Taiwanese Research Articles

Developmental Trajectories and Predictors of Incident Dementia among Elderly Taiwanese People: A 14-Year Longitudinal Study.

The aim of this study was to identify dementia trajectories and their associated predictors among elderly Taiwanese people over a 14-year period using a nationwide representative longitudinal study. This retrospective cohort study was performed using the National Health Insurance Research Database. Group-based trajectory modeling (GBTM) was used to distinguish the specific trajectory groups of incident dementia during 2000-2013. All 42,407 patients were classified by GBTM to identify the trajectory of incident dementia, which included high- (n = 11,637, 29.0%), moderate- (n = 19,036, 44.9%), and low-incidence (n = 11,734, 26.1%) groups. Those diagnosed with hypertension (adjusted odds ratio [aOR] = 1.43; 95% confidence interval [CI] = 1.35-1.52), stroke (aOR = 1.45, 95% CI = 1.31-1.60), coronary heart disease (aOR = 1.29, 95% CI = 1.19-1.39), heart failure (aOR = 1.62, 95% CI = 1.36-1.93), and chronic obstructive pulmonary disease (aOR = 1.10, 95% CI = 1.02-1.18) at baseline revealed tendencies to be classified into high-incidence groups in dementia risk. The results from a 14-year longitudinal study identified three distinct trajectories of incident dementia among elderly Taiwanese people: patients with cardiovascular disease risk factors and cardiovascular disease events tended to be classified into high-incidence dementia groups. Early detection and management of these associated risk factors in the elderly may prevent or delay the deterioration of cognitive decline.

Assessment of environmental orientations of urban Taiwanese and their relation to climate change mitigation behaviour in central Taiwan

Urban areas, where the residential and over-growing economic activities take place, have emitted huge greenhouse gasses causing global warming and climate change. This study aimed to assess the environmental orientations of urban people in central Taiwan using New Environmental Paradigm (NEP) scales and the relation to climate change-mitigation behaviour. Conducted in Taichung City, the second-largest city in central Taiwan, this study collected data from 218 samples from March to April 2021. To analyse the data, this study used factor analysis to categorize the environmental orientations and multiple regression analysis to evaluate the relationship of determinant factors of climate change mitigation behaviours. This study categorized four groups of environmental orientation, and Urban Taiwanese obtained the highest score for the role of humanity over nature, followed by the limit to growth, eco-crisis, and anti-anthropocentrism/anti-exceptionalism or misperception on environmental issues. Of the four environmental orientations, the anti-anthropocentrism/anti-exceptionalism people (Factor 2) and concern on limit to growth (Factor 4) are significantly associated with climate change attitudes that later significantly influence the intention and behaviour-related climate change. Subjective norms and educational level are also the significant determinant factors of the intention and behaviour-related climate change mitigation.

Beyond the Bipartisan System in the Taipei Mayoral Elections—Rise of Market-Oriented Strategies in Electoral Campaigns?

Current literature on political marketing seldom investigates elections in non-Western regions or countries. The analysis of the Taipei mayoral elections (TMEs) can fill this academic vacuum. This article studies the election campaigns for the TMEs between 1994 and 2018 to understand and analyse the political marketing strategies used by candidates and political parties in Taiwan, an East Asian democracy. While the New Party (NP) stuck to a product-oriented strategy, the Kuomintang (KMT) and the Democratic Progressive Party (DPP) employed sales-oriented strategies in most TMEs. This article argues that political parties with strong ideologies find it hard to use the market-oriented electoral strategy. The victory of Ko Wen-je in 2014 and 2018 TMEs can be analysed in terms of the successful employment of a market-oriented strategy. However, given the changing environment of local politics, Ko and his party, the Taiwan People’s Party (TPP), may not follow market-oriented strategies in future TMEs.

