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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.
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.
background: Musculoskeletal problems (MP) are widespread in performing artists and are due to the special demands of instrument playing, singing or dancing. Additionally, various other factors might contribute to performance-related MP. To provide a specific physiotherapeutic management for performing artists it is important to gain information about the performing art, the individual demands and contributing factors. The subjective examination (SE) is the basis of the clinical reasoning process and the hypothesis forming for further clinical examination and biomechanical analysis. In the present protocol, the SE consists of a questionnaire-based section and an interview-based section and is part of the evaluation process of the neuromusculoskeletal examination of a performing artist specific reference laboratory.
purpose: To develop a standardized SE protocol divided into a questionnaire-based section (Part 1) via web application and an interview-based SE (Part 2) to address MP of performing artists.
methods: The questionnaires for part 1 were selected based on the expertise of the research group and the psychometric properties of each possible questionnaire. A common physiotherapeutic recording of findings which addresses the relevant questions of the SE of MP was used. To adapt the anamnesis to performing-associated MP questions specific to instrument playing, singing and dancing were selected on the basis of a literature search and the expertise of the research group.
summary of content/results: Part 1 consists of three topics. (1) information about the performing art, professional level and sociodemographic data, (2) information about pain and pain processing, and (3) the anatomical location of the main MP including a body region-specific questionnaire. Part 2 is based on the five aspects of clinical practice described by Maitland and the Musculoskeletal Clinical Translation Framework by Mitchell et al. The performing arts specific part is particularly focused on performing art specific considerations, physical and psychosocial contributing factors and art-specific activities.
significance: This standardized SE protocol should help clinicians evaluating the musculoskeletal health of performing artists in a standardized and specific way.
Background: Musculoskeletal problems (MP) are widespread in performing artists and are due to the special demands of instrument playing, singing or dancing. In order to specifically evaluate these problems, a reference laboratory is under development. The evaluation covers 4 steps: a subjective examination (SE) including (1) a questionnaire-based online survey and (2) an interview-based anamnesis. On the basis of the results of the SE, hypotheses are formed for (3) an individual musculoskeletal clinical examination and a (4) biomechanical analysis. Here, the focus is on the clinical examination.
Purpose: to develop a standardized protocol for a clinical examination addressing especially musculoskeletal problems in performing artists.
Methods: A common physiotherapeutic clinical examination should be supplemented with techniques, which are specific to performance-related musculoskeletal problems and/or their risk factors. The development was based on a literature search and the clinical expertise of the physiotherapeutic research group.
Summary of content/Results: The performing arts specific clinical examination includes the common analysis of posture as well as passive/active movement capacities and specific differentiating tests in relation to the signs and symptoms of the individual artist. The examination is supplemented by a functional demonstration focusing on the special demands of playing the respective instrument, while singing or dancing. Common overuse risk factors like hypermobility, special anthropometric data or an examination of the motor control of different body regions are addressed. Optional, the various parts of the examination process could be skipped, if not relevant for the individual artist.
Significance: This clinical examination protocol should help clinicians evaluating the musculoskeletal health of performing artists in a standardized and specific way.
Talent scarcity in emerging economies such as India poses challenges for companies. Limited labour market participation among well-educated women has been observed. The reasons that professionals decide not to pursue a further corporate career remain unclear. By investigating their career decision making, this handout summerizes research results from a study that aims to highlight the contextual factors that impact those decisions.
Following a qualitative research design interviews with internationally experienced Indian business professionals show that rebellion against Indian societal and family expectations is essential to following a career path, especially for women. The current institutional framework of society and organizations serves as a legitimizing façade veiling traditional practices that hinder females’ careers.
This paper introduces ideas to reduce talent scarcity by binding female talent in India. As a theoretical lens Neo-Institutionalism in the Indian context is combined with the family-relatedness of work decision model. The qualitative research design and first results as well as propositions for companies are included.
Talent scarcity in many parts of the world leads to the necessity to enlarge talent pools in order to provide enough future holders of key positions. Taking the scholarly discussion at the overlap of talent management and current careers literature as a starting point our qualitative empirical research provides insights in talent’s career decisions in an eastern emerging market, India, and a western developed country, Germany. 49 interviews with internationally experienced knowledge-workers were held to find out how to they come to career decisions throughout their career. Special focus was the balancing act of professional and private life sphere. An inductive-deductive approach was used to develop categories in MaxQda. Results show the impact of institutional frame, cultural context, and gender differences. Consequently, a stronger focus on talent’s different life phases with context specific deviations when configuring Talent Management in Multinational Enterprises can be advised.
Despite the wealth of literature on requirements engineering, little is known about engineering very generic, innovative and emerging requirements, such as those for cross-sectional information chains. The IKM health project aims at building information chain reference models for the care of patients with chronic wounds, cancer-related pain and back pain. Our question therefore was how to appropriately capture information and process requirements that are both generally applicable and practically useful. To this end, we started with recommendations from clinical guidelines and put them up for discussion in Delphi surveys and expert interviews. Despite the heterogeneity we encountered in all three methods, it was possible to obtain requirements suitable for building reference models. We evaluated three modelling languages and then chose to write the models in UML (class and activity diagrams). On the basis of the current project results, the pros and cons of our approach are discussed.
Requirements Engineering für Referenzmodelle mittels eines multimethodischen Vorgehensmodells
(2012)
Obwohl es zahlreiche Arbeiten zum Requirements Engineering im Allgemeinen gibt, ist über die Ermittlung generischer und innovativer Anforderungen, wie sie in intersektoralen Informations-ketten eine Rolle spielen, wenig bekannt. Das Projekt IKM health zielt auf die Entwicklung von Referenzmodellen für Informationsketten zur Patientenversorgung ab. Forschungsfrage dieser Studie war, wie Informations- und Prozessanforderungen generiert werden können. Vor diesem Hintergrund wurde mit der Analyse von Leitlinien begonnen, deren Empfehlungen anschließend im Rahmen von Delphi-Befragungen und Experteninterviews zur Diskussion gestellt wurden. Trotz der sich zeigenden Heterogenität war es mit Hilfe des hier vorgestellten multimethodischen Vorgehensmodells möglich, passende Anforderungen zu erzielen und in UML zu modellieren.
Communication deficits belong to the most frequent errors in patient handovers calling upon specialized training approaches to be implemented. This study aims to harness problem-based learning (PBL) methods in handover education and evaluated the learning process. A digitally enabled PBL course was developed and implemented at Klinikum Osnabrück from which eight nurses participated in the course. They agreed on the stimulating effect of the setting regarding self-directed learning and on the potential to translate the new knowledge and skills into the daily clinical practice. In conclusion, the findings are promising that a digitally enabled PBL course is a suitable learning format for handover education.
The article describes an analysis of the use of e-learning to improve the learning transfer to practice in continuing education. Therefore an e-learning offer has been developed as a part between two attendance periods of a training course in the field of Ambient Assisted Living (AAL). All participants of the course were free to use the e-learning offer. After the end of the e-learning part we compared the e-learning users to the other participants. Using an online questionnaire we explored if there are differences in the activities in the field AAL after the training course. The results show that e-learning is beneficial especially for communication processes. Due to the fact that the possibility to talk about the learning content is an essential factor for the learning transfer, e-learning can improve the learning success.
An Iterative Methodology for Developing National Recommendations for Nursing Informatics Curricula
(2016)
The increasing importance of IT in nursing requires educational measures to support its meaningful application. However, many countries do not yet have national recommendations for nursing informatics competencies. We thus developed an iterative triple methodology to yield validated and country specific recommendations for informatics core competencies in nursing. We identified relevant competencies from national sources (step 1), matched and enriched these with input from the international literature (step 2) and fed the resulting 24 core competencies into a survey (120 invited experts from which 87 responded) and two focus group sessions with a total of 48 experts (steps 3a/3b). The subsequent focus group sessions confirmed and expanded the findings. As a result, we were able to define role specific informatics core competencies for three countries.
