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A Study on the Learning Effects and Satisfaction of Elementary School Students Participating in off-Campus Teaching Activity- Formosan Aboriginal Culture Village as an Example
No full text[[abstract]]戶外教育是學校課程的一部份，可以擴充學生知識領域、增加學習體驗。本研究旨在探討南投縣國小學生對於校外教學景點「九族文化村」之旅遊動機、服務品質滿意度及學習效益。本研究於民國108年10月29日對校外教學活動參與者進行之全面問卷調查。共發出問卷164份紙本問卷，有效問卷157份，有效問卷回收率95.73﹪。研究結果顯示如下：一、受訪者在此次造訪九族文化村前曾至園區之原因前三名排序為「專程為了遊樂設施」、「專程為了想認識原住民文化」、「專程為了搭乘日月潭纜車」。二、有關九族文化村認知學生答對率不好。三、整體服務品質滿意度以「我覺得園區內的建築物蓋得很漂亮」、「我我喜歡九族原住民文化體驗課程」、「我覺得園區內的樹木種得很好，整齊又美觀」居前三名。「我覺得園區內販賣的飲食及紀念品價格不會太貴」、「我覺得園區內的飲水機很明顯、容易找」、「我覺得在園區內，常可找得到垃圾桶在哪裡」居後三名。四、受訪者基本資料在服務品質滿意度程度之分析1.受訪者是否具「原住民身分」在環境清潔構面同意度中有顯著差異，「具原住民身分」受訪者在環境清潔構面比「不具原住民身分」之平均數大。2.「專程為了遊樂設施」受訪者在遊憩設施構面有顯著性高服務品質滿意度。3.「專程為了想認識原住民文化」受訪者在景觀構面、學習效益構面、原住民部落體驗構面有顯著性高服務品質滿意度。五、受訪者「答對題數」與其對園區所有服務品質滿意度構面無顯著相關。本研究結果及建議可以讓學校主管或老師當選擇校外教學目的地，及給九族文化村業者當未來經營管理之參考。[[abstract]]Outdoor education is a part of the school curriculum that expands students’ areas of knowledge and enhance the learning experience. The purpose of this study is to explore the tourism motivation, the satisfaction of service quality and the learning benefits of elementary students at Natou County to off-campus teaching scenery “Formosan Aboriginal Culture Village”. This research conducted a comprehensive questionnaire survey on participants of off-campus teaching activity on October 29, 2019. A total of 174 paper questionnaire were issued, 157 valid questionnaires were collected. The recovery rate of the valid questionnaires was 95.73 %. The results of the study were as follows:1.The top three reasons why respondents went to the park before their visit to the Formosan Aboriginal Culture Village were ranked as “special trip for amusement facilities”, “special trip to learn about aboriginal culture”, and “special trip to ride the Sun Moon cable car”.2.The responds number of questions answered correctly about the awareness of the Formosan Aboriginal Culture Village were not good.3.The top three satisfaction of service quality were “I ink the buildings at the parks are very beautiful”, “I like the experience course of the park”, and “I think the trees ate the park are well planted, neat and beautiful”. The least three satisfaction of service quality were “I think the drink, food, and souvenirs at the park are not too expensive”.4.Analysis of the respondents’ basic information on the satisfaction of service quality (1) The respondents with aboriginal identity at the dimension of the environmental cleanliness had significantly higher average overall satisfaction of service quality.(2) The respondents with “special trips for amusement facilities” had significantly higher average overall satisfaction of service quality. (3) The respondents with “special trips to understand aboriginal culture” had significantly higher average overall satisfaction of service quality.5. There was no significant correlation between the responds number of questions answered correctly and their overall satisfaction of service quality.The results and recommendations of this study can be used as references for future school supervisors or teachers to select the destinations of the off-campus teaching activities, and management of the Formosan Aboriginal Culture Village
A Preliminary Study on the Combination of Aquavoltaic and Regional Revitalization:From the Perspective of Tourism andLeisure Development
