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This systematic literature review aims to offer an in-depth analysis of the existing research landscape regarding the application of the flipped classroom approach within the domain of language learning. The investigators methodically selected and analyzed 57 papers from 656 documents using a systematic and rigorous approach to literature selection. Our findings demonstrate the significant international impact of this field, with contributions from many countries and districts as well as globally excellent academic institutions. This review examines multiple areas of research, including improving students' perceptions and attitudes in flipped classrooms, language proficiency, motivational factors, etc. In addition, the research methods employed were evaluated, with a particular emphasis on mixed methods which combined the quantitative method with the qualitative method. Even though the application of flipped classrooms in language learning has achieved some achievements, some limitations are obvious. The most notable are the problem of sample size, the difficulty of technology integration, the lack of teacher training, the singularity of language research, etc. The research gaps revealed in this literature review, indicate interesting possibilities for future research. The diversity of research languages, the multiplicity of research methods, the integration of advanced technologies, and intensive teacher training will be significant of the area focus. This systematic literature review not only enriches the existing knowledge system but also has the potential to the direction of the development of flipped classrooms in language learning.

Taking into account the challenges of EFL vocabulary learning for East Asian learners, this study developed a set of experimental English vocabulary material with pictographic glosses which may stimulate students' situational interest (with dimensions of exploration intention, instant enjoyment, novelty, attention demand, challenge, and total interest) in learning vocabulary and facilitate their vocabulary retention. To examine the effectiveness of the learning material, this study utilized a within-subjects quasi-experimental design. The participants were 108 graduate and college students who used the learning materials presented in text-only, text-with-picture, and pictographic formats in an online learning system. Results revealed that students' retention performance on the pictographic materials was significantly higher than on the text-only materials, while no significant differences were found between the pictographic and text-with-picture materials. The perceived situational interest in the pictographic material was significantly higher than in the other two formats. The results suggest that the pictographic vocabulary material could trigger EFL learners' situational interest and help to promote their English vocabulary learning. It could therefore serve as a novel approach to designing EFL vocabulary materials for multimedia environments.

School practitioners' receptivity to reform influences the success of policy implementation. In Taiwan, the Ministry of Education launched a curriculum reform in 2019. To determine how to enhance school agency for the policy, we explored the individual and contextual factors affecting receptivity to the new curriculum. With a survey design, this study recruited secondary school teachers and principals throughout Taiwan as samples. Hierarchical regression models were conducted to examine the effects of individual factors (conceptions of distributed leadership and collective learning) and organizational culture (power distance, uncertainty avoidance, and academic emphasis) on practitioners' receptivity to curriculum reform. Both the main and interactive effects were investigated. The results indicate that respondents who positively conceived distributed leadership and collective learning were more receptive to change. Regarding the three indicators of organizational culture, we found no significant effect of power distance, while the main effect of uncertainty avoidance and the moderation effect of academic emphasis existed. Those who perceived their schools with high uncertainty avoidance levels were more resistant to reform efforts. Besides, a positive linkage between teacher conception of collective learning and affection for change was more evident in schools with less academic emphasis. Our study suggests that school reforms must be understood within the individual and school contexts. The finding about the moderation effect of academic emphasis furthermore signifies the cultural implication in Asian societies.

Purpose: The importance of teacher leadership in enhancing school outcomes is recognized, but there remains a scarcity of research addressing the conditions for principals to nurture such leadership. This study examined how school contextual factors, i.e. faculty trust and academic emphasis, moderate the impact of principals' distributed leadership lon teacher leadership. Design/methodology/approach: A nationwide survey was conducted among junior high school teachers in Taiwan. The sample encompassed schools from different geographical regions and sizes, yielding a total of 1,340 valid responses. Hierarchical regression analyses were employed to analyze the potential moderating effects of interest. Findings: There were interactive effects of principals' distributed leadership and school contextual factors on teachers' adoption of leadership roles. The impact of principals' distributed leadership on teacher leadership was amplified in environments marked by elevated levels of trust relations and reduced academic emphasis. Practical implications: This study uncovers the critical prerequisites principals must address to cultivate teacher leadership. To effectively encourage heightened teacher engagement in leadership, principals must place a premium on nurturing trusting relations with their teaching staff and acknowledge that the influence of their leadership might be lessened in an environment where credentialism holds sway. Originality/value: The exploration into faculty trust and academic emphasis yields insights into the conducive conditions for principals to foster teacher leadership. The identified attenuating impact of academic emphasis on principal effect within an Asian societal context highlights its significance not only as an organizational property but also as a manifestation of national cultural values.

