A mixed method approach to studying self-regulated learning in MOOCs: combining trace data with interviews

To be successful in online education, learners should be able to self-regulate their learning due to the autonomy offered to them. Accurate measurement of learners’ self-regulated learning (SRL) in online education is necessary to determine which learners are in need of support and how to best offer support. Trace data is gathered automatically and unobtrusively during online education, and is therefore considered a valuable source to measure learners’ SRL. However, measuring SRL with trace data is challenging for two main reasons. First, without information on the how and why of learner behaviour it is difficult to interpret trace data correctly. Second, SRL activities outside of the online learning environment are not captured in trace data. To address these two challenges, we propose a mixed method approach with a sequential design. Such an approach is novel for the measurement of SRL. We present a pilot study in which we combined trace data with interview data to analyse learners’ SRL in online courses. In the interview, cued retrospective reporting was conducted by presenting learners with visualizations of their trace data. In the second part of the interview, learners’ activities outside of the online course environment were discussed. The results show that the mixed-method approach is indeed a promising approach to address the two described challenges. Suggestions for future research are provided, and include methodological considerations such as how to best visualize trace data for cued retrospective recall. &nbsp

Underuse of long-term routine hospital follow-up care in patients with a history of breast cancer?

Background: After primary treatment for breast cancer, patients are recommended to use hospital follow-up care routinely. Long-term data on the utilization of this follow-up care are relatively rare. Methods: Information regarding the utilization of routine hospital follow-up care was retrieved from hospital documents of 662 patients treated for breast cancer. Utilization of hospital follow-up care was defined as the use of follow-up care according to the guidelines in that period of time. Determinants of hospital follow up care were evaluated with multivariate analysis by generalized estimating equations (GEE). Results: The median follow-up time was 9.0 (0.3-18.1) years. At fifth and tenth year after diagnosis, 16.1% and 33.5% of the patients had less follow-up visits than recommended in the national guideline, and 33.1% and 40.4% had less frequent mammography than recommended. Less frequent mammography was found in older patients (age > 70; OR: 2.10; 95%CI: 1.62-2.74), patients with comorbidity (OR: 1.26; 95%CI: 1.05-1.52) and patients using hormonal therapy (OR: 1.51; 95%CI: 1.01-2.25). Conclusions: Most patients with a history of breast cancer use hospital follow-up care according to the guidelines. In older patients, patients with comorbidity and patients receiving hormonal therapy yearly mammography is performed much less than recommended

Exposure to low-dose radiation and the risk of breast cancer among women with a familial or genetic predisposition:a meta-analysis

Women with familial or genetic aggregation of breast cancer are offered screening outside the population screening programme. However, the possible benefit of mammography screening could be reduced due to the risk of radiation-induced tumours. A systematic search was conducted addressing the question of how low-dose radiation exposure affects breast cancer risk among high-risk women. A systematic search was conducted for articles addressing breast cancer, mammography screening, radiation and high-risk women. Effects of low-dose radiation on breast cancer risk were presented in terms of pooled odds ratios (OR). Of 127 articles found, 7 were selected for the meta-analysis. Pooled OR revealed an increased risk of breast cancer among high-risk women due to low-dose radiation exposure (OR = 1.3, 95% CI: 0.9- 1.8). Exposure before age 20 (OR = 2.0, 95% CI: 1.3-3.1) or a mean of a parts per thousand yen5 exposures (OR = 1.8, 95% CI: 1.1-3.0) was significantly associated with a higher radiation-induced breast cancer risk. Low-dose radiation increases breast cancer risk among high-risk women. When using low-dose radiation among high-risk women, a careful approach is needed, by means of reducing repeated exposure, avoidance of exposure at a younger age and using non-ionising screening techniques

With whom are you dealing? Using social network analysis as a tool to strengthen service delivery structures for low socioeconomic status populations

Background: Health disparities between populations with different socioeconomic status (SES) are increasing. Although a wide variety of support service organizations and arrangements are in place, no general overview of this social network, its reach, and harmonization of services surrounding low-SES populations are available. The present participatory health research study examined the current network structure and the utility of using social network analysis (SNA) as a tool to improve service delivery structures. Design and methods: We applied a mixed-methods study design. An online-questionnaire was used to examine the relationships among organizations assumed to support low-SES individuals in the municipality of Vaals, the Netherlands. In addition, semi-structured interviews and a networking session were used to examine the current network structure and to explore opportunities for improvement. Results: The SNA revealed a weak network structure, and all interviewed professionals mentioned that the current structure should be improved. Participants indicated that a first step would be to install a central information system. Conclusions: SNA can be a useful tool to gain more in-depth insights into the relations within a service delivery network. The professionals were assisted in discovering new organizations that could help them reach low SES populations and in harmonizing and improving their service delivery

