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Compared to previous studies that generally detect scientific breakthroughs based on citation patterns, this article proposes a knowledge entity‐based disruption indicator by quantifying the change of knowledge directly created and inspired by scientific breakthroughs to their evolutionary trajectories. Two groups of analytic units, including MeSH terms and their co‐occurrences, are employed independently by the indicator to measure the change of knowledge. The effectiveness of the proposed indicators was evaluated against the four datasets of scientific breakthroughs derived from four recognition trials. In terms of identifying scientific breakthroughs, the proposed disruption indicator based on MeSH co‐occurrences outperforms that based on MeSH terms and three earlier citation‐based disruption indicators. It is also shown that in our indicator, measuring the change of knowledge inspired by the focal paper in its evolutionary trajectory is a larger contributor than measuring the change created by the focal paper. Our study not only offers empirical insights into conceptual understanding of scientific breakthroughs but also provides practical disruption indicator for scientists and science management agencies searching for valuable research. [ABSTRACT FROM AUTHOR]

Parenteral and enteral nutrition support are key components of care for various medical and physiological conditions in infants, children, and adults. Nutrition support practices have advanced over time, driven by the goals of safe and sufficient delivery of needed nutrients and improved patient outcomes. These advances have been, and continue to be, dependent on research and development studies. Such studies address aspects of enteral and parenteral nutrition support: formulations, delivery devices, health outcomes, cost‐effectiveness, and related metabolism. The studies are supported by public funding from the government and by private funding from foundations and from the nutrition support industry. To build public trust in nutrition support research findings, it is important to underscore ethical research conduct and reporting of results for all studies, including those with industry sponsors. In 2019, American Society for Parenteral and Enteral Nutrition's (ASPEN's) Board of Directors established a task force to ensure integrity in nutrition support research that is done as collaborative partnerships between the public (government and individuals) and private groups (foundations, academia, and industry). In this ASPEN Position Paper, the Task Force presents principles of ethical research to guide administrators, researchers, and funders. The Task Force identifies ways to curtail bias and to minimize actual or perceived conflict of interests, as related to funding sources and research conduct. Notably, this paper includes a Position Statement to describe the Task Force's guidance on Public‐Private Partnerships for research and funding. This paper has been approved by the ASPEN Board of Directors. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Despite extensive evidence on the value of patient decision support interventions ( DESIs), there is no consensus on optimal DESI formats. Assessing clinicians' perceptions about DESI formats can help facilitate their adoption. The aim of this study was to assess clinicians' perceptions of DESIs formats and potential use in practice. Methods Semi-structured qualitative interviews were conducted with doctors from diverse practice areas (internal medicine, OB/ GYN, surgery, medical oncology, emergency medicine) and elicited perceptions toward patient DESIs formats (digital vs. paper) and timing of administration. Questions also elicited beliefs underlying attitudes, perceived social norms and self-efficacy for using DESIs and the feasibility of doing so. Data analysis was conducted using a thematic analysis approach. Results Participants identified strengths of both more comprehensive digital and shorter paper-based tools and thought they could complement each other. Participants consistently expressed the advantages of using DESIs outside the consultation to supplement clinical discussions about cancer decisions given the amount of information to discuss during these emotion-laden conversations. Participants felt that patients with older age and lower socio-economic status were more likely to use a paper-based compared with a digital DESI. Participants also noted challenges related to reliable resources such as computers and Internet in the practice setting, which would be necessary for implementing the digital DESIs on site. Conclusions Clinicians' perceptions and opinions about value of DESIs can vary widely across doctor, patient and clinic characteristics. A one-size-fits-all approach to implementation might not be feasible, suggesting that flexible approaches to providing decision support for patients are needed to drive broader adoption. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The Healthy, Hunger-Free Kids Act of 2010 ( HHKA) required schools to make changes to meals provided to children. Rural school districts have limited resources, with increased obesity rates and local food insecurity. In this study we sought to understand the perceptions of rural food service directors and the barriers to implementing the changes. METHODS Food service directors from rural school districts were invited to complete a semistructured telephone interview and online survey. A total of 51 respondents completed both, 6 completed only the online survey, and 16 completed only the telephone interview. Qualitative interview data were analyzed through open thematic coding; descriptive statistics were calculated for the quantitative data. RESULTS Food service directors mostly perceived the changes as negative, challenging, and burdensome. They believed that the changes resulted from concern about childhood obesity, which they did not view as a problem for their students. Diverse challenges were reported related to cost, preparation, and student preference. CONCLUSIONS Food service directors in isolated, rural areas need support to enhance understanding of HHKA requirements, build professional networks to learn from one another, and communicate with students, families, and other stakeholders. Future efforts should focus on changing perceptions and supporting directors in order to make implementation a success. [ABSTRACT FROM AUTHOR]

Objectives: DETERMIND (DETERMinants of quality of life, care and costs, and consequences of INequalities in people with Dementia and their carers) is designed to address fundamental, and, as yet unanswered questions about inequalities, outcomes and costs following diagnosis with dementia. These answers are needed to improve the quality of care and equity of access to care, and therefore the quality of life, of people with dementia and their carers.Method: DETERMIND is a programme of research consisting of seven complementary workstreams (WS) exploring various components that may result in unequal dementia care: WS1: Recruitment and follow-up of the DETERMIND cohort-900 people with dementia and their carers from three geographically and socially diverse sites within six months following diagnosis, and follow them up for three years. WS2: Investigation of the extent of inequalities in access to dementia care. WS3: Relationship between use and costs of services and outcomes. WS4: Experiences of self-funders of care. WS5: Decision-making processes for people with dementia and carers. WS6: Effect of diagnostic stage and services on outcomes. WS7: Theory of Change informed strategy and actions for applying the research findings.Outcomes: During the life of the programme, analysing baseline results and then follow-up of the DETERMIND cohort over 3 years, we will establish evidence on current services and practice. DETERMIND will deliver novel, detailed data on inequalities in dementia care and what drives positive and negative outcomes and costs for people with dementia and carers, and identify factors that help or hinder living well with dementia. [ABSTRACT FROM AUTHOR]

Extracellular vesicles in wound healing have become an active research field with substantial value and potential. Nevertheless, there are few bibliometric studies in this field. We aimed to visualise the research hot spots and trends of extracellular vesicles in wound healing using a bibliometric analysis to help understand the future development of basic and clinical research. The articles and reviews regarding extracellular vesicles in the wound healing were selected from the Web of Science Core Collection. VOSviewers, CiteSpace and R package "bibliometric" were used to conduct this bibliometric analysis. A total of 1225 articles from 56 countries led by China and the United States were included. The number of publications related to extracellular vesicles increased year by year. Shanghai Jiaotong University, Huazhong University of Science and Technology, Sun Yat‐sen University and Central South University are the main research institutions. International Journal of Molecular Sciences is the most popular journal in this field, while Stem Cell Research & Therapy is the most frequently cited journal. These papers come from 7546 authors, among which Zhang Wei has published the most papers and Zhang Bin has the most cocited papers. The research on the treatment strategy of extracellular vesicles in the process of wound healing is the main topic in this field. "exosomes", "miRNA", "angiogenesis", "regenerative medicine", "inflammation" and "diabetic wound" are the main key words of emerging research hotspots. This is the first bibliometric study, which comprehensively summarises the research trend and development of extracellular vesicles and exocrine bodies in wound healing. These informations determine the latest research frontiers and hot directions, and provide reference for the study of extracellular vesicles and exosomes. [ABSTRACT FROM AUTHOR]

Introduction: Despite the advancements in Patient and Public Involvement and Engagement (PPIE), the voices of traditionally underserved groups are still poorly reflected in dementia research. This study aimed to report on a PPIE partnership between academics and members of the public from underserved communities to co‐design Forward with Dementia—Social Care, a resource and information website supporting people receiving a dementia diagnosis. Methods: The PPIE partnership was set up in four stages: 1–identifying communities that have been under‐represented from PPIE in dementia research; 2—recruiting PPIE partners from these communities; 3—supporting PPIE partners to become confident to undertake their research roles and 4—undertaking research co‐design activities in an equitable fashion. Results: To address under‐representation from PPIE in dementia research we recruited seven PPIE partners from Black, Asian and other minority ethnic groups; lesbian, gay, bisexual, transgender, queer+ communities; remote/rural area; religious minorities and partners living with rare forms of dementia. The partners met regularly throughout the project to oversee new sections for the study website, refine existing content and promote the website within their communities. Conclusion: Strategies can be used to successfully recruit and involve PPIE partners from underserved communities in co‐design activities. These include networking with community leaders, developing terms of reference, setting out 'rules of engagement', and investing adequate resources and time for accessible and equitable involvement. These efforts facilitate the co‐design of research outputs that reflect the diversity and complexity of UK contemporary society. Patient or Public Contribution: This study received support from seven members of the public with lived experience of dementia from communities that have been traditionally underserved in dementia research. These seven members of the public undertook the role of partners in the study. They all equally contributed to the study design, recruitment of participants, development and revision of topic guides for the interviews and development of the website. Three of these partners were also co‐authors of this paper. On top of the activities shared with the other partners, they contributed to write independently of the academic team the section in this paper titled 'Partners' experiences, benefits and challenges of the partnership'. Further, they provided input in other sections of the paper on a par with the other (academic) co‐authors. [ABSTRACT FROM AUTHOR]

Objectives: A prospective parallel cohort trial was conducted to compare outcomes of patients treated with maxillary protraction vs LeFort 1 maxillary advancement surgery.Setting and Sample Population: The primary site for the clinical trial is Children's Hospital Los Angeles; the satellite test site is Seattle Children's Hospital. All patients have isolated cleft lip and palate and a skeletal Class III malocclusion.Material and Methods: A total of 50 patients, ages 11-14, will be recruited for the maxillary protraction cohort. The maxillary surgery cohort consists of 50 patients, ages 16-21, who will undergo LeFort 1 maxillary advancement surgery. Patients with additional medical or cognitive handicaps were excluded from the study.Results: Current recruitment of patients is on track to complete the study within the proposed recruitment period.Conclusion: This observational trial is collecting information that will examine dental, skeletal, financial and quality-of-life issues from both research cohorts. [ABSTRACT FROM AUTHOR]

Background: The potential of learning analytics dashboards in virtual reality simulation‐based training environments to influence occupational self‐efficacy via self‐reflection phase processes in the Chemical industry is still not fully understood. Learning analytics dashboards provide feedback on learner performance and offer points of comparison (i.e., comparison with one's own past performance or comparison with peer performance) to help learners make sense of their feedback. Objectives: We present a theoretical framework for describing learning analytics reference frames and investigate the impact of feedback delivered through dashboards with different reference frames on occupational self‐efficacy, while controlling for workplace self‐reflection. Methods: This experimental study engaged 42 chemical operator employees, aged between 18 and 55 years, each with at least one year of experience. We utilised a two‐group design to ask two research question each with three competing hypotheses related to changes in occupational self‐efficacy, employing Bayesian informative hypothesis evaluation. Results and Conclusions: Results for the primary research question suggest that dashboards with progress reference frames do not elicit greater change to self‐efficacy than those with social reference frames, however, they may elicit equal change. Furthermore, dashboards with social reference frames may elicit greater change to self‐efficacy than those with progress reference frames. Exploratory results found that dashboards with progress reference frames may elicit greater positive directional change than those with social reference frames and that they may elicit equal directional change. These findings contribute to the understanding of self‐efficacy beliefs within the Chemical industry, with potential impacts on skill development. The research may inform the design of targeted interventions and training programs to influence self‐efficacy. From a practical perspective, this research suggests that careful consideration is needed when choosing reference frames in learning analytics dashboards due to their potential consequences on the formation of learner self‐efficacy. Lay Description: What is already known about this topic?: Learning analytics dashboards often aim to stimulate self‐regulated learning by providing feedback.Feedback plays a crucial role in simulation‐based learning and learning analytics dashboards can be a valuable tool to deliver feedback and facilitate the learning process by providing learners with insights into their performance and progress.Previous research has highlighted the importance of reference frames as critical design features of learning analytics dashboards, as they assist learners in making sense of learning analytics feedback.Self‐efficacy is a powerful determine factor of workplace performance and is influenced by mastery experiences and social modelling information. What the paper adds?: A theoretical framework describes the mediating role self‐reflection phase processes of the self‐regulated learning cycle plays in the formation of occupational self‐efficacy.This paper introduces the concept of three learning analytics reference frame components which include the performance outcome component, point of comparison component and score delta component.The paper indicates that learning analytics dashboards designed with a progress reference frame does not elicit greater change to occupational self‐efficacy than the social reference frame.Exploratory results suggest dashboards with progress reference frames might produce greater positive directional change compared to social reference frames or elicit equal change. Implications for practice?: Learning analytics system designers who use reference frames to help learners make sense of their feedback should carefully consider which reference frames they use as these decisions likely have consequences on the formation of learner self‐efficacy beliefs.For LAD designers and stakeholders, recognising the absolute change and directional shift in self‐efficacy is crucial, as LAD designs significantly influence these dynamics and guide the tailoring of effective tools.In industries like the chemical sector, where overconfidence can result in severe consequences, understanding the nuance of self‐efficacy changes is especially pertinent. [ABSTRACT FROM AUTHOR]

Background: COVID‐19 necessitated emergency telepractice for student‐led speech‐language therapy clinical practicals in training institutions, with limited preparation and evidence‐based guidelines. Beyond the pandemic, practitioners and university training sites are likely to continue to offer telepractice necessitating thorough preparation for telepractice services underpinned by a comprehensive understanding of the complexities involved in online therapy. Aims: Adopting realist evaluation principles, our aim in this paper was to explore broadly what works and does not work in a set of student‐led telepractice sessions in a diverse, resource‐limited context. The broader goal of this project was to provide evidence‐based support to enhance the efficiency and success of telepractice sessions in student clinical training contexts. Methods & Procedures: We used qualitative observational methods with reflexive thematic analysis to analyse 28 video recordings and 61 observation notes of student‐led paediatric telepractice sessions from a South African university clinic as part of a pilot study. Outcomes & Results: We identified four overarching considerations for student‐led telepractice: (1) additional, specific preparation is required, (2) with greater management of technology and adaptation of tasks, especially during times of poor connectivity; (3) telepractice relies heavily on caregiver input and collaboration; and (4) promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical skills that are complicated by the lack of face‐to‐face contact. Conclusions & Implications: Our findings indicate that telepractice pedagogy needs to be explicitly taught and students require practical assistance as they learn how to use this service delivery approach effectively. There are some aspects peculiar to telepractice that require unique consideration and planning, especially in contexts where service providers and users may be unfamiliar with this form of service provision. The findings of this pilot study can be used by clinical educators and student clinicians to enhance clinical training opportunities involving telepractice. WHAT THIS PAPER ADDS: What is already known on this subject: Many speech‐language therapy (SLT) student clinicians had to transition quickly to telepractice service provision during COVID‐19 with limited existing guidelines and support, especially in contexts where teletherapy is typically non‐existent or difficult to access. Although there is some literature available on experiences of telepractice, there is very little evidence‐based research which explores the mechanics of such sessions in real‐time and which offers practical support to student clinicians and clinical educators engaging in this mode of service delivery. What this study adds: This pilot study examined video‐recorded, student‐led, paediatric, speech‐language teletherapy sessions to understand challenges and considerations involved in using telepractice as a clinical training tool. Findings show that additional preparation for telepractice sessions is required, particularly in contexts of poor digital literacy; students must learn to manage technology, especially when connectivity poses a challenge, and adapt therapy tasks for online work with clients; telepractice relies heavily on caregiver input and collaboration, more so than in in‐person consultations, and this relationship requires careful management; and promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical yet challenging skills in telepractice. What are the potential or actual clinical implications of this work?: Our findings highlight a need to teach telepractice pedagogy explicitly and support students practically in learning how to provide therapy effectively via this mode of service delivery. Observational methods for studying practices in recorded telepractice sessions can be used as part of a reflective approach to clinical training. Using already available data allowed us to unpack the 'messy reality' of clinical training using telepractice. [ABSTRACT FROM AUTHOR]

Background: There is a lack of evidence relating to cognitive‐communication difficulties following traumatic brain injury (TBI) sustained in older adulthood. A prominent area in which post‐TBI cognitive‐communication difficulties manifest is at the level of social communication. An investigation of social communication focusing on comparison of those injured in older and younger adulthood is a practical starting point for age‐related cognitive‐communication outcome comparison. Aims: The overall objective of this study was to explore the social communication of individuals who sustained severe TBI in an early period of older adulthood (50–70 years) compared to younger adulthood (18–40 years), as informed by self and close other reports. Methods & Procedures: This exploratory controlled group comparison study involved analysis of self‐reported and close other reported La Trobe Communication Questionnaire data for 22 adults with severe TBI (11 older at injury; 11 younger at injury) and 22 control participants (11 older; 11 younger). TBI participants were matched for injury variables and participant groups were matched for sex, age and education. Outcomes & Results: The close others of the older and younger adults with TBI reported them to have significantly more frequent difficulty with social communication than the close others of age‐matched control groups. Older adults with TBI reported significantly more frequent difficulty with social communication than uninjured older adults. In contrast, younger adults with TBI and uninjured younger adults reported a similar frequency of difficulty with social communication. No age‐based difference in the frequency of social communication difficulty was evident when comparing the self or close other reports of older and younger adults with TBI. Awareness of social communication difficulty, as indexed by comparing self and close other perceptions, showed a different pattern across the TBI groups. The older TBI group rated themselves as having significantly less frequent social communication difficulty than was perceived by their close others. In contrast, no statistically significant difference was evident between the self and close other social communication ratings of the younger TBI group. Conclusions and Implications: Where possible clinicians need to work with close communication partners to understand the nature and degree of social communication difficulty following severe TBI. This may be especially important when working with people who sustain TBI in older adulthood if future research shows that this population have greater difficulty with self‐awareness of social communication difficulty. What this paper adds: What is already known on the subject: Cognitive‐communication difficulties are a common consequence of traumatic brain injury (TBI) that can have long‐term impact on everyday functioning. These challenges have primarily been investigated in individuals who sustained TBI in younger adulthood. What this paper adds to existing knowledge: Individuals who sustain severe TBI in early older adulthood have a higher frequency of reported social communication difficulty to non‐injured adults of a similar age, albeit they may underreport such difficulties potentially in the context of reduced self‐awareness. What are the potential or actual clinical implications of this work?: Social communication difficulty is an issue for people who sustain severe TBI in early older adulthood. However, a poorer overall social communication outcome in comparison to those injured in younger adulthood should not be assumed. Clinical service delivery for these challenges is most optimally delivered in a collaborative manner with the individual and their close others. Future research is required to investigate the identified trends from this study. [ABSTRACT FROM AUTHOR]

Introduction: Virtual reality (VR) technology is a potential method to use in cognitive intervention, but the use of VR in cognitive stimulation intervention for older adults has not been investigated. Therefore, the aim of this study was to investigate the mood change of older adults after participating in the VR cognitive stimulation activity.Methods: This is a multicenter randomized controlled, cross-over trial. The intervention was a VR cognitive stimulation activity, and the control was a paper-and-pencil activity. The participants were older adults with age over 60 and recruited in the elderly community centers. The Positive and Negative Affect Score (PANAS) was used to measure mood change. Mean difference (MD) with 95% confidence interval (95% CI) was calculated. The Simulator sickness questionnaire was used to measure adverse events.Results: A total of 236 participants from 19 community centers were recruited. After the VR activity, the participants had a significant increase in total PANAS positive affect score (MD = 2.09, 95% CI = 0.69 to 3.49), and a significant reduction in total negative affect score (MD = -1.99, 95% CI = -2.55 to -1.43). The reduction in negative affect score was significantly larger in VR activity than paper-and-pencil activity (MD = -0.48, 95% CI = -0.98 to 0.00). Besides, only three participants reported severe advance events after VR activity.Conclusions: The use of VR technology is well accepted by older adults. Therefore, the use of VR technology through smartphone and a mobile app can be a potential method for future cognitive training interventions. [ABSTRACT FROM AUTHOR]

Background: In order to conduct research that is meaningful to speech and language therapy services and their patients, it is often desirable to conduct the research within routine clinical services. This can require considerable time and commitment from speech and language therapists (SLTs). It is therefore important to understand the impact that such participation in research can have. Aims: To explore the impact of research participation in the Big CACTUS study of self‐managed computerized aphasia therapy conducted in 21 UK NHS speech and language therapy departments. Methods & Procedures: An online survey was sent to SLTs who took the lead role for the study at their NHS Trust to evaluate the impact of study participation in three domains: capacity‐building, research development and health services. The questionnaire, based on the VICTOR framework for evaluating research impact, included Likert scale statements and closed and open‐ended questions. The results from open‐ended questions were coded and analysed using framework analysis in NVivo 12 and the data from closed questions were analysed descriptively. Outcomes & Results: A total of 12 SLTs returned the survey. Nine codes were identified from open‐ended questions and 20 predefined from the literature. Analysis of the responses demonstrated the perceived impact including improvements in practices and access to therapy, investments in infrastructure, increased SLT profile, and impact on research culture among SLTs. The usefulness of the intervention during the COVID‐19 pandemic was also highlighted. Conclusions & Implications: The results suggest participation in Big CACTUS has resulted in improvements in patient care and SLT research capacity and culture in speech and language therapy departments. What This Paper Adds: What is already known on the subject: Practice‐based research is encouraged to assist with the clinical relevance of the research findings. Participation in research can be seen as an activity that is additional to the core business of patient care and it can be difficult to secure time to participate or conduct research in clinical settings. Impact evaluation initiatives of individual trials facilitate early identification of benefits beyond the trial. What this paper adds to existing knowledge: This study describes specific examples of the impact on services, staff and patients from SLT participation and leadership in the Big CACTUS speech and language therapy trial in clinical settings. What are the potential or actual clinical implications of this study?: Clinical services participating in research may benefit from improved clinical care for patients both during and after the study, an improved professional reputation, and increased research capacity and culture within the clinical settings. [ABSTRACT FROM AUTHOR]

