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

Introduction: Media comparison studies examining the effectiveness of immersive virtual reality in education have yielded inconclusive findings, leaving the question of its impact on learning compared to conventional media unanswered. To address this issue, our study employs a novel approach that combines media comparison with an investigation on the influence of broader educational context. Methods: In the experiment, 262 students from two distinct types of lower secondary schools—comprehensive school and multi‐year gymnasium (a selective academic school)—participated. The students received a lesson on topography and contour line interpretation, using either an immersive virtual environment or a PowerPoint slideshow. A transfer test was carried out before, immediately after, and 1 month after the lesson to measure knowledge application. Results: The impact of the media (immersive virtual reality vs. PowerPoint slideshow) on learning outcomes was found to be minimal, with no clear advantage of one over the other in any experimental condition. In contrast, a significant influence on learning gains was observed due to school type. Multi‐year gymnasium students consistently outperformed comprehensive school students in the pre‐test and demonstrated greater learning gains, regardless of the learning media. Conclusion: The present study employs an innovative approach by integrating a comparative analysis of different media types with an investigation into the impact of learner characteristics. By including students from distinct types of schools, the study provides insights into the differential effects of immersive virtual reality in varied educational contexts. Lay Description: What is already known about this topic: Media comparison studies typically assess the effectiveness of immersive virtual reality as a learning medium in comparison to other instructional methods in education.The findings of these studies differ markedly.Numerous factors impact learning outcomes in an immersive virtual environment. What this paper adds: Recommendation that research in the field should explore not only if but also when and how IVR learning is effective.Evidence that learning achievements may not be affected by the medium used.Evidence that the type of school can significantly influence learning gains.Evidence that cognitive dispositions, such as spatial abilities, can be another factor that influence learning outcomes. Implications for practice: A technology‐centred approach alone does not allow for a proper evaluation of the learning gain potential of IVR, learner characteristics and broader educational context should also be taken into account.IVR as a learning medium may not be appropriate for all students and every educational setting.To ensure reliable evaluation of learning gains, it is necessary to align the content and format of the intervention in both learning mediums as closely as possible.Measuring learning gains not only immediately after the intervention but also with a significant time delay can contribute to a more comprehensive understanding. [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: Online collaboration tools have been identified as potentially effective means for enhancing student learning, motivation, and engagement in science education. However, their effectiveness in improving science education outcomes among middle school students remains uncertain. Objectives: The study aimed to investigate the impact of online collaboration tools on science education outcomes among middle school students, focusing on learning achievement, engagement, and motivation. Methods: A quasi‐experimental design with a pretest‐posttest control group was used in this study. A total of 60 eighth‐grade middle school students were involved in the study, with both the experimental and control groups comprising 30 students each. The experimental group incorporated the use of digital collaboration platforms, including Asana, Slack, and Team Viewer, as instrumental components of group project execution and discussion in their science lessons. Conversely, the control group adhered to the current educational approach in Turkey, characterized by the employment of an inquiry‐based learning strategy in their science instruction. Data was collected over eight weeks using a science achievement test, engagement scale, and science motivation scale. Results: The experimental group demonstrated significantly higher post‐test scores compared to the control group, suggesting that online collaboration tools positively impacted science education outcomes. Additionally, survey data indicated high levels of engagement and motivation among the experimental group students when using the online collaboration tools. Conclusions: The findings support the notion that online collaboration tools can effectively enhance learning, motivation, and engagement in science education among middle school students. These results have significant implications for educators, educational institutions, policymakers, and curriculum developers. Further research is needed to examine the potential of these tools in various educational contexts and with different student populations. This will help broaden the understanding of how online collaboration tools can be integrated into diverse learning environments, potentially benefiting a larger number of students and further improving science education outcomes. Lay Description: What is already known about this topic: Technology's role, particularly online collaboration tools, in enriching science education is undebatable (Donkin & Rasmussen, 2021; Rahmawati et al., 2022). Such tools have been theorized to bolster student learning outcomes, motivation, and engagement (Donnelly et al., 2013; Ekici, 2017; Khazanchi & Khazanchi, 2019). Yet, the empirical evidence validating their efficacy in science educational settings remains sparse. What this paper adds: This research delves into the influence of online collaboration tools on science learning outcomes among middle school learners. Data indicates that employing these digital tools substantially elevates student performance, as gauged by a science achievement test. Furthermore, students navigating through these online collaborative platforms recorded elevated levels of both engagement and motivation. The primary effectiveness of online collaboration tools stems from their ability to foster specific behaviours, such as increased communication frequency and structured task management, which can amplify learning and group collaboration through their facilitated structured interactions. Implications for practice and/or policy: This study's conclusions offer pivotal insights for educators, academic institutions, policy framers, and curriculum architects. Online collaborative platforms exhibit promise in amplifying student outcomes and engagement within the realm of science education. It is imperative to broaden this research scope to discern the tools' potential across varied educational environments and diverse student demographics. There is a compelling case for stakeholders, especially educators and policymakers, to contemplate incorporating these online tools into science pedagogy, aiming to magnify student learning experiences and engagement levels. [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]

