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During recent decades, many studies have shown that the successful restoration of species-rich grasslands is often seed-limited because of depleted seed banks and limited seed dispersal in modern fragmented landscapes. In Europe, commercial seed mixtures, which are widely used for restoration measures, mostly consist of species and varieties of non-local provenance. The regional biodiversity of a given landscape, however, can be preserved only when seeds or plants of local provenance are used in restoration projects. Furthermore, the transfer of suitable target species of local provenance can strongly enhance restoration success.
We review and evaluate the success of currently used near-natural methods for the introduction of target plant species (e.g. seeding of site-specific seed mixtures, transfer of fresh seed-containing hay, vacuum harvesting, transfer of turves or seed-containing soil) on restoration sites, ranging from dry and mesic meadows to floodplain grasslands and fens. Own data combined with literature findings show species establishment rates during the initial phase as well as the persistence of target species during long-term vegetation development on restoration sites.
In conclusion, our review indicates that seed limitation can be overcome successfully by most of the reviewed measures for species introduction. The establishment of species-rich grasslands is most successful when seeds, seed-containing plant material or soil are spread on bare soil of ex-arable fields after tilling or topsoil removal, or on raw soils, e.g. in mined areas. In species-poor grasslands without soil disturbance and on older ex-arable fields with dense weed vegetation, final transfer rates were the lowest. For future restoration projects, suitable measures have to be chosen carefully from case to case as they differ considerably in costs and logistic effort. Long-term prospects for restored grassland are especially good when management can be incorporated in agricultural systems.
The aim of this study is to assess the development of plant species diversity and species composition
over a seven-year period in two calcareous grasslands abandoned for nearly 20 years and to find out
which factors influence vegetation dynamics. In the Abava River valley, Latvia, different calcareous
grasslands were studied, one on the south-west facing slope and another on the north-east facing slope.
Vegetation analyses on permanent plots showed that dry calcareous grasslands can be resistant to deterioration for a long period of time – succession was slower than reported in many cases for Central and
Western Europe. None of the studied communities showed a decrease neither in total species number
recorded per community nor in average species richness per plot. Vascular plant species richness even
increased by 3–4 species per 1-m² plot in the grassland on the south-west facing slope. An unexpected
result of the research was that Calamagrostis epigeios did not expand in this grassland. This fact can be
explained by the influence of disturbances (drought, tree cutting) and local differences in soil parameters
and topography. In parts of the north-east exposed grassland, with deeper soils and better water availability, species diversity (Shannon index) decreased significantly in areas overgrown by Aegopodium
podagraria.
Adaptivity is prevalent in today’s software. Mobile devices
self-adapt to available network connections, washing machines
adapt to the amount of laundry, etc. Current approaches for engineering such systems facilitate the specification of adaptivity in the analysis and the technical design. However, the modeling of platform independent models for adaptivity in the logical design phase remains rather neglected causing a gap between the analysis and the technical design phase.
To overcome this situation, we propose an approach called Adapt Cases. Adapt Cases allow the explicit modeling of adaptivity with domain-specific means, enabling adaptivity to gather attention early in the software engineering process.
Since our approach is based on the concept of use cases it
is easy adoptable in new and even running projects that
use the UML as a specification language, and additionally,
can be easily incorporated into model-based development
environments.
This research paper analyzes the role of pre-crisis
reputation for quality on consumers ’ perceptions of
product-related dangers and company responsibility
in product-harm crises with varying risk information.
We consider (non-) substantiated public
complaints incorporating low and moderate product-
related risks, as well as product-recall situations
involving serious risks to the health and safety of
consumers. Hypotheses are derived from theories
and concepts of consumer behavioural psychology.
These are then tested empirically by using an
online experiment. The effects of reputation are
analyzed across different crises contexts to derive
some general insights useful for crisis management.
In order to shed light on situational differences of
the reputation mechanism its effect on individual
crisis level will also be considered. In general, the
analysis fi nds that reputation for quality is capable
of positively infl uencing the perceptions of company
responsibility and thereby shielding the
manufacturer from receiving blame. However, an
established reputation for high product quality
prior to the crisis fails to positively impacting
consumers ’ perceptions of problem severity. The
crisis-specifi c effects of reputation turn out to be
ambivalent. On the basis of these fi ndings, recommendations
to crisis managers and relevant avenues
for future research are derived.
This study examined the relation between employees' perceived extent of change and adaptive performance, focusing on the roles of expressive suppression (i.e. the habit of suppressing overt expressions of emotion) at work and perceived strain. Analysing survey data of 153 employees in Germany with different occupational backgrounds via bootstrapping, the conceptual moderated indirect effect scheme was supported. As hypothesized, greater changes were associated with higher strain. Strain, in turn, was negatively related to adaptive performance. Although extent of change did not directly affect adaptive performance, the data supported the expected indirect relationship via strain. Finally, expressive suppression at work acted as a buffer of this indirect effect: extent of change was only negatively related to strain for employees low in suppression. In line with newer evidence, our results indicate that the suppression of overt emotional expressions at work can have positive effects under certain circumstances.
Objective
The aim of this study was to assess the influence of cranio-cervical posture on the maximal mouth opening (MMO) and pressure pain threshold (PPT) in patients with myofascial temporomandibular pain disorders.
Materials and Methods
A total of 29 patients (19 females and 10 males) with myofascial temporomandibular pain disorders, aged 19 to 59 years participated in the study (mean years±SD; 34.69±10.83 y). MMO and the PPT (on the right side) of patients in neutral, retracted, and forward head postures were measured. A 1-way repeated measures analysis of variance followed by 3 pair-wise comparisons were used to determine differences.
Results
Comparisons indicated significant differences in PPT at 3 points within the trigeminal innervated musculature [masseter (M1 and M2) and anterior temporalis (T1)] among the 3 head postures [M1 (F=117.78; P<0.001), M2 (F=129.04; P<0.001), and T1 (F=195.44; P<0.001)]. There were also significant differences in MMO among the 3 head postures (F=208.06; P<0.001). The intrarater reliability on a given day-to-day basis was good with the interclass correlation coefficient ranging from 0.89 to 0.94 and 0.92 to 0.94 for PPT and MMO, respectively, among the different head postures.
Conclusions
The results of this study shows that the experimental induction of different cranio-cervical postures influences the MMO and PPT values of the temporomandibular joint and muscles of mastication that receive motor and sensory innervation by the trigeminal nerve. Our results provide data that supports the biomechanical relationship between the cranio-cervical region and the dynamics of the temporomandibular joint, as well as trigeminal nociceptive processing in different cranio-cervical postures.
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.
Musicians often suffer from disorders of the musculoskeletal system that are related to their instrument playing. Among the most frequent symptoms are complaints in the shoulder-neck area. Radial shock wave therapy is increasingly used in trigger point treatment, but only few high-level studies have examined of shock wave therapy used together with physical therapy in the treatment of musicians. METHODS: This randomized blinded study in musicians (n = 26) with nonspecific shoulder-neck problems was done to examine the effect of shock wave therapy in addition to current physical therapy on the symptoms and quality of life of the musicians as well as their habits of playing musical instruments (intervention group shock wave vs reference group placebo). The effects were documented by a pain VAS and other instruments. A questionnaire designed specifically for musicians (with initial and final questions) recorded intensity and manifestation of pain and handicaps in daily life, especially when practicing and playing. The Shoulder Pain and Disability Index (SPADI) and the Neck Pain Disability Index Questionnaire (NPDIQ) were also used. RESULTS: Both groups reported subjective improvement in pain, but significance was found only for the intervention group for the SPADI and NPDIQ. CONCLUSIONS: Trigger point treatment with radial shock wave used in combination with physical therapy makes the subjects feel temporarily relieved of neck and shoulder pains. The effects of radial shock wave without physical therapy will need to be examined in further studies.
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: Informal caregiving by family members is the most common way of caring for sick people at home. However, the number of care arrangements, in which both formal (nurses) and informal (family members) caregivers are involved, is considerable and increasing. Despite implicit assumptions in research that the involvement of nurses in home care arrangements is inherently beneficial, there is evidence that their involvement may have a destabilising effect.
Aims: The purpose of this study was to investigate the relationship between nurses and family caregivers and its impact on the actual care that is provided.
Method: Eighty-eight interviews with family caregivers (n = 57) and nurses (n = 31) were conducted in Germany and analysed according to the Grounded Theory methodology.
Findings: The relationship between formal and informal care is an encounter of two quite different perspectives that is focused on a negotiation process about caregiving work and the helpfulness of the actions taken and the interventions used. For family caregivers, it is determined by the goal of facilitating work and care for their sick family member. The nurses’ work is characterised by a process of shaping different realities in different homes. The results reveal the processes that lead to the involvement of nurses into home care arrangements and offer a deeper understanding of the negotiation processes between formal and informal caregivers.
Conclusions: To provide sufficient support in home care, nurses need the ability to engage in negotiation processes that take the whole home care arrangement into account. Developmental work is needed to design services that are helpful for family caregivers.
In the past few years, studies have been carried out to record and analyse the consumer behaviour of manual dishwashing. Manual dishwashing in households is performed in many ways that influence the use of resources. Furthermore, knowledge has been gained on the basis of experiments on how to optimize the use of resources in manual dishwashing. Optimization here means achieving the best possible cleaning performance with a minimum input of resources. This experimental knowledge, combined with the experience of everyday life, was transferred into Best Practice Tips.
The aim of this study is to verify whether it is possible to save resources while applying these Best Practice Tips in comparison with the consumers' previous behaviour.
In a laboratory study, 53 consumers from Europe (23 Germans, 30 other Europeans) were asked to apply the Best Practice Tips while washing up 12 place settings of dishes. The data gained were compared with that of previous studies recording consumers' everyday behaviour while washing up the same amount of dishes. The sample consisted of 113 European consumers and the sample of the second study consisted of 60 Europeans.
On average, the 53 test participants applying the Best Practice Tips used around 60% less water, 70% less energy and 30% less detergent compared with the average everyday behaviour the other subjects used. Additionally, they achieved a slightly better cleaning result. An evaluation questionnaire showed that the Best Practice Tips were, in general, highly accepted; however, some concerns were given about their exact application in everyday life. Because of the wide variation of washing-up habits and resource consumption among individuals, the confidence intervals of the studies are rather large. The results should therefore be seen as tendencies on how resource savings are possible when people are trained how to optimize resources in manual dishwashing. Nevertheless, this study should be the basis for further ones in which the learning is verified in everyday life and over a longer period of time.
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.
Objective. To examine the association between region of origin and severe illness bringing a mother close to death (near‐miss). Design. Retrospective cohort study. Setting. Maternity units in Lower Saxony, Germany. Population. 441 199 mothers of singleton newborns in 2001–2007. Methods. Using chi‐squared tests, bivariate and multivariable logistic regression we examined the association between maternal region of origin and near‐miss outcomes with prospectively collected perinatal data up to seven days postpartum. Main outcome measures. Hysterectomy, hemorrhage, eclampsia and sepsis rates. Results. Eclampsia was not associated with region of origin. Compared to women from Germany, women from the Middle East (OR 2.24; 95%CI 1.60–3.12) and Africa/Latin America/other countries (OR 2.17; 95%CI 1.15–4.07) had higher risks of sepsis. Women from Asia (OR 3.37; 95%CI 1.66–6.83) and from Africa/Latin America/other countries had higher risks of hysterectomy (OR 2.65; 95%CI 1.36–5.17). Compared to German women, the risk of hemorrhage was higher among women from Asia (OR 1.55; 95%CI 1.19–2.01) and lower among women from the Middle East (OR 0.66, 95%CI 0.55–0.78). Adjusting for maternal age, parity, occupation, partner status, smoking, obesity, prenatal care, chronic conditions and infertility showed no association between country of origin and risk of sepsis. Conclusion. Region of origin was a strong predictor for near‐miss among women from the Middle East, Asia and Africa/Latin America/other countries. Confounders mostly did not explain the higher risks for maternal near‐miss in these groups of origin. Clinical studies and audits are required to examine the underlying causes for these risks.
Background: This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research.
Aim: To narrow the healthcare gap for disadvantaged families in the USA and partner countries.
Methods: Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA students in the MHIRT program complete two introductory courses followed by a 3-month research practicum in a partner country guided by faculty mentors abroad. The overall program development, student study abroad preparation, research project activities, cultural learning, and student and faculty team outcomes are explored.
