Successful Transition Research Articles

Effectiveness of transitional care in Inflammatory Bowel Disease; Development, Validation, and Initial outcomes of a Transition Success Score.

The effectiveness of transition programs from paediatric to adult healthcare in adolescents with inflammatory bowel disease is not clear, as prospective studies using validated outcome measures for transition are lacking. This study aimed to develop and validate a quantitative Transition Success Score, and to apply it in a multicenter setting to assess the effectiveness of transitional care. The Top 10 outcome items related to successful transition, identified through an international Delphi study with IBD stakeholders, were integrated into a generic questionnaire, the Transition Success Score. In a prospective, multicenter study, Transition Success Score was scored by adult healthcare providers, young adult patients and caregivers, 9-15 months after transfer of care. In seven Dutch hospitals, 160 patients completed the Transition Success Score. The mean score was 25 (range 17-27), 25.6% of patients achieving maximum score. Hypothesis testing for construct validity revealed significant associations with characteristics related to transitional care, such as knowledge, independence, and quality of life (p <0.005). Structural validation indicated the score was most effective at discerning lower levels of transition success. Internal consistency was acceptable (0.64). High disease burden, exacerbation during or after transfer, and certain personality profiles were associated with lower scores. The Transition Success Score serves as a quantitative tool to evaluate the effectiveness of transitional care interventions and to identify inflammatory bowel disease patients at risk of encountering challenges during the transition to adult healthcare.

Institutional Quality and Economic Growth in the Energy Transition of MENA Countries

This paper investigates the energy transition in MENA region countries, emphasizing the pivotal role of institutional quality and its impact on economic growth. It explores the interactions between institutional quality, energy transition initiatives, and economic growth, aiming to understand how strong institutions can facilitate a successful transition. The empirical analysis employs a simultaneous equations model to identify institutional factors that can either support or hinder the energy transition and its influence on economic growth. The findings provide valuable insights for policymakers and economic stakeholders, underscoring the critical importance of robust institutions in driving the energy transition process and stimulating economic growth in the MENA region from 2000 to 2022.

Reinforcement Learning for EV Fleet Smart Charging with On-Site Renewable Energy Sources

In 2020, the transportation sector was the second largest source of carbon emissions in the UK and in Newcastle upon Tyne, responsible for about 33% of total emissions. To support the UK’s target of reaching net zero emissions by 2050, electric vehicles (EVs) are pivotal in advancing carbon-neutral road transportation. Optimal EV charging requires a better understanding of the unpredictable output from on-site renewable energy sources (ORES). This paper proposes an integrated EV fleet charging schedule with a proximal policy optimization method based on a framework for deep reinforcement learning. For the design of the reinforcement learning environment, mathematical models of wind and solar power generation are created. In addition, the multivariate Gaussian distributions derived from historical weather and EV fleet charging data are utilized to simulate weather and charging demand uncertainty in order to create large datasets for training the model. The optimization problem is expressed as a Markov decision process (MDP) with operational constraints. For training artificial neural networks (ANNs) through successive transition simulations, a proximal policy optimization (PPO) approach is devised. The optimization approach is deployed and evaluated on a real-world scenario comprised of council EV fleet charging data from Leicester, UK. The results show that due to the design of the rewards function and system limitations, the charging action is biased towards the time of day when renewable energy output is maximum (midday). The charging decision by reinforcement learning improves the utilization of renewable energy by 2–4% compared to the random charging policy and the priority charging policy. This study contributes to the reduction in battery charging and discharging, electricity sold to the grid to create benefits and the reduction in carbon emissions.

