Comment letters to the National Commission on Commission on Fraudulent Financial Reporting, 1987 (Treadway Commission) Vol. 2

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Reimagining the Online Classroom: Six Course Activities to Foster a Transformative Learning Community

This session will present the lessons learned in our learning circle on transformative learning environments. Transformative learning is in essence being open to otherness and withholding judgment to bridge and understand our differences to ultimately transform our perspectives. Transformative learning begins with critical reflection and dialogue. Transformative learning principles shift from just presenting information to building authentic learning experiences into the design and delivery of online teaching and learning. In this session, we will share strategies we have learned and lessons coming in our own online classrooms to foster a community where students can experience transformative learning activities through reflection and dialogue in the online space. Presenters from multiple disciplines will give examples of transformative learning experiences, including trying on new roles, reflection, projection, student research, and other practices

Implementation of a systematic comprehensive geriatric assessment for elderly patients suspected of pulmonary hypertension

International audienceBackground: The phenotype of patients seen for a suspicion of pulmonary hypertension has changed, with an increasing age and frequency of comorbidities. Selection of elderly patients, in whom a classical work-up is mandatory, is challenging. Comprehensive geriatric assessment (CGA) has modified the management of elderly patients with cancer. Pulmonary hypertension (PH) shares with cancer a functional impact and may evolve rapidly, depending on the group of PH. We assessed the impact of a systematic CGA in patients over 70 years old referred for a suspicion of PH.Methods: A standardised CGA was performed on every patient older than 70 years old, referred for a PH suspicion, before considering invasive tests for diagnosis and treatment, between July 2014 and May 2019. Our primary aim was to describe the impact of CGA on the decision to stop or pursue the recommended diagnostic work-up for PH.Results: Among the thirty-one patients evaluated [mean age 81,5 (72-91) years], a negative CGA leads to stop the diagnostic work-up in eleven patients. Among the nineteen remaining patients, sixteen had confirmed PH, with half being chronic thromboembolic pulmonary hypertension.Conclusions: Our study indicates that comprehensive geriatric assessment could be an excellent first screen for elderly patients referred for a PH suspicion. Involving a geriatric physician stopped the investigations in one third of patients. In patients with a favourable CGA, PH was confirmed in most of the cases, with chronic thromboembolic pulmonary hypertension being the first cause of PH

Parent Education in Youth Sport: A Community Case Study of Parents, Coaches, and Administrators

The present community case study was designed to highlight parent, coach, and administrator perceptions of community-based parent education in a youth sport community in the Rocky Mountain region of the United States. Interviews with parents (n = 12), coaches (n = 13), and administrators (n = 11) were interpreted inductively using constructivist thematic analysis. Nine emergent categories are highlighted, including parents’ sport goals for their children, parents’ involvement in youth sport including impacts of involvement on children, and barriers to implementing parent education, as well as potential content for parent education. A proposed sequential framework informing community-based parent education, as well as suggestions for further action, and study limitations are included

DLNO/DLCO ratio evolution under targeted therapy in patients with pulmonary hypertension

International audienceThe ratio of the diffusing capacity of the lung for carbon monoxide (DLCO) and for nitric oxide (DLNO) measured simultaneously is modified in patients with precapillary pulmonary hypertension (PH). The potential impact of targeted therapy on the DLCO/DLNO ratio is unknown.Simultaneous measurements of DLNO and DLCO were performed at baseline, 3-4 month follow-up (first evaluation) and 12-month follow-up (second evaluation) after initiation of targeted PH therapies in incident cases of precapillary PH. The main outcome was the change in DLNO/DLCO ratio under treatment between baseline and the first evaluation.Twenty-nine patients were included (mean age: 66.8 years, 62.1% female). No significant change in the DLNO/DLCO ratio was found between baseline and the first evaluation. Similarly, no significant differences were noted with regard to changes in Dm or Vc, the DLNO/DLCO ratio in different patient subgroups, or in the 20 patients evaluated at the second follow-up.Within the limitations of this study, the DLNO/DLCO ratio is not useful in monitoring the response to treatment in PH