Warps and Cooperative Groups

Objective: To explore and analyze the influence of accompanying midwifery with position guidance on deliveryoutcomes. Methods: A total of 68 puerpera who were admitted to Dafeng People’s Hospital from April 2021 to April 2023 were recruited, grouped using odd and even number draw methods, and divided into cooperation and regular groups with 34 cases in each group. The patients in the cooperation group cooperated with the process of accompanying midwifery and position guidance, whereas the patients in the regular group had routine midwifery intervention. The delivery outcome, the duration of each labor process, the psychological state, and the amount of postpartum hemorrhage were compared between the groups. Results: The delivery outcomes of vaginal delivery and cesarean section in the cooperation group were significantly better than those in the regular group (P < 0.05). The difference was not statistically significant when comparing the cooperation group with the regular group through a lateral vaginal incision (P > 0.05). The duration of each labor process in the cooperation group was significantly shorter than in the regular group (P < 0.05). Before the intervention, the HAMD and HAMA scores of the two groups were insignificant (P > 0.05); but the HAMD and HAMA scores of the cooperation group were significantly lower than the regular group after the intervention (P < 0.05). The amount of postpartum bleeding in the cooperation group was markedly lower than that in the regular group (P < 0.05). Conclusion: Accompanying midwifery and position guidance throughout the delivery process can improve delivery outcomes and increase the natural delivery rate.

A video-based study of student teachers' participation and content processing in cooperative group work

Background: The competence of asphyxia management on newborn baby is essential for midwife. The quality of learning process should be improved by applying interactive learning method. The cooperative learning method is often applied to enhance the effectiveness of clinical learning process. The purpose of this research was to analyze the influence of cooperative learning on competence which consists of student’s knowledge, attitude, and skill in comparison to teacher-centered learning method.Method: This is quasi-experimental research with control group pre-test and post-test design Samples were third semester students at Stikes A. Yani Yogyakarta. The samples were 80 students in cooperative learning group and 90 students in teacher-centered learning group.Result: The result showed that there was an improvement of knowledge in cooperative learning group compared to teacher-centered learning group (p=0.002). The improvement od student’s attitude in cooperative learning group was significantly higher than teacher-centered learning group (p=0.001). In the field of skills, cooperative group, although not significant (p=0.671). The competence was significantly higher in cooperative learning group rather than in teacher-centered learning group (p=0.027). Correlation between competence and method of learning was weak (rpbi = 0.134, p= 0.041).Conclusion: Cooperative learning method is proven to be improve student’s knowledge, attitude and skills. The difference is not significant for skills domain. Cooperative learning method is proven to improve student’s competence in carrying out the management of newborn babies asphyxia, even though the correlation is weak.

The Globalization of Cooperative Groups

Pediatric oncology nursing in cooperative group clinical trials comes of age.

Based on a sample of 480 academically at-risk first graders, we used a cluster analysis involving multimethod assessment (i.e., teacher-report, peer-evaluation, and self-report) of behavioral and psychological engagement to identify subtypes of academic engagement. Four theoretically and practically meaningful clusters were identified and labeled as cooperative (n = 95), resistive (n =96), enthusiastic (n = 188), and disaffected (n = 101). The four types did not differ in IQ measured with the Universal Nonverbal Intelligence Test. The cooperative group consisted of more female and Hispanic students, whereas the resistive group consisted of more male and African American students. The cooperative group was the most popular among peers, followed by the enthusiastic group. The disaffected and resistive groups had more emotional symptoms than the cooperative and enthusiastic groups. Academic engagement types also differed in growth trajectories of academic achievement measured with Woodcock Johnson III Tests of Achievement from second to fourth grade. For reading, the cooperative and enthusiastic groups outperformed the resistive and disaffected groups at the beginning. However, the growth rate was similar across engagement types. For math, the engagement types did not differ at the beginning. However, the cooperative group developed at a faster rate and had higher math achievement by fourth grade than the other types. The findings support the importance of teaching temperament-based regulatory skills and of providing a positive psychological climate for children's academic learning.

