Recipes for Success: Youth Council Guide to Creating a Youth Development System Under WIA

As we enter the new millennium, several trends exist that are radically changing the way our nation's young people will participate in the workforce. New technologies have opened up new industries and revolutionized our notion of the workplace. A booming economy has contributed to remarkably low unemployment rates. Today's young people can look forward to unprecedented opportunities, but only if they are prepared. Young people with little sense of direction, who do not obtain the knowledge and skills necessary to enter an increasingly complex workplace, will be left behind. The disparity between skilled and unskilled workers will become particularly dramatic in the next decade, when shifting demographics will increase/intensify competition for jobs.Those of us charged with helping young people reach their full potential must re-examine the way in which we prepare them for tomorrow's workplace. The Workforce Investment Act of 1998 provides an excellent opportunity to do just that. WIA authorizes over one billion dollars per year to help low income youth acquire the education, skill, work experience and support they will need to make the transition to productive adulthood.In creating the Youth Councils -- a mandated component of the Workforce Investment Boards -- WIA provides local communities with the framework for developing comprehensive and effective strategies that ensure such successful transitions. The partnerships represented on the Youth Council bring together a diverse set of stakeholders and resources, partners who can address the needs of young people more effectively that any one partner can do alone. Because the leadership provided bythe local Youth Councils will be pivotal in making this initiative work, it is essential that communities compose these Councils with great care.This guide is designed to provide practical information for community leaders, local Workforce Investment Boards (WIBs), Youth Councils, staff and others that are committed to effective youth and workforce development. It contains four sections and several appended exercises.Chapter 1: "Planning the Menu" defines youth development, outlines the basic concepts of making connections for young people (system-building), describes how WIA can make a difference and starts a work plan for Youth Councils.Chapter 2: "Youth Councils: Essential Ingredients" addresses the wide range of Youth Council responsibilities, from organization and staffing to strategic planning and accountability.Chapter 3: "Transition to WIA: From Soup To Nuts" addresses resource allocation decision making, follow-up services, the performance system, selecting service providers and other important administrative decisions.Chapter 4: "Coming Together At the Table" depicts the path ways to comprehensive service delivery based on proven princi ples and practices. The building blocks that are available as the platform for developing a system for young people are described.Youth Councils offer a leadership opportunity for local communities to bring about change in youth activities and outcomes. If communities take advantage of this opportunity, Youth Councils will be in a strong position to stimulate broad-based change, reward innovation, and improve performance in youth development and youth organizations. Communities will need assistance building effective Youth Councils. This guide will provide communities with the help they need to transform the potential of Youth Councils into measurable results, results that will make a profound difference in the lives of our nation's youth

Recipes for Success: Worksheets/Attachments

These attachments and exercises are designed to give Youth Council members and staff an opportunity to take a "hands-on" approach on dealing with complex Youth Council issues. See "Recipes for Success: Youth Council Guide to Creating a Youth Development System Under WIA" for more information

Business not as usual: how multisectoral collaboration can promote transformative change for health and sustainable development.

• We present a model of enabling fac-tors for effective multisectoral collabo-ration for improvements in health and sustainable development. • Drive change: assess whether desired change is better off achieved by mul-tisectoral collaboration; drive forward collaboration by mobilising a critical mass of policy and public attention. • Define: frame the problem strategi-cally and holistically so that all sec-tors and stakeholders can see the benefits of collaboration and contri-bution to the public good• Design: create solutions relevant to context, building on existing mecha-nisms, and leverage the strengths of diverse sectors for collective impact. • Relate: ensure resources for multi-sectoral collaboration mechanisms, including for open communication and deliberation on evidence, norms, and innovation across all components of collaboration. • Realise: learn by doing, and adapt with regular feedback. Remain open to redefining and redesigning the collaboration to ensure relevance, effectiveness, and responsiveness to change. • Capture success: agree on success markers, using qualitative and quan-titative methods to monitor results regularly and comprehensively, and learn from both failures and successes to inform action and sustain gains

The Influence of Manga on the Graphic Novel

This material has been published in The Cambridge History of the Graphic Novel edited by Jan Baetens, Hugo Frey, Stephen E. Tabachnick. This version is free to view and download for personal use only. Not for re-distribution, re-sale or use in derivative works. © Cambridge University PressProviding a range of cogent examples, this chapter describes the influences of the Manga genre of comics strip on the Graphic Novel genre, over the last 35 years, considering the functions of domestication, foreignisation and transmedia on readers, markets and forms

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Logansport, Indiana The City of Bridges

Having two rivers converge in the city called for the construction of several bridges and Logansport became known as the city of bridges. This postcard shows five of them

Molecular Mechanisms Underlying Skeletal Muscle Weakness in Human Cancer: Reduced Myosin-Actin Cross-Bridge Formation and Kinetics

PHYSICAL FUNCTION DETERIORATES substantially following a diagnosis of cancer (3, 48), and patients view this decline as one of the most distressing side effects of the disease, more so than classic side effects such as pain, nausea, and vomiting (13, 60). Functional disability can be the impetus for dose reduction or cessation of anticancer treatments and predicts chemotherapy toxicity and survival (12, 30, 33, 39). Our current understanding of the factors contributing to reduced functional capacity in patients with cancer is, however, severely limited. Physiological changes that occur within the skeletal muscle of patients with cancer can contribute to functional deterioration and physical disability. The most common adaptations believed to promote functional impairment are muscle atrophy, reduced cardiorespiratory fitness, and skeletal muscle weakness (20, 32, 54). The vast majority of studies of muscle biology in cancer have focused on signal transduction mechanisms underlying skeletal muscle atrophy (20). Understanding quantitative alterations in skeletal muscle and their mechanisms is important because they have relevance for physical function (38) and clinical outcome (18), but functional deficits persist after controlling for muscle atrophy (34, 54), and there is compelling evidence to suggest that cancer has a unique effect on the intrinsic functionality of muscle (22). In other words, a substantial proportion of the decline in physical capacity is likely explained by reductions in function per unit tissue size. Skeletal muscle contractile dysfunction has received minimal attention as a precipitant of functional changes in patients with cancer (54, 61), with the majority of studies being focused on cardiorespiratory fitness (32). However, reduced skeletal muscle contractile function is a strong predictor of decreased physical functioning in common daily activities (49) in many studies rivaling or exceeding the contribution attributed to diminished aerobic capacity (8, 51). Additionally, at a more fundamental level, the properties of the contractile elements (i.e., myofilament proteins) determine the functional character of skeletal muscle and, correspondingly, whole-body performance (24, 28, 29). As the end effectors of muscle contraction, myofilament mechanical properties necessarily set limits for muscle functionality (10). To date, no studies have evaluated the effects of cancer on myofilament protein content, structure, or functionality in humans. The goal of this study was to examine the effect of cancer on skeletal muscle contractile function at the molecular, cellular, whole-muscle, and whole-body levels. To accomplish this objective, we evaluated whole-body and whole-muscle performance using standard functional assessments and cellular/molecular structure and function on intact and chemically skinned fibers from the vastus lateralis muscle in patients with cancer and controls. Because cancer-related functional deficits are suggested to be more common in patients experiencing weight loss and during treatment (i.e., chemo/radiotherapy), we included both cachectic and noncachectic patients and patients undergoing cancer treatment. In this context, our cohort does not permit us to address the unique effect of cancer per se, but instead encompasses the effects of the disease, its treatment, and disease- and treatment-related sequelae such as weight loss. However, when discussing our findings, we refer to the effects of cancer for simplicity