Academic achievement of twins and singletons in early adulthood: Taiwanese cohort study

Objectives To examine the long term effects of low birth weight on academic achievements in twins and singletons and to determine whether the academic achievement of twins in early adulthood is inferior to that of singletons

Determinants Of Customer-Perceived Service Quality In Senior-Care Industry And Their Relationship To Customer Satisfaction And Behavioral Intentions: Research Findings From Taiwan

The senior-care market has been on the rise in Taiwan, especially in rural areas. Soaring competition among senior-care operators has led to escalating consumer demands on performances, driving the industry to become more customer-oriented. The authors examined the relationship between service quality of senior care and customer satisfaction in rural Taiwan based on Parasuraman, Zeithmal and Berry’s SERVQUAL ten dimensions (i.e., access, communication, competence, courtesy, credibility, reliability, responsiveness, security, tangibles and understanding the customer) and Lee’s food service. Multiple regression was conducted to test the relationships. The statistical results showed that access, courtesy and food service are significantly and positively related to customer satisfaction. This finding, among others, suggests that senior-care operators in rural Taiwan might have overlooked the above mentioned three dimensions as factors leading to customer satisfaction and, ultimately, to a sustainable competitive edge

Sleep Duration and Obesity among Adults Under 65 Years of Age and the Elderly in Taiwan

Background: This study investigated the determinants of obesity in adults younger than 65 years of age and those older than 65 years, focusing on the relationship between sleep duration and obesity after controlling other factors. Methods: The data were obtained from the National Survey on Knowledge, Attitude, and Practice of Health Promotion 2002 in Taiwan. A total of 23,809 participants completed this survey, including 3731 elderly persons (65 years of age and older) and 20,078 adults (between 18 and 64 years of age). A multiple logistic regression model was adopted, and obesity was defined as a binary dependent variable by the criteria of body mass index (BMI) ≥27 kg/m2. Results: A U-shaped correlation between obesity and sleep duration was identified in this study. Adults <65 years who slept for 7 hours/night (males/females: OR=0.74/0.92) and elderly people who slept for 6 hours/night (males/females: OR=0.84/0.77) showed a lower risk of obesity than the control group (5 hours/night). Conclusion: Self-reported habitual sleep duration had a U-shaped relationship with obesity in the two populations. The conflict of interest was that the cut-off point of sleep duration differed by 1 h (< 65-year-old adults: 7 h; elderly: 6 h). To preclude the possible bias introduced by self-reporting, using multiple measurements of sleep parameters is recommended in future research

Association Between Sleep Duration and Health Outcome in Elderly Taiwanese

Background: The aim was to assess the relationship between sleep duration and self-rated health outcome in the elderly Taiwanese. Methods: The data were drawn from the National Survey on Knowledge, Attitude, and Practice of Health Promotion 2002 (HPKAP 2002) in Taiwan. Three thousand seven hundred and thirty-one elderly participants (≧ 65 years of age) completed this survey, including 1955 men (52.4%) and 1776 women (47.6%). The anonymous questionnaire collected information on demographic data, sleep duration, health status, and health behaviors. After adjusting for various risk factors, a multiple logistic regression model was applied to compare the participants sleeping an average of 6 to 8 hours/night with those sleeping ≦ 5 hours and ≧ 9 hours. Results: A U-shaped relationship was found in elderly participants, with both short and long sleep durations and a higher risk of poor health perception (≦ 5 hours/night: OR = 1.13, 95% CI 0.93–1.36; ≧ 9 hours/night: OR = 1.30, 95% CI 1.01–1.75), depression (≦ 5 hours/night: OR = 1.35, 95% CI 1.02–1.86), chronic diseases (especially heart disease and limited activity), and unhealthy habits (≧ 9 hours/night: smoking – OR = 1.24, 95% CI 1.02–1.46; no exercise – OR = 1.52, 95% CI 1.17–1.97). Conclusion: A U-shaped relationship was observed between the self-reported sleep duration with risk prevalence and health outcome in the elderly population, although not all results showed a significant difference. A progressively higher change was observed during short and long sleep durations in our study

