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Background: Introducing new technologies in education sparks debates, disrupting traditional practices, and requiring teacher adaptation. ChatGPT is an example. Research explores its benefits and concerns in education, with recommendations for classroom use. Nevertheless, limited evidence supports ChatGPT as a tool for supporting English as a Foreign Language (EFL) students' research competency. Moreover, while the literature primarily focuses on the perspectives of scholars and teachers, it is essential to incorporate students' viewpoints in order to maximize the potential of this technology. Objectives: The present study investigated EFL undergraduates' perceptions and practices of ChatGPT as a tool for promoting their research competency. Additionally, the study examined the potential influence of metacognitive awareness (MA) levels in this context. Methods: The study utilized a mixed‐method research design, collecting quantitative and qualitative data from 27 EFL undergraduates (12 with low MA and 15 with high MA) over one semester. Data sources included a self‐report questionnaire, self‐study log, and semi‐structured interviews. Results and conclusions: Quantitative analysis showed significant differences between low and high MA groups in their perceptions of ChatGPT (U = 37.500, Z = 2.570). Regression analysis revealed a positive correlation between MA scores and students' perceptions and practices of ChatGPT. Qualitative analysis revealed diverse perceptions and practices of ChatGPT between the high MA and low MA groups, showcasing behaviours ranging from replication to using ChatGPT as a thought‐stimulating and supportive tool, accessing supplementary information, and seeking guidance. Key factors for effective ChatGPT use included prompt formulation, systematic thinking, self‐regulation strategies, and trust in AI. Lay Description: What is currently known about this topic: Research competency and metacognitive awareness are important for EFL undergraduates.Technology has been explored for promoting research competency.ChatGPT is used as a learning tool in EFL instruction contexts. What does this paper add: It provides a deeper understanding of the practical application of AI tools like ChatGPT for developing research competency among EFL students.It enhances understanding of metacognition's role in successful learning in digital environments by exploring MA's impact on using ChatGPT for research purposes. Implications for practice/policy: Provide explicit instructions and guidelines for EFL students to effectively use ChatGPT for research competency, emphasizing clear prompt design and fostering responsible use through critical thinking and awareness of biases and limitations.Enhance EFL students' metacognitive awareness through scaffolding, explicit instruction, and activities.Implement assessments and monitoring mechanisms to track metacognitive development and guide instructional interventions.Offer professional development opportunities for EFL teachers to enhance their understanding and skills in integrating AI tools into research instruction and other EFL aspects. [ABSTRACT FROM AUTHOR]

Background: Tele‐collaborative projects serve as invaluable platforms for students from diverse countries to engage in cross‐cultural communication and exchange cultural knowledge. These projects offer immense benefits in terms of fostering intercultural competence among participants. However, one challenge arises when participants engage in spoken communication rather than written. Those who may not share a common first language often rely on a lingua franca such as English for intercultural communication. In such spoken exchanges, varying levels of language proficiency can lead to communication errors that hinder the intercultural learning process and impede the development of intercultural competence in their fellow participants. Objectives: In the present trial study, our primary objective was to tackle the language‐related challenge associated with spoken communication head‐on. Our focus centred on addressing the discrepancies arising in spoken communication, and we aimed to mitigate these discrepancies by utilizing speech‐enabled corrective feedback technology. Methods: In a tele‐collaborative project involving 28 graduate students from the People's Republic of China and Republic of Kazakhstan, the participants engaged in spoken communication and cultural exchange in English via the internet. Given the emphasis on spoken communication and the recognition that English was not their first language, we implemented a speech‐enabled corrective feedback (SECF) technology to ensure effective communication in terms of pronunciation, grammar, and word choice. The SECF technology detected and provided instant feedback on any speech mistakes, enabling participants to make corrections accordingly. The main aim of our study was to explore the potential benefits of integrating SECF technology into a tele‐collaborative project for the development of participants' intercultural competence. Additionally, we sought to gather insights into the students' perceptions of the SECF support. Results and Conclusions: The results of our study revealed significant improvements in the participants' intercultural competence across dimensions such as knowledge, skills, attitude, and awareness. Furthermore, the participants expressed positive perceptions of the SECF technology. Drawing from our findings, we offer valuable implications and recommendations for educators and researchers in the field, enhancing their understanding of the role of SECF technology in supporting intercultural competence development in tele‐collaborative settings. Lay Description: What is currently known about the subject matter: Tele‐collaborative projects are widely utilized to enhance intercultural competence.Low language proficiency of participants often poses a significant challenge in tele‐collaborative projects. What this paper adds: The present study addressed the language barrier by incorporating speech‐enabled corrective feedback (SECF) technology to support our tele‐collaborative project.The study explored how our tele‐collaborative project, supported by SECF, facilitated the development of intercultural competence. The implications of study findings for practitioners: Scholars and practitioners should consider implementing SECF technology to address language‐related barriers in tele‐collaborative projects.Guidelines based on our study can be utilized to design tele‐collaborative projects with SECF support.Training on technology and constant support needs to be provided to participants. [ABSTRACT FROM AUTHOR]

Background: The Communicative Participation Item Bank (CPIB) is a patient‐reported outcome measure (PROM) designed to measure the extent of interference, or difficulty, experienced by adults with communication disorders participating in their day‐to‐day communication activities. To date, there is limited evidence regarding sensitivity of the CPIB for capturing change with intervention in people with Parkinson's disease (PwPD). Aims: The purpose of this study was to examine the following measurement properties of the CPIB in PwPD who received community‐based, standard care, speech‐language therapy focusing on motor speech concerns: Change over time between treatment and observation groups, comparison to patient‐defined ideal and satisfactory targets, comparison of static short form to computerised adaptive testing (CAT), comparison of self to proxy‐rated scores, and comparison to other common PROMs. Methods and Procedures: Forty‐six PwPD (20 treatment/26 observation) completed data collection upon enrolment (pre‐treatment) and 6 months later. In addition to the CPIB, PROMs included the Voice Handicap Index 10‐item short form (VHI‐10), PROMIS Global Health‐Related Quality of Life, Levels of Speech Usage, self‐rated speech severity, and Patient Health Questionnaire‐9 (PHQ‐9). Participants also engaged in qualitative interviews. Forty‐four family members completed proxy CPIB ratings. Outcomes and Results: There were no significant differences between treatment and observation groups on the CPIB pre‐treatment, but there were significant differences post‐treatment. The differences appeared to be largely due to significant gains in the treatment group. No participants reached their ideal CPIB target, and few reached their satisfactory target. Static CPIB short form and CAT scores were not significantly different, with an average of five CAT items administered per participant. Overall group similarities between patient and proxy scores may have obscured wide variability across individual patient‐proxy pairs. Associations between CPIB and VHI‐10, health‐related quality of life, self‐reported speech severity, and depression ranged from weak to moderate. Conclusions and Implications: The CPIB appears to be sensitive to capturing change with intervention, and similar results are obtained with the static short form and CAT formats. One clinical caution is that even with gains observed in the treatment group, no participants obtained their ideal communicative participation goals, and few obtained a satisfactory level of communicative participation. Thus, while current interventions are beneficial, they may not meet the full range of clients' communication needs. While responding to the CPIB through a proxy rater may be feasible, caution is warranted due to concerns about maintaining the autonomy of PwPD. What this paper adds: What is already known on this subject: The communication disorders associated with Parkinson's disease (PD) can have a negative impact on quality of life and life participation as measured by patient (or person)‐reported outcome measures (PROMs). The Communicative Participation Item Bank (CPIB) is one PROM available to use with adults with communication disorders. However, little is known about whether the CPIB captures changes in communicative participation as a result of standard care treatment for people with Parkinson's disease (PwPD). Use of computerised adaptive testing (CAT), proxy report and comparison to targeted participation outcomes have not been explored. What this study adds to existing knowledge: As a result of this study, we know that the CPIB captured differences between treatment and observation groups after community‐based, standard care speech therapy intervention focusing on motor speech production in PwPD. Static short form and CAT scores did not differ significantly, so the CAT option provides better efficiency requiring, on average, five items to administer compared to the 10‐item short form. Proxy and PwPD scores did not differ as a group, but wide variability was noted. What are the potential or actual clinical implications of this work?: The CPIB may be a clinically sensitive instrument for capturing changes in communicative participation after treatment. No participants met their ideal CPIB target, and few reached their satisfactory target, suggesting that while current interventions contribute to gains in communicative participation, there are still unmet needs that may call for support and interventions addressing the more complex array of factors affecting communicative participation outcomes for PwPD. [ABSTRACT FROM AUTHOR]

Background: Flipped classroom (FC) model has become increasingly popular in dental education (DE) with its strengths for students. However, major concerns are lack of interaction, unwillingness to complete the assignments, low engagement during the pre‐class activities because of an unwell‐designed instructional setting of FC. Objectives: The recent study aims to investigate the effects of video‐driven discussions integrated into the flipped classroom (VdDs‐FC) model on dental students' (DSs) learning achievement, practical performance, and higher‐order thinking skills in a restorative dentistry course. Methods: This study adopted a sequential explanatory design from mixed‐methods research. A total of 96 DSs participated in a dentistry faculty of Türkiye. They were randomly divided into two groups: VdDs‐FC group and the conventional flipped classroom (c‐FC) group. Results and conclusions: The results showed that the VdDs‐FC model had significant positive effects on the practical performance of DSs in practical subjects and their problem‐solving and critical thinking skills. However, there was no significant difference between the two groups in learning achievement and creativity. The use of FC in the c‐FC group did not lead to any difference in the students' achievements. Moreover, the qualitative results indicated that the VdDs‐FC model has the potential for enhancing peer learning, practical classroom activities, and higher‐order thinking skills. Implications: This study also includes several instructional implications and suggestions for educators, researchers, and practitioners on use of FC in dentistry. Lay Description: What is already known about this topic: Flipped learning has become a rapidly growing area of dentistry research.Discussion board could be beneficial to increasing dental students' higher order thinking skills, especially problem solving and critical thinking.Video‐driven discussions into flipped classroom provide several opportunities for practical performance in dental education, not for theoretical knowledge. What this paper adds: Video‐driven discussions into flipped classroom model is proposed.We compared two learning environments by including traditional flipped classroom.We found that the integrated model with flipped classroom can have a positive impact on students' achievement.Online discussions usage contributed to higher cognitive, affective, and behavioural learning outcomes.Based on interview data, the proposed model supports peer learning. Implications for practice and/or policy: Dental educators should integrated the digital discussion boards as out‐of‐class activities in the pre‐clinical dental training.From dental educators' perspective, they should be carefully trained in FC design (interaction elements, material design, integration with different methods, etc.).From instructional design perspective, micro videos should have case‐based or problem‐based activities to discuss.From learner perspective, an integration of the flipped classroom with different technologies could have a positive effect on increasing learning. [ABSTRACT FROM AUTHOR]

