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

Background: Continued professional development (CPD) is required for updated skills and knowledge. This study evaluates the efficacy of a CPD programme for mainstream school teachers. Aims: In an 11‐week intervention programme, speech–language therapists (SLTs) presented the participating teachers with whole‐class teaching techniques aimed at creating a language and communication‐supporting classroom environment. The effects of the intervention on the language development of the students in the teachers' classes were assessed. Methods & Procedures: A total of 211 first‐ and second‐year students (Mage = 7;6, range = 6;5–8;9) underwent standardized language assessments of receptive and expressive language abilities before and after their teachers' participation in the CPD. The students were divided into intervention and delayed intervention groups to enable randomized intervention allocation. Linear mixed modelling was used to estimate the individual and interaction effects of group, time and demographic factors. Outcomes & Results: Significant effects of time, group and school, respectively, but no interaction between time and group indicates that while all students advanced between assessments, the progress was not attributable to the teachers' participation in the CPD. Conclusions & Implications: Results are discussed in light of those of recent studies of universal services to support optimal language development. WHAT THIS PAPER ADDS: What is already known on this subject: Although inconclusive, previous research indicates that intervention delivered to teachers by SLTs has the potential to improve the language abilities of the students in the teachers' classrooms. What this paper adds to existing knowledge: This study explored the language development of first‐ and second‐year mainstream school students whose teachers took part in a CPD programme aimed at establishing language and communication‐supporting teaching techniques. Results indicate that the development of the students' language abilities could not be attributed to the teachers' participation in the CPD. What are the potential or actual implications of the work?: SLTs are often asked to guide teachers and teaching staff rather than themselves conduct individual assessments and interventions. The results of this trial can be used to inform the discussion on how to prioritize between tasks. [ABSTRACT FROM AUTHOR]

Background: Effective learning in computer programming courses has been a constant challenge for university teachers and has become a relevant competence for current professionals. The literature on gamification in learning presents mixed results, mainly due to problems in instructional design and inconsistency in gamification. Studies with positive empirical results on computer programming formative activities and showing under what conditions gamification is effective still need to be included. Objectives: This study aimed to quantify the effects of gamification techniques in software tools that support computer programming learning applied to data‐structures university students. The study focused on determining whether there are differences in learning when using gamification techniques in online exercising formative activities. The effects of gamification on learning objectives with diverse complexity are studied. Methods: The study was conducted on computer engineering university students following a pretest‐intervention‐posttest design. They were divided into control and experimental groups, where both used a bank of exercises in Moodle to support learning. The experimental group considered gamification techniques, including points, leaderboards, and badges. Results and Conclusions: Gamification techniques significantly outperformed in learning gains in exercising activities without gamification. Regarding learning complexity, increasing taxonomic complexity did not negatively affect gamification learning effects. Lay Description: What is currently known about the subject matter?: Gamification has been explored as a strategy to enhance learning motivation in various educational contexts, including computer programmingLiterature shows mixed quantitative results on learning improvements under gamification.Few studies cover formative exercises, deal with computer programming tasks, or use a LMS like Moodle.Lack of literature exploring the conditions for effective gamification use, and involving learning objective complexity. What does this paper add to the existing body of research?: Quantifies the impact of gamification techniques on learning outcomes, specifically focusing on computer‐programming in university.Provides empirical evidence on gamification significantly improving learning gains compared to non‐gamified data‐structures exercisesGamification is effective in tasks of diverse levels of taxonomic complexity, with consistent effectiveness regardless of learning difficulty. Implications of study findings for practitioners: Gamification techniques, can be used in higher education to enhance student engagement and learning outcomes in computer programmingThe gamification information (e.g. points and ranking) do not require an automatic update, can be processed manually and published daily.It is effective to use gamification for learning tasks of medium‐high difficulty in Moodle on computer programming topics.It is key a thoughtful instructional design when applying gamification, ensuring alignment with learning objectives and task complexity. [ABSTRACT FROM AUTHOR]

