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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]

Background: Although existing studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and music therapy have advantages in the treatment of non‐fluent aphasia, the efficacy of the combination of these two methods remains to be investigated. Aims: To investigate the clinical efficacy of low‐frequency rTMS combined with music therapy on language function and depression in patients with non‐fluent aphasia after stroke. Methods & Procedures: A single‐blind parallel randomised controlled trial was conducted. Sixty patients (mean duration = 93.78 days) with non‐fluent aphasia after stroke were randomly divided into a traditional therapy group (n = 20), a music therapy group (n = 20) and a combined therapy group (n = 20, 1 Hz). The language function and depression were evaluated before and 3 weeks after treatment with the Chinese version of the Western Aphasia Battery scale, Boston Diagnostic Aphasia Examination scale and Stroke Aphasic Depression Questionnaire Hospital Version scale. Outcomes & Results: The combined therapy group was significantly better in all outcomes than the traditional therapy group and was significantly better in depression than the music therapy group. The music therapy group was significantly better in repetition and depression than the traditional therapy group. Language improvement was positively correlated with depression improvement. For adverse events, only two patients in the combined therapy group showed slight dizziness during rTMS treatment and their symptoms improved after rest. Conclusions & Implications: Our preliminary randomised controlled study indicates that low‐frequency rTMS combined with music therapy is feasible and safe in improving language function and depression in non‐fluent aphasia patients after stroke. WHAT THIS PAPER ADDS: What is already known on this subject: Repetitive transcranial magnetic stimulation (rTMS) and music therapy respectively have advantages in the treatment of non‐fluent aphasia after stroke, but whether the combination of the two methods is more effective is still unknown. What this paper adds to the existing knowledge: This is one of the first randomised control trials to investigate whether the clinical efficacy of low‐frequency rTMS combined music therapy for non‐fluent aphasia is better. The findings show that low‐frequency rTMS combined music therapy is superior to traditional therapy in spontaneous speech, auditory comprehension, repetition, naming, aphasia quotient, functional language level and depression, and superior to music therapy in depression, while music therapy is superior to traditional therapy in repetition and depression. What are the potential or actual clinical implications of this work?: Low‐frequency rTMS combined music therapy may be a better method for treatment of non‐fluent aphasia. [ABSTRACT FROM AUTHOR]

Background Studies: Captioning and repetition are widely used multimedia instructional devices for non‐native students. Generally, studies in this area have tended to focus on second language literacy skills rather than on learning new content knowledge. Additionally, posttests were administered immediately after the treatments, while the delayed influences of captioning and repetition have never been investigated. Objectives: This paper addressed these research gaps in two separate studies. More specifically, this study attempted to examine the influences of captioning and repetition on non‐native students' immediate and relayed retention. Methods: In Study One, three captioning conditions; word‐by‐word captions, closed captions, and no‐captions; were compared to examine their efficacies in immediate and delayed content knowledge retention on 82 Chinese university students. To address the limitations in Study One as the multimedia lesson was short and played only once, Study Two incorporated captioning and two repetition types in its design. One hundred and eleven Chinese university students watch a video lesson in one of four captioning and repetition conditions. Results: The statistical analyses of Study One indicated that there were no significant differences in both immediate and delayed retention test scores across the three captioning condition. Similarly, in Study Two, there were no significant differences in retention tests scores across the four captioning and repetition conditions. Findings: Neither the availability of captions nor the repetition types had any impact on the Chinese students' immediate or delayed content knowledge retention, which lent support to existing studies. Based on the research results, the limitations and future study possibilities are discussed. Lay Description: What Is Already Known About This TopicEmpirical studies on captioning have focused on immediate learning right after the treatment, so have studies on repetition.Empirical studies on multimedia lessons for non‐native students have focused on English language learning. What This Paper AddsThree types of captioning were compared to examine their efficacies in both immediate and delayed content retention of Chinese students.Two types of repetition were compared to examine their efficacies in both immediate and delayed content retention of Chinese students. Implications for Practice and/or Policy:Neither the availability of captions nor the repetition types had any impact on the Chinese students' immediate or delayed content knowledge retention.The availability of textual keywords adjacent to their corresponding graphics might have compromised the efficacy of captioning. [ABSTRACT FROM AUTHOR]

Background: Data literacy (DL) is vital for teachers, as it enables them to build on data and improve teaching and learning. Therefore, developing DL among pre‐service teachers is critical. Objectives: The purpose of this study is threefold: to evaluate whether a feedback visualisation of peer assessment‐based teaching approach (FVPA‐based teaching approach) can (1) promote pre‐service teachers' DL; (2) enhance their learning motivation; and (3) improve their cognitive load. Methods: The research was conducted based on a pre‐test‐post‐test control group quasi‐experimental design. With 20 participants in the experimental group and 21 in the control group, a total of 41 pre‐service teachers were included in the study. The pre‐service teachers in the experimental group adopted the FVPA‐based teaching approach, and those in the control group adopted the traditional peer assessment‐based learning approach. Results and Conclusions: The experimental group participants outperformed the control group participants in DL, learning motivation, and cognitive load. FVPA was conducive to helping pre‐service teachers critically interpret data, understand their teaching and learning issues, and improve self‐reflection. The findings indicate a reciprocal relationship between learning motivation and DL; improving the learning motivation of pre‐service teachers could promote their DL. Implications: This study contributes to current knowledge by providing empirical evidence on the benefits of an FVPA‐based teaching approach in improving pre‐service teachers' DL, motivation, and cognitive load. The study findings, limitations, and prospects for future research are discussed. Lay Description: What is already known about this topic?: Teacher data literacy has emerged as a crucial competency for the forthcoming generation of educators, gaining attention from education institutions globally.Peer assessment, a well‐established practice in pre‐service teacher education, has proven effective in enhancing the learning experience for disadvantaged students by fostering motivation and improving academic performance.Despite the acknowledged benefits of feedback visualisation in facilitating self‐reflection, motivation, and academic performance, creating meaningful visualisations remains a challenge for educators and learners. What this paper adds?: This study introduces feedback visualisation in peer assessment to enhance comprehension of feedback information among pre‐service teachers.Feedback visualisation augments the benefits derived from peer assessment, refining data literacy, improving learning motivation, and alleviating cognitive load among pre‐service educators.The analysis of data directly relevant to pre‐service teachers and the provision of timely feedback can motivate critical analysis and utilisation of data, facilitating the identification of pedagogical and learning challenges.The study explores intricate interactions among learning motivation, data literacy, and cognitive load within the context of peer assessment visual feedback. The implications of study findings for practitioners: We encourage teacher educators to implement peer assessment instruction grounded in visual feedback for a comprehensive understanding of learning outcomes, identification of pedagogical challenges, determination of causes, and evidence‐informed instructional decision‐making.Teacher educator should diversify strategies to augment the motivation of pre‐service teachers, cultivating their proactive engagement in data analysis, interpretation, and application to enhance overall data literacy.We recommend that teacher educators provide rich visual feedback or present complex data in a visually accessible format for pre‐service teachers who need additional assistance to mitigate cognitive load and facilitate successful learning outcomes. [ABSTRACT FROM AUTHOR]

