Effectiveness of a multifactorial falls prevention program in community-dwelling older people when compared to usual care: study protocol for a randomised controlled trial (Prevquedas Brazil)

Background Falling in older age is a major public health concern due to its costly and disabling consequences. However very few randomised controlled trials (RCTs) have been conducted in developing countries, in which population ageing is expected to be particularly substantial in coming years. This article describes the design of an RCT to evaluate the effectiveness of a multifactorial falls prevention program in reducing the rate of falls in community-dwelling older people. Methods/design Multicentre parallel-group RCT involving 612 community-dwelling men and women aged 60 years and over, who have fallen at least once in the previous year. Participants will be recruited in multiple settings in Sao Paulo, Brazil and will be randomly allocated to a control group or an intervention group. The usual care control group will undergo a fall risk factor assessment and be referred to their clinicians with the risk assessment report so that individual modifiable risk factors can be managed without any specific guidance. The intervention group will receive a 12-week Multifactorial Falls Prevention Program consisting of: an individualised medical management of modifiable risk factors, a group-based, supervised balance training exercise program plus an unsupervised home-based exercise program, an educational/behavioral intervention. Both groups will receive a leaflet containing general information about fall prevention strategies. Primary outcome measures will be the rate of falls and the proportion of fallers recorded by monthly falls diaries and telephone calls over a 12 month period. Secondary outcomes measures will include risk of falling, fall-related self-efficacy score, measures of balance, mobility and strength, fall-related health services use and independence with daily tasks. Data will be analysed using the intention-to-treat principle.The incidence of falls in the intervention and control groups will be calculated and compared using negative binomial regression analysis. Discussion This study is the first trial to be conducted in Brazil to evaluate the effectiveness of an intervention to prevent falls. If proven to reduce falls this study has the potential to benefit older adults and assist health care practitioners and policy makers to implement and promote effective falls prevention interventions. Trial registration ClinicalTrials.gov (NCT01698580)

Oral cleft prevention program (OCPP)

Background Oral clefts are one of the most common birth defects with significant medical, psychosocial, and economic ramifications. Oral clefts have a complex etiology with genetic and environmental risk factors. There are suggestive results for decreased risks of cleft occurrence and recurrence with folic acid supplements taken at preconception and during pregnancy with a stronger evidence for higher than lower doses in preventing recurrence. Yet previous studies have suffered from considerable design limitations particularly non-randomization into treatment. There is also well-documented effectiveness for folic acid in preventing neural tube defect occurrence at 0.4 mg and recurrence with 4 mg. Given the substantial burden of clefting on the individual and the family and the supportive data for the effectiveness of folic acid supplementation as well as its low cost, a randomized clinical trial of the effectiveness of high versus low dose folic acid for prevention of cleft recurrence is warranted. Methods/design This study will assess the effect of 4 mg and 0.4 mg doses of folic acid, taken on a daily basis during preconception and up to 3 months of pregnancy by women who are at risk of having a child with nonsyndromic cleft lip with/without palate (NSCL/P), on the recurrence of NSCL/P. The total sample will include about 6,000 women (that either have NSCL/P or that have at least one child with NSCL/P) randomly assigned to the 4 mg and the 0.4 mg folic acid study groups. The study will also compare the recurrence rates of NSCL/P in the total sample of subjects, as well as the two study groups (4mg, 0.4 mg) to that of a historical control group. The study has been approved by IRBs (ethics committees) of all involved sites. Results will be disseminated through publications and presentations at scientific meetings. Discussion The costs related to oral clefts are high, including long term psychological and socio-economic effects. This study provides an opportunity for huge savings in not only money but the overall quality of life. This may help establish more specific clinical guidelines for oral cleft prevention so that the intervention can be better tailored for at-risk women. ClinicalTrials.gov Identifier NCT00397917

Development of an integrative cessation program for co-smokers of cigarettes and cannabis: demand analysis, program description, and acceptability

