Toward Marvels in Dynamic Geometry Teaching and Learning: Developing guidelines for the design of didactic sequences that exploit potentials of dynamic geometry to foster students’ development of mathematical reasoning competency

Digital technologies are gaining an increasingly prominent role in Danish primary and lower secondary school mathematics education. The expectations are that digital technologies can support students’ development of mathematical competencies. However, studies have demonstrated that the insertion of digital technologies into school mathematics does not automatically correspond to increased student learning outcomes (OECD, 2015). In fact, digital technologies can both produce marvels and cause disasters in mathematics teaching and learning (Niss, 2016). How digital tools are implemented seems to be essential. It is, therefore, a crucial research objective to unveil how didactic sequences may be designed for the efficient implementation of digital tools. The overarching purpose of this dissertation is to identify guidelines for the design of didactic sequences that exploit potentials of dynamic geometry environments (DGEs) in relation to supporting students’ development of mathematical reasoning competency in Danish lower secondary school. The dissertation consists of five papers and this summarizing report – which, altogether, seeks to shed light on the abovementioned purpose by first examining what the potentials of DGEs in relation to reasoning competency are according to previous mathematics education research (paper I) and then examining the extent to which these potentials are currently utilized in Danish lower secondary school (paper II). Based on these initial studies, guidelines are identified for the design of didactic sequences that utilize these potentials to support students’ development of mathematical reasoning competency (papers I, III, IV and V). Methodologically, a mixed methods approach was applied with a qualitative priority. The quantitative data were collected from a web-based questionnaire that was developed and distributed to lower secondary school teachers. Anchored in design-based research methodology, the qualitative data were collected in connection with the design, testing and redesign of a didactic sequence in five different school classes. The data that were collected in the iterations of design are screencast recordings, videos, interviews, audio recordings and students’ written products. The results from the project can coarsely be summarized as follows: In the review of mathematics education research, four DGE potentials were identified in relation to mathematical reasoning competency: dragging, feedback, measuring and tracing (paper I). The results of the survey indicate that these potentials are only exploited to a limited extent in lower secondary schools (paper II). The utilization of the potentials is described in guidelines that comprise a learning trajectory in terms of 5students’ cognition, task design and the role of the teacher. The a priori guidelines that are theoretically developed initially (paper I) are subsequently refined empirically based on the data that emerged in the design-based research (papers III, IV and V), leading to a posteriori guidelines (Chapter 5). The dissertation was completed in the period 1 January 2018–31 December 2020

Four different models for simulation-based training of bronchoscopic procedures

BACKGROUND: Flexible bronchoscopy procedures require detailed anatomical knowledge and advanced technical skills. Simulation-based training offers a patient-safe training environment that can be more efficient than patient-based training. Physical models are cheaper than virtual reality simulators and allow trainees to be acquainted with the equipment used in the clinic. The choice of a physical model for training depends on the local context. The aim of this study was to compare four different bronchoscopy models for flexible bronchoscopy training.METHODS: The BronchoBoy manikin, the Koken manikin, a human cadaver, and a preserved porcine lung were included in the study. Seven physicians experienced in bronchoscopy performed a bronchoscopic airway inspection, bronchoalveolar lavage (BAL), and tissue sampling on all four models with performance evaluated by observation and participant evaluation of models by questionnaire.RESULTS: Nineteen segments were identified in all human anatomy models, and the only significant difference found was that only the Thiel embedded cadaver allowed all participants to enter RB1 with an instrument in the working channel (p = 0.001). The Thiel embedded cadaver and the BronchoBoy manikin had low fluid return on BAL (22 and 52 ml), whereas the Koken manikin and the preserved porcine lung had high return (132 and 134 ml), (p = 0.017). Tissue samplings were only completed in the preserved porcine lung and the Thiel embedded cadaver (p &lt; 0.001).CONCLUSIONS: An anatomically correct bronchoscopy is best simulated with the Koken manikin or the Thiel embedded cadaver. Bronchoalveolar lavage should be simulated with the Koken manikin or the preserved porcine lung. Tissue sampling procedures are best simulated using the Thiel embedded cadaver or the preserved porcine lung.</p

Non-Contact Respiratory Measurement Using a Depth Camera for Elderly People

Measuring respiration at home for cardiac patients, a simple method that can detect the patient&rsquo;s natural respiration, is needed. The purpose of this study was to develop an algorithm for estimating the tidal volume (TV) and respiratory rate (RR) from the depth value of the chest and/or abdomen, which were captured using a depth camera. The data of two different breathing patterns (normal and deep) were acquired from both the depth camera and the spirometer. The experiment was performed under two different clothing conditions (undressed and wearing a T-shirt). Thirty-nine elderly volunteers (male = 14) were enrolled in the experiment. The TV estimation algorithm for each condition was determined by regression analysis using the volume data from the spirometer as the objective variable and the depth motion data from the depth camera as the explanatory variable. The RR estimation was calculated from the peak interval. The mean absolute relative errors of the estimated TV for males were 14.0% under undressed conditions and 10.7% under T-shirt-wearing conditions; meanwhile, the relative errors for females were 14.7% and 15.5%, respectively. The estimation error for the RR was zero out of a total of 206 breaths under undressed conditions and two out of a total of 218 breaths under T-shirt-wearing conditions for males. Concerning females, the error was three out of a total of 329 breaths under undressed conditions and five out of a total of 344 breaths under T-shirt-wearing conditions. The developed algorithm for RR estimation was accurate enough, but the estimated occasionally TV had large errors, especially in deep breathing. The cause of such errors in TV estimation is presumed to be a result of the whole-body motion and inadequate setting of the measurement area

Increased motivation for and use of digital services in heart failure patients participating in a telerehabilitation program:a randomized controlled trial

BACKGROUND: eHealth literacy (eHL) may be an important factor in the adoption of telerehabilitation. However, little is known about how telerehabilitation affects patients’ eHL. The current study evaluated changes over time in eHL for heart failure (HF) patients in a telerehabilitation program (the Future Patient Program) compared to a traditional rehabilitation program. METHODS: As part of a randomized controlled trial comparing telerehabilitation with traditional rehabilitation, 137 HF patients completed the eHealth Literacy Questionnaire (eHLQ) at 6 and 12 months of their respective rehabilitation programs. RESULTS: At 6 months, the telerehabilitation group indicated higher levels of ‘using technology to process health information’ and ‘motivated to engage with digital services’. This difference was consistent over time, and we found no other differences between groups or over time with regard to eHL. CONCLUSIONS: Providing a digital toolbox for processing health information to HF patients may aid in increasing their eHL, motivation, and ability to engage with digital services in HF patients. Especially, if the technology is designed to support patient needs in terms of the educational content of the program. Preferably technology should be provided early on in the rehabilitation process to ensure optimal outcome. TRIAL REGISTRATION: The study was registered in ClinicalTrials.gov (NCT03388918)

Impact of opioid rescue medication for breakthrough pain on the efficacy and tolerability of long-acting opioids in patients with chronic non-malignant pain

There is little evidence that short-acting opioids as rescue medication for breakthrough pain is an optimal long-term treatment strategy in chronic non-malignant pain. We compared clinical studies of long-acting opioids that allowed short-acting opioid rescue medication with those that did not, to determine the impact of opioid rescue medication use on the analgesic efficacy and tolerability of chronic opioid therapy in patients with chronic non-malignant pain. We searched MEDLINE (1950 to July 2006) and EMBASE (1974 to July 2006) using terms for chronic non-malignant pain and long-acting opioids. Independent review of the search results identified 48 studies that met the study selection criteria. The effect of opioid rescue medication on analgesic efficacy and the incidence of common opioid-related side-effects were analysed using meta-regression. After adjusting for potentially confounding variables (study design and type of opioid), the difference in analgesic efficacy between the 'rescue' and the 'no rescue' studies was not significant, with regression coefficients close to 0 and 95% confidence intervals that excluded an effect of more than 18 points on a 0-100 scale in each case. There was also no significant difference between the 'rescue' and the 'no rescue' studies for the incidence of nausea, constipation, or somnolence in both the unadjusted and the adjusted analyses. We found no evidence that rescue medication with short-acting opioids for breakthrough pain affects analgesic efficacy of long-acting opioids or the incidence of common opioid-related side-effects among chronic non-malignant pain patients

Update of the Scientific Opinion on opium alkaloids in poppy seeds

The CONTAM Panel wishes to thank the hearing experts: Pavel Cihlar, Daniel Doerge and Vaclav Lohr for the support provided to this scientific output. The CONTAM Panel acknowledges all European competent institutions and other stakeholders that provided occurrence data on opium alkaloids in food, and supported the data collection for the Comprehensive European Food Consumption Database. Adopted: 22 March 2018 Reproduction of the images listed below is prohibited and permission must be sought directly from the copyright holder:Figure A.1 in Appendix A: © Elsevier.Peer reviewedPublisher PD