Symptoms In Taiwan Research Articles

Construing, Depression, and Somatization in Mothers in Taiwan

This study explored the construing of mothers with depression and somatic symptoms in Taiwan, with a particular focus on how they construe themselves when with their children in public and private spaces. Questionnaires and repertory grid technique (RGT) were administered to 63 Taiwanese women. The findings revealed a strong correlation between depression and somatization, emphasizing the mind-body connection. Demographic factors did not significantly impact depression or somatization, suggesting that subjective construing holds more importance than circumstances alone. Tight construing was found to relate to somatization but not depression, implying that the way Taiwanese mothers construe their roles in childrearing is closely connected to somatic symptoms. Surprisingly, the dissimilarity between the actual and ideal self did not correlate with depression or somatization, indicating a possible influence of cultural factors. Moreover, the study highlighted the significant impact of self-construal in public and private spaces on the mental well-being of Taiwanese mothers. It revealed that more depressed and somatized mothers tend to see themselves as similar in both contexts. This challenges whether Western ideas of self-consistency as an indicator of mental health are applicable to East Asian cultures.

Effects of Yoga for Coping with Premenstrual Symptoms in Taiwan-A Cluster Randomized Study.

Home-based yoga practice has not been approved as a method for alleviating premenstrual symptoms in Taiwan. This study was a cluster randomized trial. A total of 128 women self-reporting at least one premenstrual symptom were enrolled in the study, of which there were 65 participants in the experimental group and 63 participants in the control group. Women in the yoga group were provided with a yoga DVD program (30 min) to practice for three menstrual months, at least three times a week. All participants were given the Daily Record of Severity of Problems (DRSP) form to measure premenstrual symptoms. After the yoga exercise intervention, the yoga group had statistically significantly fewer and/or less severe premenstrual depressive symptoms, physical symptoms, and anger/irritability. Other disturbances and the impairment of daily routine, hobbies/social activities, and relationships also occurred significantly less often in the yoga group. The study found that yoga is useful to relieve premenstrual symptoms. Moreover, home-based yoga practice is more pertinent in the pandemic era. The strengths and drawbacks of the study are discussed and further study is recommended.

The Psychometric Properties of the International Trauma Questionnaire in Taiwan.

Complex post-traumatic stress disorder was often present after chronic traumatic events. The diagnostic criteria of complex post-traumatic disorder consisted of both post-traumatic stress disorder and disturbance in self-organization. People with complex post-traumatic disorder often exposed to chronic stress. It might not be as significant as the major traumatic event as survivors with post-traumatic stress disorder had experienced. Therefore, the impact of complex post-traumatic stress disorder was often ignored. It is critical to identify the at-risk individuals with complex post-traumatic disorder in community. We planned to investigate the psychometrics of the International Trauma Questionnaire for assessing complex post-traumatic stress disorder symptoms in Taiwan. One hundred twenty-one individuals were enrolled and they completed 8 self-report scales, including International Trauma Questionnaire, Childhood Trauma Questionnaire Short Form, Beck Depression Inventory-II, Beck Anxiety Inventory, the Chinese version of the Post-traumatic Stress Disorder Checklist for DSM-5, Difficulties in Emotional Regulation Scale, Rosenberg Self-Esteem Scale, and the Interpersonal Relationship Scale. The psychometric of International Trauma Questionnaire was examined by bivariate correlation analysis, independent t-test, and factor analysis. The study showed International Trauma Questionnaire had good reliability and validity and corresponded with previous studies. The result of confirmatory factor analysis supported the structure of complex post-traumatic stress disorder criteria in International Classification of Diseases-11. The 2-factor second-order model was the best-fitting model. The 6 symptom domains of complex post-traumatic stress disorder were also significantly correlated with depressive and anxiety symptoms. It suggests that the Chinese version of International Trauma Questionnaire could be used for screening at-risk groups and future works for mental public health in Taiwan.

