¡@The shell utilization of two sympatric hermit carb species was studied in shallow waters of Kaohsiung and Pingtung, southern Taiwan. Principal components, canonical variates and univariate analysis was used to compare three major variables of shell resource: species, size, and shape between species and sites. The regression between crab and shell and shell adequacy index (SAI) revealed that two species shared the same resource which had shell size limitation in the field had different pattern. Shells used by Diogenes rectimanus were larger than those uesd by D. nitidimanus of same size. But the utilization pattern was the same under a shell sufficient condition in the laboratory, suggesting that there was no resource partitioning or competition between these two species. The size of shell composed a continuous morphological overlap at four different sites and shown a good consistency with crab size. This revealed the utilization of crabs in different size selected different shells and suggested a status of sufficient resource utilization. Although the shell resource were highly similar, but different composition of shell species and other factors could caused variances in shell size and shape between four sites, and caused crab size divergence among different populations.

Taiwan, surrounded by sea and rich in marine resources, is one of the most important fishery states in the world. Fishery activity, one of the ways for humans to obtain food, provides jobs and economic benefits for fishery personnel. Plentiful fishing resources given from the nature have been considered to be unlimited for a long time. However, with the spread of fishery knowledge and the promotion of techniques, unrestrained fishing and damaged fishery environment have caused exhausted crisis to fishing resources. It is finally recognized by humans that marine resources are not inexhaustible. Hence, humans should take necessary measures to conserve and manage fishing resources in order to utilize fishing resources sustainably. After the approval of UNCLOS in 1982, coastal states have the rights and bear the obligations to manage and utilize the fishing resources in the waters under their jurisdiction. UNCLOS itself is also the norm of management in maritime fishing resources. Owing to international responsibility, Taiwan not only signs agreements with other states and fishery organizations proactively, but also revises domestic fishery laws and regulations to implement the conventions. Taking necessary management measures is insufficient for the conservation of fishing resources that the maritime law enforcement needs to be strengthened. Consequently, illegal fishing activities can be clamped down and fishing resources can be conserved as well. Recently, the security of fishermen working in our sea area is under threat due to escalated fishing activities violating to the regulation, increased fishing boats from mainland China crossing the boundary, and disputes among neighboring countries on the overlap areas of EEZ. For growing emphasis on the conservation and management of fishery resources, this study will analyze the legal system of fishing resources conservation and inspect the situations of law enforcement by the fishery and coast guard authorities. Moreover, advanced steps will be discussed to provide suggestions to improve the law enforcement system and conserve maritime fishing resources under considerations of important fishery states¡¦ management and law enforcement measures.

Chronic liver disease is an important disease which affects national healthy in Taiwan. Hepatitis B or C virus infection is strongly relative to chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. However, the early effective treatment can decrease the progression of liver cirrhosis and hepatocellular carcinoma and increase the recovery rate. In order to promote the health care quality for the patients with hepatitis, Bureau of National Health Insurance (BNHI) implemented the ¡§Enhance Hepatitis B or C Health Care Program¡¨ in October of 2003. The new policy sets up the standard treatment models and pay medical costs to encourage the patients to participate this program and fit cost-effectiveness. Therefore, aims of the study are to estimate the effects of the new policy on health care utilization and expenditures for the patients with hepatitis B or C. The study used the database from Bureau of National Health Insurance (BNHI) in 2002 and 2004. The study sample is the patients with hepatitis B or C who enrolled the program from January to June in 2004. We compared the differences of health care utilization and expenditures with these statistics in 2002. Besides, we also analyzed the difference in the characteristics of the patients and hospitals. In health care utilization, we found that number of visits was increased but interval between visits was decreased. Total costs, costs of treatments, prescriptions, total claim amount, and averages of prescription costs in health care expenditures were all increased significantly after the new policy implemented. Otherwise, there were not different on health care utilization and expenditures between different gender and level of the hospitals. On the other hand, there were significantly correlation of ages and number of comorbility. It means that the patients¡¦ ages are older, and their number of visits and total costs are higher but interval between visits is shorter than younger. Furthermore, number of comorbility increases and then interval between visits become short. The new policy certainly affects the health care utilization and expenditures of patients with hepatitis B or C. Implementing the new program can encourage patients adopt treatment actively and physicians have standard treatment protocols to follow. Understanding the changes on health care utilization and expenditures can give a health care guideline of cost-effectiveness. In conclusion, the results can provide the information about payments on patients with hepatitis to BNHI and then use it to be a basis after the new program implemented. Moreover, other countries also can evaluate the implementation of the new policy based on our results.

