This paper presents a study of Danish young English language learners’ (YELLs’) contact with and use of Extramural English (EE) (N = 107, aged 8 (n = 49) and 10 (n = 58)). They have received little formal English instruction: two weekly lessons for one year. Data on EE-habits were collected with a one-week language diary (self-report with parental guidance). Participants reported minutes spent each day on seven EE-activities: gaming, listening to music, reading, talking, watching television, writing and other. Vocabulary proficiency scores were obtained using the Peabody Picture Vocabulary Test (PPVT™-4). The results show that most time was spent on gaming, music and watching television. Boys gamed significantly more (p < .001) than girls (235 minutes/week vs. 47 minutes/week). Additionally, the results show that gaming with both oral and written English input and gaming with only written English input are significantly related to vocabulary scores, in particular for boys. By investigating the EE-habits of YELLs and relations with second language (L2) English vocabulary learning, this study adds valuable new insights and knowledge about a topic that is becoming increasingly important for children in a globalized world.

Handover has major implications for patient care. The handover process between ambulance and emergency department (ED) staff has been sparsely investigated. The purpose of this paper is, based on a literature review, to identify and elaborate on the major factors influencing the ambulance to ED handover, and to bring suggestions on how to optimize this process. A literature search on handovers to EDs was performed in PubMed, Embase, Web of Science and Cochrane databases. A total of 18 papers were included. Issues regarding transfer of information are highlighted. Newer studies suggest that implementing a structured handover format holds the possibilities for improving the process. Electronic equipment could play a part in reducing problems. Cultural and organizational factors impact the process in different ways. The professions perceive the value and quality of information given differently. Giving and taking over responsibility is an important issue. The handover of patients to the ED has the potential to be improved. Cultural issues and a lack of professional recognition of handover importance need to be approached. Multidisciplinary training in combination with a structured tool may have a potential for changing the culture and improving handover.

No abstract

It is essential for new health information technologies (IT) to undergo rigorous evaluations to ensure they are effective and safe for use in real-world situations. However, evaluation of new health IT is challenging, as field studies are often not feasible when the technology being evaluated is not sufficiently mature. Laboratory-based evaluations have also been shown to have insufficient external validity. Simulation studies seem to be a way to bridge this gap. The aim of this study was to evaluate, using a simulation methodology, the impact of a new prototype of an electronic medication management system on the appropriateness of prescriptions and drug-related activities, including laboratory test ordering or medication changes. This article presents the results of a controlled simulation study with 50 simulation runs, including ten doctors and five simulation patients, and discusses experiences and lessons learnt while conducting the study. Although the new electronic medication management system showed tendencies to improve medication safety when compared with the standard system, this tendency was not significant. Altogether, five distinct situations were identified where the new medication management system did help to improve medication safety. This simulation study provided a good compromise between internal validity and external validity. However, several challenges need to be addressed when undertaking simulation evaluations including: preparation of adequate test cases; training of participants before using unfamiliar applications; consideration of time, effort and costs of conducting the simulation; technical maturity of the evaluated system; and allowing adequate preparation of simulation scenarios and simulation setting. Simulation studies are an interesting but time-consuming approach, which can be used to evaluate newly developed health IT systems, particularly those systems that are not yet sufficiently mature to undergo field evaluation studies.

This paper reports the results of a semi-longitudinal study investigating the role of age of onset in early foreign language (English) learning. We compared two groups of Danish school children (N = 276) who, following an educational reform in 2014, started their first English classes the same year but at different ages. One group (the early starters) was introduced to English in the 1st grade (age 7-8) and the other group (the late starters) in the 3rd grade (age 9-10). Children’s receptive vocabulary, receptive grammar, and phonetic discrimination skills were followed for three years, allowing comparisons across groups and time and tracking learning rate and shortterm proficiency (after one and two years of instruction). Results showed that the late starters outperformed the early starters in most tests. With respect to learning rate, the tests also revealed that the late starters had an advantage in the receptive grammar test, whereas the phonetic discrimination test showed a more diffuse picture with the late starters seemingly halting in development and the early starters advancing. The results also showed gender differences with boys achieving a higher level of proficiency and exhibiting a faster learning rate than girls. The pedagogical implications of the results are discussed.

Use of clinical simulation in the design and evaluation of eHealth systems and applications has increased during the last decade. This paper describes a methodological approach for using clinical simulations in the design and evaluation of clinical information systems. The method is based on experiences from more than 20 clinical simulation studies conducted at the ITX-lab in the Capital Region of Denmark during the last 5 years. A ten-step approach to conducting simulations is presented in this paper. To illustrate the approach, a clinical simulation study concerning implementation of Digital Clinical Practice Guidelines in a prototype planning and coordination module is presented. In the case study potential benefits were assessed in a full-scale simulation test including 18 health care professionals. The results showed that health care professionals can benefit from such a module. Unintended consequences concerning terminology and changes in the division of responsibility amongst healthcare professionals were also identified, and questions were raised concerning future workflow across sector borders. Furthermore unexpected new possible benefits concerning improved communication, content of information in discharge letters and quality management emerged during the testing. In addition new potential groups of users were identified. The case study is used to demonstrate the potential of using the clinical simulation approach described in the paper.

Development and implementation of eHealth is challenging due to the complexity of clinical work practices and organizations. Standardizing work processes and documentation procedures is one way of coping with these challenges, and acceptance of these initiatives and acceptance of the clinical information system are vital for success. Clinical simulation may be used as "boundary objects" and help transferring of knowledge between groups of stakeholders and help to better understand needs and requirements in other parts of the organization. This article presents a case study about design of electronic documentation templates for nurses' initial patient assessment, where clinical simulation was used as a boundary object and thereby achieved mutual clinical agreement on the content. Results showed that meetings prior to and in between workshops allowed all communities of practice an opportunity to voice their point of view and affect the final result. Implications of considering clinical simulations as boundary objects are discussed.

No abstract