Undervisning baseret på færdighedstræning via online aktiviteter med løbende feedback

Med udgangspunkt i en række kurser i biostatistik på det Sundhedsvidenskabelige Fakultet på Københavns Universitet beskriver jeg en ny undervisningsstruktur baseret på en blended learning tilgang med specifikke krav om at de studerende som en del af deres forberedelse skal træne konkrete færdigheder. Træningsaktiviteterne styres via et moderne webbaseret kommunikationsforum og de studerende får hyppig feedback på aktiviteterne dels via et online testsystem og dels ved kollektiv feedback integreret i undervisningssessionerne. På kurserne i biostatistik bliver de studerende sideløbende med ny teori indført i et programmeringsbasereret statistisk computerprogram. Nogle studerende har vanskeligt ved at vænne sig til at programmere men dette kan imødekommes ved at stille krav om at de studerende træner brugen af computerprogrammet på egen hånd: Som en del af forberedelsen skal de studerende orientere sig i computerprogrammet ved hjælp af videoer, tekstmateriale og diskussioner og udføre konkrete træningsopgaver med omgående feedback via et online testsystem. Træningsaktiviteterne integreres i den fysiske undervisning ved at fokusere på de statistiske frem for de tekniske problemer, idet opnåelsen af de tekniske færdigheder primært overlades til de studerendes forberedelse. Med den nye undervisningsstruktur oplever jeg at de studerende får et højere teknisk niveau i det statistiske computerprogram og at dette medfører et højere fagligt statistisk niveau. De studerende er generelt positive over for den nye undervisningsstruktur og finder at den understøtter læreprocessen. Undervisningsstrukturen vil også kunne benyttes i andre fag, hvor de studerende vil have glæde af at blive understøttet i deres forberedelse

Obesity Might Be a Predictor of Weight Reduction after Smoking Cessation

Background and Objectives. Approximately one in five ex-smokers reduces or maintains weight after smoking cessation but little is known about who succeeds to avoid weight gain. The purpose of this study was to identify predictors of weight reduction after long-term smoking cessation in a general population. Methods. Data was obtained from two Danish population-based cohorts (the Inter99 and the Helbred2006 study). Anthropometric measurements were performed by trained research staff. Out of 3.577 daily smokers at baseline 317 participants had quit smoking at the five-year follow-up for at least one year. Multiple logistic regression analysis was performed to determine predictors of weight reduction. Results. Thirteen percent reduced weight by at least 1 kg and 4% maintained their weight. Quitters with obesity had more than seven times higher odds than normal weight quitters to lose weight (OR 7.13 (95% CI 2.76–19.71)), and they had the largest median weight loss of 4.45 kg. The only other significant predictor of weight reduction was low tobacco consumption at baseline. Conclusions. Predictors of weight reduction after smoking cessation were high body mass index and low tobacco consumption at baseline. This study might motivate smokers with obesity to quit smoking and health professionals to give them support

A pedagogical design pattern framework:for sharing experiences and enhancing communities of practice within online and blended learning

”Design patterns” were originally proposed in architecture and later in software engineering as a methodology to sketch and share solutions to recurring design problems. In recent years ”pedagogical design patterns” have been introduced as a way to sketch and share good practices in teaching and learning; specifically in the context of technology-enhanced learning (e-learning). Several attempts have been made to establish a framework for describing and sharing such e-learning patterns, but so far they have had limited success. At a series of workshops in a competence-development project for teachers at the University of Copenhagen a new and simpler pedagogical design pattern framework was developed for interfaculty sharing of experiences and enhancing communities of practice in relation to online and blended learning across the university. In this study, the new pedagogical design pattern framework is applied to describe the learning design in four online and blended learning courses within different academic disciplines: Classical Greek, Biostatistics, Environmental Management in Europe, and Climate Change Impacts, Adaptation and Mitigation. Future perspectives for using the framework for developing new E-learning patterns for online and blended learning courses are discussed

The Use of Videos in Teaching - Some Experiences From the University of Copenhagen

