On another blog, I've published an account of the recent earthquake that struck the city in which I live, including my reasons for turning down offers to join media coverage of the disaster and its consequences.
Galton Shen vividly remembers the first time he treated a patient whose suffering was linked to an addiction to the Internet. “He was a young man, just 22, complaining of severe constipation,” says Shen, a physician who shares a clinic with another doctor in Changhua County’s Beidou Township in central Taiwan. “I’ve treated every member of his family over the years, so I knew something about their lifestyles. I asked him some questions about his diet and habits, and it was soon obvious that his problem was a result of not eating regularly and not eating healthy foods,” recalls Shen. “This surprised me because his parents grow their own vegetables.”
The next day, the young man’s mother visited Shen — to discuss her son’s health rather than her own, it turned out. “Pretty soon, I got a clearer picture of what was happening. He wasn’t working or studying, and he was spending at least 100 hours each week in an Internet cafe. Whenever he felt hungry, he’d eat instant noodles or some junk food. He wasn’t drinking enough water, and he wasn’t exercising,” the doctor says.
Shen called the young man in for another consultation. “I told him he needed to reduce his computer use, improve his diet and so on. But I knew my advice probably wouldn’t be effective. I could see it was an addiction, a compulsion that had taken over his life.”
Over the course of his career, Shen has on numerous occasions advised alcoholics to reduce their drinking and smokers to quit. “With smokers and alcoholics, I could refer them to programs that might help. But with this young man, I had nothing to offer.” Within a few months, however, the 22-year-old had drastically reduced the amount of time he spent playing online games. Shen does not take any credit for this. “He began to suffer severe eyestrain. According to his mother, the physical discomfort and warnings from his ophthalmologist pushed him to change his lifestyle,” the doctor notes.
Shen’s diagnosis of the young man took place in 2003, when the study of Web addiction in Taiwan and elsewhere was in its infancy. Among the pioneering researchers in this field locally were Wang Chih-hung, now an associate professor of Guidance and Counseling at National Changhua University of Education, and Ko Huei-chen, currently dean of the College of Humanities and Social Science at Asia University in central Taiwan’s Taichung City and head of the Center for Prevention and Treatment of Internet Addiction, also in Taichung. Since its establishment in 2012, the center has been developing diagnostic criteria for Internet disorders, researching and providing treatment for addicts, and working with various nongovernmental organizations to promote healthy computer use.
When trying to gauge the extent of Internet addiction among a group or in an individual, one of the most commonly used diagnostic tools is the Revised Chen Internet Addiction Scale (CIAS-R). The original CIAS was devised more than a decade ago by Chen Sue-huei, a professor in the Department of Psychology’s Division of Clinical Psychology at National Taiwan University in Taipei.
The CIAS-R comprises 26 questions that are answered on a scale of 1—“Does not match my experience at all”—to 4—“Definitely matches my experience.” The minimum possible score is 26, and the maximum is 104. The CIAS-R is also often used in mainland China and Hong Kong. Cross-border comparisons suggest problematic Internet use in Taiwan is comparable to other societies where inexpensive Web access is almost universal.
For a 2011 study, Ko and her co-authors considered a score of 64 or higher to indicate Web dependency, and concluded that the level of Internet addiction among local college students was 15.3 percent. They found Web addicts not only spent more time using the Internet than non-addicts, but were also more likely to display symptoms of depression, feel unsatisfied with their academic performance, and exhibit lower refusal self-efficacy, which is the ability to ignore the Internet when it is available. The study further suggested that Internet addicts were more likely to be male than female.
Researchers using other methods have come up with similar results. Between 1999 and 2003, Tsai Chin-chung and Sunny S.J. Lin of National Chiao Tung University’s Center of Teacher Education published survey results indicating that around 12 percent of Taiwanese high-school students were addicted to the Internet, spending at least 20 hours online per week.
According to the results of an Asia University-National Cheng Kung University survey of more than 9,000 individuals published in September 2015, young Taiwanese spend a great deal of time on the Web. Excluding school-related online activity, those in the fourth to sixth grades are on the Internet for 57.8 minutes per day. Junior high school students are online for 115.8 minutes daily, while for senior high schoolers the figure is 147.2 minutes. These are weekday averages; on weekends, the daily totals approximately double.
There are five generally accepted categories of Internet addiction. The first is a cyber-sexual addiction to online pornography and adult chat rooms. The second is compulsive shopping, gambling or stock trading. The third is compulsive searching for and consumption of information. The fourth is the obsessive playing of computer games. The fifth is an unhealthy preference for relationships with people online rather than real-world friends and relatives.