Background: Learning which letters correspond to which speech sounds is fundamental for learning to read. Based on previous experimental studies, we developed a serious game aiming to boost letter‐speech sound (L‐SS) correspondences in a motivational game environment. Objectives: The goal of this study was to determine the efficacy of this game in training L‐SS correspondences in pre‐readers. Additionally, an extended version of the game was developed given the importance of handwriting in audio‐visual integration. We established whether including a motoric component in the game boosted the letter‐speech sound training on top of the effect of the game without the motoric component. Methods: One‐hundred forty‐five kindergartners were randomly allocated to play either the standard audio‐visual version of the game, the motoric version or a control math game. All children were pre‐ and post‐tested on L‐SS knowledge and reading accuracy. Results and conclusions: We found that playing the game enhanced pre‐readers' L‐SS knowledge, but not reading accuracy, after a short, intensive intervention period of 3 weeks. However, children who played the motoric version of the game did not differ significantly from either the standard or the control condition. Implications: This game was efficient in training L‐SS correspondences in pre‐readers. These results suggest that this game might be useful as a preventive evidence‐based intervention for at‐risk children in kindergarten who might benefit from a head start before learning how to read. Future studies are needed to examine whether a longer intervention period results in L‐SS knowledge being translated into reading skills. Lay Description: What is already known about this topic: Automatised and fluent reading requires much exposure and practice, but intensive teacher support for all at‐risk readers is economically and practically unfeasibleHandwriting movement likely to enhance coupling of auditory and visual informationOne way to provide high exposure is with game‐based interventionsLack of studies examining the efficacy of these interventions What this paper adds: Serious game enhances letter‐speech sound knowledge in pre‐readers after 3 weeks of intensive interventionThis effect did not transfer to reading performanceNo additional effect of the handwriting movement, possibly due to the short intervention periodIn‐game measures slightly mediated intervention progress Implications for practice and/or policy: Growing evidence of game‐based interventions as promising tools to support reading developmentGame can possibly serve as evidence‐based intervention for at‐risk children in kindergarten who might benefit from a head start before learning how to read [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: 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. Lay Description: What is already known about this topic: Morphological awareness is an important reading‐related skill that predicts students' word reading and reading comprehension. However, existing morphological awareness instructions are mostly delivered by teachers or experimenters.Gamification, which is emerging as an effective approach that enhances learning and motivation, has not yet been widely applied to improve students' reading‐related skills, such as morphological awareness.Gamification is usually implemented in online learning environments where students' self‐regulated learning critically affects their online learning performance. However, few studies have provided self‐regulated learning support in a gamified learning environment. What this paper adds: We proposed a self‐regulated gamified approach specifically targeting morphological awareness and compared its effectiveness with gamified learning and non‐gamified learning.The two gamified groups led to significant gain in students' morphological awareness and intrinsic motivation than the non‐gamified group.Only the self‐regulated gamified group led to significant gain in multisyllabic word reading than the non‐gamified group. Implications for practice and/or policy: The self‐regulated gamified approach represents an effective way for learning morphological awareness. [ABSTRACT FROM AUTHOR]

