood on filter paper in the enrolled screened populations. Homozygous A208T and I281T of BCKDHA were found in two patients from Hans (non-Aboriginal Taiwanese), respectively; compound heterozygous mutations of the DBT gene [4.7 kb deletion/c.650-651insT (L217F or L217fsX223) and c.650-651insT/c.88-89delAT] were found in two patients from Amis, respectively, after direct DNA sequencing and polymerase chain reaction-restriction fragment length polymorphism studies. There were no cases of deleted 4.7-kb heterozygote out of 302 normal people (Hans, n = 125; Atayal, n = 156; and Saisiyat, n = 21); by contrast, the DBT mutations c.650-651insT and deleted 4.7-kb heterozygote were noted in 2/121 and 1/121, respectively, from the general population of the Amis, a southeastern Taiwanese tribe. Although the Taiwanese Austronesian Aboriginal tribes are considered to share a common origin, different gene preferences of MSUD were noted. The novel DBT mutation c.650-651insT was more prevalent than the deleted 4.7-kb heterozygote in the Amis population. The reported 4.7-kb deletion indicating a possible founder mutation may be preserved in the southern and eastern, but not in northern Aboriginal tribes of Taiwan. Copyright © 2013. Published by Elsevier B.V.

Drug-use pattern of Chinese herbal medicines in insomnia: a 4-year survey in Taiwan.

PubMed

Chen, L-C; Chen, I-C; Wang, B-R; Shao, C-H

2009-10-01

Insomnia is a common complaint in the general population. Interest in the use of alternative treatments for insomnia is increasing exponentially and is fairly common in Taiwan. We undertook a survey to define the drug utilization patterns of Chinese herbal medicines (CM) for insomnia in Taiwan. The survey was conducted over a period of 4 years, from January 2003 to December 2006. Outpatients with primary insomnia and being treated with CM were studied. Core drug-use indicators were the number of CM items per prescription, the dosing frequency and duration of CM prescriptions, the most common prescribed CM herbs and CM formulae used. Six thousand eight hundred and sixty patients, using 37,046 CM herb items, were screened during the study period. The average CM items per prescription was 5.40. Most of prescriptions (95.23%) were prescribed for administration three times a day. The most often prescribed Chinese herbal products were Hong-Hwa (Carthamus tinctorius) and Jia-Wey-Shiau-Yau-San, which includes Angelica sinensis, Atractylodes macrocephala, Paeonia lactiflora, Bupleurum chinense, and Poria coco. This is the first extensive survey examining the drug utilization patterns of Chinese herbal medicines in the treatment of insomnia. Although the data were generated in Taiwan, the herbs and practices identified are likely to be widely generalizable wherever Chinese herbal remedies are used for insomnia. Multiple herbs and complex formulae were commonly used. The baseline data generated should be of use in informing subsequent studies, including those aimed at a thorough evaluation of the herbs' effectiveness.

Lower Birth Weight and Diet in Taiwanese Girls More than Boys Predicts Learning Impediments

ERIC Educational Resources Information Center

Lee, Meei-Shyuan; Huang, Lin-Yuan; Chang, Yu-Hung; Huang, Susana Tzy-Ying; Yu, Hsiao-Li; Wahlqvist, Mark L.

2012-01-01

Possible links between lower birth weight, childhood diet, and learning in Taiwan are evaluated. The population representative Elementary School Children's Nutrition and Health Survey in Taiwan 2001-2002 and the national birth registry were used to examine school and social performance using the modified Scale for Assessing Emotional Disturbance…

Construction and Validation of an Instrument to Measure Taiwanese Elementary Students' Attitudes toward Their Science Class

NASA Astrophysics Data System (ADS)

Wang, Tzu-Ling; Berlin, Donna

2010-12-01

The main purpose of this study is to develop a valid and reliable instrument for measuring the attitudes toward science class of fourth- and fifth-grade students in an Asian school culture. Specifically, the development focused on three science attitude constructs-science enjoyment, science confidence, and importance of science as related to science class experiences. A total of 265 elementary school students in Taiwan responded to the instrument developed. Data analysis indicated that the instrument exhibited satisfactory validity and reliability with the Taiwan population used. The Cronbach's alpha coefficient was 0.93 for the entire instrument indicating a satisfactory level of internal consistency. However, both principal component analysis and parallel analysis showed that the three attitude scales were not unique and should be combined and used as a general "attitudes toward science class" scale. The analysis also showed that there were no gender or grade-level differences in students' overall attitudes toward science class.

Cognitive function and associated factors among older people in Taiwan: age and sex differences.

PubMed

Li, Cheng-Lun; Hsu, Hui-Chuan

2015-01-01

The aim of this study was to examine cognitive function and the risk and the protective factors by age and sex among Taiwanese older people. The data were from a nation-representative panel of older people in Taiwan. The participants completing both the 2003 and 2007 waves were included for analysis in this study (n=3228). Descriptive analysis and generalized linear model were applied, and the samples were stratified by age groups and by sex. The factors related to higher cognitive function at the intercept included being younger, male, higher education, and doing unpaid work. At the time slope, the age effect and physical function difficulties would reduce the cognitive function across time, while education and providing informational support would increase the cognitive function across time. There were age- and sex-differences in the factors related to cognitive function, particularly on the working status and social participation. Different health promotion strategies to target these populations should be accordingly developed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Cancer incidence patterns among children and adolescents in Taiwan from 1995 to 2009: a population-based study.

PubMed

Hung, Giun-Yi; Horng, Jiun-Lin; Lee, Yu-Sheng; Yen, Hsiu-Ju; Chen, Chao-Chun; Lee, Chih-Ying

2014-11-15

Currently, little information is available on childhood cancer incidence rates in Eastern Asia. The objective of this study was to report the first population-based cancer surveillance of children and adolescents in Taiwan. Data from the Taiwan Cancer Registry were examined for cancer frequencies and incidence rates among individuals ages birth to 19 years from 1995 to 2009. Types of cancers were grouped according to the International Classification of Childhood Cancer. Rates were compared by sex and age. For further comparisons with other countries, rates were age standardized to the 2000 world standard population in 5-year age groups. Trends in incidence rates also were evaluated. In total, 12,315 individuals were diagnosed with childhood cancers, for an age-standardized incidence rate (ASR) of 132.1 per million person-years from 1995 to 2009. The male-to-female incidence rate ratio was 1.19. Overall, leukemias were the most common cancer (ASR, 39.1 per million person-years), followed by central nervous system neoplasms (15.8 per million person-years), and lymphomas (15.3 per million person-years). During the 15-year study period, the incidence rates increased by 1% annually. Compared with other countries, the rate of hepatic tumors was 2 times greater in Taiwan. The rate of germ cell neoplasms in Taiwan was similar to that in the United States and was 1.3 to 1.9 times greater compared with Canada, Brazil, Israel, and Japan. Based on the current data, the observed increase in overall incidence rates was attributable only marginally to improvements in case ascertainment and diagnostic procedures. The high rates of malignant hepatic tumors and germ cell neoplasms in Taiwan suggest variations in the background risk factors. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Impact of universal health coverage on suicide risk in newly diagnosed cancer patients: Population-based cohort study from 1985 to 2007 in Taiwan.

PubMed

Lin, Po-Hsien; Liao, Shih-Cheng; Chen, I-Ming; Kuo, Po-Hsiu; Shan, Jia-Chi; Lee, Ming-Been; Chen, Wei J

2017-11-01

National Health Insurance (NHI), launched in 1995 in Taiwan, lightens patient's financial burdens but its effect on the suicide risk in cancer patients is unclear. We aimed to investigate the impacts of the NHI on the suicide in newly diagnosed cancer patients. We identified patients with newly diagnosed cancer from the nationwide Taiwan Cancer Registration from 1985 to 2007, and ascertained suicide deaths from the national database of registered deaths between 1985 and 2009. Standardized mortality ratio (SMR) of suicide risk among patients with cancer was calculated, and the suicide risk ratios were examined by gender, age group, and prognosis. For the 916 337 registered cancer patients with 4 300 953 person-years, 2 543 died by suicide, with a suicide rate of 59.1 per 100 000 person-years. Compared to the general population, cancer patients had an SMR of 2.47 for suicide, with a higher figure for males (2.73), age 45 to 64 (2.89), and cancer of poor prognosis (3.19). The suicide risk was highest in the first 2 years after the initial diagnosis. Comparing the cohorts of the period before (1985 to 1992) and after (1996 to 2007) the launch of NHI, we saw a reduction in the SMR within the first 2 years after cancer diagnosis (20%), with more prominent reduction for females (29%), age under 45 (69%), and cancer of good prognosis (33%). A universal health coverage relieving both physical and psychological distress may account for the post-NHI reduction of immediate suicide risk in patients of newly diagnosed cancer. Copyright © 2017 John Wiley & Sons, Ltd.

[The medical autonomy of elderly in Taiwan].

PubMed

Chen, Kai-Li; Chen, Ching-Huey

2014-10-01

The elderly population is increasing rapidly in Taiwan. With the average life expectancy on the rise, the elderly have become major consumers of healthcare products and services. Factors that influence respect for autonomy, a core value of medical ethics, may be related to family, society, and the medical culture. Especially in patients who are already elderly, aging causes declines in physical, mental and societal capacities. Practicing a respect for patient autonomy is particularly challenging for healthcare professionals in Taiwan due the unique culture background of elderly Taiwanese patients. This article reviews and integrates the literature related to the issue of patient autonomy and elaborates on medical decision-making among elderly patients in Taiwan in the contexts of: the disadvantages faced by the elderly, the background of Chinese culture, and the current medical decision-making environment. A few suggestions are proposed to help preserve the medical-decision-making autonomy of elderly patients in Taiwan.

Arsenic speciation in rice and risk assessment of inorganic arsenic in Taiwan population.

PubMed

Chen, Hsiu-Ling; Lee, Ching-Chang; Huang, Winn-Jung; Huang, Han-Ting; Wu, Yi-Chen; Hsu, Ya-Chen; Kao, Yi-Ting

2016-03-01

This study assessed the total arsenic content and arsenic speciation in rice to determine the health risks associated with rice consumption in various age-gender subgroups in Taiwan. The average total arsenic levels in white rice and brown rice were 116.6 ± 39.2 and 215.5 ± 63.5 ng/g weight (n = 51 and 13), respectively. The cumulative cancer risk among males was 10.4/100,000. The highest fraction of inorganic/total arsenic content in white rice ranged from 76.9 to 88.2 % and from 81.0 to 96.5 % in brown rice. The current study found different arsenic speciation of rice in southern Taiwan, where the famous blackfoot disease has been reported compared with arsenic speciation from other Taiwan areas. Therefore, rice and other grains should be further monitored in southern Taiwan to evaluate whether arsenic contamination is well controlled in this area.

New geomorphic data on the active Taiwan orogen: A multisource approach

NASA Technical Reports Server (NTRS)

Deffontaines, B.; Lee, J.-C.; Angelier, J.; Carvalho, J.; Rudant, J.-P.

1994-01-01

A multisource and multiscale approach of Taiwan morphotectonics combines different complementary geomorphic analyses based on a new elevation model (DEM), side-looking airborne radar (SLAR), and satellite (SPOT) imagery, aerial photographs, and control from independent field data. This analysis enables us not only to present an integrated geomorphic description of the Taiwan orogen but also to highlight some new geodynamic aspects. Well-known, major geological structures such as the Longitudinal Valley, Lishan, Pingtung, and the Foothills fault zones are of course clearly recognized, but numerous, previously unrecognized structures appear distributed within different regions of Taiwan. For instance, transfer fault zones within the Western Foothills and the Central Range are identified based on analyses of lineaments and general morphology. In many cases, the existence of geomorphic features identified in general images is supported by the results of geological field analyses carried out independently. In turn, the field analyses of structures and mechanisms at some sites provide a key for interpreting similar geomorphic featues in other areas. Examples are the conjugate pattern of strike-slip faults within the Central Range and the oblique fold-and-thrust pattern of the Coastal Range. Furthermore, neotectonic and morphological analyses (drainage and erosional surfaces) has been combined in order to obtain a more comprehensive description and interpretation of neotectonic features in Taiwan, such as for the Longitudinal Valley Fault. Next, at a more general scale, numerical processing of digital elevation models, resulting in average topography, summit level or base level maps, allows identification of major features related to the dynamics of uplift and erosion and estimates of erosion balance. Finally, a preliminary morphotectonic sketch map of Taiwan, combining information from all the sources listed above, is presented.

Taiwan-U.S. Relations: Recent Developments and Their Policy Implications

DTIC Science & Technology

2008-10-03

Olympics (August) and the Paralympic Games (September). For instance, while appearing more conciliatory in a reported letter to U.N. Secretary-General... Games . A 1989 agreement stipulated that Taiwan be called “Zhonghua Taipei” — or “Chinese Taipei,” a term suggesting a more ambiguous Chinese...would use to refer to Taiwan during the 2008 Olympic Games .22 Taiwan’s Ministry of National Defense also has said that acquiring submarines — a move

Taiwan-U.S. Relations: Recent Developments and Their Policy Implications

DTIC Science & Technology

2008-10-27

August) and the Paralympic Games (September). For instance, while appearing more conciliatory in a reported letter to U.N. Secretary-General Ban Ki...official PRC sources had been using “Zhongguo Taipei” — or “Taipei, China,” leading up to the Olympic Games . A 1989 agreement stipulated that Taiwan be...MOFA unsurprised by PRC reaction to U.N. participation,” Taipei Times, August 28, 2008, p. 1. Taiwan during the 2008 Olympic Games .24 Taiwan’s

Differences in Spontaneous Intracerebral Hemorrhage Cases between Urban and Rural Regions of Taiwan: Big Data Analytics of Government Open Data.

PubMed

Ting, Hsien-Wei; Chien, Ting-Ying; Lai, K Robert; Pan, Ren-Hao; Wu, Kuan-Hsien; Chen, Jun-Min; Chan, Chien-Lung

2017-12-10

This study evaluated the differences in spontaneous intracerebral hemorrhage (sICH) between rural and urban areas of Taiwan with big data analysis. We used big data analytics and visualization tools to examine government open data, which included the residents' health medical administrative data, economic status, educational status, and relevant information. The study subjects included sICH patients of Taipei region (29,741 cases) and Eastern Taiwan (4565 cases). The incidence of sICH per 100,000 population per year in Eastern Taiwan (71.3 cases) was significantly higher than that of the Taipei region (42.3 cases). The mean coverage area per hospital in Eastern Taiwan (452.4 km²) was significantly larger than the Taipei region (24 km²). The residents educational level in the Taipei region was significantly higher than that in Eastern Taiwan. The mean hospital length of stay in the Taipei region (17.9 days) was significantly greater than that in Eastern Taiwan (16.3 days) ( p < 0.001). There were no significant differences in other medical profiles between two areas. Distance and educational barriers were two possible reasons for the higher incidence of sICH in the rural area of Eastern Taiwan. Further studies are necessary in order to understand these phenomena in greater depth.

Impacts of climate change on the population health associated with pluvial disaster

NASA Astrophysics Data System (ADS)

Pan, Tsung-Yi; Chang, Tsang-Jung; Cheng, Ke-Sheng; Lai, Jihn-Sung; Chang, Hsiang-Kuan; Wu, Yii-Chen; Ho, Hao-Wei

2013-04-01

Many metropolises located in lowlands suffer pluvial inundation disaster more than pluvial flood disaster. During the post-inundation period, some water-borne illnesses would be induced from the polluted area. For improving mitigation strategies, population health risk assessment is an important tool of post-inundation disaster management, especially in the countries suffering tropical cyclones and monsoon with high frequency. Locating in the hot zone of typhoon tracks in the Western Pacific, Taiwan suffers three to five typhoons annually. Furthermore, the trend of 24 global circulation models (GCMs) shows that climate change would enhance rainfall in Taiwan. The purpose of this study is to evaluate the impacts of climate change on the population health associated with pluvial disaster. This study applies the concept that risk is composed by hazard and vulnerability to assess the risk of the population health associated with pluvial disaster. Stochastic simulation of bi-variate Gamma distribution is developed to downscale the GCMs' monthly data to extreme rainfall event scale in time domain. According to A1B scenario in short-term period of climate change, two-dimensional overland-flow coupled with drainage systems simulation is performed based on a design extreme rainfall event to calculate the impacts of climate change on pluvial hazard to population health, including flood depth, velocity and the duration of flood recession. The environmental vulnerability for population health is carried out according to the factors of resident and environment. The risk matrix is applied to show the risk by composing the inundation hazards and vulnerabilities associated with population health. The Taipei City, the Capital of Taiwan, is selected as the case study because the highest density of population in Taiwan causes high exposure to the risk of water-borne illnesses. Through assessing the impacts of climate change on the population health associated with pluvial disaster of the Taipei City, the analytical results of pluvial-induced health risk can provide useful information for setting mitigation strategies of post-inundation disaster management. Keywords: climate change, population health, pluvial disaster.

Genetic analysis of eight population groups living in Taiwan using a 13 X-chromosomal STR loci multiplex system.

PubMed

Hwa, Hsiao-Lin; Lee, James Chun-I; Chang, Yih-Yuan; Yin, Hsiang-Yi; Chen, Ya-Hui; Tseng, Li-Hui; Su, Yi-Ning; Ko, Tsang-Ming

2011-01-01

A 13 X-chromosomal short tandem repeat (STR) multiplex system (DXS6807, DXS8378, DSX9902, DXS7132, DXS9898, DXS6809, DXS6789, DXS7424, DXS101, GATA172D05, HPRTB, DXS8377, and DXS7423) was tested on 1,037 DNA samples from eight population groups currently living in Taiwan. Different distributions of the allelic frequencies in different populations were presented. DXS8377 and DXS101 were the two most polymorphic loci in these eight populations, whereas DXS7423 was the least informative marker in most of the populations studied. The genetic distances between the populations and the constructed phylogenetic tree revealed a long genetic distance between Asian and Caucasian populations as well as isolation of the Tao population. The phylogenetic tree grouped populations into clusters compatible with their ethnogeographic relationships. This 13 X-chromosomal short tandem repeat multiplex system offers a considerable number of polymorphic patterns in different populations. This system can be useful in forensic identification casework and ethnogeographic research.

Utilization of nuclear medicine scintigraphy in Taiwan, 1997-2009.

PubMed

Hung, Mao-Chin; Hsieh, Wanhua Annie; Chang, Peter Wushou; Hwang, Jeng-Jong

2011-12-01

To analyze the utilization of nuclear medicine scintigraphy in the Taiwanese population within the national health-care system between 1997 and 2009. Based on the Taiwan's National Health Insurance Research Database of 1997-2009, a retrospective population-based analysis was conducted. Descriptive statistics and regression analysis were employed to analyze the frequencies and longitudinal trends in the utilization of diagnostic nuclear medicine procedures during the period. In addition, correlation analysis was applied to determine the correlated factors in the utility of nuclear medicine scintigraphy. The annual total nuclear medicine scintigraphy was estimated to be 256,389 on average in 1997-2009 and 11.7 per 1,000 population over the period. The frequency had increased by 67% over the years, from 8.2 per 1,000 population in 1997 to 13.7 per 1,000 population in 2009. The most frequently performed procedures were whole-body bone scans (33.4% of total) and myocardial perfusion scans (29.4% of total), with 4,615 and 5,620 increments per year, respectively. Most patients were in the age group of 41-65 years old when taking examinations. In addition, male subjects were slightly more than female patients (51.5 vs. 48.5%). Furthermore, the frequencies of whole-body bone scans and PET scans were proportional to the incidences of cancers (correlation coefficients were 0.96 and 0.94, respectively). The utilization of nuclear medicine scintigraphy with the National Health Insurance system in Taiwan has been changed considerably in the past 13 years. Both whole-body bone scan and myocardial perfusion scan were performed most often with significantly increases. The trend of nuclear medicine scintigraphy may have potential impact on making health-care policy in Taiwan.

Monotherapy of aspirin or warfarin for prevention of ischemic stroke in low-risk atrial fibrillation: A Easter Asian population-based study.

PubMed

Liu, Chieh-Yu; Chen, Hui-Chun

2018-05-02

This study aimed to investigate the effectiveness of monotherapy aspirin and warfarin for stroke prevention in low-risk atrial fibrillation (AF) by using a population-based cohort study in Taiwan. A newly diagnosed low-risk AF patient cohort were identified by using National Health Insurance Research Database (NHIRD) in Taiwan in 2008. The study cohort was observed with a follow-up of 2 years to examine the onset of ischemic stroke (IS) (to 2010). The longitudinal data were analyzed by using generalized estimation equations (GEE). A total of 8,065 newly-diagnosed low-risk AF patients were identified in 2008. 7.4% were prescribed with aspirin and 4.6% were prescribed with warfarin. The GEE results showed that low-risk AF patients with hypertension who received warfarin were associated with a statistically significant 58.4% reduction of IS risk (OR = 0.416, p = 0.024, 95% CI 0.194-0.891). Additionally, low-risk AF patients with hyperlipidemia who received warfarin were associated with a 69.3% reduction of IS risk (OR = 0.307, p = 0.044, 95% CI 0.097-0.969). Warfarin is suggested to be prescribed in preventing ischemic stroke for low-stroke-risk atrial fibrillation patients with hypertension and hyperlipidemia.

Health Care Utilization and Expenditures of Patients with Diabetes Comorbid with Depression Disorder: A National Population-Based Cohort Study.

PubMed

Huang, Chun-Jen; Hsieh, Hui-Min; Chiu, Herng-Chia; Wang, Peng-Wei; Lee, Mei-Hsuan; Li, Chih-Yi; Lin, Ching-Hua

2017-11-01

The study investigated to compare health care utilization and expenditures between diabetic patients with and without depression in Taiwan. Health care utilization and expenditure among diabetic patients with and without depression disorder during 2000 and 2004 were examined using Taiwan's population-based National Health Insurance claims database. Health care utilization included outpatient visits and the use of inpatient services, and health expenditures were outpatient, inpatient, and total medical expenditures. Moreover, general estimation equation models were used for analyzing the factors associated with outpatient visits and expenditures. Multiple logistic regression analysis was applied for identifying the factors associated with hospitalization. The average annual outpatient visits and annual total medical expenditures in the study period were 44.23-52.20; NT$87,496-133,077 and 30.75-32.92; NT$64,411-80,955 for diabetic patients with and without depression. After adjustment for covariates, our results revealed that gender and complication were associated with out-patient visits. Moreover, the time factor was associated with the total medical expenditure, and residential urbanization and complication factors were associated with hospitalization. Health care utilization and expenditures for diabetic patients with depression were significantly higher than those without depression. Sex, complications, time, and urbanization are the factors associated with health care utilization and expenditures.

Epidemiology of uveitis among the Chinese population in Taiwan: a population-based study.

PubMed

Hwang, De-Kuang; Chou, Yiing-Jeng; Pu, Cheng-Yun; Chou, Pesus

2012-11-01

This study aimed to investigate the incidence and prevalence of uveitis in Taiwan, and then analyzed the risk factors related to uveitis using multivariate regression. Population-based cohort study using medical claims data. We randomly selected 1 000 000 residents from the Taiwan National Health Insurance Research Database. All participants with correct registry data (96%) were included in the study. The study period was from 2000 to 2008. All types of uveitis were identified using the International Classification of Diseases, 9th revision, Clinical Modification diagnostic codes. The annual incidence and cumulative prevalence of uveitis were calculated. A univariate and a multivariate Poisson regression were used to determine the risk factors associated with uveitis. The first diagnosis of uveitis noted during the study period. The annual cumulative incidence rate of uveitis ranged from 102.2 to 122.0 cases per 100 000 persons over the study period, and the average incidence density was 111.3 cases per 100 000 person-years (95% confidence interval, 108.4-114.1). The cumulative prevalence was found to have increased from 318.8 cases per 100 000 persons in 2003 to 622.7 cases per 100 000 persons in 2008. Anterior uveitis was the most common location and accounted for 77.7% of all incident cases, which was followed by panuveitis, posterior uveitis, and intermediate uveitis. Multivariate regression analysis showed that males, the elderly, and individuals who lived in an urban area had higher incidence rates for uveitis. The epidemiology of uveitis in Taiwan differs from most previous studies in other countries. The incidence of uveitis in Taiwan has increased significantly recently. The elderly and individuals living in urban areas are the populations that are most commonly affected by uveitis. These findings are consistent with suggestions found in several recent studies. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Governmental Disability Welfare Expenditure and National Economic Growth from 1991 to 2006 in Taiwan

ERIC Educational Resources Information Center

Lin, Jin-Ding; Lin, Lan-Ping

2009-01-01

The purposes of the present study were to describe the welfare expenditure for people with disabilities and examine its relation to national economic growth from 1991 to 2006 in Taiwan. We analyzed data mainly from the information of population with disabilities, disability welfare expenditure and national economic growth and gross national…

The Media and Suicide: Evidence Based on Population Data over 9 Years in Taiwan

ERIC Educational Resources Information Center

Tsai, Jui-Feng

2010-01-01

The relationship between the regional distribution densities of different media and the suicide death rate was explored by analyzing the annual total, male, and female suicide rates and media densities from 23 cities/counties in Taiwan during 1998-2006 by univariate and multivariate regression adjusted for five socioeconomic factors. The regional…

Internet Addiction among High Schoolers in Taiwan.

ERIC Educational Resources Information Center

Lin, Sunny S. J.; Tsai, Chin-Chung

The purpose of this study was to develop a reliable and valid measurement for the identification of Internet addictive high school students. There were 615 subjects selected by a stratified sampling from the population of Taiwanese 10th to 12th graders. The final version of the Internet Addiction Scale for Taiwan High Schoolers (IAST) contained 20…

Disability and Hospital Care Expenses among National Health Insurance Beneficiaries: Analyses of Population-Based Data in Taiwan

ERIC Educational Resources Information Center

Lin, Lan-Ping; Lee, Jiunn-Tay; Lin, Fu-Gong; Lin, Pei-Ying; Tang, Chi-Chieh; Chu, Cordia M.; Wu, Chia-Ling; Lin, Jin-Ding

2011-01-01

Nationwide data were collected concerning inpatient care use and medical expenditure of people with disabilities (N = 937,944) among national health insurance beneficiaries in Taiwan. Data included gender, age, hospitalization frequency and expenditure, healthcare setting and service department, discharge diagnose disease according to the ICD-9-CM…

Incidence of Hospitalization Due to Child Maltreatment in Taiwan, 1996-2007: A Nationwide Population-Based Study

ERIC Educational Resources Information Center

Chiang, Wan-Lin; Huang, Yu-Tung; Feng, Jui-Ying; Lu, Tsung-Hsueh

2012-01-01

Objectives: Little is known regarding the epidemiology of child maltreatment in Asian countries. This study aimed to examine the incidence of hospitalization coded as due to child maltreatment in Taiwan. Methods: We used inpatient claims data of the National Health Insurance for the years 1996 through 2007 for estimation. Hospitalization of…

High cumulative incidence of urinary tract transitional cell carcinoma after kidney transplantation in Taiwan.

PubMed

Wu, Ming-Ju; Lian, Jong-Da; Yang, Chi-Rei; Cheng, Chi-Hung; Chen, Cheng-Hsu; Lee, Wen-Chin; Shu, Kuo-Hsiung; Tang, Ming-Jer

2004-06-01

Cancer is a well-documented complication after kidney transplantation. Increased incidence of bladder cancer had been reported in long-term hemodialysis patients in Taiwan. Herein, the authors report a very high cumulative incidence of transitional cell carcinoma (TCC) of the urinary tract after kidney transplantation in Taiwan. The authors retrospectively reviewed the clinical data, medical records, and outcome of 730 kidney transplant (KT) recipients. The cumulative incidence of TCC was computed. The Cox regression method was used to analysis the role of potential risk factors. After a mean follow-up duration of 72.2 +/- 54.4 months, 69 cancers were diagnosed in 63 (8.6%) KT recipients. Of them, 30 cases (4.1%) were TCC. The cumulative incidence for TCC was 3.0% after 3 years of graft survival, increasing to 7.2% at 6 years and 17.5% at 10 years. Compared with the general population in Taiwan, the standardized mortality ratio was 398.4 (male, 192.6; female, 875.6). Painless gross hematuria was the cardinal initial symptom in 22 (73.3%) of the 30 KT recipients with TCC. Another 4 (13.3%) KT recipients with TCC presented with chronic urinary tract infection (UTI). Bilateral nephroureterectomy with removal of bladder cuffs was performed in 18 (60%) patients. Synchronous TCC in bilateral upper urinary tracts was confirmed in 11 (36.7%) of KT recipients with TCC. The age at the time of KT, female sex, compound analgesics usage, Chinese herb usage, and underground water intake had statistical significance as risk factors (P < 0.05). The KT recipients are at extremely high risk for TCC in Taiwan, with an incidence of 4.1%. This study indicates that hematuria and chronic UTI are the initial presentation of TCC in KT recipients. Carefully urologic screening is indicated for patients with high risk for TCC, including those with older age, compound analgesics usage, Chinese herbs usage, and underground water intake as well as women.

Health care satisfaction among foreign residents in Taiwan - An assessment and improvement.

PubMed

Kumar, Ajit; Maskara, Sanjeev; Chiang, I-Jen

2014-01-21

In 2012, almost half-million foreigners (2.3% of the total population) from 160 countries were estimated to live in Taiwan. In 2010, approximately eighty-seven percent of the population expressed high satisfaction in the national health care system of Taiwan. However, satisfaction level among foreign residents towards the Taiwanese health care system has not been clearly documented in the literature.OBJECTIVE: In this study, we assessed satisfaction level among foreign residents for receiving healthcare facility in Taiwanese hospital. In addition, the study came out with some potential solutions to improve health care received by them. Human-Centered Design (HCD) approach was deployed, which included three phases: observation, pattern recognition, and ideation and delivery. Each phase involved various steps. Techniques, such as ethnography, interview, discussion, and survey were used in accomplishing various steps within each phase. Four participants and two facilitators from Taiwan took part in the study. The study revealed various stories, insights, and themes about the health care received by the foreigners in Taiwan. In addition, some potential solutions and immediate available opportunities were recommended to improve their health care. The results provided a deeper understanding into the satisfaction level among foreign residents in Taiwan. For instance, this study pointed out the need to improve English proficiency of hospital's administrative staffs because a lack of English language proficiencies was found to be a major barrier in delivering quality health care to foreign residents. Therefore, adoption of various training modalities, such as English training using mobile device based games, role-play, and hospital's workflow depiction using English posters were recommended.

Health care satisfaction among foreign residents in Taiwan--an assessment and improvement.

PubMed

Kumar, Ajit; Maskara, Sanjeev; Chiang, I-Jen

2014-01-01

In 2012, almost half-million foreigners (2.3% of the total population) from 160 countries were estimated to live in Taiwan. In 2010, approximately eighty-seven percent of the population expressed high satisfaction in the national health care system of Taiwan. However, satisfaction level among foreign residents towards the Taiwanese health care system has not been clearly documented in the literature. In this study, we assessed satisfaction level among foreign residents for receiving healthcare facility in Taiwanese hospital. In addition, the study came out with some potential solutions to improve health care received by them. Human-Centered Design (HCD) approach was deployed, which included three phases: observation, pattern recognition, and ideation and delivery. Each phase involved various steps. Techniques, such as ethnography, interview, discussion, and survey were used in accomplishing various steps within each phase. Four participants and two facilitators from Taiwan took part in the study. The study revealed various stories, insights, and themes about the health care received by the foreigners in Taiwan. In addition, some potential solutions and immediate available opportunities were recommended to improve their health care. The results provided a deeper understanding into the satisfaction level among foreign residents in Taiwan. For instance, this study pointed out the need to improve English proficiency of hospital's administrative staffs because a lack of English language proficiencies was found to be a major barrier in delivering quality health care to foreign residents. Therefore, adoption of various training modalities, such as English training using mobile device based games, role-play, and hospital's workflow depiction using English posters were recommended.

International trends in antipsychotic use: A study in 16 countries, 2005-2014.

PubMed

Hálfdánarson, Óskar; Zoëga, Helga; Aagaard, Lise; Bernardo, Miquel; Brandt, Lena; Fusté, Anna Coma; Furu, Kari; Garuoliené, Kristina; Hoffmann, Falk; Huybrechts, Krista F; Kalverdijk, Luuk J; Kawakami, Koji; Kieler, Helle; Kinoshita, Takuya; Litchfield, Melisa; López, Soffy C; Machado-Alba, Jorge E; Machado-Duque, Manuel E; Mahesri, Mufaddal; Nishtala, Prasad S; Pearson, Sallie-Anne; Reutfors, Johan; Saastamoinen, Leena K; Sato, Izumi; Schuiling-Veninga, Catharina C M; Shyu, Yu-Chiau; Skurtveit, Svetlana; Verdoux, Hélène; Wang, Liang-Jen; Yahni, Corinne Zara; Bachmann, Christian J

2017-10-01

The objective of this study was to assess international trends in antipsychotic use, using a standardised methodology. A repeated cross-sectional design was applied to data extracts from the years 2005 to 2014 from 16 countries worldwide. During the study period, the overall prevalence of antipsychotic use increased in 10 of the 16 studied countries. In 2014, the overall prevalence of antipsychotic use was highest in Taiwan (78.2/1000 persons), and lowest in Colombia (3.2/1000). In children and adolescents (0-19 years), antipsychotic use ranged from 0.5/1000 (Lithuania) to 30.8/1000 (Taiwan). In adults (20-64 years), the range was 2.8/1000 (Colombia) to 78.9/1000 (publicly insured US population), and in older adults (65+ years), antipsychotic use ranged from 19.0/1000 (Colombia) to 149.0/1000 (Taiwan). Atypical antipsychotic use increased in all populations (range of atypical/typical ratio: 0.7 (Taiwan) to 6.1 (New Zealand, Australia)). Quetiapine, risperidone, and olanzapine were most frequently prescribed. Prevalence and patterns of antipsychotic use varied markedly between countries. In the majority of populations, antipsychotic utilisation and especially the use of atypical antipsychotics increased over time. The high rates of antipsychotic prescriptions in older adults and in youths in some countries merit further investigation and systematic pharmacoepidemiologic monitoring. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

Suicide death rates in patients with cardiovascular diseases - A 15-year nationwide cohort study in Taiwan.

PubMed

Wu, Victor Chien-Chia; Chang, Shang-Hung; Kuo, Chang-Fu; Liu, Jia-Rou; Chen, Shao-Wei; Yeh, Yung-Hsin; Luo, Shue-Fen; See, Lai-Chu

2018-06-01

The literature on suicide mortality rates in patients with cardiovascular diseases (CVDs) is limited. Taiwan National Health Insurance Research Database and Taiwan Death Registry were retrieved for patients with the 5 CVDs: congestive heart failure (CHF), acute myocardial infarction (AMI), ischemic stroke (IS), hemorrhagic stroke (HS), and pacemaker implantation (PMI) between January 1, 2001, and December 31, 2015. We excluded patients younger than 15 years old. The primary outcome was suicidal death. The standardized mortality ratio (SMR) was used to compare the risk of suicidal death in the 5 CVDs to the general population. From 2001 to 2015, there were 212,206 patients with CHF, 178,894 patients with AMI, 475,359 patients with IS, 189,555 patients with HS, and 64,173 patients with PMI. The suicide death rate per 100,000 person-year, 95% CI was 59.6 (54.5-64.8) for those with CHF, 44.6 (40.1-49.1) for AMI, 57.6 (54.7-60.5) for IS, 44.6 (40.2-49.0) for HS, 54.0 (45.9-62.0) for PMI, and 20.3 (20.1-20.4) for the general population. Patients with CHF patients had the highest SMR (2.10), followed by IS (1.96), PMI (1.86), HS (1.65), and AMI (1.46). The SMRs for patients with CVDs peaked at year 2 after the diagnosis, declined for patients with AMI, IS, and HS, increased and decreased for PMI alternately, and reached very similar values all five CVDs after 10th year after the diagnosis. Patients with acute CVD with AMI, IS, and HS had suicide death rates peaked early after diagnosis, but patients with chronic CVD with CHF and PMI had suicide death rates that increased progressively. In addition, patients with PMI, CHF, IS had highest association with psychiatric illness and patients with PMI who were of young to middle age had highest suicide death rate. Copyright © 2018 Elsevier B.V. All rights reserved.

Validity of cancer diagnosis in the National Health Insurance database compared with the linked National Cancer Registry in Taiwan.

PubMed

Kao, Wei-Heng; Hong, Ji-Hong; See, Lai-Chu; Yu, Huang-Ping; Hsu, Jun-Te; Chou, I-Jun; Chou, Wen-Chi; Chiou, Meng-Jiun; Wang, Chun-Chieh; Kuo, Chang-Fu

2017-08-16

We aimed to evaluate the validity of cancer diagnosis in the National Health Insurance (NHI) database, which has routinely collected the health information of almost the entire Taiwanese population since 1995, compared with the Taiwan National Cancer Registry (NCR). There were 26,542,445 active participants registered in the NHI database between 2001 and 2012. National Cancer Registry and NHI database records were compared for cancer diagnosis; date of cancer diagnosis; and 1, 2, and 5 year survival. In addition, the 10 leading causes of cancer deaths in Taiwan were analyzed. There were 908,986 cancer diagnoses in NCR and NHI database and 782,775 (86.1%) in both, with 53,192 (5.9%) in the NHI database only and 73,019 (8.0%) in the NCR only. The positive predictive value of the NHI database cancer diagnoses was 94% for all cancers; the positive predictive value of the 10 specific cancers ranged from 95% (lung cancer) to 82% (cervical cancer). The date of diagnosis in the NHI database was generally delayed by a median of 15 days (interquartile range 8-18) compared with the NCR. The 1, 2, and 5 year survival rates were 71.21%, 60.85%, and 47.44% using the NHI database and were 71.18%, 60.17%, and 46.09% using NCR data. Recording of cancer diagnoses and survival estimates based on these diagnosis codes in the NHI database are generally consistent with the NCR. Studies using NHI database data must pay careful attention to eligibility and record linkage; use of both sources is recommended. Copyright © 2017 John Wiley & Sons, Ltd.

Fifteen non-CODIS autosomal short tandem repeat loci multiplex data from nine population groups living in Taiwan.

PubMed

Hwa, Hsiao-Lin; Chang, Yih-Yuan; Lee, James Chun-I; Lin, Chun-Yen; Yin, Hsiang-Yi; Tseng, Li-Hui; Su, Yi-Ning; Ko, Tsang-Ming

2012-07-01

The analysis of autosomal short tandem repeat (STR) loci is a powerful tool in forensic genetics. We developed a multiplex system in which 15 non-Combined DNA Index System autosomal STRs (D3S1744, D4S2366, D8S1110, D10S2325, D12S1090, D13S765, D14S608, Penta E, D17S1294, D18S536, D18S1270, D20S470, D21S1437, Penta D, and D22S683) could be amplified in one single polymerase chain reaction. DNA samples from 1,098 unrelated subjects of nine population groups living in Taiwan, including Taiwanese Han, indigenous Taiwanese of Taiwan Island, Tao, mainland Chinese, Filipinos, Thais, Vietnamese, Indonesians, and Caucasians, were collected and analyzed using this system. The distributions of the allelic frequencies and the forensic parameters of each population group were presented. The combined discrimination power and the combined power of exclusion were high in all population groups tested in this study. A multidimensional scaling plot of these nine population groups based on the Reynolds' genetic distances calculated from 15 autosomal STRs was constructed, and the genetic substructure in this area was presented. In conclusion, this 15 autosomal STR multiplex system provides highly informative STR data and appears useful in forensic casework and parentage testing in different populations.

Socio-economic inequalities in low-birth weight, full-term babies from singleton pregnancies in Taiwan.

PubMed

Li, C Y; Sung, F C

2008-03-01

This study investigated the chronological trend of low-birth weight in full-term babies (TLBW) in Taiwan in the 1980s and 1990s when the nation experienced a rapid economic advancement, and assessed the association between TLBW and parental education and marital status. Data from liveborn singletons from Taiwan's birth registry, born between 1978 and 1997, were used to calculate overall and socio-economic factor-specific rates of TLBW for every 2-year interval in this 20-year period. Logistic regression models were used to assess the trend of TLBW rates, and the interaction between secular time, selected demographic factors and other predictors. Among 6,159,070 full-term, liveborn singletons, 208,729 were TLBW. The average annual rate of TLBW was 3.39% in the study period. The period-specific TLBW declined monotonically from 4.41% in 1978-1979 to 2.49% in 1996-1997, representing a 43% deduction. Multiple logistic regression demonstrated persistent declining trends irrespective of the educational level or marital status of the parents. However, the decline was slower for populations of lower socio-economic status, such as less-educated parents and unmarried mothers, which enhanced the inequalities of TLBW risk across populations. The TLBW risk ratios of the least-educated mothers to the most-educated mothers increased from 1.43 in 1978-1979 to 2.05 in 1996-1997. Unmarried status was an independent predictor of elevated risk of TLBW. The association between socio-economic inequality and the risk of TLBW infants was sustained over the 1980s and 1990s in Taiwan. Interventions are necessary to promote antenatal care and educational attainment, particularly for lower socio-economic and socially deprived populations in Taiwan.

Validity and reliability of the Traditional Chinese version of the Multidimensional Fatigue Inventory in general population.

PubMed

Chuang, Li-Ling; Chuang, Yu-Fen; Hsu, Miao-Ju; Huang, Ying-Zu; Wong, Alice M K; Chang, Ya-Ju

2018-01-01

Fatigue is a common symptom in the general population and has a substantial effect on individuals' quality of life. The Multidimensional Fatigue Inventory (MFI) has been widely used to quantify the impact of fatigue, but no Traditional Chinese translation has yet been validated. The goal of this study was to translate the MFI from English into Traditional Chinese ('the MFI-TC') and subsequently to examine its validity and reliability. The study recruited a convenience sample of 123 people from various age groups in Taiwan. The MFI was examined using a two-step process: (1) translation and back-translation of the instrument; and (2) examination of construct validity, convergent validity, internal consistency, test-retest reliability, and measurement error. The validity and reliability of the MFI-TC were assessed by factor analysis, Spearman rho correlation coefficient, Cronbach's alpha coefficient, intraclass correlation coefficient (ICC), minimal detectable change (MDC), and Bland-Altman analysis. All participants completed the Short-Form-36 Health Survey Taiwan Form (SF-36-T) and the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) concurrently to test the convergent validity of the MFI-TC. Test-retest reliability was assessed by readministration of the MFI-TC after a 1-week interval. Factor analysis confirmed the four dimensions of fatigue: general/physical fatigue, reduced activity, reduced motivation, and mental fatigue. A four-factor model was extracted, combining general fatigue and physical fatigue as one factor. The results demonstrated moderate convergent validity when correlating fatigue (MFI-TC) with quality of life (SF-36-T) and sleep disturbances (PSQI) (Spearman's rho = 0.68 and 0.47, respectively). Cronbach's alpha for the MFI-TC total scale and subscales ranged from 0.73 (mental fatigue subscale) to 0.92 (MFI-TC total scale). ICCs ranged from 0.85 (reduced motivation) to 0.94 (MFI-TC total scale), and the MDC ranged from 2.33 points (mental fatigue) to 9.5 points (MFI-TC total scale). The Bland-Altman analyses showed no significant systematic bias between the repeated assessments. The results support the use of the Traditional Chinese version of the MFI as a comprehensive instrument for measuring specific aspects of fatigue. Clinicians and researchers should consider interpreting general fatigue and physical fatigue as one subscale when measuring fatigue in Traditional Chinese-speaking populations.

Validity and reliability of the Traditional Chinese version of the Multidimensional Fatigue Inventory in general population

PubMed Central

Chuang, Li-Ling; Chuang, Yu-Fen; Hsu, Miao-Ju; Huang, Ying-Zu; Wong, Alice M. K.

2018-01-01

Background Fatigue is a common symptom in the general population and has a substantial effect on individuals’ quality of life. The Multidimensional Fatigue Inventory (MFI) has been widely used to quantify the impact of fatigue, but no Traditional Chinese translation has yet been validated. The goal of this study was to translate the MFI from English into Traditional Chinese (‘the MFI-TC’) and subsequently to examine its validity and reliability. Methods The study recruited a convenience sample of 123 people from various age groups in Taiwan. The MFI was examined using a two-step process: (1) translation and back-translation of the instrument; and (2) examination of construct validity, convergent validity, internal consistency, test-retest reliability, and measurement error. The validity and reliability of the MFI-TC were assessed by factor analysis, Spearman rho correlation coefficient, Cronbach’s alpha coefficient, intraclass correlation coefficient (ICC), minimal detectable change (MDC), and Bland-Altman analysis. All participants completed the Short-Form-36 Health Survey Taiwan Form (SF-36-T) and the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) concurrently to test the convergent validity of the MFI-TC. Test-retest reliability was assessed by readministration of the MFI-TC after a 1-week interval. Results Factor analysis confirmed the four dimensions of fatigue: general/physical fatigue, reduced activity, reduced motivation, and mental fatigue. A four-factor model was extracted, combining general fatigue and physical fatigue as one factor. The results demonstrated moderate convergent validity when correlating fatigue (MFI-TC) with quality of life (SF-36-T) and sleep disturbances (PSQI) (Spearman's rho = 0.68 and 0.47, respectively). Cronbach’s alpha for the MFI-TC total scale and subscales ranged from 0.73 (mental fatigue subscale) to 0.92 (MFI-TC total scale). ICCs ranged from 0.85 (reduced motivation) to 0.94 (MFI-TC total scale), and the MDC ranged from 2.33 points (mental fatigue) to 9.5 points (MFI-TC total scale). The Bland-Altman analyses showed no significant systematic bias between the repeated assessments. Conclusions The results support the use of the Traditional Chinese version of the MFI as a comprehensive instrument for measuring specific aspects of fatigue. Clinicians and researchers should consider interpreting general fatigue and physical fatigue as one subscale when measuring fatigue in Traditional Chinese-speaking populations. PMID:29746466

Early Childhood Inclusion in Taiwan

ERIC Educational Resources Information Center

Liao, Hua-Fang; Wu, Pei-Fang

2017-01-01

In accordance with the Special Education Act that indicates that young children with special needs must have individualized educational plans and receive education with their typically developing peers in the general education setting, Taiwan implemented an experimental preschool inclusion program in 1989. Subsequently, during the 1990s, there was…

Elucidating challenges that electronic cigarettes pose to tobacco control in Asia: a population-based national survey in Taiwan.

PubMed

Chang, Hui-Chin; Tsai, Yi-Wen; Shiu, Ming-Neng; Wang, Ying-Ting; Chang, Po-Yin

2017-03-27

This study investigated the prevalence and correlates of electronic cigarettes (e-cigarettes) use in Taiwan. We studied a nationally representative random sample in the 2015 Taiwan Adult Smoking Behavior Survey. This study included 26 021 participants aged 15 years or older (51% women, 79% non-smokers, 16% aged 15-24 years), after excluding 31 persons (0.1%) who had missing information on e-cigarette use. The prevalence of ever having used e-cigarettes was calculated in the overall sample and by smoking status (current, former and never) or age (15-24, 25-44 and ≥45 years). We performed multivariable log-binomial regression to assess correlates of ever having used e-cigarettes among all participants and separately for subgroups by smoking status and age. Approximately 3% of all participants had ever used e-cigarettes. The prevalence of ever having used e-cigarettes was high in current smokers (14%) and people aged 18-24 years (7%). E-cigarette use was particularly common in people aged 15-24 years who were current (49-52%) or former (22-39%) smokers. Ever having used e-cigarettes was positively associated with tobacco smoking (adjusted prevalence ratio (aPR): 21.5, 95% CI 15.4 to 29.8, current smokers; aPR: 8.3, 95% CI 15.2 to 13.1, former smokers), younger age and high socioeconomic status. Age remained a significant factor of ever having used e-cigarettes across smoking status groups. Among non-smokers, men had a 2.4-fold (95% CI 1.5 to 3.8) greater prevalence of e-cigarette use than women. E-cigarette use was uncommon in the general population in Taiwan, but prevalence was high among smokers and young people. This study highlights challenges that e-cigarettes pose to tobacco control, which warrant high priority action by policymakers and public health professionals. E-cigarette regulations should focus on young people. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Increased risk of chronic obstructive pulmonary disease in patients with bipolar disorder: A population-based study.

PubMed

Hsu, Jer-Hwa; Chien, I-Chia; Lin, Ching-Heng

2017-10-01

We conducted this nationwide study to examine the prevalence and incidence of chronic obstructive pulmonary disease (COPD) among patients with bipolar disorder in Taiwan. We used a random sample of 766,427 subjects who were aged ≥18 years in 2005. Patients with at least one primary diagnosis of bipolar disorder were identified. Study participants with one primary or secondary diagnosis of COPD for either ambulatory or inpatient care were also identified. We compared the prevalence of COPD in patients with bipolar disorder and the general population in 2005. In addition, we further investigated this cohort from 2006 to 2010 to detect incident cases of COPD in patients with bipolar disorder compared with the general population. The factors associated with COPD among patients with bipolar disorder were also analyzed. The prevalence of COPD in patients with bipolar disorder was higher than in the general population in 2005 (5.68% vs. 2.88%, odds ratio 2.03; 95% confidence interval, 1.53-2.67). The average annual incidence of COPD in patients with bipolar disorder was also higher than in the general population (2.03% vs. 1.03%, risk ratio 1.94; 95% confidence interval, 1.65-2.29) from 2006 to 2010. Some risk factors for COPD such as substance use, obesity, or lifestyle pattern were not available in this study. Patients with bipolar disorder had a higher prevalence and incidence of COPD compared with the general population. Higher prevalence of COPD among bipolar patients was associated with increased age, males, hypertension, and second-generation antidepressant use. Copyright © 2017 Elsevier B.V. All rights reserved.

Cost-effectiveness analysis of population-based screening of hepatocellular carcinoma: Comparing ultrasonography with two-stage screening

PubMed Central

Kuo, Ming-Jeng; Chen, Hsiu-Hsi; Chen, Chi-Ling; Fann, Jean Ching-Yuan; Chen, Sam Li-Sheng; Chiu, Sherry Yueh-Hsia; Lin, Yu-Min; Liao, Chao-Sheng; Chang, Hung-Chuen; Lin, Yueh-Shih; Yen, Amy Ming-Fang

2016-01-01

AIM: To assess the cost-effectiveness of two population-based hepatocellular carcinoma (HCC) screening programs, two-stage biomarker-ultrasound method and mass screening using abdominal ultrasonography (AUS). METHODS: In this study, we applied a Markov decision model with a societal perspective and a lifetime horizon for the general population-based cohorts in an area with high HCC incidence, such as Taiwan. The accuracy of biomarkers and ultrasonography was estimated from published meta-analyses. The costs of surveillance, diagnosis, and treatment were based on a combination of published literature, Medicare payments, and medical expenditure at the National Taiwan University Hospital. The main outcome measure was cost per life-year gained with a 3% annual discount rate. RESULTS: The results show that the mass screening using AUS was associated with an incremental cost-effectiveness ratio of USD39825 per life-year gained, whereas two-stage screening was associated with an incremental cost-effectiveness ratio of USD49733 per life-year gained, as compared with no screening. Screening programs with an initial screening age of 50 years old and biennial screening interval were the most cost-effective. These findings were sensitive to the costs of screening tools and the specificity of biomarker screening. CONCLUSION: Mass screening using AUS is more cost effective than two-stage biomarker-ultrasound screening. The most optimal strategy is an initial screening age at 50 years old with a 2-year inter-screening interval. PMID:27022228

Increased Standardised Incidence Ratio of Malignant Pleural Mesothelioma in Taiwanese Asbestos Workers: A 29-Year Retrospective Cohort Study

PubMed Central

Lin, Cheng-Kuan; Chang, Yu-Ying; Wang, Jung-Der

2015-01-01

Objective. This paper aimed to determine the standardised incidence ratio (SIR) of malignant pleural mesothelioma (MPM) in workers exposed to asbestos in Taiwan. Methods. All workers employed in asbestos-related factories and registered by the Bureau of Labour Insurance between 1 March, 1950, and 31 December, 1989, were included in the study and were followed from 1 January, 1980, through 31 December, 2009. Incident cases of all cancers, including MPM (ICD-9 code: 163), were obtained from the Taiwan Cancer Registry. SIRs were calculated based on comparison with the incidence rate of the general population of Taiwan and adjusted for age, calendar period, sex, and duration of employment. Results. The highest SIR of MPM was found for male workers first employed before 1979, with a time since first employment more than 30 years (SIR 4.52, 95% CI: 2.25–8.09). After consideration of duration of employment, the SIR for male MPM was 5.78 (95% CI: 1.19–16.89) for the workers employed for more than 20 years in asbestos-related factories. Conclusions. This study corroborates the association between occupational asbestos exposure and MPM. The highest risk of MPM was found among male asbestos workers employed before 1979 and working for more than 20 years in asbestos-related factories. PMID:26290869

Perception of earthquake risk in Taiwan: effects of gender and past earthquake experience.

PubMed

Kung, Yi-Wen; Chen, Sue-Huei

2012-09-01

This study explored how individuals in Taiwan perceive the risk of earthquake and the relationship of past earthquake experience and gender to risk perception. Participants (n= 1,405), including earthquake survivors and those in the general population without prior direct earthquake exposure, were selected and interviewed through a computer-assisted telephone interviewing procedure using a random sampling and stratification method covering all 24 regions of Taiwan. A factor analysis of the interview data yielded a two-factor structure of risk perception in regard to earthquake. The first factor, "personal impact," encompassed perception of threat and fear related to earthquakes. The second factor, "controllability," encompassed a sense of efficacy of self-protection in regard to earthquakes. The findings indicated prior earthquake survivors and females reported higher scores on the personal impact factor than males and those with no prior direct earthquake experience, although there were no group differences on the controllability factor. The findings support that risk perception has multiple components, and suggest that past experience (survivor status) and gender (female) affect the perception of risk. Exploration of potential contributions of other demographic factors such as age, education, and marital status to personal impact, especially for females and survivors, is discussed. Future research on and intervention program with regard to risk perception are suggested accordingly. © 2012 Society for Risk Analysis.

Language Policy and Group Identification in Taiwan

ERIC Educational Resources Information Center

Liu, Ruey-Ying

2012-01-01

Taiwan is a multicultural and multilingual society. Generally speaking, Taiwanese residents fall into one of four ethnic groups. Each ethnic group has a different cultural context and a preferred language. Therefore, one's use of language may reveal his/her identification with an ethnic group, and language policy implementation may imply the power…

Improving the Textbook Adoption Process in Taiwan

ERIC Educational Resources Information Center

Ho, Hsuan-fu; Hsu, Ying-tsun

2011-01-01

Textbooks were centrally selected in Taiwan until 1996 when the government commissioned its Textbook Liberalization Reform. Although this policy received complements from scholars and the general public, it encounters many unexpected problems in its implementation. The aims of this research are thus to identify the major criteria used by…

Technological and Vocational Education in Taiwan.

ERIC Educational Resources Information Center

Lee, Lung-Sheng

Beyond the nine years of compulsory education, Taiwan has the following two additional streams in the educational system: general academic education (GAE) and technological and vocational education (TVE). TVE has the two key features of a complete system to ensure students' horizontal and vertical mobility and a main schooling stream, parallel to…

Suicide and Its Association with Individual, Family, Peer, and School Factors in an Adolescent Population in Southern Taiwan

ERIC Educational Resources Information Center

Tang, Tze-Chun; Ko, Chih-Hung; Yen, Ju-Yu; Lin, Huang-Chi; Liu, Shu-Chun; Huang, Chi-Fen; Yen, Cheng-Fang

2009-01-01

A representative sample of 10,233 adolescent students was recruited to examine the rate of suicidal attempt and its correlates in the adolescents living in southern Taiwan. Five questions from the Kiddie Schedule for Affective Disorders and Schizophrenia (Kiddie-SADS-E) were used to inquire about the participants' suicidality. The associations…

Assessing Autistic Traits in a Taiwan Preschool Population: Cross-Cultural Validation of the Social Responsiveness Scale (SRS)

ERIC Educational Resources Information Center

Wang, Jessica; Lee, Li-Ching; Chen, Ying-Sheue; Hsu, Ju-Wei

2012-01-01

The cross-cultural validity of the Mandarin-adaptation of the social responsiveness scale (SRS) was examined in a sample of N = 307 participants in Taiwan, 140 typically developing and 167 with clinically-diagnosed developmental disorders. This scale is an autism assessment tool that provides a quantitative rather than categorical measure of…

From Learners to Volunteers: A Qualitative Study of Retirees' Transformative Learning in Taiwan

ERIC Educational Resources Information Center

Lee, Ya-Hui

2016-01-01

In Taiwan, older adults over the age of 65 made up 12.51% of the population in 2015, causing the government to promote older adult education to help achieve active aging. As a result, more elderly people have attended learning activities and applied new skills to volunteering. The researcher conducted focus group interviews with 93 older adults…

Users' Perspectives on Tour-Guide Training Courses Using 3D Tourist Sites

ERIC Educational Resources Information Center

Chen, Yu-Fen; Mo, Huai-en

2014-01-01

Taiwan is currently attempting to develop itself into a twenty-first century tourist hub to take advantage of today's thriving global tourism economy. In the coming years, Taiwan anticipates an urgent demand for tour guides, and there is a clear need for training solutions that can serve a rapidly growing population. Computer-mediated virtual 3D…

The Social Outcomes of Older Adult Learning in Taiwan: Evaluation Framework and Indicators

ERIC Educational Resources Information Center

Lin, Li-Hui

2015-01-01

The purpose of this study is to explore the social outcomes of older adult learning in Taiwan. In light of our society's aging population structure, the task of establishing evaluation framework and indicators for the social outcomes of learning (SOL) as applied to older adults is urgent. In order to construct evaluation indicators for older adult…

Family Structure Transitions and Early Childhood Development in Taiwan: Evidence from a Population-Based Birth Cohort Study

ERIC Educational Resources Information Center

Wu, Jennifer Chun-Li; Chiang, Tung-liang

2015-01-01

Taiwan has over the past three decades been experiencing demographic changes that may pose important concerns for children's quality of life. This study examines the relationships and potential pathways between family structure transitions and early childhood development. Our analysis is based on 19,499 children from the 2005 birth cohort who…

A Study of Older Adult Students' Satisfaction with Web-Based Distance Learning at the National Open University of Taiwan

ERIC Educational Resources Information Center

Chen, Ho-Yuan

2010-01-01

The purpose of this study was to investigate the relationships between older learners' demographic characteristics and their satisfaction with distance learning in the Web-based environment at National Open University in Taiwan (NOUT). Increases in the older adult population have had many impacts throughout societies. The major purpose of older…

What factors influence healthy aging? A person-centered approach among older adults in Taiwan.

PubMed

Liu, Li-Fan; Su, Pei-Fang

2017-05-01

The present study aimed to identify the health profiles of older adults by using latent class analysis to investigate health heterogeneity and to determine what factors predicted healthy aging among an oldest-old sample cohort that was followed up for 14 years in Taiwan. Data were drawn from five waves (carried out in 1993, 1996, 1999, 2003 and 2007) of the Taiwan Longitudinal Study on Aging to examine the changes in health heterogeneity in a nationally representative oldest-old cohort of Taiwanese. Overall, data from a total of 11 145 observations of 3155 older adults were considered. The influential factors predicting health changes were analyzed by using a generalized estimating equation. The results showed that four health profiles were identified among the aging population observed in the Taiwan Longitudinal Study on Aging. With increasing age, the combined effects of the physical functioning, cognitive and emotional health, and comorbidities of older adults significantly impact their health changes. Apart from health deteriorating with age and sex disparities, educational and economic status, health behaviors, and social participation at the individual level were found to be the robust factors in predicting healthy aging. In considering what factors impact healthy aging, we suggest that a person-centered approach would be useful and critical for policy makers to understand the compositions of health profiles and the influencing factors in view of a life-course perspective. Based on the factors identified as influencing healthy aging at the individual level, it is imperative from a policy-making perspective to maximize opportunities for healthy aging. Geriatr Gerontol Int 2017; 17: 697-707. © 2016 Japan Geriatrics Society.

Association of blood lead and mercury with estimated GFR in herbalists after the ban of herbs containing aristolochic acids in Taiwan.

