Current Programs Research Articles

Ripples in the Water: Physical Education Teacher Education Program Influence on Graduates’ Perceptions of Expanded Physical Activity Programming

Physical educators are often asked to promote whole-school physical activity programming beyond their scheduled class times. Previous research has supported that training in expanded roles would be beneficial during university-based physical education teacher education (PETE) training. In this qualitative study, 13 graduates from a single PETE program that has integrated expanded physical activity into programming shared information about their current programming as physical education teachers in K–12 schools. Campus visits and one-on-one interviews were included. Some practices and values learned during participants’ PETE training were evident in graduates’ current practices. Aligning with previous studies of professional socialization of physical educators, the resulting themes concluded that (a) strategies and resources gained during PETE training were valued and still used and (b) other ripples of influence, such as administrators and other teachers at their current placement, influenced programming. PETE programming with whole-school physical activity can lead to expanded teaching practices in schools.

Andragogy – Dynamic Past, Challenging Present and Uncertain Future

This paper explores the development and current state of andragogy as a scientific discipline in Serbia, with a particular focus on its professionalisation at the University of Belgrade. Despite periods of crisis and societal transitions, andragogy has demonstrated remarkable resilience, remaining relevant and influential in the educational landscape. The current study program at the Department of Andragogy at the University of Belgrade is depicted at the undergraduate, master’s, and doctoral levels. By analysing master’s and doctoral theses, and published scientific papers, the paper provides insights into the prevalent issues and topics in the field. The findings underscore the impact and relevance of andragogy in Serbia and suggest its future prospects. Upholding its core principles and holistic approach, andragogy can play a pivotal role in bridging the gap between the past and the present, leading to the revitalisation of adult education and shaping the trajectory of the discipline itself in Serbia and beyond.

Indications, Techniques, and Barriers for Pancreas Transplant Biopsy: A Consensus Perspective From a Survey of US Centers.

Pancreas transplant biopsy practices for the diagnosis of rejection or other pathologies are not well described. We conducted a survey of staff at US pancreas transplant programs (March 22, 2022, to August 22, 2022) to assess current program practices and perceptions about the utility and challenges in the performance and interpretation of pancreas allograft biopsies. Respondents represented 65% (76/117) of active adult pancreas transplant programs, capturing 66% of recent pancreas transplant volume in the United States. Participants were most often nephrologists (52%), followed by surgeons (46%), and other staff (4%). Pancreas allograft biopsies were performed mostly by interventional radiologists (74%), followed by surgeons (11%), nephrologists (8%), and gastroenterologists (1%). Limitations in the radiologist's or biopsy performer's comfort level or expertise to safely perform a biopsy, or to obtain sufficient/adequate samples were the two most common challenges with pancreas transplant biopsies. Pancreas transplant biopsies were read by local pathologists at a majority (86%) of centers. Challenges reported with pancreas biopsy interpretation included poor reliability, lack of reporting of C4d staining, lack of reporting of rejection grading, and inconclusive interpretation of the biopsy. Staff at a third of responding programs (34%) stated that they rarely or never perform pancreas allograft biopsies and treat presumed rejection empirically. This national survey identified significant variation in clinical practices related to pancreas allograft biopsies and potential barriers to pancreas transplant utilization across the United States. Consideration of strategies to improve program experience with percutaneous pancreas biopsy and to support optimal management of pancreas allograft rejection informed by histology is warranted.

Reconceptualising initial teacher education in South Africa: A quest for transformative and sustainable alternatives

