672 research outputs found

    Transfer von Methoden der Aktionsforschung für urbane Mobilitätslabore am Beispiel von Mobilitätsexpeditionen

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    Zwischen dem Stand der Forschung und der Praxis urbaner Mobilität ist eine deutliche Umsetzungslücke erkennbar, die Urbane Mobilitätslabore überbrücken wollen. Ziel ist es, Innovationen zu forcieren und sie in den Alltag der Menschen zu intergrieren. Urbane Mobilitätslabore erfordern dabei ein umfangreiches Methodenset aus Analyse, Kommunikation und Visualisierung, um die Bedürfnisse der Menschen zu verstehen, Innovationen in Testsituationen umzusetzen und zu vermitteln (vgl. Berger et. al. 2016b). Die urbanen Mobilitätslabore bauen größtenteils auf dem Konzept des Reallabors auf. Reallabore wiederrum können als Fortsetzung der bereits verbreiteten Aktionsforschung gesehen werden, welche auf einem experimentellen Setting in einer iterativen Abfolge von Handlung, Reflexion und Planung fußt (vgl. Parodi et.al. 2016). Im Rahmen der Sondierung1 der UMLs wurden Methoden der Aktionsforschung für den Bereich der Mobilitätsforschung adaptiert und deren Anwendbarkeit im Kontext der Mobilitätslabore getestet. So wurden beispielsweise Mobilitätsexpeditionen als reflektierte Auseinandersetzung mit der lokalen Situation realisiert. Im Rahmen der Publikation soll aufgezeigt werden, ob und wie sich diese Methoden der Aktionsforschung im Rahmen von UML-Prozessen bewähren. Hierzu werden zuerst die Methoden in ihrer Vorbereitung, Realisierung und Auswertung sturkturiert beschrieben. In einem zweiten Schritt werden die Anwendungsbeispiele gegenübergestellt und verglichen. Hierauf aufbauend können Verbesserungsansätze für den Einsatz der Methoden für die Zwecke der UML’s formuliert werden

    Crew resource management training in healthcare: a systematic review of intervention design, training conditions and evaluation

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    Objectives Crew resource management (CRM) training formats have become a popular method to increase patient safety by consideration of the role that human factors play in healthcare delivery. The purposes of this review were to identify what is subsumed under the label of CRM in a healthcare context and to determine how such training is delivered and evaluated. Design Systematic review of published literature. Data sources PubMed, PsycINFO and ERIC were searched through 8 October 2018. Eligibility criteria for selecting studies Individually constructed interventions for healthcare staff that were labelled as CRM training, or described as based on CRM principles or on aviation-derived human factors training. Only studies reporting both an intervention and results were included. Data extraction and synthesis The studies were examined and coded for relevant passages. Characteristics regarding intervention design, training conditions and evaluation methods were analysed and summarised both qualitatively and quantitatively. Results Sixty-one interventions were included. 48% did not explain any keyword of their CRM intervention to a reproducible detail. Operating room teams and surgery, emergency medicine, intensive care unit staff and anaesthesiology came in contact most with a majority of the CRM interventions delivered in a 1-day or half-day format. Trainer qualification is reported seldomly. Evaluation methods and levels display strong variation. Conclusions Critical topics were identified for the CRM training community and include the following: the need to agree on common terms and definitions for CRM in healthcare, standards of good practice for reporting CRM interventions and their effects, as well as the need for more research to establish non-educational criteria for success in the implementation of CRM in healthcare organisations

    Deep Brain Stimulation in KMT2B-Related Dystonia: Case Report and Review of the Literature With Special Emphasis on Dysarthria and Speech

