University of Bergen

This chapter has two parts. The first part explores the contemporary framework of CBL and the three phases of CBL: Engage, Investigate, and Act with a detailed guide to the mini-activities within each phase and practical examples. It details how to develop a challenge starting with team formation and choosing a big idea, through to the implementation of a solution in the final phase. The second part is a review of research that explores learning outcomes in CBL. These outcomes focus on engagement, motivation, communication, collaboration, and teamwork.

This Chapter contains five micro-level case studies that examine CBL within specific educational practices, for example, within a particular academic discipline. Case Study One explores CBL used in the master's level course Information Management and Digitalization at UiS. Case Study Two presents an innovative approach to learning dubbed “An inGenious Way of Learning,” at Linköping University, alongside a parallel implementation at the University of Stavanger. Case Study Three, also at Linköping University, details the application of CBL in sustainability education. Case Study Four showcases the implementation of CBL in a multidisciplinary integrated project at the Universidad de Sevilla. Finally, Case Study Five, again from Linköping University, explores the integration of CBL in Project Management and Organisation studies.

This chapter contains five meso-level case studies that examine CBL outside of specific educational practices such as extra-curricular CBL implementation with a particular focus on the role of external stakeholders. Case Study Six, from the University of Trento, examines the extra-curricular Alpine Smart Working Challenge, which partners with the local innovation hub. Case Study Seven from Universitat Autònoma de Barcelona details the co-creation of a CBL challenge with local stakeholders. Case Study Eight, a collaboration between Hamburg University of Technology and the University of Twente, investigates the integration of CBL with the writing of a master’s thesis through the pilot of the ECIU strategic challenge. Case Study Nine, from Kaunas University of Technology, explores the utilisation of CBL in a specific extra-curricular model focusing on innovation in CBL. Finally, Case Study Ten presents the unique implementation of CBL in a non-educational context, in a specially designed CBL programme for communications staff at the University of Stavanger.

This chapter gives a direct voice to CBL experiences through transcripts of interviews with colleagues and students shaping the narrative around the implementation of CBL. These conversations are both one-to-one interviews conducted on Teams and a questionnaire answered via Microsoft Forms. Themes discussed throughout the book in earlier chapters are revisited, offering a nuanced perspective on the transformative potential of CBL. Readers are also invited to reflect on questions specific to each interview that can enhance their own teaching practice of CBL.

This chapter contains three macro level case studies that focus on systemic and institutional perspectives to examine global issues that can be addressed through CBL. Case study eleven from Dublin City University explores the demand for and design of CBL Pathways, emphasising support for university teachers. Case study twelve, a collaborationbetween several ECIU universities, investigates innovative use of CBL as a model for Citizenship Education. Finally, case study thirteen examines the CBL continuum, an emerging tool that is of great practical usefulness for teachers in assessing the level of CBL implementation within a specific educational context.

This chapter provides a short overview of the history of Challenge-Based Learning (CBK) and its evolution as a pedagogical practice in higher education. We discuss how CBL reshapes pedagogical approaches to learning and teaching as well as student engagement and self-directed learning in collaborative practices. The vignette included compares CBL to other experiential learning methods such as problem-based and project-based learning. The chapter then discusses CBL's origins in both bioengineering at a higher education level and the Apple pilots at a high school level, both in the USA.

This chapter presents a comprehensive, practical guide to assessment, feedback, and evaluation in CBL for teachers and practitioners to use. It takes a detailed look at formative and informative methods of assessment and how it can be done in both informal and formal ways. For feedback, it looks at how this is given by all parties in CBL; teachers and practitioners, students, and external stakeholders to ensure a multi-directional learning process. It also examines how to evaluate the successful use of CBL and how to balance this with traditional evaluation methods. It offers practical tips for practitioners throughout the chapter and examples of conversations that illustrate how to conduct effective feedback sessions before concluding with a vignette giving real examples of CBL assessment and evaluation in two courses at Prague University of Economics and Business.

