Beurteilung des Screening-Verfahrens der Krankenversicherer in der Schweiz zur Identifikation von Überarztung

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Konzeptionelle und empirische Fragen der Krankheitsauswahl im Kontext der Einführung des morbiditätsorientierten Risikostrukturausgleichs in der GKV

Gemäß § 31 Abs. 1 Risikostrukturausgleichs-Verordnung (RSAV) soll sich das Versichertenklassifikationsmodell für den morbiditätsorientierten RSA an 50-80 Krankheiten orientieren. Dabei sollen insbesondere Krankheiten mit schwerwiegendem Verlauf und kostenintensive chronische Krankheiten berücksichtigt werden, bei denen die Leistungsausgaben der Versicherten im Mittel 50 % über den durchschnittlichen Ausgaben in der gesetzlichen Krankenversicherung (GKV) liegen. Die Krankheiten sollen eng abgrenzbar sein. Der Alfried Krupp von Bohlen und Halbach-Stiftungslehrstuhl für Medizinmanagement (Direktor: Prof. Dr. Jürgen Wasem) hat in Kooperation mit der CAREM GmbH ein Forschungsvorhaben durchgeführt, mit dem eine Liste von 50-80 Krankheiten für den morbiditätsorientierten Risikostrukturausgleich in der GKV entwickelt wurde. Für das Forschungsprojekt stand eine repräsentativer Individualdatensatz von rd. 3,2 Mio. Versicherten bei einer überregional tätigen Krankenkasse zur Verfügung. Die Begriffe der chronischen und schwerwiegenden Erkrankung wurden mittels systematischer Literaturrecherchen, der Definition in anderen Bereichen der GKV sowie einem Expertenworkshop operationalisiert. Es gibt keine einheitlichen Definitionen. Insgesamt erscheint es sachgerecht, chronischen Erkrankungen die folgenden Merkmale zuzuschreiben: ... --

Locus coeruleus imaging as a biomarker for noradrenergic dysfunction in neurodegenerative diseases.

Pathological alterations to the locus coeruleus, the major source of noradrenaline in the brain, are histologically evident in early stages of neurodegenerative diseases. Novel MRI approaches now provide an opportunity to quantify structural features of the locus coeruleus in vivo during disease progression. In combination with neuropathological biomarkers, in vivo locus coeruleus imaging could help to understand the contribution of locus coeruleus neurodegeneration to clinical and pathological manifestations in Alzheimer's disease, atypical neurodegenerative dementias and Parkinson's disease. Moreover, as the functional sensitivity of the noradrenergic system is likely to change with disease progression, in vivo measures of locus coeruleus integrity could provide new pathophysiological insights into cognitive and behavioural symptoms. Locus coeruleus imaging also holds the promise to stratify patients into clinical trials according to noradrenergic dysfunction. In this article, we present a consensus on how non-invasive in vivo assessment of locus coeruleus integrity can be used for clinical research in neurodegenerative diseases. We outline the next steps for in vivo, post-mortem and clinical studies that can lay the groundwork to evaluate the potential of locus coeruleus imaging as a biomarker for neurodegenerative diseases.Includes MRC, NIHR, Wellcome Trust, H2020 and FP7

Проект узла гидрирования сернистых соединений

Конструирование аппарата для гидрирования сернистых соединений содержащихся в природном газе, а также исследование методов очистки природного газа.Designing an apparatus for hydrogenating sulfur compounds in natural gas, and studying methods for purifying natural gas

Covid-19 triage in the emergency department 2.0: how analytics and AI transform a human-made algorithm for the prediction of clinical pathways

The Covid-19 pandemic has pushed many hospitals to their capacity limits. Therefore, a triage of patients has been discussed controversially primarily through an ethical perspective. The term triage contains many aspects such as urgency of treatment, severity of the disease and pre-existing conditions, access to critical care, or the classification of patients regarding subsequent clinical pathways starting from the emergency department. The determination of the pathways is important not only for patient care, but also for capacity planning in hospitals. We examine the performance of a human-made triage algorithm for clinical pathways which is considered a guideline for emergency departments in Germany based on a large multicenter dataset with over 4,000 European Covid-19 patients from the LEOSS registry. We find an accuracy of 28 percent and approximately 15 percent sensitivity for the ward class. The results serve as a benchmark for our extensions including an additional category of palliative care as a new label, analytics, AI, XAI, and interactive techniques. We find significant potential of analytics and AI in Covid-19 triage regarding accuracy, sensitivity, and other performance metrics whilst our interactive human-AI algorithm shows superior performance with approximately 73 percent accuracy and up to 76 percent sensitivity. The results are independent of the data preparation process regarding the imputation of missing values or grouping of comorbidities. In addition, we find that the consideration of an additional label palliative care does not improve the results

