Generischer Architekturansatz für Telemedizin Portale und verteilte Krankenakten

Dieser Aufsatz beschäftigt sich mit Softwarearchitekturen und Kriterien für deren längerfristige Verwendbarkeit als Basisansatz für die Entwicklung von verteilten Krankenakten und Telemedizin-Portalen. Im Vorfeld der Entwicklung eines verteilten Krankenaktensystems mit Portalfrontend am Klinikum der Universität Regensburg werden hierfür verschiedene Architekturansätze untersucht. Dabei soll ein Architekturprinzip gefunden werden, das unabhängig von Technologien und Standards die Entwicklung flexibler und gut integrierbarer verteilter Krankenaktensysteme ermöglicht. Nichtfunktionale Anforderungen der gesuchten Lösung sind Veränderbarkeit, Anpassbarkeit, Zuverlässigkeit, Erweiterbarkeit und Fehlerrobustheit. Das hier vorgestellte Konzept wurde während der Vorstudien zum Aufbau des Portalsystems entwickelt; bisherige Erfahrungen aus dem Betrieb des Portals stützen die dort getroffenen Annahmen. Als zentraler Anwendungsfall für die beiden genannten Systemtypen wird die gemeinsame Nutzung medizinischer Dokumente innerhalb einer stark heterogenen Systemlandschaft vorausgesetzt

Awareness and use of home remedies in Italy's alps: a population-based cross-sectional telephone survey

Belief in complementary and alternative medicine practices is related to reduced preparedness for vaccination. This study aimed to assess home remedy awareness and use in South Tyrol, where vaccination rates in the coronavirus pandemic were lowest in Italy and differed between German- and Italian-speaking inhabitants.; A population-based survey was conducted in 2014 and analyzed using descriptive statistics, multiple logistic regression, and latent class analysis.; Of the representative sample of 504 survey respondents, 357 (70.8%) participants (43.0% male; primary language German, 76.5%) reported to use home remedies. Most commonly reported home remedies were teas (48.2%), plants (21.0%), and compresses (19.5%). Participants from rural regions were less likely (odds ratio 0.35, 95% confidence interval 0.19-0.67), while female (2.62, 1.69-4.10) and German-speaking participants (5.52, 2.91-9.88) were more likely to use home remedies. Latent classes of home remedies were "alcoholic home remedies" (21.4%) and "non-alcohol-containing home remedies" (78.6%). Compared to the "non-alcohol-containing home remedies" class, members of the "alcoholic home remedies" class were more likely to live in an urban region, to be male and German speakers.; In addition to residence and sex, language group membership associates with awareness and use of home remedies. Home remedies likely contribute to socio-cultural differences between the language groups in the Italian Alps. If the observed associations explain the lower vaccination rates in South Tyrol among German speakers requires further study

Using surveys to calculate disability-adjusted life-year

Mapping a certain disease into a system of disabling attributes allows researchers to compare diseases within a common framework. To quantify the total burden of morbidity (e.g., morbidity attributable to alcohol use), so-called disability weights (DWs) must be generated. General-population surveys can be used to derive DWs from health valuation tasks. This article describes the application of three psychometric methods (i.e., pairwise comparisons, ranking tasks, and visual analog scales) in general-population surveys and outlines their strengths and weaknesses. A recently proposed health valuation framework also is presented, which highlights the underlying cognitive processes from a social-judgment perspective and presents a structured data-collection procedure that seems promising in deriving DWs from general-population surveys

Sustainable use of renewable resources in a stylized social–ecological network model under heterogeneous resource distribution

Human societies depend on the resources ecosystems provide. Particularly since the last century, human activities have transformed the relationship between nature and society at a global scale. We study this coevolutionary relationship by utilizing a stylized model of private resource use and social learning on an adaptive network. The latter process is based on two social key dynamics beyond economic paradigms: boundedly rational imitation of resource use strategies and homophily in the formation of social network ties. The private and logistically growing resources are harvested with either a sustainable (small) or non-sustainable (large) effort. We show that these social processes can have a profound influence on the environmental state, such as determining whether the private renewable resources collapse from overuse or not. Additionally, we demonstrate that heterogeneously distributed regional resource capacities shift the critical social parameters where this resource extraction system collapses. We make these points to argue that, in more advanced coevolutionary models of the planetary social–ecological system, such socio-cultural phenomena as well as regional resource heterogeneities should receive attention in addition to the processes represented in established Earth system and integrated assessment model

General linear models for the analysis of single subject data and for the comparison of individuals

