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The wicked problem of climate change and the challenge of engagement: Exploring educational approaches and possibilities for information literacy
Get PDFClimate change is a prime example of a “wicked problem”: it is characterized by complexity and unboundedness and has no complete or simple solutions, though communities can develop constructive interventions that address particular aspects of the problem (for example, in cities increasing green spaces that have a cooling effect). Because the problem of climate change is so expansive and the answers to it remain limited in scope and impact, engaging with the topic inevitably evokes difficult emotions like uncertainty, overwhelm, despair, and grief. So it is understandable that a common response to the realities of climate change has been denial and disengagement. But an increasing number of people are looking honestly at the difficult realities of climate change and (re)imagining ways to build futures centered on community and care, including in the realm of education.
Of particular relevance to librarians, wicked problems like climate change make evident the incredible complexity of information behaviors and the need to explore new approaches to information literacy in the face of messy challenges. As librarian Alex Hewitt convincingly argues, climate change and the related experience of ecological grief reflect the importance of attending more fully to the affective dimensions of information behaviors and information literacy (see their 2022 article “What role can affect and emotion play in academic and research information literacy practices?”). Beyond librarianship, many teachers and scholars engaged with climate change education also stress the importance of recognizing and normalizing the affective dimensions of learning about it and developing responses to it. Many of these individuals explore constructive ways within learning environments to build community and to allow space for complex and sometimes conflicting emotions like grief and hope. Much of this pedagogical work draws on areas of inquiry such as: 1) transformative learning, according to which learners who face “disorienting dilemmas” undergo a process of perspective transformation; 2) “radical futurity,” which explores how different imaginings of the future can affect the present (see Barrineau et al., 2022. Emergentist education and the opportunities of radical futurity ); and 3) an ethics of care that centers community and interrelatedness.
This presentation will introduce scholarship on the intersections of wicked problems, climate change education, and affect, and will explore potential implications of such work for information literacy education. The presenter will give particular attention to different forms and experiences of grief and hope and their relationship to (dis)engagement with information about wicked problems like climate change
The Tensegrity Curriculum: A Comprehensive Curricular Structure Supporting Cultural Humility in Undergraduate Medical Education.
Get PDFDue to growing health disparities in underserved communities, a comprehensive approach is needed to train physicians to work effectively with patients who have cultures and belief systems different from their own. To address these complex healthcare inequities, Rowan-Virtua SOM implemented a new curriculum, The Tensegrity Curriculum, designed to expand beyond just teaching skills of cultural competence to include trainees\u27 exploration of cultural humility. The hypothesis is that this component of the curriculum will mitigate health inequity by training physicians to recognize and interrupt the bias within themselves and within systems. Early outcomes of this curricular renewal process reveal increased student satisfaction as measured by course evaluations. Ongoing course assessments examine deeper understanding of the concepts of implicit bias, social determinants of health, systemic discrimination and oppression as measured by performance on graded course content, and greater commitment to continual self-evaluation and critique throughout their careers as measured by course feedback. Structured research is needed to understand the relationship between this longitudinal and integrated curricular design, and retainment or enhancement of empathy during medical training, along with its impact on health disparities and community-based outcomes
Comparison of four in vitro test methods to assess nucleus pulposus replacement device expulsion risk
