Search results for: Tainan

Authors: Tsung-Han Lin, Chia-Han Yang

Abstract:

Recently, it’s obvious that many hotels not only provide customized service, but offer local culture to give customers different experiences. Luxury decoration and fancy equipment are not enough anymore. Customers expect that hotels not just as an accommodation, but connecting to their trips. Therefore, culture becomes significant when developing marketing strategy for hotels. Tainan, located in south of Taiwan, is the city full of culture that some hospitality industries promote their hotels exactly base on culture. Historic Tainan (台南; táinán), is a city of ancient monuments, delicious food and, above all, temples: there are more gods worshipped and more festivals and rituals observed in Tainan than in any other place in Taiwan. The oldest and most absorbing parts of Tainan are historic Anping, on the west side of town by the sea, and the cultural zones in the heart of the old city; the latter were created specifically to make things easier for visitors, with city information, signs and maps tailored to each zone and well-marked in English. The Chihkan, Dong-an Fang, Five Canals and Confucius Temple cultural zones contain the richest concentration of sights – reckon on spending at least two days to do them justice. As a result, the study aims to analyze the significance of culture on marketing strategies and C and H two hotels in Tainan city as case studies conducting the comparison of cultural marketing and experience marketing to provide a framework for hotels to develop their marketing strategies.

Keywords: cultural marketing, hospitality, historical city, Tainan city

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Authors: Tzu-Jung Tseng, Pei-Hsuen Han, Tsung-Hsueh Lu

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Background: Choropleth mortality map is commonly used to identify areas with higher mortality risk. However, the use of choropleth map alone might result in the misinterpretation of differences in mortality rates between areas. Two areas with different color shades might not actually have a significant difference in mortality rates. The mortality rates estimated for an area with a small population would be less stable. We suggest of bringing the 95% confidence intervals (CI) into the choropleth mortality map to help users interpret the areal mortality rate difference more properly. Method: In the first choropleth mortality map, we used only three color to indicate standardized mortality ratio (SMR) for each district in Tainan, Taiwan. The red color denotes that the SMR of that district was significantly higher than the Tainan average; on the contrary, the green color suggests that the SMR of that district was significantly lower than the Tainan average. The yellow color indicates that the SMR of that district was not statistically significantly different from the Tainan average. In the second choropleth mortality map, we used traditional sequential color scheme (color ramp) for different SMR in 37 districts in Tainan City with bar chart of each SMR with 95% CI in which the users could examine if the line of 95% CI of SMR of two districts overlapped (nonsignificant difference). Results: The all-causes SMR of each district in Tainan for 2008 to 2013 ranged from 0.77 (95% CI 0.75 to 0.80) in East District to 1.39 Beimen (95% CI 1.25 to 1.52). In the first choropleth mortality map, only 16 of 37 districts had red color and 8 districts had green color. For different causes of death, the number of districts with red color differed. In the first choropleth mortality map we added a bar chart with line of 95% CI of SMR in each district, in which the users could visualize the SMR differences between districts. Conclusion: Through the use of 95% CI the users could interpret the aral mortality differences more properly.

Keywords: choropleth map, small area variation, standardized mortality ratio (SMR), Taiwan

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Authors: Wen-Juinn Chen, Yi-Phei Chou, Jou-Han Wang

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Tainan coast is suffering from beach erosion, wave overtopping, and lowland flooding; though most of the shoreline has been protected by seawalls, they still threatened by sea level rise. For coastal resources developing, coastal land utilization, and to draft an appropriate mitigate strategy. Firstly; we must assess the impact of beach erosion under a different scenario of climate change. Here, we have used the meteorological data since 1898 to 2012 to prove that the Tainan area did suffer the impact of climate change. The result shows the temperature has been raised to about 1.7 degrees since 1989. Also, we analyzed the tidal data near the Tainan coast (Anpin site and Junjunn site), it shows sea level rising with a rate about 4.1~4.8 mm/year, this phenomenon will have serious impacts on Tainan coastal area, especially it will worsen coastal erosion. So we have used Bruun rule to calculate the shoreline retreated rate at every two decade period since 2012. Wave data and bottom sand diameter D50 were used to calculate the closure depth that will be used in Bruun formula and the active length of the profile is computed by the beach slope and Dean's equilibrium concept. After analysis, we found that in 2020, the shoreline will be retreated about 3.0 to 12 meters. The maximum retreat is happening at Chigu coast. In 2060, average shoreline retreated distance is 22m, but at Chigu and Tsenwen, shoreline may be backward retreat about 70m and will be reached about 130m at 2100, this will cause a lot of coastal land loss to the sea, protect and mitigate project must be quickly performed.

