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We investigated whether design experts or laypersons evaluate webpages differently. Twenty participants, 10 experts and 10 laypersons, judged the aesthetic value of a webpage in an EEG-experiment. Screenshots of 150 webpages, judged as aesthetic or as unaesthetic by another 136 participants, served as stimulus material. Behaviorally, experts and laypersons evaluated unaesthetic webpages similarly, but they differed in their evaluation of aesthetic ones: experts evaluated aesthetic webpages as unaesthetic more often than laypersons did. The ERP-data show main effects of level of expertise and of aesthetic value only. There was no interaction of expertise and aesthetics. In a time-window of 110–130 ms after stimulus onset, aesthetic webpages elicited a more negative EEG-amplitude than unaesthetic webpages. In the same time window, experts had more negative EEG-amplitudes than laypersons. This patterning of results continued until a time window of 600–800 ms in which group and aesthetic differences diminished. An interaction of perceiver characteristics and object properties that several interactionist theories postulate was absent in the EEG-data. Experts seem to process the stimuli in a more thorough manner than laypersons. The early activation differences between aesthetic and unaesthetic webpages is in contrast with some theories of aesthetic processing and has not been reported before.
Despite normal neurological bedside and electrodiagnostic, some patients with non-specific neck arm pain (NSNAP) have heightened nerve mechanosensitivity upon neurodynamic testing [1, 2]. It remains however unclear whether this is associated with a minor nerve injury. The aim of this study was to evaluate potential differences in somatosensory function among patients with unilateral NSNAP with and without positive neurodynamic tests and healthy controls.
Quantitative sensory testing was performed in 40 patients with unilateral NSNAP; 23 with positive upper limb neurodynamic tests (ULNTPOS) and 17 with negative neurodynamic tests (ULNTNEG). The protocol comprised thermal and mechanical detection and pain thresholds as well as mechanical pain sensitivity, wind-up ratio and dynamic mechanical allodynia. All parameters were measured in the maximal pain area on the affected side as well as over the corresponding area on the unaffected side. Symptom severity, functional deficits, psychological parameters, quality of life and sleep disturbance were also recorded.
Fifty-seven percent of patients with NSNAP had positive neurodynamic tests despite normal bedside neurological integrity tests and nerve conduction parameters. Clinical profiles did not differ between patient groups. Somatosensory profiling revealed a more pronounced loss of function phenotype in ULNTPOS patients compared to healthy controls. Hyperalgesia (cold, heat and pressure pain) was present bilaterally in both NSNAP group. The ULNTNEG subgroup represented an intermediate phenotype between ULNTPOS patients and healthy controls in both thermal and pressure pain thresholds as well as mechanical detection thresholds.
In conclusion, heightened nerve mechanosensitivity was present in over half of patients with NSNAP. Our data suggest that NSNAP presents as a spectrum with some patients showing signs suggestive of a minor nerve dysfunction.
[1] Elvey RL. Physical evaluation of the peripheral nervous system in disorders of pain and dysfunction. J Hand Ther 1997;10:122-129.
[2] van der Heide B, Bourgoin C, Eils G, Garnevall B, Blackmore M. Test-retest reliability and face validity of a modified neural tissue provocation test in patients with cervicobrachial pain syndrome. J Man Manip Ther 2006;14:30-36.
The aim of the study was to examine different pH parameters, such as variations throughout the day, depending on differing concentrate feed proportions. Moreover, special attention was payed to individual variation in microbial efficiencies (microbial crude protein/fermented organic matter) and their relation to ruminal pH, nutrient flows and digestibilities. For this, cows were grouped according to microbial efficiency (more, n = 5, vs. less efficient cows, n = 4). After calving, thirteen ruminally cannulated pluriparous cows, including nine duodenally cannulated animals, were divided into groups offered rations with a lower (35% on dry matter basis, n = 7) or a higher (60% on dry matter basis, n = 6) concentrate feed proportion. Ruminal pH parameters were assessed continuously by using intraruminal probes. Nutrient flows, nutrient digestibility and microbial efficiency were determined for duodenally cannulated cows. For most ruminal pH parameters it seemed that individual variability was higher than the treatment effect. However, a positive relationship between actual concentrate intake and diurnal pH fluctuations was found. Besides, the effect of individually different microbial efficiencies was assessed. Again, there were no group differences for pH parameters. However, nutrient flows were significantly higher in more efficient cows, whereas digestibilities were lower in in more efficient cows.
Social determinants of health that influence the healthy living process in a vulnerable community
(2016)
Objectives: to identify the errors in daily intensive nursing care and analyze them according to the theory of human error. Method: quantitative, descriptive and exploratory study, undertaken at the Intensive Care Center of a hospital in the Brazilian Sentinel Hospital Network. The participants were 36 professionals from the nursing team. The data were collected through semistructured interviews, observation and lexical analysis in the software ALCESTE®. Results: human error in nursing care can be related to the approach of the system, through active faults and latent conditions. The active faults are represented by the errors in medication administration and not raising the bedside rails. The latent conditions can be related to the communication difficulties in the multiprofessional team, lack of standards and institutional routines and absence of material resources. Conclusion: the errors identified interfere in nursing care and the clients’ recovery and can cause damage. Nevertheless, they are treated as common events inherent in daily practice. The need to acknowledge these events is emphasized, stimulating the safety culture at the institution.
Objective: to understand the meaning of the Adult Intensive Care Unit environment of care,
experienced by professionals working in this unit, managers, patients, families and professional
support services, as well as build a theoretical model about the Adult Intensive Care Unit
environment of care. Method: Grounded Theory, both for the collection and for data analysis.
Based on theoretical sampling, we carried out 39 in-depth interviews semi-structured from
three different Adult Intensive Care Units. Results: built up the so-called substantive theory
“Sustaining life in the complex environment of care in the Intensive Care Unit”. It was bounded
by eight categories: “caring and continuously monitoring the patient” and “using appropriate
and differentiated technology” (causal conditions); “Providing a suitable environment” and
“having relatives with concern” (context); “Mediating facilities and difficulties” (intervenienting
conditions); “Organizing the environment and managing the dynamics of the unit” (strategy)
and “finding it difficult to accept and deal with death” (consequences). Conclusion: confirmed
the thesis that “the care environment in the Intensive Care Unit is a living environment, dynamic
and complex that sustains the life of her hospitalized patients”.
Report on visits in hospices located in Osnabrück/Germany and the Saint Cristopher’s Hospice in London/United
Kingdom; and present a discussion about the care mode. Methods: Experience report based on a post-doctoral research period
in Germany between November 2013 and October 2014, funded by the CAPES Foundation (Coordination for the Improvement of
Higher Education Personnel). Results: The structure, operation mode of the institutions and the main labor force were discussed,
especially the nursing staff and volunteers’ participation, the main care activities and challenges. These issues were very similar
at the hospices, highlighting the hospice responsible for spreading this moviment worldwide. Conclusion: The hospice may be
the place of death, but it provides a pleasant environment that preserves the person’s individuality and autonomy. It relies on the
participation of volunteers, dissemination of its idea and training programs, which ensure the strengthening of this movement.
Background: Pancreatic cancer is one of the malignant diseases with the highest cancer-specific mortality. At the time of diagnosis, life expectancy is often already very limited, as it is usually discovered late and in an advanced stage. Coping with cancer is a complex process. Coping strategies of patients with pancreatic cancer probably differ from those of other malignancies. Yet to date, there exists no pancreatic cancer-specific coping model.
Objective: The objective of this scoping review is to explore and characterize the academic literature related to coping processes in patients with pancreatic cancer.
Methods/Design: The JBI's three-step search strategy, combined with the Arksey and O'Malley framework, will be used to identify articles via PubMed/MEDLINE, CINAHL, Cochrane Library, Google Scholar, CAMbase, CareLit, CC Med, Scopus, and PsycARTICLES (Arksey & O'Malley, 2005; Peters et al., 2017). It follows the PRISMA guidelines for scoping reviews (Tricco et al., 2018). Primary and secondary studies and reviews which report on coping with pancreatic cancer (adenocarcinoma) in adults in English or German language will be included in this scoping review, regardless of publication date or study design.
Discussion: This scoping review will add new insights on coping with pancreatic cancer by summarizing current knowledge, and identifying research
To ensure the quality of long-term care services has been one of the key elements of German long-term care insurance since its implementation in 1995. A joint agreement between insurers and service providers served as the baseline for quality assurance. Monitoring and control of quality in institutional and home based long-term care was performed by the insurers’ Medical Board. As a result of problems in some long-term care facilities reported in the media the Long-term Care System Reform Act of 2008 contained several provisions to ensure and improve the quality of services. The obligatory use of expert standards for the performance of particular nursing interventions and the establishment of a system of public reporting were the first measures implemented. The development of quality indicators has also been initiated. These routes to quality, their anticipated effects and remaining challenges will be addressed in this article.