Background: In everyday conversations, a person with aphasia (PWA) compensates for their language impairment by relying on multimodal and material resources, as well as on their conversation partners. However, some social actions people perform in authentic interaction, proposing a joint future activity, for example, ordinarily rely on a speaker producing a multi‐word utterance. Thus, the language impairment connected to aphasia may impede the production of such proposals, consequently hindering the participation of PWAs in the planning of future activities. Aims: To investigate (1) how people with post‐stroke chronic aphasia construct proposals of joint future activities in everyday conversations compared with their familiar conversation partners (FCPs); and (2) how aphasia severity impacts on such proposals and their uptake. Methods & Procedures: Ten hours of video‐recorded everyday conversations from seven persons with mild and severe aphasia of varying subtypes and their FCPs were explored using conversation analysis. We identified 59 instances where either party proposed a joint future activity and grouped such proposals according to their linguistic format and sequential position. Data are in Finnish. Outcomes & Results: People with mild aphasia made about the same number of proposals as their FCPs and used similar linguistic formats to their FCPs when proposing joint future activities. This included comparable patterns associated with producing a time reference, which was routinely used when a proposal initiated a planning activity. Mild aphasia manifested itself as within‐turn word searches that were typically self‐repaired. In contrast, people with severe aphasia made considerably fewer proposals compared with their FCPs, the proposal formats being linguistically unidentifiable. This resulted in delayed acknowledgement of the PWAs' talk as a proposal. Conclusions & Implications: Mild aphasia appears not to impede PWAs' ability to participate in the planning of joint future activities, whereas severe aphasia is a potential limitation. To address this possible participatory barrier, we discuss clinical implications for both therapist‐led aphasia treatment and conversation partner training. WHAT THIS PAPER ADDS: What is already known on the subject: PWAs use multimodal resources to compensate for their language impairment in everyday conversations. However, certain social actions, such as proposing a joint future activity, cannot ordinarily be accomplished without language. What this paper adds to existing knowledge: The study demonstrates that proposing joint future activities is a common social action in everyday conversations between PWAs and their family members. People with mild aphasia used typical linguistic proposal formats, and aphasic word‐finding problems did not prevent FCPs from understanding the talk as a proposal. People with severe aphasia constructed proposals infrequently using their remaining linguistic resources, a newspaper connecting the talk to the future and the support from FCPs. What are the potential or actual clinical implications of this work?: We suggest designing aphasia treatment with reference to the social action of proposing a joint future activity. Therapist‐led treatment could model typical linguistic proposal formats, whereas communication partner training could incorporate FCP strategies that scaffold PWAs' opportunities to construct proposals of joint future activities. This would enhance aphasia treatment's ecological validity, promote its generalization and ultimately enable PWAs to participate in everyday planning activities. [ABSTRACT FROM AUTHOR]

Background: Patients with anomic aphasia experience difficulties in narrative processing. General discourse measures are time consuming and require necessary skills. Core lexicon analysis has been proposed as an effort‐saving approach but has not been developed in Mandarin discourse. Aims: This exploratory study was aimed (1) to apply core lexicon analysis in Mandarin patients with anomic aphasia at the discourse level and (2) to verify the problems with core words among people with anomic aphasia. Methods & Procedure: The core nouns and verbs were extracted from narrative language samples from 88 healthy participants. The production of core words for 12 anomic aphasia and 12 age‐ and education‐matched controls were then calculated and compared. The correlation between the percentages and the Aphasia Quotients of the revised Western Aphasia Battery was analyzed as well. Outcomes & Results: The core nouns and verbs were successfully extracted. Patients with anomic aphasia produced fewer core words than healthy people, and the percentages differed significantly in different tasks as well as word classes. There was no correlation between the core lexicon use and the severity of aphasia in patients with anomic aphasia. Conclusions & Implications: Core lexicon analysis may potentially serve as a clinician‐friendly manner of quantifying core words produced at the discourse level in Mandarin patients with anomic aphasia. WHAT THIS PAPER ADDS: What is already known on the subject: Discourse analyses in aphasia assessment and treatment have increasingly garnered attention. Core lexicon analysis based on English AphasiaBank has been reported in recent years. It is correlated with microlinguistic and macrolinguistic measures in aphasia narratives. Nevertheless, the application based on Mandarin AphasiaBank is still under development in healthy individuals and patients with anomic aphasia. What this paper adds to existing knowledge: A Mandarin core lexicon set was developed for different tasks. The feasibility of core lexicon analysis to evaluate the corpus of patients with anomic aphasia was preliminarily discussed and the speech performance of patients and healthy people was then compared to provide a reference for the evaluation and treatment of clinical aphasia corpus. What are the potential or actual clinical implications of this work?: The purpose of this exploratory study was to consider the potential use of core lexicon analysis to evaluate core word production in narrative discourse. Moreover, normative and aphasia data were provided for comparison to develop clinical use for Mandarin patients with anomic aphasia. [ABSTRACT FROM AUTHOR]

Child stunting prevalence is primarily used as an indicator of impeded physical growth due to undernutrition and infections, which also increases the risk of mortality, morbidity and cognitive problems, particularly when occurring during the 1000 days from conception to age 2 years. This paper estimated the relationship between stunting prevalence and age for children 0–59 months old in 94 low‐ and middle‐income countries. The overall stunting prevalence was 32%. We found higher stunting prevalence among older children until around 28 months of age—presumably from longer exposure times and accumulation of adverse exposures to undernutrition and infections. In most countries, the stunting prevalence was lower for older children after around 28 months—presumably mostly due to further adverse exposures being less detrimental for older children, and catch‐up growth. The age for which stunting prevalence was the highest was fairly consistent across countries. Stunting prevalence and gradient of the rise in stunting prevalence by age varied across world regions, countries, living standards and sex. Poorer countries and households had a higher prevalence at all ages and a sharper positive age gradient before age 2. Boys had higher stunting prevalence but had peak stunting prevalence at lower ages than girls. Stunting prevalence was similar for boys and girls after around age 45 months. These results suggest that programmes to prevent undernutrition and infections should focus on younger children to optimise impact in reducing stunting prevalence. Importantly, however, since some catch‐up growth may be achieved after age 2, screening around this time can be beneficial. Key message: Stunting prevalence was higher for older children until around age 28 months.The age with the highest stunting prevalence was fairly consistent across UNICEF regions.However, the stunting prevalence and gradient of the rise and fall in stunting prevalence across age varied between countries, living standards and sex.Programmes to prevent undernutrition and infections should focus on younger children to optimise impact in reducing stunting prevalence.Some catch‐up growth may be achieved after age 2, so screening around this time can be beneficial. [ABSTRACT FROM AUTHOR]

Background: Acute and late toxicities in patients treated with (chemo)radiotherapy for head and neck cancer (HNC) is common and can negatively impact quality of life and performance. Performance status instruments measure the functional ability to perform daily life activities and are important tools in the oncologic population. Aims: Since Dutch performance status scales for the HNC population are lacking, we conducted this study to translate the Performance Status Scale for Head and Neck Cancer Patients (PSS‐HN) into Dutch (D‐PSS‐HN) and to validate this version. Methods & Procedures: The D‐PSS‐HN was translated into Dutch according to the internationally described cross‐cultural adaptation process. It was administered to HNC patients and together with the Functional Oral Intake Scale completed by a speech and language pathologist at five different time points during the first 5 weeks of (chemo)radiotherapy. Patients were asked each time to complete the Functional Assessment of Cancer Therapy and the Swallowing Quality of Life Questionnaire. Pearson correlation coefficients were used to calculate convergent and discriminant validity and the evolution of D‐PSS‐HN scores was assessed by means of linear mixed models. Outcomes & Results: A total of 35 patients were recruited and > 98% of the clinician‐rated scales were completed. Convergent and discriminant validity were demonstrated, with all correlations rs between 0.467 and 0.819, and between 0.132 and 0.256, respectively. The subscales of the D‐PSS‐HN are sensitive to detect changes through time. Conclusion & Implications: The D‐PSS‐HN is a valid and reliable instrument to assess performance status in patients with HNC treated with (chemo)radiotherapy. It is a useful tool to measure HNC patients' current diet level and functional abilities to perform daily life activities. WHAT THIS PAPER ADDS: What is already known on the subject: Acute and late toxicities in patients treated with (chemo)radiotherapy for HNC are common and can negatively impact quality of life and performance. Performance status instruments measure the functional ability to perform daily life activities and are important tools in the oncologic population. However, Dutch performance status scales for the HNC population are lacking. Therefore, we translated the Performance Status Scale for Head and Neck Cancer Patients (PSS‐HN) into Dutch (D‐PSS‐HN) and validated this version. What this paper adds to existing knowledge: We translated the PSS‐HN and demonstrated its convergent and discriminant validity. The subscales of the D‐PSS‐HN are sensitive to detect changes through time. What are the potential or actual clinical implications of this work?: The D‐PSS‐HN is a useful tool to measure HNC patients' functional abilities to perform daily life activities. The tool can easily be used in clinical settings: since data collection duration is very short, this facilitates clinical (and research‐related) implementation of the scale. Patients' individual needs could be identified by using the D‐PSS‐HN, resulting in more appropriate approaches and (early) referrals if needed. Interdisciplinary communication could be facilitated. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic necessitated that speech–language therapists (SLTs) make a radical change to provide services to their clients safely via telepractice. For many practitioners, telepractice was an unfamiliar mode of practice that had to be implemented under emergency conditions. Limited literature on SLTs' experiences of implementing telepractice in the Global South during this time is available. Aims: To explore the experiences of South African SLTs (N = 45) who implemented telepractice services during the COVID‐19 pandemic. Methods & Procedures: SLTs across the country were invited via professional bodies to participate in an online qualitative survey distributed in 2021. Data were analysed using thematic analysis principles. Outcomes & Results: We describe participants' reports of their current telepractices, discuss their perspectives on accessibility to telepractice for SLTs, clients and caregivers, and working with specific diagnoses, and consider the support needs of SLTs to enhance telepractice services. Most participants work in private practice or school settings with primarily paediatric caseloads. They reported telepractice as a positive experience and felt it was effective, although they judged that some clients were not well served by telepractice. SLTs felt underprepared for the rapid switch to telepractice and the flexibility required, especially given the limited availability of guidelines given the pandemic crisis. Greater preparation is required for telepractice sessions and more attention needs to be paid to supporting caregiver involvement online. Conclusions & Implications: Telepractice involves various barriers and facilitators, many of which seem common across Global North and South contexts. Support is required to enhance current telepractices in terms of computer literacy, technical education, different telepractice methods and caregiver coaching. Our findings have the potential to enable the development of support, training and guidelines to improve SLTs' confidence in providing telepractice whilst delivering quality services in an accessible and safe manner. WHAT THIS PAPER ADDS: What is already known on the subject: Many SLTs had to transition quickly to telepractice service provision during COVID‐19, with limited existing guidelines and support. Although there is some literature available on SLTs' experiences of implementing telepractice in the Global North, perspectives from the Global South during this time are limited. It is important to understand experiences, barriers and facilitators to telepractice provision to provide tailored support to practitioners. What this paper adds to existing knowledge: Telepractice provides a viable alternative to in‐person therapy for specific clients and contexts. Telepractice presents both benefits and barriers for effective clinical practice across Global North and South contexts. Greater preparation is required for telepractice sessions and more attention needs to be paid to enhancing caregiver involvement online, especially since many practitioners are likely to continue offering telepractice services post‐pandemic. What are the potential or actual clinical implications of this work?: Clinicians felt underprepared for the rapid switch from service delivery mode to telepractice. Greater support, training and guidelines for students and practitioners are required to enhance current practices and ensure practitioners are equipped to provide effective telepractice in the future. In particular, support should cover technological aspects, caregiver coaching and online assessment options, especially for paediatric clients. [ABSTRACT FROM AUTHOR]

