Effectiveness Of Interventions Research Articles

Feasibility and effectiveness of a foam rolling intervention in pregnant women requiring bed rest for foetal protection: a randomised controlled trial

BackgroundBed rest during pregnancy can lead to reduced physical activity, impairing lower limb venous blood flow and increasing the risk of deep vein thrombosis (DVT) and muscle atrophy. We investigated the clinical efficacy of foam rolling intervention (FRI) in enhancing lower limb venous blood flow, mitigating the risk of DVT and muscle atrophy in pregnant women on bed rest.MethodsThis single-blind, randomised controlled trial enrolled 86 pregnant women with long-term bed rest for foetal protection (≥ 7 days), gestational age ≥ 20 weeks, and maternal age < 40 years. Participants were randomly assigned to a control or experimental group using a random number table. The control group received standard care, whereas the experimental group underwent FRI. Researchers and statisticians were aware of the treatment groups, however, the participants were blinded. Lower limb blood flow velocity, D-dimer levels, incidence of DVT, and the extent of lower limb muscle atrophy were assessed in both groups at baseline and post-intervention (day 7). To account for a 5% attrition rate and potential sampling error, the estimated sample size for each experimental and control group was 40.ResultsBefore the intervention, no significant differences were observed between the experimental and control groups in peak blood flow, mean flow velocity, D-dimer values, or leg circumference (P > 0.05), however, the peak blood velocities of the popliteal veins were significantly higher in the control group (P = 0.031). On the seventh day post-intervention, the experimental group had significantly higher mean and peak blood velocities in femoral and popliteal veins, significantly (P < 0.05), lower mean D-dimer levels (P = 0.035), and a significantly smaller reduction in thigh and calf circumference (P < 0.001). Consequently, the rate of thigh muscle atrophy was significantly slower in the experimental group (P = 0.011).ConclusionsFRI is an effective intervention for improving lower limb venous blood flow, mitigating the risk of DVT and muscle atrophy in pregnant women on bed rest.Trial registrationThis trial was retrospectively registered with the Chinese Clinical Trial Registry on June 18, 2024 (registration number: ChiCTR2400085770).

Causes of moral distress among midwives: A scoping review.

Numerous studies have evidenced moral distress among midwives; however, to date no research synthesis on causes of moral distress among midwives has been conducted. A scoping review was carried out to identify, comprehensively map, and categorize possible causes of moral distress among midwives, and to identify knowledge gaps. Six data bases were searched using Boolean logic. To be included, studies had to (a) present empirical findings on (b) causes of moral distress (c) among midwives (d) in English, German, French, or Italian. We included a final set of 43 studies. The vast majority of studies came from high-income countries (83.7%) and used a qualitative approach (69.8%); 48.8% of the studies were published in the past 5years. Identified single reasons of moral distress were grouped into eight broader clusters, forming a coherent framework of reasons of moral distress: societal disregard, contemporary birth culture, resources, institutional characteristics, interprofessional relationships, interpersonal mistreatment of service users, defensive practice, and challenging care situations. These clusters mostly capture moral distress resulting from a conflict between external constraints and personal moral standards, with a smaller proportion also from an intraindividual conflict between multiple personal moral standards. Despite projected increases in demand for midwives, the midwifery workforce globally faces a crisis and is experiencing substantial strain. Moral distress further exacerbates the shortage of midwives, which negatively affects birth experiences and birth outcomes, ultimately rendering it a public health issue. Our findings offer points of leverage to better monitor and alleviate moral distress among midwives, contributing to reducing attrition rates and improving birth experiences and birth outcomes. Further research is essential to explore the issue of ecological moral distress, develop evidence-based interventions aimed at alleviating moral distress among midwives, and evaluate the effects of both individual and system-level interventions on midwives, intrapartum care, and service users' outcomes.

