Aims and objectives: To explore differences in health outcomes between unpaid caregivers and noncaregivers living in low-and middle-income countries (LMICs). Background: Previous meta-analyses found worse health outcomes for unpaid caregivers in high-income nations. However, no meta-analysis has considered unpaid caregivers from LMICs. A systematic integration of this topic may contribute to nursing care for unpaid caregivers in LMICs. Design: Systematic review and meta-analysis of observational studies. Methods: Following PRISMA statement, studies were searched for using the CINAHL, PubMed and SciELO databases, limited to publications until 31 December 2019. Random-and fixed-effects meta-analyses were used for data synthesis. Results: Fourteen studies from Africa, Asia and South America were included. Unpaid caregivers of people with ill-health were more anxious and depressed than noncaregivers. Studies conducted in Asia and South America reported poorer health outcomes for unpaid caregivers than noncaregivers, whereas the trend for African studies was the opposite. Unpaid caregivers of healthy individuals may have better health status than noncaregivers, particularly those caring between 1-14 hr per week. Of the six studies which examined gender differences, two studies informed worse health outcomes for women, one presented the opposite effect, and three found no differences. Conclusions: Individual, social, cultural and systemic factors play an important role in the health outcomes of unpaid caregivers in LMICs. More evidence is needed from LMICs. As unpaid caregivers are predominantly female, urgent attention to the health outcomes of female unpaid caregivers is required. Relevance to clinical practice: The management of mental health problems, particularly anxiety and depression, should be an integral part of nursing care for unpaid caregivers living in LMICs. To further promote the health of unpaid caregivers in developing countries, stakeholders should consider launching educational campaigns that assist caregivers in finding ways to meet their cultural obligations while also reinforcing caregiver self-care. K E Y W O R D S gender, health outcomes, low-and middle-income countries, meta-analysis, systematic review, unpaid care | 3951 MAGAÑA et Al.

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Fourth graders were asked to read a text and either to fill in a compare-and-contrast graphic organizer, answer a set of structured questions, take notes, or simply read the text. Both the graphic organizer and questioning groups outperformed the read-only group on a comprehension test ( d = 1.24 and 1.22, respectively) and a memory test ( d = 0.54 and 0.53, respectively). No significant differences were found between the notetaking and read-only groups on the comprehension test ( d = 0.30) or the memory test ( d = 0.20). Results showed more integrative eye movements between paragraphs for the graphic organizer ( d = 1.53) and the questioning groups ( d = 1.90) than the read-only group, but not for the notetaking group ( d = −0.06). On all three measures, the graphic organizer group and the questioning group exhibited a generative learning strategy, whereas the notetaking and read-only groups exhibited a linear learning strategy.

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One of the most common technology-enhanced items used in large-scale K-12 testing programs is the drag-and-drop response interaction. The main research questions in this study are: (a) Does adding a drag-and-drop interface to an online test affect the accuracy of student performance? (b) Does adding a drag-and-drop interface to an online test affect the speed of student performance? In three different experiments involving fourth, sixth, and eighth graders, respectively; students answered reading comprehension questions presented in conventional (i.e., paper-based design) or drag-and-drop formats. The tests consisted of four-sentence ordering items in Experiment 1, four graphic organizer items in Experiment 2, and two cloze tests and two graphic organizer items in Experiment 3. The conventional and drag & drop groups were compared on test performance (i.e., accuracy) and efficiency (i.e., response time and number of mouse clicks). Across the three experiments, the conventional and drag & drop groups did not differ in mean performance, but the drag & drop group responded more efficiently than the conventional group (faster response time, d = 0.62, and fewer mouse clicks, d = 1.13).