Background In 2013, Taiwan launched a curriculum reform—the 7-year undergraduate medical education program was shortened to 6 years. This study explored the evaluation results from students regarding the curriculum reform and investigated graduates’ perceptions regarding the curriculum organization of the two academic training programs affected by this curricular reform. Methods A cross-sectional survey was conducted from May 14 to June 12, 2019. The 315 graduates from both the 7-year and 6-year curriculum programs in the same medical school in Taipei were invited to participate in this study. In total, 197 completed questionnaires were received, representing a response rate of 62.5%. The results of the principal component analysis confirmed the validity of the constructs employed in this self-administered questionnaire. Results The t-test results yielded two main findings. First, the graduates from the 6-year program had significantly lower scores for preparedness for the upcoming postgraduate-year residency training than did their 7-year program counterparts. Additionally, the male graduates had significantly higher scores in terms of perceptions regarding curriculum organization and preparedness for postgraduate-year residency training than the female graduates. The results of stepwise regression also indicated that the sex difference was significantly correlated with graduates’ readiness for their postgraduate-year residency training. Conclusion To avoid sex disparities in career development, a further investigation of female medical students’ learning environment and conditions is necessary. In addition to the cross-sectional study of students’ perceptions, further repeated measurements of the objective academic or clinical performance of graduates in clinical settings are desirable.
This study examined the relationship between the personal predisposing factors of patients and the severity of pressure injuries (PIs) developed during surgery. This retrospective cohort study collected 439 cases of peri‐operative PIs. Using binary logistic regression to identify the variables associated with PI severity, the effects of interactions between associated variables were then tested. The results of this study revealed that among the personal predisposing factors, only higher patient age (P = .001) and higher body mass index (P < .001) posed a greater risk of stage 2 PIs or higher. Among the surgery‐related facilitating factors, only patients who were placed in the prone position during surgery and patients who lost ≥1000 mL of blood during surgery were at greater risk of stage 2 PIs or higher, compared, respectively, to those placed in the supine position and those who lost ≤100 mL of blood. Furthermore, the amount of blood lost during surgery moderated the influence of age on PI severity. For elderly patients who are expected to lose a large blood volume during surgery or lose an immeasurable amount of blood due to the use of cardiopulmonary bypass, taking more precautionary measures to prevent PIs is recommended.
Background Studies on examining the relationship between physical activity patterns and frailty are lacking. This study examined physical activity patterns in older people and investigated the relationship between physical activity and frailty as well as identifying the predictors of frailty. Methods We used a nationally representative longitudinal database, the Taiwan Longitudinal Study of Aging (TLSA) database, and data for a 20-year period were extracted and analyzed. A total of 5131 participants aged ≥ 60 years in 1996 were included in the current analysis. Information regarding demographic characteristics, frailty, physical activity, comorbidities, oral health, and depressive symptoms was extracted from the TLSA database. Physical activity patterns were examined using group-based trajectory modeling from 1996 to 2015. Potential predictors were examined by performing multivariate logistic regression. Results Four trajectories of the physical activity pattern were found: consistently physically inactive (33.7%), consistently physically active (21.5%), incline (21.6%), and decline (23.2%). Throughout the period, the trajectories of the four groups significantly differed from each other at year 2015, with the incline and decline groups exhibiting the lowest and highest frailty scores, respectively (p < 0.001). Older age, male, poor oral health, diabetes, chronic kidney disease, and depressive symptoms were identified as risk factors for frailty. Conclusion Physical activity reduces the risk of chronic conditions, which contributes to healthy longevity. This study can guide the development of future research and interventions to manage frailty in older people, particularly in considering previous physical activity trajectories within the life course.
Baseball is popular in many countries around the world and is undoubtedly the most popular professional sport in Taiwan. The Chinese Professional Baseball League (CPBL) grew consistently since being founded in 1990, with a 9% average annual growth rate of attendance until 1996. A rapid decline in attendance occurred, however, during the late 1990s and early 2000s. The regular season attendance peaked at 1.65 million in 1995 but fell to just 0.3 million in 2000. The CPBL reached its lowest attendance in 2000 with the average of 1,676 spectators per game. Although the demand for Major League Baseball (MLB) has been investigated, few researchers have focused on the Asian professional sports market (e.g. Lee, 2006
Background: Minimally-invasive surgery has been shown to more demanding on the surgeon than open surgery. This can be manifested as physical fatigue and impaired dexterity, affecting the performance of the surgeon. In this study, we aimed to use hand dexterity and grip strength test as objective measures to compare the difference in surgeon fatigue associated with robotic and laparoscopic colorectal surgery. Methods: A pilot study was conducted between February 2019 and May 2019, recruiting consecutive colorectal patients operated on by a single surgeon using laparoscopy or robotics. We used the Purdue Pegboard Test (PBT) to assess hand dexterity, and the Camry Electronic Handgrip Dynamometer to assess hand grip strength. Before each operative procedure, the surgeon was tasked to perform both tests in a standardized sequence. These tests were repeated two hours into surgery.Results: Eighteen patients were operated on, including 10 robotic and 8 laparoscopic cases. Statistical analysis revealed no difference in dexterity or muscle fatigue after operating with the robot. In contrast, there was a significant difference in the hand grip strength of both hands after laparoscopic surgery (P = 0.04 and 0.02, respectively).Conclusions: Our results show that the resultant fatigue after laparoscopy affects both hands of the surgeon. In contrast, there was no difference in dexterity or muscle fatigue after operating with the robot. Given the demands of complex colorectal surgeries, robotics may be a means of optimizing surgeon performance by reducing fatigue.
This retrospective cohort study aimed to identify heterogeneous cognition, depression, and life satisfaction trajectory groups, and to examine the independent contributions of watching television and reading to these trajectories among middle‐aged and older adults. A sample was taken from the Taiwan Longitudinal Study on Aging (TLSA) with measures of cognition, depression, life satisfaction, watching television, and reading during 12 years of follow‐up (N = 4440). Group‐based trajectory models and multinomial logistic regressions were used. The findings showed that the cohort was separated into three global cognition groups of low‐cognition (n = 376), declining‐cognition (n = 805), and maintained‐cognition (n = 2718); three episodic memory groups of high‐declining (n = 540), middle‐stable (n = 2066), and improving groups (n = 1293); three depression groups of low‐to‐low (n = 2571), median‐to‐high (n = 960), and high‐to‐high groups (n = 368); and three life satisfaction groups of low‐ (n = 1133), middle‐ (n = 977), and high‐level groups (n = 1789). Also, the findings demonstrated that after adjusting for covariates, those who did not watch television or read at the baseline had independently significantly increased odds of having lower global cognitive function, higher depression, and lower life satisfaction over time versus those who watched television or read almost every day. Based on the findings obtained, group‐based trajectories of cognition, depression, and life satisfaction scores identified distinct subgroups among TLSA participants. Moreover, the findings suggest that healthcare providers need to develop more targeted population interventions to ensure successful aging. Healthcare providers can encourage older adults, particularly new retirees, to participate in leisure activities (i.e., watching television and reading) to reduce prevalence rates of cognitive impairment and depression.
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