Search

Purpose: This study aims to explore the daily stressors experienced by adolescents with Type 1 diabetes (T1D) and the perceived impact of those stressors on their self‐management and psychological well‐being. Design and Methods: We conducted semistructured in‐depth telephone interviews using a qualitative descriptive approach with 20 adolescents aged 14–17 years with T1D and analyzed subsequent data using thematic analysis. Results: Participants who were non‐Hispanic white made up 85% of the sample, 75% identified as female and mean age was 15 years. The study identified two key themes: "the everyday stress of living with diabetes" and "managing stress and supporting psychological well‐being." Participants described heightened mental load, the impact of daily activities, stress associated with public diabetes management, and added stress due to COVID‐19. Primary mitigation techniques included family support, peer support networks, activity engagement, and personal acceptance of their condition. Practice Implications: We found that there is a compound effect that occurs with balancing daily disease management with normative activities of daily living. These data will help guide the design of new interventions and tailoring of existing interventions. Future intervention development may include physical exercise, mindfulness training, and stress reducing techniques. [ABSTRACT FROM AUTHOR]

Background: Homelessness is a traumatic experience, and can have a devastating effect on those experiencing it. People who are homeless often face significant barriers when accessing public services, and have often experienced adverse childhood events, extreme social disadvantage, physical, emotional and sexual abuse, neglect, low self‐esteem, poor physical and mental health, and much lower life expectancy compared to the general population. Rates of problematic substance use are disproportionately high, with many using drugs and alcohol to deal with the stress of living on the street, to keep warm, or to block out memories of previous abuse or trauma. Substance dependency can also create barriers to successful transition to stable housing. Objectives: To understand the effectiveness of different substance use interventions for adults experiencing homelessness. Search Methods: The primary source of studies for was the 4th edition of the Homelessness Effectiveness Studies Evidence and Gaps Maps (EGM). Searches for the EGM were completed in September 2021. Other potential studies were identified through a call for grey evidence, hand‐searching key journals, and unpacking relevant systematic reviews. Selection Criteria: Eligible studies were impact evaluations that involved some comparison group. We included studies that tested the effectiveness of substance use interventions, and measured substance use outcomes, for adults experiencing homelessness in high income countries. Data Collection and Analysis: Descriptive characteristics and statistical information in included studies were coded and checked by at least two members of the review team. Studies selected for the review were assessed for confidence in the findings. Standardised effect sizes were calculated and, if a study did not provide sufficient raw data for the calculation of an effect size, author(s) were contacted to obtain these data. We used random‐effects meta‐analysis and robust‐variance estimation procedures to synthesise effect sizes. If a study included multiple effects, we carried out a critical assessment to determine (even if only theoretically) whether the effects are likely to be dependent. Where dependent effects were identified, we used robust variance estimation to determine whether we can account for these. Where effect sizes were converted from a binary to continuous measure (or vice versa), we undertook a sensitivity analysis by running an additional analysis with these studies omitted. We also assessed the sensitivity of results to inclusion of non‐randomised studies and studies classified as low confidence in findings. All included an assessment of statistical heterogeneity. Finally, we undertook analysis to assess whether publication bias was likely to be a factor in our findings. For those studies that we were unable to include in meta‐analysis, we have provided a narrative synthesis of the study and its findings. Main Results: We included 48 individual papers covering 34 unique studies. The studies covered 15, 255 participants, with all but one of the studies being from the United States and Canada. Most papers were rated as low confidence (n = 25, or 52%). By far the most common reason for studies being rated as low confidence was high rates of attrition and/or differential attrition of study participants, that fell below the What Works Clearinghouse liberal attrition standard. Eleven of the included studies were rated as medium confidence and 12 studies as high confidence. The interventions included in our analysis were more effective in reducing substance use than treatment as usual, with an overall effect size of –0.11 SD (95% confidence interval [CI], −0.27, 0.05). There was substantial heterogeneity across studies, and the results were sensitive to the removal of low confidence studies (−0.21 SD, 95% CI [−0.59, 0.17] − 6 studies, 17 effect sizes), the removal of quasi‐experimental studies (−0.14 SD, 95% CI [−0.30, 0.02] − 14 studies, 41 effect sizes) and the removal of studies where an effect size had been converted from a binary to a continuous outcome (−0.08 SD, 95% CI [−0.31, 0.15] − 10 studies, 31 effect sizes). This suggests that the findings are sensitive to the inclusion of lower quality studies, although unusually the average effect increases when we removed low confidence studies. The average effect for abstinence‐based interventions compared to treatment‐as‐usual (TAU) service provision was –0.28 SD (95% CI, −0.65, 0.09) (6 studies, 15 effect sizes), and for harm reduction interventions compared to a TAU service provision is close to 0 at 0.03 SD (95% CI, −0.08, 0.14) (9 studies, 30 effect sizes). The confidence intervals for both estimates are wide and crossing zero. For both, the comparison groups are primarily abstinence‐based, with the exception of two studies where the comparison group condition was unclear. We found that both Assertative Community Treatment and Intensive Case Management were no better than treatment as usual, with average effect on substance use of 0.03 SD, 95% CI [−0.07, 0.13] and –0.47 SD, 95% CI [−0.72, −0.21] 0.05 SD, 95% CI [−0.28, 0.39] respectively. These findings are consistent with wider research, and it is important to note that we only examined the effect on substance use outcomes (these interventions can be effective in terms of other outcomes). We found that CM interventions can be effective in reducing substance use compared to treatment as usual, with an average effect of –0.47 SD, 95% CI (−0.72, −0.21). All of these results need to be considered in light of the quality of the underlying evidence. There were six further interventions where we undertook narrative synthesis. These syntheses suggest that Group Work, Harm Reduction Psychotherapy, and Therapeutic Communities are effective in reducing substance use, with mixed results found for Motivational Interviewing and Talking Therapies (including Cognitive Behavioural Therapy). The narrative synthesis suggested that Residential Rehabilitation was no better than treatment as usual in terms of reducing substance use for our population of interest. Authors' Conclusions: Although our analysis of harm reduction versus treatment as usual, abstinence versus treatment as usual, and harm reduction versus abstinence suggests that these different approaches make little real difference to the outcomes achieved in comparison to treatment as usual. The findings suggest that some individual interventions are more effective than others. The overall low quality of the primary studies suggests that further primary impact research could be beneficial. [ABSTRACT FROM AUTHOR]

Introduction: Loneliness can have a negative impact on people's physical and psychological well‐being; building social capital is a potential means of addressing this connection. Community initiatives (e.g. groups, clubs, neighbourhood activities) may be a route that enables people to build social capital to tackle loneliness. Understanding what is known, and where gaps in knowledge exist, is important for advancing research on this topic. Methods: A scoping review was undertaken to explore the question – What community initiatives, with a focus on well‐being, have been evaluated in the United Kingdom that include information about social capital and loneliness? Four databases (Medline, CINAHL, ASSIA and Embase) were searched for relevant research papers. References were screened by two researchers to identify if they met the review's inclusion criteria. Data were summarised as a narrative and in tables. Results: Five papers met the review's inclusion criteria. They all used qualitative methods. Findings suggested that social capital could be developed through creating a sense of trust, group cohesion and reciprocity among participants in the community initiatives. This connection enabled people to experience a sense of belonging and to feel they had a meaningful relationship with others, which appeared to alleviate feelings of loneliness. Conclusion: More research is warranted on the review topic, including studies that have employed quantitative or mixed methods. Clarity around definitions of social capital and loneliness in future research is required. Engagement with community initiatives can provide a formalised route to help people develop connections and counteract limitations in their social networks. However, individuals may be wary about attending community initiatives, needing support and encouragement to do so. Social prescribing link workers are one means of motivating people to access groups, events or organisations that could improve their well‐being. [ABSTRACT FROM AUTHOR]

Background: Liver disease is an increasing cause of morbidity and mortality in the United Kingdom and can be challenging to live with in the advanced stages. There has been little research exploring the healthcare experiences of UK individuals with decompensated disease when the liver cannot carry out its functions properly. A PhD research project was developed with people who have liver disease to explore care experiences in decompensated advanced liver disease. Public involvement (PI) is an essential aspect of meaningful health research, and this paper reports on the progression of our PI approach in this ongoing study. Objective: To embed PI throughout the research project to ensure that the study is meaningful to individuals with liver disease and the people who support them. Methods: The research adopts a Constructivist Grounded Theory methodology to develop a theory of care experience. Various PI approaches were considered in developing the PI strategy for this qualitative study. Initially, Embedded consultation was the preferred model, which has evolved to include aspects of collaboration and coproduction. A PI group was set up to oversee the project through the national public engagement website VOICE, and reflections on PI from three members of the group are included in this paper to illuminate the PI process. Results: Six individuals with liver disease and three carers from across the United Kingdom are part of an ongoing PI group. Their role includes commenting on the findings of the systematic literature review for this project and contributing to decisions about recruitment, data collection and data analysis. Additionally, they had a direct impact on changing the focus of the research. The PI group will continue involvement until the completion of the project. Conclusion: Successfully embedding PI into doctoral research, as demonstrated in this project, requires commitment, planning and dedication to reciprocal working for the benefit of PI contributors as well as the research. This approach could be adopted by other postgraduate researchers. Patient or Public Contribution: This project is overseen by the PI group, whose contribution is described throughout, including reflections from three PI group members. [ABSTRACT FROM AUTHOR]

Aim: To explore and summarise published literature with regards to secondments to clinical research and to identify the gaps in research to inform further work. Design: Systematic scoping review. Method: A scoping review was undertaken in accordance with the Patterns, Advances, Gaps, Evidence and Research framework. Databases searched included CINAHL, PubMed, Medline and Embase. Inclusion/exclusion criteria were applied by two independent reviewers. Two reviewers independently retrieved full‐text studies for inclusion and applied the framework as a tool for synthesising Patterns, Advances, Gaps, Evidence and Research recommendations. Results: Six papers and one abstract published between 2003 and 2018 were included. All secondees (n = 34) were released from NHS posts, with secondments (where specified) ranging in duration from 0.25 to 2 years and for 40%–100% of their working hours. All seven papers reported benefits for personal and professional development, predominantly in the form of personal reflections. Few described involvement with research delivery teams. Conclusion: Published initiatives vary in nature and lack standardised reporting and measurement of impact. Further research is required to identify benefits at a departmental or organisational level, the facilitators for setting up secondments and the application of knowledge gained from secondment opportunities. Implications for the Profession: Undertaking a research secondment is reported to offer professional and personal benefit for clinical staff. Research secondments are one way in which a research culture can practically be embedded within clinical settings. Impact: This scoping review identified a lack of published empirical research seeking to understand research secondments as a tool to enhance research and evidence engagement. Although there is a suggestion that secondments could positively impact staff retention, there is limited evidence about the benefit for the organisation or for patient care. These findings have implications for staff, managers and their organisations. Reporting Method: The PRISMA‐ScR guidelines were used to guide reporting. No Patient or Public Contribution: This was not relevant to the research design. [ABSTRACT FROM AUTHOR]

Endoscopic submucosa dissection (ESD) has been applied extensively in the treatment of large intestine tumours due to its high total excision ratio. Nevertheless, there is a high incidence of adverse reactions in colon ESD, and the efficacy of prophylactic ESD following ESD in prevention of postoperative haemorrhage is still disputed. The purpose of this meta‐analysis is to evaluate the effectiveness of prophylaxis of wound closure in large intestine ESD after operation. For eligibility, we looked through three databases: PubMed, Embase and Cochrane Library. Heterogenity was measured by means of a chi‐square method of Q‐statistic and an I2 test. Fixed or random effects models were used for data processing. Based on the retrieval policy, we found a total of 1286 papers, and then we collected nine papers to extract the data. Regarding postoperative haemorrhage, there was a significant reduction in the risk of wound haemorrhage in the wound closure group than in the control group (OR, 0.29; 95% CI, 0.19–0.44 p < 0.0001). No statistical significance was found in the incidence of perforation in the wound closure and the control group (OR, 0.45; 95% CI, 0.19–1.03 p = 0.06). There was a significant reduction in the incidence of postoperation fever among those in the wound closure group than in the control group (OR, 0.37; 95% CI, 0.15–0.93 p = 0.04). Preventive endoscopic closure decreased the rate of ESD in colon disease, but did not significantly decrease the rate of postoperation perforation and postoperative fever. Future research will be required to clarify the risk factors and classify high‐risk individuals in order to formulate a cost‐effective prevention strategy. [ABSTRACT FROM AUTHOR]

