Die Münzprobationstage im Alten Reich

Prägeberechtigten Ständen, die ihre Münzproduktion gegenseitig auf den inneren Gehalt überprüfen wollen oder sollen, bietet sich die Einrichtung einer gemeinsamen Veranstaltung, eines Münzprobationstages, an. Nach dem Vorbild des Rheinischen Münzvereins wurde diese Institution auf den Reformreichstagen empfohlen und gelangte in die drei Reichsmünzordnungen und die Probationsordnungen. Nach mehreren Anläufen konnten sich Probationstage in acht von zehn Reichskreisen langfristig etablieren. Hauptaufgabe war die Untersuchung der aktuellen Münzproduktion auf Schrot und Korn, wie sie in den Fahrbüchsen von den einzelnen Ständen vorgelegt wurde. Daneben wurden auch Stichproben von eigenen und fremden Geldstücken aus dem Zahlungsverkehr auf ihren inneren Wert geprüft. Schließlich waren sowohl die Bewerber auf das Kreisamt des Generalmünzwardeins als auch die von den Einzelständen angenommenen Münzmeister und Spezialwardeine zu examinieren und zu vereidigen. Wie liefen nun solche Probationskonvente in administrativer Hinsicht ab, wer hatte die Veranstaltung zu besuchen, wonach wurde die Tagesordnung bestimmt, nach welchen Regeln wurden die Münzen untersucht, wie wurde in Streitfällen verfahren, auf welche Art die Ergebnisse publiziert? An welchen Orten wurde getagt, wie lange dauerten die einzelnen Zusammenkünfte, in welcher Regelmäßigkeit fanden sie statt? In welcher Beziehung standen die Probationstage zu den Kreistagen, auf denen ebenfalls Münzangelegenheiten verhandelt werden konnten? Wie lange hatte die Einrichtung Bestand, und welche Änderungen ergaben sich bis zum Ende des Alten Reiches? Darüber geben neben dem Wortlaut der Probationsordnungen auch die Protokolle, Abschiede und Probationsregister, aber auch Instruktionen für die Gesandten und Berichte von Teilnehmern Auskunft

Impact of robot antenna calibration on dual-frequency smartphone-based high-accuracy positioning: a case study using the Huawei Mate20X

The access to Android-based Global Navigation Satellite Systems (GNSS) raw measurements has become a strong motivation to investigate the feasibility of smartphone-based positioning. Since the beginning of this research, the smartphone GNSS antenna has been recognized as one of the main limitations. Besides multipath (MP), the radiation pattern of the antenna is the main site-dependent error source of GNSS observations. An absolute antenna calibration has been performed for the dual-frequency Huawei Mate20X. Antenna phase center offset (PCO) and variations (PCV) have been estimated to correct for antenna impact on the L1 and L5 phase observations. Accordingly, we show the relevance of considering the individual PCO and PCV for the two frequencies. The PCV patterns indicate absolute values up to 2 cm and 4 cm for L1 and L5, respectively. The impact of antenna corrections has been assessed in different multipath environments using a high-accuracy positioning algorithm employing an undifferenced observation model and applying ambiguity resolution. Successful ambiguity resolution is shown for a smartphone placed in a low multipath environment on the ground of a soccer field. For a rooftop open-sky test case with large multipath, ambiguity resolution was successful in 19 out of 35 data sets. Overall, the antenna calibration is demonstrated being an asset for smartphone-based positioning with ambiguity resolution, showing cm-level 2D root mean square error (RMSE)

Multimorbidity and long-term care dependency - a five-year follow-up.

BACKGROUND: Not only single, but also multiple, chronic conditions are becoming the normal situation rather than the exception in the older generation. While many studies show a correlation between multimorbidity and various health outcomes, the long-term effect on care dependency remains unclear. The objective of this study is to follow up a cohort of older adults for 5 years to estimate the impact of multimorbidity on long-term care dependency. METHODS: This study is based on claims data from a German health insurance company. We included 115,203 people (mean age: 71.5 years, 41.4% females). To identify chronic diseases and multimorbidity, we used a defined list of 46 chronic conditions based on ICD-10 codes. Multimorbidity was defined as three or more chronic conditions from this list. The main outcome was "time until long-term care dependency". The follow-up started on January 1st, 2005 and lasted for 5 years until December 31st, 2009. To evaluate differences between those with multimorbidity and those without, we calculated Kaplan-Meier curves and then modeled four distinct Cox proportional hazard regressions including multimorbidity, age and sex, the single chronic conditions, and disease clusters. RESULTS: Mean follow-up was 4.5 years. People with multimorbidity had a higher risk of becoming care dependent (HR: 1.85, CI 1.78-1.92). The conditions with the highest risks for long-term care dependency are Parkinson's disease (HR: 6.40 vs. 2.68) and dementia (HR: 5.70 vs. 2.27). Patients with the multimorbidity pattern "Neuropsychiatric disorders" have a 79% higher risk of care dependency. CONCLUSIONS: The results should form the basis for future health policy decisions on the treatment of patients with multiple chronic diseases and also show the need to introduce new ways of providing long-term care to this population. A health policy focus on chronic care management as well as the development of guidelines for multimorbidity is crucial to secure health services delivery for the older population

