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1.
BMC Public Health ; 22(1): 1483, 2022 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927656

RESUMO

BACKGROUND: Enterovirus A71 (EV A71) is one of the most important enteroviruses related to morbidity and mortality in children worldwide. This study aimed to analyse the secular trend of EV A71 in Taiwan from 1998 to 2020 and to evaluate the effectiveness of infection control measures. METHODS: We collected the epidemiological data of EV A71 from disease surveillance systems in Taiwan. We analysed the association between the secular trend of EV A71 and preventive measures such as hand washing, case isolation, and suspension of classes. RESULTS: The incidence of enterovirus infections with severe complications (EVSC) decreased from 16.25 per 100,000 children under six in 1998 to less than 9.73 per 100,000 children under six after 2012 (P = 0.0022). The mortality rate also decreased significantly, from 3.52 per 100,000 children under six in 1998 to 0 per 100,000 children under six in 2020 (P < 0.0001). The numbers of EVSC and fatalities were significantly higher in the years when EV A71 accounted for more than 10% of the annual predominant serotypes (p < 0.05). After the implementation of many non-pharmaceutical interventions in 2012, the incidence of EVSC and mortality rate decreased significantly (p < 0.001). CONCLUSIONS: After implementing active enterovirus surveillance and preventive measures, we found that the incidence of EVSC and fatalities due to EV A71 in Taiwan decreased significantly from 1998 to 2020. Continuous surveillance and strengthened infection control policies are still needed in the future.


Assuntos
Enterovirus Humano A , Infecções por Enterovirus , Enterovirus , Doença de Mão, Pé e Boca , Criança , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/prevenção & controle , Humanos , Sorogrupo , Taiwan/epidemiologia
2.
BMC Cancer ; 22(1): 849, 2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927682

RESUMO

BACKGROUND: Breast cancer is an umbrella term referring to a group of biologically and molecularly heterogeneous diseases originating from the breast. Globally, incidences of breast cancer has been increasing dramatically over the past decades. Analyses of multiple clinical "big data" can aid us in clarifying the means of preventing the disease. In addition, predisposing risk factors will be the most important issues if we can confirm their relevance. This study aims to provide an overview of the predisposing factors that contribute to a higher possibility of developing breast cancer and emphasize the signs that we ought to pay more attention to. METHODS: This is a matched nested case-control study. The cohort focused on identifying the eligible risk factors in breast cancer development by data screening (2000-2013) from the Taiwan National Health Insurance Research Database (NHIRD) under approved protocol. A total of 486,069 females were enrolled from a nationwide sampled database, and 3281 females was elligible as breast cancer cohort, 478,574 females who had never diagnosed with breast cancer from 2000 to 2013 were eligible as non-breast cancer controls, and matched to breast cancer cases according to age using a 1:6 ratio. RESULTS: We analyzed 3281 breast cancer cases and 19,686 non-breast cancer controls after an age-matched procedure. The significant predisposing factors associated with breast cancer development including obesity, hyperlipidemia, thyroid cancer and liver cancer. As for patients under the age of 55, gastric cancer does seem to have an impact on the development of breast cancer; compared with their counterparts over the age of 55, endometrial cancer appears to exhibit an evocative effect. CONCLUSIONS: In this nationwide matched nested case-control study, we identified obesity, hyperlipidemia, previous cancers of the thyroid, stomach and liver as risk factors associated with breast cancer. However, the retrospective nature and limited case numbers of certain cancers still difficult to provide robust evidence. Further prospective studies are necessitated to corroborate this finding in order to nip the disease in the bud. TRIAL REGISTRATION: The studies involving human participants were reviewed and approved by the China Medical University Hospital [CMUH104-REC2-115(AR-4)].


