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Chang-hua, Taiwan

Lu M.-H.,Mennonite Christian Hospital | Lee M.-D.,Graduate Institute of Long Term Care
Cancer Nursing | Year: 2010

Background: Breast cancer is one of the most common types of cancer among women. Older women have differences in physical conditions and culture backgrounds compared with young age, which may influence their experiences in facing the diagnosis and treatment for breast cancer. Objective: The objective of the study was to explore the experiences of older Taiwanese women when they first faced a new diagnosis of breast cancer. Methods: A qualitative design was used. Fourteen women, aged 65 to 91 years, with a new diagnosis of breast cancer were interviewed within a month after they completed the first course of treatment at a cancer hospital in northern Taiwan. Results: Content analysis of the interviews revealed 5 themes: the delay in seeking medical help, the impact caused by the initial diagnosis, facing the threat from cancer and its treatments, the battle against the illness, and living with breast cancer. Conclusion: Participants simultaneously faced physical discomfort, shock, denial, fear, worry, and hopelessness. Fortunately, despite these difficulties, they were encouraged to battle and live with breast cancer through the caring and support of family and by seeking information, searching for alternative therapies, practicing religion, readjusting their attitude to face the illness, getting back to a normal life, and appreciating the lives they have. Implications for practice: It is vital to assist older Taiwanese women to go to the physician earlier when they find something abnormal in their breast. Children, female relatives, and friends have important roles in helping them face the disease and treatment of breast cancer. Copyright © 2010 Lippincott Williams & Wilkins. Source

Yu C.-C.,Mennonite Christian Hospital
Pediatrics and Neonatology | Year: 2010

With rising numbers of extremely premature infants in the neonatal intensive care unit (NICU) who require multiple radiologic examinations for their complex medical conditions, concerns the risk of radiation exposure become a more prevalent issue. The biological effects from cumulative doses of both primary and secondary radiation can be particularly troubling for very premature babies due to their inherent sensitivity to both iatrogenic and environmental insults. Similarly, radiologic studies performed in the NICU pose potentially significant exposure risks to caretakers and to the families of patients often present in the NICU during these examinations. The purpose of this article is to critically review the available literature regarding current exposure rates in the NICU, address the validity of radiation exposure concerns, and suggest areas for improvement. With few exceptions, studies reveal that there were only low doses of radiation derived from any single radiographic examination in standard NICUs and that the radiation dosage used was in compliance with recommendations made by the Commission of European Communities (EC) and International Commission on Radiological Protection (ICRP). However, there were wide variations in the radiation dose per single examination (mean entrance skin doses ranged from 15 to 73.6 μGy) and in the frequency (mean ranged from 3.2 to 31 examinations per infant) of those examinations. Studies also reported low secondary exposure rates from scatter radiation to others present in the NICU during radiographic examinations. Key to limiting unnecessary radiation exposure in the NICU is the employment of proper radiation techniques and safety measures. Thus, adhering to recommendations made by the EC and ICRP can help to reduce the anxiety of patients' families and medical staff regarding their risks from the effects of ionizing radiation in the NICU. © 2010 Taiwan Pediatric Association. Source

Chen Y.-Y.,National Chung Hsing University | Fan Y.-C.,National Chung Hsing University | Tu W.-C.,National Chung Hsing University | Chang R.-Y.,National Dong Hwa University | And 7 more authors.
Emerging Infectious Diseases | Year: 2011

Genotype I of Japanese encephalitis virus first appeared in Taiwan in 2008. Phylogenetic analysis of 37 viruses from pig farms in 2009-2010 classified these viruses into 2 unique subclusters of genotype I viruses and suggested multiple introductions and swift replacement of genotype III by genotype I virus in Taiwan. Source

Fan Y.-C.,National Chung Hsing University | Chen J.-M.,National Chung Hsing University | Chiu H.-C.,National Defense Medical Center and Tri Service General Hospital | Chen Y.-Y.,National Chung Hsing University | And 6 more authors.
PLoS Neglected Tropical Diseases | Year: 2012

Background: Genotype I (GI) Japanese encephalitis virus (JEV) that replaced GIII virus has become the dominant circulating virus in Asia. Currently, all registered live and inactivated JEV vaccines are derived from genotype III viruses. In Taiwan, the compulsory JEV vaccination policy recommends that children receives four doses of formalin-inactivated Nakayama (GIII) JEV vaccine. Methodology/Principal Findings: To evaluate the influence of genotype replacement on the post-vaccination viral neutralizing ability by GIII and GI viruses, the small panel of vaccinated-children serum specimens was assembled, and the reciprocal 50% plaque-reduction neutralizing antibody titers (PRNT50) were measured against Nakayama vaccine strain, CJN GIII human brain isolate and TC2009-1 GI mosquito isolate. The seropositivity rate (PRNT50≥1:10) and geometric mean titers (GMT) against the TC2009-1 virus were the lowest among the three viruses. The protective threshold against the CJN and TC2009-1 viruses could only be achieved when the GMT against Nakayama virus was ≥1:20 or ≥1:80, respectively. Using undiluted vaccinees' sera, the enhancement of JEV infection in K562 cells was observed in some low or non-neutralizing serum specimens. Conclusions/Significance: Our preliminary study has shown that neutralizing antibodies, elicited by the mouse brain-derived and formalin-inactivated JEV Nakayama vaccine among a limited number of vaccinees, have reduced neutralizing capacity against circulating GI virus, but more detailed studies are needed to address the potential impact on the future vaccine policy. Source

Murray M.,Harvard University | Murray M.,Brigham and Womens Hospital | Murray M.,Massachusetts General Hospital | Oxlade O.,McGill University | And 2 more authors.
International Journal of Tuberculosis and Lung Disease | Year: 2011

Mathematical models have facilitated our understanding of infectious diseases dynamics and proved useful tools to compare control scenarios when interventional studies are not feasible or ethical. Here, we summarize evidence linking social, economic and biologic determinants to tuberculosis (TB) and review modeling approaches that have been used to understand their contribution to the epidemic dynamics of TB. Specifically, we find evidence for associations between smoking, indoor air pollution, diabetes mellitus, alcohol, nutritional status, crowding, migration, aging and economic trends, and the occurrence of TB infection and/or disease. We outline some methodological problems inherent to the study of these associations; these include study design issues, reverse causality and misclassification of both exposure and outcomes. We then go on to review two existing approaches to modeling the impact of determinants and the effect of interventions: the population attributable fraction model, which estimates the proportion of the TB burden that would be averted if exposure to a risk factor were eliminated from the population, and deterministic epidemic models that capture transmission dynamics and the indirect effects of interventions. We conclude by defining research priorities in both the study of specific determinants and the development of appropriate models to assess the impact of addressing these determinants. © 2011 The Union. Source

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