Discovering the Learning Gradient of Students' Preferences for Learning Environment

The aim of this study was to examine the effects of online learning self-regulation on learning outcomes during the COVID-19 pandemic lockdown among university college students. Quantitative k-means cluster analysis was used to examine the relationship among students in three different clusters based on their preferences toward online learning. The results indicated that online learning self-regulation had a significant positive effect on learning outcomes due to the shift to online learning. Thus, we identified a "learning gradient" among students, showing that cluster 1 students (preferences for 100% online) have the most positive preferences toward online teaching and the highest degree of self-regulation and learning outcome, cluster 2 students (moderate preferences for both physical and online teaching) are mixed (both positive and negative experiences) and moderate self-regulation and learning outcomes while cluster 3 students (preferences for physical classroom teaching) have the most negative preferences and the lowest self-regulation and learning outcome. The results from this study show that students' self-regulated learning strategies during online teaching environments are important for their learning outcomes and that cluster 1 and 2 students especially profited from the more flexible online learning environment with organized and deep learning approaches. Cluster 3 students need more support from their educators to foster their self-regulation skills to enhance their learning outcomes in online teaching environments.

Associations of health literacy with socioeconomic position, health risk behavior, and health status: a large national population-based survey among Danish adults

BACKGROUND

Health literacy concerns the ability of citizens to meet the complex demands of health in modern society. Data on the distribution of health literacy in general populations and how health literacy impacts health behavior and general health remains scarce. The present study aims to investigate the prevalence of health literacy levels and associations of health literacy with socioeconomic position, health risk behavior, and health status at a population level.

METHODS

A nationwide cross-sectional survey linked to administrative registry data was applied to a randomly selected sample of 15,728 Danish individuals aged ≥25 years. By the short form HLS-EU-Q16 health literacy was measured for the domains of healthcare, disease prevention, and health promotion. Adjusted multinomial logistic regression analyses were used to estimate associations of health literacy with demographic and socioeconomic characteristics, health risk behavior (physical activity, smoking, alcohol consumption, body weight), and health status (sickness benefits, self-assessed health).

RESULTS

Overall, 9007 (57.3%) individuals responded to the survey. Nearly 4 in 10 respondents faced difficulties in accessing, understanding, appraising, and applying health information. Notably, 8.18% presented with inadequate health literacy and 30.94% with problematic health literacy. Adjusted for potential confounders, regression analyses showed that males, younger individuals, immigrants, individuals with basic education or income below the national average, and individuals receiving social benefits had substantially higher odds of inadequate health literacy. Among health behavior factors (smoking, high alcohol consumption, and inactivity), only physical behavior [sedentary: OR: 2.31 (95% CI: 1.81; 2.95)] was associated with inadequate health literacy in the adjusted models. The long-term health risk indicator body-weight showed that individuals with obesity [OR: 1.78 (95% CI: 1.39; 2.28)] had significantly higher odds of lower health literacy scores. Poor self-assessed health [OR: 4.03 (95% CI: 3.26; 5.00)] and payments of sickness absence compensation benefits [OR: 1.74 (95% CI: 1.35; 2.23)] were associated with lower health literacy scores.

CONCLUSIONS

Despite a relatively highly educated population, the prevalence of inadequate health literacy is high. Inadequate health literacy is strongly associated with a low socioeconomic position, poor health status, inactivity, and overweight, but to a lesser extent with health behavior factors such as smoking and high alcohol consumption.

Social isolation, loneliness, socioeconomic status, and health-risk behaviour in deprived neighbourhoods in Denmark: A cross-sectional study

The importance of social isolation and loneliness on our health is widely recognised in previous research. This study compares loneliness in deprived neighbourhood with that in the general population. It further examines whether social isolation and loneliness are associated with health-risk behaviours (including low intake of fruit or vegetables, daily smoking, high-risk alcohol intake, and physical inactivity and their co-occurrence) in deprived neighbourhoods, and whether social isolation and loneliness modify the associations between socioeconomic status and health-risk behaviours. Cross-sectional data from 5113 residents of 12 deprived neighbourhoods in Denmark were analysed using multiple logistic regression. Data on 14,686 individuals from the nationally representative Danish Health and Morbidity Survey 2010 were used as a comparison group with regard to loneliness. Cohabitation status, frequency of meeting with family and friends, participation in voluntary work were used as an indicator to measure social isolation. A question on feeling often unwillingly alone was used as an indicator to measure loneliness. Compared with the general population, residents of deprived neighbourhoods had higher odds of loneliness. Both social isolation and loneliness were significantly associated with higher odds of health-risk behaviour. When social isolation and loneliness were combined with low socioeconomic status, strong associations with health-risk behaviours were found. Social isolation and loneliness did not significantly modify the associations between socioeconomic status and health-risk behaviour. The findings in this study have important implications for the future planning of health promotion intervention programmes aimed to reduce health-risk behaviour in deprived neighbourhoods.

