Zeit. Macht. Flüchtlinge. Und Flüchtlinge machen Zeit? Konzeptionen biografischer Zeiten im Asylkontext

"Der vorliegende Artikel diskutiert Teilergebnisse eines laufenden Dissertationsprojekts, das Bedeutungen in Zusammenhang mit Asyl und dem Asylverfahren aus Perspektive der AsylwerberInnen selbst verstehen will. Entlang intersubjektiver Konzeptionalisierungen biografischer Zeiten - d.h. Vergangenheit, Gegenwart und Zukunft - wird einerseits gezeigt, wie AsylwerberInnen mit Sinnangeboten der rechtlichen Praxis umgehen, und andererseits, auf welche Handlungsorientierungen und Identitätskonzepte dabei referenziert wird. Zu diskutieren, wie biografische Zeiten geformt werden und in welcher Beziehung diese zu rechtlichen und gesellschaftlichen Strukturen stehen, ermöglicht einen differenzierten Blick auf die Asylwirklichkeit in Österreich und fordert die Vorstellung von getriebenen, passiven und ohnmächtigen Flüchtlingen bzw. AsylwerberInnen heraus, ohne die wirkmächtigen strukturellen Zwänge zu vernachlässigen." (Autorenreferat)"The presented article discusses first of all results of an ongoing PhD-project, interested in understanding the meanings with regard to asylum and the asylum procedure from an asylum seekers' perspective. Focusing on intersubjective conceptualizations of biographical times - i.e., the past, the present and the future - it is shown: on the one hand, how asylum seekers deal with offered meanings of the legal practice; on the other, therein referred forms of action orientation as well as identity concepts are identified. To discuss the constitution of biographical times as well as their relation to legal and social structures allows for a differentiated perspective on asylum reality in Austria; notions of the pushed, passive and powerless refugee or asylum seeker are challenged without neglecting the powerful structural constraints." (author's abstract

Asyl als Anspruch? Der Alltag des Rechts und Rechte im Alltag von Asylsuchenden

inwiefern fordern Asylsuchende (Menschen-)Rechte ein? Können in einem allumfassend rechtlich regulierten und von Unsicherheit geprägten Alltag überhaupt Ansprüche gestellt werden? Lässt die Asylpraxis Raum für Subjektpositionen abseits von Opferschaft? Die Autorin nähert sich dem (Asyl-)Recht aus alltagssoziologischer Perspektive und fokussiert Asylsuchende als handelnde Subjekte und Rechteinhaber*innen. Dabei zeichnet sie Bedeutungen von Recht und Rechten in der österreichischen Asylwirklichkeit nach und schafft ein Verständnis für die Folgen rechtlicher, politischer und gesellschaftlicher Praktiken, die die Gewährleistung von Rechten an Dankbarkeit, Leistung und Anpassung koppeln

Daily Negative Work Events and Employees' Physiological and Psychological Reactions

Scholars have accumulated an abundant amount of knowledge on the association between work stressors and employees' health and well-being. However, notions of the complex interplay of physiological and psychological components of stress reactions are still in their infancy. Building on the Allostatic Load (AL) model, the present study considers short-term within-person effects of negative work events (NWEs) on indicators of both physiological (i.e., salivary cortisol) and psychological distress responses (i.e., negative affect and emotional exhaustion). Multilevel findings from an experience sampling study with 83 healthcare professionals suggest that reported NWEs predict employees' psychological but not endocrine stress responses. Results contribute to a more comprehensive understanding of employees' daily response patterns to occupational stressors

How are "teaching the teachers" courses in evidence based medicine evaluated? A systematic review

Background Teaching of evidence-based medicine (EBM) has become widespread in medical education. Teaching the teachers (TTT) courses address the increased teaching demand and the need to improve effectiveness of EBM teaching. We conducted a systematic review of assessment tools for EBM TTT courses. To summarise and appraise existing assessment methods for teaching the teachers courses in EBM by a systematic review. Methods We searched PubMed, BioMed, EmBase, Cochrane and Eric databases without language restrictions and included articles that assessed its participants. Study selection and data extraction were conducted independently by two reviewers. Results Of 1230 potentially relevant studies, five papers met the selection criteria. There were no specific assessment tools for evaluating effectiveness of EBM TTT courses. Some of the material available might be useful in initiating the development of such an assessment tool. Conclusion There is a need for the development of educationally sound assessment tools for teaching the teachers courses in EBM, without which it would be impossible to ascertain if such courses have the desired effect

Effect of a brief intervention on evidence-based medicine skills of pediatric residents

BACKGROUND: While Evidence-Based Medicine (EBM) skills are increasingly being taught in medical schools, teaching quality has been insufficient, so that incoming pediatric residents lack adequate EBM skills required for patient care. The objective of this study was to evaluate the effectiveness of a brief teaching module developed to improve EBM skills of pediatric residents. METHODS: With-in subjects study design with pre- and post-test evaluation was performed in a large urban pediatric residency training program in Brooklyn, New York. We included PGY-1s during intern orientation, while second and third year pediatric residents were selected based on schedule availability. Sixty-nine residents were enrolled into the study, 60 (87%) completed the training. An EBM training module consisting of three or four weekly two-hour seminars was conducted. The module was designed to teach core EBM skills including (1) formulating answerable clinical questions, (2) searching the evidence, (3) critical appraisal skills including validity and applicability, and (4) understanding levels of evidence and quantitative results for therapy articles. A portion of the Fresno test of competence in EBM was used to assess EBM skills. The test presented a clinical scenario that was followed by nine short answer questions. One to three questions were used to assess EBM skills for each of the four core skills. The κ co-efficient for inter-rater reliability was 0.74 (95% CI: 0.56–0.92). RESULTS: Prior to the training module, the residents achieved a mean score of 17% correct overall. Post intervention, the mean score increased to 63% with improvement in each EBM category. A mean of 4.08 more questions (out of 9) were answered correctly after the training (95% CI of 3.44–4.72). CONCLUSION: A brief training module was effective in improving EBM skills of pediatric residents

Epidemiology and Reporting Characteristics of Systematic Reviews

BACKGROUND: Systematic reviews (SRs) have become increasingly popular to a wide range of stakeholders. We set out to capture a representative cross-sectional sample of published SRs and examine them in terms of a broad range of epidemiological, descriptive, and reporting characteristics, including emerging aspects not previously examined. METHODS AND FINDINGS: We searched Medline for SRs indexed during November 2004 and written in English. Citations were screened and those meeting our inclusion criteria were retained. Data were collected using a 51-item data collection form designed to assess the epidemiological and reporting details and the bias-related aspects of the reviews. The data were analyzed descriptively. In total 300 SRs were identified, suggesting a current annual publication rate of about 2,500, involving more than 33,700 separate studies including one-third of a million participants. The majority (272 [90.7%]) of SRs were reported in specialty journals. Most reviews (213 [71.0%]) were categorized as therapeutic, and included a median of 16 studies involving 1,112 participants. Funding sources were not reported in more than one-third (122 [40.7%]) of the reviews. Reviews typically searched a median of three electronic databases and two other sources, although only about two-thirds (208 [69.3%]) of them reported the years searched. Most (197/295 [66.8%]) reviews reported information about quality assessment, while few (68/294 [23.1%]) reported assessing for publication bias. A little over half (161/300 [53.7%]) of the SRs reported combining their results statistically, of which most (147/161 [91.3%]) assessed for consistency across studies. Few (53 [17.7%]) SRs reported being updates of previously completed reviews. No review had a registration number. Only half (150 [50.0%]) of the reviews used the term “systematic review” or “meta-analysis” in the title or abstract. There were large differences between Cochrane reviews and non-Cochrane reviews in the quality of reporting several characteristics. CONCLUSIONS: SRs are now produced in large numbers, and our data suggest that the quality of their reporting is inconsistent. This situation might be improved if more widely agreed upon evidence-based reporting guidelines were endorsed and adhered to by authors and journals. These results substantiate the view that readers should not accept SRs uncritically

Investigation into experimental toxicological properties of plant protection products having a potential link to Parkinson's disease and childhood leukaemia

