Job strain and determinants in staff working in institutions for people with intellectual disabilities in Taiwan: A test of the Job Demand-Control-Support model

[[abstract]]Little is known about the job strain of staff working in disability institutions. This study investigated the staff's job strain profile and its determinants which included the worker characteristics and the psychosocial working environments in Taiwan. A cross-sectional study survey was carried out among 1243 workers by means of a self-answered questionnaire. The outcome variable (high-strain job) was evaluated. The explanatory variables were: worker characteristics and the psychosocial working environment evaluated according to Karasek's Job Demand-Control-Support model. The results show that many staff characteristics were correlated with job strain, such as staff's working hours, age, gender, job title, educational level, religion, in-job training, working years in disability institutions and Effort-Reward Imbalance factors. Organization factors, such as geographical, institutional ownership and accreditation performance and size were also correlated with staff's job strain. In multiple a logistic regression model of the job strain, we found that the factors of financial reward (high compare to low, OR = 0.95, 95% CI = 0.928-0.975), extrinsic effort (high compare to low, OR = 1.072, 95% CI = 1.072-1.158), perceived job stress (sometimes stressful compare to no stress, OR = 2.305, 95% CI = 1.161-4.575; very stressful compare to no stress, OR = 3.931, 95% CI = 1.738-8.893) of the staff were significantly correlated to the high jot) strain of the staff. An important focus of future research should be extending the findings to consider the factors to affect the high job strain to improve the well-being for staff working for people with intellectual disability. (C) 2008 Elsevier Ltd. All rights reserved

Physical and mental health status of staff working for people with intellectual disabilities in Taiwan: Measurement with the 36-Item Short-Form (SF-36) health survey

[[abstract]]Little explicit attention has been given to the generic health profile of staff working for people with intellectual disability in institutions. This study aimed to provide a profile of physical and mental health of staff working in disability welfare institutions, and to examine the possible demographic and organizational factors that explain an association with their health. A cross-sectional questionnaire survey was conducted to analyze 1243 staff (76% response rate) working in 24 institutions in Taiwan. The 36-Item Short-Form (SF-36) Taiwan version was used to measure their generic health status. The mean of Physical component scores (PCS) was slightly higher than Mental component scores (MCS) (50.83 vs. 45.12). With regard to each dimension among PCS, the mean score of Physical functioning (PF) was 57.14 (S.D. = 5.93), Role limitations-physical (RP) was 49.88 (S.D. = 9.69), Bodily pain (BP) was 52.14 (S.D. = 8.09) and General medical health (GH) was 51.50 (S.D. = 8.28). Among the MCS, Vitality (VT) was 46.19 (S.D. = 6.71); Social functioning (SF) was 46.44 (S.D. = 7.58); Role limitations-emotional (RE) was 47.30 (S.D. = 11.89) and Mental health (MH) was 43.58 (S.D. = 8.81). We found the generic health of staff working for people with intellectual disabilities were significantly lower in PCS and MCS than the Taiwan general population. Influences of staffs demographic and organizational characteristics on their health were also analyzed in the content. This study highlights the authorities and service providers need to continue to develop their awareness and understanding of the experiences that their staff encounters in the organizations, so that they can receive resources to support their positive health in working for people with intellectual disabilities. (C) 2008 Elsevier Ltd. All rights reserved

Roles of General Practitioners in the Provision of Health Care Services for People with Intellectual Disabilities: A National Census in Taiwan

[[abstract]]Aims The aims of the present study were to explore the perceptions of general practitioners (GPs) in the provision of health care services for people with intellectual disabilities and to analyse GPs' priorities in the delivery of health care services to this group of people in Taiwan. Methods The study employed a cross-sectional design and was conducted by a census method, the aim being to collect information from all GPs in Taiwan. A questionnaire was mailed out, between 10 April 2006 and 16 June 2006, and the responses provided by 331 GPs (response rate = 16) were included in the analysis. Results The results showed that most of the respondents did not have sufficient experience to deal with patients with intellectual disabilities and lacked adequate knowledge about intellectual disabilities. Indeed, respondents expressed the need for on-the-job training in the field of intellectual disabilities and generally agreed that their role in providing health care services for people with intellectual disabilities was important. However, they were generally not satisfied with the achievements of their role on health care issues. The study highlighted that many issues need to be prioritized for people with intellectual disabilities in relation to policy planning at different health care stages (primary, secondary and tertiary health care). The results also revealed that those senior GPs with considerable experience in treating people with intellectual disabilities were more likely satisfied with their role in providing health care for this group of people. Conclusions It is concluded that Taiwanese health and welfare authorities need to focus more carefully on issues concerning deficiencies in the training of GPs, and to employ appropriate strategies to address health care issues raised in the present study so as to improve the quality of care for people with intellectual disabilities

Serum uric acid, hyperuricemia and body mass index in children and adolescents with intellectual disabilities