No full text[[abstract]]臺灣的傳統產業在時代變遷的改革中，尋找產業轉型的新契機、求發展、找出路，而在氣候變遷的威脅及全球暖化的議題上，政府在新興產業的節能、低碳環境的永續發展評估中，尤以養殖漁業和綠電結合的經濟效益最具有發展性，漁電共生是指傳統的養殖漁業結合再生能源，共同經營發展的一種新概念經營型態，即為水下養殖、水上發電，以漁業為主、光電為輔。目的在利用養殖漁業結合綠能設施旨在產業轉型的同時，也能優化養殖生產環境、減少勞力成本，透過綠電收益促進漁民收益，最終達到漁電雙贏產業升級的效果。將漁電共生結合地方創生的多元化經營模式，加入發展觀光休閒的創新體驗吸引觀光人潮，帶動地方經濟、活化地方產業及人文特色找出屬於地方色彩的經營模式。本研究以漁電共生結合地方創生的經營樣態，做為觀光休閒發展的新方向，希望能藉此研究能找到更多元化的旅遊樂趣及觀光休閒產業的經營與發展。[[abstract]]During the changing revolution of the new era, people is searching industries、 transformation for the new opportunity、seeking for the new development、finding a break through for the new path, and in the threat of climate change and global warming issues, the government is evaluating on the development of energy saving、low-carbon policy activities; especially, the combination of Aquaculture and green energy is the most economical efficiency and the promised development solution. The conventional Aquaculture Industry combines with the Renewable Energy system is a whole new concept for the brand new business model , the Fishery and Photovoltaic Symbiosis is main focus on the Aquaculture business, and add a Photovoltaic system on top of the fishery facility. The purpose of the Fishery and Photovoltaic Symbiosis is that during the Aquaculture industry transformation, its advantage can optimize the aquaculture facility’s environment, reduce labor costs, and promote fishermen’s income with a value add Photovoltaic System creating a win-win situation for the Aquaculture industry and the Renewable Energy industry. Together with the Local business creation’s diversity business model. This innovation experience of tourism and leisure will attract tourists, prosper the local economy, activate local industries and humanistic characteristics, and find a business model that suits the locals. This research regards Aquavoltaic combined with Regional Revitalization as a new orientation for the Development of Tourism and Leisure, hoping to bring about more tourism pleasures and more paths for the Development of Tourism and Leisure Industry
Talent Training for Leisure Activity Design for Senior People - Taking Nantou County as an Example
No full text[[abstract]]我國在1993年邁入高齡化國家，當時銀髮族人口佔總人口比例為7.02%，首次超過聯合國分類標準的65歲以上老年人口超過7%「高齡化社會」，2020年8月達到14%正式進入「高齡社會」。人口快速地老化現象對台灣社會帶來的影響層面包括：代間扶養關係、銀髮族居住安全環境的規劃、銀髮族基本需求的經濟保障、長期照顧的完善規劃、銀髮族身心靈的健康照護、銀髮族照顧人力的訓練、提升照護人力的就業、終身學習及社會參與的普及及銀髮族休閒產業的發展。本研究從事銀髮族休閒活動人才培訓計畫課程，透過課程中教案設計和學員實物操作中，實際觀察學員的學習過程和完成學習目標，並且得到學員對教案設計和學習的高滿意度。於課程結束後學員能夠依據不同教學對象和能力設計教學課程，並能完成教學目標。[[abstract]]My country entered an aging country in 1993. At that time, the Senior population accounted for 7.02% of the total population. For the first time, more than 7% of the population over the age of 65 surpassed the United Nations classification standard "aging society", and in August 2020, it reached 14% officially. Enter the "senior society". The impact of rapid population aging on Taiwan's society includes: intergenerational support relationships, planning for a safe living environment for Senior people, economic security for the basic needs of Senior people, perfect planning for long-term care, physical and spiritual health care for Senior people, and Senior people. Training of care workers, promotion of employment of care workers, popularization of lifelong learning and social participation, and development of the leisure industry for Senior people. This research is engaged in the training plan course for Senior leisure activity talents. Through the design of the lesson plan in the course and the actual operation of the students, the students' learning process and the completion of the learning objectives are actually observed, and the students' high satisfaction with the teaching plan design and learning is obtained. After the course, students can design teaching courses according to different teaching objects and abilities, and can complete the teaching objectives
The Benefits Of Street Art Performance