Background: Limited research on the effectiveness of additional online and face‐to‐face practise opportunities for promoting active learning among Chinese EFL learners in higher education. Current understanding of self‐regulated and collaborative learning theories in educational contexts. Objectives: To establish the efficacy of interactive online and face‐to‐face practise opportunities for enhancing active learning among Chinese EFL learners. Methods: Employed mixed methods research to assess the impact of different types of practise opportunities on 116 EFL learners. Utilised methodological triangulation of QUAN + QUAL data and one‐way ANOVA for interpretation. Results and conclusions: The study demonstrated the effectiveness of integrating online and face‐to‐face practise opportunities to enhance active learning. Empirical evidence supports the pedagogical and theoretical benefits of these opportunities for promoting active learning among EFL learners. Lay Summary: What is currently known about this topic: Limited scholarly exploration of supplementary practise opportunities for active learning among Chinese EFL learnersExisting understanding of self‐regulated and collaborative learning theories in educational contexts What does this paper add: Establishes the effectiveness of interactive online and face‐to‐face practise opportunities for promoting active learningProvides empirical evidence supporting the integration of these opportunities to enhance active learning Implications for practise/or policy: Advocates for the combined use of online and face‐to‐face practise opportunities to enrich engagement, problem‐solving, feedback, and motivation among EFL learnersSuggests the development of instructional frameworks based on self‐regulated and collaborative learning theories for enhanced CALL courses [ABSTRACT FROM AUTHOR]

Background: As adequate support, virtual reality (VR) has been increasingly introduced into the classroom to help students learn a new language. However, empirical studies exploring the educational potential of using 360° spherical video‐based virtual reality (SVVR) in high‐school Chinese language classrooms are still lacking. Objectives: A mind mapping‐based SVVR learning system is proposed for international high‐school students' Chinese courses and examines its effects on improving Chinese learning achievements and perceptions among Grade 10 students who learn Chinese as a foreign language. Methods: This study adopted a quasi‐experiment design. Participants (N = 66) were assigned to one of three conditions: mind mapping‐based SVVR (MMBSVVR), conventional SVVR (CSVVR), or traditional lecturing (TL). Our mixed‐method approach employed pre‐and post‐tests to measure Chinese learning achievements, questionnaires to measure Chinese learning motivation, problem‐solving ability, and self‐efficacy, and semi‐structured interviews to further explore students' feelings and attitudes about Chinese courses in corresponding learning environments. Results and Conclusions: The results showed that the MMBSVVR classroom significantly improved high students' Chinese learning achievements in Chinese vocabulary and making sentence, problem‐solving ability, and self‐efficacy. Moreover, SVVR stimulates students' learning interest and class participation, and mind mapping provides students with a clear guide to arrange the knowledge. These findings help interpret the relationships between MMBSVVR and learning achievements, Chinese learning motivation, problem‐solving ability, and self‐efficacy in an international high school Chinese courses, thus providing insight on integrating MMBSVVR into existing classrooms. Lay Description: What is Already Known about this Topic: By creating fully immersive 3D environments, 360° spherical video‐based virtual reality (SVVR) in promoting language learning has been confirmed by many scholars with a focus on English language learning.Mind mapping effectively enables second language learners to review and retain new words in the target language meaningfully. Also, it can create a more vivid learning atmosphere through images and graphics and promote learners' memory and learning motivation. What This Paper Adds: A mind mapping‐based SVVR learning system has been developed with the support of the constructivism theory.A mind mapping‐based SVVR learning system is proposed to facilitate international students' Chinese learning performance in Chinese vocabulary acquisition and sentence construction.In addition to promoting international students' learning outcomes, the proposed approach indicated promising results in learning motivation, problem‐solving ability, and self‐efficacy. Implications for Practice and/or Policy: This study provides an evidence base for further research through the utilization of VR learning environments in Chinese language classrooms.This study advocates introducing SVVR technology in the Chinese learning classrooms to increase the learning context for international students. It is also worth encouraging scholars to design VR learning systems with different learning strategies.Due to the cognitive requirements of the Chinese language learning process, it is necessary to introduce mind maps in the SVVR learning system to assist students in constructing knowledge and combining prior and new knowledge to generate long‐term memory. [ABSTRACT FROM AUTHOR]

Background Study: The effects of the flipped classroom (FC) on students' academic performance remain ambiguous, and the use of pre‐class videos may be one of the main factors hindering students' progress. A software package called GeoGebra has been proposed as a substitute for pre‐class videos to aid students' learning. Objective: This study investigates the effect of the FC using GeoGebra (FCG) on mathematical performance and memory among senior secondary students. Methods: One hundred and sixty students of a senior high school in China were selected. A quasi‐experimental design was implemented in which the classes were split into the intervention group (FCG), control group A (FCV) and control group B (TL) by random assignment. Pretest, Post‐test 1 and Post‐test 2 were introduced. Results and Conclusion: The results indicate that both the FCG and the FC with pre‐class videos (FCV) were more effective than traditional lectures in enhancing students' academic test scores, and that the effect of the FCG was comparable to its video counterpart, F(2, 136) = 3.752, ρ = 0.026, η2 = 0.052. Although their effects were similar, the qualitative results revealed some hidden benefits associated with the replacement of pre‐class video with GeoGebra. Furthermore, although they were equally effective in promoting students' performance in the short‐term, the long‐term effects on academic performance of both forms of FC were non‐significant when compared with traditional lectures. Lay Description: What is already known about this topic: Flipped classroom is an effective strategy in teaching mathematics.Among those challenges, video may be one of the main factors hindering the effect of flipped classroom. What this paper adds: GeoGebra could be an effective alternative to video.Effect between the flipped classroom using GeoGebra and the flipped classroom using video were similar.Both the flipped classroom with GeoGebra and the flipped classroom with videos were more effective than traditional lectures. Implications for practice and/or policy: Students' short‐term performance could be enhanced by visualisation provided by flipped classroom.To enhance students' long‐term performance, an appropriate amount of homework is suggested. [ABSTRACT FROM AUTHOR]

Background Study: As flipped learning is a flexible pedagogical methodology to tailor students' needs and maximize the learning effects, this study integrated peer learning with MosoTeach‐supported flipped mode in an undergraduate blended EFL course. MosoTeach is a popular online learning platform in China with a variety of learning resources. Objectives: The study aimed to test the impact of MosoTeach flipped learning (MTFL) mode on undergraduate EFL students' perceived motivation, participation, feedback, and test performance. Methods: A quasi‐experimental design was carried out in Z university during the spring semester of 2020, with the experimental group (n = 34) adopting the MTFL model and a control group (n = 33) the non‐flipped mode. Results and Conclusions: The independent t‐test results showed that the experimental MTFL group outperformed the control group in post‐test scores, and a positive correlation was found in the relationship between the experimental MTFL group's post‐test scores and MosoTeach learning experience points (LEPs). Moreover, the course perception questionnaire survey indicated a higher level of students' perceived motivation, participation, and feedback in the experimental MTFL group, which corresponded to the results of the content analysis of students' responses to open‐ended questions and reflective reports. But students in both groups experienced challenges such as isolation, procrastination and technological anxiety. Lay Description: What is currently known about this topicFlipped language learning is mostly reported to be effective in improving EFL learning.Peer learning is mostly reported to be effective in improving EFL learning.MosoTeach was investigated in English learning contexts before, but without experimental design. What this paper addsMosoTeach proved as a valid online learning platform in flipped language learning, and the learning experience points (LEPs) on MosoTeach could predict students' exam performance.Students in the experimental group (MosoTeach‐supported flipped) had better exam performance and a higher level of motivation, participation and feedback.Students in both groups experienced isolation, procrastination and technological anxiety. Implications for practice:Peer discussion boards in MosoTeach provide learning support effectively for students in pre‐class learning.Group projects and peer assessment in MosoTeach integrate pre‐class peer discussion into in‐class interaction successfully.MosoTeach provides equal opportunity for every student in the large‐size Chinese English classes, thus contributing to the equity of in‐class peer interactions. [ABSTRACT FROM AUTHOR]

