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Stigmatization of overweight and obese individuals is common in interpersonal relationships. This study investigated longitudinal weight change patterns among Taiwanese adolescents and the relationship of weight change patterns with delayed romantic experience from late adolescence to young adulthood by using a representative panel survey. Individuals were divided into six weight change pattern categories according to changes in their body mass index. Two-stage stratified and clustered sampling was used to obtain a representative student sample, and 1,834 junior high school students were followed up over 7 years. Persistent obesity and a change from an underweight to a normal weight status over 7 years were independently associated with delayed romantic experience in both sexes. Moreover, females but not males who changed from an underweight or normal weight status to an overweight or obese status had increased odds of delayed romantic experience. Persistent obesity should be addressed early in life because it plays a crucial role in delayed romantic experience.

This study examined the association between adolescents' obesity and sociometric status among their peers across 1 year. The participants were 2,528 junior high school students from Taiwan (mean age = 13.31 years). The negative associations discovered between obesity and sociometric status were both concurrent and cumulative. Moreover, the adolescents who changed from nonobese to obese were more likely to have lower social acceptance and be isolated in their classrooms. These findings inform concerns regarding the sociometric status of adolescents who are (or are becoming) obese.

Background: The linkage between sleep quality and weight status among teenagers has gained more attention in the recent literature and health policy but no consensus has been reached. Methods: Using both a propensity score method and multivariate linear regression for a cross-sectional sample of 2,113 teenagers, we analyzed their body mass index (BMI) in relation to sleep quality while controlling for family characteristics (household income, parent/guardian level of education, disability status, work night shift, and smoking) and individual factors (age, sex, regular exercise, smoking, employment, and feeling secure in the neighborhood). Sleep quality was assessed using 3 scales: difficulty in initiating sleep, difficulty in maintaining sleep, and non-restorative sleep, based on Diagnostic and Statistical Manual of Mental Disorders-IV-defined insomnia. Results: Considering all 3 types of poor sleep quality, 20.9% of teenagers in Taiwan experienced some form of sleep problems. After adjusting for the other variables, 2 factors independently and statistically predicted sleep problems: current smoking and working night shifts by the head of the household. Teens experiencing difficulty in initiating sleep had higher BMIs ranging from 0.86 to 1.41 units. Conclusions: Efforts to address childhood obesity need to take into consideration sleep problems that are highly prevalent among teenagers. (Contains 3 tables.)

Objective: Sugar-sweetened beverages (SSB) are linked to increased metabolic risk. However, the sex differences in the relationship between SSB intake and adverse health effects remain unclear. Therefore, the present study examined the association between SSB consumption and metabolic risks among working-age males and females from Taiwanese communities. Design: A community-based study utilised data from a comprehensive health screening project conducted by the Public Health Bureau in Changhua County, Taiwan. Metabolic risks included waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, TAG, LDL cholesterol and fasting glucose level using serum tests. Setting: Participants were recruited in Changhua County, Taiwan. Participants: Between 2005 and 2014, 92 724 citizens participated in the health screening; our data analysis included 75 278 respondents between 30 and 64. Results: The results showed that the frequency of SSB consumption was associated with abnormal waist circumference and elevated total cholesterol, TAG, LDL and glucose in both men and women. Increased SSB consumption frequency was associated with elevated glucose and hypertension in women. Even a slight increase in SSB intake frequency was related to raising the metabolic risks. Similar patterns were evident when models included BMI; however, the associations were attenuated. In the BMI-stratified subgroup analysis, the relationship between SSB consumption and metabolic risks was more pronounced in participants without obesity. Conclusion: The present study suggests that SSB consumption carries metabolic risk among working-age Taiwanese, particularly women and those without obesity. Health promotion programmes should raise awareness of the health hazards associated with SSB. [ABSTRACT FROM AUTHOR]