Background: Formative online multiple‐choice tests are ubiquitous in higher education and potentially powerful learning tools. However, commonly used feedback approaches in online multiple‐choice tests can discourage meaningful engagement and enable strategies, such as trial‐and‐error, that circumvent intended learning outcomes. These strategies will not prepare graduates as self‐regulated learners, nor for the complexities of contemporary work settings. Objectives: To investigate whether providing only a score after formative online multiple‐choice test attempts (score‐only feedback) increases the likelihood of students to engage in self‐regulated learning compared with more directive feedback. Measurable outcomes included deeper learning, collaboration, information seeking, and satisfaction. Methods: Data in this mixed methods study were collected from nursing students through surveys, test results, focus groups, and student discussion board contributions. A quasi‐experimental design was used for quantitative data, and qualitative data were analysed thematically against domains of self‐regulated learning. Results and Conclusions: Students receiving score‐only feedback were more cognitively engaged with the content, collaborated constructively, and sought out richer sources of information. However, it was also associated with lower satisfaction. In this study, minimal feedback created states of uncertainty, which resulted in the activation of self‐regulatory actions. Implications for Practice: Providing overly directive feedback for formative online multiple‐choice tests is conducive to surface‐level learning strategies. By minimising feedback and allowing for extended states of uncertainty, students are more likely to regulate their learning through self‐assessment and problem‐solving strategies, all of which are required by graduates to meet the challenges of real‐world work settings. Lay Description: What is already known about this topic: Formative online multiple‐choice tests are widely used in higher education.Feedback is a critical element in the design of effective online multiple‐choice tests.Formative feedback should promote self‐regulated learning.Feedback types used in multiple‐choice tests facilitate strategies not conducive to self‐regulation. What this paper adds: Online multiple‐choice test feedback can influence how students self‐regulate their learning.Less feedback can result in greater self‐evaluation and performance in summative assessment.Less feedback can encourage richer help‐seeking strategies (collaboration and information seeking).However, less feedback can result in student dissatisfaction. Implications for practice and/or policy: Judicious use of feedback is required in the design of online multiple‐choice tests.Educators should consider providing less feedback to promote learner self‐regulation.Satisfaction with online multiple‐choice tests does not necessarily equate to greater learning. [ABSTRACT FROM AUTHOR]

Background: Many amateur singers enjoy singing in choirs. They are likely to lack the training and expertise of professional singers and this may have an impact on their vocal health. Aims: To assess the experiences of amateur singers, their use of warm‐up and cool‐down sessions, their vocal health, their sources of help and advice and their reactions to receiving a diagnosis and treatment. Methods and Procedures: A questionnaire was sent to amateur choir singers. Quantitative data on their use of warm‐up and cool‐down activities were collected and the singers rated how frequently they experienced adverse voice symptoms after singing. Qualitative data were collected from singers who had sought advice about their voice and from those who had received a diagnosis and treatment. Outcome and Results: Most choirs used warm‐up sessions but few used cool‐down. Singers who participated in choir warm‐ups experienced significantly less vocal symptoms. Individual warm‐ups were ineffective. Singers who had previously had a diagnosis continued to have significantly higher symptom scores. A quarter of the singers who had neither sought help nor had a diagnosis had high scores. Singers appeared uncertain about who to consult for help. Those who saw a speech and language therapist were much more likely to receive a diagnosis and treatment either by the therapist or by referral to an ear, nose and throat specialist. Those receiving treatment were mainly positive about it and likely to complete a course of therapy. Conclusions and Implications: Warm‐up sessions performed by choirs are helpful in avoiding voice symptoms and are recommended. The presence of singers who are unaware of potential damage to their voices is a concern. A simple rating system, as used in this research, may act to alert them to the dangers. Choir leaders could be more active in advising singers and refer them to professionals where necessary. Speech and language therapists appear more sensitive to their problems and could be a first point of contact. WHAT THIS PAPER ADDS: What is already known on this subject: Poor vocal health may occur in amateur singers and lead to voice disorders which will reduce the demonstrated benefits of regular singing. They may be less aware than professional singers of potential hazards and may not know how to sing in a way that ensures good vocal health. There has been less research on the extent of voice problems in amateurs or of the actions they may take to resolve the vocal difficulties they encounter. What this paper adds to the existing knowledge: This survey demonstrates that choir warm‐ups were effective in helping to avoid common symptoms associated with voice problems. A large minority of singers who had not sought help for voice problems had high symptom scores on our assessment. Singers frequently turned to a singing teacher for help. Those who consulted a speech and language therapist were much more likely to be referred for further investigation and treatment. What are the potential or actual clinical implications of this work?: We present a simple subjective measure of symptom severity which succeeds in distinguishing between singers who warm up their voices and those who do not and between singers who have received a past diagnosis and those who have not. There are a number of indications in this research that amateur singers are unsure if they need help and are uncertain who can offer it. In these circumstances the use of a simple measure of the severity of vocal abuse may be useful. [ABSTRACT FROM AUTHOR]

Background: Health sciences education prepares students for social‐ and healthcare by developing evidence‐based nursing, leadership and working life skills, including collaboration. Due to the changes caused by the global pandemic, health sciences education has shifted more to online and hybrid contexts, which can challenge students' competence development. Students' competence development and interaction in collaborative hybrid learning is a little researched area. Objectives: To observe and evaluate health sciences students' competence development in a collaborative hybrid learning context. Methods: This quasi‐experimental mixed‐method study was implemented by providing educational intervention. First‐year Bachelor's degree health sciences students (n = 18) of a Finnish university completed an educational intervention with synchronous online and face‐to‐face learning. Students' collaborative hybrid learning and interaction were video observed, while self‐evaluation of competence development was made with a questionnaire. Results: In the collaborative interactions, the students showed analytical thinking, problem‐ solving and communication and technology skills. Extensive knowledge of health sciences and ethics skills was not strongly visible in interaction. The students effectively used collaborative work time to perform tasks. Cognitive interaction (monitoring and evaluating learning) was observed in 85% and socio‐emotional interaction (expressions of emotions and motivation) in 53% of the data. Related to the students' learning results, the students' ability to communicate and interact with culturally different people improved after the educational intervention. Conclusion: Collaborative learning methods in hybrid learning can create opportunities for students to construct their competence in interaction. Attention should be paid to different areas of competence and the role of socio‐emotional interaction. Lay Description: What is already known about this topic: Health sciences education prepares students for social and healthcare by developing working life skills, including collaboration.Hybrid learning brings benefits but challenges the equity of students with different attention modes.Collaborative learning is widely used but has not been studied much in hybrid context.Students' competence development and interaction in collaborative hybrid learning is a little researched area. What this paper adds: The purpose was to observe and evaluate health sciences students' competence development in a collaborative hybrid learning context.Hybrid collaborative interaction encourages students to construct knowledge in health sciences.The students utilised the collaborative time appropriately.Socioemotional interactions were very visible in collaborative learning. Implications for practice: This study helps educational organisations to design hybrid model education.The design requires pedagogical and technical competence and should include collaborative methods.Attention should be paid to different areas of competence in collaborative learning.The role of socio‐emotional interaction needs more focus in hybrid learning. [ABSTRACT FROM AUTHOR]

Background: Dysphagia impacts negatively on quality of life, however there is little in‐depth qualitative research on these impacts from the perspective of people with dysphagia. Aims: To examine the lived experiences and views of people with lifelong or ongoing dysphagia on the impacts of dysphagia and its interventions on quality of life, and barriers and facilitators to improved quality of life related to mealtimes. Methods & Procedures: Nine adults with lifelong or acquired chronic dysphagia engaged in in‐depth interviews and a mealtime observation. The observations were recorded and scored using the Dysphagia Disorders Survey (DDS). Interviews were recorded, transcribed and de‐identified before content thematic and narrative analysis, and verification of researcher interpretations. Outcomes & Results: Participants presented with mild to severe dysphagia as assessed by the DDS. They viewed that dysphagia and its interventions reduced their quality of life and that they had 'paid a high price' in terms of having reduced physical safety, reduced choice and control, poor mealtime experiences, and poor social engagement. As part of their management of dysphagia, participants identified several barriers to and facilitators for improved quality of life including: being involved in the design of their meals, being adaptable, having ownership of swallowing difficulties, managing the perceptions of others and resisting changes to oral intake. Conclusions & Implications: This research improves understanding of the primary concerns of people with dysphagia about their mealtime experiences and factors impacting on their quality of life. Clinicians working with people with dysphagia need to consider how self‐determination, autonomy and freedom of choice could be improved through involvement in food design of texture‐modified foods. It is important that future research considers the views of health professionals on how these findings could impact on policy and practice particularly in ways to address the barriers and enhance facilitators to improved quality of life for people with dysphagia. What this paper adds: What is already known on the subject: Dysphagia impacts on quality of life, particularly as the severity of the dysphagia increases. Research to date has focused on people with dysphagia associated with an acquired health condition and has used quantitative assessment methods to measure quality of life. What this paper adds to existing knowledge: This study provides a qualitative examination of the impacts of dysphagia on quality of life from the perspective of people with lifelong or ongoing acquired dysphagia and their supporters. This study also provides qualitative insights into the barriers and facilitators of mealtime‐related quality of life. What are the potential or actual clinical implications of this work?: Health professionals should engage in open communication with their clients with dysphagia regarding the impacts of dysphagia on their lifestyle and quality of life. By considering these impacts, health professionals may be able to recommend interventions that are more acceptable to the person with the dysphagia which may have a positive impact on their mealtime experience. [ABSTRACT FROM AUTHOR]

