Insurance barriers and inequalities in health care access: evidence from dual practice

Background We investigate access disparities in pharmaceutical care among German patients with type 2 diabetes, focusing on differences between public and private health insurance schemes. The primary objectives include investigating whether patients with private health insurance experience enhanced access to antidiabetic care and analyzing whether the treatment received by public and private patients is influenced by the practice composition, particularly the proportion of private patients. Methods We estimate fixed effect regression models, to isolate the effect of insurance schemes on treatment choices. We utilize data from a prescriber panel comprising 681 physicians collectively serving 68,362 patients undergoing antidiabetic treatments. Results The analysis reveals a significant effect of the patient's insurance status on antidiabetic care access. Patients covered by private insurance show a 10-percentage-point higher likelihood of receiving less complex treatments compared to those with public insurance. Furthermore, the composition of physicians' practices plays a crucial role in determining the likelihood of patients receiving less complex treatments. Notably, the most pronounced disparities in access are observed in practices mirroring the regional average composition. Conclusions Our findings underscore strategic physician navigation across diverse health insurance schemes in ambulatory care settings, impacting patient access to innovative treatments

Resistance of poly(lactic acid)/starch composites to weathering effects

Gefördert im Rahmen des Projekts DEA

Integrated vehicle dynamics control for a mechatronic railway running gear

Safety is especially for high-speed railway traffic one of the main aspects that has to be continuously improved to sustainably strengthen the railway sector and shift the modal split. To overcome the limitations of passive systems, an active control of mechatronic running gears provides essential advantages. In the present work, the focus is on the active control of lateral and longitudinal dynamics which are closely coupled via the tangential wheel-rail contact. Therefore, the introduced integrated control concept combines lateral and longitudinal control tasks. After the description of the lateral and longitudinal sub-level controllers the benefits of the integrated control are demonstrated. A comparison of the developed concept with a reference control using a preallocated torque for the lateral track guidance is drawn. The results of a simulation including volatile wheel-rail conditions and a jump in the desired lateral position underline the potential of integrated control to reduce braking distances and simultaneously improve lateral stability

Differentiation between Hydrolytic and Thermo-Oxidative Degradation of Poly(lactic acid) and Poly(lactic acid)/Starch Composites in Warm and Humid Environments

Gefördert durch den Publikationsfonds der Universität Kasse

Decentralized Cost-Optimized Fuzzy Control of DC Microgrids

This paper presents a novel method for designing a decentralized fuzzy controller for DC microgrids, aiming to reduce operating costs. Therefore, a classical fuzzy control is created for each power supplying grid user based on the voltage droop control. The control of the active rectifier is then extended with respect to the electric costs as an additional input. The input membership functions of this controller are in a next step optimized with a genetic algorithm, whereas two different approaches were used: first, only the membership function of the rectifier was optimized, secondly, the energy storage system was added to the optimization. The optimization was performed in terms of minimizing the operative costs of the DC microgrid. This method and its results were in the end compared with the optimized characteristic diagrams presented in [1]. These diagrams were an extension of the voltage droop curves and the optimization was also based on the operating costs of the grid. Results achieved with the new concept are as good as in the previously presented characteristic diagrams approach. In addition optimization time is reduced significantly (up to 50 times) and the definition of membership functions is more handy

Influence of Chitosan and Grape Seed Extract on Thermal and Mechanical Properties of PLA Blends

Gefördert durch den Publikationsfonds der Universität Kasse

Beobachterbasierte Kraftschlussregelung von Scheibenbremssystemen

Die vorliegende Arbeit befasst sich mit einem neuartigen kraftschlussbasierten Regelkonzept (adhesion-based control) von Scheibenbremssystemen zur Verkürzung von Bremswegen unter widrigen Streckenbedingungen. Die hierfür benötigte Information zum aktuell ausgenutzten Kraftschluss wird durch ein Extended Kalman Filter geschätzt und der Sliding-Mode-Regelung zugeführt. Die vorgestellte Kombination von Regler und Beobachter ermöglicht, dass auch bei sich verändernden Streckenbedingungen während eines Bremsvorgangs stets nahe am Kraftschlussoptimum gebremst wird. Dieser Vorteil wird in einer Simulation veranschaulicht und die Ergebnisse werden mit einem schlupfbasierten Gleitschutzregler verglichen. Eine Bremswegverkürzung um rund 15% in diesem Szenario unterstreicht das Potential des entwickelten kraftschlussbasierten Ansatzes

Socioeconomic inequalities and obesity in South Africa—a decomposition analysis

BACKGROUND : Prior evidence shows that inequalities are related to overweight and obesity in South Africa. Using data from a recent national study, we examine the socioeconomic inequalities associated with obesity in South Africa and the factors associated with it. METHODS : We use quantitative data from the South African National Health and Nutrition Examination Survey (SANHANES-1) carried out in 2012. We estimate the concentration index (CI) to identify inequalities and decompose the CI to explore the determinants of these inequalities. RESULTS : We confirm the existence of pro-rich inequalities associated with obesity in South Africa. The inequalities among males are larger (CI of 0.16) than among women (CI of 0.09), though more women are obese than men. Marriage increases the risk of obesity for women and men, while smoking decreases the risk of obesity among men significantly. Higher education is associated with lower inequalities among females. CONCLUSIONS: We recommend policies to focus on promoting a healthy lifestyle, including the individual’s perception of a healthy body size and image, especially among women.https://www.mdpi.com/journal/ijerpham2022School of Health Systems and Public Health (SHSPH

DLR Forschungsinfrastruktur NGT-Fahrwerk (NGT-FuN)

Das Deutsche Zentrum für Luft- und Raumfahrt baut im Rahmen des Projektes Next Generation Train einen ersten Prototyp des für den Hochgeschwindigkeitsverkehr entwickelten, mechatronischen Einzelradfahrwerkes. Bis Ende 2022 wird das Fahrwerk mit einem Integrationsprüfstand in Betrieb genommen und anschließend auf Rollprüfständen und in Versuchsfahrzeugen weiter getestet

Über Verletzungen der Ligamenta cruciata des Kniegelenks

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