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Hintergrund/Fragestellung: An der Bewältigung der COVID-19-Pandemie sind verschiedene Akteure des Gesundheitswesens beteiligt. Laut Kassenärztlicher Vereinigung wurden in Deutschland 86% der COVID-19-Patient*innen bislang ambulant versorgt. Weltweit ist das komplexe Einwirken[zum vollständigen Text gelangen Sie über die oben angegebene URL], Who cares? – EbM und Transformation im Gesundheitswesen; 22. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Contains fulltext : 245532.pdf (Publisher’s version ) (Closed access) INTRODUCTION: Due to the COVID-19 pandemic, the German health system has faced major challenges since spring 2020. In addition to restrictions in the inpatient health care sector, the maintenance of outpatient care by health care providers has also been affected by the pandemic-related restrictions. Both a decline in treatment frequencies and temporary practice closures have been observed. The aim of the study was to survey the work and care situation in outpatient physiotherapy practices during the first wave of the pandemic. METHODS: An anonymous online survey including quantitative and qualitative items was conducted among physiotherapists in the outpatient sector in Germany between June 1 and August 31, 2020. The survey is part of the mixed-methods study "ArTheCo", which was conducted throughout Germany including outpatient therapists and patients in physiotherapy, speech therapy and occupational therapy. RESULTS: In total, 577 physiotherapists from all over Germany took part in the survey. During the first wave of the pandemic, the occupancy rate fell below 50% at 45% of the facilities. 15% of the facilities had to close temporarily. Short-time work was announced at 58% of the respondents' practices. This and the implementation of hygiene measures restricted the provision of physiotherapy. This mainly affected patients with a higher risk of a severe clinical course of disease, such as nursing home patients. Due to complex changes in practice organisation and patient care, many of the interviewees felt that their economic existence was threatened and also described a large physical and psychological burden. Existing dissatisfaction seemed to have increased by the pandemic. DISCUSSION: To maintain continuous physical therapy, a reorganisation of the reimbursement system as well as easily accessible, consistent and feasible action plans for practices are needed. In combination with threats to existence due to the pandemic and increasing skill shortage, the outpatient physiotherapeutic care also appears to be threatened beyond the pandemic. CONCLUSION: The current pandemic has highlighted long-standing challenges causing dissatisfaction and making the profession increasingly unattractive for some of the respondents. Political action to support physiotherapists needs to be initiated. This study indicates potential starting points. Publisher: Abstract available from the publisher. ger

Lower specific fuel consumption as well as noise reduction are the main goals in the sector of civilaeronautics engineering nowadays. One prominent concept of achieving these goals is the gearedturbofan engine, in which a planetary gear box is installed between the low pressure spool and thefan. This allows the low pressure turbine as well as the fan to rotate at optimum speeds. This way, thesame power can be generated by fewer stages in the faster rotating turbine, which in turn compensatesthe additional weight of the gear box. The main advantage of the geared turbofan is the possibilityto further increase the fan diameter and therefore improve the propulsion efficiency by means of ahigher bypass ratio. One crucial feature of the gear box is the cooling system needed to ensure safeoperating conditions during all phases of the flight envelope. For an efficient cooling system, optimizedwith respect to weight and cost, the heat transfer between the cooling fluid and the gears needs tobe understood thoroughly. In this study, the impingement cooling of spur gears by oil jets is forthe first time examined analytically and compared to experimental results. This provides knowledgeabout the evolution of the heat transfer coefficient distribution resulting from the cooling fluid flowrate and the gear speed, as well as a deep understanding of the underlying phenomena causing thisbehavior. The analytical solution process comprises of two calculation steps. First, the size of the oilfilm is calculated and secondly, the heat transfer across this surface is evaluated while the oil film isflung off the tooth flank by centrifugal forces. The parameters varied in this study were the oil flowrate, the rotational speed of the spur gear and the oil jet angle. The theoretical results are in goodagreement with the experimental data. The theoretical approach can therefore be applied as a newand efficient tool to estimate the global heat transfer coefficient of impingement cooled spur gears.Furthermore, the validated tool can be used as boundary condition for thermal models of spur gearsand help optimize the impingement cooling oil systems.

This article documents the addition of 277 microsatellite marker loci to the Molecular Ecology Resources Database. Loci were developed for the following species: Ascochyta rabiei, Cambarellus chapalanus, Chionodraco hamatus, Coptis omeiensis, Cynoscion nebulosus, Daphnia magna, Gerbillus nigeriae, Isurus oxyrinchus, Lates calcarifer, Metacarcinus magister, Oplegnathus fasciatus, Pachycondyla verenae, Phaethon lepturus, Pimelodus grosskopfii, Rotylenchulus reniformis, Scomberomorus niphonius, Sepia esculenta, Terapon jarbua, Teratosphaeria cryptica and Thunnus obesus. These loci were cross-tested on the following species: Austropotamobius italicus, Cambarellus montezumae, Cambarellus puer, Cambarellus shufeldtii, Cambarellus texanus, Chionodraco myersi, Chionodraco rastrospinosus, Coptis chinensis, Coptis chinensis var. brevisepala, Coptis deltoidea, Coptis teeta, Orconectes virilis, Pacifastacus leniusculus, Pimelodus bochii, Procambarus clarkii, Pseudopimelodus bufonius, Rhamdia quelen, Sepia andreana, Sepiella maindroni, Thunnus alalunga, Thunnus albacares, Thunnus maccoyii, Thunnus orientalis, Thunnus thynnus and Thunnus tonggol.