Scholarly insight 2016: a Data wrangler perspective

We are pleased to offer you our first Scholarly insight 2016: a Data wrangler perspective. The OU is going through several fundamental changes, whereby strategic, pedagogical informed research and insight what drives student learning and academic performance is essential. Making sense of Big Data in particular can be a challenge, especially when data is stored at different data warehouses and require advanced statistical skills to interpret complex patterns of data. In 2012 the Open University UK (OU) instigated a Data Wrangling initiative, which provided every Faculty with a dedicated academic with expertise in data analysis and whose task is to provide strategic, pedagogical, and sense-making advice to staff and senior management. Given substantial changes within the OU over the last 18 months (e.g., new Faculty structure, real-time dashboards, increased reliance on analytics), an extensive discussion with various stakeholders within the Faculties was initiated to make sure that data wranglers provide effective pedagogical insight based upon best practice and evidence-based analyses and research (see new Data wrangler structure). Demand for actionable insights to help support OU staff and senior management in particular with module and qualification design is currently strong (Miller & Mork, 2013), especially a desire for evidence of impact of “what works” (Ferguson, Brasher, et al., 2016). Learning analytics are now increasingly taken into consideration when designing, writing and revising modules, and in the evaluation of specific teaching approaches and technologies (Rienties, Boroowa, et al., 2016). A range of data interrogation and visualization tools developed by the OU supports this (Calvert, 2014; Toetenel & Rienties, 2016b). With the new ways of working with Data Wrangling, first we have provided our basic statistical analyses in form of our Key Metrics report. Second, from January 2017 onwards we will focus again on dealing with bespoke requests from Faculties, and where possible share the insights across all Schools and Faculties. Third, this Scholarly insight has a different purpose to previous Data wrangler work, namely we aim to provide state-of-the-art and forward looking insights into what drives our students and staff in terms of learning and learning success. Based upon consultation with the Faculties, seven key cross-Faculty themes were identified that influence our students’ learning experiences, academic performance, and retention. The first five chapters focus on how the OU designs modules, formative and summative assessments and feedback, helps students from informal to formal learning, and how these learning designs influence student satisfaction. All five chapters indicate that the way we design our modules fundamentally influences student satisfaction, and perhaps more importantly academic retention. Clear guidelines and good-reads are provided for how module teams, ALs, and others can improve our focus on Students First. In Chapter 6-7, we specifically address how individual student demographics (e.g., age, ethnicity, prior education) and accessibility in particular influence the students’ learning journeys, with concrete suggestions how to support our diverse groups of students. Note that each chapter can be read independently and in any particular order. We are looking forward to your feedback

Characterizing the Use of Telepsychiatry for Patients with Opioid Use Disorder and Cooccurring Mental Health Disorders in Ontario, Canada

Rural patients with opioid use disorder (OUD) face a variety of barriers when accessing opioid agonist therapy (OAT) and psychiatric services, due to the limited supply of physicians and the vast geographic area. The telemedicine allows for contact between patients and their physician—regardless of physical distance. Objective. We characterize the usage of telemedicine to deliver psychiatric services to patients with OUD in Ontario, as well as traits of treatment-seeking patients with opioid dependence and concurrent psychiatric disorders. Methodology. A retrospective cohort study was conducted using an administrative database for patients who received psychiatric services via telemedicine between 2008 and 2014 and who also had OUD. Results. We identified 9,077 patients with concurrent opioid use and other mental health disorders who had received psychiatric services via telemedicine from 2008 to 2014; 7,109 (78.3%) patients lived in Southern Ontario and 1,968 (21.7%) in Northern Ontario. Telemedicine was used more frequently to provide mental health services to patients residing in Northern Ontario than Southern Ontario. Conclusion. Telemedicine is increasingly being utilized throughout Ontario for delivering mental health treatment. There is an opportunity to increase access to psychiatric services for patients with opioid dependence and concurrent psychiatric disorders through the use of the telemedicine

Experiencing Jobcentre Plus Pathfinders : overview of early evaluation evidence

Jobcentre Plus is a key part of the Government's strategy for welfare reform. It brings together the services of the Employment Service and parts of the Benefits Agency to provide a single point of delivery for jobs, benefits advice and support for people of working age. In the process, it aims to provide a work focus to the benefit system for everyone using the service. The first 56 Jobcentre Plus Pathfinder offices, established in October 2001, built upon the ONE service, which from June 1999 had piloted the integration of benefit claiming and work placement/job seeking for all claimants in 12 areas of Britain. A programme of evaluation accompanied the launch of the Jobcentre Plus Pathfinders. This work was designed to provide an early assessment of the Pathfinders, to identify good practice and inform the continuous improvement and future roll out of the service. This overview report has two principal aims. First, it brings together and reports the key findings of qualitative and quantitative evaluations of Jobcentre Plus services at Pathfinder sites that were carried out from October 2001 to May 2002. This was a period during which the implementation of Jobcentre Plus was obstructed by industrial action, a factor that needs to be taken into account when assessing early performance. The findings of this research are then related to comparable research on ONE. Second, it charts the changes made in the provision of Jobcentre Plus since its inception and identifies how Jobcentre Plus has progressed from the ONE service from which it developed

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Modeling and managing learner satisfaction: use of learner feedback to enhance blended and online learning experience

A key concern for most institutions and instructors is whether students are satisfied with their learning experience. However, relatively few studies have unpacked what the key drivers for learner satisfaction are in blended and online courses. Using logistical regression modelling, learner satisfaction data of 62,986 learners in 401 undergraduate blended and online modules was analyzed. The data included over 200 potential explanatory variables based on learner and module learning design characteristics. Findings indicate that learning design has a strong and significant impact on overall satisfaction for both new and continuing learners. Learners who are more satisfied with the quality of teaching materials, assessment strategies, and workload are more satisfied with the overall learning experience. Furthermore, long-term goals of learners (i.e., qualifications and relevance of modules with learners’ professional careers) are important predictors of learner satisfaction. Individual learner characteristics are mostly insignificant, indicating that despite a wide diversity of learners studying at the Open University, UK, the underlying learning experiences are similar. Future research should focus on how learning design changes can enhance the learning experiences of students

Online learning experiences of new versus continuing learners: a large scale replication study

A vast body of research has indicated the importance of distinguishing new versus continuing students’ learning experiences in blended and online environments. Continuing learners may have developed learning and coping mechanisms for “surviving” in such learning environments, while new learners might still need to adjust their learning approaches to the new learning context. In this large scale replication study, we investigated whether and how the learning satisfaction experiences of 16670 new versus 99976 continuing students were different. Using logistical regression modelling of learner satisfaction scores of 422 undergraduate blended and online modules (including 232 learner and module learning design variables), our findings indicated that new learners indeed differed subtly in their learning and teaching experiences across two consecutive academic years. The minor differences in key drivers between the 2014 and 2015 cohorts also indicate that institutions need to continuously monitor and act upon changing learning needs