Combination chemotherapy for primary small intestinal lymphoma in the Middle East

Twelve patients with primary small intestinal lymphoma were followed prospectively for 3 years. Endoscopic abnormalities were diagnostic of lymphoma in all cases where the duodenum was involved (83%). In three cases (25%) the disease extended to the stomach. One patient (8%) had diffuse small cell cleaved and 11 (92%) diffuse large cell lymphoma stages I (8%), II (25%), III (58%) and IV (8%). Nine of them were unresectable and primarily treated with combination chemotherapy; 67% achieved complete remission, 22% partial response and 11% no response. Only one patient relapsed and achieved a second remission. All complete remission patients are currently alive and free of disease at a median follow-up of 36 months. Overall survival for all patients is 58%, and disease-free survival is 50%. No instance of chemotherapy-related bleeding or perforation was seen. Tetracycline was necessary for the treatment of IPSID-associated diarrhea and malabsorption in spite of cytotoxic chemotherapy.

Innovatus interregnum: Waiting for a paradigm shift

The purpose of this paper is to establish the case that innovation in the theory and practice of educational administration/leadership is very unlikely to occur within the existing doxa of our times. By innovation is meant a novel conceptual or practical change in the field of practice. By doxa is meant the unquestioned rules of the game and the linkage between the agencies and organs of government and foundations supporting research in the field. An approach towards thinking outside of the prevailing doxa is presented and explained as one possible antidote to the current dominant model.

Methodological issues with older users as research participants

Researching with older participants presents many unique methodological challenges. One of the reasons for this is the greater variability in abilities among older than among younger people. Thus, the standard practice in user research of assuming homogeneity in a certain demographic group may not work with older adults. Designing experiments for users with diverse capabilities is challenging and calls for re-examination of existing experimental design methods. In this paper we will share our experience in researching with people with diverse capabilities and present its implications and possible way to address them.

Who am I? Developing pre-service teacher identity in a digital world

The notions of identity and teacher education have attracted considerable research over the years, revealing a strong correlation between teacher beliefs and practices and the resultant impact on pedagogical practices in the classroom. In an era where the use of digital technologies should be synonymous with teacher pedagogical practices and transforming education, there is a growing need for pre-service teachers to develop an identity that resonates with pedagogical practices that engage and connect with students in a positive and productive way. With many educational institutions also mandating that educators use digital technologies as a tool to support and enhance teaching, pre-service teacher education needs to ensure that students understand and develop a positive identity within this digital world. Current literature acknowledges that many educators adopt digital technologies in the classroom without sometimes fully understanding its scope or impact. It is within this context that this paper reports on a three-year study of first year pre-service education students and their understanding of identity in a digital world. More specifically, the study identifies how students currently use social and digital media in their personal and professional lives to identify themselves online in order to promote a positive image. The study also seeks to identify how these technologies and an understanding of identity can be utilised to promote a positive first year experience.

Cost-effectiveness of a national initiative to improve hand hygiene compliance using the outcome of healthcare associated staphylococcus aureus bacteraemia

Background The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included. Methods The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011–2012. Findings No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER) of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits. Conclusions The Australian National Hand Hygiene Initiative was cost-effective against an Australian threshold of $42,000 per life year gained. The return on investment varied among the states and territories of Australia.