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\"Draws on international research to addresses the current key question in teacher education policy and practice: what and how do teachers learn from experience?\"-- Provided by publisher.

PurposeWe aimed to assess the impact of implementing Edmonton Symptom Assessment System (ESAS) screening on health-related quality of life (HRQoL) and patient satisfaction with care (PSC) in ambulatory oncology patients. ESAS is now a standard of care in Ontario cancer centers, with the goal of improving symptom management in cancer patients, yet few studies examine impact of ESAS on patient outcomes.MethodsWe compared ambulatory oncology patients who were not screened prior to ESAS site implementation (2011–2012), to a similar group who were screened using ESAS after site implementation (2012–2013), to examine between-group differences in patient HRQoL, PSC outcomes, and supportive care needs (Supportive Care Service Survey). Both no-ESAS (n = 160) and ESAS (n = 108) groups completed these measures: the latter completing them, along with ESAS, at baseline and 2 weeks later.ResultsAfter assessing the impact of implementing ESAS, by matching for potentially confounding variables and conducting univariate analyses, no significant between-group differences were found in HRQoL or PSC. There was significant improvement in symptoms of nausea/vomiting and constipation, after 2 weeks. Lower symptom burden with decreased ESAS scores was significantly correlated with increased HRQoL. There were no between-group differences in knowledge of/access to supportive care.ConclusionsSignificant correlation between change in ESAS and HRQoL implies ESAS could usefully inform healthcare providers about need to respond to changes in symptom and functioning between visits. This study showed no impact of early-ESAS screening on HRQoL or PSC. Further research should explore how to better utilize ESAS screening, to improve communication, symptom management, and HRQoL.

Wernicke-Korsakoff syndrome in patients with cancer is understudied. Much of what is known—that significant under-recognition and delays in treatment exist—comes from studies of alcohol misuse disorders or non-alcohol-related Wernicke-Korsakoff syndrome in patients. We investigated the frequency and associated features of cancer-related Wernicke-Korsakoff syndrome in the published literature. We included 90 articles reporting on 129 patients. Only 38 (30%) of 128 patients with data available exhibited the entire triad of classic features of Wernicke-Korsakoff syndrome: confusion, ataxia, and ophthalmoplegia or nystagmus. Diagnosis during life was missed altogether in 22 (17%) of 128 patients. The operational diagnostic criteria (at least two of the following: nutritional deficiency, ocular signs, cerebellar signs, and either altered mental status or mild memory impairment), which are considered more reliable than the classical triad, were used in only nine (7%) cases, yet 120 (94%) met the operational criteria for diagnosis at the time of presentation when applied retroactively. Complete recovery was reported in only 47 (36%) cases. Given that oncologists or haematologists accounted for only 17 (19%) first authors among the articles included, it is important that oncologists are aware of the risk factors for cancer-related Wernicke-Korsakoff syndrome, and that they are vigilant about diagnosing and treating the disease especially in the absence of alcohol misuse disorders.

