Exploring Future Teachers’ Awareness, Competence, Confidence, and Attitudes Regarding Teaching Online: Incorporating Blended/Online Experience into the Teaching and Learning in Higher Education Course for Graduate Students

Dalhousie University’s Centre for Learning and Teaching offers a Certificate in University Teaching and Learning, which includes a 12-week course entitled Teaching and Learning in Higher Education. This course provides the certificate’s theory component and has evolved to reflect the changing needs of future educators. One significant change is the development of a blended course model that incorporates graded online facilitation, prompted by the recognition that teaching assistants and faculty are increasingly required to teach online or blended (i.e., combining face-to-face and online) courses. This study invited graduate students enrolled in the course to participate in pre- and post-facilitation questionnaires that assessed their awareness, competence, confidence, and attitudes towards online and blended learning. Students recognized the value of the online component for future teaching expertise and experienced increased awareness, competence, and confidence regarding teaching online. However, preference for face-to-face teaching and student learning did not change.  Le Centre for Learning and Teaching de l’Université Dalhousie offre un certificat en pédagogie de l’enseignement universitaire, lequel comprend un cours de douze semaines intitulé « Teaching and Learning in Higher Education ». Au fil du temps, ce cours théorique a évolué pour s’adapter aux besoins des futurs pédagogues. En outre, parce que les assistants à l’enseignement et les membres de la faculté sont sollicités de plus en plus fréquemment pour donner des cours en ligne ou hybrides (combinant l’enseignement en classe et à distance), on a intégré un modèle de cours hybride facilitant la correction de travaux. C’est ainsi qu’on a invité des étudiants des cycles supérieurs à remplir un questionnaire avant de suivre le cours et après l’avoir suivi. Ce questionnaire évaluait leurs connaissances, compétences et attitudes par rapport à l’enseignement en ligne et hybride. Les étudiants ont reconnu l’importance de l’enseignement en ligne dans leur formation. Ils ont démontré une plus grande connaissance des approches d’enseignement et ont rapporté avoir une meilleure confiance en eux relativement à l’enseignement en ligne. Néanmoins, leur préférence pour l’enseignement en classe n’a pas changé.   &nbsp

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Open plan and academe: pre-and post-hoc conversations OPEN PLAN AND ACADEME: PRE-AND POST-HOC CONVERSATIONS

ABSTRACT There now exists a strong body of evidence that creative workplaces can, in certain circumstances, exert beneficial influences on organisational cultures and outputs. Academia tends to resist such spaces and faculty buildings. The reasons are explored but the reactions of staff are not found to be different from those reported in the literature on general creative spaces. The success or failure of team oriented workspaces is in large part a socially constructed perception influenced by the manner of implementation and management. As elsewhere new workplaces are about new conversations. The cases studied lead to a model of the tensions inherent in workplace redesign

In the response to COVID‐19, we can’t forget health system commitments to contraception and family planning

Contraceptive and family planning services and supplies are core components of essential health services, and access to these services is a fundamental human right. This standard must continue to be respected and protected as such by governments prioritizing scarce resources during this COVID‐19 pandemic. But with many health systems currently focusing on the response to the pandemic, the provision of basic contraception counselling, the delivery of contraceptive products and services, and the functioning of supply chains have been disrupted

The Conceptualization of the Positive Cognitive Triad and Associations with Depressive Symptoms in Adolescents

The positive cognitive triad (positive cognitions about the self, world, and future) has been considered a protective factor against depressive symptoms. This study examines three conceptualizations of the positive cognitive triad and their relation to depressive symptoms. Analyses were replicated in two samples in order to provide evidence for the validity of findings. Two samples (n = 2982, M = 13.04, Range = 11–15\ua0years; n = 2540, M = 13.11, Range = 11–16\ua0years) of Australian adolescents completed the Positive Cognitive Triad Inventory and Center for Epidemiological Studies Depression Scale. Findings supported the notion that the overall positive cognitive triad is a protective factor for depressive symptoms, and specifically, the role of positive cognitions about the self in this protection. After future studies examine the directionality of the relation between positive cognitions and depressive symptoms, mental health providers using cognitive behavioral approaches may consider examining positive cognitions with patients