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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.