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Previous studies on the interactive response system (IRS) have generally adopted the lecture method to facilitate teaching and learning, while few have made efforts to investigate the learning effects of instructional methods and IRS activities on learning and teaching. The purpose of the present study was therefore to explore whether the use of the IRS with two different teaching methods would affect students' learning performance. A quasi-experimental design was employed, with the teacher conducting the course using the learner as leader strategy in the experimental group (E.G.) and the teacher leader strategy in the control group (C.G.). The experiment was conducted over a period of 15 weeks (a semester), and questionnaires were administered at the beginning, in the middle and after the experiment to elicit the learners' views on the IRS application. The results support previous research which found that using the IRS improved learners' engagement and interaction. They also provide further evidence that the use of the IRS with both teaching strategies not only had a short-term learning effect but could also be a tool for sustaining students' learning motivation and self-directed learning for long-term learning purposes. Besides, the use of the learner as leader strategy contributed to enhancing discussion in groups, especially for the leading groups. The use of the IRS with the learner as leader strategy benefited those who acted as leaders in taking the initiative to learn the course content, and also engaged the students who acted as learners in concentrating on the course because it was their classmates who were leading. Lay Description What is already known about this topic The interactive response system (IRS) facilitates course interaction, and increases course attendance and learning performance, Most studies have integrated the IRS with lectures to facilitate teaching and learning, What this paper adds The paper explored the effectiveness of using the IRS with two teaching methods on students' learning for a semester., The use of the learner as leader strategy with IRS benefited the learners who acted as leaders in taking the initiative to learn the course content, and engaged the students who acted as learners in concentrating on the course., Implications for practice and/or policy Students are benefited in taking the initiative to learn the contents through hosting the IRS activity., Teachers could adopt both lectures and learner as leader strategy with IRS to sustain students' learning motivation and self-directed learning for long-term learning purposes. [ABSTRACT FROM AUTHOR]

This study developed a web‐based multimedia assessment system (WMA system) and applied it to science laboratory instruction. The goal was to improve students' knowledge acquisition under science laboratory instruction. The developed system enabled learners to perform self‐assessments by responding to multimedia technology test items online. The system recorded each learner's complete answer history and provided the students with personalized learning resources. This study adopted a quasi‐experimental research design. The learning content was an "experiment on separating mixtures." Students participating in the research were divided into a typical science laboratory instruction group (TI group; n = 25) and a group that received instruction through the WMA system (WMA group; n = 26). Before instruction, all the students completed the conceptual knowledge and experimental knowledge pretests. During instruction, the TI group watched the teacher's demonstration experiment, and the students then performed the experiment in a real laboratory. In the WMA group, after learning through the WMA system, the students also performed the experiment in a real laboratory. After instruction, all the students completed the conceptual knowledge and experimental knowledge posttests. The findings indicated that the students in the WMA group showed significantly higher improvements in their scientific conceptual knowledge and experimental knowledge. Lay Description: What is already known about this topic: Although science laboratory instruction is important to science education, the role of science laboratory instruction in science education has been increasingly questioned.Many teachers still follow outmoded science laboratory instruction methods in their teaching, which makes students treat scientific experiments as "following recipes to cook."Multimedia technology is effective in assisting science laboratory instruction because proper scientific experiment course and computer‐simulated activities allow students to solve scientific problems dynamically.What this paper adds: This research proposed an effective approach to perform science laboratory instruction based on digital self‐assessment and combines it with the teaching activities in a real laboratory.The web‐based multimedia assessment system (WMA system) are developed to administer multimedia technology test items and assist students in performing self‐assessment in science laboratory instruction.Integrating WMA system into science laboratory instruction is effective in improving students' conceptual knowledge and experimental knowledge.Implications for practice: Conducting scientific experiments online using a self‐assessment approach allows students to examine their own understanding of scientific experimental procedure and receive personalized learning feedback.The online self‐assessment approach could be applied in "flipped learning" of science laboratory instruction to allow learners to do assessment‐centred personalized online learning about scientific concepts and knowledge related to scientific experiment before performing a real scientific experiment. [ABSTRACT FROM AUTHOR]

