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Background: Clinical handovers at changes of shifts are typical scenarios of time restricted and information intensive communication, which are highly cognitively demanding. The currently available applications supporting handovers typically present complex information in a textual checklist-like manner. This presentation style has been criticised for not meeting the specific user requirements.
Objectives: We, therefore, aimed at developing a concept for visualising the overview of a clinical case that serves as an alternative way to checklist-like presentations in clinical handovers. We also aimed at implementing this concept in a handoverEHR in order to support the pre-handover phase, the actual handover, and the post-handover phase as well as at evaluating its usability and attractiveness.
Results: We developed and implemented a concept that draws on Tolman's pioneering work on cognitive maps that we designed in accordance with Gestalt principles. These maps provide a pictorial overview of a clinical case. The application to build, manipulate, and store the cognitive maps was integrated into an openEHR based handover record that extends conventional records with handover specific information. Usability (n = 28) and attractiveness (n = 26) testing with experienced clinicians resulted in good ratings for suitability for the task as well as for attractiveness and pragmatism.
Conclusion: We propose cognitive maps to represent and visualise the clinical case in situations where there is limited time to present complex information.
To investigate the influence of two dietary sources of vitamin D on the vitamin D status, bone metabolism, welfare and birth progress of gestating and lactating sows, forty-nine multiparous sows were randomly assigned to one of two diets: “CON” (n = 25; 50 μg vitamin D3/kg feed) and “HYD” (n = 24; 50 μg 25-hydroxycholecalciferol/kg feed). The basal diets were protein- and phosphorus-reduced. The trial started on day 3 ante insemination of the sows and ended with weaning of the piglets on day 28 postpartum. Dietary supplementation of 25-hydroxycholecalciferol resulted in improved maternal vitamin D status (p < 0.001), fewer gait changes (p < 0.01) and longer standing time after feeding (day 5 ante partum; p < 0.05) compared to vitamin D3. However, the bone markers CrossLaps and osteocalcin were not affected. Overall, the present results suggest that sows fed 25-hydroxycholecalciferol instead of vitamin D3 showed improved locomotion and stance strength. However, this outcome is probably not related to altered bone metabolism. The underlying mechanisms must be investigated in further studies.
While Nursing Informatics competencies seem essential for the daily work of nurses, they are not formally integrated into nursing education in Austria, Germany and Switzerland, nor are there any national educational recommendations. The aim of this paper is to show how such recommendations can be developed, what competency areas are most relevant in the three countries and how the recommendations can be implemented in practice. To this end, a triple iterative procedure was proposed and applied starting with national health informatics recommendations for other professionals, matching and enriching these findings with topics from the international literature and finally validating them in an expert survey with 87 experts and in focus group sessions. Out of the 24 compiled competency areas, the relevance ratings of the following four recommended areas achieved values above 90%: nursing documentation (including terminologies), principles of nursing informatics, data protection and security, and quality assurance and quality management. As there were no significant differences between the three countries, these findings laid the foundation of the DACH Recommendations of Nursing Informatics as joint German (D), Austrian (A), and Swiss (CH) recommendations in Nursing Informatics. The methodology proposed has been utilized internationally, which demonstrates the added value of this study also outside the confines of Austria, Germany, Switzerland.
Conceptualising event value co-destruction and developing a future agenda for events research
(2021)
Purpose
Value co-destruction has received little attention in an event-related context. This appears surprising, given that the interactions among actors at an event may also reduce the value for other participants, stakeholders and that of the entire event or the event's service ecosystem. This paper first aims to conceptualise value co-destruction and to provide an overview of related research in an event context. Second, a future research agenda for value co-destruction processes in an event context is developed.
Design/methodology/approach
Journals of the “Scimago Journal and Country Rank” were systematically reviewed for the keywords “value co-destruction”, “value destruction” and “negative value co-creation”. A second literature review specifically aimed at the events context extended the search scope to non-Scimago journals, Google Scholar and Google Web using the same keywords. All identified articles were qualitatively analysed concerning (1) the conceptualisation of value co-destruction and (2) reasons for value co-destruction.
Findings
The review of previous research highlights a limited scope of analysis, a focus on value co-destruction as an outcome and on interactions at the meso-level. Based on these findings, a holistic definition of value co-destruction is proposed. The paper identifies two major directions for future studies on value co-destruction at events and suggests specific examples.
Originality/value
The paper contributes to a more holistic understanding of value co-creation and co-destruction in an event setting. For example, a clearer understanding of the interactions that reduce the overall value of an event may assist to better design valuable events in the future.
Consumer Acceptance and Market Potential of Iodine-Biofortified Fruit and Vegetables in Germany
(2021)
Biofortification of food crops with iodine is a novel approach to preventing iodine deficiency in humans. The present study analyses the consumer target groups and the market potential of iodine-biofortified fruit and vegetables in Germany. For this purpose, an online survey of 1016 German fruit and vegetable consumers was conducted to investigate the acceptance of different product categories as well as relevant criteria for the market launch. The results show that io-dine-biofortified fruit and vegetables are particularly attractive to consumers who purchase at farmers’ markets, organic food shops, and farm stores. Out of this group, 39% of consumers rate such iodine-rich foods as very appealing. They attach importance to food that naturally contains iodine and prefer produce from integrated domestic cultivation. With their focus on sustainability and naturalness, this group of consumers clearly differs from typical users of dietary supplements, who are primarily concerned with health benefits. However, overall about 85% of respondents would prefer biofortified fruits and vegetables to supplements to improve their iodine supply. The greatest market potential for iodine-biofortified fruit and vegetables is to be expected in super-markets, as this is the preferred food shopping location for most consumers. A total of 28% of those who buy here rate the biofortified foods presented as very appealing. Nevertheless, a successful market launch requires that the benefits of the new products are communicated according to the potential consumer group needs.
Abstract: Thermal response curves that depict the probability of occurrence along a thermal gradient are used to derive various species’ thermal properties and abilities to cope with warming. However, different thermal responses can be expected for different portions of a species range. We focus on differences in thermal response curves (TRCs) and thermal niche requirements for four freshwater fishes (Coregonus sardinella, Pungitius pungitius, Rutilus rutilus, Salvelinus alpinus) native to Europe at (1) the global and (2) European continental scale. European ranges captured only a portion of the global thermal range with major differences in the minimum (Tmin), maximum (Tmax) and average temperature (Tav) of the respective distributions. Further investigations of the model-derived preferred temperature (Tpref), warming tolerance (WT = Tmax − Tpref), safety margin (SM = Tpref − Tav) and the future climatic impact showed substantially differing results. All considered thermal properties either were under- or overestimated at the European level. Our results highlight that, although continental analyses have an impressive spatial extent, they might deliver misleading estimates of species thermal niches and future climate change impacts, if they do not cover the full species ranges. Studies and management actions should therefore favor whole global range distribution data for analyzing species responses to environmental gradients.
Thermal response curves that depict the probability of occurrence along a thermal gradient are used to derive various species’ thermal properties and abilities to cope with warming. However, different thermal responses can be expected for different portions of a species range. We focus on differences in thermal response curves (TRCs) and thermal niche requirements for four freshwater fishes (Coregonus sardinella, Pungitius pungitius, Rutilus rutilus, Salvelinus alpinus) native to Europe at (1) the global and (2) European continental scale. European ranges captured only a portion of the global thermal range with major differences in the minimum (Tmin), maximum (Tmax) and average temperature (Tav) of the respective distributions. Further investigations of the model-derived preferred temperature (Tpref), warming tolerance (WT = Tmax − Tpref), safety margin (SM = Tpref − Tav) and the future climatic impact showed substantially differing results. All considered thermal properties either were under- or overestimated at the European level. Our results highlight that, although continental analyses have an impressive spatial extent, they might deliver misleading estimates of species thermal niches and future climate change impacts, if they do not cover the full species ranges. Studies and management actions should therefore favor whole global range distribution data for analyzing species responses to environmental gradients.
Background: In longitudinal studies, observations are made over time. Hence, the single observations at each time point are dependent, making them a repeated measurement. In this work, we explore a different, counterintuitive setting: At each developmental time point, a lethal observation is performed on the pregnant or nursing mother. Therefore, the single time points are independent. Furthermore, the observation in the offspring at each time point is correlated with each other because each litter consists of several (genetically linked) littermates. In addition, the observed time series is short from a statistical perspective as animal ethics prevent killing more mother mice than absolutely necessary, and murine development is short anyway. We solve these challenges by using multiple contrast tests and visualizing the change point by the use of confidence intervals.
Results: We used linear mixed models to model the variability of the mother. The estimates from the linear mixed model are then used in multiple contrast tests.There are a variety of contrasts and intuitively, we would use the Changepoint method. However, it does not deliver satisfying results. Interestingly, we found two other contrasts, both capable of answering different research questions in change point detection: i) Should a single point with change direction be found, or ii) Should the overall progression be determined? The Sequen contrast answers the first, the McDermott the second. Confidence intervals deliver effect estimates for the strength of the potential change point. Therefore, the scientist can define a biologically relevant limit of change depending on the research question.
Conclusion: We present a solution with effect estimates for short independent time series with observations nested at a given time point. Multiple contrast tests produce confidence intervals, which allow determining the position of change points or to visualize the expression course over time. We suggest to use McDermott’s method to determine if there is an overall significant change within the time frame, while Sequen is better in determining specific change points. In addition, we offer a short formula for the estimation of the maximal length of the time series.
Data warehouse systems have become a basic technological infrastructure in management decision making. Nevertheless, the overall utility of data warehouses remains unmeasured in most practical cases. As a consequence of this, IT-managers do not possess appropriate means to evaluate warehouse benefits in order to decide about investments in warehousing technology. This paper develops a controlling instrument for data warehouse systems based on the Balanced Scorecard (BSC) approach. On the basis of the technological aspects of data warehouse systems, the BSC perspectives are developed and populated with relevant objectives and measures for datawarehouse success. These perspectives are integrated into a consistent data warehouse scorecard. Finally, this instrument provides a holistic approach to drive the performance of data warehouse systems.
Semi-natural grasslands (SNGs) are an essential part of European cultural landscapes. They are an important habitat for many animal and plant species and offer a variety of ecological functions. Diverse plant communities have evolved over time depending on environmental and management factors in grasslands. These different plant communities offer multiple ecosystem services and also have an effect on the forage value of fodder for domestic livestock. However, with increasing intensification in agriculture and the loss of SNGs, the biodiversity of grasslands continues to decline. In this paper, we present a method to spatially classify plant communities in grasslands in order to identify and map plant communities and weed species that occur in a semi-natural meadow. For this, high-resolution multispectral remote sensing data were captured by an unmanned aerial vehicle (UAV) in regular intervals and classified by a convolutional neural network (CNN). As the study area, a heterogeneous semi-natural hay meadow with first- and second-growth vegetation was chosen. Botanical relevés of fixed plots were used as ground truth and independent test data. Accuracies up to 88% on these independent test data were achieved, showing the great potential of the usage of CNNs for plant community mapping in high-resolution UAV data for ecological and agricultural applications.
Currently, the modelling of drying processes of plant tissues pre-treated by pulsed electric field (PEF) is following experimentally identified curves or separate heat and mass transfer and diffusion models with different levels of accuracy. This research had two major objectives: mathematical modeling and control of drying process of different vegetables pretreated by PEF during convective drying. The mathematical modeling was based on Luikov's heat and mass transfer model along with properties of different vegetables. Computer modelling was done using the difference method for predicting moisture and the temperature potentials of untreated and PEF-treated vegetables. The formulation and the solution procedures were applied to simulate the simultaneous heat and mass transfer in selected vegetables subjected to the convective drying. Suggested model had a good correlation with experimental results. Moreover, cell disintegration index can be used as a controllable parameter in heat and mass transfer models to predict drying behavior of potato, onion, and carrot tissues. Obtained drying models can be used as a mathematical tool to predict drying behavior for various types of agricultural products pre-treated by pulsed electric field.
The well-documented social gradient in health in the developed world will not just disappear on its own. Tackling health inequalities by introducing a universal coverage healthcare system recently became an important notion in the U.S. Using cross-sectional data from Germany which has maintained its compulsory egalitarian healthcare system for more than 50 years now, we apply logistic and negative binomial regression to uncover utilisation behaviour patterns under universal coverage. We find that lower education and unemployment raise the risks for all diseases under consideration. Unemployment increases the chance of contacting a physician, while income and education do not apparently affect the healthcare utilisation behaviour. Those diseases concentrated among unemployed and less educated, however, are associated with intensified healthcare utilisation. We conclude that universal coverage may make access to health care easier for those facing the worst health; the unemployed and lower educated.
Jede Ernährung hat Auswirkungen auf den Gesundheitszustand des Einzelnen, auf die Umwelt und auf soziale Belange. Eine wachsende Zahl von Mahlzeiten wird in der Außer-Haus-Verpflegung eingenommen, in der eine systematische Nachhaltigkeitsbewertung nicht zur gängigen Praxis gehört. Um diese Lücke zu schließen, wurde im Rahmen des NAHGAST-Projekts ein Instrument entwickelt. Nach mehr als einem Jahr des Einsatzes des NAHGAST-Online-Tools soll nun überprüft werden, welche positiven Umwelteinflüsse durch den Einsatz des Instruments realisiert werden können. Aus diesem Grund befasst sich dieser Artikel mit der Frage, ob ein Online-Tool Akteure aus dem Bereich des Außer-Haus-Verzehrs in die Lage versetzen kann, ihre Mahlzeiten im Hinblick auf Aspekte einer nachhaltigen Ernährung zu überarbeiten. Darüber hinaus wird die Frage beantwortet, wie sich konkrete Rezeptüberarbeitungen der beliebtesten Mittagsgerichte auf den materiellen Fußabdruck sowie auf den Carbon Footprint auswirken.
