Determining eligibility for long-term care—lessons from Germany

<strong>Objectives:</strong> This paper addresses recent steps for reforming the eligibility criteria of the German long-term care insurance that have been initiated to overcome shortcomings in the current system.<p><strong>Methods:</strong> Based on findings of a survey of international long-term care systems, assessment tools and the relevant literature on care needs a new tool for determining eligibility in the German long-term care insurance was developed.</p><p><strong>Results: </strong>The new tool for determining long-term care eligibility broadens the understanding of what ‚dependency on nursing care' implies for the person affected. The assessment results in a degree of dependency from personal help provided by formal or informal caregivers. This degree of dependency can be used for determining eligibility for and the amount of long-term care benefits.<strong></strong></p><p><strong>Discussion:</strong> The broader understanding of "dependency on nursing care' and the new tool are important steps to adapt the German long-term care insurance to the challenges of the demographic and societal changes in the future</p

Mapping the Knowledge on Coping Processes in Patients with Pancreatic Cancer

Background: Pancreatic cancer is one of the malignant diseases with the highest cancer-specific mortality. At the time of diagnosis, life expectancy is often already very limited, as it is usually discovered late and in an advanced stage. Coping with cancer is a complex process. Coping strategies of patients with pancreatic cancer probably differ from those of other malignancies. Yet to date, there exists no pancreatic cancer-specific coping model. Objective: The objective of this scoping review is to explore and characterize the academic literature related to coping processes in patients with pancreatic cancer. Methods/Design: The JBI's three-step search strategy, combined with the Arksey and O'Malley framework, will be used to identify articles via PubMed/MEDLINE, CINAHL, Cochrane Library, Google Scholar, CAMbase, CareLit, CC Med, Scopus, and PsycARTICLES (Arksey &amp; O'Malley, 2005; Peters et al., 2017). It follows the PRISMA guidelines for scoping reviews (Tricco et al., 2018). Primary and secondary studies and reviews which report on coping with pancreatic cancer (adenocarcinoma) in adults in English or German language will be included in this scoping review, regardless of publication date or study design. Discussion: This scoping review will add new insights on coping with pancreatic cancer by summarizing current knowledge, and identifying research&nbsp

Occurences of the Scaly Male Fern group in the lower parts of North Rhine-Westphalia

Im Flachland Nordrhein-Westfalens konnten in den letzten Jahren mehrere Vorkommen der montanen Sippe Dryopteris affinis s. l. (Spreuschuppiger Wurmfarn i. w. S.) beobachtet werden. Mögliche Tendenzen einer Arealexpansion der Sippe sowie in Frage kommende Ursachen für diese Ausbreitung wie z. B. ein für Nordrhein-Westfalen prognostizierter Klimawandel werden diskutiert. Des Weiteren werden Bestimmungshilfen für den kritischen Formenkreis Dryopteris affinis s. l. gegeben.The Scaly Male Fern (Dryopteris affinis s.l.), a montane taxon that is most abundant in areas with high humidity, was recently found in the lowlands of North Rhine-Westphalia. This atypical habitat expansion might be, amongst others, a visible result for changing climate in North Rhine-Westphalia. This and other possible explanations are going to be discussed in this study. Furthermore, an identification key for the Dryopteris affinis group is provided

Colocando en evidencia el cuidado de enfermería como práctica social

O objetivo deste estudo foi compreender o significado do cuidado de enfermagem como prática social à luz das interações e associações do pensamento sistêmico-complexo. A metodologia utilizada foi a teoria fundamentada nos dados, com entrevista semiestruturada, realizada com trinta e cinco profissionais da saúde, distribuídos em diferentes grupos amostrais. A codificação e a análise simultânea dos dados possibilitaram a identificação da categoria central: "evidenciando o cuidado de enfermagem como prática social". O cuidado de enfermagem como prática social, orientado pelo pensamento sistêmico-complexo, se constitui em novo paradigma de intervenção, capaz de potencializar as ações locais por meio das redes interativas e associativas, bem como atuar de forma proativa, inovadora e participativa.El objetivo de este estudio fue comprender el significado del cuidado de enfermería como práctica social examinado bajo la perspectiva de las interacciones y asociaciones del pensamiento sistémico complejo. La metodología utilizada fue la teoría fundamentada en los datos, con entrevista semiestructurada, realizada con treinta y cinco profesionales de la salud, distribuidos en diferentes grupos de muestreo. La codificación y el análisis simultáneo de los datos posibilitaron la identificación de la categoría central: "colocando en evidencia el cuidado de enfermería como práctica social". El cuidado de enfermería como práctica social, orientado por el pensamiento sistémico complejo, se constituye en nuevo paradigma de intervención, capaz de potencializar las acciones locales por medio de las redes interactivas y asociativas, así como actuar de forma proactiva, innovadora y participativa.This study aimed to understand the meaning of nursing care as a social practice based on interactions and associations with complex-systemic thinking. Grounded Theory was the methodological framework used and 35 health professionals distributed in different sample groups were interviewed through a semi-structured questionnaire. Simultaneous data codification and analysis permitted the identification of the central category: "Evidencing nursing care as social practice". Nursing care as a social practice based on complex-systemic thinking constitutes a new paradigm of intervention, capable of strengthening social actions through interactive and associative networks, and of acting in a proactive, innovating and participative manner

