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Objectives Systemic lupus erythematosus (SLE) is a female-dominated autoimmune disease that can occur at any age and has a diverse course. The clinical manifestation of this disease can vary depending on the patient’s age at onset. The aim of this study was to characterise the comorbidities at the time of SLE diagnosis and after in different age groups. Methods A total 1042 incident cases of SLE with a Catastrophic Illness Card in 2005 and 10,420 age- and sex-matched controls from the general population registered in the National Health Insurance Research Database in Taiwan were enrolled in the study. The risk of comorbidities before (adjusted odds ratio, [aOR]) and after (adjusted hazard ratio, [aHR]) of SLE was analysed. The burden of these SLE-associated comorbidities was weight by the Charlson comorbidity index (CCI). We used the cumulative incidence to evaluate the impact of comorbidities on different age onset groups. Results In this study, musculoskeletal diseases had the highest positive association (aOR, 5.29; 95% confidence interval [CI]: 4.25–6.57) prior to the diagnosis of SLE and they were also the most common developing incident comorbidity after the diagnosis (HR, 13.7; 95% CI: 11.91–15.77). It only took less than 1 year for 50% of the late-onset SLE patients to develop any increase in CCI score. The developing comorbidities attributed to 16.3% all-cause mortality and they had the greatest impact on late-onset SLE patients, with 33.3% cumulative incidence to all-cause mortality. There is no difference in the incidence of infectious diseases across different age groups. The herpes zoster infection had the greatest cumulative incidence among the category of infection diseases in child-onset SLE patients. Conclusion SLE patients had increased risks of multiple pre-existing comorbidities at diagnosis. The developed comorbidity after diagnosis could contribute to all-cause mortality. The herpes zoster infection is primarily an issue in child-onset SLE patients.

How do news coverage of a grassroot protest movement and perceived importance of the movement affect people’s participation in the movement? And does people’s inference of the effect of the news on themselves versus others make a difference in participation? Informed by the third-person effect hypothesis, we examine these questions in the context of the student-led Sunflower Movement in Taiwan that rose in opposition to a trade pact with China. In the study, we advanced three propositions: First, that the perceived effects of the protest news on oneself would be a better predictor of political participation than would perceived effects of such news on others. Second, that the perceived effect on oneself, not on others, would enhance the impact of issue importance on participation in the movement. And third, how people processed protest news would be another intermediate mechanism on subsequent participatory activities. We found support for these propositions in data collected from a probability sample of 1,137 respondents. The implications of the findings for the robust third-person effect research are discussed.

In order to analyze the characteristics and long-term trend levels of PM2.5 in Tainan City, Taiwan, Mesoscale Modeling System Generation 5 (MM5) and Community Multiscale Air Quality Model (MM5-CMAQ) modelling as well as box plots and time series analysis, were utilized in this study. The long-term trend analysis shows that the levels of PM2.5 (averaged at 38.3 µg m–3 and ranged between 33.1 and 41.9 µg m–3) in Tainan City for ten years (2005–2014) were above the yearly average standards of 15 µg m–3, showing non-attainment status. Overall, the results show a decreasing trend (from 41.9 µg m–3 in 2005 to 35.0 µg m–3 in 2014) in the levels of PM2.5 in Tainan atmosphere in the ten year period. The results of the MM5-CMAQ air quality modeling, indicate that the highest contribution on PM2.5 in Tainan City was from trans-boundary pollution from neighbouring cities (34.2%), while long-range transport and local emissions from Tainan each contributed a fraction of approximately 32.9%. In terms of local sources, the highest influence is from area sources (18.6%), followed by line sources (7.7%) and point sources (6.6%). Thus, to control PM2.5 in Tainan City, the focus should be on construction, road dust, and residential activities.