Zusammenfassend lässt sich sagen, dass ein Online-Tool individuelle Nachhaltigkeitspfade für Akteure im und ermöglicht eine eigenständige Rezeptüberarbeitung für bereits bestehende Gerichte. Mahlzeiten. Die Ergebnisse zeigen, dass bereits geringfügige Änderungen in den Rezepten zu Einsparungen von bis zu einem Drittel führen können beim CO2-Fußabdruck sowie beim Materialfußabdruck führen können. Bezogen auf den Außer-Haus-Verzehr Außer-Haus-Verzehr ergibt sich daraus das Potenzial für erhebliche Multiplikationseffekte, die den Weg für die Verbreitung von nachhaltiger Ernährung ebnen.
The conservation of freshwater ecosystems has lagged behind that of marine and terrestrial ecosystems and often requires the integration of large-scale approaches and transboundary considerations. This study aims to set the foundations of a spatial conservation strategy by identifying the most important catchments for the conservation of freshwater biodiversity in Europe.
Using data on 1296 species of fish, mollusc, odonate and aquatic plant, and the key biodiversity area criteria (species Red List status, range restriction and uniqueness of species assemblages), we identified a network of Critical Catchments for the conservation of freshwater biodiversity. Applying spatial prioritisation, we show how the prioritised network differs from the ideal case of protecting all Critical Catchments and how it changes when protected areas are included, and we also identify gaps between the prioritised network and existing protected areas.
Critical Catchments (n = 8423) covered 45% of the area of Europe, with 766 qualifying (‘trigger’) species located primarily in southern Europe. The prioritised network, limited to 17% of the area of Europe, comprised 3492 catchments mostly in southern and eastern Europe and species targets were met for at least 96% of the trigger species.
We found the majority of Critical Catchments to be inadequately covered by protected areas. However, our prioritised network presents a possible solution to augment protected areas to meet policy targets while also achieving good species coverage.
Policy implications. While Critical Catchments cover almost half of Europe, priority catchments are mostly in southern and eastern Europe where the current level of protection is not sufficient. This study presents a foundation for a Europe-wide systematic conservation plan to ensure the persistence of freshwater biodiversity. Our study provides a powerful new tool for optimising investment on the conservation of freshwater biodiversity and for meeting targets set forth in international biodiversity policies, conventions and strategies.
HRM processes are increasingly AI-driven, and HRM supports the general digital transformation of companies’ viable competitiveness. This paper points out possible positive and negative effects on HRM, workplaces, and workersorganizations along the HR processes and its potential for competitive advantage in regard to managerial decisions on AI implementation regarding augmentation and automation of work.
A systematic literature review that includes 62 international journals across different disciplines and contains top-tier academic and German practitioner journals was conducted. The literature analysis applies the resource-based view (RBV) as a lens through which to explore AI-driven HRM as a potential source of organizational capabilities.
The analysis shows four ambiguities for AI-driven HRM that might support sustainable company development or might prevent AI application: job design, transparency, performance and data ambiguity. A limited scholarly discussion with very few empirical studies can be stated. To date, research has mainly focused on HRM in general, recruiting, and HR analytics in particular.
The four ambiguities’ context-specific potential for capability building in firms is indicated, and research avenues are developed.
This paper critically explores AI-driven HRM and structures context-specific potential for capability building along four ambiguities that must be addressed by HRM to strategically contribute to an organization’s competitive advantage.
In open-field vegetable production, high quantities of soil mineral nitrogen (Nmin) and N-rich crop residues often remain in the field at harvest. After the harvest of crops in autumn, this N can lead to considerable nitrate (NO3−) losses during the subsequent winter leaching period. In four field trials, different tillage depths (3–4, 10, 30 cm) and dates (early autumn, late autumn, early spring) were investigated to reduce N losses after growing spinach in the autumn. In a further treatment, the nitrification inhibitor 3,4-Dimethylpyrazole phosphate (DMPP) was directly applied to the crop residues. Potential N losses were calculated by a balance sheet approach based on Nmin concentration (0–90 cm), measured N mineralization and N uptake by catch crops. By postponing the tillage date from early to late autumn or spring, resprouting spinach stubbles acted as a catch crop, reducing N losses by up to 61 kg ha−1. However, if the spinach biomass collapsed, the N losses increased by up to 33 kg ha−1 even without tillage. The application of DMPP as well as the tillage depth were less effective. Overall, postponing tillage to spring seems to be the most promising approach for reducing N losses during the off-season.
BACKGROUND: The Craniofacial Pain and Disability Inventory (CF-PDI) is a cross-culturally adapted instrument designed from a biopsychosocial perspective to measure pain, disability, and function in orofacial head and neck pain with shown psychometric properties; however, the German cross-cultural adaption is lacking.
OBJECTIVES: To carry out a transcultural translation of CF-PDI into German and assess its psychometric properties in patients with painful temporomandibular disorders (TMD) with respect to construct and clinical validity, internal consistency and reproducibility.
STUDY DESIGN: Multicenter, prospective, cross-sectional design.
SETTING: Patients (n = 398) were recruited from dental and physical therapy clinics in middle and south Germany.
METHODS: Structural validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We investigated know-group validity by means of the scale’s potential to discriminate between affected and unaffected subjects. Multiple linear regression analysis was used to estimate convergent validity. We tested test-retest reliability by the intraclass correlation coefficient and the Internal consistency by Cronbach’s alpha, or each dimension separately, and the total score. Multiple linear regression analysis was used to estimate convergent validity.
RESULTS: Two hundred forty-six heterogeneous chronic craniofacial pain patients and 152 patients without complaints were recruited from the middle and south of Germany. The German version CF-PDI-G presents 21 items, 4 factors, and adequate psychometric properties. The test-retest reliability and internal consistency of the CF-PDI-G were both excellent for the entire instrument and also for all sub-scales (intraclass correlation coefficient [ICC] > 0.90) except for the comorbidities and interference with work which was acceptable (ICC = 0.69). Standard error of the measurement (SEM) and minimal detectable change values are sufficiently low. Assessment of clinical validity shows good potential of discrimination and classification into categories “no,” “mild,” “moderate,” and “severe.” The multiple linear regression model showed a strong association between neck disability index, Visual Analog Scale, and anamnestic questionnaire (supporting the scale’s convergent validity).
LIMITATIONS: Our sample has a higher prevalence of women and the sample was not recruited consecutively, which may lead to a biased estimation of psychometric properties.
CONCLUSIONS: The CF-PDI-G represents valid and reliable instrument to assess pain and disability in patients with orofacial pain and headache suitable for research and clinical practice.
Convergence processes are based on the activity of distinct industry sectors showing cross-industry collaborations. The aim of this paper is to analyze cross-industry collaborations between the food and pharmaceutical sectors in the convergence area of functional foods. Selected companies from food (Nestlé/Danone) and pharmaceutical (Martek/Bayer HealthCare) sectors are analyzed using the determinants of motivation and industrial scope. The analysis shows that food companies are more active in cross-industry collaborations than pharmaceutical companies. The latter are more active at the front-end of the value chain focusing on research and development, and delivering their ingredients to food companies that due to their higher expertise in consumer marketing launch the products. While the first cross-industry collaborations were based on an exploration motivation, those that follow focus on exploitation. Acquisitions and licensing agreements are dominant in inside-out and outside-in processes, whereas strategic alliances and joint ventures are based on a coupled process between the food and pharmaceutical sectors.
The aim of this paper is to advance the research on innovation at the pharma-nutrition interface by analysing the three steps of science, technology and market convergence in the area of probiotics using a life cycle perspective. Results from a bibliometric analysis drawing upon 8245 scientific publications, 2082 patents and 1357 news reports focussing on product launch announcements from 1990 up to 2009 indicate that the proposed curve shapes of the life cycles in the theory based framework can be transferred to the case of probiotics. There is a time shift considering the life cycles showing the same activities of the industrial sectors at different moments of time. The food sector dominates the field of probiotics by driving science, technology and market convergence showing earlier activities in scientific publications, patents as well as product launches, while presenting a higher clockspeed between the different life cycle phases. While the food sector dominates product launches for food products containing probiotics, the pharmaceutical sector dominates the product launches of the supplement market. In addition, a clear trend towards industry convergence can be identified by the growing number of cross-industry activities.
Every culture has its paradise vision: desirable and external conditions which, inside the concerned culture, are infrequently observed or difficult to realize and are linked to one another. This cross-cultural study compares well-being inChina,Bulgaria,FranceandGermany. The cultural patterns of the culture are differently, but well-being is easier to achieve if people adapt to their cultural patterns. The adjustment (positive subjective culture) is formed by culture-specific content and needs different in regards to different cultures.
Purpose
This study operationalizes risks in stakeholder dialog (SD). It conceptualizes SD as co-produced organizational discourse and examines the capacities of organizers' and stakeholders' practices to create a shared understanding of an organization’s risks to their mutual benefit. The meetings and online forum of a German public service media (PSM) organization were used as a case study.
Design/methodology/approach
The authors applied corpus-driven linguistic discourse analysis (topic modeling) to analyze citizens' (n = 2,452) forum posts (n = 14,744). Conversation analysis was used to examine video-recorded online meetings.
Findings
Organizers suspended actors' reciprocity in meetings. In the forums, topics emerged autonomously. Citizens' articulation of their identities was more diverse than the categories the organizer provided, and organizers did not respond to the autonomous emergence of contextualizations of citizens' perceptions of PSM performance in relation to their identities. The results suggest that risks arise from interactionally achieved occasions that prevent reasoned agreement and from actors' practices, which constituted autonomous discursive formations of topics and identities in the forums.
Originality/value
This study disentangles actors' practices, mutuality orientation and risk enactment during SD. It advances the methodological knowledge of strategic communication research on SD, utilizing social constructivist research methods to examine the contingencies of organization-stakeholder interaction in SD.
Objectives: The aims of this study were to define the Faces Pain Scale-Revised (FPS-R) and Color Analog Scale (CAS) scores associated with no pain, mild pain, moderate pain, and severe pain in children with acute pain, and to identify differences based on age, sex, and ethnicity.
Methods: We conducted a prospective observational study in 2 pediatric emergency departments of children aged 4 to 17 years with painful and nonpainful conditions. We assessed their pain intensity using the FPS-R, CAS, and qualitative measures. Pain score cut points that best differentiated adjacent categories of pain were identified using a receiver operating characteristic-based method. Cut points were compared within subgroups based on age, sex, and ethnicity.
Results: We enrolled 620 patients, of whom 314 had painful conditions. The mean age was 9.2 years; 315 (50.8%) were in the younger age group (aged 4-7 years); 291 (46.8%) were female; and 341 (55%) were Hispanic. The scores best representing categories of pain for the FPS-R were as follows: no pain, 0 and 2; mild pain, 4; moderate pain, 6; and severe pain, 8 and 10. For the CAS, these were 0 to 1, 1.25 to 2.75, 3 to 5.75, and 6 to 10, respectively. Children with no pain frequently reported nonzero pain scores. There was considerable overlap of scores associated with mild and moderate pain. There were no clinically meaningful differences of scores representing each category of pain based on age, ethnicity, and race.
Conclusions: We defined pain scores for the FPS-R and CAS associated with categories of pain intensity in children with acute pain that are generalizable across subgroups based on patient characteristics. There were minor but potentially important differences in pain scores used to delineate categories of pain intensity compared to prior convention.
Suicide is a major cause of death in adulthood and specifically in patients suffering from mental illnesses. The Depressive Symptom Inventory Suicidality Subscale (DSI-SS) is widely used to detect and prevent suicidal ideation. The aim of the present study was to determine optimal cut points for the DSI-SS in different populations.
We analysed the data of one population-based sample (n = 532), one outpatient sample (n = 180) and one inpatient sample (n = 244). Internal consistency, convergent validity and optimal cut points according to receiver operating characteristics were calculated.
In all samples, we found excellent item-total correlations and internal consistencies for the DSI-SS. Zero-order correlations between the DSI-SS and theoretically related constructs showed positive correlation coefficients, ranging from 0.50 to 0.67. The DSI-SS differentiated well between patients with and without suicide attempts in the population-based sample, but less so in the inpatient sample and only marginally in the outpatient sample. A bootstrapping analysis showed some variability in the cut points that emerged as optimal, but there was no overlap between the different samples.
The specific cut points that we identified may be used to improve the diagnostic utility of the DSI-SS and the chance to detect suicidal ideation.
Currently, only non-imaging chlorophyll fluorescence measurements are used to identify the Lower Oxygen Limit (LOL) in Dynamic Controlled Atmosphere - Chlorophyll Fluorescence (DCA-CF) storage. The disadvantage of non-imaging fluorescence is that no statement can be made about the spatial heterogeneity of the sample. In contrast, chlorophyll fluorescence imaging can detect spatial heterogeneity of photosynthetic activity and has been established in research for some decades because the information benefit is higher. In this study, the chlorophyll fluorescence (Fo, Fm, Fv, Fv/Fm) of apples (Malus x domestica, BORKH.) was measured with a fluorescence imaging system in situ during storage. Intact apples of ‘Braeburn’ and ‘Golden Delicious’ were stored under low-oxygen stress conditions (< 1 kPa). The metabolic shift from aerobic to fermentative metabolism was made visible with the chlorophyll fluorescence imaging and was spatially localized on the sample. Furthermore, a method was developed to identify the LOL based on the chlorophyll fluorescence imaging combined with the histogram division method. This method considers the heterogeneity of the fluorescence and bundles the measured Fo data as histograms. Our results showed that the fluorescence imaging combined with the histogram division method can be a powerful tool for identifying the LOL.