Background: Achieving universal health coverage (UHC) in the context of limited resources will require prioritising the most vulnerable and ensuring health policies and services are responsive to their needs. One way of addressing this is through the engagement of marginalised voices in the priority setting process. Public engagement approaches that enable group level deliberation as well as individual level preference capturing might be valuable in this regard, but there are limited examples of their practical application, and gaps in understanding their outcomes, especially with rural populations. Objective: To address this gap, we implemented a modified priority setting tool (Choosing All Together—CHAT) that enables individuals and groups to make trade‐offs to demonstrate the type of health services packages that may be acceptable to a rural population. The paper presents the findings from the individual choices as compared to the group choices, as well as the differences among the individual choices using this tool. Methods: Participants worked in groups and as individuals to allocate stickers representing the available budget to different health topics and interventions using the CHAT tool. The allocations were recorded at each stage of the study. We calculated the median and interquartile range across study participants for the topic totals. To examine differences in individual choices, we performed Wilcoxon rank sum tests. Results: The results show that individual interests were mostly aligned with societal ones, and there were no statistically significant differences between the individual and group choices. However, there were some statistically significant differences between individual priorities based on demographic characteristics like age. Discussion: The study demonstrates that giving individuals greater control and agency in designing health services packages can increase their participation in the priority setting process, align individual and community priorities, and potentially enhance the legitimacy and acceptability of priority setting. Methods that enable group level deliberation and individual level priority setting may be necessary to reconcile plurality. The paper also highlights the importance of capturing the details of public engagement processes and transparently reporting on these details to ensure valuable outcomes. Public Contribution: The facilitator of the CHAT groups was a member from the community and underwent training from the research team. The fieldworkers were also from the community and were trained and paid to capture the data. The participants were all members of the rural community‐ the study represents their priorities. [ABSTRACT FROM AUTHOR]

This study contributes to the diversity literature by probing whether diversity papers are cited as frequently as nondiversity papers in management and industrial/organizational (I/O) psychology journals. Based on the stigma‐by‐association theory, I argue that as a result of their association with minority groups, diversity papers may be devalued and thus "othered" by scholars. Using a citation analysis of 46,930 papers published in 29 peer‐reviewed management and I/O psychology journals, I present empirical evidence in Study 1 that diversity papers were cited significantly less frequently than nondiversity papers. The authors' gender and institutional prestige, journal tier and domain, and year of publication were not moderators. In Study 2, I used a scenario experiment to demonstrate the stigma‐by‐association effect. The authors' gender demonstrated a significant moderating effect in this experiment. [ABSTRACT FROM AUTHOR]

Tricuspid valve repair (TVR) combined with mitral valve surgery (MVS) has been a controversial issue. It is not clear whether the combined surgery has any influence on the occurrence of postoperative complications. The aim of this study was to compare the occurrence of complications including wound infection, wound bleeding, and mortality after MVS combined with or without TVR. By meta‐analysis, a total of 1576 papers were collected from 3 databases, and 7 of them were included. We provided the necessary data of 7 included studies such as the authors, publication date, country, surgical approach and case number, patient age, and so on. Statistical analysis was carried out with RevMan 5.3 software. We found that patients with heart failure accepting MVS combined with or without TVR, performed no statistically significant difference in postoperative wound infection (OR: 0.88; 95% CI: 0.29, 2.62; P = 0.81), wound bleeding (OR: 0.74; 95% CI: 0.3, 1.48; P = 0.39), and mortality (OR: 1.05; 95% CI: 0.42, 2.61; P = 0.92). In conclusion, current evidence indicated that the combined surgery had no additional risk of postoperative complications, and might be an effective alternative surgical approach to mitral valve diseases accompany with tricuspid regurgitation. However, for the limited case size, it was required to support the findings with a large number of cases in further studies. [ABSTRACT FROM AUTHOR]

Operative site wound infection is one of the most frequent infections in surgery. A variety of studies have shown that the results of laparoscopy might be superior to those of an open procedure. Nevertheless, there is still a lack of clarity as to whether there is a difference between open and laparoscopy with respect to the occurrence of wound infections in different paediatric operations. In this review, we looked at randomized, controlled studies that directly measured the rate of wound infection following an appendectomy with a laparoscope. We looked up four main databases for randomized, controlled studies that compare the treatment of paediatric appendicitis with laparoscopy. The surgeries included appendectomy. Through our search, we have determined 323 related papers and selected five qualified ones to be analysed according to the eligibility criteria. Five trials were also assessed for the quality of the documents. In the 5 trials, there were no statistically significant differences in the incidence of post‐operative wound infection among the paediatric appendectomy and the open‐access group (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.34–1.15, p = 0.13). The four trials did not show any statistically significant difference in abdominal abscesses among the laparoscopic and open‐access treatment groups (OR, 1.64; 95% CI, 0.90–3.01, p = 0.11). The four trials did not reveal any statistically significant difference in operating time (mean difference, −4.36; 95% CI, −17.31 to 8.59, p = 0.51). In light of these findings, the use of laparoscopy as compared with the open‐approach approach in paediatric appendectomies is not associated with a reduction in the risk of wound infection. [ABSTRACT FROM AUTHOR]

Background: Collaborations between patient organisations (POs) and the pharmaceutical industry can help identify and address the unmet needs of people living with a disease. In Alzheimer's disease (AD), the scale and complexity of the current unmet needs call for a broad and cross‐sectoral collaboration, including people living with Alzheimer's (PLWA), their care partners and the wider research community. Objective: This study aimed to describe learnings from the Finding Alzheimer's Solutions Together (F.A.S.T.) Council, a collaboration between POs and Roche, convened to better understand the unmet needs of PLWA and their care partners. Results: 1. Learnings from the collaboration, including clarifying objectives and members' expectations upfront, and establishing a set of guiding values and engagement principles. 2. Insights and recommendations for improving care in AD, including a wide range of unmet needs and potential solutions, systematically captured throughout the PLWA journey. These have resulted in several published reports and other outcomes, including (1) 'Portraits of care', highlighting the role of care partners, and the impact of coronavirus disease 2019 on care; (2) Clinical trial guidebook, recommending how PLWA and care partner experience can be incorporated into trial design; (3) 'Commitments Catalogue', highlighting progress by governmental organisations in achieving their commitments; and (4) a report to guide policy on improving diversity, equity and inclusion in clinical trials. Conclusions: Close collaboration between POs and the pharmaceutical industry in AD can enable effective research, in which PLWA and care partners are engaged as 'experts through experience' to help identify key unmet needs and co‐create solutions with the wider AD research community. This paper and the work undertaken by the F.A.S.T. Council may act as a blueprint for meaningful collaboration between POs and the pharmaceutical industry. Patient or Public Contribution: The paper reports the collaboration between POs, the F.A.S.T. Council and Roche to progress towards a future in which PLWA can live fulfilling lives with their disease managed well. Clinical Trial Registration: Not applicable. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to gain consensus among young people with a stoma due to inflammatory bowel disease (IBD) on the priorities for the content of an intervention for the self‐management of stoma‐related distress. The current identification and management of distress in young people with a stoma is often suboptimal in clinical settings and there is a need for improved support resources. Methods: Two consensus group meetings were carried out via online video conferencing, using nominal group technique. Participants generated, rated on a Likert scale and discussed, topics for inclusion in a future self‐management intervention. Results: Nineteen young people, aged 19–33, with a stoma due to IBD took part in one of two group meetings. Participants were located across England, Scotland, and Northern Ireland. Twenty‐nine topics were generated by participants, seven of which reached consensus of ≥80%, that is, a mean of ≥5.6 on a 7‐point Likert scale. These were: receiving advice from young people with lived experience of stoma surgery; advice on/addressing concerns about romantic relationships, sex and intimacy; information about fertility and pregnancy related to stoma surgery; stoma 'hacks', for example, useful everyday tips regarding clothing, making bag changes easier and so forth; reflecting on and recognising own emotional response to surgery; tips on managing the stoma during the night; and processing trauma related to the illness and surgery journey. Conclusions: Findings extend previous research on young people's experiences of stoma surgery, by generating consensus on young people's priorities for managing distress related to surgery and living with a stoma. These priorities include topics not previously reported in the literature, including the need for information about fertility and pregnancy. Findings will inform the development of a self‐management resource for young people with an IBD stoma and have relevance for the clinical management of stoma‐related distress in this population. Patient or Public Contribution: Three patient contributors are co‐authors on this paper, having contributed to the study design, interpretation of results and writing of the manuscript. The study's Patient and Public Involvement and Engagement advisory group also had an integral role in the study. They met with the research team for four 2‐h virtual meetings, giving input on the aims and purpose of the study, recruitment methods, and interpretation of findings. The group also advised on the age range for participants. The views of young people with a stoma are the central component of the study reported in this paper, which aims to gain consensus among young people with an IBD stoma on their priorities for the content of a resource to self‐manage distress related to stoma surgery. [ABSTRACT FROM AUTHOR]

Introduction: To guide good practices in patient and public involvement (PPI), several calls have been made to share detailed accounts of practical experiences. We describe our collaboration with young people with a chronic condition (YPCC) in the development, testing and implementation of the digital communication tool MyBoT (Map your Burden of Treatment). Methods: MyBoT was developed by a team of academic researchers, some of whom were practising care providers, YPCC and designers. In addition to the two co‐researchers in the research team, various groups of YPCC were involved in decision‐making through participation in a design session, workshops and a dialogue session. The Involvement Matrix was used to reflect on the PPI of all YPCC. Results: Initially, the two co‐researchers were involved in the roles of informer and co‐thinker, but their decision‐making power within the study increased over time. In the final stages of the study, the co‐researchers and researchers became partners. The other YPCC who participated in the different sessions and workshops were co‐thinkers in all stages of the study. Conclusion: The PPI of two YPCCs as co‐researchers within the research team ensured continuous involvement, whereas the PPI of various groups of YPCCs guaranteed a representative and inclusive approach. Researchers play an essential role in bringing all perspectives together, integrating them within the technical and financial constraints and ultimately building a tool that is tailored to its users' needs. Patient or Public Contribution: YPCC played a significant role in the present study. Two YPCC—who are also co‐authors of this paper—were involved in all stages of this project as members of the research team. In addition, various YPCCs were involved in the development, testing and implementation stage of MyBoT by organizing design sessions, workshops and a dialogue session. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of occupational therapy (OT) on the self‐management of function, pain, fatigue, and lived experience for people living with rheumatoid arthritis (RA). Methods: Five databases and gray literature were searched up to June 30, 2022. Three reviewers screened titles and abstracts, with two independently extracting and assessing full texts using the Cochrane risk of bias (quantitative) and Critical Appraisal Skills Programme (qualitative) tools to assess study quality. Studies were categorized into four intervention types. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) (quantitative) and GRADE‐ Confidence in Evidence from Reviews of Qualitative research (qualitative) were used to assess the quality of evidence for each intervention type. Results: Of 39 eligible papers, 29 were quantitative (n = 2,029), 4 qualitative (n = 50), and 6 mixed methods (n = 896). Good evidence supports patient education and behavior change programs for improving pain and function, particularly group sessions of joint protection education, but these do not translate to long‐term improvements for RA (>24 months). Comprehensive OT had mixed evidence (limited to home OT and an arthritis gloves program), whereas limited evidence was available for qualitative insights, splints and assistive devices, and self‐management for fatigue. Conclusion: Although patient education is promising for self‐managing RA, no strong evidence was found to support OT programs for self‐managing fatigue or patient experience and long‐term effectiveness. More research is required on lived experience, and the long‐term efficacy of self‐management approaches incorporating OT, particularly timing programs to meet the individual's conditional needs (i.e., early or established RA) to build on the few studies to date. [ABSTRACT FROM AUTHOR]

Aim: To capture and retain healthcare staff in postgraduate courses relevant to individual career aspirations, service requirements and continuous practice development (CPD) within an English UK university. Design: Two virtual career clinics for postgraduate practitioners to engage in CPD offers within the university. An online post‐enrolment online survey to explore their experiences of engagement with the university. Methods: Mixed: qualitative and quantitative methods. Engaging 10 participants attended the career clinics, and 42 participants with an online survey. Results: The career clinics were well received by participants who mapped CPD requirements and individual career aspirations. The surveys exposed challenges with marketing and enrolment; however, these were mitigated with support. Four recommendations are presented within this paper applicable to the international postgraduate education of all health practitioners. [ABSTRACT FROM AUTHOR]

