Treatment non-adherence in teenage and young adult patients with cancer

Adhering to treatment can be a significant issue for many patients diagnosed with chronic health conditions and this has been reported to be greater during the adolescent years. However, little is known about treatment adherence in teenage and young adult (TYA) patients with cancer. To increase awareness of the adherence challenges faced by these patients, we have reviewed the published work. The available evidence suggests that a substantial proportion of TYA patients with cancer do have difficulties, with reports that up to 63% of patients do not adhere to their treatment regimens. However, with inconsistent findings across studies, the true extent of non-adherence for these young patients is still unclear. Furthermore, it is apparent that there are many components of the cancer treatment regimen that have yet to be assessed in relation to patient adherence. Factors that have been shown to affect treatment adherence in TYA patients include patient emotional functioning (depression and self-esteem), patient health beliefs (perceived illness severity and vulnerability), and family environment (parental support and parent–child concordance). Strategies that foster greater patient adherence are also identified. These strategies are multifactorial, targeting not only the patient, but the health professional, family, and treatment regimen. This review highlights the lack of interventional studies addressing treatment adherence in TYA patients with cancer, with only one such intervention being identified: a video game intervention focusing on behavioural issues related to cancer treatment and care. Methodological issues in measuring adherence are addressed and suggestions for improving the design of future adherence studies highlighted, of which there is a great need.

Assessment for Learning in teaching English to Young Learners: teachers’ understanding, classroom practice and impact on interactions

It has been suggested that Assessment for Learning (AfL) plays a significant role in enhancing teaching and learning in mainstream educational contexts. However, little empirical evidence can support these claims. As AfL has been shown to be enacted predominantly through interactions in primary classes, there is a need to understand if it is appropriate, whether it can be efficiently used in teaching English to Young Learners (TEYL) and how it can facilitate learning in such a context. This emerging research focus gains currency especially in the light of SLA research, which suggests the important role of interactions in foreign language learning. This mixed-method, descriptive and exploratory study aims to investigate how teachers of learners aged 7-11 understand AfL; how they implement it; and the impact that such implementation could have on interactions which occur during lessons. The data were collected through lesson observations, scrutiny of school documents, semi-structured interviews and a focus group interview with teachers. The findings indicate that fitness for purpose guides the implementation of AfL in TEYL classrooms. Significantly, the study has revealed differences in the implementation of AfL between classes of 7-9 and 10-11 year olds within each of the three purposes (setting objectives and expectations; monitoring performance; and checking achievement) identified through the data. Another important finding of this study is the empirical evidence suggesting that the use of AfL could facilitate creating conditions conducive to learning in TEYL classes during collaborative and expert/novice interactions. The findings suggest that teachers’ understanding of AfL is largely aligned with the theoretical frameworks (Black & Wiliam, 2009; Swaffield, 2011) already available. However, they also demonstrate that there are TEYL specific characteristics. This research has important pedagogical implications and indicates a number of areas for further research.