Economic burden of osteoporotic fractures in Austria

Objective: Osteoporotic fractures impose a huge economic burden on society. Though several cost of illness studies from other countries exist, no equivalent study has been conducted in Austria. Our study aims at assessing costs resulting from osteoporotic fractures in Austria in the year 2008 from a societal perspective. Methods: We took both direct and indirect costs into consideration. Direct costs encompass medical costs such as expenses for pharmaceuticals, inpatient and outpatient medical care costs, as well as other medical services (e.g., occupational therapies). Non-medical direct costs include transportation costs and medical devices (e.g., wheel chairs or crutches). Indirect costs refer to costs of productivity losses due to absence of work. Moreover, we included costs for early retirement and opportunity costs of informal care provided by family members. For our analysis, we combined data of official statistics, expert estimates as well as unique patient surveys that are currently conducted in the course of an international osteoporotic fracture study in Austria. Results: For the year 2008, the total annual financial burden incurred by osteoporotic fractures in Austria amounted to approx. 685.2 million, the largest fraction of which was due to the opportunity cost of family care (30.2%), followed by costs for hospitalization (26.6%). Conclusions: The financial burden of osteoporotic fractures in Austria is substantial. Our findings may have implications for future economic analyses, and also support health care authorities in their decision making. Keywords: Burden of illness, Costs of illness, Osteoporosis, Austri

Die Verbindung von theoretischem und praktischem Wissen im Kontext von Bildung und Arbeit: eine konnektivitätstheoretische Perspektive auf Lehramtsstudien in der Sekundarstufe Berufsbildung

Dieser Beitrag beschäftigt sich mit möglichen Chancen und Herausforderungen, die sich durch die Einführung des Lehramts "Sekundarstufe Berufsbildung" in Österreich ergeben. Im Rahmen einer explorativen, responsiv gestalteten Evaluationsstudie mit zentralem Fokus auf die Perspektive der für die Ausbildung relevanten Stakeholder wird der Verbindung von theoretischem und praktischem Wissen im Kontext von Bildung und Arbeit nachgegangen. Hintergrund dafür bildet eine konnektivitätstheoretische Perspektive, in deren Mittelpunkt ein Zusammenwirken von unterschiedlichen Akteuren und Akteurinnen, institutionellen Kontexten und Wissensbeständen steht. Zentrale Fragestellungen sind die Ausgestaltung hochschuldidaktischer Settings, der Balanceakt zwischen Wissenschafts- und Berufsfeldorientierung, die Vernetzung der Ausbildung mit anderen Institutionen. Insgesamt zeigt sich in den ersten Ergebnissen, dass ein gewisses Ausmaß an Konnektivität mit dem Ziel der Professionalisierung bereits erreicht wurde

Das Theater in der römischen Unterstadt von Pergamon – Ergebnisse der Bauuntersuchung

