Taiwanese Participants Research Articles

Association of the ABCG2 rs2231142 variant with the Framingham Cardiovascular Disease Risk score in the Taiwanese population

BackgroundSerum uric acid (SUA) is an important predictor of cardiovascular events and mortality. The ABCG2 rs2231142 variant (TT genotype) is associated with hyperuricemia (HUA), but the relationship between ABCG2 gene polymorphisms and coronary artery disease (CAD) risk is poorly elucidated. We investigated the association between ABCG2 rs2231142 genetic variants and the Framingham Risk Score for Cardiovascular Disease (FRS-CVD) in a Taiwanese population. MethodsThis cross-sectional study enrolled 139,508 Taiwanese participants aged 30–70 years based on data from the Taiwan Biobank (TWB) database that was obtained from questionnaires, laboratory investigations, anthropometry, and Affymetrix TWB genome-wide single-nucleotide polymorphism (SNP) chip data analysis. The association between ABCG2 rs2231142 and FRS-CVD risk was evaluated using logistic regression analysis. ResultsCompared to those with the GG genotype, participants with the ABCG2 rs2231142 TT genotype had a significantly lower systolic blood pressure, smoking rate, body mass index, triglyceride level, waist circumference, waist–hip ratio, and body fat percentage, but had higher high-density lipoprotein cholesterol level. Despite the same FRS-CVD score, participants with TT genotypes had higher SUA. Even with the same SUA, TT carriers had a lower FRS-CVD than GT and GG carriers. Participants with the TT genotype had significantly lower CVD risk, particularly female participants with HUA and BMI <27 (OR: 0.760, 95 % CI: 0.587–0.985; p = 0.0381) group. ConclusionThe ABCG2 rs2231142 TT genotype is associated with a lower FRS-CVD, particularly in non-obese hyperuricemic female individuals. The complicated interplay among genetic variations, metabolic profile, and CVD risk provides insights for precision health.

Impact of reliable news information on consumers' perceptions and information seeking intentions from a food safety risk

PurposeThis study aimed to investigate whether information from reliable news sources such as medical experts and government officials, along with governmental and individual risk responses, influences consumers’ perceptions of news and intention to seek more information. Additionally, it aimed to explore the relationships between these perceptions and consumers’ intentions to seek information in a food safety risk event.Design/methodology/approachA survey design methodology was employed. A quasi-experimental approach divided 470 Taiwanese participants into three groups, each exposed to varying online news content about food safety news, designed according to the Internalization-Distribution-Explanation-Action (IDEA) model. This involved different combinations of reliable sources and risk response advice to examine the impact on news comprehension and behaviour intentions.FindingsThe results indicated that consumers perceived the news as highly credible when they read it with reliable news sources or risk response advice. Governmental and individual risk response advice significantly impacted consumers’ understanding of news. In addition, perceptions of news credibility and understanding of news can increase individuals’ information-seeking intentions to protect themselves from food safety risks.Originality/valueThis study introduced novel insights into the application of the source credibility theory (SCT) model within Taiwanese food safety incidents, identifying key factors that motivate consumer information-seeking behaviour. It marks an initial attempt to incorporate the IDEA model-based risk communication content into research design, aligning with existing literature while highlighting the critical role of reliable sources in enhancing news credibility and consumer response.

Attentional Bias for Opioids in Taiwanese Heavy Smokers with Chronic Noncancer Pain.

