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Durch die Allgegenwart digitaler Medien im Leben der Erwachsenen erhalten diese auch immer mehr Einzug in die Erfahrungswelt von jungen Kindern. Eltern nehmen dies zunehmend als Herausforderung wahr, da sie sich selbst zu wenig kompetent fühlen oder aus Zeitmangel das Smartphone oder Tablet als „Beschäftigungstherapie“ sehen, anstatt die Mediennutzung der eigenen Kinder systematisch zu begleiten. Eine vorbereitende und begleitende Auseinandersetzung der Vorschulkinder mit den Phänomenen der digital vernetzten Welt wird demnach zusehends zum Bildungsauftrag für Kindergärten, wofür es bis dato allerdings zu wenige umfassende Konzepte gibt. Der vorliegende Beitrag stellt deshalb ein Konzept vor und zur Diskussion, das an der Pädagogischen Hochschule Wien in den letzten beiden Jahren entwickelt und zusammen mit Elementarpädagog*innen aus der Praxis erprobt wurde.Due to the omnipresence of digital media in the everyday life of adults, these media also take on growing importance in the world of small children. Parents are increasingly perceiving this as a challenge because they feel they are not sufficiently competent themselves or see the smartphone or tablet as a kind of "occupational therapy" due to lack of time, instead of systematically accompanying their children's media use. A preparatory and accompanying way of dealing with the phenomena of the digitally networked world in connection with pre-school children is therefore increasingly becoming an educational task for kindergartens, for which there have so far been too few comprehensive concepts. In this context, the present paper discusses a concept that has been developed at the University College of Teacher Education Vienna over the past two years and that has already been tried out and tested together with elementary teachers

TP53 is not a prognostic markerâ clinical consequences of a generally disregarded fact

Technological progress within the last 15â 20 years has significantly increased our knowledge about the molecular basis of cancer development, tumor progression, and treatment response. As a consequence, a vast number of biomarkers have been proposed, but only a small fraction of them have found their way into clinical use. The aim of this paper is to describe the specific demands a clinically relevant biomarker should meet and how biomarkers can be tested stepwise. We name this procedure the â tripleâ R principleâ : robustness, reproducibility, and relevance. The usefulness of this principle is illustrated with the marker TP53. Since it is mutated in a broad spectrum of cancer entities, TP53 can be considered a very promising marker. Thus, TP53 has been studied in detail but there is still no explicit consensus about its clinical value. By considering our own experience and reviewing the literature, we demonstrate that a major problem of current biomarker research is disregard of whether the biomarker is prognostic or predictive. As an example, it is demonstrated that TP53 is not a prognostic marker, but rather a purely predictive marker, and that disregard of this fact has made this otherwise strong biomarker appear as not being clinically useful so far.Many biomarkers have been proposed for cancer, but only a small fraction of them are clinically useful. This paper describes the specific demands a clinically relevant biomarker should meet and how biomarkers can be tested stepwise. This is illustrated with the marker TP53, which has been studied in detail but for which there is still no explicit consensus about its clinical value.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146810/1/nyas13947.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146810/2/nyas13947_am.pd

Methods for non-proportional hazards in clinical trials: A systematic review

For the analysis of time-to-event data, frequently used methods such as the log-rank test or the Cox proportional hazards model are based on the proportional hazards assumption, which is often debatable. Although a wide range of parametric and non-parametric methods for non-proportional hazards (NPH) has been proposed, there is no consensus on the best approaches. To close this gap, we conducted a systematic literature search to identify statistical methods and software appropriate under NPH. Our literature search identified 907 abstracts, out of which we included 211 articles, mostly methodological ones. Review articles and applications were less frequently identified. The articles discuss effect measures, effect estimation and regression approaches, hypothesis tests, and sample size calculation approaches, which are often tailored to specific NPH situations. Using a unified notation, we provide an overview of methods available. Furthermore, we derive some guidance from the identified articles. We summarized the contents from the literature review in a concise way in the main text and provide more detailed explanations in the supplement (page 29)

