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Background Progress in health service quality is vital to reach the target of Universal Health Coverage. However, in order to improve quality, it must be measured, and the assessment results must be actionable. We analyzed an electronic tool, which was developed to assess and monitor the quality of primary healthcare in Tanzania in the context of routine supportive supervision. The electronic assessment tool focused on areas in which improvements are most effective in order to suit its purpose of routinely steering improvement measures at local level. Methods Due to the lack of standards regarding how to best measure quality of care, we used a range of different quantitative and qualitative methods to investigate the appropriateness of the quality assessment tool. The quantitative methods included descriptive statistics, linear regression models, and factor analysis; the qualitative methods in-depth interviews and observations. Results Quantitative and qualitative results were overlapping and consistent. Robustness checks confirmed the tool’s ability to assign scores to health facilities and revealed the usefulness of grouping indicators into different quality dimensions. Focusing the quality assessment on processes and structural adequacy of healthcare was an appropriate approach for the assessment’s intended purpose, and a unique key feature of the electronic assessment tool. The findings underpinned the accuracy of the assessment tool to measure and monitor quality of primary healthcare for the purpose of routinely steering improvement measures at local level. This was true for different level and owner categories of primary healthcare facilities in Tanzania. Conclusion The electronic assessment tool demonstrated a feasible option for routine quality measures of primary healthcare in Tanzania. The findings, combined with the more operational results of companion papers, created a solid foundation for an approach that could lastingly improve services for patients attending primary healthcare. However, the results also revealed that the use of the electronic assessment tool outside its intended purpose, for example for performance-based payment schemes, accreditation and other systematic evaluations of healthcare quality, should be considered carefully because of the risk of bias, adverse effects and corruption.

Despite the central role of quality, industry applications of data-based quality prediction for thermoplastics injection molding are rare, because of a suboptimal cost-benefit ratio. Therefore, we present a holistic approach for seamless part quality prediction, which automates the necessary data processing steps. Since the performance of the seven supervised learning algorithms applied with Bayesian hyperparameter-optimization depends on aspects such as process state, etc., we combine the learnt models using an ensemble-method to ensure good results under varying conditions. The results show that the ensemble’s performance significantly depends on the chosen ensemble-hyperparameters, so future research should focus on their automatic identification.

A new method combining isotope dilution mass spectrometry (IDMS) and standard addition has been developed to determine the mass fractions w of different elements in complex matrices: (a) silicon in aqueous tetramethylammonium hydroxide (TMAH), (b) sulfur in biodiesel fuel, and (c) iron bound to transferrin in human serum. All measurements were carried out using inductively coupled plasma mass spectrometry (ICP–MS). The method requires the gravimetric preparation of several blends (bi)—each consisting of roughly the same masses (mx,i) of the sample solution (x) and my,i of a spike solution (y) plus different masses (mz,i) of a reference solution (z). Only these masses and the isotope ratios (Rb,i) in the blends and reference and spike solutions have to be measured. The derivation of the underlying equations based on linear regression is presented and compared to a related concept reported by Pagliano and Meija. The uncertainties achievable, e.g., in the case of the Si blank in extremely pure TMAH of urel (w(Si)) = 90% (linear regression method, this work) and urel (w(Si)) = 150% (the method reported by Pagliano and Meija) seem to suggest better applicability of the new method in practical use due to the higher robustness of regression analysis.

Jane H. Mashingia and colleagues reveal the progress made to date for the East African Community Medicines Regulatory Harmonization initiative.

Laser-plasma proton acceleration was investigated in the Target Normal Sheath Acceleration (TNSA) regime using a novel gas-foil target. The target is designed for reaching higher laser intensity at the foil plane owing to relativistic self-focusing and self compression of the pulse in the gas layer. Numerical 3D particle-in-cell (PIC) simulations were used to study pulse propagation in the gas, showing a nearly seven-fold increase in peak intensity. In the experiment, maximum proton energies showed high dependence on the energy transmission of the laser through the gas and a lesser dependence on the size and shape of the pulse. At high gas densities, laser energy depletion and pulse distortion suppressed proton energies. At low densities, self-focusing was observed and comparable or higher proton energies were measured with the gas., Comment: 8 pages, 6 figures

All plastics processing companies have to fulfill the objectives of time, cost and quality. Against this background, those producing in high wage countries are especially challenged, because superior part quality is often the only possibility to prevail in competition. Since this leads to high expenses on quality assurance, for some time already efforts have been made to predict the quality of injection molded parts from process data using machine learning algorithms. However, these did not yet prevail in industry, mainly for two reasons: First, because of the inevitable learning effort that is required to set up a quality prediction model and second, because of the complexity in the application. Current research in the field of transfer learning aiming to shorten learning phases addresses the first challenge. In this paper, we present a holistic approach for the data analysis steps that are necessary once process and quality data have been generated, aiming to minimize the application effort for the operator. This includes the development and application of suitable algorithms for automatic selection of data, process features as well as machine learning algorithms including hyper-parameter optimization and model adaption. Combining the two approaches could bring quality prediction one significant step forward to successful industry application. Beyond this, the presented approach is universally applicable and can therefore be used for other plastics processing methods as well.

Predicting the quality of injection molded parts based on process data has been dealt with in research for some time. However, existing approaches did not prevail in the industry to date due to lacking integrity. An important step in building a successful quality model using machine learning methods is the selection of suitable process features. This paper describes the various methods and steps for feature selection, including filters, wrappers and embedded methods, and compares the resulting feature sets with regard to the achievable goodness of the quality models that were created using seven different supervised machine learning algorithms for regression. REFERENCES

Background Universal Health Coverage only leads to the desired health outcomes if quality of health services is ensured. In Tanzania, quality has been a major concern for many years, including the problem of ineffective and inadequate routine supportive supervision of healthcare providers by council health management teams. To address this, we developed and assessed an approach to improve quality of primary healthcare through enhanced routine supportive supervision. Methods Mixed methods were used, combining trends of quantitative quality of care measurements with qualitative data mainly collected through in-depth interviews. The former allowed for identification of drivers of quality improvements and the latter investigated the perceived contribution of the new supportive supervision approach to these improvements. Results The results showed that the new approach managed to address quality issues that could be solved either solely by the healthcare provider, or in collaboration with the council. The new approach was able to improve and maintain crucial primary healthcare quality standards across different health facility level and owner categories in various contexts. Conclusion Together with other findings reported in companion papers, we could show that the new supportive supervision approach not only served to assess quality of primary healthcare, but also to improve and maintain crucial primary healthcare quality standards. The new approach therefore presents a powerful tool to support, guide and drive quality improvement measures within council. It can thus be considered a suitable option to make routine supportive supervision more effective and adequate.

Effective supportive supervision of healthcare services is crucial for improving and maintaining quality of care. However, this process can be challenging in an environment with chronic shortage of qualified human resources, overburdened healthcare providers, multiple roles of district managers, weak supply chains, high donor fragmentation and inefficient allocation of limited financial resources. Operating in this environment, we systematically evaluated an approach developed in Tanzania to strengthen the implementation of routine supportive supervision of primary healthcare providers. The approach included a systematic quality assessment at health facilities using an electronic tool and subsequent result dissemination at council level. Mixed methods were used to compare the new supportive supervision approach with routine supportive supervision. Qualitative data was collected through in-depth interviews in three councils. Observational data and informal communication as well as secondary data complemented the data set. Additionally, an economic costing analysis was carried out in the same councils. Compared to routine supportive supervision, the new approach increased healthcare providers' knowledge and skills, as well as quality of data collected and acceptance of supportive supervision amongst stakeholders involved. It also ensured better availability of evidence for follow-up actions, including budgeting and planning, and higher stakeholder motivation and ownership of subsequent quality improvement measures. The new approach reduced time and cost spent during supportive supervision. This increased feasibility of supportive supervision and hence the likelihood of its implementation. Thus, the results presented together with previous findings suggested that if used as the standard approach for routine supportive supervision the new approach offers a suitable option to make supportive supervision more efficient and effective and therewith more sustainable. Moreover, the new approach also provides informed guidance to overcome several problems of supportive supervision and healthcare quality assessments in low- and middle income countries.

