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BACKGROUND: Thyroid cancer incidence has increased globally in recent decades, especially in females, although its trends in Taiwan have not been studied extensively. This study aimed to investigate changes in female incidence and possible causes of thyroid cancer in Taiwan. METHODS: Using the Taiwan Cancer Registry (TCR) Database, age-standardized incidence rates, age-specific incidence rates and birth cohorts were calculated. Correlation between female thyroid cancer incidence and cohort fertility rates were examined. RESULTS: Thyroid cancer incidence increased in Taiwanese female, with age-adjusted rates per 100,000 people increasing from 7.37 during 1995-1999 to 20.53 during 2015-2019; the annual percentage change (APC) was 5.9% (95% CI, 5.3-6.5). Age-specific incidence rates increased with age, with peak rates occurring at younger ages. The APCs in the 50-54 age group were the highest (6.8%, 95% CI, 6.1-7.5). Incidence rates also increased with later birth cohorts. We observed a significant negative correlation between thyroid cancer incidence and fertility rates in the same birth cohort. CONCLUSIONS: We hypothesize that overdiagnosis may be a main reason for the rapidly increasing thyroid cancer incidence in Taiwanese females. Notably, we observed a strong negative correlation between fertility and thyroid cancer incidence. However, our study is limited by the absence of individual-level cancer data in the TCR database. These associations with fertility will be an important subject for future thyroid cancer research.
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PURPOSE: This study aimed to examine determinants of undernutrition among children under 2 years of age. DESIGN AND METHODS: A matched case-control study design was conducted to recruit 300 mothers comprising 100 mothers with an undernourished child (case group) and 200 mothers with a healthy child (control group). Measurements consisted of demographic characteristics of children data, mother's data, household data, mother's knowledge of child undernutrition, mother's knowledge of nutrition, complementary feeding practices, and undernutrition parameters of the children. A conditional logistic regression was used to identify determinants of undernutrition. The risk of undernutrition was estimated by odds ratios (ORs) and 95% confidence intervals (CIs). Statistical significance was defined as any p value of <.05. RESULTS: Findings showed that mother's knowledge of undernutrition (AOR: 0.95; 95% CI: 0.91-0.98), mother's knowledge of nutrition (AOR: 0.90; 95% CI: 0.85-0.96), and mother's knowledge (AOR: 0.78; 95% CI: 0.67-0.91) and behavior of complementary feeding practices (AOR: 0.97; 95% CI: 0.94-0.99) were significant determinants of undernutrition (p < .05). PRACTICE IMPLICATIONS: Mothers with high scores on knowledge of undernutrition, knowledge of nutrition, and knowledge and behaviors of complementary feeding practices would benefit the children under 2 years to reduce the risk of undernutrition. Healthcare professionals (i.e., pediatric nurses and community health nurses) should provide early assessment of knowledge related to undernutrition, nutrition, and complementary feeding practices for mothers with children under 2 years.
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Conocimientos, Actitudes y Práctica en Salud , Desnutrición , Madres , Humanos , Femenino , Estudios de Casos y Controles , Lactante , Masculino , Madres/estadística & datos numéricos , Madres/psicología , Adulto , Desnutrición/epidemiología , Preescolar , Trastornos de la Nutrición del Niño/epidemiología , Factores de Riesgo , Estado NutricionalRESUMEN
BACKGROUND: Evidence regarding the effects of acupuncture on hot flashes in breast cancer survivors is conflicting. Little is known about the intermediate-term effects of acupuncture on hot flashes and other menopause-related symptoms in breast cancer survivors. OBJECTIVE: The objective of this study was to evaluate the short-term and intermediate-term effects of acupuncture on menopause-related symptoms and particularly on hot flashes in breast cancer survivors. METHODS: Electronic databases including EMBASE, PubMed, PsycINFO, Web of Science, CINAHL, Wanfang Data Chinese Database, and China Knowledge Resource Integrated Database from inception until June 15, 2014, were searched. Randomized controlled trials in which acupuncture was compared with sham controls or other interventions according to the reduction of hot flashes or menopause-related symptoms in breast cancer survivors were included. RESULTS: We analyzed 7 studies involving 342 participants. Acupuncture significantly reduced the frequency of hot flashes and severity of menopause-related symptoms (g = -0.23 and -0.36, respectively) immediately after the completion of treatment. In comparison with sham acupuncture, effects of true acupuncture on the frequency and severity of hot flashes were not significantly different. At 1 to 3 months' follow-up, the severity of menopause-related symptoms remained significantly reduced (g = -0.56). CONCLUSION: Acupuncture yielded small-size effects on reducing hot-flash frequency and the severity of menopause-related symptoms. IMPLICATIONS FOR PRACTICE: Acupuncture may be used as a complementary therapy for breast cancer survivors experiencing hot flashes and other menopause-related symptoms; however, whether acupuncture exerts specific treatment effects other than needling or placebo effects needs to be further evaluated.
