Taiwanese Research Articles

Social Policies for Older Indigenous People in Taiwan

Social Policies for Older Indigenous People in Taiwan

Environmental Risk Perception and Preventive Behavior during the COVID-19 Pandemic in Central Taiwan.

Due to traffic and industrial and seasonal air pollution, wearing masks outside the home has long been a daily habit for many people in Taiwan. After the emergence of the novel coronavirus (COVID-19), which has an incubation period of up to 14 days, wearing masks and maintaining social distancing was advised to reduce exposure to this new environmental risk. This study investigates open and semi-open spaces in three districts in central Taiwan, using a non-participant observation method, with the aim of understanding people’s mask-wearing behavior. The results indicate that mask-wearing rates were higher in urban areas than in rural ones and among females than males. By age cohort, mask-wearing was most prevalent among young adults and middle-aged people and least prevalent among minors, with the elderly occupying a middle position. Masks were also more likely to be worn in semi-open spaces than in open ones. This study enriches our understanding of environmental risk perception of the pandemic and of public perceptions, which are vital to increasing the adoption of preventative measures.

Geothermal energy development roadmap of Taiwan by play fairway analysis

Following the 2015 Paris Agreement dealing with the mitigation of global warming, the government and people of Taiwan have expressed their environmental awareness by accelerating the ongoing effort of substituting fossil-fuel power with green energy forms. With the deadline for promised energy policies approaching, more action is required of the geothermal option despite its high exploration cost and uncertainty issues.The Play Fairway Analysis (PFA) is an excellent low-cost decision-making tool with a quantitative approach and the capability to combine multiple factors from limited data sources and provide stakeholders a probability assessment in the early stage of the geothermal exploration. It can construct a prudent development roadmap combining geological elements alongside socioeconomic data in place.Considering the local aspects of the geological setting in metamorphic rocks and an active orogenic mountain belt uplift environment, the study adapts the PFA methodology using relevant data in geochemistry, geophysics, and geographies to depict the key geothermal factors in heat sources and fractural pathways. Existing elements available for analysis include (1) temperature of hot springs, silica geothermometry, and surface uplift rates for heat sources, and (2) active fault lines, shallow micro-earthquakes, dilatation strain rates, and elevation variation for fractural pathway. For pragmatic consideration, we choose population density and national parks to represent added human factors in this study to cover constrains such as operating cost, supply needs, regulations, and the like.Through normalizing and weighting processes from the ArcGIS platform, the resulting composite map, confirmed with previous research reports, displays the calculated values on each grid cell over the research area in an easy-to-read format. We present three suggested prospects labelled in this realistic map of potential geothermal distribution across Taiwan as candidates for the next phase of geothermal development projects as part of the long push to achieve our nation's green energy goals.

Influence of Wearing Surgical Mask on Interpersonal Space Perception Between Mainland Chinese and Taiwanese People.

Wearing face masks and maintaining social distancing of 1.5m are two common preventive measures against the spread of COVID-19. However, the interaction of these preventive measures in interpersonal space (IPS) perception remains unknown. This study evaluated the effects of wearing surgical masks, sex dyads, and approaching patterns on IPS judgment. Data were collected from participants from Mainland China (n=100) and Taiwan (n=100) through an online survey. Therefore, the regional differences were also examined. A smaller IPS was observed when participants faced confederates wearing surgical masks than in the no-mask condition. Female dyads tended to maintain a smaller IPS than did both male and mixed-sex dyads, and Taiwanese participants maintained a significantly larger IPS than did Mainland Chinese participants. No significant difference was observed between the active and passive pattern. Moreover, the interaction between region and mask had a significant influence on IPS perception. Among all test combinations, only the IPS perceived by Taiwanese participants facing confederates without surgical masks exceeded 1.5m. This study revealed that the wearing of surgical masks for health protection during the pandemic influences IPS perception in different regions. The current findings may provide useful information for social interaction and environmental design during the COVID-19 pandemic.

Cross-sectional assessment of medical students willingness to care toward older people in Taiwan

ABSTRACT The possibilities that medical students will take care of persons 65 years of age or older in hospitals and communities are increasing due to a growing aged population. This study marks one of the first in-depth attempts to explore willingness to care toward older peoples in Taiwan medical students. A cross-sectional research design was used. Stratified sampling was applied to recruit participants from six medicine colleges. There were 580 medical students who completed the questionnaire. A multiple regression analysis were conducted. The results found that the significant predictors of medical students’ willingness to care for older adults were perceptions of getting together with older people, grandparents were major caregivers during childhood, and experienced of being a volunteer who served older people. The findings of this study can provide information to faculty members and clinical preceptors for designing curricula and related activities or arranging practica.

Development of processing speed in the United States and Taiwan: A brief report

Processing speed is a critical component of intelligence, and an important cognitive ability in the facilitation of human learning. Previous studies have examined the development of processing speed across cultures. This study investigated processing speed performance using collective data from standardized Wechsler scales in the United States and Taiwan from the past two decades. Drawing comparisons between national norms from ages 4 to 80 years, the results revealed that older people in Taiwan recorded slower processing speeds than their US counterparts. Conversely, younger people in Taiwan recorded faster processing speeds than their US counterparts. This evidence shows that physiological, environmental, and genetic factors contribute to group differences in the development of processing speed.

Cross-Cultural Comparison of Sustainable Agro-Food Consumption from Consumers’ Perspectives: Cases from Taiwan and France

Sustainable agro-food consumption is a model intended to conserve the resources of today for future need. Consumers play a crucial role in transitioning towards sustainable food consumption, as they judge the attributes of products on the market and are the final decision-makers when it comes to changing consumption habits. Consequently, investigations on agro-food consumption from consumers’ perspectives are of great value. Therefore, we first referred to 60 articles to summarize 11 important factors of sustainable food consumption and identified three possible policy measures from the perspectives of consumers and cultural conditions, evaluating them using cases from both France and Taiwan. In addition, this study showed the dissimilarities between eco-consumption preferences for the two case areas, also evaluating consumers’ expectations on future policy alternatives through the application of the analytical hierarchy process (AHP) and a survey. Moreover, demographic comparisons have been undertaken to support, explain, and re-examine the results. The results show that the key factors for sustainable food consumption are product accessibility, tradition, and regional factors. Policy measures focus on product certification and information. Due to different perceptions regarding product differentiation, people in Taiwan pay less attention to sustainable food prices. In France, obvious age-differentiated preferences as regards the promotion of policies were revealed: young people preferred certification, whilst elderly people preferred the provision of information.

Can We Return to Our Normal Life When the Pandemic Is under Control? A Preliminary Study on the Influence of COVID-19 on the Tourism Characteristics of Taiwan

The COVID-19 pandemic has brought unprecedented destructive impacts and challenges to global industry and has had a wide impact on people’s lives. The threat of the virus has also caused a change in tourist travel consumption behavior. This study preliminarily examines the impact of the COVID-19 pandemic on the tourism consumption characteristics of Taiwanese people. The consumption characteristic changes of 393 people regarding their plans for domestic and outbound tourism during the different stages of the COVID-19 pandemic as well as after the pandemic ends were surveyed and collected. This study also examined and attempted to understand the relationship between people’s satisfaction with the government’s revitalization plan, the pandemic prevention policy, and their domestic tourism frequency during the pandemic period, and the results showed that during the pandemic, people’s tourism characteristics have changed and tend to be conservative. Since the pandemic is over, while there were no significant differences between people’s planned travel expenditures in Taiwan and those before the outbreak, their intended travel time was shortened. Regarding the choice of travel equipment, people had reduced the use of public transportation. Regarding outbound tourism, after the pandemic, as people’s planned travel days will be reduced, it is expected that travel expenditures will be significantly higher than before the pandemic, which shows that the COVID-19 pandemic has an impact on people’s outbound tourism consumption characteristics. During the pandemic, compared with the subsidies for tourism, how to make people feel at ease in the process of tourism is of great importance. Therefore, it is suggested that in the short-term, border control and social pandemic prevention policies should be adopted to enhance people’s confidence in government pandemic prevention, and the general public should be supplemented with travel subsidies in order to promote people’s enthusiasm for tourism. The results of this study provide useful suggestions for government units, tour operators, and related research during the pandemic and offer preliminary insights for the recovery of the tourism industry after the pandemic.

Stressful Experiences, Connection, and Depressive Symptoms Among Taiwanese Han and Indigenous Youth.

This study examined Taiwanese Han and indigenous (Tayal) youth’s experiences of stressful life events, the association between stressful experiences and depressive symptomology, and also the indirect and interactive effects of connection on the relationship between stressful experiences and depressive symptomology. Taiwanese Han (97%) is the majority group, whereas indigenous people make up 2.3% of Taiwan’s population. Taiwanese indigenous people have experienced disparities across socio-historical, educational, and economic aspects of their lives. This study included 291 eighth-grade participants (40% from the Tayal tribe, 48.8% female, and Mage = 13.44). The Han sample in this study all lived in cities, and the Tayal sample all lived in the tribal areas of the Northern Taiwan mountain regions. Person-centered (latent class analyses) and cumulative (sum of items) approaches were used to investigate family and school stressful events, respectively. Hierarchical regression analyses were conducted separately for the Han and Tayal participants to examine the role of family and school connection in relation to family and school stressors and depressive symptomology. Our results showed that stressful experiences are clearly linked to depressive symptomology and family connection was important to both Tayal and Han youth in supporting their coping with depressive symptoms. However, Tayal youth might be particularly vulnerable to family stressful events because family stressors disrupted their connection with their parents and thereby minimized the protective function of family relationships. To decrease the likely onset of depression during early adolescence, our results suggest that it is important for parents and other family members to monitor adolescents’ daily experiences of stress and provide support when needed. Furthermore, mental health interventions need to be tailored specifically for youth in specific racial, social, and economic contexts. Tayal youth mental health might benefit particularly from increasing school connection and decreasing stresses experienced in family contexts. Implications, limitations, and recommendations for future research are discussed.

Public Perception of Artificial Intelligence and Its Connections to the Sustainable Development Goals

Artificial Intelligence (AI) will not just change our lives but bring about revolutionary transformation. AI can augment efficiencies of good and bad things and thus has been considered both an opportunity and risk for the sustainable development of humans. This study designed a survey to collect 1018 samples of educated people with access to the internet in Taiwan regarding their perceptions of AI and its connections to the Sustainable Development Goals (SDGs). The respondents showed high confidence in their AI knowledge. They had a very positive attitude toward AI but at the same time thought AI was risky. In general, people in Taiwan could be “rational optimists” regarding AI. We also examined how people think of the linkages between AI and the SDGs and found that SDG 4, SDG 9, and SDG 3 had the highest “synergy” and lowest rates of “trade-off”. Significant differences for some key questions were also identified concerning the demographic variables such as gender, age, education, and college major. According to the data analysis, education played as the base to construct a sustainable AI-aided town with an embedded innovative circular economy and high-quality water and energy services, making the residents live healthier lives. The findings of this study can be referred to when the perceptions of AI and sustainability issues are of interest for an emerging high-tech economy such as Taiwan and other Asian countries.

Linkage between ABO Blood Type and Occupation: Evidence from Japanese Politicians and Athletes

In Asian countries, e.g., Japan, South Korea, China and Taiwan, many studies on the relationship between ABO blood type and personality have been conducted. Recently, it has been estimated that more than half of Japanese, Korean and Taiwanese people feel that this relationship is legitimate. Therefore, when data from these countries are used in personality tests, it is theoretically difficult to eliminate the effects of the “contamination of knowledge,” even if differences are found. To avoid this issue, this study examined the linkage between ABO blood type and occupations in Japan. The results showed that personality traits corresponding to blood type appeared in the data of each of the three groups of politicians and athletes, and all differences were statistically significant. We observed a clear and significant relationship between blood type and personality. Additionally, it is also necessary to consider the influence of social background.

Reported sources of health inequities in Indigenous Peoples with chronic kidney disease: a systematic review of quantitative studies

BackgroundTo summarise the evidentiary basis related to causes of inequities in chronic kidney disease among Indigenous Peoples.MethodsWe conducted a Kaupapa Māori meta-synthesis evaluating the epidemiology of chronic kidney diseases in Indigenous Peoples. Systematic searching of MEDLINE, Google Scholar, OVID Nursing, CENTRAL and Embase was conducted to 31 December 2019. Eligible studies were quantitative analyses (case series, case-control, cross-sectional or cohort study) including the following Indigenous Peoples: Māori, Aboriginal and Torres Strait Islander, Métis, First Nations Peoples of Canada, First Nations Peoples of the United States of America, Native Hawaiian and Indigenous Peoples of Taiwan. In the first cycle of coding, a descriptive synthesis of the study research aims, methods and outcomes was used to categorise findings inductively based on similarity in meaning using the David R Williams framework headings and subheadings. In the second cycle of analysis, the numbers of studies contributing to each category were summarised by frequency analysis.Completeness of reporting related to health research involving Indigenous Peoples was evaluated using the CONSIDER checklist.ResultsFour thousand three hundred seventy-two unique study reports were screened and 180 studies proved eligible. The key finding was that epidemiological investigators most frequently reported biological processes of chronic kidney disease, particularly type 2 diabetes and cardiovascular disease as the principal causes of inequities in the burden of chronic kidney disease for colonised Indigenous Peoples. Social and basic causes of unequal health including the influences of economic, political and legal structures on chronic kidney disease burden were infrequently reported or absent in existing literature.ConclusionsIn this systematic review with meta-synthesis, a Kaupapa Māori methodology and the David R Williams framework was used to evaluate reported causes of health differences in chronic kidney disease in Indigenous Peoples. Current epidemiological practice is focussed on biological processes and surface causes of inequity, with limited reporting of the basic and social causes of disparities such as racism, economic and political/legal structures and socioeconomic status as sources of inequities.

Letter to the Editor: Impact of COVID-19 Prevention Methods on Influenza and Other Respiratory Infections in Taiwan

Population Health ManagementVol. 24, No. 5 Letters to the EditorFree AccessLetter to the Editor: Impact of COVID-19 Prevention Methods on Influenza and Other Respiratory Infections in TaiwanDaniel L. Clinciu, Cheng-Hsien Chen, Jong-Yi Wang, and Garry HuangDaniel L. Clinciuhttps://orcid.org/0000-0001-5272-1414Department of Basic Medical Science, Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, Taiwan.Search for more papers by this author, Cheng-Hsien ChenDepartment of Optics and Photonics, National Central University, Taoyuan City, Taiwan.*Correction added on August 3, 2021 after first online publication of July 14, 2021: The second author name has been corrected from Cheng-Shien Chen to Cheng-Hsien Chen.Search for more papers by this author, Jong-Yi WangDepartment of Health Services Administration, China Medical University, Taichung City, Taiwan.Search for more papers by this author, and Garry HuangAddress correspondence to: Garry Huang, PhD, Department of Health Care Administration, College of Management, Taipei Medical University, No. 250, Wuxing St., Xinyi District, Taipei City 110, Taiwan E-mail Address: garryhuang@tmu.edu.twhttps://orcid.org/0000-0002-1328-5055Department of Health Care Administration, College of Management, Taipei Medical University, Taipei City, Taiwan.Search for more papers by this authorPublished Online:18 Oct 2021https://doi.org/10.1089/pop.2021.0140AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail The mandatory wearing of face masks, hand sanitizing, and technology-aided quarantines have been in Taiwan since January 2020 to protect against spreading COVID-19.1,2 It is highly likely that COVID-19 prevention methods lowered the number of infections from various common respiratory infections. Therefore, we investigated the effect of the COVID-19 prevention methods on the incidence of other common respiratory infections.Using the Taiwan National Infectious Disease Statistics System, we analyzed the incidence of respiratory infectious diseases (eg, influenza season before and during the COVID-19 pandemic, December 2019–February 2021). We looked at trends of influenza, meningitis, and gastroenteritis in Taiwan before and during the COVID-19 pandemic to determine if Taiwan's efficient COVID-19 mandates (eg, wearing face masks in public places; hand sanitizing at the entrance of public transportation systems, supermarkets, schools, and other facilities; technology-aided quarantines) changed the trends of these common infectious diseases.3In week 52 of year 2020, almost a year after nationwide mandates for face masks, hand sanitation, and quarantines began, there were no confirmed cases of severe influenza in Taiwan. Notably, on week 2 of 2020, before COVID-19 mandates went into effect, there were 109 confirmed severe cases at the height of the influenza season. There also were 5 cases of confirmed severe viral gastroenteritis, as opposed to only 1 confirmed severe case after preventive measures were implemented. Additionally, there were 2 cases of confirmed severe meningococcal meningitis before February 2020 compared to 0 cases from February 2020 through March 2021.The Taiwan National Infectious Disease Statistics System only records severe/complicated cases of infectious diseases; thus, many cases of mild influenza and/or other unrecorded infectious diseases that likely were prevented by mandatory face masks, hand sanitation, and quarantines were not recorded. Some countries may have experienced similar trends for common respiratory infections as Taiwan. Arguably, in other countries, reduced cases of common infections also could be attributed to more people staying home because of lockdowns, and fear of COVID-19. However, Taiwan implemented no lockdowns and there was no indication that more people in Taiwan stayed home during the pandemic, as trains and buses often operated at maximum capacity and people are seen outdoors in large numbers. The reduced number of influenza infections and other infectious diseases meant decreasing health care costs and reducing the burden on the health care system.Taiwan's example could influence and benefit other nations that, prior to the COVID-19 pandemic, did not value the benefits of face masks during influenza season, with many places and people even now stigmatized or showing skepticism over wearing face masks in public.4 Although it seems reasonable that poorer nations initially could not afford to provide masks for everyone in the country, it is clear that the cost of face masks is lower by far than the costs of providing ventilators and other medical technologies as a result of COVID-19, influenza, and other infectious diseases. Overall, the COVID-19 pandemic may have uncovered many important aspects for health care systems worldwide and population health management, especially influenza infections and other common respiratory infections.Author Disclosure StatementThe authors declare that there are no conflicts of interest.Funding InformationNo funding was received for this letter.

Changing Attitudes toward China in Taiwan and Hong Kong in the Xi Jinping Era

ABSTRACT This study examines public attitudes toward China in Taiwan and Hong Kong. It finds that before 2019, a majority of people in Taiwan and Hong Kong held positive views about the future development of China. However, many of their positive views suddenly changed during the 2019–2020 period. Those two years witnessed several contingent events underlining political tensions across the Taiwan Strait, and between China and Hong Kong. In addition, this study shows that self-interest considerations and ideology-oriented factors have different effects on public attitudes toward China in Taiwan and Hong Kong. In Taiwan, both self-interest and ideology-oriented factors have significant impacts; in Hong Kong, only ideological factors, including local identity, party identification, and belief in democracy, have significant associations with public attitudes toward China.

Differences in the Protection Motivation Theory Constructs between People with Various Latent Classes of Motivation for Vaccination and Preventive Behaviors against COVID-19 in Taiwan.

The present study aimed to identify the distinct classes of motivations to get vaccinated and to adopt preventive behaviors against the coronavirus disease 2019 (COVID-19) among people in Taiwan and to examine the roles of Protection Motivation Theory (PMT) cognitive constructs in these unique classes of motivations to get vaccinated and to adopt preventive behaviors. We recruited 1047 participants by using a Facebook advertisement. Participants’ motivations to get vaccinated and to adopt preventive behaviors against COVID-19, PMT constructs of threat appraisal (perceived severity and perceived vulnerability), and PMT constructs of coping appraisal (self-efficacy, response efficacy, response cost, knowledge, and previous vaccination for seasonal influenza) were determined. We analyzed participants’ motivations to get vaccinated and to adopt preventive behaviors against COVID-19 by using latent profile analysis. The present study identified three latent classes, including the participants with high motivation for vaccination and preventive behaviors (the class of Both High), those with low motivation for vaccination and preventive behaviors (the class of Both Low), and those with high motivation for vaccination but low motivation for preventive behaviors (the class of High Vaccination but Low Preventive Behaviors). Compared with the participants in the class of Both High, participants in the class of Both Low had lower levels of perceived vulnerability, perceived severity, self-efficacy to have vaccination, response efficacy of vaccination, knowledge about vaccination, and previous vaccination for seasonal influenza; participants in the class of High Vaccination but Low Preventive Behaviors had lower levels of perceived vulnerability and perceived severity but higher levels of response cost of vaccination. We concluded that varieties of motivations, threat, and coping appraisals should be considered in intervention programs aiming to increase motivation to adopt recommended protective behaviors against COVID-19.

Ten-year trends in lifestyle habits among community-dwelling older people in Taiwan.

Different lifestyles may contribute to chronic diseases or a health condition. We aimed to study trends in lifestyle habits among community-dwelling older people. This retrospective time-trend study enrolled 429108 participants from the Senior Citizen Health Examination in Taiwan over ten years (2001-2010). We analysed lifestyle habits including smoking, alcohol, betel nut chewing, milk drinking, fruit and vegetable intake, car driving and motorcycle riding. Joinpoint regression was used to identify changes in trend. The overall rate of smoking, alcohol and betel nut chewing was 8.2%, 18.1% and 0.3%, respectively. Smoking rates decreased gradually, but alcohol and betel nut chewing increased. We found that milk drinking, fruit and vegetable intake and car driving initially increased and then later decreased. The change in the trend was in 2003. There were significant turning points in milk drinking, fruit and vegetable intake and car driving. Implementation of strategies to change the behaviors of citizens about the intake of fruit and vegetable and milk drinking is important.

An Analysis of Behavioral Models Relating to Renewable Energy in Taiwan

This study sought to understand the behaviors and attitudes of people in Taiwan as they relate to the government’s RE policies by analyzing data from a questionnaire-based telephone survey conducted between 2013 and 2015. Demographic attributes in people’s behavioral models were analyzed for two variables: attention and support. Based on the findings, people’s behavioral models relating to RE were classified into five categories: key promotional group, promotional seed group, support-strengthening group, attention-strengthening group, and non-key promotional group. The attributes of these five segments were also analyzed and their corresponding promotional strategies were formulated. The overarching goal was to improve precision in marketing RE policies to various target groups in order to maximize impact.

The Evolution of The Colonial Modern Press in Taiwan：An Introduction to Tâi Oân Chheng Liân, Formosa, and Taiwan Minpao

The year 2021 marks the 100th anniversary of the founding of the Taiwanese Cultural Association, which was one of the most representative elements of Taiwan’s anticolonial movement in the 1920s. In order to commemorate this historically significant cultural organization, in 2018 the National Museum of Taiwan History began producing facsimile editions of Tâi Oân Chheng Liân (Taiwan Youth), Formosa (Taiwan), and Taiwan Minpao (Taiwan People’s News), which were published in the period of the “imported press”, from July 1920 to July 1927.This essay provides an overview of the development of the colonial modern press, which were called “the only organ for Taiwanese opinions,” by discussing Tâi Oân Chheng Liân , which was initially published in Tokyo, the maintenance and expansion of Formosa, and then its transformation into Taiwan Minpao. In addition, this essay outlines the various forms of domination and resistance evident between the colonizer and the colonized, which centered around the censorship system that regulated the publication and circulation of the printed media in colonial Taiwan. For the Taiwan Governor-General’s Office, it was necessary to reduce the influence of the anti-colonial modern press, which were founded by Taiwanese people, on politics and public opinion. On the other hand, the editors and supporters of Tâi Oân Chheng Liân , Formosa, and Taiwan Minpao attempted to transform the Taiwanese from passive readers of printed media to active mobilizers of public opinion.

Homo economicus? An investigation of factors influencing perceived comfort of choosing paper-based triple stimulus vouchers

PurposeTo alleviate the effects of coronavirus disease 2019 (COVID-19) on the economy, Taiwan introduced a stimulus package in the form of triple stimulus vouchers. Despite intense promotion to opt for the vouchers in digital form, Taiwanese public overwhelmingly chose the paper form. This study considers the reasons that influenced their decision comfort in choosing paper rather than digital vouchers based on two categories: rational (promotion depth and ease of use) and behavioral economics factors (analysis paralysis, mental accounting related to ease of tracking expenses, social influence and payment habits).Design/methodology/approachPartial least squares (PLS) method was utilized to analyze survey information obtained from 183 individuals who chose paper vouchers.FindingsIndividuals consider rational and behavioral economic factors in their perception of decision comfort while choosing paper over digital vouchers. Decision comfort is driven more by behavioral economics than rational factors such as ease of use. Interestingly, analysis paralysis related to paper vouchers has the greatest impact, but it positively influences decision comfort, indicating that Taiwanese people view paper vouchers as a safe haven in the midst of uncertainties and information overload. Therefore, when designing public policies or promotional campaigns, possible behavior outcomes should be considered from both rational and behavioral economic perspectives.Originality/valueThis study provides insights into the dynamics of how individuals arrive at their decision of opting paper vouchers over digital ones and offers theoretical contributions related to system adoption and behavioral economics.

Association among pterygium, cataracts, and cumulative ocular ultraviolet exposure: A cross-sectional study in Han people in China and Taiwan.

PurposePterygium is an ocular surface disorder mainly caused by ultraviolet (UV) light exposure. This study explored the relationships between six cataract types with pterygium and UV exposure.MethodsWe have previously studied cataracts in residents of three regions in China and Taiwan with different UV intensities. From that study, we identified 1,547 subjects with information on the presence or absence of pterygium. Pterygium severity was graded by corneal progress rate. Cataracts were graded by classification systems as three main types (cortical, nuclear, posterior subcapsular) and three subtypes (retrodots, waterclefts, fiber folds) with high prevalence in middle-aged and elderly people. We calculated the cumulative ocular UV exposure (COUV) based on subject data and National Aeronautics and Space Administration data on UV intensities and used logistic regression to calculate odds ratios for the associations of COUV, cataract, and pterygium.ResultsWe found an overall pterygium prevalence of 23.3%, with significant variation among the three regions. Four cataract types (cortical, nuclear, posterior subcapsular, and retrodots) were significantly associated with the presence of pterygium.ConclusionsThere was a significant association between COUV and pterygium, indicating that COUV is associated with the risk of pterygium development and that pterygium is useful as an index of UV exposure. Furthermore, the type of cataract in eyes with pterygium may indicate the level of UV exposure.