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Despite the enormous number of assistive technologies (ATs) in dementia care, the management of challenging behavior (CB) of persons with dementia (PwD) by informal caregivers in home care is widely disregarded. The first-line strategy to manage CB is to support the understanding of the underlying causes of CB to formulate individualized nonpharmacological interventions. App- and sensor-based approaches combining multimodal sensors (actimetry and other modalities) and caregiver information are innovative ways to support the understanding of CB for family caregivers. The main aim of this study is to describe the design of a feasibility study consisting of an outcome and a process evaluation of a newly developed app- and sensor-based intervention to manage CB of PwD for family caregivers at home. In this feasibility study, we perform an outcome and a process evaluation with a pre-post descriptive design over an 8-week intervention period. The Medical Research Council framework guides the design of this feasibility study. The data on 20 dyads (primary caregiver and PwD) are gathered through standardized questionnaires, protocols, and log files as well as semistructured qualitative interviews. The outcome measures (neuropsychiatric inventory and Cohen-Mansfield agitation inventory) are analyzed by using descriptive statistics and statistical tests relevant to the individual assessments (eg, chi-square test and Wilcoxon signed-rank test). For the analysis of the process data, the Unified Theory of Acceptance and Use of Technology is used. Log files are analyzed by using descriptive statistics, protocols are analyzed by using documentary analysis, and semistructured interviews are analyzed deductively using content analysis. The newly developed app- and sensor-based AT has been developed and was evaluated until July in 2018. The recruitment of dyads started in September 2017 and was concluded in March 2018. The data collection was completed at the end of July 2018. This study presents the protocol of the first feasibility study to encompass an outcome and process evaluation to assess a complex app- and sensor-based AT combining multimodal actimetry sensors for informal caregivers to manage CB. The feasibility study will provide in-depth information about the study procedure and on how to optimize the design of the intervention and its delivery. DERR1-10.2196/11630
BACKGROUND Despite the enormous number of assistive technologies (ATs) in dementia care, the management of challenging behavior (CB) of persons with dementia (PwD) by informal caregivers in home care is widely disregarded. The first-line strategy to manage CB is to support the understanding of the underlying causes of CB to formulate individualized nonpharmacological interventions. App- and sensor-based approaches combining multimodal sensors (actimetry and other modalities) and caregiver information are innovative ways to support the understanding of CB for family caregivers. OBJECTIVE The main aim of this study is to describe the design of a feasibility study consisting of an outcome and a process evaluation of a newly developed app- and sensor-based intervention to manage CB of PwD for family caregivers at home. METHODS In this feasibility study, we perform an outcome and a process evaluation with a pre-post descriptive design over an 8-week intervention period. The Medical Research Council framework guides the design of this feasibility study. The data on 20 dyads (primary caregiver and PwD) are gathered through standardized questionnaires, protocols, and log files as well as semistructured qualitative interviews. The outcome measures (neuropsychiatric inventory and Cohen-Mansfield agitation inventory) are analyzed by using descriptive statistics and statistical tests relevant to the individual assessments (eg, chi-square test and Wilcoxon signed-rank test). For the analysis of the process data, the Unified Theory of Acceptance and Use of Technology is used. Log files are analyzed by using descriptive statistics, protocols are analyzed by using documentary analysis, and semistructured interviews are analyzed deductively using content analysis. RESULTS The newly developed app- and sensor-based AT has been developed and was evaluated until July in 2018. The recruitment of dyads started in September 2017 and was concluded in March 2018. The data collection was completed at the end of July 2018. CONCLUSIONS This study presents the protocol of the first feasibility study to encompass an outcome and process evaluation to assess a complex app- and sensor-based AT combining multimodal actimetry sensors for informal caregivers to manage CB. The feasibility study will provide in-depth information about the study procedure and on how to optimize the design of the intervention and its delivery. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11630
A new measurement system (horizontal displacement, time of flight, synchronicity—HDTS) was investigated regarding the latest changes to the international evaluation rules in trampoline gymnastics. It allows for the real-time measurement of objective criteria, such as flight time and landing position, without affecting the gymnast. The aim of this study was to investigate the temporal and spatial accuracy of a measurement tool via cross-validation. Temporal precision was additionally tested via high-speed video landing and takeoff, while a three-dimensional motion capturing system was incorporated for spatial precision. The Bland–Altman “limit of agreement approach” was used for the assessment of congruence between the measurement systems. The new measurement system presented an average spatial deviation of 3.2 cm and a temporal deviation between − 5.8 and + 6.4 ms for the landing and − 11.3 and + 11.3 ms for the takeoff. Given its temporal and spatial accuracy in determining flight time and landing position as identified through cross-validation, the novel HDTS system proved to be suitable for its use in trampoline competitions.
