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Talent scarcity in many parts of the world leads to the necessity to enlarge talent pools in order to provide enough future holders of key positions. Taking the scholarly discussion at the overlap of talent management and current careers literature as a starting point our qualitative empirical research provides insights in talent’s career decisions in an eastern emerging market, India, and a western developed country, Germany. 49 interviews with internationally experienced knowledge-workers were held to find out how to they come to career decisions throughout their career. Special focus was the balancing act of professional and private life sphere. An inductive-deductive approach was used to develop categories in MaxQda. Results show the impact of institutional frame, cultural context, and gender differences. Consequently, a stronger focus on talent’s different life phases with context specific deviations when configuring Talent Management in Multinational Enterprises can be advised.
As health IT supports processes along the entire patient trajectory and involves different types of professional groups, eHealth is inter-professional by nature. The aim of this study, therefore, is to investigate which competencies are at the intersection of the individual groups of health professionals. 718 international experts provided relevance ratings of eHealth competencies for different professional roles in an online survey. Communication and leadership proved to be important competencies across all professions, not only for executives. None or very little differences between professions were found between physicians and nurses, between IT experts at different levels and between IT experts and executives. However, there were a number of competencies rated differently when contrasting direct patient care specialists with executives. These findings should encourage organisations issuing educational recommendations to specify areas of shared competencies more extensively.
This paper introduces and empirically illustrates a pedagogical approach to teaching Public Relations (PR) in higher education. The approach is based on the Communities of Practice theory (Wenger, 1998). Based on this theory and for the purposes of this paper, learning is perceived as (1) a participation in a practice of (2) a social community and (3) the understanding of this practice. The pedagogical approach to teaching PR entails the facilitation of these three elements. The approach is illustrated through a case study. The authors conducted an international undergraduate course to teach students how to conduct a social media campaign to raise engagement for social issues. Twenty students from Netherlands and Germany enrolled. The paper offers an integrated understanding of theory and practice (see Wenger, 1998, p. 48). It contrasts many current approaches in PR education, which tend to differentiate between PR theory and practice. PR educators are encouraged to facilitate an equal negotiation between theory and practice and to enable students to match whatever is theorised with practice and whatever is practiced with theory.
Frequent users of emergency departments (ED) pose a significant challenge to hospital emergency services. Despite a wealth of studies in this field, it is hardly understood, what medical conditions lead to frequent attendance. We examine (1) what ambulatory care sensitive conditions (ACSC) are linked to frequent use, (2) how frequent users can be clustered into subgroups with respect to their diagnoses, acuity and admittance, and (3) whether frequent use is related to higher acuity or admission rate. We identified several ACSC that highly increase the risk for heavy ED use, extracted four major diagnose subgroups and found no significant effect neither for acuity nor admission rate. Our study indicates that especially patients in need of (nursing) care form subgroups of frequent users, which implies that quality of care services might be crucial for tackling frequent use. Hospitals are advised to regularly analyze their ED data in the EHR to better align resources.
How do companies decide where to locate their manufacturing? This study uses insights from manufacturing company executives collected by means of in-depth interviews with 50 manufacturers in the United Kingdom to develop an understanding of manufacturing location decision making. The findings indicate that companies derive competitive advantage from organizing manufacturing in different ways. Retaining or reshoring manufacturing to a company’s home country can enhance new product development, control of quality, product customization, delivery performance, and cost leadership. On the other hand, companies can enhance new product development, customization, and delivery performance for new markets, if production facilities are offshored to or in proximity to these locations. In addition, some companies use a hybrid approach of offshoring the production of some components or products for cost arbitrage while retaining or reshoring other components or products for advantages from value chain integration. Based on the findings of this study, a set of key manufacturing location questions are developed that should be considered by firms pondering onshore, offshore, reshore, or hybrid manufacturing location decisions.
Teachers in health informatics have a broad variety of international and national educational recommendations to rely on when designing programmes, curricula, courses and educational material. However, in addition they often need very specific information for their setting, blue-prints, hands-on experience and encouragement to try something new. This workshop presents three case studies from European universities who have implemented inter-professional, technology enabled health informatics courses in undergraduate, postgraduate and open university settings. These approaches will be put into the context of the TIGER recommendation framework that includes priority ratings of health informatics competencies and case studies to illustrate them. The workshop attendees will have ample opportunity to exchange ideas with the presenters and start a mutual learning process for health informatics teachers.
