Extended Treatment with Apixaban for Venous Thromboembolism Prevention in the Netherlands:Clinical and Economic Effects

Background ?Dutch guidelines advise extended anticoagulant treatment with direct oral anticoagulants or vitamin K antagonists for patients with idiopathic venous thromboembolism (VTE) who do not have high bleeding risk. Objectives ?The aim of this study was to analyze the economic effects of extended treatment of apixaban in the Netherlands, based on an updated and adapted previously published model. Methods ?We performed a cost-effectiveness analysis simulating a population of 1,000 VTE patients. The base-case analysis compared extended apixaban treatment to no treatment after the first 6 months. Five additional scenarios were conducted to evaluate the effect of different bleeding risks and health care payers' perspective. The primary outcome of the model is the incremental cost-effectiveness ratio (ICER) in costs (€) per quality-adjusted life-year (QALY), with one QALY defined as 1 year in perfect health. To account for any influence of the uncertainties in the model, probabilistic and univariate sensitivity analyses were conducted. The treatment was considered cost-effective with an ICER less than €20,000/QALY, which is the most commonly used willingness-to-pay (WTP) threshold for preventive drugs in the Netherlands. Results ?The model showed a reduction in recurrent VTE and no increase in major bleeding events for extended treatment in all scenarios. The base-case analysis showed an ICER of €9,653/QALY. The probability of being cost-effective for apixaban in the base-case was 70.0% and 91.4% at a WTP threshold of €20,000/QALY and €50,000/QALY, respectively. Conclusion ?Extended treatment with apixaban is cost-effective for the prevention of recurrent VTE in Dutch patients

Perceptions of Current and Desired Involvement in Early Childhood Music Instruction

In this study, the researcher examined the perceptions of parents about early childhood music instruction, focusing on parental involvement and how parents’ perception of their children’s musical development affects their involvement. The researcher conducted five interviews with parents who had participated in an early childhood program at a community music school and coded and analyzed interview transcripts for emergent themes. Parents described their current involvement as marked by modeling, exploring varying roles between parent and child, and interacting with a cohort of parents and children. Several of the parents interviewed indicated satisfaction with their roles within the class and did not desire increased involvement in the class; others expressed a desire for more information about children’s musical development and the teaching method used. The perceptions that seemed to contribute to parents’ involvement, both current and desired, were the enjoyment that comes from musical interaction, the recognition of multiple roles of music in children’s lives, and the view of acquiring musical skill and knowledge as developmental

Peer Mentoring: Key to New Music Teacher Educator Success

Abstract Research and practice in mentoring preservice music teachers and music teachers during their induction years has flourished in the past 10 years. Mentoring is also essential to the success of new music teacher educators; however, there is little extant research on mentoring of "preservice" and early career music teacher educators. Though not new members of the profession, new music teacher educators often face challenges similar to those of first-year music teachers. Mentoring can take many forms for new music teacher educators, one of which is peer mentoring. Peer mentoring can serve as an effective means to help new music teacher educators both cope with and succeed in their new professional environment. This article documents our peermentoring relationship from its genesis in doctoral studies through its evolution as we, two assistant professors, begin our careers as tenure-track faculty at two major research institutions. Keywords peer mentoring, music teacher educator Mentoring goes far beyond the instinctual, habitual, repetitive, reinforcement, or pedagogical steps that comprise training. It is the sum of all of these steps. A high-order communication and learning process, mentoring is built on the analysis of professionalenvironment experiences, a learning cycle that includes observing, analyzing, and comparing known experiences and situations and applying them in new situations. - Conway (2003, p. vii