Background: Video lectures which include the instructor's presence are becoming increasingly popular. Presenting a real human does, however, entail higher financial and time costs in making videos, and one innovative approach to reduce costs has been to generate a virtual speaking instructor. Objectives: The current study examined whether the use of a virtual instructor in video lectures would facilitate learning as well as a human instructor, and whether manipulating the virtual instructor's characteristics (i.e., voice and appearance) might optimize the effectiveness of the virtual instructor. Methods: Our study set four conditions. In the control condition, students watched a human instructor. In the experiment conditions, students watched one of (a) a virtual instructor which used the human instructor's voice and an AI image, (b) a virtual instructor which spoke in an AI voice with an AI image made to speak using text‐to‐speech and lip synthesis techniques, or (c) a virtual instructor with used an AI voice and an AI likable‐image of an instructor. Results and Conclusions: The AI likable instructor condition had a significant positive effect on students' learning performance and motivation, without decreasing the attention students paid to the learning materials. Implications: Our findings suggest that instructional video designers can make use of AI voices and AI images of likable humans as instructors to motivate students and enhance their learning performance. Lay Description: What is already known about this topic: Video lectures which include the instructor's presence are becoming increasingly popular.Presenting a virtual instructor (i.e., a pedagogical agent) in video lectures has been shown to reduce costs of video production, both financially and in terms of time. What this paper adds: An AI‐generated voice and an AI‐generated image facilitated more students' transfer performance than a human instructor.The AI likable instructor condition had a significant positive effect on students' learning performance and motivation, without decreasing the attention students paid to the learning materials. Implications for practice and/or policy: We encourage instructional designers to use AI‐generated voices and AI‐generated images connected to a virtual instructor instead of a human instructor in video lectures.We encourage instructional designers to use likable human images (as defined by the students themselves) as a way to motivate students more and enhance their learning performance. [ABSTRACT FROM AUTHOR]

With the advent of mobile technologies, well‐designed fraction apps can be used to help children gain fraction knowledge, a challenging topic for both teachers and students. The present pilot study adopted a quasi‐experimental design to investigate whether children can learn fraction concepts equally well if half of the lesson time (20 min) is replaced with game‐based learning. Keeping the total lesson time (40 min) identical, the control group (N = 33) received traditional instruction, and the experimental group (N = 32) was presented with a blended learning approach spending half of the class time (20 min) playing tablet‐based fraction games, where each of the learners had their own tablet. The results suggested that in the posttest, the experimental group achieved similar learning gains to the control group and appear to have achieved better performance in the transfer test than the control group. This paper also discusses the efficiency of game‐based learning, the mechanism of how fraction games might enhance learning, and the potential of integrating game‐based learning in educational settings. Lay Description: What is already known about this topicAs a significant mathematical concept in daily life, fractions are crucial for later success in math learning.As a promising new technology, educational games show a great potential for improving learning.Well‐designed fraction apps can be used to help children gain fraction knowledge.What this paper addsGame‐based fraction learning can be combined with formal learning in school education.Game‐based fraction learning might provide a more efficient approach to increasing students' conceptual knowledge of fractions.The result showed that the experimental group achieved a similar cognitive level as the control group although they spent half of the time playing a game, suggesting that children can gain knowledge from the experiences of playing games.What are the implications for practice and/or policyThe result suggests that the proper use of educational games in teaching fractions can make learning more efficient.Further research needs to be done to determine whether the fraction understanding gained through playing these games will have an impact on students' future learning of more complicated fraction concepts. [ABSTRACT FROM AUTHOR]

Background: Socially shared regulation is a vital factor that affects students' collaborative programming performance. However, students' weak group metacognitive skills or inability to adopt shared regulation mechanisms lead to unsatisfactory collaborative programming learning. Objectives: This study proposes an approach to support socially shared regulation in collaborative programming learning in order to enhance students' programming achievements and group metacognition. Methods: A quasi‐experimental study was conducted in a junior high school over a 10‐week period to investigate the impact of the proposed approach on programming achievements, group metacognition, and cognitive load. Forty eighth‐grade students participated in the study, with the experimental group learning via the proposed approach, while the control group used the conventional collaborative programming learning approach. Results and Conclusions: The analysis included data from 38 participants. The experimental results showed that the programming achievements and group metacognition of the experimental group were significantly better than those of the control group. Additionally, the proposed approach did not increase the cognitive load of the students. Implications: This study has important implications for teachers, learners, and researchers in collaborative programming and social regulation. Our proposed collaborative programming learning approach enhances learners' social regulation and performance, providing teachers with an effective tool for improving collaborative programming learning. This study also extends the field of socially shared regulation of learning (SSRL), demonstrating its potential to improve the effectiveness of collaborative programming learning and highlighting the need for future research to explore the mechanisms of SSRL in this context. Lay Description: What is already known about this topic?: Programming learning is difficult for most learners.Collaborative programming is an effective method of programming learning.Students' weak group metacognitive skills or inability to adopt shared regulation mechanisms lead to unsatisfactory collaborative programming learning. What this paper adds?: This study proposes a method to enhance collaborative programming learning by supporting socially shared regulation among students.The study utilized a quasi‐experimental to demonstrate the effectiveness of the approach in improving students' programming learning performance.The shared regulation approach was found to significantly improve students' programming achievements and group metacognition when compared to conventional collaborative programming approaches.Importantly, the shared regulation approach did not increase the cognitive load of the students, indicating its potential for practical implementation in programming education. The implications of study findings for practitioners: This study has shown that an approach that supports social shared regulation can improve student performance in collaborative programming learning, and that teachers can use this approach to help students learn programming better collaboratively.This study also contributes to the field of social shared regulated learning by demonstrating how it can support collaborative programming and improve its effectiveness. [ABSTRACT FROM AUTHOR]

