Educational Talks Research Articles

Risk of Histological Transformation in Patients with Primary Refractory Follicular Lymphoma

INTRODUCTIONThere is a growing interest in analyzing the biological and clinical variables that might help in identifying patients at risk of histological transformation (HT), a critical event that can still lead to reduced survival in patients with follicular lymphoma (FL). As part of the Aristotle study, we have previously reported that the risk of HT as a first event has been significantly reduced by the use of rituximab (Federico et al, Lancet Hematology 2018). However, this incidence might still be unacceptable in some groups of patients. Thus, we investigated the risk of HT in patients with primary refractory FL, a subset of patients with poor prognosis.METHODSWe carried out a retrospective analysis of cumulative incidence of HT in the 289 cases with primary refractory FL retrieved from the Aristotle Study, which included a total of 6970 FL cases (grade 1, 2 or 3a), diagnosed between 1997 and 2013 and treated with systemic therapy. Refractoriness was defined as progressive disease (PD) within the end of first-line therapy. Patients with PD were compared to patients with partial response (PR) or stable disease (SD) and to patients with complete response (CR) at the end of therapy. The cumulative incidence of HT was calculated using the Nelson-Aalen estimator, with a 95 confidence interval (CI). The estimate is in absolute value, and then multiplied by 100. The overall survival (OS) and survival after relapse/progression (SAR) were calculated using Kaplan-Meier estimation, with a 95% CI.RESULTSSix hundred and twenty-eight cases (9%) were excluded for incomplete data and 6,339 were considered for analysis. The five-year cumulative incidence of HT among patients with PD was 34.2% (95% CI: 26.9-43.4), whilst it was 7.1% (95% CI: 6.0-8.5) and 3.5% (95% CI: 3.0-4.2) in the 1,954 and 4,096 patients with PR+SD and CR at the end of induction therapy, respectively. The rate observed in PD group had a Hazard Ratio (HR) of 11.4 (95CI: 8.61-15.0) compared with CR patients, and 6.14 (95% CI: 4.6-8.2), when compared with PR+SD patients. All comparisons and estimations showed a p-value below 0.001. Cumulative incidences of HT according to response to initial therapy are represented in Figure 1.The five-year SAR was 33% (95% CI: 28-39) for the PD group, with a median SAR of 1.1 year (95% CI: 0.8-1.8). At the same time point, the SAR was 56% (95% CI: 53-60) in patients with initial PR/SD, with a median SAR of 6.3 years (95% CI: 5.7-8.6). Finally, in patients with initial CR who later relapsed, the 5 year SAR was 63% (95% CI: 66-72), with a median of 10.4 years (95% CI: 10-12.2). The difference among groups was statistically significant (p-value <0.001, Figure 2). HR for PD group was 3.39 (95% CI: 2.87-4.01) compared to CR, and 2.12 (95% CI: 1.8-2.5) compared to PR/SD group.CONCLUSIONSAccording to the results of the present study, primary refractory FL patients have not only an already known reduced SAR (Casulo et al, JCO 2015), but also a dramatically increased risk of HT, which probably contributes to patients' adverse outcome. These findings reinforce the need to develop combined diagnostic and therapeutic strategies aimed to eradicate the disease at the “first shot”, reducing the risk of refractoriness and eventually further improving the outcome of FL patients. [Display omitted] DisclosuresSarkozy:ROCHE: Consultancy. Wondergem:NOVARTIS: Other: advisory board, educational talk; SANOFI: Other: advisory board; GILEAD: Other: educational talk. Chamuleau:Genmab: Research Funding; BMS: Research Funding; celgene: Research Funding; Gilead: Research Funding. Gomes da Silva:Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: lecture fees, Institution's payment for consultancy, Travelling support; Celgene: Other: Travelling support; Roche: Other: Institution's payment for consultancy, Travelling support; Abbvie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: lecture fees; BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: lecture fees; Gilead Sciences: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: lecture fees, Research Funding. Holte:Roche, Norway: Research Funding; Novartis Pharmaceuticals Corporation: Membership on an entity's Board of Directors or advisory committees. Zucca:CELGENE: Other: Grant to the Institution + Advisory Board; Janssen: Other: Grant to the Institution; ROCHE: Other: Grant to the Institution + Advisory Board; Celltrion Healthcare + Mei Pharma + Astra Zeneca: Other: Advisory Board; AbbVie + Gilead: Other: Travel Expenses; Gilead + Bristol-Myers Squibb + MDS: Other: Expert Statement + Meetings. Aurer:Roche: Consultancy, Honoraria, Research Funding; Pfizer: Honoraria, Research Funding. Marcheselli:Fondazione Italiana Linfomi (FIL) Onlus: Employment. Salles:Novartis: Consultancy, Honoraria; Acerta: Honoraria; Abbvie: Honoraria; Morphosys: Honoraria; Epizyme: Honoraria; Amgen: Honoraria; F. Hoffmann-La Roche Ltd: Consultancy, Honoraria, Research Funding; Celgene: Honoraria, Other: Advisory Board, Research Funding; Pfizer: Honoraria; Gilead: Honoraria, Other: Advisory Board; Janssen: Honoraria, Other: Advisory Board; Merck: Honoraria; Servier: Honoraria, Other: Advisory Board; Takeda: Honoraria; BMS: Honoraria, Other: Advisory Board; Servier: Honoraria.

