The International Classification of Functioning, Disability and Health (ICF) in nursing: Persons with spinal-cord injury as an example

The core aim of nursing practice is to improve or maintain the person’s well-being and quality of life. The use of standardized classifications and terminologies can contribute to this aim by facilitating intra- and inter-professional communication. Therefore, it is important to explore approaches that enhance common use of the current standard classifications of all health-care professions. The overall objective of this doctoral thesis was to investigate whether the International Classification of Functioning, Disability and Health (ICF) is a practicable and useful classification for nurses - using spinal-cord injury (SCI) nursing as an example. This doctoral thesis comprises the research, results and conclusions of two original studies published in the nursing journal “Journal of Advanced Nursing” first authored by the doctoral candidate. The objective of the first study was to identify the conceptual and practical relationships between the inter-professional ICF and the nursing-specific NANDA-I Taxonomy II for nursing diagnoses. The specific research questions were: (1) What are the commonalities and differences between the conceptional frameworks and assessment principles of the ICF and the NANDA-I Taxonomy II? and (2) Can the two classifications serve as a combined approach in SCI nursing practice? The discussion of the conceptual and practical relationships between the ICF and the NANDA-I Taxonomy II is based on (1) the most recently published descriptions of both classifications and (2) the illustration of a SCI-specific case example presenting the combined use of both classifications. The objective of the second study was to analyse the extent to which the intervention goals of nurses when caring for persons with SCI can be expressed in the standardized language of the ICF. The specific research questions were: (1) Which problems, resources and aspects of the environment of persons with SCI relevant to nurses can be translated into the ICF language? and (2) Which problems, resources and aspects of the environment relevant to nurses are still missing in the ICF? The method used to answer these questions was a worldwide Delphi Survey with SCI nurses. The results of this doctoral thesis shed light on the use of the ICF in nursing practice. First, I discuss the commonalities and differences between the ICF and the NANDA-I Taxonomy II that should be taken into account when implementing both 10 classifications in nursing practice. Important clinical requirements that are exclusive to nursing can be met with the NANDA-I Taxonomy II. The application of the ICF helps nurses communicate abbreviated nursing issues with other health professionals in a common language. A combined application of the ICF and the NANDA-I Taxonomy II is valuable, and they can complement each other to enhance the quality of clinical teamwork and nursing practice. Second, I provide a list of patients’ problems, patients’ resources or aspects of their environment treated by SCI nurses that might be introduced in nursing practice for a comprehensive standardized documentation and for a better exchange of information in a common language with other health professionals. Third, I show the strengths and weaknesses of the ICF when used in nursing care specific to SCI and provide evidence for the update and future revisions of the ICF. For example, I propose to add two qualifiers, one for “Risk for” and one for “Resource for” to the existing qualifier scale. Several recommendations for future research are based on the results of this doctoral thesis. First, there is a need to continue exploring the simultaneous use of the ICF and NANDA-I Taxonomy II. A complete linking of both classifications could reveal their commonalities and differences in a more detailed way and identify all missing elements in the ICF for nursing purposes. Second, the list of patients’ problems, patients’ resources or aspects of their environment treated by SCI nurses should be validated in different nursing settings (e.g. acute hospital care, rehabilitative care and community care). This list should also be compared with the existing Comprehensive ICF Core Sets for SCI in the early post-acute context and long-term context. Third, the personal factors identified should be taken into account when developing the ICF component Personal Factors.Das Wohlbefinden und die Lebensqualität eines Menschen zu verbessern oder zu erhalten ist das Kernziel der Pflegepraxis. Zu diesem Ziel kann der Einsatz von standardisierten Klassifikationen und Terminologien beitragen, indem diese die intra - und interprofessionelle Kommunikation erleichtern. Deshalb ist es sinnvoll, Ansätze zu untersuchen, die die gemeinsame Nutzung von standardisierten