Hidden Curriculum and Internationalization in EFL: A Call for Heightened Criticality

The notion that English as a foreign language (EFL) education is instrumental in fostering internationalization and intercultural competencies is widespread. Governments around the world often make such claims. For example, the Taiwan Ministry of Education touts the value of English in helping Taiwanese people to become “global citizens” (Republic of China Ministry of Education, 2022). Such a stance has great intuitive appeal: Those acquiring English ability certainly are poised to expand chances to interact with others outside their own sphere. Ironically, though, ample research reveals how the hidden curriculum within EFL materials can favor powerful social groups, actually hobbling just internationalization. In light of this, I argue that habitual criticality is needed to cogently trouble EFL materials.

Sexuality and Quality of Life in Eastern Taiwan People With Schizophrenia.

Patients with schizophrenia are living at the border of society and their sexuality is often neglected. The aim of the study is to explore the association among The Brief Psychiatric Rating Scale (BPRS), quality of life (QoL), Taiwanese Depression Questionnaire, and Sexual Desire Inventory in people with schizophrenia (PwS). This study used a cross-sectional design with 277 psychiatric inpatients. A descriptive analysis, difference analysis, and logistic regression model were presented to identify relevant variables that may affect the probability of good QoL. The study showed that male PwS had higher scores of standard deviation (SD) than females in PwS. The study also showed that smoking, early illness onset age, and shorter illness duration demonstrated a significantly higher SD. The logistic regression analysis showed that BPRS, depression, and SD significantly affected the probability of QoL. By structural equation model, SD would be positively correlated with mental status and SD would indirectly influence QoL. Our results showed psychological and sociological factors interactions may contribute to the QoL and SD for PwS. This study also demonstrated a close relationship between SD, depression, and BPRS. These factors may predict the probability of good life quality for the PwS.

Elucidating International Travelers’ Tourism Image of Taiwan: A Qualitative Approach

Although Western alien visitors to Taiwan have a unique, well-informed perspective of what appeals to tourists from their countries, little research has been conducted to assess their insights, representing a significant research gap. To fill this gap, this study aims to elucidate how international tourists perceive Taiwan as a tourist destination by collecting detailed qualitative data via in-depth interviews of twenty-four international expatriates. This study illustrated the image differences before and after the visit of international tourists by analyzing the dimensions of tourists’ consensus maps and the changes in their perception of the natural, social, cultural, gourmet food, and Aboriginal image of Taiwan. This study provides a better understanding of how international tourists in Taiwan view its current and potential appeal as a tourist destination, so as to identify ways of attracting new tourists from their cultures. Patterns emerged that suggest new approaches for promoting Taiwan tourism and tourism sustainability which might not occur to Taiwanese tourism professionals due to the interviewees’ unique points of view. This research concludes that the application of cultural promotion strategies, planned tour packages, and improvement of the image of nature, culture, society, food, and Aboriginal people in Taiwan will thereby improve the overall satisfaction of international tourists, building online image, and forming e-word-of-mouth.

The Impact of Awareness for the Consequences from Adopting Electric Scooters—The Crucial Role of Warm Glow and Extrinsic Appeal

With the rapidly development of electricity technology and renewable energy, adopting electric vehicles (EVs) not only can efficiently collaborate with renewable energy, but also can help decrease the negative environmental effects of traditional vehicles. However, even though electric vehicles offer many advantages, most consumers still hesitate to buy or even rent them. While there is a large growing body of studies focusing on topics related to electric public transportation and electric cars, there is still a shortage of them examining electric scooters (ESs). Based on the norm activation model (NAM), green consumption effect, and extrinsic motivation, this study aims to present the crucial antecedence of consumers’ intention to adopt ESs. As a main transportation for most of the people in Taiwan, this research adopts design of experiments and develops two studies to collect data from Taiwan. The results show that warm glow mediates the positive relationship between awareness of consequences and intention to adopt them. Moreover, the interacting effect of awareness of consequences and extrinsic appeal on intention to adopt ESs is mediated by the warm glow. For academia, the results herein fill the gap related to electric transportation. In real-world practice, this study provides valuable suggestions for governments that want to abate any negative impact from traditional scooters.

