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Læringsdesigns, forstået som en formgivning af undervisning i en for andre tilgængelig form, har vundet indpas de senere år især på institutioner for videregående uddannelser. Artiklen sætter fokus på en relativ underbelyst side af læringsdesigns, som vedrører opretholdelsen af et didaktisk råderum for de undervisere der skal anvende læringsdesign, men ikke selv har medvirket i udviklingen af dem. Heri ligger en grundlæggende modstilling, som rejser en række spørgsmål. På basis af studier fra et afsluttet forskningsprojekt undersøges didaktiske råderum i udviklingen og anvendelsen af læringsdesigns. Ved hjælp af videndelingsteori kombineret med didaktisk teori fremstiller artiklen fire modsætningsfyldte tematikker i spændingsfeltet mellem formgivning, deling og genanvendelse af læringsdesigns. Hver af disse tematikker udfoldes og begrundes i artiklen, og på basis heraf udvikles nye begreber, der kan tjene til belysning af egenskaberne ved læringsdesigns med henblik på at fastholde og styrke didaktiske råderum for undervisere.

To gather user input iteratively to develop a matching algorithm for peer-to-peer support and to assess the feasibility and usability of a web-based program to conduct matching.32 caregivers of persons with dementia (PwD) participated in semi-structured focus groups and completed surveys to provide input regarding characteristics deemed valuable in someone they would choose to be connected with for emotional support. Through an iterative process as new information emerged, a web-based prototype and matching algorithm were developed. Caregivers interacted with the prototype and provided feedback indicating ease of accessibility and use, initial impression, and comfort/satisfaction with profile content.All 32 caregivers (age 40-90, education 12/GED-20, sex 88% female, 31% Black/African-American) completed online profiles. Of those who interacted with the prototype, 23 completed the feedback survey, on which 87% had no or only mild difficulty accessing the site, 91% had no difficulty with technology once there, 86% had a very or quite positive initial impression, 91% found it very or quite easy to navigate, 87% rated a very or quite high level of comfort with completing the personal profile questions, and 82% felt very or quite confident the questions asked would lead to a good match.A large majority of caregivers of PwD demonstrated the web-based platform was easy to access and navigate, provided a positive experience, and gathered information that would lead to a good supportive relationship with another caregiver. Phase II will optimize the design and algorithm and evaluate the matching process in 350 caregivers.

Artiklen præsenterer en empirisk undersøgelse af mentoring af nye lærere. I artiklen spørges til, hvad der henholdsvis befordrer og hæmmer at praktisere mentoring for nye lærere med fokus på professionel udvikling. Mentoring på fi re skoler i samme kommune blev fulgt et år. Skolerne var udpeget af kommunen ud fra parametre om forskellighed i forhold til størrelse og erfaringer med mentoring på skolen og ud fra villighed i at deltage i projektet. Undersøgelsen viser, at ledelsens opmærksomhed på professionel udvikling, muligheden for observation, gruppementoring, hvordan man forstår mentors rolle, og udvælgelse af mentor herunder mentorkompetencer ser ud til at have betydning. Dett e udfoldes i artiklen.

Individuals with dementia with Lewy bodies (DLB) commonly die from dementia-related causes, but little is known regarding caregiver experiences during the end-of-life period in DLB. This reflects a critical knowledge gap given the high frequency of informal caregiving for individuals with dementia, high caregiver burden in DLB, and the fact that most individuals with DLB die from this disease. Investigators conducted telephone interviews with family members of individuals who died with DLB in the last 5 years. Investigators used a qualitative descriptive approach to analyze interview transcripts. Participants included 15 children, 13 spouses, and 2 other family members. Interviews averaged 31 min. Major themes included caregivers as the main drivers of care for individuals with DLB throughout the disease course and at the end of life, the impact of DLB features (e.g., fluctuations, hallucinations, and delusions) on end-of-life experiences, experiences relating to the caregiving role, death and post-death experiences, and supports employed by caregivers in the end-of-life period. End-of-life experiences for caregivers of individuals with DLB built on the accumulated burden of the disease course, where caregivers were often responsible for driving DLB care—from making the diagnosis to educating healthcare professionals and double-checking medical decisions. While some end-of-life experiences were consistent with those described in dementia palliative care more generally (e.g., financial stresses, poor sleep, being overwhelmed, and needing increased education and support), many DLB features specifically affected end-of-life caregiver experiences, such as the presence of delusions. Improving caregiver experiences at the end of life in DLB will require improved diagnosis and care for individuals with DLB throughout the disease course and also better strategies for treating behavioral symptoms. More research is needed regarding drivers of quality end-of-life experiences for individuals with DLB and their families and how drivers and strategies may differ between dementias.

