Dietary supplement use in ambulatory cancer patients: a survey on prevalence, motivation and attitudes

Purpose: Patients with cancer often believe dietary supplements (DS) such as micronutrients and botanical products to be health supporting and non-toxic despite growing concerns regarding potential pharmacological interactions. Studies on the prevalence of DS use among patients with cancer are heterogeneous and mainly conducted at university-based cancer centers. This survey focused on a particular cancer patient group treated in an ambulatory setting without regular access to professional nutritional counselling. Methods: Patients with a history of cancer or hematological malignancy were included in this survey. A self-reported questionnaire was used to evaluate the different aspects of DS use, changes in dietary habits and patients' demographic characteristics. Results: Almost every second patient reported using DS (47.2%). Women (56.3%), patients with an academic degree (56.0%) and non-smokers (84.8%) were more inclined to use DS. Along with magnesium (16.6%), calcium (14.3%), multivitamins (12.0%) and vitamin C (9.4%), use of herbal supplements (12.6%) was common. Women (84.8% vs. 74.9% of men, p = 65 y, p = 0.002) sought dietary advice more often. Support of the immune system was the main reason for DS use (26.4%) and a relevant number of patients (49.6%) reported to have changed their dietary habits following cancer diagnosis. Conclusion: DS use is common among patients with cancer treated in an ambulatory setting. This finding should encourage oncologists to implement detailed questioning about DS use and dietary habits to prevent potential interactions and offer substantial advice

Severe Weight Loss and Its Association with Fatigue in Old Patients at Discharge from a Geriatric Hospital

Although malnutrition is frequent in the old, little is known about its association with fatigue. We evaluated the relation of self-reported severe weight loss with fatigue and the predictors for fatigue in old patients at hospital discharge. Severe weight loss was defined according to involuntary weight loss ≥5% in the last three months. We determined fatigue with the validated Brief Fatigue Inventory questionnaire. The regression analyses were adjusted for age, sex, number of comorbidities, medications/day, and BMI. Of 424 patients aged between 61 and 98 y, 34.1% had severe weight loss. Fatigue was higher in patients with severe weight loss (3.7 ± 2.3 vs. 3.2 ± 2.3 points, p = 0.021). In a multinomial regression model, weight loss was independently associated with higher risk for moderate fatigue (OR:1.172, CI:1.026-1.338, p = 0.019) and with increased risk for severe fatigue (OR:1.209, CI:1.047-1.395, p = 0.010) together with the number of medications/day (OR:1.220, CI:1.023-1.455, p = 0.027). In a binary regression model, severe weight loss predicted moderate-to-severe fatigue in the study population (OR:1.651, CI:1.052-2.590, p = 0.029). In summary, patients with self-reported severe weight loss at hospital discharge exhibited higher fatigue levels and severe weight loss was an independent predictor of moderate and severe fatigue, placing these patients at risk for impaired outcome in the post-hospital period

Re-Examining School Structures of People, Place, and Time to Promote Equity at the Middle Level

In 2018 we published a chapter entitled “Middle Grades Schools and Structures” (Ellerbrock et al., 2018a) in Literature Reviews in Support of the Middle Level Education Research Agenda (Mertens et al., 2013). Building on the earlier work of Ellerbrock et al. (2018a), this chapter reviewed literature between 2000 and 2018 that reported on the organizational structures of middle level education settings in the United States of America and Australia. Though the findings highlighted the dearth of research specifically examining the organizational structures of middle level education, the literature examined supported the original three key interconnected themes of people, place, and time (Ellerbrock et al., 2018b) as being key features necessary for the implementation of effective middle schooling practices. In our conclusion, we called for more robust research in this area to guide policy and enact practices across different jurisdictions. At the same time, Bishop and Nagle (2018) noted the many increasing disparities in access to quality education and invited readers to consider how schools can serve all students both equitably and well. Equitable access is first and foremost, but equitable outcomes for all students is paramount. At the time of publication of all of these works, no one could have predicted the significant negative impact of COVID-19 and the resultant exacerbation of the already challenging inequities in education across the globe. However, research over the last five years, and particularly since 2020, has placed a greater focus on policy, system, and grassroots pedagogical changes to bridge this widening gap. In light of this heightened focus, this essay aims to reexamine the three key themes of people, place, and time and, when implemented with integrity, the ways middle grades schools and structures can contribute to creating both developmentally responsive and equitable educational experiences for young adolescent learners

Spielraum für Kommunikation und Partizipation - Befragungen im Sachunterricht. Kommunikativer Sachunterricht am Beispiel eines inklusiven Spielplatzes im Nahraum der Schule

Spielplätze gehören zum alltäglichen Leben von Kindern. Sie nutzen diese aktiv oder kommen auf dem Schulweg daran vorbei. Was aber, wenn in der Umgebung der eigenen Schule nun ein solcher Platz neu entstehen oder ein vorhandener Spielplatz umgestaltet werden soll? Mittels einer Online-Befragung wird der Spielplatz und seine Umgebung im Nahraum der Schule zum Ausgangspunkt und Gegenstand kommunikativen Sachunterrichts. Das Unterrichtsbeispiel zielt darauf ab, Schüler*innen für ihre Lebensräume und die Bedürfnisse anderer Menschen zu sensibilisieren, lässt sich an vielen Orten realisieren und auch auf andere Räume problemlos übertragen. (DIPF/Orig.

