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Many doubts accompany both the resource potential of hardwoods and their softwood substituting potential within its material utilisation. However, as the feedstock demand will rise with more and more wood-based biorefineries entering the market, wood supply security is an increasingly pressing topic. Currently, hardwood flow models are lacking, but are an essential basis for estimating future hardwood supply security. This study investigates the actual hardwood flows in Germany by applying a Material Flow Analysis (MFA). Visualising the results of the MFA for the reference year 2016. The MFA displays 4.44 +/- 0.12 million m³ (fob) recorded fellings in privately-owned forests, 8.60 +/- 0.15 million m³ (fob) recorded fellings in state forests, 9.31 +/- 0.52 million m³ (fob) as unrecorded harvest from forests (i.e. 37% of the total harvest) and 2.65 +/- 0.35 million m³ (fob) unrecorded fellings from non-forest area (11% of total harvest). Of that, almost 30% were used for materials and 70% were used for energy. Consequently, the potential for material use of hardwood in Germany lies beyond its current usage, especially given that good qualities are being used for energy due to actual low material consumer demand. Thus, the MFA assessed the quality and quantity of the German hardwood potential and showed that it offers significant possibilities for value added usage options such as, for example, producing innovative products in biorefineries using degraded high-quality assortments. Due to the low data consistency, heterogeneous datasets for the forest and wood industry sector were calibrated through data reconciliation and error propagation. Additionally, the lack of statistical data for specific wood industry sectors raised a problem, for instance, actual data on private combustion of wood, established hardwood uses, or new innovative products. Severe data issues regarding the German hardwood flow were confirmed.
Die im deutschen Gesundheitssystem implementierten Vergütungssysteme sind dringend reformbedürftig. Dies gilt insbesondere für den Krankenhaussektor, in dem die Auswirkungen diverser Fehlanreize zu einer Kaskade korrigierender Eingriffe geführt haben, ohne jedoch die tiefwurzelnden Probleme grundlegend zu adressieren. Eine alternative Vergütungsform stellen prospektive regionale Gesundheitsbudgets dar. Diese basieren auf Konzepten, die dem Prinzip der Capitation folgen und nicht für einzelne Fälle oder auch einzelne Patienten, sondern für ganze Gruppen von Versicherten eine sektorenübergreifende Vergütung beinhalten. Im Idealfall wird damit die gesamte Bevölkerung einer Region abgedeckt. Die Umsetzung derartiger pauschalierter Vergütungssysteme ist herausfordernd. Deshalb stellt dieser Beitrag Erfahrungen aus Spanien und den USA dar und diskutiert Implikationen für eine mögliche Implementierung in Deutschland. Das spanische Valencia-Modell steht dabei für einen unmittelbaren und weitreichenden Systemwechsel durch die Implementierung von Modellen, bei denen der Staat eine Konzession für die regionale Versorgung an private Akteure vergibt. Der am Beispiel einer Accountable Care Organisation dargestellte Ansatz der USA verfolgt hingegen die Strategie eines Transformationspfades , der schrittweise zu einer stärkeren Pauschalierung führt und kontinuierlich auf Basis aktueller Erkenntnisse angepasst wird. Es zeigt sich, dass die Modelle zwingend für alle Beteiligten einen Zusatznutzen gegenüber dem Status quo stiften müssen, um angenommen zu werden. Auf der wirtschaftlichen Ebene müssen die Risiken adäquat abgesichert werden, ohne dabei die gewünschten Anreize auszuhebeln. Gleichzeitig müssen wirksame Vorkehrungen getroffen werden, die Unterversorgung verhindern und positive Qualitätsanreize schaffen.
Alle Menschen sollen an den sich schnell erweiternden Möglichkeiten, die Gesundheit wiederherzustellen, zu erhalten und zu bessern, in gleicher Weise teilhaben können. Die Diskussion um steigende Ausgaben für Gesundheit, Rationierung von Leistungen, Fachkräftemangel und Disparitäten im Zugang zur Versorgung zeigt aber: Dieses Versprechen steht in Frage.
