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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMS Journal for Medical Education; VOL: 33; DOC4 /20160215/
    Publication Date: 2016-02-16
    Description: The FAMULATUR PLUS is an innovative approach to teaching physical examination skills. The concept is aimed at medical students during the clinical part of their studies and includes a clinical traineeship (English for "Famulatur") extended to include various courses ("PLUS"). The courses are divided into clinical examination courses and problembased-learning (PBL) seminars. The concept's special feature is the full integration of these courses into a 30-day hospital traineeship. The aim is to facilitate the transfer of knowledge from the courses into daily practice. Each week of the FAMULATUR PLUS is structured in line with the courses and focuses on a particular part of the body (e.g., abdomen). A physical examination course under the supervision of a physician is offered at the beginning of the week. Here, medical students learn the relevant examination techniques by practicing on each other (partner exercises). Subsequently, the techniques taught are applied independently during everyday work on the ward, corrected by the supervisor, if necessary, and thereby reinforced. The final POL seminar takes place towards the end of the week. Possible differential diagnoses are developed based on a clinical case study. The goal is to check these by taking a fictitious medical history and performing a physical examination, as well as to make a preliminary diagnosis. Finally, during the PBL seminar, medical students will be shown how physical examination techniques can be efficiently applied in the diagnosis of common cardinal symptoms (e.g., abdominal pain). The initial implementation of the FAMULATUR PLUS proved the practical feasibility of the concept. In addition, the accompanying evaluation showed that the participants of the pilot project improved with regard to their practical physical examination skills.
    Description: Die FAMULATUR PLUS ist ein innovativer Ansatz zur Vermittlung praktischer Fertigkeiten in der körperlichen Untersuchung. Das Konzept richtet sich an Medizinstudierende im klinischen Studienabschnitt und beinhaltet eine um Lehrveranstaltungen ("PLUS") erweiterte Famulatur. Die Lehrveranstaltungen umfassen klinische Untersuchungskurse und problemorientiertes Lernen (POL). Besonderheit des Konzepts ist die vollständige Integration dieser Lehrveranstaltungen in eine 30tägige Krankenhausfamulatur. Dadurch soll der Wissenstransfer von den Lehrveranstaltungen in die tägliche Praxis vereinfacht werden. Jede einzelne Woche der FAMULATUR PLUS ist hinsichtlich der Lehrveranstaltungen strukturiert vorgeplant und steht im Zeichen eines Körperabschnitts (z.B. Abdomen). Zu Wochenbeginn wird ein Untersuchungskurs unter ärztlicher Leitung angeboten. Hier erlernen die Medizinstudierenden die relevanten Untersuchungstechniken zunächst durch gegenseitige Anwendung (Partnerübungen). Anschließend werden die gelehrten Techniken im Stationsalltag eigenverantwortlich angewandt, gegebenenfalls durch den Betreuer nochmals korrigiert, und somit gefestigt. Gegen Ende der Woche findet dann das abschließende POL-Seminar statt. Ausgehend von einem klinischen Fallbeispiel werden hier mögliche Differentialdiagnosen erarbeitet. Diese gilt es dann durch fiktive Anamneseerhebung und vor allem körperliche Untersuchung zu überprüfen sowie eine Verdachtsdiagnose zu stellen. Schlussendlich soll den Medizinstudierenden im POL gezeigt werden, wie Techniken der körperlichen Untersuchung bei der Diagnostik häufiger Leitsymptome (z.B. Bauchschmerzen) effizient angewandt werden können. Bei der ersten Durchführung der FAMULATUR PLUS als Pilotprojekt erwies sich die praktische Umsetzbarkeit des Konzepts. Zudem zeigte die begleitende Evaluation eine Verbesserung der Teilnehmer des Pilotprojekts hinsichtlich der praktischen Fertigkeiten in der körperlichen Untersuchung.
    Keywords: clinical skills ; medical education ; physical examination ; practical training ; klinische Fertigkeiten ; medizinische Lehre ; körperliche Untersuchung ; praktisches Training ; ddc: 610
    Language: English
    Type: article
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMS Krankenhaushygiene Interdisziplinär; VOL: 4; DOC04 /20091216/
    Publication Date: 2009-12-16
    Description: MRSA-infected or -colonized staff can be a vector for transmission between patients. Therefore, reliable detection and rapid decolonisation of carriers is important. Literature on the effectiveness of MRSA decolonization regimes is very heterogeneous. Existing studies differ distinct in design, endpoints and patient populations studied and are therefore hard to compare. This paper summarizes routine data from decolonization treatment of MRSA-positive staff and relatives from March 2007-March 2009 at the University Hospital of Greifswald. From a total of 107 persons rated, 98.1% were successfully decolonized. In 73 cases (68%) decolonization was achieved in the first cycle. This shows the high effectiveness of regimes based on octenidine containing antiseptic preparations as part of a structured decolonization concepts.