Objectives: Evaluation of multislice-CT (MSCT) during diagnosis and therapeutic decision-making in patients with suspected non-occlusive mesenteric ischemia (NOMI).
Methods: Retrospective, institutional review board-approved study of 30 patients (20 men, 10 women, mean age 64.6±14.2 years, range 24-87 years) undergoing biphasic abdominal MSCT followed by digital subtraction angiography (DSA) due to suspected NOMI. MSCT and DSA were qualitatively and quantitatively evaluated independently by two radiologists with respect to the possible diagnosis of NOMI. MSCT analysis included quantitative measurements, qualitative evaluation of contrast enhancement and assessment of secondary findings (bowel wall thickening, hypo-enhancement, intestinal pneumatosis). MSCT diagnosis and secondary findings were compared against DSA diagnosis.
Results: NOMI was diagnosed in a total of n = 28 patients. No differences were found when comparing the R1-rated MSCT diagnosis (p = 0.09) to the "gold standard", while MSCT diagnosis was slightly inferior with R2 (p = 0.02). With R1, vessel-associated parameters revealed the best correlation, i.e. qualitative vessel width (r = -0.39;p = 0.03) and vessel contrast (r = 0.45;p = 0.01). Moderate correlations were found for quantitative vessel diameters in the middle segments (r = -0.48,p = 0.01), increasing to almost high correlations in the distal (r = -0.66;p<0.00001) superior mesenteric artery (SMA) segments. No significant correlation was apparent from secondary findings.
Conclusions: MSCT is an appropriate non-invasive method for diagnosing NOMI and leads to adequate and immediate therapeutic stratificatio
Background: Muscle fatigue has been reported as a risk factor for the
development of performance-related musculoskeletal disorders (PRMD) in
musicians. However, little research exists to support this claim. The aim of
this study was to investigate whether changes occur in muscle activity
patterns during high string performance over a prolonged playing period, and
whether this is influenced by PRMD.
Methods: High string musicians were divided into a PRMD and a non-PRMD
group. They played a chromatic scale pre and post and a self-chosen “hard”
(Borg scale 16-17) piece of music for one hour. Electromyography data
recorded from arm, shoulder and trunk muscles was analyzed: the amplitude
to measure muscle activity characteristics and the lower frequency to
measure muscle fatigue. Differences between and within groups and the
frequency spectrum were analyzed using linear mixed models.
Results: Fifteen musicians participated (7 PRMD: 22.8 years, 2 male/5 female
and 8 non-PRMD: 34.3 years, 2 male/6 female). Changes in muscle activation
patterns were observed between and within both groups, however changes
varied significantly depending on group affiliation. Significant low frequency
spectrum changes between groups were observed in overall muscles of the
right arm (p=0.04) and left forearm flexors (p=0.05) following one hour of
playing.
Conclusions: Muscle activity and frequency spectrum shifts differ in high
string musicians with and without PRMD, suggesting possible differential
muscle fatigue effects between the groups.
In idea creation and assessment processes the accruement and the description of an idea are mostly allocated to a fixed point in time, defined as the end of the generating process and the start of the idea assessment. This static approach does not fit the reality in industrial idea processes. A dynamic approach for idea assessment is therefore introduced. An idea is not seen as a static but as a dynamic state, characterized by different degrees of maturity. Maturity is understood as a measure of the assessability of the individual evaluation characteristics.
Based on Crosby’s maturity model and on classical Capability Maturity Models, a new Idea Maturity Model (IMM) has been developed and is introduced for the first time. The five Idea Maturity Levels (IML) are named Initial, Awareness, Appraisability, Valuation, and Realisability and harmonize well with other maturity models. The levels are described by general characteristics, although the development of the maturity model focussed on new product or service development. The compatibility of the IMM with idea assessment processes and conditions in organisations and companies has been checked.