Klassifikationen der Gesundheitsfachberufe unterstützen. Das übergeordnete Ziel dieser Dissertation war zu untersuchen, inwieweit die Internationale Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF) eine praktikable und nützliche Klassifikation für Pflegende darstellt - exemplarisch gezeigt anhand der Pflege von Personen mit Rückenmarksverletzung. Diese Dissertation umfasst die Untersuchungen, Ergebnisse und Schlussfolgerungen von zwei Studien, die von der Doktorandin als Erstautorin in der Pflegefachzeitschrift “Journal of Advanced Nursing” veröffentlicht wurden. Das Ziel der ersten Studie war die konzeptionellen und praxisrelevanten Beziehungen der interprofessionellen ICF und der pflegespezifischen NANDA-I Taxonomy II für Pflegediagnosen zu identifizieren. Die spezifischen Forschungsfragen waren: (1) Was sind die Gemeinsamkeiten und Unterschiede der ICF und der NANDA-I Taxonomy II bezüglich der konzeptionellen Rahmenwerke und Prinzipien der Erhebung? und (2) Inwieweit können beide Klassifikationen zur gemeinsamen Anwendung für die Pflege von Personen mit Rückenmarksverletzung genutzt werden? Die Diskussion über die konzeptionellen und praxisrelevanten Beziehungen zwischen der ICF und der NANDA-I Taxonomy II basiert (1) auf den zuletzt veröffentlichten Beschreibungen beider Klassifikationen und (2) auf der Darstellung einer kombinierten Verwendung beider Klassifikationen anhand eines Fallbeispiels einer Person mit Rückenmarksverletzung. Das Ziel der zweiten Studie war zu analysieren, in welchem Ausmaß die Behandlungsziele von Pflegenden für Personen mit Rückenmarksverletzung in der standardisierten Sprache der ICF ausgedrückt werden können. Die spezifischen Forschungsfragen waren: (1) Welche Probleme, Ressourcen und Aspekte der 7 Umwelt von Personen mit Rückenmarksverletzung, die pflegerelevant sind, können in die Sprache der ICF übersetzt werden? und (2) Welche Probleme, Ressourcen und Aspekte der Umwelt, die pflegerelevant sind, fehlen noch in der ICF? Um diese Fragen zu beantworten, wurde als Methode eine weltweite Delphi-Befragung von Pflegenden, die mit der Pflege von Personen mit Rückenmarksverletzung Erfahrung haben, gewählt. Die Ergebnisse dieser Dissertation geben Aufschluss über die Anwendbarkeit der ICF in der Pflege. Zuerst diskutiere ich die Gemeinsamkeiten und Unterschiede der ICF und der NANDA-I Taxonomy II, die bei der Implementierung beider Klassifikationen in die Pflegepraxis berücksichtigt werden sollten. Mit der NANDA-I Taxonomy II können wichtige praxisnahe Anforderungen, die ausschließlich für die Pflege relevant sind, erfüllt werden. Die Anwendung der ICF wiederum ist hilfreich für Pflegende um mit anderen Gesundheitsfachberufen anhand einer gemeinsamen Sprache vereinfacht über Pflegeprobleme zu sprechen. Eine kombinierte Anwendung der ICF zusammen mit der NANDA-I Taxonomy II ist nützlich, weil sie einander im klinischen Alltag ergänzen können und somit die Qualität der Teamarbeit und der Pflegepraxis bereichern. Zweitens stelle ich eine Liste mit Problemen, Ressourcen und Aspekten der Umwelt von Patienten mit Rückenmarksverletzung zur Verfügung, die alles umfasst, was von Pflegenden behandelt wird. Diese Liste könnte in der Pflegepraxis zur umfassenden und standardisierten Dokumentation eingesetzt werden und für einen besseren Informationsaustausch mit anderen Gesundheitsfachberufen in einer gemeinsamen Sprache dienen. Drittens zeige ich die Stärken und Schwächen der ICF in der Pflegepraxis für Rückenmarksverletzte auf und erbringe Evidenz für Verbesserungen und zukünftige Revisionen der ICF. Beispielsweise schlage ich vor, zur bestehenden Skala der Beurteilungsmerkmale, die beiden Beurteilungsmerkmale „Risiko für“ und „Ressource für“ hinzuzufügen. Aus den Ergebnissen dieser Dissertation ergeben sich einige Empfehlungen für zukünftige Forschungsarbeiten. Erstens bedarf es weiterer Forschung hinsichtlich der gleichzeitigen Verwendung der ICF und der NANDA-I Taxonomy I. Eine vollständige Verknüpfung der beiden Klassifikation auf Item-Ebene (sog. „linking“) könnte ihre Gemeinsamkeiten und Unterschiede auf eine detailliertere Weise 8 offenbaren und somit weitere fehlende Elemente hinsichtlich der Ansprüche der Pflege an die ICF identifizieren. Zweitens sollte die Liste mit Problemen, Ressourcen und Aspekten der Umwelt von Patienten mit Rückenmarksverletzung in verschiedenen Versorgungsformen validiert werden (z.B. in der Pflege im Akutkrankenhaus, in der Rehabilitationspflege und in der ambulanten Pflege). Diese Liste sollte zudem mit den existierenden sog. Umfassenden ICF Core Sets für Personen mit Rückenmarksverletzung in der Frührehabilitation und in der Langzeitversorgung verglichen werden. Drittens sollten die personbezogenen Faktoren, die in dieser Dissertation identifiziert wurden bei der Entwicklung der ICF-Komponente der Personbezogenen Faktoren berücksichtigt werden

