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Der Beitrag fragt danach, wie ein Konzept kritischer Professionalisierung, welches Aneignungs- bzw. Nutzer*innenperspektiven und arbeitsbündnistheoretische Überlegungen (insbesondere bezogen auf Schutz der Integritäten) zusammendenkt, eine Orientierungsfolie für die sich aus der Covid-19 Pandemie ergebenden Herausforderungen in der Offenen Kinder- und Jugendarbeit sein kann. Jugendarbeit allgemein und Offene Kinder- und Jugendarbeit im Besonderen sind gerade angesichts der gegenwärtigen Pandemiesituation aufgefordert, neue Praxen zu entwickeln, um Aushandlung, Partizipation und Sorge auch im digitalen Raum zu realisieren.
Die Positionsbestimmung im Indoor-Bereich
ermöglicht im Vergleich zu GPS komplett neue
Anwendungsszenarien. Hierfür ist Technologie notwendig,
welche immer weiter untersucht werden muss, um dessen
Systemgrenzen aufzuzeigen. Die Firma Decawave stellt mit dem
DWM1001 ein Ultrabreitbandmodul zur Verfügung, welches
eine Positionsbestimmung bis zu 10 Zentimetern Genauigkeit
erfüllen soll. Wie sich herausstellt, trifft dies nicht für die Höheninformation der Position zu.
Mikroskopische Simulationen zur Fahrzeugsimulation sind eine wichtige Komponente zur Entwicklung für Algorithmen autonomer Fahrzeuge. Die Generierung notwendiger Szenarien mit synthetischen Methoden ist zeitaufwendig oder bildet die Realität nicht ausreichend nach. Ziel dieser Forschungsarbeit ist die Entwicklung eines Toolsets zur Generierung realistischer Szenarien aus realen Messdaten für die Simulationsumgebung LGSVL. Das Resultat dieser Arbeit ist ein Prototyp zur Extraktion und Vorverarbeitung der Messdaten, die Generierung einer Karte aus Kartendaten
und Integration dieser in eine Simulation. Weiterhin wurde eine Anbindungsmöglichkeit zur Steuerung der Fahrzeuge und dem Datenaustausch mit der Softwarebibliothek ROS untersucht.
Highly arousing, affective stimuli have adverse effects on cognition and performance. Perception of affective stimuli is, however, highly subjective and may impact on the interaction of emotion and cognition. Here, we tested the impact of high- versus low-threatening stimuli on response inhibition as a function of perceived threat intensity. Response inhibition was probed using a stop-signal paradigm in 62 healthy adults. We used stop-signals that had previously been paired with an unpleasant electrodermal stimulation (i.e., high-threat stimuli) or that had never been paired with electrodermal stimulation (i.e., low-threat stimuli). High-threat stimuli did not affect stopping performance in general. Only participants who perceived the high-threat stimuli as highly painful showed impaired response inhibition on high-threat trials relative to low-threat trials. Participants who perceived the high-threat as mildly painful, however, showed improved response inhibition on high-threat trials. This effect was not moderated by the current anxious state. This suggests that the impact of negative affective stimuli on cognition critically depends on subjective threat perception. Ratings of affective stimuli should be included in studies probing the emotion–cognition interaction because subjective perception might strongly impact on that interaction.
Our current mobility paradigm increasingly faces economic, ecological, and social limits in urban areas. The aim of this paper is to analyse if a fleet of shared autonomous electric vehicles (AEVs) can meet these challenges while satisfying the current requirements of privately-owned internal combustion engine vehicles (ICEVs). Therefore, analytical models have been developed to simulate and investigate the impacts of mobility behaviour in Berlin and Stuttgart (Germany). The collected data were used to calculate the fleet size, the energy consumption, the emission of particulate matter, nitrogen oxides, and the carbon footprint of different shared AEVs in comparison with privately owned ICEVs. The approach shows that the system of a shared AEV fleet could lower externalities (accident avoidance, traffic jams, free spaces, parking costs and lifetime losses) in cities and generate cost benefits for customers.
Jugendhilfeplanung
(2020)
Purpose:
Hazardous alcohol consumption among university students represents a prime health risk for this population. Due to a lack of appropriate German-language (online) prevention programs, an existing U.S.-American program was transferred to the German higher education area and then evaluated.
Method:
For this purpose, both qualitative focus groups and a quantitative evaluation were undertaken. The guided focus groups allowed a further adaptation of the prevention program: An improved frequency–quantity questionnaire for the drinking behavior of German-speaking students was developed, and thresholds for hazardous consumption were included.
Results:
The additional quantitative verification of the adaptation found that 65.9% of the surveyed students found the adapted program suitable for the higher education context and 62.6% stated that every university should provide such a program.
Discussion:
The adaptation process described here made it possible to develop an online prevention program tailored to the lifeworld of students in the German-speaking region.
Over the past few years, deep neural networks have shown excellent results in multiple tasks, however, there is still an increasing need to address the problem of interpretability to improve model transparency, performance, and safety. Achieving eXplainable Artificial Intelligence (XAI) by combining neural networks with continuous logic and multi-criteria decision-making tools is one of the most promising ways to approach this problem: by this combination, the black-box nature of neural models can be reduced. The continuous logic-based neural model uses so-called Squashing activation functions, a parametric family of functions that satisfy natural invariance requirements and contain rectified linear units as a particular case. This work demonstrates the first benchmark tests that measure the performance of Squashing functions in neural networks. Three experiments were carried out to examine their usability and a comparison with the most popular activation functions was made for five different network types. The performance was determined by measuring the accuracy, loss, and time per epoch. These experiments and the conducted benchmarks have proven that the use of Squashing functions is possible and similar in performance to conventional activation functions. Moreover, a further experiment was conducted by implementing nilpotent logical gates to demonstrate how simple classification tasks can be solved successfully and with high performance. The results indicate that due to the embedded nilpotent logical operators and the differentiability of the Squashing function, it is possible to solve classification problems, where other commonly used activation functions fail.
Slips and stumbles are main causes of falls and result in serious injuries. Balance training is widely applied for preventing falls across the lifespan. Subdivided into two main intervention types, biomechanical characteristics differ amongst balance interventions tailored to counteract falls: conventional balance training (CBT) referring to a balance task with a static ledger pivoting around the ankle joint versus reactive balance training (RBT) using externally applied perturbations to deteriorate body equilibrium. This study aimed to evaluate the efficacy of reactive, slip-simulating RBT compared to CBT in regard to fall prevention and to detect neuromuscular and kinematic dependencies. In a randomized controlled trial, 38 participants were randomly allocated either to CBT or RBT. To simulate stumbling scenarios, postural responses were assessed to posterior translations in gait and stance perturbation before and after 4 weeks of training. Surface electromyography during short- (SLR), medium- (MLR), and long-latency response of shank and thigh muscles as well as ankle, knee, and hip joint kinematics (amplitudes and velocities) were recorded. Both training modalities revealed reduced angular velocity in the ankle joint (P < 0.05) accompanied by increased shank muscle activity in SLR (P < 0.05) during marching in place perturbation. During stance perturbation and marching in place perturbation, hip angular velocity was decreased after RBT (P from TTEST, Pt < 0.05) accompanied by enhanced thigh muscle activity (SLR, MLR) after both trainings (P < 0.05). Effect sizes were larger for the RBT-group during stance perturbation. Thus, both interventions revealed modified stabilization strategies for reactive balance recovery after surface translations. Characterized by enhanced reflex activity in the leg muscles antagonizing the surface translations, balance training is associated with improved neuromuscular timing and accuracy being relevant for postural control. This may result in more efficient segmental stabilization during fall risk situations, independent of the intervention modality. More pronounced modulations and higher effect sizes after RBT in stance perturbation point toward specificity of training adaptations, with an emphasis on the proximal body segment for RBT. Outcomes underline the benefits of balance training with a clear distinction between RBT and CBT being relevant for training application over the lifespan.
Mindfulness in Trainee Psychotherapies with Children and Adolescents The implementation of mindfulness-based interventions (MBIs) in cognitive-behavioral therapy has greatly increased over the past few years. However, there is little research about the implementation of MBIs in individual child and adolescent psychotherapy. The present paper gives an overview of current MBIs and their efficacy in children and adolescents. A depiction of the implementation of MBIs in individual therapy and a description of the "Mindfulness and Relaxation Study - Children and Adolescents" (MARS-CA) is given. The study aims to examine the effects of short session-introducing interventions with mindfulness elements on juvenile patients' psychopathological symptomatology and therapeutic alliance. For this reason, the authors compare session-introducing interventions with mindfulness elements with session-introducing relaxation interventions and no session-introducing intervention. Qualitative results of the pre-study show that both interventions with mindfulness elements and relaxation interventions work well with juvenile patients.
Sprache kommt in psychotherapeutischen Kontexten eine zentrale Rolle zu. Ausgehend von diesem Gedanken stellen wir mit unserem Beitrag das besondere Potenzial von Metaphern für psychotherapeutisches Arbeiten heraus. Die theoretische Basis unseres „metaphernreflexiven“ Vorgehens bildet die kognitive Metapherntheorie von Lakoff und Johnson. Anhand einer überblicksartigen Darstellung des Metaphernverständnisses der verschiedenen Psychotherapierichtungen werden wir zeigen, dass Metaphern schulenübergreifend auf gewinnbringende Weise eingesetzt werden können. Aus dieser Übersicht ergeben sich zwei grundlegend verschiedene Sichtweisen auf Metaphern: zum einen die einer umfassenden sozialwissenschaftlichen Analyse, zum anderen die (selbst metaphorische) Vorstellung von Metaphern als „Werkzeug“. Unser „metaphernreflexiver“ Vorschlag bewegt sich in der Mitte dieser beiden Pole. Anhand eines fünfschrittigen Vorgehens stellen wir vor, wie sich Metaphern in die psychotherapeutische Praxis aller Schulen integrieren lassen.