This chapter is an exploration of the multi-faceted implications of future CBL implementation for teachers, practitioners, students, and external stakeholders through a close reading of the case studies within the three levels of the ecological framework including micro, meso, and macro. This analysis draws on the details of these CBL implementations in different disciplines and in different ways to reveal contextualised practices and understandings that shape an emerging set of practical implications for those who would like to implement CBL.

This chapter sets out the rationale for categorizing the case studies commissioned for this book using a micro, meso, and macro frameworks and our intention to further document emerging practical knowledge which can contribute to the development of theoretical understanding in the field of CBL. It contextualizes our research approach through the use of case studies within the wider literature around case study-based research, presenting the benefits of using such a method. It sets out the context of the ECIU university alliance collaboration and the specifics of our research call to contribute to this book.

Background IgA nephropathy (IgAN) exhibits an unpredictable trajectory, creating difficulties in prognostication, monitoring, treatment, and research planning. This study provides a comprehensive depiction of the progression of kidney function throughout the disease course, from diagnosis to a span of 36 years post-diagnosis. Methods We utilized a cohort of 400 Norwegian IgAN patients, from diagnosis to the occurrence of death, initiation of kidney replacement therapy (KRT), or the latest follow-up. Recorded proteinuria (n = 2676) and creatinine (n = 8738) measurements were retrieved. Patients were divided into subgroups based on their specific estimated glomerular filtration rate (eGFR) slopes. Results Median follow-up was 16 years. During this period, 34% of patients either died or initiated KRT. Among patients who reached endpoint, the median duration from diagnosis to the initiation of KRT or death was 8 years. Notably, 34% of the cohort exhibited a stable disease course, characterized by an eGFR decline of less than 20% between two consecutive measurements. Differences in subsequent disease trajectories among two subgroups with similar eGFR levels at diagnosis could not be accounted for by variations in treatment strategies. Among patients with proteinuria < 1 g/24 h in less than half of the measurements, KRT was five times more prevalent compared to those with more than half of the measurements recording proteinuria < 1 g/24 h (p-value = 0.001). Conclusions While a significant proportion of IgAN patients reach kidney failure within their lifetimes, outcomes vary widely. Clinical data at diagnosis offer limited insights into long-term risks. Enhanced risk stratification necessitates data collection at multiple time points.

Introduction Exercise- Induced Laryngeal Obstruction (EILO) can lead to disabling exercise related dyspnea and hamper participation in physical activity. In this study, we aimed to investigate the effects of a standardized speech therapy protocol as treatment for EILO. Methods Patients diagnosed with EILO at our institution were invited to participate. We compared laryngeal findings obtained during a continuous laryngoscopy exercise (CLE) test and questionnaire based self-reported breathing symptoms, before vs. after the treatment intervention. The laryngeal obstruction was characterized using a standardized CLE scoring system (0–12 points). Results A total of 28 patients were evaluated. Following speech therapy, the mean reduction in the CLE score was 1.5 (95% confidence interval: 1.1–2.0) points, with the improvement primarily associated with decreased glottic-level obstruction. Twenty-four (86%) patients reported reduced symptoms during exercise. A moderate correlation was observed between changes in CLE scores and subjective symptom improvements. Conclusion This study suggests that a standardized speech therapy protocol reduces observed laryngeal obstruction during the CLE test, with the most notable improvement occurring at the glottic level, alongside a parallel reduction in self-reported symptoms of EILO.

