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# bib

id: cord-000534-ztc5holk
title: Transmissibility and temporal changes of 2009 pH1N1 pandemic during summer and fall/winter waves
author: Hsieh, Ying-Hen
date: 2011-12-02
txt: ./txt/cord-000534-ztc5holk.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247203/
doi: 10.1186/1471-2334-11-332
summary:
  BACKGROUND: In order to compare the transmissibility of the 2009 pH1N1 pandemic during successive waves of infections in summer and fall/winter in the Northern Hemisphere, and to assess the temporal changes during the course of the outbreak in relation to the intervention measures implemented, we analyze the epidemiological patterns of the epidemic in Taiwan during July 2009-March 2010. METHODS: We utilize the multi-phase Richards model to fit the weekly cumulative pH1N1 epidemiological data (numbers of confirmed cases and hospitalizations) as well as the daily number of classes suspended under a unique "325" partial school closing policy in Taiwan, in order to pinpoint the turning points of the summer and fall/winter waves, and to estimate the reproduction numbers R for each wave. The estimates for effective reproduction number R obtained from the confirmed case and hospitalization data are in good agreement, with R in the range of 1.04-1.27 for the first summer wave during July-September, and 1.01-1.05 for the second wave in fall/winter, using the generation time estimated by [26] for the spring outbreak in Mexico.

abstract:
  BACKGROUND: In order to compare the transmissibility of the 2009 pH1N1 pandemic during successive waves of infections in summer and fall/winter in the Northern Hemisphere, and to assess the temporal changes during the course of the outbreak in relation to the intervention measures implemented, we analyze the epidemiological patterns of the epidemic in Taiwan during July 2009-March 2010. METHODS: We utilize the multi-phase Richards model to fit the weekly cumulative pH1N1 epidemiological data (numbers of confirmed cases and hospitalizations) as well as the daily number of classes suspended under a unique "325" partial school closing policy in Taiwan, in order to pinpoint the turning points of the summer and fall/winter waves, and to estimate the reproduction numbers R for each wave. RESULTS: Our analysis indicates that the summer wave had slowed down by early September when schools reopened for fall. However, a second fall/winter wave began in late September, approximately 4 weeks after the school reopened, peaking at about 2-3 weeks after the start of the mass immunization campaign in November. R is estimated to be in the range of 1.04-1.27 for the first wave, and between 1.01-1.05 for the second wave. CONCLUSIONS: Transmissibility of the summer wave in Taiwan during July-early September, as measured by R, was lower than that of the earlier spring outbreak in North America and Europe, as well as that of the winter outbreak in Southern Hemisphere. Furthermore, transmissibility during fall/winter in Taiwan was noticeably lower than that of the summer, which is attributable to population-level immunity acquired from the earlier summer wave and also to the intervention measures that were implemented prior to and during the fall/winter wave.


id: cord-000581-ewx5xhrb
author: Rudge, James W.
date: 2012-02-21
txt: ./txt/cord-000581-ewx5xhrb.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283680/
doi: 10.1371/journal.pone.0031800
summary:
  This study was conducted as part of the AsiaFluCap project (www.asiaflucap.org), the overall aim of which is to conduct health systems analyses to support capacity development for responding to pandemic influenza across six countries and territories in Asia, specifically: Cambodia, Indonesia, Lao PDR, Taiwan, Thailand and Vietnam. Estimating resource needs, gaps, and associated mortality In our baseline scenario, resource gaps were estimated assuming that 12% of ''''general'''' hospital resources (beds, ventilators and human resources) are available for care of pandemic influenza cases, with the remaining 88% required for maintaining essential healthcare services, as in a previous pilot study for Thailand [20] , and based on previous reports [25] [26] . Figure 1 presents the geographical distribution of estimated resource gaps across provinces (or districts in the case of Indonesia) in each study country for the modeled pandemic influenza scenario, under our baseline assumptions and point estimates for parameter values.

title:
  Health System Resource Gaps and Associated Mortality from Pandemic Influenza across Six Asian Territories

abstract:
  BACKGROUND: Southeast Asia has been the focus of considerable investment in pandemic influenza preparedness. Given the wide variation in socio-economic conditions, health system capacity across the region is likely to impact to varying degrees on pandemic mitigation operations. We aimed to estimate and compare the resource gaps, and potential mortalities associated with those gaps, for responding to pandemic influenza within and between six territories in Asia. METHODS AND FINDINGS: We collected health system resource data from Cambodia, Indonesia (Jakarta and Bali), Lao PDR, Taiwan, Thailand and Vietnam. We applied a mathematical transmission model to simulate a “mild-to-moderate” pandemic influenza scenario to estimate resource needs, gaps, and attributable mortalities at province level within each territory. The results show that wide variations exist in resource capacities between and within the six territories, with substantial mortalities predicted as a result of resource gaps (referred to here as “avoidable” mortalities), particularly in poorer areas. Severe nationwide shortages of mechanical ventilators were estimated to be a major cause of avoidable mortalities in all territories except Taiwan. Other resources (oseltamivir, hospital beds and human resources) are inequitably distributed within countries. Estimates of resource gaps and avoidable mortalities were highly sensitive to model parameters defining the transmissibility and clinical severity of the pandemic scenario. However, geographic patterns observed within and across territories remained similar for the range of parameter values explored. CONCLUSIONS: The findings have important implications for where (both geographically and in terms of which resource types) investment is most needed, and the potential impact of resource mobilization for mitigating the disease burden of an influenza pandemic. Effective mobilization of resources across administrative boundaries could go some way towards minimizing avoidable deaths.


id: cord-001169-6sfleb1b
title: Spatio-temporal analysis on enterovirus cases through integrated surveillance in Taiwan
author: Chan, Ta-Chien
date: 2014-01-08
txt: ./txt/cord-001169-6sfleb1b.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890494/
doi: 10.1186/1471-2458-14-11
summary:
  CONCLUSIONS: Local public health professionals can monitor the temporal and spatial trends plus spatio-temporal clusters and isolation rate of EV-71 in mild and severe EV cases in a community when virus transmission is high, to provide early warning signals and to prevent subsequent severe epidemics. The specific aims of this study were: (1) to elucidate the spatio-temporal correlations between the mild and severe enterovirus cases through integrating the data of the three enterovirusrelated surveillance systems, including the sentinel physician, national notifiable diseases and laboratory surveillance systems in Taiwan, (2) to find out the feasibility of establishing an early warning signal using the increasing numbers of mild EV-71 cases and their lag time periods to appearance of severe EV-71 cases, and (3) to evaluate the trends of severe EV-71 cases over a 9.5-year period for providing better recommendations on public health efforts in the future.

abstract:
  BACKGROUND: Severe epidemics of enterovirus have occurred frequently in Malaysia, Singapore, Taiwan, Cambodia, and China, involving cases of pulmonary edema, hemorrhage and encephalitis, and an effective vaccine has not been available. The specific aim of this study was to understand the epidemiological characteristics of mild and severe enterovirus cases through integrated surveillance data. METHODS: All enterovirus cases in Taiwan over almost ten years from three main databases, including national notifiable diseases surveillance, sentinel physician surveillance and laboratory surveillance programs from July 1, 1999 to December 31, 2008 were analyzed. The Pearson’s correlation coefficient was applied for measuring the consistency of the trends in the cases between different surveillance systems. Cross correlation analysis in a time series model was applied for examining the capability to predict severe enterovirus infections. Poisson temporal, spatial and space-time scan statistics were used for identifying the most likely clusters of severe enterovirus outbreaks. The directional distribution method with two standard deviations of ellipse was applied to measure the size and the movement of the epidemic. RESULTS: The secular trend showed that the number of severe EV cases peaked in 2008, and the number of mild EV cases was significantly correlated with that of severe ones occurring in the same week [r = 0.553, p < 0.01]. These severe EV cases showed significantly higher association with the weekly positive isolation rates of EV-71 than the mild cases [severe: 0.498, p < 0.01 vs. mild: 0.278, p < 0.01]. In a time series model, the increase of mild EV cases was the significant predictor for the occurrence of severe EV cases. The directional distribution showed that both the mild and severe EV cases spread extensively during the peak. Before the detected spatio-temporal clusters in June 2008, the mild cases had begun to rise since May 2008, and the outbreak spread from south to north. CONCLUSIONS: Local public health professionals can monitor the temporal and spatial trends plus spatio-temporal clusters and isolation rate of EV-71 in mild and severe EV cases in a community when virus transmission is high, to provide early warning signals and to prevent subsequent severe epidemics.


id: cord-001202-xcrshplk
author: Yang, Nan-Ping
date: 2009-01-30
txt: ./txt/cord-001202-xcrshplk.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3924095/
doi: 10.2188/jea.je20080042
summary:
  Diagnoses of injury or poisoning; ill-defined symptoms, signs, or conditions; and diseases of the respiratory system were the 3 most common diagnostic categories in emergency units in Taiwan. 12 According to data from the 2002 US National Hospital Ambulatory Medical Care Survey (NHAMCS), children (<19 years) and seniors (65+ years) represented 27% and 15% of all 15 In an analysis of the category of injury/poisoning, young and middle-aged adults were the majority of those treated in EDs for injuries (33.1% and 26.0% in the age groups of 18-44 and 45-64 years, respectively). Data from the National Health Insurance of Taiwan on annual total medical insurance costs and ED-associated costs indicate that the percentage of the total NHI expenditure that was spent on NHI medical emergency care was 2.9% in each of the years from 2000 to 2003 and 3.1% in 2004. The epidemiology of emergency medical services use by older adults: an analysis of the National Hospital Ambulatory Medical Care Survey

title:
  Utilization of and Direct Expenditure for Emergency Medical Care in Taiwan: A Population-based Descriptive Study

abstract:
  BACKGROUND: We surveyed the emergency medical system (EMS) in Taiwan to provide information to policymakers responsible for decisions regarding the redistribution of national medical resources. METHODS: A systematic sampling method was used to randomly sample a representative database from the National Health Insurance (NHI) database in Taiwan, during the period from 2000 to 2004. RESULTS: We identified 10,124, 10,408, 11,209, 10,686, and 11,914 emergency room visits in 2000, 2001, 2002, 2003, and 2004, respectively. There were more males than females, and the majority of adults were younger than 50 years. Diagnose of injury/poisoning was the most frequently noted diagnostic category in emergency departments (EDs) in Taiwan. There were 13,196 (24.3%) and 2,952 (5.4%) patients with 2 and 3 concomitant diagnoses, respectively. There was a significant association between advanced age and the existence of multiple diagnoses (P < 0.001). With the exception of the ill-defined symptoms/signs/conditions, the two most frequent diagnoses were diseases of the circulatory system and diseases of the respiratory system in patients aged 65 years or older. On average, treatment-associated expenditure and drug-associated expenditure in Taiwan EDs averaged NT$1,155 ($35.0) and NT$190 ($5.8), respectively, which was equal to 64.5% and 10.6% of the total ED-associated cost. General ED medical expenditure increased with patient age; the increased cost ratio due to age was estimated at 8% per year (P < 0.001). CONCLUSIONS: The frequency of major health problems diagnosed at ED visits varied by age: more complicated complaints and multiple diagnoses were more frequent in older patients. In Taiwan, the ED system remains overloaded, possibly because of the low cost of an ED visit.


id: cord-002322-cy7j31wq
title: The Epidemiology of Hand, Foot and Mouth Disease in Asia: A Systematic Review and Analysis
author: Koh, Wee Ming
date: 2016-06-03
txt: ./txt/cord-002322-cy7j31wq.txt
cache: ./cache/cord-002322-cy7j31wq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5130063/
doi: 10.1097/inf.0000000000001242
summary:
  37 To assess how general the relationship between climate and transmissibility of HFMD was, we took incidence data from Tokyo, Hong Kong, Taiwan and Singapore (Fig. 2, Appendix 1) , that is, spanning temperate, subtropical and tropical latitudes, and fitted time series models to them. Updated situation of hand, foot and mouth disease (HFMD) and enterovirus infection 2010 A case-control study to identify environmental risk factors for hand, foot, and mouth disease outbreaks in Beijing Epidemic of hand, foot and mouth disease associated with enterovirus 71 infection A large-scale epidemic of hand, foot and mouth disease associated with enterovirus 71 infection in Japan in 1978 Risk factors of enterovirus 71 infection and associated hand, foot, and mouth disease/herpangina in children during an epidemic in Taiwan Estimation of the basic reproduction number of enterovirus 71 and coxsackievirus A16 in hand, foot, and mouth disease outbreaks

abstract:
  CONTEXT: Hand, foot and mouth disease (HFMD) is a widespread pediatric disease caused primarily by human enterovirus 71 (EV-A71) and Coxsackievirus A16 (CV-A16). OBJECTIVE: This study reports a systematic review of the epidemiology of HFMD in Asia. DATA SOURCES: PubMed, Web of Science and Google Scholar were searched up to December 2014. STUDY SELECTION: Two reviewers independently assessed studies for epidemiologic and serologic information about prevalence and incidence of HFMD against predetermined inclusion/exclusion criteria. DATA EXTRACTION: Two reviewers extracted answers for 8 specific research questions on HFMD epidemiology. The results are checked by 3 others. RESULTS: HFMD is found to be seasonal in temperate Asia with a summer peak and in subtropical Asia with spring and fall peaks, but not in tropical Asia; evidence of a climatic role was identified for temperate Japan. Risk factors for HFMD include hygiene, age, gender and social contacts, but most studies were underpowered to adjust rigorously for confounding variables. Both community-level and school-level transmission have been implicated, but their relative importance for HFMD is inconclusive. Epidemiologic indices are poorly understood: No supporting quantitative evidence was found for the incubation period of EV-A71; the symptomatic rate of EV-A71/Coxsackievirus A16 infection was from 10% to 71% in 4 studies; while the basic reproduction number was between 1.1 and 5.5 in 3 studies. The uncertainty in these estimates inhibits their use for further analysis. LIMITATIONS: Diversity of study designs complicates attempts to identify features of HFMD epidemiology. CONCLUSIONS: Knowledge on HFMD remains insufficient to guide interventions such as the incorporation of an EV-A71 vaccine in pediatric vaccination schedules. Research is urgently needed to fill these gaps.


id: cord-002510-h1eqnzn3
title: Taiwan''s Experience in Hospital Preparedness and Response for Emerging Infectious Diseases
author: Kao, Hui-Yun
date: 2017-04-01
txt: ./txt/cord-002510-h1eqnzn3.txt
cache: ./cache/cord-002510-h1eqnzn3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404255/
doi: 10.1089/hs.2016.0105
summary:
  The main organizing principles of the CDCMN are centralized isolation of patients with severe highly infectious diseases and centralization of medical resources, as well as a network of designated regional hospitals like those in other countries. Following the anthrax attacks in the United States in 2001, the SARS outbreak in 2003, and 2 decades of medical system reforms, a number of countries have adopted an approach that designates specific responding hospitals at the national, regional, and/or local levels to centralize resources, build capacity, and train special medical staff. In addition, considering the continuously improving healthcare system in Taiwan, all the responding hospitals were able to take in patients with highly infectious diseases and rapidly activate the emergency response plan, regardless of the category level. Activation Procedure of a Regional Responding Hospital TAIWAN''S HOSPITAL PREPAREDNESS AND RESPONSE report back to the CECC on the results of inspections of negative pressure isolation wards, manpower mobilization, training and drill plans, PPE stockpile status, and transport procedures.

abstract:
  The Communicable Disease Control Medical Network (CDCMN), established in 2003 after the SARS outbreak in Taiwan, has undergone several phases of modification in structure and activation. The main organizing principles of the CDCMN are centralized isolation of patients with severe highly infectious diseases and centralization of medical resources, as well as a network of designated regional hospitals like those in other countries. The CDCMN is made up of a command system, responding hospitals, and supporting hospitals. It was tested and activated in response to the H1N1 influenza pandemic in 2009-10 and the Ebola outbreak in West Africa in 2014-2016, and it demonstrated high-level functioning and robust capacity. In this article, the history, structure, and operation of the CDCMN is introduced globally for the first time, and the advantages and challenges of this system are discussed. The Taiwanese experience shows an example of a collaboration between the public health system and the medical system that may help other public health authorities plan management and hospital preparedness for highly infectious diseases.


id: cord-003503-t6cnjwpd
title: Phylogeographic investigation of 2014 porcine epidemic diarrhea virus (PEDV) transmission in Taiwan
author: Sung, Ming-Hua
date: 2019-03-06
txt: ./txt/cord-003503-t6cnjwpd.txt
cache: ./cache/cord-003503-t6cnjwpd.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402684/
doi: 10.1371/journal.pone.0213153
summary:
  Acknowledging the absence of a thorough investigation at the geographic level, we used 2014 outbreak sequence information from the Taiwan government''s open access databases plus GenBank records to analyze PEDV dissemination among Taiwanese pig farms. The data indicate that the 2014 Taiwan PEDV epidemic resulted from the spread of multiple strains, with strong correlations identified with pig farm numbers and sizes (measured as animal concentrations), feed mill numbers, and the number of slaughterhouses in a specifically defined geographic area. To determine specific temporal and geographic relationships associated with PEDV strain transmission, we used phylogenetic, phylodynamic and phylogeographic methods to systematically evaluate potential temporal and spatial transmission routes among Taiwanese swine farms during the 2014 outbreak. However, to date very few research efforts in Asia have utilized full genome sequencing for determining geographic structures due to the high costs and enormous amounts of computational time Phylogeographic investigation of 2014 porcine epidemic diarrhea virus transmission in Taiwan required for analyses [33, 34] .

abstract:
  The porcine epidemic diarrhea virus (PEDV) that emerged and spread throughout Taiwan in 2014 triggered significant concern in the country’s swine industry. Acknowledging the absence of a thorough investigation at the geographic level, we used 2014 outbreak sequence information from the Taiwan government’s open access databases plus GenBank records to analyze PEDV dissemination among Taiwanese pig farms. Genetic sequences, locations, and dates of identified PEDV-positive cases were used to assess spatial, temporal, clustering, GIS, and phylogeographic factors affecting PEDV dissemination. Our conclusion is that S gene sequences from 2014 PEDV-positive clinical samples collected in Taiwan were part of the same Genogroup 2 identified in the US in 2013. According to phylogenetic and phylogeographic data, viral strains collected in different areas were generally independent of each other, with certain clusters identified across different communities. Data from GIS and multiple potential infection factors were used to pinpoint cluster dissemination in areas with large numbers of swine farms in southern Taiwan. The data indicate that the 2014 Taiwan PEDV epidemic resulted from the spread of multiple strains, with strong correlations identified with pig farm numbers and sizes (measured as animal concentrations), feed mill numbers, and the number of slaughterhouses in a specifically defined geographic area.


id: cord-007556-vqs3s55p
author: Lai, Chih-Cheng
date: 2013-03-15
txt: ./txt/cord-007556-vqs3s55p.txt
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url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119003/
doi: 10.1016/j.ijantimicag.2013.02.002
abstract: nan
summary:
  title: Decrease in the incidence of meticillin-resistant Staphylococcus aureus nosocomial bloodstream infections in Taiwan However, another recent study that enrolled 14 hospitals in Europe, North America and South America over a 10-year period (1998) (1999) (2000) (2001) (2002) (2003) (2004) (2005) (2006) (2007) demonstrated that the incidence of nosocomial bloodstream infections (BSIs) was increasing and that the increased incidence was mainly due to antibiotic-resistant bacteria (ARB), including MRSA [2] . In that study, the MRSA incidence density (events per 100 000 patient-days) increased from 3.1 to 11.7 with an annual increase of 10% in seven ARBendemic hospitals [2] . During the period 2000-2010, the incidence density of all nosocomial BSIs increased from 254.7 to 308.3 per 100 000 patient-days (P < 0.001), with an annual increase of 3.9% (95% CI 2.4-10.2%). For MRSA, the incidence density significantly decreased from 27.9 to 12.3 per 100 000 patient-days, with an annual decrease of 8.5% (95% CI 7.0-10.8%) over the 10-year study period (P < 0.001).

title:
  Decrease in the incidence of meticillin-resistant Staphylococcus aureus nosocomial bloodstream infections in Taiwan


id: cord-010142-i1nh9k3e
title: Community-Acquired Pneumonia in the Asia-Pacific Region
author: Song, Jae-Hoon
date: 2016-12-17
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171710/
doi: 10.1055/s-0036-1592075
abstract:
  Community-acquired pneumonia (CAP) is an important cause of mortality and morbidity worldwide. Aging population, dense urbanization, and poor access to health care make the Asia-Pacific region vulnerable to CAP. The high incidence of CAP poses a significant health and economic burden in this region. Common etiologic agents in other global regions including Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, Chlamydophila pneumoniae, Staphylococcus aureus, and respiratory viruses are also the most prevalent pathogens in the Asia-Pacific region. But the higher incidence of Klebsiella pneumoniae and the presence of Burkholderia pseudomallei are unique to the region. The high prevalence of antimicrobial resistance in S. pneumoniae and M. pneumoniae has been raising the need for more prudent use of antibiotics. Emergence and spread of community-acquired methicillin-resistant S. aureus deserve attention, while the risk has not reached significant level yet in cases of CAP. Given a clinical and socioeconomic importance of CAP, further effort to better understand the epidemiology and impact of CAP is warranted in the Asia-Pacific region.