Diversity and distribution of mitochondrial DNA in non-Austronesian-speaking Taiwanese individuals

Many studies have described the diversity of Austronesian-speaking Taiwanese people to shed more light on their origin and their connection with the “Out of Taiwan” migrations. However, the genetic relationship between the non-Austronesian-speaking groups of Taiwan and the populations of continental Asia is still unclear. Here, we studied the diversity of mtDNA in 767 non-Austronesian speakers from 16 locations in Taiwan using partial sequencing obtained from the hypervariable segment I (HVS-I) and coding regions 8,001-9,000 and 9.801–10,900 and 85 complete mtDNA genome sequences. Bayesian analysis of population structure was used to examine their relationship with over 3662 individuals representing indigenous groups of Taiwan, continental East Asia, Japan, and Island Southeast Asia. The whole analysis identified 278 haplotypes. Complete genomes revealed 62 novel subhaplogroups, of which 31 were exclusive to Taiwan. Estimates of coalescence times of all subhaplogroups showed peaks of diversification greater than 5.0 kya, likely characterizing gene flow from continental East Asian groups but not excluding in situ Taiwanese ancestry. Furthermore, a significant number of clades exclusive to non-Austronesian speakers of Taiwan (NAN_Tw) showed coalescence peaks between 1.0 and 2.6 kya, suggesting possible late Neolithic to early metal age settlements of NAN_Tw and local expansion in Taiwan.

1319 INTERACTION BETWEEN DISTINCT MULTIMORBIDITY PATTERNS AND DISABILITY AND ITS ASSOCIATION WITH FUTURE MORTALITY AMONG OLDER ADULTS

Abstract Background Multimorbidity patterns is associated with future mortality among older adults. However, the addictive effect of disability for distinct multimorbidity patters is unclear. Our aim was to identify the multimorbidity patterns of Taiwanese people aged over 50 years and to explore their association between multimorbidity patterns with/without disability and future mortality. Methods This longitudinal cohort study used data from the Taiwan Longitudinal Study on Aging. The data were obtained from wave 3, and the multimorbidity patterns in 1996, 1999, 2003, 2007, and 2011 were analysed separately by latent class analysis (LCA). The association between each disease group with/without disability and mortality was examined using logistic regression. Results 5124 older adults with average age of 66.7 years old were included. Four disease patterns were identified in 1996, namely, the cardiometabolic (21.6%), arthritis-cataract (11.6%), relatively healthy (61.2%), and multimorbidity (5.6%) groups. After adjusting all the confounders, the cardiometabolic group with disability showed the highest risk for mortality (odds ratio: 2.83, 95% CI: 1.70-4.70), followed by Multimorbidity group with disability (odds ratio: 2.33, 95% CI: 1.17-4.64) and relatively health group with disability (odds ratio: 1.79, 95% CI: 1.22-2.62) and cardiometabolic group without disability (odds ratio: 1.21, 95% CI: 1.01-1.45). Conclusion This longitudinal study reveals disability plays an important role on mortality among older adults with distinct multimorbidity patterns. Older adults with a cardiometabolic multimorbidity pattern with disability had a dismal outcome. Thus, healthcare professionals should put more emphasis on the prevention and identification of cardiometabolic multimorbidity, with routine check-up of their functional limitation.

Associations between coping strategies and psychological distress among people living in Ukraine, Poland, and Taiwan during the initial stage of the 2022 War in Ukraine

ABSTRACT Background: The 2022 War in Ukraine has significantly affected the psychological well-being and daily lives of people in many countries. Objective: Two aims of this transnational study were (1) to compare psychological distress and coping strategies among people living in Ukraine, Poland, and Taiwan, (2) to examine whether the associations between various coping strategies (ie. problem-focused coping, emotion-focused coping, and avoidance) and psychological distress (ie. depression, anxiety, stress, posttraumatic stress disorder symptoms, and hopelessness about the ongoing war) differed among people of various countries during the initial stage of the 2022 War in Ukraine. Method: In total, 1,598 participants (362 from Ukraine, 1,051 from Poland, and 185 from Taiwan) were recruited using an online advertisement to complete online survey questionnaires, including the Brief Coping Orientation to Problems Experienced inventory; the 21-item Depression, Anxiety and Stress Scale; the Impact of Event Scale-Revised; and a questionnaire devised to assess the level of hopelessness about the ongoing war. Results: Psychological distress and adoption of coping strategies differed across people of various countries. Among Taiwanese and Polish respondents, avoidant coping strategies were most strongly associated with all categories of psychological distress compared with problem- and emotion-focused coping strategies. However, the associations of various coping strategies with psychological distress differed to a less extent among Ukrainian respondents. In addition, problem- and emotion-focused coping strategies had comparable associations with psychological distress among the people of Ukraine, Poland, and Taiwan. Conclusions: The 2022 War in Ukraine has affected the psychological well-being of people, especially the Ukrainians. Because of the strong association between the adoption of avoidance coping strategies and psychological distress, despite a less extent among Ukrainian respondents, adaptive coping strategies such as (problem- and emotion-focused) are suggested to help people during times of war.

