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Deep brain stimulation (DBS) is an established therapy for movement disorders such as in Parkinson's disease (PD) and essential tremor (ET). Adjusting the stimulation parameters, however, is a labour-intensive process and often requires several patient visits. Physicians prefer objective tools to improve (or maintain) the performance in DBS. Wearable motion sensors (WMS) are able to detect some manifestations of pathological signs, such as tremor in PD. However, the interpretation of sensor data is often highly technical and methods to visualise tremor data of patients undergoing DBS in a clinical setting are lacking. This work aims to visualise the dynamics of tremor responses to DBS parameter changes with WMS while patients performing clinical hand movements. To this end, we attended DBS programming sessions of two patients with the aim to visualise certain aspects of the clinical examination. PD tremor and ET were effectively quantified by acceleration amplitude and frequency. Tremor dynamics were analysed and visualised based on setpoints, movement transitions and stability aspects. These methods have not yet been employed and examples demonstrate how tremor dynamics can be visualised with simple analysis techniques. We therefore provide a base for future research work on visualisation tools in order to assist clinicians who frequently encounter patients for DBS therapy. This could lead to benefits in terms of enhanced evaluation of treatment efficacy in the future.
This paper presents a feasibility study for the production of recycled glycol modified polyethylene terephthalate (PETG) material for additive manufacturing. Past studies showed a variety of results for the recycling of 3D-printing material, therefore the precise effect on the material properties is not completely clear. For this work, PETG waste of the same grade was recycled once and further processed into 3D printing filament. The study compares three blend ratios between purchased plastic pellets and recycled pellets to determine the degradation effect of one recycling cycle and possible blend ratios to counter these effects. Furthermore, the results include a commercially available filament. The comparison uses the filament diameter, the dimensional accuracy of the printed test specimen and mechanical properties as quality criteria. The study shows that the recycled material has a minor decrease concerning the tensile strength and Young’s modulus.
The following paper aims to find out consumers' expectations and attitudes towards the innovation "Metaverse". It will also be explored which role the Meta Group plays in mass adaption and how the company influences consumers' possible use and opinion on the project. These results are connected to the fashion industry, further exploring new types of products and a possible distribution channel. Therefore, this study is useful to developers of Metaverses and AR/VR products, the Meta Group, and fashion companies. The main results of this research are: Meta and the Metaverse are seen as critical, the required technology has not yet reached mainstream use, but interest is present. Digital fashion had participants divided, some not willing to spend any money and some already having spent over 100€, although the Metaverse's influence on future purchases is little. The Metaverse could serve as a new distribution channel for clothing products. To conduct this research Google Forms was used. The research is classified as survey-based. The biggest limitation is the nonexistence of the Metaverse as envisioned by Meta, making it hard for participants to answer some of the questions asked.
Electric drive systems are increasingly used in automobiles. However, the combination of comfort, dynamics and safety requirements places high demands on the torque accuracy. The complex interplay of battery, inverter and electrical machine causes a lot of system uncertainties based on parameter fluctuations and measurement errors that influence the system performance. In this paper these influences on the closed loop torque control are analyzed and quantified using a variance based sensitivity analysis. The method enables to connect the variance of the torque accuracy with the parameter uncertainties causing this variance. Moreover, it quantifies the influences of the parameters independent of the complexity of the analyzed system. In addition, two methods to ensure convergence of the estimated variance based sensitivity measures are proposed. The results of the analysis are presented for 19 static working points of an battery electric drive system.