Purpose: Learning power is crucial in today's rapidly changing world, yet its application to teachers is under-explored. This study delved into the investigation of teacher learning power and examined how it matters in the relationship between teachers' experiences in lesson study and the adoption of constructivist pedagogy. Design/methodology/approach: A cross-sectional survey of 226 elementary, junior high, and senior high school teachers in Taiwan was conducted, and the results were analyzed using structural equation modeling. Findings: The findings suggest that both participation in lesson study and teacher learning power were positively associated with the practice of constructivist pedagogy. Moreover, teacher learning power partially mediated the relationship between lesson study and constructivist pedagogy. Originality/value: By incorporating the concept of teacher learning power and performing a mediation analysis to understand how it matters, this study has added to the expanding collection of works on lesson study explored from different perspectives and in various contexts.

Semaumaq means "return home" in the Paiwanese language. This article explored and described the efficacy and journey of a research team in facilitating culturally appropriate family dyadic interactions in a Paiwanese community in Taiwan using a shared book-reading program. This program was implemented in a rural elementary-school-affiliated preschool in a Paiwanese village in southern Taiwan. Eight families participated. A naturalistic inquiry method using a feedback form, strategy checklist, observations, brief interviews, and video recording was used to collect the data. "Enjoyment and improving family relationships" was identified as the core theme of the parent-child interaction experiences elicited during the program. The results of this naturalistic inquiry support the efficacy and acceptability of using parent-child shared book-reading programs in indigenous communities. The elements of the program that may have contributed to its success are described. Future research may adopt an experimental design to further validate and clarify results.

Although higher education is crucial for training future professionals to deal with environmental challenges, there have been few longitudinal studies exploring how university students' academic major influences their environmental literacy. This study identifies significant differences in environmental literacy among students from different colleges at a public comprehensive university in eastern Taiwan, both at the onset and towards the end of their studies. This analysis also shows how undergraduate students' environmental literacy changes over time. It was found that freshman students in different colleges had similar environmental literacy levels except for science and engineering students. But after four years the environmental literacy gap between seniors in management and non-management students became obvious. In addition, seniors' environmental literacy generally decreased or remained the same as that in their freshman year. The results suggest that to foster environmentally responsible citizens, educators in higher education should put more effort on cooperating with non-formal environmental education programs and connecting their teaching with environmental issues, action strategies, and inspiring visions. Finally, implications for program developers and policymakers in higher education are discussed.

The purpose of this study was twofold: (1) to examine the effect of an adapted physical education (APE) program on physical fitness of adolescents with intellectual disabilities, and (2) to investigate the associations between the changes of physical fitness tests over the course of a three-year period. A secondary data analysis design was used to evaluate the long-term effects of an adapted physical education program on physical fitness components of the participants. Forty-four students (age, 15.9 ± 0.4 years) with intellectual disabilities were included in this study. A series of repeated measures ANOVA revealed significant positive outcomes over time in body composition, muscular endurance, explosive strength, flexibility, and cardiovascular fitness. The findings were mixed, as the participants performed better in muscular strength/endurance and cardiovascular fitness by Year Three. However, participants had lower scores in body composition and flexibility. Additional research is needed to explore the factors affecting physical fitness of students with intellectual disabilities by APE programs.