Single‐port laparoscopy (SPL) has existed for several years. This meta‐analysis was conducted to evaluate the efficacy of SPL compared with conventional laparoscopy (CL) in the treatment of benign gynecologic adnexal lesions. The purpose of this meta‐analysis is to evaluate the superiority of SPL versus CL in the treatment of post‐operative wound pain. The study looked for English‐language publications from PubMed, Embase, Cochrane Library and the Web of Science until June 2023. The main result was the visual analogue scale (VAS) after 2, 4, 6, 8, 12, 24 and 48 h after operation. The paper contains 10 related papers by means of e‐search. Of these, 4 were randomized controlled trials (RCTs), while 6 were non‐RCTs. The results indicated that SPL and CL were significantly different after 2, 24 and 48 h after operation. SPL had lower post‐operative pain after 2 h compared with CL (MD, −0.6; 95% CI, −0.98, −0.21; p = 0.002). After the operation, SPL also had a lower incidence of post‐operative pain after 24 h compared with CL (MD, −0.59; 95% CI, −1.12, −0.06; p = 0.03). And the difference in pain was at 48 h after the most significant (MD, −0.49; 95% CI, −0.75, −0.23; p = 0.0002). But after 6, 8 and 12 h after operation, there was no significant difference in the degree of pain. Thus, SPL operations may result in a lower degree of pain than CL in both the post‐operative and far post‐operative phase. [ABSTRACT FROM AUTHOR]

Background: The role of patient participation and representation during crises, such as the COVID‐19 pandemic, has been under‐researched. Existing studies paint a pessimistic picture of patient representation during the pandemic. However, there are indications that patient representatives have adapted to the new situation and can contribute to the resilience of healthcare systems. This paper aims to further explore the potential contribution of patient representatives for healthcare system resilience during the COVID‐19 pandemic. Methods: The study used a qualitative approach. We conducted a thematic analysis on the following data: interviews with client council members (n = 32) and representatives from patient organizations (n = 6) and focus groups (n = 2) to investigate patient representation on both the national policy level and organizational level in the Netherlands. Results: We identified the crisis discourse, the dependent position, the diversity of patient perspectives and the layered decision‐making structure as themes that help to understand what made patient representation in pandemic times a struggle for national and local patient representatives. The analysis of the subjects these representatives put forward during decision‐making shows that their input can play an important role in broadening discussions, challenging decisions, and suggesting alternatives during a crisis. We identified several strategies (e.g., collaborating with other actors, proactively putting subjects on the policy agenda, finding new ways of contacting their 'constituency') used by the patient representatives studied to exert influence despite the difficulties encountered. Conclusions: The struggle for patient representation during pandemic decision‐making is a missed opportunity for resilient healthcare systems as these representatives can play a role in opening up discussions and putting different perspectives to the fore. Moreover, the adaptive strategies used by representatives to influence decision‐making offer lessons for future representation activities. However, adaptations to the crisis decision‐making structure are also needed to enable patient representatives to play their role. Patient Contribution: We conducted interviews with patient representatives and discussed our preliminary findings with patient representatives during the focus groups. Zorgbelang, a patient organization supporting client councils and enabling and organizing patient participation for organizations and municipalities, was partner in this research and contributed to the interview guide, conducting interviews and focus groups. Additionally, the analysis made by the first author was discussed and refined multiple times with the partners of Zorgbelang and one of them co‐authored this paper. [ABSTRACT FROM AUTHOR]

Background: For adults with inflammatory bowel disease (IBD), they experience many challenges in dietary decision‐making. Thus, this study examined the perspective and experiences of adults with IBD in dietary decision‐making. Objective: This study aimed to explore the perception and consideration of people with IBD in their daily dietary decisions through monitoring, interpretation and action during the decision‐making process. Design: A qualitative study of individuals affected by IBD was conducted through semistructured interviews. Results: Twenty patients were recruited from four tertiary hospitals in Nanjing, China, and each participant completed a semistructured interview. The majority of participants reported on the process and experience of dietary decision‐making. Key themes were categorised into three stages: (1) assessing needs, preferences and food cues (monitor); (2) moving from experience to expertise (interpret) and (3) balancing expectations amidst limitations (act). The majority of participants reported that their decisions were shaped by assessing current disease status and food cues. Those interviewed with IBD were willing to make tradeoffs for bowel stability, but their decisions were also influenced by past dietary experiences and traditional Chinese beliefs. The lack of awareness of dietary guidelines was a significant barrier to healthy eating decisions. Positive or negative feelings accompanied dietary decisions. Conclusion: Although most people with IBD change their diet after diagnosis, the changes made are often inconsistent with existing dietary recommendations. Several factors can influence the dietary decision‐making process. This study will help assess the experiences of people with IBD in dietary decision‐making to encourage the formation of targeted dietary health and well‐being interventions. Knowledge of nutrition and diet should be provided in education and training programmes for IBD management. Patient or Public Contribution: The first three authors of this paper were the lead researchers in this study's design. These authors were mentored by patient researchers who also contributed to the manuscript, and the research process was co‐lead and directed by other patient participants and consultants. The results of this paper were directly obtained from patient participants. [ABSTRACT FROM AUTHOR]

Aims: To review the literature and identify factors that make sense of and influence nurses' career success. We sought to provide insights into achieving nurses' career success. Design: An integrative review conducted in May 2022 using Whittemore and Knafl's methodology of integrative review. Methods: The databases searched were PubMed, Web of Science, Scopus, and CINAHL. Search criteria included the keywords "nurs*" and "career success" in the title and abstract. The quality of the reviewed papers was assessed using the JBI Critical Appraisal Tool for cross‐sectional studies and qualitative research. We extracted five types of information from quantitative studies: the definition of career success, factors of career success instruments, reliability or validity of career success instruments, and factors influencing nursing career success. Furthermore, we extracted two types of information from qualitative studies: themes that imply career success and factors that influence nurses' career success. Primary data were categorized into two perspectives: (1) what nurses' career success means and (2) what influences nurses' career success. Categorized data were unified into similar contents. Themes were developed from unified subgroups. Results: Fourteen studies were included in the analysis. Seven themes were integrated into the factors that make sense of nurses' career success: satisfaction, positive attitude towards work, quality work in nursing, continuation of career and professional development, positive interaction at work, person–organization fit, and enrichment of an individual's life. Three themes were integrated into the factors influencing nursing career success: personal resources, positive behavior toward nursing work and research, and job resources and environment. No Patient or Public Contribution: Patients or members of the public were not involved in this review. [ABSTRACT FROM AUTHOR]

Introduction: Implementing occupation‐based practice in low‐resourced settings can be challenging especially when working with children with HIV/Aids whose daily occupation of play is often affected by their health condition and other contextual factors such as poverty or stigma. Aim: The aim of this paper is to obtain consensus from experts on the content and application of a play‐based intervention for children with HIV/Aids living in a low‐resourced setting. Methods: A Delphi study involving two rounds using an online survey format was conducted with experts from the field of child development, play and/or HIV/Aids. Consensus agreement was reached when at least 70% of Delphi experts rated each item at 3 or higher on a 5‐point Likert scale. Consumer and Community Involvement: This paper is part of a multi‐stage study that involved input and feedback from families of children who were born HIV/Aids, occupational therapists working with families of children with HIV/Aids, and input from local and international experts working with people with HIV/Aids. Results: Thirty‐seven experts completed the first round, and 35 completed the second round of the study. Consensus was achieved on the application of the Cooper's Model of Children's Play, techniques to be used and the structure of the intervention. Experts also agreed on the inclusion of a pre‐intervention workshop as part of the play‐based intervention. Discussion and conclusion: The consensus on the content and application of a play‐based intervention framework through a process of gaining expert perspectives provides confidence that the intervention planned to promote play for children with HIV/Aids living in low‐resourced settings is likely to be effective. Key Points for Occupational Therapy: Occupation‐based practice is challenging when working with children with HIV/Aids in low‐resourced settings.Consensus was achieved on the play‐based intervention's theoretical model, techniques to be used, and the structure.Consensus from experts provides confidence that the intervention planned is likely to be effective. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disability have diverse needs and experience higher rates of diet‐related chronic disease such as type 2 diabetes compared to people without disability. However, they are infrequently included in development and implementation of interventions to address diet‐related chronic disease. The present study describes the process to plan, develop and refine the Food and Lifestyle Information Program (FLIP) culinary nutrition intervention for adults with mild‐to‐moderate intellectual disability. Methods: The project was initiated by a disability service provider and was guided by the Cook‐Ed™ model and inclusive research principles. Initially the disability service provider and academic research team members co‐designed pre‐program consultation and pilot studies, and draft program resources. Pre‐program consultation explored paid disability support worker (n = 10) perceptions of cooking and food skills, nutrition priorities and optimal program format, which guided further program drafting. Program resources and pilot study design were further developed and refined with co‐researchers with lived experience of intellectual disability who attended a pre‐pilot and then pilot study sessions as remunerated co‐facilitators. Results: Key characteristics of the FLIP intervention arising from pre‐program consultation included providing cooking task instruction in small steps, enabling participant choice in program activities, promoting an inclusive and social atmosphere, and providing paper‐based resources. Conclusions: FLIP intervention co‐design was enabled through ongoing input from the disability service provider and people with lived experience of intellectual disability. Evaluation of FLIP feasibility, acceptability and preliminary effectiveness to improve diet‐related health is underway. Highlights: An academic research team, disability service provider and people with lived experience of intellectual disability co‐designed a culinary nutrition intervention for adults with mild‐to‐moderate intellectual disabilityKey considerations for culinary nutrition programs for people with intellectual disability include providing small group practical instruction, paper‐based Easy Read recipes, providing choice and creating a social and inclusive atmosphere [ABSTRACT FROM AUTHOR]

Background: A lifelong gluten‐free (GF) diet to manage coeliac disease is recognised to be challenging. This paper comprises two studies: study one aimed to report the opinions of adults with coeliac disease on review provision and explore factors influencing dietary adherence. Study two aimed to report dietetic provision for adults with coeliac disease. Methods: A cross‐sectional online survey was completed by 722 adults with coeliac disease, including validated dietary adherence, health literacy and quality‐of‐life questionnaires. An online and paper survey designed to capture the provision of dietetic services to adults with coeliac disease was completed by 88 dietetic departments within the United Kingdom. Results: Only 26% of adults with coeliac disease were offered annual reviews. In contrast, 85% considered reviews important, with 62% preferring dietetic provision. Those who considered reviews important had lower health literacy, greater dietary burden, poorer GF dietary adherence and lower GF food knowledge (all p < 0.05) compared with those who did not consider reviews important. GF dietary adherence was associated with health literacy, self‐regulatory behaviours, dietary burden and GF food knowledge; 53% agreed with the 'cost of GF food restricts what I eat'; they had poorer GF dietary adherence compared with those who disagreed (p < 0.001). More than 72% of dietetic coeliac review provision provided content on improving access to GF foods and eating out of the home. Conclusions: A subpopulation of adults with coeliac disease have a greater need for support and guidance, which supports the viewpoint that limited resources should be targeted towards patients with the most need for support to enable successful disease management. Key points: The majority of adults with coeliac disease were not receiving healthcare reviews for coeliac disease, whereas 85% would like to have reviews.Adults living with coeliac disease who had lower health literacy, poorer gluten‐free (GF) food knowledge and poorer GF dietary adherence score rated healthcare reviews as important.A varied provision of dietetic services for coeliac disease reviews was evident across the United Kingdom. [ABSTRACT FROM AUTHOR]

