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Background Previous population-based studies in western countries had revealed increased skin cancer risk among transplant recipients compared to the general population. However, population-based studies in Asia on skin cancer among recipients of different transplanted organs were lacking in the literature. Aims This study aims to estimate skin cancer risk among recipients in Taiwan, examine the association between each specific type of skin cancer and each type of transplanted organ, and compare skin cancer risk between different immunosuppressive regimens. Methods This population-based retrospective cohort study identified 7550 patients with heart, lung, kidney or liver transplantation and 30,200 controls matched for gender, age and comorbidity index from the National Health Insurance Research Database in Taiwan between 2000 and 2015. Using multivariable Cox proportional hazard models, we estimated the hazard ratios and 95% confidence intervals for the correlation of skin cancer with organ transplantation as well as immunosuppressive regimen. Results Organ transplant recipients in Taiwan had an increased risk of skin cancer with adjusted hazard ratios of 4.327 (95% confidence intervals 2.740-6.837, P < 0.001), with the greatest risk, observed among heart recipients (adjusted hazard ratios 6.348, 95% confidence intervals 3.080-13.088, P < 0.001). The risk of non-melanoma skin cancer and melanoma was 4.473 (95% confidence intervals 2.568-7.783, P < 0.001) and 3.324 (95% confidence intervals 1.300-8.172, P < 0.001), respectively. When comparing immunosuppressants, those with calcineurin inhibitors carried the highest risk of skin cancer (adjusted hazard ratios 4.789, 95% confidence intervals 3.033-7.569, P < 0.001), followed by those with antimetabolites (adjusted hazard ratios 4.771, 95% confidence intervals 3.025-7.541, P < 0.001). Limitations We could not evaluate confounding behavioural risk factors of skin cancers that were not documented in the database, nor could we recognize patients' compliance with immunosuppressants. Conclusion Organ recipients have a greater risk of skin cancer. Clinicians should inform recipients of the importance of photoprotection and regular dermatologic follow-up. [ABSTRACT FROM AUTHOR]

The rapid development of digital technologies has transformed the world but can be a double-edged sword. We study the interaction of important variables that affect individual news reporters’ performance in which digital technology is the dominant feature. A multilevel model illustrates how transactive memory and job competence affect individual performance. The empirical study includes data from 19 teams of news reporters and 211 valid survey responses, applying hierarchical linear modeling to analyze the data. The results indicate that transactive memory and technology competence help to improve a reporter’s job performance. More importantly, teamwork competence fully mediates the relationships. Our findings thus suggest that teamwork competence is the core skill. Neither technology competence nor transactive memory alone translates directly into enhanced individual performance. [ABSTRACT FROM AUTHOR]

The Social Environment and Biomarkers of Aging Study (SEBAS) is a nationally representative longitudinal survey of Taiwanese middle-aged and older adults. It adds the collection of biomarkers and performance assessments to the Taiwan Longitudinal Study of Aging (TLSA), a nationally representative study of adults aged 60 and over, including the institutionalized population. The TLSA began in 1989, with follow-ups approximately every 3 years; younger refresher cohorts were added in 1996 and 2003. The first wave of SEBAS, based on a sub-sample of respondents from the 1999 TLSA, was conducted in 2000. A total of 1023 respondents completed both a face-to-face home interview and, several weeks later, a hospital-based physical examination. In addition to a 12-h (7 pm-7 am) urine specimen collected the night before and a fasting blood specimen collected during the examination, trained staff measured blood pressure, height, weight and waist and hip circumferences. A second wave of SEBAS was conducted in 2006 using a similar protocol to SEBAS 2000, but with the addition of performance assessments conducted by the interviewers at the end of the home interview. Both waves of SEBAS also included measures of health status (physical, emotional, cognitive), health behaviours, social relationships and exposure to stressors. The SEBAS data, which are publicly available at [http://www.icpsr.umich.edu/icpsrweb/NACDA/studies/3792/version/5], allow researchers to explore the relationships among life challenges, the social environment and health and to examine the antecedents, correlates and consequences of change in biological measures and health. [ABSTRACT FROM AUTHOR]

Aims and objectives. The purpose of this study was to explore the prevalence and risk factors of urine retention among posthaemorrhoidectomy recipients. Background. Haemorrhoids are one of the most common functional disorders of the anus. The Haemorrhoidectomy surgical procedure is one of the primary treatments for more severe haemorrhoidal occurrences, such as for third- and/or fourth-degree haemorrhoid conditions. Urine retention is a common acute complication after operation, but rare study conducted by nurses in Taiwan to explore the prevalence and risk factors. Design. A retrospective chart review was conducted. Methods. Data from a prospectively maintained database on patients who had undergone haemorrhoidectomy between April 2004 - August 2008 were retrospectively analysed. A total of 469 charts were used in this analysis. The following outcomes were studied: patient profiles, haemorrhoid type and severity, anaesthesia methods, length of operating room stay, urine retention and management, intravenous fluid given during operation and length of stay. Results. The overall urinary retention rate was 32·8% ( n = 153). Significant risk factors associated with postoperative urinary retention included severity of haemorrhoid and anaesthesia methods. Logistic regression analysis revealed that epidural anaesthesia ( p = 0·008), spinal anaesthesia ( p = 0·016) and haemorrhoids with a severity of three degrees or higher ( p = 0·017) were predictors of urinary retention post haemorrhoidectomy. Conclusions. Acute urinary retention can have an adverse effect on a patient's quality of care. Careful follow-up of patients with these risk factors can help nurses spot posthaemorrhoidectomy urinary retention early. Relevance to clinical practice. The prevalence of acute urinary retention post haemorrhoidectomy is common. Surgical ward nurses should therefore take the responsibility regarding the impact of urinary retention and seeking appropriate nursing interventions of induced urination. [ABSTRACT FROM AUTHOR]

