Community Rehabilitation Programs and Organizational Change: A Mentor Guide to Increase Customized Employment Outcomes

[Excerpt] For the purpose of this Guide, customized employment is defined as a process for individualizing the employment relationship between an employee and an employer in ways that meet the needs of both. Customized employment is based on an individualized negotiation between the strengths, conditions and interests of the person with a disability and the identified business needs of the employer or the self-employment business chosen by the job seeker. Job negotiation uses job development or restructuring strategies that result in responsibilities being customized and individually negotiated to fit the requirements of the job

Building school-based social capital through 'We Act - Together for Health' - a quasi-experimental study

Abstract Background Social capital has been found to be positively associated with various health and well-being outcomes amongst children. Less is known about how social capital may be generated and specifically in relation to children in the school setting. Drawing on the social cohesion approach and the democratic health educational methodology IVAC (Investigation – Vision – Action – Change) the aim of this study was to examine the effect of the Health Promoting School intervention ‘We Act – Together for Health’ on children’s cognitive social capital. Method A quasi-experimental controlled pre- and post-intervention study design was conducted with 548 participants (mean age 11.7 years). Cognitive social capital was measured as: horizontal social capital (trust and support in pupils); vertical social capital (trust and support in teachers); and a sense of belonging in the school using questions derived from the Health Behaviour in School Children study. A series of multilevel ordinal logistic regression analyses was performed for each outcome to estimate the effect of the intervention. Result The analyses showed no overall significant effect from the intervention on horizontal social capital or vertical social capital at the six-month follow-up. A negative effect was found on the sense of belonging in the school. Gender and grade appeared to be important for horizontal social capital, while grade was important for sense of belonging in the school. The results are discussed in relation to We Act’s implementation process, our conceptual framework and methodological issues and can be used to direct future research in the field. Conclusion The study finds that child participation in health education can affect the children’s sense of belonging in the school, though without sufficient management support, this may have a negative effect. With low implementation fidelity regarding the Action and Change dimension of the intervention at both the school and class level, and with measurement issues regarding the concept of social capital, more research is needed to establish a firm conclusion on the importance of the children’s active participation as a source for cognitive social capital creation in the school setting. Trial registration https://www.isrctn.com/ISRCTN8520301

Immunodomination during peripheral vaccinia virus infection

Immunodominance is a fundamental property of CD8+ T cell responses to viruses and vaccines. It had been observed that route of administration alters immunodominance after vaccinia virus (VACV) infection, but only a few epitopes were examined and no mechanism was provided. We re-visited this issue, examining a panel of 15 VACV epitopes and four routes, namely intradermal (i.d.), subcutaneous (s.c.), intraperitoneal (i.p.) and intravenous (i.v.) injection. We found that immunodominance is sharpened following peripheral routes of infection (i.d. and s.c.) compared with those that allow systemic virus dissemination (i.p. and i.v.). This increased immunodominance was demonstrated with native epitopes of VACV and with herpes simplex virus glycoprotein B when expressed from VACV. Responses to some subdominant epitopes were altered by as much as fourfold. Tracking of virus, examination of priming sites, and experiments restricting virus spread showed that priming of CD8+ T cells in the spleen was necessary, but not sufficient to broaden responses. Further, we directly demonstrated that immunodomination occurs more readily when priming is mainly in lymph nodes. Finally, we were able to reduce immunodominance after i.d., but not i.p. infection, using a VACV expressing the costimulators CD8+ (B7-1) and CD8+ (B7-2), which is notable because VACV-based vaccines incorporating these molecules are in clinical trials. Taken together, our data indicate that resources for CD8+ T cell priming are limiting in local draining lymph nodes, leading to greater immunodomination. Further, we provide evidence that costimulation can be a limiting factor that contributes to immunodomination. These results shed light on a possible mechanism of immunodomination and highlight the need to consider multiple epitopes across the spectrum of immunogenicities in studies aimed at understanding CD8+ T cell immunity to viruses.NHMRC (National Health and Medical Research Council of Australia