Background and Objectives: Attentional bias (AB) for addictive substances is a feature of attention found in individuals with substance misuse or diagnosed with substance use disorders. When AB exists, the attention of the addicted individual may be quickly oriented to cues related to the addictive substance or be maintained on these cues for a longer time. AB toward opioids was found in Western samples of smokers with chronic noncancer pain. The level of AB was dose-responsive. However, similar studies in the Taiwanese population are lacking. This study compared the patterns of AB for opioid analgesics in Taiwanese participants with chronic noncancer pain to that of individuals without pain. This study aimed to investigate if AB toward opioids is presented in Taiwanese heavy smokers who are on long-term opioid therapy for pain control. Materials and Methods: Participants were grouped into chronic noncancer pain smokers, chronic pain nonsmokers, and smokers without pain, according to smoking habits and whether or not on long-term opioid therapy for pain control. Each participant completed demographic questionnaires, mood scales, and the opioid-related visual probe task. Differences in AB among the groups were compared using a three-way analysis of covariance controlling for daily cigarette consumption. Results: Chronic noncancer pain smokers (n = 17) and chronic pain nonsmokers (n = 16) displayed more severe levels of depression, anxiety, and pain, compared to smokers without pain (n = 28). Only did chronic pain nonsmokers show significant AB for opioid cues that were displayed for a short time. Analysis on reaction time found that smokers without pain consistently responded faster to the tasks. No difference in reaction time was found between the pain groups. Conclusions: The current study did not fully replicate findings from studies that were based in Western countries. Formulary availability and regulatory limitations might have affected patient's perception of prescription opioids in Taiwan. However, chronic pain nonsmokers exhibited initial orientation toward opioid-related cues when daily cigarette consumption was accounted for. According to previous research, this AB for shortly displayed opioid cues can be associated with the expectation of pain relief. The current finding also indicated general psychomotor retardation in individuals who were on long-term use of opioids.

Patient considerations for orthodontists: A comparative study of university students in Malaysia and Taiwan

Background/purposePatients' considerations when choosing an orthodontist are influenced by many factors, including background, ethnicity, and location. Accordingly, this study aimed to identify factors influencing patients’ considerations when selecting an orthodontist in both Malaysia and Taiwan. Materials and methodsIn total, 248 dental students from Taipei Medical University and 110 dental students from Manipal University College Malaysia were selected for this study. Participants' considerations when selecting an orthodontist were assessed using a questionnaire survey. The questionnaire collected data regarding participants’ demographic characteristics and their preferences regarding clinical settings, orthodontist attributes, administrative systems, and the influence of social media. The gathered data were analyzed and compared using independent t-test, ANOVA, and chi-squared for both cohorts. ResultsThe present results revealed significant differences between the Malaysian and Taiwanese participants with several variables, including orthodontist experience, recommendations, pain-free treatment procedures, treatment duration, friendly reception, sources of information about orthodontists, and preferred social media platforms. Notably, among the Taiwanese participants, “person responsible for treatment costs,” was significantly correlated with the orthodontist's age, the orthodontist's work experience, information sources, travel distance, and content posted by orthodontists on social media. By contrast, among the Malaysian participants, this variable was correlated with the work experience of orthodontists. ConclusionSignificant differences were observed between the Malaysian and Taiwanese participants in terms of their considerations when choosing an orthodontist. Participant's gender significantly influenced orthodontist preferences among the Malaysian participants, whereas the individual responsible for treatment costs was identified to be the most crucial factor influencing the Taiwanese participants.

Insights Into Colorectal Cancer Screening: A Multidatabase Cohort Study of Over 1.5 Million Taiwanese

IntroductionColorectal cancer (CRC) remains a significant public health concern. This study aims to provide a comprehensive understanding of the effectiveness of fecal immunochemical test (FIT) screening on CRC incidence and mortality, leveraging the scale of over 1.5 million randomly selected Taiwanese participants and more than 11.7 million person-years of follow-up. MethodsThis prospective cohort study merges data from three robust Taiwanese health databases: the CRC screening program, cancer registration, and death registration databases. Incidence and mortality rates of CRC were calculated based on age, sex, urbanization, and past screening status. Cox proportional hazard models were used to assess the association between screening statuses and CRC incidence or mortality, adjusting for age, sex, and urbanization levels. Statistical analysis of the data was conducted in 2021-2022. ResultsFIT screening was associated with a 33% reduction in CRC incidence and a 47% reduction in mortality. The study identified a dose-response relationship between the fecal hemoglobin concentration (f-HbC) levels and CRC risk. Participants with consistent FIT-negative results had significantly reduced CRC incidence and mortality risks, while those with one or more positive FIT results faced increased risks. Notably, compliance with follow-up examinations after a positive FIT significantly lowered mortality risk. ConclusionsThis large-scale study validates the efficacy of FIT screening in reducing CRC incidence and mortality. It offers a nuanced understanding of how various screening statuses impact CRC risks, thus providing valuable insights for public health strategies aimed at CRC prevention.

