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1.
Front Public Health ; 10: 885632, 2022.
Article in English | MEDLINE | ID: covidwho-1933903

ABSTRACT

Taiwan's older population (those over the age of 65) reached ~3.95 million at the end of January 2022, accounting for around 16.9% of the country's total population. It is already an "aged society." With the gradual increase in the older population, the older people tourism market is also getting more and more attention. This article explores how older people tourism was affected by the COVID-19 pandemic (present in Tawian from early 2020), which was a major international public health event. This study adopts quantitative and PCA methods to statistically analyze the changes before and after the pandemic. The study results found that the frequency of tourism decreased after the pandemic: the number was 5.32, a decrease of 0.77, and instances of at least 1 tourist trip decreased by 3.87% after the pandemic. Regarding the reasons for not participating in tourism, during the COVID-19 pandemic, the COVID-19 accounted for a factor of 19.9%. Total travel expenses were NT$2,590, an increase of NT$229.67, and were not affected by the pandemic. We carried out a PCA analysis on tourism spending. The first component was food, accommodation, shopping, and other expenses. The factor loadings were 0.989, 0.931, 0.641 and -0.948, respectively. The second component was entertainment and transportation expenses. The factor loadings were 0.997 and 0.902, respectively. In conclusion, we put forward relevant discussions and suggestions to make tourism for older people healthier and more sustainable.


Subject(s)
COVID-19 , Aged , COVID-19/epidemiology , Humans , Pandemics , Taiwan/epidemiology , Tourism , Travel
2.
Sci Rep ; 12(1): 12053, 2022 Jul 14.
Article in English | MEDLINE | ID: covidwho-1931490

ABSTRACT

Strict and repeated lockdowns have caused public fatigue regarding policy compliance and had a large impact on several countries' economies. We aimed to evaluate the effectiveness of a soft lockdown policy and the strategy of active community screening for controlling COVID-19 in Taiwan. We used village-based daily confirmed COVID-19 statistics in Taipei City and New Taipei City, between May 2, 2021, and July 17, 2021. The temporal Gi* statistic was used to compute the spatiotemporal hotspots. Simple linear regression was used to evaluate the trend of the epidemic, positivity rate from community screening, and mobility changes in COVID-19 cases and incidence before and after a level three alert in both cities. We used a Bayesian hierarchical zero-inflated Poisson model to estimate the daily infection risk. The cities accounted for 11,403 (81.17%) of 14,048 locally confirmed cases. The mean effective reproduction number (Re) surged before the level three alert and peaked on May 16, 2021, the day after the level three alert in Taipei City (Re = 3.66) and New Taipei City (Re = 3.37). Mobility reduction and a lower positive rate were positively associated with a lower number of cases and incidence. In the spatiotemporal view, seven major districts were identified with a radial spreading pattern from one hard-hit district. Villages with a higher inflow degree centrality among people aged ≥ 60 years, having confirmed cases, specific land-use types, and with a higher aging index had higher infection risks than other villages. Early soft lockdown policy and detection of infected patients showed an effective strategy to control COVID-19 in Taiwan.


Subject(s)
COVID-19 , Bayes Theorem , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Humans , Policy , SARS-CoV-2 , Taiwan/epidemiology
3.
Biomed J ; 44(6S1): S8-S14, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1930767

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) is highly contagious, with a potential to cause large nosocomial outbreaks in the hospital setting. We report the advance deployment of comprehensive, multi-level infection control measures in a 3,700-bed large hospital to prevent nosocomial outbreaks of COVID-19 during the pandemic. METHODS: We implemented a series of dynamic infection control policies during the pandemic. A confirmed COVID-19 case was defined by positive real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay. All healthcare worker (HCW) having symptoms or close contact with the confirmed case received the RT-PCR test. RESULTS: A total of 5,722 patients were tested in our hospital from January to May 2020. Twenty-five patients were confirmed COVID-19, including two inpatients. A cluster of 4 HCWs with COVID-19 associated with the 2nd inpatient was identified in the early stage of epidemic. Our enhanced traffic control bundling, mask wearing, hand hygiene and environmental cleaning were reinforced after the outbreak. All other confirmed cases were identified at our outdoor quarantine station or epidemic clinic afterwards, and the results of testing for 146 symptomatic HCWs were all negative. CONCLUSIONS: Integrated teamwork, advance deployment of infection control measures and efficient diagnostic testing and response protected HCW and facilities from large SARS-CoV-2 outbreaks and preserved the capacity and function of the health care system during the pandemic.