Eine besser koordinierte, stärker patientenzentrierte und intersektoral angelegte Versorgung kann Teil der Lösung sein, das Versprechen weiter aufrecht zu halten. Voraussetzung hierfür ist ein Vergütungssystem, das die Sektorengrenzen tatsächlich überwinden kann und Qualität belohnt. Internationale Erfahrungen zeigen, dass sogenannte Capitation-Modelle, die auf mengenunabhängigen und sektorenübergreifenden Pro-Kopf-Pauschalen beruhen, – geeignet ausgestaltet – Anreize für eine derartige Versorgung schaffen können. In solchen Modellen übernehmen Leistungserbringer einen Teil des Versicherungsrisikos bzw. der finanziellen Verantwortung für Leistungen, die direkt von ihnen erbracht, veranlasst oder nicht vermieden werden. Das Potenzial ist deutlich sichtbar. Allerdings gibt es auch Herausforderungen und Risiken, die mit einem derartigen System einhergehen und entsprechend zu adressieren bzw. zu kontrollieren sind.
Deshalb prüft das vorliegende Buch differenziert die Voraussetzungen und Potenziale des Transfers eines derartigen populationsorientierten Vergütungsansatzes nach Deutschland und zeigt die Optionen einer möglichen Umsetzung in Form prospektiver regionaler Gesundheitsbudgets auf. Die Basis hierzu bildet eine fundierte Analyse von Modellen aus Spanien, Peru, den USA und der Schweiz.
Road network performance (RNP) is a key element for urban sustainability as it has a significant impact on economy, environment, and society. Poor RNP can lead to traffic congestion, which can lead to higher transportation costs, more pollution and health issues regarding the urban population. To evaluate the effects of the RNP, the involved stakeholders need a real-world data base to work with. This paper develops a data collection approach to enable location-based RNP analysis using publicly available traffic information. Therefore, we use reachable range requests implemented by navigation service providers to retrieve travel times, travel speeds, and traffic conditions. To demonstrate the practicability of the proposed methodology, a comparison of four German cities is made, considering the network characteristics with respect to detours, infrastructure, and traffic congestion. The results are combined with cost rates to compare the economical dimension of sustainability of the chosen cities. Our results show that digitization eases the assessment of traffic data and that a combination of several indicators must be considered depending on the relevant sustainability dimension decisions are made from.
Modern production facilities are becoming increasingly complex, as companies battle to meet the increasingly customer-specific demands with shorter lead times and higher efficiency. For the employees in the factory, who often bear the brunt of making short-term process decisions, this complexity is becoming unmanageable. The PhD project presented in the following aims to decrease the complexity of modern manufactory facilities by means of artificial intelligence. The focus is on product data analysis and manufactory process planning. Different approaches of artificial intelligence for use in a Self-Adapting Smart System (SASS) are to be investigated.
Im Rahmen der Digitalisierung der industriellen Produktion mit Industrie 4.0 und des autonomen Fahrens erlangen möglichst detaillierte digitale Abbilder von Maschinen und Fahrzeugen für den vollständigen Zeitraum ihres Einsatzes eine zentrale Bedeutung. Sowohl durch geplante Veränderungen des Arbeitspunkts aber auch durch Abnutzung und Verschleiß kommt es zu Abweichungen des Systemverhaltens. In diesem Posterbeitrag werden die Entwicklung und die Anwendung eines Identifikations-Algorithmus für die automatisierte Modellierung eines dynamischen Systems basierend auf einem gemessenen Ein- und Ausgangssignal beschrieben. Der in MATLAB und Simulink programmierte Algorithmus läuft parallel zum realen System auf einer embedded Hardware ab, so dass eine Identifikation online und selbstständig ausgeführt wird. Die prozess- oder verschleißbedingten Veränderungen des Systemverhaltens werden damit unmittelbar bei der Modellierung während des Betriebs berücksichtigt. Im Anschluss an die Identifikation sind die Selbst-Optimierung, die Vorsteuerung und die Selbst-Konfiguration des Systems, z.B. die Anpassung von Reglern, basierend auf dem aktuellen Modell durchführbar.
