ABSTRACT
Background: Inflammatory bowel diseases (IBDs) are chronic diseases that require routine hospital visits and long-term medical treatment for control of disease activity. Factors such as gender may impact the use and need for healthcare. This systematic review aimed to summarize what is known about sex differences in the risk of bowel surgery in patients with IBD Methods: Embase, Medline, CINAHL, and Web of Science abstracts (January 2012 to January 2022) were searched systematically for observational studies examining associations between sex and risk of bowel surgery. Screening and data extraction were performed independently by two reviewers using Covidence. Study data were analysed and reported in accordance with the PRISMA guidelines. Quality assessment of included studies was conducted using the Newcastle- Ottawa Scale for cohort studies. Pooled hazard ratios (HRs) were calculated using random effects model meta-analysis for the risk of surgery In addition, meta-analysis was undertaken to assess the risk of surgery by IBD subtype. The between-study heterogeneity was assessed by calculating the tau-squared and the I-squared statistics Results: Of 9,902 screened articles, 36 studies were included in the review Most studies were retrospective by design (74.6%). In total, 21 of 36 studies found statistically significant sex-based differences in the risk of bowel surgery for IBD patients. A pooled estimate of HRs for the 13 studies eligible for meta-analysis showed a statistically significant increased risk of bowel surgery among male patients (HR: 1.43 [95% confidence interval (CI): 1.09;1.86]) compared to female patients. The between-study heterogeneity was high (I2=88.60 [60.60;96.33] and tau2=0.17 [0.03;0.58]) indicating that the pooled estimate should be interpreted with caution. These findings were consistent with the subgroup analysis for ulcerative colitis (HR: 1.78 [1.16;2.72]), but no statistically significant sex difference in the risk of surgery in Crohn's disease patients was found (HR: 1.26 [0.82;1.93]) Conclusion(s): Sex differences exist in the risk of bowel surgery in IBD patients, and further research is needed to address the underlying causes and consequences of these disparities. It is unclear whether differences are due to underlying biologic mechanisms or are associated with healthcare system related factors such as differential access to care. Surgical procedures or the lack or delay thereof, will have consequences for the further disease trajectory.
ABSTRACT
Increasing use of digital tools in university teaching has drawn scholarly attention to the interaction between pedagogical design and digital technologies. The accelerated transition to online learning following the COVID-19 crisis has raised several questions regarding the links between technological affordances and learning strategies, especially with regard to the role of dialogue in learning. Based on a survey of 51 postgraduate students in a Danish university with Problem Based Learning as explicit teaching strategy, where collaborative interaction and dialogue are regarded as integral to learning, this study investigates how students navigated the altered learning environment. We found that students’ experiences with online teaching demonstrate reduced affordances for learning. They experienced decreased co-involvement in decision-making, decreased collaboration and a changed pedagogical setup that did not support learning through discursive meaning negotiations. Thus, whilst dialogues can be transformed by digital technology, these changes are not necessarily productive within an environment which emphasises democratic discourse. Arguably, the digital transformation will continue to evolve and influence the quality of university teaching. Our paper concludes by discussing the potential of democratic dialogic teaching to stimulate learning ecologies in online and hybrid learning environments. © 2021, ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering.
ABSTRACT
Digital transformation is considered a major change process that takes time and often meets employee resistance and avoidance. The outbreak of COVID-19 forced educators and students to skip the gradual transformation and transfer all teaching activities online. The present paper views this phenomenon as an 'extreme' case and a unique opportunity to gather real time data on how students respond to digital transformation with particular focus on student diversity with regard to the digital threshold. Based on a mixed-data survey with students from a graduate master programme during the first three months of the lockdown, we aim at mapping students' online learning experiences in terms of adaptability, learning outcomes and learning climate. The results are held against current exam performance in order to surface possible correlations between students' response to the online transition and their general study performance. Our research hypothesis is that capturing and understanding initial experiences during the sudden transition to online teaching can be of particular value in rethinking university teaching in a digitized perspective. Such experiences convey a response to an actual need for digitized modes of teaching and tap into the procedural knowledge domain. We conclude by reflecting on the value of creating hybrid learning spaces that may respond to specific educational needs under changing conditions. © 2020 Academic Conferences Limited. All rights reserved.