Worthwhile Outcomes Research Articles

Lived experiences of children who stutter in their own voices

IntroductionSignificant research has explored the lived experiences of adults who stutter, but less research exists regarding the lived experiences of children who stutter. The opinions and ideas of children who stutter may differ from those of adults, making it important for clinicians and researchers to obtain information directly from children who stutter. Asking children directly can lead to treatment outcomes and research questions that better align with the children's needs and values. Method: Interviews with 18 children who stutter (9 girls/9 boys) ages 8–17 were sourced from the Voices of Children Who Stutter database located at Talkbank.org. Interview questions asked the children about living with a stutter, participating in stuttering support organizations (SSOs), and their perspectives on treatment. Qualitative, phenomenological analysis was performed on their answers following standardized qualitative procedures. Results: Analysis of 910 total utterances yielded 7 themes and 9 subthemes. Themes indicated that the children: (a) had significant knowledge regarding their own stuttering, (b) had opinions regarding what constituted worthwhile treatment outcomes, (c) were clear about desirable clinician characteristics for working with kids who stutter, and (d) saw the benefits of being part of a community. Conclusions: Themes revealed that overall, children who stutter exhibit deep understanding regarding their experiences with stuttering, which clinicians can harness in person-centered goal setting. Additionally, the participants express the importance of participating in stuttering support organizations.

The Concept of Quality in Curriculum

The curriculum is a description of what students should learn in school. The curriculum itself includes many subjects and objects to be applied in educational institutions. Teachers, material subjects, students, and many other things are required to achieve worthwhile and useful learning outcomes and then realize the aim of education. The quality of the curriculum is important to the success of education in order to create students who become good people in society. This paper discusses the concept of quality in curriculum education in general. The aim of the research is to clarify the perception of curriculum quality based on references to international and national curricula. The authors used qualitative research with literature review technique compilation data. This paper summarizes the views and perceptions of national curriculum and UNESCO curriculum quality by analyzing the curriculum implemented in Indonesia. The result revealed that the quality of the curriculum has four criteria (development, the curriculum, the implementation, and evaluation) that are then developed to obey the education national standard (SNP): competence of graduates standards, contents standards, process standards, and assessment standards. Based on the data, almost 70% of the implementation of the development and improvement of the Merdeka Indonesia curriculum is going well. To date, there are 293,373 formal education units that have implemented the Merdeka curriculum optimally.

Metaphorical perceptions of Chinese college students about English learning experience

The present study has investigated the metaphorical perceptions of first-year Chinese students toward their English learning experience before college. Metaphors were collected using the prompt “English learning was (like) … because ….” and analyzed qualitatively by Elicited Metaphor Analysis. The results revealed four types of metaphors: work, journey, leisure, and necessity. Regardless of metaphor types, the students tended to perceive English learning as a slow, hardworking process leading to a sense of accomplishment and personal growth as well as language development. As for attitudes toward English learning, the students generally conceived of learning English as a highly challenging endeavor with ultimately worthwhile outcomes.

TECHNOLOGY ENHANCED PROJECT-BASED COOPERATIVE LEARNING: APPLICATION AND USE IN INDIAN HIGHER EDUCATION

The project-based learning pedagogy is a new era in the Indian educational system that encourages participatory teaching and deeper learning in the classroom. The gap between theoretical and experimental parts of a topic can be somewhat bridged by project-based learning, which also helps students gain a better knowledge of the material. To develop a better skilled workforce, knowledgeable managers, and qualified individuals to deal with real-world applications would be highly exciting and beneficial for the Indian educational system and Indian government purpose. Additionally, it will inspire our students to collaborate on a variety of themes where each person has a unique area of expertise. It will enable them to achieve some worthwhile outcomes in a timely manner. In the present article, a thoughtful analysis will be carried out to understand the PBL and Indian conventional teaching.

Graduates’ perspectives on effective continuing education and training: participation, access and engagement

ABSTRACT There is a growing global concern about providing effective continuing education and training (CET) to support and sustain the employability of working-age populations. More than enhancing workplace viability and employability, CET also assists in achieving governments’ economic and social goals. Educational institutions organise CET provisions based on intended goals, resources, capacities, and institutional imperatives. However, working-age adults’ effective engagement and worthwhile outcomes are likely to be strongest when what is afforded them is aligned with their goals, needs and readiness to participate. Thus, what constitutes effective CET provisions can be best understood by appraising them through how they secure individuals’ engagement and meet their needs. Drawing on an investigation of CET provisions in Singapore, this paper seeks to illuminate and appraise what constitutes qualities of effective CET provisions in relation to addressing issues of relevance, accessibility and quality of engagement with educational experiences. Through analyses of interview and survey data, the motivations for informants’ CET participation, their preferences and requirements for effective engagement in CET including desirable qualities of teachers were identified and delineated. Given that adults elect to participate in CET to achieve personal and professional outcomes, the findings provide bases for designing, enacting and evaluating effective CET programmes.

Oncologists’ perceptions of the need for assessing individual domains in the geriatric assessment and worthwhile outcomes in treating older patients with cancer

Background: Although the multidimensional geriatric assessment (GA) is considered the standard of care, it is not uniformly practiced. In older patients with cancer, shared decision-making requires a clear understanding of the goals of therapy. Objectives: We aimed to understand the perceptions of health-care professionals of the need to assess the various domains in the GA and what would constitute worthwhile outcomes in older patients with cancer. Materials and Methods: An online questionnaire survey was conducted by the geriatric oncology group of the Department of Medical Oncology at the Tata Memorial Hospital in Mumbai, India. Participants in the survey included various health professionals with an interest in the care of older patients with cancer. Data were collected in Microsoft Excel and basic descriptive statistics were performed. Results: Between July and August 2020, 234 health-care professionals responded to the survey. The respondents included predominantly medical oncologists (146, 70.9%), practicing in academic centers (148, 65.6%) from India (168, 87%). According to 46% of the respondents, over 30% of the patients in their practices were in the geriatric age group; yet, 144 (73.8%) respondents reported that they referred <10% of their older patients with cancer for a GA. Almost all the respondents agreed that it was important to check for the presence of polypharmacy, inappropriate medications, comorbidities, drug interactions, falls, function, psychological status, cognition, nutrition, social support, and quality of life in the older patients with cancer. Over 95% of the respondents thought that formal training in the GA should be part of the oncology training programs. According to 139 respondents (63%), an improvement in the quality of life or a decrease in toxicity were more important goals of cancer-directed therapy in older patients with cancer, compared to prolongation of overall survival. Conclusion: There is a recognition of the importance of performing a multidimensional GA in older patients with cancer; however, this has not translated into a widespread performance of the GA in actual practice. It would be important to address the barriers to implementing the GA in the clinic, to help optimize the care of older patients with cancer. The goals of cancer-directed therapy should be clearly discussed with the patients in order for true shared decision-making to occur.

On Municipalities as Technologies

Although there is a history in urban thought wherein scholars view cities as technologies, the encompassing character of such views inherently limits them. In turn, their usefulness does not efficiently support the kind of thinking that is required to deliver worthwhile outcomes that can promote social justice and human flourishing. However, narrowing the focus through examining municipalities as technologies offers possibilities that can help us achieve such goals. To maximize the utility of this endeavor, employing the structural-ethics approach provides a way to assess urban technologies to achieve success. In this paper, the author explores the ideas above, revealing how they advance our thinking when it comes to remaking, planning, and building existing and future cities. The article concludes by linking these claims to other lessons in urban studies and geography.

Contemporary Surgical Management of Peri-Hilar Cholangiocarcinoma (PH-CCA)

Introduction: Peri-hilar cholangiocarcinoma (PH-CCA) is a rare tumour of the liver hilus. Resection is a major surgical undertaking typically requiring hepatectomy with excision of the extra-hepatic biliary tree. Can this type of surgery be undertaken in regional hepatobiliary centers with worthwhile outcomes? Methods: During the 11 year period January 2009 to January 2020, 424 patients underwent hepatectomy by an individual HPB surgeon (AKS) in a regional liver surgery service. 22 underwent hepatectomy for type III or type IV PH-CCA and constitute the study population. Patients undergoing surgery for intra-hepatic cholangiocarcinoma are excluded. Pre-operative preparation included percutaneous trans-hepatic drainage of the future liver remnant followed by cardiopulmonary exercise testing and CT of the abdomen and thorax. Vascular involvement was assessed by pre-operative contrast-enhanced magnetic resonance scan. There was no policy of neoadjuvant chemo- or radiotherapy. Resection included segment I and reconstruction of biliary drainage was by Roux hepaticojejunostomy. The study was listed as an audit. Results: 8 (36%) were IIIa, 7 (32%) were IIIb and 7 were type IV. All underwent major hepatectomy with 4 (18%) requiring arterial reconstruction to the new remnant liver. In-hospital mortality was zero. Adjuvant chemotherapy was utilized in 6 (27%). Median (range) survival was 15 (2-74) months. Conclusions: This is a highly selected series and care must be exercised when extrapolating from these results. However, the data show that liver resection in the hands of an experienced team is a feasible option in carefully assessed patients with type III and type IV PH-CCA.

Health Professional Perspectives on Rehabilitation for People With Dementia.

Multidisciplinary rehabilitation is not incorporated into the usual care pathway for dementia despite increasing demand from key advocates. Clinician views regarding the relevance of rehabilitation in dementia care are not well known. This qualitative study explored the perspectives of health professionals regarding barriers to provision of multidisciplinary rehabilitation programs for people with dementia. Sixteen health professionals from a variety of settings and professional backgrounds were purposively sampled using maximum variation sampling. Semi-structured interviews were conducted to explore attitudes toward the care of people with dementia and beliefs about the feasibility and value of multidisciplinary rehabilitation in this population. Thematic analysis was used to identify themes. Participating clinicians acknowledged problems with existing dementia care pathways in Australia but rarely conceptualized rehabilitation as relevant to this pathway. Analyses yielded two main and related themes: (i) difficulty defining worthwhile outcomes of a rehabilitation program for people with dementia and (ii) perceived barriers to participation in this population. Clinicians felt that achievable outcomes for people with dementia were not sufficiently worthwhile for investment. Broader acceptance of multidisciplinary rehabilitation as relevant to dementia care will require a reframing of practice that both educates emerging health professionals regarding the outcomes that may be achievable for people with dementia and persuades staff to appreciate that the investment is worthwhile.

Silicalite‐1 Encapsulated Fe Particles over an In‐situ Crystal Process for Syngas to Gasoline with Low CO2 Selectivity

AbstractZeolite synthesis involved use of large volumes of solvent that resulted in waste and enhanced production costs. In our study, we selected a solvent‐free synthesis route that involved mixing, grinding and crystallization at various times creating Fe@Silicalite‐1. This synthesis method produced a hierarchical in‐situ microporous crystal morphology with Fe particles caged inside zeolite displaying a high gasoline (C5‐C11) selectivity of 66.0% with a relatively low CO2 and CH4 selectivity (18.5% and 10.0%, respectively) in Fischer‐Tropsch synthesis. Prolonged crystallization time of 72 h and other subsequent procedures contributed to zeolite structure and performance. Iron moieties were appropriately immobilized over silicalite support. The characterization results were correlated with the zeolite activity and selectivity. This novel zeolite at its best possesses all the potential to be advanced in other related material synthesis because of its expedient procedure, characteristics and worthwhile outcomes.

Surgical and developmental outcomes of corpus callosotomy for West syndrome in patients without MRI lesions.

This retrospective study was designed to assess the impact of corpus callosotomy (CC) in patients with intractable West syndrome (WS) without lesions on magnetic resonance imaging (MRI). This study involved 56 patients with WS who underwent CC between January 2000 and December 2014. Seizure outcomes and changes in psychomotor development were analyzed. Mean age at the onset of epilepsy and at the time of CC was 5.1 and 22.6months, respectively. Mean duration of epilepsy before CC was 17.6months. Video-electroencephalography (EEG) monitoring showed bilateral ictal and interictal abnormalities before CC. Mean follow-up duration was 36.6months. At final follow-up, seizure outcomes after CC were seizure-free in 18 patients (32.1%), excellent (E: >80% reduction in seizure frequency) in 15 (26.8%), good (G: >50% reduction) in 10 (17.9%), and poor (P: <50% reduction) in 13 (23.2%). Epileptic spasms (ES) were eliminated in 24 patients (42.9%). However, tonic seizure (TS) outcomes were poor (P<0.05). Of preoperative predictive factors related to seizure outcome, developmental delay before epilepsy onset correlated with poor outcome (P<0.05). One year post-CC, 6 patients (10.7%) had no epileptic abnormality on EEG, 19 (33.9%) had lateralized epileptic abnormalities, and 31 (55.4%) had bilateral asynchronous epileptic abnormalities. All patients without epileptic discharge achieved seizure freedom. Fifteen of 19 (78.9%) patients in the lateralized group and 12 of 31 (38.7%) in the bilateral asynchronous group had worthwhile outcomes (F+E). The patterns of EEG changes after CC correlated with seizure outcome (P<0.01). Progressive declines in developmental quotient were prevented in patients with worthwhile outcomes. CC represents an important therapeutic option for patients with WS without resectable MRI lesions. Transcallosal seizure bilateralization is critical for bilateral ES generation. Early identification of potential CC candidates and surgical intervention are important for better seizure control and cognitive capacity preservation before severe developmental delay development.

Cost and value in e-learning: the perspective of the learner.

Medical education is expensive. Its expense has led to growing interest in methods to deliver medical education that will maximise outcomes for a given spend.1 There has long been enthusiasm for the use of e-learning as a method that can be low cost and that can deliver worthwhile outcomes. However, this enthusiasm has not been built on strong evidence. There is evidence that e-learning produces broadly similar outcomes as face-to-face education.2 However, there is little evidence as to the cost utility of e-learning in medical education. There is also little evidence as to how learners perceive the utility of e-learning in light of its cost. This paper reports an evaluation of the perceptions and views of general practitioners (GPs) with regard to the cost and utility of an e-learning resource—BMJ Learning. BMJ Learning is the e-learning service of the BMJ. UK GPs who are users of BMJ Learning were asked by email to take part in an evaluation as to the cost and utility of the e-learning. Semistructured interviews were conducted by telephone with those who responded to the email. The interviews were conducted according to a schedule which was founded on existing literature …

Caucusing: Creating a space to confront our fears

Learning does not occur in a vacuum and this reality challenges all educators to provide for the differing learning needs that exist because of students’ particular relationship to the course material. Teaching Te Tiriti o Waitangi and the colonial history of Aotearoa New Zealand to adult students of social work and counselling in mainstream tertiary education programmes provides particular challenges and opportunities for tutors and students alike. When teaching this topic, it is essential that the nature of the relationships that exist today between the peoples that represent the signatories of the Tiriti / Treaty of Waitangi in 1840 is explored. Yet, at the same time, the learning needs of all students must be met.The authors have extensive experience in the teaching of Te Tiriti o Waitangi to adult learners. They have found the practice of caucusing helpful in creating a process that affords an opportunity for a transfer of learning to take place. How this process operates is the subject of this research study. In it, the authors identify distinct differences between Maaori and non-Maaori students’ experiences of caucusing. Worthwhile explanations of these differences are provided and linked to literature findings. Excerpts from research relating to the hidden dynamics of white power and domination are provided and assist in increasing an understanding of the intense reactions expressed by students during the transfer of knowledge process. Comments from students are included to highlight the shifts in understanding as the caucusing experience proceeds. The authors suggest that this topic has quite different implications for students within the same classroom, dependent upon whether they are located within the group that has experienced colonisation and domination (Maaori) or the other group, i.e. the colonising group (non-Maaori). They highlight the need to go beyond an intellectual fact-gathering exercise to achieve significant and worthwhile educational outcomes in this topic area.

Caucusing: Creating a space to confront our fears

Learning does not occur in a vacuum and this reality challenges all educators to provide for the differing learning needs that exist because of students’ particular relationship to the course material. Teaching Te Tiriti o Waitangi and the colonial history of Aotearoa New Zealand to adult students of social work and counselling in mainstream tertiary education programmes provides particular challenges and opportunities for tutors and students alike. When teaching this topic, it is essential that the nature of the relationships that exist today between the peoples that represent the signatories of the Tiriti / Treaty of Waitangi in 1840 is explored. Yet, at the same time, the learning needs of all students must be met.The authors have extensive experience in the teaching of Te Tiriti o Waitangi to adult learners. They have found the practice of caucusing helpful in creating a process that affords an opportunity for a transfer of learning to take place. How this process operates is the subject of this research study. In it, the authors identify distinct differences between Maaori and non-Maaori students’ experiences of caucusing. Worthwhile explanations of these differences are provided and linked to literature findings. Excerpts from research relating to the hidden dynamics of white power and domination are provided and assist in increasing an understanding of the intense reactions expressed by students during the transfer of knowledge process. Comments from students are included to highlight the shifts in understanding as the caucusing experience proceeds. The authors suggest that this topic has quite different implications for students within the same classroom, dependent upon whether they are located within the group that has experienced colonisation and domination (Maaori) or the other group, i.e. the colonising group (non-Maaori). They highlight the need to go beyond an intellectual fact-gathering exercise to achieve significant and worthwhile educational outcomes in this topic area.

Win-Win-Win: Reflections from a Work-Integrated Learning Project in a Non-Profit Organization

This paper reports on the educational aspects of an information systems work-integrated learning (WIL) capstone project for an organization which operates to alleviate homelessness in the Australian non-profit sector. The methodology adopted for the study is Action Design Research (ADR) which draws on action research and design research as a means for framing a project's progress. Reflective insights by the project stakeholders, namely, students, academics, and the non-profit client, reveal a curriculum at work through internal features of the organization; personal features of the participants and features of the external environment. Preliminary findings suggest that students in a WIL project for a non-profit are highly engaged, especially when they become aware of the project’s social value. As well, the improvement of professional skills and emotional intelligence by students is more likely in real-life practice settings than in other less authentic WIL activities, equipping graduates for the workforce with both strong disciplinary and generic skills. Win-win-win synergies through project collaboration represent worthwhile outcomes to education, industry and research.

Outcomes of haematology/oncology patients admitted to intensive care unit at The Canberra Hospital.

Outcomes for haematology/oncology patients have improved; however, determining their suitability for intensive care unit (ICU) admission remains challenging and controversial. Examine outcomes of patients admitted to an Australian tertiary hospital ICU and explore potential prognostic factors. A retrospective review of patients with haematological and solid tumour malignancies non-electively admitted to The Canberra Hospital (TCH) ICU, between January 2008 and December 2012. Patient demographics, cancer details, reasons for ICU admission and Acute Physiologic and Chronic Health Evaluation (APACHE) II scores were collected, and survival rates calculated and correlated with potential prognostic factors. Of 205 patients, 113 (55%) had haematological malignancies, and 92 (45%) had solid tumours: 58% male and mean age 60.3 years (standard deviation (SD) 13.4). Eighty-two per cent of solid tumour patients had metastatic disease and 55% received palliative chemotherapy. Primary reasons for ICU admission included sepsis (59%), respiratory distress (37%) and hypotension/shock (18%). Mean APACHE II score was 20.1(SD 0.55); mean length of stay in ICU, 4 days (SD 5.2); ICU survival was 76% with 62% and 41% alive at 30 days and 6 months respectively. Overall 1-year survival was 36%. High APACHE II scores and ≥2 organs failing were significant risk factors for 30-day mortality. Short-term outcomes were similar to contemporary studies from a general tertiary hospital setting and better than historical data. Sixty-two per cent of patients were alive 30 days post-ICU admission, with a significant minority alive at 12 months, confirming some patients achieved worthwhile outcomes. Further research is needed to ensure appropriate patient selection and to explore quality of life post ICU.

Outcome of Lumbar Nerve Root Block in Patients with Sciatica and Lumbar Disc Prolapse

A recent review (UK Health Technology Assessment programme 2013) reported that selective lumbar nerve root block (SLRB) may be effective and cost-effective in treatment strategies for lumbar radicular pain, although there are conflicting results from studies, possibly related to problems such as heterogeneous patient groups and confusion with back and radicular pain. Review of 842 patients with SLRB in our centre, produced 740 with acceptable data quality (28-day pain diaries with pre-injection VAS 0-10 scores plus post-treatment data). Mean pre-injection VAS was 6.4. Mean VAS was 4.5 at two days following injection. At 28 days, mean VAS was 5.1. Some patients had major reduction in VAS in the first 24 hours, but this did not predict improvement at 28 days. However, within this group, 10% of patients had VAS scores no higher than 2/10 from seven days onwards, suggesting there may be worthwhile outcomes for sub-groups of patients.

Should Protein Be Included in CHO-Based Sports Supplements?

Should Protein Be Included in CHO-Based Sports Supplements?

Organizational Justice and Behavioral Ethics: Promises and Prospects

ABSTRACT:Scholars studying organizational justice have been slow to incorporate insights from behavioral ethics research, despite the fields’ conceptual affinities. We maintain that this stems from differences in the paradigmatic approaches taken by scholars in each area. First, justice research historically has assumed that individuals are motivated by a desire for instrumental control of worthwhile outcomes or by a concern with social status, while behavioral ethics has paid more attention to the role of internalized moral convictions and duties. Second, organizational justice researchers have investigated one set of individual differences, behavioral researchers have examined another. Third, justice scholars focus on social identities while behavioral ethics scholars also investigate moral identities. As an impetus to future inquiry, our review attends to contemporary organizational justice research that takes into account concepts derived from behavioral ethics. In so doing we hope to highlight an avenue for integrative scholarship that will further our understanding of organizational justice.

Effect of Donor Nerve Injury Distal to an End-to-Side Neurorrhaphy Model

In end-to-side neurorrhaphy, "noninjury" models of the donor nerve do not seem to offer worthwhile functional outcomes. The role of donor nerve injury distal to the coaptation site remains unclear. End-to-side neurorrhaphy was studied in a rat model in which the proximal stump of the transected musculocutaneous nerve was sutured to the median nerve by end-to-side coaptation. Twenty Sprague-Dawley rats were randomized to four groups of five animals each, in which three different types of donor injury (crush, ligation, or transection injury) distal to the coaptation site were executed; findings were compared with a similar end-to-side model without donor nerve injury (control). Behavioral analysis, electrophysiological studies, muscle morphometric studies, and nerve fibers counts showed no significant differences among groups. However, there was a significant difference regarding mean myelin area (P = 0.0362) and mean fiber diameter (P = 0.0159) for the crush injury group as compared with the control group. No significant differences were found among the other groups. These data suggest that donor crush injury distal to the coaptation site may increase the rate of myelin formation in regenerating axons across an end-to-side model; however, at 4 weeks of follow-up, there was no significant behavioral or functional significance in this treatment group.