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While the topic of artificial intelligence (AI) in multinational enterprises has been receiving attention for some time, small and medium enterprises (SMEs) have recently begun to recognize the potential of this new technology. However, the focus of previous research and AI applications has therefore mostly been on large enterprises. This poses a particular issue, as the vastly different starting conditions of various company sizes, such as data availability, play a central role in the context of AI. For this reason, our systematic literature review, based on the PRISMA protocol, consolidates the state of the art of AI with an explicit focus on SMEs and highlights the perceived challenges regarding implementation in this company size. This allowed us to identify various business activities that have been scarcely considered. Simultaneously, it led to the discovery of a total of 27 different challenges perceived by SMEs in the adoption of AI. This enables SMEs to apply the identified challenges to their own AI projects in advance, preventing the oversight of any potential obstacles or risks. The lack of knowledge, costs, and inadequate infrastructure are perceived as the most common barriers to implementation, addressing social, economic, and technological aspects in particular. This illustrates the need for a wide range of support for SMEs regarding an AI introduction, which covers various subject areas, like funding and advice, and differentiates between company sizes.
While recent studies have demonstrated that events are fundamentally climate sensitive, this seems to not be fully considered in event research or corporate event practice. Thus, this study aims to identify the influencing factors that affect the acceptance of climate adaptation measures among decision-makers in the event industry. The analysis was divided into three main parts. First, the existing literature related to climate change in an events context was reviewed. Using 15 semi structured interviews, the findings from this review were then critically discussed with stakeholders in Germany involved in event planning. Finally, explicit climate adaptation measures were proposed and discussed. Based on all findings, there appears to be a low level of awareness of and interest in climate adaptation amongst German event industry players. There is an imminent need for further research on climate adaptation and for decision-makers to better prepare for climate change in order to counteract resulting negative impacts.
The 3GPP release 16 integrates TSN functionality into 5G and standardizes various options for TSN time synchronization over 5G such as transparent mode and bridge mode. The time domains for the TSN network and the 5G network are kept separate with an option to synchronize either of the networks to the other. The TSN time synchronization over 5G is possible either by using the IEEE 1588 generalized Precision Time Protocol (gPTP) based on UDP/IP multicast or via IEEE 802.1AS based on Ethernet PDUs. The INET and Simu5G simulation frameworks, which are both based on the OMNeT++ discrete event simulator, are widely used for simulating TSN and 5G networks. The INET framework comprises the 802.1AS based time synchronization mechanism, and Simu5G provides the 5G user plane carrying IP PDUs. We modified the 802.1AS-based synchronization model of INET so that it works over UDP/IP. With that, it is possible to synchronize TSN slaves (connected to 5G UEs), across a 5G network, with a TSN master clock, present within a TSN network, that is connected to the 5G core network. Our simulation results show that 500 microseconds of synchronization accuracy can be achieved with the corrected asymmetric propagation delay of uplink and downlink between the gNodeB (gNB) and the User Equipment (UE). Furthermore, the synchronization accuracy can be improved if the delay difference between uplink and downlink is known.
Recent real-time networking developments have enabled ultra reliability, very low latency and high data rates in wired networks. Wireless networking developments have also shown that they can achieve very high data rates with consistency, but they still lack in providing ultra reliability and extremely low latency. Time Sensitive Networking (TSN) developments have brought these capabilities in Industry automation and Automotive industry too. Although TSN is standardized for wired networks for a long time, for wireless networks it will be standardized within the IEEE 802.11be standard for Wi-Fi and 3GPP Release 17 for 5G in the near future. This paper provides an overview of TSN in wired and wireless networks with the aim of comparing different simulators and presenting their offered functionality and shortcomings. These tools can be used to make oneself familiar with TSN algorithms, standards, and for the development and testing of time sensitive networks. Afterwards, the paper discusses open research questions for using TSN over wireless networks.
Water retention properties of wood fiber based growing media and their impact on irrigation strategy
(2024)
Distribution of water and air in growing media during ebb-and-flow irrigation depends on water storage properties (water retention curve) and water transport properties (hydraulic conductivity) of the materials. Growing media with their high number of coarse pores are known to exhibit strong hysteresis, i.e., differences in the water retention properties during drying and wetting cycles. To account for potential ecological disadvantages of peat, wood fibers are commonly used as substitutes for peat in growing media. However, the wood fibers generally have higher air capacities and hydraulic conductivities and lower water capacities compared to peat which may results in necessary adaptions of the irrigation strategy. Tools to optimize irrigation systems are physically based water transport models, such as HYDRUS-1D, which is commonly used to describe water transport in soils, but not often for growing media. In this study, white peat and pure wood fibers were used to describe differences in their water retention behavior. Water retention curves (drying cycles) and hydraulic conductivities were measured with standard analytical procedures. Hysteresis of the water retention curves was analytically determined based on their capillary rise properties. The results were used with a modified HYDRUS-1D model to test model quality against measured water contents during ebb-and-flow irrigation cycles and to optimize the irrigation strategy for the different materials. The results showed that the model quality was sufficiently good only if the strong hysteresis of the water retention curves was considered during the simulation process. Different strategies were tested to modify ebb-and-flow irrigation (irrigation frequency, irrigation duration and irrigation height) in that way that the water suction in the root zone was similar to that of the peat material. Simulation results showed that significant improvements could only be reached by increasing the flooding depth in ebb-and-flow systems to ensure an optimum water supply of plants in the wood fiber based growing media.
Wood fibers can contribute to replacing peat in growing media and thus help to protect peatlands. As domestic, renewable raw materials, they represent a sustainable option for this purpose. To date, however, wood fibers are usually used as a peat substitute at a maxi-mum of 30% (v/v). A main reason for this limitation is the insufficient microbial stability of wood fibers, which favors nitrogen immobilization and can thus impair nitrogen supply of plants. To address this drawback, in this study wood fibers were subjected to different thermal or thermal-hydrolytic treatments. Seedling tests with napa cabbage were conducted to determine whether treated wood fibers were free of phytotoxic substances. Mixtures with 50% (v/v) wood fiber and white peat each were used. In addition, three wood fiber varieties were evaluated in the cultivation of petunia. Two wood fiber proportions (30 and 60% v/v) and two nitrogen fertilization rates (common and increased supply) were included in each case. In the seedling trial with napa cabbage, no phytotoxic effects were detectable in any of the wood fiber variants investigated. However, when cultivating petunias, both shoot mass growth and number of flowers decreased with increasing wood fiber content. In substrates with a wood fiber content of 60% (v/v), plant development was inhibited so severely that the petunias no longer achieved marketable quality. Increased nitrogen fertilization was able to compensate for this negative effect only in few cases. This suggests that other factors than nitrogen limited plant growth in wood fiber-rich substrates. Among others, physical proper-ties such as the lower water capacity of wood fibers may be a cause. More in-depth investigations are still required in this regard.
