Perceptions of parents of pediatric patients with acute lymphoblastic leukemia on oral chemotherapy administration: A qualitative analysis.

OBJECTIVE: To describe the experiences and perspectives of parents of pediatric patients with acute lymphoblastic leukemia (ALL) regarding oral chemotherapy administration during maintenance therapy. METHODS: English-speaking parents of patients 4 to <18 years who were receiving ALL maintenance oral chemotherapy were eligible to participate in this mixed methods study. Using semi-structured interviews, we asked participants how difficult they found oral chemotherapy administration. We also probed regarding barriers and facilitators of oral chemotherapy administration and strategies used to overcome challenges. Lastly, we asked participants for their advice to future parents giving oral chemotherapy to their children. RESULTS: Twenty-three participants were interviewed. One-fifth of participants stated that oral chemotherapy administration at home was hard or very hard. Common factors influencing oral chemotherapy administration were product-related (e.g., formulation) and treatment-related adverse effects (e.g., nausea), lifestyle adjustment (e.g., fitting in with family schedule), and attitudes (e.g., onus of medication administration). Strategies to address oral chemotherapy administration included several administration techniques, scheduling of medication administration, and normalization of medication taking. CONCLUSIONS: Oral chemotherapy administration during ALL maintenance therapy was hard for some parents. Identification of these parents and discussion of strategies to facilitate adherence to oral chemotherapy regimens may optimize patient outcomes.

The current provision of community-based teaching in UK medical schools: an online survey and systematic review.

OBJECTIVE: To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools. DESIGN AND DATA SOURCES: An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation. STUDY SELECTION: Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included. RESULTS: Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors' knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE. CONCLUSIONS: Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for 'Tomorrow's Doctors', a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE. STRENGTHS AND LIMITATIONS OF THIS STUDY: This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed in a consistent and comprehensive way. However, a weakness is that data from the online survey was obtained from online medical school prospectuses. This means the data may be incomplete or out of date. Data in the literature review may also be skewed by publication bias.

Visual lobe shape and search performance for targets of different difficulty.

In quantitative models of visual search it has usually been assumed that visual lobe area shape was sufficiently regular to be approximated by a circle or ellipse. However, the irregularities in visual lobe shapes that have been found in studies involving extensive lobe mapping have suggested that lobe shape may have important implications for visual search performance and for the accuracy of mathematical models used for performance prediction. However, no systematic research on the relationship between the shape aspect of visual lobes and search performance seems to have been carried out and no comparisons of visual lobe shape characteristics under the effect of target difficulty have been reported. The current study was conducted to achieve two major objectives in two experiments. Experiment 1 used two different targets (letter 'O' and letter 'Y') to map the visual lobes of subjects in order to provide a systematic and quantitative comparison of lobe shape characteristics and experiment 2 was to investigate the correlation of visual lobe shape characteristics with visual search time under the effect of target difficulty. The visual lobes of 28 subjects were mapped on 24 imaginary and regularly spaced meridians originating from the centre of the visual field to resemble the full field mapping situation. Five categories of shape indices, viz. roundness, boundary smoothness, symmetry, elongation and shape regularity were investigated. The results of this study demonstrated that the visual lobe shapes of subjects elongate horizontally with medium level of roundness, high levels of boundary smoothness, symmetry and regularity for an easy target (O) against a homogeneous background of 'X's. When a difficult target (Y) was used, the visual lobes of the subjects were still elongated horizontally but to a smaller extent and with a low level of roundness, medium level of boundary smoothness and regularity and a similar high level of symmetry to the easy target. Moreover, significant correlations between shape indices and visual search time were found, suggesting mathematical models for predicting search time should not merely rely on area but also should consider visual lobe shape indices. Finally, a universal mathematical model containing several visual lobe shape indices was developed, which was applicable in the prediction of visual search time for a range of similar search tasks.