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In the community of inquiry (CoI) frameworks, a meaningful learning with technology in higher education requires interaction of social presence, cognitive presence, and teaching presence. However, it is challenging to create a CoI within an online teaching and learning (OTL) environment especially during the COVID-19 pandemic when educators are forced to conduct it. This paper proposes three innovative approaches for such a community to enhance active learning during synchronous OTL, specifically You Talk for engaging students, Resource Pool for facilitating feedback, and Classroom Meet for recreating the classroom environment. The three approaches were implemented by independent instructors for their respective undergraduates in synchronous online class. The treatment groups show significantly better academic performance than the control groups for all the three innovative approaches. The students from the treatment groups strongly agree that these innovative approaches promote active interaction, enhance attainment of the learning contents, deliver the course contents effectively, assure satisfaction and engage students actively during OTL. It suggests that either approach to engaging students, or facilitating feedback, or recreating the classroom environment serves as teaching presence to support the social presence of the students and therefore creates cognitive presence among them. © 2023, Asian Journal of University Education. All Rights Reserved.
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Purpose: This paper aims to explore the extent to which global reporting initiative (GRI) standards reflect the material concerns of stakeholders in developing countries, with particular reference to Latin America. Design/methodology/approach: The main dataset was a sample of 120 media articles that discussed corporate conduct related to COVID-19 from both developing (Chile, Mexico and Peru) and developed (Australia, UK and the USA) countries. Concerns evident from those articles were compared and then mapped to applicable GRI standards to identify relevant disclosures and gaps. Findings were triangulated by drawing on two additional datasets: Latin American GRI-related academic literature (in Spanish) and submissions to GRI standards. Findings: Media analysis reveals significant differences between developing and developed country concerns, as well as gaps in GRI disclosure requirements in relation to customers, labour standards and corporate interactions with non-government organisations and governments. Analysis of Latin American literature corroborates the concerns raised in media articles regarding employment. Additionally, it points out country-specific issues and calls for increased reporting of corruption. Analysis of the GRI standards development process reveals marked underrepresentation of developing countries, which may contribute to the observed deficiencies in the GRI standards. Originality/value: This paper contributes to the (surprisingly rare) research concerning the quality of GRI standards and responds to calls for greater attention to developing countries in the SEA literature by showing that GRI standards may not fully meet the needs of users in the developing country context of Latin America. The paper also contributes to practice via specific recommendations for improvement to GRI standards and the standard-setting process and provides a summary of the key findings from Spanish-language Latin American literature. © 2022, Emerald Publishing Limited.
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Background: Venetoclax (Ven) in combination with hypomethylating agents, such as azacitidine (Aza) and low dose cytarabine (LDAC) has been shown to be effective therapy in acute myeloid leukaemia (AML) and has become standard of care for newly-diagnosed patients unfit for intensive chemotherapy (DiNardo et al., 2020;Wei et al., 2019;Pollyea et al., 2020). Efficacy has also been shown in the relapsed/refractory (R/R) setting in more limited data sets (Báez-Gutiérrez et al., 2021;Pollyea et al., 2020, Stahl et al., 2020;DiNardo et al., 2019). Ven combination therapy has become widely used in newly-diagnosed patients in the UK since its approval during the COVID-19 pandemic as an alternative to intensive chemotherapy and subsequently for patients unfit for intensive therapy. Aims: We describe the characteristics and outcomes of patients with AML or high risk myelodysplastic syndrome (HRMDS) receiving Ven combinations in frontline and R/R settings to provide real-world insight into their use in UK clinical practice. Methods: A retrospective analysis was performed of all patients with AML or HR-MDS who received Ven combination therapy at University College London Hospital between April 2020 and September 2021. Patient demographics, treatment history and bone marrow results were obtained from electronic health care and laboratory records. Disease stratification and response assessments were made as per European LeukemiaNet (ELN) criteria (Döhner et al., 2017). Results: At the time of analysis, 95 patients received Ven combinations (61 as frontline treatment and 34 for R/R AML), with a median follow up of 14 months. The majority of patients in both groups had adverse risk ELN classification (70.5% of frontline patients, 64.7% of R/R) and received Ven-Aza (100% frontline and 91.1% R/R) (Table 1). The median ages were 72 and 59 years respectively. The incidence of composite CR/CRi was 70.5% in the frontline setting, with median duration of response (DoR) of 8.3 months and overall survival (OS) of 7.1 months. In R/R AML, the CR/CRi rate was 64.7%, median DoR 10.5 months and median OS 9.8 months. Four out of the 43 patients who achieved CR/CRi (9.3%) following frontline treatment and 9 of the 22 R/R (40.9%) patients proceeded to allogeneic stem cell transplant (alloSCT) post induction. The median survival for all patients who underwent alloSCT is not reached in this analysis. The highest CR/CRi rates were observed in intermediate risk patients (90.9% in frontline treatment, 71.4% in R/R), with lower rates in both favourable (80% and 66.7%) and adverse risk patients (65.1% and 59.1% respectively). The presence of NPM1 and IDH1/2 mutations were associated with high CR/CRi rates in both the frontline (85.7% and 84.6% respectively) and R/R groups (100% and 81.8%), with below average response rates seen in TP53 mutated AML (62% in frontline, 40% in R/R). Notable responses were seen in patients with RUNX1 mutations in both settings (77.8% frontline, 66.6% R/R). Summary/Conclusion: Our data describes real world effectiveness for venetoclax combinations as both frontline and salvage therapy in UK clinical practice, similar to that seen in clinical trials. This further contributes to our understanding of these therapies, in particular their use as a viable treatment option in R/R patients and as a bridge to alloSCT, and highlights the importance of further characterisation of genetic predictors of response to inform treatment decisions in real-world practice.
