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Introduction: Arteriovenous fistula or arteriovenous graft is essential to long‐term survival and quality of life in patients receiving hemodialysis. To date, no research has examined the clinical impacts of different puncture methods. This study compared the rope ladder and area puncture techniques in terms of vascular patency, pain, and quality of life among patients receiving hemodialysis. Methods: A prospective longitudinal study was performed with 6‐month follow‐up. A total of 98 participants recruited from a hemodialysis center in Taiwan were randomly assigned to receive the rope ladder technique (experimental group) or the area puncture technique (control group). Vascular patency was assessed by examining access flow and percutaneous transluminal angioplasty rate. Pain and quality of life were measured using the Numerical Pain Rating Scale (NPRS) and Kidney Disease Quality of Life Instrument (KDQOL‐36™), respectively. All outcome variables were measured repeatedly and analyzed using a generalized estimating equation. Results: Overall, quality of life was significantly better for the experimental group than for the control group (β = 47.23, p < 0.001). The percutaneous transluminal angioplasty rate was lower for the experimental group than for the control group (12.0% vs. 18.8%). However, no significant differences were found in access flow and pain level between the two groups over time. Conclusion: Hemodialysis patients who received the rope ladder puncture technique had a lower percutaneous angioplasty rate and better quality of life than patients who received the area puncture technique, suggesting that the rope ladder technique could be implemented as a routine cannulation method in hemodialysis clinics. [ABSTRACT FROM AUTHOR]

Following the integration of GIS into the national curriculum standards of senior high school geography, Taiwan has systematically implemented GIS education for over a decade. However, the effectiveness of this implementation is currently unclear. Therefore, this study investigates the status of GIS education in Taiwanese senior high schools. A nationwide questionnaire survey and ten personal interviews were conducted between 2009 and 2010. The results indicate that approximately 99 percent of teachers are confident to teach about GIS. The current educational strategies of promoting GIS have proven effective and shall be continued and expanded. (Contains 6 tables and 5 figures.)

Objectives: This study investigated the association between the decline of the decayed, missing, and filled teeth (DMFT) index and several family‐level and individual‐level factors among 6‐ to 18‐year‐old Taiwanese children from 2012 to 2020. Methods: This study used data from the 2012 and 2020 Taiwan National Oral Health Survey of Children and Adolescents. Both surveys used similar methods and were performed in the same study age group. A structured questionnaire was used to collect data on parents' sociodemographic background; the number of children in the family; oral health‐related knowledge, attitudes, and behaviours; and children's dietary habits. Dental caries was recorded through standardized oral examinations. Multivariable multilevel zero‐inflated negative binomial regression models were used to determine the association between family‐level and individual‐level factors and the DMFT index from 2012 to 2020. Results: A total of 10 217 and 10 436 schoolchildren completed the oral examinations and questionnaires in the 2012 and 2020 surveys, respectively. The adjusted mean DMFT index of 12‐year‐old Taiwanese schoolchildren in 2020 was 2.01, denoting a significant decline from 2.50 in 2012 (adjusted mean ratio = 0.20, 95% confidence interval [CI] = 0.17, 0.23, p <.0001). Furthermore, children who often consumed sugar‐rich drinks had a significantly higher risk (mean ratio = 1.05, 95% CI = 1.01, 1.10) of having DMFT than those who seldom consumed such drinks (p =.017). Conclusions: In the period of 2012–2020, the DMFT index among Taiwanese children significantly declined. Children who often consumed sugar‐rich drinks had a higher DMFT index than those who seldom consumed such drinks. Our findings are valuable to paediatricians, dentists, nutritionists, and public health policymakers. [ABSTRACT FROM AUTHOR]

Purpose: To explore the spiritual needs of community‐dwelling older people living with early‐stage dementia. Design: A descriptive qualitative research design with purposive sampling was used. Methods: Ten older people who were receiving home care services from a mental hospital in central Taiwan were recruited. In‐depth semistructured interviews were conducted and content analysis was performed. Findings: Four themes emerged that described the spiritual wishes and needs of older people with early‐stage dementia: the wish to turn back time, the need to instill meaning into past experiences, the need to rely on faith‐based strength, and the wish to have one's remaining life under control. The spiritual needs centered on a strong yearning to engage in a tug‐of‐war with time to reverse the impaired memory and independence. Conclusions: This study provides insights into the spiritual needs of older people with early‐stage dementia. They struggled to maintain a balance between independence and dependence, build a sense of self and value, seek guidance and support from religious faith, and retain control over their lives. Clinical Relevance: The findings can be expected to help caregivers improve care of older people with dementia by empowering older people to hold onto control in their lives and providing opportunities for them to connect with others for fulfilling their spiritual needs. [ABSTRACT FROM AUTHOR]