Background The Taiwanese government launched a new programme in November 2004 to support adults with intellectual disabilities living in smaller facilities. This paper aims to evaluate the service outcomes of this new residential scheme over 2 years including those residents who moved from an institution and those who moved from their family. Methods A one-group repeated-measures analysis was conducted for five interviews after the adults with intellectual disabilities entered the new environment. Forty-nine adults were initially studied (T1) and 29 adults remained in the homes until the end of the study (T5). Results This study found significant improvements over the 2 years in the residents' quality of life and family contact. The results also highlight a decrease in maladaptive behaviour among the residents moving from institution and an increase in choice making and family contact among the residents moving from family. No significant changes in adaptive behaviour and community inclusion were found. Conclusion Results revealed that further policy changes and financial support including service quality assurance are required in order to improve service outcomes for adults living in the new residential scheme. [ABSTRACT FROM AUTHOR]

Cardiac disease and type 2 diabetes are prevalent diseases globally. Cardiac rehabilitation and diabetes self-management programs empower patients' self-management to improve their health outcomes. However, inappropriate delivery modes and continuing low participation rates indicate some programs are less than optimal. A previous study demonstrated the feasibility of incorporating telephone and text messages into a cardiac-diabetes self-management program in Australia; however, the program did not specifically address patients' cultural backgrounds. This current study used a randomized blocked design to evaluate short-term efficacy of the cardiac-diabetes self-management program incorporating telephone and text-messaging across different cultural contexts in Australia and Taiwan in comparison to usual care. No significant differences between groups were observed for outcomes of self-care behavior, self efficacy, knowledge and health-related quality of life, with patients in both groups demonstrating improvements. Patient-reported outcomes indicated some evidence of an interaction effect between country of origin and group allocation. Findings indicated an improved tendency of outcome measures between the baseline and follow-up assessments within usual care and intervention groups. Further research is required to clarify components of the program work for each cultural group. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims and objectives To determine the effectiveness of an oral health care program for preventing ventilator-associated pneumonia ( VAP). Background Research has shown a significant correlation between oral bacteria and VAP, indicating that an oral health care program plays a very important role in VAP prevention. Design and methods A quasi-experimental study was used and conducted in the intensive care unit in a medical centre. A total of 199 mechanically ventilated patients were enrolled and divided into two groups: the experimental group ( n = 99) and control group ( n = 100). The experimental group was cared for using an evidence-based oral health care program, and the control group was cared for using routine nursing care procedures. Each group received the assigned treatment for four consecutive days. Results The incidence of VAP in the experimental group (4%, 4/95) was significantly lower than that in the control group (21%, 18/82). The oral assessment guide ( OAG) mean score (9.16 ± 2·07) of the experimental group was significantly different ( P < 0·05) from that of the control group (10·07 ± 1·79). The general estimated equation further showed that there was a significant difference between groups ( P < 0·01) for the third post-test data and no significant difference for the pre-test or the first and second post-test data between groups, indicating that an increased duration of intervention resulted in significant decreases in the OAG scores in the experimental group compared with the control group. Conclusions The evidence-based oral health care program effectively improved oral mucosal health and statistically reduced the incidence of VAP in this study. Relevance to clinical practice The study findings may be useful as an empirical reference for health care professionals performing an oral health care program in the future. Additionally, it may serve as a reference for long-term care policies aimed at reducing the ventilation duration, days of hospitalization and mortality rate to enhance patient safety and the quality of medical care. [ABSTRACT FROM AUTHOR]

The aim of this study is to measure the levels of uncertainty in radical prostatectomy (RP) recipients who have received psychological support in comparison with those who have not. RP is one of the most effective treatments for prostate cancer, but its complications may cause patients to have a sense of uncertainty. A questionnaire survey was conducted. Participants were recruited from two hospitals. Sixty-two participants who underwent an RP were recruited to the support group, and 43 participants were included in the non-support group. The support group of males received psychological support and the control group of males did not receive psychological support. A survey was developed and used to assess each male, at least 3 months after his RP. All subjects participated in the survey and self-reported using the Chinese version of the Mishel Uncertainty Illness Scale (MUIS). The reliability ( α) of the overall MUIS was 0·92 in this study. The mean level of the uncertainty score among the support group was 45·65 (SD = 10·81), and 80·47 (SD = 5·00) among the non-support group. Two-way anova showed that psychological support produced a significant effect ( F = 197·25, p < 0·001), which indicated that the males in the psychological support group expressed lower levels of uncertainty than males in the non-support group. The results suggest that offering psychological support is an effective nursing intervention that can decrease the levels of uncertainty in RP recipients. The feeling of uncertainty among post-RP patients is common. Urological nurses should therefore assume the responsibilities associated with the consequences of prostate cancer treatment, including understanding the treatment's relevant information, seeking appropriate nursing interventions and providing psychological support to decrease the level of uncertainty in RP patients. [ABSTRACT FROM AUTHOR]

