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Containing rising health care costs by a global budget offers promise, but might have unintended effects on the composition of medical specialty workforces. When a budget is given to a group of medical providers and the physician/population ratio is growing, the ex-post total sum of fee units would exceed the ex-ante budget, thereby reducing the reimbursement for all services for all providers. Furthermore, the profit of high revenue services drops more than the profit of low revenue services. Thus, medical school graduates are less likely to choose a specialty with high revenue in response to the global budget scheme and physicians may leave labor force earlier because of lowered profit. The author provides empirical evidence by a synthetic control method that the number of surgeons in Taiwan has exhibited a decrease of 25% after 11 years of Taiwan's global budget scheme. During that same period of time, the total number of practicing physicians decreased only 13%., Competing Interests: Declaration of competing interest The author declares that he has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Losheng Sanatorium, as a prophylactic-therapeutic institution for isolation, treatment, rehabilitation and social control of leprosy patients, was established by the Japanese colonial government in Taiwan in 1930. Losheng Sanatorium effectively carried out the compulsory isolation of leprosy patients, under the assistance of the public medical system with the help of police and the Bao-Jia management in the Japanese colonial period in Taiwan. Losheng sanatorium imported DDS, a therapeutic drug for leprosy, popularised an outpatient treatment model of leprosy, and developed mobile medical services after the Second World War. Losheng detected and treated leprosy patients successfully through the support of special skin clinics in public hospitals and missionary hospitals after Multi-drug Therapy was introduced in Taiwan in 1984. The Department of Health, Executive Yuan of the Taiwan area in commenced administration of Losheng Sanatorium in 1999 transformed it into a community-based general hospital. Losheng sanatorium adopted different control strategies in different historical periods based on the requirements of health, epidemic prevention systems and leprology developments to achieve its goals of leprosy control. The Sanatorium provides an example to understand and further study epidemical control and public health practice in the Taiwan area.

The Christian missionaries preached through medicine by combining religious preaching with secularisation and social adaptiveness of medicine in the 19th century. They attempted to avoid the negative influence of culture differences between the West and China. Desjacques Marin, one of the missionaries in China, was entrusted by Benoit Edan, a French consul in Shanghai to establish a hospital in 1864, named the "General Hospital". This hospital was moved to the north bank of Suzhou Creek in 1877 and renamed as the Gongji Hospital. The hospital was designated by the Japanese Army in 1940 as a hospital for sick foreign prisoners in the war. It was taken over as an enemy property by the government of the Republic of China in 1945 and became a public hospital opened formally to Chinese patients. It was renamed as "Shanghai First People's Hospital" in 1953. Review of the historical changes of the missionary hospital is of significance for the study on Chinese medical history and medical communication between China and the West.

This research sought to investigate EFL nursing students' use of vocabulary learning strategies to learn medical terminology and further assess strategies used in relation to learning outcomes measured by two types of vocabulary knowledge: meaning recall (passive recall) and meaning recognition (passive recognition). The participants, 138 EFL nursing students in Taiwan, completed a meaning recall test and a meaning recognition test in week 8 of the semester, and they then took the English proficiency test (TOEIC Bridge) and filled out a vocabulary learning strategies survey in the following week. Both vocabulary outcomes had moderate correlations with English proficiency. Strategy use patterns appeared for the nursing students' medical terminology acquisition. They focused on looking up for corresponding meaning in L1 using a search engine, then learning orthographical and phonological forms to facilitate retention. A Pearson Correlation Analysis revealed that inferring word meaning, utilizing mnemonic devices for retention, and managing vocabulary learning were significantly and positively correlated with both vocabulary scores. In contrast, social strategies were the least conducive to achievement.

Zhaixinglou Zhidou Quanshu (, Encyclopedia of Smallpox from the Star - Picking Pavilion ) is considered as the epitome of theory and the experience collected of the doctors treating smallpox in Ming dynasty. There exists some mistakes and lack of detailed introductions about it and its author Zhu Yilin in some bibliographies. Zhu's style name is"Jixiang", and"Yingwo"is his art name. His most active time was during the reigns of Wanli and Chongzhen emperors. He learned medicine because of his illness and became good at treating smallpox. After failing to pass the Imperial examinations, he focused on practicing medicine. Zhu Yilin's printed medical works include Douyan Qulu Ji, Lundou Youxi Pian, Zhidou Dachengji (, Collections of Treating Smallpox ), and his medical records. There are the preface of 1st Year of Tianqi Reign wood-block edition, and 2 copied manuscripts, one in Japan and the other in Taiwan. Zhu's descendant Zhu Fa and Zhu Cun collected his works above and compiled as one book, renamed its name to Zhaixinglou Zhidou Quanshu during Qianlong and Daoguang Reign and printed it in 1826, which is called the Daoguang Gengletang edition. Some reference books and textbooks mistake it as compiled in 1619, printed in 1743 or 1765. In addition, Fu Zhichao Zhongdouxinfa (, Supplemented Extracts of Variolation Methods ) in Zhaixinglou Zhidou Quanshu was mainly based on Youke Zhongdou Xinfa Yaozhi (, Pediatric Variolation Essentials ), and extracted many books like Douzhen Dinglun (, Verdict on Smallpox ).

Family physicians serve as personal doctors for individuals and their families and also act as gatekeepers of the health care system. If no special status is accorded to family physicians, however, then the rates at which health care recipients utilize their service might be affected. In the present cross-sectional study, representative claims data sets for 2010 from Taiwan's National Health Insurance program, a health care system in which beneficiaries are not required to register with a family physician, were used to investigate the provision of health care to the population by family physicians. Among 919 206 beneficiaries with a total of 13 713 199 ambulatory visits, 49.1% had visited family physicians, 34.1% had visited internists, 24.3% had visited pediatricians, and 38.9% had visited otolaryngologists. Women (χ 2 (1) = 538, P < .001) and patients aged 65 and above (χ 2 (1) = 16 000, P < .001) had a higher proportion of visiting family physicians rather than visiting other specialties. The onion-shaped population pyramid with family medicine visits was compatible with the general population, and the proportion of visiting family physicians increased with increasing age. Among 112 289 patients with essential hypertension, 63 379 patients with diabetes mellitus, and 80 090 patients with hyperlipidemia, only 35.3%, 32.0%, and 31.1%, respectively, had visited family physicians. The age and sex distributions of these patients were illustrated with population pyramids for data visualization and direct comparisons. Taken together, the results of this study indicate that the utilization of family physicians in Taiwan and the effectiveness of their associated role in chronic disease management still have room for improvement.

In Taiwan, issues in technology education (TE), such as indeterminate core mission and unclear role, could be addressed through an objective knowledge map of research to discern directions of development and prospects. This study explores sub-fields, genres, characteristics, and trends in TE research in Chinese and English over 24 years through bibliometric co-citation analysis using two databases: Web of Science and Airiti Library. As per the findings: (1) TE research has been progressing slowly in Taiwan, while it is developing rapidly elsewhere; disciplines integrated with TE include education and educational research, engineering, computer science, social sciences, and medicine; (2) research topics have evolved from industrial arts, technical and vocational education, technological literacy education, and curriculum development, to pedagogical skills of teachers of technology; other countries focus on "professional development of technology teachers," while Taiwan emphasizes "curriculum and teaching materials;" (3) clusters from different periods are complementary, and research topics and fronts reflect continuity; and (4) "assessment," as a research dimension, has received insufficient attention. Insights into the evolution of research topics and research fronts are offered for technology educators.

Adherence to anti-osteoporotic regimens gradually decreases over time. We hypothesized that the determinants of non-compliance or non-persistence at different times vary and identified these differences. We used an outpatient database to retrieve information on anti-osteoporotic medications prescribed by a medical centre in southern Taiwan during 2001-2007. Compliance was defined as a medication possession ratio (MPR) ≥80 %. Persistence was determined as continuous use, allowing for a refill gap of 30 days. A multivariate Cox regression model evaluated potential predictors of non-adherence. A total of 3589 patients were included. In the multivariate analyses, non-compliance for both year 1 and year 2 was more likely in patients with non-vertebral non-hip fractures, respiratory disorders, prescription of the first anti-osteoporotic regimen by an orthopedist; and less likely in patients with follow-up bone densitometry and switched regimens. Risks for non-persistence at year 1 and year 2 were generally similar to those for non-compliance; insurance coverage and malignancy were associated with a lower risk of non-persistence at year 1 and year 2, respectively. In the subgroup with an MPR ≥80 % at year 1, an index prescription by an orthopedist was the only independent predictor of non-compliance and non-persistence at year 2. In conclusion, the positive or negative determinants of non-adherence were different at year 1 and year 2, which indicated that clinicians might deliver effective interventions to improve adherence via different precautions annually. This study also provided evidence that physician specialty had a significant effect on adherence to osteoporosis care.

Objectives: Users of Traditional Chinese Medicine (CM) and biomedicine (BM) are commonly assumed to belong to two different groups in most of the related literature. The purpose of this article is to compare the characteristics of those who use both CM and BM for the same illness (CBMS) with those who solely use BM (BMS)., Methods: Starting with a systematic sampling of 200,000 patients from a database of the Taiwan National Health Insurance program for the year 1999, the data were organized so that those who visited hospitals and clinics more than twice for the same illness were selected. In total, there were 96,872 (60%) BM users and 30,099 (19%) CBM users. The χ(2) test and mean test were applied to compare the differences in use between the above two subgroups. Logistic regression was used to calculate odds ratios of demographic variables and disease types., Results: Compared to the group using BM for the same illness (BMS), there were more females in the group using both CM and BM for the same illness (CBMS) (p < 0.0001). Most of the subjects in the CBMS group were aged 25-49 years (p < 0.0001). The mean number of total visits was higher for CBMS (16.33) than for BMS (13.71) (p < 0.0001). For both groups, the mean number of visits for females was higher than for males (p < 0.0001). Furthermore, the mean cost per visit was significantly lower for CBMS (519.58 New Taiwan Dollar [NTD]) than for BMS (582.37 NTD). Among the top eight major disease categories of patients in the two subgroups, disease of the respiratory system was the most common primary indication in both CBMS and BMS. However, diseases of the musculoskeletal system and injury showed the highest incidences in CBMS when compared with BMS., Conclusions: Alternative medicinal treatment has become increasingly popular in recent years. Providing integrated CM and BM service in one medical facility might greatly benefit patients.