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Terapia por Acupuntura , Sofocos/prevención & control , Menopausia , Neoplasias de la Mama/terapia , Femenino , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Sobrevivientes/estadística & datos numéricos , Resultado del TratamientoRESUMEN
OBJECTIVES: We aimed to determine the efficacy of an 8-week direct blood pressure (BP) biofeedback training program for prehypertensive or stage I hypertensive patients with a particular focus on the impact of the authenticity of feedback signals on the efficacy of BP regulation. DESIGNS: This study has a randomized, double-blind, parallel-group design. PARTICIPANTS AND METHODS: Fifty-nine individuals with ages from 18 to 64 years and who met the criteria for the diagnosis of prehypertenion or stage 1 hypertension participated in this study. The participants were referrals from physicians or community-dwelling volunteers. No participants had taken antihypertensive medication within the previous 2 months prior to enrollment. The participants were randomly assigned to the biofeedback group (n = 31) trained with real-time BP feedback signals or the control group (n = 28) trained with pseudofeedback signals. The primary outcome measures were systolic BP (SBP) and diastolic BP (DBP). Systolic BP and DBP were assessed at baseline, 1 week after training (week 9), and 8 weeks after training (week 16) in both groups. Only 54 participants had week 16 data. RESULTS: The changes in SBP and DBP from baseline to week 9, from baseline to week 16, and from week 9 to week 16 were not significantly different between the groups (All P > 0.05). Both groups were able to significantly decrease BP after completing the training. A percentage of 45.2% of the participants in the biofeedback group and 63.0% of the participants in the control group lowered their SBP by 5 mm Hg or more at week 9. The SBP-lowering effects were also maintained for at least 8 weeks after the completion of training. CONCLUSIONS: The equivalent magnitude of BP reduction between the 2 study groups suggests that repeated practice in BP self-regulation was more likely responsible for the efficacy of direct BP biofeedback training than was the type of feedback signals.
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Biorretroalimentación Psicológica , Hipertensión/terapia , Autocontrol , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: This meta-analysis aims to evaluate the effects of acupuncture on hot flash frequency and severity, menopause-related symptoms, and quality of life in women in natural menopause. METHODS: We systematically searched PubMed/Medline, PsychINFO, Web of Science, Cochrane Central Register of Controlled Trials, and CINAHL using keywords such as acupuncture, hot flash, menopause-related symptoms, and quality of life. Heterogeneity, moderator analysis, publication bias, and risk of bias associated with the included studies were examined. RESULTS: Of 104 relevant studies, 12 studies with 869 participants met the inclusion criteria and were included in this study. We found that acupuncture significantly reduced the frequency (g = -0.35; 95% CI, -0.5 to -0.21) and severity (g = -0.44; 95% CI, -0.65 to -0.23) of hot flashes. Acupuncture significantly decreased the psychological, somatic, and urogenital subscale scores on the Menopause Rating Scale (g = -1.56, g = -1.39, and g = -0.82, respectively; P < 0.05). Acupuncture improved the vasomotor subscale score on the Menopause-Specific Quality of Life questionnaire (g= -0.46; 95% CI, -0.9 to -0.02). Long-term effects (up to 3 mo) on hot flash frequency and severity (g = -0.53 and g = -0.55, respectively) were found. CONCLUSIONS: This meta-analysis confirms that acupuncture improves hot flash frequency and severity, menopause-related symptoms, and quality of life (in the vasomotor domain) in women experiencing natural menopause.
