Palliative and End-of-Life Care: Precepts and Ethics for the Orthopaedic Population

Since the emergence of reports such as the National Consensus Project for Quality Palliative Care (2013) and the National Association of Orthopaedic Nurses Palliative Care Consensus Document (2005), there continues to be a growing recognition of the multiple adverse effects of serious illness and chronic conditions, as well as the potential benefits of receiving palliative or end-of-life care. As modern technology expands its ability to support life, ethical dilemmas may be encountered in the provision of palliative or end-of-life care. Through integration of the precepts of palliative care and consideration of the relevant ethical principles, orthopaedic nurses may best meet their patients\u27 comprehensive needs at an exceedingly difficult time

Laboratory Exercises in Microbiology: Discovering the Unseen World Through Hands-On Investigation

The exercises in this laboratory manual are designed to engage students in hand-on activities that reinforce their understanding of the microbial world. Topics covered include: staining and microscopy, metabolic testing, physical and chemical control of microorganisms, and immunology. The target audience is primarily students preparing for a career in the health sciences, however many of the topics would be appropriate for a general microbiology course as well

The Reality of Fitness for Pre-service Teachers: What Physical Education Majors Know and Can Do

Despite the fact that fitness looms large in the profession, and the fact that there are many issues associated with teaching and testing it, little research has been done to substantiate what in-service or pre -service teachers actually know and do related to fitness. The purpose of this article is to describe the results of two types of fitness assessments on physical education majors. The results of the Fitnessgram test on all physical education majors revealed a fairly high overall rate of passing (82 % of students passed all test items); higher passing rates were apparent for specific tests. BMI was the area of greatest difficulty and concern. In addition, majors in the teacher education concentration who had completed all coursework and student teaching were given a cognitive test called FitSmart, which is a National Health-Related Fitness Knowledge Test designed for high school students. Results indicated that although the pre-service teachers scored in the 99th percentile for high school students, their mean score was 75.18 %. Results of both these assessments raise concerns for colleges and universities as fitness plays an increasingly larger role in physical education

When Culture and Change Collide In Higher Education: A Case Study at One University

Leaders in higher education regularly find themselves at the intersection of change, torn between their institution’s history and culture, the intrinsic value of education, market needs, and the desires of alumni, current, and prospective students. Higher education is often labeled reluctant to change, and many believe any change initiative not aligned with the institution’s culture is almost certain to fail. This study provides evidence that leaders in higher education can implement change that is incongruent with organizational culture while maintaining harmony among the institution’s ideals and constituents. University X, a medium-sized, highly regarded public institution located in a rural area, implemented its first fully online degree program, which was widely perceived as being incongruent with the organization’s culture. A detailed analysis of eight environmental factors and an adaptation of Kotter’s (1996) eight-step change model contributed to the overall success of this change. The keys to implementation were developing an in-depth understanding of the culture while ensuring there was both a need for change and adequate support among stakeholders. Developing a group to champion and sustain the initiative was also critical. The common thread throughout the entire change process was the frequent and effective communication maintained by the organizational leaders. The culture shift initiated by the change also allowed the institution to move quickly to transition to alternative teaching methods during the COVID-19 pandemic of 2020

Developmental Regulation of an Adhesin Gene during Cellular Morphogenesis in the Fungal Pathogen Candida albicans

Peer reviewedPublisher PD

Marketing and Engagement Like a Tiger

Lightning Round - SCLA Conference, November 9th, 201

Design and Revision of an Open-Educational Resource Microbiology Lab Manual Using Student Feedback

Open educational resources are becoming increasingly important in higher education, and are a valuable resource for instructors who want to customize course content while saving their students money. We designed, revised, and assessed an open educational resource for our Principles of Microbiology course. Student feedback was used to guide the revisions, which took place over the course of several semesters. Student survey responses to lab manual content were very positive, and students overwhelmingly favored a no-cost online manual over one that is commercially published. The process we used to develop this lab manual serves as an example for others who might want to develop their own customized materials for their courses

Targeted Maximum Likelihood Estimation for Dynamic and Static Longitudinal Marginal Structural Working Models

This paper describes a targeted maximum likelihood estimator (TMLE) for the parameters of longitudinal static and dynamic marginal structural models. We consider a longitudinal data structure consisting of baseline covariates, time-dependent intervention nodes, intermediate time-dependent covariates, and a possibly time-dependent outcome. The intervention nodes at each time point can include a binary treatment as well as a right-censoring indicator. Given a class of dynamic or static interventions, a marginal structural model is used to model the mean of the intervention-specific counterfactual outcome as a function of the intervention, time point, and possibly a subset of baseline covariates. Because the true shape of this function is rarely known, the marginal structural model is used as a working model. The causal quantity of interest is defined as the projection of the true function onto this working model. Iterated conditional expectation double robust estimators for marginal structural model parameters were previously proposed by Robins (2000, 2002) and Bang and Robins (2005). Here we build on this work and present a pooled TMLE for the parameters of marginal structural working models. We compare this pooled estimator to a stratified TMLE (Schnitzer et al. 2014) that is based on estimating the intervention-specific mean separately for each intervention of interest. The performance of the pooled TMLE is compared to the performance of the stratified TMLE and the performance of inverse probability weighted (IPW) estimators using simulations. Concepts are illustrated using an example in which the aim is to estimate the causal effect of delayed switch following immunological failure of first line antiretroviral therapy among HIV-infected patients. Data from the International Epidemiological Databases to Evaluate AIDS, Southern Africa are analyzed to investigate this question using both TML and IPW estimators. Our results demonstrate practical advantages of the pooled TMLE over an IPW estimator for working marginal structural models for survival, as well as cases in which the pooled TMLE is superior to its stratified counterpar

Diagnosing and Responding to Violations in the Positivity Assumption

The assumption of positivity or experimental treatment assignment requires that observed treatment levels vary within confounder strata. This article discusses the positivity assumption in the context of assessing model and parameter-specific identifiability of causal effects. Positivity violations occur when certain subgroups in a sample rarely or never receive some treatments of interest. The resulting sparsity in the data may increase bias with or without an increase in variance and can threaten valid inference. The parametric bootstrap is presented as a tool to assess the severity of such threats and its utility as a diagnostic is explored using simulated data. Several approaches for improving the identifiability of parameters in the presence of positivity violations are reviewed. Potential responses to data sparsity include restriction of the covariate adjustment set, use of an alternative pro jection function to define the target parameter within a non-parametric marginal structural model, restriction of the sample, and modification of the target intervention. All of these approaches can be understood as trading off proximity to the initial target of inference for identifiability; we advocate approaching this tradeoff systematically