Strategies for Preventing Drug Recidivism Cycle in Taiwan

Drug abuse is currently a worldwide problem and Taiwan is no exception. Drug abuse is a disease that must be treated on the basis of evidence (United Nations Office on Drugs and Crime 2007; World Health Organisation 2004). In order to reduce the damage caused by drug abuse to the nation, society and people, the government not only developed two anti-drug strategies - that of supply eradication and demand reduction - but since May 1994, has mobilised relevant government departments to take assertive action. Some of the actions include law enforcement enhancement, anti-drug enforcement and drug rehabilitation utilisation. In 2005, new anti-drug programs, such as the sterile needle exchange program and substitution therapy program, were also introduced. The cities implementing the Harm Reduction Program (HR Program) showed lower HIV infection rates in comparison to others without the HR Program. The income and employment conditions of drug addicted patients receiving Methadone Maintenance Treatment have been improved. The future drug policies in Taiwan will focus on drug rehabilitation (treatment), anti-drug actions (prevention) and law enforcement (punishment). The educational system, community recovery and aftercare for drug addicts will also be indispensable (WHO/UNODC/UNAIDS 2004)

Drain tube migration into the anastomotic site of an esophagojejunostomy for gastric small cell carcinoma: short report

Intraluminal migration of a drain through an anastomotic site is a rare complication of gastric surgery. Case Presentation: We herein report the intraluminal migration of a drain placed after a lower esophagectomy and total gastrectomy with Roux-en-Y anastomosis for gastric small cell carcinoma. Persistent drainage was noted 1 month after surgery, and radiographic studies were consistent with drain tube migration. Endoscopy revealed the drain had migrated into the esophagojejunostomy anastomotic site. The drain was removed from outside of abdominal wound while observing the anastomotic site endoscopically. The patient was treated with suction via a nasogastric tube drain for 5 days, and thereafter had an uneventful recovery. Conclusions: Though drain tube migration is a rare occurrence, it should be considered in patients with persistent drainage who have undergone gastric surgery

Mobile Cloud-Based Blood Pressure Healthcare for Education

Mercury, pneumatic, and electronic sphygmomanometers were widely used for traditional blood pressure (BP) measurement. Cloud BP database, and mobile information and communication technology (MICT) do not integrate to these BP measurement methods. Pen and papers were employed to record BP values for nurses and physicians, and recording errors are possible to occur. In the chapter, the cloud-based BP platform solution and advanced wireless hospital BP measurement technologies were studied. These cloud-based BT measurement technologies were used as teaching aids to train students of electrical and nursing fields for mobile BP healthcare and health promotion education, and hence interdisciplinary teaching and learning were conducted. The teachers include professors of electrical and nursing fields, physicians, hospital nurses, and the engineer and health management experts of Microlife. The interdisciplinary teaching and learning of mobile BP healthcare and health promotion for smart aging were conducted in the Department of Nursing Division, Chang Cung Memorial Hospital, Keelung Branch, Department of Nursing Ching Kuo Institute of Management and Health, School of Nursing Chung Shan Medical University, and Department of Electrical Engineering, National Taiwan Ocean University. The students of electrical and nursing fields participated for joint interdisciplinary learning. The concepts of interdisciplinary mobile BP healthcare learning and teaching involve nursing and technology, healthy aging, BP health care for smart aging, telenursing, BP care for smart aging, community/home telecare, and MICT. The objective of teaching and learning is training the design and making electrical engineers to understand BP healthcare and health promotion, and nurses to understand mobile BP healthcare and health promotion system for smart aging

Korean Red Ginseng Improves Blood Pressure Stability in Patients with Intradialytic Hypotension

