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Chapter 7: Der Allgäuer Erlebnisbus als Instrument des digitalen Besuchermanagements sowie der Verkehrs- und CO₂-Reduktion
No full textDieser Beitrag untersucht die Rolle innovativer Mobilitätskonzepte bei der Reduktion des motorisierten Individualverkehrs (MIV), der Einsparung von CO₂-Emissionen und des digitalen Besuchsmanagements. Die Analyse basiert auf dem Forschungsprojekt „Flexibler Erlebnisbus für nachhaltigen Freizeitverkehr“ (FEB-NAFV), das mit der Pilotierung des Allgäuer Erlebnisbusses neue Ansätze zur nachhaltigen Mobilität im Tourismus erprobt. Im Fokus stehen die technischen Aspekte des Projekts, insbesondere Sensorik und Prognoseverfahren, sowie die operativen Komponenten des Busbetriebs. Der Beitrag beleuchtet die Effekte einer mehrtägigen Pilotphase auf die Verringerung des MIV und der Treibhausgasemissionen
Factors shaping women’s political participation in Pakistani society: an in-depth exploration
No full textThis comprehensive qualitative study explores the intricate factors which shaped the pathways for women and how the nature of these factors changes depending on the pathway women choose for entering parliamentary roles in Pakistan. These pathways are based on the resources women have at hand. It underscores the profound influence of family lineage, sociocultural dynamics and institutional structures in women’s political engagement. This study highlights the patriarchal nature of Pakistani politics, emphasizing the need for strong social standing and political lineage to navigate entrenched cultural barriers. It reveals the ongoing struggles women face in balancing family responsibilities with professional commitments, exacerbated by societal scrutiny of women in politics. Unique to this research is the documentation of personal narratives from female legislators and a comparative analysis of the obstacles they faced depending on which entryway they opted for. The study also investigates the pivotal role of community and peer support in shaping their political aspirations. Employing a qualitative methodology, the study involves in-depth interviews with 20 female parliamentarians. The findings offer valuable insights into the factors influencing women’s participation in Pakistan’s formal politics, contributing significantly to the discourse on women’s political involvement
Global, regional, and national burden of epilepsy, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
No full textBackground
Epilepsy is one of the most common serious neurological disorders and affects individuals of all ages across the globe. The aim of this study is to provide estimates of the epilepsy burden on the global, regional, and national levels for 1990–2021.
Methods
Using well established Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) methodology, we quantified the prevalence of active idiopathic (epilepsy of genetic or unknown origin) and secondary epilepsy (epilepsy due to an underlying abnormality of the brain structure or chemistry), as well as incidence, death, and disability-adjusted life-years (DALYs) by age, sex, and location (globally, 21 GBD regions and seven super-regions, World Bank country income levels, Socio-demographic Index [SDI], and 204 countries) and their trends from 1990 to 2021. Vital registrations and verbal autopsies provided information about deaths, and data on the prevalence and severity of epilepsy, largely came from population representative surveys. All estimates were calculated with 95% uncertainty intervals (UIs).
Findings
In 2021, there were 51·7 million (95% UI 44·9–58·9) people with epilepsy (idiopathic and secondary combined) globally, with an age-standardised prevalence of 658 per 100 000 (569–748). Idiopathic epilepsy had an age-standardised prevalence of 307 per 100 000 (235–389) globally, with 24·2 million (18·5–30·7) prevalent cases, and secondary epilepsy had a global age-standardised prevalence of 350 per 100 000 (322–380). In 2021, 0·7% of the population had active epilepsy (0·3% attributed to idiopathic epilepsy and 0·4% to secondary epilepsy), and the age-standardised global prevalence of epilepsy from idiopathic and secondary epilepsy combined increased from 1990 to 2021 by 10·8% (1·1–21·3), mainly due to corresponding changes in secondary epilepsy. However, age-standardised death and DALY rates of idiopathic epilepsy reduced from 1990 to 2021 (decline of 15·8% [8·8–22·8] and 14·5% [4·2–24·2], respectively). There were three-fold to four-fold geographical differences in the burden of active idiopathic epilepsy, with the bulk of the burden residing in low-income to middle-income countries: 82·1% (81·1–83·4) of incident, 80·4% prevalent (79·7–82·7), 84·7% (83·7–85·1) fatal epilepsy, and 87·9% (86·2–89·2) epilepsy DALYs.