Going Mobile : An Empirical Model for Explaining Successful Information Logistics in Ward Rounds
(2018)
Background: Medical ward rounds are critical focal points of inpatient care that call for uniquely flexible solutions to provide clinical information at the bedside. While this fact is undoubted, adoption rates of mobile IT solutions remain rather low.
Objectives: Our goal was to investigate if and how mobile IT solutions influence successful information provision at the bedside, i.e. clinical information logistics, as well as to shed light at socio-organizational factors that facilitate adoption rates from a user-centered perspective.
Methods: Survey data were collected from 373 medical and nursing directors of German, Austrian and Swiss hospitals and analyzed using variance-based Structural Equation Modelling (SEM).
Results: The adoption of mobile IT solutions explains large portions of clinical information logistics and is in itself associated with an organizational culture of innovation and end user participation.
Conclusion: Results should encourage decision makers to understand mobility as a core constituent of information logistics and thus to promote close end-user participation as well as to work towards building a culture of innovation.
The establishment of successful clinical information logistics (CIL) within the care processes is one of the main objectives of strategic health IT management in hospitals. While technical realisations in terms of useful, usable and interoperable IT solutions are essential precursors of CIL, there is limited empirical research on what socio-organisational factors underlie an innovation-friendly culture and how they can affect successful information provision. We applied factor analysis on survey data from 403 clinical directors from Germany, Austria and Switzerland and used the dimensions identified to explain the level of CIL with ordered logistic regression analysis. The intensity of collaboration and exchange with the IT department as well as the degree of executive IT leadership showed to be strongly associated with better CIL while personal views and attitudes of clinical directors were not. Analysing country differences revealed the degree of the exchange with the IT department to be significantly lower in German hospitals. This points at a potential strategic lever for German hospital executives to focus on.
Hospital CIOs play a central role in the adoption of innovative health IT. Until now, it remained unclear which particular conditions constitute their capability to innovate in terms of intrapersonal as well as organisational factors. An inventory of 20 items was developed to capture these conditions and examined by analysing data obtained from 164 German hospital CIOs. Principal component analysis resulted in three internally consistent components that constitute large portions of the CIOs innovation capability: organisational innovation culture, entrepreneurship personality and openness towards users. Results were used to build composite indicators that allow further evaluations.
Continuity of care is a concept that is defined as the uninterrupted and coordinated care provided to a patient and that includes an informational dimension which describes the information exchange between the parties involved. In nursing, the nursing summary is the main instrument to ensure informational continuity of care. The aim of this paper is to present an HL7 Clinical Document Architecture based document standard for the eNursing Summary and to discuss the need for harmonizing these results at international level. The eNursing Summary proposed in this paper was developed on the basis of several internationally accepted concepts, primarily the nursing process, the ISO 18104 Reference Terminology Model for Nursing and various data sets. The standardisation process embraced several phases of involving nursing experts for validating its structure and content. It was finally evaluated by a network of 100 healthcare organizations. We argue that the eNursing Summary is a good starting point for standardising nursing discharge and transfer documents on a global level. However, further work is needed to bring together the different national and international strands in standardisation.
Handovers need a common ground on the clinical cases between the members of the successive shifts to establish continuity of care. Conventional electronic patient record systems (EHR) proved to be only insufficiently suitable for supporting the grounding process. Against this background we proposed a basic concept for a handover EHR that extends general EHRs in particular openEHR based systems. The resulting handover information model was implemented in a database and evaluated based on 120 clinical cases. The information items of these cases could be mapped successfully to the model, however, the new class “anticipatory guidance” needed to be introduced. The evaluation also demonstrated the importance of highly aggregated information on the clinical case, opinions and meta-information such as the relevance of an item during handovers. Based on these findings, in particular the handover database, handover EHR applications are currently developed to support the grounding process.
Aims: Intercultural competence has become a key-competence, since the world has become more and more volatile, uncertain, complex and ambiguous. Therefore, insights in the development of intercultural competence and its´ links to individual traits are crucial for companies and researchers to face the requirements in a VUCA world. This study examines the relationship between the time, students spent abroad, personality traits and circumstances during this time with the student’s intercultural competence and integration performance in the target culture. The study had a correlative cross-sectional design. Design and sample: A total of 202 academic subjects were surveyed. The average age was 22 years. There was one measuring time, to which 58 % of the participants stated that they have had a stay abroad. Measurements: Metacognitive, cognitive, motivational and behavioural intercultural competence were measured with the Cultural Intelligence Scale. The personality traits involvement, discipline, social competence, cooperation, dominance and stability were captured with the "Bochum inventory for job-related personality description-6F". Work-related attitudes as patterns of behaviour and experience were measured using the "Work-related Behaviour and Experiencing Pattern 44" (German: Arbeitsbezogene Verhaltens- und Erlebensmuster, AVEM). This scale captures the way participants relate to work in general based on the measurement of personality traits and their fit to specific clusters, which describe, whether individuals have healthy or risky patterns. In addition, the demographic factors and characteristics of stays abroad as well as the integration into the target culture based on the Sociocultural Adaption Scale were examined. The data was tested for relationships and differences by tests for mean differences, variance and regression analyses. Results: There was a positive correlation between duration and cognitive, motivational and behavioural intercultural competence. The motivational competence is higher in subjects who have no risk pattern in the AVEM. The different types of competence influence each other at diverse times. Moreover, the suggested structural equation model could be confirmed. This showed the effect of the AVEM pattern on intercultural competence, moderated by the stay abroad and the social competence. Thus, the study contributes to the understanding of both the measurement of intercultural competence and the development process of intercultural competence in a globalized world.
Do multipliers have to be more sensitized for the issue diversity? Do they have to develop specific competences? Which do they already have? These questions were analysed by a qualitative investigation. Ca. 70 interviews with managers of the large DAX companies and employees were conducted. The results show a field of tension between self-perception and perception of others and the assessment of the relevance of diversity attitudes and measures, competences and their actual implementation. The results indicate the need of promotion of competences, especially regarding the intercultural competence. We position ourselves in a functionalist perspective, in line with the work on paradigms of Burell and Morgan (2017) and Deetz (1996) in social sciences and Cross-Cultural Management. We present these results from a functionalist perspective in order to ensure the greatest possible "objectivity".
The central aim of the investigation at hand is to deal with the problem areas of Human Resource Management, which arise by demographic changes and migration. The paper focuses on mutual relationships. Managers and human resource managers are considered as multipliers. Older employees, migrants and women are important potential. Therefore, following research questions have been investigated: Which competences are necessary to promote to recognise the potential of migrants correctly and to promote them? Do the multipliers have to be more sensitized for the issue diversity? Do they have to develop specific competences to make the system more permeable and to make the entry and promotion of migrants possible? Which competences should be promoted to increase the sensitivity for diversity? The questions were examined by a qualitative investigation to develop hypotheses for a quantitative study. Overall, 30 interviews with managers, human resource managers and diversity representatives of the large DAX companies were conducted. Furthermore, 17 employees with immigration background and 15 employees without an immigration background were interviewed. The data was transcribed and analysed by the qualitative content analysis according to Mayring (2010). Comparative analyses were made with single items with Likert Scales. The investigation of managers and employees is a highly diversified issue. Therefore, the main focus of the project lays on the problem areas, conflicts and competences of human resources managers in demographic-sensitive personnel management. In comparison, employees with and without an immigration background were asked. The results show an interesting field of tension between self-perception and perception of others and the assessment of the relevance of diversity attitudes and measures, competences and their implementation. Furthermore, a contrary perception regarding strains and stresses of person with and without immigration background is determined, which is developed in the consequences of migrations stress and experiences of discrimination. The results indicate the need of promotion of competences, especially regarding intercultural competence. A critical analysis of the results will be presented.
