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Influence on persistence and adherence with oral bisphosphonates on fracture rates in osteoporosis
(2009)
Background and Aim:
Oral bisphosphonates have been shown to reduce the risk of fractures in patients with osteoporosis. It can be assumed that the clinical effectiveness of oral bisphosphonates depends on persistence with therapy.
Methods:
The influence of persistence with and adherence to oral bisphosphonates on fracture risk in a real-life setting was investigated. Data from 4451 patients with a defi ned index prescription of bisphosphonates were included. Fracture rates within 180, 360, and 720 days after index prescription were compared between persistent and non-persistent patients. In an extended Cox regression model applying multiple event analysis, the influence of adherence was analyzed. Persistence was defined as the duration of continuous therapy; adherence was measured in terms of the medication possession ratio (MPR).
Results:
In patients with a fracture before index prescription, fracture rates were reduced by 29% (p = 0.025) comparing persistent and non-persistent patients within 180 days after the index prescription and by 45% (p < 0.001) within 360 days. The extended Cox regression model showed that good adherence (MPR ≥ 0.8) reduced fracture risk by about 39% (HR 0.61, 95% CI 0.47–0.78; p < 0.01).
Conclusions:
In patients with osteoporosis-related fractures, good persistence and adherence to oral bisphosphonates reduced fracture risk significantly.
We have combined the velocity map imaging technique with time-of-flight measurements to study the surface photochemistry of KBr single crystals. This approach yields 3-dimensional velocity distributions of Br atoms resulting from 193 nm photodesorption. The velocity distributions indicate that at least two non-thermal mechanisms contribute to the photodesorption dynamics. Our experimental geometry also allows us to measure the Br(²P₃⁄₂):Br(²P₁⁄₂) branching ratio, which is found to be 24:1.
During the intraoperative radiograph generation process with mobile image intensifier systems (C-arm) most of the radiation exposure for patient, surgeon and operation room personal is caused by scattered radiation. The intensity and propagation of scattered radiation depend on different parameters, e.g. the intensity of the primary radiation, and the positioning of the mobile image intensifier. Exposure through scattered radiation can be minimized when all these parameters are adjusted correctly. Because radiation is potentially dangerous and could not be perceived by any human sense the current education on correct adjustment of a C-arm is designed very theoretical. This paper presents an approach of scattered radiation calculation and visualization embedded in a computer based training system for mobile image intensifier systems called virtX. With the help of this extension the virtX training system should enrich the current radiation protection training with visual and practical training aspects.
The objective of this student project was for the students to develop, conduct, and supervise a training course for basic work place applications (word processing and business graphics). Students were responsible for the planning, organizing and the teaching of the course. As participants, underprivileged adolescents took part in order to learn the handling of IT applications and therefore, improve their job skills and have a better chance to get into employment. Therefore the adolescents do the role of trainees at the course. Our students worked with a population that is continually overlooked by the field.
As a result, the students trained to design and implement training courses, exercised to manage projects and increased their social responsibility and awareness concerning the way of life and living conditions of other young people. The underprivileged adolescents learned to use important business applications and increased their job skills and job chances. The overall design of our concept required extensive resources to supervise and to steer the students and the adolescents. The lecturers had to teach and to counsel the students and had to be on “stand-by” just in case they were needed to solve critical situations between the two groups of young people.
Szenisches Spiel
(2009)
Die alltägliche Konfrontation mit gesellschaftlichen Tabus wie Alter, Krankheit, Tod, die Arbeit zwischen "Macht und Ohnmacht" verlangt von den Pflegenden ein hohes Maß an sozialer und personaler Kompetenz. Das szenische Lernen bzw. Spiel ist ein Ansatz, der sich hervorragend zur Förderung dieser Schlüsselqualifikationen eignet. In diesem Aufsatz werden zunächst die allgemein didaktischen Ursprünge und Hintergründe szenischen Lernens bzw. Spiels dargestellt, um anschließend seine pflegedidaktische Auslegung und Akzentuierung zu charakterisieren. Zum Schluss wird anhand der Lerneinheit „Reflexion der praktischen Ausbildung“ aufgezeigt, wie mit ausgewählten szenischen Spielverfahren in der pflegepädagogischen Praxis gearbeitet werden kann.