Stroke Risk in Young Women with Primary Dysmenorrhea: A Propensity-Score-Matched Retrospective Cohort Study.

Studies on strokes associated with dysmenorrhea are limited. We conducted a propensity-score-matched retrospective cohort study to assess the risk of stroke in women with primary dysmenorrhea (PD). From the claims data of one million people in Taiwan's insurance program, we identified 18,783 women aged 15-40 years, newly diagnosed with PD in 2000-2010, without a history of stroke. We randomly selected a comparison cohort without stroke history and dysmenorrhea, with the same sample size matched by age, index date, and propensity score. We began a follow-up with individuals one year after cohort entry to the end of 2013 to capture stroke events. The two study cohorts were well-matched for age and comorbidities, with 54% of women aged 15-24. Stroke incidence was 1.5-fold higher in the PD cohort than in the comparison cohort (6.05 vs. 4.01 per 10,000 person-years, or 99 vs. 65 cases), with an adjusted hazard ratio (aHR) of 1.51 (95%CI 1.11-2.06) after adjustment for matched pairs. Nearly 70% of strokes were ischemic strokes, which occurred 1.6 times more frequently in the PD cohort than in the comparison cohort (4.40 vs. 2.71 per 10,000 person-years, or 72 vs. 44 cases), aHR = 1.61 (95% CI 1.11-2.33), after adjustment for matched pairs. The incidence of hemorrhagic stroke was also higher in the PD cohort than in the comparison cohort (1.65 vs. 1.29 per 10,000 person-years, or 27 versus 21 cases), but the difference was not significant. Women of reproductive age with PD are at increased risk for ischemic stroke.

The Sino-Japanese Peace Treaty and the Chinese residents in Japan—Legal status problem under the 1952 regime

ABSTRACT The Sino – Japanese Peace Treaty signed in April 1952 not only set the basic framework for diplomatic relations between China, Japan, and Taiwan until 1972, but was also significant in substantially determining the legal status of Chinese residents in Japan during the same period. Subsequently, this paper analyzes both the legislative process in Japan leading up to the Sino – Japanese Peace Treaty and the process of diplomatic negotiations between Japan and China and identifies the following points. In the process of legislating the Immigration Control Ordinance, the Japanese government, while recognizing that Chinese mainlanders in Japan were Chinese nationals, considered them to be outside the legal jurisdiction of the Republic of China (R.O.C.) government, and while recognizing the jurisdiction of the R.O.C. government over Formosans in Japan to a certain extent, interpreted “the ultimate nationality of Taiwanese people has not been determined” from the standpoint that the legal status of Taiwan was undetermined. The R.O.C. government was forced to accept the Japanese government’s treatment regarding the legal status of Chinese residents in Japan because it was unable to have its sovereignty over Taiwan and the Penghu Islands clearly stated in the articles of the Sino – Japanese Peace Treaty out of consideration for the United States, which acted as an intermediary in the negotiations of the treaty.

The Right to Family Reunification Between People of Taiwan and the Mainland China: A Legal Reflection on the Impact of COVID

The Right to Family Reunification Between People of Taiwan and the Mainland China: A Legal Reflection on the Impact of COVID

Relationship between overweight and obesity and insufficient micronutrient intake: a nationwide study in Taiwan.