Background: Performance monitoring plays a key role in self‐regulated learning, but is difficult, especially for complex visual tasks such as navigational map reading. Gaze displays (i.e. visualizations of participants' eye movements during a task) might serve as feedback to improve students' performance monitoring. Objectives: We hypothesized that participants who review their performance based on screen recordings that also display their gaze would have a higher monitoring accuracy and increase in post‐test performance and would remember more executed actions than participants who review based on a screen recording only (i.e. control condition). Methods: Sixty‐four higher education students were randomly assigned to a gaze‐display or control condition. After watching an instruction video, they practiced five navigational map‐reading tasks and then reviewed their performance while thinking aloud, either prompted by a screen recording with gaze display or a screen recording only. Before and after reviewing, participants estimated the number of correctly solved tasks and finally made a five‐item post‐test. Results and conclusions: Analyses with frequentist and Bayesian statistics showed that gaze displays did not improve monitoring accuracy (i.e. estimated minus actual performance), post‐test performance, or the number of reported actions. It is concluded that scanpath gaze displays do not provide useful cues to improve monitoring accuracy in this task. Takeaways: Gaze displays are a promising tool for education, but scanpath gaze displays did not help to enhance monitoring accuracy in a navigational map‐reading task. Lay description: What is currently known?: Monitoring performance is central in self‐regulated learning.Monitoring is often difficult for learners, in particular in complex visual tasks.Gaze displays visualize viewing behaviour that was measured with eye tracking.Gaze displays can improve task performance, but effects on monitoring are unknown. What does the paper add?: We expected gaze displays to help learners to monitor their performance on a map‐reading task.However, dynamic gaze displays did not help to improve monitoring accuracy in this study.Further research should investigate whether other types of gaze displays improve monitoring. Implications for practitioners: Eye tracking provides promising ways to support monitoring and learning.However, not all forms of using gaze displays enhance monitoring or learning.The specific implementation of gaze displays might matter. [ABSTRACT FROM AUTHOR]

Background: Very young children from lower socioeconomic status (SES) backgrounds often show poorer language development. Whilst there have been attempts to provide early intervention programmes, these sometimes miss the most disadvantaged groups. Aims: This report presents preliminary feasibility and effectiveness data for a novel language intervention designed for parents of toddlers in the United Kingdom. Methods and Procedures: In total, 43 UK families of 2–4‐year‐olds were recruited to the study, half of whom completed an 8‐week course (Tots Talking) focussed on parent interaction, and half of whom acted as wait‐list controls. Results and Outcomes: Results suggest that such programmes are feasible for families with 86% staying in the intervention. In addition, greater changes in underlying communication skills such as joint attention and gesture were evident compared to wait‐list controls. Conclusions and Implications: We conclude that pre‐verbal skills may be more important to measure as initial outcomes than language or vocabulary change in this population. What This Paper Adds: What is already known on the subject: Children from lower socioeconomic status (SES) backgrounds are at higher risk of communication difficulties and there is a need for community intervention programmes for very young children. What this study adds: This study suggests that such programmes can be feasible and effective, but that very early/basic communicative skills (such as joint attention) may be boosted first rather than language or vocabulary. What are the clinical implications of this work?: Children's centres and other community services could feasibly run short parent facing courses emphasising contingent communication in low SES families and other diverse groups. These may be more successful run with younger preschoolers. Joint attention may be a better focus of intervention before expecting vocabulary or language change. Community health professionals may find this information useful in referring and supporting families in need. [ABSTRACT FROM AUTHOR]

Background: Though pedagogical artificial agents are expected to play a crucial role in the years to come, earlier studies provide inconsistent results regarding their effect on learning. This might be because their potential for exhibiting subtle nonverbal behaviours we know from human teachers has been untapped. What is more, there is little evidence of the processes underlying the effect of nonverbal behaviours of teachers (either human or artificial) on learning, so as to better guide their practical application. Objectives: The aims of the current research were threefold: firstly, to examine the effect of an artificial agent's vocal expressiveness on non‐verbal immediacy (teachers' ability to increase psychological closeness through nonverbal communication). Secondly, to test whether an artificial agent showing strong vocal expressiveness will enhance affective and cognitive learning (perceived and actual), as compared to an artificial agent that shows weak vocal expressiveness. Thirdly, to examine whether the underlying mechanisms of motivation and attention explain the effect of immediacy (and thereby also of vocal