Enhancing the nutritional value of pears through agronomic biofortification with iodine (Abstract)
(2024)
Response of petunia to wood fibre amended peat substrate under ebb-and-flow irrigation (Abstract)
(2024)
Purpose
This study operationalizes risks in stakeholder dialog (SD). It conceptualizes SD as co-produced organizational discourse and examines the capacities of organizers' and stakeholders' practices to create a shared understanding of an organization’s risks to their mutual benefit. The meetings and online forum of a German public service media (PSM) organization were used as a case study.
Design/methodology/approach
The authors applied corpus-driven linguistic discourse analysis (topic modeling) to analyze citizens' (n = 2,452) forum posts (n = 14,744). Conversation analysis was used to examine video-recorded online meetings.
Findings
Organizers suspended actors' reciprocity in meetings. In the forums, topics emerged autonomously. Citizens' articulation of their identities was more diverse than the categories the organizer provided, and organizers did not respond to the autonomous emergence of contextualizations of citizens' perceptions of PSM performance in relation to their identities. The results suggest that risks arise from interactionally achieved occasions that prevent reasoned agreement and from actors' practices, which constituted autonomous discursive formations of topics and identities in the forums.
Originality/value
This study disentangles actors' practices, mutuality orientation and risk enactment during SD. It advances the methodological knowledge of strategic communication research on SD, utilizing social constructivist research methods to examine the contingencies of organization-stakeholder interaction in SD.
Compliance of agricultural AI systems : app-based legal verification throughout the development
(2024)
Significant advances in artificial intelligence (AI) have been achieved; however, practical implementation in agriculture remains limited. Compliance with emerging regulations, such as the EU AI Act and GDPR, is now vital, even for non-critical AI systems. Developers need tools to assess legal compliance, which is complex, often requiring full legal advice. To address this issue, we are developing a support app that simplifies the legal aspects of AI system development, covering the entire lifecycle, from conception to distribution. The current app, which covers the key legal area of copyright and will soon include GDPR and the AI Act, aims to bridge the gap between AI research and agriculture. An evaluation of our app by experts from both the legal and the IT domains shows that the app assists the developers so that they make legally correct statements. Consequently, it promotes legal compliance and awareness among developers, contributing to the seamless integration of AI into agriculture. The need for compliant AI systems in various industries, including agriculture, will only increase as regulations evolve.
Artificial intelligence (AI) promises transformative impacts on society, industry, and agriculture, while being heavily reliant on diverse, quality data. The resource-intensive "data
problem" has initialized a shift to synthetic data. One downside of synthetic data is known as the "reality gap", a lack of realism. Hybrid data, combining synthetic and real data, addresses this. The paper examines terminological inconsistencies and proposes a unified taxonomy for real, synthetic, augmented, and hybrid data. It aims to enhance AI training datasets in smart agriculture, addressing the challenges in the agricultural data landscape. Utilizing hybrid data in AI models offers improved prediction performance and adaptability.
The development of base metal electrodes that can act as active and stable oxygen generating electrodes in water electrolysis systems, especially at low pH levels, remains a challenge. The use of suspensions as electrolytes for water splitting has until recently been limited to photoelectrocatalytic approaches. A high current density (j=30 mA/cm2) for water electrolysis has been achieved at a very low oxygen evolution reaction (OER) potential (E=1.36 V vs. RHE) using a SnO2/H2SO4 suspension-based electrolyte in combination with a steel anode. More importantly, the high charge-to-oxygen conversion rate (Faraday efficiency of 88% for OER at j=10 mA/cm2 current density). Since cyclic voltammetry (CV) experiments show that oxygen evolution starts at a low, but not exceptionally low, potential, the reason for the low potential in chronoamperometry (CP) tests is an increase in the active electrode area, which has been confirmed by various experiments. For the first time, the addition of a relatively small amount of solids to a clear electrolyte has been shown to significantly reduce the overpotential of the OER in water electrolysis down to the 100 mV region, resulting in a remarkable reduction in anode wear while maintaining a high current density.
Introduction: Patients undergoing revision total hip surgery (RTHS) have a high prevalence of mild and moderate preoperative anemia, associated with adverse outcomes. The aim of this study was to investigate the association of perioperative allogeneic blood transfusions (ABT) and postoperative complications in preoperatively mild compared to moderate anemic patients undergoing RTHS who did not receive a diagnostic anemia workup and treatment before surgery. Methods: We included 1,765 patients between 2007 and 2019 at a university hospital. Patients were categorized according to their severity of anemia using the WHO criteria of mild, moderate, and severe anemia in the first Hb level of the case. Patients were grouped as having received no ABT, 1–2 units of ABT, or more than 2 units of ABT. Need for intraoperative ABT was assessed in accordance with institutional standards. Primary endpoint was the compound incidence of postoperative complications. Secondary outcomes included major/minor complications and length of hospital and ICU stay. Results: Of the 1,765 patients, 31.0% were anemic of any cause before surgery. Transfusion rates were 81% in anemic patients and 41.2% in nonanemic patients. The adjusted risks for compound postoperative complication were significantly higher in patients with moderate anemia (OR 4.88, 95% CI: 1.54–13.15, p = 0.003) but not for patients with mild anemia (OR 1.93, 95% CI: 0.85–3.94, p < 0.090). Perioperative ABT was associated with significantly higher risks for complications in nonanemic patients and showed an increased risk for complications in all anemic patients. In RTHS, perioperative ABT as a treatment for moderate preoperative anemia of any cause was associated with a negative compound effect on postoperative complications, compared to anemia or ABT alone. Discussion: ABT is associated with adverse outcomes of patients with moderate preoperative anemia before RTHS. For this reason, medical treatment of moderate preoperative anemia may be considered.
Background
Beta-blocker (BB) therapy plays a central role in the treatment of cardiovascular diseases. An increasing number of patients with cardiovascular diseases undergoe noncardiac surgery, where opioids are an integral part of the anesthesiological management. There is evidence to suggest that short-term intravenous BB therapy may influence perioperative opioid requirements due to an assumed cross-talk between G-protein coupled beta-adrenergic and opioid receptors. Whether chronic BB therapy could also have an influence on perioperative opioid requirements is unclear.