Describes the results of administering the World Health Organization's Alcohol Use Disorder Identification Test (AUDIT) to 400 incarcerated drug-using women. Reports on AUDIT's utility, validity, and reliability. Results demonstrate that AUDIT can be used to identify problem drinkers among incarcerated, drug-using women. (MKA)

Stigmatization of overweight and obese individuals is common in interpersonal relationships. This study investigated longitudinal weight change patterns among Taiwanese adolescents and the relationship of weight change patterns with delayed romantic experience from late adolescence to young adulthood by using a representative panel survey. Individuals were divided into six weight change pattern categories according to changes in their body mass index. Two-stage stratified and clustered sampling was used to obtain a representative student sample, and 1,834 junior high school students were followed up over 7 years. Persistent obesity and a change from an underweight to a normal weight status over 7 years were independently associated with delayed romantic experience in both sexes. Moreover, females but not males who changed from an underweight or normal weight status to an overweight or obese status had increased odds of delayed romantic experience. Persistent obesity should be addressed early in life because it plays a crucial role in delayed romantic experience. [ABSTRACT FROM AUTHOR]

Purpose: The present study compared two nationally representative cohort datasets concerning Taiwan residents' healthy behaviors, subjective health outcomes, generalized trust, and accessibility to health promotion resources. Patients and Methods: The Taiwan Social Change Survey (TSCS) was conducted in two waves ten years apart: 2011 cohort (n = 1021; 48.4% males) and 2021 cohort (n = 1425; 47.4%) cohorts. Descriptive statistics were calculated to compare the two TSCS datasets. Then, multiple regression models were constructed with health outcome as the dependent variable, and demographics and other key components as independent variables. Results: The 2011 TSCS cohort showed higher prevalence for cigarette smoking (30.8% vs 25.2%; p=0.002), alcohol drinking (52.5% vs 24.3%; p< 0.001), exercise habits (52.7% vs 48.0%; p=0.02), and better fruit and vegetable accessibility (Mean=3.91 vs 3.82; p=0.04). The 2021 TSCS cohort reported higher body mass index (Mean=24.20 vs 23.63; p< 0.001), less residency in urban areas (22.4% vs 31.1%; p< 0.001), better jogging accessibility (4.14 vs 4.05; p=0.006), higher generalized trust (2.26 vs 2.17; p=0.001), and greater internet usage (3.43 vs 2.89; p< 0.001). The regression model showed that exercise habits (standardized coefficient=0.20 and 0.10; p< 0.001) and generalized trust (standardized coefficient=0.11 and 0.11; p=0.004 and < 0.001) were consistently associated with health outcomes in both cohorts. Additionally, internet use (standardized coefficient=− 0.07; p=0.026) and alcohol drinking behaviors (standardized coefficient=− 0.07; p=0.0022) were negatively associated with health outcomes in the 2021 cohort. Conclusion: The present study demonstrated the trends and changes over 10 years regarding multiple health-related components among Taiwan residents. The study's findings provide insight into education promotion programs to reduce unhealthy behaviors as well as enhancing generalized trust building and developing healthy behaviors for Taiwan residents. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents with obesity are more likely to be isolated by peers, but whether they also choose to disengage from their peers remains unclear.Methods: This study examined a sample of 646 adolescents between the age of 13 and 16 across 34 classrooms in 3 junior high schools in Taiwan, with data collected from May to June 2019. The sociometric network nomination method assessed peer relationships, such as unpopularity, unsociability, and alienation. Multilevel models were applied to explore the extent to which the class-level prevalence of overweight and obesity and peer support moderate the relationship between student-level obesity and peer relationships.Results: Overall, students with obesity were more likely to experience unpopularity, unsociability, and alienation from their peers in classroom settings (adjusted odds ratio [AOR] = 1.904, 2.208, 2.777, p < .05). Regardless of their obesity status, students in high classroom peer support were less likely to report unsociability (AOR = 0.124, p < .05). No cross-level interactions were observed, indicating that students with obesity did not experience a reduction of peer rejection in high peer support classrooms. Neither did obese students in classrooms with higher rates of overweight and obesity.Conclusions: Students with obesity were more likely to experience interpersonal problems. Classroom peer support can increase peer acceptance for typical students but has no beneficial influence on adolescents with weight problems. Classroom peer support needs to be directed to become adequate support for students with obesity. [ABSTRACT FROM AUTHOR]

