Advances of Hospice Palliative Care in Taiwan

Shao-Yi Cheng,Ching-Yu Chen,Tai-Yuan Chiu 한국호스피스완화의료학회 2016 한국호스피스.완화의료학회지 Vol.19 No.4

Hospice and palliative care in Taiwan has been growing continuously. The 2015 Quality of Death index, as rated by the Economist Intelligence Unit, ranked Taiwan first among Asian countries and sixth in the world. In this review article, we highlight three particular areas that might have contributed to this success; the laws and regulations, spiritual care and research network. Finally, we discuss the future challenges and prospects for Taiwanese encounters. A systemic review was conducted with the keywords “hospice palliative care Taiwan” using PubMed. The passing of the “Natural Death Act” in 2000 set the example and established a landmark for patient autonomy in Asia; it guarantees the patient’s right to request that medical staff do not resuscitate (DNR) them and to reject other futile medical treatments at the end of their life, thus reflecting the importance of palliative care from the policy perspective. In 2015, Taiwan passed another pioneering law entitled the “Patient Autonomy Act”. This law states that a patient may decline medical treatment according to his/her own will. Taiwanese indigenous spiritual care was launched in 2000. It requires a Buddhist Chaplain to successfully complete a training program consisting of lectures, as well as bedside practicum before applying Buddhist practices to end-of-life care. The Japan-Korea-Taiwan research network was established for the purpose of enabling collaborative research for the East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) cohort. With consensus from the government and society to make it a priority, hospice and palliative medicine in Taiwan has been growing steadily.

Advances of Hospice Palliative Care in Taiwan

Cheng, Shao-Yi,Chen, Ching-Yu,Chiu, Tai-Yuan Korean Society for Hospice and Palliative Care 2016 한국호스피스.완화의료학회지 Vol.19 No.4

목적: 대만의 호스피스와 완화 의료는 지속적으로 증가하고 있다. Economist Intelligence Unit에서 평가한 2015년 죽음의 질 지수 등급에서 대만은 아시아 국가 중에서 1위, 세계에서 6위를 기록했다. 이 리뷰 기사에서 우리는 성공에 기여한 것으로 보이는 세 영역, 즉 법률 및 규정, 영적 치료, 연구 네트워크에 주목하였다. 마지막으로 대만 사람에게 적용을 위한 미래의 도전과 전망에 대해 논의하기로 한다. 방법: PubMed에서 "대만의 호스피스 완화의료" 검색어를 이용해 체계적인 검토를 수행하였다. 결과: 2000년에 "자연사법"의 통과로 아시아에서 환자의 자기결정권에 대한 획기적인 본보기가 만들어지고 확립되었다. 이는 의료진에게 연명치료중지(DNR, do not resuscitate)를 요청할 수 있고 삶의 마지막에 기타 무의미한 의료 행위를 거부할 수 있는 환자의 권리를 보장하며 더불어 정책적 관점에서 완화의료의 중요성을 반영하는 것이다. 2015년에 대만은 "환자의 자기결정권 특별법"이라는 선구적인 법률을 통과시켰다. 이 법은 환자가 그/그녀의 자기의지에 따라 의료 행위를 거부할 수 있다는 것을 규정한다. 대만 고유의 영적 치료는 2000년에 도입되었는데, 불교 수행을 죽음에 직면한 환자에 적용하기 이전의 임상실습뿐 아니라 강의들로 구성된 훈련 프로그램을 성공적으로 이수하기 위해서는 불교 사제가 필요하다. 일본-한국-대만 연구 네트워크는 죽음의 과정을 자세히 설명(EASED, Elucidate the Dying process)하기 위한 동아시아 공동의 비교 문화 집단 연구를 위해 설립되었다. 결론: 대만에서의 호스피스와 완화의료는 정부와 사회의 우선적 합의에 따라 꾸준하게 성장하고 있다. Hospice and palliative care in Taiwan has been growing continuously. The 2015 Quality of Death index, as rated by the Economist Intelligence Unit, ranked Taiwan first among Asian countries and sixth in the world. In this review article, we highlight three particular areas that might have contributed to this success; the laws and regulations, spiritual care and research network. Finally, we discuss the future challenges and prospects for Taiwanese encounters. A systemic review was conducted with the keywords "hospice palliative care Taiwan" using PubMed. The passing of the "Natural Death Act" in 2000 set the example and established a landmark for patient autonomy in Asia; it guarantees the patient's right to request that medical staff do not resuscitate (DNR) them and to reject other futile medical treatments at the end of their life, thus reflecting the importance of palliative care from the policy perspective. In 2015, Taiwan passed another pioneering law entitled the "Patient Autonomy Act". This law states that a patient may decline medical treatment according to his/her own will. Taiwanese indigenous spiritual care was launched in 2000. It requires a Buddhist Chaplain to successfully complete a training program consisting of lectures, as well as bedside practicum before applying Buddhist practices to end-of-life care. The Japan-Korea-Taiwan research network was established for the purpose of enabling collaborative research for the East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) cohort. With consensus from the government and society to make it a priority, hospice and palliative medicine in Taiwan has been growing steadily.

