25 research outputs found

    European radon abatement policy: state and ongoing discussion

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    Radon is a hazardous air pollutant which can cause detriment to individuals and to the society. Thus, the natural consequence is avoiding it or in practice, limiting exposure. This has led to regulation on national and international level whose objective is reduction of radon exposure. In Europe, the Basic Safety Standards (BSS) issued in 2013, whose implementation is mandatory for EU Member States, caused a boost to efforts towards radon regulation as well as to radon research since a number of components of radon abatement policy appeared not resolved sufficiently reliable in the sense of quality assurance. In this contribution, we present the state of implementation of EURATOM Basic Safety Standards in Europe and in Germany, as a particular example. We also address a number of topics currently discussed

    Sexual abuse of care-dependent patients. Results of a nationwide cross-sectional study among general practitioners on responsibility and subjective confidence in dealing with suspected abuse

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    Hintergrund: Gewalt gegen pflegebed√ľrftige √§ltere Menschen ist h√§ufig. Haus√§rzte/-√§rztinnen k√∂nnen bei der Pr√§vention von Gewalt eine Rolle spielen. Insbesondere sexualisierte Gewalt ist stark tabuisiert und wenig untersucht. Ziel der Arbeit: Ziel dieser Arbeit ist es, die Einstellung von Haus√§rzten/-√§rztinnen zu ihrer Verantwortung bei sexuellem Missbrauch pflegebed√ľrftiger Patienten/Patientinnen zu untersuchen. Zugleich sollen die subjektive Sicherheit hinsichtlich des Vorgehens bei einem Missbrauchsverdacht sowie die Fortbildungsinteressen von Haus√§rzten/-√§rztinnen zum Thema erhoben werden. Material und Methoden: In einer Querschnittsstudie wurden 1700 Haus√§rzte/-√§rztinnen in Deutschland zwischen September und November 2016 schriftlich befragt. Fragebogen von 302 √Ąrzten/√Ąrztinnen konnten ausgewertet werden. Ergebnisse: Die Unsicherheit hinsichtlich des weiteren Vorgehens bei Verdacht auf sexuellen Missbrauch von pflegebed√ľrftigen Patienten/Patientinnen ist gro√ü. Nahezu alle Befragten sehen es als Teil der √§rztlichen Verantwortung, bei sexuellem Missbrauch pflegebed√ľrftiger Patienten/Patientinnen zu intervenieren. Haupts√§chliches Fortbildungsinteresse besteht zur Differenzialdiagnose des sexuellen Missbrauchs sowie zum richtigen Vorgehen im Verdachtsfall. Schlussfolgerung: Fortbildungen, insbesondere zu den Anzeichen sexueller Gewalt gegen Pflegebed√ľrftige, k√∂nnen einen Beitrag leisten, die Handlungssicherheit von Haus√§rzten/-√§rztinnen zu st√§rken und ihre Bereitschaft zur Pr√§vention zu erh√∂hen.Background: Violence against people in need of care is a challenge for long-term care situations. Sexual violence in particular, is subject to strong taboos and has so far been little researched. Family physicians can play a role in preventing violence against people in need of care. Objective: The objective of this study was to examine family physicians‚Äô attitudes to their responsibilities in cases of sexual abuse of patients in need of care. At the same time, we also examined subjective confidence in relation to the procedure in cases of suspected abuse and family physicians‚Äô interests in further training on this topic. Material and methods: A cross-sectional study addressed to 1700 family physicians in Germany with a written survey between September and November 2016. Questionnaires from 302 physicians could be evaluated for the study. Findings: Almost all respondents saw it as part of their responsibility as doctors to intervene in cases of sexual abuse of patients in need of care. There is great uncertainty about how to proceed in cases of suspected sexual abuse of patients in need of care. Respondents‚Äô main interest in further training related to the differential diagnosis of sexual abuse and the correct procedure in cases where abuse is suspected. Conclusion: Further training provision, particularly on the signs of sexual abuse of people in need of care, could contribute to increasing family physicians‚Äô confidence to act