The purpose of this research was to understand the cognition of female college athletes on gender consciousness and social support, which will contribute to the wellbeing of college female athletes. The research recruited 332 female college athletes were recruited as research participants. This research compiled a questionnaire suitable for the research topic, including gender consciousness scale, social support scale, and wellbeing scale. Use structural equation modeling to analyze the correlation and influence of various variables. The results showed that their experience as an athlete were mostly 5 to 7 years. The correlation of female college athletes was highest between their peer support and goal of life (r = 0.58). The more support they received from their peers, the more they could affirm their life goals and wellbeing. The gender consciousness of college female athletes is significantly correlation to wellbeing ([gamma]11 = 0.71), social support is significantly correlation to wellbeing ([gamma]21 = 0.83), and gender consciousness has significant influence to social support ([beta]21 = 0.57). In addition, the correlation between gender consciousness and stereotypes is the strongest [lambda] = 0.78, the correlation between social support and peer support is the strongest [lambda] = 0.91, and the correlation between wellbeing and self-identification is the strongest [lambda] = 0.83. This study concluded that the existing sports environment provides opportunity for female athletes. Female college athletes have gender consciousness regarding self-assurance and stereotype, and they receive support from peers and family in sports groups. These are conducive to their performance and their sense of wellbeing in life.

To make teaching personal and social responsibility (TPSR) more effective, this study aimed to determine whether integrating moral disengagement (MD) minimization strategies into TPSR can enhance students' positive behaviors and reduce their misbehaviors in PE. A pretest-posttest quasi-experimental design was conducted with an experimental group and two control groups. One hundred forty-five students from nine classes in three middle schools were assigned to experimental group (TPSR + MD minimization strategies; N = 50), control group A (TPSR; N = 46), and control group B (general PE instruction; N = 49) respectively. A pretest was performed in the first week, and a posttest was performed in the 18th week. The results showed that integrating MD minimization strategies into TPSR could significantly reduce students' misbehaviors in PE classes. However, the effects of the strategy on students' positive behaviors (e.g., following rules, helping others, and cooperation) showed no improvement. This study made a breakthrough by finding that integrating MD minimization strategies could make TPSR more effective at reducing students' misbehaviors. By understanding the psychosocial mechanisms behind student behavior in PE, we suggest that MD minimization strategies could be applied in the TPSR model.

With the goal of enhancing the competitiveness of students in the workplace, nearly two-thirds of technical universities in Taiwan have adopted a variety of standardized English proficiency tests as exit requirements, including the widespread use of TOEIC. However, employers still name "insufficient English proficiency" as one of the primary employability gaps to be bridged by graduates (104 Job Bank, 2008, 2009). This study examines whether the use of TOEIC as an exit requirement for 4-year universities in Taiwan can be justified as ensuring higher rates of employability. It explores whether (1) preparing for TOEIC can enhance the level of student English proficiency necessary for the workplace, (2) TOEIC scores are positively related to job recruitment, and (3) the use of TOEIC as an exit requirement encourages courses to prepare students for both the test and the needs of the workplace. The official TOEIC test scores of 555 technical university students and questionnaire responses from 116 employed alumni, 100 employers, and 399 technical university students were analyzed. The findings indicate that the test use consequences could be interpreted both positively and negatively. The students were able to reach the cutoff scores, with mean scores of around 150 points higher, and demonstrated the ability to perform the English skills required for the workplace according to employed alumni and employers. Hence, the standardized exit scores were positively related to job recruitment. On the other hand, the exit requirement cutoff scores may not motivate high proficiency students, who are not sufficiently challenged. In addition, the material instructed in class focuses on test preparation and four-skills' practice, without adequately engaging the students in activities to help them acquire skills such as oral communication that are often used at work.