Social network resources and self-rated health in a deprived Danish neighborhood

Research has demonstrated that living in a deprived neighborhood contributes to the occurrence and development of poor health. Furthermore evidence shows that social networks are fundamental resources in preventing poor mental health. Neighborhood relationships and networks are vital for sustaining and improving quality of life. However, to determine potentials for public health action, the health impact of various types of network resources need to be explored and the association between socioeconomic position and self-rated health needs to be analysed to determine whether it is partially explained by social network resources. This is the main aim of this article. Cross-sectional data from one deprived neighborhood located in Denmark were collected in 2008 and 2013 using a postal health survey. The target group was defined as adults older than 16 years. In 2008, 408 residents participated in the survey, and 405 residents participated in 2013. Our main explanatory variables were indicators of socioeconomic positions and social network resources. The analyses were conducted using univariate and bivariate analyses and multiple logistic regressions. The results showed that there was a significant decrease in respondents being involuntarily alone during the period from 2008 to 2013. An impact of the association between disposable income and self-rated health was found, showing that low income residents with a better social network also have slightly higher odds of having good self-rated health compared with residents with higher income. This investigation is the first Danish study that repeats a health survey in the same neighborhood to measure possible improvement in health among residents. More longitudinal research is needed in the future to explore the complex relationship between social network resources, social capital and health in neighborhoods.

Health-risk behaviour among residents in deprived neighbourhoods compared with those of the general population in Denmark: A cross-sectional study

This study compares health-risk behaviours (including the co-occurrence of health-risk behaviours) of residents in the deprived neighbourhoods with those of the general population of Denmark. It also examines associations between sociodemographic and socioeconomic characteristics and health-risk behaviours in deprived neighbourhoods in Denmark. Even after adjustment for socioeconomic characteristics there were large differences in health-risk behaviours between residents in deprived neighbourhoods and the general population. In the deprived neighbourhoods large sociodemographic and socioeconomic differences in health-risk behaviours were found among the residents. Our findings highlight the need for health promotion programmes targeting residents in deprived neighbourhoods.

Experiences with Recruitment of Marginalized Groups in a Danish Health Promotion Program: A Document Evaluation Study

Background

Studies have found that marginalized groups living in deprived neighborhoods are less likely to participate in health programs compared to the majority of society. This study evaluates recruitment approaches conducted during a national government-funded project in 12 deprived neighborhoods across Denmark between 2010 and 2014. The aim of this study was to understand how recruitment approaches could promote participation in health programs within deprived neighborhoods to reach marginalized groups.

Method

Documents from all 12 of the included municipalities were collected to conduct a document evaluation. The collected documents consisted of 1,500 pages of written material with 12 project descriptions, three midterm and 10 final evaluations. The collected data were analyzed through a qualitative content analysis.

Results

The results are based on the fact that only 10 municipalities have developed evaluations related to recruitment, and only three evaluations provided a description of which marginalized groups were recruited. Challenges related to recruitment consist of difficulties involving the target group, including general distrust, language barriers and a lack of ability to cope with new situations and strangers. Additional geographical challenges emerged, especially in rural areas. Positive experiences with recruitment approaches were mainly related to relationship building and trust building, especially through face-to-face contact and the project employees’ presence in the neighborhood. Additionally, adjusting some of the interventions and the recruitment strategy increased participation.

Conclusion

This study found that relation and trust between the residents and the project employees is an important factor in the recruitment of marginalized groups in deprived neighborhoods as well as adjusting the health interventions or recruitment strategy to the target groups. In future research, it is necessary to examine which recruitment approaches are effective under which circumstances to increase participation among marginalized groups.