The effect of high school entrance exam reform on adolescents’ depressive symptoms in Taiwan: A closer look at gender differences

In the current study, we followed motivational theories and investigated whether granting junior high school students one more opportunity to take the high-stakes high school entrance exam alleviates students’ depressive symptoms, and whether the effect is comparable for adolescent boys and girls residing in Taiwan. We analyzed two longitudinal datasets (seventh to tenth grade) from two neighboring cohorts, in which one cohort could take the exam just once (i.e., the pre-reform cohort) and the other twice (i.e., the post-reform cohort). Using a lagged-dependent-variable difference-in-differences model to compare the level of depressive symptoms before and after the entrance exam for the two cohorts, the results revealed that the reform was associated with increases in the level of depressive symptoms for both boys and girls. Despite a higher level of depressive symptoms overall, adolescent girls in the post-reform cohort showed a slower increase in the level of depressive symptoms than boys.

What is in a name? Autonomic imbalance and medically unexplained symptoms in Taiwan

Medically unexplained symptoms (MUS) are persistent bodily symptoms without known pathology. An unofficial term has recently emerged in Taiwan to accommodate MUS: autonomic imbalance (AI). AI literally refers to disturbances of the autonomic nervous system (ANS) that innervates vital organs. However, AI is variously conceptualised by different parties. This study intends to investigate what is in the name of AI. It draws on available databases and in‐depth interviews with AI sufferers and Western and Chinese medicine physicians. Some physicians research ANS functions through heart rate variability measurements. Research findings show that physicians regard AI as a convenient term for clinical communication and a euphemistic substitute for MUS or even psychiatric diagnoses. It is not a ‘real thing’. However, AI sufferers treat AI as a bona fide disease, only that it has not been officially classified. AI is therefore an unfaithful translation, or an uncontrolled equivocation, of MUS. The paper concludes by discussing the implications of treating AI as an equivocation. These implications include the limitations of the current diagnostic criteria, the necessity to rethink the dichotomy of mind and body, and the underlying realities exposed or masked by ‘diagnosis’.

Effectiveness of the BodyMind Approach® for women with depression and medically unexplained symptoms in Taiwan

This article aims to examine the hypothesis that The BodyMind Approach® (TBMA) can effectively decrease depression and the distress experienced from medically unexplained symptoms (MUS) for women in Taiwan. A quasi-experimental design was adopted to examine this hypothesis along with the use of questionnaires and a repertory grid technique (RGT). The former was used to objectively examine changes in depression and MUS distress levels, while the RGT was used to examine any changes in subjects’ psychological construct system in terms of their intra- and interrelationships in their personal context. A case study at the end presents the effectiveness of TBMA. The results showed that TBMA was more effective for reducing the distress of MUS than for reducing depression. However, its effectiveness for managing the rigid perception of social roles also cannot be strongly asserted. Nevertheless, the client in the case study showed significant improvement in lower levels of depression and MUS distress, and in psychological construct integration after treatment. This research is expected to contribute to indigenous psychology by providing an example of the adoption of a Western-developed research method (RGT) and intervention (TBMA) while retaining cultural sensitivity. TBMA is introduced as an alternative treatment for managing depression and MUS distress in Taiwan.

Sex Differences in the Mortality Risk of Elderly Patients with Systolic Heart Failure in Taiwan.

Sex differences in heart failure mortality might be affected by age, race, and treatment response. Many large studies in Western countries have shown conflicting results, however few studies have been conducted in Asian patients. We prospectively investigated the mortality risk in a multicenter cohort of 1,093 male and 416 female heart failure patients with reduced ejection fraction (HFrEF) hospitalized for worsening symptoms in Taiwan between 2013 and 2015. Kaplan-Meier curve and Cox proportional regression analyses were used to determine the one-year mortality risk by sex. There were no significant differences in major adverse cardiovascular events, re-admission rate, and mortality between sexes in the overall cohort and the young subgroup during one-year of follow-up. In the elderly subgroup, the overall and cardiac mortality rate of the male patients were higher than those of the female patients (p = 0.035, p = 0.049, respectively). We found that the prognostic effect of old age on overall mortality rate appeared to be stronger in the male patients (p < 0.0001) than in the female patients (p = 0.69) in Cox regression analysis and Kaplan-Meier survival curves. Male sex was a risk factor for all-cause mortality in the elderly (hazard ratio: 1.50, 95% confidence interval 1.02-2.25) independently of systolic blood pressure, diabetes mellitus, hemoglobin concentration, kidney function, and medications. In the Taiwan HFrEF registry, the highest mortality risk was observed in male patients aged 65 years or more. Clinicians need to pay more attention to these patients.

