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Cashflow
(2019)
Land cover change is a dynamic phenomenon driven by synergetic biophysical and socioeconomic effects. It involves massive transitions from natural to less natural habitats and thereby threatens ecosystems and the services they provide. To retain intact ecosystems and reduce land cover change to a minimum of natural transition processes, a dense network of protected areas has been established across Europe. However, even protected areas and in particular the zones around protected areas have been shown to undergo land cover changes. The aim of our study was to compare land cover changes in protected areas, non-protected areas, and 1 km buffer zones around protected areas and analyse their relationship to climatic and socioeconomic factors across Europe between 2000 and 2012 based on earth observation data. We investigated land cover flows describing major change processes: urbanisation, afforestation, deforestation, intensification of agriculture, extensification of agriculture, and formation of water bodies. Based on boosted regression trees, we modelled correlations between land cover flows and climatic and socioeconomic factors. The results show that land cover changes were most frequent in 1 km buffer zones around protected areas (3.0% of all buffer areas affected). Overall, land cover changes within protected areas were less frequent than outside, although they still amounted to 18,800 km2 (1.5% of all protected areas) from 2000 to 2012. In some parts of Europe, urbanisation and intensification of agriculture still accounted for up to 25% of land cover changes within protected areas. Modelling revealed meaningful relationships between land cover changes and a combination of influencing factors. Demographic factors (accessibility to cities and population density) were most important for coarse-scale patterns of land cover changes, whereas fine-scale patterns were most related to longitude (representing the general east/west economic gradient) and latitude (representing the north/south climatic gradient).
Commitment für die Lehre
(2019)
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.
Background:
The evaluation of somatosensory dysfunction is important for diagnostics and may also have implications for prognosis and management. The current standard to evaluate somatosensory dysfunction is quantitative sensory testing (QST), which is expensive and time consuming. This study describes a low-cost and time-efficient clinical sensory test battery (CST), and evaluates its concurrent validity compared to QST.
Method: Three patient cohorts with carpal tunnel syndrome (CTS, n=86), non-specific neck and arm pain (NSNAP, n=40) and lumbar radicular pain/radiculopathy (LR n=26) were included. The CST consisted of 13 tests, each corresponding to a QST parameter and evaluating a broad spectrum of sensory functions using mechanical and thermal detection and pain thresholds and testing both loss and gain of function. Agreement rate, significance and strength of correlation between CST and QST were calculated.
Results: Several CST parameters (cold and warm detection, cold pain, mechanical detection, mechanical pain for loss of function, pressure pain) were significantly correlated with QST, with a majority demonstrating >60% agreement rates and weak to relatively strong correlations. However, agreement varied among cohorts. Gain of function parameters showed stronger correlation in the CTS and NSNAP cohort, whereas loss of function parameters performed better in the LR cohort. Other CST parameters (vibration detection, heat pain, mechanical pain for gain of function, windup ratio) did not significantly correlate with QST.
Conclusion: Some, but not all tests in the CST battery can detect somatosensory dysfunction as determined with QST. The CST battery may perform better when the somatosensory phenotype is more pronounced.
Background
This study describes a low-cost and time-efficient clinical sensory test (CST) battery and evaluates its concurrent validity as a screening tool to detect somatosensory dysfunction as determined using quantitative sensory testing (QST).
Method
Three patient cohorts with carpal tunnel syndrome (CTS, n = 76), non-specific neck and arm pain (NSNAP, n = 40) and lumbar radicular pain/radiculopathy (LR, n = 26) were included. The CST consisted of 13 tests, each corresponding to a QST parameter and evaluating a broad spectrum of sensory functions using thermal (coins, ice cube, hot test tube) and mechanical (cotton wool, von Frey hairs, tuning fork, toothpicks, thumb and eraser pressure) detection and pain thresholds testing both loss and gain of function. Agreement rate, statistical significance and strength of correlation (phi coefficient) between CST and QST parameters were calculated.
Results
Several CST parameters (cold, warm and mechanical detection thresholds as well as cold and pressure pain thresholds) were significantly correlated with QST, with a majority demonstrating >60% agreement rates and moderate to relatively strong correlations. However, agreement varied among cohorts. Gain of function parameters showed stronger agreement in the CTS and LR cohorts, whereas loss of function parameters had better agreement in the NSNAP cohort. Other CST parameters (16 mN von Frey tests, vibration detection, heat and mechanical pain thresholds, wind-up ratio) did not significantly correlate with QST.
Conclusion
Some of the tests in the CST could help detect somatosensory dysfunction as determined with QST. Parts of the CST could therefore be used as a low-cost screening tool in a clinical setting.
Significance
Quantitative sensory testing, albeit considered the gold standard to evaluate somatosensory dysfunction, requires expensive equipment, specialized examiner training and substantial time commitment which challenges its use in a clinical setting. Our study describes a CST as a low-cost and time-efficient alternative. Some of the CST tools (cold, warm, mechanical detection thresholds; pressure pain thresholds) significantly correlated with the respective QST parameters, suggesting that they may be useful in a clinical setting to detect sensory dysfunction.
