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- Ökonomisierung (1)
- Übergewicht (1)
- Übertragung von Heilkunde (1)
- Übertragungsplan (1)
- Übung (1)
Studien zeigen, dass Anhänger der PEGIDA-Bewegung die Medienberichterstattung als unangemessen wahrnehmen und ihr misstrauen. Diese Wahrnehmung und daraus resultierende kognitive, affektive und konative Konsequenzen wurden in einer standardisierten Online-Befragung untersucht (n= 800). Es zeigt sich, dass Anhänger der PEGIDA-Bewegung der Berichterstattung über PEGIDA mehr misstrauen als PEGIDA-Gegner. Diese Wahrnehmung wiederum hat politisch relevante Konsequenzen: Je stärker PEGIDA-Anhänger und neutral Eingestellte der Berichterstattung misstrauen, desto weniger Vertrauen bringen sie den Medien allgemein entgegen, desto unzufriedener sind sie mit der Demokratie in Deutschland und desto wütender sind sie auf die Berichterstattung. Die wütenden Reaktionen korrelieren mit einer Zustimmung zu radikalen Protestformen, was wiederum die Beteiligung an den Protestmärschen erhöht. Somit zeigen die Befunde, dass das Misstrauen in die Berichterstattung über PEGIDA auch über deren Anhängerkreis hinaus eng verbunden ist mit erodierendem Vertrauen in Medien und Politik sowie mit der Bereitschaft zu radikalen Protestformen.
„Foucault im Jobcenter“ : Supervision in einem widersprüchlichen gesellschaftlichen Feld (Teil 1)
(2017)
Erwerbsarbeit ist nach wie vor der wichtigste Faktor gesellschaftlicher Teilhabe. Jobcenter erfüllen aus diesem Grund eine wichtige gesellschaftliche Funktion. Aufgrund ihrer verwickelten und konfliktreichen Geschichte ist ihre gesellschaftliche Verortung schwierig. Jobcenter sind bisher, trotz ihrer Größe und gesellschaftlichen Relevanz für maßgebliche Bevölkerungsteile, kaum beratungswissenschaftlich untersucht worden. Unserer Ansicht scheint es notwendig zu sein, sich intensiver mit dem gesellschaftlichen Feld der Jobcenter zu beschäftigten: Zum einen, weil Beratung selbst eine herausgehobene Bedeutung im Jobcenter besitzt und zum anderen, weil die Jobcenter ein wichtiges Feld für die Supervision werden könnten. Dieser Artikel soll daher eine erste kasuistische Grundlage für eine kritische Reflexion bieten und wird in zwei Teilen erscheinen. Der erste Teil wird eine grundlagentheoretische Einführung in das Thema sein. Darauf aufbauend rekonstruieren wir in einem zweiten Teil einen Fall aus dem Jobcenter, der in der nächsten Ausgabe der FoRuM Supervision unter dem Titel ‚Fallverstehen und Fallrekonstruktion‘ analysiert und reflektiert werden wird.
Im Herbst 2013 wurde in Essen ein supraleitendes dreiphasiges Koaxial-Kabel-System installiert. Dieses Ereignis regte dazu an, die Art und Weise der Leistungsübertragung auf diesem Kabel genauer zu analysieren, um die physikalischen Vorgänge besser zu verstehen. Mit Hilfe elementarer Gesetze und Gleichungen wird gezeigt, dass bei reiner symmetrischer Blindlast auf dem Kabel dennoch eine zirkulierende Wirkleistung auftritt, die in Lehrbüchern bisher nicht beschrieben ist. Bei reiner symmetrischer Wirklast treten dagegen keine Besonderheiten auf.
Der Bericht über die Mitgliederversammlung gliedert sich in vier Teile: Einen kurzen Bericht über die formalen Anteile der Versammlung (1), die kurze Vorstellung der mit dem Cora-Baltussen-Förderpreis ausgezeichneten Abschlussarbeiten (2), eine Paraphrase des Vortrags von Armin Nassehi (3) sowie eine kritisch-kommentierende Diskussion des Fishbowls über Führungskräfte in der klinischen Pflege (4).
Der Essay skizziert die Ideengeschichte eines funktionalisierenden und optimierenden Coachingverständnisses und erschließt dafür Quellen, um damit einen Anstoß für weitere Forschungsarbeiten zu geben. Dabei ist der Beitrag nur eine erste diskursanalytische Annäherung, weil Coachingverständnisse hochgradig heterogen sind, für die frühe Geschichte der Supervision nur ein unzureichender Forschungsstand vorliegt, insbesondere in Hinblick auf ihre Ideengeschichte und die erschlossenen Quellen, und sich die Entwicklung nur in der Analyse der komplexen und vielsprachigen wissenschaftlichen und praktischen Austauschprozesse insbesondere zwischen den USA und dem westlichen Europa rekonstruieren lässt. Für die Forschung wurden zahlreiche Quellen zwischen 1950 und 1980 erschlossen. Es kann gezeigt werden, dass sich einzelne Konzeptbestandteile von Coaching bereits zwischen 1945 und 1975 im Diskurs um Praxisberatung und Supervision im Kontext der Sozialen Arbeit (Social Casework, Groupwork) nachweisen lassen. Offen bleibt, ob sich Coaching unabhängig davon oder darauf aufbauend entwickelt hat. Eine systematisierte Forschung zu diesen Zusammenhängen steht aus.
Der Bericht bezieht sich auf ein Forschungssemester, das die Relevanz und Zukunft der Inhaltserschließung zum Gegenstand hatte. Er beschreibt den Verlauf des Semesters zwischen Wunsch und Wirklichkeit und erörtert Fehler, die in den verschiedenen Phasen des Projekts gemacht wurden. Aus der Beschreibung wird deutlich, dass Motivation, Leidenschaft und vor allem Spaß wichtige Voraussetzungen dafür sind, dass Forschung gelingt bzw. als gelungen erlebt werden kann.
Hintergrund: Das System der pflegerischen Versorgung in Deutschland befindet sich in einer Umbruchphase. Seit Jahren wird über eine Weiterentwicklung der Kooperation im Gesundheitswesen und damit über eine Veränderung der Aufgabenverteilung zwischen den Gesundheitsberufen diskutiert. Im Jahr 2008 hat der Gesetzgeber die Einführung von Modellvorhaben zur Übertragung von Heilkunde auf Pflegende gem. § 63 Abs. 3c SGB V ermöglicht. Die Umsetzung verläuft sehr schleppend. Das Ziel der Untersuchung war, die Gründe für diese schleppende Umsetzung aus Sicht der gesetzlichen Krankenkassen zu analysieren.
Methode: Quantitative Befragung aller gesetzlichen Krankenkassen (n=124) in Deutschland.
Ergebnisse: Zur Sicherstellung der Versorgung halten 94 % der Krankenkassen die Übertragung von Heilkunde auf nichtärztliche Leistungserbringer für einen sinnvollen Ansatz. Sie wird von 96 % der Krankenkassen als sehr wichtig empfunden. Zwar befürworten 96 % der Krankenkassen grundsätzlich die Durchführung von Modellvorhaben, tatsächlich sind aber nur 8 % an derartigen Verträgen beteiligt; 71 % der Krankenkassen planen auch keine eigenen Modellvorhaben für die Zukunft.
Als mögliche Ursachen für die bislang schleppende Umsetzung werden aus Sicht der GKV insbesondere rechtliche Hürden (90 %), Widerstand durch ärztliche Standesvertreter (84 %), ungeklärte Finanzierungs- (74 %) und Haftungsfragen (70 %) sowie nicht-praxistaugliche Regelungen in der G-BA-Richtlinie (79 %) und im Gesetz (85 %) angeführt. Weniger als die Hälfte (46 %) der Krankenkassen vermutet hohe Kosten als Ursache für die schleppende Umsetzung.
Diskussion: Die vom Gesetzgeber im aktuellen Pflegeberufereformgesetz (PflBRefG) vorgenommenen Änderungen, insbesondere die Tatsache, dass Krankenkassen entsprechende Modellvorhaben bis zum 31. Dezember 2020 vereinbaren und durchführen sollen, sind vor dem Hintergrund der geäußerten Kritik als zielführend und adäquat zu bezeichnen.
Unternehmen, die schnell auf veränderte Marktsituationen reagieren müssen, benötigen eine funktionierende Logistik, die eine Klammerfunktion für alle betrieblichen Bereiche ausübt. Kernstück eines Logistikkonzepts ist das PPS-System, das sich mit Hilfe zeitgemäßer Software immer mehr zur maßgeschneiderten Lösung entwickelt. Ein Weg, um Logistikmodule anforderungsgerecht einzuführen, lässt sich anhand eines besonderen Cim-Modells verdeutlichen, dessen letzter Arbeitsschritt das Auswählen von Hardware und Software ist.
Der Beitrag beschreibt die aktuellen Überlegungen zur Weiterentwicklung der informationswissenschaftlichen Studiengänge der Hochschule Hannover vor dem Hintergrund des laufenden Prozesses der Reakkreditierung. Zentrale Aspekte bilden hierbei die inhaltliche und strukturelle Weiterentwicklung des Curriculums vor dem Hintergrund der sich verändernden Bedürfnisse der Bibliotheken. Ebenfalls berücksichtigt werden verschiedene Formen der Kooperation mit der Bibliothekspraxis, hochschuldidaktische Überlegungen sowie die Einbindung der Studiengänge in die informationswissenschaftliche Forschungslandschaft.
Mit Blick auf Cora Baltussens Leben, Wirken und Beratungsverständnis werden die demokratischen, emanzipatorischen und internationalen Wurzeln der Rezeption der Profession Supervision in Deutschland in den 1950er und 1960er Jahren betont. Das ist besonders notwendig angesichts kritischer Weiterentwicklungen von Supervision und Coaching, bei denen die professionsethischen Grundlagenfragen zum Teil aus dem Blick geraten.
Wohnungslose Menschen wurden systematisch diskreditiert und werden immer noch systematisch ausgegrenzt. Die Angebote für wohnungslose Menschen sind unzureichend und lückenhaft. Die besonderen Erfahrungen und Bedürfnisse der Betroffenen müssen besser als bisher berücksichtigt werden um bedarfsgerechtere Hilfen und Angebote zu gestalten. Hierfür ist die Einbeziehungen der Betroffenen in Planung und Ausgestaltung der Angebote systematisch und unbefristet zu fördern. Um den Interessen der Betroffenen Gehör zu verschaffen sind entsprechende Ressourcen bereitzustellen und Kommunikationswege zu eröffnen.
