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16817939

Unabomber for President

The campaign won "Reason" magazine's worst bumper sticker for their effort "FED UP WITH 'PROGRESS'? Write-in UNABOMBER For PRESIDENT '96."

16818407

Evidence-based nursing

Evidence-based nursing (EBN) is an approach to making quality decisions and providing nursing care based upon personal clinical expertise in combination with the most current, relevant research available on the topic. This approach is using evidence-based practice (EBP) as a foundation. EBN implements the most up to date methods of providing care, which have been proven through appraisal of high quality studies and statistically significant research findings. The goal of EBN is to improve the health and safety of patients while also providing care in a cost-effective manner to improve the outcomes for both the patient and the healthcare system. EBN is a process founded on the collection, interpretation, appraisal, and integration of valid, clinically significant, and applicable research. The evidence used to change practice or make a clinical decision can be separated into seven levels of evidence that differ in type of study and level of quality. To properly implement EBN, the knowledge of the nurse, the patient's preferences, and multiple studies of evidence must all be collaborated and utilized in order to produce an appropriate solution to the task at hand. These skills are taught in modern nursing education and also as a part of professional training.

16818407

Evidence-based nursing

A spirit of inquiry refers to an attitude in which questions are encouraged to be asked about existing practices. Cultivating a spirit of inquiry allows healthcare providers to feel comfortable with questioning current methods of practice and challenging these practices to create improvements and change. A culture that fosters this should have a philosophy that incorporates EBP, access to tools that can enhance EBP, and administrative support and leadership that values EBP.

16818407

Evidence-based nursing

Key Elements to Foster EBP

16818407

Evidence-based nursing

PICOT formatted questions address the patient population (P), issue of interest or intervention (I), comparison group (C), outcome (O), and time frame (T). Asking questions in this format assists in generating a search that produces the most relevant, quality information related to a topic, while also decreasing the amount of time needed to produce these search results.

16818407

Evidence-based nursing

To begin the search for evidence, use each keyword from the PICOT question that was formed. Once results have been found on the intervention or treatment, the research can be rated to determine which provides the strongest level of evidence. There are seven levels of evidence, with a level I being of the strongest quality and a level VII being of the weakest quality:

16818407

Evidence-based nursing

The strongest levels of evidence, systematic reviews and meta-analyses, summarize evidence related to a specific topic by finding and assessing studies that specifically relate to the question being asked. Meta-analyses are systematic reviews that also use quantitative measures such as statistics to summarize the results of the studies analyzed.

16818407

Evidence-based nursing

Pyramid framework. Thinking of the information resources used to obtain evidence as a pyramid can help determine what the most valid and least biased evidence is. The top of the pyramid is just that. This is where decision support can be found, which is found within the medical record. The middle of the pyramid is the reviews of the evidence. This includes systematic reviews, practice guidelines, topic summaries, and article synopses. The bottom of the pyramid is the original studies. The bottom is also considered the foundation of the pyramid and where evidence begins. This includes research articles. Those who look for evidence here need special knowledge and skills to not only find the evidence itself but how to evaluate its worthiness.

16818407

Evidence-based nursing

To begin the critical appraisal process, three questions need to asked to determine the relevance of evidence and if evidence applies to population being cared for. The three questions are:

16818407

Evidence-based nursing

After asking these three questions, evidence appraisal continues by creating an evidence synthesis. This synthesis compares multiple studies to see if they are in agreement with each other.

16818407

Evidence-based nursing

After appraising the evidence, it is necessary to integrate it with the provider's expertise and patient's preferences. The patient is encouraged to practice autonomy and participate in the decision-making process. Therefore, even if the study had successful outcomes, the patient may refuse to receive a treatment. Assessment findings and patient history may reveal further contraindications to a certain evidence-based treatment. Lastly, availability of healthcare resources may limit the implementation of a treatment even if it is found to be effective in a study.

16818407

Evidence-based nursing

The next step in the evidence-based practice process is to evaluate whether the treatment was effective in terms of patient outcomes. It is important to evaluate the outcomes in a real-world clinical setting to determine the impact of the evidence-based change on healthcare quality.

16818407

Evidence-based nursing

The last step is to share the information especially if positive outcomes are achieved. By sharing the results of evidence-based practice process, others may benefit. Some methods to disseminate the information include presentations at conferences, rounds within one's own institution, and journal publications.

16818407

Evidence-based nursing

One method of research for evidence-based practice in nursing is 'qualitative research': "The word implies a entity and meanings that are not experimentally examined or measured in terms of quantity, amount, frequency, or intensity."

16818407

Evidence-based nursing

With qualitative research, researchers learn about patient experiences through discussions and interviews. The point of qualitative research is to provide beneficial descriptions that allow insight into patient experiences.

16818407

Evidence-based nursing

"Hierarchies of research evidence traditionally categorize evidence from weakest to strongest, with an emphasis on support for the effectiveness of interventions. That this perspective tends to dominate the evidence-based practice literature makes the merit of qualitative research unclear;" Some people view qualitative research as less beneficial and effective, with its lack of numbers, the fact that it is "feeling-based" research, makes the opponents associate it with bias. Nevertheless, the ability to empathetically understand an individual's experience (whether it be with cancer, pressure ulcers, trauma, etc.), can benefit not only other patients, but the health care workers providing care.

