Versorgungsepidemiologische Analysen kardiovaskulärer Erkrankungen auf Basis von Routinedaten der gesetzlichen Krankenkassen

Routine data of statutory health insurance providers (SHI) are increasingly used in health services research. The size, the longitudinal character of the data, the largely unselected populations as well as the possibility to evaluate routine care render SHI routine data an attractive data source for health services research. Since the data is generated for reimbursement processes, SHI routine data is limited with regard to the range and depth of information. Furthermore, the validity of the data for research purposes often is unclear. The aim of this thesis is to discuss the methodological challenges regarding the use of SHI routine data in health services research arising from the limitations inherent in the data and to further outline approaches to overcome these limitations. One of the biggest challenges regarding the use of SHI routine data in health services research is the fact that information on disease severity which may represent a confounder in analytical health services research is largely lacking. In this context, advantages and disadvantages of different propensity score methods regarding their potential for confounder control are discussed in the thesis. A further challenge is related to the fact that studies are often based on data from a single or few SHIs. Since insurants covered by the various SHIs differ with regard to sociodemographic characteristics which, in turn, can be related to the morbidity risk or the probability of receiving certain health services, the external validity of study results might be limited. Concerning this matter, weighting approaches to account for these differences are discussed. To evaluate the validity of SHI routine data with an external gold standard or to enrich SHI routine data with external data due to the limited range of information, a patient-individual record linkage with another data source is required. However, such a record linkage often cannot be realized, since processing person-identifying information requires meeting very high standards of data protection. In this thesis, methods allowing a record linkage of SHI routine data with another data source based on person-identifying information are discussed. Finally, there is an outlook regarding the availability of SHI routine data for research purposes

Short Term Rentals and Housing Prices in Large US Cities

In the past decade, platforms like Airbnb and VRBO have popularized Short-Term Rentals (STRs), and many cities have taken action to regulate this emerging market. But how do these restrictions regarding STRs affect housing prices in these cities? I answer this question using Housing Price Index (HPI) data from the Federal Housing Finance Agency as well as STR restriction data on 200 large cities in the United States. Using this data, I estimate the effect of STR regulations on housing prices by employing a differences-in-differences model with variable treatment timing and find that STR restrictions lead to a 6.136 percentage point increase in HPI. Additionally, I find that harsher STR restrictions lead to a 14.84 percentage point increase in HPI, while registration-only requirements do not have a statistically significant effect on HPI. However, I do have concerns with these results in regard to omitted variable bias.</p

Austeniittisen ruostumattoman teräksen 316 L soveltuvuus 3D-tulostukseen

Tiivistelmä. Lisäävä valmistus tai tavallisemmin 3D-tulostus on kasvanut yhdeksi valmistustekniikaksi perinteisten valmistusmenetelmien rinnalle. Erityisesti metallisten materiaalien tulostus on kasvattanut suosiotaan viimeisten vuosikymmenien aikana. Ajankohtaista tutkimustietoa eri menetelmistä ja materiaaleista on runsaasti saatavilla, johtuen valmistustavan uutuudesta. Työn tarkoituksena on tutustua metallien 3D-tulostamiseen käytettävien menetelmien toimintaan sekä tulostusmateriaaleihin. Tärkeimpänä tutkimuskohteena on austeniittisen ruostumattoman teräksen 316 L soveltuvuus metallia lisäävien menetelmien tulostusmateriaalina. Tutkielma on jaettu selkeyden vuoksi osioihin. Ensimmäiset osiot käsittelevät 3D-tulostamisen kehityskaarta sekä valmistustavan tulevaisuutta. Seuraavat osiot esittelevät 3D-tulostamisen periaatteet ja käytetyimmät metallia lisäävät valmistusmenetelmät. Lopuksi tarkastellaan tutkittavaa materiaalia ja sen tarjoamia mahdollisuuksia samalla muihin materiaaleihin verraten.Austenitic stainless steel 316 L:s suitability for 3D-printing. Abstract. Additive manufacturing or more commonly 3D-printing has grown into a manufacturing technique alongside the traditional manufacturing methods. Especially printing of metallic materials has rapidly grown its popularity over the last decades. Topical research data of different kinds of methods and materials is widely available due to the novelty of the manufacturing process. The purpose of this thesis is to introduce the working principles of various metal 3D-printing methods and printing materials. As the main subject of this thesis is to investigate how suitable austenitic stainless steel 316 L as a printing material is for metal additive manufacturing. This thesis has been split into sections for the sake of clarity. The first sections discuss the development of 3D-printing and the future of this manufacturing process. The following sections introduce the main principles of 3D-printing and the most used methods of metal additive manufacturing. At the end of this work, we look at the material of interest and showcase the possibilities it has to offer while comparing it to other used materials

Psychiatric patients turnaround times in the emergency department

BACKGROUND: To analyze the turnaround times of psychiatric patients within the Emergency Department (ED) from registration to discharge or hospitalization in a University Hospital in 2002. METHODS: Data from a one-year period of psychiatric admissions to the emergency service at a University Hospital were monitored and analyzed focused on turnaround times within the ED. Information on patients variables such as age, sex, diagnosis, consultations and diagnostic procedures were extracted from the patients' charts. RESULTS: From 34.058 patients seen in the ED in 2002, 2632 patients were examined by psychiatrists on duty. Mean turnaround time in the ED was 123 (SD 97) minutes (median 95). Patients to be hospitalized on a psychiatric ward stayed shorter within the ED, patients who later were admitted to another faculty, were treated longer in the ED. Patients with cognitive or substance related disorders stayed longer in the ED than patients with other psychiatric diagnoses. The number of diagnostic procedures and consultations increased the treatment time significantly. CONCLUSION: As the number of patients within the examined ED increases every year, the relevant variables responsible for longer or complicated treatments were assessed in order to appropriately change routine procedures without loss of medical standards. Using this basic data, comparisons with the following years and other hospitals will help to define where the benchmark of turnaround times for psychiatric emergency services might be

Passgenau?