Bundesweite Zahnärztestudie zu Grundmotiven und Zukunftsvisionen niederlassungsberechtigter Zahnärzte in Deutschland

Einführung: Ziel der vorliegenden Studie ist es, die Grundmotive hinsichtlich der Wahl der Gründungsform für eine Praxis zu erfragen, mögliche Barrieren für den Zusammenschluss von Praxisgemeinschaften herauszuarbeiten und die Bedeutung der Markenbildung für Zahnarztpraxen zu analysieren. Methode: Die Methodik der Studie basierte auf einer Primärdatenerhebung im Jahre 2012. Es wurden bundesweit 4.138 niederlassungsberechtigte Zahnärzte angeschrieben. Die Rücklaufquote betrug 11.6 %. Die Primärdaten wurden sowohl deskriptiv ausgewertet (z. B. relative und absolute Häufigkeiten, Mittelwerte und Streuungsmaße) als auch im Rahmen von bivariaten und multivariaten Modellen analysiert. Ergebnisse: Die multivariaten Modelle zeigen teilweise signifikante Zusammenhänge zwischen den Einstellungen des Zahnarztes zu Chancen und Risiken von Praxisgemeinschaften, der persönlichen Haltung gegenüber Praxisverbünden und der präferierten Geschäftsmodelle und den Merkmalen des Zahnarztes. Schlussfolgerung: Die vorliegende Studie hat gezeigt, dass die Praxisgemeinschaft durchaus eine Alternative zur Einzelpraxis darstellt. Viele Zahnärzte haben diesbezüglich jedoch noch keine gefestigte Meinung.   Nationwide Dental Study on Basic Motives and Visions of the Ranch Entitled Dentists in Germany Introduction: The aim of this study is to obtain the basic motives in regard to the choice of establishing different legal forms of practices and to potential barriers for mergers of joint practices as well as analysing the significance of branding for dental practices. Methods: The methodology of the study is based on a primary data collection in 2012. It surveyed 4,138 nationwide branch entitled dentists. The response rate was 11.6 %. The primary data were both analysed descriptively (e. g. relative and absolute frequencies, means, and measures of variability) and in the context of bivariate and multivariate models. Results: The multivariate models show some significant correlations between attitudes of the dentists to opportunities and risks of joint practices, personal attitudes towards joint surgeries and the preferred business models and the characteristics of the dentist. Discussion: The present study has shown that joint practices may constitute an alternative to the single practice. However, in this respect, many dentists still have no settled opinion. JEL-Klassifizierung:

Caught between cultures: unintended consequences of improving opportunity for immigrant girls

What happens when immigrant girls are given increased opportunities to integrate into the workplace and society, but their parents value more traditional cultural outcomes? We answer this question in the context of a reform which granted automatic birthright citizenship to eligible immigrant children born in Germany after 1 January 2000. Using survey data, we collected from students in 57 schools and comparing those born in the months before vs. after the reform, we find the introduction of birthright citizenship lowers measures of life satisfaction and self-esteem for immigrant girls by 0.32 and 0.25 standard deviations, respectively. This is especially true for Muslims, where parents are likely to prefer more traditional cultural outcomes than their daughters. Moreover, we find that Muslim girls granted birthright citizenship are less integrated into German society: they are both more socially isolated and less likely to self-identify as German. Exploring mechanisms for these unintended drops in well-being and assimilation, we find that immigrant Muslim parents invest less in their daughters’ schooling and that these daughters receive worse grades in school if they are born after the reform. Parents are also less likely to speak German with these daughters. Consistent with a rise in intra-family conflict, birthright citizenship results in disillusionment where immigrant Muslim girls believe their chances of achieving their educational goals are lower and the perceived odds of having to forgo a career for a family rise. In contrast, immigrant boys experience, if anything, an improvement in well-being, integration, and schooling outcomes. Taken together, the findings point towards immigrant girls being pushed by parents to conform to a role within traditional culture, whereas boys are allowed to take advantage of the opportunities that come with citizenship. To explain these findings, we construct a simple game-theoretic model which builds on Akerlof and Kranton (2000), where identity-concerned parents constrain their daughter’s choices, and hence lower their daughter’s well-being, when faced with the threat of integration. Alternative models can explain some of the findings in isolation