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Background: Behavioural intention (BI) has been predicted using other variables by adopting the technology acceptance model (TAM). However, few studies have examined whether BI can predict learning performance. Objectives: The present study used an extended TAM to investigate whether students' BI is a predictor of their listening learning performance (LLP) through vocabulary learning performance (VLP) in the context of mobile vocabulary‐assisted listening learning by using two mobile learning tools. Methods: A total of 129 college students with a pre‐intermediate level of English were recruited as participants, and a 10‐week mobile vocabulary‐assisted, listening‐learning course was conducted in 2022. In each task of this course, the students had to learn target words from a listening passage on Quizlet and then engage in listening activities on Randall's ESL Cyber Listening Lab. Quantitative responses obtained through an online questionnaire were analysed through partial‐least‐squares structural equation modelling. Results: The analysis results indicated that BI significantly predicted LLP through VLP. Perceived ease of use (PEU) and perceived usefulness (PU) were significant antecedents of BI. However, PEU did not significantly predict PU because of the difficulty of navigating between the two technological tools used in this study. The extended model demonstrated its effectiveness in explaining listening learning performance, as evidenced by an explained variance (R2) of 69%. Conclusion: The extended model validates the influence of BI on learning performance and it can also draw teachers' focus toward the significance of enhancing students' BI to improve their listening learning performance. Pedagogical implications based on the results are provided in this paper. Lay Description: What is already known about this topic?: TAM was used to study learners' acceptance of mobile‐assisted language learning.TAM incorporates latent variables to explore mobile‐assisted language learning.Investigating factors influencing BI is a primary research focus in extended TAM literature.Mobile tools could improve listening learning and vocabulary retention. What this paper adds to that: Learning performance was considered as a dependent variable in an extended TAM.BI might predict students' learning performance in vocabulary and listening in an extended TAM.Teachers used two mobile tools to design mobile vocabulary‐assisted listening tasks.Pre‐learning the target words facilitate students' listening learning performance. Implications for practice and/or policy: We show the importance of BI on predicting listening learning performance.The impact of BI on other factors became another focus of TAM research.Results highlight pre‐learning target words' importance for better listening performance.Existing mobile tools improve listening performance, avoiding new system development. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Because the definition of spirituality is complex and has cultural and individual dimensions, it is important to be receptive to individual differences in the perception of spirituality during clinical practice of mental health nurses.Although enhancing spiritual care is beneficial to patients diagnosed with mental illnesses, the extrinsic (e.g., education) and intrinsic factors that would affect nurses' attitudes towards spiritual care have not been investigated.Notwithstanding the known impact of certain intrinsic factors (e.g., personality‐related) of mental health nurses on their coping strategies as well as their emotional and mental health, the link to their spiritual care attitudes has received little attention. What this paper adds to existing knowledge?: This paper is the first to identify the beneficial impacts of extrinsic factors including postgraduate education, working experience, participation in palliative care education programmes, and spiritual care experience on spiritual care attitudes among mental health nurses.Certain intrinsic factors, including those personality‐related such as "Extraversion," "Openness/Intellect," "Conscientiousness," and "Agreeableness," were also associated with higher awareness of providing spiritual care among mental health nurses. What are the implications for practice?: The finding of an association of certain intrinsic factors with more positive attitudes towards spiritual care could encourage further studies to explore possible links between these factors and attitudes of spiritual care.Those less aware of the patients' spiritual needs may benefit through participating in relevant education and on‐the‐job training programmes that involves actual practice and collaboration in a multidisciplinary team. Introduction: Although enhancing spiritual care can facilitate the communication of mental health nurses with patients diagnosed with mental illnesses, extrinsic and intrinsic factors that may influence their spiritual care attitudes remain unclear. Aim: To conduct a questionnaire‐based survey on mental health nurses from eight hospitals. Method: A total of 239 psychiatric nurses were assessed based on (1) "big‐five Mini‐Markers" questionnaire and (2) spiritual care attitudes scale on three components (i.e., core values, growth, and nursing) to investigate the associations of spiritual care attitudes with social/occupational characteristics and personality. Results: A positive attitude was significantly associated with working experience, higher educational level, previous participation in palliative care education programmes, spiritual care experience, and personality factors including "Extraversion," "Openness/Intellect," "Conscientiousness," and "Agreeableness." Discussion: Despite demonstrating impacts of intrinsic factors (e.g., personality) on mental health nurses' spiritual care attitudes, other modifiable extrinsic factors (e.g., education) were important in enhancing their awareness towards spiritual care. Implications for Practice: Our findings encourage further studies to explore possible links between intrinsic factors and attitudes of mental health nurses towards spiritual care as well as suggest benefits of continuing education and on‐the‐job training that involves actual practice and collaboration in a multidisciplinary team to provide spiritual care. [ABSTRACT FROM AUTHOR]

This study evaluated the driving performance of drivers presented with 2D and 3D electronic navigation maps and a traditional paper map with various route structures. A heads-up display was used to show the different driving conditions for each navigation map system. Results revealed that the drivers using an electronic navigation map performed better compared to the drivers using a paper map. The results also indicated that drivers who used 2D-regular pattern or 2D-irregular corner maps performed more efficiently than the drivers who used a 3D-regular pattern or 3D-irregular corner maps in reaching their destinations. In addition, drivers can save time and fuel by using 2D navigation maps in unfamiliar regions. [ABSTRACT FROM AUTHOR]

Today, the various abilities that nurses require to meet patients' healthcare needs adequately are all affected by AI-enabled systems. This research used an experimental study design in which 60 subjects were randomly assigned to either an experimental (AI image e-book guidance) group or a control (text paper guidance) group after meeting the admission conditions and agreeing to participate in the study. It was proven that providing AI image e-book guidance before surgery significantly changed the behavior of patients and promoted relief of urinary catheter discomfort through self-efficacy to reduce urinary catheter pain after surgery (p < 0.001). It was found that providing AI image e-book guidance can shorten the time for health education and provide patients with repeated medical education and familiarity with health guidance, which can help to address the important clinical service demand issue and the shortage of nursing staff. [ABSTRACT FROM AUTHOR]

Background: Previous research has examined the use of augmented reality (AR) and virtual reality (VR) in English language teaching. However, to the best of our knowledge, none of the earlier studies that investigated integrating AR and VR "wearables" into teaching and learning English based on the attention, relevance, confidence, and satisfaction (ARCS) motivation model compared the differences in learning motivation and performance between traditional teaching methods and those using AR‐ and VR‐based using wearables. Objectives: To create a thematic learning environment based on learners' lived experiences and provide them with an immersive English course that extends textbook knowledge using a technology‐assisted real‐life learning context. Method: This study used a quasi‐experimental research design. A total of 119 participants were spilt into three learning groups based on teaching tools: traditional methods and AR‐ and VR‐based wearable devices. The performance of each group was evaluated through three stages using appropriate educational tools for traditional, AR‐, and VR‐based classrooms, followed by semistructured interviews. Multiple regression analysis was conducted to investigate the inference learning performance (remembering and analysing) of the four ARCS dimensions with the three teaching methods. Results: The results showed that confidence and relevance were positively correlated with learning performance in the VR‐based wearable group. In the context of the ARCS model, learners' confidence predicted learning performance and the remembering subdimension when VR‐based learning materials were used. Implications: These results suggest that, compared to traditional teaching methods, VR‐based wearables make it easier to create a highly immersive learning environment and are more likely to help learners find the correct words, improve their accuracy, and increase their confidence and sense of accomplishment in the entire learning process. Lay Description: Augmented reality (AR) and virtual reality (VR) allow learners to apply memorized subject knowledge to real‐life scenarios.The attention, relevance, confidence, and satisfaction (ARCS) motivation model enhances learning. What this paper adds: The study proposed the integration of AR and VR with "wearables" for teaching English.The study investigated the differences between how the teaching materials designed to incorporate different technological devices with the four ARCS dimensions predict their learning performance (remembering and analysing). Implications for practice and/or policy: The ARCS motivation model‐based design allows learners using VR‐based wearables to learn English through multiple interactions in real‐time.Integrating daily life experiences with course materials can attract learners' attention in the early stages of teaching.VR‐based learning creates a virtual learning environment relevant to the learners, allows them to learn English thematically in an immersive environment, and allows them to interact with the system. [ABSTRACT FROM AUTHOR]

