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Reading requires appropriate strategies to spark initial interest and sustain engagement. One promising strategy is the pedagogical approach of learning-by-teaching, transforming learners into active participants. Integrating this approach into digitalized and individualized reading contexts has the potential to foster the development of young readers. Currently, AI techniques are primarily used in chatbots as tutors, with limited focus on tutee chatbots that employ the learning-by-teaching pedagogy. Therefore, this study adopted a teachable Q&A agent and probed into the effect of chatbot training, employing AI techniques and utilizing student-generated questions and answers, with the aim of enhancing students' reading interest and engagement. Ninety-five fifth graders participated in a 9-week reading program. A quasi-experimental design was conducted. The results proved that incorporating a learning-by-teaching approach into the chatbot training activity significantly enhanced their reading interest and engagement. However, the quantity of certain question types is negatively correlated with interest and engagement. This implies that asking diverse questions poses a certain level of challenge to young readers, which requires deliberate training and incubation. Additionally, the identification of four distinct student clusters exhibited the affordances and limitations of tutee chatbots for reading.

Despite the widespread integration of technological tools in pre-service English-as-a-Foreign-Language (EFL) education, there has been a dearth of research investigating the effects of the latest virtual platforms on pre-service teachers' competence in lesson planning, perceived presence, and perceptions, particularly in relation to high- and low-achieving pre-service teachers. This study, accordingly, investigated the potential benefits of utilizing innovative online learning platforms, specifically Gather, in teacher preparation education. Through a mixed-methods, quasi-experimental, within-subjects design, 46 English-major junior students enrolled in a pre-service EFL course at a private university in central Taiwan were assigned two lesson planning tasks, the first involving in-class discussion and the second utilizing Gather for interaction. Based on their performance in the first task, the students were divided into two groups: high achievers and low achievers, each comprising 23 students. Analysis of their performances, responses to the Multiple Presence Scale, and reflective journals indicated that both groups demonstrated improvement in lesson planning and reported positive experiences in the virtual learning environment, particularly in terms of physical presence, social presence, and self-presence. Moreover, the students expressed a preference for online learning facilitated by Gather. Notably, while both groups acknowledged the perceived presences in Gather, high achievers exhibited significantly higher levels in all three aspects of presence, suggesting a stronger sense of immersion in the virtual learning setting, akin to face-to-face classroom meetings. These results suggest that platforms like Gather can enhance lesson planning outcomes, foster engagement, and serve as a valuable alternative to traditional videoconferencing tools in teacher preparation education.

Purpose: Despite the acknowledged benefits of digital storytelling in fostering language development, investigations into its cognitive and affective dimensions in English-as-a-Foreign-Language (EFL) education, especially concerning high and low achievers, have been scarce. This study, therefore, aimed to scrutinize the effects of multimodal digital storytelling presentations on storytelling outcomes and emotional responses of high and low achievers within an EFL context. Design/methodology/approach: The study enlisted 52 sophomore students from a private university in central Taiwan. Over a 14-week research period, participants were tasked with creating two digital storytelling presentations: the first employing PowerPoint and the second utilizing Book Creator. Data collection encompassed two questionnaires gauging positive/negative affective states and enjoyment in digital storytelling, along with reflective journals. Findings: The results underscored the superiority of Book Creator over PowerPoint in enhancing digital storytelling presentation quality. High-achieving students reported heightened positive affective experiences and a greater sense of enjoyment compared to their low-achieving peers. However, both groups exhibited comparable levels of negative affect, suggesting the existence of anxiety despite the presence of positive emotions during the learning process. Originality/value: This study contributes by emphasizing the equitable significance of cognitive and affective facets within technological multimodality, thereby illuminating the multifaceted essence of EFL learning.

This mixed-methods research explored the affordances of a writing instruction featuring constructivist learning, reading-writing connection, flipped learning, and online intercultural exchanges with regard to English-as-a-foreign-language (EFL) learners' writing performance and intercultural sensitivity. Forty-eight Taiwanese English-major undergraduate students were each paired with an American undergraduate partner, had intercultural online exchanges, completed two essays (a descriptive essay and an argumentative essay), and had revisions based on their peers' feedback. Multiple sources of data over a semester included the pre- and post-tests on the two essay writing tasks, responses to an intercultural sensitivity scale, and focus-group interviews. The instruction design enhanced the EFL learners' writing outcomes, strengthened their cross-cultural observations, and increased their intercultural sensitivity. This study highlights the practice with a focus on developing writing skills and intercultural sensitivity using online intercultural exchanges.

