Examining the critical role of advanced practice providers on a multidisciplinary transplant team.

It is well documented that Physician Assistants (PAs) and Nurse Practitioners (NPs), collectively known as Advanced Practice Providers (APPs), have a beneficial role beyond the field of primary care. APPs broad spectrum of knowledge make them particularly well suited for specializing in complex fields such as transplant. Variations in practice across transplant centers lead to questions regarding optimal use of APPs. Using job descriptions from transplant centers currently employing APPs, we sought to examine the critical role of transplant APPs beyond clinical care alone. In this review, we explore not only the general training of APPs and current utilization of APPs in transplant, but also safety, cost effectiveness, and comparison of APPs to other transplant providers. We aimed to highlight the importance of recruitment and retention of transplant specific trained APPs to provide continuity in transplant programs. Additionally, APPs expansion into transplant research, quality improvement, leadership, and management must be considered. We challenge transplant centers utilizing APPs to consider these important aspects when seeking ways to expand and optimize the critical role APPs provide on the transplant team.

Collective pedagogical teacher culture, teacher-student ethno-racial mismatch, and teacher job satisfaction.

Teacher job satisfaction is critical to schools' successful functioning. Using a representative sample of kindergarten teachers from the Early Childhood Longitudinal Study, we investigate the association among professional learning community and teacher collaboration, teacher ethno-racial group, teacher-student ethno-racial mismatch, and teacher job satisfaction. We find that White teachers are significantly less satisfied than African-American and Latino teachers, especially when they teach in majority non-White classrooms. However, the existence of a professional community moderates the negative influence of teacher-student ethno-racial mismatch on White teachers' job satisfaction. In effect, strong professional communities serve as a cushion to bolster teacher job satisfaction.

Total Laryngeal Transplant in the Setting of Active Laryngeal Malignancy.

Laryngeal transplant (LT) is a promising option to restore quality of life in patients with severe laryngeal dysfunction or a laryngectomy. These patients may be tracheostomy tube dependent or gastrostomy tube dependent and may lose their ability to verbally communicate. The loss of these important functions frequently results in social isolation and a severe decrease in quality of life. Laryngeal transplant has the potential to restore all of these important laryngeal functions. Herein, we report the first known documented LT performed in the setting of laryngeal chondrosarcoma.

Race and gender differences in how sense of belonging influences decisions to major in STEM.

BACKGROUND: Women and students of color are widely underrepresented in most STEM fields. In order to investigate this underrepresentation, we interviewed 201 college seniors, primarily women and people of color, who either majored in STEM or started but dropped a STEM major. Here we discuss one section of the longer interview that focused on students' sense of belonging, which has been found to be related to retention. In our analysis, we examine the intersections of race and gender with students' sense of belonging, a topic largely absent from the current literature. RESULTS: We found that white men were most likely to report a sense of belonging whereas women of color were the least likely. Further, we found that representation within one's STEM sub-discipline, namely biology versus the physical sciences, impacts sense of belonging for women. Four key factors were found to contribute to sense of belonging for all students interviewed: interpersonal relationships, perceived competence, personal interest, and science identity. CONCLUSIONS: Our findings indicate that students who remain in STEM majors report a greater sense of belonging than those who leave STEM. Additionally, we found that students from underrepresented groups are less likely to feel they belong. These findings highlight structural and cultural features of universities, as well as STEM curricula and pedagogy, that continue to privilege white males.

Race, secondary school course of study, and college type.

Race shapes many aspects of students' high school experiences relevant to post-secondary educational attainment. We examine the racially-specific effects of high school course of study on type of college attended, whether two-year or four-year, using NELS 1988-2000 and a comprehensive measure of course intensity derived from students' patterns of course-taking. Results include the presence of racially-specific effects of high school course of study, with racial/ethnic minority students in the middle course intensity ranges more likely to attend four-year college than Whites with similar coursework. Using a theory of racialized meritocracy, we also find that educational expectations mediate the relationships among race, course of study, and post-secondary attendance differently for students of different racial groups, such that they play a larger role in mediating the relationship between course of study and post-secondary attendance for White students.

Chronic drug use confirmed by hair analysis: its role in understanding both the medical cause of death and the circumstances surrounding the death.

Analysis of hair for drugs is now a well established technique. It is being used increasingly in crime investigation but seldom in routine Coroner's toxicology. Hair analysis is the only method of obtaining a reliable drug history for the weeks or months prior to death. Between 2004 and 2006 from the cases reported to HM Coroner, hair was submitted for analysis in addition to the routine specimens for 286 selected cases. These were all cases where drug use was thought to be involved in the death. The usefulness of the data from hair analysis was evaluated along with the data from the conventional samples. The types of cases were identified where hair analysis provided valuable supporting evidence. It was found that reliable information concerning long-term drug use was important in a wide range of cases including: --demonstrating a history of drug use or lack of it, demonstrating tolerance or lack of it, compliance with medication, death due to long-term cocaine use and its role in depression/suicide, sudden unexplained death, and excited delirium. The cases types are illustrated by reference to individual cases and the implications of the findings discussed. The study demonstrated that hair analysis can provide vital evidence in a wide range of cases reported to HM Coroner. This evidence can be invaluable to the pathologist, Coroner, and the family of the deceased in understanding both the medical cause of death and the circumstances surrounding the death.

Peer Contextual Influences on the Growth of Authority-Acceptance Problems in Early Elementary School.

This study investigated the effects of the peer social context and child characteristics on the growth of authority-acceptance behavior problems across first, second, and third grades, using data from the normative sample of the Fast Track Project. Three hundred sixty-eight European American and African American boys and girls (51% male; 46% African American) and their classmates were assessed in each grade by teacher ratings on the Teacher Observation of Child Adaptation-Revised. Children's growth in authority-acceptance behavior problems across time was partially attributable to the level of disruptive behavior in the class-room peer context into which they were placed. Peer-context influence, however, were strongest among same-gender peers. Findings held for both boys and girls, both European Americans and African Americans, and nondeviant, marginally deviant, and highly deviant children. Findings suggest that children learn and follow behavioral norms from their same-gender peers within the classroom.