Building a Digital Learning Assistant Program to Promote Peer Learning in the Digital Liberal Arts

Our team of instructional technologists and designers, librarians, faculty, and students have collaborated over the past year to develop a peer digital learning initiative at our small, liberal arts institution. In this presentation, we will consider concepts, models, and activities instrumental to our experience building a peer learning community around technology, digital literacy and identity, and student agency. The initiative kicked off this past August with a four-day pre-orientation program. We aimed to give students hands-on experience with various digital technologies being used for teaching and learning on campus, generate conversation around what it means to a learner and citizen in the digital age, and foster awareness of and reflection on personal agency in learning. One of the core concepts of the pre-orientation was giving the students a “dorm and a domain” or a space to physically and virtually exist on campus. Once the fall semester began, many pre-orientation participants and other interested students continued on into our Digital Learning Assistant (DLA) training program. Our primary goal was to prepare students to serve as tutors to other students in need of assistance with digital learning projects assigned in courses. Students in the training program participated in online and face-to-face activities to help advance their knowledge of core digital tools that faculty use most often in their courses for blogging, digital archives and data visualizations, digital mapping and GIS, digital storytelling, and e-portfolios. Each student selected one of these tracks for their first area of focus. In addition to developing technical skills, an important part of the training program has been to help students consider tools and skills in the context of digital identity and digital literacy as well as learn to help mentor fellow students effectively. This semester, the DLAs began offering drop-in hours to assist students, while also continuing their training in both technology and peer teaching. As they continue to develop these skills using the online course or lynda.com tutorials, they simultaneously develop their own websites in preparation for a campus-wide launch of Domain of One’s Own. Our program has been guided by our shared interests in fostering student agency, developing communities for peer learning, and growing critical digital literacy skills and perspectives. We have been inspired by our institution’s rich peer learning culture, as well as similar projects at other institutions like University of Mary Washington’s Digital Knowledge Center

Prediction of Early Childhood Negative Emotionality and Inhibition From Maternal Distress During Pregnancy

The association was investigated between psychological distress reported during each trimester of pregnancy and maternal ratings of temperament when the children were 6 months and 5 years of age. Mothers in the greater Helsinki area who were to give birth during a 1-year period completed a brief questionnaire describing their psychological adjustment and medical symptoms at each prenatal visit to government health clinics. Mothers rated their children\u27s temperament at ages 6 months and 5 years. Maternal psychological distress during pregnancy was only modestly associated with infant temperament. However, maternal distress during the first trimester was associated with ratings of negative emotionality at age 5 years, with a stronger correlation for males. Inhibition at age 5 was predicted by infant distress to novelty, particularly for males

Building a Digital Learning Assistant Program to Promote Peer Learning in the Digital Liberal Arts

Our team of instructional technologists and designers, librarians, faculty, and students have collaborated over the past year to develop a peer digital learning initiative at our small, liberal arts institution. In this presentation, we will consider concepts, models, and activities instrumental to our experience building a peer learning community around technology, digital literacy and identity, and student agency. The initiative kicked off this past August with a four-day pre-orientation program. We aimed to give students hands-on experience with various digital technologies being used for teaching and learning on campus, generate conversation around what it means to a learner and citizen in the digital age, and foster awareness of and reflection on personal agency in learning. One of the core concepts of the pre-orientation was giving the students a “dorm and a domain” or a space to physically and virtually exist on campus. Once the fall semester began, many pre-orientation participants and other interested students continued on into our Digital Learning Assistant (DLA) training program. Our primary goal was to prepare students to serve as tutors to other students in need of assistance with digital learning projects assigned in courses. Students in the training program participated in online and face-to-face activities to help advance their knowledge of core digital tools that faculty use most often in their courses for blogging, digital archives and data visualizations, digital mapping and GIS, digital storytelling, and e-portfolios. Each student selected one of these tracks for their first area of focus. In addition to developing technical skills, an important part of the training program has been to help students consider tools and skills in the context of digital identity and digital literacy as well as learn to help mentor fellow students effectively. This semester, the DLAs began offering drop-in hours to assist students, while also continuing their training in both technology and peer teaching. As they continue to develop these skills using the online course or lynda.com tutorials, they simultaneously develop their own websites in preparation for a campus-wide launch of Domain of One’s Own. Our program has been guided by our shared interests in fostering student agency, developing communities for peer learning, and growing critical digital literacy skills and perspectives. We have been inspired by our institution’s rich peer learning culture, as well as similar projects at other institutions like University of Mary Washington’s Digital Knowledge Center