Das zirkulare raumliche Mobilitatsverhalten von Erwerbstatigen, wie tagliches Berufspendeln oder Auswartsubernachtungen bei Geschaftsreisen, gewinnt zunehmend an Bedeutung. Der vorliegende Beitrag untersucht die Zusammenhange zwischen verschiedenen Formen zirkularer berufsbezogener Mobilitat mit der subjektiven Gesundheit und dem Stresserleben und geht dabei der Frage nach, ob sich die Effekte nach den soziodemografischen Merkmalen Alter, Geschlecht und Elternschaft unterscheiden. Datengrundlage ist die erste Welle der Studie „Job Mobilities and Family Lives in Europe“, eine reprasentative Querschnitterhebung von 2007 unter Personen im Alter zwischen 25 und 54 Jahre in sechs europaischen Landern (n = 2831). Die untersuchten Mobilitatsformen sind tagliches Fernpendeln (mindestens 60 min einfache Fahrzeit zur Arbeitsstatte), Vari-Mobilitat (mindestens 60 berufsbezogene Auswartsubernachtungen in den vergangenen 12 Monaten) sowie Multimobilitat (Kombination aus mindestens zwei Mobilitatsformen). Berechnet wurden semi-logarithmierte Regressionsmodelle. Die Ergebnisse differenzieren bekannte Befunde weiter. So zeigen sich negative Gesundheitseffekte des Fernpendelns sowie erhohtes Stresserleben bei Multimobilitat lediglich bei Frauen. Fur Fernpendeln und Vari-Mobilitat lassen sich erhohte Beanspruchungen insbesondere bei Personen mit Kindern nachweisen, wohingegen das Fernpendeln sowohl fur jungere als auch fur altere Erwerbstatige mit nachteiligen Effekten verbunden ist. Das raumliche Mobilitatsverhalten von Erwerbstatigen sollte verstarkt Gegenstand von Masnahmen der Pravention und der Gesundheitsforderung darstellen.

Life on Earth displays an incredible diversity in form and function, which allows it to survive not only physical extremes, but also periods of time when it is exposed to non-habitable conditions. Extreme physiological adaptations to bridge non-habitable conditions include various dormant states, such as spores or tuns. Here, we advance the hypothesis that if the environmental conditions are different on some other planetary body, a deviating biochemistry would evolve with types of adaptations that would manifest themselves with different physical and chemical limits of life. In this paper, we discuss two specific examples: putative life on a Mars-type planet with a hydrogen peroxide-water solvent and putative life on a Titan-type planetary body with liquid hydrocarbons as a solvent. Both examples would have the result of extending the habitable envelope of life in the universe.

