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BackgroundLimited studies have assessed the association of motor vehicle crashes (MVCs) during pregnancy with adverse maternal outcomes using a population-based nationwide dataset that covers all MVCs.MethodsA total of 20 844 births from women who had been involved in MVCs during pregnancy were obtained from the National Birth Notification (BN) Database in Taiwan. We randomly selected 83 274 control births from women in the BN matched on age, gestational age and crash date. All study subjects were linked to medical claims and the Death Registry to identify the maternal outcomes after crashes. Conditional logistic regression models were used to estimate the adjusted odds ratio (aOR) and 95% CI of adverse outcomes associated with MVCs during pregnancy.ResultsPregnant women involved in MVCs had significantly higher risks of placental abruption (aOR=1.51, 95% CI 1.30 to 1.74), prolonged uterine contractions (aOR=1.31, 95% CI 1.11 to 1.53), antepartum haemorrhage (aOR=1.19, 95% CI 1.12 to 1.26) and caesarean delivery (aOR=1.05, 95% CI 1.02 to 1.09) than the controls. Such elevated risks tended to be higher in the MVCs with greater severity. Scooter riders had higher ORs of various adverse maternal outcomes than car drivers.ConclusionsWomen involved in MVCs during pregnancy were at increased risk of various adverse maternal outcomes, especially in those with severe MVCs and riding scooters at MVCs. These findings suggest that clinicians should be aware of these effects, and educational materials that include the above information should be provided as part of prenatal care.

* Recognizing the pivotal role that emergency departments play in delivering care, forming first impressions, and driving operational flow, one organization utilized the balanced scorecard as a tool to focus on performance improvement. * The balanced scorecard provides a framework for measuring internal business processes, customer perspectives, financial performance, and learning and growth. * A multidisciplinary team selected the following measures on which to focus for the study period: laboratory test completion exceeding 30 minutes; laboratory specimen return rate; patient satisfaction; patient complaint rate; profit; staff satisfaction; and continuing education hours. * All measures improved during the study period, albeit in varying degrees of statistical significance. * In addition to selecting a careful array of measures, the implementation process of the measurement tool was accompanied by an educational process for the staff as well as a commitment to focus upon barriers and enablers to drive performance., WITH THE INCREASING competition in health care markets, consumerism, and a series of cost-control policy changes implemented by the National Health Insurance plan in Taiwan, more hospitals are having difficulty [...]

Chinese-language scales for assessing quality of life in women around menopause are rare. This study was conducted to evaluate the psychometric properties of a Chinese-language version of the Utian Quality of Life Scale (UQOL-C).

A possible diagnosis of breast cancer imposes a huge psychological impact on most women, but few studies have addressed uncertainty and anxiety changes at different diagnostic stages in women with suspected breast cancer. Thus, this longitudinal study examined uncertainty and anxiety and predictive factors for uncertainty in women with suspected breast cancer. Data were collected on uncertainty (Uncertainty in Illness Scale) and anxiety (State Anxiety Inventory) from 127 women at 3 times upon notice of a breast biopsy, before biopsy, and after diagnosis. The results showed that uncertainty and anxiety levels were significantly higher before than after diagnosis. At the 3 data collection times, uncertainty and anxiety were significantly lower for participants diagnosed with benign tumors than for those with malignant diagnoses. Uncertainty and anxiety were positively, moderately correlated. Uncertainty was predicted by age, marital status, education level, religious status, family history of benign breast tumor, regular breast self-examination, self-perceived probability of receiving a breast cancer diagnosis, and biopsy result. Therefore, nursing professionals should be aware of the uncertainty and anxiety changes and impact of personal attributes on women with suspected breast cancer during the diagnostic period and provide care programs to alleviate their psychological distress.

The purpose of this study was to determine the prevalence rate of prehypertension and to compare the differences in demographic factors, anthropometric measurements, lifestyles and metabolic profiles between normotensive and prehypertensive individuals.

The main purpose of this pilot study was to identify the predictors of community women's osteoporosis prevention intention. The osteoporosis assessment scales were self-developed and contained 5 scales a demographics scale, a health status scale, an osteoporosis health belief scale OHBS, a knowledge scale, and a prevention intention scale. The content validity of the five scales ranged from .90 to 1.00. Test-retest was used to examine the reliability of the demographic characteristics scale and the health status scale, which ranged from .9 to 1.0. Meanwhile, the reliability coefficients of the OHBS comprising perceived susceptibility, perceived seriousness, perceived benefit, and perceived barrier were .75, .90, .80, and .72. In this pilot study, the coefficient of KR-20 for osteoporosis knowledge was .88. The value of Cronbach's Coefficient Alpha for prevention intention was .85. The results of this research were 1 The averaged scores of the OHBS comprising perceived susceptibility, perceived seriousness, perceived benefit, and perceived barrier were 2.8 SD0.5, 2.2 SD0.7, 1.9 SD0.4, and 2.9 SD0.7. Meanwhile, the averaged score for women's knowledge on osteoporosis was 10.0 SD2.8. The averaged score for women's intentions for the prevention of osteoporosis was 2.5 SD0.6. 2 There were some significant correlations between OHBS and demographics, health status, knowledge, and prevention intention. 3 Knowledge was positively correlated with perceived barriers, prevention intention, age, self-rated score for health, breast feeding time, and amount of calcium intake. 4 Prevention intention was positively correlated with knowledge, number of children, age of fracture, and hormone replacement therapy. 5 The major factors influencing intention for community women were, in order, knowledge, educational level high school graduate, number of children n2, self-rated health score, experience of bone density examination yes, hormone replacement therapy yes, and kyphosis yes. These seven items accounted for 45.8 of the variation in intention. The results of this pilot study can help community health professionals evaluate, implement and improve community women's health beliefs regarding prevention of osteoporosis.

