Dealing with Heritage: Assessment and Conservation

It is an honor to introduce this book, which brings together a number of very important aspects of the restoration architect's profession, with this short statement. Dealing with heritage requires that the restoration architect makes well-considered and definable choices. It should not only be about conservation, but attention must and may also be paid to making heritage future-proof. When it comes to making heritage future-proof, we still stand at the start of a major (sustainability) transition, in which making interventions will be indispensable. Such interventions are made possible by recognizing and utilizing the opportunities that heritage offers, but they should always be made from a view that places the preservation of the core values of the heritage centrally. The core values of heritage take many forms and can range from physical architectural manifestations to social, cultural and historical significance. In all cases, they involve dealing with the materials that the heritage is composed of. Having knowledge of these materials plays a crucial role in the choices to be made, both in the area of conservation to preserve what already exists, as well as in choices for restoration, improvement or renewal. That this knowledge goes beyond the physical outward appearance, as perceived by the admirers of heritage, is also emphasized by the examples in this book. Knowledge of the substance, forms of decay, methods of conservation and application of new techniques requires research, and without this research we as restoration architects would never be able to make well-considered choices. Research into especially the 'invisible' damage phenomena in materials, as described in this book, still requires more attention. As certified restoration architects it is our task to recognize this, to call in specialists at an early stage of a project, and to consider options with as broad a team as possible. The methods with which to determine the degree of damage and decay as objectively as possible, as are being developed continuously by among others 'Heritage & Architecture' at Delft University of Technology, offer good tools. I am a restoration advisor and currently chairman of the ‘Vereniging van Architecten Werkzaam in de Restauratie’ (Association of Architects Working in Restoration, VAWR), an association whose members are specialists who have all chosen to be tested and recognized in the field of dealing with monuments. On behalf of our members I would like to draw attention to the specific mastery of our profession based on Knowledge, Ethics, Vision and Management. Much attention is drawn to precisely these four pillars in this book as well. I hope that the readers of this book, regardless of their background, will gain a great deal of knowledge and appreciation for the need for research, but above all that they will also become more interested in our beautiful and multifaceted profession

Meldedaten und KiTa-Register ergänzen sich in der Bewertung der Dynamik der SARS-CoV-2-Ausbrüche in Kindertageseinrichtungen

Daten zu SARS-CoV-2-bedingten Ausbrüchen in Kitas können wichtige Hinweise zur Einschätzung des Infektionsgeschehens im Kita-Setting liefern und sind ein wichtiger Bestandteil in der Gesamtbewertung des Pandemiegeschehens. Im vorliegenden Beitrag wurden SARS-CoV-2-Ausbrüche in Kitas anhand der Daten aus zwei verschiedenen Systemen (IfSG-Meldedaten und KiTa-Register) untersucht.Peer Reviewe

Применение технологий клиентоориентированного маркетинга для поддержания и развития имиджа компании

Актуальность проблем, освещенных в данной работе, заключается в необходимости изучения потребителя, при условии постоянного изменения поведения клиентов компании ввиду высокой конкуренции на розничном рынке электроники. Проблема. С помощью каких нововведений можно повысить клиентоориентированность компании ООО «М.видео Менеджмент» и её имидж? Объектом исследования ВКР являются маркетинговые коммуникации ООО «М.видео Менеджмент». Предмет исследования – технологии коммуникационных стратегий организации. Цель работы – разработка программы лояльности для поддержания и развития имиджа компании (на примере ООО «М.видео Менеджмент» г. Томск). Методологической основой исследования являются абстрактно- логические, экономико-статистические методы, а также использование системного подхода, применение методов сравнения, группировок, графического отображения исследуемой информации. Практическая значимость исследования заключается в том, что предложенная и разработанная программа лояльности может быть использована в других компаниях для поддержки и развития имиджа компании.The relevance of the issues discussed in this paper is to study the consumer, the subject of constant change of customer behavior due to high competition in the retail market of electronics. Problem. What innovations can enhance the customer focus of the company "M. video Management" and its image? The object of research WRC is the marketing communications LLC "M. video Management". Subject of research – technology communication strategies of the organization. The work purpose – development of loyalty programs for the maintenance and development of the company's image (on the example of OOO "M. video Management" Tomsk). The methodological basis of the research is abstract - logic, economic-statistical methods, and the use of a systematic approach, applying the methods of comparison of groups graphical display of researched information. Practical significance of the research lies in the fact that the proposed and developed loyalty program can be used in other companies for the support and development of the company's image