PASSGENAU? Passgenau? / Schulte-Basta, Dorothee (CC BY-NC-ND) ( -

Heat shock protein 90 is downregulated in calcific aortic disease

Peer reviewe

Word Recognition Memory in Adults with Attention-Deficit/Hyperactivity Disorder as Reflected by Event-Related Potentials

Objective: Attention-deficit/hyperactivity disorder (ADHD) is increasingly diagnosed in adults. In this study we address the question whether there are impairments in recognition memory. Methods: In the present study 13 adults diagnosed with ADHD according to DSM-IV and 13 healthy controls were examined with respect to event-related potentials (ERPs) in a visual continuous word recognition paradigm to gain information about recognition memory effects in these patients. Results: The amplitude of one attention-related ERP component, the N1, was significantly increased for the ADHD adults compared with the healthy controls in the occipital electrodes. The ERPs for the second presentation were significantly more positive than the ERPs for the first presentation. This effect did not significantly differ between groups. Conclusion: Neuronal activity related to an early attentional mechanism appears to be enhanced in ADHD patients. Concerning the early or the late part of the old/new effect ADHD patients show no difference which suggests that there are no differences with respect to recollection and familiarity-based recognition processes

Neuronal correlates of ADHD in adults with evidence for compensation strategies – a functional MRI study with a Go/No-Go paradigm

Objective: Response inhibition impairment is one of the most characteristic symptoms of attention-deficit/hyperactivity disorder (ADHD). Thus functional magnetic resonance imaging (fMRI) during a Go/No-Go task seems to be an ideal tool for examining neuronal correlates of inhibitory control deficits in ADHD. Prior studies have shown frontostriatal abnormalities in children and adolescents. The aim of our study was to investigate whether adults with ADHD would still show abnormal brain activation in prefrontal brain regions during motor response inhibition tasks

Sputum Vitamin D Binding Protein (VDBP) GC1S/1S Genotype Predicts Airway Obstruction : A Prospective Study in Smokers with COPD

Introduction: The vitamin D binding protein (VDBP, also known as GC-globulin) and vitamin D deficiency have been associated with chronic obstructive pulmonary disease (COPD). rs7041 and rs4588 are two single nucleotide polymorphisms of the VDBP gene, including three common allelic variants (GC1S, GC1F and GC2). Previous studies primarily assessed the serum levels of vitamin D and VDBP in COPD. However, less is known regarding the impact of the local release of VDBP on COPD lung function. Thus, we examined the association of sputum and plasma VDBP with lung function at baseline and at four years, and examined potential genetic polymorphism interactions. Methods: The baseline levels of sputum VDBP, plasma VDBP and plasma 25-OH vitamin D, as well as the GC rs4588 and rs7041 genotypes, were assessed in a 4-year Finnish follow-up cohort (n = 233) of non-smokers, and smokers with and without COPD. The associations between the VDBP levels and the longitudinal decline of lung function were further analysed. Results: High frequencies of the haplotypes in rs7041/rs4588 were homozygous GC1S/1S (42.5%). Higher sputum VDBP levels in stage I and stage II COPD were observed only in carriers with GC1S/1S genotype when compared with non-smokers (p = 0.034 and p = 0.002, respectively). Genotype multivariate regression analysis indicated that the baseline sputum VDBP and FEV1/FVC ratio at baseline independently predicted FEV1% at follow-up. Discussion and Conclusion: The baseline sputum VDBP expression was elevated in smokers with COPD among individuals with the GC1S/1S genotype, and predicted follow-up airway obstruction. Our results suggest that the GC polymorphism should be considered when exploring the potential of VDBP as a biomarker for COPD.Peer reviewe

BEYOND CHILDHOOD: PSYCHIATRIC COMORBIDITIES AND SOCIAL BACKGROUND OF ADULTS WITH ASPERGER SYNDROME

Background: Over the past few years, our knowledge about Asperger syndrome (AS) has increased enormously. Although it used to be a syndrome mainly encountered in childhood and adolescent psychiatry, it is now increasingly recognized in adult psychiatry. Nevertheless, little is known about psychiatric comorbidities and life course of adults with AS. The current study aimed to gain an insight into comorbidities and the development of the social situation of adults with AS. Subjects and methods: We investigated psychiatric comorbidities, psychiatric history, professional background, partnerships, and children in 50 adults with AS (34 men and 16 women) over a broad age range (20–62 years). Results: Seventy percent of adults with AS had at least one psychiatric comorbiditiy. Most frequent comorbidities were depression and anxiety disorders. Obsessive–compulsive disorder and alcohol abuse/dependence were also observed. Many adults had previously been treated with psychopharmacological or psychotherapeutic interventions. Although most adults had a high-level school leaving certificate and had gone on to complete training/university studies, less than half were currently in employment. Fourteen adults were living in a partnership and 10 had children. Conclusions: Adults with AS often have psychiatric comorbidities, indicating lower levels of mental health. Additionally, they seem to have severe limitations concerning professional success, despite having a good school education. Their family situation is also impaired with regard to starting a family. These considerable limitations in the life of adults with AS may help to understand their specific problems, and emphasize the importance of developing specific treatments for improving their mental health and social integration