1,163 research outputs found
Die Ermittlung von Lehrkonzeptionsprofilen zur UnterstĂŒtzung von Berufungsverfahren
Im Rahmen von Berufungsverfahren ist oftmals ein methodisches Defizit bei der Bewertung der Lehrqualifikation von Bewerberinnen und Bewerbern festzustellen. Auf Basis einer Literaturstudie und einer empirischen Untersuchung zu LehrkonÂzepÂtionen wurden daher ein Interviewleitfaden, ein Beobachtungsbogen und ein Auswertungsbogen in Form eines Kategoriensystems entwickelt. Zweck dieses Instrumentariums ist es, systematisch und transparent individuelle LehrkonzepÂtionsprofile erstellen und mit den jeweiligen Anforderungen abgleichen zu können. Damit wird die Grundlage fĂŒr eine verbesserte BerĂŒcksichtigung der Lehre in Berufungsverfahren gelegt.
02.11.2011 | Heinz Ahn, Yvonne Höfer & Linda Kunz (Braunschweig
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A gut-to-brain signal of fluid osmolarity controls thirst satiation.
Satiation is the process by which eating and drinking reduce appetite. For thirst, oropharyngeal cues have a critical role in driving satiation by reporting to the brain the volume of fluid that has been ingested1-12. By contrast, the mechanisms that relay the osmolarity of ingested fluids remain poorly understood. Here we show that the water and salt content of the gastrointestinal tract are precisely measured and then rapidly communicated to the brain to control drinking behaviour in mice. We demonstrate that this osmosensory signal is necessary and sufficient for satiation during normal drinking, involves the vagus nerve and is transmitted to key forebrain neurons that control thirst and vasopressin secretion. Using microendoscopic imaging, we show that individual neurons compute homeostatic need by integrating this gastrointestinal osmosensory information with oropharyngeal and blood-borne signals. These findings reveal how the fluid homeostasis system monitors the osmolarity of ingested fluids to dynamically control drinking behaviour
Low-carbon energy, sustainable development and justice: towards a just energy transition for the society and the environment
Governments and civil society are increasingly aware that the decarbonization of energy systems needs to be aligned with justice principles of recognition, distribution, and process. This paper establishes a conceptual linkage between âsustainable developmentâ, âlowâcarbon energy transitionsâ and âenergy justiceâ and examines social priorities to address peoples' competing priorities associated with lowâcarbon energy interventions. By analyzing a renewable energy project in Vietnam as a case study, the paper shows that linking social priorities to energy justice provides a useful contribution for energy policy makers toward a better understanding of the multidimensional and complex aspects of lowâcarbon energy transitions, and how different segments of society prioritize and perceive them for the achievement of socially just energy decisions
Common Reasons That Asymptomatic Patients Who Are 65 Years and Older Receive Carotid Imaging
IMPORTANCE:
National guidelines do not agree on the role of carotid screening in asymptomatic patients (ie, patients who have not had a stroke or transient ischemic attack). Recently, several physician organizations participating in the Choosing Wisely campaign have identified carotid imaging in selected asymptomatic populations as being of low value. However, the majority of patients who are evaluated for carotid stenosis and subsequently revascularized are asymptomatic.
OBJECTIVE:
To better understand why asymptomatic patients who undergo revascularization receive initial carotid imaging.
DESIGN, SETTING, AND PARTICIPANTS:
Retrospective cohort study of 4127 Veterans Health Administration patients 65 years and older undergoing carotid revascularization for asymptomatic carotid stenosis between 2005 and 2009.
MAIN OUTCOMES AND MEASURES:
Indications for carotid ultrasounds were extracted using trained abstractors. Frequency of indications and appropriateness of initial carotid ultrasound imaging for patients within each rating category after the intervention were reported.
RESULTS:
The mean (SD) age of this cohort of 4127 patients was 73.6 (5.9) years; 4014 (98.8%) were male. Overall, there were 5226 indications for 4063 carotid ultrasounds. The most common indications listed were carotid bruit (1578 [30.2% of indications]) and follow-up for carotid disease (stenosis/history of carotid disease) in patients who had previously documented carotid stenosis (1087 [20.8% of indications]). Multiple vascular risk factors were the next most common indication listed. Rates of appropriate, uncertain, and inappropriate imaging were 5.4% (227 indications), 83.4% (3387 indications), and 11.3% (458 indications), respectively. Among the most common inappropriate indications were dizziness/vertigo and syncope. Among the 4063 patients, 3373 (83.0%) received a carotid endarterectomy. Overall, 663 procedures were performed in patients 80 years and older.
CONCLUSIONS AND RELEVANCE:
Carotid bruit and follow-up for carotid disease accounted for approximately half of all indications provided by physicians for carotid testing. Strong consideration should be given to improving the evidence base around carotid testing, especially around monitoring stenosis over long periods and evaluating carotid bruits. Targeting carotid ultrasound ordering with decision support tools may also be an important step in reducing use of low-value imaging
Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort
BACKGROUND:
Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice.
METHODS:
A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively.
RESULTS:
SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655.
CONCLUSIONS:
In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin
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