Der Reflexion von Unterricht zuhören können? Eine Diskussion zum Einsatz von Stimulated Recalls als Format videobasierter Reflexion in der Lehrer*innenausbildung

Der vorliegende Beitrag stellt den Einsatz von Stimulated Recalls als ein Format videobasierter Unterrichtsreflexion vor. Dabei dient das Video (und damit das eigene Handeln) als Stimulus und Ausgangspunkt für eine Retrospektion auf die eigene Handlungspraxis. In diesem Zusammenhang wird zum einen auf die Potenziale und Grenzen für Reflexionsprozesse eingegangen und die Frage diskutiert, inwiefern durch das Stimulated Recall Reflexionsprozesse ermöglicht und dadurch professionelle Handlungsfähigkeiten angebahnt bzw. weiterentwickelt werden können. Zum anderen wird die Möglichkeit des Stimulated Recalls als Forschungsinstrument vorgestellt. Im Fokus steht dabei die empirische Rekonstruktion von Reflexionsprozessen

Risk stratification of Barrett's oesophagus using a non-endoscopic sampling method coupled with a biomarker panel: a cohort study

Background Barrett's oesophagus predisposes to adenocarcinoma. However, most patients with Barrett's oesophagus will not progress and endoscopic surveillance is invasive, expensive, and fraught by issues of sampling bias and the subjective assessment of dysplasia. We investigated whether a non-endoscopic device, the Cytosponge, could be coupled with clinical and molecular biomarkers to identify a group of patients with low risk of progression suitable for non-endoscopic follow-up. Methods In this multicentre cohort study (BEST2), patients with Barrett's oesophagus underwent the Cytosponge test before their surveillance endoscopy. We collected clinical and demographic data and tested Cytosponge samples for a molecular biomarker panel including three protein biomarkers (P53, c-Myc, and Aurora kinase A), two methylation markers (MYOD1 and RUNX3), glandular atypia, and TP53 mutation status. We used a multivariable logistic regression model to compute the conditional probability of dysplasia status. We selected a simple model with high classification accuracy and applied it to an independent validation cohort. The BEST2 study is registered with ISRCTN, number 12730505. Findings The discovery cohort consisted of 468 patients with Barrett's oesophagus and intestinal metaplasia. Of these, 376 had no dysplasia and 22 had high-grade dysplasia or intramucosal adenocarcinoma. In the discovery cohort, a model with high classification accuracy consisted of glandular atypia, P53 abnormality, and Aurora kinase A positivity, and the interaction of age, waist-to-hip ratio, and length of the Barrett's oesophagus segment. 162 (35%) of 468 of patients fell into the low-risk category and the probability of being a true non-dysplastic patient was 100% (99% CI 96–100) and the probability of having high-grade dysplasia or intramucosal adenocarcinoma was 0% (0–4). 238 (51%) of participants were classified as of moderate risk; the probability of having high-grade dysplasia was 14% (9–21). 58 (12%) of participants were classified as high-risk; the probability of having non-dysplastic endoscopic biopsies was 13% (5–27), whereas the probability of having high-grade dysplasia or intramucosal adenocarcinoma was 87% (73–95). In the validation cohort (65 patients), 51 were non-dysplastic and 14 had high-grade dysplasia. In this cohort, 25 (38%) of 65 patients were classified as being low-risk, and the probability of being non-dysplastic was 96·0% (99% CI 73·80–99·99). The moderate-risk group comprised 27 non-dysplastic and eight high-grade dysplasia cases, whereas the high-risk group (8% of the cohort) had no non-dysplastic cases and five patients with high-grade dysplasia. Interpretation A combination of biomarker assays from a single Cytosponge sample can be used to determine a group of patients at low risk of progression, for whom endoscopy could be avoided. This strategy could help to avoid overdiagnosis and overtreatment in patients with Barrett's oesophagus. Funding Cancer Research UK

Surgical technique: Posterior retropleural thoracotomy for resection of a T10 dumbbell schwannoma