Overutilization of ambulatory medical care in the elderly German population? – An empirical study based on national insurance claims data and a review of foreign studies

Background: By definition, high utilizers receive a large proportion of medical services and produce relatively high costs. The authors report the results of a study on the utilization of ambulatory medical care by the elderly population in Germany in comparison to other OECD countries. Evidence points to an excessive utilization in Germany. It is important to document these utilization figures and compare them to those in other countries since the healtcare system in Germany stopped recording ambulatory healthcare utilization figures in 2008. Methods: The study is based on the claims data of all insurants aged >= 65 of a statutory health insurance company in Germany (n = 123,224). Utilization was analyzed by the number of contacts with physicians in ambulatory medical care and by the number of different practices contacted over one year. Criteria for frequent attendance were = 50 contacts with practices or contacts with = 10 different practices or = 3 practices of the same discipline per year. Descriptive statistical analysis and logistic regression were applied. Morbidity was analyzed by prevalence and relative risk for frequent attendance for 46 chronic diseases. Results: Nineteen percent of the elderly were identified as high utilizers, corresponding to approximately 3.5 million elderly people in Germany. Two main types were identified. One type has many contacts with practices, belongs to the oldest age group, suffers from severe somatic diseases and multimorbidity, and/or is dependent on long-term care. The other type contacts large numbers of practices, consists of younger elderly who often suffer from psychiatric and/or psychosomatic complaints, and is less frequently multimorbid and/or nursing care dependent. Conclusion: We found a very high rate of frequent attendance among the German elderly, which is unique among the OECD countries. Further research should clarify its reasons and if this degree of utilization is beneficial for elderly people

Patterns of ambulatory medical care utilization in elderly patients with special reference to chronic diseases and multimorbidity

BACKGROUND: In order to estimate the future demands for health services, the analysis of current utilization patterns of the elderly is crucial. The aim of this study is to analyze ambulatory medical care utilization by elderly patients in relation to age, gender, number of chronic conditions, patterns of multimorbidity, and nursing dependency in Germany. METHODS: Claims data of the year 2004 from 123,224 patients aged 65 years and over which are members of one nationwide operating statutory insurance company in Germany were studied. Multimorbidity was defined as the presence of 3 or more chronic conditions of a list of 46 most prevalent chronic conditions based on ICD 10 diagnoses. Utilization was analyzed by the number of contacts with practices of physicians working in the ambulatory medical care sector and by the number of different physicians contacted for every single chronic condition and their most frequent triadic combinations. Main statistical analyses were multidimensional frequency counts with standard deviations and confidence intervals, and multivariable linear regression analyses. RESULTS: Multimorbid patients had more than twice as many contacts per year with physicians than those without multimorbidity (36 vs. 16). These contact frequencies were associated with visits to 5.7 different physicians per year in case of multimorbidity vs. 3.5 when multimorbidity was not present. The number of contacts and of physicians contacted increased steadily with the number of chronic conditions. The number of contacts varied between 35 and 54 per year and the number of contacted physicians varied between 5 to 7, depending on the presence of individual chronic diseases and/or their triadic combinations. The influence of gender or age on utilization was small and clinically almost irrelevant. The most important factor influencing physician contact was the presence of nursing dependency due to disability. CONCLUSION: In absolute terms, we found a very high rate of utilization of ambulatory medical care by the elderly in Germany, when multimorbidity and especially nursing dependency were present. The extent of utilization by the elderly was related both to the number of chronic conditions and to the individual multimorbidity patterns, but not to gender and almost not to age

Ambulatory health services utilization in patients with dementia - Is there an urban-rural difference?

<p>Abstract</p> <p>Background</p> <p>Due to demographic changes and an un-equal distribution of physicians, regional analyses of service utilization of elderly patients are crucial, especially for diseases with an impact like dementia. This paper focuses on dementia patients. The aim of the study is to identify differences in service utilization of incident dementia patients in urban and rural areas.</p> <p>Methods</p> <p>Basis for the analysis were all insured persons of a German Health Insurance fund (the GEK) aged 65 years and older living in rural and urban areas. We focussed on physician contacts in the outpatient sector during the first year after an incidence diagnosis of dementia. Special attention was given to contacts with primary care physicians and neurologists/psychiatrists. The dementia cohort was analyzed together with a non-dementia control group drawn according to age, gender and amount of physician contacts. Uni- and bivariate as well as multivariate analysis were performed to estimate the influences on service utilization.</p> <p>Results</p> <p>Results show that the provision of primary care seems to be equally given in urban and rural areas. For specialists contacts however, rural patients are less likely to consult neurologists or psychiatrists. This trend can already be seen before the incident diagnosis of dementia. All consultations rise in the quarter of the incident dementia diagnosis compared to the control group. The results were also tested in a linear and a logistic regression, showing a higher chance for persons living in urban areas to visit a specialist and an overall higher rate in service utilization for dementia patients.</p> <p>Conclusions</p> <p>Because of a probable increase in the number of dementia patients, service provision has to be accessible even in rural areas. Due to this and the fact that demographic change is happening at different paces in different regions, regional variations have to be considered to ensure the future service provision.</p