EMI and Beyond

This collection presents the state of the art on English-medium instruction (EMI) / Integrating content and language (ICL) in Italian higher education, drawing attention to different critical aspects of the teaching/learning experience and highlighting the perspectives of various educational stakeholders regarding the effectiveness of tertiary study in a foreign language. The chapters draw on a range of methodologies, from multimodal participant observation, to action research, to video-stimulated recall (VSR), to questionnaires and interviews, in examining language policies and practices across various educational settings. Overall, the volume suggests that internationalisation succeeds best when the form of lessons (language) and the content of lessons (disciplinary concepts) are constructively aligned in curriculum planning and delivery. This integration process requires the strategic support of educators to guarantee the quality of learning in multilingual education.

EMI and Beyond

This collection presents the state of the art on English-medium instruction (EMI) / Integrating content and language (ICL) in Italian higher education, drawing attention to different critical aspects of the teaching/learning experience and highlighting the perspectives of various educational stakeholders regarding the effectiveness of tertiary study in a foreign language. The chapters draw on a range of methodologies, from multimodal participant observation, to action research, to video-stimulated recall (VSR), to questionnaires and interviews, in examining language policies and practices across various educational settings. Overall, the volume suggests that internationalisation succeeds best when the form of lessons (language) and the content of lessons (disciplinary concepts) are constructively aligned in curriculum planning and delivery. This integration process requires the strategic support of educators to guarantee the quality of learning in multilingual education.

Treatment patterns and frequency of key outcomes in acute severe asthma in children: a Paediatric Research in Emergency Departments International Collaborative (PREDICT) multicentre cohort study

Rationale Severe acute paediatric asthma may require treatment escalation beyond systemic corticosteroids, inhaled bronchodilators and low-flow oxygen. Current large asthma datasets report parenteral therapy only. Objectives To identify the use and type of escalation of treatment in children presenting to hospital with acute severe asthma. Methods Retrospective cohort study of children with an emergency department diagnosis of asthma or wheeze at 18 Australian and New Zealand hospitals. The main outcomes were use and type of escalation treatment (defined as any of intensive care unit admission, nebulised magnesium, respiratory support or parenteral bronchodilator treatment) and hospital length of stay (LOS). Measurements and main results Of 14 029 children (median age 3 (IQR 1–3) years; 62.9% male), 1020 (7.3%, 95% CI 6.9% to 7.7%) had treatment escalation. Children with treatment escalation had a longer LOS (44.2 hours, IQR 27.3–63.2 hours) than children without escalation 6.7 hours, IQR 3.5–16.3 hours; p<0.001). The most common treatment escalations were respiratory support alone (400; 2.9%, 95% CI 2.6% to 3.1%), parenteral bronchodilator treatment alone (380; 2.7%, 95% CI 2.5% to 3.0%) and both respiratory support and parenteral bronchodilator treatment (209; 1.5%, 95% CI 1.3% to 1.7%). Respiratory support was predominantly nasal high-flow therapy (99.0%). The most common intravenous medication regimens were: magnesium alone (50.4%), magnesium and aminophylline (24.6%) and magnesium and salbutamol (10.0%). Conclusions Overall, 7.3% children with acute severe asthma received some form of escalated treatment, with 4.2% receiving parenteral bronchodilators and 4.3% respiratory support. There is wide variation treatment escalation

Contribution of the Conservation Estate to New Zealanders’ Prosperity and Wellbeing: Three Case Studies

New Zealand’s total land area is approximately 26.8 million hectares, of which 8.5 million hectares are administered by the Department of Conservation (DOC). DOC recognises that it needs to partner with others to achieve its outcome statement. The purpose of this paper is to present three case studies where DOC is partnering with community groups so that the local community can gain environmental, social and economic benefits in line with the Department’s outcome statement. The authors had previous knowledge of the three case studies and received a small amount of funding from DOC to allow some follow-up interviews with key stakeholders in each of the case studies. The paper is presented in four main parts. Part 1 describes the research questions asked in the stakeholder interviews and explains their purpose. Parts 2, 3 and 4 present the three case studies: The Oparara Valley Project Trust; The Otago Central Rail Trail; and the Kiwi Ranger programme. The paper finishes with a summary of the major common themes revealed through these case studies

Contribution of the conservation estate to New Zealanders' prosperity and wellbeing: Three case studies

New Zealand’s total land area is approximately 26.8 million hectares, of which 8.5 million hectares are administered by the Department of Conservation (DOC). DOC recognises that it needs to partner with others to achieve its outcome statement. The purpose of this paper is to present three case studies where DOC is partnering with community groups so that the local community can gain environmental, social and economic benefits in line with the Department’s outcome statement. The authors had previous knowledge of the three case studies and received a small amount of funding from DOC to allow some follow-up interviews with key stakeholders in each of the case studies. The paper is presented in four main parts. Part 1 describes the research questions asked in the stakeholder interviews and explains their purpose. Parts 2, 3 and 4 present the three case studies: The Oparara Valley Project Trust; The Otago Central Rail Trail; and the Kiwi Ranger programme. The paper finishes with a summary of the major common themes revealed through these case studies

Contribution of the conservation estate to New Zealanders' prosperity and wellbeing: three case studies