Alle(s) drin? Lernwerkstattarbeit und Professionalisierung im Kontext von Inklusion

Die Autorinnen beschreiben, wie Studierende in der Lernwerkstattarbeit mit Kindern in schulpraktischen Studien oder im Rahmen von Berufsfelderprobungen in der Hochschullernwerkstatt der PH Heidelberg die Planung und Durchführung von offenen Werkstattangeboten erproben und in der Rolle von Lernbegleiter*innen immanent das eigene pädagogische Handeln erleben und reflektieren. Insbesondere die Begegnungen mit Kindern in der Lernwerkstatt tragen maßgeblich zu einer Bearbeitung verschiedener Entwicklungsaufgaben bei. (DIPF/Orig.

Malnutrition is associated with six-month mortality in older patients admitted to the emergency department with hip fracture

Background: Hip fractures in older people are a common health problem often associated with malnutrition that might affect outcomes. Screening for malnutrition is not a routine examination in emergency departments (ED). This analysis of the EMAAge study, a prospective, multicenter cohort study, aimed to evaluate the nutritional status of older patients (>= 50 years) with hip fracture, factors associated with malnutrition risk, and the association between malnutrition and the six-months mortality. Methods: Risk of malnutrition was evaluated using the Short Nutritional Assessment Questionnaire. Clinical data as well as data on depression and physical activity were determined. Mortality was captured for the first six months after the event. To assess factors associated with malnutrition risk we used a binary logistic regression. A Cox proportional hazards model was used to assess the association of malnutrition risk with six-month survival adjusted for other relevant risk factors. Results: The sample consisted of N = 318 hip fracture patients aged 50 to 98 (68% women). The prevalence of malnutrition risk was 25.3% (n = 76) at the time of injury. There were no differences in triage categories or routine parameters measured in the ED that could point to malnutrition. 89% of the patients (n = 267) survived for six months. The mean survival time was longer in those without malnutrition risk (171.9 (167.1-176.9) days vs. 153.1 (140.0-166.2) days). The Kaplan Meier curves and the unadjusted Cox regression (Hazard Ratio (HR) 3.08 (1.61-5.91)) showed differences between patients with and patients without malnutrition risk. In the adjusted Cox regression model, risk of death was associated with malnutrition risk (HR 2.61, 1.34-5.06), older age (70-76 years: HR 2.5 (0.52-11.99); 77-82 years: HR 4.25 (1.15-15.62); 83-99 years: HR 3.82 (1.05-13.88)) and a high burden of comorbidities (Charlson Comorbidity Index >= 3: HR 5.4 (1.53-19.12)). Conclusion: Risk of malnutrition was associated with higher mortality after hip fracture. ED parameters did not differentiate between patients with nutritional deficiencies and those without. Therefore, it is particularly important to pay attention to malnutrition in EDs to detect patients at risk of adverse outcomes and to initiate early interventions

Oxygen dynamics and transport in the Mediterranean sponge Aplysina aerophoba

The Mediterranean sponge Aplysina aerophoba kept in aquaria or cultivation tanks can stop pumping for several hours or even days. To investigate changes in the chemical microenvironments, we measured oxygen profiles over the surface and into the tissue of pumping and non-pumping A. aerophoba specimens with Clark-type oxygen microelectrodes (tip diameters 18–30 μm). Total oxygen consumption rates of whole sponges were measured in closed chambers. These rates were used to back-calculate the oxygen distribution in a finite-element model. Combining direct measurements with calculations of diffusive flux and modeling revealed that the tissue of non-pumping sponges turns anoxic within 15 min, with the exception of a 1 mm surface layer where oxygen intrudes due to molecular diffusion over the sponge surface. Molecular diffusion is the only transport mechanism for oxygen into non-pumping sponges, which allows total oxygen consumption rates of 6–12 μmol cm−3 sponge day−1. Sponges of different sizes had similar diffusional uptake rates, which is explained by their similar surface/volume ratios. In pumping sponges, oxygen consumption rates were between 22 and 37 μmol cm−3 sponge day−1, and the entire tissue was oxygenated. Combining different approaches of direct oxygen measurement in living sponges with a dynamic model, we can show that tissue anoxia is a direct function of the pumping behavior. The sponge-microbe system of A. aerophoba thus has the possibility to switch actively between aerobic and anaerobic metabolism by stopping the water flow for more than 15 min. These periods of anoxia will greatly influence physiological variety and activity of the sponge microbes. Detailed knowledge about the varying chemical microenvironments in sponges will help to develop protocols to cultivate sponge-associated microbial lineages and improve our understanding of the sponge-microbe-syste

