Students as Creative Forces to Enhance Curriculum via E-Learning

Academic institutions are seeking to enhance student centered teaching with active educational encounters, but development can be hampered by limited time and resources. This session focuses on the successful engagement of student-faculty teams to create interactive e-learning modules to enhance our medical school and other health science programs curricula. UNMC launched the UNMC Student E-Learning Program for student and faculty teams to build interactive elearning modules. We started with a competitive application process, informational meetings, and a comprehensive website with resources to guide development. Then student developers, with their faculty advisors, utilized our E-Learning Studio to access tools and e-learning instructional design consultation over six instructional design and method of education. The completed e-modules were demonstrated at a campus wide E-Learning Showcase and accessed from the online UNMC E-Gallery. Through this program, 84 students in medical and health professions created 39 e-learning projects. Of these, 57 (67.9%) students responded to our survey about their experience as curriculum developers and we analyzed the results. In this session, learn what student e-learning developers said about their motivations and benefits from participation in this unique program in higher education

uBEATS Data Shows Opportunity for E-Learning Module Improvement

UNMC’s uBEATS program (UNO & UNMC Building Excellence in Academics Through STEM) is a series of free e-learning modules about various health science subjects that was launched by the University of Nebraska Medical Center in August of 2020. They were designed to supplement health science topics in schools, especially for students without access to regular education in health sciences. Statistics collected from the uBEATS data dashboard, and from data provided by Dr. Gwen Nugent on uBEATS average assessment scores and student completion rates suggest that engagement is low. Upon review of literature, it was found that uBEATS does have some design flaws that could be linked to disengagement. Several simple additions were discovered that, if implemented into uBEATS’ current curriculum, show promise of boosting motivation and engagement in future iterations of uBEATS.https://digitalcommons.unmc.edu/surp2022/1030/thumbnail.jp

Association between genotypic diversity and biofilm production in group B Streptococcus

Background: Group B Streptococcus (GBS) is a leading cause of sepsis and meningitis and an important factor in premature and stillbirths. Biofilm production has been suggested to be important for GBS pathogenesis alongside many other elements, including phylogenetic lineage and virulence factors, such as pili and capsule type. A complete understanding of the confluence of these components, however, is lacking. To identify associations between biofilm phenotype, pilus profile and lineage, 293 strains from asymptomatic carriers, invasive disease cases, and bovine mastitis cases, were assessed for biofilm production using an in vitro assay. Results: Multilocus sequence type (ST) profile, pilus island profile, and isolate source were associated with biofilm production. Strains from invasive disease cases and/or belonging to the ST-17 and ST-19 lineages were significantly more likely to form weak biofilms, whereas strains producing strong biofilms were recovered more frequently from individuals with asymptomatic colonization. Conclusions: These data suggest that biofilm production is a lineage-specific trait in GBS and may promote colonization of strains representing lineages other than STs 17 and 19. The findings herein also demonstrate that biofilms must be considered in the treatment of pregnant women, particularly for women with heavy GBS colonization

Building a Robust E-Learning Module Scorecard: The Nebraska E-Learning Scorecard (NEscore)

Teaching during a pandemic has compelled educators to transform traditional strategies towards more innovative solutions. These innovative solutions use a variety of educational technologies, and often, shift delivery modalities to an online or blended approach to learning. A key strategy in online teaching is the development of quality e-learning modules based on the core tenets of e-learning. E-learning modules aim to enhance knowledge, performance, and retention through interactive and engaging strategies. While the value of a quality e-learning module is well-supported in the literature, there are limited resources available for developers to assess if the module adheres to the core tenets of e-learning. The University of Nebraska Medical Center created a scorecard (Nebraska E-Learning Scorecard, NEscore) based on established core tenets for e-learning that was both useable and reliable in evaluating quality e-learning modules. To determine the usability and reliability of NEscore, we conducted a pilot study and six experts and six novice participants evaluated five e-learning modules utilizing NEscore. Reliability was calculated with Cronbach’s alpha and intra-class correlation coefficients. We also gathered data on demographic information and the perceived satisfaction of participants in using the NEscore. The findings showed strong internal consistency among scores with overall high reliability, and high consistency among participants, showing no significant difference between the two groups of experts and novices. Overall, participants were satisfied with the usability of NEscore. The NEscore offers institutions an established set of criteria to evaluate existing e-learning modules and also serves as a guide for the development of new e-learning modules

Building a Robust E-Learning Module Scorecard: The Nebraska E-Learning Scorecard (NEscore)

Teaching during a pandemic has compelled educators to transform traditional strategies towards more innovative solutions. These innovative solutions use a variety of educational technologies, and often, shift delivery modalities to an online or blended approach to learning. A key strategy in online teaching is the development of quality e-learning modules based on the core tenets of e-learning. E-learning modules aim to enhance knowledge, performance, and retention through interactive and engaging strategies. While the value of a quality e-learning module is well-supported in the literature, there are limited resources available for developers to assess if the module adheres to the core tenets of e-learning. The University of Nebraska Medical Center created a scorecard (Nebraska E-Learning Scorecard, NEscore) based on established core tenets for e-learning that was both useable and reliable in evaluating quality e-learning modules. To determine the usability and reliability of NEscore, we conducted a pilot study and six experts and six novice participants evaluated five e-learning modules utilizing NEscore. Reliability was calculated with Cronbach’s alpha and intra-class correlation coefficients. We also gathered data on demographic information and the perceived satisfaction of participants in using the NEscore. The findings showed strong internal consistency among scores with overall high reliability, and high consistency among participants, showing no significant difference between the two groups of experts and novices. Overall, participants were satisfied with the usability of NEscore. The NEscore offers institutions an established set of criteria to evaluate existing e-learning modules and also serves as a guide for the development of new e-learning modules

Pilus distribution among lineages of group b <i>streptococcus</i>: an evolutionary and clinical perspective

&lt;b&gt;Background&lt;/b&gt;&lt;p&gt;&lt;/p&gt; Group B Streptococcus (GBS) is an opportunistic pathogen in both humans and bovines. Epidemiological and phylogenetic analyses have found strains belonging to certain phylogenetic lineages to be more frequently associated with invasive newborn disease, asymptomatic maternal colonization, and subclinical bovine mastitis. Pilus structures in GBS facilitate colonization and invasion of host tissues and play a role in biofilm formation, though few large-scale studies have estimated the frequency and diversity of the three pilus islands (PIs) across diverse genotypes. Here, we examined the distribution of pilus islands (PI) 1, 2a and 2b among 295 GBS strains representing 73 multilocus sequence types (STs) belonging to eight clonal complexes. PCR-based RFLP was also used to evaluate variation in the genes encoding pilus backbone proteins of PI-2a and PI-2b.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt;&lt;p&gt;&lt;/p&gt; All 295 strains harbored one of the PI-2 variants and most human-derived strains contained PI-1. Bovine-derived strains lacked PI-1 and possessed a unique PI-2b backbone protein allele. Neonatal strains more frequently had PI-1 and a PI-2 variant than maternal colonizing strains, and most CC-17 strains had PI-1 and PI-2b with a distinct backbone protein allele. Furthermore, we present evidence for the frequent gain and loss of genes encoding certain pilus types.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt;&lt;p&gt;&lt;/p&gt; These data suggest that pilus combinations impact host specificity and disease presentation and that diversification often involves the loss or acquisition of PIs. Such findings have implications for the development of GBS vaccines that target the three pilus islands

Nebraska E-Learning Scorecard (NEscore)

https://digitalcommons.unmc.edu/elearning_tools/1000/thumbnail.jp

Association of Group B Streptococcus Colonization and Bovine Exposure: A Prospective Cross-Sectional Cohort Study

While Group B Streptococcus (GBS) human colonization and infection has long been suspected as originating from cows, several investigators have suggested that ongoing interspecies GBS transmission is unlikely due to genotyping data demonstrating that human and bovine-derived GBS strains represent mostly distinct populations. The possibility of ongoing transmission between humans and their livestock has not been systematically examined.To examine ongoing interspecies transmission, we conducted a prospective cross-sectional cohort study of 68 families and their livestock. Stool specimens were collected from 154 people and 115 livestock; GBS was detected in 19 (12.3%) humans and 2 (1.7%) animals (bovine and sheep). Application of multilocus sequence typing (MLST) identified 8 sequence types (STs or clones), with STs 1 and 23 predominating. There were 11 families in which two members submitted stools and at least one had GBS colonization. In 3 of these families, both members (consisting of couples) were colonized, yielding a co-colonization rate of 27% (95% CI: 7%-61%). Two of these couples had strains with identical MLST, capsule (cps) genotype, susceptibility, and RAPD profiles. One couple co-colonized with ST-1 (cps5) strains also had a bovine colonized with the identical strain type. On multivariate analysis of questionnaire data, cattle exposure was a predictor of GBS colonization, with each unit increase in days of cattle exposure increasing the odds of colonization by 20% (P = 0.02). These results support interspecies transmission with additional evidence for transmission provided by the epidemiological association with cattle exposure.Although GBS uncommonly colonizes livestock stools, increased frequency of cattle exposure was significantly associated with human colonization and one couple shared the same GBS strains as their bovine suggesting intraspecies transmission. These results set the framework for GBS as a possible zoonotic infection, which has significant public health implications

Characteristics and outcome of infants with candiduria in neonatal intensive care - a Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study

<p>Abstract</p> <p>Background</p> <p>There is limited information in the literature on the presentation and prognosis of candidal urinary tract infection (UTI) in infants in the neonatal intensive care unit (NICU).</p> <p>Methods</p> <p>This was a prospective cohort study performed in 13 Canadian NICUs. Infants with candidal UTI without extra-renal candidal infection at presentation were enrolled.</p> <p>Results</p> <p>Thirty infants fit the study criteria. Median birth weight and gestational age were 2595 grams (range 575-4255) and 35 weeks (range 24-41) with 10 infants being < 30 weeks gestation. The most common primary underlying diagnosis was congenital heart disease (n = 10). The median age at initial diagnosis was 16 days (range 6-84 days). Renal ultrasonography findings were compatible with possible fungal disease in 15 of the 26 infants (58%) in whom it was performed. Treatment was variable, but fluconazole and either amphotericin B deoxycholate or lipid-based amphotericin B in combination or sequentially were used most frequently. Extra-renal candidiasis subsequently developed in 4 infants. In 2 of these 4 infants, dissemination happened during prolonged courses of anti-fungal therapy. Three of 9 deaths were considered to be related to candidal infection. No recurrences of candiduria or episodes of invasive candidiasis following treatment were documented.</p> <p>Conclusion</p> <p>Candidal UTI in the NICU population occurs both in term infants with congenital abnormalities and in preterm infants, and is associated with renal parenchymal disease and extra-renal dissemination. A wide variation in clinical approach was documented in this multicenter study. The overall mortality rate in these infants was significant (30%). In one third of the deaths, <it>Candida </it>infection was deemed to be a contributing factor, suggesting the need for antifungal therapy with repeat evaluation for dissemination in infants who are slow to respond to therapy.</p

Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis

BACKGROUND: The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. METHODS: A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. RESULTS: There were 233 cases of proven enteroviral (EV) meningitis, 495 cases of clinical aseptic meningitis and 74 cases of possible aseptic meningitis with most cases occurring July to October. Headache, vomiting, meningismus and photophobia were more common in children ≥ 5 years of age, while rash, diarrhea and cough were more common in children < 5 years of age. Pleocytosis was absent in 22.3% of children < 30 days of age with proven EV meningitis. Enterovirus was isolated in cerebrospinal fluid (CSF) from 154 of 389 patients (39.6%) who had viral culture performed, and a nucleic acid amplification test for enterovirus was positive in CSF from 81 of 149 patients (54.3%). Imaging of the head by computerized tomography or magnetic resonance imaging was completed in 96 cases (19.7%) and 24 had abnormal findings that were possibly related to meningitis while none had changes that were definitely related to meningitis. There was minimal morbidity and there were no deaths. CONCLUSION: The clinical presentation of aseptic meningitis varies with the age of the child. Absence of CSF pleocytosis is common in infants < 30 days of age. Enterovirus is the predominant isolate, but no etiologic agent is identified in the majority of cases of aseptic meningitis in Canadian children