Nach Bologna: Warum das Neue (manchmal) nicht in die Hochschule kommt. Das Beispiel Praxisphasen im Studium

Der Beitrag präsentiert Ergebnisse einer multiperspektivischen, empirischen Untersuchung zur curricularen Verankerung von Praxisphasen im Studium und beschreibt exemplarisch dabei auftretende praktische Umsetzungsprobleme. Die Ergebnisse, die im Rahmen des BMBF-Forschungsprojektes ProPrax mittels Dokumentenanalysen und Studierendenbefragungen ermittelt wurden, verweisen auf eine Diskrepanz zwischen den Forderungen nach Reformen (z. B. Beschäftigungsfähigkeit) und der Umsetzung im Hochschulalltag. Als mögliche Gründe dafür werden sowohl strukturelle als auch hochschulspezifische Aspekte diskutiert. Empfehlungen für eine Qualitätssicherung von Praxisphasen werden abgeleitet. 02.11.2011 | Wilfried Schubarth, Karsten Speck, Andreas Seidel, Corinna Gottmann, Caroline Kamm, Andrea Kopp & Maud Krohn (Potsdam und Oldenburg

Dendritic/antigen presenting cell mediated provision of T-cell receptor gamma delta (TCRγδ) expressing cells contributes to improving antileukemic reactions ex vivo

T-cell receptor gamma delta (TCRγδ) expressing T-cells are known to mediate an MHC-independent immune response and could therefore qualify for immune therapies. We examined the influence of dendritic cells(DC)/antigen presenting cell (APC) generated from blast-containing whole blood (WB) samples from AML and MDS patients on the provision of (leukemia-specific) TCRγδ expressing T-cells after mixed lymphocyte culture (MLC). Kit-M (granulocyte-macrophage colony-stimulating factor (GM-CSF) + prostaglandin E1 (PGE1)) or Kit-I (GM-CSF + Picibanil) were used to generate leukemia derived APC/DC (DCleu)from WB, which were subsequently used to stimulate T-cell enriched MLC. Immune cell composition and functionality were analysed using degranulation- (DEG), intracellular cytokine- (INTCYT) and cytotoxicity fluorolysis- (CTX) assays. Flow cytometry was used for cell quantification. We found increased frequencies of APCs/DCs and their subtypes after Kit-treatment of healthy and patients´ WB compared to control, as well as an increased stimulation and activation of several types of immune reactive cells after MLC. Higher frequencies of TCRγδ expressing leukemia-specific degranulation and intracellularly cytokine producing T-cells were found. The effect of Kit-M-treatment on frequencies of TCRγδ expressing cells and their degranulation could be correlated with the Kit-M-mediated blast lysis compared to control. We also found higher frequencies of TCRγδ expressing T-cells in AML patients´ samples with an achieved remission (compared to blast persistence) after induction chemotherapy. This might point to APC/DC-mediated effects resulting in the provision of leukemia-specific TCRγδ expressing T-cells: Moreover a quantification of TCRγδ expressing T-cells might contribute to predict prognosis of AML/MDS patients

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Objectively measured versus self-reported physical activity in children and adolescents with cancer.

OBJECTIVE:Existing research recognizes low levels of physical activity in pediatric patients with cancer, but much uncertainty exists about their capability to self-reflect physical activity levels. The objective of this study was to compare results of subjective self-reports and objective accelerometers regarding levels of daily walking as well as moderate-to-vigorous physical activities. METHODS:Results of the objective assessment tool StepWatchTM Activity Monitor and self-reporting with a standardized questionnaire were compared in 28 children and adolescents during cancer treatment. RESULTS:The patients were 13.8±2.8 years of age and 3.4±2.0 months after cancer diagnosis. The Bland-Altman plots indicated a fairly symmetrical under- and over-estimation for daily minutes of walking with the limits of agreement ranging from -100.8 to 87.3 min (d = -6.7 min). Mean difference for moderate-to-vigorous physical activity was almost zero but limits of agreement are ranging from -126.8 to 126.9 min. The comparison for the days with at least 60 min of moderate-to-vigorous physical activity showed a marked difference with 3.0±2.6 self-reported days versus only 0.1±0.4 measured days. CONCLUSIONS:These findings suggest that physical activity in pediatric cancer patients should preferably be assessed with objective methods. Greater efforts are needed to implement supervised exercise interventions during treatment incorporating methods to improve self-reflection of physical activity

Studium und Beruf - Praxiskonzepte von Studierenden der Soziologie und Sozialwissenschaften

Hessler G, Oechsle M. Studium und Beruf - Praxiskonzepte von Studierenden der Soziologie und Sozialwissenschaften. In: Schubarth W, Speck K, Seidel A, Gottmann C, Kamm C, Krohn M, eds. Studium nach Bologna: Praxisbezüge stärken?!. Wiesbaden: Springer VS; 2012: 113-126

„Mehr ist nicht genug (…)!“ Praxiskonzepte von Studierenden in der Lehrerbildung - Ergebnisse einer qualitativen Untersuchung

Schüssler R, Keuffer J. „Mehr ist nicht genug (…)!“ Praxiskonzepte von Studierenden in der Lehrerbildung - Ergebnisse einer qualitativen Untersuchung. In: Schubarth W, Speck K, Seidel A, Gottmann C, Kamm C, Krohn M, eds. Studium nach Bologna: Praxisbezüge stärken?! Praktika als Brücke zwischen Hochschule und Arbeitsmarkt. Wiesbaden: Springer-VS; 2012: 185-195

Characteristics of the study population.

<p>Characteristics of the study population.</p

Bland-Altman plot of differences for weekly MVPA comparing AQ and SAM.

<p>x axis: mean of self-report/AQ and objective measure/SAM, y axis: differences between AQ and SAM, d = 0.05 min, 95% confidence limits.</p

Bland-Altman plot of differences for daily walking minutes comparing AQ and SAM.

<p>x axis: mean of self-report/AQ and objective measure/SAM, y axis: differences between AQ and SAM, d = -6.7, 95% confidence limits.</p

Overview of the compared categories and respective measures of the AQ and SAM.

<p>Overview of the compared categories and respective measures of the AQ and SAM.</p