Abstract Background Tobacco and cannabis use are strongly interrelated, but current national and international cessation programs typically focus on one substance, and address the other substance either only marginally or not at all. This study aimed to identify the demand for, and describe the development and content of, the first integrative group cessation program for co-smokers of cigarettes and cannabis. Methods First, a preliminary study using expert interviews, user focus groups with (ex-)smokers, and an online survey was conducted to investigate the demand for, and potential content of, an integrative smoking cessation program (ISCP) for tobacco and cannabis co-smokers. This study revealed that both experts and co-smokers considered an ISCP to be useful but expected only modest levels of readiness for participation.Based on the findings of the preliminary study, an interdisciplinary expert team developed a course concept and a recruitment strategy. The developed group cessation program is based on current treatment techniques (such as motivational interviewing, cognitive behavioural therapy, and self-control training) and structured into six course sessions.The program was evaluated regarding its acceptability among participants and course instructors. Results Both the participants and course instructors evaluated the course positively. Participants and instructors especially appreciated the group discussions and the modules that were aimed at developing personal strategies that could be applied during simultaneous cessation of tobacco and cannabis, such as dealing with craving, withdrawal, and high-risk situations. Conclusions There is a clear demand for a double cessation program for co-users of cigarettes and cannabis, and the first group cessation program tailored for these users has been developed and evaluated for acceptability. In the near future, the feasibility of the program will be evaluated. Trial registration Current Controlled Trials ISRCTN15248397

The phylogeography of trypanosomes from South American alligatorids and African crocodilids is consistent with the geological history of South American river basins and the transoceanic dispersal of Crocodylus at the Miocene

Abstract Background Little is known about the diversity, phylogenetic relationships, and biogeography of trypanosomes infecting non-mammalian hosts. In this study, we investigated the influence of host species and biogeography on shaping the genetic diversity, phylogenetic relationship, and distribution of trypanosomes from South American alligatorids and African crocodilids. Methods Small Subunit rRNA (SSU rRNA) and glycosomal Glyceraldehyde Phosphate Dehydrogenase (gGAPDH) genes were employed for phylogenetic inferences. Trypanosomes from crocodilians were obtained by haemoculturing. Growth behaviour, morphology, and ultrastructural features complement the molecular description of two new species strongly supported by phylogenetic analyses. Results The inferred phylogenies disclosed a strongly supported crocodilian-restricted clade comprising three subclades. The subclade T. grayi comprised the African Trypanosoma grayi from Crocodylus niloticus and tsetse flies. The subclade T. ralphi comprised alligatorid trypanosomes represented by Trypanosoma ralphi n. sp. from Melanosuchus niger, Caiman crocodilus and Caiman yacare from Brazilian river basins. T. grayi and T. ralphi were sister subclades. The basal subclade T. terena comprised alligatorid trypanosomes represented by Trypanosoma terena n. sp. from Ca. yacare sharing hosts and basins with the distantly genetic related T. ralphi. This subclade also included the trypanosome from Ca. crocodilus from the Orinoco basin in Venezuela and, unexpectedly, a trypanosome from the African crocodilian Osteolaemus tetraspis. Conclusion The close relationship between South American and African trypanosomes is consistent with paleontological evidence of recent transoceanic dispersal of Crocodylus at the Miocene/Pliocene boundaries (4–5 mya), and host-switching of trypanosomes throughout the geological configuration of South American hydrographical basins shaping the evolutionary histories of the crocodilians and their trypanosomes.

The phylogeography of trypanosomes from South American alligatorids and African crocodilids is consistent with the geological history of South American river basins and the transoceanic dispersal of Crocodylus at the Miocene

Background: Little is known about the diversity, phylogenetic relationships, and biogeography of trypanosomes infecting non-mammalian hosts. In this study, we investigated the influence of host species and biogeography on shaping the genetic diversity, phylogenetic relationship, and distribution of trypanosomes from South American alligatorids and African crocodilids. Methods: Small Subunit rRNA (SSU rRNA) and glycosomal Glyceraldehyde Phosphate Dehydrogenase (gGAPDH) genes were employed for phylogenetic inferences. Trypanosomes from crocodilians were obtained by haemoculturing. Growth behaviour, morphology, and ultrastructural features complement the molecular description of two new species strongly supported by phylogenetic analyses. Results: The inferred phylogenies disclosed a strongly supported crocodilian-restricted clade comprising three subclades. The subclade T. grayi comprised the African Trypanosoma grayi from Crocodylus niloticus and tsetse flies. The subclade T. ralphi comprised alligatorid trypanosomes represented by Trypanosoma ralphi n. sp. From Melanosuchus niger, Caiman crocodilus and Caiman yacare from Brazilian river basins. T. grayi and T. ralphi were sister subclades. The basal subclade T. terena comprised alligatorid trypanosomes represented by Trypanosoma terena n. sp. from Ca. yacare sharing hosts and basins with the distantly genetic related T. ralphi. This subclade also included the trypanosome from Ca. crocodilus from the Orinoco basin in Venezuela and, unexpectedly, a trypanosome from the African crocodilian Osteolaemus tetraspis. Conclusion: The close relationship between South American and African trypanosomes is consistent with paleontological evidence of recent transoceanic dispersal of Crocodylus at the Miocene/Pliocene boundaries (4–5 mya), and host-switching of trypanosomes throughout the geological configuration of South American hydrographical basins shaping the evolutionary histories of the crocodilians and their trypanosomes.