Assuntos
Neoplasias da Mama , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Obesidade/complicações , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia
3.
Front Public Health ; 10: 927340, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35942264

RESUMO

Objective: As most available biometeorological indexes were developed decades ago in western countries, the benefit of using these indexes to study the effect of weather on human health in modern eastern countries is questionable. This study aimed to reconfirm the effectiveness of applying these biometeorological indexes when analyzing demand for daily emergency ambulance services (EAS) in Taipei. Methods: More than 370,000 EAS usage records were analyzed in this study. The records were first allotted into different time-series data by age, gender, triage level, and case nature (trauma/non-trauma) in order to represent different kinds of daily EAS demand. They were then regressed on biometeorological indexes [Apparent Temperature (AT) and Net Effective Temperature (NET)]; the indexes' additional descriptive power to describe the daily EAS demand over traditional weather factors was then assessed. Results: No significant difference was observed in the descriptive powers in terms of effect on daily EAS demand of the biometeorological indexes and traditional weather factors. The largest improvement on the regression models' adjusted-R 2 using NET and AT was only 0.008. Conclusion: It may not be a good idea to make direct use of the biometeorological indexes developed in western countries decades ago. Taiwan should have a tailor-made biometeorological index for a better representation of its unique situation.


Assuntos
Triagem , Tempo (Meteorologia) , Humanos , Taiwan , Temperatura , Fatores de Tempo
4.
Longit Life Course Stud ; 13(3): 380-411, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35920633

RESUMO

There has been much debate over the micro-level relationship between employment situations and fertility in Europe and Northern America. However, related research in East Asia is scant, although countries in this region have some of the lowest fertility rates in the world. Moreover, most studies analyse the employment-fertility relationship from a static perspective and only for women, which underemphasises life course dynamics and gender heterogeneity of employment careers and their fertility implications. Drawing on retrospective data from the 2017 Taiwan Social Change Survey (TSCS), this study explores women's and men's career trajectories between ages 18 and 40 in Taiwan using sequence cluster analyses. It also examines how career variations associate with different timing and quantum of birth. Empirical results show that economically inactive women experience faster motherhood transitions and have more children by age 40 than women with stable full-time careers. For men, having an unstable career associates with slower fatherhood transitions and a lower number of children. For both genders, self-employed people are the earliest in parenthood transitions and have the highest number of children by midlife. Our findings demonstrate sharp gender contrasts in employment careers and their diversified fertility implications in low-fertility Taiwan.


Assuntos
Fertilidade , Classe Social , Adolescente , Adulto , Criança , Demografia , Feminino , Humanos , Masculino , Dinâmica Populacional , Estudos Retrospectivos , Fatores Socioeconômicos , Taiwan , Adulto Jovem
5.
Sci Rep ; 12(1): 13336, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922461

RESUMO

Epidemiological study shows inconsistent results in the association between endometriosis and Systemic lupus erythematosus (SLE). We conducted a nationwide retrospective cohort study and analyzed data from the Taiwan Longitudinal Health Insurance Research Database 2000 (n = 958,349) over a 13-year follow-up period (2000-2013). After matching 1930 SLE women with 7720 non-SLE women in a 1:4 ratio by age, we used Cox proportional hazard regression to calculate the adjusted hazard ratio (aHR) for endometriosis diagnosed after SLE. We also used a diagnosis of endometriosis with previous gynecologic surgery codes as secondary outcomes and performed sensitivity analyses using a landmark analysis. After adjustment for age, urbanization, income, length of hospital stay, and comorbidities in the age-matched group, women with SLE had a higher risk of endometriosis than women without SLE (aHR 1.32, 95% CI 1.02-1.70). When we defined endometriosis as patients with an ICD-9 endometriosis code after undergoing gynecologic surgery, the increased risk of endometriosis in patients with SLE was not significant. Our findings suggest that the risk of endometriosis was significantly elevated in the cohort of women with SLE compared with the age-matched general cohort of women. The burden of endometriosis in SLE patients requires special attention.


