Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 61
Filtrar
1.
Clin Exp Dermatol ; 47(1): 121-124, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34236722

RESUMO

Previous studies have demonstrated the heritability of alopecia areata (AA). However, whether the heritability of AA is sex-specific has not been examined. A nationwide population-based retrospective cohort study was performed using the Taiwan Maternal and Child Health Database from 2004 to 2017. We examined the heritability of AA in offspring of parents with and without AA, and determined whether the transmission of AA from parents to the next generation may occur in opposite directions depending on sex. We found that the risk ratio (RR) for heritability of AA between parents with and without AA was approximately two-fold. In addition, for fathers with AA, the risk of AA in offspring tended to be higher in girls than in boys (RR: 2.97; 95% confidence interval: 0.94, 9.31). Therefore, the present study confirms the heritability of AA, and further studies examining the sex-specific heritability of AA with a larger sample are warranted.


Assuntos
Alopecia em Áreas/genética , Adolescente , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores Sexuais , Taiwan
4.
Eur Psychiatry ; 44: 189-197, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28646731

RESUMO

BACKGROUND: Persistent gaming, despite acknowledgment of its negative consequences, is a major criterion for individuals with Internet gaming disorder (IGD). This study evaluated the adaptive decision-making, risky decision, and decision-making style of individuals with IGD. METHODS: We recruited 87 individuals with IGD and 87 without IGD (matched controls). All participants underwent an interview based on the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) diagnostic criteria for IGD and completed an adaptive decision-making task; the Preference for Intuition and Deliberation Scale, Chen Internet Addiction Scale, and Barratt Impulsivity Scale were also assessed on the basis of the information from the diagnostic interviews. RESULTS: The results demonstrated that the participants in both groups tend to make more risky choices in advantage trials where their expected value (EV) was more favorable than those of the riskless choice. The tendency to make a risky choice in advantage trials was stronger among IGD group than that among controls. Participants of both groups made more risky choices in the loss domain, a risky option to loss more versus sure loss option, than they did in the gain domain, a risky option to gain more versus sure gain. Furthermore, the participants with IGD made more risky choices in the gain domain than did the controls. Participants with IGD showed higher and lower preferences for intuitive and deliberative decision-making styles, respectively, than controls and their preferences for intuition and deliberation were positively and negatively associated with IGD severity, respectively. CONCLUSIONS: These results suggested that individuals with IGD have elevated EV sensitivity for decision-making. However, they demonstrated risky preferences in the gain domain and preferred an intuitive rather than deliberative decision-making style. This might explain why they continue Internet gaming despite negative consequences. Thus, therapists should focus more on decision-making styles and promote deliberative thinking processes to mitigate the long-term negative consequences of IGD.


Assuntos
Comportamento Aditivo/diagnóstico , Comportamento Aditivo/psicologia , Comportamento Impulsivo , Assunção de Riscos , Adulto , Tomada de Decisões , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Internet , Masculino , Recompensa , Adulto Jovem
5.
Methods Enzymol ; 582: 297-320, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28062039

RESUMO

Proteins respond to mechanical force by undergoing conformational changes and altering the kinetics of their interactions. However, the biophysical relationship between mechanical force and the lifetime of protein complexes is not completely understood. In this chapter, we provide a step-by-step tutorial on characterizing the force-dependent regulation of protein interactions using in vitro and in vivo single-molecule force clamp measurements with an atomic force microscope (AFM). While we focus on the force-induced dissociation of E-cadherins, a critical cell-cell adhesion protein, the approaches described here can be readily adapted to study other protein complexes. We begin this chapter by providing a brief overview of theoretical models that describe force-dependent kinetics of biomolecular interactions. Next, we present step-by-step methods for measuring the response of single receptor-ligand bonds to tensile force in vitro. Finally, we describe methods for quantifying the mechanical response of single protein complexes on the surface of living cells. We describe general protocols for conducting such measurements, including sample preparation, AFM force clamp measurements, and data analysis. We also highlight critical limitations in current technologies and discuss solutions to these challenges.


