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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]

BACKGROUND: The recent growth of the aviation industry, which poses significant environmental challenges, has heightened the pressure on the sustainability of airports. Airport sustainability requires a holistic approach that encompasses economic, social, environmental, and operational aspects. In this regard, the United Nations' 17 Sustainable Development Goals (SDGs) Agenda provides a roadmap for the aviation industry. However, despite recognizing the importance of SDGs, aviation authorities and airports often fail to effectively integrate them into their activities and annual reports. OBJECTIVE: This study aims to evaluate the significance of SDGs for airports and select the airport that prioritizes SDGs the most using Multi-Criteria Decision Making (MCDM) methodologies. METHODS: This study introduces a novel approach that integrates Step-wise Weight Assessment Ratio Analysis (SWARA) and Weighted Aggregated Sum Product Assessment (WASPAS) methods, which are MCDM techniques, to enhance airport sustainability. The SWARA method is employed to evaluate and assign weights to the SDGs in the context of airports. RESULTS: SDG 8 holds the highest level of significance among the goals concerning airports, while SDG 14 falls outside the scope of airport sustainability aspects. Then, five international airports that have been designated as green airports by aviation authorities and assessment organizations are selected, and the optimal alternative is determined using the WASPAS method, considering the weights obtained through SWARA. CONCLUSION: Dallas/Fort Worth International Airport is the top choice due to its successful implementations and reports aligning with the SDGs. [ABSTRACT FROM AUTHOR]

Purpose: Over the last two decades, reablement programs have been studied and implemented internationally. Goal-setting and multidisciplinary collaboration are central elements of reablement. Unfortunately, limited intervention descriptions leave questions on how they are applied in practice and how goals set by the user are achieved. As a consequence, healthcare providers and organizations often lack knowledge to implement and align reablement to their national and local context. This study aimed to collect data on goal-setting and achievement, and multidisciplinary collaboration within reablement services to provide insight into how these processes inform reablement practice as well as to explore the experiences of healthcare professionals in Norway, New Zealand, and the Netherlands. Material and Methods: A qualitative exploratory design was used comprising three focus group interviews with 20 healthcare professionals (nursing and allied health) involved in reablement programs from the three countries. Purposive sampling was employed considering a mix of gender, age and educational level. Results: Findings reflected healthcare professionals' experiences and reablement processes in three main themes: (1) Goal-setting processes; clearly demonstrating goal-setting as an essential part of reablement and contributing to better understanding of users' motives; (2) Impact of goal-setting on multidisciplinary collaboration; promoting a sense of community, learning climate, job satisfaction and task-shifting; and (3) Behavior change techniques used to reach users' goals, promoting self-reflection and changing users' perspectives. Conclusion: This study offers valuable insights from three countries. Goal-setting serves a crucial role enabling effective reablement implementation across diverse contexts. More specifically, to facilitate tailoring of reablement programs to the user's needs as well as establish more effective multidisciplinary collaboration by promoting trust, shared vision, and utilizing each other's expertise. However, despite the acknowledgement of the significance of reablement, it was reported by all that a cultural shift is necessary for users, informal caregivers as well as healthcare professionals. [ABSTRACT FROM AUTHOR]

Objective: To describe the development of a goal-directed movement intervention in two medical wards, including recommendations for implementation and evaluation. Design: Implementation Research. Setting: Pulmonology and nephrology/gastroenterology wards of the University Medical Centre Utrecht, The Netherlands. Participants: Seven focus groups were executed including 28 nurses, 7 physical therapists and 15 medical specialists. Patients' perceptions were repeatedly assessed during the iterative steps of the intervention development. Intervention: Interventions were targeted to each ward's specific character, following an Intervention Mapping approach using literature and research meetings. Main measures: Intervention components were linked to Behavior Change Techniques and implementation strategies will be selected using the Expert Recommendation Implementing Change tool. Evaluation outcomes like number of patients using the movement intervention will be measured, based on the taxonomy of Proctor. Results: The developed intervention consists of: insight in patients movement behavior (monitoring & feedback), goal setting (goals & planning) and adjustments to the environment (associations & antecedents). The following implementation strategies are recommended: to conduct educational meetings, prepare & identify champions and audit & provide feedback. To measure service and client outcomes, the mean level of physical activity per ward can be evaluated and the Net Promoter Score can be used. Conclusion(s): This study shows the development of a goal-directed movement intervention aligned with the needs of healthcare professionals. This resulted in an intervention consisting of feedback & monitoring of movement behavior, goal setting and adjustments in the environment. Using a step-by-step iterative implementation model to guide development and implementation is recommended. [ABSTRACT FROM AUTHOR]

Background: At the COP21, cities were recognised as key actors in combatting climate change. In supporting cities, climate city networks such as transnational climate networks (TCNs) and national climate networks (NCNs) have emerged to enable cities in building capacities and formulating climate policy whilst also encouraging citizen engagement and participation in public decision-making. This paper addresses the question whether and how TCN or NCN membership enables municipalities to implement citizen participation in public decision-making. Six propositions are presented addressing: presumed influence of TCN membership on citizen participation, organization of citizen participation, initiator capacity, goal setting, involvement of stakeholders, participatory methods used, and planning processes. A multi-case study research design is used to verify these propositions, comprising of four medium-sized cities in the Netherlands and three in Belgium. Results: Results of the analysis of four cities in The Netherlands show that municipalities having membership to climate city networks only to a low extent empower citizen participation via local climate agendas. Citizen participation emerges rather bottom-up via local initiatives or capacity building via EU framework programs—outside TCNs or NCNs—that better suit financial needs and provide more immediate benefits to municipalities. None of the six propositions were confirmed. A more positive image resulted from the Belgian cases that moderately confirmed four out of six propositions (i.e., organizing citizen participation, goal setting, selection of methods, and planning), and featured indirect empowerment via externally funded implementation projects following firm integration of participation in local climate policy through TCN influence. Conclusions: In terms of citizen participation selected municipalities in the Netherlands having TCN and/or NCN membership only to a small extent differ from those not having membership. This is partly due to poor implementation of TCNs and NCNs—with Covenant of Mayors and 'Klimaatverbond' lacking support structure and capacity—having lost importance during the past years. However, there is reason to believe that context makes a difference as revealed by the cases from Belgium, which revealed more positive results. [ABSTRACT FROM AUTHOR]

As research has become part of chaplaincy, many chaplains become involved in research, often in the double-role of chaplain-researcher. Despite the increase of involvement in research, how conducting research benefits chaplains' professional care for clients has not been studied. The present study aimed to describe how chaplains perceive the impact of participation in the Dutch Case Studies Project (CSP) on their professional expertise and positioning in the institution. A survey was distributed among participants of the CSP (N = 50) and was completed by 48 participants. We found that participation in research contributed to the expertise of chaplains (e.g., its goal-orientation, the use of theory and method) and their positioning as they try to legitimate their profession. This study thus substantiates the presumption that chaplains' engaging in research as chaplain-researcher contributes to the perceived improvement of the quality of chaplaincy care and its legitimation. [ABSTRACT FROM AUTHOR]

The author shares his view on older people's goals of care and person-centredness. He points out the inconsistent treatment of dementia and agrees with the treatment of iron deficiency anaemia in older people with intravenous iron supplementation. He raises the concern about the effects of antithrombotic treatment on frail older people undergoing rehabilitation.