Trends in the use of antimuscarinics and alpha-adrenergic blockers in women with lower urinary tract symptoms in Taiwan: A nationwide, population-based study, 2007-2012

BackgroundWe aim to examine the trend in the use of antimuscarinics and off-label alpha-adrenergic blockers for treatment of lower urinary tract symptoms (LUTS) in a Taiwanese Women Cohort between 2007 and 2012.MethodsThis population-based National Health Insurance Research Database (NHIRD) was used to examine the trends in the use of antimuscarinics or off-label alpha-adrenergic blockers in Taiwan. A sample of 1,000,000 individuals randomly drawn from the whole population of 23 million individuals who were registered in the NHI in 2005. From 2007 through 2012, women aged over 18 years whose claim record contained prescriptions of either of the two drugs for treatment of any of the LUTS-related diagnoses were identified and analyzed. The annual usage of the two drug classes were calculated by defined daily dose (DDD).ResultsFrom 2007–2012, there was a 0.80 fold (69676.8 to 125104.3) increase in DDD of antimuscarinics in our cohort. The overall healthcare seeking prevalence of LUTS was 7.33% in 2007 and 12.38% in 2012, in a rising trend. The prevalence of antimuscarinics-treated LUTS in our cohort increased from 2.53 in 2007 to 3.41 per 1000 women in 2012. The prevalence of LUTS treated by antimuscarinics increased especially for those older than 60 years during the study period.ConclusionsThis 6-year observational study provided the epidemiologic information of clinically significant LUTS of Asian female population. Moreover, there was a rising trend in the use of antimuscarinics and off-label alpha-adrenergic blockers in the population-based cohort.

Experiences of Living in the Community for Older Aboriginal Persons With Dementia Symptoms in Taiwan.

Improving quality of life for community-dwelling older persons with dementia symptoms (PWDS) and family caregivers requires promoting dementia-friendly communities (DFC). However, little is known regarding older Taiwanese Aboriginal PWDS' experiences of living in the community. We explored these experiences for older Atayal PWDS and their families in Taiwan. This grounded theory research used in-depth interviews to explore the perspectives of older PWDS (n = 4), their family members (n = 3), and key persons (n = 10) in an Atayal community in northern Taiwan. Data were analyzed using constant comparative analysis. Participants were interviewed between January and May 2015. Participants' experiences were captured by the overarching concept of "low dementia awareness, high family-like ambience in the community." Despite the low/absent community awareness of dementia, older Atayal PWDS functioned as freely in the community as at home due to a family-like supportive environment. Aboriginal PWDS and their families also faced environmental challenges, e.g., environmental constraints and barriers to transportation access. Our results suggest that this Aboriginal community and culture offer important DFC components, and these strengths could be further studied to enhance DFC models elsewhere. Despite these strengths in supporting PWDS, environmental challenges to transportation access still cause difficulties for PWDS and their families and need improvement. The Atayal community's low dementia awareness suggests that services introduced must be culturally appropriate and nondisruptive to existing supportive helping systems. Our study can be a model for future studies to understand and identify PWDS' needs in Indigenous communities.

A survey for ketamine abuse and its relation to the lower urinary tract symptoms in Taiwan

We aimed to explore the correlation between ketamine abuse and lower urinary tract symptoms (LUTS) and epidemiology of ketamine cystitis. Questionnaire records of ketamine abusers, such as sex, age, and details of using ketamine, including consumption method, amount, duration of ketamine use, and LUTS, were obtained from two private rehabilitation centers. We analyzed these factors and established a severity forecasting module. One hundred and six ketamine abusers completed the questionnaires. LUTS showed an onset time of 24.67 ± 26.36 months among ketamine abusers. Overactive bladder symptom score, international prostate symptom score-storage, interstitial cystitis symptom index, interstitial cystitis problem index, and visual analogue scale score were 5.25 ± 4.43, 5.95 ± 5.72, 10.96 ± 6.66, 9.73 ± 5.82, and 2.55 ± 3.18, respectively. All symptom scores were positively correlated with the duration of ketamine abuse. Ketamine snorting was significantly correlated with all symptom scores compared to smoking. Hydrodistention, intravesical hyaluronic acid instillation, intravesical injection with botulinum toxin, and hyperbaric-oxygen therapy showed better effect than oral treatment. Ketamine can induce severe storage symptoms, such as frequency or nocturia depending on the duration of abuse. Ketamine snorting may cause worse LUTS than smoking. Combining ketamine and other substances may exacerbate LUTS. Intravesical therapy may lead to better outcomes than oral treatment.

