Delivering colon cancer survivorship care in primary care; a qualitative study on the experiences of general practitioners

Background With more patients in need of oncological care, there is a growing interest to transfer survivorship care from specialist to general practitioner (GP). The ongoing I CARE study was initiated in 2015 in the Netherlands to compare (usual) surgeon- to GP-led survivorship care, with or without access to a supporting eHealth application (Oncokompas). Methods Semi-structured interviews were held at two separate points in time (i.e. after 1- and 5-years of care) to explore GPs’ experiences with delivering this survivorship care intervention, and study its implementation into daily practice. Purposive sampling was used to recruit 17 GPs. Normalisation Process Theory (NPT) was used as a conceptual framework. Results Overall, delivering survivorship care was not deemed difficult and dealing with cancer repercussions was already considered part of a GPs’ work. Though GPs readily identified advantages for patients, caregivers and society, differences were seen in GPs’ commitment to the intervention and whether it felt right for them to be involved. Patients’ initiative with respect to planning, absence of symptoms and regular check-ups due to other chronic care were considered to facilitate the delivery of care. Prominent barriers included GPs’ lack of experience and routine, but also lack of clarity regarding roles and responsibilities for organising care. Need for a monitoring system was often mentioned to reduce the risk of non-compliance. GPs were reticent about a possible future transfer of survivorship care towards primary care due to increases in workload and financial constraints. GPs were not aware of their patients’ use of eHealth. Conclusions GPs’ opinions and beliefs about a possible future role in colon cancer survivorship care vary. Though GPs recognize potential benefit, there is no consensus about transferring survivorship care to primary care on a permanent basis. Barriers and facilitators to implementation highlight the importance of both personal and system level factors. Conditions are put forth relating to time, reorganisation of infrastructure, extra personnel and financial compensation. Trial registration Netherlands Trial Register; NTR4860. Registered on the 2nd of October 2014.

Guidelines for volcano-observatory operations during crises: recommendations from the 2019 volcano observatory best practices meeting

In November 2019, the fourth Volcano Observatory Best Practices workshop was held in Mexico City as a series of talks, discussions, and panels. Volcanologists from around the world offered suggestions for ways to optimize volcano-observatory crisis operations. By crisis, we mean unrest that may or may not lead to eruption, the eruption itself, or its aftermath, all of which require analysis and communications by the observatory. During a crisis, the priority of the observatory should be to acquire, process, analyze, and interpret data in a timely manner. A primary goal is to communicate effectively with the authorities in charge of civil protection. Crisis operations should rely upon exhaustive planning in the years prior to any actual unrest or eruptions. Ideally, nearly everything that observatories do during a crisis should be envisioned, prepared, and practiced prior to the actual event. Pre-existing agreements and exercises with academic and government collaborators will minimize confusion about roles and responsibilities. In the situation where planning is unfinished, observatories should prioritize close ties and communications with the land and civil-defense authorities near the most threatening volcanoes.To a large extent, volcanic crises become social crises, and any volcano observatory should have a communication strategy, a lead communicator, regular status updates, and a network of colleagues outside the observatory who can provide similar messaging to a public that desires consistent and authoritative information. Checklists permit tired observatory staff to fulfill their duties without forgetting key communications, data streams, or protocols that need regular fulfilment (Bretton et al. Volcanic Unrest. Advances in Volcanology, 2018; Newhall et al. Bull Volcanol 64:3–20, 2020). Observatory leaders need to manage staff workload to prevent exhaustion and ensure that expertise is available as needed. Event trees and regular group discussions encourage multi-disciplinary thinking, consideration of disparate viewpoints, and documentation of all group decisions and consensus. Though regulations, roles and responsibilities differ around the world, scientists can justify their actions in the wake of an eruption if they document their work, are thoughtful and conscientious in their deliberations, and carry out protocols and procedures developed prior to volcanic unrest. This paper also contains six case studies of volcanic eruptions or observatory actions that illustrate some of the topics discussed herein. Specifically, we discuss Ambae (Vanuatu) in 2017–2018, Kīlauea (USA) in 2018, Etna (Italy) in 2018, Bárðarbunga (Iceland) in 2014, Cotopaxi (Ecuador) in 2015, and global data sharing to prepare for eruptions at Nyiragongo (Democratic Republic of Congo). A Spanish-language version of this manuscript is provided as Additional file 1.

