The impact of maternal influences on childhood obesity.

There was a lack of detailed information about maternal influences on their children's body mass index (BMI) in Taiwan. The aim of this study was to find the evidence to describe how mothers' factors could affect their 2 to 9-year-old children's BMI, with data collected from May 2021 to June 2021. Anonymous self-administered questionnaires were completed by 1035 participants from Taiwan's six metropolitan cities and eight counties. After controlling for children's factors, such as number of children in a family, children's constitution, children's age and gender, hierarchical regression models were used to analyze the effects of five maternal factors on their children's BMI: maternal BMI, age, education level, monthly household income, and marital status (single parent or not). The results were found as follow: maternal BMI [ß = .24], maternal educational level [ß = -.141], and monthly household income [ß = .071], significantly (p < 0.05) influenced their children's BMI. Higher maternal BMI was associated with a higher children's BMI. Mothers with lower levels of education background were more likely to have children with a higher BMI. Monthly household income was a positive factor influencing children's BMI. In conclusion, this study is the first detailed description of maternal influences on their 2-9 years old children's BMI in Taiwan. Although the study could not cover all of the factors influencing Taiwan's childhood obesity, we have discovered maternal BMI, education level, and monthly household income were significant factors associated with children's BMI.

An Exploration of Dance Learning Stress Sources of Elementary School Dance Class Students with Artistic Abilities: The Influences of Psychological Capital and Self-Concept.

The purpose of this study is to explore the factors which may cause the increase of students' stress in dance class in elementary school. In this study, students' demographic variables, psychological capital (which includes four sub-constructs), and self-concept (which includes five sub-constructs) were used as predicting variables to estimate their influences on dance class students' stress level. A structured questionnaire was distributed to 450 elementary art talent class students with 412 valid responses. Structural equation modeling was used to test the relationships proposed by the study. As for demographic variables, the results show that the grade, gender, and the dance class hours per week had no significant influences on stress, while the seniority level had a negative influence, which indicated that junior dance students had more stress than senior students. As for psychological capital, self-efficacy and optimism had negative influences on stress, while the other two sub-constructs, hope and resilience, did not have a significant influence on stress. As for physical self-concept, the worry of overweight had positive influences on their stress, while appearance, physical ability performance, health status, and satisfaction of body parts had no significant influence on stress. Based on the research findings, suggestions were made to reduce students' pressure in learning dance.

Development and validation of the questionnaire of satisfaction with perioperative anesthetic care for general and regional anesthesia in Taiwanese patients.

BACKGROUND: To fulfill the increasing demand of service quality improvement in recent years, it is imperative to develop a proper instrument to evaluate patient satisfaction with perioperative anesthetic care for many institutes in Taiwan. METHODS: We used a six-factor 32-item pilot questionnaire developed in our previous study as our starting point in this study. Exploratory factor analysis of the pilot questionnaire for factor structure generation was performed in general anesthesia patients (group 1, n = 320) and resulted in the generation of the Patient Satisfaction with Perioperative Anesthetic Care questionnaire (PSPACq). Confirmatory factor analysis of the PSPACq in general anesthesia (group 2, n = 565) and regional anesthesia (group 3, n = 225) patients was performed for validation and cross-validation of the PSPACq model, respectively. The confounding variables and the patient loyalty effects on PSPACq scores were analyzed to evaluate the nomological validity of the PSPACq. RESULT: Exploratory factor analysis of the pilot questionnaire in group 1 resulted in the development of the PSPACq (a seven-factor 30-item model). The standardized coefficients and indexes for the assessment of fit of the PSPACq model in group 2 (validation) and group 3 (cross-validation) patients revealed a well-fitting model. The results of the loyalty scores and confounding variables support the nomological validity of the PSPACq. CONCLUSIONS: A valid and reliable questionnaire (PSPACq) with Taiwanese culture characteristics was developed and is suitable for testing of patient satisfaction with perioperative anesthesia care for patients receiving general or regional anesthesia for their surgery.

Aphonia induced by conversion disorder during a Cesarean section.

