The impact of rotavirus vaccination in the prevalence of gastroenteritis and comorbidities among children after suboptimal rotavirus vaccines implementation in Taiwan: A population-based study.

ABSTRACT: In Taiwan, rotavirus vaccination was implemented in 2006 in the private sector. The population-based impact of rotavirus vaccination on gastroenteritis and comorbidities of children remains under-investigated.We analyzed the annual prevalence of rotavirus-related disease, including gastroenteritis, convulsions, epilepsy, type I diabetes mellitus, intussusception, and biliary atresia among children under 5 years of age. Data were collected from Taiwan's National Health Insurance Research Database, a nationwide population-based database. A 16-year retrospective cohort study was conducted between 2000 and 2015.Among children <5 years of age, the prevalence of gastroenteritis decreased after 2012 (44,259.69 per 100 thousands) and remained lower through 2015 (39,931.11per 100 thousands, P < .001). The prevalence of convulsions rose steadily and significantly from 2007 (775.90 per 100 thousands) to 2015 (962.17 per 100 thousands, P < .001). The prevalence of epilepsy decreased significantly until reaching a nadir in 2013 (from 501.56 to 293.53 per 100 thousands, P < .001). The prevalence of biliary atresia tended upward, and surged suddenly in 2007 with a peak in 2013 (18.74 per 100 thousands). Among infants (<1 year of age) from 2000 to 2015, the prevalence of gastroenteritis declined steadily, and more rapidly after 2007 (22,513 to 17,285 per 100 thousands).In Taiwan, after introducing rotavirus vaccination, gastroenteritis in young children decreased, especially in infancy. However, gastroenteritis is still common in children, given other emerging pathogens. Our results highlight the impact of rotavirus vaccines on children's health in Taiwan and provide indications for future preventive medicine and healthcare strategies in children.

Subchronic and Genetic Safety Assessment of a New Medicinal Dendrobium Species: Dendrobium Taiseed Tosnobile in Rats.

Dendrobium Taiseed Tosnobile is a new species of herba dendrobii (Shi-Hu) that was developed by crossbreeding D. tosaense and D. nobile. Its pharmacological activity and active component have been reported, but its subchronic toxicity and genetic safety have not yet been investigated. This study assessed the 90-day oral toxicity and genetic safety of the aqueous extracts of D. Taiseed Tosnobile (DTTE) in male and female Sprague-Dawley (SD) rats. Eighty rats were divided into four groups, each consisting of ten male and ten female rats. DTTE was given orally to rats at 800, 1600, or 2400 mg/kg for 90 consecutive days, and distilled water was used for the control group. Genotoxicity studies were performed using a bacterial reverse mutation assay and in vivo mammalian cell micronucleus test in ICR mice and analyzed using flow cytometry. Throughout the study period, no abnormal changes were observed in clinical signs and body weight or on ophthalmological examinations. Additionally, no significant differences were found in urinalysis, hematology, and serum biochemistry parameters between the treatment and control groups. Necropsy and histopathological examination indicated no treatment-related changes. Based on results, the no-observed-adverse-effect level of DTTE is greater than 2400 mg/kg in SD rats.

Middle-aged female spouses of patients with metastatic cancer: lived experiences.

BACKGROUND: Although the survival rate for cancer is increasing because of advances in treatment technology, cancer still comes as a great shock to the families of patients who are in the advanced stages of this disease. When a married, middle-aged man is diagnosed with advanced cancer, his spouse most often becomes his primary caregiver. However, few studies have studied the lived experience of these middle-aged spouses. PURPOSE: This study explores the lived experience of middle-aged female spouses of husbands diagnosed with advanced cancer. METHODS: A qualitative design was used. In-depth interviews were conducted with participants whose spouses were being treated at the oncology outpatient department of a teaching hospital in northern Taiwan. The data were collected with purposive sampling over a 12-month period. RESULTS: A content analysis of 11 participant interviews revealed four themes: simultaneously bearing all layers of stress, changing of attitudes and values, developing the effective skills of caregiving, and gaining support from the family and from religion. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: A middle-aged female spouse faces many layers of stress and many crises in caring for her husband with advanced cancer. Female spouses in Taiwan tend to rely significantly more on internal resources (family) than external resources (friends and medical professionals). It is recommended that these families use external resources such as medical and social welfare systems more actively to facilitate their successful passage through these crises. Understanding the lived experiences of these female spouses helps nurses provide appropriate nursing interventions.