Background: Informal caregiving by family members is the most common way of caring for sick people at home. However, the number of care arrangements, in which both formal (nurses) and informal (family members) caregivers are involved, is considerable and increasing. Despite implicit assumptions in research that the involvement of nurses in home care arrangements is inherently beneficial, there is evidence that their involvement may have a destabilising effect.
Aims: The purpose of this study was to investigate the relationship between nurses and family caregivers and its impact on the actual care that is provided.
Method: Eighty-eight interviews with family caregivers (n = 57) and nurses (n = 31) were conducted in Germany and analysed according to the Grounded Theory methodology.
Findings: The relationship between formal and informal care is an encounter of two quite different perspectives that is focused on a negotiation process about caregiving work and the helpfulness of the actions taken and the interventions used. For family caregivers, it is determined by the goal of facilitating work and care for their sick family member. The nurses’ work is characterised by a process of shaping different realities in different homes. The results reveal the processes that lead to the involvement of nurses into home care arrangements and offer a deeper understanding of the negotiation processes between formal and informal caregivers.
Conclusions: To provide sufficient support in home care, nurses need the ability to engage in negotiation processes that take the whole home care arrangement into account. Developmental work is needed to design services that are helpful for family caregivers.
Background: We see a growing number of older adults receiving long-term care in industrialized countries. The Healthcare Utilization Model by Andersen suggests that individual need characteristics influence utilization. The purpose of this study is to analyze correlations between need characteristics and service utilization in home care arrangements.
Methods: 1,152 respondents answered the questionnaire regarding their integration of services in their current and future care arrangements. Care recipients with high long-term care needs answered the questionnaire on their own, the family caregiver assisted the care recipient in answering the questions, or the family caregiver responded to the questionnaire on behalf of the care recipient. They were asked to rank specific needs according to their situation. We used descriptive statistics and regression analysis.
Results: Respondents are widely informed about services. Nursing services and counseling are the most used services. Short-term care and guidance and training have a high potential for future use. Day care, self-help groups, and mobile services were the most frequently rejected services in our survey. Women use more services than men and with rising age utilization increases. Long waiting times and bad health of the primary caregiver increases the chance of integrating services into the home care arrangements.
Conclusion: The primary family caregiver has a high impact on service utilization. This indicates that the whole family should be approached when offering services. Professionals should react upon the specific needs of care dependents and their families.
The aim of this study was to provide a systematic overview of available pressure ulcer prevention quality indicators and to evaluate the underlying empirical evidence. A systematic mapping review was conducted with combined searches in Embase and Medline, and websites of relevant institutions and organisations. The eligibility criteria were clear use of the term “quality indicator” regarding pressure ulcer prevention; English or German language; and all settings, populations, and types of resources, including articles, brochures, and online material. In total, n = 146 quality indicators were identified. Most indicators were published in the United States (n = 50). The majority of indicators was developed for the hospital setting (n = 102). Process indicators were the most common (n = 71), followed by outcome indicators (n = 49). Less than half of identified indicators appeared to be practically used. Evidence supporting the validity and reliability were reported for n = 25 and n = 30 indicators respectively. The high number of indicators demonstrate the importance of measuring pressure ulcer prevention quality. This is not an indicator of our ability to accurately measure and evaluate this construct. There is an urgent need to develop evidence-based and internationally comparable indicators to help improve patient care and safety worldwide.
Gender disparities in German home-care arrangements
An ageing population correlates with rising needs for
long-term care (LTC). Support programmes should con-
sider the specific needs of the various subgroups of care
dependents and family caregivers. The objective of this
study was to analyse the gender-specific disparities in
home-care arrangements in Germany, and for this pur-
pose, survey and insurance claims data were used. A sur-
vey of 2545 insured care recipients with high-level care
needs was conducted in 2012 with the Barmer GEK, a
major German statutory healthcare insurance. Insurance
claims data were provided for a follow-up, focussing on
the group aged 60 years and older. For statistical compar-
ison, chi-squared test and t-tests were used, and a p-
value < 0.05 was considered statistically significant. Most
care recipients are female, and they are on average
2 years older than males. Men receive family care mostly
from their wives, whereas widows frequently live alone
and receive care from daughters, sons, other relatives,
neighbours and friends, as well as from professional
nursing services. Furthermore, women more often antici-
pate the need for (further) professional assistance and
move in with a relative or to an assisted living facility or
a nursing home in good time. The desired rate for reloca-
tion to a nursing home was higher than the anticipated,
and during the 6-month follow-up, the actual rate of
relocations was in between both. In summary, the caring
situation of men and women is different. Care-receiving
men are most often cared for by their wives. Widowed
women need a social network and their children in order
to remain in their own home. To provide better home-
care arrangements for women in this situation, the fam-
ily and social networks need a stronger focus in politics
and research. To stabilise the home-care situation of men
with high-level care needs, their wives need more
support.
Objectives: This paper addresses recent steps for reforming the eligibility criteria of the German long-term care insurance that have been initiated to overcome shortcomings in the current system.
Methods: Based on findings of a survey of international long-term care systems, assessment tools and the relevant literature on care needs a new tool for determining eligibility in the German long-term care insurance was developed.
Results: The new tool for determining long-term care eligibility broadens the understanding of what ‚dependency on nursing care' implies for the person affected. The assessment results in a degree of dependency from personal help provided by formal or informal caregivers. This degree of dependency can be used for determining eligibility for and the amount of long-term care benefits.
Discussion: The broader understanding of "dependency on nursing care' and the new tool are important steps to adapt the German long-term care insurance to the challenges of the demographic and societal changes in the future
The conservation of freshwater ecosystems has lagged behind that of marine and terrestrial ecosystems and often requires the integration of large-scale approaches and transboundary considerations. This study aims to set the foundations of a spatial conservation strategy by identifying the most important catchments for the conservation of freshwater biodiversity in Europe.
Using data on 1296 species of fish, mollusc, odonate and aquatic plant, and the key biodiversity area criteria (species Red List status, range restriction and uniqueness of species assemblages), we identified a network of Critical Catchments for the conservation of freshwater biodiversity. Applying spatial prioritisation, we show how the prioritised network differs from the ideal case of protecting all Critical Catchments and how it changes when protected areas are included, and we also identify gaps between the prioritised network and existing protected areas.
Critical Catchments (n = 8423) covered 45% of the area of Europe, with 766 qualifying (‘trigger’) species located primarily in southern Europe. The prioritised network, limited to 17% of the area of Europe, comprised 3492 catchments mostly in southern and eastern Europe and species targets were met for at least 96% of the trigger species.
We found the majority of Critical Catchments to be inadequately covered by protected areas. However, our prioritised network presents a possible solution to augment protected areas to meet policy targets while also achieving good species coverage.
Policy implications. While Critical Catchments cover almost half of Europe, priority catchments are mostly in southern and eastern Europe where the current level of protection is not sufficient. This study presents a foundation for a Europe-wide systematic conservation plan to ensure the persistence of freshwater biodiversity. Our study provides a powerful new tool for optimising investment on the conservation of freshwater biodiversity and for meeting targets set forth in international biodiversity policies, conventions and strategies.
The apple fruit (Malus domestica L. Borkh) is one of the most popular fruits worldwide. Beyond their beneficial properties, apples contain proteins that trigger allergic reactions in susceptible consumers. Mal d1 to d4 are allergens present in a variety of different isoforms in apples. In this study, we used proteomics to quantify all four Mal d proteins in 52 apple genotypes with varying allergenic potentials. A total of 195, 17, 14, and 18 peptides were found to be related to Mal d1, d2, d3, and d4 proteins, respectively of which 25 different Mal d proteins could be unambiguously identified. The allergenic potential of the Mal d isoforms was characterized by comparing the isoform abundance with the allergenic score of genotypes from oral challenge tests. The detected Mal d peptides presumably have different IgE binding properties and could be used as potential molecular markers to discriminate between hypoallergenic and hyperallergenic cultivars.
