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Storytelling is a well-established literary practice in language classrooms. However, approaches influencing its effectiveness and efficiency have rarely been investigated. This study compared the effects of three storytelling approaches on the vocabulary acquisition and response patterns of third-grade students of English as a foreign language (EFL). The storytelling approaches we considered are commonly used in schools, including storytelling alone (S), storytelling with word focus (S+W), and storytelling with activities (S+A). Our research comprised a three-week pilot study and a nine-week main study. For both studies, a pretest-posttest design involving a delayed test was used. Video recordings were also captured to facilitate the categorization of in-class response patterns. Results indicated that storytelling alone achieved the best performance. Vocabulary improvement with word focus or follow-up activities faded over the long term. The groups (S and S+W) which heard more stories generated more responses based on their own knowledge and life experience (as opposed to simply recalling facts) than did the group which completed more supplementary activities (S+A). This article provides both pedagogical implications and invitations for future empirical research.

In recent years, initiatives and the resulting application of precision education have been applied with increasing frequency in Taiwan; the accompanying discourse has focused on identifying potential applications for artificial intelligence and how to use learning analytics to improve teaching quality and learning outcomes. This study used the established dropout risk prediction model to improve student learning effectiveness. The model was based on the academic portfolios of past students and built with statistical learning and deep learning methods. This study used this model to predict the dropout risk of 2205 freshmen enrolled in the fall semester of 2018 (graduated in June 2022) in the field of sustainable education. A total of 176 students with a dropout risk of more than 20% were considered high-risk students. After tracking and the appropriate guidance, the dropout risk of 91 students fell from > 20% to < 20%. To discuss the results from the perspective of gender and financial disadvantages, the improvement rate of the dropout risk for male students was 10.2% better than that of female students at 2.9%. The improvement rate in dropout risk for students with disadvantageous financial situations was as high as 12.0%, surpassing the 5.9% rate among general students. Overall, the dropout rate in the second year of the 2018 freshman cohort was lower than that of the 2016 and 2017 freshman cohorts. A predictive model established by statistical learning and deep learning methods was used as a tool to promote precision education, accurately and efficiently identifying students who are having difficulty learning, as well as leading to a better understanding of AI (artificial intelligence) in smart learning for sustainable education.

This study integrated environmental issues as the initial problem to explore the process of problem-solving of high school students and proposes the concept of environmental problem-solving (EPS) to probe the interaction between high school students' scientific performance and EPS strategies. There were 139 high school students in Taiwan who participated in this study. Participants were required to complete the "Environmental Literacy Scale," "Environmental Scientific Achievement Questionnaire," and "Environmental Problem-Solving Process Questionnaire." The result showed that the students with higher scores in environmental scientific achievement got higher scores in the EPS process as well. However, the students with higher scores in environmental literacy were able to proffer better EPS strategies, analyze EPS solutions incisively, and present multiple plans. Further discussion is provided.

The paper examines the role of organizational commercial slack (OCS) in mediating the relationship between entrepreneurial orientation (EO) and the effectiveness of knowledge transfer (KT) in universities. The paper identifies two types of commercial slack in the university setting: financial and promotional. Four research hypotheses are proposed. Pooled data, that is, a combination of a questionnaire survey of 110 Taiwanese universities with a data set of university KT effectiveness from the Ministry of Education, Taiwan, are collected to test the aforementioned research hypotheses. The empirical results indicate that the EO of a university enables the university to provide appropriate OCS. Furthermore, the commercial slack of a university positively mediates the relationship between EO and KT effectiveness. The paper concludes that developing EO and OCS are crucial for improving the KT effectiveness of a university. Moreover, some managerial and policy implications for promoting EO and OCS in universities are suggested.

This study investigated university students' attitudes towards learning English vocabulary through collaborative group work (GW) versus individual work (IW) while performing vocabulary-focused tasks following reading comprehension. The second year, non-English major, Taiwanese students (N = 44) worked either in mixed ability groups of 3-4 or alone. The same students were exposed to the two treatments: classroom intervention was conducted with alternating sessions (one-week IW, one-week GW) for 12 weeks with accompanying tests of vocabulary learning. Attitude questionnaires (44 students) were administered before the classroom intervention and again after, together with interviews (24 students). Results showed that students increased in favourable attitude to IW more than to GW over the study period, even though their actual vocabulary learning improved more with GW. Nevertheless, by the end they did report GW as less stressful than IW and as providing better support and enabling more efficient work on the tasks, with greater likelihood of correct information being obtained. The findings suggest that enhancing students' vocabulary learning through GW was valuable despite student perceptions of it not being unambiguously favourable, and the use of GW in university English classes needs to be encouraged, albeit with continuity of group membership over time.

This study explores the impact of an action-oriented environmental education course on students' environmental awareness, with 53 college students divided into experimental (N = 27) and control (N = 26) groups. Both groups participated in similar learning activities; however, the experimental group further recorded the amount of waste discharged into the environment by people around them for one and a half months (2 days/week). Students in the experimental group showed a significant difference in six of seven environmental awareness dimensions after this course. These results confirm that an action-oriented environmental education course has a positive effect on changing an individual's awareness of the environment.

This study investigated the effectiveness of group work (GW) in EFL vocabulary learning by second year, non-English major, university students in Taiwan, in comparison with working individually (IW). The students (N = 44) worked in mixed ability groups of 3-4 or in IW to complete vocabulary exercises following reading activities. The classroom intervention followed a repeated measures design with alternating sessions (one week IW, one week GW) for 12 weeks. In order to measure students' word knowledge gains, the modified vocabulary knowledge scale was used in pre-, post- and delayed-post tests, and the scores from the tests were analyzed with paired "t" tests. Qualitative information about vocabulary discovery and retention was further obtained from interviews with 24 students conducted after the classroom intervention. Results showed that students' overall improvement in vocabulary knowledge with group work was significantly higher than that with individual work on immediate post-tests, though both treatments had a beneficial effect. Later retention of word knowledge after GW was only 2% higher than that with IW. Interpretations and implications of these findings are discussed.