Each year, the Virtual Business Professional (VBP) program brings together professors and students from across the globe to engage in client projects. The VBP program of 2020 occurred from the beginning of March through the middle of April. In this article, we share how the COVID-19 pandemic affected VBP participants and their teams. We present post-project survey results (completed by 440 of 530 participants for an 83 percent response rate), professor comments, and student comments to demonstrate how VBP participants overcame many of the pandemic disruptions to work effectively in virtual teams, develop compassion and empathy for one another, and foster more global mindsets.
Design of a Low Multi-Loop Inductance Three Level Neutral Point Clamped Converter with GaN HEMTs
(2020)
This work shows a numerical and experimental analysis of a Neutral-Point-Clamp (NPC) three level inverter featuring an ultra low inductance printed circuit board (PCB) design in consideration of the mutual inductive and capacitive couplings. The commutation loops in this design are found to be strongly dependent on the vertical thickness of the used prepregs and the core. For vertical thicknesses ≤ 100 μm capacitive coupling must be taken into account in the switching cell design. Experimental measurements of a test set-up with a total PCB thickness of 400 μm results in commutation loop inductances from 1.4 nH up to 3.1 nH. In this set-up, switching tests without external gate resistor showed only a maximum voltage overshoot of 7% at 800 V. Based on a numerical analysis of the NPC cell we propose a further switching performance improvement with significant smaller parasitic inductance due to the application of novel printed circuit technologies such as the integration of bare dies into the printed circuit board or polyimide as an interlayer dielectric material.
Making one's own choices is an important part of leading a fulfilling life within society. However, people with IDs often face significant obstacles when making their own decisions. Article 12 (Equal recognition before the law) of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) aims to ensure firstly that people with IDs and others with compromised capacity are nonetheless recognized as legal individuals, and secondly that assistance is provided in the form of supported decision‐making in order to exercise this resulting legal capacity. It is unclear whether current national legislation in any country satisfies these requirements in practice. This study utilizes institutional ethnography to reveal how decision‐making is coordinated in practice for people with mild to moderate IDs living in supported residential environments in England, and to determine whether these processes are compliant with Article 12 of the CRPD. Data collection was based on observations, semi‐structured interviews, and documentary analysis, involving 29 participants including people with mild to moderate IDs. The results point to the complexity of supported decision‐making and identify three main categories of decision‐making: spontaneous decisions, mid‐term decisions, and strategic decisions. The data also show that people with mild to moderate IDs are able to exercise their legal capacity through support decision‐making in their everyday life. Immediate and informal supported decision‐making exists in daily practice for people with mild to moderate IDs living in supported residential environments. Although there are structures in place for implementing supported decision‐making, various barriers persist that limit the overall efficacy and consistency of the realization of supported decision‐making, for example, multiple use of mental capacity assessments. Such practices move away from the supported decision‐making model toward substituted decision‐making.
Living with spinal cord injury in Mongolia: A qualitative study on perceived environmental barriers
(2020)
Context: Environmental factors play a key role in the lives of individuals with a spinal cord injury (SCI). This study identifies environmental barriers and their impacts on daily lives as perceived by individuals living with SCI in Mongolia.
Design: A qualitative study with semi-structured interviews was conducted. A topic guide for the interviews was structured around the components of the International Classification of Functioning, Disability, and Health.
Setting: Urban and rural areas of Mongolia.
Participants: A purposive sample of 16 persons with traumatic SCI.
Interventions: Not applicable.
Outcome Measures: Not applicable.
Results: Seven categories of environmental barriers were mentioned, such as poor access to the physical environment, absence of wheelchair-friendly transportation, negative societal attitudes, inadequate health and rehabilitation services, lack of access to assistive devices and medicines, limited financial resources for healthcare, and inaccurate categorization of disabilities in laws. These barriers were claimed to have an impact on physical and psychological health, limit activities, and restrict participation in almost all areas of life.
