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Career pathways are critical in the vocational rehabilitation (VR) of individuals with disabilities, linking education, training, and employment to improve career outcomes.This report explores the establishment of the Career Pathways Learning Community, the development of the Career Pathways Toolkit, and the transition to the Implementation Group, highlighting how these initiatives support effective career development frameworks for individuals with disabilities within VR systems.A nationwide recruitment process brought together 61 stakeholders, including counselors and administrators from various state VR agencies, to form a Learning Community focused on six key elements of Career Pathways. This effort facilitated the design of a customizable Toolkit and established an Implementation Group to apply it.The Toolkit consists of four sections: an introduction to the Career Pathways model, an exploration of its advantages, a comprehensive implementation guide, and evaluation strategies. It provides valuable resources for enhancing career development for individuals with disabilities, while the Implementation Group fosters systems change within VR practices.The development and implementation of Career Pathways within VR systems are crucial for enabling individuals with disabilities to achieve sustainable employment. The Career Pathways Toolkit, created by the Learning Community facilitated by VRTAC-QE, serves as a practical resource for fostering systems change. Collaborative efforts through the Implementation Group aim to enhance access to meaningful employment opportunities and promote a more inclusive workforce. [ABSTRACT FROM AUTHOR]

Research reveals that yeast revertants of glc-7-1 mutants, defective in glycogen metabolism, are deficient in a glycogen synthase major isoform. However, these revertants show increased enzyme activity, which suppresses the glc7-1 mutation. Data indicate that mutation is in the phosphorylated COOH terminus.

Objective: This study explored the main and interactive effects of sexual abuse history and relationship satisfaction on self-reported parenting, controlling for histories of physical abuse and parental alcoholism. Method: The community sample consisted of 90 mothers of 5- to 8-year-old children. The sample was limited to those mothers currently in an intimate relationship, 19 of whom reported a history of childhood sexual abuse. Participants completed the Child Behavior Checklist, the Parenting Stress Inventory, the Family Cohesion Index, and questions assessing parent-child role reversal, history of abuse and parental alcoholism, and current relationship satisfaction. Results: Results of analyses and multivariate analyses of covariance suggested that sexual abuse survivors with an unsatisfactory intimate relationship were more likely than either sexual abuse survivors with a satisfactory relationship or nonabused women to endorse items on a questionnaire of role reversal (defined as emotional overdependence upon one's child). Role reversal was not significantly predicted by histories of physical abuse or parental alcoholism or child's gender. While parenting stress was inversely predicted by the significant main effect of relationship satisfaction, neither parenting stress nor child behavior problems were predicted by the main effect of sexual abuse history or by the interaction between sexual abuse history and relationship satisfaction. Conclusions: These results suggest the unique relevance of sexual abuse history and relationship satisfaction in the prediction of a specific type of parent-child role reversal--namely, a mother's emotional overdependence upon her child.

Polymorphic X-chromosome inactivation of the human tissue inhibitor of metalloproteinases (TIMP1(ital)) gene in humans is discussed. Many genes that avoid X-inactivation are clustered, so the expression of four genes within about 100 kb of TIMP1(ital) has been studied and they were expressed only from the active X chromosome, so factors that allow TIMP1(ital) expression from the inactive X chromosome are specific to the SIMP1 gene and it seems TIMP1 inactivation is polymorphic in human females.

While considerable research has targeted physical performance in older adults, less is known about the ability to rise from the floor among community-dwelling elders. The purposes of the study were to (1) examine physical performance correlates of timed supine to stand performance and (2) identify the predominant motor pattern used to complete floor rise. Fifty-three community-dwelling adults over the age of 60 (x = 78.5 ± 8.5; 36 [68%] females) performed a timed supine to stand test and physical performance assessments. Forty-eight subjects (90.6%) demonstrated an initial roll with asymmetrical squat sequence when rising to stand. Supine to stand performance time was significantly correlated with all physical performance tests, including gait speed (r = −.61; p < .001), grip strength (r = −.30; p < .05), and Timed Up and Go (TUG) performance (r = .71; p < .001). Forty-eight percent of the variance in rise time (p < .001) was attributed to TUG velocity. Findings serve to enhance both functional performance assessment and floor rise interventions. [ABSTRACT FROM AUTHOR]

Adult men and women who were sexually abused in their youth have been observed to exhibit dissociative disorders. These disorders are better examined by studying the degree of relationship between parent and child. A study involving scores taken from a Dissociative Experiences Scale test revealed the significant relationship between fearful avoidant attachment and dissociation.