Assuntos
Endometriose , Lúpus Eritematoso Sistêmico , Estudos de Coortes , Endometriose/complicações , Endometriose/epidemiologia , Feminino , Humanos , Incidência , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-35918140

RESUMO

PURPOSE: In 2013, medical schools in Taiwan implemented a 6-year medical program that replaced the previous 7-year medical education program. The postgraduate year (PGY) program was also extended from 1 year to 2 years. The new program is characterized by diversified teaching, integration of medical skills, a system-oriented curriculum, and the implementation of primary care and clinical thinking training. The purpose of this study was to examine whether postgraduate residents who learned under the new program have better patient care skills than those who learned under the previous program. METHODS: Of 101 residents in the PGY program at Taipei Veterans General Hospital, 78 were trained in the 6-year program, while 23 were trained in the 7-year program. During the PGY training, 2 objective structured clinical examinations (OSCEs) were used to evaluate clinical reasoning, communication skills, and procedural skills at the beginning of the training and after 11 months of training, respectively. The scores of each OSCE and the rate of improvement of the pre- and post-tests were analyzed. RESULTS: Residents trained in the new program scored higher on clinical reasoning (P<0.001) and the total scores of the 3 tested skills (P=0.019) on the pre-test. In terms of improvement, residents educated in the previous system improved more in clinical reasoning than those educated in the new education system. CONCLUSION: The new medical education program, which emphasizes clinical thinking, improved residents' clinical skills. The PGY program was effective in improving the clinical performance of residents who were educated in the previous system.


Assuntos
Internato e Residência , Competência Clínica , Currículo , Educação de Pós-Graduação em Medicina , Avaliação Educacional , Humanos , Taiwan
7.
BMC Psychol ; 10(1): 172, 2022 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-35831913

RESUMO

BACKGROUND: Employees are considered as one of the most important assets in many organizations, and their health well-being is critical to help achieve a sustainable and motivated workforce that is committed to delivering quality hospitality services through enhanced performance and productivity. Given the extent of the challenges and impact presented by the COVID-19 pandemic to the hospitality industry, it is timely to gain further insights on employees' health well-being. The key purpose of this study is to examine the relationships between health-related quality of life, achievement motivation and job performance in the Taiwan hospitality industry, to acquire a better understanding of their relationships through the job performance pathway models. METHODS: This study has used a purposeful sampling technique to select the 10 highest-earning hospitality companies in Taiwan. A total of 292 questionnaires were collected from the employees of these hospitality companies. Based on the multi-dimensional concept of health-related quality of life (HRQoL), the relationships between the five key dimensions (i.e. psychological health, physical health, social health, achievement motivation, and job performance) were examined. To measure these dimensions, the survey questions were adapted from previous research such as the World Health Organization's WHOQOL-BREF scale, Minnesota Satisfaction Questionnaire. Partial least squares - Structural Equation Modeling method was used to explore these dimensions, and two job performance pathway models (for manager and staff) were subsequently developed. RESULTS AND CONCLUSIONS: Findings showed that psychological health directly affected the manager's job performance and physical health had a similar effect through social health. While psychological health had not affected the staff's job performance, but it could affect achievement motivation through both direct and indirect effects of social health. The pathway models that were developed indicated that the manager's job performance was mainly affected by psychological health and social health, whereas the key dimension that had affected the staff's job performance was achievement motivation.


Assuntos
COVID-19 , Motivação , Humanos , Satisfação no Emprego , Pandemias , Qualidade de Vida , Taiwan
8.
Sci Rep ; 12(1): 11536, 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35798830

RESUMO

Greater physical fitness may lead to greater left ventricular mass (LVM) and reduce the effect of cardiometabolic risk factors on LVM. However, the cardiometabolic biomarkers associations for LVM have not been clarified in physically active young adults. This study included 2019 men and 253 women, aged 18-43 years, from the military in Taiwan. All participants underwent anthropometric and blood metabolic markers measurements, and completed a 3000-m run test for assessing fitness. LVM was calculated on the basis of an echocardiography. Multiple linear regression was used to determine the sex-specific associations between cardiometabolic risk markers and LVM indexed for the body height (g/m2.7). In men, age, systolic blood pressure (SBP), 3000-m running time, serum triglycerides, serum uric acid and waist circumference (WC) were correlated with LVM index (ß = 0.07, 0.10, - 0.01, 0.01, 0.24 and 0.24, respectively; all p-values < 0.05). The correlations were not significant for fasting plasma glucose, total cholesterol and high-density lipoprotein cholesterol (HDL-C). In women, SBP, HDL-C and WC were correlated with LVM index in the univariate analysis (ß = 0.07, - 0.05 and 0.32, respectively; all p-values < 0.05), whereas the correlation was only significant for WC in the multiple linear regression analysis (ß = 0.20; p-value < 0.001). In physically active adults, the associations of cardiometabolic risk markers with LVM might vary by sex. Better endurance exercise performance associated with greater LVM was noted only in men, while greater WC was the only metabolic risk marker for greater LVM in both men and women.


