Factors Associated with Tooth Loss in Postmenopausal Women: A Community-Based Cross-Sectional Study.

Many studies have indicated that menopause affects periodontal health and tooth loss. The possible mechanism might due to several hormonal changes and low bone mineral density (BMD) during the transition period. However, few studies have explored the role of oral hygiene in the number of remaining teeth (NRT) in postmenopausal women (PMW). The aim of this study was to explore the prevalence of and factors associated with NRT less than 20 in PMW. A community-based, cross-sectional study was conducted in coastal Yunlin County, Taiwan. NRT was calculated based on natural and filled teeth. BMD was detected by dual-energy X-ray absorptiometry at the collaborating hospital. Logistic regression analyses were used to identify the factors associated with NRT in rural PMW. Six hundred and ten rural PMW with mean age 65.4 years enrolled in this study. The mean NRT was 17.6 (standard deviation [SD] = 10.4), with 43.9% having <20 and 13.9% edentulous. More than half (65.9%) reported that they seldom brushed their teeth after meals, 79.2% rarely used dental floss, and 80% did not regularly undergo tooth scaling by a dentist. The majority of women had low BMD, including 48.7% with osteopenia and 20.7% with osteoporosis. After adjusting for potentially confounding variables, NRT <20 was associated with infrequent tooth scaling (odds ratio [OR] = 2.78, 95% confidence interval [CI] = 1.70-4.56) and dental floss use (OR = 2.01, 95% CI = 1.24-3.26), but not BMD. A high prevalence of NRT <20 was found among rural PMW, but poor oral hygiene rather than low BMD was the major contributing factor. It is an emerging issue for primary healthcare providers and clinicians to initiate oral hygiene promotion programs for these disadvantaged women.

Prevalence of and factors associated with fewer than 20 remaining teeth in Taiwanese adults with disabilities: a community-based cross-sectional study.

OBJECTIVES: To examine the prevalence of and the factors associated with a number of remaining teeth (NRT) <20 among adults with disabilities. DESIGN: A community-based, cross-sectional descriptive study. SETTING: This study was part of a health promotion programme designed for community-dwelling adults with disabilities. PARTICIPANTS: A total of 549 adults with disabilities, aged 20-80 years, living in the community in Chiayi County in Taiwan. OUTCOME MEASURES: Various parameters, including NRT, oral health behaviours (ie, oral hygiene, dietary habits and substance use), comorbidities, disability classification and capability for performing activities of daily living, were measured. Data were statistically analysed using descriptive statistics and multivariate logistic regression analysis. RESULTS: The mean NRT was 18.1 (SD=10.9); 44.8% of participants had NRT <20 (including 13.7% edentulous participants). Most participants had poor oral hygiene: 83.4% reported seldom using dental floss, 78% did not undergo regular 6-monthly dental check-ups and 77.4% seldom brushed their teeth after meal. After adjusting for potentially confounding variables, the intellectual disability group had a significantly higher risk of an NRT <20 than the physical disability group (OR 2.30, 95% CI 1.30 to 4.08). Additionally, the rare use of dental floss and hypertension significantly increased the possibility of an NRT <20 (OR 1.73-2.12, 95% CI 1.15 to 3.71). CONCLUSIONS: An NRT <20 and edentulism were highly prevalent among adults with disabilities, who displayed poor oral hygiene behaviours. Adults with intellectual disabilities had a greater likelihood of having an NRT <20 than did those with physical disability. In addition to unmodifiable factors, the poor use of dental floss was significantly associated with an NRT <20.

Depression and Its Associated Factors Among Rural Diabetic Residents.

BACKGROUND: Type 2 diabetes is a huge burden both for individuals and society as a whole. Although depression has been negatively associated with ideal glycemic control, little is known about the prevalence of depression or its associated factors among rural Taiwanese adults with Type 2 diabetes mellitus (type2 DM). PURPOSE: The purposes of this study were to investigate the prevalence of depression in rural-dwelling sufferers of type2 DM and to highlight the relationships between their depression status and health promoting behaviors such as physical activity, keeping active in life, sleep sufficiency, and adopting a diabetic diet. METHODS: A cross-sectional, correlational design was used to recruit 696 participants from local healthcare centers in rural areas of Chiayi County, Taiwan. Data were collected from March 30, 2010, to August 30, 2012. The Chinese version of the Geriatric Depression Scale and its associated physiological biomarkers were used as screening tools. Logistic regression was used to identify the factors that were associated with depression status. RESULTS: The prevalence of depression in this study was 16.8%. Factors found to be associated with depression included being female, having a low level of education, receiving reduced family support, having little physical activity, failing to follow a diabetic diet, frequent inactivity, and having insufficient sleep. There were no significant differences in the physiological indicators between the depressive and nondepressive groups. After controlling for confounding factors, a logistic regression model showed that depression status was associated with a lack of sleep (OR = 2.85, p < .001), less frequent exercise (OR = 2.67, p < .001), and frequent inactivity (OR = 2.35, p = .001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: This study showed that the prevalence of depression among adults with type2 DM living in rural areas is relatively high. From the perspective of health promotion, future research should focus on how to improve quality of sleep by enhancing daily physical activity and on investigating the effect of promoting a more active lifestyle among those at risk on depression.