Unternehmen verlassen sich bei der Entwicklung von Software und Lösungen häufig auf das Know-How externer Dienstleister. Moderne Arbeits- und Kollaborationsformen verändern gleichzeitig die Entwicklung von Produkten und Dienstleistungen. Wie beeinflussen diese Trends die Zusammenarbeit und Kooperation zwischen Unternehmen und ihren externen agilen Dienstleistern? Ziel dieser wissenschaftlichen Arbeit ist es herauszufinden, welche Schritte unternehmen müssen, um agiles Arbeiten und die Zusammenarbeit mit externen Dienstleistern umzusetzen. Daher wurde anhand einer Fallstudie inklusive einer qualitativen Befragung herausgefunden und aufgezeigt, welche Maßnahmen und Handlungen Unternehmen ergreifen müssen, um das Ziel einer effektiven Umsetzung einer agilen Zusammenarbeit und Kooperation zu erreichen. Drei Kernthemen wurden identifiziert, auf deren Grundlage die Forschungsfragen zu den Maßnahmen beantwortet werden: Erstens, welche Möglichkeiten Unternehmen haben, ein internes agiles Setup zu implementieren, um mit agilen Dienstleistern auf Augenhöhe zusammenzuarbeiten. Zweitens, welche Vertragsvarianten die agile Zusammenarbeit unterstützen und verbessern können und drittens, welche agilen Techniken und Methoden in der agilen Zusammenarbeit eingesetzt werden sollten. Die Ergebnisse der Fallstudien bestätigen die Annahme, dass die drei identifizierten Kernthemen für eine effektive Zusammenarbeit im agilen Umfeld essenziell sind. Während einerseits nachgewiesen wurde, dass sich die Vertragsanforderungen hinsichtlich ihrer Flexibilität und Anpassungsfähigkeit veränderten, wurde andererseits auch nachgewiesen, dass das interne Setup agile Treiber, Techniken und Methoden erfordert, um eine effektive Zusammenarbeit mit agilen Dienstleistern zu ermöglichen. Dieser Artikel gibt einen Überblick über die wichtigsten Inhalte innerhalb der drei genannten Kernthemen und gibt Unternehmen zudem Hinweise, wie sie eine Basis für eine effektive Zusammenarbeit schaffen können.
Unintended nuclear war
(2021)
While the contribution of renewable energy technologies to the energy system is increasing, so is its level of complexity. In addition to new types of consumer systems, the future system will be characterized by volatile generation plants that will require storage technologies. Furthermore, a solid interconnected system that enables the transit of electrical energy can reduce the need for generation and storage systems. Therefore, appropriate methods are needed to analyze energy production and consumption interactions within different system constellations. Energy system models can help to understand and build these future energy systems. However, although various energy models already exist, none of them can cover all issues related to integrating renewable energy systems. The existing research gap is also reflected in the fact that current models cannot model the entire energy system for very high shares of renewable energies with high temporal resolution (15 min or 1-h steps) and high spatial resolution. Additionally, the low availability of open-source energy models leads to a lack of transparency about exactly how they work. To close this gap, the sector-coupled energy model (UCB-SEnMod) was developed. Its unique features are the modular structure, high flexibility, and applicability, enabling it to model any system constellation and can be easily extended with new functions due to its software design. Due to the software architecture, it is possible to map individual buildings or companies and regions, or even countries. In addition, we plan to make the energy model UCB-SEnMod available as an open-source framework to enable users to understand the functionality and configuration options more easily. This paper presents the methodology of the UCB-SEnMod model. The main components of the model are described in detail, i.e., the energy generation systems, the consumption components in the electricity, heat, and transport sectors, and the possibilities of load balancing.
In this paper two simple synthetic aperture radar (SAR) methods are applied on data from a 24 GHz FMCW radar implemented on a linear drive for educational purposes. The data of near and far range measurements are evaluated using two different SAR signal processing algorithms featuring 2D-FFT and frequency back projection (FBP) method (Moreira et al., 2013). A comparison of these two algorithms is performed concerning runtime, image pixel size, azimuth and range resolution. The far range measurements are executed in a range of 60 to 135 m by monitoring cars in a parking lot. The near range measurement from 0 to 5 m are realised in a measuring chamber equipped with absorber foam and nearly ideal targets like corner reflectors. The comparison of 2D-FFT and FBP algorithm shows that both deliver good and similar results for the far range measurements but the runtime of the FBP algorithm is up to 150 times longer as the 2D-FFT runtime. In the near range measurements the FBP algorithm displays a very good azimuth resolution and targets which are very close to each other can be separated easily. In contrast to that the 2D-FFT algorithm has a lower azimuth resolution in the near range, thus targets which are very close to each other, merge together and cannot be separated.
In the single-processor scheduling problem with time restrictions there is one main processor and B resources that are used to execute the jobs. A perfect schedule has no idle times or gaps on the main processor and the makespan is therefore equal to the sum of the processing times. In general, more resources result in smaller makespans, and as it is in practical applications often more economic not to mobilize resources that will be unnecessary and expensive, we investigate in this paper the problem to find the smallest number B of resources that make a perfect schedule possible. We show that the decision version of this problem is NP-complete, derive new structural properties of perfect schedules, and we describe a Mixed Integer Linear Programming (MIP) formulation to solve the problem. A large number of computational tests show that (for our randomly chosen problem instances) only B=3 or B=4 resources are sufficient for a perfect schedule.
