Contemporary education increasingly involves a blended learning environment, which consists of a combination of offline and online delivery methods. Blended learning environments can motivate students to learn, but designing motivating blended learning environments is challenging and can result in environments that demotivate students. This conceptual article proposes a blended learning design that helps practitioners to design motivating blended learning environments. According to self-determination theory, students are motivated to learn when their three basic psychological needs for autonomy, competence, and relatedness are supported. Competency-based education (CBE) is intended to support students’ basic psychological needs. We have constructed design guidance for CBE programmes that help practitioners to design a combination of offline and online delivery methods that (1) give students choices in time and place to support their need for autonomy, (2) adapt to students’ competency levels to support their need for competence, and (3) stimulate students’ relationship building with peers and teachers to support their need for relatedness. Although the design guidance is tentative, practitioners can experiment with it to design blended learning environments that motivate students to learn.
OBJECTIVES: To determine the number of steps taken by older patients in hospital and 1 week after discharge; to identify factors associated with step numbers after discharge; and to examine the association between functional decline and step numbers after discharge.DESIGN: Prospective observational cohort study conducted in 2015-2017.SETTING AND PARTICIPANTS: Older adults (≥70 years of age) acutely hospitalized for at least 48 hours at internal, cardiology, or geriatric wards in 6 Dutch hospitals.METHODS: Steps were counted using the Fitbit Flex accelerometer during hospitalization and 1 week after discharge. Demographic, somatic, physical, and psychosocial factors were assessed during hospitalization. Functional decline was determined 1 month after discharge using the Katz activities of daily living index.RESULTS: The analytic sample included 188 participants [mean age (standard deviation) 79.1 (6.7)]. One month postdischarge, 33 out of 174 participants (19%) experienced functional decline. The median number of steps was 656 [interquartile range (IQR), 250-1146] at the last day of hospitalization. This increased to 1750 (IQR 675-4114) steps 1 day postdischarge, and to 1997 (IQR 938-4098) steps 7 days postdischarge. Age [β = -57.93; 95% confidence interval (CI) -111.15 to -4.71], physical performance (β = 224.95; 95% CI 117.79-332.11), and steps in hospital (β = 0.76; 95% CI 0.46-1.06) were associated with steps postdischarge. There was a significant association between step numbers after discharge and functional decline 1 month after discharge (β = -1400; 95% CI -2380 to -420; P = .005).CONCLUSIONS AND IMPLICATIONS: Among acutely hospitalized older adults, step numbers double 1 day postdischarge, indicating that their capacity is underutilized during hospitalization. Physical performance and physical activity during hospitalization are key to increasing the number of steps postdischarge. The number of steps 1 week after discharge is a promising indicator of functional decline 1 month after discharge.
Purpose: Business case (BC) analyses are performed in many different business fields, to create a report on the feasibility and competitive advantage of an intervention within an existing organisation to secure commitment from management to invest. However, most BC research papers on decisions regarding internal funding are either based on anecdotal insights, on analyses of standards from practice, or focused on very specific BC calculations for a certain project, investment or field. A clear BC process method is missing. Design/methodology/approach: This paper aims to describe the results of a systematic literature review of 52 BC papers that report on further conceptualisation of what a BC process should behold. Findings: Synthesis of the findings has led to a BC definition and composition of a 20 step BC process method. In addition, 29 relevant theories are identified to tackle the main challenges of BC analyses in future studies to make them more effective. This supports further theoretical development of academic BC research and provides a tool for BC processes in practice. Originality/value: Although there is substantial scientific research on BCs, there was not much theoretical development nor a general stepwise method to perform the most optimal BC analysis.
