Epidemiologie und Verlauf der Migräne bei Patienten mit Multipler Sklerose

In dieser Studie wurde erstmalig unter Zuhilfenahme der Kriterien der International Headache Society eine Evaluation der Lebenszeit-Prävalenz von Migräne bei MS durchgeführt. Im Rahmen dieser Fall-Kontroll-Studie wurden 512 Patienten mit nach Poser-Kriterien diagnostizierter MS und 512 alters- und geschlechtsgematchte Personen eingeschlossen. Bei 71 der MS-Patienten (13,9%) konnte die Diagnose Migräne gestellt werden, während in der Kontrollgruppe bei 98 Patienten (19,1%) diese Diagnose zutraf. Dieser Unterschied ist statistisch signifikant (p=0,023). Bei der schubförmigen Verlaufsform der MS ließ sich bei 37 Patienten (18,9%), bei der primär chronischen und der sekundär chronischen Verlaufsform bei insgesamt 13 Patienten (9,6%) eine Migräne diagnostizieren. Dieser Unterschied ist ebenfalls statistisch signifikant (p=0,02). Daraus lässt sich folgern, dass für den Unterschied zwischen beiden Gruppen primär die niedrige Prävalenz bei den chronischen Verlaufsformen der MS verantwortlich ist

Measuring the ambiguity tolerance of medical students: a cross-sectional study from the first to sixth academic years

BACKGROUND: Tolerance of ambiguity, or the extent to which ambiguous situations are perceived as desirable, is an important component of the attitudes and behaviors of medical students. However, few studies have compared this trait across the years of medical school. General practitioners are considered to have a higher ambiguity tolerance than specialists. We compared ambiguity tolerance between general practitioners and medical students. METHODS: We designed a cross-sectional study to evaluate the ambiguity tolerance of 622 medical students in the first to sixth academic years. We compared this with the ambiguity tolerance of 30 general practitioners. We used the inventory for measuring ambiguity tolerance (IMA) developed by Reis (1997), which includes three measures of ambiguity tolerance: openness to new experiences, social conflicts, and perception of insoluble problems. RESULTS: We obtained a total of 564 complete data sets (return rate 90.1%) from medical students and 29 questionnaires (return rate 96.7%) from general practitioners. In relation to the reference groups defined by Reis (1997), medical students had poor ambiguity tolerance on all three scales. No differences were found between those in the first and the sixth academic years, although we did observe gender-specific differences in ambiguity tolerance. We found no differences in ambiguity tolerance between general practitioners and medical students. CONCLUSIONS: The ambiguity tolerance of the students that we assessed was below average, and appeared to be stable throughout the course of their studies. In contrast to our expectations, the general practitioners did not have a higher level of ambiguity tolerance than the students did

Experiences with a simulated learning environment - the SimuScape©: virtual environments in medical education

Simulation as a tool for medical education has gained considerable importance in the past years. Various studies have shown that the mastering of basic skills happens best if taught in a realistic and workplace-based context. It is necessary that simulation itself takes place in the realistic background of a genuine clinical or in an accordingly simulated learning environment. A panoramic projection system that allows the simulation of different scenarios has been created at the medical school of the Westphalian Wilhelms-University Muenster/Germany. The SimuScape© is a circular training room of six meters in diameter and has the capacity to generate pictures or moving images as well as the corresponding background noises for medical students, who are then able to interact with simulated patients inside a realistic environment. About 1,000 students have been instructed using the SimuScape© in the courses of emergency medicine, family medicine and anesthesia. The SimuScape©, with its 270°-panoramic projection, gives the students the impression “of being right in the center of action”. It is a flexible learning environment that can be easily integrated into curricular teaching and which is in full operation for 10 days per semester. The SimuScape© allows the establishment of new medical areas outside the hospital and surgery for simulation and it is an extremely adaptable and cost-effective utilization of a lecture room. In this simulated environment it is possible to teach objectives like self-protection and patient care during disturbing environmental influences in practicePeer Reviewe

Teaching ultrasound in a curricular course according to certified EFSUMB standards during undergraduate medical education: a prospective study

Background: As a non-invasive and readily available diagnostic tool, ultrasound is one of the most important imaging techniques in medicine. Ultrasound is usually trained during residency preferable according to German Society of Ultrasound in Medicine (DEGUM) standards. Our curriculum calls for undergraduate training in ultrasound of medical students in their 4th year of undergraduate education. An explorative pilot study evaluated the acceptance of this teaching method, and compared it to other practical activities in medical education at Muenster University. Methods: 240 medical students in their 4th year of undergraduate medical education participated in the training and completed a pre- and post-questionnaire for self-assessment of technical knowledge, self-assurance of the procedure, and motivation in performing ultrasound using a Likert scale. Moreover, students were asked about their interest in pursuing a career in internal medicine. To compare this training to other educational activities a standardized online evaluation tool was used. A direct observation of procedural skills assessment (DOPS) for the first time applied on ultrasound aimed to independently assess the success of our teaching method. Results: There was a significant increase in technical knowledge and self-assurance (p < 0.001) of the students’ self-assessments. The clinical relevance and self-motivation of the teaching were evaluated positively. The students’ DOPS results demonstrated proficiency in the understanding of anatomic structures shown in ultrasonographic images, including terminology, machine settings, and transducer frequencies. Conclusions: Training ultrasound according to certified DEGUM standards was successful and should be offered in undergraduate medical education. The evaluation of the course affirmed the necessity, quality and clinical relevance of the course with a top ranking score of hands-on training courses within the educational activities of the Medical Faculty of Muenster.<br

Compound events in Germany in 2018: drivers and case studies

The European continent is regularly affected by a wide range of extreme events and natural hazards including heatwaves, extreme precipitation, droughts, cold spells, windstorms, and storm surges. Many of these events do not occur as single extreme events, but rather show a multivariate character, the so-called compound events. Within the scope of the interdisciplinary project climXtreme (https://climxtreme.net/), we investigate the interplay of extreme weather events, their characteristics and changes, intensity, frequency and uncertainties in the past, present and future and associated impacts on various socio-economic sectors in Germany and Central Europe. This contribution presents several case studies with special emphasis on the calendar year of 2018, which is of particular interest given the exceptional sequence of different compound events across large parts of Europe, with devastating impacts on human lives, ecosystems and infrastructure. We provide new evidence on drivers of spatially and temporally compound events (heat and drought; heavy precipitation in combination with extreme winds) with adverse impacts on ecosystems and society using large-scale atmospheric patterns. We shed light on the interannual influence of droughts on surface water and the impact of water scarcity and heatwaves on agriculture and forests. We assessed projected changes in compound events at different current and future global surface temperature levels, demonstrating the importance of better quantifying the likelihood of future extreme events for adaptation planning. Finally, we addressed research needs and future pathways, emphasising the need to define composite events primarily in terms of their impacts prior to their statistical characterisation