Effects of attributional retraining on writing performance and perceived competence of Taiwanese university nursing students.

BACKGROUND: Attributional retraining (AR) has been applied in various professional fields. The application of AR in nursing education is rarely seen. OBJECTIVES: This study explores the effects of AR on university nursing students' writing performance, perceived competence, and the relationship between writing performance and perceived competence using a blended platform of online and face-to-face approaches. METHODS: A single-group experimental study was used. A total of 187 students participated in this study. The setting was the two-year vocational nursing course in a university. The Scale for Rating Composition Tasks and the Perceived Competence Scale were used before and after the AR intervention. RESULTS: The students' writing performance showed significant improvement after the intervention. AR had effectively influenced the students' perceived competence. The perceived competence of the students interacted with the writing performance improvements after the AR intervention. CONCLUSIONS: The AR intervention suggests an alternative teaching approach that can help enhance students' English writing performance as well as perceived competence. The AR programme may be applied in English language teaching and professional courses.

Applying Technological Pedagogical and Content Knowledge (TPACK) model to develop an online English writing course for nursing students.

BACKGROUND: Learning English as foreign language and computer technology are two crucial skills for nursing students not only for the use in the medical institutions but also for the communication needs following the trend of globalization. Among language skills, writing has long been ignored in the curriculums although it is a core element of language learning. OBJECTIVES: To apply the TPACK (Technological Pedagogical and Content Knowledge) model to design an online English writing course for nursing students, and to explore the effects of the course to the students' learning progress as well as their satisfactions and perceptions. RESEARCH METHODS: A single-group experimental study, utilizing the CEEC (College Entrance Examination Center) writing grading criteria and a self-designed course satisfaction questionnaire, is used. Fifty one nursing students who were in their first/four semesters of the two year vocational pre-registration nursing course in a Taiwan university were selected using convenience sampling. DATA ANALYSIS METHODS: Quantitative data were analyzed using descriptive statistics and repeated measure MANOVA. Qualitative data were analyzed by content analysis. RESULTS: Students' writing competence had been improved significantly in every dimension after the instruction. Only half of the learners preferred online writing compared to the traditional way of writing by hand. Additionally, participants reported that they would prefer to receive feedback from the teacher than peers, yet they did not like the indirect feedback. The teacher perceived the course as meaningful but demanding for both learning and teaching sides. To implement the peer review activities and give feedback on time were two major challenges during the cycles. CONCLUSIONS: The TPACK model suggests a comprehensive and effective teaching approach that can help enhance nursing students' English writing performance. Teachers are advised to consider its implementation when designing their syllabus.

Insufficient early detection of peripheral neurovasculopathy and associated factors in rural diabetes residents of Taiwan: a cross-sectional study.

BACKGROUND: Diabetic peripheral neuropathy (PN) and peripheral vasculopathy (PV) are major causes of foot ulcers in patients with diabetes. The early detection of PN/PV with appropriate health counseling is the best strategy for preventing foot lesions. The objective of this study is to examine the prevalence and associated risk factors of PN/PV among rural community residents with type 2 diabetes mellitus (T2DM). METHODS: This cross-sectional descriptive study was conducted in Taiwan from February to October 2012. Type 2 diabetes mellitus and health promotion scale, Michigan neuropathy screening instrument, and ankle-brachial pressure index values were measured. RESULTS: A total of 404 (55% women) participated in and completed the program. The overall prevalence of PN and PV was 34.5 and 17.1%, respectively. The majority of the participants (90%) did not receive early PN/PV detection by health care providers. After adjustment for the potential confounding factors, multivariate analysis indicated that the factors determining PN/PV were age (P <0.001), living around sea coastal regions (P <0.001), high HbA1C level (P <0.01), and fewer regular health-promoting behaviors (P <0.01). CONCLUSION: There was a high prevalence of PN/PV among rural T2DM residents who received insufficient early detection. The early detection of PN/PV and provision of health education with customized health-promoting behaviors of people with diabetes in the rural community are important issues.

Preparing nursing students to be competent for future professional practice: applying the team-based learning-teaching strategy.

Team-based learning (TBL) has been used for many years in business and science, but little research has focused on its application in nursing education. This quasi-experimental study was to apply the TBL in four nursing courses at a university in Taiwan and to evaluate its effect on students' learning outcomes and behaviors. Adult health nursing, maternal-child nursing, community health nursing, and medical-surgical nursing were the 4 designated courses for this study. Three hundred ninety-nine students in 2-year registered nurse-bachelor of science in nursing, and regular 4-year nursing programs enrolled in the designated courses were contacted. Three hundred eighty-seven students agreed to participate in the data collection. Results showed that the TBL significantly improved the learning behaviors of students in both programs, including class engagement (p < .001) and self-directed learning (p < .001). The group readiness assurance test score was significantly higher than the mean individual readiness assurance test (IRAT) score. The final examination score was significantly higher than the IRAT score, which means that TBL is effective in improving students' academic performance. The study revealed that TBL generally improves students' learning behaviors and academic performance. These learning behaviors are important and beneficial for the students' future professional development. The TBL method can be considered for broader application in nursing education.