Keep on truckin’: how effective are health behaviour interventions on truck drivers’ health? A systematic review and meta-analysis

BackgroundTruck drivers are a vital workforce, but have higher rates of obesity and other chronic diseases than the general population. The occupation’s sedentary nature, limited physical activity opportunities and access to healthy food, and irregular sleeping patterns contribute to poor health. This systematic review and meta-analysis aimed to evaluate the effectiveness of interventions on health behaviours and cardiometabolic biomarkers of health in truck drivers.MethodsA systematic search was conducted in February 2024, and reported according to PRISMA 2020 guidelines. Experimental studies targeting physical activity, sedentary behaviour, sleep, diet, weight loss, drug/alcohol use, and/or smoking were eligible. Two reviewers independently screened and completed data extraction and risk of bias assessment. Data were combined at the study level. Pooled statistics were calculated using mean differences (MD) or standardised mean differences (SMD) for outcomes that were reported in ≥2 studies. Pre- and post-intervention means and standard deviations (SD) for the intervention and control groups were used to compute effect sizes.ResultsNineteen studies (n=2137 participants) were included. Meta-analyses found a small-to-moderate increase in fruit and vegetable consumption (SMD 0.32, p=0.03) with no other significant effects on other outcome variables.ConclusionsInterventions are moderately effective in increasing truck drivers’ fruit and vegetable consumption, but not other outcomes. There is a dearth of research in the driver population compared to other occupational groups. Future interventions should consider workplace and environmental factors to promote the health and wellbeing of truck drivers.Trial registrationThe study protocol was registered on PROSPERO (CRD42021283423).

Impact of the degree of synergy between patient and nurse perceptions on the clinical outcome of pressure injury prevention: a mixed-methods systematic review protocol

IntroductionPressure injuries are a common and significant concern in clinical practice, often serving as a vital quality indicator. While (clinical) practice guidelines have been established to offer recommendations for mitigating...

Hatha yoga reduces momentary stress but does not impact diurnal profiles of salivary cortisol and alpha-amylase: A randomized controlled trial

Does the practice of yoga impact stress? Various studies have suggested that yoga may reduce both self-reported stress and stress biomarkers, but the evidence for such claims remains inconclusive, especially for yoga styles with a focus on physical postures. In a randomized controlled trial with 98 participants, we therefore examined whether an eight-week Hatha yoga intervention (60 min, 3×/week or more) led to reduced levels of diurnal salivary cortisol (sCort), salivary alpha-amylase (sAA), and subjective momentary stress as compared to a waitlist control group. To ensure the concomitant assessment of self-report and biological measures in an ecologically valid setting, and to capture the diurnal profile of cortisol and alpha-amylase, we employed an ecological momentary assessment approach. Five times per day, participants reported their momentary stress levels on a visual analogue scale and collected saliva samples for the assessment of salivary biomarkers. The intervention led to a significant reduction of subjective momentary stress but there was no change in diurnal sCort or sAA levels. There are several potential explanations for these findings: The intervention may have helped participants to cope better with stress while leaving diurnal levels of stress biomarkers unaffected, or the change may at least not have been reflected in sCort and sAA. Alternatively, there may have been a self-report bias, insofar as a favorable disposition towards yoga may have led participants to report reductions in stress in order to indicate positive effects of the intervention. Our findings contribute to a better understanding of the effects of distinct yoga interventions, demonstrating their potential to serve as low-risk stress relief tools.

Inulin alleviates GenX-induced intestinal injury in mice by modulating the MAPK pathway, cell cycle, and cell adhesion proteins

