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The research reported in this article by David Ryan, an adviser for special educational needs and inclusion in Belfast, was based on a participatory approach in which young people in a number of schools were encouraged to develop their ideas about inclusion. The project set out to explore any differences in perceptions between pupils with special educational needs and those without. The young people were equipped with cameras and were encouraged to generate "visual narratives" expressing their views about the "reasonable adjustments" that mainstream schools might make in order to become more inclusive. David Ryan concludes that education must be personalised so that schools take account of the perspectives of individual pupils in their endeavours to become more inclusive. He also notes that young people appear to have strongly-held views about some of the sensory aspects of the school environment.

A unique talent development project took place in Belfast, Northern Ireland over the autumn (fall) term of 2007 that developed 60 young people from ten diverse schools (Special, Secondary, Grammar, Controlled (state schools) and Catholic Maintained). The project culminated in Manchester on 3 December 2007 when the Young People undertook a journey from Belfast to Manchester following in the footsteps of George Best--the famous Manchester United and Northern Ireland professional footballer. The event attracted a huge media interest--being covered by Northern Ireland's Ulster Television News programme, the leading Northern Ireland NI newspaper--The Belfast Telegraph, The Manchester Evening News, Manchester United Television-Sky channel, Manchester Evening News and BBC Manchester. A research study was undertaken in parallel with the project to quantify the young people's self-image, abilities and belief in achievement before, during and after the project. (Contains 8 tables.)

The present paper describes a developmental tool (Inclusion Analysis) that enables schools to identify how inclusive or otherwise they are in a relatively straightforward way with a minimal time commitment. The developmental background to the creation of the tool is outlined in terms of inclusion in Northern Ireland and the implementation of the Special Educational Needs and Disability (Northern Ireland) Order 2005. The benefits of using the inclusion analysis as a contributor to school improvement through the school improvement model of disability and special educational needs is described, along with its use and perceived benefits and feedback from schools that have used the tool. The paper concludes with suggestions for further work on the tool. (Contains 3 figures and 1 note.)

An observation at a problem-based learning, case-building meeting prompted the realization that building cases might itself be an effective educational intervention. We developed a process for a new continuing medical education technique that is peculiarly familiar that we call "build-a-case." Build-a-case has now been used for teaching and learning in many clinical situations and with several kinds of health professionals. Subjective evaluations of the approach are consistently positive, and people feel that they learn from it because it prompts the discussion of practice as it is in their clinics and communities. In what follows, we describe the build-a-case process and our experiences with it and suggest several theoretical constructs that might be useful in promoting thoughtful research on what may become a useful new tool for continuing education.

Introduction: Educationally influential physicians (EIPs) are identified by their colleagues as people who (1) encourage learning and enjoy sharing their knowledge, (2) are clinical experts and always seem up to date, and (3) treat others as equals. We aimed to identify surgical and pathologist EIPs for colorectal cancer (CRC) in Ontario as part of a blended knowledge transfer program. Methods: A population-based cohort of surgeons (n = 794) and pathologists (n = 449) were sent surveys modeled on the Hiss method for identifying EIPs. Four formal mailings (including incentives) and telephone calls and faxes were completed. This labor-intensive process identified "general" EIPs and surgery or pathology EIPs for CRC. The characteristics of EIPs in these groups were studied. Results: The response rate was 41% for surgeons and 42% for pathologists. One hundred eighteen general EIPs were identified and substantially more surgical EIPs for CRC (n = 63) than pathology EIPs for CRC (n = 6) were recognized. Forty-two of 81 medical centers in Ontario identified an EIP. We also identified a cohort of "domain experts," physicians whose opinion was valued for CRC but who did not meet the Hiss EIP criteria. This cohort of "domain experts" was larger than the cohort of EIPs for CRC for both surgeons (63 vs. 154) and pathologists (6 vs. 154). Discussion: In this population study, we identified EIPs for CRC using the Hiss method, although significantly more surgical than pathology EIPs for CRC were recognized. The educational influence of domain experts who do not fulfill the Hiss characteristics compared with EIPs for CRC remains to be determined.

Introduction: Severe acute respiratory syndrome (SARS) struck Toronto in the spring of 2003, causing many deaths, serious morbidity, forced quarantine of thousands of individuals, and the closure of all provincial hospitals for several weeks. Given the direction by public health authorities to cancel or postpone all continuing medical education (CME) courses, including those sponsored by the University of Toronto Faculty of Medicine, SARS has had a profound effect on the delivery of CME in Toronto and beyond. Method: Case study design using existing documents and self-report. Results: The immediate, specific response of the University of Toronto CME program to SARS is described for the period from March 2003 to September 2003. Discussion: During major outbreaks of infectious disease, continuing education providers should maintain regular contact with public health authorities and learners, enact a rational process for postponing or canceling courses, and implement a disaster plan flexible enough to ensure the delivery of education using technological advances.

