235 research outputs found
Severe historical floods on the river Roda, Thuringia: from reconstruction to implications for flood management
Using the Roda river (Thuringia) as an example, we present methods for and results of historical flood research in Germany. The Roda river is one of the tributaries of the Saale river with a length of approximately 33 km. Although the watershed only covers around 262 kmÂČ, the Roda is very vulnerable to flooding. The river caused damages of catastrophic dimensions within the urban area of Stadtroda (until 1925 âRodaâ). These damages were especially devastating after heavy rainfall events during the late spring and early summer seasons of June 1582, April 1654, June 1827, June 1871 and June 1876. This article discusses how the flood history of the Roda river and human response to the associated natural hazards can be analysed by a combination of archive and field work. By means of the available material (e.g. printed, handwritten and physical sources as well as maps, engravings and historical photos), the history of severe floods was reconstructed for several centuries. This specifically refers to 1) the genesis, magnitude, frequency and length of floods, 2) the extent of damages and losses, 3) the risk perception and evaluation by municipal and national administrations and 4) the planning and implementation of protective measures and their impacts. Interestingly, the analysis of the disastrous floods of 1871 and 1876 shows striking similarities to the current discussion (e.g. regarding the influence of land use changes). Furthermore, the combined historical accounts are an important basis for the derivation of future flood risk assessments for the Roda river. Going beyond the specific basin of the Roda, the findings also reveal important insights regarding the impacts of increases in heavy regionalized rainfall for small watersheds, which is predicted to occur more frequently in such watersheds in the state of Thuringia
Analyse aktueller Einflussfaktoren und Motive im Zusammenhang mit der Entscheidung fĂŒr oder gegen eine Karriere als Facharzt fĂŒr Allgemeinmedizin auf der Basis quantitativer und qualitativer Methoden
Vor dem Hintergrund eines zunehmenden HausĂ€rztemangels in Deutschland und zahlreichen anderen Staaten untersucht die vorliegende Arbeit mit Hilfe quantitativer und qualitativer Methoden aktuelle Einflussfaktoren und Motive im Zusammenhang mit der Entscheidung junger Mediziner fĂŒr oder gegen eine Karriere als Facharzt fĂŒr Allgemeinmedizin. Die Untersuchung kombiniert dabei im Studienverlauf erhobene Daten zur Teilnahme Medizinstudierender an definierten allgemeinmedizinischen Lehrveranstaltungen mit Daten einer spĂ€teren Absolventenbefragung (n = 659). Die Ergebnisse der quantitativen Analysen tragen zur Evidenz hinsichtlich aktueller Einflussfaktoren auf die Berufswahl Allgemeinmedizin bei und unterstĂŒtzen die Annahme, dass ein praxisorientiertes allgemeinmedizinisches Curriculum, sowohl in frĂŒhen als auch in spĂ€ten Stadien des Medizinstudiums, die Nachwuchsgewinnung im Fach befördern kann. Die Ergebnisse der qualitativen Analysen geben einen weitreichenden Ăberblick ĂŒber aktuell ausschlaggebende GrĂŒnde sowohl fĂŒr, als auch gegen eine Karriere als Hausarzt. Implikationen im Hinblick auf die Entwicklung effektiver Strategien gegen die drohende Unterversorgung werden diskutiert
Medical students' expectations towards an implementation of a family medicine textbook as a comprehensive app in Germany
Early community-based family practice elective positively influences medical studentsâ career considerations â a Pre-post-comparison
BACKGROUND: Demographic change and recruitment problems in family practice are increasingly threatening an adequate primary care workforce in many countries. Thus, it is important to attract young physicians to the field. The purpose of the present study was to examine the effect of an early community-based 28-h family practice elective with one-to-one mentoring on medical studentsâ consideration of family practice as a career option, their interest in working office-based, and several perceptions with regard to specific aspects of a family physicianâs work. METHODS: First- and second-year medical students completed questionnaires before and after a short community-based family practice elective, consisting of a preparatory course and a community-based practical experience with one-to-one mentoring by trained family physicians. RESULTS: We found a significantly higher rate of students favoring family practice as a career option after the elective (32.7% vs. 26.0%, p = 0.039). Furthermore, the ranking of family practice among other considered career options improved (p = 0.002). Considerations to work office-based in the future did not change significantly. Perceptions regarding a family physicianâs job changed positively with regard to the possibility of long-term doctor-patient relationships and treatment of complex disease patterns. The majority of the students described identification with the respective family physician tutor as a professional role model and an increased interest in the specialty. CONCLUSIONS: Our results indicate that a short community-based family practice elective early in medical education may positively influence medical studentsâ considerations of a career in family practice. Furthermore, perceptions regarding the specialty with significant impact on its attractiveness may be positively adjusted. Further research is needed to evaluate the influence of different components of a family practice curriculum on the de facto career decisions of young physicians after graduation
Quantum Control of the Hyperfine Spin of a Cs Atom Ensemble
We demonstrate quantum control of a large spin-angular momentum associated