Questionnaire to evaluate user acceptance before purchasing medical devices in health facilities
(2019)
Flucht und Bildung.
(2019)
Spielerisch Pflege lernen.
(2019)
Background Lunch provision is expected to improve the nutritional status of Cambodian garment workers. The objective of this study is to evaluate the effects of a model lunch provision through a canteen on anthropometry, hemoglobin, and micronutrient status in female garment workers in Cambodia. Methods This exploratory randomized controlled trial was implemented at a garment factory in Phnom Penh, Cambodia. Female workers (nulliparous, non-pregnant) were recruited and randomly allocated into an intervention arm (workday's lunch provision) and a control arm. Served lunch sets (̃ 700 kcal on average) included diverse local dishes. Anthropometry (body mass index, weight, triceps skinfold thickness, and mid-upper arm muscle circumference), as well as hemoglobin, serum ferritin and soluble transferrin receptor, serum retinol binding protein, and serum folate concentrations were assessed at baseline and after 5 months of lunch provision. A general linear model with adjustments for baseline values was used to estimate intervention effects for each outcome variable. Results Two hundred twenty-three women were recruited (n = 112 control and n = 111 intervention). 172 (n = 86 in each arm) completed the study. Baseline prevalence of underweight, anemia, depleted iron stores, and marginal iron stores, were 31, 24, 21, and 50%, respectively. Subjects were not affected by frank vitamin A or folate deficiency, whereas 30% showed a marginal folate status. Overall, mean changes in anthropometric variables, hemoglobin, and retinol binding protein were marginal and not significant among intervention subjects. Mean folate concentration increased insignificantly by + 1.1 ng/mL (- 0.02, 2.2) (p = 0.054). On the other hand, mean ferritin decreased by - 6.6 μg/L (- 11.9, - 1.3) (p = 0.015). Subgroup analysis prompts that effects are differently pronounced according to the baseline status of workers. Conclusions Findings indicate that model lunch sets provided a beneficial amount of dietary folate, but need to be revisited for iron content and/or iron bioavailability. It is believed that distinct positive effects on anthropometry, hemoglobin, and micronutrient status can solely be expected in malnourished individuals. The authors suggest that similar larger trials, which include sets adapted to the concrete needs of workers affected by underweight, anemia and/or definite micronutrient deficiencies, should be performed. Trial registration The trial was registered at the German Clinical Trials Register (9 January 2015, Identifier: DRKS00007666).
To contribute to a better understanding of consumer food leftovers and to facilitate their reduction in out-of-home settings, our study analyzes the effects of two common intervention strategies for reducing leftovers in a holistic behavioral model. Based on a quasi-experimental baseline-intervention design, we analyzed how the display of information posters and the reduction of portion sizes take an effect on personal, social and environmental determinants in a structural equation model. Applying data from online surveys and observations among 880 guests (503 baseline, 377 intervention) during two weeks in a university canteen, the suggested model allows to assign effects from the two interventions on plate leftovers to specific changes in behavioral determinants. Portion size reductions for target dishes are found to relate to lower levels of plate waste based on conscious perception, represented in smaller portion size ratings. Effects from seeing information posters are found to base on changed personal attitudes, subjective norms and perceived behavioral control. However, depending on how an individual reacts to the information (by only making an effort to finish all food or by making an effort and additionally choosing a different dish in the canteen) there are opposite effects on these determinants and consequently also on plate leftovers. Overall, the differentiated results on intervention effects strongly support the benefits of more holistic and in-depth analyses of interventions to reduce plate leftovers and therefore to contribute to more sustainable food consumption in out-of-home settings.