[Comparison of P-nitrobenzoic acid and hydroxylamine hydrochloride for the primary screening of mycobacterial species].

OBJECTIVES: To examine the screening methods for mycobacteria recommended by the China Anti-tuberculosis Association, in order to increase laboratory diagnostic accuracy for mycobacterial screening. METHODS: Using P-nitrobenzoic acid (PNB 0.5 g/L) as the control group, and hydroxylamine hydrochloride (HA, in 125, 150 and 175 mg/L concentrations) as the study group, laboratory preserved strains of H37Rv M.tuberculosis, and standard and clinically isolated strains of M.nontuberculosis (NTM) from Guangzhou Chest Hospital were tested for both PNB and HA sensitivity. Differences between groups were analyzed by χ(2) test. RESULTS: Among the 2529 MTB strains, the resistance rate to PNB was 3.0% (76/2529), to HA was 12.2% (308/2529), 4.8% (121/2529), and 0.9% (23/2529), respectively, corresponding to the aforementioned 3 different concentrations of HA. Among the 1766 NTM strains, the sensitive rate to PNB was 8.3% (147/1766), to HA was 0.1% (2/1766), 0.5% (9/1766), and 0.9% (16/1766), respectively, corresponding to the aforementioned 3 different concentrations of HA. There was significant difference (χ(2) = 5.44-83.50, P < 0.05). CONCLUSION: HA at 175 mg/L concentration was the optimal condition for laboratory tuberculosis preliminary screening.

[A study on the drug resistance to p-nitrobenzoic acid in Mycobacterium tuberculosis].

OBJECTIVE: To investigate the resistance of Mycobacterium tuberculosis (MTB) to p-nitrobenzoic acid (PNB), in order to provide the scientific basis for reliable identification of laboratory strains of mycobacterium. METHODS: Strains of mycobacterium grown in PNB media were identified with additional traditional biochemical tests, according to the standard protocols of laboratory diagnostics for tuberculosis by the Chinese Antituberculosis Association. For mycobacteria grown in the PNB media but highly suspected as MTB by traditional biochemical tests, MPB64 monoclonal antibody was used for the differentiation between MTB and non-tuberculosis mycobacteria group (NTM). Minimal inhibitory concentrations (MIC) of PNB was further determined for culture-confirmed MTB, 10 strains of clinically isolated MTB (control), H(37)Rv standard strain, mycobacterium avium standard strain, and 5 strains of clinically isolated NTM. RESULTS: A total of 1114 strains of MTB were confirmed, among which 58 PNB manifested resistance. The rate of resistance was 5.21% (58/1114), with an MIC ranging for 1.0 - 1.5 g/L. The MICs of control MTB and H(37)Rv standard strain were 0.25 - 0.5 g/L and 0.25 g/L, respectively. Both mycobacterium avium standard strain and clinically isolated NTM showed an MIC of > 2.0 g/L. Differences between groups were statistically significant (t = 4.87, 5.09, 6.68, respectively, P < 0.01). CONCLUSION: In order to avoid laboratory misdiagnosis, for primary screening with NTB with PNB culture, the presence of MTB characteristics, including cream-colored broccoli-like colony morphologies, as well as clinical response to first-line anti-tuberculosis medications, despite PNB tolerance, warrants further investigations of traditional biochemical tests, differentiation with MPB64 monoclonal antibodies, or simply by the use of temperature manipulation or drug-sensitivity test results.

[Analysis of the changes in bacterial types and drug sensitivity profiles of mycobacterial strains in Guangzhou over the last twelve years].

OBJECTIVE: To improve evidence-based care in the management of tuberculosis, we retrospectively analyzed the bacterial types and drug sensitivity test results of mycobacteria in Guangzhou over the past twelve years (from July 1998 to March 2010). METHODS: Over these twelve years, a total of 14 095 mycobacterial strains isolated from different samples were subjected to type identification and drug sensitivity tests according to the Standard Protocols of Laboratory Diagnostics for Tuberculosis by the Chinese Antituberculosis Association. Chi-square test was performed for statistical analyses for comparisons between groups. RESULTS: Of 14 095 strains of mycobacteria isolated, 10 844 strains (76.84%) were MTB, and 3251 strains (23.16%) were non-tuberculosis mycobacteria (NTM). Compared with the result of the fourth national survey of tuberculosis epidemiology, which showed 11.1% of NTM, the one of our study was significantly different (χ(2) = 69.79, P < 0.001). Drug sensitivity tests of MTB showed tolerance rates of 28.99% (2729/9413), 21.75% (2047/9413), 17.45% (1643/9413) and 11.53% (1085/9413) against isoniazid, rifampin, streptomycin and ethambutol, respectively. CONCLUSION: An increasing trend was observed in MTB drug tolerance against streptomycin, rifampin and isoniazid, whereas more and more NTM strains were isolated in recent years. These findings are worthy of note for clinicians.