    Sexueller Missbrauch Pflegebed√ľrftiger

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    Background!#!Violence against people in need of care is a challenge for long-term care situations. Sexual violence in particular, is subject to strong taboos and has so far been little researched. Family physicians can play a role in preventing violence against people in need of care.!##!Objective!#!The objective of this study was to examine family physicians' attitudes to their responsibilities in cases of sexual abuse of patients in need of care. At the same time, we also examined subjective confidence in relation to the procedure in cases of suspected abuse and family physicians' interests in further training on this topic.!##!Material and methods!#!A cross-sectional study addressed to 1700 family physicians in Germany with a written survey between September and November 2016. Questionnaires from 302 physicians could be evaluated for the study.!##!Findings!#!Almost all respondents saw it as part of their responsibility as doctors to intervene in cases of sexual abuse of patients in need of care. There is great uncertainty about how to proceed in cases of suspected sexual abuse of patients in need of care. Respondents' main interest in further training related to the differential diagnosis of sexual abuse and the correct procedure in cases where abuse is suspected.!##!Conclusion!#!Further training provision, particularly on the signs of sexual abuse of people in need of care, could contribute to increasing family physicians' confidence to act

    The role of pedogenesis and natural fertiliser as vectors for essential metal content in agricultural topsoils, Central India

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    Essential trace metals are well known for their environmental toxicity and for being part of complex bio-chemical cycles. Their role as critical micronutrients, delivering vital health benefits, is less widely discussed and understood, holding back strategies for combatting malnutrition. Crops grown on many Indian soils suffer from deficiencies in essential metals, notably iron (Fe), zinc (Zn), and molybdenum (Mo). The list of deficient metals will likely grow due to increasing future crop demand. Geostatistical analysis of soils and farmyard manure (FYM), the predominant fertiliser, implies that residual oxide minerals carry high concentrations of the essential trace metals Fe, Zn, copper (Cu), chromium (Cr), nickel (Ni), cobalt (Co), manganese (Mn) not only in soil but also in FYM (especially Fe, Cr, Cu, Co and Ni). A geochemical survey across a road traverse of 600¬†km, encompassing an area of c. 15,000¬†km2, was conducted in Central India to evaluate reported essential metal deficiency in key agricultural topsoils. Importantly, our evaluation of the element cycling in this system reveals that despite high bulk concentrations, some key metals remain bio-unavailable. In effect, the existence of refractory (weathering-resistant) oxides is likely a significant factor for deficiency symptoms in the soil‚Äďplant-fertiliser cycle. Further, mass balance calculations of the bioavailable pool of metals imply that only Fe and Mn are present in sufficient quantities to combat deficiency problems. Notwithstanding this limitation of FYM, its high organic carbon content, as well as its importance for Zn, Cu and Fe, validates its traditional use to maintain the fertility and physical condition of Indian topsoils.</p

    Digital teaching as an instrument for cross-location teaching networks in medical informatics: opportunities and challenges - Digitale Lehre als Instrument f√ľr standort√ľbergreifende Lehrverb√ľnde in Medizinischer Informatik: Chancen und Herausforderungen