Objectives/Hypothesis: We sought to establish normative peak expiratory flow (PEF) data for patients with idiopathic subglottic stenosis (iSGS), evaluate whether immediate changes in PEF after a procedure predict long‐term treatment response, and test if a decline in longitudinal PEF is associated with disease recurrence. Study Design: International, prospective, 3‐year multicenter cohort study of 810 patients with untreated, newly diagnosed, or previously treated iSGS. Methods: iSGS patients consented and enrolled in the North American Airway Collaborative (NoAAC) iSGS1000 cohort recorded PEF data on a mobile smartphone app. Cox regression tested the associations between the magnitude of postoperative PEF improvement and longitudinal 90‐day PEF decline with the risk of disease recurrence. Results: Within the NoAAC iSGS1000 cohort, 810 patients participated in a 3‐year prospective study comparing surgical treatment efficacy and 385 had appropriate PEF measurements and follow‐up data. Of those patients, 42% (161/385) required at least one operation during study follow‐up. The mean PEF preceding operative intervention was 241 L/min (95% confidence interval [CI]: 120–380) corresponding to a predicted PEF of 52%. The mean increase in PEF following a procedure was 111 L/min (95% CI: 96–125 L/min). Interestingly, the magnitude of immediate PEF improvement was not predictive of disease recurrence (hazard ratio [HR] for 100 L/min increase = 0.90, 95% CI: 0.60–1.00). However, recurrence was associated with the magnitude of PEF decline over 90 days (30% vs. 10% decline, HR = 2.2, 95% CI: 1.5–3.0). Conclusions: We provide normative PEF data on a large iSGS patient cohort. The degree of PEF improvement immediately after surgery was not associated with a longer procedure‐free interval. However, a 30% decline in PEF over 90 days was associated with elevated risk of disease recurrence. Level of Evidence: 2 Laryngoscope, 131:E2841–E2848, 2021 [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: Adjuvant medications including proton pump inhibitors (PPI), antibiotics (trimethoprim/sulfamethoxazole [TMP‐SMX]), and inhaled corticosteroids (ICS) may be prescribed for patients with idiopathic subglottic stenosis (iSGS). We describe medication use with endoscopic dilation (ED) or endoscopic resection with medical treatment (ERMT) and evaluate impact on outcomes. Study Design: International, prospective, 3‐year multicenter cohort study of 810 patients with untreated, newly diagnosed, or previously treated iSGS. Methods: Post hoc secondary analysis of prospectively collected North American Airway Collaborative data on outcomes linked with adjuvant medication utilization. Primary outcome was time to recurrent operation, evaluated using Kaplan–Meier curves and Cox regression analysis. Secondary outcomes of change in peak expiratory flow (PEF) and clinical chronic obstructive pulmonary disease questionnaire (CCQ) score over 12 months were compared. Results: Sixty‐one of 129 patients undergoing ED received PPI (47%), and 10/143 patients undergoing ED received ICS (7%). TMP‐SMX was used by 87/115 patients (76%) undergoing EMRT. PPI use in the ED group did not affect time to recurrence (hazard ratio [HR] = 1.00, 95% confidence interval [CI]: 0.53–1.88; P =.99) or 12‐month change in PEF (L/min) (median [interquartile range], 12.0 [10.7–12.2] vs. 8.7 [−5.1 to 24.9]; P =.59), but was associated with 12‐month change in CCQ (−0.05 [−0.97 to 0.75] vs. −0.50 [−1.60 to 0.20]; P =.04). ICS did not affect outcome measures. TMP‐SMX use in ERMT did not affect time to recurrence (HR = 0.842, 95% CI: 0.2345–3.023; P =.79), PEF at 12 months (75 [68–89] vs. 81 [68–89]; P =.92), or 12‐month change in CCQ (0.20 [−1.05 to 0.47] vs. −0.30 [−1.00 to 0.10]; P =.45). Conclusion: There is no standard practice for prescribing adjuvant medications. These data do not support that adjuvant medications prolong time to recurrence or increase PEF. Patients with iSGS and gastroesophageal reflux disease may experience some symptom benefit with PPI. Level of Evidence: 3 Laryngoscope, 131:E2880–E2886, 2021 [ABSTRACT FROM AUTHOR]

Queensland tick typhus (QTT) is endemic to Sydney, New South Wales, Australia (1-6). A prospective study of 80 serologically confirmed QTT cases (63 acquired in Sydney) yielded 68 cases with [...]