Background: Improving the quality of life for individuals with severe dysphagia is a priority when considering new areas of dysphagia management, especially if this increases opportunities to participate in social activities associated with eating and drinking. Edible foam is widely researched and available in the food industry; however, the use of edible foam within the field of dysphagia remains unexplored. Despite no research published on effectiveness and safety, a commercial product currently on the market is widely distributed across both Europe and the UK, including 28 NHS Trusts, suggesting that it is increasingly being used in clinical practice. Aims: To explore the perceptions and experiences of healthcare professionals on the use of stabilized edible foam (SEF) with adults with severe dysphagia in order to inform areas for future research in this novel dysphagia intervention. Methods & Procedures: Healthcare professionals were recruited using purposeful sampling and snowballing technique. A total of 56 healthcare professionals were initially approached, of which 10 completed the semi‐structured interviews. Interview questions were developed from a topic guide and a pilot questionnaire. Outcomes & Results: Thematic analysis was used to identify three themes: potential impact, consideration of risk and perceived experiences. Overarching each of these themes was the element of the unknown. Conclusions & Implications: Use of SEF with adults with dysphagia is in its infancy. Whilst results indicate that some clinicians are embracing this novel approach, others express concerns. Therefore, further research is needed, particularly in relation of direct experience of individuals and contra‐indications. What this paper adds: What is already known on the subject: The use of SEF with individuals with swallowing problems is a relatively novel area of dysphagia intervention in the UK. There are currently no published studies on its effectiveness and safety profile. What this paper adds to existing knowledge: This study provides valuable preliminary work into the area of SEF and adults with severe dysphagia, capturing the experience and perceptions of healthcare professions who have an awareness of SEF. What are the potential or actual clinical implications of this work?: Increasing clinicians and researcher's awareness of this novel area of dysphagia management. [ABSTRACT FROM AUTHOR]

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

Background: The present study analyses the design of programming literacy in the sixth grade of Primary Education, starting from the use of simple activities with visual block‐based programming, through Scratch, and progressively linking difficulty to the use of the Unity engine, and the C# language, with simple activities identical to those created in Scratch. Objectives: This research aims to evaluate future teachers' abilities and attitudes regarding programming and its educational possibilities. We intend to evaluate the viability of a teaching proposal that combines a visual block‐based programming environment and a more advanced one, based on C#. Method: In the settings of two public Spanish universities, we analyse the possibilities in the training of future teachers who are studying for a degree in Primary Education Teaching and a degree in Pedagogy. Based on a test and three scales, descriptive data and statistical inference are detailed through a quasi‐experimental design with a Student's t‐test in the first dimension, and a Wilcoxon test in the second dimension. Results: The participants improved their performance and attitudes towards programming with the intervention of the study in the use of coding. Conclusions: It can be concluded that coding is essential in teacher training, and that a greater presence of programming training in higher education is essential. The benefits are visible in the pedagogical approach of coding related to creativity, innovation, motivation, an active approach and interest, highlighting the fact that the implementation of visual block‐based programming by blocks and engines is feasible in Elementary Education. The training proposal—provided by appropriate progression, selection, and sequencing of content—fosters basic and practical teacher training, and this can be defined as an apt training solution. Lay Description: What is already known about this topic: Visual Programming Language (Scratch) provides benefits in educational contextsEducational Technology in classroom provides motivation and encouragement.Active methods and interactions are interesting and beneficial to elementary school students What this paper adds: Visual programming and game engine are feasible in Elementary Education, detailing significant improvements regarding academic outcomesWe found benefits in this pedagogical approach related to creativity, innovation, motivation, active approach and interest. Implications for practice and/or policy: Due to the benefits and positive results obtained in this research it is recommended to implement Visual Programming LanguageWe recommend the introduction to engine in educational settings in 6th grade in primary education though a cross‐curricular implementation.We recommend to apply an active approach, innovation, and learning computational concepts. [ABSTRACT FROM AUTHOR]

Background: Despite the importance of delivering speech and language therapy services to children who stutter (CWS), there are barriers to accessing speech and language therapy. One way to improve access for those who may otherwise be deprived of speech and language therapy services, including CWS, is through telepractice (TP). However, there is currently no evidence as to the viability of TP stuttering assessments for CWS. Aim: To investigate the validity and reliability, and acceptability of using a TP application to assess overt stuttering behaviour children aged 6–15 years. Methods & Procedure: A total of 30 CWS, aged between 6 and 15 years, were recruited from a speech therapy clinic in King Abdulaziz University Hospital in Riyadh, Saudi Arabia. Children were divided into two testing conditions, either face‐to‐face (f2f)‐led or TP‐led testing, and the Stuttering Severity Instrument (SSI‐IV) was administered, percentage of syllables stuttered (%SS) was calculated, and severity ratings (SR) assigned, either via f2f or via TP using two laptops with webcams, video conference software and a broadband internet connection. Agreement and reliability of scoring in the two testing conditions were reported in addition to findings from questionnaires exploring children's and their caregivers' perceptions both before and immediately after the TP assessment was carried out. Outcome & Results: A total of 30 sessions were successfully carried out, with results revealing unsatisfactory levels of agreement when applying the Bland and Altman method. However, when discrepancies were found, these were comparable with those from traditional f2f studies. Generally, parents and children exhibited high levels of satisfaction and held a positive view regarding TP pre‐ and post‐assessment. Conclusions & Implications: The results of the study suggest that conducting an overt stuttering assessment via TP for 6–15‐year‐olds CWS is reliable and valid. Although the TP model posed some (mainly technical) challenges for executing the assessment, high levels of satisfaction were recorded by parents and children alike. The TP system and equipment chosen in this study has provided a basis for the delivery of TP overt stuttering assessment in a clinical setting, thus addressing the barriers to access that are present for CWS. These results are preliminary, but they can be seen as a building block for future research in TP assessment studies for CWS. What this paper adds: What is already known on the subject: Stuttering treatment via TP has been proven to be feasible and successful across a variety of treatment programs (e.g., Lidcombe, Camperdown). However, the viability of assessing stuttering via videoconferencing has never been explored in children. What this paper adds to existing knowledge: Preliminary support for the assessment of overt stuttering in CWS aged 6–15 years via video conferencing. The results justify larger scale studies of this service delivery method. What are the potential or actual clinical implications of this work?: The TP system and equipment chosen in this study has provided a basis for the delivery of TP overt stuttering assessment in a clinical setting, thus addressing the barriers to access that are present for CWS aged 6–15 years. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was a clinical validation of the NANDA‐I nursing diagnosis "Impaired Resilience (00210)" in people under fertility treatment and determination of the sensitivity, specificity, and predictive value of the defining characteristics. Methods: A cross‐sectional study was conducted between September 2019 and June 2020. A total of 104 patients were recruited through fertility‐related websites, and they answered an online questionnaire after giving informed consent. The Rasch model was used for statistical analysis. The study was approved by the Ethics Committee. Findings: The "Impaired Resilience (00210)" had a prevalence of 15.4% in the sample, and seven defining characteristics confirmed as representative are "decreased interest in vocational activities," "depression," "impaired health status," "ineffective coping strategies," "low self‐esteem," "renewed elevation of distress," and "social isolation." No item showed differential item functioning. "Renewed elevation of distress" and "low self‐esteem" were the most sensitive defining characteristics and had the highest negative predictive value. "Shame" was the most specific one. Conclusions: The nursing diagnosis "Impaired Resilience (00210)" was validated, and results may improve its accuracy in people going through fertility treatment. Implications for nursing practice: This paper contributes by raising knowledge regarding NANDA‐I nursing diagnosis and enhancing the quality of nurses' critical judgment and clinical reasoning. A more effective assessment will allow early recognition of patients struggling with adversity during fertility treatment and enhance a nursing resilience approach in the reproductive field. [ABSTRACT FROM AUTHOR]

Background: Although conventional writing procedures are still the dominant instructional procedures in English as a foreign language (EFL) contexts, instructors are still struggling with time limitations to improve EFL students writing skills properly. Additionally, EFL students are not engaged in the writing process since they lack the required information about the writing tasks. Objectives: The present study, therefore, applied a sequential explanatory mixed‐methods approach to explore the impact of a flipped writing classroom on EFL students' writing skills (i.e. writing content, writing organization, and language use) and writing motivation on the one hand and possibly recommend a better instructional procedure for students' writing skills and writing motivation in EFL context on the other hand. Methods: To this aim, two intact classes were selected as the participants of the study. The two classes were randomly assigned to a flipped classroom with 27 EFL students and a non‐flipped classroom with 24 EFL students. The non‐flipped classroom was instructed through conventional writing instruction over 16 sessions whereas the flipped classroom was taught with the same content in a flipped writing mode in 10 sessions. Two timed writing tasks, a writing motivation scale, and an individual semi‐structured interview were used to gather the required data. Results and Conclusions: The findings indicated that the flipped writing classroom outperformed the non‐flipped writing classroom in improving the EFL students' writing performance, writing organization, language use, and writing motivation; however, no significant differences were found between the two groups' writing content. Moreover, the data analysis from the individual semi‐structured interview indicated that the flipped students had positive attitudes and perceptions towards the flipped writing classroom which further supported the quantitative findings. Implications: Practical implications for collaborative writing instruction using video clips and other electronic materials are suggested. Lay Description: What is already known about this topic: In a flipped classroom model, English language students can view video clips prior to class time in order to use the class time for doing academic exercises and projects in a collaborative manner.As in student‐centred learning environments, a flipped classroom engages English language students in more active learning processes, encourages them to enquire about the video lectures, and tests and evaluates their skills in applying knowledge.Individual differences, such as motivational variables and affective factors disjointedly or conjointly affect writing processes, especially in English language contexts. What this paper adds: Flipping an English language collaborative writing course improves English language students' writing performance, writing organization, language use, and writing motivation.Flipped classroom is more effective than non‐flipped classroom in improving English language students' writing performance, writing organisation, language use, and writing motivation.Flipped English language students hold positive attitudes and perceptions towards flipped collaborative writing classroom. Pedagogical implications: English language instructors are recommended to design a flipped classroom to provide English language students with video clips before class time, so students can have more collaborative and evaluative writing activities during the class time.English language students can have and receive more peer/instructor writing mediations on the writing tasks and make better use of class time (based on the video clips) and develop their writing performance accordingly.By designing a flipped classroom, English language students can enhance their writing motivation, and also, they properly cover the required materials in a shorter time. [ABSTRACT FROM AUTHOR]