Objectives:
Interpersonal problems were examined as moderators of depression outcomes between mindfulness‐based cognitive therapy (MBCT) and cognitive behavioral analysis system of psychotherapy (CBASP) in patients with chronic depression.
Methods:
Patients received treatment‐as‐usual and, in addition, were randomized to 8‐weeks of MBCT (n = 34) or 8‐weeks of CBASP (n = 34). MBCT and CBASP were given in a group format. The Hamilton depression rating scale (HAM‐D) was the primary and the Beck Depression Inventory (BDI‐II) the secondary outcome. The subscales of the Inventory of interpersonal problems (IIP‐32) were moderators. Multilevel models were performed.
Results:
Higher scores on the “vindictive/self‐centered” subscale were associated with a better outcome in MBCT than in CBASP (HAM‐D: p < .01; BDI‐II: p < .01). Higher scores on the “nonassertive” subscale were associated with a better outcome in CBASP than in MBCT (HAM‐D: p < .01; BDI‐II: p < .01).
Conclusions:
If these results can be replicated in larger trials, MBCT should be preferred to CBASP in chronically depressed patients being vindictive/self‐centered, whereas CBASP should be preferred to MBCT in chronically depressed patients being nonassertive.
All around the world, the COVID-19 pandemic is accompanied by an ostensible increase in appreciation for the work of professional caregivers. As valuable as the public recognition may seem at first glance, it entails the danger that self-care of those who care professionally might fall into oblivion. Relating it to the challenges that the pandemic poses, we will outline the professional duty of care . We will then discuss the demanding situation of moral insecurity and moral stress as well as the health-related consequences it may lead to. Following this, we will deduce suggestions for the design of workplace factors and the practice of self-care. Finally, we will come to the conclusion that self-care of caregivers plays as crucial a role in the COVID-19 pandemic as their professional care for others.
The aim of this study was to evaluate a trauma-adapted intervention for survivors of interpersonal violence that combines psychoeducation and specific mindfulness-based exercises developed for patients with posttraumatic stress disorder (PTSD) with formal practices from mindfulness-based stress reduction and loving-kindness meditation. Fourteen patients with PTSD after interpersonal violence participated in eight treatment sessions. The intervention was evaluated in a nonconcurrent multiple-baseline across-individuals design. From baseline (2, 3, and 4 weeks, randomly assigned) until 8 weeks after the intervention, self-reported PTSD symptoms and well-being were measured on a weekly basis. The intervention was further assessed through self-ratings and the Clinician-Administered PTSD Scale (CAPS-5) administered prior to treatment, immediately after treatment and at a 6-week follow-up. Tau-U analyses showed for the majority of the 12 completers a significant reduction of PTSD symptoms and a significant increase in well-being. Furthermore, we found large effects on PTSD symptoms as measured by the CAPS-5 (Hedges’ g = 1.66), as well as on depression (Hedges’ g = 1.08) and psychological distress (Hedges’ g = 0.85), complemented by relevant increases in mindfulness skills and self-compassion. This study contributes evidence that mindfulness and loving-kindness are useful for reducing PTSD in victims of interpersonal violence, especially when the intervention is tailored to the specific needs of these patients.
Rechtsextremismus und sog. ‚Islamismus‘ sind ohne Zweifel seit längerem und gegenwärtig sowohl öffentlich als auch (sozial)wissenschaftlich breit und heftig diskutierte, grassierende Demokratiegefährdungen. Dabei interessieren vor allem zum einen Antworten auf die Frage, was die allgemeinen Ursachen und insbesondere die biographisch wirksamen sozialisatorischen Beeinflussungsfaktoren dieser politisch und sozial relevanten Problematiken sind, zum anderen Erkenntnisse dazu, welche Ansätze der Entgegnung auf sie erfolgreich oder zumindest perspektivisch vielversprechend erscheinen. Der vorliegende Beitrag befasst sich nacheinander mit beiden Problematiken, zunächst mit ‚Islamismus‘, dann mit Rechtsextremismus. Er fasst jeweils in einem ersten Schritt knapp und ohne Anspruch auf Vollständigkeit die wichtigsten Aspekte des themenbezogenen Stands der Forschung zu biographischen Radikalisierungsprozessen zusammen und gibt anschließend in einem zweiten Schritt einen Überblick über aussichtsreich erscheinende Umgangsweisen mit entsprechenden Herausforderungen. Dabei fokussiert er auf die Praxis der selektiven (sekundären) und indizierten (tertiären) Prävention durch (sozial)pädagogische Konzepte, die vornehmlich auf junge Menschen ausgerichtet sind. In einem abschließenden Fazit werden Gemeinsamkeiten und Unterschiede dieser Herangehensweisen identifiziert und knapp erörtert.
Die Bedeutung der Digitalisierung für Berufliche Bildung und Fachkräftesicherung in der Pflege
(2020)
Das Jahr 2020 wurde von der Weltgesundheitsorganisation aus Anlass des 200. Geburtstags von Florence Nightingale – Pionierin der Pflege(wissenschaft) – zum »Jahr der Pf lege und des Hebammenwesens« ausgeru-fen. Gleichzeitig läuft beim International Council of Nursing (ICN) die Kampagne »Nursing Now«. Damit will der ICN auf die entscheidende Rolle der Pflegefachkräfte für die Gesundheit aller Menschen weltweit hinweisen. Parallel und unabhängig davon wird in Deutschland derzeit ein öffentlicher und politischer Diskurs im Kontext des »Fachkräfteman-gels« in der beruflichen Pflege geführt, der stark vom Thema »Berufs-attraktivität« dominiert ist. So wichtig sowohl die Diskussionen über Attraktivitätsfaktoren wie beispielsweise das Gehalt als auch die ent-sprechenden Reformanstrengungen sind, erscheinen sie doch verkürzt. Berufsattraktivität in der Pflege kann nicht ohne Betrachtung von Profes-sionalisierungsprozessen und Ökonomisierungslogiken als relevante Ent-wicklungen in der Pf lege sowie deren widersprüchlichem Spannungsverhältnis diskutiert werden. Sowohl in wissenschaftlichen als auch in politischen Diskursen werden diese beiden Prozesse meist unabhängig voneinander verhandelt. Sie stehen jedoch in einem für die Berufsattraktivität äußerst problematischen Wechselverhältnis. Dies zu berücksichtigen, erscheint für die Zukunft der beruflichen Pflege von hoher Relevanz. Dieser Beitrag erweitert den Diskurs um Fachkräftemangel beziehungs-weise -bedarf in der Pf lege um eine differenzierte Betrachtung des hoch-
komplexen wechselseitigen Spannungsverhältnisses zwischen Ökonomie und Professionalisierung sowie dessen Auswirkungen auf die Berufsattraktivität.Um das Thema in seiner Komplexität darstellen zu können, erfolgt zunächst ein Abriss des Professionalisierungsprozesses der Alten- und (Kinder-)Krankenpflege in Deutschland. Anschließend werden die Ökonomisierung des Gesundheitswesens und deren Auswirkung auf den Berufsalltag dargestellt. Die Folgen der Ökonomisierung auf den Professionalisierungsprozess und schließlich auch für die Berufsattraktivität werden anhand empirischer Daten des Forschungsverbundes ZAFH care4care – Fachkräftebedarf in der Pflege im Zeichen von Alterung, Vielfalt und Zufriedenheit1 analysiert. Daraus abgeleitet werden abschließend exemplarisch Ansatzpunkte für weitere Aushandlungsprozesse skizziert.
Zum Beispiel Pflege – Fragen an den arbeitssoziologischen Topos der Subjektivierung von Arbeit
(2020)
Pflegeberufe in stationären Einrichtungen lassen sich aufgrund ihrer formalen Verfasstheit mit Erwerbsverhältnissen außerhalb von Care-Arbeit vergleichen, gleichzeitig wohnt ihnen die Spezifik von Care-Tätigkeiten inne. Beides – Erwerbsarbeit und Care-Arbeit – unterlag in den letzten Jahrzehnten erheblichen Veränderungen. Wir fragen danach: Wie lassen sich die Veränderungen in der verberuflichten Pflege mit dem arbeitssoziologisch etablierten Diskurs der Subjektivierung von Arbeit zusammendenken? Relevant wird aus unserer Sicht dabei das Verhältnis der beiden Prozesse Subjektivierung von Arbeit und Ökonomisierung. Diese Frage diskutieren wir auf der Basis von multiperspektivischen qualitativen Betriebsfallstudien, die mit der Dokumentarischen Methode ausgewertet wurden. Als zentrales Ergebnis sehen wir eine kollektive Subjektiviertheit von Sorgetätigkeiten, die in den letzten Jahren Marktlogiken unterworfen wird. Die Unterscheidung in kollektive Subjektiviertheit im Care-Sektor und individualisierte Subjektivierung im Produktionsbereich scheint uns für die Analyse des Wandels von Erwerbsarbeit relevant. Sie hat auch Auswirkungen auf Verantwortung und Ertrag von Subjektivierung.