Detection and resolution of conflicting change operations in version management of process models
(2013)
Version management of process models requires that different versions of process models are integrated by applying change operations. Conflict detection between individually applied change operations and conflict resolution support are integral parts of version management. For conflict detection it is utterly important to compute a precise set of conflicts, since the minimization of the number of detected conflicts also reduces the overhead for merging different process model versions. As not every syntactic conflict leads to a conflict when taking into account model semantics, a computation of conflicts solely on the syntax leads to an unnecessary high number of conflicts. Moreover, even the set of precisely computed conflicts can be extensive and their resolution means a significant workload for a user. As a consequence, adequate support is required that guides a user through the resolution process and suggests possible resolution strategies for individual conflicts. In this paper, we introduce the notion of syntactic and semantic conflicts for change operations of process models. We provide a method how to efficiently compute conflicts precisely, using a term formalization of process models and consider the subsequent resolution of the detected conflicts based on different strategies. Using this approach, we can significantly reduce the number of overall conflicts and reduce the amount of work for the user when resolving conflicts.
Oleamide is used as a lubricant in the manufacturing and application of polypropylene (PP) medical devices. Samples of PP were prepared with 0, 1500, and 15 000 ppm oleamide content as lubricant. The samples were either left non-sterile, sterilized with ethylene oxide (ETO), γ-radiation (γ) or autoclaved (A) and stored for up to 4 weeks. To determine the oleamide bulk-to-surface distribution depending on sterilization method and storage time an extraction method and a washing technique were applied. The oleamide content was determined by gas chromatography (GC-FID) and compared with the coefficient of friction (COF). The COF dependent on the measured lubricant content at the surface. The content of lubricant on the surface depends on the type of sterilization: ETO increased the lubricant content to some extent, γ-sterilization and autoclaving reduced it. After storage, no migration of the lubricant to the surface could be detected.
Objectives: This paper addresses recent steps for reforming the eligibility criteria of the German long-term care insurance that have been initiated to overcome shortcomings in the current system.
Methods: Based on findings of a survey of international long-term care systems, assessment tools and the relevant literature on care needs a new tool for determining eligibility in the German long-term care insurance was developed.
Results: The new tool for determining long-term care eligibility broadens the understanding of what ‚dependency on nursing care' implies for the person affected. The assessment results in a degree of dependency from personal help provided by formal or informal caregivers. This degree of dependency can be used for determining eligibility for and the amount of long-term care benefits.
Discussion: The broader understanding of "dependency on nursing care' and the new tool are important steps to adapt the German long-term care insurance to the challenges of the demographic and societal changes in the future
Background: Availability and usage of individual IT applications have been studied intensively in the past years. Recently, IT support of clinical processes is attaining increasing attention. The underlying construct that describes the IT support of clinical workflows is clinical information logistics. This construct needs to be better understood, operationalised and measured.
Objectives: It is therefore the aim of this study to propose and develop a workflow composite score (WCS) for measuring clinical information logistics and to examine its quality based on reliability and validity analyses.
Methods: We largely followed the procedural model of MacKenzie and colleagues (2011) for defining and conceptualising the construct domain, for developing the measurement instrument, assessing the content validity, pretesting the instrument, specifying the model, capturing the data and computing the WCS and testing the reliability and validity.
Results: Clinical information logistics was decomposed into the descriptors data and information, function, integration and distribution, which embraced the framework validated by an analysis of the international literature. This framework was refined selecting representative clinical processes. We chose ward rounds, pre- and post-surgery processes and discharge as sample processes that served as concrete instances for the measurements. They are sufficiently complex, represent core clinical processes and involve different professions, departments and settings. The score was computed on the basis of data from 183 hospitals of different size, ownership, location and teaching status. Testing the reliability and validity yielded encouraging results: the reliability was high with r(split-half) = 0.89, the WCS discriminated between groups; the WCS correlated significantly and moderately with two EHR models and the WCS received good evaluation results by a sample of chief information officers (n = 67). These findings suggest the further utilisation of the WCS.
Conclusion: As the WCS does not assume ideal workflows as a gold standard but measures IT support of clinical workflows according to validated descriptors a high portability of the WCS to other hospitals in other countries is very likely. The WCS will contribute to a better understanding of the construct clinical information logistics.
Background: Continuous improvements of IT-performance in healthcare organisations require actionable performance indicators, regularly conducted, independent measurements and meaningful and scalable reference groups. Existing IT-benchmarking initiatives have focussed on the development of reliable and valid indicators, but less on the questions about how to implement an environment for conducting easily repeatable and scalable IT-benchmarks.
Objectives: This study aims at developing and trialling a procedure that meets the afore-mentioned requirements.
Methods: We chose a well established, regularly conducted (inter-) national IT-survey of healthcare organisations (IT-Report Healthcare) as the environment and offered the participants of the 2011 survey (CIOs of hospitals) to enter a benchmark. The 61 structural and functional performance indicators covered among others the implementation status and integration of IT-systems and functions, global user satisfaction and the resources of the IT-department. Healthcare organisations were grouped by size and ownership. The benchmark results were made available electronically and feedback on the use of these results was requested after several months.
Results: Fifty-ninehospitals participated in the benchmarking. Reference groups consisted of up to 141 members depending on the number of beds (size) and the ownership (public vs. private). A total of 122 charts showing single indicator frequency views were sent to each participant. The evaluation showed that 94.1% of the CIOs who participated in the evaluation considered this benchmarking beneficial and reported that they would enter again. Based on the feedback of the participants we developed two additional views that provide a more consolidated picture.
Conclusion: The results demonstrate that establishing an independent, easily repeatable and scalable IT-benchmarking procedure is possible and was deemed desirable. Based on these encouraging results a new benchmarking round which includes process indicators is currently conducted.
Every modern institution involved in higher education needs a Learning Management System (LMS) to handle learning and teaching processes. It is necessary to offer e.g. electronic lecture materials to the students for download via the internet. In some educational contexts, it is also necessary to offer internet tutorials to be able to give the students more personal support and accompany them through the whole lecture period. Many organisations have introduced commercial LMS and gained the experience that monolithic solutions do not fulfil the dynamic requirements of complex educational institutions and are very cost-intensive. Therefore, many universities face the decision to stick to their commercial LMS or to switch to a potentially more cost-effective and flexible solution, for instance by adopting available Open Source LMS. Since we have made profound experience in developing and operating an Open Source LMS, this contribution enlightens the main characteristics of this alternative. This paper describes a use case dealing with a full product lifecycle (development, deployment, use and evaluation) of an Open Source LMS at the University of Muenster (Germany). It identifies relevant instruments and aspects of system design which software architects in practical application domains should pay attention to.
Background: Clinical information logistics is the backbone of care workflows inside and outside of hospitals. Due to the great potential of health IT to support clinical processes its contribution needs to be regularly monitored and governed. IT benchmarks are a well-known instrument to optimise the availability and use of IT by guiding the decision making process. The aim of this study was to translate IT benchmarking results that were grounded on a hierarchical workflow scoring system into an appropriate visualisation concept.
Methods: To this end, a three-dimensional multi-level model was developed, which allowed the decomposition of the highly aggregated workflow composite score into score views for the individual clinical workflows concerned and for the descriptors of these workflows. Furthermore this multi-level model helped to break down the score views into single and multiple indicator views.
Results: The results could be visualised per hospital in comparison to the results of organisations of similar size and ownership (peer reference groups) and in comparison to different types of innovation adopters. The multi-level model was implemented in a benchmark of 199 hospitals and evaluated by the chief information officers. The evaluation resulted in high ratings for the comprehensibility of the different types of views of the scores and indicators.
Conclusions: The implementation of the multi-level model in a large benchmark of hospitals proved to be feasible and useful in terms of the overall structure and the different indicator views. There seems to be a preference for less complex and familiar views.
A systematic study was performed to understand the effects of the devulcanizing agent dibenzamido diphenyl disulfide (DBD) on the vulcanization and devulcanization process of a sulfur-cured ethylene-propylene-diene monomer (EPDM) rubber. The influence of DBD on vulcanization was investigated by mixing DBD with virgin rubber and curative system. The devulcanization of rubber waste was achieved with varying amounts of DBD ranging from 0.4 to 13.8 wt% and temperatures from 150 to 200°C. The quality of vulcanizates and devulcanizates was evaluated by rheometer tests, temperature scanning stress relaxation measurements, and analysis of mechanical properties. During vulcanization, DBD acts as an accelerator in the presence of sulfur. When accelerators are added, the scorch time increases, and the cure rate decreases. Thus, DBD acts as a retarder. In the presence of activators, DBD leads to a significant reduction of crosslink density. This results in composites with high elongation at break and poor compression set values. The efficiency of the devulcanization of rubber waste depends strongly on DBD concentration and temperature. The monosulfidic crosslinks are cleaved by low concentrations of DBD, while polysulfidic crosslinks require higher concentrations. These results show that DBD is effective as a devulcanizing agent and degrades the network below 200°C.
Introduction
Tests to evaluate the integrity of the alar ligaments are important clinical tools for manual therapists, but there is limited research regarding their validity.
Method
A single blinded examiner assessed alar ligament integrity using the lateral shear test (LST), rotation stress test (RST) and side-bending stress test (SBST) on a sample of convenience comprising 7 subjects with MRI confirmed alar ligament lesions and 11 healthy people. Alar ligament lesions were identified using both supine and high-field strength upright MRI.
Results
The RST had a sensitivity of 80% and a specificity of 69.2%. The SBST and the LST both showed a sensitivity of 80% and a specificity of 76.9%. In cases where all three tests were positive, the specificity increased to 84.6%.
Discussion
Tests of manual examination of alar ligament integrity have some diagnostic utility; however, these findings require further corroboration in a larger sample.
25-hydroxycholecalciferol (25-OHD3) formed via hepatic hydroxylation from vitamin D, cholecalciferol, represents the precursor of the biologically active vitamin D hormone, 1,25-dihydroxyvitamin D. Due to a higher absorption rate and the omission of one hydroxylation, dietary supplementation of 25-OHD3 instead of vitamin D3 is considered to be more efficient as plasma concentrations of 25-OHD3 are increased more pronounced. The present review summarises studies investigating potential beneficial effects on mineral homeostasis, bone metabolism, health status and performance in sows, piglets and fattening pigs. Results are inconsistent. While most studies could not demonstrate any or only a slight impact of partial or total replacement of vitamin D3 by 25-OHD3, some experiments indicated that 25-OHD3 might alter physiological processes when animals are challenged, for example, by a restricted mineral supply.
Extending assessments of climate change-induced range shifts via correlative species distribution models by including species traits is crucial for conservation planning. However, comprehensive assessments of future distribution scenarios incorporating responses of biotic factors are poorly investigated. Therefore, the aim of our study was to extend the understanding about the combined usage of species traits data and species distribution models for different life stages and distribution scenarios. We combine global model predictions for the 2050s and thermal performances of Salmo trutta and Salmo salar under consideration of different life stages (adults, juveniles, eggs), timeframes (monthly, seasonally, yearly), and dispersal scenarios (no dispersal, free dispersal, restricted dispersal). We demonstrate that thermal performances of different life stages will either increase or decrease for certain time periods. Model predictions and thermal performances imply range declines and poleward shifts. Dispersal to suitable habitats will be an important factor mitigating warming effects; however, dams may block paths to areas linked to high performances. Our results emphasize enhanced inclusion of critical periods for species and proper dispersal solutions in conservation planning.
Aims:
To assess the diagnostic utility of a novel abbreviated monofilament test in comparison with the tuning fork test to detect diabetic peripheral neuropathy in children.
Methods:
A total of 88 children with Type 1 diabetes mellitus were screened for diabetic peripheral neuropathy using the monofilament test and the tuning fork. Nerve conduction studies were performed according to the ‘gold standard’ for neuropathy. We assessed the diagnostic utility and inter-rater agreement of the two screening methods.
Results:
A total of 43 (49%) children (aged 6–18 years) had at least one abnormal nerve conduction study result. Diagnostic utility and inter-rater agreement were very low for both screening methods. The monofilament test yielded a sensitivity of 18% and a specificity of 80%. The tuning fork yielded a sensitivity of 0% and a specificity of 98%.
Conclusion:
The present study found that an abbreviated monofilament test has low diagnostic utility for the detection of early diabetic peripheral neuropathy because of its low reliability. The problem of reliability needs to be more thoroughly addressed in order to improve the screening procedures in diabetes management in childhood and adolescence.
Background:
While aiming for the same goal of building a national eHealth Infrastructure, Germany and the United States pursued different strategic approaches – particularly regarding the role of promoting the adoption and usage of hospital Electronic Health Records (EHR).
Objective:
To measure and model the diffusion dynamics of EHRs in German hospital care and to contrast the results with the developments in the US.
Materials and methods:
All acute care hospitals that were members of the German statutory health system were surveyed during the period 2007–2017 for EHR adoption. Bass models were computed based on the German data and the corresponding data of the American Hospital Association (AHA) from non-federal hospitals in order to model and explain the diffusion of innovation.
Results:
While the diffusion dynamics observed in the US resembled the typical s-shaped curve with high imitation effects (q = 0.583) but with a relatively low innovation effect (p = 0.025), EHR diffusion in Germany stagnated with adoption rates of approx. 50% (imitation effect q = -0.544) despite a higher innovation effect (p = 0.303).
Discussion:
These findings correlate with different governmental strategies in the US and Germany of financially supporting EHR adoption. Imitation only seems to work if there are financial incentives, e.g. those of the HITECH Act in the US. They are lacking in Germany, where the government left health IT adoption strategies solely to the free market and the consensus among all of the stakeholders.
Conclusion:
Bass diffusion models proved to be useful for distinguishing the diffusion dynamics in German and US non-federal hospitals. When applying the Bass model, the imitation parameter needs a broader interpretation beyond the network effects, including driving forces such as incentives and regulations, as was demonstrated by this study.
