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The network security framework VisITMeta allows the visual evaluation and management of security event detection policies. By means of a "what-if" simulation the sensitivity of policies to specific events can be tested and adjusted. This paper presents the results of a user study for testing the usability of the approach by measuring the correct completion of given tasks as well as the user satisfaction by means of the system usability scale.
Introduction:
Human Immunodeficiency Virus (HIV) infection remains prevalent co-morbidity, and among fracture patients. Few studies have investigated the role of exercise interventions in preventing bone demineralization in people who have fractures and HIV. If exercise exposed, HIV-infected individuals may experience improved bone health outcomes (BMD), function, quality of life (QoL). The study will aim to assess the impact of home based exercises on bone mineral density, functional capacity, QoL, and some serological markers of health in HIV infection among Nigerians and South Africans.
Methods and design:
The study is an assessor-blinded randomized controlled trial. Patients managed with internal and external fixation for femoral shaft fracture at the study sites will be recruited to participate in the study. The participants will be recruited 2 weeks post-discharge at the follow-up clinic with the orthopaedic surgeon. The study population will consist of all persons with femoral fracture and HIV-positive and negative (HIV-positive medically confirmed) aged 18 to 60 years attending the above-named health facilities. For the HIV-positive participants, a documented positive HIV result, as well as a history of being followed-up at the HIV treatment and care center. A developed home based exercise programme will be implemented in the experimental group while the control group continues with the usual rehabilitation programme. The primary outcome measures will be function, gait, bone mineral density, physical activity, and QoL.
Discussion:
The proposed trial will compare the effect of a home-based physical exercise-training programme in the management of femoral fracture to the usual physiotherapy management programmes with specific outcomes of bone mineral density, function, and inflammatory markers.
Die folgende Studie befasst sich mit den Auswirkungen der Corona-Pandemie und deren Effekt – ein verminderter CO2-Ausstoß in Deutschland. Für einen übersichtlichen Vergleich wird im weiteren Verlauf in unterschiedlichen Szenarien darauf eingegangen, wie sich der CO2-Ausstoß im Vergleich zu 2020 ohne die Corona-Pandemie in Deutschland verändern könnte. Grundbasis für die Ermittlungen der folgenden Szenarien ist der CO2-Trend ohne die Corona-Pandemie im Jahr 2020, in dem Deutschland das Emissionsziel von -40 % gegenüber 1990 mit einer Reduktion von lediglich 37 % verfehlt hätte. Im zweiten Szenario wird dargestellt, wie sich die aktuelle Corona-Pandemie mit verschiedenen Lockdown-Phasen auf den CO2-Ausstoß auswirkt. Deutlich wird hierbei, dass trotz der aktuellen Maßnahmen eine längere Lockdown-Phase benötigt wird, um das Klimaziel von -40 % langfristig gesichert zu erreichen. In den Szenarien 3 und 4 liegt der Fokus auf möglichen Handlungs- und Verhaltensweisen nach der Pandemie. Das Szenario 3 betrachtet die Folgen von wirtschaftsfördernden Maßnahmen nach dem Lockdown und dem damit einhergehenden CO2-Anstieg. Wie viel CO2 zusätzlich aufgrund von nachhaltigem und klimaorientiertem Verhalten eingespart werden kann, erläutert das Szenario 4 „CO2 Entwicklung unter Berücksichtigung der Corona-Pandemie 2020 und möglicher positiver Umweltentwicklungen aus dem Lockdown“.
Faktoren, wie die wachsende Bevölkerung, sich verändernde Produktionsfaktoren oder Umwelteinflüsse wurden vernachlässigt. Die Studie zeigt, dass die Chancen, die durch die wirtschaftlichen Einschnitte und die Verhaltensänderungen, die durch die Corona-Pandemie bzw. deren Folgen hervorgerufen wurden, einen maßgeblichen Einfluss auf den CO2-Ausstoß der Bundesrepublik Deutschland haben können.
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.
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.
Digital data on tangible and intangible cultural assets is an essential part of daily life, communication and experience. It has a lasting influence on the perception of cultural identity as well as on the interactions between research, the cultural economy and society. Throughout the last three decades, many cultural heritage institutions have contributed a wealth of digital representations of cultural assets (2D digital reproductions of paintings, sheet music, 3D digital models of sculptures, monuments, rooms, buildings), audio-visual data (music, film, stage performances), and procedural research data such as encoding and annotation formats. The long-term preservation and FAIR availability of research data from the cultural heritage domain is fundamentally important, not only for future academic success in the humanities but also for the cultural identity of individuals and society as a whole. Up to now, no coordinated effort for professional research data management on a national level exists in Germany. NFDI4Culture aims to fill this gap and create a usercentered, research-driven infrastructure that will cover a broad range of research domains from musicology, art history and architecture to performance, theatre, film, and media studies.
The research landscape addressed by the consortium is characterized by strong institutional differentiation. Research units in the consortium's community of interest comprise university institutes, art colleges, academies, galleries, libraries, archives and museums. This diverse landscape is also characterized by an abundance of research objects, methodologies and a great potential for data-driven research. In a unique effort carried out by the applicant and co-applicants of this proposal and ten academic societies, this community is interconnected for the first time through a federated approach that is ideally suited to the needs of the participating researchers. To promote collaboration within the NFDI, to share knowledge and technology and to provide extensive support for its users have been the guiding principles of the consortium from the beginning and will be at the heart of all workflows and decision-making processes. Thanks to these principles, NFDI4Culture has gathered strong support ranging from individual researchers to highlevel cultural heritage organizations such as the UNESCO, the International Council of Museums, the Open Knowledge Foundation and Wikimedia. On this basis, NFDI4Culture will take innovative measures that promote a cultural change towards a more reflective and sustainable handling of research data and at the same time boost qualification and professionalization in data-driven research in the domain of cultural heritage. This will create a long-lasting impact on science, cultural economy and society as a whole.
Vergleich von nativer App- und Cross-Platform-Entwicklung (Facebook React Native und Google Flutter)
(2020)
Die Entwicklung mobiler Applikationen für iOS und Android ist in der Regel mit viel Arbeit verbunden, da man für beide Plattformen gezwungenermaßen unterschiedlichen Quelltext schreiben muss. Abhilfe für dieses Problem schaffen Cross-Platform-Frameworks wie React Native von Facebook oder Flutter von Google. Anhand dieser Frameworks lassen sich Apps für beide Plattformen mit nur einer Codebase entwickeln. Eine kritische Stelle und oft gebrauchtes Kontra-Argument gegen die Entwicklung mit Cross-Platform-Frameworks ist die Hardwarenähe der nativen Applikationen, an welcher es den Frameworks vermeintlich mangelt. Doch wie ist der Stand der Dinge im Jahr 2020? Können Cross-Platform-Frameworks inzwischen performant und einfach auf Hardwarekomponenten zugreifen und machen damit die mühsame, native Entwicklung für iOS und Android vor allem in Anbetracht der Entwicklung von größerer Enterprise-Software obsolet?
Dieser Frage wird in dieser Arbeit nachgegangen und generell überprüft wie tauglich die Cross-Platform-Entwicklung ist. Nach dem Lesen dieser Bachelorarbeit sollte entschieden werden können, ob Cross-Platform-Frameworks für das Anwendungsproblem des Lesers geeignet sind. Um die Forschungsfrage zu beantworten, wurden je zwei Applikationen im Rahmen einer Fallstudie für je iOS und Android entwickelt, damit geprüft werden konnte, wie förderlich die zuvor genannten Frameworks sind. Der Fokus der Arbeit liegt also auf der Güte bzw. dem heutigen Stand der Cross-Platform-Entwicklung, vor allem im Bezug auf die Benutzung von Hardwarekomponenten bzw. betriebssystemspezifischen Diensten (Bluetooth, Kamera, etc.).
Die Ergebnisse der Fallstudie zeigen, dass es stets auf den Kontext und die Komplexität der zu realisierenden Anwendung ankommt inwiefern Cross-Platform-Frameworks verwendet werden können. In simplen Anwendungsfällen können Frameworks meist zu einer erheblichen Kostenminimierung und Zeitersparnis führen, wohingegen bei komplexeren Anwendungen relativ schnell Grenzen und starke Abhängigkeiten erreicht werden.
With an increasing complexity and scale, sufficient evaluation of Information Systems (IS) becomes a challenging and difficult task. Simulation modeling has proven as suitable and efficient methodology for evaluating IS and IS artifacts, presupposed it meets certain quality demands. However, existing research on simulation modeling quality solely focuses on quality in terms of accuracy and credibility, disregarding the role of additional quality aspects. Therefore, this paper proposes two design artifacts in order to ensure a holistic quality view on simulation quality. First, associated literature is reviewed in order to extract relevant quality factors in the context of simulation modeling, which can be used to evaluate the overall quality of a simulated solution before, during or after a given project. Secondly, the deduced quality factors are integrated in a quality assessment framework to provide structural guidance on the quality assessment procedure for simulation. In line with a Design Science Research (DSR) approach, we demonstrate the eligibility of both design artifacts by means of prototyping as well as an example case. Moreover, the assessment framework is evaluated and iteratively adjusted with the help of expert feedback.
The objective of this study is to analyze noise patterns during 599 visceral surgical procedures. Considering work-safety regulations, we will identify immanent noise patterns during major visceral surgeries. Increased levels of noise are known to have negative health impacts. Based on a very finegrained data collection over a year, this study will introduce a new procedure for visual representation of intra-surgery noise progression and pave new paths for future research on noise reduction in visceral surgery. Digital decibel sound-level meters were used to record the total noise in three operating theatres in one-second cycles over a year. These data were matched to archival data on surgery characteristics. Because surgeries inherently vary in length, we developed a new procedure to normalize surgery times to run cross-surgery comparisons. Based on this procedure, dBA values were adjusted to each normalized time point. Noise-level patterns are presented for surgeries contingent on important surgery characteristics: 16 different surgery types, operation method, day/night time point and operation complexity (complexity levels 1–3). This serves to cover a wide spectrum of day-to-day surgeries. The noise patterns reveal significant sound level differences of about 1 dBA, with the mostcommon noise level being spread between 55 and 60 dBA. This indicates a sound situation in many of the surgeries studied likely to cause stress in patients and staff. Absolute and relative risks of meeting or exceeding 60 dBA differ considerably across operation types. In conclusion, the study reveals that maximum noise levels of 55 dBA are frequently exceeded during visceral surgical procedures. Especially complex surgeries show, on average, a higher noise exposure. Our findings warrant active noise management for visceral surgery to reduce potential negative impacts of noise on surgical performance and outcome.
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.
This paper presents the fundamental investigation on crack propagation rate (CPR) and Stress Intensity Factor (SIF) for a typical fatigue and welded specimens which are Compact Tension (CT) and Single Edge Notch Tension (SENT) as well as Butt and longitudinal T-joint. The material data of austenitic stainless steel SS316L was used to observe crack propagation rate with different initial crack length and different tensile load was used for the fracture mechanics investigation. The geometry of the specimens was modelled by using open source software CASCA while Franc 2D was used for post processing based on Paris Erdogan Law with different crack increment steps. The analysis of crack propagation using fracture mechanics technique requires an accurate calculation of the stress intensity factor SIF and comparison of the critical strength of the material (KIC) was used to determine the critical crack length of the specimens. it can be concluded that open source finite element method software can be used for predicting of fatigue life on simplified geometry.
Concreteness of words has been measured and used in psycholinguistics already for decades. Recently, it is also used in retrieval and NLP tasks. For English a number of well known datasets has been established with average values for perceived concreteness.
We give an overview of available datasets for German, their correlation and evaluate prediction algorithms for concreteness of German words. We show that these algorithms achieve similar results as for English datasets. Moreover, we show for all datasets there are no significant differences between a prediction model based on a regression model using word embeddings as features and a prediction algorithm based on word similarity according to the same embeddings.
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.
Untersuchungen zu Berufen der Wirtschaftsinformatik bleiben weiterhin
interessant, wenn sie helfen können, dem mittlerweile länger anhaltenden
IT-Fachkräftemangel entgegenzuwirken. Eine Untersuchung der Hochschule
Hannover zu Wirtschaftsinformatikern/-informatikerinnen in den ersten zehn Jahren im Beruf zeigt deren berufliche Ziele und die berufliche Zufriedenheit, die sie erlangen. Deutlich wird, dass Frauen und Männer das Arbeitsklima und die Arbeitsbedingungen sehr unterschiedlich wahrnehmen und daher auch unterschiedlich zufrieden sind. Dabei bemängeln Frauen vor allem Merkmale, die mit „fehlender Fairness“ zu beschreiben sind.
Vor der Abgabe einer Studien- oder Abschlussarbeit ist dringend eine sorgfältige Überarbeitung in Form einer Endredaktion vorzunehmen, um eine gute Bewertung der Arbeit nicht zu gefährden. Dies ist einfach; denn das Vorgehen ist schlicht und wenig aufwändig. Daher wäre es besonders ärgerlich, einfache Fehler nicht zu beheben und dafür Abzüge bei der Bewertung der Arbeit hinzunehmen. Für eine Endredaktion wird hiermit eine Anleitung vorgelegt.
Insbesondere aufgrund der Zugehörigkeit zum sehr aktuellen und viel betrachteten Thema Machine Learning ist die genetische Programmierung mit ihren vielseitigen Anwendungsmöglichkeiten ein sehr interessantes Gebiet. Wie in allen Forschungsschwerpunkten gibt es auch hier viele Ansätze die standardmäßige Vorgehensweise weiter zu verbessern – einer dieser Ansätze ist die Verwendung von Subroutinen. Diese könnten in diesem Kontext auch als Methoden, Funktionen oder ähnliches bezeichnet werden und bedeuten, dass vom Algorithmus neben dem eigentlichen Programm auch wiederverwendbare Folgen von Anweisungen entwickelt werden, die über einen Bezeichner an beliebigen Stellen verwendet werden können. Hierfür gibt es bereits diverse Konzepte, die in Tests sehr gute Ergebnisse erzielt haben und eine Verbesserung gegenüber der standardmäßigen genetischen Programmierung ohne Subroutinen erreichen konnten. Diese Tests fanden allerdings immer in sehr spezialisierten Testumgebungen statt. Besonders interessant sind allerdings solche Systeme zur genetischen Programmierung, die (theoretisch) beliebige Probleme lösen kann, da sie für eine Vielzahl von Problemstellungen verwendet werden können.
Das Ziel dieser Arbeit ist es, zu untersuchen, ob und inwiefern die Verwendung von Subroutinen auch in einem solchen allgemeinen System zur genetischen Programmierung, das theoretisch dazu in der Lage ist, beliebige Probleme zu lösen, möglich und sinnvoll ist.
In parcel delivery, the “last mile” from the parcel hub to the customer is costly, especially for time-sensitive delivery tasks that have to be completed within hours after arrival. Recently, crowdshipping has attracted increased attention as a new alternative to traditional delivery modes. In crowdshipping, private citizens (“the crowd”) perform short detours in their daily lives to contribute to parcel delivery in exchange for small incentives. However, achieving desirable crowd behavior is challenging as the crowd is highly dynamic and consists of autonomous, self-interested individuals. Leveraging crowdshipping for time-sensitive deliveries remains an open challenge. In this paper, we present an agent-based approach to on-time parcel delivery with crowds. Our system performs data stream processing on the couriers’ smartphone sensor data to predict delivery delays. Whenever a delay is predicted, the system attempts to forge an agreement for transferring the parcel from the current deliverer to a more promising courier nearby. Our experiments show that through accurate delay predictions and purposeful task transfers many delays can be prevented that would occur without our approach.
Unter Crowdsensing versteht man Anwendungen, in denen Sensordaten kollaborativ von einer Menge von Freiwilligen erhoben werden. So kann Crowdsensing eingesetzt werden um die Luftqualität an Orten zu messen, an denen keine fest installierten Sensoren verfügbar sind. In Crowdsensing-Systemen müssen die Teilnehmer koordiniert und die Messdaten verarbeitet werden, um relevante Daten zu erhalten. Im Rahmen der Abschlussarbeit wurde ein System konzipiert und prototypisch umgesetzt, das auf einem Raspberry Pi (unter Einsatz geeigneter Sensoren) Sensordaten erhebt und mit der Complex Event Processing Technologie verarbeitet.
Plugins erweitern die Funktionalität von WordPress und helfen Webseitenbetreibern beim Hinzufügen neuer Elemente oder Funktionen. Dabei muss der Betreiber selbst keinen komplexen Programmcode schreiben. Auch können diese Erweiterungen als Erleichterung bei der Pflege von Informationen und Inhalten dienen. In der vorliegenden Bachelorarbeit wird die Konzipierung, Umsetzung und Anwendung eines solchen Plugins für den Vergleich von Veranstaltungen beschrieben. Dabei findet es Anwendung auf einer Internetseite zum Thema Festivals. Die Informationen bezüglich der Festivals werden per Import in einer Tabelle gespeichert und für den Vergleich dargestellt. Eintragungen können auch händisch getätigt werden, woraus sich schließlich ergibt, dass das Plugin mit seiner Importfunktion eine zeitsparende und sinnvolle Erweiterung ist.
Rezension zu:
Rösch, Hermann et al.: Bibliotheken und Informationsgesellschaft in Deutschland : eine Einführung / Hermann Rösch, Jürgen Seefeldt, Konrad Umlauf ; unter Mitarbeit von Albert Bilo und Eric W. Steinhauer ; mitbegründet von Engelbert Plassmann. – 3., neukonzipierte und aktualisierte Auflage. – Wiesbaden: Harrassowitz Verlag, 2019. – XIII, 329 Seiten. – ISBN 9783447066204 : EUR 39.80 (auch als EBook verfügbar)
Rezension zu der Doppelausstellung "Zeitenwende 1400" des Dommuseums Hildesheim und des Landesmuseums Hannover. Während die Ausstellung im Hildesheimer Dommuseum ausgehend von der Stadt und dem Hochstift Hildesheim sowie der weiteren Region eine kulturhistorische Gesamtschau der Zeit um 1400 präsentiert, stellt die Ausstellung im Landesmuseum Hannover die Goldene Tafel aus der Benediktinerabteikirche St. Michaelis in Lüneburg, ein Flügelaltarretabel aus den ersten Jahrzehnten des 15. Jahrhunderts, als herausragendes Kunstwerk des Spätmittelalters in den Mittelpunkt.
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.
Die Nutzerverfolgung im Internet durch die Verwendung von Browsercookies ist gängige Praxis, doch haben diverse datenschutzrechtliche Entwicklungen der letzten Jahre zugunsten der Verbraucher diese Form des Trackings in vielerlei Hinsicht eingeschränkt und auch die Usability von Websites maßgeblich beeinträchtigt. Um weiterhin eine Personalisierung von Werbung und anderen Inhalten unter Wahrung der Nutzbarkeit und Rechte der Nutzer zu gewährleisten, ist es unausweichlich, eine neue Methode zur Identifizierung von Besuchern zu etablieren. Das Ziel dieser Arbeit ist, verschiedene Trackingtechnologien unter Berücksichtigung gegebener Rahmenbedingungen im Rechtsraum der Europäischen Union in ihrer Funktionsweise zu vergleichen und die nach derzeitigem Stand realistische Nachfolgetechnologie zum Tracking via Cookies zu benennen – Fingerprinting. Dieses überzeugt in Bezug auf seine Langlebigkeit und rechtliche Vereinbarkeit, den Implementierungsaufwand sowie den Umfang der sammelbaren Daten. Darauf aufbauend ist eine statistische Untersuchung zur Verbreitung von Methoden aus dem Feld des Fingerprintings auf den meistgenutzten Internetseiten durchgeführt worden. Dabei ergibt sich, dass Informationen, die zur Erstellung eines Fingerprints genutzt werden können, von fast allen Websites abgefragt werden, jedoch durchschnittlich nur wenige verschiedene Arten von Fingerprints genutzt werden. Auf einigen Websites werden durch größere dritte Unternehmen Fingerprints erfasst, der Opt-in-Status hingegen hat in den meisten Fällen für die Praktizierung von Fingerprinting keine Relevanz. Da Fingerprinting auch für schädliche Zwecke, zum Beispiel das Verteilen von potenterer Schadsoftware, verwendet werden kann, ist die Reaktion von Browserentwicklern und -nutzern auf die Entwicklung von derzeitigen und zukünftigen Fingerprintingkonzepten ungewiss, und auch die rechtliche Lage der nächste Jahre hängt von angekündigten Verordnungen ab, die in ihrem Inhalt noch nicht bekannt sind.
Diversity wird vielerorts als Querschnittsaufgabe erfolgreich in die Organisationsentwicklung von Hochschulen integriert. Aus der Perspektive einer mittelgroßen Hochschule sollen die Hürden dabei näher betrachtet werden. Implementierte Maßnahmen einer diversity-reflexiven und habitussensiblen Lehre für die heterogenen Studierenden eines ingenieurswissenschaftlichen Studiengangs werden analysiert und Reaktionen auf den Versuch eines Kulturwandels eingefangen. Dabei wird hinterfragt, wie nachhaltig ein solches Vorgehen sein kann. Mit qualitativem Material wird dabei die Perspektive der bisher in den Hochschulen unterrepräsentierten Studierenden eingeholt.
The aim of this study was to examine the opinions of farmers on a consulting project, which was established for organic dairy farms in Northern Germany involving different animal health experts who participated in the meetings. Furthermore, the properties of measures that are of decisive importance for implementation on the farms were identified to improve consultancy services for dairy farming. Once a year, the farmers met on a host-farm in one of three groups consisting of five to nine farms, a facilitator and an expert. At each meeting, a host-farm was visited and the analysed data of all participating farms of the previous year were presented to the group members. Each farmer had the possibility to report on success stories and issues concerning his herd. During discussions, the farmers first proposed mutual farm-specific measures for improving herd health and animal welfare. Afterwards, the expert named possible interventions and commented on the given measures of the farmers. All measures were noted by the facilitator. At the end of each meeting, each farmer could choose which of the given measures he wanted to implement. Open group-interviews as well as anonymous questionnaires for the farmers were used at the meetings in winter 2016/2017 to evaluate their perception of this consulting project and to determine which properties of measures were important for implementation on the farms. Based on the results of this study, the participating farmers were very positive towards this kind of consulting project. They favoured the participation of an expert during the meetings and the analysis of farm-specific data. Farmers mostly chose measures for implementation proposed by farmers and approved by the expert, followed by those proposed by the expert only. Measures were chosen when they were practical in the implementation, effective, efficient and took a low additional workload for implementation.
In diesem Beitrag werden die Ergebnisse einer Personalbefragung österreichischer Polizisten und Polizistinnen in Ausbildung geschildert, bei denen die Einstellung zu Korruption erhoben wurde. Weiterhin wurden Variablen wie Geschlecht, Alter und Bildungsgrad erhoben, die in Hellfeldforschung zu Korruption häufig als Merkmale von Korruptionstätern und Korruptionstäterinnen genannt werden. Im Fokus dieses Beitrags steht unter anderem die Frage, inwieweit sich Befunde aus dem Hellfeld von Korruption im Dunkelfeld abbilden. Zur Klärung dieser Frage werden Merkmale aus dem Hellfeld der Korruptionstäter und Korruptionstäterinnen auf eine Ursache-Wirkungs-Beziehung mit der Einstellung zu Korruption im Dunkelfeld überprüft. Zudem wird in diesem Beitrag die Frage geklärt, wie die Polizisten und Polizistinnen in Ausbildung hinsichtlich der Einstellung zu Korruption im Vergleich mit der Allgemeinbevölkerung Österreichs abschneiden. Polizisten und Polizistinnen in Ausbildung sind für das Bundesamt zur Korruptionsprävention und Korruptionsbekämpfung (kurz: BAK) die größte Zielgruppe bei der Ausbildung und Weiterbildung öffentlich Bediensteter in Österreich.
Die Ergebnisse lassen erkennen, dass sich die Befunde aus dem Hellfeld von Korruption nicht im Dunkelfeld abbilden, denn die überprüften Variablen weisen insgesamt betrachtet keine substanzielle Ursache-Wirkungs-Beziehung mit der Einstellung zu Korruption auf. Hinsichtlich des Vergleichs der österreichischen Polizisten und Polizistinnen in Ausbildung mit der Allgemeinbevölkerung Österreichs zeigen sich nur geringfügige Unterschiede in der Einstellung zu Korruption. Tendenziell lehnen die Polizisten und Polizistinnen in Ausbildung Korruption eher ab als die Allgemeinbevölkerung Österreichs.
Der Autobewerter Graja, der in der Lehre zum Bewerten studentischer Java-Programme verwendet wird, stellt ein komplexes Softwaresystem dar. Aufgrund einer kaum vorhandenen Testabdeckung durch Modul- und Integrationstests, ist die Gewährleistung der fehlerfreien Funktionalität in Hinsicht auf die Weiterentwicklung nicht garantiert. Da sich Graja auf das ProFormA-Aufgabenformat stützt, stellt sich die Frage, inwiefern sich die im ProFormA-Aufgabenformat vorausgesetzten Musterlösungen, für einen automatisierten Regressionstestmechanismus eignen.
Das Ziel dieser Forschung ist es ein Konzept, für einen solchen Regressionstestmechanismus zu erstellen und mithilfe einer Referenzimplementierung als Graja-Erweiterung in die Praxis umzusetzen. Der daraus entstandene Mechanismus operiert durch Verhaltensaufzeichnung und Verhaltensabgleich und konvertiert so das in Graja beobachtete Bewertungsverhalten einer Musterlösung in einen Testfall. In der Testphase findet anschließend ein Abgleich des Soll-Verhaltens eines Testfalls und des beobachteten Ist-Verhaltens einer Musterlösung statt. Die Differenzen dieses Abgleichs sind als potenzielle Regressionen zu behandeln, da diese eine semantische Änderung des Bewertungsergebnisses darstellen.
Um diesen Verhaltensabgleich robust und mit möglichst wenigen Fehlalarme zu realisieren, wurden die in Graja verwendeten Datenmodelle auf Eignung bezüglich einer Verhaltensaufzeichnung untersucht. Außerdem fand eine Datenaufzeichnung mit einer Teilmenge der Musterlösungen statt. Nachfolgend wurde eine Analyse dieser Rohdaten, mit dem Ziel potenzielles Rauschen innerhalb der Aufzeichnungen zu detektieren, durchgeführt. So konnte letztendlich eine Strategie für eine Rauschunterdrückung innerhalb der Verhaltensaufzeichnung entwickelt werden.
Abschließend wurde ein Datenmodell entwickelt, das erlaubt, die durch den Verhaltensabgleich detektierten Regressionen verständlich und lokalisierbar darzustellen. Der durch diese Arbeit entstandene automatisierte Regressionstestmechanismus stellt somit eine Grundlage für die Gewährleistung der korrekten Bewertungsfunktionalität innerhalb des Graja-Entwicklungsprozesses dar. Durch das Detektieren von Regressionen mithilfe der Musterlösungen, lassen sich nun Änderungen an Graja gewissenhaft in eine Produktionsumgebung übernehmen.
In order to reduce antimicrobial treatment and prevent environmental mastitis, the aim of the present study was to investigate associations between herd level factors and microbial load on teat ends with environmental mastitis pathogens. Quarterly farm visits of 31 dairy farms over a one-year period were used for statistical analysis. During each farm visit, teat-skin swabs, bedding and air samples were taken and management practices and herd parameters were documented. Total mesophilic bacteria, esculin-positive streptococci and coliform bacteria were examined in the laboratory procedures from teat skin and environmental samples. Esculin-positive streptococci and coliform bacteria on teat ends increased with high temperature–humidity indices (THI) in the barn during the spring and summer. Significantly more coliform bacteria on teat ends were found in herds with an increased percentage of normal or slightly rough teat ends. Cleaning cubicles more frequently, pre-cleaning teats before milking as well as post-dipping them after milking had a decreasing effect of teat-skin load with total mesophilic and coliform bacteria at the herd level. To conclude, teat-skin bacterial load with environmental pathogens is subject to fluctuations and can be influenced by aspects of farm hygiene.
Die vergleichende Fallstudie untersucht die Auswirkungen des Einsatzes von Videokonferenzsoftware (VKS) in einer kooperativen Lernumgebung in einem Masterseminar der Hochschule Hannover im Studiengang Unternehmensentwicklung. Es wurden 13 problemzentrierte Interviews mit Teilnehmenden eines Online- und eines Präsenzkurses geführt. Die gewonnenen Daten aus den Interviewaussagen wurden unter Anwendung des an der Hochschule eingesetzten Evaluationsfragebogens auf Plausibilität geprüft. Es wurden acht Probanden aus dem Onlinekurs und fünf Probanden aus dem vorherigen Präsenzkurs befragt. Die Interviews wurden über eine qualitative Inhaltsanalyse ausgewertet. Die zentralen
Ergebnisse waren, dass das Teleteaching zwar funktioniert, die Onlinestudierenden aber eine niedrigere Aufmerksamkeit, eine gehemmte aktive Beteiligung, eine geringere Interaktion zwischen den Studierenden und eine erschwerte Interaktion in den Gruppenarbeiten wahrnehmen. Als größte Nachteile wurden die fehlenden persönlichen Kontakte und die niedrige Aufmerksamkeit identifiziert. Als größter Vorteil erwies sich die erhöhte Flexibilität durch den ersparten Anfahrtsweg. Ein für Teleteaching zentraler Erfolgsfaktor ist, dass die Kameras auch bei den Teilnehmenden angeschaltet sein sollten, damit die Aufmerksamkeit und die aktive Beteiligung gefördert werden. Zwölf der Probanden stuften den VKS-Einsatz als sinnvolle Ergänzung für Seminare ein. Präsenzseminare sind aber keinesfalls durch Onlineseminare zu ersetzen.
A descriptive cross-sectional study of cholera at Kakuma and Kalobeyei refugee camps, Kenya in 2018
(2020)
Introduction: cholera is a significant public health concern among displaced populations. Oral cholera vaccines are safe and can effectively be used as an adjunct to prevent cholera in settings with limited access to water and sanitation. Results from this study can inform future consideration for cholera vaccination at Kakuma and Kalobeyei.
Methods: a descriptive cross-sectional study of cholera cases at Kakuma refugee camp and Kalobeyei integrated settlement was carried out between May 2017 to May 2018 (one year). Data were extracted from the medical records and line lists at the cholera treatment centres.
Results: the results found 125 clinically suspected and confirmed cholera cases and one related death (CFR 0.8%). The cumulative incidence of all cases was 0.67 (95% CI=0.56-0.80) cases/1000 persons. Incidence of cholera was higher in children under the age of five 0.94(95% CI=0.63-1.36) cases/1000 persons. Children aged <5 years showed 51% increased risk of cholera compared to those aged ≥5 years (RR=1.51; 95% CI=1.00-2.31, p=0.051). Individuals from the Democratic Republic of Congo had nearly 9-fold risk of reporting cholera (RR=8.62; 95% CI=2.55-37.11, p<0.001) while individuals from South Sudan reported 7 times risk of cholera case compared to those from Somalia (RR=7.39; 95% CI=2.78-27.73, p<0.001).
Conclusion: in addition to the improvement of water, sanitation and hygiene (WaSH), vaccination could be implemented as a short-medium term measure of preventing cholera outbreaks. Age, country of origin and settlement independently predicted the risk of cholera.
Die Studie leistet einen Beitrag zur Entwicklung der professionellen Handlungsfähigkeit in der Sozialen Arbeit. Ziel ist es, Berufsanfänger*innen zukünftig größere Sicherheit über ihr erworbenes Wissen und Können und ihre Handlungsfähigkeit zu geben. Die Handlungsfelder Sozialer Arbeit sind i.d.R. komplex und gehen mit hohen Belastungen einher, so dass gerade der Berufseinstieg eine große Herausforderung darstellt.
Die vertiefte Literaturrecherche zum Kompetenzbedarf im Berufsfeld der Sozialen Arbeit bietet ein umfassendes Bild von professioneller Handlungsfähigkeit in der Sozialen Arbeit. Dabei liegt der Fokus auf der Sicht der Betroffenen, den mit der Hochschule kooperierenden Praxisanleiter*innen sowie den sich im Anerkennungsjahr befindenden Sozialarbeiter*innen, die im Forschungszeitraum ihr Anerkennungsjahr ableisteten. Die Ergebnisse aus den über einen Methodenmix erhobenen Daten geben Hinweise für die Weiterentwicklung des Curriculums, zur Unterstützung der Praxisanleiter*innen und zur Verankerung von beruflicher Reflexion im Alltag und den Studientagen sowie auf den großen Bedarf an Vernetzung zwischen den Einrichtungen und der Hochschule.
Microservices is an architectural style for complex application systems, promising some crucial benefits, e.g. better maintainability, flexible scalability, and fault tolerance. For this reason microservices has attracted attention in the software development departments of different industry sectors, such as ecommerce and streaming services. On the other hand, businesses have to face great challenges, which hamper the adoption of the architectural style. For instance, data are often persisted redundantly to provide fault tolerance. But the synchronization of those data for the sake of consistency is a major challenge. Our paper presents a case study from the insurance industry which focusses consistency issues when migrating a monolithic core application towards microservices. Based on the Domain Driven Design (DDD) methodology, we derive bounded contexts and a set of microservices assigned to these contexts. We discuss four different approaches to ensure consistency and propose a best practice to identify the most appropriate approach for a given scenario. Design and implementation details and compliance issues are presented as well.
Public knowledge and awareness towards antibiotics use in Yogyakarta: A cross sectional survey
(2020)
Irrational use of antibiotics is a public health problem. Our study aimed to evaluate knowledge and awareness of antibiotics, and to examine its’ associated factors. We conducted a cross sectional survey. The questionnaire was adapted from WHO Multi-country survey. Adults aged 18 years old and were receiving prescription from eight outpatient clinics and pharmacies in Yogyakarta province completed the survey. The questionnaire was consisted of three sections, i.e. socio-demographic factors, knowledge of antibiotics, and experiences in using antibiotics. Scores on questions and data were presented descriptively and analyzed using logistic regression to evaluate the influence of variables on knowledge of antibiotics. Out of 268 respondents, a cumulative 76% of them used antibiotics in last six months. Majority of respondents (58%) had low level knowledge on antibiotic use and awareness, and incorrectly identified that cold and cough are treatable with antibiotics (75%). Interestingly, 71% of participants agreed that internet is a major source of information on antibiotics (71%), while only 58% and 45% of respondents see pharmacists and medical professionals respectively. The antibiotics were received from prescription (79%) and 70% of respondents completed the full course of antibiotics prescribed, but only 32% of them became more cautious about antibiotic use. We found the highest association between gender, age, education level, with the knowledge of antibiotics. The overall level of knowledge and awareness on antibiotics use among residents in Yogyakarta is low. This mandates public health awareness intervention programs to be implemented on the use of antibiotics.
The practice, attitude, and knowledge of complementary and alternative medicine in Mumbai, India
(2020)
Background: In the recent times, there has been a resurging interest in the use of complementary and alternative medicine (CAM) in India. The present study was conducted to examine the prevalence of CAM use in Mumbai, the knowledge and attitude regarding CAM regarding its safety and efficacy and the reasons for the use of CAM.
Methods: A cross-sectional study was conducted among the general population of Mumbai and its adjoining regions during January-July 2020. 205 residents participated in the study and were asked to fill a pretested questionnaire. The collected data was analyzed using IBM SPSS version 23.
Results: Out of the 205 responses, 163 (79.51%) agreed to have used CAM at least once in their life. Of these, 108 (52.68%) respondents used Ayurveda and 105 (51.21%) used homeopathy. 60 (36.81%) of the respondents practicing CAM used it for common gastrointestinal (GIT)-related disorder with a 100% recovery rate, 125 (76.67%) for infectious diseases with a 93.6% recovery rate. 99 (60.74%) of the respondents preferring CAM for its safety profile, 68 (41.72%) believed that CAM is time tested and thus is efficacious. An integrative approach was suggested by 118 (57.56%) of all the respondents.
Conclusions: There is a disparity between the high prevalence in the use of CAM and its knowledge. However, a general consensus suggests that CAM is efficacious and is practiced for various indications.
BACKGROUND:
Safety climate research suggests that a corresponding climate in work units is crucial for patient safety. Intensive care units are usually co-led by a nurse and a physician, who are responsible for aligning an interprofessional workforce and warrant a high level of safety. Yet, little is known about whether and how these interprofessional co-leaders jointly affect their unit's safety climate.
PURPOSE:
This empirical study aims to explain differences in the units' safety climate as an outcome of the nurse and physician leaders' degree of shared goals. Specifically, we examine whether the degree to which co-leaders share goals in general fosters a safety climate by pronouncing norms of interprofessional cooperation as a behavioral standard for the team members' interactions.
METHODOLOGY/APPROACH:
A cross-sectional design was used to gather data from 70 neonatal intensive care units (NICUs) in Germany. Survey data for our variables were collected from the unit's leading nurse and the leading physician, as well as from the unit's nursing and physician team members. Hypotheses testing at unit level was conducted using multivariate linear regression.
RESULTS:
Our analyses show that the extent to which nurse-physician co-leaders share goals covaries with safety climate in NICUs. This relationship is partially mediated by norms of interprofessional cooperation among NICU team members. Our final model accounts for 54% of the variability in safety climate of NICUs.
CONCLUSION:
Increasing the extent to which co-leaders share goals is an effective lever to strengthen interprofessional cooperation and foster a safety climate among nursing and physician team members of hospital units.
Zur Verbesserung der IT-Sicherheit im klassischen Büroumfeld wird bereits eine neue Firewall-Technologie, die sogenannte Next Generation Firewall verwendet. Um diese Technologie im Produktionsbereich einzusetzen, muss sie vorher getestet werden, da sich die Priorisierung der Schutzziele im Produktionsbereich und im Büroumfeld unterscheidet. In dieser Arbeit werden das Einsatzgebiet und die Wirkungsweise von Firewalls in industriellen Automatisierungssystemen im Allgemeinen und spezifisch für Next Generation Firewalls untersucht. Die Untersuchung geht auf die Aufgaben der einzelnen Firewalls in einem Produktionsunternehmen ein und prüft, welche Firewall durch eine Next Generation Firewall ergänzt werden kann. Dazu werden die konventionellen Firewall-Technologien mit der neuen Firewall-Technologie verglichen und bewertet. Der Nutzen der Next Generation Firewall in der Produktionsumgebung wird am Beispiel eines ausgewählten Angriffsszenarios erklärt. Abschließend werden Empfehlungen für dessen Einsatz in industriellen Automatisierungssystemen gegeben.
Background: Virtual reality (VR) is increasingly used as simulation technology in emergency medicine education and training, in particular for training nontechnical skills. Experimental studies comparing teaching and learning in VR with traditional training media often demonstrate the equivalence or even superiority regarding particular variables of learning or training effectiveness.
Objective: In the EPICSAVE (Enhanced Paramedic Vocational Training with Serious Games and Virtual Environments) project, a highly immersive room-scaled multi-user 3-dimensional VR simulation environment was developed. In this feasibility study, we wanted to gain initial insights into the training effectiveness and media use factors influencing learning and training in VR.
Methods: The virtual emergency scenario was anaphylaxis grade III with shock, swelling of the upper and lower respiratory tract, as well as skin symptoms in a 5-year-old girl (virtual patient) visiting an indoor family amusement park with her grandfather (virtual agent). A cross-sectional, one-group pretest and posttest design was used to evaluate the training effectiveness and quality of the training execution. The sample included 18 active emergency physicians.
Results: The 18 participants rated the VR simulation training positive in terms of training effectiveness and quality of the training execution. A strong, significant correlation (r=.53, P=.01) between experiencing presence and assessing training effectiveness was observed. Perceived limitations in usability and a relatively high extraneous cognitive load reduced this positive effect.
Conclusions: The training within the virtual simulation environment was rated as an effective educational approach. Specific media use factors appear to modulate training effectiveness (ie, improvement through “experience of presence” or reduction through perceived limitations in usability). These factors should be specific targets in the further development of this VR simulation training.
Background: The mission of the pharmacy profession is to improve public health through ensuring safe, effective, and appropriate use of medications. Population health management (PHP) is a process wherein opportunities are identified to improve the quality of health care delivered and thereby, promote better health outcomes for patients.
Rationale: As concept of PHP is extremely important in today’s context, it is helpful to integrate data related to pharmacist in population health management practices. Authors conducted a systematic review of the literature on role of pharmacist in population health management practices. Method: We conducted a systematic review of the literature on literature on role of pharmacist in population health management practices by searching, PubMed Medline database using the following combination of keywords – pharmacist, population health. Truncation was used to ensure retrieval of all possible variations of search terms. The search was limited to articles published between 1st January 2015 and 31st December 2019, human studies and English language.
Results: Initial search resulted in a total of 281 studies, title abstract review to remove irrelevant studies resulted in 256 studies. Yearly trend showed that number of publications are decreasing. Highest number of publications were from Europe (47; 18%) and 29 publications (11%) discussed role of pharmacist in population health management of subjects in the age group of 10 to 20 years. Twenty five publications mentioned health management was done in the community settings. Advice on the lifestyle was mentioned in 242 (96%) and 10 (4%) publications offered advice about drugs during the health management. Pharmacists played important roles in population health management for e.g. as care provider in exploring the challenges faced in clinics for management of Type 2 DM. Pharmacists played an important role in increasing the quality of life of patients.
Discussion: Population health management concept has evolved steadily over the past few decades and is now contributing to the ‘patient care journey’ at all stages. There were 24 (9%) publications from India. Specially designed and implemented Pharm D program would play a major role in Indian health care system in future. This will give an opportunity to pharmacists to work more prominently in Indian health care system.
Conclusion: Authors are of the opinion that this is the first review encompassing the topic of pharmacist and population health management in the global context. It is clear that there is a global trend of moving towards involvement of pharmacist in healthcare management. This enables pharmacists to assume an expanded role and at same time it necessitates reforms in pharmacy education and practice.
Background: Patient satisfaction is considered as an indicator of the healthcare quality. Information on patient satisfaction based on medical expertise of the physician, interpersonal skills, physician-patient interaction time, perception and needs of the patient allow policymakers to identify areas for improvement. Primary care services and healthcare structure differ between the countries. The present study was done to determine and analyze the determinants associated with patient satisfaction in India, Pakistan, Spain and USA.
Methods: This descriptive study was performed in January to August 2019 among students from Mumbai University, India, Dow University of Health Sciences, Karachi, Pakistan, University CEU Cardenal Herrera, Valencia, Spain, Texas State University, Texas, USA. On the basis of the eligibility criterion (those who gave a written informed consent and were registered students of respective university) 890 (India: 369, Pakistan: 128, Spain: 195, USA: 99) students were selected for the present study.
Results: India had almost similar male (49%) to female (51%) ratio of participants. For other 3 countries (PK, ES, US), female participant percentage was nearly 20% or even more as compared to male participants. Overall participant’s satisfaction score about medial expertise of the doctor were highest in India (71%) and were lowest in Spain (43%). Overall satisfaction score about time spent with doctor were highest for India (64%) and were lowest for Spain (41%). Overall satisfaction score about communication with doctor were highest for US (60%) and were lowest for PK (53%). Overall satisfaction score for medical care given by the doctor was lowest in PK (43%) and was highest in US (64%). Overall satisfaction about doctor, highest number of US (83%) and lowest number of PK (32%) participants were satisfied about medical interaction with doctors.
Conclusions: These multi-country findings can provide information for health policy making in India, Pakistan, Spain and USA. Although the average satisfaction per country, except Pakistan is more than 60%, the results suggest that there is ample room for improvement.
Background:
Hereditary angioedema (HAE) is a rare genetic disease and characterized by clinical features such as paroxysmal, recurrent angioedema of the skin, the gastrointestinal tract, and the upper airways. Swelling of the skin occurs primarily in the face, extremities and genitals. Gastrointestinal attacks are accompanied by painful abdominal cramps, vomiting and diarrhea. Due to the low prevalence and the fact that HAE patients often present with rather unspecific symptoms such as abdominal cramps, the final diagnosis is often made after a long delay. The aim of this German-wide survey was to characterize the period between occurrence of first symptoms and final diagnosis regarding self-perceived health, symptom burden and false diagnoses for patients with HAE.
Results:
Overall, 81 patients with HAE were included and participated in the telephone-based survey. Of those, the majority reported their current health status as “good” (47.5%) or “very good” (13.8%), which was observed to be a clear improvement compared to the year before final diagnosis (“good” (16.3%), “very good” (11.3%)). Edema in the extremities (85.2%) and in the gastrointestinal tract (81.5%) were the most currently reported symptoms and occurred earlier than other reported symptoms (mean age at onset 18.1 and 17.8 years, respectively). Misdiagnoses were observed in 50.6% of participating HAE patients with appendicitis and allergy being the most frequently reported misdiagnoses (40.0 and 30.0% of those with misdiagnosis, respectively). Patients with misdiagnosis often received mistreatment (80.0%) with pharmaceuticals and surgical interventions as the most frequently carried out mistreatments (65.6 and 56.3% of those with mistreatment, respectively). The mean observed diagnostic delay was 18.1 years (median 15.0 years). The diagnostic delay was higher in older patients and index patients.
Conclusions:
This study showed that self-perceived status of health for patients is much better once the final correct diagnosis has been made and specific treatment was available. Further challenge in the future will still be to increase awareness for HAE especially in settings which are normally approached by patients at occurrence of first symptoms to assure early referral to specialists and therefore increase the likelihood of receiving an early diagnosis.
Background
In Germany, up to 50% of nursing home residents are admitted to a hospital at least once a year. It is often unclear whether this is beneficial or even harmful. Successful interprofessional collaboration and communication involving general practitioners (GPs) and nurses may improve medical care of nursing home residents. In the previous interprof study, the six-component intervention package interprof ACT was developed to facilitate collaboration of GPs and nurses in nursing homes. The aim of this study is to evaluate the effectiveness of the interprof ACT intervention.
Methods
This multicentre, cluster randomised controlled trial compares nursing homes receiving the interprof ACT intervention package for a duration of 12 months (e.g. comprising appointment of mutual contact persons, shared goal setting, standardised GPs’ home visits) with a control group (care as usual). A total of 34 nursing homes are randomised, and overall 680 residents recruited. The intervention package is presented in a kick-off meeting to GPs, nurses, residents/relatives or their representatives. Nursing home nurses act as change agents to support local adaption and implementation of the intervention measures. Primary outcome is the cumulative incidence of hospitalisation within 12 months. Secondary outcomes include admissions to hospital, days admitted to hospital, use of other medical services, prevalence of potentially inappropriate medication and quality of life. Additionally, health economic and a mixed methods process evaluation will be performed.
Discussion
This study investigates a complex intervention tailored to local needs of nursing homes. Outcomes reflect the healthcare and health of nursing home residents, as well as the feasibility of the intervention package and its impact on interprofessional communication and collaboration. Because of its systematic development and its flexible nature, interprof ACT is expected to be viable for large-scale implementation in routine care services regardless of local organisational conditions and resources available for medical care for nursing home residents on a regular basis. Recommendations will be made for an improved organisation of primary care for nursing home residents. In addition, the results may provide important knowledge and data for the development and evaluation of further strategies to improve outpatient care for elderly care-receivers.
Die Nutzung von Messenger-Diensten hat die Nutzung von sozialen Medien übertroffen. Diese Mediennutzung bringt veränderte Erwartungen an Unternehmen mit sich. Unternehmen begegnen den Erwartungen ihrer Kund*innen in der Online-Kundenkommunikation mit dem Einsatz textbasierter Dialogsysteme. Im Facebook-Messenger wurden 2018 bereits über 300.000 Chatbots angeboten. Das Problem ist, dass Studien seit mehreren Jahren aufzeigen, dass diese Kommunikationstechnologie sich bei den Kund*innen noch nicht durchgesetzt hat und häufig noch skeptisch betrachtet wird. Für Unternehmen ist es daher notwendig zu verstehen, welche Kriterien erfüllt sein müssen, um die Akzeptanzbildung der Kund*innen gegenüber textbasierten Dialogsystemen positiv zu beeinflussen.
Das Ziel dieser Arbeit ist es zu betrachten, inwiefern die Eigenschaften textbasierter Dialogsysteme die Akzeptanzkriterien der Kund*innen erfüllen können. Dazu wird die folgende Forschungsfrage gestellt: Wie akzeptieren Kunden den Einsatz textbasierter Dialogsysteme in der Online-Kundenkommunikation von Unternehmen?
Um die Forschungsfrage zu beantworten, wird eine Literaturanalyse durchgeführt. Die Literatur wird mit Studienergebnissen verglichen, um Übereinstimmungen und Abweichungen herauszuarbeiten.
Eine Akzeptanzanalyse hat ergeben, dass Kund*innen textbasierte Dialogsysteme vor allem akzeptieren, wenn sie darin einen Nutzen erkennen. Jedoch beeinflussen neben nutzenorientierten Faktoren auch emotionale Faktoren die Akzeptanz.
Auf dieser Grundlage ist es empfehlenswert, positive und negative Einflussfaktoren des Akzeptanzprozesses zu identifizieren und die Gestaltung textbasierter Dialogsysteme an die Kund*innen anzupassen, bevor diese eingesetzt werden.
The impact of vertical and horizontal integration in the context of Industry 4.0 requires new concepts for the security of industrial Ethernet protocols. The defense in depth concept, basing on the combination of several measures, especially separation and segmentation, needs to be complimented by integrated protection measures for industrial real-time protocols. To cover this challenge, existing protocols need to be equipped with additional functionality to ensure the integrity and availability of the network communication, even in environments, where possible attackers can be present. In order to show a possible way to upgrade an existing protocol, this paper describes a security concept for the industrial Ethernet protocol PROFINET.
Der vorliegende Beitrag beschreibt Einsatzpotenziale des Energiemanagementprofils PROFIenergy in der Prozessindustrie.
Der Blick auf den Status von Energieeffizienzmaßnahmen in der Prozessindustrie zeigt, dass diese im Wesentlichen innerhalb der verfahrenstechnischen Optimierung angesiedelt sind. Noch hat sich der durchgängige Einsatz von technischen Energiemanagementsystemen
(tEnMS) nicht etabliert. Diese Arbeit fokussiert Vorteile des tEnMS-Einsatzes und präsentiert „Best Practice“- Beispiele in der Prozessindustrie. Abschließend wird aufgezeigt, welches Potenzial das Energiemanagementprofil PROFIenergy liefern kann und welche Anwendungsfälle sich damit abdecken lassen.
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.
Der ständige Wandel der Gesellschaft hinsichtlich der Bedürfnisse und Arbeitsgewohnheiten, stellt eine Herausforderung dar, mit der sich auch Behördenbibliotheken auseinandersetzen müssen. Diese stetigen Veränderungen führen zu einem erhöhten Innovationsbedarf in diesen Bibliotheken. Die Arbeit setzt sich mit zwei möglichen nutzerorientierten Innovationsmethoden auseinander. Jene können dazu beitragen, dass die veränderten Bedürfnisse der Bibliotheksnutzer unmittelbar in Innovationsprojekte der Behördenbibliotheken mit einfließen. Im ersten Teil der Arbeit werden die theoretischen Grundlagen von Innovationen sowie der zwei Methoden, Open Innovation und Design Thinking, dargestellt. Open Innovation und Design Thinking werden darüber hinaus anhand von Praxisbeispielen aus Bibliotheken näher erläutert. Außerdem werden sowohl die Aufgaben als auch die allgemeinen Herausforderungen in Behördenbibliotheken dargestellt. Im zweiten Teil der Arbeit wird die durchgeführte empirische Untersuchung beschrieben, die einen Aufschluss über den aktuellen Stand von Innovationen in Behördenbibliotheken geben soll. Abschließend werden, anhand der theoretischen Grundlagen sowie der gewonnenen Erkenntnisse, Erfolgskriterien und Handlungsempfehlungen für die Durchführung von nutzerintegrierten Innovationsprojekten für Behördenbibliotheken gegeben.
Background:
Multiple Sclerosis (MS) is a chronic inflammatory, immune mediated disease of the central nervous system, with Relapsing Remitting MS (RRMS) being the most common type. Within the last years, the status of high disease activity (HDA) has become increasingly important for clinical decisions. Nevertheless, little is known about the incidence, the characteristics, and the current treatment of patients with RRMS and HDA in Germany. Therefore, this study aims to estimate the incidence of HDA in a German RRMS patient population, to characterize this population and to describe current drug treatment routines and further healthcare utilization of these patients.
Methods:
A claims data analyses has been conducted, using a sample of the InGef Research Database that comprises data of approximately four million insured persons from around 70 German statutory health insurances (SHI). The study was conducted in a retrospective cohort design, including the years 2012–2016. Identification of RRMS population based on ICD-10 code (ICD-10-GM: G35.1). For identification of HDA, criteria from other studies as well as expert opinions have been used. Information on incidence, characteristics and current treatment of patients with RRMS and HDA was considered.
Results:
The overall HDA incidence within the RRMS population was 8.5% for 2016. It was highest for the age group of 0–19 years (29.4% women, 33.3% men) and lowest for the age group of ≥ 50 years (4.3% women, 5.6% men). Mean age of patients with RRMS and incident HDA was 38.4 years (SD: 11.8) and women accounted for 67.8%.
Analyses of drug utilization showed that 82.4% received at least one disease-modifying drug (DMD) in 2016. A percentage of 49.8% of patients received drugs for relapse therapy. A share of 55% of RRMS patients with HDA had at least one hospitalization with a mean length of stay of 13.9 days (SD: 18.3 days) in 2016. The average number of outpatient physician contacts was 28.1 (SD: 14.0).
Conclusions:
This study based on representative Germany-wide claims data from the SHI showed a high incidence of HDA especially within the young RRMS population. Future research should consider HDA as an important criterion for the quality of care for MS patients.
Das Ziel dieser Bachelorarbeit ist es, ein einfach verständliches Simulationsmodell zur Darstellung der Wirkung von Kabelschirmen bei Betrachtung verschiedener Schirmauflageverfahren zu entwickeln. Die erarbeiteten Ergebnisse decken sich mit der allgemein vertretenen Meinung, dass die beste Schirmwirkung durch eine beidseitige und flächige Schirmauflage erzielt wird. Zuerst werden Grundlagen erklärt, wobei sich auf relevante Literatur bezogen wird. Daraus wird das Simulationsmodell hergeleitet, dessen Ergebnisse anhand von theoretischen Überlegungen und praktischen Messungen überprüft werden. Die vorliegende Arbeit ist interessant für Ingenieurinnen und Ingenieure der Automatisierungstechnik in der Prozess- und Fertigungsindustrie, die ein grundlegendes Verständnis für relevante Effekte der Kabelschirmung bilden wollen.
The aim of the current study was to investigate the effects of the prepartum external treatment of teats with a combination of four lactic acid bacteria strains viz. Lactobacillus (Lb.) rhamnosus ATCC 7469, Lactococcus lactis subsp. lactis ATCC 11454, Lb. paracasei 78/37 (DSM 26911), and Lb. plantarum 118/37 (DSM 26912) on the postcalving udder health of dairy heifers. The study used a split-udder design. Two weeks before the expected calving date, one of two contralateral teats of a teat pair was dipped with an aqueous suspension of lactic acid bacteria (final bacterial counts 8.40–8.47 log10-transformed CFU/mL) once in a week until calving; the other teat of the pair was not treated. After calving, quarter foremilk samples were taken and investigated cyto-microbiologically. In total, 629 teat pairs of 319 heifers were included. There was an association between the treatment and intramammary infections caused by the major udder-pathogenic bacteria Staphylococcus aureus, Streptococcus dysgalactiae, and enterococci, as well as clinical mastitis in the first 100 days after calving. The present study indicates that intramammary infections with major pathogens and clinical mastitis may be prevented by regular prepartum external application of lactic acid bacteria in dairy heifers.