Entmachtet das Geld!

"Banken in die Schranken" und "Wir zahlen nicht für Eure Krise", so lauten zwei der wichtigsten Parolen der Occupy Bewegung. Darin steckt die Erkenntnis, dass es nicht ausreicht, die gravierenden Mängel unseres Geld- und Finanzsystems zu benennen, wie es ständig in allen Medien geschieht. Denn "Der größte Raubzug der Geschichte"findet immer noch jeden Tag statt. Mehr

Mit meiner Kaline über das Nebelgebirge auf die Südtribüne...

Pfingstwochenende und das Wetter - mit meiner Kaline fahre ich die A 45 Richtung Norden. Die Wolken werden immer dichter, wir fahren durch Nebelschwaden! November- statt Maiwetter...
Wie gewohnt starten wir dann vom Knappi zum Westfalenstadion. Wenigstens regnet es nicht. Westfälischer Schinken im Brötchen - ziemlich viel, aber lecker!
Eine Stunde vor Spielbeginn ist noch viel Platz im Block 14. Warum geht mir nur heute diese Musikbeschallung auf die Nerven? Und dann geht es los! Der BVB hat die TSG im Griff! Nur die Chancenverwertung stimmt nicht...Was auch nicht stimmt - wir sind von fünf Rauchern "umstellt" - und der Wind bläst mir den Rauch immer ins Gesicht. Ein junger Mann dreht sich um und holt einen Flachmann hervor, trinkt einen kleinen Schluck und lacht. Mein Nebenmann links neben mir sieht das und Lacht: Wir trinken drei Liter Bier um den Pegel zu haben, den der mit einem kleinen Schluck hat, und wir müssen dann noch laufend aufs Klo...Heute ist das Wichtigste: Nur keine Verletzten! Und verlieren dürfen sie auch - nur nicht am kommenden Samstag!
Chancenverwertung - zwei Elfmeter für die TSG! So schnell kann es gehen und das Spiel dreht. Verpatzte Generalprobe kann man da nur sagen.
Zum Ausgleich: Spargel und Maischolle im Gasthof Grube!

Mehr

Der größte Raubzug der Geschichte

Mehr

Bad medicine: health promotion

Research is flawed and open to the bias of the authors because people don’t invest time and energy to prove themselves wrong. So if research conclusions don’t make intuitive sense, it is prudent to question the validity of the research. So it is with the conclusions of research into health promotion, because I don’t believe that educating (that is, lecturing) patients to change lifestyle works. It is simply not how people operate. Patients
are aware of risks but want only choose to ignore our advice. But governments ignore this: health promotion in England costs £3.7bn (€4.5bn; $5.9bn) a year.1 The coalition government is promoting the slogan “every contact counts.”2 We are to weigh in and nag about diet and smoking in every health contact because “brief interventions” work. Indeed, outreach health missionaries are storming door to door with so called health
promotion propaganda, sticking the foot in whether people want it or not. Mehr

At a Loss

A 31-year-old woman who had been unable to eat or drink for the preceding week was admitted to the hospital. For the preceding 8 months she had had nausea, vomiting, and abdominal discomfort and several episodes of crampy epigastric pain with vomiting and intermittent chills and sweats, but no documented fevers. She also had loose, pale stools occasionally, but these episodes did not represent a notable change
from her baseline. Gradually increasing fatigue, loss of appetite, and a recent weight loss of several kilograms were also reported. The patient’s medical history included hypertension, obesity, and migraine headaches. She had undergone Roux-en-Y gastric bypass 5 years before presentation and subsequently lost approximately 45 kg (100 lb). Her weight had been stable for the past few years; her body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) was 33. She had undergone laparoscopic cholecystectomy 10 years before presentation. Her only medication was nifedipine, and she
took a multivitamin on occasion. Mehr

Older Still...

In April, 2011, a 52-year-old man presented to us with a 7-day history of fleeting joint pain and stiff ness of his hips, right elbow, left shoulder, and lumbar region. The symptoms were worst in the evening and accompanied by myalgia in his quadriceps and gastrocnemius muscles. He had been unwell for 3 weeks with a swinging fever (>39°C), sore throat, cervical lymphadenopathy, and an intermittent pink rash across his chest, arms, and thighs. He had had no previous similar episodes and no recent diarrhoea, genitourinary symptoms, or red eyes. He denied any new sexual partners or travel to the tropics. On examination, he was febrile (temperature 39·2°C). He had swelling and reduced movement of his right elbow and left shoulder and discomfort on mobilisation of his lumbar spine. A striking pink rash covered his chest, arms, and thighs. There was no palpable lymphadenopathy or abdominal mass. Mehr

I did it my way...