Objective To deal with the increasing long-term care (LTC) needs of elderly people in Taiwan, the government launched the Ten-year Long-term Care Project (TLTCP) in 2007, and through the care management system, care plans for those in need were distributed and implemented by care managers according to the single assessment process. Based on the emphasis of linking the right need assessment to the care plan, this study aimed to explore the need profiles of LTC recipients with regard to their health indicators to serve as a validity check on the identified dependency levels and care plans in the current care management system. Design A model based on latent class analysis (LCA) was used for dealing with the issue of health heterogeneity. LCA provides an empirical method that examines the interrelationships among health indicators and characterizes the underlying set of mutually exclusive latent classes that account for the observed indicators. The analysis included a total of 2901 elderly care recipients in the LTC dataset from a southern city, 1 of the 5 major metropolitan areas in Taiwan. The identified dependency levels of the samples and their care plans in need assessment were compared and discussed. Results Four need profiles were explored in the LTC dataset. Apart from the low (LD) (32.95%) and moderate dependent groups (MD) (17.48%), there were 2 groups identified among the high-dependency levels, including the severe physical and psychological dependency (SPP) (26.37%) and the comorbidities and severe dependency (CSD) groups (23.20%), which in sum were approximately identified as high dependency (HD) by care managers in the LTC dataset. In addition, the CSD group currently costs more for their care plans on average in LTC services (NT. 277,081.15, approximately 9200 USD) than the SPP group (NT. 244,084.21) and the other groups. Conclusion Need assessment is a key to success in care management in LTC. The results of this study showed the importance of focusing on multifacet indicators, especially the mental and social health indicators in need assessments by improving the unified assessment process to sensitively detect those with various needs and then link them to the right care plan. [ABSTRACT FROM AUTHOR]

Social stigma is inevitable for mentally ill patients, but how patients treat themselves is a priority for rehabilitation and an important buffer mechanism. This study thus aimed to measure the effectiveness of rehabilitation models for improving self-stigma. This quasi-experimental research design applied purposeful sampling. The participants (n = 250) were persons with mental illness who received rehabilitation treatment in central Taiwan. They were divided into community- (n = 170) and institution-based (n = 80) rehabilitation groups. The Internalized Stigma of Mental Illness Scale was evaluated at the time of recruitment, and a follow-up was conducted after 1 and 3 months. A generalized estimation equation was used in data analysis to measure whether self-stigma improved with the rehabilitation model and time, and to test the effect of different rehabilitation models on participants' self-stigma improvement. The study found that the self-stigma of patients receiving CBR improved more than that of those receiving IBR when behavioral problems, education, OT level, sex, and first-time self-stigma were controlled. Returning to the community is the goal of rehabilitation for patients with mental illness, but IBR still dominates the rehabilitation model in Taiwan. Thus, it is necessary to continue promoting CBR plans for future mental health policies. [ABSTRACT FROM AUTHOR]

Following the integration of GIS into the national curriculum standards of senior high school geography, Taiwan has systematically implemented GIS edu- cation for over a decade. However, the effectiveness of this implementation is currently unclear. Therefore, this study investigates the status of GIS education in Taiwanese senior high schools. A nation- wide questionnaire survey and ten personal interviews were conducted bet- ween 2009 and 2010. The results indicate that approximately 99 percent of teachers are confident to teach about GIS. The current educational strategies of pro- moting GIS have proven effective and shall be continued and expanded. [ABSTRACT FROM AUTHOR]

Abstract: The health care needs of elderly people were influenced by their heterogeneity. This study aimed to identify the health latent classes of elderly people by using latent class analysis to deal with heterogeneity and examine their socio-demographic characteristics. Data came from the 2005 National Health Interview Survey (NHIS) in Taiwan. In total, 2449 elderly individuals with available health indicators were examined in latent class analysis (LCA), and 2217 elderly community-dwellings with complete socio-demographic data were analyzed by multinomial logistic regression. Four health latent classes were identified which included 1066 (43.5%) people in the High Comorbidity (HC), 152 (6.2%) in the Functional Impairment (FI), 252 (10.3%) in the Frail (FR), and 979 (40.0%) in the Relatively Healthy (RH) group. Multinomial logistic regressions revealed socio-demographic characteristics among health classes. The variables associated with an increased likelihood of being in the FR group were age, female, and living with families. They were also correlated to ethnicity and educations. Apart from age and gender, the Functional Impairment group was less likely to be ethnicity of Hakka, more likely to live with others than were the RH group. The HC group tended to be younger, with higher educations, and more likely to live in urban area than the Functional Impairment group. The correlations between health classes and socio-demographic factors were discussed. The health status of elderly people includes a variety of health indicators. A person-centered approach is critical to identify the health heterogeneity of elderly people and manage their care needs by targeting differential aging. [Copyright &y& Elsevier]