Fine particulate matters (PM2.5) has been identified as one of the major air pollutants in urban areas, which are responsible for the adverse effects on public health and the deterioration of visibility. New PM2.5 air quality standards were promulgated in Taiwan on 14th May 2012, as well as the standard sampling and analytical method for atmospheric PM2.5 (NIEA A205.11C) on 24th April 2012. In this study, the atmospheric levels and characteristics of PM2.5 in Tainan during 2013 were evaluated by measuring the mass concentration of PM2.5 and analyzing the water-soluble ionic, carbon, and metal components. Additionally, a Chemical Mass Balance (CMB) receptor model was used to identify possible sources of PM2.5 and their contributions. Based on results of this study, the current PM2.5 levels in Tainan in spring and winter (41–49 µg m–3) were substantially higher than the yearly average PM2.5 air quality standards (15 µg m–3). According to chemical composition analysis, secondary aerosols (NH4+, NO3–, and SO42–) contributed approximately 50% and 60% of PM2.5 mass in spring and winter respectively; but were responsible about 40% by mass in summer at both Tainan and Xinying stations. From the results of CMB model, the main contribution sources to the PM2.5 in Tainan are traffic emissions (31.5%), ammonium sulfate (25.5%), ammonium nitrate (12.5%), and crustal elements (11%). Consequently, to improve PM2.5 of Tainan City, the priority control pollutants (or sources) are primary PM2.5 (open burning, construction sites and road dust by vehicles), NOx (diesel vehicle emissions), and SOx (fuels).

Background Single-port transumbilical surgery is a well-established platform for minimally invasive abdominal surgery. The aim of this study was to compare the hemodynamics and inflammatory response of a novel transumbilical technique with that of a conventional transthoracic technique in thoracic exploration and lung resection in a canine model. Methods Sixteen dogs were randomly assigned to undergo transumbilical thoracoscopy (n = 8) or standard thoracoscopy (n = 8). Animals in the umbilical group received lung resection via a 3-cm transumbilical incision in combination with a 2.5-cm transdiaphragmatic incision. Animals in the standard thoracoscopy group underwent lung resection via a 3-cm thoracic incision. Hemodynamic parameters (e.g., mean arterial pressure, heart rate, cardiac index, systemic vascular resistance, and global end-diastolic volume index) and inflammatory parameters (e.g., neutrophil count, neutrophil 2′,7′ -dichlorohydrofluorescein [DCFH] expression, monocyte count, monocyte inducible nitric oxide synthase expression, total lymphocyte count, CD4+ and CD8+ lymphocyte counts, the CD4+/CD8+ratio, plasma Creactive protein level, interleukin-6 level) were evaluated before surgery, during the operation, and on postoperative days 1, 3, 7, and 14. Results Lung resections were successfully performed in all 16 animals. There were 2 surgery-related mortality complications (1 animal in each group). In the transumbilical group, 1 death was caused by early extubation before the animal fully recovered from the anesthesia. In the thoracoscopic group, 1 death was caused by respiratory distress and the complication of sepsis at 5 days after surgery. There was no significant difference between the two techniques with regard to the hemodynamic and immunologic impact of the surgeries. Conclusion This study suggests that the hemodynamic and inflammatory changes with endoscopic lung resection performed by the transumbilical approach are comparable to those after using the conventional transthoracic approach. This information is novel and relevant for surgeons interested in developing new surgical techniques in minimally invasive surgery.

This study focuses on examining the behavioral component of the third-person effect. It explores the self-other perceptual gap concerning the influence of nuclear pollution news on the prediction of different actions: corrective, protective, and promotional. The study analyzes data from a probability sample collected in Taiwan after the news about nuclear pollution from Fukushima was widely reported. The results showed that the discrepancy in self-other perceptions was a significant predictor of multiple behavioral intentions, which included seeking self-protection (e.g., taking iodide pills), supporting corrective actions (e.g., opposing the building of new nuclear power plants), and supporting government-led promotional measures (e.g., launching public educational campaigns on nuclear safety). These results indicate that the behavioral component of the third-person effect extends beyond the realm of willingness to censor.