Keywords: sea level rise, shoreline, coastal erosion, climate change

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Authors: Yi-Ju Lee

Abstract:

This study identified the hypothesized relationships among tourist emotion, creative experience, and behavioral intention of handmade ancient candy in Tainan, Taiwan. A face-to-face questionnaire survey was administered in Anping, Tainan. The result also revealed significant positive relationships between emotion, creative experience and behavioral intention in handmade activities. This paper provides additional suggestions for enhancing behavioral intention and guidance regarding creative tourism.

Keywords: creative tourism, sense of achievement, unique learning, interaction with instructors

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Authors: Wei Ting Han, Shiann-Far Kung

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In the early time, most of the arable land is dry farming and using rainfall as water sources for irrigation in Tainan county. After the Chia-nan Irrigation System (CIS) was completed in 1930, Chia-nan Plain was more efficient allocation of limited water sources or irrigation, because of the benefit from irrigation systems, drainage systems, and land improvement projects. The problem of long-term drought, flood and salt damage in the past were also improved by CIS. The canal greatly improved the paddy field area and agricultural output, Tainan county has become one of the important agricultural producing areas in Taiwan. With the development of water conservancy facilities, affected by national policies and other factors, many agricultural communities and settlements are formed indirectly, also promoted the change of settlement patterns and internal structures. With the development of historical geographic information system (HGIS), Academia Sinica developed the WebGIS theme with the century old maps of Taiwan which is the most complete historical map of database in Taiwan. It can be used to overlay historical figures of different periods, present the timeline of the settlement change, also grasp the changes in the natural environment or social sciences and humanities, and the changes in the settlements presented by the visualized areas. This study will explore the historical development and spatial characteristics of the settlements in various areas of Tainan County. Using of large-scale areas to explore the settlement changes and spatial patterns of the entire county, through the dynamic time and space evolution from Japanese rule to the present day. Then, digitizing the settlement of different periods to perform overlay analysis by using Taiwan historical topographic maps in 1904, 1921, 1956 and 1989. Moreover, using document analysis to analyze the temporal and spatial changes of regional environment and settlement structure. In addition, the comparison analysis method is used to classify the spatial characteristics and differences between the settlements. Exploring the influence of external environments in different time and space backgrounds, such as government policies, major construction, and industrial development. This paper helps to understand the evolution of the settlement space and the internal structural changes in Tainan County.

Keywords: historical geographic information system, overlay analysis, settlement change, Tainan County

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Authors: Ya-Ling Huang, Ming-Chun Tsai, Fan Hsu, Kai-Ru Hsieh

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This paper mainly discusses the research and practice process of a laboratory curriculum by leading students to perform field investigation into time-honoured shops that have existed for more than 50 years in the downtown area of Tainan, Taiwan, and then search again for design elements and completing the design. The participants are juniors from the Department of Visual Communication Design, Kun Shan University. The duration of research and practice is two months. Operators of these shops are invited to jointly appraise the final achievements. 9 works out of 27 are chosen for final exhibition and commercialization.

Keywords: culture creative industry, visual communication design, curriculum experimental, visual arts

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Authors: Ya-Mei Chang

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This research is intended to apply spatio-temporal point process methods to the dengue fever data in Tainan. The spatio-temporal intensity function of the dataset is assumed to be separable. The kernel estimation is a widely used approach to estimate intensity functions. The intensity function is very helpful to study the relation of the spatio-temporal point process and some covariates. The covariate effects might be nonlinear. An nonparametric smoothing estimator is used to detect the nonlinearity of the covariate effects. A fitted parametric model could describe the influence of the covariates to the dengue fever. The correlation between the data points is detected by the K-function. The result of this research could provide useful information to help the government or the stakeholders making decisions.