GenX, a substitute for perfluorooctanoic acid, has demonstrated potential enterotoxicity. The enterotoxic effects of GenX and effective interventions need further investigation. In the present study, the mice were administered GenX (2 mg/kg/day) with or without inulin supplementation (5 g/kg/day) for 12 weeks. Histopathological assessments revealed that GenX induced colonic gland atrophy, inflammatory cell infiltration, a reduction in goblet cell numbers, and decreased mucus secretion. Furthermore, a significant decrease in the protein levels of ZO-1, occludin, and claudin-5 indicated compromised barrier integrity. Transcriptomic analysis identified 2645 DEGs, which were mapped to 39 significant pathways. The TGF-β, BMP6, and β-catenin proteins were upregulated in the intestinal mucosa following GenX exposure, indicating activation of the TGF-β pathway. Conversely, the protein expression of PAK3, CyclinD2, contactin1, and Jam2 decreased, indicating disruptions in cell cycle progression and cell adhesion. Inulin cotreatment ameliorated these GenX-induced alterations, partially through modulating the MAPK pathway, as evidenced by the upregulation of the cell cycle and cell adhesion proteins. Collectively, these findings suggested that GenX exposure triggered intestinal injury in mice by activating the TGF-β pathway and disrupting proteins crucial for the cell cycle and cell adhesion, whereas inulin supplementation mitigated this injury by modulating the MAPK pathway.

Effects of an 8-Week Active Play Intervention on Body Composition and Fundamental Motor Skills in Preschool Children

Effects of an 8-Week Active Play Intervention on Body Composition and Fundamental Motor Skills in Preschool Children

A Study on the Effects of Memory Training and Speech Processing Intervention on Children's Working Memory and Speech Skills: Based on the Perspective of Brain and Cognitive Science

The present study examined the effect of phonological processing and working memory intervention on the verbal working memory and phonological skills of children with Specific reading disorders. Ten participants between 7 to 10 years of age who met ICD 10 criteria for specific reading disorders, were assigned to an experimental group, or a control group. Intelligence screening was done using the Colored Progressive Matrices. Pre - test and post - test measures were the Test of Memory for Children (TOMC) and Informal Reading Assessment (IRA). The intervention group received 30 sessions of phonological processing intervention and working memory intervention. The control group received no intervention. Post - test assessments included TOMC and IRA. Participants who had received the intervention showed more improvement than controls. The majority of the participants in the experimental group performed higher post - intervention.

Effectiveness of spiritual and religious interventions in patients with cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis aimed to combine the physiological, psychological, and spiritual health effects of spiritual and religious interventions on cardiovascular disease patients. Studies from January 1999 to December 2022 were sourced from ScienceDirect, PubMed, Web of Science, Scopus, Cochrane CENTRAL, and cumulative index to nursing and allied health literature databases. This meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data were analyzed using Comprehensive Meta-Analysis Version 4. Heterogeneity was assessed using 95% confidence intervals (CIs), p values, and fixed or random-effects models. This systematic review included 15 studies with 2,047 participants, while the meta-analysis focused on 12 studies. Spiritual and religion-based interventions notably reduced participants' heart rate (g = -0.287, 95% CI = [-0.552, -0.021]), anxiety (g = -1.081, 95% CI [-1.364, -0.831]), and depression (g = -1.346, 95% CI [-1.965, -0.726]). Moreover, these interventions significantly enhanced spiritual well-being (g = 0.692, 95% CI [0.459, 0.926]) and hope levels (g = 1.152, 95% CI [0.347, 1.956]) compared to control groups. This meta-analysis flashes on utilizing spiritual and religion-based interventions for nurses, chaplains, psychologists, social workers, and other professionals who might lead patient care to enhance health outcomes for cardiac patients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Other-self similarity, motivation, emotion, and learning

BackgroundEffort investment is a critical component of learning and can be influenced by social comparisons, motivation, and emotion. AimsThe current research investigated to what extent social comparisons and multimedia type associate with learning performance, as well as motivation and emotion, while controlling for spatial ability. SamplesParticipants were 129 (Study 1) and 138 (Study 2) female undergraduate students. MethodsParticipants were randomly assigned to study groups that received different visual interventions and multimedia types. The visual interventions showing learning progress in terms of effort were the same for both studies. However, in Study 2, the visual interventions with social comparison information also included textual other-self similarity information. ResultsStudy 1 showed no significant main effects of the visual interventions or multimedia type on task performance. As expected, spatial ability was associated with task performance. Motivation declined over time in all study groups. While Study 2 also showed no significant main effects, spatial ability did not covary with task performance. Motivation and emotion increased over time in all study groups except for the control group. These findings suggest that other-self similarity information is associated with motivation and emotion, as well as learning outcomes independent of spatial ability. ConclusionsThe research offers unique empirical evidence of the influence of effort feedback when accompanied by other-self similarity information on motivational-affective consequences and cognitive performance.