Scholars have suggested that flipped learning can be enhanced by designing effective in‐class learning activities to improve students' higher order thinking skills. Problem posing has been recognized as such a learning strategy that has great potential for improving students' higher order thinking skills. However, it has been reported as a challenging task for most students. Research evidence has indicated the potential of engaging students in group learning with step‐by‐step hints when conducting problem‐posing activities. Therefore, this study proposed a multilevel concept mapping‐based problem‐posing strategy to assist students in completing the problem‐posing tasks in flipped learning. To understand the effectiveness of the proposed strategy, a flipped learning system was developed and adopted in the science class of an elementary school. Seventy‐five fifth graders from three classes were divided into experimental group A, experimental Group B and a control group. Students in Group A used the concept map‐guided problem‐posing strategy for flipped learning (CMPP‐FL), students in Group B used the problem‐posing strategy‐based flipped learning, while students in the control group used the conventional flipped learning strategy. The results showed that the CMPP‐FL was effective in terms of improving students' learning performance, especially for students with higher levels of critical thinking tendency. Lay Description: What is already known about this topic: Flipped learning enabled teachers to have more class time to engage students in applying knowledge.Scholars have suggested that the value of flipped learning can be enhanced by designing effective in‐class learning activities to improve students' higher order thinkingProblem‐posing has been recognized as such a learning strategy that has great potential for improving students' higher order thinking. What this paper adds: This study proposed a multilevel concept mapping‐based problem‐posing strategy to assist students in completing the problem‐posing tasks in flipped learning.A flipped learning system was developed and adopted in the science class of an elementary school.It was also found that the results showed that the concept map‐guided problem‐posing strategy was effective in terms of improving students' flipped learning performance, especially for those with higher levels of critical thinking tendency. Implications for practice and/or policy: Employing concept maps as a guidance for problem posing is a promising approach.It is worth investigating the impacts of the concept map‐guided problem posing approach on the students with different personal characteristics, such as knowledge levels or motivational levels.It is worth applying the approach to other courses in the future to further explore its effectiveness. [ABSTRACT FROM AUTHOR]

Robotics education has received an increasing attention in recent years as a means to build students' motivation, team collaboration skills, and other valuable 21st century competencies. Yet there is a lack of experimental studies to investigate and identify strategies to facilitate robotics education. This study adopted a 2 × 2 quasi‐experimental design to investigate two strategies: the incorporation of augmented reality (AR) and the introduction of competition in robotics activities. Students' robotics task performance, team collaboration processes, 21st century learning competencies and learning motivation were measured as dependent variables. The results indicated that AR significantly improved students' motivation, team processes, and 21st century competencies. Moreover, the effects of AR were more pronounced with the competition groups. Implications are drawn to provide guidelines on the use of AR and competition in robotics education. Lay Description: What is currently known about the subject matter?Robots in education have been recognized as an effective approach to enhance learning competencies.The benefits of AR in learning gains and motivation. What their paper adds to this?To design robotics curricula that can be used in middle schools.To understand what middle school students can learn from the robotics curricula. The implications of study findings for practitionersHow to utilize AR in robotics education.What are the structure and pace of robotics curricula for middle school students? [ABSTRACT FROM AUTHOR]

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]

Because the microworld can create a learning environment that allows learners to interact with the real world, the view of the microworld has been widely used in education and training. In this study, the simulated transactional interactive concurrent system (STICS) was used to provide an environment that simulates the stock market trading of the Taiwan Stock Exchange; the goal is to explore the effectiveness of using STICS in enhancing the financial literacy of students. This study adopts a quasi‐experimental design approach and divides students into two groups. The intervention group was made up of 42 students who learned financial knowledge aided by STICS, with a comparison group consisting of 43 students who learned with traditional lecturing and dictating methods. The study found that learners who used the STICS as an aid to learn financial knowledge had significantly better learning effectiveness than those who did not use STICS, in terms of motivation, attitude, and achievement. The intervention group also made significant improvements in average scores in learning motivation and achievement after 8 weeks of experimental teaching and learning. Lay Description: What is already known about this topic This study employs the microworld perspective as a learning scaffold which simulates the real financial environment through computer assistant learning.By means of the computer assistant learning pattern of STICS, it not only enhances the financial literature of learners, but also increases the happiness and fun in the learning process. What this paper adds This allows learners can free from the barrier of insufficient investment funds by using STICS computer assistant learning.The STICS computer assistant learning system have the potential of promoting interactivity between learners and instructors, and improving the students' financial achievements. Implications for practice and/or policy The benefits of the STICS computer assistant learning are not only to enable students to deepen their understanding of the content of the textbook, but also to experience practical trading environment, such as profitability, risk, delivery and payment, long‐buying and short‐selling, etc.From this study, it is known that improving students' financial literacy not only contributes to personal wealth, but also avoids the recurrence of financial turmoil.In the future, we should devote ourselves to teach students how to apply knowledge to the real environment in an immersive learning, without being out of reality. [ABSTRACT FROM AUTHOR]

This study aims to examine changes in body image (BI) over time and factors related to BI among patients with prostate cancer who receive hormone therapy (HT). A cross-sectional design and longitudinal design were utilized. Patients with prostate cancer who received HT were recruited from the urology outpatient departments in two hospitals in Taiwan between August 2017 and December 2020. Cross-sectional data were collected from 177 patients who had started HT for prostate cancer. Longitudinal data were collected from 34 newly diagnosed patients before receiving HT and at 1, 3, 6, and 12 months after HT. The variables measured included hormonal symptoms and distress, self-efficacy, and BI. The results showed that BI dissatisfaction ranged from 6.1% to 17.2%. Hormonal symptoms and distress (e.g. lack of vitality) were correlated with BI dissatisfaction. Education on the side effects of HT and coping strategies can be provided to patients to prevent BI dissatisfaction. [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]

Introduction: Many tactile graphics designed for individuals with visual impairments consider single factors. According to the results of our previous study, there may be interactions among scale, representation, and complexity factors. We conducted this integrative study with these three factors. Additionally, for the representation factor, we introduced a new level that mixed the two common levels (line drawing, (LD), and texture picture, (TP)), into a textured-line drawing, (TLD). Methods: We included 18 participants with congenital blindness. They were asked to identify and name tactile graphics. The design of tactile graphics involved three factors, each at different levels, including scale (large, medium, and small), representation (TP, LD, and TLD), and complexity (easy and complex). We recorded the identification time and accuracy and conducted three-way analysis of variance to investigate interactions. Results: The identification time for small-scale graphics was shorter than that for large-scale graphics. The accuracy for small-scale graphics was higher than medium-scale graphics. Under the TLD mode, the accuracy for small and medium-scale graphics was higher than that for large-scale graphics. For medium-scale graphics, TLD performed better than LD. Discussion: Because the sizes of small-scale graphics were similar to those of actual objects, they were easy to identify. If the TLD mode is used for medium-scale graphics, the components in the operation area can be completely presented, which is helpful for identification. However, if large-scale graphics are used under the TLD mode, the operation area is relatively small and difficult to identify. Implications for Practitioners: It is recommended to present objects at 1:1 under the small-scale. Under the medium-scale, the operation area can be presented by closed plains, while non-operation areas can be presented using lines. Under the large-scale, it is recommended to reduce the size of the graphics to an extent where both hands can be used to explore. [ABSTRACT FROM AUTHOR]

Background: Establishing a nurturing bond with the unborn child is essential for expectant mothers throughout pregnancy. While the influence of family support and pregnancy adaptation on maternal-fetal bonding is evident, these factors remain unexplored in the early stages of pregnancy. This study aims to elucidate the dynamic interaction between family support, pregnancy adaptation, and maternal-fetal bonding during the first trimester, explicitly investigating the mediating role of pregnancy adaptation. Method: A cross-sectional design was conducted to recruit expectant mothers between 8 and 12 weeks of gestation without significant complications. Results: Family support and pregnancy adaptation emerged as significant predictors of maternal-fetal bonding, and pregnancy adaptation mediated the relationship between family support and maternal-fetal bonding in the first trimester. Conclusions: The study confirms the critical role of family support and pregnancy adaptation in facilitating maternal-fetal bonding during early pregnancy, with pregnancy adaptation fully mediating this relationship. Healthcare providers are encouraged to involve family members in early interventions, focusing on assessing family support and engaging them in education and activities to strengthen the emotional bond between the mother and her unborn child. [ABSTRACT FROM AUTHOR]

