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Interprofessional collaboration to support patients with social problems in general practice—a qualitative focus group study
Get PDFBackground: Social problems of patients such as family or work-related conflicts as well as financial difficulties affect the individual health situation and the treatment of diseases in general practice. General practitioners (GPs) would like to have direct access to professionals in social care services. In Germany, there are many different social care facilities for people with a wide range of social problems. As the social and health care systems hardly interact collaborations between social professionals (SPs) and GPs are rare exceptions.
This study explored perspectives of GPs regarding their patients with social problems in combination with the perspectives of SPs. Aim of this study was to explore how a systematic interprofessional collaboration between GPs and SPs could be realised.
Methods: We carried out a participatory sequential qualitative study design consisting of two focus groups with GPs, two with SPs and two mixed-professional focus groups with GPs and SPs. The focus groups were conducted with semi-structured moderating guidelines and analysed with a qualitative content analysis approach using inductive and deductive categories.
Results: GPs view themselves as the first point of contact for their patients' social problems. For persistent social problems, they expressed a desire for support and SPs were willing to provide this. We developed a stepped care implementation model for a systematic cooperation consisting of nine collaboration strategies. These strategies included: index or website of social care services, referrals to the social care system, using flyers and posters of social care services, direct contact/hotline to local social care services, participation in meetings of social care facilities, involving physician assistants, external social care advice service in GP rooms, implementation in education and training and access to volunteers.
Conclusions: Our stepped care implementation model for a systematic cooperation of GPs and SPs could be a feasible need- and resource-oriented approach for the collaborative care of patients with social problems to improve their medical treatment in most western healthcare systems. GPs and SPs are ready to generate the necessary evidence for policy makers in high quality RCTs
Solid Waste Analysis Using Open-Access Socio-Economic Data
Get PDFNowadays, problems related with solid waste management become a challenge for most countries due to the rising generation of waste, related environmental issues, and associated costs of produced wastes. Effective waste management systems at different geographic levels require accurate forecasting of future waste generation. In this work, we investigate how open-access data, such as provided from the Organisation for Economic Co-operation and Development (OECD), can be used for the analysis of waste data. The main idea of this study is finding the links between socioeconomic and demographic variables that determine the amounts of types of solid wastes produced by countries. This would make it possible to accurately predict at the country level the waste production and determine the requirements for the development of effective waste management strategies. In particular, we use several machine learning data regression (Support Vector, Gradient Boosting, and Random Forest) and clustering models (k-means) to respectively predict waste production for OECD countries along years and also to perform clustering among these countries according to similar characteristics. The main contributions of our work are: (1) waste analysis at the OECD country-level to compare and cluster countries according to similar waste features predicted; (2) the detection of most relevant features for prediction models; and (3) the comparison between several regression models with respect to accuracy in predictions. Coefficient of determination (R2), Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and Mean Absolute Percentage Error (MAPE), respectively, are used as indices of the efficiency of the developed models. Our experiments have shown that some data pre-processings on the OECD data are an essential stage required in the analysis; that Random Forest Regressor (RFR) produced the best prediction results over the dataset; and that these results are highly influenced by the quality of available socio-economic data. In particular, the RFR model exhibited the highest accuracy in predictions for most waste types. For example, for “municipal” waste, it produced, respectively, R2 = 1 and MAPE = 4.31 global error values for the test set; and for “household” waste, it, respectively, produced R2 = 1 and MAPE = 3.03. Our results indicate that the considered models (and specially RFR) all are effective in predicting the amount of produced wastes derived from input data for the considered countries
Implementation, mechanisms of change and contextual factors of a complex intervention to improve interprofessional collaboration and the quality of medical care for nursing home residents: study protocol of the process evaluation of the interprof ACT intervention package
Get PDFBackground: To improve interprofessional collaboration between registered nurses (RNs) and general practitioners (GPs) for nursing home residents (NHRs), the interprof ACT intervention package was developed. This complex intervention includes six components (e.g., shared goal setting, standardized procedures for GPs’ nursing home visits) that can be locally adapted. The cluster‑randomized interprof ACT trial evaluates the effects of this intervention on the cumulative incidence of hospital admissions (primary outcome) and secondary outcomes (e.g., length of hospital stays, utilization of emergency care services, and quality of life) within 12 months. It also includes a process evaluation which is subject of this protocol. The objectives of this evaluation are to assess the implementation of the interprof ACT intervention package and downstream effects on nurse–physician collaboration as well as preconditions and prospects for successive implementation into routine care.