Serious Adverse Drug Reactions in Children and Adolescents Treated On- and Off-Label with Antidepressants and Antipsychotics in Clinical Practice

Introduction: Despite the growing evidence base for psychotropic drug treatment in pediatric patients, knowledge about the benefit-risk ratio in clinical practice remains limited. The 'Therapeutic Drug Monitoring (TDM)-VIGIL' study aimed to evaluate serious adverse drug reactions (ADRs) in children and adolescents treated with antidepressants and/or antipsychotics in approved ('on-label'), and off-label use in clinical practice. Methods: Psychiatric pediatric patients aged 6-18 years treated with antidepressants and/or antipsychotics either on-label or off-label were prospectively followed between October 2014 and December 2018 within a multicenter trial. Follow-up included standardized assessments of response, serious ADRs and therapeutic drug monitoring. Results: 710 youth (age=14.6±2.2 years, female=66.6%) were observed for 5.5 months on average; 76.3% received antidepressants, 47.5% antipsychotics, and 25.2% both. Altogether, 55.2% of the treatment episodes with antidepressants and 80.7% with antipsychotics were off-label. Serious ADRs occurred in 8.3% (95%CI=6.4-10.6%) of patients, mainly being psychiatric adverse reactions (77.4%), predominantly suicidal ideation and behavior. The risk of serious ADRs was not significantly different between patients using psychotropics off-label and on-label (antidepressants: 8.1% vs. 11.3%, p=0.16; antipsychotics: 8.7% vs 7.5%, p=0.67). Serious ADRs occurred in 16.6% of patients who were suicidal at enrollment versus 5.6% of patients who were not suicidal (relative risk 3.0, 95%CI=1.9-4.9). Conclusion: Off-label use of antidepressants and antipsychotics in youth was not a risk factor for the occurrence of serious ADRs in a closely monitored clinical setting. Results from large naturalistic trials like ours can contribute to bridging the gap between knowledge from randomized controlled trials and real-world clinical settings

Therapeutic drug monitoring of sertraline in children and adolescents: A naturalistic study with insights into the clinical response and treatment of obsessive-compulsive disorder.

BACKGROUND Sertraline is a selective serotonin reuptake inhibitor with specific indications in child and adolescent psychiatry. Notwithstanding its frequent use and clinical benefits, the relationship between pharmacokinetics, pharmacodynamics, efficacy, and tolerability of sertraline across indications, particularly in non-adult patients, is not fully understood. METHOD This naturalistic therapeutic drug monitoring (TDM) study was conducted in a transdiagnostic sample of children and adolescents treated with sertraline (n = 78; mean age, 14.22 ± 2.39; range, 7-18 years) within the prospective multicenter "TDM-VIGIL" project. Associations between dose, serum concentration, and medication-specific therapeutic and side effects based on the Clinical Global Impression scale were examined. Tolerability was measured qualitatively with the 56-item Pediatric Adverse Event Rating Scale. RESULTS A strong linear positive dose-serum concentration relationship (with dose explaining 45% of the variance in concentration) and significant effects of weight and co-medication were found. Neither dose nor serum concentration were associated with side effects. An overall mild-to-moderate tolerability profile of sertraline was observed. In contrast with the transdiagnostic analysis that did not indicate an effect of concentration, when split into depression (MDD) and obsessive-compulsive disorder (OCD) diagnoses, the probability of clinical improvement significantly increased as both dose and concentration increased for OCD, but not for MDD. CONCLUSIONS This TDM-flexible-dose study revealed a significant diagnosis-specific effect between sertraline serum concentration and clinical efficacy for pediatric OCD. While TDM already guides clinical decision-making regarding compliance, dose calibration, and drug-drug interactions, combining TDM with other methods, such as pharmacogenetics, may facilitate a personalized medicine approach in psychiatry

