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Background: The STarT-MSK-Tool is an adaptation of the well established STarT-Back-Tool, used to risk-stratify patients with a wider range of musculoskeletal presentations.
Objective: To formally translate and cross-culturally adapt the Keele STarT-MSK risk stratification tool into German (STarT-MSKG) and to establish its reliability and validity.
Methods: A formal, multi-step, forward and backward translation approach was used. To assess validity patients aged ≥18 years, with acute, subacute or chronic musculoskeletal presentations in the lumbar spine, hip, knee, shoulder, or neck were included. The prospective cohort was used with initial data collected electronically at the point-of-consultation. Retest and 6-month follow-up questionnaires were sent by email. Test-retest reliability, construct validity, discriminative ability, predictive ability and floor or ceiling effects were analysed using intraclass correlation coefficient, and comparisons with a reference standard (Orebro-Musculoskeletal-Pain-Questionnaire: OMPQ) using correlations, ROC-curves and regression models.
Results: The participants’ (n = 287) mean age was 47 (SD = 15.8) years, 51% were female, with 48.8% at low, 43.6% at medium, and 7.7% at high risk. With ICC = 0.75 (95% CI 0.69; 0.81) test-retest-reliability was good. Construct validity was good with correlations for the STarT-MSKG-Tool against the OMPQ-Tool of rs = 0.74 (95% CI 0.68, 0.79). The ability of the tool [comparison OMPQ] to predict 6-month pain and disability was acceptable with AUC = 0.77 (95% CI 0.71, 0.83) [OMPQ = 0.74] and 0.76 (95% CI 0.69, 0.82) [OMPQ = 0.72] respectively. However, the explained variance (linear/logistic regression) for predicting 6-month pain (21% [OMPQ = 17%]/logistic = 29%) and disability (linear = 20%:[OMPQ = 19%]/logistic = 26%), whilst being comparable to the existing OMPQ reference standard, fell short of the a priori target of ≥30%.
Conclusions: The German version of the STarT-MSK-Tool is a valid instrument for use across multiple musculoskeletal conditions and is availabe for use in clinical practice. Comparison with the OMPQ suggests it is a good alternative.
Value-based controlling & international accounting
of Economic Value Added (EVA) – An overview
(2022)
This paper will discuss an important target variable in value-based management: the Economic Value Added (or EVA). EVA is a measure of a company's financial performance based on the residual wealth calculated by deducting its cost of capital from its operting profit, adjusted for taxes on a cash basis. EVA can also be referred to as economic profit, as it attempts to capture the true economic profit of a company. This measure was devised by management consulting firm Stern Value Management, originally incorporated as Stern Stewart & Co. This research will also discuss adjustments and different types of assumptions that are necessary for the calculation as well as how to use them properly to obtain an interpretable result. Paper will explain the formula and which conversions should be considered. It remains to be noted that the EVA concept only leads to small progress from a scientific point of view, but that the clever marketing by Stern & Stewart has initiated a renaissance of the underlying residual profit concept. The paper provides practitioners and academics with a good overview of the demonstrable added value of EVA controlling and, in contrast, also illustrates the weaknesses of the calculation model or the inaccuracy due to interpretation variables, which overall limit the value of EVA as a management key performance indicator. The research includes comprehensive and substantial discussion in the scientific literature on EVA and its interpretation.
This scientific paper aimed to examine workplace stressors and factors influencing the Work-Life-Balance of nursing staff to understand potential factors and challenges. The Covid-19-pandemic has only again demonstrated the importance of sufficient and well-educated nursing staff. To ensure this, it is also important to consider the well-being of the nurses, because this influences their job performance, the turnover rate and the number of sick employees. To examine the workplace stressors and the Work-Life-Balance of nursing staff, different theoretical approaches and study findings are taken under consideration to determine their influence on the perceived stress of employees in general and nurses in particular and also the importance of a healthy Work-Life-Balance. The study was conducted by the Declaration of Helsinki and Tokyo. Many different factors make the job as a nurse potentially more stressful than for example administrative occupations. Moreover, there are plenty of difficulties for a healthy Work-Life-Balance for nursing staff and also potential negative effects resulting from a poor Work-Life-Balance or a high amount of workplace stressors. It can be concluded that a solution approach for the workplace stressors and a better Work-Life-Balance can only be reached if the employer and the employees work together to decrease the amount of stress, to offer and learn better mechanisms to cope with stress and to incorporate ways to ensure a better Work-Life-Balance.
Der Erbbauzins ist bei kommunalen Erbbaurechten sowohl eine zentrale Stellgröße für die Wirtschaftlichkeit als auch von kommunalwirtschafts- und beihilferechtlicher Relevanz. Er wird zumeist ermittelt, indem ein geeigneter Erbbauzinssatz auf den Bodenwert angelegt wird. Der Erbbauzinssatz sollte dabei marktgerecht sein. Sowohl die Ableitung des Erbbauzinssatzes aus dem Primärmarkt (erstmalige Ausgabe von Erbbaurechten) wie aus dem Sekundärmarkt (Weiterverkäufe) ist aber zumindest bei Erbbaurechten für Mehrfamilienhäuser derzeit kaum sinnvoll zu diesem Zwecke durchzuführen. Auch der Liegenschaftszinssatz ist ungeeignet, da er aus einem Modell für Volleigentum mit einer vollkommen anderen Risiko-/Rendite-Konstellation abgeleitet wird. Daher wird für eine stärkere Anwendung ökonomisch basierter Verfahren plädiert und hierbei ein kapitalmarktorientiertes Mark-to-Model-Verfahren dargestellt. Erste überschlägige Ermittlungen legen zudem die Orientierung an langfristigen Baufinanzierungssätzen als Daumenregel nahe. Regelmäßig dürften von Kommunen für die Ermittlung von marktgerechten Erbbauzinssätzen öffentlich bestellte und vereidigte oder zertifizierte Grundstückssachverständige betraut werden, denen die betreffenden Verfahren jedoch oftmals fremd sind. Auch stellt sich die Frage nach der Zulässigkeit, da sie sich als Best Practice-Verfahren bislang nicht etabliert haben. Daher wäre dem Gesetz- bzw. Verordnungsgeber anzuraten, die Ermittlung marktgerechter Erbbauzinssätze ausdrücklich zu regeln und dabei jenseits von Mark-to-Market-Verfahren weitere geeignete ökonomisch gestützte Methoden wie auch empirisch abgesicherte „Daumenregeln“ zuzulassen.