Increasing Quality in large scale University Courses

Quality of education should be stable or permanently increased – even if the number of students rises. Quality of education is often related to possibilities for active learning and individual facilitation. This paper deals with the question how high-quality learning within oversized courses could be enabled and it presents the approach of e-flashcards that enables active learning and individual facilitation within large scale university courses.

PCR-based assay using occult blood detection cards for detection of diarrheagenic Escherichia coli in specimens from U.S. travelers to Mexico with acute diarrhea.

Large field studies of travelers' diarrhea for multiple destinations are limited by the need to perform stool cultures on site in a timely manner. A method for the collection, transport, and storage of fecal specimens that does not require immediate processing and refrigeration and that is stable for months would be advantageous. This study was designed to determine if enterotoxigenic Escherichia coli (ETEC) and enteroaggregative E. coli (EAEC) DNA could be identified from cards that were processed for the evaluation of fecal occult blood. U.S. students traveling to Mexico during 2005 to 2007 were monitored for the occurrence of diarrheal illness. When ill, students provided a stool specimen for culture and occult blood by the standard methods. Cards then were stored at room temperature prior to DNA extraction. Fecal PCR was performed to identify ETEC and EAEC in DNA extracted from stools and from occult blood cards. Significantly more EAEC cases were identified by PCR that was performed on DNA that was extracted from cards (49%) or from frozen feces (40%) than from culture methods that used HEp-2 adherence assays (13%) (P < 0.001). Similarly, more ETEC cases were detected from card DNA (38%) than from fecal DNA (30%) or by culture that was followed by hybridization (10%) (P < 0.001). The sensitivity and specificity of the card test were 75 and 62%, respectively, compared to those for EAEC by culture and were 50 and 63%, respectively, compared to those for ETEC. DNA extracted from fecal cards that was used for the detection of occult blood is of use in identifying diarrheagenic E. coli.

Family Preservation Journal, Winter 1996, Volume 1. (Entire issue)

Entire issue (large pdf file) Articles include: Improving Family Functioning through Family Preservation Services: Results of the Los Angeles Experiment. Family Preservation Journal. William Meezan and Jacquelyn McCroskey Idiographic Self-Monitoring Instruments to Empower Client Participation and Evaluate Outcome in Intensive Family Preservation Services. Barbara Peo Early Evaluating Family Preservation in Nevada: A University-State Agency Collaboration. Christine Bitoni and Joy Salmon The Family Partners Credit Card: A Token Economy System Adapted for Intensive Family Preservation Services to Enable Families to Manage Difficult Behavior of Adolescents. Jude Nichols and Barbara Peo Early Toward the Development of Ethical Guidelines for Family Preservation. David A Dosser Jr., Richard J. Shaffer, Michaux M. Shaffer, DeVault Clevenger, and Dustin K. Jefferies

Laufbahnen von ehemaligen Schweizer Nachwuchs-Elite-Athleten unter dem Aspekt des Erfolgs

