Wandel im Gesundheitswesen: Analyse der Auswirkungen auf Ärzte und Patienten am Beispiel der Ukraine

Background The health care sector is experiencing a drastic transition all over the world. This has an impact not only on the way hospitals, clinics, special-care homes etc. are organized, but also on patients, personnel and other stakeholders involved. The consequences of changes for both physicians and patients are investigated using a comprehensive health care reform in Ukraine as an example. Methods The analysis is based on empirical data collected from general physicians in 2 Ukrainian cities. Based on the Job Demands-Resources Model, we developed a set of hypotheses and tested them using the structural equation modelling technique. A total of 178 general physicians (81% of the approached population) participated in the study. Results Our investigation reveals a clear relationship between the organizational job demands (additional tasks, structural changes, new processes) and their psychological effects (e. g., burnout). The latter have a negative impact on cooperation of physicians in hospitals leading to lower patient satisfaction. Discussion and Conclusions Change in health care is inevitable. The example of Ukraine shows that openness of hospitals towards change reduces the probability of physicians’ burnout and, eventually, increases patient satisfaction. We strongly suggest applying the process management approach in order to increase openness to change, especially in turbulent times

A Density Functional Study of Atomic Hydrogen and Oxygen Chemisorption on the Relaxed (0001) Surface of Double Hexagonal Close Packed Americium

Ab initio total energy calculations within the framework of density functional theory have been performed for atomic hydrogen and oxygen chemisorption on the (0001) surface of double hexagonal packed americium using a full-potential all-electron linearized augmented plane wave plus local orbitals method. Chemisorption energies were optimized with respect to the distance of the adatom from the relaxed surface for three adsorption sites, namely top, bridge, and hollow hcp sites, the adlayer structure corresponding to coverage of a 0.25 monolayer in all cases. Chemisorption energies were computed at the scalar-relativistic level (no spin-orbit coupling NSOC) and at the fully relativistic level (with spin-orbit coupling SOC). The two-fold bridge adsorption site was found to be the most stable site for O at both the NSOC and SOC theoretical levels with chemisorption energies of 8.204 eV and 8.368 eV respectively, while the three-fold hollow hcp adsorption site was found to be the most stable site for H with chemisorption energies of 3.136 eV at the NSOC level and 3.217 eV at the SOC level. The respective distances of the H and O adatoms from the surface were found to be 1.196 Ang. and 1.164 Ang. Overall our calculations indicate that chemisorption energies in cases with SOC are slightly more stable than the cases with NSOC in the 0.049-0.238 eV range. The work functions and net magnetic moments respectively increased and decreased in all cases compared with the corresponding quantities of bare dhcp Am (0001) surface. The partial charges inside the muffin-tins, difference charge density distributions, and the local density of states have been used to analyze the Am-adatom bond interactions in detail. The implications of chemisorption on Am 5f electron localization-delocalization are also discussed.Comment: 9 Tables, 5 figure

Nurturing Community-School Relationships Using Art And The Environment To Create Spaces Of Care

This dissertation aims to shift Nel Noddings’ ethic of care from theory to practice. Frustration was selected for the emotion and art was chosen for a communication platform for the purposes of this research. Neil Harrington’s Frustration Discomfort Scale (FDS) survey was used to gauge root causes of frustration intolerance. The focus group, art session, and interview questions were selected to gain qualitative data of adolescent frustration intolerance for the FDS results. Six seventh graders participated in the entire study which included participating in a focus group, one art-making session or interview, a 24-hour observation, and a 7-day follow-up journaling experience. A research journal was also completed for reflection and to help form the subjective I statement. There were three findings presented in the research. First, the study indicated that FDS results can align and help explain adolescent behavior. Secondly, art and other environmental conditions provided social and emotional affordances to adolescents. Third, community organizations can inform how schools can integrate social and emotional skills into educational culture. Based on the data analysis, the first recommendation of this study is that school- community relationships and purposes be more integrated. The second recommendation is that the FDS survey should be implemented in middle school advisory programs

Assessment of Groundwater Quality and its Suitability for Domestic and Agricultural Purposes in parts of the Central Region, Ghana