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    Benning N-H, Haag M, Knaup P, et al. Digital teaching as an instrument for cross-location teaching networks in medical informatics: opportunities and challenges - Digitale Lehre als Instrument f√ľr standort√ľbergreifende Lehrverb√ľnde in Medizinischer Informatik: Chancen und Herausforderungen. GMS Journal for Medical Education. 2020;37(6).The increasingly digitized healthcare system requires new skills from all those involved. In order to impart these competencies, appropriate courses must be developed at educational institutions. In view of the rapid development of new aspects of digitization, this presents a challenge; suitable teaching formats must be developed successively. The establishment of cross-location teaching networks is one way to better meet training needs and to make the necessary spectrum of educational content available. As part of the Medical Informatics Initiative, the HiGHmed consortium is establishing such a teaching network, in the field of medical informatics, which covers many topics related to the digitization of the health care system. Various problem areas in the German education system were identified that hinder the development of the teaching network. These problem areas were prioritized firstly according to the urgency of the solution from the point of view of the HiGHmed consortium and secondly according to existing competencies in the participating societies. A workshop on the four most relevant topics was organized with experts from the German Society for Medical Informatics, Biometry and Epidemiology (GMDS), the Society for Medical Education (GMA) and the HiGHmed consortium. These are: recognition of exam results from teaching modules that are offered digitally and across locations, and their integration into existing curricula; recognition of digital, cross-location teaching in the teachers' teaching load; nationwide uniform competencies for teachers, in order to be able to conduct digital teaching effectively and with comparable quality; technical infrastructure to efficiently and securely communicate and manage the recognition of exam results between educational institutions. For all subject areas, existing preliminary work was identified on the basis of working questions, and short- and long-term needs for action were formulated. Finally, a need for the redesign of a technologically supported syntactic and semantic interoperability of learning performance recording was identified.Das zunehmend digitalisierte Gesundheitswesen erfordert neue Kompetenzen von allen Beteiligten. Um diese Kompetenzen vermitteln zu k√∂nnen, m√ľssen an den Bildungsinstitutionen entsprechende Lehrveranstaltungen entwickelt werden. Dies ist angesichts der rasanten Entwicklung neuer Digitalisierungsaspekte eine Herausforderung; passende Lehrformate m√ľssen sukzessive aufgebaut werden. Die Etablierung standort√ľbergreifender Lehrverb√ľnde ist eine M√∂glichkeit, den Ausbildungsbedarf besser zu decken und die notwendige Bandbreite an Bildungsinhalten verf√ľgbar zu machen. Im Rahmen der Medizininformatik-Initiative wird im HiGHmed-Konsortium ein solcher Lehrverbund im Fachgebiet der Medizinischen Informatik aufgebaut, in welches viele Themen der Digitalisierung des Gesundheitswesens fallen. Dabei wurden verschiedene Problemfelder im deutschen Bildungswesen identifiziert, welche den Aufbau des Lehrverbundes hemmen. Diese Problemfelder wurden unter Beachtung der Dringlichkeit der L√∂sung aus Sicht des HiGHmeducation Konsortiums und andererseits nach vorhandenen Kompetenzen in den teilnehmenden Fachgesellschaften priorisiert. Zu den vier relevantesten Themen wurde ein Workshop mit Fachleuten der deutschen Gesellschaft f√ľr Medizinische Informatik, Biometrie und Epidemiologie (GMDS), der Gesellschaft f√ľr Medizinische Ausbildung (GMA) und des HiGHmed Konsortiums ausgerichtet. Diese sind: Anerkennung von Pr√ľfungsleistungen aus Lehrmodulen, welche digital und standort√ľbergreifend angeboten werden, und Integration in bestehende Curricula; Anerkennung digitaler, standort√ľbergreifender Lehre im Deputat der Lehrenden; bundesweit einheitliche Kompetenzen f√ľr Lehrende, um digitale Lehre effektiv und mit vergleichbarer Qualit√§t betreiben zu k√∂nnen; technische Infrastrukturen, um die Anerkennung zwischen Bildungseinrichtungen effizient und sicher kommunizieren und verwalten zu k√∂nnen. F√ľr alle Themengebiete wurden anhand von Arbeitsfragen existierende Vorarbeiten identifiziert sowie kurz- und langfristige Handlungsbedarfe formuliert. Abschlie√üend wurde themen√ľbergreifend ein Bedarf f√ľr die Neugestaltung einer technologisch unterst√ľtzten syntaktischen und semantischen Interoperabilit√§t der Erfassung von Lernleistungen festgestellt

    Alfred Kröner (1939-2019)

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    Silicon and chromium stable isotopic systematics during basalt weathering and lateritisation: A comparison of variably weathered basalt profiles in the Deccan Traps, India

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    Global biomass production is fundamentally affected by the hydrological cycling of elements at the Earth?s surface. Continental weathering processes are the major source for most bio-essential elements in marine environments and therefore affect primary productivity. In addition, critical zone biomass depends on energy and chemical exchange reactions in weathering profiles. The latter reservoirs are in turn influenced by different climatic conditions that control weathering and pore water parameters like pH and Eh, these then regulate mineral break down rates that dictate the mobility and mass flux of elements. Two Deccan Trap basalt-weathering profiles of contrasting age and alteration intensity provide a natural laboratory for investigating the effects of rock alteration on Si and Cr and their isotopic systematics. The sub-recent Chhindwara profile has progressed to a moderate degree of alteration (saprolite), whilst the Paleogene Bidar example displays an extremely altered laterite. The Chhindwara profile shows a near uniform Cr and Si concentration and isotopic composition, whereas the Bidar profile is characterised by an intense loss of Si, a large enrichment of Cr within the most altered uppermost levels, and a wide range of Cr stable isotope ratios (-0.85 to 0.36 ? ?53/52Cr). A co-variation between Si and Cr isotopes, as well as their co-variation with iron content, provides empirical evidence that iron redistribution within the profile has a large effect on Cr mobility. Therefore, it is concluded that iron oxides exert a primary control over the isotopic composition of both Cr and Si in pore waters of laterites. Because laterite formation is promoted by tropical climates, the results of this study provide new evidence to suggest that the hydrological Cr and Si fluxes originating from continental weathering have changed in accordance with large-scale, deep time climate variation and continental plate configuration. An increased flux of Si and greater magnitude of Cr mobility and isotopic fractionation are possibly amplified under CO2-rich, greenhouse episodes and/or when large landmasses were tectonically arranged at near equatorial latitudes