Im Zuge des sozialen und demographischen Wandels ist der Bevolkerungsanteil von Personen mit vergleichsweise geringen Armutsrisiken (z. B. von Hochqualifizierten, Kinderlosen und Personen mittleren Alters) erheblich angewachsen. Dennoch ist die aggregierte Armutsquote im Zeitverlauf nicht gesunken. Um dieses Phanomen aufzuklaren, analysiert die Arbeit den Beitrag des Wandels von Alters-, Bildungs- und Haushaltsstruktur zur Armutsentwicklung in Deutschland zwischen 1992 und 2008. Hierzu werden individuelle Armutsrisiken nach Lebensalter, Bildungsniveau und Kinderzahl fur jedes Kalenderjahr im Betrachtungszeitraum geschatzt und auf Basis der Bevolkerungsstruktur des Jahres 1992 aggregiert. Damit wird es moglich, die Armutsentwicklung unter konstanten Bevolkerungsbedingungen, also strukturbereinigt, fur den Zeitverlauf nachzuvollziehen und mit der tatsachlichen Entwicklung zu vergleichen. Grundlage der Analysen sind die Daten des Sozio-oekonomischen Panels. Die Ergebnisse zeigen, dass durch die Zunahme der individuellen Armutsrisiken heute, strukturbereinigt, etwa ein Drittel mehr Menschen arm waren (16,6 %), als dies aktuell tatsachlich der Fall ist (12,0 %). Der strukturelle Bevolkerungswandel, hin zu sozialen Gruppen mit relativ geringen Armutsrisiken, hat damit einen Anstieg der Armutsbetroffenheit um mehr als vier Prozentpunkte verhindert. Die in den letzten Jahren zumeist stagnierende oder „nur“ leicht gestiegene Armutsquote ist damit zum grosen Teil die positive Folge der soziodemographischen Umschichtung der Gesellschaft.

Information systems play an important role in historical research as well as in heritage documentation. As part of a joint research project of the German Archaeological Institute, the Brandenburg University of Technology Cottbus and the Dresden University of Applied Sciences a web-based documentation system is currently being developed, which can easily be adapted to the needs of different projects with individual scientific concepts, methods and questions. Based on open source and standardized technologies it will focus on open and well-documented interfaces to ease the dissemination and re-use of its content via web-services and to communicate with desktop applications for further evaluation and analysis. Core of the system is a generic data model that represents a wide range of topics and methods of archaeological work. By the provision of a concerted amount of initial themes and attributes a cross project analysis of research data will be possible. The development of enhanced search and retrieval functionalities will simplify the processing and handling of large heterogeneous data sets. To achieve a high degree of interoperability with existing external data, systems and applications, standardized interfaces will be integrated. The analysis of spatial data shall be possible through the integration of web-based GIS functions. As an extension to this, customized functions for storage, processing and provision of 3D geo data are being developed. As part of the contribution system requirements and concepts will be presented and discussed. A particular focus will be on introducing the generic data model and the derived database schema. The research work on enhanced search and retrieval capabilities will be illustrated by prototypical developments, as well as concepts and first implementations for an integrated 2D/3D Web-GIS.

Am Beispiel der erreichten Schulnoten und der elterlichen Bildungsaspirationen wird der Einfluss der Stellung in der Geschwisterreihe auf die Bildungschancen und den Bildungserfolg von Grundschulkindern untersucht. Dabei wird speziell auch gepruft, ob der genannte Einfluss schichtspezifisch variiert, d. h. vom sozio-okonomischen Status des Elternhauses moderiert wird. Als theoretische Basis dienen Konzepte zur Rivalitat der Geschwister um bildungsrelevante familiare Ressourcen (resource dilution model), Annahmen zum intellektuellen Klima in der Familie (confluence model) und Hypothesen zur Pragung der Personlichkeit durch Geschwister (family niche model). Auserdem werden Statuserhaltungsmotive der Eltern zur Erklarung von Reihenfolgeeffekten herangezogen. Die Analysen basieren auf einer Erhebung bei 1369 Grundschulerinnen und Grundschuler der vierten Klasse in der Stadt Wiesbaden. Es zeigt sich, dass das Vorhandensein alterer Geschwister die gewahlten Bildungsindikatoren (Schulnoten, elterliche Bildungsaspiration) negativ beeinflusst. In Ubereinstimmung mit bekannten Befunden sinken die schulischen Leistungen (Noten), auch bei Kontrolle anderer relevanter Einflussfaktoren, in der Geburtenreihenfolge ab. Zusatzlich bestehen Effekte der Stellung in der Geschwisterreihe auf die Bildungsaspiration der Eltern. In diesem Zusammenhang ist der zentrale Befund des Artikels: Wenn altere Geschwister die Statusvererbung in intergenerationaler Perspektive bereits gewahrleisten, dann verringert dies in Familien mit hohem sozialem Status die Bildungsaspiration der Eltern fur jungere Geschwister (Wegfall des Statuserhaltungsmotivs). In Familien mit niedrigem sozialem Status hingegen steigen die Bildungsaspirationen der Eltern fur jungere Geschwister, wenn altere bereits hohere Bildungswege erreicht haben (Lernen am Modell).