The aplication of land use and nighttime lights on the development of high-resolution emission inventories for South America

In this paper, nighttime light data are suggested as a proxy for spatial distribution of vehicles running in urban and nearby areas. Nighttime lights focus on human activities, in contrast to traditional Earth observing systems that focus on natural systems. It is the human activity being visible in the form of brightness of nocturnal lights. Two available nighttime lights dataset were used in this work. The first one was provided by the U.S. Air Force Defense Meteorological Satellite Program (DMSP) Operational Linescan System (OLS), henceforth, DMSO-OLS. The second one is the NASA-NOAA Suomi National Polar-orbiting Polar-orbiting Partnership (NPP) satellite, henceforth, Suomi-NPP. To validate the new proposed methodology, hundreds of urban areas of South America were analyzed in a high degree of resolution. The results of this study showed that night-time lights are very well correlated with vehicle fleet, population, and impervious surfaces but with strong spatial variability. The results of this study suggest a better understanding of the human activities in the context of a vehicular-based city conception.

Constraint handling rules. Compositional semantics and program transformation

This thesis intends to investigate two aspects of Constraint Handling Rules (CHR). It proposes a compositional semantics and a technique for program transformation. CHR is a concurrent committed-choice constraint logic programming language consisting of guarded rules, which transform multi-sets of atomic formulas (constraints) into simpler ones until exhaustion [Frü06] and it belongs to the declarative languages family. It was initially designed for writing constraint solvers but it has recently also proven to be a general purpose language, being as it is Turing equivalent [SSD05a]. Compositionality is the first CHR aspect to be considered. A trace based compositional semantics for CHR was previously defined in [DGM05]. The reference operational semantics for such a compositional model was the original operational semantics for CHR which, due to the propagation rule, admits trivial non-termination. In this thesis we extend the work of [DGM05] by introducing a more refined trace based compositional semantics which also includes the history. The use of history is a well-known technique in CHR which permits us to trace the application of propagation rules and consequently it permits trivial non-termination avoidance [Abd97, DSGdlBH04]. Naturally, the reference operational semantics, of our new compositional one, uses history to avoid trivial non-termination too. Program transformation is the second CHR aspect to be considered, with particular regard to the unfolding technique. Said technique is an appealing approach which allows us to optimize a given program and in more detail to improve run-time efficiency or spaceconsumption. Essentially it consists of a sequence of syntactic program manipulations which preserve a kind of semantic equivalence called qualified answer [Frü98], between the original program and the transformed ones. The unfolding technique is one of the basic operations which is used by most program transformation systems. It consists in the replacement of a procedure-call by its definition. In CHR every conjunction of constraints can be considered as a procedure-call, every CHR rule can be considered as a procedure and the body of said rule represents the definition of the call. While there is a large body of literature on transformation and unfolding of sequential programs, very few papers have addressed this issue for concurrent languages. We define an unfolding rule, show its correctness and discuss some conditions in which it can be used to delete an unfolded rule while preserving the meaning of the original program. Finally, confluence and termination maintenance between the original and transformed programs are shown. This thesis is organized in the following manner. Chapter 1 gives some general notion about CHR. Section 1.1 outlines the history of programming languages with particular attention to CHR and related languages. Then, Section 1.2 introduces CHR using examples. Section 1.3 gives some preliminaries which will be used during the thesis. Subsequentely, Section 1.4 introduces the syntax and the operational and declarative semantics for the first CHR language proposed. Finally, the methodologies to solve the problem of trivial non-termination related to propagation rules are discussed in Section 1.5. Chapter 2 introduces a compositional semantics for CHR where the propagation rules are considered. In particular, Section 2.1 contains the definition of the semantics. Hence, Section 2.2 presents the compositionality results. Afterwards Section 2.3 expounds upon the correctness results. Chapter 3 presents a particular program transformation known as unfolding. This transformation needs a particular syntax called annotated which is introduced in Section 3.1 and its related modified operational semantics !0t is presented in Section 3.2. Subsequently, Section 3.3 defines the unfolding rule and prove its correctness. Then, in Section 3.4 the problems related to the replacement of a rule by its unfolded version are discussed and this in turn gives a correctness condition which holds for a specific class of rules. Section 3.5 proves that confluence and termination are preserved by the program modifications introduced. Finally, Chapter 4 concludes by discussing related works and directions for future work.