16818407

Evidence-based nursing

For qualitative research to be reliable, the testing must be unbiased. To achieve this, researchers must use random and non-random samples to obtain concise information about the topic being studied. If available, a control group should be in use, if possible with the qualitative studies that are done. Evidence should be gathered from every available subject within the sample to create balance and dissolve any bias. There should also be several researchers doing the interviewing to obtain different perspectives about the subject. Researchers must also obtain negative information as well as the positive information gathered to support the data. This will help to show the researchers were unbiased and were not trying to hide negative results from readers, and actually makes it possible to objectively understand the phenomenon under investigation. The inclusion of this negative information will strengthen the researchers' initial study, and may actually work in favor to support the hypothesis. Any data that has been gathered must be appropriately documented. If the data collected was obtained from interviews or observation, it must all be included.

16818407

Evidence-based nursing

Dates, times and gender of the sample may be needed, providing background on subjects, such as breast cancer in women over thirty-five. Any pertinent information pertaining to the sample must be included for the reader to judge the study as worthy.

16818407

Evidence-based nursing

In addition, the current evidence-based practice (EBP) movement in healthcare emphasizes that clinical decision making should be based on the "best evidence" available, preferably the findings of randomized clinical trials. Within this context qualitative research findings are considered to have little value and the old debate in nursing has been re-ignited related as to whether qualitative versus quantitative research findings provides the best empirical evidence for nursing practice.

16818407

Evidence-based nursing

In response to this crisis qualitative scholars have been called upon by leaders in the field to clarify for outsiders what qualitative research is and to be more explicit in pointing out the utility of qualitative research findings.

16818407

Evidence-based nursing

In addition, attention to "quality" in qualitative research has been identified as an area worthy of renewed focus. Within this paper two key problems related to addressing these issues are reviewed: disagreement not only among "outsiders" but also some nursing scholars related to the definition of "qualitative research", and a lack of consensus related how to best address "rigor" in this type of inquiry.

16818407

Evidence-based nursing

Based on this review a set of standard requirements for qualitative research published in nursing journals is proposed that reflects a uniform definition of qualitative research and an enlarged yet clearly articulated conceptualization of quality. The approach suggested provides a framework for developing and evaluating qualitative research that would have both defensible scholarly merit and heuristic value. This will help solidify the argument in favor of incorporating qualitative research findings as part of the empirical "evidence" upon which evidence-based nursing is founded.

16818407

Evidence-based nursing

Both legal and ethical issues are important in considering patient-based research. The American Nurses Association (ANA) has set up five basic rights for patient protection:

16818407

Evidence-based nursing

These rights apply to both researchers and participants. Informed consent is one area that nurses must be familiar with in order to complete research. Informed consent is "the legal principle that governs the patient's ability to accept or reject individual medical interventions designed to diagnose or treat an illness". Informed consent can only be obtained before the procedure and after potential risks have been explained to the participant. When dealing with the ethical portion of evidence-based practice, the Institutional Review Boards (IRB) review research projects to assess that ethical standards are being followed. The institutional review board is responsible for protecting subjects from risk and loss of personal rights and dignity. The IRB also come into play when deciding on which populations can be included in research. Vulnerable groups such as children, pregnant women, physically disabled or elderly maybe excluded from the process. Nurses must notify the IRB of any ethical or legal violations.

16818407

Evidence-based nursing

It is important to be up to date on all the appropriate state laws and regulations regarding vulnerable populations. This may mean consulting with lawyers, clinicians, ethicists, as well as the affiliated IRB. It is imperative that researchers act as advocates for these vulnerable persons that cannot do so for themselves.

16818407

Evidence-based nursing

The use of evidence-based practice depends a great deal on the nursing student's proficiency at understanding and critiquing the research articles and the associated literature that will be presented to them in the clinical setting. According to, Blythe Royal, author of "Promoting Research Utilization in nursing: The Role of the Individual, Organization, and Environment", a large amount of the preparation requirements of nursing students consists of creating care plans for patients, covering in depth processes of pathophysiology, and retaining the complex information of pharmacology. These are indeed very important for the future of patient care, but their knowledge must consist of more when they begin to practice. Evidence-based nursing in an attempt to facilitate the management of the growing literature and technology accessible to healthcare providers that can potentially improve patient care and their outcomes. Nancy Dickenson-Hazard states, "Nurses have the capacity to serve as caregivers and change agents in creating and implementing community and population-focused health systems." There is also a need to overcome the barriers to encourage the use of research by new graduates in an attempt to ensure familiarity with the process. This will help nurses to feel more confident and be more willing to engage in evidence-based nursing. A survey that was established by the Honor Society of Nursing and completed by registered nurses proved that 69% have only a low to moderate knowledge of EBP and half of those that responded did not feel sure of the steps in the process. Many responded, "lack of time during their shift is the primary challenge to researching and applying EBP." There is always and will always be a desire to improve the care of our patients. The ever-increasing cost of healthcare and the need for more accuracy in the field proves a cycle in need of evidence-based healthcare. The necessity to overcome the current issues is to gain knowledge from a variety of literature not just the basics. There is a definite need for nurses, and all practitioners, to have an open mind when dealing with the modern inventions of the future because these could potentially improve the health of patients.

