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Lee Y.-C.,National Cheng Kung University | Chan P.-C.,Lin Shin Medical Corporation Lin Shin Hospital | Lin S.-K.,Kaohsiung Armed Forces General Hospital | Chen C.-T.,National Tsing Hua University | And 2 more authors.
Research in Autism Spectrum Disorders | Year: 2016

This study aims to explore the relationships between pretend play and playfulness in children with autism spectrum disorder (ASD), children with developmental delay (DD), and typically developing (TD) children. Twenty children with ASD, 20 children with DD, and 20 TD children aged 3-7 years 11 months entered the play conditions for the assessments of pretend play and playfulness. Data were analyzed using the Pearson correlation coefficient and a regression analysis. Results revealed that the play patterns of the ASD group indicated greater reliance on others to generate novel ideas of how to play. The number of imitated actions and amount of elaborate pretend play were positively associated with the suspension of reality and framing dimensions of playfulness, respectively. In the DD group, pretend play performance was more closely related to the internal locus of control of playfulness. The play patterns for the TD group, as expected, involved more symbolic play and internal control. The results of this study provide further understanding of the relationships between pretend play and playfulness in children with ASD, children with DD, and TD children. Assisting children with ASD to engage in elaborate pretend play through adult facilitation may help improve the framing and suspension of reality dimensions of their playfulness. © 2016 Elsevier Ltd.All rights reserved.


Chi L.-W.,Chung Shan Medical University | Lin S.-C.,Chung Shan Medical University | Chang S.-H.,Lin Shin Medical Corporation Lin Shin Hospital | Wu H.-S.,Asia University, Taiwan
Biological Research for Nursing | Year: 2015

Objective: To investigate the prevalence and patterns of and factors associated with hyperphagic behavior in Taiwanese patients with dementia living at home. Methods: A cross-sectional and correlational design was used. A total of 104 patients with dementia and their primary caregivers were recruited from the geriatric, neurology, and memory clinics of a regional hospital, a medical center and two day-care centers in central Taiwan. The data related to hyperphagic behavior, functional abilities, medical conditions, body weight, and demographic characteristics of patients as well as the demographic characteristics of their primary caregivers were collected between January and May 2013. Results: Based on a strict criterion (a median score of 3 for the hyperphagic subscale), the prevalence of hyperphagia in patients with dementia was 53.8%. Specific hyperphagic patterns exhibited included increased food intake (49% of patients with dementia), hoarding (8.7%), oral exploration (6.8%), and pica (3.9%). Years of education of the patient, the use of antipsychotics in patients, and the age of primary caregivers explained 16.3% of the variance in hyperphagic behavior subscale scores (F = 6.47, p <.001). Conclusions: For the early identification and treatment of hyperphagic behavior in patients with dementia in home care or in clinic services provided by health professionals, specific attention should be paid to the usual eating behaviors of patients with lower levels of education or who are taking antipsychotic medication or those who have a female primary caregiver. © 2014, © The Author(s) 2014.


Kuo H.-T.,Lin Shin Medical Corporation Lin Shin Hospital | Kuo H.-T.,Asia University, Taiwan | Tung J.-H.,Lin Shin Medical Corporation Lin Shin Hospital | Chang T.-C.,Tien Chang Chang General Clinic
Journal of Internal Medicine of Taiwan | Year: 2010

Purple urine bag syndrome is considered to be caused by a biochemical mechanism involving indirubin and indigo in the urine; it occurs among geriatric patients who are living in long-term care centers or under home care. This study retrospectively analyzed purple urine bag phenomenon patients over four years. There were twelve patients, made up of eleven females and one male, and samples were collected from each of these. Five patients were excluded due to another infection process leaving seven patients. Using the standard criteria for symptomatic urinary tract infection, we classified these individuals into three groups. These were, firstly, simple purple urine bag syndrome (3 cases), secondly, those being treated with antibiotics (2 cases) and thirdly, a non-therapy group that was not undergoing antibiotics treatment (2 cases). Antibiotics therapy was defined based on the chart of the attending doctors. The simple purple urine bag syndrome group patients had a mean axillary temperature of 36.8 °C, a mean urine pH of 8.0 and a mean length of hospital stay of 4.67 days. The equivalent information for the therapy group was 38.0 °C, pH 5.5 and 7 days, respectively. Similarly, for the non-therapy group the values were 38.4 °C, pH 8.5 and 9 days, respectively. Based on a symptomatic urinary tract infection and purple urine bag syndrome, patients showing either disturbance in their level of consciousness or acidic urine should be admitted and antibiotic therapy started. Individuals with simple purple urine bag syndrome should be observed carefully and particular care taken with their urinary tract hygiene.