This article is based on an international comparative social policy module held annually at Malmö University (Sweden) with partner universities from several countries. Our study examines the results of intra- and interpersonal dynamics among participants and lecturers, which we call "productive tension", in relation to overarching questions about knowledge acquisition and the importance of reflexivity and reflectivity in the learning process. Students and faculty create a "community of practice" (CoP) (Lave & Wenger 1991) that benefits from a continuous interactive environment and direct engagement. Our study uses a mixed method approach. The analysis considers qualitative data from interviews with the participating students and quantitative data from questionnaires. In this article, we focus on the productive tension inherent in the reflective and reflexive processes. Reflective and reflexive processes are identified that influence the students' experience of cross-border cooperation and their professional identity. Our study also demonstrates how the knowledge about "Social Work" as a profession can be broadened through international comparative teaching and learning. The main conclusion of this work is that reflective and reflexive learning processes in social work education enable participants to see and understand themselves from a broader perspective and strengthen their own professional identity.
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.
Computer-image processing becomes more and more important in the analysis of data in biological and agricultural research and practice. However, robust image processing is highly de pendent on the histogram analysis algorithms used and the quality of the data being processed. The algorithm presented here aims to improve the accuracy of the classification of image data generated under complex boundary situations and inconsistent lighting conditions. Using the example of the determination of nitrogen content of tomato leaves and the qualitative determination of starch con tent of apples on the basis of color image processing, we showed that the developed algorithm is able to perform a robust classification and represents an improvement to simple histogram analysis.
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.
Objectives:
The purpose of this study was to determine the motor function of the abdominal muscles in singers with and without functional voice disorders and to examine them for possible differences. Additionally, the breathing behaviour and posture control was investigated.
Study Design
Observational study.
Methods:
Female subjects (n = 20) with differing levels of professional competence were used to provide the data for analysis. By using the Singing Voice Handicap Index (SVHI) the grade of dysphonia could be measured, and the subjects were organized in groups. The change of muscle thickness of the M. transversus abdominis (TVA) and the M. obliquus internus abdominis (OIA) during different singing tasks was measured by using ultrasound. The subjects were then asked to perform the Abdominal Hollowing Test (AHT) with the STABILIZER. Finally, the subjects were all filmed while singing. The videos recordings of the singing sessions were analysed by an independent clinical expert regarding breathing and secondary motor activities (SMA). For the statistical analysis, the Mann-Whitney-U Test and the Chi-Square-Test was mainly used.
Results:
The results showed a significantly thinner TVA in the group with dysphonia in comparison to the group without dysphonia. Ultrasound measurements showed significantly higher changes of muscle thickness of the TVA during singing tasks in the group with dysphonia. Regarding the AHT there was a significant difference between the two groups. The group with dysphonia was not able to increase the pressure by 15mmHg. Furthermore, the healthy subjects demonstrated abdominal breathing, while the group with dysphonia present with thoracic breathing. Additionally, it was noted that the subjects with dysphonia showed a higher level of associated movements especially at and/or on the lumbar spine, cervical spine and the left arm and shoulder.
Conclusion:
Differences in TVA-recruitment, breathing behaviour and secondary motor activities while singing were found. This study sparks new ideas for neuromusculoskeletal assessments and therapy.
Key Words
Transversus abdominis, Abdominal muscles, Dysphonia, Ultrasound, Singing voice, Singers
This chapter presents the mechanism of the enhancement of freezing by means of ultrasound (US). It has been demonstrated that the effects of US are a rather complex issue. In theory, ultrasound creates cavitation bubbles throughout the volume of the product, which promotes nucleation of the ice and crushes the crystals already present in food. They can also enhance convective heat transfer to the cooling media, thereby accelerating freezing. Moreover, it has been shown that ultrasound reduces the degree of supercooling before nucleation in frozen food. Additionally, numerous experimental studies indicate that ultrasound assisted freezing is a good method to achieve homogenous crystallizations, reduce the deteriorating effect of freezing on food, and thus improve quality after thawing.
Musicians often suffer from disorders of the musculoskeletal system that are related to their instrument playing. Among the most frequent symptoms are complaints in the shoulder-neck area. Radial shock wave therapy is increasingly used in trigger point treatment, but only few high-level studies have examined of shock wave therapy used together with physical therapy in the treatment of musicians. METHODS: This randomized blinded study in musicians (n = 26) with nonspecific shoulder-neck problems was done to examine the effect of shock wave therapy in addition to current physical therapy on the symptoms and quality of life of the musicians as well as their habits of playing musical instruments (intervention group shock wave vs reference group placebo). The effects were documented by a pain VAS and other instruments. A questionnaire designed specifically for musicians (with initial and final questions) recorded intensity and manifestation of pain and handicaps in daily life, especially when practicing and playing. The Shoulder Pain and Disability Index (SPADI) and the Neck Pain Disability Index Questionnaire (NPDIQ) were also used. RESULTS: Both groups reported subjective improvement in pain, but significance was found only for the intervention group for the SPADI and NPDIQ. CONCLUSIONS: Trigger point treatment with radial shock wave used in combination with physical therapy makes the subjects feel temporarily relieved of neck and shoulder pains. The effects of radial shock wave without physical therapy will need to be examined in further studies.
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.
Dairy farming has been the subject of public debate on animal welfare for a number of years now. Animal welfare discussions on dairy farming often include the demand for more nature connectedness in this area. This study focuses on the divergent perspectives of consumers and scientists on the importance of more nature connectedness for animal welfare strategies in German dairy farming. Within Europe, Germany is the main producer of cow’s milk and an important industry in many rural areas in Germany is dairy farming. The insights presented are based on qualitative interviews with dairy farming and livestock researchers from Germany and Austria. A key finding of this study is that we need to look more closely at the actual content of nature claims in animal welfare debates. The scientists interviewed tend to see idealized conditions in animal welfare discussions with images of nature which in fact seldom lead to improved conditions in dairy farming and, even then, only to a limited extent. The scientists interviewed rate calls for more nature connectedness in dairy farming from the nonagricultural public as anti-modern, complexity-reducing, and normative. Nevertheless, some of the scientists interviewed did have valuable insights into the nonagricultural public’s criticism of dairy farming practices. These scientists argued, however, that animal welfare needs to differentiate between nature connectedness and the innate needs of cattle when it comes to animal welfare strategies. An important conclusion of the study is that more discussion formats are needed to promote the exchange of ideas between different social groups attempting to understand animal welfare in dairy farming.
Boron dynamics in a peat-based growing medium and its impact on the growth of basil (Abstract)
(2021)
Enhancing the nutritional value of pears through agronomic biofortification with iodine (Abstract)
(2024)
Duckweed is gaining attention in animal nutrition and is considered as a potential alternative protein source for broiler chickens. In order to evaluate the nutritional value of duckweed, three individual batches were investigated. They consisted of a mixture of Lemna minuta and Lemna minor (A, 17.5% crude protein), Spirodela polyrhiza (B, 24.6% crude protein) and Lemna obscura (C, 37.0% crude protein). Treatment diets contained 50% batch A, 50% batch B, and 25, 50 and 75% of batch C. All diets were fed to broiler chickens (Ross 308) from an age of 21 to 27 days. Diets with a share of 50 and 75% of batch C led to decreased feed intake (109.3 and 74.9 g/day, respectively) compared to the control. Standardized ileal digestibility of crude protein and amino acids differed significantly between duckweed batches, at values for methionine between 49.9 and 90.4%. For all amino acids, batch A consistently had the lowest and batch C the highest digestibility. Batches had different tannin contents of 2943, 2890 and 303 mg/kg for batches A, B and C, respectively. The apparent ileal digestibility of phosphorus differed significantly between all batches (50.8–78.9%). Duckweed can be used as a protein feed for broiler chickens. However, a defined and stable biomass composition optimized for the requirements of broiler chickens is needed.
Objectives
The aims of the present study were to provide back pain (BP) point prevalence data from inpatients at an Australian tertiary hospital on one day, and compare this with Australian non-hospitalized population prevalence data; to collect data around the development of BP throughout hospital admission; and to analyse the association between BP and past history of BP, gender, age, admission specialty and hospital length of stay (LOS).
Methods
This was a single-site, prospective, observational study of hospitalized inpatients on one day during 2016, with a subsequent survey over the following 11 days (unless discharge or death occurred sooner).
Results
Data were collected from 343 patients (75% of the hospitalized cohort). A third of patients (n = 108) reported BP on admission, and almost a fifth (n = 63) developed new BP during their hospitalization. Patients who described BP at any time during their hospital stay had a higher chance of having had a history of BP, with odds increasing after adjustment for age and gender (odds ratio 5.89; 95% confidence interval (CI) 3.0 to 11.6; p < 0.001). After adjusting for age and gender, those experiencing BP had a significantly longer LOS (median 13 days; CI 10.8 to 15.3) than those who did not (median 10 days; CI 8.4 to 11.6; p = 0.034).
Conclusions
Hospital LOS for patients who complained of BP at any time during their admission was 3 days longer than those who had no BP, and a history of BP predicted a higher likelihood of BP during admission. Screening of patients on admission to identify any history of BP, and application of a package of care including early mobilization and analgesia may prevent the onset of BP and reduce LOS.