Why did England change its law on deceased organ donation in 2019? The dynamic interplay between evidence and values

In the three years since the law on adult deceased organ donation consent in England changed to include an opt-out system, there has been no discernible change to donation rates. The lack of a positive impact on donation rates was predicted by many of those who took part in debates before and during the passage of the Bill through Parliament. This invites the question as to why England moved to an opt-out system for organ donation despite equivocal evidence of likely benefit and opposition from expert health professional organisations. To address this question qualitative analyses of Parliamentary debates on organ donation was undertaken. This revealed a shift from a dominant position, which gave primacy to the evidence of likely effects, towards a more normative position where a deemed consent option was viewed as the ‘correct thing to do’ and the limited and conflicting evidence viewed in a positive light. By 2017, following Wales's move to an opt-out system, together with continued lobbying for similar changes for England by professional and patient groups, alongside sustained public popularity for organ donation, the balance of opinion had shifted towards a system where deemed consent would become the default position for most English adult

Trends in organ donation in England, Scotland and Wales in the context of the COVID-19 pandemic and ‘opt-out' legislation

Background:In May 2020, England implemented soft ‘opt-out’ or ‘deemed consent’ for deceased donation with the intention of raising consent rates. However, this coincided with the COVID-19 pandemic, making it difficult to assess the early impact of the law change. Wales and Scotland changed their organ donation legislation to implement soft opt-out systems in 2015 and 2021 respectively. This study provides a descriptive analysis of changes in consent and transplant rates for deceased organ donation in England, Scotland and Wales.Methods:Logistic regression and descriptive trend analysis were employed to assess the probability of a patient who died in critical care becoming a donor, and to report consent rates using data, respectively, from the Intensive Care National Audit and Research Centre (ICNARC) in England from 1 April 2014 to 30 September 2021, and from the Potential Donor Audit for England, Scotland and Wales from April 2010 to June 2023.Results:The number of eligible donors in April-June 2020 were 56.5%, 59.3% and 57.6% lower in England, Scotland and Wales relative to April-June 2019 (pre-pandemic). By April-June 2023, the number of eligible donors had recovered to 87.4%, 64.2% and 110.3%, respectively, of their levels in 2019. The consent rate in England, Scotland and Wales reduced from 68.3%, 63.0% and 63.6% in April-June 2019 to 63.2%, 60.5% and 56.3% in April-June 2023.Conclusions:While the UK organ donation system shows signs of recovery from the COVID-19 pandemic, the number of eligible potential donors and consent rates remain below their pre-pandemic levels

Powered mobility interventions for very young children with mobility limitations to aid participation and positive development:the EMPoWER evidence synthesis

