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Background: Disaster-related psychiatric disorders (DRPD) present a significant challenge to mental health professionals, yet there is a notable lack of emphasis on the preparedness of psychiatrists in managing these conditions within postgraduate medical education. Methods: This study utilized a questionnaire to collect data from psychiatrists, focusing on their prior involvement in managing DRPD, perceived competence, medication preferences, and factors influencing their experiences in handling such disorders. Analysis included distribution and ranking of variables, alongside cross-analysis examining associations between demographic factors (age, gender, hospital levels, years of practice, board certification) and treatment experiences, as well as readiness for in-hospital or outside-hospital mobilization in DRPD management. Results: One hundred and three Taiwanese psychiatrists participated in the study, with the majority reporting involvement in managing DRPD (71.8%), particularly in post-traumatic stress disorder (PTSD) and depression. Antidepressants, specifically serotonin selective reuptake inhibitors, were commonly preferred for DRPD treatment, including PTSD and depression. Psychiatrists aged over 40, with more than 10 years of practice, and hold the board-certified status, showed greater experiences for outside- or inside- the hospital mobilization in DRPD management. Conclusion: Findings suggest that within post-graduate medical education, Taiwanese psychiatrists demonstrate significant experience, willingness, and capacity to effectively manage DRPD. However, there is a need to integrate comprehensive training on disaster psychiatry into post-graduate psychiatric education programs to further enhance preparedness and optimize outcomes in managing these challenging conditions. [ABSTRACT FROM AUTHOR]

Acute diarrhea is mainly caused by norovirus and rotavirus. Numerous factors modify the risk of diarrhea cluster infections and outbreaks. The purpose of this study was to explore the epidemiological characteristics, differences, and trends in the distribution of viral and bacterial pathogens that cause diarrhea cluster events as well as the public places where diarrhea cluster events took place in Taiwan from 2011 to 2019. We examined publicly available, annual summary data on 2865 diarrhea clusters confirmed by the Taiwan Centers for Disease Control (CDC) from 2011 to 2019. There were statistically significant differences (p < 0.001) in event numbers of diarrhea clusters among viral and bacterial pathogens, and statistically significant differences (p < 0.001) in event numbers of diarrhea clusters among bacterial pathogens. There were also statistically significant differences (p < 0.001) in the event numbers of diarrhea clusters among public places. Norovirus infections were the first most numerous (77.1%, 1810/2347) diarrhea clusters among viral and bacterial infections. Among bacterial infections, Staphylococcus aureus infections accounted for the greatest number of diarrhea clusters (35.5%, 104/293). Schools were the places with the greatest number of diarrhea clusters (49.1%, 1406/2865) among various institutions. Norovirus single infection (odds ratio, OR = 4.423), Staphylococcus aureus single infection (OR = 2.238), and school (OR = 1.983) were identified as risk factors. This is the first report of confirmed events of diarrhea clusters taken from surveillance data compiled by Taiwan’s CDC (2011–2019). This study highlights the importance of long-term and geographically extended studies, particularly for highly fluctuating pathogens, to understand the implications of the transmission of diarrhea clusters in Taiwan’s populations. Importantly, big data have been identified that can inform future surveillance and research efforts in Taiwan. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to investigate the validity of the coin‑in‑the‑hand (CIH) test with other neuropsychological tests for the detection of malingering in the memory. Materials and Methods: A simulated scenario design was developed to investigate the validity of the CIH test, entitled the Test of Memory Malingering (TOMM), associated with the Clinical Dementia Rating, the cognitive abilities screening instrument, the Mini‑Mental Status Examination, and the WHO Quality of Life‑BREF. The performances of the patients with dementia (n = 25) were compared with one group of normal controls (n = 9), and another group instructed to simulate malingering dementia (n = 19). Results: The CIH test demonstrated good validity and displayed a better sensitivity and a positive likelihood ratio than the TOMM, while patients with dementia could provide, on average, more than nine correct answers, in comparison to only more than six correct answers in the simulated malingering group. The optimal cutoff score of the CIH test is ≤8. Conclusions: This pilot study showed that the CIH test is a quick and practical test for detecting malingering in the memory. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the associations among dementia, psychotropic medications and the risk of overall injuries. In this nationwide matched cohort study, a total of 144 008 enrolled patients ≥age of 50, with 36 002 study subjects who suffered from dementia and 108 006 controls matched for sex and age, from the Inpatient Dataset, for the period 2000-2010 in Taiwan were selected from the National Health Insurance Research Database, according to International Classification of Diseases, 9th Revision, Clinical Modification. When adjusting for the confounding factors, a Cox proportional hazards analysis was used to compare the risk of developing psychiatric disorders during the 10 years of follow-up. Of the study subjects, 6701 (18.61%) suffered injury when compared with 20 919 (19.37%) in the control group. The Cox regression analysis revealed that the study subjects were more likely to develop an injury (HR: 2.294, 95% CI=2.229 to 2.361, P<0.001) after adjusting for sex, age, monthly income, urbanization level, geographic region, and comorbidities. Psychotropic medications in the subjects with dementia were associated with the risk of injury (adjusted HR=0.217, 95% CI: 0.206 to 0.228, P<0.001). Cognitive enhancers, including acetylcholinesterase inhibitors and memantine, were associated with the risk of injury in the study subjects after being adjusted for all comorbidities and medications (adjusted HR=0.712(95% CI=0.512 to 0.925, P<0.01)). In conclusion, patients who suffered dementia had a higher risk of developing injury, and the cognitive enhancers were associated with the decreased risk of injury. [ABSTRACT FROM AUTHOR]