Results: Cross-fertilization of research, cultural awareness and ideas about improving family health occur through education, international exchange and research immersion. Faculty research and international team collaboration provide opportunities for learning about research, health disparities, cultural influences and healthcare systems. The students are catalysts in the research effort, the dissemination of research findings and other educational endeavours. Five steps of the collaborative activities lead to programmatic success.
Conclusions: MHIRT scholars bring creativity, enthusiasm, and gain a genuine desire to conduct health research about families with chronic illness. Their cultural learning stimulates career plans that include international research and attention to vulnerable populations.
Background: The painDETECT questionnaire (PD-Q) has been used as a tool to characterize sensory abnormalities in patients with persistent pain. This study investigated whether the self-reported sensory descriptors of patients with painful cervical radiculopathy (CxRAD) and patients with fibromyalgia (FM), as characterized by responses to verbal sensory descriptors from PD-Q (sensitivity to light touch, cold, heat, slight pressure, feeling of numbness in the main area of pain), were associated with the corresponding sensory parameters as demonstrated by quantitative sensory testing (QST).
Methods: Twenty-three patients with CxRAD (eight women, 46.3 ± 9.6 years) and 22 patients with FM (20 women, 46.1 ± 11.5 years) completed the PD-Q. Standardized QST of dynamic mechanical allodynia, cold and heat pain thresholds, pressure pain thresholds, mechanical and vibration detection thresholds, was recorded from the maximal pain area. Comparative QST data from 31 age-matched healthy controls (HCs; 15 women) were obtained.
Results: Patients with CxRAD demonstrated a match between their self-reported descriptors and QST parameters for all sensory parameters except for sensitivity to light touch, and these matches were statistically significant compared with HC data (p ≤ 0.006). The FM group demonstrated discrepancies between the PD-Q and QST sensory phenotypes for all sensory descriptors, indicating that the self-reported sensory descriptors did not consistently match the QST parameters (p = ≤0.017).
Conclusion: Clinicians and researchers should be cautious about relying on PD-Q as a stand-alone screening tool to determine sensory abnormalities in patients with FM.
Identification of differences in clinical presentation and underlying pain mechanisms may assist the classification of patients with neck–arm pain which is important for the provision of targeted best evidence based management. The aim of this study was to: (i) assess the inter-examiner agreement in using specific systems to classify patients with cervical radiculopathy and patients with non-specific neck–arm pain associated with heightened nerve mechanosensitivity (NSNAP); (ii) assess the agreement between two clinical examiners and two clinical experts in classifying these patients, and (iii) assess the diagnostic accuracy of the two clinical examiners. Forty patients with unilateral neck–arm pain were examined by two clinicians and classified into (i) cervical radiculopathy, (ii) NSNAP, (iii) other. The classifications were compared to those made independently by two experts, based on a review of patients' clinical assessment notes. The experts' opinion was used as the reference criterion to assess the diagnostic accuracy of the clinical examiners in classifying each patient group. There was an 80% agreement between clinical examiners, and between experts and 70%–80% between clinical examiners and experts in classifying patients with cervical radiculopathy (kappa between 0.41 and 0.61). Agreement was 72.5%–80% in classifying patients with NSNAP (kappa between 0.43 and 0.52). Clinical examiners' diagnostic accuracy was high (radiculopathy: sensitivity 79%–84%; specificity 76%–81%; NSNAP: sensitivity 78%–100%; specificity 71%–81%). Compared to expert opinion, clinicians were able to identify patients with cervical radiculopathy and patients with NSNAP in 80% of cases, our data supporting the reliability of these classification systems.
Objective: To understand the significance of healthy living for users, professionals and managers of the Family Health Strategy (FHS) team.
Methods: Research of a qualitative nature, based on grounded theory. For data collection, interviews were conducted with 25 participants, including users, professionals and managers of a FHS team, during the period between March and December, 2009. Results: The collection and analysis of data was conducted in a systematic and comparative manner, demonstrating that healthy living can be characterized as a selforganizing process, mediated by the action of the FHS team professionals, especially by the community health agent, through creation of bonds of trust and stimulation of interactions and community associations. Conclusion: We concluded that healthy living is a singular phenomenon, complex, interactive, associative, political and social, coupled with the active involvement and participation of the users and by the engagement of effective and socially responsible professionals, managers and established political authorities.