Cultural-Psychological Differences, Social Acceptance of Same-Sex Relationships, and Dating App Use Motives of Young GBMSM: A Comparative Study Across Hong Kong, Taipei, and Osaka

ABSTRACT Gay-specific mobile dating apps such as Grindr are popular among young gay, bisexual, and other men who have sex with men (GBMSM) worldwide. However, how the use of these apps differs between regions is underexplored. In this study, we drew on the uses and gratifications literature and cross-cultural studies to examine how cultural-psychological differences (sensation seeking and communication apprehension) and social acceptance of same-sex relationships are associated with the motives for using gay dating apps in three East Asian cities. Using a sample of 18–34-year-old GBMSM (217 participants from Hong Kong, 330 from Taipei, and 175 from Osaka), we found that the Taiwanese participants scored higher than their Japanese counterparts on almost all motives. Sensation seeking was positively associated with using gay dating apps for casual sex, self-worth validation, and thrill of excitement in both Taipei and Osaka. Communication apprehension was positively associated with using the apps for ease of communication in all three cities. Social acceptance of same-sex relationships had positive relationships with using the apps for love in Hong Kong and casual sex in Taipei but negative relationships with other motives in Taipei and Osaka. These inconsistent relationships between the variables across the three cities point to the importance of cultural and regional specificity in predicting gay dating app use motives.

Exposure to PM2.5 Metal Constituents and Liver Cancer Risk in REVEAL-HBV.

Ambient particulate matter is classified as a human Class 1 carcinogen, and recent studies found a positive relationship between fine particulate matter (PM2.5) and liver cancer. Nevertheless, little is known about which specific metal constituent contributes to the development of liver cancer. To evaluate the association of long-term exposure to metal constituents in PM2.5 with the risk of liver cancer using a Taiwanese cohort study. A total of 13,511 Taiwanese participants were recruited from the REVEAL-HBV in 1991-1992. Participants' long-term exposure to eight metal constituents (Ba, Cu, Mn, Sb, Zn, Pb, Ni, and Cd) in PM2.5 was based on ambient measurement in 2002-2006 followed by a land-use regression model for spatial interpolation. We ascertained newly developed liver cancer (ie, hepatocellular carcinoma [HCC]) through data linkage with the Taiwan Cancer Registry and national health death certification in 1991-2014. A Cox proportional hazards model was utilized to assess the association between exposure to PM2.5 metal component and HCC. We identified 322 newly developed HCC with a median follow-up of 23.1 years. Long-term exposure to PM2.5 Cu was positively associated with a risk of liver cancer. The adjusted hazard ratio (HR) was 1.13 (95% confidence interval [CI], 1.02-1.25; P = 0.023) with one unit increment on Cu normalized by PM2.5 mass concentration in the logarithmic scale. The PM2.5 Cu-HCC association remained statistically significant with adjustment for co-exposures to other metal constituents in PM2.5. Our findings suggest PM2.5 containing Cu may attribute to the association of PM2.5 exposure with liver cancer.

Exploring the Barriers and Facilitators of Mask-Wearing Behavior During the COVID-19 Pandemic in Taiwan, the United States, the Netherlands, and Haiti: A Qualitative Study.