Background: In example‐based learning, examples are often combined with generative activities, such as comparative self‐explanations of example cases. Comparisons induce heavy demands on working memory, especially in complex domains. Hence, only stronger learners may benefit from comparative self‐explanations. While static text‐based examples can be compared easily, this is challenging for transient video‐based modelling examples used in complex domains because simultaneous processing of two videos is not feasible. Objectives: To allow for such comparisons, we combined video‐based modelling examples with static representations (i.e., summarizing tables) of the observed optimal and a suboptimal solution of the problem‐solving process. A comparative self‐explanation prompt asked learners to compare the different solution approaches. Our study investigated the impact of video‐based modelling examples versus independent problem‐solving on cognitive load and problem‐solving skill development. Moreover, we investigated the effects of comparative versus sequential self‐explanation prompts, depending on learners' prior knowledge. Methods: In an experiment, 118 automotive apprentices learned a car malfunction diagnosis strategy. Apprentices were divided into three groups: (1) modelling examples with comparative self‐explanation prompts, (2) modelling examples with sequential prompts, and (3) no examples or prompts. Diagnostic knowledge and skills were assessed before and after the intervention. Cognitive load was measured retrospectively. Results and conclusions: Despite no observed effects on cognitive load, modelling examples enhanced diagnostic knowledge and diagnostic skills with scaffolds, though not independent diagnostic skills without scaffolds. The need for more practice opportunities to foster independent diagnostic skills is assumed. Additionally, comparative prompts seem promising for learners with higher prior knowledge. Takeaways: Video‐based modelling examples were more beneficial for learning than practising to apply the diagnostic strategy. Static representations allow for comparisons of video examples and comparative prompts are promising for learners with higher prior knowledge (cf. expertise‐reversal effect). Further research, especially on the effects on cognitive load, is necessary. Lay Description: What is already known about the topic?: Text and video examples that model how to solve a problem are widely used in education.Text examples often include self‐explanation prompts that ask learners to compare several examples.For video examples, such comparison prompts have seldom been investigated, because comparisons are difficult to implement for transient videos. What does this paper add?: This paper shows that video examples combined with static summaries of processes that have been shown in the video example are effective and allow for comparisons of video examples.Such comparisons seem to be more promising for learners with higher prior knowledge. Implications for practice: Practitioners could combine video examples with static summaries of the processes shown in the video examples to allow for comparisons. [ABSTRACT FROM AUTHOR]

Background: AI can positively influence teaching by offering support for classroom management, creating inclusive learning environments, enhancing digital skills, personalizing teaching methods, and strengthening teacher‐student relationships. Objectives: This quantitative research study investigates the opportunities, difficulties, and consequences of incorporating AI into teacher education. Methods: Data were collected through structured questionnaires from 202 college students and 68 staff members. The analysis was conducted using SPSS software. Results: The study provides a novel contribution by its thorough investigation of the diverse effects of AI on teacher education. It offers beneficial perspectives on the possible benefits and challenges, illuminating the far‐reaching changes that AI could bring to the terrain of learning and instruction and teaching methods in the time yet to come. The research sought to assess the effect of AI adoption in teacher education across five main dimensions: (i) its influence on teaching support and classroom management, (ii) its role in creating inclusive and accessible learning environments, (iii) its contribution to improving teachers' digital literacy and computer skills, and enhancing access to digital teaching resources, (iv) its positive influence on identifying students' learning styles and facilitating the adoption of diverse teaching methods, and (v) its role in strengthening teacher‐student relationships through improved interactions. Conclusion: The findings elucidate the promising opportunities that AI presents in the field of teacher education, along with the obstacles that require resolution for the effective fusion of AI educational settings. Lay Description: What is currently known about this topic?: AI has the potential to enhance various aspects of teaching, including classroom management and personalizing teaching methods.Incorporating AI into education has garnered significant interest due to its perceived benefits in improving learning outcomes. What does this paper add?: This paper provides a comprehensive investigation into the effects of AI adoption in teacher education, highlighting both the opportunities and challenges associated with its implementation.It offers insights into how AI can influence different dimensions of teaching, such as classroom management, learning environment inclusivity, and teacher‐student relationships. Implications for practice/or policy: The findings of this study underscore the importance of integrating AI into teacher education programs to leverage its potential benefits in enhancing teaching practices.Policymakers and educators should consider the implications of AI adoption in education and develop strategies to address challenges while maximizing the advantages of AI technologies in teaching and learning. [ABSTRACT FROM AUTHOR]

Background: Instructional videos constitute a pivotal component in flipped learning. Despite their significance, there is a dearth of research specifically dedicated to instructional videos within the context of flipped classrooms. This paucity has led to an empirical void in verifying the efficacy of instructional videos in flipped learning environments. Objectives: The present study endeavours to contribute to the extant literature on flipped pedagogical practices by providing empirical evidence regarding the effectiveness of instructional videos in flipped learning environments. Methods: This study employs a convergent mixed‐methods design. Forty‐five instructional videos in three subtypes were administered in two classes over a 15‐week semester. Data, both quantitative (log data from the learning management system) and qualitative (from focus group discussions at two time points), were concurrently collected from a flipped class (n = 25) and a blended class (n = 28) with the aim of gauging student engagement and learning outcomes in the flipped class and understanding video‐viewing features typical of the flipped class. Results: Both datasets corroborated that participants in the flipped class outperformed their counterparts in the blended class in terms of video‐watching, peer interaction, knowledge retention, and transfer skills. Conclusions: The instructional videos within the flipped classroom setting serve to enhance student engagement in the learning process and improve learning outcomes. The efficacy of these instructional videos in flipped learning can be further augmented through strategic approaches in both their design and implementation. Lay Description: What is currently known about this topic: The flipping pedagogy is conducive to learning.Videos play a crucial role in flipped learning.Videos prepared students for classroom activities.However, engaging students with pre‐class videos presents a challenge. What this paper adds: This paper furnishes direct empirical evidence supporting the effectiveness of instructional videos in flipped learning.It uncovers factors affecting student engagement with videos in flipped learning.It offers insights into the design and implementation of videos in flipped learning. Implications for practice: Considering facilitating conditions and affective factors when creating videos.Acknowledging learner characteristics when designing videos.Utilizing instructional strategies when implementing videos. [ABSTRACT FROM AUTHOR]

Background: Both socially regulated learning and cognitive quality are important factors affecting collaborative knowledge building, but the current research lacks a joint quantified evaluation method that combines these two aspects. Objectives: Based on the existing framework, we proposed a joint evaluation method for regulated learning and cognitive quality in collaborative knowledge building, and further extracted the evaluation indicators. Methods: This study involved 74 learners enrolled in a course named 'the Application of Modern Educational Technology' as the subject of study, and made a case analysis with this method. Results and Conclusions: First, the indicators of this joint evaluation method could complement the indicators of traditional frequency statistics methods and facilitate an analysis of regulated learning and cognitive quality in collaborative knowledge building. Second, the group with a higher proportion of high‐level cognitive quality and socially shared regulation in collaborative knowledge building achieved better final scores. Finally, four types of groups were obtained through clustering: excellent, risky, mixed group, and highly collaborative group. This study introduced a joint evaluation method for regulated learning and cognitive quality in collaborative knowledge building and provides suggestions for future research. Lay Description: What is currently known about this topic?: Online collaborative knowledge building is increasingly important.Regulated learning and cognitive quality are considered very important for successful collaborative learning.Without quantitative methods, it is difficult to assess regulated learning and cognitive quality during collaborative knowledge building in a timely manner. What does this paper add?: This paper provided a joint evaluation method of regulated learning and cognitive quality (JERC) for online collaborative knowledge building.A case study was conducted to identify JERC's usefulness. Using descriptive statistics and visualization, it was determined that indicators of JERC can not only capture the state of cognitive quality and regulated learning status, but also elucidate the nature of that status (i.e., comprehensive, dynamic, cyclical).Through clustering analysis, four distinct groups were identified, each exhibiting different characteristics and moving patterns of regulated learning and cognitive quality over time. These patterns indicate that the quality of cognitive and regulatory learning cannot be determined solely by behavioural frequency. Moreover, an excessive proportion of individual regulation cannot predict better learning performance. Implications for practice: A computable representation model of regulated learning and cognitive quality was constructed to support automated perception and intervention in regulated learning and cognitive processing.With JERC, it is possible for researchers to capture, process, analyse and predict dynamic data to examine online collaborative knowledge building combined with shared physiological arousal events.The results of JERC can be used by researchers to develop advanced techniques, such as AI deep learning, for designing adaptive supports that can foster students' online collaborative knowledge building. [ABSTRACT FROM AUTHOR]

Background: Measuring students' self‐regulation skills is essential to understand how they approach their learning tasks in order to identify areas where they might need additional support. Traditionally, self‐report questionnaires and think aloud protocols have been used to measure self‐regulated learning skills (SRL). However, these methods are based on students' interpretation, so they are prone to potential inaccuracy. Recently, there has been a growing interest in utilizing learning analytics (LA) to capture students' self‐regulated learning (SRL) by extracting indicators from their online trace data. Objectives: This paper aims to identify the indicators and metrics employed by previous studies to measure SRL in higher education. Additionally, the study examined how these measurements were validated. Methods: Following the protocol of Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA), this study conducted an analysis of 25 articles, published between 2015 and 2022, and sourced from major databases. Results and Conclusions: The results showed that previous research used a variety of indicators to capture learners' SRL. Most of these indicators are related to time management skills, such as indicators of engagement, regularity, and anti‐procrastination. Furthermore, the study found that the majority of the reviewed studies did not validate the proposed measurements based on any theoretical models. This highlights the importance of fostering closer collaboration between learning analytics and learning science to ensure the extracted indicators accurately represent students' learning processes. Moreover, this collaboration can enhance the validity and reliability of data‐driven approaches, ultimately leading to more meaningful and impactful educational interventions. Lay Description: What is already known about this topic?: Measuring students' self‐regulation skills is essential for understanding their learning approaches and identifying areas requiring further support.Traditionally, questionnaires and interviews have been used to measure learners' self‐regulation; however, these methods rely on students' own views, which can sometimes be unreliable.Recently, there has been more interest in using learning analytics to measure students' self‐regulation based on data extracted from their online activities. What this paper adds?: This paper systematically analyses how previous studies used learning analytics to measure students' self‐regulation in higher education.It examines how these measurements were validated. Implications for practise and/or policy: More collaboration is needed between researcher in learning science and learning analytics is essential to ensure that the metrics and methods developed are not only theoretically sound but also practically relevant. This collaboration ultimately contributes to the design of enhanced learning experiences and outcomes. [ABSTRACT FROM AUTHOR]

Background: Online interaction in blended learning is leveraged through social presence and convergence. However, little systematic work currently exists on how researchers have explored these challenges in higher education institutions and no studies have synthesised these challenges. Objectives: The purpose of this study is to give a novel overview of social presence and convergence to improve online interaction in blended learning in higher education. The findings will be synthesised into blended learning design principles. Method: Two systematic literature reviews, one on each challenge, were carried out through the Web of Science databases and consulting cited sources in review articles. Accordingly, 28 distinct studies were selected through the guidelines of the PRISMA statement, using predefined selection criteria. Results and Conclusions: The results show that social presence in blended learning is mostly evoked through course design, introductory f2f meetings, collaborative activities, prompt online feedback, the teacher's presence, and planned facilitation. To establish convergence, it is recommended to make basic theory available online through video clips, web‐lectures, articles, followed by simple online assignments or self‐study to increase understanding, thereby creating opportunities for deep learning during face‐to‐face through discussions and collaborative activities. Implications: This paper adds to the theory on blended learning and instructional design in higher education, and further offers an elaborate set of design principles for educational practice. Future research on instructional design may investigate in particular how a target group or student factors, are affected by the blended learning environment in order to tailor designs for a specific target group. Lay Description: What is known?: Online interaction is pivotal in blended learningOnline interaction is leveraged through social presence and convergenceSocial presence prevents the online student from feeling lonelyConvergence entails deciding the best‐suited delivery mode: online or face‐to‐face What this paper adds: A novel overview and critical analysis of social presence in blended learningA novel overview and critical analysis of convergence in blended learningA synthesis of the findings on social presence and convergenceExtraction of the findings into blended learning design principles Implications for practitioners: The teacher's presence through design and accessibility fosters students' social presencePlacing concepts online leaves room for deep learning during face‐to‐faceCollaborative activities evoke social presence and facilitate deep learningBlended learning designs should be further tailored for the target group [ABSTRACT FROM AUTHOR]