Assuntos
Caderinas/química , Microscopia de Força Atômica/métodos , Complexos Multiproteicos/química , Imagem Individual de Molécula/métodos , Caderinas/isolamento & purificação , Adesão Celular/genética , Cinética , Complexos Multiproteicos/isolamento & purificação
6.
Eur Psychiatry ; 27(1): 1-8, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22153731

RESUMO

Internet addiction is a newly emergent disorder. It has been found to be associated with a variety of psychiatric disorders. Information about such coexisting psychiatric disorders is essential to understand the mechanism of Internet addiction. In this review, we have recruited articles mentioning coexisting psychiatric disorders of Internet addiction from the PubMed database as at November 3, 2009. We describe the updated results for such disorders of Internet addiction, which include substance use disorder, attention-deficit hyperactivity disorder, depression, hostility, and social anxiety disorder. We also provide discussion for possible mechanisms accounting for the coexistence of psychiatric disorders and Internet addiction. The review might suggest that combined psychiatric disorders mentioned above should be evaluated and treated to prevent their deteriorating effect on the prognosis of Internet addiction. On the other hand, Internet addiction should be paid more attention to when treating people with these coexisting psychiatric disorders of Internet addiction. Additionally, we also suggest future necessary research directions that could provide further important information for the understanding of this issue.


Assuntos
Comportamento Aditivo/epidemiologia , Internet , Transtornos Mentais/epidemiologia , Adolescente , Agressão/psicologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Comportamento Aditivo/psicologia , Criança , Comorbidade , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Humanos , Transtornos Mentais/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
7.
Poult Sci ; 88(9): 1955-62, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19687282

RESUMO

Geese have a short egg-laying period and a low egg production rate. To induce and maintain egg laying, genes related to generating hepatic lipid for yolk deposition should be adequately expressed. Liver mRNA from 6 laying geese was extracted and used for construction of a full-length enriched cDNA library. About 2,400 clones containing gene sequences were determined and National Center for Biotechnology Information Gallus gallus Gene Index databases were used to compare and analyze these sequences. Ten highly expressed genes were selected to determine the differential expression between laying and prelay goose liver. Tissue distribution data showed that very low density apolipoprotein II, liver type fatty acid binding protein, vitellogenin I, and vitellogenin II transcripts were specifically expressed in the liver of laying geese. Ovoinhibitor, preproalbumin, alpha-2-hs-glycoprotein, and vitamin D binding protein mRNA were highly expressed in the liver and to a lesser extent in other tissues. Ovotransferrin mRNA was expressed in liver, ovary, oviduct, shell gland, brain, and adipose tissues. The concentration of transthyretin mRNA was high in the liver and brain. The mRNA concentrations of liver type fatty acid binding protein, alpha-2-hs-glycoprotein, and transthyretin in the livers of laying and prelay geese were not different. The concentrations of hepatic ovotransferrin, ovoinhibitor, preproalbumin, very low density apolipoprotein II, vitellogenin I, vitellogenin II, and vitamin D binding protein mRNA were higher in the liver of laying geese than in prelay geese, suggesting that these genes may be involved in laying function or lipid metabolism related to egg formation.


Assuntos
Gansos/genética , Gansos/metabolismo , Fígado/metabolismo , Oviposição/fisiologia , Animais , Feminino , Perfilação da Expressão Gênica , Biblioteca Gênica , Maturidade Sexual , Distribuição Tecidual
9.
CNS Spectr ; 13(2): 147-53, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18227746

RESUMO

OBJECTIVE: This study was aimed to evaluate the association between Internet addiction and depressive disorder, social phobia and adult attention-deficit/hyperactivity disorder (ADHD) in a sample of Taiwanese college students; and examine gender differences in the psychiatric comorbidity of Internet addiction in this student population. METHODS: Two hundred sixteen college students (132 males, 84 females) were recruited. Internet addiction, major depressive disorder, dysthymic disorder, social phobia, and adult ADHD of all participants were diagnosed based on psychiatric diagnostic interview. RESULTS: This study revealed that adult ADHD and depressive disorders were associated with Internet addiction among college students. However, depressive disorders were associated with Internet addiction in the males but not the females. CONCLUSION: With these results, it seems reasonable to suggest that effective evaluation of, and treatment for, adult ADHD and depressive disorders is required for college students with Internet addiction.


Assuntos
Comportamento Aditivo/epidemiologia , Comportamento Aditivo/psicologia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Internet/estatística & dados numéricos , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades , Adolescente , Adulto , Comorbidade , Feminino , Humanos , Entrevista Psicológica , Masculino
10.
Poult Sci ; 86(6): 1206-12, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17495093

RESUMO

Suppression subtractive hybridization was used to detect differential expression of genes in the livers of laying and prelaying geese. Liver tissues from prelaying and laying geese were dissected for mRNA extraction. The cDNA, reverse transcribed from liver mRNA of prelaying geese, was subtracted from the cDNA generated from the laying geese (forward subtraction). Five hundred seventy-six clones with possible differentially expressed gene fragments were observed by forward subtraction hybridization. After differential screening using the reverse and forward subtraction cDNA, 164 clones were subjected to gene sequence determination and further analysis. Using Northern analysis, 5 known and 8 unknown genes were shown to be highly expressed in the livers of laying geese compared with prelaying geese. Vitellogenin I, apoVLDL-II, ethanolamine kinase, G-protein gamma-5 subunit, and leucyl-tRNA synthase were highly expressed in the livers of laying geese compared with that from the prelaying geese (P<0.05). The expression of these known genes suggests that their function in the liver of laying geese is primarily involved in lipid and lipoprotein metabolism. Several of these differentially expressed genes were found to be responsive to estrogen stimulation, confirming the involvement of these genes in the egg-laying function of the goose.


Assuntos
Gansos/genética , Regulação da Expressão Gênica , Fígado/metabolismo , Oviposição/genética , Envelhecimento , Animais , Apolipoproteínas/metabolismo , Estradiol/análogos & derivados , Estradiol/farmacologia , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Lipoproteínas VLDL/metabolismo , Fígado/efeitos dos fármacos , Vitelogeninas/metabolismo
11.
J Intellect Disabil Res ; 51(Pt 2): 101-8, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17217474

RESUMO

BACKGROUND: There has been no longitudinal study in Taiwan to identify the nature and the scale of medical care utilization of people with intellectual disabilities (IDs) up to the present. The aim of this study is to describe inpatient utilization among people under ID care in institutions in order to identify the pattern of medical care needs and the factors affecting utilization in Taiwan. METHOD: The subject cohort was 168 individuals with ID who were cared for by a large public disability institution from 1999 to 2002 in Taipei, Taiwan. RESULTS: On the examination of the inpatient care that these persons underwent, it was found that these individuals had a heightened need (inpatient rate: 10.1-14.9%) for inpatient care compared with the general population with disabilities (9.37%) in Taiwan. The main reasons for hospitalization were pneumonia, gastrointestinal disorders, cellulites, orthopaedic problems, epilepsy and bronchitis. Using the full model of Generalized Estimating Equations for inpatient care utilization, the factors including low income family, living in an institution, being a subject with cerebral palsy and being a high outpatient user all influenced the use of inpatient care. CONCLUSIONS: This study highlights that health authorities need to promote health planning more in order to ensure an excellent quality of health monitoring and health promotion among people with ID cared for by institutions.


Assuntos
Nível de Saúde , Hospitalização/estatística & dados numéricos , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/reabilitação , Avaliação das Necessidades , Adolescente , Adulto , Área Programática de Saúde , Criança , Pré-Escolar , Demografia , Feminino , Humanos , Incidência , Lactente , Estudos Longitudinais , Masculino , Prevalência , Taiwan/epidemiologia
12.
Poult Sci ; 85(12): 2265-9, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17135685

RESUMO

The purpose of this study was to detect differential expression of genes in the pituitary gland in laying geese by suppression subtractive hybridization (SSH). Pituitary glands from prelaying and laying geese were dissected for mRNA extraction. The cDNA from pituitary glands of prelaying geese was subtracted from the cDNA from the pituitary glands of laying geese (forward subtraction); the reverse subtraction was also performed. We screened 384 clones with possible differentially expressed gene fragments by differential screening. Sixty-five clones from the differential screening results were subjected to gene sequencing and further analysis. We found that at least 19 genes were highly expressed in the pituitary glands of laying geese compared with prelaying geese. Among these, 6 genes (including 4 novel genes) were confirmed by virtual Northern analysis. We found that prolactin and visinin-like protein were highly expressed in the pituitary glands of laying geese compared with prelaying geese (P < 0.05). Further investigation is needed to demonstrate specific functions of the novel genes discovered in the current study.


Assuntos
Gansos/genética , Gansos/fisiologia , Perfilação da Expressão Gênica/veterinária , Regulação da Expressão Gênica , Oviposição/fisiologia , Hipófise/metabolismo , Animais , Feminino
13.
J Intellect Disabil Res ; 50(Pt 1): 25-32, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16316428