This research used a quasiexperimental method to explore whether integrating Science Magic (SM) into 5E Learning Cycle (5ELC) in the development of teaching materials for a friction unit would impact students' learning outcomes and attitudes toward science. A total of 68 eighth-grade students were divided into experimental and control groups. The experimental group was taught using teaching materials and methods developed using the SM-based 5ELC, while the control group adhered solely to textbook-based materials, which were also based on the 5ELC but did not involve SM activities. Two major findings were obtained in this research. First, learning effects for the experimental group were significantly higher than the control group, especially in relation to characteristics of static friction, factors that affect friction, and relationships between frictional and normal force. Second, the experimental group showed significant improvements in their attitudes toward science when juxtaposed with the control group.

This study aimed to determine how the learning stimulation and intrinsic motivation of students affect their culture sharing in volunteering via general altruism and intention. Stratified random sampling was used, and 850 invitation questionnaires were sent to participants, of whom 264 returned valid questionnaires (return rate, 31.06%), which were analyzed with the partial least squares method. It was found that students' intrinsic motivation for overseas volunteering increases their understanding of global issues. Thus, schools or organizations should develop a mechanism for volunteering students to interact with others within a professional virtual community in order to enhance their volunteering experience and inspire their continuous learning from overseas volunteering.

The issue of phrasal verb learning has caused much discussion and attracted vigorous investigation. Inspired by the theory of conceptual metaphor, a pedagogical experiment was conducted to investigate whether an approach focussing on sense extension of particle "out" in terms of conceptual metaphors can enhance the learning of phrasal verbs containing "out." One control group was instructed with general reading materials embedded with various phrasal verbs, and two experimental groups with self-constructed lessons, in which six sense types of "out" were identified and corresponding phrasal verbs were selected, and in addition, an L1 lexical item was employed to illustrate the mechanism of metaphorical extension for one experimental group. The result showed that learners receiving a cognitive inspired approach to instruction achieved significantly better learning outcomes than those receiving the traditional approach, not only on taught items but also on untaught items. However, the use of L1 lexical items to illustrate sense extension was not as effective as expected in boosting the learning of "out-phrasal verbs." It was concluded by discussing the benefit of the proposed approach to phrasal verb instruction and, more importantly, the need of teaching materials providing more profound understanding of phrasal verbs so as to facilitate phrasal verb learning.

The purpose of this study was to explore the learning performance of sixth grade elementary school students using newspapers in science teaching. A quasi-experimental design with a single group was used in this study. Thirty-three sixth grade elementary school students participated in this study. The research instruments consisted of three questionnaires, a "Learning Attitude toward Newspapers in Education Scale" (29 items, Cronbach's a = 0.90), a "Science Reading Attitude Scale" (15 items, Cronbach's a = 0.93), and an "Attitude toward Science Scale" (27 items, Cronbach's a = 0.92). All three questionnaires have good reliabilities. Furthermore, the validity of these questionnaires has been confirmed by three science educators. The results showed that the use of newspapers in education and multiple instructional strategies can (1) effectively enhance the sixth graders' learning attitudes towards the use of newspapers in science education and enhance their reading of science articles and involvement in science experiments; (2) effectively promote the sixth graders' attitudes toward science reading and enhance their science reading understanding; and (3) enhance the sixth graders' performance in scientific attitudes and significantly strengthen their science learning and interest. The research results showed that the use of newspapers in science teaching effectively enhances the science learning performance of the sixth grade students.

This paper explored the relationships among career development, personality trait, and organizational commitment and examines whether career development mediates the relationship between personality trait and organizational commitment. The sample was 275 sport communication technology talents in Taiwan. The instrument included the Personality Trait Scale, Career Development Scale, and Organizational Commitment Scale. The relationship between personality trait and organizational commitment was mediated by career development. According the findings, some suggestions and recommendations for administration agency, and further researchers were made.

This study aimed to explore different scientific creativity tests' prediction of students' science performance and domain-general creativity abilities. Two scientific creativity tests were chosen: the "Scientific Creativity Test" and the "Creative Scientific Ability Test (C-SAT)". The Science Performance Test (SPT) and Domain-General Creativity Test (DGCT) were also adapted to allow a check of the correlation between students' scientific creativity, science performance, and general creativity. Sixty junior high school students participated in this study by taking these four tests. Each test needed to be completed within 30 minutes, and the interval between each test was 2 weeks. The results showed that both the students' science performance and domain-general creativity could reflect their performance of scientific creativity better in the scores of the "Scientific Creativity Test" than in those of the C-SAT. Limitations are discussed.

In Taiwan, most students with disabilities receive education in an inclusive setting. Literature has documented the effects of interventions in increasing students' positive behaviors in inclusive settings, including students with disabilities in Western countries; however, effectiveness of such interventions in an Asian context remains unclear. The Class-Wide Function-Related Intervention Teams (CW-FIT) is one of the interventions that applies reinforcement-based strategies and provides multi-tiered supports to students with various severity of challenging behaviors. This study investigates the effects of CW-FIT Tier I (i.e. class-wide intervention) and Tier II (i.e. self-management) on the on-task and disruptive behaviors of a student with Autism Spectrum Disorder in an inclusive elementary classroom in Taiwan. Across nine weeks of intervention, the researchers used a reversal single-case design A-B-C-B-C to demonstrate experimental control over five phases. In addition, the researchers administered interviews and questionnaires to collect social validity data from the teacher and peers' perceptions toward the intervention. Findings from this study support that the CW-FIT is an effective intervention in increasing a student's on-task behaviors and decreasing disruptive behaviors in an inclusive classroom in an Asian context. The effect of implementing multiple tiers of CW-FIT was much more effective than implementing solely Tier I (class-wide intervention). The intervention was also well-received by the general education teacher and students.