id: cord-022316-mh4pslnv
title: Safety and Security Issues Affecting Inbound Tourism in the People''s Republic of China
author: Breda, Zélia
date: 2009-11-16
txt: ./txt/cord-022316-mh4pslnv.txt
cache: ./cache/cord-022316-mh4pslnv.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155563/
doi: 10.1016/b978-0-7506-7898-8.50017-5
abstract: nan
summary:
  Although there is no evidence of a threat from global terrorism in the People''s Republic of China (PRC) and the country''s image is seen as generally safe, there are some issues related to political instability, health, safety and security concerns that have caused disruptions in growth rates. Since safety and security directly influence decisions in international travel, this chapter researches the consequences of relevant events that have caused major disturbances in inbound tourism in the PRC, namely the Tiananmen Square incident and the outbreak of Severe Acute Respiratory Syndrome (SARS). Other epidemic diseases (such as HIV/AIDS, avian influenza, and mosquito-borne diseases); crime directed at foreigners in major cities and tourist areas; road and air safety; natural disasters (earthquakes, flooding, and typhoons); crossstrait relations; and restrictions on public demonstrations, political, and religious activities constitute important considerations that will be also addressed throughout the chapter.


id: cord-023510-gd4phncm
title: Theme Park Visitors’ Responses to the SARS Outbreak in Taiwan
author: Chuo, Hsin-You
date: 2007-05-02
txt: ./txt/cord-023510-gd4phncm.txt
cache: ./cache/cord-023510-gd4phncm.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7170396/
doi: 10.1016/s1745-3542(06)03006-2
summary:
  1. Can a significant discriminant function be developed to interpret the differences between respondents who did and did not visit theme parks during the SARS outbreak period in Taiwan on the basis of their personal characteristics? In addition to the information of respondents'' general demographics, their patronage frequency in the last year and whether they visited theme parks in the period of the SARS outbreak, the question content also consisted of scale items to measure ''''benefit sought,'''' ''''product involvement,'''' and ''''risk perception.'''' Ten individual benefit scale items were derived from Pearce''s (1993) Leisure Ladder Model for theme park visitors. Thus, on the one hand, whether or not the respondents visited theme parks during the SARS outbreak was adopted to be the dependant (criterion) variable; on the other, respondents'' age, their patronage frequency in the last year, and the factors condensed from scale items of respondents'' risk perception, benefit sought, and product involvement were adopted to be the independent variables (predictors) in the developing discriminant function.

abstract:
  The purpose of this study is to examine empirically different characteristics between theme park visitors who did and did not visit theme parks during the SARS outbreak period in Taiwan. The data consisting of 1,255 respondents were obtained from visitors to the five leading theme parks. Discriminant analysis was used to analyze respondents’ characteristics such as age, benefit sought, product involvement, and risk perception to examine significant differences between the two categories of respondents. Results of this study showed that younger or more frequent visitors more likely continued to visit theme parks during the SARS outbreak. Besides, visitors who continued to visit theme parks perceived greater infectious risk than those who did not visit theme parks during the SARS outbreak.


id: cord-024045-mtfqaepe
author: Kuo, Jia-Hong
date: 2008-01-24
txt: ./txt/cord-024045-mtfqaepe.txt
cache: ./cache/cord-024045-mtfqaepe.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185678/
doi: 10.1016/j.applthermaleng.2008.01.010
summary:
  This study focuses on the history of construction and development of incinerators in Taiwan as well as the characteristics of pollutants, such as heavy metals (Pb, Cd, and Hg), acid gases (NO(x), SO(x), CO, and HCl), and dioxins emitted from the incinerators. Taiwan''s extensive experience in incinerator construction and operation may serve as an example for developing countries in devising waste treatment technology, energy recovery, and the control of contagious viral diseases. In order to speed up nation''s MSW treatment and resources recycling, the Taiwan government has formulated policies concerning the reduction of waste volume in recent years. Consequently, this study discusses statistics about pollutants like acid gases, heavy metals, and organics captured by the APCDs in incineration system during the past five years. Due to the improvement of flue gas treatment instrument/technique and the policy of resource recovery, all incinerators met the regulations of TEPA in heavy metal emission.

title:
  The prospect and development of incinerators for municipal solid waste treatment and characteristics of their pollutants in Taiwan

abstract:
  Taiwan is a small, densely populated island with unique experiences in the construction and operation of incinerators. In such a small area, Taiwan has built 22 incinerators over a short span of time, combusting large amount of municipal solid waste as much as 23,250 tons per day. This study focuses on the history of construction and development of incinerators in Taiwan as well as the characteristics of pollutants, such as heavy metals (Pb, Cd, and Hg), acid gases (NO(x), SO(x), CO, and HCl), and dioxins emitted from the incinerators. Furthermore, the study also covers the generation and composition of municipal solid waste (MSW), and the production of energy in Taiwan. According to Taiwan’s data on pollutant emissions, the emission level of pollutants is under control and meets the stringent regulations of Taiwan Environmental Protection Administration (TEPA). Researches have shown that using air pollution control devices (APCDs) in the operation of incinerators provides effective measures for air pollutant control in Taiwan. The main advantage of using incinerators is the generation of electricity (waste-to-energy) during the incineration of municipal solid waste, producing energy that can be consumed by the general public and the industry. Taiwan’s extensive experience in incinerator construction and operation may serve as an example for developing countries in devising waste treatment technology, energy recovery, and the control of contagious viral diseases.


id: cord-024982-4f6m3kfc
author: Che Huei, Lin
date: 2020-05-18
txt: ./txt/cord-024982-4f6m3kfc.txt
cache: ./cache/cord-024982-4f6m3kfc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235655/
doi: 10.1177/2050312120918999
summary:
  title: Occupational health and safety hazards faced by healthcare professionals in Taiwan: A systematic review of risk factors and control strategies BACKGROUND: Healthcare professionals in Taiwan are exposed to a myriad of occupational health and safety hazards, including physical, biological, chemical, ergonomic, and psychosocial hazards. The impact of such hazards on healthcare professionals poses a serious public health issue in Taiwan; therefore, controlling, eliminating, or reducing exposure can contribute to a stronger healthcare workforce with great potential to improve patient care and the healthcare system in Taiwan. The International Labour Organization (ILO) 3 reported that millions of healthcare workers suffer from work-related diseases and accidents, and many succumb to occupational hazards. 9 This study reviewed previous works on OHS hazards, as well as their risk factors and control strategies, with a focus on healthcare professionals in Taiwan. We used the following key words in our literature search: occupational health and safety, risk factors, healthcare professionals, control strategies, and Taiwan 

title:
  Occupational health and safety hazards faced by healthcare professionals in Taiwan: A systematic review of risk factors and control strategies

abstract:
  BACKGROUND: Healthcare professionals in Taiwan are exposed to a myriad of occupational health and safety hazards, including physical, biological, chemical, ergonomic, and psychosocial hazards. Healthcare professionals working in hospitals and healthcare facilities are more likely to be subjected to these hazards than their counterparts working in other areas. OBJECTIVES: This review aims to assess current research literature regarding this situation with a view to informing policy makers and practitioners about the risks of exposure and offer evidence-based recommendations on how to eliminate or reduce such risks. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses review strategy, we conducted a systematic review of studies related to occupational health and safety conducted between January 2000 and January 2019 using MEDLINE (Ovid), PubMed, PMC, TOXLINE, CINAHL, PLOS One, and Access Pharmacy databases. RESULTS: The review detected 490 studies addressing the issue of occupational health and safety hazards; of these, 30 articles were included in this systematic review. These articles reported a variety of exposures faced by healthcare professionals. This review also revealed a number of strategies that can be adopted to control, eliminate, or reduce hazards to healthcare professionals in Taiwan. CONCLUSION: Hospitals and healthcare facilities have many unique occupational health and safety hazards that can potentially affect the health and performance of healthcare professionals. The impact of such hazards on healthcare professionals poses a serious public health issue in Taiwan; therefore, controlling, eliminating, or reducing exposure can contribute to a stronger healthcare workforce with great potential to improve patient care and the healthcare system in Taiwan. Eliminating or reducing hazards can best be achieved through engineering measures, administrative policy, and the use of personal protective equipment. IMPLICATIONS: This review has research, policy, and practice implications and provides future students and researchers with information on systematic review methodologies based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy. It also identifies occupational health and safety risks and provides insights and strategies to address them.


id: cord-030504-442pnl5s
title: Molecular characteristics of the VP1 region of enterovirus 71 strains in China
author: Sun, Haiyan
date: 2020-08-14
txt: ./txt/cord-030504-442pnl5s.txt
cache: ./cache/cord-030504-442pnl5s.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7427758/
doi: 10.1186/s13099-020-00377-2
summary:
  BACKGROUND: Enterovirus 71 (EV71) is the most commonly implicated causative agent of severe outbreaks of paediatric hand, foot, and mouth disease (HFMD).VP1 protein, a capsid protein of EV71, is responsible for the genotype of the virus and is essential for vaccine development and effectiveness. These results suggest that the genetic characteristics of the EV71-VP1 region should be continuously monitored, which is critical for epidemic control and vaccine design to prevent EV71 infection in children. In this study, the VP1 sequences of all EV71 viruses registered in Gen-Bank in China from 1996 to 2019 were collected, and the molecular characteristics of genes were analysed using bioinformatics software to provide a scientific basis for the prevention and control of HFMD epidemics. In this study, the amino acid at position 145 in most strains was found to be E, with an E145G/Q mutation rate of 6.63%, suggesting that the emergence of this mutation may result in a virus that is more likely to infect human lymphocytes.

abstract:
  BACKGROUND: Enterovirus 71 (EV71) is the most commonly implicated causative agent of severe outbreaks of paediatric hand, foot, and mouth disease (HFMD).VP1 protein, a capsid protein of EV71, is responsible for the genotype of the virus and is essential for vaccine development and effectiveness. However, the genotypes of EV71 isolates in China are still not completely clear. METHODS: The VP1 gene sequences of 3712 EV71 virus strains from China, excluding repetitive sequences and 30 known EV71 genotypes as reference strains, between 1986 and 2019 were obtained from GenBank. Phylogenetic tree, amino acid homology, genetic variation and genotype analyses of the EV71VP1 protein were performed with MEGA 6.0 software. RESULTS: The amino acid identity was found to be 88.33%–100% among the 3712 EV71 strains, 93.47%–100% compared with vaccine strain H07, and 93.04%–100% compared with vaccine strains FY7VP5 or FY-23 K-B. Since 2000, the prevalent strains of EV71 were mainly of the C4 genotype. Among these, the C4a subgenotype was predominant, followed by the C4b subgenotype; other subgenotypes appeared sporadically between 2005 and 2018 in mainland China. The B4 genotype was the main genotype in Taiwan, and the epidemic strains were constantly changing. Some amino acid variations in VP1 of EV71 occurred with high frequencies, including A289T (20.99%), H22Q (16.49%), A293S (15.95%), S283T (15.11%), V249I (7.76%), N31D (7.25%), and E98K (6.65%). CONCLUSION: The C4 genotype of EV71 in China matches the vaccine and should effectively control EV71. However, the efficacy of the vaccine is partially affected by the continuous change in epidemic strains in Taiwan. These results suggest that the genetic characteristics of the EV71-VP1 region should be continuously monitored, which is critical for epidemic control and vaccine design to prevent EV71 infection in children.


id: cord-030602-nh0s3maw
author: Shen, Ching-Fen
date: 2020-08-19
txt: ./txt/cord-030602-nh0s3maw.txt
cache: ./cache/cord-030602-nh0s3maw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7435222/
doi: 10.1186/s12929-020-00680-9
summary:
  We investigated the impact of stepwise implementation of childhood PCV programs on the prevalence of pneumococcal pneumonia, severity of acute inflammation, and associations between breakthrough pneumonia and pneumococcal serotypes in Taiwan. Therefore, the overall purpose of the present study was to investigate the impact of stepwise implementation of pneumococcal conjugate vaccine (PCV) on epidemiological change in pneumococcal CAP, including: 1) potential reduction in the prevalence of pneumococcal pneumonia, 2) whether or not childhood PCV vaccination affects the severity of acute inflammation in those who develop pneumococcal pneumonia, and 3) whether breakthrough pneumococcal pneumonia is associated with specific pneumococcal serotypes or not. Taken together, the results of these studies provide strong evidence supporting our finding that PCV vaccines may reduce the severity of acute inflammation in children with pneumococcal pneumonia attributed to serotypes 19A, 3, and 19F . Effectiveness of pneumococcal conjugate vaccines of different valences against invasive pneumococcal disease among children in Taiwan: a Nationwide study

title:
  The potential role of pneumococcal conjugate vaccine in reducing acute respiratory inflammation in community-acquired pneumococcal pneumonia

abstract:
  BACKGROUND: Pneumococcal conjugate vaccine (PCV) reduces both invasive pneumococcal disease (IPD) and other pneumococcal infections worldwide. We investigated the impact of stepwise implementation of childhood PCV programs on the prevalence of pneumococcal pneumonia, severity of acute inflammation, and associations between breakthrough pneumonia and pneumococcal serotypes in Taiwan. METHODS: In total, 983 children diagnosed with community-acquired pneumococcal pneumonia were enrolled between January 2010 and December 2015. RESULTS: Proportions of pneumococcal vaccinations increased each year in age-stratified groups with PCV7 (32.2%) as the majority, followed by PCV13 (12.2%). The proportion of pneumococcal pneumonia decreased each year in age-stratified groups, especially in 2–5 year group. Serotype 19A is the leading serotype either in vaccinated (6.4%) or unvaccinated patients (5.2%). In particular, vaccinated patients had significantly higher lowest WBC, lower neutrophils, lower lymphocytes and lower CRP values than non-vaccinated patients (p < 0.05). After stratifying patients by breakthrough infection, those with breakthrough pneumococcal infection with vaccine coverage serotypes had more severe pneumonia disease (p < 0.05). CONCLUSION: Systematic childhood pneumococcal vaccination reduced the prevalence of community-acquired pneumococcal pneumonia, especially in 2–5 year group. Serotype 19A was the major serotype for all vaccine types in patients with pneumococcal pneumonia and severity of acute inflammatory response was reduced in vaccinated patients.


id: cord-033204-v17d98c9
title: Taiwan’s COVID‐19 Management: Developmental State, Digital Governance, and State‐Society Synergy
author: Yen, Wei‐Ting
date: 2020-09-23
txt: ./txt/cord-033204-v17d98c9.txt
cache: ./cache/cord-033204-v17d98c9.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537052/
doi: 10.1111/aspp.12541
summary:
  The country''s success mainly lies in three factors: (1) reliance on the mask policy as the main disease prevention measure and the ability to quickly expand mask production capacity; (2) use of big data and technology to enhance effective implementation of disease prevention and detection measures; and (3) strong state‐society relations favoring transparency, communication, and collaboration. I then turn to the crisis management framework, discussing how the developmental state foundations and the democratic regime lead to Taiwan''s success on mask policy, digital governance, and strong state-society collaboration and communication. Moreover, the capacity of a government to define and communicate the uncertainty the crisis brings is also an essential element in an effective response because collective sense-making can help increase citizens'' voluntary compliance. Specifically, during COVID-19, digital governance helped improve disease detection through integrated databases of people''s health records and travel history, through more accurate contact tracing, and through active surveillance tracking for people under quarantine.

abstract:
  This article examines the reasons behind Taiwan’s effective COVID‐19 response. While some have argued that Taiwan’s success with COVID‐19 is based on its experience with SARS, I argue that we should not attribute Taiwan’s effective response solely to its SARS experience. The country’s success mainly lies in three factors: (1) reliance on the mask policy as the main disease prevention measure and the ability to quickly expand mask production capacity; (2) use of big data and technology to enhance effective implementation of disease prevention and detection measures; and (3) strong state‐society relations favoring transparency, communication, and collaboration. The first two factors can trace their roots to the country’s developmental state model. Democracy provides the institutional underpinning for a vibrant civil society and the synergy between state and civil society, strengthening Taiwan’s crisis governance legitimacy and increasing citizens’ voluntary compliance.


id: cord-253111-n5ywei4t
author: Keck, Frédéric
date: 2018-04-14
txt: ./txt/cord-253111-n5ywei4t.txt
cache: ./cache/cord-253111-n5ywei4t.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32336932/
doi: 10.1111/1467-9655.12813
summary:
  title: Avian preparedness: simulations of bird diseases and reverse scenarios of extinction in Hong Kong, Taiwan, and Singapore This article describes relations between humans, animals, artefacts, and pathogens in simulations of disasters, taking bird diseases in three Chinese sentinel posts as ethnographic cases. Borrowing from the anthropology of hunting societies, it argues that simulations of bird diseases, considered as signs of future species extinction, rely on cynegetic techniques of power, in which humans and animals symmetrically shift perspectives, and not only on pastoralist techniques, in which humans are above the population they monitor and sometimes sacrifice. While public health relies on pastoral techniques of power combining sacrifice and surveillance to contain the threats coming from outside in a population (Foucault 1981) , the ''One World, One Health'' approach uses techniques from birdwatchers and wildlife managers to monitor data about changing relations between humans and animals.

title:
  Avian preparedness: simulations of bird diseases and reverse scenarios of extinction in Hong Kong, Taiwan, and Singapore

abstract:
  This article describes relations between humans, animals, artefacts, and pathogens in simulations of disasters, taking bird diseases in three Chinese sentinel posts as ethnographic cases. Drawing on distinctions between simulation, ritual, and play, it shows that the engagement of actors in the imaginary of simulations, which they describe as ‘realism’, reflectively reverses the oppositions between humans and nonhumans, active and passive, fiction and reality that shape ordinary life. Borrowing from the anthropology of hunting societies, it argues that simulations of bird diseases, considered as signs of future species extinction, rely on cynegetic techniques of power, in which humans and animals symmetrically shift perspectives, and not only on pastoralist techniques, in which humans are above the population they monitor and sometimes sacrifice.


id: cord-256504-odbaubqm
author: Kuo, Fang‐Li
date: 2020-08-19
txt: ./txt/cord-256504-odbaubqm.txt
cache: ./cache/cord-256504-odbaubqm.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/kjm2.12294
doi: 10.1002/kjm2.12294
summary:
  The questionnaire included items on the demographic characteristics of hospital staff and a scale to assess stress among healthcare workers caring for patients with a highly infectious disease. The five highest stress scores were observed for the items "rough and cracked hands due to frequent hand washing and disinfectant use," "inconvenience in using the toilet at work," "restrictions on eating and drinking at work," "fear of transmitting the disease to relatives and friends," and "fear of being infected with COVID‐19." Discomfort caused by protective equipment was the major stressor for the participants, followed by burden of caring for patients. This could be attributed to physical discomfort caused by protective equipment, also, nurses often Previous studies have shown that work stress is related to one''s demographic characteristics, 13, 17 and that child care at home is a common problem for hospital staff, 28, 29 which is an important factor leading to work-family conflicts.

title:
  Survey on perceived work stress and its influencing factors among hospital staff during the COVID‐19 pandemic in Taiwan

abstract:
  This study aimed to investigate the perceived work stress and its influencing factors among hospital staff during the novel coronavirus (COVID‐19) pandemic in Taiwan. A web‐based survey was conducted at one medical center and two regional hospitals in southern Taiwan, targeting physicians, nurses, medical examiners, and administrators. The questionnaire included items on the demographic characteristics of hospital staff and a scale to assess stress among healthcare workers caring for patients with a highly infectious disease. A total of 752 valid questionnaires were collected. The hospital staff reported a moderate level of stress and nurses had a highest level of stress compared to staff in the other three occupational categories. The five highest stress scores were observed for the items “rough and cracked hands due to frequent hand washing and disinfectant use,” “inconvenience in using the toilet at work,” “restrictions on eating and drinking at work,” “fear of transmitting the disease to relatives and friends,” and “fear of being infected with COVID‐19.” Discomfort caused by protective equipment was the major stressor for the participants, followed by burden of caring for patients. Among participants who experienced severe stress (n = 129), work stress was higher among those with rather than without minor children. The present findings may serve as a reference for future monitoring of hospital staff's workload, and may aid the provision of support and interventions.


id: cord-257917-4496gzdu
author: Liou, Shwu-Ru
date: 2020-02-25
txt: ./txt/cord-257917-4496gzdu.txt
cache: ./cache/cord-257917-4496gzdu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32363142/
doi: 10.1016/j.ijdrr.2020.101545
summary:
  The purposes of the study were to determine the predictive relationships between Taiwanese nurses'' disaster competence, anticipatory disaster stress, and motivation for disaster engagement. Therefore, the purposes of the study were to determine the level of and relationships between Taiwanese nurses'' disaster competence, anticipatory disaster stress, and motivation for disaster engagement. In this study, individual differences are defined as a nurse''s personal characteristics that may influence their preparedness and motivation to engage in disaster events, such as gender, age, seniority in the hospital, educational level, hospital type, work unit, and job title. This study aimed to explore the relationships between disaster competence, anticipatory disaster stress, and motivation for disaster engagement among hospital nurses in Taiwan. The study found that even though hospitals held disaster courses and trainings every year, nurses had a worryingly low level of disaster competence, which correlated with their low motivation to participate in disaster rescue.

title:
  Relationships between disaster nursing competence, anticipatory disaster stress and motivation for disaster engagement

abstract:
  Nurses are the largest group of healthcare providers and are often the first line responders to a disaster event. Nurses' disaster competence, motivation for disaster engagement, and factors that impact their motivation to respond to disaster events need to be understood. The purposes of the study were to determine the predictive relationships between Taiwanese nurses' disaster competence, anticipatory disaster stress, and motivation for disaster engagement. A cross-sectional design was used to analyze data collected between August 2017 and December 2017 from eight hospitals in southern Taiwan. Ninety participants who met the recruitment criteria completed and returned questionnaires with an 88.24% response rate. Data collection involved administering the Disaster Nursing Competence Questionnaire, Anticipatory Disaster Stress Questionnaire, and the Motivation of Disaster Engagement Questionnaire. The results indicated that anticipatory disaster stress was positively correlated with disaster competence and motivation for disaster engagement. Disaster competence and willingness to join a hospital disaster rescue predicts an individuals' motivation for disaster engagement. The results of the study add to the understanding of factors that correlate with nurses' motivation to participate in disaster events. By understanding these factors, the government and healthcare administrators can design disaster education plans and other strategies to improve Taiwanese nurses’ motivation to engage in disaster events.