Subject(s)
COVID-19 , Cross Infection , COVID-19/epidemiology , Cross Infection/prevention & control , Disease Outbreaks/prevention & control , Hospitals , Humans , Infection Control/methods , Pandemics/prevention & control , SARS-CoV-2 , Taiwan/epidemiology
4.
PLoS One ; 17(6): e0265477, 2022.
Article in English | MEDLINE | ID: covidwho-1910561

ABSTRACT

The COVID-19 data analysis is essential for policymakers to analyze the outbreak and manage the containment. Many approaches based on traditional time series clustering and forecasting methods, such as hierarchical clustering and exponential smoothing, have been proposed to cluster and forecast the COVID-19 data. However, most of these methods do not scale up with the high volume of cases. Moreover, the interactive nature of the application demands further critically complex yet compelling clustering and forecasting techniques. In this paper, we propose a web-based interactive tool to cluster and forecast the available data of Taiwan COVID-19 confirmed infection cases. We apply the Model-based (MOB) tree and domain-relevant attributes to cluster the dataset and display forecasting results using the Ordinary Least Square (OLS) method. In this OLS model, we apply a model produced by the MOB tree to forecast all series in each cluster. Our user-friendly parametric forecasting method is computationally cheap. A web app based on R's Shiny App makes it easier for practitioners to find clustering and forecasting results while choosing different parameters such as domain-relevant attributes. These results could help in determining the spread pattern and be utilized by medical researchers.


Subject(s)
COVID-19 , COVID-19/epidemiology , Cluster Analysis , Forecasting , Humans , Taiwan/epidemiology , Time Factors
5.
PLoS One ; 17(3): e0263688, 2022.
Article in English | MEDLINE | ID: covidwho-1896443

ABSTRACT

BACKGROUND: During the COVID-19 surge in Taiwan, the Far East Memorial Hospital established a system including a centralized quarantine unit and triage admission protocol to facilitate acute care surgical inpatient services, prevent nosocomial COVID-19 infection and maintain the efficiency and quality of health care service during the pandemics. MATERIALS AND METHODS: This retrospective cohort study included patients undergoing acute care surgery. The triage admission protocol was based on rapid antigen tests, Liat® PCR and RT-PCT tests. Type of surgical procedure, patient characteristics, and efficacy indices of the centralized quarantine unit and emergency department (ED) were collected and analyzed before (Phase I: May 11 to July 2, 2021) and after (Phase II: July 3 to July 31, 2021) the system started. RESULTS: A total of 287 patients (105 in Phase I and 182 in Phase II) were enrolled. Nosocomial COVID-19 infection occur in 27 patients in phase I but zero in phase II. More patients received traumatological, orthopedic, and neurologic surgeries in phase II than in phase I. The patients' surgical risk classification, median total hospital stay, intensive care unit (ICU) stay, intraoperative blood loss, operation time, and the number of patients requiring postoperative ICU care were similar in both groups. The duration of ED stay and waiting time for acute care surgery were longer in Phase II (397 vs. 532 minutes, p < 0.0001). The duration of ED stay was positively correlated with the number of surgical patients visiting the ED (median = 66 patients, Spearman's ρ = 0.207) and the occupancy ratio in the centralized quarantine unit on that day (median = 90.63%, Spearman's ρ = 0.191). CONCLUSIONS: The triage admission protocol provided resilient quarantine needs and sustainable acute care surgical services during the COVID-19 pandemic. The efficiency was related to the number of medical staff dedicated to the centralized quarantine unit and number of surgical patients visited in ED.