The aim of the present study is to examine whether overweight or obese people in Taiwan have an inadequate intake of selected micronutrients. A population-based study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013-2016. We evaluated fourteen nutrient intakes using the 24 h dietary recall method. The dietary reference intake (DRI) adherence was estimated by the prevalence of participants whose intake was lower than the recommended dietary allowance (RDA) or adequate intakes (AIs) for selected micronutrients. Body mass index (BMI) ≥ 27 kg/m2 and waist circumference (WC), with men having WC ≥ 90 cm or women having WC ≥ 80 cm, were defined as obesity. A total of 3075 participants aged 19 years and above were included. After adjusting for confounders, we found that obese women have a lower DRI adherence of vitamin C (odds ratio (OR) 0⋅73, 95 % confidence interval (CI) 0⋅56, 0⋅95) and magnesium (OR 0⋅72, 95 % CI 0⋅54, 0⋅95), compared with normal-weight women. Obese men have a higher DRI adherence of vitamin B3 (OR 1⋅70, 95 % CI 1⋅29, 2⋅23), iron (OR 1⋅46, 95 % CI 1⋅06, 2⋅00) and zinc (OR 1⋅41, 95 % CI 1⋅07, 1⋅85), compared with normal-weight men. Similar findings were found using WC to define obesity. We conclude that obese women may have insufficient intakes of vitamin A, vitamin C and magnesium.

Analysis of Taiwan Calligraphy Design and Experience by the Delphi Method

The handwriting on the street is Taiwanese folk art and represents the life of Taiwanese people. As the actual needs of people, it is also derived from the practical functions of people’s daily life. The materials, processing techniques, and styles in the artworks describe the lifestyle and culture, and even the life attitude and life needs metaphorically. In this research, an open website platform, “Taiwan Calligraphy and Painting”, was built and used for more than one year. This platform allowed users to upload handwritten characters or hand-painted murals from alleys and streets to it, and all these artworks were commented on and annotated. The location from Google Maps was integrated into this platform, so the users understood where the artworks were found. Nearly 1,000 pieces of artwork were categorized for 6 different features “food, clothing, housing, transportation, education, and others”. We used Delphi Method to explore the media and carriers of the handwriting from the streets. 64 scholars and experts participated in the questionnaire survey. The reliability of the first-round survey was evaluated to be high. The second round survey was organized based on the first round one with a Likert five-point scale. These questions of the questionnaire were modified by the values of the InterQuartile Range. The handwriting culture represents the common people in Taiwan as cultural and creative products. The result of this research and the platform provided the foundation for further study to understand the Taiwan handwriting from people’s point of view more in detail.

Yokomitsu Riichi and Taiwan：The Birth of Sensationism (Modernism) in East Asia

This book discusses the emergence of modernism in colonial Taiwan, with a focus on the work of Yokomitsu Riichi. Through a comprehensive discussion of how Taiwanese writers were influenced by Yokomitsu’s literary theories and techniques, it explores the diverse possibilities of Taiwanese literature during the period of Japanese rule. By comparing Yokomitsu’s work and that of Taiwanese modernist writers, it examines the reception by Taiwanese people of Japanese literature and its construction of subjectivity, and explores the relationship between modernism and colonial literature from a broader perspective. In particular, the author examines the use of abstraction in these texts in detail. At the same time, he discusses Chinese and Korean modernist writers in order to place the development of modernism in colonial Taiwan in a broad context.

Elevated serum leptin levels are associated with lower renal function among middle-aged and elderly adults in Taiwan, a community-based, cross-sectional study.