Methods
A post hoc analysis of prospectively collected data from a multicenter observational (BioCog) study was performed. Inclusion criteria consisted of elderly patients (≥ 65 years) undergoing elective noncardiac surgery as well as total intravenous general anesthesia without the use of regional anesthesia and duration of anesthesia ≥ 60 min. Two groups were defined: patients with and without BB in their regular preopreative medication. The administered opioids were converted to their respective morphine equivalent doses. Multiple regression analysis was performed using the morphine-index to identify independent predictors.
Results
A total of 747 patients were included in the BioCog study in the study center Berlin. 106 patients fulfilled the inclusion criteria. Of these, 37 were on chronic BB. The latter were preoperatively significantly more likely to have arterial hypertension (94.6%), chronic renal failure (27%) and hyperlipoproteinemia (51.4%) compared to patients without BB. Both groups did not differ in terms of cumulative perioperative morphine equivalent dose (230.9 (BB group) vs. 214.8 mg (Non-BB group)). Predictive factors for increased morphine-index were older age, male sex, longer duration of anesthesia and surgery of the trunk. In a model with logarithmised morphine index, only gender (female) and duration of anesthesia remained predictive factors.
Conclusions
Chronic BB therapy was not associated with a reduced perioperative opioid consumption.
The objective of this article is to prepare for the initial certification according to IFS Global Markets Food V3 at the Landshuter Brauhaus AG private brewery at the Ellermühle site, which is expected in August 2025, and to create the basis for a potential follow-up certification according to IFS Food. The IFS Global Markets Food Program V3 is a standardized, voluntary and non-accredited assessment program for food companies, both for retail and manufacturer brand products (IFS 2023, p. 10 f.). It is based on the specifications of the Global Markets Program developed in 2008 (GFSI 2023a; VDOE 2020, p. 620).
The methodology of the target/actual analysis was used to work on the topic in order to be able to carry out a conformity check with regard to the requirements of IFS Global Markets Food V3 (see Appendix 3; IFS 2023). Observations, document analyses and employee surveys were carried out to obtain the most meaningful information possible. These have been recorded and evaluated within the target-performance analysis. A total of 65 deviations (equivalent to 53.7%) were identified at the basic level, and 60 deviations (equivalent to 82.2%) at the intermediate level. These were either processed as directly implemented corrective actions or formulated as recommendations for continuous improvement in the form of an action plan (see Appendix 15). The presentation of the action plan shows the deviations, the resulting measures, the associated responsibilities, the time period with the starting point and end point of the measures, and the current status. In addition a subdivision into "Basic" and "+Intermediate" was made for a better overview in the subsequent processing by the brewery.
A review as well as assessment of relevant requirements with regard to processes and significant violations after completion of the new building and commissioning at the Ellermühle site with regard to correlation with a potential "major" rating is recommended on the part of the operations manager or brewmaster (IFS 2023, p. 30).
The demands placed on companies in terms of up-to-date quality and sustainability management as well as health and safety measures are high and are becoming increasingly complex. Increased legal requirements, additional industry standards and derived customer requirements constantly present companies and value chains with new challenges. The integrated approach to the implementation of these different requirements has already taken place in companies in recent years. However, small businesses still find it difficult to face the complexity of requirements on their own without an accompanying consultation. Qualint is a support tool, which is currently available in the 3rd version. The tool supports companies in setting up and continuously developing their integrated management system with coordinated hybrid service bundles. The focus is on combining the fields of action of quality, environmental and sustainability management as well as occupational safety and health.The article illustrates how quality management can be used as a basis for building up digital and organizational structures in companies and value chains. The focus is on sustainability aspects and ethical requirements that are closely related to people, such as occupational health and safety. Compliance with human rights is required in ISO 26000 and is also part of occupational safety and health. Furthermore, compliance with human rights and corresponding working conditions is also regulated by the new Supply Chain Duty Act (LkSG). It shows how demands on companies have grown and how the consulting tool Qualint has developed accordingly.
The development of non-precious metal-based electrodes that actively and stably support the oxygen evolution reaction (OER) in water electrolysis systems remains a challenge, especially at low pH levels. The recently published study has conclusively shown that the addition of haematite to H2 SO4 is a highly effective method of significantly reducing oxygen evolution overpotential and extending anode life. The far superior result is achieved by concentrating oxygen evolution centres on the oxide particles rather than on the electrode. However, unsatisfactory Faradaic efficiencies of the OER and hydrogen evolution reaction (HER) parts as well as the required high haematite load impede applicability and upscaling of this process. Here it is shown that the same performance is achieved with three times less metal oxide powder if NiO/H2 SO4 suspensions are used along with stainless steel anodes. The reason for the enormous improvement in OER performance by adding NiO to the electrolyte is the weakening of the intramolecular O─H bond in the water molecules, which is under the direct influence of the nickel oxide suspended in the electrolyte. The manipulation of bonds in water molecules to increase the tendency of the water to split is a ground-breaking development, as shown in this first example.
Artificial intelligence (AI) and human-machine interaction (HMI) are two keywords that usually do not fit embedded applications. Within the steps needed before applying AI to solve a specific task, HMI is usually missing during the AI architecture design and the training of an AI model. The human-in-the-loop concept is prevalent in all other steps of developing AI, from data analysis via data selection and cleaning to performance evaluation. During AI architecture design, HMI can immediately highlight unproductive layers of the architecture so that lightweight network architecture for embedded applications can be created easily. We show that by using this HMI, users can instantly distinguish which AI architecture should be trained and evaluated first since a high accuracy on the task could be expected. This approach reduces the resources needed for AI development by avoiding training and evaluating AI architectures with unproductive layers and leads to lightweight AI architectures. These resulting lightweight AI architectures will enable HMI while running the AI on an edge device. By enabling HMI during an AI uses inference, we will introduce the AI-in-the-loop concept that combines AI's and humans' strengths. In our AI-in-the-loop approach, the AI remains the working horse and primarily solves the task. If the AI is unsure whether its inference solves the task correctly, it asks the user to use an appropriate HMI. Consequently, AI will become available in many applications soon since HMI will make AI more reliable and explainable.
Bamboo is an environmentally friendly alternative to conventional materials in mechanical engineering such as steel or aluminium. Bamboo is the fastest growing plant in the world. Instead of releasing CO2 during the manufacturing process, bamboo absorbs CO2 as it grows.