Background: At the beginning of the 21st century, international adoptions of children with cleft lip and/or palate increased dramatically in Sweden. Many children arrived partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. To date, the speech development of internationally adopted (IA) children has been described up to age 7–8 years, but later development remains unstudied. Aims: To investigate speech development between ages 5 and 10 years in children born with cleft lip and palate (CLP) adopted from China and to compare them with non‐adopted (NA) children with CLP. A secondary aim was to compare the frequencies of secondary palatal surgery and number of visits to a speech and language pathologist (SLP) between the groups. Methods & Procedures: In a longitudinal study, 23 IA children from China were included and matched with 23 NA children born in Sweden. Experienced SLPs blindly reassessed audio recordings from routine follow‐ups at ages 5 and 10 years. Velopharyngeal function (VPF) was assessed with the composite score for velopharyngeal competence (VPC‐Sum) for single words and rated on a three‐point scale (VPC‐Rate) in sentence repetition. Target sounds in words and sentences were phonetically transcribed. Per cent correct consonants (PCC) were calculated at word and sentence levels. For in‐depth analyses, articulation errors were divided into cleft speech characteristics (CSCs), developmental speech characteristics (DSCs) and s‐errors. Information on secondary palatal surgery and number of visits to an SLP was collected. Outcomes & Results: VPF differed significantly between the groups at both ages when assessed with VPC‐Sum, but not with VPC‐Rate. Regardless of the method for assessing VPF, a similar proportion in both groups had incompetent VPF but fewer IA than NA children had competent VPF at both ages. IA children had lower PCC at both ages at both word and sentence levels. More IA children had CSCs, DSCs and s‐errors at age 5 years, and CSCs and s‐errors at age 10. The development of PCC was significant in both groups between ages 5 and 10 years. The proportion of children receiving secondary palatal surgery did not differ significantly between the groups, nor did number of SLP visits. Conclusions & Implications: CSCs were more persistent in IA children than in NA children at age 10 years. Interventions should target both cleft and DSCs, be comprehensive and continue past the pre‐school years. WHAT THIS PAPER ADDS: What is already known on this subject: At the beginning of the 21st century, IA children with cleft lip and/or palate arrived in Sweden partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. Studies up to age 7–8 years show that adopted children, compared with NA peers, have poorer articulation skills, demonstrate both cleft‐related and developmental articulation errors, and are more likely to have velopharyngeal incompetence. Several studies also report that adopted children more often require secondary palatal surgery due to fistulas, dehiscence or velopharyngeal incompetence compared with NA peers. What this paper adds to existing knowledge: This longitudinal study provides additional knowledge based on longer follow‐ups than previous studies. It shows that the proportion of children assessed to have incompetent VPF was similar among IA and NA children. It was no significant difference between the groups regarding the proportion that received secondary palatal surgery. However, fewer IA children were assessed to have a competent VPF. Developmental articulation errors have ceased in most IA and all NA children at age 10 years, but significantly more adopted children than NA children still have cleft‐related articulation errors. What are the potential or actual clinical implications of this work?: Speech and language therapy should target both cleft‐related and developmental articulation errors. When needed, treatment must be initiated early, comprehensive, and continued past the pre‐school years, not least for adopted children. [ABSTRACT FROM AUTHOR]

Background: Public involvement in health services research is encouraged. Descriptions of public involvement across the whole research cycle of a major study are uncommon and its effects on research conduct are poorly understood. Aim: This study aimed to describe how we implemented public involvement, reflect on process and effects in a large‐scale multi‐site research study and present learning for future involvement practice. Method: We recorded public involvement roles and activities throughout the study and compared these to our original public involvement plan included in our project proposal. We held a group interview with study co‐applicants to explore their experiences, transcribed the recorded discussion and conducted thematic analysis. We synthesized the findings to develop recommendations for future practice. Results: Public contributors' activities went beyond strategic study planning and management to include active involvement in data collection, analysis and dissemination. They attended management, scrutiny, planning and task meetings. They also facilitated public involvement through annual planning and review sessions, conducted a Public Involvement audit and coordinated public and patient input to stakeholder discussions at key study stages. Group interview respondents said that involvement exceeded their expectations. They identified effects such as changes to patient recruitment, terminology clarification and extra dissemination activities. They identified factors enabling effective involvement including team and leader commitment, named support contact, building relationships and demonstrating equality and public contributors being confident to challenge and flexible to meet researchers' timescales and work patterns. There were challenges matching resources to roles and questions about the risk of over‐professionalizing public contributors. Conclusion: We extended our planned approach to public involvement and identified benefits to the research process that were both specific and general. We identified good practice to support effective public involvement in health services research that study teams should consider in planning and undertaking research. Public Contribution: This paper was co‐conceived, co‐planned and co‐authored by public contributors to contribute research evidence, based on their experiences of active involvement in the design, implementation and dissemination of a major health services research study. [ABSTRACT FROM AUTHOR]

This paper investigates whether free access to scientific literature increases the participation of under‐represented groups in scientific discourse. To this end, we aggregate and match data tracing access to Sci‐Hub, a widely used black open access (OA) repository or shadow library, and publication data from the Web of Science (WoS). We treat the emergence of Sci‐Hub as an exogenous event granting relatively unrestricted access to publications, which are otherwise hidden behind a paywall. We analyze changes in the publication count of researchers from developing countries in a given journal as a proxy for general participation in scientific discourse. Our results indicate that in the exemplary field of mathematics, free access to academic knowledge is likely to improve the representation of authors from developing countries in international journals. Assuming the desirability of greater international diversity in science (e.g., to generate more original work, reproduce empirical findings in different settings, or shift the research focus toward topics that are overlooked by researchers from more developed countries), our findings lend evidence to the claim of the OA movement that scientific knowledge should be free and widely distributed. [ABSTRACT FROM AUTHOR]

Background: The majority of children with cerebral palsy (CP) experience challenges in functional communication from a young age. A pivotal aspect of functional communication is language comprehension. A variety of classification systems and questionnaires are available to classify and describe functional communication skills in children with CP. A better understanding of the convergent validity of (subsections of) these tools, as well as their relationship with spoken language comprehension, will be valuable in both clinical practice and research. Aims: To investigate the convergent validity of (subsections of) functional communication tools and the relationship with spoken language comprehension in children with CP. Methods & Procedures: Cross‐sectional data on 138 children were subdivided into three developmental stages based on (Dutch) educational phases: ages 18 months–3;11y (n = 59), 4;0–5;11 years (n = 37) and 6;0–8;11 years (n = 42). The following functional communication tools were used to classify and describe functional communication: Communication Function Classification System (CFCS), subscales of the Caregivers Priorities and Child Health Index of Life with Disabilities—Dutch Version (CPCHILD‐DV) and the Focus on Communication Under Six‐34 (FOCUS‐34) questionnaire. Spoken language comprehension was assessed with the Computer‐Based instrument for Low motor Language Testing (C‐BiLLT). Correlations between the functional communication tools, and with the C‐BiLLT, were calculated using Pearson's and Spearman's correlation coefficients. It was hypothesized a priori that correlations of at least 0.60 suggest good convergent validity. Outcomes & Results: At all developmental stages, a significant ordered decreasing tendency of communication outcomes was found across CFCS levels; lower CFCS levels were associated with lower scores on the CPCHILD‐DV and FOCUS‐34, and with a lower level of spoken language comprehension (C‐BiLLT). Correlation coefficients of the functional communication tools exceeded 0.60 at all developmental stages. Correlations between C‐BiLLT raw scores and the functional communication tools varied between 0.351 and 0.591 at developmental stage 18 months–3;11 years, between 0.781 and 0.897 at developmental stage 4;0–5;11 years, and between 0.635 and 0.659 at developmental stage 6;0–8;11 years. Conclusions & Implications: The functional communication tools assessed in this study showed convergent validity at all developmental stages. The CFCS, currently most widely used in paediatric rehabilitation, is adequate in the classification of functional communication. However, for more detailed clinical goal setting and evaluation of change in functional communication, the additional use of FOCUS‐34 or CPCHILD‐DV is recommended. What this paper adds: What is already known on the subject: A range of functional communication tools are available that help describe and classify functional communication in children with CP. These include the CFCS, subsections of CPCHILD‐DV and FOCUS‐34. The CFCS classifies functional communication in daily life with familiar and unfamiliar partners. Specific subsections of the CPCHILD‐DV and FOCUS‐34 include items that pertain to communicative participation. The innovative C‐BiLLT provides a standardized method to assess spoken language comprehension in children with CP and significant motor impairments. What this paper adds to existing knowledge: In the present study, convergent validity was confirmed between CFCS and specific subsections of the CPCHILD‐DV and FOCUS‐34. Correlations between these functional communication tools and the C‐BiLLT were moderate to strong. What are the potential or actual clinical implications of this work?: For clinical and research purposes (for instance, accurate prescription of augmentative and alternative communication—AAC), healthcare and educational professionals together with parents need to know how functional communication tools converge and how functional communication levels relate to the comprehension of spoken language. The CFCS provides a valid classification of functional communication abilities in children with CP. However, to measure change in functional communication and to evaluate treatment outcomes, use of additional functional communication tools such as the CPCHILD‐DV and FOCUS‐34 is recommended. When discrepancies are found between communicative abilities and spoken language comprehension, it is strongly recommended that valid tools are used in a more detailed examination of the child's spoken language comprehension skills and functional communication. [ABSTRACT FROM AUTHOR]

