Akzeptanzanalyse eines Lehrgangs für Führungskräfte zum Erkennen von psychosozialen Krisen bei Mitarbeitern

Akzeptanzanalyse eines Lehrgangs für Führungskräfte zum Erkennen von psychosozialen Krisen bei Mitarbeitern. Ziel der qualitativen Untersuchung ist es, das Interesse bzw. die Relevanz an einem Lehrgang für Führungskräfte zum Erkennen von psychosozialen Krisen im Raum Niederösterreich zu erheben. Ebenfalls von Interesse ist die Frage, wie das Image des Roten Kreuzes im Vergleich zu seinen Konkurrenten WIFI und AUVA wahrgenommen wird. Die Ergebnisse zeigen, dass ein Bedarf am geplanten Lehrgang im Bundesland Niederösterreich besteht und der Anbieter die erforderten Kompetenzen für dieses Angebot besitzt. Das Image der Hilfsorganisation ist derzeitig sehr stark im medizinischen Bereich und in der Akutversorgung verankert. Im Gegensatz dazu wird das WIFI eindeutig als Bildungsanbieter gesehen. Die AUVA wird im präventiven Bereich wahrgenommen. Beide Aspekte sind für den zukünftigen Imagetransfer des Anbieters von Bedeutung

Prostaglandin E Positively Modulates Endothelial Progenitor Cell Homeostasis: An Advanced Treatment Modality for Autologous Cell Therapy

Aims: The mobilization of endothelial progenitor cells (EPC) and their functioning in postnatal neovascularization are tightly regulated. To identify new modulators of EPC homeostasis, we screened biologically active prostaglandin E compounds for their effects on EPC production, trafficking and function. Methods and Results: We found that EPC are a rich source for prostaglandin E 2 (PGE 2), stimulating their number and function in an auto- and paracrine manner. In vivo blockade of PGE 2 production by selective cyclooxygenase-2 inhibition virtually abrogated ischemia-induced EPC mobilization demonstrating its crucial role in EPC homeostasis following tissue ischemia. Conversely, ex vivo treatment of isolated EPC with the clinically approved PGE 1 analogue alprostadil enhanced EPC number and function. These effects were mediated by increased expression of the chemokine receptor CXCR4 and were dependent on nitric oxide synthase activity. Most importantly, ex vivo PGE 1 pretreatment of isolated EPC significantly enhanced their neovascularization capacity in a murine model of hind limb ischemia as assessed by laser Doppler analysis, exercise stress test and immunohistochemistry. Conclusions: The conserved role for PGE in the regulation of EPC homeostasis suggests that ex vivo modulation of the prostaglandin pathway in isolated progenitor cells may represent a novel and safe strategy to facilitate cell-based therapies. Copyright (C) 2009 S. Karger AG, Base

Autofluorescence bronchoscopy: quantification of inter-patient variations of fluorescence intensity

Autofluorescence (AF) from bronchial tissue is increasingly used for the endoscopic detection of early bronchial neoplasia. Several imaging systems are commercially available, all detecting the absolute or relative AF intensity and/or spectral contrasts between normal tissue and early neoplastic lesions. These devices have a high sensitivity for flat neoplasia, but the specificity remains limited. Variations in the AF intensity between individuals (inter-patient variations) is considered one of the most limiting factors. In the clinical study presented here, we quantified those variations using a non-invasive optical reference positioned in situ during AF bronchoscopy. The inter-patient variations in intensity on the main carina were in the order of 25- 30%. The results of this study are quite useful for improving and defining the design of the optical features (dynamic range, physical sensitivity) of AF detection system

A Powerful P−N Connection: Preparative Approaches, Reactivity, and Applications of P‐Stereogenic Aminophosphines

For more than five decades, P-stereogenic aminophosphine chalcogenides and boranes have attracted scientific attention and are still in the focus of ongoing research. In the last years, novel transition metal-based synthesis methods have been discovered, in addition to the long-known use of chiral auxiliaries. Enantiomerically pure compounds with N−P+−X− (X=O, S, BH3) motifs served as valuable reactive building blocks to provide new classes of organophosphorus derivatives, thereby preserving the stereochemical information at the phosphorus atom. Over the years, intriguing applications in organocatalysis and transition metal catalysis have been reported for some representatives. Asymmetric reductions of C=C, C=N, and C=O double bonds were feasible with selected P-stereogenic aminophosphine oxides in the presence of hydrogen transfer reagents. P-stereogenic aminophosphine boranes could be easily deprotected and used as ligands for various transition metals to enable catalytic asymmetric hydrogenations of olefins and imines. This review traces the emergence of a synthetically and catalytically powerful functional compound class with phosphorus-centered chirality in its main lines, starting from classical approaches to modern synthesis methods to current applications

