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- Ökonomisierung (1)
- Übergewicht (1)
- Übertragung von Heilkunde (1)
- Übertragungsplan (1)
- Übung (1)
Background: In Germany, hospice and palliative care is well covered through inpatient, outpatient, and home-based care services. It is unknown if, and to what extent, there is a need for additional day care services to meet the specific needs of patients and caregivers.
Methods: Two day hospices and two palliative day care clinics were selected. In the first step, two managers from each facility (n = 8) were interviewed by telephone, using a semi-structured interview guide. In the second step, four focus groups were conducted, each with three to seven representatives of hospice and palliative care from the facilities’ hospice and palliative care networks. Interviews and focus groups were audio recorded, transcribed verbatim and analyzed using qualitative content analysis.
Results: The interviewed experts perceived day care services as providing additional patient and caregiver benefits. Specifically, the services were perceived to meet patient needs for social interaction and bundled treatments, especially for patients who did not fit into inpatient settings (due to, e.g., their young age or a lack of desire for inpatient admission). The services were also perceived to meet caregiver needs for support, providing short-term relief for the home care situation.
Conclusions: The results suggest that inpatient, outpatient, and home-based hospice and palliative care services do not meet the palliative care needs of all patients. Although the population that is most likely to benefit from day care services is assumed to be relatively small, such services may meet the needs of certain patient groups more effectively than other forms of care.
Background: This basically anatomical study focuses on two items; firstly, the establishment of a system for the cartographic subdivision of the neopallium; secondly, the topographical correlation of extracranial landmarks and intracranial sites on the neopallium.
Materials and methods: The surface of the neopallium was subdivided into 15 sectors with reference to a newly introduced pattern of Primary Sulci. The topographical link between extracranial landmarks and certain intracranial sites (i.e. neopallium sectors) was elaborated by using a simple stereotactic device and a computer-assisted measurement device. Measurements were performed between points on the head's outer surface and on the isolated brain.
Results and Conclusions: The introduction of an anatomical three-dimensional coordinate system was an essential key issue for this investigation. This setting facilitated the measurements and calculations of the so-called indirect distances that were characterised by their alignment along the three orthogonal axes (x, y, z) of the anatomical coordinate system. The inter-individual comparison (16 adult horses [Equus caballus]) of the indirect distances revealed that each sector centre lay within a distinct morphometric residence area. The measured and calculated data also showed that each sector centre could be assigned to its proper extracranial landmark that - in comparison with other landmarks - was best suited for the optimal allocation of the sector centre point.
Report of a research project of the Fachhochschule Hannover, University of Applied Sciences and Arts, Department of Information Technologies. Automatic face recognition increases the security standards at public places and border checkpoints. The picture inside the identification documents could widely differ from the face, that is scanned under random lighting conditions and for unknown poses. The paper describes an optimal combination of three key algorithms of object recognition, that are able to perform in real time. The camera scan is processed by a recurrent neural network, by a Eigenfaces (PCA) method and by a least squares matching algorithm. Several examples demonstrate the achieved robustness and high recognition rate.
Background: Stereotactic radiosurgery (SRS) is an effective treatment for trigeminal neuralgia (TN). Nevertheless, a proportion of patients will experience recurrence and treatment-related sensory disturbances. In order to evaluate the predictors of efficacy and safety of image-guided non-isocentric radiosurgery, we analyzed the impact of trigeminal nerve volume and the nerve dose/volume relationship, together with relevant clinical characteristics.
Methods: Two-hundred and ninety-six procedures were performed on 262 patients at three centers. In 17 patients the TN was secondary to multiple sclerosis (MS). Trigeminal pain and sensory disturbances were classified according to the Barrow Neurological Institute (BNI) scale. Pain-free-intervals were investigated using Kaplan Meier analyses. Univariate and multivariate Cox regression analyses were performed to identify predictors.
Results: The median follow-up period was 38 months, median maximal dose 72.4 Gy, median target nerve volume 25mm3, and median prescription dose 60 Gy. Pain control rate (BNI I-III) at 6, 12, 24, 36, 48, and 60 months were 96.8, 90.9, 84.2, 81.4, 74.2, and 71.2%, respectively. Overall, 18% of patients developed sensory disturbances. Patients with volume ≥ 30mm3 were more likely to maintain pain relief (p = 0.031), and low integral dose (< 1.4 mJ) tended to be associated with more pain recurrence than intermediate (1.4–2.7 mJ) or high integral dose (> 2.7 mJ; low vs. intermediate: log-rank test, χ2 = 5.02, p = 0.019; low vs. high: log-rank test, χ2 = 6.026, p = 0.014). MS, integral dose, and mean dose were the factors associated with pain recurrence, while re-irradiation and MS were predictors for sensory disturbance in the multivariate analysis.
Conclusions: The dose to nerve volume ratio is predictive of pain recurrence in TN, and re-irradiation has a major impact on the development of sensory disturbances after non-isocentric SRS. Interestingly, the integral dose may differ significantly in treatments using apparently similar dose and volume constraints.
Severe mastitis can lead to considerable disturbances in the cows’ general condition and even to septicemia and death. The aim of this cross-sectional study was to identify factors associated with the severity of the clinical expression of mastitis. Streptococcus (Str.) uberis (29.9%) was the most frequently isolated pathogen, followed by coliform bacteria (22.3%). The majority of all mastitis cases (n = 854) in this study were either mild or moderate, but 21.1% were severe. It can be deduced that the combination of coliform pathogens and increasing pathogen shedding of these showed associations with severe mastitis. Furthermore, animal-related factors associated with severe disease progression were stages of lactation, and previous diseases in the period prior to the mastitis episode. Cows in early lactation had more severe mastitis. Ketosis and uterine diseases in temporal relation to the mastitis were associated with more severe mastitis in the diseased cows. Hypocalcemia was significantly associated with milder mastitis. As another factor, treatment with corticosteroids within two weeks before mastitis was associated with higher severity of mastitis. Knowledge of these risk factors may provide the basis for randomized controlled trials of the exact influence of these on the severity of mastitis.
In den letzten Jahren hat sich der Trend zu forcierter Rationalisierung, zur Automatisierung und Mechanisierung der Produktion beschleunigt. Automatisierung erfordert aber hohe Inverstitionen und lässt so den Fixkostenblock wachsen. Bei einem Rückgang der Kapazitätsauslastung rutscht das Unternehmen aber rasch in die Verlustzone. Deshalb erscheint eine Rückbesinnung auf eher flexiblere, arbeitsorientierte Organisationskonzepte sinnvoll. Vorgestellt wird ein kybernetisches Regelkreismodell mit flacher Hierarchie als "Klammer" und sich weitgehend selbstregulierenden Unternehmenseinheiten.
Bereits zum dritten Mal in Folge nahm eine zehnköpfige Gruppe Studierender der Hochschule Hannover aus dem Vollzeit- sowie dem berufsbegleitenden Bachelor-Studiengang Informationsmanagement, in Begleitung zweier Dozentinnen, an der BOBCATSSS-Konferenz teil. Nachdem bisher ausschließlich auf der Hochschulwebseite und tagesaktuell im Blog über Erfahrungen und Erlebnisse während der drei BOBCATSSS-Exkursionen berichtet wurde, folgt hiermit nun ein zusammenhängender Beitrag über die diesjährige Konferenz vom 24. bis zum 26. Januar 2018 in Riga, Lettland. Die BOBCATSSS-Konferenz ist eine internationale Konferenz der Bibliotheks- und Informationswissenschaften. Im Gegensatz zu IFLA & Co wird sie fast ausschließlich von Studierenden wechselnder Universitäten in Europa ausgerichtet.
Family risks are known to be detrimental to children’s attachment development. This study investigated whether parental sensitivity plays different roles in early attachment development in the context of risk: Sensitivity was hypothesized to mediate risk effects on attachment, as well as a moderator that shapes the relation between risk and attachment. Multiple family risks, parental sensitivity (defined as responsivity and supportive presence), and children’s attachment security of 197 infants and toddlers (Mage = 15.25 months) and their caregivers were assessed in a prospective study with a cohort-sequential-design in Germany. Caregivers’ sensitivity served as a mediator of risk effects on attachment as well as a moderator that buffers adverse consequences of risk. Early sensitivity might be relevant in setting the stage for attachment development supporting resilience.
Milk concentrates are used in the manufacturing of dairy products such as yogurt and cheese or are processed into milk powder. Processes for the nonthermal separation of water and valuable milk ingredients are becoming increasingly widespread at farm level. The technical barriers to using farm-manufactured milk concentrate in dairies are minimal, hence the suspicion that the practice of on-farm raw milk concentration is still fairly uncommon for economic reasons. This study, therefore, set out to investigate farmers’ potential willingness to adopt a raw milk concentration plant. The empirical analysis was based on discrete choice experiments with 75 German dairy farmers to identify preferences and the possible adoption of on-farm raw milk concentration. The results showed that, in particular, farmers who deemed the current milk price to be insufficient viewed on-farm concentration using membrane technology as an option for diversifying their milk sales. We found no indication that adoption would be impeded by a lack of trustworthy information on milk processing technologies or capital.
Die technische Betreuung von Produktionsanlagen durch den Anlagenhersteller oder einen Dienstleister ist in der Industrie häufig anzutreffen. Die Durchführung solcher Wartungsarbeiten erfolgt zum Großteil vor Ort an der jeweiligen Anlage. Mit der Fernwartung gibt es jedoch die Möglichkeit, die jeweiligen Arbeiten aus der Ferne durchzuführen. Unternehmen stellen sich bei der Einrichtung einer Fernwartungslösung die Frage, wie ein solches System zu planen ist. Der vorliegende Artikel beleuchtet daher, welche Anforderungen an Fernwartungssysteme zu stellen sind, welche Fernwartungskonzepte es gibt, was allgemein bei dem Einsatz eines Fernwartungssystems insbesondere aus Sicht der OT-Security zu beachten ist und wie die NOA Verification of Request bei der Fernwartung einzusetzen ist.
FID Civil Engineering, Architecture and Urbanism digital - A platform for science (BAUdigital)
(2022)
University Library Braunschweig (UB Braunschweig), University and State Library Darmstadt (ULB Darmstadt), TIB – Leibniz Information Centre for Technology and Natural Sciences and the Fraunhofer Information Centre for Planning and Building (Fraunhofer IRB) are jointly establishing a specialised information service (FID, "Fachinformationsdienst") for the disciplines of civil engineering, architecture and urbanism. The FID BAUdigital, which is funded by the German Research Foundation (DFG, "Deutsche Forschungsgemeinschaft"), will provide researchers working on digital design, planning and production methods in construction engineering with a joint information, networking and data exchange platform and support them with innovative services for documentation, archiving and publication in their data-based research.
Der Beitrag stellt zunächst die Ergebnisse einer Auswertung von Stellenanzeigen aus der Mailingliste InetBib vor, die zeigt, dass die Nachfrage nach Absolventinnen und Absolventen bibliothekarischer Studiengänge mit einer Qualifikation für den Aufgabenbereich der Vermittlung von Informationskompetenz
seit dem Jahr 2000 signifikant gestiegen ist. Ergänzend hierzu präsentieren die Autorinnen die Ergebnisse einer Befragung unter Vertreterinnen und Vertretern der bibliothekarischen Berufspraxis zu im Bereich der Vermittlung von Informationskompetenz geforderten Kompetenzen und deren
Gewichtung innerhalb der verschiedenen Qualifikationsstufen.
Flexibel mit „make or buy"
(1989)
Food protein hydrolysates are often produced in unspecific industrial batch processes. The hydrolysates composition underlies process-related fluctuations and therefore the obtained peptide fingerprint and bioactive properties may vary. To overcome this obstacle and enable the production of specific hydrolysates with selected peptides, a ceramic capillary system was developed and characterized for the continuous production of a consistent peptide composition. Therefore, the protease Alcalase was immobilized on the surface of aminosilane modified yttria stabilized zirconia capillaries with a pore size of 1.5 μm. The loading capacity was 0.3 μg enzyme per mg of capillary with a residual enzyme activity of 43%. The enzyme specific peptide fingerprint produced with this proteolytic capillary reactor system correlated with the degree of hydrolysis, which can be controlled over the residence time by adjusting the flow rate. Common food proteins like casein, sunflower and lupin protein isolates were tested for continuous hydrolysis in the developed reactor system. The peptide formation was investigated by high-performance liquid chromatography. Various trends were found for the occurrence of specific peptides. Some are just intermediately occurring, while others cumulate by time. Thus, the developed continuous reactor system enables the production of specific peptides with desired bioactive properties.
Forschungsdatenzentrum Gesundheit – Vision für eine Weiterentwicklung aus Sicht der Forschung
(2023)
Das Forschungsdatenzentrum (FDZ) Gesundheit nach der Datentransparenzverordnung (DaTraV), angesiedelt am Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM) wird Routinedaten der Gesetzlichen Krankenversicherung für die Forschung bereitstellen. Die Bereitstellung der Daten von knapp 90% der Bevölkerung in Deutschland dient dem übergeordneten Ziel, die gesundheitliche Versorgung im Hinblick auf Unter-, Über- und Fehlversorgung zu evaluieren und daraus Handlungsempfehlungen für eine evidenzbasierte Gesundheitsversorgung abzuleiten. Der gesetzliche Rahmen wird im Sozialgesetzbuch (§§ 303a-f SBG V) und zwei dazu gehörigen Verordnungen gesteckt, lässt jedoch hinreichend großen Spielraum für die Ausgestaltung auf der Organisations- und Arbeitsebene. Hier setzt das vorliegende Papier an. Aus Forscher*innensicht wurden zehn Statements für eine Weiterentwicklung formuliert, die das Potential eines Forschungsdatenzentrums aufzeigen und Ideen für die weitere zukunftsfähige Ausgestaltung und Entwicklung mit Bestandskraft darlegen.
Im Bachelorstudiengang Informationsmanagement – berufsbegleitend der HS Hannover werden seit zehn Jahren Fachangestellte für Medien- und Informationsdienste (FaMIs) für höhere Aufgaben im Bibliotheksbereich qualifiziert. Die Studierenden sind in öffentlichen oder wissenschaftlichen Bibliotheken tätig. Zum Studium gelangen sie entweder mit schulischer Zugangsberechtigung oder über den Weg der Offenen Hochschule Niedersachsen (FaMI-Ausbildung + mindestens dreijährige einschlägige Berufserfahrung). Anlässlich einer bevorstehenden Studienreform wurden die 125 Alumni der ersten sieben Jahrgänge im Februar 2023 in einer Onlinebefragung zu ihrem weiteren beruflichen Werdegang und ihrer retrospektiven Einschätzung des Studiums befragt (Rücklaufquote 93%). Die Ergebnisse zeigen eine sehr große Zufriedenheit mit Studium und beruflicher Entwicklung. Sie liefern zudem Anhaltspunkte für eine Ergänzung bzw. Vertiefung des Curriculums um Themen wie Personalmanagement und Open Science. Die 116 Antwortenden machten zudem deutlich, dass sie zwar als qualifizierte Fachkräfte auf dem Arbeitsmarkt willkommen sind, aber während des Studiums nicht genug Unterstützung von ihren Arbeitgebern bekommen haben. Ein Drittel von ihnen wechselte spätestens nach dem Studium die Einrichtung.
Foucault im Jobcenter : Supervision in einem widersprüchlichen gesellschaftlichen Feld (Teil 2)
(2018)
Ziel dieses zweiten Teils ist eine ausführliche (struktur-)hermeneutische Rekonstruktion und Interpretation des Falles, den wir 2017 im ersten Teil dieses Artikels zur Illustration einer historischen, gesellschaftskritischen und makrosoziologischen Perspektive auf den Wandel der Arbeitswelt und den aktivierenden Sozialstaat verwendet hatten. Diese Perspektive tritt nun zugunsten biografischer, sozialwissenschaftlicher und pädagogischer sowie institutions- und organisationstheoretischer Interpretationen und Analysen des Feldes Jobcenter zurück. In ihm spiegeln sich die im ersten Teil beschriebenen Desintegrationsdynamiken wie in einem Brennglas wider. Die biografische Interpretation baut auf der Gestaltmehrdeutigkeit von Biografien nach Rosenthal auf, sie thematisiert die biografischen Übergänge, die eng mit der Bewältigung der Entwicklungsaufgaben korrelieren. Darüber hinaus werden sozialwissenschaftlich sowohl psychoanalytische als auch rollen-, habitus- und machttheoretische Aspekte eine wichtige Rolle spielen. In der institutions- und organisationstheoretischen Interpretation werden die Strukturen und das Beratungsverständnis der Jobcenter als gesellschaftliche Institution analysiert. Beratungswissenschaftlich und supervisionstheoretisch bedeutsam aus der Sicht der Autoren ist, dass sowohl Supervisor_innen als auch die Mitarbeitenden in den Jobcentern über biografietheoretische, sozialwissenschaftliche und sozial-pädagogischen Wissensbestände verfügen sollten, damit sie die komplexen, unverstandenen und aufgrund der Aktenlage häufig fragmentierten Biografien ihrer ‚Kund_innen‘ besser verstehen und beurteilen können. Nur dann scheint auch eine advokatorische Ethik greifen zu können, die das unverstandene Material nicht zu Ungunsten ihrer Klient_innen auslegt. Ziel dieses Artikels ist es, einen sozial- und strukturhermeneutischen Verstehenszugang in dieses für die Supervision interessante Feld zu eröffnen, der zugleich homologe Übertragungsmöglichkeiten in andere gesellschaftliche Felder ermöglichen kann.
Der Beitrag stellt Ergebnisse der Fachgruppe Informationskompetenz der KIBA vor, in der alle Lehrenden im Bereich der Vermittlung von Medien- und Informationskompetenz an bibliotheks- und informationswissenschaftlichen Studiengängen in Deutschland zusammenarbeiten. Ausgangspunkt ist das „Framework Informationskompetenz“, ein Anforderungsrahmen, der gemeinsame Standards in der Qualifikation von Studierenden der Bibliotheks- und Informationswissenschaft für das Aufgabenfeld der Förderung von Informationskompetenz sichern soll. Es wird aufgezeigt, wie die in diesem Rahmenmodell formulierten Qualifikationsstandards in den verschiedenen Studiengängen umgesetzt werden und wo es bedarfsbezogene Ausprägung und Gewichtung in den Qualifikationszielen gibt.
Eine schnelle Erfassung aller Wartezeiten und Störungen im Produktionsablauf und ihre richtige kostenmäßige Bewertung zu einer wirksamen Kontrolle der Gemeinkosten in der Produktion ist schon seit langem eine betriebliche Forderung. Ihre Erfüllung scheiterte bisher häufig an fehlenden organisatorischen Voraussetzungen und den nicht für diese Zwecke geeigneten EDV-Sachmitteln. Mit Hilfe von online konzipierten, im Dialog arbeitenden BDE-Systemen können diese Mängel jetzt behoben werden. Schwachstellen im Prozess lassen sich aktuell lokalisieren und damit auch rasch beseitigen. Das im folgenden hier vorgestellte Programm zur Erfassung der benötigten Daten ist gleichzeitig die Kernzelle eines zur Planung und Steuerung des Auftragsbearbeitungsprozesses eingesetzten Logistiksystems, mit dem noch eine große Anzahl weiterer organisatorischer Aufgaben gelöst werden kann. Betrachtungsschwerpunkt in diesem Beitrag ist die verursachungsgerechte Erfassung von Gemeinkosten im Prozess.
Die Sozialarbeiterin Yildiz Sahinde Demirer hat mit anderen Frauen das Projekt „Erzählcafés für geflüchtete Frauen“ in Trägerschaft der Landeshauptstadt Hannover (2018 bis 2021) konzipiert und umgesetzt. In fünf Stadtteilen konnten sich die Frauen regelmäßig treffen und austauschen, sich beteiligen und kamen zu Wort. Ihre Arbeit bezeichnet Demirer als Gemeinwesenarbeit mit politischen und feministischen Schwerpunkten. Die wissenschaftliche Begleitung durch Rebecca Hassan und Joachim Romppel von der Hochschule Hannover führte zur Dokumentation und Auswertung des Modellprojekts. Das Bundesamt für Migration und Flüchtlinge (BAMF) förderte das Projekt. Bemerkenswert sind die Erfolge dieser nonformalen Bildungsarbeit.
Metagenomic studies use high-throughput sequence data to investigate microbial communities in situ. However, considerable challenges remain in the analysis of these data, particularly with regard to speed and reliable analysis of microbial species as opposed to higher level taxa such as phyla. We here present Genometa, a computationally undemanding graphical user interface program that enables identification of bacterial species and gene content from datasets generated by inexpensive high-throughput short read sequencing technologies. Our approach was first verified on two simulated metagenomic short read datasets, detecting 100% and 94% of the bacterial species included with few false positives or false negatives. Subsequent comparative benchmarking analysis against three popular metagenomic algorithms on an Illumina human gut dataset revealed Genometa to attribute the most reads to bacteria at species level (i.e. including all strains of that species) and demonstrate similar or better accuracy than the other programs. Lastly, speed was demonstrated to be many times that of BLAST due to the use of modern short read aligners. Our method is highly accurate if bacteria in the sample are represented by genomes in the reference sequence but cannot find species absent from the reference. This method is one of the most user-friendly and resource efficient approaches and is thus feasible for rapidly analysing millions of short reads on a personal computer.
Improving the graphitic structure in carbon nanofibers (CNFs) is important for exploiting their potential in mechanical, electrical and electrochemical applications. Typically, the synthesis of carbon fibers with a highly graphitized structure demands a high temperature of almost 2500 °C. Furthermore, to achieve an improved graphitic structure, the stabilization of a precursor fiber has to be assisted by the presence of tension in order to enhance the molecular orientation. Keeping this in view, herein we report on the fabrication of graphene nanoplatelets (GNPs) doped carbon nanofibers using electrospinning followed by oxidative stabilization and carbonization. The effect of doping GNPs on the graphitic structure was investigated by carbonizing them at various temperatures (1000 °C, 1200 °C, 1500 °C and 1700 °C). Additionally, a stabilization was achieved with and without constant creep stress (only shrinkage stress) for both pristine and doped precursor nanofibers, which were eventually carbonized at 1700 °C. Our findings reveal that the GNPs doping results in improving the graphitic structure of polyacrylonitrile (PAN). Further, in addition to the templating effect during the nucleation and growth of graphitic crystals, the GNPs encapsulated in the PAN nanofiber matrix act in-situ as micro clamp units performing the anchoring function by preventing the loss of molecular orientation during the stabilization stage, when no external tension is applied to nanofiber mats. The templating effect of the entire graphitization process is reflected by an increased electrical conductivity along the fibers. Simultaneously, the electrical anisotropy is reduced, i.e., the GNPs provide effective pathways with improved conductivity acting like bridges between the nanofibers resulting in an improved conductivity across the fiber direction compared to the pristine PAN system.
Ein Konferenzrückblick:
Das DFG-Forschungskolleg „Postwachstumsgesellschaften“ hatte gemeinsam mit der Deutschen Gesellschaft für Soziologie (DGS) zu einer gemeinsamen fünftägigen Konferenz vom 23. bis 27. September 2019 an die Friedrich Schiller-Universität Jena geladen, und rund 700 Wissenschaftler*innen und Studierende kamen aus dem In- und Ausland, um an den rund 150 Veranstaltungen teilzunehmen. Begleitet wurde die Konferenz von einem umfänglichen Kulturprogramm mit Konzerten, Kinofilmen und Kunst, und rechtzeitig zur Konferenz erschien als Tagungsband auch eine lesenswerte 600-seitige Sonderausgabe des Berliner Journals für Soziologie (Dörre et al. 2019).
Das Konferenzprogramm stand einerseits unter der Thematik der „Great Transformation“, also der auf Karl Polanyi (1886-1964) zurückgehenden These einer zunehmenden Vermarktlichung und Verselbstständigung der Wirtschaft gegenüber der Gesellschaft (vgl. Polanyi 1944), die das DFG-Forschungskolleg rund um die Soziologen Klaus Dörre, Hartmut Rosa und Stefan Lessenich als Titel gewählt hat. Andererseits tagten einige Sektionen der DGS als Regionalkonferenz, um sektionsspezifische Panels durchzuführen.
Junge Menschen of Color sind von Kriminalisierung betroffen. Dieser Artikel widmet sich der Frage, wie die Soziale Arbeit im Kontext institutioneller Fremdunterbringung durch die Ubiquität von nationalen Grenzen und durch Polizeipraktiken gerahmt wird. Es wird empirisch nachgezeichnet, dass Racial Profiling sich über ritualhafte Wiederholungen manifestiert. Es zeigt sich, dass der formale Charakter der sog. gefährlichen, als kriminogen klassifizierten Orte über informelle Polizeipraktiken auf Organisationen der Jugendhilfe übertragen wird.
Objective
To revise the German guidelines and recommendations for ensuring Good Epidemiological Practice (GEP) that were developed in 1999 by the German Society for Epidemiology (DGEpi), evaluated and revised in 2004, supplemented in 2008, and updated in 2014.
Methods
The executive board of the DGEpi tasked the third revision of the GEP. The revision was arrived as a result of a consensus-building process by a working group of the DGEpi in collaboration with other working groups of the DGEpi and with the German Association for Medical Informatics, Biometry and Epidemiology, the German Society of Social Medicine and Prevention (DGSMP), the German Region of the International Biometric Society (IBS-DR), the German Technology, Methods and Infrastructure for Networked Medical Research (TMF), and the German Network for Health Services Research (DNVF). The GEP also refers to related German Good Practice documents (e.g. Health Reporting, Cartographical Practice in the Healthcare System, Secondary Data Analysis).
Results
The working group modified the 11 guidelines (after revision: 1 ethics, 2 research question, 3 study protocol and manual of operations, 4 data protection, 5 sample banks, 6 quality assurance, 7 data storage and documentation, 8 analysis of epidemiological data, 9 contractual framework, 10 interpretation and scientific publication, 11 communication and public health) and modified and supplemented the related recommendations. All participating scientific professional associations adopted the revised GEP.
Conclusions
The revised GEP are addressed to everyone involved in the planning, preparation, execution, analysis, and evaluation of epidemiological research, as well as research institutes and funding bodies.
This paper aims to provide a structured overview of four open, participatory formats that are particularly applicable in inquiry-based teaching and learning contexts: hackathons, book sprints, barcamps, and learning circles. Using examples, mostly from the work and experience context of the Open Science Lab at TIB Hannover, we address concrete processes, working methods, possible outcomes and challenges.
The compilation offers an introduction to the topic and is intended to provide tools for testing in practice.
Background: Hand hygiene practices (HHP), as a critical component of infection prevention/control, were investigated among physiotherapists in an Ebola endemic region.
Method: A standardized instrument was administered to 44 randomly selected physiotherapists (23 males and 21 females), from three tertiary hospitals in Enugu, Nigeria. Fifteen participants (aged 22–59 years) participated in focus group discussions (FGDs) and comprised 19 participants in a subsequent laboratory study. After treatment, the palms/fingers of physiotherapists were swabbed and cultured, then incubated aerobically overnight at 37°C, and examined for microbial growths. An antibiogram of the bacterial isolates was obtained.
Results: The majority (34/77.3%) of physiotherapists were aware of the HHP protocol, yet only 15/44.1% rated self-compliance at 71–100%. FGDs identified forgetfulness/inadequate HHP materials/infrastructure as the major barriers to HHP. Staphylococcus aureus were the most prevalent organisms, prior to (8/53.33%) and after (4/26.67%) HPP, while Pseudomonas spp. were acquired thereafter. E. coli were the most antibiotic resistant microbes but were completely removed after HHP. Ciprofloxacin and streptomycin were the most effective antibiotics.
Conclusion: Poor implementation of HPP was observed due to inadequate materials/infrastructure/poor behavioral orientation. Possibly, some HPP materials were contaminated; hence, new microbes were acquired. Since HPP removed the most antibiotic resistant microbes, it might be more effective in infection control than antibiotic medication.
Harmonisation of German Health Care Data Using the OMOP Common Data Model – A Practice Report
(2023)
Data harmonization is an important step in large-scale data analysis and for generating evidence on real world data in healthcare. With the OMOP common data model, a relevant instrument for data harmonization is available that is being promoted by different networks and communities. At the Hannover Medical School (MHH) in Germany, an Enterprise Clinical Research Data Warehouse (ECRDW) is established and harmonization of that data source is the focus of this work. We present MHH’s first implementation of the OMOP common data model on top of the ECRDW data source and demonstrate the challenges concerning the mapping of German healthcare terminologies to a standardized format.
Background:
Promoting patient and occupational safety are two key challenges for hospitals. When aiming to improve these two outcomes synergistically, psychosocial working conditions, leadership by hospital management and supervisors, and perceptions of patient and occupational safety climate have to be considered. Recent studies have shown that these key topics are interrelated and form a critical foundation for promoting patient and occupational safety in hospitals. So far, these topics have mainly been studied independently from each other. The present study investigated hospital staffs’ perceptions of four different topics: (1) psychosocial working conditions, (2) leadership, (3) patient safety climate, and (4) occupational safety climate. We present results from a survey in two German university hospitals aiming to detect differences between nurses and physicians.
Methods:
We performed a cross-sectional study using a standardized paper-based questionnaire. The survey was conducted with nurses and physicians to assess the four topics. The instruments mainly consisted of scales of the German version of the COPSOQ (Copenhagen Psychosocial Questionnaire), one scale of the Copenhagen Burnout Inventory (CBI), scales to assess leadership and transformational leadership, scales to assess patient safety climate using the Hospital Survey on Patient Safety Culture (HSPSC), and analogous items to assess occupational safety climate.
Results:
A total of 995 completed questionnaires out of 2512 distributed questionnaires were returned anonymously. The overall response rate was 39.6%. The sample consisted of 381 physicians and 567 nurses. We found various differences with regard to the four topics. In most of the COPSOQ and the HSPSC-scales, physicians rated psychosocial working conditions and patient safety climate more positively than nurses. With regard to occupational safety, nurses
indicated higher occupational risks than physicians.
Conclusions:
The WorkSafeMed study combined the assessment of the four topics psychosocial working conditions, leadership, patient safety climate, and occupational safety climate in hospitals. Looking at the four topics provides an overview of where improvements in hospitals may be needed for nurses and physicians. Based on these results,
improvements in working conditions, patient safety climate, and occupational safety climate are required for health care professionals in German university hospitals – especially for nurses.
Context: Higher education is changing at an accelerating pace due to the widespread use of digital teaching and emerging technologies. In particular, AI assistants such as ChatGPT pose significant challenges for higher education institutions because they bring change to several areas, such as learning assessments or learning experiences.
Objective: Our objective is to discuss the impact of AI assistants in the context of higher education, outline possible changes to the context, and present recommendations for adapting to change.
Method: We review related work and develop a conceptual structure that visualizes the role of AI assistants in higher education.
Results: The conceptual structure distinguishes between humans, learning, organization, and disruptor, which guides our discussion regarding the implications of AI assistant usage in higher education. The discussion is based on evidence from related literature.
Conclusion: AI assistants will change the context of higher education in a disruptive manner, and the tipping point for this transformation has already been reached. It is in our hands to shape this transformation.
The PROFINET protocol has been extended in the current version to include security functions. This allows flexible network architectures with the consideration of OT security requirements to be designed for PROFINET, which were not possible due to the network segmentation previously required. In addition to the manufacturers of the protocol stacks, component manufacturers are also required to provide a secure implementation in their devices. The necessary measures go beyond the use of a secure protocol stack. Using the example of an Ethernet-APL transmitter with PROFINET communication, this article shows which technical and organizational conditions will have to be considered by PROFINET device manufacturers in the future.
In der Bundesrepublik Deutschland gibt es rund 200000 Lieferstellen für Molkereiprodukte vom industriellen Großverbraucher bis zum Facheinzelhändler mit Milchproduktenangebot. Gut die Hälfte der gesamten Nachfrage schöpfen die Zentralläger sowie die Geschäfte des Lebensmitteleinzelhandels ab, wobei die Belieferung des LEH weitestgehend auf Strecke erfolgt. - Dipl.-Wirtsch.-Ing. Heinrich Wietbrauk von der Bundesanstalt für Milchforschung in Kiel analysiert für „dynamik im handel" die milchwirtschaftlichen Warenströme in Deutschland.
Music streaming platforms offer music listeners an overwhelming choice of music. Therefore, users of streaming platforms need the support of music recommendation systems to find music that suits their personal taste. Currently, a new class of recommender systems based on knowledge graph embeddings promises to improve the quality of recommendations, in particular to provide diverse and novel recommendations. This paper investigates how knowledge graph embeddings can improve music recommendations. First, it is shown how a collaborative knowledge graph can be derived from open music data sources. Based on this knowledge graph, the music recommender system EARS (knowledge graph Embedding-based Artist Recommender System) is presented in detail, with particular emphasis on recommendation diversity and explainability. Finally, a comprehensive evaluation with real-world data is conducted, comparing of different embeddings and investigating the influence of different types of knowledge.
Background: Maintenance of metal homeostasis is crucial in bacterial pathogenicity as metal starvation is the most important mechanism in the nutritional immunity strategy of host cells. Thus, pathogenic bacteria have evolved sensitive metal scavenging systems to overcome this particular host defence mechanism. The ruminant pathogen Mycobacterium avium ssp. paratuberculosis (MAP) displays a unique gut tropism and causes a chronic progressive intestinal inflammation. MAP possesses eight conserved lineage specific large sequence polymorphisms (LSP), which distinguish MAP from its ancestral M. avium ssp. hominissuis or other M. avium subspecies. LSP14 and LSP15 harbour many genes proposed to be involved in metal homeostasis and have been suggested to substitute for a MAP specific, impaired mycobactin synthesis.
Results: In the present study, we found that a LSP14 located putative IrtAB-like iron transporter encoded by mptABC was induced by zinc but not by iron starvation. Heterologous reporter gene assays with the lacZ gene under control of the mptABC promoter in M. smegmatis (MSMEG) and in a MSMEGΔfurB deletion mutant revealed a zinc dependent, metalloregulator FurB mediated expression of mptABC via a conserved mycobacterial FurB recognition site. Deep sequencing of RNA from MAP cultures treated with the zinc chelator TPEN revealed that 70 genes responded to zinc limitation. Remarkably, 45 of these genes were located on a large genomic island of approximately 90 kb which harboured LSP14 and LSP15. Thirty-five of these genes were predicted to be controlled by FurB, due to the presence of putative binding sites. This clustering of zinc responsive genes was exclusively found in MAP and not in other mycobacteria.
Conclusions: Our data revealed a particular genomic signature for MAP given by a unique zinc specific locus, thereby suggesting an exceptional relevance of zinc for the metabolism of MAP. MAP seems to be well adapted to maintain zinc homeostasis which might contribute to the peculiarity of MAP pathogenicity.
The reactivity of graphene at its boundary region has been imaged using non-linear spectroscopy to address the controversy whether the terraces of graphene or its edges are more reactive. Graphene was functionalised with phenyl groups, and we subsequently scanned our vibrational sum-frequency generation setup from the functionalised graphene terraces across the edges. A greater phenyl signal is clearly observed at the edges, showing evidence of increased reactivity in the boundary region. We estimate an upper limit of 1 mm for the width of the CVD graphene boundary region.
Background
Symptoms of depression are prevalent in people living with human immune deficiency virus/acquired immune deficiency syndrome (PLWHA), and worsened by lack of physical activity/exercises, leading to restriction in social participation/functioning. This raises the question: what is the extent to which physical exercise training affected, symptoms of depression, physical activity level (PAL) and social participation in PLWHA compared to other forms of intervention, usual care, or no treatment controls?
Method
Eight databases were searched up to July 2020, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Only randomised controlled trials involving adults who were either on HAART/HAART-naïve and reported in the English language, were included. Two independent reviewers determined the eligibility of the studies, extracted data, assessed their quality, and risk of bias using the Physiotherapy Evidence Database (PEDro) tool. Standardised mean difference (SMD) was used as summary statistics for the mean primary outcome (symptoms of depression) and secondary outcomes (PAL and social participation) since different measuring tools/units were used across the included studies. Summary estimates of effects were determined using a random-effects model (I2).
Results
Thirteen studies met the inclusion criteria with 779 participants (n = 596 participants at study completion) randomised into the study groups, comprising 378 males, 310 females and 91 participants with undisclosed gender, and with an age range of 18–86 years. Across the studies, aerobic or aerobic plus resistance exercises were performed 2–3 times/week, at 40–60 min/session, and for between 6-24 weeks, and the risk of bias vary from high to low. Comparing the intervention to control groups showed significant difference in the symptoms of depression (SMD = − 0.74, 95% confidence interval (CI) − 1.01, − 0.48, p ≤ 0.0002; I2 = 47%; 5 studies; 205 participants) unlike PAL (SMD = 0.98, 95% CI − 0.25, 2.17, p = 0.11; I2 = 82%; 2 studies; 62 participants) and social participation (SMD = 0.04, 95% CI − 0.65, 0.73, p = 0.91; I2 = 90%; 6 studies; 373 participants).
Conclusion
Physical exercise training could have an antidepressant-like effect in PLWHA but did not affect PAL and social participation. However, the high heterogeneity in the included studies, implies that adequately powered randomised controlled trials with clinical/methodological similarity are required in future studies.
Background: Compromised immune function, associated with human immune deficiency virus (HIV) infection, is improved by antiretroviral therapy (ART) which also decreases bone mineral density (BMD), and possibly the quality of life (QoL). However, physical (aerobic/resistance) exercises, were reported to induce reverse effects in uninfected individuals and were appraised in the literature for evidence of similar benefits in people living with HIV/AIDS(PLWHA). The main study objective was to evaluate the impact of physical (aerobic and resistance) exercises on CD4+ count,
BMD and QoL in PLWHA.
Methods: A systematic review was conducted using the Cochrane Collaboration protocol. Searching databases, up to June 2017, only randomized control trials investigating the effects of either aerobic, resistance or a combination of both exercise types with a control/other intervention(s) for a period of at least 4 weeks among adults living with HIV, were included. Two independent reviewers determined the eligibility of the studies. Data were extracted and risk of bias (ROB) was assessed with the Cochrane Collaboration ROB tool. Meta-analyses were conducted using random effect models using the Review Manager (RevMan) computer software.
Results: Nineteen studies met inclusion criteria(n = 491 participants at study completion) comprising male and female with age range 22–66 years. Two meta-analyses across 13 sub-group comparisons were performed. However, there were no RCTs on the impact of physical exercises on BMD in PLWHA. The result showed no significant change in CD4+ count unlike a significant effect of 5.04 point (95%CI:-8.49,-3.74,p = 0.00001) for role activity limitation due to physical health (QoL sub-domain). Overall, the GRADE evidence for this review was of moderate quality.
Conclusions: There was evidence that engaging in moderate intensity aerobic exercises (55–85% Maximum heart rate-MHR), for 30–60 min, two to five times/week for 6–24 weeks significantly improves role activity limitation due to physical health problems, otherwise physical(aerobic or/and resistance) exercises have no significant effects on CD4+ count and other domains of QoL. Also, there is lack of evidence on the impact of exercises on BMD in PLWHA due to the paucity of RCTs. The moderate grade evidence for this review suggests that further research may likely have an important impact on our confidence in the estimate of effects and may change the estimate.
Acute stroke care is a time-critical process. Improving communication
and documentation process may support a positive effect on medical outcome. To achieve this goal, a new system using a mobile application has been integrated into existing infrastructure at Hannover Medical School (MHH). Within a pilot project, this system has been brought into clinical daily routine in February 2022. Insights generated may support further applications in clinical use-cases.
Background: To improve interprofessional collaboration between registered nurses (RNs) and general practitioners (GPs) for nursing home residents (NHRs), the interprof ACT intervention package was developed. This complex intervention includes six components (e.g., shared goal setting, standardized procedures for GPs’ nursing home visits) that can be locally adapted. The cluster‑randomized interprof ACT trial evaluates the effects of this intervention on the cumulative incidence of hospital admissions (primary outcome) and secondary outcomes (e.g., length of hospital stays, utilization of emergency care services, and quality of life) within 12 months. It also includes a process evaluation which is subject of this protocol. The objectives of this evaluation are to assess the implementation of the interprof ACT intervention package and downstream effects on nurse–physician collaboration as well as preconditions and prospects for successive implementation into routine care.
Methods: This study uses a mixed methods triangulation design involving all 34 participating nursing homes (clusters). The quantitative part comprises paper‑based surveys among RNs, GPs, NHRs, and nursing home directors at baseline and 12 months. In the intervention group (17 clusters), data on the implementation of preplanned implementation strategies (training and supervision of nominated IPAVs, interprofessional kick‑off meetings) and local implementation activities will be recorded. Major outcome domains are the dose, reach and fidelity of the implementation of the intervention package, changes in interprofessional collaboration, and contextual factors. The qualitative part will be conducted in a subsample of 8 nursing homes (4 per study group) and includes repeated non‑participating observations and semistructured interviews on the interaction between involved health professionals and their work processes. Quantitative and qualitative data will be descriptively analyzed and then triangulated by means of joint displays and mixed methods informed regression models.
Discussion: By integrating a variety of qualitative and quantitative data sources, this process evaluation will allow comprehensive assessment of the implementation of the interprof ACT intervention package, the changes induced in interprofessional collaboration, and the influence of contextual factors. These data will reveal expected and unexpected changes in the procedures of interprofessional care delivery and thus facilitate accurate conclusions for the further design of routine care services for NHRs.
Background:
Many patients with cardiovascular disease also show a high comorbidity of mental disorders, especially such as anxiety and depression. This is, in turn, associated with a decrease in the quality of life. Psychocardiological treatment options are currently limited. Hence, there is a need for novel and accessible psychological help. Recently, we demonstrated that a brief face-to-face metacognitive therapy (MCT) based intervention is promising in treating anxiety and depression. Here, we aim to translate the face-to-face approach into digital application and explore the feasibility of this approach.
Methods:
We translated a validated brief psychocardiological intervention into a novel non-blended web app. The data of 18 patients suffering from various cardiac conditions but without diagnosed mental illness were analyzed after using the web app over a two-week period in a feasibility trial. The aim was whether a nonblended web app based MCT approach is feasible in the group of cardiovascular patients with cardiovascular disease.
Results:
Overall, patients were able to use the web app and rated it as satisfactory and beneficial. In addition, there was first indication that using the app improved the cardiac patients’ subjectively perceived health and reduced their anxiety. Therefore, the approach seems feasible for a future randomized controlled trial.
Conclusion:
Applying a metacognitive-based brief intervention via a nonblended web app seems to show good acceptance and feasibility in a small target group of patients with CVD. Future studies should further develop, improve and validate digital psychotherapy approaches, especially in patient groups with a lack of access to standard psychotherapeutic care.
Improving Risk Assessment in Clinical Trials: Toward a Systematic Risk-Based Monitoring Approach
(2021)
Regulatory authorities have encouraged the usage of a risk-based monitoring (RBM) system in clinical trials before trial initiation for detection of potential risks and inclusion of a mitigation plan in the monitoring strategy. Several RBM tools were developed after the International Council for Harmonization gave sponsors the flexibility to initiate an approach to enhance quality management in a clinical trial. However, various studies have demonstrated the need for improvement of the available RBM tools as each does not provide a comprehensive overview of the characteristics, focus, and application. This research lays out a rationale for a risk methodology assessment (RMA) within the RBM system. The core purpose of RMA is to deliver a scientifically based evaluation and decision of any potential risk in a clinical trial. Thereby, a monitoring plan can be developed to elude prior identified risk outcome. To demonstrate RMA’s theoretical approach in practice, a Shiny web application (R Foundation for Statistical Computing) was designed to describe the assessment process of risk analysis and visualization tools that eventually aid in focusing monitoring activities. RMA focuses on the identification of an individual risk and visualizes its weight on the trial. The scoring algorithm of the presented approach computes the assessment of the individual risk in a radar plot and computes the overall score of the trial. Moreover, RMA’s novelty lies in its ability to decrease biased decision making during risk assessment by categorizing risk influence and detectability; a characteristic pivotal to serve RBM in assessing risks, and in contributing to a better understanding in the monitoring technique necessary for developing a functional monitoring plan. Future research should focus on validating the power of RMAs to demonstrate its efficiency. This would facilitate the process of characterizing the strengths and weaknesses of RMA in practice.
The present research study investigated the susceptibility of common mastitis pathogens—obtained from clinical mastitis cases on 58 Northern German dairy farms—to routinely used antimicrobials. The broth microdilution method was used for detecting the Minimal Inhibitory Concentration (MIC) of Streptococcus agalactiae (n = 51), Streptococcus dysgalactiae (n = 54), Streptococcus uberis (n = 50), Staphylococcus aureus (n = 85), non-aureus staphylococci (n = 88), Escherichia coli (n = 54) and Klebsiella species (n = 52). Streptococci and staphylococci were tested against cefquinome, cefoperazone, cephapirin, penicillin, oxacillin, cloxacillin, amoxicillin/clavulanic acid and cefalexin/kanamycin. Besides cefquinome and amoxicillin/clavulanic acid, Gram-negative pathogens were examined for their susceptibility to marbofloxacin and sulfamethoxazole/trimethoprim. The examined S. dysgalactiae isolates exhibited the comparatively lowest MICs. S. uberis and S. agalactiae were inhibited at higher amoxicillin/clavulanic acid and cephapirin concentration levels, whereas S. uberis isolates additionally exhibited elevated cefquinome MICs. Most Gram-positive mastitis pathogens were inhibited at higher cloxacillin than oxacillin concentrations. The MICs of Gram-negative pathogens were higher than previously reported, whereby 7.4%, 5.6% and 11.1% of E. coli isolates had MICs above the highest concentrations tested for cefquinome, marbofloxacin and sulfamethoxazole/trimethoprim, respectively. Individual isolates showed MICs at comparatively higher concentrations, leading to the hypothesis that a certain amount of mastitis pathogens on German dairy farms might be resistant to frequently used antimicrobials.
The present investigation was conducted to investigate the in-vitro activity of ethanolic extract of roots of Centaurea behens by using DPPH radical scavenging activity, nitric oxide radical scavenging activity, hydrogen peroxide radical scavenging activity, hydroxyl radical. Result suggests that the extract possess significant antioxidant activity as compared to the standard ascorbic acid and thus further in vivo investigation is required to evaluate the medicinal significance of the extract which can be used for assessing the possible therapeutic importance of the drug.
The adsorption of O atoms on the Fe(1 1 0) surface has been investigated by density functional theory for increasing degrees of oxygen coverage from 0.25 to 1 monolayer, to follow the evolution of the Osingle bondFe(1 1 0) system into an FeO(1 1 1)-like monolayer. We found that the quasi-threefold site is the most stable adsorption site for all coverages, with adsorption energies of ∼2.8–4.0 eV per O atom. Oxygen adsorption results in surface geometrical changes such as interlayer relaxation and buckling, the latter of which decreases with coverage. The calculated vibrational frequencies range from 265 to 470 cm−1 for the frustrated translational modes and 480–620 cm−1 for the stretching mode, and hence are in good agreement with the experimental values reported for bulk FeO wüstite. The hybridization of the oxygen 2p and iron 3d orbitals increases with oxygen coverage, and the partial density of states for the Osingle bondFe(1 1 0) system at full coverage resembles the one reported in the literature for bulk FeO. These results at full oxygen coverage point to the incipient formation of an FeO(1 1 1)-like monolayer that would eventually lead to the bulk FeO oxide layer.
Incorporation and Deposition of Spin Crossover Materials into and onto Electrospun Nanofibers
(2023)
We synthesized iron(II)-triazole spin crossover compounds of the type [Fe(atrz)3]X2 and incorporated and deposited them on electrospun polymer nanofibers. For this, we used two separate electrospinning methods with the goal of obtaining polymer complex composites with intact switching properties. In view of possible applications, we chose iron(II)-triazole-complexes that are known to exhibit spin crossover close to ambient temperature. Therefore, we used the complexes [Fe(atrz)3]Cl2 and [Fe(atrz)3](2ns)2 (2ns = 2-Naphthalenesulfonate) and deposited those on fibers of polymethylmethacrylate (PMMA) and incorporated them into core–shell-like PMMA fiber structures. These core–shell structures showed to be inert to outer environmental influences, such as droplets of water, which we purposely cast on the fiber structure, and it did not rinse away the used complex. We analyzed both the complexes and the composites with IR-, UV/Vis, Mössbauer spectroscopy, SQUID magnetometry, as well as SEM and EDX imaging. The analysis via UV/Vis spectroscopy, Mössbauer spectroscopy, and temperature-dependent magnetic measurements with the SQUID magnetometer showed that the spin crossover properties were maintained and were not changed after the electrospinning processes.
Indirekte Medienwirkungen, wie sie im Rahmen des Influence-of-Presumed-Media-Influence-Approachs und des Third-Person-Effekts diskutiert werden, sind im Hinblick auf einzelne politische Ereignisse und für Online-Medien bislang nur selten geprüft worden. Aus diesem Grund wurde der unterstellte Einfluss verschiedener On- und Offline-Medien auf Meinungsbildung und Mobilisierung im Kontext der Volksabstimmung zum Umbau des Stuttgarter Hauptbahnhofes im November 2011 („Stuttgart 21“) untersucht. Daneben stehen Konsequenzen der Einflusswahrnehmungen im Fokus des Beitrags. Als Grundlage dient eine Online-Befragung der baden-württembergischen Bevölkerung mit Internetanschluss (n = 502). Die Befragten schreiben Zeitungen und Fernsehen einen stärkeren politischen Einfluss zu als den in der Studie berücksichtigten Online-Medien, und zwar sowohl auf die Meinungsbildung als auch auf die Mobilisierung. Zudem führt ein unterstellter großer und negativ bewerteter Medieneinfluss auf die Bevölkerung bei einigen Befragtengruppen zu einer Verstärkung von Kommunikationsaktivitäten – verbunden mit dem Ziel, diesen unterstellten Einfluss zu korrigieren. Die vermuteten negativen Einflüsse führen aber auch dazu, dass eine schärfere Kontrolle des Internets befürwortet wird.
Background:
This study examined the extent to which regulatory problems in infants at 4 and 6 months influence childhood development at 12 months. The second aim of the study was to examine the influence maternal distress has on 4-month-old children’s subsequent development as well as gender differences with regard to regulatory problems and development.
Methods:
153 mother-child dyads enrolled in the family support research project “Nobody slips through the net” constituted the comparison group. These families faced psychosocial risks (e.g. poverty, excessive demands on the mother, and mental health disorders of the mother, measured with the risk screening instrument Heidelberger Belastungsskala - HBS) and maternal stress, determined with the Parental Stress Index (PSI-SF). The children’s developmental levels and possible early regulatory problems were evaluated by means of the Ages and Stages Questionnaires (ASQ) and a German questionnaire assessing problems of excessive crying along with sleeping and feeding difficulties (SFS).
Results:
A statistically significant but only low, inverse association between excessive crying, whining and sleep problems at 4 and 6 months and the social development of one-year-olds (accounting for 5% and 8% of the variance respectively) was found. Feeding problems had no effect on development. Although regulatory problems in infants were accompanied by increased maternal stress level, these did not serve as a predictor of the child’s social development at 12 months. One-year-old girls reached a higher level of development in social and fine motor skills. No gender differences were found with regard to regulatory problems, nor any moderating effect of gender on the relation between regulatory problems and level of development.
Conclusions:
Our results reinforce existing knowledge pertaining to the transactional association between regulatory problems in infants, maternal distress and dysfunctionality of mother-child interactions. They also provide evidence of a slight but distinct negative influence of crying and sleeping problems on children’s subsequent social development. Easily accessible support services provided by family health visitors (particularly to the so-called “at-risk families”) are strongly recommended to help prevent the broadening of children’s early regulatory problems into other areas of behavior.
Malnutrition, nutritional deficiency, or undernutrition is an imbalanced nutritional status resulting from insufficient intake of nutrients to meet normal physiologic requirements. Malnutrition in childhood has both short-term consequences and long-term consequences on mental and physical health as well as the overall health development of children. Of all regions in the world, the Asia and the Pacific region has achieved the fastest rate of economic growth. There is no evidence that this rapid economic growth translates into a decline in malnutrition of children in Asian countries such as India.
Influence on persistence and adherence with oral bisphosphonates on fracture rates in osteoporosis
(2009)
Background and Aim:
Oral bisphosphonates have been shown to reduce the risk of fractures in patients with osteoporosis. It can be assumed that the clinical effectiveness of oral bisphosphonates depends on persistence with therapy.
Methods:
The influence of persistence with and adherence to oral bisphosphonates on fracture risk in a real-life setting was investigated. Data from 4451 patients with a defi ned index prescription of bisphosphonates were included. Fracture rates within 180, 360, and 720 days after index prescription were compared between persistent and non-persistent patients. In an extended Cox regression model applying multiple event analysis, the influence of adherence was analyzed. Persistence was defined as the duration of continuous therapy; adherence was measured in terms of the medication possession ratio (MPR).
Results:
In patients with a fracture before index prescription, fracture rates were reduced by 29% (p = 0.025) comparing persistent and non-persistent patients within 180 days after the index prescription and by 45% (p < 0.001) within 360 days. The extended Cox regression model showed that good adherence (MPR ≥ 0.8) reduced fracture risk by about 39% (HR 0.61, 95% CI 0.47–0.78; p < 0.01).
Conclusions:
In patients with osteoporosis-related fractures, good persistence and adherence to oral bisphosphonates reduced fracture risk significantly.
Background: Improving the transparency of information about the quality of health care providers is one way to improve health care quality. It is assumed that Internet information steers patients toward better-performing health care providers and will motivate providers to improve quality. However, the effect of public reporting on hospital quality is still small. One of the reasons is that users find it difficult to understand the formats in which information is presented.
Objective: We analyzed the presentation of risk-adjusted mortality rate (RAMR) for coronary angiography in the 10 most commonly used German public report cards to analyze the impact of information presentation features on their comprehensibility. We wanted to determine which information presentation features were utilized, were preferred by users, led to better comprehension, and had similar effects to those reported in evidence-based recommendations described in the literature.
Methods: The study consisted of 5 steps: (1) identification of best-practice evidence about the presentation of information on hospital report cards; (2) selection of a single risk-adjusted quality indicator; (3) selection of a sample of designs adopted by German public report cards; (4) identification of the information presentation elements used in public reporting initiatives in Germany; and (5) an online panel completed an online questionnaire that was conducted to determine if respondents were able to identify the hospital with the lowest RAMR and if respondents’ hospital choices were associated with particular information design elements.
Results: Evidence-based recommendations were made relating to the following information presentation features relevant to report cards: evaluative table with symbols, tables without symbols, bar charts, bar charts without symbols, bar charts with symbols, symbols, evaluative word labels, highlighting, order of providers, high values to indicate good performance, explicit statements of whether high or low values indicate good performance, and incomplete data (“N/A” as a value). When investigating the RAMR in a sample of 10 hospitals’ report cards, 7 of these information presentation features were identified. Of these, 5 information presentation features improved comprehensibility in a manner reported previously in literature.
Conclusions: To our knowledge, this is the first study to systematically analyze the most commonly used public reporting card designs used in Germany. Best-practice evidence identified in international literature was in agreement with 5 findings about German report card designs: (1) avoid tables without symbols, (2) include bar charts with symbols, (3) state explicitly whether high or low values indicate good performance or provide a “good quality” range, (4) avoid incomplete data (N/A given as a value), and (5) rank hospitals by performance. However, these findings are preliminary and should be subject of further evaluation. The implementation of 4 of these recommendations should not present insurmountable obstacles. However, ranking hospitals by performance may present substantial difficulties.
Die vorliegenden Diplomarbeit bietet eine Übersicht über Filmbibliotheken, Filmarchiven und anderen Bibliotheken mit Filminformationsbeständen zum Thema. Zu diesem Zweck wurden Fragebögen an Einrichtungen verschickt, deren Arbeitsgebiet der Film im weiteren Sinne ist. Das methodische Vorgehen für diese Untersuchung wird ebenso aufgezeigt wie die sich daraus ergebende Übersicht über die Filminformationsbestände in Deutschland. Zum Vergleich des Umgangs mit der Filminformation in Deutschland und im Ausland werden einige Filminformationseinrichtungen in anderen Ländern betrachtet und beschrieben. Anschließend an die Darstellungen der Informationseinrichtungen wird der Versuch einer Systematisierung der unterschiedlichen Typen von Informationseinrichtungen und der verschiedenen Themenschwerpunkte der Bestände unternommen.
Anlässlich einer bevorstehenden Curriculumsrevision führte der Bachelorstudiengang Informationsmanagement der Hochschule Hannover im März 2016 eine Studie unter all seinen bisherigen Absolventen durch (Abschlussjahrgänge 2008 bis 2015). Bei einer Grundgesamtheit von 303 Personen antworteten 200 (66%). Die Ergebnisse enthalten ein retrospektives Feedback auf das Studium und skizzieren die Strukturreform, die daraus als Konsequenz erwächst. Zudem geben sie Aufschluss über Berufseinmündung und Berufsverlauf der Alumni und umfassen Eckdaten über ihr erstes und aktuelles Beschäftigungsverhältnis.
Der Übergang vom Studium in den Beruf gestaltet sich bei dem Gros der Befragten problemlos. Ein Drittel der Alumni schließt ein Masterstudium an. Zum Befragungszeitpunkt liegt die Beschäftigungsquote bei 96%. Davon arbeiten 64 % unbefristet. Die thematische Breite des IM-Curriculums spiegelt sich in einer Vielfalt von Branchen und Tätigkeiten wider, die die Alumni mit ihrem aktuellen Beschäftigungsverhältnis abdecken. Die Befragten äußern insgesamt eine große Zufriedenheit mit ihrer beruflichen Entwicklung, allerdings hätten sie sich im Studium mehr Orientierung und größere Wahlfreiheit bei der Fächerbelegung gewünscht. Das revidierte Curriculum wird deshalb mehr Verbindlichkeit und zugleich größere Flexibilität bei der Schwerpunktwahl vorsehen.
Die Durchsetzung der Flexibilität als wesentlicher Faktor zur Absicherung der Wettbewerbsposition eines Unternehmens beinhaltet die konsequente Hinwendung zur Markt- beziehungsweise Kundenorientierung. Denn es geht im Kern darum, alle Anstrengungen im Unternehmen darauf zu konzentrieren, dass der Kunde das nach seinen Vorgaben erstellte Produkt in kürzester Zeit ausgeliefert bekommt, wobei die Qualitätsziele nach Gebrauchstauglichkeit und Zuverlässigkeit des Produktes voll erfüllt sein müssen. Die dafür notwendige Qualitätssicherung muss deshalb im Sinne einer Prozesskette in die Leistungserstellung eingebunden werden, was im Artikel verdeutlicht wird.
Bei der Integration technischer Energiemanagementsysteme (tEnMS) in Automatisierungsanlagen fällt ein hoher Engineering-Aufwand an, besonders für die Steuerungsprogrammierung. Dieser Engineering-Aufwand ist für industrielle Anwender der Hauptgrund, integrierte tEnMS nicht einzusetzen. Im Rahmen des Forschungsprojektes „Integriertes Anlagenengineering zur Erhöhung der Energieeffizienz (IAE4)“ (Förderkennzeichen: ZN2948; Forschungsprofessur des Landes Niedersachsen/Volkswagenstiftung) wurde untersucht, wie sich dieser Engineering-Aufwand reduzieren lässt. Hierzu wurde ein Software-Werkzeug entwickelt, das die benötigten Steuerungsprogramme automatisch aus Engineering-Daten und Gerätebeschreibungsdateien generiert. Dieser Beitrag stellt die Ergebnisse des IAE4-Projektes vor.
M2M (machine-to-machine) systems use various communication technologies for automatically monitoring and controlling machines. In M2M systems, each machine emits a continuous stream of data records, which must be analyzed in real-time. Intelligent M2M systems should be able to diagnose their actual states and to trigger appropriate actions as soon as critical situations occur. In this paper, we show how complex event processing (CEP) can be used as the key technology for intelligent M2M systems. We provide an event-driven architecture that is adapted to the M2M domain. In particular, we define different models for the M2M domain, M2M machine states and M2M events. Furthermore, we present a general reference architecture defining the main stages of processing machine data. To prove the usefulness of our approach, we consider two real-world examples ‘solar power plants’ and ‘printers’, which show how easily the general architecture can be extended to concrete M2M scenarios.
Inwiefern eignet sich Gemeinde als Ort intergenerationeller Lern- und Bildungsprozesse? Zur Beantwortung dieser Frage werden drei Formen des Generationenverhältnisses sowie drei Grundkonzeptionen intergenerationellen Lernens beschrieben, um anschließend nach den didaktischen Herausforderungen und begünstigenden Rahmenbedingungen zu fragen.
During machine milking, pathogenic microorganisms can be transmitted from cow to cow through liners. Therefore, in Germany, a spray method for the intermediate disinfection of the milking cluster is often used for prevention. This method of cluster disinfection is easy to perform, requires little time and no extra materials, and the disinfection solution is safe from outside contamination in the spray bottle. Since no data on a systematic efficacy trial are available, the aim of this study was to determine the microbial reduction effect of intermediate disinfection. Therefore, laboratory and field trials were conducted. In both trials, two sprays of 0.85 mL per burst of different disinfectant solutions were sprayed into the contaminated liners. For sampling, a quantitative swabbing method using a modified wet–dry swab (WDS) technique based on DIN 10113-1: 1997-07 was applied. Thus, the effectiveness of disinfectants based on Peracetic Acid, Hydrogen Peroxide and Plasma-Activated Buffered Solution (PABS) was compared. In the laboratory trial, the inner surfaces of liners were contaminated with pure cultures of Escherichia (E.) coli, Staphylococcus (S.) aureus, Streptococcus (Sc.) uberis and Sc. agalactiae. The disinfection of the contaminated liners with the disinfectants resulted in a significant reduction in bacteria with values averaging 1 log for E. coli, 0.7 log for S. aureus, 0.7 log for Sc. uberis and 0.8 log for Sc. agalactiae. The highest reduction was obtained for contamination with E. coli (1.3 log) and Sc. uberis (0.8 log) when PABS was applied and for contamination with S. aureus (1.1 log) and Sc. agalactiae (1 log) when Peracetic Acid Solution (PAS) was used. Treatment with sterile water only led to an average reduction of 0.4 log. In the field trial, after the milking of 575 cows, the liners were disinfected and the total microorganism count from the liner surface was performed. The reduction was measured against an untreated liner within the cluster. Although a reduction in microorganisms was achieved in the field trial, it was not significant. When using PAS, a log reduction of 0.3 was achieved; when using PABS, a log reduction of 0.2 was obtained. The difference between the two disinfection methods was also not significant. Treatment with sterile water only led to a reduction of 0.1 log. The results show that spray disinfection under these circumstances does result in a reduction in the bacteria on the milking liner surface, but for effective disinfection a higher reduction would be preferred.
High-performance firms typically have two features in common: (i) they produce in more than one country and (ii) they produce more than one product. In this paper, we analyze the internationalization strategies of multi-product firms. Guided by several new stylized facts, we develop a theoretical model to determine optimal modes of market access at the firm–product level. We find that the most productive firmssell core varieties via foreign direct investment and export products with intermediate productivity. Shocks to trade costs and technology affect the endogenous decision to export or produce abroad at the product-level and, in turn, the relative productivity between parents and affiliates.
Über die vergangenen Jahrzehnte hat sich die Interne Unternehmenskommunikation stets auf durch ökonomische Herausforderungen bedingte organisationale Veränderungen eingestellt und ihre Modelle zur Motivation und Integration von Mitarbeitern den Veränderungen im strategischen und operativen Management angepasst. Ging es in den 70er und 80er Jahren dabei noch um das Herstellen von Mitarbeiterzufriedenheit, drehte sich seit den 90er Jahren in der Folge des zunehmenden globalen Wettbewerbs dann alles um das Mitarbeiterengagement.<br /> Dieser Beitrag unternimmt einen Versuch, die Geschichte der Internen Unternehmens-kommunikation in Deutschland zu beleuchten. Dazu wird der Blickwinkel des Kommunikationsmanagements eingenommen, welches die Funktion der generellen Unternehmenskommunikation und damit auch die ihrer Teildisziplin für die Anspruchsgruppe der Mitarbeiter unter betriebswirt-schaftlichen Gesichtspunkten betrachtet und in den Wertschöpfungsprozess eines Unternehmens einordnet. <br /> Es wird gezeigt, dass und wie sich die Interne Unternehmenskommunikation über die vergangenen Jahrzehnte auf durch ökonomische Herausforderungen bedingte organisationale Veränderungen eingestellt und diese unterstützt hat. Die jeweiligen Lösungsansätze der Internen Kommunikation dienten immer dazu, die Mitarbeiter zum Vorteil der Unternehmensführung in das Unternehmensgeschehen zu integrieren. <br /> Und so, wie sich im Laufe der Zeit das strategische und operative Management veränderte, entwickelte sich auch die hier zu beschreibende Disziplin weiter.<br /> Unterdessen ist der Wandel Normalität geworden, doch mehr als jeder dritte Veränderungsprozess kann auch heute noch vor allem durch eine mangelnde Integration der Mitarbeiter als nicht erfolgreich betrachtet werden. Aber mehr denn je ist die kreative Beteiligung der Betroffenen und die Übernahme von Eigenverant-wortung notwendig. Entsprechende Maßnahmen der Internen Unternehmenskommunikation müssen nun aus einem Modell für Mobilisierung erwachsen.<br /> Inzwischen stellen diese Zusammenhänge die Verantwortlichen für die Interne Kommunikation vor große Herausforderungen und erfordern ein hohes Maß an Professionalität, die aber in der Praxis noch längst nicht überall Einzug gehalten hat. So gibt dieser Beitrag auch einen Ausblick auf die aktuell zu erkennenden Unterstützungspotenziale der Internen Unternehmenskommunikation im Wertschöpfungsprozess.<br />
During the European debt crisis, German and Greek media frequently reported on the political conflict between the two countries. This article examines to what extent the media coverage in one country about the other is considered by German and Greek citizens to be hostile (‘hostile media perception’) and influential (‘influence of presumed influence’). Data from a comparative survey in Germany (n = 492) and Greece (n = 484) show that news coverage by foreign media on the European debt crisis is perceived by respondents as hostile against their own country and as influential. Moreover, both media-related perceptions are linked with intensified perceptions of hostility, such as assumptions that an individual’s country is not respected in the other country or that the other country’s citizens are demanding that the individual’s country be punished. Based on these results, it is discussed whether media-related perceptions can have a conflict-intensifying effect in international crises.
Background: Interprofessionalism, considered as collaboration between medical professionals, has gained prominence over recent decades and evidence for its impact has grown. The steadily increasing number of residents in nursing homes will challenge medical care and the interaction across professions, especially nurses and general practitioners (GPS). The nursing home visit, a key element of medical care, has been underrepresented in research. This study explores GP perspectives on interprofessional collaboration with a focus on their visits to nursing homes in order to understand their experiences and expectations. This research represents an aspect of the interprof study, which explores medical care needs as well as the perceived collaboration and communication by nursing home residents, their families, GPS and nurses. This paper focusses on GPS' views, investigating in particular their visits to nursing homes in order to understand their experiences. Methods: Open guideline-interviews covering interprofessional collaboration and the visit process were conducted with 30 GPS in three study centers and analyzed with grounded theory methodology. GPS were recruited via postal request and existing networks of the research partners. Results: Four different types of nursing home visits were found: visits on demand, periodical visits, nursing home rounds and ad-hoc-decision based visits. We identified the core category "productive performance" of home visits in nursing homes which stands for the balance of GPŚ individual efforts and rewards. GPS used different strategies to perform a productive home visit: preparing strategies, on-site strategies and investing strategies. Conclusion: We compiled a theory of GPS home visits in nursing homes in Germany. The findings will be useful for research, and scientific and management purposes to generate a deeper understanding of GP perspectives and thereby improve interprofessional collaboration to ensure a high quality of care.
Background: Given both the increase of nursing home residents forecast and challenges of current interprofessional interactions, we developed and tested measures to improve collaboration and communication between nurses and general practitioners (GPs) in this setting. Our multicentre study has been funded by the German Federal Ministry of Education and Research (FK 01GY1124).
Methods: The measures were developed iteratively in a continuous process, which is the focus of this article. In part 1 “exploration of the situation”, interviews were conducted with GPs, nurses, nursing home residents and their relatives focusing on interprofessional interactions and medical care. They were analysed qualitatively. Based on these results, in part 2 “development of measures to improve collaboration”, ideas for improvement were developed in nine focus groups with GPs and nurses. These ideas were revisited in a final expert workshop. We analysed the focus groups and expert workshop using mind mapping methods, and finally drew up the compilation of measures. In an exploratory pilot study "study part 3" four nursing homes chose the measures they wanted to adopt. These were tested for three months. Feasibility and acceptance of the measures were evaluated via guideline interviews with the stakeholders which were analysed by content analyses.
Results: Six measures were generated: meetings to establish common goals, main contact person, standardised pro re nata medication, introduction of name badges, improved availability of nurse/GP and standardised scheduling/ procedure for nursing home visits. In the pilot study, the measures were implemented in four nursing homes. GPs and nurses reviewed five measures as feasible and acceptable, only the designation of a “main contact person” was not considered as an improvement.
Conclusions: Six measures to improve collaboration and communication could be compiled in a multistep qualitative process respecting the perspectives of involved stakeholders. Five of the six measures were positively assessed in an exploratory pilot study. They could easily be transferred into the daily routine of other nursing homes, as no special models have to exist in advance. Impact of the measures on patient oriented outcomes should be examined in further research.
Trial registration: Not applicable.
To reduce the negative effects of mastitis in dairy heifers in early lactation on the future milking performance, the aim of this study was to define the time-related period of intramammary infections and to relate this to risk factors at heifer and quarter level for intramammary infections and subclinical mastitis. In total, 279 German Holstein Frisian heifers in three farms in Northern and Eastern Germany were included in this study. Quarter milk samples for cytomicrobiological examination were collected 3 +- 1 days after calving and 17 +- 3 days after calving, and risk factors
at heifer and quarter level associated with intramammary infections and clinical mastitis were recorded during the trial period. Data were analyzed using logistic regression procedures and odds ratios were calculated. Calving at older ages increased the odds of intramammary infections with non-aureus staphylococci (NAS) and coryneforms 17 +- 3 days after calving compared to heifers calving at a younger age. Detaching of milking cups during milking is a risk factor for new infections between day 3 +- 1 and 17 +- 3 postpartum. The milk yield after calving is associated with a decrease in intramammary infections with environmental pathogens and clinical mastitis. A high milk yield assists the development of udder edema with an increased risk of intramammary infections with NAS and coryneforms. An increased somatic cell count (SCC) after calving increased the odds of intramammary infections with contagious pathogens 17 +- 3 days postpartum. The early lactation has an important influence on udder health and intramammary infections postpartum in dairy heifers. Udder quarters eliminated pathogens during early lactation by 6.9% for cases in
this study. New infections manifest themselves up until 17 +- 3 days postpartum, especially with Corynebacterium spp. and NAS. In total, 82.9% of the infected quarters showed new infections with another pathogen species 17 +- 3 days postpartum than 3 +- 1 days postpartum. In conclusion, the early lactation has an important influence on udder health and intramammary infections postpartum in heifers with the possibility that udder quarters eliminate pathogens, but also the danger that new infections manifest themselves. Thus, the prevention of new infections by minimizing the associated risk factors is of great importance.
Corynebacterium spp. are frequently detected in bovine quarter milk samples, yet their impact on udder health has not been determined completely. In this longitudinal study, we collected quarter milk samples from a dairy herd of approximately 200 cows, ten times at 14 d intervals. Bacteriologically, Catalase-positive and Gram-positive rods were detected in 22.7% of the samples. For further species diagnosis, colonies were analyzed by MALDITOF MS. Corynebacterium bovis, C. amycolatum, C. xerosis and 10 other Corynebacterium spp. were detected. The three aforementioned species accounted for 88.4%, 8.65% and 0.94% of all cultured Corynebacterium spp., respectively. For further evaluation of infection dynamics, the following three infection definitions were applied: A (2/3 consecutive samples positive for the same species), B (≥1000 cfu/mL in one sample), C (isolated from a clinical mastitis case). Infections according to definition B occurred most frequently and clinical mastitis with Corynebacterium spp. occurred once during sampling. Life tables were used to determine the duration of infection. According to infection definition A, infection durations of 111 d and 98 d were obtained for C. bovis and C. amycolatum, respectively. Exemplarily, longer lasting infections were examined for their strain diversity by RAPD PCR. A low strain diversity was found in the individual quarters that indicates a longer colonization of the udder parenchyma by C. bovis and C. amycolatum.
Investigations on Transfer of Pathogens between Foster Cows and Calves during the Suckling Period
(2021)
To date, there have been few studies on the health effects of foster cow systems, including the transmission of mastitis-associated pathogens during suckling. The present study aimed to compare the pathogens detected in the mammary glands of the foster cow with those in the oral cavities of the associated foster calves and to evaluate the resulting consequences for udder health, calf health and internal biosecurity. Quarter milk sampling of 99 foster cows from an organic dairy farm was conducted twice during the foster period. Oral cavity swabs were taken from 345 foster calves. Furthermore, quarter milk samples were collected from 124 biological dams to investigate possible transmission to the foster cows via the suckling calves. All samples were microbiologically examined and confirmed by MALDI-TOF (matrix-assisted laser desorption time-offlight mass-spectrometry). Using RAPD-PCR (randomly amplified polymorphic DNA polymerase chain reaction), strain similarities were detected for Pasteurella multocida, Staphylococcus aureus, S. sciuri and Streptococcus (Sc.) suis. Transmission of P. multocida and S. aureus probably occurred during suckling. For S. sciuri and Sc. suis, environmental origins were assumed. Transmission from dam to foster cow with the suckling calf as vector could not be clearly demonstrated.
Background:
In order to prevent child abuse, instruments measuring child abuse potential (CAP) need to be appropriate, reliable and valid.
Objective:
This study aimed to confirm the 6-factor structure of the Brief Child Abuse Potential Inventory (BCAPI) in a German sample of mothers and fathers, and to examine longitudinal predictors of CAP.
Participants and setting:
Two waves of data were collected from 197 mothers and 191 fathers of children aged 10–21 months for the “Kinder in Deutschland–KiD 0–3” in-depth study. Families were stratified based on prior self-report data for screening purposes.
Methods:
138 fathers and 147 mothers were included in the analysis (invalid: 25% mothers, 30% fathers). First, validity of reporting was examined. Second, confirmatory factor analysis (CFA) was employed to assess factor structure. Third, internal reliability and criterion validity were examined. Finally, multivariate poisson regressions investigated longitudinal predictors of CAP in mothers.
Results:
A previously established six-factor structure was confirmed for mothers but not fathers. CFA failed for fathers due to large numbers of variables with zero variance. For mothers, internal consistency and criterion validity were good. BCAPI score at follow-up was associated with baseline BCAPI score (β= 00.08), stress (β= 0.06), education (β=-0.19) and alcohol use(β= .58).
Conclusions:
Findings confirm the six-factor structure of the BCAPI among German mothers. The clinical use of the BCAPI in fathers is not recommended as it might produce data that are hard to interpret. Further research with fathers is needed to establish if this is due to limitations with this dataset or with the questionnaire.
Aim:
To characterize palliative care patients, to estimate the incidence, prevalence, and 1-year all-cause mortality in patients in Germany who received palliative care treatment.
Subject and methods:
The study analyzed the InGef Research Database, which covers 4 million people insured in German statutory health insurance companies. Specific outpatient and inpatient reimbursement codes were used to capture cases with palliative conditions. The prevalence was ascertained for the year 2015. The incidence was calculated for patients without documented palliative care services in the year before the observation period. The Kaplan–Meier method was used to analyze the 1-year all-cause mortality.
Results:
The incidence rate of palliative conditions was 41.3 and 34.9 per 10,000 persons in women and men, respectively. The prevalence per 10,000 persons was 61.3 in women and 51.1 in men. The 1-year all-cause mortality among patients receiving their first palliative care treatment was 67.5%. Mortality was lower in patients receiving general outpatient palliative care treatment (AAPV; 60.8%) compared to patients receiving specialized outpatient palliative care treatment (SAPV; 86.1%) or inpatient palliative care treatment (90.6%). Within the first 30 days, mortality was particularly high (~43.0%).
Conclusions:
In Germany, more than 400,000 patients per year receive palliative care treatment, which is lower compared to estimates of the number of persons with a potential need for palliative care. This gap was observed particularly in younger to middle-aged individuals. The findings indicate a demand for methodologically sound studies to investigate the public health burden and to quantify the unmet need for palliative care in Germany.
Betreiber von Produktionsanlagen stehen oft vor der Frage, welche Norm für die Absicherung der Anlage gegen Cyberangriffe heranzuziehen ist. Aus dem IT-Bereich ist die Normreihe ISO 27000 bekannt. Im Produktionsbereich wird häufig die Normreihe IEC 62443 herangezogen. Dieser Beitrag gibt einen Überblick über beide Normreihen und schlägt einen Ansatz zur gemeinsamen Nutzung beider Standards vor.
With the increasing significance of information technology, there is an urgent need for adequate measures of information security. Systematic information security management is one of most important initiatives for IT management. At least since reports about privacy and security breaches, fraudulent accounting practices, and attacks on IT systems appeared in public, organizations have recognized their responsibilities to safeguard physical and information assets. Security standards can be used as guideline or framework to develop and maintain an adequate information security management system (ISMS). The standards ISO/IEC 27000, 27001 and 27002 are international standards that are receiving growing recognition and adoption. They are referred to as “common language of organizations around the world” for information security. With ISO/IEC 27001 companies can have their ISMS certified by a third-party organization and thus show their customers evidence of their security measures.
Mein Beitrag versucht, die philosophischen und geschichtlichen Hintergründe eines zentralen Begriffs bei Saul D. Alinsky neu auszuleuchten, dem Begriff des Ressentiments. Alinsky, der Begründer des Community Organizing, hat bei der Organisation von Bürgergruppen versucht, vorhandene Ressentiments aufzulösen, indem er die zugrundeliegende Diskriminierungen artikulierbar macht, sie in politische Forderungen verwandelt, die schließlich in Verhandlungen umgesetzt werden. Er sah darin auch ein Verfahren, die Menschen vor falschen Agitatoren zu schützen.
Klebemöglichkeiten von PTFE
(1990)
Die hohe Beständigkeit und die antiadhäsiven Eigenschaften von Polytetrafluorethylen (PTFE) erschweren das Kleben dieses Kunststoffes beträchtlich. Da PTFE praktisch unlöslich ist, können Diffusionsklebverbindungen nicht hergestellt werden und Adhäsionsklebverbindungen haben nur eine geringe Festigkeit. Es ist jedoch durch entsprechende Behandlungen möglich, die Oberfläche so zu verändern, dass hochfeste Adhäsionsklebverbindungen möglich sind.
Kleben im Kraftfahrzeugbau
(1987)
Obwohl die Klebtechnik eines der ältesten Fügeverfahren der Welt ist, sind die Kenntnisse über diese Technik häufig noch sehr gering. Dies zeigt sich an vielen Stellen, beim Verkaufsgespräch von Klebstoffen, aber auch in Beiträgen zu klebtechnischen Seminaren. Es werden manchmal "Merk"würdige Ansichten über das Kleben geäußert.
Material tests were performed on a rediscovered Klimt-artwork “Trompetender Putto”. We performed studies on the red colored spots, mainly taken from non-restored parts. MIMOS II Fe-57 Mössbauer spectroscopy (novelty in art-pigment analysis) mainly reveals haematite and crystallized goethite in red colors. Electron microscopy can identify various layers of the original and overpainting of an artwork. The number of layers fluctuates between three and four chemically painted areas. The portable X-ray fluorescence analysis enables to reduce the pigment list to containing mercury (cinnabar), lead, zinc, iron and titanium. Infrared-lightirradiation visualizes the different age of the pigments.
Hintergrund:
Feedback von Patienten über erlebte Versorgungsaspekte erfolgt auch in der Rehabilitation inzwischen zunehmend online, beispielsweise auf Bewertungsportalen. Daher soll untersucht werden, welche von Rehabilitanden auf der für Reha-Kliniken führenden Bewertungsplattform Klinikbewertungen.de veröffentlichten Versorgungsaspekte mit der Weiterempfehlung einer Rehaklinik und welche negativen Aspekte mit der Nicht-Weiterempfehlung assoziiert sind.
Methode:
Eingeschlossen wurden Reha-Kliniken der Rentenversicherung Bund und federführend von ihr belegte Kliniken. Mit einem Mixed-Methods-Ansatz wurden aus acht Reha-Indikationsgruppen nach Zufriedenheitsstufen stratifizierte freitextliche Erfahrungsberichte von Rehabilitanden inhaltsanalytisch ausgewertet. Der Zusammenhang zwischen positiven (negativen) Aussagen mit der (Nicht-)Weiterempfehlung wurde in der jeweiligen Reha-Indikationsgruppe untersucht.
Ergebnisse:
Die Inhaltsanalyse von 911 Erfahrungsberichten ergab 20 thematische Kategorien. Der von Rehabilitanden wahrgenommene "Reha-Erfolg" war am häufigsten mit der Weiterempfehlung bzw. Nicht-Weiterempfehlung signifikant assoziiert. In fünf QS-Vergleichsgruppen war das Thema "Verpflegung" assoziiert. In allen QS-Vergleichsgruppen war mindestens ein prozessorientiertes Rehabilitationsthema assoziiert: "Reha-Maßnahmen", "Reha-Plan und Reha-Ziele" und/oder "Diagnose bis Entlassung".
Diskussion und Schlussfolgerung:
Reha-Kliniken können auf Basis der vorgestellten Ergebnisse indikationsspezifisch die für die Klinik-Weiterempfehlung relevanten Versorgungsaspekte identifizieren. Die Einbeziehung von Online-Erfahrungsberichten schafft zusätzliche Erkenntnisse über die Gründe der (Un-)Zufriedenheit von Rehabilitanden. Potenziellen Rehabilitanden steht das Erfahrungswissen als niederschwellige Informationsquelle und Entscheidungshilfe zur Verfügung
Background: Epilepsy is a chronic disorder of the brain that affects people worldwide. The overall prevalence (3.0-11.9 / 1,000) and incidence (0.2-0.6/1,000) of epilepsy in India are comparable to the rates of high-income countries. The high prevalence of negative attitudes towards epilepsy has been highlighted by several studies. Pharmacy students represent a better-educated section of society regarding drugs and have the potential to create awareness, and influence attitudes towards the disease. Thus, it is important that they have the appropriate and updated knowledge and appropriate attitude towards epilepsy and antiepileptic drugs. Objective of the present study was to determine the Mumbai University pharmacy student’s awareness about epilepsy, so as to know the kind of education and awareness strategies that would be applicable to them.
Methods: A cross-sectional study was carried out among students from Mumbai University, India during May-June 2017. Two hundred and fifty students were approached to participate in the study of which 213 agreed to participate (males: 107; females: 106). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23.
Results: Response rate for this study was 85.2% (213/250). Ninety six percent (204/213) of the participants had heard or read about epilepsy. Overall knowledge was poor (40.2%) and attitude was fair (75.3%). None of the participants were aware about recent research regarding hereditary nature of epilepsy. Only 2 (0.98%) students were aware how to perform the first aid in epilepsy. Only 6.8% participants felt that epileptics should participate in sports.
Conclusions: The findings of this study show that, even with extensive curriculum covering diseases, drugs and relevant laws of land, the knowledge and attitude scores were low. There is a need to have focused education and campaigns to increase the knowledge and attitude towards epilepsy.
Knowledge and attitude towards voluntary blood donation among students from Mumbai University
(2018)
Background: Blood is scarce; its demand far outweighs the supply. In addition to limited supply, the issue of safety especially with regard to the risk of transfusion transmissible infection is also an issue of utmost concern especially in the developing countries. Blood transfusion services in India have gained special significance in recent years and forms a vital part of national health care system. Voluntary Non-Remunerated Blood Donation (VNRBD) is the safest of all types of blood donations. One of the potential sources that can be tapped for blood donation is the young and physically fit students from educational institutions across India. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May–June 2017. Two hundred and fifty students were approached to participate in the study of which 201 agreed to participate (males: 104; females: 97). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: High number of participants agreed about encouraging general public about voluntary blood donation (96%; 193/201), lack of awareness about VBD in general public (82%; 164/201). But not a single participant was able to respond to the knowledge part of the questionnaire with 100% accuracy. Almost all the participants had correct knowledge about blood groups (98%; 196/201) and blood matching need (195/201; 97%). Conclusions: Participants showed good attitude but demonstrated poor knowledge about voluntary blood donation. Details about blood donation should be incorporated in the undergraduate curriculum and periodic awareness programs should be organized for students.
Background: Human papillomavirus (HPV) is a common sexually transmitted infection (STI) that may cause cervical cancer and other malignancies including those of the vulva, anus, vagina, penis, head and neck. In most Asian countries including India, cervical cancer is the second most common cancer in women. Awareness about HPV and cervical cancer, use of vaccines can be very helpful in prevention, control and early diagnosis of cervical cancer. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May - June 2017. Two hundred students were approached to participate in the study of which 142 were selected to participate (males: 54; females: 88). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: Participants had fair knowledge (61% average) about HPV, whereas knowledge about symptoms, prevention and spread of HPV was very poor i.e. 18%. Knowledge about HPV vaccine was 50% and 78% participants had positive attitude for HPV vaccine. Conclusions: This study showed the lacunas in the pharmacy curriculum and urgent need to create awareness of HPV among bachelor of pharmacy students from Mumbai University.
Background: Discovery of antibiotics have helped to manage the devastating diseases. Presently, the antibiotic era is threatened by the emergence of high level of antibiotic resistance of important pathogens. Misuse of antibiotics poses a serious risk to infectious disease control. It is necessary to improve public awareness to bring a change in the behavior of consumers. Therefore, present study was undertaken to assess the existing knowledge, attitude and practices related to antibiotic usage among university students.
Methods: A cross-sectional study was carried out among students from Mumbai University, India during May-June 2017. 300 students were approached to participate in the study of which 250 agreed to participate (males: 117; females: 133). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23.
Results: Substantial number (33% and 40%) participants were unaware about the differences in antibiotic-anti-inflammatory drugs and antibiotic-antipyretics respectively. 28% of the participants thought it is right to stop antibiotics only based on symptoms improvement. Sixty eight percent and seventy nine percent participants believed that antibiotics should always be prescribed to treat flu like symptoms and pneumonia respectively.
Conclusions: Participants demonstrated poor knowledge about antibiotics. Similarly, their attitude and practice toward antibiotic use was associated with misconceptions. An educational intervention can be introduced to make them aware about rational antibiotic practices.
Background: Antimicrobial resistance has become a serious global problem. A potential post-antibiotic era is threatening present and future medical advances. In Pakistan, the usage of antibiotic is unnecessarily high and due to over exposure to these drugs, bacteria are developing resistance against these drugs. It is necessary to improve public awareness about the rational use of antibiotics in order to bring a change in consumer’s behaviour. Therefore, present study was undertaken to assess the existing knowledge, attitude and practices related to antibiotic usage among university students.
Methods: A cross-sectional study was carried out among university students from Karachi, Pakistan during May-June 2018. 200 students were approached to participate in the study of which 159 agreed to participate (males: 70, females: 89). Pretested questionnaire was distributed to the study subjects and the collected data was analyzed using IBM SPSS version 23.
Results: Substantial number of (33% and 50%) participants were unaware about the differences in antibiotic: anti-inflammatory drugs and antibiotic: antipyretics respectively. 29% of the participants thought it is right to stop antibiotics only based on symptomatic improvement. Thirty nine percent and eighty three percent participants believed that antibiotics should always be prescribed to treat flu like symptoms and pneumonia respectively.
Conclusions: Participants demonstrated average knowledge about antibiotics. Similarly, their attitude and practice toward antibiotic use was associated with misconceptions. An educational intervention is necessary to make them aware about rational use of antibiotics.
In Zeitmultiplex-Vielfachzugriff-(TDMA-)Durchschalte-Vermittlungsnetzen mit verteilter Steuerung können Kollisionen von Zugriffsvorgängen auftreten. Es wird unterstellt, daß die den kollidierenden Zugriffsvorgängen zugehörigen Verbindungswünsche nicht weiterbehandelt werden und deshalb wegen Kollision zu Verlust gehen. Die zugehörige Verlustwahrscheinlichkeit -genannt Kollisionsverlust BK - wird allgemein berechnet. Die numerische Auswertung zeigt, daß für Fernsprechverkehr diese - gegenüber Systemen mit konzentrierter Steuerung - zusätzlichen Kollisionsverluste vernachlässigt werden können gegenüber den üblichen Planungsverlusten wegen Abnehmermangels.
Die Funktion eines Gebäudes, seine flächenmäßige Ausdehnung und seine Gliederung sowie seine Einbettung in die Umgebung bestimmen letztendlich die Dachkonstruktion. Der Planer steht hierbei vor der Aufgabe, unter Beachtung aller bauphysikalischen wie bautechnischen Gegebenheiten ein Optimum an gestalterischer Qualität bei Respektierung wirtschaftlicher und baupraktischer Belange zu realisieren, wobei zu beachten ist, dass gerade das Dach von den die Gebäudehülle bildenden Bauteilen der größten und unmittelbarsten Beanspruchung unterliegt.
Gutes Arbeiten für Mitarbeiter ist je nach Arbeitskontext unterschiedlich zu bewerten, hängt jedoch von der Gestaltung bestimmter Kontextfaktoren ab. Die Kontextfaktoren guter Arbeit sind der zentrale Forschungsgegenstand dieser Arbeit. Dabei steht ein E‑Commerce-Team (EC-Team) von Otto im Fokus der Untersuchungen.
Das Ziel unseres Artikels ist es, die Kontextfaktoren zu analysieren, die dazu führen, dass gute Arbeit ermöglicht wird. Dabei ist eine auf Dauer funktionierende Arbeitsweise gesucht, welche eine hohe Arbeitsqualität und -quantität ermöglicht. Dazu sind die beiden primären Ziele zu definieren, was gutes Arbeiten ausmacht und zum anderen die Kontextfaktoren für gutes Arbeiten innerhalb des EC-Teams bei Otto zu identifizieren.
Unsere Forschungsfrage lautet: Welche Kontextfaktoren sind für gutes Arbeiten bei Otto im EC-Team in der derzeitigen Remote-Arbeit besonders relevant und entsprechend gestaltbar?
Um die Forschungsfrage beantworten zu können, wird zunächst eine Literaturrecherche zur Definition von guter Arbeit vorgenommen. Anschließend wird untersucht, welche Faktoren laut Literatur zu einer guten Arbeit beitragen, um aus den resultierenden Faktoren Cluster zu bilden.
Die Cluster werden dem Otto EC-Team zur Abstimmung mit der Mehrpunktabfrage über das virtuelle Kollaborations-Tool MiroFootnote 2 zur Verfügung gestellt. Aufbauend auf dem Ergebnis der Abstimmung, werden ein Gamification Board, Erinnerungsmails und ein Stimmungsbarometer erstellt, um die Auswirkungen des Clusters im Rahmen eines Experiments zu analysieren.
Diese Maßnahmen werden innerhalb von zwei Wochen durchgeführt. Um die Erfahrungen der Probanden zu sammeln, werden anschließend Interviews durchgeführt und ausgewertet. Die Ergebnisse der Interviews fließen in die anschließende Handlungsempfehlung ein.
Für die Studiengang-Auswahl existiert eine Reihe i. d. R. Fragebogen-gestützter Online-Studiengangfinder. Eine Analyse zeigte Optimierungspotenziale: Studienangebote sind meist auf ein Bundesland oder eine Hochschule beschränkt oder, allgemein beschrieben, die individuelle Studiengang-Auswahl ist nur mit Unschärfen möglich. Letzteres wirkt sich z. B. bei Bindestrich-Studiengängen (z. B. Wirtschaftsingenieurwesen) aus, die je nach Hochschule inhaltlich variieren können. Hier setzt das Portal an. Ziele sind: Bereitstellung der in der Sprachwelt Studieninteressierter gehaltenen Fragebögen, Möglichkeit für Hochschulen/Einrichtungen, Studiengänge bereitzustellen.
Die Milchwirtschaft will höhere Preise für Speisequark erlösen. Begründet wird dies mit der in der Bundesrepublik Deutschland gesetzlich verordneten Trockenmasseanhebung des Speisequarks von 17% auf 18%. Da diese Änderung zum 1. Januar 1987 bereits in Kraft trat und den Molkereiunternehmen lange vorher bekannt war, ist die Frage zu stellen, warum eine Änderung der variablen Kosten, von der alle Hersteller gleichermaßen betroffen sind, so schwer am Markt in entsprechende Preisanhebungen umzusetzen ist.
Angebote Kultureller Bildung im Kontext von Prävention arbeiten vor allem mit Jugendlichen, die im Sinne des Empowerment-Ansatzes gestärkt werden sollen, um gegen Rechtsextremismus einzutreten. Selten gibt es Projekte, die mit Jugendlichen arbeiten, die rechtsextreme Orientierungen aufweisen. Ausgehend von unterschiedlichen Dimensionen der Präventionsarbeit mit Jugendlichen in Radikalisierungsprozessen stellt der Beitrag mehrere Handlungsfelder der Kulturellen Bildung dar, in denen sich sowohl besondere Potenziale als auch Ambivalenzen der Jugendkulturarbeit mit rechtsorientierten Jugendlichen ergeben. Dabei zeigt sich, dass es für eine erfolgversprechende künstlerisch-pädagogische Arbeit mit rechtsorientierten Jugendlichen nicht nur eines besonderen milieuspezifischen Wissens über die Lebenswelt der rechtsextremen Szene bedarf. Diese Arbeit erfordert auch eine pädagogische sowie politische Haltung, die rechtsorientierte Jugendliche als Personen und Menschen mit Bedürfnissen, Träumen, Lebenszielen usw. anerkennt und mit einer milieuübergreifenden, diversitätsbewussten Perspektive die unterschiedlichen Wege und Faktoren, die zu einer „rechten Karriere“ führen können, in der jugendkulturellen Arbeit berücksichtigt, ohne die menschenverachtenden Weltbilder zu akzeptieren.
Kleine Losgrößen, bedingt durch immer neue Kundenanforderungen nach speziellen Produktausführungen, lassen aus Wettbewerbsgründen eine konventionelle Massenproduktion mit unfelxiblen Produktionsabläufen nicht mehr zu. Neue Wege sind nötig, um gegenüber der Konkurrenz - besonders aus Fernost - auch in Zukunft wettbewerbsfähig zu bleiben. Dabei hat gerade diese Konkurrenz mnachen Anstoss zur Veränderung durch für uns ungewohnte Wettbewerbsstrategien gegeben. Auch wenn viele der Grundlagen und Methoden dieser Strategien aus Europa stammen, wurden sie sehr geschickt und innovativ den dortigen gesellschaftlichen und technologischen Randbedingungen angepasst. Nun sind sie in anderer Form bei uns wieder ins Bewusstsein zurückgekehrt. Dies gilt insbesondere für Lean Production, die "schlanke" Produktion. Hier können die Fachleute bei uns lernen, wie sich durch Mitarbeitermotivierung, Vereinfachung und Dezentralisierung der Abläufe der Weltkostenstand wieder erreichen lässt.
The use of secondary data in health care research has become a very important issue over the past few years. Data from the treatment context are being used for evaluation of medical data for external quality assurance, as well as to answer medical questions in the form of registers and research databases. Additionally, the establishment of electronic clinical systems like data warehouses provides new opportunities for the secondary use of clinical data. Because health data is among the most sensitive information about an individual, the data must be safeguarded from disclosure.
Libworld. Biblioblogs global
(2007)
Zuerst wird auf die Wichtigkeit bibliotheks- und informationswissenschaftlicher Fachkommunikation eingegangen. Die Eignung von Blogs zur Kommunikation innerhalb einer wissenschaftlichen Disziplin wird hervorgehoben. Es folgt eine allgemeine Typologie der Blogger. Abschließend wird das Projekt LibWorld des Fachblogs Infobib vorgestellt. Im Rahmen dieses Projektes stellen Gastautoren aus zahlreichen Ländern die Biblioblogosphäre (bibliotheksrelevante Blogs) ihrer Heimat vor.