Identification and characterisation of watermelon green mottle mosaic virus as a new cucurbit‐infecting tobamovirus

A new virus tentatively named watermelon green mottle mosaic virus (WGMMV) was isolated from watermelon leaves showing mottle, mosaic and leaf crinkling symptoms in Taiwan. Electron microscopy identified tobamovirus‐like, rod‐shaped particles measuring about 18 nm × 300 nm in the crude saps. The enzyme‐linked immunosorbent assay (ELISA) tests of symptomatic watermelon leaves using an antiserum against Cucumber green mottle mosaic virus (CGMMV) resulted in negative reactions. Genomic fragments of WGMMV were amplified by reverse transcription‐polymerase chain reaction (RT‐PCR) using degenerate primers of cucurbit‐infecting tobamovirus. Sequence analysis revealed that WGMMV genome contains 6,482 nucleotides (Gen Bank accession no. MH837097). WGMMV coat protein (CP) gene shares 55.9–82.2% nucleotide identities and 42.6–87.7% amino acid sequence identities and its complete genome shares 62.0–80.9% nucleotide sequence identities with other cucurbit‐infecting tobamoviruses. Thus, WGMMV is a new tobamovirus. The virion origin of assembly sequence (OAS) containing a conserved GAGGUUG was found in the CP‐coding region of CGMMV, WGMMV and Cucumber mottle virus (CuMoV). A comparison of genome organisation has revealed that both WGMMV and CuMoV, belonging to the sub‐subgroup III, have a 29‐nt overlap between the movement protein and CP coding genes. Full‐length nucleotide sequence of WGMMV shares 80.9% identity with that of CuMoV. Watermelon seedlings inoculated with WGMMV showed similar symptoms with the diseased plants observed in the field. WGMMV proliferated in the inoculated seedlings as evidenced by the ELISA and western blotting analyses. Mechanical inoculation assays revealed that WGMMV caused mosaic symptoms in a wide array of cucurbitaceous plants. A primer pair specifically complementary to the WGMMV CP‐coding gene was designed and used to successfully detect WGMMV using RT‐PCR. The primers and WGMMV‐specific antiserum will be useful for rapid detection of WGMMV.

Network-based and cohesion-based social capital and variations in depressive symptoms among Taiwanese adults.

Network- and cohesion-based social capital may play an important role in improving mental health. However, there is limited understanding about these relationships among adults in Taiwan. The aim of this study was to examine the association between individual-level network and cohesion-based social capital and depressive symptoms among a population-based sample of Taiwanese adults. Data were obtained from the 1997 Taiwan Social Change Survey (n = 2,598). The 20-item Center for Epidemiological Studies Depression Scale was used to measure depressive symptom scores; ⩾16 represented high depressive symptoms. Network-based social capital was measured using a position generator. Two dimensions of cohesion-based social capital were assessed: cognitive (perceived neighborhood trust and reciprocity) and structural (local community participation and organizational participation). Multivariable log-binomial regression models, weighted to account for the complex sampling design and adjusted for confounders, estimated prevalence ratios and 95% confidence intervals (CIs) to examine the association between each social capital measure and depressive symptoms. In this study, 29.6% of respondents were classified as having high depressive symptom scores. Higher scores of composite cognitive social capital (adjusted Prevalence Ratios (aPR) = 0.92, 95% CI = [0.90, 0.95]) and structural social capital (aPR = 0.80, 95% CI = [0.65, 0.99]) were associated with a lower likelihood of high depressive symptom scores after controlling for confounders. However, there was no association between network social capital and depressive symptoms. The findings suggest that the relationship between social capital and depressive symptoms in Taiwan differs according to the specific dimension of social capital assessed. Differentiating between network- and cohesion-based social capital merits greater attention to inform our understanding of building social capital to promote and improve mental health outcomes.