Education serves as a catalyst for achieving Sustainable Development Goals (SDGs), and it is essential for education to keep pace with societal dynamics. This paper argues for the reconceptualisation of initial teacher education in South Africa to promote an alternative transformative and sustainable pedagogy. Questions arose regarding the compatibility of the current teacher education program in South Africa with the needs of today's learners. Therefore, it is important to assess whether South African higher education institutions provide adequate training for future teachers. The current teacher education programme has remained unchanged for many years, failing to adapt to the evolving educational landscape and instead adhering to traditional methods that were relevant in the past. Incorporating flexible, transformative pedagogies and technologies can enhance student learning and engage learners of the 21st century. Using a typological methodological design, this conceptual explanatory paper identifies six themes: program content, pedagogy, technological advancements, preparing teachers for inclusion, school-based experiences, and addressing anxiety. This paper contributes to existing knowledge by advocating for the reconceptualisation of teacher education programs, aiming to produce graduates who are equipped to address global challenges. Furthermore, it emphasises the need for an alternative transformative sustainable initiative to overhaul teacher education programs to align with modern societies' complexities and dynamics. Therefore, this paper calls for the reformulation of South Africa's initial teacher training to align with SDG 4 (quality education) and Agenda 2023, which underpin Africa's transformational aspirations for a better future for all.

Artificial intelligence in dermatology: advancements and challenges in skin of color.

Artificial intelligence (AI) uses algorithms and large language models in computers to simulate human-like problem-solving and decision-making. AI programs have recently acquired widespread popularity in the field of dermatology through the application of online tools in the assessment, diagnosis, and treatment of skin conditions. A literature review was conducted using PubMed and Google Scholar analyzing recent literature (from the last 10 years through October 2023) to evaluate current AI programs in use for dermatologic purposes, identifying challenges in this technology when applied to skin of color (SOC), and proposing future steps to enhance the role of AI in dermatologic practice. Challenges surrounding AI and its application to SOC stem from the underrepresentation of SOC in datasets and issues with image quality and standardization. With these existing issues, current AI programs inevitably do worse at identifying lesions in SOC. Additionally, only 30% of the programs identified in this review had data reported on their use in dermatology, specifically in SOC. Significant development of these applications is required for the accurate depiction of darker skin tone images in datasets. More research is warranted in the future to better understand the efficacy of AI in aiding diagnosis and treatment options for SOC patients.

Influence of Balcony Thermal Bridges on Energy Efficiency of Dwellings in a Warm Semi-Arid Dry Mediterranean Climate

Thermal bridges significantly influence the energy performance of buildings. However, their impact varies depending on the type of thermal bridge, climate conditions, construction methodologies, and geometric characteristics of the building. On the Spanish Mediterranean coast, buildings with large balconies are predominant. Nevertheless, the Spanish energy efficiency regulations do not adequately specify the thermal bridges at the junctions of balconies with facades, leading to a lack of consideration for their influence in the majority of architectural projects. The objective of this study is to qualitatively and quantitatively assess the impact of such thermal bridges on the energy efficiency of buildings in a dry Mediterranean climate (BShs) within a warm semi-arid climate (BSh). As a case study, the influence of this thermal bridge is analyzed in two residential buildings located on the Mediterranean coast of southeastern Spain. The study also examines the modification of various construction parameters of this thermal bridge and determines the optimal design parameters to reduce its thermal transmittance. The results demonstrate that the energy needs caused by thermal bridges account for approximately 40% of the total annual energy needs of the studied residential buildings. Balcony thermal bridges account for 25% to 40% of the energy needs caused by all thermal bridges. The lack of differentiation in Spanish standards between balcony–facade and facade–slab edge junctions causes an imprecision in calculations equivalent to 12% of the total annual energy needs of dwellings. The novelty of this research lies in highlighting that current regulations and calculation programs need improvement to better characterize balcony thermal bridges and enhance the accuracy of building energy efficiency calculations.

Research priorities for water, sanitation and hygiene (WASH) in humanitarian crises: A global prioritisation exercise