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    Objective: KMT2B-related dystonia is a progressive childhood-onset movement disorder, evolving from lower-limb focal dystonia into generalized dystonia. With increasing age, children frequently show prominent laryngeal or facial dystonia manifesting in dysarthria. Bilateral deep brain stimulation of the globus pallidus internus (GPi-DBS) is reported to be an efficient therapeutic option. Especially improvement of dystonia and regaining of independent mobility is commonly described, but detailed information about the impact of GPi-DBS on dysarthria and speech is scarce. Methods: We report the 16-months outcome after bilateral GPi-DBS in an 8-year-old child with KMT2B-related dystonia caused by a de-novo c.3043C>T (p.Arg1015*) non-sense variant with special emphasis on dysarthria and speech. We compare the outcome of our patient with 59 patients identified through a PubMed literature search. Results: A remarkable improvement of voice, articulation, respiration and prosodic characteristics was seen 16 months after GPi-DBS. The patients' speech intelligibility improved. His speech became much more comprehensible not only for his parents, but also for others. Furthermore, his vocabulary and the possibility to express his feelings and wants expanded considerably. Conclusion: A positive outcome of GPi-DBS on speech and dysarthria is rarely described in the literature. This might be due to disease progression, non-effectiveness of DBS or due to inadvertent spreading of the electrical current to the corticobulbar tract causing stimulation induced dysarthria. This highlights the importance of optimal lead placement, the possibility of horizontal steering of the electrical field by applying directional stimulation with segmented leads as well as the use of the lowest possible effective stimulation intensity

    Revisiting afro-alpine Lake Garba Guracha in the Bale Mountains of Ethiopia:Rationale, chronology, geochemistry, and paleoenvironmental implications

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    Abstract: Previous paleolimnological studies demonstrated that the sediments of Garba Guracha, situated at 3950 m asl in the afro-alpine zone of the Bale Mountains of Ethiopia, provide a complete Late Glacial and Holocene paleoclimate and environmental archive. We revisited Garba Guracha in order to retrieve new sediment cores and to apply new environmental proxies, e.g. charcoal, diatoms, biomarkers, and stable isotopes. Our chronology is established using 210Pb dating and radiocarbon dating of bulk sedimentary organic matter, bulk n-alkanes, and charcoal. Although bedrock was not reached during coring, basal ages confirm that sedimentation started at the earliest ~ 16 cal kyr BP. The absence of a systematic age offset for the n-alkanes suggests that “pre-aging” is not a prominent issue in this lake, which is characterised by a very small afro-alpine catchment. X-ray fluorescence scans and total organic carbon contents show a prominent transition from minerogenic to organic-rich sediments around 11 cal kyr BP coinciding with the Holocene onset. While an unambiguous terrestrial versus aquatic source identification seems challenging, the n-alkane-based Paq proxy, TOC/N ratios, δ13C values, and the sugar biomarker patterns suggest a predominantly autochthonous organic matter source. Supraregional climate events, such as the African Humid Period, the Younger Dryas (YD), a 6.5 cal kyr BP short drying event, and the 4.2 cal kyr BP transition to overall drier climate are recorded in our archive. The Garba Guracha record suggests that northern hemisphere forcings played a role in the Eastern African highland paleoclimate

    Rapid fabrication and interface structure of highly faceted epitaxial Ni-Au solid solution nanoparticles on sapphire

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    Supersaturated Ni-Au solid solution particles were synthesized by rapid solid-state dewetting of bilayer thin films deposited onto c-plane sapphire single-crystals. Rapid thermal annealing above the miscibility gap of the Ni-Au system followed by quenching to room temperature resulted in textured and faceted submicron-sized particles as a function of alloying content in the range of 0-28 at% Au. Morphologically, the observed kinetic crystal shapes are confined by close-packed planes; in addition, high-index facets are identified as a function of alloying content by TEM cross-sectioning and equilibrium crystal shape simulations. All samples exhibit a distinct out-of-plane as well as in-plane texture along densely packed directions. Lattice parameters extracted from independent orthogonal X-ray and electron diffraction techniques prove the formation of a solid solution without tetragonal distortion imposed by the sapphire substrate. At the particle-substrate interface of highly alloyed particles segregation of Au atoms as well as dislocations in stand-off position are found. These observations are in-line with a semi-coherent interface, where Au segregation is triggered by the reduction of the overall strain energy due to: (i) a lower shear modulus on the particle side of the interface, (ii) the shifting of misfit dislocations in stand-off position further away from the stiffer substrate and (iii) a reduction of intrinsic misfit dislocation strain energy on the tensile side. In addition, the mechanical properties of pure and alloyed particles were characterized by in situ compression experiments in the SEM. Typical force-displacement data of defect-free single-crystals were obtained, reaching the theoretical strength of Ni for particles smaller than 400 nm. Alloying changes the mechanical response from an intermittent and discrete plastic flow behavior into a homogeneous deformation regime at large compressive strain