The BBI is a first step toward putting biodiversity conservation into practice in the OHC context. The results are consistent with studies related to nutrition However, the results also show that there is room for improvement and that there are further areas to be addressed. It is also clear that commercial kitchens currently have only limited room for maneuver. If OHC is to become more biodiversity-friendly, greater transparency is needed in terms of origin labels and species/variety identifiers, and a wide range of options will also be required in terms of procurement. That being the case, it is essential to focus on the entire value chain. Furthermore, in addition to the initial recommendations, much more knowledge is required about the impacts of farming methods and heritage varieties and species, as well as about the use of fish, other marine animals and game meat. In principle, however, the BBI can already be implemented in commercial kitchens by identifying recipe optimizations that kitchens can feasibly implement, that align with their budgets, and that maintain acceptance among patrons. In addition, this approach has the potential to be integrated into the assessment framework of the NAHGAST calculator, making it readily accessible and free for OHC facilities to use. In the OHC context in particular, this could be leveraged to drive sustainable change in the food system.
The increasing diversity of cultural backgrounds offers potential for a more elaborated information processing, yet has been shown to be challenging for individuals, due to intergroup hostility, prejudices, and difficulties of intercultural communication. Current research thus focusses on the interaction of employees with different cultural heritages, as well as on their intergroup attitudes and competences. Thereby, leaders have been shown to shape the way diversity is considered in their teams in a top-down process. However, their perception of diversity as well as related challenges and chances are poorly investigated. The current paper thus aims to contribute to the understanding of leader’s perspective on and role in diversity-management by building on a comparative qualitative study with sixteen employees and twenty-two leaders. Research questions are how employees and leaders perceive cultural diversity from their specific point of view, which experiences are likely to contribute to their opinion on and perception of diversity and in how far do employees and leaders differ in these aspects. The results show that employees are aware of the topic of diversity in general but have poor competences in dealing with diversity in their daily working life. This seems to be associated with lack of experience with intercultural interaction and a lack of support from the respective organizations/leaders. Leaders are rarely aware of this lack of support. The results indicate that leaders’ experiences with cultural and age diversity, their identification with the company and previous diversity measures in the context of the companies’ policy towards diversity seem to be relevant for the formation of leaders’ attitudes. As a consequence, most participants focus on the question whether they do or do not want diversity within their teams and companies, while they actually fail to perceive the diversity that is already there.
Due to new research results in the past few years, interest in the fascia of the human body has increased. Dysfunctions of the fascia are indicated by various symptoms, amongst others, musculoskeletal pain. As a result stronger focus has been put on researching therapeutic approaches in this area. The main aim of this study was to investigate the effect of Foam Roll exercises on the mobility of the thoracolumbar fascia (TLF). Study has been conducted in a randomized and controlled trial which sampled 38 healthy athletic active men and women.
The subjects were randomly assigned to a Foam Roll Group (FMG), a Placebo Group (PG) and a Control Group (CG). Depending on the assigned group the volunteers were either instructed to do exercises with the Foam Roll, received a pseudo treatment with the Foam Roll or received no treatment.
A total of three measurements were carried out. The most important field of research was the mobility of the TLF, which was determined using a sonographic assessment. In addition the lumbar flexion and the mechanosensivity of relevant muscles were determined.
After the intervention, the FMG showed an average increase of 1.7915 mm for the mobility of the TLF (p < 0.001/d = 0.756). In contrast, only an average improvement of 0.1681 mm (p = 0.397) was shown in the PG, while the CG showed a slight improvement of 0.0139 mm (p = 0.861). However, no significant changes were observed with regard to the lumbar flexion and mechanosensivity of the treated muscles.
Thus, evidence is that the use of Foam Roll exercises significantly improves the mobility of the thoracolumbar fascia in a healthy young population.
Purpose
In a knowledge-based society, one of the main driving forces of prosperity at city and regional levels is the ability to attract students and recently qualified graduates. The purpose of this paper is to identify the urban factors that contribute to “attractiveness” from a student perspective and to subsequently analyse the influence of these factors on students’ location choices. In the corresponding case study, the criteria identified were used to evaluate student satisfaction with the German city of Osnabrück.
Design/methodology/approach
A multi-level empirical research concept was used to analyse the relevant criteria. Focus group discussions served as the basis to design and conduct a survey of almost 2,300 students in the university city of Osnabrück at the end of 2016. A follow-up study in November 2017 at two universities in Berlin provided data for comparison.
Findings
Accessible – safe – clean and with affordable housing: these terms sum up the core expectations that students have of an attractive city. In contrast to the findings of Richard Florida regarding the creative class, cultural opportunities, exciting nightlife and a multicultural population were not important factors among the survey participants.
Research limitations/implications
As the study was conducted in two cities only, the findings cannot be generalised. It should be replicated in at least five other cities to validate and compare the research findings presented here. Furthermore, this study focused on the factors influencing the attractiveness of the city as a whole. However, the attractiveness of a specific neighbourhood may be of greater relevance to the decision-making process. As housing plays a major role, students’ particular needs with regard to accommodation should also be examined at greater depth.
Practical implications
Insights generated by the empirical study provide relevant information that may assist city stakeholders in taking effective measures regarding place management to attract and retain students.
Originality/value
To date, little research has been undertaken to empirically examine the specific factors that German students look for when deciding where to study and live. The goal of this paper is to present new empirical insights concerning the quality-of-life factors that influence students’ decision-making processes.
Objectives: To measure and assess the economic impact of adherence to a single quality indicator (QI) regarding weaning from invasive ventilation.
Design: Retrospective observational single-centre study, based on electronic medical and administrative records.
Setting: Intensive care unit (ICU) of a German university hospital, reference centre for acute respiratory distress syndrome.
Participants: Records of 3063 consecutive mechanically ventilated patients admitted to the ICU between 2012 and 2017 were extracted, of whom 583 were eligible adults for further analysis. Patients’ weaning protocols were evaluated for daily adherence to quality standards until ICU discharge. Patients with <65% compliance were assigned to the low adherence group (LAG), patients with ≥65% to the high adherence group (HAG).
Primary and secondary outcome measures: Economic healthcare costs, clinical outcomes and patients’ characteristics.
Results: The LAG consisted of 378 patients with a median negative economic results of −€3969, HAG of 205 (−€1030), respectively (p<0.001). Median duration of ventilation was 476 (248; 769) hours in the LAG and 389 (247; 608) hours in the HAG (p<0.001). Length of stay (LOS) in the LAG on ICU was 21 (12; 35) days and 16 (11; 25) days in the HAG (p<0.001). LOS in the hospital was 36 (22; 61) days in the LAG, and within the HAG, respectively, 26 (18; 48) days (p=0.001).
Conclusions: High adherence to this single QI is associated with better clinical outcome and improved economic returns. Therefore, the results support the adherence to QI. However, the examined QI does not influence economic outcome as the decisive factor.
Objective
Gross mandibular position and masticatory muscle activity have been shown to influence cervical muscles electromyographic activity. The purpose of this study was to investigate the influence of three different mandible positions including conscious occlusion, tongue tip against the anterior hard palate (Palate tongue position) and natural resting position (Rest), on sagittal plane cervical spine range of motion (ROM) as well as the flexion-rotation test (FRT) in asymptomatic subjects.
Materials and methods
An experienced single blinded examiner evaluated ROM using an Iphone in 22 subjects (7 females; mean age of 29.91years, SD 5.44).
Results
Intra-rater reliability for range recorded was good for the FRT with ICC (intraclass correlation) 0.95 (95% CI: 0.88–0.98) and good for sagittal plane cervical ROM with ICC 0.90 (95% CI: 0.77–0.96). A repeated measures ANOVA determined that mean ROM recorded during the FRT differed significantly between assessment points (F(1.99, 41.83) = 19.88, P < 0.001). Bonferroni Post hoc tests revealed that both conscious Occlusion and Palate tongue position elicited a significant large reduction in ROM recorded during the FRT from baseline (p < 0.01). Despite this, one activation strategy did not influence ROM more than the other. An additional repeated measures ANOVA determined that mean sagittal cervical ROM did not significantly vary between assessment points (F(2, 42) = 8.18, P = 0.08).
Conclusion
This current study provided further evidence for the influence of the temporomandibular region on upper cervical ROM. Results suggest that clinicians should focus on the natural mandible rest position when evaluating upper cervical mobility.
A patient presenting with local pain and limitation of movement in the temporomandibular region following surgery of the left temporomandibular joint (TMJ) is described. Manual techniques like distraction of the TMJ combined with motor control exercises to restore TMJ function were not sufficient to relieve the patient's symptoms and her orofacial functions. However, during manual assessment and treatment of cranial nervous tissue, in this case the auriculotemporal nerve and its interface, pain was relieved and orofacial functions improved.
Ecological restoration of an urban demolition site through introduction of native forb species
(2020)
Urban brownfields can provide habitats for endangered native plant species but may also support invasive non native species. The aim of our study was to develop and test different measures for the ecological restoration of an urban brownfield. We aimed to enhance native plant species richness by seeding two native forb seed mix tures containing 25 (HD-mixture) and 13 species (LD-mixture), respectively, without affecting spontaneously colonizing plant species of nature conservation value. Additionally, we tested the effects of species introduction and mowing on the establishment of invasive non-native plant species, woody species development, and per ennial grass dominance.
With establishment rates of 84% (HD) and 92% (LD) in the first study year and about 60% for both seed mixtures in the fourth year, species introduction was successful and led to rapid re-vegetation of the formerly bare brownfield. Although seeding did not result in increased species richness using either seed mixture, the dominance of perennial grasses was significantly reduced by the establishment of forb species from the HD mixture. Overall, we observed the spontaneous establishment of ten plant species of conservation value; seeding affected these species only temporarily, in the second year. Seeding (with either seed mixture) and mowing both resulted in reduced cover of woody species and a lower frequency of the invasive non-native Robinia pseudoa cacia.
Our study demonstrated the high nature conservation value of dry and nutrient-poor urban brownfields for spontaneously occurring threatened plant species. Further studies have to evaluate if the reduced cover of grasses and woody species through introduction of site-specific native forb species might increase these sites’ aesthetic value and broader acceptance of brownfields by urban residents.
Injection of slurry or digestate below maize seeds is a relatively new technique developed to improve nitrogen use efficiency. However, this practice has the major drawback of increasing nitrous oxide (N2O) emissions. The application of a nitrification inhibitor (NI) is an effective method to reduce these emissions. To evaluate the effect of the NI 3,4‐dimethypyrazole phosphate (DMPP) on N2O emissions and the stabilization of ammonium, a two‐factorial soil‐column experiment was conducted. PVC pipes (20 cm diameter and 30 cm length) were used as incubation vessels for the soil‐columns. The trial consisted of four treatments in a randomized block design with four replications: slurry injection, slurry injection + DMPP, digestate injection, and digestate injection + DMPP. During the 47‐day incubation period, N2O fluxes were measured twice a week and cumulated by linear interpolation of the gas‐fluxes of consecutive measurement dates. After completion of the gas flux measurement, concentration of ammonium and nitrate within the soil‐columns was determined. DMPP delayed the conversion of ammonium within the manure injection zone significantly. This effect was considerably more pronounced in treatment digestate + NI than in treatment slurry + NI. Regarding the cumulated N2O emissions, no difference between slurry and digestate treatments was determined. DMPP reduced the release of N2O significantly. Transferring the results into practice, the use of DMPP is a promising way to reduce greenhouse gas emissions and nitrate leaching, following the injection of slurry or digestate.
The aim of the study was to examine different pH parameters, such as variations throughout the day, depending on differing concentrate feed proportions. Moreover, special attention was payed to individual variation in microbial efficiencies (microbial crude protein/fermented organic matter) and their relation to ruminal pH, nutrient flows and digestibilities. For this, cows were grouped according to microbial efficiency (more, n = 5, vs. less efficient cows, n = 4). After calving, thirteen ruminally cannulated pluriparous cows, including nine duodenally cannulated animals, were divided into groups offered rations with a lower (35% on dry matter basis, n = 7) or a higher (60% on dry matter basis, n = 6) concentrate feed proportion. Ruminal pH parameters were assessed continuously by using intraruminal probes. Nutrient flows, nutrient digestibility and microbial efficiency were determined for duodenally cannulated cows. For most ruminal pH parameters it seemed that individual variability was higher than the treatment effect. However, a positive relationship between actual concentrate intake and diurnal pH fluctuations was found. Besides, the effect of individually different microbial efficiencies was assessed. Again, there were no group differences for pH parameters. However, nutrient flows were significantly higher in more efficient cows, whereas digestibilities were lower in in more efficient cows.
Establishment of calcareous grassland on ex-arable fields by introducing target species is one of the most frequently used methods to restore the species assemblages of this highly endangered habitat type. The present study evaluates the long-term success of calcareous grassland restoration on former arable land in the vicinity of one of the oldest nature reserves in Bavaria, the “Garchinger Heide”. The restoration experiment combined different measures like topsoil removal, transfer of freshly cut seed-containing hay and additional sowing to the following variants in a 21-year experiment: (1) No topsoil removal, no hay transfer (control), (2) no topsoil removal with immediate hay transfer, (3) topsoil removal with immediate hay transfer and (4) topsoil removal with hay transfer 10 years after the start of restoration. Eleven Red List species which had not been transferred successfully were additionally sown after 9 to 19 years. Due to a limited availability of seeds, sowing of these species was mainly restricted to areas with topsoil removal, where better establishment was expected due to low vegetation cover. Five rare species with abundant seed production were also sown to plots without topsoil removal and hay transfer. The nature reserve served both as the donor area of the target species and as the reference to evaluate restoration success. Regarding aboveground biomass and total vegetation cover, greatest similarity to the donor site was observed on plots without topsoil removal. In contrast, the highest numbers of target species occurred on plots with topsoil removal, hay transfer and additional sowing. Similarity in species composition between restoration sites and the reference area increased over time, but species composition of restored sites did not fully reflect the reference after 21 years. One reason for the remaining dissimilarity was probably that topsoil removal favored stress tolerant species which were less common on the mature and more fine-grained soils of the nature reserve. Plots without topsoil removal still differed from the reference by their high vegetation cover and a significantly higher proportion of mesophytic grassland species. The study also showed that 19 Red List species were successfully established on the former arable fields, eight of them presumably by sowing. Nevertheless, various other rare species have not been observed yet. Results on functional traits characterizing environmental adaptation and reproduction also underlined the differences between restoration plots and the reference site. Our study presents a ʽdynamic restoration approachʼ where managers evaluated the original factorial treatments after a decade and modified them by additional treatments where development was sub-optimal. Such additional treatments may have confounded the experimental design, but from a management perspective proved to be a promising option to establish species rich grassland of high conservation value with a reasonable expenditure of time.