Subject(s)
COVID-19/epidemiology , Critical Care/methods , Triage/methods , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/virology , Female , Humans , Length of Stay , Male , Middle Aged , Pandemics , Patient Admission/standards , Quarantine , Retrospective Studies , SARS-CoV-2/isolation & purification , Surgical Procedures, Operative , Taiwan/epidemiology , Tertiary Care Centers , Time-to-Treatment , Young Adult
8.
Arch Gerontol Geriatr ; 102: 104746, 2022.
Article in English | MEDLINE | ID: covidwho-1881095

ABSTRACT

BACKGROUND: Care fragmentation in the elderly population prompted the need for integrated health care systems. However, evidence regarding the impact of the integrated care system in Taiwan is unclear. We aimed to conduct a systematic review to evaluate the impact of Taiwan's integrated health care programs on geriatric population. METHODS: We searched bibliographic databases MEDLINE, Embase, Web of Science, and Airiti Library for relevant publications throughout May 2022. Studies investigating the effectiveness of Taiwan's integrated care programs were included. We used the critical appraisal skills programme (CASP) checklist, to assess the risk of bias of included studies. RESULTS: Thirty-four studies, with a total of 838,026 study subjects, were assessed. The systematic review on 11 subthemes (diabetes mellitus, chronic kidney disease, hepatitis C virus, fractures, cancer, dementia, atrial fibrillation, chronic obstructive pulmonary disease, mechanical ventilation, terminal illness, outpatients and community-dwelling patients), demonstrated that the implementation of integrated health care could not only provide benefits on survival, self-care ability, health quality, physical, and functional rehabilitation outcomes, but also significantly reduce medical utilization and expenditures. CONCLUSION: The integrated health care system for multiple morbidities benefits the Taiwanese geriatric population in physical and functional outcomes. The thematic synthesis provides references for future rigorous clinical trials.


Subject(s)
Delivery of Health Care , Health Expenditures , Aged , Humans , Taiwan/epidemiology
9.
Int J Environ Res Public Health ; 19(11)2022 05 29.
Article in English | MEDLINE | ID: covidwho-1869610

ABSTRACT

In Taiwan, firefighters are responsible for transporting confirmed coronavirus cases to hospitals or epidemic prevention hotels. During the epidemic, in order to reduce the chance of cross-infection between the general public and the fire brigade, traditional collective mobilization training was limited. As a solution, this study combines a fire command course (C1) and a VR simulation for training fire station captains (VRST) and then applies the pre- and post-test evaluation approaches and the after-class questionnaire to summarize the learning effectiveness. The results show that, from a total of 244 captains that were trained, the after-training scores are significantly better when compared with the scores before training (p < 0.05, Cohen's d > 0.8). Additionally, the post-test scores collected during the epidemic (n = 158) have no significant difference compared to the ones taken before the outbreak (2019, n = 86) in terms of sizing up, decision making, and safety management. The training results are still improving. The after-class questionnaire showed that most trainees believed that VRST helped to improve their confidence as incident commanders (ICs) (mean = 4.63, top box = 66.98%), with the novice and suburban groups exhibiting more significant improvements in command ability after the training. After the pandemic, VRST can continue as a regular training method for ICs. Because of the intervention of VRST, the differences in the command experience between different IC groups can be compensated for.