Conclusion: This study contributes to the identification of targets for interventions aimed at improving the lived experience of persons with SCI in a low-resource context. The findings reveal that while the Mongolian government already has laws and policies in place to improve access to the physical environment, transportation, assistive devices and employment, much more has to be done in terms of enforcement. Specialized SCI care and rehabilitation services are highly demanded in Mongolia.
Impact of spasticity on functioning in spinal cord injury: an application of graphical modelling
(2020)
Abstract
Objective: To identify the impact of moderate-to-severe spasticity on functioning in people living with spinal cord injury.
Design: Secondary analysis of cross-sectional survey data using graphical modelling.
Subjects: Individuals (n = 1,436) with spinal cord injury aged over 16 years with reported spasticity problems.
Methods: Spasticity and 13 other impairments in body functions were assessed using the spinal cord injury Secondary Conditions Scale. Impairments in mental functions were assessed using the Mental Health subscale of the 36-item Short Form (SF-36). Independence in activities was measured with the Spinal Cord Injury Independence Measure Self-Report. Restrictions in participation were measured with the Utrecht Scale for Evaluation Rehabilitation – Participation.
Results: Fifty-one percent of participants reported moderate-to-severe spasticity. Graphical modelling showed that Chronic pain, Contractures, Tiredness, Doing housework, and Respiratory functions were associated with spasticity and were the top 5 potential targets for interventions to improve the experience of spasticity. The associations and intervention targets were dependent on the level and completeness of the lesion.
Conclusion: This is the first application of graphical modelling in studying spasticity in people living with spinal cord injury. The results can be used as a basis for studies aiming to optimize rehabilitation interventions in people with moderate-to-severe spasticity.
Lay Abstract
Spasticity is one of the most common complications of spinal cord injury. It influences limitations in functioning. Comprehensive evidence on the impact of spasticity on all domains of functioning may be beneficial to optimize rehabilitation interventions aimed at reducing the effects of spasticity. This is the first application of graphical modelling to study and visualize the impact of moderate-to-severe spasticity on functioning in people living with spinal cord injury. The results show that chronic pain, contractures, tiredness, doing housework, and respiratory functions were the functioning domains associated with spasticity. These are therefore the top 5 potential targets for interventions to improve the experience of spasticity. In addition, the level and completeness of lesions should be considered when studying spasticity in relation to all domains of functioning. These results should be used as a basis for studies aiming to optimize rehabilitation interventions in people with moderate-to-severe spasticity.
Driving forest machines on wet soils causes irreversible soil compaction, often associated with intensive rut formation and inaccessibility of wheeled forest machines for future forest operations. The German forestry equipment manufacturer FHS, Forsttechnik Handel & Service GmbH, engineered a forwarder, the Trac 81/11, equipped with conventional, well-proved bogie-axles embraced by a closed rubber track. At the center of the bogie-axle, four additional supportive rollers are placed to increase the load-carrying section between the tires of the bogie-axle. The study aimed to characterize the principle concept and the trafficability of the forwarder by analyzing the footprint area, the contact pressure, the rut formation on forest sites and the slippage during driving. Therefore, the effective contact area was measured on steel plates and rut formation was analyzed on a case study basis. Results showed that the supportive rollers increase the contact surface area by about 1/3. By this, a decrease of peak loads below the wheels and a more homogenous load distribution were observed. However, the contact surface area is still clearly divided into three parts; the area between the supportive rollers and the wheels does not take any load. Results of the rut formation were diverse: After 20 passes with 26,700 kg total mass, rut depth varied between 12.6 and 212.5 mm. Overall, the new undercarriage concept of FHS demonstrated a generally positive performance. The engineered forwarder contributes to reduce the environmental impact associated with log extraction.