Ex situ living plant collections play a crucial role in providing nature-based solutions to twenty-first century global challenges. However, the complex dynamics of these artificial ecosystems are poorly quantified and understood, affecting biodiversity storage, conservation and utilization. To evaluate the management of ex situ plant diversity, we analysed a century of data comprising 2.2 million records, from a meta-collection currently holding ~500,000 accessions and 41% of global ex situ species diversity. Our study provides critical insights into the historical evolution, current state and future trajectory of global living collections. We reveal sigmoidal growth of a meta-collection that has reached capacity in both total accessions and total diversity, and identify intrinsic constraints on biodiversity management, including a median survival probability of 15 years. We explore the impact of external constraints and quantify the influence of the Convention on Biological Diversity, which we link to reduced acquisition of wild-origin and internationally sourced material by 44% and 38%, respectively. We further define the impact of these constraints on ex situ conservation but highlight targeted initiatives that successfully mitigate these challenges. Ultimately, our study underscores the urgent need for strategic prioritization and the re-evaluation of ex situ biodiversity management to achieve both scientific and conservation goals.

People relate to news in highly complex ways. Research on news audiences has identified how content reception, user practices, and spatiotemporal contexts influence relations to news. This study aims to see these dimensions as connected, emphasizing the significance of understanding how news content, practices, and people’s situatedness resonate in the context of everyday life and how this resonance reflects personal identity. Conceptually, the paper employs the concept of news experience as an analytical lens to understand the multilayered nature of how people relate to news. Empirically, six distinct forms of news experience are identified, all in which content, practices, and situatedness resonate differently: Reassurance, control, social connection, relaxation, diversion, and stress. Drawing on a Norwegian three-step data collection, including recurring interviews, news diaries, data donations, and video-ethnography from the same informants, the article methodologically contributes to a more profound understanding of the dynamics involved in various forms of news experience.

Purpose Clinical cut-offs like minimum clinically important improvement (MCII) and patient acceptable symptom state (PASS) increase the interpretability of patient reported outcome measures (PROMs), but cut-off estimates vary considerably, clouding a clear definition of a successful surgical outcome. We report estimates of MCII and PASS following hip- and knee arthroplasty using multiple methods and compare the different estimation methods. Methods Elective hip or knee arthroplasty patients who underwent the regular pre- and postoperative assessments 2014–2018 were included. The generic EQ-5D-5L and either the Hip or Knee disability/injury and Osteoarthritis Outcome Score (HOOS/KOOS) were used. MCII and PASS were estimated based on multiple estimation techniques. Results Distributions were skewed, with up to 95% being acceptable according to anchor questions. MCII estimates for HOOS/KOOS Pain ranged 21–60/10–47, with fewest in-sample misclassifications for the lowest cut-offs, provided by the 75th percentile approach. PASS estimates for HOOS/KOOS Pain ranged 84–93/78–91, for EQ-5D Index/EQ-VAS 0.87–0.92/66–79 (for hip), and 0.79–0.88/66–76 (for knee), with fewest misclassifications for the 75th percentile approach (hip) and Pythagoras approach (knee). The 75th percentile approach was the approach most often giving MCII estimates below the minimal detectable change (MDC). Conclusions We report new one-year estimates of MCII and PASS of HOOS, KOOS and EQ-5D subscales following hip- and knee arthroplasty. Estimates varied considerably when using different anchors and estimation techniques. Overall, the 75th percentile approach had fewest misclassifications, and had the lowest thresholds for the MCII estimations, but which were often below the MDC.

Objective Folate and cobalamin deficiency or impaired function due to genetic variants in key enzymes, have been associated with neuropsychiatric symptoms. The aim of this study was to compare folate and cobalamin status in patients admitted to an acute psychiatric unit to patients from primary health care, in order to reveal factors which may be important in the follow-up of patents with mental disorders. Methods Anonymous blood samples tested for folate, cobalamin, the metabolic marker total homocysteine (tHcy), creatinine and glomerular filtration rate, as well as age and gender in patients admitted to a psychiatric acute unit (n=981) and patients from primary health care (controls) (n=32201) were reviewed retrospectively. Results Median serum folate was 18% lower and median serum cobalamin was 11% higher in patients with mental disorders compared to controls. Folate deficiency was associated with 54% higher median tHcy levels among patients with mental disorders compared to controls. The prevalence of folate deficiency was 31% and of cobalamin deficiency 6% in patients admitted to a psychiatric acute unit in a Norwegian hospital in 2024. Conclusion Folate, but not cobalamin deficiency, was prevalent in Norwegian patients with mental disorders. The higher tHcy levels in folate deficient patients with mental disorders indicate an impaired folate metabolism, which might be related to genetic factors, such as polymorphisms in the MTHFR gene. Ensuring a serum folate concentration above 15 nmol/L and a serum cobalamin above 250 pmol/L might improve symptoms in patients with mental disorders.

