Evaluation beruflicher Weiterbildung anhand des Erfolgskriteriums Zeit

In dieser Arbeit wurde untersucht, ob und anhand welcher Indikatoren der Weiterbildungserfolg einer beruflichen Weiterbildung durch die Zeit (Kriterium Zeiterfolg) evaluiert werden kann. Daneben wurde untersucht, inwiefern sich diese Indikatoren durch die Rahmen- und Umfeldbedingungen beeinflussen lassen. Für die Evaluation von beruflichen Weiterbildungen existiert eine Vielzahl an Instrumenten. Die meisten davon betrachten den pädagogischen Nutzen einer Weiterbildung oder den monetären. Gerade für Unternehmen ist es wichtig, den Erfolg einer Maßnahme anhand von Kennzahlen zu betrachten, um erkennen zu können, ob sich der Einsatz gelohnt hat und die Maßnahme gegebenenfalls wiederholt werden sollte. Die monetäre Betrachtung weist allerdings Herausforderungen und Grenzen auf. Sie ist in den wenigsten Fällen direkt durch den Teilnehmenden zu erfassen, durch subjektive Einflüsse bei der Umrechnung fehleranfällig und kann nicht immer alle pädagogischen Ergebnisse einer Weiterbildung abbilden. Der Faktor Zeit hingegen spielt im Unternehmensalltag eine immer größere Rolle (Produktlebenszyklen werden kürzer, Tarifparteien verhandeln explizit über den Zeiteinsatz der Mitarbeitenden) und ist strengen Grenzen unterworfen: Im Gegensatz zu Geld ist Zeit nicht speicherbar und verrinnt unaufhörlich. Dafür kann sie, nicht wie Geld, von jedem einzelnen Mitarbeitenden direkt erlebt und erfasst werden. Anhand einer empirischen Untersuchung durch einen Fragebogen wurden Teilnehmende von beruflichen Weiterbildungen regionaler Weiterbildungsanbieter (v. a. IHK Bodensee-Oberschwaben) untersucht. 79 Personen haben einen Vorher- und einen Hinterherfragebogen ausgefüllt. Neben den Indikatoren der Zeit wurden noch Rahmen- und Umfeldbedingungen erhoben, der Zeiteinsatz und parallel ein etabliertes, klassisches Evaluationsinstrument (Q4TE Grohmann und Kauffeld, 2013) erfasst. Die Untersuchungsergebnisse zeigen, dass der Zeiterfolg durch die Befragung der Teilnehmenden erfassbar ist. Allerdings ist auch dieser subjektiven Einflüssen sowie Rahmen- und Umfeldbedingungen unterworfen. Der Zeiterfolg und das etablierte Instrument Q4TE zeigen Zusammenhänge. Daneben gibt es aber auch viele Variablen des Zeiterfolgs, die zusätzliche Erkenntnisse über den Weiterbildungserfolg liefern können. Darüber hinaus scheint der Zeiterfolg weniger von den Umfeldbedingungen beeinflusst zu werden, als der klassische Trainingserfolg des Q4TE. V. a. für repetitive Tätigkeiten scheint sich die Evaluation über den Zeiterfolg besonders zu eignen. Das Zeiterfolg-Instrument kann daher für die Verantwortlichen im Unternehmen, je nach Weiterbildungsziel, eine ergänzende Möglichkeit sein, dieses besser zu erfassen und der sich steigernden Rolle der Zeit im Unternehmenskontext gerecht zu werden.In this work it was examined whether and by which indicators the success of further training can be evaluated by time (success of time criterion). In addition, it was examined to what extent these time indicators can be influenced by the general and environmental conditions. A large number of instruments exist for the evaluation of further training. Most of them consider the educational benefits of further trainings or the monetary ones. It is particularly important for companies to look at the success of a measure using key figures in order to be able to see whether the effort was worthwhile and whether the measure should be repeated if necessary. From a monetary point of view, however, there are challenges and limits. In very few cases it can be recorded directly by the participant, error-prone due to subjective influences during the conversion and cannot always depict all the pedagogical results of a further training. The time factor, on the other hand, plays an increasingly important role in day-to-day business (product lifecycles are becoming shorter, bargaining partners for collective agreements explicitly negotiate the use of work time by employees) and is subject to strict limits: unlike money, time cannot be stored and is constantly running out. Unlike money, it can be directly experienced and grasped by each individual employee. Based on an empirical study using a questionnaire, participants in further training courses from regional training providers (mainly IHK Bodensee-Oberschwaben) were examined. 79 people filled out a before and after questionnaire. In addition to the indicators of the time success criterion, framework and environmental conditions were also surveyed. As did the use of time and, in parallel, an established, classical evaluation instrument (Q4TE from Grohmann and Kauffeld, 2013) was recorded. The results of the study show that the success of time can be recorded by questioning the participants. However, this is also subject to subjective influences as well as framework and environmental conditions. But the success of time seems to be less influenced by the environmental conditions than the classical training success of the Q4TE. The success of time and the established instrument Q4TE show connections. In addition, there are also many variables of success of time that don`t show any connection and therefore can provide additional insights into the success of further training. The evaluation of success of time seems to be particularly suitable for repetitive activities. The time success instrument can therefore be an additional opportunity for those responsible in the company, depending on the further training goal, to record this better and to do justice to the increasing role of time in the company context