with the F=3 hyperfine ground state of 133Cs. A combination of time dependent
magnetic fields and a static tensor light shift is used to implement
near-optimal controls and map a fiducial state to a broad range of target
states, with yields in the range 0.8-0.9. Squeezed states are produced also by
an adiabatic scheme that is more robust against errors. Universal control
facilitates the encoding and manipulation of qubits and qudits in atomic ground
states, and may lead to improvement of some precision measurements.Comment: 4 pages, 4 figures (color
Reality bites:An analysis of corona deniers in Germany over time
The COVID-19 pandemic resulted in unprecedented government interventions in many people's lives. Opposition to these measures was not only based on policy disagreements but for some founded in an outright denial of basic facts surrounding the pandemic, challenging social cohesion. Conspiracy beliefs have been prolific within various protest groups and require attention, as such attitudes have been shown to be associated with lower rule compliance. Several studies have shown that the characteristics linked to holding COVID-19 conspiracy beliefs are complex and manifold; however, those insights usually rest on cross-sectional studies only. We have less knowledge on whether these cross-sectional correlates also reveal which parts of the population have been newly convinced by conspiracy theories or have dropped their support for them as the pandemic evolved. Using a unique panel data set from Germany, this paper explores a wide range of characteristics and compares the insights gained from cross-sectional associations on the one hand and links to the ways in which people change their views on the other hand. The findings show that cross-sectional analyses miss out on nuanced differences between different groups of temporary and more consistent conspiracy supporters. Specifically, this paper identifies major differences in the profiles of people who have been denying COVID-19 consistently compared to those who changed their minds on the question and those who assessed the reality correctly throughout. In doing so, socio-political and perception-based dimensions are differentiated and distinctions between respondents from East and West Germany explored
Identifying patients with psychosocial problems in general practice: a scoping review protocol
Introduction: Psychosocial problems (PSPs) are common
issues associated with negative health outcomes. Since
general practitioners are the first point of contact for any
health-related
concern, understanding their options to
recognise patients with PSPs plays an important role as it
is essential for early intervention and can prevent serious
conditions. The objective of our scoping review is to map
published evidence on the usage of instruments to identify
patients with PSPs in general practice.
Methods and analysis: We will follow the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses
extension for Scoping Reviews checklist and the
Joanna Briggs Institute Reviewerâs Manual on scoping
reviews. A systematic search of four electronic databases
(Medline (Ovid), Web of Science Core Collection, PsycInfo,
Cochrane Library) will be conducted for quantitative
and qualitative studies published in English, Spanish,
French and German. Main study characteristics as well as
information on identification instruments will be extracted
and visualised in structured tables to map the available
evidence. The protocol has been registered with Open
Science Framework, https://osfio/c2m6z.
Ethics and dissemination: This study does not require
ethical approval as we will not collect personal data.
Dissemination will consist of publications, presentations
and other knowledge translation activities
Global Efforts to Address Severe Acute Malnutrition.
Detailed description on the two formats presented, proBAM (S1A) and proBed (S1B). (XLSX 46ĂÂ kb
The Impact of the COVID-19 Pandemic on Avoidance of Health Care, Symptom Severity, and Mental Well-Being in Patients With Coronary Artery Disease
The COVID-19 pandemic affected regular health care for patients with chronic diseases.
However, the impact of the pandemic on primary care for patients with coronary artery
disease (CAD) who are enrolled in a structured disease management program (DMP) in
Germany is not clear. We investigated whether the pandemic affected primary care and
health outcomes of DMP-CAD patients (n = 750) by using a questionnaire assessing
patientsâ utilization of medical care, CAD symptoms, as well as health behavior and
mental health since March 2020. We found that out of concern about getting infected
with COVID-19, 9.1% of the patients did not consult a medical practitioner despite
having CAD symptoms. Perceived own influence on infection risk was lower and anxiety
was higher in these patients compared to symptomatic CAD patients who consulted
a physician. Among the patients who reported chest pain lasting longer than 30 min,
one third did not consult a medical practitioner subsequently. These patients were
generally more worried about COVID-19. Patients with at least one worsening CAD
symptom (chest pain, dyspnea, perspiration, or nausea without apparent reason) since
the pandemic showed more depressive symptoms, higher anxiety scores, and were less
likely to consult a doctor despite having CAD symptoms out of fear of infection. Our
results provide evidence that the majority of patients received sufficient medical care
during the COVID-19 pandemic in Germany. However, one in ten patients could be
considered particularly at risk for medical undersupply and adverse health outcomes.
The perceived infection risk with COVID-19 might have facilitated the decision not to
consult a medical doctor
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