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Background: Many cancer patients seek homeopathy as a complementary therapy. It has rarely been studied systematically, whether homeopathic care is of benefit for cancer patients. Methods: We conducted a prospective observational study with cancer patients in two differently treated cohorts: one cohort with patients under complementary homeopathic treatment (HG; n=259), and one cohort with conventionally treated cancer patients (CG; n=380). For a direct comparison, matched pairs with patients of the same tumour entity and comparable prognosis were to be formed. Main outcome parameter: change of quality of life (FACT-G, FACIT-Sp) after 3 months. Secondary outcome parameters: change of quality of life (FACT-G, FACIT-Sp) after a year, as well as impairment by fatigue (MFI) and by anxiety and depression (HADS). Results: HG: FACT-G, or FACIT-Sp, respectively improved statistically significantly in the first three months, from 75.6 (SD 14.6) to 81.1 (SD 16.9), or from 32.1 (SD 8.2) to 34.9 (SD 8.32), respectively. After 12 months, a further increase to 84.1 (SD 15.5) or 35.2 (SD 8.6) was found. Fatigue (MFI) decreased; anxiety and depression (HADS) did not change. CG: FACT-G remained constant in the first three months: 75.3 (SD 17.3) at t0, and 76.6 (SD 16.6) at t1. After 12 months, there was a slight increase to 78.9 (SD 18.1). FACIT-Sp scores improved significantly from t0 (31.0 - SD 8.9) to t1 (32.1 - SD 8.9) and declined again after a year (31.6 - SD 9.4). For fatigue, anxiety, and depression, no relevant changes were found. 120 patients of HG and 206 patients of CG met our criteria for matched-pairs selection. Due to large differences between the two patient populations, however, only 11 matched pairs could be formed. This is not sufficient for a comparative study. Conclusion: In our prospective study, we observed an improvement of quality of life as well as a tendency of fatigue symptoms to decrease in cancer patients under complementary homeopathic treatment. It would take considerably larger samples to find matched pairs suitable for comparison in order to establish a definite causal relation between these effects and homeopathic treatment.
Establishing local coherence relations is central to text comprehension. Positive-causal coherence relations link a cause and its consequence, whereas negative-causal coherence relations add a contrastive meaning (negation) to the causal link. According to the cumulative cognitive complexity approach, negative-causal coherence relations are cognitively more complex than positive-causal ones. Therefore, they require greater cognitive effort during text comprehension and are acquired later in language development. The present cross-sectional study tested these predictions for German primary school children from Grades 1 to 4 and adults in reading and listening comprehension. Accuracy data in a semantic verification task support the predictions of the cumulative cognitive complexity approach. Negative-causal coherence relations are cognitively more demanding than positive-causal ones. Moreover, our findings indicate that children's comprehension of negative-causal coherence relations continues to develop throughout the course of primary school. Findings are discussed with respect to the generalizability of the cumulative cognitive complexity approach to German.
This paper addresses the development of performance-based assessment items for ICT skills, skills in dealing with information and communication technologies, a construct which is rather broadly and only operationally defined. Item development followed a construct-driven approach to ensure that test scores could be interpreted as intended. Specifically, ICT-specific knowledge as well as problem-solving and the comprehension of text and graphics were defined as components of ICT skills and cognitive ICT tasks (i.e., accessing, managing, integrating, evaluating, creating). In order to capture the construct in a valid way, design principles for constructing the simulation environment and response format were formulated. To empirically evaluate the very heterogeneous items and detect malfunctioning items, item difficulties were analyzed and behavior-related indicators with item-specific thresholds were developed and applied. The 69 item’s difficulty scores from the Rasch model fell within a comparable range for each cognitive task. Process indicators addressing time use and test-taker interactions were used to analyze whether most test-takers executed the intended processes, exhibited disengagement, or got lost among the items. Most items were capable of eliciting the intended behavior; for the few exceptions, conclusions for item revisions were drawn. The results affirm the utility of the proposed framework for developing and implementing performance-based items to assess ICT skills.
In this explorative study, we investigate how sequences of behaviour are related to success or failure in complex problem‐solving (CPS). To this end, we analysed log data from two different tasks of the problem‐solving assessment of the Programme for International Student Assessment 2012 study (n = 30,098 students). We first coded every interaction of students as (initial or repeated) exploration, (initial or repeated) goal‐directed behaviour, or resetting the task. We then split the data according to task successes and failures. We used full‐path sequence analysis to identify groups of students with similar behavioural patterns in the respective tasks. Double‐checking and minimalistic behaviour was associated with success in CPS, while guessing and exploring task‐irrelevant content was associated with failure. Our findings held for both tasks investigated, from two different CPS measurement frameworks. We thus gained detailed insight into the behavioural processes that are related to success and failure in CPS.
Complex problem solving (CPS) is a highly transversal competence needed in educational and vocational settings as well as everyday life. The assessment of CPS is often computer-based, and therefore provides data regarding not only the outcome but also the process of CPS. However, research addressing this issue is scarce. In this article we investigated planning activities in the process of complex problem solving. We operationalized planning through three behavioral measures indicating the duration of the longest planning interval, the delay of the longest planning interval and the variance of intervals between each two successive interactions. We found a significant negative average effect for our delay indicator, indicating that early planning in CPS is more beneficial. However, we also found effects depending on task and interaction effects for all three indicators, suggesting that the effects of different planning behaviors on CPS are highly intertwined.