Predictors of Teacher Educators\u27 Research Productivity

This study examined the relationship between teacher educators\u27 research productivity (RP) and their background and professional characteristics, attitudes, motives, obstacles and time devoted to research. The sample included 161 teacher educators from four teacher education colleges in Israel. The findings indicate the significance of five variables for predicting RP: academic degree, rank, administrative position, desire to develop new knowledge and learn from research findings and perceived insufficient research competence and self-confidence. These variables account for 37.2% of the variance in RP. The results from this study provide useful information for teacher education institutions and policy makers regarding variables significantly related to RP. These variables should be addressed when recruiting teacher educators, assigning administrative duties and designing professional development programs, particularly for new career faculty

Dynamic Phenotypic Switching and Group Behavior Help Non-Small Cell Lung Cancer Cells Evade Chemotherapy

Drug resistance, a major challenge in cancer therapy, is typically attributed to mutations and genetic heterogeneity. Emerging evidence suggests that dynamic cellular interactions and group behavior also contribute to drug resistance. However, the underlying mechanisms remain poorly understood. Here, we present a new mathematical approach with game theoretical underpinnings that we developed to model real-time growth data of non-small cell lung cancer (NSCLC) cells and discern patterns in response to treatment with cisplatin. We show that the cisplatin-sensitive and cisplatin-tolerant NSCLC cells, when co-cultured in the absence or presence of the drug, display dynamic group behavior strategies. Tolerant cells exhibit a \u27persister-like\u27 behavior and are attenuated by sensitive cells; they also appear to \u27educate\u27 sensitive cells to evade chemotherapy. Further, tolerant cells can switch phenotypes to become sensitive, especially at low cisplatin concentrations. Finally, switching treatment from continuous to an intermittent regimen can attenuate the emergence of tolerant cells, suggesting that intermittent chemotherapy may improve outcomes in lung cancer

Low venous thromboembolism incidence in high risk medical patients in an Israeli hospital. Can risk assessment be extrapolated to different populations?

BACKGROUND:Guidelines recommend venous thromboembolism (VTE) prophylaxis in hospitalized medical patients with Padua prediction score (PPS) ≥4 points. This recommendation is based on the high risk of symptomatic VTE observed among these patients in the Italian PPS derivation study, and the fivefold risk reduction with VTE-prophylaxis. This study aims to assess the incidence of VTE in high risk medical patients in a medium sized hospital in Israel. METHOD:In this retrospective cohort study, data was collected of all medical patients hospitalized between January and June 2014. Patients were classified into low and high risk groups according to their PPS score, and according to whether they received anticoagulant thromboprophylaxis for VTE. Patients were further randomly selected to compare high risk patients that did or did not receive anticoagulant thromboprophylaxis. We further compared VTE incidence in high and low risk patients not treated with thromboprophylaxis. A search was conducted for diagnoses of venous thromboembolism and death during hospitalization and the following 90 days. RESULTS:568 high risk patients (PPS ≥4 points) were included, 284 treated with prophylactic anticoagulation and 284 not. There were no VTE events in either group. There was no difference in mortality. A total of 642 non anticoagulated patients were randomly selected, 474 low risk and 168 high risk. There were no VTE events in either group. CONCLUSIONS:The risk of VTE appears to be very low in our study, suggesting that among medical patients with PPS ≥4, the risk of VTE may differ dramatically between populations

Dynamic Phenotypic Switching and Group Behavior Help Non-Small Cell Lung Cancer Cells Evade Chemotherapy

Drug resistance, a major challenge in cancer therapy, is typically attributed to mutations and genetic heterogeneity. Emerging evidence suggests that dynamic cellular interactions and group behavior also contribute to drug resistance. However, the underlying mechanisms remain poorly understood. Here, we present a new mathematical approach with game theoretical underpinnings that we developed to model real-time growth data of non-small cell lung cancer (NSCLC) cells and discern patterns in response to treatment with cisplatin. We show that the cisplatin-sensitive and cisplatin-tolerant NSCLC cells, when co-cultured in the absence or presence of the drug, display dynamic group behavior strategies. Tolerant cells exhibit a ‘persister-like’ behavior and are attenuated by sensitive cells; they also appear to ‘educate’ sensitive cells to evade chemotherapy. Further, tolerant cells can switch phenotypes to become sensitive, especially at low cisplatin concentrations. Finally, switching treatment from continuous to an intermittent regimen can attenuate the emergence of tolerant cells, suggesting that intermittent chemotherapy may improve outcomes in lung cancer