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Terapia por Acupuntura/estadística & datos numéricos , Sofocos/terapia , Menopausia/psicología , Calidad de Vida , Femenino , Humanos , Menopausia/fisiología , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Encuestas y CuestionariosRESUMEN
BACKGROUND: Menopausal experience differs among women with different cultural and ethnic backgrounds and may impact quality of life. Some women with severe menopausal symptoms seek medical help to alleviate menopause-related symptoms. PURPOSE: This study examined the demographic characteristics and health-related quality of life (HRQOL) of Taiwanese women experiencing menopausal symptoms and examined associations between menopausal symptoms and, respectively, poor HRQOL and healthcare resource utilization. METHODS: This cross-sectional study used data from the 2005 National Health Interview Survey in Taiwan, which used a multistaged stratified systematic sampling scheme. A total of 4,437 women aged 35-64 years were analyzed. We used multivariable logistic regression models to identify variables significantly and independently associated with the presence of menopausal symptoms. We also used the model to assess the odds of poor HRQOL and healthcare resource utilization in women with menopausal symptoms compared with those without. RESULTS: Eight hundred and forty-six women (19.1%) reported experiencing menopausal symptoms. Age, religion, smoking, exercise, and comorbidity were independently associated with the presence of such symptoms. The propensity score-adjusted odds ratio of poor physical HRQOL, poor mental HRQOL, use of outpatient, traditional Chinese medicine and emergency room services, and hospitalization for women with menopausal symptoms were 1.85 (95% CI [1.54, 2.21]), 1.66 (95% CI [1.40, 1.97]), 1.39 (95% CI [1.18, 1.63]), 1.73 (95% CI [1.37, 2.18]), 1.44 (95% CI [1.15, 1.81]), and 1.36 (95% CI [1.02, 1.81]), respectively, compared with those without symptoms. CONCLUSIONS: Nearly one fifth of women aged 35-64 years in Taiwan experience menopausal symptoms. The presence of menopausal symptoms increases the likelihood of poor HRQOL and healthcare resource utilization even after controlling for possible confounders.
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Conocimientos, Actitudes y Práctica en Salud , Recursos en Salud/estadística & datos numéricos , Indicadores de Salud , Menopausia/psicología , Calidad de Vida/psicología , Adulto , Índice de Masa Corporal , Costo de Enfermedad , Estudios Transversales , Terapia de Reemplazo de Estrógeno/psicología , Terapia de Reemplazo de Estrógeno/estadística & datos numéricos , Ejercicio Físico/psicología , Relaciones Familiares , Femenino , Recursos en Salud/economía , Humanos , Modelos Logísticos , Menopausia/fisiología , Persona de Mediana Edad , Paridad , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Embarazo , Religión y Psicología , Factores Socioeconómicos , Encuestas y Cuestionarios , TaiwánRESUMEN
BACKGROUND AND RESEARCH OBJECTIVE: Although it is well established that symptom burden in heart failure (HF) often leads to poor health-related quality of life (QOL), the contributions of quality of sleep and daytime sleepiness to the overall perception and satisfaction with life in the HF population have yet to be determined. We thus tested the hypothesis that quality of sleep and daytime sleepiness are significant predictors of QOL as measured by the World Health Organization Quality of Life-BREF (WHOQOL-BREF) in patients with HF. SUBJECTS AND METHODS: Included were 88 medically stable patients with echocardiographically documented HF. This cross-sectional study used a correlational design, and data were collected using self-report questionnaires including the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), Epworth Sleepiness Scale, and WHOQOL-BREF Taiwan version. Multiple linear regression analyses were used to address the study hypotheses. RESULTS AND CONCLUSIONS: With the exception of the environmental domain (P = .078), poor sleepers had significantly lower scores in physical (P < .001), psychological (P = .001), and social (P = .040) domains of the WHOQOL-BREF. Multivariate regression analysis revealed that age, CPSQI, perceived health status, and comorbidities significantly predicted the physical QOL (adjusted R2 = 0.59, P < .001). For the psychological QOL, only perceived health status and CPSQI score remained in the regression model (adjusted R2 = 0.28, P = .016). For the environmental QOL, perceived health status and Epworth Sleepiness Scale were the only predictors remaining in the model (adjusted R2 = 0.17, P < .001). The findings from this study add support to the evidence that in medically stable persons with HF, poor sleep independently predicts the overall perception and satisfaction with life, in particular, in the physical and psychological domains of QOL, whereas daytime sleepiness independently predicts the environmental QOL.