[[abstract]]The aims of the preset study were to describe the profile of serum uric acid, the prevalence of hyperuricemia and its risk factors among children and adolescents with intellectual disabilities. We conducted a cross-sectional study of 941 children and adolescents with intellectual disabilities (aged 4-18 years) who participated in annual health examinations in three special schools in Taiwan. This study indicated 30.6% boys and 17.9% girls with intellectual disabilities were with hyperuricemia in Taiwan. The factors of gender, age and BMI were variables that can significantly predict the hyperuricemia occurrence in this vulnerable population. Those children and adolescents with intellectual disabilities were boys (OR = 2.93, 95% CI = 2.02-4.26) and older age (OR = 6.49, 95% CI = 2.19-19.21) were more likely to be hyperuricemia. With regard to BMI to hyperuricemia occurrence, those children and adolescents with intellectual disabilities were overweight (OR = 1.16-3.21, 95% CI = 1.16-3.21) and being obese (OR = 4.95-11.58, 95% CI = 4.95-11.58) was more likely to have a hyperuricemia than the normal weight group. This study provides the general profile of serum uric acid, hyperuricemia and its risk factors of children and adolescents with intellectual disabilities. Medical professionals should be highly alert to the possible consequences of hyperuricemia and provide useful information about the clinical manifestation of this condition for caregivers of children and adolescents with intellectual disabilities. (C) 2009 Elsevier Ltd. All rights reserved

Quality of life in caregivers of children and adolescents with intellectual disabilities: Use of WHOQOL-BREF survey

[[abstract]]The present study based on World Health Organization quality of life (WHOQOL-BREF) scale to examine quality of life of the caregivers caring for their children/adolescents with intellectual disabilities in Taiwan, and the factors contributing to their quality of life. Structured interviews were conducted with 597 caregivers of children/adolescents with intellectual disabilities. The results found that the mean scores in each domain of WHOQOL-BREF of the caregivers as the followings: physical capacity (PC) was 13.71 +/- 2.35, psychological well-being (PW) was 12.21 +/- 2.55, social relationship (SR) was 12.99 +/- 2.43 and environment (EN) was 12.32 +/- 2.38. These mean scores were lower than the general population and slight higher than the caregivers of adults with intellectual disabilities in Taiwan. Finally, multiple stepwise regressions were conducted to examine the characteristics of caregiver and children/adolescents with intellectual disabilities will more likely explained the WHOQOL-BREF mean scores. The study found the following three factors: self-perceived health status, household income and stress from insufficient family support were significantly correlated to all four domains in multiple stepwise regression analyses. The results highlights that caregivers; of children and adolescents with intellectual disabilities seem to display a lower WHOQOL-BREF mean score than the general population. probably for a combination of stress, health and household income factors. These finding must be taken into account in policy making to provide better and more specific supports and interventions for the caregivers of people with intellectual disabilities. (C) 2009 Elsevier Ltd. All rights reserved

Caregiver awareness of reproductive health issues for women with intellectual disabilities

<p>Abstract</p> <p>Background</p> <p>Limited attention has been paid to the issue of reproductive health as it affects women with intellectual disabilities, despite reproductive health being a vital issue in public health policy for women in the general population. This paper describes caregiver awareness of reproductive health issues relative to women with intellectual disabilities who are being cared for in welfare institutions in Taiwan.</p> <p>Methods</p> <p>The study employed a cross-sectional, questionnaire-based study which recruited 1,152 caregivers (response rate = 71.87%) from 32 registered disability welfare institutions in Taiwan. We classified their understanding/awareness of reproductive health issues into four domains: menstrual (1) and menopause (2) issues, sex education (3), and reproductive health services (4). Each domain had five associated yes/no questions and the total score for the four domains was out of a maximum of 20. Data were analyzed using SPSS 15.0 software.</p> <p>Results</p> <p>We found that most of the caregivers were familiar with matters concerning sex education, menopause, and reproductive health services, but they lacked adequate understanding of issues associated with menstruation in women with ID. Many aspects of reproductive health such as "menstrual pain", "age at menarche", "masturbation", "diet during perimenopause", and "publicly available reproductive health services" were issues in which caregivers lacked adequate knowledge and required further instruction. Logistic regression analysis revealed that female caregivers with a university degree, and those who had experience assisting with reproductive health care were more inclined to have higher reproductive health awareness scores than their counterparts.</p> <p>Conclusions</p> <p>This study highlights that service providers should offer appropriate reproductive health education to institutional caregivers, and that more attention be focused on the personal experiences and concerns of intellectually disabled women in future research.</p

Disparities and risks of sexually transmissible infections among men who have sex with men in China: a meta-analysis and data synthesis.