Benefits of mindfulness meditation in reducing blood pressure and stress in patients with arterial hypertension.

The objective of this randomized controlled trial is to evaluate the benefits of mindfulness meditation in controlling ambulatory blood pressure (BP) and the impact of the intervention on anxiety, stress and depression levels in a Mediterranean population. Twenty-four and 18 patients [n = 42; mean age 56.5 (7.7) years; similar men and women proportions] with high-normal BP or grade I hypertension were enrolled to an intervention and a control group, respectively. For 2 h/week over 8 weeks, the intervention group received mindfulness training and the control group attended health education talks. The patients attended pre-intervention, week 4, week 8 and week 20 follow-up visits. 61.9% of the patients had anxiety, 21.4% depression, 19.0% were smokers and 14.2% were diabetic (no significant differences between the 2 groups). At baseline, the intervention group had non-significant higher clinically measured BP values, whereas both groups had similar ambulatory BP monitoring (ABPM) values. At week 8, the intervention group had statistically significant lower ABPM scores than the control group (124/77 mmHg vs 126/80 mmHg (p < 0.05) and 108/65 mmHg vs 114/69 mmHg (p < 0.05) for 24-h and night-time systolic BP (SBP), respectively) and also had lower clinically measured SBP values (130 mmHg vs 133 mmHg; p = 0.02). At week 20 (follow-up), means were lower in the intervention group (although not statistically significant). Improvements were observed in the intervention group in terms of being less judgemental, more accepting and less depressed. In conclusion, by week 8 the mindfulness group had lower clinically measured SBP, 24-h SBP, at-rest SBP and diastolic BP values.

Características de la esfera sexual en pacientes adultos mayores

ObjectiveSexuality plays a fundamental role in our lives, but there is little research on this subject with representative samples. This study aims to analyse the knowledge and characteristics of sexual function in people over 60 years of age. Material and methodsAn observational cross-sectional study was carried out. The sample consisted of people over 60 years of age who voluntarily attended health education talks on sexuality held in urban centres for the elderly. Before the talk, they were given a questionnaire to assess their sexual habits and practices. The talk on sexuality was given, and a questionnaire related to the concepts mentioned while the talk was delivered. The data from the questionnaires were collected on spreadsheets in Microsoft Office Excel for Windows, and the statistical analysis was performed with the statistical package SPSS. ResultsThe results show that sexual activity is important in those over sixty years, with 52.53% of respondents having relationships. More than 70% of adults over 60 refer to being sexually attractive for their age. There were concepts about sexuality that were not clear after the talk. ConclusionOur society is experiencing progressive aging involving the elderly groups in sex education, emphasising the changes at the sexual level implied by age. It is important to start training sessions on health education with content on sexuality and body image reinforcement in the elderly population.

