Digital devices such as iPads are prevalent in children\'s play from an early age. How this shapes young children\'s play is an area of considerable debate without any clear consensus on how different forms of play are brought into the iPad interaction. In this study, we examined 98 play activities of children in two preschool settings, featuring 2 and 4-5-year-olds, their play with iPads and non-digital artefacts. Three analytical approaches were used: an index built on a digital play framework [Bird, Jo, and Susan Edwards. 2015. \"Children Learning to Use Technologies Through Play: A Digital Play Framework.\" British Journal of Educational Technology 46 (6): 1149-1160. doi:10.1111/bjet.12191 ], a quantitative description of the index, and a qualitative interaction analysis of children\'s play. Results show how play with iPads is characterised as less ludic than play with other artefacts, and diverges from the age-typical norms of play. We discuss what these results might mean for children\'s play in contemporary early childhood settings and for children\'s learning.

This study aims to examine the play between various archwires and bracket systems, exploring potential variations in angle values for specific torque and torque values for a given angle along different bracket systems. Therefore, seven brackets systems were evaluated in conjunction with different stainless steel archwires of varying dimensions (0.016″ × 0.022″, 0.018″ × 0.025″, and 0.019″ × 0.025″). Biomechanical behavior during torque development and transmission was assessed using a six-component force/torque sensor. Torque angles (5-45°) were specified with subsequent torque measurement, and the sequence was reversed by setting the torque (5-30 Nmm) and measuring the angle. A reference measurement with 0 Nmm torque served to evaluate bracket slot play. Bracket play (0 Nmm) during palatal load ranged between 20.06° and 32.50° for 0.016″ × 0.022″ wire, 12.83° and 21.11° for 0.018″ × 0.025″ wire, and 8.39° and 18.73° for 0.019″ × 0.025″ wire. The BioQuick® bracket exhibited the highest play, while Wave SL® and Damon® Q brackets demonstrated the lowest play (p < 0.001). Significant differences (p < 0.001) between the brackets were observed in the torque angles required to achieve torques of 5-20 Nmm. In summary, each bracket system has a different torque transmission, which is of great clinical importance in order to achieve correct torque transmission and avoid complications such as root resorption.

Parental language input influences child language outcomes but may vary based on certain characteristics. This research examined how parental language differs during two contexts for toddlers at varying likelihood of autism based on their developmental skills. Parental language (quantity, quality, and pragmatic functions) was analyzed during dyadic play and mealtime interactions as a secondary data analysis of observational data from a study of toddlers at elevated and lower likelihood of autism. Child developmental skills and sensory processing were also assessed. Parents used more words per minute, directives, and verbs during play and more adjectives, descriptions, and questions during mealtime. Parental language differed based on child fine motor skills, receptive language, and levels of sensory hyporesponsiveness but not autism likelihood. Overall, this study found that parental language varies based on context and child developmental skills. Future research examining parental language should include pragmatic functions and context across developmental trajectories.

Although play has existed in paediatric hospitals for decades, a shared understanding of why and how healthcare professionals use play in clinical practice is lacking. This study aims to reach consensus on a common set of principles and competencies for play interventions and practices in hospitals. We conducted a three-round Delphi study that included healthcare professionals selected by hospital management. The first round comprised open-ended questions on the use of play in clinical practice. Principles and competencies, including learning objectives, were established using content analysis through an iterative process. Participants rated the importance of each principle and learning objective in the second and third rounds. Among the 66 participants, 45 (68%) responded in round 1 and 41 (62%) in rounds 2 and 3. The participants represented ten countries and nine different health professions. After the three rounds, we identified 33 principles and six overall competencies: building trusting relationships; delivering information and increasing understanding; promoting cooperation and participation; reducing procedure-related anxiety and pain; supporting coping and development; and ensuring a professional approach to play, which comprised 20 learning objectives.  Conclusion: According to healthcare professionals, play in clinical practice can be used to communicate and build relationships with paediatric patients and thus potentially help provide patient-centred care. Our findings may help guide and prioritize future research initiatives and operationalize play interventions and practices in hospitals. What is Known: • Evidence suggests that using play in clinical practice can help paediatric patients during hospitals stays. • Despite the evidence supporting the use of play, a shared understanding of why and how paediatric healthcare professionals use play is needed. What is New: • This international Delphi study contributes to a shared interprofessional understanding of the principles, competencies and learning objectives for the use of play in clinical practice. • The findings have the potential to aid initiatives in developing training programmes for healthcare professionals in using play to provide care with a patient-centred approach.