Traditional Chinese medicine therapy reduces the catheter indwelling risk in dementia patients with difficult voiding symptoms

Ethnopharmacological relevanceDementia is an international health issue in elder people. Indwelling catheters to address voiding problems in patients with dementia introduce risks of urinary tract infection or urethral trauma. Traditional Chinese medicine (TCM) is widely used to treat difficult voiding symptoms in Taiwan. We investigated the long-term clinical effects of TCM for reducing the risk of indwelling catheterization in dementia patients with difficult voiding symptoms. Materials and methodsWe used National Health Insurance Research Database to conduct a retrospective study of dementia patients with difficult voiding symptoms between 1997 and 2012 in Taiwan. We collected medical data from the onset of dementia to post-catheter insertion. Cox regression proportional hazards model and cumulative incidence of the urinal catheterization curve were used to determine the association between catheter indwelling risk and TCM use. ResultsData from 11069 patients with dementia was assessed, and 3982 participants who received medication for relief voiding symptoms were categorized into 2 groups: 2121 (53.3%) were TCM users and 1861 (46.7%) were TCM non-users with a mean follow-up period of 7.25 years. Cox regression demonstrated that using TCM may decrease the need for indwelling catheterization in patients with dementia (adjusted hazards ratio (aHR) =0.58, 95% confidence interval (95% CI): 0.52–0.66) compared to TCM non-users. A relationship between longer TCM use and reduced urinary retention with indwelling catheter use was observed, especially in patients who used TCM for ≥200 days (aHR =0.46, 95% CI: 0.39–0.55). Ji-Sheng-Shen-Qi-Wan (aHR =0.44, 95% CI: 0.21–0.88), Wu-Ling-San (aHR =0.47, 95% CI: 0.16–0.92), Zhi-Bai-Di-Huang-Wan (aHR =0.50, 95% CI: 0.26–0.94), were the most 3 beneficial TCM formulae. ConclusionsThe results of this study suggest that TCM is associated with a reduced risk of indwelling catheterization in patients with dementia, with enhanced benefits from longer durations of TCM use.

The synchronized trial on expectant mothers with depressive symptoms by omega-3 PUFAs (SYNCHRO): Study protocol for a randomized controlled trial.

BackgroundMaternal depression can be harmful to both mothers and their children. Omega-3 polyunsaturated fatty acid (PUFA) supplementation has been investigated as an alternative intervention for pregnant women with depressive symptoms because of the supporting evidence from clinical trials in major depression, the safety advantage, and its anti-inflammatory and neuroplasticity effects. This study examines the efficacy of omega-3 PUFA supplementation for pregnant women with depressive symptoms in Taiwan and Japan, to provide evidence available for Asia. The rationale and protocol of this trial are reported here.MethodsThe Synchronized Trial on Expectant Mothers with Depressive Symptoms by Omega-3 PUFAs (SYNCHRO) is a multicenter, double-blind, parallel group, randomized controlled trial. Participants will be randomized to either the omega-3 PUFAs arm (1,200 mg eicosapentaenoic acid and 600 mg docosahexaenoic acid daily) or placebo arm. Primary outcome is total score on the Hamilton Rating Scale for Depression (HAMD) at 12 weeks after the start of the intervention. We will randomize 56 participants to have 90 % power to detect a 4.7-point difference in mean HAMD scores with omega-3 PUFAs compared with placebo. Because seafood consumption varies across countries and this may have a major effect on the efficacy of omega-3 PUFA supplementation, 56 participants will be recruited at each site in Taiwan and Japan, for a total number of 112 participants. Secondary outcomes include depressive symptoms at 1 month after childbirth, diagnosis of major depressive disorder, changes in omega-3 PUFAs concentrations and levels of biomarkers at baseline and at 12 weeks’ follow-up, and standard obstetric outcomes. Data analyses will be by intention to treat. The trial was started in June 2014 and is scheduled to end in February 2018.DiscussionThe trial is expected to provide evidence that can contribute to promoting mental health among mothers and children in Asian populations.Trial registrationClinicaltrials.gov: NCT02166424. Registered 15 June 2014; University Hospital Medical Information Network (UMIN) Center: UMIN000017979. Registered 20 May 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1031-2) contains supplementary material, which is available to authorized users.