Background: Women in Taiwan are at increasing risk of cervical cancer. The determinants of intentions to seek information about cervical cancer among women have not been adequately addressed in previous studies. Purpose: This study uses the theory of planned behavior and the concept of perceived risk to explore the determinants of intentions to seek information about cervical cancer among Taiwanese women. Methods: This cross-sectional study surveyed Taiwanese women aged 35 years and over. Systematic sampling was adopted to identify potential participants from the public telephone directory. A nationwide sample of 1,001 female adults aged 35 years and over completed the telephone-based survey questionnaire from April 13 to 27 of 2010. Results: The results of this study showed that subjective norms, attitude, and perceived behavioral control positively and significantly predicted the information-seeking intentions about cervical cancer of participants. In addition, those seeking information regarding cervical cancer were more concerned about risks to themselves than about risks to others. Conclusions/Implications for Practice: This investigation contributes to the literature on theory of planned behavior by documenting perceived personal risks to the patient and risks to others regarding a diagnosis of cervical cancer. It is hoped that this investigation assists scholars of health communication and information seeking behavior to better understand and positively address the determinants of the intentions of women to seek information about cervical cancer.

Online networks have become a critical venue for bisexual males to communicate with each other and solicit social support. This study reports qualitative feedback gathered from 12 married Taiwanese bisexual men about online social support in their daily lives. The analysis of interviews reveal that online social support provides participants with opportunities to screen potential friends, participate in the bisexual virtual community, come out and release stress, and look for romance. Apparently, for married bisexual men in Taiwan, the Internet offers an opportunity to anonymously manage sexual identity and solicit social support among other bisexuals.

PurposeThis study aims to examine factors influencing information‐seeking intentions and support for restrictions related to the threat of arsenic‐contaminated frying oil.Design/methodology/approachA telephone survey using a systematic random sample of 566 respondents in Taiwan was employed to test all hypotheses proposed in this study.FindingsResults from the structured equation model show that news attention and elaboration significantly and positively predict information‐seeking intentions, while optimism significantly and negatively predict information‐seeking intentions; and information‐seeking intentions significantly and positively predict support for restrictions.Practical implicationsThe findings of this study imply that increasing risk perceptions and providing useful information while facing the threat of food safety are of central importance.Originality/valueThe current study provides an appropriate opportunity for developing a model for better understanding the interaction among news attention, news elaboration, optimism, information‐seeking intentions, and support for restrictions as Taiwanese face the threat of arsenic‐contaminated frying oil.

Background. The feasibility of using a transoral approach to the thoracic cavity has not yet been measured in humans or animals. The present study aimed to evaluate the feasibility of transoral surgical lung biopsy (TOLB) in 10 canines. Methods. Through an incision over the vestibulum oris, a homemade metal tube was introduced into the thoracic cavity under endoscopic guidance and used as a working channel of surgical lung biopsy. TOLB was performed on the predetermined lung lobe by using an electrocautery loop and endoscopic grasper. Results. Successful surgical lung biopsy was achieved in 8 of 10 animals in a mean time of 132 minutes (range 130-190 minutes). There were no major intraoperative or postoperative complications, and all animals survived for 2 weeks after surgery. Autopsy showed no evidence of vital structure injury, mediastinitis, or empyema. Conclusions. TOLB was demonstrated to be safe and feasible in a canine model.

This study examines the impact of polling news in the 2008 Taiwan presidential election from a third-person effect perspective. Results of a survey using a random sample of 1,097 respondents indicate that they perceived news about election polls to have a greater effect on others than themselves, regardless of whether the effects were perceived as negative or positive. Furthermore, findings show that attention to election polling news enhanced the perceived positive effects on self and others. Findings also point to a link between poll credibility and perceived effects on self and others. The less credible elections polls are perceived, the larger is the self—other perceptual gap. Finally, concern about the negative effects of election polling news on others is found to motivate respondents to consider protective behavior. However, findings show that perceived positive effects of such news on self resulted in intention to engage in campaign discourse. Theoretical implications of the findings to advance the third-person effect research are discussed.