id: cord-262646-64ldtrjf
author: Chuang, Pei-Hung
date: 2010-05-27
txt: ./txt/cord-262646-64ldtrjf.txt
cache: ./cache/cord-262646-64ldtrjf.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/1471-2334-10-136
doi: 10.1186/1471-2334-10-136
summary:
  This study proposes a dynamic statistical model to estimate the daily number of new cases and the daily cumulative number of infected cases, which was then applied to historic dengue fever data. Our results show that when an infectious disease required a time-consuming process for diagnosis, such as the dengue fever using the previously mentioned protocol, the actual daily number of infected cases and cumulative positive cases are potentially underestimated. The Figure 3 and Table 1 for cumulative cases showed that a gamma distribution is a more appropriate assumption for the onset-todiagnosis time when estimating the probability of being a positive case using the dengue fever example; nonetheless, the difference between the gamma and the nonparametric method is again only slight except towards the end stage of the epidemic after January 1. This study has proposed a statistical method that more accurately estimates the real-time daily new cases and daily cumulative number of infected cases using a dengue fever epidemic as an example.

title:
  A dynamic estimation of the daily cumulative cases during infectious disease surveillance: application to dengue fever

abstract:
  BACKGROUND: In infectious disease surveillance, when the laboratory confirmation of the cases is time-consuming, there is often a time lag between the number of suspect cases and the number of confirmed cases. This study proposes a dynamic statistical model to estimate the daily number of new cases and the daily cumulative number of infected cases, which was then applied to historic dengue fever data. METHODS: The duration between the date of disease onset and date of laboratory confirmation was assumed to follow a gamma distribution or a nonparametric distribution. A conditional probability of a case being a real case among the unconfirmed cases on a given date was then calculated. This probability along with the observed confirmed cases was integrated to estimate the daily number of new cases and the cumulative number of infected cases. RESULTS: The distribution of the onset-to-confirmation time for the positive cases was different from that of the negative cases. The daily new cases and cumulative epidemic curves estimated by the proposed method have a lower absolute relative bias than the values estimated solely based on the available daily-confirmed cases. CONCLUSION: The proposed method provides a more accurate real-time estimation of the daily new cases and daily cumulative number of infected cases. The model makes use of the most recent "moving window" of information relative to suspect cases and dynamically updates the parameters. The proposed method will be useful for the real-time evaluation of a disease outbreak when case classification requires a time-consuming laboratory process to identify a confirmed case.


id: cord-264560-hxvadp24
title: Analysis of Imported Cases of COVID-19 in Taiwan: A Nationwide Study
author: Liu, Jui-Yao
date: 2020-05-09
txt: ./txt/cord-264560-hxvadp24.txt
cache: ./cache/cord-264560-hxvadp24.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32397515/
doi: 10.3390/ijerph17093311
summary:
  The Taiwanese authorities have made efforts to contain the importation of the disease by issuing travel advisories and implementing flight bans, entry restrictions, airport screening, home quarantining of travellers from high-risk areas, isolation of confirmed cases, and thorough contact tracing [11] [12] [13] . Travellers entering Taiwan with fever or respiratory symptoms must have oropharyngeal specimens collected for COVID-19 testing and are subject to home quarantining for 14 days, as are travellers from areas where the disease is epidemic. Of the imported cases, 32.7% were identified in airport screening, 27.7% during home quarantine, 16.2% through contact tracing, and 23.4% sought medical attention themselves and were reported by the hospitals (Table 3 ). Proactive border control measures to contain the importation of COVID-19 via airport screening, quarantining of travellers from epidemic areas, and thorough contact tracing are effective for preventing community transmission of this disease.

abstract:
  In the early stages of the 2019 novel coronavirus disease (COVID-19) pandemic, containment of disease importation from epidemic areas was essential for outbreak control. This study is based on publicly accessible data on confirmed COVID-19 cases in Taiwan extracted from the Taiwan Centers for Disease Control website. We analysed the characteristics, infection source, symptom presentation, and route of identification of the 321 imported cases that were identified from 21 January to 6 April 2020. They were mostly returned Taiwanese citizens who had travelled to one or more of 37 countries for tourism, business, work, or study. Half of these cases developed symptoms before arrival, most of the remainder developed symptoms 1–13 days (mean 4.0 days) after arrival, and 3.4% never developed symptoms. Three-quarters of the cases had respiratory symptoms, 44.9% had fever, 13.1% lost smell or taste, and 7.2% had diarrhoea. Body temperature and symptom screening at airports identified 32.7% of the cases. Of the remainder, 27.7% were identified during home quarantining, 16.2% were identified via contact tracing, and 23.4% were reported by hospitals. Under the strict enforcement of these measures, the incidence of locally acquired COVID-19 cases in Taiwan remains sporadic. In conclusion, proactive border control measures are effective for preventing community transmission of this disease.


id: cord-265146-j0n3a4m6
title: Ascertaining the 2004–2006 HIV type 1 CRF07_BC outbreak among injecting drug users in Taiwan
author: Hsieh, Ying-Hen
date: 2013-02-12
txt: ./txt/cord-265146-j0n3a4m6.txt
cache: ./cache/cord-265146-j0n3a4m6.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ijid.2013.01.002
doi: 10.1016/j.ijid.2013.01.002
summary:
  Furthermore, correlation analysis was carried out to assess the correlation between infections among the male and female IDUs. RESULTS: Model fit revealed a two-wave epidemic during April 2004–March 2007. Furthermore, correlation analysis was carried out to assess the correlation between infections among the male and female IDUs. Results: Model fit revealed a two-wave epidemic during April 2004-March 2007. Correlation analysis was performed in an attempt to determine the relationship between the male and female IDUs. The data used here were extracted from the monthly reported HIV case data between April 2004 and March 2007, for a total of 36 months, made available by the Taiwan Centers for Disease Control and Prevention (TCDC) on the TCDC website. The monthly time series data of reported HIV cases for male IDUs, female IDUs, and all IDUs in Taiwan were fit to the Richards model as in Figure 1 and Table 1 The effective reproduction number R was computed for each wave.

abstract:
  OBJECTIVE: To ascertain the explosive 2004–2006 outbreak of HIV-1 CRF07_BC among intravenous drug users (IDU) in Taiwan, which more than doubled the total number of reported HIV cases in less than 3 years, resulting in a 45-fold increase in cumulative IDU/HIV cases and a 40-fold increase in previously seldom-reported female IDU/HIV cases. METHODS: A mathematical model was utilized to fit the monthly case data, in order to estimate the turning points (peak incidence) and the reproduction number R of the outbreak. Furthermore, correlation analysis was carried out to assess the correlation between infections among the male and female IDUs. RESULTS: Model fit revealed a two-wave epidemic during April 2004–March 2007. The larger second wave started shortly after May 2005 and peaked in October 2005 before gradually subsiding. R was estimated to be 3.15 (3.14–3.16) and 27.21 (26.73–28.05) for the two respective waves. The time series of monthly differences in male and female case data were found to be most significantly correlated at lag 0 (i.e., r > 0.7) with r = 0.906 and 0.804, respectively in each direction. The Granger causality test indicated that the male time series caused the corresponding female time series with a lag of 2 months or less. CONCLUSIONS: The modeling results revealed the presence of a small first wave in 2004, before an explosion of cases after May 2005. Furthermore, a harm reduction program implemented in August 2005 contributed to the downturn in the epidemic after October. Correlation results also suggest that the upsurge in male HIV cases led to the subsequent drastic surge in female cases.


id: cord-265774-oci77t99
author: Chen, Yu-Wen
date: 2012-10-02
txt: ./txt/cord-265774-oci77t99.txt
cache: ./cache/cord-265774-oci77t99.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1684118212001739
doi: 10.1016/j.jmii.2012.08.012
summary:
  Until now, viral etiology of bronchiolitis in children in Taiwan has been limited, particularly the newly identified viruses, including human metapneumovirus (hMPV), human bocavirus (hBoV), and human coronavirus (hCoV) NL-63. To our knowledge, this is the first comprehensive viral etiology study of hospitalized pediatric patients with bronchiolitis, including newly identified respiratory viruses, in Taiwan. Results from the present study showed that RSV, hMPV, and hBoV were the most common viral pathogens for acute lower respiratory tract infection among hospitalized children, less than 2 years of age, in northern Taiwan.We demonstrated again that RSV remained the major pathogen in infants with bronchiolitis. In the present study, clinical characteristics of children with bronchiolitis due to different viral etiologies seemed similar, regardless of whether the infection was caused by single or multiple viruses. In our study, we also observed no statistical significance in clinical characteristics between children with bronchiolitis caused by different single viral infection.

title:
  Viral etiology of bronchiolitis among pediatric inpatients in northern Taiwan with emphasis on newly identified respiratory viruses

abstract:
  PURPOSE: Viral etiology of bronchiolitis in children in Taiwan has been fragmentary. We conducted a prospective study to figure out the viral epidemiology of bronchiolitis in Taiwan. MATERIALS AND METHODS: From January 2009 to March 2011, a total of 113 children with bronchiolitis, aged <2 years, hospitalized in Chang Gung Children’s Hospital were randomly selected for viral etiology investigation. Nasopharyngeal aspirates were obtained from each case and sent for viral detection by tissue culture, antigen test, and polymerase chain reaction. RESULTS: A total of 120 viruses were detected from 113 children. Positive viral etiology was identified in 86 (76%) children. Mixed viral pathogens were found in 28 cases (25%). Respiratory syncytial virus (RSV) was the most common pathogen and was identified in 43.4% of the cases. Human bocavirus (hBoV) was the second most common identified virus (in 19.5%), followed by human metapneumovirus (hMPV), rhinovirus, influenza viruses, and coronavirus OC43. In terms of clinical characteristics, no significant difference was found among the children with bronchiolitis either caused by different single or mixed viral infection. CONCLUSION: RSV was the most common etiologic agent for children with bronchiolitis in Taiwan. Newly identified viruses, including hMPV and hBoV, were also among the common causative agents. Clinical characteristics were not significantly different among the children with bronchiolitis caused by different viruses.


id: cord-266123-q75f12vh
author: Lin, Che-huei
date: 2020-10-19
txt: ./txt/cord-266123-q75f12vh.txt
cache: ./cache/cord-266123-q75f12vh.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s12962-020-00239-3
doi: 10.1186/s12962-020-00239-3
summary:
  Cost Effectiveness and Resource Allocation *Correspondence: lmh.roger@msa.hinet.net † Wang Jong Yi and Lin Ming Hung contributed equally to this work 1 Department of Pharmacy and Master Program, Tajen University, Pintung 90741, Taiwan Full list of author information is available at the end of the article enhance the distribution-related outcomes of scarce public health management resources to target populations and communities. Given their proven performance record as being a reliable resource for helping to implement public health promotion initiatives by the Taiwanese government, community pharmacies were enlisted to assist in the distribution of face masks to citizens across the country. The community pharmacy-based approach to the distribution and sale of prevention face masks to citizens for the ongoing COVID-19 pandemic has proven to be a new and innovative engagement of pharmacists in contributing to the efficient, reliable, equitable, and costeffective implementation of public health promotion and protection initiatives by the government.

title:
  The pharmaceutical practice of mask distribution by pharmacists in Taiwan’s community pharmacies under the Mask Real-Name System, in response to the COVID-19 outbreak

abstract:
  BACKGROUND: Pharmacists hold to their promise to foster, implement and promote the health of the population and to prevent disease, given their knowledge, skills, and proximity to the locals. The objective of this study was to foster equality and cost-effectiveness in the distribution and sale of masks to all Taiwanese citizens, in response to the COVID-19 pandemic. METHODS: All 6336 special community pharmacies participating in the NHI (National Health Insurance) served as mask-selling sites. Access to masks by citizens was determined and controlled, based on the weekly rationing of the number of purchasable masks per citizen and the last digit of their NHI card number. Masks were available on different weekdays for holders of cards ending with odd and even numbers, except on Sundays, when everyone was eligible to buy a mask. RESULTS: Implementing the program has provided equal access to masks for all citizens across Taiwan. It has stabilized the pricing of masks and mitigated the public’s anxiety of a perceived likely market shortage. CONCLUSION: The community pharmacy-based approach to the distribution of prevention face masks to citizens represents a new and innovative engagement of pharmacists in public health promotion and protection initiatives. Community pharmacies can greatly improve the efficiency, reliability, and cost-saving of the distribution of public health resources to local communities, especially in the face of an epidemic.


id: cord-267136-1abp6oom
author: Lan, Yu-Ching
date: 2004-12-07
txt: ./txt/cord-267136-1abp6oom.txt
cache: ./cache/cord-267136-1abp6oom.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1567134804001224
doi: 10.1016/j.meegid.2004.08.005
summary:
  Taiwan experienced a large number of severe acute respiratory syndrome (SARS) viral infections between March and July 2003; by September of that year, 346 SARS cases were confirmed by RT-PCR or serological tests. In order to better understand evolutionary relationships among SARS coronaviruses (SCoVs) from different international regions, we performed phylogenetic comparisons of full-length genomic and protein sequences from 45 human SCoVs (including 12 from Taiwan) and two civet SCoVs. All the Taiwanese SARS-CoV strains which associated with nosocomial infection formed a monophyletic clade within the late phase of the SARS epidemic. To better understand evolutionary relationships between SCoVs isolated in Taiwan and those isolated in other parts of the world, we constructed phylogenetic trees with two different methods using full-length genomic sequences from 45 human (12 Taiwanese) and two civet SCoVs. Tree topologies were consistent for the NJ (Fig. 1a) and Pars (Fig. 1b) methods. Pairwise comparison methods were used to analyze nucleotide sequence variation within the full-length genomes of 20 human SCoVs (7 from early epidemic and 13 from late epidemic) (Fig. 2) .

title:
  Phylogenetic analysis and sequence comparisons of structural and non-structural SARS coronavirus proteins in Taiwan

abstract:
  Taiwan experienced a large number of severe acute respiratory syndrome (SARS) viral infections between March and July 2003; by September of that year, 346 SARS cases were confirmed by RT-PCR or serological tests. In order to better understand evolutionary relationships among SARS coronaviruses (SCoVs) from different international regions, we performed phylogenetic comparisons of full-length genomic and protein sequences from 45 human SCoVs (including 12 from Taiwan) and two civet SCoVs. All the Taiwanese SARS-CoV strains which associated with nosocomial infection formed a monophyletic clade within the late phase of the SARS epidemic. This Taiwanese clade could be further divided into two epidemic waves. Taiwan SCoVs in the first wave clustered with three isolates from the Amoy Gardens housing complex in Hong Kong indicating their possible origin. Of the 45 human SCoVs, one isolate from Guangdong province, China, exhibited an extra 29-nucleotide fragment between Orf 10 and Orf 11—similar to the civet SCoV genome. Nucleotide and protein sequence comparisons suggested that all SCoVs of late epidemic came from human-to-human transmission, while certain SCoVs of early epidemic might have originated in animals.


id: cord-268278-owmcxq9e
author: Lin, Yu-Kai
date: 2012-06-15
txt: ./txt/cord-268278-owmcxq9e.txt
cache: ./cache/cord-268278-owmcxq9e.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0048969712005712
doi: 10.1016/j.scitotenv.2012.04.039
summary:
  However, other weather indicators, such as relative humidity (RH), wind speed (WS), water Science of the Total Environment 427-428 (2012) [41] [42] [43] [44] [45] [46] [47] [48] [49] Abbreviations: AIC, Akaike''s information criterion; AT, apparent temperature; CI, confidence interval; CWB, Central Weather Bureau; DLNM, distributed lag non-linear model; Flu, influenza; HI, heat index; NHRI, National Health Research Institute; PM 10 , particulate matter less than 10 μm in aerodynamic diameter; RR, relative risk; RH, relative humidity; TCDC, Taiwan Centers for Disease Control; THI, temperature humidity index; TEPA, Taiwan Environmental Protection Administration; WBGT, wet-bulb globe temperature; WS, wind speed; WVP, water vapor pressure. For each high-temperature index, data analysis further calculated area-specific cumulative 8-day (from lag 0 to lag 7 days) relative risks (RR) and 95% confidence intervals (CI) to determine associations with daily deaths and outpatient visits, using distributed lag nonlinear model (DLNM) (Armstrong, 2006; Gasparrini et al., 2010) .

title:
  High-temperature indices associated with mortality and outpatient visits: Characterizing the association with elevated temperature()()

abstract:
  This study aimed to identify optimal high-temperature indices to predict risks of all-cause mortality and outpatient visits for subtropical islanders in warm seasons (May to October). Eight high-temperature indices, including three single measurements (average, maximum and minimum temperature) and five composite indices (heat index, humidex, temperature humidity index, apparent temperature and wet-bulb globe temperature), and their standardized Z scores, were used in distributed lag non-linear models. Cumulative 8-day (lag zero to seven days) relative risks (RRs) and 95% confidence intervals were estimated, 1 and 2 standardized deviations above the medium (i.e., at 84.1th and 97.7th percentile, respectively), by comparing with Z scores for the lowest risks of mortality and outpatient visits as references. Analyses were performed for Taipei in north, Central Taiwan and Southern Taiwan. Results showed that standardized Z-values of high-temperature indices associated with the lowest health risk were approximately 0 in Taipei and Central Taiwan, and − 1 in Southern Taiwan. As the apparent temperature was at Z = 2, the cumulative 8-day mortality risk increased significantly, by 23% in Taipei and 28% in Southern Taiwan, but not in Central Taiwan. The maximum temperature displayed consistently a high correlation with all-cause outpatient visits at Z = 1; with the cumulative 8-day RRs for outpatient visits increased by 7%, 3%, and 4% in the three corresponding areas. In conclusion, this study has demonstrated methods to compare multiple high-temperature indices associated with all-cause mortality and outpatient visits for population residing in a subtropical island. Apparent temperature is an optimal indicator for predicting all-cause mortality risk, and maximum temperature is recommended to associate with outpatient visits. The impact of heat varied with study areas, evaluated health outcomes, and high-temperature indices. The increased extreme heat is associated with stronger risk for all-cause mortality than for outpatient visits.


id: cord-268370-kfjujs4z
author: Huang, Yu-Tung
date: 2009-05-31
txt: ./txt/cord-268370-kfjujs4z.txt
cache: ./cache/cord-268370-kfjujs4z.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/s0929-6646(09)60082-6
doi: 10.1016/s0929-6646(09)60082-6
summary:
  title: Hospitalization for Ambulatory-care-sensitive Conditions in Taiwan Following the SARS Outbreak: A Population-based Interrupted Time Series Study The purpose of this study was to explore the effect of the SARS outbreak on hospitalization for chronic ambulatory-care-sensitive conditions (ACSCs) in Taiwan. Methods We applied a population-based interrupted time series study design and used the time series auto-regressive integrated moving-average model to compare the actual and predicted admission rates of seven selected chronic ACSCs. The analyses were based on National Health Insurance hospital inpatient claims data from 1997 to 2003. We applied a population-based interrupted time series design to compare the actual with predicted hospitalization for ACSCs after the SARS outbreak, to identify conditions with increased hospitalization that might have been caused by untimely or inappropriate primary care during the SARS outbreak. We found that the actual hospitalization rates for six selected ACSCs, particularly respiratory conditions, were significantly lower than their predicted rates for at least 1 month during the SARS period.

title:
  Hospitalization for Ambulatory-care-sensitive Conditions in Taiwan Following the SARS Outbreak: A Population-based Interrupted Time Series Study

abstract:
  Background/Purpose In 2003, the severe acute respiratory syndrome (SARS) outbreak resulted in 8096 probable cases and 774 deaths in 26 countries. The purpose of this study was to explore the effect of the SARS outbreak on hospitalization for chronic ambulatory-care-sensitive conditions (ACSCs) in Taiwan. Methods We applied a population-based interrupted time series study design and used the time series auto-regressive integrated moving-average model to compare the actual and predicted admission rates of seven selected chronic ACSCs. The analyses were based on National Health Insurance hospital inpatient claims data from 1997 to 2003. Results The impact of SARS on ACSCs after the outbreak varied among seven selected chronic conditions. Hospitalization for respiratory conditions was significantly lower than the predicted values, whereas hospitalization for diabetes was significantly higher than the predicted values after the outbreak. Conclusion Admission rates for most ACSCs, except for diabetes, did not change in the post-SARS period. The reductions in outpatient utilization during the SARS outbreak did not appear to affect adversely admissions for most ACSCs.


id: cord-269723-gm65p1op
author: Tzeng, Nian-Sheng
date: 2020-10-06
txt: ./txt/cord-269723-gm65p1op.txt
cache: ./cache/cord-269723-gm65p1op.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1038/s41398-020-01021-y
doi: 10.1038/s41398-020-01021-y
summary:
  There were several studies about the psychiatric and mental health issues related to the severe adult respiratory syndrome (SARS) outbreak in 2003, however, the association between SARS and the overall risk of psychiatric disorders and suicides has, as yet, to be studied in Taiwan. A total of 285 patients with SARS and 2850 controls without SARS (1:10) matched for sex, age, insurance premium, comorbidities, residential regions, level of medical care, and index date were selected between February 25 and June 15, 2003 from the Inpatient Database Taiwan''s National Health Insurance Research Database. To the best of our knowledge, this is the first study on the association between SARS and increased risk in developing psychiatric disorders and suicide, in a 12-year follow-up, from a nationwide, population-based database.