Older adults have historically utilized mental health services at substantially low rates. Unfortunately, though professional, policy, and other recent developments portend an increase in service use, there has been scant empirical attention devoted to the current or recent utilization of mental health treatment by the elderly, and almost nothing is known about the correlates of mental health need and service use among older adults. Accordingly, the present study examined patterns of serious mental illness (SMI), specific mental health syndromes, and service use among older (65+) and younger (18- 64) adults throughout the United States, and the extent to which various factors predict mental health need and the use and magnitude of mental health treatment. In addition, the study examined factors related to unmet need, as well as age group differences in perceived benefit from treatment. The findings reveal that older adults were three times less likely than their younger counterparts to receive any outpatient mental health treatment. Only 2.5% of older individuals utilized any outpatient mental health service in the past year, versus 7.0% of younger adults. The results indicate that the low rate of utilization by older adults may be partly a function of limited subjective mental health need. Prevalence estimates for SMI and all specific mental health syndromes, with the exception of agoraphobia, were markedly lower in the older than the younger cohort. Importantly, though mental health problems appear to be significantly undertreated in older and younger age groups, the study also reveals that those older and younger adults that make it into services typically benefit considerably from treatment. It is hoped that the knowledge yielded by the current study will promote efforts to enhance mental health care access and reduce the long neglected mental health needs of the nation’s elderly population. Several factors related to mental health need and service use were identified in the study that may assist policy, planning, and outreach efforts aimed at increasing service access.

Mobile ad hoc networks are without centralized infrastructure, and suitable for the region that difficultly builds the basic network framework, for example, desert and ocean. The bandwidth in mobile ad hoc networks is likely to remain a scarce resource. A call request of a connection in a wireless network is blocked if there exits no bandwidth route. This blocking does not mean that the total system bandwidth capacity is less than the request, but that there is no path in which each link has enough residual unused bandwidth to satisfy the requirement. Like the routing in a datagram network, if packets of a virtual circuit can stream across multiple paths, we can select multiple bandwidth routes such that the total bandwidth can meet the requirement of a source-destination pair. Therefore, even though there is no feasible single path for a bandwidth-constrained connection, we may still have a chance to accept this one if we can find multiple bandwidth routes to meet the bandwidth constraint. In this dissertation, we propose a bandwidth-constrained routing algorithm to aggregate the bandwidth of multiple wireless links by splitting a data flow across multiple paths at the network layer. That is, it allows the packet flow of a source-destination pair to be delivered over multiple bandwidth routes with enough overall resources to satisfy a certain bandwidth requirement. Our algorithm considers not only the QoS requirement, but also the cost optimality of the routing paths to improve the overall network performance. Extensive simulations show that high call admission ratio and resource utilization are achieved with modest routing overheads. This algorithm can also tolerate the node moving, joining, and leaving. We also propose an algorithm, named efficient utilization polling (EUP), to support asynchronous data traffic at MAC layer by using the characteristics of Bluetooth technology. The algorithm uses a single bit in the payload header to carry the knowledge of queues in slaves for dynamically adapting the polling intervals for achieving the goals of high channel utilization and power conserving. In addition, we propose a differentiation mechanism, named shift-polling window (SPW). Based on EUP, the SPW differentiates the throughput from various classes, and still keeps the link utilization high and almost the same as that of the best-effort services. Extensive simulations are experimented on the behavior of the EUP and SPW by tuning the related parameters, such as polling interval, buffer size, and queue threshold level, etc., in order to verify the expectation of these methods.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most frequently prescribed classes of drugs worldwide. Due to their excellent effects for analgesic, anti-inflammatory and antipyretic, most elder population used frequently for osteoarthritis. Gastrointestinal symptoms and ulceration associated with NSAIDs are common. Such ulcers may cause pain, bleeding, or perforation. It leads to other medical problems. The aim of this study was to examine the utilizations of medical resources associated with inpatients with NSAID related peptic ulcer disease and compared to non-NSAID related peptic ulcer disease. The study used the database from a teaching hospital in southern Taiwan. Inpatients who were identified ICD-9 CM codes as peptic ulcer diseases from January 1st of 2008 to December 31 of 2008 were included in this study. We also examined the indications for usage of NSAIDs, the date of prescription before the index date. The results showed 17.6% of inpatients with peptic ulcer disease related to NSAIDs. Inpatients with NSAIDs related peptic ulcer disease compared with inpatients with non-NSAIDs related peptic ulcer disease had significant difference in age and comorbidity. Although rapid urease test positive rate for Helicobacter pylori was higher in group of non-NSAID related peptic ulcer disease, it seemed underestimate because of the test number of patients was low. The average total direct medical cost of inpatients with NSAID related peptic ulcer was NT$ 36,491 and non-NSAID related peptic ulcer was NT$ 37,266.1. There were no significant difference in medical costs of standard care , intensive care , blood products,endoscopy, endoscopic hemostasis, surgery, CT scan , ultrasound, laboratory tests,medications, doctor¡¦s service between the two groups. Diagnostic and therapeutic procedures were no statistically significant difference, including blood transfusion,CT scan, endoscopic hemostasis, surgery, symptoms presentations, and intensive care. In this study, the duration for using NSAID was within 30 days for inpatients associated with NSAID related peptic ulcer, which had a substantial excess numbers of ulcer hospitalization. Since the common disease for using NSAID is osteoarthritis,which is very popular in elderly, therefore, we suggested that the policy makers of the National Health Insurance should be aware that preventive usage of proton pump inhibitors for the elder population who need frequent use of NSAIDs might decrease NSAID related ulcer complications.

