Quality validation of platelets obtained from the Haemonetics and Trima Accel automated blood-collection systems.

BACKGROUND: Platelet transfusion is required to treat haemo-oncology or trauma patients. Platelet apheresis (PA) performed with apheresis equipment has increased rapidly in recent years. Leucocyte-reduced platelet apheresis (LRPA) can reduce the risk of platelet refractoriness and febrile nonhemolytic transfusion reactions (FNHTRs) for transfusion. Accordingly, this study aimed to investigate and compare the platelet metabolic and functional responses between PA performed with Haemonetics and LRPA performed with Trima Accel cell separator. METHODS: The qualities of platelets collected through PA and LRPA were evaluated in terms of visual appearance, morphology, platelet-aggregation changes, metabolic activities, and bacterium-screening test during 5-day storage. Statistical analyses included two-sample t-test and generalised estimating equation(GEE) method. RESULTS: During 5-day storage in LRPA, residual leucocytes were all <1.0×106, and the parameters of platelet function were as follows: platelet aggregated to agonists such as adenosine 5'-diphosphate (ADP) and collagen, and the extent of shape change and pO2 showed no statistically significant difference between PA and LRPA. The hypotonic shock reaction (HSR) on days 0, 1, and 3 were significantly higher in LRPA than in PA (71.78±6.92 vs. 64.10±7.42; P=0.002; 71.53±8.98 vs. 62.96±9.84; P=0.007; 68.05±7.28 vs. 57.76±6.80; P<0.0001, respectively). Values of mean platelet volume (MPV) were statistically larger in PA than in LRPA on days 0, 1, and 3. On day 5, the swirling score was higher in LRPA than in PA. The mean lactate levels had no statistically significant difference between PA and LRPA. Moreover, no growth was observed through bacterium-screening test conducted on 40 samples. CONCLUSION: Comparison of LRPA and PA products collected from the Trima Accel and Haemonetics automated blood-collection systems, respectively, revealed that both products possessed good platelet qualities even though additional processes are needed to reduce leucocytes. Furthermore, investigating the outcomes of other apheresis instruments with focus on the safety of donors, products, and recipients is necessary.

Body mass index and depressive symptoms in adolescents in Taiwan: testing mediation effects of peer victimization and sleep problems.

BACKGROUND: Despite recognition of the link between body mass index (BMI) and depression in adolescence, the underlying mechanisms behind this association remain understudied. This study aims to examine three mediational pathways from BMI to depressive symptoms through peer victimization and sleep problems. Sex differences in the mediating effects were also explored. METHODS: Data came from 1893 adolescents participating in a multi-wave longitudinal study from grade 9 to 12 in northern Taiwan were analyzed. Measures included BMI in 2009, peer victimization in 2010, sleep problems in 2011, depressive symptoms in 2012 and other covariates (sex, age, parental education, family structure, family economic stress, stressful life events, pubertal development and previous scores of focal study variables). A series of multiple regression models were conducted to test mediation hypotheses. A bootstrapping approach was applied to obtain confidence intervals for determining the significance of indirect effects. RESULTS: The association between BMI and depressive symptoms was significantly mediated by peer victimization and sleep problems. Higher BMI predicted more peer victimization and sleep problems, each of which led to higher levels of depressive symptoms. Our results further showed that higher BMI was associated with more peer victimization, which led to greater sleep problems and in turn resulted in increased depressive symptoms. No sex differences was found for the indirect effects of BMI on depressive symptoms through either peer victimization or sleep problems. CONCLUSIONS: Peer victimization and sleep problems partly explain the link between BMI and depressive symptoms. Interventions to prevent or manage depressive symptoms may yield better results if they consider the effects of these two psychosocial factors rather than targeting BMI alone.

Emerging epidemic in a growing industry: cigarette smoking among female micro-electronics workers in Taiwan.

OBJECTIVE: To explore the emerging tobacco epidemic in female workers in the growing micro-electronics industry of Taiwan. METHODS: Workers were surveyed regarding their smoking status, sociodemographics and work characteristics. In total, 1950 female employees in two large micro-electronics companies in Taiwan completed the survey. RESULTS: Approximately 9.3% of the female employees were occasional or daily smokers at the time of the survey. The prevalence of smoking was higher in those aged 16-19 years (20.9%), those not married (12.9%), those with a high school education or less (11.7%), those employed by Company A (11.7%), shift workers (14.3%), and those who had been in their present employment for 1 year or less (13.6%). Results of multivariate adjusted logistic regression indicated that younger age, lower level of education, shorter periods of employment with the company and shift working were the important factors in determining cigarette smoking among the study participants. The odds ratio of being a daily smoker was similar to that of being a current smoker. Marital status was the only significant variable when comparing former smokers with current smokers. CONCLUSIONS: Smoking prevalence in female workers in the two micro-electronics companies studied was much higher than previous reports have suggested about female smoking prevalence in Taiwan and China. We suggest that smoking is no longer a 'male problem' in Taiwan. Future smoking cessation and prevention programmes should target young working women as well as men.