title:
  What could we learn from SARS when facing the mental health issues related to the COVID-19 outbreak? A nationwide cohort study in Taiwan

abstract:
  There were several studies about the psychiatric and mental health issues related to the severe adult respiratory syndrome (SARS) outbreak in 2003, however, the association between SARS and the overall risk of psychiatric disorders and suicides has, as yet, to be studied in Taiwan. The aim of this study is to examine as to whether SARS is associated with the risk of psychiatric disorders and suicide. A total of 285 patients with SARS and 2850 controls without SARS (1:10) matched for sex, age, insurance premium, comorbidities, residential regions, level of medical care, and index date were selected between February 25 and June 15, 2003 from the Inpatient Database Taiwan’s National Health Insurance Research Database. During the 12-year follow-up, in which 79 in the SARS cohort and 340 in the control group developed psychiatric disorders or suicide (4047.41 vs. 1535.32 per 100,000 person-years). Fine and Gray’s survival analysis revealed that the SARS cohort was associated with an increased risk of psychiatric disorders and suicide, and the adjusted subdistribution HR (sHR) was 2.805 (95% CI: 2.182–3.605, p < 0.001) for psychiatric disorders and suicide. The SARS cohort was associated with anxiety, depression, sleep disorders, posttraumatic stress disorder/acute stress disorder (PTSD/ASD), and suicide. The sensitivity analysis revealed that the SARS group was associated with anxiety, depression, sleep disorders, PTSD/ASD, and suicide after the individuals with a diagnosis of psychiatric disorders and suicide were excluded within the first year, and with anxiety, depression, and sleep disorders, while those in the first five years were excluded. In conclusion, SARS was associated with the increased risk of psychiatric disorders and suicide.


id: cord-269772-4zrmsw2f
author: Liu, Ming-Der
date: 2015-06-24
txt: ./txt/cord-269772-4zrmsw2f.txt
cache: ./cache/cord-269772-4zrmsw2f.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/26104109/
doi: 10.1186/s12879-015-0987-8
summary:
  Thus, understanding all possible factors associated with risk awareness, attitudes, and practice of prevention measures (RAP), as well as differences in risk perception of outbreaks due to LPAI versus HPAI viruses between the live-poultry market workers (LPMWs) and community residents (CRs) are all important for providing further education and implementing public health policies on preventing AI infection. Therefore, the data of the reported "acceptance of avian influenza vaccine between live-poultry market workers and community residents" were thus compared only after the 2nd survey in Table 4 respondents with higher risk perception (concerning human AI infections in Taiwan) before HPAI outbreaks had not only more awareness about the AI outbreaks in mainland China affecting Taiwan, but also better attitudes toward meeting domestic needs (endorsing the government''s new policy on AI, and supporting a ban on slaughtering live poultry in markets).

title:
  Changing risk awareness and personal protection measures for low to high pathogenic avian influenza in live-poultry markets in Taiwan, 2007 to 2012

abstract:
  BACKGROUND: Outbreaks of low and high pathogenic avian influenza (LPAI, HPAI) H5N2 in chickens have occurred in Taiwan since 2003 and 2012, respectively. Fully understanding the different awareness, attitudes and protective behaviors adopted by workers in live-poultry markets (LPMWs) and local community residents (CRs) to face the challenges of LPAI and HPAI is very important to minimize viral adaptations to human populations. METHODS: A structural questionnaire containing information on respondents’ occupation, personal risk awareness, attitudes toward different policies, and preventative measures was administered. The two-stage survey (before and after HPAI H5N2 outbreaks) was conducted from 2007 to 2012, including: (1) 430 LPMWs and 418 CRs at LPMs from different geographical areas of Taiwan after the government announced outbreaks of LPAI H5N2 during 2007–2009, and (2) 73 LPMWs and 152 CRs at two LPMs in central Taiwan after the HPAI H5N2 outbreaks in 2012. The chi-squared test and logistic regression were applied for univariate and multivariate analyses, respectively. RESULTS: Before HPAI-H5N2 outbreaks, higher educated respondents demonstrated greater risk awareness and concerns regarding AI. However, LPM-workers protected themselves less from AI viruses (AIVs) and had lower acceptance of human or avian influenza vaccines. Most importantly, the participants who opposed (versus agreed with) the policy on banning live-poultry slaughtering at LPMs reported lower awareness of government prevention and control policies [Odds Ratio (OR): 0.76, 95 % Confidence Interval (CI): 0.56–1.01] or practiced preventive measures (OR: 0.42, 95 % CI: 0.25–0.70). After HPAI-H5N2 outbreaks, the risk awareness about AI in central Taiwan significantly increased [LPAI to HPAI LPMWs: 34.6 to 65.6 %, p < 0.05; CRs: 44.0 to 76.5 %, p < 0.05] and LPMWs’ belief in the effectiveness of vaccination to prevent human or avian influenza virus infection strikingly decreased (92.3 to 68.5 %, p < 0.05). CONCLUSIONS: Risk awareness depends on high or low pathogenicity of AIVs, working in LPMs, levels of education, age, and proximity to the sites of severe AI outbreaks. Regardless of novel LPAI or HPAI virus reassortants that pose public health risks, prompt and clear risk communication focusing on both correct information about AIVs and the most appropriate preventive measures are important for effective prevention of human infection. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-015-0987-8) contains supplementary material, which is available to authorized users.


id: cord-271660-5sfkhg19
author: Sun, Hsin-Yun
date: 2020-04-03
txt: ./txt/cord-271660-5sfkhg19.txt
cache: ./cache/cord-271660-5sfkhg19.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32243434/
doi: 10.1371/journal.pone.0230067
summary:
  METHODS: We measured the impact of switch to fluorescent microscopy on the smear detection rate of culture-confirmed pulmonary TB, timing of respiratory isolation, and total non-isolated infectious person-days in hospital at a high-caseload medical center (approximately 400 TB cases annually) in Taipei. Hospitalized patients had typical presentations of pulmonary TB if they had: (a) a prolonged cough for >3 weeks; (b) clinical suspicion of pulmonary TB based on chest radiography, such as cavitary pulmonary lesions, upper lobe diseases, or miliary lesions; or (c) already received a confirmed diagnosis of pulmonary TB by a positive sputum culture of Mycobacterium tuberculosis, positive acid-fast stain (AFS), or positive TB PCR, before the hospitalization. Our previous survey on age/sex-standardised TB incidence ratio of HCWs (using general population as reference)---the excess TB risk that are attributable to nosocomial TB transmission---in Medical Center A showed a drop of this risk, from 3.11 in 2006 to 1.37 in 2012 [23] , and the decrease in time-to-isolation and total non-isolated infectious patient-days was in parallel in the present study.

title:
  Impact of introducing fluorescent microscopy on hospital tuberculosis control: A before-after study at a high caseload medical center in Taiwan

abstract:
  BACKGROUND: Undiagnosed tuberculosis (TB) patients hospitalized because of comorbidities constitute a challenge to TB control in hospitals. We aimed to assess the impact of introducing highly sensitive fluorescent microscopy for examining sputum smear to replace conventional microscopy under a high TB risk setting. METHODS: We measured the impact of switch to fluorescent microscopy on the smear detection rate of culture-confirmed pulmonary TB, timing of respiratory isolation, and total non-isolated infectious person-days in hospital at a high-caseload medical center (approximately 400 TB cases annually) in Taipei. Multivariable Cox regression was applied to adjust for effects of covariates. The effect attributable to the improved smear detection rate was determined using causal mediation analysis. RESULTS: After switch to fluorescence microscopy, median non-isolated infectious duration decreased from 12.5 days to 3 days (P<0.001). Compared with conventional microscopy, fluorescence microscopy increased sputum smear detection rate by two-fold (for all patients: from 22.8% to 48.1%, P<0.001; for patients with cavitary lung lesion: from 43% to 82%, P = 0.029) and was associated with a 2-fold higher likelihood of prompt respiratory isolation (odds ratio mediated by the increase in sputum smear detection rate: 1.8, 95% CI 1.3–2.5). Total non-isolated infectious patient-days in hospital decreased by 69% (from 4,778 patient-days per year to 1,502 patient-days per year). CONCLUSIONS: In a high TB caseload setting, highly sensitive rapid diagnostic tools could substantially improve timing of respiratory isolation and reduce the risk of nosocomial TB transmission.


id: cord-272838-wjapj65w
author: Liou, Je-Liang
date: 2019-12-09
txt: ./txt/cord-272838-wjapj65w.txt
cache: ./cache/cord-272838-wjapj65w.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.tourman.2019.104055
doi: 10.1016/j.tourman.2019.104055
summary:
  This study employs an extended gravity model to analyse the complementarity or competitiveness relationship of the number of inbound tourists and corresponding tourism revenue between China and 19 other nations under the implementation of China''s Open-door Tourism Policy to Taiwan in 2008. Other studies have indicated that factors such as the security of the travelling spot, gourmet food, and scenic views are crucial for tourism decisions (Cîrstea, 2014; Enright & Table 1 Total number of tourists from the major nations to Taiwan, 2001 Taiwan, -2017 Year The other four inbound nations are India, Thailand, the Philippines, and Vietnam. The purpose of this study is to employ an extended gravity model (EGM) to explore the relationship between the change in the number of inbound tourists and the corresponding tourism revenue from China and from visitors from 19 other major nations to Taiwan in 2001-2017 under China''s Open-door Policy to Taiwan.

title:
  The effect of China''s open-door tourism policy on Taiwan: Promoting or suppressing tourism from other countries to Taiwan?

abstract:
  This study employs an extended gravity model to analyse the complementarity or competitiveness relationship of the number of inbound tourists and corresponding tourism revenue between China and 19 other nations under the implementation of China's Open-door Tourism Policy to Taiwan in 2008. A simulation for 2018–2021 demonstrates the sustained impact of this policy. The results show that the number of tourists to Taiwan from China reached its peak in 2015 at 41% and will decrease to 9% by 2021. The corresponding tourism revenue will decrease from 49% to 11% over the same period. The results also show that if the number of tourists from China remains above 836,772, the number of tourists from Japan, Hong Kong, Australasia, North America, and Europe will still increase. However, the number of tourists from South Korea and South and Southeast Asia will increase continuously regardless of tourists from China, even far below 836,772.


id: cord-273291-75j2axjd
author: Chen, Ying-Chu
date: 2020-10-31
txt: ./txt/cord-273291-75j2axjd.txt
cache: ./cache/cord-273291-75j2axjd.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S2214714420302877
doi: 10.1016/j.jwpe.2020.101409
summary:
  title: System dynamics evaluation of household water use behavior and associated greenhouse gas emissions and environmental costs: A case study of Taipei city A system dynamic model was developed to investigate interactions between household water use behaviors (toilet flushing, clothes washing, bathing/showering, and cleaning) and associated greenhouse gas emissions and environmental costs. The environmental cost of GHG emissions associated with water use behavior was US$0.001/t, causing an 8% increase in water price. Taking Taipei city as a case study, the model captures more water use behaviors including toilet flushing, clothes washing, bathing/showering, and cleaning than previous studies. Taiwan''s Water Resources Agency [62] found that toilet flushing (27 %), clothes washing (21 %), and bathing/ showering (20 %) were the highest contributors to household water use (Fig. 4) . Taking Taipei city as a case study, the model captures different behaviors including toilet flushing, clothes washing, bathing/showering, and cleaning.

title:
  System dynamics evaluation of household water use behavior and associated greenhouse gas emissions and environmental costs: A case study of Taipei city

abstract:
  Abstract Taiwan is an island surrounded by sea and only 19 % of its freshwater usage is for domestic applications. A system dynamic model was developed to investigate interactions between household water use behaviors (toilet flushing, clothes washing, bathing/showering, and cleaning) and associated greenhouse gas emissions and environmental costs. Six hundred and fifty face-to-face interviews were conducted in 12 districts of Taipei. The results showed that the respondents’ individual attributes were not significantly related to water use behaviors. The highest volume of water was used for cleaning (27.7 %), followed by clothes washing (26.2 %), bathing/showering (26.1 %), and toilet flushing (20.0 %). Five water management scenarios with 5 %–20 % reductions in water volume from different water use behaviors were simulated. The maximum reduction in water use (6.27 t) was found in the fifth scenario (20 % reduction), which reflected the priority the respondents gave to save water if its price increased. 27.2 % of respondents had water saving appliances; 20.5 % and 16.4 % of the appliances were toilets and shower heads, respectively. The environmental cost of GHG emissions associated with water use behavior was US$0.001/t, causing an 8% increase in water price. A better understanding of household water use behaviors is needed to develop bottom-up strategies or measures for sustainable water management. Water saving measures or strategies would lead to targets being met in a short time.


id: cord-275510-fotolimq
title: Expeditious responses to COVID-19 crisis: from governmental management to laboratory approach
author: Sytwu, Huey-Kang
date: 2020-09-19
txt: ./txt/cord-275510-fotolimq.txt
cache: ./cache/cord-275510-fotolimq.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S2319417020301505?v=s5
doi: 10.1016/j.bj.2020.09.002
abstract: nan
summary:
  At the beginning of the COVID-19 outbreak, the National Health Command Center (NHCC) of Taiwan, unifying a central command system that is composed of the Central Epidemic Command Center (CECC), the Biological Pathogen Disaster Command Center, the Central Medical Emergency Operations Center and the Counter-Bioterrorism Command Center, rapidly established several critical and timely actions including border control from the air and sea in early January, big data-and technology-based identification of cases, systematic quarantine of suspected cases, proactive case finding, resource allocation, daily press conference and extensive public education, negotiation with other countries and regions, formulation of policies for schools, childcare and nursing homes, and relief to businesses [1] . Facing the tremendous threat of emerging and re-emerging infectious diseases, governments all around the world should be well aware that more investments in public health, climate change countermeasures, a global health surveillance system, an effective research into identifying pathogens, subsequent treatment, vaccine development and effective health delivery systems are needed.


id: cord-276197-gmx1p71j
author: Shen, Gwan-Han
date: 2012-03-31
txt: ./txt/cord-276197-gmx1p71j.txt
cache: ./cache/cord-276197-gmx1p71j.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0924857912000039
doi: 10.1016/j.ijantimicag.2011.11.014
summary:
  Abstract The role of fluoroquinolones (FQs) as empirical therapy for community-acquired pneumonia (CAP) remains controversial in countries with high tuberculosis (TB) endemicity owing to the possibility of delayed TB diagnosis and treatment and the emergence of FQ resistance in Mycobacterium tuberculosis. The role of fluoroquinolones (FQs) as empirical therapy for community-acquired pneumonia (CAP) remains controversial in countries with high tuberculosis (TB) endemicity owing to the possibility of delayed TB diagnosis and treatment and the emergence of FQ resistance in Mycobacterium tuberculosis. RFQs have been shown to have excellent activity against key causative pathogens of CAP as well as atypical pathogens; however, use of RFQs for empirical treatment of CAP might mask the diagnosis of tuberculosis (TB), leading to delayed treatment and FQ resistance amongst subsequently isolated Mycobacterium tuberculosis strains. In addition, we review the controversies surrounding the empirical use of FQs to treat patients with CAP, treatment options for patients with a delayed TB diagnosis, and the emergence of FQ resistance amongst M.

title:
  Does empirical treatment of community-acquired pneumonia with fluoroquinolones delay tuberculosis treatment and result in fluoroquinolone resistance in Mycobacterium tuberculosis? Controversies and solutions

abstract:
  Abstract The role of fluoroquinolones (FQs) as empirical therapy for community-acquired pneumonia (CAP) remains controversial in countries with high tuberculosis (TB) endemicity owing to the possibility of delayed TB diagnosis and treatment and the emergence of FQ resistance in Mycobacterium tuberculosis. Although the rates of macrolide-resistant Streptococcus pneumoniae and amoxicillin/clavulanic acid-resistant Haemophilus influenzae have risen to alarming levels, the rates of respiratory FQ (RFQ) resistance amongst these isolates remain relatively low. It is reported that ca. 1–7% of CAP cases are re-diagnosed as pulmonary TB in Asian countries. A longer duration (≥7 days) of symptoms, a history of night sweats, lack of fever (>38°C), infection involving the upper lobe, presence of cavitary infiltrates, opacity in the lower lung without the presence of air, low total white blood cell count and the presence of lymphopenia are predictive of pulmonary TB. Amongst patients with CAP who reside in TB-endemic countries who are suspected of having TB, imaging studies as well as aggressive microbiological investigations need to be performed early on. Previous exposure to a FQ for >10 days in patients with TB is associated with the emergence of FQ-resistant M. tuberculosis isolates. However, rates of M. tuberculosis isolates with FQ resistance are significantly higher amongst multidrug-resistant M. tuberculosis isolates than amongst susceptible isolates. Consequently, in Taiwan and also in other countries with TB endemicity, a short-course (5-day) regimen of a RFQ is still recommended for empirical therapy for CAP patients if the patient is at low risk for TB.


id: cord-279754-95zawygq
title: Risk and Outbreak Communication: Lessons from Taiwan''s Experiences in the Post-SARS Era
author: Hsu, Yu-Chen
date: 2017-04-01
txt: ./txt/cord-279754-95zawygq.txt
cache: ./cache/cord-279754-95zawygq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/28418746/
doi: 10.1089/hs.2016.0111
summary:
  After the SARS outbreak, Taiwan''s Centers for Disease Control (Taiwan CDC) followed the WHO outbreak communication guidelines on trust, early announcements, transparency, informing the public, and planning, in order to reform its risk communication systems. After the SARS outbreak, Taiwan''s Centers for Disease Control (CDC) followed the WHO outbreak communication guidelines-on trust, announcing early, transparency, informing the public, and planning-to reform its risk communication systems. In order to analyze the efficiency of risk communication on influenza vaccination, Taiwan CDC has monitored the toll-free hotline to identify topics that are of most concern to the public (eg, who are the target population, where to get the shot, adverse event reporting). The government of Taiwan has demonstrated considerable improvement in its risk communication practices during public health emergencies since the SARS outbreak in 2003.

abstract:
  In addition to the impact of a disease itself, public reaction could be considered another outbreak to be controlled during an epidemic. Taiwan's experience with SARS in 2003 highlighted the critical role played by the media during crisis communication. After the SARS outbreak, Taiwan's Centers for Disease Control (Taiwan CDC) followed the WHO outbreak communication guidelines on trust, early announcements, transparency, informing the public, and planning, in order to reform its risk communication systems. This article describes the risk communication framework in Taiwan, which has been used to respond to the 2009-2016 influenza epidemics, Ebola in West Africa (2014-16), and MERS-CoV in South Korea (2015) during the post-SARS era. Many communication strategies, ranging from traditional media to social and new media, have been implemented to improve transparency in public communication and promote civic engagement. Taiwan CDC will continue to maintain the strengths of its risk communication systems and resolve challenges as they emerge through active evaluation and monitoring of public opinion to advance Taiwan's capacity in outbreak communication and control. Moreover, Taiwan CDC will continue to implement the IHR (2005) and to promote a global community working together to fight shared risks and to reach the goal of “One World, One Health.”


id: cord-280403-fcdmbo4c
author: Chang, Yuhsuan
date: 2020-11-07
txt: ./txt/cord-280403-fcdmbo4c.txt
cache: ./cache/cord-280403-fcdmbo4c.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0191886920306991?v=s5
doi: 10.1016/j.paid.2020.110508
summary:
  This study examines the relationship between proactive coping, future time orientation, and perceived work productivity during the coronavirus (COVID-19) pandemic, based on the work-from-home experience of employees in Taiwan and the United States (U.S.). The results show that in the relationship between proactive coping and perceived work productivity, future time orientation acts as a full mediator in Taiwan and a partial mediator in the U.S. The study extends the application of the COR theory to the context of the COVID-19 pandemic and offers important insights that will enable professionals to assess the role of proactive coping and future time orientation in their productivity evaluations of working tasks and to design appropriate training sessions. This study investigates the relationship between proactive coping, future time orientation, and perceived work productivity, based on the work-from-home experiences of two samples of employees during the COVID-19 pandemic.

title:
  Telecommuting during the coronavirus pandemic: Future time orientation as a mediator between proactive coping and perceived work productivity in two cultural samples

abstract:
  This study examines the relationship between proactive coping, future time orientation, and perceived work productivity during the coronavirus (COVID-19) pandemic, based on the work-from-home experience of employees in Taiwan and the United States (U.S.). It draws on the conservation of resources (COR) theory, which posits that proactive coping and future time orientation are crucial personal resources that affect the capacity of an individual to adapt to stressful situations. The results show that in the relationship between proactive coping and perceived work productivity, future time orientation acts as a full mediator in Taiwan and a partial mediator in the U.S. The study extends the application of the COR theory to the context of the COVID-19 pandemic and offers important insights that will enable professionals to assess the role of proactive coping and future time orientation in their productivity evaluations of working tasks and to design appropriate training sessions.


id: cord-285804-lyj9tua8
title: Stockpile Model of Personal Protective Equipment in Taiwan
author: Chen, Yu-Ju
date: 2017-04-01
txt: ./txt/cord-285804-lyj9tua8.txt
cache: ./cache/cord-285804-lyj9tua8.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/28418743/
doi: 10.1089/hs.2016.0103
summary:
  In addition, a joint electronic procurement platform has been established for merchandising the replaced PPE to local health authorities and medical and other institutions for their routine or epidemic use. Based on the act, the central government, local health authorities, and medical institutions are required to maintain a minimum stockpile of PPE (including surgical masks, N95 respirators, and coveralls) to ensure a sufficient supply for epidemic prevention and frontline healthcare personnel during the early phase of an epidemic. After the SARS epidemic, the Taiwan CDC proposed ''''A Strategy Plan for PPE Minimum Stockpile'''' and established the 3-tier stockpiling framework-a central health authority (managed by the Taiwan CDC), local health authorities, and medical institutions-to effectively respond to emergent demands and spread the risk of stockpiling. In addition, to ensure the surge capacity during epidemic periods, the contractors must guarantee to provide 5 million surgical masks, 100,000 N95 respirators, and 15,000 coveralls within 14 days in response to an emergency request from the Taiwan CDC.