RESUMO

BACKGROUND: Little information is available on the provision of supportive health environments for persons with intellectual disabilities (ID) in institutions. The aim of this study was to present an overview of supportive environments for health in institutions in Taiwan. METHODS: A cross-sectional survey was conducted to examine the perceptions of 121 Taiwanese Institutional Directors on their setting's implementation of supportive healthy physical, social, and economic environments. RESULTS: Analyses showed that first-aid kits (97.5%) and medicine cabinets (85.5%) were the most common health facilities in institutions. Seventy-three per cent of institutions had set up specific areas to be used for rehabilitation practice, while only 43.1% thought their rehabilitation equipment/devices adequate for their real needs. Eighty-eight per cent of institutions implemented health promotion plans for people with ID, while 76.6% had appropriated specific health promotion plans. Sixty-three institutions (52.1%) reported employment of skilled nurses to serve people with ID, and these institutions showed statistically significant differences in implementation of each health facility. CONCLUSIONS: The present paper is the first to analyze supportive environments for health in disability institutions in Taiwan. An important focus of future research will be the extension of the present findings to consider the appropriateness of each area of supportive environments for improving the quality of institutional care for people with ID.


Assuntos
Promoção da Saúde/organização & administração , Deficiência Intelectual/enfermagem , Pessoas com Deficiência Mental/psicologia , Instituições Residenciais/organização & administração , Seguridade Social/estatística & dados numéricos , Atitude do Pessoal de Saúde , Estudos Transversais , Pesquisas sobre Atenção à Saúde , Administradores de Instituições de Saúde/psicologia , Ambiente de Instituições de Saúde , Promoção da Saúde/estatística & dados numéricos , Humanos , Deficiência Intelectual/reabilitação , Pessoas com Deficiência Mental/reabilitação , Assistência Pública , Instituições Residenciais/economia , Seguridade Social/economia , Inquéritos e Questionários , Taiwan
14.
Poult Sci ; 84(1): 67-74, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15685944

RESUMO

Sterol regulatory element binding protein 1 (SREBP1) drives the expression of several lipogenic genes, whereas SREBP2 dictates the expression of every gene involved in cholesterolgenesis in mammals. In the current study, we cloned the cDNA fragments for SREBP1, SREBP2, fatty acid synthase (FAS), 3-hydroxy-3-methylglutaryl-CoA reductase (HMG-CoA reductase), and very low density apolipoprotein-II (apoVLDL-II), the genes associated with lipid metabolism. Fifteen ducks immediately before the first egg was laid (18 wk old) and 15 ducks from the same population at an egg production rate of 80% were killed. Total RNA was extracted from liver and used to amplify the targeted genes by reverse transcription-PCR and screening of a cDNA library. The sequence data showed that Tsaiya duck SREBP1, SREBP2, FAS, and HMG-CoA reductase were highly homologous to that of chicken. Tsaiya duck SREBP1 mRNA was expressed in adipose tissue, cardiac muscle, skeletal muscle, liver, and ovary. The SREBP2 mRNA concentration was highest in liver and ovary. Concentrations of FAS and HMG-CoA reductase mRNA were high in liver and lower in other tissues. The apoVLDL-II mRNA was specifically expressed in the liver. The differences between mRNA concentrations of SREBP1, SREBP2, and FAS in the livers of laying and prelay ducks were not significant. However, the concentrations of hepatic HMG-CoA reductase and apoVLDL-II mRNA were higher in the laying ducks than in prelay ducks. Therefore, laying may affect particular aspects of lipid metabolism, especially biochemical pathways that involved apoVLDL-II and HMG-CoA reductase.


Assuntos
Clonagem Molecular , Patos/genética , Expressão Gênica , Metabolismo dos Lipídeos , Lipídeos/genética , Tecido Adiposo/química , Sequência de Aminoácidos , Animais , Apolipoproteínas/química , Apolipoproteínas/genética , Sequência de Bases , Proteínas Estimuladoras de Ligação a CCAAT/genética , Colesterol/biossíntese , DNA Complementar/química , DNA Complementar/genética , Proteínas de Ligação a DNA/genética , Ácido Graxo Sintases/genética , Feminino , Hidroximetilglutaril-CoA Redutases/genética , Lipoproteínas VLDL/química , Lipoproteínas VLDL/genética , Fígado/química , Dados de Sequência Molecular , Músculo Esquelético/química , Miocárdio/química , Fases de Leitura Aberta , Ovário/química , RNA Mensageiro/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Proteína de Ligação a Elemento Regulador de Esterol 1 , Proteína de Ligação a Elemento Regulador de Esterol 2 , Fatores de Transcrição/genética
15.
J Intellect Disabil Res ; 49(Pt 1): 86-94, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15634315

