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Background: This paper proposes a novel approach to the development of competence-oriented higher education, a national transformation aimed at harmonising and digitising undergraduate medical and dental education in Finland. Methods: We apply phenomenography as a viable qualitative method for medical education research. To better understand medical teachers’ expectations towards the change in the educational paradigm, we need to study teachers’ experiences of the current practices in undergraduate medical and dental education. The phenomenographic approach facilitates solid links between research, educational development, and change. Results: The phenomenographic study maps the qualitatively different ways in which medical teachers experience undergraduate medical and dental education practices. The answers reflect the changing educational paradigm in medical schools, suggesting practical implications for further development of medical and dental education and training. Core content analysis is preferred instructional scaffold for both teachers and students to prioritise the extensive medical education objectives. The change towards competence-based orientation is in progress and national co-operation accelerates its impact. Conclusion: There is an obvious need to enrich the content of the current curriculum with national guidelines that aim for congruence in assessment and objectives. Our results suggest an assessment application for the theoretical concepts presented and promote the competence orientation of education throughout the curricula of medical and dental undergraduate education. Moreover, our results contribute to current European discourses on competence-based approaches in higher education. Up-to-date pedagogical faculty development programmes are a key prerequisite for teacher empowerment and future orientation in teaching and learning for healthcare professions.

OBJECTIVE: Lifespace, the physical area in which someone conducts life activities, indicates lived community mobility. This study explored the feasibility of technology-based lifespace measurement for older people with dementia and mild cognitive impairment (MCI), including the generation of a range of lifespace metrics, and investigation of relationships with health and mobility status. METHODS: An exploratory study was conducted within a longitudinal observational study. Eighteen older adults (mean age 86.7 years (SD: 3.2); 8 men; 15 MCI), participated. Lifespace metrics were generated from geolocation data (GPS and Bluetooth beacon) collected through a smartphone application for one week (2015-2016). Cognitive and mobility-related outcomes were compared from study data sets at baseline (2005-2007) and 6-year follow-up (2011-2014). RESULTS: Lifespace data could be collected from all participants, and metrics were generated including percentage of time at home, maximum distance from home, episodes of travel in a week, days in a week participants left home, lifespace area (daily, weekly and total), indoor lifespace (regions in the home/hour), and a developed lifespace score that combined time, frequency of travel, distance and area. Results indicated a large range of lifespace areas (0.1 - 97.88 km2 ; median 6.77 km2 ) with similar patterns across lifespace metrics. Significant relationships were found between lifespace metrics and concurrent driving status and anteceding scores on the sit-to-stand test (at baseline and follow-up). CONCLUSIONS: Further longitudinal exploration of lifespace is required to develop an understanding of the nature of lifespace of older community-dwelling people, and its relationship with health, mobility and well-being outcomes.

Purpose: The twenty-first century education system seeks to meet the societal demands of economic effectiveness and the unique professional development needs of individuals. This paper aims to discuss the qualities of competence-oriented educational processes and the recent movement towards competence-based curricula in higher education. Design/methodology/approach: This study follows a systematic literature review (SLR) methodology to explore the concept of competence within the context of educational science. The subsequent thematic synthesis analyses the findings of reviewed publications regarding graduate attributes in competence-oriented higher education and their perspectives and working-life expectations on exit profiles. Findings: Interest in competence-oriented education, training and learning has grown in recent years, resulting in numerous theoretical and technical pedagogical applications in higher education. Nonetheless, ambiguous terminology presents a significant challenge, which is demonstrated by the inconsistent language of the study’s results. Moreover, there is an obvious need for teachers’ in-service training. The qualitative synthesis of this article will be useful for both educational and working life sectors to inform and promote different perspectives on competence-oriented educational processes. A clear articulation of competences is crucial for reforming higher education to meet students’ interests and recognise their work-life needs. Originality/value: The concept of competence has been under-investigated in higher education research and practices. This study offers novel insights and practical implications for competence-oriented learning concerning the paradigmatic change across higher education.