Introduction Health warning labels (HWL) on tobacco products help educate smokers about the health effects from smoking; however, there is a need to improve HWL content including images and text to increase effectiveness. In Canada, a HWL was created that communicates smoking’s causal association with “blindness” from age-related macular degeneration (AMD). This study surveyed Canadian optometrists about their opinions regarding the image and text used in the “blindness” HWL. Material and Methods An online survey was sent to all 4528 registered Canadian optometrists. Respondents were asked if the HWL conveyed important and believable information, and if the picture was appropriate. Optometrists were invited to make open-ended comments about the label which were analyzed using a qualitative analysis framework suitable for health policy evaluation. Frequency distributions were calculated for closed-ended questions. Results The survey was completed by 850 respondents (19 %). Most respondents (90 %) reported the message was believable/somewhat believable; while 35 % felt the picture was “too graphic”. Some respondents reported in their open-ended comments that they were concerned the HWL was internally inconsistent because it reports there is “no effective treatment in most cases” for AMD but the image depicts someone undergoing surgery. There was concern that this may discourage patients from seeking needed treatment. Conclusions The majority of Canadian optometrist respondents were in agreement that the new, “RISK OF BLINDNESS” pictorial HWL includes important, believable information. Some optometrists had concerns that the HWL included a confusing message or a message that may discourage some patients from pursuing treatment for AMD. Future development of blindness-related HWL should seek practitioner input.

Survey responses from 212 physicians were compared with previous research. Results were used to attempt to validate rules they used to identify educationally influential physicians with whom to consult. The important construct of informal influence appears to need further study. (Contains 27 references.) (SK)

Objective: The objective of this study was to characterize the patterns of first recurrence after curative-intent resection for pancreatic adenocarcinoma (PDAC). Summary of Background Data: We evaluated the first site of recurrence after neoadjuvant treatment as locoregional (LR) or distant metastasis (DM). To validate our findings, we evaluated the pattern from 2 phase II clinical trials evaluating neoadjuvant chemotherapy (NAC) in PDAC. Methods: We identified site of first recurrence from a retrospective cohort of patients from 2011 to 2017 treated with NAC followed by chemoradiation and then an operation or an operation first followed by adjuvant therapy, and 2 separate prospective cohorts of patients derived from 2 phase II clinical trials evaluating patients treated with NAC in borderline-resectable and locally advanced PDAC Results: In the retrospective cohorts, 160 out of 285 patients (56.1%) recurred after a median disease-free survival (mDFS) of 17.2 months. The pattern of recurrence was DM in 81.9% of patients, versus LR in 11.1%. This pattern was consistent in patients treated with upfront resection and adjuvant chemotherapy (DM 83.0%, LR 16.9%) regardless of margin-involvement (DM 80.1%, LR 19.4%). The use of NAC did not alter pattern of recurrence; 81.7% had DM and 18.3% had LR. This pattern also remained consistent regardless of margin-involvement (DM 94.1%, LR 5.9%). In the Phase II borderline-resectable trial (NCI# 01591733) cohort of 32 patients, the mDFS was 34.2 months. Pattern of recurrence remained predominantly DM (88.9%) versus LR (11.1%). In the Phase II locally-advanced trial (NCI# 01821729) cohort of 34 patients, the mDFS was 30.7 months. Although there was a higher rate of local recurrence in this cohort, pattern of first recurrence remained predominantly DM (66.6%) versus LR (33.3%) and remained consistent independent of margin-status. Conclusions: The pattern of recurrence in PDAC is predominantly DM rather than LR, and is consistent regardless of the use of NAC and margin involvement. [ABSTRACT FROM AUTHOR]

Background There has been minimal policy development in Canada to regulate when and where e-cigarettes can be used, and no policies to-date to set a minimum legal sale age to purchase e-cigarettes. Public Health professionals that are members of an Ontario-wide Community-of-Practice (CoP) working on tobacco control issues were surveyed about e-cigarette activity at their health units. Methods The survey was completed by 19 respondents from 17 different health units (response rate of 63%; representing 47% of the province’s health units). When respondents were asked to describe how ‘high a priority’ the issue of e-cigarettes was within their health unit, 88% (n = 15) reported it was a ‘medium’ or ‘high’. The vast majority of members of the CoP (90%, n = 17) reported that their health unit is experiencing questions from the public about the safety or health risks of e-cigarettes (e.g. e-juice, nicotine cartridges, poisoning, second-hand vapour), as well as questions about the efficacy of e-cigarettes to support cessation (90%, n = 17). Almost three quarters of respondents (74%, n = 14) reported that their health unit has received complaints about people using e-cigarettes in enclosed workplaces, and roughly one quarter (26%, n = 5) reported their health unit has received complaints about outdoor e-cigarette use. Conclusions Most members of the CoP report that their local health unit is engaged in the issue of electronic cigarettes. Local authorities including cities and regions have the jurisdictional authority to regulate many dimensions of electronic smoking products including the creation of e-cigarette ‘vapour-free’ environments, and regulating sales to youth.