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Background: COVID-19 affected both the physical and mental health of frontline nurses and the stability of the nursing workforce. Purpose: This study was designed to explore the influence of demographic variables, physical and mental health status, perceived work stress, and job satisfaction on intention to continue working as nurses among nursing staff who had been infected by COVID-19. Method: In this cross-sectional study, an internal online survey was used to collect data from 152 nurses at a hospital in southern Taiwan. The questionnaires in the survey included the Chinese Health Survey Scale, Stress Scale on COVID-19 Patient Care, McCloskey/ Mueller Satisfaction Scale, and Employee Retention Scale. Data analysis was conducted using SPSS/Windows 22.0. Results: The most significant predictors identified included age, seniority, level of education, job satisfaction, physical and mental wellbeing, and work stress. These predictors collectively explained 32% of the total variance in retention willingness (F [18,128] = 4.78, p < .001). Almost half (46.7%; 71/152) of the participants expressed intent to continue working in nursing. Being a senior staff and having a master's degree or higher were positively associated with retention. Conclusions/ Implications for Practice: The findings may be referenced by healthcare organizations and managers to help healthcare staff gain strength and resilience against future pandemics. Key recommendations include reducing staff work stress, increasing job satisfaction, and facilitating a more equitable life-work balance. [ABSTRACT FROM AUTHOR]

This study investigated the effects of multimedia presentations on the efficiency of learning scientific information (i.e. information on basic anatomy of human brains and their functions, the definition of cognitive psychology, and the structure of human memory). Experiment 1 investigated whether the modality effect could be observed when the learning material contained auditory information and visuals altered in complexity, and whether the redundancy effect is caused by redundant information or by interference in information processing. In Experiment 2, verbal-only information was used to examine whether subjects could perform better with auditory rather than with on-screen textual information, and whether the length of the verbal information would exert an effect on learning. The results of Experiment 1 contradicted the prediction of the modality effect in that subjects learned no better or even worse with the audio-visual format of learning material than did subjects with the visual-only one. Besides, redundant information per se did not impair learning, which suggested that the redundancy effect could be rather caused by the interference in information processing. The results of Experiment 2 indicated a negative effect of auditory information on learning regardless of the length of the verbal information. No evidence supported the superiority of auditory instructional mode over the visual one. (Contains 6 tables and 8 figures.)

In this study we content analyzed the online discussion of several senior-high-school groups on a forum of a virtual physics laboratory in Taiwan. The goal of our research was to investigate the nature of non-course-based online discussion and to find out some useful guidelines in developing such discussion forums for learning purposes. We adapted Henri's framework and models (1992) for our analysis. The content analysis was conducted in terms of participation rate, social cues, interaction types, and cognitive and metacognitive skills. In this study, we compared the result patterns of two discussion conditions ("required" (R-)condition versus "non-required" (NR-) condition) of a non-course-based discussion forum and investigated how the quality of message content changed in the processes of discussion. In the R-condition, participants were required to reply to the thread before they were allowed to read other messages on the forum, whereas participants in the NR-condition were not restricted to this demand. The results showed that for both conditions, the most frequently involved interaction type was "direct response", and the most frequently used cognitive skill was "elementary clarification". Fewer participants of the R-condition strayed from the subject under discussion in comparison to the NR-condition. However, larger percentage of message content containing metacognitive components was found in the NR-condition. When taking the sequences of postings into account, we found that for the R-condition, the percentage of metacognitive component in the message content tended to increase in the up-third postings, whereas for the up-third postings of the NR-condition the percentage of non-cognitive components substantially increased. Overall, the results of our study indicated that the way in which participants used cognitive and metacognitive skills during the discussions was related to the discussion conditions. The initial requirement of reply fostered the use of cognitive skills, but it did not necessarily induce the use of high-level cognitive or metacognitive skills. We concluded that beside the discussion conditions the moderators' guidance would be influential in determining the quality of online discussion on a non-course-based discussion forum.

