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Background: Outpatient clinics in medical centers are the most common location where people seek medical treatment. Because they must provide patients with treatment information in a timely manner, good communication skills are a key competency for outpatient nurses. However, the tools available for communication behavior assessment are general and rarely tailored for outpatient settings. Purpose: The purpose was to develop a communication behavior inventory for outpatient nurses and to examine its reliability and validity. Methods: During phase one, the authors conducted a literature search and synthesis, using the findings to develop the Outpatient Nurses Communication Behavior Inventory. During phase two, two expert validation rounds were conducted to confirm content validity. During phase three, 220 licensed outpatient nurses were recruited from a medical center in northern Taiwan to complete the instrument (December 2018 -- January 2019.) The construct validity and internal consistency of the inventory were evaluated. Results: The literature search and synthesis identified six domains of communication, including connect, introduce, communicate, ask, respond, and exit. A total of 25 items were generated. Following the two expert panel validation rounds, the six domains remained but the inventory items were reduced to 21. Both item-content validity index and scale-level content validity index were 1.0. In phase three, the results of the confirmatory factor analysis retained six factors with a total of 16 items. Model three showed that the inventory demonstrated goodness of fit (χ² = 155.75, p < .001, RMSEA = .06, GFI = .92, AGFI = .87, N NFI = .97, NFI = .95, Model AIC = 253.75). Internal consistency was demonstrated with a Cronbach's α of .89. Conclusion/ Implications for Practice: The Outpatient Nurses Communication Behavior Inventory exhibits good reliability and validity and may be used to assess outpatient nurses' communication behaviors and as a basis for education. The six CICARE (connect, introduce, communicate, ask, respond and exit) domains may be utilized to remind outpatient nurses to demonstrate effective communication consistently, promote outpatient nurses' communication with patients, and improve quality of care. [ABSTRACT FROM AUTHOR]

The black cocoa ant, Dolichoderus thoracicus (Smith), is widely distributed across the Indomalayan region including Taiwan. Until the recent localized outbreaks in central Taiwan, this ant has never been considered as a pest. The current study tested if an introduction of non-native lineage(s) potentially contributes to the ant's sudden outbreaks in Taiwan by analyzing phylogenetic relationships of D. thoracicus in Taiwan and Southeast Asia. Our results showed that all ants were grouped into two major mitochondrial clades (Clade I and II) separated by a p-distance of 0.0414. Clade I is widespread in Taiwan and represented by six haplotypes that are genetically similar to the haplotypes from the Philippines, indicating that these ants are likely a result of range expansion of the Philippine lineage(s). In contrast, ants from central Taiwan harbor a single Clade II haplotype that is predominantly found in the samples collected from the Indochina region. Coupled with the low genetic diversity, Clade II D. thoracicus in Taiwan was most likely introduced from the Indochina region. The possibility is further supported by the fact that most D. thoracicus intercepted at the Taiwanese borders had an Indochina origin. Overall, this study suggests that a non-native lineage is responsible for the recent outbreaks of this ant in Taiwan, highlighting a potential research avenue for future research on the association between the "pest" trait and non-native genetic variant in invaded area. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the long-term effectiveness of the Care & Organize Our Lifestyle (COOL) programme, a self-regulation theory-based mHealth programme, on improving disease knowledge and physical activity in youth with congenital heart disease (CHD). Design: A three-arm parallel-group randomized controlled trial. Methods: A total 143 participants with simple and moderate CHD aged 15-24 years were recruited from June 2016 to February 2018. The 12-month programme compared two active intervention groups to a standard-care control group (n = 47). Participants in one active intervention group (n = 49) were provided with COOL Passport, a mobile healthcare application. Those in the other group (n = 47) were provided with access to the Health Promotion Cloud system and use of game-based interactive platforms along with COOL Passport. Outcomes were the Leuven Knowledge Questionnaire for Congenital Heart Disease and the International Physical Activity Questionnaire--Taiwan Show-Card Version. Results: After 12 months, 103 participants remained; the overall attrition rate was 28%. No significant differences were observed between the groups in any domain of disease knowledge after 6 months or 1 year. Neither active group exhibited significantly greater physical activity intensity than the standard-care control group in any month during the 1 year. Conclusion: The mHealth-tailored intervention of the COOL programme did not improve disease knowledge or physical activity in young adults with CHD. Impact: The application of the COOL Passport and Health Promotion Cloud system and use of game-based interactive platforms must be modified and verified in future studies and may have clinical potential. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory disease. The aim of this study was to evaluate the effects of methotrexate and retinoid on risks for developing cerebrovascular disease among psoriatic patients. A population-based nested case-control study was conducted using the Taiwanese National Health Insurance database. Cox proportional hazards models were adopted. The hazard ratio (HR.) of newly developed cerebrovascular disease was 1.28 (95% confidence interval (CI)=1.162-1.413; p

A review of published literature and practical projects of constructed wetlands (CWs) implemented in Taiwan was conducted to highlight wetland performance in wastewater treatment for various applications. Specific opportunities and limitations as well as problems and recommendations for exploring CW technology in Taiwan were also discussed. During the last decade, the number of CWs in Taiwan increased exponentially. Up to 2006, approximately 82 full-scale CWs have been installed and more than ten systems are in construction. The size of CWs ranged from 60 m2 to 80 ha to receive wastewater flow ranging from 3 to 50,000 m3/day. Warm climates in Taiwan provide great opportunities for successful wetland treatment. However, high population density forces CWs to be built in limited spaces, leading to emphasis on multiple-use values of CWs from the public. Most of the CWs were promoted under practical projects funded by various governmental organizations to develop diverse applications, such as water quality improvement of polluted surface water bodies, wastewater on-site treatment, and reuse in rural areas, campuses, recreational areas, and green architectures, management of aquaculture water and wastewater, tertiary treatment, and miscellaneous applications. The results of water monitoring obtained from several demonstrations show that CWs achieved acceptable wastewater treatment performances in removing major pollutants, including suspended solids, organic matters, nutrients, and indicating microorganisms from wastewater influent. Several issues should be studied further so as to maximize multiple-use benefits of CWs, which include establishment of a multidisciplinary approach to planning and designing of CWs and devising strategies to obtain consistent financial support for sustaining management of well operated wetland systems. [ABSTRACT FROM AUTHOR]

