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Sleep deprivation is independently associated with falls in women but not in men. Short sleep duration may be an indicator to identify women at risk for falling.

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Thermal comfort is a subjective psychological perception of people based also on physiological thermoregulation mechanisms when the human body is exposed to a combination of various environmental factors including air temperature, air humidity, wind speed, and radiation conditions. Due to the importance of gender in the issue of outdoor thermal comfort, this study compared and examined the thermal comfort-related differences between male and female subjects using previous data from Taiwanese questionnaire survey. Compared with males, the results indicated that females in Taiwan are less tolerant to hot conditions and intensely protect themselves from sun exposure. Our analytical results are inconsistent with the findings of previous physiological studies concerning thermal comfort indicating that females have superior thermal physiological tolerance than males. On the contrary, our findings can be interpreted on psychological level. Environmental behavioral learning theory was adopted in this study to elucidate this observed contradiction between the autonomic thermal physiological and psychological-behavioral aspects. Women might desire for a light skin tone through social learning processes, such as observation and education, which is subsequently reflected in their psychological perceptions (fears of heat and sun exposure) and behavioral adjustments (carrying umbrellas or searching for shade). Hence, these unique psychological and behavioral phenomena cannot be directly explained by autonomic physiological thermoregulation mechanisms. The findings of this study serve as a reference for designing spaces that accommodates gender-specific thermal comfort characteristics. Recommendations include providing additional suitable sheltered areas in open areas, such as city squares and parks, to satisfy the thermal comfort needs of females.

OBJECTIVEHyperglycemic crisis is one of the most serious diabetes-related complications. The increase in the prevalence of diabetes in the geriatric population leads to a large disease burden, but previous studies of geriatric hyperglycemic crisis were focused on acute hyperglycemic crisis episode (HCE). This study aimed to delineate the long-term mortality risk after HCE. RESEARCH DESIGN AND METHODSThis retrospective national population-based cohort study reviewed, in Taiwan's National Health Insurance Research Database, data from 13,551 geriatric patients with new-onset diabetes between 2000 and 2002, including 4,517 with HCE (case subjects) (ICD-9 code 250.1 or 250.2) and 9,034 without HCE (control subjects). The groups were compared and followed until 2011. RESULTSOne thousand six hundred thirty-four (36.17%) case and 1,692 (18.73%) control subjects died (P < 0.0001) during follow-up. Incidence rate ratios (IRRs) of death were 2.82 times higher in case subjects (P < 0.0001). The mortality risk was highest in the first month (IRR 26.56; 95% CI 17.97-39.27) and remained higher until 4-6 years after the HCE (IRR 1.49; 95% CI 1.23-1.81). After adjustment for age, sex, selected comorbidities, and monthly income, the mortality hazard ratio was still 2.848 and 4.525 times higher in case subjects with one episode and two or more episodes of hyperglycemic crisis, respectively. Older age, male sex, renal disease, stroke, cancer, chronic obstructive pulmonary disease, and congestive heart failure were independent mortality predictors. CONCLUSIONSPatients with diabetes had a higher mortality risk after HCE during the first 6 years of follow-up. Referral for proper education, better access to medical care, effective communication with a health care provider, and control of comorbidities should be done immediately after HCE.

BackgroundThe elderly are predisposed to chronic osteomyelitis because of the immunocompromised nature of aging and increasing number of chronic comorbidities. Chronic osteomyelitis may significantly affect the health of the elderly; however, its impact on long-term mortality remains unclear. We conceived this retrospective nationwide population-based cohort study to address this issue.MethodsWe identified 10,615 elderly patients (≥65 years) comprising 965 patients with chronic osteomyelitis and 9650 without chronic osteomyelitis matched at a ratio of 1:10 by age and gender between 1999 and 2010 from the Taiwan National Health Insurance Research Database. The risk of chronic osteomyelitis between the two cohorts was compared by a following-up until 2011.ResultsPatients with chronic osteomyelitis had a significantly higher mortality risk than those without chronic osteomyelitis [incidence rate ratio (IRR): 2.29; 95 % confidence interval (CI): 2.01–2.59], particularly the old elderly (≥85 years; IRR: 3.27; 95 % CI: 2.22–4.82) and males (IRR: 2.7; 95 % CI: 2.31–3.16). The highest mortality risk was observed in the first month (IRR: 5.01; 95 % CI: 2.02–12.42), and it remained persistently higher even after 6 years (IRR: 1.53; 95 % CI: 1.13–2.06) of follow-up. Cox proportional hazard regression analysis showed that chronic osteomyelitis [adjusted hazard ratio (AHR): 1.89; 95 % CI: 1.66–2.15], advanced age (≥85 years; AHR: 2.02; 95 % CI: 1.70–2.41), male (AHR: 1.34; 95 % CI: 1.22–1.48), and chronic comorbidities were independent predictors of mortality.ConclusionsThis study demonstrated that chronic osteomyelitis significantly increased the long-term mortality risk in the elderly. Therefore, strategies for prevention and treatment of chronic osteomyelitis and concomitant control of chronic comorbidities are very important for the management of the elderly, particularly for a future with an increasingly aged population worldwide.