Background: Computational thinking (CT) has become a crucial skill for individuals in the 21st century, and while more educators are starting to recognize the importance of CT education, there is still a lack of research on how to teach young children CT, particularly outside of traditional school settings. Objectives: To fill the gap in knowledge, we aimed to investigate the effectiveness of a web‐based parent education program on improving children's CT skills. Additionally, we sought to determine if children's age, gender and family socioeconomic status had any impact on the development of CT skills. Methods: We selected 86 adult–child pairs in the K3 age group to participate in a 4‐week intervention program using a quasi‐experimental approach. Results: After 4 weeks, children in the intervention group had improved their CT skills more than their peers in the control group. This shows that the intervention was successful in enhancing children's CT skills. Age had a moderating effect on CT enhancement, with older children showing a more significant improvement than younger children. However, children's gender and family socioeconomic status did not have any moderating effects. Conclusions: These results demonstrate that CT education can be effectively implemented in the home setting through web‐mediated parent education. Encouraging the use of unplugged CT activities at home can aid children in acquiring CT skills. Lay Description: What is already known about this topic: Computational thinking (CT) education can be started at the early childhood stage.Both plugged‐in and unplugged activities can promote children's CT.Unplugged activities have many advantages and are suitable for young children. What this paper adds: Web‐mediated parent education is useful for equipping parents with the knowledge and skills to conduct CT activities at home.CT education has a positive effect on children in the home setting.Parents play an important leading role in children's CT education.Parent–child unplugged activities are beneficial to children's CT enhancement. Implications for practice and/or policy: A web‐mediated approach is an appropriate way to encourage parent participation in CT training.CT‐related parent education should be scaled up so that parents can play an active educational role at home.Unplugged CT activities should be designed more for the home settings in addition to school settings. [ABSTRACT FROM AUTHOR]

Over the past decade, the call to foster computational thinking (CT) in every child has received considerable attention. However, there is little understanding of whether children are developmentally ready to think computationally and what specific CT concepts and skills can be developed at various ages. This study explored the developmental and gender differences in CT skills of 197 Grade 4–6 students (aged 9–13) before being exposed to instruction and investigated the age–gender interaction effects on their CT acquisition in an intervention combining both programming and non‐programming (unplugged) activities. Results show that students' CT skills followed a developmental progression before instruction. Gender difference across ages was insignificant in conditionals, logical operators, pattern recognition and generalization skills. Additionally, students of different ages developed CT differently during the intervention, and their CT acquisition was unaffected by gender. Implications for practice and research in CT education were discussed. Lay Description: What is currently known about the topic: Learning progressions for computational thinking have been defined in K‐12 curricula globally.Engaging in programming and non‐programming (unplugged) activities can increase students' CT skills.Controversial results have been reported on the age–gender interaction effects on CT development.Lack of understanding on children's actual progressive development of CT. What this paper adds: A developmental progression was found in CT skills of students aged 9–13. Students aged 12 and above had some a priori understanding of CT.No gender difference across ages existed in conditionals, logical operators, pattern recognition and generalization skills before instruction.Students aged 9–11 benefitted the most from an intervention combining both programming and unplugged activities compared to older students. Students' CT acquisition in the intervention was unaffected by gender.Given the intervention, students aged 9 and above developed conditionals, logical operators and pattern recognition skills. However, generalization skill was developed only for students aged 12 and above. Implications for practice and policy: The findings lay the foundation for designing evidence‐based age‐appropriate CT learning progression and pedagogies.Age‐appropriate learning content: Given appropriate learning experiences, students aged 9 and above may be ready to learn certain CT concepts and skills, including conditionals, logical operators and pattern recognition.CT pedagogies: Using programming and unplugged activities to develop CT requires careful consideration of students' cognitive development and gender needs. [ABSTRACT FROM AUTHOR]

In the increasing pervasiveness of today's digital society, mobile devices are changing the face of education. Students can interact with mobile devices in context‐aware environment. This paper presents a mobile application based on expert system (Plant‐E) for students to acquire knowledge about plant classification by answering decision‐making questions. In order to study effectiveness of Plant‐E and cognitive load of students who experience different kinds of interaction in learning process, another mobile application (Plant‐G) only providing information pages of plants was developed. A quasi‐experiment was conducted with three classes of 137 seventh graders. The three classes, Class A with 46 students using Plant‐E in campus, Class B with 44 students using Plant‐G in campus, and Class C with 47 students using Plant‐G in a traditional classroom, constitute three groups with different interaction complexity. The research conducted pretest, posttest, and delayed test to evaluate learning performance of students in three classes and used a questionnaire to investigate their perceptions and attitudes towards proposed system. Results show that interaction complexity has an impact on students' learning performance and mental effort in mobile learning; the higher the interaction complexity is, the higher mental effort and the better learning performance in mobile learning will be. Lay Description: What is already known about this topic: Mobile devices can be used to meet the urgency of learning need and can provide guidance and clues for learners in context‐aware environment.During mobile learning in context‐aware environment, students need to interact with mobile devices and environment.Mental effort reflects cognitive load related to interaction complexity, and it can affect learning performance.Self‐efficacy affects the degree of mental effort by affecting the firmness of performance goal.Cognitive load and learning performance are the main concerns that need to be considered when evaluating the effectiveness of mobile learning. What this paper adds: Interaction complexity has an impact on students' learning performance and mental effort in mobile learning.In terms of the three levels of interaction complexity in this study, the higher the interaction complexity is, the better the results that students will get in mobile learning.The higher the interaction complexity is, the higher the mental effort that students invested into in mobile learning would be.The medium self‐efficacy group invested the most mental effort and got the best grades, rather than the high or low group.Rule‐based mobile learning expert system is feasible and effective for students to learn by interacting with learning objects in context‐aware environment. Implications for practice and/or policy: Efforts should be made to make mobile learning systems more interactive; for example, learners can learn more effectively by interacting with mobile system, which can improve the frequency of observing learning objects.Rule‐based mobile learning expert system can give learners more opportunities to know how experts do when solving problems and can provide a potential method for students to learn in context‐aware environment. [ABSTRACT FROM AUTHOR]

While the use of experiments is important for developing students' scientific knowledge and skills, challenges may arise when teachers and students are conducting experiments in class, such as non‐reusable experimental resources, safety issues and difficulties simulating some specific effects. Augmented reality (AR) technology affords an alternative approach to conducting experiments by bringing students a virtual–real mixed learning environment. In this study, taking junior high school physics knowledge on the magnetic field as an example, we designed and developed an AR‐based mobile simulated experiment tool. This study investigates the effect of the AR‐based experiment on students' knowledge improvement and cognitive load compared with 3D and traditional experiments. A sample of 122 ninth‐grade students was randomly chosen and assigned to three groups (AR, 3D and Traditional). The results demonstrate that students in the AR group performed better than those in the 3D and Traditional groups in terms of their knowledge improvement. The AR group students also experienced the lowest cognitive load among the three groups. Moreover, students had positive perceptions about AR and 3D tools. The implications of this study are discussed. Lay Description: What is already known about this topic: Experiment is an important method for students' magnetic field learning.Traditional magnetic experiment consists of various procedures that may cause some inconvenience during learning.Augmented reality (AR) provides a virtual–real fusion environment to assist teaching and learning.While some studies indicate positive impact of AR on learner's cognitive load, some do not. What this paper adds: An AR‐based mobile simulated experiment tool was proposed based on the junior high school physics knowledge, the magnetic field.A Comparison was made among AR, 3D and traditional experiment for magnetic field learning.Higher knowledge improvement and lower cognitive load were observed in the AR group.3D and Traditional groups showed similar knowledge improvement and cognitive load. Implications for practice and/or policy: The AR design with hand‐held devices has unlimited scalability of educational applications.Serving the real object as marker and using the professional algorithm to simulate some specific phenomenon were recommended in future AR studies.The findings indicated that AR experimental tool had a statistically significant effect on students' knowledge improvement and cognitive load.The similar result between 3D and Traditional groups implies that not everything virtualized is good; we must consider the actual teaching and learning situations. [ABSTRACT FROM AUTHOR]

Responsive feeding serves as an important protective factor for infant growth and overall health development. This study based on self‐determination theory (SDT) aimed to assess the effects of a responsive breastfeeding (RBF) intervention programme on maternal breastfeeding and infant growth and development. A total of 110 mother–infant pairs were recruited and randomly divided into an intervention group (n = 55) and a control group (n = 55). The primary outcomes were breastfeeding motivation score, breastfeeding self‐efficacy (BSE) and exclusive breastfeeding rate; the secondary outcomes were infant physical development at 6 weeks and 3 months. A repeated measures ANOVA indicated that the intervention group had significantly higher Enjoyment scores compared to the control group at three time points: at discharge (MD: 5.28; 95% CI: 3.68 to 6.89; p < 0.001), 6 weeks post‐partum (MD: 5.06; 95% CI: 3.80 to 6.31; p < 0.001) and 3 months post‐partum (MD: 5.24; 95% CI: 4.12 to 6.35; p < 0.001). Similarly, the intervention group reported significantly higher connection and mother's self‐perception scores at discharge (MD: 4.31; 95% CI: 3.07 to 5.56; p < 0.001), 6 weeks post‐partum (MD: 4.69; 95% CI: 3.71 to 5.68; p < 0.001) and 3 months post‐partum (MD: 4.93; 95% CI: 4.14 to 5.72; p < 0.001), compared to the control group. In contrast, the pressure from significant others scores were higher in the control group relative to the intervention group at discharge (MD: −2.09; 95% CI: −2.88 to −1.31; p < 0.001), 6 weeks post‐partum (MD: −4.35; 95% CI: −5.20 to −3.49; p < 0.001) and 3 months (MD: −4.89; 95% CI: −5.70 to −4.08; p < 0.001). Finally, the intervention group also reported higher Instrumental Needs scores at all three time points: at discharge (MD: 1.96; 95% CI: 1.35 to 2.58; p < 0.001), 6 weeks post‐partum (MD: 3.58; 95% CI: 3.05 to 4.11; p < 0.001) and 3 months post‐partum (MD: 1.18; 95% CI: 0.68 to 1.69; p < 0.001). BSE scores were significantly higher in the intervention group compared to the control group at discharge (MD: 14.29; 95% CI: 10.38 to 18.21; p < 0.001), 6 weeks post‐partum (MD: 14.04; 95% CI: 11.05 to 17.02; p < 0.001) and 3 months post‐partum (MD: 6.80; 95% CI: 4.66 to 8.94; p < 0.001). The rates of exclusive breastfeeding were higher in the intervention group than in the control group at each stage of the intervention (p < 0.01). At 6 weeks post‐partum, the intervention group's infants showed slower weight (t = −0.90, p = 0.371) and length (t = −0.69, p = 0.495) growth compared to the control group, though not significantly. By 3 months post‐partum, there was a significant difference in both weight (t = −3.46, p = 0.001) and length (t = −2.95, p = 0.004) between the groups. The findings in this study suggest that the RBF intervention programme based on SDT may be effective in improving mothers' motivation to breastfeed, building breastfeeding self‐confidence and increasing the rate of exclusive breastfeeding. The effects of the intervention on infant physical development will need to be verified with longer follow‐up in future research. Key messages: This study validated the application of responsive breastfeeding (RBF) intervention during the exclusive breastfeeding phase of Chinese infants.The RBF intervention may help to increase mothers' level of autonomous motivation for breastfeeding, enhance breastfeeding self‐efficacy and increase exclusive breastfeedingrates. The intervention had no significant effect on the weight and length of 6 week old infants but significantly impacted 3monthold infants, with slower growth observed in the intervention group compared to the control group.Future intervention programmes shouldinclude extended follow‐up periods to investigate the long‐term effects of RBF on infant growth and development. [ABSTRACT FROM AUTHOR]

A semantic diagram tool is proposed in this study in order to structure collaborative problem solving (CPS) based on cognitive load theory (CLT). To investigate its effects on transaction cost and the deepening of user understandings, a comparative quasi‐experiment was designed and conducted with 49 participants from a university in East China. Analysis of group dialogic acts and self‐reported cognitive load showed that a semantic diagram tool can decrease transaction costs during CPS. It can thereby help collaborators invest less effort into those procedural conversations that are necessary for managing social interaction but which do not directly contribute to deepening collaborative learning in the task domain. Data analysis of pretested and posttested domain understanding suggested that learners achieved a greater depth of understanding after CPS supported by the semantic diagram tool. These findings are interpreted in terms of CLT. A semantic diagram tool can release the learner's limited working memory from procedural conversation, creating more working memory capacity for deepening problem understanding. Therefore, this study demonstrates one means whereby a semantic diagram tool functions as a promising technological support to structure CPS. Lay Description: What is already known about this topic: Group coordination and communication are conducted with a cost, which may impede learning.From the point of cognitive load theory, deep learning would occur when extraneous cognitive load is reduced to its minimal in the learning context.External representations have a positive effect on the cognitive and social dimensions of learning.What this paper adds: Semantic diagram tools can decrease transaction costs during collaborative problem solving (CPS) learning process.Semantic diagram tools can deepen student understanding during CPS.Implications for practice and/or policy: Semantic diagram tools with conceptual and sociocognitive support of CPS are a promising way to stimulate deep learning.The combination of CLT and sociocultural theory is a promising way to deepen our general theoretical understanding of social interactions. [ABSTRACT FROM AUTHOR]

Previous studies have shown that the school-based physical activity programme entitled "11 for Health" has been effective in improving the physical fitness, well-being and overall health profile of European children. The main purpose of the present study was to examine whether the "11 for Health" programme can have a positive impact on the physical fitness of primary school pupils in China. A total of 124 primary school pupils aged 9-11 years were included in the experiment, randomly divided into the experimental group (EG, n = 62) and the control group (CG, n = 62). EG carried out three weekly 35-minute sessions of small-sided football for a total of 11 weeks. All data were analysed by a mixed ANOVA with the Student-Newman-Keuls post hoc test. The results showed greater improvements (p<0.001) in EG than CG in relation to systolic blood pressure (-2.9 vs +2.0 mmHg). Moreover, greater improvements (all p<0.05) were observed in postural balance (13 vs 0%), standing long jump (5.0 vs 0.5%), 30-metre sprint (4.1 vs 1.3%) and Yo-Yo IR1C running performance (17% vs 6%). In both EG and CG, physical activity enjoyment was observed to be higher (P<0.05) compared to the start of the intervention with increases of 3.7 and 3.9 AU respectively. In conclusion, the study revealed that the "11 for Health" programme has positive effects on aerobic and muscular fitness, and it appears to be a relevant tool in the physical activity promotion in the Chinese school system. [ABSTRACT FROM AUTHOR]

This research conducted quasi-experiments in four middle schools to evaluate the long-term effects of an intelligent web-based English instruction system, Computer Simulation in Educational Communication ( CSIEC), on students' academic attainment. The analysis of regular examination scores and vocabulary test validates the positive impact of CSIEC, and in most cases, the positive impact is statistically significant. The reliability is ensured by the spectrum of the students from Grade 1 to Grade 3 in three junior high schools and from Grade 1 to Grade 2 in one senior high school, and of the teachers with or without blended learning experience, as well as by the various school locations from rural to urban areas in four provinces of China. The learning content-oriented design and the instant feedback feature of the web-based system, as well as its regular integration into the English class, contributed to its reliable positive effect on students' learning performance in ordinary examinations. This is the research's implication for instructional design. The conclusion of this paper could serve as a reference to the technical feasibility and pedagogical benefit of regular usage of appropriate Computer Assisted Learning system in the mainstream subject of middle schools. The multiple quasi-experiments in divergent school settings to ensure the results' reliability distinguish this research from previous ones that just implemented one single experiment in one school. [ABSTRACT FROM AUTHOR]

Aims This study examines the preliminary outcomes of an intervention targeting service providers in methadone maintenance therapy ( MMT) clinics in China. The intervention effects on both service providers and clients are reported. Design The MMT CARE intervention pilot was developed and implemented collaboratively with local health educators. After three group intervention sessions, trained providers in intervention clinics delivered two individual motivational interviewing sessions with their clients. Settings Six clinics in Sichuan, China, were randomized to either the MMT CARE intervention condition or a standard care condition. Participants A total of 41 providers and 179 clients were sampled from the six clinics. Measurements At baseline and three-, six-, and nine-month assessments, providers completed self-administrated paper/pencil questionnaires regarding provider-client interaction, MMT knowledge, perceived job-related stigma and clinic support. Clients completed a face-to-face survey about their concurrent drug use and drug avoidance self-efficacy. Mixed-effects regression models with clinic-level random effect were used to assess the intervention effects. Findings Significant intervention effects for providers were found in improved MMT knowledge, provider-client interaction and perceived clinic support. For clients, better improvements in drug avoidance self-efficacy and reduced concurrent drug use were observed for the intervention compared with the standard care group. Conclusions The MMT CARE intervention targeting providers in methadone maintenance clinics can improve providers' treatment knowledge and their interaction with clients. The intervention can also reduce clients' drug-using behavior through motivational interviewing sessions conducted by trained providers. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of enhanced recovery after surgery (ERAS)‐optimized management system with nurse‐led multidisciplinary cooperation. Design: A quasi‐experimental design. Methods: Nursing department cooperated with medical and clinical department to establish an ERAS‐optimized management system. After the system was developed, it was applied in surgical departments of the hospital. Using convenience sampling, 220 selective surgical patients, 82 nurses and 98 doctors from January 1st, 2021 to July 31st, 2021 were selected as the trial group. 220 selective surgical patients, 82 nurses and 98 doctors were selected as the control group from January 1st, 2020 to July 31st, 2020. ERAS observation indicators were compared between the two groups before and 6 months after implementation. The nurse professional identity scores and satisfaction of medical cooperation scores of the two groups at different time points were analysed by repeated analysis of variance. Results: After the implementation, ERAS observation indicators in the trial group were better than the control group (p < 0.05). There were significant differences in the group main effect, time main effect and interaction effect of nurse professional identity scores, satisfaction of medical cooperation scores and scores in all dimensions between the two groups (p < 0.05). The scores of the experimental group at 3 months and 6 months after implementation were better than those of the control group (p < 0.05). Conclusions: Enhanced recovery after surgery‐optimized management system with nurse‐led multidisciplinary cooperation was an effective working method. It could promote patients recovery and enhance nurse professional identity. [ABSTRACT FROM AUTHOR]

Aim: To examine effects of holistic sleep improvement strategies on frontline nurses who served in Wuhan, China, during a public health emergency (COVID‐19). Design: A pre–post‐test design with single group was conducted with a convenience sample applied the Transparent Reporting of Evaluations with Non‐randomized Designs statement. Methods: Fifty‐two nurses were recruited from a COVID‐19 designated hospital, receiving holistic sleep improvement intervention, which concentrated on scientific human resource management, comfortable sleep environment establishment, self‐relaxation and self‐adjustment training and humanistic care. Data was collected at baseline and 4‐week follow‐up post intervention using self‐reported questionnaires. Results: The total score of Pittsburgh Sleep Quality Index scale was 8.69 ± 4.346 at baseline. After 4 weeks of follow‐up, the score statistically significantly decreased to 7.48 ± 3.691. Subjective sleep quality (p =.016), sleep efficiency (p =.015), sleep disturbances (p =.007) were statistically significantly improved after the intervention, while there were no statistically significant differences in sleep latency (p =.205), sleep duration (p =.375), sleep medication (p =.723) or daytime dysfunction (p =.747). [ABSTRACT FROM AUTHOR]

Background: Group size is one of the important factors that affect collaborative learning, however, there is no consensus in the literature on how many students should the groups be composed of during the problem‐solving process. Objectives: This study investigated the effect of group size in a K‐12 introductory Artificial Intelligence course by comparing the students' cognitive load, learning motivation, collaborative problem‐solving quality, and in‐classroom interaction between two‐ and three‐student groups. Methods: Forty‐eight high school students were randomly assigned to two kinds of groups (i.e., the two‐student group, and the three‐student group, each consisting of 24 students). During the experiment, Xiaofei robots were used to teach the theoretical and practical content of five AI topics over 6 weeks for 1.5 h each week. Results: The ANOVA results indicated that group size mattered in the AI course, the two‐student group was more effective in terms of enhancing students' learning motivation and collaborative problem‐solving quality, as well as imposing more cognitive load than the three‐student group. The advantage was more obvious in the practical problem context. The Lag Sequential Analysis results indicated that more collaborative learning behavioural sequences existed in the two‐student group than in the three‐student groups. Contribution: This research provides empirical evidence and potential guidance for group design in Artificial Intelligence Education. Although group size did not affect students' learning achievement, it affected learning motivation, cognitive load, and problem‐solving quality and processes. Two‐student groups work better than three‐student groups in the AI course. Lay Description: Group size affected students' learning motivation, cognitive load, and problem solving process, but not their learning achievement.The two‐student group was more effective in terms of enhancing students' learning motivation and collaborative problem‐solving quality, while imposing more cognitive load than the three‐student groups.The Lag Sequential Analysis results indicated that more collaborative learning behavioural sequences existed in the two‐student group than in the three‐student groups. The tendency was more obvious in the practical problem context than in the theoretical problem context.Overall, in terms of problem‐solving and learning, group size should be considered in instructional design of AI courses. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effectiveness of nursing innovation workshop in enhancing clinical nurses' innovation ability and research ability in a tertiary hospital. Design: A quasi‐experimental study design. Methods: Thirty‐seven recruited nurses participated in a nursing innovation workshop for half a year in a tertiary hospital in Guangdong between June 2019 and March 2020. Questionnaire data on the nurses' self‐rated innovation and research abilities were collected before the training and 3 months after completing the training. Wilcoxon signed rank tests were used to analyse differences within the group before and after the intervention. The level for statistical significance was set at p ≤.05 (two‐tailed). Results: Nurses' self‐rated innovation ability (p <.001, 95% confidence interval 12.79 to 15.05) and research ability (p <.001, 95% confidence interval 14.39 to 19.09) improved significantly after the training. Since the whole design lacked a control group, the study needs to be further verified in more hospitals and among more nurses. [ABSTRACT FROM AUTHOR]

