Employments effects of Vocational Rehabilitation in Germany:A Quantitative Analysis

In this thesis, unique administrative data, a relevant time of follow-up and advanced statistical measures to handle confounding have been utilized in order to provide new and informative evidence on the effects of vocational rehabilitation programs on work participation outcomes in Germany. While re-affirming the important role of micro-level determinants, the present study provides an extensive example of the individual and fiscal effects that are possible through meaningful vocational rehabilitation measures. The analysis showed that the principal objective, namely, to improve participation in employment, was generally achieved. Contrary to the common misconception that “off-the-job training” is relatively ineffective, this thesis has provided an empirical example of the positive impact of the programs

CD8+ and Regulatory T cells Differentiate Tumor Immune Phenotypes and Predict Survival in Locally Advanced Head and Neck Cancer

Background: The tumor immune status “inflamed”, “immune excluded”, and “desert” might serve as a predictive parameter. We studied these three cancer immune phenotypes while using a simple immunohistochemical algorithm. Methods: Pre-treatment tissue samples of 280 patients with locally advanced HNSCC treated with radiochemotherapy were analyzed. A double staining of CD8+ cytotoxic T cells (CTL) and FoxP3+ (Treg) was performed and the cell density was evaluated in the intraepithelial and stromal compartment of the tumor. Results: The classification of tumors as “immune desert” when stromal CTL were ≤ 50 cells/mm2, “inflamed” when intraepithelial CTL were > 500 cells/mm2, and as “excluded” when neither of these definitions met these cut off values allowed the best discrimination regarding overall survival. These groups had median OS periods of 37, 61, and 85 months, respectively. In “immune desert” and “immune excluded” tumors high Treg tended to worsen OS, but in “inflamed” tumors high Treg clearly improved OS. Conclusions: We propose that, in locally advanced HNSCC, the tumor immune state “inflamed”, “immune excluded”, and “immune desert” can be defined by intraepithelial and stromal CTL. Tregs can further subdivide these groups. The opposing effects of Tregs in the different groups might be the reason for the inconsistency of Tregs prognostic values published earlier

Osteopatisk behandling ved irritabel tarmsyndrom

Hensikt: De siste to tiår har irritabel tarmsyndrom fått stor oppmerksomhet hos helsepersonell verden over på grunn av sin høye prevalens. Irritabel tarmsyndrom rammer 10-20% av verdens befolkning og det er en stor økonomisk belastning for samfunnet. I dag består behandling stort sett av kostholdsråd kombinert med medikamentbruk og stressmestring, men alternativ behandling er foreslått. På bakgrunn av dette er hensikten å finne ut hvordan osteopatisk behandling kan bidra til bedre livskvalitet hos pasienter med irritabel tarmsykdom. Metode: Oppgaven er en litteraturstudie som totalt inkluderer fire artikler. Studiene er ulike typer randomiserte kontrollerte studier. De inkluderte artiklene omhandler osteopatisk behandling av pasienter med irritabel tarmsyndrom hvor pasientene er diagnostisert med evalueringskriteriene Rome. Pasienter med andre organiske sykdommer og tidligere abdominal kirurgi er utelukket. Resultat/ Diskusjon: Resultatene fra de fire studiene viser noe varierende utfall. De fant i ulik grad assosiasjoner på at osteopatisk behandling kan være med å bidra til bedre livskvalitet for pasienter med irritabel tarmsyndrom. Enkelte symptomer samt velvære ser ut til å kunne bedres ved hjelp av osteopatisk behandling. Andre behandlingsmetoder er også vist å fungere, i mer eller mindre grad. Usikkert er det om hva som kan fungere for hver pasient og i hvilke kombinasjoner. Foreløpig finnes det ikke én enkelt tilfredsstillende behandlingsmetode. Konklusjon: Alle studiene viser til bedring av ulike symptomer for pasienter med irritabel tarmsyndrom. I tillegg tenderer flere av studiene til at livskvalitet kan økes ved hjelp av osteopatisk behandling. På bakgrunn av ufullstendige svar for å avklare om osteopatisk behandling kan bidra til bedre livskvalitet hos pasienter med irritabel tarmsyndrom, må det flere studier til for mer og bedre forskning. Det er usikkert hvordan osteopatisk behandling kan bidra til bedre livskvalitet hos pasienter med irritabel tarmsyndrom

FoxP3+ T regulatory cells in cancer : prognostic biomarkers and therapeutic targets

T Regulatory cells (Tregs) can have both protective and pathological roles. They maintain immune homeostasis and inhibit immune responses in various diseases, including cancer. Proportions of Tregs in the peripheral blood of some cancer patients increase by five-to ten-folds, compared to those in healthy individuals. Tregs contribute to cancer development and progression by suppressing T effector cell functions, thereby compromising tumor killing and promoting tumor growth. Highly immunosuppressive Tregs express upregulated levels of the transcription factor, Forkhead box protein P3 (FoxP3). Elevated levels of FoxP3+ Tregs within the tumor microenvironment (TME) showed a positive correlation with poor prognosis in various cancer patients. Despite the success of immunotherapy, including the use of immune checkpoint inhibitors, a significant proportion of patients show low response rates as a result of primary or acquired resistance against therapy. Some of the mechanisms which underlie the development of therapy resistance are associated with Treg suppressive function. In this review, we describe Treg contribution to cancer development/progression, and the mechanisms of Treg-mediated immunosuppression. We discuss the prognostic significance of FoxP3+ Tregs in different cancers and their potential use as prognostic biomarkers. We also describe potential therapeutic strategies to target Tregs in combination with other types of immunotherapies aiming to overcome tumor resistance and improve clinical outcomes in cancer patients. Overall, understanding the prognostic significance of FoxP3+ Tregs in various cancers and their contribution to therapeutic resistance could help in the development of more effective targeted therapeutic strategies to enhance the clinical outcomes in cancer patients

Göttinger „Universitätsverwandte im weiteren Sinne“ als Akteure im britisch-deutschen Kulturtransfer des 18. und frühen 19. Jahrhunderts

Softcover, 17x24Die Universität Göttingen hatte als Neugründung zur Zeit der hannoversch-britischen Personalunion von Beginn an eine besondere Verbindung zu Großbritannien, das als kulturell etablierte Nation im 18. Jahrhundert auch zunehmend ins Blickfeld der deutschen Bildungselite geriet. Da jedoch nur wenige Deutsche über Kenntnisse der englischen Sprache verfügten, wurden Übersetzungen entscheidend für den Zugang zu britischem Wissen. Buchhändler und Übersetzer wurden zu kulturellen Vermittlern. Angehörige beider Gruppen - insbesondere weibliche - verfügten oft über eine umfangreiche, doch nicht institutionalisierte Bildung. In der Universitätsstadt Göttingen trafen sie auf interkulturell interessierte und oftmals anglophile Gelehrte, mit denen sie Arbeitsbeziehungen ganz unterschiedlicher Art eingingen. Die Untersuchung beleuchtet die Arbeit von sechs sogenannten „Universitätsverwandten im weiteren Sinne“. Dieser Ausdruck bezeichnete den offiziellen Status der Universitätsbuchhändler und wurde hier auch für drei Übersetzerinnen übernommen, die als Töchter von Göttinger Professoren ebenfalls als „universitätsverwandt im weiteren Sinne“ bezeichnet werden können. Der Fokus der Untersuchung liegt auf der Art der Kooperation dieser „Zwischenhändler des Wissens“ mit den Mitgliedern der Gelehrtenrepublik bei der Verbreitung des Schrifttums der Aufklärungszeit sowie der Frage, wie die zeitgenössische ambivalente Auslegung des Gleichheitsgedankens diese Kooperation beeinflusste.As a newly founded university at the time of the personal union between Hanover and Great Britain, the University of Göttingen had a special connection to Britain from the very beginning. As a culturally established nation, Britain also increasingly came into the focus of the German educational elite in the 18th century. However, since few Germans had any knowledge of English, translations became crucial for access to British knowledge Booksellers and translators became cultural intermediaries. Members of both groups - especially females - often had an extensive, but not institutionalized, education. In the university city of Göttingen, they met scholars who were interculturally interested and many of whom were Anglophiles. With these scholars, booksellers and translators established working relationships of very different kinds. The study sheds light on the work of six so-called "Universitätsverwandte im weiteren Sinne (university relatives in a broader sense)". This term referred to the official status of university booksellers and was adopted here for three female translators who, as daughters of Göttingen professors, can also be described as "university-related in a broader sense" The study focuses on the nature of the cooperation between these 'middlemen of knowledge' and the members of the scholars' republic regarding the distribution of Enlightenment-era literature, and on the question of how the ambivalent interpretation of the idea of equality at the time influenced this cooperation

Pre Post differences in labor market outcomes for participants of vocational rehabilitation in Germany

Persons with disabilities have much lower employment rates than the population as a whole and are at a significantly higher risk of living in poverty (OECD, 2011, pp. 50-56 and WHO, 2011, pp. 237-239). However, many of the barriers people with disabilities face, with regards to labor market reintegration, are in fact avoidable. There has for quite some time been evidence that differences in employment and wages, between disabled and non-disabled workers, can only to a limited extent be explained by differences in human capital endowments and productivity (Kidd, Sloane, & Ferko, 2000). Instead, factors such as the absence of access to education and training, and the lack of financial assistance provided are actually significant drivers of labor market exclusion (OECD, 2009, p.15; WHO, 2011, p.239)

The Return on Work Reintegration

Die Diskussion um die Nachhaltigkeit von Dienstleistungen im öffentlichen Sektor steht in einem engen Zusammenhang mit der Frage, ob sich der Einsatz finanzieller Mittel für die Beteiligten lohnt. Daher besteht ein breites Interesse, herauszufinden, ob der Nutzen von Rehabilitationsarbeit auch finanziell messbar ist, und falls ja, wie hoch das ökonomische Potential der Investitionen ist. Um diese Frage zu beantworten, ist es notwendig Leistungen sowie die dadurch anfallenden Ausgaben statistisch zu erfassen und in einem ökonomischen Modell zu bewerten