Aphonia induced by conversion disorder during surgery is a rare event. We report a woman 28 years of age who was undergoing a Cesarean section under epidural anesthesia. The patient sustained aphonia without detected neurologic deficits. Emergency consultations of a psychiatrist and neurologist were carried out in the operating room postoperatively. After a thorough medical and neurologic work-up, the consultative psychiatrist and the neurologist unanimously made the diagnosis of conversion disorder. Thirty-six hours after the operation, the patient's voice started to return. We venture on sharing the findings of this case with our fellow anesthesiologists in order to highlight discussion and illuminate the differential diagnosis. We have reviewed the literature and excluded an organic lesion as the culprit of the event.

Patient satisfaction with anesthesia care in Taiwan: development and validation of a pilot version of a psychometric questionnaire.

BACKGROUND: To date, no pilot questionnaire of perioperative anesthetic care has been developed based on psychometric methodology in Taiwan. We describe the development and qualitative and quantitative validation of a pilot version of a psychometric questionnaire designed to measure patient satisfaction with perioperative anesthetic care in Taiwan. METHODS: A rigorous protocol was followed and involved expert consultation, literature review, development of the interview guide, semi-structured in-depth interviews, pretest and application of Aiken's two quantitative methods to determine the content validity coefficient (V value) and homogeneity reliability coefficient (H value) of each item, and the questionnaire as a whole, to ensure the pilot questionnaire showed high-content validity and reliable homogeneity. RESULTS: Our final pilot questionnaire contained six dimensions with 32 items; five of the domains were similar to those reported in the literature. One dimension entitled anesthesia-related sequelae was new. The V values for the 32 items ranged from 0.80 to 0.97 (p < 0.01) and the mean value (V) of the questionnaire as a whole was 0.90 (p < 0.01). The H values ranged from 0.55 to 0.88 (p < 0.01) and the mean H value (H) of the questionnaire as a whole was 0.71 (p < 0.01). CONCLUSION: We have developed a valid and reliable pilot questionnaire to measure patient satisfaction with perioperative anesthetic care in Taiwan. The final version of the pilot questionnaire is a 32-item instrument with six dimensions, one of which, anesthesia-related sequelae, is new.

Urinary catheterization may not be necessary in minor surgery under spinal anesthesia with long-acting local anesthetics.

BACKGROUND: This prospective study was designed to compare the incidence of urinary retention after spinal anesthesia between 0.5% hyperbaric bupivacaine and 0.5% hyperbaric tetracaine in patients who underwent minor orthopedic and general surgeries. METHODS: Eighty patients aged 18-40 were randomly assigned to receive either hyperbaric bupivacaine or tetracaine for spinal anesthesia. Intravenous fluids were administered for maintenance of basal requirement, replacement of blood loss and prevention of hypotension. The highest level of analgesia, regression time of sensory block to L5 level, length of time from spinal injection to spontaneous urinary voidance, and volume of perioperative fluid administered were recorded. RESULTS: Of the 80 patients who received either hernioplasty, fistulectomy, hemorroidectomy or orthopedic surgery, two were catheterized (2.5%) because of urinary retention. They were administered less than 800 mL of fluid intraoperatively. Intraoperative blood loss was less than 100 mL in all cases. There were no statistical differences in demographic data, types of surgery, sensory blockade and perioperative fluid administration between the two groups. Although the regression time of sensory blockade with tetracaine (means +/- SD, 259.3 +/- 39.6 min) was significantly longer than that of bupivacaine (225.0 +/- 38.6 min, P < 0.01), the time elapsing from the spinal injection to the first spontaneously voiding after surgery did not show statistical difference between two groups (433.9 +/- 89.1 vs. 411.0 +/- 98.3 min, P = 0.286). CONCLUSIONS: Our results show that, in younger surgical patients who did not receive large amount of fluid intraoperatively, the incidence of urinary retention was low, although prolonged sensory blockade by both long-acting local anesthetics was evident. Thus, urinary catheterization should not be a routine must for every patient undergoing minor surgery with long-acting spinal local anesthetics. From the viewpoint of financial expense, avoidance of complication and annoyance of urinary catheterization, careful observation of urinary bladder fullness in the form of lower abdominal distension, discomfort, bradycardia, or vomiting after surgery is superior to routine retention urinary catheterization just for ease with work in younger patients under-going minor surgery under long-acting spinal local anesthetics.