Water, sanitation and hygiene (WASH) interventions should provide access to safe water and sanitation, and promote good hygiene practices with dignity, comfort and security. Multiple systematic reviews have noted evidence gaps and is a paucity of good quality evidence related to the effectiveness and implementation of WASH programmes and interventions in humanitarian crises. The aim of this study was to generate consensus-based actionable research priorities for the humanitarian WASH sector. A research prioritisation exercise was conducted by adapting the Child Health and Nutrition Research Initiative (CHNRI) method. Research questions were compiled from a rapid scoping review, key informant interviews (KIIs) and focus group discussions (FGDs). Questions were reviewed by a technical expert group. An online survey was circulated to score research questions according to five criteria. An overall prioritisation score was calculated and weighted to prioritise questions. A diverse range of 286 global WASH and health experts engaged in the CHNRI process. A list of 128 questions were generated and scored by experts. Prioritised research questions focussed on evaluating existing interventions or programmes, and making iterative changes to current programmes. Other important questions centred on describing WASH conditions and associated health risks in crises contexts. Priorities were also stratified by gender, organisation and region to understand differences globally. The WASH in Crises Research Agenda has identified key research questions of most importance to those implementing WASH in humanitarian crises and has established a list of research priorities. The identified priorities reinforce how more evidence is needed, and underlines the need for research to evaluate current practices in order to improve the quality of humanitarian response. Stakeholders, including donors, international and national organisations, governments and academic institutions, are invited to use this research agenda to encourage, inspire and enable relevant and high-quality research that will be used to inform humanitarian responses.

Students’ satisfaction and learning experiences at higher agricultural education institutions in Saudi Arabia: an empirical inquest

AimThis study aims to explore various factors that affect students’ satisfaction regarding postgraduate agricultural programs and the likelihood of recommending such programs to others.MethodsData were collected using structured paper-based questionnaires from a random sample of 127 students who were undertaking master and doctoral programs in eight different disciplines within agricultural sciences at King Saud University.ResultsThe findings showed that majority of the students expressed high academic learning experiences and were satisfied with their program of study. Multiple regression analysis revealed that students’ academic learning experience, faculty support, and the rationale for attending the university had significant positive influence on their satisfaction with the enrolled programs. Moreover, the students’ satisfaction and faculty support also showed significant positive correlation with their likelihood to recommend agricultural programs to others.SuggestionsIn order to further enhance the impact of agricultural programs, we suggest improvements in the university curriculum as well as faculty services to make current agricultural programs up-to-date and relevant to meet the kingdom’s national agricultural and human resource development goals. There should be a particular focus on enhancing students’ research and written communication skills as postgraduate agricultural programs entail a significant component of these highly essential skills.

Education Research: Educating Child Neurology Residents About Psychogenic Nonepileptic Seizures

Background and Objectives Psychogenic nonepileptic seizures (PNES) are difficult to differentiate from epileptic seizures (ES) even for neurologists who see these conditions frequently. This difficulty is due to overlapping semiologic findings between the 2 diagnoses. Previous studies have shown that trainees, including neurology trainees, are not accurate in differentiating PNES from ES. Neurologists often find the communication of PNES difficult. Despite these challenges, most programs do not have formal curricula for teaching PNES, and there are no standards for residency curricula in this topic. The aim of this study was to understand the gaps in resident education on PNES. Methods This study was accomplished through a needs assessment of current pediatric neurology residents and residency program directors (PDs). Two unique surveys were distributed, 1 for child neurology trainees and 1 for PDs. Questions were designed to understand trainees' self-reported knowledge, confidence, current education received, and desired teaching. Similarly for PDs, questions were designed to assess the state of education on PNES at their programs, sufficiency of education, and their desire for standardized curriculum. Results Sixty-eight trainees and 21 PDs responded to the survey. Approximately one-quarter of trainees reported neutral to low levels of confidence and 38% reported neutral to low levels of knowledge in caring for patients with PNES. Trainees reported that directing patients with PNES to appropriate management was the most challenging aspect of care, followed by communicating the diagnosis, with 60% and 46% reporting difficulty, respectively. Only 21% of residents felt their current PNES education needs no improvement. One-fifth of PDs felt their current PNES education is not sufficient, and all reported they would incorporate a standardized curriculum. Trainees reported preferring to learn about this topic through lectures and simulation, while PDs preferred online modules and simulation. Discussion While residents and PDs report high confidence and knowledge in treating pediatric patients with PNES, respondents felt improvement is needed to their curricula regarding this topic. Multiple learning methods are preferred, with emphasis on communicating the diagnosis and management of patients once the diagnosis has been made. PDs desire a standardized curriculum and would incorporate one into their programs. Findings of this study could be used to create a national curriculum.