Reasons for women's non-participation in follow-up screening after gestational diabetes

BACKGROUND

Due to the increased risk of type 2 diabetes, follow-up screening after birth is recommended to women with previous gestational diabetes. Low participation in such screening has been shown to delay detection of diabetes with potentially serious consequences for the women's future health. The women's experiences of treatment and care during their pregnancies may affect participation.

AIM

This study aimed at understanding the women's experiences with treatment and care during pregnancy and to understand how these experiences influence participation in follow-up screening.

METHODS

A qualitative study was undertaken drawing on a phenomenological methodology. Seven women treated for gestational diabetes at a university hospital in the North Denmark Region participated in interviews.

FINDINGS

The women experienced lack of continuity in care between hospital departments and health sectors. We identified the following causes for low participation in follow-up screening: poor coordination, little elaboration of information, a lack of clear coordination of responsibility for follow-up screening among health care professionals and absence of focus and inclusion of their individual needs and preferences.

CONCLUSION

The women wished to be reminded of screening to increase their sense of safety. The women's experiences seem to reflect a lack of patient-centeredness during the pregnancy, which may be remedied by increasing the focus on the women's need for improved continuity in treatment and care. Participation in follow-up screening after gestational diabetes may be increased by sending reminders to the women. Raised awareness of the women's individual needs and preferences for treatment and care offers potential for improvement.

The association between social position and self-rated health in 10 deprived neighbourhoods

Background

A number of studies have shown that poor self-rated health is more prevalent among people in poor, socially disadvantaged positions. The aim of the present study was to investigate the association between self-rated health and social position in 10 deprived neighbourhoods.

Methods

A stratified random sample of 7,934 households was selected. Of these, 641 were excluded from the study because the residents had moved, died, or were otherwise unavailable. Of the net sample of 7,293 individuals, 1,464 refused to participate, 885 were not at home, and 373 did not participate for other reasons, resulting in an average response rate of 62.7%. Multiple logistic regression models were used to estimate the associations between the number of life resources and the odds of self-rated health and also between the type of neighbourhood and the odds of self-rated health.

Results

The analysis shows that the number of life resources is significantly associated with having poor/very poor self-rated health for both genders. The results clearly suggest that the more life resources that an individual has, the lower the risk is of that individual reporting poor/very poor health.

Conclusions

The results show a strong association between residents’ number of life resources and their self-rated health. In particular, residents in deprived rural neighbourhoods have much better self-rated health than do residents in deprived urban neighbourhoods, but further studies are needed to explain these urban/rural differences and to determine how they influence health.

Svømmetilbud målrettet etniske kvinder, Procesevaluering af en svømmeintervention

<p><em>Evaluation of a swimming-intervention targeting female ethnical minorities.<br /> </em><em>A health-promoting intervention in Korskærparken, established by the municipality of Fredericia, has been evaluated to identify potentials and barriers in health promotion targeting ethnic minorities. Factors that had a major effect in the success of the intervention were; a nearly cost free arrangement; the target groups ownership in the intervention; the fact that cultural and gender barriers were taken into account and the recruitment of participants through the local community, mentors and other participants. Barriers included dependence on economic support and practical arrangement. </em><strong><em></em></strong></p>

Social ulighed i sundhed i et udsat boligområde: En undersøgelse af sammenhængen mellem selvvurderet helbred, etnicitet og social position

<p><em>The purpose of this study was to investigate the association between self-rated health, ethnicity and social position in a deprived neighbourhood in Denmark where many residents have a non-western background. In the article we investigate associations between self-rated health as dependent variable and ethnicity and social position (defined by an “index for resources of living conditions”) as independent variables. The study is based on survey data collected in a geographically bounded and socially deprived neighbourhood. The analyses were conducted by logistic regression models.The results shows a strong connection between the residents “social position” and their self-rated health. In this investigation we were not able to identify any connection between ethnicity and self-rated health which indicates that ethnicity does not constitute an explanation per se for differences in self-rated health.</em></p>

[Use of multiple intervention progammes in community health projects]

An organising framework for multiple interventions in community health is described. The framework provides a foundation for programmatic research on multiple interventions. Multiple intervention programmes are characterised by the use of multiple strategies targeted at multiple levels of the socio-ecological system. A short description is given of the framework and an identification of gaps and challenges based on the international literature and critical questions are posed that need to be considered if this framework should be implemented in Danish communities.

