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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 nahezu jedem Personalauswahlverfahren stellt die Sichtung der Bewerbungsunterlagen den ersten Schritt der Beurteilung der Bewerber dar. Mit Hilfe einer Online-Befragung von 244 Personalverantwortlichen wird erstmals differenziert der Frage nachgegangen, welche Kriterien dabei in der Praxis der Personalauswahl zum Einsatz kommen. Die Ergebnisse werden zum einen mit Empfehlungen der Ratgeberliteratur, zum anderen mit den Befunden der personaldiagnostischen Forschung verglichen. In Übereinstimmung mit der Ratgeberliteratur zeigt sich eine starke Dominanz formaler Kriterien. Ergebnisse der Forschung spielen bei der expliziten Entscheidung für oder gegen bestimmte Kriterien keine Rolle. Vor dem Hintergrund der vorliegenden Befunde zur Validität der Unterlagensichtung kann die Aussagekraft der in der Praxis anzutreffenden Vorgehensweise als wenig valide eingeschätzt werden. Große Unternehmen schneiden dabei geringfügig besser ab als kleinere. Die Befunde werden diskutiert und Empfehlungen für Forschung und Praxis formuliert.
Die vorliegende Studie geht mit Hilfe eines Online-Experiments der Frage nach, welchen Einfluss die Seniorität sowie das Geschlecht der Interviewer im Einstellungsinterview auf die Wahrnehmung potentieller Bewerber hat. Es zeigt sich, dass Interviewer, die eine gewisse Seniorität aufweisen (älter sind, viel Berufserfahrung haben und weiter oben in der Hierarchie des Unternehmens stehen) als professioneller und sozial kompetenter wahrgenommen werden. Männliche Interviewer profitieren stärker von diesem Senioritätseffekt als weibliche. Darüber hinaus wirkt sich das Erscheinungsbild der Interviewer (gepflegtes Äußeres, angemessene Kleidung und Attraktivität) auf die wahrgenommenen Professionalität und Sozialkompetenz des Interviewers sowie auf die Bewertung des Unternehmens als Arbeitgeber positiv aus.
Expertenorganisation
(2016)
Der europäische Binnenmarkt
(2016)
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.
Despite the high significance of the Western Siberian grain belt for crop production in Russia, its weed communities are largely unknown. In this region spring wheat is grown on fertile Chernozem soils with large field sizes but land-use intensity per area is low compared to Central Europe. By usin a randomized sampling design we studied arable weed assemblages in the northern forest-steppe zone of Tyumen region on 99 within-field sampling plots of 100 m² size. Surprisingly, with average of 9.8 ± 3.8 species 100 m-2 species richness was low when compared with low-input farming in Central Europe and did not differ between areas of different land-use intensity. Against expectations species composition was not predominantly controlled by soil characteristics and climate, most likely due to short natural gradients. Instead, management factors such as fertilization and tillage intensity seemed to be important factors. Except for two species the Tyumen weed flora consisted mainly of species that are widespread throughout the temperate zone. We found only 10 species with an origin or core area in North Asia or Eastern Europe. The species pool was generally small and with 26% the proportion of non-native spe cies (archaeophytes) was low, when compared to Central European weed communities. Given that weed communities with higher species richness are described from neighboring Bashkiria, we conclude that arable land-use intensity in Tyumen region is high enough to reduce community species richness within arable fields estimated by a randomized sampling design. Since measured soil nutrient values did not affect species richness, herbicide use is most likely the crucial management factor. Furthermore, species-richness was vitally restricted by the small species pool. The low proportion of thermophilous arable weed species that originate from the Mediterranean or Middle-Eastern area and contribute signif icantly to the Central European weed diversity indicate that climatic dispersal limitations may be re sponsible for the small number of weed species in the Tyumen flora. An additional constraint was the short history of arable farming in Western Siberia, where considerable arable land use was started only by the end of the 17th century.