Nearly 250,000 cancer cases are diagnosed annually in Canada, with breast and prostate cancer representing 25% and 22% of new cases, respectively. Artificial intelligence (AI) applications can potentially improve the accuracy, efficiency, and timeliness of cancer care, including screening, diagnostic imaging, and early treatment. However, patient acceptability of AI in cancer care remains underexplored. This study aimed to understand the feelings and perceptions of and acceptability to patients with breast and prostate cancer regarding the inclusion of AI-powered medical robots for cancer screening, diagnosis, and early treatment and to identify barriers and facilitators to implementation. In this qualitative study, semistructured interviews were conducted with 15 patients with breast (n=6) or prostate (n=9) cancer. Participants (mean [SD] age 67 [12] y; range 41-88 y) were recruited from Sunnybrook Health Sciences Centre between May and November 2022. Each participant completed 2 semistructured interviews, each approximately 1 hour in length, conducted by telephone or Zoom by a research assistant. The first interview explored initial reactions and expectations regarding AI-assisted medical technologies, allowing us to tailor questions for the second interview to better understand practical means of introducing AI into care, while further exploring salient concepts. Data were analyzed using a conventional content analysis approach. Two research assistants independently and inductively coded transcripts, iteratively generating and refining a codebook. Data saturation was assessed after 10 interviews and confirmed through analysis of all 15 participants. Three overarching categories were developed: (1) individual beliefs, understanding, and attitudes; (2) integration of AI into care; and (3) health structure, systems, and processes. Participants reported openness toward AI-assisted medical robots but emphasized the importance of reduced wait times, demonstrated safety and reliability, and patient-centered care. Patients indicated that with appropriate education and transparent communication, they would be willing to accept AI-assisted care due to its enhanced accuracy and efficiency. Key barriers included concerns about reliability, potential loss of human interaction, and inadequate mitigation strategies for technical failures. Facilitators included timely results, improved efficiency, accessible educational resources, and assurance that AI would complement rather than replace human expertise. Participants demonstrated cautious willingness to accept AI-powered medical robots in cancer care if positioned as complementary to, rather than substitutes for, human-provided care. These findings underscore the need for maintaining the presence of health care providers during AI-assisted procedures, providing clear and accessible education, and ensuring transparent communication about safety and reliability. Personalizing patient education and offering multiple modes of information delivery may foster confidence and improve acceptability. While findings are exploratory and reflect the perspectives of a small, predominantly urban sample, they provide actionable insights into patient concerns and priorities that may inform future research and guide early implementation strategies in integrating AI into cancer care pathways.

What do teachers learn ‘on the job’? And how, if at all, do they learn from ‘experience’? Leading researchers from the UK, Europe, the USA and Canada offer international, research-based perspectives on a central problem in policy-making and professional practice – the role that experience plays in learning to teach in schools. Experience is often weakly conceptualized in both policy and research, sometimes simply used as a proxy for ‘time’, in weeks and years, spent in a school classroom. The conceptualization of experience in a range of educational research traditions lies at the heart of this book, exemplified in a variety of empirical and theoretical studies. Distinctive perspectives to inform these studies include sociocultural psychology, the philosophy of education, school effectiveness, the sociology of education, critical pedagogy, activism and action research. However, no one theoretical perspective can claim privileged insight into what and how teachers learn from experience; rather, this is a matter for a truly educational investigation, one that is both close to practice and seeks to develop theory. At a time when policy-makers in many countries seek to make teacher education an entirely school-based activity, Learning Teaching from Experience offers an essential examination of the evidence-base, the traditions of inquiry – and the limits of those inquiries.

The COVID-19 pandemic has posed an ongoing threat to the mental wellbeing of countless individuals worldwide, with healthcare workers at particularly high risk. We developed the STEADY staff wellness program prior to the pandemic based on the available literature and input from stakeholders, guided by the Knowledge-to-Action (KTA) Implementation Science Framework. We quickly adapted the STEADY program for implementation in selected high-need units within Canada’s largest trauma hospital during the pandemic’s first wave. This brief report describes implementation of the STEADY program, retroactively applying the structure of the Knowledge-to-Action Implementation Science Framework to the practical steps taken. We identified the importance of more frequent, shorter contact with HCWs that occurred in-person, with an emphasis on peer support. A flexible approach with strong support from hospital leadership were key facilitators. Our findings suggest that a flexible approach to practical program implementation, theoretically underpinned in best-practices, can result in an acceptable program that promotes increased HCW wellbeing during a pandemic.

Caregivers of men with prostate cancer report high burden, and there is a need to develop cost-effective programs to support them in their roles. This study reports on the acceptability of a dyadic, Tailored, wEb-based, psychosocial and physical activity (PA) self-Management PrOgram called TEMPO. TEMPO was accessed by a convenience sample of 19 men with prostate cancer and their caregivers (n = 18), as well as six health care professionals (HCPs). User feedback was gathered via semi-structured qualitative interviews. Data were analyzed using thematic analysis. Most dyads were satisfied with TEMPO, particularly with the dyadic feature of TEMPO, the focus on goal setting to integrate self-management, and the extensive health library. The patients and caregivers motivated each other as they worked through TEMPO. Most goals to achieve during TEMPO pertained to increasing PA, followed by learning physical symptom management. One unanticipated benefit of TEMPO for the dyads was improved communication. HCPs agreed that TEMPO was a novel approach to online cancer self-management and they echoed the benefits reported by dyads. Key suggestions for improving TEMPO were to reduce repetition, tailor content, add more exercise ideas, and have more printing options. This study provides a strong foundation on which to plan a larger trial.