Background: Media guidelines for suicide reporting are available in many countries. However, to what extent the mass media comply with the guidelines is unknown. Few studies are available that investigate systematically whether the mass media reflect the epidemiological reality of suicide deaths in their articles. Methods: Based on the WHO media guidelines, this study investigated the characteristics of newspaper articles of suicides in three Chinese communities, namely Hong Kong, Taiwan and Guangzhou. Epidemiological comparisons were conducted to identify the age and gender differences between the suicide victims as reported in the newspapers and the official records of suicide deaths in all three places. Results: The results found that one media characteristic complied with the WHO media guidelines (ie, only about 2% of the articles were printed on the front page), but there were a number of instances of non-compliance (ie, only 4--14% provided sources for help-seeking and 27--90% printed with photos). The epidemiological comparisons revealed an over-representation of younger suicides and an under-representation of late-life suicides in the newspapers of all three places. Furthermore, female suicides were found to be under-reported in Taiwan and Guangzhou newspapers, but not in Hong Kong papers. Conclusion: Non-compliant suicide articles are prevalent in the newspapers of these three Chinese settings. The observed media misrepresentations may potentially mislead the public and the policy makers about the actual risk for suicide in some demographic groups. [ABSTRACT FROM AUTHOR]

Medical Education 2010: 44: 864–873 Objectives Ethical reasoning in medicine is not well understood and medical educators often find it difficult to justify what and how they teach and assess in medical ethics. To facilitate the development of moral values and professional conduct, a model of ethical reasoning was created. The purposes of this paper are to describe the ethical reasoning model and to indicate how it can be used to foster moral and ethical behaviours. Methods The ethical reasoning model was created from information derived from two sources: (i) an examination of different ethical models described in the literature, and (ii) think-aloud interviews with ethical experts in Taiwan and Canada. All the components and cognitive steps used by experts in ethical decision making were extracted and categorised. Interview subjects consisted of 16 voluntary ethics experts. The ethical reasoning models reported in the literature were divided into two groups according to whether they were justification-based or task-based models. Neither of the two types represented the ‘whole picture’ of ethical reasoning in medicine. This analysis enabled us to identify five universal cognitive steps and the gaps between ‘logical decision’ and ‘action’. Results The think-aloud interviews verified the multi-dimensional components or steps used by experts when resolving ethical problems. The resulting model, designated the Medical Ethical Reasoning (MER) Model, reflects interactions within three domains: medical and ethical knowledge; cognitive reasoning processes, and attitude. Conclusions The MER Model accurately reflects how doctors resolve ethical dilemmas and is seen to be helpful in identifying what and how educators should teach and assess in ethical reasoning. The model can also serve as a communication framework for curricular design. A ‘humane’ doctor is competent in providing quality, ethical patient care. Making an appropriate ethical decision is the foundation for subsequent ethical behaviours. By contrast with the abundant evidence cited in previous research describing how doctors solve medical problems, there is little empirical evidence indicating how doctors make appropriate ethical decisions. Thus, the cognition of ethical reasoning in medicine is not well understood. This paper represents a step towards overcoming this problem. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the usefulness of augmented reality (AR) in teaching. An experiment was conducted to examine children's learning performances, which included the number of errors they made, their ability to remember the content of what they had read and their satisfaction with the three types of teaching materials, including a picture book, physical interactions and an AR graphic book. The three teaching materials were aimed to respectively demonstrate the characteristics of six bacteria with 2D graphics, 3D physical objects, and 3D virtual objects. Seventy-two fifth-grade children were randomly selected to participate in the study, and they were divided into three groups, each of which used the assigned teaching material to learn the name of the six different bacteria in intervals of 1, 2 and 3 min. Results showed that the AR graphic book offers a practical and hands-on way for children to explore and learn about the bacteria. Follow-up interviews indicated that the children liked the AR graphic book the most, and they preferred it to the other materials. Lay Description What is currently known about Augmented Reality and learning? Augmented reality (AR) provides a new perspective for learning by allowing learners to visualize complex spatial relationships and abstract concepts., What the paper adds to the subject matter? AR improves learning performances to a similar extent as the most used teaching materials (both picture books and physical interactions) do., AR not only facilitates learning but also increases learning motivations better than conventional teaching materials do. The implications of study findings for practitioners. If children feel bored about reading textbooks, give them AR (because AR effectively enhances learning and children are more motivated when using AR)., AR teaching material is a good alternative to conventional picture book and physical interactions. [ABSTRACT FROM AUTHOR]

Learning a foreign language requires interaction with language input while involved in a task. Given that problem‐based learning (PBL) offers hands‐on application in realistic contexts, and that virtual reality (VR) enables learners to interact with multiple modalities of information, this study examines how the integration of VR technology into PBL contexts affects students' motivation for, problem‐solving during, and vocabulary acquisition in learning English as a foreign language (EFL). A total of 84 engineering majors who enrolled in a course of English for specific purposes were randomly assigned to either an experimental group or a control group. Students in the experimental group participated in a VR‐assisted PBL context, in which they were to view a PBL scenario using VR technology and then to create VR videos about solving the given problems. Those in the control group participated in a PBL context without the use of VR technology for viewing and solving the identical scenario. After the intervention, all the students wrote a problem‐solving analysis, took a vocabulary knowledge test, completed a learning motivation questionnaire, and participated in individual interviews. The results showed that the students in the experimental group significantly outperformed those in the control group in terms of vocabulary acquisition, and were more motivated to learn English related to their future careers, whereas there was no significant difference in the problem‐solving performance of the two groups. Implications of these findings highlight the value of engaging EFL learners in immersive environments for contextualized learning through the integrated use of VR and PBL. Lay Description: What is already known about this topic?: Virtual reality (VR) technology has been shown to enhance students' knowledge and skills in STEM fields.Problem‐based learning (PBL) has been widely used in medical education but not so much in foreign language education.English as a foreign language (EFL) students usually have very limited access to the target language beyond the classroom, thus lack a motivating reason for them to learn English after graduation. What this paper adds?: The VR‐assisted PBL approach proposed in this study was found to significantly enhance the EFL students' specialized vocabulary knowledge.The VR‐assisted PBL approach was found to motivate and sustain the EFL students' interest in career English.Exposing the EFL students to PBL contexts was capable of developing their problem‐solving performance, regardless of VR integration. Implications for practice and/or policy: The proposed approach has the potential to facilitate student learning in EFL education, particularly English for occupational purposes.EFL educators may apply the VR‐assisted PBL approach to narrow the gap between language classrooms and workplace contexts by immersing students in authentic contexts that were relevant to their occupational knowledge and workplace English. [ABSTRACT FROM AUTHOR]

Background: Team-Based Learning (TBL) is a potentially effective method of instruction that has been applied only infrequently in nursing education in Taiwan. Purpose: This study was developed to examine the effects of incorporating the TBL strategy into the course "Advanced Medical Nursing English". Methods: A quasi-experimental, single group, and pre-post test design was adopted. Nursing students who took the "Advanced Medical Nursing English" elective course used the TBL strategy for 8-weeks. Students were assigned to heterogenic groups of 12 students each based on their scores on an English pre-test. The collected data included the scores on individual and group readiness tests, a self-directed learning questionnaire, learning satisfaction, and an English posttest. Self-completed reflection papers and focused group interviews were used for qualitative appraisal. Results: A total of 72 students were enrolled. Nearly all (93.1%) were female and 21-22 years of age. The results of a paired samples t-test applied to examine the effects of the TBL strategy on learning outcomes showed that English posttest and self-directed learning ability scores had both improved significantly (all p < .05). The results of ANOVA tests showed that students with lower pre-test scores improved more than those with higher pre-test scores. The results of a sample t-test with a test value of 4.0 applied to examine learning satisfaction found a non-significant change (p > .05), indicating no change in perceived satisfaction. The qualitative analysis identified four themes regarding perceptions of the TBL strategy, including "friendships in learning", "harmonious atmosphere and participations", "inertial shock and adjustments", and " excessive learning load". Conclusion: TBL was shown to be an effective learning strategy for RN-BSN students in a Medical Nursing English Course, particularly those with relatively low pre-test scores. Future studies should focus attention on reading assignments to avoid overburdening students. The results of this study may serve as a reference for medical nursing English education. [ABSTRACT FROM AUTHOR]

