In-Service Physical Educators' Experiences of Online Adapted Physical Education Endorsement Courses.

The purpose of this study was to investigate in-service physical education (PE) teachers' experiences during online adapted physical education (APE) graduate courses. Based on andragogy theory (adult learning theory) we employed a descriptive qualitative methodology using an explanatory case study design. The participants (6 female and 3 male) were in-service PE teachers enrolled in an online graduate APE endorsement program. Data collection included journal reflection reports and face-to-face interviews. A constant comparative method was used to interpret the data. Three interrelated themes emerged from the participants' narratives. The first theme, instructor communication, exposes the advantages and disadvantages the participants perceived regarding communication while enrolled in the online APE graduate courses. The second theme, bulletin board discussion experiences, described participants' perceptions of the use of the bulletin board discussion forum. Lastly, the final theme, assessment experiences, described how the participants learned knowledge and skills through online courses related to assessment and evaluation.

NK cell activating receptor ligand expression in lymphangioleiomyomatosis is associated with lung function decline.

Lymphangioleiomyomatosis (LAM) is a rare lung disease of women that leads to progressive cyst formation and accelerated loss of pulmonary function. Neoplastic smooth muscle cells from an unknown source metastasize to the lung and drive destructive remodeling. Given the role of NK cells in immune surveillance, we postulated that NK cell activating receptors and their cognate ligands are involved in LAM pathogenesis. We found that ligands for the NKG2D activating receptor UL-16 binding protein 2 (ULBP2) and ULBP3 are localized in cystic LAM lesions and pulmonary nodules. We found elevated soluble serum ULBP2 (mean = 575 pg/ml ± 142) in 50 of 100 subjects and ULBP3 in 30 of 100 (mean = 8,300 pg/ml ± 1,515) subjects. LAM patients had fewer circulating NKG2D+ NK cells and decreased NKG2D surface expression. Lung function decline was associated with soluble NKG2D ligand (sNKG2DL) detection. The greatest rate of decline forced expiratory volume in 1 second (FEV1, -124 ± 30 ml/year) in the 48 months after enrollment (NHLBI LAM Registry) occurred in patients expressing both ULBP2 and ULBP3, whereas patients with undetectable sNKG2DL levels had the lowest rate of FEV1 decline (-32.7 ± 10 ml/year). These data suggest a role for NK cells, sNKG2DL, and the innate immune system in LAM pathogenesis.