Discussing uncertainty and risk in primary care: recommendations of a multi-disciplinary panel regarding communication around prostate cancer screening.

BackgroundShared decision making improves value-concordant decision-making around prostate cancer screening (PrCS). Yet, PrCS discussions remain complex, challenging and often emotional for physicians and average-risk men.ObjectiveIn July 2011, the Centers for Disease Control and Prevention convened a multidisciplinary expert panel to identify priorities for funding agencies and development groups to promote evidence-based, value-concordant decisions between men at average risk for prostate cancer and their physicians.DesignTwo-day multidisciplinary expert panel in Atlanta, Georgia, with structured discussions and formal consensus processes.ParticipantsSixteen panelists represented diverse specialties (primary care, medical oncology, urology), disciplines (sociology, communication, medical education, clinical epidemiology) and market sectors (patient advocacy groups, Federal funding agencies, guideline-development organizations).Main measuresPanelists used guiding interactional and evaluation models to identify and rate strategies that might improve PrCS discussions and decisions for physicians, patients and health systems/society. Efficacy was defined as the likelihood of each strategy to impact outcomes. Effort was defined as the relative amount of effort to develop, implement and sustain the strategy. Each strategy was rated (1-7 scale; 7 = maximum) using group process software (ThinkTank(TM)). For each group, intervention strategies were grouped as financial/regulatory, educational, communication or attitudinal levers. For each strategy, barriers were identified.Key resultsHighly ranked strategies to improve value-concordant shared decision-making (SDM) included: changing outpatient clinic visit reimbursement to reward SDM; development of evidence-based, technology-assisted, point-of-service tools for physicians and patients; reframing confusing prostate cancer screening messages; providing pre-visit decision support interventions; utilizing electronic health records to promote benchmarking/best practices; providing additional training for physicians around value-concordant decision-making; and using re-accreditation to promote training.ConclusionsConference outcomes present an expert consensus of strategies likely to improve value-concordant prostate cancer screening decisions. In addition, the methodology used to obtain agreement provides a model of successful collaboration around this and future controversial cancer screening issues, which may be of interest to funding agencies, educators and policy makers

CHORUS Deliverable 2.2: Second report - identification of multi-disciplinary key issues for gap analysis toward EU multimedia search engines roadmap

After addressing the state-of-the-art during the first year of Chorus and establishing the existing landscape in multimedia search engines, we have identified and analyzed gaps within European research effort during our second year. In this period we focused on three directions, notably technological issues, user-centred issues and use-cases and socio- economic and legal aspects. These were assessed by two central studies: firstly, a concerted vision of functional breakdown of generic multimedia search engine, and secondly, a representative use-cases descriptions with the related discussion on requirement for technological challenges. Both studies have been carried out in cooperation and consultation with the community at large through EC concertation meetings (multimedia search engines cluster), several meetings with our Think-Tank, presentations in international conferences, and surveys addressed to EU projects coordinators as well as National initiatives coordinators. Based on the obtained feedback we identified two types of gaps, namely core technological gaps that involve research challenges, and “enablers”, which are not necessarily technical research challenges, but have impact on innovation progress. New socio-economic trends are presented as well as emerging legal challenges

Staff Development and Student Achievement: Making the Connection in Georgia Schools

The purpose of this study is to examine the connection between staff development and student achievement and to develop a base of knowledge for improving staff development in Georgia. Since 1985, the state has appropriated funds for staff development under the Quality Basic Education Act, one of the most comprehensive statewide initiatives for school improvement in the United States. In fiscal year 1998, Georgia appropriated over $35 million for staff development in schools and school districts. The Georgia Department of Education has collected information about uses of resources, levels of participation, and accomplishments of effectiveness of staff development in Georgia schools have not been conducted. Indeed, evaluations of staff development programs at a state level are rare. This study provides information to policy makers about whether or not state staff development funds are used in such a way as to have an impact on student achievement. The study also provides information that can be used to help schools maximize the effectiveness of their staff development efforts.While staff development can be defined in a number of ways, for this study we used the following definition: An organized learning opportunity for teachers to acquire knowledge and skills to help them become more effective teachers. Staff development activities may consist of activities such as a single workshop, a conference, a workshop series, summer institutes, college coursework, or organized peer coaching and study group sessions. A staff development activity may be sponsored by many entities including a school, the school district, Regional Education Service Agencies, state agencies, teacher academies, colleges, or professional networks and organizations.In this study we ask the question, "Do differences in the ways schools and school districts provide staff development for their teachers account for some of the variation in student achievement across Georgia schools?" The general strategy for the investigation was to select a sample of higher and lower achieving schools across a full range of socio-economic status, to gather data on staff development in these schools, and to test the extent to which the characteristics of staff development varied in the two groups of schools. Sixty schools in 35 districts participated in the study. At each school, we interviewed school administrators, conducted a focus group discussion with six to ten teachers, and surveyed teachers in the school (1,150 teachers responded). At the district office, we interviewed the staff development coordinator, personnel director, and finance director to determine the context in which staff development occurred at the schools