Solubility and selectivity effects of the anion on the adsorption of different heavy metal ions onto chitosan

The biopolymer chitosan is a very efficient adsorber material for the removal of heavy metal ions from aqueous solutions. Due to the solubility properties of chitosan it can be used as both a liquid adsorber and a solid flocculant for water treatment reaching outstanding adsorption capacities for a number of heavy metal ions. However, the type of anion corresponding to the investigated heavy metal ions has a strong influence on the adsorption capacity and sorption mechanism on chitosan. In this work, the adsorption capacity of the heavy metal ions manganese, iron, cobalt, nickel, copper, and zinc were investigated in dependence on their corresponding anions sulfate, chloride, and nitrate by batch experiments. The selectivity of the different heavy metal ions was analyzed by column experiments. © 2020 by the authors

Viewpoints. 75 Sides to Freie Universität Berlin

Das Buch mit 75 Illustrationen und Kurztexten ist eine Reise durch die Geschichte und Welt der Freien Universität Berlin und entstand im April 2023 anlässlich ihres 75-jährigen Gründungsjubiläums. Die Bilder zeigen, ohne Anspruch auf Vollständigkeit, mit Augenzwinkern, eine vernetzte und internationale Universität, die sich seit ihren Anfängen und fortwährend ihren Leitwerten Freiheit, Gerechtigkeit und Wahrheit verpflichtet fühlt und zu einem bedeutenden Teil der Stadt und des Wissenschaftsraums Berlin geworden ist. Aspekte ihrer Geschichte und Gegenwart wurden künstlerisch interpretiert von Yves Haltner, einem Schweizer Illustrator und Grafiker, der in Berlin lebt und arbeitet.The book containing 75 illustrations and short texts is a journey through the history and world of Freie Universität Berlin. It was created in April 2023 to mark the occasion of the 75th anniversary of the university’s founding. With a hint of irony and pointed fragmentary playfulness, the images depict a connected, international university deeply committed to its core values: freedom, justice, truth. The university has become an important part of Berlin as a city and research hub. Various aspects of the past and present of the university were artistically interpreted by Yves Haltner, a Swiss illustrator and graphic designer who lives and works in Berlin

Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

<p>Abstract</p> <p>Background</p> <p>The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF) categories relevant for nursing care in the situation of acute and early post-acute rehabilitation.</p> <p>Methods</p> <p>First, in a consensus process, "Leistungserfassung in der Pflege" (LEP) nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets).</p> <p>Results</p> <p>Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising".</p> <p>Conclusion</p> <p>The ICF Core Sets for the acute hospital and early post-acute rehabilitation facilities are highly relevant for rehabilitation nursing. Linking nursing interventions with ICF Core Set categories is a feasible way to analyse nursing. Using the ICF Core Sets to describe goals of nursing interventions both facilitates inter-professional communication and respects patient's needs. The ICF may thus be a useful framework to set nursing intervention goals.</p

Patients' functioning as predictor of nursing workload in acute hospital units providing rehabilitation care: a multi-centre cohort study

<p>Abstract</p> <p>Background</p> <p>Management decisions regarding quality and quantity of nurse staffing have important consequences for hospital budgets. Furthermore, these management decisions must address the nursing care requirements of the particular patients within an organizational unit. In order to determine optimal nurse staffing needs, the extent of nursing workload must first be known. Nursing workload is largely a function of the composite of the patients' individual health status, particularly with respect to functioning status, individual need for nursing care, and severity of symptoms. The International Classification of Functioning, Disability and Health (ICF) and the derived subsets, the so-called ICF Core Sets, are a standardized approach to describe patients' functioning status. The objectives of this study were to (1) examine the association between patients' functioning, as encoded by categories of the Acute ICF Core Sets, and nursing workload in patients in the acute care situation, (2) compare the variance in nursing workload explained by the ICF Core Set categories and with the Barthel Index, and (3) validate the Acute ICF Core Sets by their ability to predict nursing workload.</p> <p>Methods</p> <p>Patients' functioning at admission was assessed using the respective Acute ICF Core Set and the Barthel Index, whereas nursing workload data was collected using an established instrument. Associations between dependent and independent variables were modelled using linear regression. Variable selection was carried out using penalized regression.</p> <p>Results</p> <p>In patients with neurological and cardiopulmonary conditions, selected ICF categories and the Barthel Index Score explained the same variance in nursing workload (44% in neurological conditions, 35% in cardiopulmonary conditions), whereas ICF was slightly superior to Barthel Index Score for musculoskeletal conditions (20% versus 16%).</p> <p>Conclusions</p> <p>A substantial fraction of the variance in nursing workload in patients with rehabilitation needs in the acute hospital could be predicted by selected categories of the Acute ICF Core Sets, or by the Barthel Index score. Incorporating ICF Core Set-based data in nursing management decisions, particularly staffing decisions, may be beneficial.</p

Glioneuronal tumor with ATRX alteration, kinase fusion and anaplastic features (GTAKA): a molecularly distinct brain tumor type with recurrent NTRK gene fusions

Glioneuronal tumors are a heterogenous group of CNS neoplasms that can be challenging to accurately diagnose. Molecular methods are highly useful in classifying these tumors-distinguishing precise classes from their histological mimics and identifying previously unrecognized types of tumors. Using an unsupervised visualization approach of DNA methylation data, we identified a novel group of tumors (n = 20) that formed a cluster separate from all established CNS tumor types. Molecular analyses revealed ATRX alterations (in 16/16 cases by DNA sequencing and/or immunohistochemistry) as well as potentially targetable gene fusions involving receptor tyrosine-kinases (RTK; mostly NTRK1-3) in all of these tumors (16/16; 100%). In addition, copy number profiling showed homozygous deletions of CDKN2A/B in 55% of cases. Histological and immunohistochemical investigations revealed glioneuronal tumors with isomorphic, round and often condensed nuclei, perinuclear clearing, high mitotic activity and microvascular proliferation. Tumors were mainly located supratentorially (84%) and occurred in patients with a median age of 19 years. Survival data were limited (n = 18) but point towards a more aggressive biology as compared to other glioneuronal tumors (median progression-free survival 12.5 months). Given their molecular characteristics in addition to anaplastic features, we suggest the term glioneuronal tumor with ATRX alteration, kinase fusion and anaplastic features (GTAKA) to describe these tumors. In summary, our findings highlight a novel type of glioneuronal tumor driven by different RTK fusions accompanied by recurrent alterations in ATRX and homozygous deletions of CDKN2A/B. Targeted approaches such as NTRK inhibition might represent a therapeutic option for patients suffering from these tumors

eTEACH-Netzwerk Thüringen

Inhalt: Informieren; Qualifizieren; Austausc

Beach characteristics of mine waste tailings /

Includes bibliographical references.Mode of access: Internet

Compaction criteria for metal and nonmetal tailings /

Bibliography: p. 27.Mode of access: Internet

How to measure what matters: development and application of guiding principles to select measurement instruments in an epidemiologic study on functioning

The purpose of this article was to describe and to apply a comprehensive set of guiding principles in the selection of measurement instruments for a longitudinal epidemiologic study focusing on functioning using the International Classification of Functioning, Disability, and Health (ICF) as reference framework. Based on the literature, the ICF linkage rules, and the definition of ICF categories to be measured, the following guiding principles for selecting measurement instruments are defined: redundancy, efficiency, level of detail of information, comparability, feasibility, and truth and discrimination. Examples illustrate that the application of guiding principles allows for a systematic and reasoned process of measurement instrument selection and thus offers a potential solution for the multifaceted challenges that one encounters in the selection of measurement instruments. It is transparently demonstrated how the ICF linkage rules enable researchers to address issues such as efficiency, comparability, and redundancy and how the definition of a set of ICF categories to be measured allows assessing inefficiencies in measurement instruments. Because of the ICF linkage rules and the definition of ICF categories to be measured, new guiding principles for selecting measurement instruments emerge. The main challenges lie in the difficulty to quantify and prioritize the applicability of guiding principles and the fact that they strongly interact. Notably, the prioritization and application of guiding principles must be defined considering the specific characteristics and aims of the specific study