PubMed

Lin, Hsing-Hua; Chou, Shan-An; Yang, Hsiao-Yu; Hwang, Yaw-Huei; Kuo, Ching-Hua; Kao, Tze-Wah; Lo, Tsai-Chang; Chen, Pau-Chung

2013-08-01

This study was undertaken to explore the association of estimated glomerular filtration rate (GFR) with exposure to aristolochic acids (ALAs) and nephrotoxic metals in herbalists after the ban of herbs containing ALAs in Taiwan. This cross-sectional study recruited a total of 138 herbalists without end-stage renal disease or urothelial carcinoma from the Occupational Union of Chinese Herbalists in Taiwan in 2007. Aristolochic acid I (ALA-I) was measured by ultra-high-pressure liquid chromatography/ tandem mass spectrometry (UHPLC-MS/MS) and heavy metals in blood samples were analysed by Agilent 7500C inductively coupled plasma-mass spectrometry. Renal function was assessed by using a simplified Modification of Diet in Renal Disease Study equation to estimate GFR. Blood lead was higher in herbal dispensing procedures (p=0.053) and in subjects who self-prescribe herbal medicine (p=0.057); mercury was also higher in subjects living in the workplace (p=0.03). Lower estimated GFR was significantly associated with lead (β=-10.66, 95% CI -18.7 to -2.6) and mercury (β=-12.52, 95% CI -24.3 to -0.8) with a significant interaction (p=0.01) between mercury and lead; however, estimated GFR was not significantly associated with high ALA-I level groups, arsenic and cadmium after adjusting for other confounding factors. We found that lower estimated GFR was associated with blood lead and mercury in herbalists after the ban of herbs containing ALAs in Taiwan. The ALA-I exposure did not show a significant negative association of estimated GFR, which might due to herbalists having known how to distinguish ALA herbs after the banning policy. Rigorous monitoring is still needed to protect herbalists and the general population who take herbs.

Prevalence, Incidence, and Factor Concentrate Usage Trends of Hemophiliacs in Taiwan

PubMed Central

Tu, Tsu-Chiang; Liou, Wen-Shyong; Chou, Tsui-Yun; Lin, Tsung-Kun; Lee, Chuan-Fang; Chen, Jye-Daa; Cham, Thau-Ming

2013-01-01

Purpose Hemophilia A and B (HA, HB) are the most common X-linked inherited bleeding disorders. The introduction of factor concentrates has allowed for control of the lifelong chronic disease. However, no studies have been published regarding the epidemiology of hemophilia in Taiwan. Our aim was to determine the prevalence, incidence, and mortality rate, as well as trends in the use of factor concentrates, in individuals with hemophilia in Taiwan. Materials and Methods A retrospective study was conducted using the National Health Insurance Research Database between 1997 and 2007. Results We identified 988 males with hemophilia (HA : HB ratio=5.4 : 1). The mean prevalence per 100000 males was 6.7±0.1 for HA and 1.2±0.1 for HB. The estimated mean annual incidence per live male birth was 1 in 10752 for HA and 1 in 47619 for HB. Standardized mortality ratios for males with hemophilia (all severities) or severe hemophilia were 1.3- and 2.1-fold higher than that of the general male population, respectively. Mean factor VIII (FVIII) and factor IX (FIX) usage was 1.5003±0.4029 and 0.3126±0.0904 international units (IUs) per capita, respectively. Mean FVIII and FIX usage per patient with hemophilia (all severities) or severe hemophilia was 44027±11532 and 72341±17298, respectively, and 49407±13015 and 74369±18411 IUs per person with HA or HB, respectively. Conclusion Our data revealed epidemiologic and factor concentrate usage trends in males with hemophilia in Taiwan, highlighting a need for improvements in the mandatory National Health Insurance registry. A better-designed, patient-centered registry system would enable more detailed patient information collection and analysis, improving subsequent care. PMID:23225801

Aging in Taiwan: Building a Society for Active Aging and Aging in Place.

PubMed

Lin, Yi-Yin; Huang, Chin-Shan

2016-04-01

Taiwan's accelerated rate of aging is more than twice that of European countries and United States. Although demographic aging was not a major concern in Taiwan until 1993, when it became an aging society, aging issues now have become an imperative topic both in policy and in practice in the country. As this article demonstrates, in response to the challenge of the rapidly growing older population and the inspiration of cultural values of filial obligation and respect to elders, the concepts of active aging and aging in place are leading the policies and practices of gerontology to meet the diverse needs of the aging population in Taiwan. However, challenges remain, including the question of how to promote systematic endeavors, both in policies or research on aging, and how to encourage greater involvement of nongovernment organizations in the aging issue. In addition, some emerging issues about aging are addressed in this article including inadequate resources for older rural adults, building an age-friendly environment, and the increasing number of people with dementia. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Differences in Spontaneous Intracerebral Hemorrhage Cases between Urban and Rural Regions of Taiwan: Big Data Analytics of Government Open Data

PubMed Central

Ting, Hsien-Wei; Chien, Ting-Ying; Lai, K. Robert; Wu, Kuan-Hsien; Chen, Jun-Min

2017-01-01

This study evaluated the differences in spontaneous intracerebral hemorrhage (sICH) between rural and urban areas of Taiwan with big data analysis. We used big data analytics and visualization tools to examine government open data, which included the residents’ health medical administrative data, economic status, educational status, and relevant information. The study subjects included sICH patients of Taipei region (29,741 cases) and Eastern Taiwan (4565 cases). The incidence of sICH per 100,000 population per year in Eastern Taiwan (71.3 cases) was significantly higher than that of the Taipei region (42.3 cases). The mean coverage area per hospital in Eastern Taiwan (452.4 km2) was significantly larger than the Taipei region (24 km2). The residents educational level in the Taipei region was significantly higher than that in Eastern Taiwan. The mean hospital length of stay in the Taipei region (17.9 days) was significantly greater than that in Eastern Taiwan (16.3 days) (p < 0.001). There were no significant differences in other medical profiles between two areas. Distance and educational barriers were two possible reasons for the higher incidence of sICH in the rural area of Eastern Taiwan. Further studies are necessary in order to understand these phenomena in greater depth. PMID:29232864

Dose estimation for nuclear power plant 4 accident in Taiwan at Fukushima nuclear meltdown emission level.

PubMed

Tang, Mei-Ling; Tsuang, Ben-Jei; Kuo, Pei-Hsuan

2016-05-01

An advanced Gaussian trajectory dispersion model is used to evaluate the evacuation zone due to a nuclear meltdown at the Nuclear Power Plant 4 (NPP4) in Taiwan, with the same emission level as that occurred at Fukushima nuclear meltdown (FNM) in 2011. Our study demonstrates that a FNM emission level would pollute 9% of the island's land area with annual effective dose ≥50 mSv using the meteorological data on 11 March 2011 in Taiwan. This high dose area is also called permanent evacuation zone (denoted as PEZ). The PEZ as well as the emergency-planning zone (EPZ) are found to be sensitive to meteorological conditions on the event. In a sunny day under the dominated NE wind conditions, the EPZ can be as far as 100 km with the first 7-day dose ≥20 mSv. Three hundred sixty-five daily events using the meteorological data from 11 March 2011 to 9 March 2012 are evaluated. It is found that the mean land area of Taiwan in becoming the PEZ is 11%. Especially, the probabilities of the northern counties/cities (Keelung, New Taipei, Taipei, Taoyuan, Hsinchu City, Hsinchu County and Ilan County) to be PEZs are high, ranging from 15% in Ilan County to 51% in Keelung City. Note that the total population of the above cities/counties is as high as 10 million people. Moreover, the western valleys of the Central Mountain Range are also found to be probable being PEZs, where all of the reservoirs in western Taiwan are located. For example, the probability can be as high as 3% in the far southern-most tip of Taiwan Island in Pingtung County. This shows that the entire populations in western Taiwan can be at risk due to the shortage of clean water sources under an event at FNM emission level, especially during the NE monsoon period. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Discrepancy of cytogenetic analysis in Western and eastern Taiwan.

PubMed

Chang, Yu-Hsun; Chen, Pui-Yi; Li, Tzu-Ying; Yeh, Chung-Nan; Li, Yi-Shian; Chu, Shao-Yin; Lee, Ming-Liang

2013-06-01

This study aimed at investigating the results of second-trimester amniocyte karyotyping in western and eastern Taiwan, and identifying any regional differences in the prevalence of fetal chromosomal anomalies. From 2004 to 2009, pregnant women who underwent amniocentesis in their second trimester at three hospitals in western Taiwan and at four hospitals in eastern Taiwan were included. All the cytogenetic analyses of cultured amniocytes were performed in the cytogenetics laboratory of the Genetic Counseling Center of Hualien Buddhist Tzu Chi General Hospital. We used the chi-square test, Student t test, and Mann-Whitney U test to evaluate the variants of clinical indications, amniocyte karyotyping results, and prevalence and types of chromosomal anomalies in western and eastern Taiwan. During the study period, 3573 samples, 1990 (55.7%) from western Taiwan and 1583 (44.3%) from eastern Taiwan, were collected and analyzed. The main indication for amniocyte karyotyping was advanced maternal age (69.0% in western Taiwan, 67.1% in eastern Taiwan). The detection rates of chromosomal anomalies by amniocyte karyotyping in eastern Taiwan (45/1582, 2.8%) did not differ significantly from that in western Taiwan (42/1989, 2.1%) (p = 1.58). Mothers who had abnormal ultrasound findings and histories of familial hereditary diseases or chromosomal anomalies had higher detection rates of chromosomal anomalies (9.3% and 7.2%, respectively). The detection rate of autosomal anomalies was higher in eastern Taiwan (93.3% vs. 78.6%, p = 0.046), but the detection rate of sex-linked chromosomal anomalies was higher in western Taiwan (21.4% vs. 6.7%, p = 0.046). We demonstrated regional differences in second-trimester amniocyte karyotyping results and established a database of common chromosomal anomalies that could be useful for genetic counseling, especially in eastern Taiwan. Copyright © 2012. Published by Elsevier B.V.

Doctor Shopping Behavior for Zolpidem Among Insomnia Patients in Taiwan: A Nationwide Population-Based Study

PubMed Central

Lu, Tzu-Hsuan; Lee, Yen-Ying; Lee, Hsin-Chien; Lin, You-Meei

2015-01-01

Objectives: Although zolpidem is listed as a controlled drug in Taiwan, patients' behavior has not been restricted and has led to the problem of doctor shopping behavior (DSB), leading to overutilization of medical resources and excess spending. The National Health Insurance Administration in Taiwan has instituted a new policy to regulate physicians' prescribing behavior and decrease DSB. This retrospective study aimed to analyze the DSB for zolpidem by insomnia patients and assess related factors. Design and Participants: Data were extracted from the Longitudinal Health Insurance Database in Taiwan. Individuals with a diagnosis of insomnia who received more than one prescription of zolpidem in 2008 were followed for 24 mo. Doctor shopping was defined as ≥ 2 prescriptions by different doctors within ≥ 1 day overlapping in the duration of therapy. The percentage of zolpidem obtained through doctor shopping was used as an indicator of the DSB of each patient. Results: Among the 6,947 insomnia patients who were prescribed zolpidem, 1,652 exhibited DSB (23.78%). The average dose of zolpidem dispensed for each patient during 24 mo was 244.21 daily defined doses. The doctor shopping indicator (DSI) was 0.20 (standard deviation, 0.23) among patients with DSB. Younger age, chronic diseases, high number of diseases, higher premium status, high socioeconomic status, and fewer people served per practicing physicians were all factors significantly related to doctor shopping behavior. Conclusion: Doctor shopping for zolpidem appears to be an important issue in Taiwan. Implementing a proper referral system with efficient data exchange by physician or pharmacist-led medication reconciliation process might reduce DSB. Citation: Lu TH, Lee YY, Lee HC, Lin YM. Doctor shopping behavior for zolpidem among insomnia patients in Taiwan: a nationwide population-based study. SLEEP 2015;38(7):1039–1044. PMID:25761979

Patterns of outpatient care utilization by seniors under the National Health Insurance in Taiwan.

PubMed

Hsu, Wen-Chin; Hsu, Yi-Ping

2016-05-01

Taiwan has one of the fastest growing aging populations in the world, which makes the effective allocation of scarce medical resources a key issue. This paper investigates patterns in the use of outpatient services by elderly individuals in Taiwan under the National Health Insurance (NHI) program. We assembled a random sample from the NHI Research Database in Taiwan, comprising 50% of all claims made for elderly people (65 years old) in 2010 (n 1,239,836 beneficiaries) including 14 variables. In 2010, individuals aged 65 years or older comprised 10.74% of the population of Taiwan, and accounted for 11.39% of all physician and outpatient visits. The rate of medical care visits was 28.54 ± 21.23 (Standard deviation) times per person per annum, with a higher rate for women, those in the 80-84 age group, low-income beneficiaries, and the inhabitants of offshore islands. The three most frequent diagnoses for elderly patients were hypertension, diabetes, and acute upper respiratory infections. The mean insured medical costs per person per annum were US Dollars 1,132, with higher expenses for men, those in the 80-84 age group, and those inhabiting urban areas. This study employed nationally representative data in the detection of patterns in outpatient care utilization by elderly individuals in Taiwan. Medical care providers and policymakers should be fully aware of the complex patterns unique to older patients. The results of this study could be used as a benchmark with which to assess the impact of future medical care policy on elderly people. Copyright © 2015. Published by Elsevier B.V.

Prevalence of tobacco use among junior high and senior high school students in Taiwan.

PubMed

Chen, Ping-Ling; Huang, Weigang; Chuang, Yi-Li; Warren, Charles W; Jones, Nathan R; Asma, Samira

2008-12-01

Tobacco use is a major preventable cause of death in the world. This article describes and compares tobacco use prevalence for students attending junior high schools and senior high schools in Taiwan. This report uses data from the Global Youth Tobacco Survey (GYTS) completed among 4689 junior high school students and 4426 senior high school students in Taiwan in 2004-2005. The GYTS uses a 2-stage sampling design to produce nationally representative data for junior and senior high students in general and vocational schools. Higher smoking prevalence was observed among senior high (10.1% general schools and 15.9% vocational schools) than junior high (5.5%) school students. Smoking prevalence of girls in junior high (3.2%) and senior high schools (4.6% general and 11.1% vocational) was almost as high or higher than adult females' (4.3%) smoking rates. The pattern of smoking intensity across school years and type of school shows that the percentage of smokers who were experimenters (47.1%) was higher in junior high school and the percentage of smokers who were regular/established smokers (over 50%) was higher in senior high school. Smoking prevalence described in this report shows that there are challenges facing the tobacco prevention and control program in Taiwan. The findings suggest that schools should increase their smoking initiation prevention efforts and make available cessation programs and counseling to help students quit smoking. If effective youth tobacco control programs are not developed and implemented in Taiwan, future morbidity and mortality attributed to tobacco will surely increase, especially among women.

Monitoring Resistance to Spinosad in the Melon Fly (Bactrocera cucurbitae) in Hawaii and Taiwan

PubMed Central

Hsu, Ju-Chun; Haymer, David S.; Chou, Ming-Yi; Feng, Hai-Tung; Chen, Hsaio-Han; Huang, Yu-Bing; Mau, Ronald F. L.

2012-01-01

Spinosad is a natural insecticide with desirable qualities, and it is widely used as an alternative to organophosphates for control of pests such as the melon fly, Bactrocera cucurbitae (Coquillett). To monitor the potential for development of resistance, information about the current levels of tolerance to spinosad in melon fly populations were established in this study. Spinosad tolerance bioassays were conducted using both topical applications and feeding methods on flies from field populations with extensive exposure to spinosad as well as from collections with little or no prior exposure. Increased levels of resistance were observed in flies from the field populations. Also, higher dosages were generally required to achieve specific levels of mortality using topical applications compared to the feeding method, but these levels were all lower than those used for many organophosphate-based food lures. Our information is important for maintaining effective programs for melon fly management using spinosad. PMID:22629193

Mass Communication in Taiwan: An Annotated Bibliography. Asian Mass Communication Bibliography Series 5.

ERIC Educational Resources Information Center

Yang, Shou-Jung, Comp.

This bibliography lists and describes published and unpublished material relating to mass communications in Taiwan, from 1945 to 1973. Almost all the items listed are written in Chinese. The bibliography is divided into 17 sections: bibliography and reference material; communication theory and research methods; communication (general); media…

Comparing PETS and GEPT in China and Taiwan

ERIC Educational Resources Information Center

Wu, Mei

2012-01-01

This paper compares the Public English Test System (PETS) administered in mainland, China and the General English Proficiency Test (GEPT) administered in Taiwan, from the aspects of test levels, test contents and scoring weight. Compared with the PETS, the GEPT is found to value the English productive skills more, and have a greater ability to…

Characteristics, Views Held of Agricultural Extension Activities, and Communication Behavior of Hsien Extension Supervisors in Taiwan.

ERIC Educational Resources Information Center

Hong, Pi-Feng

Government agencies in Taiwan have carried out agricultural extension programs since 1910, with the assistance of Farmers' Associations. Programs have been expanded since 1953, and now include both general extension (subsidy programs) and educational extension. Comparison of personal characteristics of hsien (county) Farmers' Association…

The Main Features and the Key Challenges of the Education System in Taiwan

ERIC Educational Resources Information Center

Chien, Chiu-Kuei Chang; Lin, Lung-Chi; Chen, Chun-Fu

2013-01-01

Taiwan has undergone radical innovation of its educational system in the wake of political liberalization and democratization, with a request for a change in the idea which diverts from "de-centralization" to "individualization." The reforms have led to two main features of pluralism and generalization of education in our…

A Critical Study of Vocational-Industrial Education in Taiwan.

ERIC Educational Resources Information Center

Koo, Po-Ken

This study was concerned with determining the kind of vocational-industrial educational programs that would best suit the needs of Taiwan. The general conditions and provisions of 27 existing vocational-industrial programs were studied to determine their strengths and weaknesses and to provide a set of principles that would serve as guideposts for…

JPRS Report China.

DTIC Science & Technology

1993-05-14

Surpasses Taiwan [GUOJI JINGMAO XIAOXI 16 Mar] 26 POPULATION Male Chauvinism Hinders Family Planning Program [ZHONGGUO RENKOU BAO 1 Mar...transitional period, thereby letting the enterprises obtain their deserved economic returns. POPULATION Male Chauvinism Hinders Family Planning Program

Geographic Variation in Cancer Incidence among Children and Adolescents in Taiwan (1995–2009)

PubMed Central

Hung, Giun-Yi; Horng, Jiun-Lin; Yen, Hsiu-Ju; Lee, Chih-Ying; Lee, Yu-Sheng

2015-01-01

Background Evidence from our recent study suggested that the overall trend for cancer incidence in children and adolescents has been increasing in Taiwan. Methods To analyze geographic variations in this trend, cancer frequencies and incidence rates of disease groups were quantified according to geographic areas among 12,633 patients aged <20 years during 1995–2009 by using the population-based Taiwan Cancer Registry. Three geographic levels were defined, namely county or city, region (Northern, Central, Southern, and Eastern Taiwan), and local administrative area (special municipality, provincial city, county-administered city, township, and aboriginal area). Results Of the regions, Northern Taiwan had the highest incidence rate at 139.6 per million person-years, followed by Central (132.8), Southern (131.8), and Eastern (128.4) Taiwan. Significantly higher standardized rate ratios (SRRs) were observed in Northern Taiwan (SRR = 1.06, 95% confidence interval [CI] = 1.02–1.10) and at the township level (SRR = 1.07, 95% CI = 1.03–1.11). Of the cities or counties, New Taipei City yielded the highest SRR (1.08), followed by Taipei City (SRR = 1.07). A comparison of the rates in the four regions and the remainder of Taiwan according to cancer type revealed that only the rate of neuroblastomas in Eastern Taiwan was significantly low. Trend analysis showed that the most significant increase in incidence rate was observed at the township level, with an annual percent change of 1.8% during the 15-year study period. Conclusions The high rate of childhood cancer in Northern Taiwan and at the township level deserves further attention. The potential impacts of environmental factors on the upward trend of childhood cancer incidence rate in townships warrant further investigation. PMID:26192415

Geographic Variation in Cancer Incidence among Children and Adolescents in Taiwan (1995-2009).

PubMed

Hung, Giun-Yi; Horng, Jiun-Lin; Yen, Hsiu-Ju; Lee, Chih-Ying; Lee, Yu-Sheng

2015-01-01

Evidence from our recent study suggested that the overall trend for cancer incidence in children and adolescents has been increasing in Taiwan. To analyze geographic variations in this trend, cancer frequencies and incidence rates of disease groups were quantified according to geographic areas among 12,633 patients aged <20 years during 1995-2009 by using the population-based Taiwan Cancer Registry. Three geographic levels were defined, namely county or city, region (Northern, Central, Southern, and Eastern Taiwan), and local administrative area (special municipality, provincial city, county-administered city, township, and aboriginal area). Of the regions, Northern Taiwan had the highest incidence rate at 139.6 per million person-years, followed by Central (132.8), Southern (131.8), and Eastern (128.4) Taiwan. Significantly higher standardized rate ratios (SRRs) were observed in Northern Taiwan (SRR = 1.06, 95% confidence interval [CI] = 1.02-1.10) and at the township level (SRR = 1.07, 95% CI = 1.03-1.11). Of the cities or counties, New Taipei City yielded the highest SRR (1.08), followed by Taipei City (SRR = 1.07). A comparison of the rates in the four regions and the remainder of Taiwan according to cancer type revealed that only the rate of neuroblastomas in Eastern Taiwan was significantly low. Trend analysis showed that the most significant increase in incidence rate was observed at the township level, with an annual percent change of 1.8% during the 15-year study period. The high rate of childhood cancer in Northern Taiwan and at the township level deserves further attention. The potential impacts of environmental factors on the upward trend of childhood cancer incidence rate in townships warrant further investigation.

A Retrospective Population-Based Data Analyses of Inpatient Care Use and Medical Expenditure in People with Intellectual Disability Co-Occurring Schizophrenia

ERIC Educational Resources Information Center

Lai, Chia-Im; Hung, Wen-Jiu; Lin, Lan-Ping; Chien, Wu-Chien; Lin, Jin-Ding

2011-01-01

The paper aims to analyze the hospital inpatient care use and medical fee of people with ID co-occurring with schizophrenia in Taiwan. A nationwide data were collected concerning hospital admission and medical expenditure of people with ID (n = 2565) among national health insurance beneficiaries in Taiwan. Multiple regression analyses were…

Urolithiasis risk: a comparison between healthcare providers and the general population.

PubMed

Chen, Ming-Hung; Weng, Shih-Feng; Hsu, Chien-Chin; Lin, Hung-Jung; Su, Shih-Bin; Wang, Jhi-Joung; Guo, How-Ran; Huang, Chien-Cheng

2016-07-18

Healthcare providers have many health-related risk factors that might contribute to urolithiasis: a heavy workload, a stressful workplace, and an unhealthy quality of life. However, the urolithiasis risk in healthcare providers is not clear. Using Taiwan's National Health Insurance Research Database, we identified 50,226 physicians, 20,677 pharmacists, 122,357 nurses, and 25,059 other healthcare providers as the study cohort and then randomly selected an identical number of patients who are not healthcare providers (general population) as the comparison cohort for this study. Conditional logistical regression analysis was used to compare the urolithiasis risk between healthcare providers and comparisons. Physician specialty subgroups were also analyzed. Physicians had a lower urolithiasis risk than did the general population (adjusted odds ratio [AOR]: 0.682; 95 % confidence interval [CI]: 0.634-0.732) and other healthcare providers (AOR: 0.661; 95 % CI 0.588-0.742) after adjusting for hypertension, diabetes, hyperlipidemia, coronary artery disease, and residence location. For pharmacists, nurses, and other healthcare providers, the urolithiasis risk was not significantly different than that for general population. Subgroup analysis showed that surgeons and family medicine physicians had a lower urolithiasis risk than did physician comparisons (AOR: 0.778; 95 % CI: 0.630-0.962 and AOR: 0.737; 95 % CI: 0.564-0.962, respectively). Although job stress and heavy workloads affect physicians' health, physicians had a lower urolithiasis risk than did the general population and other healthcare providers. This might be attributable to their greater medical knowledge and access to healthcare. Our findings provide useful information for public health policy makers about the disease risks of healthcare providers.

Molecular genetic diversity of the Saccharomyces yeasts in Taiwan: Saccharomyces arboricola, Saccharomyces cerevisiae and Saccharomyces kudriavzevii.

PubMed

Naumov, Gennadi I; Lee, Ching-Fu; Naumova, Elena S

2013-01-01

Genetic hybridization, sequence and karyotypic analyses of natural Saccharomyces yeasts isolated in different regions of Taiwan revealed three biological species: Saccharomyces arboricola, Saccharomyces cerevisiae and Saccharomyces kudriavzevii. Intraspecies variability of the D1/D2 and ITS1 rDNA sequences was detected among S. cerevisiae and S. kudriavzevii isolates. According to molecular and genetic analyses, the cosmopolitan species S. cerevisiae and S. kudriavzevii contain local divergent populations in Taiwan, Malaysia and Japan. Six of the seven known Saccharomyces species are documented in East Asia: S. arboricola, S. bayanus, S. cerevisiae, S. kudriavzevii, S. mikatae, and S. paradoxus.

Predictors of Internet use for health information among male and female Internet users: Findings from the 2009 Taiwan National Health Interview Survey.

PubMed

Koo, Malcolm; Lu, Ming-Chi; Lin, Shih-Chun

2016-10-01

The Internet is an increasingly important source of health information for the general population. Both preventive health behavior and Internet use are known to be different between men and women. However, few studies have compared predictors of Internet use for health information between the sexes. To investigate the prevalence and predictors of Internet use for health information among male and female adult Internet users using data from a population-based survey in Taiwan. Respondents between the ages of 20-65 years were identified from the dataset of the 2009 Taiwan National Health Interview Survey. The outcome variable of the study, the utilization of the Internet for health information, was ascertained by asking whether the respondent had ever used the Internet to search for health information or obtain health services. Univariate and multivariate logistic regression analyses were conducted separately for men and women to evaluate factors associated with the use of Internet for health information. Of the 2741 adults aged 20-65 years who had ever used the Internet, 1766 (64.4%) of them had used it for health information or services. Multivariate logistic regression analyses showed that a higher educational level (adjusted odds ratio [AOR]=3.60, P<0.001), living alone (AOR=1.77, P=0.019), had exercised in the past two weeks (AOR=2.41, P<0.001), residing in city or urban district (AOR=1.28, P=0.049), with a perceived health status of extremely good, very good, or good (AOR=1.34, P=0.022), and had used Western medicine services in the past month (AOR=1.51, P=0.005) were significantly associated with health information use in male Internet users. On the other hand, age between 20-44.9 years (AOR=1.87, P<0.001), a higher educational level (AOR=3.57, P<0.001), being married (AOR=1.68, P=0.001), had exercised in the past two weeks (AOR=1.56, P<0.001), and had a mean monthly personal income of NT$ 20,000 and above were significant factors in female Internet users. This secondary data analysis of a representative sample of Taiwan population revealed that a similar but not identical set of independent factors was associated with the use of Internet for health information between male and female Internet users. Copyright © 2016. Published by Elsevier Ireland Ltd.

Absence of endemic measles transmission in a highly vaccinated population from 1999 to 2008: implications of sustained measles elimination in Taiwan.

PubMed

Chang, Yu-Kang; Chen, Jacky Y H; Chang, Hsiao-Ling; Yu, Mei-Ching; Hsiao, Hsu-Feng; Hou, Ching-Cheng; Liu, Shyun-Yeu; Chen, Kow-Tong

2010-07-19

Measles remains a leading vaccine-preventable cause of child mortality worldwide. The impact of vaccination programs can be seen in the increasingly low incidence of measles. However, cases of measles continue to occur in low numbers every year in Taiwan. We assessed the epidemiology of measles in Taiwan from 1999 to 2008 with a focus on domestic versus imported cases. We analyzed the data reported to surveillance systems at the Taiwan Center for Disease Control, where viral isolation was performed. A total of 84 measles cases were reported from 1999 to 2008 in Taiwan with the incidence of measles varying from 0 to 1.5 per 1,000,000 people per year, peaking in 2002 and again in 2008. The incidence decreased with increasing age in both males and females. Among the 84 reported measles cases, 39 (46%) originated internationally, 8 (10%) were epidemiologically linked to imported cases and the source was unknown in 37 (44%) of the cases. The unknown-source cases were analyzed for potential evidence of endemic measles transmission. Most of the measles cases that occurred in Taiwan from 1999 to 2008 were associated with imported cases. No endemic transmission of measles in Taiwan was identified. This study suggests that maintaining the high rate of vaccination coverage is needed to prevent future outbreak and sustain the elimination of measles in Taiwan. (c) 2010 Elsevier Ltd. All rights reserved.

Losses of seabirds in gill nets in the North Pacific

USGS Publications Warehouse

DeGange, Anthony R.; Day, Robert H.; Takekawa, Jean E.; Mendenhall, Vivian M.; Vermeer, Kees; Briggs, K.T.; Morgan, K.H.; Siegel-Causey, D.

1993-01-01

Existing knowledge on high-seas and coastal gillnet fisheries known to kill seabirds in the North Pacific is summarized. Recent estimates suggest that high-seas gillnet fisheries may have taken more than 500,000 seabirds in 1990. The majority of birds taken in those fisheries were Sooty Puffinus griseus or Short-tailed P. tenuirostris shearwaters. A recent analysis of impacts of those fisheries suggests that both shearwater populations may be declining slightly, although overall populations remain large. Impacts on seabirds of gillnet fishing in coastal waters are poorly known, except in California. Incidental mortality of seabirds in coastal gillnet fisheries may be adding additional stress to populations already compromised by habitat destruction and oil spills. Local populations of Marbled Murrelets Brachyramphus marmoratus, Common Murres Uria aalge, and Japanese Murrelets Synthliboramphus wumizusume may be particularly vulnerable to coastal gillnet fisheries. United National General Assembly Resolution 44/225 called for a moratorium on high-seas gillnet fishing by 30 June 1992. Japan has complied and Korea and Taiwan will comply with the moratorium.

The impacts of DRG-based payments on health care provider behaviors under a universal coverage system: a population-based study.

PubMed

Cheng, Shou-Hsia; Chen, Chi-Chen; Tsai, Shu-Ling

2012-10-01

To examine the impacts of diagnosis-related group (DRG) payments on health care provider's behavior under a universal coverage system in Taiwan. This study employed a population-based natural experiment study design. Patients who underwent coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty, which were incorporated in the Taiwan version of DRG payments in 2010, were defined as the intervention group. The comparison group consisted of patients who underwent cardiovascular procedures which were paid for by fee-for-services schemes and were selected by propensity score matching from patients treated by the same group of surgeons. The generalized estimating equations model and difference-in-difference analysis was used in this study. The introduction of DRG payment resulted in a 10% decrease (p<0.001) in patient's length of stay in the intervention group in relation to the comparison group. The intensity of care slightly declined with p<0.001. No significant changes were found concerning health care outcomes measured by emergency department visits, readmissions, and mortality after discharge. The DRG-based payment resulted in reduced intensity of care and shortened length of stay. The findings might be valuable to other countries that are developing or reforming their payment system under a universal coverage system. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Acculturation, psychiatric comorbidity and posttraumatic stress disorder in a Taiwanese aboriginal population.

PubMed

Lee, Chau-Shoun; Chang, Jung-Chen; Liu, Chia-Yih; Chang, Ching-Jui; Chen, Tony H H; Chen, Chien-Hsiun; Cheng, Andrew T A

2009-01-01

This study investigates acculturation and other antecedent psychiatric and socio-environmental risk factors for posttraumatic stress disorder (PTSD) in one aboriginal group (the Bunun) exposed to an earthquake disaster in Taiwan. Respondents (n = 196) were assessed 5 months after the disaster, using a Chinese version of the Schedules for Clinical Assessment in Neuropsychiatry and the Taiwan Aboriginal Acculturation Scale. Four risk factors exerted independent effect on the risk of PTSD, including magnitude of the earthquake, subsequent traumas, antecedent major depressive disorder and acculturation status. Public mental health programs need to consider the liability to PTSD in populations with different ethnicity and socio-cultural environments.

Vocational Education Influence on Underemployment in Taiwan, Republic of China.

ERIC Educational Resources Information Center

Wang, Dan-Shang; Hsieh, Yuh-Er

A study to identify the influence of vocational education on an individual's underemployment analyzed data from a Taiwan labor use survey conducted in May 1993. Data were restricted to 9,415 respondents who were currently employed, aged 20-65, and not in the army; who had participated in general or vocational high school education; and for whom…

The correlates of leisure time physical activity among an adults population from southern Taiwan.

PubMed

Chen, Yi-Ju; Huang, Ying-Hsiang; Lu, Feng-Hwa; Wu, Jin-Shang; Lin, Linda L; Chang, Chih-Jen; Yang, Yi-Ching

2011-06-03

Assessing the correlates of practicing physical activity during leisure time is important with regard to planning and designing public health strategies to increase beneficial behaviors among adult populations. Although the importance of leisure time physical activity (LTPA) is highlighted in many Western countries, there are not many publications on physical activity patterns, and even less on their correlates, in non-Western societies. The goal of this study was thus to explore the determinants influencing adults' leisure time physical activity (LTPA) in a city in southern Taiwan. A cross-sectional population-based study was conducted in 2007, using a standardized questionnaire. Energy expenditure was dichotomized into two groups based on the recommended levels of moderate physical activity from LTPA: ≥10 or < 10 MET·hr·wk(-1). Logistic regression analyses were applied to the results. A total of 762 subjects with valid data took part in the study (mean age 53.8 ± 13.8 years). In multivariate logistic regression analysis, we found the following results: Age was positively associated with LTPA. Adults with stronger perceived convenience of exercise facilities (OR = 2.04; 95%CI = 1.28-3.24) and past exercise experience in school (OR = 1.86; 95%CI= 1.19-2.91) participated in more LTPA. Subjects with more general social support (OR = 1.66;95%CI = 1.13-2.44), greater knowledge about the health benefits of exercise (OR = 1.85;95%CI = 1.25-2.74), more sports media consumption (OR = 1.94;95%CI = 1.26-2.98), and higher self-efficacy (OR = 3.99;95%CI = 2.67-5.97) were more likely to engage in LTPA. Further analysis comparing different sources of social support showed only social support from friends had a significant positive association (OR = 1.73;95%CI = 1.14-2.63) with increased LTPA. LTPA in southern city of Taiwan showed some unique associations with age, socioeconomic status and media consumption that are not commonly reported in the Western World and similar associations with regards to psychosocial correlates of LTPA participation. Further studies from developing countries are warranted to highlight culture-specific differences in physical activity participation.

Does marital status predict the odds of suicidal death in taiwan? A seven-year population-based study.

PubMed

Yeh, Jui-Yuan; Xirasagar, Sudha; Liu, Tsai-Ching; Li, Chong-Yi; Lin, Herng-Ching

2008-06-01

Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups-total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly selected from age, sex, and geographic region matched controls, four per suicide)-were studied. Using multiple logistic regression analysis including age-marital status interaction, adjusted estimates show divorced status to be the most detrimental for suicide propensity, with males showing stronger effect size. Females never married, aged below 35 and 65-plus, and widowed 65-plus had lower suicide odds.

Identifying Vulnerable Populations Using a Social Determinants of Health Framework: Analysis of National Survey Data across Six Asia-Pacific Countries

PubMed Central

Ward, Paul R.; Mamerow, Loreen; Meyer, Samantha B.

2013-01-01

Background In order to improve the health of the most vulnerable groups in society, the WHO called for research on the multiple and inter-linking factors shaping the social determinants of health (SDH). This paper analyses four key SDH (social cohesion, social inclusion, social empowerment and socioeconomic security) across six Asia-Pacific countries: Australia, Hong Kong, Japan, South Korea, Taiwan, and Thailand. Methods Population surveys were undertaken using a validated instrument in 2009-10, with sample sizes around 1000 in each country. The four SDH were analysed using multivariate binomial logistic regression to identify socio-demographic predictors in each country. Results Low socio-economic security was associated with low income in all six study countries and with poor subjective health in Japan, South Korea and Thailand and with being married or cohabiting in Australia and Hong Kong. Low social cohesion was associated with low income in all countries and with undertaking household duties in South Korea, Thailand and Taiwan. Low social inclusion was associated with low income in Australia, South Korea and Taiwan and with poor subjective health in Australia, Japan and South Korea. Older people had lower social inclusion in Taiwan (50-59 years) and Hong Kong (retired), younger people in Japan and South Korea (20-29 years in both countries) and younger and middle-aged people in Australia. Low social empowerment was associated with low income in Australia, Thailand and Taiwan, with being aged 60 years or over in Australia, Hong Kong and South Korea, and over 50 years in Thailand. Conclusions This paper provides baseline measures for identifying where and how policy should be altered to improve the SDH. Furthermore, these data can be used for future policy evaluation to identify whether changes in policy have indeed improved the SDH, particularly for marginalised and vulnerable populations. PMID:24349417

Nationwide singleton birth weight percentiles by gestational age in Taiwan, 1998-2002.

PubMed

Hsieh, Wu-Shiun; Wu, Hui-Chen; Jeng, Suh-Fang; Liao, Hua-Fang; Su, Yi-Ning; Lin, Shio-Jean; Hsieh, Chia-Jung; Chen, Pau-Chung

2006-01-01

There are limited nationwide population-based data about birth weight percentiles by gestational age in Taiwan. The purpose of this study was to develop updated intrauterine growth charts that are population based and contain the information of birth weight percentiles by gestational age for singleton newborns in Taiwan. We abstracted and analyzed the birth registration database from the Ministry of the Interior in Taiwan during the period of 1998-2002 that consisted of over one million singleton births. Percentiles of birth weight for each increment of gestational week from 21 to 44 weeks were estimated using smoothed means and standard deviations. The analyses revealed that birth weight rose with advancing gestational age, with greater slopes during the third trimester and then leveled off beyond 40 weeks of gestational age. The male to female ratio ranged from 1.088 to 1.096. The mean birth weights during the period of 1998-2002 were higher than those previously reported for the period of 1945-1967; while the birth weight distribution and percentile during the period of 1998-2002 were similar to those reported for the period of 1979-1989. The 10th, 50th, and 90th percentiles of birth weigh at 40th gestational age among the male newborns were 2914, 3374, and 3890 g respectively; and for the female newborns 2816, 3250, and 3747 g. At the gestational age of 37 weeks, the 10th, 50th, and 90th percentiles of birth weigh among the male newborns were 2499, 2941, and 3433 g respectively; and for the female newborns 2391, 2832, and 3334 g. From 1998 to 2002, there was a gradual increase in the prevalence of low birth weight and preterm birth together with the percentage of infants born to foreign-born mothers. This study provides the first nationwide singleton intrauterine growth charts in Taiwan that are population-based and gender-specific. The normative data are particularly useful for the investigation of predictors and outcomes of altered fetal growth.

Indoor Air Quality in the Metro System in North Taiwan.

PubMed

Chen, Ying-Yi; Sung, Fung-Chang; Chen, Mei-Lien; Mao, I-Fang; Lu, Chung-Yen

2016-12-02

Indoor air pollution is an increasing health concern, especially in enclosed environments such as underground subway stations because of increased global usage by urban populations. This study measured the indoor air quality of underground platforms at 10 metro stations of the Taipei Rapid Transit system (TRTS) in Taiwan, including humidity, temperature, carbon monoxide (CO), carbon dioxide (CO₂), formaldehyde (HCHO), total volatile organic compounds (TVOCs), ozone (O₃), airborne particulate matter (PM 10 and PM 2.5 ), bacteria and fungi. Results showed that the CO₂, CO and HCHO levels met the stipulated standards as regulated by Taiwan's Indoor Air Quality Management Act (TIAQMA). However, elevated PM 10 and PM 2.5 levels were measured at most stations. TVOCs and bacterial concentrations at some stations measured in summer were higher than the regulated standards stipulated by Taiwan's Environmental Protection Administration. Further studies should be conducted to reduce particulate matters, TVOCs and bacteria in the air of subway stations.

Mammography usage with relevant factors among women with mental disabilities in Taiwan: a nationwide population-based study.

PubMed

Yen, Suh-May; Kung, Pei-Tseng; Tsai, Wen-Chen

2015-02-01

Women with mental illness are at increased risk of developing and dying from breast cancer and are thus in urgent need of breast cancer preventive care. This study examined the use of screening mammography by Taiwanese women with mental disabilities and analyzed factors affecting this use. 17,243 Taiwanese women with mental disabilities aged 50-69 years were retrospectively included as study subjects. Linked patient data were obtained from three national databases in Taiwan (the 2008 database of physically and mentally disabled persons, the Health Promotion Administration's 2007-2008 mammography screening data, and claims data from the National Health Insurance Research Database). Besides descriptive statistics and bivariate analysis, logistic regression analysis was also performed to examine factors affecting screening mammography use. The 2007-2008 mammography screening rate for Taiwanese women with mental disabilities was 8.79% (n=1515). Variables that significantly influenced screening use were income, education, presence of catastrophic illness/injury, severity of mental disability, and usage of other preventive care services. Screening was positively correlated with income and education. Those with catastrophic illness/injury were more likely to be screened (odds ratio [OR], 1.40; 95% CI=1.15-1.72). Severity of disability was negatively correlated with screening, with very severe, severe, and moderate disability being associated with 0.34-0.69 times the odds of screening as mild disability. In Taiwan, women with mental disabilities receive far less mammography screening than women in general. Copyright © 2014 Elsevier Ltd. All rights reserved.

Investigating the adaptive model of thermal comfort for naturally ventilated school buildings in Taiwan.

PubMed

Hwang, Ruey-Lung; Lin, Tzu-Ping; Chen, Chen-Peng; Kuo, Nai-Jung

2009-03-01

Divergence in the acceptability to people in different regions of naturally ventilated thermal environments raises a concern over the extent to which the ASHRAE Standard 55 may be applied as a universal criterion of thermal comfort. In this study, the ASHRAE 55 adaptive model of thermal comfort was investigated for its applicability to a hot and humid climate through a long-term field survey performed in central Taiwan among local students attending 14 elementary and high schools during September to January. Adaptive behaviors, thermal neutrality, and thermal comfort zones are explored. A probit analysis of thermal acceptability responses from students was performed in place of the conventional linear regression of thermal sensation votes against operative temperature to investigate the limits of comfort zones for 90% and 80% acceptability; the corresponding comfort zones were found to occur at 20.1-28.4 degrees C and 17.6-30.0 degrees C, respectively. In comparison with the yearly comfort zones recommended by the adaptive model for naturally ventilated spaces in the ASHRAE Standard 55, those observed in this study differ in the lower limit for 80% acceptability, with the observed level being 1.7 degrees C lower than the ASHRAE-recommended value. These findings can be generalized to the population of school children, thus providing information that can supplement ASHRAE Standard 55 in evaluating the thermal performance of naturally ventilated school buildings, particularly in hot-humid areas such as Taiwan.

Investigating the adaptive model of thermal comfort for naturally ventilated school buildings in Taiwan

NASA Astrophysics Data System (ADS)

Hwang, Ruey-Lung; Lin, Tzu-Ping; Chen, Chen-Peng; Kuo, Nai-Jung

2009-03-01

Divergence in the acceptability to people in different regions of naturally ventilated thermal environments raises a concern over the extent to which the ASHRAE Standard 55 may be applied as a universal criterion of thermal comfort. In this study, the ASHRAE 55 adaptive model of thermal comfort was investigated for its applicability to a hot and humid climate through a long-term field survey performed in central Taiwan among local students attending 14 elementary and high schools during September to January. Adaptive behaviors, thermal neutrality, and thermal comfort zones are explored. A probit analysis of thermal acceptability responses from students was performed in place of the conventional linear regression of thermal sensation votes against operative temperature to investigate the limits of comfort zones for 90% and 80% acceptability; the corresponding comfort zones were found to occur at 20.1-28.4°C and 17.6-30.0°C, respectively. In comparison with the yearly comfort zones recommended by the adaptive model for naturally ventilated spaces in the ASHRAE Standard 55, those observed in this study differ in the lower limit for 80% acceptability, with the observed level being 1.7°C lower than the ASHRAE-recommended value. These findings can be generalized to the population of school children, thus providing information that can supplement ASHRAE Standard 55 in evaluating the thermal performance of naturally ventilated school buildings, particularly in hot-humid areas such as Taiwan.

Effect of Meteorological Conditions and Geographical Factors in the Onset of Enterovirus 71

NASA Astrophysics Data System (ADS)

Chen, Yu-An; Yu, Hwa-Lung

2015-04-01

Since it was first recognized in California in 1969, enterovirus 71 (EV71) infection has been a significant cause of neurological disorder and death in children worldwide. In 1998 a historic epidemic of EV71 infection caused hand-foot-and-mouth disease and herpangina in thousands of people in Taiwan. The impact of EV71 infection is greatest during the summer months in Asia, and epidemics recur with a seasonal pattern. It was reported that seasonal patterns of EV71 differed by geographical localities. Previous studies have also showed significant relationships between meteorological variables, in particular, temperature and relative humidity, and the seasonal epidemic patterns of EV71. However, important issues that remain unclear include the spatiotemporal pattern of the EV71 outbreaks in Taiwan, and what role of favorable meteorological conditions in the transmission of the disease in the space-time domain. Thus, this study used a semiparametric generalized additive model (GAM) to understand the association between EV71 and meteorological factors across space and time. This study utilized a population-based database containing space-time data for clinic and hospital visits (i.e., hospital location and appointment times) of EV71 occurring in children less than 18 years old in Taipei from 1998 to 2008. Meteorological data (i.e., temperature, rainfall, and relative humidity) for the study period were provided by the Taiwan Central Weather Bureau. This study expect to find out an important meteorological factor and threshold.

Mortality among shipbreaking workers in Taiwan--a retrospective cohort study from 1985 to 2008.

PubMed

Wu, Wei-Te; Lu, Yao-Hua; Lin, Yu-Jen; Yang, Ya-Hui; Shiue, Huei-Sheng; Hsu, Jin-Huei; Li, Chung-Yi; Yang, Chun-Yuh; Liou, Saou-Hsing; Wu, Trong-Neng

2013-06-01

Shipbreaking workers are typically exposed to a wide range of hazardous chemicals. However, long-term follow-up studies of their mortality patterns are lacking. This study examined mortality among shipbreaking workers over a 24-year follow-up period. A total of 4,962 shipbreaking workers were recruited from the database of the Kaohsiung Shipbreaking Workers Union. The data were then linked to the Taiwan National Death Registry from 1985 to 2008. The mortality ratios-standardized for age and calendar years-(SMRs) for various causes of deaths were calculated with reference to the general population of Taiwan. Among men workers, a statistically significant increased SMR was observed for all causes (SMR = 1.28), all cancers (SMR = 1.26; particularly noteworthy for lesions of oral and nasopharyngeal: SMR 2.03, liver: SMR 4.63, and lung: SMR 1.36), cirrhosis of the liver (SMR = 1.32), and accidents (SMR = 1.91). A statistically significant increase in mortality was observed for respiratory system cancer (SMR = 1.87) and lung cancer (SMR = 1.91) among workers with a longer duration of employment (≥7 years). The result also showed that among shipbreaking workers who were still alive, two people had mesothelioma and 10 people have asbestosis. Those employed in shipbreaking industries experienced an increase in mortality from all causes. The increased SMR for lung cancer was probably related to asbestos, metals, and welding fume exposure. Copyright © 2013 Wiley Periodicals, Inc.

Short-form Mini-Nutritional Assessment with either BMI or calf circumference is effective in rating the nutritional status of elderly Taiwanese -- results of a national cohort study.

PubMed

Tsai, Alan C; Chang, Tsui-Lan; Wang, Jiun-Yi

2013-09-28

The present study was aimed to validate two normalised short-form (SF) Mini-Nutritional Assessments (MNA) that contained either BMI (Taiwan version 1, T1) or calf circumference (CC; Taiwan version 2, T2) for rating the nutritional status of elderly Taiwanese. Both versions adopted Taiwanese anthropometric cut-offs, but T2 further had the BMI item replaced by CC. We compared the ability of the two SF in rating the nutritional status of 2674 elderly Taiwanese in the 1999 ‘Taiwan Longitudinal Survey on Aging’ with their respective full versions. We evaluated the agreement between the SF and full scales with weighted κ and performed Cox regression analysis for the follow-up 4-year mortality according to nutritional status rated at baseline. The results showed that the agreements between the respective SF and the full MNA were good (weighted κ: 0·679 for T1 and 0·667 for T2). Both SF performed well in predicting follow-up 4-year mortality relative to the full MNA. In conclusion, MNA-T1-SF and -T2-SF have good consistency with the full MNA and have quite comparable abilities in rating the nutritional status of elderly Taiwanese. Both SF versions appear appropriate for functioning as stand-alone units for rating the nutritional status of the elderly in community-living settings or the general population.

[The evolution of national health and the development of the nursing practice in Taiwan].

PubMed

Yin, Teresa J C

2014-08-01

Nursing is an applied science. While there is a wide range of nursing theories and nursing care models, resolving the health problems and meeting the health needs of clients is the common objective of all in the nursing profession. The nursing profession may be subdivided into hospital clinical nursing and community health nursing (CHN). CHN is further subdivided into public health nursing, school health nursing, and industrial health nursing. The past 60 years has been a period of significant growth and improvement in Taiwan that has enhanced the nation's socioeconomic condition, general living standards, and general public health. The nursing profession has seen profound progress as well, not only in terms of content but also in terms of nursing care models, which are increasingly framed around core public health needs and take into consideration different health perspectives. Nursing in Taiwan has gradually established its own professional function and autonomy.

Bayesian spatial modelling and the significance of agricultural land use to scrub typhus infection in Taiwan.

PubMed

Wardrop, Nicola A; Kuo, Chi-Chien; Wang, Hsi-Chieh; Clements, Archie C A; Lee, Pei-Fen; Atkinson, Peter M

2013-11-01

Scrub typhus is transmitted by the larval stage of trombiculid mites. Environmental factors, including land cover and land use, are known to influence breeding and survival of trombiculid mites and, thus, also the spatial heterogeneity of scrub typhus risk. Here, a spatially autoregressive modelling framework was applied to scrub typhus incidence data from Taiwan, covering the period 2003 to 2011, to provide increased understanding of the spatial pattern of scrub typhus risk and the environmental and socioeconomic factors contributing to this pattern. A clear spatial pattern in scrub typhus incidence was observed within Taiwan, and incidence was found to be significantly correlated with several land cover classes, temperature, elevation, normalized difference vegetation index, rainfall, population density, average income and the proportion of the population that work in agriculture. The final multivariate regression model included statistically significant correlations between scrub typhus incidence and average income (negatively correlated), the proportion of land that contained mosaics of cropland and vegetation (positively correlated) and elevation (positively correlated). These results highlight the importance of land cover on scrub typhus incidence: mosaics of cropland and vegetation represent a transitional land cover type which can provide favourable habitats for rodents and, therefore, trombiculid mites. In Taiwan, these transitional land cover areas tend to occur in less populated and mountainous areas, following the frontier establishment and subsequent partial abandonment of agricultural cultivation, due to demographic and socioeconomic changes. Future land use policy decision-making should ensure that potential public health outcomes, such as modified risk of scrub typhus, are considered.

Diversification, Biogeographic Pattern, and Demographic History of Taiwanese Scutellaria Species Inferred from Nuclear and Chloroplast DNA

PubMed Central

Liao, Pei-Chun

2012-01-01

The ragged topography created by orogenesis generates diversified habitats for plants in Taiwan. In addition to colonization from nearby mainland China, high species diversity and endemism of plants is also present in Taiwan. Five of the seven Scutellaria species (Lamiaceae) in Taiwan, for example, are endemic to the island. Hypotheses of multiple sources or in situ radiation have arisen to explain the high endemism of Taiwanese species. In this study, phylogenetic analyses using both nuclear and chloroplast markers revealed the multiple sources of Taiwanese Scutellaria species and confirmed the rapid and recent speciation of endemic species, especially those of the “indica group” composed of S. indica, S. austrotaiwanensis, S. tashiroi, and S. playfairii. The common ancestors of the indica group colonized first in northern Taiwan and dispersed regionally southward and eastward. Climate changes during glacial/interglacial cycles led to gradual colonization and variance events in the ancestors of these species, resulting in the present distribution and genetic differentiation of extant populations. Population decline was also detected in S. indica, which might reflect a bottleneck effect from the glacials. In contrast, the recently speciated endemic members of the indica group have not had enough time to accumulate much genetic variation and are thus genetically insensitive to demographic fluctuations, but the extant lineages were spatially expanded in the coalescent process. This study integrated phylogenetic and population genetic analyses to illustrate the evolutionary history of Taiwanese Scutellaria of high endemism and may be indicative of the diversification mechanism of plants on continental islands. PMID:23226402

Lack of association between TaqI A1 Allele of dopamine D2 receptor gene and alcohol-use disorders in Atayal natives of Taiwan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chia-Hsiang Chen; Shih-Hsiang Chien; Hai-Gwo Hwu

1996-09-20

Association studies between the A1 allele of the dopamine D2 receptor (DRD2) gene TaqI A polymorphism and alcoholism remain controversial. A recent study from Japan demonstrated that the A1 allele is associated with severe alcoholism in the Japanese population. We were interested in knowing if this association also exists in the Atayals of Taiwan, who were found to have a higher prevalence of alcohol-use disorders than the Han Chinese in Taiwan. Genotype and allele frequencies were determined in alcohol-abusing, alcohol-dependent, and nonalcoholic control Atayal natives in Taiwan. A1 allele frequencies in alcohol-dependent, alcohol-abusing, and normal control Atayals were 0.39, 0.42,more » and 0.39, respectively. No difference in A1 allele frequency was found among these three groups. Our data do not support the hypothesis that the A1 allele of the TaqI A polymorphism of the DRD2 gene increases susceptibility to alcohol-use disorders in the Atayals of Taiwan. 18 refs., 1 tab.« less

MSW management for waste minimization in Taiwan: The last two decades

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lu, L.-T.; Hsiao, T.-Y.; Shang, N.-C.

2006-07-01

Taiwan is the second most densely populated country in the world; its 22.604 million residents (2002) live in an area of 35,967 km{sup 2} (628 people/km{sup 2}). Taiwan's economy has grown rapidly during the last 20 years, resulting in a corresponding increase in the amount of municipal solid waste (MSW). This study describes and evaluates the municipal solid waste management system in Taiwan. The study's results indicate that the amount of MSW began to decline after 1997, when the government enforced aggressive MSW management policies. By 2002, total MSW production had dropped by 27%, and the average daily per capitamore » weight of MSW had fallen from 1.14 kg in 1997 to 0.81 kg in 2002. Summarizing the successful experience of MSW reduction in Taiwan, the most important factor was the government's combining of the MSW collection system with reduction/recycling programs. The second most important factor was the policy of extended producer responsibility, which laid a foundation of recycling by producers and retailers and promoted public recycling.« less

[The parenting practices of transnational marriage mothers in Taiwan].

PubMed

Chuang, Li-Yu; Shu, Bih-Ching; Huang, Chiung-Chen

2013-02-01

Childhood experience is a cornerstone of personality development. A child's cognitive function, self-concept, and behavioral development relate significantly to parental attitudes as well as to the way they were treated during childhood. The literature suggests a significant association between parenting practices and the mental health of the parents, temperament of the child, and socio-cultural factors. Raising children is typically central to the life of transnational marriage women living in Taiwan. They view parenting children as a life transforming experience. However, they must invest more effort than local mothers to survive in Taiwan. Thus, it is worth investigating the parenting practices of this significant subset of Taiwan's population. This paper applied parenting concepts to describe the condition and possible problems of immigrant women in parenting children. Based on study results, we summarize transnational marriage and its impact on parenting practices. The authors hope this paper provides information useful to identifying parenting difficulties faced by immigrant mothers so that healthcare professionals can provide relevant information and assistance to improve overall parenting practices and benefit the development of Taiwan's youngest generation.

Statistical rice yield modeling using blended MODIS-Landsat based crop phenology metrics in Taiwan

NASA Astrophysics Data System (ADS)

Chen, C. R.; Chen, C. F.; Nguyen, S. T.; Lau, K. V.

2015-12-01

Taiwan is a populated island with a majority of residents settled in the western plains where soils are suitable for rice cultivation. Rice is not only the most important commodity, but also plays a critical role for agricultural and food marketing. Information of rice production is thus important for policymakers to devise timely plans for ensuring sustainably socioeconomic development. Because rice fields in Taiwan are generally small and yet crop monitoring requires information of crop phenology associating with the spatiotemporal resolution of satellite data, this study used Landsat-MODIS fusion data for rice yield modeling in Taiwan. We processed the data for the first crop (Feb-Mar to Jun-Jul) and the second (Aug-Sep to Nov-Dec) in 2014 through five main steps: (1) data pre-processing to account for geometric and radiometric errors of Landsat data, (2) Landsat-MODIS data fusion using using the spatial-temporal adaptive reflectance fusion model, (3) construction of the smooth time-series enhanced vegetation index 2 (EVI2), (4) rice yield modeling using EVI2-based crop phenology metrics, and (5) error verification. The fusion results by a comparison bewteen EVI2 derived from the fusion image and that from the reference Landsat image indicated close agreement between the two datasets (R2 > 0.8). We analysed smooth EVI2 curves to extract phenology metrics or phenological variables for establishment of rice yield models. The results indicated that the established yield models significantly explained more than 70% variability in the data (p-value < 0.001). The comparison results between the estimated yields and the government's yield statistics for the first and second crops indicated a close significant relationship between the two datasets (R2 > 0.8), in both cases. The root mean square error (RMSE) and mean absolute error (MAE) used to measure the model accuracy revealed the consistency between the estimated yields and the government's yield statistics. This study demonstrates advantages of using EVI2-based phenology metrics (derived from Landsat-MODIS fusion data) for rice yield estimation in Taiwan prior to the harvest period.

The effect of shovel trait on Carabelli's trait in Taiwan Chinese and Aboriginal populations.

PubMed

Hsu, J W; Tsai, P L; Hsiao, T H; Chang, H P; Lin, L M; Liu, K M; Yu, H S; Ferguson, D

1997-09-01

Chinese and other Mongoloid populations differ from Caucasoids by having a high prevalence of shovel trait and a low prevalence of Carabelli's trait. This study was conducted to compare the association between the shovel and the Carabelli's traits between Chinese and aboriginal Mongoloid populations. The research is designed to sample randomly a Chinese population and an aboriginal population having low admixture with neighboring populations. The Mongoloid aboriginal group was from the Bunun tribe who resides in an isolated alpine area in Taiwan. The effects of sex and age on Carabelli's trait were controlled in this study, as was the association between tooth size and Carabelli's trait. Our results show that males had more Carabelli's trait expressed on teeth than females in both of these two Mongoloid populations. The buccolingual diameter of Carabelli's trait teeth was larger than that of teeth without the trait. After controlling for sex, age, and tooth size, the existence of the shovel trait significantly increased the likelihood of having Carabelli's trait, especially in Chinese, which implies another significant ethnic feature for Mongoloid identification.

Genetic changes in muscle protein following hybridization between Haliotis diversicolor reeve Japan and Taiwan populations revealed using a proteomic approach.