Keywords: dengue fever, spatial point process, kernel estimation, covariate effect

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Authors: Lim Lie Pin, Lin Hui Wen

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Rural tourism has become popular in Taiwan, the villages based on agriculture including fishery have to follow the trend to develop the local economy and achieve the sustainable development of the rural areas. Through cultural festivals, the tourist could experience the benefit while promoting and stimulating the local development of rural tourism. Cigu is famous for salt history and abundant natural resources, such as lagoon, black-faced spoonbills and other fishery products. Digging clam has become the most special parent-child activities in Tainan and increasing awareness since it was initiated. Therefore, festival organizers and regional destination marketers need to identify visitors’ experiences attributes which lead to opportunities for industry professionals, community involvement to plan and organize regional festivals and their programmes for effective destination branding finding out more potential rural resources encouraging the local industry growth and sustainable development.

Keywords: rural tourism, cultural festival, destination branding, tourist experience, sustainable development

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Authors: Ping-Hung Chen, Han-Liang Lin

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Taiwan has formed diverse settlement patterns in different time and space backgrounds. Various socio-network links are created between individuals, families, communities, and societies, and different living cultures are also derived. But rapid urbanization and social structural change have caused the creation of densely-packed assembly housing complexes and made neighborhood community upward developed. This, among others, seemed to have affected neighborhood relationship and also created social problems. To understand the complex relations and socio-spatial structure of the community, it is important to use mixed methods. This research employs the theory of space syntax to analyze the layout and structural indicators of the selected communities in Tainan city. On the other hand, this research does the survey about residents' interactions and the sense of community by questionnaire of the selected communities. Then the mean values of the syntax measures from each community were correlated with the results of the questionnaire using a Pearson correlation to examine how elements in physical design affect the sense of community and neighborhood relationship. In Taiwan, most urban morphology research methods are qualitative study. This paper tries to use space syntax to find out the correlation between the community layout and the neighborhood relationship. The result of this study could be used in future studies or improve the quality of residential communities in Taiwan.

Keywords: community layout, neighborhood relationship, space syntax, mixed-method

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Authors: Chen Chou, Feng-Tyan Lin

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Big Data has been attracted a lot of attentions in many fields for analyzing research issues based on a large number of maternal data. Electronic Toll Collection (ETC) is one of Intelligent Transportation System (ITS) applications in Taiwan, used to record starting point, end point, distance and travel time of vehicle on the national freeway. This study, taking advantage of ETC big data, combined with urban planning theory, attempts to explore various phenomena of inter-city transportation activities. ETC, one of government's open data, is numerous, complete and quick-update. One may recall that living area has been delimited with location, population, area and subjective consciousness. However, these factors cannot appropriately reflect what people’s movement path is in daily life. In this study, the concept of "Living Area" is replaced by "Influence Range" to show dynamic and variation with time and purposes of activities. This study uses data mining with Python and Excel, and visualizes the number of trips with GIS to explore influence range of Tainan city and the purpose of trips, and discuss living area delimited in current. It dialogues between the concepts of "Central Place Theory" and "Living Area", presents the new point of view, integrates the application of big data, urban planning and transportation. The finding will be valuable for resource allocation and land apportionment of spatial planning.

Keywords: Big Data, ITS, influence range, living area, central place theory, visualization

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Authors: Pei-Chih Wu, Hsin-Chih Lai, Yung-Lung Lee, Yun-Yao Chi, Ching-Yi Horng, Hsien-Chang Wang

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The impact of climate change to health has always been well documented. Amongst them, water-borne infectious diseases, chronic adverse effects or cancer risks due to chemical contamination in flooding or drought events are especially important in river basin. This study therefore utilizes GIS and different models to integrate demographic, land use, disaster prevention, social-economic factors, and human health assessment in the Erren River basin. Therefore, through the collecting of climatic, demographic, health surveillance, water quality and other water monitoring data, potential risks associated with the Erren River Basin are established and to understand human exposure and vulnerability in response to climate extremes. This study assesses the temporal and spatial patterns of melioidosis (2000-2015) and various cancer incidents in Tainan and Kaohsiung cities. The next step is to analyze the spatial association between diseases incidences, climatic factors, land uses, and other demographic factors by using ArcMap and GeoDa. The study results show that amongst all melioidosis cases in Taiwan, 24% cases (115) residence occurred in the Erren River basin. The relationship between the cases and in Tainan and Kaohsiung cities are associated with population density, aging indicator, and residence in Erren River basin. Risks from flooding due to heavy rainfall and fish farms in spatial lag regression are also related. Through liver cancer, the preliminary analysis in temporal and spatial pattern shows an increases pattern in annual incidence without clusters in Erren River basin. Further analysis of potential cancers connected to heavy metal contamination from water pollution in Erren River is established. The final step is to develop an assessment tool for human exposure from water contamination and vulnerability in response to climate extremes for the second year.

