While the mainstream discourses of global climate strikes focus on the issue of generational justice, the experience in the context of East Asia has been under-researched. This study explores the ...local experience and interpretation of this movement among the young activists in Taiwan. The results show that climate strike is currently impossible in Taiwan. This study discusses this from the intersectionality of age and culture, namely, obsession with academic performance, low awareness of the right to strike, and parental intervention. It also highlights the strategies that young activists employ to reduce these barriers.
A very large grey area exists between translational stem cell research and applications that comply with the ideals of randomised control trials and good laboratory and clinical practice and what is ...often referred to as snake-oil trade. We identify a discrepancy between international research and ethics regulation and the ways in which regulatory instruments in the stem cell field are developed in practice. We examine this discrepancy using the notion of ‘national home-keeping’, referring to the way governments articulate international standards and regulation with conflicting demands on local players at home.
Identifying particular dimensions of regulatory tools – authority, permissions, space and acceleration – as crucial to national home-keeping in Asia, Europe and the USA, we show how local regulation works to enable development of the field, notwithstanding international (i.e. principally ‘western’) regulation. Triangulating regulation with empirical data and archival research between 2012 and 2015 has helped us to shed light on how countries and organisations adapt and resist internationally dominant regulation through the manipulation of regulatory tools (contingent upon country size, the state's ability to accumulate resources, healthcare demands, established traditions of scientific governance, and economic and scientific ambitions).
•Rather than ethical or rogue, the stem cell therapy field is a complex grey area.•Wealth conditions the affordability of standards and stem cell strategies.•Governments create different regulatory spaces for experimental research.•Regulation for stem cell therapies can be designed to gain a competitive edge.•Local and global stem cell organisations resist and undermine dominant ones.
This article is an example of Lessons from the Field highlighting the practical implementation of a novel time‐controlled mechanism in the gamification of emergency department evacuation training via ...tabletop exercise. Tabletop exercise is one of the most common drill types for disaster preparedness. It is easy to use, effective, and low in cost, but it has some shortcomings. For example, its lack of authenticity is often criticized. We add a time‐control mechanism to the tabletop exercise and use settings similar to real events in an attempt to increase the authenticity of the tabletop exercise and the learning effect. We completed a 3‐h tabletop gamification of emergency room evacuation, which included a time control mechanism. Medical staff in our emergency department were asked to join this tabletop training. We evaluated the effectiveness of the time‐control tabletop exercise through the results of the pretest and posttests and feedback from the participants. A total of 97 emergency medical staff from the Emergency Department of Cheng Kung University Hospital, including 64 nurses, 29 emergency doctors and four nurse practitioners, participated in this tabletop exercise. After experiencing the time‐control tabletop exercise, the participants significantly improved their approach to mass casualty incidents, their method for evacuating patients, and their triage skills. The correct answer rate for the pretest and post‐test rose from 68.75% to 94.33% with statistically significant. The feedback from the participants also showed that the time‐control tabletop exercise was interesting and could increase learning motivation. The time‐control mechanism had a positive impact on the learning effect. It increased the reality of tabletop exercises, promoted participants' learning motivation, and improved their performance on the test.
Objectives: Children are vulnerable to air pollution. The Implementation Act of the Convention on the Rights of the Child stipulates that revisions of child-related policies should be completed ...within 5 years after this Implementation Act comes into effect. This study analyzed the latest policies relating to air pollution governance for children, the revisions, and the extent to which these policies are designed with the vulnerability of children in mind. Methods: This systematic policy review analyzed 12 policies relating to air pollution and environmental governance for children. Policies and revision documents published between November 2014 and November 2021 were analyzed. Results: The policies included in this study were managed by different ministries, suggesting that air pollution governance for children requires cross-ministerial collaboration. However, the policies did not involve key ministries to collaborate in managing this issue. In response to the deterioration of air quality on campuses, curren
The ABC classification problem is approached as a ranking problem by the most current classification models; that is, a group of inventory items is expressed according to its overall weighted score ...of criteria in descending order. In this paper, we present an extended version of the Hadi-Vencheh model for multiple-criteria ABC inventory classification. The proposed model is one based on the nonlinear weighted product method (WPM), which determines a common set of weights for all items. Our proposed nonlinear WPM incorporates multiple criteria with different measured units without converting the performance of each inventory item, in terms of converting each criterion into a normalized attribute value, thereby providing an improvement over the model proposed by Hadi-Vencheh. Our study mainly includes various criteria for ABC classification and demonstrates an efficient algorithm for solving nonlinear programming problems, in which the feasible solution set does not have to be convex. The algorithm presented in this study substantially improves the solution efficiency of the canonical coordinates method (CCM) algorithm when applied to large-scale, nonlinear programming problems. The modified algorithm was tested to compare our proposed model results to the results derived using the Hadi-Vencheh model and demonstrate the algorithm’s efficacy. The practical objectives of the study were to develop an efficient nonlinear optimization solver by optimizing the quality of existing solutions, thus improving time and space efficiency.
