Examining Stakeholder Perspectives: Process, Performance and Progress of the Age-Friendly Taiwan Program.

Since Taiwans age-friendly city (AFC) program was launched in 2012, the central government has provided various resources to the countrys 22 local authorities, including budgetary support, policy advocacy, and consultation from a team of experts. This study examines stakeholder perspectives on the process, performance, and outcome of the AFC program. A 53-item questionnaire was developed based on the World Health Organization (WHO) guideline, including mechanisms and processes (20 items), outcome evaluations (23 items), and resource integration (10 items). There was a great difference found among scores between facilitators and experts for inter-exchange experience with local and international cities (40%) and monitor and revise indicators (37%) in mechanisms and processes, evaluate performance of indicators and action plans (37%) in outcome evaluations, and interaction between government and community (46%) and interaction between civil organization and senior society (39%) in resource integration. Clearly, facilitators showed overly optimistic assessments in AFC mechanisms and processes, outcome evaluation, and resource integration. The results showed disconnect between experts expectations versus actual practice conducted by facilitators. Implications of these findings are to integrate top down expectations with the realities of bottom up practice to design more realistic evaluations; continue to educate stakeholders about design, implementation and evaluation; and further integrate resources from government, civil organizations, and community

Ringtone Regardless of P-Early-Media Tag

A user device placing a mobile originating call on a network using Real-time Transport Protocol (RTP) ignores P-Early-Media tags and session description protocol (SDP) in Session Initiation Protocol (SIP) packets received from the network after receiving a 180 Ringing alert packet indicating that the receiving device is ringing to minimize a delay in playing a ringback tone. The user device plays a local ringtone until the user device receives audio RTP packets containing Early Media. If the user device receives audio RTP packets containing Early Media before the call is connected, the user device plays the Early Media as a custom ringtone

The Internal Audit Performance: The Effectiveness of ERM and IT Environments

The purpose of this study is to examine the factors determining the performance of the internal audit (IA) in the context of internal auditors’ work environments. This includes Enterprise Risk Management (ERM) implementation, the Enterprise Resource Planning (ERP) system, the use of auditing software and the internal auditors’ IT (information technology) competence. Although a number of recent studies have reported tremendous changes in the roles of the IA, there is still little research on the influential factors of IA implementation and its effectiveness from a contextual perspective. This paper develops and tests a theoretical framework with samples from Taiwan. Data were analyzed using the structural equation model (SEM). This research confirms that the complete ERM implementation and effectiveness of ERP implementation have significant impacts on the performance of IA. It also highlights the importance of internal auditors’ IT competence in improving the performance of IA

An Empirical Study of Factors Influencing the Intention to Use SNS App─The Case of Facebook

Mobile Internet is coming. The social networking site application (SNS app) has become an important portal for users accessing social networking services. Based on the point of view of existing social network users, this study integrates the technology value-based adoption model and social influence to propose a framework to investigate factors influencing the use intention of the SNS app. A sample of 223 subjects surveyed from Facebook, it was found that user’s perceived value regarding the SNS app positively affects the use intention of the social networking app. Usefulness and Technicality provided by SNS app positively affects perceived value of the app. In addition, user perceived social influence also positively affects the use intention of the social networking app. Results not only advance knowledge related to social network research, as well as provide practical advice to social networking companies. They also suggest how to attract users to continually participate in social networks. Increase activeness and stickiness is critical for social network companies to facilitate long-term development

Structural and cognitive deficits in chronic carbon monoxide intoxication: a voxel-based morphometry study

