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Due to their lightweight potential and good eco-balance, thermoplastic hybrid composites with natural fiber reinforcement have long been used in the automotive industry. A good alternative to natural fibers is wood fibers, which have similar properties but are also a single-material solution using domestic raw materials. However, there has been hardly any research into wood fibers in thermoplastic back-injected hybrid composites. This article compares the bond strength of an injection molded rib from polypropylene (PP) and wood fibers to different non-wovens. The non-wovens consisted of wood fibers (spruce) or alternatively natural fibers (kenaf, hemp), both with a polypropylene matrix. Pull-off and instrumented puncture impact tests show that, given similar parameters, the natural and wood-fiber-hybrid composites exhibit very similar trends in bond strength. Further tests using viscosity measurements, microscopy, and computed tomography confirm the results. Wood-fiber-reinforced thermoplastic hybrid composites can thus compete with the natural fiber composites in terms of their mechanical behavior and therefore present a good alternative in technical semi-structural applications.
Background
Pharmaceutical expenditure grow strongly in most health care systems. Especially high prices of new drugs are perceived to be driver of growth which might threaten the sustainability of financing drugs.
Objective
The study aims to analyse a) whether German health policies can achieve sustainable growth of pharmaceutical expenditure, and b) which therapeutic groups fasten and slow pharmaceutical growth based on price and/or volume effects.
Methods
Annual growth rates of pharmaceutical expenditure in the German social health insurance (SHI) between 2006 and 2018 are compared with indicators reflecting the ability to pay. Annual growth rate in therapeutic subgroups are analysed with respects to volume and price developments.
Results
Without policies to control pharmaceutical spending, annual growth rates are significantly higher than the growths of indicators of ability to pay. After accounting for the savings from health policy
measures, net pharmaceutical expenditure does not grow significantly faster than ability to pay. Policies mainly targeting generic drugs achieve threefold savings compared with policies targeting at patent-protected drugs, although the latter account for more than halve of the expenditure. A limited number of therapeutic subgroups with new drugs grow significantly faster than average expenditure, but this growths is counterbalanced by subgroups which in the end of their innovation cycle and a huge proportion of generic drugs.
Conclusion
The growths of net drug expenditure in the German SHI does not threaten the sustainability of financing health expenditure based on comprehensive policy measures and innovation cycle effects. Generics do contribute savings to a larger extent.
Key points for decision makers:
• Germany efficiently uses a comprehensive set of health policies to control drug expenditure in the social health insurance with limited impact on reimbursement.
• Net drug expenditure grow on annual rates which correlate to ability to pay and thus do not threaten sustainability of health care financing.
• Natural progress of innovation cycles together with targeted policies on patent-protected as well as generic drugs counterbalance exaggerated growth in areas with a high degree of innovation.
• Policies targeted mainly on generic drugs yield threefold savings compared with policies targeting on patent-protected drugs. This imbalance should be considered in potential refinements of drug policies.
Typically, to improve the fire resistance of wood, chemical substances, including phosphorus, borate, phenols, nitrogen and halogen based compounds, are impregnated into the wooden material. However, due to problems related to the toxic properties of these fire-retardant compounds, new fire-retardancy methods based on a mineralization process have been developed. Cementitious mineralization of wood is a novel and alternative approach for a non-toxic flame retardant, with viable application in laminated veneer lumber. This paper briefly describes the effects of different solid impregnation materials on the thermal properties and fire retardance of beech veneers (Fagus sylvatica L.). Beech veneers were impregnated with a suspension of (i) microfine binder and glycol, (ii) microfine binder mixed with calcium oxalate monohydrate and glycol, and (iii) aluminium hydroxide and glycol, in a vacuum/high pressure process. Single-flame source tests of with different solids impregnated veneers revealed a considerable improvement in flame retardancy of cementitious mineralized beech veneers compared to untreated control specimens.