Physical exercise has been demonstrated to help maintain cognition in people with Mild Cognitive Impairment (pwMCI). We previously demonstrated yoga’s benefit in maintenance of memory related activities of daily living in pwMCI. Our research also has shown yoga helps sustain positive psychological well-being of care partners at 12 months. In this analysis, we sought to examine the impact of yoga training on physical performance in pwMCI and their care partners. In this multisite, randomized clinical trial, we enrolled 272 patients meeting National Institute on Aging–Alzheimer’s Association criteria for MCI and a care partner. The intervention program was modeled on the Mayo Clinic HABIT Healthy Action to Benefit Independence and Thinking® program. Of 5 possible interventions (memory compensation training, computerized cognitive training, yoga, support group, and wellness education), 1 of 5 interventions was randomly selected to be withheld for each intervention group. This randomization allowed for the examination of the impact of receiving yoga or no yoga on physical functioning [as measured by the Short Physical Performance Battery (SPPB)] up to 1 year post intervention, as well as the comparative effectiveness on physical functioning of the various interventions. There was a general pattern of physical decline on the SPPB over the year in pwMCI, regardless of yoga training (yoga vs. no yoga d=0.06, p=0.79). Among care partners, those who received yoga had better physical function at 12 months compared to those who did not (d=0.39 points, p=0.041). While not reaching statistical significance, yoga training tended to have a greater effect on SPPB than computerized cognitive training (d = 0.46 points, p = .063) or wellness education (d = 0.42 points, p =.088). Participation in yoga had a positive impact on physical performance outcomes at 12 month follow-up for care partners, but did not counteract general physical decline in pwMCI.

Objective In December 2016, 66 health leaders from 14 countries convened at the Salzburg Global Seminar (SGS) to engage in cross-cultural and collaborative discussions centered on 'Rethinking Care Toward the End of Life'. Conversations focused on global perspectives on death and dying, challenges experienced by researchers, physicians, patients and family caregivers. This paper summarizes key findings and recommendations from SGS. Design Featured sessions focused on critical issues of end of life care led by key stakeholders, physicians, researchers, and other global leaders in palliative care. Sessions spanned across several critical themes including: patient/family/caregiver engagement, integrating health and community-based social care, eliciting and honoring patient preferences, building an evidence base for palliative care, learning from system failures, and delivering end of life care in low-resource countries. Sessions were followed by intensive collaborative discussions which helped formulate key recommendations for rethinking and ultimately advancing end of life care. Results Prominent lessons learned from SGS include learning from low-resource countries, development of evidence-based quality measures, implementing changes in training and education, and respecting the personal agency of patients and their families. Conclusion There is a global need to rethink, and ultimately revolutionize end of life care in all countries. This paper outlines key aspects of end of life care that warrant explicit improvement through specific action from key stakeholders.

Baseret på survey, observationer og interviews er det undersøgt, hvordan ”Kompetenceløft i undervisningen” (KiU) sætter sig spor i skolens praksis og hvilke faktorer der har betydning for dette. Resultaterne viser en mangfoldighed af sporsætning. Uddannelsen sætter sig spor såvel i som uden for undervisningen i skolen og det sker i form af både didaktiske kompetencer og faglig selvtillid i kommunikationen med kolleger, elever og forældre. Der er forskelle mellem fag, men ikke signifikante forskelle i udbytte mellem kommunale modeller, i.e. KOPRA i Aarhus kommune. De fleste deltagere refererer til indre-styret motivation. Hæmmende faktorer har været manglende tid, og den afsluttende prøve nævnes også. Her er forskelle mellem KOPRA og ikke-KOPRA. KOPRA lærere nævner i højere grad kollegers anerkendelse som fremmende, men også forventning om kollegasamarbejde som hæmmende, hvis rammerne har manglet lokalt. Resultaterne perspektiveres i en model med KiU didaktiske opmærksomhedsfelter og forslag om mulige didaktiseringsstrategier.