Background: Research in word‐finding difficulties is sparse, especially in languages other than English. As a result, the factors associated with the frequency of word‐finding behaviours are poorly understood, particularly in discourse. Aims: This exploratory study is the first to collect data relative to the expected frequency of word‐finding behaviours in narration for French speakers aged 7–12 years old with typical development; and (2) to identify the factors associated with the frequency of word‐finding behaviours in narration. We hypothesized that sociodemographic characteristics, language abilities and characteristics of the spoken productions could be linked to word‐finding behaviours. Methods & Procedures: The participants consisted of 61 French‐speaking children aged 7–12 years old (M = 9;09 years, SD = 1;06 years) with typical development. Children were asked to complete a receptive vocabulary task, a non‐word‐repetition task and two narrative tasks. The children's narrative samples were coded using a discourse analysis of word‐finding behaviours, as described by Diane J. German. Outcomes & Results: Participants produced 39% of T‐units with least one word‐finding behaviour, which included relatively frequent use of repetitions and word reformulations. Regression analyses revealed that the participants' gender was the only significant variable associated with the frequency of word‐finding behaviours in narration. Boys produced a higher percentage of T‐units with at least one word‐finding behaviour. Post‐hoc analyses suggested that gender differences reflected differences in repetitions and word reformulations. Boys and girls did not differ on any other language measures collected. Conclusions & Implications: Speech–language pathologists may want to take into account a child's gender when assessing word‐finding difficulties in narration. Additional studies are needed to understand whether this finding extends to other word‐finding tasks and to children with word‐finding difficulties. WHAT THIS PAPER ADDS: What is already known on the subject: Studies in English have identified that analyses of word‐finding behaviours in discourse can be used to correctly identify children with word‐finding difficulties. Studies are needed in other languages to determine if this observation holds true across languages. Moreover, the factors associated with the frequency of word‐finding behaviours in discourse are poorly understood. What this paper adds to existing knowledge: The frequency of word‐finding difficulties in narration was higher in our study of French‐speaking children than in previous studies of English. Gender was the only factor associated with the frequency of word‐finding difficulties. What are the potential or actual clinical implications of this work?: The language and task used to assess word‐finding skills as well as the child's gender may be important to take into account when assessing word‐finding difficulties based on word‐finding behaviours. [ABSTRACT FROM AUTHOR]

Background: People with post‐stroke dysphagia often require informal care from family to facilitate safe swallowing, modify food/drink or administer tube‐feeds. Previous survey studies have found dysphagia may increase family caregiver burden. However, the experiences of family members in this population have not been fully explored. Aims: To explore family members' experiences of living with a spouse with post‐stroke dysphagia. Methods & Procedures: This exploratory qualitative study used one‐to‐one semi‐structured interviews to explore family members' experiences. They were asked open questions about previous eating routines, dysphagia onset, their role and future hopes. Interviews were audio‐recorded, transcribed and analysed thematically with an inductive approach to determine key features of family members' experiences. Outcomes & Results: Five spouses aged 70–93 years participated. Their relatives' strokes happened 3 months to 3 years before the interview. Five themes were identified: 'I do all of it'; making sense of dysphagia; emotional responses; reflecting on relationships; and redefining lifestyle. Conclusions & Implications: It is important to consider family members' perspectives as they often provide vital care to loved‐ones with dysphagia. In relation to eating and drinking, maintaining elements of previous routines seems important to families. Healthcare professionals should consider these when making recommendations for rehabilitation. Family members have differing perspectives of the comparative impact of dysphagia; patient and family priorities should be explored for healthcare professionals to provide better‐targeted support. What this paper adds: What is already known on the subject: Informal caregivers, often spouses, play a vital role in supporting the health and well‐being of older people with health conditions. The presence of post‐stroke dysphagia may present increased challenges for the informal caregiver. There are limited studies qualitatively exploring the experiences of informal caregivers in this population. What this paper adds to existing knowledge: Current health and social care provision for this population leaves informal caregivers feeling they have been left to manage dysphagia alone. Informal caregivers demonstrate a breadth of knowledge about their spouse's dysphagia, problem‐solving effective solutions. Informal caregivers have a range of interpretations of the nature and cause of dysphagia; leading to miscommunication with health professionals and complex emotional responses. What are the potential or actual clinical implications of this work?: Healthcare professionals might consider ways in which to support dysphagic patients' families later in their care pathway, through scheduling reviews or running dysphagia patient and family groups. Health and social care professionals and policymakers should learn from informal caregivers' expertise to promote better health and quality‐of‐life outcomes for the patient and caregiver. Equal, open conversations between health and social care professionals and patients/families on their understanding of dysphagia may help informal caregivers to better voice their concerns and support mutual understanding. This has implications for adherence to recommendations, psychological well‐being and patient safety. [ABSTRACT FROM AUTHOR]

The main aim of this paper is to explore and discuss the interesting juxtaposition of patient involvement within a standardised Enhanced Recovery After Surgery care programme (ERAS). We address our aim by examining the work and strategies of nursing staff caring for patients during postoperative recovery from surgery, exploring how these two potentially competing priorities might effectively co‐exist within a hospital ward. This was a qualitative exploratory study, with data generated through 42 semi‐structured interviews with patients and nurses who had taken part in an ERAS programme in one of three hospital wards in the United Kingdom, adopting a reflexive thematic approach to data analysis. We shine a light on the work undertaken by patients and nurses during the navigation of postoperative recovery, identifying strategies of collaboration and negotiation during this journey. Furthermore, we also identify and consider patients engaged in peer‐peer support during postoperative recovery. This paper adds to the existing literature and current ways of thinking in relation to the quest for standardised, clinically effective care balanced with the aspirations for individualised, patient‐centred care. This paper also helps inform thinking about the use of care pathways in relation to service delivery, considering how best to initiate and deploy best practice aimed at safe and effective postoperative recovery. [ABSTRACT FROM AUTHOR]

This paper focuses on data science in digital cultural heritage in Brazil, where there is a lack of systematized information and curated databases for the integrated organization of documentary knowledge. Thus, the aim was to systematically map the different forms of information organization and representation applied to objects from collections belonging to institutions affiliated with the federal government's Special Department of Culture. This diagnosis is then used to discuss the requirements of devising strategies that favor a better data science information infrastructure to reuse information on Brazil's cultural heritage. Content analysis was used to identify analytical categories and obtain a broader understanding of the documentary sources of these institutions in order to extract, analyze, and interpret the data involved. A total of 215 hyperlinks that can be considered cultural collections of the institutions studied were identified, representing 2,537,921 cultural heritage items. The results show that the online publication of Brazil's digital cultural heritage is limited in terms of technology, copyright licensing, and established information organization practices. This paper provides a conceptual and analytical view to discuss the requirements for formulating strategies aimed at building a data science information infrastructure of Brazilian digital cultural collections that serves as future projects. [ABSTRACT FROM AUTHOR]

Background: Most students have exhibited low motivation to engage in traditional learning methods. Additionally, students have difficulty concentrating on the course content, being easily distracted by their smartphones. Objectives: Therefore, we adopted an online 3D gamification problem‐based learning (PBL) model to motivate students and improve their learning satisfaction and achievement on a human resource development course. Methods: We followed the ADDIE instructional design model and used four essential topics to formulate our teaching activities in the three‐dimensional sandbox game, Creativerse. Moreover, this paper conducted an explorative study by using ANCOVA and partial least squares structural equation modelling to test student learning achievement and analyse the relationships between components such as performance expectancy (PE), effort expectancy (EE), social influence (SI), and facilitating conditions (FC). Results and conclusions: Our online 3D gamification PBL model enhanced learning achievement on the courses; moreover, FC is the most critical factor influencing learning satisfaction. This study provided suggestions for operating an online 3D gamification PBL teaching approach. Implications: The current paper also explained how students' learning satisfaction relates to these significant factors. Moreover, this study's findings will help instructional designers and instructors to develop online 3D gamification learning environments. Lay Description: What is already known about this topic: Gamified learning can effectively enhance learners' learning motivation.The fun and learning content of the game requires good planning.Gamification can help students become more involved and learn independently. What this paper adds: We designed the instruction that integrated 3D sandbox computer games and problem‐based learning (PBL) into a human resource development course.We conducted a pre‐experiment to test students' learning outcomes by using an ANCOVA and obtaining favourable results.Developing a questionnaire and utilizing PLS‐SEM analysis to explore what significant factors influence students' learning satisfaction. Implications for practice and/or policy: The results indicated that this teaching approach promoted students' active participation and had a learning achievement and satisfaction.This article offered suggestions for practicing a 3D gamification PBL teaching approach. [ABSTRACT FROM AUTHOR]

There is increasing evidence that citations to Chinese research publications are rising sharply. A series of reasons have been highlighted in previous studies. This research explores another possibility-whether there is a 'clubbing' effect in China's surge in research citations, in which a higher rate of internal citing takes place among influential Chinese researchers. Focusing on the most highly cited research articles in nanotechnology, we find that a larger proportion of Chinese nanotechnology research citations are localized within individual, institutional, and national networks within China. Both descriptive and statistical tests suggest that highly cited Chinese papers are more likely than similar U.S. papers to receive internal and localized citations. Tentative explanations and policy implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Haptic feedback has been shown to be an effective facilitator of the learning of scientific concepts in a series of studies. However, little is known about the underlying salient learning mechanisms, which are activated when learning from haptic feedback. Objectives: We investigate the learning mechanism in a higher chemistry education setting, in which the students learned about the abstract concept of potential energy in a quantum chemical context. Methods: In this work, we present a mixed‐methods problem‐solving prior to instruction (PS‐I) study with chemistry bachelor students. In an interactive quantum chemistry learning environment, the students explored the energetic profiles of nucleophilic substitution reactions and the corresponding activation barriers experienced as repulsion and attraction. We measured cognitive and affective mechanisms which have been shown to be activated in PS‐I designs, such as knowledge gap awareness, state curiosity, and positive affect as well as the learning outcome quantitatively and the learning trajectories qualitatively. Results and Conclusions: Planned contrasts revealed a small hindering effect of the haptic feedback on the learning outcome. Thematic analysis of the qualitative data lets us attribute this effect to the lack of scaffolding of the haptic feedback and the spontaneous atomic movements in the simulation, which may be interpreted as a visual representation of force in itself. This work highlights the importance of accurate mappings of the haptic feedback unto the target domain and further delivers insight into the prior conceptions of chemistry undergraduate students. Lay Description: What is already known about this topic: Haptic feedback can facilitate learning by grounding abstract concepts in sensory experiences.While previous studies have reported positive affective results, the cognitive results are ambiguous.Moreover, it was frequently reported that the learning of potential energy in a (quantum) chemical context is particularly difficult due to (i) the lack of grounding opportunities and (ii) the diverse previous conceptions. What this paper adds: A learning environment to interact with molecular systems in real‐time is proposed.The concept of activation energy is grounded in sensory experience of pushing and being pulled.The mixed‐methods design allows to explore cognitive and affective variables as well as the specific prior conceptions activated by the environment. Implications for practice and/or policy: We found a small negative effect of the haptic feedback on the learning outcome, potentially due to insufficient introduction of it to the students.The spontaneous movement of the atoms was identified as a more suitable external representation of the force.Future studies should investigate, if explicit introduction of the embodied metaphor can reverse this effect. [ABSTRACT FROM AUTHOR]