Background: Myelopathy and nerve root dysfunction resulting from the imperceptible growth of intraspinal schwannomas have been well documented.[1] Thoracic spine schwannomas, in particular, have exceptional growth potential due to the presence of the posterior mediastinum and retropleural spaces accommodating insidious and often subclinical tumor expansion.[5] Extraspinal extension of these lesions, however, poses a distinct challenge for surgeons.[3,4]. Case Description: Here, we provide a two-dimensional intraoperative video demonstrating the technical nuances concerning maximally safe resection of a partially cystic thoracic dumbbell schwannoma having extraspinal extension with associated bony remodeling of the T10 vertebral body and neural foramen in a middle-aged male. A posterolateral approach with T8-T12 fusion, retropleural thoracotomy, facetectomies, and pediculectomies allowed for gross total resection. No intraoperative or postoperative complications were observed, and the parietal pleura was kept intact throughout the surgery. In addition, the patient continued to have improved symptoms and was ambulatory at 6-month follow-up. Conclusion: Gross total resection of a partially cystic thoracic dumbbell schwannoma was achieved without complications. Our use of a preoperative three-dimensional reconstruction for surgical planning,[2] intraoperative ultrasound,[6] and a durable instrumentation construct were essential for a successful outcome. Moreover, great care was taken to avoid violating the tumor-parietal pleura plane, which would have resulted in postoperative respiratory complications

Der Reflexion von Unterricht zuhören können? Eine Diskussion zum Einsatz von Stimulated Recalls als Format videobasierter Reflexion in der Lehrer*innenausbildung

Der vorliegende Beitrag stellt den Einsatz von Stimulated Recalls als ein Format videobasierter Unterrichtsreflexion vor. Dabei dient das Video (und damit das eigene Handeln) als Stimulus und Ausgangspunkt für eine Retrospektion auf die eigene Handlungspraxis. In diesem Zusammenhang wird zum einen auf die Potenziale und Grenzen für Reflexionsprozesse eingegangen und die Frage diskutiert, inwiefern durch das Stimulated Recall Reflexionsprozesse ermöglicht und dadurch professionelle Handlungsfähigkeiten angebahnt bzw. weiterentwickelt werden können. Zum anderen wird die Möglichkeit des Stimulated Recalls als Forschungsinstrument vorgestellt. Im Fokus steht dabei die empirische Rekonstruktion von Reflexionsprozessen. DOI 10.18442/10

Risk stratification of Barrett's oesophagus using a non-endoscopic sampling method coupled with a biomarker panel: a cohort study.

BACKGROUND: Barrett's oesophagus predisposes to adenocarcinoma. However, most patients with Barrett's oesophagus will not progress and endoscopic surveillance is invasive, expensive, and fraught by issues of sampling bias and the subjective assessment of dysplasia. We investigated whether a non-endoscopic device, the Cytosponge, could be coupled with clinical and molecular biomarkers to identify a group of patients with low risk of progression suitable for non-endoscopic follow-up. METHODS: In this multicentre cohort study (BEST2), patients with Barrett's oesophagus underwent the Cytosponge test before their surveillance endoscopy. We collected clinical and demographic data and tested Cytosponge samples for a molecular biomarker panel including three protein biomarkers (P53, c-Myc, and Aurora kinase A), two methylation markers (MYOD1 and RUNX3), glandular atypia, and TP53 mutation status. We used a multivariable logistic regression model to compute the conditional probability of dysplasia status. We selected a simple model with high classification accuracy and applied it to an independent validation cohort. The BEST2 study is registered with ISRCTN, number 12730505. FINDINGS: The discovery cohort consisted of 468 patients with Barrett's oesophagus and intestinal metaplasia. Of these, 376 had no dysplasia and 22 had high-grade dysplasia or intramucosal adenocarcinoma. In the discovery cohort, a model with high classification accuracy consisted of glandular atypia, P53 abnormality, and Aurora kinase A positivity, and the interaction of age, waist-to-hip ratio, and length of the Barrett's oesophagus segment. 162 (35%) of 468 of patients fell into the low-risk category and the probability of being a true non-dysplastic patient was 100% (99% CI 96-100) and the probability of having high-grade dysplasia or intramucosal adenocarcinoma was 0% (0-4). 238 (51%) of participants were classified as of moderate risk; the probability of having high-grade dysplasia was 14% (9-21). 58 (12%) of participants were classified as high-risk; the probability of having non-dysplastic endoscopic biopsies was 13% (5-27), whereas the probability of having high-grade dysplasia or intramucosal adenocarcinoma was 87% (73-95). In the validation cohort (65 patients), 51 were non-dysplastic and 14 had high-grade dysplasia. In this cohort, 25 (38%) of 65 patients were classified as being low-risk, and the probability of being non-dysplastic was 96·0% (99% CI 73·80-99·99). The moderate-risk group comprised 27 non-dysplastic and eight high-grade dysplasia cases, whereas the high-risk group (8% of the cohort) had no non-dysplastic cases and five patients with high-grade dysplasia. INTERPRETATION: A combination of biomarker assays from a single Cytosponge sample can be used to determine a group of patients at low risk of progression, for whom endoscopy could be avoided. This strategy could help to avoid overdiagnosis and overtreatment in patients with Barrett's oesophagus. FUNDING: Cancer Research UK.The BEST2 study was funded by Cancer Research UKThis is the author accepted manuscript. The final version is available from Elsevier via https://doi.org/10.1016/S2468-1253(16)30118-