Groundwater in parts of the Central Region of Ghana was assessed to determine its suitability for domestic use and irrigation activities. Stiff and Piper diagrams show that the predominant water type in the area is Na-Cl, which is characterized by relatively high salinities. This water type occurs in aquifers underlying six coastal districts, namely; Abura-Asebu-Kwamankese (AA), Mfantseman (MF), Gomoa East (GE), Awutu Senya (AwS), Effutu (EF) and Cape Coast (CC). Other water types are Ca-HCO3, Ca-SO4 and Ca-Cl, that occur in districts located further away from the coast. Silicate weathering and ion exchange are identified as the geochemical processes responsible for the various ions in the groundwater. Possible processes that could be responsible for the source of Na+ and Cl- are sea water intrusion and dissolution of minerals. The results also show that the groundwater is mainly supersaturated with respect to both calcite and gypsum, indicating high concentrations of both bicarbonate and sulfate ions in solution. This is associated with considerable enrichment of the groundwater with sulfate, bicarbonate, and calcium ions. On a Wilcox diagram, the groundwater samples, mainly from the districts coded as AA, TLD, AS and AN, which are located away from the coast, plot within the “excellent to good” category, suggesting that water from the area is of acceptable quality for irrigation purposes. Similarly, Sodium Adsorption Ratio (SAR) and conductivity values for the groundwater in the AA, TLD, AS and AN districts indicate low SAR and low to medium salinity respectively. Groundwater in aquifers underlying these districts is therefore suitable for irrigation. Generally, groundwater samples from locations along the coast have high salinity and are not suitable for domestic and irrigation purposes. However, about 72% of the water samples predominantly in districts located away from the sea is suitable for the purposes stated

Adsorption and dissociation of molecular oxygen on the (0001) surface of double hexagonal close packed americium

In our continuing attempts to understand theoretically various surface properties such as corrosion and potential catalytic activity of actinide surfaces in the presence of environmental gases, we report here the first ab initio study of molecular adsorption on the double hexagonal packed (dhcp) americium (0001) surface. Dissociative adsorption is found to be energetically more favorable compared to molecular adsorption. The most stable configuration corresponds to a horizontal approach molecular dissociation with the oxygen atoms occupying neighboring h3 sites, with chemisorption energies at the NSOC and SOC theoretical levels being 9.395 eV and 9.886 eV, respectively. The corresponding distances of the oxygen molecule from the surface and oxygen-oxygen distance were found to be 0.953 Ang. and 3.731 Ang., respectively. Overall our calculations indicate that chemisorption energies in cases with SOC are slightly more stable than the cases with NSOC in the 0.089-0.493 eV range. The work functions and net magnetic moments respectively increased and decreased in all cases compared with the corresponding quantities of the bare dhcp Am (0001) surface. The adsorbate-substrate interactions have been analyzed in detail using the partial charges inside the muffin-tin spheres, difference charge density distributions, and the local density of states. The effects, if any, of chemisorption on the Am 5f electron localization-delocalization characteristics in the vicinity of the Fermi level are also discussed.Comment: 6 tables, 10 figure

Density functional study of the actinide nitrides

The full potential all electron linearized augmented plane wave plus local orbitals (FP-LAPW + lo) method, as implemented in the suite of software WIEN2K, has been used to systematically investigate the structural, electronic, and magnetic properties of the actinide compounds AnN (An = Ac, Th, Pa, U, Np, Pu, Am). The theoretical formalism used is the generalized gradient approximation to density functional theory (GGA-DFT) with the Perdew-Burke-Ernzerhof (PBE) exchange-correlation functional. Each compound has been studied at six levels of theory: non-magnetic (NM), non-magnetic with spin-orbit coupling (NM+SOC), ferromagnetic (FM), ferromagnetic with spin-orbit coupling (FM+SOC), anti-ferromagnetic (AFM), and anti-ferromagnetic with spin-orbit coupling (AFM+SOC). The structural parameters, bulk moduli, densities of states, and charge distributions have been computed and compared to available experimental data and other theoretical calculations published in the literature. The total energy calculations indicate that the lowest energy structures of AcN, ThN, and PaN are degenerate at the NM+SOC, FM+SOC, and AFM+SOC levels of theory with vanishing total magnetic moments in the FM+SOC and AFM+SOC cases, making the ground states essentially non-magnetic with spin-orbit interaction. The ground states of UN, NpN, PuN, and AmN are found to be FM+SOC at the level of theory used in the present computations. The nature of the interactions between the actinide metals and nitrogen atom, and the implications on 5f electron delocalization and localization are discussed in detail.Comment: 5 tables, 12 figure