Youth with disabilities transitioning from high school to adulthood experience barriers in achieving competitive integrated employment outcomes comparable with peers without disabilities. Promoting Readiness of Minors in Supplemental Security Income (PROMISE) in the state of Wisconsin (WI) serviced 2,024 youth and families, with 1,018 accessing services and supports, including, but not limited to, soft skills, self-advocacy, benefits counseling, career counseling, and paid work experiences. This qualitative, multiple case study purposively selected four youth participants and their families to represent one of four categories: engaged and acquired paid employment, engaged and did not acquire paid employment, unengaged but did acquire paid employment, and unengaged and did not acquire paid employment. Results indicated that participants across all four case studies expressed the desire to work and were optimistic about the future resulting from their experience with WI PROMISE. This study will go beyond the results and provide lessons learned and implications for future research. [ABSTRACT FROM AUTHOR]

The experience of transitioning into adulthood is a critical phase in life. The navigation of government benefits adds further complexity that can affect employment outcomes for youth with disabilities. Some individuals hesitate to work out of fear to losing access to monetary, disability, and related health care benefits. However, using available work incentives while pursuing employment and career paths can provide opportunities to work and address poverty without forgoing needed services. The Wisconsin Promoting Readiness of Minors in Supplemental Security Income (PROMISE) research grant aimed to positively change youth readiness to work through the use of Motivational Interviewing, work incentive benefits counseling, financial capability building, shifting expectations, and help in navigating transition resources. To measure the impact on readiness to work, 126 transition-age youth receiving supplemental security income (SSI), 188 of their family members, and 411 Division of Vocational Rehabilitation (DVR) counselors working with the youth and families completed a modified Stages of Change Scale survey. Results indicated that youths' work readiness and positive feelings about work significantly increased from baseline to follow-up, along with an increase in employment rates. The implications of these findings highlight the utility of incorporating the stages of change theory into the design and implementation of services and supports to increase work readiness for youth with disabilities in transition. [ABSTRACT FROM AUTHOR]

Saving participation in adolescence is crucial for young adults to achieve financial well-being over their lifetime. Yet, very little is known about the factors that encourage saving participation among youth with disability, including youth who receive supplemental security income (SSI). This study examines relationships between personal and family factors, transition services, and participation in Wisconsin Promoting Readiness of Minors in Supplemental Security Income (PROMISE) individual development account (IDA), within a sample of youth with disabilities who receive SSI. Results of the hierarchical binary logistic and hierarchical multiple regression analyses suggests that the PROMISE interventions variable sets emerged as the most frequent predictors of IDA saving participation among youth receiving SSI. Specifically, work incentive benefits consultation services, financial capability-focused financial coaching services, and self-advocacy training were significant predictors of a youth's IDA saving participation. This study's findings offer important implications for transition planning and building financial capability. [ABSTRACT FROM AUTHOR]

Inter-agency data systems can improve data-based decision making across service systems. The Promoting the Readiness of Minors in Supplemental Security Income (PROMISE) federal research demonstration projects required inter-agency collaboration to provide needed support to youth receiving Supplemental Security Income (SSI) and their families. Wisconsin PROMISE built a system that gathered data from multiple agencies and provided a holistic picture of participants for use in evidence-based decision making. The inter-agency management information system (MIS) supported both formative evaluation of operational activities and short- and long-term impact analyses. Wisconsin PROMISE provided services and collected participant data using information technology (IT) systems distributed across eight different state agencies and multiple divisions within those organizations. The framework implemented for the Wisconsin MIS met the project objectives for an interorganizational data system and addressed the inherent challenges of collecting interorganizational data. The MIS was used for sharing data for both service delivery and research, while providing insight into the effectiveness of PROMISE project initiatives and all agencies serving the individual and their families. The purpose of this article is to share an example of how a MIS was built so others can replicate and/or use lesson learned to build something similar for their own purposes. [ABSTRACT FROM AUTHOR]

