Elective Course Development: Occupational Therapy in the Acute Care Setting

Introduction: Observation, informal discussion with experts[1], and the literature indicate that occupational therapy (OT) students often enter the acute care setting for Level II Fieldwork (FW II) or new jobs post-graduation with deficits in knowledge, skills, and clinical judgment specifically for the acute care setting (Baird, Raina, Rogers, O’Donnell, & Holm, 2015; Gibbs, Dietrich, & Dagnan, 2017; Knecht-Sabres, 2013). Without specific courses in acute care, students in the majority of OT graduate programs do not get extensive exposure to this setting. The development of an elective on OT in acute care for Georgia State University’s (GSU) OT graduate doctorate program was proposed to address this gap. Protocol: A literature review was conducted in order to establish a basis for the course’s underlying pedagogical models and to determine key elements that made similar programs successful in enhancing student confidence, knowledge, and skill application. A three-week observation at Grady Memorial Hospital was undertaken in order to gain a better understanding of the challenges, knowledge deficits, and skill deficits that FW II educators and students identify as initial impediments early on in the FW II experience. The remaining 11 weeks were dedicated to developing the course and gaining experience in teaching skills labs. Resulting Program: A 14-unit elective course focused on OT in the acute care setting was designed to increase the confidence, performance skills, and clinical judgment of students in the OT doctorate program at GSU in preparation for FW II in the acute care setting. It follows a flipped classroom model, with asynchronous lectures to be reviewed prior to a hands-on skills lab with real-world simulations and hospital equipment. Underlying pedagogical models include Kolb’s Experiential Learning (ELT) Model and more Authentic, Reflective and Collaborative (mARC) instructional design model, with findings that indicate the importance of incorporating self-reflection, debriefing, feedback, and experiential learning. Conclusion: This course will allow the OT doctorate program at GSU to offer an additional specialized acute care elective course that students can take advantage of in order to increase their knowledge and competency in this practice setting. The offering of such a course also increases the value of GSU’s program in the following two areas: (1) the program will be more attractive to students applying to OT school by offering this specialized practice course and (2) local hospitals can expect GSU students who have completed the course to have increased foundational knowledge and skills prior to beginning FW II in acute care

Use of wikis as a collaborative ICT tool for extending the frontiers of knowledge in tertiary institutions

The human brain works much like a network of computers connected by nodes. These nodes allow computers on the same network to communicate effectively. Educators have discovered that today’s learning environment functions much the same way, with learners connecting to the internet, to other learners and to their teachers to increase their knowledge. This discovery has led to a paradigm shift in education which has transformed the learning environment from teacher-centered to learner-centered. The learner-centered environment allows for interactivity, communication and collaboration. When Web 2.0 technologies are used in the classroom, learners and teachers are given the opportunity to extend the frontiers of knowledge by collaborating and contributing to knowledge. This paper explores the possibility of using Wikis – a Web 2.0 technology – to extend the frontiers of knowledge. It also discusses how Wikis are presently being used in education; how to create a Wiki site using three different Wiki host platforms; and how to contribute content to Wikipedia – which is the world’s largest Wiki site. Finally, recommendations are given on what management of institutions can do to encourage the use of Wikis in the classroom.KEYWORDS: Collaboration, Web 2.0 technology, Wikis, Wikipedia, 21st century skills, Frontiers of knowledg

Sustainability Survey report

Although the idea of sustainability means different things to different people, one of the most common definitions comes from the UN’s 1987 Brundtland Report, which states that sustainability is that which meets the needs of the present without compromising the ability of future generations to meet their own needs. In practice, sustainability means balancing environmental protection with economic vitality and social justice. Since the 1990s, sustainability has become a powerful framework for organizational transformation, particularly at institutions of higher education. Today over 1,350 colleges and universities offer degrees in sustainability and use sustainability as a guiding principle for administrative decisions across campus. On our own campus, the Environmental Studies and Sustainability major grew 144% in the past year while enrollment in other programs declined. For many people born in the early twenty-first century, sustainability is an exciting movement that seeks solutions to the daunting economic, environmental, and social problems that their generation will face. As training grounds for the future, universities like Northern have a responsibility to prepare today’s students for these global challenges