Plant community diversity in the Chobe Enclave, Botswana: Insights for functional habitat heterogeneity for herbivores

Precise vegetation descriptions and maps are essential tools for the management of natural areas, as well as for understanding animal habitat use. The Chobe Enclave (CE), adjacent to the Chobe National Park and the Chobe Forest Reserve, forms a critical dry season range for many large herbivores. As a tool for future management and studies about wildlife habitat use and migration, this study proposed to describe the plant communities in the CE and to study their relationships with microtopography and soils. Plant species were inventoried in 82 sampling plots (40 x 20 m), covering the vegetation diversity recognised by an unsupervised classification (Landsat images, 30-m resolution). A hierarchical clustering classified the inventories in eight plant communities, mapped with a supervised classification. This study was conducted in parallel with a soil study. Soil variations and degree of flooding largely determine community composition. Floodplains along the Linyanti River and dambos (concentrating local run off from rainfall) provide reliable green forage for wildlife during the dry season. Adjacent to floodplains, riverine forests also maintain green browse and grazing well into the dry season. In drylands, vegetation is largely determined by soil texture. Forests dominated by Baikiaea plurijuga occupy the acidic, red sands in the east, while sandveld vegetation grows on deep sands in paleo-river channels. These habitats support dominant grasses, which provide important forage for grazers during the wet season. Finally, woodlands dominated by Colophospermum mopane, characterised by sodium-rich and alkaline soils, enable herbivores to meet their mineral requirements during reproduction. Conservation implications: Our soil and vegetation studies provide important insights into factors determining plant communities. Their diversity and close vicinity play a critical role in enabling herbivores to adapt to seasonal variations in forage quantity and quality. Results will enable researchers to gain insights into animal habitat seasonal use in the Chobe Enclave

Inclusion of Experimental Information in First Principles Modeling of Materials

We propose a novel approach to model amorphous materials using a first principles density functional method while simultaneously enforcing agreement with selected experimental data. We illustrate our method with applications to amorphous silicon and glassy GeSe$_2$. The structural, vibrational and electronic properties of the models are found to be in agreement with experimental results. The method is general and can be extended to other complex materials.Comment: 11 pages, 8 PostScript figures, submitted to J. Phys.: Condens. Matter in honor of Mike Thorpe's 60th birthda

First-principles simulations of vibrational decay and lifetimes in a -Si:H and a-Si:D

Phonon lifetime in materials is an important observable that conveys basic information about structure, dynamics, and anharmonicity. Recent vibrational transient-grating measurements, using picosecond infrared pulses from free-electron lasers, have demonstrated that the vibrational-population decay rates of localized high-frequency stretching modes (HSMs) in hydrogenated and deuterated amorphous silicon (a-Si:H/D) increase with temperature and the vibrational energy redistributes among the bending modes of Si in a-Si:H/D. Motivated by this observation, we address the problem from first-principles density-functional calculations and study the time evolution of the vibrational-population decay in a-Si:H/D, the average decay times, and the possible decay channels for the redistribution of vibrational energy. The average lifetimes of the localized HSMs in a-Si:H and a-Si:D are found to be approximately 51-92 ps and 50-78 ps, respectively, in the temperature range of 25-200 K, which are consistent with experimental data. A weak temperature dependence of the vibrational-population decay rates has been observed via a slight increase of the decay rates with temperature, which can be attributed to stimulated emission and increased anharmonic coupling between the normal modes at high temperature.The work is partially supported by the U.S. National Science Foundation under Grants No. DMR 1570166, No. DMR 1570118, and No. DMR 1506836. We acknowledge the use of computing resources at the Texas Advanced Computing Center and Ohio Supercomputer Center