Keywords: climate change, health impact, health adaptation, Erren River Basin

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Authors: Hung-Chun Lin, Tzu-Yuan Chao

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As the population aging has become an inevitable trend globally, issues of improving the well-being of elderly people in urban areas have been a challenging task for urban planners. Recent studies of ageing trend have also expended to explore the relationship between the built environment and mental condition of elderly people. These studies have proved that even though the built environment may not necessarily play the decisive role in affecting mental health, it can have positive impacts on individual mental health by promoting social linkages and social networks among older adults. There has been a great amount of relevant research examined the impact of the built environment attributes on depression in the elderly; however, most were conducted in the Western countries. Little attention has been paid in Asian cities with contrarily high density and mix-use urban contexts such as Taiwan regarding how the built environment attributes related to depression in elderly people. Hence, more empirical cross-principle studies are needed to explore the possible impacts of Asia urban characteristics on older residents’ mental condition. This paper intends to focus on Tainan city, the fourth biggest metropolis in Taiwan. We first analyze with data from National Health Insurance Research Database to pinpoint the empirical study area where residing most elderly patients, aged over 65, with depressive disorders. Secondly, we explore the relationship between specific attributes of the built environment collected from previous studies and elderly individuals who suffer from depression, under different socio-cultural and networking circumstances. To achieve the results, the research methods adopted in this study include questionnaire and database analysis, and the results will be proceeded by correlation analysis. In addition, through literature review, by generalizing the built environment factors that have been used in Western research to evaluate the relationship between built environment and older individuals with depressive disorders, a set of local evaluative indicators of the built environment for future studies will be proposed as well. In order to move closer to develop age-friendly cities and improve the well-being for the elderly in Taiwan, the findings of this paper can provide empirical results to grab planners’ attention for how built environment makes the elderly feel and to reconsider the relationship between them. Furthermore, with an interdisciplinary topic, the research results are expected to make suggestions for amending the procedures of drawing up an urban plan or a city plan from a different point of view.

Keywords: built environment, depression, elderly, Tainan

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Authors: Cheng-Yu Tsai, Chiung-En Huang, Ming-Tsang Wu

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The purpose of this study was to investigate the relationships among leisure motivation, leisure attitude, and health promotion lifestyle. The participants were recruited from a convenience sampling that subjects were at least 55 years of age in Tainan City, Taiwan. Three hundred survey instruments were distributed, and 227 effective instruments were returned, for an effective rate of 75.7%. The collected data were analyzed statistically. The findings of this research were as follows: 1.There is significantly correlated between leisure motivation and leisure attitude. 2. There is significantly correlated between leisure attitude and health promotion lifestyle. 3. There is significantly correlated between leisure motivation and health promotion lifestyle.

Keywords: leisure motivation, leisure attitude, health promotion lifestyle, tourism

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Authors: Cheng Chieh Hsu, Alfred Chen, Yu-Pin Ma, Meng-Jie Lin, Fu Pai Chiu, Yi-Yan Sie

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In this study, it is attempted to construct an augmented reality display platform (ARDP), and its objectives are two facets, i.e. 1) providing a creative display mode for museums/historical heritages and 2) providing a benchmark for human-computer interaction professionals to build an augmented reality display platform. A general augmented reality theory has been explored in the very beginning and afterwards a systematic process model is proposed. There are three major core tasks to be done for the platform, i.e. 1) constructing the physical interactive table, 2) designing the media, and 3) designing the media carrier. In order to describe how the platform manipulates, the authors have introduced Tainan Confucius Temple, a cultural heritage in Taiwan, as a case study. As a result, a systematic process with thirteen steps has been developed and it aims at providing a rational method for constructing the platform.