Objective: Identify the most salient elements of the head and neck cancer (HNC) care experience described by patients and caregivers in focus group interviews. Methods: Three focus groups of patients and caregivers were facilitated by research assistants and clinicians. Open-ended guiding questions captured/elicited aspects of care that were appreciated, warranted improvement, or enhanced communication and information. A four-step Delphi process derived consensus among focus group facilitators (n = 5) regarding salient discussion points from focus group conversations. Results: Seven salient themes were identified: (1) information provision, (2) burden related to symptoms and treatment side effects, (3) importance of social support, (4) quality of care at both hospital and provider levels, (5) caring for the person, not just treating cancer, (6) social and emotional impact of HNC, and (7) stigma and insufficient information regarding human papillomavirus-related HNC. Conclusion: Participants reported varying needs and support preferences, a desire for individualized communication, and to feel cared for as both a person and a patient. Findings illuminate the intricate details underlying high-quality, compassionate, person-centered HNC cancer care.

Background Prostate cancer predisposes patients and caregivers to a wide range of complex physical and psychosocial challenges, and interventions must incorporate a wide range of self-management strategies to help patients and their caregivers effectively cope with cancer challenges. To palliate this need, our team recently developed and evaluated the initial acceptability of a dyadic, Tailored, wEb-based, psychosocial, and physical activity self-Management PrOgram ( TEMPO ). TEMPO is a 10-week, interactive, web-based intervention consisting of five modules designed to help dyads manage their physical and psychosocial needs. It aims to teach dyads new self-management strategies and encourages them to increase their physical activity (PA) levels, mainly through walking and strength-based exercises. Initial acceptability evaluation of TEMPO revealed high user satisfaction, in addition to having a number of potential benefits for participants. After integrating suggested changes to TEMPO , the proposed pilot study aims to further test the acceptability and feasibility of TEMPO . Methods This study is a multicenter, stratified, parallel, two-group, pilot randomized control trial (RCT), where patient–caregiver dyads are randomized (stratified by anxiety level) to receive (a) TEMPO or (b) usual care. Participants ( n goal = 40) are recruited across Canada at participating cancer centers and through self-referral (e.g., online recruitment). Patient inclusion criteria are (a) having received prostate cancer treatment within the past 2 years or scheduled to receive treatment, (b) identified a primary caregiver willing to participate in the study, and (c) has access to the Internet. Eligible caregivers are those identified by the patient as his primary source of support. Dyads complete a baseline questionnaire (T1) and another one 3 months later (T2) assessing various aspects of physical and emotional functioning (e.g., the Medical Outcomes Study (MOS) 12-item Short Form Health Survey (SF-12), the Hospital Anxiety and Depression Scale (HADS), and the Perceived Stress Scale (PSS)), self-management behaviors (e.g., the Health Education Impact Questionnaire (heiQ)), physical activity (the International Physical Activity Questionnaires (IPAQ) and the Multidimensional Self-efficacy for Exercise Scale (MSES)), and dyadic coping (the Dyadic Coping Inventory (DCI)). Dyads that used TEMPO are also asked to participate in a semi-structured exit interview exploring their overall experience with the program. Discussion This feasibility analysis will begin to develop the knowledge base on TEMPO ’s value for men with prostate cancer and their caregivers to inform a larger trial. Trial registration NCT04304196

When a patient is diagnosed with cancer, a number of losses and grief processes occur. Theories and models of loss, grief, and mourning are explored for the patient, her family member, and the medical treatment team, through a personal reflection when treating a patient undergoing a course of radiation treatment in a large cancer center. Reflection on this event can be used to guide health care facilities to assess and develop support systems for patients, caregivers, and health care professionals to cope with loss and grief processes in a healthy and meaningful way.