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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]

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 supplementation with protein-energy (PE) and/or multiple-micronutrients (MMNs) may improve fetal growth, but trials of lipid-based nutritional supplements (LNSs) have reported inconsistent results. We conducted a post-hoc analysis of non-primary outcomes in a trial in Gambia, with the aim to test the associations of LNS with fetal growth and explore how efficacy varies depending on nutritional status. The sample comprised 620 pregnant women in an individually randomized, partially blinded trial with four arms: (a) iron and folic acid (FeFol) tablet (usual care, referent group), (b) MMN tablet, (c) PE LNS, and (d) PE + MMN LNS. Analysis of variance examined unadjusted differences in fetal biometry z-scores at 20 and 30 weeks and neonatal anthropometry z-scores, while regression tested for modification of intervention-outcome associations by season and maternal height, body mass index, and weight gain. Despite evidence of between-arm differences in some fetal biometry, z-scores at birth were not greater in the intervention arms than the FeFol arm (e.g., birth weight z-scores: FeFol −0.71, MMN −0.63, PE −0.64, PE + MMN −0.62; group-wise p = .796). In regression analyses, intervention associations with birth weight and head circumference were modified by maternal weight gain between booking and 30 weeks gestation (e.g., PE + MMN associations with birth weight were +0.462 z-scores (95% CI [0.097, 0.826]) in the highest quartile of weight gain but -0.099 z-scores (−0.459, 0.260) in the lowest). In conclusion, we found no strong evidence that a prenatal LNS intervention was associated with better fetal growth in the whole sample. [ABSTRACT FROM AUTHOR]

ABSTRACT Although urinary incontinence (UI) is not a life-threatening disease, it is a common health problem that affects quality of life. This study was conducted to investigate the effect of pelvic floor muscle exercise (PFE) with biofeedback on incontinence and quality of life in women with UI. This clinical study was a randomized, controlled and experimental research conducted on 60 patients in total (30 control and 30 intervention patients) at a university hospital. Data were collected by using a questionnaire, Incontinence Quality of Life (I- QOL) instrument, and International Consultation on Incontinence Questionnaire-Short Form ( ICIQ-SF). The intervention group received biofeedback treatment for 16 sessions in total, each of which lasted 20 min, for 8 weeks, twice weekly, in a urodynamic unit. The obtained data were evaluated using χ2, Student's t, one-way analysis of variance ( anova), Mann-Whitney U and Kruskal-Wallis tests. It was observed that the incontinence inquiry form mean score of 16·1 ± 2·2 in the intervention group before biofeedback application decreased to 11·6 ± 4·6 after the application, whereas it increased from 14·0 ± 4·7 to 14·7 ± 4·7 in the control group ( p < 0·05). It was also determined that the quality of life total mean score of 52·1 ± 10·5 in the intervention group before biofeedback application increased to 58·7 ± 14·7 after the application, whereas it decreased from 58·1 ± 16·1 to 53·5 ± 16·1 in the control group ( p < 0·05). At the end of this study it was observed that PFE with biofeedback reduced incontinence and increased quality of life in women. [ABSTRACT FROM AUTHOR]

Background It has been increasingly recognized that subthreshold depression is associated with considerable personal, social and economic costs. However, there is no accepted definition or clear-cut treatment for subthreshold depression. Cognitive bibliotherapy is a promising approach, but further research is necessary in order to assess its clinical efficacy and key mechanisms of change. Aim This study aimed to investigate the efficacy of bibliotherapy for subthreshold depression and test whether maladaptive cognitions mediate the effects of bibliotherapy on depressive symptoms. Method A total of 96 young adults with subthreshold depression were randomized in one of the following treatment conditions: immediate treatment, delayed treatment, placebo and no treatment. The main outcome was represented by depressive symptoms assessed before, during and immediately after the treatment, as well as at 3-month follow-up. Automatic thoughts, dysfunctional attitudes and irrational beliefs were also assessed throughout the study, and we investigated their involvement as mediators of bibliotherapy effects on depressive symptoms. Results The results indicated that cognitive bibliotherapy resulted in statistically and clinically significant changes both in depressive symptoms and cognitions, which were maintained at follow-up. In contrast, placebo was only associated with a temporary decrease in depressive symptoms, without significant cognitive changes. No changes in symptoms or cognitions were found in the delayed treatment and no treatment groups. We also found that automatic thoughts significantly mediated the effect of bibliotherapy on depressive symptoms. Conclusion This study provided compelling evidence for the efficacy of cognitive bibliotherapy in subthreshold depression and showed that changes in automatic thoughts mediated the effect of bibliotherapy on depressive symptoms. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Message Cognitive bibliotherapy is an effective treatment of subthreshold depression., Changing automatic thoughts is important, as they mediate the bibliotherapy effect on depressive symptoms., Cognitive bibliotherapy is a potential alternative or adjunct to psychotherapy for mildly depressed adults. [ABSTRACT FROM AUTHOR]