The 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) has been used to assess functional impairments in various disability populations and has been shown to be applicable to the youth population. The purpose of the study was to evaluate the psychometric properties of the World Health Organization Disability Assessment Schedule II–Youth Version (WHODAS-Y). Results of the study revealed a two-factor solution, including the socio-cognitive index and self-care index. The WHODAS-Y measurement appears to be a reliable and valid measure of function impairment in transition-age youth with disabilities in a community setting. This assessment tool can be integrated in vocational rehabilitation practices and guide rehabilitation counselors in identifying needs and facilitators related to education and employment-related services, as well as understanding health care needs in youth with disabilities. [ABSTRACT FROM AUTHOR]

Abstract Background Glutamate has been proposed as a transmitter in the peripheral taste system in addition to its well-documented role as an umami taste stimulus. Evidence for a role as a transmitter includes the presence of ionotropic glutamate receptors in nerve fibers and taste cells, as well as the expression of the glutamate transporter GLAST in Type I taste cells. However, the source and targets of glutamate in lingual tissue are unclear. In the present study, we used molecular, physiological and immunohistochemical methods to investigate the origin of glutamate as well as the targeted receptors in taste buds. Results Using molecular and immunohistochemical techniques, we show that the vesicular transporters for glutamate, VGLUT 1 and 2, but not VGLUT3, are expressed in the nerve fibers surrounding taste buds but likely not in taste cells themselves. Further, we show that P2X2, a specific marker for gustatory but not trigeminal fibers, co-localizes with VGLUT2, suggesting the VGLUT-expressing nerve fibers are of gustatory origin. Calcium imaging indicates that GAD67-GFP Type III taste cells, but not T1R3-GFP Type II cells, respond to glutamate at concentrations expected for a glutamate transmitter, and further, that these responses are partially blocked by NBQX, a specific AMPA/Kainate receptor antagonist. RT-PCR and immunohistochemistry confirm the presence of the Kainate receptor GluR7 in Type III taste cells, suggesting it may be a target of glutamate released from gustatory nerve fibers. Conclusions Taken together, the results suggest that glutamate may be released from gustatory nerve fibers using a vesicular mechanism to modulate Type III taste cells via GluR7.

Objectives: To determine the factors that shape utilization of social media‐based online support communities (OSCs) and study the influence of these communities on medical decision‐making in patients with Idiopathic Subglottic Stenosis (iSGS). Study design: Survey study. Methods: A survey investigating OSC use was sent to the 1,056 members of the North American Airway Collaborative (NoAAC) iSGS1000 cohort in January 2018. Responses were merged with the existing NoAAC data set containing extensive demographic data, disease‐specific history, and responses to validated patient‐reported outcome measures. Results: A total of 755 individuals with iSGS and mean age of 51.8 ± 11.6 years were included (99% female, 98% white, 63% college educated) and 58% were OSC users. Younger age, female gender, and college education were each associated with OSC use (P <.05). Users spent 2.5 ± 3.3 hours per week on the platforms. Time spent on OSC was not associated with total number of prior treatments. Higher disease anxiety (FoP‐Q, R = 0.26, P <.001), lower social support (MOS, R = −0.12, P =.037), and lower level of shared‐decision‐making with the treating physician (SDM‐Q9, R = −0.16, P =.007) were weakly associated with more hours spent engaging an OSC. OSC use influenced treatment and physician choice in 35% and 26% of users, respectively. Increased time spent on OSC use was associated with increased influence on patient medical decisions regarding treatment, surgery, and physician choice (P <.05). Conclusion: OSC engagement is common in patients with iSGS. Disease anxiety, social support, and relationship with the physician may influence OSC utilization. More OSC engagement weakly associated with greater OSC influence on patient medical decision‐making. Level of Evidence: NA. Laryngoscope, 131:1821–1827, 2021 [ABSTRACT FROM AUTHOR]