Das Theater in der Unterstadt von Pergamon gehört mit dem Amphitheater und dem Stadion zu einer Gruppe von Großbauten, die in der römischen Kaiserzeit um den Hügel im Westen der Unterstadt Musalla Mezarlığı errichtet wurden. Das Theater ist nur mit wenigen Resten erhalten, den beiden Flankenmauern, den Radialmauern im Norden und dem Bogentor (Viran Kapı) im Süden. Das von weither sichtbare und noch aufrecht stehende Viran Kapı ist eine baukonstruktive Meisterleistung, in dem die zum Asklepieion führende Heilige Straße dort diagonal mit einem Tonnengewölbe unter dem steigend geführten Gewölbe des Koilon hindurchgeführt wird. Das Bauwerk  war das größte antike Theater in Kleinasien. Die Größe und repräsentative Gestaltung können als Ausdruck der Konkurrenz zwischen den Städten Ephesos und Pergamon interpretiert werden, die sich in der Architektur ihrer Großbauten manifestiert.The theater in the lower city of Pergamon belongs, together with the amphitheater and the stadium, to a group of large buildings erected in the Roman imperial period around the hill to the west of the lower city of Musalla Mezarlığı. The theater is preserved with only a few remains, the two flank walls, the radial walls to the north and the arched gate (Viran Kapı) to the south, which is still upright and visible from a distance. The Viran Kapı is a feat of civil engineering in that the Sacred Way passes through it diagonally with a barrel vault under the rising vault of the koilon. The structure was the largest ancient theater in Asia Minor. The size and monumental design are an expression of the competition between the cities of Ephesus and Pergamon, manifested in the architecture of their large buildings.Pergamon aşağı kentinde yer alan tiyatro, Roma İmparatorluk Dönemi’nde aşağı kentin batısında bulunan Musalla Mezarlığı Tepesi’nin çevresinde, amfitiyatro ve antik stadium ile birlikte inşa edilen yapı grubunun bir parçasıdır. Tiyatro iki yanında yer alan duvarları, kuzeyde radyal uzanan duvarları ve güneyde hala ayakta olan ve uzaktan görülebilen kemerli kapısı (Viran Kapı) olmak üzere sadece birkaç kalıntısı ile korunmuştur. Viran Kapı, koilona ait yükselen tonozun altından bir beşik tonoz aracılığı ile Kutsal Yol’un çapraz şekilde geçişini sağlaması bakımından bir mühendislik şaheseridir. Yapı, Anadolu ´daki en büyük antik tiyatroydu. Büyüklük ve temsili tasarım, Efes ve Pergamon şehirleri arasındaki rekabetin büyük ve anıtsal binalarının mimarisinde ortaya çıkan bir yansımasıdır

The EPATH trial

Observational studies suggested a link between bone disease and left ventricular (LV) dysfunction that may be pronounced in hyperparathyroid conditions. We therefore aimed to test the hypothesis that circulating markers of bone turnover correlate with LV function in a cohort of patients with primary hyperparathyroidism (pHPT). Cross-sectional data of 155 subjects with pHPT were analyzed who participated in the “Eplerenone in Primary Hyperparathyroidism” (EPATH) Trial. Multivariate linear regression analyses with LV ejection fraction (LVEF, systolic function) or peak early transmitral filling velocity (e’, diastolic function) as dependent variables and N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin (OC), bone- specific alkaline phosphatase (BALP), or beta-crosslaps (CTX) as the respective independent variable were performed. Analyses were additionally adjusted for plasma parathyroid hormone, plasma calcium, age, sex, HbA1c, body mass index, mean 24-hours systolic blood pressure, smoking status, estimated glomerular filtration rate, antihypertensive treatment, osteoporosis treatment, 25-hydroxy vitamin D and N-terminal pro-brain B-type natriuretic peptide. Independent relationships were observed between P1NP and LVEF (adjusted β-coefficient = 0.201, P = 0.035) and e’ (β = 0.188, P = 0.042), respectively. OC (β = 0.192, P = 0.039) and BALP (β = 0.198, P = 0.030) were each independently related with e’. CTX showed no correlations with LVEF or e’. In conclusion, high bone formation markers were independently and paradoxically related with better LV diastolic and, partly, better systolic function, in the setting of pHPT. Potentially cardio-protective properties of stimulated bone formation in the context of hyperparathyroidism should be explored in future studies

Correlação entre os níveis de vitamina D e densidade mineral óssea em uma população iraniana saudável

