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Summary: Although more than one hundred studies have examined the prevalence of the use of benzodiazepines and benzodiazepine‐like Z‐hypnotics (BZDs) among pregnancy events, further analysis of the effects of dosage or type of BZDs is needed. The aim of this study was to examine the prevalence rate of BZDs use in pregnancy events, stratified by trimester over time, with characteristics of the dosage and type of BZDs. This is a retrospective population study based on linking three national databases. We examined the prevalence rates from 2004 to 2017, and contrasted the results based on >0 defined daily dose (DDD) and ≥0.5 DDD. We identified 2,630,944 pregnancy events with live births; 89,897 (3.4%) of the associated pregnancy events had used some form of BZD during pregnancy. The prevalence of BZDs use, as defined by >0 DDD, decreased from 4.1% in 2004 to 2.9% in 2017, indicating a decrease in sporadic use and an increase in stable use within therapeutic doses. Meanwhile, BZDs use defined by ≥0.5 DDD increased from 0.1% in 2004 to 0.4% in 2017. Zolpidem was the most frequently prescribed BZDs, as defined by >0 DDD or ≥0.5 DDD. This national cohort study demonstrates the importance of average dosage in the definition of BZDs use in pregnancy events, and it found opposite trends in the prevalence of use between different dosages. [ABSTRACT FROM AUTHOR]

Background: Medical interns’ quality of life (QOL) are related to patient care quality, but the specific factors responsible for interns’ QOL have not been well studied. Herein we presented this nationwide, prospective study to examine the impact of working hours restrictions on the QOL among medical interns. Methods: The study recruited 295 medical interns (age: 25.3 ± 2.1, male: 68.1%) from all the 8 medical colleges in Taiwan during the 2012–2013 academic years. Subjects were assessed for QOL by brief version of the World Health Organization Quality of Life Assessment (WHOQOL-BREF) and the 9-item Patient Health Questionnaire (PHQ-9) before and every 3 months during their internship. We also investigated their demographic data, working hours, workload characteristics, such as specialties of internship rotation, acceptance of new patients after 24-hour, and no 24-hour off within 7 days, and self-reported patient related burnout. We used generalized estimation equation to delineate the change of WHOQOL-BREF and PHQ-9 scores during internship. We used multivariate regression analysis to examine the associated factors of QOL. Results: WHOQOL-BREF score significantly decreased during internship (baseline: 60.0 ± 9.7, 53.7 ± 9.3 at 3 months, then remained at 55 after 9 months). Acceptance of new patients after 24 hours of continuous duty (β = -2.089), no 24-hour off within 7 days (β = -1.748), score of patient related burnout (β = -2.50), and PHQ-9 depression score (β = -1.02) were associated with lower WHOQOL-BREF score. Working hours was not significantly associated with the QOL (p = .6268). Conclusions: Our findings revealed interns’ QOL significantly decreased during internship. Acceptance of new patients after 24-hour of continuous duty and patient related burnout predominantly impacted interns’ QOL and depression more than working hours did. [ABSTRACT FROM AUTHOR]

The Social Environment and Biomarkers of Aging Study (SEBAS) is a nationally representative longitudinal survey of Taiwanese middle-aged and older adults. It adds the collection of biomarkers and performance assessments to the Taiwan Longitudinal Study of Aging (TLSA), a nationally representative study of adults aged 60 and over, including the institutionalized population. The TLSA began in 1989, with follow-ups approximately every 3 years; younger refresher cohorts were added in 1996 and 2003. The first wave of SEBAS, based on a sub-sample of respondents from the 1999 TLSA, was conducted in 2000. A total of 1023 respondents completed both a face-to-face home interview and, several weeks later, a hospital-based physical examination. In addition to a 12-h (7 pm-7 am) urine specimen collected the night before and a fasting blood specimen collected during the examination, trained staff measured blood pressure, height, weight and waist and hip circumferences. A second wave of SEBAS was conducted in 2006 using a similar protocol to SEBAS 2000, but with the addition of performance assessments conducted by the interviewers at the end of the home interview. Both waves of SEBAS also included measures of health status (physical, emotional, cognitive), health behaviours, social relationships and exposure to stressors. The SEBAS data, which are publicly available at [http://www.icpsr.umich.edu/icpsrweb/NACDA/studies/3792/version/5], allow researchers to explore the relationships among life challenges, the social environment and health and to examine the antecedents, correlates and consequences of change in biological measures and health. [ABSTRACT FROM AUTHOR]