The purpose of this study was to investigate the performance and associated factors of sexuality education by elementary school nurses in Taipei. A structured questionnaire was utilized to collect data from a convenience sample of 145 elementary school nurses. The Kuder-Richarson reliability for sex knowledge scale was .73, and Cronbach's for sex attitude scale was .93. The findings of the study were as followed 1 Sex knowledge was high among study samples. The average scores for sex knowledge regarding “masturbation”, “sexual harassment and sexual abuse” were among the highest those regarding “secondary sexual character is tics”, “ovulation”, “menstruation healthcare”, and “sexually transmitted diseases” were among the lowest. 2 Sex attitude was positive. Eighty percent of the study subjects agreed that school nurses were responsible for the promotion of sexual health in schools. More than 90 of the study subjects were willing to participate actively in sexuality education program in school, providing health consultation and guidance. 3 Twenty percent of the study subjects were not involved in sex education because they were not invited or due to busy working schedule.4 Marital status, highest level of education, job title, job seniority, continuing education or training experience were the factors as sociated with the implementation of sexuality education among school nurses.

IMPORTANCE: Literature has suggested that trauma among pregnant women is associated with an increased risk of adverse pregnancy outcomes. However, limited research has investigated the association of trauma with adverse pregnancy outcomes by using a national data set. OBJECTIVE: To investigate the association between traumatic injury and adverse pregnancy outcomes. DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study of pregnant women in Taiwan linked 3 data sets, the Taiwan Birth Registry, Household Registration Information, and National Health Insurance Research Database, from January 1, 2004, through December 31, 2014. Data, including the characteristics of pregnant women and infants, were extracted from the Taiwan Birth Registry data set; to obtain trauma data, this data set and the Household Registration Information data set were collectively linked to National Health Insurance Research Database data. The combined data set was analyzed from January to July 2019. Adverse pregnancy outcomes and premature delivery were defined using International Classification of Diseases, Ninth Revision, Clinical Modification codes. EXPOSURES: The primary exposures of this study were 2 clinical variables related to injury during pregnancy: medical treatment in the emergency department (yes or no) and hospitalization (yes or no). MAIN OUTCOMES AND MEASURES: The main outcome variable was adverse pregnancy outcomes, and the secondary outcome variable was premature delivery. Multivariate logistic regression models were used to investigate the association of injuries with adverse pregnancy outcomes after controlling for demographic characteristics and other pregnancy-related variables. RESULTS: A total of 2?973?831 pregnant women (2?475?805 [83.3%] aged 20-34 years) were enrolled between 2004 and 2014, of whom 59?681 (2.0%) sought medical treatments due to injuries. Results of multivariate logistic regression models showed that women receiving emergency treatments more than once were 1.08 times as likely (adjusted odds ratio, 1.08; 95% CI, 1.05-1.10) to have adverse pregnancy outcomes than women who received no emergency treatment. Women with injury-related hospitalization were 1.53 times more likely (adjusted odds ratio, 1.53; 95% CI, 1.41-1.65) to have adverse pregnancy outcomes than women who did not sustain injuries. Furthermore, recurrent injuries were associated with a 572% increase in odds of premature delivery (adjusted odds ratio, 6.72; 95% CI, 2.86-15.80). CONCLUSIONS AND RELEVANCE: In this study, trauma among pregnant women was associated with an increased risk of adverse pregnancy outcomes, as were hospitalization and emergency department visits due to injury.

The Stein-Leventhal syndrome (SLS), first described in 1935, is characterized by infertility, hyperandrogenization, and obesity. Because this phenotype represents an aggregation of risk factors for postmenopausal breast carcinoma, and because in general, a hormonal imbalance underlies the disorder, the authors examined the association between self-reported SLS and breast carcinoma incidence in a cohort of 34,835 cancer-free women assembled in 1986 and followed through 1992. All participants were between the ages of 55 and 69 and held a valid Iowa driver's license. A total of 472 women in the cohort (1.35%) reported a history of SLS at baseline. Incident cases of breast carcinoma were identified annually using the State Health Registry of Iowa. Data were analyzed using Cox proportional hazards regression. During the follow-up period, there were 883 incident breast carcinomas, 14 among women reporting a history of SLS. Women with SLS were more likely than women without SLS to report fertility problems and menstrual irregularities, but there were no significant differences observed regarding body mass index (BMI). Although women with SLS were 1.8 times as likely to report benign breast disease than women without SLS (P < 0.01), they were not more likely to develop breast carcinoma (relative risk [RR] = 1.2; 95% confidence interval [CI] = 0.7-2). Adjustment for age at menarche, age at menopause, parity, oral contraceptive use, BMI, waist-to-hip ratio, and family history of breast carcinoma lowered the RR to 1 (95% CI = 0.6-1.9). Despite the high risk profiles of some women with SLS, these results do not suggest that the syndrome per se is associated with an increased risk of postmenopausal breast carcinoma. Cancer 1997; 79:494-9. © 1997 American Cancer Society.

Injuries by motor vehicle crashes remain the priority concern in the public-health. The aims of this study were to determine the distribution of varied severity of motor vehicle crash (MVC) injuries, and the time trend of MVC injuries by different car type between 2003 and 2010 in Taiwan.