Zahlensysteme und binäre Arithmetik – Nachricht und Information – Codierung und Datenkompression – Verschlüsselung – Schaltalgebra, Schaltnetze und Elemente der Computerhardware – Rechnerarchitekturen – Rechnernetze – Betriebssysteme – prozedurale und objektorientierte Programmierung (C und Java) – Automatentheorie und formale Sprachen – Berechenbarkeit und Komplexität – Suchen und Sortieren – Bäume und Graphen – Software-Engineering – Datenbanken – Anwendungsprogrammierung im Internet (HTML, CSS, JavaScript und PHP) – Deep Learning mit neuronalen Netzen
Virtual teams that use integrated communication platforms are ubiquitous in cross-border collaboration. This study explores the use of communication media and team outcomes—both social outcomes and task accomplishment—in multilingual virtual teams. Based on surveys from 96 virtual teams (with 578 team members), the research shows that the more time spent in rich communication channels, such as online conferences, increased inclusion and satisfaction, whereas the more time spent with written communication that is lower in richness increased the level of task accomplishment. Team members with lower language proficiency felt less included in all collaboration channels, whereas team members with higher language proficiency felt less satisfied with lean collaboration. In addition, limited language proficiency speakers were significantly less likely to view rich tools as helpful for their teams to reach a mutual decision. Our data support media richness theory in its original context for native and highly proficient English speakers. Our study extends the scope of the theory by applying it to the new context of team members with limited language proficiency. Management should implement a collaboration infrastructure consisting of communication platforms that integrate a variety of media to account for different tasks and different communication needs.
Teams are beginning to rely on smart communication technology that is enhanced by Artificial Intelligence (AI). Yet, we lack understanding of how these smart communication technologies (SCT) influence team collaboration, especially in global virtual teams (GVT). This study empirically investigates how cultural values and practices influence the acceptance of SCT and how the use of this technology impacts communication effectiveness in GVT. We surveyed 643 members of 109 GVT before and after using the SCT. Results showed that team members from individualistic, future oriented cultures generally had more positive expectations towards the performance and enjoyment of using the technology. Uncertainty avoidance increased effort expectancy. After using SCT for communicating in the GVT, most differences disappeared. Regarding communication effectiveness, SCT had a positive influence, which was stronger for performance and future oriented cultures.
This study examines the impact of perceived foreign language proficiency on hybrid culture building in multicultural teams. Hybrid culture includes a mutually shared set of norms, communication patterns, problem-solving approaches, and synergistic task coordination that result from the diverse cultural backgrounds of the team members. Language is the main vehicle for communication and plays a major role in social interaction and therefore hybrid culture building. We argue that the level of perceived language proficiency of multicultural team members influences hybrid culture building; consequently, adequate language skills lead not only to an efficient task solution but are also an important factor in creating interpersonal relationships and building a shared culture. Our empirical analysis supports the positive influence of language proficiency in hybrid teams; however, foreign language proficiency is more influential on cognitively oriented areas of multicultural teamwork than on affective ones.
Introduction: In Germany, all new, innovative medicines are subject to an early benefit assessment by the German Federal Joint Committee with subsequent price negotiation and optional arbitration. The purpose of this study was to identify drivers of negotiated (including arbitrated) prices of new, non-orphan innovative medicines in Germany.
Methods: The analysis considered all non-orphan drugs that underwent a benefit appraisal between January 2011 and June 2016, and displayed a reimbursement price in the German Drug Directory (Lauer-Taxe®) in November 2017. Negotiated annual treatment costs were analyzed with respect to 11 explanatory variables in regression models.
Results: The total sample included 106 non-orphan drugs. The analysis showed a significant and positive association of log-transformed negotiated annual treatment cost of new medicines with log-transformed annual treatment cost of its comparator(s), extent of added benefit, and log-transformed size of the target population. Analyzing the effects of specific endpoints instead of the overall added benefit revealed that the single endpoint with the largest impact on price is adverse events (AEs). Surprisingly, an increase in AEs significantly increased the price. Various subgroup and sensitivity analyses demonstrated the robustness of the results. The adjusted R squared for all models was above 80%.
Conclusions: The analysis was able to confirm that variables whose consideration is mandated by law are, in fact, the key drivers of negotiated prices. Somewhat puzzling, the analysis also found an increase in AEs to move prices significantly upward.