Translational horizons in stem cell therapy for osteonecrosis of the femoral head: a journey from basic research to clinical practice through bibliometric insights

BackgroundOsteonecrosis of the femoral head (ONFH) significantly impacts young and middle-aged adults, with steroid use implicated in many cases. Traditional treatments have limited efficacy, prompting a shift towards innovative approaches, such as stem cell therapy, offering less invasive regenerative solutions.MethodsUsing bibliometric analysis from 1997 to 2023, we identified 392 articles on stem cell therapy for ONFH from the Web of Science Core Collection and analysed them using VOSviewer and CiteSpace to identify key trends and research directions.ResultsFrom 1997 to 2023, stem cell therapy for ONFH research expanded significantly, with 392 articles evidencing global collaboration, particularly from China, the United States and South Korea. The field is characterised by 158 core authors across 26 clusters and contributions from 417 institutions in 104 research clusters, with Shanghai Jiao Tong University as a notable leader. This research is disseminated through 23 journal clusters, emphasising interdisciplinary work, with Clinical Orthopaedics and Related Research among the most influential journals. Key findings include the identification of the most influential papers, highlighting advances, such as use of autologous mesenchymal stem cells (MSCs) and innovative delivery mechanisms. High-frequency keyword analysis further mapped the evolution of the field, from basic mechanisms to advanced therapies, underscoring a trend towards more targeted stem cell treatments for ONFH.ConclusionStem cell therapy for ONFH has advanced significantly, showcasing a successful transition from basic research to clinical practice, particularly highlighted by developments in use of autologous MSCs and delivery methods. Future research will focus on refining therapies through exosome technology, targeted modulation of stress and inflammation and integration with surgical techniques, with the aim of tailored patient care and improved ONFH outcomes.

Determinants of successful transition from adolescent to adult HIV treatment in Zambia: a facility-level based comparative study

Background: Successful transition from adolescent to adult care has not been extensively evaluated, in Zambia. The study aimed to assess the relationship between facility-based socio-demographic traits and successful transition to adult HIV care, in Zambia. Methods: A retrospective descriptive cross-sectional analysis of 7275 patient files from 718 PEPFAR sponsored facilities. Data was extracted from the National Electronic Health Record (EHR) system and imported into STATA SE v-16 for analysis. Descriptive statistics were calculated on socio-demographic features and facility-level performance. Logistic regression was used to analyse the association between level of facility and successful transition to adult care, comparing third level facilities to lower-level facilities. Chi-square was employed to evaluate the association between socio-demographic traits and effective transition outcomes at a significance level of 0.05. Results: 43.2% had successfully transitioned to adult care. Health posts performed the best, with 57.3% of patients successfully transitioning to adult care. The study found that health post type, private ownership, rural location, and province were significant factors in successful transition. Adolescents in lower-level facilities had a 59.9% success rate compared to those in third-level facilities. Conclusions: The study stresses the importance of health system structure and posits that successful transition depends on many factors, not simply adolescent traits.

Navigating transitions into, through, and beyond peer worker roles: insider insights from the Supporting Harm Reduction through Peer Support (SHARPS) study

BackgroundPeer workers are individuals who draw on their personal experiences in a professional capacity to support clients. Existing research on the role of peer workers in mental health, homelessness, and substance use services has primarily focused on their impact on client outcomes. This paper describes the development of peer workers as they transition into, through, and beyond this role. Utilising data from the Supporting Harm Reduction through Peer Support (SHARPS) study, where Peer Navigators supported people experiencing homelessness and substance use challenges, this paper explores the sense-making involved in an intensive peer support worker role, adaptation to organisational culture, and engagement with opportunities for professional advancement.MethodsSemi-structured interviews with three Peer Navigators were conducted by two SHARPS study researchers at four time points in 2018 and 2019 corresponding with the beginning, middle, and end of the intervention. These data were analysed along with entries from the three Peer Navigators’ reflective diaries. Analysis followed a multi-stage approach to thematic analysis utilising both inductive and deductive processes. The Peer Navigators’ personal reflections have also been incorporated into the recommendations.ResultsThe foundational training provided to the Peer Navigators before taking up their role helped to ensure readiness and build confidence. This training illuminated the dynamics of supporting individuals with complex health and social challenges. Integrating into diverse organisational environments, the Peer Navigators adapted to new professional expectations and consistently advocated for harm reduction and psychologically informed approaches, sometimes encountering resistance from other professionals. Establishing effective relationships with participants and professionals was essential and involved dealing with challenges such as overcoming personal biases and navigating systemic obstacles. the Peer Navigators benefitted from the specially designed training to support career progress with personal and professional development opportunities which enabled successful transitions beyond the SHARPS study.ConclusionsPre-work training, coupled with support and adherence to key principles, enabled the Peer Navigators to integrate effectively into diverse organisations. Quality relationships were vital in achieving client outcomes and supporting the professional growth of the Peer Navigators. These findings are important for services employing peer workers and underscore the importance of a commitment to training and continuing professional development.

