Gesundheitsbildung und naturwissenschaftlicher Unterricht: Eine Win-win-Situation

Zusammenfassung: Hintergrund: Gesundheitsbildung und naturwissenschaftlicher Unterricht werden in der Schule auf allen Stufen noch wenig in Zusammenhang gebracht. Das Konzept der Gesundheitskompetenz (Health Literacy) schafft einen starken Bezug zum naturwissenschaftlichen Unterricht und eröffnet so die Chance, die in den vergangenen Jahrzehnten kulturell und historisch gewachsene Kluft zur Gesundheitsförderung zu schließen. Ziel: Die vorliegende Arbeit untersucht mit einer Literaturrecherche in wichtigen Zeitschriften zur naturwissenschaftsdidaktischen Forschung, welche Ansätze der Zusammenschau dieser beiden Bildungsfelder bereits erkennbar sind. Ergebnis: Obwohl der Begriff der Gesundheitskompetenz in der didaktischen Forschung noch nicht aufgenommen worden ist, zeigt die Vielzahl empirischer Arbeiten, die Gesundheitsfragen thematisieren, eine Win-win-Situation zwischen Gesundheitsbildung und naturwissenschaftlichem Unterricht. In der Praxis kann einerseits der naturwissenschaftliche Unterricht vom Interesse der Schüler an gesundheitlichen und medizinischen Themen profitieren, während andererseits die Gesundheitsbildung besonders von der langen empirischen Tradition der Naturwissenschaftsdidaktik profitieren kan

International Law of Regional Organizations: A Comparative Perspective

This article provides a comparative analysis of the law and practice of regional international organizations (rio s). Drawing upon the International Law Association (ila) study and individual regional reports, the article offers a cross-regional account of organizations located in Europe, Eurasia, the Middle East, Africa, Latin America and the Caribbean, and the Asia-Pacific. The article focuses on the main conceptual questions that emerged during the study and reflects on some of the main insights gleaned from the cross-cutting comparisons. The article discusses the concept of ‘regional international organization’ and the debates about the appropriate definition to be used in the Study. The article discusses how international law applies to, and within, regional international organizations, examining issues such as the autonomy of the organization’s internal law. The article shows how regional international organizations have influenced the development of international law, by concluding treaties, contributing or catalysing relevant practice to the formation of customary international law, and producing authoritative ‘subsidiary means’ to identify the law. The comparative assessment allows us to offer reflections on the ‘openness’ of regional international organizations and the conditions under which they can shape, and be shaped by, international law. The article concludes with some starting points for further research on the place of regional international organizations

Elimination of chronic viral infection by blocking CD27 signaling

Neutralizing antibody (nAb) responses to lymphocytic choriomeningitis virus (LCMV) in mice and immunodeficiency virus and hepatitis C virus in humans are usually weak and slow to develop. This may be the result of structural properties of the surface glycoprotein, a low frequency of B cells with neutralizing specificity, and the necessity of prolonged affinity maturation of specific nAbs. In this study, we show that during LCMV infection, CD27 signaling on CD4+ T cells enhances the secretion of interferon-γ and tumor necrosis factor-α. These inflammatory cytokines lead to the destruction of splenic architecture and immunodeficiency with reduced and delayed virus-specific nAb responses. Consequently, infection with the otherwise persistent LCMV strain Docile was eliminated after CD27 signaling was blocked. Our data provide a novel mechanism by which LCMV avoids nAb responses and suggest that blocking the CD27–CD70 interaction may be an attractive strategy to prevent chronic viral infection

Protective T Cell–Independent Antiviral Antibody Responses Are Dependent on Complement

Complement is part of the innate immune system and one of the first lines of host defense against infections. Its importance was evaluated in this study in virus infections in mice deficient either in soluble complement factors (C3−/−, C4−/−) or in the complement signaling complex (complement receptor [CR]2−/−, CD19−/−). The induction of the initial T cell–independent neutralizing immunoglobulin (Ig)M antibody response to vesicular stomatitis virus (VSV), poliomyelitis virus, and recombinant vaccinia virus depended on efficient antigen trapping by CR3 and -4–expressing macrophages of the splenic marginal zone. Neutralizing IgM and IgG antibody responses were largely independent of CR2-mediated stimulation of B cells when mice were infected with live virus. In contrast, immunizations with nonreplicating antigens revealed an important role of B cell stimulation via CR2 in the switch to IgG. The complement cascade was activated after infection with VSV via the classical pathway, and active complement cleavage products augmented the effector function of neutralizing IgM and IgG antibodies to VSV by a factor of 10–100. Absence of the early neutralizing antibody responses, together with the reduced efficiency of neutralizing IgM in C3−/− mice, led to a drastically enhanced susceptibility to disease after infection with VSV

Can Functional Capacity Tests Predict Future Work Capacity in Patients With Whiplash-Associated Disorders?

