Solitäre in Organisationen -ein Paradoxon? Supervision an Hochschulen und Universitätsinstituten

"Die Idee der Universität" - so Jaspers 1946 - verlangt Wahrheit und Freiheit. Modeme Hochschulen haben aber völlig andere Themen und Nöte: der Wettbewerb unter den Organisationen hat Einzug gehalten, die Ökonomisierung setzt Rahmen und strukturiert Inhalte, das Label "Exzellenz" produziert Stolz und Beschämung, die Eliteidee ist neu geboren und selbstverständlich: Beratung, auch in Form von Supervision, wird nachgefragt und gewährt Einblicke in einst eher verschlossene Räume

Modeling of interventions for reducing external Enterobacteriaceae contamination of broiler carcasses during processing

This article presents a mathematical model for the Enterobacteriaceae count on the surface of broiler chicken during slaughter and how it may be affected by different processing technologies. The model is based on a model originally developed for Campylobacter and has been adapted for Enterobacteriaceae using a Bayesian updating approach and hitherto unpublished data gathered from German abattoirs. The slaughter process in the model consists of five stages: input, scalding, defeathering, evisceration, washing, and chilling. The impact of various processing technologies along the broiler processing line on the Enterobacteriaceae count on the carcasses’ surface has been determined from literature data. The model is implemented in the software R and equipped with a graphical user interface which allows interactively to choose among different processing technologies for each stage along the processing line. Based on the choice of processing technologies the model estimates the Enterobacteriaceae count on the surface of each broiler chicken at each stage of processing. This result is then compared to a so-called baseline model which simulates a processing line with a fixed set of processing technologies. The model calculations showed how even very effective removal of bacteria on the exterior of the carcass in a previous step will be undone by the cross-contamination with leaked feces, if feces contain high concentrations of bacteria

Videoleitfaden aus dem Teilprojekt „Kompetenzen der Wahrnehmung, Interpretation, Antizipation von Unterrichtsprozessen sowie der Generierung von Handlungsstrategien mittels Videoanalyse erwerben” des Forschungsprojekts „Know how to teach (K2teach) - Grundlegende Handlungskompetenzen für eine adaptive Unterrichtspraxis im Studium erwerben”

Lehrpersonen müssen im Unterricht die wichtigen Merkmale einer Situation schnell erkennen, um angemessen darauf reagieren zu können. Dies umfasst neben der Situationsdiagnose auch das Antizipieren von möglichen Handlungsverläufen, um geeignete Handlungsstrategien identifizieren zu können. Diese Kompetenzen werden auch als professionelle Wahrnehmung bezeichnet. Studien belegen, dass die Kompetenzen der professionellen Wahrnehmung durch die Analyse von Unterrichtsaufnahmen bereits in der universitären Lehramtsausbildung gefördert werden können. Um Studierende beim Aufbau dieser Kompetenzen zu unterstützen, wer- den im K2teach-Projekt Unterrichtsaufnahmen für die Bereiche Didaktik der Biologie, Politikdidaktik und Allgemeine Grundschulpädagogik erstellt. Um eine ressourcenorientierte und nachhaltige Produktion zu gewährleisten, werden die Dreharbeiten mit studentischen MitarbeiterInnen realisiert. Der vorliegende Leitfaden dokumentiert die Schritte dieser Produktion. Er soll ferner als Unterstützung für die Durchführung ähnlicher Projekte dienen

Planning training seminars in palliative care: a cross-sectional survey on the preferences of general practitioners and nurses in Austria

