Klassifikationsmodelle in der Gesundheitsförderung und Prävention: Möglichkeiten und Grenzen für die Konzeption und Evaluation von Projekten und Programmen

Zusammenfassung: Hintergrund: Um die komplexe Planung und Evaluation von Projekten und Programmen im Gesundheitsbereich zu unterstützen, kommen heute v.a. im angelsächsischen Raum unterschiedliche Klassifikationsmodelle zum Einsatz. In diesem Artikel geht es um eine kritische Prüfung von 2 Klassifikationsmodellen, die derzeit in diversen Institutionen der Schweiz angewendet werden. Methode: Das Ergebnismodell von Gesundheitsförderung Schweiz sowie das "Program-Logic-Modell" von Sue Funnell werden als 2 Typen von Klassifikationsmodellen verglichen und auf ihre Einsatzmöglichkeiten in der Planungs- und Evaluationsphase von Gesundheitsprojekten untersucht. Dazu verdeutlichen wir die vielfältigen Implikationen von Klassifikationssystemen im Gesundheitsbereich und zeigen anhand von 2 Fallstudien die Problematiken bei der praktischen Umsetzung der Modelle. Ergebnisse: Die Modelle basieren auf unterschiedlichen, impliziten Annahmen und unterscheiden sich im Strukturierungsgrad der Kategorien sowie im Grad der Explizierung von Kausalitäten. Bei der Nutzung der Modelle ergeben sich dadurch spezifische Vor- und Nachteile. Schlussfolgerungen: Unter Berücksichtigung ihrer Grenzen und inhärenten Logik sind Klassifikationsmodelle nützliche Instrumente, um die Komplexität in der Planung und Evaluation von Gesundheitsprojekten zu reduzieren. Darüber hinaus erzwingen sie einen Austausch der Stakeholder über Gesundheitsvorstellungen und Ziele im Gesundheitsbereic

The relationship between hospital patients' ratings of quality of care and communication

Objective To assess the relationship between hospital patients' quality of care ratings and their experiences with health-related information exchanges and communication during hospitalization. Design Cross-sectional multivariate dimensional analysis of data from a quality of care experience questionnaire of hospital patients comparing scores across three levels of reported satisfaction. Setting and participants Five thousand nine hundred and fifty-two patients from a Swiss University Hospital responded to the questionnaire at discharge during 2010. Main outcome measures Survey questions measuring patients' evaluation of quality of care, patient loyalty and overall satisfaction. Results Different levels of reported satisfaction are associated with differing experiences of health-related information and communication during a hospital stay. Conclusions Patients who report lower satisfaction appear to attribute to the hospital staff enduring negative dispositions from behaviours that may be due to specific situational contexts. Negative experiences appear to influence scores on most other communication and information domains. Patients who report higher satisfaction, in contrast, appear to differentiate negative experiences and positive experiences and they appear to relativize and compartmentalize negative experiences associated with their hospital sta

Clinical translation of [18F]ICMT-11 for measuring chemotherapy-induced caspase 3/7 activation in breast and lung cancer

Background: Effective anticancer therapy is thought to involve induction of tumour cell death through apoptosis and/or necrosis. [18F]ICMT-11, an isatin sulfonamide caspase-3/7-specific radiotracer, has been developed for PET imaging and shown to have favourable dosimetry, safety, and biodistribution. We report the translation of [18F]ICMT-11 PET to measure chemotherapy-induced caspase-3/7 activation in breast and lung cancer patients receiving first-line therapy. Results: Breast tumour SUVmax of [18F]ICMT-11 was low at baseline and unchanged following therapy. Measurement of M30/M60 cytokeratin-18 cleavage products showed that therapy was predominantly not apoptosis in nature. While increases in caspase-3 staining on breast histology were seen, post-treatment caspase-3 positivity values were only approximately 1%; this low level of caspase-3 could have limited sensitive detection by [18F]ICMT-11-PET. Fourteen out of 15 breast cancer patients responded to first–line chemotherapy (complete or partial response); one patient had stable disease. Four patients showed increases in regions of high tumour [18F]ICMT-11 intensity on voxel-wise analysis of tumour data (classed as PADS); response was not exclusive to patients with this phenotype. In patients with lung cancer, multi-parametric [18F]ICMT-11 PET and MRI (diffusion-weighted- and dynamic contrast enhanced-MRI) showed that PET changes were concordant with cell death in the absence of significant perfusion changes. Conclusion: This study highlights the potential use of [18F]ICMT-11 PET as a promising candidate for non-invasive imaging of caspase3/7 activation, and the difficulties encountered in assessing early-treatment responses. We summarize that tumour response could occur in the absence of predominant chemotherapy-induced caspase-3/7 activation measured non-invasively across entire tumour lesions in patients with breast and lung cancer

Comparison of different stack measuring methods

In the last decades different methods have been developed for measuring piled wood, i.e. wood stacks. There are two main groups of measurements: the first one is manual methods and the second one is automatic measurements. Taking into consideration the amount and market value of stacked wood, the accuracy of applied measurement is of high importance, as the price is calculated according to the measured amount of wood. Manual measurements are mostly time consuming and dependent on individual performance. On the other hand, the automatic methods are fast and their accuracy has increased in the last years. They allow to obtain relevant results when calculating prices at different locations, independent of the measurement time. These methods range from simple manual measurements using a tape to photo-optical measurement systems. Also, other measurement methods (e. g. water immersion) are currently used in practice. The paper describes the individual manual and automatic measurement methods for industrial timber and their working principles. Furthermore, the advantages and disadvantages related with the requirements and accuracy of the individual procedures have been explained and their practical use discussed

Atividade antimicrobiana do oleorresina de copaíba (Copaifera reticulata) frente a Staphylococcus coagulase positiva isolados de casos de otite em cães.

