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A suspension of PMMA spheres in a density matched saccharose solution is investigated with a classical Searle rheometer and a NMR (Nuclear Magnetic Resonance) spectrometer. Here the NMR is used to measure the radial distribution of the PMMA spheres in the rotating cell, in addition to the local velocity profile of the suspension. The influence of particle concentration on the wall depletion is studied. Further analysis are carried out with computational fluid dynamics software. The velocity field as well as the solid distribution in the couette flow is simulated with a two-phase model including the Darcy law and compared to the experimental data.
Continuity of care is a concept that is defined as the uninterrupted and coordinated care provided to a patient and that includes an informational dimension which describes the information exchange between the parties involved. In nursing, the nursing summary is the main instrument to ensure informational continuity of care. The aim of this paper is to present an HL7 Clinical Document Architecture based document standard for the eNursing Summary and to discuss the need for harmonizing these results at international level. The eNursing Summary proposed in this paper was developed on the basis of several internationally accepted concepts, primarily the nursing process, the ISO 18104 Reference Terminology Model for Nursing and various data sets. The standardisation process embraced several phases of involving nursing experts for validating its structure and content. It was finally evaluated by a network of 100 healthcare organizations. We argue that the eNursing Summary is a good starting point for standardising nursing discharge and transfer documents on a global level. However, further work is needed to bring together the different national and international strands in standardisation.
Characteristics of German Hospitals Adopting Health IT Systems : Results from an Empirical Study
(2011)
Hospital characteristics that facilitate IT adoption have been described by the literature extensively, however with controversial results. The aim of this study therefore is to draw a set of the most important variables from previous studies and include them in a combined analysis for testing their contribution as single factors and their interactions. Total number of IT systems installed and number of clinical IT systems in the hospital were used as criterion variables. Data from a national survey of German hospitals served as basis. Based on a stepwise multiple regression analysis four variables were identified to significantly explain the degree of IT adoption (60% explained variance): 1) hospital size, 2) IT department, 3) reference customer and 4) ownership (private vs. public). Our results replicate previous findings with regard to hospital size and ownership. In addition our study emphasizes the importance of a reliable internal structure for IT projects (existence of an IT department) and the culture of testing and installing most recent IT products (being a reference customer). None of the interactions between factors was significant.
Comparison of variable liming strategies in organic farming systems using online pH-measurements
(2011)
In organic farming, soil pH is one of the most important soil characteristics affecting nutrient availability, soil microbial activity and plant growth. Using the soil pH mapping sensor system Veris MSP, detailed information on in-field variability of soil pH can be obtained enabling spatial variable lime application. Scenario calculations for an organically managed field in Germany reveal that compared with the standard farm practice (i.e. uniform liming rate) variable lime application does not lead to higher costs while soil pH is optimized in different field zones resulting in increased crop productivity. Using two different lime qualities increases liming costs moderately but gives farmers the chance to increase pH quickly in extreme low pH areas.
Despite the wealth of literature on requirements engineering, little is known about engineering very generic, innovative and emerging requirements, such as those for cross-sectional information chains. The IKM health project aims at building information chain reference models for the care of patients with chronic wounds, cancer-related pain and back pain. Our question therefore was how to appropriately capture information and process requirements that are both generally applicable and practically useful. To this end, we started with recommendations from clinical guidelines and put them up for discussion in Delphi surveys and expert interviews. Despite the heterogeneity we encountered in all three methods, it was possible to obtain requirements suitable for building reference models. We evaluated three modelling languages and then chose to write the models in UML (class and activity diagrams). On the basis of the current project results, the pros and cons of our approach are discussed.
Handovers need a common ground on the clinical cases between the members of the successive shifts to establish continuity of care. Conventional electronic patient record systems (EHR) proved to be only insufficiently suitable for supporting the grounding process. Against this background we proposed a basic concept for a handover EHR that extends general EHRs in particular openEHR based systems. The resulting handover information model was implemented in a database and evaluated based on 120 clinical cases. The information items of these cases could be mapped successfully to the model, however, the new class “anticipatory guidance” needed to be introduced. The evaluation also demonstrated the importance of highly aggregated information on the clinical case, opinions and meta-information such as the relevance of an item during handovers. Based on these findings, in particular the handover database, handover EHR applications are currently developed to support the grounding process.
Due to the emerging evidence of health IT as opportunity and risk for clinical workflows, health IT must undergo a continuous measurement of its efficacy and efficiency. IT-benchmarks are a proven means for providing this information. The aim of this study was to enhance the methodology of an existing benchmarking procedure by including, in particular, new indicators of clinical workflows and by proposing new types of visualisation. Drawing on the concept of information logistics, we propose four workflow descriptors that were applied to four clinical processes. General and specific indicators were derived from these descriptors and processes. 199 chief information officers (CIOs) took part in the benchmarking. These hospitals were assigned to reference groups of a similar size and ownership from a total of 259 hospitals. Stepwise and comprehensive feedback was given to the CIOs. Most participants who evaluated the benchmark rated the procedure as very good, good, or rather good (98.4%). Benchmark information was used by CIOs for getting a general overview, advancing IT, preparing negotiations with board members, and arguing for a new IT project.
The article describes an analysis of the use of e-learning to improve the learning transfer to practice in continuing education. Therefore an e-learning offer has been developed as a part between two attendance periods of a training course in the field of Ambient Assisted Living (AAL). All participants of the course were free to use the e-learning offer. After the end of the e-learning part we compared the e-learning users to the other participants. Using an online questionnaire we explored if there are differences in the activities in the field AAL after the training course. The results show that e-learning is beneficial especially for communication processes. Due to the fact that the possibility to talk about the learning content is an essential factor for the learning transfer, e-learning can improve the learning success.