Assuntos
Fatores de Risco Cardiometabólico , Doenças Cardiovasculares , Fatores Sexuais , Ácido Úrico , Adolescente , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , HDL-Colesterol , Feminino , Ventrículos do Coração , Humanos , Masculino , Militares , Aptidão Física , Fatores de Risco , Taiwan , Circunferência da Cintura , Adulto Jovem
9.
Sci Rep ; 12(1): 11613, 2022 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-35803989

RESUMO

This study reported domestic and overseas Taiwanese people's perceived stress levels and examined the mediation effect of their coping strategies during the early stages of the COVID-19 pandemic. We recruited 2727 Taiwanese respondents from the COVIDiSTRESS Global Survey (N = 173,426) between March 30 and May 30, 2020. The self-report questionnaire included a modified 10-item Perceived Stress Scale and a 16-item coping strategy scale. Three stress-coping factors were extracted with principal component analysis and confirmatory factor analysis. Their effects were examined through a regression and mediation analysis. The overseas Taiwanese participants had a significantly higher stress level than domestic counterparts (2.89 to 2.69 in 1-5 scale, p < 0.001). Government guidance was associated with lower stress level among domestic (- 0.097, 95% C.I. [- 0.131, - 0.063]) but not overseas Taiwanese (0.025, [- 0.114, 0.163]). The association of stress level with residency was mediated by coping strategies, for government guidance (0.04, [0.01, 0.07], ref: domestic participants) and supportive social networks (- 0.03, [- 0.05, - 0.01]). All results hold after the propensity score matching on samples. Government guidance on COVID-19 as a channel for coping with stress is correlated with the residency status of the respondents. Public health authorities should recognize the importance of various mental health interventions during pandemics.


Assuntos
Adaptação Psicológica , COVID-19 , Estresse Psicológico , COVID-19/epidemiologia , Comparação Transcultural , Humanos , Saúde Mental , Pandemias , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Taiwan
10.
Artigo em Inglês | MEDLINE | ID: mdl-35805464

RESUMO

(1) Background: Colorectal cancer (CRC) is the third most common malignancy and the second leading cause of cancer deaths worldwide. It often diagnosed at advanced stages, and with increasing incidence at younger generation. CRC poses a heavy financial burden and a huge public health challenge nowadays. Lipoproteins and serum lipids may have an influence on carcinogenesis by making oxidative stress, inflammation, and insulin resistance. Dyslipidemia plays a potential role in the risk of CRC. The purpose of this study is to use nationally representative samples to determine epidemiologic characteristics of CRC in the Taiwanese population, and to evaluate the associations between baseline levels of lipid profile and their effect on risk of colorectal cancer (CRC) comprehensively and quantitatively. The control of dyslipidemia in primary and secondary prevention may reduce the disease burden of CRC. (2) Methods: This is a nationwide long-term community-based prospective cohort study. Data were retrieved from the nationwide population-based Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia (TwSHHH). Variables were estimated by the Cox proportional hazards model which was then further adjusted for age. We also calculated the relative ratios (RRs) of CRC for joint categories of serum cholesterol, triglyceride (TG), low-density lipoproteins cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) level, and to examine their combined effect and statistical interactions. (3) Results: Male, age, waist circumference, diabetes mellitus (DM), high TG, high cholesterol level, smoking history, and metabolic syndrome were proved to increase the risk of CRC. In addition, DM patients with a TG level ≥150 mg/dL and cholesterol ≥180 mg/dL had a 4.118-fold higher risk of CRC as compared with a TG level <150 mg/dL and cholesterol level <180 mg/dL, which was a significant difference (95% CI, 1.061-15.975; p = 0.0407). (4) Conclusions: Patients with DM should control TG and cholesterol level through diet, exercise, or taking medications more aggressively, not only for preventing cardiovascular disease, but also for first prevention of CRC. The study can be valuable for the clinicians and policy makers to implement more precisely goals about dyslipidemia management.