abstract:
  The Taiwan Centers for Disease Control (Taiwan CDC) has established a 3-tier personal protective equipment (PPE) stockpiling framework that could maintain a minimum stockpile for the surge demand of PPE in the early stage of a pandemic. However, PPE stockpiling efforts must contend with increasing storage fees and expiration problems. In 2011, the Taiwan CDC initiated a stockpile replacement model in order to optimize the PPE stockpiling efficiency, ensure a minimum stockpile, use the government's limited funds more effectively, and achieve the goal of sustainable management. This stockpile replacement model employs a first-in-first-out principle in which the oldest stock in the central government stockpile is regularly replaced and replenished with the same amount of new and qualified products, ensuring the availability and maintenance of the minimum stockpiles. In addition, a joint electronic procurement platform has been established for merchandising the replaced PPE to local health authorities and medical and other institutions for their routine or epidemic use. In this article, we describe the PPE stockpile model in Taiwan, including the 3-tier stockpiling framework, the operational model, the components of the replacement system, implementation outcomes, epidemic supports, and the challenges and prospects of this model.


id: cord-286014-cc99e24x
author: Jang, T.-N
date: 2003-11-05
txt: ./txt/cord-286014-cc99e24x.txt
cache: ./cache/cord-286014-cc99e24x.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0163445303001804
doi: 10.1016/j.jinf.2003.09.004
summary:
  To describe the clinical characteristics and outcomes of patients with severe acute respiratory syndrome (SARS). The first probable SARS patient in Taiwan returned from China via Hong Kong early in the global outbreak in February 2003. 7 We analyse the clinical, laboratory, and radiological features of patients with probable SARS who were seen at the Shin Kong Wu Ho-Su Memorial Hospital (SKMH) in Taipei, Taiwan. 16 In our study, SARS-associated coronavirus RNA was detected in oropharyngeal swabs by RT-PCR in 16 (55.1%) of 29 patients at initial presentation. Case definitions for surveillance of severe acute respiratory syndrome (SARS) A cluster of cases of severe acute respiratory syndrome in Hong Kong Severe acute respiratory syndrome in Singapore: clinical features of index patient and initial contacts Description and clinical treatment of an early outbreak of severe acute respiratory syndrome (SARS) in Guangzhou, PR China

title:
  Severe acute respiratory syndrome in Taiwan: analysis of epidemiological characteristics in 29 cases

abstract:
  Objectives. To describe the clinical characteristics and outcomes of patients with severe acute respiratory syndrome (SARS). Methods. Between March 28 and June 30 '2003, 29 patients with probable SARS seen at Shin Kong Wu Ho-Su Memorial Hospital, Taipei, were analysed. Results. Presenting symptoms included fever (100%), cough (69.0%), chills or rigor (62.1%), and shortness of breath (41.4%). Mean days to defervescence were 6.8±2.9 days, but fever recurred in 15 patients (51.7%) at 10.9±3.4 days. Common laboratory features included lymphopenia (72.4%), thrombocytopenia (34.5%) and elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) (93.1, 62.1, 44.8%, respectively). All patients except one had initial abnormal chest radiographs and 20 (69.0%) had radiological worsening at 7.5±2.6 days. Nine patients (31.0%) subsequently required mechanical ventilation with four deaths (13.8%). Most patients with clinical deterioration responded to pulse corticosteroid therapy (14 out of 17) but six complicated with nosocomial infections. The risk factors associated with severe disease were presence of diarrhoea, high peak LDH and CRP, high AST and creatine kinase on admission and high peak values. Conclusions. Prudent corticosteroid use, vigilant microbiological surveillance and appropriate antibiotics coverage are the key to successful treatment.


id: cord-286274-1tb3uha2
title: The economy, tourism growth and corporate performance in the Taiwanese hotel industry
author: Chen, Ming-Hsiang
date: 2009-08-18
txt: ./txt/cord-286274-1tb3uha2.txt
cache: ./cache/cord-286274-1tb3uha2.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.tourman.2009.07.011
doi: 10.1016/j.tourman.2009.07.011
summary:
  The indicators of corporate performance under consideration are occupancy rate (OPR), return on assets (ROA), return on equity (ROE), stock return, and the overall financial performance measured by a comprehensive score (a combined measure of asset management, profitability, short-term solvency or liquidity and long-term solvency based on factor analysis). The effects of changes in the state of economy (real GDP growth rate, [Formula: see text]) and tourism growth (growth rate of total foreign tourist arrivals, [Formula: see text]) on the corporate performance of tourist hotels are then examined via panel regression tests. In consequence, this study enables us to evaluate the impact of economic condition and tourism expansion on the corporate performance of tourist hotels in terms of not only their sales revenue, profitability and stock performance but also the overall financial performance. The dummy variables of crisis events are incorporated into test regressions to control for their potential effects on interactions between the corporate performance of hotel firms and the two factors (economy and tourism growth).

abstract:
  This study investigates the impact of economy and tourism growth on the corporate performance of tourist hotels in Taiwan. The indicators of corporate performance under consideration are occupancy rate (OPR), return on assets (ROA), return on equity (ROE), stock return, and the overall financial performance measured by a comprehensive score (a combined measure of asset management, profitability, short-term solvency or liquidity and long-term solvency based on factor analysis). The effects of changes in the state of economy (real GDP growth rate, [Formula: see text]) and tourism growth (growth rate of total foreign tourist arrivals, [Formula: see text]) on the corporate performance of tourist hotels are then examined via panel regression tests. Test results show that both [Formula: see text] and [Formula: see text] are significant explanatory factors of OPR, but only [Formula: see text] can strongly explain ROA and ROE. However, neither [Formula: see text] nor [Formula: see text] have a significant influence on hotel stock performance. Further, the economic factor [Formula: see text] is slightly more crucial than the industry factor [Formula: see text] in describing the overall financial performance in the Taiwanese hotel industry. Empirical findings offer valuable information for government tourism policymakers and tourist hotel owners and managers.


id: cord-287739-58fth3xl
author: Huang, Yhu-Chering
date: 2011-08-12
txt: ./txt/cord-287739-58fth3xl.txt
cache: ./cache/cord-287739-58fth3xl.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/21857979/
doi: 10.1371/journal.pone.0023001
summary:
  CONCLUSION/SIGNIFICANCE: Through infection control measures, MRSA HAIs can be successfully controlled, even in areas with high levels of endemic MRSA infections such as our NICUs. Methicillin-resistant Staphylococcus aureus (MRSA) is among the most important pathogens of bacteremia in the intensive care units (ICU). To reduce and control healthcare-associated infections (HAIs) caused by MRSA, a ''''search and destroy'''' strategy, which first detects the patients with MRSA colonization and then decolonizes the MRSA with certain antimicrobial agents, was recently proposed and implemented in some hospitals of different countries, with inconsistent effects [12] [13] [14] [15] [16] . Methicillin-resistant Staphylococcus aureus colonization and its association with infection among infants hospitalized in neonatal intensive care units

title:
  Successful Control of Methicillin-Resistant Staphylococcus aureus in Endemic Neonatal Intensive Care Units—A 7-Year Campaign

abstract:
  BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is among the most important nosocomial pathogens in the intensive care unit (ICU) worldwide, including Taiwan. Since 1997, our neonatal ICUs (NICUs) had become endemic for MRSA. METHODOLOGY/PRINCIPAL FINDINGS: To control MRSA spread in our NICUs, we implemented a series of infection control measures stepwise, including reinforcement of hand hygiene since January 2000, augmentation of aseptic care over the insertion site of central venous catheter since July 2001, introduction of alcohol-based handrubs since April 2003, surveillance culture for MRSA and cohort care for the colonized patients between March 2003 and February 2004, and surveillance culture with subsequent decolonization of MRSA between August 2005 and July 2006. After implementation of these measures, MRSA healthcare-associated infection (HAI) density reduced by 92%, from 5.47 episodes per 1000 patient-days in 1999 to 0.45 episodes per 1000 patient-days in 2006; MRSA bloodstream infection reduced from 40 cases in 1999 to only one case in 2006. Compared to those obtained during the period of surveillance culture without decolonization, both rates of MRSA colonization (8.6% vs. 41%, p<0.001) and infection (1.1% vs. 12%, p<0.001) decreased significantly during the period of surveillance and decolonization. Molecular analysis of the clinical isolates during the study period showed that the endemic clone, which dominated between 1998 and 2005, almost disappeared in 2006, while the community clones increased significantly in 2006–2007. CONCLUSION/SIGNIFICANCE: Through infection control measures, MRSA HAIs can be successfully controlled, even in areas with high levels of endemic MRSA infections such as our NICUs.


id: cord-288510-v90jryi2
title: Why hotel rooms were not full during a hallmark sporting event: The 2009 World Games experience
author: Sun, Ya-Yen
date: 2012-10-09
txt: ./txt/cord-288510-v90jryi2.txt
cache: ./cache/cord-288510-v90jryi2.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0261517712001707
doi: 10.1016/j.tourman.2012.09.011
summary:
  However, in the case of the 2009 World Games, the first international hallmark sporting event in Taiwan, the volume of hotel occupancies and revenue fell short of expectations, despite 4 years of planning and an investment of US$218 million. The reminder of this paper is as follows: Section 2 presents background information regarding the 2009 World Games and the ex-post analysis of the accommodation sector during the event; Sections 3 and 4 discuss the process and the results of personal interviews with representatives of the local business sector and municipal governments, while Section 5 provides implications and then concludes with discussion. From the perspective of the accommodation sector in Kaohsiung City, an elevated room price was a normal business practice because local hotels all expected that the WG would generate an influx of domestic and international visitors who were willing to pay premium prices to be part of this event.

abstract:
  Hosting mega- and hallmark-events is perceived as an important vehicle for tourism development. However, in the case of the 2009 World Games, the first international hallmark sporting event in Taiwan, the volume of hotel occupancies and revenue fell short of expectations, despite 4 years of planning and an investment of US$218 million. This study set out to investigate this phenomenon by adopting semi-structured interviews to gather opinions from key stakeholders regarding their business operation and societal conditions. Factors contributing to the lower than expected revenue included inefficient collaboration among stakeholders, a substantial displacement effect to regional hotel competitors, and the unfriendly local atmosphere associated with the fear of H1N1, Typhoon Morakot, and controversial political events. To mitigate inefficiencies from stakeholder collaborations, the study results suggest greater equality in terms of responsibility, information distribution, and risk sharing is needed among the broader tourism industry, the event planning association, and the event supervising authority. In addition, business strategies should take into account Taiwan, an island destination, and current tourism characteristics to counter the displacement effects of loyal and potential customers.


id: cord-288983-a6s9di4g
title: How Taiwan, a non-WHO member, takes actions in response to COVID-19
author: Su, Sheng-Fang
date: 2020-06-17
txt: ./txt/cord-288983-a6s9di4g.txt
cache: ./cache/cord-288983-a6s9di4g.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32582442/
doi: 10.7189/jogh.10.010380
abstract: nan
summary:
  The success of Taiwan for anti-epidemic measures included: quick response and efficient management, central production and distribution of masks/medical supplies, quarantine/isolation regulations with tracking contacts technology, and coordination between government, medical workers, public health professionals, and the whole Taiwanese society. In addition to the existing measure of onboard quarantine inspection, including fever screening of arriving passengers, suspected cases screening through history of travelling, occupation, contact and cluster (TOCC) inquiring, and health assessments conducting, all health care facilities should reinforce reporting severe cases of pneumonia among people who arrive in Taiwan from Wuhan. In light of the ongoing outbreak, CECC has introduced guidelines for high-risk individuals regarding 1) self-health management (reported cases who have tested negative and met criteria for being released from isolation, or people under "COVID-19 Community-based Surveillance), 2) 14-day home quarantine (with travel history), and 3) 14-day home isolation (who had contact with confirmed cases), and provided quarantine sites with free meals and a US$30 compensation per day during the 14-day period.


id: cord-289378-ghmqd3yv
author: Wang, Peng-Wei
date: 2020-09-18
txt: ./txt/cord-289378-ghmqd3yv.txt
cache: ./cache/cord-289378-ghmqd3yv.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32962052/
doi: 10.3390/ijerph17186827
summary:
  We determined the subjective physical and psychological health states, cognitive and affective construct of health belief, perceived social support, mental health problems, adoption of protective behavior and demographic characteristics among 1954 respondents (1305 women and 649 men; mean age: 37.9 years with standard deviation 10.8 years). The association between the deterioration of physical and psychological health and adoption of protective behaviors against COVID-19 (avoiding crowded places, washing hands, and wearing a mask) and mental health problems (general anxiety, sleep problems, and suicidal ideation) was examined using multivariate logistic regression after controlling for the effects of gender, age, and educational level. Table 2 presents the results of the univariate logistic regression model examining the associations between demographic characteristics, cognitive and affective constructs of health beliefs related to COVID-19, perceived social support, and the subjective deterioration of physical and psychological health.

title:
  Subjective Deterioration of Physical and Psychological Health during the COVID-19 Pandemic in Taiwan: Their Association with the Adoption of Protective Behaviors and Mental Health Problems

abstract:
  This study aimed to determine the proportion of individuals who reported the deterioration of physical and psychological health during the coronavirus disease 2019 (COVID-19) pandemic in Taiwan. Moreover, the related factors of deterioration of physical and psychological health and the association between deterioration of health and adoption of protective behavior against COVID-19 and mental health problems were also examined. We recruited participants via a Facebook advertisement. We determined the subjective physical and psychological health states, cognitive and affective construct of health belief, perceived social support, mental health problems, adoption of protective behavior and demographic characteristics among 1954 respondents (1305 women and 649 men; mean age: 37.9 years with standard deviation 10.8 years). In total, 13.2% and 19.3% of respondents reported deteriorated physical and psychological health during the COVID-19 pandemic, respectively. Participants with higher perceived harm from COVID-19 compared with severe acute respiratory syndrome (SARS) were more likely to report the subjective deterioration of physical and psychological health, whereas respondents who were older and perceived a higher level of social support were less likely to report a deterioration of physical and psychological health. The subjective deterioration of psychological health was significantly associated with avoiding crowded places and wearing a mask. Both subjective deteriorations of physical and psychological health positively related to general anxiety.


id: cord-290119-2yao5a80
title: EMS in Taiwan: Past, present, and future()
author: Chiang, Wen-Chu
date: 2008-12-06
txt: ./txt/cord-290119-2yao5a80.txt
cache: ./cache/cord-290119-2yao5a80.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/19059690/
doi: 10.1016/j.resuscitation.2008.10.010
summary:
  The year 1995 marked the beginning of modern EMS in Taiwan when a lot of important concepts of EMS were put into legislation, The Emergency Medical Service Act. The law designated pre-hospital care as a function of fire administration at the central and local level. Over the last eight years, Taiwan''s EMS has undergone rapid development, including the implementation of off-line medical direction, establishment of national disaster response teams, and the introduction of automatic external defibrillators (AED) by EMTs. enabling the EMS to provide fire service based advanced life support (ALS). Physicians on the medical consulting committees (required by law) are responsible for the standards of patient care, including establishment of pre-hospital medical protocols and assistance in education of EMTs. However, a lack of specific tasking and full-time positions in the fire department for medical directors has resulted in the medical oversight remaining incomplete in terms of protocol revision, quality assurance, system design, and direct medical oversight.

abstract:
  Taiwan is a small island country located in East Asia. From around 1995 modern concepts of the EMS were imported and supported by legislation. Considerable progress has since been made towards the construction of an effective pre-hospital care system. This article introduces the current status of the EMS in Taiwan, including the systems, response configurations, funding, personnel, medical directorship, and outcome research. The features and problems of in-hospital emergency care are also discussed. Key areas for further development in the country vary depending on regional differences in available resource and population density. An analysis of the strength, weakness, opportunity, and threats of the evolving EMS in Taiwan could be an example for other countries where the EMS is undergoing a similar process of development and optimisation.


id: cord-290257-2u228xe9
author: Hsu, Chih-Cheng
date: 2006-05-05
txt: ./txt/cord-290257-2u228xe9.txt
cache: ./cache/cord-290257-2u228xe9.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655306000794
doi: 10.1016/j.ajic.2005.11.008
summary:
  title: Confidence in controlling a SARS outbreak: Experiences of public health nurses in managing home quarantine measures in Taiwan This paper assesses factors related to public health nurses'' confidence in managing community SARS control programs. The third section contained questions (using 10-point Likert scale: 1 5 the worst to 10 5 the best) about the effectiveness of the nurse''s institution in managing the SARS epidemic, including the nurse''s assessment of (1) the institutional functioning on community home quarantine, (2) the quality of training received for controlling infectious disease outbreaks, and (3) the adequacy of support (for both manpower and financing) received from superior health agencies force commander said the epidemic situation was stable and advised people to return to their routine. In summary, public health nurses'' confidence in the control of a SARS outbreak and people''s compliance with quarantine measures are 2 major factors that can affect the success of a SARS-control program.

title:
  Confidence in controlling a SARS outbreak: Experiences of public health nurses in managing home quarantine measures in Taiwan

abstract:
  BACKGROUND: Taiwan experienced one of the most serious outbreaks of severe acute respiratory syndrome (SARS) during the 2003 epidemic. Public health nurses faced unprecedented challenges in implementing an extensive quarantine policy to prevent disease spread. Their professional confidence, however, was shattered during the SARS crisis. This paper assesses factors related to public health nurses' confidence in managing community SARS control programs. METHODS: In May 2003, we sent structured questionnaires to all 361 health centers in Taiwan and asked the public health nurses responsible for epidemic control to complete. A total of 312 completed surveys were returned for a response rate of 86.4%. Descriptive methods and logistic regression were used to analyze the data. RESULTS: Most public health nurses (71.9%) expressed a general lack of confidence in handling the SARS epidemic. Confidence was significantly associated with perceived epidemic severity (OR, 0.58; 95% CI: 0.35-0.99), daily epidemic updates (OR, 2.26; 95% CI: 1.28-3.98), and number of cases in the community (OR, 2.21; 95% CI: 1.13-4.31). CONCLUSION: Nurses' individual risk perception and prompt update of epidemic information significantly affect levels of professional confidence, a key factor influencing quarantine implementation success. Strategies to promote productive interagency collaboration and advocate participatory policy making involving health workers at all levels are needed to control effectively infectious disease outbreaks.


id: cord-292337-74c69z28
title: Transporting Patient with Suspected SARS
author: Tsai, Shin-Han
date: 2004-07-17
txt: ./txt/cord-292337-74c69z28.txt
cache: ./cache/cord-292337-74c69z28.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/15338533/
doi: 10.3201/1007.030608
abstract: nan
summary:
  Because medical facilities are limited on these islands, the Department of Health authorized the National Aeromedical Consultation Center (NACC), a physician-based 24-hour control center that coordinates all aeromedical transport of critically ill or injured patients within Taiwan, to coordinate transporting these patients to designated SARS hospitals in Taipei. When leaving the pre-isolation room, the physician and the PIU were sprayed with a sodium hypochloride solution before the first layer of personal protective equipment was removed. Although one report by Christopher and Eitzen (2) suggested the value of an aeromedical team to evacuate patients with suspected lethal, infectious diseases, limited evidence supported a safer means of transportation that would possibly reduce transmission of SARS to persons taking part in the mission. Interim guidance: air medical transport for severe acute respiratory syndromes (SARS) patients


id: cord-292660-02oynmvt
title: Decline in invasive pneumococcus diseases while combating the COVID‐19 pandemic in Taiwan
author: Tsai, Jong‐Rung
date: 2020-05-26
txt: ./txt/cord-292660-02oynmvt.txt
cache: ./cache/cord-292660-02oynmvt.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/kjm2.12233
doi: 10.1002/kjm2.12233
abstract: nan
summary:
  authors: Tsai, Jong‐Rung; Yang, Chih‐Jen; Huang, Wei‐Ling; Chen, Yen‐Hsu title: Decline in invasive pneumococcus diseases while combating the COVID‐19 pandemic in Taiwan According to the Taiwan CDC, there has been a marked decline in invasive pneumococcus disease since February 2020 compared with cases in the past 5 years (Figure 1 ). "Invasive pneumococcal disease" is defined as an infection confirmed by the isolation of S pneumoniae from a normally sterile site, such as blood, cerebrospinal fluid, and pleural, joint, or peritoneal fluid. 5 Invasive pneumococcus is a notifiable disease, and it must be reported to the Taiwan CDC within 1 week. We believe that the reduction in invasive pneumococcus disease has been influenced by the current preventive strategies for COVID-19 in Taiwan. Chih-Jen Yang 2 Wei-Ling Huang 2 Effectiveness of masks and respirators against respiratory infections in healthcare workers: A systematic review and meta-analysis Rational use of face masks in the COVID-19 pandemic


id: cord-293268-6l1fyl93
title: Initial rapid and proactive response for the COVID-19 outbreak — Taiwan''s experience
author: Cheng, Hao-Yuan
date: 2020-03-25
txt: ./txt/cord-293268-6l1fyl93.txt
cache: ./cache/cord-293268-6l1fyl93.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0929664620300814
doi: 10.1016/j.jfma.2020.03.007
abstract: nan
summary:
  At the early stage of the outbreak, the strategy in Taiwan had three pillars: real-time surveillance with rapid risk assessment, border control and quarantine, and laboratory capacity building. 5 CECC then announced several policies in response to the worsening outbreak in China, including border control and home quarantine requirement for travelers from affected countries and areas; export ban of surgical masks and N95 respirators to secure the domestic use; strengthening the preparedness of Communicable Disease Control Medical Network for patient isolation and clinical management; and risk communication with the public through daily press and social media such as Line app and Facebook. 6 After China released the whole genome sequence of SARS-CoV-2 on January 10, Taiwan CDC''s national reference laboratory immediately set up the real-time reverse transcription-polymerase chain reaction (RT-PCR) test for the virus. CECC already charted the next steps in COVIDFigure 1 The number of confirmed COVID-19 cases in Taiwan by reporting date, January 15eFebruary 29 and the implementation of disease control measures.