Background: Mindfulness practices enhance executive function skills and academic achievement, spurring interest in integrating mindfulness interventions into education. Embedding mindfulness practice into a digital math game may provide a low‐cost, scalable way to induce mindfulness and boost game‐based learning, yet this approach remains unexplored. Objectives: We investigated the learning benefits of integrating mindfulness exercises in a digital math learning game and examined how students' trait mindfulness might moderate the outcomes. Methods: Two classroom studies were conducted with 404 5th and 6th grade students from six public schools in the U.S. (nStudy 1 = 227, nStudy 2 = 177). The two randomized controlled experiments assigned students to one of the three conditions: passive control (playing the digital learning game Decimal Point), story‐enriched active control, or mindfulness‐enriched condition. Trait mindfulness, learning gains, and in‐game problem‐solving (including problem‐solving duration, error count and correctness after reminder) were assessed. Study 2 included a manipulation check to better understand the effects of the mindfulness intervention. Results: Findings showed no significant differences in learning gains, problem‐solving duration or error count among the conditions. Students' trait mindfulness did not moderate these outcomes. Mindfulness reminders in the mindfulness‐enriched game led to more correct answers after errors than jokes in the story‐enriched game. Study 2 revealed that we failed to induce higher state mindfulness through the mindfulness inductions. Conclusions: Mindfulness prompts could be especially beneficial for students experiencing frustration during gameplay, warranting more exploration for digital game‐based instruction. We highlight barriers and future directions for fostering mindfulness through computer‐based instruction in classrooms. Lay Description: What is currently known about this topic?: Researchers focus on digital games as productive learning environments for math, with potential for higher learning gains compared with traditional methods. However, results are mixed, and not all games lead to improved math outcomes.Executive function (EF) skills are crucial for math learning, and mindfulness‐based interventions show promise in enhancing EF skills in school‐aged students.Embedding mindfulness practice into a digital math game may provide a low‐cost, scalable way to induce mindfulness and, in turn, boost EF skills and game‐based learning, yet this approach remains unexplored What does this paper add?: This paper presents the results of two randomized control trials investigating the feasibility and benefits of incorporating mindfulness exercises into a digital math game designed for middle school students. Benefits are compared to those of a story‐enriched and regular version of the same digital math learning game.The paper also explores variations in the effects of the mindfulness‐enriched game based on students' initial trait mindfulness levels.We observe that listening to mindfulness inductions at the beginning of game sessions do not induce mindfulness, and therefore does not benefit math learning.We find that mindfulness prompts received after recurrent errors can be beneficial for students' problem solving. Implications of study findings for practitioners: Our study provides important information on how digital learning game designers should attempt to induce mindfulness in a digital game to promote learning.Digital learning game designers should consider incorporating mindfulness exercises into their games strategically. Presenting mindfulness inductions in audio format at the beginning of game sessions may not induce mindfulness or benefit math learning. Instead, designers should focus on integrating mindfulness prompts at moments when students encounter frustration within the learning game.Beyond embedding audio mindfulness exercises in the game, learning designers should also consider alternative technological and game features to induce mindfulness within a learning game. [ABSTRACT FROM AUTHOR]

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

Background: Learner profiles detected from digital trace data are typically triangulated with survey data to explain those profiles based on learners' internal conditions (e.g., motivation). However, survey data are often analysed with limited consideration of the interconnected nature of learners' internal conditions. Objectives: Aiming to enable a thorough understanding of trace‐based learner profiles, this paper presents and evaluates a comprehensive approach to analysis of learners' self‐reports, which extends conventional statistical methods with psychological networks analysis. Methods: The study context is a massive open online course (MOOC) aimed at promoting physical activity (PA) for health. Learners' (N = 497) perceptions related to PA, as well as their self‐efficacy and intentions to increase the level of PA were collected before and after the MOOC, while their interactions with the course were logged as digital traces. Learner profiles derived from trace data were further examined and interpreted through a combined use of conventional statistical methods and psychological networks analysis. Results and Conclusions: The inclusion of psychological networks in the analysis of learners' self‐reports collected before the start of the MOOC offers better understanding of trace‐based learner profiles, compared to the conventional statistical analysis only. Likewise, the combined use of conventional statistical methods and psychological networks in the analysis of learners' self‐reports before and after the MOOC provided more comprehensive insights about changes in the constructs measured in each learner profile. Major Takeaways: The combined use of conventional statistical methods and psychological networks presented in this paper sets a path for a comprehensive analysis of survey data. The insights it offers complement the information about learner profiles derived from trace data, thus allowing for a more thorough understanding of learners' course engagement than any individual method or data source would allow. Lay Description: What is already known about this topic: Researchers have made extensive use of data from online learning platforms—often referred to as learning trace data—to understand how learners engage in online learning activities.Surveys are often used to gather information about learners' motivation, perceptions, and other internal factors, to complement the insight gleaned from learning traces and thus create a more complete picture of the learning behaviour.When analysing survey data, the focus is usually on individual factors without considering how different factors are connected and affect one another.Psychological networks analysis is a novel analytic approach to studying complex phenomena both in psychology and education. What this paper adds: The paper uses psychological networks as a method for examining mutual relations among learners' internal factors (e.g., motivation, perceptions) measured through self‐reports before and after a course.By combining conventional statistical analysis of self‐reports with psychological networks analysis, the paper develops a comprehensive picture of learners' internal factors measured through self‐reports, one that accounts for both individual and interconnected nature of those factors.This comprehensive approach to information extraction from surveys allows for better understanding of trace‐based learner profiles, that is, profiles mined from data about learners' interaction with online learning activities. Implications for practice and/or policy: The presented method paves a way for a comprehensive analysis of the data collected from learners through surveys.It helps us gain a better understanding of learners' engagement with online learning activities.It can advance the evaluation of digital educational programs that aim to encourage changes in health‐related behaviour. [ABSTRACT FROM AUTHOR]

Background: The emergence of ChatGPT in the education literature represents a transformative phase in educational technology research, marked by a surge in publications driven by initial research interest in new topics and media hype. While these publications highlight ChatGPT's potential in education, concerns arise regarding their quality, methodology, and uniqueness. Objective: Our study employs unconventional methods by combining altmetrics and bibliometrics to explore ChatGPT in education comprehensively. Methods: Two scholarly databases, Web of Science and Altmetric, were adopted to retrieve publications with citations and those mentioned on social media, respectively. We used a search query, "ChatGPT," and set the publication date between November 30th, 2022, and August 31st, 2023. Both datasets were within the education‐related domains. Through a filtering process, we identified three publication categories: 49 papers with both altmetrics and citations, 60 with altmetrics only, and 66 with citations only. Descriptive statistical analysis was conducted on all three lists of papers, further dividing the entire collection into three distinct periods. All the selected papers underwent detailed coding regarding open access, paper types, subject domains, and learner levels. Furthermore, we analysed the keywords occurring and visualized clusters of the co‐occurring keywords. Results and Conclusions: An intriguing finding is the significant correlation between media/social media mentions and academic citations in ChatGPT in education papers, underscoring the transformative potential of ChatGPT and the urgency of its incorporation into practice. Our keyword analysis also reveals distinctions between the themes of the papers that received both mentions and citations and those that received only citations but no mentions. Additionally, we noticed a limitation that authors' choice of keywords might be influenced by individual subjective judgements, potentially skewing results in thematic analysis based solely on author‐assigned keywords such as keyword co‐occurrence analysis. Henceforth, we advocate for developing a standardized keyword taxonomy in the educational technology field and integrating Large Language Models to enhance keyword analysis in altmetric and bibliometric tools. This study reveals that ChatGPT in education literature is evolving from rapid publication to rigorous research. Lay Description: What is currently known about this topic?: ChatGPT in education has seen a surge in publications driven by media hype.Early publications tend to lack rigour and reiterate known advantages/disadvantages.Literature reviews on ChatGPT in education have limitations in scope and depth.Some studies have explored altmetrics and bibliometrics in other fields. What does this paper add?: Combines altmetrics and bibliometrics to analyse publications of ChatGPT in education.Addresses challenges in the discourse by offering unconventional analysis methods.Identifies publication trends and investigates the relationship between media attention and citations.Determines key themes in the literature through keyword co‐occurrence analysis. Implications for practice/or policy: Expectations of continued growth in ChatGPT literature but with evolving publication trends.Distinctive characteristics of ChatGPT in education challenge keyword analysis.Proposes the development of a unified keyword taxonomy for clarity in the field.Suggests enhancing altmetrics and bibliometrics tools using Large Language Models. [ABSTRACT FROM AUTHOR]

Background: Painting is the foundational expression across all art forms and is one of the key creative practices for fostering students' aesthetic ability and creativity within fine arts courses. Collaborative painting in the form of socially shared regulation of learning (SSRL) can be recognized as an effective strategy for enhancing creativity in both individual and group work. However, the absence of contextual experiences and collaborative spaces poses challenges for students in cultivating their creativity in painting. Objectives: The present study explores students' creativity, socially shared regulation (SSR) and positive painting behaviours using an SSRL‐based collaborative painting approach in the metaverse (Meta‐CP). Methods: Via a quasi‐experimental design, a total of 40 Chinese students in fifth grade were recruited and were randomly divided into an experimental group and a control group, with 20 students utilizing the Meta‐CP approach, while the remaining 20 students followed the conventional SSRL‐based paper‐and‐brush collaborative painting (C‐CP) approach. The Meta‐CP approach not only offers an authentic painting context and a collaborative space but also facilitates the collaborative process through the SSRL framework. The data collection included students' creative tendency, painting works and painting process. Results and Conclusions: The Meta‐CP approach effectively enhances students' creativity concerning adventure, curiosity and imagination, as well as results in the creation of more distinctive and logical artistic works. Furthermore, the approach significantly improved the quality of students' SSR. Additionally, students utilizing the Meta‐CP approach displayed more positive painting behaviours compared with those employing the C‐CP approach. Lay Description: What is already known about this topic:Collaborative painting is an effective strategy for enhancing creativity.Socially shared regulation of learning (SSRL) fosters collaborative learning.Students in collaborative painting may lack a contextual and synchronized painting space.The metaverse benefits in terms of contextual experiences and collaborative spaces. What this paper adds:Using an SSRL‐based collaborative painting approach in the metaverse (Meta‐CP) is effective in improving students' creativity.The Meta‐CP approach has the potential to improve students' quality of socially shared regulation (SSR), and positive painting behaviours. Implications for practice and/or policy:The metaverse provides an immersive synchronized painting space for art education to stimulate students' creative potential.The metaverse with proper learning strategies (e.g., SSRL) provides an effective collaborative learning environment for creation. [ABSTRACT FROM AUTHOR]

Background: Social annotation has emerged as a promising educational technology that fosters collaborative reading and discussion of digital resources among learners. While the positive impact of social annotation on students' learning process and performance is widely acknowledged, students' behavioural patterns in social annotation are underexplored. Objectives: This study investigated patterns in students' use of annotation and response behaviours in social annotation activities. We also explored how students' performance in the behavioural, cognitive, emotional, and social dimensions varied based on their behavioural patterns. Methods: We recruited 93 undergraduates who were enrolled in an elective course at a large North American University. Students were tasked with collaboratively annotating the class readings uploaded to Perusall, a social annotation platform, over 7 weeks. We used metaclustering to determine the optimal number of clusters pertaining to student behaviours. We compared the differences among clusters across multiple performance dimensions. Results and Conclusions: Two distinct clusters were identified and defined as initiators and responders. We found that responders had significantly longer active reading time and exhibited greater social annotation effort compared to initiators. However, initiators received more peer acknowledgement, as evidenced by higher upvotes. No significant difference was found in cognitive insight between initiators and responders, but responders demonstrated significantly higher cognitive discrepancy. Additionally, there were no significant differences in positive and negative tones between initiators and responders; however, responders displayed higher levels of prosocial behaviours than initiators. This study has significant practical implications regarding promoting students' collaborative learning experience in social annotation. Lay Description: What is already known about this topic: Annotation and response behaviours are two primary actions in social annotation.Understanding how students navigate through annotations and respond to their peers' contributions is essential for optimizing their learning experience.Social annotation outcomes can be assessed in the behavioural, cognitive, emotional, and social dimensions. What this paper adds: This paper revealed students' behavioural patterns in social annotation activities.This study offered a comprehensive understanding of the various dimensions of performance among students with different behavioural tendencies. Implications for practice and/or policy: The two student clusters, initiators and responders, revealed distinct engagement patterns in social annotation and informed the design of targeted scaffoldings.Responders were not passive learners since they demonstrated significantly longer active reading time, greater social annotation effort, and higher level of prosocial behaviours.Educators might not need to place significant emphasis on monitoring participants' emotional expressions in social annotation.Social annotation platforms should incorporate features that encourage and reward both initiation and response behaviours. [ABSTRACT FROM AUTHOR]

