Recent years have witnessed significant growth of interest in science-art integration in schools as an approach to creative teaching and learning. This conceptual turn in education implies profound institutional and philosophical changes. Central to this turn has been the development of Science, Technology, Engineering, Arts, Math (STEAM) education. In this article, we detail a progression from an existing model of pedagogical principles and educational objectives in science education within a global STEAM education environment, Global Science Opera, towards shared pedagogical principles and educational objectives in both science and arts education within that same environment. In this work, we rely on a transdisciplinary approach towards the integrated disciplines and the educators who teach them. We outline the need for the new, integrated approach to be validated in other, empirical, contexts in order to establish its capacity in the field of creativity in education, and specifically in global STEAM environments in order to ensure its relevance to teaching and learning of a kind which strengthen students` knowledge, abilities and democratic and inclusive values. We propose the Janus metaphor for the new approach as it represents the possibility of having a double perspective of a single focus of attention. We conclude by pointing at limitations of discipline integration in which pedagogical principles in science education are not in harmony with the pedagogical principles in arts education.
To sustain the specific intermittent activity of an official taekwondo match, high demands are placed on both aerobic and anaerobic metabolisms. Studies determining the contributions of the energy systems during the simulated match found a 62–74% participation of the oxidative system. In parallel with the widespread use of general tests for assessing endurance in taekwondo athletes, research has focused on developing sport-specific tests. This narrative review aims to present the sport-specific tests available in the current literature for assessing endurance in taekwondo. It summarizes and analyzes the development and validation process of each test. Additionally, we provide practical applications, recommendations, and future perspectives as guidelines for assessment, with the ultimate objective of encouraging scientists, coaches, and physical trainers to use sport-specific methodologies. All the tests described in this review represent alternative methodologies to classical general tests. They are easily accessible, noninvasive, simple to conduct, and specifically designed for assessing endurance in taekwondo athletes. However, it is important to consider that each test has specific methodological and application characteristics and a different development and validation path. These factors must be taken into consideration when deciding which test to use.
Modellen BrukerInvolvering i KVAlitetsutvikling (BIKVA) er prøvd ut for å løfte frem brukerstemmen i systematisk kvalitetsutviklingsarbeid i en kommune. Skoleelever med behov for særskilt tilrettelegging for læring ble involvert og hørt, og deres stemme ble løftet videre til lærere, ledere og politikere av psy-kolog i PPT. Tilpasninger av BIKVA-modellen ble gjort for å sikre at elever med ulike vansker ble trygge på deltakelsen, forstod spørsmålene og fikk svare på egne premisser. Utprøvingen viste at BIKVA-modellen var en metode som skapte engasjement, lot deltakerne bli sett og hørt, satte brukerstemmen i fokus og skapte endring i tjenestene basert på brukernes innspill.
Background The increasing frailty of home‐dwelling older people can lead to rising expectations from their family caregivers due to various demographic developments and political guidelines. European data show that 60% of home‐dwelling older people receive informal care. Frailty among older people is a state of vulnerability, increasing the risk of adverse health outcomes, declining daily activities and needing long‐term care. Aim To explore family caregivers' lived experiences with caring for frail, home‐dwelling older people. Methods We conducted a phenomenological study to obtain in‐depth descriptions of the phenomenon. We interviewed nine family caregivers, five men and four women between 52 and 90 years old, in‐depth in their homes. We used a hermeneutical phenomenological approach described by van Manen and followed the COREQ checklist. Results The phenomenon's essential meaning is described as striving to adapt throughout the caring relationship. The interrelated themes describe different caring relationships, caring for a family member and letting go of the primary caring responsibility. Conclusions Family caregivers describe care as meaningful yet demanding. In our study, the varying condition of frailty was an additional challenge in care. By addressing these challenges, healthcare providers can better support and help family caregivers to withstand their caring relationships. The Norwegian Centre for Research Data approved the study (Ref.61202).
The analysis of blood and bone marrow smear pictures aids in the detection of hematological malignancies. The colour levels of the nucleus and its neighbours in these smear images aid in identifying cell malignancy. The primary goal of this project is to conduct colour-based segmentation on blood/bone marrow smear images. These photos are first treated to contrast stretching using the dark contrast algorithm (DCA). This enhancement boosts the contrast of the nucleus and its surrounding components. Using an adaptive thresholding approach, colour-based segmentation of enhanced microscopic pictures (blood/bone marrow smear images) was performed. The colour segmented image is then transformed to binary to create the binary mask, which is then evaluated using the overlap ratio (OR) to determine performance.