Knowing about the presence and number of people in a room can be of interest for precise control of heating, ventilation and air conditioning. To determine the number and presence of occupants cost-effectively, it is of interest to use already existing air condition sensors (temperature, humidity, CO2) of the building automation system. Different approaches and methods for determining presence have attracted attention in recent years. We propose an occupancy detection method based on a method of supervised machine learning. In an experiment, measurement data were recorded in a research apartment with controllable boundary conditions. The presence of people was simulated by artificial injection of water vapour, CO2 and heat dissipation. The variation of the number of artificial users, the duration of presence and the supply air volume flow of the ventilation resulted in a total of 720 combinations. By using artificial users, the boundary conditions were accurately defined, and different presence situations could be measured time-effectively. The data is evaluated with a method of supervised machine learning called random forest. The statistical model can determine precisely the number of people in over 93% of the cases in a disjoint test sample. The experiments took part in the Rosenheim Technical University of Applied Sciences laboratory.
Ein zweistufiger Operationsverstärker wird parallel in einer 180nm CMOS Technologie in der Entwicklungsumgebung von Cadence ADE und in MATLAB/Simulink in einem modellbasierten Ansatz entworfen und simuliert. Für den Entwurf in MATLAB/Simulink wird das Kleinsignalersatzschaltbild der physikalischen Schaltung verwendet. Mit Hilfe der Co-Simulation zwischen Cadence und MATLAB/Simulink wird das Verhalten simuliert und ausgewertet. Die Ergebnisse aus beiden Modellen stimmen überein, wodurch festgestellt werden kann, dass die Co-Simulation erfolgreich war.
Oncologic patients are regarded as the population most at risk of developing a severe course of COVID-19 due to the fact that malignant diseases and chemotherapy often weaken the immune system. In the face of the ongoing SARS-CoV-2 pandemic, how particular patients deal with this infection remains an important question. In the period between the 15 and 26 April 2020, a total of 1227 patients were tested in one of seven oncologic outpatient clinics for SARS-CoV-2, regardless of symptoms, employing RT-qPCR. Of 1227 patients, 78 (6.4%) were tested positive of SARS-CoV-2. Only one of the patients who tested positive developed a severe form of COVID-19 with pneumonia (CURB-65 score of 2), and two patients showed mild symptoms. Fourteen of 75 asymptomatic but positively tested patients received chemotherapy or chemo-immunotherapy according to their regular therapy algorithm (±4 weeks of SARS-CoV-2 test), and 48 of 78 (61.5%) positive-tested patients received glucocorticoids as co-medication. None of the asymptomatic infected patients showed unexpected complications due to the SARS-CoV-2 infection during the cancer treatment. These data clearly contrast the view that patients with an oncologic disease are particularly vulnerable to SARS-CoV-2 and suggest that compromising therapies could be continued or started despite the ongoing pandemic. Moreover the relatively low appearance of symptoms due to COVID-19 among patients on chemotherapy and other immunosuppressive co-medication like glucocorticoids indicate that suppressing the response capacity of the immune system reduces disease severity.
The use of wood in geotechnical applications has seen renewed interest. However, concerns related to the durability and service life of wood in ground contact applications remain. Wood has the potential to substitute commonly used steel and concrete in the geotechnical engineering sector, but solutions to extending the service life and maintenance intervals require long-lasting wood protection systems capable of inhibiting fungal and bacterial decay. Cement, one of the constituents of concrete was identified as a potential coating material for wood used in soil stabilisation works. Spruce and beech wood rest rolls from commercial veneer peeling has been identified as a potential source for cement-coated geotechnical wood products. Norway spruce and European beech wood was subsequently used in this study.