Kurzfassung: Die vorliegende Untersuchung setzt sich mit den Problemfeldern der Personalauswahl und -entwicklung auseinander, welche die demografischen Veränderungen in Bezug auf Migration mit sich bringen. Explorativ soll die Ausprägung von sozialen und interkulturellen Kompetenzen und der Aspekt Diversity in Unternehmen untersucht werden. Hierzu wurden 69 Interviews durchgeführt und die intervallskalierten Selbsteinschätzungsskalen quantitativ verglichen. Die Ergebnisse zeigen, dass Mitarbeiter die Relevanz von Diversity-Einstellungen und Maßnahmen, Kompetenzen und Umsetzung dieser deutlich höher bewerten als die Führungskräfte. Die Ergebnisse weisen auf den Bedarf einer Kompetenzförderung hin, insbesondere in Bezug auf die interkulturelle Kompetenz.
Kurzfassung: Die vorliegende Untersuchung untersucht die Auswirkungen
der Dauer eines Auslandsaufenthaltes von Studierenden sowie von arbeitsbezogenen Persönlichkeitsfaktoren und Charakteristika auf die interkulturelle Kompetenz und die Integration der Teilnehmer. Die Untersuchung erfolgte in Form einer korrelativen Querschnittstudie. Insgesamt 202 Probanden mit akademischer Ausbildung wurden untersucht. Es wurden die interkulturelle Kompetenz, Persönlichkeitsmerkmale und arbeitsbezogene Einstellungen gemessen, sowie demographische Faktoren des Auslandsaufenthaltes und die Integration in die Zielkultur. Es gibt einen positiven Zusammenhang zwischen der Dauer von Auslandsaufenthalten und kognitiver, motivationaler und verhaltensbezogener interkultureller
Kompetenz.
Access to digital technologies depends on the availability of technical infrastructure, but this access is unequally distributed among social groups and newly summarized under the term digital divide. The aim is to analyze the perception of a tracing app to contain Covid-19 in Germany. The results showed that participants with the highest level of formal education rate the app as beneficial and were the most likely to use the app.
Comparison of quantitative sensory testing profles between people living in Germany and Australia
(2021)
In Germany, a lot of young children at risk of language difficulties still go undetected or are not assessed before preschool-age. For children where parents may suspect a disorder, this practice causes a lot of emotional distress alongside lost time for intervention. Thus, what contribution can parents and nursery staff make for the earlier detection of language difficulties? 34 children from four German kindergartens were tested with a standardized preschool screening for language problems by an SLT. Parents and nursery staff completed a questionnaire (FEE 3-4) that was designed to collect potential risk-factors and included the rating of children’s abilities across the main language domains. Outcomes from the FEE 3-4 were compared between parents and nursery staff as well as triangulated with results from the standardized screening. Agreement between parents and nursery staff re. individual children’s potential language difficulties was moderate (Kappa = 0.44, p = .050). Overall, nursery staff rated children’s language abilities more strictly and precisely than parents. Especially their rating of ‘word order’ (p = .022) and ‘verb endings’ contributed significantly to the identification of potential language difficulties similar to the standardized screening. The screening identified two children at risk without caregiver's concern, but not two others who were at risk of language disorder and for whom caregivers expressed concern. Caregiver’s awareness of early language difficulties appears to be rather intuitive. Young children at risk are most reliably detected if standardized instruments are used in combination with caregiver questionnaires. Ideally, this process includes data from parents and nursery staff to be interpreted by an experienced SLT, as the use of a standardized screening alone may lead to missed or mistaken identification where essential information about the child’s environment (e.g. risk factors) is not provided. If parents are concerned about children’s language, full assessment is clearly justified.
The increasing complexity of caseloads in SLT practice, e.g. due to higher comorbidity, lacking information or experience in the
treatment of complicated cases, calls for support from experienced as well as specialist practitioners from within the field - especially
for novice therapists. One way to tackle these challenges may be peer coaching and how it can be employed within the educational
and professional SLT setting.
Peer coaching was implemented across five semesters of a successive SLT study programme at a University of Applied Sciences in
Germany. The approach was embedded in a clinical reasoning seminar with 25 SLT students who each presented a challenging case
study from their current workload. All participants completed a short online survey to evaluate the feasibility of the team approach
within this setting as well as their personal benefit and development re. the discussed case studies.
Students felt encouraged by being able to share their experience and tackle actual challenges. They particularly valued receiving
answers from a broad range of other SLTs but also contributing to other students’ queries and providing practical solutions for
them. All participants felt that peer coaching was an appropriate approach for clinical reasoning to support their professional as well
as personal development. Other outcomes were a perceived increased ability to employ metacognitive reflection to be used with
their whole caseload but also a prospective need for further training. Some students suggested the employment of peer coaching
within their work setting.
In the educational as well as professional SLT setting, peer coaching can be successfully employed, triggering metacognitive
reflection re. practitioner’s thinking and acting, resulting in an increased awareness of needs and skills as part of the clinical
reasoning process.
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.
The Corona pandemic confronted societies with several unexpected constraints that had the effect of making certain goods much scarcer than before. Withdrawal from Russian oil and gas supplies has a similar effect. Carbon abatement can also be seen as a deliberate choice to make certain goods scarc-er than they actually are. These parallels suggests that it may be worthwhile to take a close look at societies’ responses to all three challenges. This paper makes an attempt to synthetize empirical and theoretical insights regarding these scarcity shocks from a well-being perspective, i.e. replacing the prevalent welfare economic focus on production and consumption with a focus on sustainable well-being.
Taking the case of Germany, it will be argued that the observed responses to all three challenges reflect a focus on maintaining incomes and production and that therefore these responses risk being detrimental to sustainable wellbeing and even to economic stability. This is particularly relevant if carbon abatement requires not only transient material sacrifices but lasting and significant reduc-tions of consumption.
It will be argued that the impact of these new scarcities will be much less problematic in a society that acknowledges the priority of sustainable wellbeing over production and consumption measures. Such a society would still need to incur material sacrifices, but these need not translate into a loss of wellbeing if economic conditions and social norms adapt. This will also be more sustainable not only in terms of ecological impact, but also in terms of debt, inflation and inequality.
This workshop will review the history of the TIGER initiative in order to set the framework for an understanding of international informatics competencies. We will include a description of clinical nursing informatics programs in 37 countries as well as the results of a recent survey of nursing competencies in order to further discussions of internationally agreed-upon competency definitions. These two surveys will provide the basis for developing a consensus regarding the integration of core competencies into informatics curriculum developments. Expected outcomes include building consensus on core competencies and developing plans toward implementing intra- and inter-professional informatics competencies across disciplines globally.
Teachers in health informatics have a broad variety of international and national educational recommendations to rely on when designing programmes, curricula, courses and educational material. However, in addition they often need very specific information for their setting, blue-prints, hands-on experience and encouragement to try something new. This workshop presents three case studies from European universities who have implemented inter-professional, technology enabled health informatics courses in undergraduate, postgraduate and open university settings. These approaches will be put into the context of the TIGER recommendation framework that includes priority ratings of health informatics competencies and case studies to illustrate them. The workshop attendees will have ample opportunity to exchange ideas with the presenters and start a mutual learning process for health informatics teachers.
This study describes the eHealth4all@eu course development pipeline that builds upon the TIGER educational recommendations and allows a systematic development grounded on scientific and field requirements of competencies, a case/problem-based pedagogical approach and finally results in the syllabus and the course content. The pipeline is exemplified by the course Learning Healthcare in Action: Clinical Data Analytics.
This paper describes the methodology and developments towards the TIGER International Recommendation Framework of Core Competencies in Health Informatics 2.0. This Framework is meant to augment the scope from nursing towards a series of six other professional roles, i.e. direct patient care, health information management, executives, chief information officers, engineers and health IT specialists and researchers and educators. Health informatics core competency areas were compiled from various sources that had integrated the literature and were grouped into consistent clusters. The relevance of these core competency areas was rated in a survey by 718 professional experts from 51 countries. Furthermore, 22 local case studies illustrated the competencies and gave insight into examples of local educational practice. The Framework contributes to the overall discourse on how to shape health informatics education to improve quality and safety of care by enabling useful and successful health information systems.