Guided by a financial model, this study is the first to integrate Miles and Snow's (1978) strategic typology as an external industry effect and the resource-based view of the firm as an internal effect to explain market performance of different firm sizes in business-to-consumer e-commerce firms. Factors such as strategy types, CEO commitment to ecommerce, Web site design, and IT system integration capabilities were empirically investigated. Findings showed that prospector strategy utilized by large e-brokers significantly outperformed analyzer, defender, and reactor strategies in online market share. Top managers of small-to-medium enterprises (SMEs) should choose defender or analyzer strategies to gain market performance. Large firms indeed outperformed SMEs in online market share. In addition, large firm's CEO commitment to e-commerce, Web site design and IT system integration capabilities and Web age were explanatory factors for online market share but had no effect on both market performances for SMEs. Managerial implications and future study are recommended. [ABSTRACT FROM AUTHOR]

This article uses a network approach to examine the coordination of protective services for the elderly in Taipei City, Taiwan. This article aims to examine the network structures and organizational roles in protective services for the elderly. The results indicate that a variety of organizations were involved in the protective service network for the elderly in Taipei City. The diversity of agencies working together supports literature claims that no single type of organization can provide a comprehensive range of services for the elderly who need to be protected. In terms of network structures, the results show that patterns of interorganizational coordination do depend on the kind of resources being exchanged. There are substantial exchanges among agencies in the client referral network, which is in contrast to fairly low levels of exchanges that exist in the other types of exchange. Taipei City has made an effort in developing a coordinated client referral network to protect the elderly since client referral serves an important function for organizations to meet the multiple needs of the elderly.

As there is little understanding of disability processes in Taiwanese elders, the present study aimed to identify medical predictors of the incidence of activities of daily living (ADL) disability.A total of 903 subjects were studied over a 4-year period (1994–1998). The measurement instrument was the Chinese-version Multidimensional Functional Assessment Questionnaire (CMFAQ). Only the subjects free of ADL disability at baseline were included in separate logistic regression models to predict disability in physical and instrumental ADL.The hypothesised associations between chronic conditions and future functional disability were cross-nationally confirmed. Arthritis, diabetes and hypertension were significantly predictive of the onset of physical ADL (PADL) disability; diabetes was the only medical predictor of instrumental ADL (IADL) disability. Age and educational level were significant predictors of PADL and IADL.Prevention programs for chronic disease need to pay more attention not only to the disabled population, but also to secondary prevention among those elders who have higher medical risk of developing disability. [ABSTRACT FROM AUTHOR]

The primary purpose of this study is to develop regional models of the lower part of flow duration curves (LPFDCs) to synthesize low-flow characteristics at ungauged sites in southern Taiwan. Because of the close relationship between low streamflow regimes and hydrogeological features, the model development first involved delimiting homogeneous hydrogeological regions by using two-step cluster analysis. Each homogeneous region was then discriminated by an equation developed on the basis of its hydrogeological features, which was then used to determine which of three sets of regional LPFDC models would be appropriate for a particular ungauged site. Each of the three sets of regional LPFDC models were developed using both conventional multivariate statistical regression and fuzzy regression. Thirty-four stream-gauged watersheds located in southern Taiwan provide the data set. The study results reveal that the regional LPFDC models developed in this study could be applied reasonably at ungauged sites. [ABSTRACT FROM AUTHOR]

Proposes a method for estimating fault sections in power substations. Knowledge representation and inference procedures based on the cause-effect networks and rule matrix transformation techniques; Testing of the method on a typical Taiwan Power Co.'s secondary substation; Superiority of the method to existing production systems in the inference speed and the process of implementation.