MEMBACA PERSPEKTIF BALANCED SCORECARD

Kini penetrasi internet mendisrupsi seisi negeri. Semua gagap dan tergopoh-gopoh menghadapi. Gagap gempita menyambut kelahiran Revolusi Industri 4.0. Belum usai menjadi bahan diskusi, kini kita dihadapkan pada pandemi. Covid-19 menerjang seisi bumi. Namun, seiring berjalannya waktu, kita dipaksa new normal, memang di dunia tidak ada yang kekal. Di tengah dua isu itu, dunia pendidikan pun terkena imbas. Semua tata kelola berubah, seluruh pemangku sibuk mengatur strategi dan selebihnya hanya memelas. Lalu berkelindan, pada sisi tertentu internet menjadi solusi pandemi. Terasa jauh menerawang, acapkali hanyalah angan-angan, ketika membincangkan situasi terkini. Dunia pendidikan babak belur, semua program sulit diukur. Namun alhamdulillah, kami merasa mendapat vaksin, ketika beberapa mahasiswa menyerahkan draft naskah buku yang isinya menyoal pendidikan. Sejenak kita bisa mendedahkan kegamangan situasi, dengan menkonsumsi artefak literasi. Membincang dunia pendidikan, diakui atau tidak kita selalu digiring memulainya dari soal “sekolah” Sama seperti halnya membincangkan kebudayaan, selalu diawali dengan “kesenian”. Oleh karena itu, demi memahami alur berpikir tulisan-tulisan yang disajikan dalam buku ini, kami memandang mengawalinya dari perbincangan mengenai “sekolah.” Baik, mari sejenak menjelajahi Yunani Kuno pada ratusan tahun silam. Konon istilah “sekolah” berasal dari bahasa Latin schola atau skhole yang bermakna “waktu luang” atau “waktu senggang”. Kemudian kita menyerapnya dari orang Eropa, dari kata “school” dan menjadi “sekolah”, atau urang Sunda acapkali menyebutnya “sakola” atau “iskola”. Konon, bangsa Yunani Kuno mengisi waktu senggangnya dengan berkumpul untuk mendiskusikan atau sekedar menerima hal-hal baru dari paragurunya, yang kelak dikenal sebagai filusuf. Seiring perubahan jaman, makna sekolah pun bergeser menjadi aktivitas kegiatan belajar-mengajar bahkan lebih sempit lagi menjadi aktivitas di ruang kelas. Makna terakhir inilah yang kita akan bincangkan di sini. Bagaimana pendekatan, model, metode dan strategi yang efektif demi mewujudkan sekolah bermutu dan proses pembelajaran yang menyenangkan. Kenapa demikian, sebab aktivitas pendidikan di ruang-ruang kelas inilah yang menjadi bahan kajian polemis hingga kini. Dari ragam kajian itu, hadirlah pendekatan Balanced Scorecard (BSC). Teori yang mulai dipopulerkan oleh Robert S. Kaplan dan David P. Norton pada tahun 1992 ini, kemudian ditelanjangi oleh paramahasiswa yang menulis dalam buku ini dengan cara menelisik sejauh mana teori Kaplan dan Norton tersebut dapat diimplementasikan pada bidang pendidikan, khususnya wahana pendidikan formal, mulai jenjang SD sampai Universitas. Bahkan beberapa tulisan, secara khusus membincangkan pendekatan BSC secara konseptual dan dipadupadankan dengan persoalan pentingnya perspektif pelanggan dalam dunia pendidikan. Umumnya, mereka seperti dalam kondisi gelisah. Memang kegelisahan-kegelisahan ihwal mutu pendidikan (dalam hal ini proses pembelajaran di ruang kelas) kemudian yang menginspirasi Anies Baswedan (Menteri Pendidikan dan Kebudayaan 2014-2016) membangunkan kembali visi besar Bapak Pendidikan Nasional Ki Hadjar Dewantara tentang “Sekolah sebagai Taman”. Intinya bahwa anak harus merasa senang ketika sedang belajar dan berada di sekolah, layaknya mereka