Background: The global introduction of complex measures directed at the containment of the COVID‐19 spread has spurred a massive shift to distance learning among educational institutions. As far as such a learning mode is rather forced and, probably, only a few establishments faced no difficulties with it, the matter of assuring teaching activities' effectiveness in the practice of e‐learning is relevant. Objectives: The main purpose of this article was to assess the efficiency of online‐based tools and technologies in the context of distance education and develop a set of recommendations aimed at improving the effectiveness of online teaching. Methods: The research methodology was based on an empirical approach presupposing an exploratory questionnaire survey addressed to university students. As for the e‐learning platform used, the focus was set on Microsoft Teams. Results and Conclusions: In general, the conducted investigation unveiled that the perception of the role of the instructor differs among Western and Chinese students in terms of willingness to accept psychological help and the feeling of safety during online lessons. Given this, it is reasonable to pay more attention to the psychological well‐being of international students. The comprehensive analysis of survey outcomes allowed the development of a set of recommendations able to enhance the effectiveness of teaching in online settings. These encompass, for example, giving preference to small student group formations, setting greater emphasis on means increasing students' motivation to learn, involvement of instructors in the development and delivery of video lectures, the introduction of automated student assessment, use of multimedia information, and informing students about possible ways of interaction. Lay Description: What is already known about this topic: The comprehensive analysis of survey outcomes allowed developing a set of recommendations able to enhance the effectiveness of teaching in online settings.The most convenient digital features during e‐learning implementation were instant access to information and the availability of a shared chat room.Pre‐pandemic electronic learning was often criticized for insufficient student engagement and social interaction, leading to the need to increase student engagement through interactive online activities, virtual group projects, online discussion forums, and accessibility. What this paper adds: In general, the conducted investigation unveiled that perception of the role of instructor differs among Western and Chinese students in terms of willingness to accept psychological help and the feeling of safety during online lessons.It appeared that international students are more exposed to stress factors and are less likely to trust an educator to the degree allowing them to ask for help.It was possible to develop a set of recommendations aimed at improving the effectiveness of teaching activities during e‐learning through an in‐depth analysis of survey results. Implications for practice and/or policy: Several implications for future investigations can be identified, namely: conducting further studies on the psychological well‐being of international students in online learning, examining cross‐cultural differences, exploring the effectiveness of teaching practices, and addressing broader social issues and consequences.Further research should focus on institutions across China to generalize the results obtained and formulate more reliable inferences.Another limitation is related to the instructors themselves. This variation in specialization among participants could have had an impact on the study's results, but it was not possible to address this issue within the constraints of the current research design. [ABSTRACT FROM AUTHOR]

Background: Artificial Intelligence (AI) literacy is a crucial part of digital literacy that all individuals should possess in today's technologically advanced world. Despite the potential benefits that AI education offers, little research has been done on how to teach AI literacy to children. Objectives: This study aimed to fill that gap by investigating how children were engaged in AI literacy activities that are supported by intelligent agents. These activities were implemented in a Hong Kong kindergarten with a class of six 5‐year‐olds (Mage = 62.83 months, SD = 2.91) over a 6‐week period. Methods: The study gathered data from multiple sources, including classroom observations, teacher interviews, and documents/artefacts. Results and Conclusions: The results showed that children could learn about AI through interaction with intelligent agents in embodied learning contexts. The findings of this study have implications for the broader field of digital technology education, particularly in the context of early childhood education. Lay Description: What is already known about this topic: Artificial Intelligence (AI) literacy is essential in today's world.Little research exists on engaging young children in learning AI literacy. What this paper adds: Technology‐enhanced embodied learning approach affords multimodality in enabling young children's learning with AI‐related agents.Project‐based learning and real‐life examples can enhance children's learning. Implications for practice and/or policy: Early exposure to AI can help children navigate the increasingly digital world.Practical approaches, such as embodied and multimodal learning, seem to be effective.Teachers can enhance children's digital learning by using pedagogical strategies like project‐based learning and real‐life examples. [ABSTRACT FROM AUTHOR]

To undertake a literature search and critical appraisal of best available evidence to answer the clinical question: Does the addition of clonidine (I) to standard treatment with an opioid (C) improve outcomes (O) in infants with Neonatal Abstinence Syndrome? A search of both comprehensive (MedLine and Embase) and pre-filtered databases (Dynamed, UpToDate and TRIP), utilising Boolean Operators to combine search terms appropriately. Three relevant studies were identified. One paper describing the outcomes of a randomised controlled trial by Agthe et al. (2009) most accurately answered the clinical question posed. This paper was critically appraised, and evidence applied to the clinical scenario. The use of clonidine as an adjunct to opioid in the management of infants with NAS reduces the total number of treatment days and dose of opioid required to control symptoms. However, there is a higher risk of rebound in symptoms post-cessation of opioid and clinicians need to account for this in their discharge planning. More large scale, multi-centre high-quality research is needed to clarify the role of clonidine in the treatment of NAS: as monotherapy versus adjunct, the optimal dose and longer-term impact on neurodevelopment. [ABSTRACT FROM AUTHOR]

Background & Aim: To assess consonant proficiency and velopharyngeal function in 10‐year‐old children born with unilateral cleft lip and palate (UCLP) within the Scandcleft project. Methods & Procedures: Three parallel group, randomized, clinical trials were undertaken as an international multicentre study by nine cleft teams in five countries. Three different surgical protocols for primary palate repair (Arm B–Lip and soft palate closure at 3–4 months, hard palate closure at 36 months, Arm C–Lip closure at 3–4 months, hard and soft palate closure at 12 months, and Arm D–Lip closure at 3–4 months combined with a single‐layer closure of the hard palate using a vomer flap, soft palate closure at 12 months) were tested against a common procedure (Arm A–Lip and soft palate closure at 3–4 months followed by hard palate closure at 12 months) in the total cohort of 431 children born with a non‐syndromic UCLP. Speech audio and video recordings of 399 children were available and perceptually analysed. Percentage of consonants correct (PCC) from a naming test, an overall rating of velopharyngeal competence (VPC) (VPC‐Rate), and a composite measure (VPC‐Sum) were reported. Outcomes & Results: The mean levels of consonant proficiency (PCC score) in the trial arms were 86–92% and between 58% and 83% of the children had VPC (VPC‐Sum). Only 50–73% of the participants had a consonant proficiency level with their peers. Girls performed better throughout. Long delay of the hard palate repair (Arm B) indicated lower PCC and simultaneous hard and soft palate closure higher (Arm C). However, the proportion of participants with primary VPC (not including velopharyngeal surgeries) was highest in Arm B (68%) and lowest in Arm C (47%). Conclusions & Implications: The speech outcome in terms of PCC and VPC was low across the trials. The different protocols had their pros and cons and there is no obvious evidence to recommend any of the protocols as superior. Aspects other than primary surgical method, such as time after velopharyngeal surgery, surgical experience, hearing level, language difficulties and speech therapy, need to be thoroughly reviewed for a better understanding of what has affected speech outcome at 10 years. WHAT THIS PAPER ADDS: What is already known on the subject: Speech outcomes at 10 years of age in children treated for UCLP are sparse and contradictory. Previous studies have examined speech outcomes and the relationship with surgical intervention in 5‐year‐olds. What this study adds to the existing knowledge: Speech outcomes based on standardized assessment in a large group of 10‐year‐old children born with UCLP and surgically treated according to different protocols are presented. While speech therapy had been provided, a large proportion of the children across treatment protocols still needed further speech therapy. What are the potential or actual clinical implications of this work?: Aspects other than surgery and speech function might add to the understanding of what affects speech outcome. Effective speech therapy should be available for children in addition to primary surgical repair of the cleft and secondary surgeries if needed. [ABSTRACT FROM AUTHOR]

Some media have suggested that many youths who have previously completed a gender transition are "detransitioning". Their experience is often framed around the idea of regrets but rare are the articles that provide a nuanced examination of their journey. This article presents the perspectives of youths who have detransitioned or discontinued a transition regarding their experiences and feelings on their journey from transition to detransition. Semi‐structured interviews were conducted with 20 youths between the age of 16 and 25 years who were recruited on social media and who transitioned and detransitioned or discontinued their transition. Data were analysed according to thematic analysis. Regrets and feelings of satisfaction can both coexist. The processes of transition and discontinuation or detransition appear to be non‐linear and participants do not necessarily return to a cisgender identity. Ambiguous loss theory is applied to frame youth experiences and feelings and to suggest way forward for intervention. Highlights: This paper examines the experiences and feelings of youth on their journey from transition to detransition.Their journey is experienced as non‐linear, and often comprised mixed feelings and experiences about transition and detransition steps.Ambiguous loss theory allows a nuanced understanding of feelings and experiences of their journey from transition to detransition. [ABSTRACT FROM AUTHOR]

Background: Co‐production is predicated on equal power‐sharing and responsibility in research partnerships. However, relatively few accounts exist that explore the subjective experience of how co‐researchers achieve such equality, from the perspectives of public contributors and researchers. Aim: This paper aims to provide a unique insight into the process of co‐production, by weaving personal reflections with principles to evaluate the impact arising from co‐produced knowledge. It is based upon participatory research that was initiated by a 'lay' person, on behalf of a community organization, seeking support for Somali families who are affected by autism. The paper explores the evolving partnerships that began with community theatre and qualitative research and leading to extensive dissemination and impact, all of which has been jointly owned and negotiated by the co‐researchers and community organizations. Discussion: Initially, this paper reflects on the process, drawing on principles defined for co‐production in health research and combining it with the co‐researcher's personal reflections of their experiences as insiders and outsiders, stepping in and out of each other's worlds. The value of reciprocity, flexibility and continuous reflection is illustrated. The latter part of the paper explores the impact of this co‐produced knowledge using a theoretical framework, to assess the specific impacts and its broader transformative potential. It demonstrates how (1) opportunities for all partners to be equitably involved to the maximum degree possible throughout the research process can affect social change and (2) co‐produced research can become a catalyst that is dynamic and complex, achieving multi‐layered impact. [ABSTRACT FROM AUTHOR]