PurposeThe melamine milk scandal caused a crisis of confidence in food containing dairy products. The purpose of this paper is to explore the determinants of precautionary behaviour to avoid food containing dairy products among Taiwanese college students.Design/methodology/approachOf the total respondents selected using a multistage cluster sampling plan, 1,213 respondents completed the questionnaire.FindingsThe survey results showed that subjective norms, attitude, perceived behavioural control, attention to news, and perceived credibility of information are significantly associated with the intention to take precautionary behaviour.Originality/valueThe paper developed a modified theory of planned behaviour (TPB) that focused on attention and perceived credibility of milk scandal‐related information as additional determinants of precautionary behaviour to avoid food containing dairy products. The inclusion of attention and perceived credibility of information constructs enabled a better model fit than that of the TPB model.

This study examines third-person effect of news of tainted food product recalls on oneself relative to others. The survey (N = 1,213) found that respondents tended to think the influence of the news on others was greater than on themselves (the study used reactions to a milk powder scandal in China). Message credibility and attention to and elaboration of the recall news were found to reduce the third-person perceptual gap. Furthermore, the perceived effect of news on oneself, not on others, was positively associated with the behavioral intention of information-seeking and taking protective action.

Item calibration is an essential issue in modern item response theory based psychological or educational testing. Due to the popularity of computerized adaptive testing, methods to efficiently calibrate new items have become more important than that in the time when paper and pencil test administration is the norm. There are many calibration processes being proposed and discussed from both theoretical and practical perspectives. Among them, the online calibration may be one of the most cost effective processes. In this paper, under a variable length computerized adaptive testing scenario, we integrate the methods of adaptive design, sequential estimation, and measurement error models to solve online item calibration problems. The proposed sequential estimate of item parameters is shown to be strongly consistent and asymptotically normally distributed with a prechosen accuracy. Numerical results show that the proposed method is very promising in terms of both estimation accuracy and efficiency. The results of using calibrated items to estimate the latent trait levels are also reported.

This investigation examines the source preferences and the displacement/supplement effect of traditional and new channel usage as Taiwanese college students search for information about sexually transmitted diseases and HIV/AIDS from the Internet. The study involved 535 junior and senior college students from four universities. Analytical results reveal that respondents rely mainly on information about sexually transmitted diseases and HIV/AIDS from television sources, followed by newspapers, the Internet, teachers, magazines, friends, physicians, radio sources and parents. Regression analyses show that, after adjusting for the influence of other information sources, obtaining information from the Internet significantly and positively predicts respondents' seeking information from teachers, friends, television, newspapers and magazines. In contrast, obtaining information from the Internet negatively and significantly predicts obtaining information from the radio. However, this investigation does not find ...

This study expands third-person effect research to health news coverage. It examines the perceptual and behavioral components of third-person effects. Moderator variables of third-person effects—knowledge and exposure to health news—are also examined. Using data from a survey of public opinion about the coverage of avian flu involving a probability sample of 1,107 college students in Taiwan, findings show that respondents tend to think the influence of avian flu news on others is greater than on themselves. Furthermore, exposure to avian flu news was found to narrow the self—other perceptual gap. Regarding the linkages between the third-person perception of avian news and behavioral responses to the perception, findings show that perceived effects of avian flu news on the self resulted in taking action—seeking information about avian flu and seeking out Tamiflu. However, findings further show that the third-person perception acted like a brake on taking such action.

Studies disagree as to whether an optimistic bias can account for the commonly observed third-person perceptions. This study aims to help clarify the relationship between third-person perceptions and biased optimism in the context of assessing the impact of the news about bird flu outbreaks in Taiwan. Using a random sample of 1,107 college students, third-person perception and optimistic bias were found to be robust but unrelated. Although both optimistic bias and third-person effect are psychological perceptual judgments that can be attributed to self-serving motivation, the third-person perception is a biased interpretation of media influence, while biased optimistic perceptions are a social psychological mechanism of bolstering self-esteem in self-other comparisons regarding a risk.