Abstract: Phantom vibrations and ringing of mobile phones are prevalent hallucinations in the general population. They might be considered as a “normal” brain mechanism. The aim of this study was to determine if a dimensional approach to identify individuals suffering from these hallucinations was more important than a categorical approach. A prospective longitudinal study of 74 medical interns (male: 46, mean age: 24.8 ± 1.2) was carried out using repeated investigations of the severity of phantom vibrations and ringing, as well as accompanying symptoms of anxiety and depression as measured by Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) before, at the 3rd, 6th, and 12th month during internship, and 2 weeks after internship. We utilized the cognitive and somatic subscales of the BDI, as well as the subjective, somatic and panic subscales of the BAI. The correlation between phantom vibration and ringing was lowest before the internship but became moderate during the internship and high 2 weeks after it. Compared to interns with subclinical phantom ringing and vibrations, interns with severe phantom vibrations and ringing had higher subjective and somatic anxiety and somatic depressive scores at any time point throughout the internship. Only interns with severe phantom ringing had more cognitive/affective depression. A dimensional approach to the phantom vibration and ringing syndrome is a powerful way to identify their correlation, as well as their association with anxiety and depression. [Copyright &y& Elsevier]

Background: Phantom vibration syndrome is a type of hallucination reported among mobile phone users in the general population. Another similar perception, phantom ringing syndrome, has not been previously described in the medical literature. Methods: A prospective longitudinal study of 74 medical interns (46 males, 28 females; mean age, 24.8±1.2 years) was conducted using repeated investigations of the prevalence and associated factors of phantom vibration and ringing. The accompanying symptoms of anxiety and depression were evaluated with the Beck Anxiety and Depression Inventories before the internship began, and again at the third, sixth, and twelfth internship months, and two weeks after the internship ended. Results: The baseline prevalence of phantom vibration was 78.1%, which increased to 95.9% and 93.2% in the third and sixth internship months. The prevalence returned to 80.8% at the twelfth month and decreased to 50.0% 2 weeks after the internship ended. The baseline prevalence of phantom ringing was 27.4%, which increased to 84.9%, 87.7%, and 86.3% in the third, sixth, and twelfth internship months, respectively. This returned to 54.2% two weeks after the internship ended. The anxiety and depression scores also increased during the internship, and returned to baseline two weeks after the internship. There was no significant correlation between phantom vibration/ringing and symptoms of anxiety or depression. The incidence of both phantom vibration and ringing syndromes significantly increased during the internship, and subsequent recovery. Conclusion: This study suggests that phantom vibration and ringing might be entities that are independent of anxiety or depression during evaluation of stress-associated experiences during medical internships. [ABSTRACT FROM AUTHOR]

Researchers have had a longstanding interest in understanding the determinants of mortality. This article examines the impact of a broad array of biological markers, together with self-reports of physical and mental health status, on the probability of dying for older adults. The estimates are derived from logistic regression models based on data from a national survey in Taiwan. The analysis confirms previous studies demonstrating the effects of clinical measures related to metabolic syndrome on mortality and identifies detrimental effects of neuroendocrine and immune-system markers. The results reveal that biomarkers provide independent explanatory power in the presence of self-reported health measures. The associations between biomarkers and mortality found here provide new avenues for projecting future mortality and elucidating differences in longevity across populations. [ABSTRACT FROM AUTHOR]

Background: Real-time global mental health surveillance is urgently needed for tracking the long-term impact of the COVID-19 pandemic.Objective: This study aimed to use Google Trends data to investigate the impact of the pandemic on global mental health by analyzing three keywords indicative of mental distress: "insomnia," "depression," and "suicide."Methods: We examined increases in search queries for 19 countries. Significant increases were defined as the actual daily search value (from March 20 to April 19, 2020) being higher than the 95% CIs of the forecast from the 3-month baseline via ARIMA (autoregressive integrated moving average) modeling. We examined the correlation between increases in COVID-19-related deaths and the number of days with significant increases in search volumes for insomnia, depression, and suicide across multiple nations.Results: The countries with the greatest increases in searches for insomnia were Iran, Spain, the United States, and Italy; these countries exhibited a significant increase in insomnia searches on more than 10 of the 31 days observed. The number of COVID-19-related deaths was positively correlated to the number of days with an increase in searches for insomnia in the 19 countries (ρ=0.64, P=.003). By contrast, there was no significant correlation between the number of deaths and increases in searches for depression (ρ=-0.12, P=.63) or suicide (ρ=-0.07, P=.79).Conclusions: Our analysis suggests that insomnia could be a part of routine mental health screening during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Abstract: Current findings on gender and age differences in health trajectories in later life are equivocal and largely based upon data derived from Western developed nations. This study examines gender and age variations in the trajectory of functional status among older adults in Taiwan, a non-Western newly industrialized society. Data came from a sample of some 3500 Taiwanese aged 60 and over, initially surveyed in 1989 and subsequently followed in 1993, 1996, 1999, and 2003. Hierarchical linear models with time-varying covariates were employed in depicting the dynamics of functional status across gender and age. Women and the old–old experienced higher levels of disability and rates of increase than their male and young–old counterparts. Moreover, older women bore a disproportionately larger burden of disability. There are therefore significant gender and age variations in the trajectory of functional status among older Taiwanese. These findings provide evidence for the generalizability of prior observations to a non-Western society. [ABSTRACT FROM AUTHOR]