Assuntos
Neoplasias Colorretais , Diabetes Mellitus , Dislipidemias , Hiperlipidemias , Hipertrigliceridemia , Colesterol , HDL-Colesterol , Estudos de Coortes , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etiologia , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Humanos , Hiperlipidemias/complicações , Hipertrigliceridemia/complicações , Hipertrigliceridemia/epidemiologia , Masculino , Estudos Prospectivos , Fatores de Risco , Taiwan/epidemiologia , Triglicerídeos
11.
Artigo em Inglês | MEDLINE | ID: mdl-35805493

RESUMO

Enterovirus infection is a known risk factor for type 1 diabetes (T1DM). Whether infection with other viruses induces T1DM remains undetermined. This study investigated the association between human herpesvirus (HHV) infection and the development of T1DM, using the data from Taiwan's National Health Insurance Research Database. Patients with T1DM and age- and sex-matched controls were included. Subjects with HHV infection were subgrouped into those with histories of varicella-zoster virus, herpes simplex virus (HSV), Epstein-Barr virus, and human cytomegalovirus infections. The odds ratio of the risk of T1DM was calculated using a multivariable conditional logistic regression model. Atopic diseases, autoimmune thyroid diseases, and history of enterovirus infection served as adjusted comorbidities. Our findings suggested a significant association between HSV infection and the risk of T1DM (adjusted odds ratio: 1.21; 95% CI: 1.01-1.47, p = 0.048), while infection with other HHVs was not. The result of HSV infection remained significant when subjects were restricted to age ≤ 18 years (adjusted odds ratio: 1.35; 95% CI: 1.08-1.70, p = 0.010). We found a history of HSV infection might be an independent predictive risk factor for T1DM. This could be potentially helpful to the practice in public health.


Assuntos
Diabetes Mellitus Tipo 1 , Infecções por Enterovirus , Infecções por Vírus Epstein-Barr , Herpes Simples , Infecções por Herpesviridae , Herpesvirus Humano 1 , Adolescente , Estudos de Casos e Controles , Diabetes Mellitus Tipo 1/epidemiologia , Herpes Simples/complicações , Herpes Simples/epidemiologia , Herpesvirus Humano 4 , Humanos , Taiwan/epidemiologia
12.
Artigo em Inglês | MEDLINE | ID: mdl-35805529

RESUMO

The purpose of this study was to understand the effects of a physical activity program and high-protein supplementation on body composition and upper and lower extremity muscle strength in male older adults in rural areas. In this study, 60 healthy male older adults (mean age 77.5 ± 4.6 years) from rural areas were recruited and randomly assigned to experimental group A (intervention of the physical activity program and high-protein supplementation), experimental group B (daily routine, with only intervention of high-protein supplementation), or control group C (daily routine). Experimental group A (EGa) carried out a physical activity plan three times a week, with an exercise intensity and calorie consumption of 250 kcal (5METs × â…”hr × 75) for 3 months and drank a high-protein supplement (1.3 g/kg BW/day) after each exercise; experimental group B (EGb) followed only the intervention of high-protein supplementation. All the participants underwent pre- and post-tests for body composition, waist-hip circumference (WC, HC), handgrip strength (HS), 30 s dominant arm curl, 30 s sit to stand, and 2 min step tests. The results of the study showed that EGa significantly decreased body mass index (BMI), body fat mass (BFM), body fat percentage (BFP), WC, HC, and waist-to-hip ratio (WHR) and increased basal metabolic rate and muscle mass. Although both EGa and EGb used high-protein supplementation, EGa's added three-month intervention of a physical activity program made it easier for that group to increase muscle mass and muscle strength. The WHR decreased from 1.015 to 0.931, representing a decrease of 8.28%, and an obvious weight loss effect was achieved. Thus, we concluded that the best way to maintain muscle strength in older adults is through physical activity with resistance and protein supplementation, which can reduce muscle loss in older adults.