15 δ N signals in plant and soil material integrate over a number of biogeochemical processes
related to nitrogen (N) and therefore provide information on net effects of multiple
processes on N dynamics. In general little is known in many grassland restoration projects
on soil–plant N dynamics in relation to the restoration treatments. In particular, 15 δ N signals
may be a useful tool to assess whether abiotic restoration treatments have produced the
desired result. In this study we used the range of abiotic and biotic conditions provided
by a restoration experiment to assess to whether the restoration treatments and/or plant
functional identity and legume neighborhood affected plant 15 δ N signals. The restoration
treatments consisted of hay transfer and topsoil removal, thus representing increasing
restoration effort, from no restoration measures, through biotic manipulation to major
abiotic manipulation. We measured 15 δ N and %N in six different plant species (two nonlegumes and four legumes) across the restoration treatments. We found that restoration
treatments were clearly reflected in 15 δ N of the non-legume species, with very depleted
15 δ N associated with low soil N, and our results suggest this may be linked to uptake of
ammonium (rather than nitrate). The two non-legume species differed considerably in their
15 δ N signals, which may be related to the two species forming different kinds of mycorrhizal
symbioses. Plant 15 δ N signals could clearly separate legumes from non-legumes, but our
results did not allow for an assessment of legume neighborhood effects on non-legume
15 δ N signals. We discuss our results in the light of what the 15 δ N signals may be telling
us about plant–soil N dynamics and their potential value as an indicator for N dynamics in
restoration.
The present study aims to compare the effects of maternal and offspring treatment with 25-hydroxycholecalciferol (25-OHD3) and vitamin D3 on vitamin D status, mineral homoeostasis, bone metabolism and locomotion in the offspring. Either vitamin D3 (50 μg/kg diet) or 25-OHD3 (50 μg/kg diet) was supplemented to the gestation and lactation diets of 49 multiparous sows and/or to the diets of their growing offspring. Treatment of the sows did not affect plasma concentrations of 25-OHD3 of the offspring. Pigs fed 25-OHD3 had higher plasma concentrations of 25-OHD3 than pigs that received vitamin D3 during rearing and fattening. However, neither plasma concentrations of calcium, phosphate and bone markers during the observation period nor bone ash and bone mineral density at slaughter were clearly affected by the treatment. Maternal and offspring treatment with 25-OHD3 instead of vitamin D3 resulted in a slight reduction in the prevalence of leg swelling. In addition, more pigs walked with even steps and normal stride length. Further studies are needed to test whether the slight effects observed in the present experiment are reproducible and of relevance for animal health and welfare. In that case, the underlying mechanisms should be revealed in order to take advantage of potentially beneficial influences especially under certain feeding regimes.
Farmland bird populations are in a deep crisis across Europe. Agri-environment schemes (AES) were implemented by the European Union to stop and reverse the general decline of biodiversity in agricultural landscapes. In Germany, flower strips are one of the most common AES. Establishing high-quality perennial wildflower strips (WFS) with species-rich native forb mixtures from regional seed propagation is a recent approach, for which the effectiveness for birds has not yet been sufficiently studied. We surveyed breeding birds and vegetation on 40 arable fields with WFS (20 with single and 20 with aggregated WFS) and 20 arable fields lacking WFS as controls across Saxony-Anhalt (Germany). Additionally, vegetation composition, WFS quantity and landscape structure (e.g. distance to nearest woody element) were considered in our analyses. All WFS were established with species-rich native seed mixtures (30 forbs) in agricultural practice as AES. Arable fields with WFS had a higher species richness and territory density of birds than controls, confirming the effectiveness of this AES. A forb-rich vegetation was the main driver promoting birds. Flower strip quantity at the landscape level had positive effects only on bird densities, but also single WFS achieved benefits. A short distance from WFS to woody elements increased total bird species richness. However, the density of farmland birds, which are target species of these AES, were negatively affected by the proximity and proportion of woody elements in the vicinity. The effect of the proportion of non-intensively used open habitats and overall habitat richness was unexpectedly low in the otherwise intensively farmed landscape. Species-rich perennial WFS significantly promoted breeding birds. Successful establishment of WFS, resulting in high-quality habitats, a high flower strip quantity as well as implementation in open landscapes were shown to maximise the effectiveness for restoring declining and AES target farmland birds.
Introduction
Observations show that foam rolling improves joint movements. Likewise, it can be stated that a vibration stimulation of the tissue leads to improved joint mobility.
Method
This study investigates whether the combination of foam rolling and vibrations (31 Hz) can influence the sliding of the thoracolumbar fascia more effectively than normal foam rolling. 45 subjects participated in the study and were divided into a foam roll with additional vibration group (FRV), a foam roll group (FR) and a control group (CG). The intervention groups rolled out the gluteal muscles, the lateral trunk and the upper and lower back. Mobility measures were taken pre and post the respective intervention. Subsequent cross correlation software analysis quantified the sliding of the fascia and calculated its shear strain mobility (SSM).
Results
The sliding of the thoracolumbar fascia improved significantly within the FRV by 2.83 mm (SD ± 1.08/p < .001), in the FR by 0.96 mm (SD ± 0.43/p < .001) and in the CG decreased the sliding by 0.1401 mm (SD ± 0.28/p = .076). The fascia/fascia SSM increased in the FRV by 22.61% (SD ± 15.64/p < .001), in the FR by 11.41% (SD ± 20.38/p = .056) and in the CG decreased the SSM by 0.9473% (SD ± 11.35/p < .751). The lumbar movement increased in both intervention groups, but showed no significant result.
Conclusion
The use of a foam roll with additional vibration and standard intervention have increased thoracolumbar fascia sliding and lumbar movements. The improved shear strain mobility can be attributed to the multi-activity of mechanoreceptors, such as Pacini- and Ruffini-Bodies.
In recent years, the issue of land consumption or land use has become increasingly important in many areas of our society. Logistics processes in particular take up a lot of space and have a significant impact on the environment. The question is how this use of land can be optimised. Based on a systematic literature review and interviews with experts in the period between May 2021 and July 2021, this paper presents indicators that constitute or influence space-efficient logistics in the context of cooperation. The results show that in addition to the established cooperation characteristics, there are other indicators that are directly related to land use. In the logistics sector, there is strong competitive pressure and, as a result, little trust between companies. It has been shown that with the help of a neutral moderator, the gap between trusting, land-efficient cooperation and one’s own entrepreneurial interests can be narrowed, and cooperation can be profitable for all participants. In addition, digitisation actually does not seem to be sufficient to meet the information needs of a cooperation. The exchange of information not only serves to automate processes, but also makes cooperation more transparent. It shows that legal and municipal requirements need to be developed. It also becomes clear that the indicators have a mutual influence on each other and cannot be considered in isolation when it comes to the actual implementation of a cooperation. By increasing the efficiency of cooperative processes and value creation, it offers the opportunity to make land use more sustainable.
Objectives: This study aimed at the construction of what the core of eHealth policy making is, offering new perspectives about high priority procedures along the policy making process
Methods: Following Grounded Theory methodology, 59 qualitative telephone interviews with a broad variety of stakeholders from Austria, Switzerland and Germany were conducted
Results: The findings hinted at five priorities of eHealth policy making: strategy, consensus-building, decision-making, implementation and evaluation that emerged from the stakeholders’ perception of the eHealth policy. Hereby strategy, consensus-building and implementation gained the highest attention
Conclusions: These findings suggest three high priorities in eHealth policy: 1) developing and pursuing a consistent eHealth strategy, 2) investing time and resources into consensus-building to clear up difficulties early on in the process, 3) governing implementation towards serving patient care through systems fit for practice.
Public Interest Summary: Digitalisation is playing an increasingly crucial role in providing high quality health care. However, different countries have pursued different political paths. In this study, we wanted to know how the stakeholders perceived the political process in their country to identify strengths and weaknesses. We, therefore, conducted interviews about digital health policy with experts from Austria, Switzerland and Germany covering the full spectrum of stakeholders. The findings suggest three political musts: 1) a convincing and coherent strategy followed throughout the entire process, 2) consensus- building among the stakeholders, 3) using “fit for practice” as the yardstick to measure political success.
We investigated whether design experts or laypersons evaluate webpages differently. Twenty participants, 10 experts and 10 laypersons, judged the aesthetic value of a webpage in an EEG-experiment. Screenshots of 150 webpages, judged as aesthetic or as unaesthetic by another 136 participants, served as stimulus material. Behaviorally, experts and laypersons evaluated unaesthetic webpages similarly, but they differed in their evaluation of aesthetic ones: experts evaluated aesthetic webpages as unaesthetic more often than laypersons did. The ERP-data show main effects of level of expertise and of aesthetic value only. There was no interaction of expertise and aesthetics. In a time-window of 110–130 ms after stimulus onset, aesthetic webpages elicited a more negative EEG-amplitude than unaesthetic webpages. In the same time window, experts had more negative EEG-amplitudes than laypersons. This patterning of results continued until a time window of 600–800 ms in which group and aesthetic differences diminished. An interaction of perceiver characteristics and object properties that several interactionist theories postulate was absent in the EEG-data. Experts seem to process the stimuli in a more thorough manner than laypersons. The early activation differences between aesthetic and unaesthetic webpages is in contrast with some theories of aesthetic processing and has not been reported before.
The development of augmented reality glasses is still ongoing and faces barriers in diffusion and concerns about their impact on users, organizations and society. The study aims to find sufficient solutions for this struggling digital innovation and to provide guidance for the implementation of augmented reality glasses in design-oriented projects. During a 3-year consortium research, acceptance and privacy have been identified as major phenomena that influence the adoption of augmented reality glasses in the logistics domain. To forge ahead digital innovation research, the focus of the presented research lies on the diffusion of this technology with design knowledge for the development of augmented reality glasses-based systems. Evidence and artifacts contribute to the still limited knowledge of system design based on augmented reality glasses from a domain-specific instantiation and an implementation framework.
Companies and R&D institutions increasingly collaborate not only in isolated projects but also in knowledge-based networks. In those networks, participants combine expertise and applied problems to generate both ‘problem-solving knowledge’ and specialized knowledge: during the process of common problem-solving each partner acquires some of the specialized knowledge of the other partners as well as the newly generated problem-solving knowledge. This article examines the basic principles involved and provides a simple mathematical description of the step-by-step accumulation of knowledge through the solving of applied problems in a knowledge-based network. The rate of increase of the total amount of available knowledge in the network is derived and implications for the orientation of R&D institutes and companies are set out.
Entrapment neuropathies such as carpal tunnel syndrome, radiculopathies, or radicular pain are the most common peripheral neuropathies and also the most common cause for neuropathic pain. Despite their high prevalence, they often remain challenging to diagnose and manage in a clinical setting. Summarising the evidence from both preclinical and clinical studies, this review provides an update on the aetiology and pathophysiology of entrapment neuropathies. Potential mechanisms are put in perspective with clinical findings. The contemporary assessment is discussed and diagnostic pitfalls highlighted. The evidence for the noninvasive and surgical management of common entrapment neuropathies is summarised and future areas of research are identified.
Entrapment neuropathies are a heterogenous condition reflecting distinct underlying pathomechanisms. A contemporary assessment aimed at identifying potential mechanisms may help target management for these patients.
Entrapment neuropathies are the most prevalent type of peripheral neuropathy and often a challenge to diagnose and treat. To a large extent, our current knowledge is based on empirical concepts and early (often biomechanical) studies. This Viewpoint will challenge some of the current beliefs with recent advances in both basic and clinical neurosciences.
Background
In mucosal barrier interfaces, flexible responses of gene expression to long-term environmental changes allow adaptation and fine-tuning for the balance of host defense and uncontrolled not-resolving inflammation. Epigenetic modifications of the chromatin confer plasticity to the genetic information and give insight into how tissues use the genetic information to adapt to environmental factors. The oral mucosa is particularly exposed to environmental stressors such as a variable microbiota. Likewise, persistent oral inflammation is the most important intrinsic risk factor for the oral inflammatory disease periodontitis and has strong potential to alter DNA-methylation patterns. The aim of the current study was to identify epigenetic changes of the oral masticatory mucosa in response to long-term inflammation that resulted in periodontitis.
Methods and results
Genome-wide CpG methylation of both inflamed and clinically uninflamed solid gingival tissue biopsies of 60 periodontitis cases was analyzed using the Infinium MethylationEPIC BeadChip. We validated and performed cell-type deconvolution for infiltrated immune cells using the EpiDish algorithm. Effect sizes of DMPs in gingival epithelial and fibroblast cells were estimated and adjusted for confounding factors using our recently developed “intercept-method”. In the current EWAS, we identified various genes that showed significantly different methylation between periodontitis-inflamed and uninflamed oral mucosa in periodontitis patients. The strongest differences were observed for genes with roles in wound healing (ROBO2, PTP4A3), cell adhesion (LPXN) and innate immune response (CCL26, DNAJC1, BPI). Enrichment analyses implied a role of epigenetic changes for vesicle trafficking gene sets.
Conclusions
Our results imply specific adaptations of the oral mucosa to a persistent inflammatory environment that involve wound repair, barrier integrity, and innate immune defense.