Third Quarterly Report: Mississippi Woman Suffrage Association

Recounts activities of the associationhttps://egrove.olemiss.edu/suffrage/1022/thumbnail.jp

Cost Effectiveness of Molecular Diagnostic Testing Algorithms for the Treatment Selection of Frontline Ibrutinib for Patients with Chronic Lymphocytic Leukemia in Australia

BACKGROUND: Clinical indications for ibrutinib reimbursement in Australia should consider the inclusion of patients with chronic lymphocytic leukemia (CLL) harboring prognostically unfavorable TP53/IGHV genomic aberrations. This study assessed the cost effectiveness of five first-line treatment strategies in CLL for young (aged ≤ 65 years), fit patients without significant comorbidities: (1) no testing (fludarabine, cyclophosphamide and rituximab [FCR] for all), (2) test for del(17p) only, (3) test for TP53 gene mutation status, (4) test for TP53 and IGHV gene mutation status and (5) no testing (ibrutinib for all).METHOD: A decision analytic model (decision tree and partitioned survival model) was developed from the Australian healthcare system perspective with a lifetime horizon. Comparative treatment effects were estimated from indirect treatment comparisons and survival analysis using several studies. Costs, utility and adverse events were derived from public literature sources. Deterministic and probabilistic sensitivity analyses explored the impact of modeling uncertainties on outcomes.RESULTS: Strategy 1 was associated with 5.69 quality-adjusted life-years (QALYs) and cost 458,836 Australian dollars (AUD). All other strategies had greater effectiveness but were more expensive than Strategy 1. At the willingness-to-pay (WTP) threshold of 100,000 AUD per QALY gained, Strategy 1 was most cost effective with an estimated probability of 68.8%. Strategy 4 was cost effective between thresholds 155,000-432,300 AUD per QALY gained, and Strategy 5 &gt;432,300 AUD per QALY gained.CONCLUSION: Population targeting using mutation testing for TP53 and IGHV when performed with del(17p) testing specifically in the context of frontline ibrutinib choice does not make a cost-ineffective treatment into a cost-effective treatment.</p

Protein Engineering of a Spectroscopic Probe into Malate Dehydrogenase (MDH)

Malate dehydrogenase (MDH) is an enzyme that has a key role in biological processes, like the Krebs cycle. Specifically, it reversibly catalyzes the interconversion of (S)-malate with NAD+ to oxaloacetate and NADH. Once oxaloacetate is synthesized, MDH dispatches it to citrate synthase, but it is not clear how this happens. One theory is that MDH channels it to citrate synthase by forming a metabolon, a mechanism for direct channeling, preventing diffusion of reaction intermediates into a bulk matrix. There is a lack of research in this area due to the absence of a spectroscopic probe necessary to visualize MDH’s conformational changes. Therefore, a method was tested to incorporate a fluorescent landmark into MDH’s structure and thus be used in future research to reveal the interactions between MDH and citrate synthase. Specific amino acids of MDH were mutated to tryptophan, an amino acid known to fluoresce (V189, I319, A120, I136, P119, G218). The coding sequence for the wildtype MDH and mutant MDHs were incorporated into plasmids and bacterially transformed into Escherichia coli. Both wildtype and mutant proteins were over-expressed, then purified by nickel affinity chromatography using a hexahistidine tag on the N-terminus of MDH. Data will demonstrate that I139W, V189W, and A120W had significantly lower activity than wildtype MDH, and the same is predicted for I136W. I139W and V189W emitted fluorescence at 290 nm, but I136W did not. The mutations P119W and G218W could not be overexpressed or purified. Next steps in design of a fluorescent, active MDH will be discussed