Die vorliegende Dissertation verfolgt das Ziel, zu untersuchen, wie sich ehemalige Schweizer Nachwuchs-Elite-Athleten unter dem Aspekt des sportlichen Erfolgs entwickelt haben und wie sich ihre heutige Lebenssituation präsentiert. Zudem will die Arbeit ergründen, inwiefern der sportliche Erfolg durch ausgewählte institutionelle, sportwissenschaftliche und individuelle Parameter vorhergesagt werden kann. Zu diesem Zweck wurden alle deutschsprachigen Nachwuchs-Elite-Athleten untersucht (N = 221), welche im Jahre 1999 Inhaber einer Swiss Olympic Talent-Card waren. Die Prädiktoren stammen teilweise aus einer ersten schriftlichen Befragung, welche 1999 durchgeführt wurde (Rücklauf: 79%). Die Daten für die Beschreibung der Laufbahn sowie der heutigen Situation wurden im Sommer 2011 durch eine weitere schriftliche Befragung erhoben (Rücklauf: 48%). Die Daten wurden mit deskriptiven, inferenzstatistischen, cluster- sowie regressionsanalytischen Verfahren ausgewertet. Die Resultate zeichnen insgesamt ein positives Bild. Trotz verschiedener Hürden im Nachwuchsalter schafften die meisten befragten Athleten den Sprung in die Elite-Stufe. Knapp ein Drittel von ihnen konnte dabei grosse Erfolge (Medaillengewinn) an bedeutenden internationalen Wettkämpfen erringen. Die bereits zurückgetretenen Athleten scheinen das Laufbahnende grösstenteils gut bewältigt zu haben, was wohl damit zusammenhängt, dass die Mehrheit von ihnen freiwillig zurückgetretenen ist und konkrete Pläne für die nachsportliche Laufbahn hatte. Insgesamt deuten die Ergebnisse darauf hin, dass sich ein Engagement im Leistungssport nicht negativ auf die Entwicklung in anderen Lebensbereichen auszuwirken scheint. So zeigte sich, dass sich die heutige Situation der ehemaligen Nachwuchs-Elite-Athleten in gesundheitlicher, psychologischer, sozialer, beruflicher und finanzieller Hinsicht durchwegs positiv präsentiert – in gesundheitlicher, beruflicher und finanzieller Hinsicht sogar besser als jene von gleichaltrigen Vergleichspersonen der Schweizer Bevölkerung. Bei der Vorhersage des sportlichen Erfolgs zeigte sich, dass Athleten aus weniger geförderten und weniger bedeutenden Sportarten später insgesamt erfolgreicher sind an bedeutenden internationalen Wettkämpfen. Darüber hinaus erwies sich die mentale Stärke als langfristiger Erfolgsfaktor. Die Ergebnisse erweitern das bestehende Wissen über Laufbahnen von Leistungssportlern sowie über Determinanten von sportlichem Erfolg generell, besonders aber hinsichtlich des Schweizer Sportsystems. Athleten und ihr Umfeld erhalten dadurch einen vertieften Einblick in die Chancen und Risiken eines Engagements im Leistungssport. Swiss Olympic und die Verbände gewinnen ein besseres Verständnis darüber, wie sich Nachwuchs-Elite-Athleten in ihrer sportlichen Entwicklung noch besser unterstützen lassen. Bund, Kantone und Gemeinden können anhand der Ergebnisse besser abschätzen, inwiefern sich die Förderung des Spitzensports durch öffentliche Gelder rechtfertigen lässt.

Anreizformen und Ausschöpfungsquoten bei postalischen Befragungen. Eine Prüfung der Reziprozitätshypothese

Mittels eines Methodenexperiments mit zwei randomisierten Versuchsgruppen (N jeweils 200) und einer Kontrollgruppe (N=200) wird untersucht, ob und in welchem Ausmaß Geschenke bei einer postalischen Befragung zur Erhöhung der Ausschöpfungsquote beitragen. Es zeigt sich, dass ein versprochenes Geschenk (Telefonkarte im Wert von 10 Schweizer Franken) die Ausschöpfungsquote nicht erhöht, während ein dem Fragebogen beigelegtes Geschenk zu einem Anstieg der Quote um zirka 10 Prozentpunkte führt. Die Befunde stehen in Einklang mit der Reziprozitätshypothese, derzufolge Vorleistungen von vielen Personen auch dann honoriert werden, wenn die reziproke Handlung nicht dem unmittelbaren Eigeninteresse eines Akteurs entspricht.