The purpose of this study was to investigate how mental rotation strategies affect the identification of chemical structural formulas. This study conducted event-related potentials (ERPs) experiments. In addition to the data collected in the ERPs, a Chemical Structure Conceptual Questionnaire and interviews were also admin-istered for data collection. Eighteen university students majoring in chemistry were recruited. In the ERP experiments, the participants were required to identify 2D figures, 2D chemical structural formulas, 3D objects and 3D chemical structural formulas. The contours of 2D figures are similar to those of 2D chemical structural formulas, but they contain no content knowledge. Likewise, the contours of 3D objects are similar to 3D chemical structural formulas without content knowledge. The results showed that all students used similar strategies of mental rotation in identifying 2D figures, 3D objects and 3D chemical structural formulas. However, the high-achieving students used different strategies in identifying 2D figures and chemical structural formulas, while the low-achieving students tended to use similar strategies of mental rotation in identifying both 2D figures and chemical structural formulas. The results indicate that some of the difficulties in identifying 2D chemical structural formulas that students encounter are due to their inappropriate strategies of mental rotation. These results could guide teachers and curriculum designers to develop chemistry learning tools and teaching strategies which could promote students' understanding of chemical structural formulas and practice students' representational skills through mental rotation. Furthermore, this study suggests that ERP technology could be used in further studies to explore the effects of mental rotation on science learning.

The purpose of this study is to explore the influences of students' learning motivation on Web-based collaborative learning. This study conducted learning materials of Web pages about science and collaborative learning, a motivation questionnaire and interviews were used for data collection. Eighty Grade 5 students and a science teacher were recruited in this study. The controlled group involved 40 students who need to learn the dissolve concept on the Web pages, and complete the homework which was assigned by the Web pages by themselves. The experimental group involved the other 40 students and every four students were grouped in a team. The experimental group students not only need to learn the dissolve concept on Web pages, but also need to complete the homework which was assigned by the Web pages with team members. Besides, the experimental group students need to present their homework to other teams and provide feedbacks and suggestions to other teams. The results showed that experimental group significantly promoted their science learning motivation by using Web-based collaborative learning. (Contains 3 figures and 3 tables.)

This study unveils a tertiary EFL reading teacher's reader identity and its interconnectedness with her pedagogical decisions through narrative inquiry. Community of Practice was employed to elucidate the sources of this reading teacher's reader identity and the interplay between that and her teaching practice. Findings from the categorical content analysis show that this reading teacher's reader identity was projected through her strong passion towards reading. An interactive reading process that results in a better self-understanding is experienced through the reader's reflection on her readings. She reified her reader identity in her teaching practice by forming a readers club. Reader (teacher)-text-reader (student) interaction is thus the most salient feature of this readers club and serves as a mediator that connects the members. Along with this feature, her competence of synchronicity with students was observed in this experienced reading teacher. Pedagogical implications concerning teacher education are discussed.

Key Points: Question: Is benzodiazepine use during pregnancy associated with miscarriage, taking into account both measured and unmeasured confounding factors? Findings: In this case-time-control study, benzodiazepine use during pregnancy was associated with an increased risk of miscarriage, even after accounting for unmeasured confounders, including those related to genetics and the family environment. Meaning: The observation of an increased risk of miscarriage associated with benzodiazepine use during pregnancy suggests that benzodiazepines should only be used after a thorough evaluation of the potential benefits and risks for both the mother and child. This case-time-control study evaluates the association between benzodiazepine use during pregnancy and risk of miscarriage. Importance: Benzodiazepine use during pregnancy has raised significant concerns due to the potential harmful effects of this drug class on neonates. Studies on the association between benzodiazepine use and the risk of miscarriage are limited. Objective: To quantify the risk of miscarriage associated with benzodiazepine use during pregnancy after controlling for unmeasured confounders and exposure time trends. Design, Setting, and Participants: This was a nationwide, population-based case-time-control study using Taiwan's National Birth Certificate Application database and the National Health Insurance database. Pregnancies resulting in miscarriage between 2004 and 2018 were included in the case group and were 1:1 matched with exposure time-trend control individuals using disease risk score, considering demographic characteristics and prepregnancy comorbidities. Data were analyzed from August 2022 to March 2023. Exposures: Discordant exposures to benzodiazepines during risk period (1-28 days before miscarriage) and 2 reference periods (31-58 days and 181-208 days before the last menstrual period) were compared for each pregnancy. Main Outcomes and Measures: Miscarriage was defined as any pregnancy loss occurring between the first prenatal care visit (usually 8 weeks) and the 19th completed week of pregnancy. Results: This study comprised a total of 3 067 122 pregnancies among 1 957 601 women, 136 134 of which (4.4%) resulted in miscarriage. The mean (SD) age of the study population was 30.61 (5.91) years. The use of benzodiazepines during pregnancy was associated with an increased risk of miscarriage (odds ratio [OR], 1.69; 95% CI, 1.52-1.87), and consistent findings were observed across multiple sensitivity analyses considering different time windows and accounting for misclassification. In subgroup analyses, an increased risk of miscarriage was associated with each commonly used individual benzodiazepine, ranging from case-time-control ORs of 1.39 (95% CI, 1.17-1.66) for alprazolam to 2.52 (95% CI, 1.89-3.36) for fludiazepam. Conclusions and Relevance: This nationwide case-time-control study revealed an increased risk of miscarriage associated with benzodiazepine use during pregnancy after accounting for measurable confounders, and results were unlikely to be due to unmeasured confounding. These findings underscore the necessity for health care professionals to meticulously balance the risk-benefit ratio when considering the use of benzodiazepines to treat psychiatric and sleep disorders during pregnancy. [ABSTRACT FROM AUTHOR]

Previous research indicates that understanding the state of learning motivation enables researchers to deeply understand students' learning processes. Studies have shown that visual programming languages use graphical code, enabling learners to learn effectively, improve learning effectiveness, increase learning fun, and offering various other advantages. This study is a counterbalanced experiment on the students of a class, conducted in three stages. The first stage examines the students' initial motivation states. In the second stage, students use a traditional programming language before a visual programming language to learn a specific data structure topic. Finally, in the third stage, students use a visual programming language before a traditional programming language to learn another specific data structure topic. After collecting the experimental data, we cross analyzed questionnaire results to observe whether there was any correlation between them. We found that the motivation state at stages two and three were significantly higher than at stage one. It can be deduced that the use of a visual programming language in a data structure course has a significant effect on improving learning motivation.