In China, the prevalence of undernutrition among children under 5 years of age has declined significantly during recent decades. However, noticeable gaps exist between rural and urban areas. Since 2012, a government‐funded nutrition programme, Ying Yang Bao (YYB; soybean powder‐based iron‐rich supplement) programme, has been implemented in poor rural areas to decrease the risk of developing anaemia among children aged 6–23 months, but there are still inadequate health care awareness, feeding knowledge and skills among caregivers. From June 2018 to December 2020, a child health counselling intervention was delivered through a home visit based on the YYB programme in Liangshan. Child health messages were given by trained village child health assistants while distributing YYB. Surveys were conducted before and after the intervention to analyse changes in child health check‐up frequency, complementary feeding practice and prevalence of undernutrition. After the intervention, the proportion of children who had regular health check‐ups, who were vaccinated and who met the minimum YYB consumption significantly increased from 26.0%, 81.6%, and 67.8% to 59.7%, 95.0%, and 79.2%. Increased rates of IYCF indicators (introduction of solid, semisolid, or soft foods, minimum dietary diversity and consumption of iron‐rich or iron‐fortified foods) were observed after the intervention. The prevalence of stunting, underweight, wasting, and anaemia significantly decreased from 26.3% to 10.8%, 13.4% to 8.7%, 14.0% to 10.5%, and 52.1% to 43.9%. This intervention can be well integrated into the YYB programme with less additional resources. Children in resource‐limited areas will benefit more from a comprehensive nutritional package, including food supplements and child health education. Key messages: Current evidence suggests there is a decrease in the prevalence of undernutrition among children under 5 years of age in China during recent decades. However, imbalanced development exists between rural and urban areas.Government‐funded Ying Yang Bao (YYB) programme has been implemented in poor rural areas across China covering over 800 counties, to decrease the risk of developing anaemia among children aged 6–23 months.After a child health counselling intervention jointly implemented with YYB programme, the prevalence of stunting, underweight, wasting, and anaemia among children decreased significantly.Child health counselling intervention could be well integrated into the ongoing YYB programme to reach resource‐limited areas on a large scale. [ABSTRACT FROM AUTHOR]

Background: The ability to regulate emotion effectively plays a key role in child psychosocial development and mental health. The current study examines the effect of cognitive training for executive function on emotion regulation in Chinese preschool children, and further investigate the underlying mediating mechanisms. Methods: A cluster randomized control trial design with pre‐test and post‐test was conducted in 61 preschool children aged 3–6 years in China. The intervention group consisted of 30 children who received eight cognitive training sessions on executive function, while the control group consisted of 31 children who did not receive any psychological training. Children's executive function was measured individually via five laboratory tasks both in the pre‐test and post‐test. Adaptive and maladaptive emotion regulation strategies were coded in emotion‐elicit contexts. Results: Intervention group outperformed control group in working memory and inhibitory control. Children in the intervention group exhibited increased use of adaptive emotion regulation strategies and decreased use of maladaptive emotion regulation strategies than children in the control group. Mediation analyses indicated that there were significantly indirect effects of Intervention Condition on the gain scores of adaptive and maladaptive emotion regulation strategies through the gain score of inhibitory control. Conclusions: Executive function training effectively promotes working memory, inhibitory control and the use of adaptive emotion regulation strategies, and reduces the use of maladaptive emotion regulation strategies. In addition, executive function training improves the use of adaptive and maladaptive emotion regulation strategies through the enhancement of inhibitory control capacity. [ABSTRACT FROM AUTHOR]

Background: Accurate estimation of food portion sizes remains an important challenge in dietary data collection. The present study aimed to develop a food atlas with adequate visual reference to improve the accuracy of dietary surveys in China. Methods: A food atlas for dietary surveys in China was developed using three visual reference systems, namely, regularly placed food portions, the two‐dimensional background coordinates and common objects known in daily life. The atlas was validated by estimating a meal before and after using the food atlas, and differences in weight estimation were compared using a paired t‐test. In total, 50 college students participated in the study. Results: After determination of food varieties; design of the food display; purchase, processing, cooking and weighing of food; photographing food; post‐image processing and data processing, a total of 799 pictures of 303 types of food and two types of tableware were produced. The mean value of food weight estimated with the atlas was closer to the actual weight, and the variation range of these values was smaller and more stable than that estimated without the atlas. The differences estimated before and after using the atlas for all foods were significant (P < 0.05). Comparing the differences in weight before using the atlas, the error ranges of food samples were reduced. Conclusions: A food atlas has been developed for a retrospective dietary survey in China, which can be used to enable a better understanding of nutritional adequacy in the Chinese population. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects of the simplified 5‐step and the conventional 7‐Step hand hygiene programme in a cluster randomized controlled trial among students with intellectual disabilities. Method: A total of 472 Chinese students with intellectual disabilities were randomized to either simplified 5‐step or conventional 7‐step hand hygiene programme. Assessments included handwashing technique, cleanliness and sick leave days. Results: Handwashing technique scores (g = 0.25, 95% CI [0.18, 0.32]) and hand cleanliness scores (g = 0.33, 95% CI [0.26, 0.4]) in intervention group were significantly higher than those scores in control group at 6th month post‐intervention although there were significant increases in the scores within both groups. The mean number of sick leave days decreased between baseline and 10 month in both groups according to descriptive statistics. Conclusions: It is feasible and effective to adopt the simplified 5‐step intervention as a standardized handwashing technique for the population group with intellectual disabilities. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the effect of a nurse‐led telephone‐based peer support program on health outcomes in patients after cardiac pacemaker implantation. Seventy six patients who received cardiac pacemaker implantation were recruited as participants and randomly assigned to either the peer support group or the usual care group. The usual care group received routine care and health education measures provided by nurses; the peer support group received telephone‐based peer support. Health‐related quality of life, self‐care knowledge–attitudes–practice, postoperative anxiety and depression, compliance with attending scheduled follow‐up visits, and the incidence of postoperative complications were evaluated at baseline and 6 months' postintervention for the two groups. The result showed that the interventions had a better effect on self‐care knowledge–attitudes–practice, postoperative anxiety and depression, and compliance with attending scheduled follow‐up visits in the peer support group than in the usual care group. This study confirms that telephone‐based peer support improves self‐care ability, compliance with attending scheduled follow‐up visits, and reduces postoperative anxiety and depression more effectively than conventional nurse care among patients with cardiac pacemaker implantation. [ABSTRACT FROM AUTHOR]