Background: Brief interventions have the potential to reduce heavy drinking in young adults who present to the emergency department (ED), but require time and resources rarely available. Text-messaging (TM) may provide an effective way to collect drinking data from young adults after ED discharge as well as to provide immediate feedback and ongoing support for behavior change. The feasibility of screening young adults in the ED, recruiting them for a TM-based interventional trial, collecting weekly drinking data through TM, and the variance in drinking outcomes remains unknown. Methods: Young adults in 3 urban EDs ( n = 45; aged 18 to 24 years, 54% women) identified as hazardous drinkers by the Alcohol Use Disorders Identification Test-Consumption score were randomly assigned to weekly TM-based feedback with goal setting (Intervention), weekly TM-based drinking assessments without feedback (Assessment), or control. Participants in the Intervention group who reported ≥5 (for men) and ≥4 (for women) maximum drinks during any one 24-hour period were asked whether they would set a goal to reduce their drinking the following week. We describe the interaction with TM and goal setting. We also describe the heavy drinking days (HDDs), drinks per drinking day (DPDD) using timeline follow-back procedure at baseline and 3 months. Results: We screened 109 young adults over 157 hours across 24 unique days and 52 (48%; 95% CI 38 to 50) screened positive for hazardous drinking. Of these, 45 (87%; 95% CI 74 to 94) met inclusion criteria, were enrolled and randomized, and 6 (13%; 95% CI 5 to 27) did not complete 3-month web-based follow-up; 88% (95% CI 84 to 91) of weekly TM-based drinking assessments were answered, with 77% (95% CI 58 to 90) of participants responding to all 12 weeks. Agreeing to set a goal was associated with a repeat HDD 36% (95% CI 17 to 55) of the time compared with 63% (95% CI 44 to 81) when not willing to set a goal. At 3 months, participants that were exposed to the TM-based intervention had 3.4 (SD 5.4) fewer HDDs in the last month and 2.1 (SD 1.5) fewer DPDD when compared to baseline. Conclusions: TM can be used to assess drinking in young adults and can deliver brief interventions to young adults discharged from the ED. TM-based interventions have the potential to reduce heavy drinking among young adults but larger studies are needed to establish efficacy. [ABSTRACT FROM AUTHOR]

The ultimate goal of alcohol treatment research is to develop interventions that help individuals reduce their alcohol use. To determine whether a treatment is effective, researchers must then evaluate whether a particular treatment affects changes in drinking behavior after treatment. Importantly, drinking following treatment tends to be highly variable between individuals and within individuals across time. Using data from the COMBINE study (), the current study compared 3 commonly used and novel methods for analyzing changes in drinking over time: latent growth curve (LGC) analysis, growth mixture models, and latent Markov models. Specifically, using self-reported drinking data from all participants ( n = 1,383, 69% male), we were interested in examining how well the 3 estimated models were able to explain observed changes in percent heavy drinking days during the 52 weeks following treatment. The results from all 3 models indicated that the majority of individuals were either abstinent or reported few heavy drinking days during the 52-week follow-up and only a minority of individuals (10% or fewer) reported consistently frequent heavy drinking following treatment. All 3 models provided a reasonably good fit to the observed data with the latent Markov models providing the closest fit. The observed drinking trajectories evinced discontinuity, whereby individuals seem to transition between drinking and nondrinking across adjacent follow-up assessment points. The LGC and growth mixture models both assumed continuous change and could not explain this discontinuity in the observed drinking trajectories, whereas the latent Markov approach explicitly modeled transitions between drinking states. The 3 models tested in the current study provided a unique look at the observed drinking among individuals who received treatment for alcohol dependence. Latent Markov modeling may be a highly desirable methodology for gaining a better sense of transitions between positive and negative drinking outcomes. [ABSTRACT FROM AUTHOR]

Objective: To compare the effect of specific interventions aimed at (1) the upper thoracic spine (passive mobilization) and (2) the posterior shoulder (massage, passive mobilization, and stretching) to (3) an active control intervention in a homogeneous group with extrinsic subacromial shoulder impingement (SSI). Study Design: Single‐centre, prospective, double‐blinded, randomized controlled trial. Method: Eligible individuals with clearly defined extrinsic SSI were randomized to each group. Treatment duration was 12 consecutive weeks consisting of nine treatments over 6 weeks, followed by 6 weeks when one home exercise was performed daily. Outcomes included (1) active thoracic flexion/extension range of motion, (2) passive glenohumeral internal rotation and posterior shoulder range, (3) pain rating, and (4) shoulder pain and function disability index. Data were analysed at baseline, 6 and 12 weeks. Shoulder pain and function disability index scores were investigated via email 6 months after commencement of treatment. Results: Twenty participants completed treatment in each group. No differences were identified between groups at baseline. Upper thoracic and posterior shoulder interventions, with a targeted home exercise, both significantly decreased pain and increased function scores and increased posterior shoulder range compared with active control at 12 weeks, and 6 months following cessation of the trial. Conclusion: Manual therapy treatment that addresses these extrinsic factors, of thoracic spine or posterior shoulder tightness, decreases the signs and symptoms of SSI. The trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR; 12615001303538). [ABSTRACT FROM AUTHOR]