Institutional Ethnography
(2022)
Rehabilitation aims to enable people with disabilities or who are likely to experience disability to participate fully in their daily lives through a set of interprofessional and multimodal measures. Yet, rehabilitation services are embedded within social and healthcare systems that shape what individuals, who are active within these systems, can and may have to do. This chapter introduces Institutional Ethnography, a critical method of inquiry, which aims to explicate what people actually do and experience and how their doings and experiences become organized within textually mediated social relations. For rehabilitation practice and research, Institutional Ethnography is a powerful method to delineate which concepts are dominating institutional practices and to explicate whether these concepts are comprehensive enough to serve not only institutional purposes but account for and respond to the realities of people’s daily lives.
Objective
Functioning is an important outcome for the management of rheumatoid arthritis (RA). Heterogeneity of respective patient-reported outcome measures (PROMs) challenges direct comparisons between their results. This study aimed to standardize reporting of such PROMs measuring functioning in RA to facilitate comparability.
Methods
Common-item nonequivalent group design with the Health Assessment Questionnaire (HAQ) as a common scale across data sets from various countries (including the UK, Turkey, and Germany) to establish a common metric was used. Other PROMs included are the physical function items of the Multidimensional HAQ (MDHAQ), the Disabilities of the Arm, Shoulder, and Hand questionnaire, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the World Health Organization Disability Assessment Schedule II (WHODAS II), the Medical Outcomes Study Short Form 36 (SF-36) health survey, and 4 short forms (20, 10, 6, and 4 physical function items) from the Patient-Reported Outcomes Measurement Information System. As the HAQ includes mobility, self-care, and domestic life items, this study focuses on these 3 domains. PROMs were described using standard error of measurement (SEM) and smallest detectable difference (SDD). A Rasch measurement model was used to create the common metric.
Results
The range of the SEM was 0.2 (MDHAQ) to 7.4 (SF-36 health survey physical functioning domain). The SDD revealed a range from 9.7% (WOMAC rating scale) to 33.5% (WHODAS physical functioning domain). PROMs co-calibration revealed fit to the Rasch measurement model. A transformation table was developed to allow exchange between PROM scores.
Conclusion
Scores between the daily activity PROMs commonly used in RA can now be compared. Factors such as SEM and SDD help to determine the choice of a PROM in clinical practice and research.
Die wissenschaftlichen Disziplinen, die sich mittlerweile mit ‚Kindern‘ und ‚Kindheit(en)‘ befassen, sind zahlreich. So hat sich der Forschungsblick der letzten eineinhalb Dekaden sichtbar in die frühen Entwicklungsjahre verlagert bzw. dort intensiviert und ausdifferenziert. Von Kinderfreundlichkeit, Kinderrechten, Kindesschutz und Kindeswohl, kindlichem Wohlbefinden, von der Kommunikation mit Kindern ‚auf Augenhöhe‘, und vom Prinzip der Partizipation (welches Kindern eine Teilhabe an den sie betreffenden Entscheidungen zugesteht) ist allenthalben die Rede. In Anbetracht dieser Hypertrophierung des Begriffs ‚Kind(heit)‘ und scheinbaren Asymmetrie von frühen im Vergleich zu späteren Altersphasen wirken ‚Jugend‘ und ‚Jugendliche‘ weniger prominent. Der folgende Beitrag verfolgt das Ziel einer explorativen Spurensuche entlang der Demarkationslinie zwischen Kindheit und Jugend. Hierdurch soll zu einem dynamisch-wechselseitigen Verständnis dieser beiden Lebensphasen (im Gegensatz zur häufig eher kategorial-trennenden Positionierung) beigetragen werden. Neben wissenschaftshistorischen und legislativen Dynamiken der Altersmarkierung von Kindheit und Jugend werden zeitdiagnostische Aspekte sowie forschungsmethodologische Überlegungen präsentiert.
Der Beitrag stellt grob die Regelungen der Muster-Holzbau-Richtlinie (MHolzBauRL) Ausgabe Oktober 2020 für feuerwiderstandsfähige Bauteile in Holzbauweise (die nach bauordnungsrechtlichen Vorgaben feuerbeständig oder hochfeuerhemmend sein müssen) dar. Er geht ausführlich auf die daraus resultierenden geänderten Zuordnungstabellen aus MVV TB 2020/2 Anhang 4 ein und beschreibt die Folgen für die Nachweisführung feuerwiderstandsfähiger Bauteile für Bauwerke unter diesen Regeln.