Background
Osteoarthritis of the knee is the most common cause for disability and limited mobility in the elderly, with considerable individual suffering and high direct and indirect disease-related costs. Nonsurgical interventions such as exercise, enhanced physical activity, and self-management have shown beneficial effects for pain reduction, physical function, and quality of life (QoL), but access to these treatments may be limited. Therefore, home therapy is strongly recommended. However, adherence to these programs is low. Patients report lack of motivation, feedback, and personal interaction as the main barriers to home therapy adherence. To overcome these barriers, electronic health (eHealth) is seen as a promising opportunity. Although beneficial effects have been shown in the literature for other chronic diseases such as chronic pain, cardiovascular disease, and diabetes, a systematic literature review on the efficacy of eHealth interventions for patients with osteoarthritis of knee is missing so far.
Objective
The aim of this study was to compare the efficacy of eHealth-supported home exercise interventions with no or other interventions regarding pain, physical function, and health-related QoL in patients with osteoarthritis of the knee.
Methods
MEDLINE, CENTRAL, CINAHL, and PEDro were systematically searched using the keywords osteoarthritis knee, eHealth, and exercise. An inverse variance random-effects meta-analysis was carried out pooling standardized mean differences (SMDs) of individual studies. The Cochrane tool was used to assess risk of bias in individual studies, and the quality of evidence across studies was evaluated following the Grading of Recommendations, Assessment, Development, and Evaluation approach.
Results
The literature search yielded a total of 648 results. After screening of titles, abstracts, and full-texts, seven randomized controlled trials were included. Pooling the data of individual studies demonstrated beneficial short-term (pain SMD=−0.31, 95% CI −0.58 to −0.04, low quality; QoL SMD=0.24, 95% CI 0.05-0.43, moderate quality) and long-term effects (pain −0.30, 95% CI −0.07 to −0.53, moderate quality; physical function 0.41, 95% CI 0.17-0.64, high quality; and QoL SMD=0.27, 95% CI 0.06-0.47, high quality).
Conclusions
eHealth-supported exercise interventions resulted in less pain, improved physical function, and health-related QoL compared with no or other interventions; however, these improvements were small (SMD<0.5) and may not make a meaningful difference for individual patients. Low adherence is seen as one limiting factor of eHealth interventions. Future research should focus on participatory development of eHealth technology integrating evidence-based principles of exercise science and ways of increasing patient motivation and adherence.
In urban areas, open space including brownfields often became rare due to increasing urbanisation. Urban brownfields can be important for biodiversity, but especially brownfields in early successional stages seem to be refused by urban residents due to their sparse vegetation and less aesthetic appearance. The aim of this study was to revegetate a young demolition site in the city core of Osnabrück, Germany and thereby to support native plant diversity and aesthetic values. We developed two seed mixtures of native plant species and tested them in a large-scale field experiment over two growing seasons.
Both seed mixtures developed towards structurally diverse and flower-rich vegetation. Establishment rates of sown species were consistently larger than 75%. Revegetation of the predominantly bare anthropogenically transformed soil by introduced species occurred fast. Vascular plant cover and vegetation height were higher on sown plots than in controls, but did not differ between the seed mixtures. Seeding did not increase plant species richness and did not reduce the establishment of a potentially invasive non-native plant species. The cover of Red-List species from the spontaneous vegetation was significantly higher in control plots. Our results indicate that not all aims can be reached on one restoration site. It has to be discussed if it is better to invest a restoration budget for measures aiming to increase acceptance of endangered pioneer plant species from the spontaneous vegetation or to introduce more attractive and more competitive species of later successional stages.
Background: While health informatics recommendations on competencies and education serve as highly desirable corridors for designing curricula and courses, they cannot show how the content should be situated in a specific and local context. Therefore, global and local perspectives need to be reconciled in a common framework.
Objectives: The primary aim of this study is therefore to empirically define and validate a framework of globally accepted core competency areas in health informatics and to enrich this framework with exemplar information derived from local educational settings.
Methods: To this end, (i) a survey was deployed and yielded insights from 43 nursing experts from 21 countries worldwide to measure the relevance of the core competency areas, (ii) a workshop at the International Nursing Informatics Conference (NI2016) held in June 2016 to provide information about the validation and clustering of these areas and (iii) exemplar case studies were compiled to match these findings with the practice. The survey was designed based on a comprehensive compilation of competencies from the international literature in medical and health informatics.