No full text[[abstract]]街頭藝術日益受到地方政府發展觀光產業與民眾休閒的重視。本研究之目的，旨在瞭解街頭藝術之展演效益，探討街頭藝術展演所帶給藝人本身、街頭觀眾和表演場域之隱含效益。希望透過此研究讓街頭藝人以及表演場地管理者更加瞭解街頭藝人、觀眾和表演場域三者的互動關聯，以有助於我國街頭展演藝術的深化推廣。因此，本研究採質性研究，深度訪談二十五位受訪者，包括九位街頭藝人、八位街頭觀眾，以及八位表演場域管理人員，再針對訪談內容做敘事分析。研究發現，街頭藝人走進街頭進行展演，需面對多種內外情境，包括街頭藝人自身的展演動機（熱愛表演、嘗試膽量與社群作用）、街頭舞台的展演條件（遮風避雨、觀賞位置、環境整潔與電力供應）以及街頭展演過程的實務困境（同類競爭、道具繁重、藝人飽和與演出限制）。儘管如此，街頭藝術還是持續受到藝人、觀眾與場域管理者的的廣泛青睞，原因是街頭藝術有其獨特的符號互動形式（視覺傳達、樂音沉浸、故事敘說、姿態展現與肢體接觸），並能帶給藝人、觀眾與場域豐富的社會效益。可以帶給街頭藝人「享受演出成就」、「認識多種朋友」、「認識場域文化」與「累積表演經驗」；帶給觀眾「偶遇的悸動」、「另類的藝術輕鬆」、「潛在的藝術激勵；也可帶動展演場域意象翻轉，像是「豐富場域活動」、「吸引人潮停留」與、「創造藝文氣氛」。[[abstract]]Street performance is increasingly valued by local governments to develop tourism industry and public leisure. The purpose of this study is to understand the performance benefits of street art, and to explore the implied benefits that street art performances bring to the artists themselves, audiences, and performance filed. It is hoped that through this research, street performers and the manager of performance field can better understand the interaction between street performers, audiences, and performance field, to contribute to the deepening and promotion of street performance in Taiwan.Therefore, this research uses qualitative research, in-depth interviews with 25 respondents, including nine street performers, eight street audiences, and eight performance field managers, and then conducts a narrative analysis of the interviews. The study found that street performers need to face a variety of internal and external situations when they engage with the street performance, including the performance motivation of the street performers (the passion of performance, courage and community interaction), the performance conditions of the stage on the street (water proof and wind proof devices, viewing position, clean environment and power supply) and the practical dilemma of the street performance process (same filed competition, heavy props, artist saturation and performance restrictions).Despite this, street performance continues to be widely favored by performers, audiences and performance field managers because of its unique forms of symbolic interaction (visual communication, musical immersion, storytelling, gesture display and physical contact), and It can bring rich social benefits to performers, audiences and the performance field. It can bring street performers to "enjoy achievements", "networking", "acquaint the field culture" and "accumulate the experience" bring the audience "the thrill of encounter", " leisure experience with alternative art", "potential of art inspires; it can also drive the image of the performance filed to flip, such as "enriching filed activities", "attracting people to stay" and "creating artistic atmosphere"
Cloud Service Innovation Model of Mobile Community Platform: A Case of Tencent
No full text[[abstract]]行動裝置與網路技術的發展改變大眾的生活模式，並透過社群平台縮短企業提供服務的距離，帶來許多服務創新與商業機會，然而目前有關行動雲端、服務創新的研究仍以整合性研究為主，強調兩者結合的實際應用與效用，少有針對行動雲端的服務創新進行相關性研究。因此本研究進行探索式個案研究，探討如何藉由行動雲端進行服務創新以及其中具體運作模式，挑選中國騰訊作為研究個案，蒐集個案公司自1998年至2021年8月事件資料，透過以文獻歸納事件分析架構，包含行動雲端服務類型五構面(IaaS、PaaS、SaaS、DaaS、CaaS)與服務創新模式四構面 (環境面、技術面、市場面以及組織面)，資料蒐集來源包含個案次級資料與專家深度訪談，對事件資料進行文本分析與內容分析。最終提出行動雲端服務創新概念性模型，三個前置因子(平台基礎建設投入、智能技術導入、顧客價值主張)會影響最終創新服務成效；中介因子包含研發社群協作、行動社群參與、服務提供社群協作與多元服務整合；政策法規影響為干擾變項，影響多元服務整合與績效間關係。