Building a PSU ETHOS

This white paper is about responsive change in higher education where integrative engagement replaces silo-centric traditions and all constituent voices are part of the transformation as they co-create a new educational landscape that leads with the student experience. At Plymouth State University, designing, building, and engaging the integrated cluster initiative invites students, faculty, staff, alumni, business partners, community partners, and partners beyond our local borders to co-create our future citizens, leaders, the educational landscape, local and global communities, and the local and global marketplace. By leading with the student experience, we are learner centric in all aspects of academic and administrative experiences. This provides a framework for how we get there. Working from the book length manuscript, ETHOS vision: Commitment, action, and self-transformation in higher education (Nancy Puglisi and Cheryl B. Baker, 2016), ETHOS stands for: E –Education, T-Teaching, H-Habitat, O-Organizations, and S-Society. We advance two conceptual lenses in this manuscript that we believe will help us envision our individual transformation as we engage organizational transformation. The first conceptual lens has to do with becoming an Educateur, which is a transformational professional within the academy, facilitating learning in the classroom, and actively engaging in the change processes within the organization. An Educateur is responsible, not only for the learning of their students and their own learning but also the environment within which they teach. It is essential that faculty embrace dualistic, Educateurial roles of teacher and organizational transformation emissary. The Educateur co-creates innovative venues in the classroom and within the organization to accomplish an imaginative, reflective, and contemplative environment. The focus for the changes within the classroom and the organization should include: experiential, integrative, community-based and transformational practices restructuring the classroom and the institution to meet the needs of students and the larger external community. The second conceptual lens involves shifting our approach to our teaching methodology from teaching children to teaching young adults. Using the landmark work of Malcom Knowles that identifies six assumptions about the adult learner, we can begin to envision new approaches to teaching and learning that shifts from a teacher-centric model typical with teaching children to a learner-centric model that facilitates learning by self-direction, building on student previous experiences, enabling the learner to co-create their learning, and instead of learning for a test, the learner learns with a different purpose such as to solve a problem or to touch the world around them. By seeing our students as young adults instead of children, we can better meet their diverse learning styles and needs, enhance their learning experience, enable them to own and co-create their educational experiences, and cultivate a mindset of lifelong learning. For further consideration of these ideas, we hope the attached paper is helpful. This paper is not intended as an exhaustive exploration of approaches to teaching. We are intending to identify two significant dispositions that are aligned with our current organizational life, the Educateur and teaching young adult learners

Faculty definitions of and beliefs about student ability: Are they related to classroom structures, student retention, and student pass rates?

Analysis of the interviews indicated that faculty do not have a common definition of mathematical ability and while all believed that students could learn, a few voiced the belief that students have ceilings or limits to their ability. Faculty with high retention and pass rates reported use of more activities and more active learning structures in the classroom. Cooperative group activities and boardwork were reported actively used by them. Those with low rates selected primarily lecture and imbedded problem questions. Control was referenced by the 3 younger males and the attitude of students was often mentioned as a concern limiting achievement. Faculty attitude may be another consideration.Four fulltime mathematics faculty from two different community colleges in a southwestern metropolitan city were selected based on either high or low retention and pass rates. Eight faculty were interviewed and their replies were compared and investigated.Implications include inservice professional development programs focused on learning theories, active learning strategies, task involvement vs ego involvement, and students' perception of task meaning as related to learning and ability level change. Another important consideration would be a comparison of the reasons faculty choose the classroom structures and the reasons community college students choose to engage in or not engage in those structures. Both faculty and student beliefs and perceptions will continue to be an important consideration for research and discussion.Due to community college faculty and staff concerns about low adult student retention and pass rates, an exploratory study of mathematics faculty definitions of mathematical ability, their beliefs about the nature of mathematical ability, and the classroom structures implemented was conducted. The purpose of the study was to explore the possibility that faculty definitions, beliefs, and usage of classroom structures may contribute to having higher or lower retention and pass rates

Therapist perceptions of barriers to telehealth uptake in children's occupational therapy

Introduction: The COVID-19 pandemic resulted in a rapid shift to telehealth implementation across paediatric occupational therapy services. Although telehealth can be an appealing option, access is conditional, and the delivery of a telehealth service differs from face-to-face. If telehealth is to be a viable and equitable option for families, insight is needed into why the service might be declined. The purpose of our study was to explore barriers to paediatric occupational therapy telehealth services from client and therapist perspectives in a Greater Sydney local health district. Method: A mixed method approach was used, including (i) retrospective review of clinical records for 250 clients seeking occupational therapy who declined the service and (ii) a focus group with four therapists providing the service. Client demographic information was summarised using descriptive statistics. Open-text responses about reasons for declining telehealth were analysed using qualitative content analysis, whereas thematic analysis was used to explore focus group data. Findings: Key findings from the mixed methods analysis identified barriers and issues to consider when working to ensure equitable access to telehealth for children and families. These issues included child engagement, family complexity, the nature of assessments, interventions, and overarching service characteristics as well as the family's digital inclusion. Digital inclusion comprises affordable access to the internet, data, and devices and the capacity of a child and/or family to engage online. Conclusion: Our findings suggest that telehealth is not a panacea when face-to-face services are not available. Multiple barriers confounded uptake of telehealth prompting a call to action to ensure equitable access to occupational therapy services for all children

Risk Model Development and Validation for Prediction of Coronary Artery Aneurysms in Kawasaki Disease in a North American Population.

