Biomedical subjects

Wen-Yin Chang

Publications and source records attributed to Wen-Yin Chang.

8 recordsLinked to original sources

PubMed2004

Using a population-based database to explore the inter-specialty differences in physician practice incomes in Taiwan.

Gaining an understanding of the distribution of physician incomes between different medical specialties could assist policymakers to predict the future medical manpower supply. The purpose of this study is to examine the differences in medical specialty-specific gross practice incomes between office-based physicians in Taiwan. The primary data source for the study, which includes 7444 office-based physicians, was provided by the Taiwan Department of Health, with the dependent variable of interest to this study being the annual gross income of physician practices, whilst the independent variable is physician specialty. The study controlled for physicians' age, gender, specialty-board status, type of practice, location of clinic and urbanization level of the community in which the practice was located. Multivariate regression analyses were carried out to explore the relationship between physician specialty and gross practice income. This study finds a significant relationship between the annual gross income of physician practices and the physician's medical specialty (P < 0.001). Of all physicians, those specializing in rehabilitation and orthopedics had the highest gross practice incomes; conversely, obstetricians and gynecologists had the lowest gross practice incomes. The regression analyses demonstrated that after adjusting for socio-demographic and professional characteristics, gross practice incomes of physicians were significantly related to their medical specialty. This study concludes that differences in the gross practice incomes of physicians were significantly related to medical specialties. Those physicians specializing in procedure-based specialties, such as rehabilitation and orthopedics, had higher practice incomes than their counterparts in other more diagnosis-oriented specialties such as family practice and pediatrics.

Adult↗

PubMed2004

Perimenopausal knowledge of mid-life women in northern Taiwan.

BACKGROUND: This work has been carried out keeping in view that although knowledge related to perimenopause is an important health issue for women worldwide, little information is known about mid-life Taiwanese women's knowledge of perimenopause. OBJECTIVE: The aim of this paper was to explore the level of perimenopausal knowledge of mid-life women in northern Taiwan, to describe the relationship between demographic factors and women's knowledge, and to identify what information health providers need to offer them. DESIGN: A cross-sectional descriptive survey was conducted. METHOD: The Perimenopausal Knowledge Questionnaire was used to collect data. The study was carried out in August 2000 to September 2001. A convenience sample was recruited from traditional Chinese medicine clinics, gynecology clinics and communities in northern Taipei. RESULTS: Our findings indicated that the overall mean correct answer weighted Perimenopausal Knowledge score of these mid-life women was 46.31. The rank of weighted scores from highest to lowest was: (1) self-care during perimenopause, (2) the perception of perimenopause, (3) knowledge related to hormone replacement therapy and (4) body changes associated with the declined oestrogen in perimenopause. Only educational level was significantly associated with Perimenopause Knowledge level (P < 0.01). Less than 20% (n = 353) of the women answered the items that measured self-management of symptoms related to perimenopause correctly. Less than 1.4% of the women knew that taking hormone replacement therapy required a physician's prescription and subsequent regular health check-ups. CONCLUSION: Participants lacked adequate knowledge about perimenopause. RELEVANCE TO CLINICAL PRACTICES: Health providers need to provide factual information about the normal body changes of perimenopause, self-management of perimenopausal disturbances and appropriate use of hormone replacement therapy.

Adult↗

PubMed2003

Continuing education needs and barriers for public health nurses in Aboriginal townships in Taitung, Taiwan.

In the fast-changing arena of health care, it is important for public health nurses (PHNs) to receive professional training through continuing education (CE) to maintain practice competencies in the community. However, little information is currently known about needs for and barriers to CE for PHNs in role transition; therefore, the aim of this study was to identify CE needs and barriers for 21 PHNs in four Taitung Aboriginal townships where density of Aborigines is the highest in Taiwan. Focus group interviews were used to collect data. Interview data were then analyzed using the four step processes of data analysis suggested by Webb and Kevern (2001). The results indicated that CE for PHNs in Taitung was limited. Community assessment, psychological consultation, gerontological care, palliative care, statistical analysis and interpretation, and emergency care were identified by PHNs as CE needs. For CE barriers, about 98% of the PHNs indicated that long distance traveling was the main barrier. Family factors and inadequate support from administrative leaders were the next. It is concluded that establishing local nursing schools, using the Internet to provide CE, and planning computer systematic education courses may reduce barriers for PHNs in Taitung county.

Adult↗

PubMed2003

Downregulation of superoxide dismutase activity and gene expression in cultured rat brain astrocytes after incubation with vitamin C.

