Monthly Meetings Research Articles

Making a good model better - evaluation of the NSW Combined Family Cancer Clinic meetings

Ensuring best practice in the NSW/ACT Family Cancer Service has considerable challenges given the geographical dispersion of geneticists, oncologists and genetic counsellors and the small often isolated teams in which they operate. The combined monthly meetings of 25-30 genetic health professionals were first initiated by a senior geneticist in partnership with the Centre for Genetics Education in 1996 in order to share expertise, keep abreast of rapidly developing evidence, and provide a network of support. The 3 hour meetings have been well attended, with four meetings per year via video/ teleconference. A previous evaluation was conducted in 2004. New IT technologies are providing flexibility in conferencing and an increased demand on genetic services means time away from the workplace for meetings may be less cost effective. Consequently a recent evaluation was undertaken to identify the perceived outcomes of the meeting and inform future planning and funding. A questionnaire requesting anonymous participant views on the current format, impact of the meetings on clinical practice, preferred mode of meeting and ideas for future development was distributed. 22/25 (88%) surveys were completed (though 2 were invalid). Overall, everyone was satisfied with the meeting experience and format with 90% very to extremely satisfied. 85% of participants agreed or agreed strongly that the meetings impacted positively on their clinical practice. Perceived outcomes of the meeting included: expert opinion gained on complex cases; successful avenue for updating knowledge of current literature; engagement with relevant literature through journal presentations; enhancement of clinical practice through case presentation and discussion and enhancement of patient outcomes through networking. Despite the opportunities available through IT, participants reported the inconsistency in delivery of videoconferences and the preference for face-to-face meetings. Participant comments included: ‘This is a brilliant meeting that is well worth attending each month.’; ‘Excellent opportunity to review difficult cases & go back to a patient/family with confidence.’; ‘I think these meetings help cohesion in cancer genetics - uniformity’. The perceived impact on clinical practice by participants and the high level of satisfaction is a strong endorsement for the continuation of the FCC meetings.

Perspectives on Specialist Nursing in Saudi Arabia: A National Model for Success

In many parts of the world, vulnerable patient populations may be cared for by a clinical nurse specialist (CNS). Nurses desiring to develop themselves professionally in the clinical arena, within the specialty of their choice, have the opportunity to obtain the knowledge, skills, experience and qualifications necessary to attain advanced practice positions such as CNS or nurse consultant (NC). Although studies have demonstrated the benefits of such roles and while the World Health Organization (WHO) recommends it, advanced nursing practice is not yet integrated into the health care culture in Saudi Arabia. The reasons for this are multiple, but the most important is the poor image of clinical nursing throughout the country. This article aims to share a perspective on CNS practice, while casting light on some of the obstacles encountered within Saudi Arabia. A model is proposed representing specialist nurse–physician collaborative practice for implementation nationally. The model has been implemented in the care of the colorectal and stoma patient populations while taking into consideration patient population needs and local health care culture. This model is based on the concepts of holistic “patient-centered care”, specialist nurse–physician collaborative practice, and the four practice domains for NCs (expert practice, leadership, research and education) as indicated by the Department of Health in the United Kingdom. We suggest this model will enable the introduction of advanced specialist nursing and collaborative partnerships in Saudi Arabia with benefits for patients, physicians, health care organizations and the nursing profession as a whole.

A Hospital-wide Quality-Improvement Collaborative to Reduce Catheter-Associated Bloodstream Infections

Catheter-associated bloodstream infections (CA BSIs) are associated with increased hospital length of stay, total hospital costs, and mortality. Quality-improvement collaboratives (QICs) are frequently used to improve health care quality. Our PICU was previously involved in a successful national QIC to reduce the incidence of CA BSI in critically ill children. We hypothesized that the formation of a hospital-wide QIC would reduce the incidence of CA BSI throughout our institution. We retrospectively reviewed the incidence of CA BSI from March 2006 to March 2010. The collaborative approach included hospital-wide implementation of central-line insertion and maintenance bundles that emphasized full sterile barrier precautions and chlorhexidine skin preparation during line insertion, daily discussion of catheter necessity, and meticulous site and tubing care. The hospital units involved were our 3 critical care units, the oncology unit, the bone marrow transplant unit, and wards. Each individual unit was responsible for collecting unit-specific data and performing event-cause analysis within 48 hours of identifying a CA BSI. These results were shared with the other hospital units during monthly meetings. Compliance with the insertion and maintenance bundles was monitored and reported to each unit monthly. The hospital-wide CA-BSI rate decreased from a baseline of 3.0 to <1.0 CA BSI per 1000 line-days after implementation of the QIC. Our hospital-wide QIC resulted in a significant reduction in the incidence of CA BSI at our children's hospital. A collaborative model based on improvement science methodology is both feasible and effective in reducing the incidence of CA BSI.