Background: Maintenance of speech outcomes following speech‐language therapy (SLT) in Parkinson's disease (PD) is an unmet expectation of people with PD (PWPD) and poorly defined in SLT practice. PD Check‐In, a model for supported self‐managed maintenance of speech following Lee Silverman Voice Treatment (LSVT) LOUD was investigated. Aims: To investigate the impact of the semi‐structured component of PD Check‐In on the adoption of self‐management concepts and behaviours and the identification of facilitators, barriers and strategies for speech maintenance by PWPD over 24 months post‐treatment. Methods and procedure: Following LSVT LOUD, 16 PWPD participated in individual PD Check‐In semi‐structured discussions with a SLT at 6 and 12 weeks, and 6, 12 and 24 months post treatment. A two‐stage qualitative content analysis was applied: directed content analysis using categories from the theoretical framework of PD Check‐In followed by inductive content analysis to identify subcategories. Outcomes and results: Statements from PWPD indicated adoption of seven concepts of self‐management across participants and across time. Six concepts from the theoretical framework of PD Check‐In (partnerships, self‐reflection, maintenance barriers and facilitators, revision of LSVT LOUD skill, goal setting and maintenance strategies), and one new category, participation, emerged from the analysis. Self‐reflection, maintenance facilitators and barriers and participation were most prevalent in discussions. PWPD identified facilitators, barriers and strategies for maintenance across time points. Conclusions and implications: Statements from PWPD indicated a positive impact of SLT‐supported self‐management of speech using self‐tailored strategies for sustainable maintenance according to their individual circumstances and needs. WHAT THIS PAPER ADDS: What is already known on this subject: People with Parkinson's disease (PWPD) have expressed their need for speech‐language therapy (SLT) services that are accessible for the duration of the condition and responsive to their expectation of maintaining speech following treatment. Outcomes for maintenance of the treatment effect following Lee Silverman Voice Treatment (LSVT) LOUD are variable. What this paper adds to existing knowledge: This study presents the outcomes of five PD Check‐In interventions delivered in semi‐structured discussions between PWPD and a SLT over 24 months following LSVT LOUD for the development of self‐management skills and behaviours. PWPD adopted self‐management positively using self‐tailored strategies for sustainable maintenance according to their individual circumstances and needs. What are the potential or actual clinical implications of this work?: PWPD responded positively to the individual development of self‐management skills and behaviours over time. Individuality and flexible responsivity are features of PD Check‐In which resonate with PWPD and speak to SLT supported self‐managed maintenance of speech as a long‐term model for PD. [ABSTRACT FROM AUTHOR]

Background: People with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy and young onset Alzheimer's disease may experience language and communication difficulties. However, the role of speech and language interventions for people with these non‐language led dementias has received little attention. Aims: This study aimed to explore the experiences and perspectives of people living with these conditions, and their families, regarding their language and communication difficulties and how speech and language therapy could address these needs. Methods: This study employed a qualitative design to explore the experiences of people living with or caring for somebody with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy or young onset Alzheimer's disease, and to understand their opinions about speech and language therapy. Participants were recruited from a support service connected to a dementia clinic to attend one of five focus group meetings. Videorecorded focus groups and interviews were transcribed, and reflexive thematic analysis was used to analyse data from people affected by each type of dementia. Results: A total of 25 participants were recruited to the study, with representation across the different forms of non‐language led dementias. The four main themes identified were: (1) communication difficulties as a key difficulty, (2) loss and loneliness, (3) speech and language therapy, and (4) the role of the caregiver. Sixteen subthemes were also identified which highlighted individual issues across disease types. Discussion: Although all the forms of dementia studied here are not considered to be language‐led, people with these conditions and/or their care partners identified speech, language and communication as common challenges. These communication difficulties were reported to have a negative impact on their social participation and mental health and participants felt speech and language interventions could help. There is a need for research exploring speech and language interventions developed for and with people with non‐language led dementias and their care partners, to ensure they meet the needs of the people they are designed for. WHAT THIS PAPER ADDS: What is already known on the subject: People with primary progressive aphasia present with speech, language and communication difficulties, and several speech and language interventions have been developed to meet the needs of this population. However, people with non‐language led dementias may also experience speech, language and communication difficulties, and little is known about interventions that may address these difficulties. What this paper adds to existing knowledge: People living with or caring for somebody with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy and young onset Alzheimer's disease report experiencing speech, language and communication difficulties that impact on the person with dementia's social participation and mood. Participants in this study also shared their opinions about how speech and language interventions could help, from the earliest stages of the disease. What are the potential or actual clinical implications of this work?: Speech and language therapists need to address the individual speech, language and communication needs of people with dementias, even those that are not thought to be language‐led. Current speech and language therapy service provision does not meet the needs of people with non‐language led dementias and further research is required to develop interventions and services to meet these needs. [ABSTRACT FROM AUTHOR]

Background: Early language delay is exacerbated by social disadvantage. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. Methods used to achieve successful health outcomes in socially disadvantaged clinical populations may need enhancing. Aims: To compare the impact of standard parent‐based intervention (PBI) to enhanced PBI for young children with speech, language and communication needs (SCLN) and their families living in more socially disadvantaged populations. Methods and Procedures: A multicentre clustered blind randomised controlled trial was used to compare the effect of parent‐based group interventions to improve early language development with children (mean age 27.5 months) from more socially disadvantaged populations with an expressive vocabulary of 40 or less single words. Intervention sessions were delivered by a speech and language therapist, over a 20‐week period. Participants received one of two interventions: (1) Standard Care – indirect group PBI – (PBI) (2) Enhanced Care: indirect group enhanced PBI – (EPBI). Both standardised and non‐standardised measures were used as outcomes. Parent engagement in the intervention was captured through analysis of attendance and the Parent Activation Measure – Speech & Language Therapy (PAM‐SLT) (Insignia Health, 2014). The PAM measures a person's knowledge, skills and confidence to manage their own health and well‐being (NHS England, 2018). In this study, activation referred to parents' knowledge, skills and confidence to manage their child's language development. Outcomes and Results: One hundred fifty‐five participants were randomised at baseline. Children in both groups made significant improvements in the outcome on MacArthur‐Bates Communicative Development Inventories Sentence Length, from pre‐intervention to post‐intervention and 6 months post‐intervention (p < 0.05). Changes in vocabulary and expressive language skills were more equivocal, showing wide variation in confidence intervals for both groups. Where parents attended at least one intervention session almost all effect sizes were in favour of the EPBI intervention. Parents' activation levels significantly increased for both groups (EPBI p < 0.001, PBI p = 0.003), with a moderate effect size in favour of EPBI (Hedges' G 0.37, confidence interval –0.02 to 0.76), although wide variation was found. Conclusions and Implications: This trial provides some evidence of facilitating the language development of children with SLCN from more socially disadvantaged areas through supporting caregivers. However, we found variation in outcomes; some children made excellent progress, whilst others did not. Further exploration of parent engagement and its relationship to child language outcomes will be valuable to understanding more about mechanisms of change in interventions that involve parents. WHAT THIS PAPER ADDS: What is already known on the subject: Speech, language and communication needs (SLCN) have a knock‐on effect on emotional well‐being, school readiness, literacy and school attainment, putting children at increased risk of long‐term consequences such as poor literacy, mental health problems and unemployment. In disadvantaged areas, the prevalence of language difficulties is higher than elsewhere. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. What this paper adds to existing knowledge: Children with SLCN from more socially disadvantaged areas can make improvements in their language development through parent intervention, although wide individual variation was found. There was some evidence that children achieve better outcomes with EPBI, which employed an interagency collaborative approach. Parent's engagement (activation levels) increased significantly over time with intervention, with the increase twice as big for EPBI. What are the potential or actual clinical implications of this work?: This trial provides some evidence that it is possible to facilitate the language development of children from more socially disadvantaged areas through supporting their caregivers. Further research would be useful to determine whether increases in parent engagement are related to adherence to intervention and change in child outcomes. [ABSTRACT FROM AUTHOR]

Aim: Evidence shows that 20%–30% of patients who aspirate do so silently. Research to date has not demonstrated clear evidence to indicate which patients are at higher risk of silent aspiration. Our aim was to use univariate logistic regression analysis of retrospective case review to determine potential patterns of silent aspiration. Materials and methods: We conducted a retrospective analysis of 455 fiberoptic endoscopic evaluation of swallowing (FEES) reports. The patients were divided into four groups: G1 – neurological diseases (n = 93), G2 – head and neck surgery (n = 200), G3 – gastroenterological diseases (n = 94) and G4 – other patients (n = 68). Data included the occurrence or absence of saliva penetration or aspiration, of silent fluid/solid food penetration or aspiration, type of penetration or aspiration, occurrence of cranial nerve paresis, radiotherapy and tracheostomy. Univariate logistic regression was used to evaluate independent risk factors of silent aspiration in the study population. Three models with different independent variables were considered. Results: There is a statistically significant difference in the frequency of occurrence of silent penetration and aspiration within the groups (p < 0.001), with intraglutative being most frequent. Fluid and food penetration and aspiration correlated with saliva penetration and aspiration in all groups (p < 0.001). Cranial nerve paresis (IX and X), radiotherapy and tracheostomy correlate with saliva penetration and aspiration (p = 0.020 for cranial nerve paresis; p = 0.004 for radiotherapy; p < 0.001 for tracheostomy). One hundred and fifteen patients (45.81%) in the subgroup of patients with intraglutative aspiration had cranial nerve paresis (IX, X or IX–X). Conclusions: Patients who should be prioritised or considered to be at a higher need of instrumental swallowing evaluation are those with IX and X cranial nerve paresis, tracheostomy and those who have had radiotherapy, with saliva swallowing problems, especially after paraganglioma, thyroid and parathyroid glands and middle and posterior fossa tumour surgery. WHAT THIS PAPER ADDS: What is already known on the subject: Clinical signs of penetration or aspiration include coughing, throat clearing and voice changes, while silent penetration or aspiration patients aspirate without demonstrating any clinical symptoms. The most common consequences of silent aspiration include aspiration pneumonia, recurrent lower respiratory tract infections and respiratory failure. Additionally, malnutrition and dehydration can be indicators of silent aspiration. Patients may unknowingly reduce their oral intake and lose weight. Retrospective studies have shown that 20%–30% of patients aspirate silently (e.g. patients after stroke, acquired brain injury, head and neck cancer treatment, prolonged intubation). Clinical examination of swallowing can miss up to 50% of cases of silent aspiration. What this paper adds to existing knowledge: Currently, silent aspiration is often discussed in neurological literature, but its applications to head and neck surgery are limited. In this study, we identify head and neck surgery patients who should be prioritised or considered to be in higher need of instrumental swallowing evaluation due to a higher risk of silent aspiration. What are the potential or actual clinical implications of this work?: Post‐treatment structural changes can result in lower cranial nerve paresis (IX, X, XII) and face injury, in which vagus and glossopharyngeal nerves are injured. After tracheostomy and radiotherapy, patients with problems swallowing saliva need careful clinical examination, particularly cranial nerve examination. [ABSTRACT FROM AUTHOR]

Background: Maternal input plays an important role in influencing linguistic development during the first years of life, and it is evident that mothers adapt their language according to their child's characteristics. Recently, it was demonstrated that maternal input addressed to children with sex chromosome trisomies (SCTs) at 8 months of age is prosodically and functionally different from that addressed to typically developing (TD) peers. Aims: The study aimed at analysing maternal input at 24 months when the presence of a language delay could be more evident than during the preverbal stage. We were interested in examining if maternal input was influenced by a diagnosis of SCT (by comparing children with SCT and TD children) or by children's linguistic level (by comparing children with weak lexical ability versus children with typical lexical ability regardless of the presence of genetic diagnosis). Methods and Procedures: Forty‐four mother–child dyads in which the children had an SCT and 20 mother–child dyads in which the children were TD participated in the study. Of these 64 dyads, 23 children (21 with SCTs and two TD children) formed the group of children with weak lexical ability (children with a vocabulary size lower than 50 words at 24 months). Maternal utterances were collected during one video‐recorded play session and were then coded considering both the linguistic and functional features of the input. Outcomes and Results: The results showed that the input addressed to 24‐month‐old children with SCTs is as rich and complex as that addressed to TD peers. Moreover, no significant differences in the functions expressed by maternal input were found (all ps > 0.05). Comparing the children with weak lexical ability and the children with typical lexical ability in our sample, having a poor vocabulary at 24 months of age showed a significant influence on the maternal input features: the input addressed to children with weak lexical ability was characterised by a higher presence of attention getters (U = 217.00, p = 0.007) and a lower proportion of questions (U = 236.00, p = 0.017) than that of mothers of typically‐talking children. Conclusions and Implications: At 24 months of age, it seems that the presence of a language delay and not belonging to the clinical group of children with SCTs influences the functional characteristics of the maternal input. It is important to support the parents of children with SCTs during the communication process and later during their child's development, leading them to observe their children's manifested skills rather than looking for possible predicted difficulties. WHAT THIS PAPER ADDS: What is already known on the subject: Studies in the literature demonstrated how mothers can generally adapt their input to their child's characteristics. To our knowledge, only two recent studies analysed the maternal input addressed to children with SCT at 8 months of age, highlighting significant differences. What this paper adds to existing knowledge: The maternal input addressed to children with SCT at 24 months of age is not different from that addressed to TD children. At 24 months of age, the mothers adapt their input to the verbal competence shown by their child (weak lexical ability versus typically‐talking), while belonging to the clinical group does not show an influence. What are the potential or actual clinical implications of this work?: All the participants of the present study received prenatal diagnosis disclosure by an expert team of professionals, and they were all involved in a longitudinal study aimed at monitoring the children's development and supporting their parents. These results show that giving clear and complete information about possible development paths to parents of children with SCTs during diagnosis disclosure is crucial. Moreover, supporting the parents during the communication process and later during their child's development is fundamental, leading them to observe their children's manifested skills rather than looking for possible predicted difficulties. [ABSTRACT FROM AUTHOR]