In longitudinal person-oriented and idiographic research, individual-specific parameter estimation is strongly preferred over estimation that is based on aggregated raw data. In this article, we ask whether methods of the General Linear Model, that is, repeated measures ANOVA and regression, can be used to estimate individual-specific parameters. Scenarios and corresponding design matrices are presented in which the shape of temporal trajectories of individuals is parameterized. Real world data examples and simulation results suggest that, for series of sufficient length, trajectories can be well described for individuals. In addition, scenarios are presented for the comparison of two individuals. Here again, trajectories can be well described and the statistical comparison of individuals is possible. However, in contrast to the power for the description of individual series, which is satisfactory, the power for the comparison of individuals is low (except when effect sizes are large). In all simulated scenarios, the power of tests increases only up to a certain number of observation points, and reaches a ceiling at this number. The fact that all parameters cannot always be estimated is also discussed, and options are presented that go beyond what standard general purpose software packages offer

Direction of effects in categorical variables: Looking inside the table

In the variable-oriented domain, direction of dependence analysis of metric variables is defined in terms of changes that the independent (or causal) variable has on the univariate distribution of the dependent variable. In this article, we take a person-oriented perspective and extend this approach in two aspects, for categorical variables. First, instead of looking at univariate frequency distributions, direction dependence is defined in terms of special interactions. That is, direction dependence is defined as a process that can be detected “inside the table” instead of in its marginals. Second, the present approach takes an event-based perspective. That is, direction of effect is defined for individual categories of variables instead of the entire range of possible scores (or categories). Log-linear models are presented that allow researchers to test the corresponding hypotheses. Simulation studies illustrate characteristics and performance of these models. An empirical ex-ample investigates whether there is truth to the adage that money does not buy happiness. Extensions and limitations are discussed

Strengthening arguments based on scale levels?

No abstract available

A Configural Perspective of Interindividual Differences in Intraindividual Change

Lag analysis can be used to inspect stability and change of behavior over a pre-determined time interval, the lag. In the analysis of metric variables, lag analysis is well known and used to identify such temporal effects as seasonal trends. In the analysis of categorical variables, the same can be done. Either approach can be employed in the analysis of both aggregated and individual data. In the domain of studying individual cells of contingency tables, that is, in configural analysis, only two sources exist in which lag analysis is discussed (von Eye, Mair, & Mun, 2010; von Eye & Mun, 2012). In this paper, we place the method of configural lag analysis in a person-oriented context and propose new variants for the comparison of individuals. Three approaches are considered. The first involves searching for configural types and antitypes separately for the comparison individuals. The second approach can be viewed parallel to two- or multiple group Configural Frequency Analysis. Both approaches are presented within a log-linear framework. Configural base models are specified for the original configural lag method as well as the extended comparative methods, and questions are defined that can be answered using configural lag analysis. The third approach allows researchers to test hypotheses concerning groups of cells. In an empirical example, data are analyzed from a study on the development of drinking behavior in alcoholics. Further extensions and alternative methods of analysis are discussed

Directional Dependence in the Analysis of Single Subjects

Many statistical methods applied in person-oriented research make use of theoretical principles originally derived in a variable-oriented context. From this perspective, it naturally follows that advances originated in variable-oriented methodology may potentially contribute to the development of methods suitable for person-oriented perspectives. Direction Dependence Analysis (DDA) constitutes one of these recent advances and provides a framework to statistically evaluate asymmetric properties of observed variable relations. These asymmetric properties enable researchers to make statements whether a model of the form x ! y or a model assuming y ! x is more likely to approximate the underlying data-generating process in non-experimental settings. The present article introduces DDA to the context of person-oriented research and extends the DDA principle to (linear) vector autoregressive models (VAR) which can be used to describe individual development. We show that DDA can be used to empirically evaluate directional theories of (potentially multivariate) intraindividual development (e.g., which of two longitudinally observed variables is more likely to be the explanatory variable and which one is more likely to reflect the outcome). An illustrative example is provided from a study on the development of experienced mood and alcohol consumption behavior. It is demonstrated that VAR-DDA resolves the issue of identifying the direction of contemporaneous effects in longitudinal data. Temporality issues of directional theories used to explain intraindividual development, guidelines to achieve acceptable power, methodological requirements, and potential further extensions of DDA for person-oriented research are discussed

Local Associations in Latent Class Analysis: Using Configural Frequency Analysis for Model Evaluation

It is proposed to enrich the arsenal of methods for the evaluation of local independence within latent classes by methods from Configural Frequency Analysis (CFA). CFA provides researchers with two additional options. The first involves identifying those patterns of categories of manifest variables that contradict the assumption of local independence within a given class. If such patterns exist, local independence is viewed as violated not (only) at the level of relations among variables, but at the level of individual patterns that occur at rates significantly different than expected under the assumption of variable inde-pendence. The second option involves comparing classes at the level of individual patterns. The results of such a comparison of classes can be that outlying patterns are identified as class-specific. Second, it is possible that classes differ in the occur-rence rates of individual patterns (i.e., specific response patterns may be more likely to occur in certain classes). This can occur even when these patterns do not contradict the assumption of local independence. An empirical example is given using data on alcohol consumption behavior among college students. Extensions and applications of the proposed methods are discussed