[[abstract]]The development of mobile devices and Internet technology has been a significant change in public life, social platforms has shortened the distance between enterprises and customers, also influence service innovations and business opportunities. However, the current research on mobile cloud and service innovation still focus on integrated research, it emphasize the practical application and utility in between, and less research on service innovation of mobile cloud. Therefore, this research used an exploratory case study approach to explore how to use mobile cloud to carry out service innovation and the specific operation mode, and selects Tencent as the case. This research collected the data of the case company from 1998 to August 2021, and summarize the data analysis framework by literature, including a five-dimension cloud service model (IaaS, PaaS, SaaS, DaaS, CaaS) and a four-dimension service innovation model (environment, technology, market, organizational). The data source includes secondary data and in-depth interviews with experts, and use text analysis method and content analysis method for data analysis. Finally, this research propose a mobile cloud service innovation model, three predisposing factor (platform infrastructure investment, intelligent technology adaptation, customer value proposition) will affect the final innovation service performance; mediating factor include R&D community collaboration, mobile community participation, service providing community collaboration and multiple service integration; the influence of policies and regulations is an interference factor that affects the relation between multiple service integration and performance
Sustainable recyclate packaging in Indonesian food and beverage industry: a hybrid decision-making analysis in consumption stages
No full text[[abstract]]本研究為印度尼西亞的食品和飲料可持續包裝以及包裝產品的消費前、消費中、消費後階段建立了一個有效的理論模型。食品和飲料產品包裝由於回收率慢和回收物供應量低而在總廢物成分中占主導地位，並且包裝往往在消費後階段被亂扔垃圾。本研究旨在解決可持續包裝屬性，並了解哪個消費階段需要優先改進。採用混合法，模糊德爾菲法是對屬性進行剔除和驗證。使用模糊決策試驗和評估實驗室檢查和可視化屬性之間的相互關係。優先消費階段通過Choquet積分法確定。結果表明，消費後階段的根本目的是解決可持續包裝問題。本研究發現，保護能力、環境交流和成本考慮是改善可持續包裝的驅動因素。對於實踐，最高標準被確定為包裝回收、多方利益相關者互動、廢物處置基礎設施、廢物收集基礎設施和廢物處置管理。[[abstract]]This study establishes a valid theoretical model for food and beverage sustainable packaging in Indonesia along with packaged product pre-, during-, post-consumption stages. Food and beverage product packaging dominates the total waste composition due to slow recycling rates and low recyclate supply, and packaging tends to be littered in the post-consumption stage. This study aims to address the sustainable packaging attributes and understand which consumption stage needs prioritizing for improvement. The hybrid method is employed, fuzzy Delphi method is to eliminate and validate the attributes. The interrelationships among attributes are examined and visualized using fuzzy decision-making trial and evaluation laboratory. The priority consumption stage is identified by applying Choquet integral method. The result shows that post-consumption stage fundamentally aims to address sustainable packaging. This study finds conservation proficiency, environmental communication, and cost consideration are the driving aspects in improving sustainable packaging. For practices, the top criteria are identified as recylates for packaging, multistakeholder interaction, waste disposal infrastructure, waste collection infrastructure and waste disposal management
Research on the Sustainable Development of the Industrial Ecosystem Through Design Thinking in the Health Food Industry
No full text[[abstract]]全球健康保健意識意識形態興起，二十一世紀人民服用保健食品似乎已成為全民運動，又全世界人口老化現象加劇，促使面臨醫療支付大幅上漲，為此，世界各國保健養生的觀念開始普及化，國際市場上均有發展保健食品產業趨勢，因此，保健食品產業亦逐漸成為台灣及國際間深具發展潛力產業之一，其中又以非傳統食用型態的「膳食補充劑」銷售表現最佳。不只健康，更要健美，人口老化延伸出保健食品的商機，近年更吹向年輕族群。隨著科技日益發達，現代人卻越來越多文明病，治療與預防已非主流，現代人更追求日常保養，從內在養護到外在美容方方面面都要照顧，保健食品連結新世代及市場趨勢的變化，且規模持續成長並改變人們對於健康飲食型態，因此，健康食品產業生態圈的永續發展是一有趣與值得探討的議題。近年來，多數企業利用「設計思考」的思維模式成功的創新與轉型。設計思考是一種以「人」為本且著重跨領域溝通，利用創新思維及實踐的方法，達到改變企業的創新文化。因此，本研究加入設計思考元素來探討健康產業的永續發展乃為本研究之目的。本論文訪調對象以健康產業相關人士為主，包含：（1）保健食品產業生態圈中的決策者與高階主管；（2）保健食品相關研究者；（3）長期食用保健食品之消費者，施測目的針對18到75歲為限，回收142份的問卷。研究流程經過文獻探討、建立研究架構圖、設計問卷內容、蒐集問卷，彙整資料後透過層次分析法（AHP） 「Expert Choice 11.5」軟體進行檢測分析資料，探究保健食品產業透過設計思考對商業生態系統永續發展關鍵因素。研究結果顯示保健食品產業商業生態系統永續發展四個關鍵因素依重要性由大至小排序為「檢驗商」、「原料商」、「製造商」、「設計思考」。