Restoring depleted soil organic carbon (SOC) stocks of arable land to remove carbon from the atmosphere and offset fossil fuel emissions is a promising strategy for the mitigation of climate change. In agroecosystems conservational tillage practices and the abandonment of formerly plowed fields (ex-arable land) are shown to have the highest potential to sequester SOC. Nevertheless reported sequestration rates vary and the effects of environmental site conditions remain poorly understood. Our results are based on a meta-analysis of 273 paired SOC estimates from 65 publications which included only mineral soils from the temperate zone. SOC stocks of ex-arable grasslands with an average of 14 years since abandonment were 18% larger compared to the SOC of arable land. Likewise, SOC stocks of never-plowed grassland plots were 11% larger than the SOC stocks of abandoned fields. The average sequestration rate was 0.72 t C ha− 1 yr− 1. Semi-arid and sub-humid climate as well as low initial SOC stocks positively affected proportional SOC gains suggesting that the recovery of carbon stocks is not limited by low primary production. Therefore, the northward shift of cultivation areas in the temperate zone will lead to the abandonment of soils with high SOC recovery potential. However, if native soils are opened up elsewhere to compensate for yield losses due to abandonment the surplus of SOC in ex-arable land can easily be overcompensated by cultivation losses.
Following the collapse of the Soviet Union in 1991 around 45 million hectares
of arable land became abandoned across Russia. Our study focused on the recovery
potential and conservation value of grassland vegetation on ex-arable land in the Tyumen
region of the Western Siberian grain belt. We compared ex-arable grasslands of different
successional stages with ancient grasslands as reference for the final stage of succession
along a climatic gradient from the pre-taiga to the forest steppe zone. Plant community
composition and species richness of ex-arable land clearly developed towards reference
sites over time, but even after 24 years of abandonment, the grassland vegetation had not
totally recovered. The c-diversity of vascular plants was slightly higher on ex-arable land
than in ancient grasslands but the mean a-diversity was still moderately lower. A significant proportion of the vegetation of ex-arable land still consisted of ruderal and mesic
grassland species and the number and cover of meadow-steppe species was significantly
lower than in ancient grasslands. Grazing and time since abandonment positively affected
the reestablishment of target grassland species, whereas it was negatively affected by the
cover of grasses. In contrast to ex-arable land, the conservation value of arable land is only
modest. Therefore, future intensification of land use is most likely less harmful if directed
to existing arable land. Re-cultivation of ex-arable land and grassland improvement operations such as seeding of competitive grass species are major threats for the biodiversity of secondary grasslands on ex-arable land in the forest steppe zone of Western Siberia.
Von 2010 bis 2014 wurden im Rahmen
des Projekts „ProSaum“ Verfahren zur
Wiederansiedlung arten- und blütenreicher Säume und Feldraine mit gebietsheimischem Wildpflanzensaatgut entwickelt. Für die standortangepassten
Saatmischungen wurden einheimische
Pflanzenarten ausgewählt, die typisch für
alte artenreiche Feldraine und mesophile
Saumgesellschaften im Raum Osnabrück
sind. Die Ergebnisse eines Blockversuchs und weiterer Versuche auf Landschaftsebene zeigen, dass es möglich
ist, artenreiche Säume und Feldraine
durch Ansaat in Kombination mit sorgfältiger Bodenbearbeitung und Entwicklungspflege wiederherzustellen. Aus den
Ergebnissen werden Empfehlungen für
die Standortauswahl, Bodenbearbeitung,
Ansaat und Pflege abgeleitet.
Soil seed banks have a high potential for vegetation re-establishment in restoration projects. We studied the soil seed bank in an oxbow system of a disconnected floodplain of the Danube River in Southern Germany. The aim of the study was to analyze if floodplain target species were still present in the seed bank after more than 150 years of embankment and disconnection from fluvial dynamics. In this context we investigated seed density, seed bank species richness and species composition in four broad habitat types with and without water-level fluctuations during the time of embankment (permanent water, fluctuating water, reed bed, hardwood floodplain forest). In addition, the similarity between seed bank and above-ground vegetation in these habitat types was studied in order to predict the success of future restoration measures. In total, 124 vascular plant species were determined in the seed bank samples. More than 50 % (66 species) were target species typical for floodplain habitats and 26 of these target species were lost or very rare in the above-ground vegetation. The four habitat types differed significantly in mean seed density and mean species richness. Mean species richness and the number of target species in the seed bank as well as the mean seed density were greatest in the habitats with fluctuating water level whereas mean seed density was much lower in the parts with more or less stable conditions like permanently standing water and hardwood floodplain forest. Sørensen similarity between seed bank and above-ground vegetation was very low in habitats with more or less stable water levels and desirable floodplain target species were very rare or completely absent. Our results indicate that the soil seed bank can be an important seed reservoir for the ecological restoration of floodplain plant communities especially for habitats with unstable environmental conditions during the period of disconnection. Restoration of water level dynamics is important to maintain the seed bank of populations of floodplain target species.