Anhand einer qualitativen Interviewstudie mit älteren Menschen zum Thema Tod und Sterben sind forschungspraktische Herausforderungen im Umgang mit den Themen Einverständnis, Anonymität und Verschwiegenheit aufgetreten. Diese Herausforderung betrifft dabei nicht nur vulnerable Interviewpartner, jedoch stellt sich bei dieser Personengruppe die Frage nach einem besonderen Schutz aus forschungsethischer Perspektive. Auf Basis dieser eigenen empirischen Erfahrung ist folgende forschungspraktische Frage der Erfüllung und Dokumentation von datenschutzrechtlichen Bestimmungen aufgekommen: Kann eine informierte Einwilligung anstelle der Schriftform auch auf Tonband gegeben werden?
Vor diesem Hintergrund beschäftigt sich der Beitrag mit Möglichkeiten, wie datenschutzrechtliche Bestimmungen und deren Dokumentation erfüllt werden können, ohne dass sich dieser Prozess negativ auf eine (notwendige) Vertrauensbildung im Rahmen der Interviewsituation auswirkt. Der Beitrag diskutiert hierzu den Vorschlag, das Einverständnis und deren Dokumentation nicht schriftlich, sondern in Form einer verbalen Aufzeichnung durchzuführen. Hierzu werden sowohl forschungsethische als auch datenschutzrechtliche Aspekte aufgegriffen und eingeordnet. Aus der Diskussion werden schließlich konkrete und praxisorientierte Hinweise für Forschende abgeleitet.
Aktuelle wissenschaftliche Auseinandersetzungen mit dem Sinnerleben Beschäftigter thematisieren vor allem die Problematik eines belastungsbedingten Sinnverlustes. Danach leiden immer mehr Beschäftigte darunter, ihre Arbeit nicht mehr als sinnvoll empfinden zu können. Eine solche Perspektive lässt allerdings die subjektiven Gestaltungsleistungen und Aneignungsformen von Arbeit aus dem Blick geraten. Diesen wendet sich der Beitrag zu, indem er danach fragt, inwieweit sich unterschiedliche Formen der Aneignung von Arbeit identifizieren lassen. Auf der Basis von Interviews mit vierzig hochqualifizierten Beschäftigten werden drei unterschiedliche Aneignungsmodi mit ihren inhärenten Ambivalenzen identifiziert. Jeder Modus steht für eine spezifische Sichtweise auf die eigenen Gestaltungsmöglichkeiten und für eine Form der primären Sinnzuschreibung in der Arbeit. Differenziert werden drei Idealtypen – „progressive Sinngestaltung“, „widerständige Sinnbewahrung“ sowie „pragmatische Sinnbewahrung“ –, anhand derer die Heterogenität und die Ambivalenzen der Aneignung professioneller Arbeit deutlich werden. Der Beitrag liefert so Erkenntnisse über die subjektiven Praktiken des Bedeutsam-Machens von Arbeit und trägt zur Erforschung des Zusammenspiels von Arbeit und Subjektivität bei.
Pflegeforschung mit Kindern
(2019)
Die Verdunstung als Teil des urbanen Wasserhaushalts sollte aus wasserwirtschaftlicher und energetischer Sicht im Rahmen von Planungsprozessen zielgerichtet beeinflusst werden. Lösungs-strategien können nur in einem iterativen und interdisziplinä-ren Prozess entwickelt werden. So ergeben sich zahlreiche pla-nerische Optionen blau-grüner Infrastruktur, die anhand des Oxford-Quartiers in Münster exemplarisch dargestellt werden. Die erfolgreiche Umsetzung solcher ganzheitlichen Planungen erfordert interdisziplinäre Zusammenarbeit über bisherige kom-munale Organisations- und Arbeitsstrukturen hinweg. Je nach Planungsphase unterstützen dabei unterschiedlich differenzier-te Planungswerkzeuge die Entscheidungsfindung (zum Beispiel WABILA, SWMM-UrbanEVA).