Objective: To explore the factors influencing Taiwanese adolescents' consumption of sugar-sweetened beverages (SSB) and sugary snacks from a socio-ecological perspective.Design: This study adopted a qualitative design by using face-to-face, in-depth interviews guided by a semistructured questionnaire.Setting: Eight junior high schools in New Taipei City and Changhua County, Taiwan, September to November 2018.Participants: Fifty-nine participants aged 12-14 years participated in this study.Results: Reflexive thematic analysis was used to analyse the data. This study identified four themes to address the multifaceted factors that influence adolescents' consumption of SSB and sugary snacks. At the intrapersonal level, physiological factors, psychological factors, individual economic factors and taste preferences were mentioned in connection with people's consumption of SSB and sugary snacks. Positive or negative influences of parents, siblings, peers and teachers on SSB and sugary snack intake were identified at the interpersonal level. The availability of SSB and sugary snacks at home, their availability in vending machines or in school stores in the school environment and participants' access to convenience stores and hand-shaken drink shops in the broader community influenced SSB and sugary snack consumption. Additionally, food culture and food advertising were identified as influencing societal factors.Conclusions: Overall, this qualitative study determined not only that the consumption of SSB and sugary snacks is influenced by intrapersonal factors but also that interpersonal, environmental and societal factors affect adolescents' increased sugar intake. The findings are helpful to broaden the options for designing and developing interventions to decrease SSB and sugary snack consumption by adolescents. [ABSTRACT FROM AUTHOR]

Objective: This study examined the extent to which youthful alcohol consumption and the initiation of tobacco, betel nut, and other illegal drugs may differ by their first drinking context in Taiwan--a society with social norms that are more tolerant of underage drinking. Method: In 2004, in a nationally representative sample of 11,943 school-attending youth ages 15-18, information pertaining to sociodemographic characteristics, problem behaviors, lifetime experiences of alcohol, tobacco, betel nut, and illegal drugs, as well as psychoactive, drug-specific age of initiation, context at first use, average frequency, and recency of use. was assessed by anonymous questionnaires. Results: Youth who had their first alcoholic beverages in entertainment settings or at friends' houses were more likely to become frequent drinkers. After adjustment for socioeconomic background and problem behaviors, having had the first drink in entertainment settings was associated with a faster progression into the initiation of illegal drugs (hazard ratio [HR] - 2.5, 95% confidence interval [CI]: 1.5-4.0) and betel nut (HR - 1.5, 95% CI; 1.1-2.1). Conclusions: Youthful drinking pattern and transition from alcohol to betel nut and illegal drugs may vary modestly by the first drinking context. This context may be recognized as a proxy variable to identify youth at a higher risk for alcohol and other drug problems and to devise context-based educational or prevention programs., ALCOHOL USE AND RELATED PROBLEMS in adolescence continue to cause public health concern in many industrialized countries (Bonnie and O'Connell, 2004; O'Malley et al., 1998). A number of studies have [...]

Abstract Background Mycobacterium tuberculosis infection is an ongoing public health problem in Taiwan. The National Tuberculosis Registry Campaign, a case management system, was implemented in 1997. This study examined this monitoring system to identify and characterize delayed treatment of TB patients. Methods Records of all tuberculosis cases treated in Taiwan from 2002 through 2005 were obtained from the National Tuberculosis Registry Campaign. Initiation of treatment more than 7 days after diagnosis was considered a long treatment delay. Results The study included 31,937 patients. The mean day of delayed treatment was 3.6 days. Most patients were treated immediately after diagnosis. The relationship between number of TB patients and days of delayed treatment after diagnosis exhibited a Power-law distribution. The long tail of the power-law distribution indicated that an extreme number occur cannot be neglected. Tuberculosis patients treated after an unusually long delay require close observation and follow up. Conclusion This study found that TB control is generally acceptabl in Taiwan; however, delayed treatment increases the risk of transmission. Improving the protocol for managing confirmed TB cases can minimize disease transmission.