Objective: To determine the effects on weight loss of three abbreviated behavioral weight loss interventions with and without coaching and mobile technology.Methods: A randomized controlled efficacy study of three 6-month weight loss treatments was conducted in 96 adults with obesity: 1) self-guided (SELF), 2) standard (STND), or 3) technology-supported (TECH). STND and TECH received eight in-person group treatment sessions. SELF and STND used paper diaries to self-monitor diet, activity, and weight; TECH used a smartphone application with social networking features and wireless accelerometer.Results: Weight loss was greater for TECH and STND than SELF at 6 months (-5.7 kg [95% confidence interval: -7.2 to -4.1] vs. -2.7 kg [95% confidence interval: -5.1 to -0.3], P < 0.05) but not 12 months. TECH and STND did not differ except that more STND (59%) than TECH (34%) achieved ≥ 5% weight loss at 6 months (P < 0.05). Self-monitoring adherence was greater in TECH than STND (P < 0.001), greater in both interventions than SELF (P < 0.001), and covaried with weight loss (r(84) = 0.36-0.51, P < 0.001).Conclusions: Abbreviated behavioral counseling can produce clinically meaningful weight loss regardless of whether self-monitoring is performed on paper or smartphone, but long-term superiority over standard of care self-guided treatment is challenging to maintain. [ABSTRACT FROM AUTHOR]

Background: Treatment fidelity refers to the degree to which an intervention is implemented as intended. Promoting treatment fidelity is important to achieve a valid comparison in intervention research. However, it is often underreported: few studies detail the use and development of fidelity measures. This study aims to promote the treatment fidelity of a modified version of the Derbyshire Language Scheme (M‐DLS), a manualised intervention for children with language difficulties, by exploring participants' opinions on training and intervention delivery. Results inform development of a checklist and scoring system to monitor and promote treatment fidelity in a comparison trial. Method: Ten student speech and language therapists (SLTs) and two research assistants (RAs) participated in the study. All received training on the M‐DLS, and 10 were video‐recorded completing role‐plays of an M‐DLS session in small groups. Feedback was gathered after training and role‐plays in focus groups and interviews. Feedback was interpreted using the constructs of the Theoretical Domains Framework (TDF). A treatment fidelity checklist was then developed using the feedback. The first author and two RAs rated role‐play videos using the checklist to trial it to inform amendments and to promote interrater reliability. Interrater agreement was calculated using Spearman's test of correlation. Results: Participants discussed the importance of having clear materials and time to practise sessions. They suggested amendments to the materials and training to promote treatment fidelity. The checklist and scoring system accounted for participants' suggestions, with amendments detailed in a log. Spearman's correlation results suggested agreement between the raters was strong. Conclusions: Results emphasise the importance of training quality, practice and reflective opportunities and clear materials to promote treatment fidelity. The construction of the checklist and scoring system was described in detail, informing the development of future checklists. After further trialling, the checklist can be used to ensure the M‐DLS is delivered with high treatment fidelity in the comparison trial. What this paper adds: What is already known on this subject: Treatment fidelity is an essential component of intervention effectiveness and efficacy studies, ensuring the intervention is delivered as intended. It is also an essential component of evidence-based clinical practice. However, few research studies report the treatment fidelity process or publish the checklists used, depriving clinicians of useful information for implementation. What this study adds: This study describes in detail the iterative process of treatment fidelity checklist development, engaging those implementing the intervention in development. This ensured clarity and interrater reliability of the checklist. Furthermore, a novel scoring system was developed so that accuracy of implementation can be easily compared across users and across practice attempts. What are the clinical implications of this work?: The importance of treatment fidelity when implementing effective and efficacious interventions cannot be overstated. The treatment fidelity checklist developed for research can be easily adopted to support accurate implementation in clinical practice through an audit process. [ABSTRACT FROM AUTHOR]

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

The COVID‐19 pandemic has caused disruptive changes across different life experiences essential to children's growth and development, including early childcare services and schools, thus threatening precious opportunities for children in early childhood to learn. The pandemic has also undermined the collaborative and alliance relationship between childcare services and families which has been widely considered an important aspect of modern services. This paper presents and discusses results from a mixed‐method exploratory study with early childcare services for children between 0 and 6 years in Italy in 2021, involving both teachers and parents, to understand experiences, educational practices put in place in childcare services, feelings, resources and risks perceived by families and teachers. [ABSTRACT FROM AUTHOR]

The life expectancy of persons with intellectual disability is increasing, and this is often occurring concurrently with the aging of their long‐term parental carers. Research in both Australia and around the world indicates that proactive post‐parental care planning is not widely implemented, and transitions primarily happen suddenly following a personal crisis for the primary caregiver. Little focus in Australia has been placed on identifying the barriers that inhibit post‐parental care planning in rural areas, specifically in the context of the newly implemented National Disability Insurance Scheme. This paper examines the factors that limit disability services and their staff in supporting successful post‐parental care planning for individuals with intellectual disability and their aging carers in rural South Australia. Small focus groups were conducted with three groups of rural disability support workers using online technologies to assist with the participants' geographic disparity. A semi‐structured interview guide was developed prior to commencement and was used to initiate discussions on key points. A thematic analysis methodological approach was used for data analysis. There were three themes identified through the analysis; Recruitment; Provision of Care; and Retention. The key findings relating to these themes are presented and supported with exemplar quotes. This research proposes three recommendations for policy or practice change: developing a national advertising campaign for new disability staff that positively emphasizes the high‐level skillset need for proactive planning; supporting rural disability providers to collaborate to establish shared teams of staff with expertise in post‐parental care planning; and, using incentive payments to retain staff with these invaluable skillsets in the disability sector. [ABSTRACT FROM AUTHOR]

Background: Several attitude scales have been developed to measure students' attitudes toward computer programming, including the prominent one developed by Cetin and Ozden. The development of these scales stemmed from the elusive nature of attitude and the lack of specific constructs to measure attitude. These instruments measure students' attitudes based on one‐dimensional perspective, thus, making it difficult to interpret the meaning of some attitude evaluations such as the meaning of neutral points in a 10‐point scale (for example). Objectives: The computer programming attitude scale was modified to measure ambivalence. The study also investigate attitude differences across demographic variables and used these variables to predict ambivalence. Methods: The study was conducted in two phases. In the first phase, the instrument was validated using exploratory factor analysis and confirmatory factor analysis. In the second phase, the revised scale was administered to another 547 students in four research universities for empirical investigation. Results: Results show that the instrument is valid and suitable for measuring students' programming attitudes. Participants' attitudes skewed toward the negative attitude dimension. Lastly, we found that both attitude and ambivalence are factors of programming experience. Conclusions: We discussed the findings, recommend the instrument to programming tutors, and strongly emphasise the evaluation of students' ambivalent attitudes. Lay Description: What is currently known: There are numerous scales developed to measure students' attitude toward computer programming, such as the computer programming attitude scale (CPAS).The development of these inventories stemmed from the elusive nature of attitude and the lack of specific construct to measure attitude.These instruments measure students' attitude based on one dimensional perspective, thus, making it difficult to interpret the meaning of some attitude evaluations such as the meaning of neutral points in a 10‐point scale (for example). What this paper adds: The present research brings a novel approach to instrument development by acknowledging the presence of attitude toward computer programming.This novel approach advances the knowledge of instrument development in the field of attitude measurement by introducing a paradigm shift from conventional attitude evaluation to a more diverse approach.The study has introduced new items to the existing CPAS, and subsequently, indicates the possibility of validating an attitude inventory using data obtained from ambivalence evaluation.By using this instrument, students' attitude is measured accurately rather than adopting the conventional measures that ignored the presence of negative and positive evaluations. Implication to practitioners: Through the findings of the study, computer science and programming educators would come to know that many positive and negative attitude elements are occasionally subsumed toward an attitude object, thereby leading to an ambivalence attitude.The instrument can be used by the practitioners to accurately measure students' positive and negative attitude toward programming across all levels of education.Using the instrument, practitioners can predict the identified attitude using wide range of variables such as gender, age, computational thinking skills, programming proficiency levels, among others. [ABSTRACT FROM AUTHOR]

Background: Formative assessments are vital for supporting learning and performance but are also considered to increase the workload of teachers. As self‐assessments in higher education are increasingly facilitated via digital learning environments allowing to offer direct feedback and tracking students' digital learning behaviour these constraints might be reduced. Yet, learning analytics do not make sufficient use of data on assessments. Aims: This exploratory case study uses learning analytics methods for investigating students' engagement with self‐assessments and how this relates to performance in the final exam and self‐reported self‐testing strategies. Materials & Methods: The research study has been conducted at a European university in a twelve‐weeks course of a Bachelor's program in Economic and Business Education including nenroll = 159 participants. During the semester, students were offered nine self‐assessments each including three to eight tasks plus one mid‐term and one exam‐preparation self‐assessment including all prior self‐assessments tasks. The self‐assessment interaction data for each student included: the results of the last self‐assessment attempt, the number of processed self‐assessment tasks, and the time spent on the last self‐assessment attempt, the total self‐assessment attempts, and the first as well as last access of each self‐assessment. Data analytics included unsupervised machine learning and process mining approaches. Results: Findings indicate that students use the self‐assessments predominantly before summative assessments. Two distinct clusters based on engagement with self‐assessments could be identified and engagement was positively related to performance in the final exam. The findings from learning analytics data were also indicated by students' self‐reported use of self‐testing strategies. Discussion: With the help of multiple data from self‐reports, formal exams, and a learning analytics system, the findings provided multiple perspectives on the use of self‐assessments and their relationships with course performance. These findings call for applying assessment analytics and related frameworks in learning analytics as well as providing learners with related adaptive feedback. Conclusion: Future research might investigate different (self‐report) variables for clustering, other student cohorts or self‐assessment forms. Lay Description: What is already known about this topic: Formative assessments are vital for supporting learning and performance.Learning analytics do not make sufficient use of data on assessments. What this paper adds: Students use the self‐assessments predominantly prior to summative assessments.Engagement with self‐assessments was positively related to performance in the final exam. Implications for practice and/or policy: Findings call for applying assessment analytics and implementing related learning analytics frameworks for supporting learning processes and performance.Pedagogically oriented assessment analytics may provide multiple benefits for learners, teachers, schools, and other involved stakeholders. [ABSTRACT FROM AUTHOR]

Open systems possess a dilemma whereby they both depend upon‐and are subject to disruptions arising from‐their exogenous environments. Organisations display this dilemma through the need to both manage the inbound flow of supply from upstream nodes and outputs towards downstream customers, whilst also managing issues arising from interactions with these other systems. At the centre of this dilemma sits individual agents, whether they be managers of organisations, business‐level functions or customer‐facing roles. This paper explores how individuals perceive and react towards disruptions and the wider, systemic implications of their actions. This article uses interviews with individuals based on a theoretical framework incorporating general systems theory (GST) and a series of decision theories (namely Protection Motivation Theory) to highlight the commonalities across various actions and strategies that individuals can undertake to address disruptions. [ABSTRACT FROM AUTHOR]