Keywords: human-computer interaction, media, media carrier, augmented reality display platform

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Authors: K. Y. Shih, H. M. Lin, S. Y. Lee, T. L. Hong

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Recently a number of food safety scandals have been on the news. In view of the fact that in Taiwan the majority of undergraduate college students reside in the dorms and dine out, the problem of restaurant sanitation is of utmost importance in their lives. The purpose of this study is to analyze students' dining habit and their perception of food safety. Four universities in the city of Tainan were randomly selected, and from each selected university a class was then chosen to receive 50 questionnaires. The total of 200 questionnaires yielded 144 usable returns. Students were asked to respond to questions, and each question was graded on a scale from 1 to 5 according to the importance. There were 32 questions ranging over various aspects: cleanliness of surroundings, washroom, food sanitation, serving temperature, kitchen sanitation, and service personnel cleanliness. It is found that the food sanitation received the highest score, while the service personnel ranked the lowest. An incidental finding is that the students tend to dine out in groups and as such their choice of restaurants are mostly dictated by consensus.

Keywords: food safety, restaurant, risk perception, sanitation

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Authors: Tzu-Ping Lin, Shing-Ru Yang

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Climate change has a significant impact on human living environment, while the traditional settlement may suffer extreme thermal stress due to its specific building type and living behavior. This study selected Lutaoyang, which is the largest settlement in mountainous areas of Tainan County, for the investigation area. The microclimate parameters, such as air temperature, relative humidity, wind speed, and mean radiant temperature. The micro climate parameters were also simulated by the ENVI-met model. The results showed the banyan tree area providing good thermal comfort condition due to the shading. On the contrary, the courtyard (traditionally for the crops drying) surrounded by low rise building and consisted of artificial pavement contributing heat stress especially in summer noon. In the climate change simulations, the courtyard will become very hot and are not suitable for residents activities. These analytical results will shed light on the sustainability related to thermal environment in traditional settlements and develop adaptive measure towards sustainable development under the climate change challenges.

Keywords: thermal environment, traditional settlement, ENVI-met, Taiwan

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Authors: Pei Luen Jiang

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Oysters (Ostreidae) and hard clams (Meretrix lusoria) are important shallow sea-cultured shellfish in Taiwan, and are mainly farmed in Changhua, Yunlin, Chiayi and Tainan. As these shellfish are fed primarily on natural plankton, the artificial feed is not required, leading to high economic value in aquatic farming. However, in recent years, though mariculture production areas have expanded steadily, large-scale deaths of farmed shellfish have also become increasingly common due to climate change and human factors. Through studies over the past few years, our research team has determined the impact of nitrogen deprivation on growth and morphological variations in algae and sea anemones (Actiniaria) and identified the target genes affected by adverse environmental factors. In mariculture, high-density farming is commonly adopted, which results in elevated concentrations of nitrogenous waste in the water. In addition, excessive carbon dioxide from the atmosphere also dissolves in seawater, causing a steady decrease in the pH of seawater, leading to acidification. This study to observe the impact of high concentrations of nitrogen sources and carbon dioxide on algae.

Keywords: algae, shellfish, nitrogen, acidification

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Authors: Yun-Yao Chi, Chieh-Kai Tsai, Dai-Ling Li

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In this paper, a method of fast 3D topography modeling using the high-resolution camera images is studied based on the characteristics of Unmanned Aerial Vehicle (UAV) system for low altitude aerial photogrammetry and the need of three dimensional (3D) urban landscape modeling. Firstly, the existing high-resolution digital camera with special design of overlap images is designed by reconstructing and analyzing the auto-flying paths of UAVs, which improves the self-calibration function to achieve the high precision imaging by software, and further increased the resolution of the imaging system. Secondly, several-angle images including vertical images and oblique images gotten by the UAV system are used for the detail measure of urban land surfaces and the texture extraction. Finally, the aerial photography and 3D topography construction are both developed in campus of Chang-Jung University and in Guerin district area in Tainan, Taiwan, provide authentication model for construction of 3D topography based on combined UAV-based camera images from system. The results demonstrated that the UAV system for low altitude aerial photogrammetry can be used in the construction of 3D topography production, and the technology solution in this paper offers a new, fast, and technical plan for the 3D expression of the city landscape, fine modeling and visualization.