Effect of a pediatric early warning system on all-cause mortality in Hospitalized pediatric patients: The epoch randomized clinical trial

IMPORTANCE: There is limited evidence that the use of severity of illness scores in pediatric patients can facilitate timely admission to the intensive care unit or improve patient outcomes. OBJECTIVE: To determine the effect of the Bedside Paediatric Early Warning System (BedsidePEWS) on all-cause hospital mortality and late admission to the intensive care unit (ICU), cardiac arrest, and ICU resource use. DESIGN, SETTING, AND PARTICIPANTS: A multicenter cluster randomized trial of 21 hospitals located in 7 countries (Belgium, Canada, England, Ireland, Italy, New Zealand, and the Netherlands) that provided inpatient pediatric care for infants (gestational age ≥37 weeks) to teenagers (aged ≤18 years). Participating hospitals had continuous physician staffing and subspecialized pediatric services. Patient enrollment began on February 28, 2011, and ended on June 21, 2015. Follow-up ended on July 19, 2015. INTERVENTIONS: The BedsidePEWS intervention (10 hospitals) was compared with usual care (no severity of illness score; 11 hospitals). MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause hospital mortality. The secondary outcome was a significant clinical deterioration event, which was defined as a composite outcome reflecting late ICU admission. Regression analyses accounted for hospital-level clustering and baseline rates. RESULTS: Among 144539 patient discharges at 21 randomized hospitals, there were 559 443 patient-days and 144539 patients (100%) completed the trial. All-cause hospital mortality was 1.93 per 1000 patient discharges at hospitals with BedsidePEWS and 1.56 per 1000 patient discharges at hospitals with usual care (adjusted between-group rate difference, 0.01 [95% CI, -0.80 to 0.81 per 1000 patient discharges]; adjusted odds ratio, 1.01 [95% CI, 0.61 to 1.69]; P =.96). Significant clinical deterioration events occurred during 0.50 per 1000 patient-days at hospitals with BedsidePEWS vs 0.84 per 1000 patient-days at hospitals with usual care (adjusted between-group rate difference, -0.34 [95% CI, -0.73 to 0.05 per 1000 patient-days]; adjusted rate ratio, 0.77 [95% CI, 0.61 to 0.97]; P =.03). CONCLUSIONS AND RELEVANCE: Implementation of the Bedside Paediatric Early Warning System compared with usual care did not significantly decrease all-cause mortality among hospitalized pediatric patients. These findings do not support the use of this system to reduce mortality

Combined Photosensitization and Vaccination Enable CD8 T-Cell Immunity and Tumor Suppression Independent of CD4 T-Cell Help

Cytotoxic T lymphocytes (CTLs) are key players in fighting cancer, and their induction is a major focus in the design of therapeutic vaccines. Yet, therapeutic vaccine efficacy is limited, in part due to the suboptimal vaccine processing by antigen-presenting cells (APCs). Such processing typically takes place via the MHC class II pathway for CD4 T-cell activation and MHC class I pathway for activation of CD8 CTLs. We show that a combination of skin photochemical treatment and immunization, so-called photochemical internalization (PCI) facilitated CTL activation due to the photochemical adjuvant effect induced by photosensitizer, oxygen, and light. Mice were immunized intradermally with antigen and photosensitizer, followed by controlled light exposure. PCI-treated mice showed strong activation of CD8 T cells, with improved IFN-γ production and cytotoxicity, as compared to mice immunized without parallel PCI treatment. Surprisingly, the CD8 T-cell effector functions were not impaired in MHC class II- or CD4 T-cell-deficient mice. Moreover, PCI-based vaccination caused tumor regression independent of MHC class II or CD4 T cells presence in melanoma bearing mice. Together, the data demonstrate that PCI can act as a powerful adjuvant in cancer vaccines, even in hosts with impaired T-helper functions

In-flight sleep, pilot fatigue and Psychomotor Vigilance Task performance on ultra-long range versus long range flights.

