Universal masking to prevent SARS-CoV-2 transmission from Taiwan's practices.

In the fight against the COVID-19 pandemic, Taiwan, with its universal masking policy, slowed down the spread of cases and flattened its epidemic curve without enforcing lockdown or mass quarantine in 2020. This study identifies the distinguishing features of Taiwan's universal masking policy practice, such as priority, continuous improvement, multi-stakeholder partnership, transparency and accountability, and altruism and social solidarity. By confronting uncertainty through the COVID-19 crisis, this study suggests that face masking, rather than being just a physical barrier of non-pharmacological intervention, can be adopted as an interactive policy platform to empower the public for stimulating cross-sector collaboration towards social innovation and creating spillover effects, such as acts of public trust, altruism, and solidarity.

Occurrence and Impact of Gastrointestinal Bleeding and Major Adverse Cardiovascular Events during Sepsis: A 15-Year Observational Study.

OBJECTIVE: Sepsis patients are at risk of gastrointestinal bleeding (GIB) and major adverse cardiovascular events (MACEs), but few data are available on the occurrence of GIB and MACEs and their impact on sepsis outcomes. METHODS: The medical claims records of 220,082 patients admitted for sepsis between 1999 and 2013 were retrieved from the nationwide database. The adjusted odds ratios (aORs) of composite outcomes including the hospital mortality, intensive care unit (ICU) admission, and mechanical ventilation (MV) in patients with a MACE or GIB were estimated by multivariate logistic regression and joint effect analyses. RESULTS: The enrollees were 70.15 ± 15.17 years of age with a hospital mortality rate of 38.91%. GIB developed in 3.80% of the patients; MACEs included ischemic stroke in 1.54%, intracranial hemorrhage (ICH) in 0.92%, and acute myocardial infarction (AMI) in 1.59%. Both ICH and AMI significantly increased the risk of (1) ICU admission (aOR = 8.02, 95% confidence interval (CI): 6.84-9.42 for ICH and aOR = 4.78, 95% CI: 4.21-5.42 for AMI, respectively), (2) receiving MV (aOR = 3.92, 95% CI: 3.52-4.40 and aOR = 1.99, 95% CI: 1.84-2.16, respectively), and (3) the hospital mortality (aOR = 1.08, 95% CI: 0.98-1.19 and aOR = 1.11, 95% CI: 1.03-1.19, respectively). However, sepsis with GIB or ischemic stroke increased only the risk of ICU admission and MV but not the hospital mortality (aOR = 0.98, 95% CI: 0.93-1.03 for GIB and aOR = 0.84, 95% CI: 0.78-0.91 for ischemic stroke, respectively). CONCLUSIONS: GIB and MACEs significantly increased the risk of ICU admission and receiving MV but not the hospital mortality, which was independently associated with both AMI and ICH. Early prevention can at least reduce the complexity of clinical course and even the hospital mortality.

Unmet supportive care needs of survival patients with breast cancer in different cancer stages and treatment phases.

OBJECTIVE: This study aimed to examine the differences between patients with breast cancer (BC) at different cancer stages and treatment phases in terms of unmet supportive care needs as well as to predict the critical factors that influence the unmet needs of such patients. MATERIALS AND METHODS: A retrospective study was conducted by collecting data from the case consultation and service records of a cancer center in central Taiwan. Information extracted from the case consultation and service records included patients' age, treatment phase, cancer stage, and unmet need domains. RESULTS AND CONCLUSION: Overall, 1129 BC patients were recruited. In the prediction of critical factors influential to the health information needs of patients with BC, in-treatment patients, and those undergoing a follow-up were found to have significantly lower health information needs than patients newly diagnosed with BC. In-treatment and follow-up patients had significantly lower patient care needs than those newly diagnosed with BC. Stage II, III, and IV BC patients had significantly lower nutritional needs than stage I patients. In-treatment patients and those receiving follow-ups had significantly lower nutritional needs than patients newly diagnosed with BC. Relapse and terminal care patients had significantly higher psychosocial needs than patients newly diagnosed with BC. Thus, unmet needs of patients with cancer differ according to their age, cancer stage, and treatment phase. Appropriate and punctual tailored support provided by medical care personnel to address the unmet needs of patients can reduce the unmet supportive care needs in such patients and improve the quality of medical care services they are provided with. Ultimately, the overall quality of life of patients can be improved.