Iterative Function Allocation of Single Pilot Operations Based on Biclustering Method

The successful transition from a two-pilot to a single-pilot mode cannot solely rely on simply augmenting advanced automation in the cockpit. The degree of support provided by functions at different levels of automation varies, and introducing new functions simultaneously brings new demands for the single pilot, leading to imbalanced workload. To address these shortcomings and enhance the rationality of function allocation under workload constraints, this paper introduces an iterative function allocation method. Initially, the functions are categorized and classified into different levels of automation to obtain the initial function allocation scheme. Subsequently, a novel bicluster mining algorithm called K-Miner is proposed to identify elements requiring iterative design. As a case study, the multitask surface scenario in SPO is considered. By applying the proposed iterative design method, the task performance of the single pilot is improved, the workload of the single pilot is effectively reduced, and situational awareness is improved to a certain extent.

A new playbook: preparing young team athletes for diverse futures

This article highlights innovative approaches to the development of young athletes in team sports, focusing on strategies that facilitate a successful transition to adulthood. Through a systematic review of the literature in high-impact databases, we investigate the role of positive development, the promotion of transferable skills, the fostering of a growth mindset, and the importance of diversity and inclusion in the sports context. We observe the need for athlete-centered approaches that emphasize autonomy, the development of technical, tactical, and cognitive competencies, and the importance of socio-emotional skills such as leadership, teamwork, and resilience. Another important factor found was the relevance of constructive feedback and effective communication in optimizing learning and improving sports performance. Therefore, the implementation of these innovative strategies in teaching and training contributes to the holistic development of young athletes, preparing them not only for sports success but also for facing future challenges in adult life. This study offers significant insights for researchers, coaches, and educators involved in the sports development of young athletes, highlighting the need for integrated and athlete-centered approaches to promote positive development and a successful transition to adult life.

Challenges in transitioning from adolescent to Adult Mental Health Services for young adults with ADHD in Italy: an observational study.

Ensuring a successful transition to Adult Mental Health Services (AMHS) is fundamental for attention deficit/hyperactivity disorder (ADHD) patients to prevent adverse scenarios in adults (e.g., psychiatric disorders, substance or alcohol abuse). Yet, most European nations do not have appropriate transition guidelines and still fail to adequately support transition processes. This study aims to enquire about the current transition paths in Italy and the perceived experiences of the patients and their clinicians. The present observational study collected 36 interviews with young adults with ADHD who turned 18 between 2017 and 2021. Simultaneously, two questionnaires were filled in by the clinicians (both from paediatric and AMHS) who were involved in their transition paths. These tools collected information about the transition process, the services that cared for the young adults and well-being indicators such as impairment in daily life, employment status and the presence of sentinel events (e.g., critical stage accesses to the emergency room or hospitalizations). Successful and failed referrals were analysed. A referral to an AMHS was attempted for 16 young adults (8 before age 18 and 8 when turning 18), and 8 patients (22.2% overall) were successfully taken into the care of the AMHS. Twenty patients were not referred since it was deemed unnecessary (N = 6) or because of the lack of specialized services or compliance (N = 14). At the time of the interview, only nine participants were still under AMHS care. Of eleven individuals with a high need for care (identified by the level of impairment, support needs or sentinel events), five were not followed by a mental health professional at the time of the interview. For the majority of ADHD young adults, a transition path was never started or completed. While this is partly due to mild levels of impairment, in many cases it was difficult to find a service that could care for the adult patient. Only one out of four young adults are successfully transferred to AMHS care. Creating or improving evidence-based transition guidelines should be a priority of the public health system to ensure healthcare for as many patients as possible. The results of this study will converge towards the need for recommendations for the transition of services from adolescence to adulthood for young people with ADHD for Italian clinical practice.

