Search

Abstract Background Dietary diversity has been suggested as a potential preventive measure against frailty in older adults, but the effect of changes in dietary diversity on frailty is unclear. This study was conducted to examine the association between the dietary diversity score (DDS) and frailty among older Chinese adults. Methods A total of 12,457 adults aged 65 years or older were enrolled from three consecutive and nonoverlapping cohorts from the Chinese Longitudinal Healthy Longevity Survey (the 2002 cohort, the 2005 cohort, and the 2008 cohort). DDS was calculated based on nine predefined food groups, and DDS changes were assessed by comparing scores at baseline and the first follow-up survey. We used 39 self-reported health items to assess frailty. Cox proportional hazard models were performed to examine the association between DDS change patterns and frailty. Results Participants with low-to-low DDS had the highest frailty incidence (111.1/1000 person-years), while high-to-high DDS had the lowest (41.1/1000 person-years). Compared to the high-to-high group of overall DDS pattern, participants in other DDS change patterns had a higher risk of frailty (HRs ranged from 1.25 to 2.15). Similar associations were observed for plant-based and animal-based DDS. Compared to stable DDS changes, participants with an extreme decline in DDS had an increased risk of frailty, with HRs of 1.38 (1.24, 1.53), 1.31 (1.19, 1.44), and 1.29 (1.16, 1.43) for overall, plant-based, and animal-based DDS, respectively. Conclusions Maintaining a lower DDS or having a large reduction in DDS was associated with a higher risk of frailty among Chinese older adults. These findings highlight the importance of improving a diverse diet across old age for preventing frailty in later life.

Abstract. Instruction:. Growing pains are the most common cause of musculoskeletal pain in children, affecting both children's and caregivers' well-being. The lack of definitive diagnostic criteria complicates diagnosis and treatment. Objectives:. This study aims to outline the clinical features and identify factors associated with the frequency and intensity of growing pains in children in Chongqing, China. Methods:. A cross-sectional study was conducted in a children's hospital using its Internet hospital follow-up platform. Children initially diagnosed with growing pains between July and September 2022 were enrolled. Sociodemographics, pain locations, duration, frequency, intensity, and potentially related factors were collected. Results:. Eight hundred sixty-three children were enrolled (average age: 8.19 ± 3.24 years; 455 boys [52.72%]). Pain frequency was reported as quarterly (62.11%), monthly (24.80%), biweekly (1.74%), weekly (10.08%), and daily (1.27%). The prevalence of mild, moderate, and severe pain was 26.65%, 55.74%, and 17.61%, respectively. The knee was the most common pain location (63.85%), mostly encountered between 4 pm and 5 pm (20.51%). Multivariate analysis revealed that pain frequency negatively correlated with vitamin supplementation during pregnancy, positively correlated with underweight, bad temper, increased exercise, and cold lower extremities. Pain intensity positively correlated with irritability, increased exercise, and pain sensitivity but negatively correlated with age and vitamin supplementation during lactation. Conclusion:. Growing pains typically occur on a quarterly basis, predominantly affecting the knees during 4 pm to 5 pm. Factors in sociodemographics, maternal aspect, temperament, and exercise levels can influence pain frequency and intensity. Clinicians should consider these aspects when developing comprehensive strategies for pain management.

The longitudinal study investigated the directionality and transfer mechanism of cross-linguistic transfer of phonological awareness between L1 and L2 in predicting early writing (word dictation) in Chinese children learning English as L2. Ninety primary school Grade 1 (P1) students were assessed on phonological awareness in Cantonese (syllable deletion, onset deletion, rime deletion, and tone awareness), phonological awareness in English (syllable deletion, rime detection, and phoneme deletion), Cantonese word writing, and English word writing at Time 1. These students were assessed on the same measures 1 year later at Time 2 when they were in Grade 2. The results demonstrated bidirectional cross-linguistic transfer of phonological awareness and early writing between Cantonese and English. It also showed that the transfers were achieved through same time writing skills (bidirectional) and future phonological awareness (from L1 to L2 only). No direct effect of earlier phonological awareness to later writing skill was found.

Gamification is typically implemented digitally. However, digital gamification is not always possible because of limited resources and logistical problems. It is thus necessary to explore low-threshold gamification methods that can be easily adopted in classrooms. One such method is non-digital gamification using physical game design elements. Currently, the literature provides a limited understanding of the design and effects of non-digital gamification. It is also unclear whether mixed gamification (ie, a combination of digital and non-digital gamification) is better than purely non-digital gamification. We explored these topics using an explanatory sequential mixed-methods design to compare the effectiveness of non-digital gamification in a face-to-face course and mixed gamification in a blended course in terms of student learning achievement, cognitive engagement and course satisfaction. Two secondary grade classes were randomly assigned to the mixed (N = 52) or non-digital (N = 52) gamification conditions. Contrary to our expectations, the quantitative results showed that the two approaches improved the students' learning achievement to the same extent. Although the students in the non-digital gamification condition reported significantly higher-course satisfaction than those in the mixed condition, the improvement in student cognitive engagement was significantly greater in the mixed gamification condition than in the non-digital condition. Through focus group interviews, we analysed the students' learning experiences and synthesised the factors that influenced student cognitive engagement and course satisfaction.

Background: Morphological awareness (MA) is the awareness and ability to manipulate morphemes, the smallest units of meaning in a language. It is identified as a strong cognitive precursor of word reading and reading comprehension. The current MA instructions are limited to classroom settings and delivered by teachers or experimenters. Few studies have included technology and its novel features to deliver MA instructions. Objectives: This study proposes a gamified learning approach embedded with self-regulated learning support for MA learning and examines its effects on improving English reading performance and intrinsic motivation among junior secondary grade students who learn English as a foreign language. Methods: This study adopted a randomized controlled trial design. Participants (N = 104) were randomly assigned into one of three conditions: self-regulated gamified programme, gamified programme, or non-gamified programme. Students received 16 sessions of instructions (30 min/session) and were evaluated on reading abilities (i.e., MA, word reading and reading comprehension) and intrinsic motivation before and after the programme implementation. Results and conclusions: Results from repeated measures ANOVA and follow-up ANCOVA showed that while the two gamified groups demonstrated greater improvement in MA (i.e., near transfer effect) and intrinsic motivation than non-gamified group, only the self-regulated gamified group showed more gains in multisyllabic word reading (i.e., far transfer effect) than non-gamified group. There was no significant time X group interaction effect on reading comprehension. Implications: Taken together, this research suggests gamification leads to better morphology learning and increases students' intrinsic motivation. The incorporation of self-regulated learning in gamification is recommended to achieve the far transfer effect on multisyllabic word reading.

Purpose: Morphological awareness (MA), the ability to reflect on and manipulate the smallest language units within a word, has been identified as an essential metalinguistic awareness to predict literacy development. In this study, we examine whether an online gamified English MA programme is more effective than physical face-to-face instruction in terms of cognitive, motivational and affective learning outcomes. Method: We applied a quasi-experimental design using a sample of 33 students in an intervention group (gamified MA programme) and 49 in a control group (face-to-face programme). Both programmes were 8 hours in duration (30 minutes/session for 16 sessions). Students' cognitive, motivational and affective learning outcomes were evaluated before and after delivery of the programmes. We took an exploratory sequential mixed-methods approach, in which qualitative data from semi-structured interviews were used to validate the quantitative results. Results: The intervention group performed significantly better than the control group in MA and intrinsic motivation. No differences were found for word reading, reading comprehension or affective engagement. The qualitative analyses of the interview responses revealed in detail the students' perceptions of gamified learning. Conclusion: The findings provide evidence for the beneficial effects of gamified learning experiences in terms of cognitive and motivational outcomes in comparison to face-to-face instruction.

Contribution: While design project courses offer first-year students a practical introduction to engineering, a portion of class time is usually spent on lecturing foundational knowledge instead of practicing engineering design. This article presents a blended design-based learning (bDBL) approach that makes class time more efficient and explores the changes in students' design competencies and intrinsic motivations. Background: Current approaches to cornerstone courses face challenges, such as heavy faculty involvement and heterogeneity of design projects. bDBL draws on the self-directedness of blended learning and the open-ended nature of design-based learning which may be a worthwhile instructional approach for cornerstone courses. Intended Outcomes: bDBL was applied in a cornerstone course that intended to let students understand what engineers do and motivate them in the field. Students' design competencies and intrinsic motivations were examined through pre- and post-self-reported surveys. Focus group interviews were conducted to elicit students' views on bDBL. Application Design: Online self-paced learning modules were created to deliver knowledge-based content. Students transfer what they learned from the online modules through launch-level demos. Then, students spend most of the class time working on team design projects to learn through mistakes and receive first-hand feedback from peers and instructors. Findings: From Fall 2018 to Spring 2020, 201 first-year students experienced bDBL. Quantitative results demonstrated increases in students' design competencies and intrinsic motivations. Four themes representing both positive and negative views of bDBL were elicited. A conceptual framework that connects the theoretical foundation, design elements, examined effects, and students' perceptions, is proposed.

Although prior studies have suggested the benefits of a collaborative approach to providing peer feedback in EFL writing, little is known about how students engage in collaborative peer feedback (CPF) activities. This paper reports on a case study involving five Chinese EFL students who collaboratively provided feedback on five argumentative essays written by their peers. We examined the CPF results generated by the students and found that they paid more attention to content-related issues and that negative feedback was more frequent than positive feedback. We also investigated the steps that the students took during CPF and the collaboration skills that they adopted. This revealed a four-step CPF procedure that included initiation, planning, deliberation and summarisation. Furthermore, our analysis showed that the students effectively used six of the nine social process skills in the framework of Hesse et al.: action, interaction, task completion, adaptive responsiveness, negotiation and responsibility initiative. However, the other three skills, namely audience awareness, self-evaluation and transactive memory, were not sufficiently applied. We suggest that EFL teachers integrate CPF into writing classrooms to enhance students' peer feedback performance. To enable successful CPF, teachers should help develop their students' collaboration skills. [ABSTRACT FROM AUTHOR]

Background: Research has established the link between morphological awareness and reading comprehension. However, the theoretical mechanisms underlying the association remain unclear. This study examined the direct and indirect effects of morphological awareness on reading comprehension in L1 Chinese and L2 English, with a sample of Chinese children who speak English as a second language (ESL). We tested theoretically driven predictions regarding the ways in which morphological awareness might impact reading comprehension. Methods: One hundred and fifty-six children in Grades 3 and 4 completed Chinese and English measures of morphological awareness (English: derivational awareness; Chinese: compound awareness), expressive vocabulary, word reading and reading comprehension, in addition to age, working memory and the other language's word definitions as control measures. Results: For both languages, analyses showed that morphological awareness had significant direct effects on both English and Chinese reading comprehension above and beyond mediators and control variables. In addition, morphological awareness had significant indirect effects on reading comprehension mediated by word reading (indirect path 1) as well as vocabulary and word reading in sequence (indirect path 2) after taking control variables into account. Vocabulary did not emerge as a mediator for either the English or the Chinese models. Conclusions: The results underscore the importance of morphology for reading comprehension and reveal the potential mechanisms that underpin their relations in L1 Chinese and L2 English. Our findings further specify the role of morphology in the reading systems framework and highlight the value of incorporating morphology into reading instruction for Chinese ESL children.

Objectives To identify caregiver and children factors associated with caregiver burden on primary caregivers of children with cerebral palsy (CP).Design Systematic reviewData sources Seven electronic databases, including PubMed, Cochrane Library, Scopus, PsycINFO, Web of Science, CINAHL and Embase, were systematically searched up to 1 February 2023.Eligibility criteria Original observational studies reporting caregiver burden and related factors among caregivers of children with CP.Data abstraction and synthesis Two reviewers independently screened results and assessed the quality of studies. Title, abstract, full-text screening and data abstraction were done independently by two reviewers. Risk of bias was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. The quality of evidence for factors was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.Results 16 articles were included in the review. All studies were cross-sectional and examined caregiver-reported burden measures. The Zarit Burden Interview was the most commonly used questionnaire. Depression of caregiver and severity of illness in children with CP were moderate quality of evidence for factors contributing to caregiver burden.Conclusions Higher caregiver burden is associated with more depressive feelings and worse life quality of the caregiver, and with more severe physical disability of the children. Future studies should focus on high-quality longitudinal research and appropriate assistance to reduce caregiver burden and improve the quality of caregiving for children with CP.PROSPERO registration number CRD42021268284.