Background and Objectives: Evidence suggests telehealth in speech and language therapy can enhance access to care, cost‐effectiveness and satisfaction. However, little is known about use of telehealth in the United Kingdom. Moreover, many assessments/outcome measures for aphasia have been tested for face‐to‐face administration only, posing challenges to reliable use within the telehealth context. We explored the experiences and views of speech and language therapists (SLTs) working with people with aphasia on using telehealth to conduct assessments/outcome measures, perceived barriers and facilitators in telehealth, and their priorities for research in telehealth aphasia assessment. Method: We explored views of UK SLTs through an online cross‐sectional survey (2021) delivered through the Qualtrics platform. The survey covered three main areas: (i) participant demographics; (ii) experience of using telehealth and doing telehealth assessments with people with aphasia post‐stroke during the COVID‐19 pandemic; and (iii) plans for telehealth post‐pandemic. Response formats included yes/no, multiple choice, 5‐point Likert scales and open‐ended text responses. The survey was expected to take no more than 10 min to complete. Survey data were analysed through descriptive statistics and content analysis of open‐ended questions. Results: One hundred twenty‐four SLTs responded to the survey. The majority (>80%) used telehealth during the COVID‐19 pandemic and >90% planned to continue to use telehealth in the future. The most used platforms were Zoom, Microsoft Teams and Attend Anywhere. Access to internet and telehealth platforms, and practical problems (e.g., difficulties sharing resources online, limited functionality of telehealth platforms for assessment) were common barriers. Therapists highlighted that training, resources and materials that assist the administration of assessments were important. Most participants responded that there was a need for existing measures to be tested for administration via telehealth (n = 68, 70.8%). Participants overall felt there was a need for online interactive assessments, more online resources that have been trialled for use via telehealth, accessible formats for resources for people with aphasia and clear instructions for how people with aphasia can access resources. Conclusions: This study provides new insights into the current use of telehealth assessment with people with aphasia in the United Kingdom and directions for future research. Barriers and facilitators identified can support the implementation of telehealth assessment in SLT services. WHAT THIS PAPER ADDS: What is already known on the subject: The use of telehealth in speech and language therapy has advantages in terms of access to care, cost‐effectiveness and satisfaction with care. However, little is known about the use of telehealth in aphasia rehabilitation in the United Kingdom, especially in the area of assessment and outcome measurement. What this paper adds to existing knowledge: This study identified that the majority (>80%) of aphasia therapists used telehealth during the COVID‐19 pandemic and >90% planned to continue to use telehealth in the future. A need was identified for existing measures to be tested for administration via telehealth and for training, resources (e.g., online interactive assessments) and materials (e.g., accessible formats for people with aphasia). What are the potential or actual clinical implications of this work?: To facilitate the successful implementation of telehealth assessment, there is a need for measures validated for use via telehealth and more online resources that have been trialled for use via telehealth. [ABSTRACT FROM AUTHOR]

Background: Pictures drawn by people with aphasia (PWA) are often more challenging to understand than those drawn by healthy people. There are two types of objects: those that tend to be drawn symbolically (symbolically drawn objects—SOs) and those that are likely to be drawn realistically (realistically drawn objects—ROs). Aims: To compare the identification rate and number of misunderstanding types between SOs and ROs drawn by PWA and healthy controls (HCs). To reveal trends in the misunderstandings of drawings by PWA, and to identify the language or cognitive abilities related to the identification rate of pictures drawn by PWA. Methods & Procedures: We designed a drawing task involving SOs and ROs. A total of 18 PWA and 30 HCs completed the task, and respondents identified the drawings. The identification rate and number of misunderstandings were analysed with two‐way analysis of variance (ANOVA) including group (PWA and HCs) and object type (SOs and ROs). The misunderstandings were divided into four categories varying in semantic and morphological similarity; these ratios were examined with a chi‐square test. The relationships of language and cognitive abilities with the identification rate were investigated with multiple regression analyses. Outcomes & Results: There was a significant effect of the interaction between group and object type on the identification rate (F(1.1387) = 3.90, Mean Squared Error (MSE) = 4139.67, p = 0.04): the identification rates for ROs were lower in the PWA than in the HCs. For the number of misunderstanding types, an interaction was observed between group and object type (F(1.56) = 8.26, MSE = 26.93, p < 0.01): the number of misunderstanding types for ROs in the PWA was greater than that in the HCs. The misunderstanding patterns differed between ROs and SOs (χ2(3) = 694.30, p < 0.001, V = 0.37). ROs were semantically related, whereas SOs were morphologically related. The identification rates of ROs and SOs were correlated only with Kanji writing scores (ROs: β = 3.66, p = 0.01; SOs: β = 6.57, p < 0.01). Conclusions & Implications: In drawings by the PWA, SOs had a higher identification rate, while ROs had a lower identification rate and a greater variety of misunderstandings. SOs may increase drawing motivation. Interventions to improve the identifiability of SOs and ROs should reflect each character. Identification rates were correlated only with Kanji writing scores. The PWA, whose native language was Japanese and had preserved Kanji writing abilities, and their communication abilities may be increased through drawing. WHAT THIS PAPER ADDS: What is already known on the subject: PWA often have impaired drawing abilities and draw pictures that third parties misinterpret. Some objects tend to be drawn symbolically, and some are drawn realistically. However, it is not clear whether there is a difference between these types of drawings depicted by PWA in identifiability and the tendency to be misunderstood by ordinary people. In addition, the relationships between language or cognitive abilities and the identification rate of drawn pictures are not clear. What this paper adds to the existing knowledge: The identification rate differed between SOs and ROs. In drawings by PWA, SOs had a higher identification rate, while ROs had a lower identification rate and the greatest variety of misunderstandings. Approximately half of the misunderstandings were related to the target object. SOs tended to be confused with morphologically related objects, while ROs tended to be confused with semantically related objects. Identification rates were correlated only with Kanji writing scores. What are the potential or actual clinical implications of this work?: To motivate PWA's drawing, it is suitable to begin with SOs. Examining drawing ability from the perspective of SOs and ROs increases the chance of identifying drawing ability. PWA whose native language is Japanese and have preserved Kanji writing abilities may be able to increase their communication abilities through drawing. [ABSTRACT FROM AUTHOR]

Background: Training parents to implement language and communication intervention strategies is an effective approach to promote language development for children with language delay. Aims: This study introduces an online parent training program conducted in Hubei province, China, which was designed to help parents of language‐delayed children with a diagnosis of autism spectrum disorder (ASD), developmental language disorder (DLD) or global developmental delay (GDD) apply language intervention strategies into daily interactions and promote their children's language development at home. Methods & Procedures: The Bethel Hearing and Speaking Training Center Family Training for Early Communication & Language Development (Bethel Family Training Program, BFT) (Bethel HSTC, 2020) was designed to improve the language and communication skills for children with language delay in a naturalistic way. The caregivers (including parents, grandparents and other main caregivers) participated in an 8‐h online program, including lectures on milestones in child language development, common misunderstandings of child language development, and three basic family language intervention strategies ('Looking together, playing together, and talking together') incorporating active learning through video analysis and discussion. Tongji Hospital in Hubei then continued with 3 months of online home intervention monitoring to all the caregivers via weekly online Q&As led by BFT certified speech therapists' team. The Gesell Developmental Schedules (GDS) was carried out before the online parent training program and after the 3‐month online home intervention monitoring. Outcomes & Results: 146 families whose children aged 12–68 months with language delay participated in the online training program. The results of the GDS assessments conducted before and after the program showed that not only did the developmental quotient (DQ) of language improve, but so did the DQ of social behaviour and adaptive behaviour (p < 0.001). There is no between‐group difference in the application of three strategies between the ASD group and the DLD or GDD group (p > 0.05). Furthermore, both caregivers' ability to apply 'looking together, playing together, talking together' strategies and the effective interaction time played important roles in improving the child's language abilities. Conclusion & Implications: The online parent training focusing on improving daily interaction with children through speech–language stimulation strategies promoted the development of language skills. It is an economic and practical approach for children with language delay who have limited access to local language intervention programs. WHAT THIS PAPER ADDS: What is already known on the subject: Parent‐implemented language intervention is an effective approach at improving children's language development. Telepractice is an appropriate model of service delivery for audiologists and speech–language therapists and may be the primary mode of service delivery or may supplement in‐person services. What this paper adds to the existing knowledge: This paper explores the effectiveness of an online parent training program and provides new evidence that online training on language support strategies (looking together, playing together, talking together) followed by home intervention monitoring works for Mandarin‐speaking children and it is equally effective for children with ASD and non‐ASD diagnosis. What are the potential or actual clinical implications of this work?: Developmental behavioural paediatricians and speech–language therapists in countries and areas that lack sufficient training resource for every child will have the option to deliver parent training and home intervention monitoring online, which will save time and cost considerably while offering convenience. [ABSTRACT FROM AUTHOR]

Wound analytics, infection detection, and oxygenation measurement are the three critical prerequisites for appropriate wound care. Although devices that rapidly detect the above‐mentioned parameters independently exist, there is no single point‐of‐care device that is enabled with all the three functionalities. Through this study, we are introducing and evaluating the performance of Illuminate Pro Max—a novel, rapid, hand‐held non‐contact, point‐of‐care multimodal imaging device that is equipped to measure the three wound assessment parameters. Here, a total of 60 diabetic foot ulcer patients were imaged using Illuminate Pro Max to detect bioburden and measure StO2 levels and wound dimensions (size and depth). The results were further evaluated against the current gold standard technique for each parameter, that is, culture test to detect bioburden, a transcutaneous oxygen pressure (TcPO2) measuring device—Perimed Periflux 5000 to measure oxygenation, and paper ruler to measure wound size. Culture tests reported 42 samples as infection‐positive and 18 samples as infection‐negative. On comparing with the culture report, the device showed 88% sensitivity and 86% PPV in detecting the bioburden. Wound dimensions (length and width) were comparable with the paper scale measurements. Wound depth was also reported by the device. The StO2 map generated by the device depicted the tissue oxygenation levels in various regions of the wound. In conclusion, this novel, comprehensive point‐of‐care multispectral imaging device can be an effective tool for rapid wound assessment which can help in prompt treatment. [ABSTRACT FROM AUTHOR]