Angelehnt an den Pädagogischen Doppeldecker (Wahl, 2011, S. 291), der die Kongruenz von
Handlungs- und Reflexionsebenen in vergleichbaren Lehr-Lern-Situationen an Schule und
Hochschule in Hinblick auf pädagogische Kontexte nutzt, schlägt der Autor als Erweiterungs-
form dieses Konzepts den Berufsdidaktischen Dreidecker vor, der zusätzlich den Aspekt der
nicht-pädagogischen, beruflichen Arbeit bzw. betriebliche (Ausbildungs-)Kontexte einbe-
zieht.
Hochschule und Universität Osnabrück haben mit regionalen Partnern (Stadt, Landkreis, Bistum, evangelisch-lutherischem Kirchenkreis, Kompetenzzentrum Gesundheitswirtschaft) die Grundsatzvereinbarung unterzeichnet, in Osnabrück einen Gesundheitscampus zu etablieren. Das Ziel ist, einen Ort zu schaffen, an dem Wissenschaft, Unternehmen der Gesundheitsversorgung, Träger von Gesundheitseinrichtungen und Politik zusammenkommen, um innovative Versorgungskonzepte für die Region zu erproben. „ROSE – das Lernende Gesundheitssystem in der Region Osnabrück-Emsland“ ist ein Großprojekt im Rahmen des Gesundheitscampus Osnabrück, das von dem Niedersächsischen Ministerium für Wissenschaft und Kultur (MWK) über 5 Jahre gefördert wird. Dabei wird das Prinzip des Lernens durch Feedback angewendet. Das bedeutet, dass durch Forschung in und mit der Praxis Evidenz im Sinne von practice-based evidence erzeugt wird, d.h. Evidenz für eine bessere Versorgungspraxis unter Berücksichtigung städtischer und ländlicher Strukturen. Dies hat zur Konsequenz, dass der Transferprozess zwischen Hochschule und Versorgungspraxis nicht am Ende sondern bereits am Anfang steht. Mit dem Ansatz einer wiederkehrenden Abfolge von Forschungsfragen und Analysen von Daten aus der Versorgungspraxis rekurriert ROSE auf das Prinzip des „Learning Health Care System“ (IOM, 2007). Im Rahmen von ROSE stimmen sich Hochschule und Universität Osnabrück ab, um die Ziele des Gesundheitscampus zu erreichen. Die geplante Umsetzung wird anhand eines Modells mit fünf Maßnahmen vorgestellt. Diese bauen auf der Vielfalt von bereits bestehenden Gesundheitsstudiengängen in Osnabrück auf und bringen Forschung, Nachwuchsförderung und Translation von Forschungsergebnissen zusammen.
Das Gesundheitswesen steht vor zahlreichen Veränderungen. Dazu zählen auch sich wandelnde Kompetenzprofile. Auf Seiten der Hochschulen stellt sich neben den fachlichen Aspekten zukünftiger Kompetenzprofile verstärkt die Frage nach einer höheren systemischen Durchlässigkeit und damit auch nach einer optimalen Vernetzung hochschulischer und außerhochschulisch erworbener Kompetenzen. Insbesondere in den Gesundheitsfachberufen nehmen non-formal und informell erworbene Kompetenzen einen hohen Stellenwert ein. Somit stellt sich die Herausforderung, wie die Ausgestaltung eines hochschulischen Zertifikatsprogrammes erfolgen kann, das zum einen eine Qualifizierung auf akademischem Niveau bietet und gleichzeitig die bestehenden non-formal bzw. informell im Berufsfeld erworbenen Kompetenzen der Lernenden erfassen, bewerten und entsprechend zertifizieren kann. Zielstellung ist es letztendlich, die Gesamtkompetenz einer Person in einem klar umgrenzten thematischen Umfeld zu erfassen, wertzuschätzen“ bzw. zu bewerten und gezielt weiter zu entwickeln, wobei außerhochschulische Kompetenzen eine wichtige Rolle spielen. Die in diesem Rahmen zertifizierten Kompetenzen stehen in einem möglichen Folgeprozess für eine entsprechende Anrechnung zur Verfügung. Vorgestellt wird ein erster Prototyp, der sich insbesondere als eine Erweiterung bestehender Denkmodelle im Bereich der Anrechnung versteht.
Mit der Akademisierung von praktischen Gesundheitsberufen stehen die Hochschulen und Universitäten gleichermaßen vor der Herausforderung, Pflege- und Therapiekräfte für ein noch nicht definiertes Berufsfeld zu qualifizieren. Die Wissenschaft hat die Fragen nach den genauen Inhalten und der Abgrenzung akademisierter Gesundheitsberufe zu anderen, seit langem etablierten Tätigkeitsbereichen in der Patientenversorgung zu beantworten und weiterführend zukünftigen Entwicklungen aufzuzeigen. Hier erwächst der Bedarf nach einer weitergehenden Arbeitsforschung in den akademisierten, praktischen Gesundheitsberufen. Der in diesem Beitrag vorgestellte Ansatz kombiniert die Weiterqualifizierung mit der Arbeitsforschung im Berufsfeld. Ziel ist es, Weiterbildungsmodule zu konzipieren, bei denen das praktische Arbeitsfeld mit den jeweiligen Inhalten der Module systematisch in Bezug gesetzt wird. Grundlage hierzu sind didaktische Ansätze der Theorie-Praxis-Relation aus dualen Studiengängen. Zentrales Instrument ist eine reflexionsorientierte Fallstudie, die von den Teilnehmern der Weiterbildung für jedes Modul erstellt wird, in der die Teilnehmer theoriebasierte Inhalte des Moduls aufgreifen und dazu nutzen, ihr jeweiliges praktisches Arbeitsfeld mit der fachlichen Perspektive des Moduls zu reflektieren. Die Teilnehmer werden so zu Praxisforschern und die Weiterbildung gleichzeitig zu einer wissenschaftlichen Berufsfeldreflexion, aus der die Praxis Impulse zur Weiterentwicklung erhält.
The conservation of freshwater ecosystems has lagged behind that of marine and terrestrial ecosystems and often requires the integration of large-scale approaches and transboundary considerations. This study aims to set the foundations of a spatial conservation strategy by identifying the most important catchments for the conservation of freshwater biodiversity in Europe.
Using data on 1296 species of fish, mollusc, odonate and aquatic plant, and the key biodiversity area criteria (species Red List status, range restriction and uniqueness of species assemblages), we identified a network of Critical Catchments for the conservation of freshwater biodiversity. Applying spatial prioritisation, we show how the prioritised network differs from the ideal case of protecting all Critical Catchments and how it changes when protected areas are included, and we also identify gaps between the prioritised network and existing protected areas.
Critical Catchments (n = 8423) covered 45% of the area of Europe, with 766 qualifying (‘trigger’) species located primarily in southern Europe. The prioritised network, limited to 17% of the area of Europe, comprised 3492 catchments mostly in southern and eastern Europe and species targets were met for at least 96% of the trigger species.
We found the majority of Critical Catchments to be inadequately covered by protected areas. However, our prioritised network presents a possible solution to augment protected areas to meet policy targets while also achieving good species coverage.
Policy implications. While Critical Catchments cover almost half of Europe, priority catchments are mostly in southern and eastern Europe where the current level of protection is not sufficient. This study presents a foundation for a Europe-wide systematic conservation plan to ensure the persistence of freshwater biodiversity. Our study provides a powerful new tool for optimising investment on the conservation of freshwater biodiversity and for meeting targets set forth in international biodiversity policies, conventions and strategies.
Evaporation from growing media significantly contributes to increasing the humidity in greenhouses. The effects of a pine bark mulch cover on substrate evaporation was evaluated with different pot experiments. The obtained data have been tested within the water balance model HYDRUS-1D, which was originally developed for mineral soils. Objective of this study was to test the performance of HYDRUS-1D to describe evaporation in plant containers and to evaluate the effect of pine bark as cover layer or layers within growing media. Application of pine bark in combination with peat substrate reduced evaporation up to 50% depending on position, thickness of mulch layer and water content of the substrate. The highest reduction in evaporation was measured in a dry substrate which is covered with 4 cm pine bark. The HYDRUS-1D model describes evaporation from growing media in combination with layers of pine bark correctly as long as hysteresis of the water retention curve and vapor flow is considered in the model.
The aim of this paper is to advance the research on innovation at the pharma-nutrition interface by analysing the three steps of science, technology and market convergence in the area of probiotics using a life cycle perspective. Results from a bibliometric analysis drawing upon 8245 scientific publications, 2082 patents and 1357 news reports focussing on product launch announcements from 1990 up to 2009 indicate that the proposed curve shapes of the life cycles in the theory based framework can be transferred to the case of probiotics. There is a time shift considering the life cycles showing the same activities of the industrial sectors at different moments of time. The food sector dominates the field of probiotics by driving science, technology and market convergence showing earlier activities in scientific publications, patents as well as product launches, while presenting a higher clockspeed between the different life cycle phases. While the food sector dominates product launches for food products containing probiotics, the pharmaceutical sector dominates the product launches of the supplement market. In addition, a clear trend towards industry convergence can be identified by the growing number of cross-industry activities.
Osnabrück’s so called “Green Fingers” – eleven landscape corridors reaching from the inner city into the region – structure the regional metropolis’ urban pattern. They supply the city centre with fresh air, serve as recreational destinations for the city’s inhabitants and provide space for close to the city agriculture and forestry. First defined in 1926, the Green Fingers have since been part of various planning documents and programs. However, these open spaces have been diminished bit by bit over time. The city’s growing need for land to build on had its impact just like the development of major traffic routes. On the one hand a lively debate has emerged: the Green Finger’s qualities, their ecological, aesthetical and cultural significance become increasingly important. Yet on the other hand decision makers still tend to put greenfield building activity first. A lot of efforts in striving for inner development are undermined by the ever growing demand for space. The urban sprawl continues, although various kinds of sanctuaries have been added to the urban and landscape planners’ equipment. The growing urban framework with its semidetached and single family houses does not come to a halt.
Geschäftsmodelle sind genuin ein wichtiger Schlüssel zur Logik und systematischen Darstellung unternehmerischen Treibens mit Berücksichtigung aller beteiligten Akteure und deren Aktivitäten. Trotz des Bewusstseins um die organisch-systemischen Verflechtungen von Unternehmen mit sämtlichen Stakeholdern, liegt auch bei Geschäftsmodellen der Energiewirtschaft der primäre Fokus i. d. R. darauf, das Leistungsversprechen gegenüber dem Kunden (value proposition) in ökonomische Unternehmenserträge (value captured, revenue streams) zu überführen. Dieser Beitrag geht am Beispiel von Stromspeichern der Frage nach, wie das Grundverständnis von Geschäftsmodellen theoretisch und praktisch erweitert werden muss, um sich nachhaltiger auf die Zukunft einzustellen. Dabei wird die Form des suffizienzorientierten Geschäftsmodells als Gestaltungsrahmen herausgearbeitet.
Functional foods are still of increasing interest among the scientific community. Based on the extensive literature about functional foods, four main research areas can be identified: functional food innovation (1); the scientific background of the health benefits of functional foods (2); the regulation of functional foods (3); and consumer acceptance of functional foods (4). These research areas are not detached from each other, and each presents a consumer perspective. Although multifaceted studies focus on consumer acceptance of functional foods, literature regarding a structured framework of the determinants of functional food acceptance is limited. The aim of this review is to provide the reader with an overview of the recent literature on consumer attitudes towards functional foods and with an extensive structured framework of the determinants of functional food acceptance and their intertwined relationships. The scientific literature discusses a plethora of determinants of consumer acceptance of functional foods. These determinants can be categorized into consumer and market attributes, which show interwoven relationships with each other. On the one hand, consumer attributes are widely discussed in the literature, while on the other hand structured analyses of the market perspective are inadequately represented. Additionally, the ongoing development of new scientific findings regarding health benefits of different functional ingredients leads to a large amount of new functional food products in the market. Consequently, the research area of functional foods and in particular consumer acceptance of functional food innovation will remain an important research field in the coming years.
Convergence processes are based on the activity of distinct industry sectors showing cross-industry collaborations. The aim of this paper is to analyze cross-industry collaborations between the food and pharmaceutical sectors in the convergence area of functional foods. Selected companies from food (Nestlé/Danone) and pharmaceutical (Martek/Bayer HealthCare) sectors are analyzed using the determinants of motivation and industrial scope. The analysis shows that food companies are more active in cross-industry collaborations than pharmaceutical companies. The latter are more active at the front-end of the value chain focusing on research and development, and delivering their ingredients to food companies that due to their higher expertise in consumer marketing launch the products. While the first cross-industry collaborations were based on an exploration motivation, those that follow focus on exploitation. Acquisitions and licensing agreements are dominant in inside-out and outside-in processes, whereas strategic alliances and joint ventures are based on a coupled process between the food and pharmaceutical sectors.
Our world and our lives are changing in many ways. Communication, networking, and computing technologies are among the most influential enablers that shape our lives today. Digital data and connected worlds of physical objects, people, and devices are rapidly changing the way we work, travel, socialize, and interact with our surroundings, and they have a profound impact on different domains,such as healthcare, environmental monitoring, urban systems, and control and management applications, among several other areas. Cities currently face an increasing demand for providing services that can have an impact on people’s everyday lives. The CityPulse framework supports smart city service creation by means of a distributed system for semantic discovery, data analytics, and interpretation of large-scale (near-)real-time Internet of Things data and social media data streams. To goal is to break away from silo
applications and enable cross-domain data integration. The CityPulse framework integrates multimodal, mixed quality, uncertain and incomplete data to create reliable, dependable information and continuously adapts data processing techniques to meet the quality of information requirements from end users. Different than existing solutions that mainly offer unified views of the data, the CityPulse framework is also equipped with powerful data analytics modules that perform intelligent data aggregation, event detection, quality
assessment, contextual filtering, and decision support. This paper presents the framework, describes ist components, and demonstrates how they interact to support easy development of custom-made applications for citizens. The benefits and the effectiveness of the framework are demonstrated in a use-case scenario
implementation presented in this paper.
In this article, we build on Stigler and Becker’s (1977) “consumption capitaltheory” and propose a novel conceptualization of film quality for the analysisof motion picture franchises. Generally, this theorypredicts that the utilityconsumers derive from a particular goodor service increases with prior con-sumption. We test our theoretical conjectures by drawing on the population ofsequels that were running in the US between 1992 and 2011. The empiricalresults point to the explanatory power of the proposed framework. Filmexecutives may use our findings to improve the profitability of their sequelproductions. From a theoretical point of view, consumption capital theoryallows for a more refined analysis of sequel performance along differentdimensions. Moreover, it may provide a fruitful basis for the analysis of otherserial media content, including books, TV, music, and games.
Der Bereich Ernährung wird in den kommenden Jahrzehnten vor zahlreichen Herausforderungen stehen, die sich aus den veränderten Lebensgewohnheiten und globalen Konsummustern bei gleichzeitig hohem Ressourcenverbrauch ergeben. Vor diesem Hintergrund wird in diesem Papier ein neu entwickeltes Instrument zur Verringerung der Auswirkungen auf die Ernährung vorgestellt, der sogenannte Ernährungsfußabdruck. Das Instrument basiert auf der Umsetzung des Konzepts einer nachhaltigen Ernährung in Entscheidungsprozessen und der Unterstützung einer ressourcenschonenden Gesellschaft. Das Konzept integriert jeweils vier Indikatoren aus den beiden ernährungsrelevanten Bereichen Gesundheit und Umwelt und verdichtet sie zu einem leicht kommunizierbaren Ergebnis, das sich in seinen Ergebnissen auf eine Wirkungsebene beschränkt. Anhand von acht Mittagsmahlzeiten werden die Methodik und ihre Berechnungsverfahren detailliert vorgestellt. Die Ergebnisse unterstreichen die allgemeine wissenschaftliche Sichtweise auf Lebensmittel; Mahlzeiten auf der Basis von tierischem Eiweiß sind im Hinblick auf ihre Gesundheits- und Umweltauswirkungen relevanter. Das Konzept scheint für Verbraucher nützlich zu sein, um ihre eigene Wahl zu bewerten, und für Unternehmen, um ihre internen Daten, ihre Benchmarking-Prozesse oder ihre externe Kommunikationsleistung zu erweitern. Methodische Unzulänglichkeiten und die Interpretation der Ergebnisse werden erörtert, und die Schlussfolgerung zeigt das Potenzial der Instrumente für die Gestaltung von Übergangsprozessen und für die Verringerung des Verbrauchs natürlicher Ressourcen durch die Unterstützung von Entscheidungen und Wahlmöglichkeiten von Lebensmittelanbietern und Verbrauchern.
Der Kunde als Dienstleister: Akzeptanz und Gebrauchstauglichkeit von Smart Glasses im Self-Service
(2017)
Forschungsfrage: In welchem Umfang werden Persönlichkeitseigenschaften in Stellenanzeigen verwendet, die eher als maskulin wahrgenommen werden?
Methodik: Wir nutzen einen Pool von deutschsprachigen Stellenanzeigen von Dax-30-Unternehmen, mittelständischen Unternehmen und des öffentlichen Sektors in den Bereichen Personalwesen (N=2.086) und Softwareentwicklung (N=1.811).
Praktische Implikationen: Unternehmen, die eine diverse Belegschaft anstreben, sollten nicht einseitig vor allem maskuline Persönlichkeitseigenschaften fordern. Die Eigenschaften signalisieren auch die Unternehmenskultur.