Reactive oxygen species have been linked with neuropathological changes in the central nervous system. Epidemiological studies supported the beneficial effect of supplementation of antioxidants. Superoxide dismutase (SOD) is an endogenous enzyme which can scavenge reactive oxygen species. This study investigated the effect of supplementation with ascorbic acid (vitamin C) on the changes of SOD in cultured neurological cells. Rat brain astrocytes (RBA-1 cells) were incubated with vitamin C and divided into four groups: a control group (without vitamin C) and three treatment groups with vitamin C at 40, 80, and 160 micromol/l. After short-term (2 days) and long-term (7 days) incubation, SOD activity, SOD mRNA level by Northern blotting, and SOD protein amounts by Western blotting were measured. After 2 days of incubation, vitamin C resulted in a decrease in the activity of SOD in a concentration-dependent manner (Mn-SOD from 14.8 +/- 1.2 to 13.2 +/- 0.5 U/mg protein and Cu/Zn-SOD from 64.8 +/- 1.2 to 51.7 +/- 0.9 U/mg protein; p < 0.05), and vitamin C also attenuated the Cu/Zn-SOD mRNA level from 100 to 86.3 +/- 6.7%; p < 0.01), whereas the protein amounts of these two SODs remained unchanged. After 7 days of incubation with vitamin C, the SOD activity of RBA-1 cells decreased significantly (Mn-SOD from 14.9 +/- 0.3 to 11.8 +/- 0.3 U/mg protein and Cu/Zn SOD from 61.8 +/- 1.8 to 54.6 +/- 0.9 U/mg protein; p < 0.01), and the mRNA level was also attenuated (Mn-SOD from 100 to 86.8 +/- 8.7% and Cu/Zn-SOD from 100 to 84.7 +/- 4.8%; p < 0.01). These results suggest that 2 and 7 days of incubation with relatively high concentrations of vitamin C may downregulate activity and gene expression of SOD in cultured RBA-1 cells.

Animals↗

PubMed2003

Factors related to dissatisfaction with the National Health Insurance among primary care physicians in Taiwan.

BACKGROUND: Few studies were found that evaluated dissatisfaction with the National Health Insurance (NHI) by primary care physicians in Taiwan. Therefore, the purpose of this study was to identify factors related to dissatisfaction with the NHI among primary care physicians. METHODS: A structured questionnaire was developed through a literature review, a panel discussion, and 5 focus group interviews. In total, 9336 primary care physicians were surveyed. A logistic regression analysis was employed to identify factors related to dissatisfaction with the NHI by primary care physicians. RESULTS: There were 1822 surveys returned, yielding a 19.5% response rate. They showed that 5.7% of respondents were very dissatisfied and 22.3% were dissatisfied with the current medical environment under the NHI. The dissatisfaction of primary care physicians was significantly related to age (OR = 1.029, p<0.05) and dissatisfaction with the following aspects: malpractice claims (OR = 1.744, p<0.001), complexity of medical claims (OR = 1.454, p<0.01), excessive work hours (OR = 1.790, p<0.001), decreased income (OR = 2.812, p<0.001), difficulty in finding nurses (OR = 1.379, p<0.05), and the separation of dispensing medicine from medical practice (OR = 1.389, p<0.05). CONCLUSIONS: These results can provide valuable information to help policy makers identify areas for improvement and intervention in order to reduce levels of dissatisfaction of primary care physicians under the NHI.

Adult↗

PubMed2002

Beneficial effect on blood pressure and lipid profile by programmed exercise training in Taiwanese patients with mild hypertension.

Mild essential hypertensive patients comprise a large portion of the hypertensive population. Previous reports have shown that moderate-intensity regular exercise training in these patients usually reduces blood pressure. By designing programmed exercise to evaluate whether it is effective in reducing blood pressure in mild hypertensive patients and also has beneficial effects on other biochemical parameters. Twenty-three mild hypertensive Taiwanese patients (resting blood pressure 139.1 +/- 11.4/99.5 +/- 8.0 mmHg) were divided randomly into two groups: control (no exercise) and moderate-intensity exercise (average 6.4 +/- 0.7 METs). The training group exercised three times per week at the prescribed exercise intensity by using the Treadmill exercise test. Blood pressure, heart rate and other biochemical parameters were monitored regularly every 4 weeks for 12 weeks. After 12 weeks regular exercise training, the exercise group showed for significant resting blood pressure reduction. Mean maximal reduction of systolic pressure was 18 mmHg. Significant reduction of total cholesterol, low-density lipoprotein cholesterol (LDL-C) and triglyceride were found; elevation of high-density lipoprotein cholesterol (HDL-C) was also noted. These data suggest that after 12 weeks of exercise training in mild hypertensive patients, successful reduction of blood pressure and favorable changes of lipid profile will be noted.

Adult↗

PubMed2002

Effects of arm exercise on serum glucose response in type 2 DM patients.

The aims of the study were to examine the influence of upper extremity exercise on glucose response and to establish a predictive model of changes in serum glucose under different exercise intensities and durations. Thirty-three type 2 DM patients who met the selection criteria were selected. An arm cycle ergometer exercise test was conducted, and then 12 arm exercise sessions were arranged based on different exercise intensities (40%, 60%, and 80% of maximal workload) and exercise durations (10, 20, 30, and 40 min). Serum glucose levels were measured before and after each exercise session. Serum glucose levels significantly decreased after arm exercise regardless of different intensities or durations. However, no interaction effect (intensity x duration) or main effect in exercise intensity was observed, but a significant main effect in exercise duration was observed (F = 11.756, p <.0001). Also exercise duration was a significant predictor of serum glucose changes after arm exercise. These results suggest that arm exercise can play a useful role in glycemic control for type 2 DM patients and exercise duration is a key factor in determining serum glucose response under upper-extremity exercise.

Analysis of Variance↗

PubMedDate not supplied

Using a balanced scorecard to improve the performance of an emergency department.

The performance of the emergency department significantly improved after implementing the balanced scorecard including hours of continuing education attended by the staff, staff job satisfaction, the rate of incomplete laboratory tests within 30 minutes, the average monthly inappropriate return rate, and hospital profit. The results can assist administrators plan for the future. Although this was a pilot program for implementing a balanced scorecard in an emergency department, the indicators used in this study may also be reasonable for a hospital that has limited resources.

Adult↗