Results: The resulting recommendation framework consists of 24 core competency areas in health informatics defined for five major nursing roles. These areas were clustered in the domains “data, information, knowledge”, “information exchange and information sharing”, “ethical and legal issues”, “systems life cycle management”, “management” and “biostatistics and medical technology”, all of which showed high reliability values. The core competency areas were ranked by relevance and validated by a different group of experts. Exemplar case studies from Brazil, Germany, New Zealand, Taiwan/China, United Kingdom (Scotland) and the United States of America expanded on the competencies described in the core competency areas.
Conclusions: This international recommendation framework for competencies in health informatics directed at nurses provides a grid of knowledge for teachers and learner alike that is instantiated with knowledge about informatics competencies, professional roles, priorities and practical, local experience. It also provides a methodology for developing frameworks for other professions/disciplines. Finally, this framework lays the foundation of cross-country learning in health informatics education for nurses and other health professionals.
The increasing complexity of caseloads in SLT practice, e.g. due to higher comorbidity, lacking information or experience in the
treatment of complicated cases, calls for support from experienced as well as specialist practitioners from within the field - especially
for novice therapists. One way to tackle these challenges may be peer coaching and how it can be employed within the educational
and professional SLT setting.
Peer coaching was implemented across five semesters of a successive SLT study programme at a University of Applied Sciences in
Germany. The approach was embedded in a clinical reasoning seminar with 25 SLT students who each presented a challenging case
study from their current workload. All participants completed a short online survey to evaluate the feasibility of the team approach
within this setting as well as their personal benefit and development re. the discussed case studies.
Students felt encouraged by being able to share their experience and tackle actual challenges. They particularly valued receiving
answers from a broad range of other SLTs but also contributing to other students’ queries and providing practical solutions for
them. All participants felt that peer coaching was an appropriate approach for clinical reasoning to support their professional as well
as personal development. Other outcomes were a perceived increased ability to employ metacognitive reflection to be used with
their whole caseload but also a prospective need for further training. Some students suggested the employment of peer coaching
within their work setting.
In the educational as well as professional SLT setting, peer coaching can be successfully employed, triggering metacognitive
reflection re. practitioner’s thinking and acting, resulting in an increased awareness of needs and skills as part of the clinical
reasoning process.
Die Ernährung ist für etwa 30 % des weltweiten Verbrauchs an natürlichen Ressourcen verantwortlich. Um die negativen Auswirkungen des Ernährungssektors auf die Umwelt und die Gesellschaft zu begrenzen, ist der Verbrauch und die Verarbeitung von Lebensmitteln mit vermeintlich geringen negativen Auswirkungen ein wichtiges Thema bei den Bemühungen um eine nachhaltige Entwicklung. In den Großküchen sind klar definierte Indikatoren zur Bewertung der Auswirkungen von Geschäftsaktivitäten erforderlich, um dieses Ziel zu erreichen. Die Forschungs- und Entwicklungsarbeiten im Rahmen des NAHGAST-Projekts liefern Grundlagen, die bei diesen Bemühungen eine wichtige Hilfe sein können. Es wurden zwei Versionen eines Bewertungsinstruments mit Indikatoren unterschiedlicher Komplexität (NAHGAST Meal-Basic und NAHGAST Meal-Pro) entwickelt, die von Küchenfachleuten verwendet werden können, um die Nachhaltigkeitsleistung ihrer Produkte - der angebotenen Mahlzeit - zu bestimmen. Eine sachkundige Auswahl von Indikatoren und eine Diskussion darüber, auf welche Prozesse und Auswirkungen sich dieser Indikator im weiteren Kontext bezieht, sind von wesentlicher Bedeutung und werden in diesem Papier erörtert. Darüber hinaus wurden bei der Auswahl der Indikatoren für den Zweck unserer Forschung bestimmte Kriterien gleichzeitig berücksichtigt: (1) Kommunizierbarkeit - Welche Informationen ein Indikator vermitteln kann und wie verständlich diese Informationen für verschiedene Akteure sind; (2) Machbarkeit und