Methods: This study uses a mixed methods triangulation design involving all 34 participating nursing homes (clusters). The quantitative part comprises paper‑based surveys among RNs, GPs, NHRs, and nursing home directors at baseline and 12 months. In the intervention group (17 clusters), data on the implementation of preplanned implementation strategies (training and supervision of nominated IPAVs, interprofessional kick‑off meetings) and local implementation activities will be recorded. Major outcome domains are the dose, reach and fidelity of the implementation of the intervention package, changes in interprofessional collaboration, and contextual factors. The qualitative part will be conducted in a subsample of 8 nursing homes (4 per study group) and includes repeated non‑participating observations and semistructured interviews on the interaction between involved health professionals and their work processes. Quantitative and qualitative data will be descriptively analyzed and then triangulated by means of joint displays and mixed methods informed regression models.
Discussion: By integrating a variety of qualitative and quantitative data sources, this process evaluation will allow comprehensive assessment of the implementation of the interprof ACT intervention package, the changes induced in interprofessional collaboration, and the influence of contextual factors. These data will reveal expected and unexpected changes in the procedures of interprofessional care delivery and thus facilitate accurate conclusions for the further design of routine care services for NHRs
Die gendered pains of imprisonment – Geschlechtertheoretische Perspektiven in der Strafvollzugswissenschaft
Get PDFIn der Bundesrepublik Deutschland unterliegt der Strafvollzug dem sogenannten Trennungsprinzip. Das bedeutet, männliche und weibliche Gefangene werden getrennt voneinander in gesonderten Anstalten bzw. Abteilungen untergebracht. Gerechtfertigt wird das sogenannte Trennungsprinzip durch den grundrechtlichen Schutz des Intim- und Sexualbereichs. Das Gefängnis ist somit eine nach Geschlecht differenzierte totale Institution. Zugleich ist es eine Institution sozialer Kontrolle und in kaum einem anderen Feld halten sich Geschlechterstereotypien und Zuschreibungen von Geschlechterdifferenz so hartnäckig wie im Bereich sozialer Kontrolle. Für die Strafvollzugswissenschaften bringt dies die Herausforderung mit sich, in der Forschung Geschlechterdifferenz nicht als Vorannahme zu unterstellen und immer wieder zu reproduzieren, indem Frauen und Männer betrachtet werden, sondern geschlechtertheoretische Perspektiven einzunehmen und Geschlecht als komplexe Kategorie zu fassen, die verschiedene Dimensionen aufweist. Durch diese geschlechtertheoretischen Perspektivwechsel und -verschiebungen werden Ausblendungen in der Strafvollzugswissenschaft sichtbar, die im Folgenden systematisch betrachtet werden. Dem Beitrag liegt die These zugrunde, dass der Strafvollzug nicht nur nach Geschlechtern getrennt organisiert ist, sondern dass Gefängnisse als totale Institutionen Konstruktionen von Geschlecht und Geschlechterdifferenz hervorbringen. Um der These nachzugehen, werden in einem ersten Schritt kurz die rechtlichen Regelungen und die Vollzugsgestaltung dargelegt. Vor diesem Hintergrund werden die Dimensionen der Kategorie Geschlecht mit Bezug auf ausgewählte Ergebnisse in der Strafvollzugswissenschaft vorgestellt, um dann in einem Ausblick die geschlechtertheoretischen Herausforderungen für die Strafvollzugswissenschaft zu benennen
The Need of Security Inside a Microservices Architecture in the Insurance Industry
Get PDFEven for the more traditional insurance industry, the Microservices Architecture (MSA) style plays an increasingly important role in provisioning insurance services. However, insurance businesses must operate legacy applications, enterprise software, and service-based applications in parallel for a more extended transition period. The ultimate goal of our ongoing research is to design a microservice reference architecture in cooperation with our industry partners from the insurance domain that provides an approach for the integration of applications from different architecture paradigms. In Germany, individual insurance services are classified as part of the critical infrastructure. Therefore, German insurance companies must comply with the Federal Office for Information Security requirements, which the Federal Supervisory Authority enforces. Additionally, insurance companies must comply with relevant laws, regulations, and standards as part of the business’s compliance requirements. Note: Since Germany is seen as relatively ’tough’ with respect to privacy and security demands, fullfilling those demands might well be suitable (if not even ’over-achieving’) for insurances in other countries as well. The question raises thus, of how insurance services can be secured in an application landscape shaped by the MSA style to comply with the architectural and security requirements depicted above. This article highlights the specific regulations, laws, and standards the insurance industry must comply with. We present initial architectural patterns to address authentication and authorization in an MSA tailored to the requirements of our insurance industry partners