Interpretation
Although the global trends in idiopathic epilepsy deaths and DALY rates have improved in the preceding decades, in 2021 there were almost 52 million people with active epilepsy (24 million from idiopathic epilepsy and 28 million from secondary epilepsy), with the bulk of the burden (>80%) residing in low-income to middle-income countries. Better treatment and prevention of epilepsy are required, along with further research on risk factors of idiopathic epilepsy, good-quality long-term epilepsy surveillance studies, and exploration of the possible effect of stigma and cultural differences in seeking medical attention for epilepsy
Organisationale Kohärenz kreieren: Warum Purpose für Coherence-Driven Organisations (k)einen Sinn ergibt
No full textBy articulating their purpose, companies seek to give meaning to their existence. This promises more motivated employees, more willing customers and ultimately the 'most important thing': more profit. Organisational Coherence shows why this undermines the potential of purpose and how purpose can be used effectively and sustainably as a management and leadership tool. As a meta-model, Felix Fischer's approach offers interdisciplinary theoretical considerations as well as practical impulses for (normative) management, strategy, personnel and organisational development. An (r)evolutionary idea for new ways of entrepreneurship and business.Durch die Darstellung ihres Purpose versuchen Unternehmen, ihrem Daseinszweck einen Sinn zu verleihen. Das verspricht motiviertere Mitarbeitende, kauffreudigere Kunden und damit letztlich das „Wichtigste“: mehr Gewinn. Organisationale Kohärenz zeigt auf, warum damit das Potenzial von Purpose untergraben wird und wie Sinn als Management- und Führungsinstrument wirksam und nachhaltig eingesetzt werden kann. Felix Fischers Ansatz liefert als Metamodell interdisziplinäre, theoretische Überlegungen sowie anschlussfähige, praxisorientierte Impulse für (normatives) Management, Strategie-, Personal- und Organisationsentwicklung. Eine (r)evolutionäre Idee für neue Wege des Unternehmertums und Wirtschaftens
Contrasting Galvanostatic and Potentiostatic Approaches in PEMFC Durability Testing
No full textDurability of proton exchange membrane fuel cells (PEMFCs) in single-cell setup is often assessed using potentiostatic test protocols under inert cathode atmosphere, such as the US DOE’s accelerated stress tests (ASTs). Although these voltage-controlled protocols impose consistent electrochemical stress, they do not accurately replicate real-world operating conditions, for instance due to the lack of product water formation in the cathode or due to the generation of heat. In contrast, stress testing under hydrogen and air, which is commonly employed for PEMFC durability testing on stack level, reflect the hybrid potential- and current-controlled degradation modes which are typical of mobile applications. This is usually done galvanostatic, but can also be realized in a voltage controlled manner. There are notable differences in the ageing behaviors between those two methods: Potentiostatic testing protocols, in which the voltage remains constant throughout the test duration, induce consistent electrochemical stress regarding potential driven degradation modes such as platinum dissolution, Ostwald ripening, carbon corrosion and chemical membrane degradation due to hydrogen peroxide formation. In contrast, galvanostatic testing protocols result in a gradual decline in potential with time, thereby reducing potentially driven electrochemical stress. However, in galvanostatic mode, water production remains constant (unlike in potentiostatic mode), which is known to contribute equally to fuel cell degradation. This dynamic of varying potential driven and humidity driven stress significantly affects catalyst and membrane durability, underscoring the need to understand the degradation behavior specific to each testing method. The present study compares the impact of load-cycle and voltage-cycle protocols on PEMFC degradation. Electrochemical characterizations, such as cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS), are used to identify the ageing behavior of the individual components. All tests were performed using commercial Gore® PRIMEA® membrane electrode assemblies (MEA) in a Baltic quickConnect high amp test cell with an active area of 12 cm². Our findings highlight the importance of testing under hydrogen and air to better replicate operational conditions and enhance PEMFC durability in practical applications
Erfolgsfaktoren für den Einsatz von künstlicher Intelligenz in Unternehmen - Ergebnisse einer Umfrage
No full textDiese Veröffentlichung stellt die Ergebnisse dar, die im Rahmen einer – vom Verfasser durchgeführten – Umfrage im Zeitraum Januar bis März 2025 entstanden sind
Global, regional, and national burden of chronic kidney disease in adults, 1990–2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023
No full textBackground
Chronic kidney disease (CKD) is common and ranks among the leading causes of mortality and morbidity. This analysis aimed to present global CKD estimates using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 to inform evidence-based policies for CKD identification and treatment.
Methods
This analysis focused on adults aged 20 years and older over the period 1990 to 2023, from 204 countries and territories. Data sources used were published literature, vital registration systems, kidney failure treatment registries, and household surveys. Estimates of CKD burden, including deaths, incidence, prevalence, and disability-adjusted life-years (DALYs), were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool. A comparative risk assessment approach estimated the proportion of cardiovascular deaths attributable to impaired kidney function and estimated risk factors for CKD.
