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Tsai J.C.H.,Cheng Ching General Hospital | Tsai J.C.H.,National Yang Ming University | Chen W.-Y.,Nan Kai University of Technology | Liang Y.-W.,National Taichung Nursing College
Health Policy | Year: 2011

Objectives: To explore the magnitude of nonemergent emergency department visits under the Taiwan National Health Insurance program and to identify significant factors associated with these visits. Methods: A cross-sectional analysis of the 2002 Taiwan National Health Insurance Research Database was used to identify nonemergent emergency department conditions according to the New York University algorithm. The data contained 43,384 visits, of which 83.89% could be classified. Multivariate logistic regression identified individual and contextual factors associated with nonemergent emergency department visits. Results: Nearly 15% of all emergency department visits were nonemergent; an additional 20% were emergent-preventable with primary care. Patients likely to make nonemergent emergency department visits were older, female, categorized as a Taiwan National Health Insurance Category IV beneficiary, and without major illness. Hospital accreditation level, teaching status, and location were associated with an increased likelihood of nonemergent emergency department visits. Conclusion: Understanding the factors leading to nonemergent emergency department visits can assist in evaluating the overall quality of a health care system and help reduce the use of the emergency department for nonemergent conditions. Policy makers desiring cost-effective care should assess emergency department visit rates in light of available resources for specific populations. © 2010 Elsevier Ireland Ltd. Source


Chen H.Y.,National Taichung Nursing College
Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses | Year: 2011

Enhancing self-efficacy, self-perception, and social support can be an effective way for people with spinal cord injury (SCI) to move forward. The purpose of this study was to explore relationships between "moving-forward behavior" and demographic and disease characteristics, self-efficacy, self-perception, and social support among people with SCI. The study was designed as a descriptive-correlation, cross-sectional study. The participants were selected using cluster random sampling (n = 210) through the Spinal Injury Association in Taiwan. A statistically significant relationship was found between moving-forward behavior and age (t = -2.30, p < .05), self-efficacy (gamma = -0.25, p < .01), and self-perception (gamma = -0.39, p < .01). Age (odds ratio [OR] = 0.964, p < .05) and self-perception (OR = 0.824, p < .05) were both significant predictors of moving-forward behavior. Source


Fan H.-J.,Hung Kung University | Lu C.-S.,National Taichung Nursing College | Lee W.-L.W.,Chung Shan Medical University | Chiou M.-R.,Hung Kung University | Chen C.-C.,National Taichung University of Education
Journal of Hazardous Materials | Year: 2011

The Crystal Violet (CV) dye represented one of the major triphenylmethane dyes used in textile-processing and some other industrial processes. Various metals doped titanium dioxide (TiO2) photocatalysts have been studied intensively for the photodegradation of dye in wastewater treatment. In order to understand the mechanistic detail of the metal dosage on the activities enhancement of the TiO2 based photocatalyst, this study investigated the CV photodegradation reactions under UV light irradiation using a Pt modified TiO2 photocatalyst. The results showed that Pt-TiO2 with 5.8% (W/W) Pt dosage yielded optimum photocatalytic activity. Also the effect of pH value on the CV degradation was well assessed for their product distributions. The degradation products and intermediates were separated and characterized by HPLC-ESI-MS and GC-MS techniques. The results indicated that both the N-de-methylation reaction and the oxidative cleavage reaction of conjugated chromophore structure occurred, but with significantly different intermediates distribution implying that Pt doped TiO2 facilitate different degradation pathways compared to the P25-TiO2 system. © 2010. Source


Lin E.-S.,National Taichung Nursing College | Li C.-C.,VaNung University
Journal of Medicinal Plants Research | Year: 2010

Areca is a traditional Chinese medicinal plant used to treat a variety of diseases. The antioxidant capacities of areca flower extracts were evaluated by using superoxide radical scavenging activity and reducing power, total phenolic content and total flavonoid content were also detected. In all the tested models, the areca flower extracts showed their ability to scavenge superoxide radical and reducing power in a does-dependent manner. The distilled water (AFW) extract had higher superoxide radical scavenging activity and reducing power than of distilled water/methanol (AFM) extract. These results indicated that areca flower extracts might be used as a potential source of natural antioxidant agent. © 2010 Academic Journals. Source


Tsai J.C.-H.,Cheng Ching General Hospital | Tsai J.C.-H.,National Yang Ming University | Liang Y.-W.,National Taichung Nursing College | Pearson W.S.,Centers for Disease Control and Prevention
Journal of the Formosan Medical Association | Year: 2010

Background/Purpose: We investigated the factors associated with emergency department (ED) use among patients with non-urgent medical problems, with a focus on convenience and preference to use the ED instead of primary care clinics. Methods: A five-level triage system was adopted by research nurses to decide each patient's triage level and the maximum time to physician interview. Patients who had a maximum time to physician interview of more than 60 minutes were assumed to be non-urgent in this study. Results: More than half of ED visits were considered to be non-urgent. Non-urgent patients were more likely to be unmarried, government employees, visit the ED due to trauma, have a history of chronic illness, and present in the day time or at the weekend. ED visits were also more likely to occur in patients who took less than 15 minutes to reach the ED, chose the ED for its convenience, agreed that they could have chosen another facility for their visit, did not agree that the ED was convenient for receiving medical care. Multivariate logistic regression showed that marital status, time of presentation, time needed to get to the ED, and occupation were associated with non-urgent ED visits. Conclusion: Preference for using EDs for medical care and their convenience might contribute to non-urgent ED visits. A five-level triage system reliably stratified patients with different admission rates and utilization of medical resources, and could be helpful for reserving limited medical resources for more urgent patients. © 2010 Formosan Medical Association & Elsevier. Source

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