Longitudinal Associations of Adherence to the Dietary World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and Dutch Healthy Diet (DHD) Recommendations with Plasma Kynurenines in Colorectal Cancer Survivors after Treatment
Get PDFThe tryptophan-kynurenine pathway has been linked to cancer aetiology and survivorship, and diet potentially affects metabolites of this pathway, but evidence to date is scarce. Among 247 stage I-III CRC survivors, repeated measurements were performed at 6 weeks, 6 months, and 1 year post-treatment. Adherence to the World Cancer Research Fund/ American Institute for Cancer Research (WCRF) and Dutch Healthy Diet (DHD) recommendations was operationalized using seven-day dietary records. Plasma kynurenines of nine metabolites were analysed. Longitudinal associations of adherence to these dietary patterns and plasma kynurenines were analysed using confounder-adjusted linear mixed-models. In general, higher adherence to the dietary WCRF/AICR and DHD recommendations was associated with lower concentrations of kynurenines with pro-oxidative, pro-inflammatory, and neurotoxic properties (3-hydroxykynurenine (HK) and quinolinic acid (QA)), and higher concentrations of kynurenines with anti-oxidative, anti-inflammatory, and neuroprotective properties (kynurenic acid (KA) and picolinic acid (Pic)), but associations were weak and not statistically significant. Statistically significant positive associations between individual recommendations and kynurenines were observed for: nuts with kynurenic-acid-to-quinolinic-acid ratio (KA/QA); alcohol with KA/QA, KA, and xanthurenic acid (XA); red meat with XA; and cheese with XA. Statistically significant inverse associations were observed for: nuts with kynurenine-to-tryptophan ratio (KTR) and hydroxykynurenine ratio; alcohol with KTR; red meat with 3-hydroxyanthranilic-to-3-hydroxykynurenine ratio; ultra-processed foods with XA and KA/QA; and sweetened beverages with KA/QA. Our findings suggest that CRC survivors might benefit from adhering to the dietary WCRF and DHD recommendations in the first year after treatment, as higher adherence to these dietary patterns is generally, but weakly associated with more favourable concentrations of kynurenines and their ratios. These results need to be validated in other studies
Fenster öffnen! Wissenschaftskommunikation, Fachinformationsdienste und Fachreferat : Ein Tagungsbericht
Get PDFTagungsbericht des Online-Workshops der Fachinformationsdienste für Allgemeine und Vergleichende Literaturwissenschaft (AVL) und Linguistik sowie der VDB Kommission für Fachreferatsarbeit am 10. November 202
Findbuch zum Nachlass des Dokumentarfilmers Rudolf W. Kipp
Get PDFDie aktualisierte 2. Auflage des Findbuchs zum Nachlass des Filmmachers Rudolf W. Kipp (1919 bis 1990) umfasst auch die in der ersten Auflage nicht enthaltene Nachlieferung von 2002 sowie einen biografischen Artikel zu Rudolf Kipp aus dem Lexikon CineGraph. Die Materialien sind systematisch gegliedert und über ein Filmtitelregister erschlossen
Raycasting-basiertes Voxelrendering
Get PDFDie Arbeit hat das Ziel, Volumendaten effizient zu visualisieren, ohne diese in ein alternatives Repräsentationsformat wie Polygonnetze zu überführen. Dafür werden Voxel sowie ein Raycasting-Ansatz verwendet. Die Elemente des Volumens werden als Voxel (=volumetrische Pixel), das Volumen nachfolgend als ein dreidimensionales Array aus Voxel bezeichnet. Für jeden Pixel wird ein Strahl erzeugt, der das Array iterativ traversiert, wobei in jeder Iteration geprüft wird, ob das gegebene Volumenelement ein Datum hält oder nicht. Maßgeblich hierfür ist der von (Amanatides, Woo et al., 1987) vorgestellte Ansatz, den Strahl in solche Segmente zu zerlegen, die immer jeweils so lang wie der momentan zu untersuchende Voxel groß ist: In einer Iteration wird also immer genau ein Voxel untersucht. Die Arbeit wird diese Idee verfolgen, praktisch aber anders umsetzen und sie um eine zusätzliche Beschleunigungsstruktur ergänzen. Im Idealfall soll dieser Ansatz es erlauben, mindestens 512^3 Voxel in Echtzeit zu rendern. Der beschriebene Ansatz hat zusätzlich den Vorteil, dass Änderungen direkt sichtbar werden, weil für das anschließende Rendering, auf die modifizierten Daten zurückgegriffen wird
30th BOBCATSSS Symposium - Book of Abstracts
Get PDFData and Information Science: Book of Abstracts at BOBCATSSS 2022 Hybrid Conference, 23rd - 25th of May 2022, Debrecen.
This year marks the 30th anniversary of the BOBCATSSS. The BOBCATSSS is an international, annual symposium designed for librarians and information professionals in a rapidly changing environment. Over the past 30 years, the conference has included exciting topics, great venues, interested guests and engaging presenters.
This year we would like to introduce the topics of the many papers presented in the Book of Abstracts for the first time in presence at the University of Debrecen and hybrid. The Book of Abstracts provides an overview of all presentations given at BOBCATSSS. Presentations are listed in alphabetical order by title and include speeches, Pecha Kuchas, posters and workshops.
The theme of BOBCATSSS is Data and Information Science. Data and information are the basis for decisions and processes in business, politics and science. Particularly important in the current era of digital transformation. This is exactly where this year's subthemes come in. They deal with data science, openness as well as institutional roles