Ausgangspunkt des Forschungsvorhabens SchuLae bildet die angestrebte flächendeckende Einführung institutioneller Schutzkonzepte in pädagogischen Kontexten. Im Zuge eines durch Schutzkonzepte in Gang gesetzten Organisationsentwicklungsprozesses sollen Orte des Aufwachsens für Kinder und Jugendliche zu Schutz- und Kompetenzorten werden. Ob Schutzkonzepte tatsächlich zu einem Rückgang von Viktimisierungserfahrungen und einer erhöhten Bereitschaft zur Hilfe(suche) führen, wurde bislang nicht empirisch erfasst. Der vom Bundesministerium für Bildung und Forschung (BMBF) geförderte Verbund „SchuLae – Entwicklung und Wirkung von Schutzkonzepten in Schulen im Längsschnitt“ des Deutschen Jugendinstituts und der Hochschule Hannover untersucht daher die Wirksamkeit schulischer Schutzkonzepte sowohl quantitativ als auch qualitativ im Längsschnitt und fokussiert dabei die Perspektiven von Schüler*innen.
Das PROFINET Protokoll wurde in der aktuellen Version um Security-Funktionen erweitert. Damit können für PROFINET flexible Netzwerkarchitekturen unter Berücksichtigung von OT-Security Anforderungen entworfen werden, die durch die bisher erforderliche Netzwerksegmentierung nicht möglich waren. Neben den Herstellern der Protokollstacks sind nachfolgend auch die Komponentenhersteller gefordert, eine sichere Implementierung in ihren Geräten umzusetzen. Die erforderlichen Maßnahmen gehen dabei über die Nutzung eines sicheren Protokollstacks hinaus. Der Beitrag zeigt am Beispiel eines Ethernet-APL Messumformers mit PROFINET-Kommunikation die künftig von PROFINET-Geräteherstellern zu berücksichtigenden technischen und organisatorischen Rahmenbedingungen.
Der Aufsatz erläutert anschaulich, wie der Transport der elektrischen Energie vom Erzeuger zum Verbraucher im Detail erfolgt. Die Rechnung mit Hilfe grundlegender Beziehungen aus den Grundlagen der Elektrotechnik und dem Poynting-Vektor ermöglicht es, den physikalisch realen Transport der Energie räumlich quantitativ nachzuvollziehen und zu verstehen. An vereinfachten Beispielen wird gezeigt, wie die Energie über zwei Sammelschienen zu den Verbrauchern und insbesondere in die Verbraucher hinein gelangt. Bei den Verbrauchern handelt es sich exemplarisch um einen Widerstand, einen Kondensator, eine Spule und schließlich einen bewegten Leiter im magnetischen Feld als einfachste Form eines Gleichstrommotors. Es wird dargestellt, dass die Energie keinesfalls in den Zuleitungen transportiert wird, sondern durch den umgebenden Raum.
Ob Veränderungsprojekte in Organisationen erfolgreich sind, hängt entscheidend davon ab, ob und wie die entwickelten Lösungen von den betroffenen Mitarbeitern angenommen und umgesetzt werden. Es sind nicht wirklich die Unternehmen, die sich verändern: Der Wandel muss in und mit den Menschen in den Unternehmen stattfinden. Dies kann aber nur durch Überzeugung gelingen und zwar im wesentlichen herbeigeführt durch Kommunikation. Von Bedeutung sind jedoch nicht so sehr die Massenmedien wie die Mitarbeiterzeitschrift, Broschüren oder das Intranet. Mit ihnen wird der Veränderungsprozess angestoßen und laufend unterstützt. Entscheidend für seinen Erfolg oder Misserfolg ist jedoch die geplante und organisierte persönliche Kommunikation vor allem zwischen dem Management und den Mitarbeitern. Führungskräfte müssen sich ihrer Rolle als Meinungsführer und Meinungsbildner bewusst werden und entsprechend handeln. Dazu gehört auch das Kommunikationsmanagement und der phasengerechte Einsatz von Kommunikationsinstrumenten zum gewünschten Zweck.
Background
The business of clinical research has changed in the past two decades, shifting from industrialised Western countries to so-called emerging markets such as Eastern Europe, Latin America and Africa. An appraisal of the trends could identify associated factors that may have implications for the local populations and their endemic diseases.
Objectives
To identify potential reasons why emerging countries have become attractive places for international sponsors to conduct their clinical trials.
Methods
Using ClinicalTrials.gov, the Pan African Clinical Trials Registry, the National Health Research Database and the Nigeria Clinical Trials Registry, trend data on clinical research development were determined for two emerging African markets, Nigeria and South Africa (SA), from 2010 to 2018. Also, health data on the two countries from the fact sheets of health statistics of the World Health Organization were compared, as well as regulatory and ethical conditions. Available data were analysed using descriptive statistics and trend analysis.
Results
The impact of globalisation is evident from the upward trend in clinical trials in SA before 2010, and the clear downward trend thereafter. One reason for this change could be the alignment of SA’s regulatory and ethical frameworks with the Western world. In contrast,
the upward trend is only just beginning in Nigeria, with the introduction of ethical/regulatory frameworks, and supportive institutions making the business of clinical research more attractive on an international level. Although the number of international and local sponsors increased in Nigeria from 2010 to 2018, only the latter increased in SA, with the former decreasing over the same period. Overall, there is a mismatch between country-specific diseases and the drugs being tested, to the extent that leprosy, which is endemic in Nigeria, and tuberculosis in SA were not in the list of top 10 study areas in either country.
Conclusions
The globalisation trend is evident in the clinical trials business, but cannot be generalised to all emerging countries. Timing and intensity vary from country to country relative to factors that advance the existing profit-orientated business models of the sponsors. Furthermore, various diseases have been localised, which entails a diversely increasing need for research.
Objectives:
The aim was to identify theoretically expected as well as actually reported benefits from drug development and the importance of individual patient benefits compared to the collective benefits to society in general.
Background:
Ethical guidelines require that clinical research involving humans offer the potential for benefit. A number of characteristics can be applied to define research benefit. Often benefit is categorized as being either direct or indirect. Indirect benefits can involve collective benefits for society rather than any benefits to the trial patient or subject. The purpose of this review was to examine which potential individual and societal benefits were mentioned as being expected in publications from government experts and which were mentioned in publications describing completed drug development trial results.
Methods:
Literature on research benefit was first identified by searching the PubMed database using several combinations of the key words benefit and clinical research. The search was limited to articles published in English. A Google search with the same combinations of key words but without any language limitation was then performed. Additionally, the reference lists of promising articles were screened for further thematically related articles. Finally, a narrative review was performed of relevant English- and German-language articles published between 1996 and 2016 to identify which of several potential benefits were either theoretically expected or which were mentioned in publications on clinical drug development trial results.
Results:
The principal benefits from drug development discussed included 2 main types of benefit, namely individual benefits for the patients and collective benefits for society. Twenty-one of an overall total of 26 articles discussing theoretically expected benefits focused on individual patient benefits, whereas 17 out of 26 articles mentioned collective benefits to society. In these publications, the most commonly mentioned theoretically expected individual patient benefit was the chance to receive up-to-date care (38.1%). A general increase in knowledge about health care, treatments, or drugs (70.6%) was the most commonly mentioned theoretically expected benefit for society. In contrast, all 13 publications reporting actual benefits of clinical drug development trials focused on personal benefits and only 1 of these publications also mentioned a societal benefit. The most commonly mentioned individual benefit was an increased quality of life (53.9%), whereas the only mentioned collective benefit to society was a general gain of knowledge (100.0%).
Conclusions:
Both theoretically expected and actually reported benefits in the majority of the included publications emphasized the importance of individual patient benefits from drug development rather than the collective benefits to society in general. The authors of these publications emphasized the right of each individual patient or subject to look for and expect some personal benefit from participating in a clinical trial rather than considering societal benefit as a top priority. From an ethical point of view, the benefits each individual patient receives from his or her participation in a clinical trial might also be seen as a societal benefit, especially when the drug or device tested, if approved for marketing, would eventually be made available for other similar patients from the country in which the clinical trial was conducted.
Objectives
Quality of care largely depends on successful teamwork, which in turn needs effective communication between health professionals. To communicate successfully in a team, health professionals need to strive for the same goals. However, it has been left largely unaddressed which goals professionals consider to be important. In this study, we aim to identify these goals and analyse whether differences between (1) personal and organisational goals, (2) different professions and (3) hierarchical levels exist in neonatal intensive care units (NICUs).
Design
Goals were identified based on a literature review and a workshop with health professionals and tested in a pilot study. Subsequently, in the main study, a cross-sectional employee survey was undertaken.
Setting and participants
1489 nurses and 537 physicians from 66 German NICUs completed the
questionnaire regarding personal and organisational goal importance between May and July 2013. Answers were given based on a 7-point Likert scale varying between none and exceptionally high importance.
Results
Results show that the goals can be subdivided into three main goal dimensions: patients, parents and staff. Furthermore, our results reveal significant differences between different professions and different hierarchical level: physicians rated patient goals with a
mean (95% CI) importance of 6.37 (3.32 to 6.43), which is significantly higher than nurses with a mean (95% CI) importance of 6.15 (6.12 to 6.19) (p<0.01). Otherwise, nurses classified parental goals as more important (p<0.01). Furthermore, professionals in leading positions rate patient goals significantly higher than professionals that are not in leading positions (6.36 (3.28 to 6.44) vs 6.19 (6.15 to 6.22), p<0.01).
Conclusions
Different employee goals need to be considered in decision-making
processes to enhance employee motivation and the effectiveness of teamwork.
Wearable sensors in healthcare and sensor-enhanced health information systems: all our tomorrows?
(2012)
Wearable sensor systems which allow for remote or self-monitoring of health-related parameters are regarded as one means to alleviate the consequences of demographic change. This paper aims to summarize current research in wearable sensors as well as in sensor-enhanced health information systems. Wearable sensor technologies are already advanced in terms of their technical capabilities and are frequently used for cardio-vascular monitoring. Epidemiologic predictions suggest that neuro-psychiatric diseases will have a growing impact on our health systems and thus should be addressed more intensively. Two current project examples demonstrate the benefit of wearable sensor technologies: long-term, objective measurement under daily-life, unsupervised conditions. Finally, up-to-date approaches for the implementation of sensor-enhanced health information systems are outlined. Wearable sensors are an integral part of future pervasive, ubiquitous and person-centered health
care delivery. Future challenges include their integration into sensor-enhanced health information systems and sound evaluation studies involving measures of workload reduction and costs.
Der folgende Beitrag fasst die jüngsten Ergebnisse einer Studierendenbefragung zusammen, die im Rahmen des BMBF-geförderten Forschungsprojekts „ZEITLast: Lehrzeit und Lernzeit: Studierbarkeit der BA-/BSc- und MA-/MSc- Studiengänge als Adaption von Lehrorganisation und Zeitmanagement unter Berücksichtigung von Fächerkultur und Neuen Technologien“ im Wintersemester 2010/2011 in den beiden Studiengängen „Informationsmanagement und Informationstechnologie“ und „Polyvalenter 2-Fächer-Bachelor-Studiengang mit Lehramtsoption“ an der Stiftung Universität Hildesheim durchgeführt wurde. Dieser Befragung ging in beiden Studiengängen eine Zeitbudgeterhebung voraus. Zentrale Ergebnisse werden im Folgenden vorgestellt und im Weiteren exemplarisch in den wissenschaftlichen Diskurs eingebunden. Deutlich wird, dass das Gefühl von Belastung nicht auf die reine Zeitinvestition in das Studium zurückzuführen ist, sondern auch in engem Zusammenhang mit der vorherrschenden Lehrorganisation an der Hochschule und den eigenen studentischen Kompetenzen zu sehen ist.
Ausfall- und Ausfallfolgekosten sowie Wiederanlauf- und Zusatzlaufkosten zwingen auch nach betriebswirtschaftlichen Gesichtspunkten die Unternehmen, die Bedeutung und den Umfang der Instandhaltungsaktivitäten höher als bisher einzuschätzen. Der Artikel befasst sich mit der Fragen, warum die Wartung mit in das Logistik-Konzept aufgenommen werden soll.
Background: Depletion of ovarian hormone in postmenopausal women has been associated with changes in the locomotor apparatus that may compromise walking function including muscle atrophy/weakness, weight gain, and bone demineralization. Therefore, handgrip strength (HGS), bone mineral density (BMD) and body composition [percentage body fat mass (%BFM), fat mass (FM), Fat-free mass (FFM) and body mass index (BMI)], may significantly vary and predict WB in postmenopausal women. Consequently, the study sought to 1. Explore body composition, BMD and muscle strength differences between premenopausal and postmenopausal women and 2. Explore how these variables [I.e., body composition, BMD and muscle strength] relate to WB in postmenopausal women.
Method: Fifty-one pre-menopausal (35.74 + 1.52) and 50 postmenopausal (53.32 + 2.28) women were selected by convenience sampling and studied. Six explanatory variables (HGS, BMD, %BFM, FFM, BMI and FM) were explored to predict WB in postmenopausal women: Data collected were analyzed using multiple linear regression, ANCOVA, independent t-test and Pearson correlation coefficient at p < 0.05.
Result: Postmenopausal women had higher BMI(t = + 1.72; p = 0.04), %BFM(t = + 2.77; p = .003), FM(t = + 1.77; p = 0.04) and lower HGS(t = − 3.05; p = 0.001),compared to the premenopausal women. The predicted main effect of age on HGS was not significant, F(1, 197) = 0.03, p = 0.06, likewise the interaction between age and %BFM, F(1, 197) = 0.02, p = 0.89; unlike the predicted main effect of %BFM, F(1, 197) = 10.34, p = .002, on HGS. HGS was the highest predictor of WB (t = 2.203; β=0.3046) in postmenopausal women and combined with T-score right big toe (Tscorert) to produce R2 = 0.11;F (2, 47)=4.11;p = 0.02 as the best fit for the predictive model. The variance (R2) change was significant from HGS model (R2 = 0.09;p = 0.03) to HGS + Tscorert model (R2 = 0.11;p = 0.02). The regression model equation was therefore given as: WB =5.4805 + 0.1578(HGS) + (− 1.3532) Tscorert.
Conclusion: There are differences in body composition suggesting re-compartmentalization of the body, which may adversely impact the (HGS) muscle strength in postmenopausal women. Muscle strength and BMD areassociated with WB, although, only contribute to a marginal amount of the variance for WB. Therefore, other factors in addition to musculoskeletal health are necessary to mitigate fall risk in postmenopausal women.
In der detaillierten Beschäftigung mit Quellen der Sozialen Arbeit zur Entstehung der Supervision in den 1960er Jahren legt dieser Beitrag den Fokus auf die auch in der sozialpädagogischen Geschichtsschreibung weithin unterdrückten religiösen Hintergründe. In der Beschäftigung mit den Rahmenbedingungen der Supervisionsausbildung an der katholischen Akademie für Jugendfragen in Münster kann gezeigt werden, wie eng katholische Milieus und Ethiken mit der Entstehung von Supervision im nordwestdeutschen Raum verbunden waren und was das für das frühe Verständnis von Supervision und ihre weitere Entwicklung bedeutete.
Hintergrund und Fragestellung: Die durch röntgentechnische Diagnoseverfahren in der Medizin entstehende Strahlenbelastung für Patient und Personal soll laut Strahlenschutzverordnung so gering wie möglich gehalten werden. Um dieses zu erreichen ist ein professioneller und bedachter Umgang mit den Röntgengeräten unabdingbar. Dieses Verhalten kann derzeit jedoch nur theoretisch vermittelt werden, da sich ein Üben mit realer Strahlung von selbst verbietet. Daher stellt sich die Frage wie man die Strahlenschutzausbildung durch eine verbesserte Vermittlung der komplexen Thematik unterstützen kann. Methoden: Das CBT-System (Computer Based Training) virtX, welches das Erlernen der korrekten Handhabung mobiler Röntgengeräte unterstützt, wurde um Aspekte aus dem Bereich des Strahlenschutzes erweitert. Es wurde eine prototypische Visualisierung der entstehenden Streustrahlung sowie die Darstellung des Nutzstrahlenganges integriert. Des Weiteren wurde die Berechnung und Anzeige der virtuellen Einfallsdosis für das durchstrahlte Volumen sowie für den Bereich des Bildverstärkers hinzugefügt. Für die Berechnung und Visualisierung all dieser Komponenten werden die in virtX parametrisierbaren C-Bogen-Einstellungen, z.B. Stellung der Blenden, Positionierung des Röntgengerätes zum durchstrahlten Volumen und Strahlenintensität, herangezogen. Das so erweiterte System wurde auf einem dreitägigen Kurs für OP-Personal mit über 120 Teilnehmern eingesetzt und auf der Basis von Fragebögen evaluiert. Ergebnisse: Von den Teilnehmern gaben 55 einen ausgefüllten Evaluations-Fragebogen ab (Responserate 82%). Das Durchschnittsalter der 39 weiblichen und 15 männlichen Teilnehmer (einer o.A.) lag bei 33±8 Jahren, die Berufserfahrung bei 9,37±7 Jahren. Die Erfahrung mit dem C-Bogen wurde von einem Teilnehmer (2%) mit „Keine oder bisher nur Einführung erhalten“, von acht Teilnehmern (14%) mit „bediene einen C-Bogen gelegentlich“ und von 46 (84%) mit „bediene einen C-Bogen regelmäßig“ angegeben. 45 (92%) der Teilnehmer gaben an, durch die Visualisierung der Streustrahlung etwas Neues zur Vermeidung unnötiger Strahlenbelastung dazugelernt zu haben. Schlussfolgerung: Trotz einer bislang nur prototypischen Visualisierung der Streustrahlung können mit virtX zentrale Aspekte und Verhaltensweisen zur Vermeidung unnötiger Strahlenbelastung erfolgreich vermittelt werden und so Lücken der traditionellen Strahlenschutzausbildung geschlossen werden.
Hintergrund und Fragestellung: Die korrekte intraoperative Positionierung und Einstellung eines mobilen Bildverstärkers (auch C-Bogen) kann zurzeit theoretisch mit Hilfe von Lehrbüchern erlernt, am Gerät selbst aber nur ohne visuelle Rückmeldung, d.h. ohne ein zur Ausrichtung korrespondierendes Röntgenbild, trainiert werden. Hieraus ergibt sich die Fragestellung, inwiefern das Training der Handhabung und richtigen Einstellung des C-Bogens in verschiedenen Operationsszenarien durch ein C-Bogen Simulationssystem als Teil eines CBT-Systems (Computer Based Training) unterstützt werden kann. Methoden: In Kooperation mit Ärzten aus Unfallchirurgie und Radiologie wurde das computer-basierte Trainingssystem virtX entwickelt. virtX kann dem Nutzer verschiedene Aufgaben zur Einstellung eines C-Bogens stellen und die Ausführung und das Ergebnis bewerten. Die Aufgaben können mit Hilfe eines Autorensystems erstellt und vom Trainierenden in verschiedenen Modi erfüllt werden: im rein virtuellen Modus oder im kombinierten virtuell-realen Modus. Im rein virtuellen Modus steuert der Nutzer den virtuellen C-Bogen in einem virtuellen OP-Saal mittels einer grafisch-interaktiven Benutzungsoberfläche. Im virtuell-realen Modus hingegen wird die Ausrichtung eines realen C-Bogens erfasst und auf den virtuellen C-Bogen übertragen. Während der Aufgabenerfüllung kann der Benutzer zu jeder Zeit ein realitätsnahes, virtuelles Röntgenbild erzeugen und dabei alle Parameter wie Blendenstellung, Röntgenintensität, etc. wie bei einem realen C-Bogen steuern. virtX wurde auf einem dreitägigen Kurs für OP-Personal mit 120 Teilnehmern eingesetzt und auf der Basis von Fragebögen evaluiert. Ergebnisse: Von den Teilnehmern gaben 79 einen ausgefüllten Evaluations-Fragebogen ab. Das Durchschnittsalter der 62 weiblichen und 15 männlichen Teilnehmer (zwei o.A.) lag bei 34 ± 9 Jahren, die Berufserfahrung bei 8,3 ± 7,6 Jahren. 18 Personen (23%) gaben an, gelegentlich mit einem C-Bogen zu arbeiten, 61 (77%) arbeiteten regelmäßig damit. Über 83% der befragten Teilnehmer empfanden virtX als eine sinnvolle Ergänzung zur herkömmlichen Ausbildung am C-Bogen. Das virtuelle Röntgen wurde mit einer Zustimmung von 91% der befragten Teilnehmer als besonders wichtig für das Verständnis der Arbeitsweise eines C-Bogens beurteilt. Ebenso erhielt der kombinierte virtuell-reale Modus mit 84% Zustimmung einen vergleichsweise hohen Stellenwert. Schlussfolgerung: Die Befragung zeichnet ein positives Bild der Akzeptanz des virtX-System als substanzielle Ergänzung zur herkömmlichen Ausbildung am C-Bogen.
This study investigates the influence of traumatic events on the mental health of North Korean refugee women by examining the prevalence and severity of posttraumatic stress disorder (PTSD), depression, and anxiety in comparison with their male counterparts (women = 496; men = 131). Our results suggest that women are at greater risk of developing mental health problems than men. In particular, symptoms of PTSD and anxiety were higher among women who experienced forced repatriation to North Korea, which is operationalized as a constellation of gendered traumatic incidents such as sexual abuse, rape, witnessing infanticides, and forced abortion. The policy implications of our results and suggestions for future studies are discussed.
The use of vibrational sum-frequency spectroscopy (VSFS) to study transferred graphene, produced by chemical vapour deposition, is presented. The VSF spectrum shows a clear CeH stretching mode at ~2924 cm⁻¹, which is attributed to residue of the polymer used for the transfer. This makes VSFS a powerful tool to identify adsorbates and contaminants affecting the properties of graphene.
Die Mitgliederversammlung der Deutschen Gesellschaft für Supervision und Coaching e. V. (DGSv) stand 2020 äußerlich im Zeichen von Covid-19 und damit Social Distancing, inhaltlich im Zeichen der konsequenten Fortführung begonnener Strategie- und Modernisierungsprozesse des Berufs- und Fachverbandes. Gleichzeitig aktualisierten diese Prozesse die Identitätsfrage des Verbandes.
Der Artikel befasst sich mit der Zusammensetzung multiprofessioneller Teams in Beratungsstellen - bezogen auf die Grundprofessionen. Er zeigt auf, dass die Psychologie in der Geschichte der Beratungsstellen eine dominante Rolle im multiprofessionellen Gefüge übernommen hat, mit der Folge, dass bis heute um professionsspezifische Handlungsansätze der Sozialen Arbeit in der Beratung, sowie um ein gutes Verhältnis von Psychologie und Sozialer Arbeit gerungen werden muss. Es wird aufgedeckt, dass dieses Ringen auch im Umgang mit der empirisch nachgewiesenen, neuen quantitativen Dominanz der Sozialen Arbeit im multiprofessionellen Gefüge sichtbar wird und ein nur defizitorientierter, dominant psychologischer Blick darauf vermieden werden sollte.
Die Schaffung eines marktorientierten Lieferspektrums für eine optimale Marktversorgung stellt erhöhte Anforderungen an die Planung und Steuerung des Auftragsabwicklungsprozesses. Über ein betriebsspezifisch entwickeltes Logistikkonzept mit einer anforderungsgerechten CIM-Werkzeuganwahl lassen sich die vorhandenen Probleme, ein volles Fertigwarenlager mit nicht nachgefragten Fertigartikeln, lösen.
We report velocity-dependent internal energy distributions of nitric oxide molecules, NO, scattered off graphene supported on gold to further explore the dynamics of the collision process between NO radicals and graphene. These experiments were performed by directing a molecular beam of NO onto graphene in a surface-velocity map imaging setup, which allowed us to record internal energy distributions of the NO radicals as a function of their velocity. We do not observe bond formation but (1) major contributions from direct inelastic scattering and (2) a smaller trapping–desorption component where some physisorbed NO molecules have residence times on the order of microseconds. This is in agreement with our classical molecular dynamics simulations which also observe a small proportion of two- and multi-bounce collisions events but likewise a small proportion of NO radicals trapped at the surface for the entire length of the molecular dynamics simulations (a few picoseconds). Despite a collision energy of 0.31 eV, which would be sufficient to populate NO(v = 1), we do not detect vibrationally excited nitric oxide.
Worldwide, seagrass meadows are under threat. Consequently, there is a strong need for seagrass restoration to guarantee the provision of related ecosystem services such as nutrient cycling, carbon sequestration and habitat provision. Seagrass often grows in vast meadows in which the presence of seagrass itself leads to a reduction of hydrodynamic energy. By modifying the environment, seagrass thus serves as foundation species and ecosystem engineer improving habitat quality for itself and other species as well as positively affecting its own fitness. On the downside, this positive feedback mechanism can render natural recovery of vanished and destroyed seagrass meadows impossible. An innovative approach to promote positive feedback mechanisms in seagrass restoration is to create an artificial seagrass (ASG) that mimics the facilitation function of natural seagrass. ASG could provide a window of opportunity with respect to suitable hydrodynamic and light conditions as well as sediment stabilization to allow natural seagrass to re-establish. Here, we give an overview of challenges and open questions for the application of ASG to promote seagrass restoration based on experimental studies and restoration trials and we propose a general approach for the design of an ASG produced from biodegradable materials. Considering positive feedback mechanisms is crucial to support restoration attempts. ASG provides promising benefits when habitat conditions are too harsh for seagrass meadows to re-establish themselves.
For the introduction of technical nursing care innovations, a usability assessment survey is conducted by nursing staff. The questionnaire is used before and after the introduction of technical products. This poster contribution shows the latest comparison of pre- and post-surveys on selected products.
Die Einführung von EDV-Systemen zur Steuerung und Überwachung des Produktionsprozesses, also in erster Linie PPS (Produktions-Planungs- und -Steuerungs-Systeme) und BDE (Betriebsdatenerfassungs-Systeme) ist im allgemeinen mit einem grossen Arbeits- und Kostenaufwand verbunden, wobei die Effizienz der implementierten Systeme häufig nicht den Erwartungen der Nutzer entspricht. Dies trifft besonders auf die Klein- und Mittelbetriebe zu, weil dort innerhalb der Betriebsorganisation keine Planstellen für EDV-Spezialisten vorgesehen sind, die bei der Umstellung auf eine EDV-Organisation helfen könnten. Diese Stellen liessen sich mit der alleinigen Erledigung von betrieblichen EDV-Aufgaben bei dieser Betriebsgrösse auch nicht wirtschaftlich rechnen. Es muss also vor einer solchen Einführung bereits klar sein, wie aus betriebsorganisatorischer Sicht die EDV mit den vorhandenen Mitarbeitern in den Betriebsprozess einzugliedern ist.
Vor der Abgabe einer Studien- oder Abschlussarbeit ist dringend eine sorgfältige Überarbeitung in Form einer Endredaktion vorzunehmen, um eine gute Bewertung der Arbeit nicht zu gefährden. Dies ist einfach; denn das Vorgehen ist schlicht und wenig aufwändig. Daher wäre es besonders ärgerlich, einfache Fehler nicht zu beheben und dafür Abzüge bei der Bewertung der Arbeit hinzunehmen. Für eine Endredaktion wird hiermit eine Anleitung vorgelegt.
Mobile Kommunikationsgeräte wie Smartphones revolutionieren unseren (Arbeits-)Alltag. Realität und Virtualität verschmelzen, und das Begriffspaar drückt keinen Gegensatz mehr aus. Sogenannte virtuelle Teams sind weit verbreitet und bisher überwiegend in Hinblick auf Führungsthematiken bearbeitet. Gruppen, die computergestützt kommunizieren, existieren aber inzwischen in allen Lebensbereichen. Damit überträgt sich das „Hier und Jetzt“-Prinzip der Gruppendynamik in die computervermittelte Kommunikationswelt. Diese Verlagerung ist auch
unter gruppendynamischen Aspekten weiter zu erforschen.
Type 2 Diabetes Mellitus: Risk Evaluation and Advice in Undergraduate Students in Ashrafieh, Lebanon
(2016)
Type 2 diabetes mellitus (T2DM) is a chronic lifestyle disease. It has become evident that T2DM occurs even among the younger age groups.1 In Lebanon, T2DM has a major public health impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities.2
Introduction
Atopic dermatitis (AD) is a common inflammatory skin disease. Many patients are initiating a systemic therapy, if the disease is not adequately controlled with topical treatment only. Currently, there is little real-world evidence on the AD-related medical care situation in Germany. This study analyzed patient characteristics, treatment patterns, healthcare resource utilization and costs associated with systemically treated AD for the German healthcare system.
Methods
In this descriptive, retrospective cohort study, aggregated anonymized German health claims data from the InGef research database were used. Within a representative sample of four million insured individuals, patients with AD and systemic drug therapy initiation (SDTI) in the index year 2017 were identified and included into the study cohort. Systemic drug therapy included dupilumab, systemic corticosteroids (SCS) and systemic immunosuppressants (SIS). Patients were observed for one year starting from the date of SDTI in 2017.
Results
9975 patients were included (57.8% female, mean age 39.6 years [SD 25.5]). In the one-year observation period, the most common systemic drug therapy was SCS (> 99.0%). Administrations of dupilumab (0.3%) or dispensations of SIS were rare (cyclosporine: 0.5%, azathioprine: 0.6%, methotrexate: 0.1%). Median treatment duration of SCS, cyclosporine and azathioprine was 27 days, 102 days, and 109 days, respectively. 2.8% of the patients received phototherapy; 41.6% used topical corticosteroids and/or topical calcineurin inhibitor. Average annual costs for medications amounted to € 1237 per patient. Outpatient services were used by 99.6% with associated mean annual costs of € 943; 25.4% had at least one hospitalization (mean annual costs: € 5836). 5.3% of adult patients received sickness benefits with associated mean annual costs of € 5026.
Conclusions
Despite unfavorable risk–benefit profile, this study demonstrated a common treatment with SCS, whereas other systemic drug therapy options were rarely used. Furthermore, the results suggest a substantial economic burden for patients with AD and SDTI.
The paper sheds light on the change in the concept of obedience within the Society of Jesus since the 1960s. In the aftermath of the Second Vatican Council, a so-called crisis of authority and obedience took place in the Catholic Church and the religious orders. As a consequence, the notions of responsibility and conscience came to the fore in the Jesuit definition of obedience. The religious concept of obedience, that is the obedience towards God, was reassessed as a service to humanity. The paper analyzes how the change in the concept of obedience gave rise to the promotion of social justice, which the Society of Jesus proclaimed at General Congregation 32 in 1974/75. By including the promotion of social justice into their central mission, Jesuits not only fundamentally transformed their self-conception, but also their ethical values. The paper argues that the pursuit of social justice became a form of religious obedience.
Background: One of the major challenges in pediatric intensive care is the detection of life-threatening health conditions under acute time constraints and performance pressure. This includes the assessment of pediatric organ dysfunction (OD) that demands extraordinary clinical expertise and the clinician’s ability to derive a decision based on multiple information and data sources. Clinical decision support systems (CDSS) offer a solution to support medical staff in stressful routine work. Simultaneously, detection of OD by using computerized decision support approaches has been scarcely investigated, especially not in pediatrics.
Objectives: The aim of the study is to enhance an existing, interoperable, and rulebased CDSS prototype for tracing the progression of sepsis in critically ill children by augmenting it with the capability to detect SIRS/sepsis-associated hematologic OD, and to determine its diagnostic accuracy.
Methods: We reproduced an interoperable CDSS approach previously introduced by our working group: (1) a knowledge model was designed by following the commonKADS methodology, (2) routine care data was semantically standardized and harmonized using openEHR as clinical information standard, (3) rules were formulated and implemented in a business rule management system. Data from a prospective diagnostic study, including 168 patients, was used to estimate the diagnostic accuracy of the rule-based CDSS using the clinicians’ diagnoses as reference
Nowadays, most recommender systems are based on a centralized architecture, which can cause crucial issues in terms of trust, privacy, dependability, and costs. In this paper, we propose a decentralized and distributed MANET-based (Mobile Ad-hoc NETwork) recommender system for open facilities. The system is based on mobile devices that collect sensor data about users locations to derive implicit ratings that are used for collaborative filtering recommendations. The mechanisms of deriving ratings and propagating them in a MANET network are discussed in detail. Finally, extensive experiments demonstrate the suitability of the approach in terms of different performance metrics.
Objectives: Injury to major white matter pathways during language-area associated glioma surgery often leads to permanent loss of neurological function. The aim was to establish standardized tractography of language pathways as a predictor of language outcome in clinical neurosurgery.
Methods: We prospectively analyzed 50 surgical cases of patients with left perisylvian, diffuse gliomas. Standardized preoperative Diffusion-Tensor-Imaging (DTI)-based tractography of the 5 main language tracts (Arcuate Fasciculus [AF], Frontal Aslant Tract [FAT], Inferior Fronto-Occipital Fasciculus [IFOF], Inferior Longitudinal Fasciculus [ILF], Uncinate Fasciculus [UF]) and spatial analysis of tumor and tracts was performed. Postoperative imaging and the resulting resection map were analyzed for potential surgical injury of tracts. The language status was assessed preoperatively, postoperatively and after 3 months using the Aachen Aphasia Test and Berlin Aphasia Score. Correlation analyses, two-step cluster analysis and binary logistic regression were used to analyze associations of tractography results with language outcome after surgery.
Results: In 14 out of 50 patients (28%), new aphasic symptoms were detected 3 months after surgery. The preoperative infiltration of the AF was associated with functional worsening (cc = 0.314; p = 0.019). Cluster analysis of tract injury profiles revealed two areas particularly related to aphasia: the temporo-parieto-occipital junction (TPO; temporo-parietal AF, middle IFOF, middle ILF) and the temporal stem/peri-insular white matter (middle IFOF, anterior ILF, temporal UF, temporal AF). Injury to these areas (TPO: OR: 23.04; CI: 4.11 – 129.06; temporal stem: OR: 21.96; CI: 2.93 – 164.41) was associated with a higher-risk of persisting aphasia.
Conclusions: Tractography of language pathways can help to determine the individual aphasia risk profile presurgically. The TPO and temporal stem/peri-insular white matter were confirmed as functional nodes particularly sensitive to surgical injuries.
Appropriate data models are essential for the systematic collection, aggregation, and integration of health data and for subsequent analysis. However, recommendations for modeling health data are often not publicly available within specific projects. Therefore, the project Zukunftslabor Gesundheit investigates recommendations for modeling. Expert interviews with five experts were conducted and analyzed using qualitative content analysis. Based on the condensed categories “governance”, “modeling” and “standards”, the project team generated eight hypotheses for recommendations on health data modeling. In addition, relevant framework conditions such as different roles, international cooperation, education/training and political influence were identified. Although emerging from interviewing a small convenience sample of experts, the results help to plan more extensive data collections and to create recommendations for health data modeling.
In the context of the ongoing digitization of interdisciplinary subjects, the need for digital literacy is increasing in all areas of everyday life. Furthermore, communication between science and society is facing new challenges, not least since the COVID-19 pandemic. In order to deal with these challenges and to provide target-oriented online teaching, new educational concepts for the transfer of knowledge to society are necessary. In the transfer project “Zukunftslabor Gesundheit” (ZLG), a didactic concept for the creation of E-Learning classes was developed. A key factor for the didactic concept is addressing heterogeneous target groups to reach the broadest possible spectrum of participants. The concept has already been used for the creation of the first ZLG E-Learning courses. This article outlines the central elements of the developed didactic concept and addresses the creation of the ZLG courses. The courses created so far appeal to different target groups and convey diverse types of knowledge at different levels of difficulty.
Toward a service-based workflow for automated information extraction from herbarium specimens
(2018)
Over the past years, herbarium collections worldwide have started to digitize millions of specimens on an industrial scale. Although the imaging costs are steadily falling, capturing the accompanying label information is still predominantly done manually and develops into the principal cost factor. In order to streamline the process of capturing herbarium specimen metadata, we specified a formal extensible workflow integrating a wide range of automated specimen image analysis services. We implemented the workflow on the basis of OpenRefine together with a plugin for handling service calls and responses. The evolving system presently covers the generation of optical character recognition (OCR) from specimen images, the identification of regions of interest in images and the extraction of meaningful information items from OCR. These implementations were developed as part of the Deutsche Forschungsgemeinschaft funded a standardised and optimised process for data acquisition from digital images of herbarium specimens (StanDAP-Herb) Project.
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.
4753 Webseiten wurden mit der Open-Source-Software webXray auf die Einbindung von Elementen untersucht, durch die Dritte über den Abruf einer Webseite durch einen Browser von einem Server informiert werden können. 54,77 % der analysierten Webseiten wiesen solche Third Party Elements (TPE) auf. 18,94 % setzten Cookies ein, 44,81 % banden Javascript von Drittanbietern ein. Google-Services dominieren die TPE-Anbieterliste, sie werden in 30,02 % der untersuchten Webseiten verwendet
Der Bachelorstudiengang „Bibliotheks- und Informationsmanagement“ der Hochschule für den öffentlichen Dienst in Bayern (HföD) zeichnet sich durch seinen starken Praxisbezug aus. Mit der spezifischen Ausrichtung auf die wissenschaftlichen Bibliotheken, dem mehrstufigen Auswahlverfahren der Studierenden, der Gestaltung der beiden Praxismodule, der Konzeption des theoretischen Unterrichts und den begleitenden Veranstaltungen sowie den Strukturen, in die der Studiengang eingebunden ist, werden in dem vorliegenden Aufsatz die wichtigsten Elemente für diese starke Praxisbezogenheit vorgestellt.
From an ethical perspective, clinical research involving humans is only acceptable if it involves the potential for benefit. Various characteristics can be applied to differentiate research benefit. Often benefit is categorized in direct or indirect benefit, whereby indirect benefit might be further differentiated in collective or benefit for the society, excluding or including the trial patient in the long term. Ethical guidelines, such as the Declaration of Helsinki in its latest version, do not precisely favor a particular type of benefit.
The practice, attitude, and knowledge of complementary and alternative medicine in Mumbai, India
(2020)
Background: In the recent times, there has been a resurging interest in the use of complementary and alternative medicine (CAM) in India. The present study was conducted to examine the prevalence of CAM use in Mumbai, the knowledge and attitude regarding CAM regarding its safety and efficacy and the reasons for the use of CAM.
Methods: A cross-sectional study was conducted among the general population of Mumbai and its adjoining regions during January-July 2020. 205 residents participated in the study and were asked to fill a pretested questionnaire. The collected data was analyzed using IBM SPSS version 23.
Results: Out of the 205 responses, 163 (79.51%) agreed to have used CAM at least once in their life. Of these, 108 (52.68%) respondents used Ayurveda and 105 (51.21%) used homeopathy. 60 (36.81%) of the respondents practicing CAM used it for common gastrointestinal (GIT)-related disorder with a 100% recovery rate, 125 (76.67%) for infectious diseases with a 93.6% recovery rate. 99 (60.74%) of the respondents preferring CAM for its safety profile, 68 (41.72%) believed that CAM is time tested and thus is efficacious. An integrative approach was suggested by 118 (57.56%) of all the respondents.
Conclusions: There is a disparity between the high prevalence in the use of CAM and its knowledge. However, a general consensus suggests that CAM is efficacious and is practiced for various indications.
The aim of the podcast Digitization of Medicine is to interest a broader audience and, in particular, young women, in research and work in the field of medical informatics. This article presents the usage figures and discusses their significance for further research on the success of science communication. By 24/02/2022, a total of 24,351 downloads had been made. There were slightly more female than male listeners, and they tended to be younger. Despite the importance podcast are gaining for science communication, little is known about the respective user group and further research is needed. In this context, this paper aims to help make the effectiveness of podcasts comparable.
This paper reflects the content of the presentation “The Next Generation: Ethernet-APL for Safety Systems” at the NAMUR Annual General Meeting 2022. It deals with the use of the Ethernet Advanced Physical Layer (Ethernet-APL) in combination with the PROFINET/PROFIsafe protocol for safety applications. It describes the virtues of the digital communication between the field and safety system. In parallel the aspect of OT security for this use case is touched as well. The paper proposes a secure architecture, where safety- and non-safety field communications are still separated. At the end a set of requirements for the development of future APL devices is described.
The paper presents a comprehensive model of a banking system that integrates network effects, bankruptcy costs, fire sales, and cross-holdings. For the integrated financial market we prove the existence of a price-payment equilibrium and design an algorithm for the computation of the greatest and the least equilibrium. The number of defaults corresponding to the greatest price-payment equilibrium is analyzed in several comparative case studies. These illustrate the individual and joint impact of interbank liabilities, bankruptcy costs, fire sales and cross-holdings on systemic risk. We study policy implications and regulatory instruments, including central bank guarantees and quantitative easing, the significance of last wills of financial institutions, and capital requirements.
Chronic kidney disease is one of the main causes of mortality worldwide. It affects more than 800 million patients globally, accounting for approximately 10% of the general population. The significant burden of the disease prompts healthcare systems to implement adequate preventive and therapeutic measures. This systematic review and meta-analysis aimed to provide a concise summary of the findings published in the existing body of research about the influence that mobile health technology has on the outcomes of patients with the disease. A comprehensive systematic literature review was conducted from inception until March 1st, 2023. This systematic review and meta-analysis included all clinical trials that compared the efficacy of mobile app-based educational programs to that of more conventional educational treatment for the patients. Eleven papers were included in the current analysis, representing 759 CKD patients. 381 patients were randomly assigned to use the mobile apps, while 378 individuals were assigned to the control group. The mean systolic blood pressure was considerably lower in the mobile app group (MD -4.86; 95%-9.60, -0.13; p=0.04). Meanwhile, the mean level of satisfaction among patients who used the mobile app was considerably greater (MD 0.75; 95% CI 0.03, 1.46; p=0.04). Additionally, the mean self-management scores in the mobile app groups were significantly higher (SMD 0.534; 95% CI 0.201, 0.867; p=0.002). Mobile health applications are potentially valuable interventions for patients. This technology improved the self-management of the disease, reducing the mean levels of systolic blood pressure with a high degree of patient satisfaction.
Within the HiGHmeducation consortium various online learning modules shall be developed by members of the consortium to address the increasing need for skilled professionals in a networked and digitalized healthcare system. Transferability of these modules to other locations is one main objective for the design of online learning modules. Thus, a didactical framework for online learning modules was developed. To ensure feasibility of the framework, the participating universities were analyzed concerning availability of e-learning support structures and infrastructures including learning management systems (LMS). The analysis especially focuses on the various LMS learning tools and their suitability for the framework. The framework is the basis for 12 HiGHmeducation online learning modules of which a part has firstly been conducted in winter 2019/20 and leads to a comparable structure of the modules.
The Ethernet-APL Engineering Process - A brief look at the Ethernet-APL engineering guideline
(2021)
The vision of an “Industrial Ethernet down to the sensors and actors” has become reality. At the Achema fair in June 2021 Ethernet-APL was introduced. This technology is based on a 2-wire Ethernet that conveys information as well as energy to the sensors and actuators of the automation system. Ethernet-APL is based on the 2-wire Ethernet standard IEEE 802.3cg running at 10 Mbit/s. An additional specification, the Ethernet-APL Port Profile Specification, defines additional parameters for the use of the technology in the process industry, especially in areas with potentially explosive atmospheres. As a next step, potential users need to become familiar with the engineering process of Ethernet-APL networks. For this purpose, the Ethernet-APL project provides the Ethernet-APL Engineering Guideline that covers the main areas of planning, installation and acceptance testing.
Purpose: The calculation of aggregated composite measures is a widely used strategy to reduce the amount of data on hospital report cards. Therefore, this study aims to elicit and compare preferences of both patients as well as referring physicians regarding publicly available hospital quality information.
Methods: Based on systematic literature reviews as well as qualitative analysis, two discrete choice experiments (DCEs) were applied to elicit patients’ and referring physicians’ preferences. The DCEs were conducted using a fractional factorial design. Statistical data analysis was performed using multinomial logit models.
Results: Apart from five identical attributes, one specific attribute was identified for each study group, respectively. Overall, 322 patients (mean age 68.99) and 187 referring physicians (mean age 53.60) were included. Our models displayed significant coefficients for all attributes (p < 0.001 each). Among patients, “Postoperative complication rate” (20.6%; level range of 1.164) was rated highest, followed by “Mobility at hospital discharge” (19.9%; level range of 1.127), and ‘‘The number of cases treated” (18.5%; level range of 1.045). In contrast, referring physicians valued most the ‘‘One-year revision surgery rate’’ (30.4%; level range of 1.989), followed by “The number of cases treated” (21.0%; level range of 1.372), and “Postoperative complication rate” (17.2%; level range of 1.123).
Conclusion: We determined considerable differences between both study groups when calculating the relative value of publicly available hospital quality information. This may have an impact when calculating aggregated composite measures based on consumer-based weighting.
The effects of surface temperature on the gas-liquid interfacial reaction dynamics of O(³P)+squalane
(2005)
OH/OD product state distributions arising from the reaction of gas-phase O(³P) atoms at the surface of the liquid hydrocarbon squalane C₃₀H₆₂/C₃₀D₆₂ have been measured. The O(³P) atoms were generated by 355 nm laser photolysis of NO₂ at a low pressure above the continually refreshed liquid. It has been shown unambiguously that the hydroxyl radicals detected by laser-induced fluorescence originate from the squalane surface. The gas-phase OH/OD rotational populations are found to be partially sensitive to the liquid temperature, but do not adapt to it completely. In addition, rotational temperatures for OH/OD(v′=1) are consistently colder (by 34±5 K) than those for OH/OD(v′=0). This is reminiscent of, but less pronounced than, a similar effect in the well-studied homogeneous gas-phase reaction of O(³P) with smaller hydrocarbons. We conclude that the rotational distributions are composed of two different components. One originates from a direct abstraction mechanism with product characteristics similar to those in the gas phase. The other is a trapping-desorption process yielding a thermal, Boltzmann-like distribution close to the surface temperature. This conclusion is consistent with that reached previously from independent measurements of OH product velocity distributions in complementary molecular-beam scattering experiments. It is further supported by the temporal profiles of OH/OD laser-induced fluorescence signals as a function of distance from the surface observed in the current experiments. The vibrational branching ratios for (v′=1)/(v′=0) for OH and OD have been found to be (0.07±0.02) and (0.30±0.10), respectively. The detection of vibrationally excited hydroxyl radicals suggests that secondary and/or tertiary hydrogen atoms may be accessible to the attacking oxygen atoms.
Background: The topographical correlations between certain extracranial and intracranial osseous points of interest (POIs), and their age-related changes, are indispensable to know for a diagnostical or surgical access to intracranial structures; however, they are difficult to assess with conventional devices.
Materials and methods: In this pilot study, the 3-dimensional coordinates of extra-/intracranial POIs were determined, thus avoiding perspective distortions that used to be intrinsic problems in 2-dimensional morphometry. The data sets were then analysed by creating virtual triangles. The sizes, shapes, and positions of these triangles described the extent and the directions of the age-related shifts of the POIs. A selection of extracranial and intracranial POIs were marked on half skulls of four warmblood horses in two age groups (young: 6 weeks, n = 2; old: 14 and 17 years, n = 2). The x-, y-, and z-coordinates of these POIs were determined with a measurement arm (FaroArm Fusion, FARO Europe®). Direct distances between the POIs as well as their indirect distances on the x-, y-, and z-axis, and angles were calculated.
Results: The analysed virtual triangles revealed that some parts of the skull grew in size, but did not change in shape/relative proportions (proportional type of growth, as displayed by POI A and POI B at the Arcus zygomaticus). The same POIs (A and B) remained in a very stable relationship to their closest intracranial POI at the Basis cranii on the longitudinal axis, however, shifted markedly in the dorso-lateral direction. In contrast, a disproportional growth of other parts of the cranium was, for example, related to POI C at the Crista nuchae, which shifted strongly in the caudal direction with age. A topographically stable reference point (so-called anchor point) at the Basis cranii was difficult to determine.
Conclusions: Two candidates (one at the Synchondrosis intersphenoidalis, another one at the Synchondrosis sphenooccipitalis) were relatively stable in their positions. However, the epicentre of (neuro-)cranial growth could only be pinpointed to an area between them.
BACKGROUND:
Safety climate research suggests that a corresponding climate in work units is crucial for patient safety. Intensive care units are usually co-led by a nurse and a physician, who are responsible for aligning an interprofessional workforce and warrant a high level of safety. Yet, little is known about whether and how these interprofessional co-leaders jointly affect their unit's safety climate.
PURPOSE:
This empirical study aims to explain differences in the units' safety climate as an outcome of the nurse and physician leaders' degree of shared goals. Specifically, we examine whether the degree to which co-leaders share goals in general fosters a safety climate by pronouncing norms of interprofessional cooperation as a behavioral standard for the team members' interactions.
METHODOLOGY/APPROACH:
A cross-sectional design was used to gather data from 70 neonatal intensive care units (NICUs) in Germany. Survey data for our variables were collected from the unit's leading nurse and the leading physician, as well as from the unit's nursing and physician team members. Hypotheses testing at unit level was conducted using multivariate linear regression.
RESULTS:
Our analyses show that the extent to which nurse-physician co-leaders share goals covaries with safety climate in NICUs. This relationship is partially mediated by norms of interprofessional cooperation among NICU team members. Our final model accounts for 54% of the variability in safety climate of NICUs.
CONCLUSION:
Increasing the extent to which co-leaders share goals is an effective lever to strengthen interprofessional cooperation and foster a safety climate among nursing and physician team members of hospital units.
A German university has developed a learning information system to improve information literacy among German students. An online tutorial based on this Lerninformationssystem has been developed. The structure of this learning information system is described, an online tutorial based on it is illustrated, and the different learning styles that it supports are indicated.
Targeted panel sequencing in pediatric primary cardiomyopathy supports a critical role of TNNI3
(2019)
The underlying genetic mechanisms and early pathological events of children with primary cardiomyopathy (CMP) are insufficiently characterized. In this study, we aimed to characterize the mutational spectrum of primary CMP in a large cohort of patients ≤18 years referred to a tertiary center. Eighty unrelated index patients with pediatric primary CMP underwent genetic testing with a panel-based next-generation sequencing approach of 89 genes. At least one pathogenic or probably pathogenic variant was identified in 30/80 (38%) index patients. In all CMP subgroups, patients carried most frequently variants of interest in sarcomere genes suggesting them as a major contributor in pediatric primary CMP. In MYH7, MYBPC3, and TNNI3, we identified 18 pathogenic/probably pathogenic variants (MYH7 n = 7, MYBPC3 n = 6, TNNI3 n = 5, including one homozygous (TNNI3 c.24+2T>A) truncating variant. Protein and transcript level analysis on heart biopsies from individuals with homozygous mutation of TNNI3 revealed that the TNNI3 protein is absent and associated with upregulation of the fetal isoform TNNI1. The present study further supports the clinical importance of sarcomeric mutation-not only in adult-but also in pediatric primary CMP. TNNI3 is the third most important disease gene in this cohort and complete loss of TNNI3 leads to severe pediatric CMP.