BACKGROUND: Sexually transmitted infections (STIs), including Hepatitis B and C virus, are emerging public health risks in China, especially among men who have sex with men (MSM). This study aims to assess the magnitude and risks of STIs among Chinese MSM. METHODS: Chinese and English peer-reviewed articles were searched in five electronic databases from January 2000 to February 2013. Pooled prevalence estimates for each STI infection were calculated using meta-analysis. Infection risks of STIs in MSM, HIV-positive MSM and male sex workers (MSW) were obtained. This review followed the PRISMA guidelines and was registered in PROSPERO. RESULTS: Eighty-eight articles (11 in English and 77 in Chinese) investigating 35,203 MSM in 28 provinces were included in this review. The prevalence levels of STIs among MSM were 6.3% (95% CI: 3.5-11.0%) for chlamydia, 1.5% (0.7-2.9%) for genital wart, 1.9% (1.3-2.7%) for gonorrhoea, 8.9% (7.8-10.2%) for hepatitis B (HBV), 1.2% (1.0-1.6%) for hepatitis C (HCV), 66.3% (57.4-74.1%) for human papillomavirus (HPV), 10.6% (6.2-17.6%) for herpes simplex virus (HSV-2) and 4.3% (3.2-5.8%) for Ureaplasma urealyticum. HIV-positive MSM have consistently higher odds of all these infections than the broader MSM population. As a subgroup of MSM, MSW were 2.5 (1.4-4.7), 5.7 (2.7-12.3), and 2.2 (1.4-3.7) times more likely to be infected with chlamydia, gonorrhoea and HCV than the broader MSM population, respectively. CONCLUSION: Prevalence levels of STIs among MSW were significantly higher than the broader MSM population. Co-infection of HIV and STIs were prevalent among Chinese MSM. Integration of HIV and STIs healthcare and surveillance systems is essential in providing effective HIV/STIs preventive measures and treatments. TRIAL REGISTRATION: PROSPERO NO: CRD42013003721

Sequence variations in DNA repair gene XPC is associated with lung cancer risk in a Chinese population: a case-control study

<p>Abstract</p> <p>Background</p> <p>The nucleotide excision repair (NER) protein, xeroderma pigmentosum C (XPC), participates in recognizing DNA lesions and initiating DNA repair in response to DNA damage. Because mutations in <it>XPC </it>cause a high risk of cancer in XP patients, we hypothesized that inherited sequence variations in <it>XPC </it>may alter DNA repair and thus susceptibility to cancer.</p> <p>Methods</p> <p>In this hospital-based case-control study, we investigated five <it>XPC </it>tagging, common single nucleotide polymorphisms (tagging SNPs) in 1,010 patients with newly diagnosed lung cancer and 1,011 matched cancer free controls in a Chinese population.</p> <p>Results</p> <p>In individual tagging SNP analysis, we found that rs3731055<it>AG+AA </it>variant genotypes were associated with a significantly decreased risk of lung adenocarcinoma [adjusted odds ratio (OR), 0.71; 95% confidence interval (CI), 0.56–0.90] but an increased risk of small cell carcinomas [adjusted OR, 1.79; 95% CI, 1.05–3.07]. Furthermore, we found that haplotype <it>ACCCA </it>was associated with a decreased risk of lung adenocarcinoma [OR, 0.78; 95% CI, 0.62–0.97] but an increased risk of small cell carcinomas [OR, 1.68; 95% CI, 1.04–2.71], which reflected the presence of rs3731055<it>A </it>allele in this haplotype. Further stratified analysis revealed that the protective effect of rs3731055<it>AG+AA </it>on risk of lung adenocarcinoma was more evident among young subjects (age ≤ 60) and never smokers.</p> <p>Conclusion</p> <p>These results suggest that inherited sequence variations in <it>XPC </it>may modulate risk of lung cancer, especially lung adenocarcinoma, in Chinese populations. However, these findings need to be verified in larger confirmatory studies with more comprehensively selected tagging SNPs.</p

HIV and Syphilis Co-Infection Increasing among Men Who Have Sex with Men in China: A Systematic Review and Meta-Analysis

BACKGROUND: This study aims to estimate the magnitude and changing trends of HIV, syphilis and HIV-syphilis co-infections among men who have sex with men (MSM) in China during 2003-2008 through a systematic review of published literature. METHODOLOGY/PRINCIPAL FINDINGS: Chinese and English literatures were searched for studies reporting HIV and syphilis prevalence among MSM from 2003 to 2008. The prevalence estimates were summarized and analysed by meta-analyses. Meta-regression was used to identify the potential factors that are associated with high heterogeneities in meta-analysis. Seventy-one eligible articles were selected in this review (17 in English and 54 in Chinese). Nationally, HIV prevalence among MSM increased from 1.3% during 2003-2004 to 2.4% during 2005-2006 and to 4.7% during 2007-2008. Syphilis prevalence increased from 6.8% during 2003-2004 to 10.4% during 2005-2006 and to 13.5% during 2007-2008. HIV-syphilis co-infection increased from 1.4% during 2005-2006 to 2.7% during 2007-2008. Study locations and study period are the two major contributors of heterogeneities of both HIV and syphilis prevalence among Chinese MSM. CONCLUSIONS/SIGNIFICANCE: There have been significant increases in HIV and syphilis prevalence among MSM in China. Scale-up of HIV and syphilis screening and implementation of effective public health intervention programs should target MSM to prevent further spread of HIV and syphilis infection

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente