Shiue-Ming Lin1, Chyi-Huey Bai2, Li-Ming Lien1 1. Shin Kong Wu Ho-Su Memorial Hospital, Taiwan 2. Taipei Medical University, Taiwan
High sensitive C-reactive protein (CRP) has shown a strong association with increased risks of clinical vascular diseases. However, the association with silent brain infarction (SBI) is unclear, especially in the population with low CRP levels. We explore to observe the association of CRP and SBI in general population.
Total of 74 cases and 296 controls included from 2 studies in community. Case is those had no history of stroke but had ischemic lesion in brain MRI. Four randomly sampled controls matched by age, gender and study population, from those subjects without SBI. All persons accessed the CRP levels. The subjects with SBI, than without SBI, had significantly more hypertensive, diabetics, hyperlipidemia, history of cardio-vascular disease, and higher proportions of above median CRP(≧0.133 mg/dL). Of raised CRP level to SBI risk, the age- & sex-adjusted odd ratio (OR) is 1.87 (p=0.0237) and multivariate OR is 1.71 (p=0.0569). Elevated CRP level had most markedly progression additive effects with higher Framingham stroke scores (FSS, ≧10) and serious plaque score (PS, ≧4). The persons with above median CRP levels had an additional SBI risk in those with raised FSS (OR, p: 4.06, 0.0014) or PS (3.89, 0.0004), whereas, in those without raised FSS or PS risk, those with below median CRP level did not have an increased SBI risk.
SP-185
Correlates and Accuracy of Osteoporosis Screening among Female Community Residents
Eugene Yu-Chang Peng1, Shu-Yu Lyu2, Po-Tswen Yu3, Liang-Ting Tsai4
1. Taipei City Hospital, Taiwan 2. Taipei Medical University, Taiwan
3. Health Education Center, Bureau of Health Promotion, Department of Health, the Executive Yuan, Taiwan 4. National Taichung University, Taiwan
Objectives: To explore the correlates of osteoporosis screening behavior among female community residents and to examine the accuracy of osteoporosis screening.
Method: A telephone survey was conducted using nation-wide representative samples of female community residents aged 25 and older. Data were collected using computer-assisted telephone interview systems by stratified random sampling according to geographic areas.
This survey (N=1,074) was conducted weekdays from September 24 to 30, 2008. A logistic regression was used to explore association between demographic variables and osteoporosis screening behavior.
Results: A total of 29.2% subjects underwent quantitative ultrasound (QUS) and 13.4% underwent
dual-energy X-ray absorptiometry (DXA) in the past year, with abnormality rates of 35.3% and 32.7%, respectively. The false positive rate of QUS based on DXA outcome was 26.1%; however, only 28.8% of subjects with osteoporosis diagnosed by QUS further undertook DXA. Multiple logistic regression analyses revealed that age 65 or above(OR=3.83,
95%CI=2.03-7.23), age 51 to 64(OR=2.31,
95%CI=1.55-3.45), northern residential area (OR=3.38, 95%CI=1.27-9.00), central residential area (OR=3.74, 95%CI=1.35-10.32), southern residential area (OR=3.75, 95%CI=1.39-10.07), those having a full time
job(OR=1.46, 95%CI=1.03-2.06), were more likely to undergo QUS compared to their counterparts, after controlling for subjects' level of education and household income.
Conclusions: Age, residential area, and working status were significantly correlated with osteoporosis screening behavior. We therefore not only call for increased awareness on osteoporosis screening but also
recommend further investigation once diagnosed with osteoporosis by QUS.
SP-186
Caregiver Burden among Caregivers for Children with Rare Diseases
Eugene Yu-Chang Peng1, Shu-Yu Lyu2, Chih-Chien Yang3, Sz-Fan Chen2, Liang-Ting Tsai3
1. Taipei City Hospital, Taiwan 2. Taipei Medical University, Taiwan 3. National Taichung University, Taiwan
Objective: The aim of this study was to explore the level of caregiver burden for rare disease children.
Method: There were 695 rare disease children aged 7-15 registered as members of the Taiwan Foundation for Rare Disorders. An anonymous questionnaire for the caregiver was mailed to these members’ family. A total of 344 subjects were recruited in this survey with the response rate of 49.5%. A total of 231 subjects meet the criteria of government announced rare diseases and were included in the data analyses. The Chinese version of Caregiver Burden Inventory (CCBI) and Zarit’s burden Interview-Chinese version (CZBI) were used as an instrument to measure the level of caregiver burden.
Results: The main caregiver of these rare disease children was the mother (80.5%), the father (13.4%) and others (6.1%). Roughly 47.2% of the children were diagnosed as having rare disease before two years of age, and 67.1% of their diseases were reported under control during the survey period. The mean score of the CCBI was 43.53±18.94 and it was lower than that of patients with dementia from other studies. Besides, the mean score of the CZBI was 36.04±15.94 and it was higher than that of patients with dementia from other studies.
Conclusion: The difference of mean CCBI/CZBI score of patients in this study compared to other studies raises the importance of targeted and tailored educational
counseling for this high-risk population.
Poster Session II
SP-187
Factors Contributing to Uptake of Influenza Vaccine among Community-Dwelling Elderly in Taiwan Chia-Nien Liu
National Open University, Taiwan
Objective: The objective of this study is to investigate the relationships between influenza vaccination and health status, health behavior, living arrangement, and outpatient visits for community-dwelling elderly.
Methods: This study selected a cross-sectional sample of elderly aged 65 and above from the National Health Interview Survey (NHIS) in 2005. The study sample represented senior citizens who resided in Taiwan in 2005, due to the sampling method of probability proportional to size used in NHIS. Data on individual influenza vaccination status in the last year was collected by questionnaire in NHIS. Analysis was conducted using Chi-square and logistic regression.
Results: Vaccine uptake in the total sample of 2,621 elderly was 57.6%. For male, those aged between 75 and 84 (OR=1.2, 95%CI=1.0, 1.4), living with spouse
(OR=1.4, 95%CI=1.1, 1.7), suffering with heart (OR=1.2, 95%CI=1.0, 1.4) or respiratory disease (OR=1.3,
95%CI=1.0, 1.5), keeping good health behaviors like exercise (OR=1.3, 95%CI=1.2, 1.5) and health examination (OR=1.6, 95%CI=1.4, 1.8), and making outpatient visits for last month (OR=1.2, 95%CI=1.1, 1.4), were more likely to uptake influenza vaccine. For female, elderly with diabetes (OR=1.3, 95%CI=1.1, 1.5), doing exercise (OR=1.2, 95%CI=1.0, 1.3) and health examination (OR=1.5, 95%CI=1.3, 1.8), and making outpatient visit for last month (OR=1.3, 95%CI=1.1, 1.5), were more likely to uptake influenza vaccine.
Conclusions: Vaccine uptake was associated with good health behavior, health status, and outpatient visit for both gender, and linked to living arrangement and age group for male.
SP-188
Different Types of Physical Activity and Eight-Year All-Cause Mortality among Taiwanese Older Adults Po-Wen Ku12, Li-Jung Chen3, Wen-Jung Sun4, Pe-Sus Chou2
1. National Changhua University of Education, Taiwan 2. National Yang-Ming University, Taiwan
3. National Taiwan Sport University, Taiwan 4. Hunei Health Station, Taiwan
Background: This study was designed to assess the effects of overall and different types of physical activity on all-cause mortality among older adults.
Methods: This research was a population-based study of residents aged 65 years and older (N=2133) in the township of Hunei in Taiwan from 1999 to 2007. There were 649 deaths during a mean follow-up of 6.9 years.
Physical activity was evaluated with the Physical Activity Scale for the Elderly (PASE). The Cox proportional hazard models were used to estimate the
association of physical activity with mortality adjusted for baseline potential confounders. Etiological fractions of death for physical activity among the exposed group were calculated.
Results: This study showed an inverse pattern of association between leisure physical activity and mortality with a 68% and 34% increase in low active men and women with multivariate adjustment. The low household activity groups had more than 30% increase in mortality risk. No significant association was found between work-related physical activity and longevity.
The low overall physical activity group had 64%
increase in the risk of all-cause mortality. Around 20%
of death in the population was attributable to leisure, household or overall physical activity.
Conclusion: This study extends the understanding of associations between different types of physical activity and longevity for the Chinese in Taiwan and fills the gap in the existing literature focusing on Western countries.
SP-189
Prospective Study of Physical Activity and Academic Performance in Elementary School Children
Jhih-Yuan Lin1, Po-Wen Ku1, Li-Jung Chen2, Jhing-Hui Wang1
1. National Changhua University of Education ,Taiwan 2. National Taiwan Sport University, Taiwan
Introduction: The relationship of physical activity with academic performance among school children with a six-month follow-up period was studied.
Methods: Data were collected among the grade six students (n=409, boys: 210) in one school in Taichung County, Taiwan from the first semester of the 2007 academic year with a six-month follow-up interval.
Academic performance (outcome) was the total scores in the end of the second semester of the 2007 academic year provided by the shcool. Physical activity (exposure) was measured using the International Physical Activity Questionnaire (IPAQ). Covariates included gender, intelligence quotient, depressive symptoms, baseline academic performance, father’s/mother’s educational level, whether the child belongs to single parent household. Multiple linear regression model was then adopted for predicting academic performance. The Model was conducted again statified by genders and then by different subjects, comprising language and
mathematics.
Results: Children whose participation in high or moderate physical activity level had higher scores than low physical activity level (high: β=4.60, p<.01;
moderate: β=3.50, p<.05). Boys whose participation in high or moderate physical activity level had higher scores than those with low physical activity (high:
β=4.99, p<.01; moderate: β=4.88, p<.05), but no significant correlation was found in girls. Those who with high activity level performed better on subjects of language (β=4.04, p<.01) and mathematics (β=4.54, p<.01).
Conclusions: Physical activity is positively associated with academic performance in elementary school children. Eeducational authorities, schools and parents should encourage children to participate physical activity regularly.
SP-190
Benzodiazepine Misuse Problem and Developement to Narcortic Drug in Rural Area Thailand
Sukdepat Puangkot1, Udom Pongpila2, Mali Potipim3 1. Charlermkanchana College, Thailand
2. Ubonratchathani Province Public Health Office, Thailand
3. Phiboonmansahan Hospital, Thailand
Background: benzodiazepine is one of sedative and hypnotic drugs. Increasing of its misuse and abuse makes it play an important role as narcotic drugs in Thai society.
Study Design: A qualitative research was conducted for this research. Source of data and key informant: 18 key informants willing to participate in this study were drawn from a population based survey of sedative and hypnotic drug use in rural area, northeastern region of Thailand.
As misuse and abuse drug users, key informants were identified in accordance with international standard criteria of DSM IV (revised version 1994).
Method: An in-depth interview of misuse experiences was implemented. Data analysis was performed using content analysis and triangulation methods.
Result: Most frequently used Benzodiazepine drugs were Diazepam, Lorazepam and Alprazoram. Most misused group was women who were housewife. Usually drug misuse begins with medical treatment and then drug addiction is slightly developed. Most of key informants were patients who habituated drug used reflected that benzodiazepine in their lives is harmless. Some user used Benzodiazepine as narcotic drugs, second line drugs and used involved with cannabis, alcohol and
methamphetamine. Drug users can easily find out Benzodiazepine from hospitals and some of them bought from nightclubs and smugglers from Thai-Lao free trade border.
Conclusion: Sedative and hypnotic drugs in
Benzodiazepine group have been increasing misuse until becoming abuse. Medical Law need increased strictly control and medicine dispensation of medical treatment in public health system should be seriously considered.
SP-191
Scoda as Peer Education Based on Senior High School in Effort to Prevent Drugs Abuse Tri T Yeni Tri Herwanto
University of Airlangga, Indonesia
Threat caused by drugs in Indonesia was increasing especially at young generation. High school student need the different ways to prevent drugs abuse. One of them,
it’s a peer education program. Therefore, it needed something like organization at student level which can give information. Then, it created a Study Club on Drugs Abuse (SCODA) as a peer education school-based on drugs abuse prevention. This activity was implemented in one high school in Gresik. Method of the activity was student empowerment and advocating. Student
empowerment conducted through training program by giving subjects, simulations, games, giving assignment and study tour. Whereas advocating in order to get commitment from school side to develop the
organization. The instruments used were questionnaire, subject module, training kit, simulation and game tools.
For evaluation the program used pre-post test. The outcome that have been got from these activities were Study Club on Drugs Abuse (SCODA) as peer education organization to prevent drug abuse, members of SCODA as many as 14 students who done elucidation and extension for 100 students in same school and increased knowledge about drugs and prevention measures among them. Furthermore, it can decrease drugs abuse rates among high school student. Finally, SCODA can be developed to other high schools in Indonesia, as well.
SP-192
Usefulness of Self-Report of Hypertension in Predicting Follow-Up Risks of Chronic Diseases and Mortality of Older Taiwanese
Yu-Wen Wang, Alan Tsai Asia University, Taiwan
Background: Hypertension is prevalent in the elderly. It can increase the risk of many chronic diseases and mortality. In epidemiological studies hypertension is usually determined with clinical measurement of blood pressure. However, in social survey studies, hypertension is often identified with self-report without measurement.
Objective: This study aimed to determine the usefulness of self-report of hypertension in predicting the risk of follow-up chronic diseases and mortality in older adults.
Methods: The study analyzed data of a
population-representative cross-sectional cohort study in older Taiwanese. Subjects' health conditions were analyzed at baseline in 1989 and the occurrences of new stroke, heart disease, diabetes and chronic kidney disease cases in 1999 were analyzed. Regression analysis determined the impact of hypertension on the occurrence of common chronic diseases and mortality.
Results: The prevalence of self-reported hypertension at baseline (1989) was approximately 27% (24% in men and 30% in women) for Taiwanese, 60 years or older.
Elderly who self-reported hypertension had increased risk of follow-up stroke and heart disease (p<0.05).
However, the impact on chronic kidney disease and diabetes was not statistically significant. Elderly who self-reported hypertension also had a 38% increase in mortality risk according to regression analysis.
