Ambient air pollution was known to cause central nervous system diseases and depressive symptoms. In this study, we examined the associations between air pollution exposure and the prevalence of insomnia in Taipei City of Taiwan. We applied the health information system of electrical medical records of Taipei City Hospital to collect a total of 5108 study subjects (insomniacs N = 912 and non-insomniacs N = 4196) over 18 years old from the family medicine and internal medicine outpatients of six branches of Taipei City Hospital. These patients were grouped into insomniacs and non-insomniacs following the primary insomnia diagnosis (ICD9:780.52, 780.54, 307.41, 307.42, ICD10: G47.00, G47.01, G47.09, F51.01, F51.09) and the prescription times of anxiolytics and hypnotics. We estimated one-year average concentrations of PM2.5, ozone, and NOx before the first date of insomnia diagnosis and the last date of outpatient visit for insomniacs and non-insomniacs, respectively, by using the data of nearest air quality monitoring stations relative to study subjects’ residential addresses. Logistic regression analysis was employed to examine the independent effects of air pollution concentrations on the risk of insomnia. One-year average PM2.5, ozone, and NOx levels for insomniacs was significantly higher than those of non-insomniacs. After adjusting for confounding factors, increase each 1(μg/m3) in one-year average PM2.5 showed a statistically significant association with insomnia (the odds ratio 1.610, 95% CI [1.562,1.660]). As to multi pollutants, one-year average PM2.5 (1.624, [1.570, 1.681] and ozone (1.198, [1.094, 1.311]) exposure showed a significant association with insomnia. Subgroup analysis revealed that the influence of PM2.5 and ozone on insomnia have significant risks in people with major chronic disease. This study demonstrated a positive association between PM2.5 and ozone exposure and the prevalence of hypnotic-treated insomnia. Especially, the people with major chronic diseases were with obvious effect of PM2.5 and ozone on risk of insomnia.

Objective: The purpose of this study was to describe nurses’ continuous education related to sexuality and health care and learning needs to address patients’ sexual health concerns. Design and Method: This was a cross-sectional study. A total of 454 nurses were recruited from a medical hospital in central Taiwan. Nurses completed a survey designed for this study to describe the individual characteristics and continuous education related to sexuality and health care, and a structured questionnaire, Learning Needs for Addressing Patients’ Sexual Health Concerns (LNAPSHC). Results: Results revealed that few nurses ever received continuous education related to sexuality and sexual health. Among these, sexual harassment and coping, sexual health of sexual assault and sexual abuse, and STD, HIV, and AIDS were the most common topics. The level of nurses’ learning needs about patients’ sexual health concerns were greater than moderate level (mean±SD=4.61±1.17, range 1 to 7). Among the three domains of learning needs, sexuality in health and illness was the most needed, then communication about patient’s intimate relationships, and approaches of sexual health care in turn. Clinical units (OBS/GYN) and providing care plan (ineffective sexuality pattern) were predictors of nurses’ learning needs, accounting for 0.3% of the variance. Conclusions: Our results indicated that providing nurses adequate continuous education related to patients’ sexual health is needed. Contents regarding increase nurses’ insights into patients’ sexual health concerns and specific topics suitable for diverse clinical units should be considered.