Kompetenzen von Sport unterrichtenden Lehrpersonen der Vorschul- und Primarschulstufe: Ergebnisse einer zweistufigen Delphibefragung im Rahmen des Projektes KopS

Einleitung: Sport unterrichtende Lehrpersonen sollten in der Lage sein, Sportunterricht entsprechend seinem Bildungsauftrag (Fries, Baumberger & Egloff, 2009) zu gestalten. Dies verweist auf bestimmte Kompetenzen, welche eine Lehrperson ausweisen muss (vgl. Baumert & Kunter, 2006), um ebendiese Zielsetzungen im Unterricht anzusteuern. Aus wissenschaftlicher Perspektive herrscht jedoch Uneinigkeit darüber, was (Sport unterrichtende) Lehrpersonen wissen und können sollten oder welche Kompetenzen besonders wichtig sind (Bauer, 2002). Dieser Frage wird im Forschungsprojekt KopS (Kompetenzprofile für das Fach Sport auf Vorschul- und Primarschulstufe) nachgegangen. Methode: Im Rahmen einer zweistufigen Delphibefragung wurden in einer ersten Runde ausgewählte Lehrpersonen mit Expertenstatus der Vorschul-, Unter- und Mittelstufe in halbstrukturierten Interviews zu den aus ihrer Sicht notwendigen Fähigkeiten für unterrichtende Lehrpersonen des Faches Sport befragt (N1 = 16). Daraus wurden mittels qualitativer Inhaltsanalyse nach Mayring (2008) stufenspezifische Kompetenzen abgeleitet. In der zweiten Runde wurden die gewonnenen Kompetenzen Fachdidaktikerinnen und Fachdidaktiker verschiedener Pädagogischer Hochschulen der Deutschschweiz (N2 = 10) in einem strukturierten Interview vorgelegt und nach deren Kommentierung und Beurteilung der Kompetenzen bezüglich Wichtigkeit gefragt. Ergebnisse: Die drei schulstufenspezifischen Kompetenzraster aus der ersten Delphi-Runde weisen zwischen 30-62 Kompetenzen auf. Diese sind stufenübergreifend ähnlich, wobei sich die Kompetenzen der Vor-schule tendenziell von jener der Primarschule abgrenzen lassen: Im Bewegungs- und Sportunterricht im Kindergarten wird insbesondere das Arrangieren von motorisch herausfordernden Raum- und Materialerfahrungen als zentral erachtet. In der Schule werden dagegen sportpraktisches und organisatorisches Können von Lehrpersonen als bedeutungsvoll eingeschätzt. Allen drei Kompetenzrastern werden sportunterrichtsspezifische Kompetenzen zu den Bereichen Organisation, Unterrichtsstruktur, sport- und bewegungsbezogenes Fachwissen, Beurteilung, Interaktion, Kommunikation und Sicherheit genannt. Die von den Lehrpersonen beschriebenen Kompetenzen werden von den Fachdidaktikerinnen und Fachdidaktiker als wichtig erachtet und nur marginal ergänzt. Diskussion: Mittels des beschriebenen Verfahrens wurden erstmals Kompetenzen von Sport unterrichtenden Lehrpersonen auf Vorschul- und Primarschulstufe erfasst. Die Ergebnisse zeigen, dass die sportspezifische Tönung der Kompetenzen Unterschiede zu bisherigen Kompetenzdarstellungen für Primarlehrpersonen nahelegt und es erforderlich ist, Kompetenzen stufenspezifisch zu diskutieren. Referenzen: Bauer, K.-O. (2002). Kompetenzprofil: LehrerIn. In H.U.O.T. Rauschenbach & P. Vogel (Hrsg.), Erziehungswissenschaft: Professionalität und Kompetenz (S. 49-63). Opladen: Leske & Budrich. Baumert, J. & Kunter, M. (2006). Stichwort: Professionelle Kompetenz von Lehrkräften. Zeitschrift für Erziehungswissenschaft, 9 (4), 469-520. Fries, A.-V., Baumberger, J. & Egloff, B. (PH Zürich) (2009, 18. November). Zum Auftrag des Fachs Sport in der Volksschule. Eine Diskussionsgrundlage. Zugriff am 24. Mai 2012 unter http://www2.phzh.ch/ForschungsDB/Files/367/Auftrag_Sport_27_11_09.pdf Mayring, Ph. (2008). Qualitative Inhaltsanalyse – Grundlagen und Techniken (10., neu ausgestattete Aufl.). Weinheim: Beltz.

The jews of Baltimore : an historical summary of their progress and status as citizens of Baltimore from early days to the year 1910

by Isidor Blum. With special contrib. by William Rosenau ...