Computer Vision-Based Carbohydrate Estimation for Type 1 Diabetic Patients Using Smartphones

Background: Individuals with type 1 diabetes (T1D) have to count the carbohydrates (CHOs) of their meal to estimate the prandial insulin dose needed to compensate for the meal’s effect on blood glucose levels. CHO counting is very challenging but also crucial, since an error of 20 grams can substantially impair postprandial control. Method: The GoCARB system is a smartphone application designed to support T1D patients with CHO counting of nonpacked foods. In a typical scenario, the user places a reference card next to the dish and acquires 2 images with his/her smartphone. From these images, the plate is detected and the different food items on the plate are automatically segmented and recognized, while their 3D shape is reconstructed. Finally, the food volumes are calculated and the CHO content is estimated by combining the previous results and using the USDA nutritional database. Results: To evaluate the proposed system, a set of 24 multi-food dishes was used. For each dish, 3 pairs of images were taken and for each pair, the system was applied 4 times. The mean absolute percentage error in CHO estimation was 10 ± 12%, which led to a mean absolute error of 6 ± 8 CHO grams for normal-sized dishes. Conclusion: The laboratory experiments demonstrated the feasibility of the GoCARB prototype system since the error was below the initial goal of 20 grams. However, further improvements and evaluation are needed prior launching a system able to meet the inter- and intracultural eating habits.

Holistic patterns as an instrument to predict performance of promising young football players

Multidimensional talent models represent the current state of the art. However, it remains unclear how these different dimensions interact. Based on current theories of human development, person-oriented approaches seem to be particularly appropriate for talent research. The present study adopts this approach by looking at how a holistic system consisting of the different dimensions motivation, motor behaviour and the stage of development goes along with athletic performance. For this purpose, it has to be examined which patterns were formed by the constructs net hope (Elbe et al., 2003), motor abilities (3 motor tests; Höner et al., 2014), technical skills (3 motor tests; Höner et al., 2014) and the so far achieved percentage of the predicted adult height (Mirwald et al, 2002) and how these patterns are related to subsequent sporting success. 119 young elite football players were questioned and tested three times at intervals of one year, beginning at the age of 12. At the age of 15, the performance level the players had reached was examined (national, regional or no talent card). At all three measuring points, four patterns were identified which displayed partial structural and high individual stability. As expected, the players showing values above average in all factors were significantly more likely to advance to the highest performance level (Odds ratio = 2.2, p < .01). Physically strong, precocious developed players though having some technical weaknesses, have good chances to reach the middle performance level (OR = 1.6, p = .01). Players showing values under average, have an one and a half times higher probability to advance to the lowest performance level (p < .01). The results point to the importance of holistic approaches for the prediction of performance among promising football talents in the medium-term and thus provide valuable clues for their selection and promotion.

Risk Behavior and Reciprocity of Organ Donation Attitudes in Young Men

Background Lack of donor organs remains a major obstacle in organ transplantation. Our aim was to evaluate (1) the association between engaging in high-risk recreational activities and attitudes toward organ donation and (2) the degree of reciprocity between organ acceptance and donation willingness in young men. Methods A 17-item, close-ended survey was offered to male conscripts ages 18 to 26 years in all Swiss military conscription centers. Predictors of organ donation attitudes were assessed in bivariate analyses and multiple logistic regression. Reciprocity of the intentions to accept and to donate organs was assessed by means of donor card status. Results In 1559 responses analyzed, neither motorcycling nor practicing extreme sports reached significant association with donor card holder status. Family communication about organ donation, student, or academic profession and living in a Latin linguistic region were predictors of positive organ donation attitudes, whereas residence in a German-speaking region and practicing any religion predicted reluctance. Significantly more respondents were willing to accept than to donate organs, especially among those without family communication concerning organ donation. Conclusions For the first time, it was shown that high-risk recreational activities do not influence organ donation attitudes. Second, a considerable discrepancy in organ donation reciprocity was identified. We propose that increasing this reciprocity could eventually increase organ donation rates.

Simple training tool is insufficient for appropriate diagnosis and treatment of malnutrition: A pre-post intervention study in a tertiary center.