The association between socio-demographic characteristics and perceived stress among residents in a deprived neighbourhood in Denmark

BACKGROUND

It is known that stress is associated with various negative health outcomes, and higher levels are found among people with low socio-economic status (SES) compared with those better-off. Evidence of the characteristics of deprived neighbourhoods with negative impact on health and stress is accumulating while little is known about the stress variation by the socio-demographic characteristics of the dwellers. The present study aimed to investigate how stress varies by socio-demographic characteristics of the residents in a deprived neighbourhood.

METHODS

The data used in this article were collected in the spring 2009. The 1160 participants, aged 16-104 years were randomly selected among the residents in a deprived neighbourhood in Esbjerg, Denmark. The survey was conducted through telephone and face to face interviews. Multiple linear regression analyses were carried on to examine the association of perceived stress with age, gender, ethnicity, education, civil status, economy, unemployment, sick leave, social deprivation and loneliness.

RESULTS

The results show higher levels of stress among women, immigrants, poor and lonely compared with their counterparts. Stress decreases as the economy situation improves and people get old. Education, civil status and unemployment, initially significant, lost power in association with stress when income and economic deprivation were taken into account.

CONCLUSION

The results of this study suggest that variation in the stress levels across socio-demographic characteristics may have specific features among people in the low SES hierarchy, dwellers of a deprived neighbourhood.

[Good experiences with collaboration between research and practice in public health]

In order to evaluate the first year of collaboration between Unit for Health Promotion Research (SDU) and three municipalities a survey was completed with respondents from municipalities. The evaluation showed gains: increased use of research-based working methods, image lift, concrete products delivered, and support in project development. Challenges experienced: different working traditions, translating research into practical know-how, and lack of capacity for knowledge exchange. Future development will include building capacity for knowledge exchange and finding methods for handling the organisational barriers.

Origin of human motor readiness field linked to left middle frontal gyrus by MEG and PET

Combined magnetoencephalography and positron emission tomography identified a prior source of activity in the left middle frontal gyrus during uncued movements of the right index finger. Voluntary movements gave rise to a change in the cortical electrical potential known as the Bereitschaftspotential or Readiness Potential, recorded as early as 1500 ms before the onset of movement. The Readiness Field is the magnetic field counterpart to the Bereitschaftspotential. In the present study, magnetoencephalography identified four successively active sources of fluctuation in the Readiness Field in the period from 900 ms before, to 100 ms after, the onset of the movement. The first source to be active was registered between 900 and 200 ms prior to the onset of the movement. This source of initial activity was mapped by positron emission tomography to the middle frontal gyrus, Brodmann area 9. The three sources subsequently to be active were mapped to the supplementary motor area, premotor cortex, and motor cortex (M1), all in the left hemisphere.

Auditory event-related magnetic fields in a tone-duration discrimination task. Source localization for the mismatch field and for a new component M2"

Auditory event related magnetic fields were measured using an odd-ball paradigm in which the rare event was a tone of short duration, D2, and the frequent one a tone of longer duration, D1. The subjects were required to attend to and count the number of rare stimuli. In the average across target stimuli a mismatch field (MMF) occurs and the dependence of the MMF, especially its latency, on the tone duration D2 is examined in detail. The location of an equivalent current dipole for the MMF-source is found and turns out to be at variance with earlier results. In addition to the MMF we propose a new component, here called M2", which in time overlaps the magnetic equivalent of the P200 signal and which has a source location (equivalent current dipole) lying rather close to the MMF-source. The two sources are, however, active at latencies differing by a time equal to D2. We speculate that M2" indicates the onset of the process: "evaluation of tone-duration" while the MMF indicates the end of this process.

Dependence of the auditory evoked magnetic field (100 msec signal) of the human brain on the intensity of the stimulus

The intensity dependence of the 100 msec magnetic field signal evoked by contralateral application of a tone burst stimulus has been examined for both hemispheres and for a number of frequencies. In all cases the component of the magnetic field normal to the skull was measured; in some cases this component was oriented in the outward direction (group 1 and some group 2 subjects), in the other cases in the inward direction (group 2). The experimental results were analysed in terms of an equivalent current dipole model. The analysis gave rise to the introduction of a transit time (tau 0 approximately 60 msec) from the onset of the stimulus to the activation of the current dipole and to the introduction of a functional relationship between the dipole moment and a 'reduced' intensity, and between the latency and the 'reduced' intensity. Further, the reproducibility of the signal was verified.