Das alltägliche Gesundheitshandeln von (Spät-)Aussiedlerinnen und (Spät-)Aussiedlern aus der ehemaligen Sowjetunion: eine qualitative Studie am Beispiel der Kreisstadt Merzig

Die vorliegende Dissertation untersucht das alltägliche Gesundheitshandeln von (Spät-)Aussiedlerinnen und (Spät-)Aussiedlern aus der ehemaligen Sowjetunion. Im Fokus der Arbeit stehen dabei die subjektiven Gesundheitskonzepte und -theorien sowie die Maßnahmen, die die Befragten zur Erhaltung und zur Förderung der eigenen Gesundheit ergreifen. Es konnte gezeigt werden, dass die befragten Personen komplexe, mehrdimensionale subjektive Gesundheitskonzepte und -theorien besitzen. Darüber hinaus ist das alltägliche Gesundheitshandeln vielfältig und durch unterschiedliche Schwerpunktsetzungen gekennzeichnet.This dissertation examines the health activities of ethnic German migrants (Aussiedler) from the Former Soviet Union. The thesis focusses on the subjective health concepts and theories and the measures taken by interviewees to maintain and promote their own health. The results show that the respondents possess complex and multidimensional subjective health concepts and theories. Furthermore, habitual health activities are divers and characterized by dissimilarities in emphasis

Die Versorgung von Menschen mit chronischen Wunden im Saarland aus Sicht von Betroffenen, Pflegefachkräften und Pflegedienstleitungen ambulanter und stationärer Pflegeeinrichtungen sowie Hausärzten (ChroWuSaar)

The management of patients with chronic wounds in the primary care, Saarland (Germany) Background: Non-healing wounds are usually secondary complications of chronic diseases. The aim of the study was to analyze the care of people with chronic wounds in outpatient care and nursing homes under primary care. In result of the study, recommendations for action as goal-orientated multi-professional cooperation should be recognized. Subject of analysis: The emphasis of this work was on recording and documenting the quality of life of patients with leg ulcers, pressure ulcers or diabetic foot syndrome and their treatment goals and benefits as well as the individual orientated nursing and primary care quality. In addition, the care structures of the respective institutions as well as the inter-professional delivery practice of wound management were examined by nurses, head nurses and managing directors from ambulatory care services and 74 nursing homes and family practitioners. Methodology: The study took place in Saarland (Germany) across different sectors in year 2016 over continuous period between 6 and 22 weeks. The data was collected via online and/or paper-pencil survey. The figures and analysis were carried out with the statistics program IBM SPSS Statistics Version 23 and the software MAXQDA 12. Results: 50 patients, 353 nurses, 44 Head nurses and managing directors from 20 ambulatory care services and 74 nursing homes as well as 10 family practitioners were successfully recruited for the study. As a part of result of the study it is determined that people with chronic wounds in the home environment are perceived as having lower quality of life in comparison with nursing home residents. Reasons for this were obesity (~ BMI> 33kg / m²), wound size (~ 12cm²), recurrence rate (4.8 ± 5.7) and continuous pain (75%). In the nursing home practice information meetings would mainly be offered for those affected and their relatives. In contrast, guidance meetings took place for patients in home environment settings very rarely. Most of the care programs are largely taken over by representatives of medical device manufacturers or home care companies. Advice, training and guidance as well as promotion of self sustainability were rarely offered in facilities. Family practitioners would in the last 24 months period hardly attend training sessions on wound-specific topics. The information, advice and instructions are seen by medicine staff as basics for their work. The family practitioner report shows average estimate extensiveness of chronic wounds of 15.6% at home settings and 27.6% in inpatients care settings. The figures for social care services as for people with chronic wounds in outpatients care and nursing settings show on average 4.6% of chronic wounds prevalence.Die Versorgung von Menschen mit chronischen Wunden in der saarländischen Primärversorgung Hintergrund: Nicht heilende Wunden sind meist Folgekomplikationen chronischer Erkrankungen. Das Ziel der Studie lag darin, die Versorgung von Menschen mit chronischen Wunden in ambulanten und stationären Pflegeeinrichtungen unter hausärztlicher Betreuung zu analysieren. Daraus sollten Handlungsempfehlungen für eine zielführende multiprofessionelle Zusammenarbeit formuliert werden. Fragestellung: Fokussiert wurden die Erfassung der Lebensqualität von Menschen mit Ulcus cruris, Dekubitus oder Diabetischem Fußsyndrom, deren Behandlungsziele und -nutzen sowie die subjektiv wahrgenommene pflegerische und hausärztliche Versorgungsqualität. Darüber hinaus wurden die Versorgungsstrukturen der jeweiligen Einrichtungen wie auch die interprofessionelle Versorgungspraxis des Wundmanagements von Pflegefachkräften, Pflegedienstleitungen und Hausärzten untersucht. Methodisches Vorgehen: Die saarlandweite Querschnittsstudie fand im Jahr 2016 zwischen der 6. und 22. KW statt. Die Daten wurden mittels Online- und/oder Paper-Pencil-Befragung erhoben. Die Datenanalyse erfolgte mit dem Statistikprogramm IBM SPSS Statistics Version 23 und der Software MAXQDA 12. Ergebnisse: 50 Betroffene, 353 Pflegefachkräfte, 44 Pflegedienstleitungen aus 20 ambulanten Pflegediensten und 74 stationäre Pflegeeinrichtungen sowie 10 Hausärzte konnten für die Studie erfolgreich rekrutiert werden. Menschen mit chronischen Wunden im häuslichen Umfeld nahmen eine geringere Lebensqualität im Vergleich zu Pflegeheimbewohnern wahr. Gründe hierfür stellten Adipositas (~BMI >33kg/m²), Wundgröße (~12cm²), Rezidivrate (4,8 ±5,7) und kontinuierliche Schmerzen (75 %) dar. Im pflegerischen Alltag wurden zum Großteil Informationsgespräche für Betroffene und deren Angehörige angeboten. Dagegen fanden Anleitungssituationen kaum statt. Die Veranstaltungen werden zum Großteil von Vertretern der Medizinproduktehersteller oder Home-Care-Unternehmen übernommen. Beratung, Schulung und Anleitung sowie Förderung des Selbstmanagements wurden in Einrichtungen seltener angeboten. Hausärzte nahmen in den letzten 24 Monaten kaum Fortbildungsveranstaltungen zu wundspezifischen Themen wahr und sahen für sich größtenteils auch keinen weiteren Bedarf. Informationen, Beratungen und Anleitungen sehen sie als Grundlage ihrer ärztlichen Tätigkeit. Die Angaben der Ärzte lassen eine mittlere Prävalenz chronischer Wunden von 15,6 % in der Häuslichkeit und 27,6 % in stationären Pflegeeinrichtungen beziffern. Die Angaben von Pflegedienstleitungen (ambulant und stationär) ergaben eine durchschnittliche Prävalenz von 4,6 %

