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Since February 2019, the „Katholische Erwachsenenbildung“ has been collaborating with the Institute of Music of the University of Applied Sciences Osnabrück. An institute for adult education provides the framework for a concept in which German as a second language lessons are accompanied by musicalisation. In line with elemental musical practice, whole-body experiences with voice, movement, and body-percussion play an important role. Students with the career goal of „Educating Artist“ work alongside language teachers in this project, and are mentored by university teachers. The young musicians gain monitored teaching experience and have a great opportunity to witness and help shape the linguistic and social integration of refugees.
A consequence of increasing migration is that a large number of people need to learn the language of the country of immigration. Music and language are phenomenons that share many common characteristics, such as melody, rhythm, and timbre. Music draws attention and can cause positive emotions. Music and movement are deeply rooted in the communication of emotional states und are considered to be the evolutionary biological basis for language. Thus the close relationship between language, music, and dance is evident: They all rely on differentiating perception, are able, as systems designed for social interactions, to connect people, and allow for both collective and individual expression.
The contents and procedures of the lessons are documented in a digital diary. The entire team meets at regular intervals, in order to reflect on the experiences and conduct further planning. For these purposes, video documentation of the lessons is also used. The project will end in November 2019 with a language exam; a musical final presentation is also planned. By then at the latest, findings will be available as to if and how the musical course content was able to support language acquisition. The collaboration enables the partners to realize the combining of different objectives (learning a second language, cultural participation and music making) by bringing experts together.
Auch um die Milchviehhaltung gibt es seit einigen Jahren eine öffentlich geführte Tierwohldiskussion. Zwei Aspekte sind dabei immer wieder Gegenstand der Kommunikation: Die Anbindehaltung und der Weidegang. Auf Basis von qualitativen Interviews mit zivilgesellschaftlichen Verbänden und landwirtschaftlichen Verbänden wurden die Einstellungen und die Argumentationsmuster beider Verbandsgruppen zu den Haltungsformen Weidegang und Anbindehaltung ergründet. Von Interesse ist dieser Vergleich, da im Rahmen öffentlich-medialer Kommunikation die Diskussionsfronten zwischen beiden Verbandsgruppen verhärtet erscheinen. Die Analyse der Aussagen, die im Rahmen der qualitativen Interviewreihe dieser Studie getätigt wurden, erlaubt die begründete Annahme, dass beide Verbandsgruppen mit den Themenkomplexen Anbindehaltung und Weidehaltung in einem wissenschaftliche orientierten Kommunikationskontext differenziert umgehen. Eine klare Polarisierung der Einstellungen zwischen beiden Verbandsgruppen ist in einem solchen Umfeld nicht mehr wahrnehmbar gewesen.
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.
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.
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".
Gebäude beanspruchen Ressourcen und verändern die Umwelt. Die Landwirtschaft benötigt oftmals großvolumige Gebäude. Eine nachhaltigere landwirtschaftliche Baukultur wäre damit begrüßenswert. Für das agrarische Bauen könnte eine verstärkte Verwendung des Rohstoffs Holz eine Perspektive darstellen. Holz überzeugt durch zahlreiche ökologische Vorteile wie die langfristige Kohlenstoffbindung oder eine einfache Recycelbarkeit. In Deutschland spielt Holz allerdings beim landwirtschaftlichen Bauen eine immer geringere Rolle. Diese Studie stellt Meinungsbilder deutscher LandwirtInnen zusammen zum Holzeinsatz beim Stallbau. Es wurden zehn Gruppendiskussionen gestaltet zum Themenfeld landwirtschaftliche Baukultur in verschiedenen deutschen Schwerpunktregionen der Rinderhaltung. Die Auswertungen zeigen, dass die LandwirtInnen weitestgehend die optische Wirkung von Holz schätzen, aber häufig an der Dauerhaftigkeit von Holzställen zweifeln.
Design knowledge on smart glasses-based systems is scarce. Utilizing literature analysis on software development publications, insights from the design and implementation of four smart glasses-based systems and expert interviews, we elicited 16 design principles to provide guidance in the development of future service support systems. Heuristic Theorizing is an abductive Design Science Research method, hitherto far too little known or little noticed, which was applied to conduct the research. We contribute to theory and practice with applicable design principles to support the development of smart glasses-based systems. Phenomena known to have an impact on the adoption of smart glasses are addressed by these design principles.
The usage of high-level synthesis (HLS) tools for FPGAs has increased significantly over the last years since they matured and allow software programmers to take advantage of reconfigurable hardware technology.