Investigating the role of Caspase-1 in a mouse model of Juvenile X-linked Retinoschisis

PurposePrevious studies have reported Caspase-1 (Casp1) is upregulated in mouse models of Juvenile X-linked Retinoschisis (XLRS), however no functional role for Casp1 in disease progression has been identified. We performed electroretinogram (ERG) and standardized optical coherence tomography (OCT) in mice deficient in the Retinoschisin-1 (Rs1) and Casp1 and Caspase-11 (Casp11) genes (Rs1-KO;Casp1/11−/−) to test the hypothesis that Casp1 may play a role in disease evolution and or severity of disease. Currently, no studies have ventured to investigate the longer-term effects of Casp1 on phenotypic severity and disease progression over time in XLRS, and specifically the effect on electroretinogram.MethodsRs1-KO;Casp1/11−/− mice were generated by breeding Rs1-KO mice with Casp1/11−/− mice. OCT imaging was analyzed at 2-, 4-, and 15–16 months of age. Outer nuclear layer (ONL) thickness and adapted standardized cyst severity score were measured and averaged from 4 locations 500 μm from the optic nerve. Adapted standardized cyst severity score was 1: absent cysts, 2: &lt;30 μm, 3: 30–49 μm, 4: 50–69 μm, 5: 70–99 μm, 6: &gt;99 μm. Electroretinograms (ERG) were recorded in dark-adapted and light-adapted conditions at 2 and 4 months. Results obtained from Rs1-KO and Rs1-KO;Casp1/11−/− eyes were compared with age matched WT control eyes at 2 months.ResultsIntraretinal schisis was not observed on OCT in WT eyes, while schisis was apparent in most Rs1-KO and Rs1-KO;Casp1/11−/− eyes at 2 and 4 months of age. There was no difference in the cyst severity score from 2 to 4 months of age, or ONL thickness from 2 to 16 months of age between Rs1-KO and Rs1-KO;Casp1/11−/− eyes. ERG amplitudes were similarly reduced in Rs1-KO and Rs1-KO;Casp1/11−/− compared to WT controls at 2 months of age, and there was no difference between Rs1-KO and Rs1-KO;Casp1/11−/− eyes at 2 or 4 months of age, suggesting no impact on the electrical function of photoreceptors over time in the absence of Casp1.ConclusionAlthough Casp1 has been reported to be significantly upregulated in Rs1-KO mice, our preliminary data suggest that removing Casp1/11 does not modulate photoreceptor electrical function or alter the trajectory of the retinal architecture over time

Biallelic deleterious germline SH2B3 variants cause a novel syndrome of myeloproliferation and multi-organ autoimmunity

SH2B3 is a negative regulator of multiple cytokine receptor signalling pathways in haematopoietic tissue. To date, a single kindred has been described with germline biallelic loss-of-function SH2B3 variants characterized by early onset developmental delay, hepatosplenomegaly and autoimmune thyroiditis/hepatitis. Herein, we described two further unrelated kindreds with germline biallelic loss-of-function SH2B3 variants that show striking phenotypic similarity to each other as well as to the previous kindred of myeloproliferation and multi-organ autoimmunity. One proband also suffered severe thrombotic complications. CRISPR-Cas9 gene editing of zebrafish sh2b3 created assorted deleterious variants in F0 crispants, which manifest significantly increased number of macrophages and thrombocytes, partially replicating the human phenotype. Treatment of the sh2b3 crispant fish with ruxolitinib intercepted this myeloproliferative phenotype. Skin-derived fibroblasts from one patient demonstrated increased phosphorylation of JAK2 and STAT5 after stimulation with IL-3, GH, GM-CSF and EPO compared to healthy controls. In conclusion, these additional probands and functional data in combination with the previous kindred provide sufficient evidence for biallelic homozygous deleterious variants in SH2B3 to be considered a valid gene-disease association for a clinical syndrome of bone marrow myeloproliferation and multi-organ autoimmune manifestations