Project DECIDE, part 1: increasing the amount of valid advance directives in people with Alzheimer’s disease by offering advance care planning - a prospective double-arm intervention study

Finanziert im Rahmen der DEAL-Verträge durch die Universitätsbibliothek SiegenBackground Everybody has the right to decide whether to receive specific medical treatment or not and to provide their free, prior and informed consent to do so. As dementia progresses, people with Alzheimer’s dementia (PwAD) can lose their capacity to provide informed consent to complex medical treatment. When the capacity to consent is lost, the autonomy of the affected person can only be guaranteed when an interpretable and valid advance directive exists. Advance directives are not yet common in Germany, and their validity is often questionable. Once the dementia diagnosis has been made, it is assumed to be too late to write an advance directive. One approach used to support the completion of advance directives is ‘Respecting Choices’®—an internationally recognised, evidence-based model of Advance Care Planning (ACP), which, until now, has not been evaluated for the target group of PwAD. This study’s aims include (a) to investigate the proportion of valid advance directives in a memory clinic population of persons with suspected AD, (b) to determine the predictors of valid advance directives, and (c) to examine whether the offer of ACP can increase the proportion of valid advance directives in PwAD. Method We intend to recruit at least N = 250 participants from two memory clinics in 50 consecutive weeks. Of these, the first 25 weeks constitute the baseline phase (no offer of ACP), the following 25 weeks constitute the intervention phase (offer of ACP). The existence and validity of an advance directive will be assessed twice (before and after the memory clinic appointment). Moreover, potential predictors of valid advance directives are assessed. Discussion The results of this study will enhance the development of consent procedures for advance directives of PwAD based on the ACP/Respecting Choices (R) approach. Therefore, this project contributes towards increasing the autonomy and inclusion of PwAD and the widespread acceptance of valid advance directives in PwAD

Overlapping political budget cycle

We advance the literature on political budget cycles by testing for cycles in expenditures for elections to the legislative and the executive branches. Using municipal data, we identify cycles independently for the two branches, evaluate the effects of overlaps, and account for general year effects. We find sizable effects on expenditures before legislative elections and even larger effects before joint elections to the legislature and the office of mayor. In the case of coincident elections, we show that it is important whether the incumbent chief executive seeks reelection. To account for the potential endogeneity of that decision, we apply an IV approach using age and pension eligibility rules

Prototypische Integration automatisierter Programmbewertung in das LMS Moodle

Der Beitrag erläutert die prototypische Integration automatisierter Programmbewertung in das LMS Moodle.Beschrieben wird die Grader-unabhängige Schnittstelle Grappa und die Moodle-Integration

Résumé of the AIAA FDTC Low Reynolds Number Discussion Group\u27s Canonical Cases

The AIAA Fluid Dynamics Technical Committee\u27s Low Reynolds Number Discussion Group has introduced several canonical pitch motions, with objectives of (1) experimental-numerical comparison, (2) assessment of closed-form models for aerodynamic force coefficient time history, and (3) exploration of the vast and rather amorphous parameter space of the possible kinematics. The baseline geometry is a flat plate of nominally 2.5% thickness and round edges, wall-to-wall in ground test facilities and spanwise-periodic or 2D in computations. Motions are various smoothings of a linear pitch ramp, hold and return, of 40o and 45o amplitude. In an attempt to discern acceleration effects, sinusoidal and linear-ramp motions are compared, where the latter have short runs of high acceleration and thus high noncirculatory lift and pitch. Parameter variations include comparison of the flat plate with an airfoil and ellipse, variation of reduced frequency, pitch pivot point location and comparison of pitch to quasi-steady equivalent plunge. All motions involve strong leading edge vortices, whose growth history depends on pitch pivot point location and reduced frequency, and which can persist over the model suction-side for well after motion completion. Noncirculatory loads were indeed found to be localized to phases of motion where acceleration was large. To the extent discernable so far, closed-form models of lift coefficient on the pitch upstroke are relatively straightforward, but not so on the downstroke, where motion history effects complicate the return from stall. Broad Reynolds number independency, in flowfield evolution and lift coefficient, was found in the 103 to 104 range

Experiments and Computations on Abstractions of Perching

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/83613/1/AIAA-2010-4943-835.pd