Association of Education, Health Behaviors, Concerns, and Knowledge with Metabolic Syndrome among Urban Elderly in One Medical Center in Taiwan

Background: The purpose of this study is to examine the relationship of education, health behaviors, concerns, and knowledge with metabolic syndrome (MetS) among urban elderly living in northern Taiwan. Methods: A total of 1181 participants (405 men, 34.3%; 766 women, 65.7%) were surveyed. MetS was defined using the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). An empirical model consisting of education, health behaviors, concerns, knowledge, and MetS was estimated. Results: A total of 34.4 percent of the respondents (405 persons) met the criteria for MetS. High education level was associated with reduced odds of MetS [senior high school: odds ratio (OR) = 0.50, 95% confidence interval (CI), 0.28–0.88; college: OR = 0.45, 95% CI, 0.25–0.85)]. The health behaviors of regularly monitoring waist circumference and blood pressure were associated with reduced odds of MetS (OR = 0.58, 95% CI, 0.51–0.64; OR = 0.61, 95% CI, 0.41–0.89). When the total health knowledge score was higher, the odds of MetS were lower (OR = 0.98, 95% CI, 0.97–0.99). It was found that each additional point on a scale of hypertension and diabetes knowledge was associated with 7% and 8% reductions of the MetS odds, respectively. Conclusions: This study demonstrated that high education level influences the odds of MetS. The development of health education programs that can enhance prevention and self-monitoring for MetS by providing the knowledge and behaviors is appropriate for an elderly population living in Taiwan

Gender-specific Correlations of Insomnia and Attitudes toward Treatment among Community-dwelling Elderly in Northern Taiwan

Summary: Background: This is the first study to examine gender-specific correlations and attitudes toward treatment among community-dwelling elderly individuals with insomnia in northern Taiwan. Methods: A cross-sectional survey was conducted among 1358 adults aged ≥65 years who underwent a senior citizen health examination between March and November 2009 at a medical center. Results: The overall prevalence of insomnia was 41.4%, with a higher rate in women (63.3%) than in men (36.7%). Difficulty falling asleep was the most commonly reported symptom (61.7%). About 60% of the elderly individuals had insomnia for longer than 1 year. In women, gender was an independent correlation. Higher scores on the 5-item Brief Symptom Rating Scale were associated with insomnia in both genders (odds ratio [OR] = 1.41–1.44, 95% confidence interval [CI]: 1.31–1.57). The use of medication for a chronic illness increased the correlation of insomnia in women (OR = 1.9, 95% CI: 1.39–2.59), and living with family decreased the correlation of insomnia in men (OR = 0.42, 95% CI: 0.21–0.82). Further, 47.9% of individuals reported using insomnia medication. Of those, 49.3% and 82.3% with untreated insomnia desired complementary/alternative medicine and sleep hygiene as treatments, respectively. Conclusion: Early intervention to halt the progress of sleep disturbance and avoid unnecessary medication use are important. We identified a need for improved attitudes toward sleep hygiene and treatment among elderly Taiwanese individuals. Keywords: elderly, gender, insomnia, correlations, attitudes toward treatmen

Prevalence and risk factors for insomnia in community-dwelling elderly in northern Taiwan

AbstractBackground/PurposeTo determine the prevalence and risk factors for insomnia among community-dwelling elderly in northern Taiwan.Materials and methodsA cross-sectional survey was conducted among 1358 elderly people (601 men, 44.3%; and 757 women, 55.7%) who had received a senior-citizen health examination between March 2009 and November 2009. Responses to a clinical questionnaire on insomnia (Chinese version of the Athens insomnia scale), mental health (brief symptom rating scale), and 14 physical symptoms were measured.ResultsInsomnia syndrome was found in 41% of individuals; it was more common in women than in men (63.3.0% vs. 36.7%). Multivariate models showed that aging [≥80 years old, odds ratio (OR) = 0.67, 95% confidence interval (CI): 0.46–0.93], living with family (OR = 0.51, 95% CI: 0.35–0.76), and perceived good health status (OR = 0.58 and 0.71, p<0.05) were associated with a decreased risk of insomnia. Meanwhile, female gender (OR = 1.70, 95% CI: 1.37–2.12), receipt of medication for chronic diseases (OR = 1.64, 95% CI: 1.29–2.08), high brief symptom rating scale score (1.45, 95% CI: 1.32–1.86), perceived poor health status (OR = 1.92 and 1.80, p<0.05), and total physical symptoms (OR = 1.34, 95% CI: 1.08–1.70) were associated with an increased risk of insomnia.ConclusionThe results indicate that the aging process itself is not responsible for the increased prevalence of insomnia often reported in older people. Instead, physical symptoms, receipt of medication for chronic diseases, mental health status, living status, and perceived level of well-being affected the risk of insomnia