16818407

Evidence-based nursing

There are many barriers to promoting evidence-based practice. The first of which would be the practitioner's ability to critically appraise research. This includes having a considerable amount of research evaluation skills, access to journals, and clinic/hospital support to spend time on EBN. Time, workload pressures, and competing priorities can impede research and development. The causes of these barriers include nurses' and other professional practitioners' lack of knowledge of research methods, lack of support from professional colleagues and organizations, and lack of confidence and authority in the research arena.

16818407

Evidence-based nursing

Another barrier is that the practice environment can be resistant to changing tried and true conventional methods of practice. This can be caused because of reluctance to believe results of research study over safe, traditional practices, cost of adopting new practices, or gaining momentum to rewrite existing protocols. It is important to show nurses who may be resistant to changes in nursing practice the benefits that nurses, their patients, and their institutions can reap from the implementation of evidence-based nursing practice, which is to provide better nursing care. Values, resources and evidence are the three factors that influence decision-making with regard to health care. All registered nurses and health care professionals should be taught to read and critically interpret research and know where to find articles which relate to their field of care. In addition, nurses need to be more aware of how to assess the information and determine its applicability to their practice.

16818407

Evidence-based nursing

Another barrier to implementing EBN into practice is lack of continuing education programs. Practices do not have the means to provide workshops to teach new skills due to lack of funding, staff, and time; therefore, the research may be tossed dismissed. If this occurs, valuable treatments may never be utilized in patient care. Not only will the patients suffer but the staff will not have the opportunity to learn a new skill. Also, the practitioners may not be willing to implement change regardless of the benefits to patient care.

16818407

Evidence-based nursing

Another barrier to introducing newly learned methods for improving treatments or patients' health is the fear of "stepping on one's toes". New nurses might feel it is not their place to suggest or even tell a superior nurse that newer, more efficient methods and/or practices are available.

16818407

Evidence-based nursing

Even if clinicians do act consistently it is possible that their decisions are consistently biased. People put different values on gains and losses. Tversky and Kahneman gave people the two identical problems (with the same probabilities of life and death outcomes - see fig 1) but framed the outcome choices as either lives saved or as deaths.10 Most people wanted to avoid taking risks with gains which could be safeguarded, but would take risks with losses which might be avoided; this is a framing effect. If people are given identical options but different words are used to emphasize a gain rather than a loss, then a different response is given by a large proportion of the population under study. Such a change in response appears to be inconsistent.

16818407

Evidence-based nursing

The Iowa Model is used to promote quality of care. It is a guideline for nurses in their decision making process. The decision making can include clinical and administration practices. These practices affect patient outcomes. The model is based on problem-solving steps that are a part of the scientific process. Recognition for applicability and ease of use. Key components of using the Iowa Model:

16898472

Project Sanguine

Project Sanguine was a U.S. Navy project, proposed in 1968 for communication with submerged submarines using extremely low frequency (ELF) radio waves. The originally proposed system, hardened to survive a nuclear attack, would have required a giant antenna covering two fifths of the state of Wisconsin. Because of protests and potential environmental impact, the proposed system was never implemented. A smaller, less hardened system called Project ELF consisting of two linked ELF transmitters located at Clam Lake, Wisconsin and Republic, Michigan was built beginning in 1982 and operated from 1989 until 2004. The system transmitted at a frequency of 76 Hz. At ELF frequencies the bandwidth of the transmission is very small, so the system could only send short coded text messages at a very low data rate. These signals were used to summon specific vessels to the surface to receive longer operational orders by ordinary radio or satellite communication.

16898472

Project Sanguine

The originally proposed system would have had a giant "antenna" consisting of of buried cables in a rectangular grid covering , two fifths of the state of Wisconsin, powered by 100 underground power plants in concrete bunkers. The cables were grounded at their ends, and loops of AC electric current flowed deep in the ground between the ends of the cable, generating ELF waves; this is called a "ground dipole". The original design was projected to cost billions and consume 800 megawatts of power. The goal was a system that could transmit tactical orders one-way to U.S. nuclear submarines anywhere in the world, and survive a direct nuclear attack.

16898472

Project Sanguine

The project was controversial from the start and was attacked by politicians, antiwar and environmental groups concerned about the effects of high ground currents and electromagnetic fields on the environment. The nuclear survivability of the system was made doubtful by Soviet development of MIRV ballistic missiles. After an attempt to resite the project in the Llano Uplift of Texas was also stopped by public opposition, the Navy abandoned Sanguine and proposed a series of increasingly modest variants: Project Seafarer (1975), Austere ELF (1978), and finally Project ELF (1981), which was constructed. This lower power system required 15 minutes to transmit each code group, so it was not used to transmit tactical orders directly but instead served the function of a "bell ringer", ordering a specific vessel to surface and receive further orders by ordinary radio or satellite communication. The system became nominally operational in 1989, 20 years after it first went online as "test facility," and was used until 2004, when the US Navy declared it obsolete and it was shut down and dismantled.

16898472

Project Sanguine

The scaled-down system the Navy constructed in 1969, called Project ELF, began official testing in 1982 and became officially operational in 1989. It consisted of two transmitter facilities, one at Clam Lake, Wisconsin and one at Republic, Michigan. with a total of of above-ground transmission line antenna. The two transmitters normally operated synchronized together as one antenna for greater range, but could also operate independently. The scaled down system was not designed to survive a nuclear attack.

16898472

Project Sanguine

The Clam Lake facility, which served as the test site and was originally called the Wisconsin Test Facility (WTF) consisted of two transmission line antennas (called ground dipoles) in the shape of a cross, with the transmitter station at their intersection. The Republic facility consisted of three transmission lines, two and one , in the shape of the letter "F" (the shape is not significant and was dictated by land availability). The lines, made of aluminum cable supported on insulators on wooden utility poles, resembled ordinary power transmission lines. The ends of the transmission lines were grounded by of buried copper cable and ground rods, later replaced by arrays of electrodes in deep boreholes The transmitters sent alternating currents of 300 amperes through the lines, which passed through the buried electrodes deep into the Earth.

16898472

Project Sanguine

The transmitters operated at a frequency of 76 Hz in the extremely low frequency band, with an alternate capability at 45 Hz and used a combined power of 2.6 megawatts. They were able to communicate with submarines over about half the world's surface. The system transmitted continuously, 24 hours a day, sending an "idle" message when it was not being used, so that submarines could verify they were within communication range.

16898472

Project Sanguine

Because of the extremely small bandwidth of the ELF band, the transmitters had a very slow data rate. They couldn't transmit voice (audio) but only short coded text messages of a few letters. Reportedly it took 15 minutes to transmit a single three-letter code group. Therefore the system was not used to relay operational orders, but served a "bell-ringer" function, ordering specific submarines to the surface to receive detailed orders by ordinary radio and satellite communications links.

16898472

Project Sanguine

The system was controversial, and was the target of legal attacks, suits and protests throughout its operating life. On five occasions protesters cut down transmission line poles, interrupting operation briefly.

16898472

Project Sanguine

In 2004, the Navy shut down both transmitters, with the explanation that very low frequency (VLF) communication systems had improved to the point that the ELF system was unnecessary.

16898472

Project Sanguine

Submarines are shielded by seawater from all ordinary radio signals, and therefore are cut off from communication with military command authorities while submerged. However radio waves of very low frequency can penetrate seawater; the lower the frequency the deeper in the ocean they can penetrate. Waves in the VLF range of 3 kHz to 30 kHz are able to penetrate to a depth of about 10 to 30 meters, and since WWII navies have used VLF transmitters to communicate with submarines. To receive VLF signals subs must rise to just under the surface or trail a shallow antenna buoy, making them vulnerable to detection by the enemy.

16898472

Project Sanguine

Radio waves in the extremely low frequency (ELF) band of 30 to 300 Hz can penetrate to a depth of hundreds of meters, allowing them to communicate with submarines at their normal operating depth. The lower the frequency, the longer the wavelength of the radio waves, and transmitters require longer antenna structures to generate them. ELF transmitters use huge antennas called ground dipoles consisting of tens to hundreds of kilometers of overhead cables resembling ordinary power transmission lines. The transmission lines are grounded at the ends, and looping currents deep in the Earth form part of the antenna. Because even these huge antennas are much smaller than the ELF wavelengths, they are extremely inefficient; only a tiny fraction of the input power is radiated as ELF waves, with the rest dissipated as heat in antenna resistance. At their full input power of 2.6 MW, both US ELF transmitters working together only generated about 8 watts of ELF radiation. This weak signal was able to reach submarines over half the globe only because of the extremely low attenuation of ELF waves of 1–2 dB per 1000 kilometers. ELF transmitters are most efficient when sited over certain low conductivity underground rock formations, which forces the currents to spread deeper through a larger volume of rock, forming a larger "antenna". The US system was located in Wisconsin and the Upper Peninsula of Michigan over the Laurentian Shield formation, for that reason.

16898472

Project Sanguine

Such ELF transmitters cannot be installed on submarines, because of the size of the antenna and high power requirements. So ELF communication is one-way, with a receiver in the submarine receiving orders from a shore station, but unable to reply. The low attenuation of ELF waves with distance allows a single ELF station to send messages to submarines all over the world.

16898472

Project Sanguine

Another drawback of ELF is that the ELF band has very small bandwidth, and therefore can only transmit very simple messages, very slowly. ELF signals cannot carry audio (voice) like other types of radio, and can only carry short text messages consisting of a few letters. The US Navy system (above) reportedly uses three-letter code groups and requires 15 minutes to transmit one group. So current systems are not used to transmit detailed orders, but serve a "bell ringer" function, to order a specific vessel to surface and receive further orders by ordinary radio or satellite communication.