PubMed | Chung Shan Medical University, Asia University, Taiwan and Lin Shin Medical Corporation Lin Shin Hospital
Type: Journal Article | Journal: Biological research for nursing | Year: 2015

To investigate the prevalence and patterns of and factors associated with hyperphagic behavior in Taiwanese patients with dementia living at home.A cross-sectional and correlational design was used. A total of 104 patients with dementia and their primary caregivers were recruited from the geriatric, neurology, and memory clinics of a regional hospital, a medical center and two day-care centers in central Taiwan. The data related to hyperphagic behavior, functional abilities, medical conditions, body weight, and demographic characteristics of patients as well as the demographic characteristics of their primary caregivers were collected between January and May 2013.Based on a strict criterion (a median score of 3 for the hyperphagic subscale), the prevalence of hyperphagia in patients with dementia was 53.8%. Specific hyperphagic patterns exhibited included increased food intake (49% of patients with dementia), hoarding (8.7%), oral exploration (6.8%), and pica (3.9%). Years of education of the patient, the use of antipsychotics in patients, and the age of primary caregivers explained 16.3% of the variance in hyperphagic behavior subscale scores (F = 6.47, p < .001).For the early identification and treatment of hyperphagic behavior in patients with dementia in home care or in clinic services provided by health professionals, specific attention should be paid to the usual eating behaviors of patients with lower levels of education or who are taking antipsychotic medication or those who have a female primary caregiver.


Chien Y.-L.,Taichung Veterans General Hospital | Chien Y.-L.,Lin Shin Medical Corporation Lin Shin Hospital | Huang F.-L.,Taichung Veterans General Hospital | Huang C.-M.,Taichung Veterans General Hospital | Chen P.-Y.,Taichung Veterans General Hospital
Journal of Microbiology, Immunology and Infection | Year: 2016

Background/purpose: Fever of unknown origin (FUO) can be caused by many clinical conditions and remains a diagnostic challenge in clinical practice. The etiology of FUO varies markedly among different age groups, geographic areas, and seasons. A four-stage investigative protocol for FUO is widely applied in clinical practice. The aim of this study was to evaluate the usefulness of this four-stage protocol for identifying the etiology of FUO in children. Methods: We enrolled children younger than 18 years of age who were admitted to the Taichung Veterans General Hospital during the period from January 2006 to December 2014 with FUO persisting for more than 3 weeks. The four-stage FUO investigative guideline was used to evaluate the etiology of fever in all patients enrolled in the study. Results: The etiology of FUO was identified in 79 (84.9%) of the 93 patients enrolled in the study. The most common cause of FUO was infectious disease (37.6%), followed by malignancy (17.2%), miscellaneous disease (16.1%), and collagen vascular disease (14.0%). With respect to the four-stage survey of FUO, 36 of the 79 patients (45.6%) were identified in Stage 3, 28 patients (35.4%) in Stage 2, 13 patients (16.5%) in Stage 4, and only two patients (2.5%) in Stage 1. Conclusion: A well-designed systemic review of the epidemiological information, medical history, physical examination, laboratory analysis, and adequate invasive procedures provide adequate data to identify the most common causes of FUO in children. © 2016.


PubMed | Lin Shin Medical Corporation Lin Shin Hospital and Taichung Veterans General Hospital
Type: | Journal: Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi | Year: 2016

Fever of unknown origin (FUO) can be caused by many clinical conditions and remains a diagnostic challenge in clinical practice. The etiology of FUO varies markedly among different age groups, geographic areas, and seasons. A four-stage investigative protocol for FUO is widely applied in clinical practice. The aim of this study was to evaluate the usefulness of this four-stage protocol for identifying the etiology of FUO in children.We enrolled children younger than 18 years of age who were admitted to the Taichung Veterans General Hospital during the period from January 2006 to December 2014 with FUO persisting for more than 3 weeks. The four-stage FUO investigative guideline was used to evaluate the etiology of fever in all patients enrolled in the study.The etiology of FUO was identified in 79 (84.9%) of the 93 patients enrolled in the study. The most common cause of FUO was infectious disease (37.6%), followed by malignancy (17.2%), miscellaneous disease (16.1%), and collagen vascular disease (14.0%). With respect to the four-stage survey of FUO, 36 of the 79 patients (45.6%) were identified in Stage 3, 28 patients (35.4%) in Stage 2, 13 patients (16.5%) in Stage 4, and only two patients (2.5%) in Stage 1.A well-designed systemic review of the epidemiological information, medical history, physical examination, laboratory analysis, and adequate invasive procedures provide adequate data to identify the most common causes of FUO in children.

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