Nurturing Joy and Belonging: Practices for Rehumanizing Professional Learning

In this article the authors describe a professional learning initiative focused on joyful teaching and learning during the COVID-19 pandemic and the techniques that were used to foster a culture of belonging. The authors utilize an integrative framework for understanding, cultivating, and assessing belongingness to suggest implications for school-university partnerships. Finally, the authors pose questions for school-university partnerships to reflect upon to build an intersectional approach to professional learning in a post-pandemic educational landscape

Patient experience and challenges in group concept mapping for clinical research.

BACKGROUND AND OBJECTIVE: Group concept mapping (GCM) is a research method that engages stakeholders in generating, structuring and representing ideas around a specific topic or question. GCM has been used with patients to answer questions related to health and disease but little is known about the patient experience as a participant in the process. This paper explores the patient experience participating in GCM as assessed with direct observation and surveys of participants. METHODS: This is a secondary analysis performed within a larger study in which 3 GCM iterations were performed to engage patients in identifying patient-important outcomes for diabetes care. Researchers tracked the frequency and type of assistance required by each participant to complete the sorting and rating steps of GCM. In addition, a 17-question patient experience survey was administered over the telephone to the participants after they had completed the GCM process. Survey questions asked about the personal impact of participating in GCM and the ease of various steps of the GCM process. RESULTS: Researchers helped patients 92 times during the 3 GCM iterations, most commonly to address software and computer literacy issues, but also with the sorting phase itself. Of the 52 GCM participants, 40 completed the post-GCM survey. Respondents averaged 56 years of age, were 50% female and had an average hemoglobin A1c of 9.1%. Ninety-two percent (n = 37) of respondents felt that they had contributed something important to this research project and 90% (n = 36) agreed or strongly agreed that their efforts would help others with diabetes. Respondents reported that the brainstorming session was less difficult when compared with sorting and rating of statements. DISCUSSION: Our results suggest that patients find value in participating in GCM. Patients reported less comfort with the sorting step of GCM when compared with brainstorming, an observation that correlates with our observations from the GCM sessions. Researchers should consider using paper sorting methods and objective measures of sorting quality when using GCM in patient-engaged research to improve the patient experience and concept map quality

The Isolation and Identification of a Causative Agent of the Feather Disorder Found in African Penguins (Spheniscus demersus)

Beginning in 2006, wild juvenile African Penguins (Spheniscus demersus) began to prematurely lose their juvenile feathers without immediate regrowth and were brought to the South African Foundation for the Conservation of Coastal Birds (SANCCOB) for rehabilitation5. Without immediate regrowth of feathers, energy is shunted away from growth and used for thermoregulation and metabolism. It has previously been hypothesized that potential viral and bacterial infections may be causing this disorder3,4. To test for this, Avian Polyomavirus (APV) nucleic acids, Budrigars Beak and Feather Disease Virus (BFDV) nucleic acids, and any bacterial nucleic acids were attempted to be isolated from the blood of affected penguins. Blood was drawn from affected and non-affected African Penguins at SANCCOB and stored in 70% ethanol. These samples were collected in 2008 and 2010. The samples were shipped to St. John Fisher College in Rochester, NY during the winter of 2011. Nucleic acids were then extracted from the blood using a QIAamp Blood DNA Mini. After confirmation of DNA via gel electrophoresis, PCR was performed using 2X OneTaq Megamix, water, and primers specific to the targeted viral and bacterial DNA. Gel electrophoresis was run on the PCR products. If DNA was observed at an expected range, then the PCR product was purified using a QIAquick PCR Purification Kit using the protocol included. The purified samples were sent to ATCG, Inc. for sequencing. The results were analyzed using NCBI BLAST. To date, six sequencing samples have shown the prevalence of APV, BFDV, and/or bacteria in the blood of affected penguins

The conserved arginine 380 of Hsp90 is not a catalytic residue, but stabilizes the closed conformation required for ATP hydrolysis