This study examined the association between adolescents' obesity and sociometric status among their peers across 1 year. The participants were 2,528 junior high school students from Taiwan (mean age = 13.31 years). The negative associations discovered between obesity and sociometric status were both concurrent and cumulative. Moreover, the adolescents who changed from nonobese to obese were more likely to have lower social acceptance and be isolated in their classrooms. These findings inform concerns regarding the sociometric status of adolescents who are (or are becoming) obese. [ABSTRACT FROM AUTHOR]

Background: Evidence regarding the impact of early palliative family conferences (PFCs) and decision to withdraw life-sustaining treatment (DTW) on healthcare costs in an intensive care unit (ICU) setting is inconsistent.Methods: We retrospectively analyzed patients who died in an ICU from 2013 to 2016. PFCs held within 7 days after ICU admission and DTWs were verified by reviewing medical records and claims data. Comparisons were first made between patients with and without DTWs, and secondly, between DTW patients with and without PFCs within 7 days. Propensity score matching methods were used to examine the difference in costs between patients with and without DTWs and PFCs within 7 days.Results: Of the 579 patients included, those with DTWs (n = 73) had a longer ICU stay than those without (n = 506) (12.9 ± 7.1 vs. 8.4 ± 9.6 days, p < 0.001). The DTW patients were more likely to have a "do-not-resuscitate" order (p < 0.001) and PFCs within 7 days (p < 0.001) and had lower healthcare costs (USD 7358 ± 4116 vs. 8669 ± 9,535, p = 0.038). After matching, healthcare cost reduction for patients with DTWs, compared with those without DTWs, was USD 3467 [95% CI, 915-6019] (p < 0.001). Compared with DTW patients without PFCs within 7 days, the costs for DTW patients with PFCs within 7 days further reduced to USD 3042 [95%CI, 1358-4725] (p < 0.001).Conclusion: Palliative family conferences held within 7 days after ICU admission with decisions to withdraw life-sustaining treatments significantly lowered healthcare costs. [ABSTRACT FROM AUTHOR]

Byline: Duan-Rung Chen, Tsui-Hua Kuo According to an estimation from the Institute of Medicine (IOM) (1999), 44,000 to 98,000 people died from medical errors in the USA. Medical errors are considered as the most important quality-related performance indicator for both healthcare organisations and professionals. This study applied the analytical framework of intellectual capital by Edvinsson and Malone (1997) to explore the factors associated with professional incompetence with a sample of 407 Taiwanese surgeons. Intellectual capital has been proposed to capture the intangible aspect of organisational process. We proposed that doctors' professional incompetence cannot be considered as individual-level attributes, but should be examined as the results determined by multiple interactions among human, social and organisational capital. The results of the study revealed that among all the types of medical errors reported by surgeons, the types that occur most often are misdiagnosis and delay diagnosis. Higher professional training is more likely to reduce the incidence of adverse surgical errors. Organisational capital, including establishing a formal reporting procedure, feedback mechanisms and the reduction of interruptions during surgery, can all reduce the reported surgical errors. Surgeons who frequently change their practicing organisations are less likely to accumulate hospital-specific experiences, which are needed for effective surgical teamwork, and are consequently more likely to have surgical errors. Professional incompetence, measured by medical errors, can reflect the multiple interactions between different components of intellectual capital in healthcare organisations.

