Using poetry to develop teenagers' speaking competence at Han-Mei Language Institute in Taiwan

English teaching in Taiwan is usually teacher-centred and test-oriented, especially at a private sector school like Han-Mei Language Institute which functions to ‘teach to the test’ (Brown, 1995) and trains teenage students to pass various exams for academic purposes. The exam backwash, however, has led to the imbalance of focusing on students’ linguistic abilities but neglecting their speaking competence. In addition, at Han-Mei, the required textbook, Reference Book—English in detail for junior high school, is written on the basis of grammatical rules. It is not always motivating and lacks target culture literary texts that could benefit learners in acquiring language, becoming involved with different cultures, and promoting personal growth. Hence, in order to strengthen students’ integrative competence and motivation, this dissertation has investigated utilizing poetry as a springboard for classroom interaction through Communicative Language Teaching. There are two poems, What Has Happened to Lulu? and Stopping by Woods on a Snowy Evening, which have been used as a means to allow learners to do classroom communication. The implementation, likely problems related to learners’ attitudes, teachers’ beliefs, and syllabus concern in this literature classroom have been taken into account, and possible solutions have been suggested for the future practitioners

International human rights law and the right to mental health

Purpose: Why did the WHO claim that there is “no health without mental health”? In its reform of the Ministry of Health and Welfare (MOHW), why did the Taiwan government add oral health into the Department of Mental Health? This paper explores normative accounts for the right to health which include physical and mental health as a highest state for everyone. Challenge the government should not excuse for inadequate resource to add oral to Department of mental health. Methods: We apply an analysis of international human rights law and international conventions to justify how mental health is a human right. Results: The right to the highest attainable standard of health is enshrined in the Universal Declaration of Human Rights, the International Covenant on Economic, Social, and Cultural Rights, as well as the constitution of the World Health Organization. A person’s state of health is conceptualized with a holistic perspective. Mental health, by definition and elements, is critical to an individual’s personal dignity, lifestyle, and living condition. Thus, as the fundamental basis of personal development and functioning, physical and mental health are recognized as a human right in international human rights law. The governments need to take responsibilities to build a mental healthy environment to their people. Conclusions: We found that in practice, governments (including Taiwan) often ignore people’s mental health needs when initiating health or welfare policies, especially if mental health is not regarded as a human right by the government. In fact, some governments refuse to honor mental health as a right although it is a legal obligation under international law. We urge Taiwan’s government to return the structure of the MOHW back to include an independent Department of Mental Health. To influence governmental policies, a change is needed in the research community, because researchers and practitioners in mental health and psychiatry still rarely view mental health from an international human rights perspective as well as for all public not disease oriented. We hope to initiate a review of the basic requirements of the right to mental health in terms of its positive, rather than negative, aspects

Kinetics of cytokine expression in cirrhotic rats

AbstractBackgroundCytokines are involved in liver injury and cirrhosis and systemic and hepatic cytokine levels may help predict cirrhosis evolution. However, the relevant survey has not been performed.MethodsMale Sprague-Dawley rats (240–270g) received either common bile duct ligation (BDL, animal model of cholestatic liver injury) or sham operation (control). Five rats were sacrificed and liver and serum were collected from each in weeks 1, 2, 4, 6, 8 and 10 after surgery. Hepatic expression of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) and transforming growth factor-β (TGF-β) were analyzed by immunohistochemial staining. The corresponding serum levels were measured by ELISA.ResultsCompared to the corresponding sham groups, hepatic expression of these cytokines in BDL rats was significantly and progressively enhanced during cirrhosis development. However, serum IFN-γ levels of BDL rats did not change significantly. Serum TNF-α of BDL rats increased gradually and reached a peak in week 6. Serum TGF-β level was elevated up to week 8, whereas IL-10 level decreased progressively until week 6.ConclusionCirrhosis development in BDL rats is associated with progressively enhanced expression of hepatic pro-inflammatory and anti-inflammatory cytokines, which is not in accord with the corresponding serum concentration. The circulating cytokine concentration may not totally reflect the hepatic expression level throughout the development of cirrhosis

Comparison of domiciliary oxygen using liquid oxygen and concentrator in northern Taiwan

Background/PurposeLong-term oxygen therapy has become standard treatment for patients with chronic respiratory insufficiency. However, patterns of long-term home oxygen therapy have not been well studied in Taiwan. Oxygen concentrator systems are commonly used in Taiwan, but liquid oxygen delivery systems are portable and may provide advantages over the concentrator system. This study compared oxygen usage between patients from a liquid oxygen group (LOG) and an oxygen concentrator group (OCG). The authors also assessed the physiologic responses of patients with chronic obstructive pulmonary disease (COPD) to ambulatory oxygen use at home.MethodsThe study used a retrospective, cross-sectional, observational survey design. The LOG comprised 42 patients, and the OCG comprised 102 patients. We recruited participants in northern Taiwan from July 2009 to April 2010. The questionnaire instruments that were used to collect data consisted of three parts: demographic characteristics, devices used in respiratory care, and activity status with portable oxygen. Two-minute walking tests were performed on COPD patients in their homes.ResultsCOPD was the most common diagnosis in our study, with more than 50% of patients who received oxygen long term in both groups having received this diagnosis. The LOG used oxygen for an average of 21.7 hours per day, whereas OCG averaged 15.2 hours per day (p<0.001). In the OCG, 92.2% of patients used a concentrator alone, whereas 23.8% of the LOG used liquid oxygen alone (p<0.001). The LOG patients were involved in significantly more outdoors activities (p=0.002) and reported traveling with oxygen more often (p<0.001) than the OCG patients. For patients with the same dyspnea level of COPD severity, those using liquid oxygen had a lower increase in pulse rate after the walking test, in comparison with the concentrator users.ConclusionPatients in the LOG used oxygen for longer hours, went on more outings, and were more likely to travel with oxygen than patients in the OCG. Being ambulatory with liquid oxygen might enable patients with COPD to walk more effectively

Optimizing Vancomycin Dosing in Chronic Kidney Disease by Deriving and Implementing a Web-Based Tool Using a Population Pharmacokinetics Analysis.

Background: Chronic kidney disease (CKD) patients requiring intravenous vancomycin bear considerable risks of adverse outcomes both from the infection and vancomycin therapy itself, necessitating especially precise dosing to avoid sub- and supratherapeutic vancomycin exposure. Methods: In this retrospective study, we performed a population pharmacokinetic analysis to construct a vancomycin dose prediction model for CKD patients who do not require renal replacement therapy. The model was externally validated on an independent cohort of patients to assess its prediction accuracy. The pharmacokinetic parameter estimates and the equations were productized into a Web application (VancApp) subsequently implemented in routine care. The association between VancApp-based dosing and time-to-target concentration attainment, 30-day mortality, and nephrotoxicity were assessed postimplementation. Results: The model constructed from an initial cohort (n = 80) revealed a population clearance and volume of distribution of 1.30 L/h and 1.23 L/kg, respectively. External model validation (n = 112) demonstrated a mean absolute prediction error of 1.25 mg/L. Following 4 months of clinical implementation of VancApp as an optional alternative to usual care [VancApp (n = 22) vs. usual care (n = 21)], patients who had received VancApp-based dosing took a shorter time to reach target concentrations (median: 66 vs. 102 h, p = 0.187) and had fewer 30-day mortalities (14% vs. 24%, p = 0.457) compared to usual care. While statistical significance was not achieved, the clinical significance of these findings appear promising. Conclusion: Clinical implementation of a population pharmacokinetic model for vancomycin in CKD can potentially improve dosing precision in CKD and could serve as a practical means to improve vital clinical outcomes