RESUMO

OBJECTIVES: The aims of the present study were to examine health characteristics and healthcare utilization in relation to people with intellectual disability (ID) having psychiatric disorders in Taiwan. METHODS: A cross-sectional study was employed; study subjects were recruited from the National Disability Registration Database. Taiwan, stratified by administrative geographical area for the study. Statistical analysis of 1026 carers for people with ID was made to examine the health status and healthcare utilization of individuals with ID having psychiatric disorders. RESULTS: Approximately 12.1% of people with ID had psychiatric disorders. These individuals were more likely to be poorer in health condition and consuming more medical services (in the outpatient, inpatient and emergency care areas), than those individuals without psychiatric disorders. These individuals with psychiatric disorders were also taking medicines regularly at a far greater percentage than did those without psychiatric disorders. CONCLUSIONS: Given the high prevalence of psychiatric disorders among individuals with ID, the healthcare system should take further steps to develop an appropriate health status monitoring system and community-based and easily accessible mental health services for them.


Assuntos
Nível de Saúde , Deficiência Intelectual/etnologia , Transtornos Mentais/etnologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Tratamento Farmacológico/estatística & dados numéricos , Feminino , Humanos , Lactente , Deficiência Intelectual/epidemiologia , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Prevalência , Taiwan
16.
Public Health ; 119(1): 50-4, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15560902

RESUMO

The association between areca quid chewing and methamphetamine (MAMP) use in Taiwanese adolescents was examined in 200 MAMP users and 400 non-users. Subjects were interviewed individually regarding the experience of chewing areca quid and the evidence of lifetime areca quid use disorder. The ages at which they initially chewed areca quid and used MAMP were also evaluated. The results revealed that areca quid chewing and areca quid use disorders were more common in both male and female MAMP users than in non-users. Among those who chewed areca quid and used MAMP, the mean age at initial MAMP use was older than the mean age at initial chewing of areca quid in males but not in females. MAMP users who chewed areca quid were subdivided into three groups according to the sequence of initial MAMP use and chewing areca quid. Although most males and females started chewing areca quid before using MAMP, this pattern was more prevalent in males. Adolescent MAMP users need to be educated about deleterious health sequelae caused by chewing areca quid. Adolescent areca quid chewers need to be monitored for possible progression to MAMP use.


Assuntos
Areca , Metanfetamina , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Fatores Etários , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Mastigação , Taiwan/epidemiologia
17.
Eur J Obstet Gynecol Reprod Biol ; 115(2): 219-23, 2004 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-15262360

RESUMO

OBJECTIVE: To examine the safety and feasibility of laparoscopically assisted vaginal hysterectomy (LAVH) for uteri weighing 500 g or more as compared to uteri weighing less than 500 g in the management of benign gynecological diseases. METHOD: In this prospective comparative study, 189 women with different benign gynecological diseases were scheduled for laparoscopically assisted vaginal hysterectomy. They were divided into two groups, with uterine weight greater than 500 g and uterine weight less than 500 g. Outcome measures for both the groups were studied comparatively in terms of length of operative time, amount of blood loss, requirement of blood transfusion and length of hospital stay. RESULTS: Length of operation and amount blood loss were significantly greater in the uteri >o r = 500 g group than in the <500 g at 91.1 +/- 28.7 min versus 77.4 +/- 26.6 min (P < 0.01), and 570.5 +/- 503.6 ml versus 262.5 +/- 270.0 ml (P < 0.001), respectively. However, there was no difference in length of hospital stay and overall incidence of operative complications between the two groups. None of the women had any major complications though 17 minor complications were noted. There was no incidence of switching to abdominal laparatomy during the operation except for one patient who required "minilaparotomy" for removal of large surgical specimen (2400 g). Extreme intra-operative hemorrhage of more than 1000 ml occurred in five patients, however, they made full recovery after blood transfusion. Rate of blood transfusion was significantly lower in the uteri <500 g group (4.8% versus 34.9%, (P < 0.001). CONCLUSION: This study demonstrates that despite the increased operating time and blood loss, LAVH can be safely performed for large uterus. However, surgeons need to be aware of the high risk of blood transfusion in these patients.


