Feasibility assessment and implementation strategies of green care in rural Taiwan

Pursuing the rural idyll for retirement is especially a popular age-old dream for Taiwan people. Farming for health is an emerging trend, which drivers to initiate a green care service based on a combination of agriculture resources and traditional care. The purposes of this study were to assess the feasibility of green care in rural communities and to propose implementation strategies for varied rural area types in Taiwan. This study was conducted with two stags. A feasibility study comprising two aspects of political and environmental feasibilities was assessed in the first stage. The political feasibility was assessed based on social demand and government policies. Accordingly, three alternative models for senior green care participation were proposed, including green occupational therapy (for residents), rural long-stay tourism (for tourists), and agricultural working holiday (for volunteers). The environmental feasibility assessment was conducted in 102 rural communities in northern Taiwan. Five indexes, including the natural environment, rural resources, public facilities, senior care, and community capacity, were used to evaluate the potential of communities for developing green care. The results showed that green care implementing active aging in place in rural areas is feasible. Seventeen communities with plentiful or unique rural resources and high-quality community capacity were recommended as potential communities. In the second stage, a multiple case study was conducted in three communities representing different alternative models of green care. The community leader interviews, on-site investigations, vision forum, and operation workshop were adopted to propose the implementation strategies of green care for three communities, respectively, including human resource, volunteer or tourist management, revenue distribution, and marketing.

     

Increased Ca(2+) sparks and sarcoplasmic reticulum Ca(2+) stores potentially determine the spontaneous activity of pulmonary vein cardiomyocytes

Pulmonary veins (PVs) contain cardiomyocytes with spontaneous activity that may be responsible for PV arrhythmia. Abnormal Ca(2+) regulation is known to contribute to PV arrhythmogenesis. The purpose of this study was to investigate whether PV cardiomyocytes with spontaneous activity have different intracellular Ca(2+) ([Ca(2+)](i)) transients, Ca(2+) sparks and responses to isoproterenol and ryanodine receptor modulators (magnesium and FK506) than do PV cardiomyocytes without spontaneous activity and left atrial (LA) cardiomyocytes. Through fluorescence and confocal microscopy, we evaluated the [Ca(2+)](i) transients and Ca(2+) sparks in isolated rabbit PV and LA cardiomyocytes. PV cardiomyocytes with spontaneous activity had larger [Ca(2+)](i) transients and sarcoplasmic reticulum (SR) Ca(2+) stores than PV cardiomyocytes without spontaneous activity or LA cardiomyocytes. PV cardiomyocytes with spontaneous activity also had a higher incidence and frequency of Ca(2+) sparks, and had Ca(2+) sparks with larger amplitudes than other cardiomyocytes. Magnesium (5.4 mM) reduced the [Ca(2+)](i) transient amplitude and beating rate in PV cardiomyocytes with spontaneous activity. However, in contrast with other cardiomyocytes, low doses (1.8 mM) of magnesium did not reduce the [Ca(2+)](i) transients amplitude in PV cardiomyocytes with spontaneous activity. FK506 (1 muM) diminished the SR Ca(2+) stores in PV cardiomyocytes with spontaneous activity to a lesser extent than that in other cardiomyocytes. Isoproterenol (10 nM) increased the [Ca(2+)](i) transient amplitude to a lesser extent in LA cardiomyocytes than in PV cardiomyocytes with or without spontaneous activity. In conclusion, our results suggest that enhanced [Ca(2+)](i) transients, increased Ca(2+) sparks and SR Ca(2+) stores may contribute to the spontaneous activity of PV cardiomyocytes.