A numerical program for Railway vehicle-track-structure dynamic interaction using a modal substructuring approach

This work presents a program for simulations of vehicle-track and vehicle-trackstructure dynamic interaction . The method used is computationally efficient in the sense that a reduced number of coordinates is sufficient and doesn’t require high efficiency computers. The method proposes a modal substructuring approach of the system by modelling rails , sleepers and underlying structure with modal coordinates, the vehicle with physical lumped elements coordinates and by introducing interconnection elements between these structures (wheel-rail contact, railpads and ballast) by means of their interaction forces. The Frequency response function (FRF) is also calculated for both cases of track over a structure (a bridge, a viaduct ...) and for the simple vehicle-track program; for each case the vehicle effect on the FRF is then analyzed through the comparison of the FRFs obtained introducing or not a simplified vehicle on the system.

Kalorimetrische Tieftemperaturdetektoren für niederenergetische (E 1 MeV/amu) Schwerionen und ihr erster Einsatz in der Beschleuniger-Massenspektrometrie zur Spurenanalyse von 236 U

Im Rahmen der vorliegenden Arbeit wurden zum ersten Mal kalorimetrische Tieftemperatur-Detektoren in der Beschleuniger-Massenspektrometrie (Accelerator Mass Spectrometry AMS), einer Standard-Methode zur Bestimmung kleinster Isotopenverhältnisse, eingesetzt, um das Isotopenverhältnis von 236U zu 238U zu bestimmen. Das Uran-Isotop 236U entsteht in der Neutroneneinfang-Reaktion 235U(n,gamma)236U und kann daher als Monitor-Nuklid für Neutronenflüsse verwendet werden. Die Detektoren bestehen aus einem Saphir-Absorber, auf den ein supraleitender Aluminium-Film aufgedampft ist, der als Thermistor dient. Ein energetisches Schwerion deponiert seine kinetische Energie als Wärme im Absorber, dessen Temperaturänderung durch die Widerstandsänderung des Supraleiters nachgewiesen wird. Mit solchen Detektoren konnte in vorhergehenden Experimenten bei GSI in einem Energiebereich von E = 5 - 300 MeV/amu für eine Vielzahl von Ionen von Neon bis Uran eine relative Energieauflösung von (1 - 4) E-3 erreicht werden. Der für die Beschleuniger-Massenspektrometrie typische Energiebereich liegt bei E = 0.1 - 1 MeV/amu. Im ersten Schritt wurde daher die systematische Untersuchung der Detektoreigenschaften auf diesen Energiebereich ausgedehnt. Diese Untersuchungen sowie die AMS-Messungen wurden am Tandem-Beschleuniger VERA des Instituts für Isotopenforschung und Kernphysik der Universität Wien durchgeführt. In einem Energiebereich von 10 - 60 MeV konnte für verschiedene Ionen (13C, 197Au, 238U) zunächst eine relative Energieauflösung von DeltaE/E = 7 E-3 erreicht werden. Dies übertrifft die Auflösung konventioneller Ionisations-Detektoren um ca. eine Größenordnung. Durch eine Verbesserung thermischer und elektronischer Rauschbeiträge konnte in einem zweiten Experiment für Uran der Energie 17 MeV die Auflösung auf DeltaE/E = 4.6 E-3 verbessert werden. Die Energie-Response des Detektors war linear über den gesamten beobachteten Energiebereich und unabhängig von der Ionenmasse; bis auf ein Niveau von 0.1 % wurde kein Pulshöhendefekt beobachtet. Diese Ergebnisse zeigen, daß solche Detektoren ein wertvolles Werkzeug in der Schwerionenphysik im Bereich relativ niedriger Ionenenergien darstellen. Mit der erreichten Energieauflösung war es möglich, für mehrere Proben aus natürlichem Uran das Isotopenverhältnis 236U/238U zu bestimmen: Um einen Material-Standard für Uran in der AMS zu etablieren, wurde das Isotopenverhältnis 236U/238U für zwei Proben aus der Mine ''K.u.K. Joachimsthal'' möglichst präzise bestimmt. Die Ergebnisse in der vorliegenden Arbeit stimmen gut mit früheren Messungen überein, die mit einem konventionellen Detektorsystem durchgeführt wurden. Sowohl der statistische als auch der systematische Fehler konnten deutlich reduziert werden. Für eine weitere Probe, extrahiert aus dem Wasser einer Uran-haltigen Quelle in Bad Gastein, wurde ein Isotopenverhältnis von 6.1 E-12 gemessen. Dies stellt das kleinste bislang für 236U/238U gemessene Isotopenverhältnis dar und bedeutet eine Steigerung der Sensitivität um eine Größenordnung. Die erreichte Energieauflösung ermöglicht es außerdem, die Detektoren zur direkten Massenidentifikation von schweren Ionen mittels einer kombinierten Energie-Flugzeit-Messung einzusetzen. In ersten Test-Messungen im Rahmen der vorliegenden Arbeit wurde eine Massenauflösung von DeltaM/M = (8.5 - 11.0) E-3 erreicht. In einem ersten Test für den Einsatz dieser Detektoren zum Nachweis sog. ''superschwerer Elemente (Z >= 112)'' erlaubte der große dynamische Bereich, die Reaktionsprodukte und ihre nachfolgenden Alpha-Zerfälle mit hoher Energieauflösung simultan und zeitaufgelöst nachzuweisen.

