Mona Lundin

Phases in development of an interactive mobile phone-based system to support self-management of hypertension

Hypertension is a significant risk factor for heart disease and stroke worldwide. Effective treatment regimens exist; however, treatment adherence rates are poor (30%–50%). Improving self-management may be a way to increase adherence to treatment. The purpose of this paper is to describe the phases in the development and preliminary evaluation of an interactive mobile phone-based system aimed at supporting patients in self-managing their hypertension. A person-centered and participatory framework emphasizing patient involvement was used. An interdisciplinary group of researchers, patients with hypertension, and health care professionals who were specialized in hypertension care designed and developed a set of questions and motivational messages for use in an interactive mobile phone-based system. Guided by the US Food and Drug Administration framework for the development of patient-reported outcome measures, the development and evaluation process comprised three major development phases (1, defining; 2, adjusting; 3, confirming the conceptual framework and delivery system) and two evaluation and refinement phases (4, collecting, analyzing, interpreting data; 5, evaluating the self-management system in clinical practice). Evaluation of new mobile health systems in a structured manner is important to understand how various factors affect the development process from both a technical and human perspective. Forthcoming analyses will evaluate the effectiveness and utility of the mobile phone-based system in supporting the self-management of hypertension.

Tasks and instructions on the simulated bridge: Discourses of temporality in maritime training:

In higher education programs that train students for professions with high standards of safety, such as aviation, shipping and healthcare, exercises in simulated environments provide opportunities for training in educational settings. This study explores the use of simulators in maritime education, taking an interest in how navigation training is achieved by using simulated environments. By conducting an interaction analysis of video data, the study examines how training students to coordinate with other vessels in traffic is topicalized in simulator exercises, focusing on discourses of temporality in instructions. The results show how instruction during simulations is a continuous interactional achievement built on the ability to assess the fit between the assessment criteria at work in the specifics of the situation and the ongoing tasks as they unfold. During simulations temporality becomes a matter for instruction, both when assessing how to develop the students’ understanding and as a topic in its own right. The results highlight tightly coupled relationships among tasks, instruction and technology. The implications for simulator-based training call for refocusing on training tasks rather than specific skills, and emphasize the importance of professional guidance in order to guide the students toward the discourses of maritime work practice in simulator-based training.

Patient contributions during primary care consultations for hypertension after self-reportingvia a mobile phone self-management support system

Abstract Objective: This paper reports on how the clinical consultation in primary care is performed under the new premises of patients’ daily self-reporting and self-generation of data. The aim was to explore and describe the structure, topic initiation and patients’ contributions in follow-up consultations after eight weeks of self-reporting through a mobile phone-based hypertension self-management support system. Design: A qualitative, explorative study design was used, examining 20 audio- (n = 10) and video-recorded (n = 10) follow-up consultations in primary care hypertension management, through interaction analysis. Clinical trials registry: ClinicalTrials.gov NCT01510301. Setting: Four primary health care centers in Sweden. Subjects: Patients with hypertension (n = 20) and their health care professional (n = 7). Results: The consultations comprised three phases: opening, examination and closing. The most common topic was blood pressure (BP) put in relation to self-reported variables, for example, physical activity and stress. Topic initiation was distributed symmetrically between parties and BP talk was lifestyle-centered. The patients’ contributed to the interpretation of BP values by connecting them to specific occasions, providing insights to the link between BP measurements and everyday life activities. Conclusion: Patients’ contribution through interpretations of BP values to specific situations in their own lives brought on consultations where the patient as a person in context became salient. Further, the patients’ and health care professionals’ equal contribution during the consultations showed actively involved patients. The mobile phone-based self-management support system can thus be used to support patient involvement in consultations with a person-centered approach in primary care hypertension management Key points   The clinical consultation is important to provide opportunities for patients to gain understanding of factors affecting high blood pressure, and for health care professionals to motivate and promote changes in life-style. This study shows that self-reporting as base for follow-up consultations in primary care hypertension management can support patients and professionals to equal participation in clinical consultations. Self-reporting combined with increased patient–health care professional interaction during follow-up consultations can support patients in understanding the blood pressure value in relation to their daily life. These findings implicate that the interactive mobile phone self-management support system has potential to support current transformations of patients as recipients of primary care, to being actively involved in their own health.

Higher education dominance and siloed knowledge: a systematic review of flipped classroom research

This structured review examined (academic) publications on flipped or inverted classrooms based on all Scopus database (n = 530) references available until mid-June 2016. The flipped or inverted classroom approach has gained widespread attention during the latest decade and is based on the idea of improving student learning by prepared self-studies via technology-based resources (‘flips’) followed by high-quality, in-class teaching and learning activities. However, only a few attempts have been made to review the knowledge of the field of interest more systematically. This article seeks to address this problem and investigates what constitutes the research on flipped classrooms and, in particular, to examine the knowledge contributions with the field so far in relation to the wider research topic of educational technology. This review found that the current state of flipped classrooms as a field of interest is growing fast, with a slight conference preference and a focus on higher education and STEM (science, technology, engineering and math) area contributions, with the US as the predominant geographical context. It is concluded that studies on flipped classrooms are dominated by studies in higher education sector and are relatively local in character. The research tends not to interact beyond the two clusters of general education/educational technology and subject-specific areas. This implies that knowledge contributions related to the flipped classroom approach are relatively siloed and fragmented and have yet to stabilise. Academically and socially, the research is quite scattered, and only local evidence and experiences are available. The knowledge contributions within this field of interest seem to be anecdotal rather than systematically researched. To a large extent, the research lacks anchoring in, for example, learning theory or instructional design known from educational technology traditions and which would have helped much of the flipped classroom research to examine aspects of the flipped classroom approach more fully.

Evolving and re-mediated activities when preschool children play analogue and digital Memory games

The use of apps in preschool has increased considerably during the last few years. Studies have shown that digital technologies are sometimes used to replace analogue artefacts in educational setti...

Digital competence and digital literacy in higher education research: Systematic review of concept use

Abstract Digital competence and digital literacy are concepts that are increasingly used in public discourse. However, how the concepts are used and how they are defined remains unclear. This paper presents a systematic review of research where these concepts are used in higher education research. The aim is to establish an understanding of referencing strategy to digital literacy and digital competence over time, disciplines, countries, methods and level of analysis. Three databases were used in the systematic literature review: Web of Science, Scopus and Education Resources Information Centre. We delimited the search to title, abstract and keywords in the databases. Inclusion criteria were peer-reviewed publications written in English. Initially 107 publications between 1997 and 2017 were found, with 28 addressing digital competence and 79 digital literacy. Our review demonstrates that there is a range of definitions used in higher education research. They vary depending on if the concepts are defined by policy, research or both and whether they focus on technical skills or social practices. This review indicates directions for further research in higher education i) do more research based on critical perspectives to avoid commonsensical use of the concepts, ii) take the development of definitions of these concepts seriously iii) avoid cross-referencing incompatibilities and finally iv) engage in critical investigations regarding the legitimacy of policy over research in the domain of higher education research.

Learning the discourse of quality assurance: A case of workplace learning in online in-service training

Purpose – In this study, online in-service training for people employed in the food production industry is scrutinized. The purpose of this study is to analyse how the participants adapt to such online environments in terms of the kind of discussions they establish. The more specific interest relates to how the participants discuss current work experiences in relation to the contents of quality assurance they are expected to learn. Design/methodology/approach – The data analyzed are Web discussions in forms of chat log files from ten courses. Findings – The results show that, on the one hand, general principles have to be substantiated in the form of concrete examples to actually function as principles and, on the other hand, concrete examples are made interesting only if they have a bearing on a more general issue. Another interesting finding is that the course participants gradually take over the vocabulary of quality assurance; they more frequently write about their work in terms of, e.g. criteria, relevance, estimations and hazards. The conclusion is that Web discussions as part of in-service training constitute a new arena for reflection in and on practice. Originality/value – This is interesting to explore, as it is designed to meet the needs of employers and employees to learn the new set of rules and procedures, which regulate the European food industry. In this respect, the training activities are of direct relevance to daily work practices. Simultaneously, online environments seem to offer flexibility and thus constitute a solution for training in a dispersed industry