Pancreas Transplantation: Personal Factors Associated with Good and Poor Post-Transplant Adaptive Response

Notable differences in patient adaptation after pancreas transplant cause some to thrive and return to independent living, while others struggle with emotional and social problems. In order to prepare vulnerable individuals to better cope after transplant, we investigated pre-transplant factors associated with post-transplant adaptive capacity. The pancreas transplant team de ned; good adaptive response (GAR) in patients who were responsible, resourceful, and optimistic. Poor adaptive response (PAR) was associated with patients who tended to complain and were emotionally dependent. METHODS: Experts included 3 nurse coordinators and 3 social workers. A modified Delphi approach was used to achieve consensus on the de nition of GAR and PAR. 200 of the last transplanted pancreas recipients were selected if they: received a pancreas transplant for type 1 DM, with, or without a kidney, and survived a minimum of six months post-transplant. The experts classified cases into GAR and PAR, contextualized by confidence. We completed a chart abstraction of all 200 cases using pre-transplant data and the extracted variables were regressed on the 54 top weighted GAR cases and the top 40 weighted PAR cases. RESULTS: In the final model, past smoker, currently on disability, simultaneous pancreas and kidney (SPK), and less than high school education significantly predicted probability of having a PAR (p<0.05). The model was a well-fitting model with a Hosmer and Lemeshow goodness of t test of (p=0.8250 < 0.05). Given the lack of inclusion of any of the predicted social variables for PAR patients we looked at predictors of GAR. The goodness of fit test was a well-fitting model (p= 0.6294 < 0.05). In addition to pancreas after kidney (PAK) having an odds ratio of 10.39, past smoker was 10.99 and current disability was 5.8. Discussion: The association of PAK with GAR and SPK with PAR suggests a possible effect from prior experience with transplant aiding in coping afterwards. Our findings support the need for a prospective study of coping with pancreas transplant and points to more intensive pre-transplant preparation of recipients, particularly those with lesser education

Montana Forestry Notes, June 1964

This is issue 1: Soil Temperatures in the Lubrecht Experimental Foresthttps://scholarworks.umt.edu/montana_forestry_notes/1000/thumbnail.jp

Conversion From Tacrolimus to Belatacept to Prevent the Progression of Chronic Kidney Disease in Pancreas Transplantation: Case Report of Two Patients

Belatacept is a novel immunosuppressive agent that may be used as an alternative to calcineurin inhibitors (CNI) in immunosuppression (IS) regimens. We report two cases of pancreas transplant that were switched from tacrolimus (TAC) to belatacept. Case 1: 38‐year‐old female with pancreas transplant alone maintained on TAC‐based IS regimen whose serum creatinine (SCr) slowly deteriorated from 0.6 mg/dL at baseline to 2.2 mg/dL, 16 months posttransplant. A native kidney biopsy performed showed CNI toxicity. The patient was started on belatacept and TAC was eliminated. Case 2: 49‐year‐old female with simultaneous pancreas–kidney transplant, maintained on TAC‐based regimen where the SCr worsened over an initial 3‐month period from a baseline of 1.0 to 3.0 mg/dL. Belatacept was started and TAC was lowered. Due to persistent graft dysfunction and kidney transplant biopsy still showing changes consistent with CNI toxicity, the TAC was then discontinued. At >1 year postbelatacept and off TAC follow‐up, kidney function as measured by SCr remains stable at 1.0 ± 0.2 mg/dL in both recipients. Neither patient developed rejection following the switch, and pancreas allograft function remains stable in both recipients

Secondary students' values and perceptions of science-related careers: responses to vignette-based scenarios

There has been concern about the attractiveness of science-based careers to many adolescent learners, and it has been suggested that school science may not always recognise or engage personal values that are important to young people in making life choices. The present study discusses interview comments made by upper secondary level students in England when 15 young people were asked to give their personal responses to brief vignettes describing scientific careers. Using an interview-about-scenarios approach, the students were asked about whether they would feel comfortable working in the scientific careers represented. The career areas were purposefully selected because they might be considered to potentially raise issues in relation to personal values or commitments that some students might hold. A range of student perceptions relating to the mooted careers were elicited (positive, negative and indifferent), but all of the participants raised issues that impacted on the acceptability or attractiveness of at least one of the mooted scientific careers, in terms of aspects of their own personal beliefs and values systems. It is recommended that teachers and career advisors should be aware of the range of value-related considerations that influence student views of science-related careers and should consider exploring aspects of science-based careers that link to values commonly shared by young people. This exploratory study also offers indications for directions for further research exploring how learners' value systems impact upon their perceptions of science and scientific work

Utilizing Weightlifting for Cycling Performance

Abstract available in the 9th Annual Coaches and Sport Science College

Nonenzymatic lipid mediators, neuroprostanes, exert the antiarrhythmic properties of docosahexaenoic acid

postprin

English secondary students’ thinking about the status of scientific theories: consistent, comprehensive, coherent and extensively evidenced explanations of aspects of the natural world – or just ‘an idea someone has’

Teaching about the nature of science (NOS) is seen as a priority for science education in many national contexts. The present paper focuses on one central issue in learning about NOS: understanding the nature and status of scientific theories. A key challenge in teaching about NOS is to persuade students that scientific knowledge is generally robust and reliable, yet also in principle always open to challenge and modification. Theories play a central role, as they are a form of conjectural knowledge that over time may be abandoned, replaced, modified, yet sometimes become well established as current best scientific understanding. The present paper reports on findings from interviews with 13–14 year olds in England where target knowledge presents theories as ‘consistent, comprehensive, coherent and extensively evidenced explanations of aspects of the natural world’. Student thinking reflected a two-tier typology of scientific knowledge in which largely unsupported imaginative ideas (‘theories’) became transformed into fairly definitive knowledge (such as laws) through relatively straightforward testing. These results are considered in relation to research into intellectual development which indicates that effective teaching in this area requires careful scaffolding of student learning, but has potential to contribute to supporting intellectual development across the curriculum.This is the author accepted manuscript. The final version is available from Taylor & Francis via http://dx.doi.org/10.1080/09585176.2015.104392

Hypercomplex quantum mechanics

The fundamental axioms of the quantum theory do not explicitly identify the algebraic structure of the linear space for which orthogonal subspaces correspond to the propositions (equivalence classes of physical questions). The projective geometry of the weakly modular orthocomplemented lattice of propositions may be imbedded in a complex Hilbert space; this is the structure which has traditionally been used. This paper reviews some work which has been devoted to generalizing the target space of this imbedding to Hilbert modules of a more general type. In particular, detailed discussion is given of the simplest generalization of the complex Hilbert space, that of the quaternion Hilbert module.Comment: Plain Tex, 11 page