Technological support options for the usage of Brazilian Açaí berries in the European Food Market
(2022)
The highly perishable fruit açaí grows on palm trees in northern Brazil and is colloquially known as a berry with high nutritional value. The seed of the drupe makes up around 85 percent of the fruits weight and only the pulp around the seed is used for human consumption. The manufacturing step after harvest includes the pulping and the preservation of the fruit. The preservation step is necessary, because the açaí pulp contains a high microbial load. There are several preservation processes including the use of chlorinated or ozonated water, alcoholic fermentation, pasteurization, freezing or dehydration. Those techniques are overall not very gentle and have the potential to leave residues in the final product, which can change its typical sensorial characteristics. Therefore, an experiment was conducted, to see if a relatively new gentle preservation method called PEF can reduce the microbial load in an açaí- smoothie.
For this purpose, a PEF-machine was built and verified based on the paper from HEINZ ET AL. [2003]. The self-built machine works efficiently, when there is a reduction of microorganisms like Escherichia coli in apple juice due to the induced Pulsed Electric Fields. If this is the case, the described experiment with açaí-smoothie can be carried out with the self-built PEF- machine. In this experiment the results of the validation of this PEF-machine were not comparable to those from the paper from HEINZ ET AL. [2003]. So, the self-built PEF-machine in Brazil did not work sufficiently. Hence, the experiment which should show that a reduction of microorganisms, such as Escherichia coli, in açaí-smoothie with PEF is possible, was performed in Germany. It was accrued out at ELEA with using the PEFPilotTM Dual. This experiment confirmed the assumption, that microorganisms can be reduced in açaí-smoothie with PEF. Escherichia coli was reduced by 2 logs, Saccharomyces cerevisiae by 3 logs and Lactobacillus plantarum by 6 logs. And a comparison between PEF and the known preservation methods for açaí showed that it can be a compatible alternative.
Moreover, the topic, how açaí fits into the European Food Market is answered within this paper. When offering açaí food products to the European population, ideas can be originated from the well-working Brazilian market. It can be helpful to mix açaí with known European fruits for a better acceptance by the people. Then açaí can help to meet the Europeans needs of the current time for fresh and healthy food, especially when preserved with PEF. Furthermore, it is important to work towards a sustainable supply chain system from the cultivation until the unloading at the destination in Europe. Sustainability is important for the integration in the European market, not only for environmental protection, but also in terms of social stability and marketing purposes. In addition, access requirements, further food-related regulations, and the seasonality of açaí present a major hurdle.
Building on this thesis, further papers shall be written, not only in the field of the preservation of the açaí pulp with PEF, but also in the direction of combined preservation methods for açaí, the sustainable usage of the açaí seeds, product innovations containing the Brazilian fruit or various market research.
Who is more eager to use Gamification in Economic Disciplines? Comparison of Students and Educators
(2022)
Background: In this paper, the focus is on the application of digital and mobile technologies as supporting tools for the implementation of gamification in the field of education of future economists. Objectives: The paper's main objective is to explore whether educators and students are motivated and willing to apply additional technologies as main gamification components in their work and education. Moreover, the paper aims to assess how their more comprehensive application affects the quality of teaching, work flexibility, new learning opportunities, and outcomes. Methods/Approach: The survey method was used to collect answers from educators and students primarily interested in accounting, finance, trade and tourism from higher and secondary education institutions in Croatia, Poland, Serbia and Germany. Afterwards, the responses were compared using statistical methods. Results: Research results confirm that educators and students are willing to use gamification in teaching. Still, they also expressed the need for better administrative support in using particular e-learning tools. Surprisingly, educators are more eager to use gamification in their work than students. Conclusions: The study's general conclusion is that educators and students are both aware of the advantages of using e-learning tools provided through digital and mobile technologies and are eager to implement more gamification in the teaching process. However, continuous education in applying new digital technologies is needed on both sides.
BACKGROUND: Postoperative delirium (POD) is an acute and common complication after surgery that can increase morbidity and mortality. Few previous studies with inconsistent findings have examined the association of preoperative pain and POD. Our purpose is to investigate the association of preoperative chronic pain and POD.
METHODS: This prospective observational cohort study included 200 patients ≥ 18 years scheduled for elective surgery under general anaesthesia in a tertiary care hospital. POD was defined as meeting diagnostic criteria during the study visits (according to delirium screening tests and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), or by diagnosis of the responsible physicians. Chronic pain was defined as pain lasting six months or longer. Features of chronic pain were assessed with the German Pain Questionnaire, including the Depression Anxiety and Stress Scale-21 (DASS-21). Associations with POD were assessed using logistic regression analysis adjusting for confounding factors.
RESULTS: Thirty-nine (22%) out of 176 patients developed POD. Chronic pain was not associated with POD after adjustment for ASA physical status, duration of anesthesia and DASS-21 Anxiety score (Odds ratio [OR], 95%-Confidence Interval [CI], 2.216 [0.968;5.070], P=0.060). A subgroup analysis of chronic pain patients revealed that current pain intensity was higher in patients with POD.
CONCLUSIONS: Preoperative chronic pain was no independent predictor for POD. Current pain intensity was higher in chronic pain patients with POD. This indicates that certain features of pain might be influential. Further research is needed to examine different forms of preoperative pain and their possible influence on POD.
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.
Introduction: Handovers are a central process for ensuring information continuity in patient care and, therefore, possess a major influence on patient safety as errors due to poor handovers can lead to life-threatening events. Education to improve handovers and ensure safe patient care can be supported by using critical incident reporting systems (CIRS). The aim of the study is to perform a content analysis of a national CIRS-database with regard to identifying adverse events in handovers situations and to derive competencies for the development of continuing education from these findings.
Methods: A meta model served as a research framework to merge the empirical findings with the London protocol of analysing critical events and the Canadian framework of safety competencies. Relevant cases to be investigated were searched in a freely accessible German CIRS database.
Results: A total of 253 case descriptions were found and analysed. Team factors emerged as the most frequently reported influencing factors following the analysis of the London protocol. Communication errors and missing information as well as a lack of appropriate standards and processes appeared to be the main reasons for critical events to occur. Most of the events happened in units involving surgery and intensive care. A mapping of patient safety competences with the reasons for critical events was conducted in order to determine the practical, concrete and handover related competencies.
Conclusion: Data from a CIRS database and theoretical frameworks can be combined to extract meaningful information about patient safety risks in handover situations. The results are useful for developing curricula to improve handovers based on patient safety competencies.
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.
While Nursing Informatics competencies seem essential for the daily work of nurses, they are not formally integrated into nursing education in Austria, Germany and Switzerland, nor are there any national educational recommendations. The aim of this paper is to show how such recommendations can be developed, what competency areas are most relevant in the three countries and how the recommendations can be implemented in practice. To this end, a triple iterative procedure was proposed and applied starting with national health informatics recommendations for other professionals, matching and enriching these findings with topics from the international literature and finally validating them in an expert survey with 87 experts and in focus group sessions. Out of the 24 compiled competency areas, the relevance ratings of the following four recommended areas achieved values above 90%: nursing documentation (including terminologies), principles of nursing informatics, data protection and security, and quality assurance and quality management. As there were no significant differences between the three countries, these findings laid the foundation of the DACH Recommendations of Nursing Informatics as joint German (D), Austrian (A), and Swiss (CH) recommendations in Nursing Informatics. The methodology proposed has been utilized internationally, which demonstrates the added value of this study also outside the confines of Austria, Germany, Switzerland.
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.
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.
Current challenges are a result of complex and multi-layered factors. They require systemic solutions: problems must be solved holistically by identifying interconnections between the different problems which are results of the same root cause. Social entrepreneurs are agents of change, their mission is to generate societal impact. I investigated how a social entrepreneurship think tank can be conceptualized to support systems change. Think tanks can conduct in-depth research to inform about the systems and share knowledge. Entrepreneurs can make strategic interventions based on the research findings. To create a framework of how social entrepreneurship think tanks can promote systems change I conducted 14 case studies. The framework is created based on the method of Theory of Change, it displays how different activities can contribute to succeeding in systems change. I outline eleven activities which include strategies in capacity building, research and collaboration with the other actors in the field. In the end, the framework is applied to the evolving case of a think tank founded in 2018.