Background Emotion dysregulation commonly co-occurs with attention-deficit hyperactivity disorder (ADHD), leading to a range of negative outcomes. While psychological interventions have shown promise in bringing about positive changes in emotional and cognitive domains, there is still limited knowledge on the subjective experiences of change among the participants in these interventions. Aim The present study explores the experiences of adults with ADHD who had participated in a blended digital and face-to-face intervention aimed at improving emotion dysregulation. The study focuses on understanding their experiences of change and identifying contributors to change. Methods A total of 9 adults with ADHD participated in individual semi-structured, in-depth interviews following their participation in the intervention. The interviews were analyzed using thematic analysis. Results The thematic analysis resulted in three core themes. The first theme, ‘perceiving change’, represents changes that the participants experienced, with four subthemes: 1a) being in control, 1b) feeling aware, 1c) accepting oneself and one’s emotions and 1d) gaining insight and knowledge. The second theme, ‘supporting change’, captures factors that supported the participants’ changes, with five subthemes: 2a) acquiring skills, 2b) being in it together, 2c) therapist guidance, 2d) finding motivation 2e) putting it into practice. Lastly, the third theme, ‘sustaining change’, includes aspects important to maintain change, with two subthemes: 3a) working consistently and 3b) giving it time. Conclusions The findings show that the participants experienced various changes related to the management of their emotions following their participation in the intervention. Change was perceived as a multifaceted process, supported by internal factors such as motivation and engagement, along with external factors such as support from the other group members and the therapists. Taken together, the findings from the study could be important to the development of psychological interventions for adults with ADHD and may provide valuable knowledge to clinicians and policymakers. Trial registration Registered on 21st November 2022 at ClinicalTrials.gov. ClinicalTrials.gov ID: NCT05644028.

Background Athletes participating in low-impact sports such as cycling and swimming are at increased risk for low bone mineral density, which may lead to long-term health issues. Exercise is known to increase bone mineral density, but there is little knowledge of the effects of this in athletes participating in low-impact sports. This review aims to identify potential exercise interventions that could improve bone health in these athletes. Methods There appears to be little research on this topic, and we addressed the research question using a scoping review to get a broad overview of the research literature. The scoping review was conducted following the methodological framework of Arksey and O´Malley. A literature search was conducted May 2024 in SPORTDiscus, Web of Science, Scopus, MEDLINE, EMBASE, Cinahl, Cochrane, and Google Scholar. The Consensus on Exercise Reporting Template was used to evaluate the reporting of the exercise intervention(s). Results A total of 2528 studies were screened and assessed for eligibility. Five studies met the inclusion criteria reporting results of exercise interventions on bone mineral density in cyclists and swimmers. Different designs were applied, and study populations varied. Five populations were explored; one cohort of adolescent swimmers (both sexes), one cohort of female Olympic artistic swimmers, one cohort of elite road cyclists (both sexes), one cohort of male competitive amateur cyclists, and one cohort of trained to well-trained cyclists (both sexes). Conclusion This scoping review found that resistance training, plyometric exercises, whole-body vibration, and a combined jumping exercise with collagen supplementation show promising results in improving bone mineral density in athletes participating in cycling and swimming. However, there is limited evidence due to few identified studies, with varying study designs and inconsistent exercise reporting, highlighting the need of further research to better understand how different training approaches can improve bone health in these athletes.