Perceived need for treatment and non-utilization of outpatient psychotherapy in old age: two cohorts of a nationwide survey

Beackground: Older adults with mental health problems may benefit from psychotherapy; however, their perceived need for treatment in relation to rates of non-utilization of outpatient psychotherapy as well as the predisposing, enabling, and need factors proposed by Andersen's Model of Health Care Utilization that account for these differences warrant further investigation. Methods: We used two separate cohorts (2014 and 2019) of a weighted nationwide telephone survey in Germany of German-speaking adults with N=12,197 participants. Across the two cohorts, 12.9% (weighted) reported a perceived need for treatment for mental health problems and were selected for further analyses. Logistic Generalized Estimation Equations (GEE) was applied to model the associations between disposing (age, gender, single habiting, rural residency, general health status), enabling (education, general practitioner visit) non-utilization of psychotherapy (outcome) across cohorts in those with a need for treatment (need factor). Results: In 2014, 11.8% of 6087 participants reported a perceived need for treatment due to mental health problems. In 2016, the prevalence increased significantly to 14.0% of 6110 participants. Of those who reported a perceived need for treatment, 36.4% in 2014 and 36.9%in 2019 did not see a psychotherapist - where rates of non-utilization of psychotherapy were vastly higher in the oldest age category (59.3/52.5%; 75+) than in the youngest (29.1/10.7%; aged 18-25). Concerning factors associated with non-utilization, multivariate findings indicated participation in the cohort of 2014 (OR 0.94), older age (55-64 OR 1.02, 65-74 OR 1.47, 75+ OR 4.76), male gender (OR 0.83), lower educational status (OR 0.84), rural residency (OR 1.38), single habiting (OR 1.37), and seeing a GP (OR 1.39) to be related with non-utilization of psychotherapy; general health status was not significantly associated with non-utilization when GP contact was included in the model. Conclusion: There is a strong age effect in terms of non-utilization of outpatient psychotherapy. Individual characteristics of both healthcare professionals and patients and structural barriers may add to this picture. Effective strategies to increase psychotherapy rates in those older adults with unmet treatment needs are required

Möglichkeitsdenken. Utopie und Dystopie in der Gegenwart

Utopien denken Möglichkeiten von Zukunft. Mit Beginn der historischen Moderne, in der die Erwartung an die Zukunft die Erfahrung der Vergangenheit übersteigt, entstehen in der je aktuellen Gegenwart Entwürfe, die Utopien genannt werden können. Die Temporalisierung der Erfahrung macht Projektionen in die Zukunft möglich (Reinhart Koselleck). Diese sind nie eindeutig. Sie liefern mehrdeutige Wunsch- und Schreckbilder auch in eigentümlichen Verschränkungen. Die Einsicht in diese Dialektik nimmt mit dem Grad der Selbstreferentialität von Zukunftsentwürfen zu; Utopie und Dystopie bedingen sich wechselseitig. – Gegenwärtig leben wir mit außerordentlich unsicheren Zukunftsperspektiven. Haben Utopien nur in Dystopien überlebt? Nach dem Ende des Utopismus-Verdachts am Beginn der 90er Jahre geht es heute um eine Bestandsaufnahme von Zukunftspotentialen, um Diskussionen von Denkformen des Hypothetisch-Möglichen. Bietet die Tradition des utopischen Denkens Anknüpfungspunkte für aktuelle, positiv oder negativ konnotierte Zukunftsbeschreibungen? Wunsch- oder Warnbilder sind noch immer jenem utopischen Impuls verpflichtet, der den Blick aus der Gegenwart in die Zukunft richten will. Die Frage nach der Zukunft utopischen Denkens stellt somit in den Möglichkeiten temporalen, visionären und konjunktivischen Denkens zugleich die Frage nach dem Ort des Gesellschaftlichen und der Gesellschaft heute – und damit die Frage nach der Verbindlichkeit von Tradition, und das heißt auch: nach Traditionen des Utopischen

Natural water purification and water management by artificial groundwater recharge