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]

This study aimed to comprehensively evaluate the effects of evidence‐based nursing (EBN) intervention on wound infection and postoperative complications in patients after appendectomy for acute appendicitis (AA), with the expectation of providing a theoretical basis for postoperative care in AA. Randomised controlled trials (RCTs) on the postoperative application of EBN in patients with AA were searched in PubMed, Web of Science, Cochrane Library, Embase, China Biomedical Literature Database, Wanfang and China National Knowledge Infrastructure from the inception of databases to October 2023. Two authors screened and evaluated the literature based on the inclusion and exclusion criteria, and data were extracted from the final included literature. Stata software (version 17.0) was employed for data analysis. In total, 29 RCTs involving 2848 patients with AA were included, with 1424 in the EBN group and 1424 in the conventional care group. The analyses revealed that patients with AA who experienced EBN were significantly less likely to develop postoperative wound infections (odds ratio [OR] = 0.23, 95% confidence intervals [CIs]: 0.14–0.38, p < 0.001) and postoperative complications (OR = 0.20, 95% CI: 0.15–0.26, p < 0.001) as opposed to conventional care. Available evidence suggests that EBN can effectively reduce the risk of wound infection and postoperative complications in patients undergoing appendectomy for AA, thereby improving patient prognosis. This finding is worth promoting in the clinical practice. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have characterized the gut microbiome (GM) in lung cancer (LC). Yet, the causality between GM and LC and its subtypes remain uncharacterized. Methods: Two‐sample Mendelian randomization (MR) was designed to investigate the causal relationship between the GM and LC and its subtypes, using publicly available summary data of genome‐wide association studies. The researchers ran two groups of MR analyses, including the genome‐wide statistical significance threshold (5 × 10−8) and the locus‐wide significance level (1 × 10−5). Results: Using MR analysis, we ascertained 42 groups of GM that are intimately linked to LC and its subtypes at the locus‐wide significance level. Of the 42 groups, 12 were in LC, nine in non‐small cell lung cancer (NSCLC), six in small cell lung cancer (SCLC), two in lung adenocarcinomas, and 13 in lung squamous carcinomas. After false discovery rate correction, we still found a remarkable causal interaction between the Eubacterium ruminantium group and SCLC. Moreover, five groups of GM closely linked to LC and its subtypes were recognised at the genome‐wide statistical significance threshold. This finding included one group each in LC, NSCLC and SCLC, two groups in lung adenocarcinoma and none in lung squamous carcinoma. None of the foregoing findings were heterogeneous or horizontal pleiotropy. Reverse MR revealed that genetic susceptibility to LC and its subtypes caused significant changes in three groups of GM. Conclusion: Our findings substantiate the causality between GM and LC and its subtypes. This study offers fresh insights into the function of GM in mediating the progression of LC. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the efficacy of acupuncture in the treatment of pressure ulcers. Randomized controlled trials evaluating the effects of acupuncture on pressure ulcers were identified through a comprehensive literature search on public database. The quality assessment of the included trials was performed based on the guidance of the Cochrane Reviewers' Handbook, and pooled analyses were performed by using the RevMan 5.4 software. The pooled results demonstrated that acupuncture in combination with standard wound care was significantly superior to standard wound care alone with regard to effective rate (RR 1.17, 95% CI [1.10, 1.24]), reduction in Wound Size (MD −2.78, 95% CI [−2.43, −1.44]), healing time (MD −6.24, 95% CI [−12.32, −0.17]) and the amount of 24‐h exudate (MD −0.86, 95% CI [−1.54, −0.18]). In conclusion, this study suggests that acupuncture can be used as an adjunctive therapy to promote healing of pressure ulcers. [ABSTRACT FROM AUTHOR]