INVESTIGATING THE PHYSIOLOGYCAL RESPONSES TO SUBLETHAL NITRITE EXPOSURE IN TILAPIA

Cheng-Hao Tang,Yi-Jang Hsieh,Shao-Yang Hu,Pei-Jie Meng,Ming-Yih Leu 한국수산과학회 양식분과 2015 한국수산과학회 양식분과 학술대회 Vol.2015 No.5

Shake-table testing of a 1:5 reduced-scale five-story masonry-infilled reinforced concrete frame structure

Shao-Ge Cheng,Yi-Xiu Zhu,Kui Sun,Wei-Ping Zhang 국제구조공학회 2021 Structural Engineering and Mechanics, An Int'l Jou Vol.79 No.3

This paper presents a shaking table test carried out on a 1:5 reduced-scale five-story masonry-infilled reinforced concrete (RC) frame model. Multi-level simulated earthquake motions with increasing shaking severity were used as input to deform the model structure from an elastic to a near-collapse state. The dynamic characteristics, acceleration response, displacement response, damage state, energy dissipation behavior and stiffness degradation of each story were summarized for each stage. The tests indicate that cracks developed at the masonry-frame interface during minor shaking that caused infill to separate from the frame; however, its in-plane load bearing capacity was maintained. Moreover, the infill was able to resist infrequent earthquakes without causing instability or collapse of the structure. Thus, it is rational to consider masonry infill as a structural element in the seismic design of structures. Moreover, the story drift ratio of 1/400 can be regarded as the performance criterion for controlling frame structure cracking, and the story drift ratio of 1/100 can be regarded as the performance criterion for the peak bearing capacity of a frame structure. The test results could provide a reference not only for the seismic appraisal of existing buildings, but also for the seismic design of new buildings.

In Vivo Experimental Study on the Effects of Fluid in Increasing the Efficiency of Radiofrequency Ablation

Sun, Yi-Xin,Cheng, Wen,Han, Xue,Liu, Zhao,Wang, Qiu-Cheng,Shao, Hua Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.14

Background: Radiofrequency ablation (RFA) is the most widely used and studied method internationally for the local treatment of liver tumors. However, the extension of coagulation necrosis in one RFA procedure is limited and incomplete coverage of the damaged area can lead to a high local recurrence rate. Objective: In this study, we compared the effects of different solutions in enhancing hepatic radiofrequency by establishing a rabbit VX2 liver cancer model. We also determined the optimal solution to maximise effects on the extent of RFA-induced coagulation necrosis. Methods: Thirty VX2 tumor rabbits were randomly assigned to five groups: group A, RFA alone; group B, RFA with anhydrous ethanol injection; group C, RFA with 5% hypertonic saline injection; group D, RFA with lidocaine injection; and group E, RFA with a mixed solution. Routine ultrasound examinations and contrast-enhanced ultrasound (CEUS) of the ablation areas were performed after RFA. Then, we measured the major axis and transverse diameter and compared the areas of coagulation necrosis induced by RFA. Results: The mean ablation area range increased in groups B, C and especially E, and the scopes were greater compared with group A. Preoperative application of anhydrous ethanol, hypertonic saline, lidocaine and the mixed solution (groups B, C, D and E, respectively) resulted in larger coagulation necrosis areas than in group A (p<0.05). Among the groups, the coagulation necrosis areas in group E was largest, and the difference was statistically significant compared with other groups (p<0.05). Pathological findings were consistent with imaging results. Conclusions: A mixture of dehydrated alcohol, hypertonic saline and lidocaine injected with RFA increases the extent of coagulation necrosis in the liver with a single application, and the mixed solution is more effective than any other injection alone.

