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Background: Research on cognitive effects of educational games in general shows promising results. However, there are large variations in learning outcomes between individual educational games. Research on the design process and different design elements of educational games has led to some interesting directions, but some design aspects remain unclear. Objectives: We examined how an educational game designed on the basis of intrinsic integration theory, based on a strong alignment between game and learning goals, supports the learning of Newtonian mechanics. Methods: This study applied a mixed‐methods approach (N = 223). A pre‐ and post‐test design was used to examine possible learning and transfer effects fostered by playing the educational game, Newton's Race. To examine how players played the game, log data for each player were digitally recorded during gameplay. Results and Conclusions: Our findings demonstrated a significant positive learning effect of Newton's Race (p = 0.003, d = 0.201). This can be explained through the acquired log data. Log data show that players' gameplay mostly matched expected learning during the game, with physically correct game settings occurring more and more as gameplay progressed. The ability to transfer learned knowledge to other situations was shown to be limited to situations closely resembling the game environment. Implications: Similarly, designed intrinsically integrated games on different (physics) subjects could also foster learning in a relative short time. To foster transfer to other situations we propose embedding the game within other instructional activities. Lay Description: What is already known about this topic?: Research on cognitive effects of educational games in general shows promising results.There are large variations in learning outcomes between individual educational games.Some design aspects remain unclear on the design process and different design elements of educational games.Attempting to integrate learning with gameplay, without affecting the enjoyability of the game, is not easily achieved. What this paper adds?: The current study fits within the research body that emphasizes the importance of aligning gameplay with learning in educational games (i.e., intrinsic integration).Evidence for intrinsic integration as a key element in the design process, found by examining players' log data.A better understanding of how an intrinsically integrated game supports the learning of Newtonian mechanics. Implications for practice and/or policy: Similarly, designed intrinsically integrated games on different (physics) subjects could also foster learning in a relative short time.To foster transfer to other situations we propose embedding the game within other instructional activities. [ABSTRACT FROM AUTHOR]

Background Literature relating older people's goals of care to their varying frailty status is scarce. Objective To investigate goals of care in case of acute and/or severe disease in relationship to frailty status among the general older population. Method Older people aged ≥70 in the Netherlands completed a questionnaire. They were divided into three subgroups based on a self-reported Clinical Frailty Scale: fit (CFS 1–3), mildly frail (CFS 4–5) and severely frail (CFS 6–8). Seven goals were graded as unimportant (1–5), somewhat important (6–7) or very important (8–10): extending life, preserving quality of life (QoL), staying independent, relieving symptoms, supporting others, preventing hospital admission and preventing nursing home admission. Results Of the 1,278 participants (median age 76 years, 63% female), 57% was fit, 32% mildly frail and 12% severely frail. Overall, participants most frequently considered preventing nursing home admission as very important (87%), followed by staying independent (84%) and preserving QoL (83%), and least frequently considered extending life as very important (31%). All frailty subgroups reported similar preferences out of the surveyed goals as the overall study population. However, participants with a higher frailty status attached slightly less importance to each individual goal compared with fit participants (P trend-values ≤ 0.037). Conclusion Preferred goals of care are not related to frailty status, while the importance ascribed to individual goals is slightly lower with higher frailty status. Future research should prioritise outcomes related to the shared goals of fit, mildly frail and severely frail older people to improve personalised medicine for older patients. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the use of Complete Vocal Technique (CVT) voice therapy in acquired brain injury (ABI) patients Study: This study is an exploratory retrospective study. Method: Five ABI patients (two female and three male) with an average age of 20.6 years (SD = 3.5) received CVT voice therapy from an authorized CVT teacher at a neurorehabilitation facility in conjunction with physical rehabilitation therapy and speech and language therapy. Pre- and postmeasures included Voice Handicap Index, Maximum Phonation Time, electroglottography, and acoustic measures. Results: All voice measures improved for all five patients after receiving CVT voice therapy. Voice Handicap Index scores decreased from an average of 48.4 to 22.8. Maximum Phonation Time improved while the electroglottography and acoustic data showed improved phonation stability in jitter and shimmer measures. Overall, following the intervention, patients demonstrated improved loudness range, improved range in contact quotient for different sound conditions, faster-paced speech, extended functional pitch range, and decrease in unwanted creaking and breathiness. Conclusions: The findings suggest that CVT may be used as therapy in ABI populations with promising results. Both patient self-assessment and objective voice measures demonstrate improved voice function. Given the longitudinal nature of recovery in ABI patients, more studies are needed to qualify at which stage(s) of recovery the CVT interventions are most effective and beneficial. Randomized controlled trials for specific patient populations of ABI are needed to assess the interventions' effectiveness in specific ABI diagnoses. [ABSTRACT FROM AUTHOR]