AbstractObjectiveTo determine whether functional capacity evaluation (FCE) tests predict future work capacity (WC) of patients with whiplash-associated disorders (WADs) grades I and II who did not regain full WC 6 to 12 weeks after injury.DesignProspective cohort study.SettingRehabilitation center.ParticipantsWorkers (N=267) listed on workers' compensation with grade I or II WADs 6 to 12 weeks after injury.InterventionsPatients performed 8 work-related FCE tests.Main Outcome MeasuresWC (0–100%) measured at baseline and 1, 3, 6, and 12 months after testing. Correlation coefficients between FCE tests and WC were calculated. A linear mixed-model analysis was used to assess the association between FCE and future WC.ResultsMean ± SD WC increased over time from 20.8%±27.6% at baseline to 32.3%±38.4%, 51.3%±42.8%, 65.6%±42.2%, and 83.2%±35.0% at the 1-, 3-, 6-, and 12-month follow-ups, respectively. Correlation coefficients between FCE tests and WC ranged from r=.06 (lifting low at 12-mo follow-up) to r=.39 (walking speed at 3mo). Strength of the correlations decreased over time. FCE tests did not predict WC at follow-up. The predictors of WC were ln (time) (β=23.74), mother language (β=5.49), WC at baseline (β=1.01), and self-reported disability (β=−.20). Two interaction terms, ln (time) × WC (β=−.19) and ln (time) × self-reported disability (β=−.21), were significant predictors of WC.ConclusionsFCE tests performed within 6 to 12 weeks after WADs injury grades I and II are associated with WC at baseline but do not predict future WC, whereas time course, mother language, WC at baseline, and self-reported disability do predict future WC. Additionally, the interaction between time course WC at baseline and self-reported disability predicted future WC

Diagnosis of helminths depends on worm fecundity and the distribution of parasites within hosts

Helminth transmission and morbidity are dependent on the number of mature parasites within a host; however, observing adult worms is impossible for many natural infections. An outstanding challenge is therefore relating routine diagnostics, such as faecal egg counts, to the underlying worm burden. This relationship is complicated by density-dependent fecundity (egg output per worm reduces due to crowding at high burdens) and the skewed distribution of parasites (majority of helminths aggregated in a small fraction of hosts). We address these questions for the carcinogenic liver fluke Opisthorchis viverrini, which infects approximately 10 million people across Southeast Asia, by analysing five epidemiological surveys (n = 641) where adult flukes were recovered. Using a mechanistic model, we show that parasite fecundity varies between populations, with surveys from Thailand and Laos demonstrating distinct patterns of egg output and density-dependence. As the probability of observing faecal eggs increases with the number of mature parasites within a host, we quantify diagnostic sensitivity as a function of the worm burden and find that greater than 50% of cases are misdiagnosed as false negative in communities close to elimination. Finally, we demonstrate that the relationship between observed prevalence from routine diagnostics and true prevalence is nonlinear and strongly influenced by parasite aggregation

Developing and testing a Corona VaccinE tRiAL pLatform (COVERALL) to study Covid-19 vaccine response in immunocompromised patients

BACKGROUND The rapid course of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic calls for fast implementation of clinical trials to assess the effects of new treatment and prophylactic interventions. Building trial platforms embedded in existing data infrastructures is an ideal way to address such questions within well-defined subpopulations. METHODS We developed a trial platform building on the infrastructure of two established national cohort studies: the Swiss human immunodeficiency virus (HIV) Cohort Study (SHCS) and Swiss Transplant Cohort Study (STCS). In a pilot trial, termed Corona VaccinE tRiAL pLatform (COVERALL), we assessed the vaccine efficacy of the first two licensed SARS-CoV-2 vaccines in Switzerland and the functionality of the trial platform. RESULTS Using Research Electronic Data Capture (REDCap), we developed a trial platform integrating the infrastructure of the SHCS and STCS. An algorithm identifying eligible patients, as well as baseline data transfer ensured a fast inclusion procedure for eligible patients. We implemented convenient re-directions between the different data entry systems to ensure intuitive data entry for the participating study personnel. The trial platform, including a randomization algorithm ensuring balance among different subgroups, was continuously adapted to changing guidelines concerning vaccination policies. We were able to randomize and vaccinate the first trial participant the same day we received ethics approval. Time to enroll and randomize our target sample size of 380 patients was 22 days. CONCLUSION Taking the best of each system, we were able to flag eligible patients, transfer patient information automatically, randomize and enroll the patients in an easy workflow, decreasing the administrative burden usually associated with a trial of this size