This study assessed the effects of a model that integrated the theory of planned behavior (TPB) with extrinsic motivation (EM) in predicting the intentions of fifth-grade students to not use illicit drugs. A cluster-sampling design was adopted in a cross-sectional survey (N = 571). The structural equation modeling results showed that the model attained an acceptable overall fit and explained 85% of the variance in intention. The EM variables influenced intention through subjective norms and perceived behavioral control. Study findings support the proposed TPB-EM model and show that EM can foster a social cognitive mechanism that indirectly affects intention.

Computerized self-assessment testing can help learners reflect on learning content and can also promote their motivation toward learning. However, a positive affective state is the key to achieving these learning goals. This study aims to examine learning gains and emotional reactions resulting from receiving emotional feedback in the form of applause during computerized self-assessment testing of university students. The participants were asked to solve mathematics problems in a computer-assisted self-assessment system with or without prerecorded applause as emotional feedback while EEG measurements were taken. Using psychological evidence from neuroscience technology, we tested the hypothesis that the part of the brain that generates feelings of reward is more active in male students than in female students during computer-assisted self-assessment testing. The results of this study provide support for the belief that it is useful to reduce negative emotional states in students by using emotional reactions such as applause during computer-assisted self-assessment testing, especially in the case of male students. It is suggested that instructors may wish to create such a positive emotional self-assessment learning environment to encourage students to learn by themselves more efficiently.

Understanding the nature of models and engaging in modeling practice have been emphasized in science education. However, few studies discuss the relationships between students' views of scientific models and their ability to develop those models. Hence, this study explores the relationship between students' views of scientific models and their self-generated models, and also whether views of models and modeling practice may be influenced by other factors, such as science learning performance and interest. The participants were 402 ninth-grade students in Taiwan. Data were collected using the Students' Understanding of Models in Science (SUMS) survey and students' self-evaluations of their own science learning interests and performance on a Likert-scale. The students' self-developed models explaining why three different magnetic phenomena occur were also evaluated on a schema of five levels, from lower (observational and fragmented models) to higher (microscopic and coherent models).The results reveal that most students' models remained only at the level of description of observable magnetic phenomena. A small number of the students were able to visualize unseen mechanisms, but these models were fragmented. However, several students with better science learning performance were able to develop coherent microscopic models to explain the three magnetic phenomena. The analyses indicated that most sub-factors of the SUMS survey were positively correlated with students' self-developed models, science learning performance and science learning interest. This study provides implications for teaching the nature of models and modeling practice.

The development and consequences of licensure for counseling psychologists in Taiwan are presented to promote cross-cultural awareness surrounding issues in the counseling psychology profession. The national licensure statute for counseling psychologists in Taiwan was established by the Taiwanese Legislature in 2001. While the licensing system marked an important milestone, it also brought forth a number of internal and external conflicts to the counseling psychology profession in Taiwan. The paper consists of four parts. First, it introduces the development of the Counseling Psychology profession and licensure in Taiwan. Second, challenges triggered by the statute of counseling psychologists are considered. Third, the profession's strategic response to these challenges is addressed. Finally, the profession's ongoing post-licensure development is presented. We hope this article facilitates further exchanges of initiatives undertaken by international colleagues to consolidate the ethical practice of the Counseling Psychology profession in different parts of the world.

Background: Residents in nursing homes are generally highly dependent on others, and unplanned hospitalizations often have major impacts on their physical and cognitive functions. The purpose of this study was to investigate the factors that affect the unplanned hospitalization of nursing home residents. Methods: This retrospective cohort study enrolled 98 residents from a nursing home affiliated with a regional hospital in northern Taiwan. A chart review was performed to transcribe variable data, including demographic characteristics, health status, nutritional status, and the length and frequency of unscheduled transfers to the hospital. Results: A total of 64.3% of the residents experienced one or more unplanned hospitalization. The major causes of unplanned hospitalization were cerebrovascular accident, congestive heart failure, and pneumonia. The factors affecting the unplanned hospitalization of residents were a Barthel index of 20 and the use of a nasogastric or urinary catheter. Conclusion: Strengthening the management of nursing homes and developing preventive guidelines for treating residents with poor ability to perform activities of daily living or using invasive devices are crucial. By implementing preventive measures early and improving the quality of monitoring care, nursing homes can reduce the incidence of unplanned hospitalization. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate how learning materials based on Science Magic activities affect student attitudes to science. A quasi-experimental design was conducted to explore the combination of Science Magic with the 5E Instructional Model to develop learning materials for teaching a science unit about friction. The participants were recruited from among the students of a middle school in central Taiwan. Based on our results, we conclude that our combined teaching method involving Science Magic activities and the 5E Instructional Model is effective for developing learning materials for teaching, and that this method improves students' attitudes toward science.

Previous studies on the field of education abroad have mainly focused on the factors influencing the mobility of international students from developing to developed countries and very few have been conducted to investigate the factors influencing the flow of international students to the Asia Pacific region. As a piece of country-specific research, this study, with an attempt to explore why and how international students travel to Taiwan for the purpose of study and to describe possible implications for the authorities and institutions offering higher education, is timely and worthwhile. A push-pull model is developed to identify the factors relating to the three-phase model of study abroad decision-making process, while the analytic hierarchy process method is used to examine the relative importance of these factors. The findings of this study suggest that policy makers and institutional administrators should focus on offering various kinds of scholarships for international students, designing multilingual websites for international students with different languages, promoting language training programs for international students, and designing student recruitment strategies tailored for the different study groups of international students at the government and the institution levels. This study is of particular significance because global competition between countries for international students and especially for the best among them will be more intense in the future.