Background One-fifth of all disabled children have mobility limitations. Early provision of powered mobility for very young children (aged < 5 years) is hypothesised to trigger positive developmental changes. However, the optimum age at which to introduce powered mobility is unknown. Objective The aim of this project was to synthesise existing evidence regarding the effectiveness and cost-effectiveness of powered mobility for very young children, compared with the more common practice of powered mobility provision from the age of 5 years. Review methods The study was planned as a mixed-methods evidence synthesis and economic modelling study. First, evidence relating to the effectiveness, cost-effectiveness, acceptability, feasibility and anticipated outcomes of paediatric powered mobility interventions was reviewed. A convergent mixed-methods evidence synthesis was undertaken using framework synthesis, and a separate qualitative evidence synthesis was undertaken using thematic synthesis. The two syntheses were subsequently compared and contrasted to develop a logic model for evaluating the outcomes of powered mobility interventions for children. Because there were insufficient published data, it was not possible to develop a robust economic model. Instead, a budget impact analysis was conducted to estimate the cost of increased powered mobility provision for very young children, using cost data from publicly available sources. Data sources A range of bibliographic databases [Cumulative Index to Nursing and Allied Health Literature (CINHAL), MEDLINE, EMBASE™ (Elsevier, Amsterdam, the Netherlands), Physiotherapy Evidence Database (PEDro), Occupational Therapy Systematic Evaluation of Evidence (OTseeker), Applied Social Sciences Index and Abstracts (ASSIA), PsycINFO, Science Citation Index (SCI; Clarivate Analytics, Philadelphia, PA, USA), Social Sciences Citation Index™ (SSCI; Clarivate Analytics), Conference Proceedings Citation Index – Science (CPCI-S; Clarivate Analytics), Conference Proceedings Citation Index – Social Science & Humanities (CPCI-SSH; Clarivate Analytics), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA) Database and OpenGrey] was systematically searched and the included studies were quality appraised. Searches were carried out in June 2018 and updated in October 2019. The date ranges searched covered from 1946 to September 2019. Results In total, 89 studies were included in the review. Only two randomised controlled trials were identified. The overall quality of the evidence was low. No conclusive evidence was found about the effectiveness or cost-effectiveness of powered mobility in children aged either < 5 or ≥ 5 years. However, strong support was found that powered mobility interventions have a positive impact on children’s movement and mobility, and moderate support was found for the impact on children’s participation, play and social interactions and on the safety outcome of accidents and pain. ‘Fit’ between the child, the equipment and the environment was found to be important, as were the outcomes related to a child’s independence, freedom and self-expression. The evidence supported two distinct conceptualisations of the primary powered mobility outcome, movement and mobility: the former is ‘movement for movement’s sake’ and the latter destination-focused mobility. Powered mobility should be focused on ‘movement for movement’s sake’ in the first instance. From the budget impact analysis, it was estimated that, annually, the NHS spends £1.89M on the provision of powered mobility for very young children, which is < 2% of total wheelchair service expenditure. Limitations The original research question could not be answered because there was a lack of appropriately powered published research. Conclusions Early powered mobility is likely to have multiple benefits for very young children, despite the lack of robust evidence to demonstrate this. Age is not the key factor; instead, the focus should be on providing developmentally appropriate interventions and focusing on ‘movement for movement’s sake’. Future work Future research should focus on developing, implementing, evaluating and comparing different approaches to early powered mobility. Study registration This study is registered as PROSPERO CRD42018096449. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology programme and will be published in full in Health Technology Assessment; Vol. 24, No. 50. See the NIHR Journals Library website for further project information

Evaluating the effects of climate change and chemical, physical, and biological stressors on nearshore coral reefs: A case study in the Great Barrier Reef, Australia

An understanding of the combined effects of climate change (CC) and other anthropogenic stressors, such as chemical exposures, is essential for improving ecological risk assessments of vulnerable ecosystems. In the Great Barrier Reef, coral reefs are under increasingly severe duress from increasing ocean temperatures, acidification, and cyclone intensities associated with CC. In addition to these stressors, inshore reef systems, such as the Mackay–Whitsunday coastal zone, are being impacted by other anthropogenic stressors, including chemical, nutrient, and sediment exposures related to more intense rainfall events that increase the catchment runoff of contaminated waters. To illustrate an approach for incorporating CC into ecological risk assessment frameworks, we developed an adverse outcome pathway network to conceptually delineate the effects of climate variables and photosystem II herbicide (diuron) exposures on scleractinian corals. This informed the development of a Bayesian network (BN) to quantitatively compare the effects of historical (1975–2005) and future projected climate on inshore hard coral bleaching, mortality, and cover. This BN demonstrated how risk may be predicted for multiple physical and biological stressors, including temperature, ocean acidification, cyclones, sediments, macroalgae competition, and crown of thorns starfish predation, as well as chemical stressors such as nitrogen and herbicides. Climate scenarios included an ensemble of 16 downscaled models encompassing current and future conditions based on multiple emission scenarios for two 30-year periods. It was found that both climate-related and catchment-related stressors pose a risk to these inshore reef systems, with projected increases in coral bleaching and coral mortality under all future climate scenarios. This modeling exercise can support the identification of risk drivers for the prioritization of management interventions to build future resilient reefs.publishedVersio