In the context of educational decentralisation, school leadership encompassing different sources of leadership is significant for school performance. However, few studies have investigated the pathway regarding how principals and teachers as distinct sources of learning-centred leadership exert impact on teacher learning. To this end, survey data collected from 1340 junior high school teachers in Taiwan were analysed with structural equation modelling. The results suggest that both principal leadership and teacher leadership affect teacher learning through direct pathways, and that of teachers exhibits an even greater impact. In addition, principal leadership affects teacher learning through indirect pathways mediated by teacher leadership. By further investigating the mediating effects of different practices of teacher leadership, we found that teacher-led improvement of curriculum and instruction is a critical mediator for teacher learning.

ADHD comorbidity has been associated with delayed diagnosis of ASD, but no study has investigated this association in an Asian country. Children with ASD were included and divided into three groups: ADHD before ASD, ADHD same/after ASD, and ASD only. Timing of ASD and ADHD diagnoses were assessed. The logistic regression model was performed to investigate the likelihood of being diagnosed with ASD after 6 years of age between three groups. ADHD before ASD (OR 10.93) group was more likely to being diagnosed with ASD after 6 years of age compared with ADHD same/after ASD (OR: 1.37) and ASD only groups. ADHD comorbidity would delay the diagnosis of ASD in the general clinical settings in Taiwan.

Purpose: To assess the clinimetric properties of the Stroke Self-Efficacy Questionnaire (SSEQ) and estimate the minimal detectable change (MDC) and minimal clinically important difference (MCID) from the database of our randomized controlled trials (RCT) of individuals receiving stroke rehabilitation. Methods: We retrieved the pre- and post-intervention scores of the SSEQ and Stroke Impact Scale (SIS) from 80 stroke survivors. The analysis of clinimetric properties was performed using: (1) confirmatory factor analysis and item response theory modeling (IRT) for construct validity; (2) standardized response mean and Glass's delta for responsiveness; (3) MDC based on the standard deviation (SD) or standard error of measurement (SEM) of the SSEQ change scores; (4) MCID determined by the external anchor–SIS; (5) conditional MDC (cMDC) derived from the IRT analysis. Results: There was a bi-factorial construct with excellent model-data fit and marked responsiveness. The MDC determined by the SD and SEM were 1.5 and 3.0, respectively, and the MCIDs were 3.3 and 3.7. Conclusions: This study confirmed that SSEQ is a valid and reliable assessment tool for patients receiving stroke rehabilitation. We also provided practical threshold values, especially demonstrating the benefit of using individualized cMDC, to help clinicians better interpret the change in the SSEQ scores. Implications for rehabilitation: This study indicated that the Stroke Self-Efficacy Questionnaire (SSEQ) is reliable and may involve a bi-factor structure. The SSEQ total scale and the activity domain were highly responsive to change. The self-management domain of the SSEQ was moderately responsive. Using conditional minimal detectable change (cMDC) along with MDC may improve the interpretability of treatment change. [ABSTRACT FROM AUTHOR]

Bilingual education is spreading throughout the world as an approach for teaching content and language simultaneously. This is particularly true in Taiwan where implementation of bilingual education has begun as directed by the Blueprint for Developing Taiwan into a Bilingual Nation by 2030. However, the spread of bilingual education is often coupled with policies influenced by monolingual ideologies. This collaborative autoethnography critically examines the experiences of two teachers, an American and Taiwanese English teacher, teaching in a bilingual elementary program in Taiwan. Guided by the ROADMAPPING Framework, we critically evaluate our experiences with bilingual education in order to provide a critique of the policy directives for bilingual education implementation in Taiwan. Several issues are addressed including the promotion of monolingual classrooms, the balance of content and language in bilingual education, the use of Western curricula and materials, the hiring of native English speaking teachers (NESTs), and the disconnects and effects that result from the importing of Western practices. From this analysis, we suggest that Taiwan should pursue a glocalized, rather than an internationalized, bilingual education in order to fully achieve its goals of becoming a bilingual nation.

