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Requirements and possible solutions for practice-relevant nursing research in acute care in Germany : results of a scoping workshop
Get PDFDie akademische Pflegewissenschaft in Deutschland befindet sich noch im Aufbau und ist bislang nicht ausreichend in der stationären Akutversorgung verankert. Ziel dieses Beitrags ist es, die zentralen Herausforderungen der Pflegeforschung in der Akutversorgung zu analysieren und strategische Lösungsansätze zur Stärkung der Disziplin zu entwickeln. Die Ergebnisse eines zweitägigen Scoping-Workshops mit nationalen und internationalen Expert*innen zeigen, dass die mangelnde strukturelle Anbindung der Pflegewissenschaft an die klinische Versorgung, die geringe Anzahl akademisch qualifizierter Pflegefachpersonen sowie unzureichende Forschungsförderung wesentliche Hemmnisse für die Weiterentwicklung darstellen. Basierend auf einer SWOT-Analyse wurden sechs prioritäre Handlungsfelder identifiziert: (1) Entwicklung und Implementierung von Qualifizierungs- und Karriereprogrammen, (2) Förderung von Clinician Scientists, (3) Stärkung der Sichtbarkeit und Kommunikation, (4) effektive politische Mitwirkung, (5) Ausbau der Forschungsförderung sowie (6) Erweiterung von Netzwerken und Kooperationen. Die Umsetzung dieser Strategien trägt dazu bei, die Pflegewissenschaft als eigenständige Disziplin zu etablieren, ihre gesellschaftliche Relevanz zu erhöhen und eine evidenzbasierte Pflegepraxis in der stationären Akutversorgung zu fördern. Dies erfordert eine enge Zusammenarbeit zwischen Wissenschaft, Politik und Praxis sowie eine nachhaltige strukturelle und finanzielle Unterstützung
Anwendung und Charakterisierung von Leitklebstoffverbindungen für gebäudeintegrierte Photovoltaik-Fassadenelemente
No full textThis study focuses on the development and evaluation of lead-free photovoltaic facade modules, with an emphasis on their reliability. The core objective is to utilize electrically conductive adhesives (ECA) as an alternative to traditional soldered connections. The aim is to investigate the properties and durability of these modules through innovative manufacturing techniques and comprehensive testing methods to assess their suitability for facade applications. Initially, the characterization of the adhesives is carried out using Differential Scanning Calorimetry (DSC) to identify optimal curing parameters. The mechanical stability of the string interconnections is evaluated through peel tests, while climate tests according to DIN EN 61730 and IEC 61215 standards assess the modules’ resistance to environmental influences. Soldered connections and various adhesive types, including epoxy- and acrylate-based variants, are also compared. The modules are manufactured using specific material combinations and lamination processes, which are subsequently tested for defects such as cracks and contact issues. Electrical power measurements under standard test conditions show the power values and efficiencies that can be achieved by ECA-connected modules. However, the findings also highlight the impact of mechanical damage and manufacturing defects on performance, emphasizing the need for further cyclic stress testing. This work not only contributes to the advancement of sustainable photovoltaic technologies but also provides valuable insights for the integration of lead-free modules into modern facade applications.Literaturverzeichnis: Seite 79-8
Moral and managerial perspectives on cooperatives : towards a Luhmannian reconciliation
Get PDFThe recent literature on cooperatives includes two distinct and partly conflicting strands. The moral strand emphasizes cooperatives as a sustainable alternative to shareholder capitalism, while the managerial one problematizes the maintenance organizational costs that must be incurred by these organizations. To reconcile the disparity between these strands, we develop a Luhmannian view of how cooperatives navigate the precarious relationship between the economic function system and the societal environment. On this basis, we show that the maintenance organizational costs plaguing many cooperatives are indicative of an imperfect business case for providing a sustainable alternative to shareholder capitalism. Consequently, we view these costs as a reflection of the heightened managerial challenges involved in pursuing elevated moral objectives
Successful alien plant species exhibit functional dissimilarity from natives under varied climatic conditions but not under increased nutrient availability
Get PDFAims: The community composition of native and alien plant species is influenced by the environment (e.g., nutrient addition and
changes in temperature or precipitation). A key objective of our study is to understand how differences in the traits of alien and
native species vary across diverse environmental conditions. For example, the study examines how changes in nutrient availability
affect community composition and functional traits, such as specific leaf area and plant height. Additionally, it seeks to assess
the vulnerability of high-nutrient
environments, such as grasslands, to alien species colonization and the potential for alien species
to surpass natives in abundance. Finally, the study explores how climatic factors, including temperature and precipitation,
modulate the relationship between traits and environmental conditions, shaping species success.