Corticosteroid treatment for community-acquired pneumonia--the STEP trial: study protocol for a randomized controlled trial

BACKGROUND Community-acquired pneumonia (CAP) is the third-leading infectious cause of death worldwide. The standard treatment of CAP has not changed for the past fifty years and its mortality and morbidity remain high despite adequate antimicrobial treatment. Systemic corticosteroids have anti-inflammatory effects and are therefore discussed as adjunct treatment for CAP. Available studies show controversial results, and the question about benefits and harms of adjunct corticosteroid therapy has not been conclusively resolved, particularly in the non-critical care setting. METHODS/DESIGN This randomized multicenter study compares a treatment with 7 days of prednisone 50 mg with placebo in adult patients hospitalized with CAP independent of severity. Patients are screened and enrolled within the first 36 hours of presentation after written informed consent is obtained. The primary endpoint will be time to clinical stability, which is assessed every 12 hours during hospitalization. Secondary endpoints will be, among others, all-cause mortality within 30 and 180 days, ICU stay, duration of antibiotic treatment, disease activity scores, side effects and complications, value of adrenal function testing and prognostic hormonal and inflammatory biomarkers to predict outcome and treatment response to corticosteroids. Eight hundred included patients will provide an 85% power for the intention-to-treat analysis of the primary endpoint. DISCUSSION This largest to date double-blind placebo-controlled multicenter trial investigates the effect of adjunct glucocorticoids in 800 patients with CAP requiring hospitalization. It aims to give conclusive answers about benefits and risks of corticosteroid treatment in CAP. The inclusion of less severe CAP patients will be expected to lead to a relatively low mortality rate and survival benefit might not be shown. However, our study has adequate power for the clinically relevant endpoint of clinical stability. Due to discontinuing glucocorticoids without tapering after seven days, we limit duration of glucocorticoid exposition, which may reduce possible side effects. TRIAL REGISTRATION 7 September 2009 on ClinicalTrials.gov: NCT00973154.

Subclinical hypothyroidism: summary of evidence in 2014

Subclinical hypothyroidism, which is defined as elevated thyroid-stimulating hormone (TSH) levels with free thyroxine concentrations within the reference range, is a common disorder that increases with age and affects up to 18% of the elderly, with a higher prevalence in women compared to men. Prospective data have shown an increased risk of coronary heart disease events, heart failure, and cardiovascular mortality among affected adults. Conflicting results have been found on the association between subclinical hypothyroidism and cognitive impairment, depression and the risk of fractures. Management strategies including screening and treatment of subclinical hypothyroidism are still controversial, while the ongoing European randomised controlled trial "TRUST" targets to solve these uncertainties. This narrative review aims to assess current evidence on the clinical aspects, as well as screening and treatment recommendations in adults with subclinical hypothyroidism.

Le Synhedrin ou Grand conseil de Jérusalem : son origine et son histoire

Felix Blum

Low statin use in adults hospitalized with acute coronary syndrome.

OBJECTIVE To assess recommended and actual use of statins in primary prevention of cardiovascular disease (CVD) based on clinical prediction scores in adults who develop their first acute coronary syndrome (ACS). METHOD Cross-sectional study of 3172 adults without previous CVD hospitalized with ACS at 4 university centers in Switzerland. The number of participants eligible for statins before hospitalization was estimated based on the European Society of Cardiology (ESC) guidelines and compared to the observed number of participants on statins at hospital entry. RESULTS Overall, 1171 (37%) participants were classified as high-risk (10-year risk of cardiovascular mortality ≥5% or diabetes); 1025 (32%) as intermediate risk (10-year risk <5% but ≥1%); and 976 (31%) as low risk (10-year risk <1%). Before hospitalization, 516 (16%) were on statins; among high-risk participants, only 236 of 1171 (20%) were on statins. If ESC primary prevention guidelines had been fully implemented, an additional 845 high-risk adults (27% of the whole sample) would have been eligible for statins before hospitalization. CONCLUSION Although statins are recommended for primary prevention in high-risk adults, only one-fifth of them are on statins when hospitalized for a first ACS.

Subclinical thyroid dysfunction and fracture risk: a meta-analysis.

IMPORTANCE Associations between subclinical thyroid dysfunction and fractures are unclear and clinical trials are lacking. OBJECTIVE To assess the association of subclinical thyroid dysfunction with hip, nonspine, spine, or any fractures. DATA SOURCES AND STUDY SELECTION The databases of MEDLINE and EMBASE (inception to March 26, 2015) were searched without language restrictions for prospective cohort studies with thyroid function data and subsequent fractures. DATA EXTRACTION Individual participant data were obtained from 13 prospective cohorts in the United States, Europe, Australia, and Japan. Levels of thyroid function were defined as euthyroidism (thyroid-stimulating hormone [TSH], 0.45-4.49 mIU/L), subclinical hyperthyroidism (TSH <0.45 mIU/L), and subclinical hypothyroidism (TSH ≥4.50-19.99 mIU/L) with normal thyroxine concentrations. MAIN OUTCOME AND MEASURES The primary outcome was hip fracture. Any fractures, nonspine fractures, and clinical spine fractures were secondary outcomes. RESULTS Among 70,298 participants, 4092 (5.8%) had subclinical hypothyroidism and 2219 (3.2%) had subclinical hyperthyroidism. During 762,401 person-years of follow-up, hip fracture occurred in 2975 participants (4.6%; 12 studies), any fracture in 2528 participants (9.0%; 8 studies), nonspine fracture in 2018 participants (8.4%; 8 studies), and spine fracture in 296 participants (1.3%; 6 studies). In age- and sex-adjusted analyses, the hazard ratio (HR) for subclinical hyperthyroidism vs euthyroidism was 1.36 for hip fracture (95% CI, 1.13-1.64; 146 events in 2082 participants vs 2534 in 56,471); for any fracture, HR was 1.28 (95% CI, 1.06-1.53; 121 events in 888 participants vs 2203 in 25,901); for nonspine fracture, HR was 1.16 (95% CI, 0.95-1.41; 107 events in 946 participants vs 1745 in 21,722); and for spine fracture, HR was 1.51 (95% CI, 0.93-2.45; 17 events in 732 participants vs 255 in 20,328). Lower TSH was associated with higher fracture rates: for TSH of less than 0.10 mIU/L, HR was 1.61 for hip fracture (95% CI, 1.21-2.15; 47 events in 510 participants); for any fracture, HR was 1.98 (95% CI, 1.41-2.78; 44 events in 212 participants); for nonspine fracture, HR was 1.61 (95% CI, 0.96-2.71; 32 events in 185 participants); and for spine fracture, HR was 3.57 (95% CI, 1.88-6.78; 8 events in 162 participants). Risks were similar after adjustment for other fracture risk factors. Endogenous subclinical hyperthyroidism (excluding thyroid medication users) was associated with HRs of 1.52 (95% CI, 1.19-1.93) for hip fracture, 1.42 (95% CI, 1.16-1.74) for any fracture, and 1.74 (95% CI, 1.01-2.99) for spine fracture. No association was found between subclinical hypothyroidism and fracture risk. CONCLUSIONS AND RELEVANCE Subclinical hyperthyroidism was associated with an increased risk of hip and other fractures, particularly among those with TSH levels of less than 0.10 mIU/L and those with endogenous subclinical hyperthyroidism. Further study is needed to determine whether treating subclinical hyperthyroidism can prevent fractures.

Variation in treatment strategies of Swiss general practitioners for subclinical hypothyroidism in older adults.

QUESTIONS UNDER STUDY As the best management of subclinical hypothyroidism is controversial, we aimed to assess variations in treatment strategies depending on different Swiss regions, physician and patient characteristics. METHODS We performed a case-based survey among general practitioners (GPs) in different Swiss regions, which consisted of eight hypothetical cases presenting a female patient with subclinical hypothyroidism and nonspecific complaints differing by age, vitality status and thyroid-stimulating hormone (TSH) concentration. RESULTS A total of 262 GPs participated in the survey. There was considerable variation in the levothyroxine starting dose chosen by GPs, ranging from 25 µg to 100 µg. Across the Swiss regions, GPs in the Bern region were significantly more inclined to treat, with a higher probability of initiating treatment (60%, p = 0.01) and higher mean starting doses (45 µg, p <0.01) compared with the French-speaking region (44%, 36 µg); the Zurich region had intermediate values (52%, 39 µg). We found no association between treatment rate and other physician characteristics. GPs were more reluctant to initiate treatment in 85-year-old than in 70-year-old women (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.63-0.94), and more likely to treat women with a TSH of 15 mU/l than those with a TSH of 6mU/l (OR 8.71, 95% CI 6.21-12.20). CONCLUSIONS There are strong variations in treatment strategies for elderly patients with subclinical hypothyroidism across different Swiss regions, including use of higher starting doses than the recommended 25 µg in the Swiss guidelines, which recommend a starting dose of 25 µg. These variations likely reflect the current uncertainty about the benefits of treatment, which arise from the current lack of evidence from adequately powered clinical trials.

Eine Verhandlung des deutschen Vaterlands-Vereins zu Leipzig, in der Versammlung vom 30. Mai 1848

Boberach: Eine lebhafte Debatte, an der sich der Verleger Reclam, der Historiker Wuttke, Robert Blum und J. G. Günther MdNV beteiligen, führt zu dem Ergebnis, daß der Verein sich zur Zeit nicht offen für die Republik aussprechen, aber regelmäßig über die Staatsform diskutieren soll

Sind indirecte Wahlen zur constituirenden Deutschen Nationalversammlung erlaubt und zweckmäßig? Als in der zweiten Sitzung der Frankfurter Versammlung deutscher Volksmänner ...

Boberach: Wie bereits Blum im Vorparlament dargelegt hat, können indirekte Wahlen den Volkswillen verfälschen