Worldwide, several regions suffer from water scarcity and contamination. The infiltration and subsurface storage of rain and river water can reduce water stress. Artificial groundwater recharge, possibly combined with bank filtration, plant purification and/or the use of subsurface dams and artificial aquifers, is especially advantageous in areas where layers of gravel and sand exist below the earth’s surface. Artificial infiltration of surface water into the uppermost aquifer has qualitative and quantitative advantages. The contamination of infiltrated river water will be reduced by natural attenuation. Clay minerals, iron hydroxide and humic matter as well as microorganisms located in the subsurface have high decontamination capacities. By this, a final water treatment, if necessary, becomes much easier and cheaper. The quantitative effect concerns the seasonally changing river discharge that influences the possibility of water extraction for drinking water purposes. Such changes can be equalised by seasonally adapted infiltration/extraction of water in/out of the aquifer according to the river discharge and the water need. This method enables a continuous water supply over the whole year. Generally, artificially recharged groundwater is better protected against pollution than surface water, and the delimitation of water protection zones makes it even more save

Groundwater protection: What can we learn from Germany?

For drinking water security the German waterworks proceed on a comprehensive concept, i.e., the protection of all the regions from the recharge area to the client. It includes the protection of the recharge area by a precautionary management, a safe water treatment, a strict maintenance of the water distribution network, continuous control and an intensive training of staff. Groundwater protection zones together with effective regulations and control play a very important role. Three protection zones with different restrictions in land-use are distinguished. Water in reservoirs and lakes is also protected by Surface Water Protection Zones. Within the surrounding area the land-use is controlled, too. Special treatment is necessary if acidification happens caused by acid rain, or eutrophication caused by the inflow of sewage. Very important is the collaboration between waterworks and the farmers cultivating land in the recharge area in order to execute water-protecting ecological farming with the aim to reduce the application of fertilizers and plant protection agents. Probable financial losses have to be compensated by the waterworks

Themenheft 23 "Selbsthilfe im Gesundheitsbereich"

Selbsthilfegruppen, -organisationen und -kontaktstellen zählen mittlerweile zu anerkannten Partnern im Gesundheitswesen. Die organisierte Selbsthilfe, welche auf eine lange Tradition zurückblicken kann, erfuhr in den 80er und 90er Jahren des 20. Jahrhunderts einen massiven Aufschwung. Die Zunahme chronischer Erkrankungen, verbesserte Behandlungsmöglichkeiten und steigende Lebenserwartung, die Veränderung der primären sozialen Netzwerke wie Familie, Verwandtschaft und Nachbarschaft und die zunehmende gesellschaftliche Anerkennung führen bis heute zu einer weiteren Verbreitung von Selbsthilfegruppen

Deep learning for jazz walking bass transcription

In this paper, we focus on transcribing walking bass lines, which provide clues for revealing the actual played chords in jazz recordings. Our transcription method is based on a deep neural network (DNN) that learns a mapping from a mixture spectrogram to a salience representation that emphasizes the bass line. Furthermore, using beat positions, we apply a late-fusion approach to obtain beat-wise pitch estimates of the bass line. First, our results show that this DNN-based transcription approach outperforms state-of-the-art transcription methods for the given task. Second, we found that an augmentation of the training set using pitch shifting improves the model performance. Finally, we present a semi-supervised learning approach where additional training data is generated from predictions on unlabeled datasets

Bridging the Gap: Enriching YouTube Videos with Jazz Music Annotations

Web services allow permanent access to music from all over the world. Especially in the case of web services with user-supplied content, e.g., YouTube™, the available metadata is often incomplete or erroneous. On the other hand, a vast amount of high-quality and musically relevant metadata has been annotated in research areas such as Music Information Retrieval (MIR). Although they have great potential, these musical annotations are often inaccessible to users outside the academic world. With our contribution, we want to bridge this gap by enriching publicly available multimedia content with musical annotations available in research corpora, while maintaining easy access to the underlying data. Our web-based tools offer researchers and music lovers novel possibilities to interact with and navigate through the content. In this paper, we consider a research corpus called the Weimar Jazz Database (WJD) as an illustrating example scenario. The WJD contains various annotations related to famous jazz solos. First, we establish a link between the WJD annotations and corresponding YouTube videos employing existing retrieval techniques. With these techniques, we were able to identify 988 corresponding YouTube videos for 329 solos out of 456 solos contained in the WJD. We then embed the retrieved videos in a recently developed web-based platform and enrich the videos with solo transcriptions that are part of the WJD. Furthermore, we integrate publicly available data resources from the Semantic Web in order to extend the presented information, for example, with a detailed discography or artists-related information. Our contribution illustrates the potential of modern web-based technologies for the digital humanities, and novel ways for improving access and interaction with digitized multimedia content