Diabetic Foot Osteomyelitis: Frequent Pathogens and Conservative Antibiotic Therapy

Chronic diabetic foot osteomyelitis (DFO) is a frequent complication in adult polyneuropathy patients with long-standing diabetes mellitus. Regarding the conservative therapy, there are several crucial steps in adequate diagnosing and approaches. The management should be performed in a multidisciplinary approach following the findings of recent research, general principles of antibiotic therapy for bone; and according to (inter-)national guidance. In this chapter we emphasize the overview on the state-of-the-art management regarding the diagnosis and antibiotic therapy in DFO. In contrast, in this general narrative review and clinical recommendation, we skip the surgical, vascular and psychological aspects

The leader region of Laminin B1 mRNA confers cap-independent translation

Translation initiation of eukaryotic mRNAs generally occurs by cap-dependent ribosome scanning. However, certain mRNAs contain internal ribosome entry sites (IRES) allowing cap-independent translation. Several of these IRES-competent transcripts and their corresponding proteins are involved in tumourigenesis. This study focused on IRES-driven translation control during the epithelial to mesenchymal transition (EMT) of hepatocytes that reflects crucial aspects of carcinoma progression. Expression profiling of EMT revealed Laminin B1 (LamB1) to be translationally upregulated. The 5′-untranslated region (UTR) of LamB1 was potent to direct IRES-dependent mRNA utilization of a bicistronic reporter construct. Stringent assays for cryptic promoter and splice sites showed no aberrantly expressed transcripts, suggesting that the reporter activity provided by the leader region of LamB1 mRNA exclusively depends on IRES. In accordance, LamB1 expression increased upon negative interference with cap-dependent translation by expression of human rhinovirus 2A protease or heat shock of cells. Finally, the enhanced expression of LamB1 during EMT correlated with an elevated IRES activity. Together, these data provide first evidence that the 5′-UTR of LamB1 contains a bona fide IRES that directs translational upregulation of LamB1 during stress conditions and neoplastic progression of hepatocytes

Visuomotor adaptation, internal modelling, and compensatory movements in children with developmental coordination disorder

Background: Developmental coordination disorder (DCD) is one of the most prevalent developmental disorders in school-aged children. The mechanisms and etiology underlying DCD remain somewhat unclear. Altered visuomotor adaptation and internal model deficits are discussed in the literature. Aims: The study aimed to investigate visuomotor adaptation and internal modelling to determine whether and to what extent visuomotor learning might be impaired in children with DCD compared to typically developing children (TD). Further, possible compensatory movements during visuomotor learning were explored. Methods and procedures: Participants were 12 children with DCD (age 12.4 ± 1.8, four female) and 18 age-matched TD (12.3 ± 1.8, five female). Visuomotor learning was measured with the Motor task manager. Compensatory movements were parameterized by spatial and temporal variables. Outcomes and results: Despite no differences in visuomotor adaptation or internal modelling, significant main effects for group were found in parameters representing movement accuracy, motor speed, and movement variability between DCD and TD. Conclusions and implications: Children with DCD showed comparable performances in visuomotor adaptation and internal modelling to TD. However, movement variability was increased, whereas movement accuracy and motor speed were reduced, suggesting decreased motor acuity in children with DCD

The Epidemiology of Antibiotic-Related Adverse Events in the Treatment of Diabetic Foot Infections: A Narrative Review of the Literature

The use of antibiotics for the treatment of diabetic foot infections (DFIs) over an extended period of time has been shown to be associated with adverse events (AEs), whereas interactions with concomitant patient medications must also be considered. The objective of this narrative review was to summarize the most frequent and most severe AEs reported in prospective trials and observational studies at the global level in DFI. Gastrointestinal intolerances were the most frequent AEs, from 5% to 22% among all therapies; this was more common when prolonged antibiotic administration was combined with oral beta-lactam or clindamycin or a higher dose of tetracyclines. The proportion of symptomatic colitis due to Clostridium difficile was variable depending on the antibiotic used (0.5% to 8%). Noteworthy serious AEs included hepatotoxicity due to beta-lactams (5% to 17%) or quinolones (3%); cytopenia's related to linezolid (5%) and beta-lactams (6%); nausea under rifampicin, and renal failure under cotrimoxazole. Skin rash was found to rarely occur and was commonly associated with the use of penicillins or cotrimoxazole. AEs from prolonged antibiotic use in patients with DFI are costly in terms of longer hospitalization or additional monitoring care and can trigger additional investigations. The best way to prevent AEs is to keep the duration of antibiotic treatment short and with the lowest dose clinically necessary