Conclusion: Self-report of hypertension is associated with an increased risk of follow-up stroke, heart disease
Poster Session II
and mortality. It may be of value as a proxy of hypertension prevalence but not for identifying hypertensive individuals for intervention.
SP-193
Impact of a Community Approach to Prevent Road Traffic Injuries in Rural Setting of Thailand Orapin Laosee1, Kalaya Zapuang2, Sunitra Pakinsee2, Ratana Somrongthong2
1. Chulalongkorn University, Thailand
2. College of Public Health Sciences, Thailand
Road Traffic Accidents (RTA) is a major public health problem in Thailand. The aim of the project was to promote safety awareness among road users of rural communities in the Chaing Rai province (September 2007- June 2008). The project was completed in three phases: (1) Community survey; (2) development of community network and road safety plan; and (3) monitoring and evaluation.
The survey was conducted on 1,024 road users, aged between 15 and 60 years (mean age 35.32; male: female ratio, 1.4:1) . The survey determined, in the year preceding the survey, 57 road users sustained a traffic injury which required visiting a health care service or being absent from work/school for at least 1 day
(morbidity rate 55.66/1000). Almost three-quarters (70%) of all reported traffic injures were male motorcyclists, aged 15-24 years old and the main causes of RTA injury related to drink driving (46.03%) and high speed driving (33.33%).
The community network consisting of 50 members used the survey information to create and implement a master plan for road safety which involved a set of activities to gain safety knowledge and awareness in the community.
The evaluation revealed a significant reduction of RTA mortality after implementation of the network activities when compared to RTA mortality in the same period of the preceded year. Although to enhance safety behaviors;
teaching skills is not sufficient and social enforcement and punishment that fit to the local context need to be developed in sync with raising awareness of road safety issues.
SP-194
A Global Comparison of Physical and Social Environments between More and Less Urbanized Countries
Ro-Ting Lin, Chang-Chuan Chan National Taiwan University, Taiwan
The impact of rapid urbanization on health is one of the major public health challenges in the 21st century. An understanding of how urbanization affects our living environments is important for better health. This study aims to investigate the association between the
urbanization level and physical and social environments.
Data on the urbanization level as measured by the
proportion of urban population and physical and social environments as measured using the Millennium Development Goals (MDG) indicators during the period of 2000-2008 were collected for 195 countries. Higher urbanization level significantly correlated with better physical and social environments: less poverty, better employment conditions, less undernourishment, more education, more gender equality, higher antiretroviral therapy coverage, lower proportion of slum-dwellers, and more connections to safe drinking water, basic sanitation, telephone lines, cellular phones, and internet.
As less urbanized countries are speeding up the rate of urbanization through natural population increases, ensuring the concurrent development of physical and social environments is important for these countries. On the other hand, higher urbanization level significantly correlated with more emissions of carbon dioxide and consumptions of ozone-depleting substances and water resources, raising concerns about increasing
environmental loads and global climate changes. In conclusion, this study identified that higher urbanization level is a key factor associated with better physical and social environments. Less urbanized countries should be the target of providing better physical and social living environments; while more urbanized countries should focus more on reducing emissions of global warming substances and depletions of natural resources.
SP-195
Men’s Knowledge of Cancer Cervix (CaCx) and Pap Smear Screening (Papss) Predicting Spouse’s
Screening Behavior. Contribution of Gender Roles in Reproductive Health
Intan Osman, Rashidah Shuib, Chap Sam Lim, Lilis Surienty Abd. Talib
Universiti Sains Malaysia, Malaysia
This paper links Malaysian men’s knowledge in cervical cancer (CaCx) and pap smear screening (Papss) to gender roles in reproductive health. It is part of a larger multi-centered, transdisciplinary research project sponsored by the Ministry of Science and Technology, Malaysia. Data were collected via structured
questionnaire and self-administered to 132 Chinese and Indians of selected urban and rural based household units in Northern Malaysia. Respondents were asked if they have heard of CaCx and Papss, where do they hear or obtain the information, on knowledge of signs and symptoms, causes, treatment available, reasons for as well as procedures, eligibility, timing and frequency of practicing Papss. . Overall, their knowledge on CaCx and Papss was low. However, literature on men’s
communication and support seemed to influence spouse’
Papss seeking behaviour. Thus, improving men’s knowledge on CaCx and Papss is evidently critical.
Men’s participation on women’s health could alter some of the belief and perception of women of high CaCx risks to practice Papss. Since current findings reveal that newspapers and friends provide men with
information on CaCx and Papss more than any other sources, it is necessary that the message of what, why, when, where and who of Papss reach the primary (women) and secondary (men) audience effectively.
Advancing men’s roles in reproductive health can be
Advancing men’s roles in reproductive health can be