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Background: Most smokers in developing countries begin smoking before age 18, and smoking prevalence is rising among adolescents. School personnel represent a target group for tobacco-control efforts because they interact daily with students, are role models for students, teach about tobacco-use prevention in school curricula, and implement school tobacco-control policies. The prevalence of teenage smoking has been examined in numerous studies, but few have focused on the influence of school personnel and the characteristics of school personnel who enforce school nonsmoking policy. The purpose of this study was to determine the factors associated with junior high school personnel advising students to quit smoking. Methods: School personnel (N = 7129) were recruited by cluster sampling from 60 junior high schools in Taiwan; of these, 5280 voluntarily returned self-administered, anonymous questionnaires (response rate = 74.06%) in 2004. Results: Most personnel (70%) had advised students to quit smoking. School personnel who were older, male, responsible for teaching health, smokers, with positive attitude against tobacco, or with more knowledge of tobacco hazards were more likely to advise students to quit smoking. Personnel with more interest in and access to tobacco-related materials were more likely to advise students to quit smoking. Personnel who had received tobacco-prevention training were 2.41 times more likely to persuade students to quit smoking after adjusting for other factors. However, only half of the participants had ever had access to educational materials about tobacco use, and 8% had ever received training to prevent tobacco use. Conclusions: To reduce youth smoking prevalence, school tobacco-control programs should support tobacco-prevention training for school personnel. (Contains 5 tables.)

Introduction. Unintentional injury remains the leading cause of death in children worldwide. Adequate parental supervision is a crucial strategy for preventing injury. Many factors, such as a large family size, poor socioeconomic status, and the caregiver being a single mother, contribute to unintentional injury in children. In addition, sleep deprivation in caregivers might be associated with injury in children because sleep deprivation causes impaired daytime cognitive function, wake-state instability, and negative moods, thereby impairing caregiver supervision. Therefore, this study determines the association between injury in children and the sleep quality of their primary caregivers. Method. This is a retrospective case–control study on unintentional injury in children aged 0 to 4 years who visited the emergency department (case group) and an age- and sex-matched control group. Sleep quality in caregivers was assessed using the Chinese version of the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was used to evaluate the association between aspects of the PSQI and injury. A propensity score model was used to generate a quasirandomized design. Results. This case-control study recruiting 277 injured and 274 noninjured children was conducted in Taiwan. There was no statistically significant difference in child's age and primary caregiver's age between the injured and noninjured groups. The primary outcome, Pittsburgh sleep quality index, was not significantly different between the two groups. The average scores of sleep duration and habitual sleep efficiency in the control group were higher than those in the case group. However, there was no difference between the two groups after adjusting via a propensity score model, including the following potential confounders, child's age, child's sex, number of previous injury, caregiver mental status, caregiver's sex and caregiver's age, and the number of children living together. Conclusion. Our study was the first to examine the association between injury in children and the sleep quality of their primary caregivers. We observed that no PSQI component significantly affected the risk of injury among children. [ABSTRACT FROM AUTHOR]

Background: Motorcycle full-coverage helmet use may reduce fatalities and head injuries.Methods: This retrospective cohort study extracted injury data from eight level-I trauma centres in Taiwan and performed a questionnaire survey to investigate injuries sustained by motorcyclists for the period between January 2015 and June 2017.Results: As many as 725 patients participated in the questionnaire survey and reported their helmet types or phone use during crashes. The results of multivariate logistic models demonstrated that nonstandard helmet (half or open-face helmet) use was associated with an increased risk of head injuries and more severe injuries (injury severity score ≥ 8). Drunk riding and phone use appeared to be two important risk factors for head injuries and increased injury severity. Anaemia was also found to be a determinant of head injuries."Conclusions: Compared to full-coverage helmets, nonstandard provide less protection against head injuries and increased injury severity among motorcyclists. [ABSTRACT FROM AUTHOR]

The objective of the study was to introduce the methodology and report on cohort description of Taiwan Adolescent to Adult Longitudinal Study (TAALS). TAALS is the first nationwide longitudinal survey among Taiwan adolescents, linked with the National Health Insurance Research Database (NHIRD) to obtain complete medical records of respondents in the future. The TAALS project employed the principle of probability proportional to size (PPS) sampling method. Data were collected by questionnaire from 18 064 school students participating in 2015 formal survey, with good sample representation via a goodness-of-fit test after weighting adjustments. Through expert evaluation and statistics tests, TAALS shows a well nationally representation, validity, and reliability. Results indicate that the vocational school students had poor healthy behavior than other education systems, supporting the hypothesis that different learning environment will develop different health behaviors. TAALS can serve as a foundation for analyzing health trajectories of Taiwan adolescents. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction with the information and materials received by patients undergoing cardiac catheterisation. Background Cardiac catheterisation is one of the most anxiety-provoking invasive procedures for patients. However, informational education using multimedia to inform patients undergoing cardiac catheterisation has not been extensively explored. Design A randomised experimental design with three-cohort prospective comparisons. Methods In total, 123 consecutive patients were randomly assigned to one of three groups: regular education; (group 1), accessibility-enhanced multimedia informational education (group 2) and instructional digital videodisc education (group 3). Anxiety was measured with Spielberger's State Anxiety Inventory, which was administered at four time intervals: before education ( T0), immediately after education ( T1), before cardiac catheterisation ( T2) and one day after cardiac catheterisation ( T3). A satisfaction questionnaire was administrated one day after cardiac catheterisation. Data were collected from May 2009- September 2010 and analysed using descriptive statistics, chi-squared tests, one-way analysis of variance, Scheffe's post hoc test and generalised estimating equations. Results All patients experienced moderate anxiety at T0 to low anxiety at T3. Accessibility-enhanced multimedia informational education patients had significantly lower anxiety levels and felt the most satisfied with the information and materials received compared with patients in groups 1 and 3. A statistically significant difference in anxiety levels was only found at T2 among the three groups ( p = 0·004). Conclusions The findings demonstrate that the accessibility-enhanced multimedia informational education was the most effective informational educational module for informing patients about their upcoming cardiac catheterisation, to reduce anxiety and improve satisfaction with the information and materials received compared with the regular education and instructional digital videodisc education. Relevance to clinical practice As the accessibility-enhanced multimedia informational education reduced patient anxiety and improved satisfaction with the information and materials received, it can be adapted to complement patient education in future regular cardiac care. [ABSTRACT FROM AUTHOR]