This study explored how specific inquiry-related learning activities were related to student enjoyment of learning science and intended choice of future STEM career. Analysis of Taiwan and Australia PISA 2015 data revealed that three activities, namely, "debating and planning experiments, drawing conclusions and doing hands-on experiments, teachers and students explaining ideas," were significantly related to students' enjoyment of learning science and intended choice of STEM careers in these two countries. Cross-national comparisons indicated that the percentages of inquiry-related activities for high or low scientific competency students in Australia were higher than for Taiwanese students. The activity of "teachers and students explaining ideas" was a significant determinant of enjoyment of learning for Taiwanese high scientific competency students and Australian high and low scientific competency students, while "debating and planning experiments" was a positive determinant for Taiwanese low scientific competency students. High scientific competency students from both Taiwan and Australia demonstrated significantly higher preferences for future STEM careers than low scientific competency students.

Utilizing capital as a construct to analyze leadership that triggers school transformation is a newly emerged perspective. This study employed the capital theory as the framework to explore how schools undertook the transformative tasks by multi-case study. Three secondary schools in Taiwan were recruited to investigate how leaders constructed the intellectual, social, spiritual, and financial capital and the interplay among the capitals. The findings indicated that despite certain strategies commonly employed by case schools, the ways schools develop capitals as the strategy of school transformation depended on their unique context. One form of capital might be used to facilitate another form of capital. The study applied capital perspective to Asian context has extended its explanatory power and has created the basis for further research in the field of school reform.

In much of the world, the issue of accountability and measurement of educational outcomes is highly controversial. Exit testing is part of the movement to ascertain what students have learned and hold institutions and teachers to account. However, compared to the large number of teacher washback studies, learner washback research is lacking (Cheng, 2008). By exploring standardized exit test washback in Taiwan, this study aims to test Alderson and Wall's hypotheses (1993) regarding learner washback variability, namely that a test will influence 1) degree/depth of learning, 2) attitudes toward methods of learning, and 3) some learners but not others. This study is one of very few washback studies that compare learner behaviors before and after the introduction of exit tests, thereby obtaining a clearer picture of washback effects on learners. Questionnaires and scores on two exit tests (GEPT and TOEIC) were collected from 589 Taiwanese university students before and after the introduction of English exit tests in Taiwan. This study highlights the differential effects of exit requirements for different groups of learners depending on their years of study, proficiency levels, and viewpoints of tests.

Background: As inquiry-based instruction is not universally implemented in science classrooms, it is crucial to introduce instructional strategies through the use of contextualized learning activities to allow students with different background knowledge and abilities to learn the essential competencies of scientific inquiry and promote their emotional perception and engagement. Purpose: This study explores how essential scientific competencies of inquiry can be integrated into classroom teaching practices and investigates both typical and gifted secondary students' emotional perception and engagement in learning activities. Sample: A case teacher along with 226 typical and 18 gifted students from a suburban secondary school at Taiwan participated in this study. Design and methods: After attending twelve 3-hour professional development workshops that focused on scientific inquiry teaching, the case teacher voluntarily developed and elaborated her own teaching activities through the discussions and feedback that she received from workshop participants and science educators. Quantitative and qualitative data were collected through activity worksheet, questionnaire, video camera, and tape recorders. Frequency distribution, Mann-Whitney U test, and discourse analysis were used for data analyses. Results: Case teacher's teaching activities provide contextual investigations that allow students to practice making hypotheses, planning investigations, and presenting and evaluating findings. Students' learning outcomes reveal that typical students can engage in inquiry-based learning with positive emotional perception as well as gifted students regardless of their ability level. Both gifted and typical students' positive emotional perception of and active engagement in learning provide fresh insight into feasible instructions for teachers who are interested in inquiry-based teaching but have little available time to implement such instructions into their classrooms. Conclusions: The results of our work begin to address the critical issues of inquiry-based teaching by providing an exemplary teaching unit encompassing essential scientific competencies.