Research results on teacher cooperation. A narrative review

Lehrerkooperation schreibt man sowohl einen Mehrwert für die Lernenden als auch eine entlastende Wirkung für die Lehrenden und positive Effekte für die Innovationsbereitschaft von Kollegien zu. Inwiefern diese Zusammenhänge empirisch bestätigt sind, wird durch eine Zusammenschau der Befunde der letzten 15 Jahre im deutschsprachigen Raum analysiert. Daraus lassen sich Erkenntnisse für die Praxis ziehen, Forschungsdesiderate aufzeigen und Hinweise auf forschungsmethodische Herausforderungen ableiten. (DIPF/Orig.)Cooperation of teachers has been attributed an additional benefit for learners, a relief for teachers, and positive effects on the teaching staff\u27s will to innovate schools. The review focuses on the forms, effects and conditions of success of teacher cooperation according to German research within the last 15 years. Practical advice is deduced, empirical desiderata and methodological defiances are pointed out. (DIPF/Orig.

THE CHALLENGES OF HIGHER EDUCATION FOR YOUTH FROM ALTERNATIVE CARE IN CROATIA

Polazeći od poimanja sustava visokog obrazovanja kao javnog dobra i značaja socijalne dimenzije obrazovanja, u fokusu ovog rada je studiranje djece iz skrbi za koju je samo sudjelovanje u obrazovnom procesu, a osobito postizanje višeg obrazovanja značajan čimbenik socijalne uključenosti. Rad donosi rezultate istraživanja provedenog u okviru istraživačkog projekta »Izazovi studiranja i podrške studentima odraslima u javnoj skrbi« financiranog od strane Sveučilišta u Zagrebu. S ciljem opisa specifičnosti i doživljaja studentskog života, provedeno je kvalitativno istraživanje s 23 mlade osobe s iskustvom života u alternativnoj skrbi. Održano je 5 fokusnih grupa u 5 sveučilišnih gradova: Zagrebu, Rijeci, Splitu, Osijeku i Puli. Prikupljeni podaci obrađeni su i grupirani analizom (tematskog) okvira u sljedeće teme: motivi upisa na fakultet, obilježja studiranja, percepcija sebe i drugih vršnjaka, čimbenici koji olakšavaju studiranje te socijalna mreža. Rezultati ovog istraživanja ukazuju na potrebu za pružanjem ciljane, sustavne podrške kako bi ova skupina mladih mogla unaprijediti i ostvariti svoje potencijale i lakše prevladala nepovoljne okolnosti koje prate njihov obrazovni put. U tu svrhu, važno je planirati suradnju između sustava socijalne skrbi i sustava odgoja i obrazovanja na svim razinama.Based on the perception of higher education system as a public good and the importance of the social aspect of education, this paper focuses on children from care, for whom mere participation in the education process, and especially in higher education, is a significant factor of social inclusion. The paper presents the results of research carried out as part of “The challenges of pursuing studies and providing support to students brought up in public care”, a research project financed by the University of Zagreb. The aim of qualitative research carried out on 23 students with in-care experience was to describe the particularities and experience of their student life. Five focus groups were held in five university cities: Zagreb, Rijeka, Split, Osijek and Pula. The collected data was processed and grouped according to the analysis of the (thematic) framework in the following themes: motives for enrolment, characteristics of studying, perception of self and other peers, facilitating factors in the studying process and social network. The results of this research indicate the need to provide targeted, systematic support in order for this group to improve and realize their potential and more easily overcome the unfavourable circumstances that have characterised their educational path. Hence, it is important to plan cooperation between the social care system and education system on all levels

Historisches Denken diagnostizieren. Entwicklung und Pilotierung eines Kodiermanuals

Die Förderung historischen Denkens von Kindern und damit eines reflektierten Geschichtsbewusstseins ist für eine nachhaltige Bildung von hoher Bedeutsamkeit. Denn ein reflektiertes Geschichtsbewusstsein und mit ihm historische Kompetenzen wie die Frage-, Methoden-, Reflexions- und Dekonstruktionskompetenz ermöglichen es Schüler*innen und späteren Erwachsenen, die Welt multiperspektivisch zu betrachten und zu verstehen: Sie bieten die Grundlage für eine reflektierte und selbstreflexive Orientierung in der Zeit und in der Welt, da sie dazu befähigen, Deutungsmuster zu erkennen und zu hinterfragen. Für eine in die Unterrichtsplanung eingebundene adaptive Förderung von Schüler*innen ist eine immanente Diagnostik, d.h. eine regelmäßige Einschätzung der individuellen Lernvoraussetzungen in Bezug auf das zu unterrichtende Thema, unabdingbar. Im Projekt „Früher gab’s nur kalt“ wurde ein material- und bildgestützter Interviewleitfaden entwickelt und anhand einer Stichprobe von 143 Kindern pilotiert. Im vorliegenden Beitrag wird der Entwurf eines Kodiermanuals vorgestellt, das wir derzeit aus Kodierungen im Rahmen der Interview-Pilotierung erarbeiten. Ziel ist, dadurch sowohl eine immanente Diagnostik als auch eine adaptive Förderung im Sachunterricht mit Schwerpunkt Geschichte zu erleichtern. (DIPF/Orig.