학부모의 교권 침해 상황에서 나타난 학교장 리더십 분석 -서이초 교사 사건 이후 신문기사와 FGI를 중심으로-

To investigate principals’leadership role and its relevance in school situation in conflict, this study analyzes news articles regarding school principals and interviews with a group of experienced teachers, and identifies some concrete contents of leaderships working on the school sites. Firstly, this study reviews increasing school conflicts by parents’demand for and dissatisfaction with teachers, the leadership roles by principals, and current principal selection institution and training programs and confirms that within current system, it is difficult to form effective and capable leadership to solve conflict democratically and efficiently in school situations. Secondly, this study search news articles for two months from July 18 to september 17 using the Korea Press Foundation's Big Kinds (www.bigkinds.com) service and find 217 articles related to the terms 'teacher rights' and 'principal'. After discussion, 14 articles and 22 cases were extracted and analyzed and a few distinctive leadership types are found such as avoiding responsibility, scolding teacher involved for responsibility, decisions pending, positive conflict mediation type, and proactive communication type. Thirdly, through focus group interview, we check how these kinds of leadership work on school-sites. Based on this analysis, we conclude that further researches and public discourse on leadership formation and principals’ selection and training are required.

Promotion and strategies of menstrual cup use among healthcare providers: A primer towards a sustainable solution for menstrual health and hygiene management in India

Menstrual cups are considered a sustainable solution for menstrual health and hygiene management, as they are cost-effective, environment-friendly, reusable and offer health benefits over traditional menstrual hygiene products such as pads and tampons. However, in lower middle income countries (LMICs), menstrual cup use is limited. Recently, India's current menstrual hygiene program has included menstrual cups as an option for menstrual health and hygiene management. However, the menstrual cup has not been promoted widely in the Indian context. Even if the use of menstrual cups among female healthcare providers in India is minimal, the manuscript identified the crucial challenges in menstrual health and hygiene management, the role of menstrual cups as a solution and the essential strategies to increase menstrual cup use. Programmatic success requires endorsement from healthcare providers as they are trusted sources of information related to healthcare. Good experiences and leading examples from healthcare providers about using menstrual cups is a welcoming step in the path of the dream of a "pad-free country" for India.

Reconstruction of CES time series: implementing the NAICS 2022 redefinitions

With the release of January 2023 data on March 13, 2023, the Current Employment Statistics program revised the basis for industry classification for states and areas from the 2017 North American Industry Classification System (NAICS) to NAICS 2022. The conversion to NAICS 2022 resulted in revisions to data that reflected content and coding changes within the retail trade, information, mining and logging, manufacturing, wholesale trade, financial activities, and other services sectors. In the revision process, the chief aim was to maintain the integrity of data and comparability across the redefined series.

Food Insecurity Is High in a Multi-Site Cohort of Transgender Women Vulnerable to or Living with HIV in the Eastern and Southern United States: Baseline Findings from the LITE Cohort.

The prevalence and correlates of food insecurity-the unavailability of food and limited access to it-have not been adequately considered among transgender women (TW), particularly alongside other health-related conditions burdening this population, such as HIV infection. This study examined the prevalence and correlates of food insecurity among TW. Between 2018 and 2020, 1590 TW in the Eastern and Southern U.S. completed a multi-site baseline assessment (socio-behavioral survey and HIV testing). Descriptive statistics were calculated and multivariable Poisson models with robust error variance were used to estimate prevalence ratios and 95% confidence intervals for correlates of food insecurity (dichotomized as sometimes-to-always vs. seldom-to-never running out of food). Eighteen percent of TW were living with HIV and nearly half of participants (44%) reported food insecurity. Correlates of food insecurity included being Black, multiracial, or another race/ethnicity; having < college education, low income, unstable housing, and high anticipated discrimination; and a history of sex work and sexual violence (all p < 0.05). Food insecurity was highly prevalent among TW. Current programs to provide food support do not adequately meet the needs of TW. HIV pr evention and care programs may benefit from addressing food insecurity.