OBJECTIVES To improve malnutrition awareness and management in our department of general internal medicine; to assess patients' nutritional risk; and to evaluate whether an online educational program leads to an increase in basic knowledge and more frequent nutritional therapies. METHODS A prospective pre-post intervention study at a university department of general internal medicine was conducted. Nutritional screening using Nutritional Risk Score 2002 (NRS 2002) was performed, and prescriptions of nutritional therapies were assessed. The intervention included an online learning program and a pocket card for all residents, who had to fill in a multiple-choice questions (MCQ) test about basic nutritional knowledge before and after the intervention. RESULTS A total of 342 patients were included in the preintervention phase, and 300 were in the postintervention phase. In the preintervention phase, 54.1% were at nutritional risk (NRS 2002 ≥3) compared with 61.7% in the postintervention phase. There was no increase in the prescription of nutritional therapies (18.7% versus 17.0%). Forty-nine and 41 residents (response rate 58% and 48%) filled in the MCQ test before and after the intervention, respectively. The mean percentage of correct answers was 55.6% and 59.43%, respectively (which was not significant). Fifty of 84 residents completed the online program. The residents who participated in the whole program scored higher on the second MCQ test (63% versus 55% correct answers, P = 0.031). CONCLUSIONS Despite a high ratio of malnourished patients, the nutritional intervention, as assessed by nutritional prescriptions, is insufficient. However, the simple educational program via Internet and usage of NRS 2002 pocket cards did not improve either malnutrition awareness or nutritional treatment. More sophisticated educational systems to fight malnutrition are necessary.

GoCARB: Smartphone-App zur Kohlenhydratberechnung bei Typ-1-Diabetes

Smartphone-App zur Kohlenhydratberechnung Neue Technologien wie Blutzuckersensoren und moderne Insulinpumpen prägten die Therapie des Typ-1-Diabetes (T1D) in den letzten Jahren in wesentlichem Ausmaß. Smartphones sind aufgrund ihrer rasanten technischen Entwicklung eine weitere Plattform für Applikationen zur Therapieunterstützung bei T1D. GoCARB Hierbei handelt es sich um ein zur Kohlenhydratberechnung entwickeltes System für Personen mit T1D. Die Basis für Endanwender stellt ein Smartphone mit Kamera dar. Zur Berechnung werden 2 mit dem Smartphone aus verschiedenen Winkeln aufgenommene Fotografien einer auf einem Teller angerichteten Mahlzeit benötigt. Zusätzlich ist eine neben dem Teller platzierte Referenzkarte erforderlich. Die Grundlage für die Kohlenhydratberechnung ist ein Computer-Vision-gestütztes Programm, das die Mahlzeiten aufgrund ihrer Farbe und Textur erkennt. Das Volumen der Mahlzeit wird mit Hilfe eines dreidimensional errechneten Modells bestimmt. Durch das Erkennen der Art der Mahlzeiten sowie deren Volumen kann GoCARB den Kohlenhydratanteil unter Einbeziehung von Nährwerttabellen berechnen. Für die Entwicklung des Systems wurde eine Bilddatenbank von mehr als 5000 Mahlzeiten erstellt und genutzt. Resümee Das GoCARB-System befindet sich aktuell in klinischer Evaluierung und ist noch nicht für Patienten verfügbar.

Carbohydrate Estimation by a Mobile Phone-Based System Versus Self-Estimations of Individuals With Type 1 Diabetes Mellitus: A Comparative Study

