Tainan City Research Articles

Knowledge, attitude, and practice of dengue disease among healthcare professionals in southern Taiwan

Primary physicians and nurses serve as the first-line health care providers of dengue virus infection diagnosis, notification, and treatment. Knowledge, attitude, and practice (KAP) among primary healthcare professionals (HCPs) regarding dengue diseases may pace alarm and improve the outcome of dengue control. A cross-sectional survey using a structured quiz in 264 HCPs (response rate, 76%) was conducted in Tainan City in southern Taiwan. The quiz consisted of 10 questions regarding the control measures, notification, and clinical practices of dengue diseases. Scores of KAP and demographic characteristics of HCPs were analyzed. One hundred thirty-four physicians and 130 nurses comprise the 264 HCP responders. Forty-three physicians (32%) and 80 nurses (61.5%) were practicing in medical centers, and they scored higher than nonmedical center peers on quizzes on notification (1.18 vs. 0.93 points, p<0.01) but lower on control measures (3.52 vs. 3.22 points, p<0.01). Fifty-seven physicians (42.5%) were experienced in reporting suspected dengue cases, and 13.1% of nurses had reported dengue cases. Three-fourths of HCPs failed to respond to the timing of dengue case notification, whereas nurses scored higher than physicians (0.34 vs. 0.16, p<0.01). In addition, 57.2% of the HCPs failed to respond correctly to the timing of typical skin rashes occurring in the patients with dengue. More than half of the HCPs considered Taiwan an endemic area of dengue diseases. This pilot study showed a lack of acquaintance with notification timing and important clinical features of dengue among HCPs in southern Taiwan. Future continued medical/nursing education should place more emphasis on these factors to improve dengue control in this demographic area.

Wireless Machine-to-Machine Networks

1 School of Electronics and Applied Science, Aston University, Birmingham B4 7ET, UK 2Simula Research Laboratory, Fornebu, 1325 Lysaker, Norway 3Telecommunications Research Laboratory, Toshiba Research Europe Ltd., Bristol BS1 4ND, UK 4Department of Engineering Science, National Cheng Kung University, Tainan City 70101, Taiwan 5School of Electronic and Information Engineering, Beihang University, Beijing 100191, China

PHP61 To Evaluate the Effectiveness and Cost of Pharmaceutical Care Volunteer Set Up by Tainan City Government Involved in the Hospital Attached Home Care Patients

PHP61 To Evaluate the Effectiveness and Cost of Pharmaceutical Care Volunteer Set Up by Tainan City Government Involved in the Hospital Attached Home Care Patients

Use of automated external defibrillators in patients with traumatic out-of-hospital cardiac arrest

BackgroundBecause out-of-hospital cardiac arrests (OHCAs) due to a major trauma rarely present with shockable rhythms, the potential benefits of using automated external defibrillators (AEDs) at the scene of traumatic OHCAs have not been examined. MethodsWe conducted an observational, retrospective cohort study using an Utstein-style analysis in Tainan city, Taiwan. The enrollees were adult patients with traumatic OHCAs accessed by emergency medical technicians (EMTs) from January 1, 2004 to December 31, 2010. The exposure was the use or non-use of AEDs at the scene, as determined by the clinical judgment of the EMTs. The primary outcome evaluated was a sustained (≥2h) return of spontaneous circulation (ROSC), and the secondary outcomes were prehospital ROSC, overall ROSC, survival to hospital admission, survival at one month and favorable neurologic status at one month. ResultsA total of 424 patients (313 males) were enrolled, of whom 280 had AEDs applied, and 144 did not. Only 25 (5.9%) patients had received bystander cardiopulmonary resuscitation (CPR), and merely 21 (7.5%) patients in the AED group presented with shockable rhythms. Compared to the non-AED group, the primary and secondary outcomes of the AED group were not significantly different, except for a significantly lower prehospital ROSC rate (1.1% vs 4.9%, p<0.05). Multivariate analysis showed no significant interactions between the use of AEDs and other key variables. Use of the AED was not associated with sustained ROSC (OR 1.33; 95% CI 0.75–2.38, p=0.33). ConclusionsIn a community with a low prevalence of shockable rhythms and administration of bystander CPR in patients with traumatic OHCA, we found no significant differences in the sustained ROSC between the AED and the non-AED groups. Considering scene safety and the possible interruption of CPR, we do not encourage the routine use of AEDs at the scene of traumatic OHCAs.

Population Movement and Vector-Borne Disease Transmission: Differentiating Spatial–Temporal Diffusion Patterns of Commuting and Noncommuting Dengue Cases

Commuters who acquire dengue infections could be an important route for the transmission of the virus from their homes to workplaces. Understanding the effects of routine human movement on dengue transmission can be helpful in identifying high-risk areas for effective intervention. This study investigated the effects of local environmental and demographic characteristics to clarify the role of the daily commute in dengue transmission. We analyzed the clustering patterns of space–time distances between commuting and noncommuting dengue cases from June 2007 to January 2008 in Tainan City, Taiwan. We also analyzed the network topology of space–time distances to identify possible key individuals and conducted time-to-event analysis for geographic diffusion through commuting versus noncommuting dengue cases. Our significant findings indicate that most of the space–time distances of noncommuting cases clustered within 100 m and one week, whereas commuting cases clustered within 2 to 4 km and one to five weeks. Analysis of the temporality of the geographical diffusion by villages showed that commuting cases diffuse more rapidly across villages than noncommuting cases in the late epidemic period. The role of commuting was identified as a significant risk factor contributing to epidemic diffusion (hazard ratio: 3.08, p value < 0.05). Local neighborhood characteristics (number of vacant grounds and empty houses) are independent facilitating factors for diffusion through both noncommuting cases and commuting cases (hazard ratio: 1.035 and 1.022, respectively, both p < 0.05). Higher population density is a significant risk factor only for diffusion through commuters (hazard ratio: 1.174). In summary, noncommuters, mostly elderly adults and housewives, might initiate local outbreaks, whereas commuters carrying the virus to geographically distant areas cause large-scale epidemics.

THE PERFORMANCE ANALYSIS OF AN AKF BASED TIGHTLY-COUPLED INS/GPS INTEGRATED POSITIONING AND ORIENTATION SCHEME WITH ODOMETER AND NON-HOLONOMIC CONSTRAINTS

Abstract. INS/GPS integration scheme can overcome the shortcoming of GPS or INS alone to provide superior performance, thus this study implements a tightly-coupled INS/GPS integration scheme using AKF as the core estimator by tuning the measurement noise matrix R adaptively. The AKF is based on the maximum likelihood criterion for choosing the most appropriate weight and thus the Kalman gain factors. The conventional EKF implementation suffers uncertain results while the update measurement noise matrix R and/or the process noise matrix Q does not meet the case. The primary advantage of AKF is that the filter has less relationship with the priori statistical information because R and/or Q vary with time. The innovation sequence is used to derive the measurement weights through the covariance matrices, innovation-based adaptive estimation (IAE) in this study. The covariance matrices R are adapted in the study when measurements update with time. A window based approach is implemented to update the quality of GPS pseudo-range measurements by adaptively replace the measurement weights through the latest estimated covariance matrices R. The use of odometer is particularly recommended when a low cost and precise vehicle localization system has to be implemented and there is the risk of GPS coverage failure, which is prone to happen when the vehicle enters a tunnel or cross deep valleys. Odometers are applied in land-vehicle navigation to provide augmented host velocity observations for standalone INS system in this study. There are two non-holonomic constraints (NHC) available for land vehicles. Land vehicles will not jump off the ground or slid on the ground under normal condition. Using these constraints, the velocity of the vehicle in the plane perpendicular to the forward direction is almost zero. EKF and AKF based tightly-coupled scheme with NHC is implemented in the study. To validate the performance of AKF based tightly-coupled INS/GPS integration scheme with odometer and NHC, field scenarios were conducted in the downtown area of Tainan city. The data fusion of INS/GPS/Odometer/NHC can be used as stand-alone positioning tool during GPS outages of over 1 minute, and AKF based tightly-coupled INS/GPS integration scheme can be more stable combined with odometer and NHC during GPS outages of over 1 minute likewise.