This study used a mixed-methods research design to examine how preschool teachers in Taiwan implement the embedded executive function (EF)-supporting activities within the classroom and the consequent effects on children's EF and oral language. Twelve teachers and 82 children from two preschools participated in the study. All teachers received training and developed a set of strategies employing embedded EF-supporting activities within the classroom. The study measured children's EF and oral language after a 12-week period. Although significant effects on children's EF were not observed for the overall sample, significant improvement in children's oral language was indicated by the markedly higher scores compared with the pretest. Further analysis indicated that the effects were driven by the preschool with lower EF and oral language. The results demonstrated that EF-supporting activities can enhance the quality of the classroom, including increasing the speed of clean-up, encouraging children to focus on a goal and be responsive to the teachers' directions, and more time for group discussion. The results recommend that teachers need more coaching support. Researchers need to facilitate teachers playing a more active role in designing EF-supporting activities and incorporate more time points to examine the long-term effects on children's EF skills and academic learning. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to evaluate the risk of benign peripheral persistent vertigo (BPPV) among patients with anxiety disorders by using the Taiwan National Health Insurance Research Database (NHIRD). Methods: We conducted a retrospective study of 15,470 participants (7735 anxiety disorder patients and 7735 control patients) selected from the NHIRD. Patients were observed for a maximum of 9 years to determine the rates of newly diagnosed BPPV. A Cox regression model was used to evaluate the risk of BPPV among the patients with anxiety disorders. Results: During the 9-year follow-up period, 178 (2.05 per 1000 person-years) anxiety disorder patients and 71 (0.81 per 1000 person-years) control patients were diagnosed with BPPV. The incidence risk ratio of BPPV between anxiety disorder patients and control patients was 2.52 (95% confidence interval [CI], 1.90-3.37, P < .001). After adjustment for age, sex, and comorbidities, patients with anxiety disorders were found to be 2.17 times more likely to develop BPPV (95% CI, 1.63-2.90, P < .001) than the control patients. Furthermore, female sex (HR = 1.81, 95% CI, 1.31-2.50, P < .001) and cerebrovascular disease (HR = 1.53, 95% CI, 1.00-2.34, P = .050) were independent risk factors for developing new-onset BPPV in patients with anxiety disorders. Conclusions: Anxiety disorder patients may have an increased risk of developing BPPV, especially those who are female or have cerebrovascular disease. [ABSTRACT FROM AUTHOR]

This study investigated the effects of online drill-and-practice activities using student-generated questions on academic performance and motivation as compared with online drill-and-practice using teacher-generated questions and no drill-and-practice in a student question-generation ( SQG) learning context. A quasi-experimental research method was adopted for the purposes of this study. Six fifth-grade classes ( n = 145) participated in a weekly online activity for 5 weeks. Analysis of covariance results showed significant differences among the different treatment groups with regard to both academic performance and motivation. Post hoc comparisons using simultaneous confidence intervals, however, did not demonstrate the use of online SQG combined with answering peer-generated questions to be more conducive to learning with regard to any of the observed variables as compared with the use of online SQG combined with answering teacher-generated questions. Furthermore, answering student-generated questions in addition to online SQG did not lead to added gains in learning as compared with the online SQG-alone group. Some reasons for the unexpected findings are proposed, and the significance of this study, as well as suggestions for instructional implementations and future research, are provided. [ABSTRACT FROM AUTHOR]

Aim: Urothelial carcinoma (UC) can occur multifocally in the whole urothelium. A higher rate of bilateral metachronous upper tract (UT) UC was noted in Taiwan. The incidence and risk factors were largely unknown and hence were explored in the study. Methods: From January 1977 through June 2003, 462 patients with unilateral UT-UC were studied retrospectively. The cumulative incidence of contralateral recurrence was analysed with the Kaplan–Meier analysis. Potential risk factors for contralateral recurrence including age, smoking, bladder cancer, renal function, diagnostic year etc. were evaluated with the log–rank test. Independent risk factors were identified by using the Cox regression analysis. Results: The median follow-up time was 34 months (6–337). Among the 462 patients, 52 (11.3%) developed metachronous contralateral UC. The 2, 5, and 10-year contralateral disease-free survivals were 93.5%, 84.0%, and 75.7%, respectively. The median time to contralateral recurrence was 31.0 months. With the univariate analysis, only poor renal function (serum creatinine < or ≥2.0 mg/dL, P < 0.001) and late diagnostic year (before or after 1990, P < 0.001) were risk factors for contralateral recurrence. In the multivariate analysis, poor renal function (hazard ratio: 2.98; 95% confidence interval: 1.67–5.33; P < 0.001) and late diagnostic year (hazard ratio: 4.27; 95% confidence interval: 1.71–10.65; P = 0.002) remained independent risk factors. Conclusions: The incidence of metachronous UT-UC is high in Taiwan. Patients who had either chronic renal insufficiency or a disease diagnosed after 1990 had a higher risk of contralateral recurrence. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the quality of life (QOL) impact of urinary incontinence (UI) and to examine its relationship with treatment seeking in adult Taiwanese women. We conducted a cross-section in-person questionnaire interview of 1608 adult women living in the Taipei area. The characteristics and incontinence status were recorded. A short form incontinence impact questionnaire (IIQ-7) was used to evaluate the QOL impact of UI. Multiple logistic regression analysis was used to assess the determinative factors for treatment seeking. The mean IIQ-7 score of the 205 (12.7%) women who reported urinary leakage more than once per month in the preceding 12 months was 5.0 (range: 0–19), which showed a significant correlation with the severity of incontinence (r = 0.59, p < 0.001). Women with mixed type UI had a higher IIQ-7 score compared to those with stress or urge UI. Fifty-five (26.8%) incontinent women had sought medical help. Treatment seeking was highly related to IIQ-7 scores as 75% of incontinent women with an IIQ-7 score > 10 in contrast to 5% of those with an IIQ-7 score &les; (p < 0.001) had sought medical care. On multiple logistic regression analysis, perceiving UI as a disease and a higher IIQ-7 score were independent factors predicting treatment seeking. We concluded that UI is a common problem that brings substantial QOL impact to Taiwanese women. The IIQ-7 questionnaire may provide a useful measurement to quantitate the degree of QOL impact, which is largely affected by the severity and type of incontinence. Women who perceive UI as a disease and those with a higher degree of QOL impact are more likely to seek medical help. Furthermore, treatment seeking in Taiwanese women with significant UI may be more common than thought as a great majority of women with higher IIQ-7 scores had sought medical help. [ABSTRACT FROM AUTHOR]

Explores Taiwanese mothers' descriptions of interactions with their babies with Down syndrome. Background to the study; Theoretical framework; Relationship between mothers' descriptions of abilities and limitations; Discussion and implications.