Vor dem Hintergrund des bundesweiten Fachkräftemangels in der Pflege verwundert es, dass Zeitarbeit innerhalb der Pflegebranche als Beschäftigungsform eine wachsende Bedeutung erhält. Allerdings funktioniert Zeitarbeit in der Pflege im Vergleich zu anderen Branchen nach anderen Logiken: Während beispielsweise im verarbeitenden Gewerbe durch den Einsatz von Zeitarbeitskräften bei schwankender Konjunktur Flexibilität gewährleistet oder Personalkosten gesenkt werden können, besteht in der Pflege ein anhaltend hoher Personalbedarf und die Kosten für Zeitarbeiter*innen übersteigen häufig die des Stammpersonals. Das in anderen Branchen üblicherweise als prekär bewertete Arbeitsverhältnis bietet Pflegefachkräften hingegen die Möglichkeit, sich dem zunehmenden Druck des Arbeitsalltags geprägt von Fachkräftemangel als individuelle (Teil-)Exitstrategie zu entziehen und gleichzeitig passende Rahmenbedingungen für den Einsatz mit den Zeitarbeitsagenturen auszuhandeln. Durch die Pflegepersonaluntergrenzen-Verordnung sind Pflegeeinrichtungen gesetzlich verpflichtet, Fachkraftquoten trotz Fachkräftemangel einzuhalten, was den Zeitarbeitskräften entsprechende Verhandlungsmacht verleiht. Anhand empirischer Daten wird beleuchtet, wie Zeitarbeit aus der Perspektive der Einrichtungsleitungen und des Stammpersonals eingeordnet und aus welchen Gründen sie von Beschäftigten gewählt wird. Zudem wird der Frage nachgegangen, welche Bedeutung diese Entwicklung für die Pflegebranche insgesamt haben kann.
Der Beitrag skizziert einleitend grundlegende Defizite in Lerneinheiten der Automatisierungstechnik. Als Lösungskonzept werden Digitale Zwillinge der Maschinen vorgeschlagen, die mit realer Steuerungsalgorithmik und AR/VR kombiniert werden. Die informationstechnische Umsetzung dieses Konzepts in der `Digital Twin as a Service ́ Plattform ermöglicht die Entwicklung und Bereitstellung von AR/VR-Lernszenarien. Auf Basis der technologischen Beschreibung werden vier Lernszenarien aus der Robotik aufgezeigt, die bereits in der beruflichen Bildung, der Hochschulbildung und der industriellen Bildung erfolgreich eingesetzt werden. Am Beispiel eines ausgewählten Lernszenarios werden die Lernziele und das didaktische Design detailliert betrachtet. Abschließend wird auf die Evaluierung eingegangen. Ergänzend zu diesem schriftlichen Beitrag ist unter https://www.virtual-automation-lab.de/avril2020 ein Kurzvideo über das Lösungskonzept, die Software-Plattform sowie die Lernszenarien abrufbar.
Die Diplompädagogin und Kinder- und Jugendpsychotherapeutin Katrin Boger arbei-tet seit 2010 in eigener Praxis in Aalen und hat eine eigene Methode der Traumaarbeit mit Säuglingen, Kleinkindern und Vorschul-kindern entwickelt (die Integrative Bindungs-orientierte Traumaarbeit I.B.T.). In den letzten Jahren behandelte sie immer mehr Säuglinge und Kleinkinder in ihrer Praxis, die stress-reiche Ereignisse erlebt hatten, unter denen sie noch immer zu leiden schienen. Die Ereignisse erstreckten sich von einer kom-plizierten Geburt, über Frühgeburten, frühe Erkrankungen, Unfälle und Operationen u.v.m., wodurch sie sich mehr und mehr auf diese Zielgruppe spezialisiert hat. Auch der Facharzt für Kinder- und Jugendpsychiatrie und -psychotherapie Steffen Bambach hat eine eigene Praxis in Eisenach, in der er eine psychotherapeutische Behandlung für trau-matisierte Patient*innen und ihre Familien anbietet. In den letzten Jahren hat er sich ebenfalls auf Traumatisierungen durch medizinisch notwendige Eingriffe spezialisiert. Im Interview berichten die beiden von ihren Erfahrungen und ihrem sehr ähnlichen thera-peutischen Ansatz in der Arbeit mit den trau-matisierten Kindern und ihren Eltern.
Lasst uns nicht alleine!
(2020)
In einer Serie von Artikeln stellen wir im IGA-Boten die Ergebnisse eines koope-rativen Forschungsprojektes der IGA e.V. mit der Hochschule Esslingen vor – hier liegt nun der dritte Teil vor. In den letzten IGA-Boten (siehe Nr. 55 und 56) wurden zunächst die Belastungen und die potentiell traumatisierenden Situationen sowie mögliche daraus entstandene Folgen in den Blick genommen. In dieser Ausgabe soll es nun um einen ganz wichtigen Faktor gehen, der mit darüber bestimmt, wie eine belastende Situation erlebt wird und ob sie im Nachhinein verarbeitet werden kann: die soziale Unterstützung. Oder mit den Worten von Eckart von Hirschhau-sen, Arzt, Wissenschaftsjournalist und Fernsehmoderator (2020: 11): „Manchmal braucht es nur jemanden, der dich einfach in den Arm nimmt und pustet! [...] Wis-sen ohne Zuwendung bleibt kalt. Und Zuwendung ohne Wissen bleibt manchmal unter unseren Möglichkeiten.“ Daher wollen wir uns im Folgenden mit beidem beschäftigen.
In einer Serie von Artikeln stellen wir im IGA Boten die Ergebnisse einer kleinen Studie vor – hier liegt nun der zweite Teil vor Ihnen. Im letzten IGA Boten (siehe Nr. 55) wurden zunächst die Belastungen und potentiell traumatisierenden Situationen in den Blick genommen. In dieser Ausgabe sollen nun die Folgen, die aus den Erfahrungen entstanden sind, beschrieben werden. Warum ist das ein so wichtiges Thema für die Interessengemeinschaft Arthrogryposis? Andreas Krüger, ein Facharzt für Kinderund Jugendpsychiatrie und Psychotherapie beschreibt in seinem Buch „Erste Hilfe für traumatisierte Kinder“ (2017) sehr klar, wie wichtig diese Erkenntnisse für Familien sind und stellt die Frage, warum ein gewisses Grundwissen über eine medizinische Notfallversorgung eine Selbstverständlichkeit ist, während wir so wenig über den »psychischen Notfall« und dessen Versorgung wissen.
The root area of a wind turbine rotor is usually constructed by very thick airfoils with a relative thickness of more than 35%. An airfoil at that thickness is characterized with strong flow separation. To solve this issue, vortex generators can be used as an active control in order to stabilize the airflow and improve the aerodynamic performance, consequently. Boundary layer control however, investigated employing numerical techniques, strongly depend on the employed method as well as the mesh especially due to a weak vortex conservation in the RANS model. Using the method of Delayed detached eddy simulation (DDES) the solution can benefit from effort-efficient boundary layer modeling as well as LES vortex resolving apart from the surface. The present studies aims to investigate suitable numerical approach mesh dependencies in comparison to experimental data, for application to thick airfoil in future studies.
Fragestellung Klinikaufenthalte werden einerseits mit Gewichtsverlusten und andererseits mit der Entwicklung einer Mangelernährung assoziiert. Häufig bleibt dabei unklar, was bei diesen Gewichtsverlusten genau verloren geht: Körperwasser, Fett- und/oder Muskelgewebe.
Methodik Im vom BMBF geförderten Forschungsprojekt Prävention und Behandlung von Mangelernährung bei geriatrischen Patienten im Krankenhaus wurde anhand einer Gelegenheitsstichprobe untersucht, wie sich die Körperzusammensetzung durch den Klinikaufenthalt verändert. Hierfür wurden bei PatientInnen ≥65 Jahre in den ersten 24 h nach Aufnahme und möglichst kurz vor Entlassung Gewicht, BMI und die Körperzusammensetzung per Bioimpedanzanalyse bestimmt.
Ergebnis Initial konnten 102 PatientInnen bei Aufnahme gemessen werden, 57,8 % (n = 59) sind weiblich. Der mittlere Körperfettanteil liegt bei 29,1 % (SD±10,73), der Muskelanteil bei 28,7 % (SD±5,67) und Gesamtkörperwasser 53,3 % (SD±8,17), der FFMI liegt bei 17,75 kg/m2 (SD±3,05). Gemäß MNA-SF weisen bei Aufnahme 69,6 % (n = 71) ein Mangelernährungsrisiko und 21,6 % (n = 22) eine manifeste Mangelernährung auf, nach ESPEN Kriterien sind 21,6 % (n = 22) mangelernährt. Für 63 PatientInnen (61,8 %) liegt eine Zweiterhebung vor. Zwischen Erst und Zweitmessung liegen 6,51 Tage (SD ±4,75) mit einem mittleren Gewichtsrückgang von - 0,23 kg. Während die Fettmasse tendenziell zunimmt (+0,14 kg), zeigt sich, dass vor allem Muskelmasse (- 1,17 kg) verloren geht, Wasser hingegen nur sehr geringfügig (- 0,12 l). Der Fettfreie Masse Index reduziert sich hierbei um - 0,19 kg/m2. Im Vergleich der Gruppen „Gewichtsverlust“ vs. „kein Gewichtsverlust“ mittels t-Test zeigen sich keine signifikanten Unterschiede bei den initialen Messungen zur Aufnahme. Jedoch sind die PatientInnen mit Gewichtsverlust signifikant älter (80,86 vs. 76,6 Jahre; p 0,034), das Gesamtkörperwasser (- 1,19 l vs. +0,73 l; p 0,011), die fettfreie Masse (- 2,0 kg vs. +0,94 kg; p 0,003) und der Fettfreie Masse Index sinken (- 0,8 kg/m2 vs. +0,3 kg/m2; p 0,003). Die Muskelmasse (- 1,49 kg vs. - 0,91 kg, p 0,056) und Fettmasse (- 0,49 kg vs. +0,64 kg; p 0,203) nehmen stärker ab, allerdings nicht signifikant.
Schlussfolgerung Die These, innerklinische Gewichtsverluste gingen primär auf ausgeschwemmtes Körperwasser zurück, lässt sich nicht halten. Tatsächlich geht deutlich mehr Muskelmasse verloren, wobei selbst PatientInnen ohne Gewichtsverlust im Mittel Muskelmasse verlieren.
Partner oder Konkurrenten? Die Automotive-Branche auf der Suche nach neuen Kooperationsstrategien
(2020)
Die globale Automobilindustrie befindet sich im Umbruch. Elektromobilität, autonomes Fahren, veränderte Kundenbedürfnisse, intelligente Softwaresysteme und hohe Umweltauflagen stellen den Status-quo in Frage. Dazu nimmt die Wertschöpfungstiefe der Automobilhersteller stetig ab. Dies wirkt sich auch direkt auf die Systemlieferanten aus – eine zunehmend wichtige Quelle für Produkt- und Prozessinnovationen.
The large gap in political participation between well-educated and wealthy citizens on the one hand and less educated and poorer citizens, on the other hand, has in recent years gained new attention. Several authors argue that unequal participation leads to unequal political representation and responsiveness and results in policy decisions that are tilted against the interests of disadvantaged groups, thus further increasing inequality. This paper takes a different starting point by turning the old question why people do not participate in politics around and asking why people participate. We hypothesize that enduring engagement with politics requires individuals to be resilient in the face of frustration and to possess strong, perhaps even delusional, efficacy beliefs. Using data from the German GESIS Panel we demonstrate positive correlations between individual resilience, internal and external efficacy, and political participation. We conclude by pointing to the possibility that resilience and efficacy beliefs help privileged groups to overcome collective action problems to achieve disproportionate influence on political decisions and point to avenues for further research.
Deep learning approaches can uncover complex patterns in data. In particular, variational autoencoders (VAEs) achieve this by a non-linear mapping of data into a low-dimensional latent space. Motivated by an application to psychological resilience in the Mainz Resilience Project (MARP), which features intermittent longitudinal measurements of stressors and mental health, we propose an approach for individualized, dynamic modeling in this latent space. Specifically, we utilize ordinary differential equations (ODEs) and develop a novel technique for obtaining person-specific ODE parameters even in settings with a rather small number of individuals and observations, incomplete data, and a differing number of observations per individual. This technique allows us to subsequently investigate individual reactions to stimuli, such as the mental health impact of stressors. A potentially large number of baseline characteristics can then be linked to this individual response by regularized regression, e.g., for identifying resilience factors. Thus, our new method provides a way of connecting different kinds of complex longitudinal and baseline measures via individualized, dynamic models. The promising results obtained in the exemplary resilience application indicate that our proposal for dynamic deep learning might also be more generally useful for other application domains.
Resilience has been defined as the maintenance or quick recovery of mental health during and after times of adversity. Such good longer-term mental health outcomes despite adversity presumably result from complex and dynamic processes of adaptation to stressor exposure (‘resilience processes’), which in many cases include changes in individual properties. Measuring resilience and identifying resilience processes in observational studies requires longitudinal designs involving repeated and frequent monitoring of mental health, stressor exposure, and potential adaptations. We here present a generic design solution that is currently employed in two cohort studies, the Mainz Resilience Project (MARP) and the Longitudinal Resilience Assessment (LORA). Both projects focus on resilience to everyday life stressors (i.e., microstressors), but we argue that the design scheme is also suitable for studying resilience to macrostressors, or trauma, and can solve some of the pertinent problems of trauma resilience research. We quantify resilience by indexing the reactivity of individuals’ mental health to stressors during a time interval of several months in a ‘stressor reactivity’ (SR) score, derived using a previously introduced residualization approach. SR scores are regularly re-calculated in sliding time windows, to thus build SR time courses that reflect intra-individual temporal variability in resilience. By linking these time courses to repeated measures of (temporally varying) individual properties, resilience processes can be identified. We finish by a discussion of limitations of our approach and potential future developments.
Resilience is the maintenance and/or quick recovery of mental health during and after periods of adversity. It is conceptualized to result from a dynamic process of successful adaptation to stressors. Up to now, a large number of resilience factors have been proposed, but the mechanisms underlying resilience are not yet understood. To shed light on the complex and time-varying processes of resilience that lead to a positive long-term outcome in the face of adversity, the Longitudinal Resilience Assessment (LORA) study has been established. In this study, 1191 healthy participants are followed up at 3- and 18-month intervals over a course of 4.5 years at two study centers in Germany. Baseline and 18-month visits entail multimodal phenotyping, including the assessment of mental health status, sociodemographic and lifestyle variables, resilience factors, life history, neuropsychological assessments (of proposed resilience mechanisms), and biomaterials (blood for genetic and epigenetic, stool for microbiome, and hair for cortisol analysis). At 3-monthly online assessments, subjects are monitored for subsequent exposure to stressors as well as mental health measures, which allows for a quantitative assessment of stressor-dependent changes in mental health as the main outcome. Descriptive analyses of mental health, number of stressors including major life events, daily hassles, perceived stress, and the ability to recover from stress are here presented for the baseline sample. The LORA study is unique in its design and will pave the way for a better understanding of resilience mechanisms in humans and for further development of interventions to successfully prevent stress-related disorder.
The occurrence of daily hassles is associated with increased subsequent levels of negative affect. Neuroticism has been found to exacerbate this effect. So far, most research used single‐item measures for the assessment of daily hassles or relied on daily diary studies. This study aimed to examine the interrelations of daily hassles, negative affect reactivity, and neuroticism in daily life employing an extensive inventory of daily hassles. Seventy participants (18–30 years; M = 23.9 years, 59% female) completed a 4‐week smartphone‐based ecological momentary assessment study reporting the occurrence and perceived strain of daily hassles as well as negative affect at five semi‐random signals between 9 a.m. and 8 p.m. Multilevel analyses revealed significant associations between elevated levels of negative affect and higher cumulative daily hassle strain ratings per signal in concurrent and time‐lagged analyses. Contrary to our expectations, there was no moderation by neuroticism on these associations. The results suggest that daily hassles can accumulate in their impact on mood in daily life and exert a prolonged effect on negative affect. The absence of a significant moderation by neuroticism may be interpreted in the light of methodological specifics of this study.
Background: Few data are available on the characteristics of inpatient treatment and subsequent outpatient treatment for depression in Germany. In this study, we aimed to characterize the inpatient and outpatient treatment phases, to determine the rates of readmission and mortality, and to identify risk factors.
Methods: We carried out a descriptive statistical analysis of routine administrative data from a large health-insurance carrier (BARMER). All insurees aged 18 to 65 who were treated in 2015 as inpatients on a psychiatry and psychotherapy service or on a psychosomatic medicine and psychotherapy service with a main diagnosis of depression were included in the analysis. Risk factors for readmission and death were determined with the aid of mixed logistic regression.
Results: Of the 22 893 patients whose data were analyzed, 78% had been hospitalized on a psychiatry and psychotherapy service and 22% on a psychosomatic medicine and psychotherapy service. The median length of hospital stay was 42 days. Follow-up care in the outpatient setting failed to conform with the recommendations of the pertinent guidelines in 92% of the patients with a main diagnosis of severe depression during hospitalization, and in 50% of those with moderate depression. 21% of the patients were readmitted within a year. The mortality at one year was 961 per 100 000 individuals (adjusted for the age and sex structure of the German population), or 3.4 times the mortality of the population at large. In the regression model, more treatment units during hospitalization and subsequent treatment with psychotherapy were associated with a lower probability of readmission, while longer hospitalization with subsequent pharmacotherapy or psychotherapy was associated with lower mortality.
Conclusion: The recommendations of the national (German) S3 guidelines for the further care of patients who have been hospitalized for depression are inadequately implemented at present in the sectored structures of in- and outpatient care in the German health care system. This patient group has marked excess mortality.
Resilienz bezeichnet die Aufrechterhaltung bzw. rasche Wiederherstellung der psychischen Gesundheit während oder nach stressvollen Lebensumständen. Aktuelle Forschungsergebnisse legen nahe, dass Resilienz dynamisch ist und trainiert werden kann. Obwohl Interventionen zur Stärkung der Resilienz häufig zur Gesundheitsförderung bei verschiedenen Zielgruppen eingesetzt werden, ist deren Effektivität jedoch kaum systematisch untersucht. Diese Übersichtsarbeit beurteilt narrativ die Ergebnisse 4 systematischer Reviews und Metaanalysen zu Resilienzinterventionen bei Erwachsenen und fasst die Evidenz aus den randomisiert-kontrollierten Primärstudien (N=44) zusammen. Insgesamt erzielten die Resilienzinterventionen kleine bis moderate Effekte bzgl. der Steigerung von Resilienz und der Verbesserung der psychischen Gesundheit. Trotz methodischer Schwächen scheinen Resilienzinterventionen wirksam zu sein und könnten somit eine gute Ergänzung zu aktuellen Präventionsmaßnahmen darstellen.
Background: Many existing scales for microstressor assessment do not differentiate between objective (ie, observable) stressor events and stressful cognitions or concerns. They often mix items assessing objective stressor events with items measuring other aspects of stress, such as perceived stressor severity, the evoked stress reaction, or further consequences on health, which may result in spurious associations in studies that include other questionnaires that measure such constructs. Most scales were developed several decades ago; therefore, modern life stressors may not be represented. Ecological momentary assessment (EMA) allows for sampling of current behaviors and experiences in real time and in the natural habitat, thereby maximizing the generalization of the findings to real-life situations (ie, ecological validity) and minimizing recall bias. However, it has not been used for the validation of microstressor questionnaires so far.
Objective: The aim is to develop a questionnaire that (1) allows for retrospective assessment of microstressors over one week, (2) focuses on objective (ie, observable) microstressors, (3) includes stressors of modern life, and (4) separates stressor occurrence from perceived stressor severity.
Methods: Cross-sectional (N=108) and longitudinal studies (N=10 and N=70) were conducted to evaluate the Mainz Inventory of Microstressors (MIMIS). In the longitudinal studies, EMA was used to compare stressor data, which was collected five times per day for 7 or 30 days with retrospective reports (end-of-day, end-of-week). Pearson correlations and multilevel modeling were used in the analyses.