Laparoscopic heminephrectomy and ureterectomy for lower moiety urothelial carcinoma in a complete duplex right kidney

Here, we present a rare case in which a urothelial carcinoma was located at the lower moiety of a complete duplex right kidney. Authors: PEI-YU LIN1, VICTOR CHIA-HSIANG LIN1,2, RENG-HONG WU3, TSAN-JUNG YU1,2 Department of Urology 1, E-Da Hospital/I-Shou University, Kaohsiung City 2, Department of Radiology3, Chi-Mei Medical Center, Tainan City, Taiwan Corresponding Author: Victor […]

Longitudinal analyses of geographic differences in utilization rates of children with developmental delays who participation in early intervention services

The purposes of the present study were to describe the longitudinal utilization rates of participation in early intervention services of children with developmental delays, and to examine the geographical difference of services in this vulnerable population. We analyzed service utilization of the developmentally delayed children based on data of governmental reported early intervention services from year 2003 to 2009 in Taiwan. Results show that, the utilization rate of early intervention services was 9.18‰ (range=6.96-12.09‰) of children in 0-5 years during the past 7 years. Mean utilization rate in age group of 0-2 years was 8.32‰ (range=5.73-10.93‰), and age group of 3-5 years was 9.92‰ (range=7.78-13.78‰). We found that the utilization rate in all children aged 0-5 years (R(2)=0.93; p<0.001), boy group (R(2)=0.93; p<0.001) and girl group (R(2)=0.92; p=0.001) were significant increased gradually. The higher utilization rate of early intervention services (aged 0-5 years) were more likely to locate in the north cities (Keelung City=14.65‰; Taipei City=13.49‰), east areas--Hualien County (14.03‰), Taitung County (11.76‰) and central or south counties such as, Chiayi City (14.05‰), Tainan City (12.47‰), and Miaoli County (12.38‰). Hsinchu County (5.97‰), Kaohsiung City (6.21‰), Taichung County (6.74‰), Taipei County (6.95‰) have lower utilization rates of early intervention in Taiwan. The study highlights that the health care system should close the gaps in geographic disparities of early intervention services for children with developmental delays, and respond timely to the needs of these vulnerable children and their families.

The relationship between adolescent body size and health promoting behavior and biochemical indicator factors

Tainan City has the third highest prevalence of junior high school student obesity of all administrative districts in Taiwan. School nurses play an important role in promoting student health. Understanding the factors that significantly impact student weight is critical to designing effective student health promotion programs. This study explored the relationships between health promotion behavior and serum biomarker variables and body size. Researchers used a cross-sectional descriptive study design and stratified cluster random sampling. Subjects were 7th graders who received an in-school health checkup with blood test at 41 public junior high schools in Tainan City between July 2010 and May 2011. Research instruments included the adolescent health promotion (AHP) scale, serum biochemical profile and BMI (body mass index). Obtained data were analyzed using descriptive and inferential statistics. Of the 726 students who participated in this study, 22.2% were underweight and 23.8% were overweight or obese. Higher AHP scores correlated with better biomarkers and body size. Multivariate analysis found factors that increased the risk of being overweight included: being male, having a father with a relatively low level of education, playing video games frequently, and doing little or no exercise (odds ratio = 1.93, 1.75, 1.07, 1.04, respectively). Participants with relatively healthy behaviors had better biomarkers and a lower risk of being overweight. Findings can support the development of evidence-based school programs to promote student health.