ResumoObjetivosConsiderando os resultados controversos sobre a relação entre níveis de vitamina D e densidade mineral óssea em diferentes populações, o presente estudo foi desenhado para avaliar essa correlação em uma população iraniana saudável.MétodosCom uma amostra aleatória de homens e mulheres aparentemente saudáveis, este estudo transversal multicêntrico considerou 4.450 indivíduos que vivem na região urbana de cinco grandes cidades no Irã. Os valores da densidade mineral óssea (DMO) foram analisados em conjunto com os níveis séricos de 25(OH)D e PTH. Análise da variação (Anova) foi usada para estimar os principais efeitos por meio da comparação entre os valores médios desses marcadores e a condição da densidade mineral óssea de cada gênero nesta amostra de estudo.ResultadosNíveis de 25(OH)D foram inversamente proporcionais aos valores de DMO no nível do quadril (r=‐0,062 em homens e r=‐0,057 em mulheres) e da coluna vertebral (r=‐0,076 em homens e r=‐0,107 em mulheres). Após ajuste dos dados para idade, a correlação negativa não foi mais estatisticamente significante.ConclusãoNíveis séricos de 25(OH)D são inversamente correlacionados com os valores de massa óssea em ambos os gêneros.AbstractObjectivesConsidering the controversial results regarding the relationship between vitamin D levels and bone mineral density in different populations, the present study was designed to evaluate this correlation in a healthy Iranian population.MethodsUsing a random cluster sample of apparently healthy men and women, this multicenter cross‐sectional study was carried out among 4450 individuals living in urban areas of five major cities in Iran. Bone mineral density (BMD) values at different sites were analyzed along with the serum levels of 25(OH)D and PTH. Analysis of variance (Anova) was used to estimate the main effects, through comparing the mean values of these markers based on the bone mineral density status of the study group in each sex.Results25(OH)D levels were inversely correlated with BMD values at total hip (r=−0.062 in men and r=−0.057 in women) and spine (r=−0.076 in men and r=−0.107 in women). After adjusting the data for age, the inverse correlation was no longer statistically significant.ConclusionSerum 25(OH)D levels are inversely correlated with bone mass values in both sexes

Massive stars exploding in a He-rich circumstellar medium - VIII. PSN J07285387+3349106, a highly reddened supernova Ibn

We present spectroscopic and photometric observations for the Type Ibn supernova (SN) dubbed PSN J07285387+3349106. Using data provided by amateur astronomers, we monitored the photometric rise of the SN to maximum light, occurred on 2015 February 18.8 UT (JD(max,V) = 2457072.0 +- 0.8). PSN J07285387+3349106 exploded in the inner region of an infrared luminous galaxy, and is the most reddened SN Ibn discovered so far. We apply multiple methods to derive the total reddening to the SN, and determine a total colour excess E(B-V)(tot) = 0.99 +- 0.48 mag. Accounting for the reddening correction, which is affected by a large uncertainty, we estimate a peak absolute magnitude of M(V) = -20.30 +- 1.50. The spectra are dominated by continuum emission at early phases, and He I lines with narrow P-Cygni profiles are detected. We also identify weak Fe III and N II features. All these lines show an absorption component which is blue-shifted by about 900-1000 km/s. The spectra also show relatively broad He I line wings with low contrast, which extend to above 3000 km/s. From about 2 weeks past maximum, broad lines of O I, Mg II and the Ca II near-infrared triplet are identified. The composition and the expansion velocity of the circumstellar material, and the presence of He I and alpha-elements in the SN ejecta indicate that PSN J07285387+3349106 was produced by the core-collapse of a stripped-envelope star. We suggest that the precursor was WNE-type Wolf-Rayet star in its dense, He-rich circumstellar cocoon.Comment: 12 pages, 7 figures, 2 tables. Accepted for publication in MNRA

Den Lernraum Betriebspraktikum gemeinsam öffnen

"Mandatory internships have become a firmly anchored curricular element of many vocational medium and high schools. With the help of a connectivity-oriented internship didactics, the authors unfold a special perspective on the design of teaching / learning processes in experience-completing internships. The internship is understood as a conglomeration of learning places, activities and phases centered around learning and working in the internship. The opening up of this learning space requires both the commitment of the key actors of school and enterprise, as well as a juxtaposition of the actions described at a strategic and operational level in this book. A tool fund supports readers in implementing this connectivity-oriented perspective in their own professional context. Dr. Annette Ostendorf is a University Professor of Business Education and Head of the Institute for Organization and Learning at the University of Innsbruck. Dr. Bettina Dimai is a project assistant at the same institute and works as a freelance trainer and consultant. Mag. Christin Ehrlich, PhD and Mag. Hannes Hautz, MSc are scientific assistants at the Institute for Organization and Learning, Department of Business Education.

PMS61 Health-Related Quality of Life After Vertebral Fracture: Differences Between the EQ-5D and Time-Trade-Off Instruments

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