A prospective randomised trial to study the role of levamisole and interferon alfa in an adjuvant therapy with 5-FU for stage III colon cancer

The purpose of this trial was to examine the efficacy of the addition of levamisole (LEV) or interferon alfa (IFN) to an adjuvant chemotherapy with 5-fluorouracil (5-FU) in patients with stage III colon cancer. According to a 2 × 2 factorial study design, 598 patients were randomly assigned to one of four adjuvant treatment arms. Patients in arm one received 5-FU weekly for 1 year, patients in arm two 5-FU plus LEV, in arm three 5-FU plus IFN and patients in arm four 5-FU, LEV and IFN. The relative risk of relapse and the relative risk of death were significantly higher for patients treated with LEV compared with those without LEV treatment (HR 1.452, 95% CI 1.135–1.856, P=0.0028; HR 1.506, 95% CI 1.150–1.973, P=0.0027, respectively). No significant impact on survival was observed for therapy with IFN in the univariate analysis. The addition of LEV to adjuvant 5-FU significantly worsened the prognosis of patients with stage III colon cancer. Interferon alfa had no significant influence on survival when combined with adjuvant 5-FU, but increased the toxicity of therapy substantially

An online platform supporting the analysis of water adaptation measures in the Alps

Climate change may result in reduced water supply from the Alps - an important water resource for Europe. This paper presents a multilingual platform that combines spatial and multi-criteria decision-support tools to facilitate stakeholder collaboration in the analysis of water management adaptation options. The platform has an interactive map interface that allows participants to select a location of their interest within the Alpine Arc. By utilising the decision-support tool, stakeholders can identify suitable adaptation solutions for different geographical units, according to their experience and preference. The platform was used to involve experts across Alpine borders, domains and decision-making levels, as well as a group of university students. The experts favoured the planning instruments for saving water, while the students inclined towards the measures that would improve water conservation. The initial results confirmed the suitability of the platform for future involvement of decision-makers in spatio-temporal analyses of adaptation pathways in the Alps

Risk factors for pressure injury development in critically ill patients in the intensive care unit: a systematic review protocol

BACKGROUND: Pressure injuries (PIs) create a significant burden in the health care system. Up to 49% of critically ill patients develop PIs. Identifying and understanding potential risk factors is essential to the provision of effective targeted prevention strategies to mitigate risk. The objectives of this review are to identify patient-centred clinical factors that may be associated with PI development in the adult intensive care environment and to determine the effect size of the relationship between identified factors and PI development in this unique population. METHOD/DESIGN: The review will follow the PRISMA reporting guidelines for systematic reviews. Electronic databases (Cochrane; PubMed/MEDLINE; CINAHL (EBSCOhost); Embase; Scopus; PsycINFO; Proquest; Networked Digital Library of Theses and Dissertations; Australian Digital Theses Program, Grey literature, Google scholar, and Clinical Trial Registries) will be systematically searched. A suite of search terms will identify articles that have examined the patient-centred risk factors for PI development in adult intensive care units. The search strategy will be designed to retrieve studies published since inception to 2016 in English language. Quality of the studies will be assessed by using an assessment framework designed to appraise quality in prognostic studies and methodological considerations in the analysis and publication of observational studies. Screening, study selection process, and data extraction will be undertaken by two independent reviewers. Disagreement will be resolved by discussion and, if required, a third independent reviewer. Clinical and methodological heterogeneity across studies will be assessed and, if possible, meta-analyses will be performed. DISCUSSION: The evidence synthesis arising from this review will identify person-centred risk factors that are associated with PI development among critically ill patients in intensive care. Findings from this review will demonstrate potential patient risk factors that may influence practice and research priorities to prevent PI development and improve the quality of care provided. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016037690 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13643-017-0451-5) contains supplementary material, which is available to authorized users