Numerous research methods have been developed to detect anomalies in the areas of security and risk analysis. In healthcare, there are numerous use cases where anomaly detection is relevant. For example, early detection of sepsis is one such use case. Early treatment of sepsis is cost effective and reduces the number of hospital days of patients in the ICU. There is no single procedure that is sufficient for sepsis diagnosis, and combinations of approaches are needed. Detecting anomalies in patient time series data could help speed the development of some decisions. However, our algorithm must be viewed as complementary to other approaches based on laboratory values and physician judgments. The focus of this work is to develop a hybrid method for detecting anomalies that occur, for example, in multidimensional medical signals, sensor signals, or other time series in business and nature. The novelty of our approach lies in the extension and combination of existing approaches: Statistics, Self Organizing Maps and Linear Discriminant Analysis in a unique and unprecedented way with the goal of identifying different types of anomalies in real-time measurement data and defining the point where the anomaly occurs. The proposed algorithm not only has the full potential to detect anomalies, but also to find real points where an anomaly starts.
In 2019 at IBM, it was found that there is a strong dependence on a few large banks in bank sales, and the growth targets of the sales division cannot be achieved due to the existing business with these same customers. To counteract this dependency, an NCA-specific sales team for the banking industry was established to support small and medium-sized banks with personal commitment and expertise and to develop them into long-term business partners of IBM. This research focuses on the development of a performance measurement system for NCA-Sales teams. It postulates the hypothesis that more effective and better-suited performance measurement systems can be developed for NCA-Sales of information technology towards financial institutions. Authors use the methodology of expert interviews and Mayrings qualitative content analysis to gain insights into the relevant factors that need to be considered when evaluating the performance of such sales teams. The paper identifies stakeholders, challenges, and goals that should be integrated into a performance measurement system as well as KPIs to measure them. The results are being consolidated into a conceptual sketch for an NCA-sales optimized PMS. The paper distinguishes itself from other research through an approach that gives detailed guidance for the practical implementation of its findings. The research was conducted with professionals in the IT sector; however, all of them were working for the same company, and the data was collected in the short span of one week as it was part of a research. The outcome can be used for further studies on how to effectively measure performance in NCA-Sales teams.
Geometrieerzeugung von Evolventenzahntrieben: Profilverschobene schrägverzahnte Stirnzahnräder
(2022)
In dieser Arbeit wird die Zahnradgeometrie von Stirnrädern berechnet und formatiert, um sie in ein CAD-Programm zu übertragen. Dabei werden die Konturen der Evolvente und der Trochoide nach den gleichen Regel wie bei der Herstellung durch Wälzfräsen erzeugt. Der Anwender hat die Möglichkeit die Haupteigenschaften wie Modul, Zahnkopfspiel und Eckenverrundung einzugeben. Zusätzlich können auch schrägverzahnte, profilverschobene Stirnräder mit Hochverzahnung und Kopfkürzung erzeugt werden.
Per Datenausgabe werden die Koordinaten gespeichert und durch ein Makro in das CAD-Programm übertragen. Aus den beiden Konturzügen wird der 3D-Körper durch Austragen entlang der Helix erzeugt.
Zur Weiterverarbeitung wird die Zahnradgeometrie nach manueller Tesselierung in ein universales Dateiformat exportiert.
In this paper, the mechanical damage behavior is investigated based on the characteristic roughness on the surface and the orientation of superficial structures. The main goal is to explore the surface roughness on mechanically loaded copper conductors as a lifetime indicator. For this purpose, copper conductors are mechanically stressed in accordance with EN 50,396 and then examined metallographically and microscopically. The microstructure examination shows that the roughness is caused by material extrusion and cracks due to work hardening in the surface area. Using confocal microscopy, it is shown for the first time that significant formation of surface roughness takes place over the service life of copper conductors. The roughness increases monotonically, but not linearly with number of cycles, due to internal microstructural processes and can be divided into three sections. First inspections of the conductor surface over lifetime show a correlation between the intensity of structures orientated 45° to the loading direction and the roughness. This phenomenon, already known from microscopic slip lines, is thus also evident in macroscopic roughness formation and is well founded by the research theory on material extrusion along dislocation lines. In summary, a lifetime determination is possible based on its developing roughness which enables the utilization as a sensor element.