In this study, a series of tests related to dimensional stability and fungal durability were undertaken to investigate the adhesion of a cement coating to wood and to assess the effect of a cement coating on the resistance to fungal decay. Swelling and shrinkage tests of uncoated specimens were undertaken to investigate dimensional stability. Laboratory fungal durability tests assessed changes in wood durability of specimens coated with a novel, flexural cement coating. Wood impregnated with Polyethyleneglycol-dimethacrylate (PEGDMA) prior to cement coating was investigated to improve wood dimensional stability and reduce cracking of the cement coating under changing wood moisture conditions. Cement coating thickness and delamination tests then assessed the durability of the novel cement coating itself. Results from fungal durability tests showed that a continuous, flexural, and crack-free cement coating was imperative to a wood durability improvement. Double cement-coated spruce wood showed improved resistance to decay by basidiomycetes (Coniphora puteana and Trametes versicolor). Results from swelling and shrinkage tests showed that an improvement in dimensional stability would assist in achieving a durable cement coating and impregnation with Polyethyleneglycol-dimethacrylate (PEGDMA) is one manner to improve dimensional stability and therefore cement adhesion to the wood substrate.
Study design
Cross-sectional.
Objectives
To examine the associations between activities, body structures and functions, and their relationship with aetiology, age and sex in persons with spinal cord injury (SCI) at discharge from first rehabilitation.
Setting
Swiss SCI Cohort Study (SwiSCI).
Methods
The study included 390 participants with newly acquired SCI and the International Classification of Functioning, Disability and Health (ICF) as conceptual frame of reference. Body structures were represented by injury level and severity; body functions by cardiovascular, pulmonary, skin, bowel and urinary functions and pain; mental functions by anxiety, depression, optimism and self-esteem; and activities by independence in performing activities of daily living (ADL). Using structural equation modelling (SEM), indirect effects of body structures and functions on independence in performing ADL through mental functions were tested for each mental function separately. For each structural model, fit was assessed using several indices and differences in aetiology, age and sex groups were explored.
Results
The structural model about optimism showed good fit in all indices; the models about anxiety, depression and self-esteem showed conflicting fit indices, respectively. Within all models, effects on independence in performing ADL were mainly direct. Pain showed significant (P < 0.05) indirect effects on independence in performing ADL within the depression, optimism and self-esteem models. The model about anxiety showed differences in aetiology groups.
Conclusions
Using an ICF-based modelling approach, this study presents an attempt towards a more comprehensive understanding of functioning in first rehabilitation of persons with SCI, which might be fundamental for rehabilitation planning.
The dynamic behavior and position stability of servo drives are influenced by many parameters. One major influencing parameter is the pulse width modulation (PWM) frequency. With inverters based on wide bandgap semiconductors, the PWM frequency can be increased. This enables a substantial increase in the current control bandwidth. The paper focuses on the influence of the PWM frequency on the dynamics of control loops and position stability, which are derived from theoretical correlations. The theory is verified using a test bench for high dynamic and position stability. The test bench is equipped with a voice coil motor and power electronic with gallium nitride (GaN) power semiconductors for switching frequencies of 100kHz and over. The achieved position stability, measured with a laser-based comparator at the tool center point, is lower than "+-1nm" with a standard deviation of "0.16nm" at a PWM frequency of "f_PWM=100kHz".
Providing a subset of previously studied information as a retrieval cue can impair memory for the remaining information. Previous work with adults has shown that such part-list cuing impairment (PLCI) can be transient or lasting, depending on study condition. Here, we investigated the persistence of PLCI in children. Three age groups (7- and 8-year-olds, 9- and 10-year-olds, and 12- to 14-year-olds) learned a list of items, either through a single study trial (1-study condition) or through two study-test cycles (2-study-test condition). Subsequently, two recall tests were administered, with part-list cues being provided in the first (critical) test but not in the second (final) test. Of primary interest was whether the detrimental effect of part-list cuing induced in the critical test would persist to the uncued final test. In 12- to 14-year-olds, we found an adult-like pattern of results, with lasting impairment in the 1-study condition but transient impairment in the 2-study-test condition. In contrast, in the two younger age groups, we found PLCI to be lasting in both study conditions, suggesting age differences in the persistence of PLCI. The results are discussed in light of a recently proposed two-mechanism account of PLCI that attributes lasting impairment to retrieval inhibition and transient impairment to strategy disruption. Following this account, the results suggest that whereas 12- to 14-year-olds’ PLCI was caused by (lasting) retrieval inhibition in the 1-study condition and by (transient) strategy disruption in the 2-study-test condition, 7- and 8-year-olds’ and 9- and 10-year-olds’ PLCI was caused by (lasting) retrieval inhibition in both study conditions.