Functional ability, perceived exertion and employment of the individuals with spinal cord lesion in Taiwan.

STUDY DESIGN: A survey on functional ability, perceived exertion, and employment was mailed to 190 individuals with spinal cord lesion. Analysis is based on the 91 completed replies. OBJECTIVES: To establish a database of individuals with spinal cord lesions and to assess the effectiveness of training programs designed to improve life quality and employment chances among the individuals with spinal cord lesion. SETTINGS: Subjects selected from the Spinal Cord Injury Association of the Republic of China (SCIAROC) and from the Asylum Center Spinal Cord Injury (ASCCI) in Taiwan. METHODS: Information was obtained from a survey sent to the subjects who are chosen randomly from the SCIAROC and from all the subjects through ACSCI training program. RESULTS: Respondents in ACSCI had a higher functional activity level and lower perceived exertion during activities than those in SCIAROC. The employment status is related to the functional independence and level of injury. CONCLUSION: The database provides information on functional and employment status of individuals with spinal cord lesion. The present study also demonstrates the efficacy of a vocational training program for individuals with spinal cord lesion in Taiwan.

Self-rated psychiatric symptoms and their correlates among senior high school students in Hualien City.

The association between mental health disorders beginning in adolescence and disorders in early adulthood is increasingly acknowledged. The mental health of adolescents has not been studied in the eastern area of Taiwan, where the mortality of teenagers is highest in Taiwan. The purpose of this study was to assess psychiatric symptoms among senior high school students in Hualien City, and to identify their associated factors. A total of 1,195 students were selected, via a stratified cluster sampling method, from nine high schools in Hualien City. A self-administered questionnaire was used to assess students' demographic characteristics, neurotic traits, perceived daily-life stress, social support, and psychiatric symptoms. There were 1,141 valid responses. From principal components analysis, depression-anxiety, impulsivity-paranoia, and psychoticism-obsession were found to be the most common self-rated psychiatric symptoms. About 70% of the students felt blue, 48.2% reported urges to injure someone, and 25% felt tense. Overall, about 5% to 10% of high school students had severe psychiatric symptoms. Stress from schoolwork, peer relationships, and neurotic traits were important predictors of psychiatric symptoms. The findings of this study imply that screening for psychiatric symptoms at senior high schools is essential for improving the mental health of students. The mental health care of adolescents should be school-based and in collaboration with medical professionals. Life skills must be taught at school.

Daily life stress and its correlates among high school students in Hualien city.

Adolescence is a period of physical, cognitive, social and psychosexual changes. These developmental tasks make adolescents particularly vulnerable to life stress. The purpose of this study was to assess high school students' perception of stress from daily events and to identify its associated factors. A total of 1,195 high school students were selected via stratified cluster sampling method from nine high schools. Data from 1,141 valid answers were analyzed. A self-administrated questionnaire was used to assess students' demographic characteristics, personal traits (self-acceptance, neurotic trait), social support and perceived daily life stress. From principal component analysis, school work, concern with prospects, parent-teen relationship and peer relationship were found to be the main sources of daily life stress perceived. Personalities with high neurotic trait or low self-acceptance, perceived low social support, Chinese Hans and study at regular high school were important related factors. Screening by personality trait and social support questionnaire is suggested to be a routine at school to find out the high risk individuals and give them assistance in coping with stress.

Comparison of relaxation techniques, routine blood pressure measurements, and self-learning packages in hypertension control.

BACKGROUND: Even though the effectiveness of mediation and relaxation skills is controversial in blood pressure control, extensive field studies are limited. A national study targeting 50 communities randomly selected from northern Taiwan was conducted to test and compare the effectiveness of hypertension control incorporating three strategies. METHODS: Five hundred ninety hypertensives identified from 3,128 adults at a screening survey among the 50 communities were invited to participate in the study and were randomly assigned to three treatment modalities, (a) relaxation techniques training at home, (b) routine blood pressure measurement by a health professional, and (c) reading self-learning packages, or to a control group. RESULTS: After a 2-month intervention period, the three treatment groups showed a significant reduction in systolic blood pressure levels compared with the control group (11.0 mm Hg for group 1, 9.2 mm Hg for group 2, and 5.1 mm Hg for group 3). The relaxation group had the most significant reduction in systolic blood pressure levels, followed by the routine blood pressure monitoring group and the self-learning group. However, the effect of relaxation training at home was not significantly greater than routine blood pressure measurement by a health professional.

Smoking, health knowledge, and anti-smoking campaigns: an empirical study in Taiwan.