PubMed

Di, Guilan; You, Weiwei; Yu, Jinjin; Wang, Dexiang; Ke, Caihuan

2013-03-01

Protein expression patterns were compared in a Japan and Taiwan population of Haliotis diversicolor and in a hybrid between them using 2DE and MALDI-TOF-TOF analyses. Using the software PDQuest, 924 ± 7 protein spots were detected in the Japan population (RR), 861 ± 11 in the Taiwan population (TT), and 882 ± 9 in the F1 hybrid (TR). RR and TR were clustered together, but the distance between RR and TT was the maximum using hierarchical cluster analysis. A total of 46 gel spots were identified and a total of 15 spots matched with abalone proteins (a 33.6% identification rate). Hybrid exhibiting additivity or overdominance accounted for 73.9% of these 46 identified proteins. The 46 differentially expressed proteins were shown to be involved in major biological processes, including muscle contraction and regulation, energy metabolism, and stress response. The proteins involved in energy metabolism included adenosine triphosphate (ATP) synthase β subunit, fructose 1, 6-bisphosphate aldolase, triosephosphate isomerase, enolase, arginine kinase, and tauropine dehydrogenase. These proteins exhibited additivity in their offspring. The proteins involved in stress responses included HSP Hsp70 (exhibiting overdominance in the offspring) and Cu/Zn-superoxide dismutase (exhibiting additivity). These results suggested that proteomic approach is suitable for analysis of heterosis and functional prediction of abalone hybridization. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A Genetic Analysis of Taoyuan Pig and Its Phylogenetic Relationship to Eurasian Pig Breeds

PubMed Central

Li, Kuan-Yi; Li, Kuang-Ti; Cheng, Chun-Chun; Chen, Chia-Hsuan; Hung, Chien-Yi; Ju, Yu-Ten

2015-01-01

Taoyuan pig is a native Taiwan breed. According to the historical record, the breed was first introduced to Taiwan from Guangdong province, Southern China, around 1877. The breed played an important role in Taiwan’s early swine industry. It was classified as an indigenous breed in 1986. After 1987, a conserved population of Taoyuan pig was collected and reared in isolation. In this study, mitochondrial DNA sequences and 18 microsatellite markers were used to investigate maternal lineage and genetic diversity within the Taoyuan pig population. Population differentiation among Taoyuan, Asian type, and European type pig breeds was also evaluated using differentiation indices. Only one D-loop haplotype of the Taoyuan pig was found. It clustered with Lower Changjiang River Basin and Central China Type pig breeds. Based on the polymorphism of microsatellite markers, a positive fixation index value (FIS) indicates that the conserved Taoyuan population suffers from inbreeding. In addition, high FST values (>0.2105) were obtained, revealing high differentiation among these breeds. Non-metric multi-dimensional scaling showed a clear geometric structure among 7 breeds. Together these results indicate that maternally Taoyuan pig originated in the Lower Changjiang River Basin and Central China; however, since being introduced to Taiwan differentiation has occurred. In addition, Taoyuan pig has lost genetic diversity in both its mitochondrial and nuclear genomes. PMID:25656199

The Effects of Reform in Principal Selection on Leadership Behavior of General and Vocational High School Principals in Taiwan

ERIC Educational Resources Information Center

Hsiao, Hsi-Chi; Lee, Ming-Chao; Tu, Ya-Ling

2013-01-01

Deregulation has formed the primary core of education reform in Taiwan in the past decade. The principal selection system was one of the specific recommendations in the deregulation of education. The method of designation of senior high school principals has changed from being "appointed" to being "selected." The issue as to…

Effects of Self-Evaluated Value and Cognition on Leisure Science Engagement

ERIC Educational Resources Information Center

Jack, Brady Michael; She, Hsiao-Ching; Lin, Huann-shyang

2016-01-01

This study uses the Taiwan Programme for International Student Assessment (PISA) 2006 Main Survey and Taiwan PISA 2015 Field Trial survey datasets to investigate how self-evaluated values (i.e. personal and general) and cognitive factors (i.e. self-efficacy and self-concept) of two groups of Taiwanese 15-year-old students separated by 8 years of…

Developing a Chinese Version of an Author Recognition Test for College Students in Taiwan

ERIC Educational Resources Information Center

Chen, Su-Yen; Fang, Sheng-Ping

2015-01-01

This study set out to develop a Chinese Author Recognition Test (CART) that might be used as a measure of objective print exposure for college students in Taiwan. We found that there is a linkage between print exposure and general reading achievement for college students. We also found that, among self-reported reading habits, comparative reading…

A Dialogic Classroom: Facilitating the Interaction on Cross-Taiwan-Strait Issues Regarding the Reconceptualization of the Evolution of Marxist Theories

ERIC Educational Resources Information Center

Chien, Chih-Feng

2011-01-01

With regard to the evolution of Marxist theories affecting the relationship between China and Taiwan historically and conceptually, this paper starts with the conceptual framing of the general evolution of Marxist theories--Marxism, neo-Marxist, and post-Marxism. Through dialectical and reconceptualized practice and learning the development of…

Does Educational Expansion Encourage Female Workforce Participation? A Study of the 1968 Reform in Taiwan

ERIC Educational Resources Information Center

Tsai, Wehn-Jyuan; Liu, Jin-Tan; Chou, Shin-Yi; Thornton, Robert

2009-01-01

Between 1968 and 1973 the Taiwanese government undertook the most extensive expansion on record of the public junior high school system in Taiwan. This study analyzes the effects of the 1968 education reform and subsequent high school expansion on gender disparities in employment generally, as well in different sectors and classes of employment.…

The Image of People with Intellectual Disability in Taiwan Newspapers

ERIC Educational Resources Information Center

Chen, Chih-Hsuan; Hsu, Kan-Lin; Shu, Bih-Ching; Fetzer, Susan

2012-01-01

Background: There is limited research on the development of newspaper analysis about the images of people with ID in Chinese newspapers. The purpose of this study was: (a) to understand the general image of persons with ID presented in printed newspapers in Taiwan, and (b) to classify the various images of persons with ID and to measure the…

The General Picture of Supportive Health Environments for Persons with Intellectual Disabilities among 121 Disability Welfare Institutions in Taiwan

ERIC Educational Resources Information Center

Lin, J.-D.; Yen, C.-F.; Loh, C.-H.; Chwo, M.-J.; Lee, J.-T.; Wu, J.-L.; Chu, C. M.; Tang, C.-C.

2006-01-01

Background: Little information is available on the provision of supportive health environments for persons with intellectual disabilities (ID) in institutions. The aim of this study was to present an overview of supportive environments for health in institutions in Taiwan. Methods: A cross-sectional survey was conducted to examine the perceptions…

A population-based analysis of use and outcomes of laparoscopic bariatric surgery across socioeconomic groups in Taiwan.

PubMed

Huang, Chun-Che; Huang, Yu-Tung; Chiu, Chong-Chi

2015-11-11

With the growing development of minimally invasive techniques for the treatment of morbid obesity, laparoscopic bariatric surgery (LBS) is increasingly performed. This study aimed to assess the association between patients' socioeconomic status (SES) and the likelihood of undergoing LBS and related outcomes in Taiwan. This nationwide population-based study was conducted by using data from Taiwan's National Health Insurance Research Database. A total of 3678 morbidly obese patients aged 18 years and older who underwent conventional open bariatric surgery or LBS were identified between 2004 and 2011. Regression analyses were performed using generalized estimating equation (GEE) models to account for the nesting of patients within physician to assess patients' SES category associated with the use of LBS and related outcomes. Odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated. Compared with those with medium and low SES (84.6 % and 80.2 %), patients with high SES (88.1 %) had the highest percentage of undergoing LBS (P < 0.001). After adjusting for patient demographics, institution and surgeon characteristics, the multivariate GEE analysis revealed that the highest likelihood of undergoing LBS was noted in morbidly obese patients with high SES (OR = 1.45, 95 % CI 1.10-1.90), followed by those with medium SES (OR = 1.27, 95 % CI 1.04-1.56). In addition, patients with high SES had slightly lower length of hospital stay (LOS; OR = 0.90, 95 % CI 0.82-0.99) and hospital treatment cost (OR = 0.93, 95 % CI 0.87-0.99) than their counterparts after adjustment. The increased likelihood of undergoing LBS and lower LOS and hospital treatment cost were noted among morbidly obese patients with higher SES. This finding suggests there is the need to improve clinical practice and reduce health disparities in the surgical treatment of morbidly obese patients.

Examining the types and payments of the disabilities of the insurants in the National Farmers' Health Insurance program in Taiwan.

PubMed

Wang, Jiun-Hao; Chang, Hung-Hao

2010-10-26

In contrast to the considerable body of literature concerning the disabilities of the general population, little information exists pertaining to the disabilities of the farm population. Focusing on the disability issue to the insurants in the Farmers' Health Insurance (FHI) program in Taiwan, this paper examines the associations among socio-demographic characteristics, insured factors, and the introduction of the national health insurance program, as well as the types and payments of disabilities among the insurants. A unique dataset containing 1,594,439 insurants in 2008 was used in this research. A logistic regression model was estimated for the likelihood of received disability payments. By focusing on the recipients, a disability payment and a disability type equation were estimated using the ordinary least squares method and a multinomial logistic model, respectively, to investigate the effects of the exogenous factors on their received payments and the likelihood of having different types of disabilities. Age and different job categories are significantly associated with the likelihood of receiving disability payments. Compared to those under age 45, the likelihood is higher among recipients aged 85 and above (the odds ratio is 8.04). Compared to hired workers, the odds ratios for self-employed and spouses of farm operators who were not members of farmers' associations are 0.97 and 0.85, respectively. In addition, older insurants are more likely to have eye problems; few differences in disability types are related to insured job categories. Results indicate that older farmers are more likely to receive disability payments, but the likelihood is not much different among insurants of various job categories. Among all of the selected types of disability, a highest likelihood is found for eye disability. In addition, the introduction of the national health insurance program decreases the likelihood of receiving disability payments. The experience in Taiwan can be valuable for other countries that are in an initial stage to implement a universal health insurance program.

The Taiwanese Derriford Appearance Scale: The translation and validation of a scale to measure individual responses to living with problems of appearance.

PubMed

Moss, Timothy Peter; Lawson, Victoria; Liu, Chiu Ying

2015-09-01

The extent of concern about physical appearance is increasingly the subject of scientific study, interventions by health professionals, and media attention. To enable carefully evaluated studies exploring the psychosocial antecedents of appearance distress, and to determine the success of interventions, the Derriford Appearance Scale 24 (DAS24) was developed. This psychometrically sound measure is well used and cited in the appearance psychology field. Outside of a Western context, the extent and impact of appearance distress is less well known. This paper describes the adaptation of the DAS24 for use in Taiwan. A formal translation protocol was followed to adapt the DAS24 into Taiwanese/Cantonese. Two hundred and eight participants from a general population and a visibly different population were recruited in Taipei, Taiwan. These participants completed a test pack administered comprising the translated DAS24, and established measures of anxiety and depression. The scale was analyzed on the basis of classical test theory. A translated DAS Scale comprising 19 items and including three clear factors was the best solution. The scale had good internal consistency, clear convergent validity, and good test-retest reliability. The three factors that emerged were appearance-related social avoidance, social distress, and negative affect. Consistent with expectations, (a) women scored higher than men (greater appearance distress), (b) the cause of appearance difference (burns, cleft lip/palate, etc.) was unrelated to appearance distress, and (c) those with visible differences were more concerned about their appearance than those without. The Taiwanese DAS19 is a user-friendly and psychometrically sound scale that fulfils an important clinical and scientific need. The items that were omitted from the translated version were considered in relation to cultural differences in the experience and expression of shame between Western countries and Taiwan/China, which demands a careful future analysis. © 2015 The Institute of Psychology, Chinese Academy of Sciences and Wiley Publishing Asia Pty Ltd.

Pattern of non-trauma emergency department resource utilization in older adults: An 8-year experience in Taiwan.

PubMed

Chang, Julia Chia-Yu; Yuan, Zih-Han; Lee, I-Hsin; Hsu, Teh-Fu; How, Chorng-Kuang; Yen, David Hung-Tsang

2018-06-01

To describe the patterns of non-trauma emergency department (ED) resource utilization, cost of visit, acuity level, and admission rate in older adult patients in Taiwan. This is a retrospective observational cohort study conducted at the Taipei Veterans General Hospital with an annual ED population of 80,000 patients. Patients aged ≥20 years with non-trauma ED visits from 2005 to 2012 were included in the study. We analyzed 441,665 ED visits. Older adult patients had higher ED usage, with the ratio of their ED visit and population being 3.56, 8.34, and 7.64 in the age groups 70-79, 80-89, and ≥90 years, respectively. ED cost, acuity level, and risks of intensive care unit (ICU) admission increased with increasing age. Compared with patients aged 20-29 years, patients aged ≥90 years required almost twice as much ED resources per visit [adjusted risk ratio (aRR), 1.98]. aRRs for high acuity in the age groups 70-79, 80-89, and ≥90 years were 1.96, 1.87, and 1.91, respectively. The risk of ICU admission in the age groups 40-49, 50-59, 70-79, and ≥90 years also increased by 3-fold (aRR, 2.99), 4-fold (aRR, 4.09), >6-fold (aRR, 6.66), and almost 10-fold (aRR, 9.84), respectively, compared with that in the age group 20-29 years. Among patients aged ≥90 years, 2.9% with low acuity still required ICU admission, whereas 25.1% with high acuity required ICU admission. Our study shows that older adult patients are associated with more ED visits and higher acuity, higher ED costs, and higher risks of admission to both the ordinary ward and ICU than younger adult patients. Copyright © 2018. Published by Elsevier Taiwan LLC.

Ethnic dental analysis of shovel and Carabelli's traits in a Chinese population.

PubMed

Hsu, J W; Tsai, P L; Hsiao, T H; Chang, H P; Lin, L M; Liu, K M; Yu, H S; Ferguson, D

1999-03-01

Chinese populations differ from Caucasoids by having a high prevalence of shovel trait and a low prevalence of Carabelli's trait. This study was conducted to investigate the association between the shovel and the Carabelli's traits in a Chinese population. The research design investigated a Chinese population that resides in southern Taiwan. The ancestors of this Chinese population migrated to Taiwan from mainland China, mainly from Fukien and Kwangtung. The effects of sex and age on Carabelli's trait were controlled in this investigation, as was the association between tooth size and Carabelli's trait. Results show that males were more likely to have Carabelli's trait expressed on teeth than females. The buccolingual diameter of Carabelli's trait teeth was larger than that of teeth without the trait. After controlling for sex, age, and tooth size, the existence of the shovel trait increased the likelihood of having Carabelli's trait by a factor of five and a half, which is a significant effect.

Socioeconomic factors outweigh climate in the regional difference of suicide death rate in Taiwan.

PubMed

Tsai, Jui-Feng

2010-09-30

The present study explored both socioeconomic and climatic factors to obtain a more comprehensive view of the asymmetric regional suicide death rate during 1998-2006 in Taiwan. The annual suicide death rate, population and meteorological data from 19 cities/counties in Taiwan were analysed by multiple regression. Five socioeconomic (sex ratio, no spouse, aged, unemployment and low income) and three climatic (temperature, rainfall and sunshine) factors were identified as significant, explaining 59.0% of the variance in the total suicide death rate. 'Without spouse' and 'aged' were associated with the highest risk, while 'low income with financial aids' was strongly protective. The most influential climatic factor was 'temperature,' which was negatively correlated with suicide. 'Sunshine' was positively associated with suicide. The socioeconomic and climatic factors contributed 52.7% and 6.8%, respectively, to the variance of the total suicide death rate. Limitations of the study included the fact that no individual events were considered, the study was of relatively short duration and it was confined to the territory of Taiwan. Socioeconomic factors outweighed climatic factors in explaining regional differences in the suicide death rate in Taiwan. Temperature weighed more than sunshine. 'Thermotherapy' seems more clinically relevant than the popular light therapy, at least in Taiwan. Copyright © 2008 Elsevier Ltd. All rights reserved.

Genetic Evaluation of Children with Global Developmental Delay--Current Status of Network Systems in Taiwan.

PubMed

Foo, Yong-Lin; Chow, Julie Chi; Lai, Ming-Chi; Tsai, Wen-Hui; Tung, Li-Chen; Kuo, Mei-Chin; Lin, Shio-Jean

2015-08-01

This review article aims to introduce the screening and referral network of genetic evaluation for children with developmental delay in Taiwan. For these children, integrated systems provide services from the medical, educational, and social welfare sectors. All cities and counties in Taiwan have established a network for screening, detection, referral, evaluation, and intervention services. Increased awareness improves early detection and intervention. There remains a gap between supply and demand, especially with regard to financial resources and professional manpower. Genetic etiology has a major role in prenatal causes of developmental delay. A summary of reports on some related genetic disorders in the Taiwanese population is included in this review. Genetic diagnosis allows counseling with regard to recurrence risk and prevention. Networking with neonatal screening, laboratory diagnosis, genetic counseling, and orphan drugs logistics systems can provide effective treatment for patients. In Taiwan, several laboratories provide genetic tests for clinical diagnosis. Accessibility to advanced expensive tests such as gene chips or whole exome sequencing is limited because of funding problems; however, the service system in Taiwan can still operate in a relatively cost-effective manner. This experience in Taiwan may serve as a reference for other countries. Copyright © 2014. Published by Elsevier B.V.

Psychological morbidity, quality of life, and self-rated health in the military personnel

PubMed Central

Chou, Han-Wei; Tzeng, Wen-Chii; Chou, Yu-Ching; Yeh, Hui-Wen; Chang, Hsin-An; Kao, Yu-Cheng; Tzeng, Nian-Sheng

2014-01-01

Objective The mental health of military personnel varies as a result of different cultural, political, and administrative factors. The purpose of this study was to evaluate the psychological morbidity and quality of life of military personnel in Taiwan. Materials and methods This cross-sectional study utilized the World Health Organization Quality of Life Instrument, brief version, Taiwan version, the General Health Questionnaire-12, Chinese version, and the Visual Analog Scale (VAS) in several military units. Results More than half of the subjects (55.3%) identified themselves as mentally unhealthy on the General Health Questionnaire-12, Chinese version; however, a higher percentage of officers perceived themselves as healthy (57.4%) than did noncommissioned officers (38.5%) or enlisted men (42.2%). Officers also had higher total quality of life (QOL) scores (83.98) than did enlisted men (79.67). Scores on the VAS also varied: officers: 72.5; noncommissioned officers: 67.7; and enlisted men: 66.3. The VAS and QOL were positively correlated with perceived mental health among these military personnel. Conclusion Our subjects had higher rates of perceiving themselves as mentally unhealthy compared to the general population. Those of higher rank perceived themselves as having better mental health and QOL. Improving mental health could result in a better QOL in the military. The VAS may be a useful tool for the rapid screening of self-reported mental health, which may be suitable in cases of stressful missions, such as in disaster rescue; however, more studies are needed to determine the optimal cut-off point of this measurement tool. PMID:24570587

Use of Fomepizole in Pediatric Methanol Exposure: The First Case Report in Taiwan and a Literature Review.

PubMed

Chen, Tzu-Hua; Kuo, Chang-Hung; Huang, Chia-Tsuan; Wang, Wei-Li

2016-08-01

Methanol poisoning is rare in the pediatric population, but a delay in diagnosis and intervention may cause severe morbidity and mortality. The current therapy for methanol poisoning is ethanol or fomepizole, which acts as a competitive inhibitor of hepatic alcohol dehydrogenase to inhibit the production of toxic metabolites derived from the oxidation of methanol. However, clinical experience in pediatric methanol poisoning is limited, and the safety profiles of the antidotes have not been established in children, especially in Asian populations. This is the first case to describe the use of fomepizole in a child with methanol exposure in Taiwan. Copyright © 2013. Published by Elsevier B.V.

Application of three different sets of explicit criteria for assessing inappropriate prescribing in older patients: a nationwide prevalence study of ambulatory care visits in Taiwan.

PubMed

Chang, Chirn-Bin; Yang, Shu-Yu; Lai, Hsiu-Yun; Wu, Ru-Shu; Liu, Hsing-Cheng; Hsu, Hsiu-Ying; Hwang, Shinn-Jang; Chan, Ding-Cheng

2015-11-06

To investigate the national prevalence of potentially inappropriate medications (PIMs) prescribed in ambulatory care clinics in Taiwan according to three different sets of regional criteria and the correlates of PIM use. Cross-sectional study. This analysis included older patients who visited ambulatory care clinics in 2009 and represented half of the older population included on the Taiwanese National Health Insurance Research Database. We identified 1,164,701 subjects who visited ambulatory care clinics and were over 65 years old in 2009. PIM prevalence according to the 2012 Beers criteria, the PIM-Taiwan criteria and the PRISCUS criteria was estimated separately, and characteristics of PIM users were explored. Multivariate logistic regression analysis was used to determine patient factors associated with the use of at least one PIM. Leading PIMs for each set of criteria were also listed. The prevalence of having at least one PIM at the patient level was highest with the Beers criteria (86.2%), followed by the PIM-Taiwan criteria (73.3%) and the PRISCUS criteria (66.9%). Polypharmacy and younger age were associated with PIM use for all three sets of criteria. The leading PIMs detected by the PIM-Taiwan and PRISCUS criteria were all included in the 2012 Beers criteria. Non-COX-selective non-steroidal anti-inflammatory drugs in the Beers criteria and benzodiazepines in the PIM-Taiwan and PRISCUS criteria accounted for most leading PIMs. The prevalence of PIMs was high among older Taiwanese patients receiving ambulatory care visits. The prevalence of PIM and its associated factors varied according to three sets of criteria at the population level. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Quantifying the legacy of the Chinese Neolithic on the maternal genetic heritage of Taiwan and Island Southeast Asia.

PubMed

Brandão, Andreia; Eng, Ken Khong; Rito, Teresa; Cavadas, Bruno; Bulbeck, David; Gandini, Francesca; Pala, Maria; Mormina, Maru; Hudson, Bob; White, Joyce; Ko, Tsang-Ming; Saidin, Mokhtar; Zafarina, Zainuddin; Oppenheimer, Stephen; Richards, Martin B; Pereira, Luísa; Soares, Pedro

2016-04-01

There has been a long-standing debate concerning the extent to which the spread of Neolithic ceramics and Malay-Polynesian languages in Island Southeast Asia (ISEA) were coupled to an agriculturally driven demic dispersal out of Taiwan 4000 years ago (4 ka). We previously addressed this question using founder analysis of mitochondrial DNA (mtDNA) control-region sequences to identify major lineage clusters most likely to have dispersed from Taiwan into ISEA, proposing that the dispersal had a relatively minor impact on the extant genetic structure of ISEA, and that the role of agriculture in the expansion of the Austronesian languages was therefore likely to have been correspondingly minor. Here we test these conclusions by sequencing whole mtDNAs from across Taiwan and ISEA, using their higher chronological precision to resolve the overall proportion that participated in the "out-of-Taiwan" mid-Holocene dispersal as opposed to earlier, postglacial expansions in the Early Holocene. We show that, in total, about 20% of mtDNA lineages in the modern ISEA pool result from the "out-of-Taiwan" dispersal, with most of the remainder signifying earlier processes, mainly due to sea-level rises after the Last Glacial Maximum. Notably, we show that every one of these founder clusters previously entered Taiwan from China, 6-7 ka, where rice-farming originated, and remained distinct from the indigenous Taiwanese population until after the subsequent dispersal into ISEA.

Responses of striped stem borer, Chilo suppressalis (Lepidoptera: Pyralidae), from Taiwan to a range of insecticides.

PubMed

Cheng, Xuan; Chang, Cheng; Dai, Shu-Mei

2010-07-01

Information on the insecticide susceptibility of striped stem borer, Chilo suppressalis (Walker), is essential for an effective pest management programme. An early detection of resistance development can prompt the modification of current control methods and increase the lifespan of insecticides through the rotation of chemicals with different modes of action. In this study, the susceptibility of this pest in Taiwan to four classes of insecticides has been examined. Over 1000-fold resistance to carbofuran was detected in C. suppressalis collected from Chiayi and Changhua prefectures, with estimated LC(50) values of > 3 mg cm(-2). In addition, 61-fold resistance to cartap was found in the Chiayi population. On the other hand, all tested populations of rice stem borer were still relatively susceptible to chlorpyrifos, fipronil and permethrin, with LC(50) values ranging from 30 to 553 ng cm(-2). Chilo suppressalis populations collected from the central parts of Taiwan have a higher degree of resistance to the tested insecticides than those from northern areas. The occurrence of high resistance to carbofuran in the Chiayi and Changhua areas suggests that this compound should be replaced with chemicals having a different mode of action, such as chlorpyrifos, fipronil and permethrin, to which low cross-resistance has been detected. Copyright (c) 2010 Society of Chemical Industry.

Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study.

PubMed

Chang, Ning-Chia; Dai, Chia-Yen; Lin, Wen-Yi; Chien, Chen-Yu; Hsieh, Meng-Hsuen; Ho, Kuen-Yao

2016-09-01

To estimate the prevalence and severity of hearing impairment (HI), the self-perception of HI, and the willingness to use a hearing aid (HA) in the elderly population in southern Taiwan. This community-based study was performed in a metropolitan hospital. A questionnaire about the perception of HI and the willingness to use a HA was used. The severity of HI in speech-frequency pure-tone average (PTA) was evaluated. The associations between sex, age, severity of HI, self-perception of HI, and the willingness to use a HA were analysed. A total of 599 volunteers were recruited from the health management center; 324 (54.1%) males and 275 (45.9%) females, who were 65 years of age or older. The prevalence of HI >25 dBHL in the elderly was 78%. The predicted levels for elderly persons to perceive HI and hearing difficulties were 34.38 dBHL and 54.38 dBHL, respectively. Males and younger participants were more willing to use HA. The primary reasons for refusing HA use were discomfort (25.1%) and a self-perception that the HA was unnecessary (19.7%). The prevalence of HI was high among the elderly population in southern Taiwan. Age and sex were the determinants of HA use.

Association between the accessibility to lethal methods and method-specific suicide rates: An ecological study in Taiwan.

PubMed

Lin, Jin-Jia; Lu, Tsung-Hsueh

2006-07-01

To examine the association between availability of lethal methods of suicide and method-specific suicide rates at the city/ county level in Taiwan. Age-adjusted and age-specific suicide rates of 23 cities/counties in Taiwan for the years 1999 to 2003 were calculated. Partial correlation coefficients were used to examine cross-sectional associations between independent variables, i.e., proportion of agricultural population and proportion of households living on the sixth floor or above, and suicide rates by different methods (poisoning by solids/liquids, jumping, and hanging) after adjusting for unemployment rates and prevalence of depression. The partial correlation coefficient was 0.77 (p < .001) for proportion of agricultural population with solids/liquids poisoning suicide rates. It was 0.73 (p < .001) for the proportion of households living on the sixth floor or above with suicide rates by jumping. Correlations between hanging suicide rates and proportion of agricultural population or between hanging suicide rates and proportion of households living on the sixth floor or above were not significant. The results showed strong positive associations between access to lethal methods and method-specific suicide rates. Controlling the availability of pesticides and fencing high buildings or installing window guards may be effective measures for suicide prevention.

Betel quid, chewing habits and difficult intubation: A case report and critical appraisal of evidence for practice.

PubMed

Narendra, P L; Hegde, Harihar V; Vijaykumar, T K; Nallamilli, Samson

2015-01-01

Betel quid is used by 10-20% of world of population. Oral submucus fibrosis (OSF) is a chronic premalignant disease common in South Asian countries where betel quid is chewed. It is characterized by juxtaepithelial fibrosis of oral cavity and limited mouth opening, which can cause difficult intubation. A recent study in Taiwan has revealed long-term betel nut chewing is not predictor of difficult intubation. We describe two cases of OSF and critically analyze this study and its implications for clinical practice. OSF is now seen in Saudi Arabia and western countries with use of commercial betel quid substitutes. Although betel quid without tobacco is used in Taiwan, available evidence suggests rapid and early development of OSF where commercial chewing products like Pan Masala are used in India. Effects of betel quid may vary depending on the composition of quid and chewing habits. Studies where personal habits are involved must be analyzed carefully for external validity. Even though, Taiwan study is controlled, its validity outside Taiwan is highly questionable. Since OSF can cause unanticipated difficult intubation, thus during preanesthetic assessment, history of betel quid chewing, more importantly use of commercial chewing products is more likely to give clues to severity of OSF and possible difficult intubation. Further controlled trails in populations where commercial chewing products are used is necessary to detect association of chewing habits and difficult intubation.

Micro-Raman spectroscopy and μ-XRF in the investigation of ancient glass beads from the archaeological sites, eastern Taiwan

NASA Astrophysics Data System (ADS)

San Liou, Ying; Liu, Yi Chang

2017-04-01

Ancient glass beads with different colors, shapes, and stylistics unearthed from the archaeological sites of eastern Taiwan, dating back to approximately 1850-310 BP, have been investigated. It is generally known that glass bead is alien to invade into Taiwan along with metal ware, glass, agate, etc. since the Metal Age of Taiwan. Nevertheless, souring provenance and trade routes still remain controversial. Micro-Raman spectroscopy and μ-XRF have been applied on fifty-six ancient glass beads to reveal the mineralogical and chemical compositions and to help decipher the raw materials used and souring provenance. Micro-Raman measurements indicate the presence of hematite, zincite, siderite, sphalerite, lead tin yellow type II, quartz, feldspar, anatase, rutite, ankerite, graphite, calcite, etc. Among them, hematite, zincite, siderite, sphalerite, lead tin yellow type II, and rutile were found to be colorants/opacifiers. Moreover, crystalline phases such as lead tin yellow type II (PbSn1-xSixO3), zincite (ZnO), tricalcium diphosphate (Ca2(PO4)2), sphalerite ((Zn, Fe)S) and ankerite (Ca(Fe, Mg, Mn)(CO3)2) were detected in ancient glass beads unearthed from Taiwan for the first time. The chemical results obtained by μXRF show SiO2, Al2O3, Na2O, K2O, MgO, CaO, and PbO as the most abundant oxides. Na2O, K2O, Al2O3, MgO, and PbO could be the main/minor fluxes and colorants. In general, results of mineralogical and chemical analyses are compatible. According to chemical results, ancient glass beads can be classified as mineral soda alumina glass (m-Na-Al glass), soda plant ash glass (v-Na-Ca glass), lead silicate glass, and some less well known types. Mineral soda alumina and soda plant ash glass beads, as well as lead silicate glass beads are generally believed to be the distinct phases of production and exchange in Southeast Asia and China, respectively. In terms of chronology of glass bead, beads excavated from sites of 1850-930 BP are mineral soda alumina glass (m-Na-Al glass) and soda plant ash glass (v-Na-Ca glass). On the other hand, beads from sites of <930 BP are belonging to lead silicate glass. It is indicated that the souring provenance of ancient beads of eastern Taiwan is probably a multiple sources, i.e., in earlier time, glass beads were brought into Taiwan through the maritime exchange and/or trade activities between Taiwan and Southeast Asia; at the later period, lead silicate glass beads were imported from China. However, some mineral soda alumina and soda plant ash glass beads were found in a later period, it might be attributed to glass beads reuse or trade route between Taiwan and Southeast Asia is successive since ca. 1850 BP.

The lifetime cost of hepatocellular carcinoma : a claims data analysis from a medical centre in Taiwan.

PubMed

Lang, Hui-Chu; Wu, Jaw-Ching; Yen, Sang-Hue; Lan, Chung-Fu; Wu, Shi-Liang

2008-01-01

Hepatocellular carcinoma (HCC) is the second most common cancer in Taiwan. For males in Taiwan, it is the most dangerous cancer, with both the highest incidence and mortality rate. To determine cancer-related medical care costs for long-term survivors of HCC. The estimation of the lifetime cost was based on the insurer perspective and adopted an incidence-based approach. Data was sourced from the 1999-2002 cancer registry statistics of patients with HCC and the claims data of Taipei Veterans General Hospital (TVGH). In total there were 2873 HCC patients at TVGH. In addition to this data, the research used population National Health Insurance claims data from the National Health Research Institutes (1996-2002) as the comparison group. The probabilities of survival, dying of cancer or dying of other causes were estimated using cancer registry statistics. To estimate lifetime (10-year) cost, we divided the disease process into three phases: initial, continuing and terminal. The cost of HCC was calculated as the sum of the average cost of each phase. The expected lifetime cost for treatment of an HCC patient was estimated by incorporating the phase-specific costs with the survival and mortality rates. The results showed that 895 patients survived <1 year, and treatment for each of these patients cost on average New Taiwan dollars ($NT) 206 573 ($US 1 = $NT 33, year 2002 value) over this period. For those who survived > or =1 year, the terminal phase of treatment resulted in the highest costs, $NT 237 032. On average, for each patient, the initial phase cost was $NT 140 403 and the monthly cost for the continuing phase was $NT 8687. For the average HCC patient, the 10-year lifetime cost was $NT 418 554 (in nominal $NT). Our study showed that the terminal phase cost the most out of the three treatment phases. The aggregate lifetime cost of HCC is useful for health policy making and clinical decision making.

The effects of climate factors on scabies. A 14-year population-based study in Taiwan.

PubMed

Liu, Jui-Ming; Wang, Hsiao-Wei; Chang, Fung-Wei; Liu, Yueh-Ping; Chiu, Feng-Hsiang; Lin, Yi-Chun; Cheng, Kuan-Chen; Hsu, Ren-Jun

2016-01-01

Scabies is a common infectious disease and can cause severe outbreaks if not controlled quickly. Besides personal contact history, environmental factors are also important. This study analyzed the effects of environmental climate factors on the incidence of scabies in Taiwan. We conducted a 14-year nationwide population-based study: a total of 14,883 patients with scabies infestation were enrolled. Monthly climate data were collected from Taiwan's Central Weather Bureau, including data on temperature, relative humidity, total rainfall, total rain days, and total sunshine hours. The linear relationships between these climate factors and scabies infestations or other risk factors were examined by Pearson's correlation analysis. Overall, the incidence of scabies was negatively correlated with temperature (γ = -0.152, p < 0.001), while being positively correlated with humidity (γ = 0.192, p < 0.001). This useful information may provide evidence for lowering humidity at nursing facilities, hospitals, and military camps with scabies infestations, which may help to reduce its spread and prevent outbreaks. © J.-M. Liu et al., published by EDP Sciences, 2016.

An evaluation of the 25 by 25 goal for premature cardiovascular disease mortality in Taiwan: an age-period-cohort analysis, population attributable fraction and national population-based study.

PubMed

Su, Shih-Yung; Lee, Wen-Chung; Chen, Tzu-Ting; Wang, Hao-Chien; Su, Ta-Chen; Jeng, Jiann-Shing; Tu, Yu-Kang; Liao, Shu-Fen; Lu, Tzu-Pin; Chien, Kuo-Liong

2017-01-01

The aim of the 25 by 25 goal is to reduce mortality from premature non-communicable diseases by 25% before 2025. Studies have evaluated the 25 by 25 goal in many countries, but not in Taiwan. The aim of this study was to estimate the 25 by 25 goal for premature mortality from cardiovascular diseases in Taiwan. We applied the age-period-cohort model to project the incidence of premature death from cardiovascular disease from 2015 to 2024 and used the population attributable fraction to estimate the contributions of targeted risk factors. The probability of death was used to estimate the percent change. The percent change in business-as-usual trend during 2010-2024 was only a 6% (range 1.7-10.7%) lower risk of premature mortality from cardiovascular disease among men. The greatest reduction in the risk of mortality occurred with a 30% reduction in the prevalence of smoking; however, there was only a 14.5% (10.6-18.3%) decrease in percent change and in the corresponding number of men (3706: range 3543-3868) who were prevented from dying. More than a 25% reduction in the percent change of premature cardiovascular disease mortality among women was achieved without control of any risk factor. To reach a 25% reduction in men before 2025, there needs to be a 70% reduction in the prevalence of smoking to reduce mortality by 26.2% (22.9-29.3%). Cigarette smoking is the primary target in the prevention of cardiovascular disease. Through the stringent control of smoking, the goal of a 25% reduction in premature mortality from cardiovascular disease may be achieved before 2025 in Taiwan.

Insight into alcohol-related problems and its associations with severity of alcohol consumption, mental health status, race, and level of acculturation in southern Taiwanese indigenous people with alcoholism.

PubMed

Yen, Cheng-Fang; Hsiao, Ray C; Ries, Richard; Liu, Shu-Chun; Huang, Chi-Fen; Chang, Yu-Ping; Yu, Ming-Lung

2008-01-01

While not well known in the West, Taiwan has a substantial indigenous population, and this population has rapidly developed alcohol problems. This study examined the level of insight into alcohol-related problems and its associations with the severity of alcohol consumption, mental health status, race, and the level of acculturation among indigenous populations with alcohol problems in southern Taiwan. A total of 332 indigenes, whose total Alcohol Use Disorders Identification Test (AUDIT) score was equal to 8 or higher, were interviewed. The associations between the level of insight into alcohol-related problems and the severity of alcohol drinking on the AUDIT, mental health status on the Chinese Health Questionnaire-12 (>or= 4 vs. < 4), race (Bunun vs. non-Bunun), and the level of acculturation on the Taiwan Aboriginal Acculturation Scale were examined using logistic regression models. The results of this study found that 72.6% of the participants had poor insight into alcohol-related problems and no participant had good insight. Participants who had more severe alcohol drinking or poor mental health were more likely to have a higher level of insight into alcohol-related problems. Participants who were non-Bunun were also more likely to have a higher level of insight into alcohol-related problems, but the level of acculturation was not associated with the level of insight into alcohol-related problems. These findings suggest that most alcoholic indigenes in southern Taiwan have poor insight into their own alcohol-related problems. Cultural specific interventions targeting and improving the indigenes' insight into alcohol-related problems are needed.

Radiation Therapy After Breast-Conserving Surgery: Does Hospital Surgical Volume Matter? A Population-Based Study in Taiwan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chien, Chun-Ru; Department of Radiation Oncology, China Medical University Hospital, and School of Medicine, China Medical University, Taichung, Taiwan; Pan, I-Wen

2012-01-01

Purpose: To examine the association between hospital surgical volume and the use of radiation therapy (RT) after breast-conserving surgery (BCS) in Taiwan. Methods and Materials: We used claims data from the National Health Insurance program in Taiwan (1997-2005) in this retrospective population-based study. We identified patients with breast cancer, receipt of BCS, use of radiation, and the factors that could potentially associated with the use of RT from enrollment records, and the ICD-9 and billing codes in claims. We conducted logistic regression to examine factors associated with RT use after BCS, and performed subgroup analyses to examine whether the associationmore » differs by medical center status or hospital volumes. Results: Among 5,094 patients with newly diagnosed invasive breast cancer who underwent BCS, the rate of RT was significantly lower in low-volume hospitals (74% vs. 82%, p < 0.01). Patients treated in low-volume hospitals were less likely to receive RT after BCS (odds ratio = 0.72, 95% confidence interval = 0.62-0.83). In addition, patients treated after the implementation of the voluntary pay-for-performance policy in 2001 were more likely to receive RT (odds ratio = 1.23; 95% confidence interval = 1.05-1.45). Subgroup analyses indicated that the high-volume effect was limited to hospitals accredited as non-medical centers, and that the effect of the pay-for-performance policy was most pronounced among low-volume hospitals. Conclusions: Using population-based data from Taiwan, our study concluded that hospital surgical volume and pay-for-performance policy are positively associated with RT use after BCS.« less

Genetic variants associated with phenytoin-related severe cutaneous adverse reactions.

PubMed

Chung, Wen-Hung; Chang, Wan-Chun; Lee, Yun-Shien; Wu, Ying-Ying; Yang, Chih-Hsun; Ho, Hsin-Chun; Chen, Ming-Jing; Lin, Jing-Yi; Hui, Rosaline Chung-Yee; Ho, Ji-Chen; Wu, Wei-Ming; Chen, Ting-Jui; Wu, Tony; Wu, Yih-Ru; Hsih, Mo-Song; Tu, Po-Hsun; Chang, Chen-Nen; Hsu, Chien-Ning; Wu, Tsu-Lan; Choon, Siew-Eng; Hsu, Chao-Kai; Chen, Der-Yuan; Liu, Chin-San; Lin, Ching-Yuang; Kaniwa, Nahoko; Saito, Yoshiro; Takahashi, Yukitoshi; Nakamura, Ryosuke; Azukizawa, Hiroaki; Shi, Yongyong; Wang, Tzu-Hao; Chuang, Shiow-Shuh; Tsai, Shih-Feng; Chang, Chee-Jen; Chang, Yu-Sun; Hung, Shuen-Iu

2014-08-06

The antiepileptic drug phenytoin can cause cutaneous adverse reactions, ranging from maculopapular exanthema to severe cutaneous adverse reactions, which include drug reactions with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necrolysis. The pharmacogenomic basis of phenytoin-related severe cutaneous adverse reactions remains unknown. To investigate the genetic factors associated with phenytoin-related severe cutaneous adverse reactions. Case-control study conducted in 2002-2014 among 105 cases with phenytoin-related severe cutaneous adverse reactions (n=61 Stevens-Johnson syndrome/toxic epidermal necrolysis and n=44 drug reactions with eosinophilia and systemic symptoms), 78 cases with maculopapular exanthema, 130 phenytoin-tolerant control participants, and 3655 population controls from Taiwan, Japan, and Malaysia. A genome-wide association study (GWAS), direct sequencing of the associated loci, and replication analysis were conducted using the samples from Taiwan. The initial GWAS included samples of 60 cases with phenytoin-related severe cutaneous adverse reactions and 412 population controls from Taiwan. The results were validated in (1) 30 cases with severe cutaneous adverse reactions and 130 phenytoin-tolerant controls from Taiwan, (2) 9 patients with Stevens-Johnson syndrome/toxic epidermal necrolysis and 2869 population controls from Japan, and (3) 6 cases and 374 population controls from Malaysia. Specific genetic factors associated with phenytoin-related severe cutaneous adverse reactions. The GWAS discovered a cluster of 16 single-nucleotide polymorphisms in CYP2C genes at 10q23.33 that reached genome-wide significance. Direct sequencing of CYP2C identified missense variant rs1057910 (CYP2C9*3) that showed significant association with phenytoin-related severe cutaneous adverse reactions (odds ratio, 12; 95% CI, 6.6-20; P=1.1 × 10(-17)). The statistically significant association between CYP2C9*3 and phenytoin-related severe cutaneous adverse reactions was observed in additional samples from Taiwan, Japan, and Malaysia. A meta-analysis using the data from the 3 populations showed an overall odds ratio of 11 (95% CI, 6.2-18; z=8.58; P < .00001) for CYP2C9*3 association with phenytoin-related severe cutaneous adverse reactions. Delayed clearance of plasma phenytoin was detected in patients with severe cutaneous adverse reactions, especially CYP2C9*3 carriers, providing a functional link of the associated variants to the disease. This study identified CYP2C variants, including CYP2C9*3, known to reduce drug clearance, as important genetic factors associated with phenytoin-related severe cutaneous adverse reactions.

Acoustic differentiation and behavioral response reveals cryptic species within Buergeria treefrogs (Anura, Rhacophoridae) from Taiwan

PubMed Central

Wang, Ying-Han; Tseng, Hui-Yun; Lin, Yen-Po; Komaki, Shohei

2017-01-01

Buergeria japonica is a widely distributed treefrog occurring from Ryukyu Archipelago to Taiwan. Across this wide distributional range, we combined molecular, acoustic, morphological, and behavioral characters to clarify the taxonomic status among these insular populations. Genetic differentiation in mitochondrial sequences indicated an over 16% divergence among two deeply divergent clades: Japanese clade distributes in Ryukyu Archipelago and northwestern drainages of Taiwan, while Taiwanese clade distributes in the remaining drainages on Taiwan. The Taiwanese clade can be distinguished from the nominative species not only by molecular and morphological differences, but also distinguishable by considerable acoustic differentiation, which is extraordinarily noticeable for an additional type of long call that never recorded from Japanese clade. The two clades form a parapatric distribution pattern with narrow contact zones both in western and eastern Taiwan. Playback experiments indicated that male frogs show significantly stronger defensiveness against conspecific calls rather than heterospecific calls, indicating that these signals play a crucial role in species recognition. Here we describe the Taiwanese clade as a new species; the behavioral response and the magnitude of gene flow across their contact zones are especially worth for detailed studies. PMID:28877201

Reasoning the causality of city sprawl, traffic congestion, and green land disappearance in Taiwan using the CLD model.

PubMed

Chen, Mei-Chih; Chang, Kaowen

2014-11-06

Many city governments choose to supply more developable land and transportation infrastructure with the hope of attracting people and businesses to their cities. However, like those in Taiwan, major cities worldwide suffer from traffic congestion. This study applies the system thinking logic of the causal loops diagram (CLD) model in the System Dynamics (SD) approach to analyze the issue of traffic congestion and other issues related to roads and land development in Taiwan's cities. Comparing the characteristics of development trends with yearbook data for 2002 to 2013 for all of Taiwan's cities, this study explores the developing phenomenon of unlimited city sprawl and identifies the cause and effect relationships in the characteristics of development trends in traffic congestion, high-density population aggregation in cities, land development, and green land disappearance resulting from city sprawl. This study provides conclusions for Taiwan's cities' sustainability and development (S&D). When developing S&D policies, during decision making processes concerning city planning and land use management, governments should think with a holistic view of carrying capacity with the assistance of system thinking to clarify the prejudices in favor of the unlimited developing phenomena resulting from city sprawl.

External Validation of Fatty Liver Index for Identifying Ultrasonographic Fatty Liver in a Large-Scale Cross-Sectional Study in Taiwan

PubMed Central

Fang, Kuan-Chieh; Wang, Yuan-Chen; Huo, Teh-Ia; Huang, Yi-Hsiang; Yang, Hwai-I; Su, Chien-Wei; Lin, Han-Chieh; Lee, Fa-Yauh; Wu, Jaw-Ching; Lee, Shou-Dong

2015-01-01

Background and Aims The fatty liver index (FLI) is an algorithm involving the waist circumference, body mass index, and serum levels of triglyceride and gamma-glutamyl transferase to identify fatty liver. Although some studies have attempted to validate the FLI, few studies have been conducted for external validation among Asians. We attempted to validate FLI to predict ultrasonographic fatty liver in Taiwanese subjects. Methods We enrolled consecutive subjects who received health check-up services at the Taipei Veterans General Hospital from 2002 to 2009. Ultrasonography was applied to diagnose fatty liver. The ability of the FLI to detect ultrasonographic fatty liver was assessed by analyzing the area under the receiver operating characteristic (AUROC) curve. Results Among the 29,797 subjects enrolled in this study, fatty liver was diagnosed in 44.5% of the population. Subjects with ultrasonographic fatty liver had a significantly higher FLI than those without fatty liver by multivariate analysis (odds ratio 1.045; 95% confidence interval, CI 1.044–1.047, p< 0.001). Moreover, FLI had the best discriminative ability to identify patients with ultrasonographic fatty liver (AUROC: 0.827, 95% confidence interval, 0.822–0.831). An FLI < 25 (negative likelihood ratio (LR−) 0.32) for males and <10 (LR− 0.26) for females rule out ultrasonographic fatty liver. Moreover, an FLI ≥ 35 (positive likelihood ratio (LR+) 3.12) for males and ≥ 20 (LR+ 4.43) for females rule in ultrasonographic fatty liver. Conclusions FLI could accurately identify ultrasonographic fatty liver in a large-scale population in Taiwan but with lower cut-off value than the Western population. Meanwhile the cut-off value was lower in females than in males. PMID:25781622

Secondary Primary Malignancy Risk in Patients With Cervical Cancer in Taiwan: A Nationwide Population-Based Study.

PubMed

Teng, Chung-Jen; Huon, Leh-Kiong; Hu, Yu-Wen; Yeh, Chiu-Mei; Chao, Yee; Yang, Muh-Hwa; Chen, Tzeng-Ji; Hung, Yi-Ping; Liu, Chia-Jen

2015-10-01

To evaluate the risk of secondary primary malignancy (SPM) in patients with cervical cancer using a nationwide population-based dataset.Patients newly diagnosed with cervical cancer between 1997 and 2011 were identified using Taiwan's National Health Insurance database. Patients with antecedent malignancies were excluded. Standardized incidence ratios (SIRs) for SPM were calculated by comparing with the cancer incidence in the general population. Risk factors for cancer development were analyzed using Cox proportional hazard models.During the 14-year study period (follow-up of 223,062 person-years), 2004 cancers developed in 35,175 patients with cervical cancer. The SIR for all cancers was 1.56 (95% confidence interval, 1.50-1.63, P < 0.001). SIRs for follow-up periods of >10, 5 to 10, 1 to 5, and <1 year were 1.37, 1.51, 1.34, and 2.59, respectively. After the exclusion of SPM occurring within 1 year of cervical cancer diagnosis, SIRs were significantly higher for cancers of the esophagus (2.05), stomach (1.38), colon, rectum, and anus (1.36); lung and mediastinum (2.28), bone and soft tissue (2.23), uterus (3.76), bladder (2.26), and kidneys (1.41). Multivariate analysis showed that age ≥60 was a significant SPM risk factor (hazard ratio [HR] 1.59). Different treatments for cervical cancer, including radiotherapy (HR 1.41) and chemotherapy (HR 1.27), had different impacts on SPM risk. Carboplatin and fluorouracil independently increased SPM risk in cervical cancer patients.Patients with cervical cancer are at increased risk of SPM development. Age ≥60 years, chemotherapy, and radiotherapy are independent risk factors. Carboplatin and fluorouracil also increased SPM risk independently. Close surveillance of patients at high risk should be considered for the early detection of SPMs.

Secondary Primary Malignancy Risk in Patients With Ovarian Cancer in Taiwan: A Nationwide Population-Based Study.

PubMed

Hung, Yi-Ping; Liu, Chia-Jen; Hu, Yu-Wen; Chen, Min-Huang; Li, Chun-Pin; Yeh, Chiu-Mei; Chiou, Tzeon-Jye; Chen, Tzeng-Ji; Yang, Muh-Hwa; Chao, Yee

2015-09-01

To evaluate the incidence of secondary primary malignancy (SPM) in patients with ovarian cancer using a nationwide retrospective population-based dataset. Patients newly diagnosed with ovarian cancer between 1997 and 2010 were identified using Taiwan's National Health Insurance database. Patients with antecedent malignancies were excluded. Standardized incidence ratios (SIRs) for SPM were calculated and compared with the cancer incidence in the general population. Risk factors for cancer development were analyzed using Cox proportional hazard models. Effects of surgery, chemotherapy, and radiotherapy after ovarian cancer diagnosis were regarded as time-dependent variables to prevent immortal time bias. During the 14-year study period (follow-up of 56,214 person-years), 707 cancers developed in 12,127 patients with ovarian cancer. The SIR for all cancers was 2.78 (95% confidence interval 2.58-3.00). SIRs for follow-up periods of >5, 1-5, and <1 year were 1.87, 2.04, and 6.40, respectively. After the exclusion of SPM occurring within 1 year of ovarian cancer diagnosis, SIRs were significantly higher for cancers of the colon, rectum, and anus (2.14); lung and mediastinum (1.58); breast (1.68); cervix (1.65); uterus (7.96); bladder (3.17), and thyroid (2.23); as well as for leukemia (3.98) and others (3.83). Multivariate analysis showed that age ≥ 50 years was a significant SPM risk factor (hazard ratio [HR] 1.60). Different treatments for ovarian cancer, including radiotherapy (HR 2.07) and chemotherapy (HR 1.27), had different impacts on SPM risk. Patients with ovarian cancer are at increased risk of SPM development. Age ≥ 50 years, radiotherapy, and chemotherapy are independent risk factors. Close surveillance of patients at high risk should be considered for the early detection of SPM.

Comprehensive assessment of coastal eutrophication in Taiwan and its implications for management strategy.

PubMed

Liu, Ta-Kang; Chen, Ping; Chen, Hou-Yu

2015-08-15

Due to the rapid population growth, anthropogenic activities result in agricultural, industrial, and urban diffuse runoffs that elevate the level of nutrients such as nitrogen and phosphorus in coastal waters. Currently there is no integrated analysis for coastal eutrophication in Taiwan. A comprehensive analysis of the coastal eutrophic status was performed in this study based on decade-long coastal water quality monitoring data from Taiwan's Environmental Protection Administration. A 3-tiered monitoring strategy is recommended based on the severity of the current eutrophication state. Results indicate that the most problematic area of coastal eutrophication is located in the estuary of the Donggang River (DGR) and its adjacent coastal waters, i.e., the Kao-Ping mouth (KPM) and Dapeng Bay (DPB) in south-western Taiwan. With a worsening eutrophic status, these areas demand intensive monitoring and research with higher spatial and temporal resolutions to evaluate the stresses of nutrient forcing and predict possible future responses. Copyright © 2015 Elsevier Ltd. All rights reserved.

Techno-politics of genomic nationalism: tracing genomics and its use in drug regulation in Japan and Taiwan.

PubMed

Kuo, Wen-Hua

2011-10-01

This paper compares the development of genomics as a form of state project in Japan and Taiwan. Broadening the concepts of genomic sovereignty and bionationalism, I argue that the establishment and use of genomic databases vary according to techno-political context. While both Japan and Taiwan hold population-based databases to be necessary for scientific advance and competitiveness, they differ in how they have attempted to transform the information produced by databases into regulatory schemes for drug approval. The effectiveness of Taiwan's biobank is severely limited by the IRB reviewing process. By contrast, while updating its regulations for drug approval, Japan, is using pharmacogenomics to deal with matters relating to ethnic identity. By analysing genomic initiatives in the political context that nurtures them, this paper seeks to capture how global science and local societies interact and offers insight into the assessment of state-sponsored science in East Asia as they become transnational. Copyright © 2011 Elsevier Ltd. All rights reserved.

Psychometric evaluation of the Chinese version of the Patient Perceptions of Empowerment Scale (PPES).

PubMed

Yeh, Mei-Yu; Lin, Sieh-Hwa; Tung, Tao-Hsin

2014-01-01

To evaluate the psychometric properties of the Chinese version of the Patient Perceptions of Empowerment Scale (PPES) and to perform a cross-cultural validity assessment. In this cross-sectional survey, 554 inpatients in three general hospitals in northern Taiwan were recruited. Principal component analysis was used to examine the factor structure of the scale. Confirmatory factor analyses were conducted on the measurement model of the Chinese version of the PPES. Confirmatory factor analyses supported the presence of a second-order four-factor model (information, decision, individual, and self-management) of the Chinese version of the PPES when used with a Taiwanese inpatient population. The results indicate that the 11-item, second-order, four-factor Chinese version of the PPES provided best goodness-of-fit for the data in this study. The 11-item four-factor Chinese version of the PPES is a self-completion scale. This study demonstrated that the Chinese version of the PPES is a reliable and valid self-report instrument for the assessment of patient perceptions of empowerment in clinical practice. Further adaptation and evaluation of the scale will hopefully stimulate further studies on PPES in the fields of psychometrics in Taiwan.

Psychometric Evaluation of the Chinese Version of the Patient Perceptions of Empowerment Scale (PPES)

PubMed Central

Lin, Sieh-Hwa

2014-01-01

Objectives. To evaluate the psychometric properties of the Chinese version of the Patient Perceptions of Empowerment Scale (PPES) and to perform a cross-cultural validity assessment. Methods. In this cross-sectional survey, 554 inpatients in three general hospitals in northern Taiwan were recruited. Principal component analysis was used to examine the factor structure of the scale. Confirmatory factor analyses were conducted on the measurement model of the Chinese version of the PPES. Results. Confirmatory factor analyses supported the presence of a second-order four-factor model (information, decision, individual, and self-management) of the Chinese version of the PPES when used with a Taiwanese inpatient population. The results indicate that the 11-item, second-order, four-factor Chinese version of the PPES provided best goodness-of-fit for the data in this study. Conclusion. The 11-item four-factor Chinese version of the PPES is a self-completion scale. This study demonstrated that the Chinese version of the PPES is a reliable and valid self-report instrument for the assessment of patient perceptions of empowerment in clinical practice. Further adaptation and evaluation of the scale will hopefully stimulate further studies on PPES in the fields of psychometrics in Taiwan. PMID:24971354

The Relative Contribution of Dietary Habits, Leisure-Time Exercise, Exercise Attitude, and Body Mass Index to Self-Rated Health among College Students in Taiwan.

PubMed

Hsieh, Huey-Hong; Chang, Chia-Ming; Liu, Li-Wei; Huang, Hsiu-Chin

2018-05-11

Background : Self-rated health (SRH) is consistent with objective health status and can serve as a global measure of health status in the general population. The purpose of this study is to find the connections of dietary habits, leisure-time exercise, exercise attitude, and body mass index (BMI) to SRH among college students. Methods : The "dietary⁻exercise attitude and SRH" questionnaire was developed to investigate college students in Taiwan through the Internet. Partial least squares structural equation modeling (PLS-SEM) was used to test the relationship among them. Results : The reliability and validity were confirmed using PLS-SEM. The results found exercise habits, dietary habits, and BMI explained 26.5% of SRH. Poor dietary habits and being overweight led to bad health status (negative path coefficients to SRH). Additionally, the study found that positive exercise attitude had a positive relationship with exercise habits. Conclusions : Based on the results, college students should be well-informed of the potential threat of poor dietary habits and being overweight to health and should improve their attitude with respect to exercise so as to prevent overweight-related diseases.

The Relative Contribution of Dietary Habits, Leisure-Time Exercise, Exercise Attitude, and Body Mass Index to Self-Rated Health among College Students in Taiwan

PubMed Central

Hsieh, Huey-Hong; Chang, Chia-Ming; Liu, Li-Wei; Huang, Hsiu-Chin

2018-01-01

Background: Self-rated health (SRH) is consistent with objective health status and can serve as a global measure of health status in the general population. The purpose of this study is to find the connections of dietary habits, leisure-time exercise, exercise attitude, and body mass index (BMI) to SRH among college students. Methods: The “dietary–exercise attitude and SRH” questionnaire was developed to investigate college students in Taiwan through the Internet. Partial least squares structural equation modeling (PLS-SEM) was used to test the relationship among them. Results: The reliability and validity were confirmed using PLS-SEM. The results found exercise habits, dietary habits, and BMI explained 26.5% of SRH. Poor dietary habits and being overweight led to bad health status (negative path coefficients to SRH). Additionally, the study found that positive exercise attitude had a positive relationship with exercise habits. Conclusions: Based on the results, college students should be well-informed of the potential threat of poor dietary habits and being overweight to health and should improve their attitude with respect to exercise so as to prevent overweight-related diseases. PMID:29751682

Internal exposure to trace elements in non-smoking residents living in a northern Taiwan industrial city.

PubMed

Lin, Tser-Sheng; Wu, Chin-Ching

2011-12-01

A total of 94 (54 males, 40 females) healthy adult residents living in an industrial city in northern Taiwan were recruited to study their exposure to industrial metals by measuring their blood levels of V, Cr, Mn, Ni, Co, As, Se, Mo, Cd, Pb, and W. All participants were non-smokers without obvious direct occupational exposure to these elements, although by working in administrative sectors in industrial facilities their indirect or potential exposure was increased. The average concentrations of V, Cr, Mn, Ni, Co, As, Se, Mo, Cd, Pb, and W in blood were 0.30, 1.49, 15.1, 3.84, 2.73, 21.1, 204, 3.2, 0.76, 51.1, and 0.40 ng/mL, respectively. These values were significantly higher than reference values reported for the general population, in some cases exceeding those of occupationally exposed workers. The principal component and correlation analyses among blood element levels suggested that the predominant sources of exposure were glass manufacturing and traffic-related sources. Despite of some limitations, the study demonstrates that the residents in this industrial area may suffer adverse chronic health effects attributable to exposures to these elements.

Stroke: a Hidden Danger of Margin Trading in Stock Markets.

PubMed

Lin, Shu-Hui; Wang, Chien-Ho; Liu, Tsai-Ching; Chen, Chin-Shyan

2015-10-01

Using 10-year population data from 2000 through 2009 in Taiwan, this is the first paper to analyze the relationship between margin trading in stock markets and stroke hospitalizations. The results show that 3 and 6 days after an increase of margin trading in the Taiwan stock markets are associated with greater stoke hospitalizations. In general, a 1 % increase in total margin trading positions is associated with an increment of 2.5 in the total number of stroke hospitalizations, where the mean number of hospital admissions is 233 cases a day. We further examine the effects of margin trading by gender and age groups and find that the effects of margin trading are significant for males and those who are 45-74 years old only. In summary, buying stocks with money you do not have is quite risky, especially if the prices of those stocks fall past a certain level or if there is a sudden and severe drop in the stock market. There is also a hidden danger to one's health from margin trading. A person should be cautious before conducting margin trading, because while it can be quite profitable, danger always lurks just around the corner.