Datenverfügbarkeit: Gibt es genügend Daten für einen Indikator und ist es für die Unternehmen realistisch, diesen Indikator in ihre tägliche Arbeitspraxis zu integrieren? (3) Wissenschaftliche Relevanz: Ist der Indikator für die Nachhaltigkeitsbemühungen in größerem Maßstab und für entsprechende Diskussionen in der wissenschaftlichen Gemeinschaft relevant? Die Erkenntnisse aus diesen Überlegungen sind wertvoll für zukünftige Entwicklungen in der Nachhaltigkeitsbewertung in der Außer-Haus-Gastronomie. Das Instrument wurde zur Bewertung einer Reihe von Gerichten verwendet und die Ergebnisse werden als aussagekräftig erachtet. Allerdings dürfen Bewertungen jedoch nicht als genaue Messung, sondern nur als Annäherung an die Nachhaltigkeit von Speisen verstanden werden. Auf der Ebene der einzelnen Indikatoren ermöglichen sie eine detaillierte Analyse und gezielte Optimierung von Rezepten, während die aggregierten Ergebnisse in Form von Etiketten gut an die Kunden kommuniziert werden können. Defizite und Herausforderungen, wie sie in der Anwendungsphase des Projekts festgestellt wurden, zeigen jedoch Forschungslücken im weiteren Kontext auf. Abschließend werden weitere Schritte für eine Integration des Tools in Unternehmensprozesse und verbleibende Anpassungsmöglichkeiten für Unternehmen diskutiert.
Still Searching or Have You Found It Already? – Usability and Web Design of an Educational Website
(2018)
Background: Apart from a straight-forward and intuitive operability an appealing design determines the success of a website equally well. For this reason, the selection of images and navigation bars plays a determining role. The eye tracking method proved to be appropriate in order to verify the usability of websites. Objectives: The aim of the study was to improve the usability of the website of an educational institute for trainees as target group. Methods/Approach: For this purpose, the use of an eye-tracking technology was combined with a survey. The eye-tracking study was implemented task-oriented. Test persons were asked to search for particular courses within this institute. Results: This approach in combination with a subsequent questionnaire resulted in tangible indications of search patterns of the test group. Furthermore, their perception and their appraisal of the usability as well as the web design was analysed. Even though most tasks were accomplished effectively and efficiently with a positive user feedback, a potential for improvement was detected, in particular with regard to the images and the location of the search field. Conclusions: The selected choice of methods enables researchers and web designers to derive recommendations for the orientation, structure, optimisation and comprehensibility of a website.
Small-fiber neuropathy and pain sensitization in survivors of pediatric acute lymphoblastic leukemia
(2018)
Background:
Chemotherapy-induced Peripheral Neuropathy (CIPN) of large-fibers affects up to 20% of survivors of pediatric acute lymphoblastic leukemia (ALL). We aimed to describe small-fiber toxicity and pain sensitization in this group.
Methods:
In a cross-sectional, bicentric study we assessed 46 survivors of pediatric ALL (Mean age: 5.7 ± 3.5 years at diagnosis, median 2.5 years after therapy; males: 28). Inclusion criteria: ≥6 years of age, ≥3 months after last administration of Vincristine, and cumulative dose of Vincristine 12 mg/m2. We used a reduced version of the Pediatric-modified Total Neuropathy Score (Ped-mTNS) as bedside test and Quantitative Sensory Testing (QST) for assessment of small- and large-fiber neuropathy as well as pain sensitization. We employed Nerve Conduction Studies (NCS) as the most accurate tool for detecting large-fiber neuropathy.
Results:
Fifteen survivors (33%) had abnormal rPed-mTNS values (≥4 points) and 5 survivors (11%) reported pain. In QST, the survivor group showed significant (p < 0.001) inferior large-fiber function and pain sensitization when compared to healthy matched peers. We identified deficits of vibration in 33 (72%) and tactile hypoesthesia in 29 (63%), hyperalgesia to blunt pressure in 19 (41%), increased mechanical pain sensitivity in 12 (26%) and allodynia in 16 (35%) of 46 survivors. Only 7 survivors (15%) had pathologic NCS.
Conclusion:
QST is a sensitive tool that revealed signs of large-fiber neuropathy in two thirds, small-fiber neuropathy and pain sensitization in one third of survivors. Prospective studies using QST in pediatric oncology may help to elucidate the pathophysiology of small-fiber neuropathy and pain sensitization as well as their relevance for quality of survival.