A Survey of the Experiences of Paraprofessionals With Roles, Training, and Communication When Working With Students With Autism

Paraprofessionals are critical members of instructional teams for students with autism; however, little is known about their job preparation and professional development needs. This study addressed the gap in the literature by surveying 325 paraprofessionals in public school settings in the United States and Guam who reported working with students with autism. Data were gathered on paraprofessionals’ (a) roles and responsibilities, (b) applied knowledge from different types of professional development, (c) perceived barriers to professional development, and (d) types and timing of communication with their supervising teachers. The results of this study have direct implications for individuals interested in developing a model of professional development that will meet the unique needs of paraprofessionals who work with students with autism.

Exploring “Intersectoral Collaboration” towards the Integration of Indigenous Knowledge into Adult Education Programs in North Wollo, Ethiopia

Integration of indigenous knowledge into adult education recognizes collaboration based on indigenous frameworks and methodologies and gives more attention to people’s history, politics, cultural beliefs, and philosophical views. The most important beginning phases and tasks in promoting indigenous-based learning are establishing a responsive organizational structure that helps to identify and agree on what roles and responsibilities are played by each concerned stakeholder. Considering this in mind, this study aimed to explore intersectoral coordination and their participation in the integration of indigenous knowledge into adult education. In doing so, a qualitative research approach and a case-study design were employed. The study sample was composed of adult education experts and coordinators. Data was obtained through interviews, FGD, and document analysis. Furthermore, thematic analysis was the centre of this study data analysis. As a result, the study finding revealed that stakeholders’ coordinated effort has been observed that lacks consistency in supporting indigenous-based adult education programs due to their deprived collaboration and the presence of not functional administrative structure. This makes the provision and the integration of indigenous-based knowledge systems into adult education sporadic in its coverage of indigenous learning contents and experiences.

Leadership

Leadership development happens when one can determine and/or strengthen leadership style. Development continues when there is a trusting connection, when there are clear roles and responsibilities, and when an environment that facilitates quality communication is maintained. This chapter examines a study that shows a disconnect in opinions from employees, CEOs, and human resources professionals who were all asked the same questions about how people view their organization. Top-level leaders were overly optimistic about the frequency with which their employees were being recognized for their contributions. Conversely, human resources professionals were pessimistic about frequent recognition while employees seemed to be divided about the frequency and appropriateness of recognition. The authors find a variety of team qualities as they peruse thousands of leadership, management, and self-improvement books. This chapter narrows the focus to engagement, the setting of leader and manager roles, and developing members.

Fear vs. Threat, School Shootings and Violence

The first recorded school shooting took place in Charlottesville, Virginia on November 12, 1840. The most recent school shooting took place on July 11, 2019 in Hartford, Connecticut. Over 500 school shootings have taken place since the Charlottesville incident. Sadly, school shootings are not an anomaly to many communities in America. Administrators, and particularly principals, are faced with significant challenges in creating an environment that is conducive to the development of a productive and safe school culture. The content of this manuscript will explore the existing administrative roles and responsibilities with respect to school safety and the implementation and supervision of those procedures. Also discussed in the manuscript will be the role that fear plays in the decision making process and how some decisions may be misplaced and could be redirected toward more favorable areas of emphasis (i.e., counseling, active supervision, alternative academic options, community outreach, and inclusive student opportunities).

Five Critical Domains of Effective Leadership in Higher Education Administration

Higher education today consists of a complex myriad of varying levels with individuals tasked to perform multiple roles and responsibilities. Faculty and staff find themselves tasked with multiple responsibilities and fewer resources. Many who embark on the journey of becoming academic administrators and leaders in higher education often do so based on their technical expertise and successes as a faculty member within the institution. Few organizations prepare faculty to step into leadership roles with the appropriate training. One area which often lacks training is in the area of individual leadership capabilities and connecting with others within the organization to accomplish a common goal. This chapter will provide insight into five critical domains necessary for individuals to focus on developing before entering into a leadership role within a higher education institution. Within each domain are central and core competencies which help to determine effectiveness in higher education leadership.