Die Ernährung ist für etwa 30 % des weltweiten Verbrauchs an natürlichen Ressourcen verantwortlich. Um die negativen Auswirkungen des Ernährungssektors auf die Umwelt und die Gesellschaft zu begrenzen, ist der Verbrauch und die Verarbeitung von Lebensmitteln mit vermeintlich geringen negativen Auswirkungen ein wichtiges Thema bei den Bemühungen um eine nachhaltige Entwicklung. In den Großküchen sind klar definierte Indikatoren zur Bewertung der Auswirkungen von Geschäftsaktivitäten erforderlich, um dieses Ziel zu erreichen. Die Forschungs- und Entwicklungsarbeiten im Rahmen des NAHGAST-Projekts liefern Grundlagen, die bei diesen Bemühungen eine wichtige Hilfe sein können. Es wurden zwei Versionen eines Bewertungsinstruments mit Indikatoren unterschiedlicher Komplexität (NAHGAST Meal-Basic und NAHGAST Meal-Pro) entwickelt, die von Küchenfachleuten verwendet werden können, um die Nachhaltigkeitsleistung ihrer Produkte - der angebotenen Mahlzeit - zu bestimmen. Eine sachkundige Auswahl von Indikatoren und eine Diskussion darüber, auf welche Prozesse und Auswirkungen sich dieser Indikator im weiteren Kontext bezieht, sind von wesentlicher Bedeutung und werden in diesem Papier erörtert. Darüber hinaus wurden bei der Auswahl der Indikatoren für den Zweck unserer Forschung bestimmte Kriterien gleichzeitig berücksichtigt: (1) Kommunizierbarkeit - Welche Informationen ein Indikator vermitteln kann und wie verständlich diese Informationen für verschiedene Akteure sind; (2) Machbarkeit und Datenverfügbarkeit: Gibt es genügend Daten für einen Indikator und ist es für die Unternehmen realistisch, diesen Indikator in ihre tägliche Arbeitspraxis zu integrieren? (3) Wissenschaftliche Relevanz: Ist der Indikator für die Nachhaltigkeitsbemühungen in größerem Maßstab und für entsprechende Diskussionen in der wissenschaftlichen Gemeinschaft relevant? Die Erkenntnisse aus diesen Überlegungen sind wertvoll für zukünftige Entwicklungen in der Nachhaltigkeitsbewertung in der Außer-Haus-Gastronomie. Das Instrument wurde zur Bewertung einer Reihe von Gerichten verwendet und die Ergebnisse werden als aussagekräftig erachtet. Allerdings dürfen Bewertungen jedoch nicht als genaue Messung, sondern nur als Annäherung an die Nachhaltigkeit von Speisen verstanden werden. Auf der Ebene der einzelnen Indikatoren ermöglichen sie eine detaillierte Analyse und gezielte Optimierung von Rezepten, während die aggregierten Ergebnisse in Form von Etiketten gut an die Kunden kommuniziert werden können. Defizite und Herausforderungen, wie sie in der Anwendungsphase des Projekts festgestellt wurden, zeigen jedoch Forschungslücken im weiteren Kontext auf. Abschließend werden weitere Schritte für eine Integration des Tools in Unternehmensprozesse und verbleibende Anpassungsmöglichkeiten für Unternehmen diskutiert.
Background and purpose:
Clinical information logistics is a construct that aims to describe and explain various phenomena of information provision to drive clinical processes. It can be measured by the workflow composite score, an aggregated indicator of the degree of IT support in clinical processes. This study primarily aimed to investigate the yet unknown empirical patterns constituting this construct. The second goal was to derive a data-driven weighting scheme for the constituents of the workflow composite score and to contrast this scheme with a literature based, top-down procedure. This approach should finally test the validity and robustness of the workflow composite score.
Methods:
Based on secondary data from 183 German hospitals, a tiered factor analytic approach (confirmatory and subsequent exploratory factor analysis) was pursued. A weighting scheme, which was based on factor loadings obtained in the analyses, was put into practice.
Results:
We were able to identify five statistically significant factors of clinical information logistics that accounted for 63% of the overall variance. These factors were “flow of data and information”, “mobility”, “clinical decision support and patient safety”, “electronic patient record” and “integration and distribution”. The system of weights derived from the factor loadings resulted in values for the workflow composite score that differed only slightly from the score values that had been previously published based on a top-down approach.
Conclusion:
Our findings give insight into the internal composition of clinical information logistics both in terms of factors and weights. They also allowed us to propose a coherent model of clinical information logistics from a technical perspective that joins empirical findings with theoretical knowledge. Despite the new scheme of weights applied to the calculation of the workflow composite score, the score behaved robustly, which is yet another hint of its validity and therefore its usefulness.
Background:
Large health organizations often struggle to build complex health information technology (HIT) solutions and are faced with ever-growing pressure to continuously innovate their information systems. Limited research has been conducted that explores the relationship between organizations’ innovative capabilities and HIT quality in the sense of achieving high-quality support for patient care processes.
Objective:
The aim of this study is to explain how core constructs of organizational innovation capabilities are linked to HIT quality based on a conceptual sociotechnical model on innovation and quality of HIT, called the IQHIT model, to help determine how better information provision in health organizations can be achieved.
Methods:
We designed a survey to assess various domains of HIT quality, innovation capabilities of health organizations, and context variables and administered it to hospital chief information officers across Austria, Germany, and Switzerland. Data from 232 hospitals were used to empirically fit the model using partial least squares structural equation modeling to reveal associations and mediating and moderating effects.
Results:
The resulting empirical IQHIT model reveals several associations between the analyzed constructs, which can be summarized in 2 main insights. First, it illustrates the linkage between the constructs measuring HIT quality by showing that the professionalism of information management explains the degree of HIT workflow support (R²=0.56), which in turn explains the perceived HIT quality (R²=0.53). Second, the model shows that HIT quality was positively influenced by innovation capabilities related to the top management team, the information technology department, and the organization at large. The assessment of the model’s statistical quality criteria indicated valid model specifications, including sufficient convergent and discriminant validity for measuring the latent constructs that underlie the measures of HIT quality and innovation capabilities.
Conclusions:
The proposed sociotechnical IQHIT model points to the key role of professional information management for HIT workflow support in patient care and perceived HIT quality from the viewpoint of hospital chief information officers. Furthermore, it highlights that organizational innovation capabilities, particularly with respect to the top management team, facilitate HIT quality and suggests that health organizations establish this link by applying professional information management practices. The model may serve to stimulate further scientific work in the field of HIT adoption and diffusion and to provide practical guidance to managers, policy makers, and educators on how to achieve better patient care using HIT.
Background:
While aiming for the same goal of building a national eHealth Infrastructure, Germany and the United States pursued different strategic approaches – particularly regarding the role of promoting the adoption and usage of hospital Electronic Health Records (EHR).
Objective:
To measure and model the diffusion dynamics of EHRs in German hospital care and to contrast the results with the developments in the US.
Materials and methods:
All acute care hospitals that were members of the German statutory health system were surveyed during the period 2007–2017 for EHR adoption. Bass models were computed based on the German data and the corresponding data of the American Hospital Association (AHA) from non-federal hospitals in order to model and explain the diffusion of innovation.
Results:
While the diffusion dynamics observed in the US resembled the typical s-shaped curve with high imitation effects (q = 0.583) but with a relatively low innovation effect (p = 0.025), EHR diffusion in Germany stagnated with adoption rates of approx. 50% (imitation effect q = -0.544) despite a higher innovation effect (p = 0.303).
Discussion:
These findings correlate with different governmental strategies in the US and Germany of financially supporting EHR adoption. Imitation only seems to work if there are financial incentives, e.g. those of the HITECH Act in the US. They are lacking in Germany, where the government left health IT adoption strategies solely to the free market and the consensus among all of the stakeholders.
Conclusion:
Bass diffusion models proved to be useful for distinguishing the diffusion dynamics in German and US non-federal hospitals. When applying the Bass model, the imitation parameter needs a broader interpretation beyond the network effects, including driving forces such as incentives and regulations, as was demonstrated by this study.
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.
Background: In longitudinal studies, observations are made over time. Hence, the single observations at each time point are dependent, making them a repeated measurement. In this work, we explore a different, counterintuitive setting: At each developmental time point, a lethal observation is performed on the pregnant or nursing mother. Therefore, the single time points are independent. Furthermore, the observation in the offspring at each time point is correlated with each other because each litter consists of several (genetically linked) littermates. In addition, the observed time series is short from a statistical perspective as animal ethics prevent killing more mother mice than absolutely necessary, and murine development is short anyway. We solve these challenges by using multiple contrast tests and visualizing the change point by the use of confidence intervals.
