Abstract: Background: Chronic obstructive pulmonary disease (COPD) and asthma have a high prevalence and disease burden. Blended self-management interventions, which combine eHealth with face-to-face interventions, can help reduce the disease burden. Objective: This systematic review and meta-analysis aims to examine the effectiveness of blended self-management interventions on health-related effectiveness and process outcomes for people with COPD or asthma. Methods: PubMed, Web of Science, COCHRANE Library, Emcare, and Embase were searched in December 2018 and updated in November 2020. Study quality was assessed using the Cochrane risk of bias (ROB) 2 tool and the Grading of Recommendations, Assessment, Development, and Evaluation. Results: A total of 15 COPD and 7 asthma randomized controlled trials were included in this study. The meta-analysis of COPD studies found that the blended intervention showed a small improvement in exercise capacity (standardized mean difference [SMD] 0.48; 95% CI 0.10-0.85) and a significant improvement in the quality of life (QoL; SMD 0.81; 95% CI 0.11-1.51). Blended intervention also reduced the admission rate (relative ratio [RR] 0.61; 95% CI 0.38-0.97). In the COPD systematic review, regarding the exacerbation frequency, both studies found that the intervention reduced exacerbation frequency (RR 0.38; 95% CI 0.26-0.56). A large effect was found on BMI (d=0.81; 95% CI 0.25-1.34); however, the effect was inconclusive because only 1 study was included. Regarding medication adherence, 2 of 3 studies found a moderate effect (d=0.73; 95% CI 0.50-0.96), and 1 study reported a mixed effect. Regarding self-management ability, 1 study reported a large effect (d=1.15; 95% CI 0.66-1.62), and no effect was reported in that study. No effect was found on other process outcomes. The meta-analysis of asthma studies found that blended intervention had a small improvement in lung function (SMD 0.40; 95% CI 0.18-0.62) and QoL (SMD 0.36; 95% CI 0.21-0.50) and a moderate improvement in asthma control (SMD 0.67; 95% CI 0.40-0.93). A large effect was found on BMI (d=1.42; 95% CI 0.28-2.42) and exercise capacity (d=1.50; 95% CI 0.35-2.50); however, 1 study was included per outcome. There was no effect on other outcomes. Furthermore, the majority of the 22 studies showed some concerns about the ROB, and the quality of evidence varied. Conclusions: In patients with COPD, the blended self-management interventions had mixed effects on health-related outcomes, with the strongest evidence found for exercise capacity, QoL, and admission rate. Furthermore, the review suggested that the interventions resulted in small effects on lung function and QoL and a moderate effect on asthma control in patients with asthma. There is some evidence for the effectiveness of blended self-management interventions for patients with COPD and asthma; however, more research is needed. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019119894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=119894
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Formative assessment (FA) is an effective educational approach for optimising student learning and is considered as a promising avenue for assessment within physical education (PE). Nevertheless, implementing FA is a complex and demanding task for in-service PE teachers who often lack formal training on this topic. To better support PE teachers in implementing FA into their practice, we need better insight into teachers’ experiences while designing and implementing formative strategies. However, knowledge on this topic is limited, especially within PE. Therefore, this study examined the experiences of 15 PE teachers who participated in an 18-month professional development programme. Teachers designed and implemented various formative activities within their PE lessons, while experiences were investigated through logbook entries and focus groups. Findings indicated various positive experiences, such as increased transparency in learning outcomes and success criteria for students as well as increased student involvement, but also revealed complexities, such as shifting teacher roles and insufficient feedback literacy among students. Overall, the findings of this study underscore the importance of a sustained, collaborative, and supported approach to implementing FA.
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Aim: To evaluate healthcare professionals' performance and treatment fidelity in the Cardiac Care Bridge (CCB) nurse-coordinated transitional care intervention in older cardiac patients to understand and interpret the study results. Design: A mixed-methods process evaluation based on the Medical Research Council Process Evaluation framework. Methods: Quantitative data on intervention key elements were collected from 153 logbooks of all intervention patients. Qualitative data were collected using semi-structured interviews with 19 CCB professionals (cardiac nurses, community nurses and primary care physical therapists), from June 2017 until October 2018. Qualitative data-analysis is based on thematic analysis and integrated with quantitative key element outcomes. The analysis was blinded to trial outcomes. Fidelity was defined as the level of intervention adherence. Results: The overall intervention fidelity was 67%, ranging from severely low fidelity in the consultation of in-hospital geriatric teams (17%) to maximum fidelity in the comprehensive geriatric assessment (100%). Main themes of influence in the intervention performance that emerged from the interviews are interdisciplinary collaboration, organizational preconditions, confidence in the programme, time management and patient characteristics. In addition to practical issues, the patient's frailty status and limited motivation were barriers to the intervention. Conclusion: Although involved healthcare professionals expressed their confidence in the intervention, the fidelity rate was suboptimal. This could have influenced the non-significant effect of the CCB intervention on the primary composite outcome of readmission and mortality 6 months after randomization. Feasibility of intervention key elements should be reconsidered in relation to experienced barriers and the population. Impact: In addition to insight in effectiveness, insight in intervention fidelity and performance is necessary to understand the mechanism of impact. This study demonstrates that the suboptimal fidelity was subject to a complex interplay of organizational, professionals' and patients' issues. The results support intervention redesign and inform future development of transitional care interventions in older cardiac patients.