Proficiency Testing Activities of Frequency Calibration Laboratories in Taiwan, 2009

DTIC Science & Technology

2009-11-01

cht.com.tw Abstract In order to meet the requirements of ISO 17025 and the demand of TAF (Taiwan Accreditation Foundation) for calibration inter... IEC 17025 General requirements for the competence of testing and calibration laboratories. The proficiency testing results are then important...on-site evaluation, an assessment team is organized to examine the technical competence of the labs and their compliance with the requirements of ISO

Quality assessment and improvement of nationwide cancer registration system in Taiwan: a review.

PubMed

Chiang, Chun-Ju; You, San-Lin; Chen, Chien-Jen; Yang, Ya-Wen; Lo, Wei-Cheng; Lai, Mei-Shu

2015-03-01

Cancer registration provides core information for cancer surveillance and control. The population-based Taiwan Cancer Registry was implemented in 1979. After the Cancer Control Act was promulgated in 2003, the completeness (97%) and data quality of cancer registry database has achieved at an excellent level. Hospitals with 50 or more beds, which provide outpatient and hospitalized cancer care, are recruited to report 20 items of information on all newly diagnosed cancers to the central registry office (called short-form database). The Taiwan Cancer Registry is organized and funded by the Ministry of Health and Welfare. The National Taiwan University has been contracted to operate the registry and organized an advisory board to standardize definitions of terminology, coding and procedures of the registry's reporting system since 1996. To monitor the cancer care patterns and evaluate the cancer treatment outcomes, central cancer registry has been reformed since 2002 to include detail items of the stage at diagnosis and the first course of treatment (called long-form database). There are 80 hospitals, which count for >90% of total cancer cases, involved in the long-form registration. The Taiwan Cancer Registry has run smoothly for >30 years, which provides essential foundation for academic research and cancer control policy in Taiwan. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Scientific publications in pharmacology and pharmacy journals from Chinese authors in various parts of North Asia: a 10-year survey of the literature.

PubMed

Li, G; Hu, L-H; Liao, Z; Cui, H-C; Li, Z-S

2010-01-01

The amount and quality of pharmacology and pharmacy research by authors from China was investigated by comparing published articles from 136 international journals (1998 - 2007) by authors from mainland China, Hong Kong and Taiwan. The number of articles, clinical trials, randomized controlled trials, case reports, impact factors, number of citations and number of articles published in top general medicine journals were compared. The total number of articles increased significantly between 1998 and 2007 (from 324 to 2536 per year). In total, there were 12 021 articles: 7576 from mainland China, 3267 from Taiwan and 1178 from Hong Kong. The accumulated impact factor of the articles from mainland China (16 688.94) was much higher than for those from Taiwan (8726.92) and Hong Kong (3161.22) but, among the three regions, Hong Kong had the highest mean impact factor and the most articles published in top general medicine journals.

Sleep quality and quality of life in female shift-working nurses.

PubMed

Shao, Ming-Fen; Chou, Yu-Ching; Yeh, Mei-Yu; Tzeng, Wen-Chii

2010-07-01

This paper is a report of a study of the factors that influence sleep quality and quality of life among shift-working nurses and the relationship between their sleep quality and quality of life. Although shift-working nurses strive to adapt their life schedules to shift rotations, they tend to suffer from severe sleep disturbances and increased rates of cancer, cardiovascular diseases, digestive disease and irregular menstrual cycles. Poor sleep is also associated with medical errors and occupational injuries. A cross-sectional study was conducted in 2008 with a convenience sample of 435 female nurses from five regional hospitals in Taiwan. Data were collected on sleep quality and quality of life using the Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Instrument-BREF Taiwan version respectively. Data were analysed using descriptive statistics, independent t-tests, analysis of variance and Pearson correlations. The majority of female shift workers (57%) had global sleep-quality scores > or = 5, indicating poor sleep and all mean scores in four domains of the quality-of-life measure were statistically significantly lower than those of females in Taiwan's general population. Scores for poor sleep quality and quality of life were related to premenstrual dysphoria, occupational injury, illness and medication use. In addition, the associations between scores on the sleep-quality and quality-of-life scales were statistically significantly inversely correlated. Advice should be included in both undergraduate programmes and continuing education to help nurses to recognize and improve their own sleep quality and life quality managers should create a supportive environment to encourage shift-working nurses to engage in healthy behaviours.

Human leukocyte antigen-A, -B, and -DRB1 haplotypes of cord blood units in the Tzu Chi Taiwan Cord Blood Bank.

PubMed

Wen, Shu-Hui; Lai, Meng-Jiun; Yang, Kuo-Liang

2008-07-01

Cord blood (CB) is considered an alternative resource to bone marrow and peripheral blood stem cells (PBSC) for allogeneic stem cell transplantation. In this study, human leukocyte antigen (HLA)-A, -B, and -DRB1 high-resolution allele types were analyzed from a total of 710 CB units in the Tzu Chi Taiwan Cord Blood Bank. We observed 21 HLA-A alleles, 59 HLA-B alleles, and 28 HLA-DRB1 alleles, whereas 19 unique alleles were present in the CB units of 2,023 individuals selected for confirmatory testing in the Tzu Chi Taiwan Marrow Donor Registry (TCTMDR). The allelic associations between the HLA-A and -B locus were stronger than that of either the HLA-B and -DRB1 loci or the HLA-A and -DRB1 loci. The most common haplotype of CB units in the general Taiwanese population was A*3303-B*5801-DRB1*0301 (6.59%), followed by A*0207-B*4601-DRB1*0901 (3.47%) and then A*1101-B*4001-DRB1*0901 (2.11%). Moreover, two haplotypes, A*2402-B*5201-DRB1*1502 and A*0201-B*1301-DRB1*1202, existed uniquely in the CB units but were not observed in the data of TCTMDR. Although the number of CB units studied for high-resolution of HLA typing in the current study is small, we believe our data should provide useful information to increase the chances of obtaining acceptable HLA-A-, -B-, and -DRB1-matched CB units for patients.

The figs of winter: Seasonal importance of fruiting fig trees (Ficus: Moraceae) for urban birds

NASA Astrophysics Data System (ADS)

Walther, Bruno A.; Geier, Jessica; Chou, Lien-Siang; Bain, Anthony

2018-07-01

Birds and figs are conspicuous members of the tropical and subtropical ecosystems. Because they are easily observed and very speciose, their relationships have been well studied in many areas, and the figs are considered a keystone resource for many bird species which are efficient fig seed dispersers. Taiwan has a relatively high endemism rate for many taxa (17% of bird species) but because of its high human population density, most lowland habitats are heavily developed, of which much of it covered by dense urban habitation. To establish the importance of urban figs for birds, we focused our surveys mostly on three common urban fig species (Ficus caulocarpa, F. microcarpa and F. subpisocarpa). We observed trees with ripening figs from July 2013 to December 2016 in order to determine the composition of the fig-consuming bird community. In addition, we added all the information available in the scientific literature and birdwatchers' observations which we could find. In total, we observed 42 bird species consuming 18 fig species. The bird diversity in urban areas was non-negligible even during winter. Therefore, there are two reasons why figs are important for Taiwan's bird avifauna: in cities, the tree diversity is generally low so that figs provide a stable food resource; and since figs are fruiting all year-round, they are one of the few reliable resources available during winter when many migrant birds overwinter in Taiwan. Already crucial for many species in tropical and subtropical forests, fig trees may also be essential for urban birds in tropical and subtropical regions.

Effect of assertiveness training on levels of stress and assertiveness experienced by nurses in Taiwan, Republic of China.

PubMed

Lee, S; Crockett, M S

1994-01-01

The purpose of the study was to examine the effectiveness of assertiveness training in improving self-perceived levels of stress and assertiveness among nurses in Taiwan, Republic of China. The two-group experimental design was conducted in a 2,000-bed veteran general hospital. A sample of 60 volunteer Chinese-speaking nurses participated in the study. Subjects were randomly assigned to one of two treatments: assertiveness training (AT) or alternate treatment control (ATC), which served as a control and contained updated knowledge of new computer technology for in patient settings. Subjects in each group participated in six 2-hour workshops in the same two-week period. All subjects were pre-, post-, and follow-up posttested for stress and assertiveness with the Perceived Stress Scale (PSS) and Rathus Assertiveness Schedule (RAS), respectively. Results revealed the following: (1) subjects in both groups of pretest were clearly subassertive and under considerable stress; (2) by the end of training, the AT group scored significantly higher on the rating of assertiveness than those in the ATC group, and had successfully maintained their improvement by the 4-week follow-up; and (3) by the end of training, the AT group reported significantly lower levels of stress than the ATC group as indicated on the PSS, and successfully maintained their improvements at the 4-week follow-up. Overall, the results indicate clear support for the effectiveness of assertiveness training for treating subassertive behaviors and stress in a population of professional nurses in Taiwan.

Evaluation of Site Amplification Functions For Generalized Soil Types Using Earthquake Records and Spectral Models

NASA Astrophysics Data System (ADS)

Sokolov, V.; Loh, C. H.; Wen, K. L.

When evaluating the local site influence on seismic ground motion, in certain cases (e.g. building codes provisions) it is sufficient to describe the variety of soil condi- tions by a few number of generalized site classes. The site classification system that is widely used at present is based on on the properties of top 30 m of soil column, dis- regarding the characteristics of the deeper geology. Six site categories are defined on the basis of averaged shear waves velocity, namely: A - hard rock; B - rock; C - very dense or stiff soil; D - stiff soil; E - soft soil; F - soils requiring special studies. The generalized site amplification curves were developed for several site classes in west- ern US (Boore and Joyner, 1997) and Greece (Klimis et al., 1999) using available geotechnical data from near-surface boreholes. We propose to evaluate the amplifica- tion functions as the ratios between the spectra of real earthquakes recordings and the spectra modeled for "very hard rock" (VHR) conditions. The VHR spectra (regional source scaling and attenuation models) are constructed on the basis of ground motion records. The approach allows, on the one hand, to analyze all obtained records. On the other hand, it is possible to test applicability of the used spectral model. Moreover, the uncertainty of site response may be evaluated and described in terms of random variable characteristics to be considered in seismic hazard analysis. The results of the approach application are demonstrated for the case of Taiwan region. The char- acteristics of site amplification functions (mean values and standard deviation) were determined and analyzed in frequency range of 0.2-13 Hz for site classes B and C us- ing recordings of the 1999 Chi-Chi, Taiwan, earthquake (M=7.6), strong aftershocks (M=6.8), and several earthquakes (M < 6.5) occurred in the region in 1995-1998. When comparing the empirical amplification function resulting from the Taiwan data with that proposed for western US, it has been shown that, for both class B and class C, the US amplification functions exhibit lower values than Taiwan class B function for frequencies 1-8 Hz. The Hellenic class C amplification shows, in general, the sim- ilar shape and amplitude as that evaluated for Taiwan region. Thus, the generalized site amplification curves should be also considered as region-dependent functions.

Trends in the prevalence of periodontitis in Taiwan from 1997 to 2013: A nationwide population-based retrospective study.

PubMed

Yu, Hui-Chieh; Su, Ni-Yu; Huang, Jing-Yang; Lee, Shiuan-Shinn; Chang, Yu-Chao

2017-11-01

Periodontitis is one of the most prevalent oral diseases. In this study, we probed the nationwide registered database to assess the time trends of prevalence of periodontitis in Taiwan.A retrospective study was conducted to analyze the registered database compiled by the National Health Insurance provided by the Department of Health, Taiwan, from 1997 to December 2013.We found that the prevalence of periodontitis significantly increased from 11.5% in 1997 to 19.59% in 2013 (P for trend < .0001). The mean age ± standard deviation with periodontitis from 1997 to 2013 was 54.46 ± 14.47 and 45.51 ± 16.58 years old, respectively. The proportion of individuals with periodontitis in age group >65 years old decreased markedly. The proportion of individuals with periodontitis in age groups <25 and 26 to 35 years old demonstrated an increased pattern. Compared to the reference cohort of 1953 to 1957, the recent birth cohort of 1993 to 1997 revealed the highest relative risk (RR) of periodontitis (male: RR, 67.42, 95% confidence interval [CI], 17.04-266.76; female: RR, 65.85, 95% CI, 16.70-259.70). Both male and female groups showed the similar age-effect pattern in the cross-sectional age curve from age-period-cohort model. There was an upturn with advancing age up to 40 to 50 years old and then a downward trend in both genders. Population dwelling in suburban area (RR, 0.95; 95% CI, 0.94-0.97) and rural area (RR, 0.97; 95% CI, 0.95-0.99) had the lower risk of periodontitis than those who lived in urban area. The higher income group revealed the higher risk of periodontitis compared with lower income group (RR, 1.20; 95% CI, 1.18-1.23).The prevalence of periodontitis significantly increased in Taiwan over past 17 years. The mean age with periodontitis was shown in a decreased pattern. The use of a nationwide population-based database could provide sufficient sample size, generalizability, and statistical power to assess the periodontal status in Taiwan.

MNSs Blood Group Glycophorin Variants in Taiwan: A Genotype-Serotype Correlation Study of ‘Mia’ and Sta with Report of Two New Alleles for Sta

PubMed Central

Chen, Tai-Di; Chen, Ding-Ping; Wang, Wei-Ting; Sun, Chien-Feng

2014-01-01

Background Glycophorin variants of the MNSs blood group are important in Taiwan. For more than 20 years, screening for the most frequent irregular antibody, anti-‘Mia’, has been conducted by using ‘Mia’(+) RBCs, with a significant success. However, the sensitivity and the specificity of this screening strategy have never been validated, and the true incidences of different glycophorin variants in Taiwan have been in controversy. Also, the significance of another less frequent and usually separately reported variant, Sta, has never been evaluated. Methodology/Principal Findings We ran a population-based screening (from unselected patients in our hospital) for MNSs blood group glycophorin variants by PCR-sequencing method. GP.Mur (Mil.III) was confirmed by sequence from 57 out of 1027 samples (5.6%), and there was no other Miltenberger subtype glycophorin variant found. Glycophorin variant Sta was found from 35 out of 1027 samples (3.4%). In contrast to anti-‘Mia’, which is the most frequently identified irregular antibody in Taiwan, the prevalence of anti-Sta was only 0.13% as determined by serologic method. In addition, two new alleles for Sta were found and reported. Conclusion/Significance We confirm the long-standing assumption that GP.Mur is the only prevalent Miltenberger subtype in Taiwan. The current anti-‘Mia’ screening method used in Taiwan, although neither sensitive nor specific, is still a suitable practice. Although Sta antigen has a high prevalence in Taiwan, routine screening for anti-Sta is not warranted based on current evidence. PMID:24858913

Effect of Crop Rotation on Meloidogyne spp. and Pratylenchus spp. Populations in Strawberry Fields in Taiwan

PubMed Central

Chen, P.; Tsay, T.T.

2006-01-01

Changes in population levels of Meloidogyne hapla, M. incognita, Pratylenchus coffeae, and P. penetrans were studied in 12 strawberry fields in the Dahu region of Taiwan. Ten potential rotation crops and two cultural practices were evaluated for their effect on nematode populations and influence on strawberry yield. Rotation with rice or taro and the cultural practice of flooding and bare fallowing for four months were found to reduce nematode soil populations to two or fewer nematodes per 100 ml soil. Average strawberry yields increased between 2.4% to 6.3% following taro compared to the bare fallow treatment. Corn suppressed M. incognita and M. hapla populations and resulted in an increased in strawberry yield compared to bare fallow. Other phytopathogens also present in these fields limited taro as the rotation choice for nematode management. Results of this research and economic analysis of the input requirements for various rotation crops, corn and bare fallow were recommended as the most appropriate rotation strategies for nematode management in strawberry in this region. PMID:19259538

Adoption of medication alert systems in hospital outpatient departments in Taiwan.

PubMed

Kuo, Yu-Chun; Cheng, Shou-Hsia

2017-06-01

The adoption of medication alert systems in the health care sector varies among regions. In Taiwan, the health authority introduced policies in 2005 to encourage the adoption of medication alert systems in hospitals. This study aimed to understand the adoption of medication alert systems in the outpatient departments of hospitals in Taiwan using a nationwide survey. A questionnaire was developed and mailed to 380 accredited general hospitals in Taiwan in 2013. The information collected from the questionnaire concerning the outpatient department included (1) the time of adoption of a medication alert system; (2) the operation of individual alert functions: availability, management, and stability; and (3) hospital characteristics: accreditation level, teaching status, ownership, and number of beds. A total of 216 hospitals completed and returned the questionnaire, corresponding to a response rate of 56.8%. The adoption rate of medication alert systems in hospital outpatient departments increased from less than 10% in 1997-95.83% in 2012. Approximately two-thirds of the hospitals developed and maintained the alert systems independently or collaboratively with vendors. Teaching and large hospitals tended to develop more advanced alert functions such as drug-drug interaction functions. Improving the safety and quality of pharmaceutical services and meeting the policy requirements are reasons for hospitals to establish medication alert systems. The adoption rate of medication alert systems reached 95% in accredited general hospitals in Taiwan. Government policy and available health information professionals and vendors may somewhat contribute to the high adoption rate. Copyright © 2017 Elsevier B.V. All rights reserved.

Analysis of the causes of surgery-related medical disputes in Taiwan: Need for acute care surgeons to improve quality of care.

PubMed

Hu, Yi-Hsuan; Wang, Chien-Ying; Huang, Mu-Shun; Lee, Chen-Hsen; Wen, Yi-Szu

2016-11-01

This study investigated surgery-related medical disputes and analyzed disease etiologies and the main causes of disputes in order to identify key points for the purpose of improving the quality of surgical patient care in Taiwan. Reports on all surgery-related cases appraised by the Taiwan Witness Examiner Committee of the Department of Health between 2004 and 2008 were reviewed retrospectively by three senior physicians from the emergency department who specialize in both trauma and emergency general surgery. The causes of the various medical disputes were categorized under the following descriptions: operation- or procedure-related complication, anesthesia complication, inappropriate management or decision, delayed diagnosis or misdiagnosis, and unsatisfactory result. A total of 154 cases were reviewed, of which 39 were trauma-related and 115 were disease-related. The two leading causes of disputes in this review were found to be operation- or procedure-related complications (35.7%) and unsatisfactory results (31.8%), followed by delayed diagnoses or misdiagnoses, inappropriate management, and anesthesia complications. Among these, 74 cases (48.1%) required the care of an acute care surgeon and 40 cases (26.0%) required emergency general surgery intervention. Surgery- or procedure-related complications and unsatisfactory treatment results constituted the major causes of medical disputes in Taiwan. The majority of these cases involved acute care surgery; thus, the establishment of an acute care surgery system should be considered to improve patient care. The management of hemorrhagic shock and incarcerated hernia should be reinforced in future medical training. Copyright © 2016. Published by Elsevier Taiwan LLC.

Crustal and upper mantle S-wave velocity structures across the Taiwan Strait from ambient seismic noise and teleseismic Rayleigh wave analyses

NASA Astrophysics Data System (ADS)

Huang, Y.; Yao, H.; Wu, F. T.; Liang, W.; Huang, B.; Lin, C.; Wen, K.

2013-12-01

Although orogeny seems to have stopped in western Taiwan large and small earthquakes do occur in the Taiwan Strait. Limited studies have focused on this region before and were barely within reach for comprehensive projects like TAICRUST and TAIGER for logistical reasons; thus, the overall crustal structures of the Taiwan Strait remain unknown. Time domain empirical Green's function (TDEGF) from ambient seismic noise to determine crustal velocity structure allows us to study an area using station pairs on its periphery. This research aims to resolve 1-D average crustal and upper mantle S-wave velocity (Vs) structures alone paths of several broadband station-pairs across the Taiwan Strait; 5-120 s Rayleigh wave phase velocity dispersion data derived by combining TDEGF and traditional surface wave two-station method (TS). The average Vs structures show significant differences in the upper 15 km as expected. In general, the highest Vs are observed in the coastal area of Mainland China and the lowest Vs appear along the southwest offshore of the Taiwan Island; they differ by about 0.6-1.1 km/s. For different parts of the Strait, the Vs are lower in the middle by about 0.1-0.2 km/s relative to those in the northern and southern parts. The overall crustal thickness is approximately 30 km, much thinner and less variable than under the Taiwan Island.

A material flow of lithium batteries in Taiwan.

PubMed

Chang, T C; You, S J; Yu, B S; Yao, K F

2009-04-30

Li batteries, including secondary and cylindrical/button primary Li batteries, are used worldwide in computers, communications and consumer electronics products. However, there are several dangerous issues that occur during the manufacture, shipping, and storage of Li batteries. This study analyzes the material flow of lithium batteries and their valuable heavy metals in Taiwan for the year 2006 by material flow analysis. According to data from the Taiwan Environmental Protection Administration, Taiwan External Trade Development Council, Bureau of Foreign Trade, Directorate General of Customs, and the Li batteries manufactures/importers/exporters. It was found that 2,952,696 kg of Li batteries was input into Taiwan for the year 2006, including 2,256,501 kg of imported Li batteries and 696,195 kg of stock Li batteries in 2005. In addition, 1,113,867 and 572,215 kg of Li batteries was domestically produced and sold abroad, revealing that 3,494,348 kg of different types of Li batteries was sold in Taiwan. Of these domestically sold batteries, 504,663 and 146,557 kg were treated domestically and abroad. Thus, a total of 2,843,128 kg of Li batteries was stored by individual/industry users or illegally disposed. In addition, it was also observed that 2,120,682 kg of heavy metals contained in Li batteries, including Ni, Co, Al, Cu and Ni, was accumulated in Taiwan, with a recycled value of 38.8 million USD. These results suggest that these heavy metals should be recovered by suitable collection, recycling and reuse procedures.

Crossover of Equilibrium and Nonequilibrium Carrier Density in Germanium Two-Dimensional Hole Gases

NASA Astrophysics Data System (ADS)

Su, Yi-Hsin; Chuang, Yen; Chiu, Po-Yuan; Hsu, Nai-Wen; Lu, Tzu-Ming; Li, Jiun-Yun

We performed a detailed study on the enhancement-mode two-dimensional hole gases (2DHGs) in the Ge/Ge1-xSix (0.15

Higher risk for cervical herniated intervertebral disc in physicians: A retrospective nationwide population-based cohort study with claims analysis.

PubMed

Liu, Cheng; Huang, Chien-Cheng; Hsu, Chien-Chin; Lin, Hung-Jung; Guo, How-Ran; Su, Shih-Bin; Wang, Jhi-Joung; Weng, Shih-Feng

2016-10-01

There is no study about cervical herniated intervertebral disc (cervical HIVD) in physicians in the literature; therefore, we conceived a retrospective nationwide, population-based cohort study to elucidate the topic. We identified 26,038 physicians, 33,057 non-physician healthcare providers (HCPs), and identical numbers of non-HCP references (i.e., general population). All cohorts matched a 1:1 ratio with age and gender, and each were chosen from the Taiwan National Health Insurance Research Database (NHIRD). We compared cervical HIVD risk among physicians, nonphysician HCPs, and non-HCP references and performed a follow-up between 2007 and 2011. We also made comparisons among physician specialists. Both physicians and nonphysician HCPs had higher cervical HIVD risk than non-HCP references (odds ratio [OR]: 1.356; 95% confidence interval (CI): 1.162-1.582; OR: 1.383; 95% CI: 1.191-1.605, respectively). There was no significant difference of cervical HIVD risk between physicians and nonphysician HCPs. In the comparison among physician specialists, orthopedists had a higher cervical HIVD risk than other specialists, but the difference was not statistically significant (adjusted OR: 1.547; 95% CI: 0.782-3.061). Physicians are at higher cervical HIVD risk than the general population. Because unknown confounders could exist, further prospective studies are needed to identify possible causation.

The Correlates of Leisure Time Physical Activity among an Adults Population from Southern Taiwan

PubMed Central

2011-01-01

Background Assessing the correlates of practicing physical activity during leisure time is important with regard to planning and designing public health strategies to increase beneficial behaviors among adult populations. Although the importance of leisure time physical activity (LTPA) is highlighted in many Western countries, there are not many publications on physical activity patterns, and even less on their correlates, in non-Western societies. The goal of this study was thus to explore the determinants influencing adults' leisure time physical activity (LTPA) in a city in southern Taiwan. Methods A cross-sectional population-based study was conducted in 2007, using a standardized questionnaire. Energy expenditure was dichotomized into two groups based on the recommended levels of moderate physical activity from LTPA: ≥10 or < 10 MET·hr·wk-1. Logistic regression analyses were applied to the results. Results A total of 762 subjects with valid data took part in the study (mean age 53.8 ± 13.8 years). In multivariate logistic regression analysis, we found the following results: Age was positively associated with LTPA. Adults with stronger perceived convenience of exercise facilities (OR = 2.04; 95%CI = 1.28-3.24) and past exercise experience in school (OR = 1.86; 95%CI= 1.19-2.91) participated in more LTPA. Subjects with more general social support (OR = 1.66;95%CI = 1.13-2.44), greater knowledge about the health benefits of exercise (OR = 1.85;95%CI = 1.25-2.74), more sports media consumption (OR = 1.94;95%CI = 1.26-2.98), and higher self-efficacy (OR = 3.99;95%CI = 2.67-5.97) were more likely to engage in LTPA. Further analysis comparing different sources of social support showed only social support from friends had a significant positive association (OR = 1.73;95%CI = 1.14-2.63) with increased LTPA. Conclusions LTPA in southern city of Taiwan showed some unique associations with age, socioeconomic status and media consumption that are not commonly reported in the Western World and similar associations with regards to psychosocial correlates of LTPA participation. Further studies from developing countries are warranted to highlight culture-specific differences in physical activity participation. PMID:21639878

The warming trend of ground surface temperature in the Choshui Alluvial Fan, western central Taiwan

NASA Astrophysics Data System (ADS)

Chen, W.; Chang, M.; Chen, J.; Lu, W.; Huang, C. C.; Wang, Y.

2013-12-01

Heat storage in subsurface of the continents forms a fundamental component of the global energy budget and plays an important role in the climate system. Several researches revealed that subsurface temperatures were being increased to 1.8-2.8°C higher in mean ground surface temperature (GST) for some Asian cities where are experiencing a rapid growth of population. Taiwan is a subtropic-tropic island with densely populated in the coastal plains surrounding its mountains. We investigate the subsurface temperature distribution and the borehole temperature-depth profiles by using groundwater monitoring wells in years 2000 and 2010. Our data show that the western central Taiwan plain also has been experiencing a warming trend but with a higher temperatures approximately 3-4 °C of GST during the last 250 yrs. We suggest that the warming were mostly due to the land change to urbanization and agriculture. The current GSTs from our wells are approximately 25.51-26.79 °C which are higher than the current surface air temperature (SAT) of 23.65 °C. Data from Taiwan's weather stations also show 1-1.5 °C higher for the GST than the SAT at neighboring stations. The earth surface heat balance data indicate that GST higher than SAT is reasonable. More researches are needed to evaluate the interaction of GST and SAT, and how a warming GST's impact to the SAT and the climate system of the Earth.

Effect of Weekend Admissions on the Treatment Process and Outcomes of Internal Medicine Patients

PubMed Central

Huang, Chun-Che; Huang, Yu-Tung; Hsu, Nin-Chieh; Chen, Jin-Shing; Yu, Chong-Jen

2016-01-01

Abstract Many studies address the effect of weekend admission on patient outcomes. This population-based study aimed to evaluate the relationship between weekend admission and the treatment process and outcomes of general internal medicine patients in Taiwan. A total of 82,340 patients (16,657 weekend and 65,683 weekday admissions) aged ≥20 years and admitted to the internal medicine departments of 17 medical centers between 2007 and 2009 were identified from the Taiwan National Health Insurance Research Database. A generalized estimating equation (GEE) analysis was used to compare patients admitted on weekends and those admitted on weekdays. Patients who were admitted on weekends were more likely to undergo intubation (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.16–1.39; P < 0.001) and/or mechanical ventilation (OR, 1.25; 95% CI, 1.15–1.35; P < 0.001), cardio-pulmonary resuscitation (OR: 1.45; 95% CI: 1.05–2.01; P = 0.026), and be transferred to the intensive care unit (ICU) (OR: 1.16; 95% CI: 1.03–1.30; P = 0.015) compared with those admitted on weekdays. Weekend-admitted patients also had higher odds of in-hospital mortality (OR: 1.19; 95% CI: 1.09–1.30; P < 0.001) and hospital treatment cost (OR: 1.04; 95% CI: 1.01–1.06; P = 0.008) than weekday-admitted patients. General internal medicine patients who were admitted on weekends experienced more intensive care procedures and higher ICU admission, in-hospital mortality, and treatment cost. Intensive care utilization may serve as early indicator of poorer outcomes and a potential entry point to offer preventive intervention before proceeding to intensive treatment. PMID:26871788

Effect of Weekend Admissions on the Treatment Process and Outcomes of Internal Medicine Patients: A Nationwide Cross-Sectional Study.

PubMed

Huang, Chun-Che; Huang, Yu-Tung; Hsu, Nin-Chieh; Chen, Jin-Shing; Yu, Chong-Jen

2016-02-01

Many studies address the effect of weekend admission on patient outcomes. This population-based study aimed to evaluate the relationship between weekend admission and the treatment process and outcomes of general internal medicine patients in Taiwan.A total of 82,340 patients (16,657 weekend and 65,683 weekday admissions) aged ≥20 years and admitted to the internal medicine departments of 17 medical centers between 2007 and 2009 were identified from the Taiwan National Health Insurance Research Database. A generalized estimating equation (GEE) analysis was used to compare patients admitted on weekends and those admitted on weekdays.Patients who were admitted on weekends were more likely to undergo intubation (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.16-1.39; P < 0.001) and/or mechanical ventilation (OR, 1.25; 95% CI, 1.15-1.35; P < 0.001), cardio-pulmonary resuscitation (OR: 1.45; 95% CI: 1.05-2.01; P = 0.026), and be transferred to the intensive care unit (ICU) (OR: 1.16; 95% CI: 1.03-1.30; P = 0.015) compared with those admitted on weekdays. Weekend-admitted patients also had higher odds of in-hospital mortality (OR: 1.19; 95% CI: 1.09-1.30; P < 0.001) and hospital treatment cost (OR: 1.04; 95% CI: 1.01-1.06; P = 0.008) than weekday-admitted patients.General internal medicine patients who were admitted on weekends experienced more intensive care procedures and higher ICU admission, in-hospital mortality, and treatment cost. Intensive care utilization may serve as early indicator of poorer outcomes and a potential entry point to offer preventive intervention before proceeding to intensive treatment.

Host range of emerald ash borer

Treesearch

Robert A. Haack; Toby R. Petrice; Deborah L. Miller; Leah S. Bauer; Nathan M. Schiff

2004-01-01

The emerald ash borer (EAB), Agrilus planipennis Fairmaire, is native to China, Korea, Japan, Mongolia, Russia, and Taiwan (Haack et al. 2002). Established populations of EAB were first discovered in Michigan and Ontario in 2002. Smaller populations, which resulted from human assisted movement of infested host material, were found in Ohio, Maryland,...

Early Childhood Caries-Related Knowledge, Attitude, and Practice: Discordance between Pediatricians and Dentists toward Medical Office-Based Prevention in Taiwan.

PubMed

Dima, Shinechimeg; Chang, Wei-Jen; Chen, Jung-Wei; Teng, Nai-Chia

2018-05-24

The aim of this study was to assess the knowledge, attitude, and practice regarding early childhood caries (ECC) prevention and implementation of medical setting-based caries prevention among pediatricians and dentists in Taiwan. Data were collected from currently practicing pediatricians and general and pediatric dentists using self-administered questionnaires. A total of 301 questionnaires were completed by the pediatricians ( n = 105), general dentists ( n = 117), and pediatric dentists ( n = 79). The pediatric dentists obtained significantly higher knowledge and practice scores than the general dentists and pediatricians ( p < 0.0001). The pediatricians' attitude score related to engaging physicians in medical office-based caries prevention was significantly higher than the attitude scores of the general and pediatric dentists ( p < 0.05). A Spearman rank correlation analysis indicated a significant positive correlation between knowledge and practice among the general dentists (r s = 0.271, p < 0.01) and pediatricians (r s = 0.262, p < 0.01). The correlation between knowledge and attitude among the pediatricians was significantly positive (r s = 0.242, p < 0.05). Attitude and practice among the pediatricians were significantly positively correlated (r s = 0.271, p < 0.01). Pediatricians lacked ECC-related knowledge; however, they had a more positive attitude toward medical office-based prevention when they had a higher level of knowledge. Oral health-related education for pediatricians is necessary if such medical office-based caries prevention programs are to be implemented in Taiwan.

Neonatal outcomes of extremely preterm infants from taiwan: comparison with Canada, Japan, and the USA.

PubMed

Su, Bai-Horng; Hsieh, Wu-Shiun; Hsu, Chyong-Hsin; Chang, Jui-Hsing; Lien, Reyin; Lin, Chyi-Her

2015-02-01

This study compared the current trend in survival rates and morbidity for very low birth weight (VLBW) infants in five Medical Training Centers of Prematurity for the Premature Baby Foundation of Taiwan (PBFT), with the outcomes from the USA, National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN), the Canadian Neonatal Network (CNN), and the Neonatal Research Network of Japan (NRNJ). The survival rates of VLBW infants according to gestational age (GA) and major morbidities were compared between networks (Taiwan, USA, Canada, and Japan). Taiwanese data for VLBW infants of GA ≤28 weeks between 2007 and 2012 were obtained from the "PBFT Annual Conferences of Premature Care" reports defining survival rate as neonates that survived to the time of discharge. Major morbidities included severe neurological injury (Grade 3 or 4 intraventricular hemorrhage or periventricular leukomalacia), bronchopulmonary dysplasia, severe retinopathy of prematurity, necrotizing enterocolitis, late-onset sepsis, and patent ductus arteriosus. The survival rates of VLBW infants of GA ≤28 weeks from the PBFT (Taiwan), NICHD NRN (USA), CNN (Canada), and NRNJ (Japan) were 77% (1323/1718), 72% (6859/9575), 82% (2353/2872), and 89% (4489/5069), respectively. The annual survival rates in Taiwan from 2007 to 2012 were 72%, 76%, 76%, 74%, 77%, and 78%, respectively. When GA from ≤23 weeks to 28 weeks was assessed in Taiwan, the survival rates of VLBW infants according to each week were 22%, 50%, 70%, 80%, 88%, and 92%, respectively. The survival rate, especially at lower GAs, was highest in the NRNJ (Japan). The major difference between Taiwan and Japan was attributed to the lower survival rates at lower GA (≤26 weeks) in Taiwan. Japan had the lowest rates of major morbidities among the four countries. The survival rate of VLBW infants has improved over the past 6 years in Taiwan. It is higher than the USA, but lower than Canada and Japan. However, the results from Taiwan are from five Medical Training Centers for the PBFT rather than from a population-based study. It is crucial to have a nationwide neonatal research network to develop new practical approaches for VLBW infants in Taiwan. Copyright © 2014. Published by Elsevier B.V.

A population-specific Mini-Nutritional Assessment can effectively grade the nutritional status of stroke rehabilitation patients in Taiwan.

PubMed

Tsai, Alan C; Shih, Chi-Ling

2009-01-01

To determine whether a modified version of the Mini-Nutritional Assessment without body mass index could effectively assess the nutritional risk status of stroke rehabilitation patients in Taiwan. The Mini-Nutritional Assessment was developed on the basis of clinical data of Western populations. Although widely used, its application to assess stroke rehabilitation patients has been limited. Further, to get best results, population-specific modifications to address anthropometric and lifestyle differences have been suggested, especially for non-Caucasian populations. The study assessed the nutritional status of stroke rehabilitation patients who enrolled in the Long-Term Care Service of Taipei. Strokes who were >40 years old, in the program for >1 month and cognitively able to answer the questions were recruited to participate in the study. An on-site in-person interview with structured questionnaire elicited information on personal data, disease history and healthcare use and answers to the Mini-Mental State Examination, the Activities of Daily Living and the Mini-Nutritional Assessment. Patient's nutritional status was assessed with the Mini-Nutritional Assessment in three versions: the original, population-specific (MNA-TI) and population-specific, without body mass index (MNA-TII). The original Mini-Nutritional Assessment rated 24% of patients malnourished and 57% at risk of malnutrition. Similar results, 14 and 64%, respectively, for MNA-TI; and 19 and 57%, respectively, for MNA-TII were observed. Both the original and the modified versions of the Mini-Nutritional Assessment can effectively rate the nutritional risk status of stroke rehabilitation patients in Taiwan. Version MNA-TII that adopted population-specific anthropometric cut-values but without body mass index can effectively predict the nutritional status of stroke patients. The modified scale (MNA-TII) can enhance the application of the tool and timely detection and intervention of undernutrition among stroke rehabilitation patients. It can also help to improve job efficiency of the primary care professionals.

NHI-PharmaCloud in Taiwan--A preliminary evaluation using the RE-AIM framework and lessons learned.

PubMed

Huang, San-Kuei; Wang, Pen-Jen; Tseng, Wen-Fuh; Syu, Fei-Kai; Lee, Miaw-Chwen; Shih, Ru-Liang; Sheen, Mao-Ting; Chen, Michael S

2015-10-01

The aim of this article is to present the preliminary impact of a medication monitoring program, PharmaCloud, in Taiwan and analyze the embedded factors that have contributed to the performance thereof. This article also compared PharmaCloud with similar international programs in order to draw lessons learned. The five domains of the RE-AIM framework - reach, effectiveness, adoption, implementation, and maintenance - were examined using qualitative and quantitative data. A difference-in-differences model was applied to analyze the quantitative impact of PharmaCloud on drug utilization and drug expenses. The qualitative impact was evaluated by document analysis based on field reports from the participating medical institutions. Reach and adoption: although all of the major hospitals adopted PharmaCloud and some of the hospitals had high inquiry rates, more time and incentives are needed to raise the overall inquiry rate. Effectiveness: during the study period of 3 months, the number of medications per prescription declined in the intervention group was 0.15 more than that of the general population, and the drug expense per person declined in the intervention group was NT $567 (US $18.9) more than that of the general population. The potential savings could be between 2% and 5% of the total pharmaceutical expenditure. Medication duplication was found to have decreased more in the intervention group. a variety of innovations in care delivery are being developed in which the pharmacists play a more significant role. Maintenance: the embedded National Health Insurance would lend strong support for PharmaCloud to grow and thrive. PharmaCloud owes its effectiveness to the embedded National Health Insurance (NHI) program, which is universal and provides a comprehensive benefit package including more than 16,000 prescription drugs. An effective medication program is one that operates under the principle of universality and comprehensiveness, facilitates innovations, and has a substantial level of interoperability with the intra-hospital health information systems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Declining Fertility and the Use of Cesarean Delivery: Evidence from a Population-Based Study in Taiwan

PubMed Central

Ma, Ke-Zong M; Norton, Edward C; Lee, Shoou-Yih D

2010-01-01

Objective To test the hypothesis that declining fertility would affect the number of cesarean sections (c-sections) on maternal demand, but not medically indicated c-sections. Data Sources The 1996–2004 National Health Insurance Research Database in Taiwan for all singleton deliveries. Study Design Retrospective population-based, longitudinal study. Estimation was performed using multinomial probit models. Principal Findings Results revealed that declining fertility had a significant positive effect on the probability of having a c-section on maternal request but not medically indicated c-section. Conclusions Our findings offer a precautionary note to countries experiencing a fertility decline. Policies to contain the rise of c-sections should understand the role of women's preferences, especially regarding cesarean deliveries on maternal request. PMID:20545781

Parental Body Mass Index Is Associated With Adolescent Obesity in Taiwan.

PubMed

Chen, Chen-Mei; Lou, Meei-Fang; Gau, Bih-Shya

2016-12-01

Adolescent obesity is a crucial public health concern, and understanding its risk factors can facilitate the establishment of prevention policies. In this study we investigated the prevalence of adolescent obesity in Taiwan, determined the influential factors, and compared the prevalence of obesity in our study population with international indices. The cross-sectional study was an analysis of data from the 2010-2011 Nutrition and Health Survey in Taiwan, an anthropometric measurement and questionnaire survey of adolescents aged 11-18 years. Our sample was 1,826 adolescents (910 males and 916 females). Data were analyzed using logistic regression modeling. Based on body mass index standards specific to Taiwan norms, the prevalence of overweight and obesity in Taiwan adolescents was 12.4% and 16.8%, respectively. The prevalence was lower when international indices of overweight and obesity were applied. In logistic regression, obesity was linked to male gender, an obese father, overweight or obese mother, poor dietary attitudes, and perceived low dietary benefits. Monitoring and preventing adolescent obesity should focus on both adolescents and their parents. When planning behavioral change and education for adolescent obesity, health professionals and policy-makers should view the family as a unit. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Molecular epidemiology of porcine reproductive and respiratory syndrome viruses isolated from 1991 to 2013 in Taiwan.

PubMed

Deng, Ming-Chung; Chang, Chia-Yi; Huang, Tien-Shine; Tsai, Hsiang-Jung; Chang, Chieh; Wang, Fun-In; Huang, Yu-Liang

2015-11-01

Porcine reproductive and respiratory syndrome virus (PRRSV) was first identified in Taiwan in 1991, but the genetic diversity and evolution of PRRSV has not been thoroughly investigated over the past 20 years. The aim of this study was to bridge the gap in understanding of its molecular epidemiology. A total of 31 PRRSV strains were collected and sequenced. The sequences were aligned using the MUSCLE program, and phylogenetic analysis were performed by the maximum-likelihood method and the neighbor-joining method using MEGA 5.2 software. In the early 1990s, two prototype strains, WSV and MD001 of the North American genotype, were first identified. Over the years, both viruses evolved separately. The population dynamics of PRRSV revealed that the strains of the MD001 group were predominant in Taiwan. Evolution was manifested in changes in the nsp2 and ORF5 genes. In addition, a suspected newly invading exotic strain was recovered in 2013, suggesting that international spread is still taking place and that it is affecting the population dynamics. Overall, the results provide an important basis for vaccine development for the control and prevention of PRRS.

Identifying risk factors for victimization among male prisoners in Taiwan.

PubMed

Kuo, Shih-Ya; Cuvelier, Steven J; Huang, Yung-Shun

2014-02-01

This study identified risk factors for prison victimization in Taiwan with an application of Western literature and assessed the extent of its applicability in an Eastern context. The sample was drawn from four male prisons located in Northern, Central, Southern, and Eastern Taiwan; a total of 1,181 valid surveys were collected. The results generally support the major findings of the extant Western studies. Crowding, however, was not significantly associated with the risk of victimization in any of the statistical models, which might be related to the different experiences and living conditions in the free community between Taiwanese and American inmates. This study generated clear policy implications, which may reduce prison victimization and engender a greater sense of well-being in the prison environment.

Utilizing Health Information Technology to Support Universal Healthcare Delivery: Experience of a National Healthcare System.

PubMed

Syed-Abdul, Shabbir; Hsu, Min-Huei; Iqbal, Usman; Scholl, Jeremiah; Huang, Chih-Wei; Nguyen, Phung Anh; Lee, Peisan; García-Romero, Maria Teresa; Li, Yu-Chuan Jack; Jian, Wen-Shan

2015-09-01

Recent discussions have focused on using health information technology (HIT) to support goals related to universal healthcare delivery. These discussions have generally not reflected on the experience of countries with a large amount of experience using HIT to support universal healthcare on a national level. HIT was compared globally by using data from the Ministry of the Interior, Republic of China (Taiwan). Taiwan has been providing universal healthcare since 1995 and began to strategically implement HIT on a national level at that time. Today the national-level HIT system is more extensive in Taiwan than in many other countries and is used to aid administration, clinical care, and public health. The experience of Taiwan thus can provide an illustration of how HIT can be used to support universal healthcare delivery. In this article we present an overview of some key historical developments and successes in the adoption of HIT in Taiwan over a 17-year period, as well as some more recent developments. We use this experience to offer some strategic perspectives on how it can aid in the adoption of large-scale HIT systems and on how HIT can be used to support universal healthcare delivery.

Application of Wavelet Analysis on Variability, Teleconnectivity, and Predictability November-January Taiwan rainfall

NASA Astrophysics Data System (ADS)

T.; Gan, Y.

2009-04-01

First the wavelet analysis was used to analyze the variability of winter (November-January) rainfall (1974-2006) of Taiwan and seasonal sea surface temperature (SST) in selected domains of the Pacific Ocean. From the scale average wavelet power (SAWP) computed for the seasonal rainfall and seasonal SST, it seems that these data exhibit interannual oscillations at 2-4-year period. Correlations between rainfall and SST SAWP were further estimated. Next the SST in selected sectors of the western Pacific Ocean (around 5°N-30°N, 120°E-150°E) was used as predictors to predict the winter rainfall of Taiwan at one season lead time using an Artificial Neural Network calibrated by Genetic Algorithm (ANN-GA). The ANN-GA was first calibrated using the 1974-1998 data and independently validated using 1999-2005 data. In terms of summary statistics such as the correlation coefficient, root-mean-square errors (RMSE), and Hansen-Kuipers (HK) scores, the seasonal prediction for northern and western Taiwan are generally good for both calibration and validation stages, but not so in some stations located in southeast Taiwan and Central Mountain.

Toward a collaborative model of pandemic preparedness and response: Taiwan's changing approach to pandemics.

PubMed

Schwartz, Jonathan; Yen, Muh-Yong

2017-04-01

Over time, as newly emerging infectious diseases have become increasingly common and more easily spread, it has become clear that traditional response mechanisms have proven inadequate to the task of prevention and control. To explore whether enhanced cooperation with local government and community institutions can effectively supplement traditional state-centric public health epidemic responses. Drawing on Taiwan as a case study, we assess the role of the whole-of-society approach to epidemic response as arises from the collaborative governance literature. The approach calls for enhanced cooperation, trust building, resource sharing and consensus-oriented decision making among multiple levels of government, business, non-profits, and the public in general. The Taiwan case illustrates the benefits of the whole-of-society approach. Enhanced cooperation between state, local government and non-state institutions, particularly neighborhood committees, has resulted in a strengthened, holistic epidemic preparedness and response infrastructure. The Taiwan case provides evidence that by implementing the whole-of-society approach to pandemic preparedness and response governments can enhance their ability to manage future outbreaks. We recommend that governments beyond Taiwan's borders seriously consider adopting this approach. Copyright © 2016. Published by Elsevier B.V.

Health Expenditure Growth under Single-Payer Systems: Comparing South Korea and Taiwan.

PubMed

Cheng, Shou-Hsia; Jin, Hyun-Hyo; Yang, Bong-Min; Blank, Robert H

2018-05-03

Achieving universal health coverage has been an important goal for many countries worldwide. However, the rapid growth of health expenditures has challenged all nations, both those with and without such universal coverage. Single-payer systems are considered more efficient for administrative affairs and may be more effective for containing costs than multipayer systems. However, South Korea, which has a typical single-payer scheme, has almost the highest growth rate in health expenditures among industrialized countries. The aim of the present study is to explicate this situation by comparing South Korea with Taiwan. This study analyzed statistical reports published by government departments in South Korea and Taiwan from 2001 to 2015, including population and economic statistics, health statistics, health expenditures, and social health insurance reports. Between 2001 and 2015, the per capita national health expenditure (NHE) in South Korea grew 292%, whereas the corresponding growth of per capita NHE in Taiwan was only 83%. We find that the national health insurance (NHI) global budget cap in Taiwan may have restricted the growth of health expenditures. Less comprehensive benefit coverage for essential diagnosis/treatment services under the South Korean NHI program may have contributed to the growth of out-of-pocket payments. The expansion of insurance coverage for vulnerable individuals may also contribute to higher growth in NHE in South Korea. Explicit regulation of health care resource distribution may also lead to more limited provisioning and utilization of health services in Taiwan. Under analogous single-payer systems, South Korea had a much higher growth in health spending than Taiwan. The annual budget cap for total reimbursement, more comprehensive coverage for essential diagnosis and treatment services, and the regulation of health care resource distribution are important factors associated with the growth of health expenditures. Copyright © 2018. Published by Elsevier Inc.

Revealing Pesticide Residues Under High Pesticide Stress in Taiwan's Agricultural Environment Probed by Fresh Honey Bee (Hymenoptera: Apidae) Pollen.

PubMed

Nai, Yu-Shin; Chen, Tsui-Yao; Chen, Yi-Cheng; Chen, Chun-Ting; Chen, Bor-Yann; Chen, Yue-Wen

2017-10-01

Significant pesticide residues are among the most serious problems for sustainable agriculture. In the beekeeping environment, pesticides not only impact a honey bee's survival, but they also contaminate bee products. Taiwan's agricultural environment has suffered from pesticide stress that was higher than that found in Europe and America. This study deciphered problems of pesticide residues in fresh honey bee pollen samples collected from 14 monitoring apiaries in Taiwan, which reflected significant contaminations within the honey bee population. In total, 155 pollen samples were screened for 232 pesticides, and 56 pesticides were detected. Among the residues, fluvalinate and chlorpyrifos showed the highest concentrations, followed by carbendazim, carbaryl, chlorfenapyr, imidacloprid, ethion, and flufenoxuron. The average frequency of pesticide residues detected in pollen samples was ca. 74.8%. The amounts and types of pesticides were higher in winter and in southwestern Taiwan. Moreover, five of these pollen samples were contaminated with 11-15 pesticides, with average levels between 1,560 and 6,390 μg/kg. Compared with the literature, this study emphasized that pollen gathered by honey bee was highly contaminated with more pesticides in Taiwan than in the America, France, and Spain. The ubiquity of pesticides in the pollen samples was likely due to the field applications of common pesticides. Recently, the Taiwanese government began to improve the pesticide policy. According to the resurvey data in 2016, there were reductions in several pesticide contamination parameters in pollen samples from west to southwest Taiwan. A long-term investigation of pollen pesticide residues should be conducted to inspect pesticides usage in Taiwan's agriculture. © The Author 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Long-term Effects of Hepatitis B Immunization of Infants in Preventing Liver Cancer.

PubMed

Chang, Mei-Hwei; You, San-Lin; Chen, Chien-Jen; Liu, Chun-Jen; Lai, Ming-Wei; Wu, Tzee-Chung; Wu, Shu-Fen; Lee, Chuan-Mo; Yang, Sheng-Shun; Chu, Heng-Cheng; Wang, Tsang-Eng; Chen, Bor-Wen; Chuang, Wan-Long; Soon, Maw-Soan; Lin, Ching-Yih; Chiou, Shu-Ti; Kuo, Hsu-Sung; Chen, Ding-Shinn

2016-09-01

The incidence of hepatocellular carcinoma (HCC) increases with age, but protective antibody responses decrease with time after infants are immunized against hepatitis B virus (HBV). We investigated whether immunization of infants against HBV prevents their developing HCC as adults. We also searched for strategies to maximize the cancer-preventive effects. We collected data from 2 Taiwan HCC registry systems on 1509 patients (6-26 years old) diagnosed with HCC from 1983 through 2011. Data on history of HBV immunization and prenatal maternal levels of HBV antigens of all HCC patients born after July 1984 were retrieved from the HBV immunization data bank of the Taiwan Center for Disease Control. We collected data on birth cohort-specific populations (6-26 years old) of Taiwan using the National Household Registry System. Rates of HCC incidence per 10(5) person-years were derived by dividing the number of patients with HCC by the person-years of the general population. Relative risks (RR) for HCC were estimated by Poisson regression analysis in vaccinated vs unvaccinated birth cohorts. We stratified patients by age group to evaluate the association of birth cohorts and HCC risks. Of the 1509 patients with HCC, 1343 were born before, and 166 were born after, the HBV vaccination program began. HCC incidence per 10(5) person-years was 0.92 in the unvaccinated cohort and 0.23 in the vaccinated birth cohorts. The RRs for HCC in patients 6-9 years old, 10-14 years old, 15-19 years old, and 20-26 years old who were vaccinated vs unvaccinated were 0.26 (95% confidence interval [CI], 0.17-0.40), 0.34 (95% CI, 0.25-0.48), 0.37 (95% CI, 0.25-0.51), and 0.42 (95% CI, 0.32-0.56), respectively. The RR for HCC in 6- to 26-year-olds was lower in the later vs the earlier cohorts (born in 1992-2005 vs 1986-1992; P < .001 and 1986-1992 vs 1984-1986; P < .002). Transmission of HBV from highly infectious mothers and incomplete immunization were associated with development of HCC. Based on an analysis of 1509 patients with HCC in Taiwan, immunization of infants against HBV reduces their risk of developing HCC as children and young adults. Improving HBV vaccination strategies and overcoming risk factors could reduce the incidence of liver cancer. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Is it meaningful to distinguish between generalized and specific Internet addiction? Evidence from a cross-cultural study from Germany, Sweden, Taiwan and China.

PubMed

Montag, Christian; Bey, Katharina; Sha, Peng; Li, Mei; Chen, Ya-Fei; Liu, Wei-Yin; Zhu, Yi-Kang; Li, Chun-Bo; Markett, Sebastian; Keiper, Julia; Reuter, Martin

2015-03-01

It has been hypothesized that two distinctive forms of Internet addiction exist. Here, generalized Internet addiction refers to the problematic use of the Internet covering a broad range of Internet-related activities. In contrast, specific forms of Internet addiction target the problematic use of distinct online activities such as excessive online video gaming or activities in social networks. The present study investigates the relationship between generalized and specific Internet addiction in a cross-cultural study encompassing data from China, Taiwan, Sweden and Germany in n = 636 participants. In this study, we assessed - besides generalized Internet addiction - addictive behavior in the domains of online video gaming, online shopping, online social networks and online pornography. The results confirm the existence of distinct forms of specific Internet addiction. One exception, however, was established in five of the six samples under investigation: online social network addiction correlates in large amounts with generalized Internet addiction. In general, it is of importance to distinguish between generalized and specific Internet addiction. Copyright © 2014 Wiley Publishing Asia Pty Ltd.

The characteristics of patient safety culture in Japan, Taiwan and the United States.

PubMed

Fujita, Shigeru; Seto, Kanako; Ito, Shinya; Wu, Yinghui; Huang, Chiu-Chin; Hasegawa, Tomonori

2013-01-14

Quality and safety issues are receiving growing attention. Patient safety culture (PSC) plays an important role in patient safety. The characteristics of PSC in various countries, each with a different set of values, have not been determined sufficiently. The aim of this study is to investigate the characteristics of PSC in Japan, Taiwan and the U.S. A cross-sectional survey was conducted in Japan and Taiwan using the Hospital Survey on PSC (HSOPS) questionnaire developed by the U.S. Agency for Healthcare Research and Quality (AHRQ). Data from Japan and Taiwan were also compared with the U.S. "2010 HSOPS Comparative Database" provided by AHRQ. Valid response rates in Japan, Taiwan and the U.S. were 66.5% (6,963/10,466), 85.7% (10,019/11,692) and 35.2% (291,341/827,424), respectively. The proportion of respondents with some experience of event reporting during the past 12 months was highest in Japan. In general, U.S. healthcare workers were likely to evaluate their PSC higher than that in Japan or Taiwan. The attitude of continuous improvement in Japan and event reporting of near misses in Taiwan were rated as low. In the U.S., staffing was rated as high. The results suggest that PSC varies among different countries, and the cultural setting of each country should be given special consideration in the development of effective intervention plans to improve PSC. Additional investigations with improved methodology and a common protocol are required to accurately compare PSCs among countries.

Influence of Asian dust storms on air quality in Taiwan.

PubMed

Liu, Chung-Ming; Young, Chea-Yuan; Lee, Yen-Chih

2006-09-15

In each year, dust storms triggered by cold air masses passing through northern China and Mongolia enhance the PM10 concentration over Taiwan region during winter and spring. On average, there are four to five dust events and 6.1 dust days in a year in Taiwan. Each event lasts for 1 day or even longer. A procedure to identify a dust event is rationalized and exercised on data collected during 1994-2005. Also, a ranking method named as the dust intensity rank (DIR) is developed to distinguish the intensity of each event affecting the local air quality. About 86% of dust days belong to ranks 1 and 2. In general, poorer air quality is associated with higher ranks. Ranks 4 and 5 correspond to a PSI (Pollution Standard Index) larger than 100. Linking DIR with the popular PSI is useful for both the public and the official forecasting system. It is also useful for inter-comparison between dust influences on air quality at different downstream regions in Taiwan. Composite analyses of the temporal and spatial variation of the hourly PM10 level indicate that dust particles usually arrive 12 h before the time of the peak PM10 concentration and last for 36 h at northern Taiwan, while the time of the peak concentration at eastern or western Taiwan, due to the evolution of the synoptic weather system, is about 3-12 h later. It is noted that the increase of PM10 level at the western side of Taiwan results from a mixture of upstream Asian dust inputs and local pollutants.

Genetic relatedness of indigenous ethnic groups in northern Borneo to neighboring populations from Southeast Asia, as inferred from genome-wide SNP data.

PubMed

Yew, Chee Wei; Hoque, Mohd Zahirul; Pugh-Kitingan, Jacqueline; Minsong, Alexander; Voo, Christopher Lok Yung; Ransangan, Julian; Lau, Sophia Tiek Ying; Wang, Xu; Saw, Woei Yuh; Ong, Rick Twee-Hee; Teo, Yik-Ying; Xu, Shuhua; Hoh, Boon-Peng; Phipps, Maude E; Kumar, S Vijay

2018-07-01

The region of northern Borneo is home to the current state of Sabah, Malaysia. It is located closest to the southern Philippine islands and may have served as a viaduct for ancient human migration onto or off of Borneo Island. In this study, five indigenous ethnic groups from Sabah were subjected to genome-wide SNP genotyping. These individuals represent the "North Borneo"-speaking group of the great Austronesian family. They have traditionally resided in the inland region of Sabah. The dataset was merged with public datasets, and the genetic relatedness of these groups to neighboring populations from the islands of Southeast Asia, mainland Southeast Asia and southern China was inferred. Genetic structure analysis revealed that these groups formed a genetic cluster that was independent of the clusters of neighboring populations. Additionally, these groups exhibited near-absolute proportions of a genetic component that is also common among Austronesians from Taiwan and the Philippines. They showed no genetic admixture with Austro-Melanesian populations. Furthermore, phylogenetic analysis showed that they are closely related to non-Austro-Melansian Filipinos as well as to Taiwan natives but are distantly related to populations from mainland Southeast Asia. Relatively lower heterozygosity and higher pairwise genetic differentiation index (F ST ) values than those of nearby populations indicate that these groups might have experienced genetic drift in the past, resulting in their differentiation from other Austronesians. Subsequent formal testing suggested that these populations have received no gene flow from neighboring populations. Taken together, these results imply that the indigenous ethnic groups of northern Borneo shared a common ancestor with Taiwan natives and non-Austro-Melanesian Filipinos and then isolated themselves on the inland of Sabah. This isolation presumably led to no admixture with other populations, and these individuals therefore underwent strong genetic differentiation. This report contributes to addressing the paucity of genetic data on representatives from this strategic region of ancient human migration event(s). © 2018 John Wiley & Sons Ltd/University College London.

Study of the Relevance of the Quality of Care, Operating Efficiency and Inefficient Quality Competition of Senior Care Facilities.

PubMed

Lin, Jwu-Rong; Chen, Ching-Yu; Peng, Tso-Kwei

2017-09-11

The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care facilities, followed by an iterative seemingly unrelated regression to evaluate the relation between the quality of care and operating efficiency. In the empirical studies, Taiwan census data was utilized and findings include the following: Despite the greater operating scale of the general type of senior care facilities, their average metafrontier technical efficiency is inferior to that of nursing homes. We adopted senior care facility accreditation results from Taiwan as a variable to represent the quality of care and examined the relation of accreditation results and operating efficiency. We found that the quality of care of general senior care facilities is negatively related to operating efficiency; however, for nursing homes, the relationship is not significant. Our findings show that facilities invest more in input resources to obtain better ratings in the accreditation report. Operating efficiency, however, does not improve. Quality competition in the industry in Taiwan is inefficient, especially for general senior care facilities.

