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Geschlechtsidentität, Geschlechtsinkongruenz und Geschlechtsdysphorie im Kindes- und Jugendalter
(2021)
Additive manufacturing (AM) has been growing continuously over the past 20 years, enabling unprecedented tailoring to the anatomy of each patient. In Europe, custom-made devices qualify for an exemption and pass a simplified approval process. New technologies, like AM, provoke questions about the adequacy of the current regulatory framework for custom-made devices. This article addresses the regulatory requirements for such devices in Europe and discusses the implications for AM. It concludes that the legal framework for custom-made devices entails uncertainties which need to be resolved to guide manufacturers through the regulatory requirements, highlighting the specific areas of focus for AM.
Im Mittelpunkt der Medizintechnikbranche stand in den letzten Jahren fast ausschließlich ein Thema: die Medical Device Regulation, kurz MDR. Mit Inkrafttreten der MDR steigen die regulatorischen Anforderungen für alle Akteure der Medizintechnikbranche in ganz Europa. Vor allem kleine und mittelständische Unternehmen werden durch die Implementierung der MDR vor Herausforderungen gestellt. Das Ziel der durchgeführten Online-Befragung war es, ein umfassendes Erfahrungs- und Meinungsbild hinsichtlich der Akzeptanz und Umsetzbarkeit der MDR zu gewinnen. Hierfür wurden Händler und Hersteller orthopädischer Hilfsmittel im Januar und Februar 2021 deutschlandweit anonymisiert befragt. In diesem Artikel werden die Ergebnisse der Umfrage ausführlich dargestellt und diskutiert.
Electronic Medical Records for (Visceral) Medicine: An Overview of the Current Status and Prospects
(2021)
Background: Electronic medical records (EMRs) offer key advantages over analog documentation in healthcare. In addition to providing details about current and past treatments, EMRs enable clear and traceable documentation regardless of the location. This supports evidence-based, multi-professional treatment and leads to more efficient healthcare. However, there are still several challenges regarding the use of EMRs. Understanding these challenges is essential to improve healthcare. The aim of this article is to provide an overview of the current state of EMRs in the field of visceral medicine, to describe the future prospects in this field, and to highlight some of the challenges that need to be faced. Summary: The benefits of EMRs are manifold and particularly pronounced in the area of quality assurance and improvement of communication not only between different healthcare professionals but also between physicians and patients. Besides the danger of medical errors, the health consequences for the users (cognitive load) arise from poor usability or a system that does not fit into the real world. Involving users in the development of EMRs in the sense of participatory design can be helpful here. The use of EMRs in practice together with patients should be accompanied by training to ensure optimal outcomes in terms of shared decision-making. Key Message: EMRs offer a variety of benefits. However, it is critical to consider user involvement, setting specificity, and user training during development, implementation, and use in order to minimize unintended consequences.
Introduction: Heroin overdose is a leading cause of mortality among drug users. This paper aims to identify individual and contextual factors associated with lethal and non-lethal heroin-related overdoses on the basis of case reports and semi-structured proxy interviews. Typical patterns within these cases are determined by means of cluster analysis. Methods: Within the CaRe (Case Reports of heroin-related overdoses) study, case reports (100 proxy reports of overdose events from 36 different facilities) were gathered and evaluated as part of a nationwide survey of experts conducted in Germany in 2019. Following initial descriptive analyses a two-step cluster analysis with the four binary variables of gender, age, time and place was conducted to identify patterns within the reported cases. Results: The case reports grouped into five clusters: 1) Younger male drug users, found in a public space during the daytime; 2) Female drug users; 3) Older male drug users, found in a public space during the daytime; 4) Drug users found at home at night; 5) Drug users found outside at night. Overdoses by female drug users and those which occurred at home and/or at night were significantly more likely to have a fatal outcome. Conclusion: Future prevention
and intervention measures should aim to consider the context, i.e.
The Effect of Ionic Defect Interactions on the Hydration of Yttrium-Doped Barium Zirconate, Phys
(2021)
Kinetic Monte Carlo Simulations for Solid State Ionics: Case Studies with the MOCASSIN Program, Diff
(2021)
Bauprojekte sind komplexe soziotechnische Systeme und in den konventionellen Vertrags- und Projektabwicklungsstrukturen anfällig für Störungen und opportunistisches, unkooperatives Verhalten der Projektbeteiligten. Die Gesamteffizienz ist gering und die Ziele der
Projektbeteiligten werden vielfach nicht erreicht. Ein innovativer Verbesserungsansatz für komplexe Projekte ist die „Integrierte Projektabwicklung (IPA)“, in der alle Beteiligten in einen
Mehrparteienvertrag eintreten, der teamorientiertes Verhalten fördern soll. Die veränderten vertraglichen und wirtschaftlichen Rahmenbedingungen müssen um soziokulturelle Elemente ergänzt werden, um die Projektkultur als wesentlichen Erfolgsfaktor der IPA zu stärken. Für die Gestaltung und Steuerung der Kooperation eignet sich ein vom Verfasser entwickeltes ganzheitliches Kooperationskultur-Modell. Durch eine Kosten-Nutzen-Betrachtung, eine Pilot-
Studie und einen Realisierbarkeitstest wurde der Nutzen des Modells für die Strukturierung, Messung und Steuerung der Kooperationsbeziehung und damit der Verbesserung der Projektergebnisse
aufgezeigt, so dass dessen Anwendung im Rahmen der IPA Erfolg verspricht.
Ernährungstherapie bei angeborenen Stoffwechselerkrankungen, Teil 3: Störungen des Fettstoffwechsels
(2021)
Beobachtung als Methode qualitativer Forschung: Eine flexible, kontextbezogene Forschungsstrategie
(2021)
Beratungspsychologie
(2021)
Heading in soccer involves repetitive head accelerations that may be detrimental for brain health. One way to mitigate adverse effects may be to increase head-neck stabilization and thus reduce the kinematic response after intentional headers. This study aimed to (a) assess associations between neck strength and head kinematics and (b) evaluate an exercise intervention designed to increase strength and attenuate head acceleration during intentional heading in youth soccer players. In 22 athletes, we used accelerometers to assess associations between neck strength and peak linear acceleration (PLA). We attached the accelerometers to the occiput and sternum, allowing us to differentiate between total, trunk, and head PLA. Longitudinally, we evaluated the effects of a 14-week twice-weekly resistance training in a subsample of 14 athletes compared with regular soccer training (N = 13). Results showed that female athletes had lower isolated neck strength (p ≤ 0.004), lower functional neck strength (p ≤ 0.017), and higher total PLA during purposeful headers compared with males (17.2 ± 3.5 g and 13.0 ± 2.3 g, respectively, at 9.6 m·s−1 ball velocity during impact; p = 0.003). The intervention group showed moderate to large strength gains (η
= 0.16–0.42), resulting in lower PLA (total −2.4 g, trunk −0.8 g, and head −1.5 g) during headers. We conclude that a resistance training focusing on cervical and trunk musculature is practicable in youth soccer, elicits strength gains, and helps to mitigate PLA during purposeful heading. Results should encourage youth strength and conditioning professionals to incorporate neck exercises as a risk reduction strategy into their training routine.