Background: Evidence‐based practice involves the synthesis of multiple forms of evidence to inform clinical decision‐making and treatment evaluation. Practice‐ and patient‐based evidence are two forms of evidence that are under‐represented in the stuttering literature. The collection of such knowledge is essential to support the design and delivery of effective stuttering interventions for adults. Aims: To build stakeholder consensus on the core components of intervention for adults who stutter, and to establish a guiding framework for the design and development of evidence‐based interventions for adults who stutter. Methods & Procedures: Adults who stutter and speech and language therapists (SLTs) with experience in providing stuttering intervention participated in the three‐round e‐Delphi Survey focused on: (1) identifying key stuttering intervention components, including principles, practices, and structural and contextual elements; and (2) obtaining group consensus on stuttering intervention components. Statements were categorized using the International Classification of Functioning, Disability and Health (ICF) model adapted to the study of stuttering. Outcomes & Results: A total of 48 individuals agreed to participate: 48/48 (100%) completed the Round 1 questionnaire, 40/48 (83%) responded to Round 2 and 36/40 (90%) participated in Round 3. Following content analysis of Round 1, 101 statements were developed, and consensus was achieved on 89 statements perceived as representing the core components of stuttering intervention for adults. Categorization of these statements reflected the key stuttering intervention components relating to personal reactions to stuttering, limitations in life participation and environmental factors. Conclusions & Implications: Consensus on the core components of stuttering intervention was reached through engagement with key stakeholders. The evidence‐based framework presented highlights the range of key intervention components a clinician should consider when designing interventions for adults who stutter. What this paper adds: What is already known on the subject: Evidence‐based practice endorses the synthesis of multiple knowledge forms including research, practice and patient evidence to support clinical decision‐making and treatment evaluation. The stuttering literature is characterized by an over‐representation of efficacy evidence, with significantly less practice and patient evidence to guide clinical practice. What this paper adds to existing knowledge: This study adds valuable practice‐ and patient‐based evidence for effective stuttering intervention components for adults who stutter. These relate to personal reactions to stuttering, limitations in life participation and environmental factors. What are the potential or actual clinical implications of this work?: This research presents a stakeholder‐informed framework for stuttering intervention to guide SLTs working with adults who stutter in designing evidence‐based interventions. The framework supports the adoption of a person‐centred approach to intervention to ensure each client's unique needs, preferences, values and desired outcomes are explored and integrated into therapy. [ABSTRACT FROM AUTHOR]

Background: The transition from teacher‐centred towards student‐centred approaches in English language teaching, accompanied by developments in educational technology, has attracted researchers' attention to reverse teaching or flipped class. The related literature asserts that this mode of instruction might influence instructors' and students' participation in the class. Objectives: To shed more light on the role of flipped class in affecting language learning strategies and skills, this study applied a sequential explanatory mixed‐methods approach to explore the impact of flipped class on English as a foreign language (EFL) learners' writing metacognitive strategies and writing skills. Methods: Forty‐six intermediate EFL learners with an age range of 21–27, studying at a private language institute, were randomly divided into two groups of 23 learners. The two groups were randomly assigned to a flipped class, which received writing metacognitive strategies and writing skills through video clips before the class time, and a non‐flipped class, which received writing metacognitive strategies and writing skills in a conventional way during the class time. Results and Conclusions: The results revealed that both flipped and non‐flipped classes improved the EFL learners' writing metacognitive strategies, writing performance, writing content, and writing organisation. Furthermore, one‐way ANCOVA analyses indicated that the flipped class outperformed the non‐flipped class in writing metacognitive strategies, writing performance, writing content, and writing organisation. Thematic analyses, which were used to help analyse individual semi‐structured interviews, uncovered a number of categories and themes, signifying the flipped learners' positive perceptions towards the flipped class, such as enhancing motivation, self‐confidence, and writing collaboration. Implications: Pedagogical implications were discussed for flipping writing metacognitive strategies and writing skills. Lay Description: What is already known about this topic?: Metacognitive strategies, including planning, monitoring, and evaluation strategies, help English language learners become more successful writers.Writing skills, including writing content, writing organisation, and language use, help learners deal with collaborative writing activities effectively.Flipped class has been shown to be an effective mode of instruction to improve English language learners' language learning strategies and skills. What this paper adds?: Flipped class improves English language learners' writing metacognitive strategies, writing performance, writing content, and writing organisation.Flipped class is more effective than non‐flipped class in improving English language learners' writing metacognitive strategies and writing skills.English language learners' motivation, self‐confidence, and writing collaboration are increased as a result of the flipped writing course. Pedagogical implications: Writing metacognitive strategies and writing skills need to be flipped in English language contexts in order to free up time for more effective in‐class collaborative writing activities. [ABSTRACT FROM AUTHOR]

Background: Digital game‐based learning (DGBL) has been shown to be an effective strategy for promoting learning motivation. However, a lack of attention has been paid to investigating the effects of individual differences on elementary students' reading motivation and in‐gaming achievements in DGBL. Objectives: This study developed an educational mobile game to facilitate learners' reading activities, and investigated how prior knowledge and gaming experience affected learners' reading motivation, gaming motivation, perceptions and in‐game achievements. Methods: A total of 53 third to fifth grade elementary school students participated in this study, and were divided into the high prior knowledge (HPK)/low prior knowledge (LPK) and the high gaming experience (HGE)/low gaming experience (LGE) groups. Results and Conclusions: The HPK learners had higher reading motivation, perceptions, gaming and social achievements than the LPK learners, whereas they had similar gaming motivation and reading achievements. In addition, the HGE learners had lower reading motivation, reading and gaming achievements than the LGE learners, whereas they had similar gaming motivation, perceptions and social achievements. Moreover, correlational results showed that similarities and differences were observed between the HPK/LPK and HGE/LGE learners. Implications: The findings of this study suggest that learners' prior knowledge and gaming experience play influential roles in reading motivation, gaming motivation, perceptions and in‐game achievements. A framework is proposed for researchers or game designers to develop personalized DGBL systems to accommodate the HPK/LPK and HGE/LGE learners' individual needs or preferences in DGBL. Lay Description: What is already known about this topic: Reading motivation is a critical factor influencing reading performance.Students have difficulties developing reading skills due to a lack of reading motivation, and therefore need additional support.DGBL has been shown to be an effective strategy for promoting learning motivation.Relevant empirical research investigating the impact of individual differences on reading in DGBL is scarce. What this paper adds: A mobile game‐based reading app was developed to facilitate elementary students' reading activities.This study provides understandings of the impact of prior knowledge and gaming experience on reading motivation, gaming motivation, perceptions and in‐game achievements in DGBL.The HPK learners had higher reading motivation, perceptions, gaming and social achievements than the LPK learners, whereas they had similar gaming motivation and reading achievements.The HGE learners had lower reading motivation, reading and gaming achievements than the LGE learners, whereas they had similar gaming motivation, perceptions and social achievements. Implications for practice and/or policy: Educators should consider adopting DGBL to facilitate students' reading activities.Prior knowledge and gaming experience play influential roles in reading motivation, gaming motivation, perceptions and in‐game achievements.Learners' prior knowledge and gaming experience should be taken into account when designing learning activities in DGBL.A personalized DGBL system should be developed to accommodate the needs and preferences of the HPK/LPK and HGE/LGE learners. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic has resulted in major disruption to economic, health, education, and social systems. Families with preschool children experienced extraordinary strain during this time. This paper describes a qualitative study examining the experience of parents of preschool children in Hawaii during the COVID-19 pandemic. Sample: Thirteen (N = 13) parents of preschool children living on the island of Oahu, Hawaii, participated in small group discussions occurring in February and March 2021, approximately 1 year after the start of the pandemic in the state. Discussion transcripts were coded and sorted into themes. Results: Four themes emerged: stressors due to the COVID-19 pandemic, family coping and resources, meaning of the COVID-19 crisis to the family, and family adaptation patterns. Themes mapped to the Family Adjustment and Adaptation Response model. Conclusion: Families relied on various resources to cope with stressors experienced due to the COVID-19 pandemic, and adopted new patterns related to seeking healthcare and household emergency preparedness. Findings may inform policies and interventions to support families during the ongoing COVID-19 pandemic and future public health emergencies. [ABSTRACT FROM AUTHOR]

Background: People with aphasia rely on gesture more than healthy controls to get their message across, but use a limited range of gesture types. Gesture therapy is thus a potential avenue of intervention for people with aphasia. However, currently no gesture assessment evaluates how they use gesture. Such a tool could inform therapy targets and measure outcomes. In gesture research, many different coding categories are used to describe gesture forms and functions. These coding methods are prohibitively time‐consuming to use in clinical practice. There is therefore a need for a 'quick and dirty' method of assessing gesture use. Aims: To investigate current practice among UK‐based clinicians (speech and language therapists) in relation to gesture assessment and therapy, to synthesize gesture‐coding frameworks used in aphasia research, to develop a gesture checklist based on the synthesized coding frameworks suitable for use in clinical practice, and to investigate the interrater reliability (IRR) of the checklist among experienced and unfamiliar users. Methods & Procedures: The research team synthesized seven gesture‐coding frameworks and trialled three resulting prototype checklists at a co‐design workshop with 20 clinicians. Attending clinicians were also consulted about their current clinical gesture practice using a questionnaire. A final City Gesture Checklist (CGC) was developed based upon outcomes and feedback from the workshop. The IRR of the CGC was evaluated between the research team and 11 further clinicians within a second workshop. Both groups used the CGC to count gestures in video clips of people with aphasia talking to a conversation partner. Main Contribution: A total of 18 workshop attendees completed the current practice questionnaire. Of these, 10 reported assessing gesture informally and five also used formal assessment. Gesture‐coding synthesis highlighted six main categories of gesture form. Clinicians at the co‐design workshop provided feedback on prototype checklists regarding the relevance and usability of the gesture categories, layout, use of images and instructions. A final version of the CGC was created incorporating their recommendations. The IRR for the CGC was moderate between both the researchers and clinicians. Conclusions & Implications: The CGC can be used to assess the types of gesture that people with aphasia produce. The IRR was moderate amongst both experienced users and new users who had received no training. Future research directions include investigating how to improve IRR, evaluating intra‐rater reliability and sensitivity to change, and exploring use of the CGC in clinical practice. What this paper addsWhat is already known on the subjectPeople with aphasia rely on gesture more than healthy speakers, yet use a more limited range of gesture types. Gesture therapy is used by clinicians with the aim of helping people with aphasia to compensate for their language impairment and/or to facilitate speech.What this paper adds to existing knowledgeThis study explores current gesture assessment practice among UK‐based clinicians and synthesizes the coding categories used in the literature about gesture research in aphasia. It describes the development of a novel outcome measure, the CGC, and preliminary testing of its IRR.What are the potential or actual clinical implications of this work?This 'quick and dirty' tool enables clinicians to analyse and record the types of gesture produced by people with aphasia without the need for gesture coding. Preliminary findings suggest that clinicians can use it with a fair degree of reliability by following the checklist's written instructions. [ABSTRACT FROM AUTHOR]