Prevención 365 (Prevention 365)

In Peru every year there are 1200 new cases of skin cancer, of which 80% is caused by overexposure to unprotected ultraviolet rays. In Peru, there was no culture of ultraviolet prevention. The population believed that they should only be protected from solar radiation in the summer season. Therefore, in 2017 the League Against Cancer - Peru, two major objectives were set: breaking the paradigm about protection only in summer and/or in aggressive solar exposure, and generate annual preventive check-ups. To achieve this, we created “Prevention 365”, a campaign designed to sensitize the population about the importance of protecting from the ultraviolet rays 365 days a year and not only in summer (Fig 1). Aim: Promote a change in the culture of skin cancer prevention in Peru, breaking the paradigm that you only have to protect yourself from ultraviolet rays in summer, and generate annual preventive check-ups. Strategy/Tactics: We identified the regions with the highest index of ultraviolet radiation at national level and the group of people who work under solar radiation who are more vulnerable for developing the disease, such as policemen, serene, cleaning staff, workers, journalists, taxi drivers, fishermen, among others, to carry out awareness actions. To achieve a greater impact, we convinced various characters from theater, television and sports to become spokespersons and image of the campaign, and to influence Peruvians to prevent skin cancer. We implemented a powerful digital plan that included communication on various platforms - our own and those of third parties. In this way we are able to exponentially expand the scope of our message. The mobile unit of the institution - outpatient clinic - visited municipalities, buildings, police stations, among others, where they conducted screening, educational talks and delivery of information material. Outcomes: More than 900 publications in media, which obtained 389,425,940 views and an advertising investment savings of more than US $5,660,452.00 dollars. More than 200 celebrities who shared each of our messages. More than 10 thousand people who were sensitized through outdoor advertising and media. More than 100 thousand Peruvians from areas more exposed to ultraviolet rays sensitized by materials and informative talks. More than 2 million people who received our message through our official fan page. Thanks to the campaign “Prevention 365” more than 130 thousand people made for the first time a preventive skin check. That is, more than 300% of what was projected. We have understood that a well-structured communication campaign can achieve great results. Thanks to this, the League Against Cancer has helped to reduce the incidence of skin cancer thanks to the fact that more than 130,000 Peruvians were screened for skin cancer for the first time. [Figure: see text]

Steering Your First Year as a Structural Heart Interventionalist

“I’ve learned it all, I’m a structural heart ninja. I’m ready for anything.” You may have these thoughts as you transition from your eighth or ninth year of postgraduate training into your first st...

Improvement in Hyperphosphatemia Using Phosphate Education and Planning Talks

Hyperphosphatemia is a common complication in patients with end-stage renal disease on hemodialysis. The mainstay of phosphate management involves a low-phosphate diet and use of phosphate binders, yet these are often insufficient. This study was the first to use behavioral change techniques to encourage the use of phosphate binders and dietary modifications through a series of Phosphate Education and Planning (PEP) talks. A total of 46 hemodialysis patients with hyperphosphatemia were enrolled. All patients were eligible to receive a series of 4 talks, each with defined goals of the long-term management of serum phosphate levels. Qualitative data from the talks were gathered during each intervention, whereas serum phosphate was selected as an outcome measure. There was a modest improvement (-0.31mg/dL) in the serum phosphate levels of the patients who received the entire PEP talk series. Furthermore, the most common self-identified barriers for patients were phosphate binder prescriptions not tailored to their eating routines and lack of resources for suitable dietary changes. The PEP talk series model is appropriate to manage persistent hyperphosphatemia despite usual management in outpatient dialysis unit by identifying patient-specific barriers and providing resources that can mitigate them. The strength of this model lies in using a multifaceted approach by applying both pharmacotherapy and dietary changes, along with behavioral change, to achieve lasting improvements in serum phosphate levels in hemodialysis patients with persistently elevated serum phosphate levels.

ПУБЛИЧНЫЙ ЛЕКТОРИЙ КАК ФОРМА ИНТЕЛЛЕКТУАЛЬНОГО ДОСУГА СОВРЕМЕННОГО ГОРОЖАНИНА В КРЕАТИВНЫХ ПРОСТРАНСТВАХ ГОРОДА

The article is devoted to the analysis of a form of current scientific knowledge translation through one of the most popular types of intellectual leisure of modern Russian cities inhabitants - educational public talk, revealing the reasons for its growing popularity and the analysis of its influence on the personality of a modern urban dweller. The authors present the analysis of mutual influence of public talk as a form of leisure time for the modern urban dweller and value orientations that are formed in the city environment, correlating with each other. Scientific significance of the work is in determining the tendencies of dialectical interdependdence between the creative personality, his/her value orientations, and creative leisure practices (by the example of public talk).

Does physiotherapy prehabilitation improve pre-surgical outcomes and influence patient expectations prior to knee and hip joint arthroplasty?

IntroductionEvidence supporting physiotherapy prior to hip or knee replacement for decreasing pain and improving function pre and post-operatively is equivocal. This observational cohort study used a mixed-methods approach to investigate whether 8 weeks of physiotherapy led exercise and education (‘prehabilitation’) would change pain and functional outcomes prior to surgery, and if patients' expectations and satisfaction post-surgery were influenced. MethodsParticipants awaiting THR or TKR were recruited (n = 75). Fifty two opted into the ‘prehabilitation’ group while twenty three opted for usual care. The prehabilitation group included a 45 min exercise and 15 min education session twice weekly for 8 weeks. All participants completed the WOMAC, NRS, Health Thermometer, 5xSTS and TUG outcome measures. Data were collected before and after prehabilitation and 6 weeks after surgery. Qualitative data were collected from 22 participants via telephone interviews and analysed inductively. ResultsBoth groups improved post surgery. The prehabilitation group showed statistically significant improvements in all outcome measures after prehabilitation (pre-surgery). Participants’ felt prehabilitation prepared them well for surgery and influenced expectations post-operatively. Group education talks and the experience of friends and family appeared highly valued information sources. ConclusionPrehabilitation improved patients’ pain and function before hip or knee replacement surgery.

Infants’ experience with ‘near and clear’ educator talk: individual variation and its relationship to indicators of quality

ABSTRACTThis study investigated the quantity of audible and intelligible (‘near and clear’) educator talk directly experienced by under-two-year-old infants attending early childhood education and care (ECEC) programmes and examined whether the quantity of educator talk was related to characteristics of quality in their ECEC room. Participants were 57 infants attending separate infant rooms in and around the Sydney metropolitan area, Australia. Each infant was observed for 3 h, wearing a small, custom-designed digital language processor (DLP) which digitally recorded and generated measures of ‘near and clear’ adult talk, unclear talk and infant vocalisations. Structural quality indicators include educator qualification, group size and educator-infant ratios, and Interaction Quality was assessed using the ITERS-R Interaction and Listening and Talking subscales. Infants’ experience with ‘near and clear’ talk was predicted by Interaction Quality, the presence of a degree-qualified teacher and group size. ‘Near and clear’ talk was also significantly and positively related to the quantity of infant vocalisation and, negatively, to their level of exposure to unclear talk. Findings are discussed in terms of conceptualisations of quality in infant ECEC rooms, as well as the potentials and limitations of the ‘near and clear’ talk measure for use in future studies of language development in this context.

Radiation Dose Associated With Over Scanning in Neck CT

The increasing utilization of computed tomography scans exposes patients to significant amounts of radiation. One of the factors that can result in unnecessary radiation dose is scanning beyond the clinically indicated anatomical region. This study aims to assess the optimization in overscan frequency, scan length, and radiation dose following targeted educational talks aimed to address a routinely over scanned protocol; the computed tomography Neck. A targeted radiation awareness talk regarding scan adherence as a method of radiation dose optimization was delivered to all medical imaging technologists employed at a large teaching hospital. An audit of the radiation dose associated with computed tomography Neck protocols was conducted in the month before, a month after and 1 year after the awareness talk. Results show that following the radiation awareness talks there was a 15% reduction in overscan frequency, an average over scan length reduction of 33% and a 20% reduction in overall radiation dose. The targeted nature of the talk, explicitly addressing scan range in the neck region, significantly reduced radiation dose to the patients. The results of this study are effective in illustrating the potential clinical radiation dose saving from strict adherence to scan range.

Overcoming barriers and improving adherence to nutritional protocols in enhanced recovery after surgery (ERAS) for colorectal surgery

Objectives: Nutrition is an essential component of Enhanced Recovery After Surgery (ERAS) programs. ERAS programs advocate resumption of diet within a few hours post surgery with supplementation of high-calorie drinks. In March 2016, Tan Tock Seng Hospital started to adopt ERAS protocols for elective colorectal surgery. However, internal audits and retrospective review of our data indicated poor compliance with ERAS nutritional protocols. Our aim was to identify barriers and develop strategies to improve adherence to ERAS nutritional protocols, so as to facilitate the integration of nutritional protocols within ERAS. Methods: In July 2016, a multidisciplinary project team was formed. Root cause analysis was carried out with different stakeholders. Four actionable barriers were identified in the implementation of nutritional aspect of ERAS: 1) unfamiliarity with new ERAS protocols; 2) confusion caused by an outdated existing Colorectal Clinical Pathway; 3) reluctance to adopt new practice; and 4) resource limitation and logistic issues. Strategies implemented included: educational talks to staff and patients on ERAS nutritional protocols to disseminate the practice changes; revising the existing Colorectal Clinical Pathway to align with new ERAS nutritional protocols; sharing favourable results to convince staff and overcome resistance; conducting frequent meetings to reflect on practice, build teamwork and align different ward cultures; identifying and training ERAS champions in different wards as ERAS advocates; collaborating with pharmacy to store nutritional supplements at the ward level to promote early oral nutrition. A comparison of pre and post-implementation of strategies on ERAS nutritional compliance and clinical outcomes were carried out during the period of March to October 2016 (n=135) and Nov 2016 to July 2017(n=157). Results: Overall, adherence to ERAS nutritional measures improved by 25% with an overall increasing trend. Patients recovered faster with decreased median length of stay from 7 to 6 days, complication rate dropped from 47.4% to 39.5% and 30 days readmission rate from 7.2% to 5.2%. Conclusion: Implementation of strategies addressing actionable barriers successfully improved adherence to nutritional standardisation of ERAS protocols and clinical outcomes following colorectal surgery. Disclosure of Interest: None declared.

Nivel de conocimiento de padres de pacientes con Fibrosis Quística atendidos por el servicio de Neumología Pediátrica del Hospital Infantil Dr. Robert Reid Cabral de Santo Domingo, República Dominicana, durante el período febrero-marzo de 2016

La Fibrosis Quística (FQ) es la enfermedad congénita con la tasa de mortalidad más alta en la población caucásica. Se estima que 1 de cada 2,500 personas es portadora del gen de la fibrosis quística. El objetivo de este trabajo es evaluar el nivel de conocimiento de los padres de los pacientes con fibrosis quística atendidos por el Servicio de Neumología de un hospital pediátrico de Santo Domingo, República Dominicana, durante el período febrero-marzo de 2016. Fue un estudio prospectivo, descriptivo, analítico y transversal en el que se evaluaron 40 padres para determinar el nivel de conocimiento que poseen sobre la fibrosis quística.En los resultados encontrados se establece lo siguiente: el nivel de conocimiento reflejado por los padres de pacientes con fibrosis quística fue regular, representado por un 42.5%. El principal obstáculo para que los padres aprendan acerca del proceso patológico fue la incomprensión de la terminología utilizada por los prestadores de salud, obteniendo un 31.37%. Con respecto a la relación del nivel de conocimiento versus el sexo, se muestra que el sexo femenino mostró tener un mayor conocimiento, representado por un 43.75%. El método que prefirieron para su aprendizaje fue recibir charlas educativas, significando un 35% del total. En conclusión, los padres de pacientes con fibrosis quística presentaron un nivel de conocimiento regular, lo que fue causado por la incomprensión de la terminología médica. Según la mayoría de ellos, su conocimiento podría mejorar a través de la implementación de charlas educativas por parte del personal médico.

Lesson Study: What Do Pre-Service Teachers Tell?

Education topics and talks on pre-service teacher training program and Lesson Study have individually been discussed and appeared in many journals among disciplines. However, the empirical studies on the issue about the connection between them and how they can relate and benefit one another are limited and rarely done. This study aims at investigating pre-service English teachers’ perspectives towards Lesson Study, particularly in terms of their knowledge, experience, and plan for it. This study involved seventeen pre-service teachers (PST) in a teacher education faculty in Indonesia who participated as the research subject. Empirical data were collected through interview and Focus Group Discussion (FGD). Data analysis used a descriptive qualitative method. Results of the study showed that: (1) In terms of knowledge about Lesson Study, all PSTs have good knowledge about Lesson Study. In addition, they also show positive response towards Lesson Study, (2) In terms of experience with Lesson Study, most of the PSTs have had experiences with Lesson Study activities. The experiences mostly occurred when they were being directly involved in Lesson Study activities as students, (3) In terms of the plan to do Lesson Study, the majority of the PSTs are planning to take and do Lesson Study in the future, especially when they become real teachers at schools.

Teaching the Social Determinants of Health: A Path to Equity or a Road to Nowhere?

Medical schools are increasingly called to include social responsibility in their mandates. As such, they are focusing their attention on the social determinants of health (SDOH) as key drivers in the health of the patients and communities they serve. However, underlying this emphasis on the SDOH is the assumption that teaching medical students about the SDOH will lead future physicians to take action to help achieve health equity. There is little evidence to support this belief. In many ways, the current approach to the SDOH within medical education positions them as "facts to be known" rather than as "conditions to be challenged and changed." Educators talk about poverty but not oppression, race but not racism, sex but not sexism, and homosexuality but not homophobia. The current approach to the SDOH may constrain or even incapacitate the ability of medical education to achieve the very goals it lauds, and in fact perpetuate inequity. In this article, the authors explore how "critical consciousness" and a recentering of the SDOH around justice and inequity can be used to deepen collective understanding of power, privilege, and the inequities embedded in social relationships in order to foster an active commitment to social justice among medical trainees. Rather than calling for minor curricular modifications, the authors argue that major structural and cultural transformations within medical education need to occur to make educational institutions truly socially responsible.

Effectiveness of an Educational Intervention on the Knowledge and Attitude of Patients Attending the DOTS Centre of Selected Hospitals in Mangaluru, Karnataka

Tuberculosis (TB) is still a major cause of mortality and morbidity in India due to widespread ignorance and negligence among the public. The present study evaluated the effectiveness of an educational programme on knowledge and attitude of tuberculosis, as clarity of information among the public can further curb the devastating illness. A pre-experimental design was adopted for the study; 50 patients attending the DOTS Centre of selected hospitals and PHCs at Mangaluru were selected using purposive sampling. The data was collected from Feb till May 2016. A self-administered knowledge questionnaire consisting of 30 items and a 21-item, 5-point attitude scale were the instruments used for the study. A cut off score of &gt; 13 was considered as having average knowledge and a cut off score of &gt; 84 was considered as having negative attitude. An educational talk for 45 minutes was organised for the patients attending the DOTS centres. Among 50 TB patients, only 23 (46%) knew that TB is curable and 31 (62%) knew that it is a communicable disease. 28 (56%) patients didn’t know that DOTS is the main treatment for TB; 45 (90%) had negative attitude in the pre-test. No significant association was found between the demographic variables and knowledge and attitude (p&gt;0.05). The educational programme was found to be effective in enhancing the knowledge and bringing a change in the attitude (t79=2, p&lt;0.05). Nurses are powerful agents of change and can utilise education as one of the cost effective intervention for promoting health among tuberculosis patients.

Assessment of Perceived Health and Environmental Problems of Household Energy Consumption among Ilese Ijebu Residents Southwestern Nigeria

The study was carried out among Ilese-Ijebu residents southwestern Nigeria, to assess their perceived health and environmental problems associated with different sources of household energy use for cooking, then their perception and acceptability of adopting other alternative source of energy (biogas). A focused group discussion and self-structured questionnaire administration methodologies were adopted to elicit information on their current energy sources and adoption for alternative energy source (biogas). The researchers randomly selected twenty five (25) households to include the total sample size of one hundred (100) and organized an interactive session on the subject matter, during which three prepared forms were given out to the participants to filled their demographics characteristics, sources of energy for household cooking with associated health and environmental problems and perception and acceptability of biogas, descriptive statistics and likert scale technique were used to analyze the results obtained. The results of the analysis showed that, the respondents do make use of more than one source of energy for cooking, kerosene stoves (95), firewood (63), charcoal stove(32), while lesser people made use of liquefied gas (12) and electricity (5). Average numbers of respondents 50-60 are aware of associated health and environmental problems with firewood and charcoal, but not ready to use electricity and liquefied gas because of bills and fire hazards when the energy sources is not properly handled. However, the likert scale results of the positive score of 227 and the negative score of 598 on the acceptability of use of biogas for domestic cooking indicating that, presently, the residents are not ready to adopt the biogas as the alternative energy. Therefore, there is need to organize massive awareness campaign, health education talks among the residents on the effect of air pollution associated with household energy sources and consumption, health and financial benefits of adopting other alternative clean energy source.

Primary care management of headaches and how direct-access MRI fits: a qualitative study of UK general practitioners’ views

ObjectivesTo develop a better understanding of general practitioners’ (GPs) views and experiences of the management of patients with headaches and use of direct-access MRI scans, and observe outcomes of an...

‘That's exactly what I will share with you today!’ Negotiation for a ticket of entry to unsolicited health education talks

Previous studies in health communication demonstrated how clients' mention of health-related problems serves as a ‘ticket of entry’ (ToE) in facilitating healthcare providers' advice-giving task. Based on 24 Taiwanese health education sessions in which Taiwanese college students delivered information to elderly people, this study proposes a framework analyzing discourse mechanisms and patterns of establishing ToE. Two core moves were identified: deliverers' use of perspective-checking questions via which recipients' need status for knowledge is revealed, and explicit statements that connect this need status to the upcoming information. Based on the low occurrence of ToE and its preferred collocation with a series of perspective-checking questions, we conclude that the establishment of ToE is a nuanced communication skill that warrants extensive pedagogical training.

Discursive mentoring strategies and interactional dynamics in teacher education

In this paper, we are interested in how teacher educators help and guide prospective teachers’ learning in triadic mentoring conversations. These conversations are considered as boundary activities allowing to establish a stronger link between the practicums and academic coursework and to bridge the so-called gap between theory and practice. We explore the interactional dynamics during these conversations focusing on both the content and the discursive processes at play. Content refers to ‘what’ prospective teachers and educators talk about, and processes refers to ‘how’ they talk about it – in our case the practicum experience.

Parental Concern: Parents Discuss How They Support Their Adolescents Attending Schoolies Events in Australia

ABSTRACTAdolescents who have completed their high school studies converge on coastal areas of Australia annually to celebrate their freedom in events known as “Schoolies.” The current body of research in relation to Schoolies demonstrates that adolescents consume alcohol and other drugs and engage in sexual activity during these events. Exactly how parents support adolescents in attending these events and how they perceive the Schoolies experience represent major gaps in the literature. To undertake this research, 7 parents were interviewed using a semi-structured approach. Interview transcripts were analyzed using Braun and Clarke’s thematic analysis, with 4 main themes identified: communication, consuming alcohol, peer support, and helping parents to support their adolescents in attending Schoolies. Communication was the main strategy used by parents to talk about Schoolies with their adolescent, with the majority encouraging open communication around drinking alcohol, staying with friends, and instilling correct or moral values into their adolescents in relation to respectful behavior. Parents saw the consumption of alcohol as inevitable and as something they could not control. However, the ramifications of alcohol consumption were the primary concerns for these parents. This study provides a number of insights into the perceptions that parents have about Schoolies events and how they support their adolescent to attend. Parents sought guidance in supporting their adolescent child via educational media and talking to other parents.