Therapeutic Drug Monitoring in Children and Adolescents: Findings on Fluoxetine from the TDM-VIGIL Trial

Fluoxetine is the recommended first-line antidepressant in many therapeutic guidelines for children and adolescents. However, little is known about the relationships between drug dose and serum level as well as the therapeutic serum reference range in this age group. Within a large naturalistic observational prospective multicenter clinical trial (“TDM-VIGIL”), a transdiagnostic sample of children and adolescents (n = 138; mean age, 15; range, 7–18 years; 24.6% males) was treated with fluoxetine (10–40 mg/day). Analyses of both the last timepoint and all timepoints (n = 292 observations), utilizing (multiple) linear regressions, linear mixed-effect models, and cumulative link (mixed) models, were used to test the associations between dose, serum concentration, outcome, and potential predictors. The receiver operating curve and first to third interquartile methods, respectively, were used to examine concentration cutoff and reference values for responders. A strong positive relationship was found between dose and serum concentration of fluoxetine and its metabolite. Higher body weight was associated with lower serum concentrations, and female sex was associated with lower therapeutic response. The preliminary reference ranges for the active moiety (fluoxetine+norfluoxetine) were 208–328 ng/mL (transdiagnostically) and 201.5–306 ng/mL (depression). Most patients showed marked (45.6%) or minimal (43.5%) improvements and reported no adverse effects (64.9%). This study demonstrated a clear linear dose–serum level relationship for fluoxetine in youth, with the identified reference range being within that established for adults

COVID-19: cross-border contact tracing in Germany, February to April 2020

Since January 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread to become a global pandemic [1]. Active case finding, early detection and isolation of cases and their contacts are essential for breaking transmission chains. A modelling study showed that 70% of contacts should be traced in order to control the outbreak, assuming a baseline reproduction rate of 2.5 [2]. Early warning systems for the serious cross-border spread of infectious pathogens include the International Health Regulations (IHR) 2005 and the Early Warning and Response System (EWRS) for the European Union/European Economic Area (EU/EEA) countries [3,4]. Within Germany, communication channels have been established in accordance with the German Infection Protection Act (Infektionsschutzgesetz; IfSG). Cross-border contact tracing at the national level is operated by the Robert Koch Institute (RKI), the federal public health institute in Germany. The first cases of coronavirus disease 2019 (COVID-19) in Germany occurred in Bavaria at the end of January 2020 [5]. The first SARS-CoV-2 cluster also led to cross-border contacts and exposures on flights since close contacts and suspected cases travelled to Austria and Spain after exposure. This required intensive international communication to identify and share the information on contacts with the responsible health authorities. An international communication and contact tracing team (RKI IC-Team) was rapidly created in the RKI COVID-19 Emergency Operations Centre (EOC) including members of all units of the department for infectious disease epidemiology and other departments at the RKI. The core task of the team was to collect and communicate information on confirmed COVID-19 cases and their contacts to other countries in the event of cross-border relevance. In addition, incoming information on German citizens exposed abroad was communicated through the federal state health authorities to the responsible local health authorities in Germany. The spread of SARS-CoV-2 in Germany triggered the introduction of various measures: (i) mass gatherings with more than 1,000 participants were banned after calendar week 10, (ii) schools and public places were closed in several federal states, (iii) physical distancing measures of at least 1.5 m to another person were recommended, (iv) it was recommended to cancel non-essential travel and (v) quarantine measures for travellers from high risk areas entering Germany were introduced in calendar week 15. Because of the federal structure in Germany, the measures and their implementation varied between the states. This work aimed to describe the extent and course of activities resulting from information on COVID-19 exposure events with a cross-border context. Further, we discuss the challenges experienced and possible workflow improvements.Peer Reviewe