Lessons for Change Management and Software Implementation: An Ethnographic Study of Australian Small Business

University of Technology Sydney. Faculty of Engineering and Information Technology.This research explores the impact of cloud technology adoption on work practices within Australian Small and Medium Enterprises (SMEs). It investigates the central question: “What happens within small businesses when a product is introduced that challenges long-term work practice habits?” Through an ethnographic study, the research delves into the multifaceted experiences of organisational change and technological adaptation. Key insights reveal that even in established organisations, continuous negotiations and shifts occur as individuals adapt, resist, and refine work practices, particularly during periods of technological disruption. The study adopts an ecological approach, intertwining concepts of access, trust, power, and work rhythms to shed light on the dynamic interplay between software design, organisational infrastructure, and everyday work practices. A significant outcome is the development of the 'HOME Improvement' approach, which offers an adaptive, reflective tool for organisations to introspectively assess their dynamics and design contextually fitting improvements. This research provides a novel perspective on sustainable change management for both scholars and industry practitioners navigating technological disruptions

OS PRINCÍPIOS DA CAPACIDADE CONTRIBUTIVA E DA PROGRESSIVIDADE COMO CRITÉRIO PARA UMA TRIBUTAÇÃO JUSTA

Sendo a atividade tributária a principal fonte de arrecadação do Estado, essa deve estar alicerçada em princípios e critérios justos, de modo que nem o contribuinte seja excessivamente onerado, tão pouco o Estado deixe de se ter recursos para cumprir com suas finalidades constitucionais. Nessa perspectiva, considerou-se oportuna a elaboração de um breve estudo, com o objetivo de verificar se e, em caso positivo, como os princípios da capacidade contributiva e da progressividade podem se constituir num forte critério para uma tributação justa. Para isso, optou-se por uma abordagem qualitativa do tema. Concluiu-se que a tributação fundada em princípios próprios de uma carga tributária justa pode ser um importante instrumento na busca de uma efetiva justiça fiscal e, consequentemente, na concretização dos objetivos do próprio Estado Democrático de Direito

Schnelle Simulation von Funkkoexistenz-Verhalten im 2,45-GHz-ISM-Band in großflächigen intralogistischen Szenarien

Für eine extrem schnelle Simulation des Koexistenz-Verhaltens von Funkteilnehmern im 2,45-GHz-ISM-Band im Zusammenspiel mit einem Funkortungssystem in großflächigen intralogistischen Szenarien ist eine spezielle Simulations-Software entwickelt worden. Die Ergebnisse bieten Aussagen zu Zeitverzögerungen der WLAN-Datenübertragung und der Ortungsgenauigkeit von nanoLOC. Es kann den Funkteilnehmern des Ortungssystems ein Koexistenz-Verhalten über spezielle Algorithmen aufgeprägt werden. Diese Algorithmen können dann durch Analyse der Simulationsdaten bewertet und optimiert werden