Haben zusatzlich zu den vielfach bestatigten individuellen Herkunftseffekten auch Merkmale des Klassen- und Schulkontextes einen Einfluss auf die Bildungschancen von Grundschulern? Hierzu untersucht der Beitrag den Einfluss des Leistungs- und Statusniveaus sowie des Migrantenanteils der Kontexte auf die Wahrscheinlichkeit, erstens eine Gymnasialempfehlung zu erhalten und zweitens einen Ubergang auf das Gymnasium zu realisieren. Theoretischer Ausgangspunkt ist die von Boudon (1974) getroffene Unterscheidung zwischen primaren und sekundaren Effekten, die um eine kontextuelle Perspektive und diesbezugliche Eltern- und Lehrerentscheidungen erweitert wird. Als Datengrundlage dient eine als Vollerhebung angelegte Befragung aller Schuler der vierten Klassen an Wiesbadener Grundschulen im Schuljahr 2006/07; die Modellierung der Kontexteffekte erfolgt in logistischen Mehrebenenmodellen. Die Ergebnisse zeigen, dass die Zugehorigkeit zu einem Schul- und Klassenkontext zusammen etwa 10 Prozent der Gesamtvarianz des Bildungserfolges erklaren. Dabei haben die untersuchten Kontexteffekte vor allem einen leistungsfremden Einfluss auf die individuellen Bildungschancen (sekundare Kontexteffekte). Unter Kontrolle von Individualmerkmalen beeinflusst vor allem das soziale Statusniveau der Schulen die Bildungschancen der Grundschuler. Im Hinblick auf die realisierten Gymnasialubergange ist aber auch das durchschnittliche Leistungsniveau der Schulen von Bedeutung. Im Gegensatz zu anderen Studien zeigt sich unter Kontrolle der sozialstrukturellen Zusammensetzung der Kontexte kein Effekt des Migrantenanteils. Wahrend bei der abhangigen Variable Bildungsempfehlung sowohl Klassen- als auch Schulkontexteffekte auftreten, ist beim Bildungsubergang nur die Schulebene von Bedeutung.

Replacement of the N-terminal beta-alanyl-amide moiety in previously identified matriptase inhibitors by non-charged aryl groups caused a slightly decreased potency and partially reduced selectivity, especially towards thrombin. However, some of these analogues are still potent matriptase inhibitors with K(i)-values10nM. In contrast, improved activity was observed for newly designed tribasic analogues, especially for compound 21, which inhibits matriptase with an K(i)-value of 80pM.

We study Newton's method for the open-loop optimal temperature-tracking problem in glass manufacturing. This results in an optimal boundary control problem for a nonlinear system of partial differential equations. Since at high temperatures heat transfer due to radiation plays a dominant role, we employ the diffusive SP 1 -approximation for the computation of the temperature profile. The optimization algorithm relies on the introduction of the adjoint states, which significantly reduces numerical costs. We present numerical results underlining the feasibility of our approach.

Soziookonomische Determinanten der Gesundheit und Sterblichkeit sind in den vergangenen zwei Jahrzehnten in Deutschland verstarkt in den Fokus der Sozialforschung geruckt und als wesentlicher Aspekt sozialer Ungleichheit von der Politik aufgegriff en worden. Beispielsweise wird die gesundheitliche Situation ausgewahlter benachteiligter Bevolkerungsgruppen seit 2001 regelmasig in den Armuts- und Reichtumsberichten der Bundesregierung thematisiert.