Improved delivery of cardiovascular care (IDOCC) through outreach facilitation: study protocol and implementation details of a cluster randomized controlled trial in primary care

BackgroundThere is a need to find innovative approaches for translating best practices for chronic disease care into daily primary care practice routines. Primary care plays a crucial role in the prevention and management of cardiovascular disease. There is, however, a substantive care gap, and many challenges exist in implementing evidence-based care. The Improved Delivery of Cardiovascular Care (IDOCC) project is a pragmatic trial designed to improve the delivery of evidence-based care for the prevention and management of cardiovascular disease in primary care practices using practice outreach facilitation.MethodsThe IDOCC project is a stepped-wedge cluster randomized control trial in which Practice Outreach Facilitators work with primary care practices to improve cardiovascular disease prevention and management for patients at highest risk. Primary care practices in a large health region in Eastern Ontario, Canada, were eligible to participate. The intervention consists of regular monthly meetings with the Practice Outreach Facilitator over a one- to two-year period. Starting with audit and feedback, consensus building, and goal setting, the practices are supported in changing practice behavior by incorporating chronic care model elements. These elements include (a) evidence-based decision support for providers, (b) delivery system redesign for practices, (c) enhanced self-management support tools provided to practices to help them engage patients, and (d) increased community resource linkages for practices to enhance referral of patients. The primary outcome is a composite score measured at the level of the patient to represent each practice's adherence to evidence-based guidelines for cardiovascular care. Qualitative analysis of the Practice Outreach Facilitators' written narratives of their ongoing practice interactions will be done. These textual analyses will add further insight into understanding critical factors impacting project implementation.DiscussionThis pragmatic, stepped-wedge randomized controlled trial with both quantitative and process evaluations demonstrates innovative methods of implementing large-scale quality improvement and evidence-based approaches to care delivery. This is the first Canadian study to examine the impact of a large-scale multifaceted cardiovascular quality-improvement program in primary care. It is anticipated that through the evaluation of IDOCC, we will demonstrate an effective, practical, and sustainable means of improving the cardiovascular health of patients across Canada.Trial RegistrationClinicalTrials.gov: NCT00574808

Closure to “Joseph B. Strauss, Charles A. Ellis, and the Golden Gate Bridge: Justice at Last” by Francis E. Griggs Jr.

Closure to “Joseph B. Strauss, Charles A. Ellis, and the Golden Gate Bridge: Justice at Last” by Francis E. Griggs Jr.

Competitividade interna na bovinocultura de corte no Estado do Rio Grande do Sul

O presente trabalho teve por objetivo identificar os principais fatores internos (custos, receitas, viabilidade técnico-econômica e uso de inovações tecnológicas) que afetam a competitividade da bovinocultura de corte em um sistema de produção de ciclo completo no Estado do Rio Grande do Sul. Os dados foram coletados durante o ano de 2008, a partir de reuniões mensais entre os meses de janeiro e dezembro. Posteriormente, os dados foram analisados em planilhas eletrônicas. Os custos foram subdivididos em desembolsados, operacionais e totais e as receitas por categoria e total. Dentre os custos avaliados, destacaram-se o custo de oportunidade da terra, mão-de-obra e suplementação animal, com valores de 19,9%, 18,3% e 13,6%, respectivamente, em relação ao custo total. Foram calculados os principais indicadores financeiros e técnicos utilizados comumente em análise de sistemas de produção. As margens econômicas (bruta, operacional e líquida), assim como a lucratividade e rentabilidade sobre o patrimônio líquido, foram positivos, o que demonstra a viabilidade econômica da atividade. Ao mesmo tempo, indicadores técnicos, como a taxa de desfrute e a produtividade/ha, apresentaram valores satisfatórios. Dessa forma, pode-se concluir que os fatores internos avaliados foram extremamente competitivos para o sistema em questão.

Finding a safe place to explore sexual identity

The monthly meetings of a group in Oxford give its lesbian, gay, transgender and bisexual members a forum in which to be themselves. Anna Elderton and Chris Jones tell the story of Mingle

Motivating Mathematics Learning

The authors investigated patterns of change in three middle grade teachers’ beliefs and practices about motivation in mathematics during a yearlong professional development project with a university researcher. Four principles of motivation (and corresponding instructional strategies) were introduced in this sequence: supporting students’ competence, belongingness, autonomy, and making learning meaningful. Teachers enacted strategies in their classrooms, were observed and interviewed, and discussed and reflected on results during monthly meetings. Enactment of motivation strategies was related to changes in mathematics instruction for some teachers. Results reflect the importance of situating motivation strategies in content area instruction and providing adequate support for teacher conceptual change. The authors examine both personal and contextual explanations for changing instructional practices and the obstacles to such changes.

Forty-five minutes of physical activity at school each day? Curricular promotion of physical activity in grades one to four

AimAccording to the US Department of Health and Human Services (2008) and the World Health Organization (2008), regular physical activity is essential to the healthy development of children and contributes to the reduction of chronic diseases throughout their life span. However, coordinated comprehensive national and international programs to promote physical activity and sports participation are lacking. According to the German Sports Federation (2006), physical education (PE) classes at German schools are increasingly being canceled or taught outside the school. "fit for pisa" is a German intervention developed in response to the demand for scientific evaluation of interventions like daily physical education. Its goal is to provide quality management-secured, structured and standardized PE instruction by qualified instructors.Subjects and methodsThe "fit for pisa" intervention has been implemented at five primary schools in Göttingen, Germany, since 2003. This daily physical education intervention is based on quality standards. At the five primary schools participating in "fit for pisa," students receive a supplementary 3 class hours of PE/week in addition to the mandatory 2 class hours/week for the entire school term. In other words, the children now receive one 45-min session of PE each school day. Daily physical education is now a part of their mandatory school curriculum. The curriculum content and teaching methods have been continuously developed and optimized based on the state guidelines for Lower Saxony.ResultsTeacher training is held at the participating schools once a month to promote standardized implementation and quality management of the intervention program. Additional monthly meetings are held so that the teachers can discuss any problems, deviations or other issues occurring in the classes. Checklists are provided for the teachers and external trainers to document the content and objectives of each lesson. Supervisors evaluate the checklists at regular intervals. Using these instruments, the results of the 4-year intervention program were evaluated at the five participating primary schools.ConclusionsThis study provides important data for recommendations to implement additional physical education in primary schools, for the corresponding quality assurance instruments and for the optimization of physical education guidelines for primary schools.

A modest proposal for Europe: a two-part plan for overcoming the eurozone's crisis, redesigning its crumbling architecture, and reinvigorating the European Project

During 2010, each and every response by the Eurozone to the galloping sovereign debt crisis has been consistently underwhelming. Monthly European Union Summit pronouncements, which during the first half of 2010 were met with initial goodwill by the markets and commentators, quickly proved the harbinger of further deepening of the crisis. By the end of 2010, the markets did not even wait for the European Union’s leaders to conclude their monthly meetings before signalling another jump in yields and a further deterioration of the continent’s financial outlook. Eventually, it became clear to everyone that the European approach (of extending expensive loans to fiscally stricken sovereigns on condition of savage austerity) was deeply flawed. This article outlines the basis of a policy mix that would end the crisis without any substantial institutional changes. It is in this particular sense that this proposal is both practical and modest.

Use of Outcomes Information in Child Mental Health Treatment: Results From a Pilot Study

Use of Outcomes Information in Child Mental Health Treatment: Results From a Pilot Study

The Use of Research Abstracts in Formulary Decision Making by the Joint Oncology Drug Review of Canada

Opinions on the use of research abstracts in policy decision making are conflicting. We sought to evaluate the influence of research abstracts in guiding decisions of the Joint Oncology Drug Review of Canada (JODR), which conducts clinical and economic reviews of new cancer treatment drugs for formulary listing. The minutes of the monthly meetings of the JODR between 2005 and 2007 were reviewed. One submission per drug indication was included. Elements evaluated included the level of evidence supporting each decision, the year the study was published and subsequent publication of any abstracts. There were 73 recommendations reviewed over the 36 months. Ten recommendations were deferred and eight recommendations were re-submissions, thus 55 recommendations underwent analysis. There were 31 recommendations based to some extent on abstracts, of which 14 (45%) were in favour of formulary listing and 17 (55%) were opposed. Twelve recommendations were based exclusively on abstracts, seven (58%) of which were in favour of formulary listing. As a comparison, published randomized controlled trials were part of the evidentiary base in 30 committee recommendations (55%). Of these, 17 (57%) were in favour of formulary listing, while 13 (43%) were opposed. Research abstracts are commonly involved in evidence-based decision making for formulary listing. The rates of approving cancer drugs for funding by the JODR were similar among recommendations based on abstracts and other levels of evidence. Abstracts can play an important role in guiding decision making.

Influence of a Clinic-Based Group Intervention on Asthma Perception and Management in India

Multiple patient-level notions of asthma etiology and management exist. The purpose of this study was to test the efficacy of a group-level educational intervention to change knowledge, attitude, and practice (KAP) in asthma patients. In a baseline study to assess KAP in asthma patients, 797 adults participated. All were invited to participate in this follow-up study about a group-level learning program. A total of 701 (88%) patients attended one of the monthly meetings composed of 60 to 80 patients, where they were educated regarding the nature of the disease, trigger factors, prevention, and inhaler use through a locally customized education tool using audiovisual aids. A short questionnaire to assess changes in KAP was completed by 580 participants (83%). A comparison of responses to baseline was performed using the c2 test. The baseline study revealed lacunae in 4 areas of KAP: awareness of nature of asthma, early signs of exacerbation, compliance with therapy, and preferential inhaler use. In postintervention versus baseline group comparisons, a significant increase in knowledge of disease nature (12% vs 44%, P &lt; .001), early exacerbation recognition (14% vs 76%, P &lt; .001), compliance with therapy (10% vs 33%, P &lt; .001), and preferred use of inhalers (men: 41% vs 74%, P &lt; .001; women: 9% vs 69%, P &lt; .001) was observed. Group-level education with a customized audiovisual teaching tool is effective in changing the attitude of asthma patients.

Grupo psicoeducativo multifamiliar no tratamento dos transtornos alimentares na adolescência

The psycho-educational multifamily group is part of a multidisciplinary treatment offered to adolescents with eating disorders and their families, in the out-patient Program for Children and Adolescents with Eating Disorders - PROTAD - of the Institute of Psychiatry, of Hospital das Clinicas, Medicine College, University of Sao Paulo, PROTAD-AMBULIM-HC-IPq-FMUSP. This article is based at the experience from the monthly meetings with the families and caregivers, from the out-patient program for adolescent patients with eating disorders, and exhibit the employed psycho-educational group model, linking it to the specific literature and the clinical practice.

Patients with cancer believed that chemotherapy had to “hurt” or “cause side effects” to be effective

What are cancer patients’ perceptions of adjuvant chemotherapy? Ethnography. Cancer treatment centre in western Canada. 30 patients with colon or rectal cancer who were regular, irregular, or 1-time participants in...

A Multidisciplinary Approach to Reducing Door-to-Balloon Time in a Community Hospital

A Multidisciplinary Approach to Reducing Door-to-Balloon Time in a Community Hospital

Lionel Casson (1914–2009)

Lionel Casson (1914–2009) Larissa Bonfante In accepting the Gold Medal for Distinguished Achievement of the Archaeological Institute of America in 2005, Jimmy Casson, as his friends called him, tells the story of the encounter that confirmed his early fascination with ships and the sea. In 1953 he met Jacques Cousteau, the noted oceanographer, at the now famous site of the Grand Congloué, near Marseilles. He was involved in a TV taping showing how he used his special vessel to raise ancient amphoras from sunken ships on the bottom of the sea. "It was an eye-opening experience. I knew at once that I was in on the beginning of a totally new source of information about ancient maritime matters and I determined then and there to exploit it." An excellent classical scholar, he was in a position to do so, using evidence from literature, papyri, coins, and iconography, along with his own familiarity with the sea, to build up a picture of ancient ships and seamanship and to become the undisputed master of the field. The Ancient Mariners (1959), and later Ships and Seamanship in the Ancient World (1971, often reprinted) made the maritime story of the ancient world available to both the scholar and to the non-specialist. His interests and many publications extended far beyond seamanship. Like Cousteau, he had a gift for communication, wrote clearly and elegantly, and was much in demand by publishers for both scholarly and popular books and articles, as well as for advice on matters of scholarship. His first major book was on the papyri of Nessana, Egypt (1950). The New York Times review of his last book, on ancient libraries, entitled "Shh! There's no Talking in the Papyrus Section," (July 11, 2001), is studded with typically witty asides, such as his reference to "the prolific author Didymus (known as Bronze Guts for his mind-boggling output of an estimated 3,500 to 4,000 books)". During World War II (1942–1946) he served as Lieutenant in the Department of Naval Intelligence, where he was trained to interrogate Japanese prisoners of war. Except for this period, Casson's scholarly career was spent at New York University, where he taught from 1936 through 1979. He was twice chair of the Classics Department, but his leadership was crucial for a much longer time, and the practical sense and decisiveness I admired in later years as his colleague helped the Department to survive the difficult years of the Depression, when it developed innovative courses and became involved in projects for the WPA. He developed and long taught a course on Ancient Comedy when scholarly circles ignored the subject as being too frivolous, translated Plautus and Lucian's Satires, and wrote Masters of Ancient Comedy as a textbook for the course. His Travel in the Ancient World opened up another field of research. The Periplus Mari Erythrae (1989) was written when Jimmy was leading the monthly meetings of the informal Ancient Civilization Group, where he managed—in [End Page 495] almost every case—to cut the speaker off after 10 minutes. Regular members were Bluma Trell, Blanche Brown, Annalina Levi, Morton Smith, Alan Schulman, who regaled us with tales of Egypt, Tessie Goell, who reported on Nemrud Dagh, Arthur Schiller who discussed points of Roman Law, and frequent visitors Cyrus Gordon, Theodore Gaster, and many others. He will be missed in all the worlds to which he belonged, by his colleagues, friends, and family—Judy, his wife of 63 years, and their daughters, Andrea and Gail. We honor him for what he has done here and abroad for scholarship, and for the vision of antiquity that his books have made a little clearer and more exciting. This is a democracy, and there are no titles. Otherwise, we would be remembering Sir Lionel Casson—or Sir Jimmy—today. Larissa Bonfante New York University Copyright © 2009 The Classical Association of the Atlantic States, Inc.

Engaging Early Childhood Teachers in the Thinking and Practice of Inquiry: Collaborative Research Mentorship as a Tool for Shifting Teacher Identity

The purpose of this study was to investigate the impact of participation in a research mentorship team (RMT) on early childhood teachers' professional identities. The participants were seven early childhood teachers engaged in preservice teacher supervision at a university-affiliated child care center who volunteered to be members of the RMT facilitated by two teacher educators. This process involved informal monthly meetings and activities over the course of 2 years intended to engage teachers more directly and intentionally in inquiry. The teachers' perspectives regarding the benefits and the challenges they faced in the RMT were explored. The findings of this study, derived from interviews, meeting transcripts, and supporting documents, offer insight into: (1) early childhood teachers' changing paradigms regarding the research process, (2) the role of participation in research on teachers' engagement in the intellectual/theoretical elements of teaching, and (3) the impact of changing teacher identities on the culture of an early childhood center.

Table of Contents

Abstract Ask Corporations to Recruit Holiday Volunteers Volunteer Assignments Ask the Right Questions to Find Your Volunteer's Niche Give Supporters Opportunity to Fill Holiday Wish List How Much Did Your Volunteers Give in 2008? Say Thanks With Food Recognition Efforts Why Recognize Only One Volunteer Each Month? Volunteer‐driven Events Honor Volunteers, Those They Serve With Luminary Night Volunteer‐invested Programs Paying for Training Leads to Highly Committed Volunteers Recruitment Outreach Steps to a Successful Volunteer Fair Cost‐saving Ideas Seek Out Inexpensive Means of Advertising Get the Most Out of Local TV Should You Start a Blog? Offer Mentors Training, Realistic Expectations Generous Gestures Community Supports Volunteers Fighting Gas Crunch Meeting Special Needs Keep the Aging Volunteer as a Valuable Part of the Team More Tips for Working With Seniors Member Recruitment Sponsor a Volunteer Recruitment Competition Helpful Resources Introduce a Volunteer Handbook to Your Organization Today ‘Powerful’ Award Reaps Multiple Benefits Offer Monthly Meetings To Support Volunteers Useful Communications Student Volunteers Bring Energy, Enthusiasm Three Steps Improve Student Volunteer Success Tools You Can Use Add a Skills Questionnaire to Your Volunteer Application Volunteer Managers Share Pet Peeves Team‐building Techniques Get Everyone on the Same Page Early on Volunteer‐driven Events Volunteers Put the ‘Special’ Into Special Event Do Your Part to Increase Event Ticket Sales Great Idea? Put it in Writing

Present and Prevented: A Survey of Membership Activity in Britain Yearly Meeting of the Religious Society of Friends (Quakers) *

A questionnaire was sent to all Monthly, Preparative and other Business Meetings and worshipping groups in Britain Yearly Meeting for completion on 7 May 2006. With an over 80 percent response rate meaningful statistics can be calculated for attendance at Meetings for worship, Meetings for business and involvement by Friends and attenders in the business of the Society.1