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.
Building on Rogers’ Diffusion of Innovation Theory, Bass models describe the diffusion processes distinguishing between innovation (p) and imitation (q). This study aimed at modelling the uptake of RIS, PACS and EHR systems in Germany and Finland. The Bass models revealed a quick and almost identical uptake process across all three systems for Finland. In contrast, the Bass models mirrored a slower uptake in Germany. Consequently, the Finnish “imitation” coefficients were larger than the German ones. While in Germany almost free market forces were driving the adoption through imitation but without tail wind from policy, the adoption process in Finland was centrally governed. This suggests that the diffusion process in Finland reflected a well-managed roll-out of the systems rather than imitation behaviour. Thus, in order for Bass model coefficients to be understood properly, additional contextual information is required.
Radiology has a reputation for having a high affinity to innovation – particularly with regard to information technologies. Designed for supporting the peculiarities of radiological diagnostic workflows, Radiology Information Systems (RIS) and Picture Archiving and Communication Systems (PACS) developed into widely used information systems in hospitals and form the basis for advancing the field towards automated image diagnostics. RIS and PACS can thus serve as meaningful indicators of how quickly IT innovations diffuse in secondary care settings – an issue that requires increased attention in research and health policy in the light of increasingly fast innovation cycles. We therefore conducted a retrospective longitudinal observational study to research the diffusion dynamics of RIS and PACS in German hospitals between 2005 and 2017. Based upon data points collected within the “IT Report Healthcare” and building on Rogers’ Diffusion of Innovation (DOI) theory, we applied a novel methodological technique by fitting Bayesian Bass Diffusion Models on past adoption rates. The Bass models showed acceptable goodness of fit to the data and the results indicated similar growth rates of RIS and PACS implementations and suggest that market saturation is almost reached. Adoption rates of PACS showed a slightly higher coefficient of imitation (q = 0.25) compared to RIS (q = 0.11). However, the diffusion process expands over approximately two decades for both systems which points at the need for further research into how innovation diffusion can be accelerated effectively. Furthermore, the Bayesian approach to Bass modelling showed to have several advantages over the classical frequentists approaches and should encourage adoption and diffusion research to adapt similar techniques.
The diabetic foot ulcer, which 2% – 6% of diabetes patients experience, is a severe health threat. It is closely linked to the risk of lower extremity amputation (LEA). When a DFU is present, the chief imperative is to initiate tertiary preventive actions to avoid amputation. In this light, clinical decision support systems (CDSS) can guide clinicians to identify DFU patients early. In this study, the PEDIS classification and a Bayesian logistic regression model are utilised to develop and evaluate a decision method for patient stratification. Therefore, we conducted a Bayesian cutpoint analysis. The CDSS revealed an optimal cutpoint for the amputation risk of 0.28. Sensitivity and specificity were 0.83 and 0.66. These results show that although the specificity is low, the decision method includes most actual patients at risk, which is a desirable feature in monitoring patients at risk for major amputation. This study shows that the PEDIS classification promises to provide a valid basis for a DFU risk stratification in CDSS.
Diabetic foot ulcer (DFU) is a chronic wound and a common diabetic complication as 2% – 6% of diabetic patients witness the onset thereof. The DFU can lead to severe health threats such as infection and lower leg amputations, Coordination of interdisciplinary wound care requires well-written but time-consuming wound documentation. Artificial intelligence (AI) systems lend themselves to be tested to extract information from wound images, e.g. maceration, to fill the wound documentation. A convolutional neural network was therefore trained on 326 augmented DFU images to distinguish macerated from unmacerated wounds. The system was validated on 108 unaugmented images. The classification system achieved a recall of 0.69 and a precision of 0.67. The overall accuracy was 0.69. The results show that AI systems can classify DFU images for macerations and that those systems could support clinicians with data entry. However, the validation statistics should be further improved for use in real clinical settings. In summary, this paper can contribute to the development of methods to automatic wound documentation.
Venous leg ulcers and diabetic foot ulcers are the most common chronic wounds. Their prevalence has been increasing significantly over the last years, consuming scarce care resources. This study aimed to explore the performance of detection and classification algorithms for these types of wounds in images. To this end, algorithms of the YoloV5 family of pre-trained models were applied to 885 images containing at least one of the two wound types. The YoloV5m6 model provided the highest precision (0.942) and a high recall value (0.837). Its mAP_0.5:0.95 was 0.642. While the latter value is comparable to the ones reported in the literature, precision and recall were considerably higher. In conclusion, our results on good wound detection and classification may reveal a path towards (semi-) automated entry of wound information in patient records. To strengthen the trust of clinicians, we are currently incorporating a dashboard where clinicians can check the validity of the predictions against their expertise.
This study investigates how microenterprises in Ethical Fashion (EF) retail adopt and make use of social media. Drawing on an explorative case study, supplemented by an action research approach, we first examine the antecedents of a successful Adoption based on the Technology-Organization-Environment (TOE) framework. Subsequently, we shed light on the benefits and drawbacks of social media adoption for the three microenterprises of our case study on the operational and the strategical level. More particularly, we present how they improve value creation through the employment of social media in their value networks and how they overcome the lack of a sophisticated IT infrastructure. Finally, we investigate the reluctance of the three microenterprises to adopt inter-organizational information systems. The findings of our study also reveal a halo effect in the adoption process that may mislead the adopting organization.
Studien indizieren, dass die Generation Z, die sogenannten „Digital Natives“, einen leichten Zugang zu Informations- und Kommunikationstechnologien (IKT) hat. Zugleich attribuieren sich die Individuen dieser Generation auch selbst eine hohe IKT-Affinität. Diese Kombination legt gewisse Lehrmethoden (wie Selbststudium oder Projektarbeit) im Rahmen der Hochschullehre auch für ERP-Systeme nahe. An diesem Punkt setzt dieser Beitrag an und zeigt in einem Experiment anhand von zwei SAP-Lernumgebungen mit vier Studierendengruppen, dass die unreflektierte und implizite Annahme der hohen IKT-Affinität recht trügerisch und kontraproduktiv für die Lehre ist. Von Studierenden selbst gewählte Lernmethoden haben dabei das Nachsehen. Damit einhergehend führen mehrdimensionale Lehrmethoden zu messbar höheren Lernerfolgen. Theoretisch begleitet wird diese Arbeit vom Technology Acceptance Model (TAM).
Pandemie, Nachfrageschocks und Krieg können Unternehmen an den Rand Ihrer Überlebensfähigkeit treiben. Eine Stärkung der Resilienz und der Nachhaltigkeit ist nachweislich durch Digitalisierung möglich. Aber welche Aspekte der Digitalisierung sind für die unternehmerische Resilienz besonders relevant und werden in der Praxis zielorientiert verfolgt? Diese Arbeit nutzt einen Multimethodenansatz, bestehend aus einem systematischen Literaturreview sowie aus semi-strukturierten Experteninterviews, um die obigen Fragen zu adressieren. Die Ergebnisse indizieren, dass aktuell die drei Themenfelder Dynamic Pricing, Process Mining und Self-Service Reporting/BI besonderen Fokus genießen. Andere Themenfelder hingegen, wie Neurale Netze, Blockchain Technologie, Gamification oder Text Mining werden in der Literatur zwar intensiv diskutiert, finden in der Praxis allerdings nach wie vor selten Einzug.
Seit den 90er Jahren des letzten Jahrhunderts zählt Coaching zu den etablierten Methoden der Personalentwicklung. Ursprünglich handelte es sich dabei um eine Beratungssituation, in der eine Führungskraft in mehreren Einzelsitzungen mit einem Coach Probleme des Arbeitsalltags bespricht, Lösungsansätze entwickelt und deren Umsetzung in die Wege leitet. Im Fahrwasser dieses wirtschaftlich erfolgreichen Ansatzes werden inzwischen unterschiedlichste Methoden unter dem Label „Coaching“ vermarktet, die nicht einmal mehr Plausibilität für sich in Anspruch nehmen können. Drei dieser Ansätze – Horse Sense, Organisationsaufstellung und Spirituelles Coaching – sollen kurz vorgestellt und kritisch hinterfragt werden. Am Ende des Vortrags steht eine Analyse der Vermarktungsstrategien sowie der Gründe dafür, dass derartige Methoden überhaupt Abnehmer finden.
Rationale:
Neck pain is a large health problem worldwide and often seen in musicians [1, 2]. Neck pain can radiate into the arm due to various underlying pain types and pain mechanisms making it heterogeneous in clinical signs and symptoms [3-5]. On the one hand, patients may present with dominant nociceptive neck-arm pain caused by activation of the nociceptors in muscles, joints, ligaments, fascia, tendons and the connective tissues of a nerve [6, 7]. Activation of nociceptors in nerve connective tissues may cause clinical signs of heightened nerve mechanosensitivity what is per definition categorized as nociceptive pain [6, 8, 9]. On the other hand, patients may present with dominant neuropathic pain, defined as pain as a direct consequence of a lesion or disease affecting the somatosensory system [10, 11]. The clinical profile of these different pain types is sometimes difficult to disentangle based on the localization and pain character [12]. Moreover, non-specific neck-arm pain patients shown a neuropathic pain component based on somatosensory changes detected via Quantitative Sensory Testing (QST) [3, 13]. Classifications with a defined physical examination pathway can be helpful to define subgroups to guide the clinical decision making [14]. This workshop updates the background about the pathophysiology of neck-arm pain and mediates an evidence-based examination to classify patients.
Purpose:
The aim of this workshop is to give a current insight into the background and evidence of neck-arm pain and to plan and practice a physical examination.
Content of Presentation:
This workshop will summarize evidence of neck-arm pain. Thereupon, current evidencebased diagnostic options will be presented and practiced together. Finally, a short insight in the management of neck-arm pain will be given.
Approach of Presentation:
QST testing and current cost-effective evidence-based methods will be presented to identify neuropathic components in neck-arm pain. Selected methods will be performed practically together, e.g. bedside sensory testing and neurodynamic tests.
Clinical Significance:
After the workshop, participants will have improved skills to diagnose in the spectrum of neck-arm pain for musicians with neck-arm pain.
At the end of the presentation, the participants will be able to:
- understand the heterogeneity of neck-arm pain,
- plan an appropriate diagnostic physical examination,
- have an insight in possible management strategies.
Background:
Neck pain is one of the most common musculoskeletal pains and among the fourth leading causes of years of life lost due to disability, following back pain, depression, and arthralgia. (1)
In the course of their lives, about 70% of all people will experience a clinically relevant episode of neck pain, (2) so finding a good therapy to treat it is of high interest. Aerobic exercise is associated with pain reduction in patients with different types of MSK pain. Recent studies have shown a positive impact of aerobic exercises on brain function, memory processing, cognition, and motor function. (3, 4)
Therefore, the influence of aerobic exercise on pain modulation seems to be of particular interest for individuals with chronic MSK pain, since brain imaging studies have shown that these patients have structural and functional changes, as well as abnormal brain features in various areas of the brain. The evidence regarding the effectiveness of aerobic exercise for neck pain seems limited and outdated.
Thus, a systematic review evaluating the effects of aerobic exercise in patients with neck pain is needed. Therefore, this review aims to investigate the effectiveness of aerobic exercise interventions when compared to other conservative and non-conservative interventions (e.g., localized exercises, medication, acupuncture, physical agents, manual therapy) to decrease pain intensity in people with neck pain.
Materials and methods:
Electronic literature searches were conducted in a total of six databases such as Medline, Embase, CINAHL, Cochrane Library, Web of Science, and Scopus. The review considered randomised controlled trials (RCTs) including patients over 18 years having musculoskeletal pain in the neck area. The Neck Pain Task Force's classification of pain severity describes four levels of neck pain, with the first three levels considered in this review. (5)These must be clinically diagnosed by a health care provider according to signs and symptoms or based on standardized criteria specific for each disease. Studies involving subjects with any pre-existing conditions, previous surgery, or pain not clearly related to the musculoskeletal system were excluded. No limits were applied in terms of sex, ethnicity, and living country. Data were extracted using a standardized data extraction form.
Methodological quality was determined using the Cochrane Collaboration Risk of Bias Tool (CCRBT) and the strength of the evidence with Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Data were extracted and evaluated by two independent reviewers.
Results:
A total of 21585 records were identified and screened independently for eligibility by two reviewers. A total of six unique studies, reported on ten manuscripts met the specified inclusion criteria. Different types of aerobic exercise were used in the studies. Studies included isolated and combined aerobic exercise using interventions such as cycling on an ergometer or walking outdoors at a moderate intensity. Comparison groups were for example strength training or education. The most common outcome was pain assessed with the Visual Analogue Scale (VAS) or the Nordic questionnaire.
The included studies had a high risk of bias and the overall quality of the evidence for this systematic review was considered low. There was high heterogeneity in the included studies regarding interventions applied and study results.
When looking at the effect of aerobic exercise versus control group or other intervention groups measured with VAS, it can be observed, that there was a great heterogeneity between studies results (different magnitudes and directions). Although none of the comparisons showed a statistically significant difference between aerobic exercise and control (MD 6.24 mm, 95% CI [-11.21; 23.96]) or active intervention groups (MD -9.52 mm, 95% CI [-18.48; -0.56]) on pain intensity; it seems that aerobic exercise is slightly better than a control group, and equally effective as other active treatments such as strength exercise or education.
In addition, when combined with other therapeutic modalities, aerobic exercise, could potentially help to reduce pain intensity (MD 7.71 mm, 95% CI [1.07; 14.35]). Especially in the long term, the combination of strength and aerobic exercise showed promising results. Statistically significant differences in favour of aerobic exercise for pre vs. three months follow up (MD 11.20 mm, 95% CI [2.85;19.55]) and pre vs. six moths follow up (MD 15.10 mm, 95% CI [6.99; 23.21]) were found.
Conclusions:
Although there is currently limited evidence on the effectiveness of aerobic exercise in individuals with chronic neck pain, aerobic exercise was found to not only reduce pain intensity, but also to improve disability as well as physical and emotional functioning. However, as the evidence is limited, low quality, and heterogeneous, further research is needed in this area to obtain more accurate results.
The demographic shift in the age structure has the effects that many ageing employees work in organisations. Migration can slow down the ageing of population but could not stop it. More and more people with immigration background work in organisations. Therefore, the question is, whether diversity sensitive attitudes count for all diversity aspects. The central aim of the study is to deal with the problem fields of multicultural teamwork. Thereby, the focus is on the collaboration of employees with and without immigration background. The interviews with employees with and without an immigra-tion background of various company branches were conducted. The results show that employees with an immigration background have more contact and feel comfortable with persons from different cultures than employees without an immigration back-ground. The qualitative analysis indicates that there is a high need of competence devel-opment, especially intercultural and social competences in organisations. The results of the study reveal that personality traits and characteristics of employees play a role to what extent they accept diversity and are willing to work with persons from another culture. Age is not important regarding intercultural competence development.
Symposion: Working for the greater good in services: risks and innovation impacts on employees’ wellbeing
Oral presentation: Kumbruck: Digitalization in Health and Old People’s Care and the Impacts on the Interaction Work
Purpose: Digitalization like roboter to lift or feed care receiver or like electronic patient documentation, e.g. on smartphones, changes interaction and communication between care givers and care receivers. From our research projects (Projektgruppe verfassungsverträgliche Technikgestaltung: Mobile information and communication tools in the hospital; Das Ethos fürsorglicher Praxis in der Pflege) shows impacts.
Design/Methodology/Approach/Intervention: Qualitative studies (simulation studies; narrative Interviews, observations,) with more than 60 experimentees in different health care institutions.
Results: The interaction is mediated by electronic tools. The nurses are confident by the electronic assistance and workload reduction; but they are afraid of more distance in the relationship to the patients, more mixing of private and working time activities or more observation by their superiors. The most critical aspect is seen in the patient documentation.
Limitations: These studies are explorative ones. Especially the simulation study is an experimental design.
Research/Practical Implications: There is need for more and quantitative studies. The results give a lot of indications that the organizational and political frameworks of health care are important moderators of the impacts of the digitalization in health care.
Originality/Value: The studies have an important perspective on the change in the relationship between health care givers and receivers by digitalization – a topic, which concerns everybody.
With the start of the 21st century, patient safety as a topic of special interest has attracted increasing attention in both academia and clinical practice. As technology has continued to develop since then, questions and focal points surrounding the topic have also shifted. In particular, questions regarding the impact of digitalization on patient safety and its measurement are now of high interest. This work aims to develop a maturity assessment instrument in the form of a criteria set for measuring structural requirements for digital patient safety in hospitals. Based on the results of a literature review and a derivation of maturity objects (MO) from known maturity models, 64 criteria across 11 categories were developed. Written comments of two digital patient safety experts as well as subsequent interviews were used to evaluate and refine the criteria catalog. The resulting catalog offers hospitals guidance for detecting possible areas of structural improvements in their information systems with regard to patient safety and represents a unique instrument for assessing digital maturity in this particular area.
Soziale Benachteiligung und Schwangerschaft : Was wissen wir über die Bedürfnisse der Frauen?
(2012)
Characteristics of German Hospitals Adopting Health IT Systems : Results from an Empirical Study
(2011)
Hospital characteristics that facilitate IT adoption have been described by the literature extensively, however with controversial results. The aim of this study therefore is to draw a set of the most important variables from previous studies and include them in a combined analysis for testing their contribution as single factors and their interactions. Total number of IT systems installed and number of clinical IT systems in the hospital were used as criterion variables. Data from a national survey of German hospitals served as basis. Based on a stepwise multiple regression analysis four variables were identified to significantly explain the degree of IT adoption (60% explained variance): 1) hospital size, 2) IT department, 3) reference customer and 4) ownership (private vs. public). Our results replicate previous findings with regard to hospital size and ownership. In addition our study emphasizes the importance of a reliable internal structure for IT projects (existence of an IT department) and the culture of testing and installing most recent IT products (being a reference customer). None of the interactions between factors was significant.
Current frameworks postulate the success of health IT innovations to be determined by the professionalism of the information management (PIM). Still, empirical knowledge about PIM is scarce up until today. This study seeks to answer three research questions: (1.) How can PIM be measured in a reliable and valid way, (2.) how pronounced is PIM in German hospitals and (3.) do hospital characteristics have an impact on the degree of PIM? Based on the results of an expert workshop and frameworks for information management (IM) items for a PIM inventory were developed and the inventory sent to 1349 chief information officers of German hospitals. A principle component analysis based on the responses of 196 hospitals confirmed the three components that had been proposed by the frameworks: the strategic, the tactical and the operational level. The full inventory implied satisfying reliability and allowed a PIM composite-score to be calculated. The PIM scores for strategic and tactical IM were found to be far lower than for operational IM which hints at strong deficits in these areas. A stepwise regression model indicated that the degree of PIM significantly increased with the size of the hospital, which had been expected and hints the validity of the PIM inventory. This tool offers potentials for hospitals to classify and improve their IM.
The workflow-oriented dissemination of electronic patient data is a central goal of IT deployment in hospitals. Against this background, the present study examines two research questions: (1.) Are there differences in the availability of electronic patient data (AEPD) between different clinical workflows and data types and (2.) which structural and organizational factors determine AEPD? Based on a Germany wide hospital survey, AEPD was assessed along six clinical workflows. While AEPD was lowest for ward rounds, discharge showed the highest AEPD with pre- and post-surgery processes ranging in between. With regard to the data types analyzed, patient demographics and observation findings obtained the highest AEPD scores. Electrophysiological results, checklists and warnings were less common electronically and received lower AEPD scores. Multiple linear regression analysis resulted in a significant model that explained 34.4% of the variance of AEPD. Large hospitals and those with a professional information management, a high health IT related innovation culture and a nursing informatics officer possess higher AEPD scores and thus have better clinical information logistics mechanisms at their command.
Although user participation may facilitate the realisation of IT innovations, various literature analyses show only minimal to moderate evidence for such effects possibly due to disregard of mediating factors. Against this background, this study examines the extent to which joint intrapreneurship of clinical leaders and IT leaders as well as a distinct innovation culture mediate the effect of user participation on hospitals’ IT innovativeness. IT innovativeness was measured by the availability and usability of IT functions and by the perceived ‘innovative power’ of a hospital. An empirical model was developed and tested with data from 168 clinical leaders and IT leaders who participated pairwise in a survey representing 84 German hospitals. Three parallel mediation analyses indicated that the participation of users could only lead to IT innovativeness if they were accompanied by intrapreneurial leadership on the part of clinical directors and IT leaders and if a pronounced innovation culture prevailed.
CIOs' innovation capability is regarded as a precondition of successful HIT adoption in hospitals. Based on the data of 142 CIOs, this study aimed at identifying antecedents of perceived innovation capability. Eight features describing the status quo of the hospital IT management (e.g. use of IT governance frameworks), four features of the hospital structure (e.g. functional diversification) and four CIO characteristics (e.g. duration of employment) were tested as potential antecedents in an exploratory stepwise regression approach. Perceived innovation capability in its entirety and its three sub-dimensions served as criterion. The results show that CIOs' perceived innovation capability could be explained significantly (R2=0.34) and exclusively by facts that described the degree of formalism and structure of IT management in a hospital, e.g. intensive and formalised strategic communication, the existence of an IT strategy and the use of IT governance frameworks. Breaking down innovation capability into its constituents revealed that “innovative organisational culture” contributed to a large extent (R2=0.26) to the overall result sharing several predictors. In contrast, “intrapreneurial personality” (R2=0.11) and “openness towards users” (R2=0.18) could be predicted less well. These results hint at the relationship between working in a well-structured, formalised and strategy oriented environment and the overall feeling of being capable to promote IT innovation.
Das Informationsmanagement steht im Zentrum erfolgreicher eHealth-Innovationsprozesse von Krankenhäusern. Im Kontext komplexer, zum Teil tradierter Krankenhausstrukturen kann die Gestaltungsfähigkeit des Informationsmanagements durch eine ausgeprägte Intrapreneurship-Kultur erhöht werden, wovon vermutlich auch der Digitalisierungsgrad der Einrichtungen profitiert. Vor diesem Hintergrund verfolgte die vorliegende Studie zwei Forschungsfragen: (1.) Welche Effekte hat Intrapreneurship auf den Digitalisierungsgrad der Krankenhäuser und (2.) inwiefern werden diese Effekte durch das Informationsmanagement beeinflusst? Zur Beantwortung der Forschungsfragen wurde ein konzeptionelles Untersuchungsmodell entwickelt, welches mit Daten von 224 IT-Leitern evaluiert wurde. Die Ergebnisse bestätigen, dass Intrapreneurship die Umsetzung von eHealth-Anwendungen positiv beeinflussen kann. Die identifizierten Effekte waren jedoch vorwiegend indirekter Art, vermittelt durch den Professionalisierungsgrad des Informationsmanagements. So kann Intrapreneurship auf IT-Leiter-Ebene und auf Ebene der Gesamtorganisation zu einer Professionalisierung des strategischen Informationsmanagements führen. Auf Ebene der IT-Abteilung profitiert vor allem das operative Informationsmanagement von einer ausgeprägten Intrapreneurship-Kultur.