INSIGHT responsive parenting intervention effects on child self-regulation at ages 3 and 6 years.

Self-regulation encompasses the ability to modulate behavior, cognition, and emotions. Parents can promote child self-regulation with responsive parenting (RP). RP shapes various components of self-regulation and is associated with numerous developmental outcomes. Here, we examine long-term effects of an early-life RP intervention designed for obesity prevention on later child self-regulation and temperament. Participants were from a randomized clinical trial comparing the RP intervention against a safety control (n = 279). RP intervention content in the domains of feeding, sleep, emotion regulation, and interactive play was delivered to primiparous mothers and infants at four home visits during the first year after birth, followed by clinical research center visits at ages 1 and 2 years and phone calls at 1.5 and 2.5 years. Child self-regulation and temperament were assessed with behavioral tasks and the Children's Behavior Questionnaire at child ages 3 and 6 years. A path model tested whether the RP intervention affected child self-regulation in comparison to the control group. At 6 years, children in the RP group had lower parent-reported negative affect (b = -0.34, SE = 0.15, p = .023) and better observed emotion regulation (b = 0.45, SE = 0.16, p = .007). Findings indicate that an RP intervention designed for early obesity prevention promoted emotional aspects of self-regulation in middle childhood, highlighting RP as a strategy for promoting healthy behavior across multiple domains. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effectiveness of a Novel Feeding Algorithm for Oral Feeding Transition of Infants Born Prematurely.

Feeding skill acquisition is commonly a limiting factor determining when an infant born prematurely can be discharged. This study aimed to determine if the addition of a novel feeding progression algorithm (combination of objective data from a suck measurement device and slow flow/low variability nipples) to current neonatal intensive care unit (NICU) standards could decrease feeding-related length of stay (primary outcome). We hypothesized that by timing the initiation of oral feedings to coincide with adequate sensory-motor skill development, feeding-related length of stay may be decreased. This was a prospective intervention study, with a historical control cohort, of infants born less than 30weeks' gestational age without comorbidities affecting feeding skill acquisition at a Regional Level III-S NICU at a women and infant's hospital in Louisiana. A novel feeding progression algorithm utilized objective assessment of sucking to determine progression in nipple flow rates with slow flow/low variability nipples (flow rates from 0 to 9 mL/min) for infants receiving intervention (n=18). Thirty-six controls who did not receive the feeding progression algorithm were identified via electronic medical record retrospective chart review. Eighteen completed the study. Compared to the control group, infants receiving feeding interventions had delayed sequencing initiation, extended time between initially off positive pressure ventilation and initiation of sequencing, and decreased feeding-related length of stay, with similar total length of stay. This study adds to existing research supporting the effectiveness of novel feeding progression algorithms and interventions to support the health and outcomes of infants born prematurely. Future research should focus on implementation studies for feeding progression algorithm integration into standard NICU care.

Adherence to long-term telemonitoring-supported physical activity in patients with chronic heart failure