Background
In DNA methylation analyses like epigenome-wide association studies, effects in differentially methylated CpG sites are assessed. Two kinds of outcomes can be used for statistical analysis: Beta-values and M-values. M-values follow a normal distribution and help to detect differentially methylated CpG sites. As biological effect measures, differences of M-values are more or less meaningless. Beta-values are of more interest since they can be interpreted directly as differences in percentage of DNA methylation at a given CpG site, but they have poor statistical properties. Different frameworks are proposed for reporting estimands in DNA methylation analysis, relying on Beta-values, M-values, or both.
Results
We present and discuss four possible approaches of achieving estimands in DNA methylation analysis. In addition, we present the usage of M-values or Beta-values in the context of bioinformatical pipelines, which often demand a predefined outcome. We show the dependencies between the differences in M-values to differences in Beta-values in two data simulations: a analysis with and without confounder effect. Without present confounder effects, M-values can be used for the statistical analysis and Beta-values statistics for the reporting. If confounder effects exist, we demonstrate the deviations and correct the effects by the intercept method. Finally, we demonstrate the theoretical problem on two large human genome-wide DNA methylation datasets to verify the results.
Conclusions
The usage of M-values in the analysis of DNA methylation data will produce effect estimates, which cannot be biologically interpreted. The parallel usage of Beta-value statistics ignores possible confounder effects and can therefore not be recommended. Hence, if the differences in Beta-values are the focus of the study, the intercept method is recommendable. Hyper- or hypomethylated CpG sites must then be carefully evaluated. If an exploratory analysis of possible CpG sites is the aim of the study, M-values can be used for inference.
Europe's freshwater biodiversity under climate change: distribution shifts and conservation needs
(2014)
Aim
To assess the future climatic suitability of European catchments for freshwater species and the future utility of the current network of protected areas.
Location
Europe.
Methods
Using recently updated catchment-scale species data and climate projections from multiple climate models, we assessed the climate change threat by the 2050s for 1648 European freshwater plants, fishes, molluscs, odonates, amphibians, crayfish and turtles for two dispersal scenarios and identified hotspots of change at three spatial scales: major river basins, countries and freshwater ecoregions. We considered both common species and the often overlooked rare species. To set our findings within the context of current and future conservation networks, we evaluated the coverage of freshwater biodiversity by Europe's protected area network.
Results
Six per cent of common and 77% of rare species are predicted to lose more than 90% of their current range. Eight fish species and nine mollusc species are predicted to experience 100% range loss under climate change. As the most species-rich group, molluscs are particularly vulnerable due to the high proportion of rare species and their relatively limited ability to disperse. Furthermore, around 50% of molluscs and fish species will have no protected area coverage given their projected distributions.
Main conclusions
We identified the species most at threat due to projected changes in both catchment suitability and representation within the European protected area network. Our findings suggest an urgent need for freshwater management plans to facilitate adaptation to climate change.
1. Flower strips are a fundamental part of agri-environment schemes (AESs) introduced by the European Union to counteract the loss of biodiversity and related ecosystem services in agricultural landscapes. Although vegetation composition of the strips is essential for most fauna groups, comprehensive studies analysing vegetation development and influencing factors are rare.
2. From 2017 to 2019, we investigated the vegetation composition of 40 perennial wildflower strips (WFSs) implemented in 2015 or 2016, and 20 cereal fields without WFS across Saxony-Anhalt, Germany. We analysed environmental factors on plot (cover of grasses, shading, soil fertility) and four landscape-scale levels (habitat diversity, proportion of WFS and open habitats). The provision of nectar and pollen resources was estimated by the newly developed Pollinator Feeding Index (PFI). All strips had been implemented by farmers as AES with species- rich seed mixtures comprising 30 native forbs.
3. In all study years, forb species richness, cover and related nectar and pollen supply were much higher on WFSs than on controls, confirming the effectiveness of this AES. Although sown native forbs contributed the most to the high PFI values, spontaneously established forbs expanded the total range of species considerably, especially in winter and spring. While sown forb communities remained similar over time, spontaneous forbs showed a higher species turnover. Altogether, shading and grass cover had the greatest negative effect on the performance of the sown forbs. Landscape variables had only minor effects and were inconsistent in their importance across scale levels and years.
4. Synthesis and applications. Successfully established perennial wildflower strips (WFSs) sown with species-rich native seed mixtures provided a forb-rich and diverse vegetation throughout the AES funding period of 5 years. By supplying feeding resources for pollinators under various landscape situations, WFSs have significant potential to promote farmland biodiversity and related ecosyste services. We recommend the mandatory use of species-rich wildflower mixtures for perennial flower strips and to avoid their creation in heavily shaded field edges. Advisory services for farmers are necessary to prevent failures in WFS implementation and management and to improve their ecological effectiveness.
Easy and inexpensive methods for measuring ammonia emissions in multi-plot field trials allow the comparison of several treatments with liquid manure application. One approach that might be suitable under these conditions is the dynamic tube method (DTM). Applying the DTM, a mobile chamber system is placed on the soil surface, and the air volume within is exchanged at a constant rate for approx. 90 s. with an automated pump. This procedure is assumed to achieve an equilibrium ammonia concentration within the system. Subsequently, a measurement is performed using an ammonia-sensitive detector tube. Ammonia fluxes are calculated based on an empirical model that also takes into account the background ammonia concentration measured on unfertilized control plots. Between measurements on different plots, the chamber system is flushed with ambient air and cleaned with paper towels to minimize contamination with ammonia. The aim of this study was to determine important prerequisites and boundary conditions for the application of the DTM.
We conducted a laboratory experiment to test if the ammonia concentration remains stable while performing a measurement. Furthermore, we investigated the cleaning procedure and the effect of potential ammonia carryover on cumulated emissions under field conditions following liquid manure application. The laboratory experiment indicated that the premeasurement phase to ensure a constant ammonia concentration is not sufficient. The concentration only stabilized after performing more than 100 pump strokes, with 20 pump strokes (lasting approximately 90 s) being the recommendation.
However, the duration of performing a measurement can vary substantially, and linear conversion accounts for those differences, so a stable concentration is mandatory. Further experiments showed that the cleaning procedure is not sufficient under field conditions. Thirty minutes after performing measurements on high emitting plots, which resulted in an ammonia concentration of approx.
10 ppm in the chamber, we detected a residual concentration of 2 ppm. This contamination may affect measurements on plots with liquid manure application as well as on untreated control plots. In a field experiment with trailing hose application of liquid manure, we subsequently demonstrated that the calculation of cumulative ammonia emissions can vary by a factor of three, depending on the degree of chamber system contamination when measuring control plots. When the ammoni background values were determined by an uncontaminated chamber system that was used to measure only control plots, cumulative ammonia emissions were approximately 9 kg NH3-N ha1.
However, when ammonia background values were determined using the contaminated chamber system that was also used to measure on plots with liquid manure application, the calculation of cumulative ammonia losses indicated approximately 3 kg NH3-N ha1. Based on these results, it can be concluded that a new empirical DTM calibration is needed for multi-plot field experiments with high-emitting treatments.
The study at hand focuses the interdependencies between stress incidents and strategies of stress-coping in relation with well-being in helping professions. Furthermore, the scarce areas and the proband’s strategies of health behavior, comparing helping and other vocational groups, are investigated. The sample consist of teachers, bank employees, employees of marketing agencies, employees coming from the machine construction industry, as well as nurses, psychotherapists and physicians. The results show that everyday annoyances and problem-oriented stress-coping indeed affect well-being.
Usability is a core construct of website evaluation and inherently defined as interactive. Yet, when analysing first impressions of websites, expected usability, i.e., before use, is of interest. Here we investigate to what extend ratings of expected usability are related to (a) experienced usability, i.e., ratings after use, and (b) objective usability measures, i.e., task performance. Furthermore, we try to elucidate how ratings of expected usability are correlated to aesthetic judgments. In an experiment, 57 participants submitted expected usability ratings after the presentation of website screenshots in three viewing-time conditions (50, 500, and 10,000 ms) and after an interactive task (experienced usability). Additionally, objective usability measures (task completion and duration) and subjective aesthetics evaluations were recorded for each website. The results at both the group and individual level show that expected usability ratings are not significantly related either to experienced usability or objective usability measures. Instead, they are highly correlated with aesthetics ratings. Taken together, our results highlight the need for interaction in empirical website usability testing, even when exploring very early usability impressions. In our study, user ratings of expected usability were no valid proxy neither for objective usability nor for experienced website usability.
Introduction
Socioeconomic deprivation in high‐income industrialized countries is a key factor in poor perinatal outcomes. Limited access, utilization, and quality of antenatal care seem to play an important role in poor perinatal outcomes.
Methods
This integrative review aimed to explore experiences of antenatal care among women who are socioeconomically deprived in high‐income industrialized countries. A search was conducted using 5 databases for articles published from 2004 to 2014. Six qualitative and 3 quantitative articles were selected. These were systematically appraised for quality independently by 3 researchers. Relevant themes were identified and organized into categories.
Results
The disadvantages experienced in antenatal care by women who are socioeconomically deprived start before the first contact with health care services and are notable throughout the entire pregnancy. There is disparity in choice of medical or midwifery service provision models. Six categories emerged during review: choice of service provision model, feeling valued, various types of discrimination, structural and interpersonal accessibility, comprehensibility and trustworthiness of information, and engagement and sense of responsibility. Categories underscored the importance of the woman's relationship with the antenatal care provider.
Discussion
Antenatal care models with women‐centered approaches and continuity of care, such as midwifery models, have potential to increase the satisfaction of women with low socioeconomic status with care; this may increase antenatal care utilization and improve perinatal outcomes.
The deployment of containers as building modules has grown in popularity over the past years due to their inherent strength, modular construction, and relatively low cost. The upcycled container architecture is being accepted since it is more eco-friendly than using the traditional building materials with intensive carbon footprint. Moreover, owing to the unquestionable urgency of climate change, existing climate-adaptive design strategies may no longer respond effectively as they are supposed to work in the previous passive design. Therefore, this paper explores the conceptual design for an upcycled shipping container building, which is designed as a carbon-smart modular living solution to a single family house under three design scenarios, related to cold, temperate, and hot–humid climatic zones, respectively. The extra feature of future climate adaption has been added by assessing the projected future climate data with the ASHRAE Standard 55 and Current Handbook of Fundamentals Comfort Model. Compared with the conventional design, Rome would gradually face more failures in conventional climate-adaptive design measures in the coming 60 years, as the growing trends in both cooling and dehumidification demand. Consequently, the appropriate utilization of internal heat gains are proposed to be the most promising measure, followed by the measure of windows sun shading and passive solar direct gain by using low mass, in the upcoming future in Rome. Future climate projection further shows different results in Berlin and Stockholm, where the special attention is around the occasional overheating risk towards the design goal of future thermal comfort.
Information systems (IS) play a central role in promoting corporate sustainability and pro-environmental behavior. This study explores the use of mobile apps for fostering sustainability-oriented corporate culture. It accentuates issues relating to sustainability-oriented corporate culture (RQ1), app meta-requirements as a strategic approach to addressing these issues (RQ2), as well as design and implementation principles (RQ3). Referring to the literature on sustainability apps, gamification, and nudging, our qualitative research design combines an analysis of four corporate apps intending to promote sustainable behavior and expert interviews (Grounded Theory). The proposed framework supports the planning, realization, and monitoring of this targeted app use. Single cultural dimensions inform seven issues in culture development. Five meta-requirements address this multi-dimensionality, challenges provided by new digital working environments, and principles of Green IT. Four design principles support, extend, and integrate current knowledge on app features, nudging, and gamification. Five variables determine the app intervention and maturity level. We conclude that this targeted app use should intend to foster the sustainability orientation within all dimensions of corporate culture instead of being limited to promoting sustainable behavior.
Background:
Chronic health conditions are on the rise and are putting high economic pressure on health systems, as they require well-coordinated prevention and treatment. Among chronic conditions, chronic wounds such as cardiovascular leg ulcers have a high prevalence. Their treatment is highly interdisciplinary and regularly spans multiple care settings and organizations; this places particularly high demands on interoperable information exchange that can be achieved using international semantic standards, such as Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT).
Objective:
This study aims to investigate the expressiveness of SNOMED CT in the domain of wound care, and thereby its clinical usefulness and the potential need for extensions.
Methods:
A clinically consented and profession-independent wound care item set, the German National Consensus for the Documentation of Leg Wounds (NKDUC), was mapped onto the precoordinated concepts of the international reference terminology SNOMED CT. Before the mapping took place, the NKDUC was transformed into an information model that served to systematically identify relevant items. The mapping process was carried out in accordance with the ISO/TR 12300 formalism. As a result, the reliability, equivalence, and coverage rate were determined for all NKDUC items and sections.
Results:
The developed information model revealed 268 items to be mapped. Conducted by 3 health care professionals, the mapping resulted in moderate reliability (κ=0.512). Regarding the two best equivalence categories (symmetrical equivalence of meaning), the coverage rate of SNOMED CT was 67.2% (180/268) overall and 64.3% (108/168) specifically for wounds. The sections general medical condition (55/66, 83%), wound assessment (18/24, 75%), and wound status (37/57, 65%), showed higher coverage rates compared with the sections therapy (45/73, 62%), wound diagnostics (8/14, 57%), and patient demographics (17/34, 50%).
Conclusions:
The results yielded acceptable reliability values for the mapping procedure. The overall coverage rate shows that two-thirds of the items could be mapped symmetrically, which is a substantial portion of the source item set. Some wound care sections, such as general medical conditions and wound assessment, were covered better than other sections (wound status, diagnostics, and therapy). These deficiencies can be mitigated either by postcoordination or by the inclusion of new concepts in SNOMED CT. This study contributes to pushing interoperability in the domain of wound care, thereby responding to the high demand for information exchange in this field. Overall, this study adds another puzzle piece to the general knowledge about SNOMED CT in terms of its clinical usefulness and its need for further extensions.