Background: Infective endocarditis (IE) is an important cause of morbidity and mortality in pediatric patients with heart disease. Little literature has explored differences in the presentation of endocarditis in children with and without heart disease. This study aimed to compare the clinical outcomes and determine the risk of in-hospital death in the study population. Methods: Data were retrospectively collected from 2001 to 2019 from the Chang Gung Research Database (CGRD), which is the largest collection of multi-institutional electronic medical records in Taiwan. Children aged 0–20 years with IE were enrolled. We extracted and analyzed the demographic and clinical features, complications, microbiological information, and outcomes of each patient. Results: Of the 208 patients with IE, 114 had heart disease and 94 did not. Compared to those without heart disease, more streptococcal infections (19.3% vs. 2.1%, p < 0.001) and cardiac complications (29.8% vs. 6.4%, p < 0.001) were observed in patients with heart disease. Although patients with heart disease underwent valve surgery more frequently (43.9% vs. 8.5%, p < 0.001) and had longer hospital stays (28.5 vs. 12.5, p = 0.021), their mortality was lower than that of those without heart disease (3.5% vs. 10.6%, p = 0.041). Thrombocytopenia was independent risk factor for in-hospital mortality in pediatric patients with IE (OR = 6.56, 95% CI: 1.43–40.37). Conclusion: Among pediatric patients diagnosed with IE, microbiological and clinical features differed between those with and without heart disease. Platelet counts can be used as a risk factor for in-hospital mortality in pediatric patients with IE. [ABSTRACT FROM AUTHOR]

Background: Organizational commitment, defined in nursing as the degree to which nurses identify with the goals and direction of their hospital, affects the willingness of nurses to participate actively in work tasks. Purpose: This study was designed to explore the predictive value of demographic variables, perceived work stress, and job satisfaction with regard to organizational commitment in nurses. Method: This cross-sectional study used an internet survey that included the Stress Scale on COVID-19 Patient Care, McCloskey/Mueller Satisfaction Scale, and Organizational Commitment Scale to collect data from 189 nurses at a hospital in southern Taiwan. Data analysis was conducted using SPSS/Window 22.0. Results: Societal support and job satisfaction were identified as the most significant predictors of organizational commitment during the COVID-19 pandemic, explaining 47% of the total variance in organizational commitment (F [17, 171] = 8.79, p < .001). Level of perceived work stress averaged 48.3 (SD = 15.4), which is slightly higher than the median, and was highest among the participants who were married and had young children. The stress was mainly associated with social isolation. Those participants with a bachelor's degree or higher, a monthly income > NT$70,000, or with children reported relatively higher levels of job satisfaction and organizational commitment. Conclusion/Implications for Practice: The results provide a valuable guide to hospital management. To strengthen the organizational commitment and work dedication of nurses and to minimize pandemic-related staff attrition hospital management should work to ensure their nurses receive sufficient societal support and are satisfied with their jobs. [ABSTRACT FROM AUTHOR]

Background: Attention-deficit/hyperactivity disorder (ADHD) has been linked to pediatric asthma patients treated with montelukast. This study is the first to use a nationwide health insurance research database (NHIRD) to study whether asthmatic children using montelukast are at an increased risk of ADHD.Methods: We used data from the Taiwan NHIRD, which is a longitudinal database of one million randomly selected subjects. The enrolled patients were followed up until 2013. Patients younger than and equal to 12 years old with new-onset asthma (ICD-9 CM code 493.X) diagnosed between 1997 and 2013 were enrolled. A multivariate Cox regression analysis was conducted to evaluate the association between montelukast treatment and the risk of ADHD (ICD-9-CM code 314.X).Results: We enrolled a total of 54,487 asthmatic children younger than and equal to 12 years old who had at least one claim of inpatient admission or at least three claims of an ambulatory visit. Montelukast users and match controls were identified by matching age, gender, residence, the comorbidities including allergic rhinitis and atopic dermatitis, admission or emergency department visits due to asthma attack, and index date of starting montelukast in a 1:1 ratio, with 12,806 in the montelukast group and 12,806 in the non-montelukast group. The montelukast group had a similar risk of ADHD (n = 632, 4.94%) as the non-montelukast group (n = 610, 4.76%) [adjusted hazard ratio 1.04; 95% confidence interval, 0.93 to 1.17]. In children treated with montelukast, high cumulative days of montelukast use did not increase the risk of ADHD.Conclusion: This nationwide population-based cohort study reveals that asthma children treated with montelukast were not at an increased risk of developing ADHD. Nevertheless, validation of our retrospective survey requires further prospective study. [ABSTRACT FROM AUTHOR]