(De)colonization through topophilia: Marjorie Kinnan Rawlings’s life and work in Florida

(De)colonization Through Topophilia: Marjorie Kinnan Rawlings’s Life and Work in Florida attempts to reveal the author’s intimate connection to and mental growth through her place, namely the Cross Creek environs, and its subsequent effect on her writing. In 1928, Marjorie Kinnan Rawlings and her first husband Charles Rawlings came to Cross Creek, Florida. They bought the shabby farmhouse on Cross Creek Road, trying to be both, writers and farmers. However, while Charles Rawlings was unable to write in the backwoods of the Florida Interior, Rawlings found her literary voice and entered a symbiotic, reciprocal relationship with the natural world of the Cracker frontier. Her biographical preconditions – a childhood spent in the rural area of Rock Creek, outside of Washington D. C. - and a father who had instilled in her a sense of place or topophilia, enabled her to overcome severe marriage tensions and the hostile climate women writers faced during the Depression era. Nature as a helping ally and as an “undomesticated”(1) space/place is a recurrent motif throughout most of Rawlings’s Florida literature. At a time when writing the American landscape/documentary and the extraction of the self from texts was the prevalent literary genre, Marjorie Kinnan Rawlings inscribed herself into her texts. However, she knew that the American public was not yet ready for a ‘feminist revolt’, but was receptive of the longtime ‘inaudible’ voices from America’s regions, especially with regard to urban poverty and a homeward yearning during the Depression years. Fusing with the dynamic eco-consciousness of her Cracker friends and neighbors, Rawlings wrote in the literary category of regionalism enabling her to pursue three of her major aims: an individuated self, a self that assimilated with the ‘master narratives’ of her time and the recognition of the Florida Cracker and Scrub region. The first part of this dissertation briefly introduces the largely unknown and underestimated writer Marjorie Kinnan Rawlings, providing background information on her younger years, the relationship toward her family and other influential persons in her life. Furthermore, it takes a closer look at the literary category of regionalism and Rawlings’s use of ‘place’ in her writings. The second part is concerned with the ‘region’ itself, the state of Florida. It focuses on the natural peculiarities of the state’s Interior, the scrub and hammock land around her Cracker hamlet as well as the unique culture of the Florida Cracker. Part IV is concerned with the analysis of her four Florida books. The author is still widely related to the ever-popular novel The Yearling (1938). South Moon Under (1933) and Golden Apples (1935), her first two novels, have not been frequently republished and have subsequently fallen into oblivion. Cross Creek (1942), Rawlings’s last Florida book, however, has recently gained renewed popularity through its use in classes on nature writers and the non-fiction essay but it requires and is here re-evaluated as the author’s (relational) autobiography. The analysis through place is brought to completion in this work and seems to intentionally close the circle of Rawlings’s Florida writings. It exemplifies once more that detachment from place is impossible for Rawlings and that the intermingling of life and place in literature, is essential for the (re)creation of her identity. Cross Creek is therefore not only one of Rawlings’s greatest achievements; it is more importantly the key to understanding the author’s self and her fiction. Through the ‘natural’ interrelationship of place and self and by looking “mutually outward and inward,”(2) Marjorie Kinnan Rawlings finds her literary voice, a home and ‘a room of her own’ in which to write and come to consciousness. Her Florida literature is not only product but also medium and process in her assessment of her identity and self. _____________ (1) Alaimo, Stacy. Undomesticated Ground: Recasting Nature as Feminist Space (Ithaca: Cornell UP, 2000) 23. (2) Libby, Brooke. “Nature Writing as Refuge: Autobiography in the Natural World” Reading Under the Sign of Nature. New Essays in Ecocriticism. Ed. John Tallmadge and Henry Harrington. (Salt Lake City: The U of Utah P, 2000) 200.