Electron self-injection threshold for the tandem-pulse laser wakefield accelerator

A controllable injection scheme is key to producing high quality laser-driven electron beams and X-rays. Self-injection is the most straightforward scheme leading to high current and peak energies, but is susceptible to variations in laser parameters and target characteristics. In this work improved control of electron self-injection in the nonlinear cavity regime using two laser-pulses propagating in tandem is investigated. In particular the advantages of the tandem-pulse scheme in terms of injection threshold, electron energy and beam properties in a regime relevant to betatron radiation are demonstrated. Moreover it is shown that the laser power threshold for electron self-injection can be reduced by up to a factor of two compared to the standard, single-pulse wakefield scheme.Comment: 11 pages, 9 figures, submitted for publication (2019

Polarized Proton Beams from Laser-induced Plasmas

We report on the concept of an innovative source to produce polarized proton/deuteron beams of a kinetic energy up to several GeV from a laser-driven plasma accelerator. Spin effects have been implemented into the PIC simulation code VLPL to make theoretical predictions about the behavior of proton spins in laser-induced plasmas. Simulations of spin-polarized targets show that the polarization is conserved during the acceleration process. For the experimental realization, a polarized HCl gas-jet target is under construction using the fundamental wavelength of a Nd:YAG laser system to align the HCl bonds and simultaneously circular polarized light of the fifth harmonic to photo-dissociate, yielding nuclear polarized H atoms. Subsequently, their degree of polarization is measured with a Lamb-shift polarimeter. The final experiments, aiming at the first observation of a polarized particle beam from laser-generated plasmas, will be carried out at the 10 PW laser system SULF at SIOM/Shanghai.Comment: 7 pages, 7 figure

Scaling laws for the (de-)polarization time of relativistic particle beams in strong fields

The acceleration of polarized electrons and protons in strong laser and plasma fields is a very attractive option to obtain polarized beams in the GeV range. We investigate the feasibility of particle acceleration in strong fields without destroying an initial polarization, taking into account all relevant mechanisms that could cause polarization losses, i.e. the spin precession described by the T-BMT equation, the Sokolov-Ternov effect and the Stern-Gerlach force. Scaling laws for the (de-)polarization time caused by these effects reveal that the dominant polarization limiting effect is the rotation of the single particle spins around the local electromagnetic fields. We compare our findings to test-particle simulations for high energetic electrons moving in a homogeneous electric field. For high particle energies the observed depolarization times are in good agreement with the analytically estimated ones.Comment: 17 pages and 4 figure

Segurança do paciente: compreendendo o erro humano na assistência de enfermagem em terapia intensiva

Objective: To analyze the active failures and the latent conditions related to errors in intensive nursing care and to discuss the reactive and proactive measures mentioned by the nursing team. Method: Qualitative, descriptive, exploratory study conducted at the Intensive Care Unit of a general hospital. Data were collected through interviews, participant observation and submitted to lexical analysis in the ALCESTE® software and to ethnographic analysis. Results: 36 professionals of the nursing team participated in the study. The analysis originated three lexical classes: Error in intensive care nursing; Active failures and latent conditions related to errors in the intensive care nursing team; Reactive and proactive measures adopted by the nursing team regarding errors in intensive care. Conclusion: Reactive and proactive measures influenced the safety culture, in particular, the recognition of errors by professionals, contributing to their prevention, safety and quality care

Family Health Strategy in Brazil - Shaping the profile of nursing in primary health care

Hämel K, Backes DS, Giovanella L, Büscher A. Familiengesundheitsstrategie in Brasilien - Profilierung der Pflege in der Primärversorgung. Pflege &amp; Gesellschaft. 2017;22(1):35-50