Study of the Relevance of the Quality of Care, Operating Efficiency and Inefficient Quality Competition of Senior Care Facilities

PubMed Central

Lin, Jwu-Rong; Chen, Ching-Yu; Peng, Tso-Kwei

2017-01-01

The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care facilities, followed by an iterative seemingly unrelated regression to evaluate the relation between the quality of care and operating efficiency. In the empirical studies, Taiwan census data was utilized and findings include the following: Despite the greater operating scale of the general type of senior care facilities, their average metafrontier technical efficiency is inferior to that of nursing homes. We adopted senior care facility accreditation results from Taiwan as a variable to represent the quality of care and examined the relation of accreditation results and operating efficiency. We found that the quality of care of general senior care facilities is negatively related to operating efficiency; however, for nursing homes, the relationship is not significant. Our findings show that facilities invest more in input resources to obtain better ratings in the accreditation report. Operating efficiency, however, does not improve. Quality competition in the industry in Taiwan is inefficient, especially for general senior care facilities. PMID:28892019

Injury-Proneness of Youth with Attention-Deficit Hyperactivity Disorder: A National Clinical Data Analysis in Taiwan

ERIC Educational Resources Information Center

Tai, Yueh-Ming; Gau, Susan Shur-Fen; Gau, Churn-Shiouh

2013-01-01

Limited literature documents injury-proneness of attention-deficit hyperactivity disorder in western population. However, only a few studies prospectively investigated the prediction of ADHD to injuries without considering other psychiatric and physical conditions and there is lack of such data in Asian population. To prospectively examine the…

Economic Conditions May Contribute to Increased Violence toward Children: A Nationwide Population-Based Analysis of Pediatric Injuries in Taiwanese Emergency Departments.

PubMed

Liu, Yueh-Ping; Hsu, Ren-Jun; Wu, Mei-Hwan; Peng, Chun-Chih; Chang, Shu-Ting; Lei, Wei-Te; Yeh, Tzu-Lin; Liu, Jui-Ming; Lin, Chien-Yu

2018-01-23

Childhood injuries are unfortunately common. Analysis procedures may assist professionals who work with children with developing preventive measures for protecting children's wellness. This study explores the causes of pediatric injuries presenting to an emergency department in Taiwan. This nationwide, population-based study was conducted using data from the National Health Insurance Research Database of Taiwan (NHIRD). Patients aged <18 years were identified from approximately one million individuals listed in the NHIRD. We followed up with these patients for nine years and analyzed the causes of injuries requiring presentation to an emergency department. Variables of interest were age, sex, injury mechanisms, and temporal trends. A total of 274,028 children were identified in our study. Between 2001 and 2009, the leading causes of pediatric injuries treated in emergency departments were motor vehicle injuries, falls, and homicide. The overall incidence of injuries declined over the course of the study because of reductions in motor vehicle accidents and falls. The incidence of homicide increased during the study period, particularly between 2007 and 2009. A moderately inverse correlation between homicide rate and economic growth was observed (correlation coefficient: -0.613, p = 0.041). There was a general decline in pediatric injuries between 2001 and 2009. Public policy changes, including motorcycle helmet laws and increases in alcohol taxes, may have contributed to this decline. Unfortunately, the incidence of homicide increased over the course of the study. Ongoing financial crises may have contributed to this increase. Multidisciplinary efforts are required to reduce homicide and reinforce the importance of measures that protect children against violence.

Neuraxial anesthesia improves long-term survival after total joint replacement: a retrospective nationwide population-based study in Taiwan.

PubMed

Chen, Wei-Hung; Hung, Kuo-Chuan; Tan, Ping-Heng; Shi, Hon-Yi

2015-04-01

This study explored the effects of general (GA) and neuraxial (NA) anesthesia on the outcomes of primary total joint replacement (TJR) in terms of postoperative mortality, length of stay (LOS), and hospital treatment costs. From 1997 to 2010, this nationwide population-based study retrospectively evaluated 7,977 patients in Taiwan who underwent primary total hip or knee replacement. We generated two propensity-score-matched subgroups, each containing an equal number of patients who underwent TJR with either GA or NA. Of the 7,977 patients, 2,990 (37.5%) underwent GA and 4,987 (62.5%) underwent NA. Propensity-score matching was used to create comparable GA and NA groups adjusted for age, sex, comorbidities, surgery type, hospital volume, and surgeon volume. Survival over the first three years following surgery was similar. The proportion of patients alive up to 14 years postoperatively for those undergoing NA was 58.2% (95% confidence interval [CI] 50.4 to 66.0), and for those undergoing GA it was 57.3% (95% CI 51.4 to 63.2). Neuraxial anesthesia was associated with lower median [interquartile range; IQR] hospital treatment cost ($4,079 [3,805-4,444] vs $4,113 [3,812-4,568]; P < 0.001) and shorter median [IQR] LOS (8 [7-10] days vs 8 [6-10] days, respectively; P = 0.024). Our results support the use of NA for primary TJR. The improvements in hospital costs persist even when anesthesia costs are removed. The mechanism underlying the association between NA and long-term survival is unknown.

Urban air pollution and meteorological factors affect emergency department visits of elderly patients with chronic obstructive pulmonary disease in Taiwan.

PubMed

Ding, Pei-Hsiou; Wang, Gen-Shuh; Guo, Yue-Leon; Chang, Shuenn-Chin; Wan, Gwo-Hwa

2017-05-01

Both air pollution and meteorological factors in metropolitan areas increased emergency department (ED) visits from people with chronic obstructive pulmonary disease (COPD). Few studies investigated the associations between air pollution, meteorological factors, and COPD-related health disorders in Asian countries. This study aimed to investigate the relationship between the environmental factors and COPD-associated ED visits of susceptible elderly population in the largest Taiwanese metropolitan area (Taipei area, including Taipei city and New Taipei city) between 2000 and 2013. Data of air pollutant concentrations (PM 10 , PM 2.5 , O 3 , SO 2 , NO 2 and CO), meteorological factors (daily temperature, relative humidity and air pressure), and daily COPD-associated ED visits were collected from Taiwan Environmental Protection Administration air monitoring stations, Central Weather Bureau stations, and the Taiwan National Health Insurance database in Taipei area. We used a case-crossover study design and conditional logistic regression models with odds ratios (ORs), and 95% confidence intervals (CIs) for evaluating the associations between the environmental factors and COPD-associated ED visits. Analyses showed that PM 2.5 , O 3 , and SO 2 had significantly greater lag effects (the lag was 4 days for PM 2.5 , and 5 days for O 3 and SO 2 ) on COPD-associated ED visits of the elderly population (65-79 years old). In warmer days, a significantly greater effect on elderly COPD-associated ED visits was estimated for PM 2.5 with coexistence of O 3 . Additionally, either O 3 or SO 2 combined with other air pollutants increased the risk of elderly COPD-associated ED visits in the days of high relative humidity and air pressure difference, respectively. This study showed that joint effect of urban air pollution and meteorological factors contributed to the COPD-associated ED visits of the susceptible elderly population in the largest metropolitan area in Taiwan. Government authorities should review existing air pollution policies, and strengthen health education propaganda to ensure the health of the susceptible elderly population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cultural distance between parents' and children's creativity: A within-country approach in Taiwan.

PubMed

Chang, Jen-Ho; Su, Jenny C; Chen, Hsueh-Chih

2015-07-01

The present study adopted a within-country approach to investigate the relation of cultural distance to general creativity and math creativity in Taiwan. First, we conducted a pilot study of 201 young adolescents with parents from one of the 3 largest subethnic groups in Taiwan, namely Min-nan Taiwanese, Ha-kka Taiwanese, and Outside-Province Taiwanese. The results revealed that young Taiwanese adolescents perceived the cultural distance between Min-nan Taiwanese and Outside-Province Taiwanese as larger than the cultural distance between the other subethnic groups. The main study revealed that 610 young adolescents from large cultural distance families (i.e., those comprising 1 Min-nan Taiwanese parent and 1 Outside-Province Taiwanese parent) outperformed those from small cultural distance families (i.e., those comprising 2 Min-nan Taiwanese parents, and those comprising 1 Min-nan Taiwanese parent and 1 Ha-kka Taiwanese parent) on both general creativity and math creativity. This pattern remained even after controlling for family socioeconomic status, parents' education level, and adolescents' school mathematical performance. Implications and limitations are discussed. (c) 2015 APA, all rights reserved).

Progress and Prospect of Physics Research and Education in Taiwan

NASA Astrophysics Data System (ADS)

Raynien Kwo, J.

2010-03-01

Started about two decades ago, the global trend of shifting industrial manufacture power from western developed countries toward developing countries in Asia has in turn become the impetus in building up physical science and research in these areas. A very good example is the remarkable progress of physical research and education in Taiwan, in terms of quantity and quality. The continuous elevation of Taiwan's high education into graduate level plus the government's strong commitment to research and development on a level of 2.62 % GDP have led to an impressive physics program with an annual budget ˜32 million USD from National Science Council in supporting 568 PIs. The investigation scope encompasses high energy and astrophysics, nano and condensed matter, and semiconductor, optoelectronic physics, etc. The former is vigorously conducted via international collaborative efforts of LHC, KEK, ALMA, Pan-STARRS, etc. The latter is driven by vital Taiwan high tech industry mostly semiconductor IC and optoelectronics flourished during this period. The early trend of outflows of BS physics majors to western world for advanced studies has reversed dramatically. Nearly 80% of the BS students continue their MS and PhD degrees in Taiwan, attracted by lucrative job markets of high tech industry. In addition, healthy inflow of high-quality science manpower of well trained PhDs and senior scholars returning to homeland has strengthened the competitiveness. Overall, the physics community in Taiwan is thriving. The annual Physical Society meeting is expanding at a rate of 6%, reaching ˜1800 attendants and 1200 papers, and dedicated to promotions of female physicists and students. The publication quantity of Taiwan in top journals of PRs and PRL is ranked among top 20^th for all fields of physics, and ranked the 6^th in APL. Clearly Taiwan has now emerged as a strong power in applied science, not limited by its population size. Concerted efforts on scientific exchanges are being taken to connect to international societies. The bright outlook of physical science and its vital power in Taiwan is anticipated to provide a stimulus to benefit South East Asia, and have far-reaching impacts on China and worldwide.

Renal diagnosis of chronic hemodialysis patients with urinary tract transitional cell carcinoma in Taiwan.

PubMed

Chang, Chung-Hsin; Yang, Cheng-Ming; Yang, An-Hang

2007-04-15

Transitional cell carcinoma (TCC) is the most common malignancy in dialysis patients of Taiwan. The reason for such a high incidence of TCC is undetermined. The correlation between the underlying renal disease and the development of TCC was investigated. The authors retrospectively reviewed the clinical data and outcome of 1537 chronic hemodialysis (HD) patients from 1993 to 2002. The incidence of TCC was computed. The Cox regression method was used to analyze the role of potential risk factors. After a mean dialysis duration of 46.5 months, 26 (1.69%) patients with TCC were diagnosed. The standardized incidence ratio (SIR) of TCC was 48.2 as compared with the general population and the SIR of TCC seemed higher in women (65.1) and in the age group 50 to 54 years (173.6). Of them, most cases showed no definite etiology. All these cases showed bilateral contracted kidneys. Nonnephrotic proteinuria was found in all cases and trace glucosuria was found in 17 (65%). Painless gross hematuria was the cardinal symptom and distant metastasis was rare. Also, TCC in upper urinary tracts were common and found in 14 (54%) of patients. Age at the time of dialysis, female sex, compound analgesic use, and Chinese herb use had statistical significance as risk factors (P < .05). Chronic HD patients have a high risk of TCC in Taiwan, especially in female and middle-aged patients. The study indicated that chronic tubulointerstitial nephritis (CTIN) is the most likely underlying renal disease in HD patients with TCC, a high percentage of the CTIN related to the usage of Chinese herbs or compound analgesics may contribute to the development of TCC, whereas diabetes or chronic glomerulonephritis play only a minor role.

Increased risks of upper tract urothelial carcinoma in male and female chinese herbalists.

PubMed

Yang, Hsiao-Yu; Wang, Jung-Der; Lo, Tsai-Chang; Chen, Pau-Chung

2011-03-01

It has been shown that herbs that contain aristolochic acid induce urological cancer. Chinese herbalists have easy access to such herbs. Our previous mortality study has shown a significantly increased risk of urological cancer in female but not male herbalists. To re-examine this risk in male herbalists, the incidence of urological cancer was analyzed. We enrolled all 6550 Chinese herbalists in Taiwan registered during 1985-2000, and we retrospectively followed the development of cancer until 2001 by analysis of data collected from the Taiwan Cancer Registry. Standardized incidence ratios (SIRs) were calculated for urological cancers in herbalists and compared with those for the general population in Taiwan. There were 30 newly diagnosed cases of urological cancer and most of them were transitional cell carcinoma (93.1%). The mean age at diagnosis for urothelial carcinoma was 51.6 years, and 51.9% were in the upper urinary tract. After adjustment for age and sex, the SIR for all urological cancers was 3.51 [(95% confidence interval (CI): 2.37-5.01]. When stratified by location, the SIRs for kidney and upper urinary tract cancers and bladder cancer were 4.24 (95% CI: 2.47-6.80) and 2.86 (95% CI: 1.52-4.89), respectively. When analyzed by sex, the SIRs for all urological cancers, kidney and upper urinary tract cancers, and bladder cancer were also significantly increased in male herbalists. The significant risk of urothelial carcinoma noted in male herbalists increases our suspicion that this is an occupational disease that renders regular health assessment of herbalists an urgent necessity. Copyright © 2011 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.

Incidence and survival of adult cancer patients in Taiwan, 2002-2012.

PubMed

Chiang, Chun-Ju; Lo, Wei-Cheng; Yang, Ya-Wen; You, San-Lin; Chen, Chien-Jen; Lai, Mei-Shu

2016-12-01

Little is known about the annual changes in cancer incidence and survival that occurred after the establishment of the long-form cancer registry database in Taiwan. Therefore, this study aimed to investigate the updated incidence and stage-specific relative survival rates (RSRs) among adult cancer patients in Taiwan. Cancer incidence data from 2002 to 2012 were collected using the Taiwan Cancer Registry Database. Age-standardized incidence rates, average annual percent changes (AAPCs), and sex ratios were calculated for adults. Five-year stage-specific RSRs were estimated for cases diagnosed between 2004 and 2008 and were followed up to 2013 for major cancers. The overall age-standardized incidence rates per 100,000 populations increased from 348.39 in 2002 to 401.18 in 2012, and the AAPC was 1.7% (p < 0.05), whereas the male:female ratio was approximately 1:3 during the entire period. Most cancer sites showed a trend of increasing incidence, with the exception of common cancers such as cervix uteri (AAPC = -6.2%, p < 0.05), bladder (AAPC = -2.5%, p < 0.05), stomach (AAPC = -2.4%, p < 0.05), nasopharynx (AAPC = -1.2%, p < 0.05), and liver (AAPC = -1.1%, p < 0.05). The 5-year RSRs for Stage I cancers were greater than 93% for the colon and rectum, female breast, and cervix uteri, whereas RSRs for patients with Stage IV cancers ranged from 2.9% to 38.9%, with patients with liver cancer and those with oral cancer showing the lowest and highest RSRs, respectively. Our study showed increased incidence in most cancers and provided baseline estimates of stage-specific RSRs among the Taiwanese adult population. Continuous surveillance may help politicians to improve health policies and cancer care in Taiwan. Copyright © 2016. Published by Elsevier B.V.

Taiwan Y-chromosomal DNA variation and its relationship with Island Southeast Asia

PubMed Central

2014-01-01

Background Much of the data resolution of the haploid non-recombining Y chromosome (NRY) haplogroup O in East Asia are still rudimentary and could be an explanatory factor for current debates on the settlement history of Island Southeast Asia (ISEA). Here, 81 slowly evolving markers (mostly SNPs) and 17 Y-chromosomal short tandem repeats were used to achieve higher level molecular resolution. Our aim is to investigate if the distribution of NRY DNA variation in Taiwan and ISEA is consistent with a single pre-Neolithic expansion scenario from Southeast China to all ISEA, or if it better fits an expansion model from Taiwan (the OOT model), or whether a more complex history of settlement and dispersals throughout ISEA should be envisioned. Results We examined DNA samples from 1658 individuals from Vietnam, Thailand, Fujian, Taiwan (Han, plain tribes and 14 indigenous groups), the Philippines and Indonesia. While haplogroups O1a*-M119, O1a1*-P203, O1a2-M50 and O3a2-P201 follow a decreasing cline from Taiwan towards Western Indonesia, O2a1-M95/M88, O3a*-M324, O3a1c-IMS-JST002611 and O3a2c1a-M133 decline northward from Western Indonesia towards Taiwan. Compared to the Taiwan plain tribe minority groups the Taiwanese Austronesian speaking groups show little genetic paternal contribution from Han. They are also characterized by low Y-chromosome diversity, thus testifying for fast drift in these populations. However, in contrast to data provided from other regions of the genome, Y-chromosome gene diversity in Taiwan mountain tribes significantly increases from North to South. Conclusion The geographic distribution and the diversity accumulated in the O1a*-M119, O1a1*-P203, O1a2-M50 and O3a2-P201 haplogroups on one hand, and in the O2a1-M95/M88, O3a*-M324, O3a1c-IMS-JST002611 and O3a2c1a-M133 haplogroups on the other, support a pincer model of dispersals and gene flow from the mainland to the islands which likely started during the late upper Paleolithic, 18,000 to 15,000 years ago. The branches of the pincer contributed separately to the paternal gene pool of the Philippines and conjointly to the gene pools of Madagascar and the Solomon Islands. The North to South increase in diversity found for Taiwanese Austronesian speaking groups contrasts with observations based on mitochondrial DNA, thus hinting to a differentiated demographic history of men and women in these populations. PMID:24965575

Assessing health information technology in a national health care system--an example from Taiwan.

PubMed

Chi, Chunhuei; Lee, Jwo-Leun; Schoon, Rebecca

2012-01-01

The purpose of this article is to investigate one core research question: How can health information technology (HIT) be assessed in a national health care system context? We examine this question by taking a systematic approach within a national care system, in which the purpose of HIT is to contribute to a common national health care system's goal. to promote population health in an efficient way. Based on this approach we first develop a framework and our criteria of assessment, and then using Taiwan as a case study, demonstrate how one can apply this framework to assess a national system's HIT. The five criteria we developed are how well does the HIT (1) provide accessible and accurate public health and health care information to the population; (2) collect and provide population health and health care data for government and researchers to analyze population health and processes and outcomes of health care services, (3) provide accessible and timely information that helps to improve provision of cost-effective health care at an institutional level and promotes system-wide efficiency; (4) minimize transaction and administrative costs of the health care system; and (5) establish channels for population participation in governance while also protecting individual privacy. The results indicate that Taiwan has high levels of achievement in two criteria while falling short in the other three. Major lessons we learned from this study are that HIT exists to serve a health care system, and the national health care system context dictates how one assesses its HIT. There is a large body of literature published on the implementation of HIT and its impact on the quality and cost of health care delivery. The vast majority of the literature, however, is focused on a micro institutional level such as a hospital or a bit higher up, on an HMO or health insurance firm. Few have gone further to evaluate the implementation of HIT and its impact on a national health care system. The lack of such research motivated this study. The major contributions of this study are (i) to develop a framework that follows systems thinking principles and (ii) propose a process through which a nation can identify its objectives for HIT and systematically assess its national HIT system. Using Taiwan's national health care system as a case study, this paper demonstrated how it can be done.

Taiwan-U.S. Relations: Recent Developments and Their Policy Implications

DTIC Science & Technology

2009-01-07

August) and the Paralympic Games (September). For instance, while appearing more conciliatory in a reported letter to U.N. Secretary-General Ban Ki...about the name that the PRC would use to refer to Taiwan during the 2008 Olympic Games .24 Taiwan’s Ministry of National Defense also has said that...17, 2008. 24 Reportedly official PRC sources had been using “Zhongguo Taipei”—or “Taipei, China,” leading up to the Olympic Games . A 1989 agreement

Governmental disability welfare expenditure and national economic growth from 1991 to 2006 in Taiwan.

PubMed

Lin, Jin-Ding; Lin, Lan-Ping

2009-01-01

The purposes of the present study were to describe the welfare expenditure for people with disabilities and examine its relation to national economic growth from 1991 to 2006 in Taiwan. We analyzed data mainly from the information of population with disabilities, disability welfare expenditure and national economic growth and gross national product (GNP) per capita in Taiwan from 1991 to 2006. The percentage and overtime trend were used to examine the change in disability welfare expenditure, national economic growth and GNP per capita. Taiwan's economy continued its steady expansion on record an annual average growth of 5.4% and GNP per capita of 5.7% for the year 1991-2006. At the same period of time, the registered population with disabilities increased nearly five times (204,158 persons in 1991 to 981,015 persons in 2006), the government disability welfare expenditure was dramatically increasing to over 10 times from 1991 to 2006 (US$ 74 million to US$ 784 million). Although the total disability budget increased, the beneficiary of the individual with disability increased only 2.2 times. In the content of annual welfare budget for people with disabilities, it is difficult to figure out the increase pattern of the budget growth. However, the local government plays a vital role in disability welfare services gradually, it provides more than 85% welfare budget for people with disabilities. Finally, the author emphasizes that government should examine the long term effects of welfare budget allocation shifting from central government to local government to ensure the right of people with disabilities.

Nutritional status and its health-related factors among older adults in rural and urban areas.

PubMed

Chen, Su-Hui; Cheng, Hsin-Yi; Chuang, Yeu-Hui; Shao, Jung-Hua

2015-01-01

To compare health-related characteristics, nutrition-related factors and nutritional status of older adults living in rural and urban counties of Taiwan. The older adult population of Taiwan is increasing. Furthermore, older people living in rural areas have shorter life expectancy and more chronic diseases than their urban counterparts. However, little is known about the health-related characteristics, nutrition-related factors and nutritional status of older adults living in rural and urban areas of Taiwan, limiting nurses' ability to identify and care for older adults at risk of poor nutritional health. Cross-sectional, comparative. Older adults were randomly selected from names of residents of an adjacent rural and urban area of northern Taiwan and having completing the 2009 health evaluation. From March-July 2010, older adult participants (N = 366) provided data on demographic and health-related information, nutritional self-efficacy, health locus of control and nutritional status. Data were analysed by descriptive statistics and compared using chi-square and t-test. Older rural participants had significantly lower educational level, less adequate income, higher medication use, lower scores on self-rated health status and researcher-rated health status and lower self-rated healthy eating status than their urban counterparts. Moreover, rural participants had significantly lower nutritional self-efficacy, higher chance health locus of control and poorer nutritional status than their urban counterparts. Our results suggest that nurses should assess older adults living in rural areas for nutritional health and nutrition knowledge. Based on this assessment, nurses should develop easy, practical and accessible nutritional programmes for this population. © 2014 John Wiley & Sons Ltd.

Dimensionality Analysis and Geo-Electric Structure of Long-period Magnetotelluric Data, Southern Taiwan, TAIGER project

NASA Astrophysics Data System (ADS)

Chiang, C.; Chen, C.; Bertrand, E. A.; Unsworth, M. J.; Turkoglu, E.; Hsu, H.; Hill, G.

2007-12-01

The Taiwan orogen has formed as a result of the arc-continent collision between the Eurasian continental margin and the Luzon island arc over the last 3 million years. It is the type example of an arc-continent collision. In 2004, the Taiwan Integrated Geodynamical Research (TAIGER) project was formed and began a systematic investigation of the crustal and upper mantle structure beneath Taiwan. This included new magnetotelluric (MT) data collection to study the geo-electrical structure beneath Taiwan. High quality long period MT data has been collected through collaboration between National Central University, Taiwan, and the University of Alberta, Canada. In total, 82 long-period MT stations were deployed on 4 cross- island profiles in Taiwan with a remote reference station located on Penghu Island in the Taiwan Strait. The remote reference is ~50km from the main island of Taiwan and is used to reduce cultural noise effects in these data from the populated mainland. Dimensionality analysis from tensor decomposition has been performed on these data using the McNeice-Jones algorithm. The results of this analysis indicate that the electrical structures are two-dimensional with dominant strike directions N45° E, N37° E and N29 ° E in northern, central and southern Taiwan, respectively. As expected, these strike directions are essentially parallel to the regional geology. The decomposition parameters of shear, twist and anisotropy for these profiles are small, indicating the 2-D strike directions are well constrained. The dimensionality analysis presented implies that the generation of 2- D inversion models will be appropriate for these data. The results of 2-D inversion show that the collision boundary between the Eurasian and Philippine Sea Plates is beneath the central range in the southern profile. A low resistivity zone is located beneath the western foothills. At mid-crustal depth, a boundary is imaged between conductive western sedimentary rocks and the resistive metamorphic rocks to the east which form the main orogenic belts of the central ranges. This margin occurs near the trace of the Cauchow fault where there is evidence of a conductor rising to the surface. This conductor may be related to interconnected fluids and/or thermal effects in the mid crust. In this paper, the analysis of these data will be examined in detail and the tectonic implications discussed.

Birth Trends among Female Physicians in Taiwan: A Nationwide Survey from 1996 to 2013.

PubMed

Wang, Yi-Jen; Chiang, Shu-Chiung; Chen, Tzeng-Ji; Chou, Li-Fang; Hwang, Shinn-Jang; Liu, Jui-Yao

2017-07-09

Background : Although more and more women are becoming physicians, their decisions regarding pregnancy may be affected by the lengthy period of medical education and postgraduate training. The aim of this study was to explore the birth trends among female physicians in Taiwan; Methods: Retrospective analyses of maternal ages at delivery from 1996 to 2013, both for physicians and the general population, were conducted using a nationwide dataset called National Health Insurance Research Database; Results : During the study period, 8540 female physicians were identified. The physicians delivered a total of 4940 births in that time, with a rise from 210 in 1996 to 440 in 2013. In addition, the mean maternal age of the physicians at delivery increased from 32.19 years (standard deviations (SD) 2.80) in 1996 to 33.61 (SD 3.21) in 2013, values significantly higher than those for non-physicians of 27.81 (SD 4.74) in 1996 ( p < 0.001) and 31.36 (SD 4.78) in 2013 ( p < 0.001); Conclusion : Female physicians usually gave birth at an older age than non-physicians, but the discrepancy between the two groups gradually declined over the 18-year course of the study. The establishment of a maternity-friendly environment for female physicians should be considered by those who determine healthcare system policies.

The influence of social niche on cultural niche construction: modelling changes in belief about marriage form in Taiwan

PubMed Central

Lipatov, Mikhail; Brown, Melissa J.; Feldman, Marcus W.

2011-01-01

With introduction of social niche effects into a model of cultural change, the frequency of a practice cannot predict the frequency of its underlying belief. The combination of a general model with empirical data from a specific case illustrates the importance of collaboration between modellers and field researchers, and identifies the type of quantitative data necessary for analysing case studies. Demographic data from colonial-period household registers in Taiwan document a shift in marriage form within 40 years, from a mixture of uxorilocal marriages and virilocal marriages to the latter's dominance. Ethnographic data indicate marriage-related beliefs, costs, ethnic effects and colonial policies as well as the importance of horizontal cultural transmission. We present a formal model for the effects of moral beliefs about marriage and a population economic index on the decline of uxorilocal marriage. We integrate empirical marriage rates and an estimated economic index to produce five projections of the historical frequencies of one belief. These projections demonstrate how economic development may affect a cultural niche. They also indicate the need for future research on the relationship between wealth and cultural variability, the motivational force of cultural versus social factors, and the process of cultural niche construction. PMID:21320903

The influence of social niche on cultural niche construction: modelling changes in belief about marriage form in Taiwan.

PubMed

Lipatov, Mikhail; Brown, Melissa J; Feldman, Marcus W

2011-03-27

With introduction of social niche effects into a model of cultural change, the frequency of a practice cannot predict the frequency of its underlying belief. The combination of a general model with empirical data from a specific case illustrates the importance of collaboration between modellers and field researchers, and identifies the type of quantitative data necessary for analysing case studies. Demographic data from colonial-period household registers in Taiwan document a shift in marriage form within 40 years, from a mixture of uxorilocal marriages and virilocal marriages to the latter's dominance. Ethnographic data indicate marriage-related beliefs, costs, ethnic effects and colonial policies as well as the importance of horizontal cultural transmission. We present a formal model for the effects of moral beliefs about marriage and a population economic index on the decline of uxorilocal marriage. We integrate empirical marriage rates and an estimated economic index to produce five projections of the historical frequencies of one belief. These projections demonstrate how economic development may affect a cultural niche. They also indicate the need for future research on the relationship between wealth and cultural variability, the motivational force of cultural versus social factors, and the process of cultural niche construction.

A medical cost estimation with fuzzy neural network of acute hepatitis patients in emergency room.

PubMed

Kuo, R J; Cheng, W C; Lien, W C; Yang, T J

2015-10-01

Taiwan is an area where chronic hepatitis is endemic. Liver cancer is so common that it has been ranked first among cancer mortality rates since the early 1980s in Taiwan. Besides, liver cirrhosis and chronic liver diseases are the sixth or seventh in the causes of death. Therefore, as shown by the active research on hepatitis, it is not only a health threat, but also a huge medical cost for the government. The estimated total number of hepatitis B carriers in the general population aged more than 20 years old is 3,067,307. Thus, a case record review was conducted from all patients with diagnosis of acute hepatitis admitted to the Emergency Department (ED) of a well-known teaching-oriented hospital in Taipei. The cost of medical resource utilization is defined as the total medical fee. In this study, a fuzzy neural network is employed to develop the cost forecasting model. A total of 110 patients met the inclusion criteria. The computational results indicate that the FNN model can provide more accurate forecasts than the support vector regression (SVR) or artificial neural network (ANN). In addition, unlike SVR and ANN, FNN can also provide fuzzy IF-THEN rules for interpretation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Choline and betaine food sources and intakes in Taiwanese.

PubMed

Chu, Da-Ming; Wahlqvist, Mark L; Chang, Hsing-Yi; Yeh, Nai-Hua; Lee, Meei-Shyuan

2012-01-01

Choline and betaine are involved in several similar health-relevant metabolic pathways, but the foods sources are different. We have assessed their intakes (individual, sums and ratios) from a dominantly Chinese food cultural point of view. A representative free-living Taiwanese population aged 13-64 years was drawn from the Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996. Food intake was derived from interviews as 24-hour recalls. The USDA database, with adaptations for Taiwan, provided choline and betaine food compositions. Major food contributors of these nutrients were identified and compared with data from the US Framingham offspring study. Mean and variance reduced median nutrient intakes were calculated. Top ten major food contributors of choline in Taiwan were eggs, pork, chicken, fish, soybean and its products, dark leafy vegetables, dairy, fruit, wheat products and light leafy vegetables in sequence. For betaine, the top ten were dark leafy vegetables, wheat products, fish, pork, bread, chicken, cake/cookies, grain-based alcoholic beverages, rice and its products and sauces. The main contributors of choline in Taiwan and the USA were, respectively, eggs and red meat; and for betaine, greens were similarly best contributor. The rankings of the main food contributors of choline and betaine differed substantially between Taiwan and the USA. The total daily intakes (mean±SE, mg) in Taiwan for choline were 372±19 (median=348) in men and 265±9 (median 261) for women; for betaine, values were 101±3 (median 93) in men and 78±8 (median 76) for women. These allow for health outcome considerations.

Infant Cancer in Taiwan: Incidence and Trends (1995-2009)

PubMed Central

Hung, Giun-Yi; Horng, Jiun-Lin; Yen, Hsiu-Ju; Lee, Chih-Ying

2015-01-01

Background Current information about cancer incidence patterns among infants in East Asia is rare. The objective of this study was to report the first population-based cancer surveillance of infants in Taiwan. Methods Cancer frequencies and incidence rates among subjects aged <1 year for the period 1995-2009 were obtained from the Taiwan Cancer Registry. Types of cancers were grouped according to the International Classification of Childhood Cancer. Rates and trends were analyzed by sex and disease groups and further compared with that of other countries. Results A total of 900 infants were diagnosed with cancers, giving an incidence rate of 250.7 per million person-years from 1995 to 2009. The male-to-female incidence rate ratio was 1.22. Overall, leukemias (56.3 per million) were the most common cancer, followed by germ cell neoplasms (43.2) and neuroblastomas (41.8). The incidence increased by 2.5% annually during the 15-year study period and was predominantly contributed by male infants (3.5%). Compared with other countries, the rate of hepatoblastoma in Taiwan was second to that from Beijing (China) and 2 to 5 times greater compared with the US, France, the North of England and Osaka (Japan). The rates of germ cell neoplasms were 2 to 4 times greater in Taiwan. Conclusions The current data suggests that cancer incidence rate among male infants was rising in Taiwan. The factors associated with higher rates of hepatoblastoma and germ cell neoplasms warrant further investigation on similar ethnic groups of different areas to elucidate the potential environmental impacts while controlling for race. PMID:26110595

[A comparative study on Koii (public doctor) system and its effect on public health in colonial Taiwan and Korea].

PubMed

Moon, Myungki

2014-08-01

Koii(Public Doctor) System introduced into Taiwan in 1896 for the purpose of filling up medical vacuum of rural area and therefore spreading modern medical system all over Taiwan, was transplanted in 1913 into Colonial Korea for the same purpose. In terms of system itself Koii system in both areas were almost the same, but quite different in practices. First, Koiis in Taiwan was forced to write concrete medical report every month on the medical situation in the area under jurisdiction, whereas to those in Korea writing monthly report was not so compulsory. This difference resulted in some gaps in the quality of medical statistics of the two areas. Second, Unlike their counterparts in Korea, Koiis in Taiwan organized their own associations both locally and nationally and it helped to build up their own networks and share informations on medical situation including informations on infectious diseases. Third, Koiis in Taiwan formed more harmonious relationship between Taiwanese Police than their counterparts in Korea, which helped them to execute various medical activities in more comfortable environment. Taiwanese People went to medical institutions a lot more frequently than Korean People, and this difference was basically derived from the quite different density of Koii assignment in both areas. Korean People had to spend more time and money to utilize modern medical institutions than Taiwanese People did. The different density of Koii assignment also affected the results of prevention and eradication of infectious diseases; in Taiwan plague and small-pox has been successfully controled, whereas Chosun Government general was not so successful in controling infectious diseases including small-pox. Small-pox infected in Korea was about 6 times to Taiwan, and the number of death by small-pox was 9 times to Taiwan. One of the keys to this difference is the different role of Koiis. In Korea, Koiis could do little thing about infectious diseases mainly because of manpower shortage, thus shifting their duties like vaccination onto police officers who was inevitably inferior to doctors in medical terms, whereas vaccination was led by Koiis in Taiwan, with the help of police officers and traditional doctors. The difference between Korea and Taiwan in terms of Koii system and its effect implies that public health network in colonial Taiwan was better organized and more stable than that in colonial Korea, and therefore we should be careful about applying the concept of disciplinary power or modernization theory to colonial medical history of Korea.

Sex differences in relationships between metabolic syndrome components and factors associated with health-related quality of life in middle-aged adults living in the community: a cross-sectional study in Taiwan.

PubMed

Liu, Cheng-Chieh; Chang, Hsiao-Ting; Chiang, Shu-Chiung; Chen, Harn-Shen; Lin, Ming-Hwai; Chen, Tzeng-Ji; Hwang, Shinn-Jang

2018-04-27

Metabolic syndrome (MetS) is a widespread condition with important effects on public health, in general. There is a lack of relevant research on possible sex differences in the relationship between MetS and health-related quality of life (HRQoL) and also the sex differences in factors associated with HRQoL. The aims of this study were to identify: 1) whether women exhibit greater negative impacts on physical domain HRQoL from MetS compared with men; 2) whether women exhibit greater mental domain impacts compared with men; and 3) whether factors associated with HRQoL scores are different for men and women. This cross-sectional study was conducted in Taipei, Taiwan. Using random sampling, a total of 906 participants aged 35-55 years were recruited. MetS was defined according to the MetS criteria for the Taiwanese population, and HRQoL were assessed using physical component summary (PCS) and mental component summary (MCS) scores of the Short Form Health Survey (SF-36), Taiwan version. Demographics, physical activity, medical history, and blood tests as covariates were recorded and checked. The associations were assessed by multiple linear regression. After adjusting for covariates, women but not men with more components of MetS had significantly lower PCS scores (β = - 0.542, p = 0.036). The number of components of MetS was not a significant factor in MCS score differences between the sexes. Furthermore, there were sex differences regarding age, education level, physical activity, and smoking status in association with PCS scores. For MCS scores, sex differences were found in education level, marital status, and habits of smoking and alcohol consumption. There were sex differences in the relationships between metabolic syndrome components and factors associated with HRQoL among middle-aged adults living in the community in Taiwan. Further research should be conducted to investigate mechanisms of these sex differences.

Probable high prevalence of limb-girdle muscular dystrophy type 2D in Taiwan.

PubMed

Liang, Wen-Chen; Chou, Po-Ching; Hung, Chia-Cheng; Su, Yi-Ning; Kan, Tsu-Min; Chen, Wan-Zi; Hayashi, Yukiko K; Nishino, Ichizo; Jong, Yuh-Jyh

2016-03-15

Limb-girdle muscular dystrophy type 2D (LGMD2D), an autosomal-recessive inherited LGMD, is caused by the mutations in SGCA. SGCA encodes alpha-sarcoglycan (SG) that forms a heterotetramer with other SGs in the sarcolemma, and comprises part of the dystrophin-glycoprotein complex. The frequency of LGMD2D is variable among different ethnic backgrounds, and so far only a few patients have been reported in Asia. We identified five patients with a novel homozygous mutation of c.101G>T (p.Arg34Leu) in SGCA from a big aboriginal family ethnically consisting of two tribes in Taiwan. Patient 3 is the maternal uncle of patients 1 and 2. All their parents, heterozygous for c.101G>T, denied consanguineous marriages although they were from the same tribe. The heterozygous parents of patients 4 and 5 were from two different tribes, originally residing in different geographic regions in Taiwan. Haplotype analysis showed that all five patients shared the same mutation-associated haplotype, indicating the probability of a founder effect and consanguinity. The results suggest that the carrier rate of c.101G>T in SGCA may be high in Taiwan, especially in the aboriginal population regardless of the tribes. It is important to investigate the prevalence of LGMD2D in Taiwan for early diagnosis and treatment. Copyright © 2016. Published by Elsevier B.V.

Nativity Differentials in Older Age Mortality in Taiwan: Do They Exist and Why?

PubMed Central

Hermalin, Albert I.; Ofstedal, Mary Beth; Sun, Cathy; Liu, I-Wen

2011-01-01

Comparisons of migrants versus native populations have become increasingly important as a means of gaining insight into the factors affecting health and mortality levels and the relationship between them. Taiwan underwent a unique migration in 1949–50, as more than a million people, mostly young men, arrived from Mainland China following the Communist civil war victory. The Mainlanders were distinct from the original settlers in several ways: they represented different provinces in China, were better educated, and had distinct occupational profiles. Since 1950, Taiwan has experienced a rapid demographic transition and notable economic development, resulting in mortality decline. In this paper, we generate age- and cause-specific death rates circa 1990 by education and nativity to evaluate the relative importance of each factor. We also use longitudinal survey data to help interpret the differentials in terms of selection, risk factors, and other dynamics of health and mortality. PMID:21887404

Defining the ecological hydrology of Taiwan Rivers using multivariate statistical methods

NASA Astrophysics Data System (ADS)

Chang, Fi-John; Wu, Tzu-Ching; Tsai, Wen-Ping; Herricks, Edwin E.

2009-09-01

SummaryThe identification and verification of ecohydrologic flow indicators has found new support as the importance of ecological flow regimes is recognized in modern water resources management, particularly in river restoration and reservoir management. An ecohydrologic indicator system reflecting the unique characteristics of Taiwan's water resources and hydrology has been developed, the Taiwan ecohydrological indicator system (TEIS). A major challenge for the water resources community is using the TEIS to provide environmental flow rules that improve existing water resources management. This paper examines data from the extensive network of flow monitoring stations in Taiwan using TEIS statistics to define and refine environmental flow options in Taiwan. Multivariate statistical methods were used to examine TEIS statistics for 102 stations representing the geographic and land use diversity of Taiwan. The Pearson correlation coefficient showed high multicollinearity between the TEIS statistics. Watersheds were separated into upper and lower-watershed locations. An analysis of variance indicated significant differences between upstream, more natural, and downstream, more developed, locations in the same basin with hydrologic indicator redundancy in flow change and magnitude statistics. Issues of multicollinearity were examined using a Principal Component Analysis (PCA) with the first three components related to general flow and high/low flow statistics, frequency and time statistics, and quantity statistics. These principle components would explain about 85% of the total variation. A major conclusion is that managers must be aware of differences among basins, as well as differences within basins that will require careful selection of management procedures to achieve needed flow regimes.

Epidemiology of upper urinary tract stone disease in a Taiwanese population: a nationwide, population based study.

PubMed

Huang, Wei-Yi; Chen, Yu-Fen; Carter, Stacey; Chang, Hong-Chiang; Lan, Chung-Fu; Huang, Kuo-How

2013-06-01

We investigated the epidemiology of upper urinary tract stone disease in Taiwan using a nationwide, population based database. This study was based on the National Health Insurance Research Database of Taiwan, which contains data on all medical beneficiary claims from 22.72 million enrollees, accounting for almost 99% of the Taiwanese population. The Longitudinal Health Insurance Database 2005, a subset of the National Health Insurance Research Database, contains data on all medical benefit claims from 1997 through 2010 for a subset of 1 million beneficiaries randomly sampled from the 2005 enrollment file. For epidemiological analysis we selected subjects whose claims records included the diagnosis of upper urinary tract urolithiasis. The age adjusted rate of medical care visits for upper urinary tract urolithiasis decreased by 6.5% from 1,367/100,000 subjects in 1998 to 1,278/100,000 in 2010. There was a significantly decreasing trend during the 13-year period in visits from female and all subjects (r(2) = 0.86, p = 0.001 and r(2) = 0.52, p = 0.005, respectively). In contrast, an increasing trend was noted for male subjects (r(2) = 0.45, p = 0.012). The age adjusted prevalence in 2010 was 9.01%, 5.79% and 7.38% in male, female and all subjects, respectively. The overall recurrence rate at 1 and 5 years was 6.12% and 34.71%, respectively. Male subjects had a higher recurrence rate than female subjects. Our study provides important information on the epidemiology of upper urinary tract stone disease in Taiwan, helping to quantify the burden of urolithiasis and establish strategies to decrease the risk of urolithiasis. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Projection of the dental workforce from 2011 to 2020, based on the actual workload of 6762 dentists in 2010 in Taiwan.

PubMed

Huang, Chiung Shing; Cher, Tsang-Lie; Lin, Chun-Pin; Wu, Kai-Ming

2013-09-01

Planning of the dental workforce, especially the number of dentists, requires the data of actual dental workloads. This study attempts to make projections of the dental workforce from 2011 to 2020, based on a survey of the actual workload of 6762 dentists in 2010. In 2010, a database of 11,449 current dentists was retrieved from the file of Department of Health, Executive Yuan, Taipei, Taiwan. Questionnaires with the information of each dentist and 10 questions regarding the actual workload were sent to each dentist with a return envelope. The actual workload of the dentists who returned the questionnaires was analyzed. A projection of dental workforce from 2011 to 2020 was calculated, based on the actual workload. An analysis of the actual dental workload was conducted on 6762 (59.1%) returned questionnaires. The dentist-to-population ratio (defined as the number of dentists per 10,000 people) was 5.0 in 2010. The supply of 400 dentists per year remained constant from 2006 to 2010, and is expected to be sustained for the next 10 years. Because the population of Taiwan will begin to decrease within the next 10 years, we estimate that the dentist-to-population ratio will increase to 6.0 by the year 2020 or earlier. After adjusting for working hours, working days, and gender differences, surplus dentists will number approximately 1069 in 2020. An oversupply of dentists and a decrease in population will result in a surplus of dentists. To make better projections of the dental workforce, surplus dentists can be arranged to care for the aged, disabled people, and underserved people. Copyright © 2013. Published by Elsevier B.V.

Characteristics and management of infectious industrial waste in Taiwan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, M.-C.; Lin, Jim Juimin

Infectious industrial waste management in Taiwan is based on the specific waste production unit. In other countries, management is based simply on whether the producer may lead to infectious disease. Thus, Taiwan has a more detailed classification of infectious waste. The advantage of this classification is that it is easy to identify the sources, while the disadvantage lies in the fact that it is not flexible and hence increases cost. This study presents an overview of current management practices for handling infectious industrial waste in Taiwan, and addresses the current waste disposal methods. The number of small clinics in Taiwanmore » increased from 18,183 to 18,877 between 2003 and 2005. Analysis of the data between 2003 and 2005 showed that the majority of medical waste was general industrial waste, which accounted for 76.9%-79.4% of total medical waste. Infectious industrial waste accounted for 19.3%-21.9% of total medical waste. After the SARS event in Taiwan, the amount of infectious waste reached 19,350 tons in 2004, an increase over the previous year of 4000 tons. Waste minimization was a common consideration for all types of waste treatment. In this study, we summarize the percentage of plastic waste in flammable infectious industrial waste generated by medical units, which, in Taiwan was about 30%. The EPA and Taiwan Department of Health have actively promoted different recycling and waste reduction measures. However, the wide adoption of disposable materials made recycling and waste reduction difficult for some hospitals. It has been suggested that enhancing the education of and promoting communication between medical units and recycling industries must be implemented to prevent recyclable waste from entering the incinerator.« less

Prevalence of different forms of child maltreatment among Taiwanese adolescents: a population-based study.

PubMed

Feng, Jui-Ying; Chang, Yi-Ting; Chang, Hsin-Yi; Fetzer, Susan; Wang, Jung-Der

2015-04-01

Reported cases of child maltreatment are increasing in Taiwan. Yet, comprehensive epidemiological characteristics of adolescents' exposure over the wide spectrum of violence are still lacking. The purpose of this study was to estimate the prevalence and magnitude of child maltreatment among Taiwanese adolescents. A population-based study was conducted with 5,276 adolescents aged 12-18 from 35 schools in 17 cities and townships to determine the prevalence of five forms of child maltreatment in Taiwan. A total of 5,236 adolescents completed anonymous, self-report, structured questionnaires. Most adolescents (91%, n=4,788) experienced at least one form of maltreatment with 83% (n=4,347) exposed during the previous year. Violence exposure was the most common type of child maltreatment experienced, followed by psychological abuse, physical abuse, neglect, and sexual abuse. Adolescents reported an average of 7.4 (SD=5.87) victimizations over their lifetime and 4.8 (SD=4.82) victimizations during the past year. Females reported a higher rate of neglect, while males reported a higher rate of sexual abuse. Most of the sexual abuse perpetrators were known by their victims. Adolescents' victimization and polyvictimization from child maltreatment in Taiwan deserves a review and modification of national control and prevention policies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Use of Seasonal Influenza Vaccination and Its Associated Factors among Elderly People with Disabilities in Taiwan: A Population-Based Study.

PubMed

Chang, Yu-Chia; Tung, Ho-Jui; Hsu, Shang-Wei; Chen, Lei-Shin; Kung, Pei-Tseng; Huang, Kuang-Hua; Chiou, Shang-Jyh; Tsai, Wen-Chen

2016-01-01

Influenza immunization among elderly people with disabilities is a critical public health concern; however, few studies have examined the factors associated with vaccination rates in non-Western societies. By linking the National Disability Registration System and health service claims dataset from the National Health Insurance program, this population-based study investigated the seasonal influenza vaccination rate among elderly people with disabilities in Taiwan (N = 283,172) in 2008. A multivariate logistic regression analysis was conducted to adjust for covariates. Nationally, only 32.7% of Taiwanese elderly people with disabilities received influenza vaccination. The strongest predictor for getting vaccinated among older Taiwanese people with disabilities was their experience of receiving an influenza vaccination in the previous year (adjusted odds ratio [AOR] = 6.80, 95% confidence interval [CI]: 6.67-6.93). Frequent OPD use (AOR = 1.85, 95% CI: 1.81-1.89) and undergoing health examinations in the previous year (AOR = 1.66, 95% CI: 1.62-1.69) also showed a moderate and significant association with receiving an influenza vaccination. Although free influenza vaccination has been provided in Taiwan since 2001, influenza immunization rates among elderly people with disabilities remain low. Policy initiatives are required to address the identified factors for improving influenza immunization rates among elderly people with disabilities.

Decomposing the crude divorce rate in five countries: Singapore, Taiwan, South Korea, the UK, and Australia

PubMed Central

Chen, Mengni

2018-01-01

ABSTRACT Over the past few decades, the level of divorce, measured by the crude divorce rate (CDR), has increased dramatically in both the East and the West, but has recently appeared to fall or level off in some countries. To investigate whether the recent decline or stabilisation of the CDRs reflects the real trends in divorce risk, a decomposition analysis was conducted on the changes in the CDRs over the past 20 years on two western and three East Asian countries, namely, the UK, Australia, Taiwan, South Korea, and Singapore. The following is observed: the decline in the CDRs of the UK and Australia in the 1990s, and of Taiwan and Korea in the 2000s, was mainly due to shrinkage in the proportion of the married population rather than any reduction in divorce risk; only Australia experienced a genuine reduction in divorce risk between 2001 and 2011; and the continuous increase of Singapore’s divorce level between 1990 and 2010 may be is an unintentional effect of the government’s marriage promotion policies. The shift in the population age structure, and more importantly, the drastic decline in marriage, has seriously distorted the CDRs, making them unreliable indicators for monitoring divorce trends. PMID:29930691

Challenging mental health related stigma in China: Systematic review and meta-analysis. I. Interventions among the general public.

PubMed

Xu, Ziyan; Rüsch, Nicolas; Huang, Fangfang; Kösters, Markus

2017-09-01

Mental illness stigma is widely endorsed by the general public in China. Evidence-based anti-stigma interventions to reduce public stigma are needed. However, most studies on the efficacy of anti-stigma interventions took place in Western countries and existing Chinese studies were often not included in recent systematic reviews. This review evaluates the efficacy of anti-stigma interventions among the general population in Mainland China, Hong Kong, Taiwan and Macau. Eight databases in English and Chinese were searched for randomized and non-randomized controlled trials. Subgroup analyses compared interventions with and without consumer contact. Standardized mean differences were calculated from eligible studies where possible. We included 9 trials involving 2041 participants. Interventions yielded a small effect on stereotypes reduction and a similar effect on improving mental health literacy. No study assessed discrimination outcomes. Interventions with consumer contact were not superior to those without. There were insufficient data on medium and long term effects. Heterogeneity across studies was moderate. Quality of studies was modest. Further research using rigorous methods is required. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Seismogenic patterns in the Taiwan region: insights from source parameter inversion of BATS data

NASA Astrophysics Data System (ADS)

Kao, Honn; Jian, Pei-Ru

2001-04-01

We systematically invert source parameters of 96 earthquakes that occurred in the Taiwan region between July 1995 and June 1998, using waveforms recorded by the newly established Broadband Array in Taiwan for Seismology (BATS). The results are utilized to delineate the seismogenic patterns associated with the regional tectonic processes between the Eurasia and Philippine Sea plates. In general, high seismicity is observed at five locations, including the Nan-ao basin (∼24°N, ∼122.4°E), near the Hualien area (∼24.2°N, ∼121.7°E), east of the Longitudinal Valley and within the Philippine Sea plate, the forearc region to the west of Lanshu, and the Okinawa trough. Events with focal depths less than 25 km scatter across a wide region from the Taiwan Strait to the Ryukyu and Luzon arcs, whereas events between 25 and 50 km concentrate offshore east of Taiwan. Most earthquakes that occurred beneath the Nan-ao basin are consistent with the northward subduction of the Philippine Sea plate along the plate interface. Events offshore east of the Longitudinal Valley and within the Philippine Sea plate are dominated by a compressional regime along the NW/NWW directions, whereas the Lanshu-Lutao forearc is characterized by E-W compression. Normal faults showing N-S extension are observed in the Okinawa trough where we observed a successive rotation of T-axes from N-S to NW-SE as the epicenters approach Taiwan, indicating a possible interaction between the extensional and compressional strain regimes there. Most events between 50 and 65 km depth within the subducted Philippine Sea plate beneath Ryukyu are in downdip extension with lateral compression approximately parallel to the strike of the slab. The depth where the state of strain switches from downdip extension to downdip compression is constrained at 110-125 km for the southernmost Ryukyu slab. Based on our results, we propose that the subducted Philippine Sea plate beneath NE Taiwan plays a significant role in the overall orogenic process of Taiwan. The lithospheric collision in Taiwan should consist of two major components: one is the well-recognized ;arc-continent collision; that dominates the central and southern Taiwan and another the ;slab-continent collision; that reigns in northern Taiwan. A cluster of earthquakes near Hualien suggests that an incipient west- or northwestward subduction of the Philippine Sea plate is currently taking place there. Alternatively, they can be interpreted to suggest that the steeply east-dipping Longitudinal Valley fault may have transformed, near Hualien, into a diffuse thrust zone, which eventually connects itself to the plate interplate beneath the southernmost Ryukyu arc. Earthquakes beneath Taiwan and the Taiwan Strait are compatible with the overall collision convergence and lateral extrusion. Nonetheless, the lateral extrusion is probably only a secondary feature in the tectonic processes of Taiwan.

Comparative phylogeography of two crow species: jungle crow Corvus macrorhynchos and carrion crow Corvus corone.

PubMed

Kryukov, Alexey; Spiridonova, Liudmila; Nakamura, Sumio; Haring, Elisabeth; Suzuki, Hitoshi

2012-08-01

The jungle crow Corvus macrorhynchos Wagler, 1827, and the carrion crow Corvus corone L., 1758, are two closely related species with similar ecological requirements that occupy wide distribution ranges in the Palearctic. We studied patterns of their genetic variation by using sequences of the mitochondrial cytochrome b gene. Corvus macrorhynchos demonstrates a low level of variation and differentiation throughout its range, except for a highly diverged population of Cheju Island (Korea). The haplotype network shows two haplogroups. The island group comprises populations of Sakhalin, Hokkaido, Honshu, and Kyushu, while the haplotypes of Taiwan and Ryukyu Islands proved to be closer to the mainland group, which also includes populations from the Primorye, Khabarovsk, Amur, and Magadan regions in the Russian Far East. This pattern allowed us to develop a phylogeographic hypothesis regarding the two modes of settling of the island populations. Concerning C. corone, the presence of two distinct haplogroups was confirmed within the range of C. c. orientalis. Both haplogroups are found within the same populations in Kamchatka and North Sakhalin, which implies secondary contacts there. Populations of C. corone are found to be rather stable in the western parts of its range, while in the Far East populations experienced recent growth, as was observed for C. macrorhynchos in general. The two species appear to have passed through different evolutionary scenarios.

Demographic factors influencing consensus opinion on the recall for women screened by mobile mammography unit in taiwan.

PubMed

Yu-Mei, Lee; Hsueh-Hua, Yao

2013-09-01

The incidence of breast cancer has had a four-fold increase from 1980 to 2005 in Taiwan. Limited data have been available on mobile breast screening in the Taiwanese population since 2009. This study aims at investigating the factors influencing consensus opinion on the recall for mobile breast screening in Taiwan. The factors were categorized by individual health background, socioeconomic status and knowledge about breast screening. There were 502 questionnaires collected from Taiwanese women examined on mobile mammography screening vehicle. Data were then analyzed by SPSS 12 via analysis of variance (ANOVA), F-test, t-test or chi-square test. Strong participation was associated with a younger age, higher educational level, higher incomes, previous history of cancer, previous family history of cancer, one or two prior mammographies, more correct recognitions of mammography, recall rate, and breast cancer risk. If the false-positive result occurred, 83.9%, 81.9% and 77.3% of the women agreed or strongly agreed to participate in noninvasive and invasive testing and screening mammography, respectively. The policy makers should notify the importance of demographic factors affecting further examination for early detection of breast cancer in Taiwan.

Nonemergent emergency department visits under the National Health Insurance in Taiwan.

PubMed

Tsai, Jeffrey Che-Hung; Chen, Wen-Yi; Liang, Yia-Wun

2011-05-01

To explore the magnitude of nonemergent emergency department visits under the Taiwan National Health Insurance program and to identify significant factors associated with these visits. A cross-sectional analysis of the 2002 Taiwan National Health Insurance Research Database was used to identify nonemergent emergency department conditions according to the New York University algorithm. The data contained 43,384 visits, of which 83.89% could be classified. Multivariate logistic regression identified individual and contextual factors associated with nonemergent emergency department visits. Nearly 15% of all emergency department visits were nonemergent; an additional 20% were emergent-preventable with primary care. Patients likely to make nonemergent emergency department visits were older, female, categorized as a Taiwan National Health Insurance Category IV beneficiary, and without major illness. Hospital accreditation level, teaching status, and location were associated with an increased likelihood of nonemergent emergency department visits. Understanding the factors leading to nonemergent emergency department visits can assist in evaluating the overall quality of a health care system and help reduce the use of the emergency department for nonemergent conditions. Policy makers desiring cost-effective care should assess emergency department visit rates in light of available resources for specific populations. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The East Asian age-friendly cities promotion - Taiwan's experience and the need for an oriental paradigm.

PubMed

Chao, Tzuyuan Stessa; Huang, Huiwen

2016-03-01

It is the consensus that the rapid increase of the ageing population has become a global phenomenon. In 2007, the World Health Organization (WHO) advanced a handbook called Global Age-friendly Cities: A Guide The core concept of the age-friendly cities (AFC) movement is 'active ageing'. Taiwan became one of the few Asian countries that initially responded to the WHO AFC movement in 2010. Following the guidance set by the WHO, Taiwan began its promotion at a national level, and with local authorities. However, during the advocacy process, the fundamental differences between Eastern and Western cultures in terms of family values and deep-rooted respect for the elderly have raised an awareness of the need for an oriental paradigm. This paper identifies three key elements for AFC promotion in East Asian countries based on an analysis of Taiwan's experience: during needs assessment take collectivism into consideration, during action plans at the community level community leaders' views will be more important (particularism), and when promoting AFC at the institutional level a top-down approach will be more acceptable (high power distance concept). © The Author(s) 2016.

Cancer in adolescents: Incidences and trends during 1995-2009 in Taiwan.

PubMed

Hung, Giun-Yi; Chen, Chao-Chun; Horng, Jiun-Lin; Lin, Li-Yih

2016-03-01

This study aimed to describe cancer incidence rates and trends specifically for adolescents aged 15-19 years during 1995-2009 in Taiwan. The incidence counts and census data were obtained from the population-based Taiwan Cancer Registry. During the 15-year study period, 4122 adolescents were diagnosed with cancer. The overall incidence rate was 155.2 per million person-years. Other epithelial tumors were the most frequently diagnosed cancer group (23.7%), followed by leukemias (18.0%) and lymphomas (13.9%). When compared to rates in Western countries, a significantly low rate of lymphomas was found. Moreover, rates of the subtypes of melanomas and nasopharyngeal carcinomas being 1/10- and 4-times rates in Western countries were the most striking variations. During 1995-2009, the overall rate of adolescent cancer did not significantly change. However, the most significant upward and declining trends in incidence rates were found for male germ cell neoplasms (annual percent change, APC, 6.4%) and hepatic tumors (APC, -11.1%), respectively. Further investigation and enhancement of the public discourse of possible lifestyle and environmental risk factors associated with increasing trends of certain adolescent cancers should be carried out in Taiwan. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Epidemiology and patterns of facial fractures due to road traffic accidents in Taiwan: A 15-year retrospective study.

PubMed

Yang, Cheng-San; Chen, Solomon Chih-Cheng; Yang, Yung-Cheng; Huang, Li-Chung; Guo, How-Ran; Yang, Hsin-Yi

2017-10-03

The facial region is a commonly fractured site, but the etiology varies widely by country and geographic region. To date, there are no population-based studies of facial fractures in Taiwan. We conducted a retrospective study of patients diagnosed with facial fracture and registered in the National Health Insurance Research Database of Taiwan between 1997 and 2011. The epidemiological characteristics of this cohort were analyzed, including the etiology, fracture site, associated injuries, and sex and age distributions. A total of 6,013 cases were identified that involved facial fractures. Most patients were male (69.8%), aged 18-29 years (35.8%), and had fractures caused by road traffic accidents (RTAs; 55.2%), particularly motorcycle accidents (31.5%). Falls increased in frequency with advancing age, reaching 23.9% among the elderly (age > 65 years). The most common sites of involvement were the malar and maxillary bones (54.0%), but nasal bone fractures were more common among those younger than 18 years. Most facial injuries in Taiwan occur in young males and typically result from RTAs, particularly involving motorcycles. However, with increasing age, there is an increase in the proportion of facial injuries due to falls.

