The Integrated Process of Engagement in Adult Learning

This paper explores the role of engagement in adult learning based on Illeris’ three dimensional model of learning and Yang’s holistic theory of knowledge and learning. Engagement and learning are integrated processes by which adult learners gain a deeper understanding and make meaning of the activities he or she is exposed to in a given learning environment

High-Risk Histopathological Features of Retinoblastoma following Primary Enucleation: A Global Study of 1426 Patients from 5 Continents

Purpose: To evaluate high-risk histopathological features (HRHF) following primary enucleation of eyes with retinoblastoma (RB) and assess the patient outcomes across continents // Methods: Retrospective study of 1426 primarily enucleated RB eyes from five continents // Results: Of all, 923 (65%) were from Asia (AS), 27 (2%) from Australia (AUS), 120 (8%) from Europe (EUR), 162 (11%) from North America (NA), and 194 (14%) from South America (SA). Based on the continent (AS vs. AUS vs. EUR vs. NA vs. SA), the histopathology features included massive choroidal invasion (31% vs. 7% vs. 13% vs. 19% vs. 27%, p=0.001), post-laminar optic nerve invasion (27% vs. 0% vs. 16% vs. 21% vs. 19%, p=0.0006), scleral infiltration (5% vs. 0% vs. 4% vs. 2% vs. 7%, p=0.13), and microscopic extrascleral infiltration (4% vs. 0% vs. <1% vs. <1% vs. 4%, p=0.68). Adjuvant chemotherapy with/without orbital radiotherapy was given in 761 (53%) patients. Based on Kaplan-Meier estimates in different continents (AS vs. AUS vs. EUR vs. NA vs. SA), the 6-year risk of orbital tumor recurrence was 5% vs. 2% vs. 0% vs. 0% vs. 12% (p<0.001), systemic metastasis was reported in 8% vs. 5% vs. 2% vs. 0% vs. 13% (p=0.001), and death in 10% vs. 3% vs. 2% vs. 0% vs. 11% (p<0.001) patients. // Conclusion: There is a wide variation in the infiltrative histopathology features of RB across continents, resulting in variable outcomes. SA and AS had a higher risk of orbital tumor recurrence, systemic metastasis, and death compared to AUS, EUR, and NA

33 The Integrated Process of Engagement in Adult Learning

Abstract: This paper explores the role of engagement in adult learning based on Illeris ’ three dimensional model of learning and Yang’s holistic theory of knowledge and learning. Engagement and learning are integrated processes by which adult learners gain a deeper understanding and make meaning of the activities he or she is exposed to in a given learning environment. In today’s fast-paced environment, highly demanding jobs and personal responsibilities force adults to compress learning into their lives (Merriam, Caffarella, &amp; Baumgartner, 2007). Learning is an integrated process that merges the cognitive, emotional, and social dimensions of being (Illeris, 2002). The ability of an individual to learn is an integral part of human life. Learning includes many activities, particularly for the adult learners, that both involve change, and are primarily concerned with the acquisition of habits, knowledge, and attitudes (Knowles, 1973). Learning is the interaction that occurs between the learner and their environment to help the learner become more capable of dealing adequately with their environment (Goffman, 1959). Engagement is defined as a cognitive, emotional, and behavioral state directed toward identified outcomes (Shuck &amp; Wollard, 2009). Adults who are engaged become emotionall

15 The Role of Leadership Style in Employee Engagement

Abstract: This paper explores the relationship between leadership styles and engagement in the workplace. The competitive global markets are forcing organizations to look past their products and the bottom line and move beyond just employee motivation and towards having an engaged workforce. Due to globalization, companies are changing their structure and competing in a bigger arena. Most of these organizations used to think of capital simply as shares, cash, investments, or some sort of wealth. Over the years, these organizations have changed their views and have added employee development and performance management as a strategic business priority to set them apart from their competition. With this shift, organizations are adding more value to their employees and their employees ’ skill sets (Heger, 2007). Talent management has emerged as an area in which organizations, and especially human resource professionals, can spend time and resources to develop a workforce that gives them a competitive and strategic advantage. Organization use talent management in order to achieve some of their goals, such as competitive advantage, retention, and increase productivity. For the purpose of this paper we will focus on one aspect of talent management, motivation, that leads to some of these desire

Secondary engineering of rhodolith beds by the sand tilefish Malacanthus plumieri generates distinctive habitats for benthic macroinvertebrates and fish

Whilst the importance of foundation species for biodiversity conservation has been largelyacknowledged (e.g., coral and bivalve reefs, seagrass, kelp and rhodolith beds), the role oftheir associated species as secondary habitat engineers has just begun to be appreciated.Here, we evaluated whether secondary engineering of rhodolith beds by the sand tilefishMalacanthus plumieri influences the composition and β-diversity of benthic macroinvertebratesand reef fish assemblages. Our findings indicate that, by selecting, relocating, andrearranging rhodoliths into mounds, M. plumieri creates a distinctive habitat for macroinvertebratesand fishes. M. plumieri mounds increase fish abundance by 57% in rhodolithbeds, with an 82% species turnover rate between mounds and non-mounded areas. In contrast,the macroinvertebrates in M. plumieri mounds are largely a subset of the species fromnon-mounded areas, with an 86% species nestedness rate. Despite decreasing the abundanceof macroinvertebrates in the mounds by half, M. plumieri increases the heterogeneityand structural complexity of rhodolith beds, affecting the composition of associated fishassemblage at a larger spatial scale. Our results suggest that, by increasing the structuralcomplexity of rhodolith beds and shaping their associated biodiversity, the abundance ofM. plumieri mounds could be a useful proxy to define priority areas for conservation acrossthe South Atlantic rhodolith beds, especially in the light of ongoing impacts related to offshoreoil exploitation, overfishing and carbonate mining.Fil: Roos, Natalia C.. Universidade Federal de Sao Paulo.; BrasilFil: Veras, Priscila C.. Universidade Federal de Sao Paulo.; BrasilFil: Gutierrez, Jorge Luis Ceferino. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: Gibran, Fernando Z.. Universidade Federal Do ABC; BrasilFil: Pinheiro, Hudson T.. University of São Paulo; BrasilFil: Francini Filho, Ronaldo B.. University of São Paulo; BrasilFil: Longo, Leila L.. Universidade Federal do Recôncavo da Bahia; BrasilFil: Santos, Cinthya S. G.. Universidade Federal Fluminense; BrasilFil: Senna, André R.. Universidade do Estado do Rio de Janeiro; BrasilFil: Pereira Filho, Guilherme H.. Universidade Federal de São Paulo; Brasi

Reproducibility of fluorescent expression from engineered biological constructs in E. coli

We present results of the first large-scale interlaboratory study carried out in synthetic biology, as part of the 2014 and 2015 International Genetically Engineered Machine (iGEM) competitions. Participants at 88 institutions around the world measured fluorescence from three engineered constitutive constructs in E. coli. Few participants were able to measure absolute fluorescence, so data was analyzed in terms of ratios. Precision was strongly related to fluorescent strength, ranging from 1.54-fold standard deviation for the ratio between strong promoters to 5.75-fold for the ratio between the strongest and weakest promoter, and while host strain did not affect expression ratios, choice of instrument did. This result shows that high quantitative precision and reproducibility of results is possible, while at the same time indicating areas needing improved laboratory practices.Peer reviewe

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research