Location: In our study, we used data from a globally distributed experiment manipulating nutrient supplies in grasslands worldwide
(NutNet).
Methods: We investigate how temporal shifts in the abundance of native and alien species are influenced by species-specific
functional traits, including specific leaf area (SLA) and leaf nutrient concentrations, as well as by environmental conditions such
as climate and nutrient treatments, across 17 study sites. Mixed-effects
models were used to assess these relationships. Results: Alien and native species increasing in their abundance did not differ in their leaf traits. We found significantly lower
specific leaf area (SLA) with an increase in mean annual temperature and lower leaf Potassium with mean annual precipitation.
For trait–environment relationships, when compared to native species, successful aliens exhibited an increase in leaf Phosphorus
and a decrease in leaf Potassium with an increase in mean annual precipitation. Finally, aliens' SLA decreased in plots with
higher mean annual temperatures.
Conclusions: Therefore, studying the relationship between environment and functional traits may portray grasslands' dynamics
better than focusing exclusively on traits of successful species, per se
An easier way to die? - A qualitative interview study on specialist palliative care team members' views on dying under sedation
Get PDFBackground:
Professionals’ personal perceptions of sedated patients in the context of palliative care may influence their opinion on sedation as treatment option. However, little is known of palliative care professionals’ perception of patients dying under sedation.
Aim:
To explore German specialist palliative care team members’ views on and perception of the dying process under sedation.
Design:
Qualitative phenomenological study using semi-structured interviews (n = 59). Interviews took place in-person after recruitment via a contact person and were transcribed verbatim. Framework Analysis was used for analysis.
Setting/participants:
Physicians, nurses, psychologists, physical therapists, chaplains, and social workers from 10 palliative care units and 7 specialist palliative homecare teams across 12 German cities.
Results:
Participants’ views on patients dying under sedation can be grouped into: (i) those who perceived an influence of sedation on the dying process with and without positive and/or negative connotations and (ii) those who saw no difference between dying with or without sedation. Positive connotations referred to the perception of sedation providing an easier path. Concerns were mainly related to the deprivation of patients regarding a conscious dying. The metaphorical description of sedation as “sleep” was common among participants.
Conclusions:
The wide range of perceptions of patients dying under sedation may be rooted in different judgements regarding aspects of a good death. Clarifying ideals of a good death with professionals, patients, and relatives before sedation may support transparent decision-making and help avoid conflicts or moral distress
Manipulation of supramolecular chirality in bicontinuous networks of bent-shaped polycatenar dimers
Get PDFBicontinuous cubic liquid crystalline (LC) phases are of particular interest due their possible applications in electronic devices and special supramolecular chirality. Herein, we report the design and synthesis of first examples of achiral bent-shaped polycatenar dimers, capable of displaying mirror symmetry breaking in their cubic and isotropic liquid phases. The molecules have a taper-shaped 3,4,5-trialkoxybenzoate segment connected to rod-like building unit terminated with one terminal flexible chain. The two segments were connected using an aliphatic spacer with seven methylene units to induce bending of the whole structure. Investigated by the small-angle X-ray scattering (SAXS), a double network achiral cubic phase Cub/Ia d, which is a meso-structure, and a chiral triple network cubic phase Cub/I23[*] are formed. The molecules self-assemble into molecular helices and progress along the networks. Interestingly, different linking groups such as ester or azo linkages and core fluorination lead to distinct local helicity, resulting in an alkyl chain volume dependent phase transition sequence Ia d(L) - I23* - Ia d(S). The re-entry of Ia d phase and loss of supramolecular chirality is attributed to the delicate influence of steric effect at the mono-substitute end and interhelix interaction. Besides, aromatic core fluorination was proved to be a successful tool stabilizing the cubic phases in these dimers
1,(R) versus (R, 1 + ||−/−1 ) local minimizers
No full textLet = 1,(R) be the Beppo-Levi space (homogeneous Sobolev space) with 2 ≤ < , and
for −1
< ≤ 1 let = ∩
(
R, 1 +|| −
−1 )
be the subspace of bounded continuous functions
with weight 1 + || −
−1 . In this paper we prove a Brezis-Nirenberg type result for the energy
functional ∶ → R related to the quasilinear elliptic equation in R of the form
∈ ∶ − = ()() in R,
which states that a local minimizer of in the -topology must be a local minimizer in the
’’bigger’’ -topology.