Sudden sensorineural hearing loss is characterized by a rapid-onset hearing loss that develops within 3 days. Vertigo may also be present. We conducted a retrospective study to investigate whether the severity of a loss of caloric function is associated with the initial hearing loss and with hearing recovery. Our study population was made up of 135 patients--67 men and 68 women, aged 25 to 71 years (mean: 50.9)--with sudden sensorineural hearing loss who had undergone bithermal caloric testing. We compared various patient factors according to patients' hearing level and their response to caloric testing. We also analyzed the canal paresis (CP) value in patients with an abnormal caloric response according to three factors: disease severity, vertigo, and hearing recovery, and we evaluated the correlation between the loss of caloric function and hearing outcomes. We found that an abnormal caloric response was significantly associated with a profound hearing loss at presentation, the presence of vertigo, and poor hearing recovery. Among patients with an abnormal caloric response, the CP value was significantly correlated with hearing recovery (r = 0.503, p = 0.001). Poor hearing recovery was seen in 80% of patients with a CP value of ≥40% but in only 25% of patients with a value of <40%; in addition, the degree of hearing recovery was worse in the patients with a CP value of ≥40% (p = 0.002). We conclude that a CP value of ≥40% is a significant prognostic factor for an unfavorable treatment outcome. [ABSTRACT FROM AUTHOR]

Objectives: Refractory major depressive disorder (MDD) is a serious problem leading to a heavy economic burden. Antipsychotic augmentation treatment with aripiprazole and quetiapine is approved for MDD patients and can achieve a high remission rate. This study aimed to examine how psychiatrists in Taiwan choose medications and how that choice is influenced by health insurance payments and administrative policy. Design: Descriptive study. Outcome measures: Eight questions about the choice of treatment strategy and atypical antipsychotics, and the reason to choose aripiprazole. Intervention: We designed an augmentation strategy questionnaire for psychiatrists whose patients had a poor response to antidepressants, and handed it out during the annual meeting of the Taiwanese Society of Psychiatry in October 2012. It included eight questions addressing the choice of treatment strategy and atypical antipsychotics, and the reason whether or not to choose aripiprazole as the augmentation antipsychotic. Results: Choosing antipsychotic augmentation therapy or switching to other antidepressant strategies for MDD patients with an inadequate response to antidepressants was common with a similar probability (76.1% vs 76.4%). The most frequently used antipsychotics were aripiprazole and quetiapine, however a substantial number of psychiatrists chose olanzapine, risperidone, and sulpiride. The major reason for not choosing aripiprazole was cost (52.1%), followed by insurance official policy audit and deletion in the claims review system (30.1%). Conclusion: The prescribing behavior of Taiwanese psychiatrists for augmentation antipsychotics is affected by health insurance policy. [ABSTRACT FROM AUTHOR]