Subject(s)
COVID-19 , Firefighters , COVID-19/epidemiology , Computer Simulation , Humans , Pandemics/prevention & control , Taiwan/epidemiology
10.
Front Public Health ; 10: 792946, 2022.
Article in English | MEDLINE | ID: covidwho-1834638

ABSTRACT

This study investigates the nexus of coronavirus disease 2019 (COVID-19) shock, financial flexibility (FF), and firm performance (FP) in Taiwan listed hotel firms. Quantile regression (QR) methods were used to analyze the data from Taiwan Stock Exchange listed hotel firms between 2020 Q1 and 2021 Q2. The results evidence that there is an inversed U-shaped linkage between FF and FP for the hotel industry. Additionally, FF has an inverted U-shaped effect on FP for the asset-light hotel firms for all quantiles except the 50th quantile. In addition, FF also has an inverted U-shaped impact on FP for the asset-heavy hotel firms in the 10th and 90th quantiles. A significant finding in this study is that there is a concave non-linear relationship between FF and FP, consistent with the law of diminishing marginal return. That is, with an increase in FF, the FP is on the rise; when FF exceeds the inflection point level, the FP begins to decline. Thus, a firm must ensure that the FF strategy it adopts must be the most efficient and effective, i.e., it must bring the trade-off between costs and benefits. The empirical results highlight the need for the hotel industry of Taiwan to take the rolling adjustment and optimization of FF after the COVID-19 pandemic for long-term sustainability.


Subject(s)
COVID-19 , COVID-19/epidemiology , Humans , Industry , Pandemics , Taiwan/epidemiology
11.
Inquiry ; 59: 469580221096278, 2022.
Article in English | MEDLINE | ID: covidwho-1832928

ABSTRACT

OBJECTIVE: The COVID-19 pandemic has increased psychological distress among common people and has caused health care providers, such as nurses, to experience tremendous stress. METHODS: This prospective cross-sectional study assessed the psychological impacts on nurses in a community hospital in Taiwan, including major depressive disorder (MDD), posttraumatic stress (PTS), and pessimism. According to transactional theory, coping strategies and personal factors have psychological impacts. We hypothesized that behavioral responses to COVID-19 (problem-focused coping) are more effective in reducing psychological impacts than emotional responses to COVID-19 (emotion-focused coping). Independent variables were the use of behavioral and emotional coping strategies for COVID-19 and 3 personal factors, namely sleep disturbance, physical component summary (PCS-12), and mental component summary (MCS-12) of the 12-Item Short Form Health Survey (SF-12) obtained from the Medical Outcomes Study. Dependent variables comprised 3 psychological impacts, namely MDD, PTS, and pessimism. RESULTS: We determined that behavioral coping strategies had significant negative effects on PTS and pessimism; however, emotional coping strategies had significantly positive effects on PTS and pessimism. Sleep disturbance was significantly associated with increased MDD and pessimism. PCS-12 had a significant negative effect on PTS, whereas MCS-12 was not significantly associated with any of the 3 psychological impacts. CONCLUSIONS: Nurses who adopted protective behavior against COVID-19, such as washing hands, wearing masks, avoiding touching eyes, and mouth, and avoiding personal contact, were associated with less posttraumatic stress and pessimism. Healthcare providers should consider strategies for improving preventive behaviors to help ease their worries and fears concerning COVID-19.


Subject(s)
COVID-19 , Depressive Disorder, Major , Adaptation, Psychological , Cross-Sectional Studies , Humans , Pandemics , Prospective Studies , Surveys and Questionnaires , Taiwan/epidemiology
12.
Int J Environ Res Public Health ; 19(9)2022 04 29.
Article in English | MEDLINE | ID: covidwho-1820255

ABSTRACT

During the 2020 COVID-19 pandemic in Taiwan, 6.5% of Generation Y required medical treatment for emotional and stress-related mental disorders. This study explores the moderating effect of mindfulness training on psychological needs and emotions to propose effective measures to promote the mental health of Generation Y. This study was carried out by questionnaire, using the data of respondents born in 1980-1999, collected in three different periods for quantitative analysis with compassionate mindfulness as the main variable. The results show that the compassionate mindfulness effect on emotion regulation varies greatly among different educational levels. However, it still plays a positive role in the psychological needs of Generation Y. Most members of Generation Y who receive compassionate mindfulness training have fewer basic needs and more interpersonal trust. They pay more attention to individual-oriented self-realization. Compassionate mindfulness has a greater positive moderating effect on the mental health of women aged 30-39 and those who are highly educated. Compassionate mindfulness has a more positive moderating effect on the psychological needs of members of Generation Y who were born more recently. During the COVID-19 pandemic, providing compassionate mindfulness has a significant positive effect on the prevention of mental disorders of Generation Y in Taiwan.