Results: We used linear mixed models to model the variability of the mother. The estimates from the linear mixed model are then used in multiple contrast tests.There are a variety of contrasts and intuitively, we would use the Changepoint method. However, it does not deliver satisfying results. Interestingly, we found two other contrasts, both capable of answering different research questions in change point detection: i) Should a single point with change direction be found, or ii) Should the overall progression be determined? The Sequen contrast answers the first, the McDermott the second. Confidence intervals deliver effect estimates for the strength of the potential change point. Therefore, the scientist can define a biologically relevant limit of change depending on the research question.
Conclusion: We present a solution with effect estimates for short independent time series with observations nested at a given time point. Multiple contrast tests produce confidence intervals, which allow determining the position of change points or to visualize the expression course over time. We suggest to use McDermott’s method to determine if there is an overall significant change within the time frame, while Sequen is better in determining specific change points. In addition, we offer a short formula for the estimation of the maximal length of the time series.
In a protein reduction feeding trial (Study 1) on a commercial broiler farm in northern Germany, it was attempted to be shown that research results from station tests on protein reduction can be transferred to agricultural practice. In a second study, the limits of the N reduction were tested in a research facility. In Study 1, commercial standard feeds were fed to the control group (variant 1:210,000 animals; n = 5 barns). In the test group (variant 2:210,000 animals; n = 5 barns), the weighted mean crude protein (CP) content was moderately reduced by 0.3%. The nitrogen reduction in the feed did not affect performance (feed intake (FA), daily gain (DG), feed conversion (FCR)), but nitrogen conversion rate increased from approx. 61% to approx. 63%. The solid litter weight was reduced by 12% and nitrogen excretion by 9% (p < 0.05). Significantly healthier footpads were due to lower water intake (−4%; p < 0.05) and a numerically drier bedding. In Study 2, responses of treatments (1250 broiler per variant; n = 5) showed that sharper N-lowering (−1.5% CP; weighted average) did not impair performance either, but N-conversion improved and N-excretions decreased significantly. Converted to a protein reduction of one percentage point, the N excretions were able to be reduced by 22% in Study 1 and 18% in Study 2. Feeding trials in the commercial sector, such as the present Study 1, should convince feed mills and farmers to allow the latest scientific results to be used directly and comprehensively in commercial ration design.
The current narrative literature review aims to discuss clinical reasoning based on nociceptive pain mechanisms for determining the most appropriate assessment and therapeutic strategy and to identify/map the most updated scientific evidence in relation to physical therapy interventions for patients with temporomandibular disorders (TMDs). We will also propose an algorithm for clinical examination and treatment decisions and a pain model integrating current knowledge of pain neuroscience. The clinical examination of patients with TMDs should be based on nociceptive mechanisms and include the potential identification of the dominant, central, or peripheral sensitization driver. Additionally, the musculoskeletal drivers of these sensitization processes should be assessed with the aim of reproducing symptoms. Therapeutic strategies applied for managing TMDs can be grouped into tissue-based impairment treatments (bottom-up interventions) and strategies targeting the central nervous system (top-down interventions). Bottom-up strategies include joint-, soft tissue-, and nerve-targeting interventions, as well as needling therapies, whereas top-down strategies include exercises, grade motor imagery, and also pain neuroscience education. Evidence shows that the effectiveness of these interventions depends on the clinical reasoning applied, since not all strategies are equally effective for the different TMD subgroups. In fact, the presence or absence of a central sensitization driver could lead to different treatment outcomes. It seems that multimodal approaches are more effective and should be applied in patients with TMDs. The current paper also proposes a clinical decision algorithm integrating clinical diagnosis with nociceptive mechanisms for the application of the most appropriate treatment approach.
This textbook provides a comprehensive foundation of food physics by addressing the physical properties of food, food ingredients, and their measurements. Physical properties of food play a key role in all fields where modern technological processes are applied for the generation of food raw materials and the production of food. The determination of the physical properties of food and related products is a pre-requisite for product and process development, production engineering and automation in today’s food, pharmaceutical and cosmetics industries, as well as related quality control activities.
Following the success of its first edition published in 2007, the book has been updated to reflect recent industrial applications of novel physical food processing technologies. Each chapter begins with basic principles and progresses to a comprehensive coverage of the topic. The authors enriched this second edition with several didactic elements, including definition boxes, examples, and chapter-end summaries.
This textbook helps readers to build up their knowledge of the important aspects surrounding the physical properties of foods and food ingredients. It is also an essential resource for students of food science and technology to complement textbooks in food chemistry and food microbiology, as well as for food and chemical engineers, technologists, and technicians in the food industry.
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.
The Internet of Things (IoT) is the enabler for new innovations in several domains. It allows the connection of digital services with real, physical entities. These entities are devices of different categories and range in size from large machinery to tiny sensors. In the latter case, devices are typically characterized by limited resources in terms of computational power, available memory and sometimes limited power supply. As a consequence, the use of security algorithms requires expert knowledge in order for them to work within the limited resources. That means to find a suitable configuration for the algorithms to perform properly on the device. On the other side, there is the desire to protect valuable assets as strong as possible. Usually, security goals are captured in security policies, but they do not consider resource availability on the involved device and their consumption while executing security algorithms. This paper presents a resource aware information exchange model and a generation tool that uses high-level security policies as input. The model forms the conceptual basis for an automated security configuration recommendation system.
The Internet of Things (IoT) is the enabler for new innovations in several domains. It allows the connection of digital services with physical entities in the real world. These entities are devices of different categories and sizes range from large machinery to tiny sensors. In the latter case, devices are typically characterized by limited resources in terms of computational power, available memory and sometimes limited power supply. As a consequence, the use of security algorithms requires of them to work within the limited resources. This means to find a suitable implementation and configuration for a security algorithm, that performs properly on the device, which may become a challenging task. On the other side, there is the desire to protect valuable assets as strong as possible. Usually, security goals are recorded in security policies, but they do not consider resource availability on the involved device and its power consumption while executing security algorithms. This paper presents an IoT security configuration tool that helps the designer of an IoT environment to experiment with the trade-off between maximizing security and extending the lifetime of a resource constrained IoT device. The tool is controlled with high-level description of security goals in the form of policies. It allows the designer to validate various (security) configurations for a single IoT device up to a large sensor network.
Introduction: Establishing continuity of care in handovers at changes of shift is a challenging endeavor that is jeopardized by time pressure and errors typically occurring during synchronous communication. Only if the outgoing and incoming persons manage to collaboratively build a common ground for the next steps of care is it possible to ensure a proper continuation. Electronic systems, in particular electronic patient record systems, are powerful providers of information but their actual use might threaten achieving a common understanding of the patient if they force clinicians to work asynchronously. In order to gain a deeper understanding of communication failures and how to overcome them, we performed a systematic review of the literature, aiming to answer the following four research questions: (1a) What are typical errors and (1b) their consequences in handovers? (2) How can they be overcome by conventional strategies and instruments? (3) electronic systems? (4) Are there any instruments to support collaborative grounding?
Methods: We searched the databases MEDLINE, CINAHL, and COCHRANE for articles on handovers in general and in combination with the terms electronic record systems and grounding that covered the time period of January 2000 to May 2012.
Results: The search led to 519 articles of which 60 were then finally included into the review. We found a sharp increase in the number of relevant studies starting with 2008. As could be documented by 20 studies that addressed communication errors, omission of detailed patient information including anticipatory guidance during handovers was the greatest problem. This deficiency could be partly overcome by structuring and systematizing the information, e.g. according to Situation, Background, Assessment and Recommendation schema (SBAR), and by employing electronic tools integrated in electronic records systems as 23 studies on conventional and 22 articles on electronic systems showed. Despite the increase in quantity and quality of the information achieved, it also became clear that there was still the unsolved problem of anticipatory guidance and presenting “the full story” of the patient. Only a small number of studies actually addressed how to establish common ground with the help of electronic tools.
Discussion: The increase in studies manifests the rise of great interest in the handover scenario. Electronic patient record systems proved to be excellent information feeders to handover tools, but their role in collaborative grounding is unclear. Concepts of how to move to joint information processing and IT-enabled social interaction have to be implemented and tested.
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.
Background: Clinical handovers at changes of shifts are typical scenarios of time restricted and information intensive communication, which are highly cognitively demanding. The currently available applications supporting handovers typically present complex information in a textual checklist-like manner. This presentation style has been criticised for not meeting the specific user requirements.
Objectives: We, therefore, aimed at developing a concept for visualising the overview of a clinical case that serves as an alternative way to checklist-like presentations in clinical handovers. We also aimed at implementing this concept in a handoverEHR in order to support the pre-handover phase, the actual handover, and the post-handover phase as well as at evaluating its usability and attractiveness.