Perfusion education and training in Europe anno 2023.

Background: In the absence of uniform European regulations, there have been many differences in the training of perfusionists across Europe. Furthermore, there has been no uniform or single European accreditation of the profession. One of the objectives of The European Board of Cardiovascular Perfusion (EBCP) is to standardise and monitor training of perfusionists across Europe whilst offering support in accordance with national regulations. This goal is particularly imminent as there have been numerous newly founded National perfusion societies, particularly from Eastern European countries, which are now established members of EBCP.Purpose: In this article, we provide an updated overview or'snapshot'of current European perfusion training programs that were accessible in 2022. Nationally acquired data refers to 2022unless stated otherwise. The last overview of Perfusion education in Europe was reported over 15 years ago including 20 countries.Research Design: For this report thirty-two national EBCP delegates plus representatives from Austria were contacted at the beginning of 2023 to complete a pro forma questionnaire about their national perfusion training programmes. The data has been summarized in this article and five additional derived parameters were calculated.Results: We received responses from 31 countries, providing specific national training characteristics which are summarized, listed and benchmarked by country in this article.Conclusion: There have been several national and supranational initiatives towards the recognition of perfusion as a profession in Europe, however so far without success for the majority of countries. For this reason, it remains essential for EBCP, as the only European professional perfusionist body, to define education standards and competencies for perfusionists and to monitor training by accreditation of dedicated perfusion schools across Europe.

Clinical spectrum and outcomes of the 2019-2020 pediatric diphtheria outbreak in Yemen

Background Diphtheria is an acute bacterial infectious disease characterized by serious morbidity and mortality. Outbreaks continue to occur in developing countries despite national vaccination programs. Vaccination, early recognition the disease, and adequate intervention are needed to avoid devastating outcomes.&#x0D; Objective To describe the clinical spectrum of childhood diphtheria and its association to outcomes during the 2019-2020 diphtheria outberak in Yemen.&#x0D; Methods This was a retrospective study to assess the demographic, clinical features, and outcomes of paediatric respiratory diphtheria in patients with diphtheria during the outbreak from September 2019 until May 2020 admitted at Mukalla Maternity and Children Hospital. We used SPSS 22 version for data analysis.&#x0D; Results There were 34 culture-confirmed diphtheria cases included in this study, their age ranged from 13 months to 15 years old. Most of the cases (76.5%) happened to children at more than 5 years old. There was no gender difference. Of these 34-positive diphtheria, 79.4% from Hadramout and 17.6% from Shabwa governorate. Most of the cases (35.3%) were admitted in December. More than half of the patients (52.9%) were unimmunized. Fever, sore throat, and enlarged tonsils were presented in all patients, dysphagia (82.4 %), pseudomembrane (91.7%), bull neck (52.9%), and stridor (8.8%) were also found in some patients. Complications included acute renal failure (20.6%), disseminated intravascular coagulation (DIC), shock (17.6%), and myocarditis (8.8%). Significant poor outcome (P&lt; 0.05) was associated with bull neck, myocarditis, acute renal failure, DIC, and shock. The case fatality rate (CFR) was 20.6%.&#x0D; Conclusion Fever, sore throat, tonsillitis, pseudomembrane, and bull neck are high index suspicion of diphtheria and anticipation of ominous outcome. The shifting of occurrence of diphtheria to older age group indicates the need for booster(s) diphtheria toxoid vaccine in addition to improving and strengthening the current immunization program.