Carotenoid dynamics in Atlantic salmon

BACKGROUND: Carotenoids are pigment molecules produced mainly in plants and heavily exploited by a wide range of organisms higher up in the food-chain. The fundamental processes regulating how carotenoids are absorbed and metabolized in vertebrates are still not fully understood. We try to further this understanding here by presenting a dynamic ODE (ordinary differential equation) model to describe and analyse the uptake, deposition, and utilization of a carotenoid at the whole-organism level. The model focuses on the pigment astaxanthin in Atlantic salmon because of the commercial importance of understanding carotenoid dynamics in this species, and because deposition of carotenoids in the flesh is likely to play an important life history role in anadromous salmonids. RESULTS: The model is capable of mimicking feed experiments analyzing astaxanthin uptake and retention over short and long time periods (hours, days and years) under various conditions. A sensitivity analysis of the model provides information on where to look for possible genetic determinants underlying the observed phenotypic variation in muscle carotenoid retention. Finally, the model framework is used to predict that a specific regulatory system controlling the release of astaxanthin from the muscle is not likely to exist, and that the release of the pigment into the blood is instead caused by the androgen-initiated autolytic degradation of the muscle in the sexually mature salmon. CONCLUSION: The results show that a dynamic model describing a complex trait can be instrumental in the early stages of a project trying to uncover underlying determinants. The model provides a heuristic basis for an experimental research programme, as well as defining a scaffold for modelling carotenoid dynamics in mammalian systems

Prevalence of Jumper's Knee Among Nonelite Athletes From Different Sports A Cross-Sectional Survey

Background: The prevalence of jumper's knee among nonelite athletes from different sports is unknown.Purpose: This study was undertaken to determine the prevalence of jumper's knee in nonelite athletes from different sports and to determine potential risk factors for jumper's knee.Design: Cohort study (prevalence); Level of evidence, 2.Methods: The authors interviewed 891 male and female nonelite athletes from 7 popular sports in The Netherlands: basketball, volleyball, handball, korfball, soccer, field hockey, and track and field. Using a specially developed questionnaire, information was obtained about individual characteristics (age, height, and weight), training background, previous and actual knee problems, and the VISA-P (Victorian Institute of Sport Assessment-Patella) score.Results: The overall prevalence of current jumper's knee was 8.5% (78 of 891 athletes), showing a significant difference between sports with different loading characteristics. Prevalence was highest among volleyball players (14.4%) and lowest among soccer players (2.5%); it was significantly higher among male athletes (51 of 502 [10.2%]) than female athletes (25 of 389 [6.4%]) (chi 2 = 3.91, P = .048). The mean duration of symptoms was 18.9 months (standard deviation [SD], 21.6; median value, 12.0; range, 2.0-59.8). The mean VISA-P score of the athletes with jumper's knee was 71.4 (SD, 13.8). Athletes with jumper's knee were significantly younger, taller, and heavier than those without jumper's knee.Conclusion: Prevalence of jumper's knee is high among nonelite athletes and varies between 14.4% and 2.5% for different sports. Jumper's knee is almost twice as common among male nonelite athletes compared with female athletes. Different sport-specific loading characteristics of the knee extensor apparatus, a younger age, a taller body stature, and higher body weight seem to be risk factors associated with patellar tendinopathy.</p

Menelusuri arus pemeriksaan kesehatan dan pengobatan ke luar negeri

In recent years, a big flow of patients seeking health care abroad occurs in spite of the advancement of science and technology in the health sector in Indonesia, which is not much different than abroad. This situation is less supportive for the trust to the health care and science, and the growth of the domestic economy. To explore this phenomena, a qualitative survey was done to ten people who were pleased to give their written opinion for two open ended questions delivered by email. The results showed a dissatisfied and distrust to the nation’s health care in quality, teamwork, ethics, and facilities. These unfavorable conditions affect the patient’s as well as the family’s health and well-being. Professionalism, multidimensional modernization, and holistic health management are the foreign countries policy, which are respectable values to be considered of. These survey results are valuable inputs in developing the nation’s high quality health services