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Reasons and potential solution approaches for the shortage of nursing staff in German hospitals
(2021)
The aim of this scientific paper was to find out the reasons for the shortage of nursing staff in German hospitals and to provide potential solution approaches for this shortage. Over the last years, the shortage of nursing staff has become a more and more important topic in the news: Not only due to the increasing amount of missing nurses, but also due to the ageing population in Germany, which leads to an increasing amount of patients in German hospitals. To reach this aim two surveys were done, of which one was for nursing staff only and the other one was for people from all occupational groups with the intention of creating comparative values. The surveys were done from March to April 2019 and were analysed afterwards. After a detailed analysis of the survey results, it can be summarized that the reasons for the shortage of nursing staff in German hospitals are very diverse: Starting with a weak salary, improvable working conditions – for example the shift work and the high amount of physical and psychological stress -, a difficult compatibility of family and job as well as the unattractive image of the job as a nurse in the society. It can be concluded that the solution for the shortage of nursing staff is very difficult. The future will show whether the governmental support will help to make the job as a nurse more attractive – not only for the current nurses, but also for potential future nurses.
Bauprojekte sind in der Regel komplexe Vorhaben. Sie werden mit Hilfe des Projektmanagements und dessen Verfahren, Prozessen und Techniken bewältigt. Dennoch sind deutsche Bauprojekte nicht selten von Kosten- und Terminüberschreitungen betroffen. Ziel dieser Arbeit ist es, mögliche Optimierungsfelder im Planungs- und Steuerungsprozess eines Unternehmens für Industriebauprojekte zu identifizieren und darauf aufbauende Verbesserungsansätze zu erarbeiten. Um die Ziele verfolgen zu können, wurde eine qualitative Sozialforschung mittels Experteninterviews durchgeführt. Die Expertenaussagen verdeutlichen weiterhin Optimierungspotenzial, sowohl im Planungs- als auch im Steuerungsprozess. Ausgewählte Techniken (hauptsächlich aus dem klassischen Projektmanagement) dienen indessen dazu, die Effektivität und Effizienz des Planungsprozesses zu erhöhen. Innerhalb des Steuerungsprozesses zeigt sich, dass viele Optimierungsbereiche der Steuerung auf den Defiziten der Planung beruhen.
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
Unintended nuclear war
(2021)
Cryotropic gelation is one of the most common approaches to design novel hydrogels with multifaceted technological and biological functionalities. In the present paper, we studied the ability of highly galactosyl-substituted galactomannans, i.e. fenugreek and alfalfa gum, to form physically crosslinked hydrogels via cryogenic processing. Cycling of the galactomannan solutions (0.25 to 4% wt) from 25 to −20 to 25 °C induced the physical crosslinking of the galactomannan chains leading to the formation of different cryogel structures, i.e. filamentous aggregates (c* < c < 1%), cellular-like gel networks (1 ≤ c < 4%) or a homogeneously swollen gel (c ≥ 4%), depending on the total biopolymer content. Alfalfa gum-based cryogels exhibited higher elasticity and stiffness, better uniformity of the structure and a lower macropore size than their fenugreek counterparts. The physical blending of alfalfa or fenugreek gum with locust bean gum (2% total biopolymer) led to the reinforcement of the mechanical properties of the cryogels without significantly altering their microstructural aspects.
The present work aimed at investigating an extraction protocol based on consecutive steps of isoelectric point (pH ~ 4.25) mediated gum swelling and deproteinisation as an alternative method to produce flaxseed gum extracts of enhanced techno-functional characteristics. The osidic and proximate composition, structure conformation, flow behaviour, dynamic rheological and thermal properties of gums isolated from brown and golden flaxseeds were assessed. Gum extraction under near-to-isoelectric point conditions did not impair the extraction yield, residual protein and ash content, whilst it resulted in minor changes in the sugar composition of the flaxseed gum extracts. The deconvolution of the GPC/SEC chromatographs revealed the presence of four major polysaccharidic populations corresponding to arabinoxylans, rhamnogalacturonan–I and two AX-RG-I composite fractions. The latter appeared to minimise the intra- and interchain polymer non-covalent interactions (hydrogen bonding) leading to a better solvation affinity in water and lyotropic solvents. Golden flaxseed gums exerted higher molecular weight (Mw = 1.34–1.15 × 106 Da) and intrinsic viscosities (6.63–5.13 dL g−1) as well as better thickening and viscoelastic performance than the brown flaxseed gum exemplars. Golden flaxseed gums exhibited a better thermal stability compared to the brown flaxseed counterparts and therefore, they are suitable for product applications involving severe heat treatments.
