Transition of the adolescent transplant patient to adult care

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/100316/1/cld243.pd

Assessing allocation of responsibility for health management in pediatric liver transplant recipients

Given the increased risk for non‐adherence and poor health outcomes in late adolescence, there is a need for better methods to evaluate and improve the transition process as adolescent patients are prepared to be independent adults. This study assessed the psychometrics and concurrent validity of a newly developed measure of AoR for health management in pediatric liver transplant patients. A total of 48 patients and 37 parents completed a 13‐item measure of AoR. We performed an exploratory PCA on survey results and used component scores to assess the relationship between AoR and age, age at transplant, adherence, and health outcomes. Two primary components were identified: communication with the healthcare system and self‐management tasks. Parent perception of adolescent responsibility for tasks related to communicating with the healthcare system was correlated, in younger patients, with increased non‐adherence while responsibility for tasks related to self‐management was correlated, in older patients, with decreased non‐adherence. These results support AoR as a two‐domain construct, and they provide targets for monitoring and intervention as adolescent patients advance toward transfer.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111981/1/petr12466.pd

Health literacy and its association with adherence in pediatric liver transplant recipients and their parents

ObjectiveNon- adherence to pediatric regimens is a common concern. Low health literacy is correlated with poor outcomes in adults but is understudied in pediatrics. The current project aimed to determine the relationship between health literacy, adherence, and outcomes in pediatric liver transplant recipients. Hypotheses included a) parent and patient health literacy would be positively correlated; and b) low patient and/or parent health literacy would be negatively correlated with adherence and health outcomes.Patients and MethodsEligible participants were recruited during routine follow- up visits in a pediatric liver transplant clinic. Parents and patients (>13 years old) completed 2 measures of health literacy. Patients - ¥18 years completed health literacy measures without corresponding parent surveys. Adherence variables and health outcomes were obtained from medical records.ResultsSeventy- nine patients across two sites completed the study. Variance in classification of health literacy between measures was observed; however, most parents (82%- 100%) scored within an - adequate literacy- range. More adolescents scored in lower health literacy ranges relative to the parents. Markers of SES were positively correlated with health literacy. Parent health literacy was negatively associated with biopsy- proven rejection episodes and the number of hospitalizations; however, it was not associated with measures of tacrolimus adherence. There were no relationships observed between parent and adolescent health literacy.ConclusionsHealth literacy is an important consideration in managing patient care; however, available measures demonstrate variability in capturing the skills of patients. Effective communication strategies may ameliorate admittedly small, but negative, impacts of limited health literacy on outcomes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156215/2/petr13726_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156215/1/petr13726.pd

Hybrid organic-inorganic nanoparticles: controlled incorporation of gold nanoparticles into virus-like particles and application in surface-enhanced Raman spectroscopy.

A capsid is the protein coat surrounding a virus' genome that ensures its protection and transport. The capsid of murine polyomavirus (muPy) consists of one major (VP1) and two minor (VP2/3) proteins, from which just VP1 is sufficient to form the capsid when expressed recombinantly (1). From a material engineering point of view, viral capsids are of interest because they present a paradigm for complex self-assembly on the nanometer scale. Understanding and controlling these assembly dynamics will allow the construction of nanoscale structures using a self-assembly process. The first step in this direction was the discovery that capsids of several viruses can be reversibly disassembled into their building blocks and reassembled using the same building blocks by simply changing the buffer conditions (2, 3). Such capsids already find applications as targeted in vivo delivery vectors for genes, proteins or small molecular drugs (4, 5), as optical probes for biomedical imaging and sensing purposes with unprecedented resolution and sensitivity and can potentially be used as templates for nanoelectronics (6, 7)

Low Energy Nuclear Reaction Aircraft- 2013 ARMD Seedling Fund Phase I Project

This report serves as the final written documentation for the Aeronautic Research Mission Directorate (ARMD) Seedling Fund's Low Energy Nuclear Reaction (LENR) Aircraft Phase I project. The findings presented include propulsion system concepts, synergistic missions, and aircraft concepts. LENR is a form of nuclear energy that potentially has over 4,000 times the energy density of chemical energy sources. It is not expected to have any harmful emissions or radiation which makes it extremely appealing. There is a lot of interest in LENR, but there are no proven theories. This report does not explore the feasibility of LENR. Instead, it assumes that a working system is available. A design space exploration shows that LENR can enable long range and high speed missions. Six propulsion concepts, six missions, and four aircraft concepts are presented. This report also includes discussion of several issues and concerns that were uncovered during the study and potential research areas to infuse LENR aircraft into NASA's aeronautics research

An overview of knowledge sharing in new product development

This paper provides an overview of some of the issues in knowledge management related to the sharing of knowledge in new product development. Previous research and concepts reported by international researchers, and examples of the research projects carried out by the authors will be introduced. The paper first provides an overview of the history and importance of innovation and challenges in manufacturing. Then the importance of new product development in the sustainable success of manufacturing enterprises in the globalised business operations is discussed. The formalisation and modelling of product development processes will also be introduced. The concept and different definitions of knowledge management by previous researchers are then introduced, with further discussion on knowledge sharing. At this point, the authors’ research in knowledge sharing is also introduced. Finally, the trend of using social media and Enterprise 2 technologies in knowledge management and sharing is introduced using the recent research projects of the authors as examples

UBIAD1 Mutation Alters a Mitochondrial Prenyltransferase to Cause Schnyder Corneal Dystrophy

Peer reviewe

UBIAD1 Mutation Alters a Mitochondrial Prenyltransferase to Cause Schnyder Corneal Dystrophy

Abstract Background: Mutations in a novel gene, UBIAD1, were recently found to cause the autosomal dominant eye disease Schnyder corneal dystrophy (SCD). SCD is characterized by an abnormal deposition of cholesterol and phospholipids in the cornea resulting in progressive corneal opacification and visual loss. We characterized lesions in the UBIAD1 gene in new SCD families and examined protein homology, localization, and structure

Beyond outputs: pathways to symmetrical evaluations of university sustainable development partnerships

As the United Nations Decade of Education for Sustainable Development (2005–2014) draws to a close, it is timely to review ways in which the sustainable development initiatives of higher education institutions have been, and can be, evaluated. In their efforts to document and assess collaborative sustainable development program outcomes and impacts, universities in the North and South are challenged by similar conundrums that confront development agencies. This article explores pathways to symmetrical evaluations of transnationally partnered research, curricula, and public-outreach initiatives specifically devoted to sustainable development. Drawing on extensive literature and informed by international development experience, the authors present a novel framework for evaluating transnational higher education partnerships devoted to sustainable development that addresses design, management, capacity building, and institutional outreach. The framework is applied by assessing several full-term African higher education evaluation case studies with a view toward identifying key limitations and suggesting useful future symmetrical evaluation pathways. University participants in transnational sustainable development initiatives, and their supporting donors, would be well-served by utilizing an inclusive evaluation framework that is infused with principles of symmetry

Investigation of Terahertz Vibration–Rotation Tunneling Spectra for the Water Octamer

We report a combined theoretical and experimental study of the water octamer-h16. The calculations used the ring-polymer instanton method to compute tunnelling paths and splittings in full dimensionality. The experiments measured extensive high resolution spectra near 1.4 THz, for which isotope dilution experiments and group theoretical analysis support assignment to the octamer. Transitions appear as singlets, consistent with the instanton paths, which involve the breakage of two hydrogen-bonds and thus give tunneling splittings below experimental resolution