Digital open badges are gaining popularity as a means of identification and recognition of competences acquired differently. Meanwhile new ways to motivate, scaffold and assess competence-based learning processes in professional development are emerging. This feature offers a summary of the first European doctoral dissertation to address digital open badges and digital open badge-driven learning. The thesis represents a novel application of descriptive statistical methodology to the context of educational research. The primary results culminate in defining digital open badge-driven learning process grounded on the badge constellation of competences. The entity of badge-driven learning includes learning materials, badge criteria, instructional badging, scaffolding and peer support.

Tiivistelmä Muuttuvan työelämän tarpeet ohjaavat entistä painokkaammin kehittämään yhteistyötä korkeakoulutuksen ja työelämän välillä sekä vahvistamaan jatkuvan oppimisen kulttuuria. Yksilötasolla paremmat yleiset työelämätaidot avaavat uusia työllistymismahdollisuuksia ja tukevat opiskelijaa opitun soveltamisessa. Yhteiskunnan tasolla korkeakoulujen työelämäyhteyksien kehitystyöllä varmistetaan työvoiman saatavuutta ja nopeutetaan työllistymistä. Tässä tutkimuksessa tarkastellaan käynnissä olevia ja jo päättyneitä korkeakoulutuksen ja työelämän väliseen yhteistyöhön liittyviä kehittämishankkeita (n=12), niissä tunnistettavia erilaisia työelämäyhteyksien kehittämiseen liittyviä malleja sekä työelämäyhteyksissä tapahtuneita muutoksia 10 viime vuoden aikana. Tutkimusaineisto kerättiin tammi-huhtikuussa 2019 sähköpostikyselyllä sekä puhelin- ja kasvokkaishaastatteluilla. Tutkimusaineistoa täydensivät kehittämishankkeiden hankesuunnitelmat, loppuraportit sekä hankkeiden www-sivut. Aineiston teorialähtöisessä sisällönanalyysissa sovellettiin korkeakoulujen työelämäyhteyksien kehittämismallia (spesialisti-, integratiivinen ja verkostoituneen kulttuurin malli). Työelämäläheisille kehittämishankkeille identifioitavista malleista on löydettävissä eroja alkutilanteessa, mutta yhteinen tavoite on kehittää korkeakoulutusta kohti verkostoituneen kulttuurin mallia sekä yliopistoissa että ammattikorkeakouluissa. Johtopäätöksenä esitämme, että työelämäyhteyksien kehittämismallien avulla voidaan kuvata korkeakoulutuksen työelämärelevanssin kehittymistä tutkittuna ajanjaksona. Systemaattista kehittämistyötä tarvitaan hankkeiden tulosten jalkauttamiseksi ja toimintojen vakiinnuttamiseksi., Development Projects Promoting the Working-Life Relevance of Higher Education Incremental changes in contemporary society increasingly steer collaboration between higher education and working life, simultaneously fostering a culture of continuous learning. Improved working life skills support students in applying theoretical knowledge in practice and help in opening new avenues for future employment. At the societal level, developing connections between higher education and working life improves the availability of relevant workforce and speeds up students’ path to employment, which means more potential employees. In this study, we examine ongoing and finished development projects in Finland (n=12) related to the development of collaboration between higher education and working life, e.g. identifying models or changes in collaboration over the past 10 years. We gathered data from project participants during January–April 2019 through an email survey and through faceto-face or phone interviews. We supplemented the data with project plans, project-end reports and other information gathered from projects’ internet sites. We applied the development model of higher education and working life (specialist, integrative and networked model) in our theory-based content analysis of the data. We found that the greatest differences appear between the identifiable models at the beginning of the projects; however, a clear common goal was to develop higher education toward a networked culture both in universities and universities of applied sciences. As a result, we suggest that the development model of higher education and working life successfully describes the development of working-life relevance during the time period defined in this study. However, systematic developmental work is still required in order to transfer the project results into practice and make them a part of everyday life in higher education institutions.