Optimal mental workload plays a key role in driving performance. Thus, driver-assisting systems that automatically adapt to a drivers current mental workload via brain–computer interfacing might greatly contribute to traffic safety. To design economic brain computer interfaces that do not compromise driver comfort, it is necessary to identify brain areas that are most sensitive to mental workload changes. In this study, we used functional near-infrared spectroscopy and subjective ratings to measure mental workload in two virtual driving environments with distinct demands. We found that demanding city environments induced both higher subjective workload ratings as well as higher bilateral middle frontal gyrus activation than less demanding country environments. A further analysis with higher spatial resolution revealed a center of activation in the right anterior dorsolateral prefrontal cortex. The area is highly involved in spatial working memory processing. Thus, a main component of drivers’ mental workload in complex surroundings might stem from the fact that large amounts of spatial information about the course of the road as well as other road users has to constantly be upheld, processed and updated. We propose that the right middle frontal gyrus might be a suitable region for the application of powerful small-area brain computer interfaces.
Intraspecific diet specialization, usually driven by resource availability, competition and predation, is common in natural populations. However, the role of parasites on diet specialization of their hosts has rarely been studied. Eye flukes can impair vision ability of their hosts and have been associated with alterations of fish feeding behavior. Here it was assessed whether European perch (Perca fluviatilis) alter their diet composition as a consequence of infection with eye flukes. Young-of-the-year (YOY) perch from temperate Lake Müggelsee (Berlin, Germany) were sampled in two years, eye flukes counted and fish diet was evaluated using both stomach content and stable isotope analyses. Perch diet was dominated by zooplankton and benthic macroinvertebrates. Both methods indicated that with increasing eye fluke infection intensity fish had a more selective diet, feeding mainly on the benthic macroinvertebrate Dikerogammarus villosus, while less intensively infected fish appeared to be generalist feeders showing no preference for any particular prey type. Our results show that infection with eye flukes can indirectly affect interaction of the host with lower trophic levels by altering the diet composition and highlight the underestimated role of parasites in food web studies.
The aim of this work was to develop and evaluate the reinforcement learning algorithm VentAI, which is able to suggest a dynamically optimized mechanical ventilation regime for critically-ill patients. We built, validated and tested its performance on 11,943 events of volume-controlled mechanical ventilation derived from 61,532 distinct ICU admissions and tested it on an independent, secondary dataset (200,859 ICU stays; 25,086 mechanical ventilation events). A patient “data fingerprint” of 44 features was extracted as multidimensional time series in 4-hour time steps. We used a Markov decision process, including a reward system and a Q-learning approach, to find the optimized settings for positive end-expiratory pressure (PEEP), fraction of inspired oxygen (FiO2) and ideal body weight-adjusted tidal volume (Vt). The observed outcome was in-hospital or 90-day mortality. VentAI reached a significantly increased estimated performance return of 83.3 (primary dataset) and 84.1 (secondary dataset) compared to physicians’ standard clinical care (51.1). The number of recommended action changes per mechanically ventilated patient constantly exceeded those of the clinicians. VentAI chose 202.9% more frequently ventilation regimes with lower Vt (5–7.5 mL/kg), but 50.8% less for regimes with higher Vt (7.5–10 mL/kg). VentAI recommended 29.3% more frequently PEEP levels of 5–7 cm H2O and 53.6% more frequently PEEP levels of 7–9 cmH2O. VentAI avoided high (>55%) FiO2 values (59.8% decrease), while preferring the range of 50–55% (140.3% increase). In conclusion, VentAI provides reproducible high performance by dynamically choosing an optimized, individualized ventilation strategy and thus might be of benefit for critically ill patients.
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.