Subject(s)
COVID-19 , Mindfulness , Adult , COVID-19/epidemiology , Emotions , Female , Humans , Pandemics , Taiwan/epidemiology
13.
Int J Qual Health Care ; 34(2)2022 Apr 25.
Article in English | MEDLINE | ID: covidwho-1788505

ABSTRACT

In May 2021, Taiwan experienced its first COVID-19 surge. Up until then, this geopolitically vulnerable nation had contained the pandemic well. The situation seemed dire at the peak of the surge, however, within two months, the crisis had been resolved. Aside from technical measures such as border control and mandated social distancing, other underlying systemic factors- including an accreditation-strengthened and digitalized healthcare system, government resourcefulness, and continuously adaptive strategies- were crucial to Taiwan's success, and have demonstrated the importance of systemic resilience in terms of navigating the pandemic.


Subject(s)
COVID-19 , COVID-19/epidemiology , Government , Humans , Pandemics , SARS-CoV-2 , Taiwan/epidemiology
14.
Sci Rep ; 12(1): 6053, 2022 04 11.
Article in English | MEDLINE | ID: covidwho-1784024

ABSTRACT

Facing the emerging COVID viral variants and the uneven distribution of vaccine worldwide, imported pre-symptomatic COVID-19 cases play a pivotal role in border control strategies. A stochastic disease process and computer simulation experiments with Bayesian underpinning was therefore developed to model pre-symptomatic disease progression during incubation period on which we were based to provide precision strategies for containing the resultant epidemic caused by imported COVID-19 cases. We then applied the proposed model to data on 1051 imported COVID-19 cases among inbound passengers to Taiwan between March 2020 and April 2021. The overall daily rate (per 100,000) of pre-symptomatic COVID-19 cases was estimated as 106 (95% credible interval (CrI): 95-117) in March-June 2020, fell to 37 (95% CrI: 28-47) in July-September 2020 (p < 0.0001), resurged to 141 (95% CrI: 118-164) in October-December 2020 (p < 0.0001), and declined to 90 (95% CrI: 73-108) in January-April 2021 (p = 0.0004). Given the median dwelling time, over 82% cases would progress from pre-symptomatic to symptomatic phase in 5-day quarantine. The time required for quarantine given two real-time polymerase chain reaction (RT-PCR) tests depends on the risk of departing countries, testing and quarantine strategies, and whether the passengers have vaccine jabs. Our proposed four-compartment stochastic process and computer simulation experiments design underpinning Bayesian MCMC algorithm facilitated the development of precision strategies for imported COVID-19 cases.


Subject(s)
COVID-19 , Quarantine , Bayes Theorem , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , Computer Simulation , Humans , SARS-CoV-2 , Taiwan/epidemiology
15.
Int J Environ Res Public Health ; 19(7)2022 04 02.
Article in English | MEDLINE | ID: covidwho-1776214

ABSTRACT

Severe pneumonia with novel pathogens, also called COVID-19, caused a pandemic in Taiwan as well as in the rest of the world in May 2021. Nurses are under great stress when caring for critically ill patients with COVID-19. This study aimed to explore the perceived stress and coping behaviors of nurses caring for critically ill patients with COVID-19 using a mixed-methods approach. We recruited 85 nurses from a special intensive care unit (ICU) of a medical center in Taiwan between May and June 2021. To gather data, we used a questionnaire on basic characteristics, the perceived stress scale (PSS-14), and the brief coping orientation to problems experienced inventory (B-COPE), then conducted a qualitative interview. The results showed that the average perceived stress level among nurses was 25.4 points, and most of them perceived moderate stress. The top three coping behaviors practiced by the nurses were active coping, planning, and acceptance. Nurses who received less perceived support from their friends or families and who had shorter working experience in nursing had significantly higher stress levels. The qualitative results revealed that the nurses' perceived stress came from fear, worry, and the increased burden caused by caring for critical patients with COVID-19. Coping behaviors included rest, seeking support, and affirmative fighting. Based on these findings, it is suggested that the support nurses receive from their families is an important predictor of perceived stress. Therefore, it is suggested that nurses be provided with more support in dealing with stress caused by caring for critical patients with COVID-19 in special ICUs.