In addition to the sustainability aspect, bamboo tubes also offer excellent properties as a lightweight construction material, which have been optimised through evolution. Bamboo tubes have high strength and stiffness at low weight when used as tension-compression bars or bending beams. Bamboo has strong, high-density fibres at the boundary area, where bending stresses are greatest. Towards the inside, where the stresses are lower, the bamboo becomes porous to optimise weight. This, together with knots arranged in regular intervals, counteracts buckling.
In mobile applications such as cars and bicycles, lightweight construction is sought for energy efficiency reasons. Because of its excellent lightweight properties, the project investigated whether bamboo could be used in mobile, automotive or agricultural engineering. For example, a bamboo bicycle frame has been developed with the aim to be as light as possible. There are bamboo bicycles on the market, but they can only be made one at a time by hand. The bamboo tubes are joined together and functional elements such as the bottom bracket and headset are integrated by wrapping them in resin-impregnated natural or carbon fibres. This makes the joints very heavy. A different approach is taken here: the bamboo tubes are drilled out slightly to achieve a defined internal diameter, and then short aluminium tubes are glued into the bamboo canes from the inside. To prevent the cane from breaking in the circumferential direction, i.e. perpendicular to the fibre direction, the bamboo tubes are wrapped in a thin layer of natural or carbon fibre impregnated with synthetic resin. The aluminium tubes and functional elements are welded or soldered together beforehand.
The design of the bicycle frame, i.e. the dimensioning of the bamboo tubes and joints, was based on extensive bending and tensile tests to determine the strength properties of the natural material bamboo. The bonding between the bamboo cane and the aluminium tube was also investigated experimentally. Finally, several prototype bicycle frames were made and tested for durability according to DIN-EN-14764. The frames passed the tests.
The result is a bamboo bicycle that is manufactured with standardised connectors and joints. The assembly concept developed allows both fully automated and semi-automated series production of bamboo bicycles.
Biomechanical analyses are capable of capturing and evaluating human motions. In addition to the major biomechanical fields of kinetics and kinematics, electromyography (EMG) provides a reliable way to analyse neuromuscular activities, e.g. inter- and intramuscular coordination or fatigue behavior. Based on these parameters it is possible to conclude to clinically relevant parameters such as motor control, muscular coordination or compensation strategies with different loads. In addition to this, EMG can be used in treatment itself, e.g. biofeedback-training with an EMG is an effective and evidenced based tool to improve neuromuscular control. The purpose of this workshop is to show the advantages of implementing EMG in performing artists´ health and to demonstrate additional therapy and diagnostic options.
This workshop briefly introduces the theoretical principles of EMG and the clinical applications in the context of performing artists´ health. It explains why EMG provides an additional value in the clinical reasoning process and supports the therapist, but decision making in the clinical reasoning process should never be based on EMG solely.
In the further course of the workshop the use of EMG in diagnostics and therapy (biofeedback) with performing artists is practically demonstrated and discussed with the participants.
Approach of Presentation:
1. Short presentation: introduction and understanding of EMG (educational objective 1)
2. Short case presentation of a performing artist to introduce EMG in the field of performing artists´ health and clinical reasoning (educational objective 2)
3. Interactive practical demonstration (diagnosis and biofeedback-training) as the central part of the workshop. Questions and comments will be discussed directly throughout the group (educational objective 3)
Clinical Significance:
EMG based functional neuromuscular diagnostics and biofeedback-training provides both the therapist as well as the performing artist with additional value in their clinical work.
Educational Objectives:
At the end of the workshop, the participants will be able to…
1. understand and describe the basic principles of EMG
2. understand and describe the importance of EMG in the context of performing artists´ health, physical therapy and clinical reasoning
3. use EMG on performing artists in the performance process
Nostalgia is a construct that, even when rooted in lived experiences, serves the ultimate purpose of creating a desired sense of world. Fundamental cognitive competencies, including memory and imagination, are utilized by the nostalgic subject to fulfill a need for narrative coherence. A temporal or spatial distance is necessary for the occurrence of a nostalgic episode, which can be conceptualized as a “had been” state of being, as direct access to the experience is often impossible. Nostalgia may thus be viewed as a tool for sense-making rather than solely as a yearning for the past. The nostalgic narrative form is a construct that permits human subjects to comprehend their existence in the world while drawing upon their roots. These tools for sense-making serve as bridges between past experiences and current conditions. Ultimately, nostalgic identity is not just about longing for the past but also about utilizing the past as a resource for navigating the labyrinths of the present. Analyses are conducted to examine the medium of music video at three levels - auditory, visual, and linguistic - in order to investigate the strategies and techniques employed by the Iranian diaspora to create nostalgic narratives. Samples of original pieces and renditions are contrasted in order to identify elements of nostalgic narrativity. Drawing on empirical research, it is argued that the unity of a music video arises from the integration of separate layers of sensory and conceptual inputs that have been composed towards an affective resonance and narrative coherence.
In modern times, closed-loop control systems (CLCSs) play a prominent role in a wide application range, from production machinery via automated vehicles to robots. CLCSs actively manipulate the actual values of a process to match predetermined setpoints, typically in real time and with remarkable precision. However, the development, modeling, tuning, and optimization of CLCSs barely exploit the potential of artificial intelligence (AI). This paper explores novel opportunities and research directions in CLCS engineering, presenting potential designs and methodologies incorporating AI. Combining these opportunities and directions makes it evident that employing AI in developing and implementing CLCSs is indeed feasible. Integrating AI into CLCS development or AI directly within CLCSs can lead to a significant improvement in stakeholder confidence. Integrating AI in CLCSs raises the question: How can AI in CLCSs be trusted so that its promising capabilities can be used safely? One does not trust AI in CLCSs due to its unknowable nature caused by its extensive set of parameters that defy complete testing. Consequently, developers working on AI-based CLCSs must be able to rate the impact of the trainable parameters on the system accurately. By following this path, this paper highlights two key aspects as essential research directions towards safe AI-based CLCSs: (I) the identification and elimination of unproductive layers in artificial neural networks (ANNs) for reducing the number of trainable parameters without influencing the overall outcome, and (II) the utilization of the solution space of an ANN to define the safety-critical scenarios of an AI-based CLCS.
Background: Multilingual children with suspected SLCN are often overlooked or their needs not accurately differentiated regarding the necessity of language support or therapy. The purpose of the study was to conceptualize, carry out and evaluate a local language support (LS) project within linguistically and culturally diverse (LCD) families and its effects on all collaborating participants.
Methods: Eight SLT students and one lecturer took part in the LS-project, alongside equivalent numbers of family liaison personnel. Students visited more than 10 young children aged between 2-6 years, and for each child 10 weekly home visits were carried out. Language enhancement was documented, several case studies with children and interviews with five liaison personnel conducted.
Results: All SLT students perceived changes in the behaviour and communication of participating children. Children in the case studies developed from pre-verbal to verbal means of communication and family liaison personnel reported positive changes alongside parental wishes to continue the support.
Conclusion: Local language support projects with LCD families can lead to positive differences regarding their children's communication development and better inclusion in mainstream society. SLT students benefit from working with LCD families and their collaborative support together with family liaison personnel, and vice versa.
Learning Outcomes: To differentiate the influence of language enhancement vs. formalized SLT therapy. To enhance the relationship with LCD clientele and collaboration with liaison personnel in SLCN settings. To incorporate life-long learning and intercultural sensitization.
Purpose
Sedentary behaviour (SED) and low level of physical activity (PA) might be associated with the development or worsening of pain. Still, studies assessing physical behaviours by accelerometry in individuals with orofacial pain are limited. This study aims to assess whether women with temporomandibular disorders (TMD) present different patterns of physical behaviours in days with (DWP) or without pain (DWoP).
Methods
Twenty-nine out of forty-four women (mean age 29.21 sd 7.96) were diagnosed with TMD and monitored over seven days using a thigh-worn accelerometer. DWP was determined when subjects presented pain in one of the craniocervical regions (head, jaw and neck) with intensity of at least 3 in the numerical rating scale. To be considered a DWoP, the individual presented less than 3 points in the three regions. Daily time-use compositions were described in terms of SED in short (<30 min) and long (≥30 min) bouts, light PA (LPA), moderate-to-vigorous PA (MVPA), and time-in-bed. Isometric log-ratios (ilr) were calculated to express the ratio of time-in-bed to time spent awake, SED relative to LPA and MVPA, SED in short relative to long bouts, and LPA relative to MVPA. Differences between DWP and DWoP were examined using MANOVA, followed by univariate post-hoc tests of pairwise differences.
Results
During DWP, women with TMD spent more time in SED in short (239 min) and long bouts (419 min), less time in LPA (245 min), MVPA (68 min), and in bed (468 min) compared with DWoP (235, 378, 263, 70 and 493 min, respectively). The MANOVA showed that all sets of ilrs did not differ statistically (ηp2 = 0.19, p = 0.25). Still, the post-hoc tests showed a trend that time spent SED relative to LPA and MVPA was larger in DWP than in DWoP (Cohen’s d = 0.36, p = 0.05).
Conclusions
Women with TMD did not show different patterns of physical behaviours in DWP or DWoP. However, there is a trend of more sedentary behaviour and less physical activity in DWP compared to DWoP. Future studies should consider other pain intensity cut-offs, isolated pain locations, and larger sample sizes to confirm these results.
The aim of this European interprofessional Health Informatics (HI) Summer School was (i) to make advanced healthcare students familiar with what HI can offer in terms of knowledge development for patient care and (ii) to give them an idea about the underlying technical and legal mechanisms. According to the students’ evaluation, interprofessional education was very well received, problem-based learning focussing on cases was rated positively and the learning goals were met. However, it was criticised that the online material provided was rather detailed and comprehensive and could have been a bit overcharging for beginners. These drawbacks were obviously compensated by the positive experience of working in international and interprofessional groups and a generally welcoming environment.
Background and Aims
Early identification of nerve lesions and associated neuropathic pain in spine-related pain disorders is important for tailored treatment. Management may consist of surgical intervention for compressive neural lesions.
With a growing waitlist for public surgical outpatient clinics in Western Australia and wait times exceeding the recommended wait time for initial assessment (Category 1 – assessment within 1 months, Category 2 within 3 months, category 3 within 12 months), a call to support new models of care has been made1, including the evaluation and expansion of workforce models supporting advanced skills in allied health.1
An Advanced Scope Physiotherapy (ASP) led Neurosurgery Spinal Clinic operates at Sir Charles Gairdner Hospital in Western Australia. The ASPs (2FTE) examine patients from the neurosurgery waitlist for their suitability for spinal surgery. Recommendation of either further investigation and possible assessment by a neurosurgeon or appropriate non-surgical management of the patients’ pain condition is suggested. Patient assessment is conducted either ‘in person’ at the hospital or via telehealth due to the remoteness of some rural patients. Patient cases are discussed with a neurosurgery consultant on a weekly basis. The aim of this project is to evaluate the ASP service in the year 2022.
Method
A retrospective descriptive analysis of patient data captured in 2022 was performed.
Results
In 2022, 1337 new patient referrals were managed plus 267 follow-ups from the previous year. Category 1 patients (n=81) waited on average 31 days for their first appointment, Category 2 patients (n=394) waited 76 days and Category 3 patients (n=854) waited 376 days.
287 (18%) referrals were discharged without physical assessment of the patient (DNA, cancellations, declined). Of the 1317 patients physically assessed by the ASPs (57%) were discharged directly after assessment, for 290 patients (22%) their outcome was still pending at time of analysis (March 2023) and 281 (22%) patients were referred for review with a neurosurgeon. Of the 229 patients assessed by a neurosurgeon (including patients from 2022), 103 patients (45%) were offered surgery, 52 (23%) were not offered surgery, 46 ( 20%) patients had to be reviewed, and for the remaining (n=18) their outcome was unknown.
Conclusion
Of the 1604 patients managed in the Neurosurgery Spinal Clinic, only 17% needed to see a neurosurgeon. The conversion rate to surgery of 45% is higher compared to an estimated 5%-10% in a non-triaged clinic.
The ASP model of care has proved invaluable to (i) provide access of patient care within the recommended wait times (ii) optimize neurosurgeons’ time, (iii) educate patients and, in case of non-suitability for surgery, advise and refer them for alternative appropriate management.
Relevance for Patient Care
The Advanced Scope Physiotherapy model of care at the Neurosurgery Spinal Clinic allows timely assessment of patients with spine-related disorders and supports targeted management of their condition.