This study evaluates the ability of a safer sex televised public service announcement (PSA) campaign to increase safer sexual behavior among at-risk young adults. Independent, monthly random samples of 100 individuals were surveyed in each city for 21 months as part of an interrupted-time-series design with a control community. The 3-month high-audience-saturation campaign took place in Lexington, KY, with Knoxville, TN, as a comparison city. Messages were especially designed and selected for the target audience (those above the median on a composite sensation-seeking/impulsive-decision-making scale). Data indicate high campaign exposure among the target audience, with 85%-96% reporting viewing one or more PSAs. Analyses indicate significant 5-month increases in condom use, condom-use self-efficacy, and behavioral intentions among the target group in the campaign city with no changes in the comparison city. The results suggest that a carefully targeted, intensive mass media campaign using televised PSAs can change safer sexual behaviors.

This paper synthesizes the perspectives from behavioral science and medical anthropology to discuss factors affecting prostate cancer screenings among African American men. It argues that the hegemonic health behavior model historically used to frame prostate cancer screenings without considering the context in which African American men are embedded. By the same token, the sociocultural perspective tends to articulate the cultural meaning and social relationships experienced by patients; however, it may operate largely in its own field and becomes somewhat peripheral to the domain of traditional behavioral models. This paper accordingly suggests that through exploration of a synthetic approach combining behavioral science and anthropological perspectives, we can display the relationship between individual – (e.g., perceived threats) and sociocultural – related factors (e.g., intimate and family relationship, socioeconomic status, and sense of masculinity) and practices of prostate cancer screenings among African American men.

The purpose of this cross-sectional study is to examine how personality traits such as sensation- seeking and impulsive decision-making affect Taiwanese college students' intentions to seek online information about sexually transmitted diseases (STDs) and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Five hundred thirty-five (n = 535) junior and senior college students in Taiwan were recruited and completed self-report questionnaires. This study found high sensation-seekers were more likely to seek information about STDs and HIV/AIDS on the Internet than low sensation-seekers. Impulsive decision-makers were less likely than rational decision-makers to seek information about STDs and HIV/AIDS on the Internet. These findings suggest that personality needs to be considered as an exploratory factor which potentially influences intentions to seek STD and HIV/AIDS information on the Internet among Taiwanese college students.

Under uncertain environments, information seekers are assumed to consciously select a source to meet their information needs (Case, 2002; Johnson, 1997). The outbreak of SARS in 2003 offered an opportunity for researchers to examine people’s information-seeking behaviours and perceived source credibility. Conducted in Tainan City, Taiwan, this study reached 849 college students (836 completed the survey) and found: (a) respondents rated mass media as their primary and the most credible source for receiving SARS-related information compared to interpersonal channels; (b) physicians were perceived to be the most credible source among interpersonal channels and television was rated to be the most credible source among mass media; and (c) there was no significant difference between males’ and females’ perceived credibility about different mass media, as well as between respondents’ year in college and perceived credibility about different mass media.

Background: Young people in Taiwan have become more liberal and active toward sex. Despite heavy investments of money, time, and effort, sexual education programs have generally lagged expectations. Purpose: Personality traits such as sexual sensation seeking are found to be significantly associated with risky sexual behaviors. This study, therefore, attempts to explore the link of sexual sensation seeking to acceptance by Taiwanese college students of cybersex, multiple sexual partners, and one-night stands. Methods: A cross-sectional study was conducted using the multistage cluster sampling method. Five hundred sixteen students recruited from eight universities/colleges in Taiwan participated in this study, and 507 completed the self-report questionnaire. The valid response rate was 98.26%. Results: The results reveal that high-sexual-sensation seekers were more likely than low-sexual-sensation seekers to accept cybersex, multiple sexual partners, and one-night stands. Conclusions/Implications for Practice: This study suggests that the designers of campus-based health prevention campaigns should target campaign messages on high-sexual-sensation seekers using novel, thrilling, and complex messages to achieve safe sex educational campaign goals.

