Dissertatio Inauguralis Juridica De Legibus Fundamentalibus In Genere, Et Singulatim In Imperio Romano Germanico

Gießen, Univ., Jur. Diss., 1709Quam ... Placidae Excellentiss. Academiae Procerum Disquisitioni Submittit Die Jvlii. Anno MDCCIX. Conrad. Christ. Wucherer, UlmensisAutopsie nach Ex. der ULB Sachsen-AnhaltVorlageform des Erscheinungsvermerks: Gissæ-Hassorvm, Typis Joh. Reinhardi Vulpii, Acad. Typogr. Ord

Vegetation of the Pamir (Tajikistan): land use and desertification problems

Wucherer W, Breckle S-W. Vegetation of the Pamir (Tajikistan): land use and desertification problems. In: Spehn EM, Liberman M, Körner C, eds. Land use change and mountain biodiversity. Boca Raton: CRC Taylor & Francis; 2006: 225-237

Collaborative table-top VR display for neurosurgical planning

We present a prototype of a system in development for pre-operative planning. The proposed NeuroTable uses a combination of traditional rendering and novel visualization techniques rendered to facilitate real-time collaboration between neurosurgeons during intervention planning. A set of multimodal 2D and 3D renderings convey the relation between the region of interest and the surrounding anatomical structures. A haptic device is used for interaction with the NeuroTable to facilitate immersive control over the 3D cursor and navigation modes for the neurosurgeons during their discourse of planning. A pilot experimental study was conducted to assess the performance of users in targeting points within the preoperative 3D scan. Then, two clinicians participated in the evaluation of the table in discussing and planning a case. Results indicate that the NeuroTable facilitated the discourse and we discuss the results of the speed and accuracy for the specification of entry and target points

Supporting elderly people with cognitive impairment during and after hospital stays with intersectoral care management: study protocol for a randomized controlled trial

Background The sectorization of health-care systems leads to inefficient treatment, especially for elderly people with cognitive impairment. The transition from hospital care to primary care is insufficiently coordinated, and communication between health-care providers is often lacking. Consequences include a further deterioration of health, higher rates of hospital readmissions, and institutionalization. Models of collaborative care have shown their efficacy in primary care by improving patient-related outcomes. The main goal of this trial is to compare the effectiveness of a collaborative care model with usual care for people with cognitive impairment who have been admitted to a hospital for treatment due to a somatic illness. The aim of the intervention is to improve the continuity of treatment and care across the transition between the in-hospital and adjoining primary care sectors. Methods/design The trial is a longitudinal multisite randomized controlled trial with two arms (care as usual and intersectoral care management). Inclusion criteria at the time of hospital admission due to a somatic illness are age 70+ years, cognitive impairment (Mini Mental State Examination, MMSE ?26), living at home, and written informed consent. Each participant will have a baseline assessment at the hospital and two follow-up assessments at home (3 and 12 months after discharge). The estimated sample size is n?=?398 people with cognitive inmpairement plus their respective informal caregivers (where available). In the intersectoral care management group, specialized care managers will develop, implement, and monitor individualized treatment and care based on comprehensive assessments of the unmet needs of the patients and their informal caregivers. These assessments will occur at the hospital and in participants’ homes. Primary outcomes are (1) activities of daily living, (2) readmission to the hospital, and (3) institutionalization. Secondary outcomes include (a) frailty, (b) delirium, (c) quality of life, (d) cognitive status, (e) behavioral and psychological symptoms of dementia, (f) utilization of services, and (g) informal caregiver burden. Discussion In the event of proving efficacy, this trial will deliver a proof of concept for implementation into routine care. The cost-effectiveness analyses as well as an independent process evaluation will increase the likelihood of meeting this goal. The trial will enable an in-depth analysis of mediating and moderating effects for different health outcomes at the interface between hospital care and primary care. By highlighting treatment and care, the study will provide insights into unmet needs at the time of hospital admission, and the opportunities and barriers to meeting those needs during the hospital stay and after discharge

Prenatal radiation exposure in diagnostic and interventional radiology

Background The exposure of a pregnant woman to X-rays is an event that can cause uncertainty for all concerned. This review provides guidance on how to assess such a situation and how to determine the dose to the unborn child. In general, the use of X-rays in pregnant women in radiology should be avoided. If possible, alternatives should be used, or examinations postponed to a time after the pregnancy. This review gives a summary of the procedure for determining the radiation exposure of a pregnant woman.Method Based on the previous report of 2002 and the literature on prenatal radiation exposure published thereafter, the DGMP/DRG report on the procedure for the assessment of prenatal radiation exposure was adapted to the current state of science and technology.Results Typically, only relatively low radiation exposures of less than 20 mSv occur for the unborn child in X-ray diagnostics in the vast majority of cases. At these dose level the additional risk of damage to the embryo or fetus caused by the radiation is low and therefore only a rough conservative estimate using tabulated values are made. Only in a few types of examination (CT and interventional radiology) higher doses values might occur in the uterus. Instead of dose estimates (step 1 in the two-step model) in these cases the calculation of dose (step 2) are required and further action by the physician may be necessary.Conclusions During the assessment, it is useful to initially use simple conservative estimation procedures to quickly determine whether a case falls into this large group less than 20 mSv, where there is a very low risk to the unborn child. If this is the case, the pregnant woman should be informed immediately by the doctor who performed the examination/treatment. This avoids a psychological burden on the patient. The DGMP/DRG report suggests a relatively simple, clearly structured procedure with advantages for all parties involved (physician, medical physics experts, MTRA and patient)