Dissertation (Ph.D.)--Auburn University, 2009. / Abstract. Vita. Includes bibliographic references.

Bakgrund: Ett lager är en viktig del av de flesta värdekedjor. Stora ansträngningar har därför under de senaste åren gjorts för att finna optimala strategier för planering och kontroll av lagersystem. För att uppnå en ökad produktion krävs det att kapacitetsutnyttjandet förbättras. Genom att planera sin kapacitet kan företag reducera kapacitetsbegräsningar, så kallade flaskhalsar, som är nyckeln till att förbättra produktionens kapacitetsutnyttjande. Syfte: Syftet med studien är att beskriva Staples nuvarande kapacitetsutnyttjande i påfyllnads- och plockprocessen. Vidare avser studien att identifiera kapacitetsbegränsningar inom dessa processer. Därefter ämnar studien att finna de bakomliggande orsakerna till dessa kapacitetsbegränsningar samt hur de kan förbättras. Metod: Det har genomförts ostrukturerade intervjuer, semi-strukturerade intervjuer, deltagande observationer samt insamling av kvantitativ data. Inledningsvis genomfördes en processkartläggning i syfte som ett verktyg för resterande delar av studien. Vidare utfördes beräkningar för att finna flaskhalsar i produktionen och intervjuer för att identifiera störningsmoment inom flaskhalsarna. Slutligen presenterades ett antal förbättringsförslag. Slutsatser: Efter genomförda beräkningar framgick att Staples idag inte utnyttjar sin kapacitet maximalt, dock är maximal kapacitet är en nivå som inte anses vara rimlig. Det framgick att Staples har ett kapacitetsbortfall på grund av att det finns en differens mellan nominell kapacitet och bruttokapacitet. Slutsatsen drogs att följande tre aktiviteter utgör flaskhalsar i Staples verksamhet; godsmottagning, plock ZtZ (plock av framförallt tyngre och otympliga artiklar) och plock PTS (detaljplock). Inom dessa flaskhalsar påträffades ett antal störningsmoment som till stor del har grund inom deiiiteoretiska områdena som Stevenson (2009), Slack et al. (2012) och Bergman och Klefsjö (2012) benämner som anläggning och teknik samt metod. Vidare fastslogs att en svårighet finns i att ge kortsiktiga förbättringsförslag för dessa störningsmoment. Detta på grund av studiens tidsram samt att det berör ämnen utanför studiens omfattning. Det presenteras dock tre scenarier för att hitta en fördelaktig fördelning av kapacitet mellan PTS och ZtZ. Dessa scenarier bygger på tre tidsintervaller för hur produktionen är igång samt två plockhastigheter. Baserat på att PTS:en innehar en större andel aktiva arbetstimmar och en högre plockhastighet är scenario 3 mest fördelaktigt eftersom det krävs att ZtZ är minst verksam. / Background: A warehouse is an important part of most value chains. Great effort has in recent years been made to find optimal strategies for planning and control of storage system. In order to achieve a higher production it requires the capacity utilization to be improved. By planning its capacity, companies can reduce capacity constraints, so-called bottlenecks, which is the key to improving the production’s capacity utilization. Purpose: The aim of this study is to describe Staples current capacity utilization in the filling and picking process. Furthermore, the study aim to identify capacity constraints in these processes. Then, the study intends to find the causes of these capacity constraints and how they can be improved. Method: There have been unstructured interviews, semi-structured interviews, participant observation and collection of quantitative data. Initially there was a process mapping in purpose of a tool for the remaining study. Further calculations were performed to find bottlenecks in the production and interviews to identify disturbances in the bottlenecks. Finally, a number of suggestions for improvement where presented. Conclusions: Calculations revealed that Staples is currently not using their capacity to the maximum, altough this is not a level considered reasonable. It appeared that the company has a capacity shortfall when there was a difference between the nominal capacity and gross capacity. It was concluded that the following three activities constituted bottlenecks in Staples; receiving, picking ZtZ (picking of particularly heavy and bulky items) and picking PTS (detail picking). Within these bottlenecks, there was a number of disturbances found that largely had their basis in the teoratical areas Stevenson (2009), Slack et al. (2012) and Bergman and Klefsjö (2012) terms as facility and technology and method. Furthermore, it was established a difficulty in providingvshort-term improvement suggestions to these disturbances. This’s because of the study's time frame and that it reach subjects outside the scope of the study. However, three scenarios are presented to find a favorable allocation of capacity between PTS and ZTZ. These scenarios are based on three time intervals for how production is running and two picking speeds. Based on that the PTS holds a higher proportion of active working hours and a faster pick-speed scenario 3 is the most beneficial because it requires that ZTZ is least active.