Chronic heart failure (CHF) is one of the most common diseases with a prevalence of 1–2% in adults, disproportionately affecting the elderly. Despite consistent drug therapy, physical activity (PA) is an integral part of current guidelines. Yet adherence to regular PA and exercise interventions is poor and potential predictors and barriers to PA remain elusive. We examined the effects of a telemonitoring-based exercise intervention in 699 CHF patients in a prospective, randomized-controlled (1:1), multicenter trial. The study was registered in the German Clinical Trials Register under DRKS00019022 on 28.05.2020. For both, the exercise and control group, self-reported PA (MET*h/week) increased and sedentary behavior declined during the 12-month intervention period. In the exercise group, daily step count as analyzed via activity trackers remained stable (pre: 6459 [4016] steps/day, post: 6532 [3858] steps/day; p = 0.621). The average number of completed exercise instruction videos provided via an online application was 1.50 [1.44] videos/week at the beginning and gradually decreased to 1.00 [1.50] videos/week; p < 0.001). Multivariate regression model revealed that exercise-related PA (MET*h/week) and exercise capacity (Wmax) at baseline, CHF severity, atrial fibrillation and age predicted changes in self-reported exercise-related PA (R2 = 0.396). Furthermore, the BMI and the average number of completed videos per week at baseline were associated with the change in completed videos over the course of the study (R2 = 0.251). Our results show the influence of certain baseline characteristics as barriers and predictors of PA progression. Therefore, exercise programs should pay attention to patients’ individual conditions to set achievable goals, and eventually affect the adherence and sustainability of exercise-focused interventions.

Therapeutic communication using mirroring interventions in nursing education: A mixed methods study

PurposeTherapeutic communication between nurses and patients is a method of interaction occurring throughout the process of identifying and resolving the patient’s health problems. This study investigated the effects of interventions on nursing students’ therapeutic communication competency. MethodsThis mixed methods study used a sequential exploratory design involving four sessions of therapeutic communication interventions with 40 third-year nursing students in South Korea. A pre- and post-therapeutic communication competence survey was conducted, and the effect was confirmed through individual interviews. Paired t-tests assessed the difference in therapeutic communication competence, while qualitative data underwent content analysis. ResultsTherapeutic communication competence results improved from 79.30 to 89.58 points out of 100. Three themes were derived: “the process of properly recognizing myself,” “active learning to understand communication between myself and others,” and “successful steps toward practicing sincere nursing.” ConclusionsTherapeutic communication interventions involving mirroring interviews and shared experiences improves nursing students’ patient-centered communication skills. The findings provided evidence for strategies needed to improve therapeutic communication competency in clinical settings.

Impact of hospital pharmacy interventions on length of stay in hospitals: a protocol for a systematic review and meta-analysis

Background Length of stay (LOS) is an essential metric for hospital efficiency, patient outcomes and satisfaction. Studies indicate hospital pharmacy interventions positively affect LOS and other outcomes, yet results vary due to study differences. No systematic review or meta-analysis has been conducted on this topic; thus, the aim of this study is to systematically assess the effect of interventions on LOS. Methods This review will conduct a systematic search across MEDLINE, EMBASE, Cochrane Trials, Cochrane Reviews and the Cumulative Index to Nursing and Allied Health Literature to identify pertinent studies. An expert librarian will craft the search strategy, ensuring our review adheres to standard guidelines. We will use Covidence, a specialized systematic review management software, to optimize data management, the selection process and data extraction. A dedicated team of reviewers will independently evaluate titles and abstracts in duplicate, progressing to full-text examination of articles, to determine inclusion in our review and analysis. Data will be extracted by one reviewer, with independent data extraction by a second reviewer in a proportion of papers, and checking for consistency by a third. A template in Covidence will guide extraction of study, setting, participant, intervention and outcome characteristics and findings. The findings will be described narratively, and if possible given the methodological and statistical heterogeneity, meta-analysis will be undertaken. Discussion Considering the inconsistency of previous studies, this systematic review aims to clarify the potential impact of hospital pharmacy interventions on LOS. It will expand and reinforce existing knowledge, and provide detail about which intervention types have the most impact on LOS.

Exploring Biomarkers in Nonalcoholic Fatty Liver Disease Among Individuals With Type 2 Diabetes Mellitus.

