Enhancing teachers’ classroom communication skills – Measuring the effect of a continued professional development programme for mainstream school teachers

Continued professional development (CPD), tailored to teachers’ needs and expectations, is required for updated skills and knowledge. In this study, twenty-five teachers working with first and second grade students participated in an 11-week programme focusing on enhancing classroom communication. The participating teachers were randomly assigned to either a direct intervention track (intervention) or a delayed intervention track (waiting control). Teachers’ perceptions of activities and interactions in the classroom and self-efficacy were assessed on three occasions: T1, T2, and T3. The direct intervention track received intervention between T1 and T2, while the delayed intervention track received intervention between T2 and T3. A percentage change score for changes between T1 and T2 was calculated, to compare the direct and delayed intervention tracks and assess any intervention effect. Results revealed no significant difference between the groups, i.e., the intervention had no effect on teacher self-reports. The teachers gave an overall positive evaluation of the CPD. Thematic analyses revealed continued need for professional development and insights into the reciprocal influence of student and teacher behaviour. The quantitative and qualitative results paint somewhat different pictures showing the need of mixed methods when analysing these kinds of data.

Active Surveillance of Small Renal Masses: A Systematic Review

Background: Our goal is to review current literature regarding active surveillance (AS) of small renal masses (SRMs) and identify trends in survival outcomes, factors that predict the need for further intervention, and quality of life (QOL). Methods: We performed a comprehensive literature search in PubMed and EMBASE and identified 194 articles. A narrative summary was performed in lieu of a meta-analysis due to the heterogeneity of selected studies. Results: Seventeen articles were chosen to be featured in this review. Growth rate (GR) was not an accurate predictor of malignancy, although it was the characteristic most commonly used to trigger delayed intervention (DI). The mean 5-year overall survival (OS) of all studies was 73.6% ±1.7% for AS groups. The combined cancer specific survival (CSS) for AS is 97.1% ±0.6% , compared to 98.6% ±0.4% for the primary intervention (PI) groups, (p = 0.038). Conclusions: Short and intermediate-term data demonstrate that AS with the option for DI is a management approach whose efficacy (in terms of CSS) approaches that of PI at 5 years, is cost effective, and prevents overtreatment, especially in patients with significant comorbidities.

Mismatch of corneal specialists’ expectations and keratoconus knowledge in general ophthalmologists - a prospective observational study in Switzerland

Background To assess whether Swiss general ophthalmologists have the minimal keratoconus knowledge that corneal specialists would expect them to have. Methods Corneal specialists defined “minimal keratoconus knowledge” (MKK) with respect to definition, risk factors, symptoms and possible treatment options of keratoconus. A telephone interview survey was conducted among one hundred ophthalmologists (mean age 51.9 years (SD 9.5), 60 % male) from the German-speaking part of Switzerland. For each participant, years of work experience, number of keratoconus patients seen per year and access to a topography device were obtained. We calculated the proportion of MKK and examined in multivariate analyses whether ophthalmologists with access to topography and with greater work experience performed better than other groups. Results No single ophthalmologist had MKK. The mean MKK was 52.0 %, and the range was 28.6–81.0 %. Per 10 years of working in private practice, the MKK decreased by 8.1 % points (95 % CI: -14.2, -2.00; p = 0.01). Only 24 % of participants correctly recalled the definition of keratoconus, 9 % all risk factors, 5 % all symptoms and 20 % all treatment modalities. The MKK values were not associated with the number of keratoconus patients seen per year and the availability of topography to diagnose keratoconus. Conclusions There is a substantial mismatch between corneal specialist’ expectations and general ophthalmologists’ knowledge about keratoconus. The low recall of symptoms and risk factors may explain why ophthalmologists diagnose relatively few cases of keratoconus, resulting in inefficient care delivery and delayed intervention.

To determine the outcome of isolated hemorrhagic TBI in a large tertiary care center in Karachi, Pakistan.

Objective: To assess the outcome of mild traumatic brain injury patients who have isolated intracranial hemorrhages. Study Design: Cross-sectional, Setting: Department of Neurosurgery, Abbasi Shaheed Hospital, Karachi. Period: 1st January 2018 to 31st January 2020. Material & Methods: The inclusion criteria were that all the patients have to be above the age of 18 years, presented to us with mild TBI cases and had observable intracranial hemorrhage on computer tomography (CT) scan. Patient demographics and the various types of interventions were recorded. Results: A total of n= 300 patients were included in the study, The average age was 50.5 +/- 20.6 years. There were n= 180 males and n= 120 females. We performed a total of n= 45 (15%) neurosurgical interventions, the most common intervention being craniotomies performed in n= 31 (68.66%) patients. Of all the patients who underwent an intervention 64.44% had immediate intervention 20% had planned intervention as non-emergency cases, and 15.55% had delayed intervention. A one point increment in the GCS score is associated with 50% lower odds of surgical intervention having a p value of <0.001. The mortality rate in our study population was 6%. Conclusion: We found that the length of stay and mortality are associated with an increased age and lower GCS score of the patients, care should be taken when evaluating the patients as some cases require delayed intervention hence monitoring is of prime importance.

School-based gardening, cooking and nutrition intervention increased vegetable intake but did not reduce BMI: Texas sprouts - a cluster randomized controlled trial

Background Although school garden programs have been shown to improve dietary behaviors, there has not been a cluster-randomized controlled trial (RCT) conducted to examine the effects of school garden programs on obesity or other health outcomes. The goal of this study was to evaluate the effects of a one-year school-based gardening, nutrition, and cooking intervention (called Texas Sprouts) on dietary intake, obesity outcomes, and blood pressure in elementary school children. Methods This study was a school-based cluster RCT with 16 elementary schools that were randomly assigned to either the Texas Sprouts intervention (n = 8 schools) or to control (delayed intervention, n = 8 schools). The intervention was one school year long (9 months) and consisted of: a) Garden Leadership Committee formation; b) a 0.25-acre outdoor teaching garden; c) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school-year; and d) nine monthly parent lessons. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Child outcomes measured were anthropometrics (i.e., BMI parameters, waist circumference, and body fat percentage via bioelectrical impedance), blood pressure, and dietary intake (i.e., vegetable, fruit, and sugar sweetened beverages) via survey. Data were analyzed with complete cases and with imputations at random. Generalized weighted linear mixed models were used to test the intervention effects and to account for clustering effect of sampling by school. Results A total of 3135 children were enrolled in the study (intervention n = 1412, 45%). Average age was 9.2 years, 64% Hispanic, 47% male, and 69% eligible for free and reduced lunch. The intervention compared to control resulted in increased vegetable intake (+ 0.48 vs. + 0.04 frequency/day, p = 0.02). There were no effects of the intervention compared to control on fruit intake, sugar sweetened beverages, any of the obesity measures or blood pressure. Conclusion While this school-based gardening, nutrition, and cooking program did not reduce obesity markers or blood pressure, it did result in increased vegetable intake. It is possible that a longer and more sustained effect of increased vegetable intake is needed to lead to reductions in obesity markers and blood pressure. Clinical trials number NCT02668744.