The moving writing workshop

Thesis (M.Ed.) University of Alaska Fairbanks, 2006This yearlong ethnographic case study documented the implementation of a 'moving' writing workshop at the first year of the Barnette Magnet School. This study focused on selected students in the 5/6 grades at the magnet school. In the moving writing workshop, the students changed rooms and worked in a variety of writing rooms that coincided with the writing process. The traditional writing process steps are prewriting/brainstorming, drafting, revise and response, editing, and publishing. The classroom teachers and staff at the school assisted students in the various writing rooms. This study looked at the benefits students gained by participating in the moving writing workshop. It addressed whether or not participation in the moving writing workshop improved the students' quality of writing and attitude toward writing. The writing quality and attitude of the students in the study did improve. However, after analyzing the data, with the research that was conducted, it was impossible to determine whether moving during the writing process was the factor that caused the improvements. The data did however show that the physical act of moving mostly had a positive impact on the students' writing

Incorporating economic evidence into cancer care: searching for the missing link

Since the early 1980s it has been identified that even though economic evaluation is considered useful by economist it is not widely used by health care decision-makers. One of the ways to close the gap is to involve decision-makers in the process. This project was set up to gain a better understanding of the information needs for resource allocation in the field of cancer care. The results of this project are intended to aid the development and use of the NSW Cancer Institute?s Standard Cancer Treatments (CI-SCAT) website in future years. This initiative is part of the NSW 2004-2006 Cancer to ensure that clinical practice is evidence-based and research driven. The CI-SCAT Reference Group develops and approves clinical protocols to provide clinicians with chemotherapy cancer protocols, including the evidence, cost, and drug dose calculation. Members of CI-SCAT Reference Groups were surveyed in their capacity as clinicians and decision-makers in the Australian Health Care System. The survey asked about participants? knowledge, use and views of economic evaluation in decision making. It also sought information about their knowledge and views on how resource allocation decisions were made within your local area/hospital and whether participants would value greater access to various types of economic information. This paper will explore what decision-makers at a state/local level value in terms of economic evidence.Economic evaluation, cancer, survey, decision-making, Australia

Use and outcomes of targeted therapies in early and metastatic HER2-positive breast cancer in Australia: Protocol detailing observations in a whole of population cohort

Background: The management of human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) has changed dramatically with the introduction and widespread use of HER2-targeted therapies. However, there is relatively limited real-world information on patterns of use, effectiveness and safety in whole of population cohorts. The research programme detailed in this protocol will generate evidence on the prescribing patterns, safety monitoring and outcomes of patients with BC treated with HER2- targeted therapies in Australia. Methods/design: Our ongoing research programme will involve a series of retrospective cohort studies that include every patient accessing Commonwealth-funded HER2-targeted therapies for the treatment of early BC and advanced BC in Australia. At the time of writing, our cohorts consist of 11 406 patients with early BC and 5631 with advanced BC who accessed trastuzumab and lapatinib between 2001 and 2014. Pertuzumab and trastuzumab emtansine were publicly funded for metastatic BC in 2015, and future data updates will include patients accessing these medicines. We will use dispensing claims for cancer and other medicines, medical service claims and demographics data for each patient accessing HER2- targeted therapies to undertake this research. Ethics and dissemination: Ethics approval has been granted by the Population Health Service Research Ethics Committee and data access approval has been granted by the Australian Department of Human Services (DHS) External Review Evaluation Committee. Our findings will be reported in peer-reviewed publications, conference presentations and policy forums. By providing detailed information on the use and outcomes associated with HER2-targeted therapies in a national cohort treated in routine clinical care, our research programme will better inform clinicians and patients about the real-world use of these treatments and will assist third-party payers to better understand the use and economic costs of these treatments

Introducing research initiatives into healthcare: What do doctors think?

Background: Current national and international policies emphasize the need to develop research initiatives within our health care system. Institutional biobanking represents a modern, large-scale research initiative that is reliant upon the support of several aspects of the health care organization. This research project aims to explore doctors' views on the concept of institutional biobanking and to gain insight into the factors which impact the development of research initiatives within healthcare systems. Methods: Qualitative research study using semi-structured interviews. The research was conducted across two public teaching hospitals in Sydney, Australia where institutional biobanking was being introduced. Twenty-five participants were interviewed, of whom 21 were medical practitioners at the specialist trainee level or above in a specialty directly related to biobanking; four were key stakeholders responsible for the design and implementation of the biobanking initiative. Results: All participants strongly supported the concept of institutional biobanking. Participants highlighted the discordance between the doctors who work to establish the biobank (the contributors) and the researchers who use it (the consumers). Participants identified several barriers that limit the success of research initiatives in the hospital setting including: the 'resistance to change' culture; the difficulties in engaging health professionals in research initiatives; and the lack of incentives offered to doctors for their contribution. Doctors positively valued the opportunity to advise the implementation team, and felt that the initiative could benefit from their knowledge and expertise. Conclusion: Successful integration of research initiatives into hospitals requires early collaboration between the implementing team and the health care professionals to produce a plan that is sensitive to the needs of the health professionals and tailored to the hospital setting. Research initiatives must consider incentives that encourage doctors to adopt operational responsibility for hospital research initiatives

Treatment switching in cancer trials: Issues and proposals

Objectives: Treatment switching occurs when patients in a randomized clinical trial switch from the treatment initially assigned to them to another treatment, typically from the control to experimental treatment. This study discusses the issues this raises and possible approaches to addressing them in trials of cancer drugs. Methods: Stakeholders from around the world were invited to a 1.5-day Workshop in Adelaide, Australia. This study attempts to capture the key points from the discussion and the perspectives of the various stakeholder groups, but is not a formal consensus statement. Results: Treatment switching raises challenging ethical issues with arguments for and against allowing it. It is increasingly common in cancer drug trials and presents challenges for the interpretation of results by regulators, clinicians, patients, and payers. Proposals are offered for good practice in the design, management, and analysis of trials and wider development programs for cancer drugs in which treatment switching has occurred or is likely to. Recommendations are also offered for further action to improve understanding of the importance and challenges of treatment switching and to promote agreement between key stakeholders on guidelines and other steps to address these challenges. Conclusions: The handling of treatment switching in trials is of concern to all stakeholders. On the basis of the discussions at the Adelaide International Workshop, there would appear to be common ground on approaches to addressing treatment switching in cancer trials and scope for the development of formal guidelines to inform the work of regulators, payers, industry, trial designers and other stakeholders