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This study aimed to establish a friendly environment of active living and healthy eating for citizens while promoting and increasing knowledge of healthy exercise. Acquisition of physical activity skills and citizens' lifestyle changes result in reduction in rates of obesity and deaths related to underlying metabolism syndrome. This study used a non-experimental cross-sectional design to survey residents living in Taiwan's rural Miaoli County. The inclusion criterion was positive screening for metabolic syndrome. In total, 2068 participants were recruited, and 1886 questionnaires (91.2%) were completed. An organization-spreading strategy and home convenient Lifestyles of Health and Sustainability tactic were applied to the assessment, promotion, evaluation, and planning of the project via an obesity-causing environmental scan, oriental synergy aerobics, acupuncture points massage, guide books, broadcasting, town-based "shape-it-station", and a vending cart created to facilitate the acquisition of healthy foods. After the intervention, results revealed that health condition, regular exercise habits, diet behavior, metabolic syndrome cognition, and body weight became better than before. Appropriate promotion of healthy cities through public health measures may effectively reduce the threat of death due to metabolic syndrome, which in turn reduces overall, and represents successful control of a typical non-communicable disease.

Background: Gallstone disease (GD) and stroke share a number of risk factors including diabetes and hyperlipidemia. This nationwide population-based study was designed to estimate the risk of stroke after a diagnosis of GD., Methods: Data were obtained from the Taiwan National Health Insurance Research Database. A total of 135,512 patients with a diagnosis of GD and 271,024 age- and gender-matched non-GD control patients were included to assess the risk of stroke using Cox proportional hazard regression., Results: During the study period (2000-2003), 12,234 (153.67/10,000 person-years) strokes occurred among the GD patients, and 20,680 (114.83/10,000 person-years) among the controls. The diagnosis of GD carried a higher risk of developing ischemic and hemorrhagic stroke, with a hazard ratio (HR) of 1.28 and 1.33 (95% confidence interval [CI], 1.25-1.31 and 1.25-1.41, both P < .0001), respectively. Stroke risk was increased in both genders but at a higher rate in younger age. The GD group had significantly higher prevalence rate of comorbidities that are known stroke risk factors, including hypertension, diabetes, and coronary artery disease. Stroke risk was higher in the GD group with or without any of these comorbidities., Conclusions: In this population-based longitudinal follow-up study, GD carried a significantly higher stroke risk, particularly for younger age with or without stroke risk factors. Stroke preventive measures maybe needed for patients with GD, especially those of younger age and with stroke risk factor(s)., (Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

Background: The Glasgow coma scale (GCS) score is used in the initial evaluation of patients with traumatic brain injury (TBI); however, the determination of an accurate score is not possible in all clinical situations. Our aim is to determine if the individual components of the GCS score, or combinations of them, are useful in predicting mortality in patients with TBI., Methods: The components of the GCS score and the receiver-operating characteristic (ROC) curves were analyzed from 27,625 cases of TBI in Taiwan., Results: The relationship between the survival rate and certain eye (E), motor (M) and verbal (V) score combinations for GCS scores of 6, 11, 12 and 13 were statistically significant. The areas under ROC curve of E+V, M+V and M alone were 0.904, 0.903 and 0.900, respectively, representing the 3 most precise combinations for predicting mortality. The area under the ROC curve for the complete GCS score (E+M+V) was 0.885. Patients with lower E, M and V score respectively, and lower complete GCS scores had higher hazard of death than those with the highest scores., Conclusion: The results of this study indicate that the 3 fundamental elements comprising the Glasgow coma scale, E, M, and V individually, and in certain combinations are predictive of the survival of TBI patients. This observation is clinically useful when evaluating TBI patients in whom a complete GCS score cannot be obtained., (Copyright © 2010 Elsevier Ltd. All rights reserved.)