Results: We developed and implemented a concept that draws on Tolman's pioneering work on cognitive maps that we designed in accordance with Gestalt principles. These maps provide a pictorial overview of a clinical case. The application to build, manipulate, and store the cognitive maps was integrated into an openEHR based handover record that extends conventional records with handover specific information. Usability (n = 28) and attractiveness (n = 26) testing with experienced clinicians resulted in good ratings for suitability for the task as well as for attractiveness and pragmatism.
Conclusion: We propose cognitive maps to represent and visualise the clinical case in situations where there is limited time to present complex information.
Dissertation zur Erlangung des Doktorgrades (Dr. rer. nat.)
Universität Osnabrück
Fachbereich Kultur- und Sozialwissenschaften
Institut für Geographie
in Kooperation mit der Hochschule Osnabrück
Fakultät Agrarwissenschaften und Landschaftsarchitektur
The mineralization of soil organic nitrogen (N) and crop residues can significantly contribute to the N supply of vegetable crops. However, short-term mineralization dynamics are difficult to predict. On the other hand, fast-growing crops like spinach are highly sensitive to N shortage. Therefore, in situ soil columns have been tested to estimate the actual N supply via mineralization in field-grown spinach. In ten fertilization trials covered soil columns (20 cm in diameter) were driven into the soil to a depth of 30 cm at the start of the cultivation. Eight columns were repeated in three blocks within a total trial area of 0.10 to 0.25 ha. Net N mineralization was derived by subtracting the soil mineral N concentration (Nmin) in the upper 30 cm before installation from the concentration inside the columns at harvest. For comparison, a balance sheet was calculated for spinach plots receiving no N fertilization (zero plots) as well as fertilized plots and used as a proxy for net N mineralization. In this approach the initial Nmin concentration in the upper 30 cm of the soil, the N supply via irrigation, and fertilization as well as the total aboveground N uptake by spinach and the Nmin residue were considered. By using soil columns, N mineralization was determined with a mean coefficient of variation of 18%. A higher spatial variability of up to 43% was observed when spinach was grown as a second crop. The average net N mineralization rate ranged between 2 kg ha‑1 week‑1 (0-30 cm) in winter-grown spinach and 3-7 kg ha‑1 week‑1 (0-30 cm) in the other seasons. Nitrogen mineralization measured by the soil columns was qualitatively confirmed with the data obtained by the balance sheet. Soil columns enable repeated samplings during the spinach cultivation. In this way, top dressing rates can be adjusted to the actual N supply.
Spinach is a nitrogen (N)-demanding crop characterized by a shallow root architecture. Especially in the first weeks after sowing, significant N uptake is limited to the uppermost few centimetres of the soil. However, base fertilization is usually based on the soil mineral N (Nmin) concentration in the upper 30 cm. Therefore, the objective of this study was to examine whether the soil sample depth for calculating the base N fertilization can be reduced to the 0-15 cm layer. In seven field trials, conducted during spring, summer and autumn seasons, either a low or high base fertilization dose was applied at sowing. Until top dressing, soil samples were frequently taken in the upper 0-15 and 15-30 cm layers to determine the average Nmin concentration in each layer. Top dressing was applied when the first true leaves had unfurled. With this fertilizer application, the total N supply was aligned between both treatments based on the Nmin concentration in the upper 30 cm of the soil. Aboveground fresh and dry masses were determined after reaching a fresh mass yield of 15-20 t ha‑1 and related to the mean Nmin concentration in the first 3 to 4 weeks of cultivation between sowing and top dressing. It was shown that the Nmin concentration in the upper 0-15 cm of the soil highly reflects the base fertilization rate. By contrast, the Nmin concentration in the 15-30 cm layer remained unaffected. However, the Nmin concentration of both top soil layers can affect fresh and dry mass yield at harvest. Therefore, the entire 0-30 cm soil layer should be considered when calculating the base N fertilization rate in field-grown spinach. Measurements revealed that spinach fresh and dry masses were increased until the N availability of between 54 and 59 kg ha‑1 (0-30 cm) was reached at the seedlings stage, respectively.
In the organic production of pot grown basil, yield depressions and quality impairments are often observed. During the early development stage, cotyledons become chlorotic and necrotic. Subsequently, fungal diseases such as botrytis occur. One possible reason for this problem could be the high concentration of ammonium in the growing media released by the mineralization of organic fertilizers. Therefore, a fertilization trial was carried out to investigate the effect of ammonium (NH4+) on basil in comparison to nitrate (NO3-). The experiment included different NH4+-N/NO3--N ratios (100/0, 50/50 and 0/100) and nitrogen (N) concentrations in the nutrient solution (8, 12 and 16 mmol N L‑1). Plants were cultivated in a peat substrate and fertilized with a nutrient solution which, in addition to the different N sources, contained equal concentrations of a base fertilizer as well as the nitrification inhibitor DMPP. Furthermore, an organic fertilization treatment was realized. Basil fertilized solely with NH4+ showed a diminished growth in comparison to well-developed plants receiving NO3- as N source. Germination rate, plant height and fresh matter yield were significantly reduced by NH4+ nutrition. Similar results occur in the organic treatment where the NH4+ concentration rose up to 350 mg NH4+-N L‑1 substrate at the beginning of the cultivation period. Along with a reduction in biomass production, chlorotic cotyledons were observed. These effects might have been caused by NH4+. When N mineralization declined and NH4+ was largely converted to NO3-, plants exhibited improved growth. Within the mineral N treatments, rising NO3- concentration and NO3--N/NH4+-N ratio promoted plant height and reduced plant compactness due to an increased internode elongation. At the end of the experiment, the NO3- content in basil shoots was highest in the organic treatment and lowest with NH4+ as the sole N source. The best herb quality in terms of plant compactness, turgidity and healthiness of cotyledons was observed when basil was fertilized with ammonium nitrate.
Organic pot-based production of basil (Ocimum basilicum L.) often has lower biomass yield than conventional cultivation. Previous investigations indicate that this growth impairment is related to high ammonium (NH4+) concentrations in the growing media released by the mineralization of organic nitrogen (N) fertilizers. However, as a result of this ammonification process substrate pH may also increase. Under neutral to alkaline conditions NH4+ is converted to ammonia (NH3), which is known to be phytotoxic even at low concentrations. Therefore, we investigated the impact of both ammonical N species on basil grown in a peat substrate. In total, three fertilization pot experiments were conducted in a greenhouse in order to compare the effect of different organic base dressings [250 and 750 mg N (L substrate)-1 mainly supplied by a liquid amino acid fertilizer (AAF)] and two initial substrate pH levels (5.5 and 6.5). In two treatments, 5% (v/v) mature compost was mixed into the peat 1 day and 12–days before the substrate was used for sowing, respectively. The aim of this procedure was to stimulate nitrification in this way to reduce ammonical N concentration. Ammonia concentration in the aerial plant surrounding environment was measured by using NH3 detector tubes in combination with an open-top chamber method. The results showed that the growth of basil (number of plants, fresh matter yield, plant height) was significantly inhibited in the second and third week of cultivation by rising NH3 and NH4+ exposure, as well as by a substrate pH ≥ 7.0. These adverse effects were reduced by lowering the organic base dressing rate and adjusting the initial substrate pH to 5.5. Furthermore, the addition of mature compost to peat in combination with a 12-day storage was proven to be effective for promoting nitrification in the organically fertilized substrate. As a result, plant growth was improved by both lower NH3 and NH4+ exposure as well as a faster supply of nitrate (NO3-) as an additional N source. Using this approach, it was possible to feed organically fertilized basil right from the seedling stage with a NO3--N/NH4+-N-balanced and later on providing a predominant NO3--N supply.
Background
Spinach is a nitrogen (N) demanding crop with a weekly N uptake of up to 60 kg ha–1. Consequently, a high N supply is required, which can temporarily lead to high quantities of nitrate (NO3–) being at risk of leaching.
Aims
The objective of this study was to develop a N fertilization approach to reduce the risk of NO3– leaching in field-grown spinach production without adversely affecting crop yield and quality at an early and late harvest stage.
Methods
Ten fertilization trials were conducted to compare different base fertilization rates and splits of top dressings. For top dressings, granulated fertilizers or foliar sprays were used. In a further treatment, N supply was reduced by withholding the second top dressing of 50–70 kg ha−1.
Results
Nitrate concentration at risk of leaching was considerably reduced by decreasing the base fertilizer rate as well as by splitting the top dressing. However, at an early harvest stage, total aboveground dry mass was reduced by, on average, 6% by these measures across all seasons. In contrast, at a later harvest stage, spinach was less affected by the fertilizer schedule. Urea foliar sprays proved to be insufficient in promoting plant growth and caused leaf necrosis. A reduced N supply led to impaired plant growth and yellowish leaves in both spring and winter.