Assuntos
Força da Mão , Músculo Esquelético , Idoso , Idoso de 80 Anos ou mais , Composição Corporal/fisiologia , Humanos , Extremidade Inferior , Masculino , Força Muscular/fisiologia , Músculo Esquelético/metabolismo , Taiwan
13.
Artigo em Inglês | MEDLINE | ID: mdl-35805542

RESUMO

This study aims to understand the trend distribution of violent injuries in Taiwan from 2000 to 2015. It used the data of outpatient, emergency, and hospitalization of 2 million people in the National Health Insurance sample from 2000 to 2015. We analyzed children and adolescents (hereinafter referred to as children, 0-17 years old), adults (18-64 years old), and The Elderly (over 65 years old) who suffered for the first time. The standardized rate of medical treatment for violent injuries was compared annually using the Poisson regression method. A total of 11,077 victims (7163 men, 3914 women) suffered violence during the 15 years, and the standardized rate of medical treatment for violence in adults dropped from 6.01 (1/104) in 2001 to 2.58 (1/104) in 2015. The standardized rate of medical treatment in adults over the years was higher than that in children (2.962001, 1.232015) and The Elderly (3.522001, 1.622015). The medical treatment rate of the adult generation is higher than that of the children and the elderly. The relative hazard ratio (RR) decreased from 2.38 in 2001 to 1.13 in 2014 (but the RR in 2014 was not significant). Furthermore, the rate of adult violence treatment has been decreasing every year, which shows that the government has achieved remarkable results in general violence prevention. With the accelerated aging of Taiwan's population, it is expected that older adults exposed to the risk of violence will also increase and become more serious. Therefore, the government should continue to pay attention to this issue.


Assuntos
Violência , Ferimentos e Lesões , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Taiwan/epidemiologia , Ferimentos e Lesões/epidemiologia , Adulto Jovem
14.
Artigo em Inglês | MEDLINE | ID: mdl-35805746

RESUMO

This study aimed to investigate the association between the heat-related illness (HRI) and the risk of developing psychiatric disorders. From 2000 to 2015, there were 3126 patients with newly diagnosed HRI selected from the National Health Insurance Research Database, along with 31,260 controls matched for gender and age. Fine and Gray's analysis was used to compare the risk of psychiatric disorders during the 16 years of follow-up. Among the subjects, 523 of the HRI patients and 3619 of the control group (1774.18 vs. 1193.78 per 100,000 person-years) developed psychiatric disorders. Compared with non-HRI patients, the HRI ones had a 3.849-fold risk of being attacked by psychiatric disorders (95% CI: 3.632-4.369, p < 0.001) after adjusting for potential confounders. The sensitivity analysis revealed that the relationship between the HRI and the listed psychiatric disorders was determined by the exclusion of the first-year psychiatric events after the HRI. In spite of deleting the psychiatric diagnoses of the first five years, the HRI was still correlated with the development of psychiatric disorders with the exception of schizophreniform disorders, posttraumatic stress disorders, and acute stress disorder. Therefore, our findings concluded that the HRI could be a potential influence on the increased hazard of psychiatric disorders.


Assuntos
Transtornos de Estresse por Calor , Transtornos Mentais , Bases de Dados Factuais , Transtornos de Estresse por Calor/epidemiologia , Temperatura Alta , Humanos , Transtornos Mentais/epidemiologia , Fatores de Risco , Taiwan/epidemiologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-35805754