Aerosols and droplets are the transmission routes of many respiratory infectious diseases. The COVID-19 management guidance recommends against the use of nebulized inhalation therapy directly in the ...emergency room or in an ambulance to prevent possible viral transmission. The three-dimensional printing method was used to develop an aerosol inhalation treatment mask that can potentially prevent aerosol dispersion. We conducted this utility validation study to understand the practicability of this new nebulizer mask system. The fit test confirmed that the filter can efficiently remove small particles. The different locations of the mask had an excellent fit with a high pressure making a proper face seal usability. The full-face mask appeared to optimize filtration with pressure and is an example of materials that perform well for improvised respiratory protection using this design. The filtering effect test confirmed that the contamination of designated locations could be protected when using the mask with filters. As in the clinical safety test, a total of 18 participants (10 55.6% females; aged 33.1 + or - 0.6 years) were included in the final analysis. There were no significant changes in SPO.sub.2, EtCO.sub.2, HR, SBP, DBP, and RR at the beginning, 20th, 40th, or 60th minutes of the test (all p >.05). The discomfort of wearing a mask increased slightly after time but remained within the tolerable range. The vision clarity score did not significantly change during the test. The mask also passed the breathability test. The results of our study showed that this mask performed adequately in the fit test, the filtering test, and the clinical safety test. The application of a full-face mask with antiviral properties, together with the newly designed shape of a respirator that respects the natural curves of a human face, will facilitate the production of personal protective equipment with a highly efficient filtration system. We conducted three independent tests in this validation study: (1) a fit test to calculate the particle number concentration and its association with potential leakage; (2) a filtering effect test to verify the mask's ability to contain aerosol spread; and (3) a clinical safety test to examine the clinical safety, comfortableness, and visual clarity of the mask.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Environmental Sociology has addressed gender, racial, and class dynamics within environmental movements, but the involvement of children, particularly in East Asia, remains under-researched. This ...article examines the representations of children in the news articles of Taiwanese anti-nuclear movements. With critical discourse analysis, the study examines 154 newspaper articles from two major newspapers published between 1987 and 2019. This article characterizes the representations of children in the news in three types: as slogans, as silent participants, and as defenders of rights. The paper shows that children have been reported in the news articles since the inception of the anti-nuclear movements, but their opinions were only recently reported. Dismissing children's voices in the news articles could be related to undermining children's capacity and agency to form views. The shifting representations of children in the news articles symbolize evolving power relations between children and adults, which are fluid, dynamic, and diverse rather than static. This article calls for a reflection on how children are represented in mass media and how the representations reveal the underlying presumption of children by adults.
Fever can occur after acute myocardial infarction (MI). The influence of body temperature (BT) after hospital arrival on patients with acute MI has rarely been investigated.
Patients who were ...diagnosed with acute MI in the emergency department (ED) of a tertiary teaching hospital between 1 January 2020 and 31 December 2020 were enrolled. Based on the tympanic temperature obtained at the ED triage, patients were categorized into normothermic (35.5°C-37.5°C), hypothermic (< 35.5°C), or hyperthermic (> 37.5°C) groups. The primary outcome was in-hospital cardiac arrest (IHCA), while the secondary outcomes were adverse events. Statistical significance was set at p < 0.05.