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Insuficiencia Cardíaca , Calidad de Vida , Sueño , Comorbilidad , Estudios Transversales , Estado de Salud , Insuficiencia Cardíaca/epidemiología , Humanos , Trastornos del Sueño-Vigilia/epidemiologíaRESUMEN
OBJECTIVES: The primary aim of this study was to examine the effect of a home-based deep-breathing training programme on depressive symptoms as compared with a control condition (i.e., weekly telephone support) in patients with coronary heart disease (CHD). DESIGN: This efficacy trial used a randomised controlled, parallel group design. PARTICIPANTS AND METHODS: A total of 62 CHD patients with a Beck Depression Inventory-II (BDI-II) >10 were randomised to receive either home-based deep-breathing training (experimental group, n=28) or weekly telephone support (control group, n=34). Both participants and data assessors were blinded to the study hypothesis. The primary outcome measure was the change in the self-reported depressive symptom severity, measured by the BDI-II. The secondary outcome was the change in the Patient Health Questionnaure-9 (PHQ-9)-assessed depressive symptom severity. Depressive symptoms were assessed at baseline and post-test in both groups. For the experimental group, depressive symptoms were also assessed at the end of the first 2 weeks of training. RESULTS: The post-test BDI-II and PHQ-9 were significantly lower in the experimental group than in the control group (p<0.001 and p<0.001, respectively). The decreases in BDI-II, from baseline, at post-test were significantly greater in the experimental group as compared with the control group (95% confidence interval (CI): -12.554 to -5.408, p<0.001). Similarly, the pre-test-to-post-test change in PHQ-9 scores was significantly greater in the experimental group as compared with the control group (95% CI: -5.59 to -0.092, p=0.007). Examining the changes in BDI-II and PHQ-9 within the experimental group by the repeated-measures analysis of variance (ANOVA) revealed that both measures of depressive symptoms decreased significantly over time (both p<0.001). The percentage of participants with a BDI-II >or=17 decreased over time from 28.6% at baseline, and 17.9% during treatment, to 10.7% post-test. CONCLUSIONS: Home-based deep-breathing training is effective in reducing depressive symptoms as compared with telephone support in patients with CHD.
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Enfermedad Coronaria/psicología , Depresión/terapia , Respiración , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
OBJECTIVE: The purpose of this study was to determine the prevalence rate of prehypertension and to compare the differences in demographic factors, anthropometric measurements, lifestyles and metabolic profiles between normotensive and prehypertensive individuals. DESIGN: Data were based on the Nutrition and Health Survey in Taiwan (NAHSIT), a cross-sectional survey that adopted a multi-stage, stratified clustering sampling scheme. The data collection period was from 1 January 1993 to 31 December 1996. METHODS: This study was a secondary analysis of data previously collected. Data from 1039 men and 1186 women, aged 18-96 years, were analyzed. RESULTS: Approximately 34% of Taiwanese adults had prehypertension. The prevalence rate of prehypertension was higher among men (36%) than women (32%). In univariable logistic analysis, sex, age group, age, waist-hip ratio (WHR) group, body mass index (BMI) group, waist circumference, blood sugar, triglyceride, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), cholesterol/HDL and smoking status were significantly associated with prehypertension status. Multivariable logistic regression revealed that age [odds ratio (OR) = 1.014, 95% confidence interval (CI) = 1.004-1.0249] and BMI (OR = 1.106, 95% CI = 1.051-1.165) were the determinants of prehypertension status in men. For women, age (OR = 1.033, 95% CI = 1.022-1.044), waist circumference (OR = 1.031, 95% CI = 1.012-1.051) and triglyceride (OR = 1.003, 95% CI = 1.000-1.005) were the determinants of prehypertension. CONCLUSIONS: This study underscores the importance of general obesity and central obesity as risk factors for prehypertension in the Taiwanese adult population. These two indices of obesity have different impacts on men and women.