Aim: To examine female youth's intentions for safe sex with the relationship partners based on the extended theory of planned behaviour (TPB) model and explore the direct and indirect impact of parent–child communication about sex, peer interaction related to sexual issues, and exposure to sexually explicit materials on female youth's safe sexual behaviour intentions. Design: A non‐experimental, cross‐sectional research design. Methods: A convenience sampling was employed for data collection and 731 female youth aged 15–24 years old were recruited in 2013–2014. An anonymous, self‐report structured questionnaire was used as a research instrument to collect participants' basic information and measure the internal and additional variables in the extended TPB model. Results: The extended TPB model explained 42–45% of the total variance. Perceived behavioural control (PBC) and subjective norms had a positive effect on female youth's intentions for contraceptive use, condom use, and dual use with relationship partner; PBC was found to have the greatest influence. Among the additional variables in the extended TPB model, more parent–child communication about sex was found to lead to more positive dual use intentions. More peer interaction related to sexual issues was found to lead to less dual use intentions. Conclusions: To improve female youth's sexual health, the priorities are to reinforce their PBC and subjective norms and enhance parent–child communication about sex. Future efforts should strengthen sex education in families and schools and shape a social environment that facilitates safe sex. Impact: The extended TPB model can successfully predict female youth's safe sexual behaviour intentions. Empowering female youth to establish a sense of subjectivity and awareness of being a mature individual with physical autonomy, is importance for their sexual health. [ABSTRACT FROM AUTHOR]

Abstract: Citrus tristeza virus (CTV), the causal agent of tristeza disease, causes the devastating diseases worldwide. In Taiwan, complex cultivars and long‐term infection by CTV result in more than 90% of infected citrus trees, but local strain identification and classification are still incomplete. Here, six CTV strains were categorized by grafting onto eight citrus cultivars and the pathological characteristics of the stem‐pitting mild strains were identified. After 6 months of inoculation, the pummelo stem‐pitting severe strain (CTV‐Pum/SP/T1) only caused severe symptoms in Wentan pummelo (WP) and the mild strain (CTV‐Pum/M/T5) was symptomless in every cultivar; the sweet orange (SO) stem‐pitting severe strain (CTV‐SwO/SP/T7) affected SO, WP and Ponkan mandarin (PM), and the mild strain (CTV‐SwO/M/T51) caused no symptoms in SO except for WP; the mandarin stem‐pitting severe strain (CTV‐Man/SP/T46) caused severe impacts in PM, WP and Eureka lemon, whereas the mild strain (CTV‐Man/M/T2) only caused severe stem‐pitting in WP. The full‐length sequencing of both pummelo stem‐pitting strains and phylogenetic analysis revealed that CTV‐Pum/SP/T1 and CTV‐Pum/M/T5 were related to the HA18‐9 and HA16‐5 strains from Hawaii, respectively. Moreover, recombination analysis revealed that TCT repeat sequences existed at open reading frame 1a in both the CTV‐Pum/SP/T1 and the T36 strains from the United States, indicating that the possible evolution relationship between two regions. Furthermore, improved universal and specific primer pairs were designed for more specific, sensitive detection to meet the needs for quarantine and early prevention. The understanding of strain pathogenicity and genomic analysis provided further characterization of each strain and enabled practical challenge inoculation against CTV disease. [ABSTRACT FROM AUTHOR]

Purpose: Nursing remains a female-dominated profession around the world. The masculinity and male identity of men who choose nursing careers is questioned by the general public in many countries. Few studies report the situation of novice male nurses at their first year. The purpose of this study was to explore the lived experience of novice male nurses when they first enter the workplace. Design and Method: A qualitative descriptive study was conducted using purposive and snowball sampling for recruitment. Fourteen participants, 21 to 25 years old, were recruited, all of whom had at least 5 months of work experience. On average, in-depth, face-to-face interviews lasted 1 hour, with more than one follow-up telephone interview per participant. Findings: The following six themes emerged from the transcribed verbatim data based on content analysis: choosing appropriate work departments based on personality and needs, facing the pressure and frustration of independent work, getting help, obtaining acceptance among female cliques, reflecting on the relationship between gender and profession, and concerns about dependents and financial needs. Conclusions and Implications for Practice: This study addresses masculinity issues and gender stereotyping. In addition, male nurses were very concerned about their career options and development and the likelihood of promotion. This research not only has implications for better understanding of novice male nurses’ needs and the challenges in their social life but also makes suggestions for nursing practice to attract and keep more male nurses in the nursing profession. The results illustrate how culturally congruent nursing care can be achieved when we more concern male nurses’ role pressure and address traditional gender sensitivity to promote male nurses’ career development. [ABSTRACT FROM AUTHOR]

This study was designed to understand young Taiwanese women’s perception of sexually explicit materials (SEMs). Researchers conducted six focus group discussions with 38 young women between the ages of 18 and 22 in Taiwan in 2009–2010 and used content analysis to analyze the data based on the push-pull theory. The results showed that the exposure of young women to SEMs was a sexual exploration process from no sexual activity to future sexual activity. This process was affected by the interactions of three powers: push power, pull power, and personal factors. The push power included factors, such as parents and social values, which failed to satisfy their sexual curiosity and provide them with autonomy. The pull power included SEMs and peer influence, which increased sexual arousal stimuli and curiosity to try sexual activity. The most important personal factors were young women’s growth, including sexual curiosity, cognition of SEMs, and gender equity in freedom to make sexual decisions. Understanding this push-pull process regarding SEM can help health-care providers with their own discourses in addressing sex and influence young women’s participation in desired, protected, and enjoyable sex when sufficiently ready. [ABSTRACT FROM PUBLISHER]

Aim The aim of this study was to explore the lived experiences of patients afflicted with spinal muscular atrophy. Background Existing research studies on spinal muscular atrophy address the physical and psychological effects and complications of the disease; they also provide suggestions for how to improve the current management of this disease. However, information is limited on the disease process and the lived experience of spinal muscular atrophy patients. Design A phenomenological approach was conducted. Methods Through 18 in-depth interviews recorded by a pen voice recorder, this study collected data obtained from a purposive sample of nine patients from the, 'Taiwan spinal muscular atrophy Families,' between November 2010-August 2011. The audio recordings were transcribed verbatim and data were analysed using Colaizzi's steps. Findings Four themes and eight subthemes were identified: a loss of control (loss of muscular strength and independence), breaking limitations (assistive device use and mobility design), transcending limitations (independence/autonomy and social development) and living with hope (cherishing life and self-control). The results showed that the lived experiences of the spinal muscular atrophy patients involved living with illness, transcending the self and pursuing the meaning of life. Facing a life-threatening illness, these patients made self-adjustments in their lifestyles and exerted themselves to positively cope with hardships and maintain dignity and self-control. Conclusion These findings could serve as evidence-based practice resources for healthcare professionals in helping individuals and their family members gain an in-depth understanding of spinal muscular atrophy's progression and life course and assist individuals in improving self-integrity to with hope. [ABSTRACT FROM AUTHOR]

