A randomized controlled trial of a nurse-administered educational intervention for improving cancer pain management in ambulatory settings

The persistence of negative attitudes towards cancer pain and its treatment suggests there is scope for identifying more effective pain education strategies. This randomized controlled trial involving 189 ambulatory cancer patients evaluated an educational intervention that aimed to optimize patients' ability to manage pain. One week post-intervention, patients receiving the pain management intervention (PMI) had a significantly greater increase in self-reported pain knowledge, perceived control over pain, and number of pain treatments recommended. Intervention group patients also demonstrated a greater reduction in willingness to tolerate pain, concerns about addiction and side effects, being a "good" patient, and tolerance to pain relieving medication. The results suggest that targeted educational interventions that utilize individualized instructional techniques may alter cancer patient attitudes, which can potentially act as barriers to effective pain management. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

Leading theory: Bourdieu and the field of educational leadership. An introduction and overview to this special issue

Bourdieu … makes it possible to explain how the actions of principals are always contextual, since their interests vary with issue, location, time, school mix, composition of staff and so on. This 'identity' perspective points at a different kind of research about principal practice: to understand the game and its logic requires an analysis of the situated everyday rather than abstractions that claim truth in all instances and places. (Thomson 2001a: 14)

Factors affecting student attitudes toward flexible online learning in management education

In response to recent technological advances and the trend toward flexible learning in education, the authors examined the factors affecting student satisfaction with flexible online learning. The authors identified 2 key student attributes of student satisfaction: (a) positive perceptions of technology in terms of ease of access and use of online flexible learning material and (b) autonomous and innovative learning styles. The authors derived measures of perceptions of technology from research on the Technology Acceptance Model and used locus of control and innovative attitude as indicators of an autonomous and innovative learning mode. First-year students undertaking an introductory management course completed surveys at the beginning (n = 248) and at the end (n = 256) of course work. The authors analyzed the data by using structural equation modeling. Results suggest that student satisfaction is influenced by positive perceptions toward technology and an autonomous learning mode.

Randomized controlled trial of an educational intervention for managing fatigue in women receiving adjuvant chemotherapy for early-stage breast cancer

Purpose To evaluate the efficacy of a psychoeducational intervention in improving cancer-related fatigue. Patients and Methods This randomized controlled trial involved 109 women commencing adjuvant chemotherapy for stage I or II breast cancer in five chemotherapy treatment centers. Intervention group patients received an individualized fatigue education and support program delivered in the clinic and by phone over three 10- to 20-minute sessions 1 week apart. Instruments included a numeric rating scale assessing confidence with managing fatigue; 11-point numeric rating scales measuring fatigue at worst, average, and best; the Functional Assessment of Cancer Therapy-Fatigue and Piper Fatigue Scales; the Cancer Self-Efficacy Scale; the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30; and the Hospital Anxiety and Depression Scale. For each outcome, separate analyses of covariance of change scores between baseline (T1) and the three follow-up time points (T2, T3, and T4) were conducted, controlling for the variable's corresponding baseline value. Results Compared with the intervention group, mean difference scores between the baseline (T1) and immediate after the test (T2) assessments increased significantly more for the control group for worst and average fatigue, Functional Assessment of Cancer Therapy-Fatigue, and Piper fatigue severity and interference measures. These differences were not observed between baseline and T3 and T4 assessments. No significant differences were identified for any pre- or post-test change scores for confidence with managing fatigue, cancer self-efficacy, anxiety, depression, or quality of life. Conclusion Preparatory education and support has the potential to assist women to cope with cancer-related fatigue in the short term. However, further research is needed to identify ways to improve the potency and sustainability of psychoeducational interventions for managing cancer-related fatigue.

A pragmatic 2 × 2 × 2 factorial cluster randomized controlled trial of educational outreach visiting and case conferencing in palliative care—methodology of the Palliative Care Trial [ISRCTN 81117481]

The demand for palliative care is increasing, yet there are few data on the best models of care nor well-validated interventions that translate current evidence into clinical practice. Supporting multidisciplinary patient-centered palliative care while successfully conducting a large clinical trial is a challenge. The Palliative Care Trial (PCT) is a pragmatic 2 x 2 x 2 factorial cluster randomized controlled trial that tests the ability of educational outreach visiting and case conferencing to improve patient-based outcomes such as performance status and pain intensity. Four hundred sixty-one consenting patients and their general practitioners (GPs) were randomized to the following: (1) GP educational outreach visiting versus usual care, (2) Structured patient and caregiver educational outreach visiting versus usual care and (3) A coordinated palliative care model of case conferencing versus the standard model of palliative care in Adelaide, South Australia (3:1 randomization). Main outcome measures included patient functional status over time, pain intensity, and resource utilization. Participants were followed longitudinally until death or November 30, 2004. The interventions are aimed at translating current evidence into clinical practice and there was particular attention in the trial's design to addressing common pitfalls for clinical studies in palliative care. Given the need for evidence about optimal interventions and service delivery models that improve the care of people with life-limiting illness, the results of this rigorous, high quality clinical trial will inform practice. Initial results are expected in mid 2005. (c) 2005 Elsevier Inc. All rights reserved.

Introduction: Arguments for a more grounded approach in management education

The article mentions the aims and objectives of the "Academy of Management Learning & Education" and introduces four essays in this issue. Milton R. Blood focuses on the role of business schools in generating actionable knowledge. Peter Navarro asserts that macroeconomics is necessary in MBA programs. Scott Julian and Joseph C. Ofori-Dankwa comment on business school accreditation and competition status. Michael Harmon offers an argument that competition status is negatively affecting research, teaching, and social objectives.

Business education in operations management

This paper examines trends in the practice of Operations Management and in teaching the field in major Business Schools. Operations Management has been defined as the design and management of transformation processes that create value for society. The operations function is the one function directly involved in that transformation, and hence is directly responsible for the activities that justify the existence of the firm, both economically and as a value-creating organization in society. The top rated schools in Operations Management are the top-rated research-intensive Business Schools in the world. Operations Management is an area that has been undergoing rapid change in response to changes in business practices worldwide. It is at the heart of changes of which the AACSB report Management Education at Risk, August 2002 (p 20), comments of Business Schools in general: ‘With regard to global relevance (of Business Schools), the complex opportunities and challenges that emanate from the world scope of operations, outsourcing, supply chains, partnerships, and financial and consumer markets – all linked in real time through the Internet – are not reflected adequately in curricula and learning approaches.’ Products, and even services, depend increasingly on advanced technology. This is true globally and especially so for countries in South East and East Asia, from which Australian Universities draw a significant number of students. Services operations management has become much more important, while there are both educational and industrial needs in management science or operations research.