Ethical Permissions
This project is registered as a Quality Improvement Project at Sir Charles Gairdner Hospital (QI35728) and as per the National Statement on Ethical Conduct in Human Research was exempt from review by the Sir Charles Gairdner Hospital Human Research and Ethics Committee
References
1Sustainable Health Review (2019). Sustainable Health Review: Final report to the Western Australian Government of Health, Western Australia
Workshop: “‘Sciatica’: neuropathic or not and does it matter? Outcomes from a NeuPSIG working group”
(2023)
The identification of neuropathic pain in persons with spine-related leg pain is important as this information guides treatment and management, including self-management. The NeuPSIG neuropathic pain grading system was developed to assist clinicians and researchers in determining whether patients have neuropathic pain and the level of confidence associated with that decision. Based on clinical and laboratory examination findings, patients are classified as having no neuropathic pain, possible, probable or definite neuropathic pain. Whereas this grading system works nicely in people with systemic neuropathies where sensory findings and diagnostic tests are mostly present, its application in patients with spine-related leg pain, particular in radicular pain, can be challenging. For example, in the absence of sensory changes and MRI findings, patients with radicular pain would at best reach a classification of possible neuropathic pain according to the current neuropathic pain grading system.
In this presentation I will explain the adaptations to the neuropathic pain grading system for spine-related leg pain recommended by the NeuPSIG working group. I will demonstrate its application in clinical practice using case studies and provide clarity for how the system can be incorporated in clinical trials. This will be an interactive session with audience participation.
Methods: Systematic review of randomized controlled trials (RCT). Searches were conducted in five electronic databases. Studies were selected if they included patients with NP over 18 years old treated with aerobic exercise (AE) (e.g., cycling, running, hiking, and walking). The main outcome of interest was pain intensity. Qualitative and quantitative data were extracted. The risk of bias (RoB) was determined using the Cochrane RoB Tool-2 and the overall certainty of the evidence with the GRADE recommendations.
Results: Out of 21,585 initial records screened, a total of six individual studies published in ten manuscripts were included. There was a great heterogeneity between protocols, comparisons, and studies’ results (different magnitudes and directions). When looking at the effect of aerobic exercise versus control groups or other interventions on pain intensity measured with the VAS, not statistically (nor clinical) significant differences between aerobic exercise and control groups (MD [95%CI] 5.16 mm [-6.38, 16.70]) were identified. The combined effect of AE plus other interventions seems to be effective. Strength exercise obtained better effects than aerobic exercises (MD [95%CI]: -11.34 mm [-21.6, -1.09]).
Conclusions: Aerobic exercise presented positive results to reduce pain intensity, and improving disability, and physical and emotional functioning. However, the evidence is restricted, low quality, and heterogeneous.
Methods: The searches were conducted on five electronic databases. RCTs or CTs with patients over 18 years old of both sexes with OFP diagnoses were targeted. The intervention of interest was AE (i.e., walking, cycling, and running), compared to any other conservative and non-conservative therapy. The primary outcome was pain intensity. Risk of bias (RoB) was done with the Cochrane RoB tool (RoB 2). The overall certainty of the evidence was evaluated with GRADE.
Results: Out of 21,585 initial records found in the initial database search, only one study (reported on three manuscripts) was included. The diagnosis of interest was headache plus temporomandibular disorders (TMD). Three treatment groups (strengthening (Str) exercise + manual therapy (MT) (G1); AE + MT + Str exercises (G2); AE (G3)) were compared. The main outcome was pain; the secondary outcomes included disability, strength, anxiety, and quality of life. The combined treatment (AE+MT+Str exercises) had the strongest effect to decrease pain and headache intensity in patients with OFP (SMD: 9.99 [95%CI: 7.19, 12.80].
Conclusions: a multimodal treatment strategy achieved the greatest positive effects on pain and other outcomes in the short/medium term. AE seems to be an important component of this strategy. However, the scientific evidence supporting AE’s isolated effect is limited, indicating a research gap in this scientific field.
The excitement sparked by the emergence of AI open platforms has encountered significant scrutiny from educators and educational planners, who have raised valid concerns about issues such as plagiarism, testing protocols, and the authenticity of content submitted by students. While these concerns are timely and crucial, it's essential not to overlook other pressing issues that often go unnoticed in the lived educational experience of learners, particularly within the field of social sciences. This paper aims to advocate for a humanistic approach with a focus on education in the generative AI Era.
Hyperhydricity (HH) is one of the most important physiological disorders that negatively affects various plant tissue culture techniques. The objective of this study was to characterize optical features to allow an automated detection of HH. For this purpose, HH was induced in two plant species, apple and Arabidopsis thaliana, and the severity was quantified based on visual scoring and determination of apoplastic liquid volume. The comparison between the HH score and the apoplastic liquid volume revealed a significant correlation, but different response dynamics. Corresponding leaf reflectance spectra were collected and different approaches of spectral analyses were evaluated for their ability to identify HH-specific wavelengths. Statistical analysis of raw spectra showed significantly lower reflection of hyperhydric leaves in the VIS, NIR and SWIR region. Application of the continuum removal hull method to raw spectra identified HH-specific absorption features over time and major absorption peaks at 980 nm, 1150 nm, 1400 nm, 1520 nm, 1780 nm and 1930 nm for the various conducted experiments. Machine learning (ML) model spot checking specified the support vector machine to be most suited for classification of hyperhydric explants, with a test accuracy of 85% outperforming traditional classification via vegetation index with 63% test accuracy and the other ML models tested. Investigations on the predictor importance revealed 1950 nm, 1445 nm in SWIR region and 415 nm in the VIS region to be most important for classification. The validity of the developed spectral classifier was tested on an available hyperspectral image acquisition in the SWIR-region.
Dairy farming has been the subject of public debate on animal welfare for a number of years now. Animal welfare discussions on dairy farming often include the demand for more nature connectedness in this area. This study focuses on the divergent perspectives of consumers and scientists on the importance of more nature connectedness for animal welfare strategies in German dairy farming. Within Europe, Germany is the main producer of cow’s milk and an important industry in many rural areas in Germany is dairy farming. The insights presented are based on qualitative interviews with dairy farming and livestock researchers from Germany and Austria. A key finding of this study is that we need to look more closely at the actual content of nature claims in animal welfare debates. The scientists interviewed tend to see idealized conditions in animal welfare discussions with images of nature which in fact seldom lead to improved conditions in dairy farming and, even then, only to a limited extent. The scientists interviewed rate calls for more nature connectedness in dairy farming from the nonagricultural public as anti-modern, complexity-reducing, and normative. Nevertheless, some of the scientists interviewed did have valuable insights into the nonagricultural public’s criticism of dairy farming practices. These scientists argued, however, that animal welfare needs to differentiate between nature connectedness and the innate needs of cattle when it comes to animal welfare strategies. An important conclusion of the study is that more discussion formats are needed to promote the exchange of ideas between different social groups attempting to understand animal welfare in dairy farming.
Background
The current development of sensor technologies towards ever more cost-effective and powerful systems is steadily increasing the application of low-cost sensors in different horticultural sectors. In plant in vitro culture, as a fundamental technique for plant breeding and plant propagation, the majority of evaluation methods to describe the performance of these cultures are based on destructive approaches, limiting data to unique endpoint measurements. Therefore, a non-destructive phenotyping system capable of automated, continuous and objective quantification of in vitro plant traits is desirable.
Results
An automated low-cost multi-sensor system acquiring phenotypic data of plant in vitro cultures was developed and evaluated. Unique hardware and software components were selected to construct a xyz-scanning system with an adequate accuracy for consistent data acquisition. Relevant plant growth predictors, such as projected area of explants and average canopy height were determined employing multi-sensory imaging and various developmental processes could be monitored and documented. The validation of the RGB image segmentation pipeline using a random forest classifier revealed very strong correlation with manual pixel annotation. Depth imaging by a laser distance sensor of plant in vitro cultures enabled the description of the dynamic behavior of the average canopy height, the maximum plant height, but also the culture media height and volume. Projected plant area in depth data by RANSAC (random sample consensus) segmentation approach well matched the projected plant area by RGB image processing pipeline. In addition, a successful proof of concept for in situ spectral fluorescence monitoring was achieved and challenges of thermal imaging were documented. Potential use cases for the digital quantification of key performance parameters in research and commercial application are discussed.
Conclusion
The technical realization of “Phenomenon” allows phenotyping of plant in vitro cultures under highly challenging conditions and enables multi-sensory monitoring through closed vessels, ensuring the aseptic status of the cultures. Automated sensor application in plant tissue culture promises great potential for a non-destructive growth analysis enhancing commercial propagation as well as enabling research with novel digital parameters recorded over time.
Iron deficiency is a global issue and can lead to a variety of clinical pictures. The biofor-tification of vegetables with iron could complement the existing portfolio of iron-rich products, thus improving iron supply in the long term. In order to determine whether the iron-biofortified vegetables could meet this demand and would address appropriate target groups, a quantitative online survey was conducted in Germany. Based on 1000 consumer responses, a cluster analysis was performed. The results showed a four-cluster solution. The first cluster was holistically engaged, the second was fitness-affine but health unconcerned, the third cluster consists frugal eaters with a focus on medical prevention, and the fourth cluster are hedonists. No cluster focused its consumption on iron-enriched products, but instead all developed an individual mix of the three product groups.
The mineralization of soil organic nitrogen (N) and crop residues can significantly contribute to the N supply of vegetable crops. However, short-term mineralization dynamics are difficult to predict. On the other hand, fast-growing crops like spinach are highly sensitive to N shortage. Therefore, in situ soil columns have been tested to estimate the actual N supply via mineralization in field-grown spinach. In ten fertilization trials covered soil columns (20 cm in diameter) were driven into the soil to a depth of 30 cm at the start of the cultivation. Eight columns were repeated in three blocks within a total trial area of 0.10 to 0.25 ha. Net N mineralization was derived by subtracting the soil mineral N concentration (Nmin) in the upper 30 cm before installation from the concentration inside the columns at harvest. For comparison, a balance sheet was calculated for spinach plots receiving no N fertilization (zero plots) as well as fertilized plots and used as a proxy for net N mineralization. In this approach the initial Nmin concentration in the upper 30 cm of the soil, the N supply via irrigation, and fertilization as well as the total aboveground N uptake by spinach and the Nmin residue were considered. By using soil columns, N mineralization was determined with a mean coefficient of variation of 18%. A higher spatial variability of up to 43% was observed when spinach was grown as a second crop. The average net N mineralization rate ranged between 2 kg ha‑1 week‑1 (0-30 cm) in winter-grown spinach and 3-7 kg ha‑1 week‑1 (0-30 cm) in the other seasons. Nitrogen mineralization measured by the soil columns was qualitatively confirmed with the data obtained by the balance sheet. Soil columns enable repeated samplings during the spinach cultivation. In this way, top dressing rates can be adjusted to the actual N supply.
Spinach is a nitrogen (N)-demanding crop characterized by a shallow root architecture. Especially in the first weeks after sowing, significant N uptake is limited to the uppermost few centimetres of the soil. However, base fertilization is usually based on the soil mineral N (Nmin) concentration in the upper 30 cm. Therefore, the objective of this study was to examine whether the soil sample depth for calculating the base N fertilization can be reduced to the 0-15 cm layer. In seven field trials, conducted during spring, summer and autumn seasons, either a low or high base fertilization dose was applied at sowing. Until top dressing, soil samples were frequently taken in the upper 0-15 and 15-30 cm layers to determine the average Nmin concentration in each layer. Top dressing was applied when the first true leaves had unfurled. With this fertilizer application, the total N supply was aligned between both treatments based on the Nmin concentration in the upper 30 cm of the soil. Aboveground fresh and dry masses were determined after reaching a fresh mass yield of 15-20 t ha‑1 and related to the mean Nmin concentration in the first 3 to 4 weeks of cultivation between sowing and top dressing. It was shown that the Nmin concentration in the upper 0-15 cm of the soil highly reflects the base fertilization rate. By contrast, the Nmin concentration in the 15-30 cm layer remained unaffected. However, the Nmin concentration of both top soil layers can affect fresh and dry mass yield at harvest. Therefore, the entire 0-30 cm soil layer should be considered when calculating the base N fertilization rate in field-grown spinach. Measurements revealed that spinach fresh and dry masses were increased until the N availability of between 54 and 59 kg ha‑1 (0-30 cm) was reached at the seedlings stage, respectively.
In September 2022, the interprofessional European Summer School on the topic “Information in Healthcare – From Data to Knowledge” was held at the University of Porto. This Summer School included the topics Interoperability, Data Protection and Security and Data Analytics and consisted of an online preparation phase and an attendance phase in Porto. The didactic concept involved problem-based learning using a case study. A variety of course materials were developed and used to achieve the learning objectives. There are plans to continue the Summer School concept at participating institutions in the future, starting with a Spring School 2023 in Osnabrück.