This study evaluated whether pilot fatigue was greater on ultra-long range (ULR) trips (flights >16 h on 10% of trips in a 90-day period) than on long range (LR) trips. The within-subjects design controlled for crew complement, pattern of in-flight breaks, flight direction and departure time. Thirty male Captains (mean age = 54.5 years) and 40 male First officers (mean age = 48.0 years) were monitored on commercial passenger flights (Boeing 777 aircraft). Sleep was monitored (actigraphy, duty/sleep diaries) from 3 days before the first study trip to 3 days after the second study trip. Karolinska Sleepiness Scale, Samn-Perelli fatigue ratings and a 5-min Psychomotor Vigilance Task were completed before, during and after every flight. Total sleep in the 24 h before outbound flights and before inbound flights after 2-day layovers was comparable for ULR and LR flights. All pilots slept on all flights. For each additional hour of flight time, they obtained an estimated additional 12.3 min of sleep. Estimated mean total sleep was longer on ULR flights (3 h 53 min) than LR flights (3 h 15 min; P(F) = 0.0004). Sleepiness ratings were lower and mean reaction speed was faster at the end of ULR flights. Findings suggest that additional in-flight sleep mitigated fatigue effectively on longer flights. Further research is needed to clarify the contributions to fatigue of in-flight sleep versus time awake at top of descent. The study design was limited to eastward outbound flights with two Captains and two First Officers. Caution must be exercised when extrapolating to different operations

New Zealanders working non-standard hours also have greater exposure to other workplace hazards.

Exposure to workplace hazards, such as dust, solvents, and fumes, has the potential to adversely affect the health of people. However, the effects of workplace hazards on health may differ when exposure occurs at different times in the circadian cycle, and among people who work longer hours or who do not obtain adequate sleep. The aim of the present study was to document exposures to workplace hazards across a national sample of New Zealanders, comparing people who work a standard 08:00 -17:00 h Monday-to-Friday working week (Std hours) and those who do not (N-Std hours). New Zealanders (n = 10 000) aged 20-64 yrs were randomly selected from the Electoral Roll to take part in a nationwide survey of workplace exposures. Telephone interviews were conducted between 2004 and 2006, using a six-part questionnaire addressing demographics, detailed information on the current or most recent job (including exposures to a range of workplace hazards), sleep, sleepiness, and health status. N-Std hours were categorised on the basis of: being required to start work prior to 07:00 h or finish work after 21:00 h and/or; having a regular on-call commitment (at least once per week) and/or; working rotating shifts and/or; working night shift(s) in the last month. The response rate was 37% (n = 3003), with 22.2% of participants (n = 656) categorised as working N-Std hours. Industry sectors with the highest numbers of participants working N-Std hours were manufacturing, health and community services, and agriculture, fishing, and forestry. Response rate was 37% (n = 3003) with 22.2% (n = 656) categorised as working N-Std hours. Participants working N-Std hours were more likely to be exposed to all identified hazards, including multiple hazards (OR = 2.45, 95% CI = 2.01-3.0) compared to those working Std hours. Participants working N-Std hours were also more likely to report 'never/rarely' getting enough sleep (OR = 1.38, 95% CI = 1.15-1.65), 'never/rarely' waking refreshed (OR = 1.23, 95% CI = 1.04-1.47), and excessive sleepiness (OR = 1.77, 95% CI = 1.29-2.42). New Zealanders working N-Std hours are more likely to be exposed to hazards in the workplace, to be exposed to multiple hazards, and to report inadequate sleep and excessive sleepiness than their colleagues working a standard 08:00-17:00 h Monday-to-Friday working week. More research is needed on the effects of exposure to hazardous substances outside the usual waking day, on the effects of exposure to multiple hazards, and on the combination of hazard exposure and sleep restriction as a result of shift work