Computer assisted learning (CAL) programs have been shown to be effective in improving educational outcomes. However, the existing studies on CAL have almost all been conducted over a short period of time. There is very little evidence on how the impact evolves over time. In response, we conducted a clustered randomized experiment involving 2741 boarding students in 72 rural schools in China to evaluate impacts of CAL programs over the long term. Our results indicate that a CAL program that was implemented for one year and a half increased math scores by 0.25 standard deviations for third graders and 0.26 standard deviations for fifth graders. In addition, we have shown that students gained in math learning in both CAL Phase I (which ran for one semester in spring 2011) and CAL Phase II (which ran for both semesters of the 2011-2012 academic year) programs. By testing for heterogeneous effects, we find that the CAL intervention worked well for both the poorer performing and better performing students in the third and fifth grades. We also find that the third grade girls seem to have improved more than the boys in math in the short term (CAL Phase I). [ABSTRACT FROM AUTHOR]

Aim This study was to investigate the correlation between ovarian chocolate cysts and serum carbohydrate antigen ( CA)-125 levels and to demonstrate the effect of ultrasound-guided interventional sclerotherapy ( UGIS) on serum CA-125 levels. Methods Based on the serum CA-125 level, as determined by chemiluminescence detection prior to UGIS, 105 patients with ovarian chocolate cysts were divided into the normal group ( CA-125 ≤ 35 U/mL, 45 patients) and the abnormal group (35 U/mL < CA-125 ≤ 200 U/mL, 60 patients). There were six clinical indicators including age, disease duration, dysmenorrhea history, child-bearing history, abortion history and surgical history. The ultrasonography characteristics were cyst diameter, cyst wall thickness and the side on which the cyst occurred. The correlations between serum CA-125 levels pretreatment and the clinical indicators and ultrasonography characteristics was analyzed. The serum CA-125 levels pretreatment, 3 months post-treatment and 6 months post-treatment were compared. Results The pretreatment serum CA-125 levels of the 105 patients positively correlated with disease duration ( r = 0.3932, P = 0.0040), dysmenorrhea history ( r = 0.2351, P = 0.0111), cyst diameter ( r = 0.3415, P < 0.0001) and cyst wall thickness ( r = 0.4263, P < 0.0001). Compared with the pretreatment level, the mean serum CA-125 level in the abnormal group at 3 months post-treatment was significantly lower ( P < 0.01), and at 6 months post-treatment, the mean serum CA-125 level had decreased to a normal level ( P < 0.01). Conclusion UGIS significantly decreased abnormal serum CA-125 levels in patients with ovarian chocolate cysts. [ABSTRACT FROM AUTHOR]

Background It is important to integrate adolescent health domains into pre-service nursing education in order to enhance undergraduate nursing students' competencies in promoting adolescent health. Aim To determine the effectiveness of a structured adolescent health summer programme for Chinese undergraduate nursing students. Methods A quasi-experimental design was used to evaluate differences in the Chinese undergraduate nursing students' perceived competency in promoting adolescent health. A stand-alone adolescent health course was implemented as an intervention with pre- and post-tests of a 2-week intensive summer programme in 2010. The questionnaire included demographics, adolescent health competency checklist and programme evaluation. Descriptive statistics with the Wilcoxon signed-ranks test and the Mann- Whitney U-test were used for data analysis. Results Of the 113 nursing students, seniors perceived higher adolescent health competence mean scores than the juniors in the post-test phase. Majority of nursing students revealed the increasing awareness of the importance in promoting healthy lifestyle behaviours and psychosocial well-being after attending the summer programme. They agreed that nurses do have a role to play. Limitations This 2-week summer programme may only have short-term impacts on students' perception. Conclusions A stand-alone adolescent health summer programme can prepare nursing students to respond to the health issues of adolescents by enhancing their competence in health need assessment and service delivery. Implications for nursing and health policy Nurses serve in a leadership role for health policies and programmes. In nursing education, it is important for students to understand how to put in place policies to resolve adolescent health issues. [ABSTRACT FROM AUTHOR]

Aim Optimal motor skill acquisition frequently requires augmented feedback or knowledge of results ( KR). However, the effect of functional declines on the benefits of KR remains to be determined. The objective of this research was to examine how cognitive and motor deficits of older adults influence the use of KR for motor skill learning. Methods A total of 57 older adults (mean 73.1 years; SD 4.2) received both cognitive and eye-hand coordination assessments, whereas 55 young controls (mean 25.8 years; SD 3.8) took only the eye-hand coordination test. All young and older participants learned a time-constrained arm movement through KR in three pre- KR and post- KR intervals. Results In the subsequent no- KR skill retests, absolute and variable time errors were not significantly reduced for the older learners who had KR during skill practice, especially for those with cognitive and motor dysfunctions. The finding suggests that KR results in no measureable improvement for older adults with cognitive and motor functional deficiencies. More importantly, for the older adults, longer post- KR intervals showed greater detrimental effects on feedback-based motor learning than shorter pauses after KR delivery. Discussion The findings support the hypothesis about the effects of cognitive and motor deficits on KR in motor skill learning of older adults. The dynamics of cognitive and motor aging, external feedback and internal control mechanisms collectively explain the deterioration in the sensory-motor learning of older adults. The theoretical implications and practical relevance of functional aging for motor skill learning are discussed. Geriatr Gerontol Int 2013; 13: 849-859. [ABSTRACT FROM AUTHOR]

Nurses are often called upon to play the role of first responder when disaster occurs. Yet the lack of accepted competencies and gaps in education make it difficult to recruit nurses prepared to respond to a disaster and provide assistance in an effective manner. Based on the International Council of Nurses (ICN) Framework of Disaster Nursing Competencies and Global Standards for the Initial Education of Professional Nurses and Midwives, a training course titled 'Introduction to Disaster Nursing' was designed and implemented with 150 students. A pre-post survey design was used to assess changes in participants' self-rated disaster nursing competencies. The impact of the training course on participants' attitudes toward disaster nursing and their learning experience were also assessed. All participants passed the assessments and examination with an average score of 70%. Pre- and posttraining self-ratings of the disaster nursing competencies increased from 2.09 to 3.71 ( p < .001) on a Likert scale of 1 to 5, and the effect size was large, with Cohen's d higher than 0.8. No significant difference in both examination results (60% group assignments; 40% written examination) and self-rated competencies was noted between the senior year students and graduate nurse participants by Mann-Whitney U test ( p value = .90). The majority of participants indicated their willingness to participate as a helper in disaster relief and saw themselves competent to work under supervision. The ICN Framework of Disaster Nursing Competencies was instrumental to guide the training curriculum development. This introductory training course could be incorporated into undergraduate nursing education programs as well as serve as a continuing education program for graduate nurses. The training program can be used for preparing generalist nurses of their nursing competencies in disaster preparedness, response and post-disaster recovery and rehabilitation. [ABSTRACT FROM AUTHOR]