Taking a Proposal Seriously : Orientations to Agenda and Agency in Support Workers’ Responses to Client Proposals

While joint decision-making is regularly launched by a proposal, it is the recipients’ responses that crucially influence the proposal outcome. This chapter examines how support workers respond to the proposals made by clients during rehabilitation group meetings at the Clubhouse. Drawing on a collection of 180 client-initiated proposal sequences, the paper describes two dilemmas that the support workers face when seeking to take client proposals “seriously.” The first concerns the meeting’s agenda and consists of a tension between providing recognition for the individual client and encouraging collective participation. The second dilemma has to do with agency and consists of a tension between focusing on the client as the originator of the proposal and avoiding treating him or her alone accountable for it. The analysis of these dilemmas contributes to a deeper understanding of group decision-making, in general, while these findings have specific relevance in mental health rehabilitation.While joint decision-making is regularly launched by a proposal, it is the recipients’ responses that crucially influence the proposal outcome. This chapter examines how support workers respond to the proposals made by clients during rehabilitation group meetings at the Clubhouse. Drawing on a collection of 180 client-initiated proposal sequences, the paper describes two dilemmas that the support workers face when seeking to take client proposals “seriously.” The first concerns the meeting’s agenda and consists of a tension between providing recognition for the individual client and encouraging collective participation. The second dilemma has to do with agency and consists of a tension between focusing on the client as the originator of the proposal and avoiding treating him or her alone accountable for it. The analysis of these dilemmas contributes to a deeper understanding of group decision-making, in general, while these findings have specific relevance in mental health rehabilitation.Peer reviewe

Making identity assurance and authentication strength work for federated infrastructures

In both higher Research and Education (R&E) as well as in research-/ e-infrastructures (in short: infrastructures), federated access and single sign-on by way of national federations, operated in most cases by NRENs, are used as a means to provide users with access to a variety of services. Whereas in national federations institutional accounts, e.g. provided by a university, are typically used to access services, many infrastructures also accept other sources of identity: provided by \u27\u27community identity providers\u27\u27, social identity providers, or governmental IDs. In order to assess and communicate the quality of identities being used and authentications being performed, so called Level of Assurance (LoA) frameworks are used. Because sophisticated LoA frameworks like NIST 800-63-3, Kantara IAF 1420 or eIDAS regulation are often considered too complex to be used in R&E scenarios, the REFEDS Assurance Suite, a more lightweight approach, has been developed. To select an appropriate assurance level, Service Providers need to weigh risks and potential harms in relation to the kind of service they offer. However, the management of risks is often implicitly assumed and little or no guidance to determine the appropriate assurance level is given. In this paper, first, common LoA frameworks and their relation to risk management are investigated. Following that, their components are compared against the REFEDS Assurance Suite using a graphical representation. The focus of this paper lies in providing guidance and best practices based on example scenarios for both Service Providers to request the appropriate REFEDS assurance level, as well as for Identity Provider operators on how to implement REFEDS assurance components

Detection and analysis of new psittacine beak and feather disease virus (PBFDv) nucleotide sequences

ΔΕΝ ΥΠΑΡΧΕΙ ΠΕΡΙΛΗΨΗPsittacine beak and feather disease (PBFD) affects a large number of Psittaciformes species. In this study, five White Cockatoo parrots (Cacatua alba) with clinical signs of PBFD were examined. After euthanasia, a full necropsy of parrots was performed and organs with macroscopic changes were sampled for routine histopathological evaluation. To confirm the presence of psittacine beak and feather disease virus (PBFDv), feather samples were analyzed with the PCR method. Sequence analysis of the obtained PCR products indicated their close relationship (99%) to other PBFDv isolates. Six variable nucleotide sites were discovered, two missense and four silent mutations. This paper presents the evidence of new PBFDv sequence in Cockatoo species

Promoting Client Participation and Constructing Decisions in Mental Health Rehabilitation Meetings

The chapter analyzes practices by which support workers promote client participation in mental health rehabilitation meetings at the Clubhouse. While promoting client participation, the support workers also need to ascertain that at least some decisions get constructed during the meetings. This combination of goals—promoting participation and constructing decisions—leads to a series of dilemmatic practices, the dynamics of which the chapter focuses on analyzing. The support workers may treat clients’ turns retrospectively as proposals, even if the status of these turns as such is ambiguous. In the face of a lack of recipient uptake, the support workers may remind the clients about their epistemic access to the content of the proposal or pursue their agreement or commitment to the idea. These practices involve the support workers carrying primary responsibility over the unfolding of interaction, which is argued to compromise the jointness of the decision-making outcome.The chapter analyzes practices by which support workers promote client participation in mental health rehabilitation meetings at the Clubhouse. While promoting client participation, the support workers also need to ascertain that at least some decisions get constructed during the meetings. This combination of goals—promoting participation and constructing decisions—leads to a series of dilemmatic practices, the dynamics of which the chapter focuses on analyzing. The support workers may treat clients’ turns retrospectively as proposals, even if the status of these turns as such is ambiguous. In the face of a lack of recipient uptake, the support workers may remind the clients about their epistemic access to the content of the proposal or pursue their agreement or commitment to the idea. These practices involve the support workers carrying primary responsibility over the unfolding of interaction, which is argued to compromise the jointness of the decision-making outcome.Peer reviewe

Borna disease virus infects human neural progenitor cells and impairs neurogenesis.

Understanding the complex mechanisms by which infectious agents can disrupt behavior represents a major challenge. The Borna disease virus (BDV), a potential human pathogen, provides a unique model to study such mechanisms. Because BDV induces neurodegeneration in brain areas that are still undergoing maturation at the time of infection, we tested the hypothesis that BDV interferes with neurogenesis. We showed that human neural stem/progenitor cells are highly permissive to BDV, although infection does not alter their survival or undifferentiated phenotype. In contrast, upon the induction of differentiation, BDV is capable of severely impairing neurogenesis by interfering with the survival of newly generated neurons. Such impairment was specific to neurogenesis, since astrogliogenesis was unaltered. In conclusion, we demonstrate a new mechanism by which BDV might impair neural function and brain plasticity in infected individuals. These results may contribute to a better understanding of behavioral disorders associated with BDV infection

Key Features Relevant to Select Antigens and TCR From the MHC-Mismatched Repertoire to Treat Cancer

Adoptive transfer of T cells transgenic for tumor-reactive T-cell receptors (TCR) is an attractive immunotherapeutic approach. However, clinical translation is so far limited due to challenges in the identification of suitable target antigens as well as TCRs that are concurrent safe and efficient. Definition of key characteristics relevant for effective and specific tumor rejection is essential to improve current TCR-based adoptive T-cell immunotherapies. We here characterized in-depth two TCRs derived from the human leukocyte antigen (HLA)-mismatched allogeneic repertoire targeting two different myeloperoxidase (MPO)-derived peptides presented by the same HLA-restriction element side by side comprising state of the art biochemical and cellular in vitro, in vivo, and in silico experiments. In vitro experiments reveal comparable functional avidities, off-rates, and cytotoxic activities for both TCRs. However, we observed differences especially with respect to cytokine secretion and cross-reactivity as well as in vivo activity. Biochemical and in silico analyses demonstrate different binding qualities of MPO-peptides to the HLA-complex determining TCR qualities. We conclude from our biochemical and in silico analyses of peptide-HLA-binding that rigid and high-affinity binding of peptides is one of the most important factors for isolation of TCRs with high specificity and tumor rejection capacity from the MHC-mismatched repertoire. Based on our results, we developed a workflow for selection of such TCRs with high potency and safety profile suitable for clinical translation

Serbian KINDL questionnaire for quality of life assessments in healthy children and adolescents: reproducibility and construct validity

