Vurdering fra et elevperspektiv: En kvalitativ studie om hvordan elever på ungdomstrinnet forstår tilbakemeldinger på en skriveoppgave i norsk

Hvordan forstår et utvalg elever på 9. trinn lærerens tilbakemeldinger på en skriveoppgave i norsk? Problemstillingen som danner utgangspunktet for denne studien, fokuserer på vurdering fra et elevperspektiv. Fordi vurdering er til for elevenes læring, er det viktig å forstå hvordan elevene selv forstår tilbakemeldinger de får. Det foreligger mye forskning omkring god responspraksis, men hvordan elever forstår og opplever tilbakemeldinger er fremdeles et perspektiv som er mindre diskutert. For å svare på problemstillingen tar studien utgangspunkt i to forskningsspørsmål: 1) Hvilke refleksjoner gjør elevene seg rundt tilbakemeldingene de har fått på skriveoppgaven? 2) Hvordan utvikler elevenes forståelse seg i løpet av intervjusamtalene? Problemstillingen undersøkes gjennom en kvalitativ casestudie, der fem elever på 9. trinn ved en ungdomsskole er intervjuet. Intervjuene baserer seg på tilbakemeldinger elevene har fått på en tidligere skriveoppgave knyttet til et prosessorientert skriveforløp som del av et tverrfaglig samarbeid mellom norsk og naturfag. Oppgaven tar et teoretisk perspektiv for å forstå den formative interaksjonen mellom lærer og elev, der ideen om at formativ vurdering baserer seg på moments of contingency danner utgangspunktet for forståelsen av et dialogbasert syn på læring. Studien tar utgangspunkt i at refleksjonene elevene gjør seg, strekker seg fra et affektivt aspekt mot mer kognitivt orienterte refleksjoner knyttet til vurderingskriteriene. Det viser seg at informantene opplever en form for uoverensstemmelse mellom tilbakemeldinger som knytter seg til de enkelte vurderingskriteriene, og tilbakemeldinger knyttet til deres innsats. Tilbakemeldingene en som lærer gir skal både gis i henhold til kriteriene for oppgaven, men også gis på en forståelig måte for den enkelte elev. En kan forstå denne formative interaksjonen som spennet mellom ekstern stimulus og tilbakemelding på den ene siden, og det interne, bakenforliggende hos hver enkelt elev – ryggsekken de bærer med seg, fylt med ulike erfaringer. Det viser seg at det innenfor den formative vurderingssituasjonen er et moment som er vanskelig for læreren å kontrollere – nemlig interaksjonen mellom det interne og det eksterne aspektet. Dette viser seg i studien ved at informantene opplever tilbakemeldingene ulikt. Studien bidrar til økt fokus på hvordan det ligger et uforløst potensial i samspillet som utgjør tilbakemeldingene. En utvidet dialog rundt tilbakemeldinger elever får, kan se ut til å styrke den formative funksjonen til vurdering

The Danish Atrial Fibrillation Registry:A Multidisciplinary National Pragmatic Initiative for Monitoring and Supporting Quality of Care Based on Data Retrieved from Administrative Registries

AIM: The Danish Atrial Fibrillation (AF) Registry monitors and supports improvement of quality of care for all AF patients in Denmark. This report describes the registry's administrative and organizational structure, data sources, data flow, data analyses, annual reporting, and feedback between the registry, clinicians, and the administrative system. We also report the selection process of the quality indicators and the temporal trends in results from 2017-2021.METHODS AND RESULTS: The Danish AF Registry aims for complete registration and monitoring of care for all patients diagnosed with AF in Denmark. Administrative registries provide data on contacts to general practice, contacts to private cardiology practice, hospital contacts, medication prescriptions, updated vital status information, and biochemical test results. The Danish Stroke Registry provides information on stroke events. From 2017 to 2021, the proportion with a reported echocardiography among incident AF patients increased from 39.9% (95% CI: 39.3-40.6) to 82.6% (95% CI: 82.1-83.1). The initiation of oral anticoagulant therapy among patients with incident AF and a CHA2DS2-VASc score of ≥1 in men and ≥2 in women increased from 85.3% (95% CI: 84.6-85.9) to 90.4% (95% CI: 89.9-91.0). The 1-year and 2-year persistence increased from 85.2% (95% CI: 84.5-85.9) to 88.7% (95% CI: 88.0-89.3), and from 85.4% (95% CI: 84.7-86.2) to 88.2% (95% CI: 87.5-88.8), respectively. The 1-year risk of ischemic stroke among prevalent patients with AF decreased from 0.88% (95% CI: 0.83-0.93) to 0.71% (95% CI: 0.66-0.75). Variation in clinical performance between the five administrative Danish regions was reduced.CONCLUSION: Continuous nationwide monitoring of quality indicators for AF originating from administrative registries is feasible and supportive of improvements of quality of care.</p

Phenotype and genotype of 87 patients with Mowat-Wilson syndrome and recommendations for care

Mowat-Wilson syndrome (MWS) is a rare intellectual disability/multiple congenital anomalies syndrome caused by heterozygous mutation of the ZEB2 gene. It is generally underestimated because its rarity and phenotypic variability sometimes make it difficult to recognize. Here, we aimed to better delineate the phenotype, natural history, and genotype-phenotype correlations of MWS.MethodsIn a collaborative study, we analyzed clinical data for 87 patients with molecularly confirmed diagnosis. We described the prevalence of all clinical aspects, including attainment of neurodevelopmental milestones, and compared the data with the various types of underlying ZEB2 pathogenic variations.ResultsAll anthropometric, somatic, and behavioral features reported here outline a variable but highly consistent phenotype. By presenting the most comprehensive evaluation of MWS to date, we define its clinical evolution occurring with age and derive suggestions for patient management. Furthermore, we observe that its severity correlates with the kind of ZEB2 variation involved, ranging from ZEB2 locus deletions, associated with severe phenotypes, to rare nonmissense intragenic mutations predicted to preserve some ZEB2 protein functionality, accompanying milder clinical presentations.ConclusionKnowledge of the phenotypic spectrum of MWS and its correlation with the genotype will improve its detection rate and the prediction of its features, thus improving patient care.GENETICS in MEDICINE advance online publication, 4 January 2018; doi:10.1038/gim.2017.221

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school&#x2;aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Phenotype and genotype of 87 patients with Mowat–Wilson syndrome and recommendations for care

Purpose: Mowat–Wilson syndrome (MWS) is a rare intellectual disability/multiple congenital anomalies syndrome caused by heterozygous mutation of the ZEB2 gene. It is generally underestimated because its rarity and phenotypic variability sometimes make it difficult to recognize. Here, we aimed to better delineate the phenotype, natural history, and genotype–phenotype correlations of MWS. Methods: In a collaborative study, we analyzed clinical data for 87 patients with molecularly confirmed diagnosis. We described the prevalence of all clinical aspects, including attainment of neurodevelopmental milestones, and compared the data with the various types of underlying ZEB2 pathogenic variations. Results: All anthropometric, somatic, and behavioral features reported here outline a variable but highly consistent phenotype. By presenting the most comprehensive evaluati

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Vurdering fra et elevperspektiv: En kvalitativ studie om hvordan elever på ungdomstrinnet forstår tilbakemeldinger på en skriveoppgave i norsk

Hvordan forstår et utvalg elever på 9. trinn lærerens tilbakemeldinger på en skriveoppgave i norsk? Problemstillingen som danner utgangspunktet for denne studien, fokuserer på vurdering fra et elevperspektiv. Fordi vurdering er til for elevenes læring, er det viktig å forstå hvordan elevene selv forstår tilbakemeldinger de får. Det foreligger mye forskning omkring god responspraksis, men hvordan elever forstår og opplever tilbakemeldinger er fremdeles et perspektiv som er mindre diskutert. For å svare på problemstillingen tar studien utgangspunkt i to forskningsspørsmål: 1) Hvilke refleksjoner gjør elevene seg rundt tilbakemeldingene de har fått på skriveoppgaven? 2) Hvordan utvikler elevenes forståelse seg i løpet av intervjusamtalene? Problemstillingen undersøkes gjennom en kvalitativ casestudie, der fem elever på 9. trinn ved en ungdomsskole er intervjuet. Intervjuene baserer seg på tilbakemeldinger elevene har fått på en tidligere skriveoppgave knyttet til et prosessorientert skriveforløp som del av et tverrfaglig samarbeid mellom norsk og naturfag. Oppgaven tar et teoretisk perspektiv for å forstå den formative interaksjonen mellom lærer og elev, der ideen om at formativ vurdering baserer seg på moments of contingency danner utgangspunktet for forståelsen av et dialogbasert syn på læring. Studien tar utgangspunkt i at refleksjonene elevene gjør seg, strekker seg fra et affektivt aspekt mot mer kognitivt orienterte refleksjoner knyttet til vurderingskriteriene. Det viser seg at informantene opplever en form for uoverensstemmelse mellom tilbakemeldinger som knytter seg til de enkelte vurderingskriteriene, og tilbakemeldinger knyttet til deres innsats. Tilbakemeldingene en som lærer gir skal både gis i henhold til kriteriene for oppgaven, men også gis på en forståelig måte for den enkelte elev. En kan forstå denne formative interaksjonen som spennet mellom ekstern stimulus og tilbakemelding på den ene siden, og det interne, bakenforliggende hos hver enkelt elev – ryggsekken de bærer med seg, fylt med ulike erfaringer. Det viser seg at det innenfor den formative vurderingssituasjonen er et moment som er vanskelig for læreren å kontrollere – nemlig interaksjonen mellom det interne og det eksterne aspektet. Dette viser seg i studien ved at informantene opplever tilbakemeldingene ulikt. Studien bidrar til økt fokus på hvordan det ligger et uforløst potensial i samspillet som utgjør tilbakemeldingene. En utvidet dialog rundt tilbakemeldinger elever får, kan se ut til å styrke den formative funksjonen til vurdering