IO6 is a report of the evaluation of the online courses and Summer School. The project plan of eHealth4all@EU guides the evaluation. The aim of the evaluation is to present the strengths and developing parts of the project. The main evaluation themes are eHealth, inter-professional education, and problem-based learning. For the funder’s perspective, evaluation focusing themes of digital support, lifelong learning, an active citizen, and the future. Evaluation of the project assign around all these themes and will find out students’ and teachers’ feelings of satisfaction, efficiency, and quality of the learning experience.
Interoperability, Data Protection and Security and Data Analytics are of high relevance for the future of eHealth and interprofessional care. Three online courses were therefore designed and delivered for these topics, all of which followed the same structure. A variety of materials were developed and different tools for knowledge transfer, communication and collaboration were used.
Primary Liver Cancers : Connecting the Dots of Cellular Studies and Epidemiology with Metabolomics
(2023)
Liver cancers are rising worldwide. Between molecular and epidemiological studies, a research gap has emerged which might be amenable to the technique of metabolomics. This review investigates the current understanding of liver cancer’s trends, etiology and its correlates with existing literature for hepatocellular carcinoma (HCC), cholangiocarcinoma (CCA) and hepatoblastoma (HB). Among additional factors, the literature reports dysfunction in the tricarboxylic acid metabolism, primarily for HB and HCC, and point mutations and signaling for CCA. All cases require further investigation of upstream and downstream events. All liver cancers reported dysfunction in the WNT/β-catenin and P13K/AKT/mTOR pathways as well as changes in FGFR. Metabolites of IHD1, IDH2, miRNA, purine, Q10, lipids, phosphatidylcholine, phosphatidylethanolamine, acylcarnitine, 2-HG and propionyl-CoA emerged as crucial and there was an attempt to elucidate the WNT/β-catenin and P13K/AKT/mTOR pathways metabolomically.
The University of Eastern Finland was the responsible partner of IO1: European eHealth Education: Policy and Practice Review. The aim of this intellectual output was to customize and validate the already existing international health informatics recom-mendations. Based on that the aim was also to describe the priorities of core compe-tencies and learning outcomes particularly in the fields addressed by this project. The methods used were a scoping review and focus group interviews. The aim of the scoping review was to explore how education in health informatics (HI) has been taught by evaluating the existing international frameworks and reported ed-ucations in HI. The scoping review was conducted based on the instructions of Joanna Briggs Institute to find English language publications published between 2016 and 2020. All publications found in the bibliographical database MEDLINE via PubMed, Scopus and Web of Sciences were included. The results indicated that education in HI is essential to everyone, and everyone needs skills and knowledge in both technical and non-technical skills in HI. Education in HI should be introduced already in the first year of the education and with time increase the knowledge to a more advanced level. The teaching methods can vary between lectures in class to a more hybrid method. The aim of the online focus group interview was to investigate the needs of HI compe-tencies in health care. To achieve the answers, two main questions were used as a base of the interview. The first question focused on how knowledge and competencies in health informatics could contribute to improving health care. The second question focused on which HI competencies are seen as important to learn and how to achieve them. Online focus group interviews were conducted in each of the three countries. The interviews were done the own languages (German, Portuguese, and Finnish) and later summarized and translated to English. The focus group interviews concluded that there are challenges and possibilities in health informatics. It also highlighted the com-petencies seen as important to have in daily working life. For example, skills in appli-cations in patient care, knowledge in IT-background and IT related management are considered important.
Problem-based learning (PBL) has become established as a successful didactic approach far beyond the field of medicine. Although there is no single concept of PBL, there is agreement on its objectives and implementation. Of central importance is the case that supports autonomous and reflective learning. Even before COVID-19, digital methods were used in traditional PBL. These served to support, for example, the provision of learning materials. As a result of university closures during the COVID-19 pandemic, technical solutions were made available at an unprecedented speed, which made it possible to implement the different requirements of traditional PBL in a digital PBL (DPBL). The present study results based on two scoping reviews demonstrated that PBL can be implemented digitally and that different digital methods, both asynchronous and synchronous, are available for the different steps. They show that DPBL not only leads to comparable student performance, but can also develop further competences, e.g. digital communication. With the findings, a concept for the implementation of DPBL as well as recommendations for the further development of DPBL are available.
This report summarizes and discusses the development, main achievements and overall progress of The Interprofessional European eHealth Programme in Higher Education (eHealth4all@EU) project. The project evolved through a strong partnership between members of the consortium, grounding its activities on previous initiatives like TIGER and taking them one step further while looking into the digital health competencies required by graduate students working in health and care and providing teaching approaches and other initiatives to extend further a set of core competencies: Health Information Systems Interoperability, Data Security and Privacy and Data Analytics. Although the project activities underwent during the pandemic period, a condition that forced reorganization and adaptation of the workplan, the main initiatives like the identification of significant areas of interest for digital health competencies and related relevant teaching methods that foster active learning paved the way for the construction of learning content structured around a syllabus aimed at distance learning and faceto- face learning moments developed with the intent for reuse and fostering the development of these set of competences in future Health Professionals. To this purpose, we are convinced that grounding steps have been taken with these eHealth4All@EU activities and initiatives.
Aims and Objectives:
Preventive home visits are a low-threshold counselling and support approach. They have been reported to achieve heterogeneous effects. However, preventive home visits have the potential to reduce the risk of becoming dependent on long-term care. The aim of this study is to investigate the effect of preventive home visits as a nursing intervention on health-related quality of life of older people in a longitudinal survey and to develop recommendations for which target groups preventive home visits have the highest benefit. The sample consisted of 75 people, aged between 65 and 85, who were able to understand and speak German, had not yet been eligible for benefits from the long-term care insurance and lived in the municipality under study.
Methodological Design and Justification:
A quantitative longitudinal study in order to investigate the effects of preventive home visits.
Ethical Issues and Approval:
There were no ethical concerns. Accordingly, ethical approval was granted.
Research Methods, Results and Conclusions:
The health-related quality of life was recorded four times between 01/2017 and 08/2020 with the Short-Form- Health- Survey- 12 and analysed using descriptive statistics. Results reveal that the physical health status cannot be easily influenced over a short period of time. The main effect, however, is that preventive home visits have a significant positive effect on the mental health status. The main topics during the home visits were mobility, nutrition and social participation. Increased knowledge and motivation for preventive behaviour extended the autonomy of older people. Accordingly, preventive home visits can support a self-determined life in a familiar environment. The results of the present study show that preventive home visits as a nursing intervention in rural areas are successful. In Germany, preventive home visits have not yet been implemented on a regular basis. In order to do so, a general definition of the concept is needed. Preventive home visits should be officially included in the regular health care services in Germany.