This paper uses a measure of health knowledge of smoking hazards to investigate the determinants of health knowledge and its effect on smoking behavior. In our analysis, two equations are estimated: smoking participation and health knowledge. The simultaneity problem in estimating smoking behavior and health knowledge is also considered. Overall, the estimated results suggest that anti-smoking campaigns have a significantly positive effect on the public's health knowledge, and this health knowledge in turn, has a significantly negative effect on smoking participation. The health knowledge elasticities of smoking participation are -0.48 and -0.56 for all adults and adult males, respectively.

[Family life events, maternal mental health status, and the problems of preschool children's behavior--a correlation study].

The purpose of this study was to explore the relationships of family life events and maternal mental health status to mothers' reports of the problems of their preschool children's behavior. Ninety children aged between 2.5 and 4 years old were sampled from 4 private kindergartens in Taipei. There was a positive correlation between family life events and the problems of preschool children's behavior, but "maternal mental health status" was the best predictor for the problems of preschool children's behavior by multiple regression analysis.

A study on women's practice of breast self-examination in Taiwan.

METHODS: A questionnaire interview was conducted on a sample of 3,040 women ages 30-59 years in the Taipei area through multistage sampling with probability proportional to size. Excluding mistakes in household registration, there were 2,311 qualified subjects, 1,749 of whom (75.7%) completed the interview. The study framework was set up according to Green's PRECEDE model. RESULTS: In the results of this study only 8.4% of the subjects performed breast self-examinations monthly, and no single step of the breast self-examination procedure had a correct rate above 30%. The most remarkable associative factor for the correctness of breast self-examination was "source of instruction," a variable of "enabling factors"; other variables with strong associations were "newspaper contact" (contact with health reports in newspapers), which also belongs to the enabling factors category and "knowledge of breast cancer," a "predisposing factor." Demographic factors such as "educational level" and "urbanizational level" were only indirectly related. CONCLUSION: The authors suggested using all possible routes of health education, such as mass media, hospitals and clinics, and distribution of information in the workplace, to instruct and encourage breast self-examination, especially among women from rural communities and those with less education.

[Changing seroepidemiology pattern of hepatitis B virus infection among elementary and junior high school children in Keelung, Taiwan, 1988].

A large-scale seroepidemiologic study of 20816 (35.6% of total) elementary and junior high school children (grades 1-9) in Keelung, Taiwan was conducted in April-May 1988. The study was to investigate the current status of hepatitis B virus (HBV) infection and to plan the extension of the present HBV prevention program to other age groups. Two HBV markers, hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs), were determined by enzyme immunoassay. The overall seropositivity rates of HBsAg and anti-HBs were 19.0% and 25.6%, respectively. Only 0.4% of the children studied were concurrently positive for both HBsAg and anti-HBs and 55.8% of them were negative for these two markers. It is noteworthy that the seropositivity rate of HBsAg increased with increasing age, from 15.4% in grade 1 (ages 6) to 23.7% in grade 9 (ages 15). This rate of HBsAg was not higher than the 1986 findings (14.0-25.5%) screened from children (4-13 years old) in Keelung, by comparing each age cohort strata, even though the age of study population was two years older. These data indicate that the current hepatitis control strategies have resulted in the reduction of the hepatitis B carrier rate among children from more than 20% to 15% at age 6 (grade 1) in Keelung, but the reduction is still higher than in Taipei children (10%). The seropositivity rate of anti-HBs was also increased with increasing age, from 13.5% (grade 1) to 44.1% (grade 9) and was similar to previous findings in Taiwan.(ABSTRACT TRUNCATED AT 250 WORDS)

Reliability and validity of using a Brief Psychiatric Symptom Rating Scale in clinical practice.

To develop a reliable and valid psychiatric self-rating scale for use in medical practice, the authors modified Derogatis' Symptom Check List-90-R (SCL-90-R) and designed a shorter form, named Brief Symptom Rating Scale (BSRS). The BSRS comprises 50 items, which best reflect the original ten symptom dimensions and three indices of psychopathology from the SCL-90-R. The BSRS has been proven in different populations to have an excellent split-half reliability as well as good internal structure according to factor analysis. In addition, BSRS scores are highly correlated with the parental form SCL-90-R among medical populations for each symptom dimension and the three indices. The rate of accurate classification for BSRS between psychiatric and nonpsychiatric cases was 75.8%, with a sensitivity of 66.7% and a specificity of 86.7% by discriminant analysis based on 10 dimensional scores obtained from 1,638 subjects, randomly selected from the Psychiatric Outpatient Clinic, the Family Medicine Clinic and nonpsychiatric medical inpatients. Therefore, the BSRS is a satisfactory global measure and case-finding screening instrument for psychopathology in both psychiatric and nonpsychiatric medical settings.