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.
Systematizing IT Risks
(2019)
IT risks — risks associated with the operation or use of information technology — have taken on great importance in business, and IT risk management is accordingly important in the science and practice of information management. Therefore, it is necessary to systematize IT risks in order to plan, manage and control for different risk-specific measures. In order to choose and implement suitable measures for managing IT risks, effect-based and causebased procedures are necessary. These procedures are explained in detail for IT security risks because of their special importance.
Die Marktentwicklung zu kleineren Losgrößen mit zunehmender Variantenvielfalt stellt gerade an einen Programmfertiger erhebliche Anfordungen, um immer das richtige Lieferspektrum in seinem Fertigwarenlager bereitzuhalten. Die einfachste Möglichkeit, dieses Problem zu lösen, besteht in einer hochflexiblen Produktion, bei der die nachgefragten Artikel in der Kundenausführung sofort nach Auftragseingang gefertigt werden. In der Praxis entstehen aber erhebliche Rückstände, weil keine unbegrenzte Kapazität zur Erledigung dieses Aufgabenberges vorhanden wäre.
"Coded Mark Inversion" (CMI) und "Manchester" (MAN) sind häufig verwendete binäre Leitungscodes. Die Synthese von Decodierer-Schaltungen kann mit Booleschen Funktionstabellen und Automatendiagrammen erfolgen. Diese Daten lassen sich in ein Logiksynthese-Softwarepaket eingeben und liefern als Ergebnis eine standardisierte Datei zur Programmierung eines geeigneten Logikbausteins. Die einzelnen Entwicklungsschritte von der umgangssprachlichen Problembeschreibung bis zur Programmierung sind hier erläutert.
Purpose. To identify stroke survivors with symptoms of poststroke depression and the extent of psychiatry needs and care they have received while on physiotherapy rehabilitation. Participants. Fifty stroke survivors (22 females and 28 males) at the outpatient unit of Physiotherapy Department, University of Nigeria Teaching Hospital, Enugu, who gave their informed consent, were randomly selected. Their age range and mean age were 26–66 years and 54.76 ± 8.79 years, respectively. Method. A multiple case study of 50 stroke survivors for symptoms of poststroke depression was done with Beck’s Depression Inventory, mini mental status examination tool, and Modified Motor Assessment Scale. The tests were performed independently by the participants except otherwise stated and scored on a scale of 0–6. Data were analyzed using -test for proportional significance and chi-square test for determining relationship between variables, at p < 0.05. Results. Twenty-one (42.0%) stroke survivors had symptoms of PSD, which was significantly dependent on duration of stroke ( = 21.680, df = 6, and p = 0.001), yet none of the participants had a psychiatry review. Conclusions. Symptoms of PSD may be common in cold compared to new cases of stroke and may need psychiatry care while on physiotherapy rehabilitation.
Am 12. und 13. Juni 1986 fand in Konstanz das Symposium Haftung von Verbundwerkstoffen und Werkstoffverbunden statt. Die Veranstaltung wird in vierjährigem Turnus von der Deutschen Gesellschaft für Metallkunde (DGM) in Zusammenarbeit mit dem Fraunhofer-Institut für angewandte Materialforschung (IFAM) in Bremen ausgerichtet. Als interdisziplinäres Thema stand die Haftung zwischen unterschiedlichen Stoffen auf dem Programm. In 18 Referaten sind Erkenntnisse und Probleme aus unterschiedlichen Arbeitsbereichen vorgetragen worden. Insgesamt nahmen etwas 100 Fachleute aus dem In- und Ausland teil.
The authors describe the application of a combination of velocity map imaging and time-of-flight (TOF) techniques to obtain three-dimensional velocity distributions for surface photodesorption. They have established a systematic alignment procedure to achieve correct and reproducible experimental conditions. It includes four steps: (1) optimization of the velocity map imaging ion optics’ voltages to achieve optimum velocity map imaging conditions; (2) alignment of the surface normal with the symmetry axis (ion flight axis) of the ion optics; (3) determination of TOF distance between the surface and the ionizing laser beam; (4) alignment of the position of the ionizing laser beam with respect to the ion optics. They applied this set of alignment procedures and then measured Br(²P₃/₂) (Br) and Br(²P₁/₂) (Br∗) atoms photodesorbing from a single crystal of KBr after exposure to 193 nm light. They analyzed the velocity flux and energy flux distributions for motion normal to the surface. The Br∗ normal energy distribution shows two clearly resolved peaks at approximately 0.017 and 0.39 eV, respectively. The former is slightly faster than expected for thermal desorption at the surface temperature and the latter is hyperthermal. The Br normal energy distribution shows a single broad peak that is likely composed of two hyperthermal components. The capability that surface three-dimensional velocity map imaging provides for measuring state-specific velocity distributions in all three dimensions separately and simultaneously for the products of surface photodesorption or surface reactions holds great promise to contribute to our understanding of these processes.
Surface atomic relaxation and magnetism on hydrogen-adsorbed Fe(110) surfaces from first principles
(2016)
We have computed adsorption energies, vibrational frequencies, surface relaxation and buckling for hydrogen adsorbed on a body-centred-cubic Fe(110) surface as a function of the degree of H coverage. This adsorption system is important in a variety of technological processes such as the hydrogen embrittlement in ferritic steels, which motivated this work, and the Haber–Bosch process. We employed spin-polarised density functional theory to optimise geometries of a six-layer Fe slab, followed by frozen mode finite displacement phonon calculations to compute Fe–H vibrational frequencies. We have found that the quasi-threefold (3f) site is the most stable adsorption site, with adsorption energies of ∼3.0 eV/H for all coverages studied. The long-bridge (lb) site, which is close in energy to the 3f site, is actually a transition state leading to the stable 3f site. The calculated harmonic vibrational frequencies collectively span from 730 to 1220 cm−1, for a range of coverages. The increased first-to-second layer spacing in the presence of adsorbed hydrogen, and the pronounced buckling observed in the Fe surface layer, may facilitate the diffusion of hydrogen atoms into the bulk, and therefore impact the early stages of hydrogen embrittlement in steels.
Der Autor setzt sich mit der Frage auseinander, ob pastoralpsychologisch ausgebildete Seelsorger/innen besonders geeignet sind, Mitarbeitende in Kirche und Diakonie zu supervidieren? In der Auseinandersetzung mit Vertretern der pastoralpsychologischen Supervision kommt er zu dem Ergebnis, dass die postulierten Vorteile nur dann zum Tragen kommen, wenn die Supervisoren ihre berufsbezogene Beratungstätigkeit von der theologischen Arbeit zu unterscheiden und zu trennen wissen.
Background
The eResearch system “Prospective Monitoring and Management App (PIA)” allows researchers to implement questionnaires on any topic and to manage biosamples. Currently, we use PIA in the longitudinal study ZIFCO (Integrated DZIF Infection Cohort within the German National Cohort) in Hannover (Germany) to investigate e.g. associations of risk factors and infectious diseases. Our aim was to assess user acceptance and compliance to determine suitability of PIA for epidemiological research on transient infectious diseases.
Methods
ZIFCO participants used PIA to answer weekly questionnaires on health status and report spontaneous onset of symptoms. In case of symptoms of a respiratory infection, the app requested participants to self-sample a nasal swab for viral analysis. To assess user acceptance, we implemented the System Usability Scale (SUS) and fitted a linear regression model on the resulting score. For investigation of compliance with submitting the weekly health questionnaires, we used a logistic regression model with binomial response.
Results
We analyzed data of 313 participants (median age 52.5 years, 52.4% women). An average SUS of 72.0 reveals good acceptance of PIA. Participants with a higher technology readiness score at the beginning of study participation also reported higher user acceptance. Overall compliance with submitting the weekly health questionnaires showed a median of 55.7%. Being female, of younger age and being enrolled for a longer time decreased the odds to respond. However, women over 60 had a higher chance to respond than women under 60, while men under 40 had the highest chance to respond. Compliance with nasal swab self-sampling was 77.2%.
Discussion
Our findings show that PIA is suitable for the use in epidemiologic studies with regular short questionnaires. Still, we will focus on user engagement and gamification for the further development of PIA to help incentivize regular and long-term participation.
The ability to functionalize graphene with several methods, such as radical reactions, cycloadditions, hydrogenation, and oxidations, allows this material to be used in a large range of applications. In this framework, it is essential to be able to control the efficiency and stability of the functionalization process—this requires understanding how the graphene reactivity is affected by the environment, including the substrate. In this work we provide an insight on the substrate dependence of graphene reactivity towards hydrogenation by comparing three different substrates: silicon, hexagonal boron nitride (h-BN), and molybdenum disulfide (MoS2). Although MoS2 and h-BN have flatter surfaces than silicon, we found that the H coverage of graphene on h-BN is about half of the H coverage on graphene on both silicon and MoS2. Therefore, graphene shows strongly reduced reactivity towards hydrogenation when placed on h-BN. The difference in hydrogenation reactivity between h-BN and MoS2 may indicate a stronger van der Waals force between graphene and h-BN, compared to MoS2, or may be related to the chemical properties of MoS2, which is a well-known catalyst for hydrogen evolution reactions.
Die Analyse von Struktureffekten in der „Allgemeine Milchbehandlung“ wird anhand zweier Fragen vorgenommen:
1. Welche Effekte hat die Größe der Abteilung auf die Produktionskosten?
2. Welche Kosteneinsparungen hätten - ausgehend von der bundesdeutschen Ist-Struktur milchverarbeitender Betriebsstätten - moderate Strukturveränderungen zur
Folge?
Struktureffekte bei der Schnittkäseproduktion. Thesen und Argumente zur Molkereistruktur Teil III
(1990)
Im Rahmen dieses Beitrages wird die Wechselwirkung zwischen abteilungsspezifischen Produktionskosten und der Struktur von Produktionsabteilungen für die Herstellung von Schnittkäse untersucht. Die Analyse eventueller Struktureffekte geschieht in zwei Schritten: zuerst wird der Einfluß unterschiedlicher Kapazitätsgrößen und -auslastungen von Käsereiabteilungen auf die Produktionskosten bestimmt. Danach wird der Frage nachgegangen, wie die Produktionsstrukturen für Schnittkäse in der BR Deutschland aussehen und welche Kosteneinsparungspotentiale sich bei moderaten Strukturveränderungen ergeben.
A proven method to enhance the mechanical properties of additively manufactured plastic parts is the embedding of continuous fibers. Due to its great flexibility, continuous fiber-reinforced material extrusion allows fiber strands to be deposited along optimized paths. Nevertheless, the fibers have so far been embedded in the parts contour-based or on the basis of regular patterns. The outstanding strength and stiffness properties of the fibers in the longitudinal direction cannot be optimally utilized. Therefore, a method is proposed which allows to embed fibers along the principal stresses into the parts in a load-oriented manner. A G-code is generated from the calculated principal stress trajectories and the part geometry, which also takes into account the specific restrictions of the manufacturing technology used. A distinction is made between fiber paths and the matrix so that the average fiber volume content can be set in a defined way. To determine the mechanical properties, tensile and flexural tests are carried out on specimens consisting of carbon fiber-reinforced polyamide. In order to increase the influence of the principal stress-based fiber orientation, open-hole plates are used for the tensile tests, as this leads to variable stresses across the cross section. In addition, a digital image correlation system is used to determine the deformations during the mechanical tests. It was found that the peak load of the optimized open-hole plates was greater by a factor of 3 and the optimized flexural specimens by a factor of 1.9 than the comparison specimens with unidirectional fiber alignment.
Streptococcus dysgalactiae is among the most important pathogens causing bovine mastitis. Unfortunately, there is presently a lack of clear knowledge about the mode of transmission — contagious or environmental — of this pathogen. To obtain more information on this, knowledge of the genetic diversity of the isolated microorganisms at the farm level can be useful. To observe the strain variety in different herds of cattle, isolates of Strep. dysgalactiae were collected from clinical mastitis samples at different farms, and the strains were typed using the pulsed-field gel electrophoresis (PFGE) method. Overall, we performed strain typing on 93 isolates from 16 farms in Germany and used an index to describe the degree of contagiosity of Strep. dysgalactiae at each farm. This index (CI) represents the number of isolates divided by the number of strains found in mastitis milk of clinical cases within a period of 14 months. The results differed between the farms. In one farm, all six Strep. dysgalactiae cases that occurred during the study period were caused by a single strain (CI = 6), while in another farm the six cases that occurred were caused by five different strains (CI = 1.2). All other farms fell between these two extremes. This indicates that Strep. dysgalactiae infections can occur via several routes of transmission. At the farm level, strain comparisons are necessary to determine the routes of transmission. Two strains were able to survive on the farm for a minimum of 14 months.
To effectively prevent and control bovine mastitis, farmers and their advisors need to take infection pathways and durations into account. Still, studies exploring both aspects through molecular epidemiology with sampling of entire dairy cow herds over longer periods are scarce. Therefore, quarter foremilk samples were collected at 14-d intervals from all lactating dairy cows (n = 263) over 18 wk in one commercial dairy herd. Quarters were considered infected with Staphylococcus aureus, Streptococcus uberis, or Streptococcus dysgalactiae when ≥100 cfu/mL of the respective pathogen was detected, or with Staphylococcus epidermidis or Staphylococcus haemolyticus when ≥500 cfu/mL of the respective pathogen was detected. All isolates of the mentioned species underwent randomly amplified polymorphic DNA (RAPD)-PCR to explore strain diversity and to distinguish ongoing from new infections. Survival analysis was used to estimate infection durations. Five different strains of Staph. aureus were isolated, and the most prevalent strain caused more than 80% of all Staph. aureus infections (n = 46). In contrast, 46 Staph. epidermidis and 69 Staph. haemolyticus strains were isolated, and none of these caused infections in more than 2 different quarters. The 3 most dominant strains of Strep. dysgalactiae (7 strains) and Strep. uberis (18 strains) caused 81% of 33 and 49% of 37 infections in total, respectively. The estimated median infection duration for Staph. aureus was 80 d, and that for Staph. epidermidis and Staph. haemolyticus was 28 and 22 d, respectively. The probability of remaining infected with Strep. dysgalactiae or Strep. uberis for more than 84 and 70 d was 58.7 and 53.5%, respectively. Staphylococcus epidermidis and Staph. haemolyticus were not transmitted contagiously and the average infection durations were short, which brings into question whether antimicrobial treatment of intramammary infections with these organisms is justified. In contrast, infections with the other 3 pathogens lasted longer and largely originated from contagious transmission.
Economic and political/governmental infrastructural factors are major contributors to the economic development/growth of all sectors of a country, such as in the area of healthcare systems and clinical research, including the pharmaceutical industry. But what is the interaction between economic, and political/governmental infrastructural factors and the development of healthcare systems, especially, the performance of the pharmaceutical industry? Information from selected articles of a literature search of PubMed and by using Google Advanced Search led to the generation of five categories of infrastructural factors, and were filled with data from 41 African Countries using the World Health Organization data repository. Median changes over time were given and tested by Wilcoxon signed-rank test and Friedman test, respectively. Analysis of factors related to availability of healthcare facilities showed that physicians and pharmacies were significant increased, with insignificantly decreased number of hospital beds. Healthcare Financing by the Government showed notable differences. Private health spending decreased significantly unlike Gross National Income. Analysis of infrastructural factors showed that stable supply of electricity and the associated use of the Internet improved significantly. The low level of data on the expansion of paved road networks suggests less developed medical services in remote rural areas. Healthcare systems in African countries improved over the last two decades, but differences between the individual countries still prevail and some of the countries cannot yet offer an attractive sales market for the products of pharmaceutical companies.
Staphylococcus aureus is recognized worldwide as one of the major agents of dairy cow intra-mammary infections. This microorganism can express a wide spectrum of pathogenic factors used to attach, colonize, invade and infect the host. The present study evaluated 120 isolates from eight different countries that were genotyped by RS-PCR and investigated for 26 different virulence factors to increase the knowledge on the circulating genetic lineages among the cow population with mastitis. New genotypes were observed for South African strains while for all the other countries new variants of existing genotypes were detected. For each country, a specific genotypic pattern was found. Among the virulence factors, fmtB, cna, clfA and leucocidins genes were the most frequent. The sea and sei genes were present in seven out of eight countries; seh showed high frequency in South American countries (Brazil, Colombia, Argentina), while sel was harboured especially in one Mediterranean country (Tunisia). The etb, seb and see genes were not detected in any of the isolates, while only two isolates were MRSA (Germany and Italy) confirming the low diffusion of methicillin resistance microorganism among bovine mastitis isolates. This work demonstrated the wide variety of S. aureus genotypes found in dairy cattle worldwide. This condition suggests that considering the region of interest might help to formulate strategies for reducing the infection spreading.
Wenn 12- bis 13-jährige Kinder mit diversen von ihnen begangenen Straftaten die Öffentlichkeit in Aufruhr versetzen, wird - besonders nach schweren Fällen - oft eine härtere Gangart gefordert. Doch längst nicht so viele Kinder, wie die Medien uns weis machen wollen, sind delinquent. Und anstatt zu fragen, ob und wie man problematischen Kindern und Jugendlichen bereits zu Beginn ihrer Jugendhilfekarrieren sinnvoll helfen kann, diskutiert die Politik über geschlossene Unterbringung und andere Formen strengerer Settings von sogenannten "Monsterkids". In dieser Diplomarbeit wird soziale Gruppenarbeit als Alternative diskutiert.
Nowadays, problems related with solid waste management become a challenge for most countries due to the rising generation of waste, related environmental issues, and associated costs of produced wastes. Effective waste management systems at different geographic levels require accurate forecasting of future waste generation. In this work, we investigate how open-access data, such as provided from the Organisation for Economic Co-operation and Development (OECD), can be used for the analysis of waste data. The main idea of this study is finding the links between socioeconomic and demographic variables that determine the amounts of types of solid wastes produced by countries. This would make it possible to accurately predict at the country level the waste production and determine the requirements for the development of effective waste management strategies. In particular, we use several machine learning data regression (Support Vector, Gradient Boosting, and Random Forest) and clustering models (k-means) to respectively predict waste production for OECD countries along years and also to perform clustering among these countries according to similar characteristics. The main contributions of our work are: (1) waste analysis at the OECD country-level to compare and cluster countries according to similar waste features predicted; (2) the detection of most relevant features for prediction models; and (3) the comparison between several regression models with respect to accuracy in predictions. Coefficient of determination (R2), Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and Mean Absolute Percentage Error (MAPE), respectively, are used as indices of the efficiency of the developed models. Our experiments have shown that some data pre-processings on the OECD data are an essential stage required in the analysis; that Random Forest Regressor (RFR) produced the best prediction results over the dataset; and that these results are highly influenced by the quality of available socio-economic data. In particular, the RFR model exhibited the highest accuracy in predictions for most waste types. For example, for “municipal” waste, it produced, respectively, R2 = 1 and MAPE = 4.31 global error values for the test set; and for “household” waste, it, respectively, produced R2 = 1 and MAPE = 3.03. Our results indicate that the considered models (and specially RFR) all are effective in predicting the amount of produced wastes derived from input data for the considered countries.
Mobile Kommunikationsgeräte wie Smartphones spielen eine wichtige Rolle für die Effizienzsteigerung, Verdichtung und Subjektivierung von Arbeit. Sie entgrenzen vielfach und haben Einfluss auf die Arbeitsorganisation wie auf Erschöpfung und Erholung. Gesetzliche Regelungen werden in Organisationen nicht umgesetzt oder passen nicht. Organisationen fällt es schwer, selbst Regelungen zu finden, weil zahlreiche Widersprüche bestehen. Dennoch ist es für Organisationen sowohl unter Wettbewerbsaspekten wie in Fragen der Betrieblichen Gesundheitsförderung ratsam, Klärungsprozesse zu Erreichbarkeitszeiten durchzuführen. Beratung kann Aushandlungsprozesse unterstützen.