Background: Diabetes mellitus is spreading throughout the world and diabetic individuals have been shown to often assess their food intake inaccurately; therefore, it is a matter of urgency to develop automated diet assessment tools. The recent availability of mobile phones with enhanced capabilities, together with the advances in computer vision, have permitted the development of image analysis apps for the automated assessment of meals. GoCARB is a mobile phone-based system designed to support individuals with type 1 diabetes during daily carbohydrate estimation. In a typical scenario, the user places a reference card next to the dish and acquires two images using a mobile phone. A series of computer vision modules detect the plate and automatically segment and recognize the different food items, while their 3D shape is reconstructed. Finally, the carbohydrate content is calculated by combining the volume of each food item with the nutritional information provided by the USDA Nutrient Database for Standard Reference. Objective: The main objective of this study is to assess the accuracy of the GoCARB prototype when used by individuals with type 1 diabetes and to compare it to their own performance in carbohydrate counting. In addition, the user experience and usability of the system is evaluated by questionnaires. Methods: The study was conducted at the Bern University Hospital, “Inselspital” (Bern, Switzerland) and involved 19 adult volunteers with type 1 diabetes, each participating once. Each study day, a total of six meals of broad diversity were taken from the hospital’s restaurant and presented to the participants. The food items were weighed on a standard balance and the true amount of carbohydrate was calculated from the USDA nutrient database. Participants were asked to count the carbohydrate content of each meal independently and then by using GoCARB. At the end of each session, a questionnaire was completed to assess the user’s experience with GoCARB. Results: The mean absolute error was 27.89 (SD 38.20) grams of carbohydrate for the estimation of participants, whereas the corresponding value for the GoCARB system was 12.28 (SD 9.56) grams of carbohydrate, which was a significantly better performance ( P=.001). In 75.4% (86/114) of the meals, the GoCARB automatic segmentation was successful and 85.1% (291/342) of individual food items were successfully recognized. Most participants found GoCARB easy to use. Conclusions: This study indicates that the system is able to estimate, on average, the carbohydrate content of meals with higher accuracy than individuals with type 1 diabetes can. The participants thought the app was useful and easy to use. GoCARB seems to be a well-accepted supportive mHealth tool for the assessment of served-on-a-plate meals.

A PCR based assay for the detection of enteric pathogens from Hemoccult(RTM) cards

Background. Large field studies in travelers' diarrhea (TD) in multiple destinations are limited by the need to perform stool cultures on site in a timely manner. A method for the collection, transport and storage of fecal specimens that does not require immediate processing, refrigeration and is stable for months would be advantageous. ^ Objectives. Determine if enteric pathogen bacterial DNA can be identified in cards routinely used for evaluation of fecal occult blood. ^ Methods. U.S. students traveling to Mexico in 2005-07 were followed for occurrence of diarrheal illness. When ill, students provided a stool specimen for culture and occult blood by the standard method. Cards were then stored at room temperature prior to DNA extraction. A multiplex fecal PCR was performed to identify enterotoxigenic Escherichia coli and enteroaggregative E. coli (EAEC) in DNA extracted from stools and occult blood cards. ^ Results. Significantly more EAEC cases were identified by PCR done in DNA extracted from cards (49%) or from frozen feces (40%) than by culture followed by HEp-2 adherence assays (13%). Similarly more ETEC cases were detected in card DNA (38%) than fecal DNA (30%) or culture followed by hybridization (10%). Sensitivity and specificity of the card test was 75% and 62%, respectively, and 50% and 63%, respectively, when compared to EAEC and ETEC culture, respectively, and 53% and 51%, respectively compared to EAEC multiplex fecal PCR and 56% and 70%, respectively, compared to ETEC multiplex fecal PCR. ^ Conclusions. DNA extracted from fecal cards used for detection of occult blood is of use in detecting enteric pathogens. ^

Refugees from Myanmar and their health care needs in the US: A qualitative study at a refugee-resettlement agency

In response to the recent rapid influx of refugees from Myanmar, Interfaith Ministries for Greater Houston (IM), a refugee resettlement agency, started to support them in June 2007. The study looked at the refugees' perspectives and identified the gaps in their understanding on US health care system, health seeking behaviors and challenges in utilizing health care in United States. The major issues identified were non-compliance with tuberculosis prevention medication due to barriers in obtaining medication refills, barriers in accessing specialty care services, transportation issues, written and oral language barrier, difficulties in the application for and use of Medicaid and Gold Card, misunderstanding of emergency health services, lack of resources for health education, self-treatment with Western medicine and income too low to buy private health insurance. In order to transform them to healthy citizens able to contribute to the US workforce, several multi-faceted and comprehensive approaches and better coordination among agencies are recommended. ^