The Jostedalsbreen ice cap is mainland Europe's largest ice cap and accommodates 20% (458 km ² in 2019) of the total glacier area of mainland Norway. Jostedalsbreen and its meltwater contribute to global sea-level rise and to local water management, hydropower and tourism economies and livelihoods. In this study, we construct a digital terrain model (DTM) of the ice cap from 1966 aerial photographs, which by comparing to an airborne LiDAR DTM from 2020, we compute changes in surface elevation and geodetic mass balances. The area mapped in both surveys cover about 3/4 of the ice cap area and 49 of 82 glaciers. The measured glacier area has decreased from 363.4 km ² in 1966 to 332.9 km ² in 2019, i.e. a change of −30 km ² or −8.4% (−0.16% a ⁻¹ ), which is in line with the percentage reduction in area for Jostedalsbreen as a whole. The mean geodetic mass balance over the 49 glaciers was −0.15 ± 0.01 m w.e. a ⁻¹ , however, large variability is evident between glaciers, e.g. Nigardsbreen (−0.05 m w.e. a ⁻¹ ), Austdalsbreen (−0.28 m w.e. a ⁻¹ ) and Tunsbergdalsbreen (−0.36 m w.e. a ⁻¹ ) confirming differences also found by the glaciological records for Nigardsbreen and Austdalsbreen.
A software product line (SPL) is a family of closely related software systems which capitalizes on the variability and reusability of the software products and can be formalised by a feature model. Feature model evolution plans (FMEP) capture the current SPL as well as the planned evolution of the SPL to ensure successful long-term development. As business requirements often change, FMEPs should support intermediate update. This modification may cause paradoxes in an FMEP, e.g., a node left without a parent, making the plan impossible to realise. Current tools exist to validate FMEPs, but require analysing the entire plan even when a modification affects only small parts of it. Hence, there is a need for a method that detects such paradoxes in a more efficient way. In this paper, we present an interval based feature model (IBFM), a representation for FMEPs, that allows local reasoning to validates only the parts of the plan affected by changes. We define operations for updating the FMEPs and the preconditions under which they preserve soundness, i.e., absence of paradoxes, and show the correctness of the method.
Objective: There is a growing interest in idiographic patient-reported outcome measures (I-PROMs) for routine outcome monitoring (ROM) and clinical feedback (CF) in psychotherapy, but to our knowledge, no systematic reviews of the empirical literature. Method: We conducted a systematic literature search for empirical papers investigating effects and experiences of I-PROMs for ROM/CF and found a total of 13 papers. There was only one experimental controlled effectiveness study. Results: We formulated a narrative summary of the data set as a whole. We conducted a secondary analysis of nine papers containing qualitative data on stakeholder experiences with I-PROMs and found three superordinate themes and eight subthemes, summarized as "I-PROMs can facilitate self-reflection for patients, assist in identifying and tracking therapeutic topics, and make patients more committed to therapy by giving them a greater sense of responsibility and empowerment. Formulating goals and problems can be difficult, and lack of progress can be demotivating. Time in therapy is precious and must be spent wisely. Effective use of I-PROMs is facilitated by flexibility and therapists' use of clinical skills." Conclusion: We discuss the limitations of the study and provide recommendations for future research and clinical practice.
The current study investigated gender (control) and number (target) agreement processing in Northern and non-Northern Norwegians living in Northern Norway. Participants varied in exposure to Northern Norwegian (NN) dialect(s), where number marking differs from most other Norwegian dialects. In a comprehension task involving reading NN dialect writing, P600 effects for number agreement were significantly affected by NN exposure. The more exposure the NN nonnatives had, the larger the P600 was, driven by the presence of number agreement (ungrammatical in NN). In contrast, less exposure correlated to the inverse: P600 driven by the absence of number agreement (ungrammatical in most other dialects). The NN natives showed P600 driven by the presence of number agreement regardless of exposure. These findings suggests that bilectalism entails the representation of distinct mental grammars for each dialect. However, like all instances of bilingualism, bilectalism exists on a continuum whereby linguistic processing is modulated by linguistic experience.
Background Active travel and school settings are considered ideal for promoting physical activity. However, previous research suggests limited effect of school-based interventions on overall physical activity levels among adolescents. The relationship between physical activity in different domains remains inconclusive. In this study, we examined the effects of adding two weekly hours of school-based physical activity on active travel rates. Method We analyzed data from 1370 pupils in the 9th-grade participating in the cluster RCT; the School In Motion (ScIM) project. Intervention schools (n = 19) implemented 120 min of class-scheduled physical activity and physical education, in addition to the normal 2 hours of weekly physical education in the control schools (n = 9), for 9 months. Active travel was defined as pupils who reported walking or cycling to school, while motorized travel was defined as pupils who commuted by bus or car, during the spring/summer half of the year (April–September), or autumn/winter (October–February). The participants were categorized based on their travel mode from pretest to posttest as; maintained active or motorized travel (“No change”), changing to active travel (motorized-active), or changing to motorized travel (active-motorized). Multilevel logistic regression was used to analyze the intervention effect on travel mode. Results During the intervention period, most participants maintained their travel habits. In total, 91% of pupils maintained their travel mode to school. Only 6% of pupils switched to motorized travel and 3% switched to active travel, with small variations according to season and trip direction. The intervention did not seem to influence the likelihood of changing travel mode. The odds ratios for changing travel habits in spring/summer season were from active to motorized travel 1.19 [95%CI: 0.53–2.15] and changing from motorized to active travel 1.18 [0.30–2.62], compared to the “No change” group. These findings were consistent to and from school, and for the autumn/winter season. Conclusion The extra school-based physical activity does not seem to affect rates of active travel among adolescents in the ScIM project. Trial registration Clinicaltrials.gov ID nr: NCT03817047. Registered 01/25/2019′ retrospectively registered’.