Trained immunity or tolerance : opposing functional programs induced in human monocytes after engagement of various pattern recognition receptors

Article Accepted Date: 29 January 2014. ACKNOWLEDGMENTS D.C.I. received funding from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement HEALTH-2010-260338 (“Fungi in the setting of inflammation, allergy and autoimmune diseases: translating basic science into clinical practices” [ALLFUN]) (awarded to M.G.N.). M.G.N. and J.Q. were supported by a Vici grant of the Netherlands Organization of Scientific Research (awarded to M.G.N.). This work was supported, in part, by National Institutes of Health grant GM53522 to D.L.W. N.A.R.G. was supported by the Wellcome Trust.Peer reviewedPublisher PD

Effect of Fuel Properties on Emissions from Euro 4 and Euro 5 Diesel Passenger Cars

Abstract The EN 590 specification allows up to 7% v/v FAME to be blended into conventional diesel fuel which can then be used in most light-duty diesel vehicles. It is anticipated that higher FAME levels may be needed in order to meet the 10% renewable energy target mandated by the Renewable Energy Directive (2009/EC/28). Certain diesel fuel specification properties are considered to be environmental parameters according to the European Fuels Quality Directive (FQD, 2009/EC/30) and previous regulations. These limits included in the EN 590 specification were derived from the European Programme on Emissions, Fuels and Engine Technologies (EPEFE) which was carried out in the 1990's on diesel vehicles meeting up to Euro 3 emissions standards. These limits could potentially constrain FAME blending levels higher than 7% v/v. No significant work has been conducted to investigate whether relaxing these limits would give rise to efficiency or emissions debits or benefits. For this reason, Concawe was interested in studying the impact of these parameters in Euro 4+ vehicle technology. A test programme has been conducted to evaluate the impact of specific diesel properties on emissions on a Euro 5 light-duty diesel vehicle. Tests were also carried out in a Euro 4 vehicle to provide comparison with previous work. Properties studied were Poly-Aromatic Hydrocarbon (PAH) content, density, and cetane number. The Fatty Acid Methyl Ester (FAME) content was an additional variable in the study. Results of emissions testing will be presented and discussed including effects of the above fuel properties on particulates, NOx, CO2 and fuel consumption

Associations of eczema phenotypes with emotional and behavioural problems from birth until school age. The Generation R Study.

Background Eczema phenotypes and emotional and behavioural problems are highly prevalent in childhood, but their mutual relationship is not fully clear. Objectives To examine the associations of eczema phenotypes with school-age emotional and behavioural problems, and the bidirectional associations of eczema and emotional and behavioural problems from birth until 10 years. Methods This study among 5265 individuals was embedded in a prospective population-based cohort study. Never, early transient, mid-transient, late transient and persistent eczema phenotypes were identified based on parent-reported, physician-diagnosed eczema from age 6 months until 10 years. Emotional (internalizing) and behavioural (externalizing) problems were measured repeatedly using the Child Behavior Checklist from age 15 to 10 years. Cross-lagged models were applied for bidirectional analyses. Results All eczema phenotypes were associated with more internalizing problems and attention problems at age 10 years, compared with never having eczema: range of Z-score differences 014 [95% confidence interval (CI) 001–027] to 039 (95% CI 018–060). Children with early transient eczema had more aggressive behaviour symptoms at age 10 years (Z = 016, 95% CI 005–027). Bidirectional analysis showed that eczema at 0–2 years was associated with more internalizing and externalizing problems at ages 3–6 and 10 years, while, inversely, only internalizing problems at 0–2 years were associated with an increased risk of eczema at age 10 years. Conclusions Eczema phenotypes are very modestly associated with more somatic symptoms and attention problems at school age. Early transient eczema is associated with more aggressive behaviour symptoms. Directional effects seem to occur from early-life eczema to later-life internalizing and externalizing problems, rather than the reverse