Lotta alla criminalita' e salvaguardia dei diritti e delle liberta' fondamentali nell'U.E.

La ricerca è dedicata a verificare se e come, a livello dell’Unione europea, la lotta alla criminalità (ed in particolare quella organizzata) venga condotta nel rispetto di diritti e libertà fondamentali, e se la cooperazione tra Stati membri su questo fronte possa giungere a promuovere standard omogenei ed elevati di tutela degli stessi. Gli ambiti di cooperazione interessati sono principalmente quello giudiziario in materia penale e quello di polizia, e la ritrosia degli Stati a cedere all’Unione competenze in materia si è accompagnata ad un ritardo ancora maggiore dell’emersione, nell’ambito degli stessi, della dimensione dei diritti. Ciò ha reso molto difficile lo sviluppo completo ed equilibrato di uno “spazio di libertà, sicurezza e giustizia” (art. 67 TFUE). L’assetto istituzionale introdotto dal Trattato di Lisbona e l’attribuzione di valore giuridico vincolante alla Carta hanno però posto le basi per il superamento della condizione precedente, anche grazie al fatto che, negli ambiti richiamati, la salvaguardia dei diritti è divenuta competenza ed obiettivo esplicito dell’Unione. Centrale è per la ricerca la cooperazione giudiziaria in materia penale, che ha visto la ricca produzione normativa di stampo repressivo recentemente bilanciata da interventi del legislatore europeo a finalità garantista e promozionale. L’analisi degli strumenti nella prospettiva indicata all’inizio dell’esposizione è quindi oggetto della prima parte dell’elaborato. La seconda parte affronta invece la cooperazione di polizia e quello degli interventi volti alla confisca dei beni e ad impedire il riciclaggio, misure – queste ultime - di particolare rilievo soprattutto per il contrasto al crimine organizzato. Sottesi all’azione dell’Unione in queste materie sono, in modo preponderante, due diritti: quello alla salvaguardia dei dati personali e quello al rispetto della proprietà privata. Questi, anche in ragione delle peculiarità che li caratterizzano e della loro natura di diritti non assoluti, sono analizzati con particolare attenzione.