    Description: MRSA-kolonisiertes oder -infiziertes Personal kann zum Vektor für die Übertragung zwischen Patienten werden. Daher ist eine sichere Erkennung und zügige Sanierung von Trägern wichtig. Die Literaturlage zur Effektivität der MRSA-Sanierung ist ausgesprochen heterogen. Die vorliegenden Studien sind nur begrenzt vergleichbar, da erhebliche Unterschiede in den Schemata, den Endpunkten und den untersuchten Patientenkollektiven bestehen. Die vorliegende Arbeit fasst die Routinedaten bei der Behandlung MRSA-positiver Mitarbeiter und Angehöriger von März 2007-März 2009 am Universitätsklinikum Greifswald zusammen. Von insgesamt 107 nach gleichem Schema Behandelten konnten 98,1% erfolgreich saniert werden. In 73 Fällen (68%) gelang die Sanierung bereits im ersten Zyklus. Das zeigt die hohe Effektivität der antiseptischen Sanierung auf der Basis Octenidin haltiger Präparate als Teil eines strukturierten Sanierungskonzepts.
    Keywords: MRSA ; antiseptic decolonization ; octenidine ; mupirocine ; PVP-iodine ; MRSA ; antiseptische Sanierung ; Octenidin ; Mupirocin ; PVP-Iod ; Dekolonisierung ; ddc: 610
    Language: German
    Type: article
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  • 3
    ISSN: 0889-1575
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Process Engineering, Biotechnology, Nutrition Technology
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 0889-1575
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Process Engineering, Biotechnology, Nutrition Technology
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-8798
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A detailed study of the pathogenesis of herpetic eye disease in the Guinea pig was undertaken to further develop this animal model. Several well-known HSV-1 strains were tested for their ability to produce disease and cause acute and latent infections of the trigeminal ganglion: McKrae, KOS, McIntyre, RE, and Shealey. Two HSV-2 strains failed to cause eye infections. The Shealey strain [HSV-1 (Sh)] produced the most severe eye infections, characterized by epithelial and stromal disease, corneal vascularization and ulcerative blepharitis. Consequently, HSV-1 (Sh) was selected as the prototype strain for this study. The frequency and severity of HSV-1 (Sh) eye disease patterns was determined by a semi-quantitative rating scale, which permitted accurate monitoring of the temporal development of the disease patterns cited above. Virus shedding from infected eyes was also quantified. All of the HSV-1 strains tested established trigeminal ganglionic latency with varying frequency, although HSV-1 (Sh) latency approached 100 percent. The kinetics of acute ganglionic infection by HSV-1 (Sh) was determined, and peak virus titers occurred on the third day after corneal inoculation. This study emphasizes the usefulness of the Guinea pig model for investigations on the pathogenesis, prevention and treatment of herpetic eye infections.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-0789
    Keywords: Keywords Particulate organic matter ; Tillage practices ; C and N dynamics ; Physical protection ; Potentially mineralizable N
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Geosciences , Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Notes: Abstract  This study was conducted to determine whether separation of particulate organic matter (POM) that is biologically labile from aggregate entrapped material improves the usefulness of POM as an index of soil C and N dynamics. The effects of conventional (CT) and no-tillage (NT) practices on POM were assessed using soils from three 10-year trials in Illinois. Loose and occluded POM in the 0–5 cm depth were separated from 1994 samples. Use of NT practices increased C and N contents at 0–5 cm relative to CT practices and those increases were most apparent in the occluded POM fraction. The correlation between total POM-N and potentially mineralizable N (PMN) was stronger than that between PMN and either the loose or occluded-POM fractions. In 1995, both the microbial biomass, estimated as chloroform-labile C (CFEC), and PMN were correlated with POM-C and N, but the relationship was weak when data (from different tillage and depth combinations) were not treated in aggregate. POM-C and CFEC were most strongly correlated in surface depths and in CT treatments. In NT 0–5 cm samples, PMN contents were similar (≈27 mg N kg–1 soil) at all sites despite notable differences in POM-N concentrations; PMN was not related to POM-N in CT samples. There was no consistent relationship between PMN and POM-N contents in 5–30 cm samples. DRFTIR spectra indicated that carbohydrates were most abundant in POM at 0–5 cm. Relatively low PMN rates and enrichment of polysaccharides in POM in the sicl soil suggest that physical protection of labile organic substrates was more important at that site than at sites with lighter textured soils. Improved fractionation and incubation techniques and alleviation of laboratory artifacts will improve our ability to relate POM quantity, distribution and composition to biologically mediated C and N dynamics occurring in the field.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A phase II study was carried out to evaluate the efficacy and safety of etoposide used as first-line chemotherapy for patients with advanced breast carcinoma. A total of 20 patients received 230 mg/m2 i.v. etoposide per day for 3 days (total, 690 mg/m2 per course) every 4 weeks. A total of 95 courses were given. Observed responses included 3 partial remissions (PR) and 14 cases of stable disease (NC). The median duration of response was 6 (PR) and 5.6 months (NC). Contrary to the severe hematological toxicity in heavily pretreated patients described in previous studies, no substantial problems were observed in this trial. No dose reduction was necessary, and only once did leukopenia lead to a 1-week delay in therapy. An increase in platelets up to a maximum of 685,000/mm3 was seen in all patients, particularly in those with bone metastases. No relation to the quality of remission or pretreatment was seen. Nausea, vomiting, and fatique were mild and transient, but alopecia occurred in all cases. One patient developed nonfatal anaphylactic shock after etoposide treatment.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Analytical Biochemistry 59 (1974), S. 452-461 
    ISSN: 0003-2697
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1520-5126
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 10
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
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