New Zealand's total land area is approximately 26.8 million hectares, of which 8.5 million hectares are administered by the Department of Conservation (DOC). DOC recognises that it needs to partner with others to achieve its outcome statement. The purpose of this paper is to present three case studies where DOC is partnering with community groups so that the local community can gain environmental, socal and economic benefits in line with the Department's outcome statement. The authors had previous knowledge of the three case studies and received a small amount of funding from DOC to allow some follow-up interviews with key stakeholders in each of the case studies. The paper is presented in four main parts. Part 1 describes the research questions asked in the stakeholder interviews and explains their purpose. Parts 2, 3 and 4 present the three case studies: The Oparara Valley Project Trust: The Otago Central Rail Trail; and the Kiwi Ranger programme. The paper finishes with a summary of the major common themes revealed through these case studies

Is 'minimally adequate treatment' really adequate?:investigating the effect of mental health treatment on quality of life for children with mental health problems

BACKGROUND: Minimally adequate treatment (MAT) is intended to represent treatment minimally sufficient for common mental health problems. For children, MAT has been defined over a twelve-month period as either eight or more mental health visits, or four to seven visits plus relevant medication. MAT is used to identify those missing out on adequate care, but it is unknown whether MAT improves children's outcomes. METHODS: This paper examines whether MAT is associated with improved outcomes for children. It uses survey data from the nationally representative Longitudinal Study of Australian children on 596 children with mental health problems based on the Strengths and Difficulties Questionnaire at ages 8-15 years, linked to health service administrative data from 2012 to 2016. Statistical analysis examines the association of MAT with later quality of life (Pediatric Quality of Life Inventory), using a lagged dependent variable model to account for time-varying unobserved confounding. RESULTS: Compared to children with lower levels of treatment, those who received MAT between baseline and follow up had no statistically significant improvement in either quality of life or mental health symptoms. LIMITATIONS: The observational data provide insight into real-world practice but require statistical methods to account for selection into treatment. CONCLUSIONS: While clinical trials show mental health treatments can be efficacious, this study shows no evidence that children receiving MAT in routine practice have better outcomes. These findings demonstrate the need for better understanding of the nature and impact of children's mental health care as it is delivered and received in routine practice

Qualitative study of emergency clinicians to inform a national guideline on the management of children with mild-to-moderate head injuries

Background Head injury is a common reason children present to EDs. Guideline development to improve care for paediatric head injuries should target the information needs of ED clinicians and factors influencing its uptake. Methods We conducted semi-structured qualitative interviews (November 2017–November 2018) with a stratified purposive sample of ED clinicians from across Australia and New Zealand. We identified clinician information needs, used the Theoretical Domains Framework (TDF) to explore factors influencing the use of head CT and clinical decision rules/guidelines in CT decision-making, and explored ways to improve guideline uptake. Two researchers coded the interview transcripts using thematic content analysis. Results A total of 43 clinicians (28 doctors, 15 nurses), from 19 hospitals (5 tertiary, 8 suburban, 6 regional/ rural) were interviewed. Clinicians sought guidance for scenarios including ED management of infants, children with underlying medical issues, delayed or representations and potential non-accidental injuries. Improvements to the quality and content of discharge communication and parental discussion materials were suggested. Known risks of radiation from head CTs has led to a culture of observation over use of CT in Australasia (TDF domain: beliefs about consequences). Formal and informal policies have resulted in senior clinicians making most head CT decisions in children (TDF domain: behavioural regulation). Senior clinicians consider their gestalt to be more accurate and outperform existing guidance (TDF domain: beliefs about capabilities), although they perceive guidelines as useful for training and supporting junior staff. Summaries, flow charts, publication in ED-specific journals and scripted training materials were suggestions to improve uptake. Conclusion Information needs of ED clinicians, factors influencing use of head CT in children with head injuries and the role of guidelines were identified. These findings informed the scope and implementation strategies for an Australasian guideline for mild-to-moderate head injuries in children

Measurements of calcium dynamics in the plant endoplasmic reticulum: an aequorin-based approach

Effective use of adenovirus-5 (Ad5) in cancer therapy is heavily dependent on the degree to which the virus's natural tropism can be subverted to one that favours tumour cells. This is normally achieved through either engineering of the viral fiber knob or the use of bispecific adaptors that display both adenovirus and tumour antigen receptors. One of the main limitations of these strategies is the need to tailor each engineering event to any given tumour antigen. Here, we explore bispecific adaptors that can utilise established anti-cancer therapeutic antibodies. Conjugates containing bacterially derived antibody binding motifs are efficient at retargeting virus to antibody targets. Here, we develop a humanized strategy whereby we synthesise a re-targeting adaptor based on a chimeric Ad5 ligand/antibody receptor construct. This adaptor acts as a molecular bridge analogous to therapeutic antibody mediated cross-linking of cytotoxic effector and tumour cells during immunotherapy. As a proof or principle, we demonstrate how this adaptor allows efficient viral recognition and entry into carcinoma cells through the therapeutic monoclonal antibodies Herceptin/trastuzumab and bavituximab. We show that targeting can be augmented by use of contemporary antibody enhancement strategies such as the selective elimination of competing serum IgG using "receptor refocusing" enzymes and we envisage that further improvements are achievable by enhancing the affinities between the adaptor and its ligands. Humanized bispecific adaptors offer the promise of a versatile retargeting technology that can exploit both clinically approved adenovirus and therapeutic antibodies.</p