Attributes Required by Physiotherapists to Increase Adoption and Implementation of Practice Management Software: A Qualitative Study Using Focus Groups

(1) Background: The aim of this study was to identify the practice management software (PMS) attributes required by physiotherapists to improve software design and development in order to increase the adoption and implementation of software and minimize the impact on the workflow of the clinic. (2) Methods: In total, 27 graduated physiotherapists with clinical and management expertise and experience in management software for physiotherapy services participated in six focus groups. Research staff members recorded, transcribed, and analyzed the focus groups, using a thematic analysis to code and classify the comments. (3) Results: A total of 43 categories of coded statements divided into 12 subthemes and five broad themes were identified and compiled in two core areas of content: clinical care and administrative tasks. In order to improve the adoption and implementation of physiotherapy PMS, this research provides experiential knowledge on the inefficiencies perceived by physiotherapists regarding current software programs and the specific attributes to assist practice management and facilitate workflows. The focus group analyses led us to map the multifaceted framework for physiotherapy PMS. (4) Conclusion: These findings provide valuable information as to what aspects are meaningful for the future design and development of physiotherapy PMS, thus providing guidance to both software developers and to end-users when benchmarking software solutions.

Combined repetitive facilitative exercise under continuous neuromuscular electrical stimulation and task-oriented training for hemiplegic upper extremity during convalescent phase after stroke: before-and-after feasibility trial.

Whereas repetitive facilitative exercise (RFE) affects primarily recovery of motor impairment after stroke, task-oriented training (TOT) focuses on facilitating daily use of the affected upper extremity. However, feasibility of combined RFE and TOT has not been reported. We originated "task-oriented RFE," as a new combination therapy for patients with hemiplegic upper extremity after subacute stroke, to examine its feasibility in convalescent rehabilitation wards. This is a before-and-after pilot study. Eight patients with hemiplegic upper extremity after subacute stroke received the task-oriented RFE program for 6 weeks at 80 min per day (20-60 min of TOT applied after 60-20 min of RFE under continuous neuromuscular electrical stimulation) in a convalescent rehabilitation ward. In the current program, we introduced the Aid for Decision-making in Occupation Choice (ADOC) iPad application as a goal-setting method for determining tasks. Feasibility was assessed with adherence to the protocol, adverse events in response to the intervention, and preliminary efficacy. Motor functions, amount of use and quality of movement in the hemiparetic upper extremity, and satisfaction of the patients were evaluated with Fugl-Meyer Assessment (FMA), the Action Research Arm Test (ARAT), the motor activity log (MAL) for the amount of use (AOU) and quality of movement (QOM) of the paralyzed hand, and ADOC. All participants accomplished the program, which was implemented as originally planned; neither nonattendance nor an adverse event occurred during the study. Favorable outcomes were obtained with all measures; mean changes in FMA, ARAT in the dominant hand, MAL-AOU, and MAL-QOM were greater than minimal clinically important differences. Mean changes in ADOC were greater than the minimal detectable change. The task-oriented RFE program was safe, well-tolerated, beneficial, and feasible within 80 min a day of occupational therapy, which means also within the procedural constraints of the Japanese health insurance system during the convalescent phase. Future studies are warranted to examine whether combined RFE and TOT enhances the efficacies of each program alone.

Would initiating colorectal cancer screening from age of 45 be cost-effective in Germany? An individual-level simulation analysis.

Colorectal cancer (CRC) screening has been shown to be effective and cost-saving. However, the trend of rising incidence of early-onset CRC challenges the current national screening program solely for people ≥50 years in Germany, where extending the screening to those 45-49 years might be justified. This study aims to evaluate the cost-effectiveness of CRC screening strategies starting at 45 years in Germany. DECAS, an individual-level simulation model accounting for both adenoma and serrated pathways of CRC development and validated with German CRC epidemiology and screening effects, was used for the cost-effectiveness analysis. Four CRC screening strategies starting at age 45, including 10-yearly colonoscopy (COL), annual/biennial fecal immunochemical test (FIT), or the combination of the two, were compared with the current screening offer starting at age 50 years in Germany. Three adherence scenarios were considered: perfect adherence, current adherence, and high screening adherence. For each strategy, a cohort of 100,000 individuals with average CRC risk was simulated from age 20 until 90 or death. Outcomes included CRC cases averted, prevented death, quality-adjusted life-years gained (QALYG), and total incremental costs considering both CRC treatment and screening costs. A 3% discount rate was applied and costs were in 2023 Euro. Initiating 10-yearly colonoscopy-only or combined FIT + COL strategies at age 45 resulted in incremental gains of 7-28 QALYs with incremental costs of €28,360-€71,759 per 1,000 individuals, compared to the current strategy. The ICER varied from €1,029 to €9,763 per QALYG, and the additional number needed for colonoscopy ranged from 129 to 885 per 1,000 individuals. Among the alternatives, a three times colonoscopy strategy starting at 45 years of age proves to be the most effective, while the FIT-only strategy was dominated by the currently implemented strategy. The findings remained consistent across probabilistic sensitivity analyses. The cost-effectiveness findings support initiating CRC screening at age 45 with either colonoscopy alone or combined with FIT, demonstrating substantial gains in quality-adjusted life-years with a modest increase in costs. Our findings emphasize the importance of implementing CRC screening 5 years earlier than the current practice to achieve more significant health and economic benefits.