Although understandings of scientific inquiry (as opposed to conducting inquiry) are included in science education reform documents around the world, little is known about what students have learned about inquiry during their elementary school years. This is partially due to the lack of any assessment instrument to measure understandings about scientific inquiry. However, a valid and reliable assessment has recently been developed and published, Views About Scientific Inquiry (VASI; Lederman et al. [2014], Journal of Research in Science Teaching, 51, 65-83). The purpose of this large-scale international project was to collect the first baseline data on what beginning middle school students have learned about scientific inquiry during their elementary school years. Eighteen countries/regions spanning six continents including 2,634 students participated in the study. The participating countries/regions were: Australia, Brazil, Chile, Egypt, England, Finland, France, Germany, Israel, Mainland China, New Zealand, Nigeria, South Africa, Spain, Sweden, Taiwan, Turkey, and the United States. In many countries, science is not formally taught until middle school, which is the rationale for choosing seventh grade students for this investigation. This baseline data will simultaneously provide information on what, if anything, students learn about inquiry in elementary school, as well as their beginning knowledge as they enter secondary school. It is important to note that collecting data from all of the approximately 200 countries globally was not humanly possible, and it was also not possible to collect data from every region of each country. The results overwhelmingly show that students around the world at the beginning of grade seven have very little understandings about scientific inquiry. Some countries do show reasonable understandings in certain aspects but the overall picture of understandings of scientific inquiry is not what is hoped for after completing 6 years of elementary education in any country.

Rapid urbanization has significantly altered landscape environments in both urban and rural regions, and these landscapes have been demonstrated to play a pivotal role in human well-being. This study develops a coherent framework that integrates landscape change, landscape ecological indicators, and landscape preferences within the context of the evolving landscape environments of rural communities in Taiwan. Four distinct types of rural communities were selected, and a quantitative methodology was employed to investigate the variations and transformations in landscape preferences among rural residents in the context of landscape change. A qualitative methodology was employed to investigate the relationship between landscape ecological indicators and landscape preferences. The study's findings indicate significant temporal variations in residents' landscape preferences, with landscape beauty, stewardship, and coherence emerging as key determinants in the evaluation of these preferences. Landscape ecological indicators were found to be significantly correlated with variables such as landscape complexity, landscape beauty, openness, naturalness, and comprehensive landscape assessment. The findings of this study indicate that design planners, land managers, and public sector organizations can employ multidimensional thinking in the management of rural landscapes to align with the visual aesthetic preferences of rural residents. [ABSTRACT FROM AUTHOR]

Background: To gain a comprehensive understanding of the altered sensory processing in patients with migraine, in this study, we developed an electroencephalography (EEG) protocol for examining brainstem and cortical responses to sensory stimulation. Furthermore, machine learning techniques were employed to identify neural signatures from evoked brainstem–cortex activation and their interactions, facilitating the identification of the presence and subtype of migraine. Methods: This study analysed 1,000-epoch-averaged somatosensory evoked responses from 342 participants, comprising 113 healthy controls (HCs), 106 patients with chronic migraine (CM), and 123 patients with episodic migraine (EM). Activation amplitude and effective connectivity were obtained using weighted minimum norm estimates with spectral Granger causality analysis. This study used support vector machine algorithms to develop classification models; multimodal data (amplitude, connectivity, and scores of psychometric assessments) were applied to assess the reliability and generalisability of the identification results from the classification models. Results: The findings revealed that patients with migraine exhibited reduced amplitudes for responses in both the brainstem and cortical regions and increased effective connectivity between these regions in the gamma and high-gamma frequency bands. The classification model with characteristic features performed well in distinguishing patients with CM from HCs, achieving an accuracy of 81.8% and an area under the curve (AUC) of 0.86 during training and an accuracy of 76.2% and an AUC of 0.89 during independent testing. Similarly, the model effectively identified patients with EM, with an accuracy of 77.5% and an AUC of 0.84 during training and an accuracy of 87% and an AUC of 0.88 during independent testing. Additionally, the model successfully differentiated patients with CM from patients with EM, with an accuracy of 70.5% and an AUC of 0.73 during training and an accuracy of 72.7% and an AUC of 0.74 during independent testing. Conclusion: Altered brainstem-cortex activation and interaction are characteristic of the abnormal sensory processing in migraine. Combining evoked activity analysis with machine learning offers a reliable and generalisable tool for identifying patients with migraine and for assessing the severity of their condition. Thus, this approach is an effective and rapid diagnostic tool for clinicians. [ABSTRACT FROM AUTHOR]