sedang bermain di sebuah taman. Anak tidak lagi terkungkung atau terpenjara ketika berada di ruang kelas atau lingkungan sekolah. Kemudian, gagasan ini pula yang kelak menginspirasi Nadiem Anwar Makarim (Menteri Pendidikan dan Kebudayaan kini) memunculkan konsep “Merdeka Belajar”. Secara umum, maknanya jelas bahwa belajar harus menyenangkan, anak diberi kebebasan kreativitas, sekolah menjadi tempat menyenangkan. Ini menurut kami, semacam kembali memaknai konsep awal “sekolah”. Anak bisa nyaman ketika berada di lingkungan sekolah, merdeka berkreativitas, dan tentu terasa seperti mengisi waktu senggang atau luang. Kemudian, sejauh pembacaan kami, sepilihan tulisan dalam buku ini pada dasarnya menangkap kegelisahan sebagaimana tema diskusi kita. Kegelisahan bagaimana agar sekolah bisa menyenangkan, belajar bisa bermutu, dan mengelola kegiatan di dalamnya secara terpadu. Isi tulisan mengupas bagaimana tata kelola pendidikan mulai jenjang dasar, memengah, sampai perguruan tinggi memakai pendekatan BSC. Alhasil tujuannya terasa sama, bagaimana agar kelembagaan pendidikan bisa terkelola dengan baik dan menjadi wadah yang menyenangkan demi menghasilkan kualitas pembelajaran. Berdasarkan hal itu, kemudian kami sepakat, sepilihan tulisan dalam buku ini dibagi ke dalam tiga bagian: Bagian I: Teroka Sepintas Pendekatan BSC pada Bidang Pedidikan. Isinya mengupas secara umum teori atau pendekatan BSC dalam bidang pendidikan. Bagian II: Tinjauan Pendekatan BSC pada Bidang Pendidikan jenjang Dasar dan Menengah. Isinya bagaimana pendekatan BSC diimplementasikan dalam tata kelola sekolah SD, SMA, dan SMK. Kemudian terakhir Bagian III: Tinjauan Pendekatan BSC dalam Bidang Pendidikan jenjang Perguruan Tinggi. Isinya mengupas implementasi pendeatan BSC dalam tata kelola kampus. Secara umum, sepilihan tulisan dalam buku ini terasa lengkap dan kontekstual. Hanya saja, kualitas tulisan belum merata benar. Masih terdapat beberapa tulisan yang perlu penajaman konsep, gaya penulisan, dan bagaimana mendudukkan teori ke dalam analisis implementasi. Hal lain, pembahasan konsep BSC masih terasa kaku, akibat belum dipadukannya dengan teori-teori pendukung. Padahal jika pendekatan BSC dipadukan dengan teori-teori interdisipliner lain, membaca tulisan ini akan terasa bergizi. Bagaimana pun, kami mengapresiasi sangat tinggi kehadiran rampai tulisan yang kini menjadi buku ini. Penegasan-penegasan gagasan di dalamnya dapat ditangkap, baik secara vulgar maupun samar-samar, bahwa penyumbang tulisan secara umum sedang dihinggapi gejala kegelisahan sama: Bagaimana “masa depan pendidikan” dan akan seperti apa “pendidikan masa depan”? Selanjutnya, biarlah kegelisan ini dibaca bersama agar melahirkan tawaran gagasan baru bagi pembaca untuk bangkit menjajal rimba literasi meski di tengah pandemi. Selamat kepada penulis dan kepada sidang pembaca, saran kami sesekali bacalah pada pagi hari seraya meneguk secangkir kopi. Itulah nikmatnya berliterasi. **

Inequality on the frontline:A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic

Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women's well-being and ensure healthcare system preparedness during future public health crises.</p

Students' participation in collaborative research should be recognised

Letter to the editor

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research