Objective This study aims to provide effect size estimates of the impact of two cognitive rehabilitation interventions provided to patients with mild cognitive impairment: computerized brain fitness exercise and memory support system on support partners' outcomes of depression, anxiety, quality of life, and partner burden. Methods A randomized controlled pilot trial was performed. Results At 6 months, the partners from both treatment groups showed stable to improved depression scores, while partners in an untreated control group showed worsening depression over 6 months. There were no statistically significant differences on anxiety, quality of life, or burden outcomes in this small pilot trial; however, effect sizes were moderate, suggesting that the sample sizes in this pilot study were not adequate to detect statistical significance. Conclusion Either form of cognitive rehabilitation may help partners' mood, compared with providing no treatment. However, effect size estimates related to other partner outcomes (i.e., burden, quality of life, and anxiety) suggest that follow-up efficacy trials will need sample sizes of at least 30–100 people per group to accurately determine significance. Copyright © 2017 John Wiley & Sons, Ltd.

The first Lewy Body Dementia Association (LBDA) Research Centers of Excellence (RCOE) Investigator’s meeting was held on December 14, 2017, in New Orleans. The program was established to increase patient access to clinical experts on Lewy body dementia (LBD), which includes dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD), and to create a clinical trials-ready network. Four working groups (WG) were created to pursue the LBDA RCOE aims: (1) increase access to high-quality clinical care, (2) increase access to support for people living with LBD and their caregivers, (3) increase knowledge of LBD among medical and allied (or other) professionals, and (4) create infrastructure for a clinical trials-ready network as well as resources to advance the study of new therapeutics.

IntroductionDementia with Lewy bodies (DLB) is one of the most common degenerative dementias. Despite the fact that most individuals with DLB die from complications of the disease, little is known regarding what factors predict impending end of life or are associated with a quality end of life.Methods and analysisThis is a multisite longitudinal cohort study. Participants are being recruited from five academic centres providing subspecialty DLB care and volunteers through the Lewy Body Dementia Association (not receiving specialty care). Dyads must be US residents, include individuals with a clinical diagnosis of DLB and at least moderate-to-severe dementia and include the primary caregiver, who must pass a brief cognitive screen. The first dyad was enrolled 25 February 2021; recruitment is ongoing. Dyads will attend study visits every 6 months through the end of life or 3 years. Study visits will occur in-person or virtually. Measures include demographics, DLB characteristics, caregiver considerations, quality of life and satisfaction with end-of-life experiences. For dyads where the individual with DLB dies, the caregiver will complete a final study visit 3 months after the death to assess grief, recovery and quality of the end-of-life experience. Terminal trend models will be employed to identify significant predictors of approaching end of life (death in the next 6 months). Similar models will assess caregiver factors (eg, grief, satisfaction with end-of-life experience) after the death of the individual with DLB. A qualitative descriptive analysis approach will evaluate interview transcripts regarding end-of-life experiences.Ethics and disseminationThis study was approved by the University of Florida institutional review board (IRB202001438) and is listed on clinicaltrials.gov (NCT04829656). Data sharing follows National Institutes of Health policies. Study results will be disseminated via traditional scientific strategies (conferences, publications) and through collaborating with the Lewy Body Dementia Association, National Institute on Aging and other partnerships.

Introduction The patient-centered movement advocates for greater attention to the outcomes that matter most to patients and their families. In neurodegenerative disease, determination of patient and caregiver priorities has received scant attention in part because dementia patients are deemed unreliable reporters. However, people with mild cognitive impairment (MCI) likely retain capacity to report their preferences. Methods In two separate MCI cohorts, we conducted preliminary analyses of patient and caregiver priorities among seven patient and five caregiver outcomes of the HABIT® Healthy Action to Benefit Independence & Thinking program (Mayo Clinic, Rochester, MN, USA). Results Via interview and paper-and-pencil reporting both patient and caregiver respondents’ ranked patient and caregiver quality of life and patient self-efficacy as highest priorities, ranking them ahead of patient and caregiver mood, patient functional status, patient distressing behaviors and caregiver burden. Patients and caregivers tended to value the outcomes for their loved ones higher than their own outcomes. Conclusion Caregivers appeared to be reasonable, but not perfect, proxies for patient reports. Additional research with larger cohorts and a more comprehensive range of outcomes is needed. Electronic supplementary material The online version of this article (doi:10.1007/s40120-016-0049-1) contains supplementary material, which is available to authorized users.