Background: People of Chinese ethnicity are the largest population in the world. Critical care medicine in China is developing rapidly and has achieved great advances in recent 20 years. The research contribution in critical care medicine among Chinese individuals in the three major regions of China--Mainland (ML), Hong Kong (HK), and Taiwan (TW)--is unknown., Methods: Articles published in 18 journals on critical care medicine originating from ML, TW, and HK from 1999 to 2008 were retrieved from the PubMed database and Science Citation Index Expanded. Quantity and quality analyses were conducted for the total numbers of articles, clinical trials, randomized controlled trials, impact factors (IF), citations, and articles published in high-impact journals., Results: There were 932 articles from ML (268), TW (506), and HK (158) from 1999 to 2008. The annual total numbers of articles of the three regions increased gradually from 1999 to 2008 (from 57 to 157). From 2002 onward, the number of articles published from ML exceeded that from HK, but TW still has the dominance in both annual and total number of articles published compared with ML and HK. The accumulated IF of articles from TW (1676.67) was higher than that from ML (708.25) and HK (449.51). TW had the highest average IF of 3.31 followed by HK of 2.85 and ML of 2.64. HK had the highest average citations of each article of 10.73, followed by TW of 6.74 and ML of 5.34. The Journal of Trauma was the most popular journal in the three regions., Conclusions: The total numbers of articles in China increased markedly from 1999 to 2008. TW published the most number of articles, clinical trials, and randomised controlled trials among the three regions. The Journal of Trauma was the most popular journal in the three regions.

Objectives: Based on a recent patient survey from Taiwan, where there is universal health insurance coverage and unrestricted physician choice, this study examined the relationship between physician specialty and the quality of primary medical care experiences., Methods: We assessed ambulatory patients' experiences with medical care using the Primary Care Assessment Tool, representing 7 primary care domains: first contact (ie, accessibility and utilization); longitudinality (ie, ongoing care); coordination (ie, referrals and information systems); comprehensiveness (ie, services available and provided); family centeredness; community orientation; and cultural competence., Results: Having a primary care physician was significantly associated with patients reporting higher quality of primary care experiences. Specifically, relative to specialty care physicians, primary care physicians enhanced accessibility, achieved better community orientation and cultural competence, and provided more comprehensive services., Conclusions: In an area with universal health insurance and unrestricted physician choice, ambulatory patients of primary care physicians rated their medical care experiences as superior to those of patients of specialists. In addition to providing health insurance coverage, promoting primary care should be included as a health policy to improve patients' quality of ambulatory medical care experiences.

Background: Medical centers in Taiwan have found it difficult to recruit sufficient residents in the fields of surgery and gynecology & obstetrics over the last few years. It is important to realize why this phenomenon occurs. The purposes of this study are to investigate the important (critical) factors that Taiwan medical students currently consider when choosing their specialties, and to derive the relative weight of each factor., Methods: We constructed a three-tier analytic hierarchy process (AHP) model in the questionnaire sent out to 200 senior students at a medical school in northern Taiwan. The relative weight of each factor in the model was calculated, and the Kruskal-Wallis test as well as the t-test was applied to test for any significant differences in opinion among the students., Results: On the first tier of the AHP model, the aspect of "personal preferences and work achievement" had the highest weight of 0.455, followed by "specialty characteristics" with 0.281 and the "specialty training process" with 0.263 for all respondents. Of the 14 criteria on the second tier, "personal intelligence/ability preference" had the highest weight of 0.191, followed by "career opportunities" with 0.105 and "lifestyle after completion of training" with 0.093 for all respondents. As students got older, their perception of specialties changed. Students might modify their decision as their views of the various specialties evolve., Conclusions: "Personal intelligence and/or ability preference" is the most important factor, while the economic factors, such as future income, is ranked lower (7th place). Knowledge of the attitudes of a new generation of medical students could form the basis for the development of strategies to enhance the attractiveness of specialties that currently lack sufficient applicants.

Background: To evaluate the impact of the 2002 Women's Health Initiative (WHI) study results on the prescription of menopausal hormone therapy (MHT) to treat menopause-related symptoms in Taiwan., Methods: This retrospective study participant data collected from women interviewed in 2001 Taiwan's National Health Interview Survey (NHIS) and the National Health Insurance (NHI) outpatient claims for women being treated for menopause-related symptoms. We compared prescriptions made for MHI to women seeking outpatient treatment for menopause-related symptoms before and after the publication of the 2002 WHI to study its effect of prescription behavior in Taiwan. There was one dichotomous outcome variable, which was whether MHT was prescribed or not in an outpatient visit to treat menopause-related symptoms., Results: Our study included 504 women 45 years old or above whose outpatient visits for menopause-related symptoms were covered by National Health Insurance in 2002. In total, these 504 women made 2549 outpatient visits to be treated for these symptoms. The proportion of outpatient visits in which MHT was prescribed dropped from 83.0% (n = 1,155) before WHI to 73.0% (n = 844) after WHI. We found a decrease in likelihood that women would be prescribed MHT for menopause-related symptoms after the release of the WHI report (OR = 0.36, 95% CI = 0.25 to 0.52, p < 0.05). Gynecologists and obstetricians are more likely to prescribe MHT than physicians with other medical specialties (5.34; 95% CI = 3.45 to 8.26, p < 0.05). Women with college level educations or higher became less likely to be prescribed MHT (Model 2; OR 0.30; 95% CI 0.11-0.83), and academic medical centers became less likely to prescribe MHT than other medical care institutions (Model 3; OR 0.15; 95% CI 0.34-0.63)., Conclusion: The WHI report caused a substantial decline in the use of MHT to treat menopause-related symptoms in Taiwan. It was found to exert most of its influence in patients with higher educations, physicians with specialties other than gynecologists and obstetricians, and academic medical centers.