This study aimed to examine the group differences in participation level between children with and without global delays and to explore the associations between mastery motivation, executive function, and participation in young children with and without global developmental delays (GDD). Methods: we recruited 26 children with GDD aged 2 to 5 years and 26 children with sex- and mental age-matched developing typically (TD). The participants were assessed child development using the standardized developmental test, and their mothers were asked to fill in questionnaires, including the revised Dimension of Mastery Questionnaire (DMQ 18) with preschool version to assess mastery motivation, the Behavior Rating Inventory of Executive Function with preschool version (BRIEF-P) to assess executive function, and the Young Children's Participation and Environment Measure (YC-PEM) used to obtain participation levels. Results and conclusions: young children with GDD showed significantly lower participation levels at home, daycare, and community than TD group. We found that for young children, child mastery pleasure, health condition, and total persistence were significant predictors of child participation. Therefore, coaching parents to observe and facilitate their children's motivation and executive function, as well as child developmental abilities, is important in order to enhance children's participation in daily activities. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sleep and mental health are very important in the aviation industry. Reports show that gender is one of the risk factors of insomnia, and most Asian flight attendants are female. Therefore, it is necessary to understand insomnia, and the correction to mental health among female flight attendants. OBJECTIVE: To investigate the prevalence of insomnia in female flight attendants and its association with mental health. METHODS: We used a cross-sectional design. We recruited 412 female flight attendants with more than 3 months of working experience. We collected the socio-demographic and work-related data, measured insomnia and mental health by the Athens Insomnia and Brief Symptom Rating Scales. Descriptive statistics, single-factor analysis of variance, Pearson's correlation analysis, and structural equation modeling were performed to analyze the relationships. RESULTS: There are 45.4% of female flight attendants having insomnia, and 24.8% had suspicious insomnia. The most considerable and serious insomnia problem was falling asleep (15.3%, 4.9%). Factors related to insomnia include smoking, drinking, family load (e.g., housekeeping and caring for family), economic stress and late-night/early morning workdays during last month. Also, insomnia had a direct association with mental health (T = 17.11, p < 0.001). CONCLUSION: We found that insomnia is negatively correlated with the above factors and mental health. We recommend that airline industries can run their sleep-education programs and provide relevant mental-health-promotion programs for flight attendants. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Suicide is a global mental health issue. Taking care of suicidal individuals is a substantial challenge. Most studies emphasize the suicidal individual. Few studies have emphasized the family caregivers of suicidal individuals., No study has explored the relationship between family caregivers' caring stress with suicidal attitudes and suicide care ability., What this paper adds to existing knowledge? The main results indicated that the older family caregivers tended to have a more negative attitude towards suicidal individuals. Female family caregivers' stress was higher than that of male family caregivers., A mild level of caring stress would help family caregivers have a more positive attitude towards suicidal individuals. Furthermore, a positive attitude would help family caregivers improve their caring ability., What are the implications for practice? Mental health nurses could help family caregivers, especially female family caregivers, reduce their holistic caring burden by looking for support resources and enhancing their coping strategies., Mental health nurses could help family caregivers promote positive attitudes towards suicidal relatives by understanding suicidal individuals' suffering., Abstract Introduction Suicide is a global mental health issue. Family caregivers play a key role in preventing suicide attempts. Aims The aim of this study was to examine the relationship among stress due to the family caregiver's role, suicidal attitude of the family caregiver and suicide care ability among family caregivers. Additionally, instruments of caring stress, attitudes towards suicidal relatives and caring abilities used in the study were tested to measure construct validity. Methods A cross-sectional correlational study was conducted with 164 family caregivers of people who are suicidal. The following three questionnaires were used: the Caring Stress Scale, the Suicidal Attitudes Scale and the Suicidal Caring Ability Scale. Structural equation modelling was performed using SPSS AMOS 19.0 to examine the path relationships among variables. Results Bivariate analyses showed that age was negatively correlated with suicidal attitude. In the final path model, caring stress had a positive effect on suicidal attitudes. Suicidal attitude and suicide care ability were highly positively correlated. Gender had a direct effect on caring stress, which indicated that female family caregivers experienced more stress from their role. Implications for practice: Mental health nurses could help family caregivers become aware of the emotional pain that suicidal people experience and then promote their positive attitudes towards their suicidal relatives. Furthermore, family caregivers could increase their ability to care for their suicidal relatives, which could reduce the numbers of suicides. [ABSTRACT FROM AUTHOR]

Introduction: This paper presents an epidemiologic study of appendicitis in Taiwan over a twelve-year period. An analysis of the incidence in the low-income population (LIP) is included to explore the effects of lower socioeconomic status on appendicitis. Methods: We analyzed the epidemiological features of appendicitis in Taiwan using data from the National Health Insurance Research Database (NHIRD) from 2000 to 2011. All cases diagnosed as appendicitis were enrolled. Results: The overall incidences of appendicitis, primary appendectomy, and perforated appendicitis were 107.76, 101.58, and 27.20 per 100,000 per year, respectively. The highest incidence of appendicitis was found in persons aged 15 to 29 years; males had higher rates of appendicitis than females at all ages except for 70 years and older. Appendicitis rates were 11.76 % higher in the summer than in the winter months. A multilevel analysis with hierarchical linear modeling (HLM) revealed that male patients, younger patients (aged ≤14 years), and elderly patients (aged ≥60 years) had a higher risk of perforated appendicitis; among adults, the incidence increased with age. Moreover, the risk of perforation was higher in patients with one or more comorbidities. LIP patients comprised 1.25 % of the total number of patients with appendicitis from 2000 to 2011. The overall incidence of appendicitis was 34.99 % higher in the LIP than in the normal population (NP), and the incidence of perforated appendicitis was 40.40 % higher in the LIP than in the NP. After multivariate adjustment, the adjusted hospital costs and length of hospital stay (LOS) for the LIP patients were higher than those for the NP patients. Conclusions: Appendicitis and appendectomy in Taiwan had similar overall incidences, seasonality patterns, and declining trends compared to numerous previous studies. Compared to NP patients, LIP patients had a higher risk of appendicitis, longer LOS and higher hospital costs as a result of appendectomy. [ABSTRACT FROM AUTHOR]

Background: Low physical activity is common in systemic lupus erythematosus populations. Aim: To evaluate the effect of physical activity counselling on physical activity and the association between physical activity changes and changes in fatigue, quality of sleep, and quality of life in women with systemic lupus erythematosus. Methods: A randomized, controlled, single‐blind trial was conducted from March 2015 to August 2016. Seventy‐six women with systemic lupus erythematosus were randomly assigned to the intervention or control groups. The intervention group received three sessions of physical activity counselling at 1, 4, and 8 weeks and three telephone follow‐ups over 13 weeks. Outcome measures, which include daily steps, fatigue, quality of sleep, and the quality of life, were collected at baseline and 8 and 12 weeks. Results: The study showed that daily steps, quality of sleep, and vitality in the intervention group were significantly improved compared with those in the control group at weeks 8 and 12. Mental health was significantly improved only at week 8 in the counselling group. A positive correlation between physical activity changes and changes in vitality and mental health was observed. Conclusions: Physical activity counselling can improve physical activity. As physical activity increases, systemic lupus erythematosus women feel more energetic and happier. SUMMARY STATEMENT: What is already known about this topic? Patients with systemic lupus erythematosus (SLE) have inactive lifestyles, and few of them exercise regularly.Patients with SLE have poor aerobic fitness and muscle strength.Fatigue, poor sleep, and low quality of life are common in patients with SLE. What this paper adds? The five A's physical activity counselling model is feasible and can enhance SLE patients' physical activity levels.Vitality and mental health improvement are associated with an increase in physical activity. The implications of this paper: Health care professionals could provide physical activity counselling to SLE patients during every clinical visit.Health care professionals could encourage patients with SLE to use a pedometer as a monitor to record their daily steps. [ABSTRACT FROM AUTHOR]

