English is widely regarded as a global language, and it has become increasingly important for global communication. As a result, the demand for English language education has been on the rise. In China, a significant number of individuals are engaged in learning the English language. However, many English learners in China encounter challenges when it comes to developing their speaking skills. This study aims to investigate the factors influencing the speaking skills of English learners in China. Employing a mixed-methods approach, data were collected through a questionnaire from 455 college students from three different courses (arts, science & business, and commerce) in China. The study findings identified several factors impacting the speaking skills of English learners in China, including limited opportunities for speaking practice, fear of making mistakes, limited exposure to English-speaking environments, inadequate teacher training, and the influence of the Chinese language on English pronunciation. Additionally, the study highlighted that learners who have greater exposure to English-speaking environments and more opportunities for speaking practice tend to demonstrate better speaking skills. The novelty of this study lies in its valuable insights into the factors influencing the speaking skills of English learners in China. Based on the findings, it is recommended that English teachers receive enhanced training to effectively teach speaking skills, and learners should be provided with increased opportunities for speaking practice, such as participating in group discussions or engaging in speaking activities.

The study aims to identify the mechanisms underlying the findings that will to exist, live, survive and fight (WTELS-F) optimizes executive functions. Defining executive functions (EF) as having cold (working memory, inhibition, and cognitive flexibility) and hot (e.g., motivation) components, we hypothesized that WTELS-F affects executive functions positively via two pathways. The first pathway is through the hot executive function (motivation), and the second is via survival or existential processing. In a longitudinal study of 228 adult participants two times with ten weeks in between, we used measures for WTELS-F, working memory, inhibition, shift/cognitive flexibility, and self-motivation. We tested the structural validity of the four factors\' executive function by exploratory factor analysis in time 1 data and confirmatory factor analysis in time 2 data. We conducted structural equation modeling WTELS-F change as a latent variable predicted by the change in its three components between times 1 and 2., affecting changes in self-motivation (the hot EF), and changes in the latent variable of cold EF as predicted by changes in working memory, inhibition, and shift. Results indicated that the model of EF fit the data well without modification. WTELS-F significantly affected self-motivation (the hot EF) and the cold EF longitudinally. It had further mediated effects on cold EF via its impact on self-motivation. The results provided evidence for the two pathways hypothesis of the effects of WTELS-F on EF. The conceptual and clinical implications of these findings were discussed.

UNASSIGNED: Effective paediatric basic life support improves survival and outcomes. Current cardiopulmonary resuscitation (CPR) training involves 4-yearly courses plus annual updates. Skills degrade by 3-6 months. No method has been described to motivate frequent and persistent CPR practice. To achieve this, we explored the use of competition and a leaderboard, as a gamification technique, on a CPR training feedback device, to increase CPR usage and performance.
UNASSIGNED: To assess whether self-motivated CPR training with integrated CPR feedback improves quality of infant CPR over time, in comparison to no refresher CPR training.
UNASSIGNED: Randomised controlled trial (RCT) to assess the effect of self-motivated manikin-based learning on infant CPR skills over time.
UNASSIGNED: A UK tertiary children\'s hospital.
UNASSIGNED: 171 healthcare professionals randomly assigned to self-motivated CPR training (n=90) or no refresher CPR training (n=81) and followed for 26 weeks.
UNASSIGNED: The intervention comprised 24 h a day access to a CPR training feedback device and anonymous leaderboard. The CPR training feedback device calculated a compression score based on rate, depth, hand position and release and a ventilation score derived from rate and volume.
UNASSIGNED: The outcome measure was Infant CPR technical skill performance score as defined by the mean of the cardiac compressions and ventilations scores, provided by the CPR training feedback device software. The primary analysis considered change in score from baseline to 6 months.
UNASSIGNED: Overall, the control group showed little change in their scores (median 0, IQR -7.00-5.00) from baseline to 6 months, while the intervention group had a slight median increase of 0.50, IQR 0.00-33.50. The two groups were highly significantly different in their changes (p<0.001).
UNASSIGNED: A significant effect on CPR performance was demonstrated by access to self-motivated refresher CPR training, a competitive leaderboard and a CPR training feedback device.

UNASSIGNED: The aim of this study was to explore patients\' experience of patellofemoral pain (PFP), in order to help improve the mutual understanding between the patient and the physiotherapist and consequently enhance the efficacy of treatment.
UNASSIGNED: A qualitative study design with focus groups was used to explore patient experience prior to the implementation of the therapeutic exercise program, during its duration, and up to twelve months after its conclusion.
UNASSIGNED: Patients provided a detailed description of their lifestyle prior to the enrollment in the therapeutic exercise program, their experience of the therapeutic exercise program and the behavioral changes that remained after its conclusion. Three main themes emerged from our data: 1) PFP characteristics and the impact of PFP on daily life; 2) experience with the therapeutic exercise program; and 3) changes in PFP and daily behaviors following the therapeutic exercise program.
UNASSIGNED: Our findings suggest that a targeted therapeutic exercise program effectively reduces short- and long-term PFP and enhance overall well-being. Further research is needed to investigate the effects of different therapeutic exercise programs with a focus on the role of self-motivation.