id: cord-293403-o1i999hy
title: E-health in the East Asian tigers
author: Holliday, Ian
date: 2004-09-11
url: https://api.elsevier.com/content/article/pii/S1386505604001807
doi: 10.1016/j.ijmedinf.2004.08.001
abstract:
  OBJECTIVE: The article analyzes e-health progress in East Asia's leading tiger economies: Japan, Hong Kong, Singapore, South Korea and Taiwan. It describes five main dimensions of e-health provision in the tigers: policymaking, regulation, provision, funding and physician-patient relations. METHODS: We conducted a series of fieldwork interviews and analyzed key healthcare websites. RESULTS AND CONCLUSION: Our main finding is that the development of e-health in the region is less advanced than might be expected. Our explanation focuses on institutional, cultural and financial factors.


id: cord-293430-h4r0jpy5
title: Unexplained Deaths and Critical Illnesses of Suspected Infectious Cause, Taiwan, 2000–2005
author: Wang, Tsung-Hsi
date: 2008-10-17
txt: ./txt/cord-293430-h4r0jpy5.txt
cache: ./cache/cord-293430-h4r0jpy5.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3201/eid1410.061587
doi: 10.3201/eid1410.061587
summary:
  We report 5 years'' surveillance data from the Taiwan Centers for Disease Control on unexplained deaths and critical illnesses suspected of being caused by infection. In 2000, the Taiwan Centers for Disease Control collaborated with academic institutions, medical examiners, local health authorities, and experts from different fi elds to establish a nationwide surveillance center for outbreak and unexplained death investigation due to unknown infectious causes (COUNEX) (Figure) . Local health authorities, hospitals, or clinics report suspected infection-related cases through the "notifiable infectious disease surveillance system," "syndromic surveillance system," and toll-free notification hotline Figure. *If unexplained infectious causes were suspected, COUNEX mobilized an investigation team including experts, fi eld epidemiology training program members, public health workers from the local branch of Taiwan Centers for Disease Control (TCDC), and public health authorities to proceed with further fi eld investigation.

abstract:
  We report 5 years’ surveillance data from the Taiwan Centers for Disease Control on unexplained deaths and critical illnesses suspected of being caused by infection. A total of 130 cases were reported; the incidence rate was 0.12 per 100,000 person-years; and infectious causes were identified for 81 cases (62%).


id: cord-294452-432t0q7w
title: The impact of global budgeting in Taiwan on inpatients with unexplained fever
author: Liu, Keh-Sen
date: 2019-09-13
txt: ./txt/cord-294452-432t0q7w.txt
cache: ./cache/cord-294452-432t0q7w.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1097/md.0000000000017131
doi: 10.1097/md.0000000000017131
summary:
  This study evaluated the differences in health service utilization, health care expenditures, and quality of care provided to patients with unexplained fever before and after global budget (GB) implementation in Taiwan. [27] [28] [29] [30] [31] Here, we evaluated the differences in health service utilization, health care expenditures, and quality of care among patients with unexplained fever before and after GB system implementation by using NHI Research Database (NHIRD) data. The independent variables evaluated in this study included pre-post GB, age, gender, income state index, Charlson comorbidity index, the three hospital levels, and the six geographic areas in Taiwan. There were significant differences in LOS, diagnostic costs, therapy costs, total costs, 3-day ED revisiting rate, and 14-day readmission rate before and after implementation of the GB system among patients with www.md-journal.com unexplained fever (P = .03, P = .001, P < .001, P = .01, P = .02, P = .04, respectively).

abstract:
  Unexplained fever is one of the most common and difficult diagnostic problems faced daily by clinicians. This study evaluated the differences in health service utilization, health care expenditures, and quality of care provided to patients with unexplained fever before and after global budget (GB) implementation in Taiwan. The National Health Insurance Research Database was used for analyzing the health care expenditures and quality of care before and after implementation of the GB system. Patients diagnosed as having unexplained fever during 2000–2001 were recruited; their 2000–2001 and 2004–2005 data were considered baseline and postintervention data, respectively. Data of 259 patients with unexplained fever were analyzed. The mean lengths of stay (LOSs) before and after GB system implementation were 4.22 ± 0.35 days and 5.29 ± 0.70 days, respectively. The mean costs of different health care expenditures before and after implementation of the GB system were as follows: the mean diagnostic, drug, therapy, and total costs increased respectively from New Taiwan Dollar (NT$) 1440.05 ± NT$97.43, NT$3249.90 ± NT$1108.27, NT$421.03 ± NT$100.03, and NT$13,866.77 ± NT$2,114.95 before GB system implementation to NT$2224.34 ± NT$238.36, NT$4272.31 ± NT$1466.90, NT$2217.03 ± NT$672.20, and NT$22,856.41 ± NT$4,196.28 after implementation. The mean rates of revisiting the emergency department within 3 days and readmission within 14 days increased respectively from 10.5% ± 2.7% and 8.3% ± 2.4% before implementation to 6.3% ± 2.2% and 4.0% ± 1.7% after implementation. GB significantly increased LOS and incremental total costs for patients with unexplained fever; but improved the quality of care.


id: cord-296752-jvhgrsbm
author: Phan, Huy P.
date: 2020-10-08
url: https://doi.org/10.3389/fpsyg.2020.580186
doi: 10.3389/fpsyg.2020.580186
title:
  Introducing the Study of Life and Death Education to Support the Importance of Positive Psychology: An Integrated Model of Philosophical Beliefs, Religious Faith, and Spirituality

abstract:
  Life education, also known as life and death education, is an important subject in Taiwan with institutions (e.g., high school) offering degree programs and courses that focus on quality learning and implementation of life education. What is interesting from the perspective of Taiwanese education is that the teaching of life education also incorporates a number of Eastern-derived and conceptualized tenets, for example, Buddhist teaching and the importance of spiritual wisdom. This premise contends then that life education in Taiwan, in general, is concerned with the promotion, fulfillment, and cherishing of quality life experiences (e.g., personal contentment, happiness). One example of life education, which resonates with other spiritual beliefs and religious faiths (e.g., Hinduism), is related to spiritual cultivation and the enlightenment of life wisdom. Our own teaching of the subject, likewise, places emphasis on the goal of teaching students to seek meaningful understanding of and appreciation for three major, interrelated components of life education: life wisdom, life practice, and life care. It has been acknowledged, to a certain degree, that life education has made meaningful contributions, such as the creation and facilitation of a civil, vibrant society, and that many Taiwanese individuals show dignity, respect for elders, and reverence for spiritual and religious faiths. For example, aside from high-quality hospice care, many Taiwanese engage in different types of benevolent acts (e.g., providing spiritual advice to someone who is dying), where possible. Life education is a beneficial subject for teaching and learning as its theoretical understanding may help individuals cope with pathologies and negative conditions and life experiences. One negative life experience, in this case, is the ultimate fate of humankind: death. Approaching death and/or the onset of grief is something that we all have to experience. How does one approach death? It is not easy feat, and of course, grief for a loved one is personal, and some of us struggle with this. We contend that spiritual cultivation and enlightenment, arising from life education, may assist us with the topic of death (e.g., the possibility of transcendence beyond the realm of life). More importantly however, from our own teaching experiences and research development, we strongly believe and rationalize that the subject of life education could, indeed, coincide with and support the paradigm of positive psychology (Seligman, 1999, 2010; Seligman and Csíkszentmihályi, 2000). Forming the premise of the present conceptual analysis article, we propose that a person’s “spiritual and enlightened self,” reflecting the convergence of three major aspects of life education (i.e., philosophical reflection, enrichment of personal well-being, and spiritual cultivation), would result in the initiation and creation of a number of virtues and positive characteristics, for example, having a positive outlook in life, having a perceived sense of spirituality, showing compassion, forgiveness, etc. These virtues and quality characteristics, from our philosophical reasoning, are equivalent to those qualities that the paradigm of positive psychology advocates for. In summary, we conceptualize that the subject of life education, from the perspective of Taiwanese education, may intertwine with the paradigm of positive psychology. A person’s spiritual and enlightened self, or his/her “holistic self,” from our rationalization, is the ultimate optimal life experience that he/she may have, enabling him/her to address the gamut of life conditions and experiences. The distinctive nature of life education in this case, as a point of summary, is that it incorporates spiritual beliefs and religious faiths (e.g., Buddhist faith), encouraging a person to seek nature and divine–human relationships, as well as to contemplate and to explore the complex nature of his/her inner self. The notion of Buddhist samsâra, for example, as “evidence” of spirituality, entailing the endless cycle of birth, rebirth, and redeath, may provide a person with hope into the afterlife. Such esoteric discourse, we contend, is positive and optimistic, allowing individuals to discard the dividing line between life and death.


id: cord-300815-1vy787md
title: Travel-related infections in mainland China, 2014–16: an active surveillance study
author: Fang, Li-Qun
date: 2018-07-20
txt: ./txt/cord-300815-1vy787md.txt
cache: ./cache/cord-300815-1vy787md.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S2468266718301270
doi: 10.1016/s2468-2667(18)30127-0
summary:
  We integrated the data from all entry-exit ports in mainland China to characterise travel-related infections, define the demographic features of imported cases, identify risk groups and exposure countries or regions, and assess the effectiveness of surveillance for further improvement. However, hepatitis B and C virus infections, syphilis, HIV, malaria, and dengue were substantially more common in the international group, whereas respiratory infections with rhinovirus, para influenza virus and metapneumovirus, and hand, foot, and mouth disease were more common in travellers from Hong Kong, Macau, and Taiwan ( figure 3) . Our findings, which are based on surveillance data for 45 infections among 22 797 travellers who arrived at the 272 entry-exit ports to the mainland, are helpful for increasing public health awareness about the potential risk of imported infections.

abstract:
  BACKGROUND: Transmission of infection through international travel is a growing health issue, and the frequency of imported infection is increasing in China. We aimed to quantify the total number of infections imported into mainland China by arriving travellers. METHODS: We actively surveyed arriving travellers at all 272 international entry–exit ports in mainland China. Suspected cases were detected through fever screening, medical inspection, self-declaration, and reporting by on-board staff. Participants completed a standardised questionnaire with questions about demographics, their travel itinerary (including detailed information about all countries or regions visited), and clinical manifestations. Nasopharyngeal swabs, sputum samples, faecal samples, vomitus, blood, and serum were collected as appropriate for diagnoses. Diagnosis was made by specific laboratory tests according to the national technical guidelines. Infections were classified as respiratory, gastrointestinal, vector-borne, blood-transmitted and sex-transmitted, or mucocutaneous. We divided arriving travellers into two groups: travellers coming from countries other than China, and travellers coming from Hong Kong, Macau, and Taiwan. We integrated surveillance data for 2014–16, calculated incidences of travel-related infections, and compared the frequency of infections among subgroups. FINDINGS: Between Jan 1, 2014, and Dec 31, 2016, 22 797 cases were identified among 805 993 392 arriving travellers—an overall incidence of 28·3 per million. 45 pathogens were detected in participants: 18 respiratory (19 662 cases), ten gastrointestinal (189 cases), seven vector-borne (831 cases), seven blood-transmitted and sex-transmitted (1531 cases), and three mucocutaneous (584 cases). Both the overall number and incidence of infection were more than five times higher in 2016 than in 2014. Case numbers and incidences also varied substantially by province, autonomous region, and municipality. Overall, 17 643 (77%) infections were detected by fever screening, but 753 (49%) blood-transmitted and sex-transmitted infections were identified through medical inspection. 14 305 (73%) cases of respiratory infection and 96 (51%) of gastrointestinal infections were in tourists. Tuberculosis, hepatitis A virus, vector-borne, and blood-transmitted and sex-transmitted infections were common among Chinese labourers who worked abroad. Dengue and malaria were most commonly diagnosed in travellers arriving from Africa. 12 126 (93%) of the 12 985 cases arriving from Hong Kong, Macau, or Taiwan were respiratory infections. Hand, foot, and mouth disease accounted for 2·90% of infections in travellers from Hong Kong, Macau, or Taiwan and 0·31% of infections in international travellers. INTERPRETATION: This report is the first to characterise the profile of travel-related infections among arriving travellers in mainland China. Our findings should increase public awareness of the potential risk of imported infections, and help health-care providers to make evidence-based health recommendations to travellers. FUNDING: The Natural Science Foundation of China.


id: cord-303528-4myoqms8
title: Cross–strait interactions on the South China Sea issues: a need for CBMs
author: Song, Yann-Huei
date: 2005-05-31
txt: ./txt/cord-303528-4myoqms8.txt
cache: ./cache/cord-303528-4myoqms8.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0308597X04000375
doi: 10.1016/j.marpol.2004.05.001
summary:
  Abstract Recent developments in the South China Sea (SCS) and the actions expected to be taken by China and member states of ASEAN in accordance with the Declaration on the Conduct of Parties in the SCS have the potential to further marginalize Taiwan''s role in any serious discussion on SCS issues and then deprive Taiwan of its legitimate rights and interest in the area. Recent developments in the SCS and the actions expected to be taken by China and member states of ASEAN in accordance with the Declaration on the Conduct of Parties in the South China Sea (SCSCOP Declaration) 3 have the potential to further marginalize Taiwan''s role in any serious discussion on SCS issues and then deprive of Taiwan''s legitimate rights and interest in the area. China is holding the key to Taiwan''s involvement in the regional security dialogue process on the SCS issues and its participation in any of the proposed co-operative activities in the Spratly area between China and the ASEAN based on the guidelines underlined in the SCSCOP Declaration.

abstract:
  Abstract Recent developments in the South China Sea (SCS) and the actions expected to be taken by China and member states of ASEAN in accordance with the Declaration on the Conduct of Parties in the SCS have the potential to further marginalize Taiwan's role in any serious discussion on SCS issues and then deprive Taiwan of its legitimate rights and interest in the area. These developments will also force Taiwan to respond by taking more active actions for the sole purpose of safeguarding its sovereignty and maritime jurisdiction in the SCS. This article discusses a number of possible confidence-building measures that could be considered for adoption by China to help engage Taiwan in the regional security dialogue process and enable Taiwan to participate in the planned joint co-operative activities in the SCS. The co-operative actions taken in the SCS area could enhance mutual trust between the two sides of the Taiwan Strait.


id: cord-306259-vi997dms
author: Hanvoravongchai, Piya
date: 2010-06-08
url: https://www.ncbi.nlm.nih.gov/pubmed/20529345/
doi: 10.1186/1471-2458-10-322
title:
  Pandemic influenza preparedness and health systems challenges in Asia: results from rapid analyses in 6 Asian countries

abstract:
  BACKGROUND: Since 2003, Asia-Pacific, particularly Southeast Asia, has received substantial attention because of the anticipation that it could be the epicentre of the next pandemic. There has been active investment but earlier review of pandemic preparedness plans in the region reveals that the translation of these strategic plans into operational plans is still lacking in some countries particularly those with low resources. The objective of this study is to understand the pandemic preparedness programmes, the health systems context, and challenges and constraints specific to the six Asian countries namely Cambodia, Indonesia, Lao PDR, Taiwan, Thailand, and Viet Nam in the prepandemic phase before the start of H1N1/2009. METHODS: The study relied on the Systemic Rapid Assessment (SYSRA) toolkit, which evaluates priority disease programmes by taking into account the programmes, the general health system, and the wider socio-cultural and political context. The components under review were: external context; stewardship and organisational arrangements; financing, resource generation and allocation; healthcare provision; and information systems. Qualitative and quantitative data were collected in the second half of 2008 based on a review of published data and interviews with key informants, exploring past and current patterns of health programme and pandemic response. RESULTS: The study shows that health systems in the six countries varied in regard to the epidemiological context, health care financing, and health service provision patterns. For pandemic preparation, all six countries have developed national governance on pandemic preparedness as well as national pandemic influenza preparedness plans and Avian and Human Influenza (AHI) response plans. However, the governance arrangements and the nature of the plans differed. In the five developing countries, the focus was on surveillance and rapid containment of poultry related transmission while preparation for later pandemic stages was limited. The interfaces and linkages between health system contexts and pandemic preparedness programmes in these countries were explored. CONCLUSION: Health system context influences how the six countries have been preparing themselves for a pandemic. At the same time, investment in pandemic preparation in the six Asian countries has contributed to improvement in health system surveillance, laboratory capacity, monitoring and evaluation and public communications. A number of suggestions for improvement were presented to strengthen the pandemic preparation and mitigation as well as to overcome some of the underlying health system constraints.


id: cord-308353-7ctp8bem
title: A multicenter surveillance of antimicrobial resistance in Serratia marcescens in Taiwan
author: Liou, Bo-Huang
date: 2013-06-14
txt: ./txt/cord-308353-7ctp8bem.txt
cache: ./cache/cord-308353-7ctp8bem.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1684118213000728
doi: 10.1016/j.jmii.2013.04.003
summary:
  BACKGROUND: Serratia marcescens is an important nosocomial pathogen and the characteristic property of resistance conferred by extended-spectrum beta-lactamase or a novel AmpC cephalosporinase was not unusual in Taiwan. marcescens isolates were collected biennially between 2002 and 2010 from medical centers and regional hospitals throughout Taiwan, as part of the Taiwan Surveillance of Antimicrobial Resistance program. Overall, 99.3% isolates were susceptible to imipenem, 93.8% to ceftazidime, 89.2% to minocycline, 87.8% to amikacin, 86.8% to cefepime, 82.9% to aztreonam, 73.2% to ceftriaxone, 72.7% to levofloxacin, 63.8% to ciprofloxacin, 60.8% to trimethoprim/sulfamethoxazole (TMP/SMX), and 59.6% to gentamicin. S. marcescens isolates demonstrated relatively higher resistance to ciprofloxacin and levofloxacin, and therefore continued surveillance of antimicrobial resistance, especially for fluoroquinolone, is warranted. marcescens isolates were collected biennially between 2002 and 2010, corresponding to periods IIIeVII of the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program, from medical centers and regional hospitals throughout Taiwan.

abstract:
  BACKGROUND: Serratia marcescens is an important nosocomial pathogen and the characteristic property of resistance conferred by extended-spectrum beta-lactamase or a novel AmpC cephalosporinase was not unusual in Taiwan. This study investigated the trends in antimicrobial resistance in S. marcescens from a nationwide surveillance in Taiwan. MATERIALS AND METHODS: S. marcescens isolates were collected biennially between 2002 and 2010 from medical centers and regional hospitals throughout Taiwan, as part of the Taiwan Surveillance of Antimicrobial Resistance program. Minimal inhibitory concentrations were determined by the Clinical and Laboratory Standards Institute reference broth microdilution method. RESULTS: A total of 403 nonduplicate S. marcescens isolates were collected, mostly from respiratory samples (157, 39.0%), followed by the urinary tract samples (90, 22.3%). Overall, 99.3% isolates were susceptible to imipenem, 93.8% to ceftazidime, 89.2% to minocycline, 87.8% to amikacin, 86.8% to cefepime, 82.9% to aztreonam, 73.2% to ceftriaxone, 72.7% to levofloxacin, 63.8% to ciprofloxacin, 60.8% to trimethoprim/sulfamethoxazole (TMP/SMX), and 59.6% to gentamicin. A significantly increased susceptibility rate after 2004 was observed for the following antibiotics: amikacin (73.8% vs. 97.1%), gentamicin (40.0% vs. 72.4%), ciprofloxacin (53.8% vs. 70.4%), ceftriaxone (53.8% vs. 86.0%), cefepime (74.4% vs. 95.1%), aztreonam (72.5% vs. 89.7%), and TMP/SMX (41.3% vs. 73.7%). CONCLUSION: In this 8-year study, the susceptibility of S. marcescens to ceftazidime and imipenem remained consistently high in Taiwan. S. marcescens isolates demonstrated relatively higher resistance to ciprofloxacin and levofloxacin, and therefore continued surveillance of antimicrobial resistance, especially for fluoroquinolone, is warranted.


id: cord-309133-0jh84w6f
title: Rapid establishment of a COVID-19 biobank in NHRI by National Biobank Consortium of Taiwan
author: Huang, Shiu-Feng
date: 2020-05-29
url: https://api.elsevier.com/content/article/pii/S2319417020300809
doi: 10.1016/j.bj.2020.05.018
abstract:
  By the request of the Minister of Health and Welfare, NHRI Biobank was assigned to establish a COVID-19 biobank in early Feb, 2020 to collect COVID-19 patients' blood samples for Taiwan researchers and industries in an emergent way. It was set up in less than 3 weeks and quickly opened for application. This biobank can provide applicants with biosamples, such as serum, DNA and RNA, and also the clinical and genomic data, so as to accelerate the COVID-19 treatment and prevention research in Taiwan. This COID-19 biobank already received 7 applications. It has become a very important research resource for the COVID-19 pandemic in Taiwan, including disease mechanism, the variable human responses and epidemic preventions.


id: cord-310438-744r7gc3
author: Chan, Ta-Chien
date: 2010-06-25
txt: ./txt/cord-310438-744r7gc3.txt
cache: ./cache/cord-310438-744r7gc3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/20592764/
doi: 10.1371/journal.pone.0011317
summary:
  This study evaluated the effect of matching/mismatching vaccine strains, type/subtype pattern changes in Taiwan''s influenza viruses, and the impact of post-SARS (severe acute respiratory syndrome) public health efforts on excess influenza-associated mortalities among the elderly. The aims of this study were: (1) to evaluate the effectiveness of matching or mismatching influenza vaccine strains on influenzaassociated mortality, (2) to assess whether public health improvements during the post-SARS period might have decreased elderly mortality, and (3) to investigate molecular variation among vaccine-mismatched influenza viruses that may be associated with increased excess influenza-associated mortality. Explanatory variables for the above three outcome measures include monthly meteorological parameters (monthly means of temperature and humidity), annual periodic cycle (i.e., sine/cosine function of seasonal periodicity), monthly virus isolation rates for different subtypes/types of influenza viruses [A (H3N2) or A (H1N1) or B], matching status of different vaccine strains for each subtype/type in each of the studied years, post-SARS effect, and linear temporal monthly trends.