The purpose of this study was to analyze how mobile technologies were incorporated and implemented in an outdoor learning activity. Two classes of primary school students participated in the experiment. Using activity theory as an analytical framework, it is found that underlying tensions provided rich insights into system dynamics and that technological affordances could be limited by mismatches between the Tools themselves, and between Tools and the ways that were used by learners or arranged by the instructor. The subtle human factors present in the use of technologies should be carefully considered. The influence of mobile devices on learner experiences in experiential learning is also thoroughly discussed.

Higher technical and vocational education institutions in Taiwan face the pressure of an oversupply of student places and fierce competition from domestic and international institutions. To cope with these challenges, higher technical and vocational education institutions that are better equipped to respond to market requirements are expected to achieve competitive advantage and superior performance. A sector-specific model of competitive advantage for higher technical and vocational education institutions in Taiwan is, therefore, developed and tested. The model integrates theories of strategy and competitive advantage, namely industrial organisation theory and resource-based view theory. It is concluded that integration of industrial organisation and resource-based view theories provides a useful framework in which to comprehensively and systematically analyse an industry sector in relation to competitive advantage. This study also highlights that institutional performance depends on the match between the state of the environment surrounding the higher technical and vocational education institutions and their use of resources. (Contains 6 tables and 1 figure.)

The parental report instrument is the most efficient developmental detection method and has shown high validity with professional assessment instruments. The reliability and validity of the Taiwan Birth Cohort Study (TBCS) 6-, 18- and 36-month scales have already been established. In this study, the reliability and validity of the 60-month scale was tested. The gender differences in children's longitudinal gross motor, fine motor, language and social development were also investigated. Using the dataset from the Taiwan Birth Cohort Pilot Study (TBCS-p), 2048 infants were followed up when they were 6-, 18-, 36- and 60-month-old. At the final stage, 1620 children were followed up. Development of the children was measured using the TBCS 6-, 18-, 36-, and 60-month developmental scales. The reconstructed TBCS 60-month scale yielded 16 items measuring children's development in the four dimensions of gross motor, fine motor, language and social. The scale yielded an internal consistency of 0.39-0.71. Structural equation modeling also showed good construct and predictive validity, in that the 6-, 18-, and 36-month scales were predictive of the 60-month scale. No gender differences between the gross motor dimension was found. Gender had an effect on the fine motor dimension at 36 and 60 months, language dimension at 36 months, and social dimension at 18, 36 and 60 months. Gender had a transient effect in language development and social development a continuous effect from 18 to 60 months. Thus different gender norms may need to be established to prevent misdiagnosis. The TBCS scale is a valid and reliable developmental screening instrument that can be used in continuous surveillance of children's development in community and clinical settings from 6 months to 5 years of age. (Contains 3 tables and 1 figure.)

This research consisted of 3 studies, with a sample of over 3,000 Taiwanese college students, aimed at developing and validating a situation-specific Collectivist Coping Styles (CCS) inventory from an Asian perspective. The results from the exploratory and confirmatory factor analyses supported a stable 5-factor structure of the CCS: (a) Acceptance, Reframing, and Striving; (b) Family Support; (c) Religion-Spirituality; (d) Avoidance and Detachment; and (e) Private Emotional Outlets. These factors reflected Asians' use of a combination of primary and secondary control efforts and represented different constellations of items than typically found on coping-problem solving inventories in Western countries. Estimates of concurrent and construct validity suggest the CCS is related to a problem solving inventory, an overall problem resolution index, 2 psychological distress measures, and an index of how much the trauma interfered with the lives of participants in conceptually expected directions but is not strongly related to social desirability. Overall, the CCS was found to be a useful and psychometrically sound measure of collectivistic coping. Limitations and future directions are also discussed.

Utilizing an integration of social-cognitivist and socio-cultural approaches, this study--comparing the interactive processes among peers and their mentor in two contrasting groups--was designed to explore the reasons why two learning groups, engaged in an inquiry-based learning project with comparatively sustained discussion, produced vastly differing results. Using discourse threads as the unit of analysis, together with the mentor's perceptions of group facilitation, the findings of this study highlighted the effect of group dynamics upon the mentor's facilitation. Group interaction with explicit and decisive discourse will result in a better understanding for the mentor of the group's zones of proximal development (different ZPDs), and will provide greater opportunity for effective group scaffolding.

This study compares generalized effects of a social-emotional skills training for girls and boys with autism in resource rooms on promoting positive social behaviors in general education classrooms in Taiwan. A single subject design was used to compare outcomes for 2 girls and 2 boys with autism in the experimental group with 2 boys with autism in the control group. Results of regression analyses revealed that all 4 participants in the experimental group significantly increased frequencies of positive social behaviors over time, while the two control participants did not demonstrate trends in the data. After adjusting for trends, the training had a medium effect size for 2 participants and a small effect size for 2 participants in the experimental group. This training was developed in response to educational services in Taiwan; suggestions are provided for development of interventions for children with autism that fit within general education classrooms. (Contains 4 tables and 2 figures.)

Current research seems to underscore the impact of parental expectations on college students' psychological distress. This study examined whether parental expectations or living up to parental expectations served as better predictors on Taiwanese college students' psychological distress. Study 1 developed and validated a scale for measuring parental expectations and living up to parental expectations. Results supported the factorial validity and reliability of the scale. The results of Study 2 suggested that perceiving oneself as living up to parental expectations, rather than parental expectations per se, is a better predictor of psychological distress. Implications of the results for counseling interventions as well as further research are discussed.