Exploring the link between self-regulated learning and learner behaviour in a massive open online course

Background: Learners in Massive Open Online Courses (MOOCs) are presented with great autonomy over their learning process. Learners must engage in self-regulated learning (SRL) to handle this autonomy. It is assumed that learners' SRL, through monitoring and control, influences learners' behaviour within the MOOC environment (e.g., watching videos). The exact relationship between SRL and learner behaviour has however not been investigated. Objectives: We explored whether differences in SRL are related to differences in learner behaviour in a MOOC. As insight in this relationship could improve our understanding of the influence of SRL on behaviour, could help explain the variety in online learner behaviour, and could be useful for the development of successful SRL support for learners. Methods: MOOC learners were grouped based on their self-reported SRL. Next, we used process mining to create process models of learners' activities. These process models were compared between groups of learners. Results and conclusions: Four clusters emerged: average regulators, help seekers, self-regulators, and weak regulators. Learners in all clusters closely followed the designed course structure. However, the process models also showed differences which could be linked to differences in the SRL scores between clusters. Takeaways: The study shows that SRL may explain part of the variability in online learner behaviour. Implications for the design of SRL interventions include the necessity to integrate support for weak regulators in the course structure

A Dutch Cross-sectional Population Survey to Explore Satisfaction of Women with their Breasts

BACKGROUND: Little is known about how satisfied women are with their breasts and which factors influence breast satisfaction. Therefore, the aim of this study was to elucidate this by collecting data on breast satisfaction from the general population in relation to age, body mass index, lifestyle, psychological, and physical well-being. METHOD: This study was a cross-sectional population survey performed in 2019 in the north of the Netherlands, among randomly selected women between 20 and 80 years. Breast satisfaction was measured in the 1334 participants with the preoperative reconstruction BREAST-Q module. Other applied questionnaires were the Hospital Anxiety and Depression Scale, Short Form Survey (SF-36), and a custom-made questionnaire on lifestyle and baseline characteristics. Representativeness was assessed by comparing the participants with Dutch normative data. Possible factors influencing “satisfaction with breasts” were analyzed using multivariate linear regression analyses. RESULTS: The median (IQR) BREAST-Q score for “satisfaction with breasts” was mediocre: 63 (58–79) on a 0–100 scale. Higher age and higher SF-36 scores had a positive effect on breast satisfaction (P < 0.001 and P < 0.001, respectively) and a higher body mass index, smoking and anxiety score greater than 8 were negatively associated (P < 0.001, P = 0.013 and P < 0.001 respectively, multivariate linear regression analyses). CONCLUSION: These data are the first European normative data and can serve as a reference in future population and patient-based studies regarding breast satisfaction

Measurement of neurovascular coupling in neonates

Neurovascular coupling refers to the mechanism that links the transient neural activity to the subsequent change in cerebral blood flow, which is regulated by both chemical signals and mechanical effects. Recent studies suggest that neurovascular coupling in neonates and preterm born infants is different compared to adults. The hemodynamic response after a stimulus is later and less pronounced and the stimulus might even result in a negative (hypoxic) signal. In addition, studies both in animals and neonates confirm the presence of a short hypoxic period after a stimulus in preterm infants. In clinical practice, different methodologies exist to study neurovascular coupling. The combination of functional magnetic resonance imaging or functional near-infrared spectroscopy (brain hemodynamics) with EEG (brain function) is most commonly used in neonates. Especially near-infrared spectroscopy is of interest, since it is a non-invasive method that can be integrated easily in clinical care and is able to provide results concerning longer periods of time. Therefore, near-infrared spectroscopy can be used to develop a continuous non-invasive measurement system, that could be used to study neonates in different clinical settings, or neonates with different pathologies. The main challenge for the development of a continuous marker for neurovascular coupling is how the coupling between the signals can be described. In practice, a wide range of signal interaction measures exist. Moreover, biomedical signals often operate on different time scales. In a more general setting, other variables also have to be taken into account, such as oxygen saturation, carbon dioxide and blood pressure in order to describe neurovascular coupling in a concise manner. Recently, new mathematical techniques were developed to give an answer to these questions. This review discusses these recent developments. © 2019 Hendrikx, Smits, Lavanga, De Wel, Thewissen, Jansen, Caicedo, Van Huffel and Naulaers. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms