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Background
Diabetes mellitus is a major global health issue with a growing prevalence. In this context, the number of diabetic complications is also on the rise, such as diabetic foot ulcers (DFU), which are closely linked to the risk of lower extremity amputation (LEA). Statistical prediction tools may support clinicians to initiate early tertiary LEA prevention for DFU patients. Thus, we designed Bayesian prediction models, as they produce transparent decision rules, quantify uncertainty intuitively and acknowledge prior available scientific knowledge.
Method
A logistic regression using observational collected according to the standardised PEDIS classification was utilised to compute the six-month amputation risk of DFU patients for two types of LEA: 1.) any-amputation and 2.) major-amputation. Being able to incorporate information which is available before the analysis, the Bayesian models were fitted following a twofold strategy. First, the designed prediction models waive the available information and, second, we incorporated the a priori available scientific knowledge into our models. Then, we evaluated each model with respect to the effect of the predictors and validity of the models. Next, we compared the performance of both models with respect to the incorporation of prior knowledge.
Results
This study included 237 patients. The mean age was 65.9 (SD 12.3), and 83.5% were male. Concerning the outcome, 31.6% underwent any- and 12.2% underwent a major-amputation procedure. The risk factors of perfusion, ulcer extent and depth revealed an impact on the outcomes, whereas the infection status and sensation did not. The major-amputation model using prior information outperformed the uninformed counterpart (AUC 0.765 vs AUC 0.790, Cohen’s d 2.21). In contrast, the models predicting any-amputation performed similarly (0.793 vs 0.790, Cohen’s d 0.22).
Conclusions
Both of the Bayesian amputation risk models showed acceptable prognostic values, and the major-amputation model benefitted from incorporating a priori information from a previous study. Thus, PEDIS serves as a valid foundation for a clinical decision support tool for the prediction of the amputation risk in DFU patients. Furthermore, we demonstrated the use of the available prior scientific information within a Bayesian framework to establish chains of knowledge.
Die meisten börsennotierten Gesellschaften haben ein Risikofrüherkennungssystem, das vom Abschlussprüfer ohne den Verweis auf schwerwiegende Mängel testiert wird. Tatsächlich zeigen Studien, dass die in der Praxis implementierten Systeme häufig ungeeignet sind, um an sich erkennbare bestandsgefährdende Entwicklungen zu identifizieren. Dies liegt an methodischen Schwächen, z. B. an einer fehlenden Betrachtung der Liquiditätswirkung von Risiken, einer vernachlässigten Analyse von Extremrisiken und insb. am Fehlen einer Risikoaggregation, die auch Kombinationseffekte berücksichtigt. Bei Insolvenzen, wie hier im Beispiel von Gerry Weber, lässt sich bei Betrachtung des dokumentierten Risikomanagementsystems erkennen, dass die gesetzlichen Anforderungen nicht erfüllt wurden. Um solche „überraschenden Insolvenzen“ zu vermeiden, ist es erforderlich, bessere Verfahren zu implementieren und durch Prüfer testieren zu lassen, was bisher nicht konsequent geschieht. Der Beitrag schlägt ein einfaches aber umfassendes Prüfschema für Risikofrüherkennungssysteme vor, das sowohl intern als auch von externen Prüfern verwendet werden kann.
Die folgende Studie wurde vor dem Hintergrund der zunehmenden Relevanz von ökologisch nachhaltigem Handeln in unserer Gesellschaft aufgrund von wachsenden erlebbaren Auswirkungen durch unsere Lebensweise und den Klimawandel durchgeführt. Für die folgende qualitative Studie wurden fünf Studierende und fünf Berufstätige zu den Hintergründen ihres ökologisch nachhaltigen Handelns befragt. Es wurden zehn Einflussfaktoren identifiziert, welche ökologisch nachhaltiges Handeln von Studierenden und Berufstätigen beeinflussen: Wissen & Informationen; Persönliche Relevanz; empfundene Wichtigkeit & Interesse; Erlebnisse & Erfahrungen (auch ehrenamtliches Engagement); Soziale Umfelder (persönliches, studentisches und berufliches Umfeld); Beeinflussung durch Andere (auch Beeinflussung durch Medien); Positiver Nutzen; Abwägung; Gewohnheiten; Gefühle; Möglichkeiten zur Umsetzung. Als theoretische Basis zur Untersuchung von beeinflussenden Faktoren wurde das psychologische Modell zur Erklärung nachhaltigen Handelns von Hamann, Baumann und Löschinger (2016) hinzugezogen. Des Weiteren wurden drei Aspekte zur positiven Auswirkung von ökologisch nachhaltigem Handeln zur Förderung ökologisch nachhaltigen Handelns in der Gesellschaft gefunden: fortlaufender Prozess; Beeinflussung von Anderen; Ideen zur Förderung von ökologisch nachhaltigem Handeln. Weitere Maßnahmenvorschläge und Handlungsempfehlungen wurden v. a. für die Kontexte Beruf, Studium, Schule und Medien aus den Erkenntnissen der Studie abgeleitet.
Various overoxidized poly(1H-pyrrole) (PPy), poly(N-methylpyrrole) (PMePy) or poly(3,4-ethylenedioxythiophene) (PEDOT) membranes incorporated into an acrylate-based solid polymer electrolyte matrix (SPE) were directly electrosynthesized by a two-step in situ procedure. The aim was to extend and improve fundamental properties of pure SPE materials. The polymer matrix is based on the cross-linking of glycerol propoxylate (1PO/OH) triacrylate (GPTA) with poly(ethylene glycol) diacrylate (PEGDA) and lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) as a conducting salt. A self-standing and flexible polymer electrolyte film is formed during the UV-induced photopolymerization of the acrylate precursors, followed by an electrochemical polymerization of the conducting polymers to form a 3D-IPN. The electrical conductivity of the conducting polymer is destroyed by electrochemical overoxidation in order to convert the conducting polymer into an ion-exchange membrane by introduction of electron-rich groups onto polymer units. The resulting polymer films were characterized by scanning electron microscopy, cyclic voltammetry, electrochemical impedance spectroscopy, differential scanning calorimetry, thermal analysis and infrared spectroscopy. The results of this study show that the combination of a polyacrylate-matrix with ion selective properties of overoxidized CPs leads to new 3D materials with higher ionic conductivity than SPEs and separator or selective ion-exchange membrane properties with good stability by facile fabrication.
Im Rahmen des Forschungsschwerpunktes „Inklusive Bildung“ der Hochschule Osnabrück wurde eine quantitative Erhebung mittels eines schriftlichen Fragebogens durchgeführt.Die Ergebnisse verweisen in vergleichender Perspektive auf unterschiedliche Handlungs- und Sichtweisen der Berufsgruppen hin. Damit ergeben sich verschiedene Chancen sowie Herausforderungen in der Kooperation der Bildungsbereiche – und die Notwendigkeit einer Systematisierung dieser Prozesse.
Career Decisions of Indian Female Talent: Implications for Gender-sensitive Talent Management
(2020)
Purpose: Talent scarcity in emerging economies such as India poses challenges for companies,and limited labour market participation among well-educated women has been observed. The reasons that professionals decide not to pursue a further corporate career remain unclear. By investigating career decision making, this article aims to highlight (1) the contextual factors that impact those decisions, (2) individuals’ agency to handle them, and (3) the implications for talent management (TM).
Design/methodology/approach: Following a qualitative research design, computer-aided analysis was conducted on interviews with 24 internationally experienced Indian business professionals. A novel application of neo-institutionalism in the Indian context was combined with the family-relatedness of work decisions (FRWD) model.
Findings: Career decisions indicate that rebellion against Indian societal and family expectations is essential to following a career path, especially for women. TM as part of the current institutional framework serves as a legitimising façade veiling traditional practices that hinder females’ careers.
Research limitations: Interviewees adopted a retrospective perspective when describing their career decisions; therefore, different views might have existed at the moment of decision making.
Practical implications: Design and implementation of gender-sensitive TM adjusted to fit the specific Indian context can contribute to retaining female talent in companies and the labour market.
Originality/value: The importance of gender-sensitive TM can be concluded from an empirical study of the context-based career decision making of experienced business professionals from India. The synthesis of neo-institutionalism, the FRWD model and the research results provides assistance in mapping talent experiences and implications for overcoming the challenges of talent scarcity in India.
Background
Against the background of a steadily increasing degree of digitalization in health care, a professional information management (IM) is required to successfully plan, implement, and evaluate information technology (IT). At its core, IM has to ensure a high quality of health data and health information systems to support patient care.
Objectives
The goal of the present study was to define what constitutes professional IM as a construct as well as to propose a reliable and valid measurement instrument.
Methods
To develop and validate the construct of professionalism of information management (PIM) and itsmeasurement, a stepwise approach followed an established procedure from information systems and behavioral research. The procedure included an analysis of the pertaining literature and expert rounds on the construct and the
instrument, two consecutive and comprehensive surveys at the national and international level, exploratory and confirmatory factor analyses as well as reliability and validity testing.
Results
Professionalism of information management was developed as a construct consisting of the three dimensions of strategic, tactical, and operational IMas well as of the regularity and cyclical phases of IM procedures as the two elements of professionalism.
The PIM instrument operationalized the construct providing items that incorporated IM procedures along the three dimensions and cyclical phases. These procedures had to be evaluated against their degree of regularity in the instrument. The instrument proved to be reliable and valid in two consecutive measurement phases
and across three countries.
Conclusion
It can be concluded that professionalism of information management is a meaningful construct that can be operationalized in a scientifically rigorous manner. Both science and practice can benefit from these developments in terms of improved self-assessment, benchmarking capabilities, and eventually, obtaining a better understanding of health IT maturity.
Vanadium carbide (VC) reinforced FeCrVC hardfacings have become important to improving the lifetime of tools suffering abrasive and impressive loads. This is because the microstructural properties of such hardfacings enable the primary VCs to act as obstacles against the penetrating abrasive. Because dilution is supposed to be the key issue influencing the precipitation behaviour of primary carbides during surfacing, the development of deposit welding processes exhibiting a reduced thermal impact, and hence lower dilution to the base material, is the primary focus of the current research. By inserting an additional hot wire in the melt, an approach was developed to separate the material and energy input during gas metal arc welding (GMAW) and hence realised low dilution claddings. The carbide content could be increased, and a grain refinement was observed compared with conventional GMAW. These effects could be attributed to both the reduced dilution and heterogeneous nucleation.