在「檢驗商」構面下以「技術更新」最為重要；「原料商」構面下以「原料安全性」最為重要；「製造商」構面下以「機能性配方」最為重要；「設計思考」構面下以「包裝防偽辯識」最為重要。以整體19項評估準則相對權重比較後發現，「原料安全性」是整體評估準則最重要的，第二順位是「技術更新」，第三順位是「機能性配方」。而在選擇最佳的投資標的國以「中國」為最重要選擇。總合上述結果可得知消費者期望之保健食品至少需有以下特性：（1）具有安全性認証；（2）具有提升身體機能性之配方及功能，而製造商以「消化系統」、「心血管系統」、「眼科系統」為主要生產產品可減少滯銷可能性，就整體而言，優化指標檢測方法，加強製程改良或新技術應用，產品配方設計以提升具功效成分訴求之產品為主，落實加強防偽技術之開發可提升保健食品產業商業生態系統整體競爭力，以上建議供保健食品生態系統相關產業參考。[[abstract]]In the 21st century, global health literacy emerged while functional food intake became universal. Due to the global ageing population and rising healthcare costs, global regimens and healthcare follow a developing trend. The functional food industry is one of the growing industries with potential internationally and domestically in Taiwan. Notably, dietary supplements in unconventional forms dominated functional food revenue.People want to stay healthy but also aim to be in good shape. In the past, the consequences of the ageing population led to growth in the functional food industry. Recently, younger generations have also shown interest. While technological progress, diseases of civilization also come to light, despite therapy and disease prevention are not the most favorites in modern days. Instead, people focus on a daily routine from health care to cosmetic care. Functional food connects with the new epoch and deeply changes our healthy dietary styles. While the effects market trend occurs, the functional food industries continue to grow. Therefore, a sustainable business ecosystem in the functional food industries is an engaging topic. In recent years, many enterprises have successfully implemented transformation plans and innovation via “design thinking”. Design thinking is a people-oriented concept that emphasizes cross-industry communication followed by innovative thinking and practice to create an innovative culture that transforms the company. This study aims to investigate the sustainable business ecosystem in the functional food industries with the concept of design thinking. Research participants connect with the functional food industry, including (1) decision-makers and executives in the functional food industry; (2) functional food investigators; (3) consumers that intake functional food regularly, aged between 18 to 75 years old, 142 questionnaire responses collected. The study process includes literature review, conceptual framework chart building, questionnaire design, and questionnaire responses collection. This study uses Analytic Hierarchy Process (AHP) method “Expert Choice 11.5” software for data analysis. The study analysis discovers key factors that support the functional food industry to reach a sustainable business ecosystem through design thinking.The study result shows the critical factors in the functional food industry with a sustainable business ecosystem, from most to least essential: inspection company, raw material supplier, manufacturer, and design thinking. In particular, the most important aspect of the “inspection company” is “technology upgrade”; the most important aspect of the “raw material supplier” is “raw material safeness”; the most important aspect under “manufacturer” is “functional food formulation”; the most important aspect under “design thinking” is “anti-counterfeit packaging”. In the comparison of the relative weight in all 19 columns, “raw material safeness” is the most crucial point under overall evaluation, whilst “technology upgrade” comes the second and “functional food formulation” comes the third. “China” is the most important among the best investment target selection based on country. Regarding the result above, functional food that aims to fulfil consumers’ expectations must at least include the characteristics