Keywords: 3D, topography, UAV, images

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Authors: Alfred Chen, Cheng Chieh Hsu, Yu-Pin Ma, Meng-Jie Lin, Fu Pai Chiu, Yi-Yan Sie

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This study is attempted to construct a human-computer interactive platform system that has mainly consisted of an augmented hardware system, a software system, a display table, and mixed media. This system has provided with human-computer interaction services through an interactive platform for the tourism industry. A well designed interactive platform, integrating of augmented reality and mixed media, has potential to enhance museum display quality and diversity. Besides, it will create a comprehensive and creative display mode for most museums and historical heritages. Therefore, it is essential to let public understand what the platform is, how it functions, and most importantly how one builds an interactive augmented platform. Hence the authors try to elaborate the construction process of the platform in detail. Thus, there are three issues to be considered, i.e.1) the theory and application of augmented reality, 2) the hardware and software applied, and 3) the mixed media presented. In order to describe how the platform works, Courtesy Door of Tainan Confucius Temple has been selected as case study in this study. As a result, a developed interactive platform has been presented by showing the physical entity object, along with virtual mixing media such as text, images, animation, and video. This platform will result in providing diversified and effective information that will be delivered to the users.

Keywords: human-computer interaction, mixed reality, mixed media, tourism

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Authors: Dai-Ling Li, Jung-Fa Cheng, Min-Lang Huang, Yun-Yao Chi

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The hedonic pricing model has been popularly applied to describe the economic value of environmental amenities in urban housing, but the results for cultural heritage variables remain relatively ambiguous. In this paper, integrated variables extending by GIS-based data and an existing typology of communities used to examine how cultural heritage and environmental amenities and disamenities affect housing prices across urban communities in Tainan, Taiwan. The developed models suggest that, although a sophisticated variable for central services is selected, the centrality of location is not fully controlled in the price models and thus picked up by correlated peripheral and central amenities such as cultural heritage, open space or parks. Analysis of these correlations permits us to qualify results and present a revised set of relatively reliable estimates. Positive effects on housing prices are identified for views, various types of recreational infrastructure and vicinity of nationally cultural sites and significant landscapes. Negative effects are found for several disamenities including wasteyards, refuse incinerators, petrol stations and industries. The results suggest that systematic hypothesis testing and reporting of correlations may contribute to consistent explanatory patterns in hedonic pricing estimates for cultural heritage and landscape amenities in urban.

Keywords: hedonic pricing model, cultural heritage, landscape amenities, housing

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Authors: Ting-Yu Lin, Han-Liang Lin

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This article is about the urban form of visualization by Cityengine. City is composed of different domains, and each domain has its own fabric because of arrangement. For example, a neighborhood unit contains fabrics such as schools, street networks, residential and commercial spaces. Therefore, studying urban morphology can help us understand the urban form in planning process. Streets, plots, and buildings seem as urban fabrics, and they configure urban form. Traditionally, urban morphology usually discussed single parameter, which is building type, ignoring other parameters such as streets and plots. However, urban space is three-dimensional, instead of two-dimensional. People perceive urban space by their visualization. Therefore, using visualization can fill the gap between two dimensions and three dimensions. Hence, the study of urban morphology will strengthen the understanding of whole appearance of a city. Cityengine is a software which can edit, analyze and monitor the data and visualize the result for GIS, a common tool to analyze data and display the map for urban plan and urban design. Cityengine can parameterize the data of streets, plots and building types and visualize the result in three-dimensional way. The research will reappear the real urban form by visualizing. We can know whether the urban form can be parameterized and the parameterized result can match the real urban form. Then, visualizing the result by software in three dimension to analyze the rule of urban form. There will be three stages of the research. It will start with a field survey of Tainan East District in Taiwan to conclude the relationships between urban fabrics of street networks, plots and building types. Second, to visualize the relationship, it will turn the relationship into codes which Cityengine can read. Last, Cityengine will automatically display the result by visualizing.

