Media use and eLearning in schools. Summary

The special features of e-learning as a broadly applicable and at the same time highly individualisable teaching and learning tool make it necessary to take into account not only the respective learning context but also the special prerequisites of the various user groups when designing or adapting the tool. In this respect, the state of development, experiences and concepts of internet-based modular offers with target group-specific school contents have so far been analysed quite rarely. Evaluations of the significance of new media or e-learning specifically for school learning and teaching, the importance as well as the factors and strategies of the implementation of e-learning instruments in the school sector and the resulting implications for school development and school knowledge management are almost completely lacking. This deficit justifies a specific need for investigation, since eLearning is already given a very special weight in schools. Subject and objective of the study The topic was dealt with by means of an in-depth systematic description and analysis of the technological, societal and political options for implementing eLearning instruments in the context of suitable target group-oriented "virtual school offers". In order to better classify and assess the findings, the situation abroad was examined and compared with the situation in Germany. Such a comparison was intended to identify advantages in experience in other countries, also in the sense of concrete possibilities of transfer to German conditions, as well as to point out corresponding options for action. Specifically, the concepts and the state of development, but also experiences, significance and potentials of eLearning for school learning and teaching in Germany as well as the importance for school knowledge management and school development were examined. Existing secondary analyses, studies and evaluations were evaluated in order to gain an overview of the relevant German eLearning activities in the school sector. The focus was on the following questions, among others: Which multimedia learning/teaching offers, which materials of different scope, which learning environments have been and are being developed and used? Which programmes, (support) concepts, networks and actors are involved? What educational concepts are they pursuing? Which technical, pedagogical, didactical and organisational aspects were and are in the foreground in the development and use of school eLearning content? Could the initiated and hoped-for innovative developments be achieved with the help of the use of eLearning, what successes or deficits have been recorded, which technical-organisational and pedagogical-didactic concepts, methods and instruments can best realise the intended goals? What insights can be gained from the previous experiences of ongoing projects, programmes and implementations for the strategic importance, the objectives and the choice of instruments for the use of eLearning in lessons and schools, especially with regard to the situation of school education in Germany in the context of international "educational competition"

Clinical research in Germany with special focus on non-commercial studies. Summary

Clinical research is of paramount importance both for the development of new medicinal products and other medical treatment procedures and for ensuring and optimising the application of the procedures in routine practice. All resulting clinical studies are regulated by the German Medicines Act (AMG), provided they investigate the efficacy, safety or metabolism of medicinal products with the aim of testing their safety or efficacy. This type of clinical study is referred to as a "clinical trial". Insofar as clinical research is associated with commercial interests - such as the goal of obtaining marketing authorisation for a new active substance - it is initiated and financed by the developer or manufacturer of the preparation or procedure. However, if the commercial expectations associated with the study results are low or non-existent, especially if the product already has market approval, a private-sector sponsor is often not found. Clinical trials without private funding but which are of public interest are referred to as non-commercial clinical research, science-initiated clinical trials or investigator-initiated trials (IIT), sometimes also as therapy optimisation studies. Non-commercial clinical research usually answers questions that have arisen from treatment practice. Often, already approved drugs or medical devices or interventional (e.g. surgical or psychotherapeutic) procedures are the subject of the investigation. Because the questions revolve around the exact conditions of use - for example, the advantages and disadvantages of a combination of different cancer therapies or the identification of long-term side effects or the comparison of two procedures with each other - the manufacturers of the products often have no economic advantage to expect from such studies. Then a non-commercial institution, often the medical faculty of a university, assumes responsibility for the study (it becomes the study\u27s "sponsor"), and the funding must come at least in part from public funds (from the grant for research and teaching or from dedicated project funding) or be provided by foundations. Against this background, TAB was commissioned to systematically record the significance of currently discussed as well as possible further conditions for the practice of non-commercial clinical research in Germany. To this end, a working definition was first established for the object of investigation. In order to describe and assess the initial situation, data on the frequency of non-commercial studies in Germany as well as their objectives and funding were collected. The current discourse was empirically tested for completeness from the perspective of all relevant groups of actors and previously neglected topics were added to the agenda. The practical significance of the individual factors was recorded on the basis of the survey data as well as in the context of expert interviews and the results of a final workshop. The report describes and evaluates the many factors that have an influence on efficient non-commercial clinical research in Germany and makes suggestions for further optimisation of the conditions, whereby a prioritisation of the most important options for action was undertaken

Central venous oxygen saturation and emergency intubation – another piece in the puzzle?

A recent multicentre observational study examined the effect of emergency intubation on central venous oxygen saturation (SCVo2) in critically ill patients. The main finding was that SCVo2 significantly increases 15 minutes after emergency intubation and institution of mechanical ventilation with 100% oxygen, especially in those patients with pre-intubation SCVo2 values <70%, regardless of whether these patients suffered from severe sepsis. However, in only one-quarter of this subgroup was the SCVo2 normalized to ≥70% solely by this intervention. In contrast, in patients with pre-intubation SCVo2 ≥70%, the SCVo2 failed to increase after intubation. A rise in SCVo2 can be expected when whole body oxygen extraction remains unchanged after intubation and ventilation with pure oxygen

Sepsis therapy: what's the best for the mitochondria?

It is suspected that mitochondrial dysfunction is a major cause of organ failure in sepsis and septic shock. A study presented in this issue of Critical Care revealed that liver mitochondria from pigs treated with norepinephrine during endotoxaemia exhibit greater in vitro respiratory activity. The investigators provide an elegant demonstration of how therapeutic interventions in sepsis may profoundly influence mitochondrial respiration, but many aspects of mitochondrial function in sepsis remain to be clarified

Ubiquitous Computing. Summary

Ubiquitous computing - the complex electronic networking of things that communicate - is considered a promising innovation path worldwide. Intensive R&D activities and political strategies are aimed at promoting practical technologies and applications. Where do we currently stand on the path to the "Internet of Things"? Which practical projects already show the potential that can be exploited by implementing the basic idea of ubiquitous computing? What technical, legal and social challenges must be overcome to achieve this - and what can be the contribution of politics? In the light of these questions, the authors analyse the status quo and the perspectives of ubiquitous computing and illustrate their findings with examples from trade, logistics and health care, among others. the fascinating "Brownie technology" of ubiquitous computing must, however, still be comprehensively made fit by those involved in business, society and politics if its applications are really to become economically attractive, socially acceptable and helpful in overcoming social problems

Vasopressin in vasodilatory shock: is the heart in danger?

In patients with hyperdynamic hemodynamics, infusing arginine vasopressin (AVP) in advanced vasodilatory shock is usually accompanied by a decrease in cardiac output and in visceral organ blood flow. Depending on the infusion rate, this vasoconstriction also reduces coronary blood flow despite an increased coronary perfusion pressure. In a porcine model of transitory myocardial ischemia-induced left ventricular dysfunction, Müller and colleagues now report that the AVP-related coronary vaso-constriction may impede diastolic relaxation while systolic contraction remains unaffected. Although any AVP-induced myocardial ischemia undoubtedly is a crucial safety issue, these findings need to be discussed in the context of the model design, the dosing of AVP as well as the complex direct, afterload-independent and systemic, vasoconstriction-related effects on the heart

Zielgruppenorientiertes eLearning für Kinder und ältere Menschen. Sachstandsbericht zum Monitoring »eLearning«

Bericht zu der durch das Büro für Technikfolgen-Abschätzung beim Deutschen Bundestag durchgeführten Untersuchung: lebenslanges Lernen und eLearning für Kinder und ältere Menschen, Mediennutzung und –ausstattung; Stand der Zielgruppenorientierung, Resümee und Ausblick INHALT ZUSAMMENFASSUNG 5 I. EINLEITUNG 15 1. Thematischer Hintergrund 15 1.1 eLearning – Definition und Varianten 16 1.2 Lebenslanges Lernen als neues Paradigma 18 1.3 eLearning im Kontext des Lebenslangen Lernens 19 2. Leitende Fragestellungen und Berichtsstruktur 20 3. Zusammenarbeit mit Gutachtern 22 II. KINDER ALS ZIELGRUPPE FÜR LEBENSLANGES LERNEN 23 1. Die Lebenswelten von Kindern 23 2. Kinder und Lebenslanges Lernen 27 3. Mediennutzung von Kindern 30 4. Teilnahmevoraussetzungen bei Medienangeboten 37 4.1 Mediennutzung und soziale Ungleichheit 37 4.2 Mediennutzung in Schulen 38 4.3 Informelles Lernen und Medienkompetenz 39 5. Zwischenfazit 40 III. eLEARNING FÜR KINDER 43 1. Anbieter 43 2. Marktstrategien 45 2.1 Contentanbieter 45 2.2 Vorleistungsanbieter 46 2.3 Serviceanbieter und Komplettanbieter 46 3. eLearning-Produkte für Kinder 47 3.1 Produktarten 47 3.2 Produktvielfalt 51 4. Markttransparenz bei Kinder- und Lernsoftware 53 5. Distributionskanäle 55 6. Zwischenfazit: der eLearning-Markt für Kinder 56 7. Nutzung von eLearning-Produkten durch Kinder 57 7.1 Lernprogramme 57 7.2 Computerspiele 59 8. Lerntheoretische und mediendidaktische Aspekte von Kinderund Lernsoftware 61 8.1 Bewertung unter mediendidaktischen Gesichtspunkten 62 8.2 Lernsoftware in der Vorschule 63 8.3 Lernsoftware in der Sonderpädagogik 64 8.4 Lernsoftware in der Grundschule 65 8.5 Lernsoftware in der Sekundarstufe 66 8.6 Lernsoftware im häuslichen Bereich 69 8.7 Fazit 69 9. Schlussfolgerungen 70 IV. ÄLTERE MENSCHEN ALS ZIELGRUPPE FÜR LEBENSLANGES LERNEN 73 1. Die Lebenswelten älterer Menschen 74 2. Ältere Menschen und lebenslanges Lernen 77 2.1 Altersbildung 78 2.2 Bildungsbeteiligung älterer Menschen 81 3. Mediennutzung älterer Menschen 84 3.1 Ausstattung der Haushalte mit Medien 84 3.2 Nutzung von Computer und Internet 85 3.3 Onlineinhalte und Weiterbildungsinteresse älterer Menschen 88 4. Zwischenfazit 90 V. eLEARNING FÜR ÄLTERE MENSCHEN 91 1. Anbieter von eLearning-Produkten 91 2. Marktstrategien 92 2.1 Contentanbieter 92 2.2 Vorleistungsanbieter 93 2.3 Serviceanbieter 94 3. eLearning-Produkte für ältere Menschen 94 3.1 Seminare, Kurse und Workshops 95 3.2 Internetportale 95 4. Distributionskanäle für eLearning-Produkte 96 5. Zwischenfazit: Der eLearning-Markt für ältere Menschen 97 6. Institutionelle Verankerung der eLearning-Angebote für ältere Menschen 98 6.1 Ausgewählte eLearning-Anbieter für ältere Menschen 100 6.2 eLearning-Komponenten der untersuchten Anbieter 104 6.3 Institutionen mit vorbereitenden Angeboten für eLearning 108 6.4 Zusammenfassung 111 7. Modellprojekt »Gemeinsam Lernen übers Netz« 112 8. Internationale Erfahrungen mit eLearning für ältere Menschen 117 8.1 Großbritannien 117 8.2 Niederlande 119 8.3 Schweden 119 8.4 USA 120 8.5 Zusammenfassung 121 9. Schlussfolgerungen 122 VI. STAND DER ZIELGRUPPENORIENTIERUNG – RESÜMEE UND AUSBLICK 125 1. Heterogene Mediennutzung 125 2. Der eLearning-Markt für Kinder 127 3. Der eLearning-Markt für Ältere 128 4. Perspektiven des zielgruppenorientierten eLearning 130 5. Handlungsfelder und Handlungsoptionen 132 5.1 eLearning-Potenziale für Kinder 133 5.2 Nutzung der eLearning-Potenziale für Ältere 134 LITERATUR 137 1. In Auftrag gegebene Gutachten 137 2. Weitere Literatur 137 ANHANG 145 1. Tabellenverzeichnis 145 2. Abbildungsverzeichnis 147 3. Qualitätskriterien für eLearning 148 4. Good-Practice-Beispiele: Lernsoftware für Kinder 154 5. Good-Practice-Beispiele: eLearning für ältere Menschen 16

Which variables are associated with blood glucose levels outside the target range in surgical critically ill patients? A retrospective observational study

<p>Abstract</p> <p>Background</p> <p>The aim of the present study is to determine the variables affecting blood glucose concentrations outside the target range of 80 and 150 mg/dl in critically ill surgical patients.</p> <p>Methods</p> <p>All critically ill surgical patients admitted to a university ICU, from 01/2007 to 12/2008, were surveyed daily using computer assistance with respect to minimal and maximal daily blood glucose concentrations, application of insulin and demographic/clinical variables. Multiple logistic regression for clustered data with backward elimination was performed to identify variables strongly associated with blood glucose concentrations < 80 mg/dl or ≥ 150 mg/dl in 804 patients with an ICU stay > 72 hours.</p> <p>Results</p> <p>Application of insulin (odds ratio (OR) 2.1, with corresponding 95% confidence interval (CI) 1.7; 2.6), noradrenaline (OR 1.4, 95% CI 1.2 - 1.8) or steroids (1.3, 1.003 - 1.7), and age (per year) (1.02, 1.01 - 1.03) were associated with an increased risk of blood glucose concentrations < 80 mg/dl. In analogy, application of insulin (OR 2.4, 95% CI 2.0 - 2.7), noradrenaline (1.4, 1.2 - 1.6) or steroids (1.4, 1.2 - 1.7), severe sepsis (1.2, 1.1 - 1.4), neurosurgery (OR 1.0) compared to abdominal, vascular and trauma surgery, and age (per year) (1.01, 1.01 - 1.02), were associated with an increased risk of blood glucose concentrations ≥ 150 mg/dl.</p> <p>Conclusions</p> <p>Critically ill surgical patients are at an increased risk for fluctuating blood glucose concentrations ranging < 80 mg/dl or ≥ 150 mg/dl in particular if they are of advanced age and require administration of insulin, noradrenaline, and/or steroids. Patients who underwent neurosurgery and/or presented with severe sepsis/shock are those in particular at risk for blood glucose concentrations ≥ 150 mg/dl.</p

Year in review 2007: Critical Care – shock

The research papers on shock published in Critical Care throughout 2007 are related to three major subjects: the modulation of the macrocirculation and microcirculation during shock, focusing on arginine vasopressin, erythropoietin and nitric oxide; studies on metabolic homeostasis (acid–base status, energy expenditure and gastrointestinal motility); and basic supportive measures in critical illness (fluid resuscitation and sedation, and body-temperature management). The present review summarizes the key results of these studies and provides a brief discussion in the context of the relevant scientific and clinical background