Background: Sepsis constitutes a condition that involves life-threatening organ dysfunction induced by severe infection. This nested case–control study investigated risk factors for severe sepsis and whether antipsychotic use is associated with severe sepsis risk in patients with schizophrenia, a topic that has not been comprehensively explored in previous studies. Methods: We selected 39,432 patients with schizophrenia aged between 15 and 65 years from Taiwan's Psychiatric Inpatient Medical Claims database for the period 2000–2012. The case group comprised patients with severe sepsis after their first psychiatric admission (n = 1382). The case and control groups were randomly matched (1:4) by age, sex and first psychiatric admission (year) and finally comprised 1382 and 5528 individuals, respectively. We employed multivariable conditional logistic regression to identify (1) risk factors (physical illnesses and nonpsychiatric medications) and (2) antipsychotic–severe sepsis associations. Results: Higher numbers of psychiatric admissions and physical illnesses such as delirium, cerebrovascular disease and cancer were significantly associated with a higher risk of severe sepsis. Furthermore, severe sepsis was associated with the use of antithrombotic agents, systemic corticosteroids and agents targeting the renin–angiotensin system. Clozapine (adjusted risk ratio = 1.65) and quetiapine (adjusted risk ratio = 1.59) use were associated with an increased risk of severe sepsis. The use of more than one antipsychotic drug could further increase this risk. Conclusion: Several physical illnesses and nonpsychiatric medications increase the risk of severe sepsis in patients with schizophrenia. Specifically, clozapine or quetiapine use significantly increased the risk of severe sepsis in these patients. [ABSTRACT FROM AUTHOR]

Objectives: Long sleep duration predicts adverse health outcomes in older adults. Impaired cardiac autonomic control (CAC) is a potential pathomechanism that links this relationship; however, the causal relationship between long sleep duration and CAC remains unclear. This study aimed to determine the temporal relationship between long sleep duration and poor CAC. Methods: This is a community‐based, fixed‐cohort, follow‐up study that recruited community‐dwelling older adults aged ≥ 65 years. Self‐reported sleep duration was categorized as short (≤ 5 h), mid‐range (6–7 h), and long (≥ 8 h). Participants with short or long sleep duration were defined as cases. CAC was measured using heart rate variability (HRV), and cases were classified using cutoffs defined by the lowest quintiles of four HRV parameters. Non‐case participants for sleep duration or CAC at baseline were followed. Binary and multinomial logistic regression analyses were conducted to examine baseline variables that predicted incident CAC decline and changes in sleep duration, respectively. Results: A total of 772 individuals were recruited, with a mean follow‐up period of 5.8 ± 1.7 years. In multivariable analyses, long sleep duration at baseline predicted a higher risk of cardiac vagal control decline in the follow‐up visit (odds ratio: 1.86, 95% confidence interval: 1.00–3.44). Conversely, all HRV parameters at baseline failed to predict changes in sleep duration at the follow‐up visit. Conclusions: Long sleep duration seems to precede the decline in CAC in community‐dwelling older adults. [ABSTRACT FROM AUTHOR]