Police misconduct erodes police-citizen relations, which in turn, discourages people from cooperating with police. While a substantial volume of research has focused on how citizens' demographics, media trust, and neighborhood context can exert an influence on perceptions of police misconduct, very little research has explored the impact of procedural justice in this regard. To fill in the gaps in this literature, the present study utilizes Structural Equation Modeling (SEM) to examine factors affecting citizens' perceptions of police misconduct in Taiwan. Data were obtained from a CATI telephone survey of 1,806 residents in Metropolitan Taipei in 2014. It was found that citizens' primary concerns of police misconduct include the covering-up of misconduct on the part of powerful suspects/celebrities, followed by the abuse of power by legal authorities, and the discriminatory enforcement of regulations, respectively. The results revealed importantly that procedural justice, perceptions of crime prevalence, and gender had significant direct influences, whereas media trust, victimization, and involuntary contact with police only had indirect effects on citizens' perceptions of police misconduct. Procedural justice was the most robust variable in predicting citizens' perceptions of police misconduct. [ABSTRACT FROM AUTHOR]

Background: The complication of donor site in skin grafting often acts as a causing factor for extended treatment period. The elderly individuals tend to be afflicted by impaired wound healing. Herein, we presented the outcome of skin regrafting in the elderly patients. Methods: Patients who aging over 60 had anterior thigh split-thickness skin grafting (STSG) donor sites as part of any reconstructive surgery were included. In experimental group, the over-harvest skin back was replaced on the donor site in island type, and Alleyvn (Smith & Nephew) was put upon the regrafting skin as fixation. In the control group, the donor site was only covered by Alleyvn (Smith & Nephew). Variables extracted included demographics, intra-operative data and post-operative outcomes. Vancouver scar scale (VSS) was used to evaluate scar condition in donor site in post-operative 3 months. Results: Twenty-six patients with 15 re-grafting versus 11 non-regraftingwere analyzed. Therewas a significantly shorter in the healing time of donor site in the re-grafting group than the non regrafting group (28.33 vs. 39.91, p = 0.03). All the parameters of VSSwere significant difference between regrafting versus non-regrafting groups, for the mean scores of vascularity (0.36 ± 0.34 vs. 1.64 ± 0.61, p < 0.01), pigmentation (0.52 ± 0.31 vs. 1.98 ± 0.44, p < 0.01), pliability (0.48 ± 0.26 vs. 1.49 ± 0.51, p < 0.01), height (0.23 ± 0.20 vs. 0.98 ± 0.39, p < 0.01). Conclusions: Compared with artificial dressing only, immediate regrafting of over-harvest skin on the donor site in STSG is a reliable method to provide faster healing time and better scar formation in the elderly. [ABSTRACT FROM AUTHOR]

Background: Patients with diabetes have a relatively high risk of fracture due to osteoporosis. However, the risk of osteoporosis associated with the use of oral hypoglycemic drugs and dipeptidyl peptidase-4 inhibitor (DPP-4i) by patients with diabetes is unclear. This study aimed to explore the effect of DPP-4i on the risk of osteoporosis in Taiwanese patients with type 2 diabetes mellitus (T2DM). Methods: This study enrolled 6339 patients on DPP-4i (DPP-4i group) and 25 356 patients without DPP-4i (non-DPP-4i group). They were matched by 1:4 propensity score matching, using confounding variables including sex, age, comorbidities, medication, and index year. Cox proportional hazards analysis was used to compare hospitalization and mortality during an average follow-up period of 7 years. Results: The mean age of patients in the two groups was 66 years. Men were slightly higher in number (51.79%) than women. At the end of the follow-up period, 113 (0.36%) patients had osteoporosis, of which 15 (0.24%) were in the case group and 98 (0.39%) in the control group. The risk of all-cause osteoporosis was significantly lower in the DPP-4i group than in the non-DPP-4i group (adjusted hazard ratio [HR] 0.616; 95% confidence interval [CI] 0.358--0.961; p = 0.011). Kaplan--Meier analysis showed that the preventive effect on osteoporosis was positively correlated with the cumulative dose of DPP-4i (log-rank, p = 0.039) with the class effect. Conclusion: Compared with not using DPP-4i, the use of DPP-4i in Taiwanese T2DM patients was associated with a lower risk of osteoporosis due to the class effect, and the preventive effect was dose-dependent. However, larger prospective studies are needed to validate this finding and to explore the possible mechanism of the preventive effect of DPP-4i. [ABSTRACT FROM AUTHOR]

Background: Recurrent pneumonia is uncommon in children and few studies investigate the clinical impact of underlying diseases on this issue. This study aimed to explore the difference in clinical manifestations, pathogens, and prognosis of recurrent pneumonia in children with or without underlying diseases.Methods: We conducted a retrospective study of pediatric recurrent pneumonia from 2007 to 2019 in National Taiwan University Hospital. Patients under the age of 18 who had two or more episodes of pneumonia in a year were included, and the minimum interval of two pneumonia episodes was more than one month. Aspiration pneumonia was excluded. Demographic and clinical characteristics of patients were collected and compared.Results: Among 8508 children with pneumonia, 802 (9.4%) of them had recurrent pneumonia. Among these 802 patients, 655 (81.7%) had underlying diseases including neurological disorders (N = 252, 38.5%), allergy (N = 211, 32.2%), and cardiovascular diseases (N = 193, 29.5%). Children without underlying diseases had more viral bronchopneumonia (p < 0.001). Children with underlying diseases were more likely to acquire Staphylococcus aureus (p = 0.001), and gram-negative bacteriae, more pneumonia episodes (3 vs 2, p < 0.001), a longer hospital stay (median: 7 vs. 4 days, p < 0.001), a higher ICU rate (28.8% vs 3.59%, p < 0.001), and a higher case-fatality rate (5.19% vs 0%, p < 0.001) than those without underlying diseases.Conclusion: Children with underlying diseases, prone to have recurrent pneumonia and more susceptible to resistant microorganisms, had more severe diseases and poorer clinical outcomes. Therefore, more attention may be paid on clinical severity and the therapeutic plan. [ABSTRACT FROM AUTHOR]