An introduction to the tectonophysics special issue (Geodynamics and Environment in East Asia, GEEA 2014)

NASA Astrophysics Data System (ADS)

Siame, Lionel L.; Lee, Jian-Cheng

2016-12-01

In Taiwan, tectonic and climatic processes are exacerbated, involving deformation and erosion rates that are among the highest ones in the world. The combination of these internal and external forcing factors results in frequent and severe natural hazards in many aspects, including earthquake, landslide, mud/debris flows, floods, tsunamis, etc., which became a real concern not only for in the Taiwanese society but also applying for many countries or areas in the world. Within this general context, Taiwan orogen is thus a quite exceptional natural laboratory to study the coupling relationships between internal and external processes, and thus better cope with implications on society and economics. From a fundamental science point of view, Taiwan orogen has long been recognized as one of the best places in the world to study mountain building processes including lithosphere and crustal deformation, mechanisms of mountain building, seismic cycle and seismic behaviour of active faults. In fact, Taiwan orogen is probably one of the rare mountain belts where processes of mountain building can be apprehended from oceanic to continental subduction and post-orogenic extension.

Study on occupational safety and health strategy for Taiwan.

PubMed

Chuang, Kuen-Yuan; Su, Teh-Sheng; Kuo, Chao-Yin; Lin, Chien-Liang; Lin, Han-Yu; Yu, Yi-Chun

2009-12-01

The aim of this study was to establish a set of occupational safety and health (OSH) issues and development policies suitable for adoption in Taiwan. A survey was conducted on a sample of 102 experts and 235 industrial work safety personnel in Taiwan for statistical analysis of the general consensus, with the results showing such consensus in 104 individual policy indicators. Our results reveal that the most appropriate targets were considered to be annual 10% reductions in the 'occupational accident disability rate', 'occupational accident injury rate' and 'occupational diseases before 2010'. Responding to the specific question of the appropriate method of achieving a reduction in the number of accidents in Taiwan, the primary consideration for 13.4% of the experts and 10.6% of the industry personnel was 'promoting OSH awareness and enhancing the overall safety culture'. As regards the current OSH policy focus, 11.2% of the experts considered 'improving OSH legislation, standards and systems' to be the most important, whilst 8.9% of the industry personnel felt that 'recognizing work stress, overwork and emerging OSH issues' were the most important.

Familial aggregation of gout and relative genetic and environmental contributions: a nationwide population study in Taiwan

PubMed Central

Kuo, Chang-Fu; Grainge, Matthew J; See, Lai-Chu; Yu, Kuang-Hui; Luo, Shue-Fen; Valdes, Ana M; Zhang, Weiya; Doherty, Michael

2015-01-01

Objective To examine familial aggregation of gout and to estimate the heritability and environmental contributions to gout susceptibility in the general population. Methods Using data from the National Health Insurance (NHI) Research Database in Taiwan, we conducted a nationwide cross-sectional study of data collected from 22 643 748 beneficiaries of the NHI in 2004; among them 1 045 059 individuals had physician-diagnosed gout. We estimated relative risks (RR) of gout in individuals with affected first-degree and second-degree relatives and relative contributions of genes (heritability), common environment shared by family members and non-shared environment to gout susceptibility. Results RRs for gout were significantly higher in individuals with affected first-degree relatives (men, 1.91 (95% CI 1.90 to 1.93); women, 1.97 (95% CI 1.94 to 1.99)) and also in those with affected second-degree relatives (men, 1.27 (95% CI 1.23 to 1.31); women, 1.40 (95% CI 1.35 to 1.46)). RRs (95% CIs) for individuals with an affected twin, sibling, offspring, parent, grandchild, nephew/niece, uncle/aunt and grandparent were 8.02 (6.95 to 9.26), 2.59 (2.54 to 2.63), 1.96 (1.95 to 1.97), 1.93 (1.91 to 1.94), 1.48 (1.43 to 1.53), 1.40 (1.32 to 1.47), 1.31 (1.24 to 1.39), and 1.26 (1.21 to 1.30), respectively. The relative contributions of heritability, common and non-shared environmental factors to phenotypic variance of gout were 35.1, 28.1 and 36.8% in men and 17.0, 18.5 and 64.5% in women, respectively. Conclusions This population-based study confirms that gout aggregates within families. The risk of gout is higher in people with a family history. Genetic and environmental factors contribute to gout aetiology, and the relative contributions are sexually dimorphic. PMID:24265412

Sex Distribution of Paper Mulberry (Broussonetia papyrifera) in the Pacific

PubMed Central

Peñailillo, Johany; Olivares, Gabriela; Moncada, Ximena; Payacán, Claudia; Chang, Chi-Shan; Chung, Kuo-Fang; Matthews, Peter J.; Seelenfreund, Andrea; Seelenfreund, Daniela

2016-01-01

Background Paper mulberry (Broussonetia papyrifera (L.) L'Hér. ex Vent) is a dioecious tree native to East Asia and mainland Southeast-Asia, introduced prehistorically to Polynesia as a source of bark fiber by Austronesian-speaking voyagers. In Oceania, trees are coppiced and harvested for production of bark-cloth, so flowering is generally unknown. A survey of botanical records of paper mulberry revealed a distributional disjunction: the tree is apparently absent in Borneo and the Philippines. A subsequent study of chloroplast haplotypes linked paper mulberry of Remote Oceania directly to a population in southern Taiwan, distinct from known populations in mainland Southeast-Asia. Methodology We describe the optimization and use of a DNA marker designed to identify sex in paper mulberry. We used this marker to determine the sex distribution in selected localities across Asia, Near and Remote Oceania. We also characterized all samples using the ribosomal internal transcribed spacer sequence (ITS) in order to relate results to a previous survey of ITS diversity. Results In Near and Remote Oceania, contemporary paper mulberry plants are all female with the exception of Hawaii, where plants of both sexes are found. In its natural range in Asia, male and female plants are found, as expected. Male plants in Hawaii display an East Asian ITS genotype, consistent with modern introduction, while females in Remote Oceania share a distinctive variant. Conclusions Most paper mulberry plants now present in the Pacific appear to be descended from female clones introduced prehistorically. In Hawaii, the presence of male and female plants is thought to reflect a dual origin, one a prehistoric female introduction and the other a modern male introduction by Japanese/Chinese immigrants. If only female clones were dispersed from a source-region in Taiwan, this may explain the absence of botanical records and breeding populations in the Philippines and Borneo, and Remote Oceania. PMID:27529483

Sex Distribution of Paper Mulberry (Broussonetia papyrifera) in the Pacific.

PubMed

Peñailillo, Johany; Olivares, Gabriela; Moncada, Ximena; Payacán, Claudia; Chang, Chi-Shan; Chung, Kuo-Fang; Matthews, Peter J; Seelenfreund, Andrea; Seelenfreund, Daniela

2016-01-01

Paper mulberry (Broussonetia papyrifera (L.) L'Hér. ex Vent) is a dioecious tree native to East Asia and mainland Southeast-Asia, introduced prehistorically to Polynesia as a source of bark fiber by Austronesian-speaking voyagers. In Oceania, trees are coppiced and harvested for production of bark-cloth, so flowering is generally unknown. A survey of botanical records of paper mulberry revealed a distributional disjunction: the tree is apparently absent in Borneo and the Philippines. A subsequent study of chloroplast haplotypes linked paper mulberry of Remote Oceania directly to a population in southern Taiwan, distinct from known populations in mainland Southeast-Asia. We describe the optimization and use of a DNA marker designed to identify sex in paper mulberry. We used this marker to determine the sex distribution in selected localities across Asia, Near and Remote Oceania. We also characterized all samples using the ribosomal internal transcribed spacer sequence (ITS) in order to relate results to a previous survey of ITS diversity. In Near and Remote Oceania, contemporary paper mulberry plants are all female with the exception of Hawaii, where plants of both sexes are found. In its natural range in Asia, male and female plants are found, as expected. Male plants in Hawaii display an East Asian ITS genotype, consistent with modern introduction, while females in Remote Oceania share a distinctive variant. Most paper mulberry plants now present in the Pacific appear to be descended from female clones introduced prehistorically. In Hawaii, the presence of male and female plants is thought to reflect a dual origin, one a prehistoric female introduction and the other a modern male introduction by Japanese/Chinese immigrants. If only female clones were dispersed from a source-region in Taiwan, this may explain the absence of botanical records and breeding populations in the Philippines and Borneo, and Remote Oceania.

Higher education in gerontology: A comparison of master's programs in Japan, Taiwan, and Turkey.

PubMed

Ikeuchi, Tomoko; Lu, Feng-Hwa; Holdsworth, Jason K; Arun, Özgür; Wang, Shan-Tair; Murakami, Ikuko; Osada, Hisao

2017-01-01

As of 2015, there is only one master's program of gerontology acknowledged by each of the following countries: Japan, Taiwan, and Turkey. All three programs have fewer than 15 years of history. These three countries differ in society types based on the proportion of older adults, rate of population aging, and population size. However, in terms of gerontological education, they seem to share great commonalities. Common challenges are a lack of awareness of the field of gerontology, insufficient numbers of gerontology programs and faculty members to produce trained gerontologists within society, and the inadequacy of opportunities for trained gerontologists to play an active role in various fields. This study intends not only to compare the differences and similarities among three countries and programs, but also to elucidate characteristics of a unique gerontology program in each country and identify challenges and possibilities from the perspective of gerontological educators.

The effectiveness of suicide prevention programmes: urban and gender disparity in age-specific suicide rates in a Taiwanese population.

PubMed

Lung, F-W; Liao, S-C; Wu, C-Y; Lee, M-B

2017-06-01

The effectiveness of suicide prevention programmes is an important issue worldwide today. The impact of urbanization and gender is controversial in suicide rates. Hence, this study adjusted on potential risk factors and secular changes for suicide rates in gender and rural/urban areas. Observational study. A Suicide Prevention Center was established by the Executive Yuan in Taiwan in 2005 and tried to carry out suicidal intervention in the community in every city and town. There were two phases, including the first phase of the programme from 2005 to 2008, and the second phase of the programme from 2009 to 2013. The crude suicide rates data from the period of 1991-2013, which recruited nine urban and 14 rural areas in Taiwan, were extracted from the Taiwanese national mortality data file. The suicide rates in two areas of Taiwan (Taipei city and Yilan County) were further used to compare the differences between urban and rural areas. The results show that unemployment increased the suicide rate in men aged 45-64 years and in women older than 65 years of age in Taiwan. High divorce and unemployment rates resulted in increased suicide rates in men in the city, whereas emotional distress was the main cause of suicides in men in rural areas. The main method of suicide was jumping from a high building for both sexes in the city, whereas drowning was the most common method of suicide for men in rural areas. Following the intervention programme, suicide behaviour began to decrease in all urban and rural areas of Taiwan. This study showed the cumulative effect of the intervention programme in decreasing the suicide rate in Taiwan. Moreover, the gender-specific suicidal rate and disparity in suicidal methods in urban and rural areas should be considered in further preventive strategies in Taiwan. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Characteristics of Broadband Seismic Noise in Taiwan and Neighboring Islands

NASA Astrophysics Data System (ADS)

Chen, Ching-Wei; Rau, Ruey-Juin

2017-04-01

We used seismic waveform data from 115 broad-band stations of BATS (Institute of Earth Science, Academia Sinica) and Central Weather Bureau Seismic Network from 2012 to 2016 for noise-level mapping in Taiwan and neighboring islands. We computed Power Spectral Density (PSD) for each station and analyzed long-term variance of microseism energy and polarizations of noise for severe weather events. The island of Taiwan is surrounded by ocean and the Central Range which has the highest peak Jade Mountain at 3,952 meters height occupies more than 66% of the island and departs it into the east and west coasts. The geographic settings then result in the high population density in the western plain and northern Taiwan. The dominant noise source in the microseism band (periods from 4-20 seconds) is the coupling between the near-coast ocean and sea floor which produces the high noise of averaging -130 dB along the west coastal area. In the eastern volcanic-arc coastal areas, the noise level is about 7% smaller than the west coast due to its deeper offshore water depth. As for the shorter periods (0.1-0.25 seconds) band, the so-called culture noise, an anthropic activity variance with the highest -103 dB can be identified in the metropolitan areas, such as the Taipei city and the noise level in the Central Range area is averaging -138 dB. Moreover, the noise also shows a daily and temporal evolution mainly related to the traffic effect. Furthermore, we determined the noise level for the entire island of Taiwan during 26-28 September, 2016, when the typhoon Megi hit the island and retrieved the enhancement of secondary microseism energy for each stations. Typhoon Megi landed in eastern and central Taiwan and reached the maximum wind speed of 45m/s in the surrounded eyewall. The Central Range, as a barrier, decreased the wind speed in southern Taiwan making an enhancement less than 10 dB, while in northern Taiwan where the direction the typhoon headed to, can reach more than 35 dB.

Antimicrobial usage in ambulatory patients with respiratory infections in Taiwan, 2001.

PubMed

Ho, Monto; Hsiung, Chao Agnes; Yu, Hui-Tzu; Chi, Cheng-Liang; Yin, Hsiao-Chuan; Chang, Hong-Jen

2004-02-01

Excess use of antimicrobials by ambulatory patients is a determinant of antimicrobial resistance. This study investigated the types of illnesses for which antimicrobials were prescribed and the amounts prescribed with special emphasis on respiratory infections for the year in which the Bureau of National Health Insurance (BNHI) enforced a policy to restrict antimicrobials for upper respiratory infections. The number of ambulatory patients seen and the types of ambulatory facilities in Taiwan were also described. Raw data were obtained from the BNHI database on every 500 th visit in 2001. Medical diagnoses were categorized according to the ICD-9-CM system. Antimicrobial consumption was expressed in defined daily doses per 1000 population per day (DDD/1000/day). Among the population of 22.3 million in Taiwan, there were 285.8 million ambulatory patient visits (12.8 per person), including 108.9 million visits (4.9 per person) for respiratory infections, of which 62.7 million (2.8 per person) were for upper respiratory infections (URI). Antimicrobial consumption was 19.83 DDD/1000/day [standard error (SE), 0.00055], of which 9.97 DDD/1000/day (SE, 0.00047) were for respiratory infections and 4.03 DDD/1000/day (0.00055) were for URI. 23.6% of visits for URI entailed a prescription for antimicrobials. About two-thirds (66.5%) of ambulatory patients were seen in clinics, mostly private ones, and 67.6% of all antimicrobials were received there. Aminopenicillins and cephalosporins constituted 35.2% and 19.5%, respectively, of antimicrobials prescribed. Despite the new BNHI rule restricting antimicrobial usage for URI, Taiwan still has an excessive number of ambulatory patient visits, especially for respiratory infections and URI. The majority of antimicrobials used were for URI. They were mostly prescribed in private clinics rather than hospital outpatient departments.

The relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan.

PubMed

Yang, Ya-Ting; Iqbal, Usman; Ko, Hua-Lin; Wu, Chia-Rong; Chiu, Hsien-Tsai; Lin, Yi-Chieh; Lin, Wender; Elsa Hsu, Yi-Hsin

2015-06-01

The purpose of this study was to explore the relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan. Cross-sectional study from 2007 Taiwan Longitudinal Study on Ageing (TLSA) survey. Community-based study. A total of 4249 middle-aged and elderly subjects were recruited. None. Outpatient visits within 1 month, and hospitalization, emergency visits as well as to shop in pharmacy stores within 1 year, respectively. Adjusting for important confounding variables, the middle-aged and elderly with National Health Insurance (NHI) and commercial insurance compared with those with NHI alone tended to have outpatient visits. The middle-aged and elderly with longer time to access healthcare facilities were less likely to shop in pharmacy stores compared with those with <30 min. The middle-aged and elderly who perceived inconvenient to access health care tended to shop in pharmacy stores compared with those with perceived convenience. Our study of Taiwan's experience could provide a valuable lesson for countries that are planning to launch universal health insurance system, locate budgets in health care and transportation. The middle-aged and elderly who were facing more challenges in accessing health care, no matter in perceived accessibility or real time to access health care, had less outpatient visits and more drug stores shopping. Strategic policies are needed to improve accessibility in increasing patients' perception on access and escalating convenience of transportation system for improving accessibility. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Demographic and Prescribing Patterns of Chinese Herbal Products for Individualized Therapy for Ischemic Heart Disease in Taiwan: Population-Based Study

PubMed Central

Hu, Wen-Long; Chen, Hsuan-Ju; Li, Tsai-Chung; Tsai, Pei-Yuan; Chen, Hsin-Ping; Huang, Meng-Hsuan; Su, Fang-Yen

2015-01-01

Objective Combinations of Chinese herbal products (CHPs) are widely used for ischemic heart disease (IHD) in Taiwan. We analyzed the usage and frequency of CHPs prescribed for patients with IHD. Methods A nationwide population-based cross-sectional study was conducted, 53531 patients from a random sample of one million in the National Health Insurance Research Database (NHIRD) from 2000 to 2010 were enrolled. Descriptive statistics, the multiple logistic regression method and Poisson regression analysis were employed to estimate the adjusted odds ratios (aORs) and adjusted risk ratios (aRRs) for utilization of CHPs. Results The mean age of traditional Chinese medicine (TCM) nonusers was significantly higher than that of TCM users. Zhi-Gan-Cao-Tang (24.85%) was the most commonly prescribed formula CHPs, followed by Xue-Fu-Zhu-Yu-Tang (16.53%) and Sheng-Mai-San (16.00%). The most commonly prescribed single CHPs were Dan Shen (29.30%), Yu Jin (7.44%), and Ge Gen (6.03%). After multivariate adjustment, patients with IHD younger than 29 years had 2.62 times higher odds to use TCM than those 60 years or older. Residents living in Central Taiwan, having hyperlipidemia or cardiac dysrhythmias also have higher odds to use TCM. On the contrary, those who were males, who had diabetes mellitus (DM), hypertension, stroke, myocardial infarction (MI) were less likely to use TCM. Conclusions Zhi-Gan-Cao-Tang and Dan Shen are the most commonly prescribed CHPs for IHD in Taiwan. Our results should be taken into account by physicians when devising individualized therapy for IHD. Further large-scale, randomized clinical trials are warranted in order to determine the effectiveness and safety of these herbal medicines. PMID:26322893

Chinese herbal medicine use in Taiwan during pregnancy and the postpartum period: a population-based cohort study.

PubMed

Chuang, Chao-Hua; Chang, Pei-Jen; Hsieh, Wu-Shiun; Tsai, Yih-Jian; Lin, Shio-Jean; Chen, Pau-Chung

2009-06-01

Using Chinese herbal medicines during pregnancy and postpartum is common in the Chinese community. The purpose of this current study is to explore the use of Chinese herbal medicines by women during pregnancy and postpartum in Taiwan. It is an on-going prospective longitudinal study design. We used multistage stratified systematic sampling to recruit 24,200 pairs, postpartum women and newborns, from the Taiwan national birth register in 2005. Subjects underwent a home interview 6 months after their deliveries between June 2005 and July 2006. A structured questionnaire was successfully administered to 87.8% of the sampled population. At least one Chinese herbal medicine was used by 33.6% and 87.7% of the interviewed subjects during pregnancy and the postpartum period, respectively. An-Tai-Yin, Pearl powder, and Huanglian were the most commonly used during pregnancy, while Shen-Hua-Tang and Suz-Wu-Tang were the most commonly used by postpartum women. Pregnant women aged 20-34, with high education, threatened abortion, chronic disease, and primipara appeared to use more Chinese herbal medicines than others in the sample. Postpartum women with high education, primipara, normal spontaneous delivery, and breastfeeding were found to use more Chinese herbal medicines; but women with pregnancy-related illness used less. Chinese herbal medicines are frequently used by women during pregnancy and the postpartum period in Taiwan and those with high education and primipara used more such herbs. Due to limited safety information on these herbs, we would advise caution regarding their use either during pregnancy or postpartum breastfeeding period. Moreover, it is important for nurses/midwifes enquiring about such habits, and providing the adequate education to women during prenatal and postpartum care to prevent potential side effects.

[Considering the current state of fire safety in Taiwan's care environment from the perspective of the nation's worst recent hospital fire].

PubMed

Tseng, Wei-Wen; Shih, Chung-Liang; Chien, Shen-Wen

2013-04-01

Taiwan's worst hospital fire in history on October 23rd, 2012 at Sinying Hospital's Bei-Men Branch resulted in 13 elderly patient deaths and over 70 injuries. The heavy casualties were due in part to the serious condition of patients. Some patients on life-support machines were unable to move or be moved. This disaster highlights the issue of fire safety in small-scale hospitals that have transformed existing hospital space into special care environments for elderly patients. Compared with medical centers and general hospitals, these small-scale health facilities are ill equipped to deal properly with fire safety management and emergency response issues due to inadequate fire protection facilities, fire safety equipment, and human resources. Small-scale facilities that offer health care and medical services to mostly immobile patients face fire risks that differ significantly from general health care facilities. This paper focuses on fire risks in small-scale facilities and suggests a strategy for fire prevention and emergency response procedures, including countermeasures for fire risk assessment, management, and emergency response, in order to improve fire safety at these institutions in Taiwan.

Methods of Suicide among Cancer Patients: A Nationwide Population-Based Study

ERIC Educational Resources Information Center

Chung, Kuo-Hsuan; Lin, Herng-Ching

2010-01-01

A 3-year nationwide population-based data set was used to explore methods of suicide (violent vs. nonviolent) and possible contributing factors among cancer patients in Taiwan. A total of 1,065 cancer inpatients who committed suicide were included as our study sample. The regression shows that those who had genitourinary cancer were 0.55 times (p…

Temporal trend and nationwide utility for hysterectomies in Taiwan, 1997-2010.

PubMed

Huang, Wei-Yi; Huang, Kuo-How; Chang, Wen-Chun; Wu, Shiao-Chi

2016-10-01

This study investigates the nationwide utilization and temporal trend of hysterectomies in Taiwan. The present study used the National Health Insurance Research Database that included claims of nearly the entire population in Taiwan since the inception of the National Health Insurance program in 1995. We analyzed age-adjusted rates of hysterectomies in Taiwan from 1997 through to 2010 and compared with the rates in 16 countries of the Organization for Economic Co-operation and Development. We also examined the utilization of various types of hysterectomies in Taiwan during this period. There was a cross-country variation in the age-standardized rate of hysterectomy: 105 per 100,000 females in Spain, 156 per 100,000 females in Taiwan, 179 per 100,000 females in 16 Organization for Economic Co-operation and Development countries, and 325 per 100,000 females in the United States in 2008. The trend of the age-standardized rate of hysterectomy in Taiwan declined from 222.3 per 100,000 women in 1998 to 145.2 per 100,000 women in 2010. The most common type of hysterectomy during this period was total abdominal hysterectomy (51.2%). Subtotal hysterectomies increased by 117% (r 2 =0.89; p<0.01), from 672 in 1997 to 1458 in 2010; however, total hysterectomies decreased by 3.5% (r 2 =0.43; p=0.01), from 20,966 in 1997 to 20,230 in 2010. Laparoscopically assisted procedures (laparoscopic supracervical hysterectomy and laparoscopic hysterectomy) increased 4.98-fold (r 2 =0.23; p=0.09), from 1453 in 1997 to 8684 in 2010. By contrast, the proportion of conventional open hysterectomies (total abdominal hysterectomy, and subtotal or supracervical abdominal hysterectomy) decreased by 36.5% (r 2 =0.59; p<0.01), from 17,327 in 1997 to 10,994 in 2010. The proportion of vaginal hysterectomies decreased by 29.7% (r 2 =0.72; p<0.01), from 2858 in 1997 to 2010 in 2010. As in most Western countries, hysterectomy rates in Taiwan declined by year. There was a marked shift in the types of hysterectomies from 1997 through to 2010 in Taiwan. Minimally invasive surgeries and supracervical hysterectomies were more commonly adopted. Copyright © 2016. Published by Elsevier B.V.

A retrospective cohort study on the risk of stroke in relation to a priori health knowledge level among people with type 2 diabetes mellitus in Taiwan.

PubMed

Lai, Yun-Ju; Hu, Hsiao-Yun; Lee, Ya-Ling; Ku, Po-Wen; Yen, Yung-Feng; Chu, Dachen

2017-05-22

Intervention of diabetes care education with regular laboratory check-up in outpatient visits showed long-term benefits to reduce the risk of macrovascular complications among people with type 2 diabetes. However, research on the level of a priori health knowledge to the prevention of diabetic complications in community settings has been scarce. We therefore aimed to investigate the association of health knowledge and stroke incidence in patients with type 2 diabetes in Taiwan. A nationally representative sample of general Taiwanese population was selected using a multistage systematic sampling process from Taiwan National Health Interview Survey (NHIS) in 2005. Subjects were interviewed by a standardized face-to-face questionnaire in the survey, obtaining information of demographics, socioeconomic status, family medical history, obesity, health behaviors, and 15-item health knowledge assessment. The NHIS dataset was linked to Taiwan National Health Insurance claims data to retrieve the diagnosis of type 2 diabetes in NHIS participants at baseline and identify follow-up incidence of stroke from 2005 to 2013. Univariate and multivariate Cox regressions were used to estimate the effect of baseline health knowledge level to the risk of stroke incidence among this group of people with type 2 diabetes. A total of 597 diabetic patients with a mean age of 51.28 years old and nearly half of males were analyzed. During the 9-year follow-up period, 65 new stroke cases were identified among them. Kaplan-Meier curves comparing the three groups of low/moderate/high knowledge levels revealed a statistical significance (p-value of log-rank test <0.01). After controlling for potential confounders, comparing to the group of low health knowledge level, the relative risk of stroke was significantly lower for those with moderate (adjusted hazard ratio [AHR] = 0.63; 95% CI, 0.33-1.19; p-value = 0.15) and high level of health knowledge (AHR = 0.43; 95% CI, 0.22-0.86; p-value = 0.02), with a significant linear trend (p-value = 0.02). An exposure-response gradient of moderate to high health knowledge levels to the prevention of stroke incidence among people with type 2 diabetes in community was found with 9 years of follow-up in Taiwan. Development and delivery of health education on stroke prevention to people with type 2 diabetes are warranted.

Significance of major international seaports in the distribution of murine typhus in Taiwan.

PubMed

Kuo, Chi-Chien; Wardrop, Nicola; Chang, Chung-Te; Wang, Hsi-Chieh; Atkinson, Peter M

2017-03-01

International seaports are hotspots for disease invasion and pathogens can persist in seaports even after ports are abandoned. Transmitted by fleas infected by Rickettsia typhi, murine typhus, a largely neglected and easily misdiagnosed disease, is known to occur primarily in large seaports. However, the significance of seaports in the occurrence of murine typhus has never been validated quantitatively. We studied the spatial distribution of murine typhus, a notifiable disease, in Taiwan. We investigated whether risk of infection was correlated with distance to international seaports and a collection of environmental and socioeconomic factors, using a Bayesian negative binomial conditionally autoregressive model, followed with geographically weighted regression. Seaports that are currently in use and those that operated in the 19th century for trade with China, but were later abandoned due to siltation were analyzed. A total of 476 human cases of murine typhus were reported during 2000-2014 in the main island of Taiwan, with spatial clustering in districts in southwest and central-west Taiwan. A higher incidence rate (case/population) was associated with a smaller distance to currently in-use international seaports and lower rainfall and temperature, but was uncorrelated with distance to abandoned ports. Geographically weighted regression revealed a geographic heterogeneity in the importance of distance to in-use seaports near the four international seaports of Taiwan. Our study suggests that murine typhus is associated with international seaports, especially for those with large trading volume. Thus, one of the costs of global trade in Taiwan might be elevated risks of murine typhus. Globalization has accelerated the spread of infectious diseases, but the burden of disease varies geographically, with regions surrounding major international seaports warranting particular surveillance.

Tablet splitting of narrow therapeutic index drugs: a nationwide survey in Taiwan.

PubMed

Chou, Chia-Lin; Hsu, Chia-Chen; Chou, Chia-Yu; Chen, Tzeng-Ji; Chou, Li-Fang; Chou, Yueh-Ching

2015-12-01

Tablet splitting or pill splitting frequently occurs in daily medical practice. For drugs with special pharmacokinetic characters, such as drugs with narrow therapeutic index (NTI), unequal split tablets might lead to erroneous dose titration and it even cause toxicity. The aim of this study was to investigate the frequency of prescribing split NTI drugs at ambulatory setting in Taiwan. A population-based retrospective study was conducted using the National Health Insurance Research Database in Taiwan. All ambulatory visits were analyzed from the longitudinal cohort datasets of the National Health Insurance Research Database. The details of ambulatory prescriptions containing NTI drugs were extracted by using the claims datasets of one million beneficiaries from National Healthcare Insurance Research Database in 2010 in Taiwan. The analyses were stratified by dosage form, patient age and the number of prescribed tablets in a single dose for each NTI drugs. Main outcome measures Number and distinct dosage forms of available NTI drug items in Taiwan, number of prescriptions involved split NTI drugs, and number of patients received split NTI drugs. A total of 148,548 patients had received 512,398 prescriptions of NTI drugs and 41.8 % (n = 62,121) of patients had received 36.3 % (n = 185,936) of NTI drug prescriptions in form of split tablets. The percentage of splitting was highest in digoxin prescriptions (81.0 %), followed by warfarin (72.0 %). In the elderly patients, split tablets were very prevalent with digoxin (82.4 %) and warfarin (84.5 %). NTI drugs were frequently prescribed to be taken in split forms in Taiwan. Interventions may be needed to provide effective and convenient NTI drug use. Further studies are needed to evaluate the clinical outcome of inappropriate split NTI drugs.

Significance of major international seaports in the distribution of murine typhus in Taiwan

PubMed Central

Wardrop, Nicola; Chang, Chung-Te; Wang, Hsi-Chieh; Atkinson, Peter M.

2017-01-01

Background International seaports are hotspots for disease invasion and pathogens can persist in seaports even after ports are abandoned. Transmitted by fleas infected by Rickettsia typhi, murine typhus, a largely neglected and easily misdiagnosed disease, is known to occur primarily in large seaports. However, the significance of seaports in the occurrence of murine typhus has never been validated quantitatively. Methodology/Principal findings We studied the spatial distribution of murine typhus, a notifiable disease, in Taiwan. We investigated whether risk of infection was correlated with distance to international seaports and a collection of environmental and socioeconomic factors, using a Bayesian negative binomial conditionally autoregressive model, followed with geographically weighted regression. Seaports that are currently in use and those that operated in the 19th century for trade with China, but were later abandoned due to siltation were analyzed. A total of 476 human cases of murine typhus were reported during 2000–2014 in the main island of Taiwan, with spatial clustering in districts in southwest and central-west Taiwan. A higher incidence rate (case/population) was associated with a smaller distance to currently in-use international seaports and lower rainfall and temperature, but was uncorrelated with distance to abandoned ports. Geographically weighted regression revealed a geographic heterogeneity in the importance of distance to in-use seaports near the four international seaports of Taiwan. Conclusions/Significance Our study suggests that murine typhus is associated with international seaports, especially for those with large trading volume. Thus, one of the costs of global trade in Taiwan might be elevated risks of murine typhus. Globalization has accelerated the spread of infectious diseases, but the burden of disease varies geographically, with regions surrounding major international seaports warranting particular surveillance. PMID:28264003

77 FR 42764 - Certain Integrated Circuits, Chipsets, & Products Containing Same Including Televisions; Notice...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

..., imported by respondents MediaTek Inc. of Hsinchu City, Taiwan and Zoran Corporation of Sunnyvale, California. FOR FURTHER INFORMATION CONTACT: Megan M. Valentine, Office of the General Counsel, U.S... 20436, telephone (202) 205-2000. General information concerning the Commission may also be obtained by...

Factors influencing the mammography utilization among Taiwanese women with intellectual disabilities, a nationwide population-based study.

PubMed

Lai, Hsien-Tang; Kung, Pei-Tseng; Tsai, Wen-Chen

2014-12-01

Women with intellectual disabilities (ID) have cognitive impairment and communication difficulties; for both caregivers and clinical personnel, discovering the early symptoms of breast cancer among women with ID is challenging. The mammography utilization rate of women with ID was significantly lower than that of women in the general population. This study employed a 2008 database of people with disabilities in Taiwan as a research target and analyzed the mammography utilization rate of women with ID aged 50–69 years. In addition, relevant factors influencing mammography utilization among women with ID were also investigated. A total of 4370 participants were recruited and the majority were illiterate or had elementary-level educations (82.27%). The majority of the participants had ID that was more severe than mild (83.80%). The mammography utilization rate of women with ID was 4.32%, which was significantly lower than that of women in the general population (12%). The mammography utilization rate among women with ID who were married, had higher education levels, and had been diagnosed with cancer, diabetes, or mild ID was significantly higher. However, the mammography utilization rate among women with ID, who had elementary-level educations or were illiterate, was only 4.03%. The utilization rate among women with profound ID was only 2.65%. Women with ID who had undergone pap smears or had utilized adult preventive health services demonstrated a significantly higher mammography utilization rate. This study identified that education level, a diagnosis of diabetes, and the application of pap smears or adult preventive health services were primary factors that influenced the mammography utilization rate among women with ID. This study also observed that in Taiwan, the mammography utilization rate of women with ID was lower than that of pap smears and adult preventive health services, and was only half of that of people with disabilities. An unequal situation existed in regard to the acceptance of breast cancer screening among women with ID, and a different form of strategic planning must be adopted in public health policy. Because ID differs from other disabilities and most women with ID are illiterate, tailored courses are required to train primary caregivers and clinical personnel in providing knowledge and services. The objectives are to diagnose breast cancer at an early stage to decrease the risk of mortality and ensure their rights to health.

The association between continuous positive airway pressure therapy and liver disease development in obstructive sleep apnea/hypopnea syndrome patients: a nationwide population-based cohort study in Taiwan.

PubMed

Hang, Liang-Wen; Chen, Chi-Fung; Wang, Chang-Bi; Wu, Trong-Neng; Liang, Wen-Miin; Chou, Tzu-Chieh

2017-05-01

Studies on the association between continuous positive airway pressure (CPAP) treatment and liver diseases such as non-alcoholic fatty liver disease (NAFLD) and cirrhosis in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) are limited. To the best of our knowledge, none exists that makes use of a national database in an Asian population. This study aims to evaluate the effects of CPAP treatment on patients with these two disorders in a retrospective, population-based study in Taiwan. Using the Taiwan National Health Insurance claims database, this study collected the data of OSAHS patients diagnosed between 2000 and 2008 and divided them into CPAP treatment and non-CPAP treatment groups. All subjects were followed up until 2010. Liver disease incidence and risk were calculated. The CPAP group had a lower cumulative incidence rate of developing liver disease than the non-CPAP group within the observation periods (p < 0.001). After adjusting for age, gender, urbanization level, and comorbidities, the CPAP treatment group showed a lower risk of developing liver disease compared with the non-CPAP treatment group (sub-aHR of 0.66 (95% CI 0.55-0.80), p < 0.001). Our observations suggest that CPAP treatment may play an important role to delay the progression of liver disease in OSAHS patients and decreases the incidence of liver disease among OSAHS patients. Thus, CPAP therapy may be a feasible way to decrease the risk of liver disease among patients with OSAHS.

Infective Endocarditis and Cancer Risk: A Population-Based Cohort Study.

PubMed

Sun, Li-Min; Wu, Jung-Nan; Lin, Cheng-Li; Day, Jen-Der; Liang, Ji-An; Liou, Li-Ren; Kao, Chia-Hung

2016-03-01

This study investigated the possible relationship between endocarditis and overall and individual cancer risk among study participants in Taiwan.We used data from the National Health Insurance program of Taiwan to conduct a population-based, observational, and retrospective cohort study. The case group consisted of 14,534 patients who were diagnosed with endocarditis between January 1, 2000 and December 31, 2010. For the control group, 4 patients without endocarditis were frequency matched to each endocarditis patient according to age, sex, and index year. Competing risks regression analysis was conducted to determine the effect of endocarditis on cancer risk.A large difference was noted in Charlson comorbidity index between endocarditis and nonendocarditis patients. In patients with endocarditis, the risk for developing overall cancer was significant and 119% higher than in patients without endocarditis (adjusted subhazard ratio = 2.19, 95% confidence interval = 1.98-2.42). Regarding individual cancers, in addition to head and neck, uterus, female breast and hematological malignancies, the risks of developing colorectal cancer, and some digestive tract cancers were significantly higher. Additional analyses determined that the association of cancer with endocarditis is stronger within the 1st 5 years after endocarditis diagnosis.This population-based cohort study found that patients with endocarditis are at a higher risk for colorectal cancer and other cancers in Taiwan. The risk was even higher within the 1st 5 years after endocarditis diagnosis. It suggested that endocarditis is an early marker of colorectal cancer and other cancers. The underlying mechanisms must still be explored and may account for a shared risk factor of infection in both endocarditis and malignancy.

Importance-satisfaction analysis of street food sanitation and choice factor in Korea and Taiwan.

PubMed

Joo, Nami; Park, Sanghyun; Lee, Bohee; Yoon, Jiyoung

2015-06-01

The present study investigated Korean and Taiwan adults on the importance of and the satisfaction with street food sanitation and street food choice factor, in order to present management and improvement measures for street foods. The present study conducted a survey on 400 randomly chosen adults (200 Korean, 200 Taiwanese). General characteristics, eating habits, street food intake frequency, and preference by type of street food of respondents were checked. Respondents' importance and satisfaction of street food hygiene and selection attributes were also measured. In order to test for the difference between groups, χ(2)-test and t-test were performed. ISA was also performed to analyze importance and satisfaction. Results showed that the importance of sanitation was significantly higher than satisfaction on all items in both Korea and Taiwan, and the satisfaction with sanitation was higher in Taiwan than in Korea. According to ISA results with street food sanitation, satisfaction was low while importance was high in both Korea and Taiwan. In terms of street food choice factor, importance scores were significantly higher than satisfaction scores on all items. In addition, satisfaction scores on all items except 'taste' were significantly higher in Taiwan than in Korea. A manual on sanitation management of street foods should be developed to change the knowledge and attitude toward sanitation by putting into practice a regularly conducted education. Considering the popularity of street foods and its potential as a tourism resource to easily publicize our food culture, thorough management measures should be prepared on sanitation so that safe street food culture should be created.

The Contribution of Matrix Metalloproteinase-1 Promoter Genotypes in Taiwan Lung Cancer Risk.

PubMed

Shen, Te-Chun; Chang, Wen-Shin; Tsai, Chia-Wen; Chao, Che-Yi; Lin, Yi-Ting; Hsiao, Chieh-Lun; Hsu, Che-Lun; Chen, Wei-Chun; Hsia, Te-Chun; Bau, DA-Tian

2018-01-01

Up-regulation of metallo-proteinase (MMP) proteins has been shown in various types of solid cancers and the genotype of MMP1 has been associated with the risk of solid cancers. The contribution of MMP1 genotype to lung cancer has been investigated in various countries, though, to our knowledge, not in Taiwan. Therefore, in this study, we focused on the contribution of a polymorphism in the promoter region of MMP1 to lung cancer risk in Taiwan population. Genomic DNA was isolated from peripheral blood of 358 patients with lung cancer and 716 healthy individuals (non-cancer patients). MMP1 rs1799750 polymorphic genotypes of each sample were determined using the typical methodology of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The percentages of 2G/2G, 1G/2G, and 1G/1G for MMP1 -1607 genotypes were 34.4%, 41.3% and 24.3% in the disease group and 33.9%, 44.0%, and 22.1% in the control group (p trend=0.6298), respectively. The results of carrier comparisons in dominant and recessive models also support the findings that 1G or 2G appears not to be a determinant allelic biomarker for Taiwan lung cancer. The MMP1 -1607 1G allele is a non-significant protective biomarker for lung cancer in Taiwan. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Short-term population-based non-linear concentration-response associations between fine particulate matter and respiratory diseases in Taipei (Taiwan): a spatiotemporal analysis.

PubMed

Yu, Hwa-Lung; Chien, Lung-Chang

2016-01-01

Fine particulate matter <2.5 μm (PM2.5) has been associated with human health issues; however, findings regarding the influence of PM2.5 on respiratory disease remain inconsistent. The short-term, population-based association between the respiratory clinic visits of children and PM2.5 exposure levels were investigated by considering both the spatiotemporal distributions of ambient pollution and clinic visit data. We applied a spatiotemporal structured additive regression model to examine the concentration-response (C-R) association between children's respiratory clinic visits and PM2.5 concentrations. This analysis was separately performed on three respiratory disease categories that were selected from the Taiwanese National Health Insurance database, which includes 41 districts in the Taipei area of Taiwan from 2005 to 2007. The findings reveal a non-linear C-R pattern of PM2.5, particularly in acute respiratory infections. However, a PM2.5 increase at relatively lower levels can elevate the same-day respiratory health risks of both preschool children (<6 years old) and schoolchildren (6-14 years old). In preschool children, same-day health risks rise when concentrations increase from 0.76 to 7.44 μg/m(3), and in schoolchildren, same-day health risks rise when concentrations increase from 0.76 to 7.52 μg/m(3). Changes in PM2.5 levels generally exhibited no significant association with same-day respiratory risks, except in instances where PM2.5 levels are extremely high, and these occurrences do exhibit a significant positive influence on respiratory health that is especially notable in schoolchildren. A significant high relative rate of respiratory clinic visits are concentrated in highly populated areas. We highlight the non-linearity of the respiratory health effects of PM2.5 on children to investigate this population-based association. The C-R relationship in this study can provide a highly valuable alternative for assessing the effects of ambient air pollution on human health.

Medical expenditure and family satisfaction between hospice and general care in terminal cancer patients in Taiwan.

PubMed

Lin, Wen-Yuan; Chiu, Tai-Yuan; Hsu, Hua-Shai; Davidson, Lance E; Lin, Tsann; Cheng, Kao-Chi; Chiu, Chang-Fang; Li, Chia-Ing; Chiu, Yi-Wen; Lin, Cheng-Chieh; Liu, Chiu-Shong

2009-10-01

As the number of terminal cancer patients increases, several care models have been adopted to provide better care quality and reduce medical expenditure. This study compared inpatient medical expenditure and family satisfaction in a hospice ward (HW) and general ward (GW) for terminal cancer patients in Taiwan. We enrolled terminal cancer patients who were admitted and died during the same admission period in a tertiary care hospital in Taiwan from January 2003 to December 2005. These patients were allocated into three groups: inpatient care in HW alone; inpatient care in GW alone; and inpatient care in mixed group (initially in GW, then transferred to HW). Inpatient medical expenditure and family satisfaction were compared between the three groups. A total of 1942 patients were recruited and allocated into HW (n = 292), GW (n = 1511) and mixed (n = 139) groups. The average medical expenditure per person or per inpatient day was lower in the HW than the GW or mixed group. Subjects who had ever been admitted to the intensive care unit or received cardiopulmonary resuscitation in the GW or mixed groups required more expenditure on medical care than that in the HW group. Daily medical expenditure in the HW group also was much lower than that in the GW and mixed groups, based on length of stay and cancer type. The family satisfaction score was significantly higher in the mixed and/or HW group than the GW group. For terminal cancer patients, hospice care can improve family satisfaction while reducing medical expenditure in Taiwan.

Trends in the prevalence of periodontitis in Taiwan from 1997 to 2013

PubMed Central

Yu, Hui-Chieh; Su, Ni-Yu; Huang, Jing-Yang; Lee, Shiuan-Shinn; Chang, Yu-Chao

2017-01-01

Abstract Periodontitis is one of the most prevalent oral diseases. In this study, we probed the nationwide registered database to assess the time trends of prevalence of periodontitis in Taiwan. A retrospective study was conducted to analyze the registered database compiled by the National Health Insurance provided by the Department of Health, Taiwan, from 1997 to December 2013. We found that the prevalence of periodontitis significantly increased from 11.5% in 1997 to 19.59% in 2013 (P for trend < .0001). The mean age ± standard deviation with periodontitis from 1997 to 2013 was 54.46 ± 14.47 and 45.51 ± 16.58 years old, respectively. The proportion of individuals with periodontitis in age group >65 years old decreased markedly. The proportion of individuals with periodontitis in age groups <25 and 26 to 35 years old demonstrated an increased pattern. Compared to the reference cohort of 1953 to 1957, the recent birth cohort of 1993 to 1997 revealed the highest relative risk (RR) of periodontitis (male: RR, 67.42, 95% confidence interval [CI], 17.04–266.76; female: RR, 65.85, 95% CI, 16.70–259.70). Both male and female groups showed the similar age-effect pattern in the cross-sectional age curve from age–period–cohort model. There was an upturn with advancing age up to 40 to 50 years old and then a downward trend in both genders. Population dwelling in suburban area (RR, 0.95; 95% CI, 0.94–0.97) and rural area (RR, 0.97; 95% CI, 0.95–0.99) had the lower risk of periodontitis than those who lived in urban area. The higher income group revealed the higher risk of periodontitis compared with lower income group (RR, 1.20; 95% CI, 1.18–1.23). The prevalence of periodontitis significantly increased in Taiwan over past 17 years. The mean age with periodontitis was shown in a decreased pattern. The use of a nationwide population-based database could provide sufficient sample size, generalizability, and statistical power to assess the periodontal status in Taiwan. PMID:29137082

Interpersonal-psychological theory and parental bonding predict suicidal ideation among soldiers in Taiwan.

PubMed

Huang, Kai-Cheng; Tzeng, Dong-Sheng; Lin, Chi-Hung; Chung, Wei-Ching

2017-03-01

Suicide is an important issue among military personnel, who have higher suicide rates compared with the general population. The interpersonal-psychological theory of suicide (IPTS) might provide an empirical explanation of this phenomenon, and parental bonding influences social adjustment and suicide. To investigate the relevance of IPTS and parental bonding for suicide among Taiwanese soldiers, a case-control study was conducted. Using a suicide-reporting system in a teaching general hospital in Southern Taiwan, 226 at-risk maladjusted soldiers and 229 well-adjusted controls were enrolled. We collected basic information, and participants answered four IPTS-based questions. Suicide risk was assessed using the Brief Symptom Rating Scale item 6. A four-factor model of the Parental Bonding Instrument assessed parental bonding. All participants were interviewed using the Mini International Neuropsychiatric Interview for primary screening and to recheck the accuracy of the Brief Symptom Rating Scale item 6 score. A parsimonious model obtained by regression analysis of risk factors indicated that poor academic performance, conduct-related issues in childhood, and exposure to life-threatening situations are risk factors for suicide intention. Maladjusted suicidal soldiers showed a sense of thwarted belongingness (β = 0.145; P < 0.001), higher perceived burdensomeness (β = 0.311; P < 0.001), less fear of death (β = 0.124; P < 0.05), lower paternal autonomy (β = -0.122; P < 0.05), and higher maternal indifference (β = 0.162; P < 0.0001). Interpersonal-psychological theory of suicide, accompanied by an assessment of parental bonding, could be used for assessing suicide risk and preventing suicide attempts. © 2016 John Wiley & Sons Australia, Ltd.

Soundscape in the sustainable living environment: A cross-cultural comparison between the UK and Taiwan.

PubMed

Yu, Chia-Jen; Kang, Jian

2014-06-01

This study examines the effects of cultural factors on the evaluation of acoustic quality of residential areas, within the context of general environmental conditions. A comparative study was carried out between the UK and Taiwan, through questionnaire surveys at three stages, namely in selected residential areas, with respondents in their place of work/study, and using a web-based survey, respectively. This study reveals the importance of considering cultural factors, as well as their living experiences. This is reflected by the significant differences between the two cultures in a number of aspects, including choosing and evaluating living environment, noise noticeability, annoyance and sleep disturbance, activities, and sound preference. It is interesting to note the factor 'quiet' is an important consideration compared to other factors, in both the UK and Taiwan. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

Impact of universal health coverage on urban–rural inequity in psychiatric service utilisation for patients with first admission for psychosis: a 10-year nationwide population-based study in Taiwan

PubMed Central

Chiang, Chih-Lin; Chen, Pei-Chun; Huang, Ling-Ya; Kuo, Po-Hsiu; Tung, Yu-Chi; Liu, Chen-Chung; Chen, Wei J

2016-01-01

Objective To examine the disparities in psychiatric service utilisation over a 10-year period for patients with first admission for psychosis in relation to urban–rural residence following the implementation of universal health coverage in Taiwan. Design Population-based retrospective cohort study. Setting Taiwan's National Health Insurance Research Database, which has a population coverage rate of over 99% and contains all medical claim records of a nationwide cohort of patients with at least one psychiatric admission between 1996 and 2007. Participants 69 690 patients aged 15–59 years with first admission between 1998 and 2007 for any psychotic disorder. Main exposure measure Patients’ urban–rural residence at first admissions. Main outcome measures Absolute and relative inequality indexes of the following quality indicators after discharge from the first admission: all-cause psychiatric readmission at 2 and 4 years, dropout of psychiatric outpatient service at 30 days, and emergency department (ED) treat-and-release encounter at 30 days. Results Between 1998 and 2007, the 4-year readmission rate decreased from 65% to 58%, the 30-day dropout rate decreased from 18% to 15%, and the 30-day ED encounter rate increased from 8% to 10%. Risk of readmission has significantly decreased in rural and urban patients, but at a slower speed for the rural patients (p=0.026). The adjusted HR of readmission in rural versus urban patients has increased from 1.00 (95% CI 0.96 to 1.04) in 1998–2000 to 1.08 (95% CI 1.03 to 1.12) in 2005–2007, indicating a mild widening of the urban–rural gap. Urban–rural differences in 30-day dropout and ED encounter rates have been stationary over time. Conclusions The universal health coverage in Taiwan did not narrow urban–rural inequity of psychiatric service utilisation in patients with psychosis. Therefore, other policy interventions on resource allocation, service delivery and quality of care are needed to improve the outcome of rural-dwelling patients with psychosis. PMID:26940114

Generalized Trust and Trust in Institutions in Confucian Asia

ERIC Educational Resources Information Center

Tan, Soo Jiuan; Tambyah, Siok Kuan

2011-01-01

This study examines generalized trust and trust in institutions in Confucian Asia, covering six countries namely, China, Japan, Singapore, South Korea, Taiwan and Vietnam, and one dependent region, Hong Kong. Using data from the 2006 AsiaBarometer Survey, our study affirms the reliability and validity of using a two-item scale to measure…

Effort-reward imbalance and quality of life of healthcare workers in military hospitals: a cross-sectional study.

PubMed

Tzeng, Dong-Sheng; Chung, Wei-Ching; Lin, Chi-Hung; Yang, Chun-Yuh

2012-09-08

Taiwan's National Defense Bureau has been merging its hospitals and adjusting hospital accreditation levels since the beginning of 2006. These changes have introduced many stressors to the healthcare workers in these hospitals. This study investigates the association between job stress, psychological morbidity and quality of life in healthcare workers in three military hospitals. We posted surveys to 1269 healthcare workers in three military hospitals located in southern Taiwan. The surveys included the General Health Questionnaire (GHQ), the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), and the Effort-Reward Imbalance (ERI) Questionnaire. High effort-reward (ER) ratio and overcommitment were defined when scores fell into the upper tertile of the total distribution. The survey was completed by 791 healthcare workers. On average, women reported a higher ERI than men. High ERI was associated with younger age, higher psychological morbidity, and poor physical and psychological QOL domains in this population. High ER ratio and high overcommitment were associated with psychological morbidity and poor QOL in both sexes. However, high ER ratio was not significantly associated with the social QOL domain in either sexes or the physical QOL domain in males. There was a clear association between ERI and QOL in the healthcare workers in the military hospitals under reorganization and accreditation in this study. We found ER ratio and overcommitment to be suitable indicators of job stress.

Conservation of the Eastern Taiwan Strait Chinese White Dolphin (Sousa chinensis): Fishers' Perspectives and Management Implications.

PubMed

Liu, Ta-Kang; Wang, Yu-Cheng; Chuang, Laurence Zsu-Hsin; Chen, Chih-How

2016-01-01

The abundance of the eastern Taiwan Strait (ETS) population of the Chinese white dolphin (Sousa chinensis) has been estimated to be less than 100 individuals. It is categorized as critically endangered in the IUCN Red List of Threatened Species. Thus, immediate measures of conservation should be taken to protect it from extinction. Currently, the Taiwanese government plans to designate its habitat as a Major Wildlife Habitat (MWH), a type of marine protected area (MPA) for conservation of wildlife species. Although the designation allows continuing the current exploitation, however, it may cause conflicts among multiple stakeholders with competing interests. The study is to explore the attitude and opinions among the stakeholders in order to better manage the MPA. This study employs a semi-structured interview and a questionnaire survey of local fishers. Results from interviews indicated that the subsistence of fishers remains a major problem. It was found that stakeholders have different perceptions of the fishers' attitude towards conservation and also thought that the fishery-related law enforcement could be difficult. Quantitative survey showed that fishers are generally positive towards the conservation of the Chinese white dolphin but are less willing to participate in the planning process. Most fishers considered temporary fishing closure as feasible for conservation. The results of this study provide recommendations for future efforts towards the goal of better conservation for this endangered species.

Birth Trends among Female Physicians in Taiwan: A Nationwide Survey from 1996 to 2013

PubMed Central

Wang, Yi-Jen; Chiang, Shu-Chiung; Chen, Tzeng-Ji; Chou, Li-Fang; Hwang, Shinn-Jang; Liu, Jui-Yao

2017-01-01

Background: Although more and more women are becoming physicians, their decisions regarding pregnancy may be affected by the lengthy period of medical education and postgraduate training. The aim of this study was to explore the birth trends among female physicians in Taiwan; Methods: Retrospective analyses of maternal ages at delivery from 1996 to 2013, both for physicians and the general population, were conducted using a nationwide dataset called National Health Insurance Research Database; Results: During the study period, 8540 female physicians were identified. The physicians delivered a total of 4940 births in that time, with a rise from 210 in 1996 to 440 in 2013. In addition, the mean maternal age of the physicians at delivery increased from 32.19 years (standard deviations (SD) 2.80) in 1996 to 33.61 (SD 3.21) in 2013, values significantly higher than those for non-physicians of 27.81 (SD 4.74) in 1996 (p < 0.001) and 31.36 (SD 4.78) in 2013 (p < 0.001); Conclusion: Female physicians usually gave birth at an older age than non-physicians, but the discrepancy between the two groups gradually declined over the 18-year course of the study. The establishment of a maternity-friendly environment for female physicians should be considered by those who determine healthcare system policies. PMID:28698490

Unravelling the effects of age, period and cohort on metabolic syndrome components in a Taiwanese population using partial least squares regression

PubMed Central

2011-01-01

Background We investigate whether the changing environment caused by rapid economic growth yielded differential effects for successive Taiwanese generations on 8 components of metabolic syndrome (MetS): body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), triglycerides (TG), high-density lipoprotein (HDL), Low-density lipoproteins (LDL) and uric acid (UA). Methods To assess the impact of age, birth year and year of examination on MetS components, we used partial least squares regression to analyze data collected by Mei-Jaw clinics in Taiwan in years 1996 and 2006. Confounders, such as the number of years in formal education, alcohol intake, smoking history status, and betel-nut chewing were adjusted for. Results As the age of individuals increased, the values of components generally increased except for UA. Men born after 1970 had lower FPG, lower BMI, lower DBP, lower TG, Lower LDL and greater HDL; women born after 1970 had lower BMI, lower DBP, lower TG, Lower LDL and greater HDL and UA. There is a similar pattern between the trend in levels of metabolic syndrome components against birth year of birth and economic growth in Taiwan. Conclusions We found cohort effects in some MetS components, suggesting associations between the changing environment and health outcomes in later life. This ecological association is worthy of further investigation. PMID:21619595

Conservation of the Eastern Taiwan Strait Chinese White Dolphin (Sousa chinensis): Fishers' Perspectives and Management Implications

PubMed Central

Liu, Ta-Kang; Wang, Yu-Cheng; Chuang, Laurence Zsu-Hsin; Chen, Chih-How

2016-01-01

The abundance of the eastern Taiwan Strait (ETS) population of the Chinese white dolphin (Sousa chinensis) has been estimated to be less than 100 individuals. It is categorized as critically endangered in the IUCN Red List of Threatened Species. Thus, immediate measures of conservation should be taken to protect it from extinction. Currently, the Taiwanese government plans to designate its habitat as a Major Wildlife Habitat (MWH), a type of marine protected area (MPA) for conservation of wildlife species. Although the designation allows continuing the current exploitation, however, it may cause conflicts among multiple stakeholders with competing interests. The study is to explore the attitude and opinions among the stakeholders in order to better manage the MPA. This study employs a semi-structured interview and a questionnaire survey of local fishers. Results from interviews indicated that the subsistence of fishers remains a major problem. It was found that stakeholders have different perceptions of the fishers’ attitude towards conservation and also thought that the fishery-related law enforcement could be difficult. Quantitative survey showed that fishers are generally positive towards the conservation of the Chinese white dolphin but are less willing to participate in the planning process. Most fishers considered temporary fishing closure as feasible for conservation. The results of this study provide recommendations for future efforts towards the goal of better conservation for this endangered species. PMID:27526102

East Asia Review, 1973. To sum up.

PubMed

Keeny, S M

1974-05-01

Observations are made related to the review of family planning activities in East Asia in 1973. The number of new acceptors for the region increased from 2.7 million in 1972 to 3.4 million in 1973. The leaders were Indonesia, which almost doubled its achievement of calendar year 1972, the Philippines, and Korea. In Thailand, the number of new acceptors dropped by about 10%. South Vietnam is the only country in the region without an official policy. Most couples still think that the ideal number of children is 4, with at least 2 sons. Some religious opposition does exist, particularly with reference to sterlization and abortion. More attention is being paid to women in their 20s. Sterilization and condoms are becoming more popular. Korea reports a sharp increase in vasectomies. Better methods and continuation rates should be stressed. In Taiwan a couple who start with 1 method and continue to practice some method lower their reproduction rate by 80%. More responsibility is being delegated to nurses and midwives, but too slowly. In Indonesia, the number of field workers rose from 3774 in 1972 to 6275 in 1973. The Philippines and Thailand are experimenting to see what kind of workers get best results and under what kind of salary and incentive arrangements. In-service training tends to be neglected, but preservice training is improving. Costs, in general, have risen, though in Korea the cost per acceptor has dropped from US$8.00 to US$7.80. Korea and Taiwan have reduced their annual population growth rates by more than 1/3 in 10 years, from 30 to 19-20 per 1000 each. Singapore's rate is 17 and Hong Kong's 14 (exclusive of inmigration). The number of couples currently practicing contraception in Singapore is 71%. Target systems assigning quotas to clinics are generally used except in Thailand and Malaysia, where programs emphasize maternal and child health, rather than population planning. Most programs require about 10 years to get the annual growth rate down to 2% by voluntary family planning. To get it down to 1.5% will probably take another 10 years.

Inferring Multiple Refugia and Phylogeographical Patterns in Pinus massoniana Based on Nucleotide Sequence Variation and DNA Fingerprinting

PubMed Central

Lin, Chung-Jian; Huang, Chi-Chung; Huang, Chao-Ching; Chiang, Yu-Chung; Chiang, Tzen-Yuh

2012-01-01

Background Pinus massoniana, an ecologically and economically important conifer, is widespread across central and southern mainland China and Taiwan. In this study, we tested the central–marginal paradigm that predicts that the marginal populations tend to be less polymorphic than the central ones in their genetic composition, and examined a founders' effect in the island population. Methodology/Principal Findings We examined the phylogeography and population structuring of the P. massoniana based on nucleotide sequences of cpDNA atpB-rbcL intergenic spacer, intron regions of the AdhC2 locus, and microsatellite fingerprints. SAMOVA analysis of nucleotide sequences indicated that most genetic variants resided among geographical regions. High levels of genetic diversity in the marginal populations in the south region, a pattern seemingly contradicting the central–marginal paradigm, and the fixation of private haplotypes in most populations indicate that multiple refugia may have existed over the glacial maxima. STRUCTURE analyses on microsatellites revealed that genetic structure of mainland populations was mediated with recent genetic exchanges mostly via pollen flow, and that the genetic composition in east region was intermixed between south and west regions, a pattern likely shaped by gene introgression and maintenance of ancestral polymorphisms. As expected, the small island population in Taiwan was genetically differentiated from mainland populations. Conclusions/Significance The marginal populations in south region possessed divergent gene pools, suggesting that the past glaciations might have low impacts on these populations at low latitudes. Estimates of ancestral population sizes interestingly reflect a recent expansion in mainland from a rather smaller population, a pattern that seemingly agrees with the pollen record. PMID:22952747

Smoking-related changes or brand switching? Smokers' anticipated responses to a large increase in Taiwan's Tobacco Health and Welfare Surcharge.

PubMed

Yeh, C-Y; Schafferer, C; Lee, J-M; Hsieh, C-J

2016-07-01

This study examines the impact on smokers' behaviour of a planned increase in the Health and Welfare Surcharge of Tobacco Products in Taiwan. This study used a structured questionnaire to perform telephone interviews. Stratified random sampling was applied to interview current smokers aged 18-65 years in Taiwan. Based on nationwide survey data of smokers' responses to future increases in cigarette prices, this study used multinomial logistic regression to perform its analyses. After the proposed increase in the Health and Welfare Surcharge of Tobacco Products, subsequent cigarette price increases would motivate nearly 30% of the smokers to adopt smoking-related changes and 10% to change to lower-priced brands. The study suggests that a large increase in the Health and Welfare Surcharge of Tobacco Products would lead to considerable changes in smoking behaviour, which in turn would increase cessation rate at the population level. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Taiwan's transition from high fertility to below-replacement levels.

PubMed

Freedman, R; Chang, M C; Sun, T H

1994-01-01

This article compares the fertility experience of Taiwanese in the eight years since the total fertility rate reached 2.1 with that before fertility reached replacement levels. During the earlier period, two-thirds of the fertility decline resulted from falling marital fertility and one-third from higher age at marriage. The changing age distribution retarded this decline. Since 1983, the further decline to 1.7-1.8 has been entirely the result of the trend toward later marriage. Older age distributions now facilitate the decline. Births postponed by those marrying later make the conventional TFR misleading. Computation based on parity-progression ratios raise TFRs from 1.7 to 2.0, a number less alarming to policymakers. Contraceptive prevalence is at saturation levels in all major populations strata. The "KAP-GAP" has disappeared. What would have happened without Taiwan's effective family planning program is impossible to determine, but clearly, contraceptive services supplied by the program were the major proximate cause of Taiwan's fertility decline.

Estimation and projection of nitrous oxide (N2O) emissions from anthropogenic sources in Taiwan.

PubMed

Tsai, Wen-Tien; Chyan, Jih-Ming

2006-03-01

Taiwan is a densely populated and developed country with more than 97% of energy consumption supplied by imported fuels. Greenhouse gas emissions are thus becoming significant environmental issues in the country. Using the Intergovernmental Panel on Climate Change (IPCC) recommended methodologies, anthropogenic emissions of nitrous oxide (N2O) in Taiwan during 2000-2003 were estimated to be around 41 thousand metric tons annually. About 87% of N2O emissions come from agriculture, 7% from the energy sector, 3% from industrial processes sector, 3% from waste sector. On the basis of N2O emissions in 2000, projections for the year 2010 show that emissions were estimated to decline by about 6% mainly due to agricultural changes in response to the entry of WTO in 2002. In contrast to projections for the year 2020, N2O emissions were projected to grow by about 17%. This is based on the reasonable scenario that a new adipic acid/nitric acid plant will be probably started after 2010.

[The education and training of manpower in elderly & long-term care].

PubMed

Chen, Huey-Tzy

2008-08-01

With the rapid expansion of the aged population, elderly & long-term care has become a significant issue in Taiwan, as in many developed countries, such as Japan. Service resources in long-term care have benefitted profoundly from investment and development in the past 15 years in Taiwan, but the education and training of manpower in long-term care has only recently begun to be addressed. The purpose of this article is to describe the education and training of nursing manpower in long-term care in Taiwan and in other countries. Three recommendations are also made: (1) To integrate Gerontology Nursing & Practicum into the nursing curriculum to cultivate nursing students with competency in providing direct care and competency in accountability. (2) To prepare RN-BSN students with secondary competency in management/information & communication/activities design. (3) To incorporate faculty from across disciplines in the running of gerontology & long-term care programs in order to develop students' competency in transdisciplinary team work.

Historical connectivity, contemporary isolation and local adaptation in a widespread but discontinuously distributed species endemic to Taiwan, Rhododendron oldhamii (Ericaceae)

PubMed Central

Hsieh, Y-C; Chung, J-D; Wang, C-N; Chang, C-T; Chen, C-Y; Hwang, S-Y

2013-01-01

Elucidation of the evolutionary processes that constrain or facilitate adaptive divergence is a central goal in evolutionary biology, especially in non-model organisms. We tested whether changes in dynamics of gene flow (historical vs contemporary) caused population isolation and examined local adaptation in response to environmental selective forces in fragmented Rhododendron oldhamii populations. Variation in 26 expressed sequence tag-simple sequence repeat loci from 18 populations in Taiwan was investigated by examining patterns of genetic diversity, inbreeding, geographic structure, recent bottlenecks, and historical and contemporary gene flow. Selection associated with environmental variables was also examined. Bayesian clustering analysis revealed four regional population groups of north, central, south and southeast with significant genetic differentiation. Historical bottlenecks beginning 9168–13,092 years ago and ending 1584–3504 years ago were revealed by estimates using approximate Bayesian computation for all four regional samples analyzed. Recent migration within and across geographic regions was limited. However, major dispersal sources were found within geographic regions. Altitudinal clines of allelic frequencies of environmentally associated positively selected outliers were found, indicating adaptive divergence. Our results point to a transition from historical population connectivity toward contemporary population isolation and divergence on a regional scale. Spatial and temporal dispersal differences may have resulted in regional population divergence and local adaptation associated with environmental variables, which may have played roles as selective forces at a regional scale. PMID:23591517

Sedimentary archives of fire, vegetation history, and human impacts during the late Holocene in the eastern lowland of Taiwan

NASA Astrophysics Data System (ADS)

Wang, Liang-Chi

2017-04-01

The Hualien Plain is one of the richest prehistoric sites in eastern Taiwan, and the reconstruction of late Holocene environment on the basis of the lacustrine sediments near Hualien Plain can benefit to the understandings of human-climate-environment interactions in past. The multi-decadal records of vegetation history, agriculture evidences and fire events in Liyu Lake of eastern Taiwan were reconstructed by using palynological and charcoal analysis of lake sediments. A 2.8 m sediment core covering a time period from 2,680 cal BP to the present was used to investigate the alterations in the landscape with respect to human activities and climate change. During 2680-2410 cal yr BP, frequent burning and high preservation of cultivated Poaceae pollen indicated the early cultivation during the late Neolithic period. There followed a warm climate during 2,410-1,510 cal yr BP, and the increase of lowland forest pollen showed a period of forest recovery as a consequence of reducing human activity. Following a phase of recolonization of prehistory human during 1510-560 cal yr BP, a slightly increasing trend of cultivated Poacease indicated the human activities, but the human population was low. The last 560 years record showed an intense trend of deforestation and cultivation which may correlate to a rapid increase in the human population in this area.

Modifiable Lifestyle Behaviors Are Associated With Metabolic Syndrome in a Taiwanese Population.

PubMed

Lin, Kuei-Man; Chiou, Jeng-Yuan; Ko, Shu-Hua; Tan, Jung-Ying; Huang, Chien-Ning; Liao, Wen-Chun

2015-11-01

To explore associations between metabolic syndrome and modifiable lifestyle behaviors among the adult population in Taiwan. This cross-sectional study analyzed data from a nationally representative sample that participated in the 2005-2008 Nutrition and Health Survey in Taiwan. The sample (2,337 participants older than 19 years) provided data on demographic characteristics, modifiable lifestyle behaviors, anthropometric measurements, and blood chemistry panel. These data were analyzed by descriptive statistics, univariate logistic regression, and multivariate logistic regression to determine factors associated with metabolic syndrome. Metabolic syndrome had a prevalence of 25.2%, and this prevalence increased with age. In univariate regression analysis, metabolic syndrome was associated with age, living with family members, educational level, and modifiable lifestyle behaviors (smoking, drinking, betel quid chewing, and physical activity). Individuals with a smoking history and currently chewing betel quid had the highest risk for metabolic syndrome. The risk for metabolic syndrome might be reduced by public health campaigns to encourage people to quit smoking cigarettes and chewing betel quid. Implementing more modifiable lifestyle behaviors in daily life will decrease metabolic syndrome in Taiwan. Considering that betel quid chewing and tobacco smoking interact to adversely affect metabolic syndrome risk, public health campaigns against both behaviors seem to be a cost-effective and efficient health promotion strategy to reduce the prevalence rate of metabolic syndrome. © 2015 Sigma Theta Tau International.

Alcohol dependence, consumption of alcoholic energy drinks and associated work characteristics in the Taiwan working population.

PubMed

Cheng, Wan-Ju; Cheng, Yawen; Huang, Ming-Chyi; Chen, Chiou-Jong

2012-01-01

To examine the association between work characteristics and the risk of alcohol dependence across different employment types and occupations, including the pattern of alcohol consumption in the form of energy drinks and its association with alcohol dependence. A total of 13,501 men and 8584 women participated in a national survey in Taiwan. Alcohol dependence was defined as ≥2 points in the CAGE questionnaire. A self-administered questionnaire recorded drinking behaviors, consumption of alcoholic energy drinks, employment type, occupation and a number of psychosocial work stressors, namely job demands, job control, employment security and workplace justice. Of the total, 9.4% of men and 0.8% of women were CAGE-positive, and 6.0% of men and 0.7% of women regularly consumed alcoholic energy drinks. In male and female regular consumers of alcoholic energy drinks, 38.7 and 23.3%, respectively, were alcohol-dependent. Multivariate regression analyses showed that male employees in manual skilled occupations, with lower workplace justice, having weekly working hours <40 h and on piece-rated or time-based pay systems were at higher risks of alcohol dependence. Certain occupational groups and workers with adverse psychosocial work characteristics should be targets for prevention of alcohol dependence. Alcoholic energy drink consumption should be taken into consideration while studying alcohol dependence in the work population in Taiwan.

[Centennial retrospective on the evolution and development of the nursing practice environment in Taiwan].

PubMed

Lin, Shou-Ju; Huang, Lain-Hua

2014-08-01

The practice environment for nurses has seen tremendous change over the past century due to the dedication and trailblazing work of nursing pioneers. This article describes how the nursing practice environment in Taiwan has evolved over this period. References used include nursing narratives, hospital accreditation standards, standard operating procedures, workplace safety standards, and worksite-related values and expectations. The efforts of the professional nursing community to realize a positive practice environment are further discussed. Over this century of change, the only thing that has remained unchanged is the commitment of nurses to "treat patients as one's own family". In the current as well as the previous periods of manpower shortages in nursing, the nursing community has managed to turn crisis into opportunity by using the situation to enhance pay and benefits. Nursing professionalism is widely respected and recognized throughout Taiwan society. The rapidly changing needs of the 21st century in aspects such as the advancement of high technology, the rapid growth of the elderly population, and the fast rate of social change seriously impact the development of the nursing profession. How to effectively apply high technology, simplify workflows, provide high quality and humanistic nursing care, build safe and quality workplaces, attract bright nursing students, and provide healthcare for the entire population will remain the responsibilities of nursing for generations to come.

Enhancing Appropriate Social Behaviors for Children with Autism in General Education Classrooms: An Analysis of Six Cases

ERIC Educational Resources Information Center

Yang, Nancy Kueifen; Schaller, James L.; Huang, Tzu-Ai; Wang, Meei Huey; Tsai, Shu-Fei

2003-01-01

This study compares generalized effects of a social-emotional skills training for girls and boys with autism in resource rooms on promoting positive social behaviors in general education classrooms in Taiwan. A single subject design was used to compare outcomes for 2 girls and 2 boys with autism in the experimental group with 2 boys with autism in…

Suicide Reporting on Front Pages of Major Newspapers in Taiwan Violating Reporting Recommendations Between 2001 and 2012.

PubMed

Chiang, Yi-Chen; Chung, Fung-Yu; Lee, Chun-Yang; Shih, Huei-Lin; Lin, Dai-Chan; Lee, Ming-Been

2016-11-01

Media reporting can lead to the acceptance of incorrect ideas and information by the general public, which in turn can impact behavior. A number of studies have found that suicide reporting in the media can lead to an increase in the suicide rate or copycat suicides. Therefore, the aims of this study are to (a) investigate front-page reporting of suicide in four major newspapers in Taiwan; (b) investigate violation of recommendations for reporting suicide by the four major newspapers in Taiwan; and (c) investigate the impact of important events and government policy on front-page reporting of suicide (i.e., the effect of the Apple Daily newspaper entering the market, and the start of media monitoring). We carried out content analysis of reports of suicide on the front pages of the four newspapers with the highest rates of readership in Taiwan (China Times, Liberty Times, Apple Daily, and United Daily News) between 2001 and 2012. We used the chi-squared test, chi-squared test for trend, and analysis of variance to analyze trends in violation of reporting recommendations and potential associated factors. We found that (a) suicide was most commonly reported as a front-page headline and as a whole-page spread by the four major newspapers in Taiwan, with many reports including photographs; (b) reporting of suicide by the four major newspapers in Taiwan frequently violated World Health Organization (WHO) recommendations for suicide reporting in the media; (c) following the entry of the Apple Daily newspaper into the Taiwanese market, reporting approaches to suicide by the other three major newspapers changed to more sensational photos and texts; and (d) monitoring of suicide reporting by the Taiwan Suicide Prevention Center appears to have been only partially effective. In summary, reporting of suicide by the four major newspapers in Taiwan could be further improved. Effective regulation of suicide reporting by newspapers could reduce the impact of this reporting on readers. In addition, regular assessment of observance of the WHO recommendations for suicide reporting by newspapers is an important part of suicide prevention.

Redistributive effects of the National Health Insurance on physicians in Taiwan: a natural experiment time series study.

PubMed

Yang, Chiang-Hsing; Huang, Yu-Tung A; Hsueh, Ya-Seng A

2013-02-04

Previous studies have evaluated the effects of various health manpower policies but did not include full consideration of the effect of universal health insurance on physician re-distribution. This study examines the effects of implementing National Health Insurance (NHI) on the problem of geographic mal-distribution of health providers in Taiwan. Data on health providers and population between 1971 and 2001 are obtained from relevant governmental publications in Taiwan. Gini coefficients derived from the Lorenz curve are used under a spline regression model to examine the impact of the NHI on the geographic distribution of health providers. The geographic distribution equality of the three key health providers has improved significantly after the implementation of NHI program. After accounting for the influences of other confounding factors, Gini coefficients of the three key providers have a net reduction of 1.248% for dentists, 0.365% for western medicine physicians, and 0.311% for Chinese medicine physicians. Overall, the absolute values of the three key providers' Gini coefficients also become close to one another. This study found that NHI's offering universal health coverage to all citizens and with proper financial incentives have resulted in more equal geographic distributions among the key health care providers in Taiwan.

The incidence rate and mortality of malignant brain tumors after 10 years of intensive cell phone use in Taiwan.

PubMed

Hsu, Min-Huei; Syed-Abdul, Shabbir; Scholl, Jeremiah; Jian, Wen-Shan; Lee, Peisan; Iqbal, Usman; Li, Yu-Chuan

2013-11-01

The issue of whether cell phone usage can contribute toward the development of brain tumors has recently been reignited with the International Agency for Research on Cancer classifying radiofrequency electromagnetic fields as 'possibly' carcinogenic to humans in a WHO report. To our knowledge, this is the largest study reporting on the incidence and mortality of malignant brain tumors after long-term use of the cell phone by more than 23 million users. A population-based study was carried out the numbers of cell phone users were collected from the official statistics provided by the National Communication Commission. According to National Cancer Registry, there were 4 incidences and 4 deaths due to malignant neoplasms in Taiwan during the period 2000-2009. The 10 years of observational data show that the intensive user rate of cell phones has had no significant effect on the incidence rate or on the mortality of malignant brain tumors in Taiwan. In conclusion, we do not detect any correlation between the morbidity/mortality of malignant brain tumors and cell phone use in Taiwan. We thus urge international agencies to publish only confirmatory reports with more applicable conclusions in public. This will help spare the public from unnecessary worries.

Redistributive effects of the National Health Insurance on physicians in Taiwan: a natural experiment time series study

PubMed Central

2013-01-01

Background Previous studies have evaluated the effects of various health manpower policies but did not include full consideration of the effect of universal health insurance on physician re-distribution. This study examines the effects of implementing National Health Insurance (NHI) on the problem of geographic mal-distribution of health providers in Taiwan. Methods Data on health providers and population between 1971 and 2001 are obtained from relevant governmental publications in Taiwan. Gini coefficients derived from the Lorenz curve are used under a spline regression model to examine the impact of the NHI on the geographic distribution of health providers. Results The geographic distribution equality of the three key health providers has improved significantly after the implementation of NHI program. After accounting for the influences of other confounding factors, Gini coefficients of the three key providers have a net reduction of 1.248% for dentists, 0.365% for western medicine physicians, and 0.311% for Chinese medicine physicians. Overall, the absolute values of the three key providers’ Gini coefficients also become close to one another. Conclusions This study found that NHI’s offering universal health coverage to all citizens and with proper financial incentives have resulted in more equal geographic distributions among the key health care providers in Taiwan. PMID:23374629

Embracing diversity and transcultural society through community health practicum among college nursing students.

PubMed

Chang, Luna; Chen, Shu-Chuan; Hung, Shu-Ling

2018-05-19

Based on 2015 annual report of foreign spouse populations were above 507,266 people in Taiwan. Most of them (68%) came from Mainland China, 29% from south-east Asia. 92% of foreign spouses were female (2015). Therefore, a challenge arises for nursing students to provide care to clients with multiple cultural variations in Taiwan. The study objectives were to explore the related factors of cultural care competence and estimate the effects of a short-term reinforced cultural course. The study used a quasi-experimental design. All participants were investigated to measure that changed in cultural competence before and after the community practice period. Of 95 participants, 46 experimental group students engaged with 3 times workshops. The study was conducted from May to August in 2015 at Southern Taiwan. The study results showed a significantly improvement of transcultural nursing competence from comparing control group with experimental group by ANCOVA analysis (p < .05). The study approved that the cultural workshop along with the community health nursing practice curriculum might develop students' transcultural nursing competence. In the future, in order to providing cultural sensitively care, a sustained transcultural curriculum should be advocated at Nursing schools in Taiwan. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Petersen-Lincoln estimator and its extension to estimate the size of a shared population.

PubMed

Chao, Anne; Pan, H-Y; Chiang, Shu-Chuan

2008-12-01

The Petersen-Lincoln estimator has been used to estimate the size of a population in a single mark release experiment. However, the estimator is not valid when the capture sample and recapture sample are not independent. We provide an intuitive interpretation for "independence" between samples based on 2 x 2 categorical data formed by capture/non-capture in each of the two samples. From the interpretation, we review a general measure of "dependence" and quantify the correlation bias of the Petersen-Lincoln estimator when two types of dependences (local list dependence and heterogeneity of capture probability) exist. An important implication in the census undercount problem is that instead of using a post enumeration sample to assess the undercount of a census, one should conduct a prior enumeration sample to avoid correlation bias. We extend the Petersen-Lincoln method to the case of two populations. This new estimator of the size of the shared population is proposed and its variance is derived. We discuss a special case where the correlation bias of the proposed estimator due to dependence between samples vanishes. The proposed method is applied to a study of the relapse rate of illicit drug use in Taiwan. ((c) 2008 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim).

Fatal occupational injuries in Taiwan, 1994-2005.

PubMed

Ho, Shu-Chen; Wang, Li-Yu; Ho, Chi-Kung; Yang, Chun-Yuh

2010-04-01

This study examines the trends in rates of fatal occupational injuries in Taiwan by demographic group and occupation for 1994-2005. Data on deaths due to injuries at work from 1994 through 2005 were obtained from the Department of Health which is responsible for the death registration system in Taiwan. Employment data, which were used as the denominators of fatality rates in this study, were retrieved from the Directorate-General of Budget and Accounting Statistics 'Employment and Earnings' database. A Poisson regression model was used to examine the trends in rates of fatal occupational injuries in various occupations while controlling for demographic characteristics. Overall fatal occupational injury rates declined during the study period among all demographic groups and occupations. Adjusted annual changes in rates of fatal injuries ranged from a decrease of 13.6% a year in machine operators/related workers to a decrease of 35.9% in clerks. The annual decrement was faster for males than for females and for older workers compared to young workers. Despite declining rates, the number of fatal occupational injuries in Taiwan remains significant because of the growing work force. Future research should focus on the disparities in fatal injury trends.

Pn-waves Travel-time Anomaly beneath Taiwan from Dense Seismic Array Observations and its Possible Tectonic Implications

NASA Astrophysics Data System (ADS)

Lin, Y. Y.; Huang, B. S.; Ma, K. F.; Hsieh, M. C.

2015-12-01

We investigated travel times of Pn waves, which are of great important for understanding the Moho structure in Taiwan region. Although several high quality tomographic studies had been carried out, observations of Pn waves are still the most comprehensive way to elucidate the Moho structure. Mapping the Moho structure of Taiwan had been a challenging due to the small spatial dimension of Taiwan island with two subduction systems. To decipher the tectonic structure and understanding of earthquake hazard, the island of Taiwan have been implemented by several high density seismic stations, including 71 short-period stations of Central Weather Bureau Seismic Network (CWBSN) and 42 broardband stations of Broadband Array in Taiwan for Seismology (BATS). High quality seismic records of these stations would be used to identify precise Pn-wave arrival times. After station-elevation correction, we measure the difference between the observed and theoretical Pn arrivals from the IASPI 91 model for each station. For correcting uncertainties of earthquake location and origin time, we estimate relative Pn anomaly, ΔtPn , between each station and a reference station. The pattern of ΔtPn reflects the depth anomaly of Moho beneath Taiwan. In general, Pn waves are commonly observed from shallow earthquake at epicentral distance larger than 120 km. We search the global catalog since 2005 and the criteria are M > 5.5, focal depth < 30 km and epicentral distance > 150 km. The 12 medium earthquakes from north Luzon are considered for analysis. We choose a station, TWKB, in the most southern point of Taiwan as the reference station due to that all events are from the south. The results indicate obvious different patterns of ΔtPn from different back-azimuths. The ΔtPn pattern of the events in the first group from the south south-east indicates that the Pn arrivals delay suddenly when the Pn waves pass through the Central Range, suggesting the Moho becomes deep rapidly. However, we cannot recognize the same pattern when the events from due south in the second group. The ΔtPn pattern in the second group has a clear slow gradient from the south to north through Taiwan island. It may be relative to a smooth dipping structure of the Moho. Both ΔtPn patterns reveal large delays in northern Taiwan which may be related to the north subduction structure.

Oblique Northeastward Lateral Extrusion of a Crustal Block in North-central Taiwan: a Mechanism for Syn-tectonic Extension

NASA Astrophysics Data System (ADS)

Gourley, J. R.; Byrne, T.

2005-12-01

An integrated data set of earthquake locations (Taiwan's Central Weather Bureau), focal mechanisms from the Broadband Array of Taiwan Seismicity (BATS), GPS velocities and geologic data are combined to constrain the geometry and kinematics of a crustal block within the metamorphic basement of Taiwan's northeastern Central Range. The active block is bounded by two parallel seismic zones that accommodate uplift and northeastward oblique lateral extrusion. The western shear zone is a region that dips vertically to steeply west and projects generally to the western boundary between the Slate Belt and pre-Tertiary metamorphic basement. BATS focal mechanisms consistently show east-side-up, left-lateral normal displacements. Late-stage geologic structures published previously show left-lateral faulting followed by east-west extension. The eastern shear zone dips vertically to steeply west and projects to the eastern boundary of the metamorphic basement, which correlates with the eastern mountain front in this area. BATS focal mechanisms show west-side-up reverse displacements. The kinematics of these two zones define a crustal scale block that is interpreted to be moving up and northeast towards the Okinawa Trough. The extrusion of this crustal block may be driven in part by the topographic difference between the Central Range and the Okinawa Trough, as well as by the active collision between the Philippine Sea Plate and the Eurasian basement high. This proposed northeastern lateral extrusion mirrors the active lateral extrusion in southwestern Taiwan which is observed on the southern side of the Eurasian basement high collision. The involvement of the basement high in the collision and adjacent regions appears to be an important factor in understanding local structural variations in the arc-continent collision and should be considered in both forward and reverse modeling of Taiwan deformation.

Importance-satisfaction analysis of street food sanitation and choice factor in Korea and Taiwan

PubMed Central

Joo, Nami; Park, Sanghyun; Lee, Bohee

2015-01-01

BACKGROUND/OBJECTIVES The present study investigated Korean and Taiwan adults on the importance of and the satisfaction with street food sanitation and street food choice factor, in order to present management and improvement measures for street foods. SUBJECTS/METHODS The present study conducted a survey on 400 randomly chosen adults (200 Korean, 200 Taiwanese). General characteristics, eating habits, street food intake frequency, and preference by type of street food of respondents were checked. Respondents' importance and satisfaction of street food hygiene and selection attributes were also measured. In order to test for the difference between groups, χ2-test and t-test were performed. ISA was also performed to analyze importance and satisfaction. RESULTS Results showed that the importance of sanitation was significantly higher than satisfaction on all items in both Korea and Taiwan, and the satisfaction with sanitation was higher in Taiwan than in Korea. According to ISA results with street food sanitation, satisfaction was low while importance was high in both Korea and Taiwan. In terms of street food choice factor, importance scores were significantly higher than satisfaction scores on all items. In addition, satisfaction scores on all items except 'taste' were significantly higher in Taiwan than in Korea. CONCLUSIONS A manual on sanitation management of street foods should be developed to change the knowledge and attitude toward sanitation by putting into practice a regularly conducted education. Considering the popularity of street foods and its potential as a tourism resource to easily publicize our food culture, thorough management measures should be prepared on sanitation so that safe street food culture should be created. PMID:26060542

Host range of emerald ash borer

Treesearch

Robert A. Haack; Toby R. Petrice

2005-01-01

The emerald ash borer (EAB), Agrilus planipennis Fairmaire, is native to China, Korea, Japan, Mongolia, Russia, and Taiwan. Established populations of EAB were first discovered in Michigan and Ontario in 2002, and since then additional infestations have been found in Indiana, Ohio, Maryland, and Virginia.

Development and Application of a Taiwan Domestic Generalized Water Supply Model

NASA Astrophysics Data System (ADS)

Ho, C. C.; Chang, L. C.

2016-12-01

Water allocation in Taiwan is more complicated than other countries because high river turbidity caused by rainstorm, reservoir management governed by different organization and conjunctive use of inter-basin reservoirs and dams. Those properties cause water resource planners need make extra effort on developing customized model to simulate the impact of water supply strategies on water resources. Hence, the study develops a Generalized Water Supply Model (GWSM) to analysis Multi-reservoirs water allocation in Taiwan for advancing the planning process. The model has following functions: (1) considering reservoirs operating rule curve. (2) considering the rule of multi-reservoir operation. Such as setting supply priority of different reservoirs or using "index balance" rule. (3) considering optimal hydroelectric power operation. (4) estimating the impact of high river turbidity on water supply. (5) considering the supply priority of different water use. (6) considering irrigation supply under special constraint. Such as the maximum irrigation supply is subject to natural inflow without reservoir storage. (7) considering two-way conduit transport. (8) considering environmental flow reservation. Conjunctive use Taan and Dajia Rivers was selected to demonstrate the ability of GWSM. The results also can be provided to different authorities to realize the impact of different strategies and that is good for negotiation and reaching a consensus.

A 3-year surveillance on causes of death or reasons for euthanasia of domesticated dogs in Taiwan.

PubMed

Huang, Wei-Hsiang; Liao, Albert Taiching; Chu, Pei-Yi; Zhai, Shao-Hua; Yen, I-Feng; Liu, Chen-Hsuan

2017-11-01

Over the last 2 decades, there has been growing interest in research on the mortality of domesticated pets. These studies relied on an effective data-collecting system. During 2012-2014, a real-time reporting system was designed for mortality data in owned dogs and cats. The present retrospective study aimed to report on the causes of death (CODs) or reasons for euthanasia (RFEs) in domesticated dogs in Taiwan, and to investigate CODs/RFEs segregated by demographic variables. Data from 2306 domesticated dogs were acquired during the 3-year period in the present study. The median age at death of the study population was 10.2 years (median interquartile range 7.0-14.0; range 0.0-25.0). Crossbred, female, and neutered dogs showed greater ages at death than other groups. The most common COD/RFE was neoplasia, followed by multiple organ involvement (MOI) and cardiovascular diseases. Segregated by cut-off ages, the most common COD/RFE was infection among dogs younger than 3 years or 1year, and neoplasia among dogs at or older than 3 years or 1year of age; the most common COD/RFE was neoplasia among dogs younger than median age, and MOI among dogs at or older than median age. Segregated by geographic variables, the ranking and frequency of CODs/RFEs displayed different patterns between the capital city/non-capital areas, and among areas stratified by human population densities. The study provides various insights into age at death and CODs/RFEs in owned-dog population in Taiwan, and provides new directions for future research. Copyright © 2017 Elsevier B.V. All rights reserved.

Geographic disparity in chronic obstructive pulmonary disease (COPD) mortality rates among the Taiwan population.

PubMed

Chan, Ta-Chien; Chiang, Po-Huang; Su, Ming-Daw; Wang, Hsuan-Wen; Liu, Michael Shi-yung

2014-01-01

Chronic obstructive pulmonary disease (COPD) causes a high disease burden among the elderly worldwide. In Taiwan, the long-term temporal trend of COPD mortality is declining, but the geographical disparity of the disease is not yet known. Nationwide COPD age-adjusted mortality at the township level during 1999-2007 is used for elucidating the geographical distribution of the disease. With an ordinary least squares (OLS) model and geographically weighted regression (GWR), the ecologic risk factors such as smoking rate, area deprivation index, tuberculosis exposure, percentage of aborigines, density of health care facilities, air pollution and altitude are all considered in both models to evaluate their effects on mortality. Global and local Moran's I are used for examining their spatial autocorrelation and identifying clusters. During the study period, the COPD age-adjusted mortality rates in males declined from 26.83 to 19.67 per 100,000 population, and those in females declined from 8.98 to 5.70 per 100,000 population. Overall, males' COPD mortality rate was around three times higher than females'. In the results of GWR, the median coefficients of smoking rate, the percentage of aborigines, PM10 and the altitude are positively correlated with COPD mortality in males and females. The median value of density of health care facilities is negatively correlated with COPD mortality. The overall adjusted R-squares are about 20% higher in the GWR model than in the OLS model. The local Moran's I of the GWR's residuals reflected the consistent high-high cluster in southern Taiwan. The findings indicate that geographical disparities in COPD mortality exist. Future epidemiological investigation is required to understand the specific risk factors within the clustering areas.

Geographic patterns of hepatocellular carcinoma mortality with exposure to iron in groundwater in Taiwanese population: An ecological study

PubMed Central

2013-01-01

Background Many studies have examined the risk factors for HCC (including hepatitis B virus, hepatitis C virus, aflatoxin, retinol, cigarette smoking, and alcohol consumption). However, data from previous studies on the association between iron exposure, land subsidence, and HCC mortality/incidence were limited, especially in Taiwanese population. We aimed to explore the geographical distribution of HCC mortality rates by township-specific data and to evaluate the association between HCC mortality, land subsidence, and iron levels in groundwater in Taiwan. Methods We conducted an ecological study and calculated the HCC age-standardized mortality/incidence rates according to death certificates issued in Taiwan from 1992 to 2001 and incidence data from 1995–1998. The land subsidence dataset before 2005 and iron concentrations in groundwater in 1989 are also involved in this study. Both geographical information systems and Pearson correlation coefficients were used to analyze the relationship between HCC mortality rates, land subsidence, and iron concentrations in groundwater. Results Township-specific HCC mortality rates are higher in southwestern coastal townships where serious land subsidence and higher township-specific concentrations of iron in groundwater are present. The Pearson correlation coefficients of iron concentrations in groundwater and ASRs of HCC were 0.286 (P = 0.004) in males and 0.192 (P = 0.058) in females for mortality data; the coefficients were 0.375 (P < 0.001) in males and 0.210 (P = 0.038) in females for incidence data. Conclusions This study showed that HCC mortality is clustered in southwestern Taiwan and the association with the iron levels in groundwater in Taiwanese population warrant further investigation. PMID:23590585

Comparative cost-effectiveness of metformin-based dual therapies associated with risk of cardiovascular diseases among Chinese patients with type 2 diabetes: Evidence from a population-based national cohort in Taiwan.

PubMed

Ou, Huang-Tz; Chen, Yen-Ting; Liu, Ya-Ming; Wu, Jin-Shang

2016-06-01

To assess the cost-effectiveness of metformin-based dual therapies associated with cardiovascular disease (CVD) risk in a Chinese population with type 2 diabetes. We utilized Taiwan's National Health Insurance Research Database (NHIRD) 1997-2011, which is derived from the claims of National Health Insurance, a mandatory-enrollment single-payer system that covers over 99% of Taiwan's population. Four metformin-based dual therapy cohorts were used, namely a reference group of metformin plus sulfonylureas (Metformin-SU) and metformin plus acarbose, metformin plus thiazolidinediones (Metformin-TZD), and metformin plus glinides (Metformin-glinides). Using propensity scores, each subject in a comparison cohort was 1:1 matched to a referent. The effectiveness outcome was CVD risk. Only direct medical costs were included. The Markov chain model was applied to project lifetime outcomes, discounted at 3% per annum. The bootstrapping technique was performed to assess uncertainty in analysis. Metformin-glinides was most cost-effective in the base-case analysis; Metformin-glinides saved $194 USD for one percentage point of reduction in CVD risk, as compared to Metformin-SU. However, for the elderly or those with severe diabetic complications, Metformin-TZD, especially pioglitazone, was more suitable; as compared to Metformin-SU, Metformin-TZD saved $840.1 USD per percentage point of reduction in CVD risk. Among TZDs, Metformin-pioglitazone saved $1831.5 USD per percentage point of associated CVD risk reduction, as compared to Metformin-rosiglitazone. When CVD is considered an important clinical outcome, Metformin-pioglitazone is cost-effective, in particular for the elderly and those with severe diabetic complications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

76 FR 58536 - Certain Standard Steel Fasteners From China and Taiwan

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-21

...: Effective Date: September 14, 2011. FOR FURTHER INFORMATION CONTACT: Douglas E. Corkran, Office of Investigations, telephone 202-205-3057, or Mary Jane Alves, Office of General Counsel, telephone 202-708-2969, U...

Doctor Shopping Behavior for Zolpidem Among Insomnia Patients in Taiwan: A Nationwide Population-Based Study.

PubMed

Lu, Tzu-Hsuan; Lee, Yen-Ying; Lee, Hsin-Chien; Lin, You-Meei

2015-07-01

Although zolpidem is listed as a controlled drug in Taiwan, patients' behavior has not been restricted and has led to the problem of doctor shopping behavior (DSB), leading to overutilization of medical resources and excess spending. The National Health Insurance Administration in Taiwan has instituted a new policy to regulate physicians' prescribing behavior and decrease DSB. This retrospective study aimed to analyze the DSB for zolpidem by insomnia patients and assess related factors. Data were extracted from the Longitudinal Health Insurance Database in Taiwan. Individuals with a diagnosis of insomnia who received more than one prescription of zolpidem in 2008 were followed for 24 mo. Doctor shopping was defined as ≥ 2 prescriptions by different doctors within ≥ 1 day overlapping in the duration of therapy. The percentage of zolpidem obtained through doctor shopping was used as an indicator of the DSB of each patient. Among the 6,947 insomnia patients who were prescribed zolpidem, 1,652 exhibited DSB (23.78%). The average dose of zolpidem dispensed for each patient during 24 mo was 244.21 daily defined doses. The doctor shopping indicator (DSI) was 0.20 (standard deviation, 0.23) among patients with DSB. Younger age, chronic diseases, high number of diseases, higher premium status, high socioeconomic status, and fewer people served per practicing physicians were all factors significantly related to doctor shopping behavior. Doctor shopping for zolpidem appears to be an important issue in Taiwan. Implementing a proper referral system with efficient data exchange by physician or pharmacist-led medication reconciliation process might reduce DSB. © 2015 Associated Professional Sleep Societies, LLC.

Birth weight among singletons born to foreign-born mothers in Taiwan: a population-based birth register study.

PubMed

Shen, Yu-Ming; See, Lai-Chu; Lin, Sheue-Rong

2009-01-01

We compared the birth weight of newborns born to foreign-born mothers (FBMs) and Taiwan-born mothers (TBMs), using data from the 2005-2006 Taiwan Birth Registry of singleton live births. The Wilcox-Russell method, data restriction, and multiple linear regression were used to analyze the data. The rates of low birth weight (<2500 g) with 95% confidence intervals were computed for TBMs, and for each of the nationalities of FBMs. The mean birth weight of newborns of FBMs was 3157 g, which was higher than that of newborns of TBMs (3109 g). On analysis using the Wilcox-Russell method, both the rate and residual proportion of low-birth-weight (LBW) births were lower among newborns of FBMs (4.1% and 1.1%, respectively) than among newborns of TBMs (5.9% and 1.7%, respectively). After adjusting for sex, mode of delivery, maternal age, smoking status, predisposing maternal risk factors, and condition during pregnancy, the newborns of FBMs weighed 72.9 g (95% CI, 68.8 g to 77.0 g) more than the newborns of TBMs. When data were restricted to mothers without any adverse conditions and adjusted for maternal age, the differences in birth weight between the 2 groups remained unchanged. The rates of LBW deliveries among FBMs in Taiwan were significantly lower than those in their respective countries of origin. In Taiwan, newborns of FBMs had a higher birth weight than those of TBMs, even after accounting for potential confounding factors, and had lower rates of LBW deliveries than did mothers in their respective countries of origin.

Mitochondrial DNA phylogeography of Semisulcospira libertina (Gastropoda: Cerithioidea: Pleuroceridae): implications the history of landform changes in Taiwan.

PubMed

Hsu, Kui-Ching; Bor, Hor; Lin, Hung-Du; Kuo, Po-Hsun; Tan, Mian-Shin; Chiu, Yuh-Wen

2014-06-01

The mitochondrial DNA cytochrome c oxidase subunit I sequences from 95 specimens of Semisulcospira libertina in Taiwan were identified as two major phylogroups, exhibiting a southern and northern distribution, north of Formosa Bank and south of Miaoli Plateau. The genetic distance between these two phylogroups was 12.20%, and the distances within-phylogroups were 4.97 and 5.56%. According to a molecular clock of 1.56% per lineage per million years, the divergence time between these two major phylogroups was estimated at 4.94 million years ago (mya), with the two phylogroups forming at 3.64 and 3.75 mya, respectively. Moreover, the geological events have suggested that Taiwan Island emerged above sea level at 4-5 mya, and became its present shape at 2 mya. These results suggested that these two phylogroups might originate from two independent ancestral populations or divergent before colonizing Taiwan. Within South phylogroup, the initial colonization was hypothesized to be in Kaoping River (WT), followed by its northward. The high divergence between south- and north of WT River was influenced by the formation of the Kaoping foreland basins. Within North phylogroup, the colonization was from central sub-region through paleo-Miaoli Plateau to northern and northeastern sub-regions. This study showed that the landform changes might have shaped the genetic structure of S. libertina in concert. Apparently, two cryptic species or five different genetic stocks of S. libertina could be identified; these results are useful for the evaluation and conservation of S. libertina in Taiwan.

Phylodynamic and Genetic Diversity of Canine Parvovirus Type 2c in Taiwan

PubMed Central

Chiang, Shu-Yun; Wu, Hung-Yi; Lin, Jih-Hui; Chiou, Ming-Tang; Lin, Chao-Nan

2017-01-01

Canine parvovirus type 2c (CPV-2c) emerged in 2000 and is known for causing a more severe disease than other CPV-2 variants in puppies. In 2015, the emerging CPV-2c variant was isolated in Taiwan and it subsequently became the predominant variant. To trace the evolution of Taiwanese CPV-2c, we compared complete VP2 genes of CPV-2c from Taiwan and sequences obtained from GenBank. The evolutionary rate of CPV-2c was estimated to be 4.586 × 10−4 substitutions per site per year (95% highest posterior density (HPD) was 3.284–6.076 × 10−4). The time to the most recent common ancestor (TMRCA) dated to 1990 (95% HPD: 1984–1996) and 2011 (95% HPD: 2010–2013) for the CPV-2c variant and Taiwanese isolates, respectively. The CPV-2c variant isolated from Taiwan was clustered with CPV-2c from China. This phylogenetic clade began to branch off in approximately 2010 (95% HPD was 3.823–6.497). Notably, two unique mutations of Taiwanese CPV-2c were found, Q383R and P410L. In summary, this is the first report on the genome evolution of CPV-2c in Taiwan, revealing that this CPV-2c variant shares a common evolutionary origin with strains from China. The demographic history inferred by the Bayesian skyline plot showed that the effective population of CPV-2c increased until 2006 and then slowly declined until 2011. PMID:29236084

Assessing the evolution of scientific publications in orthopedics journals from mainland China, Hong Kong, and Taiwan: a 12-year survey of the literature.

PubMed

Jiang, Hua; Nong, Bingjin; Yang, Lijing; Zong, Shaohui; Zhan, Xinli; Wei, Qingjun; Xiao, Zengming

2016-06-17

In China, the field of orthopedics has experienced significant growth over the past 12 years. However, the recent status of research on orthopedics among individuals in mainland China, Hong Kong, and Taiwan is unknown. In this study, we investigated characteristics and trends of orthopedics publications from these three regions. Between 2003 and 2014, all articles published in 63 orthopedics journals originating from mainland China, Hong Kong, and Taiwan were identified via Science Citation Index Expanded (SCIE) database. A survey was conducted to systematically analyze the published orthopedics articles from the three regions according to the numbers of articles, study design, impact factors (IFs), citations, most prolific authors, and institutions. Additionally, we evaluated global trends in orthopedics publications, and ranked top 10 countries in terms of the total number of published articles over 12 years and the number of published articles per year. A total number of 123,317 articles were published in the 63 orthopedics journals between 2003 and 2014. The worldwide number of annually published orthopedics articles tended to increase during the study period. The total number of orthopedics publications from the three regions, especially in mainland China, increased markedly from 2003 to 2014. The annual number of orthopedics articles from mainland China increased from 6 in 2003 to 813 in 2014, Hong Kong increased from 32 in 2003 to 71 in 2014, and Taiwan increased from 68 in 2003 to 168 in 2014. For accumulated IFs and total citations of articles, mainland China ranked the first place, followed by Taiwan and Hong Kong. However, publications from Taiwan had the highest average citations per article, and publications from Hong Kong had the highest average IFs. Among the top 10 most prolific authors and institutions, 4 authors and 4 institutions were from Taiwan, 3 authors and 4 institutions were from mainland China, and 3 authors and 2 institutions were from Hong Kong. The quantity of articles published in international orthopedics journals from mainland China presented a remarkable upward trend during the past 12 years. Given the relative size of the populations, it should be emphasized that mainland China still has a long way to go to achieve the academic performance of Hong Kong and Taiwan.

Polynesian genetic affinities with Southeast Asian populations as identified by mtDNA analysis.

PubMed Central

Melton, T; Peterson, R; Redd, A J; Saha, N; Sofro, A S; Martinson, J; Stoneking, M

1995-01-01

Polynesian genetic affinities to populations of Asia were studied using mtDNA markers. A total of 1,037 individuals from 12 populations were screened for a 9-bp deletion in the intergenic region between the COII and tRNA(Lys) genes that approaches fixation in Polynesians. Sequence-specific oligonucleotide probes that identify specific mtDNA control region nucleotide substitutions were used to describe variation in individuals with the 9-bp deletion. The 9-bp deletion was not observed in northern Indians, Bangladeshis, or Pakistanis but was seen at low to moderate frequencies in the nine other Southeast Asian populations. Three substitutions in the control region at positions 16217, 16247, and 16261 have previously been observed at high frequency in Polynesian mtDNAs; this "Polynesian motif" was observed in 20% of east Indonesians with the 9-bp deletion but was observed in only one additional individual. mtDNA types related to the Polynesian motif are highest in frequency in the corridor from Taiwan south through the Philippines and east Indonesia, and the highest diversity for these types is in Taiwan. These results are consistent with linguistic evidence of a Taiwanese origin for the proto-Polynesian expansion, which spread throughout Oceania by way of Indonesia. PMID:7668267

Variations in early life history traits of Japanese anchovy Engraulis japonicus in the Yangtze River Estuary.

PubMed

Liu, Chunlong; Xian, Weiwei; Liu, Shude; Chen, Yifeng

2018-01-01

Resources of Japanese anchovy ( Engraulis japonicus Temminck & Schlegel, 1846) are undergoing dramatic recessions in China as the consequence of intensifying anthropogenic activities. Elucidating the influences of local-scale environmental factors on early life history traits is of great importance to design strategies conserving and restoring the declining anchovy resources. In this research, we studied hatching date and early growth of anchovy in the Yangtze River Estuary (YRE) using information obtained from otolith microstructure. Onset of hatching season and growth rates of anchovy was compared to populations in Japan and Taiwan. In YRE, the hatching date of anchovy ranged from February 26th to April 6th and mean growth rate ranged from 0.27 to 0.77 mm/d. Anchovies hatching later had higher growth rates than individuals hatching earlier before the 25th day. Among populations, hatching onsets of anchovy from the higher latitude were later than populations in the lower latitude, and growth rates of anchovy in YRE were much lower than populations in Japan and Taiwan. Variations in hatching onsets and early growth patterns of anchovy thus provide important knowledge on understanding the adaptation of anchovy in YRE and designing management strategies on conserving China's anchovy resources.

Reappraisal of fetal abdominal circumference in an Asian population: analysis of 50,131 records.

PubMed

Lu, Szu-Ching; Chang, Chiung-Hsin; Yu, Chen-Hsiang; Kang, Lin; Tsai, Pei-Ying; Chang, Fong-Ming

2008-03-01

Fetuses from different populations may show different growth patterns. In obstetrics, fetal abdominal circumference (AC) is a very useful index for assessing fetal growth. In this study, we attempted to establish the normal fetal growth curves of AC in an Asian population in South Taiwan. We reviewed our computer ultrasound database of fetal AC records from January 1991 to December 2006. During the study period of 16 years, only the fetuses examined by ultrasonography with gestational age between 14 and 41 weeks were included. We excluded extreme bilateral records after initial analysis. Eventually, 50,131 records of AC were included for final analysis. The observed gestation-specific AC values and the predicted AC values were calculated. The best-fit regression equation of AC versus gestational age is a second-order polynomial equation. In general, fetal AC values in our population showed similar patterns to those in Western populations. Besides, we established a table of the predicted AC values based on specific gestational age, including the 5 th , 10 th , 50 th , 90 th and 95 th centiles, for clinical reference. To the best of our knowledge, our series is the largest sample of AC reported in the medical literature. We believe that the gestational age-specific nomogram of fetal AC is important for further clinical assessment of fetal growth.

Bisphenol A (BPA) in China: a review of sources, environmental levels, and potential human health impacts.

PubMed

Huang, Y Q; Wong, C K C; Zheng, J S; Bouwman, H; Barra, R; Wahlström, B; Neretin, L; Wong, M H

2012-07-01

Bisphenol A (BPA), identified as an endocrine disruptor, is an industrially important chemical that is used as a raw material in the manufacture of many products such as engineering plastics (e.g., epoxy resins/polycarbonate plastics), food cans (i.e., lacquer coatings), and dental composites/sealants. The demand and production capacity of BPA in China have grown rapidly. This trend will lead to much more BPA contamination in the environmental media and in the general population in China. This paper reviews the current literature concerning the pollution status of BPA in China (the mainland, Hong Kong, and Taiwan) and its potential impact on human health. Due to potential human health risks from long-term exposure to BPA, body burden of the contaminant should be monitored. Copyright © 2011 Elsevier Ltd. All rights reserved.

Chinese herbs containing aristolochic acid associated with renal failure and urothelial carcinoma: a review from epidemiologic observations to causal inference.

PubMed

Yang, Hsiao-Yu; Chen, Pau-Chung; Wang, Jung-Der

2014-01-01

Herbal remedies containing aristolochic acid (AA) have been designated to be a strong carcinogen. This review summarizes major epidemiologic evidence to argue for the causal association between AA exposure and urothelial carcinoma as well as nephropathy. The exposure scenarios include the following: Belgian women taking slimming pills containing single material Guang Fang Ji, consumptions of mixtures of Chinese herbal products in the general population and patients with chronic renal failure in Taiwan, occupational exposure in Chinese herbalists, and food contamination in farming villages in valleys of the Danube River. Such an association is corroborated by detecting specific DNA adducts in the tumor tissue removed from affected patients. Preventive actions of banning such use and education to the healthcare professionals and public are necessary for the safety of herbal remedies.

Chinese Herbs Containing Aristolochic Acid Associated with Renal Failure and Urothelial Carcinoma: A Review from Epidemiologic Observations to Causal Inference

PubMed Central

Yang, Hsiao-Yu; Chen, Pau-Chung; Wang, Jung-Der

2014-01-01

Herbal remedies containing aristolochic acid (AA) have been designated to be a strong carcinogen. This review summarizes major epidemiologic evidence to argue for the causal association between AA exposure and urothelial carcinoma as well as nephropathy. The exposure scenarios include the following: Belgian women taking slimming pills containing single material Guang Fang Ji, consumptions of mixtures of Chinese herbal products in the general population and patients with chronic renal failure in Taiwan, occupational exposure in Chinese herbalists, and food contamination in farming villages in valleys of the Danube River. Such an association is corroborated by detecting specific DNA adducts in the tumor tissue removed from affected patients. Preventive actions of banning such use and education to the healthcare professionals and public are necessary for the safety of herbal remedies. PMID:25431765

Psychometric properties of the World Health Organization quality of life assessment – brief in methadone patients: a validation study in northern Taiwan

PubMed Central

2013-01-01

Background Quality of life (QOL) is an important outcome measure in the treatment of heroin addiction. The Taiwan version of the World Health Organization Quality of Life assessment (WHOQOL-BREF [TW]) has been developed and studied in various groups, but not specifically in a population of injection drug users. The aim of this study was to analyze the psychometric properties of the WHOQOL-BREF (TW) in a sample of injection drug users undergoing methadone maintenance treatment. Methods A total of 553 participants were interviewed and completed the instrument. Item-response distributions, internal consistency, corrected item-domain correlation, criterion-related validity, and construct validity through confirmatory factor analysis were evaluated. Results The frequency distribution of the 4 domains of the WHOQOL-BREF (TW) showed no floor or ceiling effects. The instrument demonstrated adequate internal consistency (Cronbach’s alpha coefficients were higher than 0.7 across the 4 domains) and all items had acceptable correlation with the corresponding domain scores (r = 0.32-0.73). Correlations (p < 0.01) of the 4 domains with the 2 benchmark items assessing overall QOL and general health were supportive of criterion-related validity. Confirmatory factor analysis yielded marginal goodness-of-fit between the 4-domain model and the sample data. Conclusions The hypothesized WHOQOL-BREF measurement model was appropriate for the injection drug users after some adjustments. Despite different patterns found in the confirmatory factor analysis, the findings overall suggest that the WHOQOL-BREF (TW) is a reliable and valid measure of QOL among injection drug users and can be utilized in future treatment outcome studies. The factor structure provided by the study also helps to understand the QOL characteristics of the injection drug users in Taiwan. However, more research is needed to examine its test-retest reliability and sensitivity to changes due to treatment. PMID:24325611

Age- and gender-specific epidemiology, treatment patterns, and economic burden of osteoporosis and associated fracture in Taiwan between 2009 and 2013.

PubMed

Wang, Chen-Yu; Fu, Shau-Huai; Yang, Rong-Sen; Shen, Li-Jiuan; Wu, Fe-Lin Lin; Hsiao, Fei-Yuan

2017-10-25

This nationwide study investigated the epidemiology, treatment patterns, and economic burden of osteoporosis and associated fracture in Taiwan. The treatment of osteoporosis is alarmingly suboptimal, considering the significantly increased economic burden of major osteoporotic fracture. Osteoporosis men received lesser anti-osteoporosis drugs but had higher incremental costs attributable to osteoporotic fractures. This nationwide study investigated the epidemiology, treatment patterns, and economic burden of osteoporosis and associated fracture between 2009 and 2013 in Taiwan. We used the National Health Insurance Research Database as our data source. The prevalence of diagnosed osteoporosis and major osteoporotic fractures was calculated annually from 2009 to 2013, stratified by age and gender. Osteoporosis patients who received any prescription of anti-osteoporosis drugs during each fiscal year were defined as osteoporosis patients under treatment. Healthcare utilization and associated direct medical costs were used to quantify the economic burden of osteoporosis. For patients who encountered major osteoporotic fracture, the incremental changes of direct medical costs attributable to fracture using a pre- and post-quasi-experimental design were estimated. Furthermore, we compared the annual direct medical costs of patients who encountered major osteoporotic fracture with those diagnosed osteoporosis only and with the general population. The prevalence of diagnosed osteoporosis increased with age, with the highest rate among those aged 80 and older. Overall, less than one-third of women and only 10% of men received anti-osteoporosis drugs among osteoporosis patients. The annual direct medical costs for osteoporosis patients increased steadily from 2009 to 2013. The total medical costs and incremental change of direct medical costs were higher in men than those in women. We found the treatment of osteoporosis to be alarmingly suboptimal, considering the significantly increased economic burden of major osteoporotic fracture also identified in this study. Osteoporosis men received lesser anti-osteoporosis drugs but had higher incremental costs attributable to major osteoporotic fractures.

Depression among female psychiatric nurses in southern Taiwan: main and moderating effects of job stress, coping behaviour and social support.

PubMed

Lin, Huey-S; Probst, Janice C; Hsu, Yu-C

2010-08-01

In this study, we tested the following hypotheses among psychiatric nurses: (1) job stress would be positively correlated with depression; (2) coping behaviour would be significantly correlated with depression and moderate the relationship between job stress and depression; (3) social support would be significantly negatively correlated with depression and was a significant moderator on the relationship between job stress and depression. Most studies in Taiwan related to depression have focused on the general public rather than nurses. The main effect of job stress (coping behaviour, social support) on level of depression has been documented in some population, but the moderating effects of coping behaviours and social support on the relationship between job stress and depression have not been well studied among nurses, especially among psychiatric nurses. A cross-sectional research design was employed. A self-report questionnaire was adopted to measure personal characteristics, depression (Beck Depression Inventory), job stress (Taiwanese Nurse Stress Checklist), coping behaviour (Jalowiec Coping Scale) and social support (short form, Interpersonal Support Evaluation List). Eligible subjects were female, non-supervisory, inpatient ward nurses in a psychiatric hospital in southern Taiwan. One hundred and fifty-four questionnaires were distributed, and the response rate was 91.6%. After adjusting for covariates, we found that: (1) Job stress and affective-oriented coping were significantly positively correlated with BDI-II scores. (2) Coping behaviour was not a significant moderator on the relationship between job stress and depression scores among psychiatric nurses, but social support was. Depression scores were correlated with job stress and affective-oriented coping, but social support could work to reduce the effect of stress on depression among psychiatric nurses. Nursing managers should explore both ways of reducing job stress and techniques for building social support networks in the institution to protect their members against stress and depression.

Accountability, utilization and providers for diabetes management in Taiwan, 2000-2009: an analysis of the National Health Insurance database.

PubMed

Chang, Tien-Jyun; Jiang, Yi-Der; Chang, Chia-Hsiun; Chung, Ching-Hu; Yu, Neng-Chun; Chuang, Lee-Ming

2012-11-01

The prevalence of diabetes has increased worldwide. To obtain nationwide data on accountability and utilization of health resources among diabetes patients in Taiwan, an analysis of the claims data for the National Health Insurance (NHI) from 2000 to 2009 was conducted. One-third of the NHI claims database was randomly sampled from 2000 to 2009. Diabetes was defined by three or more outpatient visits with diagnostic codes [International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM): 250 or A code: A181] within 1 year, or one inpatient discharge diagnosis. Accountability items and NHI codes of various metabolic parameters and examinations were identified. Medical utilization was measured by the frequency and cost of care associated with ambulatory visits, hospitalizations, and emergency care within each year. The annual check-up frequency for various examinations significantly increased from 2000 to 2009. Both the average outpatient department (OPD) cost per diabetes patient/year and the average inpatient department (IPD) cost per time increased 1.34-fold in the past decade. The average OPD cost per diabetes patient and average IPD cost of each admission for diabetes patients was four times and 1.4 times compare with the general population, respectively. The annual average medical cost of each diabetes patient affected with both micro- and macrovascular complications was four times compared with those without vascular complications. There was an increasing trend for diabetes patients to visit regional hospital for OPD and IPD, whereas visits to the local hospital decreased in the past decade. Due to the increased frequency of annual check-ups after various examinations, the quality of diabetes management has improved in the past decade in Taiwan. As diabetes patients affected with both micro- and macrovascular complications incurred costs four times compared with those without complications, it is worth screening high-risk individuals to ensure earlier intervention and thus reduce diabetic complications and healthcare expenditure. Copyright © 2012. Published by Elsevier B.V.

Estimated Daily Intake and Cumulative Risk Assessment of Phthalates in the General Taiwanese after the 2011 DEHP Food Scandal

NASA Astrophysics Data System (ADS)

Chang, Jung-Wei; Lee, Ching-Chang; Pan, Wen-Harn; Chou, Wei-Chun; Huang, Han-Bin; Chiang, Hung-Che; Huang, Po-Chin

2017-03-01

A food scandal occurred in Taiwan in 2011 because the DEHP (di-2-ethylhexyl phthalate) had been intentionally used in food products. We assessed the daily intakes (DIs) and cumulative risk of phthalates in Taiwan’s general population after the scandal. The DIs of 6 phthalates, including di-n-butyl phthalate (DnBP), di-iso-butyl phthalate (DiBP), and DEHP, were evaluated using urinary phthalate metabolites. Hazard quotients of phthalates classified as affecting the reproductive (HQrep) and hepatic (HQhep) systems were assessed using cumulative approach. The creatinine-based model showed that the highest DI values in children 7-to 12- years-old were for DEHP (males: median: 4.79 μg/kg bw/d; females: median: 2.62 μg/kg bw/d). The 95th percentile (P95) of HQrep values were all >1 in the 7- to 12-year-old and 18- to 40-year-old male groups. The P95 of HQhep values were all >1 in the 7- to 18- year-old male groups. Most of the HQrep was attributable to the HQs of DnBP and DiBP (53.9-84.7%), and DEHP contributed most to HQhep (83.1-98.6%), which reveals that DnBP, DiBP and DEHP were the main risk of phthalate exposure for Taiwanese. Taiwan’s general population is widely exposed to DnBP, DiBP and DEHP, especially for young children.

Widespread Rickettsia spp. Infections in Ticks (Acari: Ixodoidea) in Taiwan.