In this study, we aimed to evaluate the effect of moxibustion on pressure ulcers. A thorough search was performed for articles published from database inception up to 14 December 2023. Randomized controlled trials, which evaluated the effects of moxibustion were included. Finally, 11 relevant trails that enrolled a total of 795 participants met inclusion criteria. The results of meta‐analysis suggested beneficial effects of moxibustion for pressure ulcer compared with control on the response rate (RR: 1.21; 95% CI: 1.13–1.29; p = 0.82; I2 = 0%), healing time (MD: −5.69; 95% CI: −9.58 to −1.80; p<0.05; I2 = 97%) and pressure ulcer scale for healing scores (MD: −1.13; 95% CI: −1.36 to −0.89; p = 0.79; I2 = 0%). The evidence suggests that moxibustion possesses satisfactory efficacy in promoting healing of pressure ulcers. However, due to the small number of trials included in this study, as well as the small sample size and high risk of bias, we were unable to draw firm conclusions about the effectiveness of moxibustion for pressure ulcers. [ABSTRACT FROM AUTHOR]

This study systematically evaluated the effect of hydrocolloid dressings on facial pressure ulcers in patients receiving non‐invasive positive pressure ventilation (NIPPV). The Embase, PubMed, Cochrane Library, CNKI, VIP, Chinese Biomedical Literature Database and Wanfang databases were searched for randomised controlled trials on the use of hydrocolloid dressings in patients receiving NIPPV published from the inception of each database to August 2023. The literature was independently screened, data were extracted by two authors based on the inclusion and exclusion criteria, and the quality of the included literature was assessed. The meta‐analysis was performed using Stata 17.0. Thirteen studies including 1248 patients were included, with 639 patients in the intervention group and 609 patients in the control group. Meta‐analysis showed that the hydrocolloid dressing significantly reduced the incidence of facial pressure ulcers in patients with NIPPV (odds ratio = 0.16, 95% confidence intervals: 0.11–0.24, p < 0.001). Hydrocolloid dressings are effective in reducing the incidence of facial pressure ulcers in patients receiving NIPPV. However, because of the small number of included studies, this conclusion needs to be confirmed with larger samples and high‐quality clinical studies. [ABSTRACT FROM AUTHOR]

Wound care is a complex procedure and the related research may include many variables. Deficiencies in the sample inclusion and exclusion criteria may limit the generalizability of randomized controlled trials (RCTs) for wound patients in the real world. This study aimed to evaluate deficiencies in reporting the inclusion and exclusion criteria and the characteristics of patients in RCTs of pressure injuries (PI) therapeutic interventions. We conducted a systematic methodological review in which 40 full text RCTs of PI treatment interventions published in English, from 2008 to 2020, were identified. Data on the general characteristics of the included RCTs and data about inclusion/exclusion criteria and characteristics of patients were collected. The inclusion/exclusion criteria were categorized into five domains (definition of disease, precision, safety, ethical/legal and administrative). Study duration (in weeks) was 8.0 (quartile 1: 2.0; quartile 3: 48.0); only 5.0% of the trials mentioned race, skin colour or ethnicity, and 37.5% reported the duration of the wound. Only 9 (22.5%) studies reported the drugs that the included patients were using and 10 (25.0%) RCTs reported adverse events. The presence of the five domains was observed only in 12.5% of RCTs and only 12 (30.0%) had the precision domain. Much more research is required in systematic assessments of the external validity of trials because there is substantial disparity between the information that is provided by RCTs and the information that is required by clinicians. We concluded that there are deficiencies in reporting of data related to inclusion/exclusion criteria and characteristics of patients of RCTs assessing PI therapeutic interventions. [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]