Bei der Umsetzung der digitalen Transformation bewegt sich das ITManagement in Krankenhäusern in einem Spannungsfeld aus historischkulturellen Vorbedingungen und den besonderen Herausforderungen wissensintensiver Expertenorganisation. Um zu untersuchen, wie professionell das ITManagement vor diesem Hintergrund ist, wurde in der vorliegenden Studie der Professionalisierungsgrad des IT-Managements als Beschreibungsgröße vorgeschlagen. Darüber hinaus wurden Ausprägungen der IT-Governance und des IT-Entrepreneurships als mögliche Determinanten des Professionalisierungsgrades konzeptionalisiert. Ein entsprechend aufgestelltes, hypothesengeleitetes Untersuchungsmodell wurde anhand der Daten von 164 CIOs deutscher Krankenhäuser überprüft. Die Ergebnisse der Studie deuten auf Professionalisierungspotenziale des IT-Managements im strategischen und evaluierenden Bereich hin. Etablierte Kommunikationskanäle zwischen CIO und Krankenhausleitung sowie eine ausgewiesene IT-Budgetverantwortungen wirkten sich positiv auf den Professionalisierungsgrad aus. Zudem Das agierte das ITManagement umso professioneller, je stärker der IT-Entrepreneurship auf organisatorischer und individueller Ebene ausgeprägt war. Die Ergebnisse können den theoretischen Erkenntnisstand über die Wirkungsweise von IT-Governance und IT-Entrepreneurship erweitern und auf ähnliche, wissensintensive Expertenorganisationen übertragen werden.
Charakteristika innovativer Krankenhäuser in Deutschland : Ergebnisse einer empirischen Untersuchung
(2011)
Derzeit wird die Personalbedarfsermittlung von Hebammen im Kreißsaal vornehmlich erlösbasiert vorgenommen oder basiert auf einer Vereinbarung der Deutschen Krankenhausgesellschaft, den Krankenkassen und dem Deutschen Hebammenverband aus dem Jahre 1993 (Plücker 2012). Während das erstere Verfahren nicht den Personalstand dem tatsächlichen Bedarf anpasst, sondern lediglich die Erlöse berücksichtigt, ist das letztere Verfahren durch die Umstellung der Krankenhausfinanzierung nicht mehr bindend, beruht auf einer veralteten und nicht validen Datengrundlage (Lippert 1990).
Zudem erfordert eine veränderte Geburtshilfe in Deutschland, mit einer Zunahme an Kaiserschnitten und anderen Interventionen (AQUA 2012), eine aktuelle Analyse der Prozesse in geburtshilflichen Abteilungen, um ein adäquates und zeitgemäßes Instrument für die Personalbedarfsermittlung auszugestalten.
Im Rahmen des Forschungsschwerpunkts „Versorgung während Schwangerschaft, Geburt und Wochenbett – Instrumente zur sektorenübergreifenden Qualitätsentwicklung – IsQua“ an der Hochschule Osnabrück und dem Teilprojekt „Personalbedarfsermittlung von Hebammen im Kreißsaal“ wird diese Thematik im Rahmen einer Bachelorarbeit bearbeitet. Es werden jeweils zweiwöchige Hospitationen in voraussichtlich vier geburtshilflichen Abteilungen der vier verschiedenen Versorgungsstufen angestrebt. Unter Anwendung von Expertengesprächen (Meuser u. Nagel 2009), Dokumentenanalysen sowie nicht teilnehmender Beobachtung soll folgende Forschungsfrage beantwortet werden: Welche Prozesse von Hebammen im Kreißsaal gibt es, wie können sie definiert werden und welchen Einfluss haben diese auf den Personalbedarf?
Die Fertigstellung der Bachelorarbeit ist für Ende Januar 2014 geplant.
Das Ziel des Projekts ist mithilfe der Prozessanalyse in den teilnehmenden Häusern hebammenspezifische Tätigkeiten zu erkennen, zu definieren und einzugrenzen bzw. von hebammenfernen Tätigkeiten abzugrenzen. Durch das Erkennen und das Abgrenzen einzelner Prozesse kann eine Prozessoptimierung der Hebammenarbeit und somit eine verbesserte Versorgung und Betreuung der Frauen durch Hebammen in den geburtshilflichen Abteilungen erzielt werden.
Erste Ergebnisse werden auf der 2. Internationalen Fachtagung der DGHWi in Kassel vorgestellt.
Das Projekt greift ein aktuelles Thema der Berufsgruppe der Hebammen auf. Hebammenspezifische Tätigkeiten sollen beschrieben werden, um sich von anderen Berufsgruppen abgrenzen zu können. Nach den Hospitationen in den Häusern der verschiedenen Versorgungsstufen wird sich herausstellen welche Prozesse eindeutig abgrenzbar sind, wie man diese definieren kann und in wie weit Prozesse standardisierbar oder auf andere Häuser übertragbar sind und welchen Einfluss diese auf Personalbedarfsermittlung haben.
Mithilfe der Prozessanalyse und -optimierung kann einerseits das knappe Budget, welches aus Fallpauschalen errechnet wird optimal genutzt werden. Hebammen könnten primär hebammenspezifische Tätigkeiten ausüben und hebammenferne Tätigkeiten würden durch anderes Personal ausgeführt. Andererseits kann diese einen Ausgangspunkt zum tatsächlichen Personalbedarf geben sowie eine Grundlage für die Personalbedarfsermittlung schaffen (BMI 2007, Gütersloher Organisationsberatung GmbH 2011).
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
Rationale:
Performing artists are exposed to high strains during their performance. These strains are similar to the ones of professional athletes, but in contrast to athletes there is a comprehensive undersupply of care regarding preventive and rehabilitative therapy offers.
Purpose:
The purpose of RefLabPerform is to develop a reference laboratory for the assessment of neuromusculoskeletal disorders using physiotherapeutic assessment methods in combination with biomechanical motion analysis. This includes the automatized integration of the physiotherapeutic assessments with the technical biomechanical analysis for an individual treatment recommendation with decentralized health care recommendations for a home-based therapy based on evidence-based prevention and rehabilitation strategies.
Methods:
Several work packages are processed systematically, whereby according to the requirements in the course of the project an overlapping of work packages occurs. First, the component planning of the innovative reference laboratory structure is carried out, on which the clinical and technical development of the reference laboratory is based. The next steps are the development of individual clinical assessment protocols, prevention and rehabilitation strategies as well as the setup of the laboratory and the development of technical routines. Parallel to this, various analysis tools are being developed for biomechanical data as well as for physiotherapeutic diagnostics and merged at the end of this work package for individual results for different groups of performing artists. Overlapping with the previous work packages, the reference laboratory will be tested for application and manageability. Clinical and technical data are brought together and checked by means of individual case trials on various groups of artists. In terms of an agile software development process, the results flow back into the previous work packages in order to optimize them and then test them again.
Results:
At the end of the project a functional and proven reference laboratory for the comprehensive analysis of performing artists will be developed.
Conclusions:
This reference laboratory is specialized to the diagnosis and treatment of playing- and performance-related dysfunctions with a focus on clinical findings and biomechanical movement analysis.
Educational Objectives:
At the end of the presentation, the participants will be able to…
1. describe the innovative content of the project RefLabPerform
2. understand the advantages of merged analysis strategies by physiotherapeutic and biomechanical examinations
3. understand the complex interdisciplinary process to develop a reference laboratory for performing artists
Rationale:
Performing artists are exposed to high strains during their performance. These strains are similar to the ones of professional athletes, but in contrast to athletes there is a comprehensive undersupply of care regarding preventive and rehabilitative therapy offers.
Purpose:
The purpose of RefLabPerform is to develop a reference laboratory for the assessment of neuromusculoskeletal disorders using physiotherapeutic assessment methods in combination with biomechanical motion analysis. This includes the automatized integration of the physiotherapeutic assessments with the technical biomechanical analysis for an individual treatment recommendation with decentralized health care recommendations for a home-based therapy based on evidence-based prevention and rehabilitation strategies.