Background: Autistic people require varying levels of support at different stages of their lives. Yet, the healthcare needs of autistic adults are largely unmet. Speech and language therapy (SLT) is one healthcare service that has an important role in supporting autistic people: both with initial diagnosis, and with the ongoing support needed to navigate different communicative challenges across the lifespan. Despite recommendations for such support, currently there is no clear SLT pathway for autistic adults, and a lack of established approaches to support autistic adults' speech, language and communication needs. Aims: To seek autistic adults' views on (1) their communication skills and support needs; (2) the type of support SLT could offer; and (3) how such support could be provided. Methods & Procedures: A total of 18 autistic adults were interviewed in their preferred mode of communication (e.g., face to face, phone call, text messaging, e‐mail), expressing their views on their communication skills and needs. Interview data were analysed using thematic analysis. Outcomes & Results: Autistic adults presented complex views on communication, identifying the benefits of communication, while also emphasizing the significant negative impact that communication difficulties can have on their everyday lives. Identifying a range of internal (e.g., personal feelings) and external (e.g., the communication partner) factors, they highlighted the need for support at both individual levels (for specific life situations) and broader societal levels (to increase awareness and acceptance of communication difficulties). Conclusions & Implications: Considering the negative impact that communication difficulties can have for autistic adults, a need for support was emphasized. Despite recognition of this need within current legislation (in the UK) and positive steps toward providing support, more needs to be done. As experts in supporting individuals with communication difficulties, speech and language therapists could play a pivotal role in providing support at an individual level, as well as increasing awareness of communication differences more widely. What this paper addsWhat is already known on this subjectThere is a growing population of autistic adults with unmet support needs. A core characteristic of autism is difficulty with neurotypical social communication and interaction, which persists into adulthood and impacts across various life domains.What this paper adds to existing knowledgeAutistic adults outlined the types of communication difficulties they experience, and how these can negatively impact on physical and mental health. Results highlight how these difficulties are not just rooted within the person themselves but can be influenced by external factors (e.g., the environment and the communication partner).What are the potential or actual clinical implications of this work?Some autistic adults may benefit from direct support from SLT services. However, increased awareness and respect for communication differences at a broader societal level is also needed. Speech and language therapists can play an important role in increasing this level of awareness, positively highlighting differences in communication and ways to support people with communication difficulties/differences. [ABSTRACT FROM AUTHOR]

Objective: Two percent of the Japanese population is comprised of foreign residents with further increase expected due to immigration policy revisions. The purpose of this paper is to examine the healthcare needs and difficulties experienced by foreign residents in Japan by level of their Japanese language fluency. Design: A quantitative, descriptive design was used. Sample: We surveyed foreign residents in the greater Tokyo area (N = 209). Measurements: The research team created the survey questions and the contents of the survey include foreign residents' experiences during their visits or stays at medical and public health facilities in Japan. Results: More than 90% of the participants or their families visited medical facilities in Japan regardless of Japanese language fluency; however, those with less Japanese language fluency experienced statistically significant uneasiness or inconvenience concerning communication compared to those with native Japanese language fluency (p =.000). Conclusions: Nurses in Japan may benefit from additional training related to use of interpreters as well as education about diversity and cultural humility. Through better understanding of the specific communication barriers of foreign residents, nurses will be able to better anticipate difficulties and address them. [ABSTRACT FROM AUTHOR]

Objectives: Current oral health literacy (OHL) instruments vary in focus, methodology, administration time and burden. The widely used word recognition tests fail to encompass important OHL domains, while others exceed time frames for use in practical settings, require an interviewer or mainly measure self‐assessments. This paper describes the development of the Oral Health Literacy Profile (OHLP), introduces its components and evaluates the psychometric properties of its two core modules, the knowledge tests. Methods: A preliminary version of the questionnaire was developed and assessed for content validity, relevance and redundancy by an expert panel. It was tested in a convenience sample (n = 95) leading to the creation of a 28‐item questionnaire, which was afterwards tested in a second convenience sample (n = 193). Item difficulty, discrimination, internal reliability and construct validity were assessed for the oral health knowledge (OHK) and dental health system knowledge (DHSK) modules. Results: The items showed acceptable range of difficulty (ideal: 7 items; easy: 5 items; and difficult: 3 items) and good to very good discriminatory power (the point‐biserial index (PBI) > 0.30: all items). Construct validity was considered to be fulfilled when 75% of the hypotheses of expected group differences were met. Satisfactory internal reliability was observed. Conclusion: With all its components, the OHLP is a suitable short instrument to assess the most relevant dimensions of the multifaceted construct of OHL. Practice implication: The OHLP can be widely used in research, especially suitable in practical settings, and thereby identify patients who may benefit from oral health education. [ABSTRACT FROM AUTHOR]

Background: Virtual reality can be a useful substitute to improve nursing education outside of the hospital setting. In the wake of COVID‐19, an opportunity to compare a virtual reality activity for nursing students in the traditional classroom and in an online environment took place. Objectives: The goal of this study was to examine the effects of incorporating a virtual reality activity into the traditional classroom and in an online environment to enhance nursing education. Methods: Fifty nursing students participated in an exploratory descriptive study. Twenty‐five students participated face‐to‐face while in the traditional classroom setting and 25‐students participated in an online environment using a communication platform. Through a virtual reality activity, nursing students successfully created a tour which demonstrated identifying infectious sites in a hospital room setting. Results and Conclusions: Results of the pre‐and post‐test showed students' positive perceptions and performances in both traditional classroom and online settings. However, the study revealed a statistical difference between the two group perceptions towards the use of the virtual reality tour creator. Nursing students who were in the traditional classroom group found that the use the virtual reality tour creator was easier. Implications: Designing a meaningful virtual reality activity has a positive impact of the student learning experience. Students may benefit from a more through orientation to the technology prior to engaging in the activity. A carefully constructed activity can enhance student learning outside of the hospital room. Lay Description: What is already known about this topic?: Virtual reality can be applied to nursing education with a positive impact on the student learning experience.Nursing students perceived the virtual reality learning activity useful to substitute for in‐hospital training. What this paper adds?: Virtual reality learning activities can help promote nursing performance in both the traditional classroom and online settings.Students can have similar academic performance between the classroom and online modes despite having different experiences. Implications for practice and/or policy: Virtual reality integration might be implemented by pre‐training to make sure students are comfortable with the technology before jumping into course activities.The instructional design and delivery of a virtual reality learning activity greatly influenced the students' learning experiences, rather than the use of virtual reality technology itself. [ABSTRACT FROM AUTHOR]

Background: The outbreak of the novel coronavirus (COVID‐19) at the beginning of 2020 forced most higher education institutions to shift immediately from traditional learning to distance learning and emergency remote teaching (ERT). Objectives: This research aimed to capture the authentic sounds of this unusual learning experience from the field while it was still fresh and to explore congruence with existing models of online learning success factors. We also aimed to examine the differences between freshman students and more advanced students (second year onwards) with regard to the emerging data and its respective model. Methods: During the second semester of 2020, 170 Tel Aviv university students majoring in various fields responded to an online questionnaire consisting of open‐ended questions. Results and conclusions: The researchers classified the themes retrieved from 1559 statements into a framework of critical success factors for distance learning. The framework included five dimensions: course, student, instructor, learning environment and institution. Well‐known benefits of distance learning emerged, among them flexibility and personalized learning pace. Nevertheless, the findings revealed that the rapid transition to distance learning posed challenges and difficulties, mainly concerning the readiness of students and instructors for this form of teaching and learning. The number of statements in instructor dimension indicated the importance of providing support and training to instructors and staff. Significant differences were found in students' perceptions according to the year standing. More advanced students made more 'internal' references, attributing more statements to student and learning environment dimensions. In contrast, freshman made more 'external' references, attributing more statements to instructor and course dimensions than students in their second year and onwards. Major takeaways: The results may help in planning and preparing for times of crisis. From a broader perspective, the findings may help in designing ways to incorporate distance learning. Lay Description: What is already known about this topic?There are several critical success factor models for implementing distance learning.Academic experience influences students' perceptions of distance learning.Year of studies is known to exert an influence on students' attitudes and degree of satisfaction from distance learning.At the onset of COVID‐19, higher education shifted immediately to ERT. What this paper adds?Authentic view of students' ERT experience in the first weeks of the COVID‐19 outbreak.Adaptive framework for Distance Learning Success Dimensions (DLSD).Advantages and disadvantages for students forced into ERT.Freshmen and advanced students have different perceptions of instructor and course DLSD.Advanced students focus on student dimension, while freshmen focus on Instructor dimension. Implications for practice and/or policyUsing developed DLSD framework for planning, designing and evaluating in crises and routine times.Providing empirical evidence for perceptual differences between freshmen and experienced students.Students' differing perceptions of helpful and unhelpful factors point to diverse needs.Flexible learning times and assignment due dates are crucial for students in ERT.Technical training for instructors may contribute to remote teaching effectiveness.Scaffolds for freshmen may enhance their ERT experience. [ABSTRACT FROM AUTHOR]

Background: Despite emerging evidence of validity and reliability, speech and language therapists' (SLT) uptake of telehealth has been limited and barriers remain to the effective and confident use of this service model. The COVID‐19 pandemic has caused significant disruption to essential health services, including speech and language therapy assessment and intervention, meaning that telehealth must now be considered as part of the suite of service delivery options for all clinicians. Aims: To explore the perceived barriers and facilitators of telehealth among community paediatric SLTs before and after their use of a telehealth platform with an embedded standardised assessment tool. Methods & Procedures: Mixed‐methods questionnaires were developed for this study and completed by SLTs before and after the 3‐month trial of the telehealth platform. A total of 38 SLTs completed the pre‐trial questionnaire and training in the use of telehealth platform (Coviu), including instruction in using a standardised, norm referenced language test as an integrated tool within the Coviu platform. A total of 27 SLTs went on to use the telehealth platform, and 25 of these completed the post‐trial questionnaire on which subsequent qualitative and quantitative analysis was completed. Outcomes & Results: Prior to using the platform, perceived barriers included technology issues, limited clinician experience and concerns around parent acceptance of the service. Potential facilitators included access to appropriate platforms, tools and resources as well as increased clinician confidence with telehealth. Following the trial, barriers to telehealth use continued to include technology barriers, particularly internet stability, and client issues, including suitability for telehealth services. Facilitators for future telehealth use included access to appropriate platforms for telehealth, stable and appropriate internet connectivity, and more extensive telehealth resources for both assessment and intervention for this mode of service delivery. Conclusions & Implications: This study provides insights into the perceptions of the barriers and facilitating factors for telehealth use among community‐based SLTs. This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery beyond the pandemic. What this paper adds: What is already known on the subject: Research about telehealth has shown that it is a reliable and valid way of delivering speech pathology services, yet many clinicians have been wary of its use and uptake of telehealth prior to COVID‐19 had been limited. We wanted to know what SLTs thought about using telehealth before and after participating in a 3‐month trial of a telehealth platform with an embedded formal language assessment. What this study adds to existing knowledge: This study indicates that technology issues including internet stability are a barrier to effective telehealth services, but that appropriate telehealth platforms, resources and experience are facilitators of uptake and successful use of telehealth. What are the potential or actual clinical implications of this work?: This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery for children during and beyond the pandemic, including those isolated by geographical or transport barriers. [ABSTRACT FROM AUTHOR]