Analysis of content and online public responses to media articles that raise awareness of the opt-out system of consent to organ donation in England

BACKGROUND: Preceded by a national media campaign, in May 2020, England switched to a soft opt-out system of organ donation which rests on the assumption that individuals meeting specific criteria have consented to organ donation unless they have expressed otherwise. We aimed to learn more about how the changes were communicated, how people responded and any discrepancies between key messages and how they were interpreted by the public. METHODS: Summative content analysis of 286 stories and related reader-generated comments in leading UK online news sources (April 2019 to May 2021). Further detailed thematic analysis of 21 articles with reader-generated content, complemented by thematic content analysis coding of all 286 stories. RESULTS: Most media coverage on both organ donation and the law change was positive, with little variation over time or between publications. The importance of organ donation, benefits of the law change, and emotive stories (often involving children) of those who had donated an organ described as "superheroes" or those who had received organs as benefiting from a "miracle" were frequently cited. In contrast, reader-generated comments were markedly more negative, for example, focusing on loss of individual freedom and lack of trust in the organ donation system. Commentators wished to be able to choose who their organs were donated to, were dismissive and blaming towards minority ethnic groups, including undermining legitimate worries about the compatibility of organ donation with religious beliefs and end of life cultural norms, understanding and acceptance of brain-stem death and systemic racism. Misinformation including use of inflammatory language was common. CONCLUSION: The portrayal of donors and recipients as extraordinary is unlikely to help to normalise organ donation. Undermining legitimate concerns, in particular those from ethnic minorities, can alienate and encourage harmful misinformation in underrepresented groups. The discrepancies between the tone of the articles and the readers comments suggests a lack of trust across the public, health, policy and media outlets. Easily accessible, ongoing and tailored sources are needed to mitigate misinformation and disinformation and ensure key messages are better understood and accepted in order to realise the ambitions of soft opt-out organ donation policies

A machine-learning approach to estimating public intentions to become a living kidney donor in England: Evidence from repeated cross-sectional survey data

BACKGROUND: Living kidney organ donors offer a cost-effective alternative to deceased organ donation. They enable patients with life-threatening conditions to receive grafts that would otherwise not be available, thereby creating space for other patients waiting for organs and contributing to reducing overall waiting times for organs. There is an emerging consensus that an increase in living donation could contribute even more than deceased donation to reducing inequalities in organ donation between different population sub-groups in England. Increasing living donation is thus a priority for National Health Service Blood and Transplant (NHSBT) in the United Kingdom. METHODS: Using the random forest model, a machine learning (ML) approach, this study analyzed eight waves of repeated cross-sectional survey data collected from 2017 to 2021 (n = 14,278) as part of the organ donation attitudinal tracker survey commissioned by NHSBT in England to identify and help predict key factors that inform public intentions to become living donors. RESULTS: Overall, around 58.8% of the population would consider donating their kidney to a family member (50.5%), a friend (28%) or an unknown person (13.2%). The ML algorithm identified important factors that influence intentions to become a living kidney donor. They include, in reducing order of importance, support for organ donation, awareness of organ donation publicity campaigns, gender, age, occupation, religion, number of children in the household, and ethnic origin. Support for organ donation, awareness of public campaigns, and being younger were all positively associated with predicted propensity for living donation. The variable importance scores show that ethnic origin and religion were less important than the other variables in predicting living donor intention. CONCLUSION: Factors influencing intentions to become a living donor are complex and highly individual in nature. Machine learning methods that allow for complex interactions between characteristics can be helpful in explaining these decisions. This work has identified important factors and subgroups that have higher propensity for living donation. Interventions should target both potential live donors and recipients. Research is needed to explore the extent to which these preferences are malleable to better understand what works and in which contexts to increase live organ donation