Bariatric surgery for type 2 diabetes

Bariatric surgery provides substantial, sustained weight loss and major improvements in glycaemic control in severely obese individuals with type 2 diabetes. However, uptake of surgery in eligible patients is poor, and the barriers are diffi cult to surmount. We examine the indications for and effi cacy and safety of conventional bariatric surgical procedures and their eff ect on glycaemic control in type 2 diabetes. How surgical gastrointestinal interventions achieve these changes is of great research interest, and is evolving rapidly. Old classifi cations about restriction and malabsorption are inadequate, and we explore understanding of putative mechanisms. Some bariatric procedures improve glycaemic control in people with diabetes beyond that expected for weight loss, and understanding this additional eff ect could provide insights into the pathogenesis of type 2 diabetes and assist in the development of new procedures, devices, and drugs both for obese and non-obese patients. Mehr

Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer

Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the publication of the American Thyroid Association’s guidelines for the management of these disorders was published in 2006, a large amount of new information has become available, prompting a revision of the guidelines. Mehr

Was ist ein gutes Fotos?

Am 8. Mai erscheint zum ersten Mal ZEIT Fotografie – ein Sonderheft, das der ZEIT beiliegt, gemacht von der Redaktion des ZEITmagazins. Das Heft soll Fragen beantworten wie: Was ist ein gutes Foto? Nach welchen Maßstäben werden Fotos beurteilt und ausgewählt? Welche Rolle spielen Technik, Innovation und die 170 Jahre lange Geschichte der Fotografie? Und was kann man als Amateur von guten Fotos lernen?  

All das erklärt F.C. Gundlach, einer der führenden Fotoexperten. Der ehemalige Modefotograf und bedeutende Fotosammler ist der Pate von ZEIT Fotografie. Sie als Leser können Gundlach selbst Fragen stellen. Eine Auswahl wird er im Heft und auf ZEIT ONLINE beantworten. Mehr

Wie gut ist mein Foto?

Wie unscharf darf ein Bild sein? Sind Brennweiten überflüssig geworden? Erfüllt mein Foto künstlerische Kriterien? Der Fotograf F.C.Gundlach beantwortet Fragen der Leser. Mehr

A Lobectomy by Any Other Name

There is growing recognition that not all lobectomies for lung cancer are the same. The components of the lobectomy treatment process are numerous, making it difficult to study lobectomy as a single treatment modality. Each of the lobectomy components must be viewed as having a potentially important influence on quality of life and survival. Aspects that are important include patient selection, particularly, finding a patient who is medically fit to withstand the surgical procedure and who has been thoroughly assessed by noninvasive or minimally invasive means to rule out metastatic disease. In addition, patients and their support system should be emotionally preparedfor the procedure and the postoperative issues that arise. The surgeon must be thoroughly trained, educated, skilled, and focused to perform themost appropriate procedure to provide the best outcome: the best short- and long-term survival with the least probability of morbidity and debility. Mehr

Profile Alex Ezeh: bringing world-class research home

He was the fi rst person in his family to go to a secondary school, the second person in his Nigerian village to go to university, and as the fi rst head of the Kenya-based African Population and Health Research Center (APHRC) Alex Ezeh is transforming the way research is done in and for Africa. Unsurprisingly, he’s a remarkable man to talk to. Intense yet charming, the thing that really hits home is the clarity of his vision for development in Africa, the role of the APHRC in that development, and the power with which he communicates that vision. “He is a unique African driven by the ambition to improve the volume, relevance, and quality of research in Africa by Africans or Africanists that ultimately improves the wellbeing of Africans”, says Moses Oketch, of the University of London’s Institute of Education in the UK. It was The Lancet’s pleasure to catch up with Ezeh during a recent trip to London for the Consortium for Advanced Research Training in Africa. Mehr

Offline: An ignominious defeat

Doctors are taught to abhor bias. The aim of a research study is to achieve a result that comes as close to the truth as possible. Anything that systematically infl uences a result in such a way as to lead it away from the truth is bad. Bias can come in many different forms - patient selection, measurement, confounding, or at the time of publication. But are there hidden biases that we don’t take into account, biases that might be even more important than those we learn about in epidemiology? We rarely question the assumptions that lead us to devise and defend certain beliefs about health. Last week, a debate took place entitled “Architecture as Antidote: should cities make us fit.” Mehr

Patientenakademie 2013 Asklepios Klinik Langen by Prof Dr Dr Ernst Hanisch

DPLA - "Today we can realize the dream of the Enlightenment philosophers"

A good ten days ago the “Digital Public Library of America” (DPLA) went online, providing access to around 2.4 million digital copies of books, photos, handwritten documents and other documents from 12 major US libraries and institutions. Historian and Director of Harvard University Library Prof. Robert Darnton is the driving force behind the project. In a current article for “The New York Review of Books” he gives an in-depth explanation of the idea behind the DPLA. We asked him for an interview. Mehr

Will MOOCs transform medicine?