Subject(s)
COVID-19 , Adaptation, Psychological , COVID-19/epidemiology , Critical Illness , Humans , Stress, Psychological/epidemiology , Taiwan/epidemiology
16.
Front Public Health ; 10: 849547, 2022.
Article in English | MEDLINE | ID: covidwho-1776064

ABSTRACT

Fatal vehicle crashes (FVCs) are among the leading causes of death worldwide. Professional drivers often drive under dangerous conditions; however, knowledge of the risk factors for FVCs among professional drivers remain scant. We investigated whether professional drivers have a higher risk of FVCs than non-professional drivers and sought to clarify potential risk factors for FVCs among professional drivers. We analyzed nationwide incidence rates of FVCs as preliminary data. Furthermore, by using these data, we created a 1:4 professionals/non-professionals preliminary study to compare with the risk factors between professional and non-professional drivers. In Taiwan, the average crude incidence rate of FVCs for 2003-2016 among professional drivers was 1.09 per 1,000 person-years; professional drivers had a higher percentage of FVCs than non-professional drivers among all motor vehicle crashes. In the 14-year preliminary study with frequency-matched non-professional drivers, the risk of FVCs among professional drivers was significantly associated with a previous history of involvement in motor vehicle crashes (adjustment odds ratio [OR] = 2.157; 95% confidence interval [CI], 1.896-2.453), previous history of benzodiazepine use (adjustment OR = 1.385; 95% CI, 1.215-1.579), and speeding (adjustment OR = 1.009; 95% CI, 1.006-1.013). The findings have value to policymakers seeking to curtail FVCs.


Subject(s)
Accidents, Traffic , Automobile Driving , Accidents, Traffic/mortality , Humans , Incidence , Occupations , Taiwan/epidemiology
17.
Front Public Health ; 10: 726924, 2022.
Article in English | MEDLINE | ID: covidwho-1775963

ABSTRACT

Background: Taiwan faced a surge of COVID-19 infections in May 2021. Because new cases were quickly increasing, parents called for school closures. A national parent group used an online survey to collect opinions about upcoming school closings planned by the Ministry of Education. This study evaluated the results of the survey for all respondents and investigated the level of viral transmission following school closures among students in Taiwan. Methods: An online survey titled "Survey of Opinions of School Closures during the Current COVID-19 Outbreak" (SOSC-COVID-19) was designed by the national parent association and then distributed to members of the community throughout Taiwan via local parent groups from May 17 to 18, 2021. The survey included an open-ended respondents' opinions about school closures. Differences among regions and socioeconomic scores (SES) were analyzed with chi-square tests. Results: A total of 8,703 completed survey forms data were analyzed. Nearly all respondents (7,973, 91.6%) approved of school closures; there were no differences of opinions inside and outside municipalities or by regional SES scores. Only 8.4% of respondents were opposed to any type of school closure, believing parents should decide whether their child attended school, which also did not vary with region or SES score. Qualitative feedback from parent and teacher responders indicated students' health and economic impacts were additional concerns that influenced their choice of whether the government or parents should decide about school closures. On the afternoon of May 18, 2021, the government of Taiwan closed all schools. Although a spike in new cases of COVID-19 occurred among students 10 days after school closures, over the next 40 days new cases declined, falling to zero by July 5th. Conclusions: Despite the inability of nationwide school closures to completely halt transmission of the virus within families during the COVID-19 outbreak, school closures helped to impede transmission between students.


Subject(s)
COVID-19 , COVID-19/epidemiology , Child , Disease Outbreaks , Humans , Schools , Surveys and Questionnaires , Taiwan/epidemiology
18.
J Med Internet Res ; 24(4): e36830, 2022 04 26.
Article in English | MEDLINE | ID: covidwho-1775590

ABSTRACT

BACKGROUND: Vaccination is an important intervention to prevent the incidence and spread of serious diseases. Many factors including information obtained from the internet influence individuals' decisions to vaccinate. Misinformation is a critical issue and can be hard to detect, although it can change people's minds, opinions, and decisions. The impact of misinformation on public health and vaccination hesitancy is well documented, but little research has been conducted on the relationship between the size of the population reached by misinformation and the vaccination decisions made by that population. A number of fact-checking services are available on the web, including the Islander news analysis system, a free web service that provides individuals with real-time judgment on web news. In this study, we used such services to estimate the amount of fake news available and used Google Trends levels to model the spread of fake news. We quantified this relationship using official public data on COVID-19 vaccination in Taiwan. OBJECTIVE: In this study, we aimed to quantify the impact of the magnitude of the propagation of fake news on vaccination decisions. METHODS: We collected public data about COVID-19 infections and vaccination from Taiwan's official website and estimated the popularity of searches using Google Trends. We indirectly collected news from 26 digital media sources, using the news database of the Islander system. This system crawls the internet in real time, analyzes the news, and stores it. The incitement and suspicion scores of the Islander system were used to objectively judge news, and a fake news percentage variable was produced. We used multivariable linear regression, chi-square tests, and the Johnson-Neyman procedure to analyze this relationship, using weekly data. RESULTS: A total of 791,183 news items were obtained over 43 weeks in 2021. There was a significant increase in the proportion of fake news in 11 of the 26 media sources during the public vaccination stage. The regression model revealed a positive adjusted coefficient (ß=0.98, P=.002) of vaccine availability on the following week's vaccination doses, and a negative adjusted coefficient (ß=-3.21, P=.04) of the interaction term on the fake news percentage with the Google Trends level. The Johnson-Neiman plot of the adjusted effect for the interaction term showed that the Google Trends level had a significant negative adjustment effect on vaccination doses for the following week when the proportion of fake news exceeded 39.3%. CONCLUSIONS: There was a significant relationship between the amount of fake news to which the population was exposed and the number of vaccination doses administered. Reducing the amount of fake news and increasing public immunity to misinformation will be critical to maintain public health in the internet age.


Subject(s)
COVID-19 , Social Media , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Disinformation , Humans , Internet , Prevalence , Retrospective Studies , Taiwan/epidemiology , Vaccination
19.
Ophthalmology ; 129(8): 880-889, 2022 08.
Article in English | MEDLINE | ID: covidwho-1763922