This pilot study examined the functional impact of computerized versus compensatory calendar training in cognitive rehabilitation participants with mild cognitive impairment (MCI). Fifty-seven participants with amnestic MCI completed randomly assigned calendar or computer training. A standard care control group was used for comparison. Measures of adherence, memory-based activities of daily living (mADLs), and self-efficacy were completed. The calendar training group demonstrated significant improvement in mADLs compared to controls, while the computer training group did not. Calendar training may be more effective in improving mADLs than computerized intervention. However, this study highlights how behavioral trials with fewer than 30–50 participants per arm are likely underpowered, resulting in seemingly null findings.

The Dementia with Lewy Bodies (DLB) Consortium has refined its recommendations about the clinical and pathologic diagnosis of DLB, updating the previous report, which has been in widespread use for the last decade. The revised DLB consensus criteria now distinguish clearly between clinical features and diagnostic biomarkers, and give guidance about optimal methods to establish and interpret these. Substantial new information has been incorporated about previously reported aspects of DLB, with increased diagnostic weighting given to REM sleep behavior disorder and 123iodine-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. The diagnostic role of other neuroimaging, electrophysiologic, and laboratory investigations is also described. Minor modifications to pathologic methods and criteria are recommended to take account of Alzheimer disease neuropathologic change, to add previously omitted Lewy-related pathology categories, and to include assessments for substantia nigra neuronal loss. Recommendations about clinical management are largely based upon expert opinion since randomized controlled trials in DLB are few. Substantial progress has been made since the previous report in the detection and recognition of DLB as a common and important clinical disorder. During that period it has been incorporated into DSM-5, as major neurocognitive disorder with Lewy bodies. There remains a pressing need to understand the underlying neurobiology and pathophysiology of DLB, to develop and deliver clinical trials with both symptomatic and disease-modifying agents, and to help patients and carers worldwide to inform themselves about the disease, its prognosis, best available treatments, ongoing research, and how to get adequate support.

BACKGROUND: A major potential barrier for studying behavioral interventions for patients with Mild Cognitive Impairment (MCI) is the willingness and ability of people to enroll in and adhere to behavioral interventions, especially when the intervention involves dyads of patients with MCI and support partners. Details regarding recruitment strategies and processes (such as number of dyads screened) are often missing from reports of behavioral trials. In addition, reports do not detail the reasons a potentially eligible candidate opts out of participation in a research study. OBJECTIVES: To describe the challenges and successes of enrollment and retention in a behavioral trial for persons with MCI and their care partners, and to better understand barriers to participation from the patient’s point of view. DESIGN: Multi-site, randomized trial. SETTING: Major medical centers. PARTICIPANTS: Our accrual target for the study was 60 participants. Potential candidates were patients presenting to memory evaluation clinics whose resulting clinical diagnosis was MCI. A total of 200 consecutive potential candidates were approached about participating in the study across the three sites. INTERVENTION: Detailed recruitment and retention data of a randomized trial comparing two behavioral interventions (memory notebook training versus computer training) provided in two separate training time frames (10 days versus 6 weeks). MEASUREMENTS: Structured interview with those declining to participate in the trial. RESULTS: Overall recruitment 37% with a range of 13%-72% across sites. Overall retention 86% with a range of 74%-94% across sites. CONCLUSIONS: The primary barriers to enrollment from the patient’s perspective were distance to the treatment center and competing comprehensive behavioral programming. However, retention data suggest that those dyads who enroll in behavioral programs are highly committed.

This study aims to provide effect size estimates of the impact of two cognitive rehabilitation interventions provided to patients with mild cognitive impairment: computerized brain fitness exercise and memory support system on support partners' outcomes of depression, anxiety, quality of life, and partner burden.A randomized controlled pilot trial was performed.At 6 months, the partners from both treatment groups showed stable to improved depression scores, while partners in an untreated control group showed worsening depression over 6 months. There were no statistically significant differences on anxiety, quality of life, or burden outcomes in this small pilot trial; however, effect sizes were moderate, suggesting that the sample sizes in this pilot study were not adequate to detect statistical significance.Either form of cognitive rehabilitation may help partners' mood, compared with providing no treatment. However, effect size estimates related to other partner outcomes (i.e., burden, quality of life, and anxiety) suggest that follow-up efficacy trials will need sample sizes of at least 30-100 people per group to accurately determine significance. Copyright © 2017 John WileySons, Ltd.