Extensive green roofs (EGRs) offer several beneficial ecosystem services for sustainable urban development. However, most standard green roofs have been designed with species-poor plant mixtures containing non-native species. Aiming to increase the nature conservation values of EGRs, we developed and tested a vascular plant seed mixture including regionally occurring native sandy dry grassland species in experimental miniature roofs in Northwestern Germany (temperate oceanic climate) over 4 years. We tested the mixture at two seed densities (1 and 2 g/m2). Additionally, we tested seeding at 1 g/m2 and introducing raked plant material collected from an ancient dry grassland. The total establishment rates of sown species reached 92–96% in the first year, but dropped to 40–60% in the last 2 years, with the highest values for the plots with raked material. Twenty-four additional species (11 vascular, 7 lichen, and 6 moss species, including 7 red-list species) typical of sandy dry grasslands were introduced through the raked material. Vascular plants reached 60–70% cover in the second year. Severe drought periods in the third and the fourth year led to a strong decline of vascular plant cover then. As this cover was higher in the plots with raked material, we assume facilitative effects through the well-developed cryptogam layer containing a mix of pleurocarpous and acrocarpous mosses and lichens. Spontaneously establishing acrocarpous mosses in sown plots did not seem to provide this same function. We conclude that EGRs designed with regionally occurring sandy dry grassland plant species and especially the application of raked plant material from ancient grassland is a fruitful approach to increase the value of green roofs for native phytodiversity.
Iodine biofortification of butterhead lettuce (Lactuca sativa)viafoliar sprays was investigated infield trials, focusing on assessing the influence of the time and application method. The iodine (I)concentrations in the edible plant parts increased when potassium iodide (KI) and potassiumiodate (KIO3) solutions were sprayed at doses up to 0.25 kg I ha–1on different dates close to har-vest. Crop yield and marketable quality were not significantly affected by I treatments. A greaterefficacy of KI was frequently observed and probably related to its lower point of deliquescenceand smaller anion size in comparison with KIO3. KI sprays on butterhead lettuce at different timesof the day resulted in a higher I enrichment when applied at 11:00 and 15:00 h. The diurnal varia-tion in I uptake may reflect the impact of fluctuating climatic conditions at the time of application.Iodine treatments at different application dates near harvest led to an increasing I concentrationin the vegetable produce that could be related to the rising shoot fresh mass and leaf area.When KI and KIO3were sprayed simultaneously with commercial calcium fertilizers, fungicidesor insecticides, I accumulation in butterhead lettuce was not negatively affected or in some caseseven significantly enhanced. The results show that foliar sprays of KI and KIO3are an effectivemethod to biofortify butterhead lettuce with I and this approach may easily be implemented as aroutine method in commercial cultivation.
Fairness and Team Efficiency
(2013)
This study applies to the perception of fairness during teamwork. Students were assigned to work groups by lot and were instructed to prepare a course presentation. Groups were given no guidelines relating to allocation of tasks, but each group was graded as a whole. Since a real grade was given in a non-simulated experiment, it was possible to determine team efficiency, work satisfaction, and perception of fairness via a subsequent study. Results show a strong influence of fairness on team efficiency.
Aim: The aim of this study was to give an overview of family caregiver satisfaction within the home palliative care situation in North Rhine-Westphalia, Germany.
Design: A cross-sectional study.
Methods: An anonymous questionnaire, with seven validated scales, and comprising of 71 items, was used. The items investigated perceived needs and burdens of families within a home-based palliative care situation.
The satisfaction of the family caregivers with the services delivered by palliative care teams was measured by the FAMCARE-2 Scale. Descriptive statistics and analysis of covariance (ANCOVA) were performed.
Results: A convenience sample of 106 family members agreed to participate in the study. Overall, we found high satisfaction within our sample. There was high satisfaction with how the services respected the dignity of families, and how they provided comfort to patients. Satisfaction was lower with regard to information about patients.
Conclusion: High or low satisfaction with palliative care, tells us little about the quality of services. The high satisfaction within this study could be interpreted as a sign that palliative care was important to families at the time of availability. Regular and continuous assessment can serve to inform the continuous quality of care provision for patients and their families.
Background and aims
In 2008, the International Association for the Study of Pain Special Interest Group on Neuropathic Pain (NeuPSIG) proposed a clinical grading system to help identify patients with neuropathic pain (NeP). We previously applied this classification system, along with two NeP screening tools, the painDETECT (PD-Q) and Leeds Assessment of Neuropathic Symptoms and Signs pain scale (LANSS), to identify NeP in patients with neck/upper limb pain. Both screening tools failed to identify a large proportion of patients with clinically classified NeP, however a limitation of our study was the use of a single clinician performing the NeP classification. In 2016, the NeuPSIG grading system was updated with the aim of improving its clinical utility. We were interested in field testing of the revised grading system, in particular in the application of the grading system and the agreement of interpretation of clinical findings. The primary aim of the current study was to explore the application of the NeuPSIG revised grading system based on patient records and to establish the inter-rater agreement of detecting NeP. A secondary aim was to investigate the level of agreement in detecting NeP between the revised NeuPSIG grading system and the LANSS and PD-Q.
Methods
In this retrospective study, two expert clinicians (Specialist Pain Medicine Physician and Advanced Scope Physiotherapist) independently reviewed 152 patient case notes and classified them according to the revised grading system. The consensus of the expert clinicians’ clinical classification was used as “gold standard” to determine the diagnostic accuracy of the two NeP screening tools.
Results
The two clinicians agreed in classifying 117 out of 152 patients (ICC 0.794, 95% CI 0.716–850; κ 0.62, 95% CI 0.50–0.73), yielding a 77% agreement. Compared to the clinicians’ consensus, both LANSS and PD-Q demonstrated limited diagnostic accuracy in detecting NeP (LANSS sensitivity 24%, specificity 97%; PD-Q sensitivity 53%, specificity 67%).
Conclusions
The application of the revised NeP grading system was feasible in our retrospective analysis of patients with neck/upper limb pain. High inter-rater percentage agreement was demonstrated. The hierarchical order of classification may lead to false negative classification. We propose that in the absence of sensory changes or diagnostic tests in patients with neck/upper limb pain, classification of NeP may be further improved using a cluster of clinical findings that confirm a relevant nerve lesion/disease, such as reflex and motor changes. The diagnostic accuracy of LANSS and PD-Q in identifying NeP in patients with neck/upper limb pain remains limited. Clinical judgment remains crucial to diagnosing NeP in the clinical practice.
Implications
Our observations suggest that in view of the heterogeneity in patients with neck/upper limb pain, a considerable amount of expertise is required to interpret the revised grading system. While the application was feasible in our clinical setting, it is unclear if this will be feasible to apply in primary health care settings where early recognition and timely intervention is often most needed. The use of LANSS and PD-Q in the identification of NeP in patients with neck/upper limb pain remains questionable.
Duckweed is a promising resource for future feed and food production as well as wastewater treatment. However, diseases and pests can critically limit the performance of the production systems. Patches of discolored and bleached duckweed (Lemna minor L.) appeared in hydroponic systems and spread rapidly through the crop. Pythium myriotylum was confirmed as the causing pathogen by microbiological and molecular biological analysis. This is the first report of P. myriotylum on duckweed in Germany. The result and possible countermeasures are discussed.
Semi-solid metal alloys, as used in industrial thixoforming, have a special microstructure of globular grains suspended in a liquid metal matrix. The complex rheological properties are strongly influenced by the local solid fraction, particle shape, particle size and state of agglomeration. It was analysed how the microstructure develops in dependence of the shear rate and cooling rate during the solidification and it was observed that the average particle size increased with increasing shear rate and decreasing cooling rate. In order to account for those phenomena, the rate of crystal growth and the relationship between average particle diameter and viscosity was modelled by applying the Sherwood two-film model for the mass transport. The dependence of the viscosity from the particle size were modelled with a modified Krieger–Dougherty model. Based on the rheological and microstructural observations an evaluation method was elaborated that allows for the construction of objective master curves that are independent of the particle growth during the experimentation. The isothermal experiments for the characterisation of the rheological behaviour consisted of step-change of shear-rate and yield-stress experiments. From the experimental data the steady-state flow curves could be determined as well as the time-dependent relaxation of the shear stress after a change of shear rate. The steady-state rheological behaviour was found to be shear thinning. Nevertheless, immediately after a shear-rate change an overshoot was observed that resulted from a short-time shear-thickening behaviour. The yield stress was found to strongly depend on the microstructure and the degree of agglomeration of the solid phase. With increasing rest time the yield stress was increasing strongly, because of the agglomeration of the solid particles. Based on the step-change of shear-rate experiments a single-phase flow has been developed that consists of a modified Herschel–Bulkley approach and accounts for the thixotropic as well as for the yield-stress behaviour of the alloys.
Ohmic heating (OH) is an alternative sustainable heating technology that has demonstrated its potential to modify protein structures and aggregates. Furthermore, certain protein aggregates, namely amyloid fibrils (AF), are associated with an enhanced protein functionality, such as gelation. This study evaluates how Ohmic heating (OH) influences the formation of AF structures from ovalbumin source under two electric field strength levels, 8.5 to 10.5 and 24.0–31.0 V/cm, respectively. Hence, AF aggregate formation was assessed over holding times ranging from 30 to 1200 sunder various environmental conditions (3.45 and 67.95 mM NaCl, 80, 85 and 90 °C, pH = 7). AF were formed under all conditions. SDS-PAGE revealed that OH had a higher tendency to preserve native ovalbumin molecules. Furthermore, Congo Red and Thioflavin T stainings indicated that OH reduces the amount of AF structures. This finding was supported by FTIR measurements, which showed OH samples to contain lower amounts of beta-sheets. Field flow fractioning revealed smaller-sized aggregates or aggregate clusters occurred after OH treatment. In contrast, prolonged holding time or higher treatment temperatures increased ThT fluorescence, beta-sheet structures and aggregate as well as cluster sizes. Ionic strength was found to dominate the effects of electric field strength under different environmental conditions.
A recently published study of high temperature nitridation of iron chromium aluminum alloys (FeCrAl) at 900°C in N2–H2 has redundantly shown the formation of locally confined corrosion pockets reaching several microns into the alloy. These nitrided pockets form underneath chromia islands laterally surrounded by the otherwise protective alumina scale. Chromia renders a nitrogen‐permeable defect under the given conditions and the presence of aluminum in the alloy. In light of these findings on FeCrAl, a focused ion beam–scanning electron microscope tomography study has been undertaken on an equally nitrided FeNiCrAl sample to characterize its nitridation corrosion features chemically and morphologically. The alloy is strengthened by a high number of chromium carbide precipitates, which are also preferential chromia formation sites. Besides the confirmation of the complete encapsulation of the corrosion pocket from the alloy by a closed and dense aluminum nitride rim, very large voids have been found in the said pockets. Furthermore, metallic particles comprising nickel and iron are deposited on top of the outer oxide scale above such void regions.
The distribution of a species along a thermal gradient is commonly approximated by a unimodal response curve, with a characteristic single optimum near the tempera‐ture where a species is most likely to be found, and a decreasing probability of occur‐rence away from the optimum. We aimed at identifying thermal response curves (TRCs) of European freshwater species and evaluating the potential impact of climate warming across species, taxonomic groups, and latitude. We first applied generalized additive models using catchment‐scale global data on distribution ranges of 577 freshwater species native to Europe and four different temperature variables (the current annual mean air/water temperature and the maximum air/water temperature of the warmest month) to describe species TRCs. We then classified TRCs into one of eight curve types and identified spatial patterns in thermal responses. Finally, we in‐tegrated empirical TRCs and the projected geographic distribution of climate warm‐ing to evaluate the effect of rising temperatures on species’ distributions. For the different temperature variables, 390–463 of 577 species (67.6%–80.2%) were char‐acterized by a unimodal TRC. The number of species with a unimodal TRC decreased from central toward northern and southern Europe. Warming tolerance (WT = maxi‐mum temperature of occurrence—preferred temperature) was higher at higher lati‐tudes. Preferred temperature of many species is already exceeded. Rising temperatures will affect most Mediterranean species. We demonstrated that fresh‐water species’ occurrence probabilities are most frequently unimodal. The impact of the global climate warming on species distributions is species and latitude depend‐ent. Among the studied taxonomic groups, rising temperatures will be most detri‐mental to fish. Our findings support the efforts of catchment‐based freshwater management and conservation in the face of global warming.
Gender disparities in German home-care arrangements
An ageing population correlates with rising needs for
long-term care (LTC). Support programmes should con-
sider the specific needs of the various subgroups of care
dependents and family caregivers. The objective of this
study was to analyse the gender-specific disparities in
home-care arrangements in Germany, and for this pur-
pose, survey and insurance claims data were used. A sur-
vey of 2545 insured care recipients with high-level care
needs was conducted in 2012 with the Barmer GEK, a
major German statutory healthcare insurance. Insurance
claims data were provided for a follow-up, focussing on
the group aged 60 years and older. For statistical compar-
ison, chi-squared test and t-tests were used, and a p-
value < 0.05 was considered statistically significant. Most
care recipients are female, and they are on average
2 years older than males. Men receive family care mostly
from their wives, whereas widows frequently live alone
and receive care from daughters, sons, other relatives,
neighbours and friends, as well as from professional
nursing services. Furthermore, women more often antici-
pate the need for (further) professional assistance and
move in with a relative or to an assisted living facility or
a nursing home in good time. The desired rate for reloca-
tion to a nursing home was higher than the anticipated,
and during the 6-month follow-up, the actual rate of
relocations was in between both. In summary, the caring
situation of men and women is different. Care-receiving
men are most often cared for by their wives. Widowed
women need a social network and their children in order
to remain in their own home. To provide better home-
care arrangements for women in this situation, the fam-
ily and social networks need a stronger focus in politics
and research. To stabilise the home-care situation of men
with high-level care needs, their wives need more
support.