Introduction. Intradialytic hypotension (IDH) is a common complication during hemodialysis which may increase mortality risks. Low dose of Korean red ginseng (KRG) has been reported to increase blood pressure. Whether KRG can improve hemodynamic stability during hemodialysis has not been examined. Methods. The 8-week study consisted of two phases: observation phase and active treatment phase. According to prehemodialysis blood pressure (BP), 38 patients with IDH were divided into group A (BP ≥ 140/90 mmHg, n = 18) and group B (BP < 140/90 mmHg, n = 20). Patients were instructed to chew 3.5 gm KRG slices at each hemodialysis session during the 4-week treatment phase. Blood pressure changes, number of sessions disturbed by symptomatic IDH, plasma levels of vasoconstrictors, blood biochemistry, and adverse effects were recorded. Results. KRG significantly reduced the degree of blood pressure drop during hemodialysis (P < 0.05) and the frequency of symptomatic IDH (P < 0.05). More activation of vasoconstrictors (endothelin-1 and angiotensin II) during hemodialysis was found. The postdialytic levels of endothelin-1 and angiotensin II increased significantly (P < 0.01). Conclusion. Chewing KRG renders IDH patients better resistance to acute BP reduction during hemodialysis via activation of vasoconstrictors. Our results suggest that KRG could be an adjuvant treatment for IDH

An Integrated Model of Scenario Planning and Decision Tree Analysis for New Product Development Financial Planning: A Case of Smart Phone Development Project in Taiwan

Demands of smart phones have been rapidly and dramatically increasing whereas R&amp;D and marketing of smart phones have been facing severer competition and more dynamic environment. Most existing studies of new product development (NPD) focused on the traditional net-present-value (NPV) method and the real option analysis which are lack of flexibility to model asymmetric multi-stage decisions and flexible uncertain states. This study aims to integrate scenario planning and decision tree analysis for NPD evaluation. In so doing, scenarios for modeling uncertainties can be generated systematically. A case study of a Taiwanese OEM company shows the viability of the proposed model. Compared with the performance of the realized decisions, the proposed analysis is more robust and lowering the risk to minimal with appropriate R&amp;D resource allocation. A two-way sensitivity analysis helps determine boundaries of the probability of R&amp;D success and the cost of R&amp;D where the R&amp;D project will become profitable

Drain tube migration into the anastomotic site of an esophagojejunostomy for gastric small cell carcinoma: short report

Abstract Background Intraluminal migration of a drain through an anastomotic site is a rare complication of gastric surgery. Case Presentation We herein report the intraluminal migration of a drain placed after a lower esophagectomy and total gastrectomy with Roux-en-Y anastomosis for gastric small cell carcinoma. Persistent drainage was noted 1 month after surgery, and radiographic studies were consistent with drain tube migration. Endoscopy revealed the drain had migrated into the esophagojejunostomy anastomotic site. The drain was removed from outside of abdominal wound while observing the anastomotic site endoscopically. The patient was treated with suction via a nasogastric tube drain for 5 days, and thereafter had an uneventful recovery. Conclusions Though drain tube migration is a rare occurrence, it should be considered in patients with persistent drainage who have undergone gastric surgery.</p

Zolpidem increased cancer risk in patients with sleep disorder: A 3-year follow-up study

Background: Zolpidem has been increasingly used in patients with sleep disorder due to its minimal respiratory depressor effects and short half-life. Materials and Methods: Recent case reports indicate that zolpidem usage may be associated with increased cancer mortality. This study aimed to determine the impact of zolpidem usage on the risk of incident cancer events in sleep disorder patients over a 3-year follow-up. Of the 6924 subjects diagnosed with sleep disorder in 2004, 1728 had used zolpidem. A Cox proportional hazard model was performed to estimate 3-year cancer event-free survival rates for patients using zolpidem and those not using it, after adjusting for confounding and risk factors. Results: At the end of follow-up, 56 patients had incident cancers, 26 (1.5%) who used zolpidem, and 30 (0.6%) who did not. After adjustments for gender, age, comorbidities, and other medications, patients using zolpidem had a 1.75 times (95% confidence interval [CI], 1.02–3) greater risk of cancer events than those not using zolpidem during the 3-year follow-up. Greater mean daily dose and longer use were associated with increased risk. Among patients with sleep disorder, mean daily dose >10 mg and length of drug use >2 months was associated with 3.74 times greater risk (95% CI, 1.42–9.83; P = 0.008) of incident cancer events. Conclusions: In this study, zolpidem use increased cancer events risk in sleep disorder patients. Risks and benefits of chronic zolpidem usage should be explained to sleep disorder patients, and long-term use should be monitored