<p>Abstract</p> <p>Background</p> <p>The KINDL questionnaire is frequently used to evaluate quality of life (QOL) and the impacts of health conditions on children's everyday living. The objectives of this study were to assess the reproducibility and construct validity of the Serbian KINDL for QOL assessments in healthy children and adolescents.</p> <p>Methods</p> <p>Five hundred and sixty-four healthy children and adolescents completed the KINDL. Reproducibility was analyzed using the intraclass correlation coefficient (ICC). Confirmatory factor analysis (CFA) was performed to assess the structure of the KINDL construct validity.</p> <p>Results</p> <p>The intraclass correlation coefficients ranged from 0.03 to 0.84 for the subscales and total score. A second order CFA model as originally hypothesized was tested: items (24), primary factors (six subscales), and one secondary factor (QOL). The fit indexes derived from a CFA failed to yield appropriate fit between the data and the hypothesized model.</p> <p>Conclusion</p> <p>Majority of the subscales and total KINDL possess appropriate reproducibility for group comparisons. However, a CFA failed to confirm the structure of the original measurement model, indicating that the Serbian version should be revised before wider use for QOL assessments in healthy children and adolescent.</p

Dabigatran for the Treatment and Secondary Prevention of Venous Thromboembolism; A Cost-Effectiveness Analysis for the Netherlands

Background Dabigatran was proven to have similar effect on the prevention of recurrence of venous thromboembolism (VTE) and a lower risk of bleeding compared to vitamin K antagonists (VKA). The aim of this study is to assess the cost-effectiveness (CE) of dabigatran for the treatment and secondary prevention in patients with VTE compared to VKAs in the Dutch setting. Methods Previously published Markov model was modified and updated to assess the CE of dabigatran and VKAs for the treatment and secondary prevention in patients with VTE from a societal perspective in the base-case analysis. The model was populated with efficacy and safety data from major dabigatran trials (i.e. RE-COVER, RECOVER II, RE-MEDY and RESONATE), Dutch specific costs, and utilities derived from dabigatran trials or other published literature. Univariate, probabilistic sensitivity and a number of scenario analyses evaluating various decision-analytic settings (e.g. the perspective of analysis, use of anticoagulants only for treatment or only for secondary prevention, or comparison to no treatment) were tested on the incremental cost-effectiveness ratio (ICER). Results In the base-case scenario, patients on dabigatran gained an additional 0.034 quality adjusted life year (QALY) while saving epsilon 1,598. Results of univariate sensitivity analysis were quite robust. The probability that dabigatran is cost-effective at a willingness-to-pay threshold of epsilon 20,000/ QALY was 98.1%. From the perspective of healthcare provider, extended anticoagulation with dabigatran compared to VKAs was estimated at epsilon 2,158 per QALY gained. The ICER for anticoagulation versus no treatment in patients with equipoise risk of recurrent VTE was estimated at epsilon 33,379 per QALY gained. Other scenarios showed dabigatran was cost-saving. Conclusion From a societal perspective, dabigatran is likely to be a cost-effective or even cost-saving strategy for treatment and secondary prevention of VTE compared to VKAs in the Netherlands

Writing : A Versatile Resource in the Treatment of the Clients’ Proposals

This chapter investigates how writing serves as a resource in decision-making at the Clubhouse and how writing activities relate to professionals’ responses to clients. The ideology of the Clubhouse is one of interaction, and in accordance with this perspective, support workers and clients should be treated equally in decision-making processes related to the activity of the Clubhouse. However, as demonstrated in previous research, encouraging clients in mental health rehabilitation to participate actively in interaction and decision-making can be difficult. Therefore, support workers carry a substantial responsibility for promoting clients’ participation in interactions; this responsibility is supported by how they respond to clients. The focus in this chapter is on a certain type of participation-encouraging response—that is, a response that promotes the documentation of vaguely expressed ideas in written documents and encourages a dialogue between support workers and Clubhouse clients around the formulations in a text-in-production.This chapter investigates how writing serves as a resource in decision-making at the Clubhouse and how writing activities relate to professionals’ responses to clients. The ideology of the Clubhouse is one of interaction, and in accordance with this perspective, support workers and clients should be treated equally in decision-making processes related to the activity of the Clubhouse. However, as demonstrated in previous research, encouraging clients in mental health rehabilitation to participate actively in interaction and decision-making can be difficult. Therefore, support workers carry a substantial responsibility for promoting clients’ participation in interactions; this responsibility is supported by how they respond to clients. The focus in this chapter is on a certain type of participation-encouraging response—that is, a response that promotes the documentation of vaguely expressed ideas in written documents and encourages a dialogue between support workers and Clubhouse clients around the formulations in a text-in-production.Peer reviewe