A process model for developing learning design patterns with international scope

This paper investigates the process of identifying design patterns in international collaborative learning environments. In this context, design patterns are referred to as structured descriptions of best practice with pre-defined sections such as problem, solution and consequences. We pay special attention to how the scope of a design pattern is identified and articulated. Based on a review of the seminal design patterns literature and current practice in the area of learning design, the lack of a more specific process description for developing patterns with international scope is identified. The paper suggests a process model for developing patterns with international scope. This model is exemplified in a case study that links the analysis of observation in international learning environments to the articulation of design patterns by identifying culturally independent core values that constitute the foundations of a design pattern with international scope. These core values are linked to recurrent learning behaviors and specific artefacts that support learning in the articulation of a design pattern. The findings contribute to gaining a deeper understanding of the pattern scoping and abstraction process in international learning environments

A Novel Phosphorus Repletion Strategy in a Patient With Duodenal Perforation

We describe a case in which a patient receiving parenteral nutrition (PN) developed hypophosphatemia. Due to lack of availability of parenteral phosphate supplements, we chose to restore phosphate using diluted hypertonic sodium phosphate enemas. Due to the recent shortages of parenteral minerals and vitamins, such an alternate means of repletion is of increasing importance. Diluted hypertonic sodium phosphate enemas are inexpensive, easy to administer, and effective since phosphate is readily absorbed across the rectal mucosa. We hope that through this type of repletion, life-threatening hypophosphatemia among patients receiving PN can be avoided