Risk of Diabetic Retinopathy between Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists

Tzu-Yi Lin,Eugene Yu-Chuan Kang,Shih-Chieh Shao,Edward Chia-Cheng Lai,Sunir J. Garg,Kuan-Jen Chen,Je-Ho Kang,Wei-Chi Wu,Chi-Chun Lai,Yih-Shiou Hwang 대한당뇨병학회 2023 Diabetes and Metabolism Journal Vol.47 No.3

Background: To compare risk of diabetic retinopathy (DR) between patients taking sodium-glucose cotransporter-2 inhibitors (SGLT2is) and those taking glucagon-like peptide-1 receptor agonists (GLP1-RAs) in routine care.Methods: This retrospective cohort study emulating a target trial included patient data from the multi-institutional Chang Gung Research Database in Taiwan. Totally, 33,021 patients with type 2 diabetes mellitus using SGLT2is and GLP1-RAs between 2016 and 2019 were identified. 3,249 patients were excluded due to missing demographics, age <40 years, prior use of any study drug, a diagnosis of retinal disorders, a history of receiving vitreoretinal procedure, no baseline glycosylated hemoglobin, or no follow-up data. Baseline characteristics were balanced using inverse probability of treatment weighting with propensity scores. DR diagnoses and vitreoretinal interventions served as the primary outcomes. Occurrence of proliferative DR and DR receiving vitreoretinal interventions were regarded as vision-threatening DR.Results: There were 21,491 SGLT2i and 1,887 GLP1-RA users included for the analysis. Patients receiving SGLT2is and GLP-1 RAs exhibited comparable rate of any DR (subdistribution hazard ratio [SHR], 0.90; 95% confidence interval [CI], 0.79 to 1.03), whereas the rate of proliferative DR (SHR, 0.53; 95% CI, 0.42 to 0.68) was significantly lower in the SGLT2i group. Also, SGLT2i users showed significantly reduced risk of composite surgical outcome (SHR, 0.58; 95% CI, 0.48 to 0.70).Conclusion: Compared to those taking GLP1-RAs, patients receiving SGLT2is had a lower risk of proliferative DR and vitreoretinal interventions, although the rate of any DR was comparable between the SGLT2i and GLP1-RA groups. Thus, SGLT2is may be associated with a lower risk of vision-threatening DR but not DR development.

In-situ TEM Observation of Repeating Events of Nucleation in Epitaxial Growth of Nano CoSi₂ in Nanowires of Si

Chou, Yi-Chia,Wu, Wen-Wei,Cheng, Shao-Liang,Yoo, Bong-Young,Myung, Nosang,Chen, Lih J.,Tu, K. N. American Chemical Society 2008 NANO LETTERS Vol.8 No.8

The back contact modification in high-efficiency Cu₂ZnSn(S,Se)₄ solar cells by a thin MoO₃ layer

Septia KHOLIMATUSSADIAH,Cheng-Ying CHEN,Wei-Chao CHEN,Yi-Rung LIN,Shao-Hung LU,Meng-Chia HSIEH,Jan-Kai CHANG,Chih-I WU,Ruei-San CHEN,Kuei-Hsien CHEN,Li-Chyong CHEN 한국진공학회 2016 한국진공학회 학술발표회초록집 Vol.2016 No.8

The Analysis of City-geology Problems in the Growth of Cites

( Jian Jun Song ),( Long Yi Shao ),( Cheng Ling Chu ),( Jian Ping Ye ),( Fan Yu Ye ) 대한지질공학회 2007 국제학술발표회 논문집 Vol.2007 No.-

Human lactoferrin efficiently targeted into caprine beta-lactoglobulin locus with transcription activator-like effector nucleases

Yu-Guo Yuan,Shao-Zheng Song,Meng-Ming Zhu,Zheng-Yi He,Rui Lu,Ting Zhang,Fei Mi,Jin-Yu Wang,Yong Cheng 아세아·태평양축산학회 2017 Animal Bioscience Vol.30 No.8

Objective: To create genetically modified goat as a biopharming source of recombinant human lacotoferrin (hLF) with transcription activator-like effector nucleases. Methods: TALENs and targeting vector were transferred into cultured fibroblasts to insert hLF cDNA in the goat beta-lactoglobulin (BLG) locus with homology-directed repair. The gene targeted efficiency was checked using sequencing and TE7I assay. The bi-allelic gene targeted colonies were isolated and confirmed with polymerase chain reaction, and used as donor cells for somatic cell nuclear transfer (SCNT). Results: The targeted efficiency for BLG gene was approximately 10%. Among 12 Bi-allelic gene targeted colonies, five were used in first round SCNT and 4 recipients (23%) were confirmed pregnant at 30 d. In second round SCNT, 7 (53%), 4 (31%), and 3 (23%) recipients were confirmed to be pregnant by ultrasound on 30 d, 60 d, and 90 d. Conclusion: This finding signifies the combined use of TALENs and SCNT can generate bi-allelic knock-in fibroblasts that can be cloned in a fetus. Therefore, it might lay the foundation for transgenic hLF goat generation and possible use of their mammary gland as a bioreactor for large-scale production of recombinant hLF.