Background: Numerous studies have demonstrated that different weight change patterns from adolescence to adulthood may exert different effects on opportunities from which individuals subsequently benefit. Objectives: This study aimed to investigate the association of weight change patterns from late adolescence to young adulthood with monthly wage in young adulthood for both genders in Taiwan. Methods: A nationally representative retrospective panel of 3730 young people (1707 men and 2023 women) from the Taiwan Educational Panel Survey (2001–2014) was included. Individuals were divided into four weight-change-pattern categories based on changes in their body mass index at two time points that were 7 years apart, between late adolescence (aged 18–19 years) and young adulthood (aged 25–26 years). These categories were (1) no obesity, (2) obesity reversal, (3) developing obesity, and (4) persistent obesity. Cross-classified, hierarchical linear regression modeling analysis was performed to explore the association of weight change patterns with monthly wage in young adulthood, after adjustment for both individual- and contextual-level variables. Results: Of the weight-change-pattern categories for both genders, individuals with persistent obesity had the lowest monthly wage. For women, the mean monthly wage decreased progressively for the categories of no obesity, obesity reversal, developing obesity, and persistent obesity (test for difference, P = 0.016; test for trend, P = 0.026). Women with persistent obesity earned 20% less per month than did those who were never obese (P = 0.024), after controlling for individual and contextual factors. For men, no association was found between weight change patterns and monthly wage. Conclusion: Persistent obesity from late adolescence to young adulthood is associated with low monthly wage in young adulthood in women but not in men. These findings highlight the urgency of addressing persistent obesity early in life, especially for women. [ABSTRACT FROM AUTHOR]

This randomized controlled trial explored the effects of a Ving Tsun (VT) Chinese martial art training program on reactive standing balance performance, postural muscle reflex contraction latency, leg muscle performance, balance confidence and falls in community-dwelling older adults. We randomly assigned 33 healthy older adults to either a VT group (mean age = 67.5 years) or a control group (mean age = 72.1 years). The VT group received two 1-hour VT training sessions per week for three months (24 sessions). Primary outcome measures collected before and after the intervention period were electromyographic muscle activation onset latencies of the hamstring and gastrocnemius and the center of pressure path, length and movement velocity in standing (reactive balance performance). Secondary outcome measures included isometric peak force and time to isometric peak force of the knee extensors and flexors, the Activities-Specific Balance Confidence Scale score, and fall history. Results revealed that the mean gastrocnemius muscle activation onset latency was significantly longer (22.53 ms) in the VT group after the intervention. The peak force of the knee flexors significantly increased (by 1.58 kg) in the control group over time but not in the VT group. The time to reach peak force in the knee flexors was significantly longer (by 0.51 s) in the control group (but not the VT group) at posttest compared with the pretest value. No other significant group, time, or group-by-time interaction effects were noted. We discussed possible reasons for the failure of three months of martial art training to benefit fall risks among these older adults. [ABSTRACT FROM AUTHOR]

Purpose: The health of physicians can have a strong impact on the quality and safety of the health care they provide. Studies have shown a link between work stress, burnout, and depression. The aim of this study was to examine the association between malpractice dispute experiences and the well-being of physicians.Methods: We conducted a cross-sectional survey to collect information about the malpractice experiences of primary care physicians in 2004. Data on sociodemographic and clinical characteristics and SF-36 measures were also collected. We used propensity score matching to estimate the association of medical malpractice experience with the general health, mental health, and vitality of physicians.Results: Among the 1206 primary care physicians who completed the survey (response rate of 13.4%), 25.2% reported having ever experienced a malpractice dispute. After adjustment for baseline variables, physicians who had experienced a malpractice dispute had significantly worse health-related quality of life with regard to general health [-4.85; 95% confidence interval (CI), -7.61 to -1.80; P = 0.0016], mental health (-2.68; 95% CI, -5.03 to -0.34; P = 0.0252), and vitality (-3.28; 95% CI, -6.10 to -0.47; P = 0.0224). The effects were particularly strong among physicians specializing in surgery or obstetrics and gynecology.Conclusion: The results reveal that a malpractice dispute can have a long-term negative effect on the health of physicians. Harm reduction programs for physicians involved in malpractice disputes should be implemented. [ABSTRACT FROM AUTHOR]