Objective: The association between Sjögren’s syndrome (SS) and chronic hepatitis virus infection is inconclusive. Hepatitis B (HBV) and hepatitis C virus (HCV) infections are highly prevalent in Taiwan. We used a population-based case-control study to evaluate the associations between SS and HBV and HCV infections. Materials and Methods: We identified 9,629 SS patients without other concomitant autoimmune diseases and 38,516 sex- and age-matched controls without SS from the Taiwan National Health Insurance claims data between 2000 and 2011. We utilized multivariate logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the associations between SS and HBV and HCV infections. Sex- and age-specific (<55 and ≥55 years) risks of SS were evaluated. Results: The risk of SS was higher in patients with HCV than in those without chronic viral hepatitis (OR = 2.49, 95% CI = 2.16–2.86). Conversely, HBV infection was not associated with SS (OR = 1.10, 95% CI = 0.98–1.24). Younger HCV patients were at a higher risk for SS (<55 years: OR = 3.37, 95% CI = 2.62–4.35; ≥55 years: OR = 2.20, 95% CI = 1.84–2.62). Men with HCV were at a greater risk for SS (women: OR = 2.26, 95% CI = 1.94–2.63; men: OR = 4.22, 95% CI = 2.90–6.16). Only men with chronic HBV exhibited a higher risk of SS (OR = 1.61, 95% CI = 1.21–2.14). Conclusion: HCV infection was associated with SS; however, HBV only associated with SS in men. [ABSTRACT FROM AUTHOR]

Regression and neural network models have been developed to predict the cost and duration of projects for the reconstruction of schools which must be quickly rebuilt. Data for the school reconstruction projects in central Taiwan, which received the most serious damage from the Chi‐Chi Earthquake, were collected and analysed. The analytical results demonstrate that the floor area provides a good basis for estimating the cost and duration of school reconstruction projects, and suggest that the neural network model with back‐propagation learning technique is a feasible approach that yields better prediction results than the regression model for school reconstruction projects. [ABSTRACT FROM AUTHOR]

Due to the occurrence of ponding during the period of rice growth, the analyses of rainfall-runoff in paddy fields are different from those in general lands. The diffusive tank model has been successfully applied in rainfall-runoff simulations in paddy fields because it can well describe the features of the local water flow. In most of the applications of this model, although the determination of the related model parameters is important, detailed investigations on each individual parameter are definitely needed to improve the accuracy of the results. In the study, an improved procedure is proposed to determine certain variables involved in the diffusive tank model and the application is conducted in a field area in Taiwan. In the application, the roughness of the river channel was assessed according to the actual field conditions. Instead of using the observed water levels in each rainfall event, the notch width of the rectangular contracted weir per unit area was evaluated by direct field measurements to calibrate the discharge coefficient. Test results from the selected field in six rainfall events showed that the local average value of the notch width of the rectangular contracted weir per unit area was 1·025 m/ha. Compared to the results of field measurements, the relative errors of the predictions were within 3% in all tests of rainfall events. In addition, for different types of catchment partitions, it was found that the corresponding weir discharge coefficients remained roughly unchanged. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

When heavy rain strikes Taiwan, it always results in cracks in road pavement, and damages arising from potholes. Tremendously compromising road safety, road users may have fatal accidents caused by untimely repair actions. The road maintenance department needs to take the responsibilities for road sections in the form of inspections and faces the decision about how to properly allocate available resources to repair pavement damages immediately. When performing pavement repair works, we need to consider the resource consumption behavior and explore the mechanism of replenishing resources and calculating the return time. Therefore, in order to help maintenance units to deal with consumable resource issues, this study proposes a novel approach to offer the mechanism of consumable resource calculation, which is difficult to solve through the traditional vehicle routing problem (VRP) approach. This proposed model treats the pothole repair problem as a resource-constrained project scheduling problem (RCPSP), which is capable of resolving such consumable resource considerations. The proposed model was developed by adopting constraint programming (CP) techniques. Research results showed that the proposed model is capable of providing the optimal decisions of pavement pothole repair tasks and also meets practical requirements to make appropriate adjustment, and helps the maintenance unit to shorten total repair duration and optimize resource assignment decisions of pavement maintenance objectives. [ABSTRACT FROM AUTHOR]

An abstract of the article "Gender Differences? Internet Use and Parent-Child Communication About Sex Toward Sexual Attitudes Among Early Adolescents in Taiwan," by Ying-Hua Tseng and colleagues is presented.

The aims of this study were to examine gender differences in how parent-child discussions on sex issues, peer interactions around sexual issues, and exposure to sexually explicit materials affect the intention to engage in casual sex among adolescents and young adults in Taiwan. This cross-sectional survey study recruited 767 participants (348 men and 419 women) aged 15-24 years. The survey collected data on participants' intention to engage in casual sex, their attitude toward and perception of casual sex based on the theory of planned behavior (TPB) (favorable attitude, perceiving positive social norms toward casual sex, and perceived control over involvement), parent-child and peer discussions about sexual issues, and exposure to sexually explicit materials. The results of multiple regression analysis revealed that parent-child discussions on sex issues, peer interactions around sexual issues, and exposure to sexually explicit materials were significantly associated with the intention to engage in casual sex. The results of structural equation modeling (SEM) further supported that favorable attitude, perceiving positive social norms toward casual sex, and control over involvement mediated the associations. For men, decreased favorable attitude mediated the negative association between parent-child discussions and casual sex intention; increased favorable attitudes and decreased control over involvement mediated the positive associations between peer interactions and casual sex intention. For women, decreased control over involvement mediated the positive association between exposure to sexually explicit materials and casual sex intention. The associations between peer interaction and subjective norms of acceptance, perceived control over involvement, and casual sex intention were stronger in men than in women; the association of favorable attitudes with casual sex intention was also stronger in men than in women.

Dating violence (DV) constitutes a major public health and safety issue worldwide; however, only limited research into this important subject has been conducted in Taiwan. This study examined university students' intention to commit DV, based on the expanded theory of planned behavior (TPB), with a history of family violence and gender stereotyping also included as further factors in the original TPB model. A total random sample consisting of 450 university students from four universities in four regions in Taiwan, namely, the northern, southern, central, and eastern regions, participated. Of these participants, 365 (81.1%) completed all of the parts of the questionnaires, which included a survey of demographic data, such as any history of family violence; a gender stereotyping questionnaire; and a DV behavioral intention questionnaire. The results showed that the three main variables of the TPB-that is, subjective norms, attitudes, and perceived behavioral control-significantly related to university students' intentions to commit DV. More specifically, university students' attitudes and subjective norms emerged as significant related factors of their intention to commit DV behaviors. Overall, the expanded TPB explained 30.4% of the variance in DV intentions, and attitude was the most significant factors after controlling the background variables. These findings can hopefully be used to help design and implement programs for the prevention of DV behaviors among university students.

Dating violence (DV) is a major public health problem among youth. The majority of DV studies in Taiwan involve the assessment of DV without the use of a robust psychological framework to guide research accuracy. Therefore, the purpose of this study was to utilize the Theory of Planned Behavior (TPB) to assess intention and other salient factors related to DV among university students. A two-phase, mixed-method design study was conducted among university students from seven universities in Taiwan, aged 18 to 24 years. In Phase I, questionnaires used were specifically developed based on the TPB, consisting of both direct and indirect measures related to DV. In Phase Ⅱ, questionnaire evaluation and related factors were examined through a two-step process of structural equation modelling (SEM) to test the TPB model. The results of this study found that perceived behavioral control, subjective norm, and attitude toward DV on behavioral intention accounting for 37.5% of the total variance. Among the related factors, attitude toward the behavior was the strongest (β = 0.48, p < 0.001), followed by perceived behavioral control (β = 0.19, p < 0.05). Findings from this study could expand the knowledge base in this important area and might help prevent DV.

Objective: The association between chronic hepatitis virus infection and rheumatoid arthritis (RA) remains debatable. This nationwide population-based cohort study assessed the risk of RA among patients with a chronic infection of hepatitis B and/or C virus., Materials and Methods: We used data extracted from the claims of 1,000,000 randomly sampled individuals covered under the Taiwan National Health Insurance program. Among the 49,892 persons identified in 2000-2010 with chronic hepatitis virus infection, 35,652 had chronic HBV infection alone, 10,253 had chronic HCV infection alone, and 3,987 had chronic HBV/HCV dual infections. The comparison cohort comprised 199,568 persons matched on sex, age and calendar year without chronic hepatitis virus infection. All study participants were free of RA at baseline and traced through 2011 with new RA cases identified., Results: After adjusting for covariates, chronic HCV infection alone was significantly associated with an increased risk for RA (hazard ratio (HR)  = 2.03, 95% confidence interval (CI)  = 1.27-3.22). The increased risk for RA among participants with chronic HCV infection remained significant after restricting the analysis to those who were prescribed disease-modifying anti-rheumatic drugs. The corresponding HR for the overall sample was 1.89 (95% CI  = 1.15-3.11). However, HBV carriers did not appear to be at a significantly higher risk for RA., Conclusion: Our data imply that chronic HCV infection is associated with RA development.

Aims: To investigate whether self care behaviours, medical outcomes and quality of life of Taiwanese elderly with Type 2 diabetes mellitus (DM) can be improved by delivery of an educational health care package., Background: DM is a major health problem in developed and developing countries, with older adults constituting about half of the diabetic population. Type 2 DM is the most rapidly increasing chronic disease in Taiwan., Methods: During 2005 and 2006, Taiwanese elderly with Type 2 DM (n = 500) were randomly allocated to either an intervention or control group. Data collection using validated instruments occurred at baseline and 6 months follow-up. Main outcome measures were blood glucose levels and diabetic complications., Results: At baseline, 88.4% participants in the control and 78.8% in the experimental group had a blood glucose level above normal range (p = 0.076); respective results at 6 months were 92.4% for the control group and 60.4% for the experimental group (p < 0.001). The multivariate adjusted result showed that the intervention group was 11.1 times less likely to have blood glucose levels above normal (p = 0.002) at 6 months follow-up compared to the control group. Occurrence of complications was significantly fewer in the intervention group at baseline and at 6 month follow-up compared to the control group (baseline: 42.0% versus 82.1%, p = 0.003; 6 month follow-up: 48.4% versus 87.0%; p = 0.006)., Conclusion: Although overall occurrence of complications remained unchanged, the educational health care package specifically developed for Taiwanese elderly with Type 2 DM improved blood glucose levels.

Background/purpose: Human growth hormone (GH) has been successfully used in children with GH deficiency (GHD). However, there are few published data on the effect of GH in Taiwanese children with GHD., Methods: We performed a retrospective cohort study to identify factors influencing the effect of GH therapy on ethnic Chinese children with GHD in Taiwan. Idiopathic GHD can be classified into isolated GHD (IGHD) and multiple pituitary hormone deficiency (MPHD). The study looked at the effect of GH on the auxological, biochemical, and imaging parameters of 51 patients (13 girls and 38 boys) in three different diagnostic groups: MPHD (n = 12), IGHD (n = 8), and transient GHD (TGHD; n = 31). TGHD is defined as a GH peak >10 μg/L in re-evaluation by two GH stimulation tests approximately 6 months after discontinuation of GH therapy., Results: The height velocity for first-year GH therapy was 7.61 ± 1.46, 8.14 ± 1.92, and 9.99 ± 2.75 cm/y in the TGHD, IGHD, and MPHD groups, respectively. After post hoc comparison, the MPHD group had a significantly accelerated height velocity in the first year compared to the TGHD group. Correlation analysis showed that a change in height standard deviation score (SDS) in the first year had a significant negative correlation with the following variables: peak GH (r = -0.52, p < 0.001), pretreatment height SDS (r = -0.49, p < 0.001), and height-target height (Ht-TH) SDS (r = -0.49, p < 0.001). Change in height SDS in the first 2 years had a significantly negative correlation with peak GH (r = -0.51, p < 0.001), insulin-like growth factor-1 SDS (r = -0.35, p = 0.022), height SDS (r = -0.60, p < 0.001), difference between bone age and chronological age (r = -0.46, p = 0.001), and Ht-TH SDS (r = -0.50, p = 0.001). After using multiple linear regression, the pretreatment GH peak value was found to be significantly associated with height increments after 1 year of GH treatment (B = -0.07, p = 0.014)., Conclusion: The administration of GH to children with GHD results in a pronounced acceleration in linear growth during the first year of treatment, especially in those with MPHD. The diagnosis of GHD requires comprehensive auxological, biochemical, and brain magnetic resonance imaging assessment. We also suggest that patients with GHD, specifically IGHD, must undergo a re-evaluation of GH secretion after completion of GH therapy., (Copyright © 2012. Published by Elsevier B.V.)