Cross-Continental Research Collaborations about Online Teaching

Increasingly, faculty academics are required to teach and design online courses. However, in many cases, faculty members report having low levels of confidence, self-efficacy and competence to teach in online environments. Although their professional learning is often enhanced by institutional support strategies such as workshops, online instruction and mentoring systems, many faculty academics learn through “just-in-time” rather than “just-in-case” strategies. This paper reports on the findings from a cross-continental research project between researchers in two higher education institutions in the United States and Australia. The project was initiated to: 1) determine the learning needs of faculty members who teach online and design online courses; and 2) to develop tailored professional learning programs and resources to enable faculty members to become effective online teachers and skilled online course designers. As well as providing an account of the research findings to date, the paper provides recommendations for other researchers who may be considering cross-institutional or cross-continental research about online teaching, online course design and professional learning programs

Bumpy Moments and Joyful Breakthroughs: The Place of Threshold Concepts in Academic Staff Development Programs About Online Learning and Teaching

In this article the authors address the situation in higher education of academic staff facing what they conceptualise as “bumpy moments and joyful breakthroughs” as they work through the process of becoming teachers in online learning environments. The article comes from a research project, which gathered and analysed data from systematic observations and questionnaires. The authors base their study on the known fact that while many academics have grounded experience in on-campus teaching and learning situations they do not necessarily have the skills required today for extending learning through on-line environments. The authors discover that when academics start teaching in online environments, or at least start facing the fact that there are requirements to do so, and they begin to explore this environment both personally and theoretically, “they encounter threshold concepts that can unsettle their most deeply held personal and pedagogical beliefs about what it means to teach and learn, and what it means to be an effective teacher and learner”. This paper gives an account of the research into these new conditions for educators and offers a set of recommendations “to inform the design of a multi-strategy academic staff learning program, which facilitated the development of online teaching skills”. [From Introduction to issue of ACCESS]

Threshold Concepts about Online Pedagogy for Novice Online Teachers in Higher Education

The use of threshold concepts to define key points of curricula is a relatively recent development in educational research. Threshold concepts represent crucial stages of learning, the acquisition of which enables learners to progress from one level of achievement to another. In this context, the learner is described as passing through an unsettling liminal space in which they may encounter troublesome knowledge and experience uncertainty or anxiety. When applied to online pedagogy in higher education contexts, academic staff become the learners as they extend their on-campus teaching knowledge into the online realm. In this setting, the identification of threshold concepts has the potential to inform the content of professional development (PD) programmes for novice online teachers. Because little research has yet been reported on threshold concepts associated with online teaching, this study identified these threshold concepts and investigated their specific nature. Funded by an Office for Learning and Teaching Australia Grant, the project employed a mixed-methods research approach. A mixture of qualitative and quantitative data was gathered from responses to questionnaires and reflective journal entries provided by university educators who were teaching in online contexts. Also, experts in the fields of PD, online teaching and threshold concepts were consulted using a modified Delphi technique that incorporated two rounds of surveys. Results of this study are discussed in association with potential applications to PD design for novice online educators, informed by the most fundamental learning experiences encountered by their more experienced colleagues

Threshold Concepts about Online Teaching: Progress Report on a Five Year Project

The burgeoning expansion of online education has presented the challenges of articulating an appropriate pedagogy for online education (Stevens, 2003; Runnels et al., 2006; Gosselin, 2009) while also contending with perceived and real deficits in lecturer competence (Shephard, 2007). Conceptually, the identified areas of concern are viewed as troublesome knowledge (Perkins, 1999), or knowledge that is counter intuitive to traditional teaching face to face teaching. To meet the emerging difficulties of new modes of distance teaching, researchers have focused on transformative learning using threshold concepts, or new portals, that allow understanding of concepts through new modes of thinking (Meyer & Land, 2003). Northcote and her colleagues used findings from their research into threshold concepts of online teaching to develop a tailored staff development training program (Northcote et al., 2011; Northcote et al., 2013). By identifying troublesome knowledge and threshold concepts, several unique benefits have been realised that include: 1) a focus for professional development programs; 2) a clearer understanding of the processes and resources needed to facilitate development; 3) support from institutional leadership; and 4) increased competence and confidence for online course developers

Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage

Congenital heart disease is identified as the most common birth defect with single ventricle physiology carrying the highest mortality. Staged surgical palliation is required for treatment, with mortality historically as high as 22% in the four- to six-month period from the first- to second-stage surgical palliation, known as the interstage. A standardized postoperative feeding approach was implemented through an evidence-based protocol, parent engagement, and interprofessional team rounds. Five infants with single ventricle physiology preprotocol were compared with five infants who received the standardized feeding approach. Mann- Whitney tests were conducted to evaluate the hypotheses that infants in the intervention condition would consume more calories and have a positive change inweight-to-age -score (WAZ) and shorter length of stay (LOS) following the first and second surgeries compared to infants in the control condition. After the protocol, the change inWAZ during the interstage increased by virtually one standard deviation from 0.05 to 0.91.Median LOS dropped 32% after the first surgery and 43% after the second surgery. Since firstand second-stage palliative surgeries occur within the same year of life, this represents savings of $500,000 to$800,000 per year in a 10-infant model.The standardized feeding approach improved growth in single ventricle infants while concurrently lowering hospital costs

iPSC-derived neuronal models of PANK2-associated neurodegeneration reveal mitochondrial dysfunction contributing to early disease

Mutations in PANK2 lead to neurodegeneration with brain iron accumulation. PANK2 has a role in the biosynthesis of coenzyme A (CoA) from dietary vitamin B5, but the neuropathological mechanism and reasons for iron accumulation remain unknown. In this study, atypical patient-derived fibroblasts were reprogrammed into induced pluripotent stem cells (iPSCs) and subsequently differentiated into cortical neuronal cells for studying disease mechanisms in human neurons. We observed no changes in PANK2 expression between control and patient cells, but a reduction in protein levels was apparent in patient cells. CoA homeostasis and cellular iron handling were normal, mitochondrial function was affected; displaying activated NADH-related and inhibited FADH-related respiration, resulting in increased mitochondrial membrane potential. This led to increased reactive oxygen species generation and lipid peroxidation in patient-derived neurons. These data suggest that mitochondrial deficiency is an early feature of the disease process and can be explained by altered NADH/FADH substrate supply to oxidative phosphorylation. Intriguingly, iron chelation appeared to exacerbate the mitochondrial phenotype in both control and patient neuronal cells. This raises caution for the use iron chelation therapy in general when iron accumulation is absent

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe