Участие кураторов академических групп в определении образовательной траектории обучения студентов первого курса

Context. The German Hospice and Palliative Care Evaluation (HOPE) is a national, long-term quality assurance project. Every year, German hospice and palliative care institutions document a core data set for their patients for a period of three months. Objectives. To validate the multidimensional symptom and problem checklist (HOPE-SP-CL) of the core data set and report details on reliability and validity. Methods. Data from yearly evaluation periods between 2002 and 2009 were used to calculate construct and convergent validity, internal consistency, test-retest reliability, and documentation discipline and acceptance of the core documentation system. Results. The HOPE-SP-CL includes items on physical, nursing, psychological, and social symptoms and problems. Factor analysis extracted four low to moderately intercorrelating factors with eigenvalues greater than 1.0 explaining 56% of the total variance. Discriminant validity of the HOPE-SP-CL showed good properties in detecting patient groups with different symptom intensities and overall symptom burden using the Eastern Cooperative Oncology Group performance status and primary cancer diagnosis as external validation criteria. The global sum score of the HOPE-SP-CL correlated most closely with the Palliative Outcome Scale staff version (r = 0.750). Internal consistencies ranged between alpha = 0.768-0.801 at three different times of assessment. Test-retest coefficients showed moderate to high correlations at one-week intervals. Conclusion. Analyses of reliability and validity of the HOPE-SP-CL showed satisfactory to good psychometric properties; therefore, the HOPE-SP-CL can be recommended for standard implementation in German hospice and palliative care institutions. J Pain Symptom Manage 2012;43:593-605. (C) 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved

Development of a breadboard design of a high-performance, high-reliability switching regulator

A comparison of two potential conversion methods, the series inverter and the inductive energy transfer (IET) conversion technique, is presented. The investigations showed that a characteristic of the series inverter circuit (high equalizing current values in each half cycle) could not be accomplished with available components, and the investigations continued with the IET circuit only. An IET circuit system was built with the use of computer-aided design in a 2, 4, and 8 stage configuration, and these stages were staggered 180, 90, and 45 degrees, respectively. All stages were pulsewidth modulated to regulate over an input voltage range from 200 to 400 volts dc at a regulated output voltage of 56 volts. The output power capability was 100 to 500 watts for the 2 and 8 stage configuration and 50 to 250 watts for the 4 stage configuration. Equal control of up to eight 45 degree staggered stages was accomplished through the use of a digital-to-analog control circuit. Equal power sharing of all stages was achieved through a new technique using an inductively coupled balancing circuit. Conclusions are listed

Functional Analysis of Phagocyte Activity in Whole Blood from HIV/Tuberculosis-Infected Individuals Using a Novel Flow Cytometry-Based Assay.

The accurate assessment of immune competence through ex vivo analysis is paramount to our understanding of those immune mechanisms that lead to protection or susceptibility against a broad range of human pathogens. We have developed a flow cytometry-based, whole blood phagocyte functional assay that utilizes the inflammatory inducer zymosan, coupled to OxyBURST-SE, a fluorescent reporter of phagosomal oxidase activity. The assay measures both phagocytic uptake and the superoxide burst in the phagocyte populations in whole blood. We utilized this assay to demonstrate impaired superoxide burst activity in the phagocytes of hospitalized HIV-positive patients with laboratory-confirmed tuberculosis. These data validate the use of the assay to assess the immune competence of patients in a clinical setting. The method is highly reproducible with minimal intraindividual variation and opens opportunities for the rapid assessment of cellular immune competence in peripheral blood in a disease setting

Nachhaltigkeit in der Milcherzeugung : Was hat sich getan?

Nachhaltigkeit definieren, Fakten sammeln, Ansätze für Entwicklungen aufzeigen - das sind die Ziele des QM-Nachhaltigkeitsmoduls Milch. Das QM-Nachhaltigkeitsmodul Milch wurde gemeinschaftlich von dem QM-Milch e.V. und dem Thünen-Institut für Betriebswirtschaft erarbeitet. Und das nicht im stillen Kämmerlein: Mehr als 200 Stakeholder waren eingebunden - Landwirte und Molkereien, aber auch NGOs, Lebensmitteleinzelhandel, Industriekunden, Wissenschaft, Beratung und Politik. Seit 2017 nutzen mehr als 30 Molkereien und deren Milcherzeuger das Tool, um sich gemeinschaftlich auf den Weg zu noch mehr Nachhaltigkeit zu begeben

"Ist das Tierwohl auf kleinen Milchviehbetrieben besser?" : Ergebnisse von 3.085 deutschen Milchviehbetrieben

Der europäische Agrarsektor unterliegt einem kontinuierlichen Strukturwandel, in dessen Folge eine Konzentration der Produktion auf wenige, größere und meist spezialisierte Betriebe zunimmt (z. B. Zimmermann und Heckelei 2012, Europäische Kommission 2013). Gleichzeitig findet das Thema Tierwohl in der Landwirtschaft vor allem in einkommensstarken Ländern wie den Mitgliedsstaaten der Europäischen Union zunehmend Beachtung (European Commission 2016). Vor diesem Hintergrund werden in öffentlichen und privaten Tierwohlzertifizierungs- und/oder -regulierungsprogrammen Themen wie Haltungssystem, Auslauf, Platz oder auch Betriebsgrößenbeschränkungen als mögliche Kriterien diskutiert, um Tierwohl zu gewährleisten und um das Verbrauchervertrauen zu erhalten. Beispielsweise legt das Labelprogramm "Für mehr Tierwohl" des Deutschen Tierschutzbundes e.V. für teilnehmende Milchviehbetriebe eine maximale Betriebsgröße von 600 Kühen pro Betrieb fest (Deutscher Tierschutzbund e.V. 2021). Betriebsgrößenbeschränkungen werden eingeführt, weil in der öffentlichen Debatte häufig ein negativer Zusammenhang zwischen Betriebs- bzw. Herdengröße und Tierwohl vermutet wird (z.B. Busch et al. 2018; Pfeiffer at al. 2021). Landwirte selbst hingegen sehen weniger, dass die Betriebsgröße mit dem Tierwohl in Verbindung steht (z. B. Vanhonacker et al. 2008; Sørensen und Fraser 2010). Wissenschaftliche Untersuchungen zeigen bislang keine eindeutigen Ergebnisse hinsichtlich eines Zusammenhangs zwischen Tierwohl und Betriebsgröße. Vor diesem Hintergrund untersucht der vorliegende Beitrag den Zusammenhang zwischen Tierwohl und Betriebsgröße auf deutschen Milchviehbetrieben

QM-Dairy Sustainability Tool

• Objectives: define sustainability, collect facts, initiate improvement processes. • Around 30 dairies and milk producer associations are participating. Nearly 15,000 milk producers have completed the sustainability questionnaire, around 4,000 of them for the second time (as of 03/2023). • The results show that the dairy farms already have many strengths in terms of sustainability. However, there is still room for improvement in some criteria. • The transparency gained gives the dairy industry the opportunity to provide information to customers and society

Non-cancer patients in specialized palliative care in Germany: What are the problems?

To determine the role of non-cancer palliative care in inpatient services in Germany, data from the Hospice and Palliative Care Evaluation (HOPE) were analysed. Since 1999, a three-month census has been conducted annually in German palliative care units. Pooled data from 2002–2005 were tested for differences between non-cancer patients (NCs) and cancer patients (Cs). A total of 4182 patients (NC: 3.5%; C: 96.5%) were documented; functional status (using Eastern Cooperative Oncology Group (ECOG) measures) in NCs was lower compared to Cs (p = 0.009). NCs suffered more often from dyspnoea (40%; C: 29%; p = 0.004), weakness (92,3%; C: 84,5%; p = 0.011) and tiredness (75.4%; C: 66.7%; p = 0.03) and less from nausea (17.1%; C: 28.9%; p = 0.002), vomiting (8.2%; C: 19.4%; p = 0.001) or loss of appetite (55.5%; C: 67.9%; p = 0.002). There were no differences in pain and constipation. Other problems (nursing, psychological) were more frequent for NCs, in particular the need for support in the activities of daily life (90.3%; C: 72.8%; p < 0.001) and disorientation/confusion (32.1%; C: 17.2%; p < 0.001). There were no differences in social problems. NCs are still rare in specialized inpatient palliative care institutions in Germany. The palliative care needs in patients with non-malignant disease will challenge the health care system as the workload for these services will grow over proportionally