What Happens During Language and Literacy Coaching? Coaches’ Reports of Their Interactions With Educators

Research Findings: This study investigated coaches’ interactions with educators in the context of a large-scale, state-implemented literacy professional development (PD). We examined log data and open-comment reports to understand what coaches found salient about their interactions with educators as well as how those reports aligned with the initial design of the PD. Coaches reported spending a large proportion of their interactions with educators completing administrative tasks. Our findings also indicate that coaches disproportionally targeted instructional content from the PD while also adding unrelated instructional content to their coaching. Although coaches reported focusing on relationship building, they reported using less efficacious coaching strategies (e.g., observation and discussion) more frequently than coaching strategies demonstrated to be more efficacious (e.g., modeling and co-teaching). Practice or Policy: Our findings suggest an explanation for the mixed evidence around coaching, as coaches in the study seemed to move beyond the specifications of the PD in their coaching interactions. This work has implications for the design of PD for both improving coach training and allowing some flexibility to meet educators’ learning needs that may be secondary to the content of the PD. Findings also support the need for more nuanced mechanisms for investing in coaching and coaching outcomes

What Happens During Language and Literacy Coaching? Coaches’ Reports of Their Interactions With Educators

Research Findings: This study investigated coaches’ interactions with educators in the context of a large-scale, state-implemented literacy professional development (PD). We examined log data and open-comment reports to understand what coaches found salient about their interactions with educators as well as how those reports aligned with the initial design of the PD. Coaches reported spending a large proportion of their interactions with educators completing administrative tasks. Our findings also indicate that coaches disproportionally targeted instructional content from the PD while also adding unrelated instructional content to their coaching. Although coaches reported focusing on relationship building, they reported using less efficacious coaching strategies (e.g., observation and discussion) more frequently than coaching strategies demonstrated to be more efficacious (e.g., modeling and co-teaching). Practice or Policy: Our findings suggest an explanation for the mixed evidence around coaching, as coaches in the study seemed to move beyond the specifications of the PD in their coaching interactions. This work has implications for the design of PD for both improving coach training and allowing some flexibility to meet educators’ learning needs that may be secondary to the content of the PD. Findings also support the need for more nuanced mechanisms for investing in coaching and coaching outcomes

What Happens During Language and Literacy Coaching? Coaches’ Reports of Their Interactions With Educators

Research Findings: This study investigated coaches’ interactions with educators in the context of a large-scale, state-implemented literacy professional development (PD). We examined log data and open-comment reports to understand what coaches found salient about their interactions with educators as well as how those reports aligned with the initial design of the PD. Coaches reported spending a large proportion of their interactions with educators completing administrative tasks. Our findings also indicate that coaches disproportionally targeted instructional content from the PD while also adding unrelated instructional content to their coaching. Although coaches reported focusing on relationship building, they reported using less efficacious coaching strategies (e.g., observation and discussion) more frequently than coaching strategies demonstrated to be more efficacious (e.g., modeling and co-teaching). Practice or Policy: Our findings suggest an explanation for the mixed evidence around coaching, as coaches in the study seemed to move beyond the specifications of the PD in their coaching interactions. This work has implications for the design of PD for both improving coach training and allowing some flexibility to meet educators’ learning needs that may be secondary to the content of the PD. Findings also support the need for more nuanced mechanisms for investing in coaching and coaching outcomes

Uric Acid Predicts Long-Term Cardiovascular Risk in Type 2 Diabetes but Does Not Mediate the Benefits of Fenofibrate: the FIELD Study

Aim To explore the relationship between baseline uric acid (UA) levels and long-term cardiovascular events in adults with type 2 diabetes (T2D) and to determine whether the cardioprotective effects of fenofibrate are partly mediated through its UA-lowering effects. Methods Data from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial were utilized, comprising 9795 adults with T2D randomly allocated to treatment with fenofibrate or matching placebo. Plasma UA was measured before and after a 6-week, active fenofibrate run-in phase in all participants. Cox proportional hazards models were used to explore the relationships between baseline UA, pre-to-post run-in reductions in UA and long-term cardiovascular outcomes. Results Mean baseline plasma UA was 0.33 mmol/L (SD 0.08). Baseline UA was a significant predictor of long-term cardiovascular events, with every 0.1 mmol/L higher UA conferring a 21% increase in event rate (HR 1.21, 95% CI 1.13-1.29, P <.001). This remained significant after adjustment for treatment allocation, cardiovascular risk factors and renal function. The extent of UA reduction during fenofibrate run-in was also a significant predictor of long-term cardiovascular events, with every 0.1 mmol/L greater reduction conferring a 14% lower long-term risk (HR 0.86, 95% CI 0.76-0.97, P = .015). This effect was not modified by treatment allocation (P-interaction = .77). Conclusions UA is a strong independent predictor of long-term cardiovascular risk in adults with T2D. Although greater reduction in UA on fenofibrate is predictive of lower cardiovascular risk, this does not appear to mediate the cardioprotective effects of fenofibrate.Peer reviewe