03 Best practice for transition from paediatric complex pain care: A scoping review

Abstract Background Many adolescent and young adults (AYA) experiencing chronic pain often continue to have pain in adulthood and thus must make the transition from paediatric care to adult care. Persistent pain and disability due to chronic pain throughout young adulthood can disrupt the attainment of important developmental milestones at transition to adulthood that impact quality of life. Inadequate transition planning may be associated with poor health outcomes and increased health utilization. However, only few studies have described the specific transition protocol from paediatric to adult care that AYA with chronic pain must make. Objectives To improve understanding of transitional care needs during transition planning and after transition (quality of care), this paper will determine known barriers to successful transition from paediatric chronic pain care to adult care as well as factors associated with successful transition from paediatric multidisciplinary paediatric chronic pain care, identify patient care needs at transition from paediatric chronic pain care, and finally describe the best practice (existing frameworks) to support youth at transition from paediatric chronic pain care. Design/Methods This scoping review used previously published Arksey and O’Malley framework and followed the PRISMA guidelines. It sought to answer the following questions. What are the barriers to successful transition and what factors are associated with successful transition from paediatric chronic pain care to adult care? What are patient care needs at transition from paediatric chronic pain care? How can we best support youth at transition from interdisciplinary paediatric chronic pain care? A literature search was carried on Ovid Medline and 12 studies (11 research articles and 1 dissertation) published from 2015 to 2022 were included in the review, with only one theoretical transition framework that may be useful in the Canadian healthcare setting. Results In this scoping review, interpersonal, organizational, and systemic barriers and enablers for successful transition were identified. The most frequently identified barriers to successful transition include lack of self-efficacy, trust, communication, coordination of care between paediatric and adult care. A need of early transition, an individualized approach, fluid and dynamic transition process, and age-appropriate resources were identified as primary patient care needs during transition. Four frameworks supporting transitional care for AYA with chronic health conditions were identified. Conclusion Limited evidence suggests that there is lack of standardized transition protocol for clinical use. There is an urgent need for an evidence-based transition tools for clinical use for AYA with chronic pain.

Empowering Student Transition and Engaging Students Using Actionbound: A Gamified Collaborative Community Learning Platform

Transition to University is a significant milestone for students who are embracing new experiences and challenges. It is particularly vital for international students who have to adapt to a new and different learning environment in the UK. Successful transition and sense of belonging in a new institution lay foundation for students’ academic success. However, transition is a process rather than an event. Accordingly, fostering a collaborative community learning environment and facilitate peer networks and community support becomes critical. It enables social interactions and active learning by engaging students in collaborative group activities, which would in turn support students’ transition to and belonging in a new learning environment. With the advancement of technology, computer-assisted and computer-supported collaborative learning flourished in 21st century. The emergence of mobile digital technology leads to the design of gamification in learning, known as game-based learning or gamified collaborative community learning in order to engage students in fun and interactive activities. ‘Actionbound’ is one of the versatile gamification platforms and mobile apps which can engage students in collaborative community learning with gamified activities. It enables users to create, share and participate in interactive scavenger hunts, tours, games and quizzes. It allows users to design custom challenges, incorporate multimedia content and track players’ progress in real-time. It engages participants to work collaboratively to solve challenges and complete tasks. At UHBS, we have used Actionbound to support the student transition into the University’ learning journey at the start of term. We used scavenger hunt game and quiz functions within Actionbound to direct students to collaborate in teams to solve the challenges and tasks. In this action research, students found Actionbound fun and loved the competitive nature with points and leaderboards. It helped them build network and form friendship. Together, they solved puzzles and tackled challenges which supported their transition and got them prepared for learning in a new environment. Moving forward, as an ongoing action research, we would like to extend the use of Actionbound to term time and in module delivery so to track students’ engagement with the collaborative learning platform and investigate the impact on their academic performance.