Background/purpose: Medical school graduates are the source of a country's physicians. Determining how the graduates of these schools select their areas of specialization is the key to achieving a balanced distribution of doctors among all specialties. The purposes of this study were to determine the factors that influence medical students' choice of medical specialty, and to derive the relative weight of each factor., Methods: We constructed a two-tiered analytic hierarchy process (AHP) model which was represented in a questionnaire sent to 500 senior medical students to survey their opinions. The relative weight of each factor in the model was calculated. Analysis of variance and t test were applied to test for any significant differences in opinion among the students., Results: On the first tier of the AHP model, the aspect of "personal preferences and work achievement" had the highest weight of 0.460, followed by "specialty characteristics" with 0.291, and then the "specialty training process" with 0.249. Of the 14 criteria on the second tier, "personal intelligence/ability preference" had the highest weight of 0.197, followed by "career opportunities" with 0.107 and "lifestyle after completion of training" with 0.094., Conclusion: This study found that personal intelligence/ability preference and career opportunities were more important factors to the current generation of students in choosing a specialty. Knowledge of these students' attitudes could form the basis for the development of strategies to enhance the attractiveness of specialties facing the problem of a shortage of manpower.

Background: We used the insurance claims of a representative cohort to quantify the patterns of ambulatory care visits, especially the doctor-shopping phenomenon, in Taiwan., Methods: The ambulatory visit files of the 200,000-person cohort datasets from the National Health Insurance Research Database in 2002 were analyzed. Only a visit with physician consultation would be considered. We computed the visit patterns both by visit count and by patient count., Results: In 2002, there were 182,474 eligible people with 2,443,003 physician consultations. During the year, 87.4% of the cohort had visited physician clinics and 57.5% had visited hospital-based outpatient or emergency departments. On average, a person had 13.4 physician consultations and consulted 3.4 specialties, 5.2 physicians, and 3.9 healthcare facilities in a year. In 2002, 17.3% of the cohort had ever visited different healthcare facilities on the same day; 23.5% had ever visited physicians of the same specialty at different healthcare facilities within 7 days and the percentage of second visits was 3.8% of all visits. Besides, 7.6% of the cohort had visited two or more specialties at the same facility on the same day, and such visits make up 2.5% of all visits., Conclusion: The people in Taiwan did visit the physicians and outpatient departments frequently. Many patients not only consulted several physicians of different specialties and at different healthcare facilities during the year, but also switched the physicians and facilities quickly. An effective referral system with efficient data exchange between facilities might be the solution.

Purpose: This study explored the neural marker indexing deficits in discriminating lexical tone changes in Mandarin-speaking children with developmental language disorders (DLDs) using mismatch negativity, an event-related potential component for auditory change detection. Mandarin has four lexical tones characterized by a high-level tone (T1), high-rising tone (T2), low-dipping tone (T3), and high-falling tone (T4), in which the T2/T3 contrast is acoustically less discriminable in developmental groups. Therefore, this study further examined how deficits in children with DLD would vary with tonal contrasts' acoustic saliency. Method: Event-related potentials were measured using the multideviant oddball paradigm described by Lee et al. (2012), who used Mandarin syllables [i] in T3 as the standard sound (80%), T1 as the large deviant (10%), and T2 as the small deviant (10%). Twelve children with DLD aged between 4 and 6 years participated in this study, and 12 age-matched children with typical development were selected from the data set of Lee et al. (2012) as the controls. Results: The T1/T3 change elicited adultlike mismatch negativity in both the DLD and control groups, while no group difference was revealed. The T2/T3 change elicited a robust positive mismatch response (P-MMR) in children with DLD, while the P-MMR was less significant in the control group. The group comparisons revealed a larger P-MMR in children with DLD than in the control group. Furthermore, children with lower scores in language assessments tend to reveal larger P-MMRs. Conclusions: This study demonstrated that deficits in children with DLD in discriminating subtle lexical tone changes reflect greater positivity of P-MMR to T2/T3 change. This implies that MMR to T2/T3 may serve as a neural marker for evaluating language delay in preschoolers.

Taiwan's population has undergone rapid growth. From 3000000 in 1906. It had grown to 6000000 by 1941. By the end of 1996 the total population has reached 21500000. This large population is served by over 120000 health professionals. For every 10000 people there are 12.91 doctors (including 11.52 Western medical doctors and 1.39 Chinese medical doctors), 3.37 dentists and 9.36 pharmacists. There has been a huge change in causes of mortality. Under the Japanese occupation, the main causes of death were malaria, pneumonia, dysentery, enteritis, and pulmonary tuberculosis. After the return to Chinese control, the main causes were acute contagious diseases and digestive tract disease. At present, malignant tumors, cerebrovascular accident, heart disease, and diabetes are the main causes of death. With the development of the health-care system, infectious diseases have been controlled or eliminated. Malaria was eradicated from the island in 1956.

During this period, malaria, pneumonia, dysentery and enteritis, and acute infectious diseases, including plague, typhoid fever, dysentery, cholera, smallpox, infectious epidemic meningitis, malaria, tsutsugamushi and endemic diseases such as goitre were the important causes of death. In parasitology, the most important discovery was lung fluke, followed by research achievement in clinical and basic sciences. In Taiwan, studies on poisonous snake were proceeded rather early. The special medical system in this period included the Gynecological Hospital and medical insurance system. In the medical staff, not a few Japanese were included. Dr. Du Congming, who made great contributions to medicine in Taiwan, may be viewed as the father of medicine in Taiwan. A Journal of Taiwan Medical Association was published in Taiwan by the said Association.

In recent years, considerable concern has arisen over the use of digital games as instructional tools in educational research. However, game-based learning not only enhances students' learning motivation and effectiveness, but also fosters knowledge transfer. Taiwanese people living in rural areas often receive health-related information through television and radio advertisements. However, a lack of correct information leads to incorrect medication usage. Therefore, the purpose of this study is the practical development of a digital game related to correct medication usage. The technology acceptance model was applied to examine the impact of the game-based learning experience. The results showed that the post-test scores for correct medication usage were significantly higher than those obtained in the pre-test and indicated that the digital game could enhance students' learning effectiveness. In addition, perceived ease of use and usefulness had significant impacts on attitude toward the correct medication usage digital game. In conclusion, game-based learning significantly enhanced students' knowledge and abilities related to the correct usage of medication.

Background: The significant increase in medical disputes and lawsuits in recent years in Taiwan has severely affected behavior and ecology in medical practice. For this reason, we designed integrated courses on ethics and law and conducted a questionnaire-based career plan study to understand whether these issues influence their specialty selection process. Method: We randomly selected sixth-year medical students that rotated to our hospital to take an integrated course on medical ethics, laws and regulations, and problem-based learning. The students completed the same questionnaire before and after the course. We used a five-point Likert scale for agreement. In addition to calculating the proportion of agreement, we used paired t-tests in the question items before and after the course at a 0.05 level of significance. A qualitative analysis was also made. Results: This study included 98 medical students, 65 of whom were male, and 33 were female. In terms of reasons for studying medicine, the question item with the highest agreement proportion was "I chose to study medicine because being a doctor will enable me to lead a stable life"; in terms of career plans, it was "I will choose my specialty based on my personal aspirations and interests". On agreement scale, significant increases were presented in "I will choose my specialty based on my personal aspirations and interests" and "I will choose my specialty based on my sense of accomplishment". However, a significant reduction was found in "I will choose my specialty based on quality-of-life considerations". Qualitative analysis indicated that the students learnt that "acquiring good communication skills and fulfilling the obligation to obtain informed consent are the fundamental means of preventing medical disputes". Conclusion: After completing the course, medical students put greater emphasis on personal aptitude, interests, and sense of accomplishment, and less on quality-of-life in choosing a specialty.

The aim of this study is to evaluate a 3D (Three Dimensional) Traditional Chinese Medicine (TCM) e-learning platform and determine the factors affecting students' intention to continue to use the platform in TCM courses. Students from two classes were invited to participate in the experiment. To compare the effectiveness of both learning methods, one class serves as the control group and used the traditional classroom lecture method while the other serves as the experimental group using the 3D e-learning platform. To determine the factors affecting TCM students' intention to continue to use the platform, we propose an evaluation model modified from the post-acceptance model of information systems. Data collected from the experimental group students are used to test the proposed research model via the PLS-SEM method. We find that TCM students using the 3D e-learning platform outperformed those who used the traditional classroom lecture method. Meanwhile, the integrated evaluation model is found to provide reasonable explanatory power regarding TCM students' intention to continue to use the e-learning platform.

This research focuses on elementary pupils' attitudes toward gender roles and the learning results from using two types of teaching materials, multimedia animation and a role-play transcript, based on the biographies of women in science, technology, and medicine. We selected two fifth-grade classes for the experiment, which was conducted during the students' science period. The findings revealed that using the two teaching materials positively benefited elementary pupils' attitudes toward gender roles, particularly in terms of games and toys.

This study aimed to investigate and compare the impact of pursuing top university status on the management and academic practices of two departments in a top-ranked institution in Taiwan. Qualitative interviews, official policy documents, website resources and relevant documents were the main sources of empirical data. Interview data were collected from 10 interviewees, the department heads and four full-time academics in both departments. This study found that departments and academics were required to plan and work in accordance with the university's overall development plan and the two departments played different roles in contributing to various aspects of the university managers' idea of what a world-class university is. This should be understood within the unique and complex academic tribes of different subject fields and the deeply rooted dimensions of Chinese culture in Taiwan.

This systematic review examines the effectiveness of Mozart's music in decreasing seizures in children with epilepsy (Mozart Effect) using the Johns Hopkins Nursing Evidence-Based Practice rating scale©. A search for articles with "Mozart Effect," "child*," and "epilepsy" was conducted in CINAHL Complete, Science Direct, Cochrane, and PubMed databases. Eight studies were selected based on the exclusion and inclusion criteria after removal of duplicates (n = 17) and others (n = 46). Studies included were English language, peer reviewed, published between April 2010 and February 2017, and available in full text with an abstract. Quasi-experimental studies demonstrate that the Mozart Effect May reduce epileptiform discharges or seizures in children and has potential as an adjunct to medical management of seizure activity or alone when medication or surgery is not accepted. A causal relationship between the music of Mozart and decreased seizure activity has yet to be demonstrated.

The history of medicine in China is divided into four periods, from about 2700 B.C. to the present. Brief descriptions of standard works of these periods (e.g. Pèn-Ts'ao, Nei Ching, Nan Ching, Shang Han Lun, Ch'in K'ue Yao Lüeh, Chai I Ching, Chou Hou Pei Chi Fang, Mo Ching, Ming I Pieh Lu, Ch'ao Shih Pin Yüan, Chien Chin Yao Fang, Wai T'ai Pi Yao, Hsi Yüan Lu, Pèn-Ts'ao Kang-Mu, etc.) are given. The latter part of the paper deals with the state of modern medical research and literature in Mainland China, where equal emphasis is placed on the practice of both traditional Chinese and Western medicine in the treatment of diseases, thus resulting in a new era in Chinese medical history. This is based on the information obtainable in Hong Kong. Information about medical developments in Taiwan is readily available elsewhere and so has been omitted.

This study describes a change process of implementing role-plays in a course on workplace communication in English, and of engaging in retrospective reflection. Considering that English education for nursing students in Taiwan has focused on the development of medical terminology and that students' communicative competence is the main deficiency, the author conducted the change process in a medium-scale district hospital where she worked as a clinical nurse and in a nursing college where she taught English as a part-time teacher. The results show that engaging in retrospective reflection allows a teacher to construct knowledge from experience for professional growth.

Few studies have explored the learning difficulties and misconceptions that students encounter when using information and communication technology for e-learning. To address this issue, this research developed a system for evaluating the learning efficiency of medical students by applying two-tier diagnosis assessment. The effectiveness of the proposed system was evaluated in 11 resident doctors of dermatology enrolled according to a one-group pre- and post-test experimental design. After using the proposed e-learning system, the resident doctors had significantly improved learning efficiency and high satisfaction with the system functions. Although the number of subjects in this study was low, the significant improvements in clinical skills observed at the end of the educational training program indicate that the proposed integrated e-learning system is user-friendly and effective for self-education in the diagnosis skills required by medical students and dermatology residents.

Modern biotechnology is one of the most important scientific and technological revolutions in the 21st century, with an increasing and measurable impact on society. Development of biotechnology curriculum has become important to high school bioscience classrooms. This study has monitored high school students in Taiwan on their knowledge of and attitudes towards biotechnology for nearly two decades. Not surprisingly, knowledge of biotechnology of current students has increased significantly (p < 0.001) and most students have learned some definitions and examples of biotechnology. There was a positive correlation between biotechnology knowledge and attitudes toward biotechnology for current students who study Advanced Biology (AB). However, for current students who did not study AB, there was a negative correlation.The attitude results showed that students today expressed less favorable opinions toward agricultural biotechnology (p < 0.001) despite studying AB or not. However, there is no significant difference between students today and 18 years ago in opinions towards medical biotechnology. In addition, current students showed a greater concern involving environmental risks than former students. Interestingly, the high school curriculum did affect students' attitudes toward genetically engineered (GE) plants but not GE animals. Our current study also found that the students' attitude towards GE animals was influenced more by their limited knowledge than by their moral belief. On the basis of findings from this study, we suggest that more materials of emerging animal biotechnology should be included in high school curriculum and recommend that high school teachers and university faculty establish a collaborative framework in the near future.

Recent empirical evidence demonstrated that open-ended creativity (which refers to creativity measures that require various and numerous responses, such as divergent thinking) correlated with alpha brain wave activation, whereas closed-ended creativity (which refers to creativity measures that ask for one final correct answer, such as insight problem solving) was related to larger variability in electroencephalogram (EEG) differences between alpha and beta waves. This study designed two EEG neurofeedback procedures to examine their training effects on open- versus closed-ended creative potentials. In the alpha-enhancement condition, participants were reinforced to elevate only their alpha frequencies by auditory feedback for 10 sessions. In the alpha-transformation condition, enhancement and suppression of the signal tone (and hence, the appearance and disappearance of alpha waves) were both practiced. Pre- and posttest comparisons indicated that, compared to the active contrast condition, the alpha-enhancement practice improved only open-ended creativity performance. The alpha-transformation training enhanced closed-ended creativity performance, which was first demonstrated in the literature, and simultaneously facilitated open-ended creativity performances. In addition, changes in brain wave patterns by training positively correlated with change in predicted creativity performances. All of these results were of medium to large effect sizes. The effectiveness of these EEG neurofeedback procedures for creativity training was implied and discussed.

Contemporary understanding of brain functions provides a way to probe into the mystery of creativity. However, the prior evidence regarding the relationship between creativity and brain wave patterns reveals inconsistent conclusions. One possible reason might be that the means of selecting creative individuals in the past has varied in each study. By distinguishing creative potential as open-ended versus closed-ended based on theoretical views, this study examined different brain wave patterns and cortical control abilities in relation to different creative potentials by using electroencephalogram (EEG) biofeedback equipment. The results demonstrated that participants' performance on the open-ended creative problem was positively related to EEG alpha frequencies, whereas performance on the closed-ended creative problem was related to larger variability in EEG dynamics between alpha and beta waves when performing either open-ended or closed-ended creativity tasks. Further, better control in changing states of brain wave activities according to the EEG biofeedback signals could predict closed-ended creativity performance. Open-ended creativity was related only to the enhancement of alpha signals. These results help clarify previous inconsistent findings, reveal different natures of distinct creativities, and further suggest ways to improve different aspects of creativity with modified biofeedback procedures.