Background
Forced migration significantly endangers health. Women face numerous health risks, including sexual violence, lack of contraception, sexually transmitted disease, and adverse perinatal outcomes. Therefore, sexual and reproductive healthcare is a significant aspect of women asylum seekers’ health.
Even when healthcare costs of asylum seekers are covered by the government, there may be strong barriers to healthcare access and specific needs may be addressed inadequately. The study’s objectives were a) to assess the accommodation and healthcare services provided to women asylum seekers in standard and specialised health care, b) to assess the organisation of healthcare provision and how it addresses the sexual and reproductive healthcare needs of women asylum seekers.
Methods
The study utilised a multi-method approach, comprising a less-dominant quantitative component and dominant qualitative component. The quantitative component assessed accommodation conditions for women in eight asylum centres using a survey. The qualitative component assessed healthcare provision on-site, using semi-structured interviews with health and social care professionals (n = 9). Asylum centres were selected to cover a wide range of characteristics. Interview analysis was guided by thematic analysis.
Results
The accommodation in the asylum centres provided gender-separate rooms and sanitary infrastructure. Two models of healthcare were identified, which differed in the services they provided and in their organisation: 1) a standard healthcare model characterised by a lack of coordination between healthcare providers, unavailability of essential services such as interpreters, and fragmented healthcare, and 2) a specialised healthcare model specifically tailored to the needs of asylum-seekers. Its organisation is characterised by a network of closely collaborating health professionals. It provided essential services not present in the standard model. We recommend the specialised healthcare model as a guideline for best practise.
Conclusions
The standard, non-specialised healthcare model used in some regions in Switzerland does not fully meet the healthcare needs of women asylum seekers. Specialised healthcare services used in other regions, which include translation services as well as gender and culturally sensitive care, are better suited to address these needs. More widespread use of this model would contribute significantly toward protecting the sexual and reproductive integrity and health of women asylum seekers.
Reconnection of floodplains to rivers to enhance fluvial dynamics is a favored method of floodplain restoration in Europe. It is believed that the restoration of hydrological conditions of the floodplain facilitates natural dispersal of target species, and hence the reestablishment, of typical plant communities. The aim of our study was to investigate whether floodplain target species could reach restoration sites via hydrochorous dispersal. We analyzed seed inflow from the river and seed dispersal in different sectors of a new watercourse in the Danube floodplain. Seeds were captured using 27 seed traps during three sampling periods of 3 weeks each from summer 2011 to spring 2012. After germination seedlings were identified, we detected a total of almost 39,000 seeds of 176 species, including 80 target species of riparian habitats. We found significant differences between seasons (most seeds in autumn/winter) and between stream sectors. Fewer seeds came in from the Danube (2,800 seeds) than were transported within the floodplain. Several new floodplain target species were detected, which had not been found in the aboveground vegetation or soil seed bank before the start of the restoration. Seeds of nonnative species did not disperse further than approximately 1 km. Our results indicated that hydrochorous seed dispersal from upstream habitats along the new watercourse was important for the establishment of target species and hence for the success of floodplain restoration. Technical water diversion weirs must be traversable for seeds, and small donor sectors upstream might enhance the reestablishment of target vegetation along new sectors downstream.
Species dispersal, establishment, and assembly are crucial stages of the life history of plants, and clear understanding ofthe governing forces and rules that shape species composition in a particular community is vital for successful ecologicalrestoration. In this article, we focus on five aspects of seed dispersal and plant establishment, which should be consideredduring habitat restoration actions. In the first two sections, we discuss the success of spontaneous dispersal and establishmenton restoration based on either spatial dispersal or local seed banks. In the third section, we assess the possibilities ofspecies introduction and assisted dispersal. In the fourth section, we introduce some possibilities for the improvement ofestablishment success of spontaneously dispersed or introduced species. Finally, we highlight issues influencing long-termpersistence and sustainability of restored habitats, related to the alteration of management type and intensity, climate change,and spread of non-native species. With the present article, we introduce the special issue entitled “Seed dispersal and soil seedbanks – promising sources for ecological restoration” containing 15 papers by 62 authors from 10 countries arranged in theabovementioned five topics.