Background: Recent shoulder injury prevention programs have utilized resistance exercises combined with different forms of instability, with the goal of eliciting functional adaptations and thereby reducing the risk of injury. However, it is still unknown how an unstable weight mass (UWM) affects the muscular activity of the shoulder stabilizers. Aim of the study was to assess neuromuscular activity of dynamic shoulder stabilizers under four conditions of stable and UWM during three shoulder exercises. It was hypothesized that a combined condition of weight with UWM would elicit greater activation due to the increased stabilization demand.
Methods: Sixteen participants (7 m/9 f) were included in this cross-sectional study and prepared with an EMG-setup for the: Mm. upper/lower trapezius (U.TA/L.TA), lateral deltoid (DE), latissimus dorsi (LD), serratus anterior (SA) and pectoralis major (PE). A maximal voluntary isometric contraction test (MVIC; 5 s.) was performed on an isokinetic dynamometer. Next, internal/external rotation (In/Ex), abduction/adduction (Ab/Ad) and diagonal flexion/extension (F/E) exercises (5 reps.) were performed with four custom-made-pipes representing different exercise conditions. First, the empty-pipe (P; 0.5 kg) and then, randomly ordered, water-filled-pipe (PW; 1 kg), weight-pipe (PG; 4.5 kg) and weight + water-filled-pipe (PWG; 4.5 kg), while EMG was recorded. Raw root-mean-square values (RMS) were normalized to MVIC (%MVIC). Differences between conditions for RMS%MVIC, scapular stabilizer (SR: U.TA/L.TA; U.TA/SA) and contraction (CR: concentric/eccentric) ratios were analyzed (paired t-test; p ≤ 0.05; Bonferroni adjusted α = 0.008).
Results: PWG showed significantly greater muscle activity for all exercises and all muscles except for PE compared to P and PW. Condition PG elicited muscular activity comparable to PWG (p > 0.008) with significantly lower activation of L.TA and SA in the In/Ex rotation. The SR ratio was significantly higher in PWG compared to P and PW. No significant differences were found for the CR ratio in all exercises and for all muscles.
Conclusion: Higher weight generated greater muscle activation whereas an UWM raised the neuromuscular activity, increasing the stabilization demands. Especially in the In/Ex rotation, an UWM increased the RMS%MVIC and SR ratio. This might improve training effects in shoulder prevention and rehabilitation programs.
Introduction: The use of social marketing strategies to induce the promotion of cognitive health has received little attention in research. The objective of this scoping review is twofold: (i) to identify the social marketing strategies that have been used in recent years to initiate and maintain health-promoting behaviour; (ii) to advance research in this area to inform policy and practice on how to best make use of these strategies to promote cognitive health.
Methods and analysis: We will use the five-stage methodological framework of Arksey and O'Malley. Articles in English published since 2010 will be searched in electronic databases (the Cochrane Library, DoPHER, the International Bibliography of the Social Sciences, PsycInfo, PubMed, ScienceDirect, Scopus). Quantitative and qualitative study designs as well as reviews will be considered. We will include those articles that report the design, implementation, outcomes and evaluation of programmes and interventions concerning social marketing and/or health promotion and/or promotion of cognitive health. Grey literature will not be searched. Two independent reviewers will assess in detail the abstracts and full text of selected citations against the inclusion criteria. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart for Scoping Reviews will be used to illustrate the process of article selection. We will use a data extraction form, present the results through narrative synthesis and discuss them in relation to the scoping review research questions.
Ethics and dissemination: Ethics approval is not required for conducting this scoping review. The results of the review will be the first step to advance a conceptual framework, which contributes to the development of interventions targeting the promotion of cognitive health. The results will be published in a peer-reviewed scientific journal. They will also be disseminated to key stakeholders in the field of the promotion of cognitive health.