This experimental study aims to investigate the effects of using cooperative learning to enhance the English reading comprehension and learning motivation of EFL freshmen by comparing the cooperative learning instruction and traditional lecture instruction. This experiment was implemented in a Freshman English Reading course, a two credit course, with two hours of instruction per week, over a full semester. Seventy-eight EFL freshmen taking Freshman English Reading courses participated in this study, with 44 participants in the experimental group and 34 in the comparison group. We employed a pretest-posttest comparison group quasi-experimental design. The experimental group received a reciprocal cooperative learning instruction, whereas the comparison group received a traditional lecture instruction. Both groups were administered three English-reading achievement tests and an English learning motivation scale. The data were analyzed by means, standard deviations, t tests, and one-way ANCOVA. The findings indicate statistically significant differences in favor of cooperative learning instruction on English reading comprehension, particularly among medium- and low-proficiency students. Cooperative learning instruction also created a significantly positive effect on student motivation toward learning English reading. In conclusion, we strongly suggest teachers use cooperative learning instruction in university-level EFL reading classes.

Primary aldosteronism (PA) is the most common form of endocrine hypertension, characterized by excess aldosterone production that leads to an increased risk of cardiovascular events and target organ damage. Both adrenalectomy and medical treatment have shown efficacy in improving clinical outcomes and comorbidities associated with PA, including a specific subtype of PA with autonomous cortisol secretion (ACS). Understanding the comorbidities of PA and establishing appropriate follow-up protocols after treatment are crucial for physicians to enhance morbidity and mortality outcomes in patients with PA. Additionally, the screening for hypercortisolism prior to surgery is essential, as the prognosis of patients with coexisting PA and ACS differs from those with PA alone. In this review, we comprehensively summarize the comorbidities of PA, encompassing cardiovascular, renal, and metabolic complications. We also discuss various post-treatment outcomes and provide insights into the strategy for glucocorticoid replacement in patients with overt or subclinical hypercortisolism. This clinical practice guideline aims to equip medical professionals with up-to-date information on managing concurrent hypercortisolism, assessing treatment outcomes, and addressing comorbidities in patients with PA, thereby improving follow-up care. [ABSTRACT FROM AUTHOR]

Research indicates that transition education contributes to forming a long-term support to high-school students with disabilities for their adult life. Also, Community-Based Instruction (CBI) which is a preparation of vocational skills and awareness, has its positive influences improvement of self-esteem as result of higher work inclination and employment. A car-washing curriculum of a CBI practice created an "acquisition-rich" environment" with the Scaffolding Theory in one high school located in Taiwan and brought about the mutual connection between the school and a local community. The educational implementation had yielded its benefits because of the emphasis of transition education and CBI. In this case, car-washing as a CBI facilitated student-initiated learning which promoted intellectual disabled students' vocational skills, awareness and self-efficacy and became a critical role between a school and a community.

Various forms of pre-listening support, such as the provision of vocabulary and topic information, have been used to help second language (L2) learners better understand what they listen to. Results of studies on the effects of vocabulary support have been mixed. Furthermore, there has been little research on the effects of different quantities of vocabulary items and types of word information provided on the listening performance of L2 students of different proficiency levels. Therefore, this study investigated the effectiveness of two different levels of 18-week vocabulary support (an expanded vocabulary-instruction support that targeted both a greater quantity of lexical items and a focus on multiword units vs. an unexpanded vocabulary-instruction support with a focus on single words only) for enhancing listening ability of students of English as a foreign language (EFL) defined as their performance on the listening test of the Test of English for International Communication (TOEIC). The results indicate that the group that received the expanded vocabulary support attained a significant gain and performed significantly better on the posttest than the group that received the unexpanded vocabulary support. The results also reveal that the expanded vocabulary support was particularly helpful for lower proficiency level students. Pedagogical and research implications are also discussed.

Before the COVID-19 pandemic, Mycoplasma pneumoniae infections emerged during spring to summer yearly in Taiwan, but infections were few during the pandemic. M. pneumoniae macrolide resistance soared to 85.7% in 2020 but declined to 0% during 2022-2023. Continued molecular surveillance is necessary to monitor trends in macrolide-resistant M. pneumoniae. [ABSTRACT FROM AUTHOR]