Edward Davies, US news and features editor, BMJ

edavies@bmj.com

Massive open online courses (MOOCs) have received a lot of attention in recent months. They are being variously credited with everything from improving social mobility to transforming the economics of education. As one essayist wrote in the New England Journal of Medicine last year, "In an era with a perfect video-delivery platform [online], why would anyone waste precious class time on a lecture?" (doi:10.1056/NEJMp1202451)
The premise of MOOCs is implicit in the name—online courses delivered and open to a massive number of people. Some of the benefits of delivering education online like this are obvious; the constraints on time and space dictated by a lecture theatre are immediately overcome, and the cost and inconvenience of getting to a single location are removed. Education can be handily fitted into the lives of those wishing to be educated.
But there are downsides as well. As an article in this week’s New York Times points out: "While the courses have enrolled millions of students around the world, most who enroll never start a single assignment, and very few complete the courses." Evidence as to how well the courses work is thin (www.nytimes.com/2013/04/30/education/colleges-adapt-online-courses-to-ease-burden.html?ref=tamarlewin&_r=0).
Then, of course, there are the benefits and challenges that are specific, if not exclusive, to a medical education. Ben Harder explores these in a feature in this week’s BMJ (doi:10.1136/bmj.f2666).
He finds both enthusiasts and sceptics for the new modality, with one noteworthy example suggesting that, in medical education, MOOCs are unlikely to become the norm.
Harry Goldberg, molecular biophysicist at Johns Hopkins University, offers an informed opinion: for the past 15 years he and a team of faculty colleagues have been making taped lectures available to medical students taking a course on cardiovascular physiology. Now, the university offers one of academia’s more comprehensive online course catalogs in the health sciences.
But Goldberg is circumspect. MOOCs have a role in medical education, he says, but he thinks that role is a lot smaller than people hope it will be. That’s mainly because lecture style didactics—or "content delivery," in the parlance of the web—are just one small piece of the overall learning experience in medicine.
Cite this as: BMJ 2013;346:f2877

Mailied

Wie herrlich leuchtet
Mir die Natur!
Wie glänzt die Sonne!
Wie lacht die Flur!

Es dringen Blüten

Aus iedem Zweig,
Und tausend Stimmen
Aus dem Gesträuch,

Und Freud und Wonne

Aus ieder Brust.

O Erd o Sonne
O Glück o Lust!

O Lieb’ o Liebe,
So golden schön,

Wie Morgenwolken

Auf ienen Höhn;

Du segnest herrlich
Das frische Feld,
Im Blütendampfe

Die volle Welt.

O Mädchen Mädchen,
Wie lieb’ ich dich!
Wie blinkt dein Auge!
Wie liebst du mich!

So liebt die Lerche

Gesang und Luft,
Und Morgenblumen
Den Himmels Duft,

Wie ich dich liebe

Mit warmen Blut,

Die du mir Jugend
Und Freud und Muth

Zu neuen Liedern,
Und Tänzen giebst!

Sey ewig glücklich

Wie du mich liebst!

Johann Wolfgang von Goethe

Erinnerung an Marie A.

An jenem Tag im blauen Mond September
Still unter einem jungen Pflaumenbaum
Da hielt ich sie, die stille bleiche Liebe
In meinem Arm wie einen holden Traum.
Und über uns im schönen Sommerhimmel
War eine Wolke, die ich lange sah
Sie war sehr weiß und ungeheur oben
Und als ich aufsah, war sie nimmer da. 


Seit jenem Tag sind viele, viele Monde
Geschwommen still hinunter und vorbei.
Die Pflaumenbäume sind wohl abgehauen
Und fragst du mich, was mit der Liebe sei?
So sag ich dir: ich kann mich nicht erinnern
Und doch, gewiß, ich weiß schon, was du meinst.
Doch ihr Gesicht, das weiß ich wirklich nimmer
Ich weiß nur mehr: ich küßte es dereinst. 


Und auch den Kuß, ich hätt ihn längst vergessen
Wenn nicht die Wolke dagewesen wär
Die weiß ich noch und werd ich immer wissen
Sie war sehr weiß und kam von oben her. 
Die Pflaumenbäume blühn vielleicht noch immer
Und jene Frau hat jetzt vielleicht das siebte Kind 
Doch jene Wolke blühte nur Minuten
Und als ich aufsah, schwand sie schon im Wind.

Berthold Brecht

Eva bereist die Welt...

Mehr

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2. Verzeihen Sie, wenn ich störe... von Joachim Ringelnatz, Audiobuch Verlag, Freiburg
3. Risiko. Wie man die richtigen Entscheidungen trifft von Gerd Gigerenzer, C. Bertelsmann
4. Flucht, Vertreibung, Ansiedlung, Integration. Vertriebene erzählen ihr Schicksal von H Mirtes, G Fritsche, Heimatkreis Mies-Pilsen, Dinkelsbühl
5. Drosseln begraben. Die schönsten Erzählungen von Sergio Pitol, Klaus Wagenbach Verlag