Assuntos
Histerectomia Vaginal/métodos , Laparoscopia/métodos , Doenças Uterinas/cirurgia , Útero/patologia , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Tamanho do Órgão , Resultado do Tratamento , Doenças Uterinas/patologia
18.
J Intellect Disabil Res ; 48(Pt 3): 252-61, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15025668

RESUMO

BACKGROUND: Although Taiwan has already had a higher quality of health care compared with other countries, there still is a need to review the quality and effectiveness of services provided. The lack of health care policy for persons with disabilities is a reflection of health care provision in Taiwan. Health care provision problems will limit persons with disabilities in their access to the health care system. The purpose of the present study was to examine the general beliefs about the current health care policies for persons with intellectual disabilities (ID) in Taiwan. METHODS: Data were obtained from two sources, namely government policies analysis and interviews with representatives for key stakeholders in the field of ID. RESULTS: The results illustrate that health care service problems for persons with ID include: how to enforce the discovery system and early intervention service, disability evaluation system, National Health Insurance medical payment and medical care resource development are still confining their quality of care. Furthermore, the links between social welfare, education and health care have been lost because the different roles and perspectives of people in these fields are fundamentally at odds with one another. Health care professionals have become less reform-minded as a consequence of the conditions of their work. Consequently, a complete and coordinated health care policy for persons with ID has become unattainable in society. The present paper draws on evidence from research and policies to explore the problems and potential of service development for persons with ID, and to identify review and action points for managing its implementation.


Assuntos
Política de Saúde/legislação & jurisprudência , Acessibilidade aos Serviços de Saúde/economia , Deficiência Intelectual/diagnóstico , Pessoas com Deficiência Mental , Humanos , Seguro Saúde , Deficiência Intelectual/economia , Deficiência Intelectual/fisiopatologia , Relações Interprofissionais , Taiwan
19.
Chang Gung Med J ; 24(8): 476-82, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11601189

RESUMO

BACKGROUND: The purpose of this study was to assess the usefulness and feasibility of 3-dimensional (3D) ultrasound for routine fetal observation. METHODS: Eighty-five normal pregnancies with gestational ages of 20-36 weeks were studied. A conventional ultrasound scanner with a specially designed operation unit, frame memory, and 3D probe was the apparatus used in this study. The unit has a circuit board consisting of digital integrated circuit chips designed to make calculations of volume ray tracings for volume rendering in real time. For each fetus, scanning was performed with different levels of opacity in the equation for volume rendering. In areas where there was an inadequate amniotic fluid pocket to perform an adequate examination, the pregnant woman was asked to push the fetus to the opposite side by gently pressing on her abdomen. RESULTS: Face, limbs, and fingers which are difficult to visualize on conventional ultrasonography could be seen clearly. Extremely satisfactory images were obtained at between 24 and 34 weeks of gestation that produced sonographic pictures easily recognized even by laypersons. Beyond 34 weeks of gestation due to the relative decrease in the size of amniotic fluid pockets, and before 24 weeks of gestation due to frequent fetal movement, the soft tissue of fetuses is thin and its acoustic impedance is virtually the same as that of water, so surface-rendered images are less satisfactory. In addition, the anterior wall placenta, multiple pregnancies, and oligohydramnios made viewing even more difficult. CONCLUSION: Between 24 and 34 weeks of gestation, 3D ultrasound is a feasible and useful procedure for routine antenatal examination.


Assuntos
Imageamento Tridimensional , Ultrassonografia Pré-Natal , Feminino , Humanos , Gravidez
20.
Chang Gung Med J ; 24(6): 388-92, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11512371

RESUMO

Perihepatic adhesions between the liver capsule and the diaphragm or the anterior peritoneal surface characterizes Fitz-Hugh-Curtis syndrome (FHCS). FHCS is an extrapelvic manifestation of pelvic inflammatory disease and usually refractory to medical treatment and surgical intervention. With the increased incidence of pelvic inflammatory disease, chronic pelvic pain and sequalae of the process are becoming more common. Herein, we report 3 patients with pelvic inflammatory disease in whom medical treatment failed initially and FHCS was diagnosed via laparoscopy. Laparoscopic lysis of pelvic and perihepatic adhesions, irrigation of the abdomino-pelvic cavity, and antibiotics treatment after surgery successfully relieved these patients' symptoms. FHCS is not a new syndrome but most gynecologists might neglect this condition. Laparoscopy is a less invasive procedure than exploratory laparotomy. We recommend laparoscopy in patients with lower abdominal and right upper quadrant discomfort when other organic disease has been ruled out and medical treatment has failed to relieve symptoms.


Assuntos
Diafragma , Hepatopatias/diagnóstico , Doença Inflamatória Pélvica/complicações , Doenças Peritoneais/diagnóstico , Adulto , Feminino , Humanos , Laparoscopia , Hepatopatias/terapia , Doenças Peritoneais/terapia , Síndrome , Aderências Teciduais/diagnóstico , Aderências Teciduais/terapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...