Results: High correlations were found between end-of-week, end-of-day, and EMA data for microstressor occurrence (counts) (r≥.69 for comparisons per week, r≥.83 for cumulated data) and for mean perceived microstressor severity (r≥.74 for comparisons per week, r≥.85 for cumulated data). The end-of-week questionnaire predicted the EMA assessments sufficiently (counts: beta=.03, 95% CI .02-.03, P<.001; severity: beta=.73, 95% CI .59-.88, P<.001) and the association did not change significantly over four subsequent weeks.
Conclusions: Our results provide evidence for the ecological validity of the MIMIS questionnaire.
Keywords: daily hassles; ecological momentary assessment; microstressor; validation.
Background
Resilience can be defined as maintaining or regaining mental health during or after significant adversities such as a potentially traumatising event, challenging life circumstances, a critical life transition or physical illness. Healthcare students, such as medical, nursing, psychology and social work students, are exposed to various study‐ and work‐related stressors, the latter particularly during later phases of health professional education. They are at increased risk of developing symptoms of burnout or mental disorders. This population may benefit from resilience‐promoting training programmes.
Objectives:
To assess the effects of interventions to foster resilience in healthcare students, that is, students in training for health professions delivering direct medical care (e.g. medical, nursing, midwifery or paramedic students), and those in training for allied health professions, as distinct from medical care (e.g. psychology, physical therapy or social work students).
Search methods:
We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results.
Selection criteria:
Randomised controlled trials (RCTs) comparing any form of psychological intervention to foster resilience, hardiness or post‐traumatic growth versus no intervention, waiting list, usual care, and active or attention control, in adults (18 years and older), who are healthcare students. Primary outcomes were resilience, anxiety, depression, stress or stress perception, and well‐being or quality of life. Secondary outcomes were resilience factors.
Data collection and analysis:
Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post‐test only).
Main results:
We included 30 RCTs, of which 24 were set in high‐income countries and six in (upper‐ to lower‐) middle‐income countries. Twenty‐two studies focused solely on healthcare students (1315 participants; number randomised not specified for two studies), including both students in health professions delivering direct medical care and those in allied health professions, such as psychology and physical therapy. Half of the studies were conducted in a university or school setting, including nursing/midwifery students or medical students. Eight studies investigated mixed samples (1365 participants), with healthcare students and participants outside of a health professional study field.
Participants mainly included women (63.3% to 67.3% in mixed samples) from young adulthood (mean age range, if reported: 19.5 to 26.83 years; 19.35 to 38.14 years in mixed samples). Seventeen of the studies investigated group interventions of high training intensity (11 studies; > 12 hours/sessions), that were delivered face‐to‐face (17 studies). Of the included studies, eight compared a resilience training based on mindfulness versus unspecific comparators (e.g. wait‐list).
The studies were funded by different sources (e.g. universities, foundations), or a combination of various sources (four studies). Seven studies did not specify a potential funder, and three studies received no funding support.
Risk of bias was high or unclear, with main flaws in performance, detection, attrition and reporting bias domains.
At post‐intervention, very‐low certainty evidence indicated that, compared to controls, healthcare students receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.43, 95% confidence interval (CI) 0.07 to 0.78; 9 studies, 561 participants), lower levels of anxiety (SMD −0.45, 95% CI −0.84 to −0.06; 7 studies, 362 participants), and lower levels of stress or stress perception (SMD −0.28, 95% CI −0.48 to −0.09; 7 studies, 420 participants). Effect sizes varied between small and moderate. There was little or no evidence of any effect of resilience training on depression (SMD −0.20, 95% CI −0.52 to 0.11; 6 studies, 332 participants; very‐low certainty evidence) or well‐being or quality of life (SMD 0.15, 95% CI −0.14 to 0.43; 4 studies, 251 participants; very‐low certainty evidence).
Adverse effects were measured in four studies, but data were only reported for three of them. None of the three studies reported any adverse events occurring during the study (very‐low certainty of evidence).
Authors' conclusions:
For healthcare students, there is very‐low certainty evidence for the effect of resilience training on resilience, anxiety, and stress or stress perception at post‐intervention.
The heterogeneous interventions, the paucity of short‐, medium‐ or long‐term data, and the geographical distribution restricted to high‐income countries limit the generalisability of results. Conclusions should therefore be drawn cautiously. Since the findings suggest positive effects of resilience training for healthcare students with very‐low certainty evidence, high‐quality replications and improved study designs (e.g. a consensus on the definition of resilience, the assessment of individual stressor exposure, more attention controls, and longer follow‐up periods) are clearly needed.
Background
Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work‐related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience‐promoting training programmes.
Objectives:
To assess the effects of interventions to foster resilience in healthcare professionals, that is, healthcare staff delivering direct medical care (e.g. nurses, physicians, hospital personnel) and allied healthcare staff (e.g. social workers, psychologists).
Search methods:
We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results.
Selection criteria:
Randomised controlled trials (RCTs) in adults aged 18 years and older who are employed as healthcare professionals, comparing any form of psychological intervention to foster resilience, hardiness or post‐traumatic growth versus no intervention, wait‐list, usual care, active or attention control. Primary outcomes were resilience, anxiety, depression, stress or stress perception and well‐being or quality of life. Secondary outcomes were resilience factors.
Data collection and analysis:
Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post‐test only).
Main results:
We included 44 RCTs (high‐income countries: 36). Thirty‐nine studies solely focused on healthcare professionals (6892 participants), including both healthcare staff delivering direct medical care and allied healthcare staff. Four studies investigated mixed samples (1000 participants) with healthcare professionals and participants working outside of the healthcare sector, and one study evaluated training for emergency personnel in general population volunteers (82 participants). The included studies were mainly conducted in a hospital setting and included physicians, nurses and different hospital personnel (37/44 studies).
Participants mainly included women (68%) from young to middle adulthood (mean age range: 27 to 52.4 years). Most studies investigated group interventions (30 studies) of high training intensity (18 studies; > 12 hours/sessions), that were delivered face‐to‐face (29 studies). Of the included studies, 19 compared a resilience training based on combined theoretical foundation (e.g. mindfulness and cognitive‐behavioural therapy) versus unspecific comparators (e.g. wait‐list). The studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources. Fifteen studies did not specify the source of their funding, and one study received no funding support.
Risk of bias was high or unclear for most studies in performance, detection, and attrition bias domains.
At post‐intervention, very‐low certainty evidence indicated that, compared to controls, healthcare professionals receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.45, 95% confidence interval (CI) 0.25 to 0.65; 12 studies, 690 participants), lower levels of depression (SMD −0.29, 95% CI −0.50 to −0.09; 14 studies, 788 participants), and lower levels of stress or stress perception (SMD −0.61, 95% CI −1.07 to −0.15; 17 studies, 997 participants). There was little or no evidence of any effect of resilience training on anxiety (SMD −0.06, 95% CI −0.35 to 0.23; 5 studies, 231 participants; very‐low certainty evidence) or well‐being or quality of life (SMD 0.14, 95% CI −0.01 to 0.30; 13 studies, 1494 participants; very‐low certainty evidence). Effect sizes were small except for resilience and stress reduction (moderate). Data on adverse effects were available for three studies, with none reporting any adverse effects occurring during the study (very‐low certainty evidence).
Authors' conclusions:
For healthcare professionals, there is very‐low certainty evidence that, compared to control, resilience training may result in higher levels of resilience, lower levels of depression, stress or stress perception, and higher levels of certain resilience factors at post‐intervention.
The paucity of medium‐ or long‐term data, heterogeneous interventions and restricted geographical distribution limit the generalisability of our results. Conclusions should therefore be drawn cautiously. The findings suggest positive effects of resilience training for healthcare professionals, but the evidence is very uncertain. There is a clear need for high‐quality replications and improved study designs.
The use of small-scale wind turbines (SSWTs) in private households not only allows for increased renewable energy generation, but also improved grid stability and resilience of individual regions. However, there are strict requirements regarding the efficiency, reliability and electrical safety of SSWTs because of their low power levels, long payback period and the fact that they are installed nearby residential areas. This paper proposes a novel yaw inductive power transfer system, based on multilevel inverter, which mitigates the main disadvantages of SSWTs - slip rings, low voltage energy generation etc. The system utilizes low voltage MOSFETs in multilevel boost-series resonant topology combined with ZVS techniques to maximize efficiency. The operating principle, switching waveforms and behavior of the inverter are described and analyzed. Cell voltage balancing algorithms are presented as well. Two different control techniques for power flow regulation have been introduced and compared. The effectiveness of the proposed solution has been verified by building a 3.3 kW prototype system and comprehensive measuring of its performance. The experimental results show that peak power transfer efficiency reaches 92.5% while converting generator voltage from 60 V DC to grid compatible 400 V DC.
One-dimensional objects as nanowires have been proven to be building blocks in novel applications due to their unique functionalities. In the realm of magnetic materials, iron-oxides form an important class by providing potential solutions in catalysis, magnetic devices, drug delivery, or in the field of sensors. The accurate composition and spatial structure analysis are crucial to describe the mechanical aspects and optimize strategies for the design of multi-component NWs. Atom probe tomography offers a unique analytic characterization tool to map the (re-)distribution of the constituents leading to a deeper insight into NW growth, thermally-assisted kinetics, and related mechanisms. As NW-based devices critically rely on the mechanical properties of NWs, the appropriate mechanical modeling with the resulting material constants is also highly demanded and can open novel ways to potential applications. Here, we report a compositional and structural study of quasi-ceramic one-dimensional objects: α-Fe ⊕ α-FeOOH(goethite) ⊕ Pt and α-Fe ⊕ α-Fe3O4(magnetite) ⊕ Pt core–shell NWs. We provide a theoretical model for the elastic behavior with terms accounting for the geometrical and mechanical nonlinearity, prior and subsequent to thermal treatment. The as-deposited system with a homogeneous distribution of the constituents demonstrates strikingly different structural and elastic features than that of after annealing, as observed by applying atom probe tomography, energy-dispersive spectroscopy, analytic electron microscopy, and a micromanipulator nanoprobe system. During annealing at a temperature of 350 °C for 20 h, (i) compositional partitioning between phases (α-Fe, α-Fe3O4 and in a minority of α-Fe2O3) in diffusional solid–solid phase transformations takes place, (ii) a distinct newly-formed shell formation develops, (iii) the degree of crystallinity increases and (iv) nanosized precipitation of evolving phases is detected leading to a considerable change in the description of the elastic material properties. The as-deposited nanowires already exhibit a significantly large maximum strain (1–8%) and stress (3–13 GPa) in moderately large bending tests, which become even more enhanced after the annealing treatment resulting at a maximum of about 2.5–10.5% and 6–18 GPa, respectively. As a constitutive parameter, the strain-dependent stretch modulus undoubtedly represents changes in the material properties as the deformation progresses.
The theories of multi-criteria decision-making (MCDM) and fuzzy logic both aim to model human thinking. In MCDM, aggregation processes and preference modeling play the central role. This paper suggests a consistent framework for modeling human thinking by using the tools of both fields: fuzzy logical operators as well as aggregation and preference operators. In this framework, aggregation, preference, and the logical operators are described by the same unary generator function. Similarly to the implication being defined as a composition of the disjunction and the negation operator, preference operators were introduced as a composition of the aggregative operator and the negation operator. After a profound examination of the main properties of the preference operator, our main goal is the implementation into neural networks. We show how preference can be modeled by a perceptron, and illustrate the results in practical neural applications.
Interpretable neural networks based on continuous-valued logic and multicriteria decision operators
(2020)
Combining neural networks with continuous logic and multicriteria decision-making tools can reduce the black-box nature of neural models. In this study, we show that nilpotent logical systems offer an appropriate mathematical framework for hybridization of continuous nilpotent logic and neural models, helping to improve the interpretability and safety of machine learning. In our concept, perceptrons model soft inequalities; namely membership functions and continuous logical operators. We design the network architecture before training, using continuous logical operators and multicriteria decision tools with given weights working in the hidden layers. Designing the structure appropriately leads to a drastic reduction in the number of parameters to be learned. The theoretical basis offers a straightforward choice of activation functions (the cutting function or its differentiable approximation, the squashing function), and also suggests an explanation to the great success of the rectified linear unit (ReLU). In this study, we focus on the architecture of a hybrid model and introduce the building blocks for future applications in deep neural networks.
The current study describes analyses of the WINSENT wind energy test sitelocated in complex terrain in Southern Germany by highly resolved numerical simulations.The resolved atmospheric turbulence is simulated with Delayed Detached Eddy Simulations bythe flow solver FLOWer without consideration of the research wind turbines.The mean inflow and wind direction of the analysed time period is provided by precursorsimulations of project partners. The simulation model chain consists of three codes with differenttime scales and resolutions. The model chain provides a data transfer from mesoscale WRFsimulations to OpenFOAM. As a next step OpenFOAM provides inflow data in the valleyof the terrain site for the present FLOWer simulations, the code with the highest resolutionin space and time. The mean velocity field provided by OpenFOAM is superimposed withfluctuations that are based on measurements to obtain the small turbulent scales within theFLOWer simulations, which the previous tools of the model chain can not resolve.Comparisons with the two already installed met masts clarify that the current FLOWersimulations provide an adequate agreement with measured data. The results are verified withthe application of a second simulation, in which a homogeneous velocity profile is superimposedwith turbulence. Thus, comparisons with measured data showed that the benefit of using theinflow data of this model chain is especially evident near the ground.
In this paper, new automated processes for applying the commercial Computational Fluid Dynamics (CFD) tools ANSYS Fluent and ANSYS CFX to wind modelling in complex terrain are developed with the goal of decreasing the Actual Total Costs (ATC) related to planning wind energy projects. Simulations are carried out at the complex terrain site Stotten in southern Germany using ANSYS Fluent and ANSYS CFX, and the ATCs related to the simulations estimated. The simulation set-up and post-processing effort are identified as having the highest effect on the ATC, and therefore the automated processes focus on reducing the effort of these tasks. Simulations of the same test site are carried out with the new automated processes, and compared to the manual processes as well as to an industry-standard tool, WindSim. The new automated tools are found to reduce the ATC of this case by a factor of 12 for Fluent and seven for CFX, to approximately half the value of WindSim. All three simulations show similar deviations compared to measurements and therefore these results are comparable. It should be noted that these results are highly specific to this case, and the absolute cost-saving values cannot be directly transferred to other cases. Nevertheless, it can be concluded that these new processes have significantly reduced the Actual Total Cost and are likely to have a large effect on the choice of the most cost-effective model for a given wind energy project. On-going work involves quantifying the effect of these cost savings on the choice of most app
Micrometeorological observations from a tower, an eddy-covariance (EC) station and an unmanned aircraft system (UAS) at the WINSENT test-site are used to validate a computational fluid dynamics (CFD) model, driven by a mesoscale model. The observation site is characterised by a forested escarpment in a complex terrain. A two-day measurement campaign with a flow almost perpendicular to the escarpment is analysed. The first day is dominated by high wind speeds, while, on the second one, calm wind conditions are present. Despite some minor differences, the flow structure, analysed in terms of horizontal wind speeds, wind direction and inclination angles shows similarities for both days. A real-time strategy is used for the CFD validation with the UAS measurement, where the model follows spatially and temporally the aircraft. This strategy has proved to be successful. Stability indices such as the potential temperature and the bulk Richardson number are calculated to diagnose atmospheric boundary layer (ABL) characteristics up to the highest flight level. The calculated bulk Richardson values indicate a dynamically unstable region behind the escarpment and near the ground for both days. At higher altitudes, the ABL is returning to a near neutral state. The same characteristics are found in the model but only for the first day. The second day, where shear instabilities are more dominant, is not well simulated. UAS proves its great value for sensing the flow over complex terrains at high altitudes and we demonstrate the usefulness of UAS for validating and improving models.
This paper analyzes a principal-agent model with three risk-averse players to investigate incentive provision and optimal team size in a setting with uncertain productivity and team synergies. A principal hires a team of workers and a manager to supervise the team. Workers provide productive effort, whereas the manager exerts effort to reduce measurement noise and productivity risk. We find that moral hazard is a limiting factor for team size and that the risk from uncertain productivity leads to smaller optimal teams, which stands in contrast to previous literature. Furthermore, we show that the manager’s and workers’ compensation increases with team size and that the pay differential between them is higher for larger teams. Our analysis demonstrates that the interdependency between team size and incentive provision makes it essential to coordinate the choice of these design variables.
A number of planetary boundaries, including climate change as a result of greenhouse gas emissions, has already been exceeded. This situation has deleterious consequences for public health. Paradoxically, 4.4% of these emissions are attributable to the healthcare sector. These problems have not been sufficiently acknowledged in health professions curricula. This paper addresses two main issues, humanistic learning and the application of knowledge acquisition to clinical practice. Humanistic learning principles can be used to emphasize learner-centered approaches, including knowledge acquisition and reflection to increase self-awareness. Applying humanistic principles in everyday life and clinical practice can encourage stewardship, assisting students to become agents for change. In terms of knowledge and skills application to clinical practice, an overview of varied and novel approaches of how sustainable education can be integrated at different stages of training across several health care professions is provided. The Health and Environment Adaptive Response Taskforce (HEART) platform as an example of creating empowered learners, the NurSusTOOLKIT, a multi-disciplinary collaboration offering free adaptable educational resources for educators and the Greener Anaesthesia and Sustainability Project (GASP), an example of bridging the transition to clinical practice, are described.
Tagespflege in Bewegung
(2020)
In einem Kooperationsprojekt entstand die Idee zu dem Konzept „Tagespflege in Bewegung – Was geht (noch)?!“ Mithilfe von kreativen Angeboten sollen die Mobilität und Alltagsaktivitäten im Alter gefördert und ein Leben im Quartier ermöglicht werden. Das gelingt am besten durch die Verknüpfung über Sektorengrenzen hinweg.
Power-to-Heat
(2020)
Zum Gelingen der Energiewende wird der Sektorkopplung und damit auch der Power-to-Heat-Technologie eine Notwendigkeit von Seiten der Wissenschaft, Wirtschaft und Politik zugesprochen. Trotzdem werden die Potenziale der Power-to-Heat-Technologie für eine weitere Flexibilisierung der Energieversorgung in Deutschland noch vergleichsweise wenig genutzt. Ziel dieser Veröffentlichung ist es daher, den aktuellen Stand des Ausbaus von Power-to-Heat-Anlagen und vielversprechende Forschungsbemühungen an technischen Entwicklungen aufzuzeigen. Dazu werden die unterschiedlichen Ausprägungen der Power-to-Heat Technologie und Wärmespeicher kurz vorgestellt. Der aktuelle Stand des Ausbaus und noch ungenutze Potenziale werden aufgezeigt.
Die installierte Leistung aller Power-to-Heat-Anlagen in Deutschland hat Ende 2019 die Marke von 1 GW überschritten, dabei handelt es sich hauptsächlich um Anwendungen in Kombination mit Fernwärmenetzen. Entsprechend beschränken sich auch die Wärmespeichertechnologien im Wesentlichen auf drucklos oder druckaufgeladene geschichtete Wasserspeicher mit einer Temperatur bis maximal 200 °C. Seit 2014 ist ein innovativer Zwei-Zonen-Speicher auf dem Markt zu finden. Darauf aufbauend wird die aktuelle Forschung im Bereich Hochtemperaturwärmespeicher und die damit verbundene Möglichkeit Power-to-Heat-to-Power diskutiert. Abrundend werden die aktuelle Gesetzgebung und deren zukünftige Ausgestaltung zum Thema Power-to-Heat, sowie aktuelle Reformvorschläge erörtert. Damit wird auch ein Appell an die Politik gerichtet, die regulatorischen Rahmenbedingungen weiter anzupassen, um Geschäftsmodelle im Bereich Power-to-Heat auf breiter Ebene tragfähig zu machen.