Integrating biomarkers into a comprehensive strategy is crucial for precise patient management, especially considering the significant healthcare costs associated with diseases. Current studies emphasize the urgent need for a paradigm shift in conceptualizing nonalcoholic fatty liver disease (NAFLD), now renamed metabolic dysfunction-associated steatotic liver disease (MASLD). Biomarkers are emerging as indispensable tools for accurate diagnosis, risk stratification, and monitoring disease progression. This review classifies biomarkers into conventional and novel categories, such as lipids, insulin resistance, hepatic function, and cutting-edge imaging/omics, and evaluates their potential to transform the approach to MASLD among individuals with type 2 diabetes mellitus (T2D). It focuses on the critical role of biomarkers in early MASLD detection, enhancing predictive accuracy, and discerning responses to interventions (pharmacological or lifestyle modifications). Amid this discussion, the complexities of the relationship between T2D and MASLD are explored, considering factors like age, gender, genetics, ethnicity, and socioeconomic background. Biomarkers enhance the effectiveness of interventions and support global initiatives to reduce the burden of MASLD, thereby improving public health outcomes. This review recognizes the promising potential of biomarkers for diagnostic precision while candidly addressing the challenges in implementing these advancements in clinical practice. The transformative role of biomarkers emerges as a central theme, promising to reshape our understanding of disease trajectories, prognosis, and the customization of personalized therapeutic strategies for improved patient outcomes. From a future perspective, identifying early-stage biomarkers, understanding environmental impact through exposomes, and applying a multiomics approach may reveal additional insight into MASLD development.

To rule or not to rule? The policy process of the excise tax on sugar-sweetened beverages in Indonesia

PurposeThe rising incidence of non-communicable diseases and sugar-sweetened beverages (SSB) consumption in Indonesia is a concern to the central government. However, the excise tax policy proposal for SSBs, introduced by the Minister of Finance in a 2020 meeting with the Parliament, remains unapproved until 2023. This study analyzes the process and factors influencing stakeholders in managing the implementation of the excise tax policy on SSBs in Indonesia.Design/methodology/approachThis research is based on Kingdon’s Multiple Streams Theory (MST), focusing on the problem, policy and politics streams. It employs a qualitative design and combines a literature review and in-depth interviews in data collection. Interviews were conducted with policymakers, civil servants, senior representatives from nongovernmental health and consumer organizations, trade associations and academics in nutrition, health and taxation.FindingsWe identified that policy entrepreneurs have not succeeded in aligning the policy with the ideology of decision-makers and broader government goals. Therefore, the Parliament has not ratified the SSB excise tax policy until 2023. The effectiveness of interventions is expected to be the primary driver of policy adoption. Despite the complexity of this policy process, we conclude that implementing some reinforcing strategies may be necessary to facilitate policy change. In the Indonesian context, other actors who proactively manage potential criticism from multiple stakeholders are needed. The power of the Coordinating Ministry for Economic Affairs is expected to navigate political complexities and interests among stakeholders. Support for adopting the SSB excise tax policy will likely rise when framing policy alternatives aligns with decision-makers values, involves coordination between ministries, and has a broad public appeal.Originality/valueDespite the constitutional mandate to regulate levies through legislation, there is no research on policy processes in Indonesia, specifically regarding levies and taxes. Examining the Indonesian institutional context in which a policy process takes place may improve the understanding of the many components of MST under unique conditions, providing insights into the specific factors that drive policy change in certain cases.

Effectiveness of Reproductive Biology Educational Interventions in Reducing the Prevalence of Elective Caesarean Sections

Indonesia has the highest caesarean section rate globally, with a prevalence of 17.6% in 2018, rising to 22.50% among urban women by 2021, far exceeding the WHO recommendation of 10-15%. Although caesarean sections can be life-saving, they carry higher risks of complications for both mother and baby compared to normal delivery. This study aims to evaluate the impact of reproductive biology educational interventions on reducing elective caesarean sections at Aulia Pandeglang Regional Hospital in Banten in 2024. Utilizing a quasi-experimental design with a One Group Pre and Post Test approach, the research shows that such educational interventions significantly lower elective caesarean rates. Pre-test data revealed that 70% of cases were in the medium category, while post-test data showed a reduction to 43% in the low category. All respondents participated in both pre-test and post-test evaluations. The findings strongly support the effectiveness of reproductive biology education in decreasing elective caesarean sections, prompting Aulia Pandeglang Regional Hospital to continue its educational program for pregnant women to promote normal delivery.