Denne artikel handler om læseloggen som et pædagogisk redskab til at facilitere dybdegående læringsstrategi, kreativ forståelse, distribueret kognition og som udgangspunkt for en reel dialogisk aktiverende undervisning. Argumentationen baseres på konstruktivistisk læringsteorii et sociokulturelt perspektiv og på Ramsdens teori om overfladestrategi og dybdestrategi i tilegnelse af fagligt stof.

There is a growing emphasis on delivering services for persons with early-stage dementia (ie, ‘‘persons with memory loss,’’ or PWMLs) and their family members (care partners). The goal of this evaluation was to determine whether participation in the Memory Club, a 10- to 13-session joint support group, would result in decreased distress, enhanced preparation for care, and improved feelings of confidence managing the challenges of early-stage dementia. The single group, pre-/post-test evaluation included 63 PWMLs and 61 care partners who participated in three Memory Club sites in Minnesota. Paired T-test results found that care partners reported significant (P < .05) increases in preparation activities, feelings of preparation, and confidence in managing memory loss. The results suggest that the Memory Club can fill an important gap in early-stage dementia care by offering care partners the opportunity to plan, prepare, and increase coping skills in the face of early dementia progression.

With the aging of society, Alzheimer’s disease (AD) poses a potential public health crisis. This potential crisis has spurred research on making an early diagnosis of AD. Progress has been made in identifying AD risk factors, including those involving genetics. This progress has led to hope that prevention models might work in AD as they have in cancer and heart disease. These trends offer exciting new directions in AD research. However, the potential impact of these trends on AD caregivers has received little consideration. The goal of this chapter is to explore the potential impact of early diagnosis, advances in genetics, and prevention models on AD caregivers. An examination of what is currently known in these areas will be followed by discussion of the research, education, practice, and policy needs these trends have created. Finally, we will speculate about future directions in AD caregiving that may result from early diagnosis and prevention efforts.

Medication safety is a special concern for the 30% to 40% of dementia patients who live alone at the time of diagnosis, and it plays an important part in relocation decisions. Televideo monitoring could improve medication self-administration accuracy and improve mood for persons with mild dementia who live alone or spend a significant amount of their day alone. The authors used 2-way interactive video technology to monitor medication compliance of 8 persons with mild dementia. They conducted more than 4000 contacts with these persons and found adequate technical outcome in 82% of calls. End medication compliance was 81% in the video-monitored group compared to 66% in the controls ( P < .05). Comparison of compliance from initial to end ratings revealed that video-monitored participants’ compliance remained stable while unmonitored patients’ compliance fell 12 percentage points, consistent with expectations for dementia. This difference was also significant. Quantitative and qualitative outcome data from this project are presented.

Artiklen er resultatet af en metasyntese om viden om vejledning i nordiske læreruddannelser, udarbejdet fra artikler omhandlende forsknings- og udviklingsarbejder i udvalgte databaser. Forskningsspørgsmålet: Hvilken samlet evident forsknings- og udviklingsviden findes om vejledning i nordiske læreruddannelser fra 2008 – 2014? Hvilke typer af vejledning er beskrevet i relation hertil? 9 ud af 13 artikler blev inkluderet ud fra en kvalitetsvurdering. Den fundne viden handler primært om praktikvejledning. Forskningsviden om vejledning i andre uddannelseskontekster fx karrierevejledning er nærmest fraværende. Metasyntesen viser, at det at kunne praktikvejlede til fortsat professionel udvikling kalder på flere kompetencer og viden, end aktuel praksis viser. The article is the result of a meta-syntheses about counseling in Nordic teacher education, compiled from articles dealing with research- and development work in selected databases. The research question: What kind of evident knowledge is available for counseling in Nordic teacher education from 2008-2014? Which kinds of counseling are described in relation to this? Nine out of 13 articles were assessed as being qualified. The knowledge of counseling is primarily concerning practice guidance, meanwhile research knowledge in other parts e.g. career-counseling is almost absent. The meta-syntheses shows, that continued professional development through practice guidance calls for competence and more knowledge.

In the Center for Didactic Methods and Approaches, VIA University College, we have developed a didactic model of reflection for teachers and managers with the purpose of reflecting on education, teaching, and explaining the educators’ educational paradigms. During the work, we found different understandings of the relationship between teacher education and professional practice. We found that this relationship may impact how a teacher or manager actually practices the profession of education, including the methods teachers employ to teach, the methods the student teachers employ to teach, and on the education totality. We also found that a lack of explanation of the educational paradigms to which teachers adhere may influence students’ optimal professional development.