Aim: The purposes of this study were to describe the degree of knowledge and explore the factors associated with knowledge of infertility among women of childbearing age with breast cancer. Methods: In this cross‐sectional study, we recruited women of childbearing age with a diagnosis of breast cancer who had completed chemotherapy at a hospital in Taipei from 2015 through 2016. Face‐to‐face interviews were completed with 201 (62%) of 324 eligible women, asking about sociodemographic variables, disease and treatment characteristics, fertility intention, and infertility‐related knowledge. Results: The result showed one in 10 women had thought about becoming pregnant after completion of breast cancer chemotherapy. The mean score of infertility knowledge among participants was low, especially for general knowledge. Women with higher levels of education had better knowledge scores. Fertility intention score, especially for the domain of the pregnant risk, was negatively associated with infertility knowledge score. Conclusion: Women with breast cancer lacked knowledge about infertility and underestimated the possibility of infertility. We suggest future patient education on infertility after cancer treatment and about reproductive technology in oncologic practice before treatment begins. SUMMARY STATEMENT: What is known about this topic? Women with cancer diagnosed during the reproductive age are interested in a subsequent pregnancy.Less than half of childbearing‐age women with cancer have a comprehensive discussion about the potential impact of cancer therapy on fertility with the oncology physician.Reproductive‐age women with breast cancer have gaps in their knowledge of fertility planning as breast cancer survivors. What this paper adds? One in 10 women had thought about becoming pregnant after completion of breast cancer chemotherapy.Most women with breast cancer lack sufficient general and cancer‐specific knowledge about infertility.Factors associated with knowledge of infertility are fertility intention and education level. The implications of this paper: Results offer oncological nurses an understanding of fertility needs and infertility‐related knowledge in childbearing‐age women with breast cancer.Clinical nurses should continue to assess fertility willingness and knowledge of infertility in women with cancer both before and after cancer treatments.Comprehensive education about fertility and infertility in Taiwan is suggested. [ABSTRACT FROM AUTHOR]

This study examines the efficacy of a novel college sustainability course in promoting relevant environmental knowledge and interest in careers related to environmental aspects within the Taiwanese educational context. The core content of the course covers the essential concepts of sustainability and introduces students to environmental issues and their interrelation with the nexus of food, energy, and water, as well as related economic and social issues. This action competencefocused course was designed to allow students to develop their understanding of sustainability through a combination of engaging lectures, novel group activities, case studies, exercises, and team projects. The sample consisted of 44 Taiwanese undergraduate and graduate students majoring in the science, technology, engineering, and mathematics (STEM) disciplines. Participants' interest in STEM careers and perceived knowledge were measured by a pre-test and post-test administered before and after the program, respectively. Analyses of variance, correlation analyses, and crosslagged panel regression analyses were conducted to test four hypotheses. Results of repeatedmeasure analysis of covariance indicated that knowledge increased significantly from pre-test to post-test, but not career interest. Results of a cross-lagged panel regression analysis also indicated that pre-test knowledge was a significant positive predictor of post-test career interest. By creating an engaging class atmosphere and promoting experiential self-learning activities, this course was highly effective in enhancing students' knowledge of key sustainability aspects. Implications for interest development theory and sustainability pedagogy are also discussed. [ABSTRACT FROM AUTHOR]

Some studies show that the Twitter's growth is leveling off and that its marketing has become ineffective. The purpose of this paper is to analyse what is needed for microblogs’ perpetuation. Factors such as message quality, source credibility, perceived usefulness, perceived interactivity, perceived playfulness, confirmation, and satisfaction were tested for their impact on continuance intention. A post-acceptance model of microblog continuance was proposed based on information system continuance model. We found that continuance intention to use microblogs is greatly affected by satisfaction, which in turn is affected by perceived interactivity and perceived usefulness, but satisfaction is not affected by confirmation or perceived playfulness. Although confirmation has no direct effect on satisfaction, it affects perceived interactivity and perceived usefulness, which in turn affect satisfaction. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to investigate the influence of shareholding stability of institutional investors on firm performance. We analyze 647 sample companies listed in the Taiwan Stock Exchange from 2005 to 2009 using the coefficient of variance of institutional holding proportion as the measure for ownership stability. The empirical results show that increasing stability of institutional holdings is related to better firm performance. The low-risk and younger firms with higher CEO incentive compensation, larger insider holdings, and higher growth usually have better performance. Furthermore, when the long-term institutional shareholdings, particularly of foreign institutions, are higher, the firm performance is better. [ABSTRACT FROM AUTHOR]

Aims This paper is a report on the effectiveness of a self-management programme based on the self-efficacy construct, in older people with heart failure. Background Heart failure is a major health problem worldwide, with high mortality and morbidity, making it a leading cause of hospitalization. Heart failure is associated with a complex set of symptoms that arise from problems in fluid and sodium retention. Hence, managing salt and fluid intake is important and can be enhanced by improving patients' self-efficacy in changing their behaviour. Design Randomized controlled trial. Methods Heart failure patients attending cardiac clinics in northern Taiwan from October 2006-May 2007 were randomly assigned to two groups: control ( n = 46) and intervention ( n = 47). The intervention group received a 12-week self-management programme that emphasized self-monitoring of salt/fluid intake and heart failure-related symptoms. Data were collected at baseline as well as 4 and 12 weeks later. Data analysis to test the hypotheses used repeated-measures anova models. Results Participants who received the intervention programme had significantly better self-efficacy for salt and fluid control, self-management behaviour and their heart failure-related symptoms were significantly lower than participants in the control group. However, the two groups did not differ significantly in health service use. Conclusion The self-management programme improved self-efficacy for salt and fluid control, self-management behaviours, and decreased heart failure-related symptoms in older Taiwanese outpatients with heart failure. Nursing interventions to improve health-related outcomes for patients with heart failure should emphasize self-efficacy in the self-management of their disease. [ABSTRACT FROM AUTHOR]

Background: Evaluations of higher education programs are increasingly centered on the learner and designed to assess learning effectiveness and core competencies. Although the Taiwan Nursing Accreditation Council (TNAC) has established eight core competencies for college nursing departments, little research has been done to identify the most salient contributors to undergraduate nursing students' perceived competency levels. Purpose: This paper investigates the influence of student demographic factors and learning experience on students' development in terms of a selected sample of core nursing competencies and then identifies factors that significantly predicts such development. Methods: This is a cross-sectional descriptive correlational study. We collected data from a sample of freshmen students currently enrolled in a two-year nursing bachelor degree program at a private vocational university in Taipei, Taiwan. Participants self-assessed abilities in designated core nursing competencies using the Competency Inventory of Nursing Students (CINS). A total of 279 of 290 distributed questionnaires were returned and used in data collection, giving this study a valid return rate of 96.2%. Results: Participants earned a mean CINS score of 5.23 (SD = 0.49). Scale dimensions from highest to lowest mean score rank were: ethics, accountability, caring spirit, communication and cooperation, lifelong learning, general clinical nursing skills, critical thinking, and basic biomedical science. Differentiated analysis revealed that nursing students who expressed a strong interest in nursing, had a clear career plan, held aspirations to pursue higher nursing education, designated "major hospital" as their first workplace of choice, designated a post-college department / workplace preference, had participated in campus activities, were outspoken in classroom discussions and debates, made consistent effort to complete homework assignments and prepare for examinations, and performed relatively strong academically earned CINS scores significantly above the mean. The three factors "having a clear career plan," "having designated a post-college department / workplace preference," and "having participated in campus activities" accounted for 14.4% of variance in subjects' CINS self-rating scores (adjusted R² = 12.5%). Conclusion: The CINS is an effective instrument for assessing the core professional competencies of nursing students. We recommend that nursing education strategies may be adjusted to enhance student interest in nursing, encourage their developing career plans, and encourage greater participation in campus activities and classroom discussions as a way to improve core professional competencies. [ABSTRACT FROM AUTHOR]

This paper presents a self-paced reading experiment comparing the processing of subject-extracted relative clauses (SRCs) and object-extracted relative clauses (ORCs) in supportive contexts in Chinese. It is argued that lack of a consistent pattern in the literature for the comparison between Chinese SRCs and ORCs is due to potential temporary ambiguity in these constructions in null contexts. By placing the materials in contexts biased towards a relative clause (RC) interpretation, we limit the effects of temporary ambiguity. The results of the experiment demonstrate that SRCs are read more slowly than ORCs in supportive contexts. These results provide evidence for working memory-based sentence processing theories whereby processing difficulty increases for connecting sentence elements that are further apart. Some convergent evidence that strengthens these conclusions comes from recent research on aphasic populations where a dissociation between English and Chinese RC processing has been revealed: whereas English aphasic patients have more difficulty with ORCs and Chinese aphasic patients have more difficulty with SRCs (Su, Lee, & Chung, 2007). Taken together, these results support the idea that sentence processing is constrained by working memory limitations. [ABSTRACT FROM AUTHOR]