Variowohnungen. Bezahlbar-Anpassbar-nachhaltig

Immer mehr junge Menschen streben ein Studium an – bevorzugt zieht es sie dafür in Metropolregionen. Damit verbunden zeigt sich vor allem in Ballungsgebieten eine steigende Nachfrage nach passendem Wohnraum. Auch Auszubildende, Rentnerinnen und Rentner, einkommensschwache Haushalte und anerkannte Geflüchtete suchen nach ähnlichen Wohnformen. Wie kann angesichts dieser Entwicklung die Schaffung von anpassbarem, kostengünstigem Wohnraum umgesetzt werden und funktionieren? Im Rahmen des Modellvorhaben-Programms der Variowohnungen wurden Wohnkonzepte für Studierende und Auszubildende umgesetzt und beforscht, die architektonische und wohnliche Qualitäten aufweisen und sich an verschiedene Lebensentwürfe anpassen lassen. Ein spezielles Augenmerk lag dabei auf Innovationen im Bereich des modularen und vorgefertigten Bauens und der Frage, wie sich der Anspruch an hohe architektonische Qualität mit niedrigen Mieten in Einklang bringen lässt. Zukunft Bau setzt seit über fünfzehn Jahren wichtige Impulse für Architektur und Bauwesen, schlägt Brücken zwischen Bauforschung und Baupraxis. Im Mittelpunkt steht der baurelevante Erkenntnisgewinn zu aktuellen Forschungsthemen wie Klimaschutz, Material- und Ressourceneffizienz, Digitalisierung, kostengünstigem Bauen und demografischem Wandel. Hierfür bietet Zukunft Bau eine Plattform, um entsprechende innovative Ansätze zu erforschen, zu konzipieren, zu erproben und zu vermitteln. Dabei sollen neue Rahmenbedingungen des Bauwesens ausgelotet wie auch die Forschung als Methode beim Planen und Bauen in größerer Breite etabliert werden. Getragen wird das Innovationsprogramm Zukunft Bau vom Bundesministerium des Innern, für Bau und Heimat (BMI) gemeinsam mit dem Bundesinstitut für Bau-, Stadt- und Raumforschung (BBSR)

Variowohnungen. Bezahlbar-Anpassbar-nachhaltig

Immer mehr junge Menschen streben ein Studium an – bevorzugt zieht es sie dafür in Metropolregionen. Damit verbunden zeigt sich vor allem in Ballungsgebieten eine steigende Nachfrage nach passendem Wohnraum. Auch Auszubildende, Rentnerinnen und Rentner, einkommensschwache Haushalte und anerkannte Geflüchtete suchen nach ähnlichen Wohnformen. Wie kann angesichts dieser Entwicklung die Schaffung von anpassbarem, kostengünstigem Wohnraum umgesetzt werden und funktionieren? Im Rahmen des Modellvorhaben-Programms der Variowohnungen wurden Wohnkonzepte für Studierende und Auszubildende umgesetzt und beforscht, die architektonische und wohnliche Qualitäten aufweisen und sich an verschiedene Lebensentwürfe anpassen lassen. Ein spezielles Augenmerk lag dabei auf Innovationen im Bereich des modularen und vorgefertigten Bauens und der Frage, wie sich der Anspruch an hohe architektonische Qualität mit niedrigen Mieten in Einklang bringen lässt. Zukunft Bau setzt seit über fünfzehn Jahren wichtige Impulse für Architektur und Bauwesen, schlägt Brücken zwischen Bauforschung und Baupraxis. Im Mittelpunkt steht der baurelevante Erkenntnisgewinn zu aktuellen Forschungsthemen wie Klimaschutz, Material- und Ressourceneffizienz, Digitalisierung, kostengünstigem Bauen und demografischem Wandel. Hierfür bietet Zukunft Bau eine Plattform, um entsprechende innovative Ansätze zu erforschen, zu konzipieren, zu erproben und zu vermitteln. Dabei sollen neue Rahmenbedingungen des Bauwesens ausgelotet wie auch die Forschung als Methode beim Planen und Bauen in größerer Breite etabliert werden. Getragen wird das Innovationsprogramm Zukunft Bau vom Bundesministerium des Innern, für Bau und Heimat (BMI) gemeinsam mit dem Bundesinstitut für Bau-, Stadt- und Raumforschung (BBSR)