Village Tourism

Tema ovog rada je seoski turizam. Seoski turizam nije novost cjelokupne svjetske turističke ponude, ali način na koji se on događa u današnje doba je novost i napredak u odnosu na prošla vremena. U prošlosti su bogati članovi društva, najčešće članovi kraljevskih obitelji, išli u lov u svoje seoske kuće za odmor. Danas je turistička ponuda ipak drugačija. Seoski turizam je idealan spoj poljoprivrede, turizma i gastronomije. Ljudi se okreću seoskom turizmu kako bi se odmorili od stresne svakodnevice, upoznali prirodu, te probali okuse sa domaćih poljoprivrednih gospodarstava. Seoski turizam će u budućnosti svakako još napredovati s obzirom na to da sve više zemalja prepoznaje važnost ovog turističkog segmenta.The topic of this paper is rural tourism. Rural tourism is not new overall world tourism offer, but the way it happens in this day and age is a novelty and progress compared to past times. In the past, wealthy members of society, most often members of royal families, went hunting in their country holiday homes. Today, however, the tourist offer is different. Rural tourism is an ideal combination of agriculture, tourism and gastronomy. People turn to rural tourism to take a break from stressful everyday life, get to know nature, and try flavors from local farms. Rural tourism will certainly continue to thrive in the future as more and more countries recognize the importance of this tourism segment

Application of virtual and augmented reality technology in the function of cultural tourism management

Turizam je vrlo značajna grana industrije koja zemljama sa razvijenom turističkom ponudom donosi veliku količinu financijskih resursa. Kao i svaku granu industrije, utjecaj industrijalizacija i globalizacije čini i turizam podložnim promjenama. Najpoznatije vrste virutalnih tehnologija su virtualna stvarnost, virtualna restauracija i proširena stvarnost, koje najveću primjenu nalaze upravo u području turizma i edukacije. Virtualna stvarnost odnosi se na povezivanje stvarnih objekata sa virutalnim uz primjenu tehnologije. Kod ove vrste virtualne tehnologije, radi se o računalnoj simulaciji. Osoba se tada osjeća kao da se nalazi u virtualnom okruženju, a taj doživljaj ima kroz monitor u koji gleda ili kroz naočale koje nosi. Proširena stvarnost se odnosi na stvarnu sliku koju korisnik vidi, ali u proširenom obliku, dakle sa nadograđenim informacijama koje su stvorene virtualno.Virtualna i proširena stvarnost su tehnologije koje su našle svoje mjesto u kreiranju nove turističke ponude i novih proizvoda. Pomoću njih, turističke destinacije razvijaju sasvim nove vrste ponude koje se temelje na digitalizaciji usluga i turističkih proizvoda. Specijalizirani, odnosno selektivni oblici turizma možda najviše mogu iskoristiti ovakve tehnologije, a osobito kulturni turizam i njegovi oblici.Tourism is a very important branch of industry that brings a large amount of financial resources to countries with a developed tourist offer. Like every branch of industry, the impact of industrialization and globalization makes tourism subject to change. The most well-known types of virtual technologies are virtual reality, virtual restoration and augmented reality, which are most widely used in the field of tourism and education. Virtual reality refers to connecting real objects with virtual ones with the application of technology. With this type of virtual technology, it is a computer simulation. The person then feels as if he is in a virtual environment, and he has this experience through the monitor he is looking at or through the glasses he is wearing. Augmented reality refers to the real image that the user sees, but in an expanded form, i.e. with upgraded information created virtually. Virtual and augmented reality are technologies that have found their place in the creation of new tourist offers and new products. Using them, tourist destinations develop completely new types of offers based on the digitization of services and tourist products. Specialized or selective forms of tourism can perhaps make the most use of these technologies, especially cultural tourism and its forms