Für die Versorgungsforschung ist wichtig, dass verteilte und heterogene Daten so integriert werden, dass sie offen für neue Analyse-Anforderungen und leicht um neue Datenquellen erweiterbar sind. Für die Integration von Versorgungsdaten werden bislang hauptsächlich Data-Warehouses eingesetzt, die Daten dimensional oder als Entity-Attribute-Value-Struktur (EAV) modellieren. Diese Datenmodelle sind jedoch entweder unflexibel oder weisen ein zu geringes Maß an Datenorganisation auf, was longitudinale Analysen erschwert. Wir haben den EAV-Ansatz um die Data-Vault-Modellierung ergänzt und damit die Datenstrukturen der Krankenhaus-Qualitätsberichte des Gemeinsamen Bundesausschusses (G-BA) modelliert sowie die Daten der Jahre 2011 bis 2015 integriert. Dies ermöglicht eine Historisierung der Metadaten für Merkmale, insbesondere der Qualitätsindikatoren, sowie ein hohes Maß an Erweiterbarkeit gegenüber neuen heterogenen Datenquellen. Der vorgeschlagene Ansatz erlaubt es, den Abstraktionsgrad für die zu modellierenden Entitäten frei zu wählen, so dass auch ein vollständig generisches EAV-Modell mit historisierten Metadaten erstellt werden kann.
Background: For more than 30 years, there has been close cooperation between Japanese and German scientists with regard to information systems in health care. Collaboration has been formalized by an agreement between the respective scientific associations. Following this agreement, two joint workshops took place to explore the similarities and differences of electronic health record systems (EHRS) against the background of the two national healthcare systems that share many commonalities.
Objectives: To establish a framework and requirements for the quality of EHRS that may also serve as a basis for comparing different EHRS.
Methods: Donabedian's three dimensions of quality of medical care were adapted to the outcome, process, and structural quality of EHRS and their management. These quality dimensions were proposed before the first workshop of EHRS experts and enriched during the discussions.
Results: The Quality Requirements Framework of EHRS (QRF-EHRS) was defined and complemented by requirements for high quality EHRS. The framework integrates three quality dimensions (outcome, process, and structural quality), three layers of information systems (processes and data, applications, and physical tools) and three dimensions of information management (strategic, tactical, and operational information management).
Conclusions: Describing and comparing the quality of EHRS is in fact a multidimensional problem as given by the QRF-EHRS framework. This framework will be utilized to compare Japanese and German EHRS, notably those that were presented at the second workshop.
Multinational health IT benchmarks foster cross-country learning and have been employed at various levels, e.g. OECD and Nordic countries. A bi-national benchmark study conducted in 2007 revealed a significantly higher adoption of health IT in Austria compared to Germany, two countries with comparable healthcare systems. We now investigated whether these differences still persisted. We further studied whether these differences were associated with hospital intrinsic factors, i.e. the innovative power of the organisation and hospital demographics. We thus performed a survey to measure the “perceived IT availability” and the “innovative power of the hospital” of 464 German and 70 Austrian hospitals. The survey was based on a questionnaire with 52 items and was given to the directors of nursing in 2013/2014. Our findings confirmed a significantly greater IT availability in Austria than in Germany. This was visible in the aggregated IT adoption composite score “IT function” as well as in the IT adoption for the individual functions “nursing documentation” (OR = 5.98), “intensive care unit (ICU) documentation” (OR = 2.49), “medication administration documentation” (OR = 2.48), “electronic archive” (OR = 2.27) and “medication” (OR = 2.16). “Innovative power” was the strongest factor to explain the variance of the composite score “IT function”. It was effective in hospitals of both countries but significantly more effective in Austria than in Germany. “Hospital size” and “hospital system affiliation” were also significantly associated with the composite score “IT function”, but they did not differ between the countries. These findings can be partly associated with the national characteristics. Indicators point to a more favourable financial situation in Austrian hospitals; we thus argue that Austrian hospitals may possess a larger degree of financial freedom to be innovative and to act accordingly. This study is the first to empirically demonstrate the effect of “innovative power” in hospitals on health IT adoption in a bi-national health IT benchmark. We recommend directly including the financial situation into future regression models. On a political level, measures to stimulate the “innovative power” of hospitals should be considered to increase the digitalisation of healthcare.
Objective: To pilot benchmark measures of health information and communication technology (ICT) availability and use to facilitate cross-country learning.