below: (1) food authentication and (2) functional food formulation and function that strengthen body function. Manufacturers that principally produce “digestive system”, “cardiovascular system”, and “ophthalmic system” products are likely to decrease dead stock. In addition, optimize indicator tests, enhance process improvement and new technology applications, product formula design focus on improving product effectiveness, and ensure anti-counterfeit technology development can ameliorate the competitiveness of the business ecosystem in the functional food industry. Suggestions above are references for functional food-related industries
A Study of Marketing Strategy and Management of Enclosed Chain Store
No full text[[abstract]]新冠病毒(COVID-19)仍依舊持續影響著全球，然而連鎖便利商店在疫情之下的經濟表現卻是兩樣情，一種是經濟表現逆向成長之幹道、住宅型連鎖便利商店，另一種是屬於封閉型的連鎖便利商店如學校、醫院等空間，這類型的連鎖便利商店相對於第一種類型的商店，便受到較大的衝擊，因此本研究欲找出封閉型的連鎖商店，在受到外在環境衝擊時還能找出其他維持經濟的方法。本研究以商家的角度，瞭解封閉型連鎖便利商店之經營與行銷策略，並以安索夫的市場成長矩陣作為本研究構面，並搭配修正式德菲法作為研究方法，期望本研究結果能對醫院封閉型連鎖便利商店的經營與行銷上，建立有效的策略以提高疫情衝擊下的經濟狀況，並作為個案未來執行策略上的參考。 根據本研究發現，封閉型連鎖便利商店之重要順序與重要因素數量為「多角化經營策略」共5題、「市場開發策略」共5題、「產品開發策略」共6題、「市場滲透策略」共4題。[[abstract]]The Coronavirus Disease (COVID-19) still maintains a continuous impact, and it maintains a continuous impact on the spread of economic spread around the world. Convenience stores are an economical chain convenience store with a reverse growth path. The other is suitable as the main road for COVID-19. Such chain convenience stores, such as schools, hospitals, etc., are related to one type of store and are subject to the first shock. Therefore, this study aims to find out the closed chain stores, and find other ways to maintain the economy when they are impacted by the external environment. From the perspective of merchants, this research understands the operation and marketing strategies of closed chain convenience stores, and uses Ansoff's market growth matrix as the research dimension, and uses the modified Delphi method as the research method. For the operation and marketing of closed chain convenience stores in hospitals, establish an effective strategy to improve the economic situation under the impact of the epidemic, and use it as a reference for future implementation strategies of individual cases.According to the findings of this study, the important sequence and the number of important factors of closed chain convenience stores are 5 factors in “diversified business strategy”, 5 factors in “market development strategy”, 6 factors in “product development strategy”, and 4 factors in “market penetration strategy”
Analysis major virulence genes and regulatory genes of Clostridium difficile from university hospital at the western area of Taiwan
No full text[[abstract]]困難梭狀芽胞桿菌（Clostridium difficile）是一種重要的人畜共患病原體，可引起嚴重的胃腸道疾病。困難梭狀芽胞桿菌的嚴重感染會引起其他許多疾病，例如腹部絞痛，水樣腹瀉，與抗生素有關的腹瀉，中毒性巨結腸，結腸穿孔和敗血病，甚至威脅生命的假膜性結腸炎(pseudomembranous colitis ; PMC）也是由困難梭狀芽胞桿菌感染（Clostridium difficile infection ; CDI）所引起的嚴重結腸疾病。這些CDI疾病是通過糞便途徑傳播，主要影響醫院或長期護理機構中免疫力低下的患者，通常在使用抗生素治療後容易發生。許多研究表示，該疾病的嚴重程度與菌株是否包含腸毒素A（TcdA），細胞毒素B（TcdB）和二元毒素（binary toxin）有密切相關性。對tcdA、tcdB、cdtA、cdtB等基因和調節基因rstA的調查將是控制困難梭狀芽胞桿菌造成疾病傳播的重要策略。本實驗研究結果顯示，來自我們所蒐集到的困難梭狀芽胞桿菌分離株，大多數具有侵入腸道上皮細胞的毒性活性，並且這些主要毒力因子和調節因子，在每個分離株中都有所不同的表現。希望藉由本實驗研究所做出的結果，能夠提供更多的資訊，以增進對該病原菌致病機制的了解和認知。?