A daily perspective on work interruptions

Diese Dissertation basiert auf einem theoretischen Artikel und zwei empirischen Studien.rnrnDer theoretische Artikel: Es wird ein theoretisches Rahmenmodell postuliert, welches die Kumulierung von Arbeitsunterbrechung und deren Effekte untersucht. Die meisten bisherigen Studien haben Unterbrechungen als isoliertes Phänomen betrachtet und dabei unberücksichtigt gelassen, dass während eines typischen Arbeitstages mehrere Unterbrechungen gleichzeitig (oder aufeinanderfolgend) auftreten. In der vorliegenden Dissertation wird diese Lücke gefüllt, indem der Prozess der kumulierenden Unterbrechungen untersucht wird. Es wird beschrieben,rninwieweit die Kumulation von Unterbrechungen zu einer neuen Qualität vonrn(negativen) Effekten führt. Das Zusammenspiel und die gegenseitige Verstärkung einzelner Effekte werden dargestellt und moderierende und mediierende Faktoren aufgezeigt. Auf diese Weise ist es möglich, eine Verbindung zwischen kurzfristigen Effekten einzelner Unterbrechungen und Gesundheitsbeeinträchtigungen durch die Arbeitsbedingung ‚Unterbrechungen‘rnherzustellen.rnrnStudie 1: In dieser Studie wurde untersucht, inwieweit Unterbrechungen Leistung und Wohlbefinden einer Person innerhalb eines Arbeitstages beeinflussen. Es wurde postuliert, dass das Auftreten von Unterbrechungen die Zufriedenheit mit der eigenen Leistung vermindert und das Vergessen von Intentionen und das Irritationserleben verstärkt. Geistige Anforderung und Zeitdruck galten hierbei als Mediatoren. Um dies zu testen, wurden 133 Pflegekräften über 5 Tage hinweg mittels Smartphones befragt. Mehrebenenanalysen konnten die Haupteffekte bestätigen. Die vermuteten Mediationseffekte wurden für Irritation und (teilweise) für Zufriedenheit mit der Leistung bestätigt, nicht jedoch für Vergessen von Intentionen. Unterbrechungen führen demzufolge (u.a.) zu negativen Effekten, da sie kognitiv anspruchsvoll sind und Zeit beanspruchen.rnrnStudie 2: In dieser Studie wurden Zusammenhänge zwischen kognitiven Stressorenrn(Arbeitsunterbrechungen und Multitasking) und Beanspruchungsfolgen (Stimmung und Irritation) innerhalb eines Arbeitstages gemessen. Es wurde angenommen, dass diese Zusammenhänge durch chronologisches Alter und Indikatoren funktionalen Alters (Arbeitsgedächtniskapazität und Aufmerksamkeit) moderiert wird. Ältere mit schlechteren Aufmerksamkeitsund Arbeitsgedächtnisleistungen sollten am stärksten durch die untersuchten Stressoren beeinträchtigt werden. Es wurde eine Tagebuchstudie (siehe Studie 1) und computergestützternkognitive Leistungstests durchgeführt. Mehrebenenanalysen konnten die Haupteffekte für die abhängigen Variablen Stimmung (Valenz und Wachheit) und Irritation bestätigen, nicht jedoch für Erregung (Stimmung). Dreifachinteraktionen wurden nicht in der postulierten Richtung gefunden. Jüngere, nicht Ältere profitierten von einem hohen basalen kognitivenrnLeistungsvermögen. Ältere scheinen Copingstrategien zu besitzen, die mögliche kognitive Verluste ausgleichen. rnrnIm Allgemeinen konnten die (getesteten) Annahmen des theoretischen Rahmenmodellsrnbestätigt werden. Prinzipiell scheint es möglich, Ergebnisse der Laborforschung auf die Feldforschung zu übertragen, jedoch ist es notwendig die Besonderheiten des Feldes zu berücksichtigen. Die postulieren Mediationseffekte (Studie 1) wurden (teilweise) bestätigt. Die Ergebnisse weisen jedoch darauf hin, dass der volle Arbeitstag untersucht werden muss und dass sehr spezifische abhängige Variablen auch spezifischere Mediatoren benötigen. Des Weiteren konnte in Studie 2 bestätigt werden, dass die kognitive Kapazität eine bedeutsamernRessource im Umgang mit Unterbrechungen ist, im Arbeitskontext jedoch auch andere Ressourcen wirken.

Immunophenotyping of acute leukemia and lymphoproliferative disorders: a consensus proposal of the European LeukemiaNet Work Package 10

The European LeukemiaNet (ELN), workpackage 10 (WP10) was designed to deal with diagnosis matters using morphology and immunophenotyping. This group aimed at establishing a consensus on the required reagents for proper immunophenotyping of acute leukemia and lymphoproliferative disorders. Animated discussions within WP10, together with the application of the Delphi method of proposals circulation, quickly led to post-consensual immunophenotyping panels for disorders on the ELN website. In this report, we established a comprehensive description of these panels, both mandatory and complementary, for both types of clinical conditions. The reason for using each marker, sustained by relevant literature information, is provided in detail. With the constant development of immunophenotyping techniques in flow cytometry and related software, this work aims at providing useful guidelines to perform the most pertinent exploration at diagnosis and for follow-up, with the best cost benefit in diseases, the treatment of which has a strong impact on health systems.