Organizational culture refers to the beliefs and values that have existed in an organization for a long time, and to the beliefs of the staff and the foreseen value of their work that will influence their attitudes and behavior. Administrators usually adjust their leadership behavior to accomplish the mission of the organization, and this could influence the employees' job satisfaction. It is therefore essential to understand the relationship between organizational culture, leadership behavior and job satisfaction of employees.

Knowledge capital is becoming more important to healthcare establishments, especially for hospitals that are facing changing societal and industrial patterns. Hospital staff must engage in a process of continual learning to improve their healthcare skills and provide a superior service to their patients. Internal marketing helps hospital administrators to improve the quality of service provided by nursing staff to their patients and allows hospitals to build a learning culture and enhance the organizational commitment of its nursing staff. Our empirical study provides nursing managers with a tool to allow them to initiate a change in the attitudes of nurses towards work, by constructing a new ‘learning organization’ and using effective internal marketing.

This study is based on competitive dynamics theory, and discusses competitive actions (including their implementation requirements, strategic orientation, and action complexity) that influence hospitals’ performance, while also meeting the requirements of Taiwan’s “global budget” insurance payment policy. In order to investigate the possible actions of hospitals, the study was conducted in two stages. The first stage investigated the actions of hospitals from March 1 to May 31, 2009. Semi-structured questionnaires were used, which included in-depth interviews with senior supervisors of 10 medium- and large-scale hospitals in central Taiwan. This stage collected data related to the types of actions adopted by the hospitals in previous years. The second stage was based on the data collected from the first stage and on developed questionnaires, which were distributed from June 29 to November 1, 2009. The questionnaires were given to 20 superintendents, deputy superintendents, and supervisors responsible for the management of a hospital, and focused on medical centers and regional hospitals in central Taiwan in order to determine the types and number of competitive actions. First, the strategic orientation of an action has a significantly positive influence on subjective performance. Second, action complexity has a significantly positive influence on the subjective and the objective performance of a hospital. Third, the implementation requirements of actions do not have a significantly positive impact on the subjective or the objective performance of a hospital. Managers facing a competitive healthcare environment should adopt competitive strategies to improve the performance of the hospital.

The evidence of metformin’s effect on dementia is conflicting. This study investigates the association between metformin use and the risk of dementia among patients with diabetes mellitus (DM). This study included patients with new-onset DM between 2002 and 2013. We divided the patients into patients who used metformin and patients who did not. Two models were used to assess metformin use: the cumulative defined daily dose (cDDD) of metformin use and the intensity of metformin use. This study with 3-year and 5-year follow-ups investigated the risk of dementia among patients with DM who used metformin. At the 3-year follow-up, patients who received cDDD < 300 had an odds ratio (OR) of developing dementia of 0.92 (95% confidence interval [CI] = 0.89–0.96); patients who used metformin at intensities 500 (OR = 1.48, 95% CI = 0.48–4.60) or at an intensity >25 DDD/month (OR = 0.84, 95% CI = 0.60–1.18) were not associated with an incident of dementia. There were similar results at the 5-year follow-up. Patients with a low intensity of metformin use had a lower risk of dementia. However, higher doses of metformin with higher intensity exhibited no protective role in dementia. Prospective clinical trials are warranted to evaluate the actual underlying mechanisms between metformin dosage and the risk of dementia.

Background: Taiwan’s colleges and universities are struggling to maintain their student enrollment rates owing to the declining fertility rate. Focusing on students in higher education programs, this study aims to analyze online behavioral patterns for university departmental websites and accordingly, suggests response strategies to increase the rate of enrollment. Methods: We use Google Analytics to examine the websites of two departments in a medical university between February 1 and July 30, 2018. We study website patterns during the study periods for three college admission routes: STARS program, personal applications, and admission through examination and placement. Results: Most website visitors during the three visiting date ranges for the two departments are 18–24 years. The visitor groups are mainly freshmen at the university and their parents. The homepage and Subject Credits, Course Planning, Teacher Lineup, and Certificate of Subjects were the most visited webpages. The overall number of daily page views varied by academic event. Conclusions: University departments should enhance the presentation of featured courses on their webpage or distinguish course characteristics from those of competing departments in the curriculum to ensure clear market segmentation. In addition, departments should consider examining online data to identify suitable high schools that can be visited to attract potential students and to improve students’ willingness to choose their university.