Aims and objectives. This paper is a report of a study conducted to investigate differences between nurse practitioners' perceptions of the importance of required competencies and their self-evaluated existing competencies, and the main factors influencing these differences. Background. The difference between nurse practitioners' perceptions of required competencies and their existing competencies has never been investigated. Therefore, it is still uncertain whether these two competencies differ. Design. A nationwide survey study was authorised by the Department of Health (DOH) in Taiwan. Methods. For this nationwide survey study, the Questionnaire of Competencies in the Nurse Practitioner's Role was mailed to all nurse practitioners who qualified for the first annual national NP licence exam in Taiwan. Of 582 questionnaires distributed, 374 valid questionnaires were returned for a response rate of 64·2%. Results. The scores for required competencies were all higher than existing competencies. The competencies with largest differences were (in increasing order) clinical research, direct care, and leadership and reform. The competencies with smallest differences were (in ascending order) medical assistance, communication and coordination, and ethical decision-making. Differences in the total score between required and existing competencies were significantly influenced by nurse practitioners' age, seniority as nurse practitioner, whether the nurse practitioners' institution had a nurse practitioner advancement system, and the number of patients under their care. Conclusions. Nurse practitioners' perceptions of the importance of their expected role competencies were significantly greater in most cases than their actual competencies. Relevance to clinical practice. These findings could serve as a reference to improve cultivation of the NP system in Taiwan, to strengthen professional competencies in NP training programs. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study is to compare the efficacy of an 8‐week pelvic floor muscle training program with surface electromyography feedback, performed in different body positions (supine, sitting, and standing), in women with stress urinary incontinence. Design This is a prospective observational study performed January 2014 to May 2016. Methods: The training program was performed by 110 women with stress urinary incontinence, each completing 4 individual training sessions. The main outcome was the electromyography activity of the pelvic floor muscles and of the synergistic abdominal muscles. Outcome measures were evaluated at 4 time points, namely at baseline and at 2, 4, and 8 weeks of training. Results: A notable effect of training was identified at week 2, which was sustained through to week 8. Training yielded a significant improvement in increased sustained voluntary contraction of the pelvic floor muscles in all 3 positions. The efficacy of training was influenced by the duration of training, age, body mass index, and history of vaginal delivery. Conclusion: Training of the pelvic floor muscles, with positive reinforcement by surface electromyography feedback of the pelvic floor muscles and of the synergistic abdominal muscles, was effective for the treatment of stress urinary incontinence in women and should be considered as a feasible option by healthcare providers. SUMMARY STATEMENT: What is already known about this topic? In women with stress urinary incontinence, the sudden loss of urine negatively affects their quality of life.Conservative treatment remains the mainstay for managing this condition, for which pelvic floor muscle training is regarded an effective treatment.Biofeedback provides positive reinforcement during pelvic floor muscle training and can be achieved via several methods including electromyography, manometry, or ultrasonography. What this paper adds? An 8‐week training program, using surface electromyography as feedback, was effective in reducing female stress urinary incontinence; the effect was notable after 2, 4, and 8 weeks of training.The program was effective when performed in supine, standing, and sitting positions, with the greatest improvement obtained in the supine position.The duration of training, age, body mass index, and history of vaginal delivery were significant factors influencing training outcome. The implications of this paper: Health care professions should be adept at evaluating the severity of stress urinary incontinence symptoms to provide the best treatment.Nurses should acknowledge the benefits of the pelvic floor muscle training with bio‐assisted surface electromyography feedback and encourage patients with stress urinary incontinence to consider the program.Factors that might influence the efficacy of the training, namely age, body mass index, and history of vaginal delivery, should be considered during treatment counselling and treatment. [ABSTRACT FROM AUTHOR]

Abstract: The paper reports research derived from over 800 respondents who self-completed questionnaires while patronising love motels in the Taipei greater metropolitan region, Taiwan. The paper provides a brief history of Taiwanese love motels and distinguishes them from western massage parlours. Five clusters are found that are based on two primary canonical discriminate functions that explain 83 percent of the variance – the dimensions being sexual conventionality–adventurousness and comfort seeking. These dimensions are wholly consistent with the basic premise of the love motels, although additionally privacy for intimate relationships is also important. The survey questionnaire was based on a concept of physical and relationship constraints on leisure, and generally it was found that the ‘push’ factors based on a need to escape these constraints was weaker than the ‘pull’ factors of comfort and privacy. [Copyright &y& Elsevier]

chuang l.-l., lin l.-c., cheng p.-j., chen c.-h., wu s.-c. & chang c.-l. (2012) Effects of a relaxation training programme on immediate and prolonged stress responses in women with preterm labour. Journal of Advanced Nursing 68(1), 170-180. Abstract Aim. This paper is a report of an experimental study of the effects of relaxation-training programme on immediate and prolonged stress responses in women with preterm labour. Background. Hospitalized pregnant women with preterm labour experience developmental and situational stress. However, few studies have been performed on stress management in such women. Methods. An experimental pretest and repeated post-test design was used to compare the outcomes for two groups in northern Taiwan from December 2008, to May 2010. A total of 129 women were randomly assigned to an experimental ( n = 68) or control ( n = 61) group. The experimental group participants were instructed to listen daily to a 13-minute relaxation programme. Measurements involved the stress visual analogue scale, finger temperatures, State Trait Anxiety Inventory, Perceived Stress Scale and Pregnancy-related Anxiety. Two-way analysis of variance and hierarchical linear modelling were used to analyse the group differences. Results. Compared with those in the control group, participants in the experimental group showed immediate improvements in the stress visual analogue scale scores and finger temperatures. The State Trait Anxiety Inventory-State subscale score for the experimental group was significantly lower than that for the control group ( P = 0·03). However, no statistically significant differences for the Perceived Stress Scale and Pregnancy-related Anxiety scores were found between the experimental group and the control group. Conclusions. The relaxation-training programme could improve the stress responses of women with preterm labour. [ABSTRACT FROM AUTHOR]

Background.: Knowledge regarding the relationship between writing kinetics and the difference among writing tasks is limited. Purpose.: This study examined the differences in handwriting performance when doing tasks with different levels of challenge from both temporal and kinetic perspectives among children in four different age groups. Method.: The cross-sectional design introduced a force-acquisition pen to detect differences of pen grip and writing kinetics among 170 school-age children doing writing tasks at different difficulty levels. Data were obtained on the force information of the digits and pen tip and the kinetic parameters to examine the coordination-and-control mechanism between the digits and pen. Statistical analyzes were carried out to indicate the differences in writing performance among groups and tasks. Findings.: Statistical differences in the pen-grip forces, force fluctuation, and force ratio between grip and pen-tip forces were found when performing different writing tasks and among different age groups. Implications.: The study provides an alternative method to explore how writing performance among school-age children can vary according to the difficulty of the writing tasks. [ABSTRACT FROM AUTHOR]

wang j.-j. (2011) A structural model of the bio-psycho-socio-spiritual factors influencing the development towards gerotranscendence in a sample of institutionalized elders. Journal of Advanced Nursing 67(12), 2628-2636. Abstract Aims. This paper is a report of a study to determine the bio-psycho-socio-spiritual factors influencing the development towards gerotranscendence in institutionalized older people. Physical ability, depressive symptoms, social network support, meaning of life and life satisfaction were examined through a Structured Equation Modelling approach. Background. Older people's pursuit of gerotranscendence is believed to facilitate successful ageing and late-life growth. Although a few Scandinavian studies have identified the relationship between psychosocial factors and the development of gerotranscendence, there is little trans-cultural study of the model, which limits the ability of the gerotranscendence theory to be applied worldwide. Methods. Cognitively intact older residents ( N = 195) from six long-term care facilities in southern Taiwan participated in a structured interview using the Gerotranscendence scale, Barthel's Index, the Geriatric Depression Scale short form, the Inventory of Socially supportive Behaviour, the Life Meaning scale, and the Life Satisfaction scale. Data were collected over a 6-month period in 2008. Results. The model-fit indexes of the final model (χ2 = 32·08, d.f. = 14, P = 0·004; CMIN/d.f. = 2·29; GFI = 0·97, AGFI = 0·89, TLI = 0·94, NFI = 0·96) exceeded acceptable levels except for χ2. In the final model, social support, life satisfaction and meaning of life had direct effects on gerotranscendence (standardized regression weight 0·54, 0·43, and 0·76). Conclusion. The gerotranscendence model of healthy ageing is congruent in the Taiwanese population. Findings of this study can guide nursing and other health professionals in planning implementation of best practice in older people's care. [ABSTRACT FROM AUTHOR]