OBJECTIVES: The objectives of the study are to characterize paretic upper limb (UL) use in people with different levels of impairment 4 weeks poststroke and to compare accelerometry and direct observational approaches. METHODS: Twelve stroke inpatients (five mild, three moderate, and four severe UL impairment) were recruited from a rehabilitation hospital. UL use was measured using accelerometry (24 hr) and direct observation (12 hr of behavioural mapping). Accelerometry variables included duration of use, use ratio, magnitude ratio, bilateral magnitude, and variation ratio. Direct observation recorded the duration of use and type of UL movement (e.g., functional vs. non-functional). RESULTS: From accelerometry data, people with mild, moderate, and severe UL impairments used their paretic UL 59%, 45%, and 22% of a 24 hr-day, respectively. People with severe UL impairment had the lowest paretic UL use duration (median 1.49 hr/day), magnitude ratio, and variation ratio compared with people with mild and moderate UL impairment. From 12 hr of observational data, people with mild impairment were using their UL for 37.8% of the observed time, whereas the people with moderate and severe impairment were using their UL 15.8% and 4.9%, respectively. UL movements for the mild cohort were mainly functional, whereas UL movements of the moderate and severe cohorts were mainly non-functional. UL movements were predominantly active for the mild and moderate cohorts but passive for the severe cohort. Duration of paretic UL use from accelerometry and observation data were highly correlated (ICC > 0.8), but the absolute percentage error between methods ranged from 34.2% to 42.7%. CONCLUSIONS: Paretic UL use within the first 4 weeks poststroke differs across levels of impairment in this exploratory study. Accelerometry and observation findings of paretic UL use were correlated and may be needed in different situations as they capture different information.

Nusa Tenggara, including East Timor, located at the crossroad between Island Southeast Asia, Near Oceania, and Australia, are characterized by a complex cultural structure harbouring speakers from two different major linguistic groups of different geographic origins (Austronesian (AN) and non-Austronesian (NAN)). This provides suitable possibilities to study gene-language relationship; however, previous studies from other parts of Nusa Tenggara reported conflicting evidence about gene-language correlation in this region. Aiming to investigate gene-language relationships including sex-mediated aspects in East Timor, we analysed the paternally inherited non-recombining part of the Y chromosome (NRY) and the maternally inherited mitochondrial (mt) DNA in a representative collection of AN-and NAN-speaking groups. Y-SNP (single-nucleotide polymorphism) data were newly generated for 273 samples and combined with previously established Y-STR (short tandem repeat) data of the same samples, and with previously established mtDNA data of 290 different samples with, however, very similar representation of geographic and linguistic coverage of the country. We found NRY and mtDNA haplogroups of previously described putative East/Southeast Asian (E/SEA) and Near Oceanian (NO) origins in both AN and NAN speakers of East Timor, albeit in different proportions, suggesting reciprocal genetic admixture between both linguistic groups for females, but directional admixture for males. Our data underline the dual genetic origin of East Timorese in E/SEA and NO, and highlight that substantial genetic admixture

Evidence for effective falls prevention interventions in acute wards is limited. One reason for this may be suboptimal program implementation. This study aimed to identify perceived barriers and enablers of the implementation of the 6-PACK falls prevention program to inform the implementation in a randomised controlled trial. Strategies to optimise successful implementation of 6-PACK were also sought. A mixed-methods approach was applied in 24 acute wards from 6 Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on barriers and enablers of 6-PACK implementation was obtained through surveys, focus groups and interviews. Questions reflected the COM-B framework that includes three behaviour change constructs of: capability, opportunity and motivation. Focus group and interview data were analysed thematically, and survey data descriptively. The survey response rate was 60% (420/702), and 12 focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Capability barriers included beliefs that falls could not be prevented; and limited knowledge on falls prevention in patients with complex care needs (e.g. cognitive impairment). Capability enablers included education and training, particularly face to face case study based approaches. Lack of resources was identified as an opportunity barrier. Leadership, champions and using data to drive practice change were recognised as opportunity enablers. Motivation barriers included complacency and lack of ownership in falls prevention efforts. Motivation enablers included senior staff articulating clear goals and a commitment to falls prevention; and use of reminders, audits and feedback. The information gained from this study suggests that regular practical face-to-face education and training for nurses