expressiveness) on the two learning outcomes. Methods: The study used a between‐participants design, with the participants being randomly assigned to one of the two experimental conditions: artificial modelling with strong expressiveness and artificial modelling with weak vocal expressiveness. Results and conclusions: Results showed that an artificial agent with strong vocal expressiveness increased affective and perceived cognitive learning. Partial support was found for actual cognitive learning. What is more, our findings revealed that vocal expressiveness is related to affective and perceived cognitive learning because it promotes nonverbal immediacy. Finally, results provided evidence of motivation as a mediator of the path from immediacy to affective learning. Major takeaways: The current findings verify the important role of nonverbal immediacy found in traditional educational settings. However, showing that these results also apply to artificial teachers is essential, given that the educational landscape is changing and reshaping by artificial intelligence. Thus, taking into consideration the role of vocal expressiveness in the development of artificial teachers or voice assistants like Alexa, Siri, and Google assistant, as a way to enhance immediacy and affective experience of learners is of imperative value, since they will be found more and more in our societies. Lay Description: What is currently known about the subject matter: There is a positive effect of nonverbal cues of human teachers on students' learningThe artificial agent's voice is important for learning. What their paper adds to this: Provides strong evidence of the positive effect of vocal expressiveness of artificial agents on learning outcomes.Reveals that vocal expressiveness is related to learning outcomes because it enhances immediacy.Examines the proposed mechanisms of motivation and attention as mediators of the path from immediacy to affective and cognitive learning. Implications of study findings for practitioners: Taking into consideration vocal expressiveness of artificial agents during the design process is essential for increased learning.The combination of the vocal parameters of pitch and speech rate is effective for constructing vocal expressiveness.By showing the underlying mechanisms of artificial agents' nonverbal cues (i.e., vocal cues) on learning, it helps designers to make a better decisions during construction.The study's findings are also pertinent for human teachers in improving students' learning in traditional educational settings. [ABSTRACT FROM AUTHOR]

Background: The feedback offered to students in audience response systems may enhance conformity bias, while asking closed‐type questions alone does not allow students to externalize and elaborate on their knowledge. Objectives: The study explores how writing short justifications and accessing peer justifications as collective feedback could affect students' performance, confidence and opinions in multiple‐choice audience response systems that apply the Peer Instruction model of voting/revoting. Methods: For 8 weeks, 98 students, enrolled in an undergraduate course, attended each lecture following a flipped classroom approach. At the beginning of each lecture, students participated in a quiz with eight multiple‐choice questions. Four of these questions included a justification form in which students could elaborate on their answers. The students were randomly grouped into two conditions according to the collective feedback they received: the Shared group (n = 54) could see both the percentage each question choice received from the class and the respective peer justifications, while the Unshared group (n = 44) could only see the percentage information. Results: Analysis showed that students in both groups performed significantly better in questions with the justification form being available. Also, the two groups were comparable in terms of performance and self‐reported level of confidence suggesting no main effect for making peer justification available. Despite this, students in the Shared group expressed a significantly more positive opinion in the end‐of‐activity questionnaire in terms of perceived learning gains and the helpfulness of writing justifications for their answers. Take Away: Writing short justifications can have a positive impact on students' academic performance. Lay Description: What is currently known about the subject matter: Audience response systems (ARS) typically include closed‐type items.Therefore, students do not have the opportunity to elaborate on their answers.Externalizing and elaborating on one's answer could enhance understanding. What their paper adds to this: Integration of short justifications alongside multiple‐choice questions.System feedback includes percentage, confidence and peer justifications.Analysis on how writing/reading justifications affect performance in ARS. Implications of study findings for practitioners: Writing short justifications enhances student performance.Being able to read peer justifications does not affect student performance.Being able to read peer justifications increases activity acceptance. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the current study was to investigate the robustness of the human movement effect and its stability over time by comparing the effectiveness of dynamic and static presentations on acquisition and retention of a gross motor skill. Methods: One hundred and seven first‐year students studying for the certificate in Physical Education course were randomly divided into three groups: (i) static pictures (N = 32), (ii) enriched static pictures with arrows (N = 34), and (iii) video (N = 41). They were instructed to observe the demonstration of the Ippon‐Seoi‐Nage (a Judo technique) and reproduce it during the acquisition phase or after a delay of 1 week during the retention phase. Results and Conclusions: The results showed that enriched static pictures (with arrows) resulted in more efficient learning than the static pictures (without arrows). Most importantly, it was shown that learners receiving the video presentation outperformed learners receiving the static presentations, with regard to acquisition and retention, indicating therefore a robust human movement effect. Implications: These findings provide confirmation of the superiority of video presentations for teaching and learning motor skills involving the entire human body. Lay Description: What is already known about this topic:External visualizations are broadly used in Physical education (PE) and sport context.Static visualizations are regarded as the fundamental tools used by PE teachers to communicate visual information that is difficult to verbally describe.Increasing use of dynamic visualizations such as videos largely supplanted the use of static pictures in PE contextWhat this paper adds:Comparing the effectiveness of static pictures and digital videos in tactical learningExploring the human movement effect and its stability over timeImplications for practice and/or policy:The human movement effect is a robust phenomenon not only when it is evaluated immediately after the learning phase but also after a notable delay.Dynamic visualizations remain the most powerful computer‐based technique by which people can learn complex motor skills. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapy often involves handwriting acquisition practices that include the non‐dominant hand when improvements in the dominant hand function are not possible because of trauma or stroke. This study explored whether character tracing and using a pegboard can effectively improve the handwriting of the non‐dominant hand. Methods: A randomised controlled trial involving 60 healthy university students aged ≥18 years was conducted. Participants were randomly assigned to the writing group, peg group or control group. The character recognition rate was evaluated by computer software. Furthermore, character quality and writing speed were evaluated by humans using global legibility scales. Evaluations were performed before the intervention (baseline) and on days 5 and 10 of the intervention. Using the non‐dominant hand, the writing group traced characters on paper with a ballpoint pen, and the peg group used a pegboard for 15 min/day for 10 days. Results: Compared with the peg and control groups, the writing group showed significant improvements in the character recognition rate and global legibility scale score. However, the global legibility scale score did not improve to the same level as that achieved with the dominant hand. None of the evaluation scores of the peg group showed significant improvements compared with those of the control group. There were no significant differences in improvements in the writing speed of the writing and peg groups compared with the control group. Conclusion: Tracing characters can improve the handwriting ability of the non‐dominant hand, but using a pegboard may be less effective. Future research is needed to examine how much practice is necessary to improve the handwriting ability of the non‐dominant hand sufficiently. [ABSTRACT FROM AUTHOR]

Prenatal iron supplementation improves children's health and cognitive performance, but few studies explore behavioural development. This study assessed the effects of adjusting prenatal iron supplementation to maternal iron stores during early pregnancy on children's behavioural problems. Randomized controlled trial conducted in Tarragona (Spain) involving 230 nonanaemic pregnant women and their children after a 4‐year follow‐up. Based on haemoglobin (Hb) levels before gestational week (GW) 12, women receive different iron doses: those with Hb = 110–130 g/L were randomized to receive 80 or 40 mg/day and those with Hb > 130 g/L were randomized to receive 20 or 40 mg/day. Maternal iron stores at GW12 were classified using serum ferritin (SF) as low (SF < 15 µg/L), normal (SF = 15–65 µg/L), and normal‐high (SF > 65 µg/L). Children's behaviour was assessed by parents using the Child Behaviour Checklist for ages 1.5–5 years and the Behaviour Rating Inventory of Executive Function‐Preschool Version, and by teachers using the Teacher's Report Form for ages 1.5–5 years. Multivariable regression models were performed. Taking 80 mg/day of iron improved child behaviour when women had