Most HLS tools employ methods to optimize for loops, e. g. by unrolling or pipelining them. But there is hardly any work on the optimization of while loops. This comes at no surprise since most while loops have loop-carried dependences involving the loop condition which result in large recurrence cycles in the dataflow graphs. Therefore typical while loops cannot be parallelized or pipelined.
We propose a novel transformation which allows to optimize while loops nested within a for loop. By interchanging the two loops, it is possible to pipeline (and thereby parallelize) the inner loop, resulting in a reduced execution time. We present two case studies on different hardware platforms and show the speedup factors - compared to a host processor and to an unoptimized hardware implementation - achieved by our while loop optimization method.
Sustainability is a growing megatrend in our society entailing an increasing importance of sustainable consumption. Consumers associate sustainable products with ecological and regional production including a high credibility. In order to take advantage of this trend manufacturers of sustainable foods must communicate the sustainability of their products via packaging and displays at the point of sale. The objective of this article is to examine how the design of display elements succeeds in conveying sustainability for a new organic juice. In addition, the perception of individual design elements of sustainable products is determined. To this end, a field study was carried out in a supermarket combining eye-tracking technology with a survey of 32 customers. At the entrance, customers were asked to buy a variety of the newly introduced "Emsländer" organic juice, and then participate in the survey. The results demonstrate that customers with a positive attitude towards sustainable food fixate individual display elements referring to sustainability components for longer and remember product features better. Hence, the positive attitude towards sustainable food results in a higher visual attention at the point of sale. These findings provide recommendations for the design of the display.
Personal health records (PHR) are instruments to compile, store and present health and wellness related data digitally with proven effects on self-management of diseases. The aim of this study was to investigate whether there were differences in the intention to use (ITU) and perceived usefulness (PU) of two technologies allowing users to access the PHR, i.e. a kiosk system and a smart phone based app (access as usual). The study also aimed at modelling ITU and PU with multiple linear regressions. A total of 46 subject participated in the study who were randomly assigned to one of the two experimental groups (nkiosk = 22; napp = 24). The task for both groups was to digitise their “Medikationsplan” (medical record) and upload it to the PHR. There was no significant difference in ITU and PU between the two technologies. ITU could only be significantly explained by PU (R2 = .55, p < 0.001), while PU was determined by perceived ease of use and psychological factors (R2 = .64, p < 0.001). Severity of disease did not play any significant role. The German “Terminservice- und Versorgungsgesetz” underpins the importance and timeliness of this study. The assumption that both – the publicly accessible kiosk and the app – are equally acceptable for people of different gender, age and technology background demonstrates the opportunity to master a potential digital divide among the population and allows users to get access to their PHR in multiple ways.
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.
Background: Crowding in emergency departments (ED) has a negative impact on quality of care and can be averted by allocating additional resources based on predictive crowding models. However, there is a lack in effective external overall predictors, particularly those representing public activity.
Objectives: This study, therefore, examines public activity measured by regional road traffic flow as an external predictor of ED crowding in an urban hospital.
Methods: Seasonal autoregressive cross-validated models (SARIMA) were compared with respect to their forecasting error on ED crowding data.
Results: It could be shown that inclusion of inflowing road traffic into a SARIMA model effectively improved prediction errors.
Conclusion: The results provide evidence that circadian patterns of medical emergencies are connected to human activity levels in the region and could be captured by public monitoring of traffic flow. In order to corroborate this model, data from further years and additional regions need to be considered. It would also be interesting to study public activity by additional variables.
The interdisciplinary research project TiP.De - Theatre in Dementia Health Care aims at identifying the effects of theatre pedagogy on quality of life of people with dementia in two German nursing homes.
The mixed-methods intervention study measures cognitive impairment, quality of life in daily living and agitation in a pre-post-comparison, as well as emotional reactions during the theatre pedagogical interventions of the participants.
The intervention is expected to have a positive impact on cognitive impairment, quality of life, agitation and relationship between the participants and the assisting nursing home staff. Further data analysis will show correlations between specific items.
The results and the theatre pedagogy concept for people with dementia will be published, so that theatre pedagogues are able to implement the concept in other nursing homes. The nursing situation, communication and work experience of nurses, as well as quality of life of people with dementia are going to be positively affected.
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.
A structured hospital discharge management process can lead to a smoother transition to aftercare. In practice, providing continuity of nursing care after a stationary hospital stay is accompanied by numerous challenges. The presented study aims to point out the use cases and requirements for an IT system supporting the diverse tasks of the participating actors. Within the scope of a multi-method research design, the authors conducted and analysed stakeholder interviews, a shadowing, a systematic literature search and statutes in order to gain the presented results. This publication presents 37 requirements, grouped to 14 use cases. A process model in BPMN visualises the discharge management process. Further, the authors derived implications for practice and research. These can be used for the development, classification and assessment of IT systems. Therefore, this publication provides a significant contribution to the development of socio-technical systems within the health care domain.
Rationale: Three-dimensional (3D) motion analysis has proved helpful in the diagnosis of different musculoskeletal syndromes and identifying injurious movement patterns in high string players. Furthermore, an optoelectronic 3D motion capture system allows an accurate and objective assessment of upper body posture and motion during violin and viola performance. However, no reference upper body model of high string players has been proposed as yet. Moreover, a more physiological shoulder model that separates the joints of the shoulder complex has not been reported. Especially in view of given the role of the scapula in the normal movement of the humerus, it cannot be disregarded when evaluating musculoskeletal strain in the shoulder.
The International Society of Biomechanics recommends definitions of joint coordinate systems for the report of upper body joint motion using anatomical landmarks as reference for the placement of surface markers. Using markers on the skin for some of the proposed locations is, however, inappropriate when an instrument is being played. There are skin movement artifacts, e. g. caused by the movement of the scapula underneath the skin, whereas some markers interfere with the instrument on the shoulder or might be occluded by the bowing arm in motion.
Purpose: The aim of this study was to develop a marker-based method for quantifying 3D upper body kinematics of high string players and to demonstrate its clinical feasibility in violin and viola performance. The method is intended to provide an objective evaluation of high string players’ motor strategies, especially in the shoulder complex, while minimizing skin movement artifacts, marker occlusions and limitations in instrument placement.
Methods: A custom marker set was developed consisting of thirty-one single markers to define the anatomical coordinate systems of sixteen upper body segments including the pelvis, thorax, spine and head, as well as both scapulae, upper arms, forearms and hands. Twenty-one of these markers as well as two pre-built and four custom-made rigid marker clusters were used for tracking the segment motions.
Twelve professional violinists without history of musculoskeletal or neurological problems were recruited for assessing the clinical feasibility of the method. They were asked to perform a single sequence of two consecutive musical notes on each of two adjacent strings (G- and D-string) in real time, played at 50 bpm with tempo audibly regulated by a metronome, and using a standardized violin and bow. The participants played up- and down-bow alternately using the whole length of the bow.
A custom biomechanical model was applied to the motion capture data and the rotation angles of fifteen joints were calculated. The location of each glenohumeral joint rotation center was computed by upper arm movements with respect to the scapula based on a functional method. For a description of the motion patterns, minimum, maximum and range of angular motion were averaged across participants for each string and rotation. Inter-subject variability was assessed by calculating the standard deviation (SD) at each sample of the angle-time series between participants for each rotation and for both strings. Then SD was averaged over sequences for each rotation and string. For comparing mean rotation angles between strings over time, random effect models were used.
Results: The highest range of motion was observed in the right elbow flexion and right wrist flexion/extension. Also, high ranges of motion (> 10°) were found in all right glenohumeral rotations and right wrist deviation and pronation/supination. In conclusion, lumbar and thoracic spine, thorax, neck, and left upper limb were quite static, while large motion occurred in the right upper limb during up and down bowing.
Most rotation angles showed a reasonable inter-subject variability except for left and right glenohumeral plane of elevation as well as left glenohumeral internal/external rotation, and left and right wrist pronation/supination (> 10°).
Significant differences in the rotation angles between G- and D-string bowing were detected especially in the left wrist and right shoulder joints.
Conclusions: This is the first study that used quantitative 3D analysis to explore the upper body kinematics of high string players during performance, providing a detailed view of the motor control in the shoulder as well as in the lumbar and thoracic spine. The biggest advantage over previously published methods is the more physiological shoulder and spine models while providing a simple application.
The method was found to give consistent motion patterns across participants and to be sensitive to differences between adjacent strings. Although the method appears to be valid, more rigorous validation is necessary. Since there is no gold standard with which we could compare results, we were only able to assess the clinical feasibility. We believe that our method represents a good compromise between accuracy and practicability for clinical application.
Due to the inclusion of multi-segmented shoulder and spine models, it will improve understanding of the motor strategies adopted by high string players and may contribute to injury prevention, diagnosis and treatment.