VBA mit Excel
(2020)
Dieses Buch bietet eine anwendungsorientierte Einführung in die Programmierung mit Visual Basic for Applications (VBA) in Microsoft Excel. Es ermöglicht auch Einsteigern die selbstständige Lösung kleiner bis mittelgroßer Programmieraufgaben aus dem betriebswirtschaftlichen Alltag. Der Schwierigkeitsgrad der Inhalte ist überwiegend einfach gehalten, sodass Nutzer, die bereits grundlegende Tätigkeiten in MS Excel beherrschen, sich nach ihren jeweiligen Anforderungen entsprechend fortbilden können. Zahlreiche Praxisbeispiele und Übungen, die auf einem Windows-Betriebssystem entwickelt und getestet wurden, unterstützen das Lernen Schritt für Schritt und zeigen, wie hilfreich VBA durch Automatisierung und Individualisierung in jedem Büro sein kann.
Environmental regulations force automotive companies to modify the powertrain technology portfolio offered to the customer to comply with greenhouse gas (GHG) emission targets. Automotive companies, in turn, are faced with the decision of finding the right powertrain technology portfolio because the selection of a particular technology portfolio affects different company targets at the same time. What makes this decision even more interesting is the fact that future market shares of the different technologies are uncertain. With its numerous objectives, this challenge requires multi-criteria decision-making techniques to identify the optimal powertrain technology portfolio. The objective of this research is to present a new decision support approach for assembling optimal powertrain technology portfolios while making decision-makers aware of the trade-offs between the achievable market share, the market share risk, and the GHG emissions generated by the selected vehicle fleet. The proposed approach combines `a posteriori' decision-making, multi-objective optimization, and the Markowitz portfolio theory. In an application case, the outlooks of selected market studies are fed into the proposed decision support system. The result is a visualization and analysis of the current real-world decision-making problem faced by many automotive companies. Interesting findings of this research include that for the assumed GHG restrictions in place in 2030, there exists no optimal powertrain technology portfolio that is not composed of at least 20% of electric vehicles.
Background
Joint contractures in frail older people are associated with serious restrictions in participation. We developed the Participation Enabling CAre in Nursing (PECAN) intervention, a complex intervention to enable nurses to promote participation in nursing home residents with joint contractures. The aim of this study was to examine the feasibility of the implementation strategy and to identify enablers and barriers for a successful implementation.
Methods
The implementation of PECAN was investigated in a 6-month pilot cluster-randomised controlled trial (c-RCT). As a key component of the implementation strategy, nominated nurses were trained as facilitators in a one-day workshop and supported by peer-mentoring (visit, telephone counselling). A mixed-methods approach was conducted in conjunction with the pilot trial and guided by a framework for process evaluations of c-RCTs. Data were collected using standardised questionnaires (nursing staff), documentation forms, problem-centred qualitative interviews (facilitators, therapists, social workers, relatives, peer-mentors), and a group discussion (facilitators). A set of predefined criteria on the nursing home level was examined. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using directed content analysis.
Results
Seven nursing homes (n = 4 intervention groups, n = 3 control groups) in two regions of Germany took part in the study. Facilitators responded well to the qualification measures (workshop participation: 14/14; workshop rating: “good”; peer-mentor visit participation: 10/14). The usage of peer-mentoring via telephone varied (one to seven contacts per nursing home). Our implementation strategy was not successful in connection with supplying the intervention to all the nurses. The clear commitment of the entire nursing home and the respect for the expertise of different healthcare professionals were emphasised as enablers, whereas a lack of impact on organisational conditions and routines and a lack of time and staff competence were mentioned as barriers.
Conclusion
The PECAN intervention was delivered as planned to the facilitators but was unable to produce comprehensive changes in the nursing homes and subsequently for the residents. Strategies to systematically include the management and the nursing team from the beginning are needed to support the facilitators during implementation in the main trial.
Trial registration
German clinical trials register, DRKS00010037. Registered 12 February 2016.
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