<p>Abstract</p> <p>Background</p> <p>Training in palliative care is frequently requested by health care professionals. However, little is known in detail about the subject matters and the educational preferences of physicians and staff or assistant nurses in this field.</p> <p>Methods</p> <p>All 897 registered GPs and all 933 registered home care nurses in the district of Steiermark/Austria were sent postal questionnaires.</p> <p>Results</p> <p>Results from 546 (30%) respondents revealed that GPs prefer evening courses and weekend seminars, whereas staff and assistant nurses prefer one-day courses. Multidisciplinary sessions are preferred by almost 80% of all professional groups. GPs preferred multi disciplinary groups most frequently when <it>addressing psychosocial needs </it>(88.8%) and <it>ethical questions </it>(85.8%). Staff and assistant nurses preferred multidisciplinary groups most frequently in the area of <it>pain </it>management (88%) and opted for multi disciplinary learning to a significantly higher extent than GPs (69%; p < 0.01). Those topics were ranked first which are not only deepening, but supplementing the professional training. On average, GPs were willing to spend a maximum amount of € 400 per year for training seminars in palliative care, whereas nurses would spend approximately € 190 for such classes.</p> <p>The results provide a detailed analysis of the preferences of GPs and nurses and offer guidance for the organisation of training seminars in palliative care.</p> <p>Conclusions</p> <p>Medical and nursing education programs often pursue separate paths. Yet our findings indicate that in palliative care multidisciplinary training seminars are favoured by both, doctors and nurses. Also, both groups prefer topics that are not only deepening, but supplementing their professional knowledge.</p

Plasma Ghrelin Levels Are Associated with Anorexia but Not Cachexia in Patients with NSCLC

Background and Aims: The ghrelin receptor is one of the new therapeutic targets in the cancer anorexia-cachexia syndrome. Previous studies revealed that plasma ghrelin levels were high in patients with anorexia nervosa and low in obese subjects. We studied to what extent ghrelin levels are related with anorexia and cachexia in patients with cancer. Materials and Methods: Fasted ghrelin levels were determined as well as anorexia and cachexia in patients with stage III/IV non-small cell lung cancer before chemotherapy. Total plasma ghrelin was measured by radioimmunoassay. Anorexia was measured with the FAACT-A/CS questionnaire (cut-off value ≤ 37). Cachexia was determined as > 5% weight loss (WL) in 6 months or > 2% WL in 6 months in combination with low BMI or low muscle mass. The Kruskal-Wallis test was performed to assess differences in plasma ghrelin levels between four groups: patients with (+) or without (-) anorexia (A) or cachexia (C). Multiple regression analyses were performed to assess differences in plasma ghrelin levels between patients C+ and C- and patients with A+ and A- (adjusted for age and sex). Results: Forty patients with stage III (33%) or stage IV (68%) were recruited, of which 50% was male. Mean age was 59.6 ± 10.3 years. Sixteen patients had no anorexia or cachexia (A-C-), seven patients had both anorexia and cachexia (A+C+), ten patients had anorexia without cachexia (A+C-) and seven patients had cachexia without anorexia (A-C+). The levels of total plasma ghrelin were significantly different between the four groups of patients with or without anorexia or cachexia (p = 0.032): the A+C- patients had significantly higher ghrelin levels [median (IQR): 1,754 (1,404-2,142) compared to the A-C+ patients 1,026 (952-1,357), p = 0.003]. A+ patients had significantly higher ghrelin levels compared A- patients (C+ and C- combined, β: 304, p = 0.020). Plasma ghrelin levels were not significantly different in C+ patients compared to C- patients (A+ and A- combined, β: -99, p = 0.450). Conclusions: Patients with anorexia had significantly higher ghrelin levels compared to patients without anorexia. We therefore hypothesize that patients with cancer anorexia might benefit from treatment with a ghrelin receptor agonist to prevent WL and deterioration in physical functioning

Assessment of scapular position in patients suffering from shoulder dysfunction

Shoulder dysfunction inhibits 80% of competitive swimmers from performing optimally. The most common contributing factor to shoulder dysfunction is an altered scapula position. A standard for the distance between T4 and the medial border of the scapula is lacking. Measurements of the distance between T4 and the root of the scapula were made and the relationship of the distance and the function of trapezius middle fibres at resting length was tested. A Vernier caliper® (ICC 0.94) was used to measure the distance from T4 to the medial border of the scapula. Exercises and stretches to retrain and strengthen the middle fibres of the trapezius specifically were performed twice a week, scheduled around the swimmers’ regular training and strengthening sessions, for six weeks. The results showed that palpation of the scapula to measure the distance between T4 and the spinal root is reliable and valid. A normalisation index should be used to adjust for body build and posture. Furthermore, the distance between the thoracic spine and the scapula did not change, regardless of the statistical improvement in the function of trapezius middle fibres (p < 0.05). The research results are of importance for clinical practice, evaluation and treatment programmes for physiotherapists. The data obtained from this study can serve as a baseline for further studies.http://www.journals.co.za/content/journal/ajpherd1am2017Physiotherap