Get PDFBackground: Nucleus replacement devices (NRDs) are not routinely used in clinic, predominantly due to the risk of device expulsion. Rigorous in vitro testing may enable failure mechanisms to be identified prior to clinical trials; however, current testing standards do not specify a particular expulsion test. Multiple methods have therefore been developed, complicating comparisons between NRD designs. Thus, this study assessed the effectiveness of four previously reported expulsion testing protocols; hula-hoop (Protocol 1), adapted hula-hoop (Protocol 2), eccentric cycling (Protocol 3), and ramp to failure (Protocol 4), applied to two NRDs, one preformed and one in situ curing. Methods: Nucleus material was removed from 40 bovine tail intervertebral disks. A NRD was inserted posteriorly into each cavity and the disks were subjected to one of four expulsion protocols. Results: NRD response was dependent on both the NRD design and the loading protocol. Protocol 1 resulted in higher migration and earlier failure rates compared to Protocol 2 in both NRDs. The preformed NRD was more likely to migrate when protocols incorporated rotation. The NRDs had equal migration (60%) and expulsion (60%) rates when using unilateral bending and ramp testing. Combining the results of multiple tests revealed complimentary information regarding the NRD response. Conclusions: Adapted hula-hoop (Protocol 2) and ramp to failure (Protocol 4), combined with fluoroscopic analysis, revealed complimentary insights regarding migration and failure risk. Therefore, when adopting the surgical approach and animal model used in this study, it is recommended that NRD performance be assessed using both a cyclic and ramp loading protocol
Robust AI-Driven Segmentation of Glioblastoma T1c and FLAIR MRI Series and the Low Variability of the MRIMath© Smart Manual Contouring Platform
Get PDFPatients diagnosed with glioblastoma multiforme (GBM) continue to face a dire prognosis. Developing accurate and efficient contouring methods is crucial, as they can significantly advance both clinical practice and research. This study evaluates the AI models developed by MRIMath© for GBM T1c and fluid attenuation inversion recovery (FLAIR) images by comparing their contours to those of three neuro-radiologists using a smart manual contouring platform. The mean overall Sørensen–Dice Similarity Coefficient metric score (DSC) for the post-contrast T1 (T1c) AI was 95%, with a 95% confidence interval (CI) of 93% to 96%, closely aligning with the radiologists’ scores. For true positive T1c images, AI segmentation achieved a mean DSC of 81% compared to radiologists’ ranging from 80% to 86%. Sensitivity and specificity for T1c AI were 91.6% and 97.5%, respectively. The FLAIR AI exhibited a mean DSC of 90% with a 95% CI interval of 87% to 92%, comparable to the radiologists’ scores. It also achieved a mean DSC of 78% for true positive FLAIR slices versus radiologists’ scores of 75% to 83% and recorded a median sensitivity and specificity of 92.1% and 96.1%, respectively. The T1C and FLAIR AI models produced mean Hausdorff distances (\u3c5 mm), volume measurements, kappa scores, and Bland–Altman differences that align closely with those measured by radiologists. Moreover, the inter-user variability between radiologists using the smart manual contouring platform was under 5% for T1c and under 10% for FLAIR images. These results underscore the MRIMath© platform’s low inter-user variability and the high accuracy of its T1c and FLAIR AI models
WHY TAKE AP? ACCESS TO HIGH SCHOOL ADVANCED PLACEMENT COURSES LONG-TERM IMPACT ON CAREER/WORKPLACE OPPORTUNITIES
No full textThis study sought to understand the long-term impact of providing access and equity to highly rigorous Advanced Placement (AP) coursework to underserved and/or underrepresented high school students, and its long-term impacts on career. Using a qualitative approach, this study explored the experiences and opportunities of 6 graduates from a rural public high school in New Jersey with open access to AP courses who are now in a career/workplace environment. All six graduates took at least one AP course while in high school, graduated between 2010 and 2016, and had two or more potential barriers to opportunity while attending high school in an underrepresented or underserved population. Themes unique to this group of graduates included: taking AP was expected, peers, teachers, and guidance counselors were instrumental in providing access to AP. There are several recommendations for how educators might begin to improve the learning landscape for students including the elimination of tracking, providing parents with AP information beginning in middle school, securing funds to take the AP exam(s), and a suggestion that counselors should develop more inclusive recruitment practices, so that information relative to the AP program is made available to all students. The results of this study should be shared with educational leadership organizations to further spread the impacts of AP on individuals and their careers
A Literature Review of Current Treatments for the Hypermobility Subtype of Ehlers-Danlos Syndrome
Get PDFPurpose: The purpose of this study is to compare pharmacologic intervention, neurocognitive therapy, physical therapy, and orthotics in treating the hypermobility subtype of Ehlers-Danlos Syndrome (hEDS) and determine which has the most positive effect on symptoms.