Keywords: Cityengine, urban fabric, urban morphology, visual simulation

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Authors: Tzu-Jung Tseng, Pei-Hsuen Han, Tsung-Hsueh Lu

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Background: Ensuring patients with ST-elevation myocardial infarction (STEMI) access to hospitals that could perform percutaneous coronary intervention (PCI) in time is an important concern of healthcare managers. One commonly used the method to assess the coverage of population access to PCI hospital is the use GIS-estimated linear distance (crow's fly distance) between the district centroid and the nearest PCI hospital. If the distance is within a given distance (such as 20 km), the entire population of that district is considered to have appropriate access to PCI. The premise of using district centroid to estimate the coverage of population resident in that district is that the people live in the district are evenly distributed. In reality, the population density is not evenly distributed within the administrative district, especially in rural districts. Fortunately, the Taiwan government released basic statistical area (on average 450 population within the area) recently, which provide us an opportunity to estimate the coverage of population access to PCI services more accurate. Objectives: We aimed in this study to compare the population covered by a give PCI hospital according to traditional administrative district versus basic statistical area. We further examined if the differences between two geographic units used would be larger in a rural area than in urban area. Method: We selected two hospitals in Tainan City for this analysis. Hospital A is in urban area, hospital B is in rural area. The population in each traditional administrative district and basic statistical area are obtained from Taiwan National Geographic Information System, Ministry of Internal Affairs. Results: Estimated population live within 20 km of hospital A and B was 1,515,846 and 323,472 according to traditional administrative district and was 1,506,325 and 428,556 according to basic statistical area. Conclusion: In urban area, the estimated access population to PCI services was similar between two geographic units. However, in rural areas, the access population would be overestimated.

Keywords: accessibility, basic statistical area, modifiable areal unit problem (MAUP), percutaneous coronary intervention (PCI)

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Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

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Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: catchment area of healthcare, chronic disease management, Geographic information system, quality of diabetes care

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Authors: Chu-Tzu Chen, Angela S. Huang, Yu-Min Chou, Chin-Hui Yang

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Dengue is a major public health concern throughout tropical and sub-tropical regions. Taiwan is located in the Pacific Ocean and overlying the tropical and subtropical zones. The island remains humid throughout the year and receives abundant rainfall, and the temperature is very hot in summer at southern Taiwan. It is ideal for the growth of dengue vectors and would be increasing the risk on dengue outbreaks. During the first half of the 20th century, there were three island-wide dengue outbreaks (1915, 1931, and 1942). After almost forty years of dormancy, a DEN-2 outbreak occurred in Liuchiu Township, Pingtung County in 1981. Thereafter, more dengue outbreaks occurred with different scales in southern Taiwan. However, there were more than ten thousands of dengue cases in 2014 and in 2015. It did not only affect human health, but also caused widespread social disruption and economic losses. The study would like to reveal the epidemiology of dengue on Taiwan, especially the severe outbreak in 2015, and try to find the effective interventions in dengue control including dengue vaccine development for the elderly. Methods: The study applied the Notifiable Diseases Surveillance System database of the Taiwan Centers for Disease Control as data source. All cases were reported with the uniform case definition and confirmed by NS1 rapid diagnosis/laboratory diagnosis. Results: In 2014, Taiwan experienced a serious DEN-1 outbreak with 15,492 locally-acquired cases, including 136 cases of dengue hemorrhagic fever (DHF) which caused 21 deaths. However, a more serious DEN-2 outbreak occurred with 43,419 locally-acquired cases in 2015. The epidemic occurred mainly at Tainan City (22,760 cases) and Kaohsiung City (19,723 cases) in southern Taiwan. The age distribution for the cases were mainly adults. There were 228 deaths due to dengue infection, and the case fatality rate was 5.25 ‰. The average age of them was 73.66 years (range 29-96) and 86.84% of them were older than 60 years. Most of them were comorbidities. To review the clinical manifestations of the 228 death cases, 38.16% (N=87) of them were reported with warning signs, while 51.75% (N=118) were reported without warning signs. Among the 87 death cases reported to dengue with warning signs, 89.53% were diagnosed sever dengue and 84% needed the intensive care. Conclusion: The year 2015 was characterized by large dengue outbreaks worldwide. The risk of serious dengue outbreak may increase significantly in the future, and the elderly is the vulnerable group in Taiwan. However, a dengue vaccine has been licensed for use in people 9-45 years of age living in endemic settings at the end of 2015. In addition to carry out the research to find out new interventions in dengue control, developing the dengue vaccine for the elderly is very important to prevent severe dengue and deaths.

Keywords: case fatality rate, dengue, dengue vaccine, the elderly

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