Background/purpose: To compare the clinical outcomes of Taiwanese patients with ovarian clear cell carcinomas (CCCs) and serous carcinomas (SCs).Methods: We retrieved the clinical records of women with epithelial ovarian cancer (Stage I-IV) who received primary surgeries between 2000 and 2013. Cancer-specific survival (CSS), progression-free survival, and survival after recurrence (SAR) of CCC and SC patients were retrospectively compared. Multivariate analysis was used to identify the independent predictors of survival.Results: Of 891 women diagnosed with epithelial ovarian cancer, 169 CCCs and 351 high-grade SCs were analyzed. The 5-year CSS rates of CCC patients were significantly lower than those of SC for both Stage III (22.3% vs. 47.3%, p = 0.001) and Stage IV (0% vs. 24.4%, p = 0.001) disease. In the absence of gross residual malignancies, the 5-year CSS rate was better for CCC (82.3%) than SC (75.2%, p = 0.010). The 5-year SAR rate was significantly lower for CCC than SC (14.3% vs. 24.4%, p = 0.002). Old age and residual malignancies were independent prognostic factors for CSS in the entire cohort of CCC patients. In the subgroup of Stage I CCC, positive cytology was identified as the only adverse prognostic factor for CSS.Conclusion: The clinical outcomes of CCC are generally poorer than SC. Complete cytoreduction to no gross residual disease should be ideally achieved in CCC patients. A greater understanding of the molecular pathogenesis of CCC may lead to tailored therapies, ultimately optimizing outcomes. [ABSTRACT FROM AUTHOR]

Background/purpose: Renal transplant candidates who are highly sensitized to human leukocyte antigens (HLAs) tend to wait longer to find a matched donor and have poor outcomes. Most organ-sharing programs prioritize highly sensitized patients in the allocation scoring system. The HLA sensitization status is traditionally evaluated by the panel-reactive antibody (PRA) assay. However, this assay is method dependent and does not consider the ethnic differences in HLA frequencies. A calculated PRA (cPRA), based on a population's HLA frequency and patients' unacceptable antigens (UAs), correctly estimates the percentage of donors suitable for candidates. The Taiwan Organ Registry and Sharing Center does not prioritize sensitized patients. We propose that the incorporation of the cPRA and UAs into the renal allocation program will improve the local kidney allocation policy.Methods: We established a cPRA calculator using 6146 Taiwanese HLA-A, -B, -C, -DR, and -DQ phenotypes. We performed simulated allocation based on the concept of acceptable mismatch for 76 candidates with cPRA values exceeding 80%.Results: We analyzed 138 waitlisted renal transplant candidates at our hospital, and we determined that the concordance rate of the cPRA and PRA for highly sensitized (%PRA > 80%) candidates was 92.5%, which decreased to 20% for those with %PRA < 80%. We matched 76 highly sensitized patients based on acceptable mismatch with the HLA phenotypes of 93 cadaver donors. Forty-six patients (61%) found at least one suitable donor.Conclusion: The application of the cPRA and acceptable mismatch can benefit highly sensitized patients and reduce positive lymphocyte cytotoxicity crossmatch. [ABSTRACT FROM AUTHOR]

Summary Introduction Obesity screening among young adult groups is meaningful. Body mass index (BMI) is limited to discriminate between fat and lean mass. Asian young adult group tends to have lower BMI and higher body fat percentage (BFP) than other ethnic groups. Accuracy of obesity screening by commonly used BMI criteria is unclear in young Taiwanese population. Material and methods A total of 894 young adults (447 males and 447 females) aged 20–26 were recruited. BMI, regional fat percentage and BFP determined by bioelectrical impedance analysis (BIA) were measured. BMI cutoff points were based on the criteria adopted by the Ministry of Health and Welfare in Taiwan. Cutoff points of low or high BFP were defined as 24% in men and 31.4% in women. Results Prevalence of BFP defining obesity was 14.8% in young men and 27.3% in young women. 23.2% of young men and only 8.3% of young women were classified to overweight or obesity categories according to the BMI criteria. Disagreement was noticed mainly among overweight males and normal weight females. 68.7% of BMI defining overweight young men had low BFP; however, 29.7% of young women of BMI defining normal group had high BFP. Up to 69.7% of young women with high BFP would be missed by BMI category only. Conclusion Disagreement between BMI and BFP was significant among young adults, especially young women. We suggest combining BMI and BIA for obesity and overweight screening in Asian young adults. [ABSTRACT FROM AUTHOR]

To examine whether changes in metabolic syndrome (MetS) status over time are associated with risk of all-cause and cardiovascular disease related (CVD) mortality. This prospective cohort study consisted of 544,749 individuals who participated in a self-funded comprehensive health surveillance program offered by Taiwan MJ Health Management Institution between 1998 and 2016. We included 236,216 adults who had at least two repeated MetS measures 5.9 (4.6) years apart and were followed up for mortality over 18.8 (5.2) years. Participants were classified according to the change in their MetS status as follows: MetS-free at both time points (n = 173,116), MetS-developed (n = 22,607), MetS-recovered (n = 13,616), and MetS-persistent (n = 26,877). Multivariable Cox proportional hazards model was used to determine the association between change in MetS status and risk of all-cause and CVD mortality. Over the 4,436,842 person-years follow-up period, 14,226 participants died, including 2671 (19%) of CVD-related causes. The crude CVD mortality rate per 1000 person-years in the study groups were MetS-free, 0.32; MetS-developed, 0.75; MetS-recovered, 1.22; and MetS-persistent, 2.00 (P < 0.001). Compared to the persistent MetS group, participants in the MetS-recovered group had a lower risk of all-cause (adjusted hazard ratio [aHR], 0.87; 95%CI, 0.82–0.92) and CVD mortality (aHR, 0.81; 95% confidence interval [CI], 0.71–0.93). Development of MetS increased the risk for all-cause (aHR, 1.11; 95%CI, 1.05–1.17) and CVD mortality (aHR, 1.22; 95%CI, 1.07–1.39), compared to the MetS-free group. Recovery from MetS was significantly associated with a lower risk of all-cause and CVD mortality, whereas development of MetS was associated with increased risk. [ABSTRACT FROM AUTHOR]