This paper covers videos created and used in different learning patterns. The videos are grouped according to the teaching or learning activities in which they are used. One group of videos are used by the teacher for one-way communication, including: online lectures, experts interacting with one another, instruction videos and introduction videos. Further videos are teacher-student interactive videos, including: feedback on student deliveries, student productions and interactive videos. Examples from different courses at different faculties at The University of Copenhagen of different types of videos (screencasts, pencasts and different kinds of camera recordings, from quick-and-dirty videos made by teachers at their own computer to professionally produced studio recordings) as well as audio files are presented with links, as an empirical basis for the discussion. The paper is very practically oriented and looks at e.g. which course design and teaching situation is suitable for which type of video; at which point is an audio file preferable to a video file; and how to produce videos easily and without specialized equipment, if you don’t have access to (or time for) professional assistance. In the article, we also point out how a small amount of tips & tricks regarding planning, design and presentation technique can improve recordings made by teachers themselves. We argue that the way to work with audio and video is to start by analyzing the pedagogical needs, in this way adapting the type and use of audio and video to the pedagogical context

Efficacy and safety of azithromycin maintenance therapy in primary ciliary dyskinesia (BESTCILIA): a multicentre, double-blind, randomised, placebo-controlled phase 3 trial.

BACKGROUND Use of maintenance antibiotic therapy with the macrolide azithromycin is increasing in a number of chronic respiratory disorders including primary ciliary dyskinesia (PCD). However, evidence for its efficacy in PCD is lacking. We aimed to determine the efficacy and safety of azithromycin maintenance therapy for 6 months in patients with PCD. METHODS The Better Experimental Screening and Treatment for Primary Ciliary Dyskinesia (BESTCILIA) trial was a multicentre, double-blind, parallel group, randomised, placebo-controlled phase 3 trial done at 6 European PCD clinics (tertiary paediatric care centres and university hospitals in Denmark, Germany, Netherlands, Switzerland, and UK). Patients with a confirmed diagnosis of PCD, aged 7-50 years old, and predicted FEV1 greater than 40% were recruited. Participants were randomly assigned (1:1), stratified by age and study site, via a web-based randomisation system to azithromycin 250 mg or 500 mg as tablets according to bodyweight (</≥ 40 kg) or identical placebo, three times a week for 6 months. The random allocation sequence was a permuted block randomisation, with a block size of four, generated by an external consultancy. Participants, investigators, and care providers were masked to treatment allocation. The primary endpoint was the number of respiratory exacerbations over 6 months. Analysis was by intention to treat. This study is registered in the EU Clinical Trials Register, EudraCT number 2013-004664-58. FINDINGS Between June 24, 2014, and Aug 23, 2016, 102 patients were screened, of whom 90 were randomly assigned to either azithromycin (n=49) or placebo (n=41). The study was ended without having included the planned number of participants due to recruitment difficulties. The mean number of respiratory exacerbations over 6 months was 0·75 (SD 1·12) in the azithromycin group compared with 1·62 (1·64) in the placebo group, and participants receiving azithromycin had significantly lower rate of exacerbations during the individual treatment periods (rate ratio 0·45 [95% CI 0·26-0·78]; p=0·004). Four serious adverse events were reported, occurring in one (2%) of 47 participants in the azithromycin group and in three (7%) of 41 participants in the placebo group. Loose stools or diarrhoea were more common in the azithromycin group than in the placebo group (11 [23%] vs two [5%]). INTERPRETATION This first multinational randomised controlled trial on pharmacotherapy in PCD showed that azithromycin maintenance therapy for 6 months was well tolerated and halved the rate of respiratory exacerbations. Azithromycin maintenance therapy is an option for patients with PCD with frequent exacerbations potentially leading to reduced need for additional antibiotic treatments and preventing irreversible lung damage. FUNDING European Commission Seventh Framework Programme and Children's Lung Foundation (Denmark)

Doubly Robust Estimation of Optimal Dynamic Treatment Regimes

We compare methods for estimating optimal dynamic decision rules from observational data, with particular focus on estimating the regret functions defined by Murphy (in J. R. Stat. Soc., Ser. B, Stat. Methodol. 65:331–355, 2003). We formulate a doubly robust version of the regret-regression approach of Almirall et al. (in Biometrics 66:131–139, 2010) and Henderson et al. (in Biometrics 66:1192–1201, 2010) and demonstrate that it is equivalent to a reduced form of Robins’ efficient g-estimation procedure (Robins, in Proceedings of the Second Symposium on Biostatistics. Springer, New York, pp. 189–326, 2004). Simulation studies suggest that while the regret-regression approach is most efficient when there is no model misspecification, in the presence of misspecification the efficient g-estimation procedure is more robust. The g-estimation method can be difficult to apply in complex circumstances, however. We illustrate the ideas and methods through an application on control of blood clotting time for patients on long term anticoagulation