Introduction: In 24/7 disability care facilities, patient‐reported experience measures (PREMs) are important to help healthcare professionals understand what matters to care users and to improve the quality of care. However, the successful implementation of a PREM is complex. In a Dutch disability care organization, stakeholders cocreated tailored implementation strategies aimed at improving the use and integration of a qualitative PREM. This study gives insights into the uptake and experiences with these cocreated implementation strategies and the perceived impact of the set of strategies. Methods: We performed a prospective process evaluation between February 2020 and February 2021. We collected data in three disability care facilities from 35 care users, 11 professionals, 3 facility managers and 4 organization representatives. Data collection included observations during kick‐offs and learning goal meetings and several attendance checklists. We collected 133 questionnaires (Time 0 and Time 1). We conducted 35 individual semistructured interviews and an online focus group interview. Quantitative data were analysed using descriptive statistics and qualitative data using directed content analysis. Results: The exposure to and adoption of strategies was between 76% and 100%. Participants were positive about tailoring the strategies to each facility. Implementation was hindered by challenges in care users' communication and COVID‐19. The perceived impact referred to an improved understanding of the goal and added value of the PREM and better preparation and execution of the PREM. The impact of the set of strategies was mainly experienced on the micro level. Conclusion: The uptake of the cocreated implementation strategies was acceptable. The participants valued the tailored approach, which enabled them to focus on facility‐specific learning goals. Stakeholder engagement and co‐created strategies may have strengthened the adoption of and experiences with the implementation. Patient or Public Contribution: In this article, we present the process evaluation of implementation strategies for the integrated use of a PREM in disability care. A development group consisting of communication vulnerable care users, trainers and professionals developed the implementation strategies. The disability care organization was responsible for the planning and organization of the implementation process. During the process evaluation the end users, trainers, professionals and managers tailored the implementation strategies to their own settings and needs. Researchers observed this implementation process and interviewed the stakeholders about their experiences and the perceived impact. [ABSTRACT FROM AUTHOR]

Summary: Recovery from stress is essential for employees' well-being, even more so in jobs where high stress is inevitable. The purpose of this study was to examine the influence of achievement goal orientation on recovery from stress (i.e. need for recovery and vigour) over several years. We followed a sample of social workers in the Netherlands (N = 238) across four years, with three measurement points (T1–T3). Data were analysed with latent growth curve modelling. Findings: Results showed that need for recovery and vigour were fairly stable over time and therefore we could not examine the effects of achievement goal orientation on change in vigour and need for recovery over time. However, level of mastery goal orientation (mastery-approach and mastery-avoidance goal orientation) at T1 was positively related to the initial level of vigour at T1, even after controlling for job autonomy and workload. Our results indicate that mastery goal orientation is relevant for employees to feel energetic and vital in a job with high stress. Practical implications: Our results showed that organizations can prevent depletion among social workers by ensuring an acceptable workload, while vigour can be enhanced by selecting employees with high mastery goal orientation. Organizations can also contribute to the vitality of social workers by stimulating and fostering mastery goal orientation. [ABSTRACT FROM AUTHOR]