Plasma leptin is considered a risk factor for obesity and cardio-metabolic disease, but the link between serum leptin and renal function is still under evaluation. In our study, we focused on the relationship between serum leptin and renal function, and we investigated the relationship in more detail. The 396 middle-aged and elderly Taiwanese adults recruited for our health survey were the subject of our research. All participants agreed to participate and signed a consent form before they joined and completed our study. We divided the participants into three groups according to eGFR tertiles and analyzed the parameters between each group. Then, we used Pearson's correlation test to investigate the relationship between eGFR levels and cardio-metabolic risk factors with adjustment for age. The scatter plot indicates the trend between serum leptin levels and eGFR levels. Participants were reclassified into three subgroups according to their leptin levels and the bar chart reveals the prevalence of chronic kidney disease (CKD) in each group. Finally, we used multivariate linear regression to evaluate the relationship between serum leptin and eGFR levels with adjustment for age, sex, smoking status, drinking status, body mass index (BMI), uric acid levels, hypertension (HTN), diabetes mellitus (DM), and dyslipidemia. In our study, we analyzed the data from 396 eligible participants. A total of 41.4% of the participants were male, and the average age of all participants was 64.81 years ( ± 8.78). The participants in the high eGFR group were more likely to have lower serum leptin levels. Furthermore, eGFR values were negatively correlated with serum leptin levels even after adjustment for age. The prevalence of CKD in the high serum leptin group was higher than that in the low serum leptin group. Serum leptin levels showed significant negative correlations with eGFR levels (β=-0.14, p<0.01) in the multivariate linear regression after adjusting for age, sex, smoking status, drinking status, BMI, uric acid levels, HTN, DM, and dyslipidemia. According to our study, serum leptin levels show a negative relationship with eGFR levels in middle-aged and elderly people in Taiwan. In addition, high serum leptin levels could be an novel marker to survey kidney failure in clinical practices.

The Future of our Roots and the Land: The Re-vival of the Atayal Weaving Material Ramie

This study focuses on ramie, a nettle plant known for its length and toughness used in traditional weaving by the Atayal, an Indigenous people in Taiwan. It discusses the Lihang Workshop’s revival of traditional weaving practices over the last thirty years and the application of these practices in art and culture. It also looks at historical writings about ramie, its role in the development of contemporary culture, and the use of the entire plant in adhering to the concepts of zero waste and a circular economy in Atayal culture.

Traditional Amis Architecture and Its Environment in a Contemporary Context

This essay discusses issues the author encountered while constructing a house in 2020 using traditional methods of the Amis, one of the officially recognised Indigenous groups in Taiwan. The author dealt with many obstacles including legal, environmental, and resource issues. These problems point to the historically disadvantaged status of Indigenous Taiwanese people in terms of land rights. With the help of others in his village, the author completed the construction of the house, an achievement that highlights the challenges faced by Indigenous Taiwanese people wishing to implement traditional building practices and lifestyle in the contemporary context.

Genome-wide association study reveals ethnicity-specific SNPs associated with ankylosing spondylitis in the Taiwanese population

BackgroundAnkylosing spondylitis (AS) is an autoimmune disease affecting mainly spine and sacroiliac joints and adjacent soft tissues. Genome-wide association studies (GWASs) are used to evaluate genetic associations and to predict genetic risk factors that determine the biological basis of disease susceptibility.We aimed to explore the race-specific SNP susceptibility of AS in Taiwanese individuals and to investigate the association between HLA-B27 and AS susceptibility SNPs in Taiwan.MethodsGenotyping data were collected from a medical center participating in the Taiwan Precision Medicine Initiative (TPMI) in the northern district of Taiwan. We designed a case–control study to identify AS susceptibility SNPs through GWAS. We searched the genome browser to find the corresponding susceptibility genes and used the GTEx database to confirm the regulation of gene expression. A polygenic risk score approach was also applied to evaluate the genetic variants in the prediction of developing AS.ResultsThe results showed that the SNPs located on the sixth chromosome were related to higher susceptibility in the AS group. There was no overlap between our results and the susceptibility SNPs found in other races. The 12 tag SNPs located in the MHC region that were found through the linkage disequilibrium method had higher gene expression. Furthermore, Taiwanese people with HLA-B27 positivity had a higher proportion of minor alleles. This might be the reason that the AS prevalence is higher in Taiwan than in other countries. We developed AS polygenic risk score models with six different methods in which those with the top 10% polygenic risk had a fivefold increased risk of developing AS compared to the remaining group with low risk.ConclusionA total of 147 SNPs in the Taiwanese population were found to be statistically significantly associated with AS on the sixth pair of chromosomes and did not overlap with previously published sites in the GWAS Catalog. Whether those genes mapped by AS-associated SNPs are involved in AS and what the pathogenic mechanism of the mapped genes is remain to be further studied.