BACKGROUND: Patients with carbon monoxide (CO) intoxication may develop ongoing neurological and psychiatric symptoms that ebb and flow, a condition often called delayed encephalopathy (DE). The association between morphologic changes in the brain and neuropsychological deficits in DE is poorly understood. METHODS: Magnetic resonance imaging and neuropsychological tests were conducted on 11 CO patients with DE, 11 patients without DE, and 15 age-, sex-, and education-matched healthy subjects. Differences in gray matter volume (GMV) between the subgroups were assessed and further correlated with diminished cognitive functioning. RESULTS: As a group, the patients had lower regional GMV compared to controls in the following regions: basal ganglia, left claustrum, right amygdala, left hippocampus, parietal lobes, and left frontal lobe. The reduced GMV in the bilateral basal ganglia, left post-central gyrus, and left hippocampus correlated with decreased perceptual organization and processing speed function. Those CO patients characterized by DE patients had a lower GMV in the left anterior cingulate and right amygdala, as well as lower levels of cognitive function, than the non-DE patients. CONCLUSIONS: Patients with CO intoxication in the chronic stage showed a worse cognitive and morphologic outcome, especially those with DE. This study provides additional evidence of gray matter structural abnormalities in the pathophysiology of DE in chronic CO intoxicated patients

Prevention and early management of carotid blowout syndrome for patients receiving head and neck salvage boron neutron capture therapy (BNCT)

Background/purpose The incidence rate of oral and pharyngeal cancers in Taiwan has increased gradually over the past few decades. The standard treatment strategy for oral and pharyngeal cancers includes surgery or radiotherapy, with concurrent chemotherapy in certain types of tumors. Unfortunately, in-field recurrence is sometimes inexorable. Furthermore, re-irradiation of the recurrence site may cause severe complications due to the tolerance of normal tissue to radiation therapy. One fatal complication is carotid blowout syndrome (CBS). Boron neutron capture therapy (BNCT) is a new modality of radiation therapy, which is also mentioned as targeted radiotherapy. It is a feasible treatment that has the potential to spare normal tissue from being damaged by irradiation while simultaneously treating the primary tumor. In this presentation, we will share our experience with BNCT in treating recurrent head and neck cancers, as well as the prevention and management of CBS. Materials and methods We evaluated 4 patients with head and neck cancers treated by BNCT in Taiwan. All patients had undergone surgery previously and had received postoperative concurrent chemoradiotherapy. Results The 4 patients in this study were diagnosed with head and neck malignancies. The median follow-up period after the first course of BNCT was 15.1 months. After BNCT, 2 patients developed impending CBS, and 1 of them died. The remaining 3 patients survived until the last date of follow-up. Conclusion Pre-BNCT carotid artery evaluation through computed tomography angiography and early intervention if necessary is crucial when treating patients with recurrent head and neck cancers by BNCT

Drastic population fluctuations explain the rapid extinction of the passenger pigeon

To assess the role of human disturbances in species' extinction requires an understanding of the species population history before human impact. The passenger pigeon was once the most abundant bird in the world, with a population size estimated at 3-5 billion in the 1800s; its abrupt extinction in 1914 raises the question of how such an abundant bird could have been driven to extinction in mere decades. Although human exploitation is often blamed, the role of natural population dynamics in the passenger pigeon's extinction remains unexplored. Applying high-throughput sequencing technologies to obtain sequences from most of the genome, we calculated that the passenger pigeon's effective population size throughout the last million years was persistently about 1/10,000 of the 1800's estimated number of individuals, a ratio 1,000-times lower than typically found. This result suggests that the passenger pigeon was not always super abundant but experienced dramatic population fluctuations, resembling those of an "outbreak" species. Ecological niche models supported inference of drastic changes in the extent of its breeding range over the last glacial-interglacial cycle. An estimate of acorn-based carrying capacity during the past 21,000 y showed great year-to-year variations. Based on our results, we hypothesize that ecological conditions that dramatically reduced population size under natural conditions could have interacted with human exploitation in causing the passenger pigeon's rapid demise. Our study illustrates that even species as abundant as the passenger pigeon can be vulnerable to human threats if they are subject to dramatic population fluctuations, and provides a new perspective on the greatest human-caused extinction in recorded history