Plötzlich digital!?
(2020)
Bei QUICKSTEP© handelt es sich um ein von der Hochschule Esslingen in der Entwicklung begriffenes Tablet-basiertes Erhebungsinstrument für Kinder –angelehnt an Meier u.a. (2011) und Klein/Landhäußer (2017) im Modus der CAPI- beziehungsweise CASI-Methode (vgl. Meier u.a. 2011; Klein/Landhäußer 2017). Das Akronym QUICKSTEP© steht dabei für Qualitätsanalyse in child care- und Kindertageseinrichtungen mittels standardisierter Erhebungsinstrumentarien aus Kinderperspektive.
In recent years, a number of bidirectional inductive power transfer systems (BD-IPT) suitable for wireless grid integration of electric vehicles have been developed. These developments have been fueled by the enhanced efficiency and spatial tolerance offered by BD-IPT systems. A typical BD-IPT system utilizes two synchronized full-bridge converters operating at fixed duty cycles to drive the primary and secondary magnetic couplers. However, in order to cater for a wide range of loading conditions, additional circuitry is employed at the expense of cost and power density. As an alternative solution, this paper proposes a novel power converter, named a boost active bridge (BAB), to replace the full-bridge converters. The BAB topology caters to a wide range of loading conditions without the need for any extra switching devices. A comprehensive mathematical model that predicts steady-state currents, voltages, and power transfer is presented to highlight the operating principles of the BAB technology. Experimental results obtained from a 3.5-kW prototype show a nearly constant efficiency under all loading conditions, validating the viability of the proposed BAB topology.
Processing of liquid silicone rubber (LSR) in the injection molding process has a high economic potential. Since there are some fundamental differences compared to classical thermoplastic injection molding, up to now there is a lack of well‐founded knowledge of the process which allows an estimation of the cycle time. Because, in addition to reverse temperature control, LSR processing also involves an irreversible temperature‐ and time‐dependent chemical reaction. In this paper, the complex cross‐linking reaction is first modelled phenomenologically using dynamic differential scanning calorimetry (DSC) measurements and the well‐fitting Kamal‐Sourour model. Afterwards, a temperature and cross‐linking simulation is set up, which reliably simulates the time‐ and travel‐dependent temperature profile and degree of cross‐linking in the mold. Therefore, the released exothermic cross‐linking heat is also taken into account. The simulated temperature values are verified with measurements in the cavity during the injection molding process. The measured values correspond very well with the simulated values at different mold temperatures. It is shown that the influence of the cross‐linking heat on the overall temperature profile in the LSR component during the injection molding process is relatively low. Nevertheless, the model is necessary to determine the degree of cross‐linking ‐ it can be used to calculate the cycle time at which the component of a certain cross‐section can be ejected at a known tool temperature and is fully cross‐linked. With this knowledge, existing processes can be optimized in terms of mold temperature and curing time, but also new components can be calculated economically.
Waste
(2020)
This study investigates how integrated reporting (IR) creates value for investors. It examines how providers of financial capital benefit from an improved firm information environment provided by IR. Specifically, this study investigates the effect of voluntary IR disclosure on analyst earnings forecast accuracy as well as on firm value. To do so, we use an international sample of 167 listed companies that voluntarily publish an integrated report. Our analysis shows no significant effect of a voluntary IR publication on analyst earnings forecast accuracy and no significant effect on firm value. We thus do not find evidence for the fulfillment of IR's promises regarding improved information environment and value creation of voluntary adopters. We conclude that such companies might already have a relatively high level of transparency leading to an absent additional effect of IR disclosure. Positive effects of IR appear to be more relevant in environments where IR is mandatory.
Comparing multidimensional sensor data from vehicle fleets with methods of sequential data mining
(2020)
Reading and understanding large amounts of sensor data from vehicle test drives becomes more and more important. In order to test vehicle components or analyze exhaust emissions in real test drives, the sensor data obtained from these test drives have to be comparable. Otherwise components or exhaust emissions are tested and analyzed under false conditions. The sensor data obtained during test drives are highly multidimensional which makes it even more complicated to identify recurring patterns. We present a process model to compare different test drives according to their sensor data and so give an answer to the question whether or not test drives in different cities, locations and environments are representative to real driving scenarios. The algorithms we use focus on segmentation of the individual multivariate test drive data and on clustering of the segments according to different methods. We present several segmentation and cluster methods and compare which of them is best suited for comparing test drives. The segmentation method we identified as best suited is based on principal component analysis. As cluster methods we examine hierarchical, partitioning and density-based clustering in detail.
The wet-flue-gas desulfurization (FGD) process plays an important role in removing water-soluble flue-gas components such as sulphur dioxide (SO2) and oxidized mercury compounds. Under the reducing environment of the FGD, there is the possibility of re-emission of the already absorbed mercury (Hg) to the gas phase, which may be diminished by the utilization of specific additives. In this study, the effect of two different additives on Hg re-emission from the aqueous phase and Hg partitioning in gypsum and filtrate of a lab-scale wet-limestone FGD is investigated. Furthermore, the behaviour of additives in the presence of different halides is studied. The studied additives are TMT 15® as a sulphidic precipitating agent, which forms non-soluble mercury compounds, and activated lignite (AL) as a carbon-based sorbent, which adsorbs Hg compounds from the aqueous phase. TMT 15® has no significant effect on SO2 absorption; on the other hand, addition of AL improves the SO2-removal efficiency by up to 30%. Using both additives, Hg re-emission is suppressed in all the experimented cases except for AL in the absence of halides, in which Hg re-emission shows no change. Thus, the need to form nucleophilic oxidized mercury compounds in the slurry for the adsorption of oxidized mercury on AL can be concluded. Usage of both additives improves Hg retention in the slurry to different extents. It is shown that, for the additive-free slurries, the Hg-adsorption capacity of the solid fraction of the slurry is the limiting parameter. Moreover, the utilization of both additives results in a significant increase in the Hg concentration of solid fraction. The correlation between redox potential and partitioning of Hg in the slurry is presented by comparing the change in the redox potential of slurries when additives are used.
Optimized production strategy of the major capsid protein HPV 16L1 non-assembly variant in E. coli
(2020)
The capsid of human papillomavirus (HPV) consists of two capsid proteins - the major capsid protein L1 and the minor capsid protein L2. Assembled virus-like particles, which only consist of L1 proteins, are successfully applied as prophylactic vaccines against HPV infections. The capsid subunits are L1-pentamers, which are also reported to protect efficiently against HPV infections in animals.
The recombinant production of L1 has been previously shown in E. coli, yeast, insect cells, plants and mammalian cell culture. Principally, in E. coli-based expression system L1 shows high expression yields but the protein is largely insoluble. In order to overcome this problem reported strategies address fusion proteins and overexpression of bacterial chaperones. However, an insufficient cleavage of the fusion proteins and removal of co-purified chaperones can hamper subsequent down streaming.
We report a significant improvement in the production of soluble L1-pentamers by combining (I) a fusion of a N-terminal SUMO-tag to L1, (II) the heterologous co-expression of the chaperon system GroEL/ES and (III) low expression temperature. The fusion construct was purified in a 2-step protein purification including efficient removal of GroEL/ES and complete removal of the N-terminal SUMO-tag. The expression strategy was transferred to process-controlled high-cell-density fermentation with defined media according to the guidelines of good manufacturing practice. The produced L1 protein is highly pure (>95%), free of DNA (260:280 = 0.5) and pentameric. The production strategy yielded 5.73 mg of purified L1-pentamers per gram dry biomass. The optimized strategy is a suitable alternative for high yield L1-pentamer production and purification as a cheaper process for vaccine production.
In a recent study, Gebauer et al. addressed a fundamental question regarding the effects of mind-body practices (MBPs) on the self. Does the practice of MBPs in accordance with traditional contemplative traditions quiet the ego or is the practice of MBPs associated with increased self-centrality, which breeds self-enhancement bias? Both hypotheses were investigated in two separate studies with a longitudinal design. Study 1 included 93 participants, who regularly practiced yoga, and study 2 contained 162 participants, who regularly practiced loving-kindness meditation. In both studies, trait questionnaires of self-centrality and self-enhancement were taken after the practice of yoga (over the course of 15 weeks) or meditation (over the course of 4 weeks). Findings from both studies showed that participants scored higher on measures of self-enhancement and self-centrality after practicing yoga and meditation as compared with not practicing yoga and meditation. Based on these findings, Gebauer et al. argued that MBPs such as yoga and meditation do not quiet the ego, but instead lead to self-enhancement bias through increased self-centrality. We have concerns about the far-reaching conclusions made by Gebauer et al. regarding the effects of MBPs on the self. The key concerns refer to the conceptualization of the quiet ego and to the assessment of the psychological constructs investigated in this study. Gebauer et al. addressed a timely and important research question, but their far-reaching interpretations should be reconsidered due to conceptual and methodological ambiguities.
Mindfulness-based and mindfulness-informed programs such as mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), or dialectic behavior therapy (DBT) have gained widespread attention over the past few decades. One way of bringing mindfulness programs into clinical practice is via a planned implementation process where empirically validated interventions are disseminated and implemented on a large scale. However, besides this planned process, it can be observed that mindfulness has diffused into current society as well as into psychotherapy practice in an unsystematic way. To date, however, little is known about the proliferation of mindfulness in clinical practice. We investigated a randomly drawn sample of German psychological psychotherapists with regard to their use of mindfulness in clinical practice using a web survey. Additionally, the psychotherapists’ personal mindfulness practice was assessed. The overwhelming majority (82%) of psychotherapists reported using mindfulness practices at least sometimes with their patients. Programs such as MBSR and MBCT are rarely applied. Rather, therapists use individual mindfulness practices in an eclectic way. Our results show that in addition to investigating the implementation of empirically underpinned mindfulness-based programs, mindfulness researchers should also investigate the ways in which mindfulness-based practices have diffused into clinical work with individuals. Guidelines on best practice for this work will support the future integrity of mindfulness programs.