Hsp90, a dimeric ATP‐dependent molecular chaperone, is required for the folding and activation of numerous essential substrate “client” proteins including nuclear receptors, cell cycle kinases, and telomerase. Fundamental to its mechanism is an ensemble of dramatically different conformational states that result from nucleotide binding and hydrolysis and distinct sets of interdomain interactions. Previous structural and biochemical work identified a conserved arginine residue (R380 in yeast) in the Hsp90 middle domain (MD) that is required for wild type hydrolysis activity in yeast, and hence proposed to be a catalytic residue. As part of our investigations on the origins of species‐specific differences in Hsp90 conformational dynamics we probed the role of this MD arginine in bacterial, yeast, and human Hsp90s using a combination of structural and functional approaches. While the R380A mutation compromised ATPase activity in all three homologs, the impact on ATPase activity was both variable and much more modest (2–7 fold) than the mutation of an active site glutamate (40 fold) known to be required for hydrolysis. Single particle electron microscopy and small‐angle X‐ray scattering revealed that, for all Hsp90s, mutation of this arginine abrogated the ability to form the closed “ATP” conformational state in response to AMPPNP binding. Taken together with previous mutagenesis data exploring intra‐ and intermonomer interactions, these new data suggest that R380 does not directly participate in the hydrolysis reaction as a catalytic residue, but instead acts as an ATP‐sensor to stabilize an NTD‐MD conformation required for efficient ATP hydrolysis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92411/1/2103_ftp.pd

Developing network adequacy standards for VA Community Care

OBJECTIVES: To inform how the VA should develop and implement network adequacy standards, we convened an expert panel to discuss Community Care Network (CCN) adequacy and how VA might implement network adequacy standards for community care. DATA SOURCES/STUDY SETTING: Data were generated from expert panel ratings and from an audio-recorded expert panel meeting conducted in Arlington, Virginia, in October 2017. STUDY DESIGN: We used a modified Delphi panel process involving one round of expert panel ratings provided by nine experts in network adequacy standards. Expert panel members received a list of network adequacy standard measures used in commercial and government market and were provided a rating form listing a total of 11 measures and characteristics to rate. DATA COLLECTION METHODS: Items on the rating form were individually discussed during an expert panel meeting between the nine expert panel members and VA Office of Community Care leaders. Attendees addressed discordant views and generated revised or new standards accordingly. Recorded audio data were transcribed to facilitate thematic analysis regarding opportunities and challenges with implementing network adequacy standards in VA Community Care. PRINCIPAL FINDINGS: The five highest ranked standards were network directories for Veterans, regular reporting of network adequacy data to VA, maximum wait time/distance standards, minimum ratio of providers to enrolled population, and qualitative assessments of network adequacy. During the expert panel discussion with VA Community Care leaders, opportunities and challenges implementing network adequacy standards were highlighted. CONCLUSIONS: Our expert panel shed light on priorities for network adequacy to be implemented under CCN contracts, such as developing comprehensive provider directories for Veterans to use when selecting community providers. Remaining questions focus on whether the VA could reasonably develop and implement network adequacy standards given current Congressional restraints on VA reimbursement to community providers

Recommendations for the Evaluation of Cross-System Care Coordination from the VA State-of-the-art Working Group on VA/Non-VA Care

In response to widespread concerns regarding Veterans\u27 access to VA care, Congress enacted the Veterans Access, Choice and Accountability Act of 2014, which required VA to establish the Veterans Choice Program (VCP). Since the inception of VCP, more than two million Veterans have received care from community providers, representing approximately 25% of Veterans enrolled in VA care. However, expanded access to non-VA care has created challenges in care coordination between VA and community health systems. In March 2018, the VA Health Services Research and Development Service hosted a VA State of the Art conference (SOTA) focused on care coordination. The SOTA convened VA researchers, program directors, clinicians, and policy makers to identify knowledge gaps regarding care coordination within the VA and between VA and community systems of care. This article provides a summary and synthesis of relevant literature and provides recommendations generated from the SOTA about how to evaluate cross-system care coordination. Care coordination is typically evaluated using health outcomes including hospital readmissions and death; however, in cross-system evaluations of care coordination, measures such as access, cost, Veteran/patient and provider satisfaction (including with cross-system communication), comparable quality metrics, context (urban vs. rural), and patient complexity (medical and mental health conditions) need to be included to fully evaluate care coordination effectiveness. Future research should examine the role of multiple individuals coordinating VA and non-VA care, and how these coordinators work together to optimize coordination

Troubled Worlds: A Course Syllabus about Information Work and the Anthropocene

The goal of this syllabus is to interrogate the material, and socioeconomic processes which underpin our everyday information work. In particular, we examine the relationships developing between contemporary information practices and what problematically gets configured as “nature”—that messy world of non-human entanglements that often exists beyond the purview of innovation work, whether digital software development or industrial engineering. Much recent work on the environmental conditions of computing has sought to break down technology-nature dualisms in order to expose the implication of information technology in broader social and material ecologies. Library and information professionals and researchers are well poised to deepen this inquiry by presenting alternative nature-technology epistemologies grounded in longstanding analyses of information resources and their consumption. The “Troubled Worlds” syllabus starts with a discussion of concerns most obviously germane to the work of most library and information science professionals: practices at the intersection of structuring information and computing. Building on this attention, we turn to humanistic approaches to thinking through the era of dominant human activities widely known as the “Anthropocene” by introducing poetic, artistic, and activist lenses. We explore how artistic objects representing an increasingly troubled natural world raise awareness of the challenges facing it, as well as how they may incorporate and reshape information for aesthetic ends. We then look to questions of disability justice and how it works in blended built and natural spaces as well as the many different ways in which bodies respond to the toxic environments produced by information technologies. We next consider the newer design approaches to library and information research, specifically asking how design perspectives on digital information objects get inscribed in the Anthropocene. Lastly, we consider paradigms of repair and making and analyze the different valences through which information researchers and professionals categorize and contextualize what is possible with them. This compilation does not provide a comprehensive review of the literature on the environment within the information fields. Instead, it extends this literature to promote experimental research and practice. The modules construct an interdisciplinary and provisional path through the related literature in a form that we hope may be continually adjusted, rearranged, and augmented. Pre-print first published online 03/15/202

Effects of improved home heating on asthma in community dwelling children: randomised controlled trial

Objective To assess whether non-polluting, more effective home heating (heat pump, wood pellet burner, flued gas) has a positive effect on the health of children with asthma

Once I Take that One Bite : the Consideration of Harm Reduction as a Strategy to Support Dietary Change for Patients with Diabetes

BACKGROUND: Despite well-established guidelines to treat diabetes, many people with diabetes struggle to manage their disease. For many, this struggle is related to challenges achieving nutrition-related lifestyle changes. We examined how people with diabetes describe barriers to maintaining a healthy diet and considered the benefits of using a harm reduction approach to assist patients to achieve nutrition-related goals. METHODS: This is a secondary analysis of 89 interviews conducted with adults who had type 1 or type 2 diabetes. Interviews were analyzed using a content analysis approach. Themes regarding food or diet were initially captured in a food node. Data in the food node were then sub-coded for this analysis, again using a content analysis approach. RESULTS: Participants frequently used addiction language to talk about their relationship with food, at times referring to themselves as an addict and describing food as their drug. Participants perceived their unhealthy food choices either as a sign of weakness or as cheating. They also identified food\u27s ability to comfort them and an unwillingness to change as particular challenges to sustaining a healthier diet. CONCLUSION: Participants often described their relationship with food through an addiction lens. A harm reduction approach has been associated with positive outcomes among those with substance abuse disorder. Patient-centered communication incorporating the harm reduction model may improve the patient-clinician relationship and thus improve patient outcomes and quality-of-life while reducing health-related stigma in diabetes care. Future work should explore the effectiveness of this approach in patients with diabetes. TRIAL REGISTRATION: Registered on ClinicalTrials.gov, NCT02792777. Registration information submitted 02/06/2016, with the registration first posted on the ClinicalTrials.gov website 08/06/2016. Data collection began on 29/04/2016

I had no other choice but to catch it too : the roles of family history and experiences with diabetes in illness representations.

BACKGROUND: A family history of diabetes and family members\u27 experiences with diabetes may influence individuals\u27 beliefs and expectations about their own diabetes. No qualitative studies have explored the relationship between family history and experiences and individuals\u27 diabetes illness representations. METHODS: Secondary data analysis of 89 exploratory, semi-structured interviews with adults with type 1 or type 2 diabetes seeking care in an urban health system. Participants had a recent diabetes-related ED visit/hospitalization or hemoglobin A1c \u3e 7.5%. Interviews were conducted until thematic saturation was achieved. Demographic data were collected via self-report and electronic medical record review. Interviews were audio-recorded, transcribed, and coded using a conventional content analysis approach. References to family history and family members\u27 experiences with diabetes were analyzed using selected domains of Leventhal\u27s Common Sense Model of Self-Regulation. RESULTS: Participants cited both genetic and behavioral family history as a major cause of their diabetes. Stories of relatives\u27 diabetes complications and death figured prominently in their discussion of consequences; however, participants felt controllability over diabetes through diet, physical activity, and other self-care behaviors. CONCLUSIONS: Findings supported an important role of family diabetes history and experience in development of diabetes illness representations. Further research is needed to expand our understanding of the relationships between these perceptions, self-management behaviors, and outcomes. Family practice providers, diabetes educators and other team members should consider expanding assessment of current family structure and support to also include an exploration of family history with diabetes, including which family members had diabetes, their self-care behaviors, and their outcomes, and how this history fits into the patient\u27s illness representations