16898472

Project Sanguine

The US, Russia, India, and China are the only nations known to have constructed ELF communication facilities. The Indian Navy has an operational ELF communication facility at the INS Kattabomman naval base to communicate with its Arihant class and Akula class submarines. The Russian Navy reportedly operates an ELF transmitter, ZEVS, located northwest of Murmansk on the Kola Peninsula in northern Russia.

16669903

Economic history of Taiwan

The recordkeeping and development of the economic history of Taiwan started in the Age of Discovery. In the 17th century, the Europeans realized that Taiwan is located on the strategic cusp between the Far East and Southeast Asia. Two main European empires that competed to colonize it were the Dutch and Spanish Empires. Taiwan also became an intermediate destination for trade between Western European empires and East Asia states. The history of Taiwan as a colony of the Dutch Empire, Kingdom of Tungning, Qing China, and Empire of Japan between 1630 and 1945 was based heavily on economics.

16669903

Economic history of Taiwan

In the 1950s, the Republic of China (ROC) government, retreated to Taiwan after losing the Chinese Civil War, carried out land reform policies such as the 375 Rent Reduction. In the 1960s, the agrarian economy was replaced with light industry as small and medium enterprises started to form. From 1966 to 1980, Taiwan's economy was gradually stabilized as the Ten Major Construction Projects laid a foundation in further economic developments. After the 1980s, the role of government in the economy gradually lessened as many government-owned corporations were privatized.

16669903

Economic history of Taiwan

According to archaeological evidences, Taiwan has been inhabited by human since the late Upper Paleolithic (ca. 50,000 - 10,000 BP). One of the first civilizations developed was the Changpin culture () in southern Taiwan. Many archaeological sites of Neolithic civilizations were found in the Taipei basin in northern Taiwan. The economic activities during this period, which cannot be described with detail as there was no written language, were fishing, gathering, and farming.

16669903

Economic history of Taiwan

About 2,000 years ago, northern Taiwan entered the Bronze Age. Iron metallurgy and advanced agricultural techniques strengthened economic activities. The Shihsanhang culture () rose during this period and had weaving technology. It did not end until the arrival of Han Chinese.

16669903

Economic history of Taiwan

Most scholars believe that the Shihsanhang culture represented the activities of the Taiwanese Plain Aborigines. Although there is no evidence to support this, it is generally recognized that the Taiwanese aboriginal tribes economically relied on fishing, hunting, and pursued slash-and-burn agriculture.

16669903

Economic history of Taiwan

In the early 17th century, the Dutch East India Company originally only traded along the Pescadores. However, the Ming Dynasty claimed the archipelago to be part of its territory and drove out the Dutch. The Dutch were forced to retreat to the main island of Taiwan, then known as Formosa. They established a trading post in Tayoan (modern-day Tainan City).

16669903

Economic history of Taiwan

The Dutch recognized the significance of cane sugar as an export product and extensively developed the industry in the areas under their control. Dutch exports of sugar rose rapidly throughout their colonial tenure and had reached 1,300 tons by 1660, a tenfold increase from 1636.

16669903

Economic history of Taiwan

The main purpose of the occupation of Taiwan was to trade with mainland China, Japan, Korea, and Southeast Asia, attempting to monopolize on the trade in East Asia. The main Taiwanese resources that they exported were sugar, sika deerskin, deer meat, antlers, rattan, and rice. By 1658, the company exported sugar to Persia, Japan, and Jakarta and had about 35 trading posts in Asia. Tayoan gained 25.6% profit, ranked second out of all of the Dutch trading posts, after Nagasaki, Japan. However, the profit was distributed to shareholders of the company, and not the local Taiwanese.

16669903

Economic history of Taiwan

At the time, the Japanese were also interested in commercial activities in Taiwan. As a result of the economic challenge from the Japanese, the Dutch East India Company levied heavy taxes on the Japanese merchants. In 1628, the Japanese kidnapped governor Pieter Nuyts and closed down the trading post in Nagasaki. It was reopened again in 1632, after Nuyts was extradited to be jailed in Japan.

16669903

Economic history of Taiwan

Amid the conquest of the Qing dynasty, the Ming partisan Koxinga invaded Dutch Formosa to use as a base for assaults along China's coast. After his successful siege of Ft Zeelandia, he had accomplished this but his rule caused the Qing to revive the sea bans and cut off maritime trade in a bid to weaken him. His dynasty ruled Taiwan as the independent Kingdom of Tungning, establishing land distribution systems in order to efficiently supply food for their army. British Empire and Japan continued to trade with Taiwan as an independent state. The English East India Company even established a commercial treaty with the Kingdom of Tungning.

16669903

Economic history of Taiwan

After defeating Koxinga's private army, the Qing dynasty had no interest in improving the economy of Taiwan, calling it an uncivilized land ("huawai zhi di"). Therefore, the economic activities mostly came from the settlements of migrants. The most significant economic development during this time period was the establishment of irrigation systems and hydraulic engineering projects. The agricultural surplus caused by these improvements led to the export of rice to mainland China. On the other hand, the commercial activities continued throughout major trading ports. Tainan, Lukang, and Banka became the three largest cities in Taiwan.

16669903

Economic history of Taiwan

In 1858, four ports were opened in Anping, Ta-kau, Keelung, and Tamsui as a result of pressures from the British and French Empires after the Second Opium War. These trading ports exported Taiwanese tea and camphor and further boosted the economy of Taiwan.

16669903

Economic history of Taiwan

For the most part, Taiwan's economy during the Japanese rule period was a colonial economy. For example, the human and natural resources of Taiwan were used to aid both the economic and military development of Japan. This policy began under Governor-General Kodama Gentarō and reached its peak in 1943, in the middle of World War II. Before the 1920s, the sugar industry dominated Taiwan's economy, while from 1920 to 1930, rice became the primary export. During these two periods, the primary economic policy of the Office of the Governor-General (OGG) was "industry for Japan, agriculture for Taiwan". After 1930, due to war needs the OGG began to pursue a policy of industrialization.

16669903

Economic history of Taiwan

Under Governor Akashi Motojiro, a vast swamp in central Taiwan was transformed into a huge dam in order to build a hydraulic power plant for industrialization. The dam and its surrounding area, known today as Sun Moon Lake, has become a must-see for foreign tourists visiting Taiwan.

16669903

Economic history of Taiwan

Although the main focus of each of these periods differed, the primary goal throughout the entire time was increasing Taiwan's productivity to satisfy demand within Japan, a goal which was successfully achieved. As part of this process, new ideas, concepts, and values were introduced to the Taiwanese; also, several public works projects, such as railways, public education, and telecommunications, were implemented. As the economy grew, society stabilized, politics was gradually liberalized, and popular support for the colonial government began to increase. Taiwan thus served as a showcase for Japan's propaganda on the colonial efforts throughout Asia, as displayed during the .

16669903

Economic history of Taiwan

After the Kuomintang retreat to Taiwan, the Taiwanese society was relatively stable politically in the 1950s. However, it faced some obstacles economically as a result of the mass destruction during World War II and the Chinese hyperinflation in the 1940s. The sudden increase in population caused by the Kuomintang migration from mainland China also affected Taiwan's economy.

16669903

Economic history of Taiwan

Facing the economic pressure, the Kuomintang regime established several economic plans and policies. Of primary importance for the long-run growth of this economy was the commitment to education, beginning with universal elementary education, expanded to upper level schooling as basic levels of literacy were attained. The New Taiwan dollars were issued to replace the Old Taiwan dollars. Successful land reform also took place, enabled by the KMT's interesting role as recent immigrants, and not vested landowners. In addition, the United States aid also helped the reformation of Taiwan's economy.

16669903

Economic history of Taiwan

The government also carried out an import substitution policy, taking what was obtained by agriculture to give support to the industrial sector, trading agricultural product exports for foreign currency to import industrial machinery, thus developing the industrial sector. The government raised tariffs, controlled foreign exchange and restricted imports in order to protect domestic industry. By the 1960s, Taiwan's import exchange industry was faced with the problem of saturating the domestic market. At the same time, the factories of some industrialized nations, because of rising wages and other reasons, slowly moved to certain areas that had both basic industry and low labor costs. By slow steps, the economic policy of Taiwan changed to pursue export expansion under advice of academic economists such as Ta-Chung Liu and Sho-Chieh Tsiang of Cornell University. They also promoted allowing interest rates to rise, to encourage domestic savings and expand the amount of resources available to fund new businesses. Additional academic advisers also members of Academic Sinica provided sound advice encouraging innovation in agricultural techniques, enabling one of the few successful takeoffs toward modern growth based on agricultural investment in cash crops for export.

16669903

Economic history of Taiwan

A major turning point in Taiwan's economy was during the 1970s. The expulsion of the Republic of China (Taiwan) from the United Nations in 1971, the 1973 oil crisis, and the switching of American diplomatic relations heavily affected the economy of Taiwan. But executive premier Chiang Ching-kuo's Ten Major Construction Projects served as the basis for heavy industrial development in Taiwan.

16669903

Economic history of Taiwan

After the 1980s, Taiwan's economy began to stabilize. It eventually became one of the Four Asian Tigers as a dynamic capitalist economy. The 1997 Asian financial crisis did not affect Taiwan nearly as harshly due to greater restrictions on the outflow of invested foreign capital than were in place in countries hurt by rapid capital flight. The Chen Shui-bian administration in the 2000s focused on joining international organizations. Taiwan was able to join the World Trade Organization in 2002.

16871120

Perthes test

The Perthes test is a clinical test for assessing the patency of the deep femoral vein prior to varicose vein surgery. It is named after German surgeon Georg Perthes.

16871120

Perthes test

The limb is elevated and an elastic bandage is applied firmly from the toes to the upper 1/3 of the thigh to obliterate the superficial veins only. With the bandage applied the patient is asked to walk for 5 minutes. If deep system is competent, the blood will go through and back to the heart.

16871120

Perthes test

If the deep system is incompetent, the patient will feel pain in the leg.

16871120

Perthes test

This test is sometimes referred to as the Delbet-Mocquot test, named after French physicians Pierre Delbet and Pierre Mocquot.

16871120

Perthes test

The test is done by applying a tourniquet at the level of the sapheno-femoral junction to occlude the superficial pathway, and then the patient is asked to move in situ. If the deep veins are occluded, the dilated veins increase in prominence.

16871120

Perthes test

This is a more objective test as it does not depend on patient's pain threshold.

16614130

Stanley family

The Stanley family (or Audley-Stanley family) is an English family with many notable members, including the Earls of Derby and the Barons Audley who descended from the early holders of Audley, Staffordshire. The Audley family in the male line lost prominence after its considerable estates were passed by a number of female heiresses in different branches of the family.

16614130

Stanley family

The use of "Stanley" as a first name began with political followers of the family.

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Stanley family

The first mention of Audley, Staffordshire is in the Domesday book of 1086, when it was called Aldidelege (Aldithley), when the lands were held by an English thegn called Gamel. The descent of the Audley and Stanley families can be traced back as far as two brothers of English origin, Ligulf of Aldithley, who held the estate during the reign of kings Stephen and Henry II, and his brother Adam, whose relationship, if any, to Gamel is unknown. The Stanley family later fabricated a Norman origin, at the time more prestigious than an English one, by pushing Ligulf back in time and presenting him, despite his non-Norman name and the English etymology of Aldithley, as son of an Adam, lord of a fictitious 'Aldithley in Normandy' and follower of William the Conqueror. Later, as pre-Norman ancestry came into vogue, their Stanley holding would be attributed to an Anglo-Saxon with the improbable Norman name of William. It is from Adam, brother of Ligulf, that the Stanley family traces descent.

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Stanley family

The extended Audley family, originally of Audley Castle but who later built (or re-built) Heighley Castle, Madeley, Staffordshire in 1226, had several additional households including Red Castle at Hawkstone in Shropshire, Buglawton Manor in Congleton, Newhall Tower at Newhall, Cheshire and a home in Nantwich. In the early 12th century Adam's grandson William married Joan de Stanley heiress of Stoneleigh, Staffordshire thereby becoming William de Stanley of Stoneleigh. This branch of the Audley thus took the name Stanley and Thomas Stanley, 1st Earl of Derby was a direct descendant.

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Stanley family

The main line of the Audley family, who had become Baron Audley in 1313, failed in 1391 when Nicholas Audley, 3rd Baron Audley died without a male heir. His sister Joanne married Sir John Tuchet (b 1327) for whose descendant John Tuchet (b 1371) the title of 4th Baron Audley was granted in 1408. He was succeeded by his son James Touchet, 5th Baron Audley. Later generations of the Tuchets became Earl of Castlehaven.

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Stanley family

Another branch of the Audley family was created by Hugh Audley of Stratton Audley, Baron Audley from 1317, whose son became 1st Earl of Gloucester. His daughter and heir Margaret de Audley, 2nd Baroness Audley, was abducted by Ralph de Stafford, 1st Earl of Stafford, to become his second wife, which despite some scandal, the king allowed.

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Stanley family

The last very prominent male to carry the Audley name was Thomas Audley, 1st Baron Audley of Walden KG, PC, KS (c. 1488 – 30 April 1544), an English barrister and judge who served as Lord Chancellor of England from 1533 to 1544, and earlier Speaker of the House of Commons. In typical Audley style, he left no sons and his estates passed via his daughter Margaret Audley, Duchess of Norfolk to the Howard family. She was both the cousin and sister-in-law of Lady Jane Grey, the latter by her first marriage to Lord Henry Dudley, the youngest son of John Dudley, 1st Duke of Northumberland, who later died.

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Stanley family

Between 1405 and 1736 the Stanleys were first King of Mann and later Lord of Mann (this with some gaps), a title reflecting the special status of the Isle of Man, that was later sold back to the Crown.

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Stanley family

The Audley and Stanley families and their descendants remained prominent throughout the history of England and Ireland into modern times. The Stanleys were, at one time, one of the richest landowning families in England.

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Stanley family

In 1385, Isabella de Lathom, the eldest daughter of parents who had no male heir, married Sir John Stanley and the Latham family (originally Lathom or Lothe Hom – "Brick house" from Lathom, Lancashire) and Stanley families became linked. Following this marriage, the Stanley family adopted the 'eagle and child' arms of the Lathom family and continue to use it to this day.

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Stanley family

Several successive generations of the Stanley Earls, along with other members of the family, have been prominent members of the Conservative Party, and at least one historian has suggested that this family rivals the Cecils (Marquesses of Salisbury) as the single most important family in the party's history.

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Stanley family

Arms of the Stanley Family descended from the Audley Family:

16614965

Jurhum

Jurhum (; also Banu Jurhum or The second Jurhum) historically referred to as Gorrhamite by the Greeks, was an old Arab tribe in the Arabian peninsula. Traditionally, they were a Qahtanite tribe whose historical abode was Yemen before they emigrated to Mecca.