Im Oktober 2019 veröffentlichte die Amerikanische Psychologische Gesellschaft APA die siebte, überarbeitete Auflage ihres Publikationshandbuchs "Publication Manual of the American Psychological Association". In diesem Ratgeber werden Ihnen die Grundregeln des enthaltenen Zitierregelwerks vorgestellt, ergänzt um eine Einführung in das Zitieren. Einige wenige Regeln wurden der deutschen Grammatik angepasst (z. B. hinsichtlich Kommasetzung vor "&").
Inhalt:
1. Zitieren: Einleitung
2. Zitieren: Definitionen, Grundregeln und Plagiate
3. Zitiersysteme: Klassifikation
4. Zitiersysteme: APA – ein erster Eindruck
5. Text: Kurzbelege gestalten und platzieren
6. Text: sinngemäße Zitate
7. Text: direkte Zitate
8. Literaturverzeichnis: Inhalt und Sortierung (allgemein)
9. Literaturverzeichnis: Autor-Element (allgemein)
10. Literaturverzeichnis: Datum-Element (allgemein)
11. Literaturverzeichnis: Titel-Element (allgemein)
12. Literaturverzeichnis: Quellen-Informations-Element (allgemein)
13. Literaturverzeichnis: Quellen-DOI/URL-Element (allgemein)
14. Literaturverzeichnis: Schriftwerke
14.1 Periodika (Beiträge in Zeitschriften, Zeitungen etc.)
14.2 Bücher (Fach-, Lehrbücher, Sammel-, Nachschlagewerke u. Ä.)
14.3 Beiträge in Sammel- und Nachschlagewerken
14.4 Berichte und graue Literatur
14.5 Tagungs- und Konferenzbeiträge
14.6 Dissertationen und Abschlussarbeiten
14.7 Rezensionen und Besprechungen (in Periodika oder Blogs)
14.8 Unveröffentlichte und informell veröffentlichte Werke
14.9 Normblätter
14.10 Patentschriften
14.11 Spezial: Juristische Texte
15. Datensätze, Software und Tests
15.1 Datensätze
15.2 Software, mobile Apps, Apparaturen und Ausrüstung
16. Tests, Skalen und Messinstrumente
17. Audiovisuelle Medien
17.1 Audiovisuelle Werke (allgemein)
17.2 Ton-Bild-Werke (Filme etc.)
17.3 Tonwerke (Musikalben etc.)
17.4 Bildwerke (Karten etc.)
18. Online-Medien
18.1 Soziale Medien
18.2 Webseiten und Websites
19. Abbildungszitate gemäß APA
20. Zitiersysteme: APA-Handbuch und -Zitierhilfen
21. Zitiersysteme: Alternativen
22. Extra: Tipps für das Zusammenstellen einer Literaturgrundlage
Background: In recent years, the volume of medical knowledge and health data has increased rapidly. For example, the increased availability of electronic health records (EHRs) provides accurate, up-to-date, and complete information about patients at the point of care and enables medical staff to have quick access to patient records for more coordinated and efficient care. With this increase in knowledge, the complexity of accurate, evidence-based medicine tends to grow all the time. Health care workers must deal with an increasing amount of data and documentation. Meanwhile, relevant patient data are frequently overshadowed by a layer of less relevant data, causing medical staff to often miss important values or abnormal trends and their importance to the progression of the patient’s case.
Objective: The goal of this work is to analyze the current laboratory results for patients in the intensive care unit (ICU) and classify which of these lab values could be abnormal the next time the test is done. Detecting near-future abnormalities can be useful to support clinicians in their decision-making process in the ICU by drawing their attention to the important values and focus on future lab testing, saving them both time and money. Additionally, it will give doctors more time to spend with patients, rather than skimming through a long list of lab values.
Methods: We used Structured Query Language to extract 25 lab values for mechanically ventilated patients in the ICU from the MIMIC-III and eICU data sets. Additionally, we applied time-windowed sampling and holding, and a support vector machine to fill in the missing values in the sparse time series, as well as the Tukey range to detect and delete anomalies. Then, we used the data to train 4 deep learning models for time series classification, as well as a gradient boosting–based algorithm and compared their performance on both data sets.
Results: The models tested in this work (deep neural networks and gradient boosting), combined with the preprocessing pipeline, achieved an accuracy of at least 80% on the multilabel classification task. Moreover, the model based on the multiple convolutional neural network outperformed the other algorithms on both data sets, with the accuracy exceeding 89%.