Village Tourism

Tema ovog rada je seoski turizam. Seoski turizam nije novost cjelokupne svjetske turističke ponude, ali način na koji se on događa u današnje doba je novost i napredak u odnosu na prošla vremena. U prošlosti su bogati članovi društva, najčešće članovi kraljevskih obitelji, išli u lov u svoje seoske kuće za odmor. Danas je turistička ponuda ipak drugačija. Seoski turizam je idealan spoj poljoprivrede, turizma i gastronomije. Ljudi se okreću seoskom turizmu kako bi se odmorili od stresne svakodnevice, upoznali prirodu, te probali okuse sa domaćih poljoprivrednih gospodarstava. Seoski turizam će u budućnosti svakako još napredovati s obzirom na to da sve više zemalja prepoznaje važnost ovog turističkog segmenta.The topic of this paper is rural tourism. Rural tourism is not new overall world tourism offer, but the way it happens in this day and age is a novelty and progress compared to past times. In the past, wealthy members of society, most often members of royal families, went hunting in their country holiday homes. Today, however, the tourist offer is different. Rural tourism is an ideal combination of agriculture, tourism and gastronomy. People turn to rural tourism to take a break from stressful everyday life, get to know nature, and try flavors from local farms. Rural tourism will certainly continue to thrive in the future as more and more countries recognize the importance of this tourism segment

Application of virtual and augmented reality technology in the function of cultural tourism management

Turizam je vrlo značajna grana industrije koja zemljama sa razvijenom turističkom ponudom donosi veliku količinu financijskih resursa. Kao i svaku granu industrije, utjecaj industrijalizacija i globalizacije čini i turizam podložnim promjenama. Najpoznatije vrste virutalnih tehnologija su virtualna stvarnost, virtualna restauracija i proširena stvarnost, koje najveću primjenu nalaze upravo u području turizma i edukacije. Virtualna stvarnost odnosi se na povezivanje stvarnih objekata sa virutalnim uz primjenu tehnologije. Kod ove vrste virtualne tehnologije, radi se o računalnoj simulaciji. Osoba se tada osjeća kao da se nalazi u virtualnom okruženju, a taj doživljaj ima kroz monitor u koji gleda ili kroz naočale koje nosi. Proširena stvarnost se odnosi na stvarnu sliku koju korisnik vidi, ali u proširenom obliku, dakle sa nadograđenim informacijama koje su stvorene virtualno.Virtualna i proširena stvarnost su tehnologije koje su našle svoje mjesto u kreiranju nove turističke ponude i novih proizvoda. Pomoću njih, turističke destinacije razvijaju sasvim nove vrste ponude koje se temelje na digitalizaciji usluga i turističkih proizvoda. Specijalizirani, odnosno selektivni oblici turizma možda najviše mogu iskoristiti ovakve tehnologije, a osobito kulturni turizam i njegovi oblici.Tourism is a very important branch of industry that brings a large amount of financial resources to countries with a developed tourist offer. Like every branch of industry, the impact of industrialization and globalization makes tourism subject to change. The most well-known types of virtual technologies are virtual reality, virtual restoration and augmented reality, which are most widely used in the field of tourism and education. Virtual reality refers to connecting real objects with virtual ones with the application of technology. With this type of virtual technology, it is a computer simulation. The person then feels as if he is in a virtual environment, and he has this experience through the monitor he is looking at or through the glasses he is wearing. Augmented reality refers to the real image that the user sees, but in an expanded form, i.e. with upgraded information created virtually. Virtual and augmented reality are technologies that have found their place in the creation of new tourist offers and new products. Using them, tourist destinations develop completely new types of offers based on the digitization of services and tourist products. Specialized or selective forms of tourism can perhaps make the most use of these technologies, especially cultural tourism and its forms