Background: Elderly adults have comprised the fastest growing population adopting the Internet and computer technology over the past decade. However, how their experiences can shed light on elderly learning theory has not been examined much in the literature.Objective: This study investigated the factors and reasons associated with Internet adoption and withdrawal among older adults in Taiwan, and if any gender differences exist in this context.Methods: Data on participants aged 50 years and older from the nationally representative "Digital Opportunity Survey on Individuals and Households in Taiwan," who did not use the Internet in 2005 but adopted it in 2007 (n=1548), and those who reported using Internet in 2011 but then withdrew (n=1575), were analyzed. Factors and reasons associated with Internet adoption and withdrawal were examined using both quantitative and qualitative data.Results: Education level independently predicted Internet adoption behavior. With regard to the reasons for adoption, 66% (62/94) of participants indicated they started using the Internet to meet certain "needs"; for example, "keeping up with the world" (40.4%, 38/94) was listed as the most critical reason, followed by "job needs" (25.5%, 24/94). Older adults with a positive attitude toward the Internet with regard to increasing employment opportunities (OR 2.0, 95% CI 1.0-3.9, P=.04) and the amount of information obtained (OR 0.5, 95% CI 0.3-0.9, P=.01), as well as enriching recreation and entertainment (OR 0.6, 95% CI 0.4-0.9, P=.02), were less likely to withdraw from the Internet. The most common reason for Internet withdrawal was "psychological barriers" (eg, no available time, no meaningful use, or nothing worth reading/watching; 66.3%, 193/291), followed by "health barriers" (eg, eyes or body deteriorate with Internet use; 21.0%, 61/291). Although psychological barriers were the most important factor for Internet withdrawal for both men (72.5%, 100/138) and women (62%, 93/150), women were more likely than men to be affected by health barriers (26.0%, 39/150 vs 15.9%, 22/138; P=.004) and anthropic factors or accidental barriers (7.3%, 11/150 vs 2.9%, 4/138; P=.02).Conclusions: Our findings that the need to keep up with the world associated with Internet adoption, and gender differences in reasons behind Internet withdrawal, such that women reported more health and anthropic factors or accidental barriers than man, may provide a new perspective that help health educators understand strategies that encourage older adults to keep learning, an important component of active aging. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory distress syndrome (ARDS) carries significant morbidity and mortality. No previous studies have investigated the long-term outcomes of ARDS patients in Taiwan. Objective; This study aimed to investigate the survival of ARDS patients after discharge from the hospital in Taiwan. Methods: Medical records from 150 ARDS patients discharged alive from the intensive care unit from January 2004 to June 2009 were reviewed. Survival of these patients was followed for 5 years, and prognostic factors were identified. Results: Cumulative survival rates were 81.4% at 6 months, 79.0% at 1 year, 67.2% at 2 years, and 45.7% at 5 years. Independent prognostic factors influencing both 1- and 5-year survival rates were age, previous lung disease, and disposition after discharge. For 5-year survival, renal disease was also an independent risk factor. Discussion: The mortality rate of ARDS survivors after intensive care unit discharge is still high in Taiwan. Three independent risk factors were found to affect the overall survival of these patients. [ABSTRACT FROM AUTHOR]

Polybrominated diphenyl ethers (PBDEs) were commonly used flame retardants in the world, while some of PBDEs have been listed as persistent organic pollutants (POPs). Decabrominated diphenyl ether (BDE-209) was the most commercially used PBDEs. A farm near the factory located in Northern Taiwan was highly contaminated with BDE-209. Since PBDEs in the contaminated soils can be uptake by crops shown in our previous studies and could be potentially consumed by humans, it is very important to establish a feasible treatment method for PBDE remediation in this contaminated farm. Thermal treatment of PBDEs in soil was studied. The initial concentration of BDE-209 in contaminated soil was 1.472 mg/kg. A series of thermal experiments under different operating conditions including various temperature (105, 150, 200, 250, 300, 350, 400 and 450 °C), holding time (10, 20 and 30 min), heating rate (5, 10, 20 and 40 °C/min), and soil amount (10, 100, 1000 and 2000 g) were investigated. The optimal heating conditions for thermal treatment of contaminated soil were heating at 450 °C for 30 min with a heating rate of 10 °C/min. Under this condition, the removal of BDE-209 in the different weights of contaminated soil was tested. The soils in the contaminated farm were tested to further evaluate the feasibility of remediating the on-site PBDE contaminated soil through thermal treatment, suggesting that the holding time was extended to 2 h for the field-scale contaminated soil. The results showed that BDE-209 had been removed to below the detection limit in on-site soil. This investigation is the first study using thermal treatment to remediate soils really contaminated with PBDEs. [Display omitted] • PBDEs can be completely degraded by thermal treatment at 450 °C in on-site soil. • Thermal treatment mechanism of BDE-209 in field contaminated soil is debromination. • Optimal thermal treatment on PBDE-contaminated soil is 450 °C (10 °C/min) for 30 min. • For field trial, extending above parameter to 2 h can completely degrade PBDEs. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory distress syndrome (ARDS) carries significant morbidity and mortality. No previous studies have investigated the long-term outcomes of ARDS patients in Taiwan., Objective: This study aimed to investigate the survival of ARDS patients after discharge from the hospital in Taiwan., Methods: Medical records from 150 ARDS patients discharged alive from the intensive care unit from January 2004 to June 2009 were reviewed. Survival of these patients was followed for 5 years, and prognostic factors were identified., Results: Cumulative survival rates were 81.4% at 6 months, 79.0% at 1 year, 67.2% at 2 years, and 45.7% at 5 years. Independent prognostic factors influencing both 1- and 5-year survival rates were age, previous lung disease, and disposition after discharge. For 5-year survival, renal disease was also an independent risk factor., Discussion: The mortality rate of ARDS survivors after intensive care unit discharge is still high in Taiwan. Three independent risk factors were found to affect the overall survival of these patients.