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The COVID-19 pandemic has been one of the greatest public health challenges imposing significant economic and societal costs. A wide range of public health interventions (PHIs) have been implemented to control the virus, with many aggressive measures that led to economic downturn and social calamity. However, evidence concerning their impacts in terms of costs and benefits of the best buy strategy is limited. This systematic review aimed to provide a critical summary of full economic evaluations (EEs) to inform decisions concerning their adoptions. A systemic search in 7 relevant databases and other sources were conducted. Out of 11,584 and 11 records identified from databases and other sources, a total 31 full EEs focusing on PHIs were included. Majority of studies included were in good quality and from the US and upper-middle, and high-income countries whereas only 6 studies were from low and middle-income countries. Suppression/containment was the most deployed strategy (n=19), followed by screening/detection (n = 8), and protection (n = 4). Aggressive elimination strategy usually results in more lives or QALYs saved compared to mitigation strategies but at a very high cost. The trade-off between aggressive and loose suppressions depends on several factors including timing of implementation, duration, epidemiological characteristics of the virus, and the healthcare capacity. Tight and timely adoption of effective intervention at the early stage of pandemic is key in shrinking the number of cases. Using a combination approach is generally more cost-effective compared to a single intervention. Personal protective measure is highly cost-effective in protecting healthcare workers in a high prevalence scenario and when it is adopted together with social distancing strategy. Future studies to address the flaws of current evidence are warranted. This review provides important insights regarding adoption of PHIs and their cost-effectiveness which would be useful to inform policy decisions in response to COVID-19 and future pandemics. © 2022, HH Publisher. All rights reserved.
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Aim: Soft tissue sarcomas (STS) are rare and aggressive tumours. Appropriate multidisciplinary management requires robust knowledge of best practice and understanding of current guidelines. Plastic surgery trainees must therefore be proficient in the assessment, investigation, and treatment of patients with STS. We aimed to evaluate trainee education, confidence, and competence in managing patients with STS. Method: All plastic surgery trainees in Wales completed an online questionnaire and written assessment. This was designed by the lead for STS and TPD. Formal training, knowledge of national guidelines and excision margins for different types of STS and skin cancer was assessed using short answer questions. A five-point Likert scale was used to assess trainee confidence in STS and skin cancer management and follow-up. Volume and type of teaching in sarcoma and skin cancer was also quantified. Results: Trainees received less sarcoma training and were less confident in STS assessment and follow-up, in comparison to skin cancer. More senior trainees or those with formal sarcoma training were more confident in skin cancer management (mean confidence rating 4.4 vs 2.2) and performed better in the written assessment of excision margins (mean score 100% vs 61.45%) Conclusions: Trainees receive less training in sarcoma with a significant impact on their competence and confidence in sarcoma care. We believe this is consistent across the United Kingdom as evidenced by just two sarcoma webinars held during the COVID-19 pandemic. Formal national evaluation of sarcoma teaching should be carried out to inform ongoing efforts to improve educational resources on this important topic for trainees.
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Biopsy, Needle , Bites and Stings/surgery , Debridement/methods , Anesthetics, Local , Animals , HumansABSTRACT
This paper describes an intervention piloted in secondary schools in Singapore in the second half of 2020, in response to the COVID-19 pandemic. The intervention aims to afford learners more authentic understandings of the need to invest effort and self-discipline in nurturing the new habit of practicing safe-distancing, beyond just doing so because of public exhortation. It seeks to achieve this objective through two complementary halves, the first being an activity within a virtual environment during which a (virtual) virus is diffusing, and the second being dialogue and discussion around students' decision-making and behaviours, as informed from an analysis of data of interaction from the first half, via a web-based interface. In this way, the Socially Responsible Behaviour through Embodied Thinking (SORBET) Project represents not only an intervention designed to meet the challenges to learning imposed by COVID-19, but also one of the current few which attempt to do so by leveraging students' evolving conceptions about the diffusion of a virus amongst a population. Understood thusly, the intervention has potential curricular applications in a number of disciplinary domains, such as in mathematics, geography, biology and citizenship education. Copyright © 2020 Asia-Pacific Society for Computers in Education.