Findings
Globally, in 2023, 788 million (95% uncertainty interval 743–843) people aged 20 years and older were estimated to have CKD, up from 378 million (354–407) in 1990. The global age-standardised prevalence of CKD in adults was 14·2% (13·4–15·2), a relative rise of 3·5% (2·7–4·1) from 1990. The region with the highest age-standardised prevalence was north Africa and the Middle East (18·0%; 16·9–19·4). Most people had stage 1–3 CKD, with a combined prevalence of 13·9% (13·1–15·0). In 2023, CKD was the ninth leading cause of death globally, accounting for 1·48 million (1·30–1·65) deaths, and the 12th leading cause of DALYs, with an age-standardised DALY rate of 769·2 (691·8–857·4) per 100 000. Impaired kidney function as a risk factor accounted for 11·5% (8·4–14·5) of cardiovascular deaths. High fasting plasma glucose, body-mass index, and systolic blood pressure were all leading risk factors for CKD DALYs.
Interpretation
CKD is a major global health issue, with rising prevalence and increasing importance as a cause of death and as a risk factor for cardiovascular death. A better understating of aetiology, appropriate screening, and implementation programmes are needed to translate advances in CKD treatment into improved patient outcomes
Predictors of health-seeking behavior in patients with chronic liver disease and a comparison of health-seeking based on patient-type
No full textBackground
Pakistan has one of the highest rates of chronic liver disease (CLD) burden in the world. Poor and underserved patients of CLD in the country may suffer from limited health-seeking behaviors, but there is not much research in this area. The aim of this study is to better plan support for CLD patients by identifying: (i) Health-seeking behaviors (HSB) according to patient-type; and (ii) the relationship of HSB with patient socio-demographic variables and independent study domains.
Methods
We conducted a cross-sectional study. Data was collected over a four-month period from May 2022 to August 2022. A total of 850 patients visiting the Pakistan Kidney and Liver Institute and Research Centre were part of the study. We used correlation tests and multivariate logistic regression to investigate the relationship between the health-seeking behavior and the independent study domains (economic stability, health literacy, social support, experiencing grief, mental health, healthcare service quality, and coping strategies).
Results
Main results suggest that patients with hepatocellular carcinoma, non-viral liver disease, and cirrhosis have less HSB, compared to patient with chronic viral hepatitis. Multivariate logistic regression results reveal that the following groups have lower odds for health-seeking behavior: (i) illiterate people; (ii) those living in rented homes; (iii) those belonging to nuclear families; and (iv) those with low monthly household income. The following study domains also show lower odds for HSB: (i) health illiteracy; (ii) low health service quality; (iii) low ability to use coping strategies; (iv) grief; (v) lack of social support; (vi) mental health challenges; and (vii) economic instability.
Conclusions
Our study highlights that the majority of CLD patients are poor, illiterate, or semi-literate and in urgent need of holistic care with respect to health literacy, mental health counseling, financial help, and improved support from provider and families. This is only possible through the integration of social policy officers and social workers in the tertiary health sector of the country
Organisationen nachhaltig gesundheitsfördernd gestalten
No full textGesundheitsfördernde und zeitgemäße Arbeitsbedingungen zu gestalten, bedeutet immer auch Organisationen zu verändern. Um organisationale Veränderungsprozesse umzusetzen, müssen (teils) unbewusste organisationale Strukturen und Muster erkannt werden. Die Organisationsdiagnostik ist ein Instrument, das diese Strukturen und Muster aufdeckt und damit als Ressource für den weiteren Veränderungsprozess zugänglich macht. Das Regionale Kompetenzzentrum KompIGA hat die organisationalen Kontexte von vier Einrichtungen des Sozial- und Gesundheitswesens analysiert. So wurde eine Basis geschaffen, um innovative Arbeitswelten in die Versorgungspraxis zu implementieren. Die Ergebnisse der Diagnosen zeigen unter anderem, dass die gelebte Führungskultur eine wichtige Ressource für (geplante) Veränderungsprozesse sein kann
Aging in the Digital Era: Need for Holistic Approaches to Bridging the Digital Divide
No full textIn this chapter, we demonstrate empirical and conceptual insights into the digital divide with a focus on older people. By highlighting the complex dynamics of the digital divide and explaining its drivers and effects, we aim to provide a holistic understanding. Current established strategies aimed at narrowing the digital divide mostly focus on strengthening individual digital skills and promoting digital literacy. However, as individual strategies seem insufficient, we propose a differentiated, comprehensive, holistic approach to bridging this gap. Our argument is based on the belief that information and communication technologies should be harnessed for the benefit of all, with special consideration for the requirements of older people