Job satisfaction and stressors for working in out-of-hours care – a pilot study with general practitioners in a rural area of Germany

Background: Challenging work environment, high workload, and increasing physician shortages characterize current rural general practice in Germany and in most European Countries. These factors extend into Out-Of-Hours Care (OOHC). However, little research about potential stressors for general practitioners (GPs) in OOHC settings is available. This pilot study aimed to evaluate workload, different elements of job satisfaction and stressors for GPs in OOHC and to analyze whether these aspects are associated with overall job satisfaction. Methods: Cross-sectional survey with a sample of 320 GPs who are working in OOHC was used to measure workload in OOHC, job satisfaction (using the Warr-Cook-Wall scale) and stressors with the effort-reward imbalance questionnaire. In order to assess associations between workload, job satisfaction and stressors at work we performed descriptive analyses as well as multivariable regression analyses. Results: The response rate was 40.9%. Over 80% agreed that OOHC was perceived as a stressor and 79% agreed that less OOHC improved job satisfaction. Only 42% of our sample were satisfied with their overall job satisfaction. The regression analysis showed that the modification of current OOHC organization was significantly associated with overall job satisfaction. Conclusions: Our results suggest that OOHC in the current form is a relevant stressor in daily work of rural GPs in Germany and one of the reasons for a decreasing overall job satisfaction. Strategic changes such as the implementation of structural reforms e.g. reducing frequency of OOHC duties for each GP and improving continuing professional development options related to OOHC are needed to address current workload challenges experienced by GPs providing OOHC in Germany

Does free-floating carsharing reduce private vehicle ownership? The case of SHARE NOW in European cities

During the last decade, the use of free-floating carsharing systems has grown rapidly in urban areas. However, little is known on the effects free-floating carsharing offerings have on car ownership in general. Also the main drivers why free-floating users sell their cars are still rarely analysed. To shed some light on these issues, we carried out an online survey among free-floating carsharing users in 11 European cities and based our analysis on a sample of more than 10,000 survey participants. Our results show that one carsharing car replaces several private cars – in optimistic scenarios up to 20 cars. In Copenhagen (followed by Rome, Hamburg, and London) one carsharing car replaces about two times more private cars than in Madrid, the city with the lowest number. The main non-city specific influencing factor of shedding a private car due to the availability of the free-floating carsharing services seems to be the usage frequency of the service. The more kilometres users drive with these cars, the more likely it becomes that they sell a private car (or they sell their car and, therefore, use this service more often). Further memberships of bikesharing and other carsharing services, users that live in larger buildings as well as users that own several cars are more likely to reduce their number of cars, too. Finally, our findings are highly valuable for carsharing operators and (transport) policy makers when introducing free-floating carsharing systems in further cities. According to our results, all 11 cities show a reduced private car fleet due to members’ access to free-floating carsharing

A Study on Free-floating Carsharing in Europe : Impacts of car2go and DriveNow on modal shift, vehicle ownership, vehicle kilometers traveled, and CO2_{2} emissions in 11 European cities

Free-floating carsharing, i.e., carsharing that allows pick-up and return of a car anywhere within a specified area in a city, has now been available in European cities for more than 10 years. As an important example of the sharing economy, carsharing strives for a more efficient use of resources with positive economic, social, and environmental impacts. After a decade of operation and user experience, an evaluation seems appropriate. car2go and DriveNow, who merged into SHARE NOW in 2019, are the largest carsharing operators in the world. They commissioned this study to identify the impact of carsharing on vehicle holdings, modal shift, vehicle kilometers traveled (VKT), and greenhouse gas emissions. The study was conducted in 2018 and 2019. It is based on a survey among car2go and DriveNow customers in 11 European cities. A previous study was performed by the University of California, Berkeley, for 5 North American cities in 2016 [7]. [...

Influence of Novel Space Filling PBF-LB Scanning Strategies on Part Distortion and Density

Additive Manufacturing, especially Powder Bed Fusion – Laser Beam (PBF-LB), is known for its ability to create intricate designs with high precision. Yet, residual stresses remain a challenge, causing distortion. Novel laser paths, including various spiral and space-filling curves such as Hilbert, Gosper, and Peano, have been investigated. They were compared with standard stripe strategies. Parameters such as scan length and hatch distance are varied while maintaining energy density constant. Cantilever beams were used to measure distortion and density. Fractal strategies show minimal distortion with slight density loss. Spiral paths lead to a minimized porosity but show an increased distortion. Segmenting paths reduce distortion across all strategies. The orientation of the cantilever relative to the gas flow affects the distortion extent. Gosper and Hilbert curves reduce distortion with slight density reduction, while spiral paths minimize porosity but increase distortion. Segmenting paths effectively reduce distortion without density loss in all strategies.Mechanical Engineerin

The mathematical development of children with Apert syndrome

Apert syndrome is a rare condition (birth prevalence of 1 in 65000) with associated risks of other physical disabilities. Children with the condition experience major surgery involving the fingers. It has been suggested that these children have greater difficulty with mathematics than with other curriculum subjects. This study explored the mathematical learning of 10 primary school age children with Apert syndrome over two years. The children in the study had varied sensory disabilities, which included hearing and visual impairments, as well as limited finger mobility. The children were visited five or six times at school, in order to detect change over time. The children were observed when they were learning mathematics in school. To explore the children’s understanding and thinking in mathematics, clinical interviews using items from number skills tests were conducted. Standardized measures of working memory and mathematical achievement were administered. Interviews were carried out with the children’s parents and school staff supporting their education. A central finding of this study is that children with Apert syndrome are heterogeneous. The only factor that the children in the study shared was their initial lack of finger use when engaging with work involving number and arithmetic. In line with contemporary neuroscience, this study suggests that finger knowledge and awareness, or finger gnosis, and finger mobility are important in early number development. Exercises in developing of finger gnosis may enable flexibility in strategy use and development for solving problems in arithmetic. However, children with Apert syndrome will continue to be confronted with many other challenges that impact their learning of mathematics

Prevalence, incidence and concomitant co-morbidities of type 2 diabetes mellitus in South Western Germany - a retrospective cohort and case control study in claims data of a large statutory health insurance

BACKGROUND: Type 2 diabetes mellitus (T2DM) has become a world-wide epidemic. This chronic metabolic disease has a major impact on life expectancy and on quality of life. The burden of this disease includes a number of co-morbidities. However, estimates of prevalence, incidence and associated diseases as well as the current temporal development and regional differences are largely missing for South Western Germany. METHODS: Lifetime diagnosis-based prevalence, incidence and presence of concomitant co-morbidities were examined between the years 2007 and 2010 in the claims data set of all insured persons of the AOK Baden-Wuerttemberg, a large statutory health insurance. The analysis was based on the respective WHO-ICD-10 codes. Data were standardized for age and sex on the residential population of about 10 million inhabitants of South Western Germany. RESULTS: The total study cohort involved approximately 3.5 million persons each year. The standardized diagnosis-based prevalence (SDP) of T2DM rose from 6.6 %, 7.4 %, 8.0 %, up to 8.6 % in the years 2007 to 2010. Yearly SDP was between 14.0 % and 18.9 % at an age range of 60 to 64 years and between 26.7 % and 31.8 % at an age of 75 years or older. In the year 2010 the regional distributions of standardized diagnosis-based prevalence were between 7.6 % and 11.6 %, respectively. Incidence rates were 8.3 in 2008, 7.8 in 2009, and 8.7 in 2010 (all rates per 1000). The excess disease risk (odds ratio) of T2DM was for adiposity 2.8 to 3.0, hypertension 2.4 to 3.7, coronary heart disease 1.8 to 1.9, stroke 1.7 to 1.8, renal insufficiency 2.8 to 3.4, and retinopathy 2.8 to 2.9 in the years 2007 to 2010. These co-morbidities appeared several years earlier compared to the non-diabetic population. CONCLUSIONS: T2DM is common and increasing in South Western Germany. In particular a quarter of the population in higher ages was afflicted by T2DM. Interestingly a region-specific pattern was observed as well as an increase in numbers during earlier years in life. Our data underline the need for diabetes awareness programmes including early diagnosis measures as well as structured and timely health surveys for major diseases such as T2DM and its concomitant co-morbidities. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-015-2188-1) contains supplementary material, which is available to authorized users