Research suggests that online interventions preventing risky substance use can improve student health. There is an increasing interest in transferring evidence-based online programs into university health promotion practice. However, little is known about how to best tailor the implementation process to capacities and context of individual universities. The purpose of this study was to assess the level of readiness (capacity) of German universities concerning the implementation of evidence-based online programs for risky substance use prevention employing an adapted Community Readiness Assessment (CRA) and to develop tailored action plans for implementation. The CRA involved 43 semi-structured interviews with key persons at 10 German universities. The interviews addressed five dimensions (knowledge of efforts, leadership, community climate, knowledge of the issue, and resources) at nine possible readiness stages (no awareness—ownership) and additional contextual factors. Overall, readiness for implementing online interventions across universities was rather low. Universities readiness levels ranged between the denial stage with a score of 2.1 and the preplanning stage with a score of 4.4. University-specific readiness was very heterogeneous. On the basis of the results of the CRA, universities received feedback and options for training on how to take the necessary steps to increase readiness and to prepare program implementation. The adapted version of the CRA was well suited to inform future implementation of evidence-based online programs for the prevention of risky substance use at participating universities.
Die Demokratie scheint in Deutschland gefestigt zu sein, gleichzeitig wird sie jedoch von einer nennenswerten Anzahl von Bürgerinnen und Bürgern – auch von Jugendlichen – zunehmend in Frage gestellt. Die Bundesregierung hat auf diesem Hintergrund für den nächsten Kinder- und Jugendbericht das Thema „Förderung demokratischer Bildung im Kindes- und Jugendalter“ vorgesehen. Kurt Möller und Oliver Hohner gehen in ihrem Beitrag der Frage nach, welche Potentiale für Demokratiebildung die Offene Kinder- und Jugendarbeit bietet; auch die Aufsuchende Jugend(sozial)arbeit nehmen sie in den Blick. Die Autoren haben im Herbst 2019 eine Online-Befragung unter Einrichtungen der Offenen Kinder- und Jugendarbeit und Aufsuchenden Jugend(sozial)arbeit durchgeführt. Das Vorgehen, die wichtigsten Ergebnisse und zentrale Schlussfolgerungen daraus stellen sie vor. Abgefragt wurden u.a. die Häufigkeit von Diskussionen über politische Themen in den genannten Arbeitsfeldern, Ausgrenzungen unter Jugendlichen oder die Intensität von Beteiligung und Mitbestimmung der Jugendlichen. Deutlich wird ein erheblicher Bedarf an Aus-, Fort- und Weiterbildung zu solchen Herausforderungen. Die Autoren arbeiten auch Spezifika und Unterschiede zwischen den Arbeitsfeldern der Offenen Kinder- und Jugendarbeit und der Aufsuchenden Jugend(sozial)arbeit heraus.
Um Pauschalablehnungen und Diskriminierungen entgegenzuwirken, braucht Jugendarbeit Verständnis für deren Hintergründe sowie fallbezogene Handlungsfähigkeit. Der Artikel präsentiert dafür Konzepte. Ausgehend von Forschungsbefunden zeigt er auf, wie sich Strategien entwickeln lassen, die an den Lebenswirklichkeiten und Ressourcen von Adressat*innen ansetzen.
Innovation und Qualität
(2020)
Analyse der Wirksamkeit des Harninkontinenzmanagements in einer geriatrischen Rehabilitationsklinik
(2020)
Hintergrund
Harninkontinenz ist ein weitverbreitetes gesundheitsrelevantes Problem, welches insbesondere im Alter auftritt. Ziel der Studie war es, die Effektivität des Kontinenzmanagements in einer geriatrischen Rehabilitationsklinik in der Routineversorgung zu evaluieren.
Methodik
Es wurde eine prospektive Beobachtungsstudie ohne Kontrollgruppe im Zeitraum vom 07.02.2018 bis zum 07.06.2018 durchgeführt. Alle in die Studie eingeschlossenen Patienten (n = 32) erhielten individualisierte leitliniengerechte Maßnahmen zur Verbesserung ihrer Inkontinenz durch das Kontinenzteam im Rehabilitationszeitraum. Zur Bewertung der Symptomveränderung wurde zum Aufnahmezeitpunkt (T0) und Entlasszeitpunkt (T1) der International Consultation on Incontinence Modular Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) verwendet. Die Beurteilung der Patientenzufriedenheit erfolgte zum Zeitpunkt T1 mittels des Fragebogens „Benefit, Satisfaction, and Willingness to Continue Treatment“ (BSW).
Ergebnisse
Zwischen T0 und T1 verbesserte sich der Summen-Score des ICIQ-UI SF um durchschnittlich 3,4 Punkte (p = 0,004). Die Verbesserung resultierte v. a. im Bereich der Abnahme der Häufigkeit der Inkontinenzepisoden sowie bei der Reduktion des Harnverlustvolumens. Während zum Zeitpunkt der Aufnahme 9,4 % der Patienten „eine große Menge Harn“ verloren, reduzierte sich der Anteil auf 3,1 % zum Ende der Rehabilitation. Der Anteil der Patienten, die vor der Behandlung mehrmals täglich Urin verloren, reduzierte sich von 68,6 % auf 31,3 %. Von den eingeschlossenen Patienten erhielten 80 % eine leitliniengerechte Behandlung innerhalb des Rehabilitationszeitraums. 64 % der Patienten waren mit der Behandlung zufrieden.
Zusammenfassung
Die leitliniengerechte Behandlung der Inkontinenz bei geriatrischen Patienten führte zu einer Verbesserung der Symptome. Eine hohe Anzahl an Patienten profitierte vom Kontinenzmanagement während des Rehabilitationszeitraums.
Hintergrund Im vom BMBF finanzierten Forschungsprojekt „Entwicklung, Umsetzung und Evaluation eines Konzepts zur Prävention und Behandlung von Mangelernährung bei geriatrischen Patienten im Krankenhaus“ sollen interdisziplinäre Praxiskonzepte mithilfe eines Vorher-Nachher-Designs evaluiert werden.
Material und Methodik Ziel dieser Arbeit ist eine erste Analyse von Veränderungen des Ernährungsstatus von PflegeheimbewohnerInnen mit mindestens 3-tägige stationären Krankenhausaufenthalt vor Konzeptentwicklung. Hierfür wurden Routinedaten von 2 großen Altenhilfeträgern herangezogen und insgesamt 1899 Fälle eingeschlossen.
Ergebnisse 38 % (n = 721) der Fälle sind bereits bei Aufnahme mangelernährt, nach Klinikaufenthalt 48,6 % (n = 784). Der mittlere BMI sinkt von 25,0 kg/m2 (SD ± 5,3) auf 24,5 kg/m2 (SD ± 5,1), wobei 19,3 % (n = 276) zwischen 5 % und 10 % ihres Körpergewichts verlieren und 9,4 % (n = 134) ≥ 10 %. PatientInnen mit Mangelernährung weisen bei Entlassung eine um 3,09 Tage längere Verweildauer auf (p < 0,001). Eine Mangelernährung bei Einweisung ist mit einem signifikant höheren Pflegegrad (Differenz = 0,18; p = 0,002), einer höheren Anzahl an Stürzen (Differenz = 0,45; p < 0,001) sowie einem häufigeren Versterben in der Klinik (p < 0,001; r = 0,120) und den nachfolgenden 6 Monate (p < 0,001; r = 0,200) assoziiert. Ein geringeres Risiko für eine Mangelernährung bei Entlassung ist assoziiert mit dem männlichen Geschlecht (OR = 0,671; p = 0,003), einem höheren BMI vor dem Klinikaufenthalt (OR = 0,887; p < 0,001), der Einweisungsdiagnosegruppe psychische und Verhaltensstörungen (OR = 0,306; p = 0,008) und Erkrankungen der Schilddrüse in den Nebendiagnosen (OR = 0,707; p = 0,02). Ein längerer Klinikaufenthalt (OR = 1,067; p < 0,001) geht dagegen mit einem höheren Risiko für eine Mangelernährung einher.
Schlussfolgerung Ein akut-stationärer Aufenthalt zeigt signifikante Auswirkungen auf den Ernährungsstatus. Aufgrund der Zusammenhänge von Mangelernährung und steigender Mortalität ist es notwendig, das klinische Ernährungsmanagement mithilfe von Praxiskonzepten zu optimieren.
This paper uses several techniques to monitor the ageing of commercial LiFePO4 cells, which are cycled at 55 °C and −20 °C at various depths of discharge. Ageing at lower depth of discharge leads to higher capacity fading, as compared to higher depth of discharge. The highest capacity fading is observed using 50% depth of discharge for cycling at 55 °C, while the lowest capacity fading is observed for the cells aged at 100% depth of discharge when cycled at −20 °C. Using incremental capacity analysis and differential voltage analysis the capacity fading is monitored and underlying ageing mechanisms are described. The loss of lithium inventory and the loss of active material, especially on the cathode side, are the major degradation mechanisms for the cells. The first incremental capacity analysis peak of the discharge process can be used in our case to predict remaining life and cell capacity.
Diese Arbeit stellt einen Lösungsansatz
für das Erstellen einer Karte für autonome Systeme auf Grundlage von Objekten mit Lebenspunkten vor. Dafür werden von
den Sensoren erfasste Punkte mit einem DBSCAN verarbeitet,
um zusammenhängende Cluster zu finden. Diese Cluster werden
mit Lebenspunkten versehen, welche die Existenzplausibilität
widerspiegeln.