Transition road maps – an investigative approach to map the daily life consumption of individuals
(2014)
The present paper aims at investigating an innovative approach to guide consumers’ daily life choices in Germany towards a more sustainable way of acting. This should be achieved by introducing a new concept: transition road maps. Transition road maps bear the capability of illustrating courses of consumption behaviour without being prohibitive. These schemes foster self-determined behaviour and encourage the consumer to rethink and restructure his or her habits of consumption, with a focus on sustainability. The innovative thought is, not to simply stick to the usual triad of spheres of activity, consisting of nutrition, mobility and housing. Instead further aspects of consumers’ daily routines are considered, such as leisure activities, time usage or financial activities. Moreover the transition road maps are based on a new ideology of combining and connecting the qualitative algorithm of time use, financial spending and resource impact of social practices in the area of private consumption. In the long-term, the transition road maps could e.g. be used in sustainability communication or consumer counselling.
Restricted Versus Unrestricted Search Space : Experience from Mining a Large Japanese Database
(2015)
The aim of this study was to investigate whether standard Big Data mining methods lead to clinically useful results. An association analysis was performed using the apriori algorithm to discover associations among co-morbidities of diabetes patients. Selected data were further analyzed by using k-means clustering with age, long-term blood sugar and cholesterol values. The association analysis led to a multitude of trivial rules. Cluster analysis detected clusters of well and badly managed diabetes patients both belonging to different age groups. The study suggests the usage of cluster analysis on a restricted space to come to meaningful results.
Although national eHealth strategies have existed now for more than a decade in many countries, they have been implemented with varying success. In Germany, the eHealth strategy so far has resulted in a roll out of electronic health cards for all citizens in the statutory health insurance, but in no clinically meaningful IT-applications. The aim of this study was to test the technical and organisation feasibility, usability, and utility of an eDischarge application embedded into a laboratory Health Telematics Infrastructure (TI). The tests embraced the exchange of eDischarge summaries based on the multiprofessional HL7 eNursing Summary standard between a municipal hospital and a nursing home. All in all, 36 transmissions of electronic discharge documents took place. They demonstrated the technical-organisation feasibility and resulted in moderate usability ratings. A comparison between eDischarge and paper-based summaries hinted at higher ratings of utility and information completeness for eDischarges. Despite problems with handling the electronic health card, the proof-of-concept for the first clinically meaningful IT-application in the German Health TI could be regarded as successful.
Management of agricultural processes is often troubled by disconnections and data transfer failures. Limited cellular network coverage may prevent information exchange between mobile process participants.
The research projects KOMOBAR and ISOCom designed, implemented und field-tested a delay tolerant platform for robust communication in rural areas and challenging environments. An adaptable combination of infrastructure-based cellular networks and infrastructure-free multihop ad hoc communication (WLAN) leads to a variety of new communication opportunities. Temporal storage and forwarding of data on mobile farm machinery as well as dynamic platform configurations during process runtime strongly enhance reliability and robustness of data transfers.
he development of context-aware applications is a difficult and error-prone task. The dynamics of the environmental context combined with the complexity of the applications poses a vast number of possibilities for mistakes during the creation of new applications. Therefore it is important to test applications before they are deployed in a life system. For this reason, this paper proposes a testing tool, which will allow for automatic generation of various test cases from application description documents. Semantic annotations are used to create specific test data for context-aware applications. A test case reduction methodology based on test case diversity investigations ensures scalability of the proposed automated testing approach.
For Delay-Tolerant Networks (DTNs) many routing algorithms have been suggested. However, their performance depends heavily on the applied scenario. Especially heterogeneous scenarios featuring known and unknown node movements as well as different kinds of data lead to either poor delivery ratios or exhausted network resources.
To overcome these problems this paper introduces Data-Driven Routing for DTNs. Data is categorized according to its requirements into priority queues. Each queue applies an appropriate DTN routing algorithm that fits the data requirements best. Simulation results show that Data-Driven Routing allows high delivery ratios for time-critical data while saving network resources during the transfer of less time-critical data at the same time.
Smart city applications in the Big Data era require not only techniques dedicated to dynamicity handling, but also the ability to take into account contextual information, user preferences and requirements, and real-time events to provide optimal solutions and automatic configuration for the end user. In this paper, we present a specific functionality in the design and implementation of a declarative decision support component that exploits contextual information, user preferences and requirements to automatically provide optimal configurations of smart city applications. The key property of user-centricity of our approach is achieved by enabling users to declaratively specify constraints and preferences on the solutions provided by the smart city application through the Decision Support component, and automatically map these constraints and preferences to provide optimal responses targeting user needs. We showcase the effectiveness and flexibility of our solution in two real usecase scenarios: a multimodal travel planner and a mobile parking application. All the components and algorithms described in this paper have been defined and implemented as part of the Smart City Framework CityPulse.
Innovations are typically characterised by their relative newness for the user. In order for new eHealth applications to be accepted as innovations more criteria were proposed including “use” and “usability”. The handoverEHR is a new approach that allows the user to translate the essentials of a clinical case into a graphical representation, the so-called cognitive map of the patient. This study aimed at testing the software usability. A convenience sample of 23 experienced nurses from different healthcare organisations across the country rated the usability of the handoverEHR after performing typical handover tasks. All usability scales of the IsoMetricsL questionnaire showed positive values (4 “I agree”) with the exception of “error tolerance” (3 “neutral statement”). A significant improvement was found in self-descriptiveness as compared to an initial usability testing prior to this study. Different subgroups of users tended to rate the usability of the system differently. This study demonstrated the benefits of formative evaluations in terms of improving the usability of an entirely new approach. It thus helps to transform a novel piece of software towards becoming a real innovation. Our findings also hint at the importance of user characteristics that could affect the usability ratings.