A genuine solution of the diffusion advection equation sesquilinear way to multi-source problem

The present work is a proposal for an alternative approach for pollution dispersion modelling, including some characteristics that may be associated to the phenomenon of turbulence. As a starting point we consider two axiomatic properties that shall lead to a model and its solution compatible with distributional descriptions. The first one states that a solution shall be semi-positive as expected for a distribution, whereas the second axiom demands for compatibility with coherent structures, which are implemented by the use of sesquilinear forms

Modular Architecture and Unique Teichoic Acid Recognition Features of Choline-Binding Protein L (CbpL) Contributing to Pneumococcal Pathogenesis

The human pathogen Streptococcus pneumoniae is decorated with a special class of surface-proteins known as choline-binding proteins (CBPs) attached to phosphorylcholine (PCho) moieties from cell-wall teichoic acids. By a combination of X-ray crystallography, NMR, molecular dynamics techniques and in vivo virulence and phagocytosis studies, we provide structural information of choline-binding protein L (CbpL) and demonstrate its impact on pneumococcal pathogenesis and immune evasion. CbpL is a very elongated three-module protein composed of (i) an Excalibur Ca 2+ -binding domain -reported in this work for the very first time-, (ii) an unprecedented anchorage module showing alternate disposition of canonical and non-canonical choline-binding sites that allows vine-like binding of fully-PCho-substituted teichoic acids (with two choline moieties per unit), and (iii) a Ltp-Lipoprotein domain. Our structural and infection assays indicate an important role of the whole multimodular protein allowing both to locate CbpL at specific places on the cell wall and to interact with host components in order to facilitate pneumococcal lung infection and transmigration from nasopharynx to the lungs and blood. CbpL implication in both resistance against killing by phagocytes and pneumococcal pathogenesis further postulate this surface-protein as relevant among the pathogenic arsenal of the pneumococcus.We gratefully acknowledge Karsta Barnekow and Kristine Sievert-Giermann, for technical assistance and Lothar Petruschka for in silico analysis (all Dept. of Genetics, University of Greifswald). We are further grateful to the staff from SLS synchrotron beamline for help in data collection. This work was supported by grants from the Deutsche Forschungsgemeinschaft DFG GRK 1870 (to SH) and the Spanish Ministry of Economy and Competitiveness (BFU2014-59389-P to JAH, CTQ2014-52633-P to MB and SAF2012-39760-C02-02 to FG) and S2010/BMD- 2457 (Community of Madrid to JAH and FG).Peer Reviewe

Spatially Anchored Molecular Neighborhoods in Lupus Nephritis

Background: Lupus nephritis (LN) affects 1 in 3 individuals with systemic lupus erythematosus. Suboptimal treatment precipitates irreversible kidney damage, leading to end stage renal disease. Kidney damage in lupus is characterized by immune cells injuring epithelial, endothelial, and stromal cells. We characterized molecular neighborhoods composed of immune cells interacting with resident cells of the kidney through spatial transcriptomics (ST). Methods: Visium ST experiments were conducted in 8 healthy controls (233 glomeruli) and 3 LN samples (48 glomeruli). Cell type labels from the Kidney Precision Medicine Project single cell RNA-seq atlas were transferred to deconvolute ST spots into specific cell types. Using histology and NPHS2 expression, glomeruli were selected as functional tissue units. Data were normalized, dimensionally reduced, and clustered with Seurat v4. Spatially anchored gene signatures of LN were identified. Glomeruli were re-clustered according to cell composition, to identify associated neighborhoods by fisher’s exact test. We characterized the cell composition, differentially expressed genes (DEGs), and pathways of relevant neighborhoods. Results: Between LN and control glomeruli, we identified HSPA8, PLEK, COL1A2 DEGs, associated with hypoxia, fibrosis, and immune response. We identified glomerular neighborhoods consistent with immune complex deposition, endothelial dysfunction (e.g. wire loop lesions), and mesangial cell expansion enriched in LN (p<0.05). Immune complex-mediated injury neighborhoods were characterized by interferon signaling, endothelial cell migration, and vascular genesis, consistent with DEGs BST2, CXCL12, and ENG. Endothelial dysfunction neighborhoods present cellular adhesion, immune cell signaling, and hypoxic pathways. DEGs included ITGB2, HLA-DPB1, and EGR1. Pathways enriched in mesangial expansion neighborhoods included matrix adhesion, podocyte development, and ERK1 and ERK2 cascade, aligned with ITGB3, NPHS1, and APOE DEGs. Conclusion/ Clinical Impact and Implications: Neighborhood characterization provides insight into cell-cell interactions that drive kidney disease progression. Future directions will change how kidney biopsy specimens drive treatment by delineating specific cell-cell interactions, linking molecular and histopathological signatures, and defining genes associated with therapeutic resistance