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Zusammenfassung. Im Projekt QueB 1 – Qualität entwickeln mit und durch Bewegung in Kitas – wurde untersucht, inwieweit Kitas unterstützt werden können, ihre Organisation so zu entwickeln, dass sowohl die Kinder als auch die pädagogischen Fachkräfte ihre Handlungsmöglichkeiten für einen aktiven Lebensstil nachhaltig erweitern. Die Kitas folgten einem 10-Schritte-Programm, das sich am Public Health Action Circle orientierte und von Coaches begleitet wurde. Verschiedene Methoden wie eine Kita-Check-App, eine Bewegungstagebuch-App und Schrittzähler wurden eingesetzt. Getestet wurde das Vorgehen in einer einjährigen Studie in zwei Regionen in Bayern mit Wartegruppe, prä-post-Design und mixed-methods Ansatz. Die Ergebnisse zeigen u.a. positive Veränderungen in den Bewegungsaktivitäten. Kinder machten rund 10% mehr Schritte und reduzierten ihre Sitzzeiten. Pädagogische Fachkräfte steigerten ihre Aktivität sogar um fast 15%. In der Kita wurden nicht nur die vorhandenen Möglichkeiten sich zu bewegen mehr genutzt, es wurden auch neue Bewegungsgelegenheiten geschaffen. Analysen der Ziele, die die Kitas individuell formulierten, zeigten vielfältiges Potential für die Kita-Entwicklung.

Suppose that $${\mathscr {N}}$$ is a set of subsets of a finite set Q. $${\mathscr {N}}$$ may be interpreted, for example, as a set of observed states as a result of an experiment or as a model of some theory. In a further step, the elements of $${\mathscr {N}}$$ can be weighted by some set function $$f: {\mathscr {N}}\rightarrow {\mathbb {R}}$$ such as various kinds of uncertainty measures or probabilities. In this paper, we demonstrate the process of analysing data based on observed granules according to the model proposed by G. Gigerenzer, and argue the necessity of an error theory when passing from a theoretical model to empirical data. We also investigate changes that occur when using granule structures weaker than a Boolean algebra, and under which conditions results based on a granule set can be extended to the whole power set algebra. Our main examples are results of a test taken by a population of students, and their interpretation by various probability functions such as basic probability assignments and belief functions.

Background In Germany, work-related skin diseases are predominant within the spectrum of reported occupational diseases. Metal workers are among the high-risk professions. Offering effective prevention programs to affected patients is of utmost importance to avoid deterioration of the disease and job loss. We conducted a 1-year follow-up in patients who participated in a multidisciplinary, complex outpatient prevention program representing a standard procedure of patient care by the respective statutory accident insurance. Methods The multi-component prevention program consists of multiprofessional individual patient counseling, a structured skin protection seminar in a group, as well as workplace visits and on-site counseling in terms of appropriate skin protection (e.g. gloves). An observational study with a 1-year follow-up and four measurements (T1-T4, longitudinal pre/post-test design) including dermatological examinations and standardized written questionnaires was conducted between 2013 and 2016 to assess changes over time regarding job loss and disease severity. Results Data from 94 patients (87 male, mean age: 45.4 years) were included in the analysis. One year after the skin protection seminar (T4), 83 patients (88.3%) remained in their original professional metalworking activity and four patients (4.3%) had given up their profession because of their skin disease. At baseline (T1), irritant contact dermatitis of the hands was the most frequent diagnosis (80.7%). Methods for self-reported disease severity showed good correlation with the clinical gold standard at T1 and T2 (dermatological examination with the Osnabrück Hand Eczema Severity Index / OHSI), and a significant decrease of the self-reported disease severity was found over time from T1 to T4 (p

We consider Guttman scales both from an algebraic and a statistical point of view. We present a duality between a class of algebras and Guttman scalable response structures, and show that the index of reproducibility is not always a reliable indicator for the Guttman scalability of a data set. Furthermore, we present a model checking procedure, and close with an example.

In this exploratory article, we draw attention to the common formal ground among various estimators such as the belief functions of evidence theory and their relatives, approximation quality of rough set theory, and contextual probability. The unifying concept will be a general filter function composed of a basic probability and a weighting which varies according to the problem at hand. To compare the various filter functions we conclude with a simulation study with an example from the area of item response theory.

Summary Background Foot eczema often occurs in combination with hand eczema. However, in contrast to the situation with hand eczema, knowledge about foot eczema is scarce, especially in occupational settings. Objective To evaluate the prevalence of foot eczema and associated factors in patients with hand eczema taking part in a tertiary individual prevention programme for occupational skin diseases. Patients/materials/methods In a retrospective cohort study, the medical records of 843 patients taking part in the tertiary individual prevention programme were evaluated. Results Seven hundred and twenty-three patients (85.8%) suffered from hand eczema. Among these, 201 patients (27.8%) had concomitant foot eczema, mainly atopic foot eczema (60.4%). An occupational irritant component was possible in 38 patients with foot eczema (18.9%). In the majority of patients, the same morphological features were found on the hands and feet (71.1%). The presence of foot eczema was significantly associated with male sex [odds ratio (OR) 1.78, 95% confidence interval (CI) 1.29–2.49], atopic hand eczema (OR 1.60, 95%CI: 1.15–2.22), hyperhidrosis (OR 1.73, 95%CI: 1.33–2.43), and the wearing of safety shoes/boots at work (OR 2.04, 95%CI: 1.46–2.87). Tobacco smoking was associated with foot eczema (OR 1.79, 95%CI: 1.25–2.57), in particular with the vesicular subtype. Conclusions Foot eczema is common in patients with hand eczema, and is related to both occupational and non-occupational factors.

Summary Background In 2011, 25,056 notifications of suspected occupational dermatitis (OD) were submitted to the statutory accident insurance (UVT), predominant by dermatologist's reports. Parallel to the introduction of the improved dermatologist's procedure, the hierarchical multi-step intervention approach to OD was launched within the UVT. It is aimed at ensuring that patients with OD can be allocated to preventive dermatological interventions quickly and appropriately according to the severity of their OD. From 2007–2010, the quality of dermatological interventions as well as the corresponding administrative procedures were evaluated in a unique research project supported by the German Social Accident Insurance. Patients and methods About 10 % (n = 1 600) of notified cases with suspected OD in 2007 in Germany were analyzed in a random quota sample by occupational dermatologists and administrations. Follow-up was 12 months. If a dermatologist's procedure was initiated after the initial notification, patients’ and dermatologists’ opinions were obtained by questionnaires. Results More than 85 % of the OD notifications were submitted by dermatologists and only 1.6 % by occupational physicians. In 88 %, the dermatologist's report was used. Yet, there is room for optimizing procedures: e.g., the clinical and/or occupational relevance of type IV allergies was assessed only in 36.5 % of patients. Job loss due to OD occurred less often if suitable preventive and/or therapeutic strategies (e.g., skin protection seminars) were implemented by the UVT (p = 0.001). Preventive and therapeutic strategies were initiated more often when the dermatologist's report was conclusive, a central element is the outpatient care by a dermatologist. Conclusions The research project shows that the quality of dermatological intervention, as well as administrative procedures, can be optimized. Early intervention with suitable preventive and therapeutic strategies in patients with OD should be aimed at, as this is crucial for the outcome of OD.

Anfang 2006 wurde das „optimierte Hautarztverfahren“ eingefuhrt, dazu komplementar das „Stufenverfahren Haut“, das verwaltungsseitig die rasche Einleitung von sinnvoll gestuften praventiven Masnahmen bei Patienten mit berufsbedingten Hauterkrankungen gewahrleisten soll. An der Universitat Osnabruck werden mittels bundesweiter randomisierter Quotenstichprobe (N=1600) erstmals ca. 10% der jahrlichen BK-5101-Verdachtsmeldungen dermatologisch und verwaltungsseitig evaluiert (Forschungsvorhaben „EVA_Haut“). Nach derzeitiger Datenlage wurde in N=995 Fallen der randomisierten Stichprobe nach der Meldung ein Hautarztverfahren eingeleitet: In diesen Fallen werden die involvierten Akteure (Hautarzt, Patient, Unfallversicherungstrager) mittels standardisierter Erhebungsinstrumente befragt; gleichzeitig erfolgt eine berufsdermatologische Auswertung der anonymisierten Aktenauszuge durch ABD-zertifizierte Gutachter im „double review“. Die Falle, in denen bisher kein Hautarztverfahren eingeleitet wurde (N=556), werden ebenfalls berufsdermatologisch und verwaltungsseitig analysiert. Wesentliche Beurteilungskriterien sind Berufsverbleib, Verlauf der Hauterkrankung sowie Kosten des Verfahrens. Der Nachbeobachtungszeitraum betragt 1 Jahr nach Eingang der Meldung. Das Forschungsvorhaben bietet erstmalig die Chance, im Rahmen der Qualitatssicherung Verwaltungshandeln und dermatologisches Berichtswesen als Eckpfeiler der dermatologischen Fruhpravention zu analysieren, um wissenschaftlich begrundet Optimierungsmoglichkeiten fur die Versorgung von Patienten mit berufsbedingten Hauterkrankungen zu entwickeln.

If employees are threatened to loose their job due to a severe occupational skin disease (OSD), intensive interdisciplinary measures of tertiary individual prevention (TIP) are required. TIP comprises 2-3-weeks in-patient treatment plus intensive health-pedagogic counseling, and consecutive 3-weeks out-patient treatment by the local dermatologists. Each patient (pt) will stay off work for a total of usually 6 weeks to allow full barrier-recovery.All 1,486 TIP-pts from various high-risk-professions, treated in our institution in the period 1994-2003, were followed up 1 year after the TIP by a standardised questionnaire, which was returned by 1,164 (78%) pts.Seven hundred and sixty-four (66%) of the responding 1,164 TIP-pts had successfully remained in their (risk-)professions. It could be demonstrated that to remain in the workplace was dependent on the individual motivation to use skin protection (P0.001), the provision of skin protection by the employer (P0.001), (higher) age of pt (P0.001) and the duration of continued out-patient-treatment by the local dermatologist (P0.001). However, there were no significant differences concerning the likelihood of successful job-continuation in the various high-risk-professions, e.g. hairdressers, nurses, metal-workers, food handlers, construction-workers.The obtained data from TIP reveal remarkable pertinent options for interdisciplinary pt-management in severe OSD in all risk-professions.