Leadership decision making at a time of rapid reform: An English Case Study

This paper explores the decision making process of a school leadership team at a time of rapid educational reform using Bourdieu’s thinking tools of field, capital and habitus. The context of educational policy making is viewed as a field, a site in which schools in England struggle for symbolic capital from within the policy arena. Initial findings of this historically successful case study school is that the perceptions of school leaders indicate a) the field of educational policy is in flux and the decision making reveals the habitus of the head teacher to seize the pragmatic opportunity to increase symbolic capital within the field by converting into an academy, b) that whilst there is an element of risk taking involved in this decision to become an autonomous institution operating outside of local authority of control this is outweighed by the promises autonomy will bring to develop a new model for delivery of education provision. As such the school leaders c) recognise the hierarchy of power in the field and base their decision making upon the desire to protect their school’s interests and to increase their capital and position within the field by gaining official recognition from the policy actors within the field. Thus the on-going policy codification of ‘new practices and old hierarchies in the field’ is a powerful way to understand how school leaders interpret policy and position themselves and the school in relation to current educational reform. The case study illustrates that the on-going struggle within and across the symbolic economy of educational reform is encouraging school leaders to respond and behave in certain ways, to second-guess in the wake of centralised decentralisation. However that drive to conform is motivated by their knowledge of the specific context in which the school operates and thus decisions are made which first and foremost respond to the local need, interest and intake of their students. Thus the study shows that the school leaders are engaged with viewing the positive possibilities made available through reform processes and that the potential for remodelling school structures through the academies programme in England offers an opportunity for school leaders to innovate within a centrally recognised and endorsed framework

Table_1_Effects of intermittent fasting on quality of life tolerance of chemotherapy in patients with gynecological cancers: study protocol of a randomized-controlled multi-center trial.docx

Fatigue is a very common side effect during intravenous chemotherapy. Unfortunately, only few effective therapeutic options are available, mostly based on daily activity. In our pilot trial we were able to demonstrate that intermittent fasting can reduce fatigue in healthy people, thus we aimed to assess the effects of the fasting dietary on quality of life during chemotherapy in patients with gynecological cancer, especially on the domain of fatigue. The IFAST trial is designed as a prospective, randomized-controlled, multi-center trial. Participation will be offered to women with gynecological cancers (breast cancer, ovarian cancer including peritoneal and fallopian tube cancers, endometrial cancer and cervical cancer) who are planned to receive intravenous chemotherapy for at least three months. Eligible patients will be randomized 1:1, stratified by tumor type and study center. Primary endpoint is the difference in mean change in fatigue, assessed with the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT- FS©). Exploratory secondary endpoints will include general Quality of Life impairment, tolerance of chemotherapy, immunological changes, peripheral cell damage in blood cells, as well as tumor response to chemotherapy. There is new evidence that prolonged fasting periods of 46-96 hours during chemotherapy can positively influence the quality of life during chemotherapy. However, these fasting regiments are not feasible for many patients. Intermittent fasting could be a feasible (manageable) option for many patients to actively improve their quality of life and tolerance to chemotherapy and possibly even enhance the effectiveness of chemotherapy.Trial Registrationhttps://drks.de, identifier DRKS00031429.</p

DataSheet_1_A multicenter randomized trial for quality of life evaluation by non-invasive intelligent tools during post-curative treatment follow-up for head and neck cancer: Clinical study protocol.pdf

Patients surviving head and neck cancer (HNC) suffer from high physical, psychological, and socioeconomic burdens. Achieving cancer-free survival with an optimal quality of life (QoL) is the primary goal for HNC patient management. So, maintaining lifelong surveillance is critical. An ambitious goal would be to carry this out through the advanced analysis of environmental, emotional, and behavioral data unobtrusively collected from mobile devices. The aim of this clinical trial is to reduce, with non-invasive tools (i.e., patients’ mobile devices), the proportion of HNC survivors (i.e., having completed their curative treatment from 3 months to 10 years) experiencing a clinically relevant reduction in QoL during follow-up. The Big Data for Quality of Life (BD4QoL) study is an international, multicenter, randomized (2:1), open-label trial. The primary endpoint is a clinically relevant global health-related EORTC QLQ-C30 QoL deterioration (decrease ≥10 points) at any point during 24 months post-treatment follow-up. The target sample size is 420 patients. Patients will be randomized to be followed up using the BD4QoL platform or per standard clinical practice. The BD4QoL platform includes a set of services to allow patients monitoring and empowerment through two main tools: a mobile application installed on participants’ smartphones, that includes a chatbot for e-coaching, and the Point of Care dashboard, to let the investigators manage patients data. In both arms, participants will be asked to complete QoL questionnaires at study entry and once every 6 months, and will undergo post-treatment follow up as per clinical practice. Patients randomized to the intervention arm (n=280) will receive access to the BD4QoL platform, those in the control arm (n=140) will not. Eligibility criteria include completing curative treatments for non-metastatic HNC and the use of an Android-based smartphone. Patients undergoing active treatments or with synchronous cancers are excluded.Clinical Trial Registration: ClinicalTrials.gov, identifier (NCT05315570).</p