The cooperative groups sponsored by the National Cancer Institute (NCI) were formed beginning in the mid-1950s and have provided a publicly funded standing infrastructure to conduct cancer clinical trials ever since (Appendix Fig A1, online only). The accomplishments of the US cooperative groups, often in collaboration with similar organizations in Europe and Canada, are notable for the development of curative therapies for most pediatric cancers; the introduction of effective combined modality treatments for many diseases, including head and neck cancer, cervical cancer, esophageal cancer, non–small-cell lung cancer, and anal cancer; the development of adjuvant chemotherapy as a standard of care for many solid tumors, particularly breast cancer and colorectal cancer; and the introduction of chemoprevention strategies for patients at high risk of developing breast and prostate cancer. The groups have also worked collaboratively with the pharmaceutical industry to introduce new cancer drugs into medical practice and to develop new indications for already approved drugs. Indeed, more than 20 new indications for cancer drugs have resulted directly from cooperative group studies. Clinical trials performed by the cooperative groups have also provided important insights into optimal scheduling and sequencing of chemotherapy drugs and the preferred route of drug administration that have established new standards of care, such as the introduction of dose-dense chemotherapy as part of adjuvant treatment of breast cancer and the demonstration of improved survival when intraperitoneal administration of chemotherapy is used for treatment of ovarian cancer. Importantly, cooperative groups have also rigorously evaluated purported advances in cancer care that were popularized by single individuals or centers and, in some cases, such as high-dose chemotherapy and autologous stem-cell transplant for breast cancer, have proven them ineffective. Finally, many important advances in supportive care for patients with cancer have come from cooperative group studies, such as the recent demonstration of the value of duloxetine to relieve symptoms of chemotherapyinduced painful peripheral neuropathy. In the current era of molecular medicine, the cooperative group biospecimen repositories, populated with specimens from clinical trial participants who received uniform treatments and have welldocumented outcomes, are invaluable resources for the development of new prognostic, predictive, and response biomarkers across a range of cancer types. These repositories will support a new generation of biomarker-driven clinical trials currently in development by the cooperative groups. And, with the heightened public interest in comparative effectiveness and cost, the cooperative groups, as publicly funded entities free from commercial bias, are ideally positioned to directly compare therapeutic approaches or drugs from competing commercial firms, combine drugs from different sponsors, develop treatments for rare diseases with small commercial markets, and rigorously examine the cost effectiveness of new treatments and their impact on patient quality of life. Beyond their scientific contributions, the cooperative groups have developed many of the standard methods to conduct multicenter clinical trials, extended clinical trials to community oncologists, and provided a fertile training ground for generations of clinical investigators and countless research staff. Despite their many contributions to cancer care and research, the cooperative groups have been subjected to scrutiny and criticism for nearly their entire existence. In the last 15 years alone, no fewer than five committees have been convened by NCI or at the request of NCI to evaluate the cooperative group program. Most recently the Institute of Medicine (IOM) of the National Academy of Sciences produced a report at the request of the NCI entitled, “A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the NCI Cooperative Group Program,” which identified the many challenges faced by the cooperative groups at the present time, including stagnant funding; inefficient and redundant processes; excessive and complex government oversight, with many layers of review performed by multiple agencies; long delays in the launch of clinical trials; and increasing competition from the pharmaceutical industry for patient accrual to studies. When the IOM report was issued, the time required to activate a phase III trial in the cooperative groups averaged nearly 2 years, and JOURNAL OF CLINICAL ONCOLOGY S P E C I A L A R T I C L E VOLUME 32 NUMBER 3 JANUARY 2

To assess the proportion of children with cancer who have been managed by mainstream pediatric cancer programs, population-based cancer incidence data for Los Angeles County (LAC) children (under 20 years of age) for the years 1972 through 1987 were linked with patient records of children registered with the two national cooperative pediatric oncology groups, Children's Cancer Study Group and Pediatric Oncology Group. The proportion of children with cancer who were registered by cooperative groups increased markedly over time: 9% of LAC children younger than 15 years of age who were diagnosed with cancer in 1972 were registered with cooperative groups, compared to 52% of those diagnosed in 1980 and 62% of those diagnosed in 1987. Registration rates decreased with increasing age at cancer diagnosis. In the most recent time period, 1984-1987, 66% of LAC children diagnosed with cancer under age 5 years were registered with cooperative groups compared to 62% of those who were 5 to 9 years old and 49% of those who were 10 to 14 years old; although they were frequently diagnosed with tumors considered to be childhood cancers, only 19% of older adolescents (aged 15-19 years) were registered. In LAC, there was no apparent bias in registration rates with regard to gender or racial-ethnic background. Among patients diagnosed in the period 1984-1987, children in the highest of five socioeconomic status categories were underrepresented among registrants. Registration rates were highest (70% or greater) for patients with acute lymphocytic and acute nonlymphocytic leukemia, medulloblastoma, hepatoblastoma, Wilms tumor, and rhabdomyosarcoma. Fewer than 50% of patients with other brain and central nervous system tumors, retinoblastoma, other soft tissue sarcomas, and bone tumors were registered with the cooperative groups.

Objective To evaluated the effect of the cooperative model implemented on the length of time from first medical contact (FMC) to balloon dilation (B) , economic expense and prognosis in patients with acute coronary syndrome (ACS). Methods Patients with ACS (including ST-segment elevation and non-ST-segment elevation) selected from other hospitals within 24 hours after onset were treated with emergency percutaneous coronary intervention. Patients were divided into two groups, regional cooperative rescue group and control group without the cooperative model approved. The lengths of FMC-to-B time and Door-to-B time (from arrival at emergency department or OPD to balloon dilation) , time required for patients referred to our hospital, cardiac function, averaged hospital costs, average hospital stay, percentage of medication used and a major adverse cardiac event (MACE) were analyzed. Results Mean FMC-to-B time, Door-to-B time, referral time and time consumed to obtain informed consent were significantly shorter [(106 ±33) min , (31 ±8) min , (62 ±18 , 8 ±3) min ] vs. [(231 ±35) min, (109 ±26) min, (98 ±31) min, (28 ±11) min, respectively] by implementing the cooperative compared with control group, and LVEF was increased, and LVED was deceasedin cooperative rescue group. The mean costs [(44 123.0 ±3 427.0) yuanvs. (51 587.0 ±5 621.0) ] yuan, days of hospital stay [(8.7 ±4.1) vs. (13.2 ±6.4) ] and percentage of medication used were significantly decreased in the cooperative group. The incidence of MACE in cooperative rescue group was 6.2% , whereas the incidence in control group was 16.8%. Conclusions The cooperative model can improve the prognosis and decrease the FMC-to-B time, the rate of MACE and financial burden in patients with ACS. Key words: Acute coronary syndrome; First medical contact; Regional cooperative; Prognosis; Major adverse cardiac event; Door to balloon; Economics; Rescue

Current status and future perspectives of cooperative study groups for lung cancer in Japan.

The effects of cooperative group learning on students’ persistence, self‐regulation, and efforts to please teachers and parents were examined. Eighty‐one high school geometry students were randomly assigned to either a cooperative learning or traditional lecture group. Twenty‐seven students received cooperative group instruction for nine weeks and then received traditional classroom instruction for nine weeks. Twenty‐five students received traditional instruction for nine weeks and then received cooperative group instruction for nine weeks. Twenty nine students received traditional classroom instruction for 18 weeks. Participants completed pre, post, and post‐posttest motivation questionnaires at each phase of the project. Students in the cooperative group classrooms exhibited significantly greater gains in persistence, self‐regulation, and efforts to please their parents and teacher. The implications of these findings for motivation theory and cooperative group structures are discussed.

The impact of individual feedback was compared with the impact of group feedback on achievement, attitudes, and behavior in cooperative learning groups. Fifty-six American eighth-grade students studying German were randomly assigned to conditions stratified for academic ability and knowledge of the German language and culture. During an 11-week period, they worked in heterogeneous cooperative learning groups for 14 class sessions. They were trained in the social skills of praising, supporting, asking for information, giving information, asking for help, and giving help. Students received either individual or group feedback in written form only on how frequently members engaged in the targeted behaviors. Individual feedback was more effective than group feedback in increasing students' achievement motivation, actual achievement, uniformity of achievement among group members, and influence toward higher achievement within cooperative learning groups. Individual, compared with group, feedback result...

Background: Innovation in the training of future physiotherapy professionals through the use of collaborative learning could be an effective method for developing advanced competencies such as professional ethics. This study aimed at comparing the effects of cooperative learning and individual learning on the knowledge of professional ethics, the perception of knowledge regarding professional ethics, the teaching quality assessment and satisfaction in future physiotherapy professionals. Methods: A prospective, assessor-blinded, controlled trial was performed. A 12-week program was carried out with future physiotherapy professionals. The cooperative learning group was based on group activities, while the individual learning group performed the same activities with an individual approach. Knowledge, perception of knowledge regarding professional ethics, teaching quality and satisfaction were assessed. Results: A total of 216 participants completed the study (cooperative group n = 106; individual group n = 110). The cooperative learning group showed higher knowledge and perception of knowledge regarding professional ethics compared to the individual learning group (p < 0.001 and p < 0.001, respectively). Additionally, the cooperative learning group reported higher scores in the teaching materials, attitude towards future professionals and the teacher’s global score. Conclusions: Cooperative learning showed a positive impact on developing advanced competencies such as knowledge and perception of knowledge regarding professional ethics. Both methodologies showed adequate results in the assessment of teaching quality and satisfaction.

Allogeneic Hematopoietic Stem-Cell Transplantation (HSCT) in First Complete Remission Is Superior Compared to Chemotherapy/Autologous HSCT in Patients with Intermediate-Risk Cytogenetics Acute Myeloid Leukemia Lacking Mutations in NPM1, FLT3-ITD, and CEBPA: A Joint Study of AMLSG, Cetlam and Acute Leukemia Working Party of EBMT

Co-operative groups have played an important role in the advance of health-related quality of life (HRQL) research. However, definitions of the concept, criteria for selection of existing instruments and methods for data collection and interpretation remain poorly defined in the literature. A survey was conducted amongst the major cancer co-operative groups in order to gain a better understanding of their current policy and processes to ensure optimal HRQL data collection within cancer clinical trials. The topic of health economics was similarly addressed. A written questionnaire was addressed to 16 major European and North American cancer co-operative groups. Eleven groups responded (response rate: 69%). however, one group could not provide information for the survey, thus ten questionnaires were available for analysis. The results from this survey among co-operative groups show that HRQL (more than health economics) is recognized as an important, although usually secondary, outcome measure in oncology trials. On the whole, co-operative groups have a rather flexible policy towards the inclusion of HRQL (and HE) into their clinical trials, and practice is very much on a case-by-case basis, but use standard practice guidelines and internal procedures is to ensure well-defined study protocols and enhance good quality studies.