title:
  The Impact of Matching Vaccine Strains and Post-SARS Public Health Efforts on Reducing Influenza-Associated Mortality among the Elderly

abstract:
  Public health administrators do not have effective models to predict excess influenza-associated mortality and monitor viral changes associated with it. This study evaluated the effect of matching/mismatching vaccine strains, type/subtype pattern changes in Taiwan's influenza viruses, and the impact of post-SARS (severe acute respiratory syndrome) public health efforts on excess influenza-associated mortalities among the elderly. A negative binomial model was developed to estimate Taiwan's monthly influenza-associated mortality among the elderly. We calculated three winter and annual excess influenza-associated mortalities [pneumonia and influenza (P&I), respiratory and circulatory, and all-cause] from the 1999–2000 through the 2006–2007 influenza seasons. Obtaining influenza virus sequences from the months/years in which death from P&I was excessive, we investigated molecular variation in vaccine-mismatched influenza viruses by comparing hemagglutinin 1 (HA1) of the circulating and vaccine strains. We found that the higher the isolation rate of A (H3N2) and vaccine-mismatched influenza viruses, the greater the monthly P&I mortality. However, this significant positive association became negative for higher matching of A (H3N2) and public health efforts with post-SARS effect. Mean excess P&I mortality for winters was significantly higher before 2003 than after that year [mean ± S.D.: 1.44±1.35 vs. 0.35±1.13, p = 0.04]. Further analysis revealed that vaccine-matched circulating influenza A viruses were significantly associated with lower excess P&I mortality during post-SARS winters (i.e., 2005–2007) than during pre-SARS winters [0.03±0.06 vs. 1.57±1.27, p = 0.01]. Stratification of these vaccine-matching and post-SARS effect showed substantial trends toward lower elderly excess P&I mortalities in winters with either mismatching vaccines during the post-SARS period or matching vaccines during the pre-SARS period. Importantly, all three excess mortalities were at their highest in May, 2003, when inter-hospital nosocomial infections were peaking. Furthermore, vaccine-mismatched H3N2 viruses circulating in the years with high excess P&I mortality exhibited both a lower amino acid identity percentage of HA1 between vaccine and circulating strains and a higher numbers of variations at epitope B. Our model can help future decision makers to estimate excess P&I mortality effectively, select and test virus strains for antigenic variation, and evaluate public health strategy effectiveness.


id: cord-316278-niurdu7t
title: Delayed Treatment of Diagnosed Pulmonary Tuberculosis in Taiwan
author: Chern, Jimmy PS
date: 2008-07-13
url: https://www.ncbi.nlm.nih.gov/pubmed/18620595/
doi: 10.1186/1471-2458-8-236
abstract:
  BACKGROUND: Mycobacterium tuberculosis infection is an ongoing public health problem in Taiwan. The National Tuberculosis Registry Campaign, a case management system, was implemented in 1997. This study examined this monitoring system to identify and characterize delayed treatment of TB patients. METHODS: Records of all tuberculosis cases treated in Taiwan from 2002 through 2005 were obtained from the National Tuberculosis Registry Campaign. Initiation of treatment more than 7 days after diagnosis was considered a long treatment delay. RESULTS: The study included 31,937 patients. The mean day of delayed treatment was 3.6 days. Most patients were treated immediately after diagnosis. The relationship between number of TB patients and days of delayed treatment after diagnosis exhibited a Power-law distribution. The long tail of the power-law distribution indicated that an extreme number occur cannot be neglected. Tuberculosis patients treated after an unusually long delay require close observation and follow up. CONCLUSION: This study found that TB control is generally acceptabl in Taiwan; however, delayed treatment increases the risk of transmission. Improving the protocol for managing confirmed TB cases can minimize disease transmission.


id: cord-317093-c70c1op4
title: Urban transportation energy and carbon dioxide emission reduction strategies()
author: Cheng, Yung-Hsiang
date: 2015-11-01
url: https://doi.org/10.1016/j.apenergy.2015.01.126
doi: 10.1016/j.apenergy.2015.01.126
abstract:
  Sustainability is an urban development priority. Thus, energy and carbon dioxide emission reduction is becoming more significant in the sustainability of urban transportation systems. However, urban transportation systems are complex and involve social, economic, and environmental aspects. We present solutions for a sustainable urban transportation system by establishing a simplified system dynamics model with a timeframe of 30 years (from 1995 to 2025) to simulate the effects of urban transportation management policies and to explore their potential in reducing vehicular fuel consumption and mitigating CO(2) emissions. Kaohsiung City was selected as a case study because it is the second largest metropolis in Taiwan and is an important industrial center. Three policies are examined in the study including fuel tax, motorcycle parking management, and free bus service. Simulation results indicate that both the fuel tax and motorcycle parking management policies are suggested as potentially the most effective methods for restraining the growth of the number of private vehicles, the amount of fuel consumption, and CO(2) emissions. We also conducted a synthetic policy consisting of all policies which outperforms the three individual policies. The conclusions of this study can assist urban transport planners in designing appropriate urban transport management strategies and can assist transport operation agencies in creating operational strategies to reduce their energy consumption and CO(2) emissions. The proposed approach should be generalized in other cities to develop an appropriate model to understand the various effects of policies on energy and CO(2) emissions.


id: cord-317753-x8faz08x
title: Effects of COVID-19 Prevention Measures on Other Common Infections, Taiwan
author: Lee, Hong-Hsi
date: 2020-10-17
txt: ./txt/cord-317753-x8faz08x.txt
cache: ./cache/cord-317753-x8faz08x.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32730735/
doi: 10.3201/eid2610.203193
summary:
  These policies may not only reduce the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but may also have similar effects on spread of other infectious diseases (2,3). Using nationwide weekly surveillance data (4), we compared the activity of common infections during 2015-2020 with the timeline of actions and policies implemented to protect against spread of SARS-CoV-2 in Taiwan. By comparing the cost of SARS-CoV-2 prevention and the effect on the economy and health during the pandemic in Taiwan and other areas, we could evaluate the cost-effectiveness of these measures and use this information to develop policies for future disease control. To determine whether policies to limit transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) hinder spread of other infectious diseases, we analyzed the National Health Insurance database in Taiwan. To determine whether policies to limit transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) hinder spread of other infectious diseases, we analyzed the National Health Insurance database in Taiwan.

abstract:
  To determine whether policies to limit transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) hinder spread of other infectious diseases, we analyzed the National Health Insurance database in Taiwan. Rates of other infections were significantly lower after SARS-CoV-2 prevention measures were announced. This finding can be applied to cost-effectiveness of SARS-CoV-2 prevention.


id: cord-318336-hslnkv6p
author: Ke, Kai-Yuan
date: 2020-07-24
url: https://www.ncbi.nlm.nih.gov/pubmed/32722337/
doi: 10.3390/ijerph17155357
title:
  Enhancing Local Disaster Management Network through Developing Resilient Community in New Taipei City, Taiwan

abstract:
  Large-scaled disaster events had increasingly occurred worldwide due to global and environmental change. Evidently, disaster response cannot rely merely on the public force. In the golden hour of crisis, not only the individuals should learn to react, protect themselves, and try to help each other, but also the local school, enterprise, non-government organization (NGO), nonprofit organization (NPO), and volunteer groups should collaborate to effectively deal with disaster events. New Taipei City (NTPC), Taiwan, was aware of the need for non-public force response and therefore developed the process of enhancing local disaster management networks through promoting the resilient community since 2009. The concept of a resilient community is to build community-based capacity for mitigation, preparedness, response, and recovery in an all-hazards manner. This study organized the NTPC experience and presented the standard operation procedure (SOP) to promote the resilient community, key obstacles, maintenance mechanism, and the successful formulation of the local disaster management network. The performance of the promotion was evaluated through a questionnaire survey and found that participants affirmed the positive effect of building community capacity through the entire process. In general, the resilient community as the center of the local disaster management work is shown promising to holistically bridge the inner/outer resources and systematically respond to disaster events.


id: cord-321691-46la29tm
title: SARS Antibody Test for Serosurveillance
author: Hsueh, Po-Ren
date: 2004-09-17
url: https://www.ncbi.nlm.nih.gov/pubmed/15498156/
doi: 10.3201/eid1009.040101
abstract:
  A peptide-based enzyme-linked immunosorbent assay (ELISA) can be used for retrospective serosurveillance of severe acute respiratory syndrome (SARS) by helping identify undetected chains of disease transmission. The assay was developed by epitope mapping, using synthetic peptides from the spike, membrane, and nucleocapsid protein sequences of SARS-associated coronavirus. The new peptide ELISA consistently detected seroconversion by week 2 of onset of fever, and seropositivity remained through day 100. Specificity was 100% on normal blood donor samples, on serum samples associated with infection by other pathogens, and on an interference panel. The peptide-based test has advantages of safety, standardization, and automation over previous immunoassays for SARS. The assay was used for a retrospective survey of healthy healthcare workers in Taiwan who treated SARS patients. Asymptomatic seroconversions were detected in two hospitals that had nosocomial disease.


id: cord-322451-cwpz4akv
title: Heroes of SARS: professional roles and ethics of health care workers
author: Hsin, Dena Hsin-Chen
date: 2004-07-27
url: https://api.elsevier.com/content/article/pii/S0163445304001410
doi: 10.1016/j.jinf.2004.06.005
abstract:
  Objectives. To examine the professional moral duty of health care workers (HCWs) in the outbreak of severe acute respiratory syndrome (SARS) in 2003. Methods. Descriptive discussion of media reports, analysis of ethical principles and political decisions discussed in the outbreak, with particular emphasis on the events in mainland China and Taiwan. Results. There were differences in the way that Taiwan and mainland China responded to the SARS epidemic, however, both employed techniques of hospital quarantine. After early policy mistakes in both countries HCWs were called heroes. The label ‘hero’ may not be appropriate for the average HCW when faced with the SARS epidemic, although a number of self-less acts can be found. The label was also politically convenient. Conclusions. A middle ground for reasonable expectations from HCW when treating diseases that have serious risk of infection should be expected. While all should act according to the ethic of beneficence not all persons should be expected to be martyrs for society.


id: cord-324798-qh0cxp10
author: Tanaka, Miho
date: 2020-10-16
url: https://doi.org/10.1186/s12910-020-00535-w
doi: 10.1186/s12910-020-00535-w
title:
  Forgoing life-sustaining treatment – a comparative analysis of regulations in Japan, Korea, Taiwan, and England

abstract:
  BACKGROUND: Regulations on forgoing life-sustaining treatment (LST) have developed in Asian countries including Japan, Korea and Taiwan. However, other countries are relatively unaware of these due to the language barrier. This article aims to describe and compare the relevant regulatory frameworks, using the (more familiar) situation in England as a point of reference. We undertook literature reviews to ascertain the legal and regulatory positions on forgoing LST in Japan, Korea, Taiwan, and England. MAIN TEXT: Findings from a literature review are first presented to describe the development of the regulatory frameworks surrounding the option of forgoing LST in each country. Based on the findings from the four countries, we suggest five ethically important points, reflection on which should help to inform the further development of regulatory frameworks concerning end-of-life care in these countries and beyond. There should be reflection on: (1) the definition of – and reasons for defining – the ‘terminal stage’ and associated criteria for making such judgements; Korea and Taiwan limit forgoing LST to patients in this stage, but there are risks associated with defining this too narrowly or broadly; (2) foregoing LST for patients who are not in this stage, as is allowed in Japan and England, because here too there are areas of controversy, including (in England) whether the law in this area does enough to respect the autonomy of (now) incapacitated patients; (3) whether ‘foregoing’ LST should encompass withholding and withdrawing treatment; this is also an ethically disputed area, particularly in the Asian countries we examine; (4) the family’s role in end-of-life decision-making, particularly as, compared with England, the three Asian countries traditionally place a greater emphasis on families and communities than on individuals; and (5) decision-making with and for those incapacitated patients who lack families, surrogate decision-makers or ADs. CONCLUSION: Comparison of, and reflection on, the different legal positions that obtain in Japan, Korea, Taiwan, and England should prove informative and we particularly invite reflection on five areas, in the hope the ensuing discussions will help to establish better end-of-life regulatory frameworks in these countries and elsewhere.


id: cord-326924-4h4q9h02
author: Cheng, Yi-Hsien
date: 2018-09-06
url: https://doi.org/10.2147/idr.s169820
doi: 10.2147/idr.s169820
title:
  Assessing health burden risk and control effect on dengue fever infection in the southern region of Taiwan

abstract:
  BACKGROUND: The high prevalence of dengue in Taiwan and the consecutive large dengue outbreaks in the period 2014–2015 suggest that current control interventions are suboptimal. Understanding the effect of control effort is crucial to inform future control strategies. OBJECTIVES: We developed a framework to measure season-based health burden risk from 2001 to 2014. We reconstructed various intervention coverage to assess the attributable effect of dengue infection control efforts. MATERIALS AND METHODS: A dengue–mosquito–human transmission dynamic was used to quantify the vector–host interactions and to estimate the disease epidemics. We used disability-adjusted life years (DALYs) to assess health burden risk. A temperature-basic reproduction number (R(0))–DALYs relationship was constructed to examine the potential impacts of temperature on health burden. Finally, a health burden risk model linked a control measure model to evaluate the effect of dengue control interventions. RESULTS: We showed that R(0) and DALYs peaked at 25°C with estimates of 2.37 and 1387, respectively. Results indicated that most dengue cases occurred in fall with estimated DALYs of 323 (267–379, 95% CI) at 50% risk probability. We found that repellent spray had by far the largest control effect with an effectiveness of ~71% in all seasons. Pesticide spray and container clean-up have both made important contributions to reducing prevalence/incidence. Repellent, pesticide spray, container clean-up together with Wolbachia infection suppress dengue outbreak by ~90%. CONCLUSION: Our presented modeling framework provides a useful tool to measure dengue health burden risk and to quantify the effect of dengue control on dengue infection prevalence and disease incidence in the southern region of Taiwan.


id: cord-328229-dybchjfl
title: Sentinel surveillance at airports: Experience of dengue and COVID‐19 prevention in Taiwan
author: Chang, Ko
date: 2020-07-15
txt: ./txt/cord-328229-dybchjfl.txt
cache: ./cache/cord-328229-dybchjfl.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32668030/
doi: 10.1002/kjm2.12265
abstract: nan
summary:
  key: cord-328229-dybchjfl title: Sentinel surveillance at airports: Experience of dengue and COVID‐19 prevention in Taiwan cord_uid: dybchjfl These findings revealed that sentinel surveillance at airports detected 3.3% to 14% of dengue cases and 29.2% of imported COVID-19 cases in Taiwan, even though a high number of passengers were screened and the positive rate of symptomatic passengers was low. In addition to sentinel surveillance, other interventions at airports such as onboard quarantine announcements and home quarantine notices delivered to each passenger highlight the multidisciplinary measures at national gates required to effectively prevent the spread of SARS-CoV-2, especially during the containment stage of pandemic control. Epidemiologic and clinical characteristics of 91 hospitalized patients with COVID-19 in Zhejiang, China: a retrospective, multi-centre case series Airport sentinel surveillance and entry quarantine for dengue infections following a fever screening program in Taiwan Phylogenetic study of dengue-3 virus in Taiwan with sequence analysis of the core gene


id: cord-330260-xuw31zfn
title: Identification of Taiwan and China-like recombinant avian infectious bronchitis viruses in Taiwan
author: Chen, Hui-Wen
date: 2009-01-20
url: https://www.ncbi.nlm.nih.gov/pubmed/19100792/
doi: 10.1016/j.virusres.2008.11.012
abstract:
  Infectious bronchitis virus (IBV) infections in poultry cause great economic losses to the poultry industry worldwide. The emergence of viral variants complicates disease control. The IBV strains in Taiwan were clustered into two groups, Taiwan group I and Taiwan group II, based on the S1 gene. A variant was previously identified and showed a distinct S1 gene homology with other local strains. This study investigated the 3′ 7.3 kb genome of eight Taiwan strains isolated from 1992 to 2007. The genes of interest were directly sequenced. Sequence analyses were performed to detect any recombination event among IBVs. The results demonstrated that all of the examined viruses maintained the typical IBV genome organization as 5′-S-3a-3b-E-M-5a-5b-N-UTR-3′. In the phylogenetic analyses, various genes from one strain were clustered into separate groups. Moreover, frequent recombination events were identified in the Simplot analyses among the Taiwan and China CK/CH/LDL/97I-type strains. Putative crossover sites were located in the S1, S2, 3b, M genes and the intergenic region between the M and 5a genes. All of the recombinants showed chimeric IBV genome arrangements originated from Taiwan and China-like parental strains. Field IBVs in Taiwan undergo genetic recombination and evolution.


id: cord-330674-enq6kgab
author: Yu, Jung-Sheng
date: 2014-06-12
txt: ./txt/cord-330674-enq6kgab.txt
cache: ./cache/cord-330674-enq6kgab.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32288884/
doi: 10.1016/j.eujim.2014.06.003
summary:
  INTRODUCTION: Traditional Chinese medicine (TCM) has been used to treat upper respiratory tract infections/common colds (URTIs) in Asian countries for over 2000 years. METHODS: The TCM treatments for patients consulting with an URTIs were analyzed from the National Health Insurance Research Database using the appropriate codes from the International Classification of Diseases, Ninth Revision, Clinical Modification diagnoses for Taiwan in 2009. Traditional Chinese medicine (TCM) has been used to treat upper respiratory tract infections/common colds (URTIs) in Asian countries for over 2000 years. A number of Chinese herbs have been used to treat URTIs. TCM treatment of disease in Taiwan is generally in accordance with TCM theories and the personal experience of the CMDs. Our results showed that Yin-Qiao-San was the most popular TCM formula that was used to treat URTIs. Yin-Qiao-San first appeared in the record of WenBingTiaoBian (1798-1836 A.D.) and remains a common TCM prescription for treating seasonal influenza [35] , as well as the common cold, fever, cough, and other respiratory tract diseases [36] .

title:
  Traditional Chinese medicine treatments for upper respiratory tract infections/common colds in Taiwan

abstract:
  INTRODUCTION: Traditional Chinese medicine (TCM) has been used to treat upper respiratory tract infections/common colds (URTIs) in Asian countries for over 2000 years. However, Chinese medicine doctors (CMDs) follow the traditional treatment rules to select or administer these diverse Chinese medicine formulae. The main purpose of our study was to explore data on the frequency of medication and medication habits by CMDs for the treatment of URTIs with Chinese herbs and Chinese medicine formulae. METHODS: The TCM treatments for patients consulting with an URTIs were analyzed from the National Health Insurance Research Database using the appropriate codes from the International Classification of Diseases, Ninth Revision, Clinical Modification diagnoses for Taiwan in 2009. A data mining and association rules, were used to analyze co-prescriptions of TCM for patients with URTIs. RESULTS: For 472,005 patients who sought the treatment of URTIs, a total of 46,805 patients with URTIs received TCM treatments, of these 29,052 patients sought both TCM and Western medication treatments. Of the URTIs patients who had received a TCM treatment, 79% presented with an acute common cold, 9% had influenza, and 9% had acute upper respiratory infections. Furthermore, 53.89% of the sample were aged between 20 and 49 years, and 62.84% were women, 3.56% of the patients used Yin-Qiao-San and 2.76% used Jie-Geng. Yin-Qiao-San and Ma-Xing-Gan-Shi-Tang were the most commonly combinations of prescriptions for patients with URTIs. CONCLUSIONS: The patients experiencing URTIs were more likely to request TCM treatment if their symptoms were mild and they were women. The Chinese medicine doctors treating URTIs generally followed TCM theory. A coding system for TCM diagnostic classifications could improve evaluations of TCM treatments.


id: cord-331123-8e1fkafa
title: Herd immunity or suppression strategy to combat COVID-19
author: Jung, F.
date: 2020-07-22
url: https://www.ncbi.nlm.nih.gov/pubmed/32538831/
doi: 10.3233/ch-209006
abstract:
  Some months ago, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out in Wuhan, China, and spread rapidly around the world. Some states, such as the Netherlands, Germany, Great Britain, Sweden and the USA initially focused on keeping the restrictions for economy and society as low as possible. The responsible authorities were of the opinion - and still are e.g. in Sweden - that it is sufficient enough to protect particularly vulnerable persons such as the elderly or people with pre-existing conditions. The idea behind this is that as soon as 60 to 70 percent of the population is infected with a pathogen, a so-called “herd immunity” has developed. However, the increasing numbers of deaths and modelling studies showed the expected overload of the hospitals. Therefore, most countries decided for a temporary lockdown with the exception of Sweden. Based on the number of the total population, three times more people died from COVID-19 in Sweden (2679 deaths per 10 million inhabitants) compared to Germany (6848 deaths per 80 million inhabitants). The comparison Sweden versus Taiwan is even worse because 1072 times more people died in Sweden based on the number of the population (6 deaths per 24 million inhabitants). In the face of the lack of an antiviral treatment and the lack of a protective vaccine one must state Taiwan has made the best out of the pandemic situation whereas Sweden failed completely.