The present study investigates consumers’ acceptance of Se-biofortified apples, as well as Se health and nutrition claims that have been approved by the European Commission. Despite indications that such statements are more likely to be accepted if the carrier product itself has a healthy image, unprocessed fruits biofortified with Se have not been investigated in this context yet. Apples as the most frequently-consumed type of fresh fruit in Germany may offer the potential to improve the Se status of consumers when the produce is enriched with Se. Therefore, an online survey of 356 German adults was conducted to analyze different aspects that could affect the perception of and preference for the proposed product concept by consumers. The findings indicate a moderate acceptance of Se-biofortified apples, as well as of Se health and nutrition claims among the participants. Additional information about beneficial health effects of Se had a significant impact on consumer acceptance. People who regularly eat convenience food and prefer to buy apples at supermarkets were particularly attracted by the product idea. In conclusion, the results of the study indicate good prospects for a successful introduction of Se-rich apples in the German food market, if the produce is advertised with approved health and nutrition claims.
After hesitating until the mid-2010s, German industry has now embraced the energy transition and moved to a driver. The pioneers of change are the major energy companies, followed large parts of industry which have initiated radical changes. Even the energy-intensive industries steel and chemistry are phasing out fossil fuels.
The demand for evidence-based health informatics and benchmarking of 'good' information systems in health care gives an opportunity to continue reporting on recent papers in the German journal GMS Medical Informatics, Biometry and Epidemiology (MIBE) here. The publications in focus deal with a comparison of benchmarking initiatives in German-speaking countries, use of communication standards in telemonitoring scenarios, the estimation of national cancer incidence rates and modifications of parametric tests. Furthermore papers in this issue of MIM are introduced which originally have been presented at the Annual Conference of the German Society of Medical Informatics, Biometry and Epidemiology. They deal as well with evidence and evaluation of 'good' information systems but also with data harmonization, surveillance in obstetrics, adaptive designs and parametrical testing in statistical analysis, patient registries and signal processing.
While developing traffic-based cognitive enhancement technology (CET), such as bike accident prevention systems, it can be challenging to test and evaluate them properly. After all, the real-world scenario could endanger the subjects’ health and safety. Therefore, a simulator is needed, preferably one that is realistic yet low cost. This paper introduces a way to use the video game Grand Theft Auto V (GTA V) and its sophisticated traffic system as a base to create such a simulator, allowing for the safe and realistic testing of dangerous traffic situations involving cyclists, cars, and trucks. The open world of GTA V, which can be explored on foot and via various vehicles, serves as an immersive stand-in for the real world. Custom modification scripts of the game give the researchers control over the experiment scenario and the output data to be evaluated. An off-the-shelf bicycle equipped with three sensors serves as a realistic input device for the subject’s movement direction and speed. The simulator was used to test two early-stage CET concepts enabling cyclists to sense dangerous traffic situations, such as trucks approaching from behind the cyclist. Thus, this paper also presents the user evaluation of the cycling simulator and the CET used by the subjects to sense dangerous traffic situations. With the knowledge of the first iteration of the user-centered design (UCD) process, this paper concludes by naming improvements for the cycling simulator and discussing further research directions for CET that enable users to sense dangerous situations better.
Positive factors are increasingly recognized in the field of psychology, however, few studies have investigated the longitudinal measurement invariance (LMI) and reciprocal associations of positive core constructs, such as happiness, life satisfaction and positive mental health. This study evaluated the LMI of these constructs over four years in a Chinese Student Sample (n = 4400) using the Subjective Happiness Scale (SHS), the Satisfaction with Life Scale (SWLS) and the Positive Mental Health Scale (PMH-scale). The longitudinal reciprocal associations of the constructs were examined within a random intercept cross-lagged panel model (RI-CLPM). The results show that the SHS, SWLS and PMH-scale are measurement invariant over time and that the constructs are positively inter-related, but show different reciprocal patterns over time.
Health-related quality of life (HRQOL) in parents of children suffering from renal disease is often diminished by the illness burden experienced in daily life and by unfavorable ways of coping. Our aim was to examine the relationship between psychosocial strains perceived by parents, their ways of coping, and HRQOL. In an anonymous cross-sectional study, parents completed a questionnaire concerning psychosocial strains, coping strategies, and HRQOL, as well as sociodemographic and illness parameters. Study participants were recruited in two outpatient dialysis centers. Participating in the study were 195 parents (105 mothers, 90 fathers; age 43 ± 8 years; representing 108 families) of children suffering from renal disease (age 12 ± 5 years). Parents of children with chronic renal failure reported moderate HRQOL with parents of children undergoing dialysis experiencing more limitations in quality of life than parents of children living with a kidney graft and parents of children undergoing conservative treatment. Mothers experienced lower HRQOL and higher psychosocial strains than fathers. HRQOL was predicted by the coping strategies “focusing on child” (β = –0.25), “improving marital relationship” (β = 0.24), “seeking social support” (β = –0.22) and “self-acceptation and growth” (β =0 .19) as well as parents′ perceived limitation by illness in daily life (β = –0.15; explained variance 57%). In the comprehensive care for families with a child suffering from a renal disease, screening for psychosocial strains and ways of coping, along with applying interventions to strengthen adaptive coping strategies, may be a preventative means of improving parents′ quality of life.
Quantitative Umweltbewertungen sind von entscheidender Bedeutung, wenn es darum geht, effektiv auf nachhaltige Produktions- und Verbrauchsmuster hinzuarbeiten. In den letzten Jahrzehnten haben sich Lebenszyklusanalysen (LCA) als praktikables Mittel zur Messung der Umweltauswirkungen von Produkten entlang der Lieferkette etabliert. In Bezug auf Nutzer- und Konsummuster wurden jedoch methodische Schwächen festgestellt, und es wurden mehrere Versuche unternommen, Ökobilanzen entsprechend zu verbessern, beispielsweise durch Einbeziehung von Effekten höherer Ordnung und verhaltenswissenschaftlicher Unterstützung. In einer Diskussion solcher Ansätze zeigen wir, dass den Konzepten des Verbrauchs keine explizite Aufmerksamkeit geschenkt wurde, was häufig zu produktzentrierten Bewertungen führt. Wir führen Theorien sozialer Praktiken ein, um Konsummuster für LCA zugänglich zu machen. Soziale Praktiken sind routinierte Handlungen, die aus miteinander verbundenen Elementen (Materialien, Kompetenzen und Bedeutungen) bestehen, die sie als eine Einheit denkbar machen (z. B. Kochen). Da die meisten sozialen Praktiken eine Art von Verbrauch (Material, Energie, Luft) beinhalten, konnten wir einen Rahmen entwickeln, der soziale Praktiken mit der Ökobilanz verbindet. Der vorgeschlagene Rahmen bietet eine neue Perspektive für quantitative Umweltbewertungen, indem er den Schwerpunkt von Produkten oder Nutzern auf soziale Praktiken verlagert. Dementsprechend sehen wir die Chance darin, die reduktionistische Sichtweise zu überwinden, dass Menschen nur Nutzer von Produkten sind, und sie stattdessen als Praktiker in sozialen Praktiken zu sehen. Dieser Wandel könnte neue Methoden der interdisziplinären Konsumforschung ermöglichen, die beabsichtigte Sozialwissenschaften und wirkungsorientierte Bewertungen einbeziehen. Allerdings bedarf der Rahmen einer weiteren Überarbeitung und vor allem einer empirischen Validierung.
Background:
Cardiac surgery patients represent a high-risk cohort in intensive care units (ICUs). Central venous pressure (CVP) measurement seems to remain an integral part in hemodynamic monitoring, especially in cardio-surgical ICUs. However, its value as a prognostic marker for organ failure is still unclear. Therefore, we analyzed postoperative CVP values after adult cardiac surgery in a large cohort with regard to its prognostic value for morbidity and mortality.
Methods:
All adult patients admitted to our ICUs between 2006 and 2019 after cardiac surgery were eligible for inclusion in the study (n = 11,198). We calculated the median initial CVP (miCVP) after admission to the ICU, which returned valid values for 9802 patients. An ROC curve analysis for optimal cut-off miCVP to predict ICU mortality was conducted with consecutive patient allocation into a (a) low miCVP (LCVP) group (≤11 mmHg) and (b) high miCVP (HCVP) group (>11 mmHg). We analyzed the impact of high miCVP on morbidity and mortality by propensity score matching (PSM) and logistic regression.
Results:
ICU mortality was increased in HCVP patients. In addition, patients in the HCVP group required longer mechanical ventilation, had a higher incidence of acute kidney injury, were more frequently treated with renal replacement therapy, and showed a higher risk for postoperative liver dysfunction, parametrized by a postoperative rise of ≥ 10 in MELD Score. Multiple regression analysis confirmed HCVP has an effect on postoperative ICU-mortality and intrahospital mortality, which seems to be independent.
Conclusions:
A high initial CVP in the early postoperative ICU course after cardiac surgery is associated with worse patient outcome. Whether or not CVP, as a readily and constantly available hemodynamic parameter, should promote clinical efforts regarding diagnostics and/or treatment, warrants further investigations.
Household income determines access to specialized pediatric chronic pain treatment in Germany
(2016)
Background
Families with lower socioeconomic status (SES) often face problems with gaining access to health care services. Information is scarce on the relationship between SES and health care delivery for children suffering from chronic pain.
Methods
Families presenting to a specialized pain center (N = 1,001) provided information on ‘household income, ‘parental education’ and ‘occupation’ to aid the evaluation of their SES. To assess whether the SES of the clinical sample is representative of the general population, it was compared to data from a community sample (N = 14,558). For the clinical sample, travel distance to the clinic was described in relation to the 75 % catchment area. Multiple logistic regression was used to analyze the association between SES and the journey from outside the catchment area.
Results
The SES was significantly higher in the clinical sample than in the community sample. Within the clinical sample, the distance traveled to the pain center increased with increasing SES. The 75 % catchment area was 143 miles for families with the highest SES and 78 miles for the lowest SES. ‘Household income’ predicted travel distance (OR 1.32 (1.12–1.56)). Education and occupational status were not significant predictors of travel from outside the catchment area.
Conclusions
In Germany, specialized care for children with chronic pain is subject to disparities in access. Future activities should focus on identifying barriers to access and seeking to prevent inequalities in specialized pediatric health care delivery. Increasing the number of specialized treatment facilities could improve access to specialized pediatric pain treatment, regardless of socioeconomic determinants.
In the race against climate change, small and medium-sized enterprises (SMEs) play a fundamental role. To clarify the contribution of corporate culture to SMEs' emission reduction, three perspectives can be useful: corporate culture as driver and barrier, current and planned corporate culture development actions, and the corporate culture profile as an outcome. As the first application of the extended Belief-Action-Outcome framework, this single case study exemplifies the role of corporate culture in an SME from the steel construction and manufacturing sector in Germany. The investigated SME has achieved emission reduction while increasing its revenue and is an early adopter of sustainable and digital development. The rich insights from an employee survey, semi-structured interviews, observation, and document analysis allowed us to outline an informed approach toward corporate culture development that emphasizes vision development of the desired corporate culture and the role of information systems for promoting emission reduction.
Using eye-tracking, this study investigates fixation duration of students viewing pictures of pigs, which systematically vary in the facial expression of the pig and in the barn setting. The aim of this study is to analyze which picture elements are viewed and for how long, as well as how fixation times vary with a change of the expression of the pig and the barn type. The results show clear effects of picture composition: pig expression and pen type affect fixation durations of different areas of interest with the influence of the pig being considerably larger. Face regions are viewed longer in the “happy” pig, while floor/bedding and the eyes are viewed longer in pictures showing the “unhappy” pig which might be a hint for infor-mation search. The power of facial expressions, also for the depiction of farm animals, is a new finding of this paper, which might be of importance when select-ing agricultural pictures for different purposes.
Dieser Artikel befasst sich mit dem bundesweiten Niveau der Treibhausgas (THG)-Emissionen und des Ressourcenverbrauchs in der deutschen Gemeinschaftsverpflegung im Segment "Business" und deren Einsparpotenziale durch verschiedene Szenarien der ungestützten und gestützten Rezeptüberarbeitung. Unter "ungestützt" verstehen wir in dieser Arbeit die intuitive Optimierung von Rezepten durch die Mitarbeiter von Betrieben der Gemeinschaftsverpflegung. Die "unterstützten" Ansätze mussten dagegen bestimmte Zielvorgaben erfüllen, zum Beispiel der Deutschen Gesellschaft für Ernährung; engl. Deutschen Gesellschaft für Ernährung oder das nachhaltige Niveau. Konkret Konkret wird getestet, wie sich (A) eine ungestützte Rezeptüberarbeitung, (B) eine Rezeptüberarbeitung auf Basis von Ernährungsempfehlungen und (C) eine Rezeptüberarbeitung mit wissenschaftlicher Begleitung die Umweltauswirkungen eines Gerichtes beeinflussen. Als methodischer Rahmen diente eine Online-Befragung von Unternehmen der Gemeinschaftsverpflegung sowie eine Szenarioanalyse auf Menüebene und auf nationaler Ebene durchgeführt. Die Ergebnisse basieren zum einen auf empirischen Daten und zum anderen auf Hochrechnungen. Die Ergebnisse zeigen, dass die die bundesweite Umsetzung der Rezepturüberarbeitung nach wissenschaftlichen Vorgaben - wie konkrete Zielvorgaben für die THG Emissionen pro Portion - bis zu 44% des Ressourcenverbrauchs in der deutschen Betriebsgastronomie einsparen kann (das entspricht 3,4 Millionen Tonnen Ressourcen pro Jahr) und bis zu 40 % der THG-Emissionen (0,6 Millionen Tonnen THG-Emissionen pro Jahr) einsparen.