Lactation-focused audio relaxation versus standard care for mothers of very preterm infants (the EXPRESS randomised clinical trial).

Mothers of very premature newborns often have low milk supply. Systematic review has shown increased milk quantity with relaxation interventions. We hypothesised that a self-directed audio relaxation and lactation-specific visualisation would increase milk quantity after a very premature birth. Unmasked, randomised, controlled trial, recruiting 132 participants in four United Kingdom neonatal units. Eligible women had given birth to one or two infants between 23+0 and 31+6 weeks of gestation. The intervention was a 12-min voice recording including breathing exercises, muscle relaxation and lactation-specific visualisation. Primary outcome was the highest 24-h breastmilk weight expressed on any of day 4, day 14 or day 21 after birth. Mean birth gestation was 27.8 weeks (SD 2.4), with 26% of participants giving birth under 26 weeks (34/132). Adjusted mean difference in primary outcome was 73.9 g (95% CI -61.7 to 209.5, p = 0.28). Spielberger State-Trait Anxiety Index adjusted mean difference was -1.9 (-8.2 to 4.3, p = 0.54). The majority of relaxation group participants felt the intervention was relaxing (32/42, 76%). There was no beneficial effect of this relaxation intervention on milk quantity. Mothers of very premature infants may value relaxation interventions but they are unlikely to have a large effect on milk quantity. This randomised trial did not show a beneficial effect of a self-directed audio relaxation and visualisation on mothers' own milk quantity expressed after very preterm birth. Mothers of very and extremely preterm infants may value relaxation interventions, but they are unlikely to have a large effect on milk quantity. Prior systematic review of mixed populations has shown an increase in mothers' own milk quantity with relaxation interventions. Combining this study with existing meta-analysis could result in a new hypothesis that the lower the gestation at birth, the smaller the impact of relaxation on milk quantity.

Effects of pedagogical intervention on Chinese EFL learners' use of motivational regulation strategies and oral English proficiency improvement

This study investigated the role of motivational regulation strategies (MRSs) in English as a foreign language (EFL) pedagogy, with a focus on Chinese university students. While prior research has explored MRSs, their specific impact on the oral proficiency of Chinese EFL learners remains under-examined. This mixed-methods research offers empirical insights, advocating for the integration of MRSs into EFL instruction to bolster students' oral proficiency. The study is bifurcated, with the first phase dedicated to cataloging MRSs' usage among Chinese university students and crafting the Speaking Strategies for Motivational Regulation Questionnaire (SSMRQ). This initial phase engaged 171 EFL students from a northern Chinese "211 project" university, employing convenience sampling. Factor analysis of participant responses culminated in a 15-item SSMRQ, spanning five dimensions: Environment Structuring (ES), Mastery Self-Talk (MST), Self-Consequating (SC), Self-Oriented Performance Self-Talk (SPST), and Externally-Oriented Performance Self-Talk (EPST). The second phase assessed the efficacy of MRSs-oriented instruction on student application of MRSs and oral English proficiency. This quasi-experimental study involved 22 consenting second-year English majors from the participating university. Data collection instruments encompassed the SSMRQ, oral English proficiency tasks, reflective journals, and semi-structured interviews. The instructional intervention spanned four weekly 30-min sessions, targeting the five MRSs' dimensions and offering feedback on oral performance. Assessments were conducted pre- and post-intervention using the SSMRQ, oral tasks, and reflective journals. Six participants, selected based on their oral English performance, were interviewed in-depth. Results suggest that the instructional intervention had a significant effect on the students' use of MRSs and their oral English proficiency. The study offers pedagogical insights into EFL speaking instruction in the higher education context, underscoring the importance of personalized teaching strategies tailored to individual learner needs. Collectively, this research introduces the SSMRQ and elucidates the pedagogical merits of MRSs-based instruction on oral English proficiency, establishing an empirical base for subsequent inquiry and pedagogical advancement in language education.