The association between malnutrition risk and revised Edmonton Symptom Assessment System (ESAS-r) scores in an adult outpatient oncology population: a cross-sectional study.

BACKGROUND: Cancer-associated malnutrition is associated with worse symptom severity, functional status, quality of life, and overall survival. Malnutrition in cancer patients is often under-recognized and undertreated, emphasizing the need for standardized pathways for nutritional management in this population. The objectives of this study were to (1) investigate the relationship between malnutrition risk and self-reported symptom severity scores in an adult oncology outpatient population and (2) to identify whether a secondary screening tool for malnutrition risk (abPG-SGA) should be recommended for patients with a specific ESAS-r cut-off score or group of ESAS-r cut-off scores. METHODS: A single-institution retrospective cross-sectional study was conducted. Malnutrition risk was measured using the Abridged Patient-Generated Subjective Global Assessment (abPG-SGA). Cancer symptom severity was measured using the Revised Edmonton Symptom Assessment System (ESAS-r). In accordance with standard institutional practice, patients completed both tools at first consult at the cancer centre. Adult patients who completed the ESAS-r and abPG-SGA on the same day between February 2017 and January 2020 were included. Spearman's correlation, Mann Whitney U tests, receiver operating characteristic curves, and binary logistic regression models were used for statistical analyses. RESULTS: 2071 oncology outpatients met inclusion criteria (mean age 65.7), of which 33.6% were identified to be at risk for malnutrition. For all ESAS-r parameters (pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, anxiety, and wellbeing), patients at risk for malnutrition had significantly higher scores (P < 0.001). All ESAS-r parameters were positively correlated with abPG-SGA score (P < 0.01). The ESAS-r parameters that best predicted malnutrition risk status were total ESAS-r score, lack of appetite, tiredness, and wellbeing (area under the curve = 0.824, 0.812, 0.764, 0.761 respectively). Lack of appetite score ≥ 1 demonstrated a sensitivity of 77.4% and specificity of 77.0%. Combining lack of appetite score ≥ 1 with total ESAS score > 14 yielded a sensitivity of 87.9% and specificity of 62.8%. CONCLUSION: Malnutrition risk as measured by the abPG-SGA and symptom severity scores as measured by the ESAS-r are positively and significantly correlated. Given the widespread use of the ESAS-r in cancer care, utilizing specific ESAS-r cut-offs to trigger malnutrition screening could be a viable way to identify cancer patients at risk for malnutrition.

Tutor's Role in WhatsApp Learning Groups: A Quali-Quantitative Methodological Approach.

In recent years, digital tools, such as WhatsApp, have been increasingly deployed to support group interaction and collaboration in higher education contexts. To understand contemporary, digitally-mediated collaborative dynamics - including the role played by tutors and the situated nature of group development - robust and innovative methodologies are needed. In this paper, we illustrate how integrating qualitative methods with quantitative tools used in qualitative ways makes it possible to trace how tutors adapt their style to support group development, which in turn triggers student development in a circular and responsive process. To make visible this contemporary phenomenon, we combine thematic content analysis - a qualitative tool - with a quantitative method: Social Network Analysis. Drawing on data generated by two WhatsApp learning groups (six students and four academic tutors) in research exploring the collaborative construction of boundary objects in a master's level "E-learning Psychology" course, we suggest that our methodological approach has the potential to support interrogation of complex and dynamic digitally-mediated group interactions. Our results show the situational nature of an effective tutorship style through its complex adaptation to learners' maturity, digital tools, and learning goals.

Remembering, Reflecting, Reframing: Examining Students' Long-Term Perceptions of an Innovative Model for University Teaching.

This article presents a follow-up examination of 10 iterations of a blended course on educational psychology and e-learning carried out at the University of Bari. All iterations of the course considered in this study were designed using the constructive and collaborative participation (CCP) model. Our main research questions are: What are the students' long lasting memories of this course? How do the students use the skills and the competences acquired through the course across an extended period of time? In line with these research questions, the aims of this investigation can be summarized as follows: (i) to understand the students' perceptions and long lasting memories of the course and (ii) to investigate the transfer of skills and knowledge across an extended period of time, based on a self-reported survey. The analysis was carried out by administering the survey to all 196 students who took part in the course in the 2005-2015 decade. 96 participants responded to the survey. The survey is designed to collect data in two areas. First, the memories related to the course and second, the way skills and content knowledge acquired during the course have been transferred to and used in other contexts after the course ended. The data were analyzed using a mixed methods approach, which revealed trends in the responses across the decade. In general, participants remembered the teaching methodology and often recalled specific activities such as Role Taking and the creation of products through group-work. These activities and approaches seemed to provide significant learning opportunities for the students. Several students also recalled key concepts and content knowledge acquired during the course. In relation to transfer of skills, participants tended to reuse mostly transversal skills, such as communicative and organizational skills, especially in work contexts. Further, about half of the respondents reused the content knowledge of the course. This analysis is valuable because it allows us to understand the aspects of the model that are significant for the students in the long term, and to discover and interrogate the acquisition and transfer of skills useful for the students' personal and professional lives beyond the academy.