Background Accurate prediction of coronary artery aneurysms ( CAAs ) in patients with Kawasaki disease remains challenging in North American cohorts. We sought to develop and validate a risk model for CAA prediction. Methods and Results A binary outcome of CAA was defined as left anterior descending or right coronary artery Z score ≥2.5 at 2 to 8 weeks after fever onset in a development cohort (n=903) and a validation cohort (n=185) of patients with Kawasaki disease. Associations of baseline clinical, laboratory, and echocardiographic variables with later CAA were assessed in the development cohort using logistic regression. Discrimination (c statistic) and calibration (Hosmer-Lemeshow) of the final model were evaluated. A practical risk score assigning points to each variable in the final model was created based on model coefficients from the development cohort. Predictors of CAAs at 2 to 8 weeks were baseline Z score of left anterior descending or right coronary artery ≥2.0, age <6 months, Asian race, and C-reactive protein ≥13 mg/ dL (c=0.82 in the development cohort, c=0.93 in the validation cohort). The CAA risk score assigned 2 points for baseline Z score of left anterior descending or right coronary artery ≥2.0 and 1 point for each of the other variables, with creation of low- (0-1), moderate- (2), and high- (3-5) risk groups. The odds of CAA s were 16-fold greater in the high- versus the low-risk groups in the development cohort (odds ratio, 16.4; 95% CI , 9.71-27.7 [ P<0.001]), and >40-fold greater in the validation cohort (odds ratio, 44.0; 95% CI, 10.8-180 [ P<0.001]). Conclusions Our risk model for CAA in Kawasaki disease consisting of baseline demographic, laboratory, and echocardiographic variables had excellent predictive utility and should undergo prospective testing

Treatment Intensification in Patients With Kawasaki Disease and Coronary Aneurysm at Diagnosis.

BackgroundCoronary artery aneurysms (CAA) are a serious complication of Kawasaki disease. Treatment with intravenous immunoglobulin (IVIg) within 10 days of fever onset reduces the risk of CAA from 25% to <5%. Corticosteroids and infliximab are often used in high-risk patients or those with CAA at diagnosis, but there are no data on their longer-term impact on CAA.MethodsRetrospective multicenter study including children who had CAA with a z score ≥2.5 and <10 at time of diagnosis and who received primary therapy with IVIg alone or in combination with either corticosteroids or infliximab within 10 days of onset of fever.ResultsOf 121 children, with a median age of 2.8 (range 0.1-15.5) years, 30 (25%) received primary therapy with corticosteroids and IVIg, 58 (48%) received primary therapy with infliximab and IVIg, and 33 (27%) received primary therapy with IVIg only. Median coronary z scores at the time of diagnosis did not differ among treatment groups (P = .39). Primary treatment intensification with either corticosteroids or infliximab were independent protective factors against progression of coronary size on follow-up (coefficient: -1.31 [95% confidence interval: -2.33 to -0.29]; coefficient: -1.07 [95% confidence interval: -1.95 to -0.19], respectively).ConclusionsAmong a high-risk group of patients with Kawasaki disease with CAA on baseline echocardiography, those treated with corticosteroids or infliximab in addition to IVIg had less progression in CAA size compared with those treated with IVIg alone. Prospective randomized trials are needed to determine the best adjunctive treatment of patients who present with CAA

Trypanosoma brucei aquaglyceroporin 2 is a high-affinity transporter for pentamidine and melaminophenyl arsenic drugs and the main genetic determinant of resistance to these drugs.

OBJECTIVES: Trypanosoma brucei drug transporters include the TbAT1/P2 aminopurine transporter and the high-affinity pentamidine transporter (HAPT1), but the genetic identity of HAPT1 is unknown. We recently reported that loss of T. brucei aquaglyceroporin 2 (TbAQP2) caused melarsoprol/pentamidine cross-resistance (MPXR) in these parasites and the current study aims to delineate the mechanism by which this occurs. METHODS: The TbAQP2 loci of isogenic pairs of drug-susceptible and MPXR strains of T. brucei subspecies were sequenced. Drug susceptibility profiles of trypanosome strains were correlated with expression of mutated TbAQP2 alleles. Pentamidine transport was studied in T. brucei subspecies expressing TbAQP2 variants. RESULTS: All MPXR strains examined contained TbAQP2 deletions or rearrangements, regardless of whether the strains were originally adapted in vitro or in vivo to arsenicals or to pentamidine. The MPXR strains and AQP2 knockout strains had lost HAPT1 activity. Reintroduction of TbAQP2 in MPXR trypanosomes restored susceptibility to the drugs and reinstated HAPT1 activity, but did not change the activity of TbAT1/P2. Expression of TbAQP2 sensitized Leishmania mexicana promastigotes 40-fold to pentamidine and >1000-fold to melaminophenyl arsenicals and induced a high-affinity pentamidine transport activity indistinguishable from HAPT1 by Km and inhibitor profile. Grafting the TbAQP2 selectivity filter amino acid residues onto a chimeric allele of AQP2 and AQP3 partly restored susceptibility to pentamidine and an arsenical. CONCLUSIONS: TbAQP2 mediates high-affinity uptake of pentamidine and melaminophenyl arsenicals in trypanosomes and TbAQP2 encodes the previously reported HAPT1 activity. This finding establishes TbAQP2 as an important drug transporter