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The purpose of this study was to examine the relationships between outdoor experiences in adolescence and outdoor activity involvement in adulthood, with the aim of determining which kinds of outdoor experiences could significantly influence outdoor activity involvement. According to a literature review, five variables appeared to be common in early-life outdoor experiences, including participating in outdoor activities with family and friends, participating alone, participating in outdoor activities provided by organizations, and extracurricular outdoor activities provided by schools. Data were collected from 800 participants in outdoor activities in the Da-Keng recreational area in Taiwan, with questionnaires asking about their level of activity involvement and their early-life outdoor experiences. The results revealed that there were three significantly predictive factors: participating in outdoor activities with parents, participating in outdoor activities with friends, and participating in outdoor activities provided by organizations. Based on these results, suggestions were made and discussed. [ABSTRACT FROM PUBLISHER]

Overseas kidney transplantation has often been reported to have unsatisfactory outcomes. This study aims to compare post-transplantation outcomes between overseas and domestic kidney transplant (KT) recipients in Taiwan. The Taiwanese National Health Insurance Research Database was used to identify 310 domestic and 643 overseas KT recipients, who survived for longer than 1 month after the transplantation, in a cohort of 45 453 chronic haemodialysis patients in 1997-2002. Cox proportional hazards models were used to assess risks of mortality and graft failure. The 1, 3 and 5 year survival rates for domestic KT recipients were 96.5%, 93.3% and 91.6%, respectively, while those for overseas KT recipients were 94.9%, 87.9% and 77.1%, respectively ( P = 0.015). For the overseas group, those who received a KT before 2001 had significantly higher hazard ratios of mortality and graft failure (2.85 and 1.71, respectively). However, for those receiving a KT in 2001-2002, no significant outcome difference could be found between overseas and domestic recipients. The risk disparity between overseas and domestic KT recipients is mainly attributable to when the transplantation was performed. In attempting to dissuade potential recipients from organ trafficking, merely emphasizing the previously acknowledged poor outcomes no longer suffices as a valid reason. In this paper, Hsu and colleagues from Taiwan analyze the outcome of kidney transplantation performed overseas in two time periods, before and after 2001, and show the outcome of kidney transplants performed outside Taiwan after 2001 are comparable to those performed in Taiwan. The implication of this paper is that emphasis on poor mortality and graft outcome from 'transplant tourism' is less sustainable than before and new strategies to deter this will need to be developed. [ABSTRACT FROM AUTHOR]

Background. Incident and prevalent (I&P) rates in dialysis end-stage renal disease (ESRD) patients in Taiwan increased rapidly following the launch of National Health Insurance (NHI) in 1995. Our aim was to explore the impact of NHI on the status and trends of ESRD epidemiology in Taiwan. Methods. This study was conducted using retrospective cohort analysis of data collected from the Taiwan national dialysis registry. Results. From 1990 to 2001, I&P rates of ESRD patients increased 2.6 times from 126 to 331 per million populations (pmp) and 3.46 times from 382 to 1322 pmp, respectively. Increasing ESRD was seen in patients who were middle-aged, elderly and who had diabetic nephropathy as their primary renal disease. The mean age of I&P patients increased by 7.2 years and 7.1 years, respectively. All of these parameters increased markedly in 1995, the year of NHI implementation. First-year mortality decreased to 7.8 per 1000 patient-months in 1994, and then increased to 18.0 in 2001. The cumulative survival rate of the elderly subgroup (age >65) in the incident 1990–1994 cohort was greater than in the 1995–1999 cohort. These data indicated that NHI implementation significantly influenced the inflow and the mortality of ESRD patients. Conclusion. In addition to presenting ESRD epidemiology in Taiwan, this study demonstrated that NHI implementation stimulated the growth of treated ESRD populations. Preventive plans mounted against chronic kidney diseases will be essential to reduce the growth of ESRD patient numbers and consequent economic burdens. [ABSTRACT FROM AUTHOR]

Background. Taiwan has the worlds highest incidence and second highest prevalence of end-stage renal disease (ESRD), particularly in older age groups. However, the transition from chronic kidney disease (CKD) to death or ESRD remains unclear. This study aimed to investigate the impact of late-stage CKD on all-cause and cause-specific mortality by identifying the CKD population. Methods. This was an observational cohort study (n = 35 529), mean age 75.7 years (SD = 5.3), of participants in the Elderly Health Examination Program (EHEP) in Kaohsiung City, Taiwan, between 2002 and 2004. Estimated glomerular filtration rate (eGFR) was calculated by the simplified modified diet in renal disease equation. Proportional hazard ratios (HR) of mortality associated with late-stage CKD were assessed by Cox regression. Results. The crude prevalence rate of CKD stages 3–5 was 39.4%; 1840 participants (5.18%) died within 2-year follow-up, a mortality rate of 20.3 per 1000 person-years overall and 16.4 per 1000 person-years in the reference group. Higher HR for all-cause and cause-specific mortality were found in the groups with decreased eGFR. Compared with the reference group (eGFR > 60 mL/min/1.73 m2), adjusted HR for all-cause mortality were 1.5, 2.1 and 2.6 for groups with eGFR 30–44, 15–29 and P P Conclusion. Late-stage CKD is a significant risk factor for mortality, especially due to cardiovascular and renal diseases, in elderly Taiwanese. Given the higher prevalence rate of late-stage CKD in the study area, CKD patient mortality was relatively lower, which might reflect underestimation of renal function for patients at early stages of CKD, or partly explain the high ESRD population. [ABSTRACT FROM AUTHOR]

The purpose of the study was to examine the relations of five dimensions of free-time management (including goal setting and evaluating, technique, values, immediate response, and scheduling) with leisure boredom, and whether these factors could predict leisure boredom. A total of 500 undergraduates from a university in southern Taiwan were surveyed with 403 usable questionnaires was returned. Pearson correlation analysis revealed that five dimensions of free-time management had significant negative relationships with leisure boredom. Furthermore, the results of stepwise regression analysis revealed that four dimensions of free-time management were significant contributors to leisure boredom. Finally, we suggested students can avoid boredom by properly planning and organizing leisure time and applying techniques for managing leisure time.