    Th/U and U series systematics of saprolite: importance for the oceanic 234U excess

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    The presence of excess U-234 in seawater is a compelling argument for active delivery of solutes from the continents to the oceans. Previous studies found, however, that the complementary U-234 deficit on the continents is surprisingly modest, which would require protracted U loss from a large continental weathering pool. Our new compilation and statistical analysis of the published data, coupled with a mass balance calculation demonstrates that the apparent small U-234 deficit in the continental weathering pool implied by previous studies is insufficient to balance the observed oceanic excess. Our new data for a saprolite weathering profile developed on Deccan basalt reveal a very strong overall loss of U (elevated Th/U) with a strong U-234 deficit attributable to chemical weathering. The U and U-234 deficits reported here from a geologically recent saprolite confirm the importance of the early stages of chemical weathering at the weathering front in the supply of nutrients to the oceans. Thus, as much as half the oceanic U-234 inventory is likely sourced from a thin active saprolite zone

    Elemental and isotope fingerprint of metal deficiency in soils

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    Metal deficiency in soils is a frequently observed phenomenon in (sub)-tropical regions, and both natural and anthropogenic processes contribute to the depletion of soil reservoirs. Advanced chemical weathering, in old regolith, can lead to very severe natural depletion of metals in certain soil types, while soil over-cropping represents the human impact that increases the net offtake of metals from many soils. In both cases, the health of humans can suffer since many trace metals have vital functions in the human body. For example, nearly half the world population is affected by Zn deficiency symptoms caused by over-dependence on local crops that are grown on Zn deficient soils. This is all the more concerning in view of the anticipated rise in world population that will put additional demands on crop production with likely knock-on effects for essential metal depletion in soil. This thesis presents petrographic, mineralogical and geochemical as well as isotopic investigations of two contrasting weathering profiles from the Deccan Traps, India to investigate the natural causes of metal deficiency in soils. Major- and trace elements (including essential metals), organic carbon (C) content, chemical weathering indices, uranium-series (U-series) systematics as well as zinc (Zn)- and chromium (Cr)- isotopes were analysed to quantify the mineralogical transformations, biogeochemical processes and environmental factors that lead to the loss of metals during soil formation. In addition, agricultural topsoil and animal manure samples were investigated from Zn deficient regions in India to compare and contrast their biogeochemical fingerprints to the findings from the weathering profiles. The work revealed that actively weathering soils are strongly depleted in the isotope 234U, hosted in labile sites in minerals. The chemical breakdown of metal-rich primary silicates and clay minerals in saprolite results in the mobilisation of substantial amounts of metals to aqueous solutions and plants. Ultimately, the breakdown of these minerals contributes to oceanic metal inventories, exemplified by the excess of 234U in seawater. By contrast, strongly weathered soils (i.e. laterites) have lost their natural capacity to supply bio-available forms of metals to the environment and concentrations of residual essential metals such as Zn or redistributed Cr are mainly hosted in weathering resistant iron (Fe)-oxides. The isotopic fractionation of Zn and Cr is strongly affected by the formation of Fe-oxides, whereas the metal stable isotope ratios in actively weathering saprolite remain in the range of unweathered bedrocks. Hence, Zn isotopes can be used to distinguish between fertile and Zn deficient soils. Importantly, the geochemical fingerprints in the agricultural topsoils reveal that high concentrations of essential metals (Zn, copper (Cu), cobalt (Co), nickel (Ni), Cr) are also hosted in bio-unavailable oxide phases, whereas the bio-available pool in the inorganic soil constituents is much lower. Since the bio-available concentrations of metals in animal manure are too low to counterbalance essential metal deficiencies in Indian soils, their fertility status remains delicate without application of industrial metal fertilisers. Overall, the findings of this thesis suggest that geochemical and isotopic data can contribute to a deeper understanding of metal deficiency in soils and help in the development of more sustainable farming practices in (sub)-tropical regions
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