Influence of Prolonged Visual Display Terminal Use on Physical and Mental Conditions among Health Care Workers at Tertiary Hospitals, Taiwan

This study aimed to examine the effects of prolonged VDT working time on physical and mental health disadvantages among health care workers (HCWs) in tertiary hospitals based on their work characteristics, age, and sex. Included in the study were 945 and 1868 participants in the non-doctor/nurse and doctor/nurse groups, respectively. The questionnaire included VDT usage-related information, the Nordic Musculoskeletal Questionnaire (NMQ), computer vision syndrome (CVS), perceived occupational stress, burnout, the Brief Symptom Rating Scale-5 (BSRS-5), and self-rated health (SRH). After adjustment, multiple logistical regression analysis revealed that the two groups showed that the longer the VDT working time, the higher the risk of muscle pain, severe headaches, severe job stress, and self-assessed bad sleep quality. This showed that the condition of the doctor/nurse group was more severe than that of the non-doctor/nurse group. According to the stratified analysis by sex and age, in the group of women under the age of 30, the adjusted odds ratio value of physical and mental conditions increased with longer VDT working time and was statistically significant. The result show that it is important to reduce daily VDT exposure for doctor, nurses, and women under 30

Varicella Seroprevalence in Healthcare Workers at a Medical Center Following Changes in National and Local Hospital Vaccination Policies

Background: Varicella seroprevalence in healthcare workers at a tertiary care hospital in Taiwan was assessed following the inclusion of varicella zoster vaccination in the national vaccination schedule in 2004 and was made a hospital policy in 2008. Methods: Seroprevalence data were extracted from records of pre-employment health check-ups performed between 2008 and 2018 at a single medical center. Staff with complete medical records and anti-varicella zoster virus immunoglobulin G (VZV IgG) titers were included. Sex and age group differences in terms of geometric mean titer (GMT) were compared using analysis of variance and chi-squared tests. The significance of the correlation between age and the anti-VZV IgG titer was tested by linear regression. The odds of significant associations among age, sex, vocation, and the years of national and hospital adoption of vaccination were determined using univariate and multivariate analyses. p &lt; 0.05 was considered statistically significant. Results: Of the 7314 eligible participants, 5625 (76.90%) were women, and the mean patient age was 26.80 ± 8.00 years. The lowest VZV-positivity rates were in 18–20-year-old women (85.16%; GMT, 362.89 mIU/mL) and men (87.59%; GMT, 288.07 mIU/mL). VZV positivity increased with age (p &lt; 0.001). Participants born before 2002 were more likely to be seropositive than those born after 2003 (odds ratio, 2.51 vs. 1.0; p &lt; 0.001). The lowest seropositive rate was found in the nursing staff (88.91%; 95% confidence interval, 87.74%–90.05%). Varicella vaccine boosters have been required at pre-employment health check-ups since 2008 if anti-VZV antibodies were not detectable. A follow-up evaluation found marginal significant differences in the odds ratios of seropositivity after 2007 (p = 0.052), especially in 2008 and 2014 (p &lt; 0.05) after the hospital policy launched. Conclusions: Despite public health efforts, a small number of healthcare workers were inadequately protected, and antibody titers were lower than required to maintain herd immunity. For effective prevention of nosocomial infection, VZV IgG status should be documented for all HCWs, and susceptible HCWs should be vaccinated to avoid outbreaks. Pre-employment screening and vaccination have increased immunity and need to be conducted to ensure protection of vulnerable patients