Conclusions: In this work, we show that using machine learning and deep neural networks to predict near-future abnormalities in lab values can achieve satisfactory results. Our system was trained, validated, and tested on 2 well-known data sets to ensure that our system bridged the reality gap as much as possible. Finally, the model can be used in combination with our preprocessing pipeline on real-life EHRs to improve patients’ diagnosis and treatment.
Static (one-legged stance) and dynamic (star excursion balance) postural control tests were performed by 14 adolescent athletes with and 17 without back pain to determine reproducibility. The total displacement, mediolateral and anterior-posterior displacements of the centre of pressure in mm for the static, and the normalized and composite reach distances for the dynamic tests were analysed. Intraclass correlation coefficients, 95% confidence intervals, and a Bland-Altman analysis were calculated for reproducibility. Intraclass correlation coefficients for subjects with (0.54 to 0.65), (0.61 to 0.69) and without (0.45 to 0.49), (0.52 to 0.60) back pain were obtained on the static test for right and left legs, respectively. Likewise, (0.79 to 0.88), (0.75 to 0.93) for subjects with and (0.61 to 0.82), (0.60 to 0.85) for those without back pain were obtained on the dynamic test for the right and left legs, respectively. Systematic bias was not observed between test and retest of subjects on both static and dynamic tests. The one-legged stance and star excursion balance tests have fair to excellent reliabilities on measures of postural control in adolescent athletes with and without back pain. They can be used as measures of postural control in adolescent athletes with and without back pain.
Ahmad et al. in their paper for the first time proposed to apply sharp function for classification of images. In continuation of their work, in this paper we investigate the use of sharp function as an edge detector through well known diffusion models. Further, we discuss the formulation of weak solution of nonlinear diffusion equation and prove uniqueness of weak solution of nonlinear problem. The anisotropic generalization of sharp operator based diffusion has also been implemented and tested on various types of images.
Background: Stratified care has the potential to be efficient in addressing the physical and psychosocial components of low back pain (LBP) and optimise treatment outcomes essential in low-income countries. This study aimed to investigate the perceptions of physiotherapists and patients in Nigeria towards stratified care for the treatment of LBP, exploring barriers and enablers to implementation.
Methods: A qualitative design with semistructured individual telephone interviews for physiotherapists and patients with LBP comprising research evidence and information on stratified care was adopted. Preceding the interviews, patients completed the Subgroups for Targeted Treatment tool. The interviews were recorded, transcribed and analysed following grounded theory methodology.
Results: Twelve physiotherapists and 13 patients with LBP participated in the study (11 female, mean age 42.8 (SD 11.47) years). Seven key categories emerged: recognising the need for change, acceptance of innovation, resistance to change, adapting practice, patient’s learning journey, trusting the therapist and needing conviction. Physiotherapists perceived stratified care to be a familiar approach based on their background training. The prevalent treatment tradition and the patient expectations were seen as major barriers to implementation of stratified care by the physiotherapists. Patients see themselves as more informed than therapists realise, yet they need conviction through communication and education to cooperate with their therapist using this approach. Viable facilitators were also identified as patients’ trust in the physiotherapist and adaptations in terms of training and modification of the approach to enhance its use.
Conclusion: Key barriers identified are the patients’ treatment expectations and physiotherapists’ adherence to the tradition of practice. Physiotherapists might facilitate implementation of the stratified care by communication, hierarchical implementation and utilisation of patients’ trust. Possibilities to develop a consensus on key strategies to overcome barriers and on utilisation of facilitators should be tested in future research.
Background: Stratified care approach involving use of the STarT-Back tool to optimise care for patients with low back pain is gaining widespread attention in western countries. However, adoption and implementation of this approach in low-and-middle-income countries will be restricted by context-specific factors that need to be addressed. This study aimed to develop with physiotherapists, tailored intervention strategies for the implementation of stratified care for patients with low back pain.
Methods: A two-round web-based Delphi survey was conducted among purposively sampled physiotherapists with a minimum of three years of clinical experience, with post-graduation certification or specialists. Thirty statements on barriers and enablers for implementation were extracted from the qualitative phase. Statements were rated by a Delphi panel with additional open-ended feedback. After each Delphi round, participants received feedback which informed their subsequent responses. Additional qualitative feedback were analysed using qualitative content analysis. The criteria for consensus and stability were pre-determined using percentage agreement (≥ 75%), median value (≥ 4), Inter-quartile range (≤ 1), and Wilcoxon matched-pairs test respectively.