Spatial patterns and temporal trends of trace elements in mosses from 1990 to 2020 in Germany

BackgroundThe accumulation of trace elements in mosses is used as an indirect measure of atmospheric deposition and an important complement to the techniques used to monitor the Geneva Air Pollution Convention. The aim of this paper is to quantify and map temporal and spatial trends of metal enrichment in mosses collected in Germany in 1990, 1995, 2000, 2005, 2015 and 2020. Collection and chemical analysis of the moss samples were carried out according to international guidelines.ResultsThe analysis shows that since 1990, the median concentrations of As, Cd, Cu, Ni, Pb and Sb in the mosses have been decreasing significantly, with the with the highest decline of Pb (− 86%). This trend reversed in 2000 and 2005 and between 2015 and 2020 by increases in the concentrations of some trace elements. In the 2000 Moss Survey, higher concentrations were measured for Cd, Cu, Ni and Sb than in 2015, ranging from + 26% (Cu) to + 165% (Ni). For As and Pb, no significant changes can be observed in 2020 compared to 2015. The increase in metal concentrations in the mosses over the last five years does not correspond to the corresponding trends in reported metal emissions in Germany (2015–2020). In contrast, the long-term trends of the As, Cd, Cu, Ni and Pb concentrations measured in the mosses showed good overall correspondence with the emission trends in Germany (1990–2020). The long-term trends of the moss data are mostly weaker than those of the emission data. The spatial patterns of the temporal trends were mapped and discussed for As, Cd, Cu, Ni, Pb and Sb.ConclusionsThe study shows that for valid monitoring of atmospheric deposition, it is not enough to consider only emission data or the modelled deposition derived from these data. In this respect, the study provides one of many necessary contributions to the discussion on the extent to which analytes of current monitoring programmes are still relevant and up-to-date and whether there are new substances that are also relevant or even more relevant than existing analytes and to what extent this should be taken into account in designing future environmental monitoring.

ECMOve: A Mobilization Device for Extracorporeal Membrane Oxygenation Patients.

Extracorporeal membrane oxygenation (ECMO) is a temporary lifesaving treatment for critically ill patients with severe respiratory or cardiac failure. Studies demonstrated the feasibility of in-hospital mobilizing during and after ECMO treatment preventing neuromuscular weakness and impaired physical functioning. Despite more compact mobile ECMO devices, implementation of ambulatory ECMO remains labor-intensive, complex, and challenging. It requires a large multidisciplinary team to carry equipment, monitor and physically support the patient, and to provide a back-up wheelchair in case of fatigue. Moreover, there is no adequate solution to ensure the stability of the patient's cannula and circuit management during ambulation. We developed a system contributing to improvement and innovation of current ambulatory ECMO patient programs. Our modular cart-in-cart system carries necessary ECMO equipment, features an extendable walking frame, and contains a folding seat for patient transport. An adjustable shoulder brace with lockable tubing-connectors enables safe fixation of the blood tubing. ECMOve provides safety, support, and accessibility while performing ambulatory ECMO for both patient and caregiver. Prototype evaluation in a simulated intensive care unit showed feasibility of our design, but needs to be evaluated in clinical care.