BACKGROUND: Adolescents with disabilities experience alarmingly higher rates of depression and isolation than peers without disabilities. There is a need to identify interventions that can improve mental health and isolation among this underserved population. Innovations in virtual reality (VR) gaming \"standalone\" headsets allow greater access to immersive high-quality digital experiences, due to their relatively low cost.
OBJECTIVE: This study had three purposes, which were to (1) examine the preliminary effects of a low-cost, home-based VR multiplayer recreation and socialization on depression, socialization, and loneliness; (2) quantify the acceptability of the program as measured by participant adherence, total play time, and exercise time; and (3) identify and describe behavioral mechanisms that affected participant engagement.
METHODS: This was a single-group, pre- to postdesign trial. The intervention was conducted at home. Participants were recruited from a children\'s hospital. The intervention lasted 4 weeks and included 2×1-hour sessions per week of supervised peer-to-peer gaming. Participants used the Meta Quest 2 headset to meet peers and 2 coaches in a private party held digitally. Aim 1 was evaluated with the Children\'s Depression Inventory 2 Short Form and the University of California, Los Angeles Loneliness Scale 20 items, which are measures of social isolation and loneliness, respectively. Aim 2 was evaluated through the following metrics: participant adherence, the types of games played, friendship building and playtime, and program satisfaction and enjoyment.
RESULTS: In total, 12 people enrolled (mean age 16.6, SD 1.8 years; male: n=9 and female: n=3), and 8 people completed the program. Mean attendance for the 8 participants was 77% (49 sessions of 64 total possible sessions; mean 6, SD 2 sessions). A trend was observed for improved Children\'s Depression Inventory 2 Short Form scores (mean preintervention score 7.25, SD 4.2; mean postintervention score 5.38, SD 4.1; P=.06; effect size=0.45, 95% CI -0.15 to 3.9), but this was not statistically significant; no difference was observed for University of California, Los Angeles Loneliness Scale 20 items scores. Most participants (7/8, 88%) stated that they became friends with a peer in class; 50% (4/8) reported that they played with other people. Participants reported high levels of enjoyment and satisfaction with how the program was implemented. Qualitative analysis resulted in 4 qualitative themes that explained behavioral mechanisms that determined engagement in the program.
CONCLUSIONS: The study findings demonstrated that a brief VR group program could be valuable for potentially improving mental health among adolescents with physical disabilities. Participants built friendships with peers and other players on the web, using low-cost consumer equipment that provided easy access and strong scale-up potential. Study findings identified factors that can be addressed to enhance the program within a larger clinical trial.
BACKGROUND: ClinicalTrials.gov NCT05259462; https://clinicaltrials.gov/study/NCT05259462.
UNASSIGNED: RR2-10.2196/42651.

UNASSIGNED: Nature has been found to improve and promote health and prevent disease. Nature-based rehabilitation (NBR) delivered as part of neurorehabilitation is a developing approach. Yet to date the research is sparse. Following an acquired brain injury (ABI), people often experience impairments that cause limitations in activity and participation in daily life, which can impact the quality of life long-term. NBR delivered in neurorehabilitation has previously been explored from the perspective of occupational therapists and physiotherapists, however, to date patients\' experiences are yet to be explored. This study aims to explore patients\' experiences and perspectives of NBR delivered as part of standard neurorehabilitation.
UNASSIGNED: This qualitative study had a constructivist and phenomenological design. Semi-structured focus group interviews were carried out across three healthcare settings in Denmark with 17 participants. Data was analysed using content analysis.
UNASSIGNED: The analysis generated three categories: 1. Outdoor versus indoor environment, 2. The natural environment as a co-therapist, and 3. Interrelatedness.
UNASSIGNED: The study provides insight into participants\' experiences of NBR. They reported that interacting with the natural environment as part of neurorehabilitation enhanced activity. Moreover, being in nature increased their self-efficacy, sense of autonomy, community spirit, cooperation, and joy, and led to a feeling of peace.
Nature-based rehabilitation (NBR) delivered as part of neurorehabilitation provides an alternative to indoor rehabilitation.The natural environment offers multisensory stimulation, sensory-motor training, and opportunities for mental restoration.NBR promotes social engagement, cooperation, and feelings of being in the same boat and may increase autonomy, self-efficacy, activity, and participation.NBR can be designed and delivered in a way where the natural environment and the intervention promote individual and group rehabilitation.The benefits of NBR in neurorehabilitation for patients appear to be an underexposed topic, and the intervention may provide an opportunity for improving rehabilitation for patients with acquired brain injury.