Results: Participants in the first round were 139 and 125 of them completed the study, yielding a response rate of 90%. Participants were aged 35.2 (SD6.6) years, and 55 (39.6%) were female. Consensus was achieved in 25/30 statements. Wilcoxon’s test showed stability in responses after the 5 statements failed to reach consensus: ‘translate the STarT-Back Tool to pidgin language’ 71% (p = 0.76), ‘begin implementation with government hospitals’ 63% (p = 0.11), ‘share knowledge with traditional bone setters’ 35% (p = 0.67), ‘get second opinion on clinician’s advice’ 63% (p = 0.24) and ‘carry out online consultations’ 65% (p = 0.41). Four statements strengthened by additional qualitative data achieved the highest consensus: ‘patient education’ (96%), ‘quality improvement appraisals’ (96%), ‘undergraduate training on psychosocial care’ (96%) and ‘patient-clinician communication’ (95%).
Conclusion: There was concordance of opinion that patients should be educated to correct misplaced expectations and proper time for communication is vital to implementation. This communication should be learned at undergraduate level, and for already qualified clinicians, quality improvement appraisals are key to sustained and effective care. These recommendations provide a framework for future research on monitored implementation of stratified care in middle-income countries.
Concerning human and environmental health, safe alternatives to synthetic pesticides are urgently needed. Many of the currently used synthetic pesticides are not authorized for application in organic agriculture. In addition, the developed resistances of various pests against classical pesticides necessitate the urgent demand for efficient and safe products with novel modes of action. Botanical pesticides are assumed to be effective against various crop pests, and they are easily biodegradable and available in high quantities and at a reasonable cost. Many of them may act by diverse yet unexplored mechanisms of action. It is therefore surprising that only few plant species have been developed for commercial usage as biopesticides. This article reviews the status of botanical pesticides, especially in Europe and Mediterranean countries, deepening their active principles and mechanisms of action. Moreover, some constraints and challenges in the development of novel biopesticides are highlighted.
Resource prospects of municipal solid wastes generated in the Ga East Municipal Assembly of Ghana
(2017)
Background: Municipal solid wastes management has recently become an important public health concern. Municipal solid wastes are a major source of raw materials that could be used for resource recovery for diverse applications.
Objectives: The present study aimed to determine the composition of municipal solid waste and recoverable resources from the waste of the Ga East Municipal Assembly (GEMA) in the Greater Accra region of Ghana.
Methods: An exploratory approach was used to collect pertinent data from the Abloradgei dumpsite in GEMA using semi-structured interviews and focus group discussion. A field characterization study was undertaken to segregate and estimate the value of various components of collected waste. Dumpsite workers were asked about current general composition of MSW, mode of collection and disposal, record of sanitation-related diseases, use of modern treatment plant, waste management legislation and enforcement challenges, number of trucks received by the dumpsite per day, record on pretreatment of MSW before disposal, and use of personnel protective equipment.
Results: The results showed that significant proportions (48.8%) of the municipal solid wastes were organic materials, while the remaining (51.2%) were inorganic materials. The results also showed that 63% of the municipal solid waste is collected with no sorting from the source and no modern treatment applied before dumping. It was estimated that the value of the recyclable materials in GEMA municipal solid waste amounts to Ghana Cedis (GH¢) 9,381,960 (plastic); 985,111 (mixed glass); 5,160,078 (paper) and 11,586,770 (metal) with a total of GH¢ 27,113,919 ($10,845,568) equivalent to 2,106,339.2 m3 (74,384,667.5 ft3) per annum of biogas from these components with a market value of GH¢ 1,997,972.17 ($768, 393.62); 11,579 Mwh (1.32 Mw) of electricity and 9,535 Mwh (1.09 Mw) of heat. This is estimated to be lost with the current waste management practices.
Conclusions: We recommend that GEMA institute sustainable recycling practices and utilization of biogas production technologies and prioritize sanitation and waste management education for the public, obligate home segregation of waste materials, involve workers by providing them with protective clothing, incorporate informal waste collectors and scavengers into the new system and collaborate with research institutions in waste-to-resource projects to ensure a more sustainable waste management system in the municipality.