Prompt Gamma-ray Spectroscopy (PGS) in conjunction with the Monte Carlo Library Least Squares (MCLLS) approach was investigated for the purposes of range monitoring in proton therapy through Monte Carlo simulations. Prompt gamma-rays are produced during treatment and can be correlated to the range of the proton beam in the tissue. In contrast to established approaches, MCLLS does not rely on the identification of specific photopeaks. Instead it treats each individual constituent as a library spectrum and calculates coefficients for each spectrum, and therefore takes both the photopeaks and the Compton continuum into account. It can thus be applied to organic scintillators traditionally not used for energy spectroscopy due to their low Z number and density. Preliminary results demonstrate that the proposed approach returns a strong linear correlation between the range of the primary proton beam and the calculated library coefficients, depending on the composition of libraries. This can be exploited for range monitoring.
Aim To evaluate the impact of usual care plus a fundamental nursing care guideline compared to usual care only for patients in hospital with COVID‐19 on patient experience, care quality, functional ability, treatment outcomes, nurses' moral distress, patient health‐related quality of life and cost‐effectiveness. Design Parallel two‐arm, cluster‐level randomized controlled trial. Methods Between 18th January and 20th December 2021, we recruited (i) adults aged 18 years and over with COVID‐19, excluding those invasively ventilated, admitted for at least three days or nights in UK Hospital Trusts; (ii) nurses caring for them. We randomly assigned hospitals to use a fundamental nursing care guideline and usual care or usual care only. Our patient‐reported co‐primary outcomes were the Relational Aspects of Care Questionnaire and four scales from the Quality from the Patient Perspective Questionnaire. We undertook intention‐to‐treat analyses. Results We randomized 15 clusters and recruited 581 patient and 418 nurse participants. Primary outcome data were available for 570–572 (98.1%–98.5%) patient participants in 14 clusters. We found no evidence of between‐group differences on any patient, nurse or economic outcomes. We found between‐group differences over time, in favour of the intervention, for three of our five co‐primary outcomes, and a significant interaction on one primary patient outcome for ethnicity (white British vs. other) and allocated group in favour of the intervention for the ‘other’ ethnicity subgroup. Conclusion We did not detect an overall difference in patient experience for a fundamental nursing care guideline compared to usual care. We have indications the guideline may have aided sustaining good practice over time and had a more positive impact on non‐white British patients' experience of care. Implications for the Profession and/or Patient Care We cannot recommend the wholescale implementation of our guideline into routine nursing practice. Further intervention development, feasibility, pilot and evaluation studies are required. Impact Fundamental nursing care drives patient experience but is severely impacted in pandemics. Our guideline was not superior to usual care, albeit it may sustain good practice and have a positive impact on non‐white British patients' experience of care. Reporting Method CONSORT and CONSERVE. Patient or Public Contribution Patients with experience of hospitalization with COVID‐19 were involved in guideline development and writing, trial management and interpretation of findings.
Background Gynaecological cancer illness and treatment have a significant impact on women's sexual health and concerns regarding sexual health are known to be an unmet need in survivors. The digital support programme Gynea was designed to enhance women's health, including sexual health, after gynaecological cancer treatment. This study aimed to explore how cancer survivors experienced participation in Gynea. Methodology This is a phenomenological hermeneutic study. Individual, in‐depth semi‐structured interviews were conducted to explore lived experiences. Twenty women were interviewed after completing the Gynea programme. The transcripts were analysed using Lindseth and Norberg's phenomenological hermeneutic method. Findings Three main themes (with subthemes) emerged from the analysis: (1) A silent existential trauma; (2) Redefining sexual health; (3) Communicating with a partner about sexuality. The women redefined sexual health rather than just being sexual intercourse, being a rediscovery of the body. The women's increased awareness and understanding of their own sexual health empowered their communication about their sexuality with their partners. This was important for regaining sexual health and intimacy in their relationships. Conclusion Participation in Gynea helped to strengthen the women's sexual integrity. Knowledge and support empowered them to take care of their sexual needs and communicate these with their partners. Implications for Patient Care Healthcare services and nurses need to be aware that sexual health is an existential state of being, in which good sexual health does not necessarily equate to sexual function, but rather to sexual empowerment. Digital support with nurse guidance can support women in caring for their sexual health after cancer illness by thematizing sexual health with a holistic approach and should be part of the medical treatment. Patient or Public Contribution Twenty gynaecological cancer survivors contributed by sharing their experiences from the sexual health module in Gynea.