O objetivo do presente trabalho foi investigar o potencial antimicrobiano do oleorresina de Copaifera reticulata Ducke em isolados de Staphylococcus coagulase positiva (SCP) provenientes de casos de otite externa em cães. O método de microdiluição em caldo foi utilizado para determinação da concentração inibitória mínima (CIM) e concentração bactericida mínima (CBM) de oleorresina de copaíba. Em adição, foi determinado o perfil de suscetibilidade aos antimicrobianos dos isolados de SCP pelo método de difusão em ágar. Oito classes de antimicrobianos foram usadas para o cálculo de multirresistência antimicrobiana. A determinação da composição química do oleorresina de copaíba foi realizada por cromatografia em fase gasosa acoplada à espectrometria de massas (GC/MS), sendo que β-cariofileno, β-bisaboleno e (E)-a-bergamoteno foram os compostos majoritários. O oleorresina de copaíba demonstrou CIM90 de 0,164mg/mL e CBM90 de 1,31mg/mL. A multirresistência foi verificada em 27% das cepas testadas. Os resultados sugerem que o oleorresina de copaíba exerceu atividade bacteriostática e bactericida mesmo em cepas multirresistentes de Staphylococcus coagulase-positiva

Poincaré on the Foundation of Geometry in the Understanding

This paper is about Poincaré’s view of the foundations of geometry. According to the established view, which has been inherited from the logical positivists, Poincaré, like Hilbert, held that axioms in geometry are schemata that provide implicit definitions of geometric terms, a view he expresses by stating that the axioms of geometry are “definitions in disguise.” I argue that this view does not accord well with Poincaré’s core commitment in the philosophy of geometry: the view that geometry is the study of groups of operations. In place of the established view I offer a revised view, according to which Poincaré held that axioms in geometry are in fact assertions about invariants of groups. Groups, as forms of the understanding, are prior in conception to the objects of geometry and afford the proper definition of those objects, according to Poincaré. Poincaré’s view therefore contrasts sharply with Kant’s foundation of geometry in a unique form of sensibility. According to my interpretation, axioms are not definitions in disguise because they themselves implicitly define their terms, but rather because they disguise the definitions which imply them

Bone mineral density, pulmonary function, chronological age, and age at diagnosis in children and adolescents with cystic fibrosis

AbstractObjectiveTo assess bone mineral density in patients with cystic fibrosis (CF), and to correlate it with possible intervening variables.MethodsChildren and adolescents diagnosed with CF, aged 6 to 18 years, followed at the outpatient clinic were included in the study. First, demographic data were collected and, subsequently, patients underwent a spirometric test. All patients answered the Cystic Fibrosis Quality of Life Questionnaire (CFQ) and underwent the six-minute walk test (6MWT) and bone densitometry (DXA).ResultsA total of 25 CF patients were included, of which 56% were males. The mean age was 12.3±3.4 years; mean height was 149.2±14.4 cm; and mean weight was 44.4±13.9 kg. Most results on pulmonary function and bone mineral density (BMD) were within normal limits. The mean forced expiratory volume in one second (FEV) was 92.5±23.6 (% of predicted), mean forced vital capacity (FVC) was 104.4±21.3 (% of predicted), and1 mean BMD z-score was 0.1±1.0. BMD was moderately correlated with FEV (r = 0.43, p = 0.03) and FVC (r = 0.57, p = 0.003). Regarding chronological age and age at diagnosis, a moderate and inverse correlation was also found (r = −0.55, p = 0.004; r = −0.57, p = 0.003, respectively). However, no significant correlations were found with the data from CFQ, 6MWT, and body mass index.ConclusionMost patients had BMD within normal limits and presented a positive correlation with pulmonary function, as well as a negative correlation with chronological age and age at diagnosis

Biochemical parameters of silver catfish (Rhamdia quelen) after transport with eugenol or essential oil of Lippia alba added to the water

The transport of live fish is a routine practice in aquaculture and constitutes a considerable source of stress to the animals. The addition of anesthetic to the water used for fish transport can prevent or mitigate the deleterious effects of transport stress. This study investigated the effects of the addition of eugenol (EUG) (1.5 or 3.0 mu L L-1) and essential oil of Lippia alba (EOL) (10 or 20 mu L L-1) on metabolic parameters (glycogen, lactate and total protein levels) in liver and muscle, acetylcholinesterase activity (AChE) in muscle and brain, and the levels of protein carbonyl (PC), thiobarbituric acid reactive substances (TBARS) and nonprotein thiol groups (NPSH) and activity of glutathione-S-transferase in the liver of silver catfish (Rhamdia quelen; Quoy and Gaimard, 1824) transported for four hours in plastic bags (loading density of 169.2 g L-1). The addition of various concentrations of EUG (1.5 or 3.0 mu L L-1) and EOL (10 or 20 mu L L-1) to the transport water is advisable for the transportation of silver catfish, since both concentrations of these substances increased the levels of NPSH antioxidant and decreased the TBARS levels in the liver. In addition, the lower liver levels of glycogen and lactate in these groups and lower AChE activity in the brain (EOL 10 or 20 mu L L-1) compared to the control group indicate that the energetic metabolism and neurotransmission were lower after administration of anesthetics, contributing to the maintenance of homeostasis and sedation status.Fundacao de Amparo a Pesquisa do Estado do Rio Grande do Sul (FAPERGS/PRONEX) [10/0016-8]; Conselho Nacional de Pesquisa e Desenvolvimento Cientifico (CNPq) [470964/2009-0]; Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES); CNPqinfo:eu-repo/semantics/publishedVersio