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Jurhum

According to Arabic accounts, the tribe of the Jurhum gave protection to Hagar and her son Ishmael, a relationship cemented with Ishmael's marriage to a Jurhumite woman, Rala bint Mudad ibn 'Amr ibn Jurhum. The Jurhum are said to have been involved in the worship centering around the Kaaba, the holy sanctuary rebuilt by Ishmael and his father Abraham and revered as a pilgrimage site. According to one tradition, their custodianship over the Kaaba ended after they were ousted by the Khuza'a, a tribal group from the south.

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Jurhum

Islamic tradition further holds that Hagar and Ishmael found a spring in Mecca, the Zamzam well, from which the Jurhum wanted to drink, and that after their ousting by the Khuza'a tribe, the Jurhum collected the treasures dedicated to the Kaaba and destroyed the Zamzam well so that nobody would find it.

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Jurhum

The Jurhum are attested to in Greek literature. "Isma’il grew up among the Jurhum tribe, learning the pure Arabic tongue from them. When grown up he successively married two ladies from the Jurhum tribe, the second wife being the daughter of Mudad ibn ‘Amr, leader of the Jurhum tribe."

16547029

Agriculture in Madagascar

Agriculture employs the majority of Madagascar's population. Mainly involving smallholders, agriculture has seen different levels of state organisation, shifting from state control to a liberalized sector.

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Agriculture in Madagascar

Rice is the main produce and main export crop of Madagascar. It is mainly planted in a terraced paddy system in the central highlands. Other major subsistence crops include cassava, corn, and sweet potato, while coffee, cloves, vanilla and other cash crops are exported.

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Agriculture in Madagascar

Among livestock, zebu account for most of the cattle, while pigs, sheep and poultry are also raised. Fishing is popular, and aquaculture has grown in importance.

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Agriculture in Madagascar

Madagascar has seen high rates of deforestation, and the illegal extraction of highly valued timber species such as mahogany, ebony, and rosewood threatens native stands. The traditional slash-and-burn agriculture ("tavy") together with population growth put increasing pressure on the native and very diverse flora of Madagascar.

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Agriculture in Madagascar

Madagascar produced, in 2018:

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Agriculture in Madagascar

In addition to smaller productions of other agricultural products, like coffee (57 thousand tons), clove (23 thousand tons), cocoa (11 thousand tons), cashew (7 thousand tons) and vanilla (3 thousand tons).

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Agriculture in Madagascar

Agriculture in Madagascar is heavily influenced by the island's rainfall, which is generally abundant on the whole East coast, decreases sharply on the highlands, and falls to less than 500 mm per year in the South and South-West. The main growing season starts with the first rains in October – November. The cropping calendar greatly varies from region to region, according to the very different climatic conditions, soils and altitude.

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Agriculture in Madagascar

There are 2,4 million farms of which the large majority are smallholders. This sector is characterized by farms not exceeding 1,3 hectares on average, fragmented (which hampers mechanization), with a large variety of crops, extensive practices, traditional varieties, limited equipment and infrastructures and poor water control, producing barely enough to feed their families.

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Agriculture in Madagascar

Agricultural production is not constrained by lack of cultivable land. In fact, out of the 41 million hectares of agricultural land, only 3.5 million hectares are cultivated annually. The remainder of the area is under pastures (37.3 million ha) and forest (13 million ha). Irrigation would be possible over 1.5 million hectares of which about 1.1 million are somehow irrigated, with wide areas needing rehabilitation and investments

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Agriculture in Madagascar

Food crop production is the most important agriculture sub-sector accounting for around 75 percent of the cultivated area (2009). Rice is the staple food, covering 1.34 million hectares throughout the country – with the exception of some semi-arid areas in the South and in the South-West – under both rain-fed and irrigated systems. Other food crops include maize (mainly grown in the South and Central-East regions), cassava, sorghum (in the South), beans, groundnut, sweet potatoes and a wide variety of vegetables. Cassava is an important component of the smallholder's risk reduction strategy because it is drought tolerant and resistant to disease. Cassava, sweet potato and maize are the main source of calories in the lean season (from September to January). Groundnut is cultivated on sandy soils in most locations and makes an important contribution to household diet and income. The main cash crops are cotton, vanilla, coffee, litchi, pepper, tobacco, groundnut, sugar cane, sisal, clove and ylang-ylang.

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Agriculture in Madagascar

In general, levels of production and revenue of smallholders remain low due to a combination of multiple negative factors including land tenure insecurity, weak organisation of the agricultural filières, low intensity inputs use, no mechanization, and low soil productivity due to land degradation (especially erosion in the highlands). Nevertheless, rice production has increased from 2.4 million tons in 1990 to 4.0 million tons in 2009 thanks to the increase of both cultivated area (15 percent) and yields (40 percent).

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Agriculture in Madagascar

Traditional farming methods vary from one ethnic group or location to another, according to population density, climate, water supply. The most intensive form of cultivation is practiced among the Betsileo and Merina groups of the central highlands, where population densities are the highest. At the other extreme are the extensive slash-and-burn methods of brush clearing and shifting cultivation in the south and the east.