Objective: The mental health of military personnel varies as a result of different cultural, political, and administrative factors. The purpose of this study was to evaluate the psychological morbidity and quality of life of military personnel in Taiwan. Materials and methods: This cross-sectional study utilized the World Health Organization Quality of Life Instrument, brief version, Taiwan version, the General Health Questionnaire-12, Chinese version, and the Visual Analog Scale (VAS) in several military units. Results: More than half of the subjects (55.3%) identified themselves as mentally unhealthy on the General Health Questionnaire-12, Chinese version; however, a higher percentage of officers perceived themselves as healthy (57.4%) than did noncommissioned officers (38.5%) or enlisted men (42.2%). Officers also had higher total quality of life (QOL) scores (83.98) than did enlisted men (79.67). Scores on the VAS also varied: officers: 72.5; noncommissioned officers: 67.7; and enlisted men: 66.3. The VAS and QOL were positively correlated with perceived mental health among these military personnel. Conclusion: Our subjects had higher rates of perceiving themselves as mentally unhealthy compared to the general population. Those of higher rank perceived themselves as having better mental health and QOL. Improving mental health could result in a better QOL in the military. The VAS may be a useful tool for the rapid screening of self-reported mental health, which may be suitable in cases of stressful missions, such as in disaster rescue; however, more studies are needed to determine the optimal cut-off point of this measurement tool. [ABSTRACT FROM AUTHOR]

Background: The human norovirus (NV) circulates worldwide and is a major cause of epidemics, which have increased in Taiwan since 2002. NV in acute gastroenteritis (AGE) and non-acute gastroenteritis (asymptomatic) patients, including children and adults, have not been previously examined in Taiwan; therefore, we examined the epidemiology and phylogeny of NV in AGE and asymptomatic patients of all ages. Methods: 253 stool samples were collected from August 2011 to July 2012 (including 155 AGE and 98 asymptomatic samples in Taiwan) and analyzed using reverse transcription-polymerase chain reaction (RT-PCR) for NV. Primers targeting the RNA-polymerase gene were used for RT-PCR to allow DNA sequencing of Taiwan NV strains and phylogenetic analyses. Results: NV was detected in 24 (9.5%) of 253 stool specimens using RT-PCR. NV was isolated from all age groups (1 to 86 y) and those NV-positive samples were major identified from inpatients (79.2%, 19/24). Statistical analysis showed that the NV infectious rate of AGE patients was statistically significant (P < 0.05) for age, season and water type, respectively. Phylogenetic analyses of the RdRp region sequence showed that 24 NV isolates belonged to Genogroup II Genotype 4 (GII.4). They were closely related to the epidemic strain in Taiwan in 2006, the GII.4-2006b pandemic strain in 2006, and the GII.4-New Orleans strain in 2010. Conclusion: This study is the first to examine NV in sporadic AGE and asymptomatic patients in Taiwan. Furthermore, epidemic strains of isolated GII.4 were predominant in Taiwan during 2011 and 2012. [ABSTRACT FROM AUTHOR]

Tanshinone I (T1) and tanshinone II (T2) are the major diterpenes isolated from Danshen (Salvia miltiorrhiza Bunge). Three human lung adenocarcinoma cell lines, A549, CL1-0, and CL1-5, were treated with Tl and T2 for the in vitro antitumor test. Results showed that Tl was more effective than T2 in inhibiting the growth of lung cancer cells via suppressing the expression of VEGF, Cyclin A, and Cyclin B proteins in a dose-dependent manner. Moreover, a transgenic mice model of the human vascular endothelial growth factor-A165 (hVEGF-A165) gene-induced pulmonary tumor was further treated with Tl for the in vivo lung cancer therapy test. Tl significantly attenuated hVEGF-A165 overexpression to normal levels of the transgenic mice (Tg) that were pretreated with human monocytic leukemia THP-1 cell-derived conditioned medium (CM). It also suppressed the formation of lung adenocarcinoma tumors (16.7%) compared with two placebo groups (50% for Tg/Placebo and 83.3% for Tg/CM/Placebo; P < 0.01). This antitumor effect is likely to slow the progression of cells through the S and G2/M phases of the cell cycle. Blocking of the tumor-activated cell cycle pathway may be a critical mechanism for the observed antitumorigenic effects of T1 treatment on vasculogenesis and angiogenesis. [ABSTRACT FROM AUTHOR]