ABSTRACT

PURPOSE: Premyopia at a young age carries a great risk of developing early-onset myopia, especially in regions with myopia epidemics, such as the developed areas in East Asia. This study aims to report the prevalence of premyopia and its risk factors in a Taiwan preschool population and lifestyle changes among premyopic preschoolers before and during the Coronavirus Disease 2019 (COVID-19) pandemic. DESIGN: Repeated countywide population-based, cross-sectional study in Yilan County, northeastern Taiwan. PARTICIPANTS: From 2014 to 2020, a total of 23 930 kindergarteners aged 5 to 6 years were identified in the Yilan Myopia Prevention and Vision Improvement Program (YMVIP). Of those, 21 761 (11 335 [52.1%] boys; mean age, 5.15 ± 0.37 years) were included for final analysis. METHODS: Annual kindergarten-based eye examinations and myopia prevention strategies have been conducted since the commencement of the YMVIP in 2014. Refractive error was determined by cycloplegic autorefraction. The data of potential risk factors for myopia were gathered by caregiver-administered questionnaires. MAIN OUTCOME MEASURES: The prevalence of premyopia (spherical equivalent [SE] > -0.5 diopter [D] and ≤ +0.75 D in the eye with less SE value). RESULTS: The prevalence of myopia (SE ≤ -0.5 D), premyopia, and hyperopia (SE > +0.75) was 10.7% (95% confidence interval [CI], 10.3-11.1), 52.0% (95% CI, 51.3-52.7), and 37.3% (95% CI, 36.7-37.9), respectively. Multinomial logistic regression analysis showed that premyopia prevalence was significantly associated with male gender (odds ratio [OR], 1.25; 95% CI, 1.18-1.32), caregiver myopia (OR, 1.46; 95% CI, 1.37-1.56), screen time ≥ 1 hour per weekdays (OR, 1.10; 95% CI, 1.04-1.17), 2-year exposure to myopia prevention strategy (OR, 0.59; 95% CI, 0.54-0.65), and college or higher education level of caregiver (OR, 0.91; 95% CI, 0.85-0.96). Even without large-scale school closure in Taiwan, there was a slight upward trend of increased time spent on screen-based devices during the COVID-19 pandemic. CONCLUSIONS: Our findings showed that premyopia was the most common refractive error in a Taiwan preschool population. Premyopia was also associated with both parental and environmental myopiogenic factors. Longitudinal studies are warranted to examine the lifestyle change and myopic shift of premyopic preschoolers in the postpandemic era.


Subject(s)
COVID-19 , Myopia , Refractive Errors , COVID-19/epidemiology , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Myopia/epidemiology , Pandemics , Prevalence , Refraction, Ocular , Refractive Errors/epidemiology , Risk Factors , Schools , Surveys and Questionnaires , Taiwan/epidemiology
20.
PLoS Negl Trop Dis ; 16(2): e0010134, 2022 02.
Article in English | MEDLINE | ID: covidwho-1753179

ABSTRACT

BACKGROUND: Dengue virus (DENV) infection may be associated with increased risks of major adverse cardiovascular effect (MACE), but a large-scale study evaluating the association between DENV infection and MACEs is still lacking. METHODS AND FINDINGS: All laboratory confirmed dengue cases in Taiwan during 2009 and 2015 were included by CDC notifiable database. The self-controlled case-series design was used to evaluate the association between DENV infection and MACE (including acute myocardial infarction [AMI], heart failure and stroke). The "risk interval" was defined as the first 7 days after the diagnosis of DENV infection and the "control interval" as 1 year before and 1 year after the risk interval. The incidence rate ratio (IRR) and 95% confidence interval (CI) for MACE were estimated by conditional Poisson regression. Finally, the primary outcome of the incidence of MACEs within one year of dengue was observed in 1,247 patients. The IRR of MACEs was 17.9 (95% CI 15.80-20.37) during the first week after the onset of DENV infection observed from 1,244 eligible patients. IRR were significantly higher for hemorrhagic stroke (10.9, 95% CI 6.80-17.49), ischemic stroke (15.56, 95% CI 12.44-19.47), AMI (13.53, 95% CI 10.13-18.06), and heart failure (27.24, 95% CI 22.67-32.73). No increased IRR was observed after day 14. CONCLUSIONS: The risks for MACEs are significantly higher in the immediate time period after dengue infection. Since dengue infection is potentially preventable by early recognition and vaccination, the dengue-associated MACE should be taken into consideration when making public health management policies.


Subject(s)
Dengue/complications , Heart Failure/complications , Myocardial Infarction/complications , Stroke/complications , Adolescent , Adult , Child , Child, Preschool , Dengue/epidemiology , Dengue Virus , Female , Heart Failure/epidemiology , Humans , Incidence , Infant , Male , Middle Aged , Myocardial Infarction/epidemiology , Risk Factors , Stroke/epidemiology , Taiwan/epidemiology
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