Digital competence is critical for university students to adapt to and benefit from digitally enhanced learning. Prior studies on its measurement mostly focus on educators and relied on factor analyses. However, there is a lack of valid and convenient tools to measure university students' digital competence. This study aimed to develop a digital competence scale for university students (DC‐US) in digitally enhanced learning with robust psychometric properties. An initial DC‐US with 23 items was proposed to measure the single latent trait of digital competence. It was validated and refined continuously through a pilot study, a main study and a predictive validity study in three datasets involving 825 participants altogether, using factor analyses, Rasch analyses and the partial least squares modelling. The final DC‐US turned out to comprise two subscales: technical literacy and digital skills, with 10 items retained, and manifested high internal consistency, unidimensionality and measurement invariance. The scale also demonstrated strong predictive validity, with technical literacy greatly predicting digital skills, which negatively predicted technostress. The DC‐US enables instructors and school administrators to conveniently obtain preliminary information of university students' digital competence, informing their digital class preparation and development of timely interventions for addressing digital deficiencies. Lay Description: What is already known about this topic?: Digital competence is critical for university students to adapt to and benefit from digitally enhanced learning (DEL).There is a lack of valid and convenient tools to measure university students' digital competence.Prior studies on its measurement mostly focus on educators and relied on factor analyses. What this paper adds?: A unidimensional, valid and unbiased digital competence scale was developed for university students.Rasch analyses and classical test theory were employed jointly for the scale development.The digital competence scale comprised two subscales: Technical literacy and digital skills. Implications for practice: University students can use the scale for a quick self‐assessment of their digital competence before joining DEL.Instructors can use the scale to gain an initial knowledge of their students' digital competence to inform digital class preparation.University administrators can rely on the scale to quickly evaluate the implementation effectiveness of DEL schemes. [ABSTRACT FROM AUTHOR]

Learning a foreign language requires interaction with language input while involved in a task. Given that problem‐based learning (PBL) offers hands‐on application in realistic contexts, and that virtual reality (VR) enables learners to interact with multiple modalities of information, this study examines how the integration of VR technology into PBL contexts affects students' motivation for, problem‐solving during, and vocabulary acquisition in learning English as a foreign language (EFL). A total of 84 engineering majors who enrolled in a course of English for specific purposes were randomly assigned to either an experimental group or a control group. Students in the experimental group participated in a VR‐assisted PBL context, in which they were to view a PBL scenario using VR technology and then to create VR videos about solving the given problems. Those in the control group participated in a PBL context without the use of VR technology for viewing and solving the identical scenario. After the intervention, all the students wrote a problem‐solving analysis, took a vocabulary knowledge test, completed a learning motivation questionnaire, and participated in individual interviews. The results showed that the students in the experimental group significantly outperformed those in the control group in terms of vocabulary acquisition, and were more motivated to learn English related to their future careers, whereas there was no significant difference in the problem‐solving performance of the two groups. Implications of these findings highlight the value of engaging EFL learners in immersive environments for contextualized learning through the integrated use of VR and PBL. Lay Description: What is already known about this topic?: Virtual reality (VR) technology has been shown to enhance students' knowledge and skills in STEM fields.Problem‐based learning (PBL) has been widely used in medical education but not so much in foreign language education.English as a foreign language (EFL) students usually have very limited access to the target language beyond the classroom, thus lack a motivating reason for them to learn English after graduation. What this paper adds?: The VR‐assisted PBL approach proposed in this study was found to significantly enhance the EFL students' specialized vocabulary knowledge.The VR‐assisted PBL approach was found to motivate and sustain the EFL students' interest in career English.Exposing the EFL students to PBL contexts was capable of developing their problem‐solving performance, regardless of VR integration. Implications for practice and/or policy: The proposed approach has the potential to facilitate student learning in EFL education, particularly English for occupational purposes.EFL educators may apply the VR‐assisted PBL approach to narrow the gap between language classrooms and workplace contexts by immersing students in authentic contexts that were relevant to their occupational knowledge and workplace English. [ABSTRACT FROM AUTHOR]

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

Information technology provides the potential for polychronic learning. However, research on polychronicity in the educational field is scarce. The purposes of this study were to develop a multidimensional polychronicity scale for information technology learning and explore the relationship between polychronicity in information technology‐supported learning and personality traits. This study is divided into two phases. First, a questionnaire survey was used to develop a multidimensional polychronicity scale for information technology learning, and 602 questionnaires were included in the analysis. Second, 129 participants reported their polychronicity in information technology‐supported learning and Big Five personality traits. The first phase results showed that the scale of polychronicity in IT‐supported learning (SPITSL) contained three constructs, that is, time tangibility (α =.89), scheduling preference (α =.84) and involvement with people (α =.85) and that the total variance explained was 69.43%. The confirmatory factor analysis results indicated that the preliminary model fit, overall model fit and internal model fit were acceptable. The second phase results showed that polychronicity was related to the Big Five personality traits. This study showed that the SPITSL has a multidimensional structure that is consistent with the definition of polychronicity advocated by many scholars. Lay Description: What is already known about this topic: Multitasking has become one of the most common behaviours in student learning.Research on polychronicity in the educational field is important but scarce. What this paper adds: The study aims to develop a polychronicity scale for digital learning.The scale of polychronicity in IT‐supported learning (SPITSL) reflected the multidimensionality of polychronicity.The polychronic students in this study prefer the scheduled learning tasks. Implications for practice and/or policy: SPITSL may help to understand the multitasking learning preference of students online.It needs more research on students' polychronicity in the IT learning environment. [ABSTRACT FROM AUTHOR]

Aim: To investigate the efficacy of waiting room media for reducing anxiety and increasing satisfaction at a paediatric rehabilitation hospital.Method: In this clustered, parallel, randomized controlled trial, 310 young people with disabilities (age range 5-19y) and their parents attending outpatient clinics were assigned to interactive media (n=113), a silent nature video (n=97), or media-free comparison (n=100) groups. Young person and parent anxiety was reported using the State-Trait Anxiety Inventory (STAI) on arrival and after 10 minutes in the waiting space. Questionnaires measured young person, parent, and staff satisfaction.Results: Young people exposed to interactive media reported a postexposure state anxiety that was 1.1 raw points (2.7 standardized points) lower on the STAI than the comparison group (95% confidence interval [CI] -1.9 to -0.22). There was no difference in postexposure state anxiety between the passive media and comparison groups (95% CI -0.64 to 1.1). Parents' state anxiety did not differ between conditions, but interactive media were associated with greater satisfaction (p=0.009). Of 120 staff, 119 reported that interactive media improved the clinic experience for families.Interpretation: Interactive media designed for accessible, hands-free play mitigate waiting anxiety and increases satisfaction. This paper provides evidence to guide design and decision-making around the use of interactive media in health care spaces.What This Paper Adds: Interactive media reduced preclinic waiting anxiety for young people with disabilities. Interactive media were accessible to young people with a range of mobility. Interactive media increased parental and staff satisfaction in the clinic. Guidelines for the design of hands-free, inclusive interactive media for health care facilities are presented. [ABSTRACT FROM AUTHOR]

Objective Aboriginal people experience a higher burden of disease as a consequence of drug and alcohol (D&A) abuse. Although media campaigns can be a popular tool for disseminating health promotion messages, evidence of the extent to which they reduce the impact of substance abuse is limited, especially for rural Aboriginal communities. This paper is the first to examine the impact a locally designed D&A radio advertising campaign for Aboriginal people in a remote community in Western NSW. Design A post-intervention evaluation. Setting The radio campaign was implemented in Bourke, (population 2465, 30% Aboriginal). Participants Fifty-three community surveys were completed. Main outcome measure(s) The self-reported level of awareness of the campaign and the number of self-referrals to local D&A workers in the intervention period. Results Most respondents (79%) reported they listen to radio on a daily basis, with 75% reporting that they had heard one or more of the advertisements. The advertisement that was remembered best contained the voice of a respected, local person. There was one self-referral to local health services during the intervention timeframe. Conclusion The community-led radio advertising campaign increased community awareness of substance abuse harms, but had limited impact on formal help-seeking. This paper highlights the value of radio as a commonly used, trusted and culturally relevant health promotion medium for rural communities, especially when engaging local respected Aboriginal presenters. [ABSTRACT FROM AUTHOR]

This study applies Kuhlthau's Information Search Process stage (ISP) model to understand bilingual users' Internet search experience. We conduct a quasi‐field experiment with 30 bilingual searchers and the results suggested that the ISP model was applicable in studying searchers' information retrieval behavior in search tasks. The ISP model was applicable in studying searchers' information retrieval behavior in simple tasks. However, searchers' emotional responses differed from those of the ISP model for a complex task. By testing searchers using different search strategies, the results suggested that search engines with multilanguage search functions provide an advantage for bilingual searchers in the Internet's multilingual environment. The findings showed that when searchers used a search engine as a tool for problem solving, they might experience different feelings in each ISP stage than in searching for information for a term paper using a library. The results echo other research findings that indicate that information seeking is a multifaceted phenomenon. [ABSTRACT FROM AUTHOR]