low iron stores but worsened it when mothers had normal–high iron stores, except for depressive and attention/hyperactivity problems. Taking 20 mg/day of iron improved behaviour only in those children whose mothers had SF > 65 µg/L in early pregnancy. Additionally, executive functioning improved at high doses of prenatal iron when maternal baseline SF < 15 µg/L. Adjusting prenatal iron supplementation to both maternal baseline Hb levels and iron stores reduces behavioural problems in 4‐year‐old children. Key messages: Prenatal iron supplementation succeeds in improving maternal haematological outcomes and cognitive performance of children, but few studies have focused on behavioural development.Prenatal iron supplementation adjusted to maternal iron stores reduces behavioural problems in 4‐year‐old children.Maternal iron stores early in pregnancy should be measured in addition to haemoglobin concentration.These findings contribute greatly to the advancement of public health by giving physicians the tools to prescribe the most appropriate dose of iron supplementation to contribute to better child development. [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]

Background: Sensitive responsiveness is an important aspect in affect‐regulation of people with severe to profound intellectual disabilities. Aim: This randomized controlled trial evaluated the Attune & Stimulate‐checklist, a tool for detecting subtle and idiosyncratic communicative behaviours and responding adequately. Methods: Effects on the sensitive responsiveness of professional caregivers and the arousal and valence of adults with severe to profound intellectual disabilities were investigated. Video recordings of 102 interactions were analysed with several observation instruments. Results: Although no significant effect was found on the checklist‐suggestions of responsive behaviours (d = 0.33, p =.052), the intervention increased caregivers' sensitive responsive and affective behaviour (d = 0.94 – 1.10, p <.001) and clients' optimal arousal (d = 0.48, p =.019) and interactive engagement (d = 0.40 – 0.48, p =.018 ‐.050). Conclusion: This low‐intensity intervention had a medium to large immediate effect on the interaction. Future research should investigate medium‐ and long‐term effects. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to compare performance 5 h after a 90‐min endurance training session when either carbohydrate only or carbohydrate with added whey hydrolysate or whey isolate was ingested during the first 2 h of the recovery period. Methods: Thirteen highly trained competitive male cyclists completed three exercise and diet interventions (double‐blinded, randomized, crossover design) separated by 1 week. The 90‐min morning session (EX1) included a 60 min time‐trial (TT60). Immediately and 1 h after exercise, participants ingested either (1) 1.2 g carbohydrate∙kg−1∙h−1 (CHO), (2) 0.8 g carbohydrate∙kg−1∙h−1 + 0.4 g isolate whey protein∙kg−1∙h−1 (ISO) or (3) 0.8 g carbohydrate∙kg−1∙h−1 + 0.4 g hydrolysate whey protein∙kg−1∙h−1 (HYD). Additional intakes were identical between interventions. After 5 h of recovery, participants completed a time‐trial performance (TTP) during which a specific amount of work was performed. Blood and urine were collected throughout the day. Results: TTP did not differ significantly between dietary interventions (CHO: 43:54 ± 1:36, ISO: 46:55 ± 2:32, HYD: 44:31 ± 2:01 min). Nitrogen balance during CHO was lower than ISO (p < 0.0001) and HYD (p < 0.0001), with no difference between ISO and HYD (p = 0.317). In recovery, the area under the curve for blood glucose was higher in CHO compared to ISO and HYD. HR, VO2, RER, glucose, and lactate during EX2 were similar between interventions. Conclusion: Performance did not differ after 5 h of recovery whether carbohydrate only or isocaloric carbohydrate plus protein was ingested during the first 2 h. Correspondingly, participants were not in negative nitrogen balance in any dietary intervention. [ABSTRACT FROM AUTHOR]

Aims: Determine efficacy of "KARER" educational intervention on caring ability and burden of caregiving relatives of disabled patients with stroke and cardiovascular diseases. Design: Clinical, randomized, controlled and double blinded trial with a mixed approach. Methods: Study population will be made up of 96 caregiving relatives of patients of home‐hospitalized care programs in the cities of Bogotá and Bucaramanga, (Colombia), between March 2021 and March 2022. Participants will be randomly assigned into two groups, either intervention (n = 48) or control (n = 48). The intervention is interdisciplinary and multi‐component: B‐Learning modality and clinical simulation. Follow‐up of participants will last 8 weeks from intervention period start‐out, and measurements will be taken and analysed in masked form. The main results will be the mean score changes of care ability and caregiver burden. Discussion: Caregiving relatives will show better adaptation to their role through effective use of caring abilities as they look after disabled persons with chronic diseases. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to compare the efficacy of e‐flipped and online case‐based workshops on the nurses' knowledge, attitude and behaviour regarding thalassemia during the COVID‐19 pandemic. Design: A pre‐test–posttest interventional study was conducted with two intervention groups and a control group. Methods: One hundred and fifty nurses were recruited from comprehensive urban health centres in June–December 2020. The nurses were randomly allocated to one of the three groups: case‐based e‐flipped workshop (n = 50), case‐based online workshop (n = 50) and control (n = 50). A researcher‐made questionnaire was completed by eligible subjects at baseline, after the end of the training sessions and 4 weeks after interventions to assess their knowledge, attitude and behaviour. Data were analysed in IBM SPSS v16.0. ANOVA and Tukey's post hoc tests were used to compare the three groups. Results: The mean knowledge, attitude and behaviour scores in the intervention groups increased significantly more than that in the control group (p <.001). One week and 4 weeks following the intervention, the mean score of knowledge, attitude and behaviour in the e‐flipped group was greater than that in the online group (p <.001). According to the results, e‐flipped and online case‐based workshops can improve nurses' knowledge, attitude and behaviour regarding thalassemia. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbance negatively affects recovery and survival of patients in intensive care units (ICUs). Aims and Objectives: This study aimed to measure the noise levels and evaluate the impact of a white noise app on the sleep quality of critically ill patients. Design: A quasi‐experimental time series pre‐test–post‐test control group design with repeated measures was adopted. Methods: The study was conducted in the high dependency unit (HDU) of a selected tertiary care hospital in Mangalore, Karnataka State, India. Conscious oriented patients with systolic blood pressure ranging from 100/70 to 140/90 mm Hg and hearing acuity of at most 20 dB in both ears were included in the study. Noise levels in the HDU were measured using calibrated sound level meter on weekdays/weekends in three different shifts and an average of 24 readings was obtained per shift. A 4‐point Likert scale was used to assess the sleep quality. The intervention included administration of white noise app twice a day, for three consecutive days by using different masking sounds such as white noise on day 1 which resembles to a humming AC conditioner, pink noise on day 2 which resembles to the sound of ocean waves and brown noise on day 3 which resembles a steady rainfall. The app was used with the help of JBL earphones C10SI an excellent noise cancellation and noise isolating earphone. Results: Among the 54 subjects, the mean age of the patients was 40.28 years, majority 34 (63%) were males. The noise level in the ICU was more than 60 dB. There was a significant difference in the sleep quality after the application of the white noise app in the experimental group on Day 1 (Z = −3.996; P =.001), Day 2 (Z = −3.302; P =.001), and Day 3 (−2.822; P =.005) compared to the control group. Conclusion: Adoption of technology driven noise reduction applications would enhance the quality of sleep among the ICU patients. Relevance to clinical practice: The use of a technology‐driven application helps control noise levels which promotes improved sleep quality among critically ill patients in the intensive care units. [ABSTRACT FROM AUTHOR]

Frontal plane postures during the ultimate step of sidestepping are linked to increased anterior cruciate ligament injury risk. However, there is a lack of research detailing the kinematic strategies present in the penultimate step. This study, therefore, investigated penultimate and ultimate step kinematics of planned sidestepping (pSS) and unplanned sidestepping (upSS) to further understand the effect of planning time on known ultimate step kinematic and kinetic differences. Sixty male amateur Australian Rules football players performed three trials of straight‐line running (RUN), pSS, and upSS in a randomized order. Mediolateral foot placement and three‐dimensional joint kinematics for the knee, pelvis, and trunk were measured at final foot contact of the penultimate step and initial foot contact of the ultimate step. Peak knee moments were measured during the weight acceptance phase of the ultimate step. In pSS, at the penultimate step final foot contact, the support foot was placed across the midline of the center of mass, in the frontal plane, contralateral to the sidestep direction. Greater trunk lateral flexion toward the sidestep direction and greater negative pelvic lateral tilt were observed in pSS compared with upSS and RUN. Differences between pSS and upSS frontal plane kinematics at penultimate step final foot contact suggest preparatory reorientation strategies are likely constrained by the amount of planning time available. As there are clear differences in preparatory kinematics, we recommend that planning time be considered when training and assessing sidestepping maneuvers and planned and unplanned maneuvers not be treated as interchangeable skills. [ABSTRACT FROM AUTHOR]