The stormwater management model SWMM of the US EPA is widely used to analyse, design or optimise urban drainage systems. To perform advanced analysis and visualisations of model data this technical note introduces the R package swmmr. It contains functions to read and write SWMM files, initiate simulations from the R console and to convert SWMM model files to and from GIS data. Additionally, model data can be transformed to produce high quality visualisations. In accordance with SWMM’s open source policy the package can be obtained through github.com or the Comprehensive R Archive Network (CRAN).
Hintergrund Die Interaktion zwischen Patienten und Therapeuten gilt als unspezifischer Wirkfaktor in der physiotherapeutischen Behandlung. Neben praktischen, interpersonalen und kommunikativen Fähigkeiten beeinflussen organisatorische Rahmenbedingungen die Interaktion.
Ziel In dieser Arbeit erfolgte eine handlungsfeldspezifische Analyse der Interaktion zwischen Patienten und Therapeuten in ambulanten Physiotherapiepraxen. Dabei wurde der Frage nachgegangen, welche Merkmale die Interaktion in der ambulanten Praxis charakterisieren und welche Bedeutung die Rahmenbedingungen der ambulanten Praxis in diesem Zusammenhang haben.
Methode Die Studie wurde gemäß der Grounded Theory nach Corbin und Strauss konzipiert [1] [2]. Das Datenmaterial umfasste Videoaufzeichnungen von Behandlungen, Protokolle des lauten Denkens der aufgezeichneten Behandlungen, Feldprotokolle von Beobachtungen und Transkriptionen von Interviews. Nach dem Prinzip des Contrast Samplings wurden nach Rahmenbedingungen und Therapeutenmerkmalen differenzierte Situationen aufgenommen. Das Datenmaterial wurde transkribiert und interpretativ-kodierend ausgewertet. In die Studie waren insgesamt 9 in ambulanten Praxen arbeitende Therapeuten eingeschlossen.
Ergebnisse Der Takt der ambulanten Physiotherapiepraxis wurde ausgehend von der zentralen Anforderung „immer im Takt bleiben“ definiert. Organisatorisch-strukturelle, therapeutisch-inhaltsbezogene und beziehungsbezogene Aufgaben sind Dimensionen dieses Takts. Sie verdeutlichen, dass pauschale Zeitvorgaben einem situationsspezifischen und patientenzentriertem Vorgehen entgegenstehen.
Schlussfolgerung Der Takt der ambulanten Physiotherapiepraxis eröffnet eine Perspektive auf Anforderungen in der ambulanten Praxis. Dieser stellt ein heuristisches Modell dar, welches den gelungenen Umgang mit den Widersprüchlichkeiten beschreibt und insbesondere die situations- und beziehungsbezogenen Aspekte berücksichtigt
An emerging class of inorganic optical reporters are near-infrared (NIR) excitable lanthanide-based upconversion nanoparticles (UCNPs) with multicolor emission and long luminescence lifetimes in the range of several hundred microseconds. For the design of chemical sensors and optical probes that reveal analyte-specific changes in their spectroscopic properties, these nanomaterials must be combined with sensitive indicator dyes that change their absorption and/or fluorescence properties selectively upon interaction with their target analyte, utilizing either resonance energy transfer (RET) processes or reabsorption-related inner filter effects. The rational development of UCNP-based nanoprobes for chemical sensing and imaging in a biological environment requires reliable methods for the surface functionalization of UCNPs, the analysis and quantification of surface groups, a high colloidal stability of UCNPs in aqueous media as well as the chemically stable attachment of the indicator molecules, and suitable instrumentation for the spectroscopic characterization of the energy-transfer systems and the derived nanosensors. These topics are highlighted in the following feature article, and examples of functionalized core–shell nanoprobes for the sensing of different biologically relevant analytes in aqueous environments will be presented. Special emphasis is placed on the intracellular sensing of pH.