Learning letters is an important area of language learning, conducive to the beginning of reading and writing. Indeed, today's generation prefers to learn through digital games rather than through formal teaching processes. Inspired by this need, the researcher designed this study (a) to test the effectiveness of an instructional digital game, "Kes Sesi," designed to teach letter recognition skills and (b) to briefly present its instructional development process, which was based on the ADDIE model. This was a quasi‐experimental study with two treatment groups and a control group involving 87 kindergarteners. Treatment groups played the game for 12–6 weeks for learning, 6 weeks for practice. The control group continued with its regular class activities. One treatment group played the game based on predefined sound categorization, the other without any categorization. A test on children's sound recognition abilities was administered three times as a pretest, a midtest, and a posttest. The treatment groups performed significantly better than the control group. The game enhanced the kindergarteners' ability to practice uncategorized content while it enhanced their ability to learn categorized content. The results are promising in that Kes Sesi can be useful in self‐supported learning contexts with little adult input and with minimum outside interference. Lay Description: What is already known about this topic: Learning letters is an important area of language learning, conducive to the beginning of reading and writing.There is a variety of research studies on digital games for learning in the literature.It is a challenge to teach preschool children letters. What this paper adds: There seems to be a gap when it comes to experiments on kindergarteners' early reading skills.Although there are many relevant games in the market, there are no studies investigating kindergarteners' sound recognition skills through game playing on mobile technology.This study has its unique feature in terms of providing a sample article on "Design, development and application of learning tools and systems," which is a topic within the Journal's scope. Implications for practice and/or policy: Digital educational games such as "Kes Sesi" can be useful in self‐supported learning circumstances with little adult input or intervention.Similar educational games can be designed by taking the current research study as an example, and it is believed that it will encourage production of many similar games.Students' performances reach an optimal level when educational games are used after the teacher helps them construct their learning and guide them in this endeavor. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To adapt the Canadian Diabetes Risk Assessment Questionnaire for the Chinese population and to evaluate its psychometric properties. Design and Sample: A cross‐sectional study was conducted with a convenience sample of 194 individuals aged 35–74 years from October 2014 to April 2015. Methods: The Canadian Diabetes Risk Assessment Questionnaire was adapted and translated for the Chinese population. Test–retest reliability was conducted to measure stability. Criterion and convergent validity of the adapted questionnaire were assessed using 2‐hr 75 g oral glucose tolerance tests and the Finnish Diabetes Risk Scores, respectively. Sensitivity and specificity were evaluated to establish its predictive validity. Results: The test–retest reliability was 0.988. Adequate validity of the adapted questionnaire was demonstrated by positive correlations found between the scores and 2‐hr 75 g oral glucose tolerance tests (r = .343, p < .001) and with the Finnish Diabetes Risk Scores (r = .738, p < .001). The area under receiver operating characteristic curve was 0.705 (95% CI .632, .778), demonstrating moderate diagnostic value at a cutoff score of 30. The sensitivity was 73%, with a positive predictive value of 57% and negative predictive value of 78%. Conclusions: Our results provided evidence supporting the translation consistency, content validity, convergent validity, criterion validity, sensitivity, and specificity of the translated Canadian Diabetes Risk Assessment Questionnaire with minor modifications. This paper provides clinical, practical, and methodological information on how to adapt a diabetes risk calculator between cultures for public health nurses. [ABSTRACT FROM AUTHOR]

Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of 'The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,' 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experiences in the planning stages of an MNP intervention, encompassing assessment, enabling environment and adaptation, as well as considerations for supply. Methods included a review of published and grey literature, key informant interviews, and deliberations throughout the consultation process. We found that assessments helped justify adopting an MNP intervention, but these assessments were often limited by their narrow scope and inadequate data. Establishing coordinating bodies and integrating MNP into existing policies and programmes have helped foster an enabling environment and support programme stability. Formative research and pilots have been used to adapt MNP interventions to specific contexts, but they have been insufficient to inform scale-up. In terms of supply, most countries have opted to procure MNP through international suppliers, but this still requires understanding and navigating the local regulatory environment at the earliest stages of an intervention. Overall, these findings indicate that although some key planning and supply activities are generally undertaken, improvements are needed to plan for effective scale-up. Much still needs to be learned on MNP planning, and we propose a set of research questions that require further investigation. [ABSTRACT FROM AUTHOR]

An effective delivery strategy coupled with relevant social and behaviour change communication (SBCC) have been identified as central to the implementation of micronutrient powders (MNP) interventions, but there has been limited documentation of what works. Under the auspices of 'The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,' three working groups were formed to summarize experiences and lessons across countries regarding MNP interventions for young children. This paper focuses on programmatic experiences related to MNP delivery (models, platforms, and channels), SBCC, and training. Methods included a review of published and grey literature, interviews with key informants, and deliberations throughout the consultation process. We found that most countries distributed MNP free of charge via the health sector, although distribution through other platforms and using subsidized fee for product or mixed payment models have also been used. Community-based distribution channels have generally shown higher coverage and when part of an infant and young child feeding approach, may provide additional benefit given their complementarity. SBCC for MNP has worked best when focused on meeting the MNP behavioural objectives (appropriate use, intake adherence, and related infant and young child feeding behaviours). Programmers have learned that reincorporating SBCC and training throughout the intervention life cycle has allowed for much needed adaptations. Diverse experiences delivering MNP exist, and although no one-size-fits-all approach emerged, well-established delivery platforms, community involvement, and SBCC-centred designs tended to have more success. Much still needs to be learned on MNP delivery, and we propose a set of implementation research questions that require further investigation. [ABSTRACT FROM AUTHOR]

Continual course correction during implementation of nutrition programmes is critical to address factors that might limit coverage and potential for impact. Programme improvement requires rigorous scientific inquiry to identify and address implementation pathways and the factors that affect them. Under the auspices of 'The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,' 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powder (MNP) interventions for young children. This paper focuses on how MNP interventions undertook key elements of programme improvement, specifically, the use of programme theory, monitoring, process evaluation, and supportive supervision. Methods included a review of published and grey literature, interviews with key informants, and deliberations throughout the consultation process. We found that although much has been written and published about the use of monitoring and process evaluation to inform MNP interventions at small scale, there has been little formal documentation of lessons for the transition from pilot to scaled implementation. Supervision processes and experiences are not documented, and to our knowledge, there is no evidence of whether they have been effective to improve implementation. Improving the efficiency and effectiveness of interventions requires identification of critical indicators for detecting implementation challenges and drivers of impact, integration with existing programmes and systems, strengthened technical capacity, and financing for implementation of effective monitoring systems. Our understanding of programme improvement for MNP interventions is still incomplete, especially outside of the pilot stage, and we propose a set of implementation research questions that require further investigation. [ABSTRACT FROM AUTHOR]

This paper presents the initial translation process and follow-up psychometric evaluation of the Japanese version of the Primary Communication Inventory (J-PCI). The J-PCI was developed using the committee approach to translation and then used in a study exploring Japanese couples' communication satisfaction while separated during Satogaeri Bunben - a Japanese perinatal tradition. The committee approach attends to cultural nuance and context and is especially useful when languages have dissimilar linguistic roots and cultures, such as Japanese and English. The translation process and evaluation included five steps; (i) selection of the original PCI for research; (ii) selection of translators; (iii) development of the J-PCI using a committee approach; (iv) an initial small pilot study; and (v) a larger follow-up study. The J-PCI has good initial validity and reliability, although some nuances were observed in scoring. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a doctoral research project that involved a state-wide investigation into mental health triage nursing in Victoria, Australia. Mental health triage is a specialized domain of nursing practice that has emerged within the context of wider mental health reform in the State. The overall aim of the study was to produce a comprehensive definition and description of psychiatric triage nursing in Victoria. Methodological triangulation was used in the design of the study to enable the use of both survey (n = 139) and semi-structured interview (n = 21) data collection methods. Mental health triage nursing was found to be a complex, stressful role that involves high levels of responsibility, clinical decision making, and multiple role functions, many of which overlap into areas of practice previously the exclusive domain of medicine, such as assessment, diagnosis, and referral. The paper raises discussion on contemporary professional issues of concern to mental health triage nursing, and concludes with recommendations for the future development of the discipline. [ABSTRACT FROM AUTHOR]

There is evidence to suggest that community mental health nurses experience stress and burnout related to their work. Previous research has been limited by a number of methodological problems. One of the problems is that studies have tended to have small or unrepresentative samples, and many researchers have only examined mental health nurses as a subset within their research, which limits the generalizability of the findings. The All-Wales Community Mental Health Nurse (CMHN) Stress Study was set up in order to address this issue. The total population of CMHNs in Wales was surveyed (N = 614) and 301 (49%) responded. The questionnaire booklet contained a number of validated instruments to measure stress, burnout, and coping, together with a demographic questionnaire. The demographic questionnaire included three open ended-questions. These questions were asked in order in determine the CMHNs' own views of the sources of stress in the workplace, and to investigate which methods they use to cope. This paper reports the findings from the content analysis of the three questions. The results from the other measures are reported in the companion paper (Edwards et al. 2000). The most frequently cited stressors included perceived workload, excessive paperwork and administration, and a broad spectrum of client-related issues. Coping strategies that CMHNs reported using included peer support, a range of personal strategies such as relaxation, and belief in self and supervision. It appears from the findings that a range of factors such as organizational pressures and factors related to working with patients are important in determining stress levels, and that informal rather than formal support networks are the preferred methods of coping. [ABSTRACT FROM AUTHOR]

Aim To examine the effects of a web-based nursing process documentation system on the stress and anxiety of nursing students during their clinical practice. Methods A quasi-experimental design was employed. The experimental group ( n = 110) used a web-based nursing process documentation program for their case reports as part of assignments for a clinical practicum, whereas the control group ( n = 106) used traditional paper-based case reports. Stress and anxiety levels were measured with a numeric rating scale before, 2 weeks after, and 4 weeks after using the web-based nursing process documentation program during a clinical practicum. The data were analyzed using descriptive statistics, t tests, chi-square tests, and repeated-measures analyses of variance. Results Nursing students who used the web-based nursing process documentation program showed significant lower levels of stress and anxiety than the control group. Conclusion A web-based nursing process documentation program could be used to reduce the stress and anxiety of nursing students during clinical practicum, which ultimately would benefit nursing students by increasing satisfaction with and effectiveness of clinical practicum. [ABSTRACT FROM AUTHOR]