RESUMO

The UCLA Loneliness Scale, with different short versions, is widely used to assess levels of loneliness. However, whether the scale is valid in assessing loneliness among sexual-minority men is unknown. Additionally, it is unclear whether the 8-item and 3-item short versions are comparable to the full 20-item version. The present study compared the validity of the three versions of the UCLA Loneliness Scale (i.e., 20-item, 8-item, and 3-item versions) among gay and bisexual men in Taiwan. The participants comprised 400 gay and bisexual men in Taiwan who completed a cross-sectional online survey, which included the UCLA Loneliness Scale, Center for Epidemiological Studies Depression Scale (CES-D) and State-Trait Anxiety Inventory (STAI). Confirmatory factor analysis was used to evaluate factorial validity. Convergent validity was examined between the three versions of the UCLA Loneliness Scale and the CES-D and STAI. Known-group validity was investigated with participants' sexual orientation and educational levels. The unidimensional construct was supported in all three versions of the UCLA Loneliness Scale tested in the present study. Convergent validity was supported as the level of loneliness was correlated with the level of depression and anxiety for all three versions. There were no significant differences between gay and bisexual men, although significant differences were found across different educational levels. The study confirmed that all three versions of the UCLA Loneliness Scale were comparable with satisfactory reliability and validity in Taiwanese sexual-minority men.


Assuntos
Solidão , Minorias Sexuais e de Gênero , Estudos Transversais , Feminino , Humanos , Masculino , Psicometria/métodos , Reprodutibilidade dos Testes , Taiwan
16.
Comput Intell Neurosci ; 2022: 8687947, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35774435

RESUMO

As of January 2022, 16.91% of Taiwan's population was over the age of 65, and a 2017 study indicated that 94.2% of patients who required long-term care in Taiwan received home care. This study produced a "post-home care patient information survey" to understand the characteristics of home care patients and the volume and results of home care and investigate the relationships between them. Different diagnoses were found to have no significant effect on the volume or results of home care. Positive correlations were found between the services patients required and the volume of home care and specific results. Volume and specific results were also positively correlated. The termination of home care was primarily due to medical needs (98.6%). As the Taiwanese population ages, home care must be improved, and the conditions for which patients can receive home care should be expanded. Care services should replace diagnoses in determining benefit standards for home care payments.


Assuntos
Serviços de Assistência Domiciliar , Programas Nacionais de Saúde , Idoso , Envelhecimento , Humanos , Taiwan/epidemiologia
17.
Sci Rep ; 12(1): 11720, 2022 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-35810252

RESUMO

To investigate the impact of chronic hepatitis on cardiovascular events in patients with type 2 diabetes mellitus (T2DM). This nationwide retrospective cohort study included 152,709 adult patients (> 20 years) with T2DM enrolled in the National Health Insurance Diabetes Pay-for-Performance Program from 2008 to 2010 and followed up until the end of 2017. Patients were categorized into groups with hepatitis B, hepatitis C, fatty liver disease, and patients without chronic hepatitis. The incidence of cardiovascular events in patients with T2DM and hepatitis C (79.9/1000 person-years) was higher than that in patients with diabetes combined with other chronic hepatitis, or without chronic hepatitis. After adjusting for confounding factors, T2DM with fatty liver (adjusted hazard ratio [HR]: 1.10; 95% confidence interval [CI]: 1.07-1.13) and hepatitis C (adjusted HR: 1.09; 95% CI: 1.03-1.12) demonstrated a significantly higher risk of cardiovascular events. The adjusted visit-to-visit coefficient of variation of HbA1c and fasting blood glucose were associated with a high risk of cardiovascular events (HRs of the highest quartile were 1.05 and 1.12, respectively). Chronic hepatitis affects cardiovascular events in adult patients with T2DM. Glucose variability could be an independent risk factor for cardiovascular events in such patients.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Hepatite Crônica , Adulto , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Hepatite C/complicações , Hepatite Crônica/complicações , Humanos , Incidência , Reembolso de Incentivo , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia
18.
Int J Med Sci ; 19(6): 1049-1055, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35813300

