Гносеологическая прозрачность терминов-аббревиатур в различных дискурсивных практиках (на материале сферы «Вспомогательные репродуктивные технологии»)

В статье рассматривается изменение уровня гносеологической прозрачности семантики терминов-аббревиатур, номинирующих процедуры отрасли «Вспомогательные репродуктивные технологии», при их функционировании в различных видах дискурса (научный медицинский и сетевой популярно-медицинский)

On death and dying – an exploratory and evaluative study of a reflective, interdisciplinary course element in undergraduate anatomy teaching

BACKGROUND: Teaching in palliative care aims not only at providing students with specialized knowledge in symptom therapy in advanced disease, but also at developing a professional attitude consistent with the principles and philosophy of palliative care. Reflecting about one’s own or the patient’s death and dying is considered essential for empathic patient care. In medical education the dissection course is often the first encounter with the issue of death and dying and represents a significant emotional challenge to many medical students. Against this background we implemented a new course element in preparation for the dissection course, offering opportunity to reflect own experiences with death and dying and providing support in finding a balance between authentic empathy and pragmatic action towards deceased persons. We discuss issues such as dignity and professional distance and reason whether guided support for medical students regarding these issues might influence their future attitude as doctors caring for their patients. METHODS: In tandem, we performed a formal evaluation of the seminar and explored the students’ experiences with death and dying, their expectations and fears in the run-up to the dissection course and their attitude towards dissection. RESULTS: This article describes the structure and the concept of this new interdisciplinary course element and presents the results of the formal course evaluation as well as the explorative part of the accompanying research. Medical students had broad experiences with death and dying even before the dissection course. 89.1% of students had worried about some kind of emotional stress during the dissection course before, but 61.7% stated to have actually perceived emotional stress afterwards. The willingness to donate one's own body for anatomy purposes decreased significantly during the course. The given room for reflection and discussion was appreciated by the students, who felt that the effects of this seminar might be of use even beyond the dissection course. CONCLUSION: This new course element successfully assisted medical students during the dissection room experience and gave opportunity to reflection and discussion on death and dying. The accompanying research confirmed the demand for support and gave insight into experiences, emotions and attitudes of medical students

Adaptation of the Australian Palliative Care Phase concept to the German palliative care context: a mixed-methods approach using cognitive interviews and cross-sectional data

BACKGROUND Palliative care phases (stable, unstable, deteriorating, terminal and bereavement) are routinely used in Australia and the UK to describe the clinical situation of patients and their families and to evaluate the associated care plan. In addition, it serves as a benchmark developed by the Australian Palliative Care Outcome Collaboration (PCOC) and is used nationwide for comparisons between services. In Germany, the concept is not used consistently due to various translations. Furthermore, there is no nationwide systematic approach to routinely assess clinical outcomes in palliative care. The study aims to develop a German version of the palliative care phase definitions by adapting them culturally, and to examine the inter-rater reliability of the adjusted definitions with healthcare professionals. METHODS Mixed-methods approach: Cognitive interview study using 'think aloud' and verbal probing techniques and a consecutive multi-center cross-sectional study with two clinicians independently assigning the phase definitions. Interviewees/participants were selected through convenience and purposive sampling in specialist palliative care inpatient units, advisory and community services and in three specialist palliative care units with doctors, nursing staff and allied health professionals. RESULTS Fifteen interviews were conducted. Identified difficulties were: Some translated terms were 1) not self-explanatory (e.g. 'family/carer' or 'care plan') and (2) too limited to the medical dimension neglecting the holistic approach of palliative care. (3) Problems of comprehension regarding the concept in general occurred, e.g. in differentiating between the 'unstable' and 'deteriorating' phase. Inter-rater reliability was moderate (kappa = 0.44; 95% CI = 0.39-0.52). The assignment of the phase 'deteriorating' has caused the most difficulties. CONCLUSION Overall, the adapted palliative care phases are suitable to use in the German specialist palliative care setting. However, the concept of the phases is not self-explanatory. To implement it nationwide for outcome measurement/benchmarking, it requires further education, on-the-job training and experience as well as the involvement of healthcare professionals in implementation process. For the use of international concepts in different healthcare systems, a deeper discussion and cultural adaptation is necessary besides the formal translation

COMPANION: development of a patient-centred complexity and casemix classification for adult palliative care patients based on needs and resource use – a protocol for a cross-sectional multi-centre study