Introduction: The real‐world mechanisms underlying prospective entrustment decision making (PEDM) by entrustment or clinical competency committees (E/CCCs) are poorly understood. To advance understanding in this area, the authors conducted a realist synthesis of the published literature to address the following research question: In E/CCC efforts to make defensible prospective entrustment decisions (PEDs), what works, for whom, under what circumstances and why? Methods: Realist work seeks to understand the contexts (C), mechanisms (M) and outcomes (O) that explain how and why things work (or do not). In the authors' study, contexts included individual E/CCC members, E/CCC structures and processes, and training programmes. The outcome (i.e. desired outcome) was a PED. Mechanisms were a substantial focus of the analysis and informed the core findings. To define a final corpus of 52 included papers, the authors searched four databases, screened all results from those searches and performed a full‐text review of a subset of screened papers. Data extraction focused on developing context–mechanism–outcome configurations from the papers, which were used to create a theory for how PEDM leads to PEDs. Results: PEDM is often driven by default (non‐deliberate) decision making rather than a deliberate process of deciding whether a trainee should be entrusted or not. When defaulting, some E/CCCs find red flags that sometimes lead to being more deliberate with decision making. E/CCCs that seek to be deliberate describe PEDM that can be effortful (when data are insufficient or incongruent) or effortless (when data are robust and tell a congruent story about a trainee). Both information about trainee trustworthiness and the sufficiency of data about trainee performance influence PEDM. Several moderators influence what is considered to be sufficient data, how trustworthiness data are viewed and how PEDM is carried out. These include perceived consequences and associated risks, E/CCC member trust propensity, E/CCC member personal knowledge of and experience with trainees and E/CCC structures and processes. Discussion: PEDM is rarely deliberate but should be. Data about trainee trustworthiness are foundational to making PEDs. Bias, equity and fairness are nearly absent from the papers in this synthesis, and future efforts must seek to advance understanding and practice regarding the roles of bias, equity and fairness in PEDM. Entrustment decisions made by committees are rarely deliberate, but should be. These authors provide practical advice, based in the literature, for improvement. [ABSTRACT FROM AUTHOR]

Background: Previous systematic reviews of the relationships of people with intellectual disabilities have included consideration of intimate relationships. In this paper, we report a systematic review of papers describing friendship only. Method: A systematic qualitative meta‐synthesis of the research exploring experiences of friendship as reported by people with intellectual disabilities. Results: Seven papers met the inclusion criteria for analysis. Three superordinate themes were identified. (1) Reciprocity, 'Someone who helps me, and I help them'. (2) The building blocks of friendships, 'I can tell her some secrets'. (3) Managing friendship difficulties, 'In real life it's much harder'. Conclusion: People with intellectual disabilities value friendship and actively engage in reciprocal exchanges. We explore the strengths and limitations of current research, clinical implications, and directions for future research. [ABSTRACT FROM AUTHOR]

Severe acute malnutrition (SAM) remains a major global public health problem. SAM cases are treated using ready‐to‐use therapeutic food (RUTF) at a dosage of ∼200 kcal/kg/day per the standard treatment protocol (STD). Emerging evidence on simplifications to the standard protocol, which among other adaptations, includes reducing the daily RUTF dosage, indicates that it is effective and safe for treating children with SAM. In response to a foreseen stock shortage of RUTF, the government of Afghanistan endorsed the temporary use of a modified treatment protocol in which the daily RUTF dosage was prescribed at 1000 kcal/day (irrespective of body weight) until the child achieved moderate acute malnutrition status (weight‐for‐height z‐score ≥ −3 or mid‐upper arm circumference [MUAC] ≥ 115 mm), at which point 500 kcal/day was prescribed until cured (modified treatment protocol [MTP]). In this paper, we report the results of this nonweight‐based daily RUTF dosage experience. Data of 2042 children with SAM, treated using either the STD protocol (n = 269) or the MTP protocol (n = 1773) from August 2019 to March 2021 in five provinces, were analyzed. The per‐protocol analyses confirmed noninferiority of MTP protocol when compared to STD protocol for recovery rate [93.3% vs. 90.2%; ∆ (95% confidence interval, CI) = 3.1 (−0.9; 7.2) %] and length‐of‐stay [82.6 vs. 75.6 days; ∆ (95% CI) = 6.9 (3.3; 10.5) days], considering the margin of noninferiority of −10% and +14 days, respectively. Weight gain velocity was smaller in the MTP protocol group than in the STD protocol group [3.7 (1.7) vs. 5.2 (2.9) g/kg/day; ∆ (95% CI) = −1.5 (−1.8, −1.2); p < 0.001]. The STD group had a significantly higher mean than the MTP group for absolute MUAC gain [∆ (95% CI) = 1.7 (1.0; 2.3) mm; p < 0.001] and the MUAC velocity [∆ (95% CI) = 0.29 (0.20; 0.37) mm/week; p < 0.001]. Our results confirm the noninferiority of a nonweight‐based daily dosage and support the endorsement of this modification as an alternative to the standard protocol in resource‐constrained contexts. Key messages: More evidence supporting the use of the nonweight‐based daily ready‐to‐use therapeutic food (RUTF) dosage for treating uncomplicated severe acute malnutrition (SAM), in specific contexts, is needed.Our real‐world prospective nonrandomized study showed that the fixed nonweight‐based daily RUTF dosage protocol is as effective as the standard weight‐based protocol for treating uncomplicated SAM in children <5 in the Afghanistan context.Our findings support the reflection of a nonweight‐based daily RUTF dosage in resource‐constrained contexts in national and global policies and guidelines to improve coverage of all children in need of treatment. [ABSTRACT FROM AUTHOR]

Understanding the drivers of improvements in child undernutrition at only the national level can mask subnational differences. This paper aimed to understand the contributions of factors in the enabling environment to observed differences in stunting reduction between districts in Rwanda. In 2017, we conducted 58 semi‐structured interviews with mid‐level actors (n = 38) and frontline workers (n = 20) implementing Rwanda's multi‐sectoral nutrition policy in five districts in which stunting decreased (reduced districts) and five where it increased or stagnated (non‐reduced districts) based on Rwanda's 2010 and 2014/15 Demographic and Health Surveys. Mid‐level actors are government officials and service providers at the subnational level who represent the frontline of government policy. Interviews focused on political commitment to and policy coherence in nutrition, and contributors to nutrition changes. Responses were coded to capture themes on the changes and challenges of these topics and compared between reduced and non‐reduced districts. Descriptive statistics described district characteristics. Political commitment to nutrition was high in both reduced and non‐reduced districts. Respondents from reduced districts were more likely to define commitment to nutrition as an optimal implementation of policy, whereas those from non‐reduced districts focused more on financial commitment. Regarding coherence, respondents from reduced compared to non‐reduced districts were more likely to report the optimal implementation of multi‐sectoral nutrition planning meetings, using data to assess plans and progress in nutrition outcomes and integration of nutrition into the agriculture sector. In contrast, respondents from non‐reduced districts more often reported challenges in their relationships with national‐level stakeholders and nutrition and/or monitoring and evaluation capacities. Enhancing the integration of nutrition in different sectors and improving mid‐level actors' capacity to plan and advocate for nutrition programming may contribute to reductions in stunting. Key messages: Understanding the lens through which policy implementers at subnational levels view multi‐sectoral nutrition strategies and their role in these strategies provides useful information on the facilitators and constraints of implementation for nutrition actions.Differences in leadership and responsiveness to prioritise nutrition at the subnational levels are important in decentralised governance systems where responsibilities in nutrition planning, coordination and implementation shift to mid‐level actors.Mainstreaming nutrition responsibilities across sectors and administrative levels requires investments in capacities to plan, monitor and advocate for multi‐sectoral nutrition programming, including for mid‐level actors. [ABSTRACT FROM AUTHOR]

Introduction: Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. The purpose of this paper is to review these recommendations and the Australian Government's policy responses and explore the emerging changes in allied health service provision in residential aged care. Methods: Data from the four available Quarterly Financial Reports from the 2022–2023 financial year were extracted and analysed in relation to staff costs and time per person per day across personal care, nursing, and allied health workers. Supplementary data sources including the 2020 Aged Care Workforce Census were accessed to provide contextual data relating to individual allied health professions, including occupational therapy. Results: The analysis shows a modest increase in median registered nurse minutes per person per day, and cost per person per day, from the first to second quarter, and again in the third and fourth. By contrast, median time and cost for allied health declined. From 5.6 minutes per person per day in the first quarter, reported allied health minutes fell to 4.6 minutes per person per day in the second quarter, an 18% decrease, and by the fourth quarter was 4.3 minutes per person per day. This is just over half the Australian average of 8 minutes reported to the RCACQS in 2019. Conclusion: Under recent residential aged care reforms, aged care providers have regulatory incentives to concentrate their financial resources on meeting the mandated care hours for registered nurses, enrolled nurses, personal care workers, and assistants in nursing. These same reforms do not mandate minutes of allied health services. Although providers of residential aged care in Australia continue to employ and value allied health, we argue that mandating care minutes for personal and nursing care without mandating the provision of allied health creates a perverse incentive whereby access to allied health services is unintentionally reduced. PLAIN LANGUAGE SUMMARY: Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. In this paper, we argue that despite the positive intentions of some of the reforms following the Royal Commission, there have been unintended consequences that have reduced the spending on allied health in residential aged care and reduced the minutes residents receive of allied health. Consideration to mandating allied health care minutes in residential aged care should be considered. [ABSTRACT FROM AUTHOR]

Background Study: Virtual reality (VR) is becoming a popular technology for safety training in construction. Several VR training prototypes have been designed and tested, which show they can perform better than traditional training tools. However, most of these existing tools are not underpinned by clear pedagogical theory, and studies assessing the impact of pedagogical theories on the effectiveness of VR prototypes are still rare in the literature. Objectives: This study aims to investigate if and how the productive failure theory and the directive instruction theory have an impact on the effectiveness of VR safety training for confined space workers. Methods: The study used a randomized controlled method involving 74 participants. The effectiveness of these two training methods was assessed in terms of knowledge acquisition and retention. Results and Conclusions: The results illustrate that the productive failure training design performed better in terms of knowledge acquisition and retention. This paper introduces the Productive Failure Theory and shows the great potential of this approach for self‐service VR safety training in the field of construction. Lay Description: What is already known about this topic: PF has been proven effective in classroom‐based teaching practice.PF has been proven effective in non‐immersive virtual training.DI is a commonly used pedagogical method for VR training. What this paper adds: The present paper investigates the feasibility of applying PF theory in VR safety training.The present paper examines the pedagogical impacts of the two pedagogical approaches within VR serious games. Implications for practice and/or policy: PF can be applied to self‐help VR safety training, reducing the demand for resources such as teaching staff and venues.PF training design performed better in terms of knowledge acquisition and retention.PF has great potential for self‐help VR safety training in various fields. [ABSTRACT FROM AUTHOR]

Background: Virtual reality (VR) offers much potential for learning, but it challenges learners' orientation. Objectives: This paper investigates whether it is possible to use light or movement cues to facilitate orientation in a search task in a desktop‐VR environment so that participants can better attend to the learning content presented simultaneously. Methods: In two pre‐registered online experiments, we investigated the effects of cueing (light and movement) on search time, learning, and several evaluation variables. Participants were asked to find tools in a virtual workshop, while information about the respective tool was narrated. Experiment 1 (N = 60) used a within‐subject design, that is, the objects were alternately highlighted by light, movement or not. For Experiment 2 (N = 159) the narration was substantially shortened, and a between‐subject design was used. Cognitive load and presence were measured additionally. Results and conclusions: In Experiment 1, only the movement cue decreased search time, indicating automatic guidance of learners' attention. There was no effect of cueing on learning, which may be due to the average search time being substantially shorter than the narration, leaving sufficient time to attend to the narration exclusively. In Experiment 2 search times were significantly faster for both cueing methods, but only the light cue resulted in better learning outcomes, which could be explained by the slightly lower presence in the movement cue condition. Implications: Results imply that it is important to develop cues that automatically guide attention without reducing presence. Lay Description: What is already known about this topic: Virtual reality (VR) offers a lot of opportunities for the integration of educational scenarios.VR is challenging for learners with regard to orientation in a 360° environment.Regarding learning outcomes, research on the effects of cues to highlight important content in a 360° environment is still rare.Presence, defined as the feeling of being there in a VR environment, is an important prerequisite for learning in VR. What this paper adds: The influence of light and movement cues on search times and learning outcomes in a desktop‐VR environment was tested.Movement cues can reliably reduce search times (indicating successful orientation), whereas light cues only reduced search times in predictable scenarios.In a predictable scenario, light cues enhanced learning outcomes compared with movement cues.Movement cues reduced presence, which is one potential reason why movement cues did not improve learning. Implications for practice and/or policy: Using light cues might assist orientation and enhance overall performance in predictable scenarios (i.e., when learners know what kind of cue to expect).In an unpredictable setting with variable cues, light cues did not facilitate orientation, whereas movement cues did.However, movement cues reduced presence, which may have negatively affected learning outcomes. It is important to develop cueing methods that also work in more unpredictable settings, but that do not reduce presence. [ABSTRACT FROM AUTHOR]