Access to Enantiomerically Pure P ‐Stereogenic Primary Aminophosphine Sulfides under Reductive Conditions

Stereochemically pure phosphines with phosphorus-heteroatom bonds and P-centered chirality are a promising class of functional building blocks for the design of chiral ligands and organocatalysts. A route to enantiomerically pure primary aminophosphine sulfides was opened through stereospecific reductive C−N bond cleavage of phosphorus(V) precursors by lithium in liquid ammonia. The chemoselectivity of the reaction as a function of reaction time, substrate pattern, and chiral auxiliary was investigated. In the presence of exclusively aliphatic groups bound to the phosphorus atom, all competing reductive side reactions are totally prevented. The absolute configurations of all P-stereogenic compounds were determined by single-crystal X-ray diffraction analysis. Their use as synthetic building blocks was demonstrated. The lithium salt of (R)-BINOL-dithiophosphoric acid proved to be a useful stereochemical probe to determine the enantiomeric purity. Insights into the coordination mode of the lithium-based chiral complex formed in solution was provided by NMR spectroscopy and DFT calculations

ToSkORL: Selbst- und Fremdeinschätzung bei der Untersuchung des Kopf-Hals-Bereichs

BACKGROUND A~central goal of medical school is acquisition of theoretical and practical competences. However, evidence on how capacity acquisition can be measured for special examination techniques is scarce. ToSkORL (Teaching of Skills in Otorhinolaryngology) is a project aimed at scientifically and didactically investigating students' self-evaluation skills in otorhinolaryngologic and head and neck examination techniques. METHODS During the examination techniques course, a~standardized oral and practical exam for nine different techniques was conducted. Using Likert scales, self-evaluation was based on questionnaires before the clinical skills exam and objective evaluation was performed by the examiners during the examination using a checklist. Self- and objective evaluation were correlated. Nine different examination skills were assessed 42~times each by a~total of 91~students. RESULTS Self-evaluation of competence in the different examination skills varied widely. Nevertheless, self- and objective evaluation correlated well overall, independent of age and gender. Students highly interested in otorhinolaryngology rated their own skills higher but tended toward overestimation. For examination items with intermediate difficulty, the highest divergences between self- and objective evaluation were found. CONCLUSION Student self-evaluations are an appropriate instrument for measuring competences in otorhinolaryngologic examinations. Instructors should focus on items with allegedly intermediate difficulty, which are most often over- and underestimated. ZUSAMMENFASSUNG HINTERGRUND: Ein zentrales Ziel des Medizinstudiums ist der Erwerb theoretischer und praktischer Kompetenzen. Es mangelt jedoch an Evidenz, wie der Erwerb von Kompetenzen in speziellen Untersuchungstechniken gemessen werden kann. ToSkORL (Teaching of Skills in Otorhinolaryngology) ist ein Projekt, das die studentische Selbstwahrnehmung ihrer Kompetenz bei speziellen Untersuchungstechniken der Hals-Nasen-Ohren-Heilkunde und des Kopf-Hals-Bereichs aus didaktisch-wissenschaftlicher Sichtweise beleuchtet. METHODIK Im Rahmen des Untersuchungskurses erfolgte eine standardisierte mündlich-praktische Prüfung zu neun verschiedenen Untersuchungstechniken. Vor der Prüfung erfolgte eine Evaluation der studentischen Selbsteinschätzung mittels Fragebogen, die Prüfung wurde mittels Checkliste durch die Prüfenden standardisiert geprüft. Selbst- und Fremdeinschätzung nach der Likert-Skala wurden korreliert. Die neun Untersuchungstechniken wurden jeweils 42-mal von insgesamt 91~Studierenden in gegenseitiger Untersuchung durchgeführt. ERGEBNISSE Die Selbsteinschätzung der Kompetenz in den Untersuchungstechniken variiert erheblich, insgesamt schätzten Studierende ihre eigene Untersuchungskompetenz weitgehend unabhängig von Alter und Geschlecht meist realistisch ein. Studierende mit einem hohen Interesse an der Hals-Nasen-Ohren-Heilkunde gaben bessere Selbsteinschätzungen an, neigten jedoch auch eher zur Selbstüberschätzung. Bei Untersuchungen des mittleren Schwierigkeitsniveaus ergab sich die größte Divergenz von Selbst- und Fremdeinschätzung. SCHLUSSFOLGERUNG Die studentische Selbsteinschätzung ist ein geeignetes Instrument zur Messung der Untersuchungskompetenz in der Hals-Nasen-Ohren-Heilkunde. Es sollte ein besonderer Fokus auf die Lehre vermeintlich mittelschwerer Untersuchungstechniken gelegt werden, da diese am stärksten über- und unterschätzt werden