No abstract

We found that the mean monthly suicide rate for earthquake victims was higher while the low-exposure group remained stable and consistent throughout the observation period, indicating that the impact on the high-exposure group was attributable to the earthquake. This indicates the need for providing strengthened psychiatric services during the first year following major disasters.

This study examined the association between pressure pain sensitivity and various single nucleotide polymorphisms (SNPs) of human l-, j-, and d-opioid receptor (i.e. OPRM1, OPRK1, and OPRD1) genes in 72 healthy adult Taiwanese women of Han Chinese race. Pressure pain threshold and tolerance were measured by an algometer and polymorphisms of the opioid receptor genes determined from blood samples. Our data revealed that pressure pain threshold, but not tolerance, in subjects with the minor allele (termed 'GA') genotype of the IVS2+31G>A polymorphism of the OPRM1 gene was significantly higher than those with major allele (termed 'GG') genotype. Neither pressure pain threshold nor tolerance between major and minor alleles of other SNPs of the OPRM1, OPRK1, and OPRD1 genes were significantly different. These data suggest an association between the IVS2+31G>A SNP of the OPRM1 gene and pressure pain sensitivity in healthy adult females. We have previously shown that pre-operative pressure pain sensitivity, especially pressure pain tolerance, predicts postoperative pain and analgesic consumption in female patients [1]. However, the mechanisms that underlie the substantial inter-individual variability in pressure pain sensitivity in females remain to be elucidated.The human l-opioid receptor mediates the analgesic effects of endogenous opioid peptides and exogenous opioid agents [2]. The function of the l-receptor is under the influence of single nucleotide polymorphisms (SNPs) of the human l-opioid receptor (OPRM1) gene [3]. With an incidence of 10-15%, the 118A>G SNP is one of the most widely studied SNPs of the OPRM1 gene [4]. In the terminology, '118' refers to the position of this SNP in the genome (i.e. position 118 in the exon) and 'A>G' represents a possible substitution of the nucleotide adenine, A, by guanine, G [4]. The genotype of individuals in relation to this SNP can therefore be homozygous GG, or -where a substitution occurshomozygous AA, or heterozygous AG. As the incidence of AA is significantly higher than that of GG, the genotype AA is referred to as the 'major homozygous genotype' and the genotype GG is referred to as the 'minor homozygous genotype' of this SNP [4].Fillingim et al. reported that the 118A>G SNP of the OPRM1 gene was associated with pressure pain sensitivity in healthy adults: individuals with heterozygous (AG) and minor homozygous (GG) genotypes of this SNP were found to have higher pressure pain threshold than individuals with major homozygous (AA) genotype [5]. However, when data from men and women were analysed separately this association of genotype with response was only significant in men [5]. Since substantial inter-individual variability in pressure pain sensitivity also exists in females, these data suggest that the 118A>G SNP of the OPRM1 gene may not be the mechanism that

Objectives. To assess the causes and cause-specific risks of hospitalization among physicians in Taiwan. Data Source. The data used in this study were retrieved from filed claims and registries of the National Health Insurance Research Database. A cohort of 33,380 physicians contracted with the national insurance program between 1997 and 2002 were linked to the information on the inpatient claim data for hospitalization. Study Design. The physicians' incidence density of hospitalization was compared with that of the general population, other health personnel, and nurses to compute the calendar year-, age-, and gender-standardized hospitalization ratios (SHRs). A multivariate log-linear model was also used to assess the effects of gender, age, type of contract, and specialty on the risks of hospitalization. Principal Findings. Compared with the general population, physicians experienced significantly reduced risks of all causes (SHR 5 54.5, 95 percent confidence interval [CI] 53.4-55.5) and all major cause-specific hospitalizations, especially mental disorders (SHR 5 6.9, 95 percent CI 5.8-8.4). On the other hand, compared with other health personnel, physicians had a small but significantly higher risk of all causes of hospitalization (SHR 5 107.8, 95 percent CI 105.1-110.6). Higher risks of hospitalization were also noted for neoplasms (SHR 5 108.9,) and diseases of the respiratory system (SHR 5 114.2, 95 percent CI 107.3-121.5). In addition to the above diagnoses, physicians also had significantly higher risks for genitourinary and musculoskeletal system and connective tissue problems than nurses. Compared with their physician colleagues, female physicians, young (o30 years) and older ( 60 years) physicians, and those working with the health institutions and programs were at elevated risks of hospitalization for all causes as well as for certain specific diseases. Conclusions. Physicians in Taiwan are at higher risks of developing specific diseases compared with their allied health colleagues. As the health of physicians is vital to the quality of care, Taiwanese health policy analysts should recognize that increased patient volume and satisfaction with public health care should not be achieved at the expense of physicians' health.

Background: Increases in certain cause-specific hospital admissions have been reported during Asian dust storms (ADS), which primarily originate from north and northwest China during winter and spring. However, few studies have investigated the relationship between the ADS and clinic visits for respiratory diseases in children.Objective: We investigated the general impact to children’s health across space and time by analyzing daily clinic visits for respiratory diseases among preschool and schoolchildren registered in 12 districts of Taipei City during 1997–2007 from the National Health Insurance dataset.Methods: We applied a structural additive regression model to estimate the association between ADS episodes and children’s clinic visits for respiratory diseases, controlling for space and time variations.Results: Compared with weeks before ADS events, the rate of clinic visits during weeks after ADS events increased 2.54% (95% credible interval = 2.43, 2.66) for preschool children (≤ 6 years of age) and 5.03% (95% credible interval = 4.87, 5.20) for schoolchildren (7–14 years of age). Spatial heterogeneity in relative rates of clinic visits was also identified. Compared with the mean level of Taipei City, higher relative rates appeared in districts with or near large hospitals and medical centers.Conclusion: To our knowledge, this is the first population-based study to assess the impact of ADS on children’s respiratory health. Our analysis suggests that children’s respiratory health was affected by ADS events across all of Taipei, especially among schoolchildren.