Conclusions
Base N fertilization of spinach is only required in spring, but not in other seasons. Despite slight yield reduction, the top dressing should be split to reduce the risk of NO3− leaching after an early harvest.
In open-field vegetable production, high quantities of soil mineral nitrogen (Nmin) and N-rich crop residues often remain in the field at harvest. After the harvest of crops in autumn, this N can lead to considerable nitrate (NO3−) losses during the subsequent winter leaching period. In four field trials, different tillage depths (3–4, 10, 30 cm) and dates (early autumn, late autumn, early spring) were investigated to reduce N losses after growing spinach in the autumn. In a further treatment, the nitrification inhibitor 3,4-Dimethylpyrazole phosphate (DMPP) was directly applied to the crop residues. Potential N losses were calculated by a balance sheet approach based on Nmin concentration (0–90 cm), measured N mineralization and N uptake by catch crops. By postponing the tillage date from early to late autumn or spring, resprouting spinach stubbles acted as a catch crop, reducing N losses by up to 61 kg ha−1. However, if the spinach biomass collapsed, the N losses increased by up to 33 kg ha−1 even without tillage. The application of DMPP as well as the tillage depth were less effective. Overall, postponing tillage to spring seems to be the most promising approach for reducing N losses during the off-season.
In the past few years, studies have been carried out to record and analyse the consumer behaviour of manual dishwashing. Manual dishwashing in households is performed in many ways that influence the use of resources. Furthermore, knowledge has been gained on the basis of experiments on how to optimize the use of resources in manual dishwashing. Optimization here means achieving the best possible cleaning performance with a minimum input of resources. This experimental knowledge, combined with the experience of everyday life, was transferred into Best Practice Tips.
The aim of this study is to verify whether it is possible to save resources while applying these Best Practice Tips in comparison with the consumers' previous behaviour.
In a laboratory study, 53 consumers from Europe (23 Germans, 30 other Europeans) were asked to apply the Best Practice Tips while washing up 12 place settings of dishes. The data gained were compared with that of previous studies recording consumers' everyday behaviour while washing up the same amount of dishes. The sample consisted of 113 European consumers and the sample of the second study consisted of 60 Europeans.
On average, the 53 test participants applying the Best Practice Tips used around 60% less water, 70% less energy and 30% less detergent compared with the average everyday behaviour the other subjects used. Additionally, they achieved a slightly better cleaning result. An evaluation questionnaire showed that the Best Practice Tips were, in general, highly accepted; however, some concerns were given about their exact application in everyday life. Because of the wide variation of washing-up habits and resource consumption among individuals, the confidence intervals of the studies are rather large. The results should therefore be seen as tendencies on how resource savings are possible when people are trained how to optimize resources in manual dishwashing. Nevertheless, this study should be the basis for further ones in which the learning is verified in everyday life and over a longer period of time.
Using eye-tracking, this study investigates fixation duration of students viewing pictures of pigs, which systematically vary in the facial expression of the pig and in the barn setting. The aim of this study is to analyze which picture elements are viewed and for how long, as well as how fixation times vary with a change of the expression of the pig and the barn type. The results show clear effects of picture composition: pig expression and pen type affect fixation durations of different areas of interest with the influence of the pig being considerably larger. Face regions are viewed longer in the “happy” pig, while floor/bedding and the eyes are viewed longer in pictures showing the “unhappy” pig which might be a hint for infor-mation search. The power of facial expressions, also for the depiction of farm animals, is a new finding of this paper, which might be of importance when select-ing agricultural pictures for different purposes.
A patient presenting with local pain and limitation of movement in the temporomandibular region following surgery of the left temporomandibular joint (TMJ) is described. Manual techniques like distraction of the TMJ combined with motor control exercises to restore TMJ function were not sufficient to relieve the patient's symptoms and her orofacial functions. However, during manual assessment and treatment of cranial nervous tissue, in this case the auriculotemporal nerve and its interface, pain was relieved and orofacial functions improved.
Osnabrück’s so called “Green Fingers” – eleven landscape corridors reaching from the inner city into the region – structure the regional metropolis’ urban pattern. They supply the city centre with fresh air, serve as recreational destinations for the city’s inhabitants and provide space for close to the city agriculture and forestry. First defined in 1926, the Green Fingers have since been part of various planning documents and programs. However, these open spaces have been diminished bit by bit over time. The city’s growing need for land to build on had its impact just like the development of major traffic routes. On the one hand a lively debate has emerged: the Green Finger’s qualities, their ecological, aesthetical and cultural significance become increasingly important. Yet on the other hand decision makers still tend to put greenfield building activity first. A lot of efforts in striving for inner development are undermined by the ever growing demand for space. The urban sprawl continues, although various kinds of sanctuaries have been added to the urban and landscape planners’ equipment. The growing urban framework with its semidetached and single family houses does not come to a halt.
The study at hand focuses the interdependencies between stress incidents and strategies of stress-coping in relation with well-being in helping professions. Furthermore, the scarce areas and the proband’s strategies of health behavior, comparing helping and other vocational groups, are investigated. The sample consist of teachers, bank employees, employees of marketing agencies, employees coming from the machine construction industry, as well as nurses, psychotherapists and physicians. The results show that everyday annoyances and problem-oriented stress-coping indeed affect well-being.
The following article deals with equivalence as a specific quality criterion concerning cross cultural research in psychology and provides an overview for this topic. The comparability of constructs as well as of data is analyzed. For this, the different levels of equivalence are regarded, e.g., translation equivalence and others. Classical as well as modern methods for the testing and guarantee of equivalence are analyzed. Critical approaches and methodical problems of cross cultural research are described.
Fairness and Team Efficiency
(2013)
This study applies to the perception of fairness during teamwork. Students were assigned to work groups by lot and were instructed to prepare a course presentation. Groups were given no guidelines relating to allocation of tasks, but each group was graded as a whole. Since a real grade was given in a non-simulated experiment, it was possible to determine team efficiency, work satisfaction, and perception of fairness via a subsequent study. Results show a strong influence of fairness on team efficiency.
Every culture has its paradise vision: desirable and external conditions which, inside the concerned culture, are infrequently observed or difficult to realize and are linked to one another. This cross-cultural study compares well-being inChina,Bulgaria,FranceandGermany. The cultural patterns of the culture are differently, but well-being is easier to achieve if people adapt to their cultural patterns. The adjustment (positive subjective culture) is formed by culture-specific content and needs different in regards to different cultures.
A successful integration of migrants in the labour market and in the organisations is getting more important based on demographic changes. The central aim of the investigation is to deal with problem fields of the Human Resource Management, which arise by demographic changes regarding migration. Therefore, an explorative qualitative study with human resource managers and diversity representatives of the large DAX companies was conducted. The views of leaders and employees with and without an immigration background regarding diversity potentials in organisation are compared in this study. The results indicate that diversity is important for organisation. Employees have recognised the importance of diversity. Managers have not recognised the seriousness and urgency of cultural diversity and diversity actions. Human resource managers are not able to assess the additional stress of migrants correctly and to consider them in their day-to-day management and diversity actions.
Work–life balance is one of the challenges of a globalized world. The study described in this chapter aimed to identify the factors influencing the work–life balance of working mothers. Additionally, we will describe differences and similarities between the well-being and working styles of German and US-American working mothers. It is particularly difficult for mothers to be successful, because to do so, they must master the double burden of work and family. In this study, 320 working mothers were surveyed, 142 in Germany and 178 in the USA. It was found that the cultural concepts of work–life balance of these working mothers are comparable. Furthermore, differences in working styles were identified: US-Americans valued both well-being and work–life balance more strongly than Germans. In both cultures, younger mothers felt more burdened by work than older mothers. This may indicate that competences are learned with an increasing age, enabling a more successful mastery of challenges, even though an increasing age usually has a negative effect on health. The number of children, family status and education did not influence work–life balance. These findings are further discussed in this chapter.
Building on Hofstede's finding that individualism and social hierarchy are incompatible at the societal level, the authors examined the relationship between individualism-collectivism and orientations toward authority at the individual level. In Study 1, authoritarianism was related to three measures of collectivism but unrelated to three measures of individualism in a U.S. sample (N = 382). Study 2 used Triandis's horizontal-vertical individualism-collectivism framework in samples from Bulgaria, Japan, New Zealand, Germany, Poland, Canada, and the United States (total N = 1,018). Both at the individual level and the societal level of analysis, authoritarianism was correlated with vertical individualism and vertical collectivism but unrelated to horizontal collectivism. Horizontal individualism was unrelated to authoritarianism except in post-Communist societies whose recent history presumably made salient the incompatibility between state authority and self-determination.