Background: The TFT-LCD (thin film transistor liquid crystal display) industry is rapidly growing in Taiwan and many other countries. A large number of workers, mainly women, are employed in the light-on test process to detect the defects of products. At the light-on test workstation, the operator is generally exposed to low humidity (in the clean room environment), flashing light, and low ambient illumination for long working hours. Many workers complained about eye discomfort, and therefore we conducted a study to evaluate the tear secretion function of light-on test workers of a TFT-LCD company. Methods: We recruited workers engaged in light-on tests in the company during their periodical health examination. In addition to a questionnaire survey of demographic characteristics and ophthalmic symptoms, we evaluated the tear secretion function of both eyes of each participant using the Schirmer's lacrimal basal secretion test with anaesthesia. A participant with one or both eyes yielding abnormal test results was defined as a case of tear secretion dysfunction. Results: During the study period, a total of 371 light-on test workers received the health examination at the clinic of the park, and 52 of them were excluded due to having ophthalmic diseases and other systemic diseases that may affect ophthalmic function. All the remaining 319 qualified workers agreed to participate in this study, and they were all females working by 4-shift rotations. The average age was 24.2 years old (standard deviation [SD] = 3.8), and the average employment duration was 13.6 months (SD = 5.7). Among the 11 ophthalmic symptoms evaluated, eye dryness was the most prevalent (prevalence = 43.3%). In addition, the prevalence of tear secretion dysfunction in at least one eye was 40.1% (128 cases), and contact lens users had an odds ratio of 1.73 (95% confidence interval = 1.02-2.94) in comparison with non-contact lens users. Comparing the Schirmer's test results of those who also participated in the screening in the previous year, we found 40 of the 156 participants (17.2%) with normal test results in the previous year turned abnormal in 2001. In contrast, only 21 of the 76 participants (9.1%) with abnormal test results in the previous year turned normal, and the difference was statistically significant (p = 0.02 for McNemar's test). Conclusion: The prevalence of tear secretion dysfunction in woman workers engaged in light-on tests is high and increases with a one-year duration of employment. The use of contact lens may further increase the risk. [ABSTRACT FROM AUTHOR]

Objectives To assess the quality of life (QoL) in adults with congenital heart disease (ACHD) and to explore the sex-related differences and biopsychosocial determinants in an Asian cohort. Design Prospective cross-sectional clinical study. Setting One tertiary medical centre in Taiwan. Patients and methods The QoL of ACHD (≥20⇔…years) was investigated using the Taiwanese version of the QoL questionnaire designed by the WHO, which assesses four domains of QoL (physical, psychological, social and environmental). Personality, psychological distress and family support were assessed using the Maudsley Personality Inventory, Brief Symptom Rating Scale, and the Family APGAR score, respectively. Results A total of 289 patients (age 33.2±10.6⇔…years; 36% men) were studied. ACHD women had significantly lower QoL scores in the physical and psychological domains compared to the age-matched general population, whereas no differences were observed between ACHD men and the general population. Multivariate analysis showed that female gender was associated with poorer physical QoL; the sex difference in the psychological QoL was mediated by psychological distress. Interaction analysis showed that the effect of family support on the psychological domain of QoL may be different by sex. The determinants of QoL varied between different domains. Extroversion personality trait, psychological distress and family support were common determinants of most domains of QoL. Conclusions In ACHD, female gender was associated with poor physical and psychological QoL. The common denominators for QoL were primarily personality trait, psychological distress and family support, but not disease severity. [ABSTRACT FROM AUTHOR]

Acinetobacter baumannii has emerged recently as a major cause of health care-associated infections due to the extent of its antimicrobial resistance and its propensity to cause large nosocomial outbreaks. Here we report the genome sequence of Acinetobacter baumannii TYTH-1 isolated in Taiwan during 2008. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) and childhood obesity are emerging global health issues. The aim of this study was to identify a simple predictor of NAFLD in children and adolescents. This community-based study was conducted from December 2012 to September 2013 in Taiwan and included 1,222 children between 10 and 19 years of age. After excluding alcohol consumption and hepatic-related lesions, NAFLD was diagnosed according to sonographic criteria. Potential confounding factors (including age, gender, and anthropometric and laboratory data) were tested by logistic regression analysis. The cutoff value was determined using receiver operating characteristic (ROC) curve analysis. In addition to older age, heavier weight, and wider waist, subjects with NAFLD had significantly higher blood pressure, lipid disturbances, and alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratios. The correlation between NAFLD and ALT/AST ratio remained significant even after adjusting for confounders (adjusted odds ratio [OR], 2.19; 95% confidence interval [CI], 1.24-3.87; p = .007). The risk score of having a fatty liver, based on ALT/AST ratio, was greater than 0.981 according to ROC curve analysis (sensitivity, 60.5%; specificity, 80.3%; area under the curve, 0.756; CI, 0.71-0.80; p < .001). Therefore, ALT/AST ratio may represent a powerful index of hepatosteatosis in children and adolescents.