Sex differences in trajectories of depressive symptoms among older Taiwanese: the contribution of selected stressors and social factors

Objectives: We assessed female–male differences in depressive symptoms among older Taiwanese and quantified the contribution of sex differences in exposure and response to selected covariates in explaining the gap. Methods: Using data from six survey waves over 18 years for a nationally representative cohort of 4049 Taiwanese aged 60+, we employed growth curve analysis to model individual-level trajectories of depressive symptoms across age. Results: Among older Taiwanese, women's disadvantage with respect to social position and employment accounted for about 40% of the sex difference in depressive symptoms. Sex differences in decision control and exposure to widowhood and financial decline played surprisingly little role. Although we found no evidence that the effects of marriage, recent widowhood or recent child death varied by sex, living apart from one's children appeared to be more detrimental for women than for men in this society. Moreover, the effect of living with children depended on the arrangement: living with an unmarried son was more strongly associated with depressive symptoms than living with a married son and daughter-in-law. Conclusion: Sex differentials in social position and employment are major contributors to the sex difference in depressive symptoms among older Taiwanese, yet sex differences in exposure or response to selected stressors appear to play little role. Differential vulnerabilities to particular living arrangements may also contribute to women's excess psychological distress, although more research is needed to elucidate the mechanisms by which living arrangements influence depressive symptoms in Taiwan.

Utilization of traditional Chinese medicine in patients treated for depression: A population-based study in Taiwan

Traditional Chinese medicine (TCM) has been used to treat depression-like symptoms in Taiwan. We aim to examine factors associated with utilization of TCM in patients with depression and to test whether the use of TCM would impact the use of psychiatric services with a subsequent impact on healthcare costs. Adult patients (n = 216,557) who received antidepressant treatment for depression in 2003 was identified in the National Health Insurance Research Database in Taiwan. A Two-Part model was conducted. A multivariate logistic regression was employed to explore factors associated with the use of TCM, with a particular focus on baseline comorbidities, painful physical symptoms (PPS), and frequency of psychiatric service contacts over the ensuing 12-month study period. Multivariate generalized linear modeling was then applied to examine factors associated with healthcare costs for TCM users. More than 40% of individuals prescribed with antidepressant treatments for depression used TCM services. Younger age, female gender, the presence of certain comorbid mental/physical illnesses or PPS, as well as having fewer psychiatric service contacts were found to be associated with the use of TCM services. These factors also affected TCM costs for users; the TCM costs equaled to 30% of costs of psychiatric out-patient services for TCM users. The current study suggested a set of significant factors which could influence use and cost of TCM services for patients with depression. Utilization of TCM services could have a substantial impact on use of psychiatric services and healthcare costs for patients with depression.

Reliability and Validity of the King's Health Questionnaire for Male Lower Urinary Tract Symptoms in Taiwan.

To investigate the reliability and validity of the King's Health Questionnaire (KHQ), and understand the impacts of lower urinary tract symptom (LUTS) on health-related quality of life (HR-QoL). A cross-sectional design was used and a convenience of 393 men participated in the study. The reliability was measured by testing the Cronbach's α coefficients. Factor analysis was used to explore the underlying factor structure of the KHQ. The discriminant validity was assessed using the one-way analysis of variance (ANOVA) tests with post hoc analysis (Games-Howell method) by comparing the differences scores in KHQ domains between men with three LUTS severity groups (mild, moderate, and severe). Men with severe, moderate, mild LUTS accounted for 7.9, 25.4, and 66.7%, respectively. Internal consistency of KHQ was excellent with Cronbach's α coefficients of 0.750-0.943. Factor analysis showed three underlying components to explain constructive validity. The KHQ subscores in both the severe and moderate LUTS groups were significantly higher than those in mild LUTS group (all P < 0.05), implying that the discriminant validity was adequate. Excepting for two single-item questions, the first three greater disparities in KHQ domains between the severe and mild LUTS groups were "Emotion", "Sleeping/Energy", and "Physical limitation", while the least disparities was found in "Personal relationships" domain. LUTS could produce a substantial impact on different domains of HR-QoL. The traditional Chinese KHQ has suitable reliability and validity for men with general LUTS, and might be a useful tool for HR-QoL measure in future.

Leisure Experiences and Depressive Symptoms Among Chinese Older People: A National Survey in Taiwan

We aimed to explore older people's subjective leisure experiences and to further examine associations of such experiences with their depressive symptoms in Taiwan. Known correlates of depression, such as demographics, physical health, and social support, were taken into account. Face-to-face interviews were conducted to collect data using structured questionnaires from a national representative sample of community older people (N = 1308, aged 65 +). We found that (a) being female, older, single, less educated, and having lower family income were demographic risk factors of depression; (b) worse physical health, lack of independent functioning in Activities of Daily Living (ADL), and disability were related to more depressive symptoms; (c) greater social support was related to fewer depressive symptoms; (d) having controlled for effects of demographics, physical health, and social support, positive leisure experiences were independently related to fewer depressive symptoms. The benefits of meaningful leisure pursuits for successful aging are discussed.

Genomic characterization of Calla lily chlorotic spot virus and design of broad‐spectrum primers for detection of tospoviruses

Calla lily chlorotic spot virus (CCSV) collected from calla lily plants showing symptoms in Taiwan has been identified as a tentative species of the genus Tospovirus based on the comparison of S RNA sequences. In this investigation, the complete sequences of its L and M RNAs were determined. The L RNA contains 8911 nucleotides (nt) and encodes a putative RNA‐dependent RNA polymerase of 2882 amino acids (aa) (332 kDa) in the viral complementary (vc) sense. The M RNA was shown to be 4704 nt in length, encoding a nonstructural NSm protein of 309 aa (35 kDa) in the viral sense and a Gn/Gc glycoprotein precursor (GP) of 1123 aa (128 kDa) in the vc sense. Phylogenetic analysis of the individual tospoviral proteins indicated that CCSV is closely related to Tomato zonate spot virus, a new tentative tospovirus isolated from tomato in southern China. Two degenerate primer pairs gL2740/gL3920c and gM410/gM870c, designed, after sequence comparison, from the highly conserved regions of the L and NSm genes, respectively, were successfully used to detect 12 greenhouse‐cultured tospoviruses, including six formal species and six tentative species, by reverse transcription‐polymerase chain reaction. They were also used to detect Melon yellow spot virus and Watermelon silver mottle virus from field cucurbit samples in Taiwan. The results indicate that the two degenerate primer pairs can be used for prompt detection of most tospoviruses and exploration of unknown tospovirus species.

Clinical Presentation of Pediatric Myocarditis in Taiwan

The purposes of this study were to characterize the symptoms and signs of children with myocarditis at the time of presentation to the hospital and to identify the predictors of death. This was a 5-year retrospective study in a tertiary hospital. We collected demographic data and clinical symptoms and signs when children with myocarditis presented at the hospital. The outcome for patient was classified as either survival or death, and the predictors of death were identified. Over the 5-year period, 27 children (14 boys and 13 girls) met the definition of clinical myocarditis. The mean age of the myocarditis patients was 9.1±5.1 years (range, 0.08-17.9 years), and the maximum age was 10-12 years. The most common presentation was gastrointestinal symptoms. We used extracorporeal membrane oxygenation on nine (33%) children, and pacemaker was implanted in eight (30%). Six (22%) children died in this study, and only one of them was younger than 6 years. The poor prognosis predictors were gastrointestinal symptoms, hepatomegaly, and hypotension. Pediatric myocarditis presents primarily with gastrointestinal symptoms in Taiwan. Careful check of heart rhythm may provide a useful objective marker of myocarditis. The predictors of a poor prognosis were gastrointestinal symptoms, hepatomegaly, and hypotension.