UNASSIGNED: This study examines the training (age at club entry, hours in club practice, free play, other sports) and environmental characteristics (popularity, media coverage, school and parental support) influencing the development of female Swiss national team players in elite football over a three-decade period.
UNASSIGNED: A retrospective questionnaire was completed by 84 participants, who were divided into three cohorts based on their first game with the Swiss national team (C1 = until 2000, n = 24; C2 = 2001-2010, n = 29; C3 = 2011-2022, n = 31). ANOVAs were employed to compare the cohorts regarding training and environmental variables.
UNASSIGNED: The findings demonstrate better perceived environmental conditions, stagnating volume of free play and other sports in childhood, decreasing age at club entry, and increasing club practice and total training volume across cohorts.
UNASSIGNED: Practical implications highlight talent development avenues in unstructured settings during free time and in the micro-structure of club practice.

This study aimed to improve hand performance and play behavior in children with developmental disabilities (DD) using a remodeled glove puppetry approach. Overall, 62 children with DD were randomly assigned to experimental and control groups (n = 31 each). The experimental group underwent a 12-week rehabilitation program by playing with the remodeled glove puppetry, while the children in the control group played with non-remodeled glove puppetry. The Chinese puppet was remodeled using a Lego EV3® robot. Hand kinematics were analyzed through the Siliconcoach® Pro 7 software, which measured the force produced by the baseline ® hydraulic pinch gauge. Play behavior was measured using the Knox Preschool Play Scale-revised (KPPS-r). The experimental group exhibited significant improvements compared to the control group in hand kinematics (wrist range of motion [ROM], p < .05; metacarpophalangeal ROM, p < .05; proximal interphalangeal ROM, p < .05) and KPPS-r scores (space management, p < .05; material management, p < .05; pretense-symbolic, p < .05; participation, p < .05). After the 12-week rehabilitation with the remodeled glove puppetry, the experimental group exhibited significant improvement in kinematics and KPPS-r scores.

Long working hours have been suggested to affect fathers\' parenting behavior, but previously reported findings have been inconsistent. This study examined the association between the working hours and parenting behavior of fathers while accounting for other factors related to their parenting behavior, using data from the Japan Environment and Children Study (JECS), a large cohort study in Japan.
Data from 43,159 father-mother pairs were analyzed. The mother assessed the father\'s frequency of seven parenting behaviors at 6 months after delivery. Then, each behavior was classified into a high-engagement group (always and sometimes) or a low-engagement group (rarely and never). The father\'s weekly working hours was obtained from his responses and was classified into six levels.
Logistic regression analysis showed that after adjustment for covariates, fathers\' weekly working hours was inversely associated with the frequency of all parenting behaviors examined in this study (p for trend <0.0001). Compared with fathers working ≥0 to ≤40 h per week, those working >65 h per week showed the following adjusted odds ratios (95% confidence intervals) for low engagement in parenting behaviors: playing at home, 2.38 (2.08-2.72); changing diapers, 2.04 (1.89-2.20); and bathing the child, 2.01 (1.84-2.18).
This study suggests that the greater time constraints imposed by longer working hours constitute a major factor that discourages fathers from engaging in childrearing behavior. Intervention targeting long working hours could contribute to measures aimed at promoting high-engagement parenting behaviors among fathers.

Preschool teachers are uniquely positioned to impact children\'s physical activity levels, yet the relationship between teachers\' and children\'s physical activity levels has not been widely investigated. The purpose of this study was to explore preschool teachers\' physical activity levels, practices, and perceptions and how this relates to children\'s physical activity at preschool centers. This convergent mixed methods study included eight teachers and 20 children from four preschool classrooms. Accelerometers were used to measure their physical activity. Pearson correlations were used to explore the relationship between teachers\' and children\'s physical activity levels. Direct observation was used to contextualize children\'s physical activity while at preschool. Teachers completed a semi-structured interview to explore their physical activity perceptions and practices. On average, teachers and children were physically active for 50.2 ± 9.3% and 29.5 ± 7.0% of their time at preschool, respectively. A significant positive correlation (p = 0.02; r = 0.98) was found between teachers\' and children\'s percent of time at preschool per day in moderate-to-vigorous physical activity. Children mostly engaged in low-intensity activities (stationary play; light walking) during free play both indoors and outdoors and were mostly sedentary during teacher-initiated group times. All teachers stated they had a positive influence on children\'s physical activity. Teachers commonly reported pain or health conditions as a barrier to their physical activity. There was a positive relationship between teachers\' and children\'s physical activity. More research is needed to confirm this relationship and to explore the impacts of high amounts of occupational physical activity on teachers\' health.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s10643-023-01486-8.