In 2013, EFSA published a literature review on epidemiological studies linking exposure to pesticides and human health outcome. As a follow up, the EFSA Panel on Plant Protection Products and their residues (PPR Panel) was requested to investigate the plausible involvement of pesticide exposure as a risk factor for Parkinson's disease (PD) and childhood leukaemia (CHL). A systematic literature review on PD and CHL and mode of actions for pesticides was published by EFSA in 2016 and used as background documentation. The Panel used the Adverse Outcome Pathway (AOP) conceptual framework to define the biological plausibility in relation to epidemiological studies by means of identification of specific symptoms of the diseases as AO. The AOP combines multiple information and provides knowledge of biological pathways, highlights species differences and similarities, identifies research needs and supports regulatory decisions. In this context, the AOP approach could help in organising the available experimental knowledge to assess biological plausibility by describing the link between a molecular initiating event (MIE) and the AO through a series of biologically plausible and essential key events (KEs). As the AOP is chemically agnostic, tool chemical compounds were selected to empirically support the response and temporal concordance of the key event relationships (KERs). Three qualitative and one putative AOP were developed by the Panel using the results obtained. The Panel supports the use of the AOP framework to scientifically and transparently explore the biological plausibility of the association between pesticide exposure and human health outcomes, identify data gaps, define a tailored testing strategy and suggests an AOP’s informed Integrated Approach for Testing and Assessment (IATA)

The effectiveness of a clinically integrated e-learning course in evidence-based medicine: A cluster randomised controlled trial

BACKGROUND: To evaluate the educational effects of a clinically integrated e-learning course for teaching basic evidence-based medicine (EBM) among postgraduates compared to a traditional lecture-based course of equivalent content. METHODS: We conducted a cluster randomised controlled trial in the Netherlands and the UK involving postgraduate trainees in six obstetrics and gynaecology departments. Outcomes (knowledge gain and change in attitude towards EBM) were compared between the clinically integrated e-learning course (intervention) and the traditional lecture based course (control). We measured change from pre- to post-intervention scores using a validated questionnaire assessing knowledge (primary outcome) and attitudes (secondary outcome). RESULTS: There were six clusters involving teaching of 61 postgraduate trainees (28 in the intervention and 33 in the control group). The intervention group achieved slightly higher scores for knowledge gain compared to the control, but these results were not statistically significant (difference in knowledge gain: 3.5 points, 95% CI -2.7 to 9.8, p = 0.27). The attitudinal changes were similar for both groups. CONCLUSION: A clinically integrated e-learning course was at least as effective as a traditional lecture based course and was well accepted. Being less costly than traditional teaching and allowing for more independent learning through materials that can be easily updated, there is a place for incorporating e-learning into postgraduate EBM curricula that offer on-the-job training for just-in-time learning. TRIAL REGISTRATION: Trial registration number: ACTRN12609000022268

A clinically integrated curriculum in Evidence-based Medicine for just-in-time learning through on-the-job training: The EU-EBM project

Background: Over the last years key stake holders in the healthcare sector have increasingly recognised evidence based medicine (EBM) as a means to improving the quality of healthcare. However, there is considerable uncertainty about the best way to disseminate basic knowledge of EBM. As a result, huge variation in EBM educational provision, setting, duration, intensity, content, and teaching methodology exists across Europe and worldwide. Most courses for health care professionals are delivered outside the work context ('stand alone') and lack adaptation to the specific needs for EBM at the learners' workplace. Courses with modern 'adaptive' EBM teaching that employ principles of effective continuing education might fill that gap. We aimed to develop a course for post-graduate education which is clinically integrated and allows maximum flexibility for teachers and learners. Methods: A group of experienced EBM teachers, clinical epidemiologists, clinicians and educationalists from institutions from eight European countries participated. We used an established methodology of curriculum development to design a clinically integrated EBM course with substantial components of e-learning. An independent European steering committee provided input into the process. Results: We defined explicit learning objectives about knowledge, skills, attitudes and behaviour for the five steps of EBM. A handbook guides facilitator and learner through five modules with clinical and e-learning components. Focussed activities and targeted assignments round off the learning process, after which each module is formally assessed. Conclusion: The course is learner-centred, problem-based, integrated with activities in the workplace and flexible. When successfully implemented, the course is designed to provide just-in-time learning through on-the-job-training, with the potential for teaching and learning to directly impact on practice. </p