Das asiatische Jahrhundert - dreht sich die Welt falsch? : eine Antwort auf Kishore Mahbubani
(2019)
Asiatische Intellektuelle kritisieren zunehmend scharf strategische Fehler westlicher Globalpolitik. Kishore Mahbubani (Singapur) etwa wirft dem Westen falschen Umgang mit dem Islam, Demokratisierungseifer, die Erniedrigung Russlands und die Nichtbeachtung Chinas vor. Rainer Lisowski versucht in seinem Essay, auf die Thesen Mahbubanis zu antworten und zu verdeutlichen, dass dessen Analyse oberflächlich zwar an manchen Punkten zutrifft, aber in der Tiefe zwei entscheidende Treiber westlicher Entwicklung unterschätzt werden: eine immer weiter zunehmende Verrechtlichung der Welt und eine Wohlstandsverwahrlosung durch überzogenen Konsum. Sie sind der tiefere Grund, wieso realpolitische Außenpolitik im Westen zunehmend erschwert wird. Und Asien folgt dem westlichen Vorbild zeitverzögert - insgesamt keine guten Aussichten.
Der generalistisch ausgerichtete Studiengang Pflege an der Hochschule Osnabrück verbindet die Ausbildung zur Gesundheits- und Krankenpflege bzw. Gesundheits- und Kinderkrankenpflege und die Ausbildung der Altenpflege mit dem Bachelor of Science. Im Studienprogramm werden theoretische und praktische Ausbildung sowie Studium gleichberechtigt koordiniert und kooperativ gestaltet. In diesem Verschränkungsmodell (Moers et al. 2012) werden die drei Lernorte Hochschule, Berufsfachschule und Fachpraxis miteinander verknüpft und abgestimmt.
Introduction
Tests to evaluate the integrity of the alar ligaments are important clinical tools for manual therapists, but there is limited research regarding their validity.
Method
A single blinded examiner assessed alar ligament integrity using the lateral shear test (LST), rotation stress test (RST) and side-bending stress test (SBST) on a sample of convenience comprising 7 subjects with MRI confirmed alar ligament lesions and 11 healthy people. Alar ligament lesions were identified using both supine and high-field strength upright MRI.
Results
The RST had a sensitivity of 80% and a specificity of 69.2%. The SBST and the LST both showed a sensitivity of 80% and a specificity of 76.9%. In cases where all three tests were positive, the specificity increased to 84.6%.
Discussion
Tests of manual examination of alar ligament integrity have some diagnostic utility; however, these findings require further corroboration in a larger sample.
Der Wandel von Arbeit, der als Subjektivierung und Digitalisierung diskutiert wird, hat unerwartete Folgen: Mehr Selbstverantwortung schafft noch keine befreite Welt der Erwerbsarbeit, und Technik dringt in die Domänen geistiger Arbeit ein. Der Band versammelt Analysen aus soziologischer, psychologischer und psychoanalytischer Sicht und beleuchtet Subjektivität in der Erwerbsarbeit mithilfe verschiedener theoretisch-konzeptioneller Zugänge. Das Ziel ist, einen neuen Bezugsrahmen für kritische Arbeitsforschung zu bilden. Der Inhalt Erfordert der Wandel von Arbeit eine neue Sicht auf Subjektivität? Zur Einführung • Humane Arbeit als geistige Arbeit? • Relationale Subjektivität in subjektivierten Arbeitsverhältnissen • Wie brauchbar sind rollentheoretische Konzeptionen in flexibilisierten Arbeits- und Lebenswelten? • Aus der Subjektivierungsfalle zum handlungsfähigen Akteur – Das Versprechen der Aktionsforschung • Herrschaftsverhältnisse und Wissensformen – Kritische Betrachtung eines Umbruchs bei der Wissensvermittlung in Unternehmen • Die Grenzen instrumenteller Verfügbarkeit von Subjektivität – Einsichten aus der Arbeitswelt der Pflege • Entfremdung und Aneignung in der Arbeit • Subjekt-Objekt-Relationen in der Sozialisation, in der Arbeit und im Alltag Die Herausgebenden Fritz Böhle, Prof. Dr., Universität Augsburg und Institut für sozialwissenschaftliche Forschung e.V. München. Eva Senghaas-Knobloch, Prof. Dr., Universität Bremen, interdisziplinäres Forschungszentrum Nachhaltigkeit (artec)
Mit Geltung der EU-Datenschutz-Grundverordnung (DS-GVO)1 hat das Datenschutzrecht im Mai 2018 eine umfassende Harmonisierung erfahren. Dies gilt auch für Anforderungen an eine datenschutzrechtliche Einwilligung. Die Anpassungen wirken sich nicht nur auf die spezifischen Datenschutzgesetze der Mitgliedstaaten, sondern ebenso auf weitere nationale Gesetzgebungen aus. Betroffen sind sämtliche Bereiche, die die Verarbeitung personenbezogener Daten zum Gegenstand haben. Dieser Beitrag beschäftigt sich speziell mit den Auswirkungen für die Einwilligung in die Datenverarbeitung im Rahmen des digitalen Strommesswesens (sog. Smart Metering.
Unternehmen stellen sich gerne als nachhaltig, wertschätzend und fair dar. Das ist - sagen wir mal - nett. Doch die Bewerber interessieren sich dafür kaum. Statt paradiesische Zustände vorzugaukeln, die sich in der Realität oft ganz anders darstellen, sollte in Jobanzeigen mehr von "Hard Facts" die Rede sein - eben davon, was Bewerber tatsächlich wissen wollen.
Die Entscheidungen des BVerfG zur Verfassungswidrigkeit des Wahlrechtsausschlusses vollbetreuter Personen begründen Zweifel, ob der Ausschluss von unter 18-Jährigen bei Wahlen verfassungsrechtlich zu halten ist. Dieser Beitrag kommt für die Europawahlen zu dem Ergebnis, dass ein verfassungswidriger Wahlrechtsausschluss vorliegt.
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.