id: cord-331148-40gvay7i
author: Hsieh, Yu-Chia
date: 2018-10-23
url: https://doi.org/10.1038/s41598-018-34077-4
doi: 10.1038/s41598-018-34077-4
title:
  Clinical characteristics of patients with laboratory-confirmed influenza A(H1N1)pdm09 during the 2013/2014 and 2015/2016 clade 6B/6B.1/6B.2-predominant outbreaks

abstract:
  A novel pandemic influenza A(H1N1)pdm09 virus emerged in 2009 globally, and it continues to circulate in humans. The National Influenza Surveillance Network in Taiwan identified five A(H1N1)pdm09-predominant seasons, representing the 2009/2010, 2010/2011, 2012/2013, 2013/2014, and 2015/2016 outbreaks from 2009 to 2016. Independently, a retrospective cohort study (which enrolled 639 infected patients during the five seasons) was conducted at Chang Gung Memorial Hospital to explore the risk factors associated with influenza A(H1N1)pdm09-related complications. A phylogenetic analysis of hemagglutinin (HA) sequences showed that the circulating A(H1N1)pdm09 virus belonged to clades 1, 2, and 8 in 2009/2010; clades 3, 4, 5, and 7 in 2010/2011; clades 7 and 6C in 2012/2013; clades 6B in 2013/2014; and 6B/6B.1/6B.2 in 2015/2016. Compared to individuals infected in non-6B/6B.1/6B.2 seasons (2009/2010, 2010/2011, and 2012/2013), those infected in 6B/6B.1/6B.2 seasons (2013/2014 and 2015/2016) were at higher risk for influenza-related complications (adjusted odds ratio [aOR]: 1.6, 95% confidence interval [CI]: 1.0–2.8), pneumonia (aOR: 1.78, 95% CI: 1.04–3.04), mechanical ventilation (aOR: 2.6, 95% CI: 1.2–5.6), and acute respiratory distress syndrome (aOR: 5.5, 95% CI: 1.9–15.9). For the increased severity of infection during the influenza A(H1N1)pdm09 clade 6B/6B.1/6B.2 seasons, aspects related to the antigenic change of A(H1N1)pdm09 virus, immune response of the host, and environmental factors required further investigation.


id: cord-333225-654rd38j
title: Collateral Benefits on Other Respiratory Infections during Fighting COVID-19
author: Chan, Khee-Siang
date: 2020-06-05
url: https://api.elsevier.com/content/article/pii/S0025775320303535
doi: 10.1016/j.medcli.2020.05.026
abstract:
  Abstract Purpose: Influenza virus infection is associated with a high disease burden. COVID-19 caused by SARS-CoV-2 has become a pandemic outbreak since January 2020. Taiwan has effectively contained COVID-19 community transmission. We aimed to validate whether fighting COVID-19 could help to control other respiratory infections in Taiwan. Method: We collected week-case data of severe influenza, invasive Streptococcus pneumoniae disease and death toll from pneumonia among 25 calendar weeks of the influenza season for four years (2016-2020), which were reported to Taiwan CDC. Trend and slope differences between years were compared. Result: A downturn trend of severe influenza, invasive Streptococcus pneumoniae disease and the death toll from pneumonia per week in 2019/2020 season and significant trend difference in comparison to previous seasons were noted, especially after initiation of several disease prevention measures to fight potential COVID-19 outbreak in Taiwan. Conclusions: Fighting COVID-19 achieved collateral benefits on significant reductions of severe influenza burden, invasive Streptococcus pneumoniae disease activity, and the death toll from pneumonia reported to CDC in Taiwan.


id: cord-333976-zhiuuwv1
title: Implementation of the IHR Joint External Evaluation: Taiwan's Experiences
author: Lo, Yi-Chun
date: 2017-04-01
url: https://www.ncbi.nlm.nih.gov/pubmed/28418741/
doi: 10.1089/hs.2016.0093
abstract:
  In February 2016, the World Health Organization developed the Joint External Evaluation (JEE) tool to independently assess country capacity to prevent, detect, and respond to public health threats as part of the International Health Regulations (IHR) (2005) monitoring and evaluation framework. In light of this, the Taiwan government actively engaged at least 19 government agencies or institutions and voluntarily implemented the JEE. An External Assessment Team consisting of 6 US subject matter experts conducted the external evaluation, including site visits, from June 21 to July 1, 2016. The results, published on October 18, 2016, are useful and will be translated into actions and change in the system. Based on Taiwan's experiences, early stakeholder engagement and an experts' pre-JEE pilot visit would contribute to a successful JEE process.


id: cord-340385-ffk0ifwy
title: ARMAX modelling of international tourism demand
author: Lim, Christine
date: 2008-09-10
url: https://www.sciencedirect.com/science/article/pii/S0378475408002930
doi: 10.1016/j.matcom.2008.08.010
abstract:
  Box–Jenkins (1970) models are often used to capture the autoregressive moving average of past observations of tourist arrivals from Japan to Taiwan and New Zealand. However, other explanatory variables, such as real income in the origin country, have also affected the demand for international travel. The purpose of this paper is to use the ARMAX model to investigate the dynamic relationship between tourism demand and real income of Japan, and to compare the findings with the single-equation model. Unit root tests and diagnostics are performed before estimating the income elasticity of travel demand by Japan for New Zealand and Taiwan based on seasonally unadjusted quarterly data for 1980(1) to 2004(2). The empirical results of the ARMAX model support the economic theory that the demand for international travel is positively related to income of the origin country.


id: cord-340889-ff35696d
author: Ko, Nai-Ying
date: 2020-08-11
url: https://www.ncbi.nlm.nih.gov/pubmed/32796759/
doi: 10.3390/ijerph17165822
title:
  Changes in Sex Life among People in Taiwan during the COVID-19 Pandemic: The Roles of Risk Perception, General Anxiety, and Demographic Characteristics

abstract:
  This study used data collected from an online survey study on coronavirus disease 2019 (COVID-19) in Taiwan to examine changes in sex life during the pandemic and the factors affecting such changes. In total, 1954 respondents were recruited from a Facebook advertisement. The survey inquired changes in sex life during the pandemic, including satisfaction with the individual’s sex life, frequency of sexual activity, frequency of sex-seeking activity, and frequency of using protection for sex. The associations of change in sex life with risk perception of COVID-19, general anxiety, gender, age, and sexual orientation were also examined. For each aspect of their sex life, 1.4%–13.5% of respondents reported a decrease in frequency or satisfaction, and 1.6%–2.9% reported an increase in frequency or satisfaction. Risk perception of COVID-19 was significantly and negatively associated with frequencies of sexual and sex-seeking activities. Higher general anxiety was significantly and negatively associated with satisfaction of sex life and frequencies of sexual and sex-seeking activities. Sexual minority respondents were more likely to report decreased satisfaction with sex life and frequencies of sexual activity and sex-seeking activities during COVID-19. Health care providers should consider these factors when developing strategies for sexual wellness amid respiratory infection epidemics.


id: cord-341105-3uvbfp8c
author: Li, Dian-Jeng
date: 2020-06-22
url: https://www.ncbi.nlm.nih.gov/pubmed/32580433/
doi: 10.3390/ijerph17124479
title:
  COVID-19-Related Factors Associated with Sleep Disturbance and Suicidal Thoughts among the Taiwanese Public: A Facebook Survey

abstract:
  Coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of people’s lives all over the world. This Facebook survey study aimed to investigate the COVID-19-related factors that were associated with sleep disturbance and suicidal thoughts among members of the public during the COVID-19 pandemic in Taiwan. The online survey recruited 1970 participants through a Facebook advertisement. Their self-reported experience of sleep disturbance and suicidal thoughts in the previous week were collected along with a number of COVID-19-related factors, including level of worry, change in social interaction and daily lives, any academic/occupational interference, levels of social and specific support, and self-reported physical health. In total, 55.8% of the participants reported sleep disturbance, and 10.8% reported having suicidal thoughts in the previous week. Multiple COVID-19-related factors were associated with sleep disturbance and suicidal thoughts in the COVID-19 pandemic. Increased worry about COVID-19, more severe impact of COVID-19 on social interaction, lower perceived social support, more severe academic/occupational interference due to COVID-19, lower COVID-19-specified support, and poorer self-reported physical health were significantly associated with sleep disturbance. Less handwashing, lower perceived social support, lower COVID-19-specified support, poorer self-reported physical health, and younger age were significantly associated with suicidal thoughts. Further investigation is needed to understand the changes in mental health among the public since the mitigation of the COVID-19 pandemic.


id: cord-342157-qjyooq68
title: Comparative analysis of full genomic sequences among different genotypes of dengue virus type 3
author: King, Chwan-Chuen
date: 2008-05-21
url: https://www.ncbi.nlm.nih.gov/pubmed/18495043/
doi: 10.1186/1743-422x-5-63
abstract:
  BACKGROUND: Although the previous study demonstrated the envelope protein of dengue viruses is under purifying selection pressure, little is known about the genetic differences of full-length viral genomes of DENV-3. In our study, complete genomic sequencing of DENV-3 strains collected from different geographical locations and isolation years were determined and the sequence diversity as well as selection pressure sites in the DENV genome other than within the E gene were also analyzed. RESULTS: Using maximum likelihood and Bayesian approaches, our phylogenetic analysis revealed that the Taiwan's indigenous DENV-3 isolated from 1994 and 1998 dengue/DHF epidemics and one 1999 sporadic case were of the three different genotypes – I, II, and III, each associated with DENV-3 circulating in Indonesia, Thailand and Sri Lanka, respectively. Sequence diversity and selection pressure of different genomic regions among DENV-3 different genotypes was further examined to understand the global DENV-3 evolution. The highest nucleotide sequence diversity among the fully sequenced DENV-3 strains was found in the nonstructural protein 2A (mean ± SD: 5.84 ± 0.54) and envelope protein gene regions (mean ± SD: 5.04 ± 0.32). Further analysis found that positive selection pressure of DENV-3 may occur in the non-structural protein 1 gene region and the positive selection site was detected at position 178 of the NS1 gene. CONCLUSION: Our study confirmed that the envelope protein is under purifying selection pressure although it presented higher sequence diversity. The detection of positive selection pressure in the non-structural protein along genotype II indicated that DENV-3 originated from Southeast Asia needs to monitor the emergence of DENV strains with epidemic potential for better epidemic prevention and vaccine development.


id: cord-343634-ybouh0cw
author: Huang, Irving Yi‐Feng
date: 2020-05-22
txt: ./txt/cord-343634-ybouh0cw.txt
cache: ./cache/cord-343634-ybouh0cw.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1111/puar.13239
doi: 10.1111/puar.13239
summary:
  In this review, I pinpoint some background on the systems and organizations that helped Taiwan streamline a task force (Command Center) in a timely manner to launch related initiatives, mobilize the public, and engage private resources to implement the strategies and policies which were further enhanced by collaborative behaviors and volunteers. <Insert Table 1 here> According to the authorization of Enforcement Regulations Governing the Central Epidemics Command Center, the CECC commanding officer has the unified authority to command, supervise, and coordinate government organizations at various levels, public enterprises, reserved servicemen''s organizations, and non-governmental organizations to implement disease control matters. Based on these and later border controls, the CECC required all travelers arriving in Taiwan to be quarantined for 14 days and their information to be passed to local governments. Taiwan CDC announces activation of Central Epidemic Command Center (CECC) for Severe Special Infectious Pneumonia to comprehensively prevent novel coronavirus pneumonia outbreak in China and ensure health of Taiwanese public

title:
  Fighting Against COVID‐19 through Government Initiatives and Collaborative Governance: Taiwan Experience

abstract:
  Taiwan is situated less than 200 km from the first Covid‐19 outbreak state, China, and has millions of international visitors yearly. Taiwan's collective efforts to block and eliminate the invisible enemy (Covid‐19) from the island, have resulted in relatively low infection and death numbers, and were hailed as a successful anomaly amid the global pandemic. In this review, I pinpoint some background on the systems and organizations that helped Taiwan streamline a task force (Command Center) in a timely manner to launch related initiatives, mobilize the public, and engage private resources to implement the strategies and policies which were further enhanced by collaborative behaviors and volunteers. Also, even subject to similar threatening conditions such as cruise ship stopover and numerous foreign immigrant workers, there were no outbreaks of community infection in Taiwan similar to Singapore, Japan, etc. Taiwan's successful measures offer good example for future comparative studies. This article is protected by copyright. All rights reserved.


id: cord-343780-084lq92r
title: Detection, sequence analysis, and antibody prevalence of porcine deltacoronavirus in Taiwan
author: Hsu, Tien-Huan
date: 2018-07-26
url: https://doi.org/10.1007/s00705-018-3964-x
doi: 10.1007/s00705-018-3964-x
abstract:
  Porcine deltacoronavirus (PDCoV) was initially documented in Hong Kong and later in the United States, South Korea, and Thailand. To investigate if PDCoV is also present in Taiwan, three swine coronaviruses—PDCoV, porcine epidemic diarrhea virus (PEDV), and transmissible gastroenteritis coronavirus (TGEV)—were tested using real-time reverse transcription polymerase chain reaction (rRT-PCR) in 172 rectal swab samples from piglets exhibiting diarrhea between January 2016 and May 2017 on 68 pig farms in Taiwan. The rRT-PCR results were positive for PDCoV (29/172, 16.9%), PEDV (36/172, 20.9%), TGEV (2/172, 1.2%), and coinfections (16/172, 9.3%). After cloning and sequencing, PDCoV nucleocapsid genes were analyzed. Phylogeny results indicated that the nucleotide sequences of all isolates were like those reported in other countries. To further trace PDCoV in the period of 2011 to 2015, an enzyme-linked immunosorbent assay (ELISA) was used to detect antibodies against PDCoV. The results showed that 279 of 1,039 (26.9%) sera were positive for the PDCoV nucleocapsid protein, implying that PDCoV might have existed in Taiwan before 2011.


id: cord-346515-8wqpvf68
author: Chiu, Hsiao-Hsuan
date: 2014-07-17
txt: ./txt/cord-346515-8wqpvf68.txt
cache: ./cache/cord-346515-8wqpvf68.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3402/gha.v7.24516
doi: 10.3402/gha.v7.24516
summary:
  Based on the abovementioned findings, several important conclusions were made, which includes: 1) the designation of the PoEs should be based on consensus; 2) the stakeholders with the responsibility of implementing the core capacities should be brought together, not only from the health sector, but also from other public and private sectors; 3) the successful implementation of this program requires strong support from the cabinet and its subordinate organizations; 4) a coordination mechanism, with clear functions and structure, is necessary; 5) an agreed protocol, which clarifies the strategies, timeline, and multidisciplinary/multisectoral duties, is essential, and 6) all strategies should be harmonized with the currently available resources, national administrative structure, and consensus made by the participants.

title:
  Building core capacities at the designated points of entry according to the International Health Regulations 2005: a review of the progress and prospects in Taiwan

abstract:
  BACKGROUND: As designated points of entry (PoEs) play a critical role in preventing the transmission of international public health risks, huge efforts have been invested in Taiwan to improve the core capacities specified in the International Health Regulations 2005 (IHR 2005). This article reviews how Taiwan strengthened the core capacities at the Taoyuan International Airport (TIA) and the Port of Kaohsiung (PoK) by applying a new, practicable model. DESIGN: An IHR PoE program was initiated for implementing the IHR core capacities at designated PoEs. The main methods of this program were 1) identifying the designated PoEs according to the pre-determined criteria, 2) identifying the competent authority for each health measure, 3) building a close collaborative relationship between stakeholders from the central and PoE level, 4) designing three stages of systematic assessment using the assessment tool published by the World Health Organization (WHO), and 5) undertaking action plans targeting the gaps identified by the assessments. RESULTS: Results of the self-assessment, preliminary external assessment, and follow-up external assessment revealed a continuous progressive trend at the TIA (86, 91, and 100%, respectively), and at the PoK (77, 97, and 99.9%, respectively). The results of the follow-up external assessment indicated that both these designated PoEs already conformed to the IHR requirements. These achievements were highly associated with strong collaboration, continuous empowerment, efficient resource integration, and sustained commitments. CONCLUSIONS: Considering that many countries had requested for an extension on the deadline to fulfill the IHR 2005 core capacity requirements, Taiwan's experiences can be a source of learning for countries striving to fully implement these requirements. Further, in order to broaden the scope of public health protection into promoting global security, Taiwan will keep its commitments on multisectoral cooperation, human resource capacity building, and maintaining routine and emergency capacities.


id: cord-354780-yzyixucr
title: Importation of SARS-CoV-2 infection leads to major COVID-19 epidemic in Taiwan
author: Lin, Chih-Yen
date: 2020-06-13
url: https://www.sciencedirect.com/science/article/pii/S1201971220304665?v=s5
doi: 10.1016/j.ijid.2020.06.031
abstract:
  Abstract Objective COVID-19 has recently become a pandemic affecting many countries worldwide. This study aims to evaluate current status of COVID-19 in Taiwan and analyze the source of infection. Methods National data regarding SARS-CoV-2 infection were obtained from Taiwan CDC at the end of April, 2020. These data were subjected for analysis of the current status and correlation between indigenous and imported COVID-19 cases. Phylogenetic tree was performed to analyze the phylogeny of Taiwanese SARS-CoV-2 isolates. Results The initial case of SARS-CoV-2 infection in Taiwan was detected on January 21, 2020. Epidemiological data indicate that by April 30, there were a total of 429 COVID-19 confirmed cases with the death rate of 1.3%. Most of cases were identified as imported (79.9%; 343/429) with majority transmitted from United States of America (22.1%) and United Kingdom (17.6%). Results from phylogenetic tree analyses indicate that the Taiwanese SARS-CoV-2 isolates were clustered with the SARS-CoV-2 isolates from other countries (bootstrap value 98%) and sub-clustered with bat SARS-like coronaviruses (bootstrap value 99%). Conclusion This study suggests that importation of SARS-CoV-2 infection was the primary risk-factor resulting in the COVID-19 epidemic in Taiwan.


id: cord-355280-l8pbw4ry
title: Environment-adjusted total-factor energy efficiency of Taiwan's service sectors
author: Fang, Chin-Yi
date: 2013-09-05
url: https://www.ncbi.nlm.nih.gov/pubmed/32287870/
doi: 10.1016/j.enpol.2013.07.124
abstract:
  This study computes the pure technical efficiency (PTE) and energy-saving target of Taiwan's service sectors during 2001–2008 by using the input-oriented data envelopment analysis (DEA) approach with the assumption of a variable returns-to-scale (VRS) situation. This paper further investigates the effects of industry characteristics on the energy-saving target by applying the four-stage DEA proposed by Fried et al. (1999). We also calculate the pre-adjusted and environment-adjusted total-factor energy efficiency (TFEE) scores in these service sectors. There are three inputs (labor, capital stock, and energy consumption) and a single output (real GDP) in the DEA model. The most energy efficient service sector is finance, insurance and real estate, which has an average TFEE of 0.994 and an environment-adjusted TFEE (EATFEE) of 0.807. The study utilizes the panel-data, random-effects Tobit regression model with the energy-saving target (EST) as the dependent variable. Those service industries with a larger GDP output have greater excess use of energy. The capital–labor ratio has a significantly positive effect while the time trend variable has a significantly negative impact on the EST, suggesting that future new capital investment should also be accompanied with energy-saving technology in the service sectors.


id: cord-355448-ed3fth3i
title: Anxiety symptoms and preventive measures during the COVID-19 outbreak in Taiwan
author: Wong, Li Ping
date: 2020-07-16
txt: ./txt/cord-355448-ed3fth3i.txt
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url: https://doi.org/10.1186/s12888-020-02786-8
doi: 10.1186/s12888-020-02786-8
summary:
  Because of the importance of determining the level of psychological distress and understanding the psychobehavioural consequences of COVID-19 in the general public while the epidemic is still ongoing, our main objective in this study was to investigate the anxiety symptoms caused by COVID-19, and use of preventive measures against COVID-19, among the general public. We also aimed to compare the anxiety symptoms and preventive measures during the week immediately prior to the study, while the outbreak was still on the rise, and at the time the COVID-19 outbreak was first reported in China. Despite it being widely circulated in the news media that older adults affected by COVID-19 likely have a higher risk of complications and mortality, and the recent large epidemiological data from the Chinese Centre for Disease Control and Prevention that shows that those above 60 years of age accounted for 44.1% of confirmed cases in Wuhan [33] , our study''s participants in the older age group appear to have a lower level of anxiety.

abstract:
  BACKGROUND: It is hypothesized that anxiety and behavioral responses are intense at the beginning of an epidemic. The objective of this study was to investigate anxiety symptoms and use of preventive measures against COVID-19. The study also compared the association between preventive measures and anxiety symptoms during the week immediately preceding the study and those symptoms and measures at the beginning of the outbreak. METHODS: A cross-sectional population survey using an online questionnaire commenced on 14 February 2020. The study participants were residents of Taiwan ages 20 to 70 years. The 6-item state version of the State–Trait Anxiety Inventory (STAI-6) was used to assess anxiety symptoms. The questions about preventive measures asked participants about their personal protection, cough etiquette, contact precautions, voluntary quarantine, and prompt reporting. Multivariable logistic regression was used to determine the factors influencing an increase in the preventive measures scores. RESULTS: Of a total of 3555 completed responses, a total of 52.1% (95% confidence interval [CI] 50.4–53.7) of the respondents reported moderate to severe levels of anxiety symptoms in the past week, whereas 48.8% (95%CI 47.2–50.5) reported moderate to severe anxiety symptoms at the beginning of the outbreak. With a higher score indicating greater anxiety, the median scores for anxiety symptoms in the past week and at the beginning of the outbreak were 46.7 (IQR [interquartile range] 36.7–53.3) and 43.3 (IQR 36.7–53.3), respectively. The median scores for the preventive measures taken in the past week and at the beginning of the outbreak were 26.0 (IQR 21.0–30.0) and 24.0 (IQR 19.0–28.0), respectively, out of a maximum score of 36. In the multivariable analysis, an increased anxiety symptom score from the beginning of the outbreak to the past week (adjusted OR = 7.38, 95%CI 6.28–8.66) was a strongly significant determinant of an increased preventive measures score in the past week compared with the score at the beginning of the outbreak. CONCLUSIONS: Anxiety and preventive measures scores were high and increased with the epidemic rate. Higher anxiety was associated with an increased use of preventive measures against COVID-19.