There were 440 enrollees; significant differences were found among the normothermic (n = 369, 83.9%), hypothermic (n = 27, 6.1%), and hyperthermic (n = 44, 10.0%) groups in the triage respiratory rate (median IQR) (20.0 4.0 cycles/min versus 20.0 4.0 versus 20.0 7.5, p = 0.009), triage heart rate (88.0 29.0 beats/min versus 82.0 28.0 versus 102.5 30.5, p < 0.001), presence of ST-elevation MI (42.0% versus 66.7% versus 31.8%, p = 0.014), need for cardiac catheterization (87.3% versus 85.2% versus 72.7%, p = 0.034), initial troponin T level (165.9 565.2 ng/L versus 49.1 202.0 versus 318.8 2002.0, p = 0.002), peak troponin T level (343.8 1405.9 ng/L versus 218.7 2318.2 versus 832.0 2640.8, p = 0.003), length of ICU stay (2.0 3.0 days versus 3.0 8.0 versus 3.0 9.5, p = 0.006), length of hospital stay (4.0 4.5 days versus 6.0 15.0 versus 10.5 10.8, p < 0.001), and infection during hospitalization (19.8% versus 29.6% versus 63.6%, p < 0.001) but not in IHCA (7.6% versus 14.8% versus 11.4%, p = 0.323) or any adverse events (50.9% versus 48.1% versus 63.6%, p = 0.258). Multivariable analysis showed no significant association of triage BT with IHCA or any major complication.
Triage BT did not show a significant association with IHCA or adverse events in patients with acute MI. However, triage BT could be associated with different clinical presentations and should warrant further investigation.
Resuscitation guidance has advanced; however, the predictive performance of the termination of resuscitation (TOR) rule has not been validated for different resuscitation protocols published by the ...American Heart Association (AHA).
A retrospective study validating the basic life support (BLS) and advanced life support (ALS) TOR rules was conducted using an Utstein-style database in Tainan city, Taiwan. Adult patients with nontraumatic out-of-hospital cardiac arrests from January 1, 2015, to December 31, 2015, (using the AHA 2010 resuscitation protocol) and from January 1, 2020, to December 31, 2020, (using the AHA 2015 resuscitation protocol) were included. The characteristics of rule performance were calculated, including sensitivity, specificity, positive predictive value (PPV) and negative predictive value.
Among 1260 eligible OHCA patients in 2015, 757 met the BLS TOR rule and 124 met the ALS TOR rule. The specificity and PPV for predicting unfavorable neurological outcomes were 61.1% and 99.0%, respectively, for the BLS TOR rule and 93.8% and 99.2%, respectively, for the ALS TOR rule. A total of 970 OHCA patients were enrolled in 2020, of whom 438 met the BLS TOR rule and 104 met the ALS TOR rule. The specificity and PPV for predicting unfavorable neurological outcomes were 85.7% and 100%, respectively, for the BLS TOR rule and 99.5% and 100%, respectively, for the ALS TOR rule.
Both the BLS and ALS TOR rules performed better when using the 2015 AHA resuscitation protocols compared to the 2010 protocols, with increased PPVs and decreased false-positive rates in predicting survival to discharge and good neurological outcomes at discharge. The BLS and ALS TOR rules can perform differently while the resuscitation protocols are updated. As the concepts and practices of resuscitation progress, the BLS and ALS TOR rules should be evaluated and validated accordingly.
Schizophrenia is associated with autonomic dysfunction and this may increase cardiovascular mortality. Past studies on autonomic modulation of schizophrenic patients focused on inpatients rather than ...individuals in a community setting, especially those receiving non-intensive case management (non-ICM). Besides, autonomic modulation and its association with health-related quality of life (HRQoL) in this population remain unexplored.
A total of 25 schizophrenic patients treated by non-ICM and 40 healthy volunteers were matched by age, gender and body mass index; smokers were excluded. Between the two groups, we compared the individuals' 5 min resting assessments of heart rate variability and their HRQoL, which was measured using EuroQoL-5D (EQ-5D). Patients with schizophrenia were assessed for psychopathology using the Positive and Negative Syndrome Scale for Schizophrenia (PANSS). We examined the relationship between heart rate variability measurements, HRQoL scores, PANSS scores, and other clinical variables among the schizophrenic patients treated by non-ICM.
Compared to the controls, patients with schizophrenia showed a significant impairment of autonomic modulation and a worse HRQoL. Cardiovagal dysfunction among the schizophrenic patients could be predicted independently based on lower educational level and more negative symptoms. Sympathetic predominance was directly associated with anticholinergics use and EQ-5D using a visual analogue scale (EQ-VAS).
Patients with schizophrenia treated by non-ICM show a significant impairment of their autonomic function and HRQoL compared to the controls. Since the sympathovagal dysfunction is associated with more negative symptoms or higher VAS score, the treatment of the negative symptoms as well as the monitoring of HRQoL might help to manage cardiovascular risk among these individuals. In addition, EQ-VAS scores must be interpreted more cautiously in such a population.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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