Class imbalance problem has attracted many attentions in recent years. When the available training sample size of each class is imbalanced, the directly established classification model will tend to allocate the testing sample into the majority class. A proper resampling method together with a power classifier is generally employed for dealing with this problem. Many multi-classifier ensembles have been shown to outperform single classifier in many experiments. Bagging and boosting are two most popular multi-classifier frameworks and have been applied to deal with the class imbalance problem. By observing that the sample information of the minority class is very limited and the small sample size (SSS) problem might decrease the performance of the classifiers, another powerful multi-classifier method called random subspace method (RSM) is introduced to deal with the class imbalance problem in this study. To evaluate the performance of different classifiers, a well-known resampling method called SMOTE is employed. The experiment results showed RSM has the best performance in most of the considered situations.

The current study is an analysis of public service announcements (PSAs) from an effective safer sex campaign that utilized a sensation-seeking targeting (SENTAR) approach. Two random samples of heterosexually active young adults (sample one N = 1,463, sample two N = 895) viewed different sets of safer sex PSAs on a laptop computer and answered questions about their perceived sensation value and perceived effectiveness. Multiple regression analyses examined the impact of (a) demographic, (b) individual difference, (c) sexual context, and (d) message variables including perceived message sensation value (PMSV) on the perceived message effectiveness (PME) of the PSAs. Results indicated that females, African Americans, condom users, and those with less education viewed the PSAs as slightly more effective than males, Caucasians, non-condom users, and those with more education. PMSV and personal utility emerged as the strongest predictors of PME, even after controlling for all of the aforementioned variables. Implications for further research on PMSV and perceived and actual effectiveness of PSAs are offered.

Background: This study explores optimistic bias and information seeking in prostate cancer patients and how they impact intention to undergo prostate cancer screening. Methods: A national sample of 427 Taiwanese male adults aged at least 45 years (mean (M) = 57) were recruited to complete a telephone-based survey questionnaire between April 30 and May 8, 2008. Results: The questionnaire results showed that respondents considered themselves less likely than others to get prostate cancer. The relationship between optimistic bias and intention to undergo prostate cancer screening was non-significant, while information seeking positively and significantly predicted such an intention. Conclusions: The findings of this study imply that health educators should include risk-awareness strategies and information seeking interventions in the design of cancer prevention programs.

A cross-sectional study, testing a model of predictors and consequences of body dissatisfaction, was undertaken in Taiwan from December 30, 2006 to January 10, 2007. Two hundred and thirty-two female college students enrolled at a major university completed the self-administered questionnaire. Analytical results revealed that body dissatisfaction among respondents increased with BMI (beta=.32, p.001), perceptions of how others viewed their bodies (beta=.38, p.001), and upward social comparisons (beta=.17, p.01). Body dissatisfaction also markedly influenced respondent weight-loss intentions (beta=.51, p.001). Results imply that medical, psychological and social factors must be considered by school health educators wishing to understand the causes and consequences of body dissatisfaction among female college students.

Hydrothorax developing from pleuroperitoneal communication as a complication of peritoneal dialysis was first described in 1967 [Edward SR, Unger AM. Acute hydrothorax-a new complication of peritoneal dialysis. JAMA 1967; 199:853-5. ]. The incidence of hydrothorax is approximately 1.6-2% of continuous ambulatory peritoneal dialysis (CAPD) patients. The key to successful therapy is obliteration of the transdiaphragmatic route of dialysate leakage with video-assisted thoracoscopic surgery (VATS). The method in which air leakage is checked intraoperatively is the preferred choice and better than all other procedures.