Materials and Methods: A prior Organization for Economic Cooperation and Development–led effort involving 30 countries selected and defined functionality-based measures for availability and use of electronic health records, health information exchange, personal health records, and telehealth. In this pilot, an Organization for Economic Cooperation and Development Working Group compiled results for 38 countries for a subset of measures with broad coverage using new and/or adapted country-specific or multinational surveys and other sources from 2012 to 2015. We also synthesized country learnings to inform future benchmarking.
Results: While electronic records are widely used to store and manage patient information at the point of care—all but 2 pilot countries reported use by at least half of primary care physicians; many had rates above 75%—patient information exchange across organizations/settings is less common. Large variations in the availability and use of telehealth and personal health records also exist.
Discussion: Pilot participation demonstrated interest in cross-national benchmarking. Using the most comparable measures available to date, it showed substantial diversity in health ICT availability and use in all domains. The project also identified methodological considerations (e.g., structural and health systems issues that can affect measurement) important for future comparisons.
Conclusion: While health policies and priorities differ, many nations aim to increase access, quality, and/or efficiency of care through effective ICT use. By identifying variations and describing key contextual factors, benchmarking offers the potential to facilitate cross-national learning and accelerate the progress of individual countries.
Der Beitrag untersucht, worin die Mängel der schweizerischen Direktdemokratie bestehen, welches Verhältnis die AfD – auch unter rechtspolitischem, verfassungstheoretischem und ideengeschichtlichem Blickwinkel – zu Volksabstimmungen aufweist und was demgegenüber eine grundrechtsbasierte, streng rechtsstaatlich eingebundene Volksgesetzgebung im Kontext der deutschen Verfassungstradition auszeichnet.
Mutterschaft ab 35 Jahren: Das Altersrisiko in der Wahrnehmung von Frauen – eine Literaturstudie
(2017)
Hintergrund Die Anzahl derjenigen Frauen, die im Alter von 35 Jahren oder später Mutter werden, steigt in den Industrienationen weltweit. Mit dem höheren Alter ist eine Zunahme von Risiken für die Fertilität, für die Schwangerschaft, für die Geburt und für die Neugeborenen verbunden. Risikozuschreibungen in der Schwangerschaft beeinflussen die psychosoziale Situation von Frauen negativ. Daher stellt sich die Frage, wie Frauen das Altersrisiko erleben.
Methodik Die internationale systematische Literaturrecherche wurde zwischen Dezember 2015 und März 2016 in den elektronischen Datenbanken PubMed, CINAHL, PsycINFO und Sowiport durchgeführt. Eingeschlossen wurden Studien, welche die Wahrnehmung der reproduktiven Altersrisiken der Mutterschaft in fortgeschrittenem Alter, definiert als ≥ 35 Jahre, fokussieren.
Ergebnisse Es wurden elf Studien unterschiedlichen Designs ausgewertet. Mit Ausnahme von Kenntnissen über die durch das Alter abnehmende Fertilität und die Zunahme bei Trisomie 21 zeigen sich insgesamt geringe Kenntnisse der Teilnehmenden über altersassoziierte Risiken. In der Konfrontation mit den Risiken werden diese als bedrohlich erlebt. Strategien im Umgang mit der Besorgnis sind vielfältig: Informationsmanagement mit Problemen von Über- und Fehlinformation und Informationsvermeidung, Ablenkung von Gedanken an Risiken, Bedürfnis nach Kontrolle und guter Vorbereitung oder eine emotionale Distanz zur Schwangerschaft. Die persönliche Risikobewertung durch die Frauen ist komplex und bezieht ihre sozialen Lebensumstände und ihren Lebensstil mit ein. Dabei werden die medizinischen Zuschreibungen relativiert. Durch die Fokussierung ein gesundes Kind zu gebären unterbleibt häufig die Vorbereitung auf das Leben mit dem Neugeborenen. Auswirkungen auf das Erleben von Mutterschaft zeigen sich insbesondere in einer postpartalen Überforderung in der Versorgung des Neugeborenen.
Diskussion Das Altersrisiko kann von den Betroffenen nur unzureichend eingeschätzt werden. Es zeigen sich verschiedene aus der Risikoforschung bekannte Phänomene. Die medizinische Risikoeinschätzung unterscheidet sich von der Risikowahrnehmung der Frauen. Die Folgen für das Erleben der Mutterschaft machen das Konzept des Altersrisikos diskussionswürdig. Diese Ergebnisse legen für die Gesundheitsberufe nahe, die Versorgung von Schwangeren in fortgeschrittenem Alter stärker auf gesundheitsfördernde Aspekte, Partnerschaft und das Neugeborene auszurichten.
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.