Sun, Y.-C. (2011). The impact of locus of control and priming on the endowment effect. Scandinavian Journal of Psychology 52, 420-426. This paper demonstrates the effects of different priming conditions on the endowment effect with respect to seller and buyer roles for individuals with different loci of control. Individuals with an external locus of control process information less rationally, and they are more susceptible to external influences. In addition, the literature reports that when individuals are making a purchasing decision, they tend to perceive the value of the product as being higher because of its utility aspect because decision makers search for reasons and arguments to justify their choices (; ). Therefore, this study investigates the effects of different priming conditions (utilitarian priming vs. hedonic priming) on the endowment effect according to each type of locus of control (internal vs. external). The results showed that the endowment effect was larger when externals were exposed to utilitarian priming as opposed to hedonic priming. Finally, the implications of these findings and suggestions for future research are discussed. [ABSTRACT FROM AUTHOR]

This study examines generalized trust and trust in institutions in Confucian Asia, covering six countries namely, China, Japan, Singapore, South Korea, Taiwan and Vietnam, and one dependent region, Hong Kong. Using data from the 2006 AsiaBarometer Survey, our study affirms the reliability and validity of using a two-item scale to measure generalized trust. Our analysis suggests that due to demographic differences, there are variations in the level of generalized trust of countries in Confucian Asia, despite the fact that these societies share a similar background in Confucian philosophy. The relationships between generalized trust and political trust, and between generalized trust and trust in public institutions, are weak but positive. The positive relationship between generalized trust and trust in economic institutions is only significant for some of the economies, while trust in international institutions has the weakest relationship with generalized trust for all societies. We conclude the paper with research implications. [ABSTRACT FROM AUTHOR]

tsai m.-c., tsai y.-f., hwang f.-m. & liu c.-y. (2011) Effectiveness of a brief intervention for managing hazardous drinking problems of inpatients in Taiwan. Journal of Advanced Nursing 67(9), 2038-2046. Abstract Aims. This paper is a report of a randomized control trial undertaken to evaluate the efficacy of the Brief Intervention for Alcohol Use in Taiwanese inpatients with hazardous drinking patterns. Background. The Brief Intervention for Alcohol Use has been found to be as effective as medical and psychological treatments for individuals with alcohol use disorders in western countries. However, few studies have examined brief alcohol interventions for a Chinese population. Methods. Patients from the medical and surgical wards of a medical centre in northern Taiwan were enrolled if they had an Alcohol Use Disorders Identification Test score >8. Participants were randomly assigned to the experimental group ( n = 47), which received the Brief Intervention, and the control group ( n = 48), which received no special psychosocial intervention except routine nursing care. Data were collected from February 2005 to March 2006 on hospitalized participants' demographic characteristics and alcohol use. Scores on the Alcohol Use Disorders Identification Test were re-assessed over the telephone 6 months later by a trained assistant blinded to the treatment group. Results. The experimental group had a significantly higher mean improved Alcohol Use Disorders Identification Test score and better outcomes in all three dimensions of the test than the control group. Conclusions. The Brief Intervention for Alcohol Use is recommended for use in clinical settings to help Taiwanese inpatients with hazardous drinking patterns to improve their drinking problems. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to investigate the factors that affect the adoption of cloud computing by firms belonging to the high-tech industry. The eight factors examined in this study are relative advantage, complexity, compatibility, top management support, firm size, technology readiness, competitive pressure, and trading partner pressure. Design/methodology/approach – A questionnaire-based survey was used to collect data from 111 firms belonging to the high-tech industry in Taiwan. Relevant hypotheses were derived and tested by logistic regression analysis. Findings – The findings revealed that relative advantage, top management support, firm size, competitive pressure, and trading partner pressure characteristics have a significant effect on the adoption of cloud computing. Research limitations/implications – The research was conducted in the high-tech industry, which may limit the generalisability of the findings. Practical implications – The findings offer cloud computing service providers with a better understanding of what affects cloud computing adoption characteristics, with relevant insight on current promotions. Originality/value – The research contributes to the application of new technology cloud computing adoption in the high-tech industry through the use of a wide range of variables. The findings also help firms consider their information technologies investments when implementing cloud computing. [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]

This paper presents the evident effects of acupoint stimulation, using EEG (electroencephalogram) measurements. With acupuncture stimulation and the EEG measurement on the same meridian, EEG is able to accurately detect the effects of acupunctural point stimulation on brain waves. In this study, 24 subjects without heart or neural diseases were randomly separated into two groups of 12, named test and control groups. Similar procedures are performed; the subjects lay on a bed with eyes closed for ten minutes as the baseline. The test group received acupuncture at their Waiguan points (TE5) on their left hands for 20 minutes, while the control group did not. EEGs are recorded during pre-acupuncture, acupuncture stimulation and post-acupuncture stimulation periods. The EEG electrodes are at the T3, T4, O1 and O2 locations. Continuous wavelet transformation analysis is adopted; therefore, EEGs are divided into the following bands: δ (0.5-4HZ), θ (4-8HZ), α (8-13HZ) and β (13-30HZ). During acupuncture stimulation, the θ energy is increased and had statistical differences at all electrode points, T3, T4, O1 and O2. Upon removing the needle, the energy at the T3 and T4 points slowly declined and revealed obvious statistical differences. During acupuncture, only α energy has been noted to have statistical difference and it was increased at the T3 point. However, the energy was decreased and had no statistical difference after five minutes. Acupuncture is proven to be able to affect brain waves, as the stimulation might have changed the tissues between the cranium and scalp; therefore, the brain waves are detected more easily. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study of psychometric properties of the Problem-Focused Style of Coping-Chinese version questionnaire. Background. Coping with stress is an important topic in the 21th century, which deserves further attention. Although a variety of instruments have emerged to assess an individual's coping responses to stress, research suggests that numerous problems are associated with the current measurements. Since most coping scales are criticized as lacking valid estimates across occupational samples and cultures, there is an immediate need to develop a reliable and valid coping-style scale. Method. The study used a convenience sample and a sampling frame consisting of 307 nurses from different medical units in two regional hospitals in Taiwan. The data collection period was from May 2009 to June 2009. Exploratory factor analyses and reliability estimates were calculated. Results. The factor analysis revealed three coping factors: reflective, suppressive and reactive. All reliability and validity estimates were satisfactory. Conclusion. The Problem-Focused Style of Coping-Chinese version questionnaire is a valid and reliable measure of nurses' dispositional coping style and can be used for educational training programmes to enhance nurses' stress management skills. [ABSTRACT FROM AUTHOR]

This paper investigated the possible predictive and mediating determinates of quality of life in this often forgotten population, focusing specifically on the role of sociodemographics, mental impairments, coping mechanisms, resilience and hope on subjective quality of life. The family members of survivors of man-made trauma are sometimes severely traumatised themselves and may suffer from post-traumatic stress disorder, depression and poor quality of life. Most studies focus on the victims and ignore the effect of the incidents on the victim's family members. Data were collected between October 2007-March 2008, a self-report questionnaire incorporating seven scales was administrated to 175 family members of victims of man-made trauma. One-way was performed to compare the variance in the reported quality of life. The structural equation models of path analysis was used to evaluate the main effects and interactions and interrelations among variables. Of the psychosocial factors, having a personal previous traumatic experience was found to significantly affect post-traumatic stress disorder, depression and physical health. Post-traumatic stress disorder and depression were found to directly and indirectly affect quality of life. Coping mechanism, resilience and a hope state mediated the effect of post-traumatic stress disorder and depression making the three significant predictors of subjective quality of life. Based on these findings and the scores of the different scales, clinicians may be able to design treatment plans that encourage the poorly adapting family members of victims of trauma, especially those with symptoms of post-traumatic stress disorder or depression, to accept changes as a part of life, nurture a positive view of the self, make connections for better social support and maintain or re-create a hopeful outlook towards life goals. Knowledge of the psychosocial factors associated with resistance to severe trauma can also help in the prevention and treatment of individuals at high risk for developing post-traumatic stress disorder or depression. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study that examined the effects of work demands, including employment status, work inflexibility and difficulty reconciling work and family caregiving, on role strain and depressive symptoms of adult-child family caregivers of older people with dementia. Background. Family caregivers also employed for pay are known to be affected by work demands, i.e. excessive workload and time pressures. However, few studies have shown how these work demands and reconciliation between work and family caregiving influence caregivers' role strain and depressive symptoms. Method. For this cross-sectional study, secondary data were analysed for 119 adult-child family caregivers of older people with dementia in Taiwan using hierarchical multiple regression. Results. After adjusting for demographic characteristics, resources and role demands overload, family caregivers with full-time jobs (b = 0.25, P < 0.01) and more difficulty reconciling work and caregiving roles (b = 0.36, P < 0.01) reported significantly more role strain than family caregivers working part-time or unemployed. Family caregivers with more work inflexibility reported more depressive symptoms (b = 0.29, P < 0.05). Conclusion. Work demands affected family caregivers' role strain and depressive symptoms. Working full-time and having more difficulty reconciling work and caregiving roles predicted role strain; work inflexibility predicted depressive symptoms. These results can help clinicians identify high-risk groups for role strain and depression. Nurses need to assess family caregivers for work flexibility when screening for high-risk groups and encourage them to reconcile working with family-care responsibilities to reduce role strain. [ABSTRACT FROM AUTHOR]

This paper is a report of a study to examine the influence of demographic, learning behavior and learning performance variables on learning outcomes of baccalaureate nursing students within a blended learning environment. A cross-sectional survey was conducted using the self-structured demographic questionnaire, case analysis attitude scale (CAAS), the case analysis self-evaluation scales (CASES), the metacognition scale (MS) and blended learning satisfaction scale (BLSS) to measure learning outcomes after the blended learning course. A total of 99 senior undergraduate nursing students currently studying at a public nursing college in Taiwan were eligible to participate in the study in 2008. Data were analyzed by descriptive statistics and multiple linear regression. Univariate analysis showed significant associations between frequency of online dialogues, time spent on the internet, CAAS, and MS and scores on the ethical course. However, frequency of online dialogues, time spent on the internet, and the CAAS were significantly independent predictors for scores on the ethical course in the final model of multivariate analysis. The final model of the data analysis could account for 78% variances scores of ethical course (R2 = 0.78 and adjusted R2 = 0.77). It can be concluded from this study that frequency of online dialogue, time spent on internet, and the CAAS score are all useful predictors for learning outcome. In addition, blended learning was found to have contributed to learners' learning outcome by facilitating their metacognitive development and self-regulatory development. In blended learning courses, students have more responsibilities placed upon them than in traditional face-to-face learning environments. The first step of constructing a working blended learning model is to develop student-oriented teaching pedagogies that include face-to-face and online instruction, rather than just focusing on the provision of technical skills. [ABSTRACT FROM AUTHOR]

shyu y.-i.l., chen m.-c., wu c.-c. & cheng h.-s. (2010) Family caregivers' needs predict functional recovery of older care recipients after hip fracture. Journal of Advanced Nursing 66(11), 2450-2459. Aim. This paper is a report of a study of the effect of family caregivers' needs on the functional recovery of elders with a hip fracture during the first 6 months after discharge. Background. Family members are closely involved in the postdischarge care of older Chinese patients. However, the influence of family caregiving-related variables, such as caregiver's needs, on recovery after hip fracture has not been explored. Methods. Data were collected between 2002 and 2005 with elders with hip fracture and their family caregivers at a medical centre in Taiwan. Data were collected at 1, 3 and 6 months after discharge, and 120 people completed all follow-ups. The effect of caregiver needs on elders' recovery was analysed using the generalized estimating equations approach. Findings. Elders whose caregivers reported a need for information on caregiving and related health care were more likely (odds ratio = 1·93, confidence interval = 1·08-3·46) to recover their walking ability than those whose caregivers did not report such need. However, elders whose caregivers reported a need for social services were less likely to recover their walking ability (odds ratio = 0·38, confidence interval = 0·18-0·78), and activities of daily living (odds ratio = 0·40, confidence interval = 0·17-0·94) than those whose caregivers did not report such need. Conclusion. Healthcare providers should include caregivers' needs in their clinical assessment of Chinese elders after surgery for hip fracture. Given the rapidly increasing population of Asian elders in Western countries, the results of this study may be applicable to other countries with Chinese populations. [ABSTRACT FROM AUTHOR]

liu w.-i., edwards h. & courtney m. (2010) Case management educational intervention with public health nurses: cluster randomized controlled trial. Journal of Advanced Nursing 66(10), 2234–2244. Aim. This paper is a report of a study conducted to determine the effectiveness of a community case management collaborative education intervention in terms of satisfaction, learning and performance among public health nurses. Background. Previous evaluation studies of case management continuing professional education often failed to demonstrate effectiveness across a range of outcomes and had methodological weaknesses such as small convenience samples and lack of control groups. Method. A cluster randomized controlled trial was conducted between September 2005 and February 2006. Ten health centre clusters (five control, five intervention) recruited 163 public health nurses in Taiwan to the trial. After pre-tests for baseline measurements, public health nurses in intervention centres received an educational intervention of four half-day workshops. Post-tests for both groups were conducted after the intervention. Two-way repeated measures analysis of variance was performed to evaluate the effect of the intervention on target outcomes. Results. A total of 161 participants completed the pre- and post-intervention measurements. This was almost a 99% response rate. Results revealed that 97% of those in the experimental group were satisfied with the programme. There were statistically significant differences between the two groups in knowledge ( P = 0·001), confidence in case management skills ( P = 0·001), preparedness for case manager role activities ( P = 0·001), self-reported frequency in using skills ( P = 0·001) and role activities ( P = 0·004). Conclusion. Collaboration between academic and clinical nurses is an effective strategy to prepare nurses for rapidly changing roles. [ABSTRACT FROM AUTHOR]

huang c.-l., lin h.-h. & wang h.-h. (2010) Cigarette dependence questionnaire: development and psychometric testing with male smokers. Journal of Advanced Nursing 66(10), 2341–2349. Aim. This paper is a report of a study conducted to develop and test a theoretically derived Cigarette Dependence Questionnaire for adult male smokers. Background. Fagerstrom questionnaires have been used worldwide to assess cigarette dependence. However, these assessments lack any theoretical perspective. A theory-based approach is needed to ensure valid assessment. Methods. In 2007, an initial pool of 103 Cigarette Dependence Questionnaire items was distributed to 109 adult smokers in Taiwan. Item analysis was conducted to select items for inclusion in the refined scale. The psychometric properties of the Cigarette Dependence Questionnaire were further evaluated 2007–08, when it was administered to 256 respondents and their saliva was collected and analysed for cotinine levels. Criterion validity was established through the Pearson correlation between the scale and saliva cotinine levels. Exploratory factor analysis was used to test construct validity. Reliability was determined with Cronbach’s alpha coefficient and a 2-week test–retest coefficient. Results. The selection of 30 items for seven perspectives was based on item analysis. One factor accounting for 44·9% of the variance emerged from the factor analysis. The factor was named as cigarette dependence. Cigarette Dependence Questionnaire scores were statistically significantly correlated with saliva cotinine levels ( r = 0·21, P = 0·01). Cronbach’s alpha was 0·95 and test–retest reliability using an intra-class correlation was 0·92. Conclusion. The Cigarette Dependence Questionnaire showed sound reliability and validity and could be used by nurses to set up smoking cessation interventions based on assessment of cigarette dependence. [ABSTRACT FROM AUTHOR]

lin p.c., lin l.c., shyu y.i.l. & hua m.s. (2010) Chinese version of the Pain Assessment in Advanced Dementia Scale: initial psychometric evaluation. Journal of Advanced Nursing 66(10), 2360–2368. Aim. This paper is a report of the validity and reliability testing of the Chinese version of the Pain Assessment in Advanced Dementia Scale (PAINAD-C). Background. Pain is under-reported and under-treated for people with dementia, largely due to impairment of communication. An adequate instrument for assessment of pain in this population is essential to improving their quality of life and decreasing disability and behavioural disturbances, but none were found that were appropriate for these purposes. Method. The PAINAD-C was developed in three phases in 2006. First, back-translation was used to create the Chinese version, where five medical and nursing experts assessed content validity. Inter-rater reliability, internal consistency reliability and test–retest reliability were then examined. Finally, principal component analysis and known-group comparisons were used to test construct validity. Participants with dementia were selected from five licensed long-term care facilities in Taiwan. Direct observation was used to collect data. Results. Inter-rater reliability showed an intra-class correlation coefficient of 0·80–0·86, and a test–retest reliability intra-class correlation coefficient of 0·71. The internal consistency reliability was 0·55–0·66. Factor analysis of the PAINAD-C showed two factors that explained 62·48% of variance. The PAINAD-C scores showed statistically significant differences between the non-dementia group and the advanced dementia group as well as significant differences between activities and rest groups. Conclusion. The PAINAD-C is useful in a clinical setting for people with advanced dementia for both research and practice. It is easy to use and is a comprehensive instrument. [ABSTRACT FROM AUTHOR]