This study sought to understand why college students of Mexican origin underutilize mental health services (i.e., university counseling services). Previous research has identified several potential reasons for the underutilization of mental health services by Mexican Americans. These reasons can be grouped into one of three categories: (1) negative attitudes toward mental illness and mental health services, (2) greater use of alternative, informal resources, and (3) barriers. To examine these factors in the context of help-seeking behavior, Ajzen’s theory of planned behavior (TPB) was used. The TPB assumes that the best predictor of a certain behavior is an individual’s intention to perform that specific behavior. This model includes three determinants of the intent to perform a certain behavior: (1) attitudes toward the behavior, (2) subjective normative beliefs about performing the behavior, and (3) perceived behavioral control of performing the behavior. The primary aim of this study was to examine the meditating effects of culture on the TPB and investigate the unique factors contributing to help-seeking behavior in college students of Mexican origin reporting anxious and/or depressive symptoms. Results showed that the TPB was effective in predicting help-seeking behavior, with attitudes and subjective normative beliefs as the strongest predictors. Acculturation and cultural values did not mediate the TPB model as originally predicted, however the TPB determinants differed in predictability between help-seekers and non help-seekers. Specifically, among help-seekers, attitudes predicted intent to seek psychological services; among non help-seekers, subjective normative beliefs predicted intent. Help-seekers also reported more ease than non help-seekers on a few of the steps toward help-seeking. Lastly, qualitative measures supported findings based on the TPB and provided additional support for the strong stigmatizing views among college students of Mexican origin. These findings suggest that non help-seekers are a complex group and other variables, such as acculturative stress, perceived social support, and screening participants on perceived symptom distress and impairment, need to be addressed. In addition, subjective normative beliefs need to be considered in the development of psychoeducational interventions which encourage seeking psychological services for individuals of Mexican origin experiencing significant anxious or depressive symptoms. / text

The purpose of this study was to investigate the impact of Medicare Part D on prescription utilization, health services utilization, and health care expenditures in the general Medicare population – as well as Medicare sub-populations, including non-Hispanic blacks (NHBs), Hispanics, near poor individuals, and persons with higher disease burden. A retrospective analysis of Medicare beneficiaries (N=32,228) was conducted using the Medical Expenditure Panel Survey 2002 to 2009 data. Multivariable quantile regression was used to estimate the following outcomes, adjusting for socio-demographic characteristics: 1) number of prescription fills; 2) out-of-pocket (OOP) drug expenditures; 3) total drug expenditures; 4) OOP health care expenditures; 5) total health care expenditures; 6) number of hospitalizations; and 7) number of emergency department (ED) visits between the pre-Part D (2002-2005) and post-Part D (2006-2009) periods. All expenditures were inflation-adjusted to 2009 dollars. The average age of the study sample was 71.0 (SD=14.5). In the general Medicare population, Part D was associated with decreases in OOP drug expenditures (-25.7% to -33.6%; p<0.0001) and OOP health care expenditures (-22.1% to -24.3%; p<0.0001) as well as increases in the number of prescription fills (5.8% to 8.4%; p<0.0001) and total drug expenditures (75th percentile: 5.5%; 90th percentile: 10.2%; p<0.0001). Part D was not associated with changes in total health care expenditures in the general Medicare population. Changes in hospitalizations and ED visits were tested at the 90th percentile, and the results were not statistically significant. In sub-group analyses based on race/ethnicity, non-Hispanic whites (NHWs) experienced more significant reductions in OOP drug and/or health care expenditures when compared with NHBs and Hispanics. Near poor beneficiaries experienced larger reductions in OOP drug expenditures than beneficiaries with middle- to high-income, while Medicare beneficiaries with three or more conditions experienced more substantial reductions in OOP drug and OOP health expenditures after Part D was introduced, compared with those with fewer than three conditions. Part D resulted in increases in medication utilization and reductions in OOP drug and OOP health care expenditures among Medicare beneficiaries. Part D was not associated with differences in total health care spending. The effects of Part D were more pronounced in Medicare subgroups, including NHWs, near poor individuals, and patients with higher chronic disease burden. / text