This study explored the barriers and facilitators of mask-wearing behaviors during the pandemic in Taiwan, the United States, the Netherlands, and Haiti. Face-to-face interviews were conducted in Taiwan and online interviews were conducted with participants in the United States, the Netherlands, and Haiti. In general, the habit of wearing a mask before coronavirus disease 2019 (COVID-19) was reported by Taiwanese participants. Additionally, Taiwanese participants perceived that wearing a mask was a social responsibility during the pandemic, suggesting that the collectivistic context might influence mask-wearing behavior. Unlike the Taiwanese population, some people in the United States and the Netherlands were reluctant to wear masks due to perceived restrictions on their freedom. Participants from Haiti mentioned that people who wore masks encountered violence, bullying, and discrimination. The results of this study suggest that political leadership and mask mandates have a strong impact on people's mask-wearing behavior. These findings have valuable implications for the design of diverse behavioral interventions to enhance mask-wearing as part of infectious disease preparedness. Additionally, the findings from these countries offer valuable insights for the development of effective public health interventions to enhance society's resilience during the current pandemic and future infectious disease outbreaks.

Perceived Interpersonal Distances: A Cross-Cultural Analysis of Young Taiwanese and Young Southeast Asians during the COVID-19 Pandemic.

Prior research on interpersonal distance (IPD) has predominantly concentrated on specific nationalities or population groups within their respective regions. There is a dearth of studies investigating IPD differences among individuals of distinct nationalities coexisting in the same geographical location. This study aimed to examine the variances in IPD between 100 young Taiwanese participants (comprising 50 males and 50 females) and 100 Southeast Asian individuals (including 50 males and 50 females). This study also considered factors affecting IPD, including target genders and mask-wearing conditions. The results of the four-way ANOVA indicate that target gender and mask-wearing conditions had a significant impact on IPD (p < 0.001). While there were no significant main effects for region and participant gender, there was a noteworthy interactive effect between these two variables on IPD. In general, Southeast Asian participants exhibited lower sensitivity to changes in IPD in response to the independent variables in comparison to their Taiwanese counterparts; in certain instances, their IPD did not notably increase when confronted with targets not wearing masks. While prior research typically indicated that women tend to maintain larger IPD than men, the current study observed this gender difference only among young Taiwanese participants. However, such a gender gap was absent among young individuals from Southeast Asia.

Motivated cognitive control during cued anticipation and receipt of unfamiliar musical themes: An fMRI study

Principal themes, particularly choruses in pop songs, hold a central place in human music. Singing along with a familiar chorus tends to elicit pleasure and a sense of belonging, especially in group settings. These principal themes, which frequently serve as musical rewards, are commonly preceded by distinctive musical cues. Such cues guide listeners' attention and amplify their motivation to receive the impending themes. Despite the significance of cue-theme sequences in music, the neural mechanisms underlying the processing of these sequences in unfamiliar songs remain underexplored. To fill this research gap, we employed fMRI to examine neural activity during the cued anticipation of unfamiliar musical themes and the subsequent receipt of their opening phrase. Twenty-three Taiwanese participants underwent fMRI scans while listening to excerpts of Korean slow pop songs unfamiliar to them, with lyrics they could not understand. Our findings revealed distinct temporal dynamics in lateral frontal activity, with posterior regions being more active during theme anticipation and anterior regions during theme receipt. During anticipation, participants reported substantial increases in arousal levels, aligning with the observed enhanced activity in the midbrain, ventral striatum, inferior frontal junction, and premotor regions. We posit that when motivational musical cues are detected, the ventral striatum and inferior frontal junction played a role in attention allocation, while premotor regions may be engaged in monitoring the theme's entry. Notably, both the anticipation and receipt of themes were associated with pronounced activity in the frontal eye field, dorsolateral prefrontal cortex, posterior parietal cortex, dorsal caudate, and salience network. Overall, our results highlight that within a naturalistic music-listening context, the dynamic interplay between the frontoparietal, dopaminergic midbrain-striatal, and salience networks could allow for precise adjustments of control demands based on the cue-theme structure in unfamiliar songs.

AMERICANS AND TAIWANESE: A COMPARISON OF BELIEFS IN AND PREFERENCES FOR ADVANCE DIRECTIVES BY SOCIODEMOGRAPHICS

Abstract Introduction Advance directives (ADs) are legal documents that allow individuals to express their end-of-life wishes. However, cultural differences related to collectivism and family values may impact AD beliefs and preferences. This study compares AD beliefs and preferences between American and Taiwanese adults. Methods A survey was used to collect data from adults in the US (n=166) and Taiwan (n=2000) to assess AD beliefs and preferences. Propensity score matching was used to compare the populations, and bivariate analyses were conducted to identify AD-specific differences between the two groups. Results Compared to the US, Taiwanese participants were younger (mean age = 45 vs. 50), higher percentage female (80% vs. 63%), and higher percentage married (50% vs. 48%). Taiwanese adults had a higher belief in preparing an AD (89.3% vs. 80.7%; p=0.02) and were more willing to complete one than American adults (85.6% vs. 63.1%; p&amp;lt; 0.01). 59.4% of Taiwanese adults preferred their family/loved ones make healthcare decisions, compared to 46.0% of Americans (p=0.01). However, only 50.8% of Taiwanese adults believed their loved ones’ decisions aligned with their wishes, while 79.5% of Americans held this belief (p&amp;lt; 0.001). Conclusion This study reveals noteworthy differences in AD beliefs and preferences between the two groups, with Taiwanese adults valuing AD preparation more and being more willing to complete them. Taiwanese adults also rely on their loved ones to make AD decisions, even though they believe these wishes may not align with their own. These differences likely stem from cultural norms of filial piety and collectivism in Taiwan.

A randomized, placebo-controlled study of givosiran in patients with acute hepatic porphyrias (ENVISION): Final (36-month) analysis of the Taiwan Cohort

Background/purposeAcute hepatic porphyrias (AHP) are rare genetic disorders associated with acute neurovisceral attacks and chronic symptoms. This analysis was conducted to examine the long-term efficacy and safety of givosiran in Taiwanese participants in the ENVISION study (NCT03338816). MethodsPatients (age ≥12 years) with AHP and recurrent attacks were randomized to receive givosiran 2.5 mg/kg or placebo for 6 months during the double-blind period. Patients then switched from placebo to givosiran (placebo crossover group) or continued taking givosiran (continuous givosiran group) during a 30-month open-label extension period. The total study duration was 36 months. An analysis was conducted that included patients enrolled in Taiwan (N = 7). ResultsDuring the double-blind period and open-label extension period, the median annualized attack rates were 0.0 and 0.0, respectively, in the continuous givosiran group (n = 5) and 15.1 and 4.6, respectively, in the placebo crossover group (n = 2; 70 % decrease). Median annualized days of hemin use in the double-blind period and open-label extension period were 0.0 and 0.0, respectively, in the continuous givosiran group, and 23.8 and 5.0, respectively, in the placebo crossover group (79 % decrease). EQ-5D VAS scores remained relatively stable in both groups, and PPEQ responses indicated improved functioning and satisfaction in both groups. Delta-aminolevulinic acid and porphobilinogen levels remained low with long-term givosiran treatment. Serious adverse events were reported by 3 patients (43 %). ConclusionLong-term efficacy and safety results in the Taiwan cohort are consistent with those in the global cohort.

The Association among Urinary Lead and Cadmium, Serum Adiponectin, and Serum Apoptotic Microparticles in a Young Taiwanese Population.

Previous studies reported that lead (Pb) and cadmium (Cd) exposure are linked to changes in serum adiponectin; an adipokine that promotes glycolysis and inhibits gluconeogenesis to regulate glucose metabolism. However, no study has ever explored the relationship between exposure to these two heavy metals and adiponectin in adolescents and young adults. Additionally, the role of adiponectin in the relationship between Pb and Cd exposure and vascular endothelial cell apoptosis has never been investigated. In this study, 724 Taiwanese participants, aged 12 to 30 years, were enrolled to investigate the association among urinary lead and cadmium, serum adiponectin, and apoptotic microparticles (CD31+/CD42a-, CD31+/CD42a+, and CD14). The results of the current study revealed a statistically significant inverse association between urine Pb and Cd levels and adiponectin levels, as well as a positive association with apoptotic microparticles (CD31+/CD42a-, CD31+/CD42a+, and CD14). Adiponectin was also inversely correlated with CD31+/CD42a- and CD31+/CD42a+. Moreover, when subjects with both Pb and Cd levels above the 50th percentile were compared to those below it, the former group exhibited the lowest average adiponectin value. Additionally, a more pronounced positive association between heavy metals and apoptotic microparticles (CD31+/CD42a- and CD31+/CD42a+) was observed when adiponectin levels were lower. Furthermore, an interaction between adiponectin and heavy metals was identified in the relationship between these metals and CD31+/CD42a-. In conclusion, these findings suggest that Pb and Cd exposure may have an adverse effect on adiponectin, and it may play a role in the link between heavy metal exposure and the dysfunction of vascular endothelial cells. Future studies are needed to establish whether a causal relationship exists.

The acceptability of homebased exercise snacking and Tai-chi snacking amongst high and low function UK and Taiwanese older adults.

Introduction: Exercise "snacking" and Tai-chi 'snacking' protocols are designed to overcome typical barriers to older adults' participation in muscle strength and balance exercise, using short bouts of home-based exercise. This study aimed to investigate the acceptability of homebred exercise- and Tai-chi snacking in British and Taiwanese older adults of high and low physical function. Methods: Thirty-three British and Thirty Taiwanese older adults took part in semi-structured interviews, after trying 1-week of exercise- and Tai-chi snacking. The interview schedule and deductive framework analysis was based on the seven components of the Theoretical Framework of Acceptability (TFA). Differences between the Taiwanese and United Kingdom participants and those considered high versus low physical function were also analysed. Results: Both snacking regimes were found to be convenient and easy to implement. Participants reported that no activity had to be given up, and considered the programmes would be beneficial to their physical and mental health. Interestingly, more UK-based participants preferred the elegant and relaxing movements of Tai-chi snacking, yet participants with low physical function experienced difficulties when mastering Tai-chi movements. A few high physical function participants perceived exercise snacking to be tedious. Discussion: Overall, the snacking exercise was found to be acceptable and useful. Personal affective attitude and different cultural backgrounds may affect exercise participation. Nevertheless, it is important to consider individuals' physical function when designing exercise regime. The findings indicate that making Tai-chi snacking easier to master initially, building in progression and adding some upper body movements in the exercise snacking may further enhance acceptability.

Efficacy and Tolerability of Ramucirumab Plus Erlotinib in Taiwanese Patients with Untreated, Epidermal Growth Factor Receptor-Mutated, Stage IV Non-small Cell Lung Cancer in the RELAY Study.

In RELAY, a randomized, double-blind, phase III trial investigating the efficacy and safety of ramucirumab+erlotinib (RAM+ERL) or ERL+placebo (PBO) in patients with untreated, stage IV, epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC), RAM+ERL demonstrated superior progression-free survival (PFS) versus PBO+ERL, with no new safety signals. The aim of this paper was to report efficacy and tolerability findings for the Taiwanese participants of RELAY. Patients were randomized 1:1 to RAM+ERL or ERL+PBO. Primary endpoint was investigator-assessed PFS. Secondary endpoints included objective response rate (ORR), duration of response (DoR) and tolerability. Data for the current analysis are reported descriptively. In RELAY, 56 Taiwanese patients were enrolled; 26 received RAM+ERL, 30 received ERL+PBO. The demographic profile of the Taiwanese subgroup was consistent with that of the overall RELAY population. Median PFS for RAM+ERL/ERL+PBO, respectively, was 22.05 months/13.40 months (unstratified hazard ratio 0.4; 95% confidence interval 0.2-0.9); ORR was 92%/60%; median DoR was 18.2 months/12.7 months. All patients experienced one or more treatment-emergent adverse events (TEAEs); those most commonly reported were diarrhea and dermatitis acneiform (58% each) for RAM+ERL and diarrhea (70%) and paronychia (63%) for PBO+ERL. Grade ≥3 TEAEs were experienced by 62%/30% of RAM+ERL/PBO+ERL patients, respectively, and included dermatitis acneiform (19%/7%), hypertension (12%/7%), and pneumonia (12%/0%). PFS for the Taiwanese participants of RELAY receiving RAM+ERL versus ERL+PBO was consistent with that in the overall RELAY population. These results, together with no new safety signals and a manageable safety profile, may support first-line use of RAM+ERL in Taiwanese patients with untreated EGFR-mutant stage IV NSCLC. www. gov , NCT02411448.

How restorative landscapes can benefit psychological and physiological responses: a pilot study of human–nature relationships in Sweden and Taiwan

Restorative landscapes provide people with the opportunity to experience nature. This pilot study aimed to determine whether cultural differences affect psychological and physiological responses to restorative landscapes. Two populations, one in Taiwan and one in Sweden, were experimentally compared by showing them photos of restorative landscapes from each country. The results showed that restorativeness was affected more by photos of the restorative landscape in Sweden than in Taiwan. The results showed that restorativeness in terms of psychological and physiological responses was affected. A significant variation in heart rate was observed between the populations: Taiwanese participants experienced higher heart rates when viewing unfamiliar and novel scenery when compared to Swedish participants. No significant differences between the populations were observed regarding attention capacity, working memory, and muscle tension. The psychological and physiological responses to the two countries’ distinctive restorative landscapes may have implications for designing such landscapes in urban green spaces.

Universalists, Republicans and Rationalists: Exploring Health Sector Solidarity and Its Boundary through the Comparative Experience of Overseas Taiwanese

Abstract Through users’ cross-system comparative experience engaging with the health systems in Taiwan and other countries, this article probes into their understandings and value judgments and specifically their reasonings for the ‘solidarity with whom?’ question in the health sector solidarity. With the cross-system comparison approach, the study adopted semi-structured interviews with 30 Taiwanese participants who have studied, lived or worked abroad and engaged with the health system in Canada, the USA or the UK. This approach offers the opportunity for one to evaluate the health system in the home country from a relative viewpoint from the host country. The participants suggested that the boundary of Taiwan’s National Health Insurance (NHI) should be as inclusive as possible, covering all legal residents in Taiwan regardless of their status, and that the citizens should share more financial responsibility. The ethical reasons for supporting the NHI include recognizing health sector solidarity among people, considering the coverage as a protection of the human right to health, humanitarian reasons and self-interest. Three archetypes of users emerged from the synthesis: Universalists, Rationalists and Republicans. The cross-system comparative experience makes the participants have more supportive attitudes toward the ideals of health sector solidarity.

Sex difference in the associations among risk factors with depression in a large Taiwanese population study.

Depression is a common psychiatric health issue affecting an estimated 5% of adults worldwide, and it can lead to disability and increased economic burden. Consequently, identifying the factors associated with depression as early as possible is a vital issue. The aim of this study was to explore these associations in a large cohort of 121,601 Taiwanese participants in the Taiwan Biobank, and also to identify sex differences in the associations. The study cohort included 77,902 women and 43,699 men (mean age, 49.9 ± 11.0 years), who were further classified into those with depression (n = 4,362; 3.6%) and those without depression (n = 117,239; 96.4%). The results of multivariable analysis showed that female sex (vs. male sex; odds ratio = 2.578; 95% confidence interval = 2.319-2.866; p < 0.001) was significantly associated with depression. Older age, diabetes mellitus (DM), hypertension, low systolic blood pressure (SBP), smoking history, living alone, low glycated hemoglobin (HbA1c), high triglycerides, and low uric acid were significantly associated with depression in the men. In the women, older age, DM, hypertension, low SBP, smoking history, alcohol history, education level of middle and high school (vs. lower than elementary school), living alone, high body mass index (BMI), menopause, low HbA1c, high triglycerides, high total cholesterol, low estimated glomerular filtration rate (eGFR), and low uric acid were significantly associated with depression. Further, there were significant interactions between sex and DM (p = 0.047), smoking history (p < 0.001), alcohol use (p < 0.001), BMI (p = 0.022), triglyceride (p = 0.033), eGFR (p = 0.001), and uric acid (p = 0.004) on depression. In conclusion, our results showed sex differences in depression, and the women were significantly associated with depression compared to men. Furthermore, we also found sex differences among the risk factors associated with depression.

Depression, anxiety and post-traumatic stress during the 2022 Russo-Ukrainian war, a comparison between populations in Poland, Ukraine, and Taiwan

Ukraine has been embroiled in an increasing war since February 2022. In addition to Ukrainians, the Russo-Ukraine war has affected Poles due to the refugee crisis and the Taiwanese, who are facing a potential crisis with China. We examined the mental health status and associated factors in Ukraine, Poland, and Taiwan. The data will be used for future reference as the war is still ongoing. From March 8 to April 26, 2022, we conducted an online survey using snowball sampling techniques in Ukraine, Poland, and Taiwan. Depression, anxiety, and stress were measured using the Depression, Anxiety, and Stress (DASS)-21 item scale; post-traumatic stress symptoms by the Impact of Event Scale-Revised (IES-R) and coping strategies by the Coping Orientation to Problems Experienced Inventory (Brief-COPE). We used multivariate linear regression to identify factors significantly associated with DASS-21 and IES-R scores. There were 1626 participants (Poland: 1053; Ukraine: 385; Taiwan: 188) in this study. Ukrainian participants reported significantly higher DASS-21 (p < 0.001) and IES-R (p < 0.01) scores than Poles and Taiwanese. Although Taiwanese participants were not directly involved in the war, their mean IES-R scores (40.37 ± 16.86) were only slightly lower than Ukrainian participants (41.36 ± 14.94). Taiwanese reported significantly higher avoidance scores (1.60 ± 0.47) than the Polish (0.87 ± 0.53) and Ukrainian (0.91 ± 0.5) participants (p < 0.001). More than half of the Taiwanese (54.3%) and Polish (80.3%) participants were distressed by the war scenes in the media. More than half (52.5%) of the Ukrainian participants would not seek psychological help despite a significantly higher prevalence of psychological distress. Multivariate linear regression analyses found that female gender, Ukrainian and Polish citizenship, household size, self-rating health status, past psychiatric history, and avoidance coping were significantly associated with higher DASS-21 and IES-R scores after adjustment of other variables (p < 0.05). We have identified mental health sequelae in Ukrainian, Poles, and Taiwanese with the ongoing Russo-Ukraine war. Risk factors associated with developing depression, anxiety, stress, and post-traumatic stress symptoms include female gender, self-rating health status, past psychiatric history, and avoidance coping. Early resolution of the conflict, online mental health interventions, delivery of psychotropic medications, and distraction techniques may help to improve the mental health of people who stay inside and outside Ukraine.

Intergroup benefits of metacognitive cultural self? Cultural self-awareness and multicultural involvement on attitudes towards migrants

The investigation of attitudes towards different groups is crucial for improving intergroup relations and increasing acceptance of diversity. The present research examined the potential of metacognitive understanding of cultural self in improving attitudes towards migrants, as individuals reflectively consider their cultural assumptions in evaluating migrants. We tested the effect of individuals’ awareness of culture’s influence on the self (i.e., cultural self-awareness) and how such an effect was moderated by how much individuals’ life experience involved foreign cultures (i.e., multicultural involvement). Study 1 measured American participants’ cultural self-awareness and attitudes towards immigrants. Studies 2 and 3 manipulated Taiwanese participants’ cultural self-awareness and measured their attitudes towards Southeast Asian migrant workers (Studies 2 and 3) and marriage immigrants (Study 3). Results showed that cultural self-awareness had a more positive effect on attitudes towards migrants for low (vs. high) multicultural involvement individuals. The positive role of metacognitive cultural self in intergroup relations and the boundary conditions for such positive effect are discussed.