Kommentare zum "Bildungs- und Erziehungsplan für Kinder von 0 bis 10 Jahren in Hessen"

Der „Erziehungs- und Bildungsplan von Anfang an“ soll ein Orientierungsrahmen für die Erziehung der Kinder von 0-10 Jahren sein. Er richtet sich vor allem an das pädagogische Fachpersonal von Kindertagesstätten und Schule in Hessen. In drei Aufsätzen zu den Themenschwerpunkten biographische Lernprozesse, Spracherwerb und Weiterentwicklung von pädagogischen Einrichtungen wird aufgezeigt, dass der hessische Bildungsplan nur begrenzt und äußerst widerspruchsvoll einlöst, was er verspricht. In den zentralen Argumentationslinien und den zentralen Begriffen (Bildung, Kompetenz, Wissen etc.) sind viele Widersprüche und Unklarheiten zu finden, die ihn als Orientierung für die pädagogischen Institutionen schwer handhabbar machen. Die Autoren geben mit Ihrer kritischen Stellungsnahme Anregungen für die Diskussion des Bildungs- und Erziehungsplan an Schulen und Kindertageseinrichtungen

Allogeneic Stem Cell Transplantation with Sequential Melphalan-Based Conditioning in AML: Residual Morphological Blast Count Determines the Risk of Relapse

Introduction: Allogeneic hematopoietic cell transplantation (HCT) during chemotherapy-induced aplasia may offer long-term survival in acute myeloid leukemia (AML) with otherwise poor prognosis including ELN adverse risk, relapsed or refractory disease. However, the value of residual morphologic disease prior HCT in this context has not been conclusively settled until yet. Therefore, we aimed to investigate variables predicting outcome in this unique setting of sequential conditioning therapy, with a focus on pretreatment morphologic blast count. In contrast to the most popular FLAMSA-RIC protocol, we used a melphalan-based conditioning regimen during aplasia. Methods: We retrospectively analyzed data from 173 AML patients who underwent a sequential melphalan-based conditioning therapy between 2003 and 2015 at our centre. All patients participated either in the prospective Phase 2 BRIDGE trial (NCT01295307), the Phase 3 AML2003 study (NCT00180102) or were treated according to this protocol and underwent allogeneic HCT after melphalan-based conditioning in treatment-induced aplasia. Results: Median bone marrow blast count prior to conditioning was 10% (range, 0–96%). Four year probabilities of EFS and OS were 34% (95% CI, 28–43%) and 43% (95% CI, 36–52%), respectively. In multivariate analysis, blast count >20% was associated with worse EFS (HR = 1.93; p = 0.009) and OS (HR = 1.80; p = 0.026). This effect was not significant anymore for HCT during 1st line therapy. Conclusion: Allogeneic HCT in aplasia with a melphalan-based conditioning regimen has the potential to cure a subset of adverse risk AML patients, even with persistent morphological disease prior HCT. However, a high pre-transplant blast count still indicates patients with a dismal prognosis, especially in the relapsed patient group, for whom post-transplant strategies should be considered to further optimize post HCT outcome

Compensating the effects of FES-induced muscle fatigue by rehabilitation robotics during arm weight support

Motor functions can be hindered in consequence to a stroke or a spinal cord injury. This often results in partial paralyses of the upper limb. The effectiveness of rehabilitation therapy can be improved by the use of rehabilitation robotics and Functional Electrical Stimulation (FES). We consider a hybrid arm weight support combining both. In order to compensate the effect of FES-induced muscle fatigue, we introduce a method to substitute the decreasing level of FES support by cable-driven robotics. We evaluated the approach in a trial with one healthy subject performing repetitive arm lifting. The controller automatically adapted the support and thus no increase in user generated volitional effort was observed when FES induced muscle fatigue occured