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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.
Aim: The aim of this scientific paper was to examine important trends and developments influencing the nursing care in order to forecast future opportunities and challenges and how to deal with them in the best possible way.
Background: The Corona-pandemic demonstrated the importance of nursing care in the entire world and had drawn attention to the issue of a well-educated and enough nursing staff. The nursing care will face opportunities and challenges due to current trends and developments, which are important to examine in order to provide the best possible nursing care.
Methods: To reach the above-mentioned aim, intensive research was done by using secondary sources and surveys.
Results/Findings: After a detailed analysis of the research it can be summarized that there are three important topics influencing the nursing care: The demographical development with an increasing life expectancy leading to an increasing amount of old people with a demand for care and decreasing birth rates leading to less working people. Cultural transformation and diversity imply many opportunities because the employment market can fill gaps with foreign workers and the immigrating people can compensate the decreasing birth rates. Nevertheless, it can imply many challenges and potential problems which need to be solved by the society and the immigrating people. Furthermore, the changing gender roles can lead to more men becoming a nurse, which might have a significant impact on the shortage of nursing staff. The third important topic influencing the nursing care is technological trends which can help to decrease physiological stress, by facilitating the nurses’ work and by taking over some work from them.
Conclusion: It can be concluded that the trends and developments influencing the nursing care are very diverse and imply many different opportunities as well as challenges.
Background: The extramuscular connective tissue (ECT) has been shown to play a significant role in mechanical force transmission between musculoskeletal structures. Due to this and owing to its tight connection with the underlying muscle, the ECT may be vulnerable to excessive loading. The present study aimed to investigate the effect of eccentric elbow flexor exercise on the morphology of the biceps brachii ECT. In view of the high nociceptive capacity of the ECT, an additional objective was to elucidate the potential relationship between ECT damage and the occurrence of delayed onset muscle soreness (DOMS).
Methods: Eleven healthy participants (♂ = 7; 24 ± 2 years) performed fatiguing dumbbell elbow flexor eccentric exercise (EE) for one arm and concentric exercise (CE) for the other arm in random order and with random arm allocation. Before, immediately after and 24–96 h post-exercise, maximal voluntary isometric contraction torque of the elbow flexors (dynamometer), pressure pain (algometer), palpation pain (100 mm visual analog scale), biceps brachii ECT thickness and ECT/muscle mobility during passive movement (both high-resolution ultrasound) were examined.
Results: Palpation pain, suggestive of DOMS, was greater after EE than CE, and maximal voluntary isometric contraction torque decreased greater after EE than CE (p < .05). Relative to CE, EE increased ECT thickness at 48 (+ 17%), 72 (+ 14%) and 96 (+ 15%) hours post-exercise (p < .05). At 96 h post-EE, the increase in ECT thickness correlated with palpation pain (r = .68; p < .05). ECT mobility was not different between conditions, but compared to CE, muscle displacement increased at 24 (+ 31%), 72 (+ 31%) and 96 (+ 41%) hours post-EE (p < .05).
Conclusion: Collectively, these results suggest an involvement of the ECT changes in delayed onset muscle soreness.
Vibroarthrography measures joint sounds caused by sliding of the joint surfaces over each other. and can be affected by joint health, load and type of movement. Since both warm-up and muscle fatigue lead to local changes in the knee joint (e.g., temperature increase, lubrication of the joint, muscle activation), these may impact knee joint sounds. Therefore, this study investigates the effects of warm-up and muscle fatiguing exercise on knee joint sounds during an activity of daily living. Seventeen healthy, physically active volunteers (25.7 ± 2 years, 7 males) performed a control and an intervention session with a wash-out phase of one week. The control session consisted of sitting on a chair, while the intervention session contained a warm-up (walking on a treadmill) followed by a fatiguing exercise (modified sit-to-stand) protocol. Knee sounds were recorded by vibroarthrography (at the medial tibia plateau and at the patella) at three time points in each session during a sit-to-stand movement. The primary outcome was the mean signal amplitude (MSA, dB). Differences between sessions were determined by repeated measures ANOVA with intra-individual pre-post differences for the warm-up and for the muscle fatigue effect. We found a significant difference for MSA at the medial tibia plateau (intervention: mean 1.51 dB, standard deviation 2.51 dB; control: mean -1.28 dB, SD 2.61 dB; F = 9.5; p = .007; η2 = .37) during extension (from sit to stand) after the warm-up. There was no significant difference for any parameter after the muscle fatiguing exercise (p > .05). The increase in MSA may mostly be explained by an increase in internal knee load and joint friction. However, neuromuscular changes may also have played a role. It appears that the muscle fatiguing exercise has no impact on knee joint sounds in young, active, symptom-free participants during sit to stand.
Organic semiconductor distributed feedback laser fabricated by direct laser interference ablation
(2007)
We use a pulsed, frequency tripled picosecond Nd:YAG laser for holographic ablation to pattern a surface relief grating into an organic semiconductor guest-host system. The resulting second order distributed feedback lasers exhibit laser action with laser thresholds being comparable to those obtained with resonators structured by standard lithographic techniques. The details of the interference ablation of tris-(8-hydroxyquinoline) aluminum (Alq(3)) doped with the laser dye 4- dicyanomethylene-2-methyl-6-(p-dimethylaminostyryl)-4H-pyran (DCM) are presented and discussed. Lasing action is demonstrated at a wavelength of 646.6 nm, exploiting second order Bragg reflection in a relief grating with a period of 399 nm.