Magnetic resonance spectroscopy (MRS) is the primary method that can measure the levels of metabolites in the brain in vivo. To achieve its potential in clinical usage, the reliability of the measurement requires further articulation. Although there are many studies that investigate the reliability of gamma‐aminobutyric acid (GABA), comparatively few studies have investigated the reliability of other brain metabolites, such as glutamate (Glu), N‐acetyl‐aspartate (NAA), creatine (Cr), phosphocreatine (PCr), or myo‐inositol (mI), which all play a significant role in brain development and functions. In addition, previous studies which predominately used only two measurements (two data points) failed to provide the details of the time effect (e.g., time‐of‐day) on MRS measurement within subjects. Therefore, in this study, MRS data located in the anterior cingulate cortex (ACC) were repeatedly recorded across 1 year leading to at least 25 sessions for each subject with the aim of exploring the variability of other metabolites by using the index coefficient of variability (CV); the smaller the CV, the more reliable the measurements. We found that the metabolites of NAA, tNAA, and tCr showed the smallest CVs (between 1.43% and 4.90%), and the metabolites of Glu, Glx, mI, and tCho showed modest CVs (between 4.26% and 7.89%). Furthermore, we found that the concentration reference of the ratio to water results in smaller CVs compared to the ratio to tCr. In addition, we did not find any time‐of‐day effect on the MRS measurements. Collectively, the results of this study indicate that the MRS measurement is reasonably reliable in quantifying the levels of metabolites.
With an ageing population and improved treatments people live longer with their chronic diseases, and primary care clinics face more costly and difficult-to-treat multimorbid patients. To meet these challenges, current guidelines for the management of type 2 diabetes suggest that an interprofessional team should collaborate to enhance the delivery of worthwhile self-management support interventions. In this study, we aimed to evaluate the effects of an empowerment-based interprofessional follow-up intervention in people with type 2 diabetes in primary care on patient-reported outcomes, biomarkers and weight, and to explore the experiences of patients attending the intervention. We invited patients during regular visits to their general practitioners. The 12-month intervention included 1) empowerment-based counselling; 2) a standardized medical report. The control group received consultations with physicians only. The primary outcome was the Patient Activation Measure, a patient-reported measure assessing individual knowledge, skills, and confidence integral to managing one’s health and healthcare. After the trial we conducted qualitative interviews. We observed no difference in the primary outcome scores. On secondary outcomes we found a significant between-group intervention effect in favor of the intervention group, with mean differences in glycemic control after 12 months (B [95% CI] = -8.6 [-17.1, -0.1] mmol/l; p = 0.045), and significant within-group changes of weight (B [95% CI] = -1.8 kg [-3.3, -0.3]; p = 0.02) and waist circumference (B [95% CI] = -3.9 cm [-7.3, -0.6]; p = 0.02). The qualitative data showed that the intervention opened patients’ eyes for reflections and greater awareness, but they needed time to take on actions. The patients emphasized that the intervention gave rise to other insights and a greater understanding of their health challenges. We suggest testing the intervention among patients with larger disease burden and a more expressed motivation for change.
Objectives To describe the prevalence, incidence and burden of all health problems in the Norwegian women’s premier league. Methods During the 2020 and 2021 seasons, players in the Norwegian women’s premier league reported all health problems (sudden-onset injuries, gradual-onset injuries and illnesses) weekly, using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Team medical staff diagnosed reported problems using the Sport Medicine Diagnostic Coding System. We calculated average weekly prevalence, incidence and burden of all health problems reported. Results We included 294 players (age: 22±4 years) from 11 teams. Response rate to the weekly questionnaire was 79%. On average, 32% (95% CI: 31% to 33%) of the players reported at least one health problem at any time and 22% (95% CI: 21% to 23%) reported a substantial health problem negatively affecting their training volume or performance. The overall incidence was 10.7 health problems per 1000 hours of football exposure. Sudden-onset injuries were most severe (68% of the total time loss), followed by gradual-onset injuries (25%) and illnesses (8%). Thigh was the most common injury location (26%), while knee injuries were most severe, causing 42% of the total injury time loss. Anterior cruciate ligament (ACL) injuries alone caused 30% of the total injury time loss. Conclusion One in five players had a health problem negatively affecting their training volume or performance at any time. Sudden-onset injuries represented the most burdensome health problem. Thigh injuries were most frequent, while knee injuries, ACL injuries especially, were most severe.
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