Communiversity: Values in Action Project 2020–2022

The Communiversity project grew out of the creative dialogue of a collection of like-minded colleagues at a Cathedrals Group sponsored Sandpit event held at York St John in 2019. In Phase 1 University of Cumbria, led a scoping exercise, which explored the range of community engagement/ volunteering projects taking place in the respective Cathedrals Groups universities (Hempsall and Elton-Chalcraft, 2019) Phase 2, ‘The Communiversity: Values in Action’ began in 2020. Having gained funding from the Church Universities fund to build on Phase 1, four collaborating universities each initiated new, or selected ongoing, community engagement / volunteering projects to investigate. With a more diverse, inclusive, outward facing approach to study and learning outcomes or ‘learning gain’ in Higher Education, the concept of ‘The Communiversity: Values in Action’ has brought about a meta-reflexive approach (Archer, 2010) to university experience. It encourages stakeholders to reframe their actions in terms of ‘the bigger picture’ and to broaden the sphere of university activity and knowledge exchange (KE) beyond the campus towards ‘service learning’, benefiting the community (Bamber, Bullivant and Stead, 2013). This involves ‘breaking down the walls of the academy to let scholarship out and invite communities in’ (Lessem, Adodo and Bradley, 2019)

What is the economic cost of providing an all Wales postpartum haemorrhage quality improvement initiative (OBS Cymru)? A cost-consequences comparison with standard care

Background and Objective: A postpartum haemorrhage quality improvement initiative (the Obstetric Bleeding Strategy for Wales [OBS Cymru]), including about 60,000 maternities, was adopted across Wales (2017–2018). We performed a cost-consequences analysis to inform ongoing provision and wider uptake. Methods: Analysis was based on primary data from the All Wales postpartum haemorrhage database, with a UK National Health Services perspective, a time horizon from delivery until hospital discharge and no discounting. Costs were based on UK published sources with viscoelastic haemostatic assay costs provided by the OBS Cymru national team. Mean costs per eligible patient (postpartum haemorrhage > 1000 mL) were calculated for OBS Cymru, using the early implementation period as a comparator. Modelling allowed comparisons of three scenarios (two predefined and one post hoc) and implementation in different sizes of maternity unit. Results: All analyses demonstrated consistent savings in blood products, critical care and haematology time, and also a reduced occurrence of massive postpartum haemorrhage (> 2500 mL). Incremental postnatal length of stay varied between scenarios, substantially impacting on total costs. Mean incremental cost of OBS Cymru, compared with standard care, across Wales was £18.41 per patient (postpartum haemorrhage > 1000 mL) or − £10.66 if the length of stay was excluded. Modelling a maternity unit of 5000 births per annum, OBS Cymru incurred an incremental cost of £9.53 per patient with postpartum haemorrhage > 1000 mL. Conclusions: OBS Cymru reduces the occurrence of massive postpartum haemorrhage, need for transfusions, quantity of blood products and intensive care. In medium-to-large maternity units (>3000 maternities per annum), the OBS Cymru intervention approaches cost neutrality compared to standard care

World Federation of Pediatric Imaging (WFPI) volunteer outreach through tele-reading: the pilot project in South Africa

BackgroundShortages in radiology services are estimated to affect 3.5-4.7 billion people worldwide. Teleradiology is a potential means of alleviating this shortage.ObjectiveThis paper examines the practicality and sustainability of a pilot pediatric teleradiology project at the Khayelitsha District Hospital in sub-Saharan Africa. We analyze how this World Federation of Pediatric Imaging (WFPI) program fares against the global challenges described in the current literature facing these practice types.Materials and methodsA teleradiology pilot was developed to provide coverage to the Khayelitsha District Hospital after the district pediatrician requested assistance in interpreting radiographs. This program utilized a network of WFPI volunteer pediatric radiologists, direct JPEG conversion of digital radiographic images, and an e-mail delivery system of images, referral requests and teleradiology opinion. Data were collected retrospectively from referral cards and JPEG images of radiographs, as well as from the volunteer officer database.ResultsA total of 555 referral cards and 1,106 radiographs were submitted for teleradiology opinion during the course of this pilot program; 74.6% of requests for image interpretation were chest radiographs and 14.2% of those were for the evaluation of tuberculosis. There were 40 volunteer teleradiologists from 17 countries; all spoke English, and 14 were bilingual (8 fluent in Spanish, 5 in Portuguese, and 1 in Italian).ConclusionTeleradiology is a viable option to alleviate radiologist shortages in underserved areas, but there are many challenges to designing an adequate teleradiology system. The WFPI pilot teleradiology program can be considered a successful one