Depressive symptoms in addition to visual impairment, reduced strength and poor balance predict falls in older Taiwanese people

to determine whether depression is an important and independent predictor of falls in community-dwelling older people living in Taiwan. longitudinal study. five randomly selected villages from Tainan city, Taiwan. in total, 280 community-dwelling people not taking anti-depressant medication aged 65-91 years (mean age 74.9). Participants completed the Geriatric Depression Scale and underwent a range of sensorimotor, balance and mobility tasks and were then followed up for 2 years with monthly telephone calls to determine falls incidence. of the 260 participants with complete follow-up data, 174 (66.9%) experienced no falls, 51 (19.6%) fell once and 35 (13.5%) fell two or more times. Depressive symptoms were significantly more prevalent in recurrent fallers (40.0%) and once-only fallers (27.5%) compared with non-fallers (16.1%). Negative binomial regression analysis identified depression, poor depth perception, reduced lower limb strength and increased sway as independent and significant predictors of falls. depressive symptoms were found to be common in older Taiwanese people and associated with an increased fall risk. These findings suggest that in addition to implementing approaches to maximise vision, strength and balance, fall prevention strategies should also include interventions to assess and treat depression.

A Study to Assess Shade in Tainan City for Thermal Comfort

This study examined “EEWH-HI” standards of shade in Tainan, and used rain and the sun as indicators to verify The Plan of Good Looking Corner to improve urban thermal comfort levels on the roads. The Plan of Good Looking Corner in Tainan was ran by the Tainan City Government for schools, offices, green spaces, squares, communities, and other public spaces, to create corners of green in order to beautify and improve the overall urban landscape. This study selected 173 locations to conduct assessments for shade indicators from the rain and sun. Statistical analysis, ANOVA, Regression Analysis, and the Correlation Coefficient method were applied to clarify the impact factor effects of urban shade and thermal comfort to prepare final recommendations.

Comparison of surface heat balance in three cities in Taiwan using Terra ASTER and Formosat-2 RSI data

In order to investigate the influences of the city scale, usage, topography, and climate on surface heat balance, the authors compared the surface heat balance for three urban areas in Taiwan, namely, Kaohsiung City, Taichung City, and Tainan City, estimated using ASTER and Formosat-2 data. The net radiation was in a similar range in all three study areas because the cities are in close proximity to each other. Tainan City released 60–70% of the sensible heat flux of the other cities because of its smaller size. Taichung City, which is located in a basin, exhibited the largest sensible heat flux, due to the radiation cooling during the night before the observation. Anthropogenic heat discharge clearly decreased the storage heat flux in certain industrial areas in Kaohsiung City and Taichung City, while the small scale urban functions moderated the variation of storage heat flux in Tainan City. These results imply that the terrain around a given city as well as the scale of urban activity significantly affect the heat balance in the cities.

Exploring Tourists' Stated Preferences for Heritage Tourism Services – the Case of Tainan City, Taiwan

This study examines tourists' preferences and taste variations with regard to heritage service attributes and tourists' willingness to pay for service attributes in Tainan city, Taiwan, using a choice experiment approach. The results indicate that service attributes, such as outdoor catering services, longer operating hours and entrance fees, exhibit significant effects on tourists' preferences. Tourists appear to be willing to pay extra money to use more service attributes at heritage attractions.

Spatial performance to locate city fire stations

Analysis of the spatial characteristics of disasters is a critical component of accurate disaster prevention planning and management. Reports from the Tainan City Fire Department were analysed to explore the spatial distribution of incident locations via address matching, spatial coordination transformation and GIS technologies. The characteristics of these locations were further investigated using spatial autocorrelation analysis in order to explore potential future demand for emergency rescue services. The performance levels of existing and newly added emergency rescue facilities were analysed using maximal covering location problem tests and Lagrangian heuristic calculations. These methods are able to simulate and analyse rescue performance after new facilities have been added to a system and the results can also be used to guide the future locations of rescue facilities.

