Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general care

Abstract Background In rural regions with a low population density, distances to health care providers as well as insufficient public transport may be barriers for the accessibility of health care. In this analysis it was examined whether the accessibility of gynecologists and GPs, measured as travel time both by car and public transport has an influence on the utilization of health care in the rural region of Western Pomerania in Northern Germany. Methods Utilization data was obtained from the population based Study of Health in Pomerania (SHIP). Utilization was operationalized by the parameter “at least one physician visit during the last 12 months”. To determine travel times by car and by public transport, network analyses were conducted in a Geographic Information System (GIS). Multivariate logistic regression models were calculated to identify determinants for the utilization of gynecologists and GPs. Results There is no significant association between the accessibility by car or public transport and the utilization of gynecologists and GPs. Significant predictors for the utilization of gynecologists in the regression model including public transport are age (OR 0.960, 95% CI 0.950–0.971, p < 0.0001), social class (OR 1.137, 95% CI 1.084–1.193, p < 0.0001) and having persons ≥18 years in the household (OR 2.315, 95% CI 1.116–4.800, p = 0.0241). Conclusions In the examined region less utilization of gynecologists is not explainable with long travel times by car or public transport

Toolbox for Research, or how to facilitate a central data management in small-scale research projects

Abstract Background In most research projects budget, staff and IT infrastructures are limiting resources. Especially for small-scale registries and cohort studies professional IT support and commercial electronic data capture systems are too expensive. Consequently, these projects use simple local approaches (e.g. Excel) for data capture instead of a central data management including web-based data capture and proper research databases. This leads to manual processes to merge, analyze and, if possible, pseudonymize research data of different study sites. Results To support multi-site data capture, storage and analyses in small-scall research projects, corresponding requirements were analyzed within the MOSAIC project. Based on the identified requirements, the Toolbox for Research was developed as a flexible software solution for various research scenarios. Additionally, the Toolbox facilitates data integration of research data as well as metadata by performing necessary procedures automatically. Also, Toolbox modules allow the integration of device data. Moreover, separation of personally identifiable information and medical data by using only pseudonyms for storing medical data ensures the compliance to data protection regulations. This pseudonymized data can then be exported in SPSS format in order to enable scientists to prepare reports and analyses. Conclusions The Toolbox for Research was successfully piloted in the German Burn Registry in 2016 facilitating the documentation of 4350 burn cases at 54 study sites. The Toolbox for Research can be downloaded free of charge from the project website and automatically installed due to the use of Docker technology

Constraining interactions mediated by axion-like particles with ultracold neutrons

We report a new limit on a possible short range spin-dependent interaction from the precise measurement of the ratio of Larmor precession frequencies of stored ultracold neutrons and 199Hgatoms confined in the same volume. The measurement was performed in a ∼1 μT vertical magnetic holding field with the apparatus searching for a permanent electric dipole moment of the neutron at the Paul Scherrer Institute. A possible coupling between freely precessing polarized neutron spins and unpolarized nucleons of the wall material can be investigated by searching for a tiny change of the precession frequencies of neutron and mercury spins. Such a frequency change can be interpreted as a consequence of a short range spin-dependent interaction that could possibly be mediated by axions or axion-like particles. The interaction strength is proportional to the CP violating product of scalar and pseudoscalar coupling constants gS x gP. Our result confirms limits from complementary experiments with spin-polarized nuclei in a model-independent way. Limits from other neutron experiments are improved by up to two orders of magnitude in the interaction range of 10−6 < λ < 10−4 m.publisher: Elsevier articletitle: Constraining interactions mediated by axion-like particles with ultracold neutrons journaltitle: Physics Letters B articlelink: http://dx.doi.org/10.1016/j.physletb.2015.04.024 content_type: article copyright: Copyright © 2015 The Authors. Published by Elsevier B.V.status: publishe

The Energy Spectrum of Atmospheric Neutrinos between 2 and 200 TeV with the AMANDA-II Detector

The muon and anti-muon neutrino energy spectrum is determined from 2000-2003 AMANDA telescope data using regularised unfolding. This is the first measurement of atmospheric neutrinos in the energy range 2 - 200 TeV. The result is compared to different atmospheric neutrino models and it is compatible with the atmospheric neutrinos from pion and kaon decays. No significant contribution from charm hadron decays or extraterrestrial neutrinos is detected. The capabilities to improve the measurement of the neutrino spectrum with the successor experiment IceCube are discussed.Comment: submitted to Astroparticle Physic