PubMed

Kuo, Chi-Chien; Shu, Pei-Yun; Mu, Jung-Jung; Lee, Pei-Lung; Wu, Yin-Wen; Chung, Chien-Kung; Wang, Hsi-Chieh

2015-09-01

Ticks are second to mosquitoes as the most important disease vectors, and recent decades have witnessed the emergence of many novel tick-borne rickettsial diseases, but systematic surveys of ticks and tick-borne rickettsioses are generally lacking in Asia. We collected and identified ticks from small mammal hosts between 2006 and 2010 in different parts of Taiwan. Rickettsia spp. infections in ticks were identified by targeting ompB and gltA genes with nested polymerase chain reaction. In total, 2,732 ticks were collected from 1,356 small mammals. Rhipicephalus haemaphysaloides Supino (51.8% of total ticks), Haemaphysalis bandicota Hoogstraal & Kohls (28.0%), and Ixodes granulatus Supino (20.0%) were the most common tick species, and Rattus losea Swinhoe (44.7% of total ticks) and Bandicota indica Bechstein (39.9%) were the primary hosts. The average Rickettsia infective rate in 329 assayed ticks was 31.9% and eight Rickettsia spp. or closely related species were identified. This study shows that rickettsiae-infected ticks are widespread in Taiwan, with a high diversity of Rickettsia spp. circulating in the ticks. Because notifiable rickettsial diseases in Taiwan only include mite-borne scrub typhus and flea-borne murine typhus, more studies are warranted for a better understanding of the real extent of human risks to rickettsioses in Taiwan. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Near real-time finite fault source inversion for moderate-large earthquakes in Taiwan using teleseismic P waveform

NASA Astrophysics Data System (ADS)

Wong, T. P.; Lee, S. J.; Gung, Y.

2017-12-01

Taiwan is located at one of the most active tectonic regions in the world. Rapid estimation of the spatial slip distribution of moderate-large earthquake (Mw6.0) is important for emergency response. It is necessary to have a real-time system to provide the report immediately after earthquake happen. The earthquake activities in the vicinity of Taiwan can be monitored by Real-Time Moment Tensor Monitoring System (RMT) which provides the rapid focal mechanism and source parameters. In this study, we follow up the RMT system to develop a near real-time finite fault source inversion system for the moderate-large earthquakes occurred in Taiwan. The system will be triggered by the RMT System when an Mw6.0 is detected. According to RMT report, our system automatically determines the fault dimension, record length, and rise time. We adopted one segment fault plane with variable rake angle. The generalized ray theory was applied to calculate the Green's function for each subfault. The primary objective of the system is to provide the first order image of coseismic slip pattern and identify the centroid location on the fault plane. The performance of this system had been demonstrated by 23 big earthquakes occurred in Taiwan successfully. The results show excellent data fits and consistent with the solutions from other studies. The preliminary spatial slip distribution will be provided within 25 minutes after an earthquake occurred.

A Smartphone Application Supporting Recovery from Heroin Addiction: Perspectives of Patients and Providers in China, Taiwan, and the USA.

PubMed

Schulte, Marya; Liang, Di; Wu, Fei; Lan, Yu-Ching; Tsay, Wening; Du, Jiang; Zhao, Min; Li, Xu; Hser, Yih-Ing

2016-09-01

Smartphone-based interventions are increasingly used to support self-monitoring, self-management, and treatment and medication compliance in order to improve overall functioning and well-being. In attempting to develop a smartphone application (S-Health) that assists heroin-dependent patients in recovery, a series of focus groups (72 patients, 22 providers) were conducted in China, Taiwan, and the USA to obtain their perspectives on its acceptance and potential adoption. Data were analyzed according to the Diffusion of Innovation (DOI) theory of characteristics important to the adoption of innovation. Important to Relative Advantage, USA participants cited S-Health's potential ability to overcome logistical barriers, while those in China and Taiwan valued its potential to supplement currently limited services. In terms of Compatibility, participants across sites reported recovery needs and goals that such an application could be helpful in supporting; however, its utility during strong craving was questioned in China and Taiwan. Important factors relevant to Complexity included concerns about smartphone access and familiarity, individualization of content, and particularly in China and Taiwan, participants wanted assurance of privacy and security. The study results suggest a general acceptance, but also indicate cultural variations in access to therapeutic and other social support systems, legal repercussions of substance use, societal perceptions of addiction, and the role of family and other social support in recovery. Taking these factors into consideration is likely to increase diffusion as well as effectiveness of these smartphone-based interventions.

A Smartphone Application Supporting Recovery from Heroin Addiction: Perspectives of Patients and Providers in China, Taiwan, and the USA

PubMed Central

Schulte, Marya; Liang, Di; Wu, Fei; Lan, Yu-Ching; Tsay, Wening; Du, Jiang; Zhao, Min; Li, Xu

2016-01-01

Smartphone-based interventions are increasingly used to support self-monitoring, self-management, and treatment and medication compliance in order to improve overall functioning and well-being. In attempting to develop a smartphone application (S-Health) that assists heroin-dependent patients in recovery, a series of focus groups (72 patients, 22 providers) were conducted in China, Taiwan, and the USA to obtain their perspectives on its acceptance and potential adoption. Data were analyzed according to the Diffusion of Innovation (DOI) theory of characteristics important to the adoption of innovation. Important to Relative Advantage, USA participants cited S-Health’s potential ability to overcome logistical barriers, while those in China and Taiwan valued its potential to supplement currently limited services. In terms of Compatibility, participants across sites reported recovery needs and goals that such an application could be helpful in supporting; however, its utility during strong craving was questioned in China and Taiwan. Important factors relevant to Complexity included concerns about smartphone access and familiarity, individualization of content, and particularly in China and Taiwan, participants wanted assurance of privacy and security. The study results suggest a general acceptance, but also indicate cultural variations in access to therapeutic and other social support systems, legal repercussions of substance use, societal perceptions of addiction, and the role of family and other social support in recovery. Taking these factors into consideration is likely to increase diffusion as well as effectiveness of these smartphone-based interventions. PMID:26846506

Plasma lipid profiles and epidemiology of atherosclerotic diseases in Taiwan--a unique experience.

PubMed

Pan, W H; Chiang, B N

1995-12-01

Rapid economic growth in Taiwan is accompanied by changing lifestyles, and the mortality pattern has switched from predominantly infectious diseases to chronic diseases. Age-adjusted mortality from heart disease has increased slowly but steadily. However, mortality from heart disease in Taiwan remains low compared with many other countries. Mortality from the cerebrovascular diseases has decreased gradually. Current age- and sex-specific values of blood cholesterol low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) are, in general, higher than values in mainland China, but lower than those in the NHANES III and PROCAM studies. From 1950 to 1987, percent dietary fat increased from 16% to 36% in Taiwan. However, a high polyunsaturated fat/saturated fat (P/S) ratio (1.3) maintained during this period may in part explain the favorable blood lipid status and low mortality from heart disease. Data from prospective studies are scarce. In case-control studies carried out in Chinese, significantly higher values of TG, CHOL LDL-C, but lower high density lipoprotein cholesterol (HDL-C) levels have often been found in coronary artery disease (CAD) patients than in controls. The percent differences in TG and HDL-C values (20%) were much greater than those of CHOL and LDL-C (3%). A few studies have identified the TG level as an independent risk factor for stroke and CAD in Taiwan, where a moderate to high fat diet with an advantageous P/S ratio is consumed.

Innovation-diffusion: a geographical study of the transition of family limitation practice in Taiwan.

PubMed

Ting, T Y

1984-09-01

This paper uses map analysis to study the transition of family limitation practice in Taiwan between 1961-80. The innovation-diffusion perspective emphasizes that birth control, particularly contraception, is a recent innovation and is essentially new in human culture. The innovation-diffusion theory assumes that the decline of fertility began in a setting where there was no, or at most very limited, previous practice of birth control. The theory emphasizes the importance of the spread of information. It also assumes that innovation starts in metropolitan centers, diffuses to other urban places with some delay, and penetrates to rural areas still later. Innovation behavior also diffuses from 1 area to another which is culturally and linguistically similar. Although there was some urban to rural diffusion from the Taiwan family planning program, the government supported program provided services more evenly between urban and rural areas, thus somewhat limiting the diffusion effect from the program. For the diffusion of family practice in Taiwan, it is expected that the availability of of information about and means of family limitation practice may effect the rate of the increase of small m values -- an index of family limitation -- in an area. The case study of Pingtung county shows that the demand-side diffusion from urban to rural areas was important in the earlier decade of the transition of family plimitation practice, but distance from urban center was less important as practice became more uniform through diffusion. Ethnicity, whether or not the township was dominated by Hakka or Fukienese, also seems to have played an important role in determining the pace at which the local residents adopted family practice limitation. Hakka townships seem to have adopted family limitation practice more slowly than Fukienese townships about the same distance from the urban center. The map analysis of Pingtung county provides descriptive evidence to support the diffusion of family limitation from urban centers to distant areas, while ethnic variables like Hakka population tend to delay the adoption of family limitation practice. In general, the urban center had higher m values than the surrounding rural areas in Pingtung county and for areas other than the urban center the the level of m values is a negative function of the distance to the urban center.

Completeness and timeliness of tuberculosis notification in Taiwan

PubMed Central

2011-01-01

Tuberculosis (TB) is a notifiable disease by the Communicable Disease Control Law in Taiwan. Several measures have been undertaken to improve reporting of TB but the completeness and timeliness of TB notification in Taiwan has not yet been systemically evaluated. Methods To assess completeness and timeliness of TB notification, potential TB cases diagnosed by health care facilities in the year 2005-2007 were identified using the reimbursement database of national health insurance (NHI), which has 99% population coverage in Taiwan. Potential TB patients required notification were defined as those who have TB-related ICD-9 codes (010-018) in the NHI reimbursement database in 2005-2007, who were not diagnosed with TB in previous year, and who have been prescribed with 2 or more types of anti-TB drugs. Each potential TB case was matched to the national TB registry maintained at Taiwan Centers for Disease Control (CDC) by using national identity number or, if non-citizen, passport number to determine whether the patients had been notified to local public health authorities and Taiwan CDC. The difference in the number of days between date of anti-tuberculosis treatment and date of notification was calculated to determine the timeliness of TB reporting. Results Of the 57,405 TB patients who were prescribed with 2 or more anti-tuberculosis drugs, 55,291 (96.3%) were notified to National TB Registry and 2,114 (3.7%) were not. Of the 55,291 notified cases, 45,250 (81.8%) were notified within 7 days of anti-tuberculosis treatment (timely reporting) and 10,041(18.2%) after 7 days (delayed reporting). Factors significantly associated with failure of notification are younger age, previously notified cases, foreigner, those who visited clinics and those who visited health care facilities only once or twice in 6 months. Conclusion A small proportion of TB cases were not notified and a substantial proportion of notified TB cases had delayed reporting, findings with implication for strengthening surveillance of tuberculosis in Taiwan. Countries where the completeness and timeliness of TB notification has not yet been evaluated should take similar action to strengthen surveillance of TB. PMID:22151346

What Kind of International Interchange Is Beneficial? Experiences of Taiwanese Indigenes

ERIC Educational Resources Information Center

Chen, Shan-Hua

2014-01-01

Because of globalization, international interchanges among indigenes in every country have become more frequent. Influenced by international multicultural trends, Taiwan's government not only supports indigenous populations to revive their traditional cultures, but also encourages the promotion of the international interchange activities among…

The soapberry bug, Jadera haematoloma (Insecta, Hemiptera, Rhopalidae): First Asian record, with a review of bionomics

PubMed Central

Tsai, Jing-Fu; Hsieh, Yi-Xuan; Rédei, Dávid

2013-01-01

Abstract The soapberry bug, Jadera haematoloma (Herrich-Schäffer, 1847) (Insecta: Hemiptera: Heteroptera: Rhopalidae: Serinethinae), a species native in tropical and subtropical regions of the New World and accidentally introduced to Hawaii, is reported for the first time from Asia (Taiwan). This record represents the first occurrence of the species in Asia. Stable populations composed of hundreds of specimens were found in seven localities of Kaohsiung City and one locality in Tainan City, and a single specimen was observed in Chiayi County. Aggregating adults and larvae fed in large numbers on the sapindacean plants Cardiospermum halicacabum L. and Koelreuteria elegans (Seem.) A. C. Smith ssp. formosana (Hayata) F. G. Meyer. Diagnostic characters of adults and larvae of Jadera haematoloma are discussed. A review of its bionomics and a bibliography are provided. Initial observations on the populations in southern Taiwan are presented. The species is potentially invasive, and further extension of its range is anticipated in Southeast Asia. PMID:23794880

Association of the shuffling of Streptococcus pyogenes clones and the fluctuation of scarlet fever cases between 2000 and 2006 in central Taiwan.

PubMed

Chiou, Chien-Shun; Wang, You-Wun; Chen, Pei-Ling; Wang, Wan-Ling; Wu, Ping-Fuai; Wei, Hsiao-Lun

2009-06-01

The number of scarlet fever occurrences reported between 2000 and 2006 fluctuated considerably in central Taiwan and throughout the nation. Isolates of Streptococcus pyogenes were collected from scarlet fever patients in central Taiwan and were characterized by emm sequencing and a standardized pulsed-field gel electrophoresis (PFGE) method. National weekly report data were collected for investigating epidemiological trends. A total of 23 emm types were identified in 1,218 S. pyogenes isolates. The five most prevalent emm types were emm12 (50.4%), emm4 (23.2%), emm1 (16.4%), emm6 (3.8%) and emm22 (3.0%). PFGE analysis with SmaI suggested that, with a few exceptions, strains with a common emm type belonged to the same clone. There were two large emm12 clones, one with DNA resistant to cleavage by SmaI. Each prevalent emm clone had major PFGE strain(s) and many minor strains. Most of the minor strains emerged in the population and disappeared soon after. Even some major strains remained prevalent for only 2-3 years before declining. The large fluctuation of scarlet fever cases between 2000 and 2006 was associated with the shuffling of six prevalent emm clones. In 2003, the dramatic drop in scarlet fever cases in central Taiwan and throughout the whole country was associated with the occurrence of a severe acute respiratory syndrome (SARS) outbreak that occurred between late-February and mid-June in Taiwan. The occurrences of scarlet fever in central Taiwan in 2000-2006 were primarily caused by five emm types, which accounted for 96.8% of the isolates collected. Most of the S. pyogenes strains (as defined by PFGE genotypes) emerged and lasted for only a few years. The fluctuation in the number of scarlet fever cases during the seven years can be primarily attributed to the shuffling of six prevalent emm clones and to the SARS outbreak in 2003.

Aromatherapy Benefits Autonomic Nervous System Regulation for Elementary School Faculty in Taiwan

PubMed Central

Chang, Kang-Ming; Shen, Chuh-Wei

2011-01-01

Workplace stress-related illness is a serious issue, and consequently many stress reduction methods have been investigated. Aromatherapy is especially for populations that work under high stress. Elementary school teachers are a high-stress working population in Taiwan. In this study, fifty-four elementary school teachers were recruited to evaluate aromatherapy performance on stress reduction. Bergamot essential oil was used for aromatherapy spray for 10 minutes. Blood pressure and autonomic nervous system parameters were recorded 5 minutes before and after the application of the aroma spray. Results showed that there were significant decreases in blood pressure, heart rate, LF power percentage, and LF/HF while there were increases in heart rate variability and HF power percentage (P < .001∗∗∗) after application of the aromatherapy spray. Further analysis was investigated by dividing subjects into three background variables (position variables, age variables, gender variables) and anxiety degree groups. All parameters were significantly different for most subgroups, except for the substitute teachers and the light-anxiety group. Parasympathetic nervous system activation was measured after aromatherapy in this study. It encouraged further study for other stress working population by aromatherapy. PMID:21584196

Asymmetric Introgression in the Horticultural Living Fossil Cycas Sect. Asiorientales Using a Genome-Wide Scanning Approach

PubMed Central

Chiang, Yu-Chung; Huang, Bing-Hong; Chang, Chun-Wen; Wan, Yu-Ting; Lai, Shih-Jie; Huang, Shong; Liao, Pei-Chun

2013-01-01

The Asian cycads are mostly allopatric, distributed in small population sizes. Hybridization between allopatric species provides clues in determining the mechanism of species divergence. Horticultural introduction provides the chance of interspecific gene flow between allopatric species. Two allopatrically eastern Asian Cycas sect. Asiorientales species, C. revoluta and C. taitungensis, which are widely distributed in Ryukyus and Fujian Province and endemic to Taiwan, respectively, were planted in eastern Taiwan for horticultural reason. Higher degrees of genetic admixture in cultivated samples than wild populations in both cycad species were detected based on multilocus scans by neutral AFLP markers. Furthermore, bidirectional but asymmetric introgression by horticultural introduction of C. revoluta is evidenced by the reanalyses of species associated loci, which are assumed to be diverged after species divergence. Partial loci introgressed from native cycad to the invaders were also detected at the loci of strong species association. Consistent results tested by all neutral loci, and the species-associated loci, specify the recent introgression from the paradox of sharing of ancestral polymorphisms. Phenomenon of introgression of cultivated cycads implies niche conservation among two geographic-isolated cycads, even though the habitats of the extant wild populations of two species are distinct. PMID:23591840

Aromatherapy benefits autonomic nervous system regulation for elementary school faculty in taiwan.

PubMed

Chang, Kang-Ming; Shen, Chuh-Wei

2011-01-01

Workplace stress-related illness is a serious issue, and consequently many stress reduction methods have been investigated. Aromatherapy is especially for populations that work under high stress. Elementary school teachers are a high-stress working population in Taiwan. In this study, fifty-four elementary school teachers were recruited to evaluate aromatherapy performance on stress reduction. Bergamot essential oil was used for aromatherapy spray for 10 minutes. Blood pressure and autonomic nervous system parameters were recorded 5 minutes before and after the application of the aroma spray. Results showed that there were significant decreases in blood pressure, heart rate, LF power percentage, and LF/HF while there were increases in heart rate variability and HF power percentage (P < .001(∗∗∗)) after application of the aromatherapy spray. Further analysis was investigated by dividing subjects into three background variables (position variables, age variables, gender variables) and anxiety degree groups. All parameters were significantly different for most subgroups, except for the substitute teachers and the light-anxiety group. Parasympathetic nervous system activation was measured after aromatherapy in this study. It encouraged further study for other stress working population by aromatherapy.

Gender ratios of administrative prevalence and incidence of attention-deficit/hyperactivity disorder (ADHD) across the lifespan: A nationwide population-based study in Taiwan.

PubMed

Huang, Charles Lung-Cheng; Weng, Shih-Feng; Ho, Chung-Han

2016-10-30

To verify the hypothesis that there is different gender ratio of attention-deficit/hyperactivity disorder (ADHD) among adults compared to children and adolescents in the clinical setting among Asian population. The nationwide population-based database containing data on enrollees in the National Health Insurance program in Taiwan during 2000-2007 was used in this study, and we investigated the lifetime gender ratios of administrative prevalence and incidence in healthcare-seeking ADHD patients (n=228,029). The male-to-female ratios of diagnosed incidence and prevalence of child/adolescent ADHD (age <20 years) ranged from 3.39 to 4.07 and 3.87-4.31, respectively. The male-to-female ratios of diagnosed incidence and prevalence of ADHD in the adult group (age 20-65 years) ranged from 0.24 to 0.76 and 0.35-0.98, respectively. In conclusion, there was substantially increased female-to-male ratio in adults ADHD compared to children and adolescents in the clinical setting. Further researches on the management and mechanism are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Study of seven single-nucleotide polymorphisms identified in East Asians for association with obesity in a Taiwanese population.

PubMed

Huang, Wei-Hsin; Hwang, Lee-Ching; Chan, Hsin-Lung; Lin, Hsiang-Yu; Lin, Yung-Hsiang

2016-08-10

This study aimed to examine single-nucleotide polymorphisms (SNPs) of seven previously reported obesity genes in East Asians and to analyse their associations and synergistic effects on obesity in the Taiwanese population. Cross-sectional study. One medical centre in northern Taiwan. A total of 323 non-obese and 264 obese participants were recruited. The threshold for obesity in this study was a body mass index of ≥27 kg/m(2), as defined by the Ministry of Health and Welfare in Taiwan. The study was performed with the approval of the institutional review board of MacKay Memorial Hospital, Taipei, Taiwan (application number 12MMHIS106). We analysed the genotype distributions of seven SNPs localising to the PPARγ2, GNB3, SDC3, ADRB2, FTO, PPARγ and ESR1 genes in obese and non-obese groups and then paired obesity-related SNPs to determine if they have synergistic effects on obesity. Analysis of the genotype distributions in obese and non-obese groups revealed only a significant positive correlation between an SNP in rs2282440-syndecan 3 (SDC3) and obesity in the Taiwanese population (p=0.006). In addition, the T/T genotype of SDC3 was significantly associated with a larger waist and hip circumference, higher body fat percentage and lower high-density lipoprotein cholesterol. Moreover, the combination of the rs2282440-SDC3T/T genotype with the rs1801282-peroxisome proliferator-activated receptor-gamma2 gene (PPARγ2) G carrier genotype was strongly associated with obesity (OR=6.77). We found that the rs2282440-SDC3T/T genotype is associated with obesity in the Taiwanese population. Furthermore, there is a synergistic effect of the high-risk alleles of the SDC3 and PPARγ2 genes on the obese phenotype in the Taiwanese population. 12MMHIS106; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

ARSENIC MODE OF ACTION AND DEVELOPING A BBDR MODEL

EPA Science Inventory

The current USEPA cancer risk assessment for inorganic arsenic is based on a linear extrapolation of the epidemiological data from exposed populations in Taiwan. However, proposed key events in the mode of action (MoA) for arsenic-induced cancer (which may include altered DNA me...

Association between socioeconomic status and cerebral palsy.

PubMed

Tseng, Sung-Hui; Lee, Jiun-Yih; Chou, Yi-Lin; Sheu, Mei-Ling; Lee, Yuan-Wen

2018-01-01

The present study investigated the annual prevalence of cerebral palsy (CP) among children aged <7 years in Taiwan and the association between socioeconomic status and CP prevalence. Data from the Taiwan National Health Insurance Research Database for the 2002-2008 period were used in this population-based study. Severe and total CP were defined according to catastrophic illness certificate and medical claim records, respectively. The annual CP prevalence was calculated as the number of children with CP among all children aged <7 years. From 2002 to 2008, the annual prevalence of total and severe CP ranged from 1.9 to 2.8 and from 1.1 to 1.4 per 1000 children, respectively. Boys were 30% more likely to have CP than girls [adjusted relative risk (RR) and 95% confidence interval (CI) ranged from 1.3 (1.2-1.4) to 1.4 (1.2-1.5)]. Low family income was associated with a higher CP prevalence [adjusted RR (95% CI) ranged from 5.1 (4.2-6.2) to 6.4 (5.4-7.6)]. The prevalence of CP in rural area was higher than that in urban or suburban areas. The mortality rate of severe CP ranged from 12.2-22.7 per 1000 children within the 7 years study period. The prevalence of CP in Taiwan is similar to that in Western countries. A higher prevalence of CP is associated with male sex, low income, and rural residential location. Our findings provide insights into CP epidemiology among the Chinese population.

Prescriptions for category D and X drugs during pregnancy in Taiwan: a population-based study.

PubMed

Kao, Li-Ting; Chen, Yi-Hua; Lin, Herng-Ching; Chung, Shiu-Dong

2014-10-01

This study aimed to investigate the most prescribed medications and principle diagnoses for category D and X drugs during pregnancy using a population-based dataset in Taiwan. The data for the present study were sourced from the Taiwan Longitudinal Health Insurance Database 2000. We selected 14 125 women who had live singleton births between 1 January 2009 and 31 December 2011. In total, 217 226 prescriptions prescribed to these pregnant women were identified. Of the total 217 226 prescriptions, 1.1% were category D or X drugs; in the first, second, and third trimesters of pregnancy, 1.8%, 0.7%, and 0.5% of prescriptions were category D or X drugs, respectively. Progestins (15.3%) and propylthiouracil (10.7%) were the two most frequently prescribed category D or X drugs during pregnancy. In particular, progestins (20.4%) and estrogens (15.6%) were the most frequently prescribed category D or X drug in the first trimester of pregnancy. Propylthiouracil was the most prescribed category D or X drug in the second (20.3%) and third trimesters (23.1%) of pregnancy, respectively. The most common principal diagnosis during pregnancy was "disorders of menstruation and other abnormal bleeding from the female genital tract" (22% of all principal diagnoses for prescribing category D and X drugs). Our study found that the physicians obviously reduced the use of category D and X drugs for women after becoming aware that they were pregnant. Copyright © 2014 John Wiley & Sons, Ltd.

Changing patterns of HIV epidemic in 30 years in East Asia.

PubMed

Suguimoto, S Pilar; Techasrivichien, Teeranee; Musumari, Patou Masika; El-saaidi, Christina; Lukhele, Bhekumusa Wellington; Ono-Kihara, Masako; Kihara, Masahiro

2014-06-01

The HIV epidemic in East Asia started relatively late compared to the rest of the world. All countries or areas, except for North Korea, had reported HIV and AIDS cases, with China being the major contributor to the epidemic. Though initially driven by injecting drug use in China, East Asia did not experience an explosive spread. Strong commitment in China and early harm reduction programs in Taiwan managed to reduce transmission substantially among injecting drug users. In contrast to China and Taiwan, injection drug use has accounted just a little, if not at all, for the spread of HIV in other East Asian counties. However, following a global trend, sexual contact has become a major route of infection across the region. While much progress has been achieved in this region, with the epidemic among other key populations relatively stable, the emerging epidemic through sex between men is a growing concern. Recent estimates suggest that HIV prevalence among men who have sex with men (MSM) has reached 6.3 % in China, 7.5 % in Mongolia, and ranges between 8.1 %-10.7 % in Taiwan and between 2.7 %- 6.5 % in South Korea. In Japan, 74 % of male HIV cases were among MSM in 2012, while Hong Kong has witnessed a sharp increase of HIV cases among MSM since 2004. There is urgent need to address issues of discrimination and stigma toward homosexuality, and to strengthen the strategies to reach and care for this population.

National surveillance of 2,3,7,8-substituted polychlorinated dibenzo-p-dioxins/furans in soil in Taiwan.

PubMed

Hsu, Yi-Chyun; Que, Danielle E; Gou, Yan-You; Tsou, Tsui-Chun; Liu, Chung-Kun; Wang, Yen-Ling; Hou, Wen-Che; Lin, Yi-Hsien; Liu, Wen-Yao; Chao, How-Ran; Lee, Wen-Jhy

2018-07-01

In this study, the polychlorinated dibenzo-p-dioxin/furan (PCDD/F) levels in 381 soil samples coming from different background areas (n = 238) and contaminated areas (n = 143) in Taiwan were investigated from 2011 to 2015 using high resolution gas chromatograph/high resolution mass spectrometry (HRGC/HRMS). The contaminated areas showed higher PCDD/F contamination as compared to the background areas (1230 vs 749 pg/g dry weight (dw)); 14.0 vs 6.25 pg WHO 2005 -TEQ/g dw). The lowest levels were recorded in the outlying islands (1.28 pg WHO 2005 -TEQ/g dw). PCDD/F congener distribution profiles in the background and contaminated areas as well as on the islands varied. OCDD was the dominant congener in almost all locations, including the northern background (87.7%) and central contaminated (74.2%) areas. Other dominant species included OCDF and 1,2,3,4,6,7,8-HpCDD. Levels of PCDD/F-TEQs in Taiwanese soils, including the background areas, were higher than in some developing countries and regions with global background levels due to high industrialization except for the contaminated areas. Geographic differences in dioxin-contaminated soils were also shown in this study. Higher soil dioxin-TEQs were observed in locations with high populations and population densities. Despite the limitations, the economic status of Taiwan represented by the annual averaged family income (AAFI) was positively correlated to soil dioxin-TEQs. Copyright © 2018. Published by Elsevier Ltd.

Factors associated with tocolytic hospitalizations in Taiwan: evidence from a population-based and longitudinal study from 1997 to 2004

PubMed Central

2009-01-01

Background The use of tocolytic hospitalization in antenatal care is controversial and worthy of more research. We investigated individual, institutional, and area factors that affect the use of tocolytic hospitalizations in Taiwan where fertility has rapidly declined. Methods Longitudinal data from the 1996 to 2004 National Health Insurance Research Database in Taiwan were used to identify tocolytic hospitalizations. The probit model was used to estimate factors associated with tocolytic hospitalizations. Results The decline in fertility was significantly associated with the probability of tocolytic hospitalizations. Several physician and institutional factors-including physician's age, hospital ownership, accreditation status, bed size, and teaching status-were also significantly correlated to the dependent variables. Conclusions The provision of inpatient tocolysis is influenced not only by clinical considerations but also by physician, institutional, and area factors unrelated to clinical need. Fertility declines in Taiwan may have led obstetricians/gynecologists to provide more tocolysis to make up for their lost income. If the explanation is further validated, reimbursement policies may need to be reviewed to correct for overuse of inpatient tocolysis. The correlation could also be explained by the increasing use of artificial reproductive technologies and higher social value of newborns. In addition, the physician and institutional variations observed in the study indicate potential misuse of inpatient tocolysis that warrant further investigation. PMID:20021650

The Species and Origin of Shark Fins in Taiwan's Fishing Ports, Markets, and Customs Detention: A DNA Barcoding Analysis.

PubMed

Chuang, Po-Shun; Hung, Tzu-Chiao; Chang, Hung-An; Huang, Chien-Kang; Shiao, Jen-Chieh

2016-01-01

The increasing consumption of shark products, along with the shark's fishing vulnerabilities, has led to the decrease in certain shark populations. In this study we used a DNA barcoding method to identify the species of shark landings at fishing ports, shark fin products in retail stores, and shark fins detained by Taiwan customs. In total we identified 23, 24, and 14 species from 231 fishing landings, 316 fin products, and 113 detained shark fins, respectively. All the three sample sources were dominated by Prionace glauca, which accounted for more than 30% of the collected samples. Over 60% of the species identified in the fin products also appeared in the port landings, suggesting the domestic-dominance of shark fin products in Taiwan. However, international trade also contributes a certain proportion of the fin product markets, as four species identified from the shark fin products are not found in Taiwan's waters, and some domestic-available species were also found in the customs-detained sample. In addition to the species identification, we also found geographical differentiation in the cox1 gene of the common thresher sharks (Alopias vulpinus), the pelagic thresher shark (A. pelagicus), the smooth hammerhead shark (Sphyrna zygaena), and the scalloped hammerhead shark (S. lewini). This result might allow fishing authorities to more effectively trace the origins as well as enforce the management and conservation of these sharks.

Ecological and physical barriers shape genetic structure of the Alpine porcini (Boletus reticuloceps).

PubMed

Feng, Bang; Liu, Jian Wei; Xu, Jianping; Zhao, Kuan; Ge, Zai Wei; Yang, Zhu L

2017-04-01

The Alpine porcini, Boletus reticuloceps, is an ectomycorrhizal mushroom distributed in subalpine areas of Southwest China, central China, and Taiwan Island. This distribution pattern makes it an ideal organism to infer how ectomycorrhizal fungi have reacted to historical tectonic and climatic changes, and to illustrate the mechanism for the disjunction of organisms between Southwest China and Taiwan. In this study, we explored the phylogeographic pattern of B. reticuloceps by microsatellite genotyping, DNA sequencing, ecological factor analysis, and species distribution modeling. Three genetic groups from the East Himalayas (EH), northern Hengduan Mountains (NHM), and southern Hengduan Mountains (SHM), were identified. The earlier divergent SHM group is found under Abies in moister environments, whereas the EH and NHM groups, which are physically separated by the Mekong-Salween Divide, are found mainly under Picea in drier environments. Samples from Taiwan showed a close relationship with the SHM group. High mountains did not form dispersal barriers among populations in each of the EH, NHM, and SHM groups, probably due to the relatively weak host specificity of B. reticuloceps. Our study indicated that ecological heterogeneity could have contributed to the divergence between the SHM and the NHM-EH groups, while physical barriers could have led to the divergence of the NHM and the EH groups. Dispersal into Taiwan via Central China during the Quaternary glaciations is likely to have shaped its disjunct distribution.

Development and psychometric evaluation of the psychological cigarette dependence scale for male smokers in taiwan.

PubMed

Huang, Chih-Ling; Cheng, Chung-Ping; Wang, Hsiu-Hung

2014-06-01

The influence of psychological factors on cigarette dependence often surpasses the direct effects of the nicotine itself. Researcher opinions on the nature and extent of psychological contributors to cigarette dependence vary widely. This study develops and psychometrically tests the Psychological Cigarette Dependence Scale (PCDS) for male smokers in Taiwan. The PCDS was developed using domain identification, individual interviews for item generation, expert reviews, and testing for construct validity and instrument stability. After initial item analysis, the PCDS was tested for concurrent and construct validity and reliability on 256 adult male smokers recruited from community centers, trade and business organizations, private companies, and factories in southern Taiwan. Participants were limited to adult men because female smokers are a small (4.1%) proportion of the female population in Taiwan and thus are difficult to recruit in statistically significant numbers. Exploratory factor analysis showed that lifelong binding and health concerns are the two predominating factors addressed by the 37-item PCDS. The PCDS correlated positively with the Fagerstrom questionnaire (r = .54, p < .01). Cronbach's alpha was .94, and test-retest reliability (intraclass coefficient) was .77 (N = 28). Preliminary evidence suggests that this scale is a valid measure of psychological cigarette dependence. Assessment results may help nursing professionals focus on smoking cessation interventions that are tailored to the patterns and severity of patients' psychological cigarette dependence.

The influence of nurses' working motivation and job satisfaction on intention to quit: an empirical investigation in Taiwan.

PubMed

Tzeng, Huey-Ming

2002-11-01

The present era of cost-containment pressures indicates that nursing executives have to ensure that, their nurses have a work environment with the work characteristics known to be linked to job satisfaction and good outcomes. The research hypothesis investigated here was: the higher nurses' levels on general job satisfaction, overall satisfaction with their professional role, and general job happiness, the lower their intention to quit would be. The controlling variables included demographic characteristics, working motivation, and nine job satisfaction subscales. This study was conducted in 3 hospitals located in southern Taiwan. All nurses working for these 3 hospitals were the target subjects. The overall response rate (648 completed questionnaires) was 82%. The nurses' Job Satisfaction and the perceptual degree of its importance questionnaire was used. Ordinal logistics regression analyses were utilized. General job satisfaction, general job happiness, satisfaction with salary and promotion, institution, educational background, and age of nurses' youngest child were proved to be significant predictors of nurses' intention to quit. Suggestions for future studies and administrative strategies in decreasing nurses' intention to quit were discussed. Copyright 2002 Elsevier Science Ltd.

Evaluation of an innovative nursing exchange programme: health counselling skills and cultural awareness.

PubMed

Lee, Regina L T; Pang, Samantha M C; Wong, Thomas K S; Chan, M F

2007-11-01

In 2006, a two-week summer exchange programme was conducted for nursing students from 15 institutes and/or universities, including places in Taiwan, Macau, Chinese mainland and Hong Kong. This paper evaluates a summer exchange programme focusing on nursing students' professional and personal development within the context of learning health counselling skills and studying cultural aspects of the host Region. The programme was evaluated using a mixed method of both quantitative and qualitative research design. Three dimensions include students' exchange perspective, professional development and personal development were evaluated at the end of the two-week programme. Data for this evaluation were derived from the results of questionnaires completed by the 64 nursing students enrolled in this programme, and from the analysis of five focus group interviews. Overall, students (98%) reported that they were very positive about their experiences during the programme, and felt they had gained a greater awareness of effective health counselling skills, of the latest developments in advanced nursing technology within the host School, and of cultural diversity in relation to their personal and professional development. Comparison of sub-total mean scores and standard deviations (mean+/-SD) of the three dimensions among students from Taiwan, Chinese mainland and Hong Kong/Macau, revealing significant differences in the exchange perspective (Taiwan: 18.6+/-1.4; Chinese mainland: 18.8+/-1.4; and Hong Kong/Macau: 16.5+/-1.1) professional development (Taiwan: 18.4+/-1.6; Chinese mainland: 18.2+/-1.5; and Hong Kong/Macau: 16.2+/-2.0) and personal development dimensions (Taiwan: 18.9+/-1.0; Chinese mainland: 18.6+/-1.4; and Hong Kong/Macau: 17.3+/-1.1) among these three places (p<0.001). For paired comparison (post-hoc test), the findings also show that the sub-total mean scores of the students from Taiwan and Chinese mainland were significantly higher than those of students from Hong Kong and Macau in the exchange perspective (Taiwan versus Hong Kong/Macau, p<0.001; Chinese mainland versus Hong Kong/Macau, p<0.001), professional development (Taiwan versus Hong Kong/Macau, p=0.001; Chinese mainland versus Hong Kong/Macau, p<0.001), and personal development (Taiwan versus Hong Kong/Macau, p<0.001; Chinese mainland versus Hong Kong/Macau, p=0.002). Although the findings cannot be generalized, the programme evaluation highlights the positive impact on one's exchange perspective and professional and personal development of a culturally integrated exchange programme for nursing students, with emphasis on skill practices and cultural diversity.

The determinants of health care expenditure toward the end of life: evidence from Taiwan.

PubMed

Chang, Simon; He, Yang; Hsieh, Chee-Ruey

2014-08-01

This paper empirically investigates the relationship between the health care expenditure of end-of-life patients and hospital characteristics in Taiwan where (i) hospitals of different ownership differ in their financial incentives; (ii) patients are free to choose their providers; and (iii) health care services are paid for by a single public payer on a fee-for-services basis with a global budget cap. Utilizing insurance claims for 11 863 individuals who died during 2005-2007, we trace their hospital expenditures over the last 24 months of their lives. We find that end-of-life patients who are treated by private hospitals in general are associated with higher inpatient expenditures than those treated by public hospitals, while there is no significant difference in days of hospital stay. This finding is consistent with the difference in financial incentives between public and private hospitals in Taiwan. Nevertheless, we also find that the public-private differences vary across accreditation levels. Copyright © 2013 John Wiley & Sons, Ltd.

Scenario analysis of freight vehicle accident risks in Taiwan.

PubMed

Tsai, Ming-Chih; Su, Chien-Chih

2004-07-01

This study develops a quantitative risk model by utilizing Generalized Linear Interactive Model (GLIM) to analyze the major freight vehicle accidents in Taiwan. Eight scenarios are established by interacting three categorical variables of driver ages, vehicle types and road types, each of which contains two levels. The database that consists of 2043 major accidents occurring between 1994 and 1998 in Taiwan is utilized to fit and calibrate the model parameters. The empirical results indicate that accident rates of freight vehicles in Taiwan were high in the scenarios involving trucks and non-freeway systems, while; accident consequences were severe in the scenarios involving mature drivers or non-freeway systems. Empirical evidences also show that there is no significant relationship between accident rates and accident consequences. This is to stress that safety studies that describe risk merely as accident rates rather than the combination of accident rates and consequences by definition might lead to biased risk perceptions. Finally, the study recommends using number of vehicle as an alternative of traffic exposure in commercial vehicle risk analysis. The merits of this would be that it is simple and thus reliable; meanwhile, the resulted risk that is termed as fatalities per vehicle could provide clear and direct policy implications for insurance practices and safety regulations.

Surgeon and Hospital Volume as Quality Indicators for CABG in Taiwan: Examining Hazard to Mortality and Accounting for Unobserved Heterogeneity

PubMed Central

Hockenberry, Jason M; Lien, Hsien-Ming; Chou, Shin-Yi

2010-01-01

Objective To investigate whether provider volume has an impact on the hazard of mortality for coronary artery bypass grafting (CABG) patients in Taiwan. Data Sources/Study Setting Multiple sources of linked data from the National Health Insurance Program in Taiwan. Study Design The linked data were used to identify 27,463 patients who underwent CABG without concomitant angioplasty or valve procedures and the surgeon and hospital volumes. Generalized estimating equations and hazard models were estimated to assess the impact of volume on mortality. The hazard modeling technique used accounts for bias stemming from unobserved heterogeneity. Principal Findings Both surgeon and hospital volume quartiles are inversely related to the hazard of mortality after CABG. Patients whose surgeon is in the three higher volume quartiles have lower 1-, 3-, 6-, and 12-month mortality after CABG, while only those having their procedure performed at the highest quartile of volume hospitals have lower mortality outcomes. Conclusions Mortality outcomes are related to provider CABG volume in Taiwan. Unobserved heterogeneity is a concern in the volume–outcome relationship; after accounting for it, surgeon volume effects on short-term mortality are large. Using models controlling for unobserved heterogeneity and examining longer term mortality may still differentiate provider quality by volume. PMID:20662948

Surgeon and hospital volume as quality indicators for CABG in Taiwan: examining hazard to mortality and accounting for unobserved heterogeneity.

PubMed

Hockenberry, Jason M; Lien, Hsien-Ming; Chou, Shin-Yi

2010-10-01

To investigate whether provider volume has an impact on the hazard of mortality for coronary artery bypass grafting (CABG) patients in Taiwan. Multiple sources of linked data from the National Health Insurance Program in Taiwan. The linked data were used to identify 27,463 patients who underwent CABG without concomitant angioplasty or valve procedures and the surgeon and hospital volumes. Generalized estimating equations and hazard models were estimated to assess the impact of volume on mortality. The hazard modeling technique used accounts for bias stemming from unobserved heterogeneity. Both surgeon and hospital volume quartiles are inversely related to the hazard of mortality after CABG. Patients whose surgeon is in the three higher volume quartiles have lower 1-, 3-, 6-, and 12-month mortality after CABG, while only those having their procedure performed at the highest quartile of volume hospitals have lower mortality outcomes. Mortality outcomes are related to provider CABG volume in Taiwan. Unobserved heterogeneity is a concern in the volume-outcome relationship; after accounting for it, surgeon volume effects on short-term mortality are large. Using models controlling for unobserved heterogeneity and examining longer term mortality may still differentiate provider quality by volume. Copyright © Health Research and Educational Trust.

The influence of asymmetric convections on typhoon cyclonic deflection tracks across Taiwan

NASA Astrophysics Data System (ADS)

Hsu, L. H.; Su, S. H.

2016-12-01

This study focus on the mechanisms of typhoon cyclonic deflection tracks (CDT) approaching the east coast of Taiwan. We analyzed for 84 landfall typhoons which has 49 CDT cases, 18 cases are with very large deflection angles (DA) ( > 20°) and another 7 cases are with cyclonic looping tracks (CLT). Most of the large DA and CLT cases are with relatively slow translation speeds of 4 m s-1 and occurred near the east coast, north of 23 °N in Taiwan. The Weather Research and Forecasting (WRF) Model was used to simulate the typhoon CDT cases. We use the potential vorticity (PV) tendency diagnosis to analyze the typhoon movements, and decompose the wave number one component of PV tendencies into horizontal advection (HA), vertical advection (VA) and diabatic heating (DH) terms. The northern landfall storms have significant vorticity stretching and subsidence warming to the south of the storm. The subsidence warming suppresses convections and produces heating asymmetries for the typhoon structure. The vorticity stretching (VA effect) and diabatic heating asymmetries (DH effect) which lead the southwestward deflection storm motion. The HA effect in general does not contribute to the CDT. Our results highlight the effects of vorticity stretching and asymmetric convective heating in producing the CDT to north of 23 °N near the east coast of Taiwan.

Change in hepatitis A epidemiology after vaccinating high risk children in Taiwan, 1995-2008.

PubMed

Tsou, Tsung-Pei; Liu, Cheng-Chung; Huang, Ji-Jia; Tsai, Kun-Ju; Chang, Hsiu-Fang

2011-04-05

Taiwan started to immunize children in 30 indigenous townships against hepatitis A since June 1995. The program was further expanded to 19 non-indigenous townships with higher incidence or increased risk of epidemic in 1997-2002, covering 2% of total population. Annual incidence of hepatitis A decreased from 2.96 in 1995 (baseline period) to 0.90/100,000 in 2003-2008 (vaccination period). The incidence in vaccinated townships and unvaccinated townships declined 98.3% (49.66-0.86/100,000) and 52.6% (1.90-0.90/100,000). In 2003-2008, incidence doubled in people aged >=30 years, mostly in unvaccinated townships (0.42-0.92). During 2003-2008, travel to endemic countries was the most commonly reported risk factor (13.5%). First dose vaccine coverage was 78.8% in 1994-2005 birth cohort. Taiwan's experience demonstrates the great, long-term efficacy of hepatitis A vaccine in disease control in vaccinated townships, and out-of-cohort effect in unvaccinated townships. Further reduction can be achieved by improving vaccination coverage of adults at risk. Copyright © 2011 Elsevier Ltd. All rights reserved.

Genotype and phenotype in patients with Prader-Willi syndrome in Taiwan.

PubMed

Lin, Hsiang-Yu; Lin, Shuan-Pei; Chuang, Chih-Kuang; Chen, Ming-Ren; Yen, Jui-Lung; Lee, Yann-Jinn; Huang, Chi-Yu; Tsai, Li-Ping; Niu, Dau-Ming; Chao, Mei-Chyn; Kuo, Pao-Lin

2007-06-01

Several different genetic defects have been found to result in the characteristic phenotypic expression of Prader-Willi syndrome (PWS). We performed a retrospective analysis of 67 cases of molecularly confirmed PWS diagnosed from January 1980 through July 2006 in five medical centres in Taiwan. Clinical manifestations were compared between patients with deletion and those with maternal uniparental disomy (UPD). Deletion was present in 56 (84%), UPD in 10 (15%), and a probable imprinting centre deletion or imprinting defect in 1 (1%). PWS with deletion was more likely than that with UPD to be characterized by hypogonadism (p < 0.001), small hands and feet (p < 0.001), and hypopigmentation (p < 0.002). Both maternal (p = 0.015) and paternal age (p = 0.021) were higher in the UPD group. No other clinical features differed significantly different between the two groups. In contrast to most Western populations with a higher incidence of UPD, this study of PWS in Taiwan shows a higher incidence of deletion. There may be subtle phenotypic differences between the UPD and deletion genotypes, but its not clear that these are important clinically.

Speaking one more language in early life has only minor effects on cognition in Taiwanese with low education level: the Taishan Project.

PubMed

Liu, Yi-Chien; Liu, Yen-Ying; Yip, Ping-Keung; Meguro, Mitsue; Meguro, Kenichi

2017-07-01

Increasing evidence shows that bilingualism or multilingualism may have beneficial effects on preventing dementia. We performed a cross-sectional, community-based study in Taiwan. Some elders (older than 70 years) in Taiwan can speak Japanese because of the formal Japanese education they received before World War II, when Taiwan was under Japanese rule. After the war, Mandarin Chinese was adopted as the official language of Taiwan. We assessed whether constantly using three languages had an effect on dementia prevalence and cognitive function. We defined multilingualism as the ability to fluently speak Taiwanese (T), Japanese (J), and Mandarin Chinese (C) in daily life. We evaluated the Mini-Mental State Examination and AD8 questionnaire results of 514 community-dwelling people older than 70 years in Taishan, Taiwan. Seventy-three of the subjects (14.2%) were multilingual (T, J, C) and 441 (85.8%) were bilingual (T, C). No difference was noted in dementia prevalence between multilingual (6.8%) and bilingual (7.4%) populations, but multilinguals were older than bilinguals (mean age: 79.9 vs 77.3 years). Multilinguals had higher Mini-Mental State Examination scores than bilinguals (mean: 24.6 vs. 22.7). However, after the subjects were stratified into low and high education level groups, the Mini-Mental State Examination difference was found to be significant in only the low education level group. Dementia prevalence did not significantly differ between the multilingual (T, J, C) and bilingual (T, C) groups. However, given that the average age of the multilingual group was approximately 2 years older than that of the bilingual group, there may have been minor effects in the multilingual group. © 2017 Japanese Psychogeriatric Society.

Quality of life (QOL) among community dwelling older people in Taiwan measured by the CASP-19, an index to capture QOL in old age.

PubMed

Wu, Tai-Yin; Chie, Wei-Chu; Kuo, Kuan-Liang; Wong, Wai-Kuen; Liu, Jen-Pei; Chiu, Shih-Ting; Cheng, Yeung-Hung; Netuveli, Gopal; Blane, David

2013-01-01

There was no existing scale in Mandarin Chinese to specifically measure QOL in old age. We aimed to validate a Chinese Taiwan version of the CASP-19 (control, autonomy, self-realization, pleasure), a QOL questionnaire, in Taiwan. The existing CASP-19 Cantonese version was modified into Chinese Taiwan version and pilot tested. Data were then gathered from 699 older people. Score distribution, exploratory and confirmatory factor structure, reliability and clinical validity of the CASP-19 and its shortened version, the CASP-12, were examined. The mean age of the participants was 75.5 (standard deviation (SD) 6.5), and half (49.5%) were female. The mean CASP-19 score was 38.2 (range 11-56; SD 7.1), lower than that of Western countries. Exploratory factor analysis revealed an additional factor, 'participation' (CASPP-19). There was satisfactory internal consistency (Cronbach's α 0.63-0.85) for the subscales, except for the control domain. For the 19-item scale, the first order five-domain model (CASPP-19) yielded the best fit. For the CASP-12, first and second order original CASP-12 models performed equally well. There was an inverse relationship between the CASP total scores and frailty, chronic diseases, depressive disorders, living alone and fall events in the past 12months, supporting good clinical validity for all versions of the CASP scale (CASP-19, CASPP-19, original and new CASP-12). The original CASP-12 may be presently the best choice for use in China, Taiwan or other Mandarin-speaking populations due to its conciseness and model parsimony. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Changing incidence patterns of hepatocellular carcinoma among age groups in Taiwan.

PubMed

Hung, Giun-Yi; Horng, Jiun-Lin; Yen, Hsiu-Ju; Lee, Chih-Ying; Lin, Li-Yih

2015-12-01

This study examined and compared the incidence patterns of hepatocellular carcinoma among age groups in Taiwan, 30 years after a universal hepatitis B virus immunization program was launched. Data for hepatocellular carcinoma diagnosed in 2003-2011 were collected from the population-based Taiwan Cancer Registry. Age-standardized incidence rates were calculated to analyze and compare the changes in incidence rates and trends. More specific analyses were performed on four age groups separated by sex. A total of 82,856 patients were diagnosed with hepatocellular carcinoma in 2003-2011 in Taiwan, yielding an age-standardized incidence rate of 32.97 per 100,000 person-years. Hepatocellular carcinoma was predominantly diagnosed in middle-aged adults (50.1%) and elderly people (49.1%), in contrast to the low incidences in children (0.04%) and adolescents and young adults (0.8%). Striking variations in trends were found for children (annual percent change: -16.6%, 2003-2010) and adolescents and young adults (annual percent change: -7.9%, 2003-2011). The incidence rate of hepatocellular carcinoma in children decreased to zero in 2011; only a slight decline in trends occurred for the middle-aged group (annual percent change: -2%, 2003-2011), and a slight upward trend was observed for elderly people (1.3%), specifically in women (1.7%). In Taiwan, hepatitis B virus-related hepatocellular carcinoma was nearly eradicated in children in 2011. The findings on age-specific incidence patterns and trends of hepatocellular carcinoma suggest that different control strategies for treating this devastating disease in the future be made according to age. Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Oseltamivir use and outcomes during the 2009 influenza A H1N1 pandemic in Taiwan

PubMed Central

2013-01-01

Background The Taiwan CDC provided free oseltamivir to all patients with influenza infections confirmed by rapid testing or who had clinical warning symptoms during the 2009 H1N1 influenza pandemic in Taiwan. However, oseltamivir utilization patterns, cost, and outcomes among oseltamivir-treated patients remained unclear. Method A population-level, observational cohort study was conducted using the Taiwan National Health Insurance Database from January to December 2009 to describe the use of oseltamivir. Result Prescription trend over weeks increased after a change in government policy and responded to the influenza virus activity. The overall prescription rate was 22.33 per 1000 persons, with the highest prescription rate of 116.5 for those aged 7–12 years, followed by 69.0 for those aged 13–18 years, while the lowest rate was 1.7 for those aged ≥ 65 years. As influenza virus activity increased, the number of prescriptions for those aged ≤18 years rose significantly, whereas no substantial change was observed for those aged ≥65 years. There were also regional variations in terms of oseltamivir utilization and influenza complication rates. Conclusions Oseltamivir was widely used in the 2009 H1N1 influenza pandemic in Taiwan, particularly in those aged 7–18 years. The number of prescriptions for oseltamivir increased with a change in government policy and with increasing cases of pandemic influenza. Further study is needed to examine whether there is an over- or under-use of anti-influenza drugs in different age groups or regions and to examine the current policy of public use of anti-influenza drugs to reduce influenza-associated morbidity and mortality. PMID:23849163

Availability, health-care costs, and utilization patterns of biologics in Taiwan.

PubMed

Hsieh, Chee-Ruey; Liu, Ya-Ming

2012-01-01

To provide an overview of the use of biologics in Taiwan, including the access to new biologics, the impact of this access on the growth of health-care expenditure, and the utilization patterns. We first conducted a market-level analysis to investigate the availability of global biologics in Taiwan as well as the growth and concentration of aggregate spending on biologics. We then conducted a patient-level analysis to investigate the costs and utilization patterns for selected new biologics. We found that the concentration index is such that the 20 leading biologics in Taiwan account for more than 90% of the total spending on biologics. In our patient-level study on four biologics, the annual cost of treatment per patient ranged from NT$100,000 to NT$400,000. The prevalence rate of the user was between 6.5 and 37.2 per 100,000 of population. The treatment costs were inversely related to the prevalence rate of users. We also found that physicians in larger and public hospitals were more likely to prescribe new biologics to their patients compared with their counterparts practicing in smaller and private hospitals. In addition, we found that physicians were more likely to prescribe biologics to patients with more severe diseases and higher comorbidities. We conclude that public spending on biologics in Taiwan is highly targeted toward about 20 products with higher annual expenditures and growth rates and that the utilization of these biologics is targeted at a small number of patients. In addition, the access to these costly biologics is not uniform among patients in a country with universal coverage for prescription drugs. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

2016 guideline strategies for the use of antifungal agents in patients with hematological malignancies or hematopoietic stem cell transplantation recipients in Taiwan.

PubMed

Ko, Bor-Sheng; Chen, Wei-Ting; Kung, Hsiang-Chi; Wu, Un-In; Tang, Jih-Luh; Yao, Ming; Chen, Yee-Chun; Tien, Hwei-Fang; Chang, Shan-Chwen; Chuang, Yin-Ching; Lin, Dong-Tsamn

2017-07-25

The Infectious Diseases Society of Taiwan (IDST), the Hematology Society of Taiwan, the Taiwan Society of Blood and Marrow Transplantation, Medical Foundation in Memory of Dr. Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, and CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines cooperatively published this guideline for the use of antifungal agents in hematological patients with invasive fungal diseases (IFDs) in Taiwan. The guideline is the first one endorsed by IDST focusing on selection of antifungal strategies, including prophylaxis, empirical (or symptom-driven) and pre-emptive (or diagnostic-driven) strategy. We suggest a risk-adapted dynamic strategy and provide an algorithm to facilitate decision making in population level as well as for individual patient. Risk assessment and management accordingly is explicitly emphasized. In addition, we highlight the importance of diagnosis in each antifungal strategy among five elements of the antimicrobial stewardship (diagnosis, drug, dose, de-escalation and duration). The rationale, purpose, and key recommendations for the choice of antifungal strategy are summarized, with concise review of international guidelines or recommendation, key original articles and local epidemiology reports. We point out the interaction and influence between elements of recommendations and limitation of and gap between evidences and daily practice. The guideline balances the quality of evidence and feasibility of recommendation in clinical practice. Finally, this version introduces the concept of health economics and provides data translated from local disease burdens. All these contents hopefully facilitate transparency and accountability in medical decision-making, improvements in clinical care and health outcomes, and appropriateness of medical resource allocation. Copyright © 2017. Published by Elsevier B.V.

Special Report on Ingested Inorganic Arsenic: Skin Cancer; Nutritional Essentiality (Sab Review Draft)

EPA Science Inventory

A technical panel of EPA's Risk Assessment Forum has studied three special issues regarding certain health effects, particularly skin cancer, associated with arsenic ingestion: (1) the validity of the Taiwan study and its use for dose-response assessment in the U.S. population, (...

Performance assessment methodology and preliminary results for low-level radioactive waste disposal in Taiwan.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arnold, Bill Walter; Chang, Fu-lin; Mattie, Patrick D.

2006-02-01

Sandia National Laboratories (SNL) and Taiwan's Institute for Nuclear Energy Research (INER) have teamed together to evaluate several candidate sites for Low-Level Radioactive Waste (LLW) disposal in Taiwan. Taiwan currently has three nuclear power plants, with another under construction. Taiwan also has a research reactor, as well as medical and industrial wastes to contend with. Eventually the reactors will be decomissioned. Operational and decommissioning wastes will need to be disposed in a licensed disposal facility starting in 2014. Taiwan has adopted regulations similar to the US Nuclear Regulatory Commission's (NRC's) low-level radioactive waste rules (10 CFR 61) to govern themore » disposal of LLW. Taiwan has proposed several potential sites for the final disposal of LLW that is now in temporary storage on Lanyu Island and on-site at operating nuclear power plants, and for waste generated in the future through 2045. The planned final disposal facility will have a capacity of approximately 966,000 55-gallon drums. Taiwan is in the process of evaluating the best candidate site to pursue for licensing. Among these proposed sites there are basically two disposal concepts: shallow land burial and cavern disposal. A representative potential site for shallow land burial is located on a small island in the Taiwan Strait with basalt bedrock and interbedded sedimentary rocks. An engineered cover system would be constructed to limit infiltration for shallow land burial. A representative potential site for cavern disposal is located along the southeastern coast of Taiwan in a tunnel system that would be about 500 to 800 m below the surface. Bedrock at this site consists of argillite and meta-sedimentary rocks. Performance assessment analyses will be performed to evaluate future performance of the facility and the potential dose/risk to exposed populations. Preliminary performance assessment analyses will be used in the site-selection process and to aid in design of the disposal system. Final performance assessment analyses will be used in the regulatory process of licensing a site. The SNL/INER team has developed a performance assessment methodology that is used to simulate processes associated with the potential release of radionuclides to evaluate these sites. The following software codes are utilized in the performance assessment methodology: GoldSim (to implement a probabilistic analysis that will explicitly address uncertainties); the NRC's Breach, Leach, and Transport - Multiple Species (BLT-MS) code (to simulate waste-container degradation, waste-form leaching, and transport through the host rock); the Finite Element Heat and Mass Transfer code (FEHM) (to simulate groundwater flow and estimate flow velocities); the Hydrologic Evaluation of Landfill performance Model (HELP) code (to evaluate infiltration through the disposal cover); the AMBER code (to evaluate human health exposures); and the NRC's Disposal Unit Source Term -- Multiple Species (DUST-MS) code (to screen applicable radionuclides). Preliminary results of the evaluations of the two disposal concept sites are presented.« less

Adaptive Genetic Divergence Despite Significant Isolation-by-Distance in Populations of Taiwan Cow-Tail Fir (Keteleeria davidiana var. formosana)

PubMed Central

Shih, Kai-Ming; Chang, Chung-Te; Chung, Jeng-Der; Chiang, Yu-Chung; Hwang, Shih-Ying

2018-01-01

Double digest restriction site-associated DNA sequencing (ddRADseq) is a tool for delivering genome-wide single nucleotide polymorphism (SNP) markers for non-model organisms useful in resolving fine-scale population structure and detecting signatures of selection. This study performs population genetic analysis, based on ddRADseq data, of a coniferous species, Keteleeria davidiana var. formosana, disjunctly distributed in northern and southern Taiwan, for investigation of population adaptive divergence in response to environmental heterogeneity. A total of 13,914 SNPs were detected and used to assess genetic diversity, FST outlier detection, population genetic structure, and individual assignments of five populations (62 individuals) of K. davidiana var. formosana. Principal component analysis (PCA), individual assignments, and the neighbor-joining tree were successful in differentiating individuals between northern and southern populations of K. davidiana var. formosana, but apparent gene flow between the southern DW30 population and northern populations was also revealed. Fifteen of 23 highly differentiated SNPs identified were found to be strongly associated with environmental variables, suggesting isolation-by-environment (IBE). However, multiple matrix regression with randomization analysis revealed strong IBE as well as significant isolation-by-distance. Environmental impacts on divergence were found between populations of the North and South regions and also between the two southern neighboring populations. BLASTN annotation of the sequences flanking outlier SNPs gave significant hits for three of 23 markers that might have biological relevance to mitochondrial homeostasis involved in the survival of locally adapted lineages. Species delimitation between K. davidiana var. formosana and its ancestor, K. davidiana, was also examined (72 individuals). This study has produced highly informative population genomic data for the understanding of population attributes, such as diversity, connectivity, and adaptive divergence associated with large- and small-scale environmental heterogeneity in K. davidiana var. formosana. PMID:29449860