文化与创意：台南市安平海山馆的个案研究

本文旨在采用所谓“文化政策三支柱”观点：科技、机构与空间文化，探讨现行台南市的文化政策，并以台南市古蹟的文化创意活动与再生计画为经验研究的对象。本文采用的研究方法主要包括深入访谈、参与观察法以及文件分析等三种方法。所需资料主要来自21位游客的访谈答案，并以质性分析法进行研究。研究结果发现：1) 台南市在“科技、沟通与媒体”与“机构、艺术与文化”此二支柱的表现尚佳，惟“空间文化与公开表演”支柱的表现较为不足。2) 目前安平海山馆/海山派乐地的成效仅在“科技、沟通与媒体”此一支柱方面的表现尚佳，而“机构、艺术与文化”与“空间文化与公开表演”此二支柱的表现较为不足，仍待加强。3) 文化标籤尚未能够应用到台南市城市生活之中，而且社会–经济发展也未被充分整合至城市之中。最后，本文提出一个都市必须努力建构并采用所谓“创意/文化城市模型”的呼吁，作为未来研究方向。 The aim of this paper is to explore cultural policy in Tainan City via “three cultural pillars” con-cepts: Technology, Institutions, and Spatial Culture. We will take on empirical study on cultural/creative ac-tivity and regeneration plan in relics in Tainan City. Some major research methods are applied, including in-depth interview, participant observation and document analysis. Data will be obtained from the interview answers of about 21 visitors and analysed via qualitative method. The outcomes of the paper are as follows: 1) Tainan City has good credits in “Technology” and “Institutions”, but insufficient in “Spatial Culture and Pub-lic Performance”. 2) Haishan Hall has only good credits in “Technology”, but insufficient in “Institutions” and “Spatial Culture and Public Performance”. 3) Images and charmingness of “Cultural Ancient City” have not yet integrated into city life and it is same as socio-economic development. Furthermore we think one city must construct a “creative/cultural city model” as its city’s future direction.

More medical resources do not imply better quality of life : A population- based study in Taiwan

Studies regarding medical resources input-output (I/O) efficiencies gained increasing importance in recent years. Most of published studies measure medical resources I/O efficiencies of hospitals or clinics, however, very limited number of studies investigating nation-wide medical resources I/O efficiencies. Besides, there was also very limited number of studies using population data of quality of life (QOL) as an outcome variable. The aim of this study was to investigate nation-wide medical resources I/O efficiencies of Taiwan, by using national medical service volumes statistics as input variables and population QOL as outcome variables. The population QOL data were from 2005 National Health Interview Survey (NHIS) and the national medical service volumes statistics were from 2005 National Statistics of Health Care Providers and Medical Services, which were issued by Department of Health in Taiwan. The population QOL was measured by SF-36. The data envelopment analysis (DEA) method was used to investigate the medical resources I/O efficiencies. Twenty three cities and counties of Taiwan were regarded as decision making units (DMUs). The results showed that 40% of cities and counties achieved efficiency regarding health care resources allocation. The results showed that the Tai-Nan city (an emerging high-tech city) and the Taiwan capital, Taipei City, were the two lowest QOL DMU. In summary, cities with high tech development and with more medical resources are not necessarily the cities with better quality of life.

The Elderly Access to On-Line Local Government Social Relief Information: Practices in Taiwan

There are numerous studies analyzing the quality of governments’ websites produced by academics, but very little analysis has been done regarding specific users, especially senior people. This leads the authors to evaluate the quality of Websites of Taiwan's local governments in facilitating internet access to spread social relief information to their low-to-mid-income families. Following and modifying the model of Perez et al. (2005), the objective of this study is to obtain a series of indicators that represent how access and navigability the websites are. In sum, the friendly index (FI) is highest in the case of the Yunlin county Web page, with a friendly index value of 90 percent. And Tainan city Web page gets a friendly index value of 20 percent.