Introduction: Ehlers-Danlos Syndrome is an inheritable connective tissue disorder which results from a genetic mutation that alters the body’s ability to produce collagen. The most common subtype of Ehlers-Danlos Syndrome is hEDS, which leads to hypermobility and hyperextensibility and can cause frequent joint dislocations.
Methods: A review of literature was performed to compare each treatment based on reported results. The types of studies reviewed include systematic reviews, randomized clinical trials, review articles, cross sectional studies, and longitudinal studies. This study includes patients diagnosed with hEDS.
Results: Data was analyzed from different studies and presented using various figures and tables to compare the effectiveness of each treatment modality.
Discussion: Pain medications such as opioids and NSAIDs are the most commonly used treatment option, but they carry the risk of addiction and other side effects. Use of orthotics was the most successful treatment option in alleviating symptoms of hEDS.
Conclusion: Pharmacologic intervention, neurocognitive therapy, physical therapy, and orthotics each have their own benefits in treating hEDS. Therefore, a combination of each therapy should be used to ensure the greatest positive effect on the symptoms of hEDS. Future research should focus on more direct comparisons of each treatment method to identify which modality consistently yields the best results
Brief Review: Regional Anesthesia for Vaso-occlusive Pain Crises
Get PDFVaso-occlusive pain crisis occurs with obstruction of blood vessels from sickled red blood cells. This results in ischemic injury causing in pain. Acute vasoocclusive pain crisis is one of the most common reasons for patients with sickle cell disease to present to the hospital for medical attention. Acute treatment involves IV opioid therapy, non-opioid therapy, and IV hydration. There is a known lack of trust between a patient in acute pain and a provider in the emergency department (ED) and hospital secondary to stereotypes regarding pain seeking behavior. Here we discuss a case of vasoocclusive pain crisis refractory to opioid therapy and local regional anesthesia as an alternative treatmen
Case Report: An Emergency Department Presentation of an Ovarian Teratoma
Get PDFA teratoma (from the Greek terato for “monster” and onkoma for “mass” or “swelling”) is a type of neoplasm composed of tissues from two or three germ layers. Mature cystic teratomas (MCTs) constitute 70% of all ovarian neoplasms. They typically present with nonspecific symptoms such as pain and nausea. They account for approximately 2% of all primary ovarian malignant cancers and are predominately diagnosed via ultrasound. Computed tomography may be necessary if malignancy is suspected. Larger size warrants a higher suspicion of malignancy. Management is symptom control and ultimately, surgical removal. Prognosis is generally excellent, provided there is no malignant transformation or other complications. Modern research increasingly supports a conservative management via resection of the mass without negative impact on fertility. Here we present the case of an emergency department patient who was diagnosed with an ovarian teratoma
Case Report: Monkeypox Diagnosed in the ED
Get PDFRashes are one of the most common chief complaints we see as emergency medicine physicians on a day-to-day basis. Most of them tend to be self-limited and require very little workup and can be discharged home; however, it is our job to try to identify rashes that may require isolation in order to prevent an outbreak in our communities. Here we present a case of one such rash that has gained major media attention as of late, Monkeypox
Case Report: Wellens Syndrome in 28-Year-Old with Pleuritic Chest Pain
Get PDFWe report a case of a 28-year-old male with months of diffuse, pleuritic, intermittent, non-exertional chest pain. He had an elevated troponin and ECG showing Wellens’ syndrome and was found to have 80% LAD coronary artery occlusion and 100% apical occlusion. Identification and proper management of Wellens’ syndrome relies on being familiar with its ECG patterns. Other information such as age, cardiac risk factors, chest pain with exertion and at rest, and elevated troponin, are all helpful supplemental information, but as demonstrated in the following case report, presentations may vary or even cause as distractors to the diagnosis