Abstract: The efficiency of Taiwan''s waste management and resource recycling systems has been well recognized in recent years, but the present model used to locate recycling centers and to assign collection depots to those centers continues to show low efficiency. To address this issue, the study herein suggests implementing a new location-planning and assignment model to reduce the number of existing recycling centers. Such a reduction would reduce the use of land resources. Moreover, the total transportation distance would decrease through the efficient assignment of collection depots to recycling centers. On the basis of results from previous studies, this study proposes a 2-stage location set covering problem–P-median integrated model that obtains exact solutions using heuristic algorithms on the basis of set operations. The results of numerical analyses show that the model introduced in this study is effective in solving the problems stated above as well as in improving the layout of Taiwan''s existing recycling centers. [Copyright &y& Elsevier]

Abstract: This study aims to explore whether various service quality conditions and age stereotypes would affect perceptions of service quality in customers of fine dining restaurants in Taiwan. This research also identifies the moderating effect of servers’ age stereotype, age in-group bias, and respondents’ age on perceived service quality. A total of 406 subjects participated in the study with 2 (scenarios of service quality: favorable vs. unfavorable)×2 (ages of server: young vs. middle-aged) between-subjects factorial design. The results showed that the respondents’ perceived service quality of server with young appearance was better than the counterpart with middle-aged appearance on tangibles and reliability dimensions under favorable and unfavorable service quality conditions. However, the differences were not significantly affected by servers’ age stereotypes. [Copyright &y& Elsevier]

Background: Human milk–borne nucleotides and their related metabolic products have been reported to have important physiological roles in breast-fed infants. The purpose of this study was to measure the concentrations of free nucleotides and nucleosides in human milk from Taiwanese women. Methods: A total of 24 individual milk specimens were collected from women in Taipei and Kaohsiung, at four stages of lactation. Vegetarian or non-vegetarian dietary patterns were recorded. The samples were analyzed for nucleotides and nucleosides by high-performance liquid chromatography. Results: The mean (±standard deviation) free nucleotide and nucleoside concentrations in Taiwanese human milk were 213.13±76.26μmol/L and 16.38±7.11μmol/L. The predominant nucleotide was cytidine diphosphate for almost all samples, regardless of the location, stage of lactation, or dietary status of the subjects. Overall, the mean concentrations of cytidine diphosphate, cytidine monophosphate, uridine monophosphate, guanosine monophosphate, adenosine monophosphate, and inosine monophosphate, in milk samples were 129.86μmol/L, 49.10μmol/L, 5.60μmol/L, 0.82μmol/L, 2.96μmol/L, and 25.25μmol/L, respectively (equivalent to 61.0%, 23.1%, 2.6%, 0.4%, 1.0%, and 11.9% of free nucleotide composition). In free nucleosides, cytidine and uridine were predominant during all stages of lactation. The average concentrations of cytidine, uridine, adenosine, guanosine, and inosine, in milk samples were 9.25μmol/L, 6.33μmol/L, 0.18μmol/L, 0.36μmol/L, and 0.23μmol/L, respectively (equivalent to 56.5%, 38.7%, 1.1%, 2.2%, and 1.4% of free nucleoside composition). Comparing vegetarian and non-vegetarian statuses, it was found that the total free nucleotide concentration was high in the vegetarian group (p =0.037). Conclusion: Our data showed a wide range of concentrations of individual nucleotides and nucleosides in Taiwanese human milk. Unique dietary status could affect the nucleotide and nucleoside levels in human milk, especially the nucleotides in our study. However, the mechanism of modulation of nucleotide and nucleoside levels in human milk is not clear. [Copyright &y& Elsevier]

This study provides an evaluation of the potential of Taiwan's hot springs tourism sector by proposing a model of competitiveness that has broad applicability to hot springs destinations. Using the analytic hierarchy process method to generate weightings for the various elements which contribute to destination competitiveness, the study prioritizes aspects of hot springs tourism which would benefit from further development. A panel of experts commented on the relative competitiveness of hot springs tourism in Taiwan and Japan. and concluded that hot springs proprietors need to reinforce their conservation efforts and engage in the sustainable use of hot springs and surrounding environments. They noted that governments should formulate and implement strategic destination planning and development to avoid a repetition of previous mistakes. The increasing Taiwanese preoccupation with good health and longevity and Taiwan's rich endowment of high-grade natural hot springs produces a favorable environment development of the hot springs tourism sector. It also offers business opportunities to extend the appeal of hot springs tourism into health protection and medical treatment. The article concludes that Taiwan's hot springs tourism sector has a promising future, but that concerted effort will be needed to match the product offerings of its competitors. [ABSTRACT FROM AUTHOR]

Background/purpose: To investigate the prevalence of lower urinary tract symptoms (LUTS), their impact on quality of life, and their association with socioeconomic and lifestyle factors among indigenous and non-indigenous women in Eastern Taiwan.Methods: A total of 376 indigenous women and 509 non-indigenous women aged over 18 years were interviewed concerning LUTS in the recent 6 months using International Prostate Symptom Score questionnaires.Results: Indigenous women had a higher prevalence of one or more LUTS than non-indigenous women (44.9%vs. 31.2%). Indigenous women had a significantly higher prevalence of urgency (7.7%vs. 4.3%, p = 0.024), straining to void (6.1%vs. 3.3%, p = 0.036), and nocturia (37.2%vs. 24.8%, p < 0.001) than non-indigenous women. There was no significant difference in the prevalence of impaired quality of life between indigenous and non-indigenous women (33.8%vs. 31.2%). Lower educational level, alcohol consumption, betel quid chewing, and cigarette smoking, and not difference in race, had significant effect on a higher prevalence of bothersome LUTS in indigenous women than non-indigenous women.Conclusion: Indigenous women with lower educational level and specific lifestyle risk factors have a higher prevalence of LUTS than non-indigenous women in Taiwan. [ABSTRACT FROM AUTHOR]