Impact of On-Farm Interventions against CTX-Resistant Escherichia coli on the Contamination of Carcasses before and during an Experimental Slaughter

Cefotaxime (CTX)-resistant Enterobacteriaceae are still an ongoing challenge in human and veterinary health. High prevalence of these resistant bacteria is detected in broiler chickens and the prevention of their dissemination along the production pyramid is of major concern. The impact of certain on-farm interventions on the external bacterial contamination of broiler chickens, as well as their influence on single processing steps and (cross-) contamination, have not yet been evaluated. Therefore, we investigated breast skin swab samples of broiler chickens before and during slaughter at an experimental slaughter facility. Broiler chickens were previously challenged with CTX-resistant Escherichia coli strains in a seeder-bird model and subjected to none (control group (CG)) or four different on-farm interventions: drinking water supplementation based on organic acids (DW), slow growing breed Rowan × Ranger (RR), reduced stocking density (25 kg/sqm) and competitive exclusion with Enterobacteriales strain IHIT36098(CE). Chickens of RR, 25 kg/sqm, and CE showed significant reductions of the external contamination compared to CG. The evaluation of a visual scoring system indicated that wet and dirty broiler chickens are more likely a vehicle for the dissemination of CTX-resistant and total Enterobacteriaceae into the slaughterhouses and contribute to higher rates of (cross-) contamination during processing

SYMptom monitoring with Patient-Reported Outcomes using a web application among patients with Lung cancer in the Netherlands (SYMPRO-Lung):Study protocol for a stepped-wedge randomised controlled trial

Introduction Lung cancer and its treatment cause a wide range of symptoms impacting the patients’ health-related quality of life (HRQoL). The use of patient-reported outcomes (PRO) to monitor symptoms during and after cancer treatment has been shown not only to improve symptom management but also to improve HRQoL and overall survival (OS). Collectively, these results favour implementation of PRO-symptom monitoring in daily clinical care. However, these promising outcomes have been obtained under trial conditions in which patients were selected based on stringent inclusion criteria, and in countries with a dissimilar healthcare system than in the Netherlands. The primary aim of the SYMptom monitoring with Patient-Reported Outcomes using a web application among patients with Lung cancer in the Netherlands (SYMPRO-Lung) study is to evaluate the effect of PRO-symptom monitoring during and after lung cancer treatment on HRQoL in daily clinical practice. Secondary objectives include assessing the effect of PRO-symptom monitoring on progression-free survival, OS, the incidence and grade of PRO symptoms, medication adherence, implementation fidelity and cost-effectiveness. Methods and analysis The SYMPRO-Lung study is a prospective, multicentre trial with a stepped wedge cluster randomised design. Study participants (n=292 intervention, n=292 controls) include patients with lung cancer (stages I–IV) starting treatment with surgery, systemic treatment, targeted treatment and/or radiotherapy. Every participating centre will consecutively switch from the control period to the intervention period, in which patients report their symptoms weekly via an online tool. In the intervention group, we evaluate two alert approaches: the active and reactive approach. If the symptoms exceed a predefined threshold, an alert is sent to the healthcare provider (active approach) or to the patient (reactive approach). Both the control and intervention group complete HRQoL questionnaires at 4 time points: at baseline, 15 weeks, 6 months and 1-year post treatment). Differences in HRQoL between the groups will be compared using linear mixed modelling analyses, accounting for within-centre clustering, potential time effects and confounding. Ethics and dissemination The study protocol was approved by the Institutional Review Board and the Medical Ethics Committee of the Amsterdam UMC (under number NL 68440.029.18) and the institutional review boards of the participating study sites. The dissemination of the results will be conducted through publication in peer-reviewed journals and through scientific conferences. Trial registration number Trial register identifier: Netherlands Trial register Trial NL7897. Date of registration: 24 July 2019. https://www.trialregister.nl/trial/7897