Methods:
Several work packages are processed systematically, whereby according to the requirements in the course of the project an overlapping of work packages occurs. First, the component planning of the innovative reference laboratory structure is carried out, on which the clinical and technical development of the reference laboratory is based. The next steps are the development of individual clinical assessment protocols, prevention and rehabilitation strategies as well as the setup of the laboratory and the development of technical routines. Parallel to this, various analysis tools are being developed for biomechanical data as well as for physiotherapeutic diagnostics and merged at the end of this work package for individual results for different groups of performing artists. Overlapping with the previous work packages, the reference laboratory will be tested for application and manageability. Clinical and technical data are brought together and checked by means of individual case trials on various groups of artists. In terms of an agile software development process, the results flow back into the previous work packages in order to optimize them and then test them again.
Results:
At the end of the project a functional and proven reference laboratory for the comprehensive analysis of performing artists will be developed.
Conclusions:
This reference laboratory is specialized to the diagnosis and treatment of playing- and performance-related dysfunctions with a focus on clinical findings and biomechanical movement analysis.
Educational Objectives:
At the end of the presentation, the participants will be able to…
1. describe the innovative content of the project RefLabPerform
2. understand the advantages of merged analysis strategies by physiotherapeutic and biomechanical examinations
3. understand the complex interdisciplinary process to develop a reference laboratory for performing artists
Background: Muscle fatigue has been reported as a risk factor for the
development of performance-related musculoskeletal disorders (PRMD) in
musicians. However, little research exists to support this claim. The aim of
this study was to investigate whether changes occur in muscle activity
patterns during high string performance over a prolonged playing period, and
whether this is influenced by PRMD.
Methods: High string musicians were divided into a PRMD and a non-PRMD
group. They played a chromatic scale pre and post and a self-chosen “hard”
(Borg scale 16-17) piece of music for one hour. Electromyography data
recorded from arm, shoulder and trunk muscles was analyzed: the amplitude
to measure muscle activity characteristics and the lower frequency to
measure muscle fatigue. Differences between and within groups and the
frequency spectrum were analyzed using linear mixed models.
Results: Fifteen musicians participated (7 PRMD: 22.8 years, 2 male/5 female
and 8 non-PRMD: 34.3 years, 2 male/6 female). Changes in muscle activation
patterns were observed between and within both groups, however changes
varied significantly depending on group affiliation. Significant low frequency
spectrum changes between groups were observed in overall muscles of the
right arm (p=0.04) and left forearm flexors (p=0.05) following one hour of
playing.
Conclusions: Muscle activity and frequency spectrum shifts differ in high
string musicians with and without PRMD, suggesting possible differential
muscle fatigue effects between the groups.
Rationale:
Dance as an intense kind of performance is associated with high loads on the musculoskeletal system. In particular, the lower limb is exposed to these high loads, which is reported by a high prevalence. Most dancers are affected by injuries during their careers, most in the lower limb. Typical risk factors for dancers include the compensatory turnout, hypermobility, and core stability. The correlation between these factors and lower limb injuries is not fully understood.
Purpose:
The aim of this study was to evaluate the correlation between lower limb injuries and the risk factors compensated turnout, hypermobility and core stability. Based on these results, hypotheses can be generated for further studies.
Methods:
This explorative pilot study was conducted at Osnabrück University of Applied Sciences. All eligible participants were scheduled for a single research appointment if they fulfilled the inclusion criteria of dance experience (ballet, modern, contemporary or jazz) at least one year with dance lessons of at least 5 hours per week. Parameters for the correlation analysis were (1) core stability, measured by the motor control tests battery proposed by Luomajoki, (2) hypermobility, measured by the Beighton Score (3) compensated turnout, measured by the difference between functional turnout and external rotation of both hips, (4) dance hours per week, (5) dance experience in years, (6) professional dance experience in years and (7) dance style (ballet, modern, contemporary, jazz). These parameters were correlated with the numbers of lower limb injuries. Significance level was set at 90% because of the explorative character of the study with the purpose to generate hypotheses.
Results:
Sixteen female dancers with different levels of dance experience (mean 11.3 years) and dance lessons per week (mean 17.6 hours) fulfilled the inclusion criteria and participated in this study. Significant correlations with the numbers of lower limb injuries were found at core stability (rs=0.489, p=0.034, medium effect), dance hours per week (rs=0.459, p=0.048, medium effect) and professional dance experience in years (rs=0.396, p=0.093, medium effect). Two dance styles (modern dance: rs=0.388, p=0.101 and contemporary dance: rs=0.385, p=0.104) were close to the significance level.
Conclusions:
These results show correlations between core stability, dance hours per week, professional dance experience in years and lower limb injuries in dancers.
Due to the limitations of a small and heterogeneous sample size as well as the medium effects, these results should be interpreted with caution, but may provide a basis for further research to this topic in the field of dance research and can be helpful in generating research hypotheses.
Rationale:
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, fatigue behavior or timing. 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.
Purpose:
To show the importance of EMG in musicians´ health and to demonstrate additional therapy and diagnostic options.
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 musicians´ health, physical therapy and the clinical reasoning process
3. use EMG on musicians in the performance process
Content of Presentation:
This workshop briefly introduces the theoretical principles of EMG and the clinical applications in the context of musicians´ 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 musicians 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 musician to introduce EMG in the field of musicians´ health and the clinical reasoning process (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 musician with additional value in their clinical work.
Rationale:
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, fatigue behavior or timing. 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.
Purpose:
To show the importance of EMG in musicians´ health and to demonstrate additional therapy and diagnostic options.
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 musicians´ health, physical therapy and the clinical reasoning process
3. use EMG on musicians in the performance process
Content of Presentation:
This workshop briefly introduces the theoretical principles of EMG and the clinical applications in the context of musicians´ 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 musicians 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 musician to introduce EMG in the field of musicians´ health and the clinical reasoning process (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 musician with additional value in their clinical work.
Rationale:
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.
Purpose:
To show the advantages of implementing EMG in performing artists´ health and to demonstrate additional therapy and diagnostic options.
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
Content of Presentation:
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.
Introduction: Hamstring injuries are among the most common injuries in soccer players. Especially the danger of hamstring injuries increases in the final third of each half, with the biceps femoris muscle being highly susceptible, but currently there is no supporting evidence in soccer players. It is important to investigate to provide a basis for further clinical investigations in order to reduce the risk of hamstring injuries.
Objective: To investigate a soccer-specific muscle fatigue protocol has an effect on the activation patterns of the biceps and semitendinosus muscles and correlates with the subjectively perceived exertion of the soccer players.
Methods: 19 healthy soccer players aged 19 - 35 years were included and underwent a standardized procedure that included: (1) performance of the nordic hamstring curls (NHC) and a 10m sprint (pre-test), (2) a soccer-specific muscle fatigue loading protocol for 30 minutes with subsequent rating of perceived exertion (RPE), (3) re-assessed like pre-assessment (post- test). Electromyography (EMG) data were recorded the biceps and
semitendinosus muscles of both legs. Two parameters were analyzed: the peak amplitude during the NHC and the mean amplitude during the 10m sprint.
Results: The RPE score (9.5, p<0.001) and 10m sprint shows significant differences between pre- and post- test for the biceps (standing leg: -82.45, kicking leg: -81.77; p<0.01) and semitendinosus muscle (standing leg: -60.08, p=0.001); kicking leg: -65.30, p=0.03). Significant correlation exists between RPE score and biceps muscles at posttest (standing leg: r=-0.54, kicking leg: r=-0.51; p<0.05).
Conclusion: Muscle fatigue leads to significant changes in the activation behavior of the hamstring muscles. In particular, the biceps muscle shows a correlation with perceived exertion, the higher the exertion, the lower the muscle activity. This may help explain the higher prevalence of the biceps muscle in hamstring injuries and offers a basis for further clinical investigations