Background: The idea of computational thinking is underpinned by the belief that anyone can learn and use the underlying concepts of computer science to solve everyday problems. However, most studies on the topic have investigated the development of computational thinking through programming activities, which are cognitively demanding. There is a dearth of evidence on how computational thinking augments everyday problem solving when it is decontextualized from programming. Objectives: In this study, we examined how computational thinking, when untangled from the haze of programming, is demonstrated in everyday problem solving, and investigated the features of such solvable problems. Methods: Using a multiple case study approach, we tracked how seven university students used computational thinking to solve the everyday problem of a route planning task as part of an 8‐week‐long Python programming course. Results and Conclusions: Computational thinking practices are latent in everyday problems, and intentionally structuring everyday problems is valuable for discovering the applicability of computational thinking. Decomposition and abstraction are prominent computational thinking components used to simplify everyday problem solving. Implications: It is important to strike a balance between the correctness of algorithms and simplification of the process of everyday problem solving. Lay Description: What is already known about this topic: Computational thinking is a problem solving skill.Computational thinking is different from programming.There is dearth of evidence on how computational thinking augments everyday problem solving. What this paper adds: Computational thinking practices are latent in everyday problem solving.Intentional restructuring of problems is required to uncover how computational thinking applies in solving them. Implications for practices: Decomposition and abstraction are critical in solving everyday problems.Computational thinking should be taught explicitly through everyday problems.Finding balance between the correctness of algorithm and simplification of the problem solving process is important. [ABSTRACT FROM AUTHOR]

Introduction: During the COVID‐19 lockdown in 2020, teachers had to shift their teaching and assessment to online. Formative assessment (FA) can help teachers to engage, guide and monitor students' (online) learning. However, more knowledge is needed of how teachers could use the full FA process online. Methods: In this study data from 50 secondary school teachers, who taught different grade levels and subjects and joined a FA learning network that started before and continued during the lockdown, were collected. The study investigates how they used online FA practices differently than face‐to‐face FA, what challenges and opportunities they experienced in online FA and what lessons they learned and intended to keep. This mixed methods study used data from a questionnaire, interviews and webinars that were segmented, coded and analysed. Results: Results showed that many teachers implemented new FA strategies and adopted, more often than in their face‐to‐face practice, all the five phases of the FA process in an aligned matter in online FA. Teachers indicated opportunities in stimulating student engagement and guiding and monitoring student learning more at an individual level in the online FA process, but also experienced challenges, mainly in lack of interaction online. Discussion: The sudden and necessary shift to online FA, due to the COVID‐19 lockdown, challenged teachers to more fundamentally reconsider their assessment practices and assumptions. Teachers intended to make use of these learned lessons to improve their future (blended) FA practice. Lay Description: Known about the subject matter: Online formative assessment (FA) can help teachers to engage, guide and monitor online learning.Most earlier research of online FA looked at parts of the FA process or tools.Teachers' former knowledge and skills in FA influences the online implementation.Online FA offers opportunities to promote learning, but is also challenging. What their paper adds to this: Experienced teachers were able to implement complete FA processes online.Teachers experienced that online FA could stimulate student engagement.Teachers made more time for individual help and feedback during online FA.Teachers intended to maintain these lessons learned in their future (blended) FA practice. The implications of study findings for practitioners: Combining online FA activities with face‐to‐face activities creates opportunities for future blended FA.The five phases of the FA cycle help teachers to implement FA online or in blended forms. [ABSTRACT FROM AUTHOR]

Virtual reality is widely recognized as offering the potential for fully immersive environments. This paper introduces a framework that guides the creation and analysis of immersive environments that are pedagogically structured to support situated and experiential education. The "situated experiential education environment" framework described in this paper is used to examine the impact that a virtual environment can have on the user experience of participants in a virtual space. The analysis of a virtual environment implemented to support learner exploration of issues of tourism development and the related impacts, suggest that this type of experience is capable of providing participants with a holistic experience of real‐world environments that are otherwise too expensive, impractical, or unethical for large groups of people to visit in person. The pedagogical value of such experiences is enabled through immersion in a reality‐based environment, engagement with complex and ambiguous situations and information, and interaction with the space, other students, and teachers. The results demonstrate that complex immersive learning environments are readily achievable but that high levels of interactivity remain a challenge. Lay Description: What is already known about this topic: Virtual reality (VR) technology is developing rapidly with interest from practitioners and researchers increasing concurrently.Although VR headsets are extensively researched in a gaming context, there is insufficient research examining the user‐experience of VR headsets in the context of education.What this paper adds: Users reported a multitude of positive features of the VR headsets in the context of experiential learning that is situated in a meaningful context, such as a Pacific island when learning about sustainable development.In particular, a strong sense of immersion was reported by users of the VR headsets.Additionally, the complexity of the material studied, an important feature of situated experiential learning, was also reported to high.Implications for practice and/or policy: VR headsets provide significant opportunities to foster situated experiential learning in a virtual environmentParticularly the immersive experience and the complexity of the material studied were reported to be effective with the VR headsets. However, the interaction with other learners and teachers could not be examined in depth, although interaction is also an important feature of situated experiential learning [ABSTRACT FROM AUTHOR]

This paper provides guidance for researchers with some mathematical background on the conduct of time-to-event analysis in observational studies based on intensity (hazard) models. Discussions of basic concepts like time axis, event definition and censoring are given. Hazard models are introduced, with special emphasis on the Cox proportional hazards regression model. We provide check lists that may be useful both when fitting the model and assessing its goodness of fit and when interpreting the results. Special attention is paid to how to avoid problems with immortal time bias by introducing time-dependent covariates. We discuss prediction based on hazard models and difficulties when attempting to draw proper causal conclusions from such models. Finally, we present a series of examples where the methods and check lists are exemplified. Computational details and implementation using the freely available R software are documented in Supplementary Material. The paper was prepared as part of the STRATOS initiative. [ABSTRACT FROM AUTHOR]

Background: Although discourse‐level assessments contribute to predicting real‐world performance in persons with aphasia (PWA), the use of discourse measures is uncommon in clinical settings due to resource‐heavy procedures. Moreover, assessing function word use in discourse requires the arduous procedure of defining grammatical categories for each word in language transcripts. Aims: The purpose of this exploratory study was twofold: (1) to develop core function word lists as a clinician‐friendly means of evaluating function word use in discourse; and (2) to examine the ability of the core function word measure to differentiate PWA from cognitively healthy adults and persons with fluent aphasia from non‐fluent aphasia. Methods & Procedures: The 25 most commonly used function words (core function words) were extracted from narrative language samples from 470 cognitively healthy adults, which were divided into seven age groups (20s, 30s, 40s, 50s, 60s, 70s and 80s). The percent agreement of core function words for 11 PWA (fluent aphasia = 5; non‐fluent aphasia = 6) and 11 age‐ and education‐matched controls were then calculated. Percent agreement for the core function words produced was compared between the controls and the PWA group, and between participants with fluent aphasia and non‐fluent aphasia. Outcomes & Results: The results indicated that PWA produced fewer core function words from the lists than the control group, and that core function word use was strongly correlated with aphasia severity. Persons with non‐fluent aphasia produced fewer core function words than those with fluent aphasia, although this could be a confound of aphasia classification from the use of the Western Aphasia Battery (WAB)—Revised. Conclusions & Implications: Core function word lists consisting of a limited number of items for quantifying function word use in discourse remain in a nascent stage of development. However, the findings are consistent with previous studies analysing the total production of function words in language samples produced by PWA. Therefore, core function words may potentially serve as a clinician‐friendly manner of quantifying function words produced in discourse. What this paper addsWhat is already known on the subjectFunction word analysis in discourse requires arduous processes of identifying the error production and grammatical category of function words in discourse. Previous studies have demonstrated that core lexicon measures are an efficient, simple means of quantifying discourse in PWA. However, function words have never been considered for generating an independent core lexicon list.What this paper adds to existing knowledgeAs an exploratory study, we focused primarily on developing a clinician‐friendly measure to evaluate function word production in discourse, motivated by the idea of an adaptation strategy within the core lexicon framework. Our findings demonstrated that by using a simple scoring system that the core lexicon measure provides, we differentiated the control group from the PWA group, and persons with fluent aphasia from persons with non‐fluent aphasia. Additionally, we found significant correlations between function word production and aphasia severity determined by WAB Aphasia Quotient (AQ).What are the potential or actual clinical implications of this work?The results add empirical evidence for the utility of core function word lists for quantifying function word usage in discourse in PWA. Counting the presence and absence of function words in discourse will allow clinicians to avoid labour‐intensive preparatory work, and to obtain useful diagnostic information in a less time‐consuming way. [ABSTRACT FROM AUTHOR]

Background: Medical students use a variety of self‐regulated learning (SRL) strategies in different medical reasoning (MR) processes to solve patient cases of varying complexity. However, the interplay between SRL and MR processes is still unclear. Objectives: This study investigates how self‐regulated learning (SRL) and medical reasoning (MR) occurred concurrently in medical students while completing a diagnostic task in an intelligent tutoring system. This study aims to provide new insights into performance differences between high‐ and low‐achieving students in tasks of varying complexity. Methods: Thirty‐one medical students (67.6% female) from a large North American university were tasked with solving two virtual patient cases in an intelligent tutoring system, BioWorld. BioWorld was designed for medical students to practice clinical reasoning skills deliberately. We collected students' think‐aloud protocols, based on which we coded their use of SRL behaviours and medical reasoning activities. We analysed the co‐occurrences of SRL behaviours and medical reasoning activities using the epistemic network analysis (ENA) method. Results: The SRL behaviour self‐reflection and MR activity lines of reasoning co‐occurred more frequently in a difficult task than in an easy task. In both tasks, high performers demonstrated more co‐occurrences of self‐reflection and lines of reasoning than low performers. Moreover, the MR activity conceptual operations co‐occurred more frequently with the SRL activities of monitoring and evaluation among high performers compared to low performers in an easy task. Implications: The co‐occurrences of SRL behaviours and MR processes account for students' performance differences. The design of computer‐based learning environments for clinical reasoning should promote the acquisition of both SRL and medical reasoning abilities. Moreover, medical educators should consider task complexity when scaffolding. Lay Description: What is already known about this topic: Self‐regulated learning (SRL) and medical reasoning skills are both crucial for diagnosing patients.Medical students can practice clinical reasoning with computer simulations. What this paper adds: Students solved virtual patients of varying complexity in an intelligent tutoring systemWe examined the co‐occurrences of SRL behaviours and medical reasoning process.Epistemic network analysis was used to analyse the interplay of SRL and medical reasoning.High performers show more co‐occurrences of reflection and higher‐order reasoning. Implications for practice and/or policy: Task complexity has impact on students' learning and reasoning co‐occurrences.Intelligent tutoring systems should foster regulation and reasoning acquisition. [ABSTRACT FROM AUTHOR]