Operationalizing critical success factors of employee ownership using principles of learning management

ABSTRACT The importance of employee-owned (EO) organizations around the world is increasing. Countries, communities and organizations are realizing that passing profits to workers increases wealth at all levels of society. The benefits, widely known, include personal prosperity, organizational profitability and stability, and a host of economic benefits for communities in which EO companies operate. Selling a company to employees, or starting a cooperative organization containing worker owners, is not without risk. New skills are required for the company to reap the rewards inherent in EO organizations, but the method of creating this change varies significantly from one organization to another. Each is unique, but there are some factors that are common to most EO organizations that have achieved a dynamic organizational culture. These factors, which are critical for success, can be isolated using structured research, organized through a lens of general systems theory and operationalized using principles of Learning Management (LM). The result is an organized knowledge transfer plan that maximizes resources and provides the highest probability of a successful transition to a uniquely profitable EO company.

Junior to senior transition of male elite junior tennis players: A retrospective study.

This study explores the intricate dynamics of the Junior-to-Senior (JTS) transition phase in elite tennis. Focusing on challenges faced by young talents, the research aims to unveil factors influencing successful transitions and the role of elite junior tournaments. In a retrospective analysis, male tennis players (n = 240) from national teams in the ITF World Junior Tennis Finals tournament (2012-2016) were analyzed using Chi-square tests, Cramer's V, Bayesian statistics, and Multinomial Logistic Regression (MLR). Results revealed that 62.1% of elite junior participants were found in the Association of Tennis Professionals database, emphasizing the significance of team nominations and tournament results as important variables to monitor. Inferential and Bayesian statistics confirmed robustness, with MLR highlighting tournament results' importance. The findings highlight the complexities of the JTS transition and underscore the pivotal roles of participation, national team nominations, and tournament results. The study recommends the implementation of comprehensive player development programs, urging strategic team selections by national federations and academies. Coaches, stakeholders, and organizations should prioritize monitoring these variables for early talent identification and support. These measures collectively aim to optimize success trajectories, navigating the critical JTS phase in junior tennis players' sporting careers.

Neurally Adjusted Ventilatory Assist to Monitor Diaphragmatic Activity in Infantile Botulism.

Infantile botulism is a potentially life-threatening neuromuscular disorder. It presents with descending paralysis that can involve the diaphragm and cause respiratory failure. Neurally adjusted ventilatory assist (NAVA) provides synchronized bilevel positive pressure by using electrical diaphragmatic (Edi) signals. Diaphragmatic paresis is thought to be a contraindication for using NAVA. However, the use of a NAVA catheter allows continuous assessment of diaphragm activity in infantile botulism. We discuss a case of infantile botulism in an infant from central Pennsylvania who presented with poor oral feeding, hypothermia, and lethargy and progressed to develop apnea and acute respiratory failure. The infant was intubated and mechanically ventilated. A diagnosis of infantile botulism was confirmed through the detection of botulinum toxin in the infant's stool, and the infant was treated with botulism immune globulin neutralizing antibodies. During his recovery phase, a NAVA catheter was placed, which allowed monitoring of Edi signals to gauge the return of diaphragm activity and to assist with the assessment of extubation readiness. We describe the trends in this infant's Edi signals following administration of globulin neutralizing antibodies and the successful transition to invasive, and subsequently, noninvasive NAVA. Our report demonstrates the clinical utility of monitoring diaphragmatic activity using a NAVA catheter and that NAVA provided adequate respiratory support to an infant during the recovery phase of infantile botulism.

Discharge Communication and the Achievement of Lifestyle and Behavioral Changes Post-Stroke in the Transitions of Care Stroke Disparities Study

Objectives: This study identifies the association between patient perception of discharge education/resources and adequate transitions of care (ATOC) (i.e., patient achievement of at least 75% of recommended positive behaviors and activities within 30 days post-stroke hospitalization). Methods: The analysis measured the association between sufficient discharge communication (SDC) (i.e., patient receipt of sufficient diet education, sufficient toxic habit cessation education, if applicable, and scheduled medical follow-up appointment) and ATOC within 30 days post-discharge overall and by race/ethnicity [non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic] in the Transitions of Care Stroke Disparities Study (TCSD-S) (2018-2023). Results: In our sample (N = 1151, Average Age 64+/−14 years, 57% Men, 54% NHW, 24% NHB, 23% Hispanic), 31% overall, as well as 22% of NHW, 43% of NHB, and 41% of Hispanics reported SDC. After covariate adjustment, patients reporting SDC had increased likelihood of accomplishing ATOC when compared to patients not reporting SDC overall (OR = 1.97; 95% CI: 1.42-2.74) and among NHW (OR = 2.76; 95% CI: 1.64-4.64) and NHB (OR = 2.29; 95% CI: 1.16-4.53). The association among Hispanic participants was not statistically significant. Conclusion: Our findings reinforce the importance of providing quality communication to patients to ensure a successful transition of care from hospital to home or rehabilitation facility.

SaaS-Based reporting systems in higher education: A digital transition framework for operational resilience

The rapid digital transformation in higher education necessitates innovative solutions to enhance operational resilience. Software as a Service (SaaS)-based reporting systems emerge as pivotal tools that facilitate data-driven decision-making and streamline institutional processes. This abstract presents a digital transition framework for integrating SaaS-based reporting systems in higher education institutions, emphasizing their role in improving efficiency, accessibility, and adaptability in an increasingly complex educational landscape. SaaS-based reporting systems provide scalable solutions that allow higher education institutions to collect, analyze, and report data in real-time, fostering transparency and accountability. By leveraging cloud technology, these systems enable users to access critical information from anywhere, thereby promoting collaborative decision-making across departments. The framework proposed in this study outlines essential components for a successful transition to SaaS-based reporting, including stakeholder engagement, data governance, and change management strategies. The implementation of SaaS reporting systems not only enhances operational efficiency but also supports institutional goals related to student success, faculty performance, and resource allocation. With robust data analytics capabilities, institutions can identify trends and make informed decisions, ultimately leading to improved academic outcomes and resource utilization. Furthermore, the adaptability of SaaS solutions allows institutions to respond effectively to changing regulatory requirements and emerging educational trends. Challenges associated with the transition to SaaS-based reporting systems include concerns regarding data security, integration with existing systems, and the need for training faculty and staff. The proposed framework addresses these challenges by emphasizing the importance of a comprehensive implementation strategy that includes risk assessment, user training, and continuous support. In conclusion, adopting SaaS-based reporting systems within a structured digital transition framework can significantly enhance operational resilience in higher education institutions. By embracing these technologies, institutions can not only improve their reporting capabilities but also foster a culture of innovation and responsiveness to the evolving educational environment. Keywords: Saas-Based Reporting Systems, Higher Education, Digital Transition Framework, Operational Resilience, Data-Driven Decision-Making, Cloud Technology, Stakeholder Engagement, Data Governance.

Assessing predictors of successful transition services for students with disabilities in Saudi Arabia

This study examines the factors that predict successful transition outcomes for college students with impairments in Saudi Arabia. A stratified random sample method was employed to survey 500 people across various educational levels and disability categories. The efficacy of Individualized Education Plans (IEPs), cultural variables, and perceptions of transition services have been investigated using Structural Equation Modeling (SEM). The study revealed significant positive correlations between the efficacy of Individualized Education Programs (IEPs) and favourable impressions of transition services. Additionally, it highlighted the impact of cultural variables on transition results. The assessment of indirect effects confirmed that cultural variables partially mitigate the connection between IEPs and transition assistance. The document provides practical suggestions for enhancing the efficiency of Individualized Education Programs (IEPs), improving cultural proficiency among educators, facilitating collaboration among stakeholders, and guiding policies. These findings contribute to ongoing efforts to develop inclusive and culturally appropriate transition programs for students with impairments in Saudi Arabia.

Operationalization of ESG-Integrated Strategy Through the Balanced Scorecard in FMCG Companies

The increasing focus on sustainability and climate change mitigation necessitates that corporate strategies not only build competitive advantage but also contribute to the creation of sustainable operations. The purpose of the article is to present, based on the analyses of the development of the strategic targets of leading Fast-Moving Consumer Goods (FMCG) companies, a method for operationalizing an ESG-adapted corporate strategy within FMCG companies using the Balanced Scorecard (BSC). ESG, encompassing environmental, social, and governance factors, requires a shift in both strategic management theory and practice. The author explores how ESG metrics can be integrated into the traditional BSC framework alongside financial, customer, and business processes and learning and growth perspectives to align with the growing importance of sustainability. The study identifies specific measures that contribute to a successful transition toward sustainable business practices. The findings demonstrate that the BSC, when adapted to incorporate ESG considerations, is an effective tool for strategy implementation and operational management in FMCG companies. While the proposed framework focuses on the FMCG sector, it has potential applications across other industries. The article makes important theoretical contributions, though it would benefit from further empirical research, sector-specific comparisons, and a more detailed examination of external ESG factors that impact corporate strategy.

ASLO Opportunities for Students and Early Career Professionals in Aquatic Sciences

AbstractStudents and early career researchers/professionals (ECRs) must increasingly acquire a variety of skills and expand their collaborative networks to become more competitive as they apply for jobs and grants. Funding for skills training and overall availability of opportunities can, however, pose a challenge to this career plan. The Association for the Sciences of Limnology and Oceanography (ASLO) is proud to support the professional development of member and non‐member students and ECRs by offering a myriad of skill‐building programs. These include opportunities to: receive mentoring, travel to ASLO events, expand networks, conduct outreach projects, research exchanges, and internships, better understand scientific publishing, and exercise leadership within the society. In addition, ASLO recognizes the contribution of member students and ECRs to their communities, field, and to the society. Participation in ASLO‐sponsored programs can, thus, assist in the successful transition of students to ECRs, and of ECRs to independent researchers.

Dual prostacyclin infusions: A case report of a patient symptom-driven transition from high-dose intravenous epoprostenol to subcutaneous treprostinil for the treatment of pulmonary arterial hypertension.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. A case of successful transition from high-dose epoprostenol to high-dose subcutaneous treprostinil for treatment of pulmonary arterial hypertension (PAH) is reported. PAH is a chronically progressive disease characterized by pulmonary artery luminal narrowing that causes increased pulmonary artery pressures leading to right ventricular failure. Parenteral prostacyclin analogues, such as epoprostenol and treprostinil, are direct vasodilators and are cornerstones of therapy for patients with severe disease that have been proven to reduce mortality and increase exercise tolerance. These agents must be administered continuously via intravenous or subcutaneous devices and are high-risk medications due to their potent vasodilatory actions. Chronic use of these medications requires constant attention from both providers and patients because of potential complications including central venous catheter infection, thromboembolism, therapy interruptions, and other undesirable consequences. This case report describes management of a 35-year-old male patient on high-dose outpatient intravenous epoprostenol (101ng/kg/min; dosing weight, 47kg) for treatment of PAH who was admitted to the hospital with a malfunctioning central venous catheter. Surrounding manipulation of the central catheter, the patient experienced an ischemic stroke that led to cognitive disability resulting in a lack of ability to manage his previously used home infusion device. The patient was successfully transitioned from intravenous epoprostenol to subcutaneous treprostinil (discharge dose, 200ng/kg/min) over 5 days by infusing both medications simultaneously and adjusting doses based upon patient-reported symptoms. This successful transition from high-dose epoprostenol to high-dose subcutaneous treprostinil demonstrates the importance in considering patient-specific factors during high-risk medication transitions, the value of a patient-directed flexible prostacyclin transition plan, and the benefit of institutional training and education in ensuring the safe use of parenteral prostacyclin analogues.