Background Children from developing countries are more vulnerable to traumatic experiences and more likely to suffer a range of psychological problems than children from developed countries. Method The current paper describes a survey of 1360 children and adolescents from Bangladesh who were selected either from the general community or through a range of social service organizations. Children completed a checklist of traumatic events and questionnaires to assess symptoms of PTSD, anxiety and depression. Results Children from both samples reported high levels of exposure to traumatic events, both via direct experience and indirectly. Direct experiences with intentional, man-made events were more frequently reported by children from support services while trauma from natural disasters was more common among community children. Psychological symptoms were significantly higher within children from social support services. The strongest predictors of psychological symptoms were age, gender, sample source and exposure to man-made direct traumas. Conclusion The results point to the common occurrence of traumatic events and their emotional consequences among children and adolescents from Bangladesh and indicate the need to develop effective and accessible mental health services for Bangladeshi children and adolescents. [ABSTRACT FROM AUTHOR]

Background As future health educators, nursing and physiotherapy students will play an essential role in the prevention of smoking. Aim To determine the prevalence of smoking among students and to analyse their knowledge of and attitudes towards smoking. Method This was a descriptive cross-sectional study using an anonymous questionnaire and conducted in a Spanish Faculty of Health Sciences in 2013. Findings 247 nursing and physiotherapy students (82.33%) participated in the study. The global prevalence of smoking (18.2%) was lower compare with the general population group of the same age. We have observed statistical significance in relation to previous studies. Nursing and physiotherapy students showed a low nicotine dependence. We found a lack of knowledge about the harmful effects of cigarette consumption on health. Statistically significant results were also found in relation to degree courses (p < 0.01) as regards students' opinions about their knowledge of strategies and methods to help patients stop smoking. Conclusion Most students started smoking before commencing their university studies; consequently, interventions should focus on cessation programmes. An analysis of university curricula leading to the award of a degree in the health sciences could serve to identify educational deficiencies in order to implement the necessary modifications. Implications for nursing and health policy This paper presents an update in tobacco use characteristics amongst nursing and physiotherapy students. Those results have showed a need to improve the curricula in order to develop specific programmes to improve knowledge, attitudes and beliefs. Measures to prevent smoking must be taken at school. [ABSTRACT FROM AUTHOR]

Rationale aims and objectives Problems exist with Do Not Attempt Cardiopulmonary Resuscitation ( DNACPR) orders: they are often misinterpreted by clinicians to mean that other treatments should be withheld; resuscitation decision discussions are difficult; patients remain inappropriately for resuscitation. We developed an alternative approach. Methods An adapted Delphi method was used. Senior clinicians were interviewed about the strengths and weakness of current practice. Teams who had initiated alternative approaches internationally were contacted. Focus groups were conducted with doctors, nurses and patients to further understand problems with DNACPR orders and establish essential aspects of a new approach. A behavioral economist and management consultant contributed advice. The resulting form was recirculated and further refined. It was: snowballed out to others with specialist expertise (palliative care physicians, intensivists, etc) for further feedback; assessed in simulated clinical encounters before being piloted; further adjusted once in clinical practice. In parallel, a patient information leaflet was developed along with education materials. Results Consensus was achieved that the new approach should: be universal; have discussions and clinical conditions documented first; clarify goals of overall treatment (active treatment or optimal supportive care); contextualize the resuscitation decision among other treatment decisions; have a free text box for 'opting out' of invasive treatments, rather than tick boxes; be green; be limited to one page. Conclusions The Universal Form of Treatment Options was developed iteratively with patients, doctors and nurses as an alternative approach to resuscitation decisions. This paper illustrates a cross-disciplinary approach to developing practical alternatives in health care. [ABSTRACT FROM AUTHOR]

Background/aim Engagement in desired occupations can promote health and wellbeing in older adults. Assessments of engagement often measure frequency, amount or importance of specific activities. This study aimed to develop a scale to measure older adults' evaluation of the extent to which their everyday activities are contributing to their health and wellness. Methods Eighteen items, each scored with a seven-point rating scale, were initially developed by content experts, covering perceptions of how daily activities contribute to physical and mental health, as well as satisfaction and activity participation in the last six months. Rasch analysis methods were used to refine the scale using the pencil and paper responses of 460 community-living older adults. Results Initial Rasch analysis indicated three unlabelled rating scale categories were seldom used, reducing measurement precision. Five items were conceptually different by misfit statistics and principal component analysis. Subsequently, those items were removed and the number of rating scale steps reduced to 4. The remaining 13-item, 4-step scale, termed the Activity Significance Personal Evaluation ( ASPEn), formed a unidimensional hierarchy with good fit statistics and targeting. Person separation reliability (2.7) and internal consistency (.91) indicated the tool is appropriate for individual person measurement. Relative validity indicated equivalence between Rasch measures and total raw scores. Conclusions ASPEn is a brief, easily administered assessment of older adults' perception of the contribution of everyday activities to personal health and wellness. ASPEn may facilitate occupational therapy practice by enabling clinicians to assess change in meaning of an older adult's activity over time. [ABSTRACT FROM AUTHOR]

Parents frequently do not engage in child welfare services. A lack of engagement can lead to significant negative consequences for families. A relationship between psychological reactance and engagement in the context of child welfare work has been theorized but not examined empirically. This paper presents the results of a preliminary descriptive study ( N = 43) which found a significant negative relationship (r = −0.277, P < 0.05) between individual reactance levels and levels of engagement in child welfare services. A four-dimension measure of engagement was used. Significant relationships were found between reactance and the dimensions of working relationship (r = −0.260, P < −0.05) and mistrust (r = 0.340, P < 0.05) and a similar trend was seen with a third dimension, receptivity (r = −0.245, P = 0.056). There was no significant relationship between reactance and the fourth dimension, buy-in. The implications of these findings for child welfare work are explored. [ABSTRACT FROM AUTHOR]

This paper examines the role of the belief in a just world as a personal resource when people are faced with the adverse consequences of inflation and financial crises by presenting results from two longitudinal studies. The first study, based on responses from 262 German residents, found that participants with a strong personal belief in a just world perceived a lower economic impact in light of price increases following a tax increase. This effect remained stable after controlling for the socioeconomic variables of gender, age, household income, and education. The second study, based on a sample of 177 German residents, found that residents with a strong personal belief in a just world perceived a lower economic impact in light of the global subprime mortgage crisis. Again, this effect remained stable after controlling for the socioeconomic variables of gender, age, household income, and education. Furthermore, the personal belief in a just world influenced perceived economic impact over time and the relationship between personal belief in a just world and perceived economic impact was partially mediated by differences between life satisfaction in the future as measured in a first wave and current life satisfaction as measured in a second wave. [ABSTRACT FROM AUTHOR]

MANZANO GARCÍA G. & AYALA CALVO J. C. (2011) Emotional exhaustion of nursing staff: influence of emotional annoyance and resilience. International Nursing Review 59, 101-107 Aim: This paper aimed to study the influence of emotional annoyance and resilience on the emotional exhaustion levels of nursing staff. Background: Emotional exhaustion is one of the key factors in understanding both the performance and the quality of care that nurses give to their patients. There is a considerable body of knowledge that has focused on the study of emotional exhaustion in relation to cynicism and professional efficiency. More recently emotional annoyance and resilience have been identified as variables that could help explain levels of emotional exhaustion. Methods: Nine hundred eighty-three nurses who work in five hospitals in the north of Spain were invited to participate in the study. Five hundred questionnaires were distributed, of which 200 were fully completed. The average response rate was 40%. A personal information form, and a questionnaire concerning nurses' emotional annoyance, resilience, professional efficiency and cynicism were used as data collection instruments. To estimate a path model with latent variables, partial least squares was used. Findings: Emotional annoyance and resilience contribute to a better understanding of emotional exhaustion levels of nursing staff. There was a significant association between emotional annoyance and emotional exhaustion (β = 0.26, P = 0.020), while resilience appeared to be protective against emotional exhaustion (β = −0.22, P = 0.004). Conclusion: A more complete explanation and understanding of emotional exhaustion in nursing is achieved when emotional annoyance and resilience is measured in addition elements of burnout, which include professional efficiency and cynicism. [ABSTRACT FROM AUTHOR]

GURKOVÁ E., ČÁP J., ŽIAKOVÁ K. & ĎURIŠKOVÁ M. (2011) Job satisfaction and emotional subjective well-being among Slovak nurses. International Nursing Review 59, 94-100 Purpose: The purpose of this study is to investigate job satisfaction and emotional subjective well-being and the correlations between these two constructs among Slovak nurses. Design: A cross-sectional survey was used to investigate this relationship among nurses ( n = 104) working in seven public hospitals in Slovakia. Methods: Data were collected using a set of questionnaires that included the questionnaire to measure job satisfaction, the Positive Affect Scale, the Negative Affect Scale and a demographics form. Findings: Findings of this study confirmed some general satisfying and dissatisfying elements for the nursing profession across different clinical specialties and different cultures. The results also indicate that there is a positive correlation between positive emotions and job satisfaction of Slovak nurses. Conclusion: The paper has drawn attention to the job satisfaction and emotional well-being among nurses. Further studies in this field, extended to different countries, work settings and nursing specialties, may help to improve subjective well-being of nurses. Study limitations: Participants came from a limited number of hospitals in Slovakia. A larger sample from different hospitals in Slovakia could have enhanced the generalizability of the results and increased the power of the study to detect significant differences and associations. [ABSTRACT FROM AUTHOR]

Objectives. Dissatisfaction with services has been associated with poorer child mental health outcomes, early treatment termination as well as disagreements over the nature of mental health difficulties, reasons for referral and therapy goals. The development of straightforward, reliable, and accurate methods of eliciting service users' views is essential within child and adolescent mental health care. This paper describes the development of the child and adolescent service experience (ChASE), a tool to measure children and young people's service experience Design. The study comprises a non-experimental, cross-sectional design. Methods. Participants were 132 mental health service users aged 8-18 years. Participants and their main carer completed the ChASE, Parent Satisfaction Questionnaire (PSQ) () and Strengths and Difficulties (SDQ) Impact Supplement. Clinicians completed the SDQ Impact Supplement and provided clinical activity data. A sub-sample of participants completed the ChASE on a second occasion, 6 weeks after the completion of the first questionnaire. Results. Scrutiny of ChASE data indicated high levels of completion. Principal axis factoring identified three factors within the ChASE: Relationship, Privacy, and Session Activity. The ChASE has good internal consistency and test-retest reliability. Significant correlations were found between the ChASE and carer satisfaction, service use, and youth clinical outcomes. Conclusions. The ChASE is a short, psychometrically robust tool for routine measurement of children, and young people's experience of mental health services, which users can complete easily. The results underline the importance of alliance factors to children and young people and their association with clinical improvement as well as the potential for the ChASE to be used a measure of children's therapeutic progress and alliance. [ABSTRACT FROM AUTHOR]