This article introduces the primary beliefs about ancestor worship, Taoism, Confucianism, Buddhism and traditional Chinese medicine that have influenced Chinese people for thousands of years, particularly in relation to death and dying. These cultures and traditions remain important for Chinese people wherever they live. Over a long period, Chinese people have integrated these philosophies and religions to form the basis of their culture and traditions. Although they agree that death is a natural part of the life span, a unique belief about death and dying has emerged among the Chinese from this integration. From this, the people find a significant definition of death and dying.

This article explores the history of the Chinese Nationalist Party (Kuomintang KMT) government's expansion of health insurance in Taiwan from 1950 to the 2010s through the lens of ethnicity, politics and medicine. I argue that the KMT party-state's expansion of health insurance privileged government employees who were the core supporters of the ruling party. By comparing the history of the insurance programs for government employees and laborers, the article makes the case that KMT provided better coverage, lower premiums, and less medical gatekeeping for Chinese waisheng government employees who fled to Taiwan with the KMT than for ordinary Taiwanese bensheng laborers. Global actuarial science experts from the United Nations International Labor Organization also buttressed such a discriminatory process. This China-centered approach towards universalizing healthcare on the island became increasingly challenged by provincial legislators, labor activists, and the emerging political opposition that promoted local Taiwanese concerns on healthcare equity and access. This article concludes that this dual process of KMT's population management and leveraging of United Nations actuarial expertise as the Republic of China became symbolic of the bio-geopolitics that animated the history and development of health insurance in Taiwan. [ABSTRACT FROM AUTHOR]

Abstract HIV acquisition has been found to be associated with increased risk of cardiometabolic syndrome in the past. In this study, we attempt to delineate the associated factors of metabolic syndrome among persons living with HIV in a single medical center in Taiwan using mostly integrase inhibitors-based regimen as HAART. A cross-sectional study involving all people living with HIV (PLWH) aged ≥ 18 years who visited MacKay Memorial Hospital, Taipei, Taiwan between September 7, 2022 to January 31, 2023 was performed. A modified National Cholesterol Education Program ATP III definition of metabolic syndrome was used to define metabolic syndrome and body mass index was used as surrogate for waist circumference. 809 PLWH participated in the study, in which 81.3% of patients were on integrase inhibitor-based HAART regimen. The prevalence of metabolic syndrome was 10.0%, which is markedly lower than those reported in the literature. Age was a significant risk factor for metabolic syndrome. HIV-related factors (CD4, viral load, HAART regimen) did not affect the presence of metabolic syndrome. Prevalence rate of metabolic syndrome appeared to have declined among PLWH compared to previous reports, possibly secondary to widespread use of integrase inhibitors. Age remains a strong risk factor for the development of metabolic syndrome among PLWH.

Abstract Rapid urbanization has significantly altered landscape environments in both urban and rural regions, and these landscapes have been demonstrated to play a pivotal role in human well-being. This study develops a coherent framework that integrates landscape change, landscape ecological indicators, and landscape preferences within the context of the evolving landscape environments of rural communities in Taiwan. Four distinct types of rural communities were selected, and a quantitative methodology was employed to investigate the variations and transformations in landscape preferences among rural residents in the context of landscape change. A qualitative methodology was employed to investigate the relationship between landscape ecological indicators and landscape preferences. The study’s findings indicate significant temporal variations in residents’ landscape preferences, with landscape beauty, stewardship, and coherence emerging as key determinants in the evaluation of these preferences. Landscape ecological indicators were found to be significantly correlated with variables such as landscape complexity, landscape beauty, openness, naturalness, and comprehensive landscape assessment. The findings of this study indicate that design planners, land managers, and public sector organizations can employ multidimensional thinking in the management of rural landscapes to align with the visual aesthetic preferences of rural residents.

Objectives: This study aims to assess the impact of Traditional Chinese Medicine (TCM) on dementia patients, utilizing real-world data. Specifically, it seeks to evaluate how TCM influences clinical outcomes by examining changes in the Clinical Dementia Rating (CDR) and Mini-Mental State Examination (MMSE) scores, as well as its effect on medical expenses over a two-year period. Data from a multi-center research database spanning from 2004 to 2021 will be used to achieve these objectives, addressing the current gap in empirical data concerning intuitive outcomes and cognitive function assessments. Methods: Propensity score matching was adopted to improve comparability among the intervention and control groups. Due to repeated dependent variable measurements, the generalized estimating equation was used to control for socio-demographic characteristics, regional characteristics, and Western medicine treatments for dementia. Results: After propensity score matching, a total of 441 research subjects were included: 90 in the TCM intervention group and 351 in the non-TCM intervention group. The results of multivariate regression analysis showed that compared with the non-TCM intervention group, the MMSE scores in the TCM intervention group increased by 0.608 points each year. The annual change in CDR scores in the TCM intervention group was 0.702 times that of the non-TCM utilization group. After TCM intervention, annual outpatient expenses increased by US$492.2, hospitalization expenses increased by US$324.3, and total medical expenses increased by US$815.9, compared with the non-intervention group. Conclusions: TCM interventions significantly decelerate cognitive decline in dementia patients, evidenced by slower reductions in MMSE scores and mitigated increases in CDR scores. However, these benefits are accompanied by increased medical expenses, particularly for outpatient care. Future healthcare strategies should balance the cognitive benefits of TCM with its economic impact, advocating for its inclusion in dementia care protocols. [ABSTRACT FROM AUTHOR]

We investigated 2 acute cases and 1 previous case of Seoul hantavirus infection in workers in a feeder rodent breeding farm in Taiwan. Prevalence of hantavirus IgG among the tested feeder rats was 37.5%. Appropriate prevention measures, including using disinfection protocols and personal protective equipment, are crucial to lowering risk.