Background:
Midwifery care in Germany is a legal right for every woman (SGB V). Midwives work employed or freelance in hospitals or in community services, providing maternal care from pregnancy until the end of breastfeeding (Sayn-Wittgenstein 2007). Increasingly, a shortage of midwifery care has been observed, forcing hospitals to understaff or to close their birth units, leaving women and their families without care (Sander et al. 2018). At the same time, birth rates are rising, thus leading to an increasing demand of midwifery care (Destatis 2019). As off today there is no central register for midwives across Germany’s 16 states. Therefor the exact number of registered midwives as well as the scope of services provided by midwives are not known (Niedersächsisches Landesgesundheitsamt 2019). Given the present situation, it seems to be imperative to establish effective midwifery workforce planning.
The aim of this poster is to identify already existing health workforce planning approaches and to determine the extent to which those can be transferred to the German system of midwifery care.
Methods:
Health workforce planning approaches, already being used on a national and international level, have been analysed, focusing their applicability to midwifery services in Germany.
Results:
Particular elements of the workforce planning approaches already being used in Germany for registered physicians seem to be adoptable. However, they need to be adjusted and enhanced to ensure the characteristics of midwifery in the German public health services. Internationally used approaches are not readily transferable due to systemic differences in health care systems.
Conclusions:
The development of new specific workforce and service planning approaches for midwifery care in Germany is crucial to meet present and future needs of women and their families during the childbirth period.
Climate change is the biggest social challenge facing the globalised world. The aim of this paper is to investigate the requirements for governance structures in regional sustainability programmes against climate change.
The study is an explorative case study. It is based on a literature review and expert interviews. It also involves the participatory observation of working groups meetings, and a design thinking workshop.
In spite of their enormous importance, little is known about the institutional conditions of the regional governance of climate change projects in Germany.
For this reason, the research project focuses on the important aspect of networking and governance structures. Consequently, the investigation will contribute to answering the question of which institutional framework conditions can raise the likelihood of climate change projects having a sustainable effect.
The outcomes of the application
This research has not only practical implications for the single case. The exploration of the critical factors of success also offers other regions important food for thought in shaping their governance structures. In particular, the design thinking process and the business network in the District of Steinfurt offer valuable points of reference.
Optimised Nutrient Recovery from Biogas Digestate by Solid/Liquid Separation and Membrane Treatment
(2019)
Anaerobic digestion products of agricultural biogas plants are characterised by high nitrogen, phosphorus, and potassium content. In three scale-up steps, a membrane based digestate treatment process of solid-liquid-separation, ultrafiltration, and reverse osmosis for nutrient recovery was investigated. Lab-scale trials delivered a very good understanding of fluid properties and subsequent ultrafiltration performance, which is the limiting process step in terms of energy demand and operation costs. In semi-technical experiments, optimisation, and design parameters were developed, which were subsequently applied to pilot-scale tests at two full-scale biogas plants. The process optimisation resulted in 50 % energy reduction of the ultrafiltration step. About 36 % of the sludge volume was recovered as dischargeable water, 20 % as solid N/P-fertiliser, and 44 % as liquid N/K-fertiliser.
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.
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.
We describe an automated approach, to easily track patients regaining their walking ability while recovering from neurological diseases like e.g. stroke. Based on captured gait data and objective measures derived out of it the rehabilitation process can be optimized and thus steered. In order to apply such system in clinical practice two key requirements have to be fulfilled: (i) the system needs to be applicable in terms of ease of use and performance; (ii) the derived measures need to be accurate.
Despite similar policy goals, the adoption of eHealth practices took different paths in Austria (AT), Switzerland (CH), and Germany (GER). We seek to provide a rigorous analysis of the current state of hospitals by focusing on three key eHealth areas: electronic patient records (EPR), health information exchange (HIE), electronic patient communication. For validation and in order to gain better contextual insight we applied a mixed method approach by combining survey results from clinical directors with qualitative interview data from eHealth experts of all three countries. Across countries, EPR adoption rates were reported highest (AT: 52%, CH: 78%, GER: 50%), HIE-rates were partly lower (AT: 52%, CH: 14%, GER: 17%), and electronic patient communication was reported lowest overall (AT: 17%, CH: 8%, GER: 19%). Amongst others, results indicate patient awareness about eHealth to be equally weak across countries, which thus may be an important focal point of future policy initiatives.
This study identifies and evaluates factors for success in innovation work in the Bavarian dairy farming industry. The research is based on an analysis of innovation system theories and a comparison with innovation work in the Dutch dairy sector. Dutch dairy farming is characterized by high productivity and technical efficiency at the farm level. Moreover, important developments in dairy farming have originated in the Netherlands. Therefore, this study delves into the systemic background of the successful innovation work in the Netherlands and makes a comparison with Bavaria. The main result of this study is that innovation work in the Bavarian dairy farming sector is lacking in two respects: end-user (farmer) integration and within-sector cooperation.