We investigated the assumption that independent versus interdependent self-construals yield different manifestations of psychological reactance in different group contexts. We expected collectivists (interdependent) to value the collective freedom of an ingroup more in face of an outgroup threat than individualists (independent) who should be protective of their individual freedom especially within an ingroup. In Study 1, we showed that collectivists (Taiwanese students) did not show reactance when a threat to their freedom of choice originated in the ingroup, but they did show reactance when it originated in an outgroup. In Study 2, Austrian students showed more reactance the more interdependent their self-construal was when confronted with an outgroup restriction. However, the more independent Austrian students' self-construal was, the more reactance they showed when the threat came from the ingroup. Priming an independent (versus interdependent) self-construal in Study 3, we again observed more reactance when freedom was restricted by the ingroup. The findings underline the importance of understanding psychological reactance as a socially situated phenomenon. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Urinary incontinence (UI) is a major complication among patients after radical prostatectomy (RP). Although previous research supports the efficacy of pelvic floor exercises for male UI, there are both positive and no significant effects. The purpose of this study was to examine the effect of pelvic floor exercises on UI after RP. This was a quasi-experimental, randomized, mixed-method study design. All participants were older than 45 years and had undergone an RP. Outcome measurements included a 1-h pad test, personal demographics, and disease-related data. After catheter removal, participants were distributed into either an exercise group ( n = 39) or a non-exercise group ( n = 28). Patients in the exercise group took part in a pelvic floor exercise during their regular daily activities. The non-exercise group did not perform the prescribed exercise. We examined urinary function at 1, 3 and 6 months after catheter removal. Following a mixed-model anova test for differences, the results of the pad test revealed significant differences for the main effect of time ( F = 75·30 ,P < 0·001), indicating that the amount of urine leakage decreased over time regardless of the group. Results for the main effect of group were statistically significant ( F = 8·85 ,p < 0·01), indicating that urine leakage also decreased over time in both groups, but that urinary control in the exercise group was better than in the non-exercise group. Although improvements in surgical technique have significantly improved the outcome of prostate surgery, we believe that patient education regarding pelvic floor exercises by a nurse prior to and after surgery has a significant impact on the early recovery of urinary continence. We believe these exercises would certainly have a positive impact on our patients undergoing RP by improving the quality of life after major urological surgery. [ABSTRACT FROM AUTHOR]

Urinary incontinence (UI) and sexual dysfunction are common complications among patients after radical prostatectomy (RP). Although a nerve-sparing procedure has been recommended to reduce these two complications, the benefits of this procedure still need to be examined in Taiwan. The purposes of this study were to describe and compare the changes over time in the urinary and sexual function of prostate cancer patients treated with or without nerve-sparing RP. In this study, a longitudinal pre-test and four post-test study designs were employed. In all, 62 prostate cancer patients who had undergone an RP were recruited from two hospitals in southern Taiwan. Structure questionnaires and one-hour pad tests were administered to the patients upon their first visit to the urological clinic (as baseline data) and at follow-up visits at the clinic 3, 6, 9 and 12 months after RP. All of the patients experienced UI and sexual dysfunction from the first month after undergoing an RP to 12 months. A two-way multivariate analysis of variance with repeated measurements indicated that the nerve-sparing procedure ( F = 4·41, p < 0·01) and time ( F = 12·47, p < 0·001) significantly affected the combined dependent of UI and sexual function. The results of a univariate analysis of variance indicated that the International Index of Erectile Function (IIEF) scores were significantly different for patients who underwent the nerve-sparing procedure ( F = 7·72, p = 0·001), but pad weights were not altered by the effects of the nerve-sparing procedure. Regarding the effects of time, the results demonstrated that both pad weights and IIEF scores changed significantly over time ( F = 12·47, p < 0·001). This study demonstrates that nerve-sparing positively affects sexual dysfunction, but that it exhibits limited benefit for UI in RP patients. These results can assist health care providers in providing patients with pre-operation information. [ABSTRACT FROM AUTHOR]