    Dopant clustering, electronic inhomogeneity, and vortex pinning in iron-based superconductors

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    We use scanning tunneling microscopy to map the surface structure, nanoscale electronic inhomogeneity, and vitreous vortex phase in the hole-doped superconductor Sr0.75K0.25Fe2As2 with Tc=32 K. We find that the low-T cleaved surface is dominated by a half Sr/K termination with 1×2 ordering and ubiquitous superconducting gap, while patches of gapless, unreconstructed As termination appear rarely. The superconducting gap varies by σ/Δ¯=16% on a ∼3 nm length scale, with average 2Δ¯/kBTc=3.6 in the weak-coupling limit. The vortex core size provides a measure of the superconducting coherence length ξ=2.3 nm. We quantify the vortex lattice correlation length at 9 T in comparison to several iron-based superconductors. The comparison leads us to suggest the importance of dopant size mismatch as a cause of dopant clustering, electronic inhomogeneity, and strong vortex pinning.Physic

    Impact of bedside percutaneous dilational and open surgical tracheostomy on intracranial pressure, pulmonary gas exchange, and hemodynamics in neurocritical care patients

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    Aim was to compare the impact of bedside percutaneous dilational tracheostomy (PDT) and open surgical technique (ST) on intracranial pressure (ICP), pulmonary gas exchange and hemodynamics. We retrospectively analyzed data of 92 neurocritical care patients with invasive ICP monitoring during either PDT (43 patients) or ST (49 patients). Peak ICP levels were higher during PDT (22 [17-38] mm Hg vs 19 [13-27] mm Hg, P=.029). Mean oxygen saturation (SpO(2)) and end-tidal carbon dioxide partial pressure (etCO(2)) did not differ. Episodes with relevant desaturation (SpO(2)50mm Hg) occurred rarely (5/49 during ST vs 3/43 during PDT for SpO(2)<90%; 2/49 during ST vs 5/43 during PDT for hypercapnia). Drops in mean arterial pressure (MAP) below 60mm Hg were seen more often during PDT (8/43 vs 2/49, P=. 026). Mean infusion rate of norepinephrine did not differ (0.52mg/h during ST vs 0.45mg/h during PDT). No fatal complications were observed. Tracheostomy can be performed as ST and PDT safely in neurocritical care patients. The impact on ICP, pulmonary gas exchange and hemodynamics remains within an unproblematic range

    Transmission control of schistosomiasis mansoni in a low endemicity area through a single intervention with rigorous prospection of infected cases treated with praziquantel: evaluation after 7 years of intervention

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    A prospective cohort study with rigorous searching for schistosomiasis cases was conducted among residents of Pedra Preta, Montes Claros, Minas Gerais State, Brazil, seven years after an intervention. Kato-Katz (KK), Saline Gradient, Miracidia Hatch and Polymerase Chain Reaction (PCR) were used as the diagnostic methods in 2008. In the period of 2013-2016, 175 patients remaining in the area were examined using the diagnostic methods Kato-Katz (24 slides, 1 g of feces) and Saline Gradient (2 procedures, 1 g of feces). Sixty-eight out of the 69 infected and treated individuals in 2008 tested negative. The percentage of new cases was 2.29% (4/175), and the 4 infected individuals presented low parasitic load [1, 6, 7 and 19 eggs per gram (EPG)]. All the participants answered epidemiological questionnaires on risky behavior. All residences had pit latrines and domiciliary water supply. The primary transmission focus (lake) was dry for several months. Malacological surveys showed a few non-infected specimens of Biomphalaria glabrata. A clear dominance of Biomphalaria straminea was observed. It can be inferred that a significant decrease in the disease transmission occurred after a single action through an intense search for infected and treated cases under the ecoepidemiological conditions of this area
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