Study protocol: cross-national comparative case study of recovery-focused mental health care planning and coordination (COCAPP).

BACKGROUND: The collaborative care planning study (COCAPP) is a cross-national comparative study of care planning and coordination in community mental healthcare settings. The context and delivery of mental health care is diverging between the countries of England and Wales whilst retaining points of common interest, hence providing a rich geographical comparison for research. Across England the key vehicle for the provision of recovery-focused, personalised, collaborative mental health care is the care programme approach (CPA). The CPA is a form of case management introduced in England in 1991, then revised in 2008. In Wales the CPA was introduced in 2003 but has now been superseded by The Mental Health (Care Co-ordination and Care and Treatment Planning) (CTP) Regulations (Mental Health Measure), a new statutory framework. In both countries, the CPA/CTP requires providers to: comprehensively assess health/social care needs and risks; develop a written care plan (which may incorporate risk assessments, crisis and contingency plans, advanced directives, relapse prevention plans, etc.) in collaboration with the service user and carer(s); allocate a care coordinator; and regularly review care. The overarching aim of this study is to identify and describe the factors that ensure CPA/CTP care planning and coordination is personalised, recovery-focused and conducted collaboratively. METHODS/DESIGN: COCAPP will employ a concurrent transformative mixed methods approach with embedded case studies. Phase 1 (Macro-level) will consider the national context through a meta-narrative mapping (MNM) review of national policies and the relevant research literature. Phase 2 (Meso-level and Micro-level) will include in-depth micro-level case studies of everyday 'frontline' practice and experience with detailed qualitative data from interviews and reviews of individual care plans. This will be nested within larger meso-level survey datasets, senior-level interviews and policy reviews in order to provide potential explanations and understanding. DISCUSSION: COCAPP will help identify the key components that support and hinder the provision of personalised, recovery-focused care planning and provide an informed rationale for a future planned intervention and evaluation

Current practice and surgical outcomes of neoadjuvant chemotherapy for early breast cancer : UK NeST study

Funding Information: This work was funded by a grant from the Association of Breast SurgeryPeer reviewedPublisher PD

The potential role of three-dimensional surface imaging as a tool to evaluate aesthetic outcome after Breast Conserving Therapy (BCT)

To establish whether objective measurements of symmetry of volume and shape using three-dimensional surface imaging (3D-SI) can be used as surrogate markers of aesthetic outcome in patients who have undergone breast conserving therapy (BCT). Women who had undergone unilateral BCT in the preceding 1-6 years were invited to participate. Participants completed a satisfaction questionnaire (BREAST-Q) and underwent 3D-SI. Volume and surface symmetry were measured on the images. Assessment of aesthetic outcome was undertaken by a panel of clinicians. The Kruskal-Wallis test was used to assess the relationship between volume and shape symmetry measurements with the panel score. Spearman's rho correlations were used to assess the relationship between the measurements and patient satisfaction. 200 women participated. Median volume symmetry was 87% (IQR 78-93) and shape symmetry was 5.9 mm (IQR 4.2-8.0). The participants were grouped according to panel assessment of aesthetic outcome (poor, fair, good, excellent) and the median volume and shape symmetry was calculated for each group. Volume symmetry significantly differed between the groups. Post hoc pairwise comparisons demonstrated that these differences existed between panel scores of fair versus good and good versus excellent. Median shape symmetry also differed according to patient panel groups with four significant pairwise comparisons between poor versus good, poor versus excellent, fair versus good and fair versus excellent. There was a significant but weak correlation of both volume symmetry and surface asymmetry with BREAST-Q scores (correlation coefficients 0.187 and -0.229, respectively). Breast volume and shape symmetry are both associated with panel assessment scores and patient satisfaction. The objective volume and shape symmetry measures were strongly associated with panel assessment scores, such that a 3D-SI tool could replace panel assessment as a faster and more objective method of evaluating aesthetic outcomes