German farmers are required by law to regularly self-assess the welfare of their animals. The project Q Check is aiming at developing a system that will assist farmers to objectively assess animal health and welfare in dairy cows. For this reason, a quarterly report will be compiled from animal-based key indicators to give an overview of the on-farm situation. The anonymised and aggregated reports can also be used for national animal welfare monitoring: Continuous collection of these key indicators enables the summary and publication of figures reflecting the current animal health and welfare status and progressions at federal state and at national level. Q Check is based on four data recording and analysis systems, which are already established in Germany and implemented on a national level. Out of these systems, the most suitable indicators to describe herd health have been selected by 215 experts within a twostage Delphi study. In addition, over 50 face-to-face interviews with stakeholders related to the German dairy sector have been performed in order to take into account the socio-scientific point of view. To complete the process, the selected indicators are currently being checked against mass data and hence tested for suitability regarding monitoring purposes. An automatic farm-specific evaluation of animal health, based on verified indicators, will provide support to farmers in fulfilling their legal requirements and in identifying weak points on the individual farms. A benchmarking system will be set up which will allow tracking the individual herd health indicators in the same farm in their course over time and compared with similar farms. These routinely provided horizontal and vertical statistics will facilitate targeted intervention and support objectified management decisions, implying that dairy farmers can benefit in several respects. In the course of the project, new tools for determining the risk of ketosis in the scope of milk recording will also be validated and implemented at national level to enhance monitoring of this major disease complex. The results of these nationwide, systematic investigations will contribute substantially to objectifying the discussion about the health and welfare situation of dairy cows.
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.
Use of Emergency Departments by Frail Elderly Patients : Temporal Patterns and Case Complexity
(2019)
Emergency department (ED) care for frail elderly patients is associated with an increased use of resources due to their complex medical needs and frequently difficult psycho-social situation. To better target their needs with specially trained staff, it is vital to determine the times during which these particular patients present to the ED. Recent research was inconclusive regarding this question and the applied methods were limited to coarse time windows. Moreover, there is little research on time variation of frail ED patients’ case complexity. This study examines differences in arrival rates for frail vs. non-frail patients in detail and compares case complexity in frail patients within vs. outside of regular GP working hours. Arrival times and case variables (admission rate, ED length of stay [LOS], triage level and comorbidities) were extracted from the EHR of an ED in an urban German teaching hospital. We employed Poisson time series regression to determine patterns in hourly arrival rates over the week. Frail elderly patients presented more likely to the ED during already high frequented hours, especially at midday and in the afternoon. Case complexity for frail patients was significantly higher compared to non-frail patients, but varied marginally in time only with respect to triage level and ED LOS. The results suggest that frailty-attuned emergency care should be available in EDs during the busiest hours. Based on EHR data, hospitals thus can tailor their staff needs.
The Internet of Things (IoT) relies on sensor devices to measure real-world phenomena in order to provide IoT services. The sensor readings are shared with multiple entities, such as IoT services, other IoT devices or other third parties. The collected data may be sensitive and include personal information. To protect the privacy of the users, the data needs to be protected through an encryption algorithm. For sharing cryptographic cipher-texts with a group of users Attribute-Based Encryption (ABE) is well suited, as it does not require to create group keys. However, the creation of ABE cipher-texts is slow when executed on resource constraint devices, such as IoT sensors. In this paper, we present a modification of an ABE scheme, which not only allows to encrypt data efficiently using ABE, but also reduces the size of the cipher-text, that must be transmitted by the sensor. We also show how our modification can be used to realise an instantaneous key revocation mechanism.
This paper describes the development and test of a novel LiDAR based combine harvester steering system using a harvest scenario and sensor point cloud simulation together with an established simulation toolchain for embedded software development. For a realistic sensor behavior simulation, considering the harvesting environment and the sensor mounting position, a phenomenological approach was chosen to build a multilayer LiDAR model at system level in Gazebo and ROS. A software-in-the-loop simulation of the mechatronic steering system was assembled by interfacing the commercial AppBase framework for point cloud processing and feature detection algorithms together with a machine model and control functions implemented in MATLAB/ Simulink. A test of ECUs in a hardware-in-the-loop simulation and as well as HMI elements in a driver-in-the-loop simulation was achieved by using CAN hardware interfaces and a CANoe based restbus simulation.