A Virtual Reality-Cycling Training System for Lower Limb Balance Improvement.

Stroke survivors might lose their walking and balancing abilities, but many studies pointed out that cycling is an effective means for lower limb rehabilitation. However, during cycle training, the unaffected limb tends to compensate for the affected one, which resulted in suboptimal rehabilitation. To address this issue, we present a Virtual Reality-Cycling Training System (VRCTS), which senses the cycling force and speed in real-time, analyzes the acquired data to produce feedback to patients with a controllable VR car in a VR rehabilitation program, and thus specifically trains the affected side. The aim of the study was to verify the functionality of the VRCTS and to verify the results from the ten stroke patients participants and to compare the result of Asymmetry Ratio Index (ARI) between the experimental group and the control group, after their training, by using the bilateral pedal force and force plate to determine any training effect. The results showed that after the VRCTS training in bilateral pedal force it had improved by 0.22 (p = 0.046) and in force plate the stand balance has also improved by 0.29 (p = 0.031); thus both methods show the significant difference.

Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters.

BACKGROUND: Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. METHODS: We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. RESULTS: Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. CONCLUSIONS: According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients' perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients' overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly affects patient satisfaction, which represents a direct effect; and (B) service quality and patient trust are used as intervening variables to affect patient satisfaction, which represents an indirect effect. Due to differences in the scale, resources and costs among medical institutions of different levels, it is a most urgent and concerning issue of how to control customers' demands and preferences and adopt correct marketing concepts under the circumstances of intense competition in order to satisfy the public and build up a competitive edge for medical institutions.

Motivating medical information system performance by system quality, service quality, and job satisfaction for evidence-based practice.

BACKGROUND: No previous studies have addressed the integrated relationships among system quality, service quality, job satisfaction, and system performance; this study attempts to bridge such a gap with evidence-based practice study. METHODS: The convenience sampling method was applied to the information system users of three hospitals in southern Taiwan. A total of 500 copies of questionnaires were distributed, and 283 returned copies were valid, suggesting a valid response rate of 56.6%. SPSS 17.0 and AMOS 17.0 (structural equation modeling) statistical software packages were used for data analysis and processing. RESULTS: The findings are as follows: System quality has a positive influence on service quality (γ11= 0.55), job satisfaction (γ21= 0.32), and system performance (γ31= 0.47). Service quality (ß31= 0.38) and job satisfaction (ß32= 0.46) will positively influence system performance. CONCLUSIONS: It is thus recommended that the information office of hospitals and developers take enhancement of service quality and user satisfaction into consideration in addition to placing b on system quality and information quality when designing, developing, or purchasing an information system, in order to improve benefits and gain more achievements generated by hospital information systems.

Prior contest experience exerts a long-term influence on subsequent winner and loser effects.

INTRODUCTION: Animals are capable of using information from recent experiences to modify subsequent behavioral responses. Animals' ability or propensity to modify their behavior in the light of new information has repeatedly been shown to correlate with, or be influenced by, either their intrinsic competitive ability or their dominance experience - an influence which can be long-lasting. Using a mangrove killifish, Kryptolebias marmoratus, as the study organism, we investigated whether and if so how the effect of a winning or a losing experience one day prior to a dyadic contest was modulated by both competitive ability measured two months previously and a winning or losing experience forced on the contestants one month previously. RESULTS: Winning/losing experience forced on the fish one month previously affected how they utilized information from their winning/losing experience one day before Test Day: Individuals that were randomly assigned a losing experience one month previously were more susceptible to the influence of their 1-day winning/losing experience than those assigned a winning experience. Competitive ability measured two months previously, winning/losing experience from one month previously and the winning/losing experience received one day previously all significantly influenced the fish's contest behaviors on Test Day, although only 2-month competitive ability significantly influenced escalation duration, indicating that it was still a good index for the fish's competitive ability two months later. CONCLUSIONS: These results suggest that the value to the fish of information from a recent win or loss depends on the outcome of their past contests and show that contest experience has a long-term effect on contest behavior.

Raising nurses' job satisfaction through patient-oriented perception and organizational citizenship behaviors.

BACKGROUND: Because nurses deliver care to patients on behalf of hospitals, hospitals have to enhance first-line nurses' patient-oriented perception and spontaneous organizational citizenship behaviors for the sake of higher patient satisfaction and better patient care. OBJECTIVES: The purpose of this study was to investigate how patient-oriented perception among nurses could affect their organizational citizenship behaviors and job satisfaction. METHODS: SPSS 12.0 and Amos 7.0 (structural equation modeling) statistical software packages were used for data analysis and processing. Of the 500 questionnaires distributed, 232 valid ones were collected, with a valid response rate of 46.4%. RESULTS: Nurses' patient-oriented perception has a positive influence on organizational citizenship behaviors (γ11 = .795, p < .05), and their organizational citizenship behaviors (ß21 = .681, p < .05) have a positive influence on job satisfaction. DISCUSSION: Nurses' patient-oriented perception has the most positive influence on interpersonal altruistic behavior but the least positive influence on organizational public welfare behavior.