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The aim of the project is to design, test, refine and deploy a new assessment tool focusing on individual Future Literacy of students. Future Literacy is the ability to produce and process complex visions of the future and make sense thereof. FL is therefore an essential component of any 21st Century Skills set, in the sense that it focuses on the ability of students to prepare themselves for uncertainty and unexpected challenges. At present, the competing concepts of 21st Century Skills have a common denominator in the core idea of fostering personal development of "T-shaped individuals" who have depth in a particular field and breadth in their skill set and thinking. The students' individual ability to "use the future": make sense of emergent reality, deal with complex problems, make decisions based on collective intelligence, plan and prepare for the future, is as important in making educational choices as in taking educated bets concerning their professional, personal and political futures. The project outcome: a new tool for FL assessment will test the feasibility of rigorous measurement, and assessment of FL, to inform better curriculum design and methodological development.
KnowledgeFlows in Marine Spatial Planning - Sharing Innovation in Higher Education(KnowledgeFlows) aims at further enforcing the European higher education community to meet the growing demands for knowledge, skills and innovation within the still emerging field of marine or maritime spatial planning (MSP).Marine Spatial Planning (MSP) is an emerging governmental approach towards a more effective use of the sea. MSP is of great interest in Europe and can be considered a societal process to balance conflicting interests of maritime stakeholders and the marine environment. Many different activities take place at sea, ranging from shipping, fisheries, to offshore wind energy activities. Simultaneously, new and evolving policies focus on strategies to integrate different marine demands in space and resources. MSP is now legally binding in the EU and is much needed approach to manage and organize the use of the sea, while also protecting the environment.KnowledgeFlows will contribute to the development of new innovative approaches to higher education and training on MSP by means of problem-based learning schemes, transdisciplinary collaboration, and advanced e-learning concepts. KnowledgeFlows builds on results from former project outputs (Erasmus+ Strategic Partnership for Marine Spatial Planning SP-MSP), such as the online learning platform MSP Education Arena (https://www.sp-msp.uol.de).The strategic partnership consists of a transnational network of experts both in research and in practice based in the north Atlantic, Baltic Sea and North Sea Regions including Aalborg University (DK, lead partner), The University of Oldenburg (D), the University of Liverpool (U.K.), the University of Nantes (F), the Leibniz Institute for Baltic Sea Research (D), the Breda University of Applied Sciences (NL), University of Ulster (U.K.), and the Finnish Environment Institute (FI). Gothenburg University, also being a higher education organisation, will be associated partner.Furthermore, three international organisations, the Marine Spatial Planning Research Network, the Baltic inter-governmental VASAB and the pan-Nordic Nordregio will be involved in the partnership as associated organisations deeply rooted in the MSP community of practice.The further improvement of curricula, exchange of knowledge and experts, and transparency and recognition of learning outcomes to reach higher qualifications in MSP are key components of KnowledgeFlows. A mutual learning environment for MSP higher education will enable problem-driven innovation among students and their educators from research and governance also involving stakeholders. Related activities on intellectual outputs, multiplier events and lecturing will be carried out by all participating organisations.The intellectual outputs are related to three major contributions to the European higher education landscape:1) an advanced level international topical MSP course (Step-up MSP)2) digital learning facilities and tools (MSP Education Arena)3) designing problem-based learning in MSP (MSP directory)The advanced level inter-institutional topical MSP course will include different teaching and training activities within a problem-based learning environment. Digital learning facilities enabling communication and training will include a further enrichment of the MSP Education Arena platform for students, practitioners and lecturers for including modules forcollaborate learning activities, documentation and dissemination, mobilisation/recruitment, thesis opportunities, placements/internships. Designing problem-based learning in MSP will include topics as; the design of didactics and methods; guidance for lecturers, supervisors and students; evaluation and quality assurance; assessment.Five multiplier events back to back or as part of conferences within the MSP community will be organised to mainstream the outputs and innovative MSP didactics among other universities and institutions.Different teaching and training activities feeds into the intellectual output activities, which will include serious gaming sessions (MSP Challenge (http://www.mspchallenge.info/) and others), workshops, excursions, courses/classes as well as a conference with a specific focus on facilitating the exchange of innovative ideas and approaches among students at bachelor´s, master´s and doctoral level and the MSP community of practice.Project management meetings (twice a year) will assure coherence in project planning and implementation. As the core focus of the strategic partnership is on collaboration, mutual learning, and innovation among educators, students, and practitioners in order to meet actual and future needs regarding knowledge exchange and training within the MSP community, the project will be designed to have long lasting effects.Results