BACKGROUND: A casemix classification based on patients’ needs can serve to better describe the patient group in palliative care and thus help to develop adequate future care structures and enable national benchmarking and quality control. However, in Germany, there is no such an evidence-based system to differentiate the complexity of patients’ needs in palliative care. Therefore, the study aims to develop a patient-oriented, nationally applicable complexity and casemix classification for adult palliative care patients in Germany. METHODS: COMPANION is a mixed-methods study with data derived from three subprojects. Subproject 1: Prospective, cross-sectional multi-centre study collecting data on patients’ needs which reflect the complexity of the respective patient situation, as well as data on resources that are required to meet these needs in specialist palliative care units, palliative care advisory teams, and specialist palliative home care. Subproject 2: Qualitative study including the development of a literature-based preliminary list of characteristics, expert interviews, and a focus group to develop a taxonomy for specialist palliative care models. Subproject 3: Multi-centre costing study based on resource data from subproject 1 and data of study centres. Data and results from the three subprojects will inform each other and form the basis for the development of the casemix classification. Ultimately, the casemix classification will be developed by applying Classification and Regression Tree (CART) analyses using patient and complexity data from subproject 1 and patient-related cost data from subproject 3. DISCUSSION: This is the first multi-centre costing study that integrates the structure and process characteristics of different palliative care settings in Germany with individual patient care. The mixed methods design and variety of included data allow for the development of a casemix classification that reflect on the complexity of the research subject. The consecutive inclusion of all patients cared for in participating study centres within the time of data collection allows for a comprehensive description of palliative care patients and their needs. A limiting factor is that data will be collected at least partly during the COVID-19 pandemic and potential impact of the pandemic on health care and the research topic cannot be excluded. TRIAL REGISTRATION: German Register for Clinical Studies trial registration number: DRKS00020517

Implementing the cross-disciplinary subject of palliative medicine (Q13) against the backdrop of recent changes of the legal framework using University Medical School Göttingen as an example

Palliative care for patients with advanced and progressive diseases has recently become an integrated and compulsory part of undergraduate training in Germany. Up until now, undergraduate teaching in this cross-disciplinary medical field varied and therefore problems during the implementation process with regard to formal aspects and teaching content are to be expected

Использование ископаемых углей при производстве ферросилиция

Рассматривается возможность использования ископаемых углей в качестве компонентов восстановительных смесей при производстве ферросилиция

Оценка воздействия на атмосферный воздух деятельности компрессорной станции

Объектом исследования является поступление в атмосферный воздух выбросов от источников компрессорной станции "Вертикос", расположенной в Каргасокском районе Томской области. Цель работы – оценить загрязнение атмосферы выбросами компрессорной станции. В процессе исследования изучены стандарты Газпрома, методики расчетов выбросов загрязняющих веществ при эксплуатации компрессорной станции. В результате исследования получены значения массовых выбросов загрязняющих веществ, которые можно использовать при разработке нормативов выбросов из источников станции.The object of the research is the release of atmospheric emissions from sources of the “Verticos” compressor station located in the Kargasoksky district of the Tomsk region. The purpose of the work is to estimate the pollution of the atmosphere by the emissions from the compressor station. In the process of the research, Gazprom standards, methods for calculating pollutant emissions during the operation of the compressor station were studied. As a result of the research, the values of mass emissions of pollutants that can be used for the development of emission standards from station sources have been obtained

Создание Web-сайта предприятия

В современном мире постоянно развивающихся технологий для каждой компании как никогда важна автоматизация бизнес-процессов, позволяющая выйти на более высокий уровень. На сегодняшний день осталось немного мест на нашей планете, где люди не могут выйти в Интернет. Всемирная паутина настолько охватила мир, что пользователи зачастую чувствуют себя беспомощными без той информации, которую она может дать. Реклама в печатных изданиях не способна в полной мере осветить деятельность фирмы, информация в рекламных буклетах и брошюрах быстро теряет актуальность. Именно поэтому все больше предприятий идут на создание качественного сайта с целью более эффективной реализации своей продукции или услуг. Цель данного проекта – повышение качества услуг, предоставляемых предприятием за счет разработки интерактивного Web-сайта. При создании хорошо спланированного, интерактивного информационного сайта, приходится применять не только технологические знания, но и аналитические, что позволяет более полно раскрыть специфику специальности «прикладная информатика в экономике». Работа над проектом, целью которого является разработка Web-сайта, начинается с определения концепции ресурса. Интерфейс и конкретное наполнение (контент) сайта зависят от целого ряда факторов, главными среди них являются объем и состав задач, которые планируется решать с помощью данного сайта, а также его целевая аудитория. В заключении сделаны выводы по проекту, определены пути его внедрения на объекте и направления дальнейшего совершенствования.In today's world of evolving technologies for each company are more important than ever to automate business processes, allowing to reach a higher level. To date, there are few places on our planet where people can't get online. The world wide web so swept the world that users often feel helpless without the information that it can give. Advertising in printed publications is not able to fully cover the activities of the company, the information in the brochures and pamphlets are quickly losing relevance. That is why more and more companies are going to create a quality website to more effectively market their products or services. The purpose of this project is to improve the quality of services provided by the company through the development of an interactive Web site. When you create a well-planned, interactive information website, it is necessary to apply not only technical knowledge, but also analytical, which allows to better reveal the specifics of the specialty "applied Informatics in Economics". Work on the project, whose goal is the development of a Web site begins with the definition of the concept resource. Interface and specific content (content) of the site depend on a number of factors, chief among these are the volume and composition of tasks that will be solved with the help of this website and its target audience. In conclusion, the findings of that project, identifies ways of its implementation at the facility and areas for further improvement