Background: A majority of Taiwan's foreign-national nursing aides are contract workers from Vietnam. Ensuring they enjoy a satisfactory quality of life (QOL) is critical to the well being of these Vietnamese aides as well as to their ability to deliver appropriate patient care. Few studies have addressed Vietnamese nursing aide QOL in Taiwan. Purpose: This study explored factors associated with the QOL of Vietnamese nursing aides working at medical institutions in Taiwan. Methods: This cross-sectional study recruited Vietnamese nursing aides currently working at regional hospitals in Kaohsiung city and county who had worked in Taiwan for at least three months. We distributed a structured questionnaire to potential participants and collected 264 valid questionnaires between January and April 2010; SPSS17.0 was used for statistical analysis. Results: "Role limitations due to emotional problems" earned the highest QOL score; "mental health" earned the lowest QOL score. Stepwise multiple regression results found those working 11-12 hours per day earned significantly lower scores than those working 8-10 hours per day. Participants educated to the high school level scored significantly better than those educated to the college level on the physical component summary (PCS), mental component summary (MCS), and 36-item short-form health survey (SF-36). Participants 31-55 years of age earned significantly better PCS and SF-36 scores than those 21-30 years of age. Participants given less than 3 days off per month earned significantly lower PCS scores. Participants with over two years of working experience earned significantly higher MCS scores. Participants who worked night shifts took care of fewer patients and earned significantly higher MCS scores. Conclusions: This study indicates working hours per day, education level, age, number of days off per month, years of working experience, and working night shifts are significant QOL predictors in Vietnamese nursing aides working in Taiwan. [ABSTRACT FROM AUTHOR]

The article focuses on a cross-sectional study conducted at 30 worksites in Taiwan which suggested that companies that initiates health promotion programs need to conduct a detailed assessment of nature of the workplace settings and the perceptions of employees. It states that Taiwan Workplace Health Promotion (WHP) Initiatives helped employees to improve their personal health skills. It informs that health services and health environment domains agreed to health promotion effectiveness.

Background: Colonoscopy is currently considered the best screening tool in the diagnosis of colon diseases. However, this procedure often causes pain and discomfort in patients, thus reducing patient willingness to undergo and comply with this procedure. Purpose: This study explores the effects of providing procedure-related information to patients receiving colonoscopy in terms of anxiety and pain reduction and identifies factors that influence the pain and anxiety experienced by patients during this procedure, Methods: This study adopted a quasi-experimental design that targeted colonoscopy patients in outpatient clinics. Two hundred thirteen patients were recruited, with 103 patients in the experimental group and 110 in the control group. Participants were recruited between January and April 2011. All of the participants received standard care, and only those participants who were assigned to the experimental group were asked to watch "A Guide to the Colonoscopy Procedure,'' a multimedia health informatics CD-ROM. Results: Anxiety scores of the experimental group dropped from 48.7 + 11.6 to 39.2 + 8.7 after the intervention. The average pain score of the experimental group was significantly lower than that of the control group (3.8 ± 2.5 vs. 5.0 ± 2.7). Furthermore, trait anxiety, gender, and educational level were identified as the main predictors for state anxiety, and state anxiety was identified as an important predictor for pain during the colonoscopy examination. Conclusions/Implications for Practice: This study found that using a multimedia health informatics CD-ROM to provide information on the colonoscopy procedure effectively reduced the examination-related anxiety and pain of patients. [ABSTRACT FROM AUTHOR]