[[abstract]]Clostridium difficile (C. difficile) is an importantly zoonotic pathogen and cause severe gastrointestinal disease. The severe infection of C. difficile would cause other many disease such as abdominal cramping, watery diarrhea, antibiotic-associated diarrhea, toxic megacolon, perforation of the colon, and septicemia. Life-threatening pseudomembranous colitis (PMC) is a severe colonic disease which caused by Clostridium difficile infection (CDI). These diseases of CDI are transmitted by fecal-oral route, which mainly affects low immunity of patients in hospitals or in long-term care facilities and usually occurs after use of antibiotic treatment. Many studies indicated that the severity of the disease will also be closely related to whether the strains were contained enterotoxin A (tcdA), cytotoxin B (tcdB) and binary toxin (cytolethal distending toxin). The survey of tcdA, tcdB, cdtA, and cdt B genes and regulatory genes rstA will be an important strategy in controlling the dissemination of C. difficile-associated severe disease. The results of study indicated that most C. difficile isolates from our study were the potentially toxic activity to invade the intestinal epithelial cells and these major virulence factors and regulatory factors were different in individual specimens. This study will provide more information to improve understanding and monitoring of pathogenesis
A Retrospective Study Comparing Enhanced Recovery After Surgery And Traditional Surgery in Elderly Patients Undergoing Total Knee Replacement
No full text[[abstract]]背景:實證文獻提倡以術後加速康復療程模式(Enhanced Recovery After Surgery, 簡稱 ERAS )，為手術全期照護之新概念，實現術後快 速康復成效。 目的:探討術後加速康復療程於老年全膝關節置換術患者術後恢復成 效。方法:回溯比較性研究法收集 2016 年 08 月 01 日至 2021 年 03 月 01 日，中部某醫院骨科資料庫接受「全膝關節置換手術」之住院患者病 歷資料，符合收案條件共 433 位，分為 ERAS 模式及傳統照護模式進 行資料分析。ERAS 模式含術前矯正營養狀態及肌力訓練、術中快速 甦醒麻醉逆轉劑、預防出血措施及避免管路留置策略、多模式疼痛控 制、術後肌力訓練運動及出院後轉介骨科個案管理師持續返家後追蹤。 傳統組則採用一般骨科病房常規照護模式。採用獨立樣本 t 檢定、卡 方檢定、重複測量變異數分析與Mann-WhitneyU檢定分析兩組成效。結果:ERAS 照護模式在手術及麻醉總時間、術後輸血率、及傷口引 流瓶留置率顯著低於傳統組(p0.05)。術後膝功能、疼痛及日常生活 功能方面，ERAS 組在 OKS 與 KSS 總得分優於傳統組。 結論:ERAS 照護模式相較傳統照護有加速康復之趨勢，研究結果可 提供骨科臨床照護之參考。[[abstract]]Background: The evidence based promotes that the new concept of taking care of patients by using Enhanced Recovery After Surgery (ERAS) to increase patient’s recovery speed after surgery.Purpose: To explore Enhanced Recovery After Surgery (ERAS) of elderly patients with total knee replacement surgery after surgery.Methods: This retrospective observational cohort study was conducted at a hospital in Taichung. Records created between August and March 31, 2021 were reviewed. In total, 433 patients who had total knee replacement surgery were included. Research data is divided into ERAS and traditional model for analysis. The ERAS modal included education patient properly nutrition condition and muscles strengthening before surgery, and using rapidly recovery neuromuscular reversal agent on general anesthesia, preventing excessive blood loss, and avoiding drainage tube indwelling strategies during surgery procedure and provided multimodal analgesia and muscle strengthening exercise after surgery . When patient was discharged, the patient would be referred to the orthopedic manager to constantly assessment and further consolation. However, the traditional model adopted general routine care in orthopedic ward. Independent sample t test, Chi-square test, Repeated measurement of variance and Mann-Whitney U test were used to analyze the effectiveness between the two groups.Results: The total time of operation and anesthesia, postoperative blood transfusion rate, and surgical drainage tube indwelling rate in patients with ERAS model were significantly lower than those in the traditional model (p0.05). In the term of the knee functions, pain and daily activities after discharged, in ERAS model the total score of OKS and the KSS total score had gotten a significant higher score than traditional group (p<0.05).Conclusion: That is a trend by utilizing ERAS modal in elderly patients undergoing knee replacement surgery has a tendency to accelerate recovery compared with traditional nursing. The results of this study can provide a reference for orthopedic clinical nursing