Background: Social acceptance of smoking is associated with smoking prevalence. Higher smoking rates and ETS exposure might be considered as important indicators for pro-tobacco social norms or social climate. Among studies indicating the association between youth smoking and adult smoking behaviors, most were from individual-level study designs. Objectives: An ecological study was conducted to determine the role of social climate, i.e., adult smoking behaviors and exposure to environmental tobacco smoke (ETS), on youth smoking behaviors. Methods: Data on the smoking behavior and ETS of 16,688 Taiwanese adults were collected in 2004 by telephone administration of the Taiwan Adult Smoking Survey. Similar data on 22,339 junior high school students were collected in 2004 by school-based administration of the Taiwan Youth Tobacco Survey. City/county-level data were analyzed across 25 counties by descriptive statistics, Pearson's' correlation, and hierarchical multiple regression. Results: In both adult and youth populations, overall or gender-specific smoking prevalence and ETS varied widely across counties/cities. The current youth smoking rate within counties was significantly positively correlated with the current adult smoking prevalence as well as home ETS exposure in adults or youth. For male youth, a 1% increase in the rate of home ETS exposure reported by youth increased the current male youth smoking rate by 0.20% after controlling the female youth smoking rate and home ETS exposure reported by adults (p =0.0197). For female youth, male youth smoking prevalence was the only variable that contributed significantly (Beta=0.46, p <0.001). Conclusions: Community health nurses should develop tobacco-control interventions that are tailored to support smoke-free environments by decreasing the social acceptability of smoking. [Copyright &y& Elsevier]

Abstract: Objectives: Most smokers begin using tobacco in their teens and recent reports indicate that smoking prevalence is climbing among youth in Taiwan. The purpose of this paper was to determine the associated factors of susceptibility of youth smoking by different types of schools. Methods: A total of 4689 junior high students and 3918 senior high students participated in a school-based survey to determine the associated factors of susceptibility of youth smoking through anonymous self-administered questionnaire in 2004–2005. Results: Susceptibility to initiate smoking ranged from 11.3% for junior high to 12.7% for general senior high and 12.4% for vocational senior students. For all/male smoking-susceptible students, more junior high students had one or more parents or best friends who smoked than did general or vocational senior high students. For all/female smoking-susceptible students, significantly more junior high students experienced secondhand smoke in public places than did non-susceptible students. Conclusions: Developing tailored, comprehensive smoking-prevention programs for junior high students should involve establishing tobacco-free households and communities. [Copyright &y& Elsevier]

Abstract: Background: Although there is a significant correlation between the degree of family support and clinical outcome, little research has focused on the effectiveness of family partnership intervention care (FPIC) for patients with poorly controlled type 2 diabetes. Objectives: This study aimed to compare FPIC with conventional care (CC) across a number of outcome measures in patients with poorly controlled type 2 diabetes. Design: The study was performed using a randomized controlled trial design. Participants: Patients with poorly controlled type 2 diabetes who were solely treated with oral antidiabetic agents and had at least two out of three hemoglobin A1C readings equal to or above 7% in the previous 12 months, were randomly assigned to the FPIC group (n =28) and to the CC group (n =28). Methods: Baseline and 6-month follow-up scores were compared using the following outcome measures: (1) hemoglobin A1C, (2) BMI, (3) lipid profile, (4) family supportive behaviours, (5), knowledge of and attitudes toward diabetes, and (6) diabetes self-care behaviours. Descriptive and non-parametric statistics were employed to compare differences in outcome measures between the groups. Results: There were no significant differences in the reduction of hemoglobin A1C levels (p =0.46), lipid profile values (p >0.05), and improvement of diabetes self-care behaviours (p =0.61) between the groups at 6 months post-intervention. However, there were significant differences in the scores of family supportive behaviours (p =0.031) and patients’ knowledge of and attitudes toward diabetes between the groups (p <0.05). Conclusion: These findings support the use of FPIC to enhance family supportive behaviours, and to improve patients’ knowledge of and attitudes toward diabetes. Thus, the study is of value in helping policy decision-makers to develop more effective diabetes control intervention programmes. [Copyright &y& Elsevier]