Global ∞-estimates for solutions of general quasilinear elliptic equations of divergence type
in R on the one hand, and decay estimates for solutions of -Laplace equations via nonlinear
Wolff potentials as well as comparison theorems for -Laplacian type operators on the other
hand play an important role in the proofs
Improved survival of advanced melanoma patients receiving immunotherapy with concomitant antithrombotic therapy : a multicenter study on 2419 patients from the prospective skin cancer registry ADOReg
Get PDFBackground:
Cancer immunotherapy has revolutionized melanoma treatment, but the high number of non- responders still emphasizes the need for improvement of therapy. One potential avenue for enhancing anti- tumor treatment is through the modulation of coagulation and platelet activity. Both have been found to play an important role in the tumor microenvironment, tumor growth and metastasis. Preclinical studies indicate a beneficial effect, clinical data has been inconsistent.
Methods:
We examined a cohort of advanced, non-resectable melanoma patients (n =2419) derived from the German prospective multicenter skin cancer registry ADOReg, who were treated with immune checkpoint in
hibitors (ICI). The patients were classified based on whether it was documented that they received platelet aggregation inhibition (PAI) (n =137) (acetylsalicylic acid (ASA) or clopidogrel), anticoagulation (AC) (n =185) (direct oral anticoagulation (DOAC), phenprocoumon, heparins) at the start of ICI or no antithrombotic
cation (n =2097) at any point during ICI treatment. The study endpoints were best overall response (BOR), progression-free survival (PFS) and overall survival (OS).
Results:
A significantly improved PFS was observed in patients documented to receive ASA (15.1 vs 6.4 months, HR 0.67, 95 % CI: 0.5 to 0.88, p =0.0047) as well as in patients to receive AC (15.1 vs. 6.4 months, HR 0.7, 95 % CI: 0.53 to 0.91, p =0.01) compared to patients for whom no antithrombotic medication was documented. Multivariate analysis of OS showed significant risk reduction in patients who received DOAC (HR 0.68, 95 % CI: 0.49 to 0.92, p =0.0170) or phenprocoumon (HR: 0.44, 95 % CI: 0.19 to 0.85, p =0.0301).
Conclusion:
Our study indicates a positive prognostic effect of anticoagulant and antiplatelet concomitant medication in melanoma patients receiving ICI. Further studies are needed to confrim the cancer-related benefit of adding anticoagulation or platelet inhibition to ICI treatment
Trisomy 26 in a Holstein calf with disorders of sex development
Get PDFHypospadias occurs sporadically in male livestock and is characterized by a non-fused urethra during fetal development. In this study, perineal hypospadias, a bifid scrotum, penile hypoplasia, and bilateral abdominal cryptorchidism were diagnosed in a neonatal Holstein male calf. Septicemia was also suspected due to hypothermia, blurred conjunctivae, and loss of sucking and swallowing reflexes. Gross pathology revealed that both testicles were located intraabdominally caudally to the kidneys. Histopathological examination of the hypospadias showed a urothelium-lined mucosal fold and parts of the corpus cavernosum penis and prepuce in the subcutis. Whole genome sequencing was performed on the affected calf. Analysis of short-read coverage depth along the chromosomes identified an entire extra copy of chromosome 26. Based on the comparison of available variant calling data from the sire, the identified trisomy 26 is due to non-disjunction of homologous chromosomes during the generation of paternal gametes. We have shown for the first time an association between bovine hypospadias and trisomy 26, which adds to the understanding of variation in fetal male sexual development
Scale-dependent effects of plant diversity drivers across different grassland habitats in Ukraine
Get PDFUnderstanding the factors governing grassland biodiversity across different spatial scales is crucial for effective conservation and management. However, most studies focus on single grain sizes, leaving the scale-dependent mechanisms of biodiversity drivers unclear. We investigated how climate, soil properties, abiotic disturbance, and land use influence plant diversity across two fine spatial scales in various grassland types in Ukraine. Using spatially explicit data on plant species presence and their cover, collected at smaller (10 m2) and larger (100 m2) grain sizes, we assessed spatial β-diversity—the variability of biodiversity between scales. We analyzed whether the effects of ecological drivers on β-diversity are mediated by changes in species evenness, density (total cover), and intraspecific aggregation in plant community. In our study, the most influential factors of local plant diversity at both grain sizes were climate variables, followed by soil humus content, litter cover, and soil pH. Soil and litter effects were primarily driven by the response of locally rare species, while climate and grazing effects were driven by locally common species. The strength of most of these effects varied between spatial scales, affecting β-diversity. Soil properties influenced β-diversity through changes in total plant community cover, while the effects of climate and litter operated via changes in species evenness and aggregation. Our findings highlight that biodiversity responses to climate, soil factors, and litter depend on the size of the sampled area and reveal the role of total plant cover, evenness, and aggregation in driving fine-scale β-diversity in grasslands across different habitat types