The proliferation of smartphones in recent years appears to have altered the nature of Internet dependency. According to experts, the typical addict is less likely than before to be a teenager who engages in overnight binge sessions of gaming at Internet cafes, and more likely to be someone in their 20s who checks their phone for social network updates several times each hour...
Few comestibles are more Taiwanese than tofu, soy sauce and soymilk. All three are made from soy, a legume first cultivated in Northeast Asia at least 2,700 years ago. Directly and indirectly, Taiwanese now consume soybeans in far greater quantities than two generations ago, a change in diet caused in part by American influences, and made possible by American imports. Around 97 percent of the approximately 2.3 million tonnes of soybeans consumed annually by humans or animals in Taiwan is imported, and in most years the US is the no. 1 supplier. During the second half of the 20th century, US shipments of soybeans to Taiwan grew 20-fold, peaking at 2.61 million tonnes in 1996.
"Total US soybean exports to Taiwan in 2014 totaled US$725 million. Of that 12% was for human food, while 88% was for crushing into oil and soybean meal for animals," says W. Garth Thorburn, chief of the Agricultural Section at the American Institute in Taiwan. Other uses, such as using soy to make ink or wax, are so small these categories are not monitored, he adds. "The US share of Taiwan’s total soybean imports fluctuates because of price and other market factors, but was 65% during the first eight months of 2015, when Taiwan purchased 977,992 tonnes of American soy." Tofu (doufu) appears in classy vegetarian feasts as well as humble lunchboxes. Dried tofu (dougan) is a popular snack, and a key ingredient of Hakka stir-fry (kejia xiaochao). Very soft tofu, sometimes called bean-curd pudding (douhua), is a traditional dessert enjoyed with peanuts, tapioca balls, adzuki beans or mung beans. Some Westerners visiting Taiwan have no direct experience of soyfoods until their local hosts take them to sample stinky tofu (choudoufu). The eponymous host of Travel Channel’s Bizarre Foods with Andrew Zimmern favorably compared this pungent delicacy to Limburger cheese. New Taipei City’s Shenkeng District, is considered Taiwan’s stinky tofu capital; the town’s soy delights were described in the April 2011 issue of Taiwan Business Topics. "Growing up in the 1970s in Michigan, I never heard of or encountered tofu until I began shopping at a co-op in East Lansing, where I went to college," says Robyn Eckhardt, who now writes about food on her blog EatingAsia and for publications including the New York Times. "The first meal my now-husband cooked for me after we started dating was tofu in spaghetti sauce, and I didn't think much of it. Then I went to Chengdu after graduating from university, and that forever changed my idea of what tofu is or should be. I didn't eat it often after going back to the US, simply because it's hard to find good, tasty tofu there." "Once we moved back to Asia about a decade ago, I started eating a lot of it," says Eckhardt, who is now based in Malaysia. After extensive traveling, she has concluded that Taiwan’s soyfoods are as every bit as "deliciously ethereal" as those served in Japan. Because it can be turned into "mock meat," soy has been embraced by many who do not eat animal flesh. That said, one of the Sinophere’s best known recipes uses meat to enhance the flavor of the tofu. Mapo tofu (mapo doufu) features minced pork or beef alongside chunks of tofu in a spicy sauce. The spread throughout China of Buddhism and related vegetarian principles caused soy sauce (jiangyou) to gradually supplant the meat-based fermented sauces which, until the sixth century or so, had been the country’s condiment of choice. One place where soy sauce is still made the traditional way is the 106-year-old Wuan Chuang Soy Sauce Tourism Factory in Yunlin County’s Xiluo Township. Visitors to Wuan Chuang can try their hand at making a batch of sauce using black soybeans. (Some types of soy sauce use yellow soybeans). The beans are washed, soaked, then steamed. After cooling, each batch is smeared with Aspergillus oryzae fungus. The mold is allowed to thrive for a week, then washed off with brine. The bean paste is poured into large earthenware pots, sealed beneath a layer of salt, and left to ferment for six months. The viscous black liquid removed at the end of this period is filtered, diluted and bottled. By contrast, the production process for mass-market brands is often less than a week, as chemicals are used to accelerate fermentation. Roasted grain is a common ingredient in many types of soy sauce. Some attribute the popularity of soymilk (doujiang) in Taiwan to an energetic septuagenarian from Ohio. Having previously set up soy diaries on the Chinese mainland and in his home state, surgeon-missionary Dr. Harry W. Miller was invited to Taipei in 1953 to found an Adventist Sanitarium in Taipei. While here, he also established a soymilk production line... The read the whole article, get the January issue of Taiwan Business Topics, or go to this webpage (where the article has a somewhat different title). The photo above, which I took, shows salty soymilk with spicy oil and other condiments as served by a Kaohsiung eatery.