The aim of the study is to find out how SMEs used Social Media during Corona and how customers received it, to determine what should be continued or avoided by SMEs in the future. In this study, an interpretivist approach was adopted through problem-centred interviews with three SMEs. The second part of the study used an objectivist approach, where an online-based survey with a purpose sampling was conducted. The results were evaluated by means of thematic analysis.The SMEs interviewed considered Social Media essential during Corona. This was due to limited resources and the feeling of being overwhelmed by the situation. For customers a Social Media presence is also considered indispensable, and that the followership is based on the desire for the latest information. However, it also became clear that the survey participants do not believe the information on Social Media and prefer information on the website or at the location itself. No answers could be found about how the experts would answer sans or post Corona. Furthermore, due to anonymisation efforts, it was not possible to clarify the attitude of the survey participants specifically to the individual SMEs.
The implementation of single-use technologies offers several major advantages, e.g. prevention of cross-contamination, especially when spore-forming microorganisms are present. This study investigated the application of a single-use bioreactor in batch fermentation of filamentous fungus Penicillium sp. (IBWF 040-09) from the Institute of Biotechnology and Drug Research (IBWF), which is capable of intracellular production of a protease inhibitor against parasitic proteases as a secondary metabolite. Several modifications to the SU bioreactor were suggested in this study to allow the fermentation in which the fungus forms pellets. Simultaneously, fermentations in conventional glass bioreactor were also conducted as reference. Although there are significant differences in the construction material and gassing system, the similarity of the two types of bioreactors in terms of fungal metabolic activity and the reproducibility of fermentations could be demonstrated using statistic methods. Under the selected cultivation conditions, growth rate, yield coefficient, substrate uptake rate, and formation of intracellular protease-inhibiting substance in the single-use bioreactor were similar to those in the glass bioreactor.
This study introduced an automated long-term fermentation process for fungals grown in pellet form. The goal was to reduce the overgrowth of bioreactor internals and sensors while better rheological properties in the fermentation broth, such as oxygen transfer and mixing time, can be achieved. Because this could not be accomplished with continuous culture and fed-batch fermentation, repeated-batch fermentation was implemented with the help of additional bioreactor internals (“sporulation supports”). This should capture some biomass during fermentation. After harvesting the suspended biomass, intermediate cleaning was performed using a cleaning device. The biomass retained on the sporulation support went through the sporulation phase. The spores were subsequently used as inocula for the next batch. The reason for this approach was that the retained pellets could otherwise cause problems (e.g., overgrowth on sensors) in subsequent batches because the fungus would then show undesirable hyphal growth. Various sporulation supports were tested for sufficient biomass fixation to start the next batch. A reproducible spore concentration within the range of the requirements could be achieved by adjusting the sporulation support (design and construction material), and an intermediate cleaning adapted to this.
Disconnection in a left-hemispheric temporo-parietal network impairs multiplication fact retrieval
(2023)
Arithmetic fact retrieval has been suggested to recruit a left-lateralized network comprising perisylvian language areas, parietal areas such as the angular gyrus (AG), and non-neocortical structures such as the hippocampus. However, the underlying white matter connectivity of these areas has not been evaluated systematically so far. Using simple multiplication problems, we evaluated how disconnections in parietal brain areas affected arithmetic fact retrieval following stroke. We derived disconnectivity measures by jointly considering data from n = 73 patients with acute unilateral lesions in either hemisphere and a white-matter tractography atlas (HCP-842) using the Lesion Quantification Toolbox (LQT). Whole-brain voxel-based analysis indicated a left-hemispheric cluster of white matter fibers connecting the AG and superior temporal areas to be associated with a fact retrieval deficit. Subsequent analyses of direct gray-to-gray matter disconnections revealed that disconnections of additional left-hemispheric areas (e.g., between the superior temporal gyrus and parietal areas) were significantly associated with the observed fact retrieval deficit. Results imply that disconnections of parietal areas (i.e., the AG) with language-related areas (i.e., superior and middle temporal gyri) seem specifically detrimental to arithmetic fact retrieval. This suggests that arithmetic fact retrieval recruits a widespread left-hemispheric network and emphasizes the relevance of white matter connectivity for number processing.
In relation to the fast development of e-commerce and rapid increasing of parcels, urban logistic sector is facing the challenge of sustainability. Especially, last-mile delivery as the last step of goods transport, it connects to customers’ satisfaction, cost efficiency of logistic companies, and more and more public expectations to sustainability of urban logistics. To handle with the complexity of urban logistics conditions, governments and logistics companies should develop a co-operating strategy for sustainability of urban last-mile delivery. This paper is based on data collection from the long-term empirical research and a survey to the e-commerce users in Germany and China to develop a sustainable concept for the urban last-mile delivery. The key to the development of concept is to create a balance among the requirements of customers, the competition abilities of logistics companies and the public interest.