Abstract This study aims to estimate the familial risks of pterygium and assess its relative contributions to environmental and genetic factors using the 2000–2017 Taiwan National Health Insurance Research Database. The marginal Cox's model and the polygenic liability model were made. In Taiwan, the prevalence rate of pterygium in 2017 was 1.64% for individuals with affected first-degree relatives, higher than the general population (1.34%). The adjusted relative risk (RR) for pterygium was highest for twins of the same sex (15.54), followed by siblings of the same sex (4.69), offsprings (3.39), siblings of the different sex (2.88), spouse (2.12), parents (1.86), twins of the different sex (1.57), respectively. The phenotypic variance of pterygium was 21.6% from additive genetic variance, 24.3% from common environmental factors shared by family members, and 54.1% from non-shared environmental factors, respectively. Sensitivity analysis by restricting those with surgical pterygium reveals that aRRs and the three components were similar to those of the overall pterygium. In summary, the prevalence rate of pterygium was higher for individuals with affected first-degree relatives than for the general population. The non-shared environmental factors account for half of the phenotypic variance of pterygium; genetic and shared environmental factors explain the rest.

Ulcerative colitis (UC) is a chronic inflammation of the gastrointestinal tract and is characterized by alternating periods of inflammation and remission. Although UC incidence is lower in Taiwan than in Western countries, its impact remains considerable, demanding updated guidelines for addressing local healthcare challenges and patient needs. The revised guidelines employ international standards and recent research, emphasizing practical implementation within the Taiwanese healthcare system. Since the inception of the guidelines in 2017, the Taiwan Society of Inflammatory Bowel Disease has acknowledged the need for ongoing revisions to incorporate emerging therapeutic options and evolving disease management practices. This updated guideline aims to align UC management with local contexts, ensuring comprehensive and context-specific recommendations, thereby raising the standard of care for UC patients in Taiwan. By adapting and optimizing international protocols for local relevance, these efforts seek to enhance health outcomes for patients with UC.

Crohn’s disease (CD) is a chronic, fluctuating inflammatory condition that primarily affects the gastrointestinal tract. Although the incidence of CD in Taiwan is lower than that in Western countries, the severity of CD presentation appears to be similar between Asia and the West. This observation indicates the urgency for devising revised guidelines tailored to the unique reimbursement system, and patient requirements in Taiwan. The core objectives of these updated guidelines include the updated treatment choices and the integration of the treat-to-target strategy into CD management, promoting the achievement of deep remission to mitigate complications and enhance the overall quality of life. Given the diversity in disease prevalence, severity, insurance policies, and access to medical treatments in Taiwan, a customized approach is imperative for formulating these guidelines. Such tailored strategies ensure that international standards are not only adapted but also optimized to local contexts. Since the inception of its initial guidelines in 2017, the Taiwan Society of Inflammatory Bowel Disease (TSIBD) has acknowledged the importance of continuous revisions for incorporating new therapeutic options and evolving disease management practices. The latest update leverages international standards and recent research findings focused on practical implementation within the Taiwanese healthcare system.

Hematopoietic stem cell transplantation (HSCT) can cure malignant and nonmalignant hematological disorders. From 1983 to 2022, Taiwan performed more than 10,000 HSCT transplants. The Taiwan Blood and Marrow Transplantation Registry collects clinical information to gather everyone's experience and promote the advances of HSCT in Taiwan to gather everyone's experience and promote advances of HSCT in Taiwan. Compared with matched sibling donors, transplants from matched unrelated donors exhibited a trend of superior survival. In Taiwan, transplant donors showed remarkable growth from unrelated (24.8%) and haploidentical (10.5%) donors. The number of older patients (17.4%; aged ≥61 years) who underwent transplantation has increased markedly. This review summarizes several significant developments in HSCT treatment in Taiwan. First, the use of Anti-thymocyte globulin (ATG) and intravenous busulfan regimens were important risk factors for predicting hepatic sinusoidal obstruction syndrome. Second, a new, machine learning-based risk prediction scoring system for posttransplantation lymphoproliferative disorder has identified five risk factors: aplastic anemia, partially mismatched related donors, fludarabine use, ATG use, and acute skin graft-versus-host disease. Third, although the incidence of idiopathic pneumonia syndrome was low (1.1%), its mortality rate was high (58.1%). Fourth, difficult-to-treat mantle cell and T-cell lymphomas treated with autologous HSCT during earlier remission had higher survival rates. Fifth, treatment of incurable multiple myeloma with autologous HSCT showed a median progression-free survival and overall survival of 46.5 and 70.4 months, respectively. Sixth, different haploidentical transplantation strategies were compared. Seventh, caution should be taken in administering allogeneic HSCT treatment in older patients with myeloid leukemia with a Charlson Comorbidity Index ≥3 because of a higher risk of nonrelapse mortality.