RESUMO

Background: Diabetes mellitus (DM) is a major public health problem worldwide. It involves dysfunction of blood sugar regulation resulting from insulin resistance, inadequate insulin secretion, or excessive glucagon secretion. Methods: This study collated 971,401 drug usage records of 51,009 DM patients. These data include patient identification code, age, gender, outpatient visiting dates, visiting code, medication features (included items, doses, and frequencies of drugs), HbA1c results, and testing time. We apply a random forest (RF) model for feature selection and implement a regression model with the bidirectional long short-term memory (Bi-LSTM) deep learning architecture. Finally, we use the root mean square error (RMSE) as the evaluation index for the prediction model. Results: After data cleaning, the data included 8,729 male and 9,115 female cases. Metformin was the most important feature suggested by the RF model, followed by glimepiride, acarbose, pioglitazone, glibenclamide, gliclazide, repaglinide, nateglinide, sitagliptin, and vildagliptin. The model performed better with the past two seasons in the training data than with additional seasons. Further, the Bi-LSTM architecture model performed better than support vector machines (SVMs). Discussion & Conclusion: This study found that Bi-LSTM models is a well kernel in a CDSS which help physicians' decision-making, and the increasing the number of seasons will negative impact the performance. In addition, this study found that the most important drug is metformin, which is recommended as first-line treatment OHA in various situations for DM patients.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Aprendizado Profundo , Diabetes Mellitus Tipo 2 , Diabetes Mellitus , Metformina , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Masculino , Metformina/uso terapêutico , Taiwan
19.
Int J Med Sci ; 19(6): 1013-1022, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35813301

RESUMO

Single nucleotide polymorphisms (SNPs) of tissue inhibitor of metalloproteinases-3 (TIMP-3) have been revealed to be related to various cancers. To date, no study explores the relationships between TIMP-3 polymorphisms and uterine cervical cancer. The purposes of this research were to investigate the associations among genetic variants of TIMP-3 and development and clinicopathological factors of uterine cervical cancer, and patient 5 years survival in Taiwanese women. The study included 123 patients with invasive cancer and 97 with precancerous lesions of uterine cervix, and 300 control women. TIMP-3 polymorphisms rs9619311, rs9862 and rs11547635 were checked and their genotypic distributions were determined by real-time polymerase chain reaction. It showed that women with genotypes CT/TT in rs9862 were found to display a higher risk of developing cervical cancer with moderate and poor cell differentiation. Moreover, it revealed that cervical cancer patients carrying genotypes CC in rs9619311 exhibited a poorer 5 years survival, as compared to those with TT/TC in Taiwanese women, using univariate analysis. In addition, pelvic lymph node metastasis was determined to independently predict 5 years survival in cervical cancer patients using multivariate analysis. Conclusively, TIMP-3 SNPs polymorphisms rs9619311 are related to cervical patient survival in Taiwanese women.


Assuntos
Neoplasias do Colo do Útero , Feminino , Predisposição Genética para Doença/genética , Humanos , Polimorfismo de Nucleotídeo Único/genética , Taiwan/epidemiologia , Inibidor Tecidual de Metaloproteinase-3/genética , Neoplasias do Colo do Útero/genética , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/patologia
20.
Int J Med Sci ; 19(6): 1023-1028, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35813302

RESUMO

Triple-negative breast cancer (TNBC) is the third most common female cancer in Taiwan. EZH2 plays an important role in cancer development through transcriptional repression by chromatin remodeling. However, the expression of EZH2 in breast cancer is highly correlated with tumorigenesis, and patient survival is not matched to TNBC. Furthermore, it has not been determined if specific EZH2 genetic variants are associated with breast cancer risk. In this paper, we evaluated the survival of different types of breast cancer. The results indicated that a lower expression of EZH2 led to poor survival of TNBC patients. Therefore, we aimed at studying the relationship between genetic polymorphisms of EZH2 and susceptibility to TNBC in Taiwan. Four single-nucleotide polymorphisms (SNPs) of EZH2 (rs6950683, rs2302427, rs3757441, and rs41277434) were analyzed by real-time PCR genotyping in 176 patients with TNBC and 1000 cancer-free controls. The results showed that TNBC patients under 60 years old who carried a TC or CC genotype at EZH2 rs6950683 and re3757441 had a tumor size of 20 mm or smaller (T1). Thus, this study is the first to examine the age and mutant genes associated with EZH2 SNPs in TNBC progression and development in Taiwan.


Assuntos
Neoplasias de Mama Triplo Negativas , Proteína Potenciadora do Homólogo 2 de Zeste/genética , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Taiwan/epidemiologia , Neoplasias de Mama Triplo Negativas/genética , Neoplasias de Mama Triplo Negativas/patologia
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