The Research of City-County Consolidation and People Intentions - an Empirical Study on the Cases of Tainan

This study uses the case of Tainan City, the old city typical of Taiwan history and culture, to explore, by questionnaire survey, the people's anticipation for and feeling about the changes of ten effects of city-county consolidation and their satisfaction with 17 aspects of municipal governance before and after the consolidation. The study also investigates the variation of influences by the personal traits of the subjects. The research found that the items of improvement anticipated by the subjects for the city-county consolidation focused on the overall development of the city. Less priority was given to the anticipated improvement on the items of actual service to the individual. That matches the vision as the theme of policy marketing by the local government when it was making the city-county consolidation happen, and is identical to the items of improvement which the people were satisfied with after the consolidation as well. It indicates that the policy marketing by the local government in making city-county consolidation happen with the vision creation as the object instead of setting administrative reform as the theme did better in gaining people's recognition for the city-county consolidation policy and made it smooth for the government to lead the execution of the consolidation. In addition, almost seventy percent of the subjects thought after the consolidation that the city-county consolidation had no significant effect on the improvement of governance. In summary, it was found in the case herein that the creation of vision for the consolidation as the theme of policy marketing during the process of administrative zone consolidation did successfully gain people's recognition for the realization of the vision and idea. However, the overall decline of satisfaction with the aspects of governance after the consolidation and people's disappointment with urban construction, traffic convenience and administrative efficiency indicate that the increase of governance efficacy soon after consolidation not being recognized by people is relevant. Yet, there may be other external factors, for instance, the timing of survey was too close to the consolidation or the replacement of the administrative team.

Two-Frequency Ultrasonic System with Direct Digital Frequency Synthesizers and Vernier Caliper Phase Meter for Measuring Air Temperature

Department of Electrical Engineering, National Cheng Kung University, No. 1, University Road, Tainan City 701, Taiwan, R.O.C. 1Department of Computer Science and Information Engineering, Cheng Shiu University, No. 840, Chengcing Rd., Niaosong Dist., Kaohsiung City 83347, Taiwan, R.O.C. 2Department of Electronic Engineering, I-Shou University, No. 1, Sec. 1, Syuecheng Rd., Dashu District, Kaohsiung City 84001, Taiwan, R.O.C. 3Department of Electronic Engineering, Cheng Shiu University, No. 840, Chengcing Rd., Niaosong Dist., Kaohsiung City 83347, Taiwan, R.O.C.

Occupational hand dermatitis among cement workers in Taiwan

Occupational dermatitis among cement workers is a major occupational health concern. The two most important occupational hazards for cement workers are irritant and allergic cement contact dermatitis. The objective of this study was to investigate the severity of occupational cement contact dermatitis and the common allergens among cement workers in Taiwan. A total of 97 cement workers from the Cement Workers' Association of Tainan City and County participated in this study. A structured questionnaire was used to evaluate the demographic data and work-related activities of these cement workers. A complete skin examination was conducted, and skin manifestations were assessed by a dermatologist. Allergens from European Standard Tray (Chemotechnique Diagnostic AB, Sweden) with a total of 25 substances were used for patch testing. Our results showed that 65 out of 97 cement workers were suffering from occupational cement hand contact dermatitis. The most affected skin area was the hand. Thickening of the dorsal surface of the hand, especially around the metacarpophalangeal joint area, and hyperkeratosis of the palm were the major skin manifestations. The results of the patch test showed that 24 out of 97 were allergic to potassium dichromate, nine were allergic to thiuram mix, nine were allergic to fragrance mix and seven were allergic to cobalt chloride. The final diagnosis, based on the results of the skin examination and the patch test, showed that 43 of 97 cement workers had irritant cement contact dermatitis and 22 had allergic cement contact dermatitis. We conclude that occupational cement hand dermatitis among cement workers is an important and severe issue in Taiwan, and the most common allergens among cement workers are potassium dichromate, thiuram mix, fragrance mix and cobalt chloride. The high positive rate of chromium hypersensitivity among cement workers reflects the urgency to regulate the addition of ferrous sulfate to cement in Taiwan.