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We have implemented a methodology for using short videos as a part of a flipped classroom design in an introductory, multi-campus physics course for engineering students. These pre-recorded videos introduced theory and concepts to students ahead of in-class sessions, which enabled a reduction in the time used for traditional lectures. The time spent in classes puts emphasis on student activities, such as quizzes, Q&A sessions with the lecturer answering student-submitted questions, and problem solving. The physics course has a modular design for customized delivery to a multitude of study programmes and is coordinated by a team of teachers who provide localized classes at several campuses. Although teachers manage individual classes, the course uses an open learning environment which allows enrolled students access to all study materials published by any teacher. We present results from a questionnaire investigating student experiences with the use of short videos, by measuring the overall level of satisfaction with the videos, as well as collecting students’ comments to the videos. We investigate correlations between student satisfaction with the videos and the comments they make, and whether students whose teacher is featured in the video are more satisfied than students without a personal relationship with the featured teacher. Students report overall satisfaction with video length and level of precision, while requesting more worked examples and detailed calculations. We identify a set of good practices for flipped classroom designs, based on the students’ feedback.

This paper investigates how guides on Svalbard make sense of their relations to the environment whilst working with mass tourism. The Arctic is heating up more rapidly than any other part of the world, and over the last 30 years the effect of climate change has had a large impact on the environment in the Arctic. The guides as such find themselves living a paradox where their work destroys the nature that they care about and depend on. This paper analyses empirical data collected during four months of fieldwork amongst guides in Svalbard. Throughout the paper, two dimensions are explored: the guides’ relation to and understanding of the environment as well as their ways of caring for it. Building on illustrations of the guides’ preconceptions of the environment, it is shown how the guides in their everyday life are engaged in pro-environmental practices. These practices are embedded in the guides’ reciprocal relationship with the environment, where they negotiate between different trade-offs. The guides thus find a way to navigate the complexity of caring for the environment and working in tourism through their intimate relation to the environment.

Background Cancer patients experience many physical and psychosocial problems for which they need support. WebChoice is an Internet-based, interactive health communication application that allows cancer patients to monitor their symptoms and problems, provides individually tailored information and self-management support, e-communication with expert cancer nurses, and an e-forum for group discussion with other patients. Objective The objective of this study was to examine the effects of WebChoice on symptom distress (primary outcome), depression, self-efficacy, health-related quality of life, and social support (secondary outcomes). Methods In this 1-year repeated-measures randomized controlled trial, 325 breast and prostate cancer patients were randomized into 1 experimental group with access to WebChoice and 1 control group who received URLs of publicly available cancer Web sites. Results Group differences on symptom distress were significant only for the global symptom distress index on the Memorial Symptom Assessment Scale (slope estimate, -0.052 [95% confidence interval, -0.101 to -0.004]; t = 4.42; P = .037). There were no significant group differences on secondary outcomes. Additional analyses showed significant within-group improvements in depression in the experimental group only. In the control group, self-efficacy and health-related quality of life deteriorated significantly over time. Conclusion This randomized controlled trial is one of the first to evaluate effects of an interactive health communication application to support cancer patients in illness management on symptoms. Although only 1 hypothesis was partially supported, the combined results show a clear trend toward better scores in the intervention group on most outcome measures. Implications for practice If findings can be supported with additional research, WebChoice may become an important tool to support nursing care that can equip cancer patients to better manage their illness.

Objective The purpose of this paper was to describe patients' use of a multi-component eHealth application, WebChoice, designed to support cancer patients in illness management. With WebChoice patients can monitor their symptoms, obtain individually tailored, evidence-based self-management support, ask questions to a clinical nurse specialist, communicate with other patients in a Forum, and use a diary. Methods To better understand what components were most helpful, we analyzed user logs of breast and prostate cancer patients who participated in the experimental arm of an RCT to test effects of WebChoice on clinical outcomes. Patients could freely use the system for one year. After 6 months into the study, participants received questionnaires asking about reasons for using the different WebChoice components and their usefulness. Results 103 (64%) patients actively used WebChoice, on average 60 times. The Forum and asking questions to the nurse were used the most, yet there were large individual variations in use patterns. Also, patients used different WebChoice components for different reasons. The e-mail communication with nurses was valued highest. Discussion Differences were found between breast and prostate cancer patients and between patients with a first time diagnosis and metastases or recurrences. The large variations among patients in their use of WebChoice components demonstrate that patients' needs for support vary. Conclusion The use patterns and patients' appraisals of usefulness in this study provide important insights into cancer patients' information and communication behavior that are important for further improvements and the design of eHealth applications for illness management support.

The Danish National Board of Health recommends graduated care of type 2 diabetes patients based on risk stratification. This requires a systematic monitoring of indicators for the development of complications.Retrospective evaluation of type 2 diabetes patients referred from general practice in the 2004-2007 period.1) Diabetes duration = two years, 2) Diabetes control exclusively handled in primary care in the previous two years, 3) Referred from general practice to outpatient assessment by the diabetes centre, 4) The physician used a laboratory affiliated to the Aarhus County laboratory database, 5) Written referral could be found. Data was gathered by reviewing records, searching the laboratory database and register of diabetic eye care service.A total of 97 patients were included. By the time at referral (mean): Age 61.5 years, diabetes duration 8.4 years, body mass index 31.7 kg/m2. In the last two years before referral, the following percentage had at least one p-lipid measurement: 85%, eye examination: 61% and measurement of microalbuminuria: 53%. HbA1c at referral was 9.0% (n = 97), 9.1% (n = 93) seven months before and 8.7% (n = 82) 20 months before referral.Glycaemic control was poor 20 months before referral. The prerequisites for the recommendation of The Danish National Board of Health was not present since eye examination was not performed in 39% and assessment of microalbuminuria was not performed in 47% of the patients in the previous two years before referral.

Internet-based online patient-nurse communication (OPNC) services can constitute an important opportunity to support patients to manage their illness between treatment and rehabilitation while being at home. We explored the content of messages sent by prostate and breast cancer patients to an OPNC service to identify symptoms, problems, concerns and information needs expressed in these messages. Using qualitative content analyses we examined 276 messages sent from 38 breast and 22 prostate cancer patients during 15 months. Two main themes emerged: Concerns about physical symptoms and treatment side effects; and worries and questions about treatment and follow up. Analyses showed that cancer patients have many serious unanswered questions and concerns that can create considerable uncertainty and anxiety. An OPNC service can to a great extent meet patients' need for advice and information and thus be an important health care supplement that can improve quality of care.

A major challenge in the design of Internet support for patients is to organize the content in a way that patients perceive as meaningful and easy to find. We used card sorting and clustering techniques to understand how patients organize cancer-related symptoms and problems into meaningful groups, and compared their symptom categorizations to those done by professional nurses. Patients sorted symptoms into significantly fewer groups than nurses, and had difficulties in distinguishing between symptom types and their associations. Nurses typically organized symptoms by physiological or physical body structure, and classified problems around physical, emotional, and social functioning. This study shows how patients categorize symptoms and problems differently from the professionally-oriented conceptual structures of disease. We used this information to improve the design of a cancer patient support system.

The Danish National Board of Health recommends graduated care of type 2 diabetes patients based on risk stratification. This requires a systematic monitoring of indicators for the development of complications.